Vermont becomes first state to permit drug imports from Canada

Vermont Republican Gov. Phil Scott Wednesday signed legislation making his state the first to legalize importing prescription drugs from Canada, an idea President Donald Trump’s top health officials oppose that’s also drawn fierce opposition from the pharmaceutical industry.

A spokeswoman for Scott said he signed the bill Wednesday morning. The measure had overwhelming support in the Democratic-controlled legislature and is one of the most aggressive attempts by a state to tackle rising drug prices that critics say are crippling state finances.

Its enactment also puts the Trump administration in a bind after the rollout of a highly anticipated plan for tackling rising drug costs. HHS still has to certify Vermont’s program.

“Trump is trumpeting his desire to do something about high-cost drugs,” said Democratic state Sen. Claire Ayer, one of the bill sponsors. “I’m hoping that they’ll see it as an opportunity for him to say that he’s done something Continue reading “Vermont becomes first state to permit drug imports from Canada”

Trump challenge to Native Americans’ health splits HHS, alarms Hill GOP

HHS leaders want states to settle the contentious question of whether Native Americans should get jobs in order to keep their health care — a move that likely won’t resolve the underlying challenge to tribal sovereignty and was sparked by an unusual split between the agency’s politically appointed administrators and legal counsel.

The agency’s position that tribes are a racial group and not separate governments — a determination by Trump administration lawyers that POLITICO first detailed last month — has raised concerns in Congress and alarmed the tribes, who say it reverses centuries of protections enshrined in the Constitution and upheld by the Supreme Court.

HHS Secretary Alex Azar, the agency’s former general counsel, told tribal leaders at a meeting Thursday that state Medicaid administrators will be able to work with tribal governments on designing any employment requirements.

“This vision is best implemented locally, where governments know the needs of Continue reading “Trump challenge to Native Americans’ health splits HHS, alarms Hill GOP”

Red states find Trump an unpredictable ally on Medicaid

Conservatives state lawmakers aren’t getting everything they want from the Trump administration as they try to overhaul Medicaid.

Federal officials on Monday denied Kansas’ request to implement the first-ever lifetime limits on Medicaid coverage, delivering a reality check with larger implications for how far the GOP can go trimming the health program for the poor.

It marked the first time the Trump administration has categorically denied Medicaid cuts pushed by a red state. The decision — delivered in a brief letter from the Centers for Medicare and Medicaid Services without elaboration — dismayed some conservatives and frustrated state lawmakers, who say it’s virtually impossible to know what will get approved without an onerous back-and-forth with federal officials.

“They won’t tell us what they will or won’t approve until we apply. We’re throwing spaghetti on the wall and seeing what sticks,” said Utah state Sen. Daniel Hemmert, whose state has asked Continue reading “Red states find Trump an unpredictable ally on Medicaid”

Iowa governor signs most restrictive abortion ban in country

Iowa Republican Gov. Kim Reynolds on Friday signed into law the most restrictive abortion legislation in the country, prohibiting the procedure once a fetal heartbeat is detected, often at six weeks.

The new law is almost certain to prompt court challenges. Abortion opponents emboldened by the prospect of President Donald Trump further shaping the ideological direction of the Supreme Court are wagering the Iowa ban or similar measures could provide a test case for overturning Roe v. Wade, the landmark 1973 Supreme Court decision that legalized abortion.

Reynolds, who is running for reelection and has referred to abortion in the past as murder, signed the law just days after it was approved by Iowa’s GOP-dominated state Legislature. Iowa had already banned most abortions after 20 weeks. Eighteen states ban abortion at that point, but efforts to set earlier restrictions haven’t survived legal challenges.

“I understand and anticipate that this will Continue reading “Iowa governor signs most restrictive abortion ban in country”

Tom Price walks back remarks on mandate repeal

Former Health and Human Services Secretary Tom Price Wednesday walked back comments about how Republican efforts to undo Obamacare’s individual mandate would increase costs for people who remain insured, saying that his remarks were reported out of context.

“Repealing the individual mandate was exactly the right thing to do. Forcing Americans to buy something they don’t want undermines individual liberty as well as free markets,” Price said in a statement. “The only fair and effective way to bring down healthcare costs is to allow markets to create more choices for consumers and small businesses.”

Price told the World Health Care Congress on Tuesday that repealing the Obamacare mandate as part of the GOP’s tax overhaul will harm insurance markets because younger and healthier people would be likelier to not buy coverage, raising prices for others who do.

Obamacare supporters immediately pounced on the remarks, which marked a significant break Continue reading “Tom Price walks back remarks on mandate repeal”

Maine governor sued for defying Medicaid expansion ballot measure

Obamacare supporters are suing Maine Gov. Paul LePage’s administration to force him to expand Medicaid, accusing the Republican of ignoring a ballot initiative that ordered the state to join the coverage program.

LePage has refused to expand Medicaid nearly six months after 59 percent of the state’s voters approved it in a first-of-its-kind ballot measure. He has insisted he won’t adopt Medicaid expansion unless state lawmakers meet his conditions for funding the program.

“With the goal of getting health care to people as soon as possible, we decided we couldn’t wait any longer,” said Robyn Merrill of Maine Equal Justice Partners, one of the advocacy groups behind the lawsuit.

The lawsuit against LePage‘s administration was expected after the Maine Legislature’s recent session ended without a funding agreement. A LePage spokesperson didn’t immediately respond to a request for comment.

LePage, now in his last year in office, previously vetoed Medicaid expansion Continue reading “Maine governor sued for defying Medicaid expansion ballot measure”

Trump officials tell Idaho it can’t dump Obamacare

The Trump administration today threw cold water on Idaho’s plan to ignore key Obamacare requirements, telling the red state that it must follow the health care law.

Idaho was moving to let insurers offer plans that don’t meet the Affordable Care Act’s robust coverage rules — including protections for pre-existing conditions and mandated benefits — in a bid to expand the availability of cheaper health plans. The Idaho plan has sparked considerable interest from other red states that have long opposed Obamacare.

But Trump administration health officials, who’ve worked to unwind Obamacare through regulation and have encouraged states to pursue alternative coverage options, said that they ultimately had to make sure the law is enforced while it’s on the books.

“CMS is committed to working with states to give them as much flexibility as permissible under the law to provide their citizens the best possible access to healthcare. However, the Continue reading “Trump officials tell Idaho it can’t dump Obamacare”

Scott Walker wants to save Obamacare in Wisconsin

Wisconsin’s Scott Walker, one of the nation’s most militantly anti-Obamacare governors, is making strengthening the health care law a key plank of his reelection platform as Republicans fret over potential losses in November.

Walker wants to prop up his Obamacare market with a $200 million program that would compensate health insurers for high-cost patients so they don’t hike premiums for everyone. He also would enshrine Obamacare protections for people with pre-existing conditions.

It’s a startling turnabout for a chief executive who has repeatedly called for repealing and replacing the health law. But it could prove smart politics in a swing state where a Democrat recently flipped a seat in a state Senate district that Donald Trump carried by 17 points — a result Walker called a “wake-up call” for state Republicans.

Walker sought to get out in front of a potential issue by blaming Washington — and, of course, Obamacare Continue reading “Scott Walker wants to save Obamacare in Wisconsin”

How one conservative state is flouting Obamacare

Idaho is going rogue on Obamacare.

The Republican-led state has a maverick plan to flout the federal health care law, letting insurers sell plans that don’t meet Obamacare coverage rules and patient protections. And the brazen move — Gov. Butch Otter is plowing ahead on his own, without seeking federal waivers or permission — poses a test for the Trump administration.

Other conservative states see Idaho’s gambit as a blueprint for shaking off Obamacare’s strict regulations. But legal experts and consumer advocates who back the Affordable Care Act say it won’t be so easy. They expect costly and time-consuming lawsuits over health insurance and state directives that directly conflict with federal law.

"It sure seems open-and-shut to me," said Jay Angoff, a former Obama administration health official and attorney who has challenged other state efforts to undercut the 2010 law.

The state’s largest insurer, Blue Cross of Idaho, announced Wednesday Continue reading “How one conservative state is flouting Obamacare”

Trump administration OKs Medicaid rollback in Kentucky

The Trump administration has approved an overhaul of Medicaid in Kentucky that for the first time will require some low-income people to work to keep their health coverage, just one day after issuing guidance making it easier for states to seek work requirements.

The administration’s approval represents a seismic philosophical shift for Medicaid, which was created more than 50 years ago to cover the poor. The Kentucky proposal developed by Republican Gov. Matt Bevin will force some poor adults to work approximately 20 hours per week to retain their benefits.

At the same time, the Trump administration greenlighted a host of other conservative policies, including new mandated payments from enrollees and coverage lockouts, which will significantly roll back coverage protections in Kentucky’s Medicaid program. Those changes will result in about 95,000 enrollees being forced off the program, Kentucky estimates.

“Kentucky is leading the nation in this reform," Bevin said at Continue reading “Trump administration OKs Medicaid rollback in Kentucky”

Trump paves the way for states to impose Medicaid work requirements

The Trump administration took a major step Thursday to let states establish the first-ever work requirements for Medicaid recipients.

The policy guidance is the most concrete development yet toward achieving goal of tying Medicaid benefits to employment — a long-time conservative goal that has never been permitted since the health care entitlement program for the poor was created 52 years ago.

CMS in its letter to state Medicaid directors outlined the criteria it would use to approve state employment proposals that would require able-bodied, working-age Medicaid enrollees to get a job or participate in a related activity like job training for at least 20 hours a week in order to keep their health coverage. CMS Administrator Seema Verma has made it clear from the moment she took office last year that the Trump administration will approve such proposals, but requests from nearly a dozen conservative states have stalled with federal Continue reading “Trump paves the way for states to impose Medicaid work requirements”

Medicaid expansion fight looms after Virginia statehouse drawing

A showdown over Obamacare’s Medicaid expansion pitting Republican lawmakers against Virginia’s newly elected governor is almost certain following the GOP victory in a drawing to decide control of the state’s House of Delegates.

The expected fight in a purple state demonstrates the law’s staying power even as a Republican president and Congress work to undo it.

Gov.-elect Ralph Northam campaigned heavily on expanding the state’s Medicaid program and has made it a top priority. But Democrats’ inability to gain a 50-50 split in the state’s lower legislative chamber on Thursday means they will need Republican defectors to back a plan, as well as figure out how to pay for its share of costs. Republicans also maintain a narrow 21-19 majority in the state Senate.

“I think there is a real possibility, because you’re talking about one or two people in each House,” University of Virginia politics expert Larry Sabato Continue reading “Medicaid expansion fight looms after Virginia statehouse drawing”

Children’s health funding hangs in the balance as Congress leaves town

Congress is likely to depart Washington this week approving just enough money for children’s health insurance through March and leaving families and governors wondering what’s next.

Only days after clearing a massive tax reform bill along party lines, Republicans are still trying to figure out how to keep the government open past Friday, with hopes of including funding for the Children’s Health Insurance Program, which covers roughly 9 million low- and middle-income kids. So far, Republican and Democratic sources say they don’t expect to be able to attach more than six months of CHIP funding, with three of those months retroactive to when Congress let funding lapse, on Sept. 30.

States would welcome the patch but warn that they still could be forced to shut down their CHIP programs or freeze enrollment in the near future without a more permanent source of dollars.

Republican and Democratic lawmakers have pledged to Continue reading “Children’s health funding hangs in the balance as Congress leaves town”

State officials panicked over children’s health program

Families are becoming increasingly panicked about children losing health insurance without new funding from Congress, state officials warned Wednesday as a new report showed nearly 2 million kids could be dropped from coverage next month.

Roughly 1.9 million children across the country could lose insurance in January if Congress fails to renew Children’s Health Insurance Program funding, according to a new report from the Georgetown University Center for Children and Families. Another 1 million could lose coverage by the end of February if the congressional stalemate drags on.

“We’re in a terrible situation right now,” Linda Nablo, the chief deputy director of the Virginia Department of Medical Assistance Services, said on a call with reporters. More than 68,000 children and 1,100 pregnant women in Virginia could lose CHIP coverage without a funding extension.

Federal funds for CHIP, which covers roughly 9 million low-income children and pregnant women, expired on Continue reading “State officials panicked over children’s health program”

How blue states might save Obamacare’s markets

The looming demise of Obamacare’s individual mandate is spurring talks in a handful of blue states about enacting their own coverage requirements, as state officials and health care advocates fear repeal will roil their insurance markets.

Republicans in Congress are poised to kill off the individual mandate in their sweeping tax overhaul, knocking out one of Obamacare’s most unpopular features — but one that health experts have said is essential to making the law’s insurance marketplaces function.

Blue state officials, who have been working to protect their insurance markets from the Trump administration’s efforts to dismantle the health law, are beginning to grapple with strategies for preserving coverage. Those officials — in California, Connecticut, New Jersey and elsewhere — aren’t ruling out a state-level requirement that residents must obtain health insurance.

But even in the most Obamacare-friendly states, trying to implement an individual mandate could be politically risky, particularly in Continue reading “How blue states might save Obamacare’s markets”

Battered by Trump, Obamacare triumphs at the polls

Obamacare made a comeback in Tuesday’s elections, its strongest show of support since President Donald Trump was elected and the GOP spent months on a futile effort to repeal it.

In the governor’s race in Virginia and a ballot initiative in Maine, the Affordable Care Act buoyed Democrats, a remarkable reversal from how Trump and congressional Republicans won elections excoriating the “failed” and “doomed” law.

A remarkable 4 out of 10 Virginians in an early exit poll said health care was their top issue in a race that saw Democrat Ralph Northam, the current lieutenant governor, handily defeat Republican Ed Gillespie to become Virginia’s next governor. And in Maine, voters in a landslide backed Obamacare Medicaid expansion, which their governor had vetoed on five separate occasions.

As Democrats now look to the 2018 midterms that will decide control of the House, Senate and key governorships across the country, they can Continue reading “Battered by Trump, Obamacare triumphs at the polls”

Maine voters approve expanding Medicaid under Obamacare

Maine voters on Tuesday delivered a strong rebuke to their governor by approving an expansion of the state’s Medicaid program under Obamacare — the first time state voters have directly authorized such an expansion.

The vote makes Maine the 32nd state to agree to expand Medicaid to thousands of low-income adults who qualify for coverage and represents a major setback for Republican Gov. Paul LePage, an ally of President Donald Trump who vetoed expansion bills on five occasions. The measure was winning 59 percent to 41 percent with roughly two-thirds of precincts reporting as of 10 p.m., according to the Associated Press, just weeks after Republicans in Congress failed in their efforts to repeal the health care law.

The ballot measure, known as Question 2, attracted progressive activists from around the country eager to revive expansion efforts in the mostly GOP-led holdout states. Liberal groups poured more than Continue reading “Maine voters approve expanding Medicaid under Obamacare”

Cummings to Gowdy: Subpoena HHS, White House over Price’s private jet use

Rep. Elijah Cummings has asked the chairman of the House Oversight Committee to subpoena the White House and Health and Human Services Department for full information about former Secretary Tom Price’s use of private and military planes, which cost taxpayers at least $1 million.

Cummings, the committee’s top Democrat, wrote in a letter today to Chairman Trey Gowdy (R-S.C.) that the administration has not sent complete details about Price’s flights on private or military aircraft, including manifests showing all passengers, flight destinations and costs. A spokesperson for Oversight Committee Republicans did not immediately respond to a request for comment.

Price, a Georgia Republican who was confirmed as HHS secretary in February, resigned at the end of September amid controversy over his use of charter aircraft for official government business, which was detailed in a POLITICO investigation. HHS said Price reimbursed the U.S. Treasury for the cost of Continue reading “Cummings to Gowdy: Subpoena HHS, White House over Price’s private jet use”

Obama goes to bat for health law on first day of sign-ups

Former President Barack Obama sought to boost his namesake health law Wednesday by appearing in a video urging people to sign up for coverage on the first day of the 2018 enrollment season.

Obama’s call comes as the Trump administration has taken numerous actions to undermine the law while doing almost nothing to publicize the start of the six-week enrollment season that wraps up on Dec. 15.

“HealthCare.gov is open for business right now,” the former president said in the video released by Get America Covered, an advocacy organization run by former Obama health officials. “You can shop for a health insurance plan that’s right for you and your family. It only takes a few minutes, and the vast majority of people qualify for financial assistance.”

Obama has made few public statements about the Affordable Care Act since leaving office, even as Republicans have repeatedly tried to undo Continue reading “Obama goes to bat for health law on first day of sign-ups”

How Trump’s White House can still undermine Obamacare

Obamacare may have survived another Republican repeal effort, but the Trump administration can still take steps to weaken it.

The administration for months has taken steps to undercut the Affordable Care Act independent from Congress. Friday’s collapse of Senate Republicans’ slimmed-down repeal bill could push President Donald Trump to escalate those efforts, possibly by taking aim at the law’s individual mandate.

“As I said from the beginning, let Obamacare implode, then deal. Watch!” Trump tweeted after the GOP’s so-called skinny repeal bill went down in flames.

Among Trump’s options is unilaterally cutting off billions of dollars in crucial subsidy payments to insurers — funding seen as necessary to keep the law’s insurance markets afloat. The administration so far has paid the subsidies, which total about $7 billion this year, on a month-to-month basis. But insurers fear Trump could make good on past threats to cut them off, possibly to Continue reading “How Trump’s White House can still undermine Obamacare”