Daily on Healthcare: GOP revives calls for new healthcare law after Texas ruling…Health insurers tumble on Wall Street

By | December 17, 2018

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With Obamacare in limbo, GOP revive calls for new healthcare law. Republicans revived their calls to replace Obamacare in the wake of a federal judge declaring the healthcare law unconstitutional, but Democrats have no plans to abandon the legal battle ahead. Obamacare remains the law of the land despite the ruling Friday night from U.S. District Judge Reed O’Connor in the Northern District of Texas, though it faces some level of uncertainty as it makes its way through the courts. President Trump called on Congress to pass a healthcare law that protects people with pre-existing conditions. “Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions,” he wrote on Twitter. “Mitch and Nancy, get it done!” Trump said, referring to Senate Majority Leader Mitch McConnell, R-Ky., and House Minority Leader Nancy Pelosi, D-Calif., who is expected to take over the speaker’s gavel next year. House Ways and Means Committee Chairman Kevin Brady, R-Texas, said that if the courts ultimately uphold the decision then both parties should “start over” on healthcare, while keeping popular protections in place including allowing children to stay on their parents’ healthcare plan until age 26. Energy and Commerce Committee Chairman Greg Walden, R-Ore., echoed the calls for new legislation. “We have a rare opportunity for truly bipartisan healthcare reform,” he said.

Opinion: Texas judge’s decision on its unconstitutionality is an assault on the rule of law.

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Health insurers tumble on Wall Street after Obamacare ruling. Top insurers began the trading day on Monday with losses on Wall Street after a federal judge ruled Friday night that Obamacare is unconstitutional. Anthem’s stock was down 2.62 percent to $ 268.37 per share in trading in New York. UnitedHealth Group was down 1.6 percent to $ 260.78, while Centene was down 7.94 percent to $ 117.40. Insurers have been performing better in the markets created under the health law after years of struggling. Revenue at Centene, for example, rose 36 percent to $ 16 billion in the third quarter. The insurer, which has significant operations in the federal insurance business, plans to expand to Pennsylvania, North Carolina, South Carolina, and Tennessee next year. At Molina Healthcare Inc., which plans to enter Utah and Wisconsin in 2019 after not offering plans in the states in 2018, net income rose to $ 197 million in the third quarter after losses a year earlier. Molina’s stock was down 12.96 percent to $ 114.65 per share on Monday.

Democrats plan to battle through the courts instead. California Attorney General Xavier Becerra has vowed to appeal the ruling, calling it “misguided,” and other Democratic-led states are expected to join him. Senate Minority Leader Chuck Schumer said he hoped the ruling would be overturned and said Democrats in the Senate would push for a vote to allow the Senate to  intervene and overturn the District Court’s decision. “Legislation when it comes to healthcare, as we have seen, is very difficult and the president and a large number of Republicans are actually for cutting back on health care,” he said Sunday on NBC’s Meet the Press. “That’s what they have done for two years. We have a divided House and Senate. I think the courts have to be the first and best way to go.” Pelosi also said the House would “swiftly intervene” in the appeals process. The case is likely to be appealed to the U.S. Court of Appeals for the 5th Circuit in New Orleans, and from there, it may go before the Supreme Court. Sarah Sanders, the White House press secretary, said Friday night that she expected it would land before the high court. “The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional,” she said. “Once again, the president calls on Congress to replace Obamacare and act to protect people with pre-existing conditions and provide Americans with quality affordable healthcare.”

O’Connor’s opinion sided with GOP state officials. The suit in the case, Texas v. Azar, was brought by 20 Republican state officials, who asked that all of Obamacare be thrown out as a consequence of the new tax law, which zeroed out the “individual mandate” penalty on the uninsured. The officials argued that the penalty was central to making the rest of the law work, and that without it, the rest should crumble. O’Connor, a George W. Bush appointee, wrote in his opinion that he believed Congress would not have enacted Obamacare in the first place, with its various rules and taxes, without the mandate, and that the regulatory framework was intended to work together. “Congress stated many times unequivocally – through enacted text signed by the president – that the individual mandate is ‘essential’ to the ACA,” he wrote. “And this essentiality, the ACA’s text makes clear, means the mandate must work ‘together with the other provisions’ for the Act to function as intended.” O’Connor was talking about the Obama administration’s argument that the mandate could not be severed from the rest of the law in a 2012 Supreme Court case.

Trump celebrates ‘Great news’ that Obamacare ruled unconstitutional. Trump said it was “great news” for Americans that the judge deemed Obamacare unconstitutional.  “Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!” Trump tweeted Friday. On Monday, he criticized Obamacare’s deductibles. “The DEDUCTIBLE which comes with ObamaCare is so high that it is practically not even useable! Hurts families badly,” Trump tweeted Monday morning. “We have a chance, working with the Democrats, to deliver great HealthCare! A confirming Supreme Court Decision will lead to GREAT HealthCare results for Americans!”

Susan Collins: Obamacare-killing court ruling ‘will be overturned.’ One of the Republican senators who helped scuttle GOP efforts to repeal Obamacare believes the latest legal challenge to the healthcare law will be overturned. “I think this will be overturned on appeal,” Sen. Susan Collins, R-Maine, told CNN. “There’s no reason why the individual mandate provision can’t be struck down and keep all the good provisions of the Affordable Care Act, such as coverage for people with pre-existing conditions.”

Medical groups blasted the decision. A slew of medical groups expressed their disapproval about the Texas ruling, calling for the decision to be stayed and for the case to be swiftly appealed.  “This ruling has an unconscionable result,” said Altha Stewart, president of the American Psychiatric Association. “Should this ruling stand, millions of our patients will lose their healthcare. We cannot afford to go back to the days when Americans were denied coverage due to pre-existing conditions or when insurance companies would not cover mental health and substance use disorders.” Matt Eyles, president and CEO of America’s Health Insurance Plans, called the decision “misguided and wrong.” Rick Pollack, president and CEO of the American Hospital Association, said the ruling would make it “more difficult for hospitals and health systems to provide access to high-quality care.” Dr. Barbara McAneny, president of the American Medical Association, called it “an unfortunate step backward.” “No one wants to go back to the days of 20 percent of the population uninsured and fewer patient protections, but this decision will move us in that direction,” she added. In a joint statement, the American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, and the National Multiple Sclerosis Society said the decision “threatens to resurrect barriers to health care for people with serious illnesses.”

Obamacare’s open enrollment closed Saturday. The decision on Texas v. Azar came just one day before the end of open enrollment, the period during which people are allowed to sign up for healthcare plans with subsidies from the federal government. The Centers for Medicare and Medicaid Services, the agency that operates this part of the law, said enrollment was still underway despite the ruling. “The recent federal court decision is still moving through the courts, and the exchanges are still open for business and we will continue with open enrollment,” a spokesperson said. “There is no impact to current coverage or coverage in a 2019 plan.” Andy Slavitt, the former CMS administrator, called for the Trump administration to extend its deadline until Jan. 15 to allay confusion, but the Trump administration closed enrollment on time.

California extends open enrollment. The Golden State runs its own exchange, known as Covered California, and state officials decided Saturday that they would allow people more time to sign up given the Texas v. Azar ruling. Californians now have until Friday, Dec. 21, to enroll in plans. The ultimate deadline for the state isn’t until Jan. 15, but residents had until Dec. 15 to sign up if they wanted coverage that would begin in the new year. “Open enrollment is full-steam ahead and continues in California and other states for several more weeks,” Covered California Executive Director Peter Lee said in a statement. “No one in California should let this ruling discourage them from enrolling in health coverage or be worried about using the health plan they have.”

Collins: Brett Kavanaugh ruled ‘impartially, independently’ in Planned Parenthood case. Collins on Sunday defended her choice to support Supreme Court Justice Brett Kavanaugh after he sided with liberal justices in the first abortion case to be considered by the court since he joined the bench. “Planned Parenthood was Brett Kavanaugh’s No. 1 opponent. They went after him with everything that they had. And yet, when it came to this case, he was able to put that aside and rule impartially, independently,” Collins told CNN. Collins told the network last week she “certainly” did feel “vindication” after Kavanaugh joined Chief Justice John Roberts in denying a request to review a lower court decision from Kansas and Louisiana about defunding Planned Parenthood. As a result of the Supreme Court declining to take the case, a ruling preventing the states from rescinding Medicaid contracts with Planned Parenthood affiliates was left intact. “I was trying to speak to his temperament, and his fairness, and his impartiality, which I think he did demonstrate in this case,” she to CNN Sunday.

Teen vaping is soaring as the Trump administration tries to crack down. As many as 1.3 million more teens have tried vaping this year compared to last year, according to the latest government-funded survey on teen nicotine use.

DC judge flexes antitrust authority in another sting to Justice Department. The Trump administration’s antitrust agenda is butting heads yet again with a now familiar foe for the federal government: U.S. District Court Judge Richard Leon. At a recent hearing to examine CVS Health’s $ 69 billion takeover of Aetna, Leon warned he would not serve as a rubber-stamp for an agreement made to win Justice Department approval that required Aetna to divest its Medicare Part D business. At the heart of the potential challenge is a statute known as the Tunney Act, the 1974 law that requires the courts to review consent decrees from the Justice Department that ensure mergers don’t violate antitrust laws. While the purpose of the examination is to ensure the deal reached is in the public interest, most federal judges approve the measures without much fuss. The potential challenge to the CVS-Aetna deal may test the boundaries of the updated law. Earlier this month, Leon issued a warning that the two companies may need to keep their assets separate and set a date for another hearing on Dec. 18. CVS and Aetna closed the transaction in November and have already begun to merge.

Johnson & Johnson dismisses ‘conspiracy theory’ in baby-powder report. Johnson & Johnson dismissed as an “absurd conspiracy theory” a Reuters report on Friday that employees had, for decades, covered up tests showing its baby powder was sometimes tainted with cancer-causing asbestos. The powder “is safe and asbestos free,” the New Brunswick, N.J.-based company said in a statement, and studies of more than 100,000 people have shown talc – an ingredient in Johnson’s Baby Powder – doesn’t cause cancer or asbestos-related disease. The company acknowledged mounting product-liability lawsuits over its baby powder, with cases filed primarily in Missouri, California and New Jersey, in a regulatory filing as recently as October. Chief Executive Officer Alex Gorsky has promised to appeal a $ 4.7 billion verdict against the firm in a Missouri lawsuit. The Reuters article ignores the thousands of tests showing that Johnson & Johnson’s talc doesn’t contain asbestos as well as the company’s full cooperation with the FDA and other regulators, Johnson & Johnson said Friday.

DOJ worried transgender enlistments could continue into 2020. The Justice Department is worried that without Supreme Court intervention, an ongoing court battle could allow transgender people to continue joining the military well into 2020, according to a new court filing.

The protracted fight could push the debate and legal fight over Trump’s transgender military policy into the midst of the next presidential election and even into a new administration, according to attorneys for transgender plaintiffs. Trump’s Justice Department laid out the concern in a new filing Thursday asking the court to lift an injunction and clear the way for Defense Secretary Jim Mattis to end the enlistments that began for the first time in January.


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FRIDAY | Dec. 14

Dec. 13-14. 31 Center Drive, Bethesda, Md. National Institutes of Health advisory committee meeting. Details.

Dec. 13-14. 1300 Pennsylvania Ave. NW. Medicaid and CHIP Payment and Access Commission meeting. Details.

Dec. 13-15. Las Vegas. Annual World Congress. Schedule.

SATURDAY | Dec. 15

End of healthcare.gov open enrollment.