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Headlines in Health Policy: November 26, 2018

Headlines in Health Policy Affordable Care Act

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HealthCare.Gov Sign-Ups Drop 400,000 During Open Enrollment

A little more than 1.9 million people signed up for health insurance in the first three weeks of the Affordable Care Act open enrollment for 2019 coverage. That compares with almost 2.3 million during the first three weeks of open enrollment last year, which included an additional day.  Americans are signing up for coverage through the federal marketplace at a slower rate this year, but the Centers for Medicare and Medicaid Services numbers don't include enrollment in states that operate their own exchanges, or those who will be automatically enrolled in plans during the last week of open enrollment, which ends Dec. 15 in most states. (Shelby Livingston, Modern Healthcare)

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House Democrats Target DOJ Decision Not to Defend Obamacare

Democrats will scrutinize the Trump administration’s decision not to defend Obamacare in federal court, when they take control of the U.S. House of Representatives next year, a leading Democrat said on Monday. In June, the Department of Justice declared the health care law’s individual mandate unconstitutional in federal court, which threatened to undermine insurance protections for people with preexisting conditions, and helped make health care a winning issue for Democrats in House elections on Nov. 6. (David Morgan, Reuters)

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Medicaid

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Trump Administration Again Permits Kentucky to Impose Work Requirement for Medicaid Recipients

The Trump administration has reinstated permission for Kentucky to compel many of its low-income residents on Medicaid to work or prepare for a job, after a federal court had blocked the state’s ability to begin the requirements. Federal health officials announced Tuesday night that they had, for a second time, approved Kentucky’s plan to impose "community engagement" requirements as part of Medicaid, saying they could start in April, nine months after they originally were to have taken effect. (Amy Goldstein, Washington Post)

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With New Work Requirement, Thousands Lose Medicaid Coverage in Arkansas

A major initiative of the Trump administration has been adding work requirements to benefit programs for the poor, now including Medicaid. This year, Arkansas became the first state to roll out the requirement. As a result, more than 12,000 people there have lost their coverage.  (Catherine Rampell, PBS Newshour)

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Kansas Medicaid Expansion in Doubt Despite Governor Support

Democratic and moderate Republicans lawmakers worked together last year to try to make Kansas the latest state to expand Medicaid, only to see their bipartisan effort rewarded with a veto from former conservative GOP Gov. Sam Brownback. The election this month of a governor who supports Medicaid expansion seemed to remove the biggest hurdle for those hoping to bring health coverage to thousands of the state’s poor. But it’s not that simple. In the same election that put Democrat Laura Kelly in the governor’s office, Kansas voters also elected a more conservative legislature. (John Hanna, Associated Press)

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Maine Judge Orders GOP Governor to Implement Medicaid Expansion

A Maine judge on Wednesday ruled that the state must implement an expansion of Medicaid passed by voters last year, despite strong objections from outgoing GOP Gov. Paul LePage. Maine Superior Court Justice Michaela Murphy on Wednesday ordered LePage to comply, and set a deadline of Dec. 5 for putting in place rules around the expansion. (Peter Sullivan, The Hill)

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Prescription Drugs

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Opioid Industry Fights Efforts to Make It Pay for Crisis

Opioid makers and distributors are fighting a novel New York State law that aims to collect hundreds of millions of dollars from the industry to help defray costs of the opioid crisis, with some companies reengineering their supply chain to avoid the new tax. Companies and trade groups have argued in three legal challenges filed in recent months that the law, which seeks $600 million over six years, is unconstitutional. They point to a lawsuit New York’s attorney general has already filed against major opioid industry players to recoup money for the state, and say the tax is an improper end-run around resolution of that case. (Sara Randazzo, Wall Street Journal)

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The Bernie Sanders-Trump Mind Meld on Drug Costs

Sen. Bernie Sanders and President Donald Trump are on the same page on drug pricing once again. A bill released Tuesday morning by Sanders (I-Vt.) and Rep. Ro Khanna (D-Calif.) to reduce U.S. drug prices takes a cue from the president’s recent proposal to reduce Medicare drug costs — both proposals seek to lower U.S. drug costs by tying them to international prices. (Sarah Karlin-Smith, Politico)

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Marketplace

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Trump Administration Invites Health Care Industry to Help Rewrite Ban on Kickbacks

The Trump administration has labored zealously to cut federal regulations, but its latest move has still astonished some experts on health care: It has asked for recommendations to relax rules that prohibit kickbacks and other payments intended to influence care for people on Medicare or Medicaid. The goal is to open pathways for doctors and hospitals to work together to improve care and save money. The challenge will be to accomplish that without also increasing the risk of fraud. (Robert Pear, New York Times)

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Headlines in Health Policy: November 26, 2018