• Americans Are Beginning to Lose Healthcare Coverage  Los Angeles Times by Michael Hiltzik — Trumpcare, defined as the current administration's effort to undo every achievement of the Affordable Care Act, is going from strength to strength. The latest readings of its accomplishments come from the Commonwealth Fund, a healthcare advocacy think tank, and Tom Price, who was drummed out of his job as Trump's first secretary of Health and Human Services over his predilection for luxury charter flights when commercial flights would do just as well. The Commonwealth Fund reported Tuesday that the administration's concerted attack on the ACA has driven the uninsured rate among working-age people (those aged 19 to 64) to 15.5 percent, up from 12.7 percent in 2016. That translates into lost coverage for 4 million Americans.
  
  
• Former HHS Secretary Price: it Was Mistake to Zero Out Coverage Penalty  Modern Healthcare by Virgil Dickson —  Former Health and Human Services (HHS) Secretary Dr. Tom Price, who long pushed to repeal the Affordable Care Act, said Tuesday that Republican lawmakers made a mistake by zeroing out the penalty for not complying with the individual mandate. "There are many — I am one of them — that actually believe that will harm the [risk] pool in the exchange market," Price said in a speech at the World Health Care Congress. "Younger and healthier people may now not participate in that market and consequently that drives up the costs for other folks." President Donald Trump in December signed the Tax Cuts and Jobs Act, which zeroed out the penalty for not having insurance starting Jan 1, 2019. Price's comment appears to be an about-face from his stance while leading HHS. During an interview on ABC's "This Week" last summer, he slammed the ACA and particularly the individual mandate. "The individual mandate is one of those things that is actually driving up the cost for the American people in terms of coverage," Price said.
  
  
• On Anniversary of House Obamacare Repeal, Democrats Look to Extract a Price  New York Times by Thomas Kaplan —  House passage of the Obamacare repeal bill left that chamber's Republicans in a no-win situation. They took the hard vote, but because the Senate failed to follow suit, no one can claim a victory. Now Democrats hope to extract a price. Far from the liability that the Affordable Care Act has been in past elections, Democrats believe health care will be a key advantage heading into this fall's midterm elections. Though President Barack Obama's signature domestic achievement has endured, Democrats accuse the Trump administration and congressional Republicans of sabotaging the health law's insurance marketplaces through actions such as ending the requirement that most people have coverage or pay a penalty. And in the weeks before this fall's elections, consumers are expected to learn of another wave of premium increases.

• 'Deaths of Despair' in Pennsylvania, Led by Opioid Fatalities, Double in 10 Years  Philadelphia Inquirer by Sarah Gantz — Deaths from suicide, alcohol, and drug use doubled over a 10-year period in Pennsylvania, driven by historically high levels of opioid overdose deaths, according to a new report by the Commonwealth Fund. In New Jersey, the rate of these deaths is also climbing rapidly, yet the number of deaths per capita still remains below the national average. Pennsylvania ranked 24th in overall health in the 2018 Scorecard on State Health System Performance, which evaluates states based on an analysis of dozens of health indicators. The state received high marks for access to care, employer contributions to insurance plans and preventive care for children, but suicide, drug and alcohol deaths ranked 45th among all states, dragging down Pennsylvania’s overall score. Drug, alcohol, and suicide deaths, sometimes called "deaths of despair," are on the rise nationally, increasing by 50 percent between 2005 and 2016. But they’ve risen more rapidly in Pennsylvania — by 96 percent over the same time period — and in New Jersey, with a 68 percent increase.

• Maine Governor Sued for Defying Medicaid Expansion Ballot Measure  Politico by Rachana Pradhan — 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. The lawsuit against LePage's administration was expected after the Maine Legislature's recent session ended without a funding agreement.
  
  
• Idaho Medicaid Expansion Ballot Measure Moving Forward  The Hill by Nathaniel Weixel — Idaho is poised to allow a vote on Medicaid expansion after an activist group said it has collected enough signatures to put it on the November ballot. Reclaim Idaho said it has collected the required 56,192 signatures needed to place the measure on the ballot. The deadline to turn in the signatures is Monday. According to the group, county clerks need to verify the signatures by June 30 in order for the initiative to be placed before voters. The initiative would provide coverage for up to 62,000 Idahoans who now fall into a coverage gap, making too much to qualify for Medicaid but not enough to qualify for subsidized health insurance through the state insurance exchange. Idaho would join Utah as the second state in the last month where groups have gathered enough signatures to place Medicaid expansion on the November ballot. Groups in Nebraska and Montana are also attempting to gather enough signatures.
  
  
• Trump Officials Abruptly Pull Back from Decision on Medicaid Lifetime Limits The Hill by Peter Sullivan — The Trump administration planned to announce Tuesday that it was rejecting Kansas's request to impose a three-year lifetime limit on Medicaid benefits, but canceled the announcement at the last minute due to internal administration disagreements, sources say. The rejection of Kansas's request would be significant, in that the Trump administration would be drawing the line against major new restrictions on the health insurance program for the poor. The administration has already approved work requirements in Medicaid, a controversial step on its own. But if the administration turned down Kansas, it would be rejecting efforts to go beyond that and limit Medicaid benefits to three years, after which people would be dropped from the program forever.

• Drug Industry Faces Trump-Fueled Storm Over Prices  The Hill by Peter Sullivan — Drugmakers are trying to navigate a growing storm over high drug prices as President Trump prepares to unveil new actions on the issue. The drug industry has traditionally been able to beat back actions from Washington, notably escaping unscathed in the fight over ObamaCare. But the climate appears to be changing. Trump has railed against drug companies for their prices, saying they are "getting away with murder." And Congress, where pharmaceutical companies have traditionally had allies in both parties, dealt the industry a rare defeat earlier this year by shifting more costs onto drugmakers in Medicare.
  
  
• President Trump Wants to Go Further on Drug Prices Reuters — Health and Human Services (HHS) Secretary Alex Azar on Wednesday said President Donald Trump wants to go further in lowering drug prices, an issue he campaigned on during the 2016 presidential race. "HHS is currently working with the President on a comprehensive strategy to solve these problems," Azar said in a speech at World Health Care Congress. "We'll be building on the proposals in the President's budget, but he wants to go further." The Republican president has said pharmaceutical companies are "getting away with murder" and has vowed to lower prescription drug prices. But the administration's proposals so far have been modest and do not go after drug companies. Congressional action on the issue is seen as unlikely. Last week, Trump postponed a speech on lowering prescription drug prices to a date in the near future.
  
  
• FDA Chief Floats Rethinking of Laws Allowing Drug-Plan Rebates  Bloomberg News by Anna Edney —  Days ahead of the expected rollout of a White House plan to tackle soaring drug prices, a top U.S. health official asked whether the legal status of drug-plan rebates should get another look. Food and Drug Administration Commissioner Scott Gottlieb asked in a speech what would happen if the U.S. government re-examined the safe harbor that drug rebates have under federal anti-kickback laws. "Such a step could help restore some semblance of reality to the relationship between list and negotiated prices, and thereby boost affordability and competition," Gottlieb said in remarks prepared for an appearance at a conference of pharmaceutical-industry lawyers in Washington.

• McConnell: Senate Likely to Consider Anti-Opioid Package  Associated Press by Bruce Schreiner — The U.S. Senate is working on crafting a comprehensive package to combat the nation's opioid addiction problems and ease the transition from treatment to the workforce, Senate Majority Leader Mitch McConnell said Monday. The Kentucky Republican attended discussions in Louisville that included business representatives and executives on the front lines of treating people battling drug addiction. McConnell emerged to promote his recently introduced measure aimed at helping people make the successful journey from treatment to the workplace. "We're likely to put together an opioid package in the Senate," he told reporters. "This bill will be a part of it. There are other aspects that others are taking the lead on."
  
  
• If You're Worried About Prescription Opioids, You Should Be Really Scared of Fentanyl  Los Angeles Times by Karen Kaplan — The U.S. opioid crisis has passed a dubious milestone: Overdose deaths involving synthetic opioids like illicit fentanyl have surpassed deaths involving prescription opioids. This switch occurred in 2016, according to data published Tuesday in the Journal of the American Medical Assn. And it seemed to happen pretty suddenly. Data from the National Vital Statistics System show that there were 42,249 opioid-related overdose deaths in 2016. That includes 19,413 that involved synthetic opioids, 17,087 that involved prescription opioids and 15,469 that involved heroin. (In some cases, more than one type of drug was implicated in the death.) That means synthetic opioids were a factor in 46% of all fatal opioid overdoses in 2016, compared with 40% for prescription opioids Just one year earlier, in 2015, 29% of all opioid-related overdose deaths involved a synthetic opioid (9,580 out of 33,091 deaths).

• Health Insurers Had Their Best Quarter in Years, Despite the Flu Bloomberg News by Zachary Tracer — U.S. health insurers just posted their best financial results in years, shrugging off worries that the worst flu season in recent history would hurt profits. Aetna Inc., for instance, posted its widest profit margin since 2004. Centene Corp. had its most profitable quarter since 2008. And Cigna Corp., which reported on Thursday, had its biggest margin in about seven years. Analysts at Morgan Stanley, in a research note, said insurers are in the midst of a "hot streak." One big reason for the windfall is the tax cuts passed by Congress last year, which in some cases more than halved what the insurers owe the government. Aetna said its effective tax rate fell to 16.8 percent from 39.6 percent, for example. Many insurers also spent less on medical care than analysts had expected, even taking into account increased spending on flu treatments.

Editor: Peter Van Vranken