Daily on Healthcare: ‘Fit for duty’? Trump is due for his routine physical

By | January 10, 2019

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Is the president still ‘fit for duty’? Trump is due for his routine physical. President Trump is nearing the one-year mark since his last routine medical checkup, an endeavor that last year provoked speculation and commentary about whether the commander in chief is physically and mentally up to the job. The White House has not provided the Washington Examiner with an answer to the question whether Trump plans to have his annual exam at Walter Reed National Military Medical Center in Bethesda, Md., or whether he will release his medical records to the public, as he did around this time last year, despite multiple inquiries. Trump’s health has not been at the center of national dialogue in the same way that it was before his first exam in the White House. But ever since before the 2016 election, and into his presidency, Trump’s critics have weaponized questions about his mental and physical health, seizing on reports that his only exercise is golfing and that he enjoys Diet Coke and fast food. Critics have mocked Trump’s personal longtime physician, Dr. Harold Bornstein, for writing in a letter when Trump was running for president that he would be “the healthiest individual ever elected to the presidency,” a phrase later reported to have been dictated by Trump himself. They have speculated that Trump’s speeches and tweets are evidence of mental deterioration, despite medical associations pleading for such “armchair psychiatry” to stop. A new exam is bound to bring about a new round of scrutiny, even if it is conducted by the current White House physician, Dr. Sean Conley.

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Grassley opposes Medicare drug negotiation, has other proposals. Sen. Chuck Grassley, chairman of the Senate Finance Committee, said Wednesday that he opposes legislation to have the government directly negotiate the prices of prescription drugs in Medicare, a proposal that Democrats in the House and Senate have called for. The part of Medicare that deals with prescriptions people get at the pharmacy is known as Part D, and prices are negotiated through private companies instead of through the government. “I feel very strongly that we don’t mess with that provision of it,” Grassley said, noting the program has come in under budget projections. “If it’s working don’t mess with it,” he added, though he acknowledged some things might change to modify the program. Grassley laid out other areas the committee plans to tackle. One is a bill that would ban “pay for delay” settlements between brand and generic drug companies. Another is the CREATES Act that would help generic companies get access to copies of drugs faster. A bill allowing U.S. citizens to re-import cheaper drugs from Canada is also on the table, and the Senate will evaluate what the Trump administration can do through regulation. “We’ll be working very closely with Azar on what he can do administratively through regulation or guidance,” Grassley said of Health and Human Services Secretary Alex Azar.

Azar issues warning shot to pharma price gouging. Azar has vowed to consider all regulatory and legislative options that will bring the list prices down for drugs. “I want to be really clear to PhRMA companies out there and to the pharmacy benefit managers: The president and I will not stop until list prices of drugs come down; this behavior has to stop,” Azar said on Fox Business. “Drug prices must come down and we will roll out more regulatory and legislative proposals and we will work with Democrats and Republicans to get drug prices down.” Azar met this week with Trump, who is frustrated by reports of drug pricing increase.

Cassidy will introduce bill to block illegal immigrants from getting Medicaid. Sen. Bill Cassidy, R-La., has vowed to introduce a bill that would block people who are in the U.S. illegally from receiving Medicaid, a program jointly covered by the state and federal governments. “Federal tax dollars should benefit Americans, not reward people from other countries who break the law,” he wrote on Twitter. “That only encourages more illegal immigration.” The comments were in response to California Gov. Gavin Newsom proposing that Medicaid in his state be extended to cover people up to age 26 who are in the country illegally, who meet the low-income threshold.

Putting GOP in tough spot, Dems have House counsel intervene in Obamacare lawsuit. House Democrats approved a resolution Wednesday to have the chamber’s counsel defend Obamacare in a legal case seeking to undo it, a move intended to underscore Republican actions to gut the healthcare law. The resolution, called the Restoring Congress for the People Resolution, passed 235-192, with three Republicans voting in favor. It affirms the counsel’s authorization to defend the healthcare law on behalf of the House. The impact of the House’s actions are largely political, and aren’t likely to weigh heavily on the outcome of the lawsuit.

Instead, Democrats aimed with the vote to keep the spotlight on Republicans who ran campaigns during the midterm elections telling voters they were devoted to keeping in place Obamacare’s protections on pre-existing illnesses. They put Republicans in a difficult position of voting to defend a law they have vowed to replace, while also making them demonstrate whether they were really committed to the promises they made on pre-existing conditions.

House Republicans introduce bill to protect pre-existing conditions. Rep. Dave Joyce, R-Ohio, re-introduced a bill reinforcing that Obamacare’s protections for people with pre-existing illnesses, such as cancer and diabetes, are still in place even if a judge were to find the law unconstitutional.  The Continuing Coverage for Preexisting Conditions Act is co-sponsored by GOP Reps. Mike Turner of Ohio, John Katko of New York, Anthony Gonzalez of and Jamie Herrera Butler of Washington. “I have always believed that no American should ever be penalized by or rejected from health insurance coverage because of a preexisting condition, and I look forward to continuing my efforts to ensure they are able to access the quality health care that they need,” said Joyce, who had voted against the bill to repeal and replace Obamacare.  

House Democrats ask leadership to make opioid crisis a top priority. More than 60 House Democrats have asked the Democratic leadership in a letter to make addressing the opioid crisis a top priority for the 116th Congress. The letter was signed by members that came from areas of the country particularly hard hit, and calls for “increased resources, creative solutions, and more legislative staff.” Rep. Elijah Cummings, chairman of the Committee on Oversight and Reform, said in a statement that he supported the letter. “I plan to dedicate staff to investigate and hold hearings on various aspects of this national crisis,” he said. “I am also 100 percent committed to working with my colleagues in the House to develop and advance strong legislation to provide additional funding for desperately needed treatment, wrap-around services, and related infrastructure.

Romaine calm: CDC says E. coli outbreak is over. U.S. health officials on Wednesday declared an end to the E. coli outbreak linked to romaine lettuce that affected over 60 U.S. consumers and put at least 25 people in the hospital in the final three months of 2018. From October to December, the outbreak sickened 62 people from 16 states and the District of Columbia. Out of the 62 cases, the final three were reported in the latter half of December. Two out of the 25 hospitalized suffered kidney failure, and at least 29 cases were also recorded by the Public Health Agency of Canada. No deaths were reported. Investigators, including the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration, found the strain of E. coli that caused the illnesses in a reservoir at a farm in Santa Barbara County in California. They concluded that romaine lettuce harvested from northern and central California was the likely source of the outbreak.

Study: 8 percent of high school students in Louisiana are shooting up drugs. High school students in Louisiana are using intravenous drugs at three times the rate of the national average, according to an analysis of government data exclusively obtained by the Washington Examiner. Eight percent of Louisiana high school students tried to inject illegal drugs in 2017, compared with 2.7 percent of students nationwide, according to a report by American Addiction Centers’ “Project Know.” The company analyzed information from the latest Youth Risk Behavior Surveillance System study by the CDC. Drugs that can be injected include heroin, cocaine, methamphetamine, ecstasy, ketamine, PCP, and prescription drugs. Arkansas was the runner-up — 7.4 percent of students admitted to having used needles to shoot up. Of the remaining states, 20 reported rates of 1 percent to 4.4 percent, while the remainder did not report any use.

RUNDOWN

NPR Democrats’ healthcare ambitions meet the reality of divided government

Washington Post Food inspections by the FDA have been sharply reduced, alarming critics

The New York Times A virus even more dangerous than Zika to pregnant women

CQ Roll Call Senators clash over abortion fee rule

The Associated Press Liberal lawmakers challenge Trump with drug cost legislation

THURSDAY | Jan. 10

Jan. 7-10. J.P. Morgan Healthcare conference. Details.

Senate and House in session.

MONDAY | Jan. 14

Trump administration’s Obamacare birth control exemptions to take effect.

Noon. National Press Club. 529 14th St. NW. CVS CEO Larry Merlo to address Aetna acquisition, healthcare challenges. Details.

TUESDAY | Jan. 15

7:30 a.m. Health and Human Services Secretary Alex Azar and members of Congress to speak at “The Price of Good Health” event. Details.

Midnight. Open enrollment ends for California exchange, Covered California.

WEDNESDAY | Jan 15

8:15 a.m. 1099 14th St NW. Politico event on “Healthcare Innovators: New Players Meet Long-Established Regulations.” Details.

Healthcare