Overnight Health Care — Presented by Rare Access Action Project — Appeals court strikes ObamaCare mandate, sends case back to lower court | Grassley says McConnell blocking drug price bill | Trump officials move toward drug imports

Overnight Health Care — Presented by Rare Access Action Project — Appeals court strikes ObamaCare mandate, sends case back to lower court | Grassley says McConnell blocking drug price bill | Trump officials move toward drug imports

Welcome to Wednesday’s Overnight Health Care. The Fifth Circuit Court of Appeals finally released its decision on the Texas ObamaCare case and back in Washington, the Trump administration proposed limited drug importation from Canada. 

We’ll start with the big court ruling.



Appeals court strikes ObamaCare mandate, sends case back to lower court

A federal appeals court on Wednesday ruled that ObamaCare’s individual mandate is unconstitutional, but punted on the larger question of what it means for the rest of the health law.

The Fifth Circuit Court of Appeals remanded the case back to a federal judge in Texas to decide just how much of the rest of the law, if any, is also unconstitutional.

A group of Republican attorneys general, led by Texas, sued to overturn ObamaCare last year, arguing Congress’ repeal of the individual mandate penalty made the entire law unconstitutional. 

Texas District Judge Reed O’Connor sided with the Republican attorneys general last December, ruling that the entire law had to go. Democratic AGs who won the right to defend ObamaCare in court (because the Trump administration declined to) argued the individual mandate is severable from the rest of the law. 

Key points: The ruling issued Wednesday was critical of O’Connor for not considering the intent of Congress in 2017, when it repealed the individual mandate penalty. Instead, O’Connor considered the intent of Congress when ObamaCare was first passed in 2010. 

“The opinion gives relatively little attention to the intent of the 2017 Congress, which appears in the analysis only as an afterthought despite the fact that the 2017 Congress had the benefit of hindsight over the 2010 Congress,” the ruling reads. 


Why it matters: We waited months for the Fifth Circuit to release this decision… and now we’ll likely wait several more months before the lower court issues another. This could very well push the decision past the 2020 elections, where health care, and this lawsuit, will play a big role. 

Dissent: “The district court’s opinion is textbook judicial overreach,” wrote a dissenting judge. 

“The majority perpetuates that overreach and, in remanding, ensures that no end for this litigation is in sight.”

Court breakdown: In the circuit court ruling, Judge Jennifer Walker Elrod, a George W. Bush appointee, was joined by Judge Kurt Engelhardt, a Trump appointee. Judge Carolyn Dineen King, a Carter appointee, dissented.

For more on the ruling, click here.


In other health care news, Grassley does not seem thrilled with McConnell on drug pricing

Asked why more Republican senators have not signed onto his bill to lower drug prices, Sen. Chuck GrassleyCharles (Chuck) Ernest GrassleySenate GOP blasts impeachment: ‘The mob took over the House’ Overnight Health Care — Presented by Rare Access Action Project — Appeals court strikes ObamaCare mandate, sends case back to lower court | Grassley says McConnell blocking drug price bill | Trump officials move toward drug imports GOP chairmen seek interview with Obama officials as part of Biden-Ukraine probe MORE (R-Iowa) told reporters, “because McConnell’s asked them not [to],” in a shot at the Senate Majority Leader.

He added that “leadership doesn’t want it to come up.”

But President TrumpDonald John TrumpRepublican group targets Graham in ad calling for fair Senate trial Democratic presidential candidates react to Trump impeachment: ‘No one is above the law’ Trump attacks Schumer at fiery rally in Michigan MORE, who says lowering drug prices is a priority for him, supports the Grassley-Wyden bill. 

Grassley on Wednesday accused McConnell of hindering Trump’s policy priorities. 

“The president wants it,” Grassley said. “Senate majority leaders historically, if you’ve got the president of the same party, tend to be spokesmen for the administration, not against the administration.”

Big picture: This escalates the public disagreement between two powerful senators. It’s possible Grassley’s bill, or something like it, could be part of a drug pricing package that Speaker Nancy PelosiNancy PelosiRepublican group targets Graham in ad calling for fair Senate trial Trump attacks Schumer at fiery rally in Michigan Schumer, Pelosi to meet as Democrats debate tactics MORE (D-Calif.) is pushing for ahead of a May deadline for expiring health programs, but any agreement will be hard in an election year. 

Read more here.  



Trump administration proposes limited drug importation from Canada

The Trump administration is laying the groundwork to allow some cheaper prescription drugs to be imported from Canada.

The administration is issuing a proposed rule, along with a proposed guidance for the drug industry, that will allow states, pharmacies, wholesalers and manufacturers to import prescription drugs if they meet conditions designed to ensure that the importation poses no additional risk to safety and will save consumers money.

Importing drugs from abroad is a departure from the traditional Republican approach, but President Trump has long supported the idea, and is searching for drug pricing victories ahead of the 2020 election.

Administration officials announced the plan on Wednesday, the same day the House planned to vote to impeach the president, and made a point to say they would not let partisanship distract them from delivering savings for Americans. 

But President Trump has struggled to find wins on the issue. To date, almost every administrative effort on drug pricing has been blocked in court or been withdrawn in the face of opposition. 


Context: This is unlikely to be a win for the Trump administration. It faces considerable opposition from the drug industry and Canadians. If the guidance is finalized, it would likely face lawsuits, delaying its implementation. 

Read more on the Trump plan here. 


Advocates hopeful gun violence research funding will lead to prevention 

Doctors and advocates are hopeful that new funding for federal agencies to study gun violence will prove to be the first step in preventing mass shootings, suicides and other firearm deaths.

For the first time in 23 years, a government spending bill will set aside funds — in this case, $25 million — for the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) to collect data on what the American Medical Association has called a public health crisis.

Activists are optimistic that getting fresh data will provide policymakers with the information needed to reduce gun deaths.


“It’s a step in the direction of us taking proactive measures to protect Americans,” said Christian Heyne, vice president of policy for Brady United Against Gun Violence. “It’s taken us too long to get here. My hope is this is one more milestone in the long road ahead.”

Questions that researchers don’t currently have good answers to include: Who are the victims? How are they getting shot and with what kinds of firearms? Where did the weapons come from? What are the relationships between shooters and victims? What’s the role of mental illness, drugs and alcohol? What is the relationship between domestic violence and gun violence?

Read more here. 


Teen drinking, cigarette smoking down as marijuana vaping rises: study

A new study by the National Institute on Drug Abuse (NIDA) finds more teens are vaping marijuana and nicotine but fewer are drinking alcohol or smoking cigarettes.

The report — which surveys 8th, 10th and 12th graders — shows that 14 percent of 12th graders said they had vaped marijuana within the last month, up from 7.5 percent last year.

When asked if they had vaped marijuana at least once in the past year, 7 percent of 8th graders said yes, along with 19.4 percent of 10th graders and 20.8 percent of 12th graders.

“Teens are clearly attracted to vaping products, which are often concentrated amounts of drugs disguised as electronic gadgets,” said NIDA Director Dr. Nora Volkow.

“Their growing popularity threatens to undo years of progress protecting the health of adolescents in the U.S.”

Read more on the study here. 


What we’re reading

Why are Democrats in Congress undermining ObamaCare? (Washington Post editorial)

Doctors win again, in cautionary tale for Democrats (New York Times) 

Some big health care policy changes are hiding in the federal spending package (NPR)


State by state

Medicaid expansion on the table, says Mississippi lieutenant governor (jacksonfreepress.com)

More Californians are buying health care through the state’s health care exchange (The Sacramento Bee)


The Hill op-eds

Owning up to the failures of welfare reform 

Why pancreatic cancer research lags behind, and how to change it 

It’s essential for doctors to be involved in politics

Click Here: liverpool mens jersey