Pharmaceutical & Life Sciences News

Capsule: Cost Conscious Shoppers, HIV Goals, Medicaid Requirements

March 29, 2019, 9:40 AM

Welcome to Capsule—your weekly dose of health-care news, where we give you a recap of this week’s highs and lows for key players in the industry. You can expect us every Friday morning.

There was a lot of big news this week, so let’s just dive in.

Here’s what ended the week on a high note:

Reproductive Rights

  • Twenty one states and D.C. are demanding invalidation of final rules giving employers the ability to avoid paying for employee health plans that cover birth control if they object on religious or moral grounds, Mary Anne Pazanowski writes.
  • Women across the country will be hurt by the new rules, which exempt certain employers from Obamacare’s minimum essential health-care coverage requirements for women, a Massachusetts-led coalition told the U.S. Court of Appeals for the Third Circuit March 25 in a friend-of-the-court brief.
  • Meanwhile, Massachusetts would cover any cutback in federal funds to clinics that provide abortions and other reproductive services for low-income women under an emergency spending bill approved by the Massachusetts House this week, Adrianne Appel reports.
  • And in North Carolina, a 1973 law barring abortions after a fetus reaches 20 weeks’ gestation is unconstitutional, a federal court says. Mary Anne Pazanowski and Andrew M. Ballard have the story.

Cost Conscious Shoppers

  • Looking up the price of routine health costs should be as easy as a price check on a can of peas in a grocery store, the Senate Finance Committee’s top Democrat said this week. Sen. Ron Wyden (D-Ore.) unveiled a three-part proposal to help millions of Americans get better information about their health-care costs in a more digestible way, Jeannie Baumann reports.
  • Price limits on some high-cost prescriptions might become a reality in Maryland, Andrew M. Ballard and Madison Alder write. The House of Delegates passed by 98-40 a bill (H.B. 768) this week that would create a “prescription drug affordability board” to determine how much the state and local governments would pay for medications.
  • A highly-anticipated federal bill that would ding branded drug companies for delaying generic competition inched forward in the House this week.
  • Co-pay assistance programs are gaining in popularity in places like West Virginia and Virginia, which would help patients afford their medicines, Alder and Ballard write.

Medicaid Recipients

  • A federal judge blocked Kentucky and Arkansas from requiring some Medicaid recipients to work, another setback for a Trump administration policy that other states are seeking to adopt, John Tozzi and Andrew Harris report.
  • In simultaneous rulings, U.S. District Judge James Boasberg in Washington decided on March 27 that work rules in the two states shouldn’t stand. He’d ruled against the requirements in Kentucky once before.
  • “The secretary’s failure to consider the effects of the project on coverage alone renders his decision arbitrary and capricious,” Boasberg wrote of the Arkansas program’s approval by Department of Health and Human Services Secretary Alex Azar.

It was a bleak week for others. Here’s whose Thursday closed on a downswing:


  • The Trump administration hardened its legal position toward Obamacare this week, arguing the entire law is unconstitutional in a shift that promises to bring the issue to the forefront of the 2020 election campaign, Sahil Kapur writes.
  • The position is a change for the Justice Department after it argued last year that large parts of the 2010 law — but not all of it — should be struck in the case Texas v. U.S.
  • Meanwhile the number of Obamacare enrollees this year dropped slightly, Sara Hansard writes. The federal Medicaid agency also issued guidance extending the period for which plans that don’t comply with the Affordable Care Act can be “grandmothered” in and sold. They can continue through the plan year that starts Oct. 1, 2020, under the guidance.
  • Democrats are pushing back though. The ACA’s premium subsidies would be expanded and several Trump administration rules would be blocked under a bill released by House Democrats March 26, Danielle Parnass and Alex Ruoff write.

HIV Goals

  • A pill with the potential for halting the spread of HIV sits at the crux of two important health policy issues—President Donald Trump’s plan to end the epidemic in America by 2030 and increasing pressure on drug companies to reduce prices, Madison Alder writes.
  • In the six years that Truvada has been used for PrEP HIV prevention therapy in the U.S., the number of new infections has stayed flat at about 40,000 new instances per year, while the price of Truvada has increased. A 30-pill bottle costs about $1,700 when sold to purchasers like pharmacies, according a spokesman for Gilead, which sells the drug.
  • Meanwhile, tossing Obamacare in its entirety—as the Trump team now favors—would undermine its strategy to end HIV by 2030.

Rural Opioid Users

  • Many rural counties—where the opioid crisis has hit the hardest—are receiving low levels of funding compared to more populated areas, a report tracking federal spending on the epidemic found, Jeannie Baumann writes.
  • While the rate of overall drug use is lower in rural areas, the death rate from overdoses has been higher in those areas compared to urban areas since 2006, according to the Centers for Disease Control and Prevention. As many as 74 percent of farmers have been directly impacted by the opioid crisis, the Department of Agriculture said.
  • The analysis identified a number of counties, including 40 of the 95 counties in Tennessee, that received no direct federal funding in FY 2018, but had overdose mortality rates in the highest 25 percent in the state.

Thanks for joining us this week and have a great weekend. I’m all ears when it comes to your two cents, tips, critiques, or coordinating exclusive interviews. Send them my way at jlee1@bloomberglaw.com.

To contact the reporter on this story: Jacquie Lee in Washington at jlee1@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Randy Kubetin at rkubetin@bloomberglaw.com

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