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SENATE PANEL CLOSES IN ON BIPARTISAN HEALTHCARE VICTORY: After the efforts to shore-up Obamacare failed in 2018, the Senate Health, Education, Labor, and Pensions Committee turned its attention to the issue in healthcare that voters say they are most concerned about: How to lower what people pay for their own medical care.

On Wednesday, their efforts are getting even closer to coming together as they hope to score a bipartisan victory on healthcare ahead of 2020. The committee is marking up and voting on the Lower Health Care Costs Act, intended to lower what patients pay for medical care and to bring generic drugs to market faster. You can tune in here.

What the bill would do: The legislation would help shield patients from “surprise medical bills,” which come after patients receive medical care outside their network, by setting a benchmark payment on what hospitals are allowed to charge and enacting other protections for patients. The bill also would make it easier for generics to get approved. It contains public health measures such as an education campaign on vaccines at a time when measles rates continue to rise.

Latest additions: The bill would raise the minimum age to purchase tobacco from 18 to 21 and would apply to both traditional cigarettes and vaping products. A second addition is a long-stalled drug pricing measure known as the Creates Act. The bill would allow generic drug companies to more easily sue brand-name drug companies when they try to block them from having access to the samples needed to make cheaper copies.

What to watch for: Will a debate over arbitration emerge? It’s excluded from the HELP bill and doesn’t have the support of the White House, but a provision to allow a third-party arbiter to determine prices does have some bipartisan support.

A group of senators led by Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H., had crafted the STOP Surprise Medical Bills Act. That bill would have insurers pay out-of-network doctors and hospitals for the difference between a patient’s in-network cost-sharing requirements and the median in-network rate for their services. If either party wanted to appeal the amount, they could do so using an arbitration process.

Cassidy expressed his disapproval of the committee’s agreement at the start of the hearing. “There was a delicate balance struck between insurance companies, hospitals and doctors,” he said of his legislation. “What has been adopted in entirely in the insurance companies’ interest.”

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

CALIFORNIA MEDICAID SUIT OVER LATINO BARRIERS TO CARE MOVES AHEAD: The Alameda County Superior Court ruled Tuesday that a lawsuit from civil rights advocates and medical workers alleging racial discrimination in the state’s Medicaid program, known as Medi-Cal, should be allowed to go forward.

The lawsuit was filed two years ago and claims that the state’s health department discriminated against people who enrolled in the program, most of whom were Latino, by allowing rates to fall so low to the point that many doctors wouldn’t accept Medi-Cal patients. The complaint says that as a result patients have long waits for care and must travel long distances. It specifically alleges the decision was racially motivated because reimbursement rates for doctors, who serve Latino populations, fell, while reimbursement rates for long-term care, whose patients are white, steadily increased.

MARCH FOR LIFE LAUNCHES 6-FIGURE AD BUY FOR DEBATES: The anti-abortion organization March for Life will air ads ahead of the Democratic debate on MSNBC to underscore that voters support limits on abortion. The ad calls out Democrats for supporting abortions late in pregnancy and government funding for abortions.

LAST NORTH DAKOTA ABORTION CLINIC FILES FREE SPEECH SUIT TO BLOCK ANTI-ABORTION LAWS: North Dakota’s sole abortion clinic, Red River Womens Clinic, teamed up with the American Medical Association to file a federal free speech suit to overturn two anti-abortion laws. The first would force doctors to tell women that a pill-induced abortion can be reversed, a claim disputed by the AMA. The second law requires doctors to tell a woman that an abortion “will terminate the life of a whole, separate, unique, living human being,” which the plaintiffs say is an ideological statement rather than a scientific one.

MASSACHUSETTS DEMOCRATS AIM TO LOOSEN ABORTION RESTRICTIONS: The Massachusetts state legislature recently held a hearing for a controversial measure to allow abortions after 24 weeks of pregnancy with a doctor’s authorization and to remove the parental consent requirement for minors seeking abortions.

EXPANDING MEDICAID IN NORTH CAROLINA WOULD INSURE ALMOST 400,000 AND CREATE ALMOST 40,000 JOBS: ANALYSIS: Expanding Medicaid in North Carolina would insure about 365,000 people and create over 37,000 jobs, according to George Washington University researchers. Thanks to increased coverage and more jobs, researchers say business activity in the state would increase by $11.7 billion in just three years. North Carolina is one of 14 states that have not yet expanded Medicaid under the Affordable Care Act, and nearly 1 million are uninsured.

CONNECTICUT GOVERNOR SIGNS PAID LEAVE LAW: Democractic Gov. Ned Lamont signed paid family and medical leave into law Tuesday for all Connecticut residents, which will be funded by a payroll tax of 0.5% on workers. The law will provide up to 12 weeks of replacement wages on a sliding scale. The tax will go into effect in January 2021. Even though there is no business contribution, business are the primary opponents, saying it could leave small business with a shortage of employees.

FDA ISSUES YET ANOTHER WARNING TO KRATOM MANUFACTURERS: The Food and Drug Administration sent two warning letters Tuesday to kratom manufacturers for marketing the unapproved drug as a treatment or cure for opioid addiction. The FDA has warned manufacturers in the past that kratom has not been proven to help treat opioid abuse disorder, and government data suggests that kratom actually has opioid properties that could expose users to the risks of addiction. The FDA called kratom and manufacturers “health fraud scams.”

MCCONNELL PROMISED 9/11 FIRST RESPONDERS SENATE WILL REPLENISH VICTIM FUND: Mitch McConnell, recently harassed by Jon Stewart over the 9/11 Victim Compensation Fund, met with 9/11 first responders and promised them the Senate will reauthorize the fund by August. After their meeting, first responder John Feal said, “Mitch McConnell promised to work for us and I’m going to take him for his word.” Feal then said, “We’re the world’s best pain in the asses. We don’t go away.”

SAN FRANCISCO SLATED TO BECOME FIRST MAJOR US CITY TO BAN E-CIGS: San Francisco’s city council voted unanimously Tuesday to ban the sale of e-cigarettes in the city if the device hasn’t been reviewed by the FDA. As of now, none have. The ordinance must now be approved by the Mayor London Breed, who has expressed her support. If Breed signs it, the ban will go into effect within 30 days. JUUL, headquartered in San Francisco, has said the company supports enforcement of age requirements but not prohibition. Spokesman Ted Kwong said: “This full prohibition will drive former adult smokers who successfully switched to vapor products back to deadly cigarettes… and create a thriving black market instead of addressing the actual causes of underage access and use.”

ABBVIE TAKES OVER BOTOX MANUFACTURER ALLERGAN FOR $63 BILLION: The drugmaker AbbVie announced Tuesday that it would merge with Allergan, manufacturer of Botox, for $63 billion. This is the latest of 40 drug company mergers just this year that may hinder congressional and administration efforts to lower drug prices by increasing competition. Democrats have also begun targeting drug company patents for brand-name drugs that could reap profits for decades, impeding generics from entering the market.

VETERAN WHO BATTLED TALIBAN ON HORSEBACK SLAMS AOC FOR HER DEFENSE OF VA: Army Brig. Gen. Donald Bolduc, who helped fight the Taliban on horseback and is now running for the U.S. Senate in New Hampshire seat, pushed back against Rep. Alexandria Ocasio-Cortez’s April defense of the VA, in which she said that a lack of funding is the department’s biggest problem. Bolduc, a veteran who served 36 years in the Army, including 10 tours in Afghanistan, said people who work in the VA are “caught in a bureaucracy that prevents them from being effective, and that’s the number one thing that needs to be changed.” Bolduc teamed up with Afghanistan’s Northern Alliance warlords to defend southern Afghanistan from Taliban forces.

TRANSGENDER KANSANS CAN NOW CHANGE THEIR BIRTH CERTIFICATES: Kansas birth certificates may now be altered to reflect a transgender person’s gender identity, after four transgender members of the Kansas Statewide Transgender Education Project and state officials reached a settlement to reverse current policy on altering birth certificates, which is only allowed for cases when the biological sex of the child was incorrectly assigned at birth. “This judgement makes me feel safer and like my state finally recognizes me as a woman,” said Nyla Foster, a plaintiff.

ILLINOIS BECOMES THE 11TH STATE TO LEGALIZE MARIJUANA: Democratic Gov. J.B. Pritzker signed a bill into law Tuesday to legalize marijuana for recreational use. Pritzker campaigned on the issue, saying it would help alleviate the opioid crisis in the state, increase tax revenue, and become a catalyst for prison reform. The law will also expunge records of prisoners who were convicted for buying or possessing 30 grams or less.

The Rundown

The New York Times Risk for dementia may increase with long-term use of certain medicines

Texas Tribune Immigrant children returned to West Texas facility despite reports of squalid conditions

Reuters Special Report: How judges added to the grim toll of opioids

The Wall Street Journal When patients can’t pay, many hospitals are suing

Politico How the VA uses algorithms to predict suicide



House and Senate in session.

June 26-27. 1615 H St. NW. U.S. Chamber of Commerce Foundation “Ignite Wellness Summit.” Details.

9 a.m.-3 p.m. Long View Gallery. 1234 9th St NW. The Hill’s Future of Healthcare Summit. Details.

10 a.m. 1100 Longworth. House Ways and Means Committee markup of healthcare bills. Details.

10:30 a.m. Dirksen 124. Senate Health, Education, Labor, and Pensions Committee markup of the Lower Healthcare Costs Act.

2 p.m. Pew Charitable Trusts. 901 E St. NW. Surgeon General Jerome Adams to speak on combating the opioid crisis. Details.

2 p.m. 2247 Rayburn. House Committee on Oversight and Government Reform hearing on “U.S. Biodefense, Preparedness, and Implications of Antimicrobial Resistance for National Security.” Details.

2 p.m. HVC 210. House Committee on Veterans Affairs Subcommittee on Health Oversight hearing on “Beyond the Million Veterans Program: Barriers to Precision Medicine.” Details.

2:30 p.m. 1539 Longworth. CSRxP Congressional briefing on addressing rising prescription drug costs.

THURSDAY | June 27

10 a.m. Dirksen 226. Senate Judiciary Committee executive session on drug-pricing bills. Details.

Noon. Hart 902. Alliance for Health Policy briefing on “Addressing the Drivers of Maternal Mortality.” Details.

Noon. 2044 Rayburn. American Association for Cancer Research briefing on ““Let’s End HPV-related Cancers.” Details.

FRIDAY | June 28

9 a.m. 1789 Massachusetts Ave. NW. American Enterprise Institute event on “What Do We Tell Our Children? The Health Risks and Policy Problems of Cannabis Legalization.” Details.

10 a.m. National Press Club. 529 14th St. NW. Bipartisan Policy Center event on “Good Health is Good Business.” Details.