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Overnight Health Care — Presented by Johnson & Johnson – House progressives may try to block vote on Pelosi drug bill | McConnell, Grassley at odds over Trump-backed drug pricing bill | Lawmakers close to deal on surprise medical bills

Welcome to Friday’s Overnight Health Care.

House progressives are fuming about a drug pricing bill coming to the floor next week, an appeals court ruled on the “public charge” rule, legal marijuana could be to blame for some vaping illnesses in Massachusetts, and tension is growing between Mitch McConnell and Chuck Grassley over a bipartisan drug pricing bill.

We’ll start with a drug pricing fight over in the House…

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House progressives may try to block vote on Pelosi drug bill

House Speaker Nancy Pelosi (D-Calif.) is planning to bring a sweeping drug pricing bill to the floor next week. But she may have to deal with a group of unhappy progressive lawmakers, who are contemplating trying to block the bill. 

House progressives are considering voting against a procedural motion to proceed unless they get changes to the measure, effectively threatening to stop the bill in its tracks. 

The Congressional Progressive Caucus (CPC) on Friday is conducting a whip count of its 98 members to see how many would be willing to vote “no” on what is known as the rule for the legislation. 

The move, while not certain yet, is a sign of the intense frustration among some progressive House lawmakers that they have not been able to win changes to the bill they have sought for months, in what they say has been a closed off, top-down process. 

“There are a lot of people who are saying if we don’t get some of these things in, we have to consider all our options, including voting against the rule,” Rep. Pramila Jayapal (D-Wash.), the co-chairwoman of the CPC, told reporters on Friday. 

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Progressives hope that if they vote “no” on the motion, they can force leadership to either allow floor votes on progressive amendments or make changes to the underlying bill before the vote.

Read more on the drama here.

 

 

In drug pricing news across the Capitol…

 

Grassley, Wyden unveil updated Senate drug pricing package 

The bipartisan leaders of the Senate Finance Committee unveiled a modified version of their drug pricing plan on Friday.

The legislation has been tweaked slightly from the version that was first introduced over the summer to try to get additional GOP senators on board, but Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) have also tied the new version to a variety of health care “extenders”– legislation that will expire unless Congress gives them new funding at the end of the year.

The idea is to use the savings from the drug pricing provisions to pay for the extenders, like funding for Medicaid in Puerto Rico, and the Temporary Assistance for Needy Families (TANF) program. 

Congress and the White House want to find ways to lower drug costs, and the Grassley/Wyden bill seems like the only legislative vehicle that could get a vote in the Senate. If Pelosi can calm the progressives and pass her bill in the House, Majority Leader Mitch McConnell (R-Ky.) will not bring it up for a vote. 

But McConnell hasn’t been very excited about the Wyden/Grassley bill either, and that’s led to some tension…

 

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McConnell, Grassley at odds over Trump-backed drug bill

President Trump wants the Finance Committee bill to pass. But McConnell has said privately that he thinks Grassley’s bill is bad policy, according to sources who heard his comments.

Grassley, meanwhile, is trying to increase pressure on McConnell to support his bill, arguing that lowering drug prices will help vulnerable Republicans at the ballot box.

But the bill has more support among Democrats than it does among Republicans. When the measure came up for a vote in the Finance Committee over the summer, nine Republicans voted against it, compared with just six who backed it.

McConnell is loathe to hold votes on measures that could divide Republicans.

Grassley said he didn’t expect McConnell to have held a vote by now — Grassley is still building support for the legislation — but said he is banking on the White House to help win over Republican senators.

Pressure campaign: Joe Grogan, the director of the White House Domestic Policy Council, wrote an op-ed with White House Council of Economic Advisors director Tom Philipson on Friday saying that Trump would sign the Finance Committee bill if it passes.

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Grassley has been making his pitch to GOP colleagues on the Senate floor and in other one-on-one conversations. But he has yet to see an outpouring of support from Republicans, and when asked, at least some said they had not been contacted by the White House.  

Read more on the dynamic here.

 

Massachusetts links vaping illnesses with state-regulated marijuana

Six Massachusetts patients with probable cases of vaping-related lung injuries reported using regulated marijuana products from state-licensed dispensaries, according to new state data.

The Department of Public Health posted the information online late Thursday night as part of its weekly update. The cases mark the first time legal marijuana vaping products in Massachusetts have been linked to the outbreak of a vaping illness that has sickened nearly 2,300 people in every state. However, the injuries have not been confirmed to be vaping-related and state officials did not release any information about which products the patients used or which retailers they visited. 

Federal health officials have mainly pointed to black market THC products as a likely culprit of the mysterious vaping illness, though at least one death has reportedly been linked to oil bought legally at a dispensary in Oregon. 

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Massachusetts health officials listed a number of THC products that were named by patients with either probable or confirmed lung illnesses, including products labeled as “Dank,” which is an illicit brand that as been tied to the injuries. The state itself did not distinguish which products were regulated and which were not.

Read more here.

 

Appeals court hands Trump partial win over ‘public charge’ rule for immigrants

A federal appeals court on Thursday delivered a partial legal victory to the Trump administration, lifting an injunction blocking their “public charge” rule, which links immigrants’ legal status to whether they obtain federal benefits.

In a 2-1 ruling on Thursday, a three-judge panel of the Ninth Circuit Court of Appeals lifted two of four lower court injunctions against the rule. However, the policy still cannot take effect because of two separate nationwide injunctions.

The majority opinion said Congress has the authority to act, not the courts.  

“An agency has broad discretion to administer the programs entrusted to it by Congress,” wrote Judge Jay Bybee, a George W. Bush appointee. “We are not the proper foil to this or any other administration as it crafts our immigration policies.

Read more here.

 

Key negotiator says deal close on surprise medical bills legislation

A deal in Congress on legislation that could fix so-called “surprise” medical bills is close. 

Four key House and Senate health care negotiators have an “agreement in principle” on long-awaited legislation to protect patients from so-called surprise medical bills, Oregon Rep. Greg Walden, the top Republican on the powerful Energy and Commerce Committee, said Friday. 

“Yes, we have four corners agreement in principle, I would tell you. We’re very close to the final wording, but as you know … we got to make sure every word’s what we all agreed upon, but I think we’re really close,” Walden said during an appearance on C-SPAN’s “Newsmakers” that is set to air this weekend.

The agreement would be between Walden, House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.), and Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), the leaders of the Senate Health Committee. 

Read more on the deal here.

 

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What we’re reading: 

Inside the opioid industry’s marketing machine (Washington Post)

Safety problems lead to early end for study of ‘abortion pill reversal’ (NPR)

Samoa arrests anti-vaccine activist as it combats deadly measles outbreak (ABC News)

Website errors raise calls for Medicare to be flexible with seniors’ enrollment (Kaiser Health News)

Anti-vaccine groups take dangerous online harassment into the real world (NBC News)

 

State by state

The extraordinary danger of being pregnant and uninsured in Texas (ProPublica/Vox)

Wisconsin’s health secretary pushes ObamaCare enrollment as numbers lag (Wisconsin State Journal)

Medicaid expansion keeps breaking through in red America. Next stop: North Carolina? (Washington Post Opinion

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