THE PROGNOSIS

Now President Trump is almost certainly off the hook for coming up with an Obamacare replacement before the November election.

That’s a political plus for him, despite the president's recent frustrations over polls showing voters don’t tend to trust him on health-care issues.

The Supreme Court turned down a chance yesterday to quickly decide a lawsuit that could dismantle the 2010 health-care law and its provision of coverage for millions of Americans. “A practical effect is that the Affordable Care Act probably will remain in place through the fall elections,” Washington Post Supreme Court reporter Bob Barnes writes.

One could almost sense the relief from Health and Human Services Secretary Alex Azar, in an interview yesterday with the Nevada-based “Kevin Wall Radio Show.” Over the past year, Azar was subject to erratic demands by Trump to come up with a viable ACA replacement — despite the fact that Republicans crashed and burned in that effort back in 2017.

Now the court’s refusal to expedite the case saves Azar and Trump from having to conjure up a replacement out of practical necessity.

“There's really not a need for a replacement of the Affordable Care Act unless and until either there’s a final Supreme Court decision that would get rid of it or large parts of it … or until there’s a Congress that would actually work with the president on repealing or replacing the Affordable Care Act,” Azar said on the radio show. 

“Frankly, it’s not a material thing right now,” he added.

Trump’s lawyers and the GOP-led states bringing the lawsuit against the ACA have said there’s no hurry to decide it. But Democrats, who clearly feel Texas v. Azar is a political liability for Republicans, had been champing at the bit for a final decision before the November election.

“It wasn’t something most Republican were interested in having a conversation about between now and November,” said Lanhee Chen, a health-care policy expert who advised now-Sen. Mitt Romney (R-Utah) during his 2012 presidential bid. 

The Supreme Court’s announcement yesterday is “a political victory for Trump,” Leslie Dach, chairman of the Democratic-affiliated group Protect Our Care, wrote me in an email.

“The whole reason Trump and the [Republicans] oppose the court taking the case now is to postpone the public focus on the disastrous impacts of the lawsuit until after the election,” Dach wrote.

The justices, without comment, turned down a motion by the Democratic-led House and Democratic-led states to expedite review of last month’s decision by the U.S. Court of Appeals for the 5th Circuit. That court struck down the ACA’s mandate for Americans to buy health insurance but sent back to a lower court the question of whether the rest of the law can stand without it.

California Attorney General Xavier Becerra, who is leading the defense of the health-care law, is holding out hope the Supreme Court might still decide to hear the high-stakes case this year:

But it’s an increasingly dim possibility, given yesterday’s developments. The court could still eventually hear the case, but that probably won’t occur for many more months, after the lower courts fully consider it. Dach, whose group hounds the administration and Republicans for trying to roll back Obamacare, acknowledged as much.

“Folks and the whole system will live with uncertainty for a long period of time,” Dach wrote.

The New York Times's Margot Sanger-Katz: 

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation: 

Just look at the reactions to the Supreme Court’s announcement. There was virtually no response from Republicans. There was lots of frustration from Democrats and several groups representing the interests of low-income populations.

Sen. Ron Wyden (Ore.), the ranking Democrat on the Senate Finance Committee: “This decision rewards Republicans in their never-ending crusade to rip away pre-existing condition protections from families while leaving Americans with massive uncertainty about the future of their health care.”

Rep. Bill Pascrell Jr. (D-N.J.):

The Association for Community Affiliated Plans: The “Supreme Court leaves in place the cloud of uncertainty that hangs over the Affordable Care Act. … Plans will postpone investment and innovation in the individual market, dampening competition. Consumers will be left to wonder about the fate of important consumer protections against discrimination on the basis of pre-existing conditions, lifetime coverage caps, and rescissions of coverage.”

A joint statement from the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association, the American Lung Association and other patient advocacy groups: “The Court’s decision today will leave millions of Americans with pre-existing conditions and those who rely on federal tax credits to obtain coverage unsure about their ability to keep or afford comprehensive health care coverage for months to come.”

A group that promotes safety-net health plans:

And from Job Creators Network, a conservative advocacy group that opposes Obamacare: “This decision to look at the ACA in the normal time frame provides the time and opportunity for legislators on the left and right to look at new solutions to the healthcare problem. JCN’s extensive research has shown the American public is hungry for a system that gives them choice and allows them to have a relationship with their doctor.”

AHH, OOF and OUCH

AHH: In another radio interview, Azar praised the bipartisan drug pricing legislation from Wyden and Sen. Chuck Grassley (R-Iowa). 

“Chairman Grassley and Sen. Wyden have an incredible bipartisan package to get drug prices down and lower what seniors pay out of pocket for their drugs,” he said in an interview with an Iowa radio station. “I have worked closely with them — we’ve got to get that package to the Senate floor. We’ve got to get that passed out of Congress.”

He addressed concerns about drug costs that have increased even as Washington ramps up pressure on drug manufacturers. He said the Grassley-Wyden bill would “actually have financial penalties for increasing the list price of your drugs. It could really turn around this constant dynamic of every January 1 and every July 1, the drug companies jack up the list prices of their drugs ... We can start breaking that dynamic if we get this bipartisan legislation passed through Congress.” 

Azar’s numerous radio hits follows a report from our Post colleagues Josh Dawsey and Yasmeen Abutaleb that Trump lashed out at the HHS secretary for not doing more to address health care and drug pricing. 

Some other context from Bloomberg News's Alex Ruoff:

OOF: After supporting Sen. Susan Collins (R-Maine) for years, Planned Parenthood is endorsing Sara Gideon, the Democrat running to unseat her.

The abortion rights group says Collins “turned her back on women” when she voted in 2018 to confirm Brett Kavanaugh to the Supreme Court, a move that mobilized liberal activists against her, as our Post colleague Colby Itkowitz writes. 

“Despite Collins’s record as an abortion rights Republican and defender of federal funding for Planned Parenthood, her critical vote on Kavanaugh lost her the trust of Maine’s Planned Parenthood campaign arm, wrote Margot Milliken, chairwoman of the state chapter, in an op-ed for the Portland Press Herald on Saturday,” Colby writes. 

As recently as 2017, Planned Parenthood honored Collins as an “outspoken champion for women’s health,” the Associated Press’s David Sharp reports. Now, acting Planned Parenthood president Alexis McGill Johnson says it’s clear that she has turned her back on those she should be championing.”

The Collins campaign dismissed the endorsement, saying Planned Parenthood has become more partisan. “Senator Collins has not changed, but leadership at Planned Parenthood certainly has,” Collins campaign spokesman Kevin Kelley told David. “It’s sad that the group is now run by far-left activists who would rather focus on partisan politics than bipartisan policies that provide health care to women.”

OUCH: A Washington state man was diagnosed with the first confirmed case in the United States of the mysterious and potentially deadly coronavirus that broke out last month in China. The man was diagnosed after returning to the United States after a trip to the region around the Chinese city of Wuhan and is now in stable condition at a hospital in Everett, Wash., our Post colleagues Lena H. Sun and Lenny Bernstein report. 

The man returned before federal health officials began screening travelers from Wuhan at several international airports. CDC officials said yesterday they will expand the screenings to international airports in Atlanta and Chicago after initially conducting screenings at international airports in Los Angeles, San Francisco and New York’s John F. Kennedy. 

“Shortly after arriving at Seattle’s international airport, he began feeling ill and reached out to his health-care provider on Sunday. Local, state and federal officials quickly collected samples and sent them to the Centers for Disease Control and Prevention for testing,” our colleagues write. “… Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Disease, said the risk posed by the virus to the general American population is low but that older adults with underlying health conditions may be at increased risk.” 

— The pneumonia-like virus has so far killed at least six people and sickened hundreds in China and others in Thailand, Japan, Taiwan and South Korea. Here’s an updating post about what we know about the coronavirus, from Lena and our Post colleague Miriam Berger. 

— Meanwhile, Chinese health officials have advised people in Wuhan not to leave. 

“In China — with hundreds of millions of people packing onto public transport to make their annual visits home for the Lunar New Year — a new sense of panic set in after confirmation that the coronavirus could be transmitted person to person,” our colleagues Anna Fifield, Lena and Lenny report. “Long lines formed at pharmacies and convenience stores around the country as people rushed to buy surgical masks, with unlucky customers posting photos on social media of bare shelves. People around the country canceled their trips home for the Spring Festival, as new year celebrations are known, the most important holiday on the Chinese calendar."

— Azar outlined the steps his agency is taking, in an interview yesterday with Fox Business host Lou Dobbs. Azar said flights containing 84 percent of travelers coming to the U.S. from Wuhan are being funneled to the major cities of LA, San Francisco and New York and the flight plans of the other 16 percent "will be changed to they can also be surveilled before entering the U.S."

Azar also said CDC has created a diagnostic test for the illness and educated health-care professionals to be on the lookout for the virus

"While this is a potentially serious public health issue, it's one for which we have the playbook," Azar said.

REPRODUCTIVE WARS

— First in The Health 202: Antiabortion group Susan B. Anthony List says 28 of the 30 House Democrats in districts won by Trump have consistently voted for abortion rights despite the president's strong actions against the controversial procedure. The group has graded these 28 Democrats with a “F” in a new congressional scorecard it will roll out today.

The scorecard, which grades all House and Senate members for their stances on abortion-related legislation, mostly gives “A” grades to Republicans and “F” grades to Democrats, with some exceptions. Just two of the 30 House Democrats in districts won by Trump got “D” or “C” grades: Rep. Ben McAdams of Utah and Rep. Collin Peterson of Minnesota.

SBA List President Marjorie Dannenfelser said the scorecard “is a powerful tool to educate voters and empower them to hold abortion extremists accountable at the ballot box.” Last week, the group announced a $52 million election spend for the 2020 election cycle.

— A new poll out this morning from the Kaiser Family Foundation found that two-thirds of Americans believe the recent wave of abortion restrictions that have passed at the state level aim to make access to abortion more difficult. 

The findings were released ahead of the Wednesday anniversary of the landmark 1973 Supreme Court Roe v. Wade ruling, as well as Friday’s annual March for Life in Washington. 

Here are some of the notable findings: 

  • There is support for some of the state-level regulations that have emerged: Sixty-nine percent of Americans support laws that require abortion providers to have admitting privileges at nearby hospitals, and 49 percent support laws that ban abortions once fetal cardiac activity is detected. But support for these laws drop once people hear some of the counterarguments.
  • The poll also found a 79 percent majority of people say decisions about abortions should be made by women in consultation with their doctors, compared with 20 percent who say lawmakers should decide when abortions should be made available and under what conditions.
  • The foundation also reports a 69 percent majority of Americans don’t want to see Roe v. Wade overturned. It found 91 percent of Democrats and 70 percent of independents don’t want the ruling overturned, while 57 percent of Republicans would like to see it overturned.

OPIOID OPTICS

— The federal government will start allowing states to tap into funds allotted for the opioid crisis to address a meth and cocaine crisis growing nationwide. It’s part of a change buried in the massive spending bill lawmakers passed in 2019, the Associated Press’s Ricardo Alonso-Zaldivar reports. 

“Pressed by constituents and state officials, lawmakers of both parties and the Trump administration agreed to broaden the scope of a $1.5 billion grant program previously restricted to the opioid crisis,” Ricardo writes. “Starting this year states can also use those federal dollars to counter addiction to ‘stimulants,’ a term the government uses for methamphetamine and cocaine.” 

Meth accounts for a large number of the drug-involved deaths in states west of the Mississippi, according to government data from 2017, while fentanyl is a major killer in the East and Midwest. Cocaine ranks third overall across the country for drug-related deaths.

“The federal Substance Abuse and Mental Health Services Administration is preparing to notify states of the newly available grant flexibility,” Ricardo writes. “Ultimately, state officials want Congress to consider folding the opioid money into a larger block grant program administered by the same agency, creating a big pool of federal money to treat addiction, with fewer restrictions on its use.” 

— And here are a few more good reads:

INDUSTRY RX

In 2018, Akili Interactive Labs asked the FDA to market a video game that physicians would prescribe for ADHD. The greenlight has still yet to come.
Stat

STATE SCAN

Virginia Politics
One bill would have allowed Virginians to carry concealed weapons without a permit.
Patricia Sullivan and Laura Vozzella
The drug is acetaminophen, known outside the U.S. as paracetamol and used to treat pain and fevers. It is the basis for more than 600 prescription and over-the-counter medications for adults and children, found in well-known brands like Tylenol, Excedrin, Sudafed, Robitussin and Theraflu.
Associated Press
Louisa Snuffer and her wife, Nikki, wanted to build a family together. Now they're the parents of eight children from West Virginia's foster care system.
NBC News

MEDICAL MISSIVES

The for-profit hospice industry has grown, allowing more Americans to die at home. But few family members realize that "hospice care" still means they'll do most of the physical and emotional work.
NPR

DAYBOOK

Coming Up

  • The annual National March for Life will be held in Washington on Friday.

 

SUGAR RUSH