• Senate Dems Question Legality of Trump Work Requirements Associated Press by Ricardo Alonso-Zaldivar — The Trump administration's new policy allowing state work requirements for Medicaid recipients is legally questionable, more than two dozen Democratic senators said Thursday, framing an argument likely to be aired in court. The senators' letter to acting health secretary Eric Hargan reads like a memo to legal groups preparing a court challenge on behalf of low-income Medicaid beneficiaries. Last week the administration unveiled its policy letting states to impose Medicaid work requirements, and promptly approved a waiver request by Kentucky to carry out its version.…"Harmful ideological policies such as work requirements, mandatory drug testing, time limits, onerous cost-sharing and the like undercut and exceed the statutory authority provided" for the Department of Health and Human Services to grant Medicaid waivers, the letter said. Such proposals "clearly undermine the purpose of the Medicaid Act, prioritizing ideology over health," the letter concluded, asking the Trump administration to reconsider its policy.
  
  
• Kentucky Governor Threatens to End Medicaid Expansion The Hill by Nathaniel Weixel — An executive order issued by Kentucky Gov. Matt Bevin (R) would end the state's Medicaid expansion if any part of the state's newly-approved Medicaid overhaul is struck down by a court. If the expansion were to end, nearly 500,000 people would lose Medicaid coverage. The waiver, which was approved on Friday, will allow Kentucky to impose strict work requirements on some Medicaid beneficiaries, as well charge monthly premiums and lock beneficiaries out of coverage if they don't pay. Bevin's executive order would instruct the secretary of the Cabinet for Health and Family Services and the Medicaid commissioner to "take necessary steps to terminate Kentucky's Medicaid expansion" if any part of his plan is struck down in court.
  
  
• The Nation's First Medicaid Work Rules Loom, and Many Fear Losing Health Coverage Washington Post by Amy Goldstein — Gov. Matt Bevin is exultant as his administration sets out to transform Medicaid. Only a week ago, he won federal permission to pursue a goal that has animated his two years in office: making hundreds of thousands of poor Kentuckians hold jobs or engage in their communities in other ways to keep their health insurance. It is an approach never tried by any state, and it will also transform lives. Meanwhile, consumer health advocates in Kentucky and Washington are finalizing a lawsuit to try to block the state, contending that its action undermines Medicaid's purposes and is illegal. In the middle are an estimated 394,000 Kentuckians. That is state officials' most recent snapshot of how many of 1.4 million Medicaid recipients are able-bodied people ages 19 to 64 who will not be exempt because of circumstances such as pregnancy, schooling, medical frailty or disability. Officials expect that perhaps 264,000 will not be in compliance when the rules begin between July and November. 

• Senate Panel Advances Trump Health Secretary Pick  Associated Press — A Senate committee has signed off on President Donald Trump's pick for health secretary, clearing the way for final confirmation of Alex Azar. The Finance Committee voted 15-12 on Wednesday to send Azar's nomination to the full Senate. Although the panel's vote was largely along party lines, Azar's confirmation hearings weren't nearly as contentious as the deliberations over his predecessor, Tom Price. One Democrat, Sen. Tom Carper of Delaware joined majority Republicans to advance Azar's nomination. Azar, 50, is an Ivy League lawyer and a former drug company and government executive. As the new secretary of Health and Human Services, Azar would head a $1 trillion department with 80,000 employees. He's promised to make the high cost of prescription drugs his top priority. No floor vote has been scheduled.
  
  
• Trump Again Targets Drug Policy Office, Proposing 95 Percent Budget Cut Politico by Sarah Karlin-Smith and Brianna Ehley — President Donald Trump is planning to slash the budget of the Office of National Drug Control Policy, in what marks his administration's second attempt to gut the top office responsible for coordinating the federal response to the opioid crisis. The plan would shift the office's two main grant programs, the High Intensity Drug Trafficking Areas grant and the Drug Free Communities Act, to the Justice and Health and Human Services departments, respectively, multiple sources in the administration and others working with the government on the opioid crisis told POLITICO. The move would result in a reduction of about $340 million, or 95 percent of the ONDCP's budget. Trump administration officials say the office would still serve as the White House's drug policy shop, while the grants would be administered by larger agencies.
  
  
• Conflict-of-Interest Concerns Keep CDC's Fitzgerald Away from Yet Another Meeting with Congress  Modern Healthcare by Steven Ross Johnson — A Senate health committee held the first of two hearings Wednesday over the current state of the nation's readiness to address public health emergencies, which led to calls to improve the reliability of data collected during and after disasters.  But before senators could tackle some of those pressing issues, they first had to contend with the fact that Centers for Disease Control and Prevention Director Dr. Brenda Fitzgerald again canceled an appearance before Congress. Fitzgerald cited ongoing potential conflicts of interests related to her personal financial investments as the reason for recusing herself.
  
  
• The Religious Activists on the Rise Inside Trump's Health Department Politico by Dan Diamond — A small cadre of politically prominent evangelicals inside the Department of Health and Human Services (HHS) have spent months quietly planning how to weaken federal protections for abortion and transgender care — a strategy that's taking shape in a series of policy moves that took even their own staff by surprise. Those officials include Roger Severino, an anti-abortion lawyer who now runs the Office of Civil Rights and last week laid out new protections allowing health care workers with religious or moral objections to abortion and other procedures to opt out…'Inside HHS, staff say that those leaders are steering their offices to support evangelicals at the expense of other voices, such as a recent decision to selectively post public comments that were overwhelmingly anti-abortion.

• Lawmakers Weigh Measure to Fight High Drug Prices  The Hill by Peter Sullivan — Lawmakers are considering adding a measure aimed at fighting high drug prices to an upcoming spending deal, in what would be a rare defeat for the powerful pharmaceutical industry. The measure, known as the Creating and Restoring Equal Access to Equivalent Samples Act, is intended to prevent branded drug companies from using tactics to delay competition from cheaper generic drugs. It is co-sponsored by a set of unusual bedfellows in both parties. The bill therefore could be a rare instance in which Congress acts against high drug prices, something the public rates as a top priority in polls. Pharmaceutical companies are pushing back and lobbying against the measure, arguing it would harm patient safety and open companies up to wasteful lawsuits.

• Health Care Companies Mulling What to Do with GOP Tax Bill Benefits  Modern Healthcare by Shelby Livingston — For-profit healthcare companies last week were buzzing about the savings they expect to reap from the Trump administration's sweeping tax overhaul, which reduced the corporate tax rate to 21 percent from 35 percent. Details were sparse on just how much they expect to save due to the lower tax rate — although the Express Scripts CEO said the pharmacy benefit manager would see a $850 million reduction in taxes thanks to the changes. The St. Louis-based PBM's 2016 net income totaled $3.4 billion. "We will not be sitting on that cash, I can promise you that," Express Scripts CEO Tim Wentworth said at the J.P. Morgan Healthcare Conference in San Francisco last week. Other companies promised a deeper look at savings when they announce fourth-quarter 2017 financial results in the next month. Payers are already considering what to do with the extra funds, but it's unclear if customers will benefit from those savings in the form of lower insurance premiums.
  
  
• Tax Break Helps UnitedHealth 4Q Earnings, 2018 Guidance Soar  Associated Press by Tom Murphy — UnitedHealth Group's earnings more than doubled in the final quarter of 2017, and the nation's largest insurer hiked its forecast well beyond expectations largely due to help from the federal tax overhaul. UnitedHealth said Tuesday that it added $1.2 billion in 2017 non-cash earnings, as its fourth-quarter and full-year corporate tax rates were cut. The $1.5 trillion tax cut plan that Republican lawmakers and President Donald Trump sped into law last month also has prompted other companies to raise forecasts for the new year and announce employee bonuses. UnitedHealth said it will dedicate most of the benefit it receives from the law to accelerating investments in data analytics and technology.

Editor: Peter Van Vranken