Good morning … Vitals and I are both taking the rest of this week off for a prolonged celebration of July 4, which is the best holiday of the year. But my colleagues Bob Herman and Caitlin Owens will have you covered at axios.com.
Photo: Zach Gibson/Getty Images
The next Supreme Court justice could usher in significant changes to Medicaid, giving states far more power to cut the program, Caitlin reports.
The issue: Many conservative lawyers and judges say private entities — like health care providers — shouldn't be able to sue over Medicaid's coverage decision. If that view ultimately prevails, states could make much bigger cuts without the threat of a lawsuit.
Where it stands: Retiring Justice Anthony Kennedy “was willing to leave the courthouse doors open in Medicaid cases, whereas the conservative majority is willing to shut it — I mean, really slam it," said Sara Rosenbaum, a George Washington University law professor.
The impact: If the right to sue goes away, “it's certainly possible that a state would start hacking away at its program. There would be no deterrence at all," Rosenbaum said.
What to watch: Kansas, Louisiana and Arkansas are all in the midst of litigation over whether Planned Parenthood can sue them for kicking it out of their Medicaid programs.
Go deeper: Read Caitlin's full story.
So much for voluntary drops in drug prices.
Many pharmaceutical companies this week trotted out fresh price increases on existing products, a common mid-year occurrence that has not abated despite the Trump administration’s assertions that prices are coming down.
Why it matters: As we’ve reported over and over again, the pharmaceutical industry’s practices have not changed one iota even with the administration’s pricing blueprint, and drug companies still have every incentive to raise prices.
The Trump administration yesterday confirmed some of the trends we had all suspected about enrollment in the individual insurance market: It’s way down among people who don’t receive the Affordable Care Act’s premium subsidies, but basically stable for people who do.
The details, per the Centers for Medicare & Medicaid Services report:
The big picture: This is more evidence that the ACA is becoming a vastly scaled-back version of what it was intended to be.
Go deeper: The ACA is smaller, weaker and more liberal than former President Obama intended.
Amazon is buying PillPack for $1 billion. Photo: PillPack
Amazon may be buying PillPack, but it still has a long way to go if it wants to drastically change the drug supply chain, Bob reports this morning.
The unresolved issue: Payment. Uninsured people or patients willing to pay cash for their prescriptions can easily switch to PillPack, but that is a tiny part of the market.
The bottom line: Pharmacies are tethered to PBMs. That means Amazon will have to play ball with the big guns that often create favorable contracts for themselves, or "Amazon needs to buy a PBM (which is possible) to have a meaningful impact on market share," Ann Hynes of investment bank Mizuho Securities USA wrote in a note to Wall Street.
Yes, but: Amazon has 100 million Prime members who very well could demand their prescriptions be covered through Amazon's pharmacy.
Illustration: Lazaro Gamio/Axios
Axios' Dan Primack scooped some financial information yesterday about Juul, the vaping company whose products are incredibly popular with young people, that helps explain investors' interest in the company.
Driving the news: Juul is raising $1.2 billion at a valuation of around $15 billion.
By the numbers:
Behind the numbers, via Dan: These numbers would normally make Juul a no-brainer for venture capital and growth equity types, particularly given that the San Francisco-based company hasn't yet tapped overseas markets other than Israel.
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Happy 4th! Eat a hot dog. Drink a beer. Admit that fireworks are cool. Hurrah. See you next week.