Good morning ... Situational awareness: The Senate's vote on opioids legislation, initially scheduled for this week, will slip to next week.
Pro-Medicaid protesters on Capitol Hill. Photo: Bill Clark/CQ Roll Call via Getty Images
The Affordable Care Act’s insurance exchanges have been the law's headline feature over the past eight years, but the law’s Medicaid expansion has covered just as many people, and its rolls are more likely to grow under the Trump administration.
Driving the news: Roughly 8.8% of Americans were uninsured last year, according to new Census figures released yesterday — essentially unchanged from 2016. That means the Trump administration has not kept the ACA’s coverage gains going, nor has it successfully rolled them back — at least, not yet.
However you slice it, states that expanded Medicaid cover more people, with more stability.
What’s next: The Trump administration has mostly muddied the waters for the ACA's exchanges, rather than blown them up. Its biggest threat to the Medicaid expansion is its willingness to approve work requirements for the program.
Yes, but: More states are also likely to opt into the expansion this year or next, and work requirements are facing a challenge in the courts.
HHS Secretary Alex Azar spoke with Bloomberg yesterday about drug prices, and one particular quote stood out to my colleague Bob Herman. It’s tied to the still-mysterious proposal to alter drug rebates:
“There will be margins, there will be businesses,” [Azar] said, implying the changes aren’t designed to dismantle companies. “They will reorient their business models, and the channel will reorient around any changes we make to the rules of the road.”
Between the lines: Some analysts have wondered if Azar would make drug rebates illegal altogether, considering that pharmacy benefit managers have been an easy political target in the drug pricing debate.
But Azar's comments indicate that PBMs aren't going to face catastrophic change — and that the administration may be overselling some of its drug pricing reforms.
Situational awareness: Azar also spoke to Wall Street investors and pharmaceutical companies yesterday at the Morgan Stanley Global Healthcare Conference in New York. There was no public livestream, and audio/transcript of his speech was not immediately available.
He's slated to speak this afternoon at the Financial Times' Pharma Pricing and Value Summit.
Apple expanded its health care footprint yesterday with its latest Apple Watch, adding features that can monitor users' heart rates and also detect falls.
The big picture: Apple is carving out a consistent niche for itself as the tech industry more broadly searches for ways into the health care market.
There are limits to the watch's new capabilities. The Food and Drug Administration signed off on Apple's heart-monitoring features, but said consumers should use them "for informational purposes only" and should not use them as the basis for any clinical decisions without consulting a doctor first.
Doctors said the new features could help patients quickly identify an irregular heartbeat, but could also lead to false positives and over-treatment.
Voters say pretty much everyone in Washington is dropping the ball on prescription drug prices, according to a new survey from the nonpartisan West Institute and NORC at the University of Chicago.
By the numbers: 50% of those surveyed said they disapprove of the way congressional Republicans are handling drug prices, compared with 46% disapproval for Trump and 43% for congressional Democrats.
Three specific policy proposals scored an approval rating of 80% or higher: direct Medicare price negotiations, more generics, and “requiring drug companies to release information to the public on how they set their drug prices.”
Echoing a slew of other polls, this survey also found that health care — and costs, specifically — is one of voters’ top concerns in the midterm elections.
Medication-assisted therapy is gaining more widespread acceptance as an effective treatment for opioid addiction, but there’s still at least one important holdout: “recovery houses” where people battling addiction live together.
Why it matters: Public health experts have largely praised the growing acceptance of medication-assisted therapy, especially from some of the Trump administration’s top health care officials. But there’s still a stigma to overcome, despite evidence these products can make a big difference for people in recovery.
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