Good morning ... I will not write an intro about how absurd the D.C. Streetcar is, I will not write an intro about how absurd the D.C. Streetcar is, I will not write an intro about how absurd the D.C. Streetcar is ...
You might have thought the Supreme Court upholding the Affordable Care Act’s individual mandate would settle the question of its constitutionality. You might have thought Congress repealing the mandate would satisfy its critics.
Well, buddy, Texas Attorney General Ken Paxton has some news for you.
The latest: Paxton and 19 other Republican attorneys general filed a lawsuit late yesterday claiming — once again — that the individual mandate is unconstitutional and that the rest of the ACA has to fall along with it.
Here’s how the logic of this argument plays out:
Quick take: With no enforcement mechanism in place for the mandate, it’ll be a lot harder to convince a court that it’s harming anyone — a key component of having the legal standing to sue.
Trump says the U.S. should bring back mental institutions. Photo: Chip Somodevilla/Getty Images
In his response to the Parkland school shooting, President Trump has repeatedly called for bringing back "mental institutions." And the facilities he's describing sound a lot like the state psychiatric hospitals of old, which mostly just warehoused mentally ill patients without helping them get much better.
What they're saying: There's very little desire to bring back psychiatric hospitals. But some experts told my colleague Caitlin Owens and me that they hope Trump's comments might lead to a broader reevaluation of the mental health system's capacity.
Notable: I asked Gionfriddo if Trump's rhetoric about mental institutions has helped or hurt. He says it would all depend on the resultant policy actions.
Pharmacy benefit managers have been on the hot seat for a while now over their role in the country’s drug pricing debate.
Driving the news: My colleague Bob Herman plans to keep a close eye on Arkansas, where so many people are angry at PBMs that legislators now want them regulated by the state’s insurance department, per the Arkansas Democrat-Gazette.
Why it matters: There are a lot of independent pharmacists in other states who are equally unhappy with PBMs, and could begin to make similar pushes in their own state legislatures.
It’s only been about two years since Congress wrote a whole new payment system for Medicare — one that aimed to move away from the existing model of paying for each service, and toward a more coordinated system of care.
Yes, but: The health care team at the Brookings Institution says the new system isn’t working out. In a blog post at Health Affairs, they lay out what’s wrong and how Congress should fix it.
The problems, according to Brookings’ experts:
Go deeper: You can read the whole treatise here.
Remember when he became infamous for buying the drug Daraprim and jacking up the price by 5,000%, to $750 per tablet? Quick note from Bob: The list price on Daraprim is still $750 per tablet.
The bottom line: Political outrage and congressional hearings not only failed to change the broader drug pricing system, they haven't even changed the price of the individual drug they were so focused on.
What we’re watching today: Senate HELP Committee hearing on the opioid crisis (10am; livestream)
House Judiciary subcommittee hearing on the CVS-Aetna acquisition (1:30 pm; details). House Budget Committee hearing on oversight of the Congressional Budget Office; one of CBO’s senior health analysts is scheduled to testify (10am; livestream).
Ways and Means chairman Kevin Brady and Rep. Richard Neal, the panel’s top Democrat, plan to send out a request for information today to several sectors of the health care industry, seeking input about ways to combat the opioid epidemic.
What we're watching this week: Energy and Commerce holds an opioid hearing tomorrow.
Do you have any new ideas for ACA lawsuits? Let's hear 'em! email@example.com.