Overnight Health Care — Presented by Coalition Against Surprise Medical Billing — Judge blocks Trump 'public charge' rule | Appeals court skeptical of Trump arguments for Medicaid work requirements | CDC offers guidance for treating vaping-related cases

Welcome to Friday’s Overnight Health Care. 

The Trump administration was dealt a defeat in court over its public charge rule, the CDC has released new guidance for clinicians whose patients might have lung illnesses related to vaping, and Medicaid work requirements were back in court.  

We’ll start with the public charge rule:  


Judge blocks Trump ‘public charge’ rule

The Trump administration was dealt a blow Friday when a federal judge in New York temporarily blocked the “public charge” rule linking immigrants’ legal status to their use of public benefits.

Judge George Daniels of the U.S. District Court for the Southern District of New York issued a temporary nationwide injunction stopping the administration from enforcing the requirements, as well as a stay of the effective date.

The rule was scheduled to take effect Oct. 15.

In his 24-page ruling, Daniels, a Clinton appointee, said the Trump administration likely exceeded its authority. 

“Defendants do not articulate why they are changing the public charge definition, why this new definition is needed now, or why the definition set forth in the rule — which has absolutely no support in the history of U.S. immigration law — is reasonable,” he wrote. “The rule is simply a new agency policy of exclusion in search of a justification.”

While advocates cheered the ruling, the stay is only temporary until the court can rule on the merits of the rule. The Justice Department is also likely to appeal.

“An objective judiciary will see that this rule lies squarely within long-held existing law,” Acting Director of U.S. Citizenship and Immigration Services Ken Cuccinelli said in a statement. “The public charge regulation defines this law to ensure those seeking to come or stay in the U.S. can successfully support themselves financially and will not rely on public benefits as they seek opportunity here.”

Flashback: The public charge rule has been a priority of immigration hard-liners in the administration, especially White House adviser Stephen MillerStephen MillerOvernight Health Care: Trump attacks ‘Medicare for All’ in Florida | Lawsuit from separated children, families seeks damages | Cases of vaping-related illness top 1,000 Lawsuit by ‘traumatized’ separated children and families seeks damages from Trump administration Trump suggested shooting migrants in the legs: NYT MORE. Under the rule, any immigrant who receives at least one designated public benefit– including Medicaid, food stamps, welfare or public housing vouchers — for more than 12 months within any three-year period will be considered a “public charge” and will be more likely to be denied a green card by immigration officials. The rule would also examine the likelihood of an immigrant using such benefits in the future. 

Read more here.

In other court news…


Appeals court skeptical of Trump arguments for Medicaid work requirements 

It was not a good day in the courts for the Trump administration. A federal appeals court on Friday sounded dubious about the Trump administration’s authority for imposing work requirements on Medicaid beneficiaries. 

The three-judge panel repeatedly pressed a Trump administration attorney on whether the Department of Health and Human Services considered how many people would lose coverage if they were subjected to Medicaid work requirements.

The administration said a previous court was wrong to block work requirements in Kentucky and Arkansas, and argued that work requirements will allow beneficiaries to transition to other forms of coverage, and will free up state funding from people that may not need it. According to administration attorney Alisa Klein, conserving a state’s “finite resources” by having people get coverage from an employer or from the ObamaCare marketplace fulfills the objectives of the Medicaid program.

Key quotes: The justices sounded skeptical.

“The other things you say may be laudable goals, but to say they outweigh the principal goal [of Medicaid] seems a bit strange,” said Judge David Sentelle, appointed by President Ronald Reagan and the only Republican on the panel.

Judge Harry Edwards, who was appointed by President Jimmy CarterJimmy CarterGarth Brooks on Jimmy Carter’s volunteer work: ‘Nobody cares about “Republican” or “Democrat” in heaven’ Jimmy Carter calls out Trump administration for ‘trying to stonewall’ impeachment inquiry Jimmy Carter back to building homes for Habitat for Humanity one day after fall MORE, said Klein never addressed the central issue that Medicaid experiments must promote coverage. “There are adverse effects. People are going to lose coverage. You haven’t addressed that,” Edwards said. “You can’t point to other objectives. The principal objective [of Medicaid] is coverage.”

Read more on the arguments here.

CDC issues new guidance for doctors treating vaping-related illnesses

The Centers for Disease Control and Prevention (CDC) released new guidance Friday for clinicians whose patients might have lung illnesses related to vaping.

Because the illness is new, there had been no guidelines for how clinicians should treat patients suspected of having the illness.

Having official guidance from the CDC becomes more important as the U.S. enters the flu season, officials said Friday.

Several symptoms of the flu and other viral infections overlap with those associated with the vaping illness.

As such, all patients with apparent respiratory infections, like the flu, should be asked about their vaping history. 

Context: Some symptoms experienced by patients with the vaping illness include: cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhea, fatigue, fever or weight loss. … Sounds like the flu. 

That’s why the CDC is recommending that clinicians ask all flu-presenting patients about their vaping history. 

Read more here.


Hoyer: ‘Possible’ House votes on drug pricing bill week of October 28

Get ready for some (possible) drug pricing action towards the end of this month. 

House Majority Leader Steny HoyerSteny Hamilton HoyerTrump attacks ‘Medicare for All’ in Florida, accuses Dems of wanting to fund ‘socialism’ Poll: 54 percent say House should cancel recess, start impeachment proceedings quickly Bottom Line MORE (D-Md.) wrote in a letter to colleagues that it is “possible” the House will vote on Speaker Nancy PelosiNancy Pelosi‘Off-script’ Trump rails against impeachment, Democrats at feisty rally Overnight Health Care — Presented by Coalition Against Surprise Medical Billing — Planned Parenthood charges into 2020 | PhRMA CEO warns against Pelosi drug pricing bill | Medicaid work requirements costing states millions On The Money: Trump to meet China’s vice premier during trade talks | Appeals court says Deutsche Bank doesn’t have Trump’s tax returns | House Appropriations Chair Nita Lowey to retire MORE‘s (D-Calif.) signature drug pricing bill the week of Oct. 28.

The committees of jurisdiction would mark up the legislation before then. 

The question: House leaders want to move quickly on the legislation, one of their top legislative priorities. One question is whether they can reach a deal for some changes to the bill with progressive House Democrats, who have objected that the measure does not go far enough. 


Appeals court upholds preliminary injunction against Ohio abortion ban 

A federal appeals court on Friday ruled Ohio cannot enforce a law that would block doctors from performing abortions if the mother is seeking one because of a down syndrome diagnosis.

A panel of the Court of Appeals for the Sixth Circuit in a 2-1 decision upheld a preliminary injunction issued by a lower court last year blocking the state from enforcing the law. 

The state is expected to appeal the decision to the full court. 

Former Gov. John Kasich (R) signed the law in 2017 after the measure passed the state’s Republican-controlled legislature.  

Under the law, a doctor could face felony charges if they perform an abortion knowing the mother wants one because the fetus has, or might have, down syndrome. 

The court ruled Friday the law is likely unconstitutional and shouldn’t be enforced while legal challenges continue. 

Some states have passed similar laws hoping to press the Supreme Court to revisit Roe v. Wade, the landmark ruling that established the right to an abortion. 

But the Supreme Court in May declined to hear an appeal of a similar law from Indiana. 

Supreme Court Justice Clarence ThomasClarence ThomasSupreme Court can prove its independence — or its partisan capture Supreme Court session begins without ill Clarence Thomas Supreme Court abortion case poses major test for Trump picks MORE dissented, writing that the law promoted the state’s “compelling interest in preventing abortion from becoming a tool of modern-day eugenics.” 

Ohio was also blocked this year from enforcing a separate “heartbeat” law that would ban abortions at about six weeks into pregnancy.  

Read more here.

What we’re reading

Trump’s smoke-and-mirrors 2020 health care strategy (Axios

Wasted health care spending in the U.S. tops annual defense budget, study finds (CBS)

A patient hopes gene-editing can help with pain of sickle cell disease (NPR)

Some patients with vaping-related lung injuries are being hospitalized a second time (The Washington Post)


State by state 

Colorado has a new plan to bring a “public option” of sorts to the state level (Vox.com)

John CornynJohn CornynGOP requests update on criminal referrals prompted by 2018 Kavanaugh probe Bottom Line NBA draws bipartisan backlash over China response MORE garners both criticism and credit for wading into fractious debate over drug-pricing legislation (Dallas Morning News

California’s new transparency law reveals steep rise in wholesale drug prices (California Healthline)

Medicaid petition meets goal of 178,000 signatures, campaign says (The Oklahoman)

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