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Will Obamacare stabilization rise from the (near) death? While pessimism swirls around the prospects for adding the bills to the omnibus, lawmakers hint that the effort isn’t over. Walden told reporters Monday “we’re not done here. “Sens. Alexander, [Susan] Collins and [Lindsey] Graham are still trying to find a vehicle to prevent what would be a pretty substantial rate hike.” What that vehicle is not clear. The omnibus is likely to be the last must-pass legislation that Congress considers this year. It is highly doubtful that the legislation would pass by itself because of massive objections from House Republicans and new objections from Democrats over Hyde. But things aren’t a done deal if a last-minute deal on Hyde language can be reached. Collins said she is still talking with Democratic Sen. Patty Murray about the dispute. “We have explained what the intent is. I am pro-choice and I would not be supporting legislation what I thought would be unreasonable burdens on a woman’s right to choose,” Collins told reporters Monday. “It has always been the case that federal funds cannot be used for abortion since the Hyde Amendment passed in the mid-70s.”

CBO: Obamacare funding bill would increase deficit by $19 billion. The legislation released Monday would increase the deficit by more than $19 billion over a decade, according to a report from the Congressional Budget Office and Joint Committee on Taxation. The agencies project that the legislation, if passed, would increase the number of people with health insurance coverage by fewer than 500,000 in each year from 2019 through 2022, though it would lower premiums by roughly 10 percent in 2019 and by an average of 20 percent in 2020 and 2021. Republicans supportive of the Obamacare bill noted that the CBO/JCT estimates didn’t take into account that the federal subsidies are not being paid. The alternative score showing this reality would “pay for itself,” they said in a joint statement. “The report also says that the proposal will not add a penny to the federal debt, if the agency’s scoring is based on real spending — which shows that Obamacare subsidy spending has increased since cost-sharing reduction subsidies are not currently being paid,” Sen. Lamar Alexander, R-Tenn., Sen. Susan Collins, R-Maine, House Energy and Commerce Committee Chairman Greg Walden, R-Ore., and Rep. Ryan Costello, R-Pa., said in a joint statement.

Abortion clinic sues after Mississippi sets 15-week abortion ban. Mississippi Gov. Phil Bryant on Monday signed a bill into law that would ban abortions after 15 weeks, the most restrictive in the U.S. The law provides exemptions if a fetus would be unable to survive outside the womb or if a pregnant woman’s life or “major bodily function” is threatened. It does not provide exemptions for rape or incest. Shortly after Bryant signed the ban into law, the Center for Reproductive Rights filed a lawsuit on behalf of the only abortion clinic in the state, Jackson Women’s Health Organization. The Center for Reproductive Rights is asking the court to block the ban from going into law, saying it was unconstitutional. It pointed to Roe v. Wade, the 1973 Supreme Court case that made abortion legal nationwide, to bolster its argument because the law specifies that states are not to ban abortions up to “fetal viability.”

Trump mulls anti-opioid ads to ‘show how bad it is for the kids.’ The Trump administration has introduced a website where people can share their personal stories about the dangers of opioid addiction, and will soon air commercials to educate children about the issue. “We are thinking about doing really a large-scale rollout of commercials that show how bad it is for the kids,” Trump said at an event in New Hampshire. “And when they see those commercials, hopefully they are not going to be going to drugs of any kind. And we’ll save a lot of lives and we’ll make their lives a lot easier.” The website, crisisnextdoor.gov, contains videos from administration officials, including Surgeon General Jerome Adams, who shared the story about his brother’s addiction and imprisonment. The site provides a button for people to share their stories through videos.

White House wants more funding for fighting opioids. The White House wants more than double the funding Congress is expected to provide to fight the opioid epidemic. White House counselor Kellyanne Conway told reporters on Air Force One Monday that it wants $13 billion to fight the opioid crisis, far more than the $6 billion over two years that Congress is considering. Conway made comments while traveling with President Trump to New Hampshire. The $6 billion over two years that Congress is considering is expected to be used for treatment.

Charges for drug dealers rise as Trump calls for tougher actions. Prosecutors have increasingly been pressing charges against dealers who sell opioids that kill people, a trend they say is necessitated by the drug epidemic. However, advocates of treatment-first policies are worried the charges are counterproductive. Many of the charges are for involuntary manslaughter, which carry heavier punishments than drug charges, and have been waged not only on high-level drug traffickers but on family members and friends. Some have been been found guilty of unintentional homicide, and have been sentenced to prison for decades or for life without parole. Law enforcement officials stress they believe their work is only one prong of a broader strategy that will be needed to combat opioid overdoses. “This is just one quiver in the arsenal,” said Saleh Awadallah, supervising assistant county prosecutor for Cuyahoga County, Ohio. “Our approach is a multi-faceted approach. That seems more reasonable than saying, ‘Let’s not prosecute anyone, let’s treat our way out of this.’”

Opioid epidemic costs D.C., West Virginia the most: analysis. Washington and West Virginia have felt the biggest economic burden of the opioid epidemic, according to an analysis from the right-leaning think tank American Enterprise Institute. The economic burden from the epidemic was $504 billion in 2015, according to federal data. The think tank looked into where those costs were incurred, and found that West Virginia had the highest per-person cost at $4,378. The District of Columbia came in second at $3,657. Those costs were the sum of healthcare, productivity loss and criminal justice costs for a locality. New Hampshire came in third at $3,640, and was followed by Ohio at $3,385, and Maryland at $3,337. Nebraska had the lowest per person total cost at $394.

House committee introduces bill to revamp over-the-counter drug approval system. House lawmakers released legislation Monday aimed at updating the outdated system that the Food and Drug Administration uses to approve over-the-counter drugs. An OTC drug has to conform to a monograph that outlines the dose, formulation and labeling for a drug to be sold. Any drug that conforms to that monograph can be manufactured and sold without approval from the FDA. The problem is that the system hasn’t been updated or completed and movement on unfinished monographs has been slow, according to a release on the bill. The legislation, called the Over-the-Counter Monograph Safety, Innovation and Reform Act, would create new pathways for monograph products to be approved faster. Reps. Bob Latta, R-Ohio, Michael Burgess, R-Texas; Gene Green, D-Texas; Diana Degette, D-Colo.; Brett Guthrie, R-Ky.; and Debbie Dingell, D-Mich., are the other sponsors of the bill.

Pharma, hospital lobbies go to war over drug discount program. The pharmaceutical and hospital lobbies are dueling to sway lawmakers pondering changes to a drug discount program for some hospitals. Lawmakers are considering changes to the 340B program that in 2016 gave the hospitals $8 billion in drug discounts, representing about 1.3 percent of total drug spending. At the crux of the argument is how those discounts are being used. The program requires drugmakers to provide discounts to eligible hospitals, including teaching hospitals, children’s hospitals, facilities that provide charity care, and those that serve rural areas. But drug companies and some lawmakers charge that hospitals are misusing the discounts. Lawmakers are pushing for more clarity on the program’s mission, since it has evolved since it was created in 1992. “There needs to be more clarity about what the program allows and doesn’t allow,” said Sen. Lamar Alexander, R-Tenn., during a hearing last week of the Senate Health, Education, Labor and Pensions Committee.

Senators seek meeting with HHS secretary on healthcare payment reform. Sens. Bill Cassidy, R-La., and Sheldon Whitehouse, D-R.I., want Health and Human Services Secretary Alex Azar to share his plans for payment reform. The letter comes as Cassidy and other senators are pushing legislation to increase transparency for prices for healthcare procedures. The letter said Azar has a vital role since he oversees Medicare, a major purchaser of healthcare. “You have an opportunity to galvanize action among public and private healthcare stakeholders by setting clear and measurable targets for payment reform, and corresponding goals for quality improvement and reducing costs,” the letter said. “We urge you to take up the cause, and to do so explicitly and thoughtfully.” The letter comes a few weeks after Azar spoke about the need for more transparency surrounding pharmacy benefit managers, which oversee drug plans for employer-sponsored plans, which secretly negotiate rebates with drug makers.

RUNDOWN

Axios How the ACA changed Americans’ incomes

NPR Lawmakers weigh mandatory screenings for postpartum depression

STAT News FDA, industry ponder changes to clinical trials for rare disease treatments

Washington Post Trump talked tough on drugs. But applying the death penalty to traffickers is even tougher

Healthcare Dive AMA survey says prior authorizations are hurting clinical outcomes

Associated Press Florida governor signs major bill to combat the opioid crisis

Kaiser Health News Congress is tackling the opioid epidemic, but how much will it help?

Reuters FDA seeks data on role of flavors in tobacco addiction