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Healthcare is on the ballot on Election Day. Tomorrow voters in several states will face measures on whether to expand Medicaid to low-income people, whether to place restrictions on abortion, and whether to cap off profits for dialysis centers in California, among many others. Here’s a guide to 2018 ballot measures.

Right after the election, a judge will decide the fate of Medicaid expansion in Maine. There is no time for any election night hangovers in the healthcare world! A Maine judge will hear oral arguments on Wednesday over Republican Gov. Paul Lepage’s effort to block the Medicaid expansion in his state. Maine’s voters approved the expansion in 2017 but it did not include a funding mechanism and LePage, who leaves office next year because of term limits, has blocked implementing the expansion. A group called Maine for Equal Justice sued LePage for blocking the expansion. The legal battle will take place a day after voters in four states (Nebraska, Idaho, Montana, and Utah) will decide whether to expand Medicaid. Nebraska and Idaho do not contain a funding mechanism but the other states do.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email [email protected] for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Trump says Jeff Sessions gave him no warning on Obamacare lawsuit. Attorney General Jeff Sessions did not notify President Trump that the Department of Justice would join a lawsuit challenging Obamacare’s rules on pre-exising conditions, the president told Axios on HBO.

“No, he didn’t,” Trump said when asked whether Sessions had given him the head’s up about the decision. That claim goes against Sessions’ recollection of events — he told House Speaker Paul Ryan in June that Trump approved of the move. The case, Texas v. Azar, is awaiting a decision in the U.S. District Court for the Northern District of Texas, and is likely to be appealed. It has been a major rallying cry for Democrats ahead of the midterm elections, who have seized on the lawsuit to warn voters that Republicans will go after their healthcare. But Trump said in the interview that “it wouldn’t matter” if the court throws out the rules, because a Republican replacement will protect pre-existing conditions. “If we terminate it, we will put pre-existing conditions back in,” Trump said, promising to “get it done.” Republican replacement plans in Congress have contained similar language as Obamacare for protecting sick people, but omit other portions to make coverage affordable to them. The protections poll well, but because of the way Obamacare was written, certain customers are priced out of the market entirely. Conservative groups have recommended that Republicans go about the protections entirely differently than Obamacare by setting up a fund that would directly pay for the sickest customers. Democrats have offered certain proposals that would funnel more government funds to the market, and others that would put more people onto public coverage.

Can marijuana save Claire McCaskill? Down-ballot initiatives, including three medical marijuana proposals, could help boost voter turnout for Democratic Sen. Claire McCaskill in her fight against Republican challenger Josh Hawley to represent Missouri in the Senate. McCaskill, a centrist, needs young people and progressive voters next week to drive up her margins of victory in Missouri’s urban centers in case she doesn’t win enough support from rural areas to beat Hawley, the state’s attorney general. Having pot on the ballot may just get her over the line, according to some students in the state.

Approval of powerful opioid likely to increase scrutiny of FDA. Activists and Democrats are livid with the Food and Drug Administration’s decision to approve the most powerful opioid ever, hinting at a possible probe into the way the agency oversees drug approvals. The FDA on Friday made the controversial decision to approve the powerful opioid Dsuvia, which would be administered only in a medical setting. The approval drew a sharp rebuke from Senate Democrats and activists worried about another powerful version of the opioid fentanyl hitting the streets, and they are concerned that the agency did not involve a key safety committee in the approval process.

FDA to hold meeting on e-cigarette use among youths. The Food and Drug Administration announced on Friday it will hold a meeting on Dec. 5 to address the agency’s crackdown on e-cigarette use among minors. The hearing will focus on “the need for drug therapies to support youth cessation of other tobacco products, including combustible products, such as cigarettes or cigars, or smokeless tobacco products,” FDA Commissioner Scott Gottlieb said in a statement on Friday. The agency has cracked down on e-cigarette use among minors in recent months, sending warnings to more than 1,000 retailers for sales to minors. Gottlieb has also threatened to end sales of e-cigarettes in convenience stores unless major e-cigarette makers put together a plan to curb minor e-cigarette use.

House lawmakers call for more monkeys to be released from medical testing. The FDA’s Animal Welfare Council should recommend more retirements for monkeys who are being used for medical research, Reps. Matt Gaetz, R-Fla., and Brendan Boyle, D-Pa., said in a letter to Gottlieb. Earlier this year the FDA stopped primate testing for medical research on nicotine, and the animals are being moved to a sanctuary in Florida. The council was created as a result of that decision and FDA said at the time that it was “working to reaffirm and strengthen our commitment to replacing, reducing, and/or refining animal studies.”

Chuck Schumer: Great job numbers ‘will mean little’ to families. Stellar job numbers released Friday won’t mean much to the average American family because of other GOP policies, Senate Minority Leader Chuck Schumer, D-N.Y., said. Schumer, in a statement released hours after the Labor Department reported employers added 250,000 jobs in October, more than 30 percent higher than expected. He acknowledged the numbers “may look good,” but said they “coexist” with GOP tax cuts that are increasing the deficit. He also warned Republicans will end Obamacare. “The latest jobs numbers may look good but we must not forget they coexist with a huge deficit-ballooning GOP tax break that went mainly to the wealthy for which we will pay a price for down the road,” Schumer said. “When the average family sees their health care costs go up because of Republican actions, these numbers will mean little.”

Scott Walker on the defensive over pre-existing conditions. Republican Gov. Scott Walker is being hit hard by Democrats over whether he’ll protect health insurance coverage for people with pre-existing conditions, putting him on the defense days before Wisconsin voters decide whether to give him a third term. At several campaign stops, Walker called Democrats’ attacks that he would not protect one of the most popular pillars of the Affordable Care Act untrue. Walker has been a longtime opponent of the healthcare law, permitting Wisconsin’s attorney general to join a multistate lawsuit in February to overturn it. However, as he fights for his political survival, he told reporters Thursday he wants to adopt a portion of the law as it stands now. “People want to know, they want to hear it directly from me that we will always cover people with pre-existing conditions,” Walker told reporters. “No matter what happens in the courts or in Congress, in Wisconsin we’ll codify that, with the exact same language that’s in the Affordable Care Act, we’ll make sure that everyone living with pre-existing conditions is covered here in the state.”

Judge shuts down insurer peddling worthless “Trumpcare” plans. A federal judge on Friday temporarily shut down a Florida-based insurer for collecting more than $100 million selling essentially worthless health plans that were marketed as “TrumpCare.” The Federal Trade Commission said on Friday it had filed the complaint against Simple Health Plans LLC for misleading consumers into getting what they thought was comprehensive insurance but really turned out to be worthless. “Many consumers were misled into thinking they had purchased comprehensive health insurance, but when they needed to rely on that insurance, they learned they had none of the promised benefits,” said Andrew Smith, the director of the FTC’s Bureau of Consumer Protection, in a statement. The insurer allegedly claimed that consumers were getting a comprehensive plan that covered pre-existing conditions, prescription drugs, doctor visits and surgical procedures, FTC said. But, in actuality, they got a medical discount program or a very limited benefits program.

Trump administration’s cuts infuriate the hospital lobby. Hospital groups are threatening to sue the Trump administration for cutting Medicare payments for visits to clinics residing in hospitals. The Centers for Medicare & Medicaid Services released a final rule on Friday outlining the cut to reimbursements for outpatient hospital departments, which include clinics or surgical centers. CMS lowered the reimbursements for such clinic visits to bring them in line with the reimbursements it gives out for visits to regular doctors’ offices, which are lower. But a few hours after the rule was released on Friday, the American Hospital Association threatened to sue the administration over the “ill-advised” cuts. Currently, the average Medicare payment for a hospital-based clinic visit is about $116, and the senior’s copay of that amount would be $23. But under the new cut, Medicare would pay $81 and the copay would be $16.

More people die from drug overdoses than in 2017 than guns, murders or car accidents. Drug overdoses led to more deaths in the U.S. in 2017 than any year on record and were the leading cause of death in the country, according to a Drug Enforcement Administration report issued Friday. More than 72,000 people died from drug overdoses in 2017, according to the NIH — about 200 per day. That number is more than four times the number who died in 1999 from drug abuse: 16,849. The figures are up about 15 percent from 63,632 drug-related deaths in 2016. Since 2011, more people have died from drug overdoses than by gun violence, car accidents, suicide, or homicide, the DEA report stated. The DEA attributed last year’s uptick in deaths to a spike in opioid-related fatalities. The agency said 49,060 people died as a result of abusing opioids, up from 42,249 in 2016.

Pediatricians call for spanking ban. The American Academy of Pediatrics said Monday that spanking, hitting, and slapping were harmful for children and don’t work. “There’s no benefit to spanking,” Dr. Robert Sege, one of the authors of the policy, said in a statement. “We know that children grow and develop better with positive role modeling and by setting healthy limits. We can do better.” To bolster its position, AAP pointed to studies suggesting a correlation between spanking and aggressive behavior, and others that suggested children who have been spanked develop mental health issues during their teens. The group recommended that pediatricians advise patients against spanking and said its members should advocate against it in cities and states.

RUNDOWN

Kaiser Health News Tobacco tax battle could torch Montana Medicaid expansion

Roll Call GOP candidates are hearing it from constituents with pre-existing conditions

STAT News The FDA, but with guns: How far should a little-known office go to track down counterfeit drugs?

Washington Post A shocking number of U.S. women still die of childbirth. California is doing something about that

Politico Would Republicans take another shot at repealing Obamacare?

Milwaukee Journal-Sentinel Leah Vukmir-linked group disparaged Obamacare’s pre-existing condition protections

The Hill Medicare administrator violated Hatch Act, says watchdog group

Associated Press Virginia facing high unexpected Medicaid costs