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Alexander-Murray push for adding Obamacare money to spending deal. Senators must overcome disagreements on funding for two bills aimed at stabilizing Obamacare to get the legislation ready to add to a must-pass spending bill next month. Democrats are pushing to add money to boost income-based subsidies to a bill co-sponsored by Sen. Lamar Alexander, R-Tenn., and Sen. Patty Murray, D-Wash., to lower the cost of insurance on Obamacare's marketplaces, a Democratic aide said. The bill would restore Obamacare insurer payments in return for states getting more latitude to waive Obamacare insurer regulations. Some Republicans are doubtful that more money can be added to the legislation. Democrats also want to restore advertising and outreach funding cut by the Trump administration for open enrollment last year. The administration cut funding by 90 percent to $10 million for the 2018 open enrollment period, which ended last year, from $100 million for the 2017 open enrollment period under the Obama administration. Alexander said he and Murray are discussing changes to the bill now. “We need to come to a prompt conclusion on our proposal so it can be part of the omnibus,” Alexander said, referring to the two-year budget bill that the senators hope to use as a vehicle to pass the bills. “We are gonna be trying to do that in the next few days.” Sen. Susan Collins, R-Maine, who is behind one of the two bills, added that she didn’t think it was feasible to add more money for subsidies to the Alexander-Murray legislation. Collins and Sen. Bill Nelson, D-Fla., sponsored legislation to give states $10 billion over two years to set up a reinsurance program that covers the highest medical claims from Obamacare insurers. The companies in turn would lower premiums overall.

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Trump signs short-term spending bill following overnight partial shutdown. The Senate passed legislation shortly before 2 a.m. Friday, and the House followed up with a 5:30 a.m. vote to keep the government open. The government partially shut down after midnight, and many were blaming Sen. Rand Paul, R-Ky., for refusing to agree to a vote Friday afternoon in order to protest the two-year spending deal that was agreed by Senate leaders. The short-term spending bill will keep the government open through March 23, and it's the first step toward implementing the bigger spending agreement. That deal will end the defense and non-defense sequester for 2018 and 2019, and is expected to boost spending by nearly $300 billion over those two years. The short-term bill passed early Friday also turns off the debt ceiling for about one year, allowing the government to borrow whatever it wants during that period. The legislation includes funding to improve mental healthcare and to address the opioid crisis, funds community health centers for two years and funds the Children's Health Insurance Program for a decade.

Ending Obamacare’s cost-cutting panel actually costs $17 billion. Repealing the Obamacare cost-cutting panel that Republicans have long despised would cost the federal government $17.4 billion over the next decade, the Congressional Budget Office said Thursday. A two-year budget agreement would repeal the Independent Payment Advisory Board, created under Obamacare to cut Medicare if spending gets too high. The price tag for repeal would be $17.4 billion through 2027, according to a CBO estimate on the full budget deal. IPAB has been a target of Republican ire since Obamacare was created. During the debate over Obamacare in 2009, former Alaska Gov. Sarah Palin inaccurately referred to the board as a “death panel” that would cut off seniors from healthcare. In reality, the 15-member panel was created to rein in healthcare costs. If Medicare spending reaches a certain point, the panel meets to trigger certain cuts to the program. Congress can overturn the cuts, but only if it gets a supermajority. The panel was never convened and spending never reached the point to trigger the cuts. However, Republicans and even some Democrats have long hated the panel because it cedes congressional authority over Medicare spending to an outside group.

Other budget deal tidbits. The two-year budget deal included several healthcare items that flew under the radar. In addition to adding funding for medical research, community health centers, the Children’s Health Insurance Program and fighting opioid abuse, the two-year deal:

*Encourages the use of telehealth in healthcare. Sen. Brian Schatz, D-Hawaii, tweeted Friday that the addition of a bipartisan bill would help expand access for people to healthcare, especially in rural areas. “Right now, lots of people have to drive to a hospital or clinic just to have a monitoring device put on some part of their body for a few minutes,” Schatz tweeted. “That should be done in the home”;

*Closes Medicare Part D’s “donut hole” for seniors starting in 2019. The donut hole refers to a coverage gap in Medicare Part D, the law’s prescription drug plan. There is a temporary limit on what the drug plan covers for drugs, according to Medicare. The budget deal closes this gap starting next year;

*Provides nearly $5 billion for Medicaid in Puerto Rico and the Virgin Islands. Puerto Rico Rep. Jenniffer Gonzalez-Colon (R) said on Facebook that the budget deal would fully fund Medicaid for two years, according to a report in The Hill; and

*Eases requirements for providers on implementing electronic health records.

Portman calls for opioid funding to go through opioid law framework. Sen. Rob Portman, R-Ohio, has some ideas on how Congress should allocate the extra $6 billion in funding over two years to tackle the opioid epidemic. Portman said in a statement Friday that the funding should go through the framework created by the Comprehensive Addiction and Recovery Act, which Portman led and was signed into law in 2016. “CARA’s evidence-based programs provide a good framework for how this new funding can be spent effectively, including a number of programs focused on prevention, treatment and recovery programs, as well as programs that provide resources to law enforcement and first responders who are on the frontlines of this epidemic every day,” he said in a statement. It remains unclear how the funding for preventing opioid abuse will be spent.

Flu kills another 10 children, CDC says. The Centers for Disease Control and Prevention said Friday that 10 more children died last week because of a flu season that is showing no signs of slowing down. The CDC said flu has caused the deaths of 63 children so far, and cautioned that the flu season may not have peaked. The agency said the U.S. could be in store for several more weeks of severe influenza. “Flu is incredibly difficult to predict and we don’t know if we have hit the peak yet,” acting CDC director Anne Schuchat said on a call Friday with reporters. Schuchat said the flu usually peaks either around week 11 or week 20 each season, and the current flu season is at week 11. She added that this is shaping up to be a historically severe flu season. The number of outpatient and emergency room visits because of the flu is as high this season as they were at the peak of the 2009 influenza pandemic, the CDC said. Schuchat added that the rate of hospitalizations continues to soar. The CDC started a new method for tracking hospitalizations in 2010. It found overall there have been 59.9 hospitalizations per 100,000 people due to the flu, compared to 35.1 hospitalizations for the previous severe flu season in 2014-2015.

Democrats raise concerns over anti-abortion ties of top civil rights official. Democratic lawmakers are accusing a top Trump administration health official of once having secretly coordinated with the Center for Medical Progress, an anti-abortion group that released edited videos purporting to show that Planned Parenthood was trafficking fetal tissue. The official, March Bell, is the chief of staff for the Office of Civil Rights in the Department of Health and Human Services. Prior to taking on this role, he was staff director and chief council for the Select Panel, a House panel that was investigating whether Planned Parenthood was involved in selling fetal tissue for profit, a practice that is illegal. Democratic representatives are accusing him of secretly coordinating with David Daleiden, founder of the Center for Medical Progress, while in that role. They raised instances of statements Bell allegedly made at the Law of Life Summit, in which he stated that the panel relied on "lots of phone calls with David Daleiden" and also noted that he spoke with anti-abortion activists Troy Newman of Operation Rescue and Mark Crutcher of Life Dynamics during the Select Panel’s investigation. The Democratic lawmakers — Reps. Jan Schakowsky of Illinois, Jerrold Nadler of New York, Diana DeGette of Colorado, Jackie Speier of California, Bonnie Watson Coleman of New Jersey, and Suzan DelBene of Washington — asked that Bell be recused from any cases involving abortion services or the sale of fetal tissue that come before the Office of Civil Rights. “It is clear that Mr. Bell is not an impartial investigator on those topics, and we do not believe he can be trusted to fairly adjudicate any related cases," they wrote.

Four organizations forgo funding following Mexico City abortion policy. The finding comes from a State Department report, showing that 733 organizations received U.S. aid global funding totaling $8.8 billion, but four went without following the reinstatement of the Mexico City Policy. The policy  prohibits dollars for U.S. aid from going toward organizations that provide or promote abortions, and is often dubbed the “global gag rule.” International Planned Parenthood Federation and Marie Stopes International, an organization that provides contraception in Asia and Africa, were among the four organizations that no longer receive funding.  Marjorie Dannenfelser, the president of Susan B. Anthony List, which opposes abortion, said that the latest findings indicate that the "dire prognostics" of abortion rights groups hadn't come true. “The Trump administration’s pro-life policy has not reduced foreign assistance by a dime, but instead ensures that U.S. international aid partners act consistently to save lives, rather than promoting and performing abortion," she said. "Only a tiny minority of extreme pro-abortion groups have stubbornly refused to put the well-being of all women ahead of their agenda." But Planned Parenthood called the report "misleading," saying it painted "an incomplete picture of both prime and sub-recipients in impacted countries." The report did not provide information about how many people would not receive reproductive health services. “This incomplete review tells a misleading story that President Trump wants the public to hear," said Latanya Mapp Frett, executive director at Planned Parenthood Global. "The truth is that the effects of the global gag rule will be far reaching and deadly. The Trump-Pence administration has taken unprecedented steps to expand a lethal policy that deprives women around the world of the right to healthcare and full information to plan their futures."She warned that the policy would result in a rise in unintended pregnancies as well as a rise in unsafe abortions.

Scientists warn Trump administration that banning kratom will result in more opioid deaths. A group of scientists who have studied kratom are warning the Trump administration that banning the drug would worsen the opioid epidemic, following a declaration from the Food and Drug Administration that kratom has "opioid properties" and is associated with 44 deaths. The drug, a Southeast Asian tree leaf, is legal under federal law, but FDA officials have recommended it be categorized as a Schedule 1 drug, which would effectively mean that scientists would be unable to study its effects. People who take the drug, which can be sipped in a tea or taken as a pill, say that is has helped them beat off cravings for opioids and has alleviated chronic pain and depression. The scientists pleaded against a kratom ban in a letter sent to Robert Patterson, acting administrator of the Drug Enforcement Administration, and Kellyanne Conway, counselor to the president who is overseeing the administration's efforts on the opioid crisis. They raised doubts about the deaths determined to be associated with kratom and drew attention to surveys that have indicated that kratom was being used as "a lifeline away from strong, often dangerous opioids for many of the several million Americans who use kratom." For these users, they wrote, a ban would result in "relapse to opioid use with the potential consequence of overdose death." Instead, they wrote, the government should be encouraging research on the product to assess its safety and effectiveness. "Placing kratom into Schedule I of the [Controlled Substances Act] will ... have a profound and pervasive chilling effect on this needed additional research," they wrote.


Bloomberg Trump budget to target drug prices, out-of-pocket costs, Azar says

Reuters Trump administration may target immigrants who use food aid, other benefits

Axios The Trump administration is quietly revolutionizing Medicaid

New York Times Drug industry wages opioid fight using an anti-addiction ally

STAT News Mouse footprints could help doctors develop new pain drugs

Des Moines Register ‘Fetal heartbeat’ abortion bill advances in Iowa Senate after contentious hearing

Kaiser Health News Upsurge of suburban poor discover healthcare’s nowhere land



FRIDAY | Feb. 9

Noon. 226 Dirksen. George Mason University Law & Economics Center event on “Inventing New Liability? Who Should We Blame When Generic Drugs Harm Patients?” Details.

Monday | Feb. 12

President Trump to release his budget proposal.

Feb. 12-13. National Academies of Sciences, Engineering and Medicine workshop on physician-assisted death. Details.

TUESDAY | Feb. 13

10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing on “Improving Animal Health: Reauthorization of FDA Animal Drug User Fees.” Details.


8 a.m. Newseum. The Hill event on “America's Opioid Epidemic: Supporting Recovery.” Details.

10 a.m. 1100 Longworth. Health and Human Services Secretary Alex Azar to testify on agency budget before House Ways and Means. Details.

11:15 a.m. 2322 Rayburn. House Energy and Commerce Committee hearing on “Examining the Impact of Health Care Consolidation.” Details.

THURSDAY | Feb. 15

12:30 p.m. Rayburn 2123. House Energy and Commerce Committee hearing on “Oversight of the Department of Health and Human Services.” Details.