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CHIP reauthorization clears Senate Finance Committee. The committee on Wednesday approved a bill that reauthorizes federal funding for a health insurance program that covers low-income children. The bill, known as the Keep Kids' Insurance Dependable and Secure Act, extends funding for the Children's Health Insurance Program, commonly known as CHIP. The program has bipartisan support and must be re-authorized every five years. It officially expired Sept. 30. The committee did not determine how it would fund roughly $8 billion for the program. The only senator to vote against advancing the bill was Sen. Pat Toomey, a Pennsylvania Republican, who said he was concerned about how Congress was using a large portion of the funding for purposes other than children’s healthcare. "This is becoming a slush fund for the Appropriations Committee," he said. "They spend it on something else completely in violation of the spending caps we’re supposed to have." Toomey's office provided documentation from the Congressional Research Service showing that during the past seven years more than $42 billion had been been used on unrelated programs through the appropriations process. Toomey and Sen. Mike Crapo, R-Idaho, had planned to offer an amendment that would help ensure funding went only to children's health insurance. Senate Finance Committee Chairman Orrin Hatch, R-Utah, said he was upset to learn about the funding being used for other purposes, and Toomey didn't call for a vote on his amendment but said he wanted to continue talking to different committees about his concerns.

House markup scheduled for this afternoon. The House version of CHIP reauthorization is set to be held at 1 p.m. in the Energy and Commerce Committee. Its bill seeks to pay for the reauthorization funding by taking money from Obamacare’s public health fund, which Republicans have derided as a “slush fund” for the law, and charging higher Medicare premiums to seniors who earn more than $500,000.

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Schumer, Pelosi call on Trump to oppose GOP budget over Medicare, Medicaid cuts. Democratic congressional leaders sent a letter to President Trump Wednesday urging him to oppose the proposed Republican budget they say would cut cut Medicare and Medicaid programs in a push to fund tax cuts they hope to enact through tax reform this year. Senate Minority Leader Chuck Schumer of New York and House Minority Leader Nancy Pelosi of California, among others, made the call to Trump, pointing to his May 2015 remarks as a candidate when he said he would not cut either program. "We write to urge you to uphold your repeated promises to not cut Medicare and to publicly reject the almost $500 billion in Medicare benefit cuts in both House and Senate Republicans’ fiscal year 2018 budget resolutions," the group wrote.  "We also ask you reject the more than $1 trillion in Medicaid benefit cuts in the House and Senate budget resolutions," they wrote. "Medicare and Medicaid should not be used to finance new tax breaks for the wealthy, and we request that you pledge to veto any legislation that includes these cuts. The letter is also signed by Sen. Bernie Sanders, I-Vt., Rep. John Yarmouth of Kentucky, the top Democrats on the Senate and House budget committees, respectively, and Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee.

Democrats question why House is taking up repeal of Obamacare panel. House Democrats bashed Republicans for taking up a bill to repeal Obamacare’s Independent Payment Advisory Board, or IPAB, while major healthcare priorities languish. “Children’s health expired,” said Rep. John Larson, D-Conn., in the House Ways and Means Committee Wednesday, referring to expiration of the Children’s Health Insurance Program that expired last weekend. “There is no fierce urgency of now in this Congress and that is what frustrates this side of the aisle.” The IPAB is a 15-member body that decides on Medicare cuts if spending on the entitlement program reaches a limit. The committee staff estimated that the advisory board won’t be triggered until 2022. Democrats say that since the board, which was once the center of unfounded rumors that Obamacare would create a death panel, won’t go into effect for four years, there is no need to repeal it now. “I am disappointed we are here today to markup one of the least timely agenda items on our to-do list,” said Rep. Bill Pascrell, D-N.J. But Republicans shot back that repealing the board is a timely issue and there is no reason to postpone it. “We hear every reason why today is not the right time,” said Rep. Carlos Curbelo, R-Fla. “There is always a good excuse to postpone bipartisanship and I just don’t understand that.”

Report: Las Vegas shooter was prescribed Valium. Stephen Craig Paddock was prescribed the anti-anxiety drug in June, which lists aggressive behavior as a possible side effect, according to the Las Vegas Review-Journal, which reported he was prescribed the medication in June. He was supposed to take one pill per day and fulfilled the prescription on the same day it was written. "If somebody has an underlying aggression problem and you sedate them with that drug, they can become aggressive," said Dr. Mel Pohl, chief medical officer of the Las Vegas Recovery Center. "It can disinhibit an underlying emotional state. … It is much like what happens when you give alcohol to some people … they become aggressive instead of going to sleep."

Former Obamacare officials create enrollment group: A group of former Obama administration officials created a new Obamacare enrollment group they say will counteract the Trump administration's cutbacks in outreach. The group Get America Covered started Wednesday and seeks to boost enrollment efforts. Former Obama administration officials Lori Lodes and Joshua Peck, who oversaw outreach for Obamacare, will lead the group. Former acting Centers for Medicare and Medicaid Services Administrator Andy Slavitt is also a co-chairman, as is former insurer CEO and Obamacare booster Mario Molina. The goal is to fill the gaps that the Trump administration is creating in getting people to sign up for Obamacare, according to a statement. Critics point to the Trump administration's decision to drastically cut ad and outreach funding and cut the window to sign up for Obamacare in half as acts of sabotage for the law, which the administration hopes to repeal. The Trump administration counters that it cut Obamacare ad funding by 90 percent because more people are aware of the law now that it is entering its fifth open enrollment. Administration officials have said they cut funding to Obamacare "navigators," nonprofits dedicated to enrollment and education, by nearly 40 percent because of low enrollment numbers. Navigators counter that signing up people for Obamacare is just one of its duties, which include education and helping people pick insurance plans. Open enrollment for the 2018 coverage year starts Nov. 1 and runs till Dec. 15, six weeks earlier than 2017's open enrollment.

House passes 20-week abortion ban. The Pain-Capable Unborn Child Protection Act, which passed Tuesday, would penalize medical providers who perform abortions after 20 weeks of gestation with up to five years in prison or fines, or both. The bill contains limited exceptions, including when a woman's pregnancy puts her life at risk and in cases of rape or incest. The legislation, which passed 237-189, has support from President Trump, who said in a statement of administration policy Monday that if it were to reach his desk his team would recommend he sign it into law. The bill, however, is likely to be defeated in the Senate, as it needs 60 votes for passage but Republicans hold only 52 seats. A similar piece of legislation met the same fate in 2015 and in 2013.  During the start of debate, Democrats called attention to the House voting on abortion rights rather than on gun restrictions after the Las Vegas shooting.

Rep. Tim Murphy suggested mistress have an abortion, then voted to pass abortion ban. The Pennsylvania Republican on Tuesday voted for the bill, which he co-sponsored, soon after news broke that he told a woman he was having an affair with that she should consider having an abortion.

Republicans pessimistic about chances for bipartisan Obamacare deal. Several Republican senators left a closed-door luncheon Tuesday pessimistic about the chances of reaching a bipartisan deal to stabilize Obamacare's markets. Democratic and Republican negotiators are trying to find consensus on how much flexibility to give states in exchange for insurer subsidy payments. Republicans are fighting resistance from conservatives and a skeptical House to reach an agreement as Obamacare insurers finalize their rates for 2018. Sen. Lamar Alexander, R-Tenn., gave a short briefing on the status of talks during the GOP conference luncheon. The chairman of the Senate Health, Education, Labor and Pensions Committee told reporters that no agreement has been reached and that the level of flexibility to give states to waive Obamacare regulations is a key sticking point. "The issue is basically getting Republicans and Democrats to agree on the definition of giving meaningful flexibility to states to approve insurance policies as a way of lowering healthcare costs," he told reporters Wednesday. "We haven't found a consensus on that yet."

Massachusetts bakery fights to keep “love” on the label. A Massachusetts bakery has learned that love is truly a battlefield as it fights the federal government to keep "love" on its label. In a lengthy warning letter the Food and Drug Administration sent to Nashoba Brook Bakery in Concord, Mass., is an odd problem with one of the ingredients in its granola: "love." The letter, which listed multiple problems, said the bakery was violating a federal regulation because the granola label lists "love" as an ingredient, which is not a "common or usual name of an ingredient." A "common or usual name" is defined in federal law as common ingredients such as milk, eggs and oils and fats. But the CEO of the bakery hopes to keep love on the label. "We would like to keep love in the mix," CEO and co-founder John Gates told the Washington Examiner. Gates said the special ingredient of the bakery's granola is love, which is why it's on the label. "We just always took that as a nice signal to the consumer base as what kind of place we are," he said. "We don't take ourselves so seriously that we can't share the secret sauce." If the FDA orders "love" to be removed from the granola label, the bakery will comply.

RUNDOWN

The Hill Hurricane Maria worsens Puerto Rico water woes

STAT News Scott Gottlieb rocketed to the top of the FDA. He may keep rising

Roll Call Next health secretary could set course for insurance system

Bloomberg Failing or doing fine? How Obamacare’s marketplaces are shaping up in 2018

New York Times With Affordable Care Act’s future cloudy, costs for many seem sure to soar

Washington Post Puerto Rico’s problems include a Medicaid shortfall



Calendar

WEDNESDAY | Oct. 4

Oct. 2-6. National Health IT Week. Details.

12:30 p.m. Senate to vote on confirmation of deputy HHS secretary, Eric Hargan.

1 p.m. Rayburn 2122. House Energy and Commerce Committee to Mark up CHIP. Details.

2 p.m. Commonwealth Fund teleconference on buying health insurance across state lines. Details.

THURSDAY | Oct. 5

10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing on the “Federal Response to the Opioid Crisis.” Details.