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Deadline slips to pass Obamacare stabilization bill. Sen. Susan Collins, R-Maine, says she now hopes to get her Obamacare stabilization bills through Congress “before premiums rise in 2019 as a result of the tax law’s individual mandate repeal,” according to an interview with Inside Health Policy. That is a long time from Collins’ original deadline to get two bills passed by the end of 2017. Collins and Sen. Bill Nelson, D-Fla., have a bill that gives states $10 billion over two years to set up a reinsurance program that covers the sickest claims from Obamacare insurers. Another bill from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., makes Obamacare insurer payments for two years in exchange for giving states more latitude to waive Obamacare insurer regulations. President Trump cut off the payments, which reimburse Obamacare exchange insurers for lowering out-of-pocket costs for low-income enrollees, on Oct. 18. Collins told Inside Health Policy that she is now “willing to work with other, more conservative, Republicans to shape and pass the legislation as soon as possible.” Senate Majority Leader Mitch McConnell and Trump gave Collins a commitment to get the legislation done by the end of last year. However, resistance in the House has been a major sticking point. Key conservative Republicans have called the Obamacare payments a “bailout” and are resistant to the legislation. House Speaker Paul Ryan never committed to passing the legislation. Collins and Alexander abandoned an effort to get the bills into a must-pass spending bill last month. Now government funding expires Jan. 19 and it is not clear  if Collins will try again to get the bills in the next spending bill.

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 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.

Book claims Trump had little interest in repealing Obamacare, floated 'Medicare for all.' A book detailing the first year of Trump's presidency claims he floated the idea of covering all Americans through Medicare and had little interest in repealing Obamacare. "All things considered, he probably preferred the notion of more people having health insurance than fewer people having it," Michael Wolff writes in Fire and Fury: Inside the Trump White House. "He was even, when push came to shove, rather more for Obamacare than for repealing Obamacare." Trump also reportedly asked his aides aloud, "Why can't Medicare simply cover everybody?" The book goes on to say that Trump wasn't interested in the details of the legislation to repeal and replace Obamacare. Trump went along with the plan to support repealing Obamacare, the book said, because he was "simply trying to get out from under something he didn't especially care about" and had "likely never had a meaningful discussion in his life about health insurance." "Trump had little or no interest in the central Republican goal of repealing Obamacare," Wolff wrote. "The details of the contested legislation were, to him, particularly boring; his attention would begin wandering from the first words of a policy discussion. He would have been able to enumerate few of the particulars of Obamacare — other than expressing glee about the silly Obama pledge that everyone could keep his or her doctor — and he certainly could not make any kind of meaningful distinction, positive or negative, between the healthcare system before Obamacare and the one after."

Democrats rip into Trump administration for proposal on association health plans. Democrats slammed the latest proposal coming out of the Department of Labor, which would allow more small businesses and individuals to band together for the purpose of buying health insurance. Democrats said they were concerned that the proposed rule, released Thursday, would provided inadequate coverage or find ways to skirt around the Obama requirement that people with pre-existing conditions not be charged more or denied coverage. Senate Minority Leader Chuck Schumer accused the administration of “sabotage” in its actions. “The administration’s announcement today is disturbingly consistent with an administration clearly hell-bent on sabotaging the health insurance markets and sending premiums soaring for millions of Americans,” he said. “This regulation is simply a roundabout attempt to allow for the sale of junk insurance, which would actually increase out-of-pocket costs on many Americans, particularly leaving older Americans and those with pre-existing conditions with utterly unaffordable health care costs and fewer choices.”  Patty Murray, top-ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, made similar warnings. “The Trump administration is unfortunately starting this year with yet another harmful policy that will further undermine families’ health care by expanding loopholes that will raise costs for people with pre-existing conditions,” she said. “Patients and families want affordable, quality coverage, not partisan politics and healthcare sabotage. It is well past time President Trump and Republicans listened.” American Bridge, the liberal super PAC, warned that Obamacare’s exchanges would become weaker and that voter would react. “This would send even more tremors into the health insurance marketplaces already destabilized by Trump's actions — and the American people know exactly who to blame," said Andrew Bates, spokesman for the group.

House Republican slams Sessions’ decision on marijuana. Rep. Matt Gaetz, R-Fla., criticized Attorney General Jeff Sessions’ decision to allow federal prosecutors to go after states that legalized marijuana, including states that have medical marijuana laws. Gaetz called the decision by Sessions as “cruel.” He added in a statement Thursday that in his district “children have been helped by medical marijuana when all other treatments have failed. Some have gone from surgeries and seizures to baseball games and homecoming dances.” Gaetz’s anger over the attack on medical marijuana joins the American Cancer Society’s opposition to Sessions’ order. Other Republicans have lashed out at the order, including Sen. Cory Gardner, R-Colo., who said he would hold up any judiciary nominees due to the order.

FDA commissioner urges calm over drug shortages due to Hurricane Maria. The head of the Food and Drug Administration said the agency is making progress in mitigating critical shortages of saline and amino acid that occurred after Hurricane Maria hammered Puerto Rico in September. Baxter, a major producer of saline fluids and amino acids used in IV drips, said that all its facilities on the island got power late last year, said FDA Commissioner Scott Gottlieb in a notice Thursday. Gottlieb added that all other companies that manufactured products on the island that were at risk for a shortage are now on the power grid. “Many of these companies report to us that their production is increasing,” he wrote in the notice. The drug shortage continues, but Gottlieb said he remains “optimistic” that the “stress of the shortage will begin to abate, even if the shortages will not be fully resolved immediately.”

Maryland Obamacare enrollment drops. Maryland saw a nearly 3 percent drop in Obamacare signups for 2018 compared to the last open enrollment, according to final signup figures released Thursday. The state-run Obamacare exchange enrolled 153,571 people on the individual market for the 2018 coverage year, a 2.6 percent decline from the 157,637 that enrolled for 2017. The biggest difference between the two years was the change in the duration of the open enrollment period. For 2017, Maryland's enrollment period stretched from Nov. 1 to Jan. 31, but for 2018 it ran from Nov. 1 to Dec. 22.

CDC to hold event on preparing for nuclear war. The Centers for Disease Control and Prevention is holding a briefing Jan. 16 that will inform the public about what to do in the case of nuclear war. “While a nuclear detonation is unlikely, it would have devastating results and there would be limited time to take critical protection steps,” according to the event announcement. “Despite the fear surrounding such an event, planning and preparation can lessen deaths and illness.” The posting cites as an example that most people don’t realize sheltering in place for at least 24 hours is crucial to saving lives and reducing exposure to radiation. The event will take place at its main campus in Atlanta and will be live streamed.

Opinion from Tom Coburn: Making medicine affordable is simple. “The National Academies of Sciences, Engineering, and Medicine recently released a sweeping report, ‘Making Medicines Affordable: A National Imperative,’ adding a new perspective to our national conversation about drug prices. Unfortunately, the recommendations made by this report fail to solve the drug pricing problem because they do not go far enough in addressing the lack of transparency and competition in the biopharmaceutical space. In my mind, the solution is simple: Reintroduce true markets to pharmaceuticals, and many of the pricing and access problems will diminish significantly. This will not require any difficult maneuvering. We simply need to allow market forces to work as they do in the rest of our economy.” Read more from Coburn, former Republican senator from Oklahoma.


The Hill Trump poised to take action on Medicaid work requirements

Axios GOP divided over next steps: healthcare, welfare or neither?

NPR Hospitals nationally hit hard by Medicare’s safety penalties

Washington Post Trump is pushing a new healthcare button, but it could be smaller than he wants

Kaiser Health News Maine voters chose Medicaid expansion. Why is their governor resisting?

Wall Street Journal CVS, Walgreens say drug prices are easing after years of ballooning

Los Angeles Times LA County officials confirm first case of sexually transmitted Zika virus

USA Today Confidential deals can obscure sexual misconduct allegations against doctors as Cleveland Clinic case shows

Bloomberg Plans to slash medical costs in America run into generic drug concerns


MONDAY | Jan. 8

Jan. 8-11. San Francisco. 36th annual JP Morgan conference. Details.

TUESDAY | Jan. 9

9 a.m. 215 Dirksen. Senate Finance Committee to hold a confirmation hearing for Alex Azar, President Trump’s pick for Health and Human Services Secretary. Details. 

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on “The Opioid Crisis: An Examination of How We Got Here and How We Move Forward.” Details.

FRIDAY | Jan. 12 

Walter Reed National Military Medical Center. President Trump to undergo routine medical exam. Details.