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House set to ax Obamacare’s individual mandate penalties today. Republicans appear to have maintained near-unanimous support to pass their tax legislation that would repeal individual mandate penalties, despite efforts by Democrats to build public opposition to the measure by labeling it a tax cut for the rich that will explode the deficit. A handful of Republicans have announced they will not support the legislation, and they come largely from places where state and local property taxes are among the highest in the nation. The tax bill would give individual filers the choice of claiming a deduction for state income tax, or local property tax, but not both. And it caps the amount at $10,000. Republican Reps. Leonard Lance of New Jersey, Darrell Issa of California, and John Faso of New York are among the lawmakers who say they will vote "no." The legislation would effectively end the Obamacare mandate by eliminating the fines imposed on those who do not purchase health insurance plans. “I’m pleased to say this bill repeals the tax penalty associated with Obamacare’s individual mandate,” Rep. Kevin Brady, chairman of the House Rules Committee, said in a hearing Monday. “No longer will Americans be strong-armed into Obamacare health plans they do not want and cannot afford.”

Enough senators announce support for tax plan to guarantee its passage. After House passage, the Senate will start 10 hours of debate before a final vote late Tuesday or early Wednesday, said Majority Leader John Cornyn, R-Texas. By Monday, enough senators had announced their support to reach the threshold needed for passage under reconciliation, and Vice President Mike Pence postponed a trip to the Middle East to be close by if GOP votes come up short. Sen. Susan Collins, R-Maine, said Monday afternoon that she will vote for the final version of the Republican tax bill, likely guaranteeing that it will pass the upper chamber this week. They are down one vote, as Sen. John McCain, who has an aggressive form of brain cancer, is recuperating in Arizona for the month. Yet none of the other 51 Republicans have said that they will vote against the measure, and now several undecideds have announced their support for it. Tennessee Sen. Bob Corker, the only Republican to vote against the Senate version of the bill, said last week he would support it. Sen. Jeff Flake, R-Ariz., has not announced how he will vote. Pence is allowed to cast a vote only in the case of a tie, and with McCain absent, only 99 senators will be on hand to vote, making a tie impossible unless someone else doesn't show up.

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Key author of Obamacare overhaul bill welcomes states passing their own mandates. Sen. Bill Cassidy said he welcomes the possibility that blue states would create their own individual mandates in response to Congress repealing the provision from Obamacare, saying it would help lay the groundwork for passage of his healthcare bill. "Our big thing about federalism is that states are quite capable of doing that," said Cassidy, a Louisiana Republican who has pressed for Congress to pass an Obamacare overhaul bill he co-introduced, known as Graham-Cassidy-Heller-Johnson. Cassidy has proposed various ways that states could implement their own healthcare plans to get more people covered, such as by creating an auto-enrollment system by which people who are uninsured would receive catastrophic coverage. "I think auto-enrollment is a fantastic idea and I think states should have the ability to do that," he told the Washington Examiner Monday. "There are a lot of ways that states can enroll people," he continued, noting programs such as Medicaid were attractive to people for reasons other than a mandate, which he said was ineffective. Massachusetts already has an individual mandate, and Washington, D.C., and states such as California and Maryland have begun conversations about implementing their own. Nevada allows people to sign up for private, off-exchange health insurance at any time during the year, but makes residents wait 90 days to receive coverage. Hawaii has had an employer mandate since the 1970s, which requires employers to provide coverage to people they employ for at least 20 hours a week. "There are a lot of ways to do it," Cassidy said, referring to a potential impetus to get more people covered by health insurance. "Folks who are negative just don't think about it."

Collins explained her vote against repealing parts of Obamacare this year and looking to repeal the individual mandate penalties. Collins said during her Senate floor speech that she would have preferred that healthcare aspects of the bill had remained separate, but that she saw the two bills differently. "I have never supported the individual mandate,” she said. “There is a big difference between fining people who choose people who choose go without health insurance, versus the bills considered last summer and fall that would have taken away insurance coverage from people who have it and want it. Those bills also would have made sweeping cuts in the Medicaid program." She touted the Obamacare funding bills she negotiated to be brought to the floor for passage.

Obamacare payment showdown set for the House. The Senate’s plan to add legislation to fund Obamacare insurer payments is picking up some major opposition from House Republicans. The House is expected to take up a short-term measure to fund the government into January. The Senate is expected to add the subsidy legislation when the House sends the bill to the upper chamber. House conservatives are already griping about it. “That would be a problem,” Rep. Jim Jordan, R-Ohio, a member of the conservative House Freedom Caucus, said Tuesday.

Groups urge Congress to include anti-abortion provisions in spending bill. The anti-abortion group March for Life Action is urging Congress to include language in its spending bill that would bar Obamacare funds from going toward abortions. The group otherwise will score against the spending bill, it warned in a letter sent to the House and Senate Monday. Another anti-abortion group, Susan B. Anthony's List, issued a similar warning last week. The groups are urging that the bill include language in the Hyde Amendment, which prevents federal dollars from going toward most abortions. Congressional leaders are considering including funding for Obamacare as part of their spending bill, by including cost-sharing reduction subsidies and reinsurance.  Anti-abortion groups fear the funding would indirectly help pay for abortions and are requesting specific language to prohibit that from happening.

Opioid prescriptions down 16 percent over last four years. The number of prescriptions for opioids dropped by 16 percent in 2016 from a peak in 2012, according to a report released Tuesday by the consulting firm Avalere Health. Roughly 225 million prescriptions of opioids containing hydrocodone and oxycodone were dispensed in 2016, compared to roughly 275 million in 2012, the report said. Federal data shows 91 Americans a day die from an opioid overdose.

FDA proposes crackdown on homeopathic medicines. The Food and Drug Administration on Monday proposed a new framework for enforcing health and safety rules against homeopathic medicines that could lead to warning letters, involuntary seizures or criminal investigations. The agency is focusing on a variety of homeopathic products, including those that have reported safety concerns or that are aimed at people who are vulnerable, including people with addictions or who have cancer. That means the FDA will more aggressively go after some manufacturers, but under the proposal, the vast majority of homeopathic remedies would remain on the market. The Monday announcement followed hearings and public comments over the last few years, and the draft proposal has been posted for public comment over the next 90 days. The agency will take those comments into consideration before issuing its final policy, but it did not say when that would occur. The homeopathic industry is worth about $3 billion, and its products are sold online as well as in pharmacies and stores.

Pennsylvania governor vetoes 20-week abortion ban. Pennsylvania Gov. Tom Wolf, a Democrat, vetoed a bill that would ban abortions at 20 weeks, a decision that was widely expected. The veto is a setback for anti-abortion advocates, who are pushing for a U.S. Senate vote on a 20-week abortion ban. Currently 17 states ban abortion at about 20 weeks, according to the abortion rights group Guttmacher Institute. The House passed a 20-week abortion ban a few months ago. However, it has lagged in the Senate as Senate Majority Leader Mitch McConnell has not taken it up. The legislation most likely would be defeated as it would require 60 votes to break a Democratic-led filibuster.

Court orders Trump administration to allow two illegal immigrants to receive abortions. The Trump administration must allow two illegal immigrants access to abortions, according to a U.S. district judge’s ruling on Monday. The order was placed on hold by Judge Tanya Chutkan to allow the Justice Department to appeal the ruling. In response, the Justice Department filed a notice of appeal to the U.S. Court of Appeals for the District of Columbia. The ruling is the latest development after a 17-year-old girl, who was in the U.S. illegally, petitioned the court to allow her to receive an abortion in October.

Democrats seek answers on CDC’s use of words. Top House and Senate Democrats are the Trump administration respond to reports that the CDC banned certain words that include “science-based,” “fetus,” and “diversity.” A letter to the Health and Human Services comes in response to a news report that the Centers for Disease Control and Prevention banned use of the words in preparing documents for its 2019 budget request. The CDC denied the initial report in the Washington Post that it banned the words. The letter — wrote by Rep. Frank Pallone, R-N.J., and Sen. Patty Murray, D-Wash. — asked HHS if it directed employees to avoid certain words while preparing budget documents. “The department’s leaders cannot both uphold a commitment to prioritizing science over politics and ideology and support prohibiting the use of key words and phrases that are central to the broader health mission of the department,” the letter said.

Yuval Levin: CDC did not ban words. Levin, a former Bush administration health policy official, spoke to some HHS officials and reports that stories of a word ban at the CDC were not really accurate. Read the more nuanced and complicated explanation here.


Axios Debt collection is a big business for hospitals

Kaiser Health News Drug industry spent millions to squelch talk about high drug prices

New York Times Without the insurance mandate, healthcare’s future may be in doubt

Washington Post Progressives riled up by Northam’s comments on Medicaid, bipartisanship

Politico HHS defends withholding comments critical of abortion, transgender policy

STAT News The pharma industry spent $57 million on lobbying last year. And that’s just the start of its spending

CNN Allergic to eggs? You can now get the flu shot, new guidelines say


TUESDAY | Dec. 19

House and Senate to vote on Tax Cuts and Jobs Act.

Noon. Health officials to discuss hepatitis A outbreak in webinar. Details.

FRIDAY | Dec. 22

Deadline to pass government spending bill before funding runs out.