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Letting CHIP fall where it may: Dems reject GOP gambit, shutdown now likely. House Democrats say Republican efforts to use the Children’s Health Insurance Program to get them to support a short-term spending deal is backfiring. Several lawmakers said before the House voted Thursday 230-197 on a one-month continuing resolution to extend government funding that the House Democratic conference is "pretty unified" against the bill. Democrats are infuriated over the lack of protections in the bill for “Dreamers” and after President Trump blasted a bipartisan immigration deal. In the end, only six House Democrats joined 224 Republicans to approve the CR, while 11 Republicans and 186 Democrats voted against it. Republicans had used CHIP to pressure Democrats to get on board, and to shore up their own numbers. Rep. Frank Pallone of New Jersey, the top Democrat on the House Energy and Commerce Committee, said the only reason CHIP was included was because “they think somehow they will get more votes because of it.” Republicans started a full-court press to try to pressure Democrats into voting for the spending bill. “The Democrats would rather support illegal aliens as opposed to our American children,” said Rep. Ralph Abraham, R-La. House Democrats said the pressure is not working. “They have been trying to use this as leverage since December and it is not working,” said Rep. Diana DeGette, D-Colo. “Don’t put those millions of kids in jeopardy of losing their health insurance because you guys are trying to get political leverage.” The addition of CHIP doesn’t appear to be shoring up Democratic votes on the Senate side, either. A senior Democratic aide said Senate Democrats have enough votes to block the spending bill. Three Republican senators have said they will oppose the measure. Seventeen Democrats voted for the Dec. 22 continuing resolution. The bottom line is that Senate Democrats are giving every indication that they are willing to force a shutdown of government to get a DACA deal, because they fear that once immigration gets severed from the must-pass spending bill, they will lose leverage.

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Trump: Government shutdown looming because of Senate Democrats. Trump argued Friday that a partial shutdown of the federal government is on the horizon because Senate Democrats refuse to support a continuing resolution, and said voters should send more Republicans to Congress in November as a result. "Government Funding Bill past last night in the House of Representatives. Now Democrats are needed if it is to pass in the Senate - but they want illegal immigration and weak borders. Shutdown coming? We need more Republican victories in 2018!" Trump tweeted Friday morning.

Half of employees at health agencies would be affected by a government shutdown. The Department of Health and Human Services issued an extensive memo about how its agencies would be affected in the event of a partial government shutdown. HHS would furlough 40,959 staff and retain slightly less, 40,956 beginning on the second day of the shutdown. The Indian Health Service is among the agency where most staff would be retained. Agencies like the Administration of Children and Families, the Substance Abuse and Mental Health Services Administration, the Administration for Community Living and the Agency for Healthcare Research and Quality will see larger portions of their staff on furlough. At the Centers for Disease Control and Prevention, 2,714 staff would carry out excepted activities for hurricane response and continue to provide support to overseas projects. At the National Institutes of Health clinical center, 2,231 staff would continue providing medical care to patients.

House votes to require doctors to help babies that survive abortion. The House passed legislation Friday that obligates healthcare workers to provide a specific level of care to babies who are born alive after an abortion attempt. The Born Alive Abortion Survivors Act passed 241-183, with help from just six Democrats. The legislation would hold any healthcare provider at the scene criminally accountable if an abortion is botched and a baby is born, and the provider fails to help the infant. Actions they could take include bringing a baby to a hospital or using the same type of medical care that they would toward a baby that is born premature. During floor debate ahead of the vote, House Democrats said that the bill was unnecessary because doctors already have requirements to provide medical care to babies that are born alive. "This bill is a solution in search of a problem," said Rep. Judy Chu, D-Calif. "It's unnecessary, redundant, and part of a broader attack on women's health and reproductive health from the chamber and the Trump administration." Democrats said, as well, that the bill could require all newborn infants to be transferred to a hospital regardless of whether that would be the best means of care. Rep. Ami Bera, D-Calif., called the legislation "a blatant attempt to intimidate doctors from practicing the medicine that is in the best interest of their patients." But Republicans said the legislation was necessary and told stories of babies who had been born alive after a failed abortion and were left to die on a clinic floor or in a garbage bag. They argued that a law was needed aimed specifically at healthcare providers. They cited the case of Kermit Gosnell, an abortion provider in Philadelphia who was convicted of murdering infants born alive following an attempted abortion. "The problem is [the law] is not being followed," said Rep. Vicky Hartzler, R-Mo.

March for Life takes place Friday as anti-abortion activists take a victory lap. Trump is expected to address thousands of anti-abortion activists Friday at the 45th Annual March for Life in Washington. House Speaker Paul Ryan is also expected to address marchers Friday. Activists are touting the accomplishments they have made over the past year. Susan B. Anthony List President Marjorie Dannenfelser wrote in an op-ed Friday in the New York Post that Trump has kept his promises to the anti-abortion movement. “The greatest triumph was the appointment of Supreme Court Justice Neil Gorsuch. Gorsuch, whose stellar qualifications are apparent to all but the most partisan ideologues, was an inspired choice,” she wrote. “Furthermore, Trump has been busy filling the benches of lower federal courts with outstanding judges like Amy Coney Barrett, Joan Larsen and many more. Despite pro-abortion obstruction in the Senate, he has set a record for the most circuit court confirmations in the first year of any president.” The Trump administration also signed an executive order last May that called for his administration to pursue policies that focused on expanding religious liberty. Later in 2017 the administration issued an interim final rule that dramatically scaled back Obamacare’s requirement for employers to provide birth control. The rule lets employers with either a moral or religious objection to birth control get a full exemption. Religious nonprofits such as charities or universities sued the Obama administration seeking a full exemption.

Trump opens door to let states defund Planned Parenthood. The Trump administration is overturning Obama-era advisories aimed at preventing states from cutting Medicaid funding to Planned Parenthood, HHS announced Friday. The administration is rescinding an April 2016 letter that the Obama administration sent to states warning them that restricting Medicaid funding to Planned Parenthood could violate federal law. Administration officials said Friday it is rescinding the guidance to give states more flexibility over how they manage Medicaid. “States who run Medicaid jointly have had a say in whether providers in borders eligible to participate in Medicaid program,” said Charmaine Yoest, assistant secretary for public affairs at HHS. The Obama administration sent the 2016 letter after 10 states moved to end Medicaid funding to the women’s health and abortion provider. States targeted Planned Parenthood in response to a series of undercover videos from an anti-abortion activist that appeared to show Planned Parenthood officials discussing the donation and harvesting of aborted fetal tissue. A senior administration official said that the new guidance only goes back to appropriate legal standards before the 2016 letter. It also provides state flexibility without the federal government “putting a thumb on the scale,” the official said.

Administration also puts out new regs for religious liberty division. Administration officials also gave more detail on the creation of a new division of HHS’ Office of Civil Rights. The division will focus on religious liberty, specifically in fielding complaints from healthcare providers that they are forced by supervisors to do procedures that violate their religious or moral beliefs like abortions. The administration is putting out a new regulation Friday that details the 25 areas that deal with conscience and religious freedom. The statutory provisions are in federal law, but “in previous years weren’t enforced at all,” said Roger Severino, director of the Office of Civil Rights. “The statutes we are talking about focus on actions that providers say they cannot do in good conscience.” He gave examples of abortion and assisted suicide. However, critics charge that the new office will lead to doctors being allowed to not treat lesbian, gay, bisexual or transgender individuals.

Bobby Scott slams new HHS division on religious liberty. Democratic Rep. Bobby Scott said Thursday that Trump is attempting to "legalize discrimination," citing the administration's creation of a religious liberty division in the Department of Health and Human Services. HHS on Thursday formally announced the office, which will be housed inside the Office of Civil Rights, fulfilling an executive order Trump signed last year. The new office will help doctors and other providers who do not want to perform services that violate their religious or moral beliefs such as abortions or transgender surgery. "This announcement must be examined as part of the administration's broader pattern of promoting discrimination," said Scott, D-Va., arguing there was no need for the office because there was no indication that any individual religious rights were being violated. "These actions make clear that so-called ‘religious liberty’ and moral views are being used as a knife to cut down the rights of others. To be clear — this effort does not represent religious liberty; it is government-sanctioned discrimination." Administration officials argued it was the other way around. "Too many of these healthcare practitioners have been bullied and discriminated against because of their religious beliefs or moral convictions,” said acting HHS Secretary Eric Hargan at an event at HHS in Washington on Thursday.

Advocates note Planned Parenthood still hasn’t been defunded federally. A glaring hole in the list of accomplishments though is the inability of Congress to defund Planned Parenthood, a major goal of the anti-abortion movement. Several Obamacare repeal and replace bills included defunding Planned Parenthood for one year. While the House passed a repeal bill last May that included defunding, the Senate was unable to do so. For now attempts to defund Planned Parenthood are on hold as Congress increases its focus on immigration with a March deadline for the expiration of deportation protections for so-called “dreamers” which come to the country illegally as children. The lack of progres highlights the limits of accomplishments that the anti-abortion movement can rack up under Trump. While the GOP controls each chamber of Congress, the legislative filibuster requires that any bill in the Senate get 60 votes. Case in point is a 20-week abortion ban that passed the House last year. The bill has gone nowhere in the Senate yet, even though sponsors are pushing for a vote soon. The bill would likely gain some Democratic support but not enough to get 60 votes.

Oscar Health and Cleveland Clinic enroll more than 11,000 in health partnership plan. Health insurer Oscar Health and the Cleveland Clinic announced that 11,000 people had enrolled in the partnership plan they were offering for 2018, both on and off the Obamacare exchange. The total represents about 15 percent of the market share in the surrounding area. Oscar said in a release that a third of its members had select a primary care doctor and 70 percent created a profile on the company’s web app. Joel Klein, chief policy and strategy officer at Oscar Health, said in a statement that “there is clearly strong demand for a product that combines Oscar’s member engagement and navigation capabilities with Cleveland Clinic's comprehensive, high-quality clinical network.”

ADHD medications climb among women of reproductive age, says CDC. From 2003 to 2015, the number of prescriptions filled for medicine to treat attention-deficit/hyperactivity disorder increased 344 percent among women who have private health insurance, going from 0.9 percent of women to 4 percent of women. The findings are according to a study conducted by the Centers for Disease Control and Prevention on women who are of reproductive age, meaning between the ages of 15 and 44. For women between the ages of 25 to 29, the number of women who filled a prescription increased by 700 percent, and the second-largest increase was among women ages 30 to 34, at 560 percent. Officials warned that more research was needed to determine how safe it is for women to take the medications when they are pregnant. “Half of all pregnancies in the United States are unplanned, and women may be taking prescription medicine early in pregnancy before they know they are pregnant,” Coleen Boyle, director of CDC’s National Center on Birth Defects and Developmental Disabilities, said in a statement. “Early pregnancy is a critical time for the developing baby. We need to better understand the safest ways to treat ADHD before and during pregnancy.”

RUNDOWN

Axios The Medicare drug policy war between pharma and insurers

STAT News Pence says Congress should get right to try legislation DONE

CNN Is this a better way to build a flu vaccine?

Politico Trump again targets drug office, proposing 95 percent budget cut

Washington Post The nation’s first Medicaid work rules loom, and many fear losing coverage

Associated Press Government scientists scramble to save research ahead of potential shutdown

Reuters Trump moves on healthcare religious freedom prompts discrimination fears.



Calendar

FRIDAY | Jan. 19

Deadline for government spending bill.

45th annual March for Life rally in protest of Roe v. Wade. Will include speech from House Speaker Paul Ryan and satellite video from President Trump and Vice President Pence.

SATURDAY | Jan. 20

Las Vegas. Second annual Women’s March.