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McConnell’s warning to conservatives: If Republicans fail to reach an agreement on a healthcare bill to partially repeal and replace Obamacare, they would have to work with Democrats to fix the exchanges, Senate Majority Leader Mitch McConnell said during a Rotary Club Meeting Thursday in his home state of Kentucky. "If my side is unable to agree on an adequate replacement, then some kind of action with regard to private health insurance markets must occur," he said. "No action is not an alternative. We've got the insurance markets imploding all over the country, including in this state." The comments were treated as big news, especially given that McConnell has written off the idea of working with Democrats on a bill as unrealistic as part of his explanation for why he is bypassing the usual committee process. But in reality, McConnell has used this tactic throughout the process, floating the idea of working with Democrats as being a viable fallback to try to nudge conservatives into compromising. The choice he wants to give conservatives is either they can vote for a bill that they may call “Obamacare Lite,” but that still repeals elements of Obamacare and cuts taxes and spending, or they can dig in their heels, and he’ll be forced to cut a deal with Democrats that props up Obamacare without giving conservatives anything. McConnell won’t be eager to get into protracted negotiations with Democrats and drag out some sort of comprehensive overhaul, which is why conservatives view it as a bit of an empty threat. In reality, any deal with Democrats is likely to be limited to pumping some money into the insurance markets for a limited time.  

Schumer responds: Senate Minority Leader Chuck Schumer, D-N.Y., said Democrats were eager to work with Republicans to stabilize the exchanges and improve the law, and stressed that Obamacare’s cost-sharing reduction payments needed to be guaranteed first. "It's encouraging that Sen. McConnell today acknowledged that the issues with the exchanges are fixable, and opened the door to bipartisan solutions to improve our healthcare system," he said.

Heritage Action: Senate Republicans promised to repeal Obamacare, not bail it out: “Talk of a bipartisan bailout of Obamacare would have two major effects: It would embolden Republican moderates as they continue to hold out in attempt to keep as much of Obamacare on the books as possible, and it would undermine honest efforts that empower states to get out from under Obamacare's burdensome regulations,” CEO Michael Needham said. “If the Republican Party wants to work with Democrats to bail out Obamacare, the results will be catastrophic for the party. For seven years it has pledged it is the party of repeal and now is the time to work toward that goal." 

Republicans' fatal healthcare concession. Most of the problems Republicans are encountering come back to a fatal concession made to liberals: the decision to take Obamacare's approach to pre-existing conditions. Opinion column here.  

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Sen. John Hoeven latest to oppose the GOP healthcare bill. The North Dakota Republican is the 10th GOP senator to oppose the Better Care Reconciliation Act. Hoeven said at a meeting with constituents at Altru Hospital in Grand Forks, N.D., that he “doesn’t support the bill as it stands,” according to the Bismarck Tribune. The meeting to discuss healthcare reform included Dave Molmen, CEO of Altru Hospital; Meghan Compton, general counsel at Altru Hospital; Brad Gibbens, deputy director of the Center for Rural Health; Pete Antonson, aministrator of Northwood Deaconess Health Center; and Alan O’Neil, CEO of Unity Medical Center in Grafton. Hoeven elaborated on his position in a press release: “Premiums and deductibles in North Dakota and across the nation continue to rise and some areas of the country will be left with little or no insurer competition next year. That is why we’re working to reform our healthcare system. While I do not support the Senate healthcare bill in its current form, we continue working on the legislation with the goal of providing greater access to healthcare and more affordable health insurance. Addressing the problems with Obamacare and reforming our healthcare system will be a process, not one bill, and meetings like today’s will allow us to take feedback from healthcare providers in North Dakota back to Washington.” 

Sen. Pat Toomey explains why he believes the healthcare bill has stalled: "I didn't expect Donald Trump to win. I think most of my colleagues didn't. So we didn't expect to be in this situation," Toomey, R-Pa., said Wednesday at a televised town hall. "Given how difficult it is to get to a consensus, it was hard to force that until there was a need to. That's what we've been working on." 

A surprising holdout gets an earful on health bill: Sen. Jerry Moran, R-Kan., was probably the most surprising senator to oppose the healthcare bill. Moran faced a throng of hostile constituents at a town hall earlier this week. He told constituents that he has concerns about the impact of Medicaid changes for the disabled and elderly, according to a report in Politico. Moran, however, emphasized that Obamacare still has “significant difficulties” that need attention. 

Georgia insurer plans 26 percent price hike: Blue Cross Blue Shield Georgia proposed to raise Obamacare rates by 26 percent next year. The reason for the increase is inflation in healthcare costs and higher use of medical services from a sicker population signing up on Obamacare’s exchanges, according to the Atlanta Journal Constitution. Blue Cross is the latest insurer to propose double-digit rate hikes for Obamacare in 2018. The reasons for such hikes have varied from uncertainty over whether the Trump administration will pay insurer subsidies to concerns about the exchange population and the reinstallment of a tax on insurers. 

Schumer: Sen. Ted Cruz healthcare amendment a 'hoax.’ The amendment by the Texas Republican would allow insurance companies to sell healthcare plans that are not compliant with the Affordable Care Act as long as they make one plan available that qualifies under the current law. Cruz said his goal is lower premiums, but Schumer countered that many would pay instead through more expensive deductibles and co-payments. "Make no mistake, the Cruz amendment is a hoax," Schumer said Thursday. "Under the guise of lowering premiums, it makes healthcare more expensive because deductibles and co-payments would be so onerous that many Americans would pay much more out of their pockets than they pay today. It's a foolhardy trade to exchange lower premiums for far more expensive deductibles and co-payments. In addition, Americans with pre-existing conditions will almost certainly be left without access to affordable and quality healthcare, making this even worse than the House bill on this issue.”  

Healthcare industry adds 37,000 jobs in June. Employment increased by 26,000 in ambulatory health care services and by 12,000 in hospitals. Healthcare has added an average of 24,000 jobs per month in the first half of 2017, compared with a monthly average of 32,000 jobs in 2016, according to the Bureau of Labor Statistics. Read more about the jobs report here.

President Trump picks Georgia Public Health Commissioner Brenda Fitzgerald to lead CDC. Fitzgerald, an OB/GYN and former Air Force major, has served as the director of Georgia's disease prevention agency since 2011. She previously worked as a healthcare policy adviser for former House Speaker Newt Gingrich, who is also from Georgia, according to the Georgia Department of Public Health website. The CDC, based in Atlanta, is facing a budget cut of up to $1 billion under the administration's proposed budget. Dr. Tom Price, Health and Human Services secretary, made the announcement Friday. “Having known Dr. Fitzgerald for many years, I know that she has a deep appreciation and understanding of medicine, public health, policy and leadership — all qualities that will prove vital as she leads the CDC in its work to protect America’s health 24/7,” he said in a statement. “We look forward to working with Dr. Fitzgerald to achieve President Trump's goal of strengthening public health surveillance and ensuring global health security at home and abroad.” Dr. Tom Frieden was the former director of the CDC, a post he held since 2009, but Dr. Anne Schuchat has been working as acting director since Frieden resigned in January. Schuchat will return to the role of principal deputy director, the same title she held since 2015 under former President Barack Obama.

Doctors prescribing fewer opioids. Prescriptions for opioids, such as painkillers, fell for the first time after reaching a peak in 2010, though the amount prescribed in 2015 was still three times higher than in 1999, according to the Centers for Disease Control and Prevention. In 2015, the amount of opioids prescribed, including oxycodone and hydrocodone, was enough for every American to be medicated around the clock for three weeks. Death rates from overdoses have increased, from 21,000 in 2010 to 33,000 in 2015, despite the reduction in prescribing patterns. Heroin deaths more than tripled from 3,036 to 10,574 during that period, according to CDC mortality data.
 

RUNDOWN

 

Axios Healthcare bill the most unpopular bill in three decades

Politico Rand and Donald’s wild health ride

Washington Post One reason the GOP health bill is a mess: No one thought Trump would win

The Hill Conservatives revolt over talk of keeping Obamacare tax

Kaiser Health News Amount of opioids prescribed in U.S. has been falling since 2010

LA Times Republicans are in charge, so why can’t they deliver on healthcare?

Wall Street Journal Maryland sued by generic drug trade group over pricing law

ProPublica The Medicaid threat that isn’t getting much attention

New York Times The hidden subsidy that helps pay for insurance



Calendar

FRIDAY | JULY 7

Noon. G50 Dirksen. Alliance for Health Policy and the Commonwealth Fund event on “Understanding What’s Next for Medicaid.” Details.

5 p.m. ADT. 200 Katlian St., Stika, Alaska. Sen. Lisa Murkowski to hold healthcare town hall. Details.


SATURDAY | JULY 8

Noon. 300 North Loop West Freeway, Houston. Sen. Ted Cruz holds town hall with Concerned Veterans of America. Details.

MONDAY | JULY 10

Senate back in session.

8 a.m. CST/9 a.m. EST. Harlan Community HIgh School. Harlan, Iowa. Sen Joni Ernst will hold a town hall.

TUESDAY | JULY 11

House back in session.

10 a.m. 1225 I St. NW. Bipartisan Policy Center event on “Solutions to long-term care financing in politically challenging times.” Details.

2:30 p.m. SR-418 Russell. Senate Committee on Veterans’ Affairs on “Pending Healthcare Legislation.” Details.


WEDNESDAY | JULY 12

July 12-13. Children’s Hospital Association holds family advocacy day. Details.

9 a.m. National Press Club. Event on “Genetic Engineering: The Future of Agriculture and Public Health.” Details.

10 a.m. 334 Cannon. House Committee on Veterans' Affairs hearing on “Care Where It Counts: Assessing VA’s Capital Asset Needs.” Details.

10 a.m. 2123 Rayburn. House Energy and Commerce Committee Hearing on “Combating the Opioid Crisis: Battle in the States.” Details.

1 p.m. National Press Club. The Association of American Universities and the Science Coalition hold a discussion on “The State of American Science.”

3 p.m. Urban Institute. 2100 M St. NW. “The Impact of Early Childhood Education on Health and Well-Being: The Latest Research from Policies for Action.” Details.

THURSDAY | JULY 13

9 a.m. Newseum. 555 Pennsylvania Ave. NW. CQ Roll Call, members of Congress and David Cordani, president and CEO of Cigna, will convene a group of government officials and stakeholders to discuss preliminary research findings of a new study examining the impact of the growing opioid crisis in the U.S. Details.

10 a.m. Bipartisan Policy Center. 1225 I St. NW. Event on “Future of Health Care: Can Increased State Flexibility Balance Innovation, Cost and Coverage?” Details.

2 p.m. 334 Cannon. House Veterans’ Affairs Committee hearing on “Maximizing Access and Resources: An Examination of VA Productivity and Efficiency.” Details.