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Medicaid work requirements floated in Senate Budget Committee. The Senate Budget Committee this morning began discussing amendments to the 2018 budget resolution. Sen. John Kennedy, R-La., proposed a work requirement amendment for people who use programs such as Medicaid. The requirement to work or volunteer for 20 hours a week would not apply to people who are over 55, have children or are disabled. "In order to maintain these programs they have to maintain fiscal integrity," Kennedy said. "The best way is to help people who need that help get in a position where they don’t need that help." Sen. Angus King, I-Maine, said he didn't object to considering the work requirement but added that more should be done to help people find work through training programs or allow them to receive support such as child care. Sen. Bernie Sanders, I-Vt., blasted the budget proposal for its cuts to the entitlement programs, saying that President Trump had vowed not to touch the programs.

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Lindsey Graham doesn’t want to end legislative filibuster for 20-week abortion ban. Sen. Lindsey Graham on Thursday said he did not support ending the legislative filibuster as he introduced legislation to ban abortions after 20 weeks. The South Carolina Republican said he expects the abortion ban to pass the Senate with "60 votes over the arc of time. The best way to protect the pro-life issue and to pass this bill is to build consensus and get 60 votes and not turn the Senate into the House." He said conservatives needed to take the long view about the filibuster. "Democrats have been more in charge of this place than we have by a factor of three," he said. Graham is pressing Senate Majority Leader Mitch McConnell for a vote on the legislation, but has not received a guarantee. A spokesman for the majority leader said no announcements on a vote have been made. The House passed its version of the legislation earlier this week.

House panel advances CHIP after testy hearing. A House committee advanced a bill to extend the Children's Health Insurance Program for another five years, but not until after a contentious clash over how it should be funded. The House Energy and Commerce Committee passed by a 28-23 party-line vote Wednesday a bill to extend CHIP and fund community health centers for two years, moving it to the full House floor. The traditionally bipartisan affair broke down into partisan skirmishes Wednesday after Democrats objected to the methods Republicans adopted to fund the program. The bill would raise Medicare premiums on seniors who make more than $500,000 a year. It also would shorten the grace period on when to shut out people who don't pay their Obamacare premiums and take money from an Obamacare prevention and wellness fund. Democrats vociferously objected to those funding decisions and opened old wounds about the bitter fight over Obamacare repeal. The GOP-controlled House passed a repeal bill in May but repeal efforts died in the Senate. "The Republican Party is not trusted on healthcare," said Rep. Anna Eshoo, D-Calif. "You are not trusted on healthcare because of what you have done."

Ron Wyden: ‘Mistake’ to do CHIP in partisan way. The Oregon Democrat and ranking member of the Senate Finance Committee was dismayed that the House Energy and Commerce Committee approved the traditionally bipartisan program by a party-line vote.  “I think it is a mistake to stake out ground for doing CHIP in a partisan way,” he told reporters Thursday. “This is too important.” But Wyden and Senate Finance Committee Chairman Orrin Hatch, R-Utah, have not decided on their own funding mechanism for the program. The committee advanced the Senate version of the reauthorization bill, but it does not include ways to pay for it. Wyden said he and Hatch have begun “concrete discussions” on funding but wouldn’t say if he supports any of the House’s funding sources.

Schumer calls for CHIP to be added to Obamacare stabilization bill. Senate Minority Leader Chuck Schumer urged lawmakers on Wednesday to consider combining CHIP with a yet-to-be-agreed-upon bill that would stabilize parts of Obamacare. The New York Democrat called for Senate Majority Leader Mitch McConnell to bring the proposals to the Senate floor for a vote. But it's not clear whether the Obamacare stabilization bill has enough support in either chamber or in the White House. "Leader McConnell should immediately put this bill to the Senate floor for a vote and include much-needed bipartisan provisions to stabilize the markets, lower premiums in 2018, and renew funding for community health centers and numerous other important health provisions that expired over the weekend," Schumer said. "No family in New York or elsewhere should ever have to make the agonizing decision between taking their child to the doctor and footing the cost of exorbitant medical bills they cannot afford," he added. Senate Finance Committee Chairman Orrin Hatch, R-Utah, said he was opposed to Schumer's proposition. "We should not jeopardize vulnerable children's health insurance coverage by turning the bill into a Christmas tree and adding controversial policies like bailing out insurance companies," he said. "It's regrettable that some Democrats are more interested in trying to score cheap political points than actually solving the problem.

Ways and Means advances bill to repeal Obamacare panel. The House Ways and Means Committee advanced a bill that would eliminate an advisory board created by Obamacare that was at the center of rumors the healthcare law would create a death panel. The committee voted 24-13 Wednesday to advance the bill after a testy hearing in which Democrats complained they had more pressing priorities to address. The panel, called the Independent Payment Advisory Board, is made up of 15 experts who determine cuts to Medicare if spending on the entitlement program reaches a limit. The committee staff estimated that the advisory board wouldn't be triggered until 2022. The bill had bipartisan co-sponsors, but Democrats were perturbed the committee wasn't working on other priorities.

Republicans say state flexibility offers from Democrats inadequate. Senate Republicans say they are willing to fund two years of insurer payments to help stabilize Obamacare but haven't received an adequate tradeoff from Democrats to reach a deal. Republicans are hoping they can pass a bill that would provide more flexibility for how states implement Obamacare, and how quickly the changes they request can be green-lighted by federal officials. The willingness to fund the cost-sharing payments is a shift for HELP Committee Chairman Lamar Alexander, who said during hearings in early September that he believed the funds should be appropriated for one year. Alexander said Wednesday that he and Sen. Patty Murray, the committee's top-ranking Democrat, are still talking. It isn't clear what offers for state flexibility Murray has made that Republicans have deemed inadequate. "The issue now is how much flexibility will the Democrats allow, as opposed to kind of sticking to the old Obamacare approach," said Sen. John Barrasso, chairman of the Senate Republican Policy Committee. One option being discussed was to allow other states to replicate waivers that one state had received, rather than "having to go through the full process," he said.

Tim Murphy to retire amid scandal over asking mistress to get abortion. Rep. Tim Murphy, R-Pa., announced he will retire and not seek re-election in 2018, following a report that the publicly pro-life congressman asked his mistress to have an abortion. "After discussions with my family and staff, I have come to the decision that I will not seek re-election to Congress at the end of my current term," Murphy said in a statement to KDKA-Pittsburgh Wednesday. "I plan to spend my remaining months in office continuing my work as the national leader on mental healthcare reform, as well as issues affecting working families in southwestern Pennsylvania," he added. Murphy met with Republican leaders Wednesday after it was revealed Shannon Edwards, the woman with whom Murphy admitted he was involved with in an affair last month, sent a text message to Murphy in January to call him out for an anti-abortion Facebook post, according to the Pittsburgh Post-Gazette. Murphy was faced with resigning immediately or announcing his retirement once his term expires.

Senate approves Trump’s pick for second in command at HHS. The Senate on Wednesday confirmed Eric Hargan to be deputy secretary of Health and Human Services, making him the second-in-command at the agency shortly after Tom Price resigned as secretary. The Senate approved Hargan in a 57-38 vote. Price resigned from his post Friday afternoon after reports revealed that he took almost $1 million worth of flights on military and charter jets this year. Don Wright of Virginia is serving as acting secretary for HHS. Hargan worked at HHS from 2003 to 2007 under former President George W. Bush and was part of Trump's transition team.

Cigna will no longer cover prescription opioid OxyContin. The company is notifying customers who are receiving the prescription so they can have time to discuss other treatment options with their doctors. "Our focus is on helping customers get the most value from their medications – this means obtaining effective pain relief while also guarding against opioid misuse," said Jon Maesner, Cigna's chief pharmacy officer. Cigna will have exemptions for customers who are in hospice care or who are receiving cancer treatment. As with other medications, doctors can press the insurer for coverage if they believe the drug is medically necessary. Cigna also announced that it would cover an alternative opioid offered by Collegium Pharmaceutical, called Xtampza ER. Under the terms of the contract, Collegium is financially accountable if the average daily dosage prescribed is above a specified threshold. If it is exceeded, Collegium has to reduce the cost of the medication to Cigna.


Axios ACA premiums blame game may turn against Republicans

Washington Post The healthcare fight is back as part of GOP’s tax reform effort

Politico Abortion fight may draw Trump’s filibuster wrath

The Hill Obamacare groups: If Trump won’t, we will

STAT News IBM to Congress: Watson will transform healthcare, so keep your hands off our supercomputer

Kaiser Health News Despite boost in Social Security, rising Medicare Part B costs leave seniors in a bind

New Hampshire Union Leader Commission faces deadline on Medicaid expansion

Reuters Obamacare signup challenge: Proving the law is not dead

NPR To save opioid addicts, this experimental court is ditching the delays



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

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

MONDAY | Oct. 9

Columbus Day

TUESDAY | Oct. 10

Oct. 10-12. 2101 Constitution Ave. NW.  Microbiology of the Built Environment Research and Applications Symposium jointly organized by the National Academies of Sciences, Engineering, and Medicine and the Alfred P. Sloan Foundation. Details.

House in session. Senate not in session.


10:15 a.m. Rayburn 2123. House Energy and Commerce Committee, Subcommittee on Health hearing on ““Examining How Covered Entities Utilize the 340B Drug Pricing Program.” Details.