New version of Graham-Cassidy-Heller Obamacare overhaul coming any day The trio of Republican senators are set to release a new version soon of their Obamacare overhaul bill that would give federal funding to states in the form of block grants. Sen. Bill Cassidy of Louisiana, one of the co-sponsors, said Friday he hopes to get a vote in the Senate before the end of the month. The GOP has until the end of the month to pass a repeal bill under reconciliation, which lets a bill be passed with only 51 votes instead of 60 needed to break a filibuster. Sens. Dean Heller of Nevada and Lindsey Graham of South Carolina are the other co-sponsors. Cassidy told reporters that the goal is to get a score from the nonpartisan Congressional Budget Office in the next two to three weeks. Senate Majority Leader Mitch McConnell has promised a vote on the bill if the trio can reach 50 votes, with Vice President Mike Pence as the tie-breaking vote. The new bill is expected to include tweaks to the formula for providing funding to states. The bill would use block grants for Obamacare’s Medicaid expansion funding and the funding for tax credits to reduce premiums for Obamacare plans.

The path to 50 It is not clear if the senators can get to 50. Cassidy told reporters that he was heartened that Sen. John McCain, R-Ariz., signaled his support for the bill. McCain voted against a “skinny” Obamacare repeal bill in late July that failed 49-51. However, McCain’s office later issued a statement that said he would have to see the bill before signing on. Sen. Susan Collins, R-Maine, another “no” vote, has been skeptical of the bill and potential cuts to Medicaid. Sen. Lisa Murkowski, the other “no” vote, has not said if she would support it. Also, the bill is well to the left of the failed Senate bill because it would keep much of Obamacare intact, which means it will be a tough sell to conservatives.

Liberal groups ready to pounce Obamacare supporters are gearing up to mount another defense of the law and are already aiming at the Graham-Cassidy-Heller plan. “Reports about the plan, known as Graham-Cassidy-Heller, suggest that it will include the same draconian cuts to Medicaid as the Senate’s previously introduced Better Care Reconciliation Act by eliminating the enhanced federal funding for the ACA’s Medicaid expansion and turning the remaining program into a block grant,” according to the pro-Obamacare group Protect Our Care. The group said the proposal would give states a block grant that would shrink over time and end entirely by 2027. “Anyone who thinks Republicans have been listening to voters who hated the first five healthcare repeal attempts is sorely mistaken — this latest scheme is even worse,” said Protect Our Care Campaign Director Brad Woodhouse.

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 dailyonhealthcare@washingtonexaminer.com 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.

Bannon: GOP leaders said Obamacare would be repealed by Easter. In his first television interview since leaving the Trump administration, former White House chief strategist Steve Bannon said Republicans met with Trump at the start of his term when they agreed to a deal that would have brought the president a bill to sign on Obamacare before the Easter break. “The plan was to do Obamacare because, remember, Paul Ryan and these guys come in and said, ‘We've done this for seven years. We've voted on this 50 times. We understand this issue better than anybody. We know how to repeal and we know how to replace, and this is ours.’” Bannon pointed out that senators who had previously voted on a bill to repeal Obamacare under the former administration did not do so again this summer. “But I will tell you, leadership didn't know it at the time,” he said. “They didn't know it till the very end.” When asked by “60 Minutes” host Charlie Rose whether he accepted the failures of the administration, Bannon replied, “When you say failures, it's eight months in, give me a failure. Obama didn't have Obamacare for the first 18 months. You're holding him to an unfair standard.”

House cancels Monday votes because of Hurricane Irma, because of concerns about members who may not be able to return to D.C. on time. The storm impacted Florida, parts of Georgia and Alabama beginning late Sunday night and into Monday morning and afternoon. With the rescheduling, the first votes for the House are scheduled for 6:30 p.m. Tuesday, according to the majority leader's office. The Senate, meanwhile, has yet to cancel a Monday vote scheduled for 5:30 p.m. after the upper chamber holds a remembrance for the anniversary of the Sept. 11, 2001, terrorist attacks, according to Senate Cloakroom.

How federal health agencies prepped for Hurricane Irma. While government agencies are focused on helping people get food, water, transportation and shelter, over the long term they face a major challenge in monitoring patients with chronic conditions who will struggle to receive the care they had before the storm devastated their homes and neighborhoods. "The biggest challenge from a health standpoint in these storms is making certain that those people with chronic illnesses and chronic diseases are able to hook back up with their providers," Health and Human Services Secretary Tom Price said during a news conference Friday. "When you get displaced from your pharmacy and from your doctor or clinic for a period of time, then those chronic health challenges become more acute." HHS has identified people who depend on electricity for their care, including people on dialysis or who need oxygen, and sent their information to Florida officials, who will contact patients. Price said more than 5,000 patients on dialysis had been identified as well as 20,000 other people who rely on electricity and 6,700 people who rely on oxygen for their care. He had declared a public health emergency in Florida, which allows medical resources to get to people faster and can temporarily lift government regulations. For instance, the federal government lifted certain prescription requirements so that people could get more of their medications for a longer period of time or refill prescriptions early.

Opioid maker cites FDA decisions in response to lawsuit. Purdue Pharma is arguing that an Ohio lawsuit should be thrown out because the Food and Drug Administration approved the use of its popular painkiller. Ohio is among several states suing opioid makers and says the companies falsely marketed the drugs and downplayed the addictive effects of opioid painkillers that drove an epidemic still ravaging the United States. Purdue Pharma, maker of popular painkiller Oxycontin, argues that it marketed the drugs according to FDA guidelines. Ohio argued in its lawsuit that Purdue Pharma marketed the drugs to treat chronic pain. Ohio defines chronic pain as noncancer pain lasting three or more months. However, Purdue Pharma says that the FDA approved Purdue's long-acting products to treat chronic pain, which includes noncancer pain. Purdue also said the lawsuit is pre-empted by federal law and prior decisions made by the FDA.

GAO to investigate Zinke's possible threats against Murkowski for Obamacare vote. The government watchdog will investigate whether Interior Secretary Ryan Zinke violated anti-lobbying laws for allegedly threatening repercussions against Alaska after GOP Sen. Lisa Murkowski voted against a Republican plan to partially repeal Obamacare. The investigation from the Government Accountability Office is a response to a request sent by Reps. Raul Grijalva, D-Ariz., and Frank Pallone, D-N.J., to look into conversations the secretary had with Murkowski, a Republican, and Sen. Dan Sullivan, R-Alaska. The Alaska Dispatch News reported that during a phone call, Zinke alluded to the fact that Murkowski's vote could have an impact on economic development work in the state. Sullivan said the call had a "troubling message." The Interior Department's inspector general started a similar probe in August, calling the comments "unproductive." Zinke has called the reports about his phone call with Murkowski and Sullivan "laughable."

Key Obamacare architect Max Baucus now backs single payer. The former Democratic senator from Montana and key legislator behind Obamacare, said it's time for the U.S. to consider a government-run, single-payer healthcare system. "My personal view is we've got to start looking at single-payer," Baucus said Thursday night at Montana State University, according to the Bozeman Daily Chronicle. "I think we should have hearings. ... We're getting there. It's going to happen." Eight years ago, Baucus, now 75, was chairman of the Senate Finance Committee, when he said the U.S. wasn't prepared to pass a bill for a single-payer system such as in Canada. He also was instrumental in rejecting the public option in Obamacare, which would have offered a government-run healthcare plan for people to buy into as an alternative to private health insurance sold on the exchanges. Baucus said then that there was "a lot to like" about a public option, but that he didn't believe it would be able to gain the 60 votes needed to block a filibuster. Single-payer proponents criticized the omission, and some have drawn attention to the fact that one of the aides whom Baucus often credited with writing the law, Elizabeth Fowler, had worked for the health insurance industry. She later joined the drug industry after overseeing the law's implementation for the White House.

Obamacare groups struggle with meeting ad funding cuts. Outside groups are scrambling to figure out how to fill the $90 million in ad funding for Obamacare that was cut by the Trump administration. Advocacy groups said they were surprised and shocked by the Trump administration's abrupt decision last month to provide only $10 million for outreach for Obamacare's 2018 open enrollment. That figure is 90 percent less than the $100 million the Obama administration shelled out for 2017. Advocacy groups say they are meeting to figure out how to make up the gap. But some say additional funds won't be enough because the Trump administration, which oversees healthcare.gov, knows best where to put the money. "It is impossible to replace the funding and it is impossible to replace the system because the administration knows who is coming to visit the website and might need a nudge," said Leslie Dach, campaign chairman for Protect Our Care, during a call with reporters last week. Dach said the administration knows who enrolled for this year and plays a key role in communication. "They hold the keys to communication, and they made it clear they will keep those and not do anything to make the law work and actively undermine it," he said.

Reintroduced bill would repeal Obamacare’s ‘full time’ definition. The Save American Workers Act, introduced Friday by Sens. Susan Collins, R-Maine and Joe Donnelly, D-Ind., would define a full-time worker as someone who works 40 hours a week, rather than 30 hours as defined under Obamacare. Employers with more than 50 workers are supposed to offer health insurance coverage to employees who work at least 30 hours a week, and the definition in the bill would bring it in line with the Fair Labor Standards Act. The legislation has support from the National Restaurant Association. “The 30-hour definition has taken flexibility away from restaurant employees and made it harder for some employees to grow their incomes,” said Cicely Simpson, executive vice president of policy and government affairs for the group. Collins called the legislation “straightforward” and said it would “remedy a serious

flaw in the Affordable Care Act that is causing workers to have their hours reduced and their pay cut. “Our concerns are not hypothetical: thousands of employers across our country are cutting work hours or staffing levels as a result of the law,” she said, noting that she has heard concerns from school employees, restaurant staff, seasonal employees, home care nurses and municipal workers.

RUNDOWN

The Hill Senate panel looks to quickly strike deal on Obamacare

Axios What the Senate has in mind for Obamacare’s innovation waivers

Washington Post Mosquitoes, carbon monoxide and chemicals are big post-Irma health concerns

Newsday 9/11 first responders face illness, uncertain future

Wall Street Journal Hospital watchdog gives seal of approval, even after problems emerge

Cleveland Plain Dealer Ohio Gov. John Kasich’s health ideas gaining steam

Vox Once Obamacare repeal is dead, the GOP has no plan B

New York Times How to protect a drug patent? Give it to a Native American tribe



Calendar

MONDAY | Sept. 11

Sept. 10-12. Swissôtel, 323 East Upper Wacker Drive. Chicago. Eighth International Congress on Peer Review and Scientific Publication. Details.

Sept. 11-13. Hogan Lovells. 555 13th St. NW. Food is Medicine Coalition National Symposium.

TUESDAY | Sept. 12

Sept. 12-13. Marriott Wardman Park. 2660 Woodley Rd. NW. 2017 Association for Accessible Medicines Biosimilars Council Conference. Includes keynote by CMS Administrator Seema Verma. Agenda.

8 a.m. Newseum. 555 Pennsylvania Ave. Discussion hosted by The Hill on “Turning Genes into Medicine: Reimagining Our Healthcare System.” Details.

9 a.m. Gallup HQ, 901 F St. NW. Event on “Addressing the Opioid Epidemic With Drug-Free Pain Management.” Details.

10 a.m. 420 Dirksen. The Senate Health, Education, Labor and Pensions Committee will hold a third  hearing on stabilizing the Obamacare exchanges, with discussions on state flexibility. Details.

10 a.m. 215 Dirksen. Senate Finance Committee hearing on “Health Care: Issues Impacting Cost and Coverage.” Details.

11 a.m. 562 Dirksen. Homeland Security and Governmental Affairs Committee Minority roundtable on opioid sales and marketing.

2:30 p.m. Brookings Institution. 1775 Massachusetts Ave. NW. Event on “Inclusive School Environments: Improving Outcomes for Students With and Without Disabilities.” Details.

WEDNESDAY | Sept. 13

8 a.m. AJAX. 1011 Fourth St. NW. Event hosted by The Hill on “America’s Opioid Epidemic: Search for Solutions” with Sen. Rob Portman, R-Ohio, and Rep. Paul Tonko, D-N.Y. Details.

9 a.m. 529 14th St. NW. National Press Club. Event on “Understanding the Value of Innovation in Medicine.” Details.

THURSDAY | Sept. 14

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on stabilizing the Obamacare exchanges, with testimony from healthcare stakeholders. Details.

1:30 p.m. Alliance for Health Policy Webinar on “New Administration, New Approach to Medicaid Waivers?” Details.

FRIDAY | Sept. 15

Sept. 15-19. Chicago. American Academy of Pediatrics conference. Schedule.

8 a.m. Newseum. 555 Pennsylvania Ave NW. Atlantic forum on “Children and Cancer.” Details.

Noon. 325 Russell. Alliance for Health Policy event on “Chronic Pain & Opioid Addiction: The Role of Integrated Care.” Details.

TUESDAY | Sept. 19

8:15 a.m. Ronald Reagan Building. 1300 Pennsylvania Ave NW. Bloomberg Live event on “The Future of Healthcare: Unlocking and Supporting Value.” Details.