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Tax bill with Obamacare’s individual mandate repeal heads to final passage. The massive tax overhaul bill is headed to both chambers of Congress for final passage by mid-week, and Republicans have expressed confidence that the bill will be placed on President Trump's desk before Christmas. "This is a great bill, and it’s closed now," said Sen. Rob Portman, R-Ohio, a member of the conference committee. "And I think we’ll get the support on Tuesday or Wednesday to have a vote. And we already had enough senators as it came through the Senate, the bill is even improved further in House-Senate conference process, so I’m confident we’ll have the votes." On the health side, the tax bill would not only repeal Obamacare’s individual mandate penalties but also expand the medical expense deduction. It is not clear if the final version will get the support of Sen. Susan Collins, R-Maine, who has been pressing for Congress to take up two Obamacare stabilization bills before a final vote on taxes. There is still a possibility, however, that those two bills will be included in a Dec. 22 continuing resolution. Collins also had negotiated the medical expense deduction portion of the bill, which would allow taxpayers deduct medical expenses that reach 7.5 percent of gross income, rather than the current 10 percent.

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One way you can still switch your Obamacare plan. A little-discussed provision under Obamacare allows people to make changes to their health insurance plans if their insurer drops out of, even though most other enrollees will be locked into their plans once the enrollment period ends. Changes are permitted during a special enrollment period that was allowed under the Obama administration and continued by the Trump administration. If existing customers failed to change, renew, or cancel their health insurance coverage by Dec. 15, and their insurer is no longer participating in the exchange, they were automatically placed into a plan similar to the one they just lost. But those customers aren't locked into the plans if they don't want them or cannot afford them, and have a couple of months to switch coverage. For them, a 60-day special enrollment period is triggered when their new coverage starts in January, meaning the deadline to get a different plan is March 1, though they can sign up for plan by Dec. 31 to receive coverage for the new year, an official from the Centers for Medicare and Medicaid Services confirmed.

Trump administration allows some leeway for last-minute Obamacare customers. The Trump administration is allowing some leeway for last-minute Obamacare customers who were not able to sign up for health insurance in time for's Friday deadline. Customers were permitted to leave their names if they couldn't get through to the call center on's last day because of high volume. Those customers will still be able to enroll after the deadline when they receive a call back, and their coverage will begin Jan. 1. The Centers for Medicare and Medicaid Services stopped short of announcing a grace period, as the agency had done on deadline day under the Obama administration in 2015 and 2016. Enrollment staff working through the Twitter handle said there would be "no extension" and the website on Saturday morning carried a message that read, "2018 Open Enrollment is over." It had guidance for customers who might qualify for Medicaid and gave examples of how some customers might still be able to enroll under a special enrollment period.

McCain to miss tax vote, family hopes he returns to Washington by January. The family of Sen. John McCain, R-Ariz., on Monday said the GOP lawmaker's body is responding well to continued cancer treatment and hopes he will return to work in Washington by January. "Senator McCain has returned to Arizona and will undergo physical therapy and rehabilitation at Mayo Clinic. He is grateful for the excellent care he continues to receive, and appreciates the outpouring of support from people all over the country. He looks forward to returning to Washington in January," his family said in a statement Monday morning. One of McCain's doctors in Washington reported Monday that his recent viral infection is being successfully treated. McCain will miss this week's vote on the GOP tax bill.

Trump: McCain would come back to Washington if he's needed for tax vote. Trump sent well wishes to McCain and said he thinks he would come back to the Capitol if he's needed to pass the tax bill. Trump told reporters he had spoken to McCain’s wife, Cindy, as he arrived at the White House Sunday night. “I wished her well. I wish John well. They’ve headed back [to Arizona],” Trump said. “I understand he’ll come if we ever needed his vote, which hopefully we won’t. But the word is John will come back if we need his vote. It’s too bad. He’s going through very tough time, there’s no question about it. But he will come back if we need his vote.”

Insurance commissioners support bipartisan bills to fund Obamacare. The National Association of Insurance Commissioners sent a letter Friday to Collins, Sens. Lamar Alexander, R-Tenn., Patty Murray, D-Wash, and Bill Nelson, D-Fla., in support of their legislative package to stabilize the individual health insurance market. “The individual markets in many states continue to be unstable due to uncertainty in federal funding and the risk of the pool,” the group wrote. “Providing reliable federal funding to reimburse health insurance carriers for the Cost-Sharing Reduction program assistance they give to low-income consumers and grants for states to establish invisible high risk pools or reinsurance programs would reduce premium increases as much as 20 percent and could encourage some carriers to stay in the market. Such funding is not a ‘bailout for insurers’ as some have argued, but rather goes directly to improving the availability and affordability of health insurance for our most financially vulnerable consumers…. More can be done to improve access and affordability to health insurance, but taken together these measures are an important first step.”

John Cornyn: Congress to pass CHIP funding this week. Congress will pass a long-term funding bill for the Children's Health Insurance Program this week, according to Senate Majority Whip John Cornyn. The Texas Republican made the announcement Friday on Twitter. A handful of states have sent letters to parents warning them that their children's coverage may run out if Congress doesn't come through on funding soon.

Medical device industry presses for suspension of Obamacare tax in spending bill. The tax is slated to take effect again in 2018, which the industry has been hoping would be pushed further down the road or ended altogether. “At a time when the medical technology field is poised for growth and life-saving promise, Congress is doing its best to stall those efforts,” said Scott Whitaker, president and CEO of AdvaMed. “Congress has five days to end the medical device tax before the IRS shows up in January to once again confiscate billions that could be spent on saving individuals’ lives. This can’t be a message Congress wants to send to American patients and families.” The health insurance tax is another provision that may get suspended. As a result, costs of premiums for Obamacare customers would fall slightly.  

Pentagon’s claim that it needs to train 23,000 people on transgender recruits ‘suspicious,’ former military surgeons general say. The Trump administration’s claim that it would struggle to train tens of thousands of personnel by Jan. 1 to process new transgender recruits, and the rush to do that could damage the military, is “suspicious,” according to a policy paper by three former top military medical officials. Preparing more than 23,000 military recruiters and medical evaluators for the recruiting ordered to begin in two weeks by federal courts would not be difficult or time-consuming, former surgeons general of the Navy and Army and a former Coast Guard director of health and safety wrote in the paper set to be published by the Palm Center rights group Monday. Recruiters, who account for about 20,000 of the group to be trained, could be readied by sending a one-page instruction to their stations and evaluators require about four hours of training, according to the paper.

Trump administration settles lawsuit over Obamacare payments. The Trump administration has settled a long-fought lawsuit with the House and Democratic attorneys general over cost-sharing reduction payments to Obamacare insurers. Since Trump has entered the White House, a decision on the lawsuit had been put off. Trump said in October that he would not make the payments next year because of concerns about constitutionality, despite insurers threatening to raise premiums to offset the loss of the payments. A separate lawsuit by Democratic attorneys generals will continue.

Lawmakers zero in on next target in fight against high drug prices. Republican and Democratic senators have criticized moves by drug makers to extend the life of their monopolies on sales. But action on high drug prices, a major concern for consumers, has been negligible in this Congress. Senators on the Senate Health, Education, Labor, and Pensions Committee complained during a hearing last week about drug makers that game the system. Drug makers have used a technique called evergreening to extend the life of a patent for a brand-name drug.  Murray lashed out that “companies are systematically continuing to layer new patents on old drugs to keep competitors off the market.” Some of her Republican colleagues joined the criticism. “An obstacle is what is called the patent thicket strategy that too many drug companies pursue,” said Collins. “Humira, which is the best-selling drug in the world with $16 billion in annual sales, does not have a generic equivalent because its manufacturer has obtained more than 100 patents with various changes to block generic companies from coming to the market.” When the Food and Drug Administration approves a new drug, it gives the manufacturer 17 years of sales exclusivity. After that time is up, a generic drug maker can make and sell a cheaper version of the product. However, a drug maker can receive a patent for a slight modification for a product, extending its exclusivity.

Federal court blocks Trump's rollback of birth control mandate. A federal judge in Pennsylvania on Friday blocked Trump's decision to roll back Obamacare's requirement that employers provide birth control to workers at no cost. The judge for the U.S. Eastern District of Pennsylvania issued the preliminary injunction to halt an interim final rule that severely scales back the mandate. The decision halts a controversial decision by the Trump administration to let any employer not pay for birth control if it has a religious or moral objection. Federal Judge Wendy Beetlestone, who was appointed by Obama, issued the order.

Planned Parenthood chief blasts Paul Ryan's call for women to have more babies. Planned Parenthood President Cecile Richards on Friday criticized House Speaker Paul Ryan’s call for higher birth rates in the U.S. Richards tweeted that “if more members of Congress could get pregnant, maybe they wouldn’t tell the rest of us when and why to get pregnant.” Ryan said during his press conference Thursday that he did his part, “but we need to have higher birth rates in this country.” Ryan has three children. Congress has 105 female lawmakers: 84 in the 435-member House and 21 in the 100-member Senate.

Planned Parenthood says Trump administration's 'disdain' for women's health is 'clearer than ever' after CDC ban on word 'fetus.’ Planned Parenthood says the Trump administration’s “disdain” toward women’s health and the LGBTQ community is “clearer than ever” after the Centers for Disease Control was reportedly banned from using certain words in official documents, including '"fetus." “It’s clearer than ever: this administration has disdained women’s health, LGBTQ people, and science since day one,” the women’s health organization tweeted Friday night. The Washington Post reported Friday that the CDC was banned from using seven words, including “science-based,” “fetus,” and “transgender,” in official documents related to the the 2019 budget. In a statement provided to the Washington Examiner, Planned Parenthood’s Dana Singiser said: “This move is reckless, and will put millions of lives in danger." “It is unimaginably dangerous to forbid the Centers for Disease Control and Prevention from speaking about things essential to Americans’ health,” the statement added. Alison Kelly, a senior leader in the agency’s Office of Financial Services, led the 90-minute meeting about the banned words, but the Post's source said Kelly did not have an explanation for their banishment.

CDC director denies the allegations. The CDC director is denying reports the agency has banned staff from using the words. "I want to assure you there are no banned words at CDC," Brenda Fitzgerald, the director, said Sunday on Twitter. "We will continue to talk about all our important public health programs."

Pelosi warns Trump administration heading toward 'thought control' with word ban. House Minority Leader Nancy Pelosi warned against an attempt at "thought control" by the Trump administration in response to the CDC report. "DANGER!," the California Democrat tweeted Saturday in all caps, adding that the administration is "going further down a dangerous and un-American path" by banning such words as "science-based" and "diversity."


Politico How blue states might save Obamacare’s markets

Modern Healthcare
Centene's Washington subsidiary fined $1.5 million, briefly barred from selling individual plans

The Associated Press Signups show health law’s staying power in Trump era

Kaiser Health News Looking North: Can a single-payer health system work in the U.S.?

Wall Street Journal Humana and private-equity firms in talks to buy Kindred Healthcare

Washington Post ‘We feel like our system was hijacked’: DEA agents say a huge opioid case ended in a whimper

New York Times In opioid battle, Cherokee want their day in tribal court

New York Post Why depression and suicide are rampant among American farmers


MONDAY | Dec. 18

Congress to vote this week on Tax Cuts and Jobs Act.

TUESDAY | Dec. 19

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

FRIDAY | Dec. 22

Deadline to pass government spending bill before funding runs out.