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Trump and Pence to meet Senate Republicans as Rand Paul endorses tax bill repealing mandate. President Trump and Vice President Mike Pence are scheduled to meet at 12:30 p.m. with Republican Sens. Orrin Hatch of Utah, who is chairman of the Senate Finance Committee, as well as with Sens. Pat Toomey of Pennsylvania, Rob Portman of Ohio, Tim Scott of South Carolina and John Cornyn of Texas. The discussion is expected to center on tax reform, and the Senate bill contains a provision to repeal the penalties for Obamacare’s individual mandate. Senate leaders are hoping to vote on the tax bill later this week. Their efforts gained momentum as Sen. Rand Paul, R-Ky., who had opposed a number of versions of the healthcare bill from the right, announced that he would be supporting the GOP tax bill. He praised the inclusion of the repeal of the individual mandate penalties, which he said were in the bill “in part by my urging.” “The mandate is clearly a tax, a fact that was established by the Supreme Court when it upheld Obamacare,” he wrote. “So including it in the tax bill only makes sense. In addition, with CBO scoring it as a $350 billion savings, repealing the mandate helped pave the way for increased middle-class tax cuts, like an expanded child tax credit. I was pleased to work directly with President Trump to push this important change that lets us keep multiple promises in one bill — cut taxes and repeal the Obamacare mandate we’ve been fighting against for years.”

Trump promises to return to Obamacare repeal after tax reform. President Trump on Thursday night promised to tackle Obamacare repeal once more, just as soon as the Republican tax cut bill as signed into law. "Obamacare premiums are going up, up, up, just as I have been predicting for two years," Trump tweeted. "Obamacare is OWNED by the Democrats, and it is a disaster. But do not worry. Even though the Dems want to Obstruct, we will Repeal & Replace right after Tax Cuts!" Republicans are trying to take a nibble out of Obamacare as part of the tax bill. Partly because the Supreme Court said the law's individual mandate penalties are a legal tax, some in the GOP are hoping to zero out that penalty in the bill cutting taxes for individuals and businesses. The GOP failed earlier this year to repeal and replace Obamacare after a “skinny” repeal bill that included repeal of the individual mandate didn’t get enough votes in the Senate.

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Jerry Moran not a fan of mandate repeal in tax reform. Sen. Jerry Moran, R-Kan., has encouraged GOP leadership to strip the individual mandate repeal from the tax reform bill, according to a report from Kansas News Service. “I hope that we can get healthcare separated from taxes to start with,” Moran said at a town hall on Wednesday. Moran helped deep-six GOP leadership’s plans for repealing and replacing Obamacare when he and Sen. Mike Lee, R-Utah, announced their opposition to the Better Care Reconciliation Act. GOP leadership scrambled to put together a “skinny” repeal bill in late July that would have repealed the law’s individual mandate. However, while Moran signed on to that bill, three GOP senators joined all Senate Democrats to defeat the bill. The GOP’s decision to add mandate repeal has caused concern from other senators, including centrist Sen. Susan Collins, R-Maine.

Trump’s decision to halt Obamacare payments leads to some cheap plans. Trump's decision to cut off Obamacare payments to insurers has driven up the number of zero-cost plans being sold to customers for 2018. The move to stop the cost-sharing reduction subsidies has led to higher tax credits for low-income customers, which in turn has led to an increase in the number of cheap Obamacare plans available for no premium but high deductibles. The eligibility for a zero-cost plan varies depending on where an enrollee lives and how much he or she makes. For instance, 2,436 counties in the U.S. offer free bronze plans — the cheapest of Obamacare’s four metal tiers — to a 40-year-old making $20,000 a year, according to an analysis from the health research organization Kaiser Family Foundation. “There were certainly cases previously where zero premium bronze plans were available to people receiving tax credits, but the availability has increased dramatically for 2018,” said Larry Levitt, senior vice president for Kaiser.

Judge strikes down Texas abortion law. A federal judge struck down a Texas law that would halt access to most second-term abortions, saying it would put an "undue burden" on women. The order from Judge Lee Yeakel in the U.S. District Court for the Western District of Texas came as his temporary restraining order against the Texas law was set to expire Wednesday. The Center for Reproductive Rights and Planned Parenthood filed a lawsuit that challenged the bill, which was signed this year and had been set to go into effect Sept. 1. Yeakel issued the temporary restraining order on the measure a day before the effective date. The bill would ban the most common form of second-trimester abortions called dilation and evacuation.

Anti-tobacco, court-ordered ads paid for by cigarette manufacturers hit newspapers and television. Cigarette manufacturers beginning on Sunday are running a series of “corrective” TV and print ads that explain how they misled the public about the negative health effects of their products and will remind viewers about the dangers of smoke and secondhand smoke. The actions began following an initial lawsuit filed by the Department of Justice in 1999, under former President Bill Clinton, that was intended to recoup expenses of caring for people with smoking-related illnesses. Then in 2006 a judge ruled that the “corrective” ads needed to run, though delays of more than a decade occurred because of a series of appeals filed by the industry. The court ruled tobacco companies violated civil racketeering laws and that they worked to deceive the American public about the dangers of their products, resulting in “a staggering number of deaths per year, an immeasurable amount of human suffering and economic loss, and a profound burden on our national healthcare system,” wrote U.S. District Judge Gladys Kessler in her 2006 final opinion. The ads, in text and voiceover say, “More people die every year from smoking than from murder, AIDS, suicide, drugs, car crashes and alcohol, combined.” Though smoking has declined significantly, from 42.4 percent in 1965 to 16.8 percent in 2014, it remains the No. 1 cause of preventable death in the U.S.

RUNDOWN

Bloomberg Patent ‘Death Squad’ pitting tech and pharma heads to Supreme Court

The Hill Five healthcare fights facing Congress in December

Politico Trump doesn’t know what’s next after taxes

Kaiser Health News Taken for a ride? Ambulances stick patients with surprise bills

New York Times As healthcare changes, hospitals and drugstores team up

NPR Telemedicine for addiction treatment? Picture remains fuzzy

Wall Street Journal Amid a dearth of workers, New Hampshire taps recovering addicts for jobs

Washington Post From pills to psychotherapy, treating depression often in a gray zone

Axios Why Trump may need an opioids czar



Calendar

MONDAY | Nov. 27

Senate in session. House not in session.

12:30 p.m. President Trump to meet with Republicans from the Senate Finance Committee.

TUESDAY | Nov. 28

House in session.

12:30 p.m. House Oversight and Government Reform Committee will hold a field hearing at the Johns Hopkins Hospital in Baltimore to examine the opioid epidemic and the recommendations of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. Details.

WEDNESDAY | Nov. 29

Nov. 29-30. New York. Forbes Healthcare Summit. Details.

9:30 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on the nomination of Alex Azar for secretary of Health and Human Services. Details.

2 p.m. 2172 Rayburn. Foreign Affairs Subcommittee hearing on “A Global Update on Alzheimer’s Disease.” Details.

THURSDAY | Nov. 30

9 a.m. New York. CMS Administrator Seema Verma to discuss the Trump administration’s agenda for Medicare and Medicaid with Avik Roy at the Forbes Healthcare Summit. Details and Stream Live.

10 a.m. 430 Dirksen Senate Health, Education, Labor and Pensions Committee hearing on “The Front Lines of the Opioid Crisis: Perspectives from States, Communities, and Providers.” Details.

10 a.m. Rayburn 2123. House Energy and Commerce Committee hearing on the implementation of the 21st Century Cures Act, with testimonies from NIH Director Francis Collins and FDA Commissioner Scott Gottlieb. Details.

11:05 a.m. Dr. Nora Volkow, director of the National Institute on Drug Abuse, to discuss the opioid epidemic at the Forbes Healthcare Summit. Stream Live.

FRIDAY | Dec. 1

Noon. Dirksen G50. Alliance for Health Policy and Commonwealth Fund event on “What's Next for Medicare Provider Payment?”  Details.