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Trump declares Obamacare “over” as he signs mandate repeal into law. President Trump on Friday morning signed the tax bill into law that eliminates the individual mandate penalties. “Essentially, I think Obamacare is over because of that," Trump said from the Oval Office as he touted the biggest legislative accomplishment of his presidency. He said, “we have essentially repealed Obamacare." Starting in 2019, the new tax law will scrap the penalties for individuals who do not purchase government approved insurance policies. There is a broad debate in the healthcare policy community as to how much of a difference this will make. Standard conventional wisdom has traditionally been that the mandate is a central pillar of the law -- a way of pushing younger and healthier individuals into the system to help offset the cost of covering older and sicker enrollees. Without enough healthy customers, insurers could be left with only sicker individuals, which could trigger more premium increases and market exits from insurers. But in recent years, there’s been a questioning of whether the individual mandate has much impact given Obamacare’s more limited success in enrolling individuals who don’t qualify for free or near free care.

Obamacare signs up 8.8 million under Trump despite Democratic charges of 'sabotage.’ Despite dire predictions and Democratic accusations of "sabotage" by the Trump administration, at least 8.8 million customers signed up for Obamacare plans by the end of the open enrollment that ended last week, according to Seema Verma, the administrator for the Centers for Medicare and Medicaid Services. That was down only slightly from the 9.2 million who had signed up a year ago, but final figures may end up being even higher. The latest data do not include signups that occurred in the final three hours on the west coast (which would be 12am to 3am in the east), nor those that are still ongoing as staffers work their way through a list of callers who left their information to be called back and enrolled. Verma made the announcement on Twitter, and her agency put out detailed figures later in the day that showed 4,143,968 people selected plans or were automatically re-enrolled through during the final week of open enrollment.  Final enrollment numbers may grow.  Nearly 2.4 million new customers signed up for plans on, and the rest were returning customers.

Mitch McConnell predicts Senate will 'move on' from Obamacare repeal, but would still like to do it. Senate Majority Leader Mitch McConnell said Thursday the Senate is unlikely to pursue a repeal and replacement of Obamacare next year, though by Friday he explained that he wouldn’t necessarily rule it out. McConnell said on NPR on Thursday that the Senate was unable to repeal and replace Obamacare with a 52-48 majority earlier this year, and indicated it will be even tougher with one less Republican. "We'll have to take a look at what that looks like with a 51-49 Senate," he said. "But I think we'll probably move on to other issues." He added that the focus would be on the bipartisan bills that aim to stabilize the exchanges. Sen. Lindsey Graham, R-S.C., who led an Obamacare replacement bill with Sen. Bill Cassidy, R-La., told reporters that moving away from repeal would "be a mistake." “I think we should do everything we can to replace it as much as they did to pass it,” Graham told reporters. In his year-end press conference on Friday, McConnell said "My view is, as soon as we have the votes to achieve it, I’d like to do that,” on healthcare and he said he would “encourage” Graham and Cassidy to keep working on garnering the necessary support to pass a bill. However, he reiterated his skepticism that they would be able to pass an Obamacare replacement given that they weren’t able to with 52 votes and now they’ll be down to 51 after the loss of the Alabama senate seat.

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 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.

Editor’s note: Daily on Healthcare will be taking a hiatus over Christmas week and New Year’s. This will be our last edition for 2017 and we will resume publication on Tuesday, Jan. 2.

Ryan says he wants to tackle healthcare inflation in 2018. In the wake of the Republican victory on tax reform, House Speaker Paul Ryan, R-Wis., said that his priorities for 2018 will be welfare reform, healthcare, and entitlement reform. The comments would appear to put him at odds with Senate Majority Leader Mitch McConnell, R-Ky., who has said that he didn't want to deal with entitlements, welfare, or Obamacare repeal next year — and with President Trump, who has signaled he wants to take on infrastructure next.  “I don’t think the health care issue is done,” Ryan said in an interview with the Weekly Standard's Stephen Hayes. He suggested revisiting the Obamacare issue as early as January. “At the end of the day, we’ve got to go after the root cause—health care inflation and entitlements. Welfare reform is going to be our next lift.”

GOP, Democrats take credit for surge in Obamacare sign-ups. Both proponents and opponents of Obamacare are taking credit for the surge in sign-ups on in the most recent open enrollment period. The Trump administration claimed credit for the efficiency and smart decision-making that led to more than 8.8 million sign-ups and counting, while pro-Obamacare groups credited the results with Obamacare's staying power and urged Republicans to abandon efforts to undo the law. "The Affordable Care Act is working, and people’s lives are improving because of it," said Brad Woodhouse, director of the pro-Obamacare group Protect Our Care. "Despite widespread sabotage by the Trump administration ... these numbers prove that people want and need the affordable, quality health coverage the ACA provides, they rely on it for health and financial peace of mind and any further attempts at sabotage will be met with severe resistance. It’s time for the GOP to abandon efforts to take away people’s healthcare.”  

Second court blocks Trump’s rollback of birth control mandate. A second federal court has blocked President Trump’s attempt to drastically scale back Obamacare’s mandate that birth control be offered at no cost. A judge with the U.S. District Court of the Northern District of California issued a preliminary injunction Thursday over two interim final rules that roll back the mandate. The order, in response to a lawsuit from California, comes about a week after a federal judge in Pennsylvania made a similar order. The order prevents the interim rules that scale back the mandate from going into effect until the lawsuit runs its course. The California judge found that the Trump administration rushed out the two rules that go into effect immediately, not leaving the public enough time to comment on them. The judge said in the order that the administration failed to “provide the public with an advance opportunity to comment, making it impossible for the agency to consider the input of any interested parties before enactment.” The judge also doubted the claim for making the two rules: that the mandate infringed on the employer’s religious liberty. The rules would allow any employer to get an exemption from the mandate if they have a religious or moral objection to providing birth control to employees.

Governors demand full funding for CHIP. The National Governors Association warned Thursday that states desperately need Congress to fully reauthorize CHIP for five years before leaving for the Christmas break. "Governors’ message to Congress is that states and families are out of time. Congress must act now for the well-being of millions of children," the NGA said in a statement. “In the past week, Virginia and Connecticut have sent notices to more than 68,000 families indicating that the CHIP impasse in Congress will lead to termination of health insurance coverage for their children,” the NGA added. The group noted that Alabama plans to freeze enrollment in CHIP and Connecticut to freeze enrollment on Saturday if no funding is available.

Planned Parenthood asks Supreme Court to intervene in Arkansas abortion case. Planned Parenthood Great Plains is asking the Supreme Court to intervene against an Arkansas law that it says would effectively ban medication abortion in the state. Arkansas' Act 577 requires doctors who provide medication abortion to contract with a second doctor who holds admitting privileges at a local hospital. Its proponents say that it keeps women safe, but Planned Parenthood says the regulations are unnecessary and make it more difficult for a woman to obtain an abortion. In 2015 Planned Parenthood filed a lawsuit because it had not been able to find a doctor who was willing to partner with them because they were concerned about backlash. A federal district judge blocked the act last year, but it was overturned in July by the 8th Circuit Court of Appeals. Three clinics currently perform abortions in the state, and two of them only provide medication abortion, which can be done up to nine weeks into a pregnancy. According to Planned Parenthood, if the law were to go into effect, the state would be left with one clinic that offers abortions. Planned Parenthood drew parallels between the Arkansas' law and one in Texas that was struck down by the Supreme Court last year, in which the state had passed specific medical requirements clinics must meet in order to provide abortions. The Supreme Court ruled in that case, called Whole Woman's Health v. Hellerstedt, that Texas' law provided an undue burden to a woman who was seeking an abortion.


Kaiser Health News Medicare Fails To Recover Hundreds Of Millions Of Dollars In Lab Overcharges

USA Today McCain and Moran op ed: Health care for veterans needs another big fix:

Forbes In Global Play, UnitedHealth Bids $2.8 Billion For Latin American Insurer


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