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Trump gives a nod to Obamacare insurer payments. An interesting addition to President Trump’s budget is a call for insurers to get cost-sharing reduction payments and risk corridor payments, which many conservatives have attacked as a “bailout” for insurance companies. Cost-sharing reduction payments reimburse insurers for lowering co-pays and deductibles for low-income Obamacare customers. Trump stopped making the payments from the executive branch in the fall, but his budget calls for the payments to be appropriated by Congress. Funding the payments has received bipartisan support in the Senate but has faced heavy resistance in the House. Risk corridors were installed from 2014 to 2016 to help insurers on Obamacare’s exchanges adjust to a new marketplace. The corridors work by insurers that earn a certain amount pay into the program and in turn cover heavy losses from other insurers. However, the program didn’t work as intended as too many insurers sought payments and not enough paid into the program to offset the losses. Trump’s budget calls for $812 million in payments.

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.

Trump budget reforms unlikely to make big dent in drug prices, experts say. Trump’s budget request contains several proposals to lower drug prices, but experts say they won't help much since they aren’t targeting the priciest, brand-name products. The budget proposal includes several measures such as an experiment to give state Medicaid programs more power to negotiate for lower drug prices and another proposal to boost generic drug competition. However, none of the proposals released Monday directly address the problem of expensive, specialty drugs, experts say. “They do not seem to be able to save significant amounts of money,” said W. Gerard Anderson, professor at Johns Hopkins Bloomberg School of Public Health. “They are tinkering around the edges on the drug issue, but they are not doing what President Trump promised, which was to really negotiate drug prices.”

Trump administration proposes sending food directly to low-income families. The Trump administration proposed in its budget to have the Department of Agriculture prepare and send packages of food directly to low-income families, replacing a portion of their food stamp benefits. The proposal is for families to receive some of their benefits “in the form of a USDA Foods package, which would include items such as shelf-stable milk, ready-to-eat cereals, pasta, peanut butter, beans and canned fruit, vegetables, and meat, poultry or fish.”

Trump administration drafting 'scorecard' for Medicaid changes. The Trump administration is working on a "scorecard" with states that will measure how well the changes they make to Medicaid are working, the Centers for Medicare and Medicaid Services said. "The scorecard is still in development and is a priority for CMS," an agency official told the Washington Examiner. "We have been working with states on its development to ensure it’s a collaborative process and isn’t a 'federal government knows best' approach to providing greater transparency and accountability of the Medicaid program." A timeline wasn't provided but the document is expected later this year. According to a speech in which CMS Administrator Seema Verma previewed the scorecard, documentation would use data from states to track whether positive health outcomes had resulted from the policies and would be available to the public. It would measure items such as outcomes in children's health, how well the program is being carried out and measuring the effects of treatment and prevention.

Bill Cassidy doubts Republicans will take another stab at Obamacare alone. Sen. Bill Cassidy's legislation to overhaul Obamacare was endorsed in Trump's budget request, but the Louisiana Republican said Congress is unlikely to act unless a groundswell of opposition to the law forces Democrats to come to the table. Cassidy, speaking during a meeting Monday with the Washington Examiner’s editorial board, suggested it was unlikely that Republicans would make another effort at passing major healthcare legislation on a purely partisan basis, having failed several times last year to deliver on their long promise to repeal and replace Obamacare. Though it is still possible for Republicans to repeal Obamacare with a simple majority, Cassidy is not betting on that happening. For one thing, doing so would require Republicans to pass a budget, which remains very much in doubt. “Right now the healthcare issue does not have a swell of concern beneath it,” he said. “You do major policy when there is a swell of concern and people are looking for a solution and you have thought out a solution.” Cassidy said that groundswell could start as states begin to shoulder more of the financial burden of Obamacare's Medicaid expansion. Though it was fully funded by the federal government initially, states are starting to gradually take on more of the costs, and by 2020 they will have to cover 10 percent of the expanded Medicaid. “Do I think that states are going to come to the federal government and at some point say we can’t afford our Medicaid programs? Absolutely,” Cassidy said, noting that a number of states are already struggling.

Cassidy didn’t know who Jimmy Kimmel was. At the intersection of politics and pop culture, Cassidy got jumped. The Louisiana Republican went on Jimmy Kimmel to explain his attempt at a bipartisan healthcare bill before getting absolutely skewered off air by the partisan comedian. Why would Cassidy do an interview with a comedian who got his big start instructing women on the street to figure out what was down his pants before hanging out with former President Barack Obama? “I actually didn’t know who Jimmy Kimmel was,” Cassidy told the Washington Examiner. By all accounts, the physician-turned-senator was making a good-faith effort to explain a complex issue on a popular television show. Cassidy even helped coin the “Kimmel Test” in May: “that no family should be denied medical care, emergency or otherwise, because they can't afford it.” When Kimmel balked at provisions inside the Graham-Cassidy Obamacare overhaul in September, the comedian accused the politician of lying “right to my face.” The moment went viral and dominated the news. Kimmel later admitted he got most of his material from Senate Minority Leader Chuck Schumer.

Paul Ryan still bitter over Obamacare repeal’s defeat. House Speaker Paul Ryan on Tuesday called out Sen. John McCain for sinking the Republicans' best chance at repealing Obamacare last summer. In July 2017, McCain made a dramatic entrance onto the Senate floor and gave a thumbs-down to the GOP bill under consideration. The plan was to pass it, and in a House-Senate conference, get closer to a bill to repeal the law. But McCain's "no" vote made the bill fail 49-51 in the Senate. On Tuesday morning, the Wisconsin Republican made it clear the party was still smarting over McCain's surprise vote. "Unfortunately, somebody did this instead of that in the Senate, and it didn't pass," Ryan said on Fox Business, giving a thumbs down and then a thumbs up.

Ryan says he isn’t giving up on entitlement reform. Ryan defended his reputation as a deficit hawk Tuesday despite his recent support for tax cuts and spending hikes, saying that he still favors major entitlement reforms. "Over the long-term horizon, we’ve got to get this debt under control and the only way to do that is entitlement reform," Ryan said. "That’s why we’re never going to give up on entitlement reform." Ryan was forced to defend his fiscal bona fides after host Maria Bartiromo challenged him for first passing a major tax cut and then agreeing to a deal to increase spending over the next two years. "I still am" a deficit hawk, Ryan said. The spending deal was necessary to fund the military, he argued, and the tax cut was needed to keep companies from leaving the U.S. because of its tax system. The underlying problems driving the mounting debt, he said, are the aging of the country and rising healthcare costs. "Social Security is a part of a solvency problem ... but nothing like we do on the healthcare entitlements," he said. "That’s why we can never give up on healthcare reform, because that is the key driver of our debt in the future."

Opioid crisis cost more than $1 trillion since 2001, study finds. America’s opioid epidemic has cost the country more than $1 trillion from 2001 to 2017 and could cost another $500 billion by 2020, a new analysis found. The analysis released Tuesday from consulting firm Altarum estimates the cost of the opioid crisis increased from $29.1 billion in 2001 to $115 billion in 2017. The analysis says the costs of the crisis come from lost wages, lost productivity in the private sector, and healthcare costs. Other costs include lost tax revenue from federal, local and state governments, and more spending on healthcare and other services to fight the epidemic. In 2016, 42,249 Americans died from opioids, five times more than in 1999, according to the Centers for Disease Control and Prevention. The number of opioid overdose deaths last year is estimated to be higher than 62,500 based on data through June, Altarum said.

Probe finds opioid makers give nearly $9 million to advocacy groups. Opioid makers gave money to third-party groups to try to downplay the risks of opioid abuse, a new congressional investigation finds. Sen. Claire McCaskill, D-Mo., released a report Tuesday that found five leading opioid makers donated nearly $9 million to 14 third-party advocacy groups over five years. The groups pursued messages that were favorable to increased opioid use and in turn the financial interest of opioid makers, the report said. “These groups have issued guidelines and policies minimizing the risk of opioid addiction and promoting opioids for chronic pain, lobbied to change laws directed at curbing opioid use, and argued against accountability for physicians and industry executives responsible for overprescription and misbranding,” a statement on the report said.

Planned Parenthood going on offense. Planned Parenthood plans to lobby in every state this year to expand access to abortion and other reproductive healthcare, including backing legislation in California requiring the public college system supply the abortion pill to students. In a call with reporters Tuesday, Planned Parenthood pointed to the measure in California, awaiting the governor's signature, as a victory for the organization, saying that it was planning to go on the "offense" across the country. The group is backing more than a dozen measures in other states, including re-establishing cancer and STI prevention and testing funding in New Jersey that was blocked by former Republican Gov. Chris Christie, as well as a bill that would repeal a 72-hour waiting period for an abortion in Missouri. A bill Planned Parenthood supports in Maine would allow nurse practitioners to provide the abortion bill to patients.

Senate bipartisan bill would overhaul red tape associated with children getting specialized care across state lines. Sens. Chuck Grassley, R-Iowa, and Michael Bennet, D-Colo., have introduced the Accelerating Access to Kids Care Act, which would allow states to use a faster screening and enrollment process for out-of-state pediatric care providers who need to enroll in another state’s Medicaid program. The senators say that children who have complex medical needs can’t always get the specialized care they need in their home state, causing them to travel elsewhere. “The process is difficult and full of red tape, delaying children and their families from receiving the care they desperately need, and in some cases not receiving access to care at all,” according to a release about the legislation.

Medical device industry wants to end payment logjams. In recent weeks, members of the medical device industry have celebrated victories on Capitol Hill, including the suspension of Obamacare's medical device tax in the January spending bill and the Republican-backed tax law. Overseeing the advocacy work for the industry is Scott Whitaker, president and CEO of AdvaMed, the world's largest medical technology organization. A former chief of staff and assistant secretary for legislation at the Department of Health and Human Services, Whitaker is familiar with how the federal government operates. He also brings his experience to AdvaMed as former chief operating officer at the Biotechnology Innovation Organization. Whitaker discussed the future of the device industry with the Washington Examiner at the organization's offices in downtown Washington. He discussed how the government could help promote innovation and what the recent legislative wins will mean for his industry. Read or watch the interview.

Illinois lawmakers take on 'food deserts.' An Illinois Democrat says she’s found a way to please everyone in her diverse district with legislation that would alleviate Chicago-area “food deserts” by lifting a barrier to fruit and vegetable production in rural areas. Rep. Robin Kelly’s “Feeding America through Farm Flexibility Act” would modify a rule that discourages farmers of major commodities, such as corn and wheat, from switching production to fruits and vegetables.


Associated Press Winners and losers under Medicare plan in Trump’s budget

Wall Street Journal Amazon’s latest ambition: to be a major hospital supplier

Washington Post Trump wants to overhaul America’s safety net with giant cuts to housing, food stamps and healthcare

Bloomberg A long era of low healthcare inflation may be coming to an end

Axios Health insurer loses $73 million after Trump ends Obamacare subsidies

Kaiser Health News Maryland offers many insured men free vasectomy coverage

Politico Trump’s HHS worked with conservative group on Planned Parenthood policy

STAT News Risky tactic, desperate need: Trial to test brain implants for opioid addiction


TUESDAY | Feb. 13

12:30 p.m. 1330 G St. NW. Kaiser Health News event on “Living Well with Dementia.” Details.


8 a.m. Newseum. The Hill event on “America's Opioid Epidemic: Supporting Recovery.” Details.

8:45 a.m.  SVC-203 Capitol Visitors’ Center. Bipartisan Policy Center event on “Budgeting for Biodefense: Are We Prepared?” Details.

10 a.m. SD-342 Dirksen. Senate Homeland Security and Governmental Affairs Committee to hold a business meeting to consider pending legislation, including the Repeal Insurance Plans of the Multi-State Program Act of 2017.

10 a.m. 1100 Longworth. Health and Human Services Secretary Alex Azar to testify on the agency budget before the House Ways and Means Committee. Details.

10:15 a.m. 2322 Rayburn. House Energy and Commerce Committee hearing on “Examining the Impact of Health Care Consolidation.” Details.

3:30 p.m. 2123 Rayburn. House Energy and Commerce Committee markup of the Good Samaritan Health Professionals Act of 2017. Details.

THURSDAY | Feb. 15

9 a.m. SD-219. Senate Finance Committee hearing on the Health and Human Services budget. Details.

9 a.m. National Press Club. Public workshop with the Duke Margolis Center for Health Policy on “Strategies for Promoting the Safe Use and Appropriate Prescribing of Prescription Opioids.” Details.

10 a.m. Rayburn 2175. Joint Hearing: Subcommittee on Health, Employment, Labor, and Pensions; and Subcommittee on Workforce Protections to discuss “The Opioids Epidemic: Implications for America's Workplaces.” Details.

12:30 p.m. Rayburn 2123. House Energy and Commerce Committee hearing on “Oversight of the Department of Health and Human Services.” Details.

FRIDAY | Feb. 16

9 a.m. 1775 Massachusetts Ave. NW. Brookings event on “Patient Cost Sharing for Prescription Drugs: Policy Issues.” Details.

Noon. National Academies of Sciences, Engineering and Medicine webinar on “Improving Care for High-Need Patients.” Details.