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Trump's executive order could lower premiums for healthier Americans. President Trump is expected to sign an executive order on Obamacare this week that would allow people to buy cheaper health insurance with fewer regulations, targeting healthcare goals that eluded congressional Republicans all year. Trump would direct the Departments of Labor, Treasury and Health and Human Services to make changes to regulations so more people could band together to buy "association health plans" that would allow individuals or small businesses to band together to buy plans sold across state lines. The order also would allow people to buy short-term health insurance plans for longer than the Obama administration allowed and would encourage the use of health savings accounts. Both association health plans and short-term plans are less expensive than Obamacare plans because they offer limited coverage. They don't guarantee same-cost coverage, or any coverage, for people with pre-existing illnesses and they do not cover a broad range of medical care, from addiction treatment to maternity care. Critics have referred to the plans as "junk insurance," warning that expanding access to them would take customers back to the days before the passage of Obamacare. They also warn that providing such options would peel more people from Obamacare's exchanges, leaving an even sicker — and costly — population with Obamacare plans. But people who don't receive federal help paying for their premiums, meaning people who make more than $48,240 for an individual or $98,400 for a family of four, and who do not have a pre-existing illness, may look to use one of the options. Many of those customers are facing double-digit premium increases in 2018. The number of people who have unsubsidized health insurance is pegged at between 6 million and 9 million people. Some will face insurance that is so expensive that under Obamacare they would not be required to pay the law's penalty if they decide not to get coverage. The executive order could offer an alternative, but it's not clear how quickly the plans will become available to customers.

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.

West Virginia to see double-digit Obamacare rate hike. West Virginia residents will see a double-digit premium increase for Obamacare in 2018, the latest state to experience major rate hikes. The state’s insurance regulator reported late Tuesday that premiums for Highmark West Virginia will rise by about 25 percent and CareSource by 19.6 percent, according to a report in MetroNews.

White House: Obamacare order due to congressional inaction. Trump's upcoming health insurance executive order was born out of frustration with Congress' inability to repeal Obamacare, press secretary Sarah Sanders said Tuesday. "I think that the American people have demanded something happen, they have elected a number of people to Congress to deal specifically with this issue," she said at a press briefing. "Due to Congress failing to act, it is no surprise the president is going to try to take action." The statement was in response to a question on Trump previously criticizing former President Barack Obama for issuing immigration executive orders instead of getting legislation through Congress.

Trump appoints new acting HHS secretary. Trump appointed Eric Hargan to serve as the acting secretary of Health and Human Services, replacing agency veteran Don Wright. Hargan was recently confirmed by the Senate to serve as the deputy HHS secretary. He will temporarily serve as acting secretary while the administration looks for a permanent replacement for Tom Price, who resigned after a scandal involving his rampant private jet use. Hargan is a lawyer at the Chicago-based firm Greenberg Traurig and focused on health law. He previously worked at HHS under former President George W. Bush and worked on Trump's transition team.

FDA chief Scott Gottlieb dispels rumors that the HHS title may go to him. Gottlieb said Tuesday that he believed he could best serve the country in his current role as FDA commissioner. “I feel like I want to continue to follow through on the policies we’ve put out and it’s where I think I can be most effective,” Gottlieb told Reuters. He declined to say if the White House had approached him about the job. “I‘m not going to get into private discussions I might have had around that,” he said.

House panel delays sending children’s insurance bill to floor. A House committee said it will delay sending a bill to reauthorize the Children's Health Insurance Program to the full House to give bipartisan talks on funding more time. The House Energy and Commerce Committee will delay sending the bill it marked up last week to the House floor, Chairman Greg Walden, R-Ore., said Tuesday. The delay comes as talks with Democrats heat up on new funding offsets after those in the bill came under criticism from Democrats. Walden said the panel would need to act quickly. Some states expect to run out of CHIP funding, which pays for health insurance for low-income children through block grants, by late November while others can last until early 2018. The program expired Sept. 30. If the House panel isn't able to reach a deal by the end of the week, "I would expect the House to take up the committee marked bill immediately following the district work period," Walden said.

Meanwhile, the Senate continues talks. The leaders of the Senate Finance Committee continue to discuss how to offset the funding for CHIP. A five-year reauthorization bill passed the panel a few weeks ago with only one Republican senator opposing. But that bill didn’t include any offsets.

Trump: 'Obamacare is Obama's fault.’ Trump this week defended his planned actions on Obamacare, saying the problems the law is facing are the result of his predecessor, Obama. "Well, we're actually, what we're doing is trying to keep it afloat, because it's failing," Trump said in a wide-ranging Forbes interview published online Tuesday. "I mean the insurance companies are fleeing and have fled. They fled before I got here. But with that being said, no, Obamacare is Obama's fault. It's nobody else's fault." Trump was responding to a question from Forbes about whether it was his duty to make sure Obamacare runs smoothly. In the interview, Trump said that the problems faced by the exchanges, including rising costs of premiums, predated his term. "It's a failed concept," he said. "It's thousands and thousands of pages. It's been amended by additional thousands of pages. It's a total mess. The premiums are going up, you know." The president said he still believed enough support could be reached for passing legislation to repeal Obamacare, ahead of the 2018 midterm elections. "It'll be far better than it is," he said. "Because Obamacare has failed, badly. So I'm working on that now. But we actually, I would say, I either have the votes or I'm one vote short. And I believe we'll get healthcare done sometime prior to the election." He hinted that he was leaving open the option of making a deal with Democrats on healthcare as well. "As you have noticed, I'm very able to make deals with Democrats if I have to," he said, referring to a spending deal he recently reached with Senate Minority Leader Chuck Schumer and House Minority Leader Nancy Pelosi. Trump and Schumer spoke about healthcare over the phone this weekend, but Schumer warned any deal that included repealing the law would not receive Democratic support.

Obamacare navigators plan staff cuts after funding drops. Many groups tasked with Obamacare sign-ups are planning to cut services and lay off staff due to major federal funding cuts, a new survey found. The Trump administration cut federal funding to the navigators by 41 percent for 2018, and the administration will send out grants based on the number of people a navigator signed up last open enrollment. Navigators say in a survey from the nonpartisan Kaiser Family Foundation the formula doesn't align with key duties of navigators, such as helping people sign up for Medicaid. Kaiser found 49 percent of the navigators who responded to the survey had their 2018 funding reduced by more than half from 2017, with 33 percent getting less than half and 18 percent receiving the same amount of funding or an increase. The Trump administration cut funding from $62 million sent out in 2016 to roughly $36 million, a 41 percent cut, according to Kaiser. The group said it used funding totals from the Obamacare advocacy group Get America Covered and not from the Trump administration. Of the 94 navigator programs, 51 percent responded to Kaiser's survey. "Some programs expect to close following open enrollment, others will cut back to a skeletal staff," the Kaiser report said. "As a result, consumers who need assistance at tax time, or help with special enrollment or post-enrollment problems during the year, may have difficulty finding it."

Pelosi testifies on solutions for opioid addiction and overdoses. House Minority Leader Nancy Pelosi made an unusual appearance to offer testimony Wednesday at a hearing devoted to tackling the opioid epidemic. "I really came to listen as well as to convey some thoughts," said the California Democrat, who has held her leadership role for more than 12 years. "This is only the second time I have ever testified as leader ... because this issue rises to level, as you know, of life and death." House members met during the hearing to discuss how to mitigate the opioid crisis. Last year Congress passed the 21st Century Cures Act, which included language from the House Comprehensive Addiction and Recovery Act targeting treatment and solutions. Pelosi, with others, proposed increasing funding. “It has the language, it just doesn't have the money to the adequate extent," she said. She also said that Democrats distrust Republicans because of their efforts to repeal portions of Obamacare and overhaul Medicaid. Pelosi said more states should look to expand the Medicaid program under Obamacare. "It has provided a vital lifeline for tens of thousands of Americans struggling with addiction," she said. "We stand ready to work with you in ... good faith with Republicans to update and improve the ACA, but we remain vigilant at efforts to gut Medicaid because it would create even more of a problem in terms of opioids, just to name one thing.”

ACLU, Planned Parenthood sue Missouri over abortion law. The lawsuit, filed Tuesday, seeks a temporary injunction to block Missouri's abortion law from going into effect Oct. 24. It focuses on a requirement that says doctors have to give information about the procedure to a pregnant woman seeking an abortion at least 72 hours beforehand. Though the information is already provided, and includes discussing women's options and what the procedure will be like, the new waiting period is new. That would mean that women would need to make at least two trips to the clinic, and the plaintiffs say that some women need to drive a long way. They also say it creates an undue burden on providers because it requires annual state health department inspections of clinics and approval of clinics’ plans for handling complications during medication-induced abortions.

Utah police officer who dragged and arrested nurse is fired. Detective Jeff Payne, the Utah police officer who forcefully handcuffed a nurse after she refused to allow a patient's blood to be drawn, has been fired. Chief Mike Brown decided to release Payne on Tuesday, the Associated Press reported. Body-camera footage showed nurse Alex Wubbels being dragged outside the University of Utah Hospital in Salt Lake City after she requested Payne show a warrant or a formal consent to draw blood from a patient. She explained that hospital policy required at least one of those requirements be met. Brown issued an apology after the July 26 incident and the police department updated its policies in response.

Melania Trump shares images from her 'incredibly special' visit to baby drug treatment center. First lady Melania Trump said on Tuesday her trip to visit children at a drug treatment center in West Virginia was "incredibly special." "Today's visit to @LilysPlaceWV was incredibly special," Trump said, referring to an infant recovery facility in Huntington, W.Va., that treats babies who have been exposed to addictive substances while in their mothers' wombs. "Let us all find ways to help children grow into happy, healthy adults." Trump also shared images of her interactions with patients and staff at the center on social media as members of the media were not allowed access during that portion of the day.

Twitter reverses decision to suspend Marsha Blackburn ad. Twitter has backtracked its initial position and is no longer suspending an ad from Tennessee Senate candidate Rep. Marsha Blackburn, after "reconsidering the ad in the context of the entire message."

"Our ads policies strive to balance protecting our users from potentially distressing content while allowing our advertisers to communicate their messages. Nowhere is this more difficult than in the realm of political advertising and the highly charged issues that are often addressed therein," Twitter spokesman Nicholas Pacilio said Tuesday. "After further review, we have made the decision to allow the content in question from Rep. Blackburn's campaign ad to be promoted on our ads platform. While we initially determined that a small portion of the video used potentially inflammatory language, after reconsidering the ad in the context of the entire message, we believe that there is room to refine our policies around these issues. We have notified Rep. Blackburn's campaign of this decision." The ad in question shows Blackburn saying she "fought Planned Parenthood, and we stopped the sale of baby body parts, thank God." Twitter initially told Blackburn's team the ad would be prohibited due to that remark because it was an "inflammatory statement." Although Twitter originally said the video could not be used as an online ad, they said the video could still be shared on the platform. Blackburn spearheaded the House investigation into Planned Parenthood after a series of videos emerged of Planned Parenthood officials discussing aborted fetus tissue for medical research. Blackburn announced last week she would run for Senate to replace Republican Sen. Bob Corker, following his announcement he plans to retire and not seek re-election in 2018.


STAT News An old-school pharmacy hand-delivers drugs to Congress, a little-known perk for the powerful

U.S. News & World Report Rankings on Aging in America

The Hill Battle over drug prices shifts back to the states

New York Times In new test for Obamacare, Iowa seeks to abandon marketplace

Bloomberg This is what Trump can do on Obamacare through executive order

Associated Press Critics say Trump’s birth control rule ignores science

CNN Trump’s ‘so-called’ judge to hear birth control mandate challenge

Forbes Here come more gene therapies and more pricing debates



House in session. Senate not in session.

Oct. 10-12. 2101 Constitution Ave. NW.  Microbiology of the Built Environment Research and Applications Symposium jointly organized by the National Academies of Sciences, Engineering, and Medicine and the Alfred P. Sloan Foundation. Details.

Oct. 11-13. Second National MACRA MIPS/APM Summit. Details.

Noon. 214 Massachusetts Ave. NE. Heritage Foundation event on “Gender Dysphoria in Children: Understanding the Science and Medicine.” Details.

THURSDAY | Oct. 12

8:30 a.m. U.S. Chamber of Commerce event on “The Opioid Epidemic: From the Front Lines to the Boardroom.” Details.

10 a.m. 2154 Rayburn. House Oversight Committee hearing on the 2020 U.S Census. Details.

Noon. G-50 Dirksen. Alliance for Health Policy event on “Measuring Quality for  Person-Centered Accountable Care. Details.

Noon. 1 Dupont Circle. Aspen Institute event on “The Caring Economy: How to Improve Service and Work in the Long-Term Care Industry.” Details.

FRIDAY | Oct. 13

10 a.m. 2226 Rayburn. Democrats from the House Energy and Commerce Committee to host forum on traumatic brain injuries.


Oct. 14-16. National Academy of Medicine Annual Meeting. Details.


1:30 p.m. 1615 H Street NW. U.S. Chamber of Commerce on “A Path Forward on Health Reform: Advancing Priorities and Innovative Solutions Amid Uncertainty.” Details.