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Mitch McConnell up for bipartisanship on healthcare, with a catch. The Senate majority leader appears to be coming around to continuing to pay Obamacare insurers cost-sharing subsidies. The senator told reporters Saturday that he would “consider” a nascent bipartisan effort from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash. McConnell didn’t divulge major details, noting only that Alexander is working on “some kind of bipartisan approach” that would involve subsidies to insurance companies, according to the Associated Press. The subsidies could be payments to insurers to reimburse them for lowering out-of-pocket costs such as deductibles for low-income Obamacare customers. The White House has yet to say whether it will make the payments to insurers in 2018, leaving some insurers to flee Obamacare’s or raise premiums. Immediately after the Senate narrowly defeated a “skinny” Obamacare repeal bill, McConnell said the Senate would hear Democratic ideas. He sharply said that bailouts for insurance companies wouldn’t receive any support from his side of the aisle. Democrats want to continue the CSR payments next year, but some have called for them to extend beyond 2018. Some Democrats also have called for reinsurance, which would help pay the sickest claims for Obamacare insurers that would in turn reduce premiums for everyone. It is not clear if there is enough support in the Senate for new funding for reinsurance. Alexander and Murray — the chairman and the top Democrat, respectively, on the Senate Health, Education, Labor and Pensions Committee — plan to hold bipartisan hearings on stabilizing Obamacare’s exchanges when Congress returns next month. Alexander has said he hopes to get a bipartisan deal passed by the end of September.

The first thing that McConnell thought of when Sen. John McCain killed the health bill. "I choose not to dwell on situations where we come up a little bit short," the Kentucky Republican said Saturday at a Republican event in Kentucky. "Even on the night when we came up one vote short of our dream to repeal and replace Obamacare, here's the first thing I thought about: Feel better, Hillary Clinton could be president,” according to WFPL.

He also doesn’t think Obamacare repeal is dead … yet. McConnell told reporters Saturday that repeal and replace of Obamacare could come back. But he said that the window is closing rapidly, according to the Associated Press. Senate Republicans could get some good news from the Congressional Budget Office over the August recess about several replacement measures that may provide new momentum for repeal and replace. However, Congress is staring down a busy September, as it needs to pass a spending bill and legislation to raise the debt ceiling by the end of the month.

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.

Republicans brace for dissatisfied voters this summer. Sen. John Kennedy is expecting to get an earful when the freshman Republican returns to Louisiana for the August recess and holds his regular live radio town hall with constituents. Voters will be angry that Congress failed to pass tax reform or a bill to repeal and replace Obamacare, which were the two major agenda items they had promised to complete by the summer break, he said. Kennedy knows how he will respond to the frustrated callers. "What I'm going to say to them is the truth, they are right," Kennedy said as senators fled the U.S. Capitol Thursday for nearby Ronald Reagan Washington National Airport. "We are six months into this Congress. We failed on healthcare. We will eventually get it right, but I was very disappointed we couldn't pass a replacement for the Affordable Care Act."

Hawaii plans to file for another Obamacare waiver. Officials from the Aloha State said at a working group at the summer conference of the National Association of Insurance Commissioners in Philadelphia that they were considering filing a second waiver under Obamacare, called an innovation waiver, Kimberly Leonard reports. This version would allow for a reinsurance program similar to the ones filed by Alaska and Minnesota. The solution was explored in Minnesota partly because 50 percent of claims in the state came from 2.2 percent of enrollees. In the same working group, state officials revealed divisions about how well they had done under Obamacare. J.P. Wieske, deputy commissioner of Insurance for Wisconsin, said he believed factors outside of political uncertainty had contributed to troubles with the exchange in his state. “If you've seen one health insurance market, you've seen one health insurance market,” he said. Later, he added: "This one-size-fits all has been the problem from the beginning.”

Sen. Ron Johnson: Put healthcare reform on back burner. The Wisconsin Republican said it is probably time for legislators to focus on areas of work such as taxes and the economy while continuing to negotiate on a healthcare bill in the background. Johnson was asked by CNN's Jake Tapper about a tweet from President Trump aimed specifically at Congress' upper chamber, stating, "Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!" "I really do think we probably ought to turn our attention to the debt ceiling and funding the government and tax cuts until we can really get all the parties together," Johnson said. "From my standpoint that really is getting the governors, House members, senators [and] the White House on the same page in terms of healthcare."

Republicans attack Democrats on government-run healthcare. The National Republican Congressional Committee, the House GOP campaign arm, is running digital ads in eight states hitting Democrats for supporting the creation of what is called a single-payer healthcare system. Democrats have been adopting support for such a government-run system with increasing frequency, a position to the left of Obamacare and closer to the socialized medicine seen in other countries such as the United Kingdom and Canada. House Republicans believe the position could hurt Democratic candidates in 2018.

Obamacare repeal failure gives Republicans a tax headache. Republicans' plan to ditch healthcare to work on tax reform will be complicated by the fact that leaving Obamacare in place means keeping $700 billion in taxes, many of which are hated by some of the small businesses Republicans are trying to help. Sen. Orrin Hatch and Rep. Kevin Brady, the top Republican taxwriters who will be tasked with writing the overhaul of the tax code, have said that they oppose the taxes and would prefer to see them eliminated in any scenario, but they have not said specifically if or how they might be repealed and their revenues replaced in tax reform. The problem facing GOP lawmakers is that if they want to eliminate those $700 billion in taxes as part of tax reform without adding to the deficit, they would have to do so by eliminating a proportionate amount tax breaks, a possibility sure to invite fierce opposition from interests that benefit from those provisions in the tax code.

Sen. Claire McCaskill turns to Congress' healthcare as a solution for counties without Obamacare insurers. A proposal to stabilize the Obamacare exchanges would allow people who live in counties with no insurer to buy coverage from the same place members of Congress get theirs: Through the small business exchange in Washington, D.C., created under the law. Just like members of Congress and their staff members who live in other states, people from these "empty" counties would be able to buy coverage through the D.C. small business exchange, called SHOP. But because they don't receive contributions from an employer to pay for coverage, the federal government would contribute toward the cost of premiums if they meet a certain income threshold. The idea, called the Health Care Options for All Act, from McCaskill, D-Mo., is somewhat similar to an often-cited proposal by Republicans, which would enable people to buy their coverage across state lines, but it's not clear whether it would receive bipartisan support. Outside experts caution that some hurdles would need to be worked out.

'Pharma Bro' Martin Shkreli found guilty of securities fraud. The infamous pharmaceutical CEO was found guilty Friday on two charges of securities fraud and another charge of conspiracy to commit securities fraud. Shkreli, who gained infamy for being CEO of Turing Pharmaceuticals when it raised the price of an antimalarial drug by 5,000 percent, was on trial for defrauding investors in a separate company. He left Turing after he was charged by the federal government last year. Shkreli was found guilty on three of eight charges by a New York jury after five days of deliberations. The trial focused on whether Shkreli defrauded investors in a company called Retrophin Pharmaceuticals. Shkreli had used profits from a separate hedge fund to prop up Retrophin. His lawyers argued that he did not lose any money for his clients, so therefore they were not harmed.

Shkreli leaves legacy on Capitol Hill. A day before he was convicted of securities fraud, his presence was being felt as the Senate passed a bill targeting the price-gouging that made him infamous. Experts say it also helped shed light on a particular brand of price gouging in the pharmaceutical industry. "He is the person that keeps on giving for pharmaceutical reform," said W. Gerard Anderson, professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health. "Many of the things that he made visible we have developed legislative fixes, so the next person can't do it." Anderson said Shkreli's actions as CEO of Turing Pharmaceuticals helped highlight a practice used by some companies to acquire older drugs that have been off patent for decades and then raise the price. Those drugs have little to no competition because not enough patients use them, making the price hikes easy as companies didn't want to go through an approval process of a year or more by the Food and Drug Administration.

Insurer Molina wins $52 million in Obamacare lawsuit. The federal government owes health insurer Molina $52 million for payments it was supposed to receive involving losses under Obamacare, the U.S. Court of Federal Claims ruled Friday. The payments, called "risk corridors," were diminished as part of a spending bill advanced by Republicans, who referred to them as a "bailout" for the insurance industry. Withholding them contributed to losses for insurers and to the shutdown of nonprofit insurance co-ops created under the law. Republicans argued the funds needed an appropriation by Congress and that riders attached to 2015 and 2016 appropriations bills banned such payments. The court rejected those arguments in its ruling.



Axios Hospitals hide the cost of pricey medical procedures

ProPublica Take the generic drug patients are told, unless the insurer says no

Atlantic Why Republicans can’t just pivot to tax reform

The Hill Kasich: GOP needs to admit that some people ‘need help’

Bloomberg AbbVie wages Hepatitis C drug-price war with Gilead

CNN Here, heroin spares no one, not even the sheriff’s wife

STAT News With Trump in the White House, Obama’s science experts operate shadow network to press their positions

Kaiser Health News Congress revamps housing program to benefit areas where HIV is spreading

Washington Post First Affordable Care Act enrollment season of Trump era still a mystery


MONDAY | Aug. 7
Aug. 6-9. Philadelphia Marriott. National Association of Insurance Commissioners’ summer conference. Details.

Aug. 7-8. National Institutes of Health summit on caregiving. Details.

TUESDAY | Aug. 8

10 a.m. 529 14th St. NW. National Press Club. Press conference on the National Business Group on Health’s health plan survey. Details.



9:30 a.m. 529 14th St. NW. National Press Club. Family, Career and Community Leaders of America will raise awareness of the need for safer intersections near schools and announce the results of their Teen Road Safety Assessment initiative. Details.


THURSDAY | Aug. 10

11 a.m. S&P Global Ratings webcast on “U.S. Health Insurance: Earnings, Regulations And Credit Trends.” Details.

12:30 pm. 2055 L St. NW. Center for Global Development on “Implementing Clinical Trials during Epidemics: The Ebola Experience.” Details.