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Republicans return to healthcare talks: Senators did not speculate on when they might come to an agreement on the bill. Senate Majority Leader Mitch McConnell, R-Ky., said Monday that Republicans “will continue working” on a healthcare bill but did not schedule a vote. Sen. Susan Collins, R-Maine, a key centrist vote who has said she believes Republicans should work with Democrats on crafting a bill, emphasized that provisions to cover pre-existing illnesses were important to her, as were many other healthcare provisions. “I have a lot of concerns about Sen. Cruz’s amendment,” she said, referring to a proposal by Sen. Ted. Cruz, R-Texas, and Sen. Mike Lee, R-Utah, that would allow insurers to offer plans free of Obamacare’s regulations as long as they offered at least one that met current requirements. “It would erode protections for people with pre-existing conditions, and it is simply not the answer. I think it would cause premiums to go up for a lot of people.” Conservatives, meanwhile, are concerned that the bill doesn’t do enough to reduce premiums and see the Cruz proposal as the last, best hope to achieve genuine cost reduction. Still, if a new score from the Congressional Budget Office were to project difficulties in accessing coverage for people with pre-existing conditions, centrists likely would continue opposing the bill. Others appeared open to seeing how the proposal would play out.
Meanwhile, conservatives worry Cruz-Lee amendment won’t be in the GOP healthcare bill. According to Republican aides, only an outline of the Cruz-Lee proposal, called the Consumer Freedom Act, was sent to the CBO for analysis, which suggests that the GOP leadership isn’t serious about including it in the final bill. GOP leaders are hoping to bring to the floor for a vote as early as next week. “Senate leadership was given full text of the CFA the Friday before July 4th,” a leadership aide told the Washington Examiner. “But CBO was only given bullet points. We have since diligently responded to all of CBO’s questions about the text.” Sen. Mike Lee, R-Utah, would oppose the bill if it didn’t include the amendment and other conservatives would likely remain in the “no” camp with him, especially if the bill axed the amendment while keeping increased funding to stabilize insurance markets.
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Pence urges Senate GOP to pursue repeal if consensus can’t be reached, heads to Kentucky. “If they can’t pass this carefully crafted repeal-and-replace bill, we ought to repeal only,” Vice President Mike Pence said in an interview on Rush Limbaugh’s show. The vice president will travel to Lexington, Ky., Wednesday to speak with business owners about the need for repealing and replacing Obamacare, the White House announced Tuesday. Pence’s visit to the Horse Capital of the World will include a stop at Bryant’s Rent-All, on the western side of downtown Lexington.
White House projects healthcare optimism as Trump tweets about no August recess. “Whether it’d be before August recess or during August recess, the president expects the Senate to fulfill the promises it made to the American people,” Reince Priebus said during an appearance on “Fox News Sunday.” Priebus said Trump expects to see Congress repeal and replace Obamacare “maybe before” or “maybe a little bit into” the August recess, which will begin the week of July 31 if it proceeds as scheduled. Marc Short, the White House’s legislative affairs director, projected optimism this week that Republican lawmakers could resolve their disputes before the recess begins. However, he echoed Trump and Pence by suggesting members should vote on a clean Obamacare repeal bill if they fail to muster the support necessary to pass the current healthcare plan. “We still look forward to completing the repeal and replace before August,” Short told reporters at the White House Monday, adding that he hoped Congress could pass a tax reform package in the same time frame. And Sarah Sanders, deputy press secretary, declined to elaborate on the president’s warning when pressed about the August recess Monday. “I don’t know that he’s going to lay out a list of consequences” for members who stall the healthcare bill, Sanders told reporters. “His focus is making sure it gets done, not on what happens if it doesn’t.”
Police arrest 80 people protesting on Capitol Hill. Demonstrators from across the country descended on more than a dozen lawmakers’ offices as part of an organized protest, using the call-and-response “mic check” to share their personal stories, including their own pre-existing conditions they fear will be at risk if the partial Obamacare repeal effort is successful. Some carried signs that read “Trumpcare = death” and “Love it, improve it, Medicare for all.” The sounds of their chants, including “Hey hey, ho ho, Trumpcare has got to go” and “Kill the bill, don’t kill me” filled the office buildings and echoed down the hallways as tourists and staffers, many ushered by Capitol police, hurried by the protesters.
AARP targets GOP senators during health bill’s final push: The seniors lobby announced a new ad buy Tuesday to convince five GOP senators to oppose the Senate healthcare bill as it comes up for a vote as early as next week. The ads will target Sens. Lisa Murkowski of Alaska, Dean Heller of Nevada, Cory Gardner of Colorado, Rob Portman of Ohio and Shelley Moore Capito of West Virginia. The ads on the radio and TV will call for them to vote against the health bill. All of the senators are opposed to the bill except for Gardner and Murkowski, with Murkowski saying she has severe reservations about it. AARP has been a staunch opponent of the bill, deriding a plan to allow insurers to charge seniors five times the amount they charge younger people. Obamacare allows insurers to charge three times the amount.
Uninsured rate rises slightly. The percentage of U.S. adults without health insurance grew during the second quarter of 2017 to 11.7 percent, up from 11.3 percent during the first quarter, according to Gallup and Sharecare. The uninsured rate has been measured by the group since 2008, and it had reached a record low of 10.9 percent during the third and fourth quarters of 2016. Rates were highest, at 20.4 percent, among adults between the ages of 26 to 34, suggesting that the provision to allow children to stay on a parent’s plan until the age of 26 is effective at ensuring coverage. Authors of the poll said that people may be sensitive to the price increases that occurred this year and that they also may be unsure whether they will be penalized under Obamacare if they choose to go uninsured. Uninsurance rates are projected to rise even higher under the GOP healthcare plan, to 22 million more people by 2026 than under current law.
Almost 40 percent fewer Obamacare insurers sign up for next year. For 2018, 141 insurers submitted applications to offer plans on healthcare.gov. That is down from 227 insurers that submitted plans at the initial deadline last year. The Centers for Medicare and Medicaid Services report released Monday also showed a steep decline in insurer participation at the start of last year’s open enrollment. Although 227 insurers initially submitted plans, only 167 insurers participated in open enrollment in the fall. Insurers can decide later whether to participate in Obamacare, as the final deadline is not until the fall. Open enrollment for 2018 is expected to start in November.
FDA user fees expected to reach House floor this week. “AdvaMed is pleased the full House will be taking up the FDA Reauthorization Act this week,” said Scott Whitaker, the group’s president and CEO, who urged House members to vote in favor of the legislation. “Passage of this legislation will help patients everywhere as it will bring us one step closer to helping FDA fulfill its crucial mission to ensure the availability of safe and effective medical devices and diagnostics. The robust performance goals, process improvements, increased accountability and additional resources built into the new user fee agreement mean that patients will benefit from more timely access to the latest medical innovations and companies will benefit from greater certainty as they plan for the next-generation of advancements.”
Bill aims to get seniors to make living wills. A new bill tries to get more seniors to put together living wills by paying them. The bipartisan bill spearheaded by Sen. Chris Coons, D-Del., would give seniors a one-time payment of $75 if they can show they put together a living will. The will, also called an advance directive, lays out their wishes for medical treatment if they are incapacitated. The $75 would be paid out by the Centers for Medicare and Medicaid Services and is intended to get seniors and family members talking about a difficult issue, a Senate aide told the Washington Examiner.
Cruz remakes his image in Texas ahead of re-election race. In a sharp departure from his fiery, “abolish the IRS” presidential revivals, Cruz opened a forum on veterans issues just after Independence Day by touting the strength of his constituent services operation. It was a subdued and earnest senator, part of Cruz’s concerted effort before running for re-election in 2018 to repair an image that took a huge hit in Texas, partly because of memories of his hostility toward President Trump. Gone was Cruz the ideological warrior, who cultivated a national base by railing against his party’s establishment and scorning his Republican colleagues — often by name, a breach of time-honored Senate decorum. So, nearly four years after defying Republican leaders to lead a government shutdown aimed at forcing former President Barack Obama to defund his signature healthcare law, Cruz was telling a mostly friendly crowd that he was negotiating a compromise on legislation to partially repeal Obamacare.
FDA beefs up safety requirements on opioids. The Food and Drug Administration decided Monday to strengthen training and prescribing requirements for immediate-release painkillers. The agency said it will add immediate-release opioids to its Risk Evaluation and Mitigation Strategy, which are safety requirements that drug makers have to meet to get their products on the market. The FDA already has a REMS for extended-release opioids, but expanded it to immediate-release painkillers. The actions earned plaudits from Sen. Joe Manchin, D-W.Va. “I strongly support mandatory prescriber education, and I am grateful that] Administrator [Scott] Gottlieb will finally begin taking steps to strengthen prescriber education for immediate release opioids,” he said.
RUNDOWN
STAT News In rare move, FDA reverses course on drug developed by CEO with Trump ties
Axios What’s next if the Senate health bill fails?
The Hill Ted Cruz: ‘Crazy’ to go into August recess without healthcare plan
Bloomberg Ditching Obamacare may make U.S. income inequality even worse
Washington Post Senate Democrats turn to Republican governors in effort to scuttle healthcare bill
Roll Call Healthcare’s Senate mountain stage
Politico Conservatives bet on risky plan that could tank Obamacare markets
Modern Healthcare With health bill vote looming, HHS seeks comments on how to stabilize markets
New York Times Foes of Obama-era rule work to undo birth control mandate
Calendar
TUESDAY | JULY 11
House back in session.
2:30 p.m. SR-418 Russell. Senate Veterans’ Affairs Committee hearing on “Pending Healthcare Legislation.” Details.
WEDNESDAY | JULY 12
House expected to vote on five-year renewal of FDA user fee programs.
July 12-13. Children’s Hospital Association holds family advocacy day. Details.
9 a.m. National Press Club. Event on “Genetic Engineering: The Future of Agriculture and Public Health.” Details.
10 a.m. 334 Cannon. House Veterans’ Affairs Committee hearing on “Care Where It Counts: Assessing VA’s Capital Asset Needs.” Details.
10 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Combating the Opioid Crisis: Battle in the States.” Details.
10:30 a.m. 2322 Rayburn. House Energy and Commerce subcommittee meeting on “Examining Medical Product Manufacturer Communications.” Details.
1 p.m. National Press Club. The Association of American Universities and the Science Coalition hold a discussion on “The State of American Science.”
3 p.m. Urban Institute. 2100 M St. NW. “The Impact of Early Childhood Education on Health and Well-Being: The Latest Research from Policies for Action.” Details.
7 p.m. George Washington University. Lisner Auditorium. 730 21st St. NW. Town Hall on “America’s Opioid Crisis: A National Town Hall.” Details.
THURSDAY | JULY 13
9 a.m. Newseum. 555 Pennsylvania Ave. NW. CQ Roll Call, members of Congress and David Cordani, president and CEO of Cigna, will convene a group of government officials and stakeholders to discuss preliminary research findings of a new study examining the impact of the growing opioid crisis in the U.S. Details.
10 a.m. Bipartisan Policy Center. 1225 I St. NW. Event on “Future of Health Care: Can Increased State Flexibility Balance Innovation, Cost and Coverage?” Details.
2 p.m. 334 Cannon. House Veterans’ Affairs Committee hearing on “Maximizing Access and Resources: An Examination of VA Productivity and Efficiency.” Details.
