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Congress set to return Washington with a full plate on healthcare. The Senate will return to Capitol Hill this week and the House returns next week with a lengthy to-do list on healthcare. The next deadline to fund the government is Jan. 19, and as part of the spending bill lawmakers must decide on funding for the Children’s Health Insurance Program and community health centers. They also must come to an agreement on whether they will pass two funding bills that would be aimed at stabilizing Obamacare and help reduce the cost for unsubsidized Obamacare customers. One item that didn’t make the cut in 2017? Obamacare’s medical device tax. That goes into effect this year after a two-year suspension. The Senate Finance Committee soon will hold a hearing for President Trump’s nominee for health and human services secretary, Alex Azar, but confirmed this morning that it had not been scheduled. Finally, lawmakers appear to be divided on whether to take another swing at repealing other parts of Obamacare or whether to instead focus on ways to stabilize it. Congressional Republicans last year were unable to coalesce around a plan to replace Obamacare and are in a similar situation headed into 2018, with one less Senate seat and in a midterm election year.  

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 dailyonhealthcare@washingtonexaminer.com 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.

Uncertainty swirls over next move on broader legislative agenda. Trump or senior White House officials are slated to meet at least twice with GOP congressional leaders next week as Republican lawmakers prepare to return to Washington amid uncertainty about which of the big-ticket items on their legislative agenda they will prioritize first. Beyond the immediate need to fund the government past mid-January, the next focus of congressional leaders appears less clear. The White House, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell have expressed interest in pursuing different policies in the new year as Republicans ride high on the successful passage of their tax reform bill last month. Ryan has signaled a greater interest in exploring welfare reform heading into 2018 than other priorities such as infrastructure. A senior congressional aide told the Washington Examiner that welfare reform is likely to be a major topic of discussion during Trump’s summit at Camp David this weekend. Ryan said he has worked to convince Trump of the need to reform entitlement programs such as Medicare despite Trump’s campaign-era promise not to touch the social safety net. McConnell, for his part, has warned that welfare reform has little chance of surviving the Senate, which soon will have one fewer Republican when Democratic Sen.-elect Doug Jones of Alabama is seated Wednesday.

Trump's medical exam will disappoint critics. Trump's critics looking to seize on his medical records to undermine his presidency or take away his powers are likely to be dissatisfied by the information that will be made public in January. Trump is expected to have his first routine physical as president at Walter Reed National Military Medical Center in Bethesda, Md., on Jan. 12, which will partly serve to address some of the speculation that has been swirling about his health. The medical records may provide some clarity, but no law demands their disclosure or that they are complete. The president must consent to which details are released and with whom. "Very few people have that kind of an exam where they would release everything into the public domain," said Arthur Caplan, founding head of the Division of Medical Ethics at NYU School of Medicine. "The Walter Reed physical is more for the president, president's family, and close advisers to see what they learn. Whether they share it with us is completely up to them."

What's facing Trump in the exam? Since Ronald Reagan, releasing medical information has become more common for presidents. George H.W. Bush had at least four routine medical exams while in office, while Bill Clinton underwent six exams over two terms, George W. Bush had at least five, and Obama had at least four. A Washington Examiner review of past medical records shows significant variation in these physicals. The exams last about four hours, with the White House doctor sometimes taking part alongside other specialists. Other than weight and cholesterol levels, some records have indicated whether presidents had moles removed or received vaccinations. Other information can potentially be more embarrassing, including whether the president has gained weight or has hemorrhoids, or whether he has ever had a sexually transmitted infection.

Obamacare sign-ups slip as some customers cancel plans. Final sign-ups for Obamacare plans on healthcare.gov reached 8.7 million this open enrollment, falling slightly since the Dec. 15 deadline partly because some customers canceled plans they were automatically enrolled in. The Centers for Medicare and Medicaid Services initially reported that 8.8 million people signed up for plans. A CMS official told the Washington Examiner that the number declined because some customers canceled their plans within hours of the deadline. The final data, which extend to Dec. 23, are difficult to parse because they include customers who were not tallied as part of the enrollment totals released several days after the deadline, including those who enrolled between midnight and 3 a.m. on Dec. 16, the final three hours on the West Coast, nor did they include people who had left their numbers with a call center and would still be allowed to enroll. The latest data from Thursday include a mix of these as well as those who dropped out of plans.

Federal watchdog slams FDA food recall authority. A federal watchdog found the Food and Drug Administration was lax in initiating voluntary food recalls. The Department of Health and Human Services’ Inspector General released the report last week that examined 30 voluntary food recalls from the 1,557 reported to the FDA from October 2012 to May 2015. “We identified deficiencies in FDA's oversight of recall initiation, monitoring of recalls, and the recall information captured and maintained in FDA's electronic recall data system,” the report said. The FDA received new authority in the Food Safety Modernization Act to order recalls of harmful foods. The report found that the FDA didn’t always evaluate health hazards in a timely manner or collect timely and complete status reports from firms that did recall foods, the IG said.

RUNDOWN

Washington Post Generic drugs had a great 2017

Politico GOP Obamacare quandary: Easy to hate, hard to kill

The Hill GOP set to shift Obamacare tactics in 2018

Bloomberg Trump FDA chief Scott Gottlieb isn’t pharma’s BFF after all

Cleveland Plain-Dealer New Medicaid rule will further open acupuncture services to help combat opioid abuse

STAT News Too much screening has misled us about cancer risk factors, experts say

Axios How your healthcare will be reshaped in 2018



Calendar

WEDNESDAY | Jan. 3

Senate back in session. House not in session.

THURSDAY | Jan. 4

9:45 a.m. American Enterprise Institute event on “Reconnecting health care policy with economics: Finding and fixing distortive incentives.” Details.

TUESDAY | Jan. 9

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on “The Opioid Crisis: An Examination of How We Got Here and How We Move Forward.” Details.