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Daily on Healthcare: House Republicans seek anti-abortion provisions in Obamacare bills

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House Republicans seek anti-abortion provisions in Obamacare bills. House Republicans want to ensure that Obamacare stabilization bills include protections to prevent the money from funding abortions. Supporters of the two bills are looking to add them to a must-pass, two-year spending bill Congress is expected to take up this month. House Republicans have called for the bills to include protections to ensure federal dollars don’t go toward abortions, and the White House is seeking to make the bills more conservative. “Hyde language needs to be in whatever we do,” said House Energy and Commerce Committee Chairman Greg Walden, R-Ore., referring to the Hyde Amendment, a spending rider that prevents federal dollars from being used for abortions. House Speaker Paul Ryan wants any bills intended to stabilize the Obamacare marketplace to be compliant with the Hyde Amendment, spokeswoman AshLee Strong told the Washington Examiner. The White House, meanwhile, is seeking changes that include boosting health savings accounts as well as the Hyde protections. Obamacare’s tax credits, which help customers pay for the cost of health insurance, already must comply with the Hyde Amendment. Republicans have previously questioned whether more protections are needed and if the amendment’s protections are being enforced.

Conservatives aren’t pleased Obamacare could be added to spending bill. House conservatives are not pleased that the Obamacare bills might be added to the omnibus spending bill, which will appropriate money agreed to under a budget deal last month. “There are all kinds of things that might possibly go into the [omnibus],” said Rep. Jim Jordan, R-Ohio, a founder of the House Freedom Caucus. “We are obviously not for that.” Freedom Caucus Chairman Rep. Mark Meadows, R-N.C., said the bills likely would be included in the omnibus. “There are issues from a conservative standpoint as most conservatives don’t support that,” he told reporters Wednesday. Even though conservatives don’t like the bills, Meadows hinted they likely would not derail the $1.2 trillion spending bill. “I think there is not going to be another shutdown and that is part of why we are seeing a cool, calm collected approach,” he said. Congressional negotiators are hammering out the specific proposals that will be included in the spending package.

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.

Baldwin introduces bill aimed at getting more younger people into Obamacare. Sen. Tammy Baldwin, D-Wis., has introduced a bill that would increase the amount of Obamacare subsidies that go toward younger adults, aiming to bring more of them into the exchanges to help stabilize the marketplace. The Advancing Youth Enrollment Act would give bigger federal subsidies to people between the ages of 18-34 so that the cost of private Obamacare plans would be lower. Under Obamacare, people who don't get health insurance through a job or through a government program, like Medicare or Medicaid, can buy health insurance with the help of the federal government. An analysis by the pro-Obamacare group Young Invincibles projects that 4 million people between the ages of 19 to 34 would be eligible for higher subsidies if the legislation passed.

Alex Azar calls out Obamacare as Trump administration shifts to value-based care. Health and Human Services Secretary Alex Azar on Thursday laid blame on the Affordable Care Act for placing burdens on insurers. Azar pointed to recent moves by the Trump administration to offer cheaper but low-quality plans that bypass Obamacare’s insurance regulations. “We are committed to using the flexibilities we have within the law to allow insurers to offer competitive products that work for consumers,” he said Thursday at the America’s Health Insurance Plans policy conference in Washington. “We know the layers of regulation imposed by the Affordable Care Act have made this almost impossible.” Azar’s speech largely mirrored one he gave this week before the Federation of American Hospitals. He said the Trump administration is making moves to shift payments more toward the value of the service provided rather than just for a procedure. “There are a number of regulations that may be getting in the way of value-based transformation, including certain Medicare and Medicaid price reporting rules, restrictions in some [Food and Drug Administration] communication policies, and current interpretations of various anti-fraud protections,” he said.

Azar slams negotiations between payers and manufacturers. Azar said during his speech that more transparency is needed for prices throughout the healthcare system, but he had some pointed words for the discounts negotiated between pharmacy benefit managers and drug manufacturers, saying the huge gaps between the list price and the actual price are “notorious. It’s like the gap between the $500 rack rate on the back of the door in your Hampton Inn room and the $100 you actually pay,” he said. “The thicket of negotiated discounts makes it impossible to recognize and reward value, and too often generates profits for middlemen rather than savings for patients.” The remarks came a day after Food and Drug Administration Commissioner Scott Gottlieb said at the conference that the payment system was rigged against patients.

Speaking of pharmacy benefit managers and insurers... Cigna made waves late Wednesday by announcing a plan to take over PBM giant Express Scripts. The $67 billion bid for one of the biggest PBMs in the country is the latest move in the growing consolidation among healthcare service companies. It follows a bid by the CVS pharmacy chain, which is getting into the PBM market, to buy health insurance giant Aetna. The PBM market is heavily concentrated, with three companies controlling 80 percent of the market.

Ellison becomes lead House Democrat on 'Medicare for All' bill. Rep. Keith Ellison, deputy chairman of the Democratic National Committee, is becoming the lead sponsor of a healthcare bill that would move everyone in the U.S. onto the Medicare program. The Minnesota Democrat is replacing Rep. John Conyers Jr., as the sponsor of the Expanded and Improved Medicare For All Act after receiving unanimous consent. Conyers retired from Congress under pressure following allegations of sexual harassment. "Healthcare is a human right, and Medicare for All is an idea whose time has come," said Ellison, referring to the policy in a tweet shortly after the announcement. More Democrats are backing a healthcare system in which the government would be the sole payer for healthcare services. Under the proposal, Medicare would pay for a range of medical services, from mental health to emergency services and prescription drugs.

Top Republican looks to codify move to short-term healthcare plans. Sen. John Barrasso, R-Wyo., introduced legislation Wednesday that would let more people enroll in short-term health insurance plans, an idea that builds off a Trump administration proposal issued last month.

The Improving Choices in Health Care Coverage Act would allow people to stay on less expensive, short-term medical plans for as long as 364 days and allow them to renew for subsequent years. "We should discuss actually giving people more freedom, more flexibility to choose a health care plan that is right for them. I’m introducing a bill today to do just that," Barrasso said on the Senate floor of his legislation. The Trump administration has issued a proposal to allow people to remain on short-term plans for as long as 364 days. Barrasso’s bill goes further than the Trump administration because it would allow a change the law, which would limit future administrative actions. It would guarantee that the plans can be renewed, which means that people could stay in their plan without reapplying and wouldn't be dropped from coverage after getting sick.

Lawmakers seek to renew momentum around right-to-try. Reps. Andy Biggs, R-Ariz., and Brian Fitzpatrick, R-Pa., are hoping to get a bill that would let terminally ill patients try experimental drugs through the House. “The Right to Try Act merely allows terminally ill patients who have exhausted all other options to try medications that have passed basic Food and Drug Administration safety protocols but not completed the full, multiyear approval process,” the two lawmakers said in an op-ed in the Washington Examiner. “This bill safeguards any pharmaceutical company that may wish to participate in Right to Try, but it in no way requires participation, nor does it impose a mandate on anyone. Instead, this legislation gives patients who have no other options a chance.” The bill passed the Senate last year but it has stalled in the House Energy and Commerce Committee. Chairman Rep. Greg Walden, R-Ore., has said that he is hoping to address some concerns surrounding the legislation to make it more bipartisan.



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THURSDAY | March 8

March 5-9. Las Vegas. HIMSS 2018 Conference and Business Exposition. Details.

March 7-8. Ritz Carlton. America’s Health Insurance Plans Health Policy Conference. Details.

TUESDAY | March 13

March 13-15. Miami. Barclays Global Healthcare Conference. Details.

2 p.m. 1789 Massachusetts Ave. NW. AEI event on “The Numbers Behind the Opioid Crisis”: Remarks from Sen. Mike Lee, R-Utah. Details.