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Daily on Healthcare: Republicans schedule hearing on Cassidy-Graham Obamacare overhaul bill...Bipartisan Senate group prepares to present Obamacare fix this week

Daily on Healthcare: Republicans schedule hearing on Cassidy-Graham Obamacare overhaul bill...Bipartisan Senate group prepares to present Obamacare fix this week
Daily on Healthcare: Obamacare emerges as wildcard in tax debate
Daily on Healthcare: Obamacare emerges as wildcard in tax debate

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Republicans schedule hearing on Cassidy-Graham overhaul bill. After months of criticism that Senate Republicans were trying to ram through a healthcare bill without any hearings, on Monday one Senate committee has scheduled a hearing for Sept. 26 to discuss a Republican effort to overhaul Obamacare by redistributing money to states in the form of block grants.The hearing will be led by the Senate Homeland Security and Governmental Affairs Committee, headed by one of the sponsors of the overhaul, Sen. Ron Johnson, R-Wis. The committee does not typically have jurisdiction over healthcare policy and the event would be held just four days before the limit on passing the bill in Congress would expire. The big question, however, is whether the hearing is enough to mollify the procedural objections of Sen. John McCain, R-Ariz., who cited the lack of hearings in sinking Republicans’ previous effort to partially repeal Obamacare. In addition to Johnson, other sponsors of the bill include Sens. Bill Cassidy of Louisiana, Lindsey Graham of South Carolina and Dean Heller of Nevada.  

Bipartisan Senate group prepares to present Obamacare fix this week. Senators on the health committee worked over the weekend to try to reach an agreement on a stabilization bill for Obamacare that they hope will temper insurer exits and premium increases expected for customers buying coverage on the exchanges. The negotiations follow four hearings over two weeks in which senators from both parties on the Health, Education, Labor and Pensions Committee heard from governors, health insurance commissioners, health policy experts and insurers. Republican Sen. Lamar Alexander, HELP Committee chairman, and Sen. Patty Murray of Washington, the committee's top-ranking Democrat, are expected to release a bill this week. Alexander and Murray expressed optimism about their ability to arrive at a deal, even as Senate leaders have not guaranteed it would receive a vote. Further complicating an agreement are other healthcare bills in Congress. Four Republicans are trying to push through a last-ditch Obamacare overhaul measure, while 17 Senate Democrats are sponsoring a socialized medicine bill, called the Medicare for All Act, introduced by Sen. Bernie Sanders, I-Vt. "It's going to be a tough needle to thread for both sides," a senior GOP aide told the Washington Examiner. "We got a clear indicator on actually how interested many Democrats are in a bipartisan solution for healthcare when 17 of them introduced single payer this week."

Lindsey Graham: Obamacare overhaul is 'Bernie Sanders' worst nightmare.’ The South Carolina Republican warned that America has a choice to make between supporting a Republican plan to overhaul Obamacare or heading toward a socialized medicine proposal introduced by Sen. Bernie Sanders, I-Vt. "This is Bernie Sanders' worst nightmare," Graham said in an interview on Breitbart News Saturday on SiriusXM, speaking about his healthcare proposal. "It's either this or we're going to Obamacare and Berniecare. Now, Berniecare is full-blown single-payer socialism. It is his dream, and that's where Democrats are going."

Cassidy-Graham overhaul bill will add fuel to debate about importance CBO places on individual mandate. Regardless of what it ends up meaning for its prospects of passage, the coming score of the overhaul bill likely will reignite the debate over the weight that the Congressional Budget Office places on the individual mandate when evaluating coverage gains or losses from a given piece of legislation. The CBO determined that prior Republican healthcare bills that would have significantly reduced expected Obamacare spending and nixed the individual and employer mandates would have led to roughly 20 million or so additional uninsured Americans. Though Cassidy-Graham also repeals the individual and employer mandate penalties, it would spend almost as much as Obamacare on coverage. Though there would be redistribution among the states, if CBO believed that spending was a primary determinant of coverage levels, one would expect coverage to be noticeably higher under the latest proposed overhaul than in earlier GOP healthcare bills. But if the CBO again determines that something close to 20 million fewer people would be uninsured without the mandate regardless of how much is spent on subsidizing coverage, it would demonstrate the importance CBO analysts place on the mandate. This is likely to generate controversy, especially because on Friday the CBO acknowledged in a presentation the challenges it has in figuring out the influence of the mandate. The CBO's presentation referred to a study released in May that showed the response to the mandate could grow over time. But the study, co-authored by one of Obamacare's architects, Jonathan Gruber, found that overall coverage rates weren't affected as much by the individual mandate. The CBO said it is difficult to figure the impact of repealing the mandate, among other reasons, because repealing it is "not the same as never having had a mandate." "How much will the knowledge about the benefits of having health insurance, subsidies and the enrollment process that consumers have already gained affect their decisions in the future?" the presentation asked.

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.

Paul Ryan: Cassidy-Graham healthcare bill has 'real promise and potential.’ The House speaker expressed confidence Friday that the Cassidy-Graham bill, which would give states Obamacare funding in the form of block grants, could pass before the end of September, saying the bill has "real promise and potential." Ryan told a local Wisconsin radio program that the state's GOP Sen. Ron Johnson, one of the bill’s sponsors, is "pretty optimistic" that healthcare could be resuscitated in the Senate with the proposal, which would need to pass the chamber by the end of September because of reconciliation rules. "I just came from lunch with Ron Johnson here in Madison an hour ago," Ryan told WISN's Vicki McKenna. "He's pretty optimistic that they may be able to resuscitate this issue. I spoke with Lindsey Graham this morning. There's this Graham-Cassidy bill that I actually think has some real promise and potential. "It's basically federalism where you just block grant the whole thing," Ryan said. "You block grant Obamacare back to the states. Just the whole thing." He also gave the bill a shoutout on Twitter. "I appreciate Senators [Lindsey] Graham and [Bill] Cassidy continuing to work on a plan to pass the Senate," Ryan tweeted. "I'll take federalism over Obamacare any day."

Rand Paul continues assault on bill. The Kentucky Republican isn’t walking back his decision to vote no on Cassidy-Graham, further complicating the math for the Obamacare repeal effort. Paul tweeted on Monday that “Graham/Cassidy keeps Obamacare and tells the states to run it. No thanks.” He then tweeted that no “conservative should vote for a rebranded trillion dollar spending program just because it adds some block grants.” Paul said last week that he would not support the bill, which gives Obamacare funding to states in the form of block grants. His opposition, which has been pretty steadfast, severely complicates the senators’ hopes of getting 50 votes. Paul is the only Republican senator to publicly oppose the bill, although others such as Sen. Susan Collins, R-Maine, have criticized it. Collins has been upset about the defunding of Planned Parenthood for one year. Collins and Republican Sens. Lisa Murkowski of Alaska and John McCain of Arizona voted against a “skinny” repeal bill in late July, dooming that effort.

McCain offers some clues on where he stands. On “Face the Nation” Sunday, McCain reiterated that any healthcare repeal bill should be done through regular order. “If I could just say again, the way to do this is to have a bill, put it through the committee,” he said. “We have Patty Murray and Lamar Alexander are doing fine — bring it to the floor.” While Johnson has scheduled a Sept. 26 hearing on the Graham-Cassidy bill in the Homeland Security and Government Affairs Committee, the two committees that have jurisdiction over healthcare — the HELP and Finance committees — have not.

What about Murkowski? The Alaska Republican has not made any decision on the bill, according to a spokesman in her office. She and Cassidy met Thursday to discuss the bill but she is still reviewing the details. However, Murkowski did tell Bloomberg’s Steve Dennis that she was more excited about “Alexander-Murray,” the bipartisan Obamacare stabilization package expected to be released this week.

America’s Essential Hospitals, which treats a high share of low-income patients, blasted Cassidy-Graham. The group urged Congress to continue working on the bipartisan bill instead. “It appears to significantly restrict federal healthcare funding through per-capita caps and block grants, which would shift costs to states, patients, providers and taxpayers,” said Dr. Bruce Siegel, president and CEO of America’s Essential Hospitals. “Further, by taking an approach so close to that of the earlier House and Senate plans, it’s reasonable to conclude it would have a similar result: millions of Americans losing coverage. Unlike those previous proposals, the Graham-Cassidy bill provides no meaningful relief from looming cuts to Medicaid disproportionate share hospital payments. Further, it would impose strict new limits on how states raise support for the safety net. Rather than providing flexibility, this would limit states’ coverage and financing choices.”

Obamacare stabilization funding could cut premiums by 17 percent. The creation of a $15 billion stabilization fund could lower premiums on Obamacare's exchanges by an average of 17 percent, according to a new analysis. The analysis from consulting firm Avalere Health comes as the Senate is expected to release a new Obamacare stabilization package. But it is not clear if the items that Avalere says will lead to premium decreases will be included in the bill. Avalere found that adding a $15 billion reinsurance fund could help to lower average premiums. Reinsurance would pay Obamacare insurers for their sickest claims, which would in theory lead to lower premiums for everyone else. Avalere said guaranteeing insurer subsidies to lower out-of-pocket costs for low-income Obamacare customers and delaying a tax on insurers would contribute to the 17 percent decline.

Reversing course, Anthem to fill Obamacare's bare counties in Virginia. Health insurer Anthem said Friday that it is reversing its decision to quit the Obamacare exchange in Virginia and instead will expand its presence in the commonwealth. The company, part of Blue Cross Blue Shield, will sell Obamacare plans on and off the exchange in 68 counties in the state, including the 63 counties that would not have had an insurer selling the plans. Several insurers have left Virginia, causing counties to become empty at times. The most recent change came from Optima Health, which decided to offer fewer plans than in 2017 after previously saying it would offer plans in every state.

Florida nursing home says emergency call to governor made 36 hours before patients died. Nursing home officials at the Rehabilitation Center at Hollywood Hills in Florida said they called an emergency cell phone number connected to Florida Gov. Rick Scott's office asking for help 36 hours before patients began to die, but Scott is pushing back. Eight of the nursing home residents died last week after the massive power outages from Hurricane Irma caused the facility's air conditioning to fail. After placing multiple calls to the local electricity utility, Florida Power and Light, a senior official with the nursing home called the number given by Scott and that call went straight to voicemail. A message was left, saying the nursing home required "immediate assistance" from Florida Power and Light, according to the local CBS affiliate. More calls were placed to the power company and the governor's office as the patients’ conditions deteriorated. The governor's office says calls to the emergency cellphone number were transferred to two other agencies, according to ABC News. Scott said he was "heartbroken" by the news and was determined to "aggressively demand answers." "If they find that anyone wasn't acting in the best interests of their patients, we will hold them accountable to the fullest extent of the law," the governor said.

Rep. Bobby Scott proposes grant program open to unions. The top-ranking Democrat on the House Education and the Workforce Committee proposed a new grant program Friday to aid caregivers for the elderly and disabled. Among those eligible to receive the federal funding under the program, dubbed the Direct Care Opportunity Act, would be labor unions. "As one of the fastest-growing occupational sectors in our nation, we must make meaningful investments to ensure that this field is attractive and provides advancement opportunities for those dedicated to the profession. The Direct Care Opportunity Act will support innovative strategies to recruit, retain and support our nation's direct care workers," the Virginia Democrat said Friday. He added that the legislation would "addresses the need for a well-trained, prepared and empowered direct care workforce now and for the future." The proposed legislation would direct the departments of Labor and Health and Human Services to create "not more than" 15 five-year grants "to conduct projects for purposes of recruiting, retaining or providing advancement opportunities to direct care workers." The legislation does not include a specific funding level.


Talking Points Memo Health advocacy groups hit the panic button on GOP’s last-ditch repeal effort

Politico Senate GOP tries one last time to repeal Obamacare

The Hill Clock ticking down on children’s health funding

Boston Globe VA hospitals flooded with complaints about care

Kaiser Health News Trump’s deadline on Dreamers reverberates through health industries

New York Times Amid opioid crisis, insurers restrict pricey, less addictive painkillers

Associated Press Pharmacist in deadly meningitis outbreak headed for trial

Bloomberg FDA clears biotech drug copycats, but buying them isn’t easy

Forbes Take two: Inside Bill Cassidy’s plan to repeal and replace Obamacare


MONDAY | Sept. 18

Sept. 15-19. Chicago. American Academy of Pediatrics conference. Schedule.

Health and Human Services Secretary Tom Price discusses recovery efforts from Hurricane Irma with Florida Gov. Rick Scott.

3:30 p.m. 1301 K St. NW. Washington Post event on Chasing Cancer; includes FDA Commissioner Scott Gottlieb. Details.

TUESDAY | Sept. 19

8 a.m. Newseum. 555 Pennsylvania Ave NW. Roll Call event on “Tackling Mental Health Through Innovation.” Details.

8:15 a.m. Ronald Reagan Building. 1300 Pennsylvania Ave. NW. Bloomberg Live event on “The Future of Healthcare: Unlocking and Supporting Value.” Details.

Noon. Harvard T. Chan School of Public Health event on “In Pursuit of a Single Payer Plan: Lessons Learned” with Vermont Gov. Peter Shumlin. Live Stream.

3 p.m. 430 Dirksen. PCORI event on “Addressing America’s Opioid Problem: The Need for Evidence-Based Strategies” with Sen. Shelley Moore Capito, R-W.Va. Details.

WEDNESDAY | Sept. 20

9 a.m. 562 Dirksen. Senate Special Committee on Aging hearing on “Disaster Preparedness and Response: The Special Needs of Older Americans.” Details.  

9 a.m. National Press Club. 529 14th St. NW. Researchers to announce global study from

Journal of Adolescent Health on “Common Cause of Multiple Social Maladies.”

4 p.m. Washington Post event with Dr. Francis Collins, director of the National Institutes of Health. Details.

SUNDAY | Sept. 24

Sept. 24-28. AHIP’s conference on Medicare, Medicaid and duals. Includes keynote by CMS Administrator Seema Verma. Details.

MONDAY | Sept. 25

10 a.m. National Press Club. 529 14th St. NW. Discussion on “Mental Health and the Opioid Crisis” with healthcare workers and Rep. Tim Ryan, D-Ohio, co-chairman of the House’s Addiction Treatment and Recovery Caucus. Details.

TUESDAY | Sept. 26

10 a.m. Senate Committee on Homeland Security and Governmental Affairs hearing on “Block Grants: How States Can Reduce Healthcare Costs.”  Details.