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Daily on Healthcare: Trump heads into first routine medical exam as president, predicts it will go ‘very well’

Daily on Healthcare: Trump heads into first routine medical exam as president, predicts it will go ‘very well’
Daily on Healthcare: Obamacare emerges as wildcard in tax debate
Daily on Healthcare: Obamacare emerges as wildcard in tax debate

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Trump heads into first routine medical exam as president, predicts it will go ‘very well.’ The White House physician, Dr. Ronny Jackson, will lead the exam at Walter Reed National Military Medical Center in Bethesda, Md., beginning at 12:45 p.m. today. Jackson will provide details of his findings and answer questions Tuesday during the White House briefing, White House press secretary Sarah Sanders said. "He'll put out a brief statement but will take the weekend to compile the rest of the results, lab results, things like that," she said. Jackson was appointed to his role by former President Barack Obama in 2013. A routine medical exam such as the one Trump is facing tends to focus more on a general assessment of a person's physical well-being. Assessments of memory, function, depression, and anxiety are typically conducted for people over age 65, using a questionnaire by a primary care provider. It is not clear, however, whether these assessments will be included for Trump, who is 71, and if they are, whether they will be made public. As with previous administrations, a president must consent to which medical information is made public. Read more about what to expect from the president’s physical. Disclosure of medical information is not only political but can have implications on foreign policy, public policy and the economy, a point Trump made Thursday when asked about how he expected his exam to go. The president said Thursday he will be “surprised” if his upcoming physical produces negative news about his overall health, saying the stock market could tank if he's wrong. “I think it's going to go very well,” he said. “It better go well, otherwise the stock market will not be happy.”

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Pelosi dismisses Trump 'stable genius' declaration: 'Doesn't that raise certain questions?' House Minority Leader Nancy Pelosi, D-Calif., dismissed Trump's declaration last week that he is a "stable genius" and said that such a statement raises "certain questions" about any individual making such a proclamation. "What difference does it make what I think?" Pelosi told reporters at her weekly press conference. "No. I'm not going to that place. I take issue with a person presenting himself as a genius. Doesn't that raise certain questions? But I'm not going to go to how he — his tweets. I'm just not going to that place."

Another mental health group slams tone of dialogue on Trump’s mental health. The Bazelon Center for Mental Health Law, a national legal advocacy organization, slammed members of the media and the public for throwing around words such as “unhinged,” “crazy” and “unstable” to describe the president’s mental health. “Behind these provocative words lies the all-too-common assumption that a person who has a mental health disability cannot possibly be trusted, let alone successful,” the group writes. “Unfortunately, this assumption seems prevalent even among psychiatrists who should professionally be most aware of this falsehood.” The group said it believed using these descriptions would cause harm to people with mental health disabilities, who have faced discrimination in employment, housing and other areas, and have therefore avoided seeking treatment. “Some of those eager to diagnose the president have cited concerns about his ‘verbal aggressiveness, boasting about sexual assaults, inciting violence in others and the continual taunting of a hostile nation with nuclear weapons,’” the group wrote. “While concerns about such conduct may be fairly raised, it is the conduct itself, not a mental health diagnosis, which is relevant. Claiming a person must be mentally ill – or ‘crazy’ – to exhibit these behaviors is factually incorrect and blatantly discriminatory.” The American Psychiatric Association issued a similar rebuke earlier in the week.

Democrats push for permanent CHIP reauthorization. Some Democrats are pushing for a permanent reauthorization to the Children’s Health Insurance Program after a new estimate finds it would save the federal government money. The nonpartisan Congressional Budget Office found that a 10-year reauthorization would save the federal government $6 billion over the next decade. The development has led to some Democrats to call for more than a five-year reauthorization of the program, which some Republicans are eyeing. “I would like this to be as long as possible,” Sen. Ron Wyden, D-Ore., said Thursday. Wyden said he hasn’t heard of any Democrats who would vote against a much longer or permanent reauthorization. Others said Thursday they would like to get a permanent reauthorization, but would accept a shorter period. “It would be smarter to do a permanent deal, but I think we need to be realistic on what we can get done in the next couple of weeks,” said Sen. Chris Murphy, D-Conn. Republicans are already eyeing at least a five-year reauthorization package for CHIP to be included in a short-term spending bill to fund the government after current funding expires Jan. 19.

House lawmaker doesn’t want CHIP to be in the next spending bill. Rep. Frank Pallone, D-N.J., is among those pushing for a permanent reauthorization, but he doesn’t want CHIP to be taken care of in the spending bill because it may not pass. “We don’t know if the [continuing resolution to fund the government] is gonna pass,” he said. CHIP would get “subsumed in this whole [continuing resolution] spending debate.” Pallone also slammed a five-year CHIP reauthorization bill that passed the House a few months ago but stalled in the Senate. Democrats largely opposed the bill due to funding offsets that include charging wealthy seniors higher Medicare premiums, raiding an Obamacare disease prevention fund, and shortening the grace period between when a person doesn’t pay their premium and their Obamacare coverage gets cut off. “We want to get rid of these bad pay-fors that sabotage the [Affordable Care Act],” Pallone said. But CBO may have made the funding offset issue moot. Wyden asked the budget office to examine the impact on government spending if CHIP is reauthorized for 10 years. The agency looked at a Senate bill that would reauthorize the program for five years and estimated what happened if the reauthorization period extended for twice as long. The CBO found that it would save the federal government $6 billion if CHIP were reauthorized for a decade. The reason is costs for alternatives such as Obamacare subsidies or Medicaid would be higher.

White House: Some take advantage of Medicaid. White House press secretary Sarah Sanders said Thursday that some Medicaid enrollees may be taking advantage of the program that offers little- or no-cost health insurance. "I think there are certainly cases where that happens," Sanders said at the White House press briefing. "We don't think that's the overwhelming majority, but certainly that's an issue and something we want to be able to address." Sanders was responding to a question from a reporter who asked if the Trump administration believed people were "taking advantage of the system," and had therefore given states the ability to set Medicaid work, volunteer or education requirements as a condition of being enrolled in the program. The administration has stressed that the guidelines are meant to move people out of needing Medicaid — in most states, residents must make less than $16,000 a year to qualify — and into work where they can be offered healthcare coverage.

Kevin Brady: Delay of ‘Cadillac’ tax could ‘possibly’ make it into spending bill. The must-pass spending bill to fund the government next week could include a delay of Obamacare’s “Cadillac” tax on high-cost health plans, according to House Ways and Means Chairman Kevin Brady, R-Texas. Brady told reporters Thursday that even some Democrats believe the tax needs to be delayed again. It is scheduled to go into effect in 2020 after being delayed by Congress and the Obama administration in 2015. “Right now, and even Democrats who put that awful tax place, believe it needs to be delayed,” he said. Brady was then asked if a delay could be included in a continuing resolution to fund the government after the current one expires Jan. 19. “Possibly. I would like to see some action there,” he responded. “We want to work closely with our Democrat colleagues and the leadership on that.”

Heidi Heitkamp will support HHS pick, all but ensuring confirmation. Sen. Heidi Heitkamp, D-N.D., said Thursday she would support President Trump’s pick to lead the Department of Health and Human Services. Heitkamp is the second Democratic senator to publicly support nominee Alex Azar, and joins Sen. Joe Manchin, D-W.Va. Both senators are up for re-election in 2018 in states that voted overwhelmingly for Trump in 2016. Heitkamp called Azar, a former pharmaceuticals executive and HHS veteran under the George W. Bush administration, “incredibly competent.” The support from Manchin and Heitkamp makes Azar's confirmation even easier. Azar won't need Democratic support to be confirmed in the GOP-led Senate, but support from Democrats will let Republicans say he had bipartisan support. Still, some Democrats have railed against Azar, and have said that he raised the prices of multiple drugs while he was the head of Eli Lilly’s U.S. division from 2012 to 2017. First Azar must get through the Senate Finance Committee, which held a confirmation hearing on his nomination earlier this week. A vote has not been scheduled.

FDA says cough medicines with opioids shouldn’t be given to children. The Food and Drug Administration announced Thursday that it is requiring changes to the labels that will stipulate the prescription cough and cold medicines, which contain opioids such as codeine and hydrocodone, should not be given to children. The labels will need to include a boxed warning, which is the most prominent type of label that the FDA requires, saying that the drug has a risk of misuse, abuse, addiction, overdose and death.  “Given the epidemic of opioid addiction, we’re concerned about unnecessary exposure to opioids, especially in young children,” FDA Commissioner Scott Gottlieb said. “We know that any exposure to opioid drugs can lead to future addiction. It’s become clear that the use of prescription, opioid-containing medicines to treat cough and cold in children comes with serious risks that don’t justify their use in this vulnerable population.”


Axios New Medicaid rules will face lawsuits almost immediately

The Hill Officials defend ending ‘flawed’ mental health, drug abuse registry

Politico Dozens of experts urge doctor to examine Trump’s neurological health during physical

Bloomberg Trump is getting a physical. What about your CEO?

JAMA The rise and fall of mandatory cardiac bundled payments

Washington Post Mental health professionals can’t agree on evaluating Trump’s psyche

Reuters U.S. judge pushing for opioid settlement reaches out to states

Roll Call States alarmed by delay in HHS family planning money


FRIDAY | Jan. 12

Jan. 11-12. 1300 Pennsylvania Ave NW. MedPac January public meeting. Details.

12:45 p.m. Walter Reed National Military Medical Center. President Trump to undergo routine medical exam. Details.


Martin Luther King Jr. holiday. Federal offices closed.


9:30 a.m. 1225 I St. NW. Bipartisan Policy Center event on “Reinventing Rural Health Care: A Case Study of Seven Upper Midwest States.” Details.

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on “Facing 21st Century Public Health Threats: Our Nation’s Preparedness and Response Capabilities.”  Details.

10 a.m. SD-342 Dirksen. Senate Homeland Security and Governmental Affairs Committee hearing on “Unintended Consequences: Medicaid and the Opioid Epidemic.” Details.

10 a.m. 1100 Longworth. House Ways and Means Committee hearing on preventing opioid misuse. Details.