Daily on Healthcare: Hinge week for healthcare…Trump wants ‘beautiful’ bill before recess…

Hinge week for healthcare: As Republicans return to Washington, Senate Majority Leader Mitch McConnell, R-Ky, is scrambling to figure out a path to get a healthcare bill across the finish line. This week may not be make or break for the process, but we’re calling it “hinge week” because it could help determine the direction that the legislation is likely to go from here. Republicans expect to hear back from the Congressional Budget Office with an estimate on two versions of an updated bill. Both versions include more funding for the fight against opioid abuse, more money to stabilize insurance markets and a provision to allow individuals to use health savings account money toward paying premiums. But one version will include a measure from Sen. Ted Cruz, R-Texas, to allow insurers to offer health plans that don’t meet Obamacare’s regulatory requirements as long as they offer a plan that is fully compliant. Adoption of the item is crucial to gaining conservative support for the bill, but it also spooks moderates. Senate reaction to the CBO score will shape the next round of negotiations and could force McConnell to abandon the current framework and take a drastically different approach.

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President Trump pressures Congress to pass ‘beautiful’ healthcare bill before summer break. “I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!” Trump wrote on Twitter Monday morning. On Sunday, he tweeted: “For years, even as a ‘civilian,’ I listened as Republicans pushed the Repeal and Replace of ObamaCare. Now they finally have their chance!”  

Pence interview underscores GOP impatience on healthcare: Vice President Mike Pence told conservative talk radio show host Laura Ingraham that Republicans are “close” to a deal on healthcare. But Ingraham didn’t appear convinced, mentioning McConnell’s comments last week that if the health bill fails, Republicans should work with Democrats to fix Obamacare. Pence noted that repealing Obamacare is a major priority since the law is collapsing. “We all know that and we are not getting it done,” Ingraham responded. Pence said the coming week was “critical” for getting Obamacare repealed.

​Senate Democrats urge GOP to stabilize the exchanges: Lawmakers said in a letter to McConnell that they wanted to discuss solutions such as guaranteeing cost-sharing reduction subsidies, expanding reinsurance programs, and finding solutions for counties facing the prospect of having no insurer next year. They pointed to several bills that address these provisions, saying they would have an immediate impact on reducing the cost of premiums.

Senate GOP holdouts targeted by Pro-Obamacare group: The group Save My Care wants to ensure that key senators don’t switch their vote against healthcare reform. The group targeted Sens. Lisa Murkowski of Alaska, Dean Heller of Nevada, Shelley Moore Capito of West Virginia, and Susan Collins of Maine with ads. All of them have said publicly they oppose the Senate health bill in its current form. The goal behind the ads is to get the senators to stand firm and turn down any backroom deals that may emerge to entice holdouts to jump on board, the group said. Republicans can afford only two GOP defections, so if the four holdouts continue to oppose the health bill, it would fail.

Cruz’s healthcare proposal faces cost concerns. Conservatives have cheered an amendment from the Texas Republican that would let insurers sell plans on the individual market that don’t comply with Obamacare’s coverage requirements, as long as they sell some plans that do. The measure, however, is prompting questions about whether it would increase federal spending on tax credits since sicker people would face higher premiums. Cruz has said that tax credits and a stability fund of $50 billion over four years would defray higher premiums for sicker people in the Obamacare pool. Cruz said last week that if sick people were subsidized, it could be “far better for that to happen from direct tax revenue rather than forcing a bunch of other people to pay much higher premiums.” Some experts question if that could lead to more federal funding since tax credits rise to meet any increases in premiums.

Cruz calls for clean Obamacare repeal if GOP can’t pass new healthcare law. Speaking Sunday on ABC’s “This Week,” Cruz said the GOP’s goal should be to see premiums drop with their new legislation, but if they can’t agree on how to do that, they should change their focus to solely repealing Obamacare. “If we can’t get this done right now, I agree with the president, then let’s honor the promise on repeal,” Cruz said.

Sen. Bill Cassidy: Senate healthcare plan, as originally proposed, is dead. Cassidy, R-La., said on “Fox News Sunday” there is no public Senate Republican healthcare plan because the Better Care Reconciliation Act is undergoing a revision that will change much of its tenets. “We don’t know what the plan is,” he said. “The draft plan has now been in serious rewrite. We don’t know the serious rewrite. Clearly, the draft plan is dead but we don’t know what’s in the serious rewrite.” Cassidy has proposed a healthcare bill of his own with Sen. Susan Collins, R-Maine, that has six co-sponsors. He said Sunday that he has “reservations” about the Senate GOP plan to repeal Obamacare and he thinks his bill — which keeps Obamacare taxes in place for the most part and devolves federal healthcare power to the states — is the only possible solution. Of the proposal to repeal Obamacare and replace it later, Cassidy said:  “Non-starter. “It’s wrong, I think it betrays President Trump’s campaign pledges.”

Sen. Chuck Grassley: Cruz amendment may be ‘subterfuge’ for pre-existing illnesses. “There’s a real feeling that that’s subterfuge to get around pre-existing conditions,” Grassley, R-Iowa, told Iowa Public Radio last week. “If it is subterfuge and it has the effect of annihilating the pre-existing condition requirement that we have in the existing bill, then obviously I would object to that.”

Analysis suggests exchanges are stabilizing. Health insurance companies are doing better financially when it comes to participating in the Obamacare exchanges, findings from a Kaiser Family Foundation analysis suggest. The analysis, published Monday, noted that enrollees in the plans did not appear to be sicker, and therefore more costly, than in previous years, and that the share of health premiums paid out as claims has started to decline. The average amount by which premium income exceeded claims costs per enrollee in a given month also began to appear more favorable. Authors concluded that the data provide evidence that the individual market has been stabilizing and that insurers are profiting.

Medicaid enrollees happy with care: A large majority of Medicaid enrollees are able to get care they need, according to a new study that contradicts Obamacare critics’ claims that the Medicaid expansion has hindered access to doctors. Medicaid enrollees rated their overall healthcare a 7.9 out of 10, according to the study published in the Journal of the American Medical Association. The study also found that 84 percent of enrollees could get all the care their physician thought was necessary in the past six months and 83 percent reported having a regular source of care. Only 3 percent of enrollees couldn’t get care, the study found. The study was based on a survey of 272,679 beneficiaries across 46 states from December 2014 to July 2015.

Sen. Bernie Sanders: GOP healthcare bill ‘must be defeated.’ Sanders, I-Vt., rallying supporters against the Better Care Reconciliation Act, said during a speech in West Virginia Sunday that the bill “must be defeated.” “The so-called ‘healthcare’ bill passed in the House last month, strongly supported by President Trump, is the most anti-working class legislation ever passed in the modern history of our country, and the Senate bill, also supported by Trump, in some respects is even worse,” he said. Echoing a theme from his failed run for the 2016 Democratic presidential nomination, Sanders said in his speech the U.S. should adopt a single-payer system. “This bill is a moral outrage,” he said. “It must be defeated. We should not be paying the highest prices in the world per capita for health care. We should not be paying the highest prices in the world for prescription drugs. We should have the guts to take on the insurance companies and the drug companies and move toward a Medicare-for-all, single-payer system.”

Former Democratic Rep. Donna Edwards: My MS would not be covered under GOP healthcare bill. Edwards urged congressional Republicans not to pass legislation that would result in her losing her health insurance due to her struggle with multiple sclerosis. Edwards’ letter, published Friday night in the Washington Post, said the Maryland Democrat said she worries she will lose her coverage if Obamacare is replaced with a bill passed by the GOP. “If we return to a time when people with pre-existing conditions can be charged more than healthy people, it will surely result in my never being able to afford insurance again,” Edwards wrote. “If we return to a time of lifetime caps, I will no longer have health insurance. 

Obamacare wounds doctor-owned hospitals. The federal healthcare law largely bans the expansion of physician-owned hospitals, and new physician-owned hospitals cannot be set up unless they forego government reimbursement from Medicare or Medicaid. Because of Obamacare, 37 physician-owned hospitals were not built, 40 nearly finished construction projects were prevented and 20 major expansion projects have been halted, according to their trade group Physician Hospitals of America. The group estimates the ban resulted in a loss of $200 million in tax revenue and 30,000 jobs that went uncreated. Supporters of the ban, among them nonprofit community and for-profit hospitals, argued for years that doctors at these hospitals are improperly referring patients to facilities in which they have a financial interest. These doctors, they say, have cherry-picked healthier patients and those who need specialized, profitable medical treatment, and have ordered unnecessary medical procedures that result in higher costs to the government. The evidence is mixed about whether doctor-owned hospitals were engaged in troubling practices. But experts say there must have been a better way to curb abuse, if it existed, than by imposing an outright ban on new ones. Read more.

Senate Minority Leader Chuck Schumer wants FDA to investigate ‘snortable chocolate.’  Schumer, D-N.Y., is calling for the agency to investigate the nutritional details and effects of “snortable chocolate,” a type of food powder marketed mostly online as a stimulant. “This suspect product has no clear health value,” he said in a statement, according to the Associated Press. “I can’t think of a single parent who thinks it is a good idea for their children to be snorting over-the-counter stimulants up their noses.” One such product is “Coco Loko,” which bills itself as “raw cocoa snuff” and promises consumers an “endorphin rush” and “euphoric energy.”

RUNDOWN  

Axios Healthcare’s widespread overbilling problem

Washington Post Ted Cruz picks government healthcare subsidies as the lesser of two evils

Kaiser Health News Senate GOP bill seeks to add psych beds; squeeze on Medicaid signals their undoing

LA Times With Senate Republicans at an impasse over Obamacare, many ask: Now what?

NPR For many, Medicaid provides only route to mental healthcare

Roll Call Senate returns no closer to healthcare deal

Politico President Trump’s enemy list

Bloomberg Senate health bill fails to pick up support after week of recess

The Hill Republicans debate Plan B if Obamacare repeal fails

Washington Post Drugmakers knew tamper-resistant painkillers could be abused, lawsuit claims

Calendar

MONDAY | JULY 10

Senate back in session.

TUESDAY | JULY 11

House back in session.

10 a.m. 1225 I St. NW. Bipartisan Policy Center event on “Solutions to long-term care financing in politically challenging times.” Details.

2:30 p.m. SR-418 Russell. Senate Veterans’ Affairs Committee hearing on “Pending Healthcare Legislation.” Details.

WEDNESDAY | JULY 12

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.