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Big changes likely for Obamacare deal. Republican senators are pushing for major changes to a bipartisan deal to fund Obamacare payments in an effort to win President Trump’s support.
But some Democrats were skeptical of making any alterations to the deal, which was formally introduced in Congress on Thursday. Sen. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., introduced the legislation with 24 sponsors evenly divided among Republicans and Democrats. Senate Minority Leader Chuck Schumer said Thursday the legislation has the support of at least 60 senators, enough to break a filibuster because all 48 Democrats are expected to support it. But the legislation is likely to see some changes, especially since Trump opposes the deal as it stands now. Trump derided the payments, which reimburse insurers for lowering co-pays and deductibles for low-income Obamacare customers, as bailouts of insurance companies.
Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., said they are working with Sen. Ron Johnson, R-Wis., on changes to the legislation to satisfy Trump and House Speaker Paul Ryan, who is also opposed. “We recognize this short-term stabilization will not pass unless concerns of the House are addressed,” said Graham and Cassidy, who are co-sponsoring the Alexander-Murray legislation. But a major question mark is whether Democrats would be open to making any of the changes. Several Democratic senators were skeptical. Sen. Tom Carper, D-Del., a co-sponsor, said that he wasn’t familiar with the president’s demands and would prefer to keep the deal where it is. Sen. Chris Murphy, D-Conn., who is not a co-sponsor, was flummoxed by the timing of Trump’s demands, which he said he has not seen. “Why didn’t he make those demands two weeks ago?” Murphy asked. “We should move forward with this bill and put it on his desk.” Murphy added that time is running out for the bill to have an impact on 2018 open enrollment, which starts Nov. 1 and ends Dec. 15.”If we go out and renegotiate this package we won’t be able to affect rates this year and won’t restore the marketing in time for open enrollment,” he said. “We gotta move and we’ve gotta move fast.”
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Schumer urges Trump to ‘come around’ on bipartisan Obamacare bill. Schumer said Thursday that he hopes Trump will “come around” to support Alexander-Murray, though he appeared to leave the door open to making changes to the legislation’s language. “We can only hope he comes around and grasps what’s in the bill,” he said the Senate floor, though he later added that he would welcome suggestions. Trump has referred to the subsidies as a “bailout” and said he does not support the current bill. The White House has offered suggestions on how to change it, but Schumer said Wednesday that Democrats should not reopen negotiations on the legislation. In his floor remarks Thursday, he appeared to leave the door open to changes, but didn’t cite specific provisions that Trump had listed, such as offering “relief” from the individual and employer mandates. He focused instead on the language about cost-sharing reduction subsidies. Schumer argued that ending the payments hurts customers rather than insurance companies, which still must offer the discounts and will raise premiums on everyone to do so. “Restoring cost-sharing will help people, not insurance companies,” Schumer said. “Senators Alexander and Murray have made sure of it. I’ve worked, I’ve talked to them about their language, it’s good language. And maybe we can make it better. If the president has suggestions we welcome it. But as it is, it’s pretty strong.” Schumer noted that Trump initially appeared to support the legislation before coming out against it. “We’ve seen President Trump’s near-constant equivocation on the agreement,” Schumer said. “We shouldn’t let it impede the progress of this very important bipartisan compromise. He’s for the bill one day; he’s against it the next. That’s not uncommon – the president is sometimes for and against something in the same sentence.”
Trump says Republicans ‘within one vote’ of repealing Obamacare. Trump claimed Senate Republicans nearly have the votes to repeal Obamacare on Thursday, endorsing the idea of a short-term compromise that could stabilize the healthcare system until lawmakers move to end the Affordable Care Act. “We will probably like a short-term solution until we get the block grants,” Trump told reporters at the White House. Earlier this week, Trump expressed opposition to the Alexander-Murray compromise, saying it padded the pockets of health insurance companies. “What I did say, though, is I don’t want the insurance companies making any more money than they have to,” Trump said of the plan plan. Trump had signaled he could be open to supporting a bipartisan compromise earlier in the week, but he criticized the Alexander-Murray proposal partly because it offered to extend the cost-sharing reduction, or CSR, payments to insurance companies that his administration has already moved to end. “I think we have the votes or we’re certainly within one vote,” Trump said of repealing Obamacare. “Votes are very fragile … I thought we had it the last time.” The president noted he still backs the concept of the healthcare reform package that failed narrowly this summer. That bill would have given states Medicaid funding in the form of block grants. “The concept of blocking it out, block grants to the states, that’s what people want, and that’s what the states want,” Trump said.
Senate votes down Obamacare repeal again. The Senate voted down an amendment from Sen. Mike Lee, R-Utah, during the budget vote-a-rama Thursday night that would have stripped the law’s insurance regulations. Sen. Rand Paul, R-Ky., also included Obamacare repeal in an amendment, which also was shot down. The amendments would have added Obamacare repeal to the fiscal 2018 budget resolution and opened the possibility of taking another shot at repeal in the budget vehicle Republicans want to use for tax reform. Heritage Action, the advocacy arm of the conservative think tank Heritage Foundation, wasn’t happy with the vote on Lee’s amendment, which received support from only 32 Republicans. “If you want to know why Republicans failed to repeal and ultimately replace Obamacare this year, look no further than tonight’s vote,” said Heritage Action CEO Michael Needham. He added that it is “clear that a significant number of Republicans were not committed to following through on their campaign rhetoric.” The failure of the amendments comes after the Senate defeated four Obamacare repeal bills earlier this year.
Uninsured rate rises under Trump. The uninsured rate is back on the rise as Obamacare’s premiums have soared and the program faces uncertainty in Congress, according to a new survey. The new uninsured rate, measured by Gallup and Sharecare, released Friday shows an increase in the third quarter of 2017 to 12.3 percent, a 1.4 percentage point increase from the end of 2016. Gallup said it is now the highest recorded uninsured rate since the last quarter of 2014, when it was 12.9 percent. But it is well below the peak of 18 percent in the third quarter of 2013, before Obamacare’s major expansion was implemented. Gallup points to several possibilities for the increase in the uninsured rate. One factor is rising premiums and insurer defections on the individual market that includes Obamacare’s exchanges. Another is uncertainty over the healthcare law’s future.
IRS to crack down on Obamacare declarations next year. The Internal Revenue Service will not accept electronically filed tax returns for the upcoming filing season in which people fail to note whether they have health insurance, according to an agency announcement that is a reversal of an informal policy under the Obama administration. Failure to note health insurance status could result in tax refund delays, according to the IRS. “The IRS will not accept the electronic tax return until the taxpayer indicates whether they had coverage, had an exemption or will make a shared responsibility payment,” the agency said. “In addition, returns filed on paper that do not address the health coverage requirements may be suspended pending the receipt of additional information and any refunds may be delayed.” Under former President Barack Obama, the IRS would still process returns that left this question unanswered, though taxpayers would receive a letter saying they had failed to answer the question. Obama instructed the IRS to stop processing those filings, called “silent returns,” beginning with the 2016 tax filing season, but Trump ditched those plans when he became president and went back to the previous policy.
Steve Bannon-backed PAC rips Alabama Dem for ‘extreme’ abortion views in first TV ad. A super PAC aligned with former White House chief strategist Steve Bannon released its first TV ad Thursday targeting Doug Jones, the Democratic nominee for Alabama’s Senate seat, for holding “deceptive” views on abortion. Jones, 63, is running against former Alabama Chief Justice Roy Moore, who soundly defeated incumbent Republican Sen. Luther Strange in a runoff election last month and is poised to win the seat in December’s general election. Bannon publicly endorsed Moore in the weeks leading up to the run-off and flooded the airwaves with anti-Strange ads produced by his super PAC, the Great America Alliance. Now, the outside group is turning its attention to Jones by claiming the former U.S. attorney is “completely out of step with Alabama values” because of his position on abortion. The new 30-second spot features a soundbite in which Jones describes himself as a “right-to-lifer” only after a baby has been born. “Claiming to be ‘right to life’ when he holds such extreme views on abortion is absurd and insults the intelligence of voters he claims he wants to represent,” said Eric Beach, co-chaiman of Great America Alliance. A source close to Bannon said the ad is the beginning of an aggressive campaign against Jones. Moore and Jones both stood at 42 percent support in a Fox News poll published Tuesday. The ad is set to run digitally through the end of the week before hitting the airwaves in Alabama next week.
Judge halts abortion order for teen illegally in US. The D.C. Circuit Court of Appeals, which is taking up the case Friday, on Thursday temporarily stayed an order by a federal judge saying that the Trump administration must allow a teen who is in the U.S. illegally and under the custody of the U.S. government to have an abortion this week. “The purpose of this administrative stay is to give the court sufficient opportunity to consider the emergency motion for stay and should not be construed in any way as a ruling on the merits of that motion,” the court said in asking for additional documents to be filed later in the day. U.S. District Judge Tanya Chutkan on Wednesday ordered the federal government to transport the girl to an an abortion facility by Friday or Saturday or allow a guardian to do so “promptly and without delay.” The order Chutkan issued for the girl to receive counseling for her abortion on Thursday remains in effect under the D.C. Circuit decision. The counseling is required by law in Texas, where the girl, 17, is being detained after coming to the U.S. illegally from Mexico. Federal health officials had taken the girl to a crisis pregnancy center to receive counseling but haven’t allowed her to obtain an abortion, triggering a lawsuit by the American Civil Liberties Union.
RUNDOWN
The Hill Alexander struggles to find healthcare breakthrough
Politico Blindsided Trump officials scrambling to develop opioid plan
NPR Rural hospice that spurns federal funds has offered free care for 40 years
New York Times Will Mitch McConnell help his friend get a healthcare deal?
STAT News While federal standards to battle the opioid epidemic take shape, states codify their own
Reuters Short on staff: Nursing shortage strains U.S. hospitals
Axios Senate largely ignoring Trump’s flip-flopping on healthcare
Wall Street Journal Drop in teen pregnancies drives declining birth rate
Calendar
TUESDAY | Oct. 24
10 a.m. 2358-C Rayburn. House Appropriations Committee hearing on “The Role of Facilities and Administrative Costs in Supporting NIH-Funded Research.” Details.
10 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Examining HHS’s Public Health Preparedness for and Response to the 2017 Hurricane Season.” Details.
1:30 p.m. Alliance for Health Policy webinar previewing open enrollment. Details.
WEDNESDAY | Oct. 25
8:30 a.m. 1777 F St. NW. The Hill event with Dr. Ben Carson, secretary of Housing and Urban Development, on “The Future of Housing.” Details.
10 a.m. 2358-C Rayburn. House Appropriations Committee hearing on “Down Syndrome: Update on the State of the Science and Potential for Discoveries Across Other Major Diseases.” Details.
10 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Federal Efforts to Combat the Opioid Crisis: A Status Update on CARA and Other Initiatives.” Details.
THURSDAY | Oct. 26
Oct. 26-30. San Francisco. World Conference of Science Journalists. Details.
FRIDAY | Oct. 27
11:45 p.m. G50 Dirksen. The National Institute for Health Care Management briefing on “Transforming Health Care to Drive Value.” Details.