Daily on Healthcare: Senate conservatives rebel against bipartisan Obamacare ‘fix’

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 [email protected] 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.

Tom Price’s private flight reimbursement may not save him. The Health and Human Services secretary has promised to reimburse the federal government for the costs of chartering expensive private jets, a face-saving move that is unlikely to satisfy President Trump’s desire to make an example of him, according to several people familiar with the situation. In a statement late Thursday, Price said American taxpayers “won’t pay a dime” for the five recent occasions on which he chose to travel via private jet for government-related business. The statement came nearly 10 days after his expensive method of travel was first reported. His spokeswoman, Caitlin Oakley, later clarified that Price will pay only “his share of the travel,” a sum close to $52,000. Oakley said the reimbursement was not to be taken as an admission of wrongdoing. Trump said Wednesday he was not happy with the reports of Price’s jet travel, but sources say he is close to livid. “He’s pissed that he is getting bad press on this,” a former White House official told the Washington Examiner, calling the situation a “distraction from tax reform.” “This is really ‘do as I say, not as I do’ swampy,” said former Trump campaign aide Sam Nunberg, who pointed to Price’s personal stock trading, which raised conflict-of-interest questions before the former Georgia congressman was confirmed to lead HHS, as another source of “bad press” for the Trump administration. The White House on Thursday demanded a temporary halt on private flights at HHS.

Price used military aircraft for trips to Africa, Europe and Asia: Report. The White House authorized Price, who was accompanied by his wife, to use military aircraft during trips to Africa, Europe, and Asia this year, costing taxpayers more than $500,000, according to a report Thursday evening. As a result, taxpayers have had to foot a bill totaling more than $1 million for Price’s travels since May, Politico reported. An HHS spokeswoman said Price reimbursed the agency for his wife’s travel. Travel on military aircraft is generally granted only to the president, vice president and Cabinet members who oversee national security issues, such as the secretary of defense and the secretary of state.

Republicans’ next attempt at killing Obamacare won’t come until next year. Republicans’ next attempt to repeal and replace Obamacare will likely be pushed well into 2018, an election year. The reason for the delay is both political and procedural with the GOP pivoting to tax reform, another major legislative priority. And House Republicans are already saying that the process for considering a repeal again needs to change after the Senate failed multiple times to pass legislation. The Senate Finance Committee on Friday released a fiscal 2018 budget resolution that Congress is expected to take up next week. The resolution lays out the framework Republicans can use to pass tax reform with only 51 votes in the Senate, bypassing the need for 60 to break a filibuster. But Republicans did not add Obamacare repeal to the budget resolution, because GOP members didn’t want it to interfere with their next major priority. So under the Budget Control Act, the earliest a budget resolution for fiscal 2019 could be passed would be in the calendar year for Oct. 1, 2018, the start of the federal fiscal year. However, Republicans could get permission from the Senate parliamentarian to pass a budget resolution earlier, as they did for Obamacare repeal this year. For now, Republicans have not set a deadline to finish tax reform, but Rep. Mark Meadows, R-N.C., said Thursday that there is talk of finishing it as early as November. “I think everybody is pushing to have it done before Thanksgiving,” said Meadows, leader of the conservative House Freedom Caucus. But Republicans haven’t publicly committed to a timeline. Congress first has to pass the budget, a House aide told the Washington Examiner. However, they are moving “forward as quickly as possible.” Other suggested timelines include finishing tax reform by the end of the year.

CMS announces special enrollment periods for areas hit by hurricanes. The Centers for Medicare and Medicaid Services announced Thursday that it would open special enrollment periods for all Medicare beneficiaries and qualifying individuals who are seeking coverage through the Federal Health Insurance Exchange, allowing those impacted by recent hurricanes to alter their plans or gain coverage. “The lives of millions of Americans have been disrupted and impacted in some way by recent hurricanes,” said CMS Administrator Seema Verma. “Setting up special enrollment periods gives Medicare beneficiaries and individuals seeking coverage on the federal exchange the opportunity to access health coverage during this difficult time and when they need it the most.” The Medicare special enrollment period permits those affected by Hurricanes Harvey, Irma and Maria to enroll, disenroll or change to another Medicare health or prescription drug plan, effective until Dec. 31.

Graham-Cassidy authors committed to holding hearings. Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., the two authors of the latest Republicans effort to overhaul Obamacare to collapse in the Senate, met with Trump on Thursday, and afterwards said they look forward to continue the debate over healthcare, even as Congress turns its focus to tax reform. While the Senate will miss a Sept. 30 deadline to use the reconciliation tool that only requires 51 votes to repeal parts of Obamacare, Republicans are rallying around the idea that it could get another shot next year. In the meantime, Graham and Cassidy say they will reach out for input on healthcare to help ease concerns about rushing legislation through that contributed to dooming the last healthcare reform effort. They also acknowledged Trump’s desire to work with the Democrats and said they “strongly encouraged” him to do so.

Nancy Pelosi: GOP healthcare bill ‘like a zombie.’ The House Minority Leader said Thursday that the Republican effort to dismantle Obamacare is like a zombie rising from the dead. “While we were happy on the day that the bill was pulled again, we must be ever vigilant. They are talking about doing it next year,” the California Democrat told reporters at her weekly press conference. “It’s like a zombie. It keeps rising up and we have to keep putting a stake in its heart.” Zombie experts agree that the way to kill a zombie is to cut off its head or shoot it in the head, while a stake through the heart is a remedy for vampires. “We are always prepared to protect our care,” Pelosi said, adding that Republicans “wasted a month” on the Graham-Cassidy healthcare bill that failed earlier in the week.

House panel to take up children’s insurance bill next week. The House Energy and Commerce Committee said it will consider a bill to extend funding for the Children’s Health Insurance Program next week. Congress is expected to miss the Sept. 30 deadline to reauthorize the bipartisan program. However, a congressional advisory board predicts states won’t run out of CHIP funds until December at the earliest. The markup has not been scheduled, and the committee has not said what measures would be included in the funding bill. “CHIP, now in its 20th year, has always been bipartisan, and we hope this extension will be no different,” said Committee Chairman Greg Walden, R-Ore. A Senate bill would reauthorize CHIP through 2022 and cut some of the extra funding Obamacare gave to the program starting in 2021.

Cochran plans return to Senate in mid-October after medical issues. Sen. Thad Cochran, R-Miss., announced Thursday that he will be sidelined from his work in the Senate until Oct. 16 as he recovers from a urological issue in Mississippi. “My physician told me today I am improving, but recommended I remain at home in Mississippi another week,” Cochran said. “I will follow that advice.” Cochran’s medical issues came to the forefront when Trump tweeted that one senator who was a “yes” vote on a Republican bill to reform federal health policy was in the “hospital.” Cochran was not in a hospital but was at home recovering, and was not in Washington. “Thanks for the well-wishes. I’m not hospitalized, but am recuperating at home in Mississippi and look forward to returning to work soon,” Cochran tweeted Wednesday.

Maryland price gouging law set to take effect Sunday. The first state law going after the rising price of prescription drugs is set to go into effect in Maryland on Sunday, but a judge could still act to suspend the law. “We’re seeking an injunction and we’re waiting on a ruling,” said Rachel Schwartz, spokeswoman for the Association for Accessible Medicines, which represents generic drugs. “We’re waiting on it — told the decision is coming by the end of this week.” The law, passed in April and formally known as the “Prohibition Against Price Gouging for Essential Off-Patent or Generic Drugs,” gives the state attorney general authority to challenge drug companies when they have significantly raised the prices of a generic drug to an “unconscionable” level or one that is “excessive” and “not justified.” Advocates say they hope the law can reduce healthcare costs and health insurance premiums. Opponents, including generic drugmakers, counter that the law’s language is too vague and likely violates the Constitution. They note that prescription drug prices are not set by states and that the power to regulate interstate commerce belongs to the federal government.

Melania Trump lends ear at opioid roundtable. The first lady on Thursday met with first responders, families and treatment advocates at the White House to hear from them about their experiences in the trenches of the deadly opioid epidemic. “I’m here today to listen and learn from all of your stories and hope you will feel free to give me your thoughts and opinions on how best I can help,” Trump said. She has made the well-being of children a priority as first lady and attended a key opioid meeting in August. On Thursday, she said she looked forward to working with the opioid commission established by the Trump administration and with others around the table to “teach children about the dangerous consequences of drug abuse.” Trump adviser Kellyanne Conway, who led some of the conversation at the round table, said, “These are not statistics. These are our children, our nieces and nephews, our friends. This is no longer someone else’s kids, someone else’s co-worker, someone else’s community. Everyone in this country is impacted by drug addiction and by the opioid crisis. Too many families know the personal emotional toll of this increasing epidemic.” Other administration officials who attended included Health and Human Services Secretary Tom Price and New Jersey Gov. Chris Christie, who is chairman of the president’s Opioid Commission. Three of the guests shared their stories.

Pro-abortion activists protest Gorsuch speech at Trump Hotel. More than a dozen activists from NARAL Pro-Choice America protested Supreme Court Justice Neil Gorsuch’s Thursday speech at the Trump Hotel in Washington. Gorsuch spoke at a lunch hosted by the Fund for American Studies, on the conservative education group’s 50th anniversary. Critics of Trump and Gorsuch have complained about the new justice’s decision to speak at the venue given the president’s financial interest in the hotel. The NARAL protesters chanted “Stolen court!” and carried signs opposing Gorsuch’s presence on the Supreme Court. The protesters also brought a large inflatable “Corruption Cleanup” dummy that held a sign reading, “Hey Gorsuch: Trump Hotel = Racism, Corruption, Shame, so Shame on You!”

Move to decertify Minnesota home-care union gathers steam. Activists turned in more than 10,000 signatures Thursday to the office of Minnesota Gov. Mark Dayton from state-subsidized personal care attendants seeking to decertify the union that represents them. The activists argue that the union was created through fraud and doesn’t have the support of most of the caregivers. The personal care attendants take care of people, mostly incapacitated family members, with the help of a program subsidized through a combination of state and federal funds. In 2014, the then-Democrat-led state legislature passed a law declaring that the providers were public employees, although most work at their homes. Following a mail-in election, SEIU Healthcare Minnesota was certified as the workers’ representative, making the union eligible for a 3 percent cut of the workers’ subsidy checks. That adds up to $948 annually for most of the workers. “We have determined that there were fraudulent-showing cards that brought about that election … In any event, no matter what fraud level there was, only 3,500 [personal care attendants] voted for this union. We have more than 10,000 cards” signed by people who want a new election, said Doug Seaton, the attorney representing MNCPA, a nonprofit activist group leading the decertification effort, at a press conference in the state capitol. Personal care attendants participating the drive said that they did not want or need union representation and were blindsided by the election results.

Julia Louis-Dreyfus plugs her union health insurance when revealing she has breast cancer. Julia Louis-Dreyfus announced Thursday she has been diagnosed with breast cancer while tying in her support for a universal healthcare program in America. The actress, famous for her roles in “Veep” and “Seinfeld,”  made the announcement on Twitter, writing the “good news” is she has “fantastic insurance through” her union, but the bad news being not all women diagnosed with cancer are as lucky. “So let’s fight all cancers and make universal healthcare a reality,” she wrote. Louis-Dreyfus also said she has “the most glorious group of supportive and caring family and friends.”

RUNDOWN

Kaiser Health News Absent federal action, states take lead on curbing drug costs

Roll Call Narrow health deal close as Republicans plot future efforts

Washington Post Here’s how Tom Price could be spending his time

Politico Alexander, Murray inching toward deal to stabilize Obamacare

Bloomberg Tom Price may not be leaving just yet

Axios The children who got health coverage through CHIP

The Hill Anti-abortion groups fuming over GOP failure to defund Planned Parenthood

Reuters Washington state sues Oxycontin maker Purdue Pharma

STAT News FDA approves Eli Lilly pill for common advanced breast cancer

NPR Why huge quality gaps among nursing homes are likely to grow if Medicaid is cut

Calendar

SATURDAY | Sept. 30

Reconciliation and CHIP reauthorization deadlines. End of federal fiscal year.

MONDAY | Oct. 2

Oct. 2-6. National Health IT Week. Details.

Oct. 2-3. Hyatt Regency Capitol Hill, 400 New Jersey Ave. NW. Behavioral Heal Hill Days. Details.

8:30 a.m. National Press Club. 529 14th St NW. Poynter event on “Covering Healthcare Policy Changes.” Details.

TUESDAY | Oct. 3

House to vote on 20-week abortion ban, Pain Capable Unborn Child Protection Act.

WEDNESDAY | Oct. 4

8 a.m. Westin New York. S&P Global Ratings’ Health Care Conference. Agenda.

8 a.m. Newseum. 555 Pennsylvania Ave NW. Event with the Hill on “Innovating to improve patient health.” Details.

THURSDAY | Oct. 5

10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing on the “Federal Response to the Opioid Crisis.” Details.