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Tom Price wants Congress to try, try again on Obamacare repeal. The Department of Health and Human Services secretary called on Congress to resume efforts to repeal Obamacare when lawmakers return from their August recess next month, even though congressional Republican leadership is eager to start work on tax reform instead. “It is incumbent upon Congress to come back to town, when they come back to town, and get to work and make certain we move in a much better direction from a healthcare standpoint,” President Trump’s top health official said Wednesday on Fox News. On Tuesday, he alluded to similar themes, saying, the “healthcare challenge is not dead.” “What we believe needs to occur is that the Congress needs to address the issue in a way that allows individuals to gain the kind of access to care and coverage that they need,” he said. When he was finished with his remarks, reporters asked him about planned cuts to Medicaid in the Senate healthcare bill. “Nobody is interested in cutting Medicaid,” Price said. “The fact of the matter is that the president’s budget and the proposals that were before Congress were an effort to try to secure and make a Medicaid system work for patients. That’s the goal we had.” One version of the Senate healthcare bill aimed to tie the growth in Medicaid spending to the standard rate of inflation, rather than to medical inflation, which is higher. The Congressional Budget Office estimated that the change, which would be scheduled to go into effect in 2025, would result in cuts to the program of $770 billion over a decade. The plan also would have rolled back Obamacare’s Medicaid expansion, which covered low-income people, beginning in 2021.
Other administration officials were more blunt. Trump communications aide Dan Scavino Jr. was a little more blunt about Congress’ failure to repeal Obamacare despite seven years of promises to do so. Scavino blasted Senate Majority Leader Mitch McConnell’s remarks this week that Trump had “excessive expectations” for Congress. “More excuses. @SenateMajLdr must have needed another 4 years — in addition to the 7 years — to repeal and replace Obamacare,” Scavino tweeted.
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Sen. Ron Johnson wonders whether Sen. John McCain’s cancer affected his vote on ‘skinny repeal.’ The Wisconsin Repuboican suggested Tuesday that McCain’s brain tumor, coupled with the timing of the healthcare vote in the Senate, may have played a role. “I’m not going to speak for John McCain — he has a brain tumor right now — that vote occurred at 1:30 in the morning, some of that might have factored in,” Johnson told the radio show “Chicago’s Morning Answer.” The radio host pressed Johnson on whether he really felt McCain’s brain tumor affected his judgment. “Again, I don’t know exactly — we really thought — and again I don’t want to speak for any senator,” the Wisconsin Republican said. “I really thought John was going to vote yes to send that to conference at 10:30 at night. By about 1, 1:30, he voted no. So you have to talk to John in terms of what was on his mind.” McCain, R-Ariz., flew back to Washington to vote on the healthcare bill days after he had surgery to remove a blood clot above his left eye, which led to the brain cancer diagnosis.
The Senate does plan to take up healthcare when it comes back after Labor Day, but not Obamacare repeal. The duo of Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., are working on a short-term stabilization bill to prop up Obamacare markets next year. They are the chairman and top Democrat on the Senate Health, Education, Labor and Pensions Committee.
The Senate has a very busy September. The amount of work that Congress has to do further complicates Price’s wish for a return to Obamacare repeal. The Senate not only has to raise the debt ceiling but also reach a deal to fund the government by the end of September. It also has to reauthorize the Children’s Health Insurance Program and pass legislation to stabilize the Obamacare market. That doesn’t mean the Senate is giving up on Obamacare repeal, though. Senate leadership is waiting to get some scores from the Congressional Budget Office on several repeal measures. Those include an amendment from Sen. Ted Cruz, R-Texas, to let insurers sell Obamacare plans that don’t comply with the law’s regulations as long as they sell one plan that does, and one from Sen. Rob Portman, R-Ohio, that would add $100 billion in funding to Medicaid.
Congress faces tight deadline to reduce Obamacare premiums. Congress needs to reach a deal to fund payments to Obamacare insurers by the end of September if lawmakers want to avoid even heftier price increases for customers, experts say. The deadline illustrates the major task Congress faces as it tries to reach a bipartisan deal to fund cost sharing reduction payments, known as CSRs, to reimburse insurers for reducing out-of-pocket costs for low-income Obamacare enrollees next year. If negotiations spill into October, it may be too late to reduce premiums for enrollees next year, some experts say. The White House has not said if it intends to make the payments. Congress can make an appropriation for the payments if Trump decides not to fund them. Insurers are scheduled to sign final contracts with the Centers for Medicare and Medicaid Services for Obamacare plans and rates by Sept. 27.
Sen. Shelley Moore Capito: Kill Obamacare mandates, but keep the subsidies. The West Virginia Republican is proposing a solution to the GOP’s healthcare woes that pleases West Virginians — one that would keep parts of Obamacare, but let people and companies escape the law’s mandates and would boost funding to fight opioid addiction. “There is still going to be a lot of passion, at least I’m seeing it at home, on protecting certain parts of Obamacare,” Capito told the Washington Examiner. Capito left the Capitol last week after a failed attempt by Republican senators to advance a measure to repeal and replace Obamacare. She was among a handful of swing GOP votes who initially refused to vote for the Republican measure, and announced, “I did not come to Washington to hurt people.” She later voted to advance the “skinny” Obamacare repeal bill, but it failed when three other Republicans refused to support it. Trump this week called out Capito at a huge rally in Huntington, referring to her as a “friend … who voted for us on healthcare.” Capito is now looking ahead to what must happen to stabilize the failing Obamacare health insurance markets, which have dwindled to one or two choices in every county in the state. Premiums have climbed 169 percent since 2013. According to Capito, Congress must stabilize the marketplace by ensuring federal money is provided for cost-sharing subsidies for insurers, which help reduce premiums for low-income Obamacare customers.
Price says Trump won’t declare national emergency for opioid crisis. The decision means that Trump is not going to accept the recommendation from an opioid commission that he convened to study the problem. Price told reporters that the declaration, which would free up funds and let health workers waive red tape, is not needed. His comments came after meeting with Trump at his private golf club in Bedminster, N.J. “We believe at this point that the resources that we need or focus that we need to bring to bear to the opioid crisis can be addressed without the declaration of emergency,” he said. Previous national health emergency declarations have focused on a specific area, being intended for a “time-limited problem, either an infectious disease or specific threat to public health,” he said. He gave some recent examples of public health emergencies, including the Zika virus and Hurricane Sandy.
Kellyanne Conway: Trump ‘currently on losing side’ of opioid epidemic. “The problem is very complicated and currently, we are on the losing side of this war,” the White House counselor told reporters during the press conference with Price. Conway and Price met with Trump and his wife, Melania, earlier Tuesday to discuss their recommendations for combating addiction, regulating prescriptions and eliminating the trafficking of fentanyl into the United States. Both administration officials have spent months visiting various parts of the country that have been rocked by record drug overdose deaths and opioid abuse. “The secretary and I have traveled to a number of different states and we have heard the harrowing and very sad stories,” Conway said. “No state has been spared and no demographic has gone untouched.” She continued, “This is not a problem of young or old, of black or white, of rural or suburban … we didn’t get here overnight and we can’t solve the crisis overnight either.”
Trump on opioids: ‘No good, really bad for you in every way.’ Trump on Tuesday said one of the best ways to prevent addictions to drugs such as heroin and prescription painkillers is to keep young people from taking them in the first place. “If they don’t start, they won’t have a problem,” he said in remarks to the media, according to pool reports. “If they do start, it’s awfully tough to get off. So if we can keep them from going on and maybe by talking to youth and telling them, ‘No good, really bad for you in every way.’ But if they don’t start, it will never be a problem.” Overdoses from opioids, including legal drugs such as Oxycontin and illegal drugs such as heroin, killed more than 33,000 people in 2015, according to data from the Centers for Disease Control and Prevention. CDC mortality data show that deaths from illegal opioids are highest among people between the ages of 25 and 34, and surveys from the National Institute on Drug Abuse show that opioid use has declined among teens. Later in his statement, Trump elaborated by saying that not only young people are struggling under the epidemic and that he is working with a team of experts to work on solutions. “Nobody is safe from this epidemic that threatens all — young and old, rich and poor, urban and rural communities. Everybody is threatened. Drug overdoses are the leading cause of accidental death in the United States,” he said.
Trump wants to see more prosecutions. “Meanwhile, federal drug prosecutions have gone down in recent years. We’re going to be bringing them up and bringing them up rapidly,” he said. “At the end of 2016, there were 23 percent fewer than in 2011. So they looked at this scourge and they let it go by, and we’re not letting it go by.”
New Hampshire latest state to sue prescription opioid maker. The state’s attorney general accused Purdue Pharma in a civil complaint of downplaying OxyContin’s risk of addiction, overstating its effectiveness and failure to report medical providers who were over-prescribing the medication. According to the legal document, the state believes the company “engaged in a long-running campaign of deception to create and sustain a market for its opioids.” In New Hampshire, nearly 500 people died of overdoses in 2016, a 10-fold increase since 2000. The New Hampshire lawsuit comes after attorney general’s office investigated the issue for two years, and the lawsuit states that it found several medical providers who said drug representatives visited them up to three times a week, encouraging them to prescribe OxyContin to treat chronic pain. Purdue and three of its executives pleaded guilty to criminal charges for deceptive conduct in 2007, but the New Hampshire lawsuit says the practices continued. The company denied the allegations in an interview with the Associated Press and said it shares the state’s concern about drug abuse. “OxyContin accounts for less than 2 percent of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone — all important components for combating the opioid crisis,” said spokesman Robert Josephson. Several other states have sued the drugmaker.
Job change: HHS official heads to Blue Cross Blue Shield of North Carolina. Dr. Patrick Conway, a Department of Health and Human Services holdover from the Obama administration, has been appointed CEO of Blue Cross Blue Shield of North Carolina, the company announced Tuesday. “Blue Cross NC’s role in transforming the healthcare system in North Carolina is a model that other plans aspire to and that I want to work with the Blue Cross NC team to further improve,” Conway said. He will join the company Oct. 1. Conway served as acting administrator for the Centers for Medicare and Medicaid Services until Seema Verma was confirmed. In his role in the Obama administration, which carried over after Verma was confirmed, Conway was deputy administrator for innovation and quality at the Centers for Medicare and Medicaid Services, which aimed to improve health outcomes while reducing costs. He was also director of the Center for Medicare and Medicaid Innovation, which tested payment models such as accountable care organizations, bundled payments and other approaches aimed at rewarding providers according to quality and value. Before working for the federal government, he oversaw clinical operations and research at Cincinnati Children’s Hospital Medical Center in Ohio.
Trump sued over his transgender military ban policy. Two advocacy groups said Wednesday they filed a lawsuit challenging Trump’s tweets last month declaring a ban on transgender military service. The suit was filed against Trump, Defense Secretary Jim Mattis and other top officials in a D.C. federal district court on behalf of five transgender service members. It argues against reversing a year-old policy of allowing transgender people to serve openly. The National Center for Lesbian Rights and GLAAD, both advocates for gender rights, are sponsoring the lawsuit for the five troops, who were all listed as “Jane Doe” on the complaint. “I am married and have three children, and the military has been my life. But now, I’m worried about my family’s future,” one of the anonymous plaintiffs said in a released statement. Citing costs and disruption, Trump tweeted on July 26 that transgender troops would no longer be able to serve in any capacity in the military, catching most of the Pentagon and Capitol Hill off guard.
RUNDOWN
STAT News How U.S. states have used emergency declarations to fight the opioid epidemic
Axios We still haven’t solved the healthcare cybersecurity problem
Washington Post Trump doesn’t need to declare the opioid crisis a national emergency
NJ.com “F— you opioids:” A funeral director’s visceral response to the opioid epidemic
CNN GOP donors withhold $2 million amid Senate failure on health plan, sources say
Politico The GOP’s monstrous healthcare fail may save the party
Kaiser Health News Taking a U-Turn on benefits, big employers vow to continue offering health insurance
New York Times When the prescription is a recipe
Calendar
WEDNESDAY | Aug. 9
Aug. 6-9. Philadelphia Marriott. National Association of Insurance Commissioners’ summer conference. Details.
THURSDAY | Aug. 10
11 a.m. S&P Global Ratings webcast on “U.S. Health Insurance: Earnings, Regulations And Credit Trends.” Details.
