Daily on Healthcare: Acting HHS chief: ‘Opioid epidemic is the crisis of our time’…This week in Congress: Tax negotiations and funding the government

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Acting HHS chief: ‘Opioid epidemic is the crisis of our time.’ Eric Hargan is about to get a demotion, and he is just fine with that. The acting secretary of Health and Human Services is more than thrilled to go back to the position he held when President Trump tapped him to lead the agency after the former secretary, Tom Price, resigned over scrutiny of his travel revealed a taste for the excess. Once Alex Azar, the president’s new choice to run HHS, is confirmed, Hargan said he will happily go back to his original job. He told the Washington Examiner in an exclusive interview that HHS has redoubled its effort to tackle a crisis that is killing 71 Americans a day. “We had our office of civil rights put on a clarification that means that families understand that they can actually hear from the doctors about what is going on with their family member,” Hargan told the Washington Examiner. “The doctors know they can communicate to families that their loved ones are suffering from overdoses and are incapacitated. Previously, people thought that our HIPAA law meant that they couldn’t share that information.”

This week in Congress: Tax negotiations and funding the government. Republicans in the House and Senate will begin hammering out a compromise on each chamber’s respective tax plans this week and could face a showdown with Democrats on legislation to temporarily fund the government. While lawmakers work behind the scenes on final tax legislation, both chambers must pass spending legislation by Dec. 8, when government funding expires. Appropriators are readying a two-week spending bill, which they believe will provide enough time to write another spending bill that would last until the end of the fiscal year.

Democrats, angry that year-end spending legislation will exclude immigration legislation they are seeking, are threatening to oppose the government funding legislation — although it is not clear whether they will try to block the two-week extension. “We will pass a short-term CR that is necessary to keep the government open, to keep talks going” on a long-term bill, said House Speaker Paul Ryan, R-Wis. “Hopefully, people will decide to participate in these talks. And if the Senate Democrats choose to filibuster that, then they will have chosen to shut the government down, something that we do not want to see happen.” Among the differences in the tax legislation that must be hammered out is the repeal of the Obamacare individual mandate penalty, which the House version does not contain. But Trump supports it and this year the House passed a healthcare bill that repealed it. Still, House Republicans are wary of simply eliminating the mandate in the tax bill without a replacement to the law. According to analysts, dropping the mandate would raise premiums 10 percent thanks to fewer people signing up for plans. “There are a lot of our members who would like to do it but there are some that don’t want to conflate healthcare and taxes,” Rep. Tom Cole, R-Okla., told the Washington Examiner.

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.

Will 2018 see the return of Graham-Cassidy? Republicans have begun to stress that they see the different actions in Congress on healthcare as a lead-up to a replacement plan, though it’s not clear that Alexander-Murray and the reinsurance bill will gain the 60 votes in the Senate needed for passage. Both bills are expected to be brought up in a must-pass vehicle such as an end-of-year spending bill. “Most of us look at this as a sort of runway to get to what we hope will eventually be something along the lines of Graham-Cassidy where we would do a more systemic fix for Obamacare that shifts money back to the states,” said Sen. John Thune of South Dakota, the Republican Conference chairman, referring to the name of a plan that would shift Obamacare’s revenues to states. “In the meantime, you’ve got to deal with the issues that are cropping up in the foreseeable future.”

Pro-Obamacare group slams Collins for tax bill support. The pro-Obamacare group Save My Care released a new television ad Friday targeting Collins a few hours after she announced her support for the tax legislation. The national ad calls on Collins’ constituents to call her and demand she work to remove a repeal of Obamacare’s individual mandate from the tax bill. “Collins has previously said she is opposed to any tax bill that rips away healthcare coverage for millions of Americans and has voted against several attempts to repeal healthcare,” the Obamacare group said.  She previously told the Washington Examiner that she does not support the mandate because it primarily affects middle- to low-income Americans. She also secured other concessions such as an expansion of the medical expense deduction.

Collins confident Congress will avoid Medicare cuts. Collins defended her vote for tax reform Sunday by saying on “Meet the Press” she got an “ironclad commitment” from GOP leadership to avoid $25 billion in cuts to Medicare next year. Collins is referring to the 2010 Statutory Pay-As-You-Go Law that triggers spending cuts if the deficit reaches a certain threshold. The Senate’s tax bill is expected to add $1 trillion to the deficit over the next decade. The nonpartisan Congressional Budget Office said a bill that raises the deficit by $1.5 trillion would trigger the law and cause $136 billion in cuts, including $25 billion to Medicare. Pay-go cuts have never gone into effect though since the law was passed, as Congress has waived it 16 times. However, GOP leaders need Democratic support to waive the law, and so far Democrats have been coy about whether they would agree to a waiver.

CVS plans to buy Aetna in massive $69 billion move. CVS Health, the pharmacy and retail chain, closed a deal to buy Aetna for a reported $69 billion. Aetna stockholders would receive $207 per share, $145 in cash and 0.8378 of a CVS share, or $62, in stock, the companies announced Sunday. Though the deal still needs to be approved by regulators and by shareholders, the Wall Street Journal on Sunday described the acquisition of Aetna, one of the biggest health insurance companies in the U.S., “a landmark deal that would change the U.S. health-care landscape by bringing a large insurer and a big provider of pharmacy services under one roof.”  A purchase by CVS Health would allow Aetna to have its own pharmacy benefits manager, as one of its competitors, UnitedHealthcare, already does.

Report recommends solutions for high drug prices. A report from the National Academies of Sciences, Engineering and Medicine has some new recommendations for Congress to tackle high drug prices. The report wants to establish limits on the total annual out-of-pocket costs paid by Medicare Part D customers. It calls for Congress to remove the cost-sharing requirement for patients that reach the catastrophic coverage limit. It also calls for Congress to prohibit direct-to-consumer ads of prescription drugs as a tax-deductible business expense. The report notes that such ads, which are banned in other countries, can influence consumer behavior. In addition, large drug makers spend more money on marketing and administrative costs than on research and development, the report added.

Obamacare sign-ups outpace last year for Colorado exchange. More than 43,000 Coloradans selected healthcare coverage for 2018 through the state health insurance marketplace in November, a rate 29 percent ahead of signups one year ago, according to new data released this weekend by Connect for Health Colorado. Colorado’s exchange has a later deadline than the federal exchange, running until Jan. 12, but if enrollees want their coverage to begin on Jan. 1, they must enroll by Dec. 15. “With only two weeks left to enroll for January coverage, I am pleased with the pace of plan selections,” Connect for Health Colorado CEO Kevin Patterson said.

Utah warns families of low funds for children’s health insurance. Utah warned families aiming to use the Children’s Health Insurance Program that it will run out of funding by February if Congress doesn’t act. Utah said in a notice on its state CHIP page Friday that it has enough money that it didn’t use in prior years to continue offering insurance coverage until probably Jan. 31. The state’s department of health said it would send families a letter telling them when their coverage is going to end.

Republican presses McConnell to take up anti-abortion bill next. Rep. Trent Franks, R-Ariz., applauded Senate Majority Leader Mitch McConnell on getting tax reform across the finish line Saturday, but he also made a plug for his own anti-abortion legislation. Franks said he hopes the “feeling of accomplishment becomes addicting for Mitch McConnell and the rest of GOP leadership in the upper chamber.” He said the Senate needs to take another run at repealing Obamacare and pass legislation he sponsored that would ban abortion after 20 weeks. The bill passed the House this year but has not been brought up for a vote in the Senate. The reason is that it likely would fail as it would require 60 votes to break a filibuster. While such long-term abortion bans have received some Democratic support, it is not clear if it could get support among enough Democrats to win 60 votes.

RUNDOWN

Politico GOP Medicaid work rules imperil care for opioid abusers

USA Today VA hires doctors with past malpractice claims, discipline for poor care

Bloomberg CVS-Aetna deal may hinge on antitrust approach under Trump

Wall Street Journal Passage of Senate tax bill puts R&D tax credit in doubt

Roll Call Consumer choice for healthcare lags behind rhetoric

Kaiser Health News Middle-class earners weigh love and money to curb Obamacare premiums

New York Times Heading toward tax victory, Republicans eye next step: Curb spending

Axios Where the $0 Obamacare insurance plans are

Governing Maine’s Obamacare vote revives Medicaid expansion debate in some states

Calendar

TUESDAY | Dec. 5

7:30 a.m. Ajax. 1011 4th St. NW. Axios event on “A New Era in Healthcare.” Details.

8:30 a.m. 1301 K St. NW. Washington Post event on “Pathways to Progress: Combatting the HIV/AIDS epidemic.” Details.

10 a.m. Dirksen 124. Senate Appropriations Committee hearing on “”Addressing the Opioid Crisis in America: Prevention, Treatment & Recovery.” Details.

WEDNESDAY | Dec. 6

10 a.m. 2175 Rayburn. House Health, Employment, Labor, and Pensions Subcommittee hearing on “Workplace Leave Policies: Opportunities and Challenges for Employers and Working Families.” Details.

10 a.m. National Press Club. 529 14th St. NW. California Attorney General Xavier Becerra will discuss the legal actions his state has taken against the Trump administration. Details.

THURSDAY | Dec. 7

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on the 21st Century Cures Act. Details.

Noon. Capitol Visitor Center. Congressional Meeting Room, South. Capitol Visitor Center. American Psychiatric Association briefing on “Improving the Physical Health of Patients with Serious Mental Illness:Identifying Breakthroughs in Approaches to Treatment.” RSVP to [email protected].

FRIDAY | Dec. 8

Deadline for Congress to pass a spending bill before the government runs out of money.