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House abortion language complicates Senate talks: As senators attempt to hash out a compromise, one looming complication, according to multiple sources familiar with the ongoing discussions, has been the uncertainty over whether the abortion language attached to the House healthcare bill can pass muster under reconciliation rules allowing for Republicans to pass legislation with a simple majority. The issue concerns the tax credits to purchase health insurance, which, under the House bill, would include Hyde Amendment language prohibiting any federal funds from being used for abortion. There’s been concern as to whether the Senate parliamentarian would see the abortion language as impermissible under reconciliation. If the new tax credits are ruled out of order, Republicans would have to find a way to work within existing healthcare programs that already have Hyde language attached to them. That would leave them with two options. Either they somehow attach the tax credits to Medicaid or they merely tweak Obamacare’s tax credit subsidies (which is problematic because the program has weaker abortion language). As it is, conservatives see embracing tax credits as a major concession, with Sen. Rand Paul, R-Ky., especially vocal in blasting them as an entitlement because they function as subsidies. Any change to the tax credits that makes them even more like Obamacare (i.e., moving from an age-based, fixed-sum tax credit to an income- and geographically adjusted credit scheme), could risk a collapse of conservative support for the bill, dooming any chances of passage.
Trump administration meets with healthcare providers hurt by Obamacare: At the White House Wednesday, White House staff, Secretary of Health and Human Services Tom Price, and Centers for Medicare and Medicaid Services Administrator Seema Verma met with medical and healthcare professionals for a listening session.
Alexander backs cost-sharing payments: Another prominent Republican wants President Trump to fund payments to Obamacare insurers. Sen. Lamar Alexander, R-Tenn., called for Trump to commit long term to cost-sharing reduction payments to insurers. Alexander is chairman of the Senate Health, Education, Labor and Pensions Committee. The call came soon after Rep. Kevin Brady, R-Texas, chairman of the House Ways and Means Committee, made a similar proclamation. Trump has agreed to fund the payments for now, which reimburse insurers for reducing co-pays and deductibles for low-income Obamacare customers, but not for 2018.
House votes on Obamacare-related bills today: The House is scheduled to vote today on two health bills. One of the bills, the Broader Options for Americans Act, lets people use Obamacare tax credits toward unsubsidized COBRA coverage. It also allows Americans who lost their jobs at churches or houses of worship to use the tax credits. The other is the Veteran Act that puts into law an existing regulation that ensures veterans not receiving care from Veterans Affairs can get tax credits for Obamacare.
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Insurer Highmark requests double-digit rate increases in Delaware: Highmark requested rate increases of 33.6 percent to sell plans on the exchange in the state, a proposal that must be approved by the Delaware Department of Insurance. The company assumes in its request that the individual mandate obligating people to buy health insurance or pay a fine will not be in place and that federal payments to insurers, called cost-sharing reduction subsidies, will not be paid. “If the federal government fails to live up to its obligations under the law, insurers will likely continue to exit the marketplace,” said Trinidad Navarro, Delaware’s insurance commissioner.
Ohio gains another Obamacare exchange insurer in Oscar Health: The insurer is entering into a partnership with the Cleveland Clinic to sell health plans in five Ohio counties that Anthem said this month that it planned to vacate. The partnership with Cleveland Clinic and Oscar is also supposed to offer a different approach to healthcare that will help patients follow up on wellness visits and use telehealth. Mario Schlosser, CEO and co-founder of Oscar, said the partnership with the Cleveland Clinic would focus on keeping customers healthy, helping them find the right kind of care and reducing the cost of healthcare. Oscar was co-founded by Josh Kushner, brother of Trump’s son-in-law Jared Kushner, but he has no operational role in the company.
Why does Trump think the GOP-passed healthcare bill is ‘mean?’ Health and Human Services Secretary Tom Price said during an appropriations hearing that he didn’t know because he had not been present and did not discuss it with the president. “I only know what I read in the papers,” Price said, responding to a line of questioning from Sen. Jeff Merkley, D-Ore. He asked Price if Trump had called the bill “mean” because it threatened to reduce the number of uninsured and would provide a tax cut for the rich. “I would disagree with that characterization,” Price replied.
July Fourth vote is a ‘hope, aspiration, a plan:’ Sen. John Thune, R-S.D., refused to say that the goal of getting a vote on healthcare reform before the July 4 recess was dead. “It is a hope, an aspiration, it’s a plan,” he said Thursday morning on his way to votes. But then Thune gave an important caveat on the reality of getting a vote in two weeks. “You’ve got to be realistic based on where we are,” he said.
Medical device industry descends on Capitol Hill: AdvaMed’s members on Thursday will be discussing repealing the medical device tax with lawmakers, which is set to go back into effect on Jan. 1 and will result in a 2.3 percent tax increase on the industry. They also will discuss the medical device user fee agreements, which is part of FDA reauthorization. The trip involves 56 CEOs or heads of medical device lines of business in their companies. They will meet with more than 50 members of the House and Senate, as well as officials from the Department of Health and Human Services, U.S. Trade Representative and the Treasury Department.
States to spend $8.5 billion on Medicaid expansion in 2018. State spending for Medicaid expansion under Obamacare is expected to reach $8.5 billion in 2018, a $4 billion increase from 2016, according to a national report released Thursday. The report, assembled annually by the National Association of State Budget Offices, or NASBO, shows that median general fund spending on Medicaid grew 2.7 percent in fiscal 2016 and is estimated to grow at 5.2 percent in fiscal 2017. That outpaces median general fund revenue growth, which reached 2.4 percent in fiscal 2016 and 2.5 percent in fiscal 2017.
Maternity coverage, other benefits at risk: In 2013, before Obamacare went into effect, 75 percent of health plans didn’t cover delivery and inpatient maternity care. A new study from the nonpartisan Kaiser Family Foundation posits that insurers would be reluctant to cover all the benefits mandated under Obamacare if not required to. The American Health Care Act, which passed the House last month, allows states to opt out of enforcing the essential health benefit insurer mandate, which forces insurers on the individual market to cover 10 health benefits, including maternity care and hospitalization. The analysis found in 2013 all individual plans covered basic benefits such as hospital services and physician and surgical services. However, only 25 percent of individual plans covered maternity care and 62 percent covered mental health. About 55 percent of plans covered substance abuse.
White House huddles over drug prices: The White House is working on an executive order to take on the high cost of prescription drugs, according to a report. White House Budget Director Mick Mulvaney is running a meeting with senior government officials Friday, including Health and Human Services Secretary Tom Price, Politico reported. It isn’t known when the executive order is expected to emerge. However, the news service Biocentury reported that the order would instruct agencies to use “value-based” contracts for drug purchases and pursue trade policies that boost intellectual property rights of drug companies, which pharmaceutical companies have been seeking in recent trade deals.
Democrats cry foul over HHS promotion of health law. House and Senate Democrats sent a letter Wednesday to the Government Accountability Office complaining that the Department of Health and Human Services promoted Republican legislation to partially repeal Obamacare. The Democrats say that at least two of HHS’ Twitter accounts promoted the bill. “These actions appear to violate restrictions on the use of the department’s appropriations for supporting the enactment of legislation pending before Congress,” according to the letter.
RUNDOWN
Kaiser Health News Long waits and long odds for people who need social security disability
Denver Post Anti-abortion lawmaker spearheads letter asking for abortion restrictions to stay in health bill
STAT News China rises as a biotech powerhouse
Axios Who could lose from state health benefit limits?
Bloomberg Opioid costs push struggling states to dust off tobacco strategy
Washington Post Mom’s fever during pregnancy may increase risk of child’s autism
The Hill Insurers confront big Obamacare decision
Calendar
CALENDAR
THURSDAY | JUNE 15
June 14-16. Hyatt Regency. 400 New Jersey Ave. NW. Mental Health America annual conference on “Drugs, Sex and Rock and Roll.” Details.
June 14-16. Oregon Convention Center. Portland. Annual conference for the Association for Professionals in Infection Control. Details.
June 14-15. National Library of Medicine. Lister Hill National Center for Biomedical Communications conference on “Consequential Research: Accelerating Continuous Improvement.” Details.
TBD. House Ways and Means markup of “bills to strengthen families.” Details.
Senate appropriations hearing on Department of Health and Human Services budget. Began 10 a.m. Details.
SATURDAY | JUNE 17
The Children’s March for Humanity will hold nationwide marches and rallies in more than 24 U.S. cities. Details.
MONDAY | JUNE 19
June 19-22. San Diego Convention Center. 111 W Harbor Dr. Biotechnology Innovation Organization annual convention. Details.
TUESDAY | JUNE 20
Noon. Rayburn 2103. Briefing on neuroscience research with the Congressional Neuroscience Caucus.
6 p.m. Carnegie Library. 801 K St. NW. Bipartisan Policy Center panel discussion on documentary “Unseen Enemy” with Johnson & Johnson and the Blue Ribbon Study Panel. Details.
