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Trump’s CHIP tweet creates confusion as shutdown looms. President Trump on Thursday morning threw Republican efforts to extend CHIP and avoid a government shutdown into disarray with a tweet that seemed to oppose the GOP’s plan even though his administration already indicated he would support it. After weeks of negotiations, House Republicans finally settled on a plan they thought was their best way of avoiding a government shutdown when current funding runs out Friday: the plan is to attach a six-year extension of CHIP to a short-term bill to keep the government open, and to leave immigration out of it for now. The hope is that the CHIP extension will woo enough Democrats to make up for any Republican defections, smoothing passage through the House and Senate. Republicans were working to ramp up pressure on Democrats to get onboard with the measure to fund CHIP, with Rep. Cathy McMorris Rodgers, R-Wash., saying there was no time to wait on reauthorizing CHIP. But this morning, Trump tweeted, “CHIP should be part of a long term solution, not a 30 Day, or short term, extension!” Just a day earlier, the White House released a statement indicating that Trump would sign the House bill if it got to his desk. Senate Majority Whip John Cornyn attempted to delicately set the record straight about a short-term spending bill being negotiated in Congress. “The current house Continuing Resolution package has a six-year extension of CHIP, not a 30 day extension,” Cornyn, a Texas Republican, wrote on Twitter. A White House spokesman subsequently said that Trump still supports the stopgap measure. But with Republicans already scrambling for votes, Trump’s tweet renewed fears of fence-sitting Republicans that if they voted for the bill, Trump could easily pull the rug out from under them, as he did when he urged them to vote for a healthcare bill that he later called “mean” when the legislation moved to the Senate. House Democratic leadership is telling members to vote no on a deal to fund the government until Feb. 16 partly because it does not include protections for “Dreamers,” who are young adults who entered the country illegally as children. Democrats have charged that Republicans are using CHIP to undermine Obamacare. It is an open question if Republicans have enough votes in their own conference for the funding deal. But several Republicans used a press conference Wednesday to bash Democrats for not supporting a deal for CHIP, which provides insurance for about nine million low-income children. “The Democrats would rather support illegal aliens as opposed to our American children,” said Rep. Ralph Abraham, R-La. Despite all the mixed signals from the Trump administration, House Speaker Paul Ryan, R-Wis., said, “I have confidence we’ll pass this because members will understand, why on earth would we want to have a government shutdown and hurt the military.”
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Trump administration creates religious liberty division to allow doctors to opt out of abortions, transgender surgeries. The Trump administration created a new office to help doctors and other providers to not perform services that violate their religious or moral beliefs such as abortions or transgender surgery. The Department of Health and Human Services created a new division on religious liberty in its Office of Civil Rights. The division was created as part of a direction under President Trump’s executive order in May that called for the federal government to do more to uphold religious liberty. “Too many of these healthcare practitioners have been bullied and discriminated against because of their religious beliefs or moral convictions,” said acting HHS Secretary Eric Hargan at an event at HHS in Washington today. Hargan said that there are already strong laws that ensure healthcare providers do not have to provide services that would violate religious or moral beliefs. Now those laws will be “vigorously enforced by [Office of Civil Rights],” he said. The Office of Civil Rights is HHS’ law enforcement agency that enforces federal laws over civil rights and conscience.
Can states wait for an omnibus? The Dec. 22 short-term spending bill included nearly $3 billion to tide states over until the end of March. However, a report from Georgetown University estimates that 11 states will run out of funding at the end of February. And whether Congress could put together a long-term omnibus deal by Feb. 16 is an open question. An estimate from the Congressional Budget Office found extending CHIP for a decade would save the government $6 billion.
In a twist, Republicans using CBO score from a Democrat as political fodder. McMorris Rodgers pointed to a new estimate from CBO that funding CHIP for 10 years would save the government $6 billion. The House passed a five-year CHIP reauthorization in November with about two dozen Democrats. However, the bill went nowhere in the Senate because of Democratic objections over how Republicans want to pay for it. Republicans sought to pay for CHIP by charging wealthy seniors higher Medicare premiums and raiding an Obamacare disease prevention fund. Republicans also sought to shorten a grace period for the time between when a person stops paying their premium and when their coverage is cut off. Now, Republicans are applying political pressure by pointing out that funding isn’t a problem any more. The CBO estimate was requested by a Democrat, Sen. Ron Wyden of Oregon. Now the estimate is being used by Republicans to spur Democrats into supporting a short-term deal they do not want.
Health insurers likely to have to deal with Obamacare tax this year. The continuing resolution also includes two-year delays to Obamacare’s medical device tax and “Cadillac” tax on high-cost health plans. It also would delay the health insurance tax one year starting in 2019. The health insurance lobby and some conservative groups have been pushing for the delay to also apply retroactively to 2018. That effort doesn’t appear to be gaining much traction on the hill. Rep. Mark Walker, R-N.C., chairman of the 170-member Republican Study Committee, told reporters Wednesday that there hasn’t been any talk of making the tax delay retroactively apply.
Other healthcare extender funding likely to be in omnibus. The CHIP deal does not include funding for other critical health programs including for community health centers, which are nonprofits that provide healthcare to a certain geographic area. The House package that passed in November had two years of funding for health centers and delayed cuts of disproportionate-share hospital payments, which reimburse hospitals for charity care provided to low-income patients. Obamacare required hospitals to make the cuts starting in 2018. Hospitals are pushing back, charging that some facilities, especially in rural areas, can’t afford to lose the funding. Rep. Greg Walden, R-Ore., chairman of the House Energy and Commerce Committee, said the goal is to get funding for those healthcare programs in the longer-term omnibus spending deal.
Speaking of omnibus, remember Alexander-Murray? Walden isn’t the only lawmaker aiming to insert big healthcare legislation in the omnibus. Sen. Lamar Alexander, R-Tenn., said he wants to add legislation to try to stabilize Obamacare’s insurance exchanges in the long-term spending deal. Alexander said Congress at some point will pass an omnibus, which he believes is the opportunity to add the two bills. The Tennessee Republican said the legislation would help to “lower rates on the individual market,” which houses Obamacare’s insurance exchanges. Alexander and Sen. Patty Murray of Washington, the top Democrat on the committee, sponsored a bill to make Obamacare insurer payments called cost-sharing reductions for two years in exchange for giving states more latitude to waive Obamacare regulations. Another bill sponsored by Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla., gives states $10 billion over two years to set up a reinsurance program, which covers the highest claims for Obamacare insurers so they can lower premiums overall. Both bills have enough support to pass the Senate, but the House has been another question as conservatives have balked at what they perceive as a “bailout” of Obamacare.
Trump to deliver live video address to March for Life attendees. Trump will deliver live video remarks to attendees of the 45th annual March for Life Friday, becoming the first president to do so in the history of the massive anti-abortion event. White House press secretary Sarah Sanders confirmed the upcoming appearance on Wednesday, noting that Trump will speak to the crowd via satellite from the Rose Garden. Vice President Mike Pence, who participated in the march last year, is also slated to speak. Previous Republican presidents, including George W. Bush and Ronald Reagan, have addressed March for Life participants by phone but never in-person or via satellite video. Trump has regularly supported anti-abortion causes as president, such as advocating for the end of federal funding for Planned Parenthood. The president’s upcoming address comes as his administration is planning to offer protections for healthcare workers who decline to perform abortions over religious objections.
Senate panel approves HHS nominee Alex Azar. The Senate Finance Committee voted Wednesday to advance Trump’s nominee to serve as head of Health and Human Services. The vote was 15-12, with Sen. Tom Carper of Delaware the only Democrat to support him. Azar now faces a Senate floor vote, where he is expected to be confirmed. Two Democrats, Sens. Heidi Heitkamp of North Dakota and Joe Manchin of West Virginia, have said they would vote for Azar’s nomination, giving Republicans more than enough votes to pass him.
Aetna settles HIV privacy case for $17 million. Health insurer Aetna will pay $17 million to settle claims that it exposed sensitive health information about thousands of customers who were taking medications to treat or prevent HIV. Aetna sent a mailing to more than 13,000 customers in at least 23 states last year, and information about customers’ medication could be seen through the clear display windows on the envelopes. The case resulted a federal class-action lawsuit filed by AIDS Law Project of Pennsylvania, the Legal Action Center, and Berger & Montague in August. In response, Aetna agreed to pay at least $500 to customers whose privacy was breached and $75 to 1,600 customers whose names were improperly disclosed to a vendor.
White House stands by Trump’s glowing medical report. The White House is standing by a glowing medical report about Trump’s health, even as some in the media insist that he has heart disease or that information about his weight was mischaracterized. Sanders said she supported the assessment of the White House physician, Dr. Ronny Jackson, “100 percent that the president is in excellent health.” “Dr. Jackson has been a White House physician for the last 12 years, trusted by President Bush, President Obama and now President Trump,” Sanders said. “He is the only doctor that has weighed in on this matter that has actually examined the president and so I think a doctor that has spent the amount of time with the president as Dr. Jackson has is not only the most qualified but the only credible source when it comes to diagnosing any health concerns.”
Trump: ‘I get more exercise than people think.’ “I get exercise. I mean I walk, I this, I that,” Trump told Reuters during an Oval Office interview. “I run over to a building next door. I get more exercise than people think.” Trump says he gets his exercise on the golf course, though he prefers to use a golf cart to get around because he doesn’t “want to spend the time” walking. “A lot of people go to the gym and they’ll work out for two hours and all. I’ve seen people … then they get their new knees when they’re 55 years old and they get their new hips and they do all those things. I don’t have those problems,” Trump said. The president said he surprised doctors during his physical exam last week by how long he was able to stay on the treadmill. “I was on a treadmill for the first time actually in quite a while, and it was at a very steep angle, and I was there for a very long time,” Trump said. “They were surprised. And they said, ‘Well you can stop now, that’s amazing.’ And I said, ‘I can go much longer than this if you want me to.’”
Jimmy Kimmel weighs in on CHIP funding debate. Late night host Jimmy Kimmel on Wednesday got into a Twitter fight with a spokesman for House Speaker Paul Ryan over the GOP plan to pass legislation this week funding a children’s health program for six years. On Wednesday evening, a Politico reporter tweeted that it would be hard for Democrats to resist the bill, even though they have said they would vote against it because it doesn’t help the Dreamers. A spokesman for Ryan, Doug Andres, retweeted that message by saying “CC: @Jimmy Kimmel.” But Kimmel responded by accusing Republicans of unfairly tying the two issues together. “Shame on your for making CHIP a bargaining chip, shame on your for tying our children’s lives to immigration and shame on you and @SpeakerRyan for doing ANYTHING other than funding CHIP cleanly and IMMEDIATELY,” Kimmel tweeted. Andres replied by saying, “Republicans are the ones funding CHIP completely and immediately. Democrats are the ones voting no.”
Poll: Nearly half of Americans support legalizing marijuana. A new poll found that 49 percent of people favor legalizing recreational marijuana just as the Trump administration aims to crack down on state laws that allow recreational sales. Marijuana remains illegal under federal law, but several states have decriminalized it and allowed sales for recreational use. A poll from the Mason-Dixon polling firm found that 49 percent of respondents support legalization for recreational use and 29 percent support legalization for medical use. Only 16 percent supported keeping the current policy that makes marijuana illegal under federal law. Another 5 percent support decriminalizing marijuana use by removing the possibility of jail time for possession but keeping the sale of marijuana illegal, the poll found.
RUNDOWN
Axios Hospitals to launch generic drug company
Washington Post Teens are daring each other to eat Tide pods. We don’t need to tell you that’s a bad idea.
New York Daily News Lower blood-alcohol limit recommended to reduce drunk driving deaths, panel says
Wall Street Journal Millions bought insurance to cover retirement health costs. Now they face an awful choice
STAT News Trump’s doctor says he has incredible genes. Will they keep protecting their health?
The Hill Senate Dems push for health center funding in spending bill
NPR Repeated head hits, not concussions, may be behind a type of chronic brain damage
Calendar
THURSDAY | Jan. 18
1p.m. 1330 G St. NW. Kaiser Health News event on healthcare in 2018. Details.
FRIDAY | Jan. 19
Deadline for government spending bill.
45th annual March for Life rally in protest of Roe v. Wade. Will include speech from House Speaker Paul Ryan.
9 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Safety of the U.S. Food Supply: Continuing Concerns Over the Food and Drug Administration’s Food-Recall Process.” Details.
