Daily on Healthcare: Obamacare is safe, but not sound

But it is not sound: Senate Minority Leader Chuck Schumer, D-N.Y., speaking for Democrats after the embarrassing defeat of the bill, described what he was feeling as “relief.” Though Democrats may be feeling that for now, the demise of the GOP healthcare push means that all of Obamacare’s very real problems remain. Premiums are still soaring, networks are getting narrower, insurers are still losing money and pulling out of markets, and young and healthy individuals are turned off from purchasing insurance. This was the case when the Obama administration was using all of the tools in its arsenal to prop up the law. The Trump administration has vowed to take a different approach. After the failure of the bill, Trump said he would let the law “implode” and Secretary of Health and Human Services Tom Price said, “Since day one of the Trump administration, the team at HHS has taken numerous steps to provide relief to Americans who are reeling from the status quo, and this effort will continue.” To this date, Trump has continued to make the cost-sharing reduction payments to insurers that Republicans argued in court were illegal, but absent an ongoing legislative process to repeal and replace Obamacare, it’s not clear he will do so in the months ahead. Furthermore, now that McConnell is freed of the need to woo centrist Republicans to support a comprehensive bill that repeals major parts of Obamacare, there will be much less appetite for an injection of money into the insurance markets. In his floor speech after the failed vote, McConnell said, “For myself I can say — and I bet I’m pretty safe in saying for most on this side of the aisle — that bailing out insurance companies with no thought of any kind of reform is not something I want to be part of.”  

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.

President Trump calls for Senate to implement 51-vote threshold after ‘skinny’ repeal bill fails. “If Republicans are going to pass great future legislation in the Senate, they must immediately go to a 51-vote majority, not senseless 60…” Trump tweeted. “Even though parts of healthcare could pass at 51, some really good things need 60. So many great future bills & budgets need 60 votes.”

Rep. Mark Meadows: ‘It’s not over.’ There is a new effort to craft a bill that can pass the Senate that would include proposals offered by Sens. Lindsey Graham, Bill Cassidy, Ted Cruz and Rob Portman, said the House Freedom Caucus chairman, a key negotiator in the effort to repeal and replace Obamacare. “We continue to work on two different plans with our Senate colleagues,” the North Carolina Republican told the Washington Examiner. “We will continue to do that over the next couple of weeks on a plan that can get to 51” votes in the Senate. Meadows said he is has talked to senators, including Graham, in the hours after last night’s failure to pass a “skinny” repeal bill, and the mood is “all hands on deck” to come up with a new deal. “I believe we deliver, still, on healthcare,” Meadows said.

Republicans surprised, disappointed after defeat. Republican senators walked away from a narrow defeat of their effort to repeal Obamacare trying to figure out their next steps after a years-long effort collapsed early Friday morning. Republicans are going back to the drawing board with some talking of kickstarting bipartisan talks. McCain was one of three GOP senators to vote against the repeal bill; it was also opposed by Sens. Lisa Murkowski of Alaska and Susan Collins of Maine. The decision by McCain to oppose the measure caught some senators by surprise and left them disappointed. “Sen. McCain knows how to improve the drama,” said Sen. Bill Cassidy, R-La. “I had been told he might be a yes and so I was a little surprised at that.”

On the other side, Democrats took a victory lap. House Minority Leader Nancy Pelosi and other top Democrats celebrated Friday and called for both parties to come together and shore up the healthcare system. Pelosi, D-Calif., House Minority Whip Steny Hoyer, D-Md., and other lawmakers expressed how grateful they were with McCain after he cast the deciding vote against the bill. Pelosi said it was a “victorious” night for the American people. “I know it was a late night, but a victorious one for the American people,” Pelosi said. “I want to thank Senator McCain for establishing a higher level of participation as to how we should proceed and to senators who courageously — Sen. Murkowski, Sen. Collins, and Sen. McCain — thank you for hearing the voices of the families.”

Mick Mulvaney: ‘We have not given up.’ President Trump’s budget director said Friday that lawmakers needed to find a bill they could pass, but he didn’t specify whether that meant working with Democrats to improve Obamacare or whether it meant continuing efforts to repeal the law. “We have not given up,” Mulvaney said on CNBC. “We understand that various senators continue to talk to each other and to the White House. I don’t think they can go home without doing something. The healthcare discussion is still very much alive despite the vote last night.”

“We have not given up,” Mulvaney said on CNBC. “We understand that various senators continue to talk to each other and to the White House. I don’t think they can go home without doing something. The healthcare discussion is still very much alive despite the vote last night.”

A suspense-filled night. Ahead of a dramatic vote that was in doubt until the final minutes, Vice President Mike Pence was seen working McCain in the Senate chamber. McCain flew into Washington this week from Arizona, where he was resting after a diagnosis with brain cancer, to participate in healthcare votes — and he ended up being a deciding vote against the bill.

Why McCain did it: He wasn’t confident that the bill would not become law. McCain said he was concerned because there was no guarantee that the House would not send the bill directly to President Trump’s desk. A statement issued by House Speaker Paul Ryan, R-Wis., did not assuage his concerns. “The speaker’s statement that the House would be ‘willing’ to go to conference does not ease my concern that this shell of a bill could be taken up and passed at any time,” he said. He also wants to see the two parties work together, under regular order. “We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of the aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable healthcare for the American people,” he said.

Why Sen. Susan Collins voted no. The Maine Republican said she voted against the Senate’s “skinny” Obamacare repeal bill because healthcare requires a bipartisan solution. “We need to reconsider our approach,” the Maine Republican said Friday. “The [Affordable Care Act] is flawed and in portions of the country is near collapse. Rather than engaging in partisan exercises, Republicans and Democrats should work together to address these very serious problems.”

McConnell: ‘Time to move on’ from Obamacare repeal. McConnell said that he was disappointed in the result, which he has been working months on. “Our only regret is we didn’t achieve what we hoped to accomplish,” he said. “I think the American people are gonna regret we couldn’t find a better way.”

Sen. Ted Cruz: Voters will feel ‘sense of betrayal’ over failure. The Texas Republican warned that the Republican failure will disappoint Republican voters around the country who were told the GOP was going to dismantle the law. “There are going to be a great many Americans who tonight feel a sense of betrayal, feel a sense of betrayal that politicians stood up and made a promise,” Cruz said early Friday morning. “I tell you this, if you stand up and campaign and say we’re going to repeal Obamacare, and you vote for Obamacare, those are not consistent,” he said. “And the American people are entirely justified in saying, ‘any politician who told me that and voted the other way didn’t tell me the truth. They lied to me.'”

Rep. Tom Cole: Time to listen to Democrats’ ideas. One of the House’s top Republicans who has close ties to leadership said the GOP’s next step on healthcare reform should be to listen to ideas from Democrats about how to reform healthcare. “Now I think it’s really incumbent on our friends on the other side of the aisle to keep going,” The Oklahoma lawmaker said on MSNBC Friday morning. “There’s a lot of problems with Obamacare, we need to fix it, not repeal it,” he said. “OK, let’s see what your fixes are. I think we should sit down with an open mind and listen to them.” But Cole said finding those answers won’t be easy. He said in his home state, only one Obamacare insurance provider is left, and people are expecting a 69 percent increase in premiums. “This is not a system that’s succeeding,” he said.

Rep. Mo Brooks: Ditch McConnell, find ‘somebody bold’ to lead the Senate. The Alabama Republican said Friday that it’s time for new leadership in the Senate after McConnell failed to bring a healthcare reform bill over the finish line. Brooks said on CNN that he hopes the Senate doesn’t stop trying to pass a bill, but said if the Senate is done, the GOP should start looking for a new leader. “If they’re gonna quit, well then, by golly, maybe they ought to start at the top with Mitch McConnell leaving his position, and letting somebody new, somebody bold, somebody conservative take the reins so that they can come up with a plan that can get through the United States Senate and serve the needs of the American people,” Brooks said.

Sen. Ron Johnson: GOP pledge to repeal Obamacare was an ‘over-promise.’ The Wisconsin Republican admitted Thursday that Republicans on the campaign trail over-promised by saying repeatedly that they would repeal and replace Obamacare. “I come from the business world where the standard is to always underpromise and overdeliver. I did that for 30-some years in business,” Johnson said. “I would say that’s … one of the reasons after the election why I started talking about what we ought to do is repair the damage, focus on repairing the damage and working to transition to a system that actually works. I think it’s far more realistic expectations. I think it’s exactly what we’re trying to do at this point,” Johnson said. “But that advice wasn’t heeded. Everybody loved the slogan ‘repeal-replace,’ and yeah, I would say that was an over-promise.”

Senate rejects single-payer healthcare. Earlier Thursday, an amendment that would have created a single-payer healthcare system was defeated 57-0 in the Senate. Several Democrats voted against the amendment, including Sens. Joe Donnelly of Indiana, Joe Manchin of West Virginia, Jon Tester of Montana and Angus King of Maine, an independent. All 52 Republicans voted “no” and other Democrats voted “present,” meaning that they like the proposal but believe it has flaws. The amendment was introduced by Sen. Steve Daines, R-Mont., and was a copy of a single-payer bill that has been introduced in the House by Rep. John Conyers, D-Mich., and has more than 100 Democratic co-sponsors. Often dubbed “Medicare for all,” the proposal has gained traction among more left-leaning Democrats. The healthcare system would be paid for by raising income taxes on the top 5 percent of earners and raising taxes on payroll and self-employment income, unearned income, and stock and bond transactions. Daines does not support a single-payer healthcare system, but he presented the amendment to force Democratic senators running for re-election in 2018 to take a position on the policy. Most Democrats voted “present” as a way to object to the political maneuver.

Rep. Sean Duffy says Tammy Baldwin’s inaction could cost Democrats her Senate seat.  Sen. Tammy Baldwin, D-Wis., is one of 10 Democratic senators up for re-election in states Trump won in November, a scenario that puts the party at risk of losing even more seats in the upper chamber come 2018 — and Duffy thinks she’s in serious trouble. “I think Tammy, with the right candidate, will lose,” he told the Washington Examiner on Thursday. Duffy, a fourth-term Republican who represents a district in the northern part of the state, believes Baldwin’s inaction on healthcare could be what dooms her candidacy. “Here, you have a senator who in the House voted for Obamacare, wants to bring us to a single-payer system,” he said. “She sits back as our prices have gone up. Our families are paying almost a 100 percent more in premiums, and she has done nothing; she hasn’t lifted one finger to help fix this problem.”

FDA aims to reduce nicotine in cigarettes. The Food and Drug Administration is looking into whether to lower the nicotine levels in cigarettes to prevent addiction. The agency said Friday that it would look into the addictive levels of nicotine as part of a larger strategy to curb addiction. The agency said it plans to start a public dialogue to lowering nicotine levels to “non-addictive levels through achievable product standards.” The FDA did not say what level it was aiming for.

RUNDOWN

CNN Healthcare state of play: what happens next?

Politico Bipartisan House group meets quietly on Obamacare

Bloomberg Healthcare mess makes farming even riskier

USA Today Feel better? Maybe you don’t have to finish those antibiotics after all

Kaiser Health News Five ways the White House can use its muscle to undermine Obamacare

The Hill GOP Lawmaker: Time for us to listen to Democrats on healthcare

Washington Post Stretchy glue inspired by slugs could be the future of sutures

Morning Consult Obamacare repeal staves off cuts to preventive health programs