Daily on Healthcare: Cruz proposal emerges as red line for conservatives

Cruz amendment emerges as red line for conservatives: When Republicans return from recess next week, they expect to receive updated scores from the Congressional Budget Office on two versions of the healthcare bill. Both versions will include increased funding for opioid treatment, more money for the insurance market “stability” fund, and a provision allowing individuals to use health savings accounts to be used toward payment of premiums. But one version will include an additional measure, being touted by Sen. Ted Cruz, R-Texas, and backed by his conservative allies, that would allow insurers that offer at least one fully compliant Obamacare plan in a state to offer additional plans that do not meet all of the program’s regulatory requirements. This is the Senate conservative twist on the House bill, which allowed states to waive some Obamacare requirements. And just as that proved the difference maker in getting the House bill across the finish line, Cruz’s amendment is emerging as a line in the sand for Senate conservatives, according to Republican aides. In a scenario in which the Cruz proposal is adopted, conservatives would be generally willing to accept the increasing “stability” funding. The logic is that if the proposal were adopted, healthier individuals would tend to gravitate toward the non-compliant health plans that would be less comprehensive but cheaper, leaving the Obamacare exchanges disproportionately comprised of older and sicker enrollees. Effectively, the exchanges would become high-risk pools, and conservatives would largely be OK with increased funding, as long as the market is allowed to operate freely for other health insurance consumers. But if the Cruz amendment is stripped, conservatives would no longer accept the additional injection of stabilization funding. Sen. Mike Lee, R-Utah, in particular, has communicated that the Cruz amendment is a red line for him – if it is not included, Senate Majority Leader Mitch McConnell will have to scramble for 50 votes without being able to count on Lee’s support.

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A roundup of reactions Republicans have received on the healthcare bill:

*Sen. Susan Collins of Maine told the Bangor Daily News that during the Fourth of July parade in Eastport, constituents encouraged her to keep fighting on healthcare. “People in this county are particularly attuned to the cuts in Medicaid,” Collins said. “The new Congressional Budget Office analysis — that says that over the next 20 years the Medicaid program would be cut by a third under the Senate bill — is frightening to people because they know that our rural hospitals are barely holding on as it is now.”

*Sen. Bill Cassidy of Louisiana held a town hall in which he sought to talk about flood relief, but attendees raised questions about the GOP healthcare bill. According to the Advocate, Cassidy kept his remarks about the bill general, saying that he supports a patient-focused system that would keep costs down. The Associated Press reported that several attendees shouted, “Vote no! Vote no!”

*Cruz made a speech on the Fourth of July that was largely drowned out by protesters and supporters. Cruz said he met with protesters who were angry about the GOP’s healthcare bill. He told reporters at the Texas Tribune that he saw a sign about how health insurance costs are too high and said: “I tell ya, I agree. I hear that from Texans all over the state who face premiums skyrocketing under Obamacare, who want relief.”

Sen. Susan Collins wants Senate healthcare bill ‘dramatically changed.’ During the July 4 recess, her constituents have told her that they want to keep working on the legislation and “don’t want me to support it in its current form,” she told CNN. She pointed out that the legislation would cut Medicaid funding 35 percent compared to Obamacare by 2036, a number that the Congressional Budget Office projected last week.

Ivanka Trump defends paid family leave from WSJ editorial board. “The reality is that in 63 percent of American homes with children, all parents work. Providing a national guaranteed paid-leave program — with a reasonable time limit and benefit cap — isn’t an entitlement, it’s an investment in America’s working families,” Trump wrote in a follow-up column to Stephen Schwarzman and the editorial board‘s pieces. The editorial board wrote on June 24 that it did not oppose family leave for mothers and fathers, but did not want the government in charge of implementing such a policy. “As the Journal also so aptly points out, ‘a growing economy is the best antidote to inequality.’ I agree. Women’s increased participation in the workforce in recent decades has been an important driver of middle-class incomes; in fact, research by the Council of Economic Advisers suggests that the vast majority of middle-income growth since 1970 is the result of increased female labor-force participation and education,” Trump wrote. “Meanwhile, we agree wholeheartedly that government benefits should not be a substitute for private-sector investment. We see a national paid-leave benefit as the necessary floor from which private-sector companies and state governments can build.” Trump said she will continue “working with lawmakers on both sides of the aisle to design a paid-leave policy that provides a targeted benefit to help the people who need it the most and are least likely to receive it from their employer, without discouraging larger companies from developing more generous policies.”

Health statistics from the Fourth of July:

*Americans ate an estimated 150 million hot dogs over the Fourth of July, according to the National Hot Dog and Sausage Council. Eating the most hot dogs, at Nathan’s hot dog contest, was Joey “Jaws” Chestnut, 33, who consumed 72 hot dogs in 10 minutes. Chestnut has won 10 of these contests in 11 years. “There’s no secret. I love to eat, and I love doing it. I love to win, so I had to figure out my body and push it to the limit,” he told the AP.

*American households in total spent $7.2 billion on the Fourth of July, according to the National Retail Federation.

*In 2014, medical staff in emergency rooms treated 10,500 injuries related to fireworks, according to latest-available data from the Consumer Product Safety Commission.

*An estimated 44.2 million Americans traveled 50 miles or more during the Fourth of July, according to AAA. This is also the time of year when most driving-related deaths occur, according to the Insurance Institute for Highway Safety.

OPINION: When reforming healthcare, remember, markets work. “President Trump, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell are not going to replace the American healthcare system with a free market. There are just too many obstacles, political, moral and economic. But the Republican Party does have a chance to create small experiments in market-based healthcare amidst the tangle of safety net programs, and outside the reach of Byzantine insurance regulations. If they write a bill that allows these experiments by either states, individuals or organizations, they might transform the industry in the long run and perhaps beat back the Left’s hitherto relentless march toward socialized healthcare,” writes the Washington Examiner’s editorial board.

RUNDOWN

The Wall Street Journal GOP senators weigh higher health premiums’ possible effect on midterms

The Washington Post At parades and protests, GOP lawmakers get earful about healthcare

Stat How the GOP and Democrats might begin to compromise on healthcare

The Hill Cruz plan could be key to unlocking healthcare votes

POLITICO Nevada governor wields outside clout in Obamacare repeal debate

California Healthline Why teens are smoking less, in their own words  

U.S. News & World Report Are cities bad for mental health?

Independent France to make vaccination mandatory from 2018 as it is ‘unacceptable children are still dying of measles’

Calendar

WEDNESDAY | JULY 5

6 p.m. 1900 Gateway Blvd, McKinney, Texas. Sen. Ted Cruz holds town hall with Concerned Veterans of America. Details.

THURSDAY | JULY 6

11:30 a.m. CST/12:30 a.m. EST. McKenna Youth and Activity Center. 311 Main St, Palco, Kan. Sen. Jerry Moran, R-Kansas, to hold a town hall. Details.

1 p.m. 2101 Constitution Ave. NW. National Academy of Medicine event on “Effective Care for High-Need Patients: Opportunities for Improving Outcomes, Value and Health.” Details.

2 p.m. 1789 Massachusetts Ave. NW. American Enterprise Institute event on “Unbundling the Benefit for Better Health: A Broader Role for Health Savings Accounts.” Details.

6 p.m. CST/7 p.m. EST. 9721 Arboretum Blvd, Austin, Texas. Sen. Ted Cruz holds town hall with Concerned Veterans of America. Details.

FRIDAY | JULY 7

Noon. G50 Dirksen. Alliance for Health Policy and the Commonwealth Fund event on “Understanding What’s Next for Medicaid.” Details.

5 p.m. ADT. 200 Katlian St., Stika, Alaska. Sen. Lisa Murkowski to hold healthcare town hall. Details.

SATURDAY | JULY 8

Noon. 300 North Loop West Freeway, Houston. Sen. Ted Cruz holds town hall with Concerned Veterans of America. Details.

MONDAY | JULY 10

Senate back in session.

8 a.m. CST/9 a.m. EST. Harlan Community HIgh School. Harlan, Iowa. Sen Joni Ernst will hold a town hall.

TUESDAY | JULY 11

House back in session.

10 a.m. 1225 I St. NW. Bipartisan Policy Center event on “Solutions to long-term care financing in politically challenging times.” Details.