Daily on Healthcare: Trump says ‘best things’ in healthcare require 60 votes, renews call for interstate insurance

Trump says ‘best things’ in healthcare require 60 votes, renews call for interstate insurance: Frustrated by Senate Republicans’ inability to advance legislation, Trump on Tuesday called for an end to the 60-vote threshold that is needed to break a filibuster in the upper chamber. “Some of the best things in healthcare require 60 votes,” Trump told the thousands of supporters who braved the heat to attend his rally in Phoenix. “So even when you say we’re voting on healthcare, like across state lines, purchase across state lines. One of the most important things, I’ve been talking about it for two years during debates. It gives competition. Insurance companies come in, your prices go way down. Arizona is a disaster in terms of the price increase of your insurance, 116 percent interest.” Trump called for ending the filibuster so Republicans could pass anything with a simple majority of 51. Senate Majority Leader Mitch McConnell, R-Ky., previously rejected such a move, telling reporters in May that eliminating the filibuster “would fundamentally change the way the Senate has worked for a very long time.” “We’re not going to do that,” McConnell said. Senate Republicans already have attempted to bypass the rule via reconciliation, which requires a simple majority of 51 votes – including a tie-breaking vote by Vice President Mike Pence – to pass any legislation that affects the budget.

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Trump calls out Sen. John McCain for his vote against Obamacare ‘skinny repeal.’ “One vote away! I will not mention any names,” he said during his Phoenix rally. “Very presidential.” He joked about how his aides urged him not to call out anyone and urged the crowd to “speak to your senator.” The senator he was talking about was McCain, R-Ariz., who returned to Washington in July after learning he had an aggressive form of brain cancer. McCain first voted to advance debate on the GOP healthcare bill and then delivered the fatal blow over a bill Senate leaders wanted to advance so they could hash out details in conference with the House.

Trump and McConnell haven’t spoken in weeks: Report. Heated phone calls and aggressive meetings that were once private have devolved into “open conflict,” The New York Times reported Tuesday, citing more than a dozen people involved in the relationship between the two. McConnell reportedly lacks faith that Trump will be able to recover following months of conflict and questions weighing down on his administration. A phone call between the two took place a couple of weeks ago before they got into a public tussle over the repeal of Obamacare. McConnell had complained about artificial deadlines, lamenting “excessive expectations.” After those comments grabbed headlines, Trump expressed his disappointment with the Republican leader over the phone and urged McConnell to continue efforts to pass healthcare reform legislation. The president then publicly criticized McConnell on Twitter for not coming through on a “repeal & replace” for Obamacare.

Iowa aska administration for speedy approval of Obamacare waiver. Its backers hope approval will take less than the 180 days the federal government typically requires. The waiver specifically asks the Trump administration for “emergency relief from strict compliance.” The state is running out of time because it must sign insurance contracts by Sept. 27. Iowa’s waiver would restructure Obamacare’s tax credits available to people in the exchange, making a single, standard plan available to every eligible customer, instead of tiered levels, and would have a flat credit to help anyone who enrolls pay for his or her premiums, based on age and income. “We went with a flat subsidy, which actually gives every consumer purchasing power,” Iowa Insurance Commissioner Doug Ommen said in an interview. Under the plan, Iowa also would create a reinsurance program, which would take funding from federal tax credits for premiums and cost-sharing reduction subsidies that go to out-of-pocket costs, and put it toward the claims of more costly enrollees. The cost-sharing subsidies, which are mired in a political and legal battle in Washington, would not be provided to customers. Even with the measure, Iowa’s insurance division wrote that it still expected 4,000 to 6,000 residents to become uninsured. Still, its authors point out, it would be lower than the 18,000 to 22,000 people otherwise expected if the waiver is not approved. “This does not fix all of the problems we’ve seen in [Obamacare] but it dramatically impacts the rates that people without subsidies would otherwise face and likely leave the market,” said Ommen, a Republican.

HELP committee sets Obamacare hearings for September. The hearings will focus on how to cushion the blow of planned double-digit rate increases on gross premiums for Obamacare plans in many states. The Senate Health, Education, Labor and Pensions Committee will hold a hearing Sept. 6 with state insurance commissioners and on Sept. 7 with governors, in which they will discuss how to stabilize premiums. In many states, unsubsidized premiums are set to increase by double digits following mass exits by insurers as a result of uncertainty over what’s ahead and as they wait for information about how much they will receive in federal funds. They also have left the Obamacare exchanges as they lose hundreds of millions of dollars from selling plans. “Eighteen million Americans, including 350,000 Tennesseans – songwriters, farmers and the self-employed – do not get their health insurance from the government or on the job, which means they must buy insurance in the individual market,” said Senate health committee Chairman Lamar Alexander, R-Tenn. “My goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018.” The fix would be implemented ahead of the open enrollment season that begins Nov. 15 in most states, but Congress faces an even tighter deadline to come up with a solution because contracts between states and insurers are due Sept. 27.

Whistleblower asks VA secretary: Why is retaliation still allowed? Department of Veterans Affairs Secretary David Shulkin was challenged Monday by a VA whistleblower who asked why he was still facing retaliation by the department, even though VA prohibits actions against officials who highlight problems within the agency. Shulkin met with VA officials in Montana to tour the Fort Harrison facility and later participated in a question-and-answer session. That’s when Greg Chiles, a veteran and VA police officer, asked Shulkin why retaliation against him is not being stopped. As part of his official duties, Chiles — who had never had any previous disciplinary problems at VA — had issued a citation to a VA psychologist for driving 36 miles-per-hour in a 20-mph zone. Then, in 2014, Chiles failed a mandatory annual mental evaluation administered by that same psychologist. Chiles told the Washington Examiner that the actions against him were a form of retaliation for enforcing the rules against a senior VA official and for his complaint against that official for improperly accessing and altering his military record. Many of the psychologist’s actions toward Chiles were criticized in a Dec. 12, 2016, Merit Systems Protection Board hearing, but Chiles said the retaliation has gotten worse.

RUNDOWN

Vox Exclusive: Schatz’s new healthcare idea could be the Democratic Party’s future

Modern Healthcare Experts: Hate crimes are a public health issue
Bloomberg How Roche tweaked an aging drug to keep profits rolling in

Wall Street Journal Insurers are still denying treatments for pre-existing conditions

Stateline War over opioids moves to veterinarians’ offices

Forbes Employee out-of-pocket health costs will eclipse $2,500 next year

Press-Herald Republican group asks to strike ‘insurance’ from Medicaid expansion ballot wording

Healthcare Dive Hospitals brace for more uncompensated care, lower reimbursements

Calendar

WEDNESDAY | Aug. 23
3:45 p.m. CST/4:45 p.m. EST. Ringgold County Courthouse. Sen. Chuck Grassley, R-Iowa, to hold town hall. Details.

2 p.m. MST/4 p.m. EST. Bud Werner Memorial Library. Sen. Michael Bennet, D-Colo. to hold town hall. Details.

5:30 p.m. EST. UMass Dartmouth. Sen. Elizabeth Warren, D-Mass., to hold town hall. Details.

THURSDAY | Aug. 24

9 a.m. Reporter conversation with congressional staff, hosted by the Alliance for Health Policy. Details.

11 a.m. CST/noon EST. Bedford City Hall. Sen. Chuck Grassley, R-Iowa, to hold town hall. Details.

Noon. Webcast by the Association of Health Care Journalists on “Responsible, accurate reporting on addiction.” Details.

3:15 p.m. CST/4:15 p.m. EST. Eagles’ Landing. Sen. Jerry Moran, R-Kansas, to hold town hall. Details.

5:30 p.m. EST. Furnace Brook Middle. Sen. Elizabeth Warren, D-Mass., to hold town hall. Details.

6 p.m. CST/7 p.m. EST. North Central College Wentz Hall. Sen. Dick Durbin, D-Ill., to hold town hall. Details.

FRIDAY | Aug. 25

11 a.m. PST/1 p.m. EST. Seaside City Council Chambers. Sen. Ron Wyden, D-Ore., to hold town hall. Details.

12:30 MDT/2:30 EST. Northwest Kansas Technical College, Memorial Student Union. Sen. Jerry Moran, R-Kansas, to hold town hall. Details.

2 p.m. PST/5 p.m. EST. Pine Grove Community House. Sen. Ron Wyden, D-Ore., to hold town hall. Details.

5:30 p.m. EST. Concord-Carlisle High School. Sen. Elizabeth Warren, D-Mass., to hold town hall. Details.