Health Care

Murkowski Tax Vote Contingent on Health Vote First

Sen. Lisa Murkowski (R-AK) “said that her vote on the current version of the tax overhaul is contingent on passing a separate bill to stabilize the individual health insurance market,” Roll Call reports.

“The tax legislation now includes a section to repeal the individual mandate — a provision that opens up over $300 billion in revenue — but could also threaten the viability of the overall health law.”

Obamacare Sign Ups Are Up

Sam Baker: “Nearly 1.5 million people have signed up for coverage through HealthCare.gov in the first two weeks of this year’s open enrollment period — up from just over 1 million at the same point in the last enrollment window. Those results are stronger than many experts anticipated, in light of the Trump administration’s cuts to enrollment outreach.”

Republicans Trade a Math Problem for a Political One

First Read: “But even if the legislation does pass (and it seems like Senate Republicans are doing whatever it takes to pass it) they won’t have an easy time selling it to the American public. Higher premiums, fewer who are insured, tax cuts for corporations, estate-tax repeal for the wealthiest of Americans – the TV ad attacks in 2018 are easy to envision.”

“And pairing repeal of the individual mandate makes it all but impossible to get some Senate Democrats (West Virginia’s Joe Manchin, North Dakota’s Heidi Heitkamp, Indiana’s Joe Donnelly) to support the GOP’s tax plan. And we’ve seen how partisan legislation plays with the American public at the ballot box.”

“Bottom line: Senate Republicans may have solved their math problem by repealing the individual mandate, but they’ve now added other problems to their tax plan – a week after health care was the most important issue in Virginia’s gubernatorial election, per the exit poll, and after Maine easily passed Medicaid expansion. What’s more, only 27 percent of Americans approve of President Trump’s handling of health care, according to last month’s NBC/WSJ poll.”

Skinny Repeal Lives

Sam Baker: “Senate Republicans’ latest tax proposal includes a provision to repeal the Affordable Care Act’s individual mandate. It’s a risky maneuver, but one that GOP leaders waded into with at least an outward projection of confidence, saying they believed they had 50 votes for the overall tax package.”

“Remember ‘skinny repeal’? The repeal bill that all but three Senate Republicans voted for on the express condition that it not become law? Because, as Sen. Lindsey Graham put it, ‘the skinny bill as policy is a disaster’? The policy is basically the same this time around.”

“That said, none of the three senators who killed skinny repeal — Susan Collins, John McCain or Lisa Murkowski — has said repealing the individual mandate would be a deal-breaker for their tax votes.”

Senate GOP Will Try to Repeal Obamacare Mandate

“Senate Republican leaders have decided to include a major change to their fast-moving tax cut bill that would repeal a key plank of the Affordable Care Act, trying to accomplish two of their top domestic priorities in a single piece of legislation,” the Washington Post reports.

“Republicans had so far resisted making the change, worried that injecting health care politics into the process could imperil the tax bill, but many of their members have supported the idea and they appear on the verge of including it.”

New York Times: “Repealing the so-called individual mandate, as President Trump had urged, would help Republicans with the difficult math problem they face in refining their tax plan. But it also risks reigniting the contentious debate over health care that Republicans found themselves mired in for much of the year.”

Obamacare Signups Surge in Early Days

“A record number of people signed up for Obamacare in the first few days of open enrollment this year compared to the same period in previous years,” The Hill reports.

“The surge in sign-ups, which was confirmed by an administration official, comes despite fears from Democrats that enrollment would fall off due to the Trump administration’s cutbacks in outreach and advertising.”

GOP May Try to Use Tax Bill to Overhaul Obamacare

“Republicans are poised to begin debating details of their tax plan this week, but House Speaker Paul Ryan (R-WI) signaled Sunday that party leaders are still mulling whether to use the proposal to end a central element of the Obama-era Affordable Care Act,” the Washington Post reports.

“The tax-writing House Ways and Means Committee is set to begin reviewing the GOP plan on Monday in public hearings that could stretch into Thursday. But significant differences remain, and new proposals could be added. Ryan signaled that a repeal of the health law’s individual mandate is still up for discussion, while a key New York Republican warned that he and other GOP lawmakers from highly taxed northeastern states remain opposed to the legislation.”

GOP May Add Individual Mandate Repeal to Tax Bill

Playbook: “There’s been a push in the Capitol in the last 24 hours to include a repeal of the individual mandate in the House Republican tax bill. We snickered in the speaker’s lobby when North Carolina Rep. Mark Meadows said there’s an ‘overwhelming consensus’ to gut the health care law as part of tax reform, but since then, we’ve heard it from a bunch of other lawmakers, and sources in Republican leadership aren’t shooting it down all together.”

“Let’s be honest: Republicans need as much revenue as they can get, since they’re slashing taxes so drastically, and repealing the individual mandate gives them $400 billion more to play with. Stay tuned.”

Most Would Blame Trump for Higher Health Costs

A new NBC News/Wall Street Journal poll finds 50% of Americans say they will blame President Trump and congressional Republicans if health care costs increase under Obamacare and if more end up losing coverage, while 37% say they would put the blame on former President Obama and Democrats.

As for Trump’s tax plan, 25% of Americans say it’s a good idea, compared with 35% who say it’s a bad idea; another 39% say they don’t have an opinion.

Quote of the Day

“If we can teach young people not to take drugs… it’s really, really easy not to take them.”

— President Trump, quoted by Axios, while declaring a “nationwide public health emergency” on the opioid crisis.

Trump’s Action Could Lead to Free Health Insurance

“If President Trump prevails in shutting down a major Obamacare health insurance subsidy, it would have the unintended consequence of making free basic coverage available to more people, and making upper-tier plans more affordable,” the AP reports.

“The unexpected assessment comes from consultants, policy experts, and state officials, who are trying to discern the potential fallout from a Washington health care debate that’s becoming even more complicated and volatile.”

GOP Lawmaker Suggests Quarantine for HIV Patients

Georgia state Rep. Betty Price (R), the wife of former Health and Human Services Secretary Tom Price, asked in a hearing this week “what are we legally able to do” to limit the spread of HIV throughout the state, Stat reports.

Said Price: “I don’t want to say the quarantine word — but I guess I just said it. Is there an ability, since I would guess that public dollars are expended heavily in prophylaxis and treatment of this condition, so we have a public interest in curtailing the spread. … Are there any methods legally that we could do that would curtail the spread?”

Trump Blindsides Advisers with Promised Opioid Plan

President Trump “overrode his own advisers when he promised to deliver an emergency declaration next week to combat the nation’s worsening opioid crisis,” Politico reports.

“Blindsided officials are now scrambling to develop such a plan, but it is unclear when it will be announced, how or if it will be done, and whether the administration has the permanent leadership to execute it.”

“Trump’s off-script statement stunned top agency officials, who said there is no consensus on how to implement an emergency declaration for the drug epidemic.”