Health Care

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.

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.”

Senators Urge Trump to Back Bipartisan Health Deal

“Key Senate Republicans are urgently trying to get President Trump to reconsider his apparent opposition to a bipartisan deal shoring up health insurance markets,” Politico reports.

Sens. Lindsey Graham (R-SC) and Lamar Alexander (R-TN), who negotiated the deal with Democratic Sen. Patty Murray (D-WA), both spoke to the president about it on Wednesday evening.

Said Graham: “You can’t save Obamacare but you can keep the markets from collapsing until we get a replacement, which will be Graham-Cassidy … I just don’t see a transition to Obamacare to a block grant that doesn’t require at least a couple years to implement.”

Bipartisan Health Bill Not Dead Yet

Sam Baker: “Yes, the Senate’s bipartisan Affordable Care Act bill ran into some political roadblocks yesterday. The White House said President Trump, who had taken several positions over the course of the day, is against it. House Speaker Paul Ryan is also against it. And conservatives are against it.”

“The story of the Alexander-Murray bill likely won’t be over until December, when Congress has to take care of several must-pass bills, in negotiations where Democrats have a lot of leverage. The December agenda already includes funding the government and raising the debt ceiling — must-pass items that can only pass with a lot of Democratic votes, just like Alexander-Murray.”

Ryan Does Not Support Bipartisan Health Bill

Speaker Paul Ryan’s press secretary told Axios that despite the bipartisan push behind the Alexander-Murray health bill, “The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare.”

“This is a huge setback for the bill. Even if the measure can get 60 votes in the Senate, it still needs to pass the House. With Ryan against it, the odds of it passing aren’t looking good.”