Overnight Health Care: Bipartisan health plan faces new challenge from conservatives

by Peter Sullivan, Nathaniel Weixel and Jessie Hellmann - 10/24/17 6:10 PM ET

Republicans are once again at odds over health care — this time on how to stabilize ObamaCare’s insurance markets.

A bipartisan agreement to shore up the law was rejected Tuesday by two powerful Republican committee chairmen, who introduced an alternative bill that includes the top priorities of conservatives and the White House.

The new bill, introduced by Senate Finance Chairman Orrin Hatch (R-Utah) and House Ways and Means Chairman Kevin Brady (R-Texas), would fund key ObamaCare insurer subsidies that Democrats and some Republicans have been asking for. In that respect, it’s similar to the deal that Sen. Lamar Alexander (R-Tenn.) negotiated with Democrats.

But their legislation would also temporarily repeal ObamaCare’s individual and employer mandates, something that was not part of the deal and that Democrats are unlikely to accept.

Hatch and Brady’s proposal highlights the divisions Republicans face within their party over how to deal with ObamaCare following Congress’s multiple failed attempts to repeal the law.

“I think it proves we should be focused on tax reform right now, because obviously we haven’t gotten our act together on health care,” said Sen. John Thune (R-Utah), the Senate’s No. 3 Republican.

The bipartisan deal, which Alexander negotiated with Sen. Patty Murray (D-Wash.), already faced an uncertain future because it hasn’t yet been endorsed by President Trump or House and Senate leadership.

Now critics of the Alexander-Murray deal have a new, more conservative bill to embrace that would temporarily get rid of one of ObamaCare’s most unpopular provisions — the mandates.

Read more here.

As for that other bill… Trump stops short of endorsing bipartisan ObamaCare deal

President Trump expressed appreciation for work on a bipartisan ObamaCare deal in a meeting with GOP senators on Tuesday but did not endorse the bill, multiple lawmakers said.

“He just encouraged us to continue to work on it. He made it clear that he appreciated what Sen. [Lamar] Alexander [R-Tenn.] was doing,” Sen. Mike Rounds (R-S.D.) said.

But Trump did not endorse the bill. “He just said continue to work on it,” Rounds said.

A Senate GOP aide said Trump turned to Alexander in the lunch and said: “Thanks for your great work on health care. It’s good, it’s good.”

The bipartisan plan was crafted by Alexander and Patty Murray (D-Wash.), the chairman and ranking member, respectively, of the Senate Health Committee.

Senate Republicans have been looking to Trump for guidance on the bill, but the president has given mixed signals. Read more here.

House conservatives scoff at bipartisan ObamaCare deal

The Senate’s bipartisan health bill is a “nonstarter” in the House without significant changes, conservative lawmakers said Tuesday.

“A compromise would be subsidies to stabilize the markets but somehow injecting competition in such a way that prices and premiums could come down,” said Rep. Dave Brat (R-Va.), a member of the conservative House Freedom Caucus.

“If you answer that problem, solve that problem, then we’re open to that conversation. But right now, it’s a nonstarter,” he said.

The bill, sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), would fund ObamaCare’s insurer subsidies for two years and give states more flexibility to change their ObamaCare programs.

But some House conservatives argue Congress shouldn’t fund the payments because they’re a “bailout” for insurance companies. Read more here.

House passes bill to combat flow of opioids into US

Legislation to beef up U.S. Customs and Border Protection’s (CBP) ability to detect attempts to smuggle opioids into the country passed in the House on Tuesday.

The House voted 412-3 to approve the bill, which would authorize $9 million to ensure the CBP has chemical screening devices, scientists and other personnel available to detect the illegal importation of fentanyl and other synthetic opioids.

“The federal government must do its part to ensure our first responders have the tools they need in this greatest of public health fights,” said Rep. Niki Tsongas (D-Mass.), who authored the legislation with Rep. Brian Fitzpatrick (R-Pa.).

Read more here.

Federal court: Trump can’t stop undocumented teen from getting an abortion

An appeals court ruled Tuesday that an undocumented teenager held in Texas who was blocked from getting an abortion can have the procedure.

The U.S. Court of Appeals for the District of Columbia overruled a previous decision by a three-judge panel on the court that had prevented the 17-year-old from getting the abortion until a she has a sponsor.

In the previous ruling from Friday, the court gave the Department of Health and Human Services until 5 p.m. on Oct. 31 to find a sponsor.

The teenager, known in court documents only as Jane Doe, was estimated to be 15 weeks pregnant. Abortions are banned in Texas after 20 weeks.

The Trump administration had argued that federal policy does not require it to help “facilitate” an abortion, but Jane Doe’s lawyers argued the abortion would not be paid for by the government.

Read more here.

Opioid epidemic also hitting older adults

As America grapples with an opioid epidemic, senior citizens are often overlooked.

Yet, older adults are highly susceptible to chronic pain and the prescription painkiller addiction is hitting this population.

“We really are looking at the opioid epidemic, we know how destructive it is, but we think of its younger victims,” Rep. Katherine Clark (D-Mass.) said at an event on aging and addiction, hosted by The Hill and sponsored by Surescripts.

“This is more of a quiet, more silent, but equally deadly part of the opioid epidemic.”

Roughly one in three beneficiaries in Medicare’s prescription drug program received a prescription for opioids in 2016. About half a million received high amounts of opioids. And nearly 90,000 are at “serious risk” of opioid misuse or overdose, according to a July report by the inspector general of the Department of Health and Human Services (HHS).

At the event, Clark and Rep. Markwayne Mullin (R-Okla.) touted their bill requiring e-prescriptions for controlled substances under Medicare.

Read more here.

The Hill event

Join The Hill on Tuesday, November 7, for America’s Opioid Epidemic: Strategies for Prevention featuring FDA Commissioner Scott Gottlieb and Sen. Jeanne Shaheen (D-N.H.). Topics of conversation include the response to the opioid crisis, prevention initiatives, and the role education might play in lowering addiction rates.

What we’re reading

HHS Secretary or not, Seema Verma could redefine Medicaid (Governing)

To mend a birth defect, surgeons operate on patient within the patient (The New York Times)

How many American women die from causes related to pregnancy or childbirth? No one knows (Propublica)

State by state

Virginia governor calls for Medicaid expansion to cover children’s health insurance (Roanoke Times)

Why a California law to rein in drug prices may not make much difference (statnews.com)

US hospitals wrestle with shortages of drug supplies made in Puerto Rico (The New York Times)

Send tips and comments to Jessie Hellmann, jhellmann@digital-stage.thehill.com; Peter Sullivan, psullivan@digital-stage.thehill.com; Rachel Roubein, rroubein@digital-stage.thehill.com; and Nathaniel Weixel, nweixel@digital-stage.thehill.com.