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“Disaster” – That’s how one conservative aide familiar with Senate healthcare negotiations characterized Thursday’s meeting of the working group. Despite the publicly upbeat tone from many of the senators after they wrapped up, from what Daily on Health has been able to gather from sources familiar with what went on inside the meeting room, deep rifts opened up on Medicaid, Obamacare regulations and the timing of any repeal. In the meeting, led by Senate Majority Leader Mitch McConnell, Sen. Lamar Alexander, R-Tenn., presented ideas that would keep Obamacare’s subsidy and regulatory structure intact through 2020, and provide an additional $15 billion in funding to shore up insurance markets in the meantime. That was unsettling to conservatives led by Sens. Mike Lee, R-Utah, and Ted Cruz, R-Texas, who are skeptical that repeal would ever happen if it were delayed until after the next presidential election. But Sens. John Thune, R-S.D., John Cornyn, R-Texas, and Rob Portman, R-Ohio, were more sympathetic. More centrist members of the group also spoke of tightening the rules for regulatory waivers, forcing states to enact measures to auto-enroll residents in health plans before they can be eligible to apply to get out of enforcing Obamacare’s rules. This was another non-starter for conservatives in the group, who have another ally on the regulatory front in Sen. Ron Johnson of Wisconsin. Additionally, as reported earlier in this week, Sen. Pat Toomey and Portman were instructed by McConnell to hash out a compromise on Medicaid, but talks got nowhere, as Portman still wants a more gradual transition off Obamacare’s expansion and has been presenting a plan from Sen. Dean Heller, R-Nev., that would allow federal Medicaid payments to grow at medical inflation plus 2 percent. But Toomey and the rest of conservatives want to see its growth slowed down and an accelerated timeline for unwinding the expansion. Other sources, however, pushed back against this dire portrait of talks, portraying things as more unsettled, and the various proposals being presented as more discussion points than firm lines in the sand.

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Aetna CEO says single-payer debate should happen: CEO Mark Bertolini pointed to public-private partnerships, like those of Medicare Advantage and Medicaid Managed Care. ” The government doesn’t administer anything,” he said. “T he first thing they’ve ever tried to administer in social programs was the ACA, and that didn’t go so well. So the industry has always been the back room for government… But if we want to turn it all over to the government to run, is the government really the right place to run all this stuff? And that’s the debate that needs to be had. They could finance it, and if there is one financer, and you could call that single-payer.

Kaiser Permanente plans to stay in Obamacare exchanges: Bernard Tyson, chief executive of insurer Kaiser Permanente, said Thursday that the company would be sticking with the Obamacare exchanges, despite acknowledging that they were unstable.

Republicans search for ways to reduce insurer premiums: The 14-member healthcare working group met briefly Thursday to discuss Obamacare’s insurance regulations, including protections for pre-existing conditions and essential health benefits. Senators said they discussed how to stabilize the exchanges, both in the short- and long-term, and touted certain aspects of the House plan, including the option of turning to risk pools to help cover costs of people with pre-existing conditions.

Delaware judge allows Cigna to walk away from merger with Anthem: The proposed $48 billion merger was initially challenged by the Justice Department under the Obama administration on antitrust grounds, and the latest decision marks the second time that a judge has opposed the merger. Anthem has until noon Monday to decide whether to appeal to Delaware’s Supreme Court, or it otherwise may have to pay out $15 billion to Cigna. Anthem also has asked the Supreme Court to weigh the case.

Budget chief Mick Mulvaney: “person who sits at home, eats poorly and gets diabetes” is “not the same as Jimmy Kimmel’s kid”: Mulvaney said the president was considering executive order actions that he could take on drugs and cast the Congressional Budget Office as inadequate at projecting the costs and uninsurance rates for legislation. Appearing on the panel with him was Peter Orszag, who was OMB director for a time under Obama. Orszag defended the scorekeeping agency as well as Obamacare. Mulvaney was asked what he thought of the “Jimmy Kimmel test.” “I do think it should meet that test,” Mulvaney said of a new healthcare law. “We have plenty of money to deal with that. We have plenty of money to provide that safety net so that if you get cancer you don’t end up broke … that is not the question. The question is, who is responsible for your ordinary healthcare? You or somebody else?” He said the debate centered on whether others should pay the burden of paying for someone’s healthcare. “That doesn’t mean we should take care of the person who sits at home, eats poorly and gets diabetes. Is that the same thing as Jimmy Kimmel’s kid? I don’t think that it is.”

Walls fall in on Obamacare: From the Washington Examiner editorial board: “It’s not just a Republican talking point that Obamacare is falling apart. Democrats’ efforts to shift all blame to President Trump and his party are misleading. Obamacare is crumbling because it was poorly made.”

Trump health bill really unpopular, poll shows: Twenty-one percent of Americans approve of the Republican bill to repeal and replace Obamacare that passed the House last week, a modest 4 percentage point improvement over the last poll…The poll showed that 56 percent of Americans disapprove of the House bill, called the American Health Care Act, while 23 percent didn’t answer the question or said they didn’t know. The poll also gave key insights into feelings on major sticking points over healthcare.

VA whistleblowers say retaliation getting worse under Trump: Whistleblowers who have been in their share of battles with the Department of Veterans Affairs under the Obama administration say retaliation is getting worse under President Trump, despite Trump’s assurances in April that he was taking steps to protect employees who point out problems at the troubled agency. Several whistleblowers and sources with experience investigating the VA told the Washington Examiner that while Trump seems to want to fix the broken VA, his goals, including whistleblower protection, are largely being ignored. “The VA’s going after these guys with a vengeance,” said Eric Hannel, former staff director for the House Veterans’ Affairs subcommittee on oversight and investigations, who is still in contact with whistleblowers around the country.


STAT News Ousted surgeon general sounds off on HHS Secretary Tom Price’s opioid comments

Politico Tax credits may be rallying cry for Senate Obamacare repeal

Washington Post With bird flu surging, U.S. needs to do more to prepare for pandemic, GAO says

Axios Healthcare industry finds a more receptive Senate

The Hill GOP: FBI firing won’t slow down agenda

Modern Healthcare GOP senators likely to pass healthcare bill because failure not an option

Kaiser Health News Rural shoppers face slim choices, steep premiums on Obamacare exchanges

New York Times Do hand sanitizers really cut down on illness?

NPR Price: Communities key to fighting the opioid crisis

USA Today Hepatitis C infections tripled in five years



Former first lady Michelle Obama made remarks at the closing plenary for Partnership for a Healthier America. Playback.


Monday to Thursday. Sheraton Pentagon City. “Developing Solutions for the Next Generation of Veteran Care.” Details.

9 a.m. Sheraton Pentagon City. VA Interim Deputy Secretary Scott Blackburn to deliver keynote on “The Future of Healthcare Delivery to Our Nation’s Veterans.” Details.

9:30 a.m. Sheraton Pentagon City. A Principal Deputy Under Secretary for Benefits Thomas Murphy Performing to deliver keynote on” Benefit Delivery: Providing for Those Who Gave the Most.” Details.

10 a.m. Sheraton Pentagon City. Karen Ott, VA Director for Policy, Education and Legislation in the VA’s Office of Nursing Services to appear on panel discussion about addressing the nursing shortage. Details.

1:30 p.m. Sheraton Pentagon City. Tara Galovski, VA director of Women’s Health Sciences Division, to discuss “Identifying and Mitigating the Potential Toll Combat Deployments can have on Women’s Health Functioning and Well-Being.” Details.


House returns from recess. Schedule.

9 a.m. Sheraton Pentagon City. Curtis Coy, VA Deputy Under Secretary for Economic Opportunity, to deliver keynote on “Providing for the Economic Well Being of the Veterans.” Details.

9:30 a.m. HVC 215 Capitol Visitor Center. Avik Roy, President of the Foundation for Research on Equal Opportunity will present a new white paper that will describe how federal policy has artificially driven up the cost of prescription drugs.

9:30 a.m. Sheraton Pentagon City. Dr. Thomas Lynch, VA Assistant Deputy USH for Clinical Operations and Management, to speak on “Managing the Continued Improvement of Clinical Care in Today’s Veteran Population.” Details.

1 p.m. Sheraton Pentagon City. Scott Blackburn, VA Interim Deputy Secretary, to speak on “Update on MyVA and How It Is Affecting Veterans Benefit Delivery.” Details.

1 p.m. Sheraton Pentagon City. Tiffany Love, VA Deputy Associate Director of Patient Care Services, to speak on “Social Media and Its Evolving Impact on Veterans.” Details.

1:30 p.m. Sheraton Pentagon City. Joseph Ronzio, VA Deputy Chief Health Technology Officer, to speak on “Incorporating Wearable and Implantable Technology into the Next Generation of Healthcare Delivery.” Details.


10 a.m. 2358-C Rayburn. Oversight hearing on advances in biomedical research. Details.

10 a.m. Senate Commerce, Science and Transportation Committee hearing on “Current Issues in American Sports: Protecting the Health and Safety of American Athletes.” Details.

10 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Future of Emergency Alerting.” Details.

10:15 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Examining Initiatives to Advance Public Health.” Details.


2 p.m. 1100 Longworth. House Committee on Ways and Means hearing on the “Current status of the Medicare Program, Payment Systems and Extenders.” Details.