Overnight Healthcare: Inside the chaotic fight for ObamaCare

Exactly nine years after President Obama launched his White House bid, we've got a fresh look at the bitter fight behind his signature domestic achievement:

Less than 48 hours before the final vote on the Affordable Care Act, President Obama was irritated. Jason Altmire, a centrist Democratic congressman representing the Pittsburgh area, had just announced he would vote against ObamaCare. The White House needed every vote it could get, with the bill in serious jeopardy of dying on the House floor.

Altmire's phone rang at 7:30 p.m. on Friday, March 19, 2010. It was the president.

"What's the matter?" Obama asked. "We didn't give you enough attention?"

The administration had given Altmire plenty of attention in the first few months of 2010: trips to the White House, private conversations with Obama and Vice President Biden, as well as many long discussions with then-White House chief of staff Rahm Emanuel.

Altmire voted no on the House ObamaCare legislation in 2009 and had been undecided on the final measure.

The tense moment showed how confident Obama was that the Affordable Care Act would pass. At that time, though, the legislation was teetering. And Obama knew he still needed more votes.

Read the full story here: http://bit.ly/23WKKoB

GUN POLITICS STYMIE MENTAL HEALTH BILL: Partisan tensions over gun control flared during a Senate hearing on mental healthcare reform Wednesday, threatening the effort to find a bipartisan path forward.

The Senate Judiciary Committee examined a bill from Sen. John CornynJohn CornynGOP at decisive moment on Planned Parenthood Opioid crisis threatens GOP ObamaCare repeal Lawmakers want meeting with Trump administration to take US-Mexico border trade MORE (Texas), the Senate's No. 2 Republican, that seeks to increase treatment for mentally ill people as an alternative to imprisonment -- a bipartisan goal.

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But Democrats argue that other sections of the bill would make it easier for mentally ill people to get guns, including tougher requirements on a full judicial hearing before someone can be banned from buying firearms because of mental illness.

"Some of the provisions in Sen. Cornyn's bill would make it easier, not harder, for mentally ill individuals to access firearms," Sen. Charles SchumerCharles SchumerWarren cautions Dems against infighting FCC advances proposal to unmask blocked caller ID in threat cases Trump: Pelosi's leadership good for the GOP MORE (N.Y.), the Senate's No. 3 Democrat, said Wednesday. "That is the opposite direction from which we should be moving."

But Cornyn hit back. "Nothing in my legislation makes it easier for mentally ill people to get access to firearms. Nothing," he insisted.

The divisive politics of gun control have long complicated efforts to move forward on mental healthcare reform, which has been a source of hope for bipartisan agreement. Democrats have been aggravated that Republicans consistently point to overhauling healthcare for the mentally ill as a response to mass shootings rather than new gun control laws.

The controversial gun-related provisions of Cornyn's bill are a stumbling block for a Senate effort to address the issue this year. Sens. Bill Cassidy (R-La.) and Chris MurphyChris MurphyDems push for more action on power grid cybersecurity Senate panel demands Trump's legal rationale for shooting Syrian jet Dems limited in their ability to slow ObamaCare vote MORE (D-Conn.) have introduced a bipartisan bill that steers clear of the issue of guns, a version of which is expected to move through the Senate Health, Education, Labor and Pensions (HELP) Committee.

Read more here: http://bit.ly/1XjpGnu

KASICH UNDER FIRE ON ABORTION RECORD: Planned Parenthood is unleashing paid ads against GOP presidential contender John Kasich, casting him as an anti-abortion extremist who defunded women's health centers across his home state of Ohio, including a rape crisis center.

The group's political arm announced its five-figure ad buy on Wednesday, one day after the Ohio governor's strong second-place finish in New Hampshire, which is raising his profile in the presidential race.

It's also the same day that Kasich is expected to sign the Ohio state legislature's bill to eliminate funding for Planned Parenthood in the state's budget.

The 30-second ad blasts Kasich for cutting funding for programs that prevent infant mortality and domestic violence prevention initiatives, in addition to breast and cervical cancer screenings – a familiar line against GOP opponents of Planned Parenthood. Read more here: http://bit.ly/20MfF7W

HHS CONSIDERING ACTION ON DRUG PATENTS Health and Human Services Secretary Sylvia BurwellSylvia Mathews BurwellOvernight Healthcare: GOP chairman to introduce pre-existing condition bill ObamaCare enrollment hits 11.5M for 2017 Obama, Dems eyeing strategy to defend ObamaCare MORE said Wednesday that her department is considering issuing guidelines on an executive action known as "march-in rights" as a way to fight high drug prices.

Under a 1980 law, when federally-funded research was involved in creating a new drug, HHS can assert "march-in rights" to break a drug patent when the price is too high and not "available to the public on reasonable terms."

Lawmakers have asked for HHS to issue guidelines "in response to price gouging" for when this power could be used, saying that just the issuance of guidelines could warn drug companies to avoid price hikes.

Burwell confirmed that the proposal is being considered. Read more here: http://bit.ly/20WkE2v

ON TAP TOMORROW

The Senate Finance Committee will hear from Health and Human Services Secretary Sylvia Mathews Burwell on the 2017 budget proposal.

The health subpanel of the Senate Appropriations Committee will hold a hearing on the White House emergency request for Zika virus funding.  

WHAT WE'RE READING:

Biden picks adviser – and survivor – to oversee 'moonshot' (STAT)

Biden holds roundtable on cancer initiative at Duke University (ABC11)

IN THE STATES:

Ohio House passes bill to deny funds to Planned Parenthood (Reuters)

Texas researchers under fire for Planned Parenthood study (Bay News 9)

Wyoming governor explains why he changed his mind on Medicaid (Wyoming Tribune Eagle)

ICYMI FROM THE HILL:

GOP skeptical of new funding for Zika: http://bit.ly/23XEnRR

Send tips and comments to Sarah Ferris, sferris@thehill.com, and Peter Sullivan, psullivan@thehill.com. Follow us on Twitter: @thehill@sarahnferris@PeterSullivan4