The heads of the nation’s largest hospital, pharmaceutical and insurer trade group all said Tuesday that they wouldn’t support a Clinton administration’s push for a public option without first making fixes to the ObamaCare marketplace.

“We think we need to make these [marketplaces] viable before we give any consideration of going to a public option,” Rick Pollack, president of the American Hospital Association (AHA), told a crowd at the U.S. Chamber of Commerce.

{mosads}Marilyn Tavenner, who leads America’s Health Insurance Plans (AHIP), said creating a public option would be “a huge mistake.”

“I just think we need to solve the problems that we have rather than chasing yet another government program,” she said.

Supporters such as Sen. Bernie Sanders (I-Vt.), a one-time Democratic presidential candidate, have said a competing government-run public option would ensure competition nationwide — particularly in rural areas.

Hillary Clinton threw her support behind the proposal in July as part of her effort to court Sanders’s voters in the wake of a competitive primary.

Some Democrats have vowed to push for a public option again in 2017: A bill by progressive Sen. Jeff Merkley (D-Ore.) has 33 cosponsors.

But Steve Ubl, the head of Pharmaceutical Researchers and Manufacturers of America, said the idea was “rightly rejected” during the last healthcare debate.

“It puts the government’s thumbs on the scales in a way that is likely to discourage private plans from participating in the market,” Ubl, who is the former CEO of the medical device lobby, said. http://bit.ly/2dyjJot

Can Clinton get Congress to boost subsidies?

In a debate about how to bolster ObamaCare’s marketplaces, healthcare experts say it’s likely easier politically to push for bigger subsidies than a stricter penalty for lacking coverage.

But conversations with several people who helped draft the law show it will likely be another tough policy to perfect. The Department of Health and Human Services, Treasury Department and White House officials huddled roughly 50 times on the issue of the subsidies and the mandate from 2009 to 2010.

What ultimately passed was a mix of various proposals, and the result of other considerations, such as trying to make the law fully paid for, sources said. Read more here: http://bit.ly/2dpf8lb

Don’t hold your breath for ObamaCare fixes

Some of the experts most familiar with ObamaCare say they’re not expecting any major fixes to the health law in the next Congress.

“We shouldn’t hold down great expectations for significant change,” Robert Reischauer, one of two public trustees of the Social Security and Medicare trust funds, said Tuesday at a panel hosted by the National Coalition on Healthcare.

“What we should probably do is tamp down the behavior that would make things worse,” he said, referring to six years of Republican attempts to undermine the law.

Reischauer, the former president of the Urban Institute, said he projects more inaction next year, as Democrats won’t agree on ways to fix the healthcare law — in part because several are up for reelection in 2018 in traditionally red states.

He added that Republicans are unlikely to act because they wouldn’t be facing the blame for health insurance problems under a Clinton presidency.

“I doubt they’re going to want to be seen as saving the Affordable Care Act from — what Donald Trump has said — that it’s going to collapse by itself,” Reischauer said. http://bit.ly/2eibjkq

Advocates: Social Security boost isn’t enough to cover drug costs

Social Security recipients and federal retirees will get only a small boost in their monthly benefits checks next year amid low inflation, the administration announced Tuesday.

That increase amounts to about $5 more in monthly payments – a boost that groups like the Alliance for Retired Americans say is not enough to keep up with the cost of their prescription medications.

The boost in monthly checks could be entirely wiped out for beneficiaries who are also enrolled in Medicare Part B. The premiums for that program are expected to increase by enough next year to nix the COLA increase. Read more here: http://bit.ly/2eCxepE

ON TAP TOMORROW

BlueCross BlueShield is holding a briefing on Capitol Hill focused on specialty care innovations at 12:30 p.m.

The Generic Pharmaceutical Association holds a webinar to release a new report on drug costs at 10:30 a.m.

WHAT WE’RE READING

UnitedHealth Group is projecting strong financial growth next year, after largely ditching the ObamaCare marketplace. (Bloomberg)

People buying ObamaCare next year will have the option of buying new standardized plans that don’t include deductibles. (New York Times)

More than half of America’s remaining uninsured people don’t qualify for ObamaCare subsidies, according to a study by the Kaiser Family Foundation. (Washington Examiner)

Toxic chemicals have been tied to $340 billion in U.S. health costs and lost wages. (Reuters)

People with mental health conditions are relying more on hospital emergency rooms for treatment. (NPR)

IN THE STATES

Voters in the Florida Keys will decide this November whether to allow an experiment with genetically modified mosquitoes in their community. (Five Thirty Eight)

Activists trying to legalize marijuana in Massachusetts are facing the most organized and powerful cannabis opposition in the country, in part led by Sheldon Adelson. (Boston Globe)

New Jersey’s attorney general is making the case to suspend a doctor who prescribed fentanyl to a patient who later died of an overdose, and hopes the legal action serves as a broad warning for other providers. (STAT News)

State health officials outlined nearly a dozen proposals to limit the rising costs of prescription drugs, including new laws that require more transparency from drugmakers. (STAT News)

ICYMI FROM THE HILL DOT COM

Gunmakers spend $16M to defeat Clinton http://bit.ly/2eigDnF

Alarm sounds on Medicare premium hikes http://bit.ly/2erWknG

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