Health Care

Overnight Healthcare: Conservatives push back on Senate changes to health bill

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Conservatives are pushing back strongly against the Senate’s proposed changes to the healthcare bill, fearing the legislation is moving in the wrong direction.

Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.) — some of the chamber’s more centrist members — have proposed gradually phasing out extra federal funds for Medicaid over seven years, beginning in 2020. That is longer than a GOP leadership proposal to eliminate Medicaid expansion funding by 2023.

But there’s the conservative wing to contend with, and a conservative Senate aide called both plans for Medicaid “terrible ideas.”

“These provisions will make it difficult for conservative senators to vote for the bill,” the aide wrote in an email.

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Heller supports seven-year phase-out of Medicaid expansion funds 

Sen. Dean Heller (R-Nev.), a key GOP senator on healthcare who is up for reelection next year, said Thursday that he supports a seven-year phase-out of funding for ObamaCare’s expansion of Medicaid.

“I support seven, I support seven,” Heller told reporters on his way into a healthcare working group meeting in the Capitol. “So do a number of us, including [Sen. Rob] Portman [R-Ohio] and others who have been working on this.”

Heller’s comments indicate that he is willing to end the extra federal funding for Medicaid expansion, as long as it is on a slow enough timetable. His comments, and those of other more centrist GOP senators, could indicate that Republicans can find some compromise on the Medicaid issue, one of their biggest obstacles to passing an ObamaCare repeal bill.

The proposal from Portman and others is to gradually phase down the federal funding for Medicaid expansion over a seven-year period from 2020 to 2027.

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Senate GOP paves way for ObamaCare repeal bill

Senate Majority Leader Mitch McConnell (R-Ky.) fast-tracked the House ObamaCare repeal-and-replace bill on Thursday, placing it on the upper chamber’s calendar and allowing it — as had been expected — to skip over the committee process.

Senate Republicans are writing their own proposal, but will use the House bill as a shell to get their bill through the upper chamber. McConnell’s move will allow him to bring up the legislation quickly once Republicans are ready to vote.

McConnell predicted after a closed-door caucus lunch this week that Republicans would be moving forward with their legislation in the “near future.”

“We’ve had plenty of time to discuss this issue. … We’re getting close to having a proposal to whip and take to the floor,” he told reporters during a weekly press conference.

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GOP chairman: We should continue ObamaCare insurer payments

House Ways and Means Chairman Kevin Brady (R-Texas) called for the funding of ObamaCare’s insurer payments Thursday, acknowledging that the uncertainty is leading to proposed rate increases for 2018.

The Trump administration has not indicated whether it will fund the cost-sharing reduction payments, which reimburse insurers for giving discounted deductibles and copays to low-income customers, past May.

Insurers want to know whether the payments will continue through next year. If they don’t, they warn, premiums could increase next year to make up for it.

“We should act within our constitutional authority now to temporarily and legally fund Cost Sharing Reduction payments as we move away from ObamaCare and toward a patient-centered system that truly works for the American people,” Brady said at a hearing on President Trump’s budget request for the Health and Human Services Department.

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But the administration isn’t providing insurers certainty

Insurers didn’t get certainty from Health and Human Services Secretary Tom Price that they’ll continue to receive key payments from the federal government, despite Democratic pressure at a Thursday Senate Finance Committee hearing.

The administration hasn’t said how long it will continue the payments to insurers that go toward decreasing out-of-pocket costs for lower-income ObamaCare consumers. Lawmakers have said they want to stabilize the market in some way, but haven’t said definitively if Congress will decide to fund cost-sharing reduction payments.

“I notice it’s in your budget through fiscal year 2018. What should we believe?” Sen. Bill Nelson (D-Fla.) asked Price.

Price responded that his answer might not be satisfying, but as the current defendant in the House v. Price case, he couldn’t comment beyond the fact that “the budget reflects the payments of the CSR payments through 2018.”

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GOP senators push to allow sale of short-term insurance plans

A group of 14 GOP senators want the Trump administration to sell short-term insurance plans while they try to repeal ObamaCare.

The senators, led by Ron Johnson (Wis.), asked Health and Human Services Secretary Tom Price to reverse a rule issued by the Obama administration last year that limited these plans to three months or less.

“These plans have offered great value to people, real protection and broad provider networks,” the senators wrote in a letter to Price.  

Short-term insurance plans generally don’t cover the same benefits that ObamaCare-compliant plans are required to, like pre-existing conditions, prescription drugs and maternity care. 

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What we’re reading:

If insurance market crashes, can lawmakers put the pieces back together (

Cancer drug prices are so high that doctors will test cutting doses (Washington Post)

U.S. officials are starting to treat opioid companies like big tobacco – and suing them (Vox)


State by state

Women’s healthcare bill falls short in Connecticut state house (Fox)

Judge tells Illinois to pay Medicaid providers more (Becker’s Hospital Review)

Wisconsin tweaks, but doesn’t retreat, from controversial Medicaid waiver (Modern Healthcare)


Send tips and comments to Jessie Hellmann,; Peter Sullivan,; Rachel Roubein,; and Nathaniel Weixel,

Tags Bill Nelson Dean Heller Kevin Brady Mitch McConnell Rob Portman Ron Johnson Shelley Moore Capito

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