Overnight Health Care: Senators discuss path forward on ObamaCare fix | Lawmakers say they are close to children's health deal | Trump signs bill on synthetic opioids | ObamaCare repeal fades as GOP priority

Overnight Health Care: Senators discuss path forward on ObamaCare fix | Lawmakers say they are close to children's health deal | Trump signs bill on synthetic opioids | ObamaCare repeal fades as GOP priority
© Greg Nash

Lawmakers say they are close to CHIP deal

Lawmakers in both parties say that a long-running disagreement over children's health funding has almost been resolved and that funding could be passed as soon as next week.

The reauthorization of the Children's Health Insurance Program (CHIP) could be attached to a short-term government funding bill that must pass before Jan. 19, lawmakers say. Whether the reauthorization is ultimately tied to the bill, however, will depend on broader leadership negotiations.

Funding for the program, which covers 9 million children, has been stalled for months amid partisan fighting over how to pay for it.

But the Congressional Budget Office (CBO) issued a new cost estimate this week that now puts the cost of a five-year extension at just $800 million, down from $8 billion.

Finding an agreement on how to pay for that smaller sum won't be an issue, said House Energy and Commerce Committee Chairman Greg WaldenGregory (Greg) Paul WaldenHouse GOP blocks Trump-supported drug pricing provision from spending bill GOP turns its fire on Google Hillicon Valley: Twitter chief faces GOP anger over bias | DOJ convenes meeting on bias claims | Rubio clashes with Alex Jones | DHS chief urges lawmakers to pass cyber bill | Sanders bill takes aim at Amazon MORE (R-Ore.). "I don't think that will be a problem," Walden told reporters on Wednesday.

Read more here.


Murray, Alexander meet to discuss ObamaCare fix

Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderOvernight Health Care: Senators target surprise medical bills | Group looks to allow Medicaid funds for substance abuse programs | FDA launches anti-vaping campaign for teens The Hill's Morning Report — Sponsored by United Against Nuclear Iran — Kavanaugh confirmation in sudden turmoil Cruz gets help from Senate GOP in face of serious challenge from O’Rourke MORE (R-Tenn.) and Patty MurrayPatricia (Patty) Lynn MurrayJudiciary Democrat calls for additional witnesses to testify on Kavanaugh Kavanaugh allegations set stage for Anita Hill sequel Time for action to improve government data analysis MORE (D-Wash.) met Wednesday to discuss the path forward for their bipartisan legislation aimed at stabilizing ObamaCare, aides in both parties said.

The legislation's future has been thrown into question after it was punted at the end of last month. Alexander is now pushing for the legislation to be included in a government funding package when a long-term deal on that measure is reached.

Murray and other Democrats, though, want significant changes to the bill, saying that it needs to be redone now that Republicans have destabilized health insurance markets by repealing ObamaCare's individual mandate in the tax reform bill last month.

Democrats have not yet said what changes they are looking for.

But Alexander told reporters on Wednesday that the bill will remain "fundamentally what was agreed to."

Read more here.


Trump signs bipartisan bill to combat synthetic opioids

President TrumpDonald John TrumpTrump: I hope voters pay attention to Dem tactics amid Kavanaugh fight South Korea leader: North Korea agrees to take steps toward denuclearization Graham calls handling of Kavanaugh allegations 'a drive-by shooting' MORE signed a bipartisan bill Wednesday aimed at stopping powerful synthetic opioids from coming into the country illegally.

A group of Republican and Democratic lawmakers attended the bill signing, a rare showing of bipartisanship with members of both parties seeking to show their support for tackling the issue.

The opioid epidemic has been ravaging the country, and the rates of overdose deaths from synthetic opioids, such as fentanyl -- which can be 50 more times potent than heroin -- more than doubled from 2015 to 2016.

The Interdict Act aims to give the U.S. Customs and Border Protection more chemical screening devices at entry ports and mail facilities; bolster the resources to interpret these screening tests; and authorize money for both actions.

Read more here.


ObamaCare repeal fades from GOP priorities list in new year

The chances of repealing ObamaCare this year are fading further, with top Republicans saying they hardly discussed repeal of the law during a Camp David retreat last weekend focused on their 2018 agenda.

Meanwhile, Republicans say talk of welfare or entitlement reform this year is also narrowing down to an emphasis on things like job training, not the broad overhaul of Medicare, Medicaid and other entitlements that Democrats have warned against.

While some conservative groups and select lawmakers are pushing for ObamaCare repeal in 2018, President Trump and GOP leaders have signaled a desire to move on, at least for now, after unsuccessful repeal efforts sucked up months of the legislative calendar in 2017. Trump also declared after signing the GOP tax overhaul in December, which did away with the mandate that most people buy health insurance or face a tax penalty, that Republicans had "essentially repealed ObamaCare."

"There's some work we need to do on the health-care front, but I would hope we're in a position to do things on a bipartisan basis," said Sen. John CornynJohn CornynGOP mulls having outside counsel question Kavanaugh, Ford Blumenthal: Kavanaugh nomination should be withdrawn Cornyn takes on O'Rourke over AR-15s MORE (R-Texas), one of the GOP leaders who huddled with Trump at Camp David to discuss the 2018 agenda.

Asked if ObamaCare repeal was discussed in the meetings over the weekend, Cornyn -- the Senate's No. 2 Republican -- replied flatly, "No."

Read more here.


Ex-drug czar nominee looks to change image

The congressman who saw his bid to become President Trump's drug czar torpedoed by a bombshell story about the nation's opioid epidemic is on the comeback trail.

Rep. Tom MarinoThomas (Tom) Anthony Marino'Paws for Celebration' event brings rescue animals to the Capitol In the shadow of another epidemic, we must protect our children Republicans refuse to back opioids bill sponsored by vulnerable Dem MORE (R-Pa.) is facing a primary challenge against an opponent who plans to make drug legislation backed by the incumbent a key issue in the race.

As he seeks a fifth term in office, the incumbent is taking a page from President Trump's playbook in arguing the media got it wrong in casting him as the villain.

Read more here.


Senators eye Puerto Rico Medicaid funding for disaster bill

Senators are floating a temporary fix for Puerto Rico's dwindling Medicaid funds as part of the chamber's disaster aid package for the island.

According to sources familiar with the discussions, the legislation would include a provision to temporarily lift restrictions on how much money the federal government can spend on Puerto Rico's Medicaid program.

Under the potential deal, the government would completely fund Puerto Rico's Medicaid program for two years. The legislation could also include an infusion of $6 billion to help out the cash-strapped program.

Puerto Rico has grappled with funding shortfalls even before Hurricane Maria decimated the territory's health-care system. Before the storm, the territory had enough Medicaid money to last until April 2018.

Now, experts predict that unless Congress acts, funding will be exhausted by March, if not earlier. If Puerto Rico's federal Medicaid funding is exhausted, up to 900,000 people would likely be cut from Medicaid -- more than half of total enrollment, according to estimates.

Read more here.


Trump ends registry for substance abuse, mental health programs

The federal government has ended a national registry designed to provide information to the public about evidence-based mental health and substance use interventions and programs.


The National Registry of Evidence-based Programs and Practices, which is funded and administered by the Department of Health and Human Services (HHS), has existed since 1997 to help people, agencies and organizations identify and implement evidence-based behavioral health programs and practices in their communities, according to the website.

But the Substance Abuse and Mental Health Services Administration (SAMHSA), the department under HHS that manages the program, wrote on its website that the contract for the database had been discontinued.

SAMHSA is still "very focused on the development and implementation of evidence-based programs in communities across the nation," the notice says.

Read more here.


Paul RyanPaul Davis RyanCorey Stewart fires aide who helped bring far-right ideas to campaign: report GOP super PAC hits Randy Bryce with ad starring his brother Super PACs spend big in high-stakes midterms MORE to speak at anti-abortion march in DC

Speaker Paul Ryan (R-Wis.) will address this year's March for Life, an annual anti-abortion rally in Washington, D.C.

March for Life President Jeanne Mancini called it an "honor" to have Ryan speak at the Jan. 19 event. 

"Speaker Ryan has been an unwavering champion for the pro-life cause since taking office, and continues to utilize his post to promote the inherent dignity of the human person at all stages of life," Mancini said in a statement.

Read more here.


Lawmakers look to step up oversight on discount drug program

House Republicans are demanding more oversight and transparency for a discount drug program they say has grown out of control in recent years.

The 340B drug program, created to help rural and charity hospitals and clinics, has become the subject of intense scrutiny in recent years, with more than 12,000 entities now participating in the multibillion-dollar program, far more than when the program was created in 1992.

Following a two-year review by the House Energy and Commerce Committee, Chairman Greg Walden (R-Ore.) told reporters that Republicans will push for substantial changes to bring what they argue is much-needed transparency and oversight to 340B, namely by expanding the federal government's authority over the program.

Walden said the committee's review found that participating hospitals and clinics aren't required to track how much they're saving through the program or how they're using the money. The federal government also has limited authority to ensure participating hospitals are following the rules of the program, he said.

Read more here.


South Dakota will seek work requirements for some Medicaid recipients

South Dakota is set to join a growing list of states looking to impose work requirements on Medicaid recipients.

The state's Republican Gov. Dennis Daugaard said Tuesday the state will ask the Trump administration for permission to require that work be a condition for eligibility.

"Work is an important part of personal fulfillment," Daugaard said during his State of the State address.

Read more here.


Humana leaves insurers group

Humana has ended its membership with the health insurance industry's largest trade group, America's Health Insurance Plans (AHIP).

According to a Humana spokesman, the formal termination happened Dec. 31, but he said the company "has not actively participated in AHIP since early 2017."

The move could be seen as a blow to AHIP's influence on Capitol Hill, as Humana is the third major insurer to leave the association.

Read more here.


Groups push fix to keep infusion therapy at home

Two groups are leading an effort to urge congressional leaders to quickly pass a temporary patch that would ensure patients can continue to receive a critical medical treatment at home.

In a letter sent to House and Senate leaders Tuesday, the Immune Deficiency Foundation said time is of the essence to fix what they say is a problem created by the 21st Century Cures Act, which was signed into law in 2016.

Advocates are concerned about the impact the law is having on Medicare beneficiaries with heart failure and with disorders where their immune system does not function properly.

Read more here.


What we're reading

Hospitals brace patients for pain to reduce risk of opioid addiction (NPR)

IV bag shortage has hospitals scrambling to treat flu (Associated Press)

'Evidence-based' program that evaluates behavioral health therapies halted (STAT)


State by state

A poor neighborhood in Chicago looks to Cuba to fight infant mortality (WBEZ)

Listen: How a 'hippie clinic' in San Francisco inspired a medical philosophy (KQED)

California examines prison guards' high suicide rate (Associated Press)


In case you missed it from The Hill:

Pennsylvania governor declares statewide disaster for opioid epidemic

New chairmen named for health, tax subcommittees

House votes next week on abortion bill


From The Hill's opinion page:

Middlemen are driving up the cost of livesaving drugs

The hidden story behind lower life expectancy