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KHN First Edition: September 25, 2017

KHN

First Edition

Monday, September 25, 2017
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: GOP Health Bill’s Changes Go Far Beyond Preexisting Conditions
The latest GOP effort to “repeal and replace” the Affordable Care Act is getting a lot of attention, even if its passage seems unlikely. But there is far more to the measure than its changes to rules regarding preexisting health conditions. In fact, the bill proposed by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) would disrupt the existing health system more than any of the measures considered so far this year, according to supporters and critics. (Rovner, 9/22)

Kaiser Health News: A Tale Of Two States: California, Texas And The Latest ACA Repeal Bid
The GOP’s latest attempt to repeal the Affordable Care Act wobbled on Friday as Sen. John McCain (R-Ariz.) said he could not support it. But the bill known as Graham-Cassidy isn’t dead yet. And whatever its fate, the long-held Republican goal it embodies — to fundamentally change how the government funds Medicaid — will survive. Graham-Cassidy would dramatically redistribute federal funds to states. And, generally, states that expanded Medicaid — like California — stand to lose billions of dollars as that money is doled out to states that didn’t — like Texas. (Dembosky and Lopez, 9/22)

Kaiser Health News: Sunday Hours: Obamacare Website To Be Shut Down For Portion Of Most Weekends
The Trump administration plans to shut down the federal health insurance exchange for 12 hours during all but one Sunday in the upcoming open enrollment season. The shutdown will occur from 12 a.m. to 12 p.m. ET on every Sunday except Dec. 10. The Department of Health and Human Services will also shut down the federal exchange — healthcare.gov — overnight on the first day of open enrollment, Nov. 1. More than three dozen states use that exchange for their marketplaces. (Galewitz, 9/22)

Kaiser Health News: Everyone Says We Must Control Exorbitant Drug Prices. So, Why Don’t We?
Of all the promises President Donald Trump made for the early part of his term, controlling stinging drug prices might have seemed the easiest to achieve. An angry public overwhelmingly wants change in an easily vilified industry. Big pharma’s recent publicity nightmare included thousand-percent price increases and a smirking CEO who said, “I liken myself to the robber barons.” Even powerful members of Congress from both parties have said that drug prices are too high. (Hancock, 9/25)

Kaiser Health News: Money-Saving Offer For Medicare’s Late Enrollees Is Expiring. Can They Buy Time?
Many older Americans who have Affordable Care Act insurance policies are going to miss a Sept. 30 deadline to enroll in Medicare, and they need more time to make the change, advocates say. A lifetime of late enrollment penalties typically await people who don’t sign up for Medicare Part B — which covers doctor visits and other outpatient services — when they first become eligible. That includes people who mistakenly thought that because they had insurance through the ACA marketplaces, they didn’t need to enroll in Medicare. (Jaffe, 9/22)

The New York Times: Why The Latest Health Bill Is Teetering: It Might Not Work
Health insurers, who had been strangely quiet for much of the year, came off the sidelines to criticize it. Many state Medicaid directors could not stomach it, either. For months now, proposals to repeal and replace the Affordable Care Act have risen and fallen in the House and the Senate, almost always uniting health care providers and patient advocacy groups in opposition but winning support among conservatives, including Republican policy makers. But the version drafted by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana — and hastily brought into the spotlight last week — went further. (Stolberg and Pear, 9/23)

The New York Times: Senators Revise Health Bill In Last-Ditch Effort To Win Votes
With time running short, the authors of the latest plan to repeal and replace the Affordable Care Act shifted money in the bill to Alaska and Maine, which are represented by Republican senators who appear reluctant to support it. The revised version of the bill, written by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, would provide extra money for an unnamed “high-spending low-density state,” a last-minute change seemingly aimed at Alaska and its holdout Republican senator, Lisa Murkowski, who has yet to say how she will vote. It would also send money toward Maine, whose Republican senator, Susan Collins, had said earlier on Sunday that she would almost certainly vote no. (Pear and Kaplan, 9/24)

The Washington Post: A Closer Look At How The Revised Health Bill Would Benefit Key Senators’ States
The revised Republican health-care bill that senators plan to unveil Monday would partly even out wide gaps between states that would win and lose financially, providing more generous funding to states of some reluctant GOP lawmakers, but would give states less freedom to unwind federal health insurance rules. The new version of the Cassidy-Graham legislation eliminates what had been one of the measure’s most controversial features, which would have enabled states to get federal permission to let insurers charge higher prices to customers with preexisting medical conditions. In addition, states now would not be able to allow health plans to impose annual or lifetime limits on coverage, as the original bill would have done. (Goldstein and Eilperin, 9/25)

The Washington Post: New Version Of Health-Care Bill Will Help Alaska And Maine — Home Of Two Holdout Senators
The plan was distributed among Republicans late Sunday, with party leaders just one “no” vote away from defeat and as Republican senators from across the political spectrum were distancing themselves from the prior draft. Aides to Murkowski and Collins did not immediately comment late Sunday. Some Republicans close to the process have long counted Collins as an eventual “no,” predicting that little could be done to the bill to change her mind. On Sunday night, some were once again privately pessimistic the changes would convince her to vote yes. (Sullivan, Cunningham and Phillip, 9/24)

Politico: Graham, Cassidy Revise Obamacare Repeal Bill, Appealing To Holdouts
Under the revised text, the bill's authors now project increases in federal funding for Arizona (14 percent), Kentucky (4 percent) and Alaska (3 percent), which would have seen declines under the previous version, according to a leaked analysis from Trump's health department. In particular, Murkowski's home state would uniquely benefit from Sec. 129, which allows the state with the highest separate poverty guideline — Alaska — to receive a 25 percent hike in federal matching funds for Medicaid. (Pradhan and Diamond, 9/24)

The Wall Street Journal: GOP Health Push Hits More Snags
The bill by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina would set “block grants” of federal funding for each state to use for health care, including the Medicaid program for the poor. The revised text of the bill gives states broad authority to make changes to coverage mandated under the ACA, and they no longer must seek a waiver to roll back some of those requirements, which was in the earlier text of the bill, health analysts reviewing the new bill said. (Radnofsky and son, 9/24)

Los Angeles Times: Senate Republicans Unsure What Their Healthcare Bill Would Do, Even As They Push Ahead On It
With a vote expected as soon as Wednesday, according to the White House, and backers still talking about potentially major changes, the legislation will get its first and only congressional hearing Monday afternoon. The independent Congressional Budget Office, which lawmakers rely on to assess major legislation, already has said it won’t have time to analyze the bill’s effect on health coverage and insurance premiums. “This is like legislating blind,” said University of North Carolina political scientist Jonathan Oberlander, who has written extensively on the history of major healthcare legislation.“It is really hard to find an example of something where Congress was this reckless.” (Levey, 9/25)

The Washington Post: Sen. Rand Paul Lays Out Demands On Health Care As Talks Continue
The embattled Republican effort to repeal the nation’s health-care law now centers on winning over a hard-line conservative, Sen. Rand Paul (R-Ky.), who continues to engage with President Trump and Senate leaders, giving proponents of the latest GOP bill a glimmer of hope. While Paul remains wary of that proposal, he signaled Sunday that he is willing to consider a “narrow” version of the legislation, which would give states vast authority over money provided under the Affordable Care Act and waive many federal rules and regulations. (Costa, 9/24)

The Hill: Paul: Block Grants Can 'Set Up A Perpetual Food Fight' 
Sen. Rand Paul (R-Ky.), who has said he will vote against the GOP's latest ObamaCare repeal bill, said Sunday that converting health care funding into block grants to states sets up “a perpetual food fight.” “Well I’ve always been a yes for repeal but the bill, unfortunately the Graham-Cassidy, basically keeps most of the ObamaCare spending,” Paul told NBC’s “Meet the Press,” referencing the legislation Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) are pushing. (Shelbourne, 9/24)

Politico: Cruz Opposes Latest Obamacare Repeal Attempt
Sen. Ted Cruz on Sunday said he doesn’t support the latest Obamacare repeal plan, dealing a fresh blow to Republicans’ last-ditch effort to kill Barack Obama’s signature health care law. After seven years of promises to repeal Obamacare, Republicans have six days to pass legislation with a party-line vote. But with Cruz’s opposition, at least five Republicans in the 52-member caucus have signaled that they either won’t vote for or are leaning against supporting the Graham-Cassidy bill. (Rayasam and McCaskill, 9/24)

The Associated Press: GOP's 'Obamacare' Repeal All But Dead; McCain Deals The Blow
Sen. John McCain declared his opposition Friday to the GOP's last-ditch effort to repeal and replace "Obamacare," dealing a likely death blow to the legislation and, perhaps, to the Republican Party's years of vows to kill the program. It was the second time in three months the 81-year-old McCain emerged as the destroyer of his party's signature promise to voters. "I believe we could do better working together, Republicans and Democrats, and have not yet really tried," McCain said of the bill, co-written by Lindsey Graham of South Carolina, his best friend in the Senate, and Bill Cassidy of Louisiana. "Nor could I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it." (9/22)

The Associated Press: McCain's Moment: Ailing Senator Plays Spoiler Again For GOP
Longtime friends and advisers of Sen. John McCain say they're not surprised by his decision to oppose a last-ditch Republican effort to overhaul the nation's health care law. McCain objected to the legislation in part because Senate GOP leaders wanted a vote without holding hearings or debate. The Arizona senator has made a return to "regular order" in the Senate a priority since he came back to Congress following a cancer diagnosis. (9/25)

The New York Times: McCain Announces Opposition To Republican Health Bill, Likely Dooming It
For months, Mr. McCain has lamented a Senate legislative process that avoided hearings or formal bill-drafting procedures and excluded Democrats. On Friday, he said those tactics were intolerable. “We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009,’’ Mr. McCain said. “If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do.’’ (Kaplan and Pear, 9/22)

The Wall Street Journal: McCain Says He Can’t Support Latest GOP Senate Health Bill
A defeat for Graham-Cassidy would be a blow for President Donald Trump and Senate Majority Leader Mitch McConnell (R., Ky.), who threw their support behind the last-ditch legislation just as it gained momentum that surprised even some Republicans. Mr. Trump has regularly criticized Republicans who oppose the party’s health-care efforts, including in a tweet Friday morning aimed at the holdout Mr. Paul. It could also be the death knell of the GOP’s seven-year quest to dismantle former President Barack Obama’s signature health law, often called Obamacare. (Armour and son, 9/22)

Politico: Why McCain Screwed The GOP On Obamacare Repeal — Again
Not even 24 hours after John McCain dramatically tanked a Republican effort to repeal Obamacare in late July, his best friend, Lindsey Graham, started working feverishly in private to try again. Graham — who’s never shown much interest in health care policy — quietly trekked to the White House with Sen. Bill Cassidy to try and sell President Donald Trump on their latest proposal that would transform Obamacare into a block grant program for states. (Everett and Kim, 9/22)

The Associated Press: Trump Trying To Turn Around GOP Holdouts On Health Bill
Unwilling to concede defeat on a bedrock GOP promise, President Donald Trump on Saturday tried to sway two Republican holdouts on the party's last-ditch health care hope while clawing at his nemesis who again has brought the "Obamacare" repeal-and-replace effort to the brink of failure. Trump appealed to Sen. Lisa Murkowski, a possible "no" vote, to swing around for the sake of Alaskans up in arms over high insurance costs, and suggested that Kentucky Sen. Rand Paul might reverse his stated opposition "for the good of the Party!" (9/23)

The Wall Street Journal: Trump Applies Late Pressure To Senators In Health-Bill Push
“Large Block Grants to States is a good thing to do. Better control & management,” Mr. Trump tweeted Saturday. “Great for Arizona. McCain let his best friend L.G. down!” Mr. McCain was the second Republican to oppose the bill, following Sen. Rand Paul (R., Ky.) On Friday Sen. Susan Collins (R., Maine) said she was leaning against the legislation. Mr. Trump said Saturday that he hoped to persuade Mr. Paul to change his mind. (son, 9/23)

The Washington Post: Graham Is ‘Pressing On’ With The Health-Care Bill. Other GOP Senators Signal They’re Moving On.
Sen. Joni Ernst (R-Iowa) looked out at hundreds of Democrats crowded into a tense town hall meeting Friday afternoon and told them that they’d won. Just an hour earlier, Sen. John McCain (R-Ariz.) had come out against the GOP’s latest attempt to repeal the Affordable Care Act on partisan terms. “I hope that Lamar and Patty can come back again together, hopefully next week,” said Ernst, referring to Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.), who had been working on a bipartisan bill to stabilize the ACA. “We can pick back up and try again.” (Weigel and Sullivan, 9/23)

The New York Times: Three Ways The New Republican Health Bill Differs From Past Repeal Efforts
At first glance, the latest Republican plan to repeal the Affordable Care Act might appear similar to earlier bills. It would repeal the individual mandate to purchase insurance and get rid of certain subsidies for out-of-pocket health expenses. But the measure has important differences from the three bills that failed to pass the Senate in July and the one that passed the House in May. (Park, 9/22)

The Associated Press: Memo To GOP: Red States Also Among Losers In Health Bill
Memo to Republican senators: Many of the states President Donald Trump won last year would lose significant federal financing under the last-ditch Republican health care bill headed for a possible showdown in the Senate this week. Among states expected to lose are Arizona, Florida, Kentucky, and Ohio, where cuts could swell the number of uninsured people. That has political implications for Republicans girding for congressional midterm elections next year, as well as for the next presidential race in 2020. That year is when the biggest spending reductions from the legislation by GOP Sens. Lindsey Graham and Bill Cassidy would start taking effect. (Alonso-Zaldivar, 9/25)

Los Angeles Times: California Would Take Biggest Hit Under Senate Republicans' Latest Obamacare Repeal Plan
California, which has used the Affordable Care Act to extend health protections to millions of its residents and cut in half the number of people without health insurance, stands to lose more than any other state under the latest Republican plan to roll back the 2010 law. The GOP plan, which Senate leaders want to bring to a vote this week, would slash more than $100 billion in federal funding for the state over the next decade and tens of billions more in the years that follow. (Levey, 9/24)

NPR: Key Flash Points In The Health Care Overhaul Bill
If Senate Republicans vote to repeal and replace the Affordable Care Act this week, it would affect the health care of pretty much every American. Here's a recap of four key flash points in the health overhaul debate with links to NPR coverage over the past six months, and our chart laying out how the Graham-Cassidy bill under consideration in the Senate addresses those issues compared with the Affordable Care Act. (Shute, 9/24)


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