Home / World / Daily on Healthcare: Angry Trump demands GOP Senate pass healthcare bill … but McConnell's fundamental problem … – Washington Examiner

Daily on Healthcare: Angry Trump demands GOP Senate pass healthcare bill … but McConnell's fundamental problem … – Washington Examiner

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Angry Trump demands GOP Senate pass healthcare bill … but McConnell’s fundamental problem remains: Continuing to vacillate between saying he was perfectly content to see Obamacare “implode” and demanding swift action from Congress, President Trump spent the weekend putting pressure on Republicans to pass a healthcare bill by any means necessary. Taking to his favorite communications platform, he once again urged the Senate to ditch the filibuster rule. He also wrote: “Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!” Senate Majority Mitch McConnell, R-Ky., has repeatedly rejected the idea of ending the filibuster for legislation, fearing that if he were to do that, it would come back to bite Republicans because a future Democratic Senate would be able to pass legislation at warp speed. But regardless, ending the legislative filibuster would not solve McConnell’s problem. His problem is that in a Senate Republican caucus where the ideological gulf runs from Sen. Rand Paul to Sen. Susan Collins, he can’t cobble together a single piece of legislation that would garner even 50 votes. Republicans can talk all they want about efforts to revive the bill, but until there is a breakthrough that can win over 50 Republicans, the healthcare push will remain dead.    

Trump taking aim at special treatment of Congress: In an attempt to hit Republicans where it counts, Trump on Monday morning tweeted, “If ObamaCare is hurting people, & it is, why shouldn’t it hurt the insurance companies & why should Congress not be paying what public pays?” It was at once an effort to threaten insurers about withholding Obamacare cost-sharing reduction payments and to threaten Congress about the special treatment it receives under Obamacare. Given that the treatment of Congress is source of a lot of misconceptions, it’s worth taking a moment to remember what the situation is. At the time when Obamacare passed, Sen. Chuck Grassley, R-Iowa, proposed that Congress be forced to live under the laws it imposed on everybody else, and thus it became part of the law that lawmakers and their staffers be forced into Obamacare plans. When it came implementing it, however, there was no mechanism for congressional employees, who received federal benefits in the pre-Obamacare days, to receive money toward the purchase of Obamacare. If the conclusion was that the federal government (in this case, the employer) couldn’t continue to provide money toward the purchase of health benefits, then Congress would be uniquely punished by Obamacare. It would mean that they were the only workers in the United States who were effectively barred from receiving any employer-based health benefits. And, unlike lawmakers themselves, many of the thousands of people who work as congressional staffers aren’t earning large salaries. Preventing them from being able to receive health benefits could mean an exodus of competent staffers from the Hill. So, during the Obama administration, the Office of Personnel Management issued a rule that allowed congressional offices to be treated as small businesses, and thus make contributions toward their employees’ purchase of insurance on the exchanges. This is what some people point to when they say Congress “exempted” itself from Obamacare with a special carveout. But that isn’t quite right. It isn’t quite right to say that congressional workers are “exempted” when they are the only workers forced to use Obamacare plans. On the other hand, one could argue that when members of Congress and their staffs became potential victims of Obamacare, they got a special rule issued to protect themselves from the consequences — which isn’t true for everybody else who has suffered under Obamacare.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email dailyonhealthcare@washingtonexaminer.com for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Obamacare’s next threat: Trump will make a decision on cost-sharing reduction subsidies this week, says Kellyanne Conway. When asked on “Fox News Sunday” if Trump plans on authorizing those payments, Conway said, “He’s going to make that decision this week and that’s a decision that only he can make.”

Mick Mulvaney to Senate: Don’t take up any issues before healthcare. The director of the Office of Management and Budget said Sunday it is official White House policy that nothing should be voted on in Congress before healthcare. “Yes. I think what you’re seeing there is the president simply reflecting the mood of the people,” Mick Mulvaney told CNN’s Jake Tapper when asked if it is official White House policy that “nothing” should be voted on before the Senate votes again on healthcare. “In the White House’s view they can’t move on in the Senate. In the people’s view, they should … stay and work and figure out a way to solve this problem,” Mulvaney said.

Poll: America ready to move on from healthcare reform. Despite Mulvaney’s thinking, most Americans are ready to move on from healthcare, a new poll found. The poll from Reuters/Ipsos found that 64 percent wanted to keep Obamacare either as is or after fixing problem areas. That figure is up from 54 percent in January. The poll was of more than 1,130 Americans and took place July 28-29, after the Senate voted 49-51 against a “skinny” repeal bill that would have killed big parts of Obamacare.

Tom Price: Trump threats aimed at getting healthcare ‘moved in the right direction.’ Trump doesn’t think letting Obamacare implode is the right thing to do, but he will continue to threaten to do so because he doesn’t think it is working for the American people, Price said Sunday. The health and human services secretary was shown a clip of Trump speaking at the Conservative Political Action Conference arguing that the best thing to do politically was let Obamacare implode, but it wasn’t the right thing to do. Price was asked if Trump still feels the same way after making multiple threats to let the system fall apart after Senate Republicans couldn’t pass a healthcare bill last week. “It’s not the right thing to do because it hurts people,” Price said. When asked why Trump threatens to let the system implode if he believes it will hurt people, Price said it “punctuates the concern he has about getting this moved in the right direction. He understands this system may be working for Washington, it may be working for insurance companies, but it’s not working for people and that’s where his passion is,” Price added.

Republicans reject Trump’s call to let Obamacare implode. Republicans in Congress are rejecting President Trump’s call to let Obamacare “implode” after the Senate failed to advance healthcare legislation. Senate Republicans said hours their failed vote that they should continue to work on healthcare reform, although they disagreed on a way forward and had no immediate plans to act. House Republicans, having passed legislation to partially repeal the Affordable Care Act in May said flatly that Trump’s off-again, on-again recommendation that he might deliberately let the law crash to put pressure on Congress to respond is unacceptable and wouldn’t be tolerated by their voters. “I don’t think that letting it fail is the best option, even though it certainly allows additional pressure to happen,” said Rep. Mark Meadows, R-N.C., who is chairman of the House Freedom Caucus and has close ties to the White House. “We can do better than that.” Rep. Mark Amodei, R-Nev., rebuked Trump more directly. “No,” he said when asked if he agreed with the president. “Clear-cut question — no.”

Sen. Susan Collins tells Senate Republicans to go back to the drawing board. “The ball is really in our court right now,” Collins, R-Maine, told CNN’s “State of the Union” Sunday morning, calling on senators to go back to the committees and create a series of healthcare bills. “We need to go back to committee, identify the problems [with Obamacare], carefully evaluate possible solutions through hearings, and then produce a series of bills to correct these problems,” Collins said. “Our job is not done.” The first issue Congress should address is the “impending collapse” of the insurance markets, she said. “I certainly hope the administration does not do anything in the meantime to hasten that collapse,” Collins added.

Rep. Ron DeSantis: Congress will kill Obamacare if Trump kills lawmakers’ subsidies. DeSantis, R-Fla., argued Monday that Trump should follow through on his weekend threat and cancel all subsidies that federal lawmakers get to buy insurance under Obamacare. He also said killing lawmakers’ subsidies might be the best way to kill Obamacare. “I think if he moves swiftly on it, I think you’d see a lot of these members and senators, they would want to work to repeal Obamacare very quickly,” DeSantis said on Fox News. Trump tweeted Saturday that if Congress can’t pass a healthcare bill, “bailouts for members of Congress will end very soon!” Lawmakers and their aides get a government subsidy under Obamacare in the form of an employer contribution. “I decline the subsidy,” DeSantis said. “It’s not right and I don’t take it because I don’t think it’s lawful. I think the president would be absolutely within his rights to cancel the Obama rule that conferred this subsidy on Congress,” he added.

Sen. Jeff Flake: ‘We’ve just seen the limits of what one party can do.’ The Arizona Republican said on CBS’ “Face The Nation” the failed attempt to pass a bill repealing and replacing Obamacare shows Republicans aren’t going to be able to accomplish their agenda alone. “I mean, there are big issues that we’ve got to solve. We’ve talked about North Korea, the difficult foreign policy things that we have to do. But debt and deficit, for example, healthcare reform, these are things that can’t be done by one party. We’ve just seen the limits of what one party can do,” Flake said. Healso said Republicans should resist the call from Trump to change the rules of the Senate to kill the legislative filibuster.

Schumer: Trump needs to ‘stop playing politics with people’s lives.’ Senate Minority Leader Chuck Schumer, D-N.Y., hit President Trump on his threat to withhold payments to insurers for lowering co-pays and deductibles for poor people. “If the president refuses to make the cost-sharing reduction payments, every expert agrees that premiums will go up and health care will be more expensive for millions of Americans,” Schumer said. “The president ought to stop playing politics with people’s lives and healthcare, start leading and finally begin acting presidential.” Trump said soon after the Senate narrowly defeated Obamacare that he wants to let the law’s marketplaces implode. He called the cost-sharing payments bailouts to insurers.

Bipartisan healthcare reform off to a rocky start. The early signs show that working with Democrats on new healthcare legislation won’t be any easier. After the GOP bill failed 49-51, Senate Majority Leader Mitch McConnell immediately explained what Republicans were not going to give up in any talks with the Democrats. “I can say, and pretty safe in saying for most of the people on this side of the aisle, that bailing out insurance companies with no thought of any kind of reform is not something I want to be part of,” he said. Bipartisanship is seen by many as the last, best chance for a healthcare reform bill in the Senate, but McConnell’s comment goes directly against what Democrats are hoping to get if the talks ever go anywhere.

So what do Democrats want exactly? Schumer laid out his goals for a bipartisan bill:

*Negotiate with GOP to revise reinsurance, which covers the sickest claims for insurers. This in turn can let insurers reduce premiums for everybody.

*A plan to provide health coverage to rural areas where no policies are sold.

*Make permanent the cost-sharing reduction payments that lower co-pays and deductibles for low-income Obamacare customers. President Trump has toyed with eliminating them, which could prompt insurers to raise premiums.

Republican leadership in the House and Senate have not said if they would agree to any of those requests. Schumer said at bare minimum this is what Congress needs to do initially.

“Then, we should sit down and trade ideas,” he said.

Ohio Gov. John Kasich: Failure of Senate GOP to pass a healthcare deal is a ‘good thing.’ The former Republican presidential candidate said Sunday the collapse of the Republican healthcare bill in the Senate was a “good thing,” but was adamant the debate was not over. “I’m happy to say I actually think it’s a good thing for this reason,” he said on “Fox News Sunday.” “I think Republicans looked over the cliff and I think they saw that there were going to be a lot of people who were going to be hurt, particularly people who don’t have much of a voice, who the machine and the system grinds down, and they pulled back.” Kasich said he understood there would be Senate hearings held into the health insurance exchanges, but warned that a bipartisan effort from rank-and-file members of Congress was required to pass comprehensive reform. “They have to work on it and this is where they should call the Democrats in and they should demand Democrat participation,” he said. “I don’t think we’re done with it yet. We can’t be done with it yet.”

Two retired politicians helped talk Sen. John McCain into opposing ‘skinny’ Obamacare repeal. McCain was one of three Republicans who helped shoot down the “skinny” repeal of Obamacare early Friday morning, and two retired Washington politicians reportedly helped talk him into the “no” vote. Former Vice President Joe Biden and former Sen. Joe Lieberman, I-Conn., both pressed McCain to oppose McConnell’s efforts, according to a Washington Post report. Biden’s discussion with McCain in particular was described as emotional as his son, Beau, died in 2015 from the same aggressive brain cancer that McCain recently was diagnosed with.

Sen. Bernie Sanders: ‘Of course’ I will introduce single-payer healthcare legislation. “Absolutely. Of course we are, we’re tweaking the final points of the bill and we’re figuring out how we can mount a national campaign to bring people together,” the Vermont independent said on CNN’s “State of the Union” Sunday. Sanders did say when he would introduce the legislation. The Senate is scheduled to be in session for two more weeks before its August recess.


The Hill GOP lawmaker: Senate needs to “get to work” on healthcare

Politico Lawsuits could force feds to pay Obamacare insurers

Axios Who emerged stronger after the Senate’s healthcare failure?

NPR “Social camouflage” may lead to underdiagnosis of autism in girls

Bloomberg Republicans face a tough choice: Repeal Obamacare or cut taxes

Associated Press Schumer wants FDA to investigate fast-food packaging

Washington Post House Republicans have spent 378 hours on votes to undercut Obamacare that went nowhere

CNN The future of healthcare is anyone’s guess



9 a.m. Humana second-quarter earnings call. Details.


8:30 a.m. Aetna second-quarter earnings call. Details.

FRIDAY | Aug. 4 

8 a.m. Cigna second-quarter earnings call. Details.

10 a.m. 215 Dirksen. Senate Finance Committee considers nomination of Matthew Bassett to be an assistant secretary of Health and Human Services. Details.

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