Per the White House, the following conservatives, who all oppose the GOP repeal and replace health care plan, met with Trump this evening at the White House: David McIntosh of Club for Growth, Jim DeMint of Heritage, Tim Phillips of Americans for Prosperity, Adam Brandon of FreedomWorks, Mike Needham of Heritage Action, Jenny Beth Martin of Tea Party Patriots.
McIntosh said: "I'm encouraged that the president indicated they're pushing to make changes in the bill."
President Trump is meeting with conservative group leaders this afternoon, and Office of Management and Budget director Mick Mulvaney has invited Freedom Caucus members to go bowling next week. But the message from the conservatives is clear: It's going to take more than schmoozing to change their minds on the Obamacare replacement plan the House Republican leadership wants. They want big, substantive changes — enough to make it a fundamentally different bill.
The Energy and Commerce and Ways and Means markups of the Obamacare repeal and replacement are still going, pausing only for members to go vote on the House floor.
What you need to know: Nothing. Nothing of significance has happened. Most of the House Freedom Caucus – the members opposed to the bill who can block it on the floor – are not in either committee.
In Ways and Means, the last five-ish hours have been full of congressional theater, roll call votes and Democratic amendments trolling Republicans (ie the "Trump promise test" amendment saying the bill can't pass until CBO says every taxpayer and their dependents will have coverage under it).
In Energy and Commerce, Ranking Member Frank Pallone demanded staff read the entire bill. They finished after about an hour and moved on. As of 4 p.m., they hadn't even started amendments yet.
Financial analysts at the investment bank Robert W. Baird & Co. sent a strong message this week to Wall Street investors: Don't touch pharmacy benefit managers.
"We would not currently invest in PBMs, despite depressed valuation, strong cash flow and potential tax reform benefits that bulls reasonably cite." — Robert W. Baird analysts
Why the caution? In two words: drug prices. Drug companies, pharmacists and lawmakers have thrown pharmacy benefit managers into the spotlight, arguing the middlemen encourage the use of high-priced drugs to reap bigger profits. The industry — which is dominated by Express Scripts, CVS Health and UnitedHealth Group's OptumRx — argues it keeps insurance premiums at bay by negotiating discounts with drug makers and pharmacies.
A handful of other investment firms encourage buying pharmacy benefit managers' stocks. But Baird analysts said the "whirlwind of negative headlines," including a plethora of lawsuits from pharmacies (such as this one against Express Scripts) and criticism of controversial clawback payments, makes the industry way too risky right now.
Trump as LBJ? White House officials say President Trump is prepared to use a combination of hug and hammer to try to rescue Republicans' repeal-and-replace plan for Obamacare.
If you got dizzy from all of the Obamacare repeal news yesterday, here's the bottom line: Two House committees are about to take up the Republican repeal and replacement bills this morning with no path to the 218 votes needed to pass the House. That's because conservative Republicans are in full rebellion, even after President Trump's endorsement and an afternoon of sweet talking from their former colleague, Vice President Mike Pence.
The Kaiser Family Foundation quickly compiled data comparing the current Obamacare subsidy given to people on exchanges with the GOP refundable tax credit included in the repeal and replacement bill released Monday. It let us take this data and show how different people would fare compared to what assistance they receive now.
AsCongress continues to debate how it will repeal and replace the Affordable Care Act (if at all), Thumbtack, a marketplace for professional services from plumbing to piano lessons, surveyed 14,393 service providers about the ACA:
55% of service professionals want Congress to keep the ACA in place.
71% of professionals surveyed believe the U.S. government should help all Americans access affordable health insurance. Only 43.1% of self-identified Republicans feel this way, while 95% of Democrats do.
91% of Republican professionals on Thumbtack approve of President Trump's handling of healthcare policy, while just 5% of Democrats and 38% of independents do. Overall, 57.5% disapprove of Trump's record on healthcare thus far, while 42.5% approve.
One in four full-time Thumbtack professionals surveyed say health insurance was a factor in their decision to start a business.
Over half of professionals reported they can't afford to take time off from work for childbirth or adoption.
A strong majority of Republican and Democratic professionals think the federal government should try to lower drug prices.
ACA's provision that prevents insurance companies from denying patients with pre-existing conditions is the most popular: 82.3% want to keep it.
The conservative House Freedom Caucus met tonight to supposedly get everybody onboard with the Republican plan for Obamacare repeal and replace. If that was the goal, it didn't go according to plan. Here's Rep. Mo Brooks after the meeting:
Right now the Speaker of the House does not have the votes to pass this bill unless he's got substantial Democratic support.
What this means: It means what Mo says. House Speaker Paul Ryan has a Republican Obamacare bill that's not backed by enough Republicans to pass the House.
Members coming out of the meeting, which was attended by OMB Director Mick Mulvaney, said the administration had expressed a willingness to negotiate on the bill. However, committee markups start tomorrow morning.
Influential right-wing websites are beating the daylights out of the Obamacare replacement plan developed by the House Republican leadership and the Trump administration.
Why this matters: Trump, Ryan and co. were already going to have a hard time selling their plan to right flank of the House and Senate. The last thing they need is a conservative media war against them. You can bet that someone's going to walk into the President's office during the next 24 hours with a print out of the Breitbart stories. It'll be interesting to see whether he stays the course against the backlash.
Advocate Health Care and NorthShore University HealthSystem have canceled their planned merger after a federal judge ruled against it, Crain's Chicago Business reports.
The merger had been in the works for two-and-a-half years. The combined Advocate-NorthShore system would have had $7.5 billion in annual revenue and dominant hospital market share throughout Chicago and its suburbs.
Why this matters: The Federal Trade Commission ultimately won this battle, as it argued the merger would have given Advocate and NorthShore too much pricing power that would have caused health insurance premiums to skyrocket. Health economists have warned that hospital and physician mergers have monopolized local markets and driven up health care spending. The Trump administration's FTC may look more favorably on transactions, but it likely will continue to review provider deals closely. Tad Lipsky, the new director of the FTC's Bureau of Competition, said Tuesday the FTC was "delighted" by the court's ruling to strike down the Advocate-NorthShore deal.
The chairmen of the main House health care committees had a message for conservative Republicans today: Don't tank the Obamacare replacement bill. "We can act now, or we can keep fiddling around and squander this opportunity to repeal Obamacare," Ways and Means Committee chairman Kevin Brady said at a press conference about the replacement bills. Energy and Commerce Committee chairman Greg Walden added that the Medicaid rewrite in his bill — which would convert the program to per-person funding limits — would be "the biggest entitlement reform in the last 25 years."
Between the lines: They're trying to fight back conservatives' charges that the package is "Obamacare Lite." Some of the leading GOP critics, including Freedom Caucus Chairman Mark Meadows and Sen. Rand Paul, are having a press conference this afternoon to blast the bills, which are scheduled for markups in both House committees tomorrow.
The Republican Study Committee (RSC) outline the major concerns they have with the GOP's new healthcare bill in their latest policy memo. Their main worries?
Medicaid expansion: The RSC doubts that Congress will allow a freeze to Medicaid expansion in 2020, as the draft bill suggests, noting that the future reduction "is premised on a future Congress being willing" to let spending cuts go into effect.
Tax credit: "Writing checks to individuals to purchase insurance is, in principle, Obamacare," states RNC. Argues that the costs incurred from the new plan may increase the deficit at the same rate as Obamacare.
Well, you wanted to know what the Obamacare replacement plan was, right? The bills are out, and the House Energy and Commerce Committee and the Ways and Means Committee are going to "mark up" their pieces at the same time on Wednesday. Here's my speed-read writeup, or if you'd rather read the summaries yourself, you can take a look here and here.
Here are the main plot lines to watch in the coming days.
