Good morning ... And welcome to Day 3 of the government shutdown.
Congress is still deadlocked. Photo: Drew Angerer/Getty Images
The Senate is scheduled to vote at noon on a bill to reopen the federal government and, yes, fund the Children's Health Insurance Program.
Yes, but: As of the moment we're hitting "send" on this email, there is no actual deal yet — just a plan to vote, while talks continue.
The bottom line, via The Washington Post:
In the health care world, this means CHIP remains in limbo and, barring a breakthrough later today, half of the Health and Human Services Department's workforce will be told to stop doing their jobs.
Whenever Congress actually passes a bill to reopen the government, it will likely delay some of the Affordable Care Act's taxes. This is chipping away the revenues that were supposed to help pay for the law's coverage expansion, my colleague Caitlin Owens notes, but most of the law's major revenue-raisers are still intact.
What's been delayed: These have been frozen or delayed before, and would have been frozen or delayed again in the bill that passed the House last week:
Major revenue sources still in place:
Sound smart: The most significant delay from a budget perspective, especially over the long term, is of the Cadillac tax.
It’s not the dosage that increases a patient’s risk of getting hooked on opioids. It’s the length of the prescription, according to a study published last week in the BMJ journal (h/t Becker’s Hospital Review). It found that a single refill of an opioid prescription increase the risk of misuse by 44% — far higher than any links to the dosage patients were given.
Why it matters: Doctors still don’t have a lot of guidance on how their prescribing habits might contribute to the opioid epidemic, per the BMJ. This should at least give them a hint.
A board member at the University of North Carolina is questioning the legality of the merger between the school’s hospital system, UNC Health Care, and Carolinas HealthCare System because executives held clandestine talks before informing the board, according to the Charlotte News & Observer.
Key quote: "The Manhattan Project wasn’t as well-kept a secret as this was,” UNC board member Tom Fetzer told the newspaper.
Context: Fetzer is a registered lobbyist for Blue Cross and Blue Shield of North Carolina, the largest insurer in the state — which could get squeezed in payment negotiations if the merger is cleared. He also represents WakeMed, a hospital system that competes with UNC.
Get smart: Axios’ Bob Herman covered this large deal when it was announced in August. He says the systems face even bigger questions than secretive talks — namely, whether the deal will pass federal antitrust muster, and how the systems will prove that their merger would lower consumers’ costs.
Speaking of Bob, and lobbyists, he was sifting through federal lobbying documents last week and noticed that several health care companies with large pending acquisitions have hired lobbying firms to bulk up their influence.
Between the lines: All three of these clients hired lobbying firms with significant ties to people who look at mergers and antitrust matters. They’re pushing hard to get their deals across the finish line.
What we're watching this week: The shutdown drama.
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