Good morning ... Busy day. Let's just get into it.
My Axios colleague Caitlin Owens reported yesterday that things aren't going quite as smoothly as they appear within the Senate HELP Committee, as it tries to map out a plan to stabilize states' Affordable Care Act exchanges.
The problem: Disagreements over how broadly to alter the process by which states can waive some of the law's requirements.
Democrats' fear: Once you stop requiring states' alternative ideas to meet the same standards as the ACA, you've started pulling a thread that could unravel the many interconnected components of the ACA's consumer protections.
Yes, but: Alexander still sounded like he wanted to safeguard those popular provisions when Caitlin caught up with him yesterday evening:
The bottom line: Just changing the application process isn't much for Republicans to write home about. But the more any deal weakens those "guardrails," the more likely it is to implicate some of the law's most popular provisions and thus alienate Democrats. But failing to reach a deal leaves the ACA weak in certain places, which is also no good for Democrats, and isn't what Alexander wants, either.
Equifax doesn't just track consumers' credit (and then expose nearly half of all Americans to possible identity theft) — it also handles income verification for HealthCare.gov.
Per Bloomberg, the company has a contract worth $329 million over five years to verify the incomes of people signing up for ACA coverage. It's the only company with such a contract, Bloomberg reports, but federal officials said company officials have told them that HealthCare.gov information wasn't part of the massive hack that compromised millions of Social Security numbers and other personal information.
The rebuilding from Hurricanes Harvey and Irma will take years — and repairing those storms' damage to the health care system will be a major part of that effort. As Florida begins to take stock of Irma's damage and Texas enters the second week of its recovery, both states' health care systems are facing critical emergencies and are just beginning to grapple with longer-term challenges.
"Everything about the details of people getting health care in the usual way is going to be disrupted," said Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University.
Some key concerns, per Redlener:
Alexander has made it clear he's interested in adding a "copper," or catastrophic, plan option to the exchanges for people 30 and older.
So what exactly would this do?
Experts with differing ideologies generally agree that making this change wouldn't have major consequences. Best-case scenario, it would bring more young, healthy people into the marketplace. Worst-case scenario, it would siphon off some of the young, healthy people from more comprehensive plans, raising premiums for people still enrolled in them.
The Centers for Disease Control and Prevention is trying to crack down on its employees' conversations with the press, according to an internal email obtained by Axios. The message — sent by public affairs officer Jeffrey Lancashire and dated Aug. 31 — instructs all CDC employees not to speak to reporters, "even for a simple data-related question."
What it said:
Lancashire did not respond to requests for comment about the policy. But I'd love to know what harm was being done by CDC employees answering "the most basic of data requests." If you work at the CDC and have any insight, go ahead and communicate directly with me: firstname.lastname@example.org.
The health care plan from Sens. Bill Cassidy and Lindsey Graham is wildly unlikely to go anywhere as a substantive effort, but it's still proceeding apace as a political document — as something for Republicans to point to, and Democrats to attack.
My thought bubble: The Cassidy-Graham bill is very unlikely to ever become a health care law. It would have to have 51 votes, which is a stretch, and it would have to get there by Sept. 30, which is an even bigger stretch.
State Medicaid directors feel they dodged a bullet with the failure of congressional Republicans' plans to dramatically cut the program, but know more changes are on the horizon. That's the mood Axios' Bob Herman picked up yesterday at a conference run by Health Management Associates, which has become the de facto consulting shop for the Medicaid industry.
Bob has a full readout here, but here are a few quick takeaways:
Why it matters: Medicaid covers more than 74 million Americans, and though the political fight over the program often focuses on its coverage for poor people, it does a lot more. Medicaid also covers vulnerable populations including kids and adults with disabilities, frail seniors, the blind, and people who are home-bound.
"We have very sick people that we're taking care of and we need to spend money on," Cantwell said. "It's not a homogenous population."
What we're watching today: HELP Committee hearing on state flexibility at 10 a.m. (webcast here). Finance Committee hearing on "issues impacting cost and coverage," also at 10 a.m. (webcast here). Census Bureau releases new data on the number of uninsured Americans at, you guessed it, 10 a.m. Gonna be one of those mornings. Census webcast here.
Sen. Claire McCaskill and the other Democrats on the Senate Homeland Security and Governmental Affairs Committee hold a roundtable at 11 a.m. on their investigation of Insys Therapeutics and opioid manufacturers' marketing tactics.
What we're watching this week: Sen. Bernie Sanders introduces his single-payer bill on Wednesday. HELP Committee wraps up its stabilization hearings Thursday. Energy and Commerce hearing Thursday on health care workforce programs.
Are you a Democrat who might want to run for president? I'd love a heads-up before you co-sponsor Sanders' single-payer bill: email@example.com