Good morning ... How can Republicans get momentum back for their health care agenda? It's awfully hard to do it after an embarrassment that big, but keep an eye on those secret talks President Trump keeps talking about. If not, there's going to be more conservatives pushing for a new bill — maybe one that Democrats won't reject out of hand.
It's not just the Obamacare repeal that's stalled with Trumpcare — it's also all of the market-based reforms Republican wonks have been working on for years. So naturally, Republicans don't want to see all of that work go to waste, but there's a divide over what the next steps should be.
Bottom line: The "fix the bill" camp probably has the advantage right now, as long as quiet conversations about the House bill continue. But if they don't bring the House bill back to life soon — like by the end of this week — the "start over" camp may gain the upper hand.
There have been a lot of recent signals that some quiet Trumpcare negotiations are still going on, but what do they really add up to? My best read, from talking to GOP sources over the weekend:
Bottom line: This is the part of the zombie movie where the townsfolk reassure the kids that everything's fine, but they also start moving everyone to the basement just in case.
Did not realize you could use the words "Obamacare" and "profit" in the same sentence. But then, Bob Herman filed this story about Florida Blue, the state's dominant health insurer, raking in lots of profits — $1.1 billion in gross profits (before taxes and other expenses) from its Obamacare plans. And remember, that's in a state with a Republican governor (Rick Scott) who hates Obamacare and isn't trying to promote enrollment in any way.
It's another reminder that while some insurers really have been doing badly — and pulling out of lots of Obamacare markets — others have been doing just fine, especially if they priced their health plans wisely at the beginning. Read Bob's story here.
We heard a lot of GOP demands for Medicaid work requirements during the Trumpcare debate, and we'll keep hearing about them now that Centers for Medicare and Medicaid Services chief Seema Verma is encouraging them. But how many people on Medicaid are actually sitting around not working? Not a lot, according to Kaiser Family Foundation president and CEO Drew Altman. His latest column gives us a valuable fact check on that debate.
Sure, there's a big group of people on Medicaid (a little more than four out of 10) who don't work. There just aren't a lot of them who would be considered "able bodied," so people who support the requirements might be disappointed at the results, even if they think it's a good idea in principle.
What does it mean when top Republicans — like Rep. Tom Cole — say they're open to giving insurers the Obamacare cost-sharing reduction payments they need, but they don't want to reopen negotiations on the next federal funding bill to do it? It means they want to handle the money differently.
Caitlin Owens reports that GOP appropriators want it to be classified as "mandatory funding" — the term that's usually used for entitlement spending, the kind that just happens on its own and Congress doesn't have to budget for it every year. That's Washington-speak for, "We don't want it to come out of the pots of money we've already negotiated." It also means someone else has to make the decision to add the money — like GOP leaders.
Tick-tock, people: If they want to do it, they'd better do it soon, before the federal government runs out of money on April 28.
What we're watching today: Centers for Medicare and Medicaid Services expected to release final Medicare Advantage payment rates and policies.
What we're watching this week: Senate HELP Committee hearing on Food and Drug Administration user fee agreements, Tuesday; House Energy and Commerce oversight subcommittee hearing on health care cybersecurity, Tuesday; Senate HELP Committee confirmation hearing for FDA nominee Scott Gottlieb, Wednesday; House Appropriations Labor/HHS subcommittee hearing on the opioid crisis, Wednesday.
Thanks for reading, and let me know what's the most Trumpcare-like zombie movie you've seen: firstname.lastname@example.org.