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Good morning ... How's your Trumpcare hangover? Everyone I've talked to this weekend is still in disbelief that a seven-year repeal effort just fell apart. But we haven't seen the end of calls for Congress to do something, like take a vote, any vote. Meantime, watch how the Trump administration and Congress actually handle Obamacare from here.

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The new Obamacare agenda: From repeal to neglect?


Trumpcare may be dead, but that doesn't mean Obamacare is safe. The next thing to watch is whether the law actually does fall apart, not because of the design flaws, but because the Trump administration has no incentive to prevent a collapse.

When President Trump tweets that "Obamacare will explode," and House Speaker Paul Ryan says it can't be fixed, they're not sending signals that they're looking for success. The reality is that insurers will need incentives to stay in the market and not impose another round of rate hikes. Instead, we could get a meltdown followed by an endless round of finger-pointing: Trump and Ryan would blame the Democrats for a poorly designed law, and Democrats would blame them for rooting for failure.

You can read more about the decisions ahead via the New York Times' Margot Sanger-Katz and Politico's Dan Diamond, but here are the main ones:

  • Cost-sharing subsidies: The Trump administration and Congress have to decide whether to settle a GOP lawsuit over the subsidies, which help low-income Obamacare customers, and just pay them to insurers. The problem is, it's no longer clear whether Congress would be able to approve the money. It would need the Freedom Caucus for that too, and chairman Mark Meadows has said he could support the payments only as part of a plan to replace Obamacare.
  • Stabilization: Health and Human Services secretary Tom Price has told Republicans the department is considering another rule to stabilize the markets next month — but that was based on the assumption that Congress would pass a repeal and replacement plan. HHS hasn't said whether it will stick with its plans.
  • Outreach: Right after the Trump was sworn in, the administration dialed back all of the efforts to encourage people to sign up for 2017, and total enrollment dropped from last year. Now HHS will have to decide whether to promote the law in the next open enrollment, at the end of this year, or keep saying the law has failed.
  • Recruiting insurers: The administration has noted all of the insurers that dropped out of Obamacare in the last enrollment season, but it does have the power to try to recruit more into the marketplaces — if it wants to.

Why the incentives have changed: The Trump administration had wanted to keep insurers in the market to guarantee a smooth transition to a new system, but that incentive "will wane" now that there isn't going to be a new system, because "they're going to be viewed as improving the law that they hate," said Chris Condeluci, a former Senate Republican aide and a member of the Axios board of experts.

Peace talks? But White House chief of staff Reince Priebus did suggest on Fox News Sunday that Trump doesn't really want a collapse: "He wants to make sure that people don't get left behind. He wants to make sure that there's competition in the marketplace so that rates are lower and people can choose their doctor."

Americans for Prosperity: Time for a straight repeal vote

Republican leaders are already coming under pressure not to let Obamacare repeal drop. Americans for Prosperity, one of the most powerful outside conservative groups, says the House should allow a vote on a straight repeal bill — even if it fails. Why? Because even a failed vote is better than just walking away from the repeal effort that Republicans have been promising for seven years.

"Let every member be on the record where it really matters. Then you're keeping your promise that you made to the American people for four consecutive elections," AFP president Tim Phillips told me this weekend. The voters who called for Obamacare repeal, he said, won't have any patience with arguments over what can and can't be done through budget reconciliation: "That's exactly what people hate about Washington, D.C. They expect you to do what you said you would do."

Why it matters: AFP was one of the Koch brothers groups that opposed the GOP replacement bill, and set up a seven-figure fund to support House members who voted against it. But that doesn't mean it wanted the repeal effort to end — it just wanted to go back to the original idea of a clean repeal. "We respect Speaker Ryan," Phillips said. "This is just one issue where we disagree, not on the final goal, but on the execution."

What the moderate Democrats want

Priebus said Sunday that the Trump administration might reach out to moderate Democrats on health care — a self-described "warning shot" to the conservative Republicans that wouldn't work with them. But they'll find that those Democrats want narrower fixes than Republicans want. And they may not like the Democrats' conditions — because they'd have to drop all repeal talk.

Sen. Mark Warner, one of the purple-state Democrats most likely to get the call, might be willing to work with Republicans on some of the fixes he has already proposed, spokeswoman Rachel Cohen tells me — but only if Republicans promise not to undermine the law. The main fixes he'd support:

  • Add a new category of low-cost health plans for young adults, called "copper plans"
  • Make employer reporting requirements easier
  • Allow health insurance to be sold across state lines, but only with "appropriate protections"
Reality check: There's so much bad blood between Republicans and Democrats on Obamacare that it's hard to see them talking seriously any time soon. Plus, even moderate Democrats would have to be convinced why it's in their interests to bail Trump out. But if you want to know which Democrats would be most likely to talk under the right conditions, it's worth rereading this letter from January. It's by Sen. Tim Kaine, Warner's Virginia colleague (and the guy who could have been vice president).

What's next for health care

You mean there are other issues besides Obamacare? Here are the next things to watch:

  • The next big health care fight will be over defunding Planned Parenthood, an issue that's likely to bog down the government funding bill that has to be approved by April 28, Jonathan Swan reports.
  • House Energy and Commerce Committee chairman Greg Walden told reporters his committee will turn to the reauthorization of the Children's Health Insurance Program, which has to be done by the end of September, and policies to fight the opioid epidemic.
  • His committee is also working on reauthorizing the Food and Drug Administration user fee programs, as is the Senate HELP Committee. That also has to be done by the end of September.
  • Energy and Commerce is also likely to work on drug pricing legislation, including a bipartisan bill by Reps. Gus Bilirakis and Kurt Schrader to speed the approval of generic drugs.
  • The appropriations committees will have to start working on funding for federal health programs for next year. They've signaled that they have no interest in the 19 percent budget cut Trump proposed for the National Institutes of Health, but they'll have to find the money to avoid it.
  • House Ways and Means Committee chairman Kevin Brady said on Fox News' Sunday Morning Futures that he's moving on to tax reform. He made no mention of any piecemeal attempt to get rid of Obamacare's taxes — he said they'll stay in place.

If Trump is looking for a path forward ...

Bob Kocher, a partner at Venrock and a member of the Axios board of experts, gave us this smart piece about what Trump could do to stabilize Obamacare if he really wants to avoid a collapse. He should get Congress to pay for the cost-sharing subsidies, Kocher writes, and tell the IRS to enforce the individual mandate so insurers don't have to worry about not getting enough healthy customers. He also suggests making it easier for private web brokers to help sign people up.

Other views from our board of experts:

  • Stanford's Lanhee Chen expects the action to shift almost entirely to HHS, where Price can show a lot of flexibility on Medicaid, waivers to allow states to achieve the law's goals in different ways, and the "essential benefit" requirements.
  • Condeluci doesn't see a lot of incentives for the Trump administration to fix up the law. But he doesn't see a realistic path forward on repeal and replacement, either — Republicans are basically "stuck."
  • And don't expect Congress to make piecemeal improvements to help bring down premiums, like getting rid of the tax on health insurers. It would only have a tiny impact on costs, Condeluci said — and Republicans would ask themselves, "I voted for something to improve this law? Why would I want to do that?"

While you were weekending ...

  • Freedom Caucus chairman Mark Meadows on ABC's This Week, insisting he's not done with Obamacare repeal: "it's incumbent upon those two groups, the conservatives and the moderates to come together, hopefully in the coming days, to find consensus."
  • Sen. Tom Cotton on CBS's Face the Nation, suggesting Congress should revisit Obamacare when it's time to reauthorize CHIP: "It is very important to a lot of Democrats. By that point, I hope that we can reach some kind of consensus."
  • Ohio Gov. John Kasich on CNN's State of the Union: "If Republicans quietly over time will reach out to Democrats, find the constructive ones, you will begin to marginalize the extremes."
  • In a USA Today op-ed, former Centers for Medicare and Medicaid Services chief Andy Slavitt says Trump and Congress can take some relatively simple steps to stabilize the Obamacare markets.

What we're watching this week: House Energy and Commerce health subcommittee hearing on the FDA's medical device user fee program, Tuesday; House Appropriations Committee hearing on the HHS budget, featuring testimony from Price, Wednesday.

Thanks, and let me know what other non-Obamacare news we should be covering:


Trump admin bans CDC from using certain words like "fetus"

Outside the CDC headquarters in Washington, D.C. Photo: Photo by James Leynse / Corbis via Getty Images

Policy analysts at the Centers for Disease Control and Prevention were told by the Trump administration on Thursday that they are not allowed to use the words like "science-based," "evidence-based" and "transgender," in their budget documents, according to a CDC analyst who spoke to The Washington Post.

Why it matters: The administration wants to control what it considers controversial wording from agencies as they submit documents for the president's budget for 2019, expected to be released in February. However, the analyst told the WashPost they "could not recall a previous time when words were banned from budget documents" due to ideology.

The details, per The Washington Post:

  • The list of banned words: vulnerable, entitlement, diversity, transgender, fetus, evidence-based and science-based.
  • The meeting about the banned words was led by Alison Kelly, a senior leader in the agency’s Office of Financial Services, who told the CDC officials she was just the messenger.
  • The CDC has offices that directly work with public health issues that relate to those words, such as its research on fetus development for the Zika virus and preventing HIV among transgender people.

Other CDC officials confirmed the existence of a list of forbidden words, the article said, although spokespeople from CDC or OMB did not comment by their deadline.


White House, Democrats settle lawsuit over ACA payments

The action could signal an end to a long-running conflict. Photo: AP file

The Trump administration, House Republicans and Democratic attorneys general have settled a lawsuit over the Affordable Care Act's cost-sharing reduction payments to insurers, Bloomberg reports. The court filing doesn't give any details of the settlement, per Bloomberg, except to say that it's "conditional."

What to watch: It's hard to know the true significance of the settlement when zero details are available. But for California Attorney General Xavier Becerra, one of the Democratic attorneys general involved in the lawsuit, it represents a chance to move forward and try to preserve the subsidies on their merits.

That's because the settlement only applies to a lower court decision stopping the payments until Congress funds them, according to a spokesperson for the California Department of Justice.

From a spokesperson for House Speaker Paul Ryan: "We are gratified that as a follow-up to the executive branch’s acknowledgement that making Obamacare payments to insurers without a congressional appropriation was unlawful, the parties have now agreed to resolve this lawsuit while leaving in place the district court’s legal rulings vindicating the House’s constitutional powers."

This story has been updated with statements from the California Department of Justice and House Speaker Paul Ryan.


Federal judge blocks Trump from changing contraception rules

A month's supply of hormonal birth control pills. Photo: Rich Pedroncelli / AP

The Trump administration's decision to roll back access to birth control under the Affordable Care Act has been blocked temporarily by a federal judge in Pennsylvania, Buzzfeed reports. The new rules went into effect in October and allowed employers and universities to decline providing birth control coverage for "religious or moral" reasons.

Why it matters: The ruling is one of several recent court orders blocking a Trump administration law. Trump's series of travel bans as well as his order preventing transgender troops from serving in the military have also been halted in court.

U.S. District Judge Wendy Beetlestone agreed to grant Pennsylvania Attorney General Josh Shapiro's motion for a preliminary injunction, ruling that the Trump administration’s decision could potentially result in “enormous and irreversible” harm to the women of Pennsylvania. The injunction is applicable to all 50 states.

What's next: The block will remain in place until all arguments in the case are heard, which means the ACA requirement that all employers pay for contraception will stay in effect in the interim.

The Pennsylvania ruling joins a handful of similar lawsuits, including one in California, filed against the Trump administration's contraception rules.


Battery exec leaves Dyson two years after $90 million buyout

Michigan entrepreneur Ann Marie Sastry has left vacuum-maker Dyson, two years after it acquired her controverial lithium-ion battery company, Axios has learned. The $90 million all-cash buyout remains one of the richest lithium-ion deals ever.

Quick take: Sources with knowledge of the situation were not certain of the circumstances of Sastry's departure. But it comes eight months after Dyson relinquished Sakti3's core battery patents, and doubts remain in the field regarding her main claim, asserted repeatedly — that she was on the verge of commercializing much-sought-after solid state battery technology.

Why it matters: For the last two years, Dyson founder James Dyson has spoken of ambitious plans to spend $1 billion to $3 billion to revolutionize batteries and electric cars. He has said said his electric car will ready for the road by 2020. At the time, Dyson's October 2015 purchase of Sakti3 was the spearpoint of the mission, and Sastry's departure suggests more internal turmoil than he has let on.

  • Sastry's Linkedin page says she left Dyson last month. She identifies herself as the founder and CEO of a company called Amesite, which a source said is involved with artificial intelligence and education.

In September, Dyson told Bloomberg that he had created two competing battery teams—Sakti3, plus another that was attempting a different approach to solid state. One explanation for Sastry's departure was that the other team won. In an interview with the Guardian, Dyson said the company's batteries were already more efficient than those in commercial electric vehicles.

At the time of the October 2015 deal and since, numerous leading U.S. battery researchers told me they wondered why Dyson had bought Sakti3. Despite Sastry's robust claims of the company's progress with solid state, she had revealed very little publicly and, since no one else had made much progress, the deep suspicion was that she was exaggerating. Indeed, in reporting for a story at the time of the buyout, former Sakti3 executives told me that the doubters were correct—the company's technology was rudimentary and nowhere near commercial.

Dyson said Sastry is no longer with the company but declined to comment further. Sastry could not be reached.

Dan Primack contributed to this story.


Bob Corker flips to "yes" on tax reform

Sen. Bob Corker (R-Tenn.), the only holdout on the Senate's initial tax bill, announced Friday that he will vote "yes" on the GOP's tax cuts bill, less than an hour after Sen. Marco Rubio (R-Fla.) said he will also vote yes.

Why it matters: Corker's vote essentially cements the tax bill's passage before the Christmas deadline.

His statement:

"After many conversations over the past several days with individuals from both sides of the aisle across Tennessee and around the country — including business owners, farmers, chambers of commerce and economic development leaders — I have decided to support the tax reform package we will vote on next week.

"This bill is far from perfect, and left to my own accord, we would have reached bipartisan consensus on legislation that avoided any chance of adding to the deficit and far less would have been done on the individual side with items that do not generate economic growth.

"But after great though and consideration, I believe that this once-in-a-generation opportunity to make U.S. businesses domestically more productive and internationally more competitive is one we should not miss. While many project that it is very possible over the next ten years we could be at least $500 billion short on a $43 trillion policy baseline, I believe this bill accompanied with the significant regulatory changes that are underway, and hopefully, future pro-growth oriented policies relative to trade and immigration , could have significant positive impact on the well-being of Americans and help drive additional foreign direct investment in Tennessee.

"In the end, after 11 years in the Senate, I know every bill we consider is imperfect and the questions becomes is our country better off with or without this piece of legislation. I think we are better off with it. I realize this is a bet on our country's enterprising spirit, and that is a bet I am willing to make."


Release of texts between FBI officials to media was unauthorized

Deputy Attorney General Rod Rosenstein. Photo: Andrew Harnik / AP

The Department of Justice said that some members of the media received early copies of the texts between FBI officials Peter Strzok and Lisa Page, and that the release was not authorized by the department, Business Insider reports.

Why it matters: The texts are part of an ongoing investigation; they were shared with lawmakers on Tuesday night, prior to Deputy Attorney General Rod Rosenstein's testimony to the House Judiciary Committee, and were shared with reporters afterwards. But DOJ spokeswoman Sarah Isgur Flores said some reporters had already received them.


Rubio officially yes on tax bill

Sen. Marco Rubio Photo: Pablo Martinez Monsivais / AP

Sen. Marco Rubio's office has confirmed to reporters that the senator will be voting for the GOP tax cuts bill now that the child tax credit has been enhanced to meet his standards.

Why it matters: This thing looks ready to pass.


Report: FCC to fine Sinclair $13 million over undisclosed ads

AP Photo/Steve Ruark, File

The FCC plans to fine Sinclair Broadcasting Corporation milions of dollars over undisclosed cancer ads that aired during newscasts over a six-month period in 2016, Reuters reports.

The news comes one day after reports surfaced that the DOJ wants Sinclair to divest roughly 12 local broadcast stations in order for its $3.9 million merger with Tribune Media Company to be approved. It also comes as FCC Chairman Ajit Pai is being attacked for what is seen as a close relationship with Sinclair.

The fine addresses roughly 1,700 commercials that aired for the Huntsman Cancer Institute. According to the report, Sinclair has previously told reporters that the violations were unintentional.

Reuters reports that the fine was approved by the five-member FCC but has not yet been made public. Sinclair's management has always been right-leaning and conservative-leaning Pai has been accused by progressives as being favorable to the broadcaster.


White House says Western Wall will stay in Israel

Pence and Israeli Prime Minister Benjamin Netanyahu at a 2014 meeting in Israel. Photo: Amos Ben Gershom / GPO via Getty Images

A senior White House official told reporters today that the Trump administration believes the Western Wall in East Jerusalem will remain part of Israel in any future peace agreement with the Palestinians. The issue came up during a briefing to reporters on Vice President Mike Pence's upcoming visit to Israel.

Why it matters: The statement risks further infuriating the Palestinians at a time when the administration is trying to cool down the crisis created by President Trump's Jerusalem speech. The Western wall was occupied by Israel during the Six-Day War in 1967 and was never recognized as part of Israel by any country around the world.

Context: During previous negotiations between Israel and the Palestinians, the U.S. supported the Israeli position that the Western Wall should stay part of Israel, but it was never articulated publicly.

What to watch: The official said Pence will visit the Western Wall during his trip to Israel, and he will do it as the vice president and not as a private citizen. "We cannot envision any situation under which the Western Wall would not [be] part of Israel," the official said. "But as the president said, the specific boundaries of sovereignty of Israel are going to be part of the final status agreement."

The bottom line: After the briefing ended, the White House official noted that the U.S. "cannot imagine Israel would sign a peace agreement that didn’t include the Western Wall."

What's next: In the meantime, White House special envoy Jason Greenblatt will arrive in Israel early next week. It is unclear whether Greenblatt is going to meet any Palestinian officials. Palestinian Authority president Mahmoud Abbas announced he does not see the U.S. as an honest broker and said the Palestinians will not meet with Pence during his visit.

While in Israel, Greenblatt will meet Fernando Gentilini, European Union envoy for Middle East peace. The 28 leaders of EU member states announced yesterday they see Jerusalem as the shared capital of both Israel and Palestine — pushing back against Trump's announcement that the U.S. recognizes it as the capital of Israel.

The White House official added that given the timing, Greenblatt will stay on for Pence’s visit to provide any relevant support.


Facebook admits that some social media use can be harmful

The Facebook logo is displayed on an iPad. Photo: Matt Rourke / AP

In a new installment of its "Hard Questions" series, Facebook acknowledges that social media can have negative (or positive) effects on people, depending on how they use it.

Why it matters: This might be the first public acknowledgment from the company that its product — and category in general — can have detrimental effects on people.

Facebook is also addressing the topic shortly after two former executives publicly criticized the company for what they described as exploiting human psychology.

Good and bad use, according to research cited by Facebook:

  • Bad: Passive use of social media — reading information without interacting with others — makes people feel worse. Clicking on more links or "liking" more posts than the average user also leads to worse mental health, according to one study.
  • Good: Active use — interacting with people, sharing messages, posts, comments, and reminiscing about past interactions — is linked to improved well-being.
  • It takes two: Interacting with other users is key, according to research. Simply posting on Facebook without interacting with other people isn't enough.

But: This isn't a capitulation from Facebook, admitting that it may be doing some harm. Instead, the company is simply telling us that we just need to use its social network in more positive ways.