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Trump adviser Larry Kudlow: 'We'll continue to go after Obamacare.' President Trump's economic adviser Larry Kudlow, speaking to conservatives at a private dinner on Wednesday night, said the administration had no plans to touch large entitlement programs, but would address deficits by going after Obamacare, adding work requirements to smaller entitlement programs, and spurring economic growth. “We have no plans to tackle the large entitlement programs," Kudlow said in response to my question. He said, however, “We’ll continue to go after Obamacare. We’re making great gains. Both regulatory reforms and we’ll come back for legislative reforms.” Though he later acknowledged that if Democrats took over the House, it would be difficult to get much accomplished legislatively. He also said, “President Trump is really pushing hard for ‘workfare’ regarding the smaller entitlements -- food stamps, whatever welfare’s called now, Social Security disability -- there’s a whole bunch of them," he said. In addition, he argued that economic growth would also help narrow the fiscal gap by boosting revenues.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Mitch McConnell defends Trump administration's anti-Obamacare lawsuit. Senate Majority Leader Mitch McConnell said in new remarks Thursday that he backs the Trump administration's decision to join a lawsuit that would undo Obamacare's protections for the sick.

"It’s no secret that we preferred to start over," the Kentucky Republican said about Obamacare, which included new protections for people with pre-existing health conditions. "So no, I don’t fault the administration for trying to give us an opportunity to do this differently and to go in a different direction." McConnell made his remarks in an interview with Bloomberg Tuesday that was published Thursday. The suit could result in all of Obamacare being thrown out, or just its protections banning health insurers from turning away sick people or charging them more. GOP efforts to overhaul Obamacare failed in 2017 after the party fell short by one vote in the Senate.

"Nothing wrong with going to court. Americans do it all the time; we can do it too," McConnell said.

McConnell says Republicans will try to repeal Obamacare if they keep majority. McConnell also said Wednesday that Republicans would try again to repeal Obamacare if they win enough seats on Election Day. “If we had the votes to completely start over, we’d do it," he said in an interview with Reuters. "But that depends on what happens in a couple weeks... We’re not satisfied with the way Obamacare is working.” The comment was the second time in recent days that McConnell, R-Ky., has made such a promise. McConnell told Reuters that failing at the repeal was “the one disappointment of this Congress from a Republican point of view.” On Tuesday, McConnell told The Weekly Standard that he would like to give Obamacare repeal another shot. "That’s the one place we came up short, and I’d like to finish the job,” he said. Senate Minority Leader Chuck Schumer seized on the remarks in a statement, warning that Republicans would "take away" healthcare. “Americans should make no mistake about it: if Republicans retain the Senate they will do everything they can to take away families’ health care and raise their costs, whether it be eliminating protections for pre-existing conditions, repealing the health care law, or cutting Medicare and Medicaid," he said. "Americans should take Senator McConnell at his word.”

But there are caveats a plenty with McConnell’s statement. Republicans have repeatedly said that they want to try again on Obamacare repeal ever since the collapse of a last-ditch effort to revive repeal last September. But it has always been a question if Republicans will have the votes to do so. Three Republican senators joined all Senate Democrats last year to take down a narrow repeal bill. Plus if Democrats take the House then the issue of bringing up Obamacare repeal is likely punted to 2021. Plus if the Republicans keep the House and get a few more seats in the Senate what would Obamacare repeal look like? Would the leadership go back to the proposal from GOP Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana that converted Obamacare funding into block grants? Cassidy said after support for the bill collapsed in September 2017 that he hoped he had more time to convince lawmakers of the idea of block grants.

HHS touts reduction in regulations after Trump orders Cabinet to cut agency budgets by 5 percent. President Trump on Wednesday asked his Cabinet to find a way to cut their agencies by 5 percent, and signaled he wants a leaner, trimmer government after a two-year spending deal that saw defense and domestic spending rise. "I'm going to ask everybody to come back with a 5 percent for our next meeting," Trump said in a White House meeting with his Cabinet members. "I think you'll all be able to do it." Trump's order comes amid growing worry among conservatives about rising federal spending. He said he "made deals with the devil" before signing a $1.3 trillion spending package in March that boosted both domestic and military spending, but said he was now determined to reduce spending. Ahead of Trump's request, the White House Office of Management and Budget circulated an estimate that said Trump administration regulation cuts have saved "American families and businesses" an estimated $23 billion, though the OMB did not offer related savings to the government. A statement issued by Health and Human Services Secretary Alex Azar suggested healthcare costs could be reduced through regulatory relief, shortly following the OMB report and comments from Trump. Azar said the OMB report showed his agency was delivering on the president’s promise to “reform regulations to unleash our economy while enhancing and protecting the health and well-being of the American people.” “HHS was the No. 1 cabinet agency in terms of regulatory accomplishments for Fiscal Year 2018, reducing the burden of its regulations in present-value terms by $12.5 billion,” he said. The agency said its regulatory actions would create a $5.2 billion reduction in spending from 2018 to 2021 at the Centers for Medicare and Medicaid Services.

Democrats warn voters: The GOP is coming for your Social Security, healthcare. Democrats warned Wednesday that McConnell's comments about how Medicare, Medicaid, and Social Security were large contributors to the deficit mean Republicans would be targeting those programs to fund their tax cuts, and said they would hammer away at that message before Election Day. "All of our candidates will be letting voters know of their plan to cut Social Security and Medicare," said Sen. Chris Van Hollen, D-Md. In an interview with Bloomberg TV on Tuesday, McConnell did not say that Republicans would cut the programs. But he did cite “bipartisan reluctance” to reform federal entitlement programs for the rising federal deficit, which the Treasury Department said Monday reached $779 billion in 2018. “Hopefully at some point here, we’ll get serious about this," McConnell said. "We haven’t been yet.” Democrats seized on his comments to say that the programs would be under attack by Republicans. Sen. John Yarmuth, D-Ky., the top Democrat on the Budget Committee, accused McConnell of "calling for dramatic cuts" to the programs to give tax breaks to the "richest Americans and American corporations." Sen. Ben Cardin, D-Md., said McConnell's comments showed Democratic predictions that Republicans would next turn to cutting the programs were accurate, and said seniors and vulnerable families would be targeted. "Now the numbers are in and the deficit has grown by leaps and bounds," he said.

Healthcare remains top voter issue ahead of midterm elections. Healthcare is still the top issue for voters less than a month before the 2018 midterm elections but also thoughts on President Trump are major factors, according to a national poll.  The poll released Thursday from Kaiser Family Foundation said that healthcare was the top issue with 71 percent calling it “very important.” The poll also found that voters in Florida and Nevada favor candidates that seek to protect coverage for people with pre-existing conditions.

FLOTUS visits hospital for launch of program on neonatal abstinence syndrome. First lady Melania Trump visited Thomas Jefferson University Hospital on Wednesday as the administration plans more actions to help babies that have neonatal abstinence syndrome. The convening, with HHS Secretary Azar, was designed to help with the launch of a new initiative to measure the long-term health outcomes and needs of infants suffering from NAS. The bill to combat opioids that Trump is expected to sign soon will provide better insight into the condition, which results after babies are exposed to opioids in the womb. In remarks at the event, Azar called it “one of the most acute threats to vulnerable children today.” Health experts have said they need better information on treatment for babies. They say standards for screening and working with pregnant women are key, and that they need more data about which parts of the country have been particularly hard hit. Certain hospitals have protocols for care; others do not. “There is still so much room to expand our understanding of NAS,” Azar said at the event. “It is one of the most tragic consequences of the opioid epidemic, it is heartbreakingly common, and it is not well-enough understood.”

Trump: Jon Tester treated Ronny Jackson 'worse than the Democrat Mob' treated Kavanaugh. Trump on Wednesday rehashed grievances with Sen. Jon Tester, D-Mont., over how he torpedoed Trump's first choice for secretary of the Department of Veterans Affairs. "Ever since his vicious and totally false statements about Admiral Ron Jackson, the highly respected White House Doctor for Obama, Bush & me, Senator John [sic] Tester looks to be in big trouble in the Great State of Montana! He behaved worse than the Democrat Mob did with Justice K!" Trump tweeted, referring to the protests against Supreme Court Justice Brett Kavanaugh's nomination. Former White House physician Rear Adm. Ronny Jackson withdrew his candidacy as Veterans Affairs secretary following unsubstantiated reports of him being drunk on the job, over-prescribing pain medication, and creating a hostile work environment. Tester, the top Democrat on the Senate Veterans Affairs' Committee, shared some of the allegations with members of the media. Tester is among the vulnerable Democratic senators up for re-election in states Trump won handily in 2016. The lawmaker, who is vying for his third term in office, is 3 percentage points ahead of Republican opponent Matt Rosendale, according to RealClearPolitics' poll aggregator.

Democratic senators seek answers from CDC on mysterious illness. Democratic Sens. Patty Murray and Maria Cantwell, both from Washington state, are seeking answers on how the Centers for Disease Control are going to combat a spread of a rare illness that is paralyzing children. Officials believe the illness has infected 127 people across 22 states, and 62 are confirmed to have the illness called acute flaccid myelitis. The senators asked the CDC in a letter on Wednesday what research is in progress or planned at the agency on how to treat AFM and what efforts it is doing to address the rising number of cases that have sprouted up.

Ebola will not yet be declared an international emergency. The World Health Organization will not be declaring the Ebola outbreak in the Democratic Republic of the Congo a public health emergency of international concern, officials announced after a committee meeting Wednesday. It added that it remained “deeply concerned” about the outbreak and said that it must ramp up its medical response. WHO use the emergency declaration during the 2014 Ebola outbreak, and has used it three other times since its definition was set in 2007. These included the swine flu outbreak in 2009, polio in 2014, and Zika in 2016. The number of deaths in the Congo, in war-torn a part of the country, has climbed to 139.

Scorecard on antibiotics. Shake Shack and BurgerFi, which don’t routinely use antibiotics in beef, were the only restaurants to earn an “A” on the fourth annual “Chain Reaction” scorecard from six major consumer and environmental organizations. Twenty two out of 25 burger chains got an “F” grade, including McDonald’s. Wendy’s received a “D-” grade because it buys 15 percent of its beef from producers that reduced one type of antibiotic. Public health experts have warned that the improper use of antibiotics is leading to bacterial resistance and creating life-threatening superbugs. U.S. PIRG Education Fund, Center for Food Safety, Consumer Reports, Food Animal Concerns Trust, Friends of the Earth and Natural Resources Defense Council created the scorecard.


The Hill Michigan woman says pharmacist refused to fill her miscarriage medication due to religious beliefs

Axios Illinois is unaffordable, even with insurance

Kaiser Health News Children’s hospitals again cry for help from voters, but are they really hurting?

Associated Press GOP on defense to explain pre-existing conditions

CNBC Medicaid expansion and the fate of Obamacare at the heart of heated Georgia gubernatorial race

NPR Private Medicaid plans receive billions of tax dollars with little oversight

Wall Street Journal Study questions hospitals’ use of accrediting watchdogs

Time The Heathcare 50: 50 people who are transforming healthcare


THURSDAY | Oct. 18

House and Senate in recess until after the Nov. 6 midterm elections.

Oct. 14-18. America’s Health Insurance Plans conference on Medicare, Medicaid, and dual eligibles. Agenda.

3 p.m. 1775 Massachusetts Ave. NW. Brookings conversation with Centers for Medicare and Medicaid Services Administrator Seema Verma. Details.

FRIDAY | Oct. 19

Noon. G-50 Dirksen. Alliance for Health Policy event on “Flexibility and Innovation in Medicaid.” Details.


White House to host event commemorating “a year of historic action to combat the opioid crisis.”