| ObamaCare expected to suffer enrollment decline as Trump cuts timeframe Fewer people are expected to sign up for ObamaCare coverage ahead of Friday's deadline to enroll in the exchanges. The Trump administration's abbreviated enrollment period has left advocates acknowledging the numbers are almost surely going to be lower than the 9.2 million who signed up on HealthCare.gov at the end of the last open enrollment season. It's not clear how much the numbers will drop. ObamaCare supporters have said the sign-ups so far have been higher than they anticipated in the face of what they view as the White House's efforts to sabotage the health-care law. "Unfortunately, the Trump administration has cut [open] enrollment in half, as well as cutting the advertising and outreach budget, and so we are concerned that we won't be at the same point as we were last year by any stretch," said Cheryl Fish-Parcham, access initiatives director at Families USA, a liberal consumer health advocacy group. Nearly 4.7 million people have signed up for coverage on HealthCare.gov this year as of Dec. 9, compared to the about 4 million who signed up at a similar point last enrollment season. But there are only a few more days to add to that total, and little if any chance that the Trump administration will extend the enrollment period. Read more here. Lawmakers battle Trump, Pharma on discount drug rule Lawmakers in both parties are seeking to block the Trump administration's changes to a Medicare drug discount program, arguing it would have a negative impact on hospitals that serve low-income people. A rule from the Centers for Medicare and Medicaid Services (CMS) slated to go into effect on Jan. 1 would result in $1.6 billion in cuts to "safety net" hospitals that serve a significant number of low-income patients under the so-called 340B drug discount program. Now lawmakers are seeking to block the change in a must-pass spending bill, possibly with a one-year moratorium on instituting the rule. Read more here. Alabama result deals heavy blow to ObamaCare repeal The surprise election of a Democrat in Alabama has dealt a major blow to Republican hopes of reviving ObamaCare repeal next year. Republicans already failed multiple times this year to pass an ObamaCare replacement through the Senate with a 52-48 majority. Next year, thanks to the election of Democrat Doug Jones in Alabama, their margin for error will be even slimmer, at 51-49. Several Republican lawmakers acknowledged on Wednesday that the chances of bringing back ObamaCare repeal had taken a major hit. "Well, certainly, I think if you have one less Republican it makes it tougher," said Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, though he noted that perhaps the greater problem is a handful of Republicans already in Congress who opposed the effort. "I'm still hoping. I don't know that I'm optimistic it will get done, but I certainly am hoping, yes," Meadows said of trying again. Read more here. Ryan: We need to 'revisit' ObamaCare Speaker Paul Ryan (R-Wis.) said Thursday that lawmakers need to "revisit" ObamaCare, but also pointed to welfare reform as the focus of next year. "ObamaCare is collapsing and failing, so we won't be able to ignore that problem," Ryan said at a news conference. "So we're going to have to revisit the problem of a health-care marketplace that is collapsing and that is something that we're just going to have to get on to." However, Ryan did not make clear whether ObamaCare repeal would be part of next year's fast-track process known as reconciliation to get a measure through the Senate without needing Democratic votes. Read more here. Senator presses DOJ on opioid campaign criticized for 'scare tactics' Sen. Ed Markey (D-Mass.) is raising concerns about a campaign in his home state aimed at combating the opioid epidemic and questioning the Department of Justice's role in it. In a letter to Attorney General Jeff Sessions sent Thursday, Markey asked what the department's role was in "designing, funding or supporting" the campaign in Massachusetts. Recently, the U.S. Attorney's Office in Boston -- along with the New England field division of the Drug Enforcement Administration -- launched a statewide opioid abuse prevention campaign called #ReducetheRisk that Markey said received criticism from the public health and medical community. "They expressed concern that the advertising campaign utilizes scare tactics that have proven ineffective in changing behaviors or preventing young people from beginning to use drugs," Markey wrote. Read more here. Health groups call on states to override Trump ObamaCare order Health-care groups are urging states to override changes made under an executive order from President Trump, warning the moves threaten to undermine insurance markets. A coalition of leading health-care groups, including America's Health Insurance Plans and the American Cancer Society Cancer Action Network, wrote a letter Thursday to state insurance commissioners urging them to take action to counteract an order signed by Trump in October. That order aimed to ease ObamaCare rules and opened up cheaper insurance plans that do not have to meet all of the ObamaCare requirements. The groups warn that healthy people could be siphoned away into these skimpier, cheaper plans, causing instability and rising premiums in the market for everyone else. Read more here. What we're reading Kellyanne Conway leading an 'opioids cabinet,' as she assumes more active policy role (Stat News) Telemedicine for addiction treatment? Picture remains fuzzy (Side Effects Public Media) Those that shall not be named: Cost sharing reductions (Roll Call) State by state Nursery and delivery rooms at D.C.'s public hospital will not reopen (The Washington Post) With no deal on children's health plan, U.S. states scramble for Plan B (Reuters) If California wants to go all in on universal health care, Vermont's former governor is here to help (Sacramento Bee) Rauner's big health care headache in 2018? Medicaid. (Crain's Chicago Business) From The Hill's opinion pages For real results, the next HHS secretary must boldly shift to value-based health care | 
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