| Happy Thursday, and welcome to Overnight Health Care. It's almost congressional spring break. The House rushed through a vote on the omnibus early Thursday afternoon and left town for the rest of the month. Now, senators are ... waiting on Rand Paul, who is not too pleased with the 2200 plus page bill. Omni update: - The House passed its bill 256-167.
- The Senate hasn't scheduled votes yet. ¯\_(ツ)_/¯
- McConnell filed cloture on the bill Thursday evening, but needs the consent of every senator, including Paul to speed up the vote.
- "Well here it is, all 2,232 budget-busting pages. The House already started votes on it. The Senate is expected to soon. No one has read it. Congress is broken," Paul tweeted earlier Thursday.
- Paul has been tweeting as he reads the bill. After 4:30 p.m., he tweeted that he was on "Page 281 of 'crumni-bus."
- Melanie Zanona breaks down the winners and losers in the bill.
Also mad about the omnibus: Things got heated on the Senate floor Thursday when Sen. Lamar Alexander (R-Tenn.), chairman of the Senate's health committee, railed against Democrats for refusing to support his ObamaCare stabilization plan, which never made it into the omnibus. While it started off as a bipartisan endeavor between Alexander and Sen. Patty Murray (D-Wash.), Democrats said they couldn't support it after Republicans added in Hyde language, a long-standing amendment applied to other health programs that restricts the use of federal funding for abortions. Alexander accused Democrats of coming up with "excuse after excuse" for not supporting the bill, noting that the spending bill Democrats support and will soon vote on already applies Hyde to other programs, like Medicaid and Title X family planning dollars. "Every single Democrat today who votes for the omnibus bill will be voting to apply the Hyde language to at least 100 other programs," he said. "Democrats are blocking a 40 percent rate decrease for one single reason. The president of the United States supports it, the Speaker supports it, the Majority Leader supports it, we're ready to put it in the bill, and they say no." Murray argues that applying Hyde to the ObamaCare stabilization bill would further restrict access to abortion. "From the start, I have said I will not allow women's reproductive freedoms to be a political football," Murray said on the floor. Murray took to Twitter to defend her position, and said she thought a deal could still be reached.
We are not far from an agreement, I still think we can get there, and I hope Republicans and Democrats will join me in supporting the amendment I am offering today--and that even if they don't, I hope we can get back to the table and resume talks. -- Senator Patty Murray (@PattyMurray) March 22, 2018 Sen. Susan Collins (R-Maine), who helped Alexander make the changes to the stabilization bill, said Majority Leader Mitch McConnell (R-Ky.) has "kept his commitment completely" to support the ObamaCare fixes she championed. Collins pushed back on criticism she has received from Democrats that she should not have voted for the tax-reform bill in December in hopes of later passing her measure aimed at lowering ObamaCare premiums. "Senator McConnell has been completely supportive, has offered me a roll call vote if I want one, and if Lamar wants one, and he has kept his commitment completely on this," Collins said, referring to Sen. Lamar Alexander (R-Tenn.) McConnell also added himself as a cosponsor to the bill Thursday afternoon. Read more here. Senate Majority Whip John Cornyn also promised Thursday the Senate would vote on the bill. Read more here.
The $1.3 trillion package, posted around 8 p.m. Wednesday night, does include a range of other health measures... What the omnibus doesn't include: new money for gun research. The legislation contains a clarification that the Centers for Disease Control and Prevention is not barred from conducting gun violence research under the 1996 Dickey amendment. But top appropriators in the House and Senate on Thursday said they were not interested in funding new federal research into the causes of gun violence. Sen. Roy Blunt (R-Mo.) and Rep. Tom Cole (R-Okla.) said in separate interviews they don't see the need to give federal research agencies like the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) additional money meant to study the causes of gun violence. Both Blunt and Cole suggested that federal agencies should decide for themselves if they want to do any research into gun violence, and that money appropriated specifically for that task is unnecessary. Centers for Medicaid & Medicare Services Administrator Seema Verma talked to reporters, and made some ObamaCare news. Verma told a roundtable of reporters on Thursday that the administration will try to help prevent "bare counties," with no ObamaCare insurers offering coverage for 2019. She said the Trump administration would not sit back and blame ObamaCare. "We kind of have a motto at CMS and that is putting people first and putting patients first and so this happened last year and there was a lot of scrambling for insurance commissioners," Verma said. "I made calls to insurance commissioners and I said let me know what I can do to help." "So that is the attitude [we are taking]," she added. Meanwhile, the House passed the "right to try" bill on experimental drugs largely along party lines late last night. The bill passed handedly in a 267-149 vote. It was the second time the measure had come up for a vote on the floor, but this time, a simple majority vote was needed. Thirty-five Democrats voted for the bill, and two Republicans opposed it. The measure heads back to the Senate, where a version of the bill passed in August by unanimous consent. Sen. Ron Johnson (R-Wis.), who has championed the bill in the Senate, urged his chamber to quickly pass the measure. "Right to try needs to become the law of the land. It passed the Senate unanimously last summer, and I'm disappointed the House didn't pass that bill and send it to the president for his signature," Johnson said in a statement. "Nonetheless, I plan to ask my colleagues to pass right to try again immediately. Terminally ill patients and their families have waited long enough." Read more here. On the opioid front... The House Energy and Commerce Health Subcommittee wrapped up two days of back-to-back hearings on prevention and public health bills. And several Republican lawmakers are pushing for tougher sentencing for traffickers of a powerful synthetic opioid called fentanyl (it's up to 50 times more potent than heroin). Fentanyl is "as much a weapon of mass destruction as it is a drug," Sen. Tom Cotton (R-Ark.) said at a Thursday press conference, holding up a nearly empty salt shaker and explaining how that amount -- less than 40 grams -- of fentanyl could kill thousands of people. Federal mandatory minimums for fentanyl kick in after trafficking 40 grams or more. So Cotton, along with five other GOP senators, introduced a bill Thursday that would reduce the amount of fentanyl required for mandatory minimum sentences to apply. The effort, senators said, is aimed at taking into account the synthetic drug's potency -- which is up to 50 times more powerful than heroin. Read more here. Also, Cory Booker and Jeff Flake had a snowball fight today: It wasn't exactly Hamilton-Burr, or even Trump-Biden, but it was a monumental battle. @CoryBooker's drop & roll maneuver was legit. pic.twitter.com/kKWwYf239B -- Jeff Flake (@JeffFlake) March 22, 2018 And guess why Flake won? Just guess. (OK, we'll tell you) Reporter: Senator Booker, how did you lose a snowball fight to someone from Arizona?
Booker: "Because his name is Flake." -- Jordain Carney (@jordainc) March 22, 2018 What we're reading Omissions on death certificates lead to undercounting of opioid overdoses (Side Effects Public Media) Civil rights chief at HHS defends the right to refuse care on religious grounds (NPR)
Health care firms turn to drugmaker executives as businesses converge (The Wall Street Journal) State by state Idaho's House rejects another health care proposal (Associated Press) Centene hasn't fixed ObamaCare plan doctor shortage, Washington state says (Bloomberg) Tennessee intends to raid welfare funding to enforce Medicaid work requirement (Nashville Public Radio) Governor renews calls for Medicaid expansion in Virginia (Associated Press) | 
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