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2018年4月17日 星期二

Overnight Defense: Lawmakers worry over Syria strategy | Trump's base critical of strikes | Flake undecided on Pompeo | Coast Guard plans to keep allowing transgender members | GOP chair wants to cut $25B from Pentagon agencies

 
 
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THE TOPLINE: Defense Secretary James Mattis and Joint Chiefs of Staff Chairman Gen. Joseph Dunford were on Capitol Hill Tuesday for classified House and Senate briefings on last week's air strikes on Syria.

The pair, who spoke to lawmakers along with Director of National Intelligence Dan Coats, sought to answer questions on the current U.S. role in Syria and the legal authority for the strikes.

But lawmakers from both sides of the aisle expressed concern that the Trump administration has no clear outline for a larger U.S. strategy in Syria should Washington be drawn further into the warn-torn country.

 

The issue: President Trump and his defense officials have repeatedly stressed that defeating the Islamic State in Iraq and Syria within the war-torn nation remains the goal and focus of the administration.

But the United States, along with allies the United Kingdom and France, launched 105 missiles Friday night at three targets related to Syrian President Bashar Assad's chemical weapons program.

The strike was in response to a chemical attack launched by the Assad regime that killed at least 70 civilians in Duma, a suburb of the capitol Damascus, and was designed specifically to avoid further escalation that would drag the United States into the Syrian civil war, according to the administration.

Just days before the chemical attack, however, Trump was pushing his military advisors to withdraw from Syria, where U.S. troops are fighting ISIS, as soon as possible.

 

Lawmakers reaction: Sen. Lindsey Graham (R-S.C.), emerged from the classified session telling reporters "everything" in the briefing made him "more worried, not less." Graham had advocated for Trump to destroy Assad's air force or even target Assad himself.

Rather, he said, the briefing confirmed for him that Trump is intent on withdrawing from Syria as soon as possible and that "there is no military strategy on the table" to deal with the influence of Russia and Iran inside Syria.

 

Key quote: "It seems to me that the president is going to pull out of Syria as soon as he can, and I believe that ISIS can never be destroyed unless there is a credible holding force, and some Americans need to be part of that holding force or else we learn nothing from Iraq," Graham said. "If you leave without an adequate holding force, they come back."

 

TRUMP DRAWS CRITICISM FROM BASE ON SYRIA: President Trump has drawn criticism from some of his most vociferous conservative supporters over his decision to again intervene militarily in Syria, highlighting the pressure on the president to retain a non-interventionist, "fortress America"-style foreign policy.

Conservatives wary of U.S. involvement overseas who liked Trump's criticism of the Iraq and Afghanistan wars were deeply disappointed with his decision to launch missile strikes for a second time on Syria.

 

The big question: Is the public criticism indicative of a deeper schism?

 

POMPEO WATCH: CIA Director Mike Pompeo's nomination to lead the State Department is still on shaky grounds as of Tuesday.

Sen. Jeff Flake (R-Ariz.) said that he is undecided on Pompeo and that he is still waiting for some information from him.

 

Who has already said no: Sen. Chris Murphy (D-Conn.) said he will not vote for Pompeo, as has Sen. Tim Kaine (D-Va.), who announced his opposition Sunday.

In addition, Pompeo is facing opposition from Sen. Rand Paul (R-Ky.). 

 

Why it matters: Republicans hold a fragile 51-seat majority in the Senate. With Paul's opposition and Sen. John McCain (R-Ariz.) absent, they are already one vote shy of the 50 they need to let Vice President Pence break a tie.

If Flake, who supported Pompeo's nomination to be CIA director, ultimately votes against him, that would require that Pompeo pick up at least two Democratic votes in order to be confirmed.

 

TRANSGENDER BAN UPDATE: The head of the U.S. Coast Guard on Tuesday said it will continue allowing transgender members to serve in the military branch until a policy officially bans transgender troops.

Commandant Adm. Paul Zukunft told lawmakers that the Coast Guard is "certainly committed" to transgender individuals' continued service in the branch.

Zukunft said that of the United States Coast Guard's more than 40,000 active-duty members, there are 17 known individuals who have identified as transgender or have transitioned into another sex -- one happens to serve on Zukunft's personal staff.

"I work with the chairman. I work with the other service chiefs as we look at the policy going forward. We will make sure that there is one policy for all service members," he said, adding that the issue still needs to be "reconciled" between all military branches.

 

Ban still on hold: Trump declared on Twitter last July that the Pentagon would "not accept or allow" transgender people to serve "in any capacity," but the policy is still facing several legal challenges, including several court orders to halt the ban.

 

federal judge ruled late Friday that the injunctions put in place to halt Trump's ban should remain in place.

 

HOUSE CHAIRMAN WANTS DEFENSE CUTS: House Armed Services Committee Chairman Mac Thornberry (R-Texas) on Tuesday unveiled a new set of reforms aimed at slashing the Pentagon's defense agencies budget by more than $25 billion by 2021. 

A group, which includes 28 agencies, field activities and military media outlets not directly under military services, makes up at least $100 billion of defense spending per year, according to Thornberry.

The House bill would look to impose a mandatory 25 percent spending cut for that group and in the process eliminate seven of the agencies: the Defense Technical Information Center, Defense Test Resource Management Center, Office of Economic Adjustment, Defense Technology Security Administration, Defense Information Systems Agency, Defense Human Resources Activity and Washington Headquarters Services.

Should the 25 percent savings not be met by the January 2021 deadline, it would trigger an automatic 25 percent across-the-board cut.

 

Who is exempt: Thornberry noted that some combat support agencies are exempt from the cuts, and the Defense Health Agency, also in that group, would largely be untouched. 

 

ON TAP FOR TOMORROW:

The House Armed Services Committee will hold a hearing on "Oversight and Reform of the Department of Defense '4th Estate'" at 10 a.m. at the Rayburn House Office Building, room 2118. 

The House Foreign Affairs Committee will hold a hearing on U.S. policy toward a turbulent Middle East at 10 a.m. at Rayburn 2172. 

A House Foreign Affairs subcommittee will hold a hearing on "the Dayton Legacy and the Future of Bosnia and the Western Balkans," at 2 p.m. in Rayburn 2200. 

Another House Foreign Affairs subcommittee will hold a hearing on "Libya Fractured: The Struggle for Unity," at 2 p.m. in Rayburn 2172. 

A House Armed Services subcommittee will hold a hearing on the fiscal 2019 budget for energy, installations and environment at 2 p.m. at Rayburn 2212. 

A Senate Armed Services subpanel will hear from with Michael Griffin, Defense undersecretary for research and engineering, on accelerating new technologies to meet emerging threats at 2:30 p.m. at the Senate Russell Office Building, 232-A. 

A House Armed Services subcommittee will hold a hearing on the ground force modernization budget for 2019 at 3 p.m. at Rayburn 2118. 

A Senate Armed Service subpanel will hear from defense officials on Air Force modernization at 3:30 p.m. at Russell 222.  

 

ICYMI:

-- The Hill: North, South Korea may announce official end to Korean War: report

-- The Hill: Trump asking Arab nations to replace US military in Syria after defeat of ISIS: report

-- The Hill: Trump gives his 'blessing' to Korean peace talks

-- The Hill: Trump administration seeks to transfer unnamed enemy combatant within 72 hours

-- The Hill: Opinion: Having served with Gina Haspel, I know firsthand her integrity and honesty

-- Reuters: Arming the world: Inside Trump's 'Buy American' drive to expand weapons exports

 
 

Please send tips and comments to Rebecca Kheel, rkheel@thehill.com, and Ellen Mitchell, emitchell@thehill.com.

Follow us on Twitter: @thehill@Rebecca_H_K@EllenMitchell23

 
 
 
 
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Overnight Health Care: Rep. Debbie Dingell on the pain and tragedy of the opioids crisis | DEA moves to curb opioid oversupply | Dem says Trump pick opposes VA privatization

 
 
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Good evening, and welcome to Overnight Health Care. It's only Tuesday, but tomorrow is the last day of votes in the House for the week. We're jealous it's House lawmakers' Friday.

Keep reading for one Dem lawmaker's personal connection to the opioid crisis, details on a flurry of bills to deal with the epidemic and how President Trump's pick to lead the VA is making the Senate rounds.

 
 

The second of The Hill's Close to Home series on opioids, presented by Partnership for Safe Medicines, took a deep dive into Rep. Debbie Dingell's personal connection to the opioid epidemic.

The Michigan Democrat has seen what prescription painkillers can do. Both her father and sister misused opioids. Her sister died in 2005 from an overdose after cycling in and out of drug treatment centers. Sometimes, Dingell would call morgues when her family couldn't find Mary Grace, hoping she wasn't there.

But Dingell also knows that the drugs can help.

Her husband, 91-year-old John Dingell -- the longest-serving member in Congress's history -- needs opioids to ease his chronic pain.

Key quote: "I try to tell people how complicated [the opioid epidemic] is," she said.
"We've got to be balanced, we've got to not make people with legitimate needs feel criminalized. We've got to keep kids from starting to begin with," she said of the nation's challenges when it comes to opioids.

Perspective: As state lawmakers and the health industry work to clamp down on opioid abuse, they've begun placing controversial limits on the opioids doctors can prescribe. 

Dingell says lawmakers must enact policies that help stem the tide of the epidemic, while remaining mindful that some patients in pain need access to opioids.

Read more here.

 
 

In case you're having trouble keeping track of all the opioid bills introduced, we've got you covered. Here's your roundup of bills introduced today: 

  • Bernie Sanders is talking tough on opioid manufacturers. Sanders unveiled legislation targeting drug companies over their role in the opioid crisis. The bill bans companies from marketing opioids to consumers as nonaddictive, and fines them 25 percent of profits from opioid products if they are found in violation. It would also make top pharma executives criminally liable if their companies are found to be responsible for the opioid epidemic.
  • Senate Health Committee is moving its opioid bill through the legislative process. The panel's leaders formally introduced the bipartisan bill Tuesday after lawmakers reviewed a discussion draft during a legislative hearing last week. Next up: A mark up next week.
  • Three senators want to ensure recovery homes have more oversight and guidance. Sens. Tim Kaine (D-Va.), Orrin Hatch (R-Utah) and Elizabeth Warren (D-Mass.) introduced legislation authorizing the Substance Abuse and Mental Health Administration (SAMHSA) to develop best practices and provide assistance to states after some sober homes were found to have unscrupulous actors.

 

More opioid news:

Some communities, consisting of just thousands of people, have been flooded with millions of pills.

But a new proposed rule from the Drug Enforcement Administration aims to help reduce the oversupply of opioids in an effort to curb the number of painkillers sold illegally.

Specifically, the agency is proposing a rule that would change how it sets limits on the amount of opioids drug companies can make every year.

Key quote: "Under this proposed new rule, if DEA believes that a company's opioids are being diverted for misuse, then they will reduce the amount of opioids that company can make," Attorney General Jeff Sessions said Tuesday during remarks he gave on the opioid crisis in North Carolina.

Context: West Virginia Attorney General Patrick Morrisey (R) says the proposed rule is the result of a lawsuit he filed against the DEA seeking more transparency and input in the process the agency uses to determine how many opioids can be produced each year.

The lawsuit was placed on hold in March after Sessions asked the DEA to evaluate its policies on crafting production quotas for opioids.
Read more here.

 

Trump's VA pick says he doesn't support privatization efforts. But he hasn't told Trump that. Sen. Jon Tester (D-Mont.) the ranking Democrat on the Senate Veterans' Affairs Committee, said Ronny Jackson pledged during a one-on-one meeting that he is against privatization.

Jackson is making courtesy visits to Democratic and Republican senators this week in a goodwill tour ahead of his April 25 committee hearing.

 

Why the promise is important: Trump's decision to oust former VA Secretary David Shulkin late last month and replace him with Jackson stoked speculation that the White House wants to allow veterans more access to private-sector health-care providers. The VA has denied it, but Democrats don't trust the administration, and could gum up Jackson's confirmation process.

 

Context: Tester said he has other concerns, and noted Jackson has yet to tell President Trump that he opposes privatization. Jackson "said all the right things," but the vetting process is just getting started, Tester said.

Read the full story here.

 

First endorsement from a new drug pricing group

Patients for Affordable Drugs NOW, a new drug pricing group trying to counterbalance drug companies' campaign spending, made its first campaign endorsement on Tuesday, of Rep. David McKinley (R-W.Va.).

"McKinley earned the support of patients thanks to his leadership on legislation that would lower drug prices, his independence from Big Pharma, and his work to protect rural hospitals from paying more for prescriptions for low-income West Virginians," the group said in a press release.

 

Look for more endorsements: The group plans to endorse more lawmakers in both parties. It is spending six figures on McKinley and plans to spend seven figures overall.

Read more here.

 

Tuesday roundup:

  • 113 health organizations, in a letter to House and Senate leadership, argue the Trump administration should withdraw a proposed rule that would expand access to short-term health plans "until it adequately protects patients and consumers." Such plans would harm patients with serious, acute and chronic diseases and disabilities, they argue.
  • GOP New Hampshire Gov. Chris Sununu initially resisted a visit to his state from President Trump last month over the country's opioid addiction crisis, telling the White House that he didn't want his state used as a prop for the administration, according to a report from CBS. "The president cannot come to New Hampshire without a plan that has substance," Sununu reportedly told the White House. "You can't come here with an empty bag and use the state as a prop," a source added, paraphrasing the governor.
  • Health and Human Services Secretary Alex Azar is postponing a planned appearance before a Senate committee on Thursday as he recovers from an intestinal condition, an HHS official said Tuesday. The official said Azar, who was hospitalized overnight on Sunday before being released, has had his first bout of diverticulitis, an infection of pouches in the colon that can be painful.

 

What we're reading

Nursing homes routinely refuse people on addiction treatment (Stat)

Why deep-brain stimulation for depression didn't pass clinical trials (The Atlantic)

Congressional advisers urge Medicare payments to many stand-alone ERs be cut (Kaiser Health News)

 

State by state

California insurer faces whistleblower complaint over health law taxes (California Healthline)

Nebraska doesn't extend Medicaid benefits to elderly nuns (AP)

Pennsylvania House OKs work mandate for 'able-bodied' Medicaid recipients (AP)

 

From The Hill's Opinion page:

Baltimore City's real solution to the opioid epidemic

'Right to try' efforts have been timid and poorly conceived

 
 

Send tips and comments to Jessie Hellmann, jhellmann@thehill.com; Peter Sullivan, psullivan@thehill.com; Rachel Roubein, rroubein@thehill.com; and Nathaniel Weixel, nweixel@thehill.com.

Follow us on Twitter: @thehill@jessiehellmann@PeterSullivan4@rachel_roubein, and @NateWeixel.

 
 
 
 
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News Alert: Former first lady Barbara Bush dies at 92

 
 
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Former first lady Barbara Bush dies at 92
Former first lady Barbara Bush died Tuesday at the age of 92, a spokesperson announced in a statement.
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