POLITICO Pulse, presented by UnitedHealth Group: Anxious insurers to meet with CMS — Heller open to federal funds for Planned Parenthood — Wisconsin seeks Medicaid changes

By Adam Cancryn | 04/18/2017 10:00 AM EDT

Republicans are confronting worried constituents over Obamacare for the second straight week, a GOP senator's stance on Planned Parenthood funding raises eyebrows and yet another state wants to make big changes to its Medicaid program.

But first: Health insurers are headed to CMS today for a big meeting with the agency's new administrator, Seema Verma.

VERMA HOSTS ANXIOUS HEALTH INSURERS - The CMS chief is meeting today with a big group of insurance executives and trade organizations amid growing uncertainty over whether the Trump administration will pull $7 billion of critical cost-sharing funding out from under insurers on the Obamacare exchanges. The powwow is scheduled to touch on several topics across Medicare, Medicaid and the individual insurance markets. But the top priority is what the White House plans to do with Obamacare's cost-sharing subsidies.

Insurers are urging the administration to continue the payments, which are funneled through insurers to help pay for enrollees out-of-pocket costs. Top business and consumer groups are also hoping the funding will remain in place, warning that cutting it off would spark an exodus of insurers from the market. But President Donald Trump has toyed with pulling the money in a bid to force Democrats to negotiate over the broader plan to repeal and replacement of Obamacare.

The attendee list. Oscar Health Insurance - the startup co-founded by White House senior advisor Jared Kushner's brother Josh - is slated to be there. Big regional players like Molina Healthcare, Geisinger Health Plan and Florida Blue are also scheduled to attend, in addition to representatives from AHIP and the Blue Cross Blue Shield Association.

Notably absent: Aetna. The insurance giant - which has yet to commit to participating on the exchanges in 2018 - won't be there because the meeting was organized through BCBSA and AHIP, the trade group that Aetna broke from last year. But that's no big deal for Aetna - its CEO, Mark Bertolini, secured a one-on-one meeting with Verma a few weeks back, according to a source familiar with the sit-down.

TOWN HALL WHIPAROUND

Heller open to federal dollars for Planned Parenthood. Nevada Sen. Dean Heller told constituents at a town hall he has "no problems" with letting federal funds flow to Planned Parenthood, potentially complicating any GOP push to defund the women's health organization.

"I do not have a problem with Planned Parenthood as long as they provide the health care services that you need - for my children, for your children, for everybody," Heller said.

The swing-state lawmaker, one of the few Senate Republicans facing a tough re-election fight in 2018, later hedged his position, suggesting that Planned Parenthood should be funded for "some of the activities" that occur there. Still, Heller's stance is notable - his vote could stand in the way of Republican attempts to strip Planned Parenthood of its federal dollars, Pro's Jennifer Haberkorn reports. GOP Sens. Lisa Murkowski and Susan Collins are already publicly opposed to defunding the organization. More from Jen here.

Texas' Barton toes the line on Obamacare. Rep. Joe Barton waited for years to tear down Obamacare. But now that the Texas Republican finally has the chance to do it, he's hesitating, Pro's Renuka Rayasam reports. Like many of his House colleagues, Barton is stuck between keeping his long-held promise to repeal Obamacare and preserving the benefits that the health law has brought to his district. The uninsured rate in Texas' sixth district hit 13.9 percent in 2015, down from 20.8 percent the year Obamacare was enacted. Safety net clinics have served thousands more uninsured patients with the increased funding provided by the Affordable Care Act.

"We're very concerned - it takes money to keep the place open," said Hope Clinic CEO Barbara Clark. "Whatever [Barton's] decision on health care, there will be a lot more people here."

But Obamacare remains deeply unpopular in Texas. And Barton - who sits on the influential Energy and Commerce Committee - is trying to thread the needle by pushing for broader fixes to the law, rather than eliminating it altogether. More from Renu here.

Tax reform could include Obamacare rollback. Obamacare's taxes may not be safe even if the GOP's repeal efforts remain stalled, Rep. Adrian Smith (R-Neb.) told Pro's Brent Griffiths following a town hall. The senior Ways and Means member floated rolling back the health law's taxes as part of a broader tax reform package that the White House is hoping to pursue this year. Among the Obamacare taxes frequently on the chopping block are the excise tax on medical devices and the so-called Cadillac tax on price insurance plans. More from Brent here.

Good Tuesday morning and welcome to PULSE, where we always welcome our constituents' feedback. Send comments, questions and tips to acancryn@politico.com or @adamcancryn on Twitter.

With help from Victoria Colliver (@vcolliver)

** A message from UnitedHealth Group: On the front lines of health care, there are always new challenges and opportunities. At UnitedHealth Group, we're built for both. To all those with a passion to improve health care, our question is: How can we help? UnitedHealth Group. Built for Better Health. Learn more at www.unitedhealthgroup.com. **

WISCONSIN WANTS NEW MEDICAID RESTRICTIONS - Wisconsin Gov. Scott Walker will seek federal permission for new limits on the state's Medicaid program, including requiring certain beneficiaries to pay monthly premiums and instituting a drug testing program. The proposal would also prevent individuals aged 19 to 49 from collecting Medicaid benefits for more than four consecutive years, Pro's Rachana Pradhan reports.

Wisconsin is planning to submit waiver requests to HHS for the changes by the end of May, making it just the latest red state hoping to put eligibility restrictions on their respective Medicaid programs. More from Rachana here.

CALIFORNIA BILL LOOKS TO REGULATE PBMs - A bill that attempts to regulate the mysterious middlemen of medicine, or pharmacy benefit managers, goes before the Assembly Business and Professions Committee today. The bill's author, Assemblyman Jim Wood, said Assembly Bill 315 would allow for a "look under the hood" of these companies by requiring PBMs to disclose their business practices, including aggregate drug costs, rebates and administrative fees.

The bill on Monday picked up official endorsements from groups including Project Inform, the California Medical Association and the California Pharmacists Association. Other groups, including the California Life Sciences Association and the California Association of Health Plans, are opposed.

THERANOS AGREES TO TWO-YEAR LAB BAN - The embattled blood-testing firm is barred from owning or operating a clinical lab until 2019 as part of a new settlement with CMS over the company's failed inspections. Theranos will also pay $30,000 under the agreement, in exchange for CMS' agreement not to revoke the certification it needs to run blood-testing labs.

UNITEDHEALTH EARNINGS ON TAP - The health care company holds its quarterly earnings conference call this morning, where executives are likely to be pressed on their view of the health care landscape. UnitedHealth is only a bit player on Obamacare's exchanges, but it's one of the health insurance industry's largest companies and the first major insurer to report first-quarter earnings. Translation: Its opinions carry weight.

TWENTY-FIVE DOC GROUPS BACK MARCH FOR SCIENCE - More than two dozen medical groups are showing support for this coming weekend's March for Science, arguing that it's "critical that we protect federal investment in our health."

"Over the past several decades, research supported by the National Institutes of Health (NIH) has yielded significant advances across all field of medicine," the group wrote in a statement, heaping additional praise on the Agency for Healthcare Research and Quality and Centers for Disease Control and Prevention.

The groups emphasized that the support is a "nonpartisan call for appreciation" of science. But the Trump administration has called for slashing HHS' budget - including a $6 billion cut to NIH - as part of its 2018 budget blueprint.

Obama science adviser to speak at March for Science event. John Holdren, the White House science adviser under Barack Obama, is set to speak Friday as part of a March for Science-related event hosted by the American Association for the Advancement of Science. Holdren will focus on "the state of science and technology policy," the organization said.

WHAT WE'RE READING by Jennifer Haberkorn

President Trump is expected on Wednesday to sign a bill that would extend a temporary program that gives veterans access to private-sector health care, the AP reports.

An Ohio drug dealer who sold heroin that caused more than two dozen overdoses was sentenced to more than 18 years in prison, the AP reports.

Most Americans want a single-payer health system, Catherine Rampell writes in an opinion piece for The Washington Post.

White House staff held a meeting on Obamacare's cost-sharing program on Monday, Vox reports.

** A message from UnitedHealth Group: On the front lines of health care, there are always new challenges and opportunities. At UnitedHealth Group, we're built for both. We're helping employers with data and insights to improve health outcomes; ensuring seniors have stability and choice in their benefits; and working with governments to expand access to care, lower health care costs and improve quality. To all those with a passion to improve health care, our question is: How can we help? UnitedHealth Group. Built for Better Health. Learn more at www.unitedhealthgroup.com. **

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http://www.politico.com/tipsheets/politico-pulse/2017/04/anxious-insurers-to-meet-with-cms-219833

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