• Week Ahead: Senators Work Toward Deal to Fix Obamacare Markets The Hill by Jessie Hellmann — The Republican and Democratic heads of the Senate Health Committee are looking to cobble together a bipartisan Obamacare deal, after the GOP's latest failure to repeal the law. Chairman Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) are zeroing in on a deal aimed at stabilizing Obamacare's markets, which could come in days. Lobbyists have told The Hill the bill could potentially include two years of funding for Obamacare's insurer subsidies and an expansion of state waivers. It could also allow Obamacare enrollees to buy "copper plans," which are cheaper, less generous insurance plans that currently only people under age 30 can buy.
  
  

• The GOP Repeal Bill is Imploding. Here Are 5 Things Left Hanging on Obamacare Kaiser Health News by Julie Rovner — Here are five ongoing challenges the Affordable Care Act faces:

1.  Insurers still face tremendous uncertainty
2. The Trump administration has cut funding for efforts to sign people up for insurance. 
3. The 2018 enrollment period is half the length of 2017's, and now it will be shorter still.
4. The Trump administration is dragging its feet on giving states flexibility to stabilize their markets. 
5. Republicans could take another shot at a full overhaul next year — or even this year.

• Trump Laid Out 3 Potential Paths Forward After the Latest Republican Failure on Health Care Business Insider by Bob Bryan — The day after the latest Republican health care bill collapsed, President Donald Trump laid out a few potential paths forward on healthcare for the federal government. During a question-and-answer session with reporters on the lawn of the White House, Trump suggested a few things: that Republicans have enough votes to go it alone on repealing the Affordable Care Act; that he could work with Democrats to pass a bill by early 2018; and that he could issue executive orders within weeks to make unilateral changes to the system. Finally, Trump said he was considering signing an executive order that he said would allow people to purchase insurance across state lines.

• Price’s Exit Further Complicates GOP Health Care Push Associated Press by Jill Colvin and Ricardo Alonso-Zaldivar — The ouster of Tom Price as President Donald Trump’s health secretary is yet another self-inflicted blow for Republicans wishing to put their own stamp on health care — and the latest distraction for a White House struggling to advance its agenda after months of turmoil. Price resigned Friday amid investigations into his use of costly charter flights for official travel at taxpayer expense. His exit makes it even more unlikely that Republicans will be able to deliver on their promise to repeal and replace former President Barack Obama’s law, even though they control the White House and both chambers of Congress. “I think health care is a dead letter through the next election,” Joe Antos, a policy expert with the business-oriented American Enterprise Institute, said Saturday.
  
  
• Trump’s Next Move on Health Care? Choice for Secretary May Offer Clue New York Times by Peter Baker and Robert Pear — President Trump’s selection of a secretary of health and human services could be a turning point in a health care debate that has polarized Washington, as he faces a choice of working with Democrats to fix the current system or continuing his so-far failed efforts to dismantle his predecessor’s program. One adviser said on Saturday that Mr. Trump was serious about compromising with Democrats and would pick a secretary who would help make that happen….The White House had no comment on Saturday, but two advisers who asked not to be identified discussing internal matters said two top candidates were Scott Gottlieb, the commissioner of the Food and Drug Administration, and Seema Verma, the administrator of the Centers for Medicare and Medicaid Services.

• Time Is Running Out to Fund a Program That Insures 9 Million Kids Fortune by Simon Haeder — Little attention has been paid to a long-running bipartisan program providing insurance coverage to millions of American children: the Children's Health Insurance Program, often referred to simply as CHIP, which provides coverage to nine million American children. Since its creation by a bipartisan coalition under the Clinton administration, CHIP has been crucial for the health and well-being of millions of American children, their families, and their communities. Yet funding for CHIP is running out at the end of September, leaving both state governments and families with great uncertainty.
  
  
• House Panel to Consider Children's Health Measure The Hill by Nathaniel Weixel — Legislation to reauthorize CHIP will get a markup in the House Energy and Commerce Committee on Oct. 4, days after the program's funding expires. CHIP funding expires Saturday, along with funding for community health centers. The House aims to include both programs in its bill, but Senate Finance Committee Chairman Orrin Hatch (R-Utah) has said he wants CHIP to stand alone. Details of the House legislation have yet to be released, and the length of the extension or any potential offsets won't be known until early next week, a committee aide said.
  
  
• The Benefits of Early Childhood Education and Health Programs May Last Longer Than a Lifetime The Wall Street Journal by Ben Leubsdorf — New research suggests programs aimed at helping low-income U.S. children, such as Head Start early childhood education and Medicaid health coverage, may have benefits not only for participating children but for their children as well. A recent working paper found the 1980s expansion of Medicaid programs to cover more low-income pregnant women led, years later, to their children giving birth to healthier babies. Another working paper found childhood access to Head Start led to better long-term outcomes in the next generation, including higher high-school graduation rates and reduced criminal behavior. 

• Community Health Clinics Face Funding Cliff as Congress Fails to Act Tennessean by Holly Fletcher — Community health centers are girding to keep the fight for Congress to reauthorize funding going deeper into autumn as the funding cliff approaches — with no legislation teed up. Clinics, which serve the working poor, uninsured and homeless around the state, are set to lose 70 percent of 2018 funding if Congress doesn't pass legislation to help them. Funds are allocated on a rolling cycle starting January 1. For the cycle starting February 1, Congress would have to act by early December.

• Obamacare Rates Soar as White House Refuses to Make Long Term Commitment to Subsidies USA Today by Jayne O'Donnell — Insurance rates for those who buy health care coverage through the Affordable Care Act keep rising because of continued uncertainty about the Trump administration's plans for the law, officials and insurance experts say….The questions about what the administration will do about subsidies are the "main cause" of rate hikes, says Sara Collins, a vice president at the health policy foundation Commonwealth Fund.  Insurers have said somewhere between 15 percent and 40 percent of their rate increases were due to administration efforts to undermine the law, according to ACASignups.net.

• Senate GOP Abandons Latest Effort to Unwind the Affordable Care Act  Washington Post by Juliet Eilperin, Sean Sullivan and Amy Goldstein — Senate Republican leaders on Tuesday abandoned their latest campaign to dismantle the Affordable Care Act, conceding that their plan lacked key support. But they showed little interest in moving swiftly to shore up the seven-year-old law with the crucial funding it needs. The official collapse of the Cassidy-Graham health-care bill once again leaves the party short of fulfilling a signature promise, which some Republicans worried could inspire a backlash among their base heading into the 2018 midterm elections. And the failure of that alternative to the ACA, combined with the GOP's reluctance to fix weaknesses in the existing law, leaves states, insurers and millions of consumers who rely on its coverage with substantial uncertainty. Enrollment begins in barely a month for 2018 health plans in marketplaces created under the law.
  
  
• Inside the Life and Death of Graham-Cassidy Politico by Jennifer Haberkorn, Burgess Everett, and Seung Min Kim — At one point, the bill seemed to have a real chance of success. And then it ran into the same hurdles that killed every other GOP health plan. Ultimately, a number of Senate Republicans remain wary of transforming the U.S. health system in such a haphazard process — especially with plans to make deep cuts to Medicaid and roll back protections for people with pre-existing conditions. And yet the sudden spurt of momentum behind Graham-Cassidy, once considered a long shot, underscores how nervous Republicans are about facing voters in 2018 without fulfilling their top campaign promise or having much of a legislative record.

• Right After Trump Blamed High Drug Prices on Campaign Cash, Drugmakers Gave More Kaiser Health News by Sydney Lupkin and Elizabeth Lucas — "The cost of medicine in this country is outrageous," President Donald Trump said at a rally in Louisville, Ky., two months after his inauguration. He went on about how identical pills have vastly lower price tags in Europe. "You know why?" the president asked, before spreading his hands wide. "Campaign contributions, who knows. But somebody is getting very rich." It was March 20, 2017. The next day, drugmakers donated more money to political campaigns than they had on any other day in 2017 so far, according to a Kaiser Health News analysis of campaign spending in the first half of the year reported in Federal Election Commission filings. Eight pharmaceutical political action committees made 134 contributions, spread over 77 politicians, on March 21. They spent $279,400 in all, showering Republicans and Democrats in both legislative bodies with campaign cash, according to FEC filings.

• The High Price of Failing America’s Costliest Patients New York Times by Dhruv Khullar —It’s well known that the country’s staggering health care costs are not evenly distributed. Just 1 percent of patients account for 20 percent of costs, and 5 percent of the population accounts for nearly half the nation’s health care spending. But exactly who these patients are — and how we can better meet their needs — is less clear. "We can’t make the system work unless we do better with this population," said David Blumenthal, a health policy expert and president of the Commonwealth Fund. "It’s important from a humane standpoint — these are our friends, our family. But it’s also important from a cost standpoint, and the effect on taxpayers."
  
  
• Is Health Care a Right? The New Yorker by Atul Gawande — Is health care a right? The United States remains the only developed country in the world unable to come to agreement on an answer. Earlier this year, I was visiting Athens, Ohio, the town in the Appalachian foothills where I grew up. The battle over whether to repeal, replace, or repair the Affordable Care Act raged then, as it continues to rage now. So I began asking people whether they thought that health care was a right. The responses were always interesting....Two sets of values are in tension. We want to reward work, ingenuity, self-reliance. And we want to protect the weak and the vulnerable—not least because, over time, we all become the weak and vulnerable, unable to get by without the help of others. Finding the balance is not a matter of achieving policy perfection; whatever program we devise, some people will put in more and some will take out more. Progress ultimately depends on whether we can build and sustain the belief that collective action genuinely results in collective benefit. No policy will be possible otherwise.
  
  
• Whatever Happened to the National Emergency on Opioid Abuse? St. Louis Post-Dispatch — There are 29 active national emergencies in place today in the United States. The latest is the one that President Donald Trump declared on Aug. 10: "The opioid crisis is an emergency, and I am saying, officially, right now, it is an emergency. It's a national emergency. We're going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis. It is a serious problem the likes of which we have never had." In spite of Trump's penchant for hyperbole, this declaration was a wise decision and came in response to draft recommendations of a presidential commission Trump appointed last spring. Unfortunately, it's been six weeks since the emergency was declared, and the only step the administration has taken is to form a public-private partnership on the issue with some of the drug companies that have profited mightily from the addiction crisis.

Editor: Peter Van Vranken