"State insurance commissioners have warned that abrupt cancellation of cost-sharing subsidies would cause premiums, copays and deductibles to increase and more insurance companies to leave the markets, Congress now should pass balanced, bipartisan, limited legislation in September that will fund cost-sharing payments for 2018."

 — Sen. Lamar Alexander (R-TN)

• Report: Higher Premiums If Trump Halts 'Obamacare' Subsidies Associated Press by Ricardo Alonso-Zaldivar —  Premiums for a popular type of individual health care plan would rise sharply, and more people would be left with no insurance options if President Donald Trump makes good on his threat to stop "Obamacare" payments to insurers, the Congressional Budget Office says. The nonpartisan number crunchers also estimated that cutting off payments that now reduce copays and deductibles for people of modest incomes would add $194 billion to federal deficits over a decade. That head-scratching outcome is because a different Affordable Care Act subsidy would automatically increase as premiums jump, more than wiping out any savings.
  
  
• Trump Administration, Facing Pressure, Agrees to Continue Obamacare Subsidy for Now Los Angeles Times by David Lauter — The decision to make this month's payment, which was due next week, signaled that the administration has decided against immediately precipitating a collapse, potentially giving Congress time to pass a bipartisan package of fixes to some of the law's problems. Leading Republican members of Congress have pressed the administration to keep making the payments, fearing that any move to cut them off would cause chaos in insurance markets. Trump has said voters would blame Democrats for any problems with the markets, but few Republican elected officials share that view.

• White House to Pressure McConnell on Obamacare The Hill by Alexander Bolton —  White House officials are exploring ways to pressure Senate Majority Leader Mitch McConnell (R-Ky.) to return to the controversial issue of Obamacare repeal when the Senate returns to work in September. President Trump, who has repeatedly criticized McConnell in public, wants to hold the leader's feet to the fire on the issue, say White House sources. "I have not heard a single voice in the White House say give up on health care. Everyone keeps saying 'let's keep trying and let's keep pushing,' " said one White House source. "We're definitely not ready to move on and feel members should keep looking for a way to pass the bill. It would be one thing if it had fallen 30 votes short but they were just one vote shy of passing a bill in the Senate," the source added.
  
  
• One More Try? Why Obamacare Repeal Is on the Horizon Again The Fiscal Times by Rob Garver — The effort to repeal and replace the Affordable Care Act, which many assumed was dead or at least in a state of suspended animation for the foreseeable future, may be showing some stirring of life after all. After the Senate's attempt to pass a bill that few members of the body wanted to become law failed by a single vote in July, top leaders in the chamber have been signaling that it is time to move on to tax reform and other priorities. However, given the way the Congress is currently divided, with Republicans holding both houses but boasting only a 52–48 majority in the Senate, the opportunities for the GOP to pass controversial legislation that can't garner any Democratic support are limited. Because the Democrats have enough seats in the Senate to filibuster most legislation, Republicans face a choice between trying to pass bills that have bipartisan support or cramming their most important priorities into budget reconciliation bills -- legislation that, for all intents and purposes, is available only once a year.
  
  
• At Senator Menendez's Trial, Stakes Are High for Democrats New York Times by Shane Goldmacher —  When Senator Robert Menendez of New Jersey goes on trial on federal corruption charges in less than three weeks, far more than his own fate hinges on the outcome. If Mr. Menendez, a Democrat, is convicted and then expelled from the United States Senate by early January, his replacement would be picked by Gov. Chris Christie, the Republican governor of New Jersey and an ally of President Trump. That scenario — where Mr. Menendez's interim replacement would more than likely be a Republican — would have immediate and far-reaching implications: The Republicans would be gifted a crucial extra vote just as the party remains a single vote shy in the Senate of advancing its bill to dismantle President Obama's signature health care law. Those potential consequences only heighten the drama around the first federal bribery charges leveled against a sitting senator in a generation.

• Trump Administration Could Zap Obamacare Enrollment by Dropping Outreach Deals CNBC by Dan Mangan — The Trump administration refused Monday to commit to partnering with outside groups to promote enrollment in Obamacare health plans, potentially reversing four years of those cooperative efforts. The administration's stance, coupled with its similar refusal to commit to key Obamacare subsidies to insurers through next year, could result in fewer people signing up for health coverage in the individual insurance plans for 2018 after open enrollment starts in November. And if those subsidies, known as cost-sharing reduction payments, are ended, insurers could end up charging individual plan customers much higher premiums next year.
  
  
• Trump Administration Extends Deadline for Insurers to Decide on Obamacare Markets NPR by Alison Kodjak —  The Trump administration is giving insurance companies an extra three weeks to decide whether to offer insurance plans through the Affordable Care Act markets, and how much to charge. The extension comes as insurance companies wait for President Trump to decide whether he will continue to make payments to insurance companies that are called for under the Affordable Care Act but that some Republicans have opposed. The U.S. Department of Health and Human Services says it is offering the extra time so insurance companies can plan ahead in case the government decides to end the payments. In a memo Friday, the agency said many states are now requiring companies to file their rates for 2018 on the assumption that they won't be reimbursed.

• Climbing Cost of Decades-Old Drugs Threatens to Break Medicaid Bank Kaiser Health News by Sydney Lupkin — Skyrocketing price tags for new drugs to treat rare diseases have stoked outrage nationwide. But hundreds of old, commonly used drugs cost the Medicaid program billions of extra dollars in 2016 vs. 2015, a Kaiser Health News data analysis shows. Eighty of the drugs — some generic and some still carrying brand names — proved more than two decades old. Rising costs for 313 brand-name drugs lifted Medicaid's spending by as much as $3.2 billion in 2016, the analysis shows. Nine of these brand-name drugs have been on the market since before 1970. In addition, the data reveal that Medicaid outlays for 67 generics and other non-branded drugs cost taxpayers an extra $258 million last year.
  
  
• Express Scripts to Limit Opioids; Doctors Concerned Associated Press by Jim Salter — The nation's largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans. But the new program from Express Scripts is drawing criticism from the American Medical Association, the largest association of physicians and medical students in the U.S., which believes treatment plans should be left to doctors and their patients. About 12.5 million Americans misused prescription opioids in 2015, according to the U.S. Department of Health and Human Services. More than 33,000 deaths that year were blamed on opioid overdoses.
  
  
• Trump Tweets Up a Storm on Drug Prices but Delivers Little Change Politico by Sarah Karlin-Smith — President Donald Trump's condemnation on Twitter Monday of Merck CEO Kenneth Frazier for what he called "RIPOFF DRUG PRICES" was just his latest rebuke of the drug industry for its soaring prices. But six months into his administration, the president's rhetoric bears little resemblance to his record. But the White House has invested little political capital in the issue, appointing industry insiders to key posts while abandoning key campaign pledges to allow Medicare to negotiate drug prices and import cheaper medicines from overseas. "His rhetoric is full of fire and fury, but so far the White House has not taken any real action to lower drug prices," said David Mitchell, president of Patients for Affordable Drugs, which is pushing for policies at the state and federal level to lower drug prices.

• CMS Moves to Cancel Medicare Programs Overhauling Some Hospital Payments Stat by Erin Mershon — The Trump administration is canceling or scaling back an array of Obama-era programs that were aimed at encouraging doctors and hospitals to more quickly move away from traditional, fee-for-service medicine. The CMS moved to cancel pilot programs that would have paid certain hospitals a lump sum for all of the care associated with heart attacks, bypass surgeries, and some hip and femur fractures, including the initial visit, the surgery, and follow-up care. It's canceling a similar program that targeted cardiac rehabilitation, and the agency is also proposing to drastically reduce the number of hospitals that have to participate in a separate program already underway that offers similar lump payments for hip and knee replacements.

Editor: Peter Van Vranken