The last-ditch Obamacare repeal bill is gaining steam Presented by

GRAHAM-CASSIDY HAS LEGS — The last-ditch Obamacare repeal bill is gaining steam.

— It's getting a hearing on Monday. "Senators have expressed a strong desire to examine the details of the Graham-Cassidy proposal through a public hearing," Senate Finance Committee Chairman Orrin Hatch said in a statement last night. "A hearing will allow members on both sides of the aisle to delve deeper into its policy and gain a better understanding of what the authors hope to achieve."

... The Senate Homeland Security and Governmental Affairs Committee also has planned a hearing for Sept. 26 on health care block grants, a clear reference to a key plank in the Graham-Cassidy health care plan. Sen. Ron Johnson, who is a co-author of the Graham-Cassidy bill, leads the committee.

... It's not clear yet whether the hearings will win over Sen. John McCain, a Graham ally who has said that he doesn’t want to vote for a bill that doesn’t go through regular order and receive committee hearings.

— But Rand Paul is still a 'no.' President Donald Trump's effort to enlist Sen. Rand Paul in the resurgent GOP effort to repeal Obamacare didn't work, POLITICO's Jen Haberkorn writes.

Paul — the only Republican who has announced opposition to the repeal bill sponsored by Sens. Lindsey Graham and Bill Cassidy — said on Monday the legislation doesn’t go far enough to repeal the health care law and sets up a potentially unworkable system.

“I talked to the president this afternoon but I told him — I just, I promised people I was for repeal, I didn’t promise people I was for keeping it,” Paul said. More for Pros.

— And other votes are still uncertain. For instance, it's not clear whether Graham-Cassidy can win the support of the Senate's conservative wing. Sen. Mike Lee — whose opposition helped tank the GOP's previous repeal-and-replace bill — is "very encouraged" by the state waiver provisions in Graham-Cassidy, a spokesman told POLITICO, but is nevertheless still pushing for technical changes that would ensure those waivers "work as intended."

Grassroots conservative groups aren't exactly whipping up support either, preferring to stay focused on tax reform rather than pour resources into pushing a bill that still doesn't come close to fully repealing Obamacare.

"We're talking to allies on the Hill. They're working to make some improvements," FreedomWorks' Jason Pye told POLITICO's Adam Cancryn. "Bottom line: This may be better than nothing. But it's not what we were promised for seven years."

— CBO analysis won't be ready in time. While the Congressional Budget Office will release a preliminary assessment of the Senate’s 11th-hour Obamacare repeal plan early next week, it won't be able to produce a detailed analysis of how the legislation would alter the number of Americans with health coverage or affect the federal deficit for weeks. More for Pros.

— Countdown until reconciliation runs out: 11 days.

Bill Cassidy and Lindsey Graham are feeling confident about their last-ditch Obamacare repeal proposal. | AP Photo

THERE IS NO BIPARTISAN OBAMACARE DEAL — Sen. Patty Murray on Monday made an offer of "significant state flexibility" in the hopes of getting to a deal on a bipartisan Obamacare bill, according to a senior Democratic aide. The aide declined to identify the flexibility or any details of the policy under discussion. A Republican aide countered that there is "no agreement yet on a deal that could pass."

The bipartisan Senate talks, which have been underway between Murray and Sen. Lamar Alexander for weeks, have now been overshadowed by growing momentum for the Graham-Cassidy repeal bill.

... Alexander told POLITICO's Jen Haberkorn on Monday afternoon that the partisan health care bills have hampered his bipartisan discussions. "Senator Sanders and other Democrats announcing their single-payer [bill] last week and the Graham-Cassidy bill have created a crossfire that have made bipartisan consensus more difficult, there’s no doubt about that," he said. Alexander declined to say whether he would support the Graham-Cassidy bill if its brought to the floor, echoing many other Republicans who said they want more time to read the bill. "I’ve always liked the idea of block grants for education, health care, other areas but it’s a big bill and I want to read it carefully," he said.

THIS IS TUESDAY PULSE — Where the battles in Congress have your author recalling the key theme of Battlestar: Galactica. (For the readers who wonder what the frak PULSE is referencing, it's this: "All of this has happened before, all of this will happen again.")

Haven't seen BSG? Rectify that now. The rest of you can send tips to [email protected] or @ddiamond on Twitter.

With help from Jen Haberkorn (@JenHab), Rachana Pradhan (@RachanaDixit), Dan Goldberg (@DanCGoldberg), Joanne Kenen (@JoanneKenen) and Adam Cancryn (@AdamCancryn).

A message from PhRMA: Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. More.

MEANWHILE, ABOUT THAT CHIP FUNDING… The Senate Finance Committee bill to extend federal CHIP funding for five years — unveiled just 12 days before the program's money lapses — makes minor tweaks to the Obamacare requirement that prevented states from rolling back eligibility for children enrolled in the program as of March 2010, Pro's Rachana Pradhan reports.

The legislation maintains the so-called maintenance of effort requirement — a provision frequently criticized by Republicans — through September 2019. After that, it would apply to children in families whose incomes do not exceed 300 percent of the federal poverty level. As expected, the bill also keeps for two years the ACA's 23 percent increase in federal matching funds for states, before it begins to wind down in 2020.

...But the odds of Congress passing a funding extension bill before the end of the month are becoming increasingly unlikely, as Rachana reported for Pros on Friday. The House still hasn't unveiled a bill and Finance hasn't committed to a mark-up despite committee chair Hatch and ranking member Sen. Ron Wyden having solidified an agreement. And Obamacare repeal is back in the limelight, with the momentum behind Graham-Cassidy sucking up legislative airtime with few days left on the calendar this month.

NON-ACA ISSUES: SEE YOU IN DECEMBER? — At a meeting of the Zetema Project, a nonpartisan group that brings diverse health care experts together to try to find some common ground, there was a fair amount of consensus that none of the non-ACA issues awaiting congressional action – CHIP, the Medicare extenders, or cost-reduction subsidies (assuming the Lamar Alexander bill doesn’t defy the odds and sail through Congress in the next 12 days) – will move in September.

Our editor Joanne Kenen, who was among the health journalists present, tells us that the group wasn’t certain about how the burst of energy around the Cassidy-Graham bill would play out. But participants largely expected that in October Congress would turn to the budget and tax reform. That means everything else on health care would have to be addressed in the mad dash between Thanksgiving and Christmas.

New Jersey: Christie-led opioid commission announces public-private partnership with pharma. A presidential commission on opioid addiction is urging greater collaboration between pharmaceutical companies and the federal government to develop non-addictive pain treatment options.

Republican Gov. Chris Christie, the commission chair, announced the “new partnership” between the pharmaceutical industry and the NIH to “fast track” the development of non-opioid pain medication, as well as new medication assisted treatment options, at a press conference in Trenton today.

He was joined by Kellyanne Conway, counselor to President Donald Trump, and representatives from NIH, the FDA and the industry trade group PhRMA. More for Pros.

New York: Cuomo jumps on single-payer train. Gov. Andrew Cuomo on Monday gave his most vocal support yet to New York's single-payer health care bill, saying the legislation is "a very exciting possibility." Cuomo, a Democrat who is positioning himself for a possible 2020 presidential run, also endorsed a federal "Medicare for All" bill during an appearance with WNYC's Brian Lehrer. "I think that would be a good idea," Cuomo said.

That bill, S. 1804 (115), which is sponsored by Sen. Bernie Sanders, and backed by several other Democrats including Sen. Kirsten Gillibrand, has become an early litmus test for presidential aspirants. But Sanders' bill has almost zero chance of passing during the next four years. It would almost certainly be filibustered in the Senate even if Democrats were to take control of Washington. The New York Health Act, A4738 (17R), sponsored by Assemblyman Richard Gottfried (D-Manhattan), could pass the Legislature if Democrats take the state Senate, a real possibility in 2018. Read more here.

IBM pins its hopes for Watson on VA health system. The company unveiled its Watson Health system in a blitz of hype in 2013, promoting it with an army of sales reps and even Super Bowl ads. But Watson's artificial intelligence has failed to blow away doctors, a humbling experience for the company that hoped to 'disrupt' health care the way competitors transformed other industries, POLITICO's David Pittman writes. More here.

Weekend wedding: POLITICO's deputy health care editor Jason Millman to Monica Dean, senior program associate at the United Nations Foundation. The couple met in 2014 and were married at the Woodend Sanctuary in Chevy Chase, Md.

Spotted: POLITICO's health care editor Joanne Kenen, health wonk Emma Sandoe, recovering health care reporter-turned-Congress ace Kyle Cheney and other illustrious guests.

by Jennifer Haberkorn

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