House Republicans have altered legislation to extend funding for the Children's Health Insurance Program, but the changes won't sway Democrats, who are accusing the GOP of using a must-pass bill to gut ObamaCare.

An updated version of the legislation eliminates a provision opposed by Democrats that would have charged higher premiums to Medicare beneficiaries earning more than $500,000 a year. But in its place, the bill would cut more money from ObamaCare's public health fund.

The bill would also shorten the grace period for ObamaCare enrollees who fail to make premium payments. According to an analysis by the left-leaning Center on Budget and Policy Priorities, between 259,000 and 688,000 people could lose their insurance as a result of the shortened grace period.

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A Democratic aide said the changes make the bill even worse.

"It is a further example that this has become a vehicle to sabotage the Affordable Care Act," the aide said.

The bill extends CHIP for five years and was combined with a separate bill that extends funding for community health centers for two years.

The bill will be voted on this week after Republicans and Democrats failed to reach an agreement following weeks of negotiating ways to pay for the program.

Read more here.

Dems: No talks with Trump on ObamaCare fix

Democrats say they have not had any negotiations with the White House about its demands for changes to a bipartisan ObamaCare fix, indicating a murky future for legislation aimed at shoring up insurance markets.

Sen. Lamar Alexander Andrew (Lamar) Lamar AlexanderChamber of Commerce endorses McSally for reelection Trump health officials grilled over reports of politics in COVID-19 response Now is the time to renew our focus on students and their futures MORE (Tenn.), the lead Republican sponsor of the bill, said last week that he wanted the White House to negotiate with Democrats on the administration's proposed changes. Democrats at the time countered by pressuring GOP leaders to bring the bill up for a vote as it is.

A week later, Democrats are showing no interest in negotiating to win President Trump's support, despite GOP leaders offering no sign they will bring the bill up as it is.

Sen. Patty Murray Patricia (Patty) Lynn MurrayTrump health officials grilled over reports of politics in COVID-19 response CDC director pushes back on Caputo claim of 'resistance unit' at agency The Hill's Morning Report - Sponsored by The Air Line Pilots Association - Pence lauds Harris as 'experienced debater'; Trump, Biden diverge over debate prep MORE (Wash.), the lead Democratic sponsor, said on Tuesday that she had not had any talks with the White House about the bill. "Lamar's stayed in touch with them," she said.

When asked about Alexander's desire that she negotiate with the White House, Murray laughed and said, "I negotiated with Lamar."

The Alexander-Murray bill, aimed at stabilizing markets, funds key payments to insurers for two years in exchange for more flexibility for states to change ObamaCare rules. Many conservatives view it, and the payments in general, as a "bailout" of insurers.

Read more here.

Senate Health chairman expects new funding to fight opioids

The chairman of the Senate Health Committee on Tuesday predicted that Congress will provide more money to fight the opioid epidemic.

"There will be additional new funding," Sen. Lamar Alexander (R-Tenn.) said, noting that the "last significant" funding came from a biomedical innovation bill he sponsored and that passed last year. That bill included $1 billion over two years to fight opioid abuse.

Last week, President Trump declared opioid abuse a national public health emergency. The move didn't come with an infusion of new federal dollars, drawing pushback from some advocates and Democrats, who said robust funding is needed to combat overdose deaths from prescription painkillers and heroin.

There's not much money left in the public health emergency fund -- about $57,000.

Read more here.

Notre Dame ending no-cost contraceptive coverage

The University of Notre Dame is reportedly ending its free contraceptive coverage after the Trump administration rolled back an ObamaCare requirement that employers include birth control coverage in their health insurance plans.

The Catholic university will stop the coverage starting on Jan. 1, 2018, according to The South Bend Tribune.

Coverage will end for students on the university's health-care plan on Aug. 14, 2018.

Employees in the past had been able to get contraceptives and contraceptive services at no cost through a third party. This allowed Notre Dame to continue its religious opposition to contraceptives while still meeting the ObamaCare requirement, according to the South Bend Tribune.

Read more here.

Report: ObamaCare enrollment could drop because of Trump

Enrollment in ObamaCare's exchanges next year could drop by as much as 1.6 million people because of uncertainty caused by the Trump administration, according to a Wall Street forecast released Tuesday.

The estimate from S&P concludes that enrollment next year could be 7 to 13 percent lower than the 12.2 million people who signed up in 2017.

ObamaCare's fifth open enrollment period begins Wednesday and ends Dec. 15 in most states.

Enrollment in the exchanges could be anywhere from 10.6 million to 11.4 million, the report predicts.

"Insurer exits, higher-than-expected premium rate hikes, a series of repeal-and-replace votes, the cancelation of future federal cost-sharing reduction (CSR) subsidies, an executive order on health care, and a recent discussion about a short-term bipartisan fix have all contributed to the uncertainty that has been brewing lately," the report said.

Read more here.

Brady rejects bid to repeal ObamaCare mandate in tax reform

House Ways and Means Chairman Kevin Brady Kevin Patrick BradyBusinesses, states pass on Trump payroll tax deferral Trump order on drug prices faces long road to finish line On The Money: US deficit hits trillion amid pandemic | McConnell: Chance for relief deal 'doesn't look that good' | House employees won't have payroll taxes deferred MORE (R-Texas) is rejecting a push by Sen. Tom Cotton Tom Bryant CottonRenewed focus on Trump's Supreme Court list after Ginsburg's death Republicans call for DOJ to prosecute Netflix executives for releasing 'Cuties' Loeffler calls for hearing in wake of Netflix's 'Cuties' MORE (R-Ark.) to add a repeal of ObamaCare's individual mandate to tax reform.

Brady said in an interview with radio host Hugh Hewitt on Tuesday that he fears the move could jeopardize tax reform, a concern held by many Republicans.

"What I don't want to do is to add things that could again kill tax reform like health care died over there," Brady said, referencing the Senate.

He pointed out that even the "skinny" ObamaCare repeal bill, which repealed the individual mandate and a few other items, failed to pass the Senate in July.

House Republicans are set to unveil their tax reform plan on Wednesday.

Read more here.

Mylan executive targeted in generic drug price-fixing probe

A top executive at Mylan is the target of a multi-state investigation into price fixing by generic drug manufacturers, state attorneys general said Tuesday.

The state officials are seeking to sue Rajiv Malik, president and executive director of Mylan N.V., as part of a larger investigation by 45 states, plus the District of Columbia and Puerto Rico, according to a statement by Connecticut Attorney General George Jepsen.

This is the first time a senior executive has been targeted in the case, which was initially filed in December.

The amended complaint also seeks to expand the number of defendants from six generic drug manufacturers to 18, and the number of drugs from two to 15.

The states allege the companies and executives colluded to keep prices high and reduce competition.

Read more here.

The Hill event

Join The Hill on Tuesday, November 7, for America's Opioid Epidemic: Strategies for Prevention featuring FDA Commissioner Scott Gottlieb and Sen. Jeanne Shaheen Cynthia (Jeanne) Jeanne ShaheenSenate Democrats introduce bill to sanction Russians over Taliban bounties Trump-backed candidate wins NH GOP Senate primary to take on Shaheen Democratic senator urges Trump to respond to Russian aggression MORE (D-N.H.). Topics of conversation include the response to the opioid crisis, prevention initiatives, and the role education might play in lowering addiction rates.

From The Hill's opinion pages

Breast Cancer Awareness -- putting pink into historic perspective

What we're reading

How climate change is already affecting health, spreading disease (NPR)

Most ObamaCare enrollees could pay less for policies next year (CNN)

Trump opioid commission will recommend nationwide drug courts (Stat News)

State by state

Puerto Rico's dire health-care crisis (The Atlantic)

Covered California addresses 2018 open enrollment confusion (The Mercury News)

Medicaid cuts to roughly 40,000 Iowans approved by feds (Des Moines Register)

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.

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