With the first wave of Kavanaugh confirmation drama complete, the Senate is expected to vote on an opioid package this week. It's a noteworthy step for the Senate although it's still not entirely clear what a final package will look like. Both sides can declare victory going into the election without the bill becoming law. Time will tell if a final package can be completed in lame duck.

The House Energy & Commerce Committee is still hard at work looking ahead at issues that should be of interest to both parties moving forward. This week, the Health subcommittee will be looking at ways to remove barriers to value-based care in Medicare, which could mean changes to Stark or anti-kickback statute. They will also examine maternal mortality, where the U.S. has become one of the worst in the developed world for maternal death rates.

Also on the House side, negotiations on appropriations are moving right along. This week, the House is expected to vote on H.R. 5895, which includes three of 12 regular FY 2019 appropriations bills. While the Labor- HHS-Education is still being worked out among the top lawmakers of jurisdiction, conversations are reportedly heading in the right direction.

Congress has roughly seven working days with both chambers in session until the September 30 funding deadline.

We continue to monitor the potential for a government shutdown but it seems that, for now, those in the room see a path to the President's desk that avoids shutting down the government. For now.

OBAMA ON MEDICARE FOR ALL

Last week, you might've caught President Obama praising Democrats for running on good, new ideas like Medicare for All. While Obama stopped short of embracing the policy, his signaling on the issue is significant for the dozens of House candidates and the direction of Democrats on health care, especially as we move towards the November midterm elections.

With Republicans intent on repealing the Affordable Care Act and Democrats continuing to push left on Medicare for All, there is very little political room for those interested in shoring up the law for the long-term. Rather ironic given that the ACA appears to be as stable as it has been since implementation began.

What does this mean for stakeholders as we look to 2019 and beyond? Uncertainty. But understanding what policymakers mean when they say repeal, or Medicare for All, is critical for staying ahead of the curve.

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