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Political Cartoon: 'Rock The Boat?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Rock The Boat?'" by Gary Varvel, The Indianapolis Star.

Here's today's health policy haiku:


It was here … then gone.
A real “reality show”
No one expected.

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Summaries Of The News:

Health Law

A Secret Pact, A Novice President And A Group Of Hardliners: How The GOP Health Plan Failed

Take a look at what went on behind the scenes in Republicans' efforts to push through the American Health Care Act.

Politico: How A Secret Freedom Caucus Pact Brought Down Obamacare Repeal
Speaker Paul Ryan and House leaders had been toiling behind closed doors for weeks assembling their Obamacare repeal bill as suspicion on the far-right simmered to a boil. So on March 7, just hours after Ryan unveiled a plan that confirmed its worst fears, the House Freedom Caucus rushed to devise a counterstrategy. The few dozen true believers knew that pressure from House leaders and President Donald Trump to fall in line would be immense and they were intent on not getting boxed in. (Bade, Dawsey and Haberkorn, 3/26)

The Wall Street Journal: How Democrats Aided In The Demise Of The GOP’s Health Bill
President Donald Trump blamed Democrats for the defeat of his bid to overturn the 2010 Affordable Care Act and enact Republican policy in its place. In some ways he may have been right. Supporters of the health law popularly known as Obamacare launched an all-out campaign for its survival, keeping Democrats unified in opposition to its repeal, and identifying and exploiting Republican divisions that ultimately forced GOP leaders to pull the bill at the eleventh hour Friday. (Radnofsky, 3/26)

Roll Call: How The GOP’s Health Care Law Went Down
It was a nail-biter of a day with a photo finish. The Republican Party’s seven-year effort to repeal the 2010 health care law ended with a thud Friday when the GOP decided not to even subject its do-or-die alternative to a vote. ... Here’s how it all went down Friday. (Akin, 3/24)

As Republicans' Sift Through The Rubble, They Find Plenty Of Blame To Go Around

Republicans, who had unified in their opposition of former President Barack Obama, now struggle with a civil war that could tear them apart.

The New York Times: Trump Becomes Ensnared In Fiery G.O.P. Civil War
President Trump ignites a lot of fights, but his failure to repeal the Affordable Care Act, the biggest defeat in his short time in the White House, was the result of something else: a long-running Republican civil war that humbled a generation of party leaders before he ever came to Washington. (Thrush and Haberman, 3/25)

Politico: Republicans Turn Fire On Each Other
White House officials insisted Sunday that the relationship between President Donald Trump and Speaker Paul Ryan is strong, even as Republican infighting over the failure to repeal Obamacare exploded into the open over the weekend. After Trump urged his Twitter followers Saturday to watch Fox News’ Jeanine Pirro — who opened her show last night with six-minute plea for Speaker Paul Ryan to step down — Washington was abuzz with speculation about a Trump-Ryan rift. (Cheney and Bresnahan, 3/26)

The New York Times: Paul Ryan Emerges From Health Care Defeat Badly Damaged
For two days in January, all seemed right in the Republican Party. Gathered in Philadelphia for their annual congressional retreat, less than a week after President Trump’s inauguration, lawmakers exulted in the possibilities of total government control, grinning through forums about an aggressive 200-day agenda that began with honoring a central campaign promise: repealing the Affordable Care Act. (Flegenheimer and Kaplan, 3/25)

Roll Call: Cloud Hangs Over Trump-Ryan Partnership After Health Care Bill Fails
The death of President Donald Trump’s first major legislative initiative raises major questions about his ability to keep the fractious Republican caucus together and work with House Speaker Paul D. Ryan. GOP House members handed Trump another early-term setback Friday by killing the health care bill he demanded they take up when too many of them refused to support it. (Bennett, 3/27)

Bloomberg: Trump Praises Ryan On Health As Aides Privately Blame The Speaker 
In public, President Donald Trump is standing by House Speaker Paul Ryan over the failed Obamacare replacement bill. “I like Speaker Ryan; he worked very, very hard,” Trump said in the Oval Office after Ryan on Friday pulled the legislation from the House floor for lack of support. Instead, the president pinned the responsibility on Democrats. Behind the scenes, though, the president’s aides blame Ryan for the bill’s embarrassing defeat, which stymied a Republican goal for more than seven years, a senior administration official said. (Jacobs and Pettypiece, 3/24)

Bloomberg: In Ryan Health-Care Defeat, Lessons For Speaker In Age Of Trump 
For [Speaker Paul] Ryan, who has been speaker for 17 months, the question is whether he can take anything away from this episode to help him wrangle his divided conference, accustomed to obstructionism not action under eight years of Barack Obama. To have any hope for success on other Republicans goals such as tax overhaul, Ryan must also learn to work with an unpredictable president in Donald Trump, who insists he is standing by Ryan. (Edgerton, 3/26)

Politico: Republicans Wonder Whether Trump's Heart Was In Healthcare Fight
While President Donald Trump’s first major legislative push hurtled toward a major defeat, one of his top advisers, his son-in-law Jared Kushner, was photographed with his wife, Ivanka Trump, on a ski gondola in Aspen. Kushner may not have been the lead White House negotiator on the doomed healthcare bill. But the image of Trump’s top consigliere hitting the slopes at perhaps the most critical moment of his young presidency sent a message loud and clear: The White House wanted a win, but health care was not the dominant priority for Trump that it was for the Republican members of Congress who actually had to take a vote. (Karni, 3/25)

Trump Points Finger At Far Right For Health Plan's Collapse

The head of the Freedom Caucus, however, didn't hit back at President Donald Trump.

The Washington Post: Trump Shifts Blame For Health-Care Collapse To Far Right
President Trump cast blame Sunday for the collapse of his effort to overhaul the health-care system on conservative interest groups and far-right Republican lawmakers, shifting culpability to his own party after initially faulting Democratic intransigence. His attack — starting with a tweet that singled out the House Freedom Caucus as well as the influential Club for Growth and Heritage Action for America — marked a new turn in the increasingly troubled relationship between the White House and a divided GOP still adjusting to its unorthodox standard-bearer. (Sullivan, Wagner and Phillips, 3/26)

The Washington Post: Trump Goes After Freedom Caucus, But Its Leader Doesn’t Hit Back
Asked about the tweet on the Sunday news shows, two Freedom Caucus members appeared set on avoiding a confrontation with the president. “If they’re applauding, they shouldn’t,” Rep. Mark Meadows (R-N.C.), the head of the Freedom Caucus, said of the Democrats on ABC’s “This Week.” “Because I can tell you, conversations over the last 48 hours are really about how we come together in the Republican Conference and get this over the finish line.” (Sullivan, 3/26)

The Wall Street Journal: House Conservatives Are Undeterred After Health-Bill Failure
The head of the most conservative Republican House faction sought to deflect blame Sunday for last week’s stunning collapse of a White House-backed health-care measure, saying the lawmakers hadn’t given up on trying to repeal the Affordable Care Act. The chairman of the House group also signaled in an ABC interview that the bloc would make its voice a central part of other legislative debates, including an overhaul of the federal tax code. (Bender and Hughes, 3/26)

The Hill: Report: Trump Didn't Want To Talk Details In Freedom Caucus Meeting 
President Trump avoided discussing policy details during a Thursday meeting with the House Freedom Caucus on the ObamaCare repeal bill, Politico reported Saturday. Trump met with members of the ultra-conservative lawmaker group in his push to whip up votes for the American Health Care Act (AHCA). The bill would have fulfilled the GOP's longtime campaign promise to repeal and replace ObamaCare. (Shelbourne, 3/25)

Politico: Freedom Caucus Member Resigns From Group Over Obamacare Rift
Rep. Ted Poe (R-Texas) resigned from the House Freedom Caucus over the group's opposition to the Republican plan to repeal and replace Obamacare. "I have resigned from the House Freedom Caucus. In order to deliver on the conservative agenda we have promised the American people for eight years, we must come together to find solutions to move this country forward," Poe wrote in a statement. (Bade, 3/26)

The Hill: Freedom Caucus Founding Member: GOP Health Plan Did Not Meet Campaign Promises
A founder of the conservative House Freedom Caucus said on Sunday that Republicans should focus on a clean repeal of ObamaCare, arguing the GOP's failed American Health Care Act did not meet Republican campaign promises to the American people. “This is about the American people and what we told them we were going to do,” Rep. Jim Jordan (R-Ohio) told “Fox News Sunday.” Conservative lawmakers argued the GOP measures did not cleanly repeal ObamaCare. (Shelbourne, 3/26)

'You Can Only Do So Much As President': Supporters Give Trump A Pass In Blame Game

Voters instead are focusing on House Speaker Paul Ryan (R-Wis.) and Democrats.

Stat: In Trump Country, Voters Know Who’s To Blame For The Health Bill Debacle. And It’s Not Their President.
They blame the establishment. They blame the Democrats. They blame the media. But it seems that few voters in Trump country blame President Trump for the stunning collapse of the Republican-led effort to repeal and replace Obamacare. “He did all he could, I think,” said Edward Reede, 73, who was pacing the sidewalk as he waited for a relative in the rural town of Front Royal in northwest Virginia. “You can only do so much as president. You can only twist so many arms.” (Siegelbaum and Martin, 3/25)

Lawmakers Went Out On Political Limb Only To Watch It Disintegrate Beneath Them

For Republicans who supported the American Health Care Act, 2018 may be a year of reckoning for their decision.

The New York Times: Health Bill’s Failure Leaves Supporters In A Political Jam Back Home
They went to unusual, even dangerous lengths to support President Trump’s unpopular health care bill, facing down protesters at home and begging for special accommodation from House leaders in Washington. John Faso of New York negotiated a side deal for his state in exchange for backing it. Mike Coffman was the lone Colorado lawmaker to endorse the bill, while his Republican neighbors agonized and stalled. (Burns, 3/25)

Los Angeles Times: Failure Of Their Healthcare Bill Leaves Republicans Running Obamacare. That Could Open The Way For Bipartisan Changes
Unable to kill the Affordable Care Act, Republicans may now have to fix it. The White House and even GOP members of Congress risk a huge political backlash if they allow the healthcare law to come apart, as President Trump has predicted it will. That leaves Republicans with a strong incentive to take steps to shore up Obamacare insurance markets, keep premiums in check and preserve consumer protections in a way that would be acceptable to both sides of the aisle in Congress. (Levey, 3/25)

McClatchy: Mitch McConnell Is A Top Republican Untouched By GOP’s Health Care Mess
One key Republican Washington power player – Senate Majority Leader Mitch McConnell – emerges from the wreckage of Friday’s GOP effort to overhaul Obamacare relatively unscathed. While McConnell had supported the bill, which failed to get enough Republican support and was pulled from the House floor, the Kentucky Republican never asked his 52-member majority to put anything at risk for it. Now none of the senators have to cast a vote either way. (Tate, 3/24)

CQ Roll Call: Lawmakers Predict Health Care Bill Will Be 2018 Campaign Issue
Republicans won’t have a recorded vote on leadership’s health care plan but that doesn’t mean their position on it won’t be used against them in campaign ads in 2018. Former National Republican Congressional Committee Chairman Greg Walden, now chairman of the Energy and Commerce Committee, acknowledged as much Friday evening. “Everybody staked out their position so they’ll be able to reap the benefit of that position or take the hit,” he told CQ Roll Call. Some Republicans actually do have recorded votes that will be used against them. (Pathe, 3/25)

Politico Pro: Democrats Eye Comstock's Swing Seat After Obamacare Repeal Failure
Rep. Barbara Comstock dodged constituents, declined town halls and avoided taking a public stance on the Republican Party’s increasingly unpopular health care bill in the months leading up to its collapse.Her last-minute decision to oppose it — after other GOP moderates had spoken out and sealed the bill’s doom — is unlikely to protect her in 2018. Democrats had already smelled blood, targeting Comstock after Hillary Clinton won her increasingly purple district in northern Virginia by 10 percentage points. (Ehley, 3/27)

CQ Magazine: Red Districts With The Most Constituents On Expanded Medicaid
While House GOP leadership failed to come up with a framework for dismantling the Affordable Care Act that could win enough support among the most conservative representatives to pass, another element of the party has been sitting quietly on the sidelines. Reticence is understandable when more than 40 percent of your constituents have incomes low enough to qualify for Medicaid under the 2010 health care law’s expansion. (Leonard, 3/27)

Milwaukee Journal Sentinel: Wisconsin GOP House Members Spared From Difficult Health Care Vote
House Speaker Paul Ryan’s decision to pull his party’s Obamacare replacement bill spared his fellow Republicans from voting on an unpopular piece of legislation that lacked the votes to pass the House or Senate... Ryan’s fellow Republicans from Wisconsin were mostly prepared to support his controversial health care bill. Jim Sensenbrenner and Glenn Grothman planned to vote yes. (Golbert, 3/24)

Atlanta Journal-Constitution: Failed Health Plan Shadows GOP Georgia Special Election Debate 
The blast radius of the failed healthcare measure shook up a Republican debate over who should succeed Tom Price in the special election to represent his suburban Atlanta district, as several top GOP contenders sparred over what Congress should have done. The four candidates running to represent the suburban Atlanta district at the Sunday debate split on the next steps, with some blaming the GOP establishment for the failure of the measure and others praising the coalition of moderates and conservatives who ultimately scuttled the proposal. (Bluestein, 3/27)

Austin American-Statesman: Doggett: Obamacare Fight Led To Victory For Resistance But GOP ‘
Austin’s U.S. Rep. Lloyd Doggett might feel like the force is strong with Democrats on Friday after a GOP attempt to repeal and replace the Affordable Care Act – aka Obamacare – foundered, but he warned that the “Empire will strike back.” Doggett’s statement came just after U.S. House Speaker Paul Ryan announced that he had pulled the President Trump-backed American Health Care Act because of a lack of Republican votes. (Jankowski, 3/24)

Meanwhile, some ads cause embarrassment after the health plan was pulled —

Cox Media Group: TV Ads Prematurely Thank Congressmen For Repealing Obamacare
Television advertisements thanking Republican representatives for repealing the Affordable Care Act on Friday has the conservative American Action Network PAC slightly red-faced. President Donald Trump and the Republican leadership suffered a major setback in their efforts to repeal the Affordable Care Act when Speaker Paul Ryan pulled his bill to repeal Obamacare from the House floor after support began to crumble. (D'Angelo, 3/25)

Democrats Riding Celebratory Wave After Republicans' Crushing Defeat

Although President Donald Trump says he expects Democrats to come to Republicans to fix problems with the health law, Democrats are optimistic that they are in the best political position they've been in since the election.

The New York Times: Democrats, Buoyed By G.O.P. Health Defeat, See No Need To Offer Hand
President Trump, looking for a flicker of hope after his Republican majority fell to pieces last week, predicted that the opposition party would eventually give in: “I honestly believe the Democrats will come to us and say let’s get together and get a great health care bill or plan,” he said. But Democrats will not be lending a hand anytime soon. (Martin, 3/26)

The Associated Press: Blaming Conservatives, Trump Signals New Openness To Dems
[The president's] aides made clear that Trump would be seeking support from moderate Democrats, leaving open the possibility he could still revisit health care legislation. White House chief of staff Reince Priebus scolded conservative Republicans, explaining that Trump had felt "disappointed" that a "number of people he thought were loyal to him that weren't." (3/26)

The Associated Press: Schumer Seizes On Trump Team's Offer To Work With Dems
President Donald Trump's aides have opened the door to working with moderate Democrats on health care and other issues. Senate Democratic leader Chuck Schumer has quickly offered to find common ground with Trump for repairing former President Barack Obama's health care law. Schumer said Sunday that Trump must be willing to drop attempts to repeal his predecessor's signature achievement, warning that Trump was destined to "lose again" on other parts of his agenda if he remained beholden to conservative Republicans. (3/27)

Politico: Trump’s Obamacare Stumble Empowers Pelosi
Nancy Pelosi is suddenly relevant again. The implosion of the all-Republican effort to lay waste to Obamacare showed that President Donald Trump might need the San Francisco Democrat to salvage the rest of his agenda. The self-professed master negotiator couldn’t get it done with his own party, despite a 44-seat House majority, and hinted afterward he might start to look across the aisle. (Caygle, 3/27)

In Wake Of Loss, Some See Window Of Opportunity For Bipartisan Path Forward

“The reason why Obamacare failed was because it wasn’t a bipartisan bill,” said Don Young, Republican of Alaska. His party made the same mistake, he said, writing their bill without Democrats. “We were very frankly guilty of that."

The New York Times: Some Lawmakers Now Look To Bipartisanship On Health Care
The sudden death of legislation to repeal the Affordable Care Act has created an opening for voices from both parties to press for fixes to the acknowledged problems in President Barack Obama’s signature health law, as lawmakers and some senior White House officials appealed for bipartisanship. But the White House, still smarting from a disastrous defeat on Friday, appeared uncertain on the path forward. President Trump predicted that “Obamacare will explode” and offered no plan to stop it, but his was not the only voice from the White House. (Pear and Shear, 3/26)

The Hill: GOP Rep: Healthcare Reform Needs To Be Bipartisan
Rep. Charlie Dent (R-Pa.) on Sunday said healthcare reform must be both bipartisan and sustainable. “In order to reform healthcare in this country, we’re going to have to do it in a durable, sustainable way and in a bipartisan manner,” Dent told NBC’s “Meet the Press.” Dent refused to support the American Health Care Act, which was ultimately pulled before a vote last week. (Shelbourne, 3/26)

Bloomberg: McCain Says Democratic Help May Be Needed To Repair Health Care
U.S. Senator John McCain said Republicans in Congress may need to reach out to Democrats in an attempt to reform health care after the House of Representatives’ efforts to undo Obamacare failed. “Doing nothing is not the answer after the setback,” McCain said at a German Marshall Fund forum in Brussels on Saturday. “It might be a good idea now for at least an attempted outreach to the Democrats to see if there are areas where we can come to an agreement.” (Strauss, 3/25)

Meanwhile, some lawmakers are looking at other health care issues —

Morning Consult: Leaders Plan To Scrap Health Reform, But Some In GOP See Path Forward
Republican health care policy has focused for seven years around repealing and replacing the Affordable Care Act. Now members appear split on whether to continue toward that goal, or move on to other issues. ... Rep. Michael Burgess (R-Texas), chair of the House Energy and Commerce Subcommittee on Health, told reporters he didn’t know how to move on from calling to overhaul Obamacare. Instead, for the rest of the year he plans to focus on reauthorizing Food and Drug Administration user fees and the Children’s Health Insurance Program, as well as oversight of two bipartisan health bills that passed during the last Congress. But other Republicans weren’t so sure that the failure of the bill, dubbed the American Health Care Act, was the end of the road for GOP-led health reform. (McIntire, 3/26)

Winners And Losers: The Poor And Hospitals May Be Happy But High Earners Not So Much

Several news outlets take stock of how stakeholders will fare now that the House bill has been deep-sixed.

Modern Healthcare: Who Won And Lost In The Battle To Repeal Obamacare 
After seven years and many promises, Republican leadership failed to get enough votes to pass legislation that would repeal the Affordable Care Act. The American Health Care Act was pulled before a single vote was cast. The move received mixed reactions from many who had a lot at stake under the bill. Here's a quick list of who won and lost as a result of the failed attempt to repeal Obamacare. (Meyer, 3/26)

Georgia Health News: Hospitals Relieved To See GOP Health Care Bill Withdrawn In Congress 
House Speaker Paul Ryan (R-Wis.) said the GOP proposal to replace the 2010 Affordable Care Act, often called Obamacare, was withdrawn because it did not have enough votes to pass. The biggest relief in Georgia may be felt by Atlanta’s Grady Health System, whose leaders estimated that the health care proposal would cost the safety-net provider $65 million annually. (Miller, 3/24)

The Affordable Care Act Is Here To Stay For Now -- So What Does That Mean For Consumers?

Media outlets offer guidance to anxious consumers on what's going to happen now that the Republicans' plans to dismantle the Affordable Care Act have failed.

The Associated Press: Now What? Options For Consumers As Health Law Drama Fades
As the political drama over health care legislation in Washington fades, the rest of the country faces a more immediate concern: Getting insurance for next year. The Republican health plan designed to replace the Obama-era health law known as the Affordable Care Act would not have taken full effect for a few years anyway — and now it's dead. (3/25)

Politico Pro: What's Next After Obamacare's Latest Brush With Death? 
Congress choked. Obamacare lives.House Republicans are at an unfamiliar crossroads after their seven-year effort to repeal the law collapsed. The direction they and the Trump administration choose will determine whether Obamacare survives, or faces new threats as political opposition continues to simmer and flaws recognized even by its supporters go unaddressed. (Cancryn, Haberkorn and Pradhan, 3/24)

The New York Times: More Than Obamacare Repeal, Small Businesses Want Congress To Rein In Costs
LaRonda Hunter, a business owner in Fort Worth, Tex., views the Affordable Care Act as a literal job killer. Fearful of triggering the law’s employer mandate, which requires businesses with 50 or more workers to offer health insurance or pay penalties, Ms. Hunter has held off on expanding her small chain of hair salons. She voted for President Trump with the hope that he would quickly make good on his promise to strike down the health care law. (Cowley, 3/26)

The Associated Press: New Anxieties As Trump Says Obamacare Will 'Explode'
Americans who have benefited from the Affordable Care Act are feeling some relief at the failure of Republican efforts to repeal it, but they face new anxieties with President Donald Trump tweeting that "ObamaCare will explode." Premiums have risen and major insurers have backed out of the state markets where people can buy insurance online under Obama's signature health care law. But people who say it saved their lives or helped them start a business want lawmakers to fix these problems, not encourage them. (3/26)

Nashville Tennessean: Older Tennesseans Fret Over Future Under Obamacare Reform
The AHCA was under fire from the AARP, a host of health care associations, physicians and leaders as well as the Council on Aging of Middle Tennessee for a variety of its tenets, but particularly the disproportionate impact the legislation could have on older adults and people who are low income because of how it would overhaul Medicaid. Tennesseans buying individual insurance plans under the AHCA would have seen an average increase of $5,709 a year, compared with a $3,600 average across the country, according to the Center on Budget and Policy Priorities. The net premium for a 60-year-old making $22,000 a year could rise by $11,835. (Fletcher, 3/26)

Chicago Tribune: Illinois Health Care Advocates Cheer GOP Bill's Demise, Worry About Future
Many health care leaders in Illinois cheered the demise of House Republicans' Obamacare replacement bill Friday — but it didn't take long for reality to quiet the celebration. Despite the bill's downfall, challenges remain in Illinois and across the U.S. when it comes to health insurance, they said. "We can stop and take a breath and regroup, (but) I wouldn't say celebrate because I don't think the work is over," said John Peller, president and CEO of the AIDS Foundation of Chicago. "I think everyone agrees, Republicans and Democrats alike, that the Affordable Care Act as it stands now is far from perfect and needs improvement." (Schencker, 3/25)

California Healthline: Californians Speak After GOP’s Obamacare Repeal Attempt Falls Flat
Relief, disappointment, unassuaged worry, political swagger, straightforward determination. From the state Capitol to the halls of academia, and from the interior to the coast, Californians reacted strongly on Friday to the dramatic news that the Affordable Care Act would be around “for the foreseeable future,” as House Speaker Paul Ryan conceded after being forced to withdraw the Republican repeal bill for lack of support within his own party. Here are some of the comments from policymakers, advocates and consumers around the state. (3/27)

The CT Mirror: Death Of GOP Health Care Bill Increases CT Dems’ Calls To Fix Obamacare 
With the stunning failure of the GOP to win support for its health care bill Friday, Connecticut Democrats increased their calls for reforms of the Affordable Care Act that would keep it alive... After having to pull the health care bill from a  scheduled vote Thursday, and then again Friday, House Speaker Paul Ryan, said the GOP bill was dead and,  “Obamacare is the law of the land for the foreseeable future.” But he predicted the Affordable Care Act would spiral into oblivion, saying premiums would keep rising and insurers would continue to abandon the state exchanges created by the ACA. (Radelat, 3/24)

WBUR: AHCA Defeat Spells Relief For Massachusetts 
AARP was one of dozens of groups that urged members to call their congressional representatives and urge them to vote no on the American Health Care Act (AHCA). The intense lobbying effort may be one reason House Speaker Paul Ryan could not muster the 216 votes needed and pulled his bill — leaving the Affordable Care Act (ACA) in place "for the foreseeable future." (Bebinger, 3/24)

NPR: Worries About Health, Prejudice And Immigration Swirl At LA Clinic
Lourdes Flores Valdez says she got her diabetes under control after she was able to sign up for Medi-Cal, California's version of Medicaid, under the Affordable Care Act's expanded eligibility rules. Sitting in an exam room at the UMMA Community Clinic's Fremont Wellness Center in South Los Angeles, she suddenly veers away from discussing the health law and starts talking about her husband, who is in the United States illegally. (Plevin, 3/25)

The Hill: Inspector General Reviewing HHS Decision To Halt ObamaCare Ads
The Department of Health and Human Services' (HHS) inspector general is reviewing the Trump administration's decision earlier this year to halt its ObamaCare outreach efforts. The review was initiated after Democratic Sens. Elizabeth Warren (Mass.) and Patty Murray (Wash.) requested the HHS watchdog investigate the administration's move in late January. (Vladimirov, 3/24)

Just Because GOP's Health Plan Was Pulled, Doesn't Mean Obamacare Won't Change

A look at what the Trump administration can do to further water down the Affordable Care Act.

Reuters: How Republicans Can Hobble Obamacare Even Without Repeal
Republicans may have failed to overthrow Obamacare this week, but there are plenty of ways they can chip away at it. The Trump administration has already begun using its regulatory authority to water down less prominent aspects of the 2010 healthcare law. (Steenhuysen, 3/26)

The Wall Street Journal: With GOP Plan Dead, Trump Weighs Other Ways To Reshape Health Care
With the collapse of Republicans’ health plan in the House on Friday, the Trump administration is set to ramp up its efforts to alter the Affordable Care Act in one of the few ways it has left — by making changes to the law through waivers and rule changes. The initiative now rests with Health and Human Services Secretary Tom Price, who has vowed to review every page of regulation and guidance related to the ACA. The steps he and the administration take next could have sweeping repercussions, accomplishing some of the same types of changes Republicans were unable to push through Congress. (Armour, 3/25)

Bloomberg: Trump May Have Lost On Obamacare Yet Still Controls Its Fate 
Matt Lloyd, an HHS spokesman, didn’t respond to a request for comment on Friday about how the agency will approach the health law going forward. Sylvia Burwell, the department’s secretary under Obama, said there are “important steps that the administration can take to promote competition and affordability in the marketplace as well as maintain the quality improvements that millions of Americans have experienced.” (Tracer, 3/24)

And a look at how the Republicans are making some other regulatory changes --

The Hill: Here’s How Trump Is Using A Special Law To Do Away With Obama Regulations 
President Trump and the Republican-led Congress are using a special rule to do away with many of President Obama’s regulations. Since Trump entered the White House two months ago, the House has passed 14 resolutions disapproving of Obama-era regulations under the Congressional Review Act (CRA). The Senate has approved 10 resolutions, and President Trump has signed three measures into law. The CRA allows Congress to do away with regulations through an expedited legislative process that prevents the minority from using the Senate’s filibuster. The catch is that Congress only has a window of 60 legislative days in which it can reach back into 2016 to repeal a regulation through this process. (Devaney, 3/26)

Already-Jittery Insurers Eye Uncertain Future With Concern

A crisis for the marketplaces could be brewing after the defeat of the American Health Care Act.

Modern Healthcare: As GOP Bill Founders, Pressure Mounts On Insurers To Keep ACA Alive 
GOP leaders could face a crisis soon when jittery insurers must announce whether they'll sell plans for 2018 and how they'll price them. [House Speaker Paul] Ryan said his big concern is that the ACA insurance market could collapse, with exiting insurers and soaring premiums. “We'll try to prop it up, but it's so fundamentally flawed that I don't know if it's possible.” But many experts say administration actions and and inactions—notably the failure to fund payments to insurers for cost-sharing reductions and reinsurance—have contributed to the instability. (Meyer, 3/25)

Pence Says Health Law Supporters' 'Victory Won't Last Long'

At a rally in West Virginia, the vice president blamed Democrats and a few Republicans for the failure to get a replacement bill through the House. Also, The Washington Post checks out Pence's statements about selling insurance across state lines.

The Hill: Pence: 'Every Day ObamaCare Survives Is Another Day America Suffers'
Vice President Pence on Saturday blamed House Democrats and a "handful" of Republicans a day after the White House and House GOP leaders suffered a stunning failure to secure support for their healthcare plan. Speaking at a construction supply depot in West Virginia, Pence appeared to shrug off the failure of President Trump's first major legislative push, dismissing the defeat as a sign that "Congress just wasn't ready" for healthcare reform. (Greenwood, 3/25)

The Washington Post: Pence’s Strange Claim That Selling Health Insurance Across State Lines Would Be Like Car And Life Insurance
One of President Trump’s signature promises is to allow the purchase of health insurance across state lines. This was supposed to be tackled in “phase three” of the administration’s plan to repeal and replace the Affordable Care Act, now in doubt because of the failure on Friday to advance the “phase one” bill in the House. Many experts are skeptical about whether buying health insurance across state lines would actually work — more on that below — but we were interested in claims made by administration officials such as Vice President Pence and White House press secretary Sean Spicer that this would be similar to buying life insurance and car insurance. (Kessler, 3/27)

Capitol Hill Watch

GOP Turns Attention To Tax Reform, But Grand Plans Take A Blow From Health Law Failure

Not only has Trump's aura of political invincibility been shattered, but without killing the Affordable Care Act, Republicans will have to take a different approach to rewriting the tax code than previously planned.

The New York Times: Dealt A Defeat, Republicans Set Their Sights On Major Tax Cuts
Picking themselves up after the bruising collapse of their health care plan, President Trump and Republicans in Congress will start this week on a legislative obstacle course that will be even more arduous: the first overhaul of the tax code in three decades. Mr. Trump’s inability to make good on his promise to repeal the Affordable Care Act has made the already daunting challenge of tax reform even more difficult. (Rappeport, 3/26)

The Associated Press: Failure On Health Bill Also Hurts Prospects For Tax Overhaul
House Republicans' failure to repeal Barack Obama's health care law deals a serious blow to another big part of President Donald Trump's agenda: tax reform. Trump and House Speaker Paul Ryan, R-Wis., say they will soon turn their attention to the first major re-write of the tax code in more than 30 years. But they will have to do it without the momentum of victory on health care. (Ohlemacher, 3/25)

CQ Roll Call: Setback On Health Care Repeal Could Scramble Budget Work
Republicans see tough work ahead on spending and budget negotiations following a bungled attempt to repeal Obamacare that exposed deep divisions between House moderates and hardline conservatives. But there is also a possible upside — if Republicans clear the decks of action on health care, that could break a legislative logjam when it comes to moving ahead on multiple pressing spending issues.(Mejdrich, 3/24)

Bloomberg: Trump's Retreat On Health Care Deals A Blow To The Rest Of His Agenda 
The gambit was straight out of a corporate deal-maker’s playbook: President Donald Trump told House Republicans that it was now or never to repeal and replace Obamacare and demanded a vote by Friday. No more negotiations. It was a bluff, and a stubborn band of Republican lawmakers called him on it. Now Trump’s been struck with a humiliating defeat on his first major legislative test, and it’s a body blow that calls into question whether he can move his agenda through Congress, including proposals on tax reform and infrastructure spending that helped propel a stock market rally since his election. (Pettypiece and Jacobs, 3/24)

The Associated Press: GOP Controls Federal Government But Struggles To Govern
The Republican Party of "no" for Democrat Barack Obama's eight years is having a hard time getting to "yes" in the early Donald Trump era. The unmitigated failure of the GOP bill to replace Obamacare underscored that Republicans are a party of upstart firebrands, old-guard conservatives and moderates in Democratic-leaning districts. Despite the GOP monopoly on Washington, they are pitted against one another and struggling for a way to govern. (Beaumont and Barrow, 3/27)

The Hill: This Week: GOP Picks Up The Pieces After Healthcare Defeat 
Republicans will try to figure out what comes next this week after the House GOP’s embarrassing setback in trying to pass long-promised legislation to repeal and replace ObamaCare. Their seven-year campaign pledge to get rid of the 2010 law suffered a major blow after GOP leaders and President Trump couldn’t stop a revolt from conservatives and centrists. With the GOP healthcare plan dead, Republicans are quickly setting their sights on another challenging campaign promise: tax reform. (Marcos and Carney, 3/27)

CQ Roll Call: Health Care Bill Is Dead For The Year, Committee Leaders Say
Committee chairmen who oversee health care acknowledged that legislative efforts to revise the 2010 law are over this year after House Speaker Paul D. Ryan abandoned the Republican bill Friday. "This bill is dead," said Energy and Commerce Committee Chairman Greg Walden, R-Ore. "The president has said he's moving on, and unless he changes his mind, we're moving on," said Ways and Means Committee Chairman Kevin Brady, R-Texas. "Obamacare is clearly still in place and it's continuing to collapse, and we worked very hard to avoid that." (Mershon, 3/24)

Emboldened By Win, Some Democrats Begin To Dream Big Over Single Payer System

Now that the Republican health plan has failed, some lawmakers look to pull health care further left, including Sen. Bernie Sanders who plans to introduce a "Medicare-for-all" bill.

The Washington Post: With AHCA Defeat, Some Democrats See Chance To Push For Universal Coverage
At their first town meeting since the Republicans’ surprise surrender on the Affordable Care Act, progressives in blue America celebrated — then asked for more. Rhode Island’s two Democratic senators, joined by Rep. Jim Langevin, told several hundred happy constituents that the next step in health reform had to mean expanded coverage, provided by the government. “We have to look harder at a single-payer system,” said Langevin (D-R.I.), using a term for universal coverage. (Weigel, 3/26)

Politico: Sanders To Offer Single-Payer Health Care Plan
Sen. Bernie Sanders said Sunday he planned to introduce a single-payer health care plan to Congress, inviting Republican leaders to negotiate the measure. “I'm going to introduce a Medicare-for-all single-payer program," Sanders told anchor Dana Bash on CNN's "State of the Union." The Vermont senator, who has repeatedly stated his support for such a plan in the past, said he hoped to garner bipartisan support for the plan. (Lima, 3/26)

The Hill: Sanders Says He Will Introduce 'Medicare For All' Bill 
Sen. Bernie Sanders (I-Vt.) is planning to introduce a single-payer healthcare bill in Congress. The Vermont senator said during a town hall Saturday he plans to introduce a "Medicare for all" bill "within a couple of weeks," Vermont Public Radio reported. “It is a commonsense proposal, and I think once the American people understand it, we can go forward with it,” Sanders said after the town hall meeting. (Savransky, 3/26)

Administration News

New Head Of HHS Civil Rights Office Is Opponent Of Transgender Patients' Rights, Planned Parenthood

Former Heritage Foundation staffer Roger Severino is now listed as the head of the civil rights office, which is in charge of enforcing patient privacy and civil rights protections including that services are free from discrimination and that patients have access to services such as interpreters.

ProPublica: Heritage Foundation Alum Critical Of Transgender Rights To Lead HHS Civil Rights Office 
The Trump administration has quietly appointed a Heritage Foundation staffer who has railed against civil rights protections for transgender patients as director of the federal agency charged with protecting the civil rights of all patients. Though the administration did not issue a formal announcement, Roger Severino is now listed on the website of the U.S. Department of Health and Human Services as director of the Office for Civil Rights. His prior position was as director of the DeVos Center for Religion and Civil Society at the Heritage Foundation, where he focused on “religious liberty, marriage and life issues.” (Ornstein, 3/24)


Though Convenient, Telehealth Appointments Don't Cut Costs

A study finds that total annual spending was $45 more per patient for people who used telehealth to treat acute respiratory illnesses than it was for patients who saw doctors for the same conditions.

NPR: Telehealth Makes Some Health Care More Expensive
Telehealth takes a lot of forms these days. Virtual visits with a health care provider can take place by video, phone or text, or via the Web or a mobile app. The one commonality: You get to consult a doctor from your home, the office, Starbucks or anywhere with a wifi or mobile connection. (Brooks, 3/26)

In other news —

Women’s Health

New Utah Law Requires Doctors To Tell Women That Abortion Induced By Pill Can Be Stopped, Despite No Evidence Proving Claim

In news from other states' debates on the abortion issue, an Oklahoma lawmaker defends his antiabortion legislation that does not include an exception for cases of rape or incest, saying such pregnancies are instances when “God can bring beauty from ashes.” And in Montana, state senators advance a measure seeking to protect "pain-capable" fetuses.

The Washington Post: Oklahoma Lawmaker Defends Pregnancy From Rape And Incest As ‘Beauty From Ashes’
In defending his controversial antiabortion legislation, Oklahoma state Rep. George Faught said that even in pregnancies that result from rape or incest, “God can bring beauty from ashes.” Faught made the statement during a debate on the Oklahoma House floor earlier this week. Faught’s bill, which overwhelmingly passed the House on Tuesday, would outlaw abortions sought by women based solely on a diagnosis of Down syndrome or other genetic abnormalities. A fellow lawmaker criticized the Republican from Muskogee for not including an exception for pregnancies that resulted from rape and incest. (Phillips, 3/25)

The Associated Press: Montana Bill Seeks Abortion Ban On ‘Pain-Capable’ Fetuses
The Montana Senate on Friday advanced a proposal seeking to extend protections to so-called “pain-capable” fetuses. If approved, Montana would join more than a dozen states adopting laws protecting pain-capable fetuses. The measure is one of a pair of anti-abortion bills that continued moving through the Montana Legislature. Earlier in the week, a House committee further advanced a bill that would effectively ban all abortions after 24 weeks of pregnancy by requiring doctors to save a fetus. (Calvan, 3/24)

Public Health And Education

Doctor's Social Media Promos For His Company's Cancer 'Breakthrough' May Violate Federal Rules

Following questions from Stat about promotion of a non-Food and Drug Administraiton approved treatment, NantKwest softened the language. Meanwhile, The New York Times writes on how more surgeries are being conducted while patients are awake. And other news outlets report on tuberculosis, the flu vaccine, Zika, another virus that can cause birth defects called Cytomegalovirus and more public health stories.

Stat: CEO's Promotion Of 'Breakthrough' Cancer Therapy Raises Questions
The emotional video tells of a patient with blood cancer who tries an experimental therapy involving “natural killer” cells. “NEW BREAKTHROUGH HELPS PATIENTS KILL CANCER” the banner headline declares as the patient, wiping away tears, covers her face with her hands and murmurs, “It’s really good news.” Billionaire Dr. Patrick Soon-Shiong retweeted the video several times in recent days, amid a flurry of social media posts in which he vowed to “solve” cancer. But where the ordinary viewer might see an inspirational story, drug industry experts saw a likely violation of federal regulations. (Robbins, 3/27)

The New York Times: Going Under The Knife, With Eyes And Ears Wide Open
“Do you want to see your tendons?” Dr. Asif Ilyas, a hand and wrist surgeon, was about to close his patient’s wound. But first he offered her the opportunity to behold the source of her radiating pain: a band of tendons that looked like pale pink ribbon candy. With a slender surgical instrument, he pushed outward to demonstrate their newly liberated flexibility. (Hoffman, 3/25)

Stat: How One County Battled A Deadly Strain Of Tuberculosis
The drug-resistant TB had quietly spread for the better part of a decade among [Atlanta's] homeless population. Then in 2014, the stubborn strain turned fatal, killing at least three men and infecting dozens. The deadly “Atlanta strain” also cropped up in more than a dozen states nationwide. Alarmed, the Centers for Disease Control and Prevention intervened with emergency aid. A multimillion-dollar effort to screen and treat vulnerable residents has worked: Officials announced this week that TB cases in Fulton County, which includes most of Atlanta and and some of its surrounding suburbs, have dropped by nearly a third. They say the approach here can offer valuable lessons to other communities battling public outbreaks. (Blau, 3/24)

NPR: New Parents Get Baby Boxes To Encourage Safe Sleep
For Jernica Quiñones, the reality of sudden infant death syndrome, or SIDS, hit close to home this year when a friend woke up on New Year's Day and discovered the lifeless body of her baby girl. That's why Quiñones' 4-month-old son, Bless'n, has spent a lot of his life so far sleeping in a cardboard box. (Pao, 3/26)

The Baltimore Sun: Study: African-Americans Don't Trust Flu Vaccine; Whites Don't Think Flu Is That Bad 
The researchers found African-Americans worried about the safety of the shot more than the health risks of the flu. The findings are important as the medical community tries to improve vaccination rates. Fewer than half of Americans get the flu vaccine, according to the Centers for Disease Control and Prevention. Just 41 percent of African-Americans get vaccinated, compared with 47 percent of whites. The study, published in the journal Risk Analysis, included 800 white and 800 African-American participants. Researchers from the University of Georgia and the University of Pittsburgh also participated in the research. (McDaniels, 3/25)

NPR: Common Virus Can Cause Devastating Birth Defects
When Kathleen Muldoon had her second child everything was going smoothly. The delivery was short, the baby's APGAR score was good and he was a healthy weight. "Everyone said he was amazing," says Muldoon. But when a doctor noticed that Gideon was jaundiced, everything changed. (Neighmond, 3/27)

NPR: Breast-Fed Kids May Be Less Hyper, But Not Necessarily Smarter, Study Finds
Breast-feeding has many known health benefits, but there's still debate about how it may influence kids' behavior and intelligence. Now, a new study published in Pediatrics finds that children who are breast-fed for at least six months as babies have less hyperactive behavior by age 3 compared with kids who weren't breast-fed. (Aubrey, 3/27)

Kaiser Health News: Want To Live Past 100? Centenarians Share Secrets Of Knee Bends And Nips Of Scotch
Gertrude Siegel is 101 and hears it all the time. “Everyone says ‘I want to be just like you.’ I tell them to get in line,” she said. John and Charlotte Henderson, 104 and 102, often field questions from wannabes eager to learn their secrets. “Living in moderation,” he said. “We never overdo anything. Eat well. Sleep well. Don’t overdrink. Don’t overeat. And exercise regularly.” (Jayson, 3/27)

New 'War On Drugs' Needed To Battle Opioid Crisis, Sen. Manchin Argues

Stat interviews the West Virginia senator about his focus on a national epidemic that has hit his state particularly hard. In related news about the crisis: a New Jersey family files suit against a fentanyl manufacturer, doctor and pharmacy; Maryland lawmakers rush to pass an opioid bill; a New Hampshire physician assistant faces criminal charges over his Subsys prescriptions; and more.

Stat: Sen. Manchin: Time For A New 'War On Drugs' To Tackle Opioids
Senator Joe Manchin stepped onto the Senate floor last week to read a letter sent to him by Leigh Ann Wilson, a home caregiver whose 21-year-old daughter, Taylor, died from an opioid overdose last fall. “Please work quickly to prevent thousands of other Taylors from the same fate,” Manchin read. That was just the latest of many such letters that Manchin, a Democrat, has read on the Senate floor over the past year. He represents West Virginia, which has the highest rate of drug overdose deaths in the nation. And he seeks to amplify the voices of those most affected. (Blau, 3/27)

Stat: Lawsuit Blames Improper Marketing Of Potent Opioid For Woman's Death
The family of a New Jersey woman who died after using a prescription version of the potent opioid fentanyl filed a wrongful death lawsuit Thursday against the drug’s maker, her doctor, and a specialty pharmacy that provided the drug. The lawsuit, filed in a New Jersey state court, alleges 32-year-old Sarah Fuller was the victim of a nationwide push by Insys Therapeutics to entice doctors to prescribe its Subsys fentanyl spray for patients for which the drug was not suitable. (Armstrong, 3/24)

Columbus Dispatch: More Ohio Newborns Suffer From Mother’s Addiction
The number of Ohio babies who come into the world sick and craving drugs continues to soar. New state reports show that the rate of neonatal abstinence syndrome — the medical term for withdrawal symptoms suffered by newborns — jumped to 159 per 10,000 live births in 2015. That's more than eight times the rate a decade earlier, in 2005, when there were just 19 such hospitalizations for every 10,000 live births. (Price, 3/27)

The Hill: 'Deaths Of Despair' On The Rise Among Blue-Collar Whites 
A decades-long trend of economic stagnation and social immobility may be to blame for a shocking increase in death rates among middle-aged white Americans, a new study finds, as the number of deaths caused by drugs, alcohol abuse and suicide reaches levels not seen in generations. For nearly a century, advances in medical technology and healthy living have sent mortality rates of all Americans plummeting. But in recent years, a stark divide has emerged along educational and racial lines: as death rates plunge for minorities and well-educated whites, the number of whites without a college education dying in middle age is skyrocketing. (Wilson, 3/25)


Iowa Officials Secretly Agree To Help Medicaid Managed Care Companies Cover Some Losses

The three companies that won contracts to manage the state's Medicaid program have been seeking government help on their $450 million in losses. State officials agreed to contract changes that will cost about $10 million in February but the information was only released Friday in response to a Des Moines Register open-records request. In other Medicaid news, South Carolina nursing homes accept a state offer to settle a dispute, and New Hampshire officials ponder how to improve their funding formula.

Des Moines Register: State Agrees To Help Medicaid Companies Shoulder Huge Losses
State leaders have agreed to help private Medicaid management companies shoulder huge losses they’ve suffered in covering more than 500,000 poor or disabled Iowans, documents released Friday show. The three national companies have complained about “catastrophic” losses on the Iowa project, which started last April. They have pleaded for the government to help them make up for about $450 million in red ink. ... The documents were released Friday afternoon in response to a Des Moines Register open-records request made Jan. 12. (Leys, 3/24)

The (Columbia, S.C.) State/Independent Mail: State To Pay $12 Million To Nursing Homes For Medicaid Delays
Two dozen Upstate nursing homes have agreed to accept a total of $1.8 million to settle a dispute with state officials over delays in processing Medicaid applications. The payments are part of the $12 million that the South Carolina Department of Health and Human Services offered to pay 148 nursing homes throughout the state last month to avoid litigation. As of Friday, 138 nursing homes had agreed to the proposed settlement, said Colleen Mullis, the department’s deputy communications director. (Brown, 3/26)

Concord (N.H.) Monitor: New Hampshire Medicaid Match Among Nation’s Lowest
Now that the Republican effort to repeal the Affordable Care Act is off the table, New Hampshire and other states will get to keep their expanded Medicaid programs – at least for now. Even though that outcome is being welcomed by health care providers, the fact remains that New Hampshire’s current Medicaid reimbursement rates are some of the worst in the nation. The Granite State is among the states who receive a 50 percent Medicaid match from the federal Centers for Medicare and Medicaid – the lowest rate available for hospitals and other health care organizations. (Nilsen, 3/25)

State Watch

State Highlights: Incidents Call Into Question Mass. Mental Health Care System; Texas 'Granny Tax' Sparks Nursing Homes Debate

Media outlets report on news from Massachusetts, Texas, Kansas, Connecticut, Washington, Tennessee, California and Wisconsin.

Boston Globe: In Massachusetts’ Failing Mental Health Care System, Even The Lucky Ones Aren’t So Lucky
James Boyd Jr.’s death is one of seven recent incidents involving Department of Mental Health clients that illuminate a growing concern inside the state agency: that the department is releasing a steady stream of people with serious mental illness to live in the community without proper supervision. While thousands with serious mental illness struggle to get any help, the roughly 21,000 Department of Mental Health clients are promised treatment at state-run facilities and state-funded programs in the community that are operated by private vendors... But the string of incidents raises questions about whether the department is doing enough to ensure the safety of its clients and the public. (Helman and Russell, 3/25)

San Antonio Press-Express: Nursing Homes Joust Over Fee Proposal: ‘Granny Tax’ Or Funding Lifeline? 
Nursing homes that are stretched thin as they care for Medicaid residents are asking lawmakers to approve a fee on their facilities that would allow Texas to get hundreds of millions of matching federal dollars to boost their low reimbursements. But the idea has generated a backlash from nursing homes that serve private-pay patients and object to paying the proposed assessment, which they call a “granny tax.” Their private-pay patients are outside of Medicaid, and the homes aren’t confident of promises that they’ll be otherwise repaid for their share of the fees that would trigger more Medicaid dollars. (Fikac, 3/25)

KCUR: Kansas Mental Health Centers Seek Exemption From Gun Law 
Unless the Legislature makes a change, community mental health centers across Kansas will have to allow patients and staff to bring their guns starting in July. A 2013 state law requires most publicly owned buildings to allow concealed weapons or to install metal detectors and post armed guards. The law included a four-year exemption for community mental health centers, universities, publicly owned medical facilities, nursing homes and low-income health clinics that ends July 1. (Wingerter, 3/24)

The CT Mirror: Anthem’s Cost Savings At Center Of Merger Suit Appeal Argument
Anthem and the Justice Department faced off in court Friday over the insurer’s proposed merger with Cigna, with the legal wrangling centered on whether any savings from the deal would justify shrinking the market for large employer insurance policies from four to three carriers. A federal district court in February sided with the Justice Department – and 11 states including Connecticut – in blocking the $54 billion merger. (Radelat, 3/24)

Seattle Times: Nurses Gain Traction In Legislature On Bills To Address ‘Dangerous’ Staffing 
For years, nurses have gone to Olympia, imploring lawmakers to understand that staffing problems were placing patient care at risk. There are constant staff shortages that force nurses to forgo meals and bathroom breaks in order to properly care for patients. There are the 12-hour nursing shifts that grow longer due to scheduling issues. There are nurse-to-patient ratios that seem to grow more dangerous. Nurses returned to Olympia this week to reiterate those messages to the Legislature yet again. But this time they have more optimism that lawmakers are listening. (Baker, 3/26)

Boston Globe: New State Rules For Long-Term Care Insurance Forgo Limits On Rate Hikes 
After five years of fits and starts, Massachusetts regulators are close to adopting rules that would increase oversight of long-term care insurance, a market that has been roiled by skyrocketing premiums for consumers and declining profits for insurance companies. But some consumers and advocates argue that the proposals would not do enough to protect policyholders from the escalating costs of long-term care insurance, which helps pay for nursing homes, home health services, and assisted living. (Fernandes, 3/26)

Nashville Tennessean: Can Nashville Find Cure For Price Blindness In Health Care?
“Price blindness,” or a lack of price transparency, affects healthcare consumers across the U.S. Pricing is so opaque that even many doctors and hospitals can’t estimate what a service might cost, leaving patients no options to compare or price-shop. This problem is unique to healthcare — can you imagine driving a car off the dealer’s lot and getting a bill in the mail later? Would you buy a television at Best Buy without a quick Amazon search? Most of us would not, but until recently, there just wasn’t a way for consumers to easily compare costs in healthcare. But Nashville companies like Healthcare Bluebook and MD Save are trying to change that, especially as consumers pick up more of the costs of their care. (Tolbert, 3/26)

Los Angeles Times: L.A. Officials Push For New Steps To Address Health Risks From Homebuilding Near Freeways
In a new push to address health risks from a surge in residential construction near freeways, Los Angeles officials have requested a study of development restrictions, design standards and other steps to protect residents from traffic pollution. Planning, transportation and other officials should prepare “strategies to address the hazard of freeway pollution affecting residents of new and existing structures,” according to a motion filed this week by councilmen Jose Huizar and Paul Koretz. These could include buffer zones and barriers, air filtration requirements and regulations on building design. (Barboza and Zahniser, 3/24)

Milwaukee Journal Sentinel: State Nearly Returned Suspended Psychologist To Wisconsin's Youth Prison
State officials last year were on the verge of returning a suspended psychologist to his job at Wisconsin’s troubled juvenile prison, but backed off after a prosecutor said he could be charged with falsifying records, state records show. After learning of possible charges, the Department of Corrections kept psychologist Wilson Fowle on paid leave and began its own investigation. Six weeks later, Fowle retired and by the end of 2016 agreed to surrender his psychology license. (Marley, 3/24)

Boston Globe: Dozens Of Industries Could See A Boost From Legalized Marijuana 
A Swiss company that for years has provided Massachusetts with cigarette tax stamp services — helping the state thwart the black market — has its eyes set on what could be a much bigger public contract: tracking legal marijuana from seed to sale to keep it from being diverted to criminal enterprises... Such product tracing is one of dozens of industries that could see a big boom in business when recreational marijuana shops, growhouses, testing facilities, and infused-product manufacturers (think candy and brownies) open in Massachusetts, probably next year. (Miller, 3/27)

Editorials And Opinions

Perspectives From Monday Morning Quarterbacks: How The Health Bill Unraveled

Opinion writers analyze what happened last week in Congress when the House GOP's health law replacement plan came undone.

The Wall Street Journal: The ObamaCare Republicans
House Republicans pulled their health-care bill shortly before a vote on Friday, and for once the media dirge is right about a GOP defeat. This is a major blow to the Trump Presidency, the GOP majority in Congress, and especially to the cause of reforming and limiting government. (3/24)

The Wall Street Journal: High Anxiety Over Health-Care Reform
What politicians, those hardy folk, don’t understand about health care is how anxious it makes their constituents. Not suspicious, not obstinate, but anxious. Because unlike such policy questions as tax reform, health care can be an immediate life-or-death issue for you. It has to do with whether, when, and where you can get the chemo if you’re sick, and how long they’ll let you stay in the hospital when you have nobody, or nobody reliable and nearby, to care for you. To make it worse, the issue is all hopelessly complicated and complex and pits you as an individual against huge institutions—the insurance company that doesn’t answer the phone, the hospital that says “I’m afraid that’s not covered”—and you have to make the right decisions. (Peggy Noonan, 3/24)

The Washington Post: The Lessons Trump And Ryan Failed To Learn From History
If President Trump and House Speaker Paul D. Ryan (R-Wis.) had paid attention to Mitt Romney, they could have avoided the fiasco of their now dead and unmourned health-care bill. They would not now face a situation in which both of them are being blamed because they both deserve to be. And the Republican Party would not be engulfed in a festival of recriminations. (E.J. Dionne Jr., 3/26)

The New York Times: The G.O.P.’s Existential Crisis
Give Donald Trump this: His travel ban enraged only half the country. The House Republicans’ attempt to replace the Affordable Care Act, meanwhile, has alienated everyone, including members of the Republican Party itself. The bill was supposed to go to a vote on Friday, but the leadership, facing a likely defeat, was forced to pull it when it became clear it didn’t have the necessary support. It was perhaps better off dead: Already a rushed, Rube Goldberg solution in search of a problem, by the time it neared the House floor it had so many compromises woven into it to win votes that, even if it passed, it would have probably gone down in defeat in the Senate. (Corey Robin, 3/24)

The Washington Post: Republicans’ Dangerous Health-Care Delusions
The jaw-dropping spectacle in which their party holds the White House and majorities in both houses of Congress and yet failed on its first, and arguably most significant, agenda item should disabuse Republicans of a number their deeply held, inaccurate beliefs. (Jennifer Rubin, 3/26)

USA Today: Colossal GOP Failure And Not Just On Health
The plan to replace Obamacare with a new bill crafted by House Speaker Paul Ryan has failed, and embarrassingly so. And that failure is part and parcel of a larger failure of the Republican-led Congress to push an agenda in the new administration. (Glenn Harlan Reynolds, 3/26)

Bloomberg: A Republican Fiasco Years In The Making
We should pause and realize what a big deal this is. The number one agenda item for years, the one that most House Republicans campaigned on when first elected, and they couldn't manage to even get an initial bill out of the House. Not only that, but it was clear this week that even though most of them were willing to vote for it, practically no one was enthusiastic about what they had produced. It also polled terribly, and conservative health care wonks hated the bill. (Jonathan Bernstein, 3/24)

Los Angeles Times: Trump Discovers That Legislating Is Complicated As The GOP Healthcare Bill Goes Down In Flames
Having recently learned that healthcare is complicated, President Trump has now discovered that legislating is complicated too. Trump's attempt to force a half-baked bill to "repeal and replace" Obamacare down the throats of reluctant House Republicans failed, as House leaders were simply unable to satisfy the conflicting demands from the two wings of their party. In the end, it wasn't a case of savvy dealmakers coming up with an offer that buyers couldn't refuse; it was a case of buyers looking at the offer and saying, “No thanks.” (3/24)

Los Angeles Times: Boy, These Washington Big Shots Ate Well While Their Healthcare Bill Was Blowing Up
One can always count on this feature in the aftermath of any great event that has taken place behind closed doors: the journalistic “inside story.” It’s known in the trade as a “tick-tock.” And the implosion of the House Republicans’ Obamacare repeal bill has thrown off its fair share of examples, notably in the New York Times, Politico, the Washington Post and at CNN. They’re full of scenes of heightened drama from the last week, all described in cinematic detail, replete with the interior monologues of participants at the White House, the Capitol and other locations around town. (Michael Hiltzik, 3/26)

State Reviews Of The GOP's Health Plan Implosion

Editorial pages examine who dodged the bullets in their states and detail what went wrong with the American Health Care Act.

Kansas City Star: Americans Want Health Care That Works For All 
I continue to believe that most Americans think everyone should have health care. And while the current law is far from perfect and would benefit from some bipartisan improvements, it is by any measure — coverage, cost, continuity of care — vastly superior to the law Republicans proposed and then couldn’t pass last week. (Kathleen Sebelius, 3/25)

Cleveland Plain Dealer: Collapse Of Trumpcare A Victory For Republicans Who Pushed Back To Protect States Like Ohio
The dramatic collapse today of efforts by House Speaker Paul Ryan and President Donald Trump to force House Republicans to pass Ryan's jury-rigged repeal of Obamacare was a victory not just for common sense but also for those Republicans who stood up to Trump. Among them: Sen. Rob Portman of Ohio, who, along with several other Republican senators, sent a letter to Majority Leader Mitch McConnell earlier this month outlining the plan's likely harm to the millions of Americans covered by Medicaid expansion, in Ohio and other states -- and to the states themselves. (3/24)

Miami Herald: Healthcare Bill, And GOP, Fail Miserably
But, and pardon the tortured mix of metaphor, Republicans had the ball in their court, for seven years now, and fumbled it — most spectacularly on Friday. That’s when their controversial bill to replace the Affordable Care Act, failed to win the necessary 216 votes to pass. House Speaker Paul Ryan recommended pulling it. President Trump, the biggest loser, agreed. The bill, a cornerstone of Trump’s campaign and that of scores of new Republican lawmakers, went down. Obamacare rules — until Republicans get serious. That’s great news for millions of Americans, and Floridians especially. The bill would have left almost 2 million state residents without health insurance and forced many others to pay thousands more for coverage. Republican Rep. Ileana Ros-Lehtinen told her local constituents she would vote No, while her more cowed Miami colleagues kept mumbling about having to study the situation. (3/25)

The Kansas City Star: Congratulations, Republicans. This Health Care Defeat Is Really A Win.
Cheer up, Republicans. Sometimes, what looks and feels like a loss is really a win. Usually it takes a while for the all-for-the-best benefits of a short-term defeat to sink in. But the health care bill that the Republicans pulled at the last minute on Friday would have quickly made the GOP nostalgic for the days when they could take bows for show votes repealing the Affordable Care Act for the umpteenth time. Had the bill passed, Republicans would have lost both politically and in human terms as the bill devastated many of the very voters who believed President Donald Trump’s campaign promise that “everybody’s going to be taken care of much better than they’re taken care of now.” (3/24)

Chicago Tribune: Why Health Care Can't Be Fixed
Bill Clinton tried to fix America's health care problems and was shot down by Congress. Barack Obama got his solution enacted only to find most people didn't like it. Republicans who voted repeatedly to repeal Obamacare and replace it with something far better have found it fiendishly hard to agree on how. (Steve Chapman, 3/24)

What Happens Next?: How To Move Forward On Fixing The Nation's Health Care

Opinion writers speculate on what will happen now for the future of Obamacare.

The New York Times: How To Build On Obamacare
“Nobody knew that health care could be so complicated.” So declared Donald Trump three weeks before wimping out on his promise to repeal Obamacare. Up next: “Nobody knew that tax reform could be so complicated.” Then, perhaps: “Nobody knew that international trade policy could be so complicated.” And so on. (Paul Krugman, 3/27)

USA Today: Here's The Bipartisan Path Forward On Health Care: Andy Slavitt
The failure of Trumpcare last week can be seen as a rejection of policies that Americans judged would move the country backwards. But it also presents the opportunity to end the divisiveness that hampered the Obamacare era and move forward in a bipartisan direction that focuses not on destructive rhetoric, but squarely on reducing premiums and expanding access for all Americans. (Andy Slavitt, 3/26)

USA Today: Trump's New Health Care Opportunity: Our View
President Trump says he has a new strategy to address problems with the Affordable Care Act. He is going to wait "to let Obamacare explode" and then wait some more to let the Democrats "come to us" so we can "make one beautiful deal for the people." (3/26)

Chicago Tribune: Moving On: Who'll Fix Obamacare Now?
This week in Washington, a staggered president and his party dig out from the rubble of their failed Obamacare replacement effort. As House Speaker Paul Ryan says, there's no sugarcoating this. The politics of the Republicans' failure to pass, or even vote on, the American Health Care Act was ugly. House conservatives in the Freedom Caucus sought a full repeal without an effective replacement, guaranteeing the smoldering political debris in Washington. Why be greedy? Millions of Americans gained coverage via Obamacare. You can't replace something, no matter how gravely flawed, with nothing. (3/26)

USA Today: The Health Care War Is Far From Over
After eight years of fear-mongering and spreading outright lies about the Affordable Care Act, Republicans finally got the chance to step to the plate and give it their best swing. And they whiffed. Hard. (Neera Tanden, 3/27)

Taking Stock: After The Smoke Clears, The Health Insurance Issues Remain

Premium costs, essential benefits, Medicaid expansion and the fact that the health industry has a huge impact on the financial markets are among the thoughts on which opinion writers continue to focus.

Bloomberg: Market Impact Of Republicans’ Insurance Debacle Far From Clear
Having stiff-armed political risk for quite a while, market participants now have to think a lot more about the issue in general -- and specifically, about how much the Trump administration’s legislative agenda will suffer on account of Republicans’ last-minute decision on Friday to pull their health-care bill from an imminent vote on the floor of the House of Representatives. Some may be inclined to predict other failures that would impact forthcoming economic bills, given the erosion of Republicans’ political capital and the Washington blame game that’s sure to play out. But the situation on the ground is a lot more complicated than that. (Mohamed A. El-Erian, 3/24)

RealClear Health: The Root Cause Of Health Care Dysfunction
Before the Affordable Care Act (ACA) passed in March 2010, President Obama repeatedly promised that the typical family’s health premiums would go down by (sometimes “up to” but frequently “on average”) $2,500. That decline did not occur because the ACA strengthened the control that insurance companies—as opposed to patients—have over health care spending. In fact, Americans’ increasing dependence on health insurance over the last seven decades has been a major contributor to exploding health costs. (John R. Graham, 3/27)

Modern Healthcare: Some Insurance Benefits Are Essential
The House of Representatives last week postponed voting to gut Obamacare after new provisions weakening the essential benefits guarantee failed to win the support from right-wing Republicans, who are opposed to any form of subsidized health insurance. Suffice it to say that the last-minute maneuvering clarified how far the modern Republican Party is willing to go in undermining health insurance, and the healthcare system along with it. (Merrill Goozner, 3/25)

Forbes: More States To Expand Medicaid Now That Obamacare Remains Law
More states will pursue expansion of Medicaid health benefits for poor Americans under the Affordable Care Act after Republicans failed to repeal and replace the law. ... At least two states – Kansas and North Carolina – are already working toward becoming the 32nd and 33rd states to expand Medicaid under the ACA. (Bruce Japsen, 3/26)

Viewpoints: When Insurers Reject 'Unproven Therapies'; Can Trump Help Americans Who Are Dying 'Deaths Of Despair'

A collection of opinions on health care from around the country.

Arizona Republic: Sarah Wants Her Life Back (UnitedHealthcare Refuses To Give It To Her)
Isn’t it nice that the insurance company is looking out for Sarah, preventing her from having to endure “unproven therapies,” regardless of what her doctor has witnessed with other patients over and over and, well, over again? I’m quite sure UnitedHealthcare’s denial is for Sarah's own good. Quite sure it has nothing to do with the cost of IVIG: about $32,000 a month. Or the fact that she’d need it for up to a year. (Laurie Roberts, 3/26)

The Washington Post: Americans Are Dying ‘Deaths Of Despair.’ Will Trump Help? 
It is a political cliche that President Trump owes his electoral victory to the extraordinary support he received from white voters without a college degree, two-thirds of whom voted for the Republican. Much less settled is the question of why these largely low-income voters, once reliable Democrats, cast their lot with a brash billionaire from New York. (3/25)

The Washington Post: More Lies On Planned Parenthood
Not "even a scintilla of evidence.” That was the judgment of a federal judge last month in Texas about allegations of wrongdoing by Planned Parenthood. He was not alone in finding that the health-care organization did not illegally profit from fetal-tissue donation: Three Republican-led congressional investigations, 13 states and a Texas grand jury all could find no substance to claims about the alleged sale of “baby body parts,” which gained currency through videos released by anti-abortion activists. (3/26)

The Wall Street Journal: High-Tech Help For The Freelance Physician
From Amazon to eBay and Uber to Airbnb, digital technology has revolutionized everyday life. But when you get sick, you might as well take a time machine back a few decades. You phone your doctor’s office to make an appointment. You sit in a waiting room stocked with old magazines. The physician writes down notes about your symptoms and stores them in paper files. When you’re done, a receptionist hands you a little card with the date and time of your next visit. (Allysia Finley, 3/24)

Louisville Courier-Journal: 'Tired Of Burying My Friends'
I am a full-time student with a part-time job. I went to decent schools and stayed away from the neighborhoods my parents warned me about. I am not an anomaly, and neither is gun violence. I apologize if I seem insensitive towards the individual’s right to own a gun, but it is time we take a critical look at our society’s priorities. What good is a world full of guns if we must fill our days with this pain? How many of our children are we willing to lose to maintain our sense of entitlement? (Tara Ann Steiden, 3/23)

The New York Times: To Win Again, Democrats Must Stop Being The Abortion Party
But once-solid Catholic support for Democrats has steadily eroded. This was due at least in part to the shift by many American Catholic bishops from emphasizing social issues (peace, the economy) to engaging in the culture wars (abortion, gay marriage). Along the way, many Catholics came to view the Democrats as unconditionally supporting abortion. Last year’s election was a watershed in this evolution. Hillary Clinton lost the overall Catholic vote by seven points — after President Obama had won it in the previous two elections. She lost the white Catholic vote by 23 points. In heavily Catholic states like Pennsylvania, Wisconsin and Michigan, she lost by a hair — the last by less than 1 percent. A handful more of Catholic votes per parish in those states would have won her the election. (Thomas Groome, 3/27)