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Here's today's health policy haiku:

THE IMPACT OF THE GOP HEALTH REPLACEMENT PLAN? A SPIKE IN UNINSURED RATES

Who is keeping track?
The CBO. … What they found
Is not so rosy.

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Summaries Of The News:

Health Law

CBO: 18M Could Lose Insurance, Premiums Would Spike If Health Law Is Gutted

The House speaker's office called the report "meaningless," but Democrats seized on the dire numbers to drive home their messaging on saving the health law.

The New York Times: Health Law Repeal Could Cost 18 Million Their Insurance, Study Finds
Eighteen million people could lose their insurance within a year and individual insurance premiums would shoot upward if Congress repealed major provisions of the Affordable Care Act while leaving other parts in place, the nonpartisan Congressional Budget Office said on Tuesday. A report by the office sharply increases pressure on Republicans to come up with a comprehensive plan to replace the health care law. (Pear, 1/17)

Los Angeles Times: Repealing Obamacare Without Replacement Would Hike Premiums 20% And Leave 18 Million Uninsured, Report Says
In the first year, insurance premiums would jump by 20% to 25% for individual policies purchased directly or through the Obamacare marketplace, according to the report. The number of people who are uninsured would increase by 18 million. Those numbers would only increase in subsequent years. Premium prices would continue to climb by 50% the next year, with the uninsured swelling to 27 million, as full repeal took effect, the report said. (Mascaro, 1/17)

The Washington Post: Pressure Mounts On GOP For Post-Obamacare Plan Following CBO Report
Democrats seized on the report, issued Tuesday by the nonpartisan Congressional Budget Office, to discredit Republican efforts to repeal Obamacare and rally Americans who are insured under the program. The report underscored the political peril that Trump faces in trying to meet one of his top campaign promises — and also the discord among Republicans about how to do it. (Eilperin, Sullivan and Goldstein, 1/17)

USA Today: Congress' Budget Office: 18M Lose Coverage If No Obamacare Replacement
Some of the CBO's previous reports on the ACA have been controversial for how far off they were in their projections of ACA enrollment. But it isn't because of any liberal bias. The office is now headed by Keith Hall, a conservative former economist in the George W. Bush administration who also worked at the free market Mercatus Center at George Mason University.Chris Jacobs, a former Republican congressional policy aide, said in a blog post Tuesday, that CBO's earlier miscalculations undercut its new message. (O'Donnell, 1/17)

CQ Roll Call: CBO: 32 Million Would Lose Coverage Under Prior GOP Repeal Bill
“[It’s] crystal clear that the Republican effort to repeal the Affordable Care Act will increase health care costs for millions of Americans and kick millions more off of their health insurance. The numbers are even worse than experts could have imagined: tens of millions will lose their health insurance, and individuals will see their premiums double,” Senate Minority Leader Charles E. Schumer of New York, one of the lawmakers that requested the report, said in a statement about CBO’s findings. (Williams, 1/17)

Roll Call: Democrats Use CBO Report to Message Against Obamacare Repeal
House Minority Leader Nancy Pelosi said the CBO report describes a “nightmare” scenario under which “health care costs will explode, Americans in the individual market will see their premiums double by 2026, and the number of uninsured Americans will surge by 18 million in the first year alone and by 32 million by 2026.” The California Democrat added: “Republicans need to wake up to the brutal impact that repealing the ACA will have on the lives of their constituents.” Members of her team and other Democrats picked up on the theme as well. (McPherson, 1/17)

Atlanta Journal-Constitution: CBO Report On Obamacare Repeal Stirs Health Care Battle In Congress 
“This projection is meaningless,” said Ashlee Strong, a spokesperson for Speaker Paul Ryan, as she argued the CBO report “takes into account no measures to replace the law nor actions that the incoming administration will take to revitalize the individual market that has been decimated by Obamacare.” “CBO misses the point,” said House Majority Whip Steve Scalise (R-LA). “Obamacare will be replaced with lower costs and more choices.” (Dupree, 1/17)

Bloomberg: Obamacare Repeal Would Leave 32 Million Uninsured, Report Finds 
Under Obamacare, the uninsured rate fell to 8.9 percent in the first half of 2016, down from 16 percent in 2010 after 20 million people gained coverage. With three days to go until President-elect Donald Trump’s inauguration, the report offers a look at a possible post-repeal landscape. Trump has expressed support for "essentially simultaneously" repealing and replacing Obamacare, and said his own plan is almost complete. But House Speaker Paul Ryan said Friday that passing a new law would be a "thoughtful, step-by-step process." (Greifeld, 1/17)

The Fiscal Times: The Potential Cost Of Obamacare Repeal: 32 Million Without Insurance 
Trump and the Republicans have promised a plan that will not only cover as many Americans as the ACA, but will provide even better care at lower costs, while providing wider choice. However, all of the plans put forward so far have been outlines at best, in which hand-waving about the power of market forces does virtually all of the heavy economic lifting. (Garver, 1/17)

Health Law Has Never Been More Popular -- Just As GOP Is Poised To Dismantle It

The poll started asking about Obamacare in April 2009, and this month marks both the highest percentage of respondents who signaled their approval for the law and the first time that more people surveyed said they like it than dislike it.

The Wall Street Journal: More In U.S. Like ‘Obamacare,’ As Ax Hovers Over It: Poll
Americans are starting to warm up to the Affordable Care Act amid concerns about Republicans’ efforts to dismantle it, a new Wall Street Journal/NBC News poll finds. A new Wall Street Journal/NBC News poll finds that 45% of Americans think the 2012 health law is a “good idea,’’ the highest mark since pollsters began asking about President Barack Obama’s vision for a health overhaul in April, 2009. (Radnofsky, 1/17)

Politico: Poll: Obamacare At Its Most Popular On Eve Of Repeal
The NBC/WSJ poll found that 50 percent of respondents have “little to no confidence that Republican proposals to replace the law will make things better.” Congressional leaders had first advocated repealing the law immediately and leaving open a window before it would take effect so they can take more time to pass a replacement package. Trump and some others, though, have publicly pushed back on that plan. (Conway, 1/17)

Reuters: Quarter Of Republicans Would Keep Obamacare: Reuters/Ipsos Poll
About a quarter of U.S. Republicans do not want to see Obamacare repealed, according to a Reuters/Ipsos poll released on Tuesday. Trump and his fellow Republicans, who control Congress, have promised to repeal and replace the Affordable Care Act, known as Obamacare, but a majority of Americans, including 25 percent of Republicans polled, do not want it to be repealed. (1/17)

If You Like It, You Can Keep It: GOP Senator Proposes States Decide If They Want Health Law

Sen. Bill Cassidy, R-La., is championing a plan that allows states that like the health law to keep it if desired, while others can adopt something different. In other health law and repeal news, insurers push for Congress to rollback a particular tax, Health and Human Services Secretary Sylvia Mathews Burwell plans on signing up for Obamacare, 6 lesser-known provisions that are on the chopping block, why interstate health insurance sounds better than it is, and more.

Bloomberg: Republican Senator Would Let States Keep Obamacare If They Want
Republican Senator Bill Cassidy is making an offer to Democrats he hopes they won’t refuse: If their states like Obamacare, they can keep it. A doctor who worked for decades in charity hospitals and clinics before joining Congress, Cassidy plans to introduce soon an updated version of his health-care plan aimed at giving states flexibility to keep Obamacare, nix it entirely or transition to a new system of health savings accounts and automatic health plan enrollment. (Dennis, 1/17)

Politico: HHS Secretary Burwell Will Sign Up For Obamacare
HHS Secretary Sylvia Mathews Burwell will be signing up for Obamacare. Burwell, who has led implementation of the Affordable Care Act for more than two years, plans to sign up for coverage on D.C.’s health insurance exchange when her federal employee plan ends — even as Republicans wrestle with how to repeal the law. (Haberkorn, 1/17)

Stateline: Interstate Health Insurance: Sounds Good, But Details Are Tricky
President-elect Donald Trump has repeatedly pledged to allow health insurers to sell policies across state lines to spur competition and lower premiums. On his campaign website, Trump proclaimed that, “by allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.” He also touted the idea during the second presidential debate, and since the election, Vice President-elect Mike Pence has made the same argument. The implication is that federal law prevents insurers from selling policies across state lines. That isn’t the case. (Ollove, 1/18)

Sacramento Bee: Research Groups Tout Contrasting Proposals And Priorities For Obamacare 
Separate reports released Tuesday offered differing strategic advice and policy recommendations for lawmakers grappling with the repeal and replacement of the Affordable Care Act. A new report by The Committee for a Responsible Federal Budget says any repeal-and-replace legislation should embody three basic principles: Reduce the national debt, replace or strengthen the health care law’s cost-control measures, and maintain or improve Medicare solvency. A similar report by the Urban Institute urged lawmakers to address complaints and correct problems with the health law through legislative fixes rather than the disruptive process of repealing and replacing the law. (Pugh, 1/17)

Miami Herald: With Obamacare, She Can Run Her Own Business. Without It, She’ll Have To Close.
Healthy meals are the cornerstone of the small business that Gaby De Jesus of Miami founded in 2015 to help people struggling with weight gain and heart conditions. But affordable health insurance is the key to the company’s survival, she said Tuesday. Speaking at a press conference opposing repeal of the Affordable Care Act, De Jesus said she launched the private chef service and catering company, Fork & Knives, because the health law better known as Obamacare had given her the option of starting her own business rather than finding a job with health benefits. (Chang, 1/17)

Pioneer Press: Minnesotans Bracing For Health Care Spike Urge Lawmakers On Relief Deal
An estimated 120,000 Minnesotans are in a similar position to [Sheri] Sexton: facing premium increases of 50 percent or more but earning too much money to qualify for federal subsidies that can offset those hikes. Divisions over the best way to deliver relief continue to delay the final passage of that relief this week, the third of the 2017 session. Democrats and Republicans disagree about who should administer the 25 percent insurance discounts and whether that relief should be bundled with long-term reform. They’re facing a ticking clock. The open-enrollment period for the individual insurance market ends Jan. 31, so a relief package needs to become law before then for Minnesotans to take any discounts into account when choosing insurance. (Montgomery, 1/17)

Administration News

Price Hearing Expected To Be Turbulent As Nominee Faces Scrutiny Over Health Stocks

Democrats even tried to delay the "courtesy" hearing for Donald Trump's Health and Human Services nominee before the Senate Committee on Health, Education, Labor and Pensions.

NPR: Trump's HHS Nominee Faces His First Senate Grilling
On Wednesday, Rep. Tom Price, R-Ga., goes before the Senate Committee on Health, Education, Labor and Pensions in his first grilling since he was nominated to lead the Department of Health and Human Services. ... Here are five things to look out for. (Kodjak, 1/18)

The Associated Press: Pointed Questions Await Trump's Pick For Health Secretary
With coverage for millions of people at stake, Rep. Tom Price is facing pointed questions about President-elect Donald Trump's health policies — and his own investments in health care companies — from senators considering his selection as health secretary. While Price, an orthopedic surgeon-turned-lawmaker, is largely a known quantity on Capitol Hill, Trump's bottom line on health care remains a mystery for Democrats and Republicans alike. (Alonso-Zaldivar, 1/18)

The Washington Post: Facing The Senate, HHS Nominee Price Will Defend GOP’s Health Care Overhaul
The courtesy hearing before the Senate Health, Education, Labor and Pensions (HELP) Committee will mark the first time Price has appeared before lawmakers since being nominated; his formal confirmation hearing, before the Senate Finance Committee, is set for Jan. 24. This first encounter will both give the six-term congressman his first opportunity to make a public case for his selection, while allowing Democrats to argue why the incoming administration should preserve — not jettison — the Affordable Care Act. (Eilperin and Goldstein, 1/18)

The Wall Street Journal: Health Secretary Pick Tom Price To Face Questions On Stock Trades, Obamacare Plans At Confirmation Hearing
A spokesman for Mr. Price has said he followed all relevant laws and rules, and the Trump transition team rejected the idea that any serious concerns surround Mr. Price.“The only pattern we see emerging is that Senate Democrats and their liberal media allies cannot abide the notion that Dr. Tom Price is uniquely qualified to lead HHS and will stop at nothing to smear his reputation,” Phillip Blando, a spokesman for the Trump transition team, said in a statement. (Armour, 1/18)

Stat: 6 Questions For Rep. Tom Price, Trump's Nominee To Lead HHS
Price is also appearing before lawmakers at a time of growing scrutiny over his investments in health care and tobacco companies. Last week, he pledged to divest his financial interests from 43 companies. But questions remain about whether Price, whose shares in Innate Immunotherapeutics boomed shortly after his purchase last fall, secured a deal that was not available to the general public. Here are some questions we would like to see answered. (Kaplan, 1/17)

CQ Roll Call: Democrats Unsuccessfully Seek Delay In HHS Hearing
Three Democratic senators on Tuesday asked to delay a hearing scheduled for Wednesday on Rep. Tom Price, President-elect Donald Trump's choice to lead the Department of Health and Human Services, until the lawmaker's trading of health stocks is investigated. However, the committee chairman said the hearing is still on. Price, a Georgia Republican, traded in dozens of medical stocks while serving on the House Ways and Means Committee's health subcommittee. He has also led GOP efforts to undo the 2010 health law (PL 111-148, PL 111-152) and to block or delay the Obama administration's efforts to test alternative Medicare payments for orthopedics and medicines. (Williams and Young, 1/17)

Politico Pro: Democrats Step Up Attacks On Price 
The author of the law that shed sunlight on Rep. Tom Price’s health care stock trades has been calling on the SEC to investigate — and more Democrats are following suit as Price faces his first confirmation hearing Wednesday. "It’s shameful," Rep. Louise Slaughter (D-N.Y.) on POLITICO's "Pulse Check" podcast said of the more than $300,000 in health care trades made by Donald Trump’s pick to run HHS. Slaughter authored the 2012 STOCK Act that requires lawmakers to disclose certain transactions — and which sparked a series of stories on Price’s investments. (Diamond, 1/18)

Los Angeles Times: Trump's Health Secretary Pick Fought To Limit Coverage In One Of America's Neediest States
From the packed hallways of Atlanta’s massive county hospital to the thousands of patients who line up around the state every year to get Obamacare, yawning gaps in Georgia’s overburdened healthcare system aren’t hard to find. “The need for care is just tremendous,” said Dr. Charles Moore, a Harvard-trained ear, nose and throat specialist who runs an Atlanta clinic for poor patients. Georgia has some of the worst health outcomes in the country, with high rates of untreated illness and death from preventable diseases. (Levey, 1/18)

The Wall Street Journal: Tom Price, Nominee For HHS Secretary And A Doctor, Is A Harbinger Of Health Care Under Donald Trump
Tom Price walked into an emergency room years ago when he was a practicing orthopedic surgeon to see a patient with a broken hip, a case one fellow doctor described as among the worst he’d ever seen. “What you have is really bad,” Mr. Price reportedly said, “but I can fix this.” Mr. Price, President-elect Donald Trump’s nominee to run the Department of Health and Human Services, did fix the patient’s hip, according to the story, which was relayed by a longtime friend. But the U.S. representative from Georgia is now taking on a far bigger repair job, hoping to remedy a health-care system he believes is badly broken. Critics fear he will only make it worse. (Armour, 1/17)

The Associated Press: In Price's Ga. District, What Happens After Health Repeal
Carla Dent is a restaurant owner who steers her employees to federal health insurance exchanges. Eden Purdy helps poor and working-class Georgians navigate the health care marketplace. Bryson Boech is a grocery cashier recently diagnosed with multiple sclerosis, what the insurance industry calls a pre-existing condition. None of the three claims to be intensely political, but all say they are concerned their congressman, Tom Price, will rip up President Barack Obama's 2010 health care law if the Senate confirms the Georgia Republican to be Donald Trump's health secretary. (Barrow, 1/17)

Marketplace

After Pulling Back From ACA Marketplace, UnitedHealth Posts Big Q4 Profits

UnitedHealth Chief Executive Stephen J. Hemsley on a call with analysts spoke approvingly of some mainstay ideas Republicans have had for reshaping the health care coverage landscape.

The Wall Street Journal: UnitedHealth’s Revenue, Profit Tops Forecasts
UnitedHealth Group Inc. reported a 56% increase in profit in the latest quarter, with results fueled by growth in its core insurance unit and its Optum health-services arm, as well as reduced impact from its money-losing Affordable Care Act business. The Minnetonka, Minn., company reported net income of $1.90 billion, or $1.96 a share, compared with $1.22 billion, or $1.26, in the year-ago quarter. (Wilde Mathews and Jamerson, 1/17)

The Associated Press: UnitedHealth Looks Beyond Insurance To Help Fuel 4Q Growth
The nation's biggest health insurer made most of its money in the fourth quarter by selling things other than health insurance. UnitedHealth Group's Optum division, which manages prescription drug plans, runs doctor practices and analyzes health care data, generated slightly more of a profit than the company's traditional business of selling insurance. (Murphy, 1/17)

In other health industry news —

The Wall Street Journal: Second Theranos Lab Failed U.S. Inspection
Theranos Inc. failed a second major U.S. regulatory inspection of its laboratory facilities, people familiar with the situation said, a setback the Silicon Valley blood-testing firm hasn’t disclosed to investors or patients.The failed regulatory inspection—at its one active lab at the time—has put the company at risk of a new round of sanctions, these people said. (Weaver and Carreyrou, 1/17)

Women’s Health

U.S. Abortion Rate Drops To Lowest Since Roe V. Wade

The researchers credit improved access to contraception and an increase in state regulations on the procedure.

The Associated Press: New Report: Abortions In US Drop To Lowest Level Since 1974
Even as the election outcome intensifies America's abortion debate, a comprehensive new survey finds the annual number of abortions in the U.S has dropped to well under 1 million, the lowest level since 1974. The report, which counted 926,200 abortions in 2014, was released Tuesday by the Guttmacher Institute, a research group which supports abortion rights. It is the only entity which strives to count all abortions in the U.S.; the latest federal survey by the Centers for Disease Control and Prevention lacks data from California, Maryland and New Hampshire. (1/17)

Los Angeles Times: Abortion Rate Declines To Historic Low, With Obamacare A Likely Contributor, Study Says
“We saw declines in abortion in almost every single state,” said Jenna Jerman, a public health researcher at the Guttmacher Institute, a reproductive rights think tank in New York, and a coauthor of the study, which was published Tuesday in the journal Perspectives on Sexual and Reproductive Health. Though the study did not look at the reasons for the decline, the authors and other experts suggested that improved access to contraception played the biggest role by preventing unintended pregnancies. (Agrawal, 1/17)

The Philadelphia Inquirer/Philly.com: Report: U.S. Abortion Rate Reaches Historic Low
The abortion rate has fallen to the lowest level ever recorded, even lower than before the Supreme Court's Roe v. Wade decision made abortion legal nationally in 1973, a new report finds. The analysis by the Guttmacher Institute, a research center that supports abortion rights, attributes the trend mostly to better access to contraception and fewer unintended pregnancies. About 62 percent of the decline in the number of abortions in recent years occurred in the 28 states that did not have new abortion restrictions. (McCullough, 1/17)

Cleveland Plain Dealer: Abortion In The United States At Historical Lows, Researchers Find
The number of abortions in the United States dipped below 1 million in 2013 and 2014, hitting its lowest mark in more than 40 years, a new report found. The report published Tuesday by the Guttmacher Institute, a think tank that does research and policy analysis on reproductive health, does not investigate the reason for the drop. But researchers surmise that better use of contraception led to fewer unwanted pregnancies and new state laws putting greater restrictions on abortion cut down on numbers. (Higgs, 1/17)

WBUR: U.S. Abortion Rate Falls To Lowest Level Since Roe V. Wade
The abortion rate in the United States fell to its lowest level since the historic Roe v. Wade Supreme Court decision legalized abortion nationwide, a new report finds. The report by the Guttmacher Institute, a research group that supports legalized abortion, puts the rate at 14.6 abortions per 1,000 women of childbearing age (ages 15-44) in 2014. That's the lowest recorded rate since the Roe decision in 1973. The abortion rate has been declining for decades — down from a peak of 29.3 in 1980 and 1981. (McCammon, 1/17)

Meanwhile, lawmakers in Iowa are mulling a bill that would let women sue doctors following an abortion —

With No Presidential Veto Protection, Planned Parenthood Braces For The Worst

Congress has long tried to defund the organization, and with control over both chambers and the White House, they might succeed. Meanwhile, The Washington Post fact checks Speaker Paul Ryan's claim that for every Planned Parenthood clinic there are 20 other centers to offer care for women, and hundreds rally in California to oppose threats to the organization.

The Washington Post: Planned Parenthood Could Be First Casualty Of Obamacare Repeal Efforts
A fierce battle over the future of reproductive rights is now underway in Washington as congressional Republicans made the first move last week to slash funding for Planned Parenthood. In starting to roll back the Affordable Care Act, the GOP is also planning to target the country’s largest women’s health-care provider. Planned Parenthood could lose millions in dollars of reimbursements from Medicaid and other funding as soon as this spring, if the repeal effort advances. (Snell, 1/18)

Sacramento Bee: Hundreds Rally To Support Planned Parenthood At California State Capitol 
Pink scarves, hats and boxing gloves symbolizing opposition to threats to defund Planned Parenthood were the fashion du jour Tuesday outside the state Capitol, where hundreds of people from around Northern California rallied to support the network of health clinics that treat many of the state’s low-income women. The midday mix of protest and party featuring pink-clad legislators and celebrities pushed back against federal threats to block Planned Parenthood from receiving Medicaid funding. Beneath the festivities in downtown Sacramento, however, roiled worry from patients about where they’ll find affordable health care if the clinics close their doors. (Caiola, 1/17)

San Jose Mercury News: Lena Dunham, Wilson Cruz To Speak At Planned Parenthood Rally
Actors Lena Dunham and Wilson Cruz on Tuesday decried congressional efforts to defund Planned Parenthood, saying it was an attack on women, the poor and others who rely on the clinics for basic health services and family planning... The “Pink Out” rally on the Capitol steps, just three days before Donald Trump takes office, drew hundreds of demonstrators and a dozen or more state lawmakers. Many of the politicians wore bright pink scarves — and some of them put on pink boxing gloves — to show their support. (Murphy, 1/17)

And out of Texas —

Reuters: Texas Planned Parenthood Asks Judge To Block Medicaid Funding Cut
The leaders of Texas Planned Parenthood asked a federal judge on Tuesday to block the state's bid to halt Medicaid funding for the healthcare group, which has long been targeted by Republicans for providing abortions. Planned Parenthood has said the threatened funding cut, by terminating Planned Parenthood's enrollment in the state-funded healthcare system for the poor, could affect nearly 11,000 patients across Texas. (1/17)

Texas Tribune: At Court, Planned Parenthood Argues Against Removal From Medicaid 
Lawyers for Planned Parenthood argued in federal court on Tuesday there could be devastating consequences for low-income Texas men and women if the reproductive health provider is kicked out of Medicaid. In the first day of a multi-day hearing in the U.S. District Court in Austin, Planned Parenthood lawyers and witnesses said in front of a packed courtroom that ending the organization’s reimbursements from the joint federal-state health insurance program for the poor and disabled could endanger access to family planning services for Texas’ most vulnerable populations. (Evans, 1/17)

Capitol Hill Watch

Senators Overseeing Health Policy Don't Share Trump's Concerns About Vaccinations

Stat finds that 18 of the 23 members of the Senate Health, Education, Labor and Pensions Committee have confidence in the country's system of immunizations. Also, Senate Majority Leader Mitch McConnell introduces a bill to extend health care benefits for retired coal miners.

Stat: Senators On Key Panel Reject Trump's Skepticism About Vaccines
Most members of a key Senate committee are rejecting President-elect Donald Trump’s skepticism about the safety of vaccines, which suggests Trump could face significant backlash in Congress if he seeks to advance the anti-vaccine movement from the Oval Office. In the week following Trump’s controversial meeting with vaccine skeptic Robert F. Kennedy Jr., STAT contacted all 23 members of the Senate Committee on Health, Education, Labor and Pensions and asked whether they shared Trump’s concerns about vaccine safety. ... Eighteen senators, including eight of the 12 Republicans in the committee’s majority, expressed confidence in the US vaccination system and recognized the health benefits of vaccination. (Facher and Scott, 1/18)

CQ Rollcall: McConnell Introduces His Own Solution For Miners' Health Care
Senate Majority Leader Mitch McConnell, R-Ky., introduced legislation Tuesday to permanently extend health care benefits for retired coal miners and their spouses, a measure that could help ensure coverage for some 16,000 people. The bill would also include a sense of the Senate provision that says Congress should work with the incoming Trump administration to dismantle environmental rules, which he says hurt the industry. The health care benefits were threatened by the exhaustion of the United Mine Workers Association 1993 Benefit Plan, which became underfunded as the fortunes of the mining industry declined in the face of competition from lower-cost natural gas and federal regulations that aimed to reduce emissions of climate-warming gases from power plants. (Dillon, 1/17)

Medicaid

Medicaid Sets Managed Care Rule Blocking Billions In Funding For Safety Net Providers

The payments are made to Medicaid managed care plans, which pass them on to doctors, hospitals and clinics that treat a disproportionate share of Medicaid or uninsured patients with complex or costly cases. Federal officials have said the payments are not actuarially sound. Also, Tennessee and North Carolina officials consider future Medicaid policies.

Modern Healthcare: Final Pass-Through Pay Rule Would Cost Hospitals More Than $3 Billion A Year 
Bucking outcry from providers, the CMS has finalized a rule related to pass-through payments in Medicaid managed care. The rule would block billions in supplemental funding to safety net providers. The rule applies to all states with Medicaid managed care plans and are used to entice providers to see Medicaid beneficiaries. The CMS doesn't have exact numbers of providers that would be affected but it's estimated to be thousands of hospitals, doctors and clinics. (Dickson, 1/17)

Nashville Tennessean: Bill Would Smooth Tennessee Pursuit For Medicaid Block Grant If D.C. Signals OK
A new bill in the state legislature would help pave the way for Tennessee to pursue a Medicaid block grant if the incoming federal administration moves in that direction. The bill, SB0118 filed by Sen. Richard Briggs, would allow the Division of Health Care Finance and Administration to expand TennCare to include people up to 138 percent of the federal poverty line if President-elect Donald Trump and the Republican-led Congress move toward fewer federal regulations and block grants for Medicaid. Under a block grant, the state would get some fixed level of funding to provide care for eligible Medicaid enrollees. (Fletcher, 1/17)

Winston-Salem (N.C.) Journal: Federal Judge Agrees To Hear Motions On Expanding N.C. Medicaid
A federal judge has agreed hear legal complaints surrounding Gov. Roy Cooper’s attempt to expand the state’s Medicaid program. Judge Louise Flanagan said late Monday she will review by teleconference Friday an injunction request by Republican legislative leaders and the motions to dissolve the request that were made Monday by federal and state health officials. (Craver, 1/17)

State Watch

State Highlights: Mass. Gov. Proposes Plan To Penalize Employers That Don’t Offer Insurance; Ga. Grapples With Nurse Shortage

Outlets report on health news from Massachusetts, Georgia, Maryland, Kansas, Washington, Pennsylvania, California, Texas, Florida, Minnesota and Iowa.

Boston Globe: Baker To Propose Assessment For Companies That Don’t Offer Employee Health Insurance 
Governor Charlie Baker, seeking to rein in the continued rise in medical spending, is proposing to penalize employers $2,000 per worker if they do not provide health insurance, and to also place new limits on hospital prices. Baker administration officials said Tuesday that they want to bring back a provision of Massachusetts’ landmark 2006 health care law that was later axed: requiring employers with more than 10 full-time workers to pay a penalty if they fail to offer “adequate” health insurance. (Dayal McCluskey, 1/17)

WBUR: Gov. Baker Plans Measures To Address Escalating MassHealth Costs 
Companies that do not offer their employees health insurance would pay a $2,000 annual assessment per full-time worker to the state under a plan Gov. Charlie Baker plans to offer later this month to blunt the impact of escalating, enrollment-driven costs in the state's Medicaid program, the State House News Service has learned. The proposal -- the bulk of which is expected to be filed within the governor's budget due on Jan 25. -- would also impose growth caps on the rates health providers can charge for medical services in an effort to control the cost of care in the commercial market and make it more affordable for employers. (Murphy, 1/17)

Georgia Health News: Georgia Has Too Few Nurses, And The Problem Could Get Much Worse
A shortage of nurses is gripping Georgia, and all hospitals are looking for RNs, she says. One key factor fueling Georgia’s nursing shortage, Fort adds, is that the state’s population “is growing fairly rapidly, and our elderly population is growing fairly rapidly.” Hospital systems across Georgia confirm to GHN that there’s a shortage of RNs in the state. (Miller, 1/17)

The Baltimore Sun: Patients Ending Up With Large Bills For Out-Of-Network Doctors They Did Not Select 
Privately insured Maryland patients typically pay several times more for out-of-network medical services and procedures than what Medicare pays for the same services, according to new research from John Hopkins. They face unexpectedly large bills after doctors who were not part of their insurance companies' network of approved providers are assigned to treat them at hospitals. (McDaniels, 1/17)

The Baltimore Sun: Nation's Drug Czar Highlights Baltimore's Efforts At Curbing Drug Addiction 
Just days from the end of his tenure as the nation's drug czar, Michael Botticelli visited Baltimore's health department on Tuesday to highlight the efforts of local officials to combat the nation's opioid epidemic and warn against a scaling back of health insurance coverage for addiction treatment. Millions of people have gained access to addiction treatment through insurance provided under the federal Affordable Care Act, he said. That's now under threat from the GOP-led Congress and the incoming administration of Donald Trump, which have pledged to repeal the law known as Obamacare. (Cohn, 1/17)

KCUR: Appeals Court Cuts Award To Health Care Foundation From $434M To $188M
An appeals court has cut by more than half the $434 million in damages awarded to the Health Care Foundation of Greater Kansas City in its breach-of-contract lawsuit against hospital giant HCA. In a long-anticipated decision, the Missouri Court of Appeals in Kansas City on Tuesday reduced the judgment to $188 million, finding a capital expenditures commitment HCA made when it acquired the assets of Health Midwest 14 years ago was partly met by HCA’s construction of new hospitals in Independence and Lee’s Summit.  (Margolies, 1/17)

Seattle Times: State Senator Wants To Ban Safe-Injection Sites For Drug Users
A Republican state senator has introduced a bill that would ban safe-injection sites for heroin users in Washington state. The bill by Sen. Mark Miloscia, R-Federal Way, comes after a task force last year recommended two King County pilot sites for users to inject heroin under medical supervision. Supporters say the pilot sites could reduce overdose deaths, cut down on needles littering sidewalks and bring down the cost of emergency medical services used by addicts. (O'Sullivan, 1/17)

The Philadelphia Inquirer: South Jersey Woman Gets A Transplant After Craigslist Kidney Donation Is Canceled
A South Jersey woman who made national news by finding a kidney donor on Craigslist a year ago only to have the transplant fall through announced Tuesday that she had the life-saving procedure last month. Nina Saria, 34, a wife and mother from Egg Harbor City, was able to get a new kidney from her mother Nana Gulua, who lives in the Republic of Georgia. But Saria, who discussed her surgery Tuesday in the Barrington office of Sen. Bob Menendez (D., N.J.), said she might not have had the transplant if Menendez had not intervened with federal officials to grant her mother permission to travel to the United States. (Giordano, 1/17)

Los Angeles Times: Gardens Regional Hospital And Medical Center To Close After Failing To Find Buyer
A struggling Hawaiian Gardens hospital will close because it could not find a buyer willing to set aside a state-mandated level of funding for uninsured patients who can’t afford treatment. Gardens Regional Hospital and Medical Center found an interested buyer in a bankruptcy auction in July, according to court documents, but the state attorney general’s office said in November that it would approve the $19.5-million sale to Strategic Global Management Inc. only if, among other things, the new operator agreed to provide $2.25 million per year in charity care for six years. (Ehehad, 1/17)

Miami Herald: Florida Ranks In The Middle Of All States In The Financial Cost Of Smoking 
Tobacco use can be blamed for about 500,000 deaths in the U.S. each year and is the leading cause of lung cancer, according to the American Lung Association. It is also the leading cause of preventable death. Second-hand smoke can be harmful, too. Since 1964, smoking-related illnesses have killed 2.5 million non-smokers. What’s more, the dangerous habit is expensive. Americans spend more than $300 billion on tobacco–related services every year, including almost $170 billion in direct medical care and more than $156 billion in lost productivity. (Veciana-Suarez, 1/17)

The Star Tribune: Pioneering Spinal Surgery In The Womb Boosts Babies' Odds In Minneapolis 
A team of Minneapolis surgeons is helping to pioneer a bold advance in prenatal medicine — operating on fetuses with spinal deformities while they're still in the womb, then leaving them in place until they are ready to be born. Doctors with the Midwest Fetal Care Center, a collaboration between Children's Minnesota and Allina Health, have performed six open fetal surgeries, each one to halt the physical and cognitive degeneration caused by open spina bifida, an incomplete closing of the skin and backbone over the spinal cord. (Olson, 1/17)

Iowa Public Radio: A Program Designed To Stop The Bleed 
West Des Moines is becoming the first city in Iowa to sign on to the national program known as Stop the Bleed. The effort is meant to train citizens to become first responders in cases of mass injuries. The White House launched the project in partial response to the 2012 shootings at Sandy Hook Elementary School in Newtown, Conn. Stop the Bleed is designed to train and equip people to save lives in emergency situations involving serious bleeding.  (Dillard, 1/17)

Tampa Bay Times: State Begins Medical Marijuana Rule Process 
Tuesday morning, the Florida Department of Health published its initial proposed rules for a statewide medical marijuana program and announced public hearings. But the rules essentially merge new patients into an existing, small medical cannabis program already functoning in the state, diverging from some of the key ideas pushed during the November election by backers of Amendment 2, the constitutional amendment that expanded medical marijuana. (Auslen, 1/17)

Prescription Drug Watch

Drugmakers' Influence On Treatment Guideline Authors Worries Experts

News outlets report on stories related to pharmaceutical drug pricing.

ProPublica: Pharma Money Reaches Guideline Writers, Patient Groups, Even Doctors On Twitter
The long arm of the pharmaceutical industry continues to pervade practically every area of medicine, reaching those who write guidelines that shape doctors' practices, patient advocacy organizations, letter writers to the Centers for Disease Control and Prevention and even oncologists on Twitter, according to a series of papers on money and influence published Tuesday in JAMA Internal Medicine. (Ornstein, 1/17)

Stat: Are Treatment Guidelines Swayed By Conflicts Of Interest With Pharma?
As physicians increasingly rely on treatment guidelines issued by medical societies and government agencies, researchers raise concerns that drug makers may subtly influence the proceedings through various financial relationships and they recommend stronger actions for disclosing potential conflicts of interest. The industry influence can take different forms, however, according to the research, which was published in a pair of papers on Tuesday in JAMA Internal Medicine. (Silverman, 1/17)

Stat: Few Americans Believe Pharma Places Patients Over Profits: Poll
Just 9 percent of Americans believe drug makers place more value on patients than profits, and only insurers have an overall worse reputation among consumers than the pharmaceutical industry among different entities in the health care system, according to a new Harris Poll. (Silverman, 1/17)

Stat: Pfizer Chief: Hatred Of Pharma Is ‘A Problem Of Perception’
The pharma business may be “getting away with murder” in the eyes of President-elect Donald Trump, but the leader of the US’s biggest drug maker remains defiant and unapologetic in the face of mounting criticism for his industry. Speaking at the annual World Economic Forum in Davos, Switzerland, Pfizer CEO Ian Read said pharma has hardly earned its bad reputation, blaming instead a handful of bad actors, widespread misunderstanding, and what he sees as a woefully flawed healthcare system. (Garde, 1/17)

Bloomberg: New FDA Chief Should Have Medical Experience, Drugmakers Say 
President-elect Donald Trump’s pick to lead the U.S. Food and Drug Administration should have a medical background, and the agency should continue evaluating new medications’ effectiveness, drugmaker executives said in comments indicating opposition to two candidates for the regulator’s top post. Trump’s FDA chief should be a doctor or physician-scientist with experience in clinical care and medical research, said Roger Perlmutter, head of research and development for Merck & Co. The president-elect is considering appointing former biotechnology industry executive Balaji Srinivasan and Jim O’Neill, a Silicon Valley investor, according to people with knowledge of the matter. Neither has a medical background, and O’Neill has suggested that the FDA should focus solely on new drugs’ safety, leaving the market to decide whether they work. (Hopkins, 1/17)

Stat: With Faster Drug Approvals, Taxpayers May Be Left To Foot The Bill
Between a new law aimed at springboarding treatments and a new administration promising to steamroll regulations, the federal government seems primed to approve more prescription drugs — and to do so faster. But one unintended consequence could be a waste of taxpayer dollars. Whether the Food and Drug Administration should hasten drug approvals is a matter of vigorous debate from a scientific and safety standpoint. But many critics of that approach also make another argument that has been largely overlooked: More drug approvals could mean more unnecessary public spending. (Joseph, 1/13)

Boston Globe: Mass. Biotechs Won’t Commit To Drug Price Cap
Under growing pressure to control prices, three big drug companies have separately pledged to hold increases on their prescription medicines to below 10 percent in 2017. So far, however, biopharma companies that are based in Massachusetts or have large operations here have declined to make a similar pledge, even though some say their recent price increases have been below the 10 percent cap embraced by AbbVie Inc., Allergan PLC, and Novo Nordisk. (Weisman, 1/13)

The New York Times: Trump’s Plan To Cut Drug Imports Could Raise Prices, Not Lower Them
First it was cars, then air-conditioners. This week, President-elect Donald J. Trump targeted another industry that has shifted manufacturing abroad: pharmaceuticals. American drug imports have grown significantly in recent years, figures show. At the same time, however, drug costs continue to rise, an issue Mr. Trump suggested his government could address. But any move to curtail pharmaceutical imports could raise, rather than lower, drug prices, experts warn. That is because many of the cheaper drugs in the United States come from abroad. (Bradsher, 1/12)

Bloomberg: Why Trump Faces Stiff Fight To Slash Drug Prices
Pharmaceutical executives briefly celebrated Donald Trump’s election to the U.S. presidency, expecting the businessman to be friendlier to their industry than his opponent Hillary Clinton, a tough critic. But foreboding about Trump’s unpredictable ire soon set in, and the fears proved justified nine days before the inauguration, when Trump said the industry was “getting away with murder.” He vowed to bring prices down by making pharmaceutical companies bid for the government’s business. (Bloomfield, 1/13)

The Wall Street Journal: Pharma Investors Find Themselves In The Spotlight
If drug makers thought they would escape the political spotlight in 2017, the first few weeks of the new year have certainly dissuaded them of that notion. In magazine and newspaper interviews, on Twitter and during his press conference, President-elect Donald Trump has homed in on the industry’s pricing of drugs. That’s not something investors in those companies expected. The iShares Nasdaq Biotechnology exchange-traded fund had surged 8.9% the trading session after Election Day, apparently on the belief that a Republican-controlled White House and Congress was unlikely to prioritize drug pricing reform. That clearly is not the case. (Eisen, 1/17)

Stat: Supreme Court Agrees To Review Biosimilar Launch Rules
The US Supreme Court has agreed to delve into a contentious patent dispute between Sandoz and Amgen over how quickly lower-cost biosimilar drugs can make it to market. This has huge implications for how all biosimilars are marketed and priced, because these drugs represent some $44 billion in health care cost savings through 2024. Biosimilars are expected to be priced at 10 to 30 percent less than their branded counterparts. (Keshavan, 1/13)

Kaiser Health News: Drugmakers Manipulate Orphan Drug Rules To Create Prized Monopolies
More than 30 years ago, Congress overwhelmingly passed a landmark health bill aimed at motivating pharmaceutical companies to develop new drugs for people whose rare diseases had been ignored. By the drugmakers’ calculations, the markets for such diseases weren’t big enough to bother with. But lucrative financial incentives created by the Orphan Drug Act signed into law by President Ronald Reagan in 1983 succeeded far beyond anyone’s expectations. More than 200 companies have brought almost 450 “orphan drugs” to market since the law took effect. (Tribble and Lupkin, 1/17)

Kaiser Health News: Sky-High Prices For Orphan Drugs Slam American Families And Insurers
Sarah Jane Tribble and Sydney Lupkin report: "Before Luke Whitbeck began taking a $300,000-a-year drug, the 2-year-old’s health was inexplicably failing. A pale boy with enormous eyes, Luke frequently ran high fevers, tired easily and was skinny all over, except his belly stuck out like a bowling ball. “What does your medicine do for you?” Luke’s mother, Meg, asked after his weekly drug treatment recently. “Be so strong!” Luke said, wrapping his chubby fist around an afternoon cheese stick." (Tribble and Lupkin, 1/17)

Stat: Sound Advice: Making Drug Packaging Easy — And Helpful
Patients tired of tiny print guidelines and difficult-to-understand drug use instructions could see their medical packaging get an innovative upgrade. Design and development company Cambridge Consultants has created a new type of medical packaging that could make it easier for patients to learn how to properly take their medication. It could be particularly useful for self-injected drugs such as insulin, which can run the risk of user error. The AudioPack aims to cut down on that risk by breaking down instructions in an easy-to-read package with oral, step-by-step instructions from a helpful guide named Anna. (Thielking, 1/17)

Stat: FDA Is Making Progress Inspecting Foreign Drug Plants, But Could Do Better
In the wake of concerns over the safety of foreign-made medicines, the US Food and Drug Administration significantly increased the number of inspections of overseas facilities. Yet the agency has failed to assess the extent to which its efforts are actually improving the quality of drugs entering the country, according to a new report by the US Government Accountability Office. The GAO noted that nearly 40 percent of finished drugs and about 80 percent of active pharmaceutical ingredients are made in facilities that are registered in more than 150 countries. And by some measures, the FDA has made progress – the agency has reduced the number of facilities that have gone without an inspection history to 33 percent of foreign establishments, compared to 64 percent in 2010. (Silverman, 1/17)

Stat: FDA Guidelines For Biosimilars May Give Edge To Big Pharma
After years of anticipation, the US Food and Drug Administration released a final guideline for naming both pricey biologic medicines and identical, but lower-cost versions that are known as biosimilars. However, the agency appears to have adopted a position that may give an edge to brand-name drug makers, a significant move given the huge sales that are at stake. (Silverman, 1/12)

Bloomberg: Where The U.S. Actually Gets Its Drug Supply: QuickTake Q&A
After calling out makers of cars and air conditioners, U.S. President-elect Donald Trump has set his sights on a new industry to pressure for manufacturing jobs: drug companies. In his first press conference since his election, Trump lumped pharmaceutical firms in with the car companies that so far have borne the brunt of his Twitter feed for moving operations abroad. “We’ve got to get our drug industry back,” he said. “They supply our drugs but they don’t make them here, to a large extent.” Afterward, pharmaceutical stocks around the world plunged, partly on Trump’s promise to cut drug prices but also on concerns that companies could face the same choice he’s proposed for carmakers: make it in the U.S. or face punitive tariffs. (Altstedter, 1/17)

Perspectives: If U.S. Can Negotiate Over Aircraft Carriers, It Can Over Drugs, Too

Read recent commentaries about drug-cost issues.

USA Today: Trump's Right About Drug Prices
Donald Trump has certainly gotten the pharmaceutical industry's attention with his ruminations about drug prices. Within 20 minutes of last Wednesday's news conference, in which the president-elect called for the government to negotiate directly with pharmaceutical companies, the industry shed roughly $25 billion in stock value. (1/16)

USA Today: Let Consumers Control Drug Money
The drug prices are too damn high, but having government “negotiate” lower prices is a distraction from reforms that would actually work. To make drugs more affordable, we need not one tough-talking negotiator but 300 million of them. Congress can raise and equip that army by returning to the people the $3 trillion of health care spending that government and employers control, and by eliminating government-imposed barriers to affordable medicine. (Michael F. Cannon, 1/16)

Bloomberg: Biopharma Can't Keep Getting Blindsided By Trump
The day after Donald Trump won the U.S. presidential election, pharma and biotech investors seemed to decide his administration would be one in which scrutiny of drug pricing would vanish and profits would soar. Shares in the Nasdaq Biotech Index (NBI) surged more on November 9 than they had in more than eight years.This dream was a fiction. (Max Nissen, 1/11)

Salon: Donald Trump Vs. Big Pharma: He Can’t Bring Down Prescription Drug Costs Alone
President-elect Donald Trump’s book “The Art of the Deal” details using leverage in business negotiations to contain costs and deliver the goods. Whether Trump wrote his greed-is-good ’80s-era bestseller or not, the book offers a selective glimpse into Trump’s political style. His wheeling-and-dealing background came out again this week when he lashed out at Big Pharma at his Wednesday press conference, accusing the industry of price-gouging the public and promising a new art to that deal. (Angelo Young, 1/14)

Fortune: Trump Drug Price Control Plan Would Revive 'Death Panel' Politics
President-elect Donald Trump sent biopharma stocks into a tailspin Wednesday after asserting that pharma is "getting away with murder" on drug prices during a closely-watched press conference. But Trump's suggestions for keeping these high prices in check through a bidding process for Medicare could re-invigorate the nastiest political debates about "care rationing" that surrounded the Affordable Care Act, aka Obamacare. (Sy Mukherjee, 1/13)

Bloomberg: Trump’s Strategy For Cutting Drug Prices Is DOA
Trump didn’t say a whole lot in his press conference on Wednesday, but his remark that America needed to revise its process for buying pharmaceuticals made some enormous waves. “They’re getting away with murder,” he said. Big Pharma lost almost $25 billion in market value in just 20 minutes. From the size of the market’s reaction, you would assume that pharma must really be getting away with murder. (Megan McArdle, 1/13)

Bloomberg: Merck's Lead In Lung Cancer May Be Unbeatable
Merck & Co Inc. and its immune-boosting cancer drug Keytruda keep putting out market stunners.  A clinical trial failure by Bristol-Myers Sqibb Co. in August gave Merck a big head start in treating lung cancer, leaving Keytruda as the only drug of its type available to newly diagnosed patients. And on Monday, Merck announced the FDA had accepted its application to combine Keytruda with chemotherapy to treat a much wider group of patients than it currently does. (Max Nissen, 1/12)

Editorials And Opinions

Thoughts On Trump's 'Mystery' Health Plan; Questions For Price; Flirting With Repeal Disaster?

Opinion writers express their thoughts on the strategies to dismantle the 2010 health law and how a replacement measure could steer clear of a "health-care calamity" as well as their concerns about Rep. Tom Price, R-Ga., Donald Trump's nominee to lead the Department of Health and Human Services.

Los Angeles Times: Donald Trump, Rand Paul And The Myth Of A Cheap Obamacare Replacement
News on the Obamacare-replacement front was dominated this past weekend by Donald Trump and Sen. Rand Paul (R-Ky.), who both touted their Obamacare replacement plans. To be absolutely precise, they touted the claim that they had Obamacare replacement plans. They didn’t go into any great detail about what would be in those plans. (That didn’t stop CNN from captioning its interview with Paul, “Rand Paul Releases Obamacare Replacement Details.”) (Michael Hiltzik, 1/17)

The Baltimore Sun: Trump's Mystery Health Care Plan 
Not only would his secret plan to replace Obamacare include "insurance for everybody" even "if you can't pay for it," it would also involve "lower numbers, much lower deductibles" and be "much less expensive." And Americans are not just going to be covered, they'll be "beautifully covered." That's a big contrast with what Republicans in Congress have been up to. Last week, they passed legislation to repeal most of the law, an effort that would, the Congressional Budget Office reported this morning, result in 18 million people losing coverage in the first year and a doubling of health insurance premiums over the next decade. In short, it would make things worse than they were before the ACA. (1/17)

The Washington Post: Topping Obamacare May Be Harder Than Republicans Think
The Congressional Budget Office put out a report today on the costs associated with repeal of Obamacare (the Affordable Care Act, or ACA). The analysis looks at repeal without replacement, which Republicans have figured out is a nonstarter. Nevertheless, the CBO provides a road map for Republicans if they want to claim honestly that they delivered something better than Obamacare. (Jennifer Rubin, 1/17)

The Wall Street Journal: How Republicans Can Overcome The Tyranny Of The Anecdote
While Republicans debate whether to repeal the Affordable Care Act outright or piecemeal, here are a few people they should meet: Paula, 52, a breast-cancer survivor; Namir, 35, with a rare tumor; Cameron, 44, who suffers from Parkinson’s; and Jason, 36, fighting a blood infection. They all received lifesaving treatment through ObamaCare; they, and others, will literally interpose their bodies in front of any attempt to reform or repeal it. (Merrie Spaeth, 1/17)

The Washington Post: The Magnitude Of The Health-Care Calamity Republicans Are About To Cause Is Becoming Clear
On Tuesday, the nonpartisan Congressional Budget Office released a new report that makes clear the magnitude of the health-care calamity Republicans are preparing to unleash on the country. While it doesn’t tell the whole story of this debate, it shows why their effort to repeal the Affordable Care Act is already spurring a public backlash, and why that backlash is only going to grow. (Paul Waldman, 1/17)

Vox: Here’s How Donald Trump Could Replace Obamacare Without Courting Disaster
Over the weekend, Donald Trump told the Washington Post that his plan would provide “insurance for everybody” with “much lower deductibles.” Oh, and don’t worry about the cost. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it,” he said. “That’s not going to happen with us.” There is simply no way, within the GOP paradigm of private insurance, lower taxes, and less regulation, to make that work. But perhaps he doesn’t need to. (Ezra Klein, 1/17)

Bloomberg: Trump Buries Paul Ryan Under Expensive Promises
What Trump is describing is not the Ryan agenda. What he is describing is a more generous and expansive version of Obamacare, the sort of thing Republicans routinely dismiss as "socialized medicine." Like others before him -- students at "Trump University," investors in bankrupt Trump casinos -- Ryan thought he could piggyback on Trump's self-interest. Trump would get the White House. Ryan would get his ambitious agenda: large tax cuts for the wealthy, huge spending cuts in anti-poverty programs, such as food stamps and Medicaid, and the replacement of Obamacare with a less-regulated system that reduces subsidies for the needy, leaving millions without reliable access to health care. (Francis Wilkinson, 1/17)

Forbes: Four Critical Problems With The CBO's Latest Obamacare Repeal Estimates
It’s right to say that if Republicans were to defund Obamacare, without passing a replacement, fewer people would have health insurance. That’s because H.R. 3762 would keep Obamacare’s regulations in place, while removing many of its funding streams. But the GOP has repeatedly promised to repeal and replace Obamacare. Over the weekend, President-Elect Trump stated that his replacement would provide “insurance for everybody,” which obviously means covering more people than Obamacare does. The CBO can’t score Trump's replacement because it hasn’t been drafted yet. But CBO's estimates of the impact of H.R. 3762 are largely meaningless without consideration of what the GOP’s replacement will look like. (Avik Roy, 1/17)

Bloomberg: Tom Price's Hippocratic Oath And The Future Of Obamacare
The other day, I was at a white coat ceremony, a ritual where medical students don their white coats to mark the transition from the classroom to the patient’s bedside. Seasoned physicians reflected on their experiences with patients and families who guided them along their own professional journey from student to doctor. There was no discussion of money, of insurance, of Obamacare. The day was all about the honor and duty of caring for people as they suffer or as they get well, of healing them. (Anne Armstrong-Coben, 1/17)

The New York Times: Tom Price’s Dubious Trades In Health Care Stocks
Even before Tom Price became President-elect Donald Trump’s nominee to head the Department of Health and Human Services, he played a big role in shaping health policy in the House. He also frequently traded health care stocks, raising questions about whether he used his position in Congress for personal profit. Mr. Price, who will testify at a Senate confirmation hearing on Wednesday, has bought and sold stocks worth more than $300,000 over the last four years, The Wall Street Journal reported last month. (1/18)

Bloomberg: Hard Questions For Trump's Health Secretary Pick
At his confirmation hearing Wednesday, Tom Price, the U.S. representative from Georgia who is Donald Trump’s nominee to lead the Department of Health and Human Services, will no doubt be asked about conflicts of interest. Specifically, Price will face questions about his decision to trade stocks whose value may have been affected by legislation he sponsored. This is as it should be. But senators should save plenty of time to ask about Obamacare. (Jan. 18)

Bloomberg: UnitedHealth Has Trump Insurance 
UnitedHealth Group Inc. on Tuesday was the first of the big health insurers to report fourth-quarter earnings, and it largely demurred on the industry's burning question: What does Donald Trump mean for health care? CEO Stephen Hemsley emphasized that the company has "no better sense" than anybody else about what might happen to the Affordable Care Act.  Though it may deny extra insight, the company seems to have made better preparations. Its profit beat analysts' expectations, helped by an early pullback from the ACA's individual exchange markets and a push for diversification. The insurer looks better positioned than many rivals for whatever might come. (Max Nisen, 1/17)

Stat: Elevating Feelings Over Facts Is A Bad Way To Make Health Policy
The rise of feelings over fact can be seen in discussions about declines in crime, arguments about whether global climate change is real, and in discussions of how people feel about Obamacare, even as they support its provisions. When individuals’ feelings become equal to fact, it becomes difficult to move policy forward. If we can’t agree on a common set of facts established through rigorous methods that can be verified by others, it becomes tough to have reasoned discussions and find common ground. It is challenging to argue with how someone feels, especially if their sense of an issue may not be grounded in fact or supported by science that extends knowledge beyond the individual. (Jennifer Reich, 1/17)

Viewpoints: The Medical Bankruptcy Myth; Needle Exchange And Reducing Harm

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

Bloomberg: The Myth Of The Medical Bankruptcy
Did medical bills single-handedly account for more bankruptcies than anything else? No. This is an exaggerated half-remembering of a series of studies, authored by (among others) Elizabeth Warren, that were themselves exorbitant exaggerations. I went into detail on the problems with the work seven years ago, but the highlight reel is that these authors have an aggressive tendency to employ any technique that ratchets the count of “medical bankruptcy” upward, while not using similar techniques that would tend to ratchet up other categories and diminish the number of bankruptcies counted as medical, and to present their results in misleading ways -- so as to obscure, for example, the fact that by their own accounting, the number of medical bankruptcies actually fell by hundreds of thousands between 2001 and 2007. (Megan McArdle, 1/17)

The New York Times: Injecting Drugs, Under A Watchful Eye
It has been nearly 30 years since the first needle exchange program opened in the United States, in Takoma, Wash., in 1988. It was a health measure to prevent injecting drug users from sharing needles, and therefore spreading H.I.V. and hepatitis. The idea was controversial, to say the least. Many people felt — and still feel — that it enables drug use and sends a message that drug use is O.K. and can be done safely. (Tina Rosenberg, 1/18)

Stat: New Rule On Clinical Trial Reporting Doesn't Go Far Enough
Roughly half of clinical trials go unreported. Industry-sponsored trials are four times more likely to produce positive results than non-industry trials. And even when trials are reported, the investigators usually fail to share their study results: nearly 90 percent of trials on ClinicalTrials.gov lack results. Failure to report clinical trial results puts patients in danger. (Chris Cai, 1/17)