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Kaiser Health News Original Stories

On The Air With KHN

As health care issues hit center stage in Washington again, Kaiser Health News reporters hold forth on a number of radio and television shows. (3/22)

Medicaid Caps Pitched By GOP Could Shrink Seniors' Benefits

Advocates for the elderly worry that GOP plans to end Medicaid’s open-ended spending and replace it with per-capita limits could pose a risk for low-income older people who rely on the federal-state program for nursing and other long-term care. (Stephanie O'Neill, 3/22)

Political Cartoon: 'Slowpoke?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Slowpoke?'" by Clay Bennett, Chattanooga Times Free Press.

Here's today's health policy haiku:

AN ACA BIRTHDAY WISH

You’re 7, health law!
How can you best celebrate?
Just repeal “Repeal.”

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Capitol Hill Watch

House GOP Health Plan Vote Nears Amidst Uncertainty

It will be a long day for President Donald Trump and House Speaker Paul Ryan (R-Wis.) as they push to gather the needed support to ensure passage of the American Health Care Act, a measure that is key to both of their futures.

Politico: Obamacare Repeal In Jeopardy As Trump Offers 11th-Hour Concessions
The Republican push to replace Obamacare – backed forcefully by President Donald Trump and House Speaker Paul Ryan —is in jeopardy, as a last-ditch bid by the White House to win conservative support late Wednesday appeared to repel moderates. Moderate Republicans huddled with Speaker Paul Ryan and House leaders for nearly two hours Wednesday night but emerged without consensus. Immediately after exiting the meeting, Rep. Charlie Dent (R-Pa.), leader of the House’s moderate Tuesday Group, panned the bill, known as the American Health Care Act. (Cheney, Bade and Bresnahan, 3/22)

NPR: Fate Of Republican Health Care Bill Unclear Heading Into Final Hours
Republicans will be tested today on the strength of party unity in the Trump era and their party's ability to deliver on the promises they've made to the voters that sent them here. "This is our chance and this is our moment. It's a big moment," House Speaker Paul Ryan told reporters earlier this week. "And I think our members are beginning to appreciate just what kind of a 'rendezvous with destiny' we have right here." (Davis, 3/23)

Los Angeles Times: Trump's Awkward Alliance With Ryan Faces Biggest Test. Will Healthcare Vote Bind Or Push Them Apart?
The two are not natural allies, something that was clear during the presidential campaign. As any number of Trump controversies swirled, particularly those that raised questions about the nominee’s temperament and judgment, Ryan (R-Wis.) did his best to keep his party’s standard bearer at arm’s length. But they began working closely after Trump’s victory in November to set a strategy for their legislative agenda. Healthcare was the first big item — the bill that would fulfill a central campaign promise for the GOP and open the way to other priorities, including a major tax cut. (Bierman and Memoli, 3/22)

Boston Globe: Trump And Ryan Lack House Votes For `Do-Or-Die’ Healthcare Replacement 
President Trump and House Speaker Paul Ryan pushed conservative lawmakers to get behind the GOP health care plan Wednesday, but their efforts appeared to come up short, casting Thursday’s vote into doubt, along with the ability of Republicans to drive a legislative agenda despite their control of the White House and Congress. Less than 24 hours before the House of Representatives was scheduled to vote on the conservative plan, the group of right-wing lawmakers known as the House Freedom Caucus announced they had more than 25 members voting “no” — enough opposition to sink the bill’s prospects of passage. More moderate House Republicans also signaled their opposition Wednesday. (Herndon and McGrane, 3/22)

USA Today: 8 GOP House Members Whose Votes On Health Care Will Be Crucial
With Democrats united against the GOP's American Health Care Act, the key votes will come from Republicans — mainly from moderates who fear the legislation will harm senior citizens and low-income families and from hard-line conservatives who aren't convinced that it goes far enough in getting rid of government subsidies and regulations. ... Here's a look at eight GOP House members whose votes will be crucial in deciding the outcome. (Kelly and Collins, 3/23)

Politico: House Rules To Resume Work On Obamacare Repeal Thursday Morning
The House Rules Committee recessed late Wednesday after more than 13 hours of deliberations without finalizing a rule for debating House Republicans’ Obamacare repeal bill, after key parts of the legislation remained in flux. The committee will reconvene Thursday, Chairman Pete Sessions said. The panel gave lawmakers the authority to consider any health care bill through Monday. (Pradhan, 3/23)

Will There Be Art To This Deal? Trump, House Leaders Make Last-Ditch Bids For Health Plan

President Donald Trump is "pulling out all the stops" to win the 215 votes necessary to pass the GOP measure in the House. In doing so, he and Republican leaders face a delicate balancing act between the interests of caucus conservatives and moderates. Meanwhile, members who resist could face retribution.

Politico: Inside Trump’s Last-Ditch Bid To Avoid A Health Care Disaster
With one day to go until the biggest vote of his brief presidency, [President Donald] Trump is using all the trappings of his office to try to clinch the needed 215 votes. It’s unclear whether it will be enough to save the legislation. But late Wednesday, the White House floated a major change to the bill in a bid to win over roughly three dozen House conservatives. It was over the same issue [Rep. Steve] King had raised in the White House meeting earlier in the day. (Bade, Bresnahan and Cheney, 3/22)

The Hill: High Drama For ObamaCare Vote
President Trump and GOP leaders are pulling out all the stops to win over House conservatives to their ­ObamaCare replacement bill ahead of a crucial up-or-down vote scheduled for Thursday. At press time, it appeared that Trump still lacked the votes in the House, but late-breaking developments suggested a deal that could win over House Freedom Caucus members was possible. (Sullivan, Wong and Lillis, 3/22)

Politico: White House Shift To Right On Health Care Angers Moderates
The Republican push to replace Obamacare – backed forcefully by President Donald Trump and House Speaker Paul Ryan — is in jeopardy, as a last-ditch bid by the White House to win conservative support late Wednesday appeared to repel moderates. Moderate Republicans huddled with Speaker Paul Ryan and House leaders for nearly two hours Wednesday night but emerged without consensus. Immediately after exiting the meeting, Rep. Charlie Dent (R-Pa.), leader of the House’s moderate Tuesday Group, panned the bill, known as the American Health Care Act. (Cheney, Bade and Bresnahan, 3/22)

Roll Call: Chris Collins Advocates Retribution For Recalcitrant Republicans
If House Freedom Caucus members sink the GOP leadership’s health care bill Thursday, they should be stripped of plum committee assignments and denied access to campaign committee resources, Rep. Chris Collins told reporters Wednesday. “If this goes down, they’re not on our team,” the New York Republican said. (McPherson, 3/22)

The Hill: GOP Rep: Trump Could Be 'One-Term President' If Healthcare Bill Passes 
A Republican member of the House is warning President Trump that his first term in office could be his last if the GOP's current healthcare measure becomes law. During an appearance on CNN Wednesday night, Rep. Thomas Massie (R-Ky.) said that the plan to repeal and replace the Affordable Care Act will only become less popular over time, further degrading its already tepid support. (Greenwood, 3/22)

Obamacare's Essential Health Benefits May Fall Prey To Legislative Horse Trading

Some of the intense, intra-GOP negotiations focus on easing federal requirements that insurers cover such basic services as prescription drugs, maternity care and substance abuse treatment.

The New York Times: Leaders Struggle To Unite House Republicans Behind Health Bill
The House bill to repeal the Affordable Care Act faced an uncertain fate on Wednesday as conservative Republicans pushed to eliminate federal requirements that health insurance plans provide certain benefits to consumers. House Republican leaders met with members of their party late into the night on Wednesday as they struggled to muster support for the bill, scheduled for a vote on the House floor on Thursday. (Pear and Kaplan, 3/23)

The Associated Press: GOP Health Bill On The Brink Hours From House Showdown Vote
The stakes could hardly be higher for a party that gained monopoly control of Washington largely on promises to get rid of former President Barack Obama's signature legislative achievement and replace it with something better. Now Republicans are staring at the possibility of failure at the very moment of truth, an outcome that would be a crushing political defeat for Trump and Hill GOP leaders and would throw prospects for other legislative achievements into extreme uncertainty. (Werner and Alonso-Zaldivar, 3/23)

The Wall Street Journal: GOP Lawmakers Struggle To Unite On Health Bill
The GOP plan to replace the Affordable Care Act, backed by President Donald Trump and House Speaker Paul Ryan, remained in jeopardy Wednesday after a day of intense negotiations among Republicans showed signs of rallying conservatives behind the bill while driving away more centrist lawmakers. Ahead of a planned vote by the House on Thursday, Mr. Trump and Vice President Mike Pence, as well as other senior administration officials, huddled with lawmakers through the day on proposed changes to the bill. (Peterson, Hughes and Andrews, 3/22)

The Associated Press: Obama Health Law's 'Essential Benefits' May Be In Jeopardy
Scrambling to nail down votes for the health care overhaul legislation, Republicans are considering ways to ease federal requirements that insurers cover such basic services as prescription drugs, maternity care and substance abuse treatment. Lawmakers emerging from a meeting late Wednesday of the conservative Freedom Caucus said "essential health benefits" are in play as party leaders and the White House explore ways to advance the bill. But undermining the Affordable Care Act's (ACA) benefits is likely to trigger a backlash from patient groups and doctors. (Alonso-Zaldivar, 3/23)

The Washington Post: GOP Health-Care Plan Hangs In Balance As Conservatives Demand Changes
The Republican health-care overhaul spearheaded by House Speaker Paul D. Ryan (Wis.) and backed by President Trump hung in the balance Wednesday, as the White House signaled at the 11th hour a willingness to rework the measure to mollify conservatives. After insisting for weeks that the changes sought by hard-right members would render the bill unable to pass the Senate, White House officials and GOP House leaders appeared to shift their thinking — and opponents agreed to keep working on a deal with the goal of holding a floor vote in the House by Thursday night. (DeBonis, Eilperin, Weigel, 3/23)

The Hill: Freedom Caucus, Trump Reach 'Agreement In Principle' On ObamaCare Repeal Bill 
Freedom Caucus Chairman Mark Meadows (R-N.C.) said Wednesday night he and President Trump have come to an “agreement in principle” on a plan to repeal and replace ObamaCare, just one day before a historic House vote on the bill. “The president and I came to an agreement in principle,” Meadows said during an interview with Fox News’s Sean Hannity, adding that he was still ironing out a few final details with the White House. (Sullivan and Wong, 3/22)

Stat: This Unheralded Part Of Obamacare Just Shot To The Center Of The Health Care Debate
As Republicans frantically scramble to find votes to pass their health care bill, the most important debate may be about one issue: essential health benefits. That is the Affordable Care Act’s requirement that health insurance plans sold to individuals and small groups cover 10 types of services, from prescription drugs to substance abuse treatment to maternity care. That requirement was never as widely discussed or debated as Obamacare’s individual mandate or Medicaid expansion. But it is now central to understanding the debate in Congress. (Scott, 3/22)

Modern Healthcare: GOP Eyes Eliminating Benefit Mandates In Late Scramble To Pass ACA Repeal
The White House and U.S. House of Representatives' ultra-conservatives reportedly were negotiating Wednesday night to repeal the Affordable Care Act's insurance benefit rules in a last-minute effort to salvage House Republicans' ACA replacement bill. The provision being discussed would erase the ACA's minimum essential benefits requirement for fully insured plans in the individual and group markets. That requires all plans to cover benefits in 10 categories, with benefits determined by the states but comparable to the most common small-group plans. (Meyer, 3/22)

McClatchy: Trump Pledges Support For Retired Miners Fund
President Donald Trump pledged his support Wednesday for the rescue of a health-care fund for thousands of retired coal miners and their families, an issue that almost triggered a government shutdown in December. Rep. David McKinley, R-West Virginia, raised the issue at a meeting of about 18 House Republicans Wednesday morning, including House Majority Whip Steve Scalise, R-La., at the White House, a meeting called to discuss the Republican bill to replace Obamacare. (Tate, 3/22)

As Republicans Woo Conservatives, They Offer 'A Complete Unwinding' Of Medicaid Rules

To gain more support for the legislation, House leaders have endorsed dramatic changes in the current Medicaid program, including a move to different funding formulas, the ability of states to require some enrolled adults to work and pay premiums and the end of the expansion supported by the Affordable Care Act.

The Wall Street Journal: Health-Care Bill Would Bring Big Changes To Medicaid
Changes to Medicaid included in the House Republican health-care bill would usher in the biggest structural overhaul ever to a program that covers roughly one in five Americans, or more than 70 million people. The bill, if passed by both chambers, would transform an entitlement program, in which everyone who qualifies has a right to health coverage, into a system where that is no longer guaranteed. (Armour, 3/22)

Kaiser Health News: GOP Health Plan Aims To Curb Medicaid, Expand State Options
For all its populist design, the House GOP’s latest proposal to overhaul federal Medicaid funding creates financial risks for states and could leave some enrollees worse off. Dramatic changes in Medicaid are a big part of the House bill to partially repeal the Affordable Care Act that’s steaming toward a floor vote scheduled for Thursday. Big revisions were made to the legislation this week to appeal to conservatives pushing to reduce federal Medicaid spending and shift more power to states. (Galewitz, 3/22)

Kaiser Health News: Medicaid Caps Pitched By GOP Could Shrink Seniors’ Benefits
But advocates for the elderly now worry that [Carmencita] Misa and other low-income seniors who receive long-term care in facilities or at home could see their benefits shrink or disappear under Republican-proposed legislation to cap federal Medicaid contributions to states. The proposal is part of a broader GOP plan to repeal and replace former President Barack Obama’s Affordable Care Act. (O'Neill, 3/22)

Modern Healthcare: GOP Governors Offer Alternative Medicaid Reforms, But Who's Listening?
Governors are analyzing the House Republican bill to restructure Medicaid and phase out the Obamacare expansion of the program, and they don't like what they see. That prompted four Republican governors from Medicaid expansion states—John Kasich of Ohio, Rick Snyder of Michigan, Brian Sandoval of Nevada and Asa Hutchinson of Arkansas—last week to offer their congressional colleagues a sharply different Medicaid proposal. In their letter, they wrote that the House bill “provides almost no new flexibility for states, does not ensure the resources necessary to make sure no one is left out and shifts significant new costs to states.” (Meyer, 3/21)

Conservative Groups Amp Up Pressure On GOP Rank-And-File To Oppose The American Health Care Act

Organizations such as the Heritage Foundation and the Americans for Prosperity are "flexing their muscles" to rally conservative House members against the House GOP plan because they believe it doesn't go far enough to truly dismantle Obamacare.

McClatchy: Inside The Final Conservative Push To Thwart Trump’s Health Care Bill 
In the final hours before a vote on the Republican health care overhaul, powerful conservative groups raced to ensure that their Capitol Hill allies will oppose a bill they see as too weak, despite mounting pressure and threats from President Donald Trump. Influential conservative groups treated Wednesday as a national day of action, flooding phone lines of members of Congress, running ads urging “no” votes in key congressional districts across the country and engaging in last-ditch lobbying efforts with Capitol Hill, demanding changes to a bill that, they argue, doesn’t go far enough in repealing former President Barack Obama’s health care law. (Glueck, 3/22)

Politico: Inside Conservatives' Quandary On The GOP Repeal Bill
Passage of the Obamacare repeal bill would give Republicans an achievement that they’ve pursued since the Reagan years: shrinking federal payments to Medicaid. But some of the conservatives most eager to overhaul the health care program for the poor are threatening to cast no votes because it doesn’t completely dismantle Obamacare. (Kenen, 3/23)

CQ Roll Call: Conservatives Ask To Start Over On GOP Health Plan
Conservatives are flexing their muscles in Congress as they get closer to securing the “no” votes that would sink the GOP leadership-crafted bill to repeal and replace the 2010 health care law. As of Wednesday afternoon, there were 30 “no” votes on the bill, according to a conservative lawmaker who requested anonymity to discuss private whip counts. With the Rules Committee meeting Wednesday to formulate a rule for a scheduled vote on Thursday, time is running short to secure the needed votes for a majority. (Rahman and McPherson, 3/22)

The Washington Post: Conservative Groups Keep Lobbying Against GOP’s Health-Care Bill
As members of the House Freedom Caucus elbowed past reporters to enter their Wednesday meeting, a slim backpack-toting man slipped in almost unnoticed. He was Michael Cannon, director of health-policy studies at the libertarian Cato Institute, and he was offering some advice on why Republicans’ American Health Care Act needed to die. A chart-packed three-page memo, given to every member, warned that passage would mean the GOP would absorb “blame for the ongoing collapse” of Affordable Care Act exchanges, split the right (“the left will be motivated”) and “risk single-payer” after Republicans lost. (Weigel, 3/22)

The Associated Press: Koch Network Spending Millions To Stop GOP Health Care Bill
The conservative Koch network is promising to spend millions of dollars to defeat the health care overhaul backed by President Donald Trump and top House Republicans. The network’s leading organizations, Americans for Prosperity and Freedom Partners, announced late Wednesday the creation of a special fund to support House members who vote against the health care bill. (Peoples, 3/22)

'Rendezvous With Destiny' Or Test Of Partisan Unity -- Where Do Representatives Stand?

There's a lot riding on the vote scheduled to occur later today on the American Health Care Act and news outlets across the country are reporting on where their delegations stand.

Milwaukee Journal Sentinel: U.S. Rep. Paul Ryan Of Wisconsin Has A Lot Riding On House Health Plan Vote
Along with the vast political stakes for his party and president, the dramatic House showdown over health care is an acid test of Speaker Paul Ryan’s ability to deliver on the promise of unified Republican rule. ... Ryan is calling it his party’s “rendezvous with destiny.” But it is also the sternest measure by far of his 16-month-old tenure as speaker, and of his leadership style, salesmanship, deal-making skills and capacity to corral a GOP caucus united against Obamacare but divided over what should take its place. (Gilbert, 3/22)

Chicago Tribune: Most Illinois House Republicans Follow Party On Health Care 
There were few signs Illinois' seven House Republicans will break ranks when their party's health care overhaul comes up for a historic vote Thursday, but some declined to tip their hands amid a frenzied, last-minute lobbying push on both sides of the debate. U.S. Reps. Adam Kinzinger of Channahon, Darin LaHood of Peoria and Rodney Davis of Taylorville, support the GOP bill to replace the Affordable Care Act, or Obamacare, aides said. (Skiba, 3/22)

Houston Chronicle: Two Austin Lawmakers Join GOP Push For Obamacare Repeal Bill 
The last ditch effort to pass the Republicans' Obamacare replacement bill included two Texas lawmakers in a "Women in Healthcare" panel at the White House Wednesday. State Sens. Dawn Buckingham (R-Lakeway) and Donna Campbell (R-New Braunfels), both physicians, met with President Donald Trump to rally support for the embattled legislation, which faces a close vote in the U.S. House on Thursday. ... A Chronicle survey of Texas Republicans in the U.S. House found more than a half-dozen conservatives who were still undecided Tuesday, as pressure groups on both sides have been lobbying overtime. (Diaz, 3/22)

The Washington Post: Virginia Opposition To Health Care Bill Grows, But Rep. Comstock Still Mum
Rep. Barbara Comstock was not saying Wednesday how she planned to vote on the big legislative question looming before Congress: the GOP plan to remake the Affordable Care Act. And with good reason. The ­second-term Republican was in the hot seat — she is a lawmaker who represents a Northern Virginia district that voted for Hillary Clinton — but she is also an ally of Speaker Paul D. Ryan (R-Wis.), the architect of the House bill. (Portnoy, 3/22)

Atlanta Journal-Constitution: Jody Hice’s Rejection Of GOP Health Care Plan Could Help Sink Bill 
Georgia Congressman Jody Hice is firmly against the Republican health care plan, one of at least two dozen reported GOP opponents who are imperiling the White House-backed legislation roughly 24 hours before the House is expected to vote on the proposal. The Monroe Republican said the current plan “doesn’t go far enough” to repeal Obamacare, despite recent changes leaders made to win over conservatives like him. (Hallerman, 3/22)

Des Moines Register: King Lone 'Yes' Vote On Health Care Bill Among Iowa's House Members
With a key vote looming Thursday, Iowa’s entire congressional delegation has staked out positions on the Republican health care proposal aimed at repealing and replacing Obamacare. Three Iowa members, U.S. Reps. David Young, Rod Blum and Dave Loebsack — two Republicans and a Democrat — have announced they oppose the measure and will vote “no” on Thursday. The delegation's other Republican, U.S. Rep. Steve King, says he will support the bill. (Noble, 3/22)

Atlanta Journal-Constitution: Perdue, Isakson Shun The Health Care Spotlight Ahead Of House Nail-Biter
At a time when their House colleagues are in the hot seat on health care, Georgia’s two senators are studiously avoiding the spotlight – for now. Republican Sens. David Perdue and Johnny Isakson have both sounded positive notes about their party’s plan for repealing and replacing Obamacare, but neither has said definitively whether they’ll back or shun the plan as-is. (Hallerman, 3/22)

Miami Herald: Scramble For GOP Healthcare Votes Puts Cuba Policy In Play 
The showdown in Congress over House Republicans’ healthcare bill might have nothing to do with Raúl Castro — if it weren’t for Miami. Thursday’s planned vote on the American Health Care Act is so razor tight that House GOP leaders and the White House are leaning hard on every single shaky Republican for their support. One of them: Rep. Mario Diaz-Balart of Miami, whose foremost want is to overturn the Obama administration’s Cuba opening — and who has recently taken it upon himself to outline a possible Cuba policy for the Trump administration. (Mazzei and Gamez Torres, 3/22)

Texas Tribune: Texas Republicans Divided As Health Care Overhaul Is In Peril 
In the dawn-to-dusk fight over repealing the law that served as a central campaign issue for Republicans over the past four election cycles, Pelosi's troops were in lockstep behind her — all House Democrats oppose repeal. Instead, the fight is among Republicans; allies of House leadership are trying to pass the bill, while hardline conservatives, many of whom are members of a group called the Freedom Caucus, are trying to stymie it. Many in Congress — including at least one Texas Republican House member who asked not to be named — predict that if the bill reaches the House floor Thursday, it will fail. (Livingston, 3/22)

Austin American-Statesman: Texas Senators Meet Trump For Health Care Discussion
Two Texas state senators, both physicians, took part Wednesday in a White House panel on women in health care — attended by President Donald Trump — in preparation for Thursday’s U.S. House vote on the Republican plan to replace Obamacare. ... In a phone interview with the American-Statesman, [Dawn] Buckingham said she spoke about “the failed experiment of Obamacare,” including personal insurance coverage she lost and patients who sought care elsewhere because of the Affordable Care Act. (Lindell, 3/22)

Indianapolis Star: Gov. Eric Holcomb Backs GOP Health Care Bill That Cuts Medicaid Funding
Gov. Eric Holcomb on Wednesday backed a GOP alternative to the Affordable Care Act that would significantly reduce Medicaid spending, the source of two-thirds of federal funding received by Indiana for a program used by about 1 in 5 Hoosiers. ... Nearly all of Indiana’s eight GOP members of Congress have said they will vote for the bill. Rep. Trey Hollingsworth,R-Jeffersonville, and Republican Sen. Todd Young have not taken a position. (Groppe, 3/22)

Democrats See Roadblocks For GOP Bill In Arcane Budget Procedures Used In The Senate

Because the bill will be brought up under rules that don't allow a filibuster, Senate officials will strike any provisions that don't deal with federal spending, and Democrats think they can use that to amend the Republican legislation.

Roll Call: Senators Working The Ref Already On Health Care Bill
As House Republicans struggle to cobble together the votes to pass legislation to repeal and replace the 2010 health care law, members are already looking to navigate the Senate’s labyrinth of procedural rules that could make or break the measure. Senate Democrats are already setting up for the battle with the parliamentarian about which provisions could run up against the Byrd Rule, which requires budget reconciliation bills that can pass with a simple-majority vote to be primarily about spending and revenues, without extraneous matter. (Lesniewski, 3/23)

CQ HealthBeat: Senate Democrats: Many Byrd Rule Problems In Obamacare Repeal
Senate Democrats say they have found multiple examples of potential violations of the Byrd rule in House-written budget legislation that would dismantle the health care law, setting the measure up for a potential parliamentary challenge. Two of these possible problems have been publicized, and Democrats say there are more to explore...The comments by Democrats added to the ongoing drama over the House bill (HR 1628) that would repeal and replace the 2010 health care law. (Krawzak, 3/23)

The Wall Street Journal: The Tough Senate Math For The GOP Health Plan
The Republican health plan, which is expected to face a tight vote in the House this week, is also likely to encounter a rocky road in the Senate. Some states have seen big improvements in recent years in the number of residents with health insurance, and some GOP senators are wary of losing those gains. Here is a look at where senators stand. (Rust and Shin, 3/22)

The Hill: Trump Woos Right With Promise Of Senate Changes To ObamaCare Replacement
President Trump gave his word Wednesday to a group of 18 House Republicans that he would publicly call on the Senate to amend the House GOP’s healthcare bill to include the repeal of ObamaCare’s “essential health benefits,” sources in the meeting told The Hill. Senate Majority Leader Mitch McConnell (R-Ky.) is on board with the plan, top Trump aides told the lawmakers gathered at the White House. (Wong and Sullivan, 3/22)

Issues And Impacts: What If The House GOP Health Plan Were To Become Law

News outlets detail some of the other major changes advanced by this measure, which will face an uphill climb in the Senate if it clears the House of Representatives.

USA Today: The House Health Care Battle: What's At Stake?
The bill, as it stands, would replace swaths of the Affordable Care Act, a signature legacy achievement of President Barack Obama. It would eliminate requirements that individuals maintain health insurance at all times and that larger companies provide it to employees, while keeping provisions allowing children to stay on their parents' plans until age 26 and prohibiting insurance companies from denying coverage based on pre-existing conditions. But it would also reduce tax credits for individuals buying private insurance, as well as the amount of money provided to states for Medicaid. The nonpartisan Congressional Budget Office predicted last week that it would also increase the number of uninsured Americans by as many as 24 million over the next 10 years. (Korte and Slack, 3/22)

Morning Consult: Biden Blasts GOP Health Care Bill As A $1 Trillion Tax Cut For The Wealthy
Former Vice President Joe Biden on Wednesday joined congressional Democrats on the Capitol steps to defend Obamacare and deride Republicans’ proposal to repeal and replace the 2010 health care law as a tax cut for the richest Americans. In his first appearance on the Hill since leaving office, Biden said “the costs are enormous” if the Affordable Care Act, President Barack Obama’s signature policy achievement, is repealed. He said the GOP plan amounts to a “transfer of about a trillion dollars” to wealthy Americans in the form of tax benefits. (Yokely, 3/22)

The Associated Press: Republican Health Bill Would Widen America's Big Wealth Gap
House Republicans' health care bill provides massive tax cuts to the wealthy while increasing taxes for many lower income families, adding to America's big income gap between the rich and everyone else. Over the past quarter century, only one group of people has seen significant increases in income — those at the very top. Families in the middle or at the bottom of the economic ladder have seen little or no increase in wages. (Ohlemacher, 3/23)

Stat: GOP Bill Doubles Down On Loathed Part Of Obamacare
In letter after letter, Republican lawmakers have reminded their constituents: Obamacare cut Medicare. Implied, and sometimes stated outright, was that the GOP’s own plan should instead bolster the program...“Obamacare took $500 million from Medicare to pay for its infrastructure,” Poe continued. “That was wrong, and Medicare must be strengthened so that it is still there for future generations.” But the bill now working its way through Congress does not reverse those cuts. Instead, Republicans for now appear committed to keeping this reviled part of the law. (Scott, 3/22)

The Washington Post: There’s Yet Another Tax Benefit For The Wealthy Buried In The Republican Health Plan
The Republican health plan would allow Americans to put a larger slice of their paycheck into tax-exempt accounts for paying their health-care bills, but while the plan's authors are celebrating the change as a victory for consumer choice, health policy experts and Treasury Department data suggest the benefits will land mainly in the laps of the wealthy. Under the GOP plan, the cap on these “Health Savings Accounts” would nearly double, from the current family limit of $6,750 to a proposed $13,100. (Johnson, 3/22)

The Associated Press: Retirement Dreams Fizzle For Some With 'Obamacare' Repeal
Workers dreaming of early retirement are getting the jitters as Washington debates replacing the Obama-era health care law with a system that could be a lot more expensive for many older Americans. The uncertainty over the cost of coverage in the individual market has caused some in their 50s and early 60s to put plans on hold. Others who already left jobs with health benefits before reaching Medicare age are second-guessing their move to self-employment. (Johnson, 3/22)

Politico: Is Trumpcare Already Here?
No matter what happens to the Republicans’ troubled health bill in Congress, Trumpcare is here to stay. The Trump administration has already begun to transform the health insurance market, wielding executive power to rewrite coverage rules, slash Obamacare’s marketing budget and signal an all-out assault on his predecessor’s health care law. And Republicans have high expectations the administration will take additional measures to unwind Obamacare, such as targeting its contraception coverage requirement at the center of two recent religious liberty cases at the Supreme Court. (Diamond, 3/23)

The Washington Post: How Is A Ban On Preexisting Conditions Preserved In The GOP Replacement Bill?
One of the most popular features of the Affordable Care Act is a provision that prohibits insurance companies from denying coverage or raising premiums based on a preexisting condition. Among health-care wonks, this is known as “guaranteed issue.” In 2010, one of the key intellectual architects of the ACA, MIT Prof. Jonathan Gruber, described guaranteed issue as one of the three legs of the “stool” holding up the law. The two other legs were the requirements that everyone buy insurance (the widely disliked individual mandate) and tax subsidies that make insurance affordable. (Kessler, 3/23)

Roll Call: John Dingell Tweets A First-Person History Of Health Care Reform
Former Dean of the House of Representatives John Dingell took to his and President Donald Trump’s favorite medium — Twitter — to tell the story of health care reform and what will happen if the 2010 health care law is repealed. Dingell started his tweetstorm by paraphrasing Trump, who was derided when he told a gathering of governors earlier this month that “nobody knew health care could be so complicated” before telling the story of how his father, former Rep. John Dingell Sr., proposed the first attempt to increase health care coverage for Americans in the 1940s. (Garcia, 3/22)

As States' Concerns Grow About Medicaid Losses, Study Analyzes Impact On Families

Officials and advocates from Rhode Island to California are trying to parse how their Medicaid programs will be affected.

Kaiser Health News/KJZZ: Repeal Of Health Law Could Force Tough Decisions For Arizona Republicans
Connie Dotts is a big fan of her insurance. “I like that we can choose our own doctors,” said the 60-year-old resident of Mesa, Ariz. “They also have extensive mental health coverage.” Dotts isn’t on some pricey plan, either. She’s among the nearly 2 million people enrolled in Medicaid in Arizona and one of the more than 400,000 who have signed up since the Republican-led state expanded Medicaid in 2014. (Stone, 3/23)

San Jose Mercury News: California Would Lose Billions Under GOP Health Plan, State Officials Say
With House Republicans poised to vote Thursday to dismantle the Affordable Care Act by replacing it with a pared-down health plan, a new California analysis reveals that the substitute would severely impact the state’s ability to pay for health care for its poorest residents. The study released Wednesday by the Department of Health Care Services and Department of Finance shows that California would lose almost $6 billion in federal Medicaid funding in 2020 — a figure that would increase to $24.3 billion annually by 2027 if the GOP plan is passed by Congress and signed by President Donald Trump. (Seipel, 3/22)

Kaiser Health News: By Decade’s End, California Estimates It Would Lose $24 Billion Annually Under GOP Health Plan
California would lose $24.3 billion annually in federal funding by 2027 for low-income health coverage under the current Republican plan to replace the Affordable Care Act, according to a state analysis released Wednesday. The bill, up for a vote in the House on Thursday, represents a “massive and significant fiscal shift” from the federal to state governments by setting caps on Medicaid spending, reducing the amount of money available for new enrollees and eliminating other funding for hospitals and Planned Parenthood, the analysis said. (Gorman, 3/23)

California Healthline: In Deep-Blue State, Millions In Reddish Heartland Are Counting On Medicaid
Under Republican efforts to repeal, replace or reform the health law, many people on Medicaid — the nation’s single-largest insurer, with 72 million beneficiaries — could see their coverage slashed. The biggest chunk of them — 13.5 million — live in California. The state predicted Wednesday it could lose $24 billion in federal funding annually by 2027 under the current GOP proposal. Among the hardest hit regions would be the Central Valley, the state’s agricultural heartland, stretching hundreds of miles from Redding to Bakersfield. (Ibarra and de Marco, 3/22)

Sacramento Bee: Jerry Brown Casts Doubt On Single-Payer Health Care 
Gov. Jerry Brown, in Washington warning about the billions his state could lose on the eve of a Republican effort to repeal and replace Obamacare, strained Wednesday to understand the logic behind pushing another system like single-payer. ... Universal healthcare has gained in popularity, particularly among liberal groups in California, as an answer to what they see as the undermining of Obamacare. (Cadelago, 3/22)

Richmond Times-Dispatch: Gov. McAuliffe, Advocates For Virginians With Disabilities And Mental Illness Raise Concerns About Proposed GOP Health Care Bill 
The bill’s latest iteration, which may be voted on as early as today by the U.S. House of Representatives, could reduce Virginia’s Medicaid funding by $708 million over the next decade, Joe Flores, deputy secretary of Health and Human Resources, said late Wednesday afternoon. Had the bill been passed in its earliest version, the decrease in funding would have been around $1.8 billion, he said. McAuliffe and several of his cabinet secretaries met in Washington on Wednesday afternoon to discuss with Virginia’s congressional delegation their opposition to the bill, which has the support of several leading conservative groups. (Kleiner, 3/22)

Chicago Tribune: Obamacare Replacement Bill Could Harm Illinois Residents With Disabilities, Advocates Say
The Republican bill to replace Obamacare could harm Illinois residents with disabilities — a group that hasn't gotten much attention in the debate, advocates warned Wednesday, one day before a scheduled House vote on the measure. More than 140,000 Illinois residents with disabilities receive Medicaid-funded services that allow them to remain in their homes or in community settings instead of nursing homes, according to the Illinois Department of Healthcare and Family Services. Another 19,000 Illinois residents with developmental disabilities want services but have not received them, according to the Illinois Department of Human Services. (Schencker, 3/22)

Detroit Free Press: With Vote Looming, Here's County Breakdown On Obamacare Recipients
The plan also makes changes that critics including Gov. Rick Snyder say could end Healthy Michigan, which insures some 650,000 residents just over the poverty limit and force reductions in traditional Medicaid. Together, it could mean billions in tax dollars saved but fewer people covered nationwide. Republicans say the changes are necessary given premium hikes and fewer insurers providing policies under the existing program and most of Michigan’s Republican members of the U.S. House support the proposal. Even though the U.S. Senate is expect to change the plan if it passes, a vote this week could be the harbinger of drastic changes in coverage for people across Michigan. (Spangler, 3/22)

Rhode Island Public Radio: "Trumpcare" Could Cut $200M From Medicaid, Destabilize HealthSource RI
Anya Rader Wallack, interim head of the Executive Office of Health and Human Services, says the Republican proposal could mean a loss of nearly $200 million over four years for Rhode Island’s Medicaid program. That comes from scaling back the expanded coverage Medicaid offered to single adults under Obamacare and capping state Medicaid spending per person. Wallack says that could ultimately drive up the number of uninsured Rhode Islanders. (Gourlay, 3/22)

Providence Journal: Medicaid Crisis: R.I.’s Loss In GOP Proposal Would Be $595M
Rhode Island officials estimate it would cost the state $595 million more over five years to prevent up to 75,000 low-income adults from losing their Medicaid coverage under the U.S. House GOP plan to overhaul healthcare. And that's just for the adults without children who became newly eligible for coverage since 2014 under the Affordable Care Act. Medicaid insures close to 300,000 Rhode Islanders, or nearly one-third of the population. (Arditi, 3/22)

Colorado Public Radio: For Coloradans Getting Long-Term Care On Medicaid, The GOP Plan Brings Uncertainty
Three out of five nursing home residents in Colorado are covered by Medicaid. Older people with disabilities, in long-term care, make up nearly 10 percent of the state’s overall Medicaid population, but they account for more than 40 percent of the costs, according to the state budget office. Matt Salo, the head of the National Association of Medicaid Directors, said they “serve the sickest, the frailest, the most medically complex and the most expensive populations in the country.” For Salo, it’s important to understand that Medicaid, not Medicare, the federal program that covers elderly Americans, picks up costs for long-term care. (Daley, 3/22)

The Wall Street Journal: In Trump Country, Health-Care Overhaul Has Support, But Cost Is A Worry
[Waynesboro, Pa.] has two messages for President Donald Trump and his party as they consider reworking the nation’s health insurance system: Go full-speed at repealing the Affordable Care Act, but keep the costs of insurance down. ... Waynesboro is also full of the lower-income voters for whom a bump in insurance costs could be a hardship. Its median household income is roughly $38,000, lower than the national average by more than $15,000. (Chinni, 3/22)

Kaiser Health News/KUT: Texas Braces For Medicaid Cuts Under GOP Health Plan
Many in Texas are keeping a close eye on the Republican bid to replace the Affordable Care Act. One of the big changes is how it would affect low-income people, seniors and people with disabilities who all get help from Medicaid. And Texans on both sides of the political spectrum say the Lone Star State is not going to fare well. As the GOP bill, the American Health Care Act, works its way through Congress, Anne Dunkelberg, with the left-leaning Center for Public Policy Priorities in Austin, said she’s a little stumped. (Lopez, 3/23)

AMA Takes A Strong Stand Against The House Health Plan

The physician organization maintained its opposition to the measure in a letter sent to Capitol Hill Wednesday, noting its continued concerns about the millions of people who would lose coverage if it becomes law. Meanwhile, Molina Healthcare's chief executive is one of the few voices from the insurance industry protesting the Republican's overhaul. Another industry -- the tanning business -- has high hopes for the legislation.

Modern Healthcare: AMA Urges Congress To Vote No On Amended ACA Repeal Bill
The American Medical Association called on Congress to vote down the American Health Care Act despite Republican's last-minute amendments to the bill, claiming millions will lose coverage if it becomes law. The trade group said in a letter to Congress Wednesday that it is still concerned about the law's plan to roll back Medicaid expansion. AMA said the bill's proposed tax credits are less generous than the Affordable Care Act's cost-sharing subsides for low-income individuals. (Dickson, 3/22)

The New York Times: As Rivals Stand Silent, One Health Insurer Protests G.O.P. Plan
In recent weeks, Dr. J. Mario Molina has anxiously approached lawmakers on Capitol Hill and governors across the country, warning them that the Republican efforts to overhaul the health care system could be devastating for insurers and patients alike. As head of the California company founded by his father, Dr. Molina has become one of the few insurance executives publicly criticizing the House bill, which he believes could strip away coverage for millions of their clients and cause considerable turmoil for the insurance industry. The major insurers have mostly stayed silent during the debate, supporting some of the Republicans’ provisions that promise near-term stability for the insurance exchanges and a repeal of a tax on health insurance. (Abelson, 3/22)

Bill Closing Antitrust Loophole For Insurers Passes With Rare Bipartisan Support

The House also passed a second health care-related bill to establish rules on plans that allow small businesses in the same field or professional association to band together. Meanwhile, the Senate moved to block an Obama-era workplace safety rule.

CQ Roll Call: With Repeal Vote Looming, House Passes Two Health Bills
The House on Wednesday passed a pair of bills that are part of Republican plans to remake the health system. The bills, which would close a narrow antitrust loophole for health insurers and establish rules for a new type of plans for small businesses, are part of the GOP’s “third phase” of action to replace the 2010 health law. The first bill (HR 372), which passed 416-7, would close an antitrust loophole that allows health insurance companies to share information with each other when they are trying to assess risks and set rates. ... The second bill (HR 1101) passed 236-175. It would establish rules for association health plans. These plans would allow groups of small businesses in the same field or professional association to band together and create an employee pool large enough to offer lower-cost health insurance for their employees. (Siddons, 3/22)

The Associated Press: Senate Votes To Block Another Obama-Era Rule
The Republican-led Senate voted Wednesday to block an Obama-era rule that critics said would have led to more citations for workplace safety record-keeping violations. ... Employers are required to maintain a log of workplace injuries and illnesses that occur during a five-year span, but an employer may only be cited for failing to keep proper health and safety records within a six-month window. (3/22)

Administration News

Trump Budget Would Shake Medical Research And Health Training Programs

In related news, Mayo Clinic's CEO says that he urged the Trump administration to maintain funding for research and to take foreign doctors into account in the administration's immigration policy.

Arizona Republic: Funding For Medical Research, Health Training Takes Hit In Trump Budget
President Donald Trump’s budget outline would have widespread implications for health-care training and research in Arizona, including at the state's universities. The budget would eliminate $403 million in training programs for nurses and health professionals. The budget would, however, maintain training programs that place practitioners in communities with a shortage of health professionals. (Alltucker and Ryman, 3/22)

The Star Tribune: Mayo CEO Tells Business Leaders He Advised Trump On Value Of Immigration, Research Funding 
Mayo Clinic’s chief executive told Minnesota business leaders Wednesday that he has pressed the Trump administration to maintain federal research funding and keep the nation’s borders open to patients needing care and doctors who seek training. ... Immigration restrictions proposed by the Trump administration have presented potential obstacles for foreign doctors in certain nations to practice and train in the United States. (Olson, 3/23)

Public Health And Education

Ex-Compounding Pharmacy Exec Acquitted Of Murder Allegations In Meningitis Outbreak

Barry J. Cadden, the former co-owner and head pharmacist at the New England Compounding Center, was found guilty by jurors of fraud and racketeering. Fungus-tainted drugs from the facility killed 64 people and sickened hundreds more across the country.

Boston Globe: Jury Reaches Verdict In New England Compounding Center Trial
The former co-owner and head pharmacist at a Framingham company that shipped tainted drugs across the country, causing more than 60 deaths and hundreds of illnesses, was convicted of fraud and racketeering Wednesday, though a federal jury refused to brand him a murderer. Barry J. Cadden, who jurors found had run New England Compounding Center like a criminal enterprise, could serve several years in prison. But the jury’s verdict spared him from a life sentence in one of the worst pharmaceutical scandals in US history. (Valencia and Lazar, 3/22)

The Associated Press: Ex-Pharmacy Exec Convicted In Deadly Meningitis Outbreak
The former head of a Massachusetts pharmacy was acquitted Wednesday of murder allegations but convicted of racketeering and other crimes in a meningitis outbreak that was traced to fungus-contaminated drugs and killed 64 people across the country. Prosecutors said Barry Cadden, 50, ran the business in an ‘‘extraordinarily dangerous’’ way by disregarding unsanitary conditions to boost production and make more money. (Lavoie, 3/22)

WBUR: Mixed Verdicts In NECC Trial 
The former co-owner of the New England Compounding Center, the pharmaceutical company at the center of a meningitis outbreak in 2012, has been found not guilty on the most serious charges in that trial but convicted of other charges. Barry Cadden was charged with murder, racketeering and fraud in relation to the 2012 nationwide fungal meningitis outbreak that killed 64 people and sickened nearly 700. A Boston federal jury today found Cadden not guilty of second degree murder, and guilty on more than 50 other lesser counts. (Chakrabart, Sundt and McNerney, 3/22)

'Right-To-Try' Advocates Help Pass Laws In 33 States As Movement Gains National Foothold

Legislation to allow terminally ill patients access to experimental treatments not approved by the Food and Drug Administration also have momentum in the other 17 states. Today's other public health stories report developments on a potential sepsis treatment, a devicemaker's redesigned medical scope, a link between breast implants and a deadly cancer and the latest on the bird flu outbreak.

Stat: 'Right To Try' Is Becoming The Law Of The Land, State By State
Over the past three years, “right-to-try” advocates in 33 states have helped enact legislation to eliminate legal obstacles blocking terminally ill patients from treatments that aren’t yet approved by the Food and Drug Administration. Those advocates are showing considerable momentum in the remaining 17 states, potentially upending the established order for experimental drugs. The movement has been fueled in no small part by the anti-regulatory sentiment that propelled Donald Trump’s rise to the presidency and by the explicit support of Vice President Mike Pence. (Tedeschi, 3/23)

NPR: Doctor Turns Up Possible Treatment For Deadly Sepsis
It's hard not to get excited about news of a potentially effective treatment for sepsis, a condition that leads to multiple organ failure and kills more people in the hospital than any other disease. But there have been so many false promises about this condition over the years, it's also wise to treat announcements — like one published online by the journal, Chest — with caution. The study, from Eastern Virginia Medical School in Norfolk, Va., reported some remarkable success in treating patients who were at high risk of sudden death. (Harris, 3/23)

Los Angeles Times: Olympus' Redesigned Scope Linked To Infection Outbreak
Doctors have tied a superbug outbreak at a foreign health facility to a medical scope that Olympus modified last year in an attempt to reduce its risk of spreading bacteria between patients. Five patients treated with the modified device tested positive for the same potentially deadly bacteria, according to a report filed with the Food and Drug Administration. (Petersen, 3/22)

NPR: Breast Implants Linked To Rare Blood Cancer In Small Proportion Of Women
The Food and Drug Administration says at least nine women have died of a rare blood cancer after receiving breast implants, and that the agency is officially acknowledging an association between the implants and the disease. On Tuesday, the agency announced that as of Feb. 1, it had received 359 breast implant-associated reports of a rare type of non-Hodgkin's lymphoma called anaplastic large cell lymphoma, or ALCL. (Hersher, 3/22)

As 'Deaths Of Despair' Among White Adults Spike, Researchers Identify Root Causes

Husband-and-wife economists find links between the job market and the mortality-rate jump among middle-aged, less-educated white Americans from drugs, alcohol-related diseases and suicide.

NPR: The Forces Driving Middle-Aged White People's 'Deaths Of Despair'
In 2015, when researchers Ann Case and Angus Deaton discovered that death rates had been rising dramatically since 1999 among middle-aged white Americans, they weren't sure why people were dying younger, reversing decades of longer life expectancy. Now the husband-and-wife economists say they have a better understanding of what's causing these "deaths of despair" by suicide, drugs and alcohol. (Boddy, 3/23)

The Wall Street Journal: Death Rates Rise For Wide Swath Of White Adults, Study Finds
Mortality has been rising since the turn of this century for an even broader swath of white adults, starting at age 25, the researchers found, driven by troubles in a hard-hit working class. Death rates for white non-Hispanics with a high-school education or less now exceed those of blacks overall, the pair said—and they’re 30% higher for whites age 50 to 54 than for blacks overall of that age. (McKay, 3/23)

The Associated Press: Less-Educated Middle-Age US Whites Dying Younger Than Others
"This is a story of the collapse of the white working class," [Angus] Deaton said in an interview. "The labor market has very much turned against them." Those dynamics helped fuel the rise of President Donald Trump, who won widespread support among whites with only a high school degree. Yet Deaton said his policies are unlikely to reverse these trends, particularly the health care legislation now before the House that Trump is championing. That bill would lead to higher premiums for older Americans, the Congressional Budget Office has found. (Rugaber, 3/23)

State Watch

Opponents Of KanCare Expansion Challenge Supporters' Claim It Will Pay For Itself

Outlets report on news out of state legislatures in Kansas, Minnesota, Texas, Arkansas and Florida.

KCUR: Cost Of KanCare Expansion Debated Ahead Of Key Vote
A dispute about the cost and potential benefits of expanding Medicaid eligibility is heating up ahead of a Kansas Senate committee vote on a bill. In testimony Monday to the Senate Public Health and Welfare Committee, supporters of expanding eligibility for KanCare, the state’s privatized Medicaid program, said expansion would more than pay for itself. Former Kansas Senate President Dave Kerr, a Hutchinson Republican, said in its first full year, expansion would add about $81 million to the cost of KanCare. But he said it would generate more than $154 million in revenue and savings, enough to cover the costs of expansion with about $73 million to spare. (McLean, 3/22)

The Star Tribune: Dayton Issues Warning On 'Reinsurance' Plans 
Gov. Mark Dayton on Wednesday warned Republican lawmakers he won’t agree to give insurance companies hundreds of millions of dollars to stabilize Minnesota’s individual health insurance market without more information about how the companies would use the money. The House and Senate passed bills last week to spend, respectively, $384 million or $600 million over the next two years on a new “reinsurance” program to protect insurers against unusually high claims. (Golden, 3/22)

Austin American-Statesman: Texas Senate Gives Initial OK To Ban On Abortion Insurance
The Texas Senate, voting 19-10, gave initial approval Wednesday to a bill that would ban insurance coverage for abortions in the state. Senate Bill 20 by Sen. Larry Taylor, R-Friendswood, would prohibit abortion coverage in private plans, under the Affordable Care Act and in state-issued insurance plans, except for medical emergencies. Those interested in abortion coverage would have to purchase supplemental coverage if offered by their insurer. (Lindell, 3/22)

Texas Tribune: Texas Senate Passes Restrictions On Abortion Insurance 
The Texas Senate on Wednesday gave initial approval to a measure that would require women to pay a separate premium if they want their health plan to cover an elective abortion. Under Senate Bill 20, health plans would still be allowed to cover abortions that are deemed medically necessary. The measure does not make exceptions for cases of rape or incest. (Evans, 3/22)

The Associated Press: 'Sex-Selection' Abortion Ban Gets Final OK In Arkansas House
A proposal to impose fines and prison time on doctors who perform abortions that are based solely on whether the mother wants to have a boy or girl received final passage from the Arkansas House. The measure was passed Wednesday on a 57-9 vote. The bill's sponsor, Republican Rep. Charlie Collins previously told lawmakers that having this ban as law is the right thing to do. (Mukunyadzi, 3/22)

Tampa Bay Times: Future Of Medical Pot In Florida Still Cloudy After Senate Discussion 
Lawmakers have put forward competing proposals to implement Amendment 2, which passed with 71 percent of the vote in November and lets patients with debilitating medical conditions such as cancer, HIV/AIDS, epilepsy and post-traumatic stress disorder use cannabis. On Wednesday, the Senate's Health Policy panel discussed five approaches to implement the voters' will. Their deliberations, led by Sen. Dana Young, R-Tampa, revealed the first look at what kind of cannabis bill might pass the Senate — as well as early fault lines. (Auslen, 3/22)

Rural Georgia Hospitals To See Financial Benefit From New Tax Increase

In other state hospital news, executives for Beth Israel Deaconess Medical Center and Lahey Health tout the economic benefits of merging the two facilities. And a Philadelphia hospital brings in puppies and kittens to relieve the stress of its medical staff.

Georgia Health News: Recent Events Hearten Advocates Of Georgia’s Rural Hospitals 
Voters in Monroe and Jefferson counties Tuesday approved tax increases to help preserve their rural hospitals, which are in financial danger. And a proposed tax credit upgrade for donors to rural hospitals, an idea that had appeared dead in this year’s Georgia General Assembly session, is alive again less than two weeks before the legislators are expected to adjourn. (Miller, 3/22)

Boston Globe: Beth Israel, Lahey CEOs Say Merger Will Help Contain Health Care Costs
The chief executives of Beth Israel Deaconess Medical Center and Lahey Health on Wednesday pitched their proposed merger as an antidote to the state’s high health care costs, arguing that coming together would allow them to grab market share from pricier hospitals. In their first sit-down interviews with The Boston Globe since going public with their merger negotiations nearly two months ago, Dr. Howard R. Grant of Lahey and Dr. Kevin Tabb of Beth Israel Deaconess said the deal would also help them weather coming changes in the health care market, including shrinking reimbursements from insurers and the government, and changes to federal health care policy. (Dayal McCluskey, 3/23)

The Philadelphia Inquirer: RX For Hospital Stress: Hug A Puppy, Cuddle A Kitten
Wednesday’s event was Paws for Pennsy (P4P), a popular program that was started last year at the Philadelphia hospital. It was the creation of Care for the Care Provider, a hospital committee whose mission is to look at ways to address the stress and even sorrow that can come with being in the medical profession. Losing a longtime patient, experiencing the unexpected death of a patient or colleague, or other on-the-job losses can be so traumatic, the consequences have come to be known as "second-victim phenomenon." (Giordano, 3/22)

Former Obama Drug Czar Named To Lead Addiction Research Center In Boston

Michael Botticelli, who speaks openly about his history of alcohol and drug abuse, said his leadership of the new Grayken Center for Addiction Medicine will be rooted in his philosophy that addiction is a public health issue best remedied by treatment.

Boston Globe: Boston Medical Center Picks Ex-Obama Drug Czar To Run Opioid Center 
The nation’s former drug czar is bringing his expertise back to Massachusetts. Michael Botticelli, a recovering addict who rose to become director of the White House Office of National Drug Control Policy, will head Boston Medical Center’s new Grayken Center for Addiction Medicine, which aims to become a national leader in fighting opioid abuse. (Pfeiffer, 3/22)

WBUR: Former White House Drug Czar To Lead Addiction Medicine Center In Boston
The center was formally established earlier this month with a $25 million private gift from the Grayken family to be used to improve addiction treatment, prevention and training in addiction medicine. In an interview, Botticelli said he's eager to come back to Massachusetts. He worked for the state Department of Public Health for decades until 2012. He later was named director of the Office of National Drug Control Policy under the Obama administration. (Becker, 3/22)

In other news on the crisis —

The Philadelphia Inquirer: Mayor's Opioid Task Force Sees Huge Obstacles To Safe-Injection Sites In Philly
The idea of opening special facilities where heroin users could inject drugs safely in Philadelphia was panned Wednesday by numerous members of Mayor Kenney’s opioid task force. The 20-member group met for the final time to review and refine the 20 recommendations it will submit to help combat opioid abuse and addiction in the city, which had 910 fatal drug overdoses last year. But the bulk of the two-hour meeting was spent on the controversial concept of reducing that death toll by creating injection sites that are medically supervised. (McCullough, 3/22)

The Associated Press: Some Of The Youngest Opioid Victims Are Curious Toddlers
Curious toddlers find the drugs in a mother's purse or accidentally dropped on the floor. Sometimes a parent fails to secure the child-resistant cap on a bottle of painkillers. No matter how it happens, if a 35-pound toddler grabs just one opioid pill, chews it and releases the full concentration of a time-released adult drug into their small bodies, death can come swiftly. (Ehlke, 3/23)

State Highlights: Pharma Launches Campaign Against N.Y. Plan To Curb Drug Prices; Fla., Ga. Residents Struggle With Medical Bills

Media outlets report on news from New York, Florida, Illinois, Michigan, Minnesota and Louisiana.

The Wall Street Journal: Drug Industry Launches TV Ads Lambasting Cuomo’s Pricing Plan
On the heels of a presidential election in which the pharmaceutical industry was a popular target, Gov. Andrew Cuomo proposed new state controls over drug prices. Now the industry is punching back. On Wednesday, the industry’s largest trade group began running television ads in New York lambasting the proposal, a campaign that cost $100,000, people involved said. (Vilensky, 3/22)

Miami Herald: Floridians Report Trouble With Medical Bills In 2016, Survey Says 
Residents of Florida and Texas were more likely to report having difficulty paying their medical bills in 2016 than those who lived in California or New York, according to a survey published Wednesday by the nonprofit Commonwealth Fund, a health policy think tank and advocate for coverage. Though all four states made gains in the numbers of residents with health insurance since the launch of the Affordable Care Act’s coverage expansions in 2014, the survey found that Florida and Texas residents were more likely to report having a medical bill problem in the prior year or having carried long-term medical debt. (Chang, 3/22)

Chicago Sun Times: Health Study Finds Huge Disparities Based On Race, Neighborhood 
A three-year health study of nine city neighborhoods found large disparities among racial and ethnic groups in areas including physical and mental health, food insecurity and encounters with the criminal-justice system. Funded by a $1 million Chicago Community Trust grant, the study, titled “Community Health Counts,” is believed the largest community-driven, face-to-face health survey ever conducted in Chicago. (Ihejirika, 3/23)

Modern Healthcare: Mental Health Agencies Say They've Saved State Billions Under Medicaid 
A new report by advocates for Michigan's public Medicaid behavioral health system estimates it has saved the state $5.3 billion over the past 18 years and would save an additional $7.4 billion through 2024 using their patient-centered and integrated care model. They also contend rate increases for behavioral health systems were lower than Medicaid HMOs and state Medicaid programs during that period. A trade group for the HMOs contends that the comparison is unfair because the figures used for HMOs are national in scope rather than focused on Michigan. (Greene, 3/22)

The Star Tribune: Mental Clinic Owned By Marcus Bachmann Sanctioned For Violating State Rules
A Christian counseling center owned by the husband of former congresswoman Michele Bachmann violated a series of state rules governing patient treatment and client records, according to a state correction order released Tuesday. Bachmann & Associates Inc., which does business as Counseling Care at clinics in Lake Elmo and Burnsville, was cited for failing to keep information about its clients’ developmental condition, as well as failing to keep records demonstrating that clients were informed of treatment alternatives and possible outcomes, among other violations, the Minnesota Department of Human Services found. (Serres, 3/22)

New Orleans Times-Picayune: How Long Should Louisiana Keep Old, Ill Criminals In Prison? 
Gov. John Bel Edwards is expected to make a push to lower Louisiana's highest-in-the-world incarceration rate, in part by opening options for parole for non-violent offenders who serve shorter prison sentences. But the governor also has said he is interested in reducing the number of Louisiana inmates with longer sentences as well. Many of Louisiana's older, long-term prisoners might no longer pose a threat to society, judging from national studies of recidivism. And for prisoners with serious illnesses, the costs of treatment can be daunting. Taxpayers are responsible for prison medical care, but some of that money could be used elsewhere, such as for higher education and mental health care for children, if ill prisoners were released. (Donoghue, 3/22)

Weekend Reading

Longer Looks: Explaining The GOP Health Bill, Utah's Teen Suicide Spike And Election Anxiety

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

FiveThirtyEight: How The GOP Bill Could Change Health Care, In 8 Charts
After years of trying to repeal and replace the Affordable Care Act, aka Obamacare, Republicans finally got their chance with the election of President Trump. The House GOP made haste coming up with a bill, releasing the American Health Care Act on March 6. It’s a partial repeal of Obamacare — it includes substantial changes to the law, but when it comes to health insurance coverage and how people get it, the GOP bill largely works within the framework set up by the Affordable Care Act. (Anna Maria Barry-Jester and Charlie Smart, 3/20)

Vox: “If It Wasn’t For Insurance, I Wouldn’t Be Here”: How Obamacare’s End Would Worsen The Opioid Crisis
[Jessica] Goense is one of the hundreds of thousands of Americans who rely on the Affordable Care Act (“Obamacare”) and particularly Medicaid, which Obamacare expanded, for addiction care. By expanding not just access to health insurance but also enforcing requirements that insurers cover mental health and addiction services, Obamacare and the rules tied around it have dramatically expanded access to addiction coverage. By one estimate, the law gave potentially life-saving coverage to 2.8 million Americans with drug use disorders. (German Lopez, 3/21)

The New York Times: Coming Out In Droves For Free Health Care
A nonprofit sets up temporary clinics that provide free medical services to people in rural areas of the United States. For the hundreds that showed up in Cookeville, Tenn., this was a chance to get a checkup, dental treatment or eye care. Video. (Chris Carmichael, Niko Koppel and Kaitlyn Mullin, 3/22)

The Atlantic: The Silent Victims Of The GOP Health-Care Proposal
This is a 21st-century success story, one that health-care policy experts attribute to the Affordable Care Act, Medicaid, and the Children’s Health Insurance Program. Since 2008, the number of uninsured kids in the country has been cut in half. Since 2014, when the ACA was implemented, uninsurance among children dropped 20 percent. The bad news is that the significant gains in coverage for kids in recent years appear poised for a reversal. (Adrienne Lafrance, 3/20)

The Economist: Donald Trump Has Not Faced A Challenge Like Fixing American Health Care Before
On the campaign trail, [now-President Donald] Trump pledged to abolish what he called the “disaster” that is the ACA, and to “come up with a new plan that’s going to be better health care for more people at a lesser cost.” He promised to scrap things that the public dislikes about Obamacare, starting with its government mandate to buy health insurance or pay a penalty, while keeping things that are popular, such as protections for people with pre-existing conditions. (3/16)

Vox: “I See My Son In Every One Of Them”: With A Spike In Suicides, Parents Of Utah’s Queer Youth Fear The Worst
In recent years, suicide has become the leading cause of death in Utah among adolescents between the ages of 10 and 17, whereas national rates of youth suicide are considerably lower. According to the Centers for Disease Control and Prevention, suicide is the third leading cause of death among teenagers across the US each year. Hard data on the youth suicide rate is difficult to come by for 2016 because the year has only recently drawn to a close. (Nico Lang, 3/20)

FiveThirtyEight: Did The Election Stress Americans Out? If It Did, We Didn’t See Our Doctors About It
A wealth of anecdotes, and some research, supports the idea that the turbulence and hostility of the current political environment, along with many Americans’ fear that they will be adversely affected by changes in policy, could be bad for our mental health. After the election, for example, the National Suicide Prevention Lifeline reported a surge in calls for help. Recent research has also found that Google searches for “presidential election” are associated with searches for anxiety and depression. And a new report from the American Psychological Association found that 57 percent of Americans say the current political climate is a “very” or “somewhat” significant source of stress and that 59 percent of Republicans and 76 percent of Democrats are stressed about the future of the country. (Anupam Jena, Josh Gray, Stewart Richardson and Dhruv Khullar, 3/16)

Editorials And Opinions

Viewpoints: Ryan Says Vote Will Fulfill GOP Promise; Small Business Sees Relief; Vote No On 'Skinflint' Bill

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

The Wall Street Journal: Keeping Our Promise To Repeal ObamaCare
The election of Donald Trump and a Republican Congress provides an opportunity: We can immediately halt the leftward drift of American social policy, while renewing prosperity through market-based, state-driven solutions that empower people instead of bureaucrats. This is the stuff of conservative dreams. But it will become reality only if Republicans keep the promises we have made. (House Speaker Paul Ryan, 3/22)

Los Angeles Times: A Healthcare Test We're Hoping Republicans Will Flunk
On Thursday, House Republicans and President Trump face their first big test since the election that put the GOP in complete control of the federal government. The House will be voting on a bill to repeal much of the healthcare reform law Democrats pushed through Congress in 2010, replacing it with a skinflint alternative that’s projected to leave 24 million more people uninsured in a decade. It’s a horrible proposal, and the main hope for the country is that dissident Republicans will kill it because it’s not awful enough for them. (3/22)

Huffington Post: Mental Health, Maternity Care Guarantees In Jeopardy As GOP Wrangles For Votes
Someone with bipolar disease might have no way to pay for a psychiatrist to monitor his condition. A couple might have to fork over $15,000 to have a baby. These are just two of the possible consequences of a deal now under discussion in the U.S. House as Republican leaders working with the Trump administration try furiously to round up the votes they need to win approval for their bill to repeal the Affordable Care Act. (Jonathan Cohn, 3/23)

Los Angeles Times: Eliminating Essential Health Insurance Benefits Is A Stupid Idea That Won't Save Money. Here's Why.
David Anderson of Duke points us to a recent paper by Milliman, the preeminent cost-analysis firm in healthcare, about how much these essential benefits actually add to the cost of health insurance and the consequences of removing the mandates. The paper finds that eliminating the most vulnerable mandates, such as maternity care, will reduce average premiums somewhat but drive costs for people who need those services sky-high and transfer much of the cost to other public programs. The net gain for society is almost invisible. To put it another way, the savings are an illusion. In fact, eliminating the mandates might even cost the federal government more money. (Michael Hiltzik, 3/22)

USA Today: Vote 'No' On Ryancare: Our View
During the presidential campaign, Donald Trump repeatedly promised to repeal Obamacare and replace it with "something terrific." There are many words for the House Republicans' latest health care plan, embraced by Trump and scheduled for a vote on Thursday. "Terrific" is not among them. (3/22)

USA Today: Repair Damage From Obamacare: Opposing View
For decades, the National Federation of Independent Business (NFIB) has asked small business owners to rank the top challenges. For more than 30 years, their No. 1 problem has been the high cost of health care. Obamacare turned this concern into a crisis for small businesses. It fails to deliver on its main promise to make health care more affordable. For small business owners, the law has made insurance more complicated, more restrictive and more expensive. (Juanita Duggan, 3/22)

Los Angeles Times: The GOP Healthcare Bill Would Be Good For Small Business
The Affordable Care Act, or Obamacare, was perfectly misnamed. It failed entirely to make insurance affordable for small business owners and millions of other Americans. On the contrary, Obamacare has driven up costs for small business owners, who are hit with higher payroll taxes, taxes on health insurance products, the employer and individual mandate penalties, and the so-called Cadillac tax on expensive health insurance plans. (Tom Scott, 3/23)

Richmond Times-Dispatch: Obamacare Stinks. Small Businesses Need Something Better. 
Eight years ago, small-business owners were given many promises about the Affordable Care Act: that it would drive down costs; that small-business owners could take advantage of new tax credits; and that new exchanges would give owners and employees new options to purchase coverage. By the time President Obama signed the bill, it was abundantly clear that the law would do more to harm small businesses than help them. (Nicole Riley, 3/22)

Los Angeles Times: The GOP's Tax Cut For Healthcare CEO Pay Is A Bigger Ripoff Of Taxpayers Than It First Seemed
As the House of Representatives prepares to vote Thursday to repeal the Affordable Care Act, there’s a new estimate of the cost of one of its hidden provisions, a rollback of rules designed to restrain executive pay at health insurance companies. Here’s the bottom line: Rolling back the provision will result in an even bigger ripoff of the American taxpayer than previously calculated. (Michael Hiltzik, 3/22)

Boston Globe: Health Bill Isn’t Reform; It’s A Tax Cut For The Wealthy 
Under Barack Obama, the Affordable Care Act adapted the Massachusetts model, and it now covers 22 million formerly uninsured Americans. But congressional Republicans are attacking national health reform and are seeking to destroy the ACA, not reform it. If they succeed, a moderate Republican governor and a liberal state legislature will soon face the choice of undoing coverage or once again leading the country on health reform. (Jon Kingsdale, 3/22)

Boston Globe: Romney’s Health Care Legacy Under Attack, Just Like Obama’s
Romneycare, as it came to be known, provided the conceptual foundation for Obamacare. And President Trump’s commitment to repealing President Obama’s signature accomplishment — the Affordable Care Act — also puts Romney’s signature accomplishment at great risk. Governor Charlie Baker is warning that the Republican plan to repeal the ACA would reduce federal funding to Massachusetts by as much as $1.1 billion to $1.9 billion. (Joan Vennochi, 3/22)

Forbes: In Amended Health Care Bill, GOP Doubles Down On Tax Breaks For The Rich, Reduced Medicaid Funding
Yesterday, the GOP released amendments to its health care bill, and in response to the shortcomings highlighted by the CBO report, the changes to the bill would add more tax breaks for the rich and further slash Medicaid funding. Yup, you read that right. But as counterintuitive as it may seem, there is a method to the GOP's madness, as yesterday's changes 1) make it more likely the bill will pass the House and potentially, the Senate, and 2) it brings within reach the bigger prize being sought by Republican leaders: tax reform. (Tony Nitti, 3/22)

The Washington Post: Health-Care Reform Is A Lot Harder Than Tax Cuts. So Why Are The Republicans Trying To Do It First?
Today, the House Republicans are voting on what I consider their awful health-care replacement plan for the Affordable Care Act. I’ve already explained my negativity about the highly regressive American Health Care Act. If you think the problem is that the wealthy don’t have enough after-tax income and the poor have too much health care, this is the plan for you. ... Why are Republicans making their lives harder by starting with a complicated health-care replacement plan, one that itself conflates health policy with tax cuts? The answer, as tax analyst Chye Ching Huang points out in a new piece, is that “passing the health package first facilitates deeper tax cuts for the wealthy and corporations in subsequent tax legislation.” (Jared Bernstein, 3/22)

Bloomberg: Republicans Want To Repeal Medicaid, Too 
Under the AHCA, each state would instead be given a capped allowance, and that amount would rise each year with medical inflation. It would not account for any unforeseen expenses. Over time, as the rise in per-patient costs outstripped the rise in general medical inflation -- as the Congressional Budget Office assumes they will -- the federal share of funding would decline. Hundreds of billions in costs would be shifted from the federal government to the states. In response, states would need to either raise their own spending on Medicaid -- or more likely, offer fewer services to fewer people. (3/22)

Seattle Times: Medicaid Is A Lifeline For Our Children
As discussions continue to swirl around the future of our nation’s health-care system and the American Health Care Act (AHCA), it’s vital we do not forget about the well-being of those who represent the future of our nation — our children. Medicaid is the most critical health care program for our country’s youth, and we at Seattle Children’s are deeply alarmed about the proposed changes to Medicaid that would disproportionately impact our children. (Jeff Sperring, 3/22)

The New York Times: Why Medicaid Work Requirements Won’t Work
Paul Ryan’s plan to replace Obamacare is headed to the House floor on Thursday for a vote that, even now, could go either way. That may sound surprising since Republicans have a sizable majority in the House. But if you’ve been following the debate over their replacement plan, the American Health Care Act, you know that, as harsh as it is, it’s not draconian enough for some members of Speaker Ryan’s party. In an attempt to win over those lawmakers, the Republican leadership has offered ideas to restrict coverage even further. One of the worst is a Medicaid work requirement. (Jared Bernstein and Ben Spielberg, 3/22)

Cincinnati Enquirer: America Needs A Clean Repeal Of Obamacare
There is no question that former President Barack Obama’s signature legislation – Obamacare – has been a massive failure with deadly consequences. The law, which requires Americans to buy insurance from private companies, also manages to increase premiums drastically. ... Democrats have been stunningly comfortable playing politics with the life and death consequences of health insurance coverage. ... Now is the chance to repeal Obamacare, and it is not a minute too soon. (Ken Blackwell, 3/22)

Cincinnati Enquirer: Insurance Has No Place In Medicine
No fiscal conservatives make health care policy or legislation. Nothing about today’s health care system is fiscally conservative. Insurance is a “needless markup” in the healthcare industry. The management and control of the medical/industrial/Congressional complex must be returned to physicians. Doctors receive only 10 percent of the monies that flow through this system, so they are not the cost problem. (James Baker, 3/22)

The Washington Post: Would The GOP Benefit If Its Obamacare Replacement Failed?
House Republicans plan to vote Thursday on an Obamacare replacement plan, called the American Health Care Act. On Tuesday, Post Opinions writer Jennifer Rubin and Alice Stewart, former spokeswoman for Sen. Ted Cruz’s 2016 presidential campaign, discussed how passage of the bill would affect the GOP’s political fortunes. The email discussion was moderated by Post Opinions digital editor James Downie and has been edited for style and clarity. (3/22)