KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

HMO Doctors Take Pains To Slash Opioid Prescriptions

A Kaiser Permanente pain management program in Southern California aims to help patients taper off addictive painkillers. Some doctors and patients see it as a godsend; others complain that patients have been cut off medications they need. (Sam Quinones, 3/13)

Political Cartoon: 'Hard Sell?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Hard Sell?'" by Hilary Price.

Here's today's health policy haiku:


Repeal and replace!
Let's not and say we did though.
Obamacare Lite.

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

Republicans Expecting Bad News From CBO's Coverage And Costs Analysis

The Congressional Budget Office is expected to release its projections on the Republicans' new health care plan as early as Monday.

Roll Call: CBO Score Will Ring In Another Round Of House Fight
All eyes this week are off the floor as Capitol Hill awaits a Congressional Budget Office score for House Republicans’ health care plan and the House Budget Committee prepares to mark up the plan. While a CBO estimate on how much the plan to partially repeal and replace the 2010 health care law will cost and what effect it would have on those with insurance is expected as soon as Monday, the Budget Committee has scheduled its markup of the legislation for Wednesday morning. (Dick, 3/13)

The Associated Press: Republicans Brace For Downbeat CBO Analysis Of Health Bill
Republicans pushing a plan to dismantle Barack Obama’s health care law are bracing for a Congressional Budget Office analysis widely expected to conclude that fewer Americans will have health coverage under the proposal, despite President Donald Trump’s promise of “insurance for everybody.” House Speaker Paul Ryan said he fully expects the CBO analysis, set to be released as early as Monday, to find less coverage since the GOP plan eliminates the government requirement to be insured. (Yen, 3/13)

Reuters: Agency's Analysis Of Republican Health Bill May Sharpen Resistance To Measure
House of Representatives Speaker Paul Ryan, the Republican healthcare plan's top backer in Congress, acknowledged on NBC's "Meet the Press" program on Sunday that the CBO projections would likely show a decline in insurance coverage because the legislation would drop an Obamacare provision mandating that Americans obtain health insurance or pay a fine. "The one thing I'm certain will happen is CBO will say: 'Well, gosh. Not as many people will get coverage,'" Ryan said. "You know why? Because this isn't a government mandate." (3/13)

CNN Money: The Truth About The Uninsured Rate In America
The nation's uninsured rate has fallen to a historic low under Obamacare, but you'd never know that listening to Republican leaders speak.Bracing for a harsh assessment of their Obamacare repeal bill, House GOP leadership and the Trump administration are attacking the accuracy of the congressional agency tasked with reviewing it. (Luhby, 3/13)

Ryan Hedges On Question About Americans Losing Coverage: 'It’s Up To People'

House Speaker Paul Ryan (R-Wis.) said that because Republicans are doing away with the individual mandate, the plan could mean fewer people have insurance.

The Hill: Ryan: 'Can't Answer' How Many Will Lose Health Coverage Under GOP Plan
“I can't answer that question," Ryan told CBS News’s “Face the Nation,” when asked how many people will lose healthcare coverage. "It's up to people.” “Here's the premise of your question: Are you going to stop mandating people buy health insurance? People are going to do what they want to do with their lives because we believe in individual freedom in this country.” (Shelbourne, 3/12)

Politico: Ryan: Disaster If GOP Health Care Reform Fails
“I believe we can get 51 votes out of the Senate,” Ryan told host John Dickerson on CBS’ “Face the Nation.” “Look, this is what the legislative process looks like. When you are going through a deliberative legislative process, not ramming and jamming things but going through all the committees, going through the entire process — people are going to try and negotiate.” Ryan downplayed the opposition to the House bill as typical “negotiations and compromises.” (McCaskill, 3/12)

Intra-Party Discord Continues To Threaten Republicans' Success

The right wing of the party is demanding changes be made to what they are calling "Obamacare Lite."

Politico: Conservatives Escalate Threats To Tank Obamacare Repeal
So much for President Donald Trump's charm offensive with conservatives. Conservative Hill leaders warned on Sunday that they won’t support the House GOP Obamacare alternative as it’s written, saying they’ll let the bill fail if they don’t get concessions. (Bade, 3/12)

The Washington Post: GOP Infighting Over Health Care, Other Issues Belies Victory
Less than 24 hours after Donald Trump had won the White House, House Speaker Paul Ryan triumphantly proclaimed the start of a new era of Republican leadership that would “hit the ground running.” Six weeks into Trump’s administration, Republicans are running — just in different directions. As congressional leaders move forward with efforts to undo former President Barack Obama’s health care law, conservative activists and GOP lawmakers are slamming the proposal as “Obamacare lite,” ‘’Obamacare 2.0” and “RINOcare” — RINO standing for Republicans In Name Only, a term of derision. (Lerer and Beaumont, 3/13)

Meanwhile, in the Senate —

Reuters: Republican Senators Wobble On House Obamacare Plan
If the Republicans' plan to dismantle most of Obamacare is approved later this month by the U.S. House of Representatives, where it cleared initial hurdles last week, it would go next to the Senate, where its fate is uncertain. At least nine Republican senators have expressed concerns about the plan, which is moving forward in the House without a clear assessment of its impact on the federal budget or how it would impact the level of health insurance among Americans. (3/13)

Politico: Another Key Republican Senator Knocks GOP Obamacare Plan
Sen. Dean Heller panned House Speaker Paul Ryan's bill to repeal and replace Obamacare during a closed meeting with constituents on Saturday, according to audio obtained by POLITICO. The remarks by Heller, the most vulnerable GOP senator on the ballot next year, are another sign of the difficult prospects the House bill faces in the other chamber. Already, more than a half-dozen senators have criticized the bill, and Republicans can afford to lose only two votes. (Everett, 3/12)

Arizona Republic: Arizona Republicans In Congress Find 'Obamacare' Repeal Tough To Swallow
Arizona's congressional delegation highlights how the situation has lawmakers off balance as President Donald Trump's first high-stakes legislative battle takes shape. Not only must they consider that opposing the plan would put them at odds with the president — and his Twitter account — but also with significant interest groups and donors who fund their campaigns, as well as their leaders in Congress, who can yield significant influence over their career path on Capitol Hill. (Hansen and Nowicki, 3/12)

The Associated Press: For Kentucky Voters, A Familiar Fight: Trump Vs. Paul
Duard Rutledge voted for Donald Trump and Rand Paul for the same reason: They’re not afraid of a fight. That’s why the 66-year-old retired Toyota worker wasn’t worried to see Kentucky’s junior senator getting in the way of the Republican plan to replace Obama’s health care law. “When you get two thoroughbreds, they are high strung,” he said. “But if you get them headed the right way they can both win the race.” (Beam, 3/10)

After Years Of Absorbing Political Punches Over Health Care, Dems Angling To Turn The Tables

Some experts are even predicting control of the House is within reach if the backlash to the Republicans' health care plan is strong enough.

The New York Times: The G.O.P.’s High-Risk Strategy For Health Law Repeal
President Trump and House Republicans are pressing forward with a high-risk strategy to repeal and replace the Affordable Care Act, disregarding the views of medical professionals and potentially imperiling the party’s political future in conservative states where many voters stand to lose their health care. The effort could cause upheaval in an already roiled insurance market next year, as Republicans face voters for the first time with Mr. Trump in the White House — though that turmoil would happen only if the plans manage to clear a divided Senate. (Pear and Kaplan, 3/11)

In other news —

The Hill: Sanders: GOP Healthcare Proposal An 'Absolute Disaster' And A 'Disgrace' 
Sen. Bernie Sanders (I-Vt.) on Sunday slammed the proposed GOP healthcare plan as an "absolute disaster” and a "disgrace." “It is an absolute disaster. It is a disgrace. And by the way, this really has nothing to do with healthcare,” Sanders told CBS News’s “Face the Nation.”...House Republicans last week unveiled two measures to repeal and replace ObamaCare. The proposed legislation is experiencing opposition both from Democrats and conservative members of Congress. The new GOP plan would get rid of some components of ObamaCare while keeping others in place. It would dismantle ObamaCare's Medicaid expansion and eliminate the individual mandate requiring people purchase coverage or pay a fine to the government. The GOP plan, instead, would allow insurance providers to charge a 30 percent penalty for gaps in coverage. (Shelbourne, 3/12)

The Associated Press: Familiar Democratic Name Kennedy Fights GOP On Health Care
A familiar name from Massachusetts, Rep. Joe Kennedy III, is carrying his family legacy into a new era, battling Republicans who want to undo Barack Obama’s health care law. Kennedy, the 36-year-old grandson of the late Sen. Robert F. Kennedy and great-nephew of the late Sen. Ted Kennedy and President John F. Kennedy, has been a low-key presence in the House since he was first elected in his Boston-area district in 2012. He emerged last week as a major Democratic voice against the Republican health care bill, delivering several speeches in a committee’s all-night session that have been viewed millions of times on the internet. (Jalonick, 3/13)

The Hill: Sebelius On GOP Healthcare Plan: 'I'm Not Sure What The Goal Is Here'
Former Health and Human Services Secretary Kathleen Sebelius said she doesn't know what the focus of the GOP's plan to repeal and replace ObamaCare is. "We were clear in the Obama administration about what the goal was: insure everybody. Get everybody into the health system. We knew we had to change insurance rules to do that," she said on NBC's "Meet The Press." (Savransky, 3/12)

Health Law

Trump Playing Pitchman Behind The Scenes But Staying Out Of Limelight So Far On Repeal

President Donald Trump holds off from wading into the public debate quite yet.

The Wall Street Journal: Donald Trump Plays Background Role In Health-Care Battle
The course of Donald Trump’s presidency will be defined by his ability to seal a deal to rework the U.S. health-care system, but so far he has outsourced the job of hammering out the details to about a dozen Republican leaders and White House advisers while he serves in the background as a pitchman. (Radnofsky and Bender, 3/10)

The New York Times: Trump Keeps Low Profile After Praising Health Care Overhaul
President Trump praised House Republican leaders on Friday for their plan to overhaul the Affordable Care Act, but otherwise kept a conspicuously low profile, with a newfound silent treatment of the news media. The president’s meeting with House leaders came the day after Anthem, one of the nation’s largest health insurers, offered strong support for the Republican plan, which has been denounced by other providers and which conservatives have vowed to reject. (Thrush and Abelson, 3/10)

The Hill: Adviser: Trump Willing To Accept Improvements To Healthcare Proposal 
Gary Cohn, President Trump’s chief economic adviser, said Sunday that Trump is open to negotiating with House conservatives who are demanding changes to the current GOP health care proposal. “The president has been very open and transparent on the issue,” Cohn told “Fox News Sunday” host Chris Wallace. ... Republicans are demanding changes to the current ObamaCare repeal and replacement plan. Some demands include an end the expansion of Medicaid by 2018 instead of 2020, and the removal of insurance mandates that provide certain benefits such as maternity care. (Beavers, 3/12)

The Washington Post Fact Checker: President Trump, The King Of Flip-Flops
There is no rule that politicians must remain consistent in their policies. Circumstances change, both economically and politically, and a skillful politician certainly can adjust his or her positions accordingly. But politicians need to explain to voters why they changed their minds. At The Fact Checker, we award an Upside-Down Pinocchio when a politician shifts position on a policy without acknowledging that they did so. (Kessler, 3/13)

'Nobody Will Be Worse Off Financially': Price, Pence Dispatched To Sell GOP Health Plan

Both Health and Human Services Secretary Tom Price and Vice President Mike Pence spoke out in defense of the American Health Care Act over the weekend.

The Wall Street Journal: Trump Administration Officials Defend GOP Health Bill Amid Party Disagreement
Trump administration officials sought to buck up support for House Republican plans to overhaul the Affordable Care Act on Sunday amid vocal dissension within the party about the measure. “We strongly support the plan,” Health and Human Services Secretary Tom Price said on NBC’s Meet the Press, adding it would bring coverage to more people without raising costs. “I firmly believe nobody will be worse off financially in the process that we’re going through.” (Harrison and Harris, 3/12)

Politico: Price On Obamacare Replacement: ‘Nobody Will Be Worse Off Financially’
Health and Human Services Secretary Tom Price said Sunday that “nobody will be worse off financially” after Republicans in Congress repeal and replace Obamacare. “I firmly believe that nobody will be worse off financially in the process that we’re going through, understanding that they’ll have choices that they can select the kind of coverage that they want for themselves and for their family, not [that] the government forces them to buy,” Price told host Chuck Todd on NBC’s “Meet the Press” in an interview that aired Sunday. “So there’s cost that needs to come down, and we believe we’re going to be able to do that through this system. There's coverage that’s going to go up.” (McCaskill, 3/12)

The Hill: Price: This Is 'Absolutely Not' ObamaCare Lite
Health and Human Services Secretary Tom Price in an interview broadcast Sunday pushed back against characterizing the GOP's healthcare replacement plan as ObamaCare lite. Host Chuck Todd on NBC News's "Meet the Press" questioned how Price would respond to those referring to the plan as ObamaCare lite, and saying they are "essentially accepting the architecture but just trying to remodel the building." "No, absolutely not," Price said. (Savransky, 3/12)

Bloomberg: White House Pledges No One ‘Worse Off’ In Obamacare Replacement 
Sweeping White House promises that insurance premiums will fall and more people will have coverage under the Obamacare replacement plan may be hard to keep as conservatives demand limits to government involvement in health care before they support the measure. Top officials from Donald Trump’s administration fanned out across political talk shows on Sunday to sell the merits of the American Health Care Act, the House bill intended to replace former President Barack Obama’s signature health law. (Edney and Tracer, 3/12)

The Washington Post: Pence Relies More On Charm Than Oratory To Push The GOP Health-Care Plan In Kentucky
Vice President Pence was in full charm mode Saturday when he touched down here for a visit to try to sell the Republican health-care plan in a state that has a complex relationship with former president Barack Obama’s Affordable Care Act. Just a day earlier, Kentucky’s Republican Gov. Matt Bevin had told reporters that while he is eager to overhaul Obama’s health plan, he found himself skeptical of the initial Republican proposal and more in line with the views of Sen. Rand Paul (R-Ky.), who has been an outspoken opponent of the bill. (Parker, 3/11)

The Associated Press: Pence Appeals For Complete GOP Support For Health Overhaul
Vice President Mike Pence appealed for total GOP congressional support for a White House-backed health overhaul during a brief visit Saturday to Kentucky, where the Republican governor and junior senator are among the plan’s skeptics. “This is going to be a battle in Washington, D.C. And for us to seize this opportunity to repeal and replace Obamacare once and for all, we need every Republican in Congress, and we’re counting on Kentucky,” Pence said at an energy company where business leaders had gathered. (Thomas, 3/11)

The Hill: Pence Takes GOP Healthcare Pitch On The Road 
Vice President Mike Pence on Saturday took the Trump administration’s pitch for the GOP's ObamaCare repeal on the road. ... Pence vowed to stand by the GOP’s healthcare plan, and insisted that the transition would be swift and orderly. But the vice president focused the brunt of his address on pointedly attacking the Affordable Care Act as an unworkable and failed policy. (Greenwood, 3/11)

Bloomberg: Pence Promises Kentucky Obamacare ‘Nightmare’ About To End 
Mike Pence said the “nightmare” of Obamacare will soon end as he visited Kentucky in hopes of drumming up some good publicity for a contentious health bill that’s united many conservatives and liberals -- as well as doctors, seniors and hospitals -- in opposition.  “Obamacare has failed the people of Kentucky it has failed the people of America and Obamacare must go,” the vice president told an invited audience of about 100 mostly small business owners and Republican backers in Louisville. Pence also spoke to a smaller group of business executives, including John Schnatter, chief executive officer of locally-headquartered pizza company Papa John’s International Inc. (Pettypiece, 3/11)

Concerns About Medicaid Bog Down Prospects For GOP Replacement Bill

Republican governors, members of Congress and the administration are having difficulties coming to agreement on how to handle Obamacare's expansion of the health insurance program for low-income people.

The Washington Post: Sleeper Issue Of Medicaid’s Future Could Prove Health-Care Plans’ Stumbling Block
As House Republicans hurtle toward shifting the nation’s health-care system onto a more conservative path, nearly lost so far in the roiling debate over their plans is the profound impact they would have on insurance for the nation’s poorest and most vulnerable residents. The proposed American Health Care Act would break with the government’s half-century-old compact with states in helping to finance Medicaid, which covers 68 million low-income people, including children, pregnant women and those who are elderly or disabled. (Goldstein and Eilperin, 3/12)

The Wall Street Journal: Lawmakers Debate Fate Of Medicaid
The Republican push to overhaul the Affordable Care Act showed signs of bogging down Friday over the fate of Medicaid, as governors from states that expanded the program under the law faced off against conservative lawmakers who want to cut it back. Republican governors from the 16 states that expanded Medicaid intend to produce their own proposal for preserving some aspects of the Medicaid expansion, according to people familiar with the plan. It is expected to clash with a House GOP proposal that would freeze federal funding in 2020 for states that expanded Medicaid and bring other steep cuts. But the 16 governors don’t appear to be in agreement, one of these people said. (Hackman, Armour and Hughes, 3/11)

CQ Roll Call: Conservatives Pushing For Quicker Medicaid Expansion Changes
House Republicans ended the week still sharply divided about how quickly to try to halt new enrollment in the Medicaid expansion, with conservatives seeking White House support for speeding the timeline in GOP legislation to replace the 2010 health care law. The dispute previews the challenges ahead for Republicans as they seek to replace the law, which added about 11 million Americans to Medicaid rolls by raising income limits. So far, GOP leaders appear to be holding firm to the draft House legislation's 2019 date for effectively halting the expansion. (Young, 3/10)

Morning Consult: GOP Leaders Reject Calls To Scrap Medicaid Expansion Sooner
House Republican leaders on Friday dismissed conservatives’ calls for an earlier rollback of the Affordable Care Act’s Medicaid expansion. “I think right now that’d be very difficult to do,” House Majority Leader Kevin McCarthy said of pulling back the expansion before the current date of 2020. (Reid, 3/10)

Stat: Congressman Roger Marshall Softens Comment On Poor And Obamacare
Congressman Roger Marshall of Kansas is distancing himself from comments he made recently to STAT about poor patients and their health care, which garnered considerable backlash. In a recent interview, discussing the Affordable Care Act’s Medicaid expansion, Marshall, a Republican, said: “Just like Jesus said, ‘The poor will always be with us.’ There is a group of people that just don’t want health care and aren’t going to take care of themselves.” ... Marshall’s office sought to soften his tone and pointed to his decades of experience helping to oversee free family clinics. (Facher, 3/10)

Pittsburgh Post-Gazette: Proposed GOP-Backed Medicaid Overhaul Concerns Advocates
A Republican-crafted bill that would overhaul the Affordable Care Act has begun making its way through Congress. But in addition to changing then-President Barack Obama’s signature health care law, the legislation also proposes major changes to the Medicaid program, the federal- and state-funded program that insures many disabled individuals, elderly people and children. And that has advocacy groups concerned. (Giammarise, 3/13)

The Wall Street Journal: Following Health-Care Tweet, Medicaid Official Cancels SXSW Appearance
Days after tweeting his opposition to the House Republican plan to replace the Affordable Care Act, Medicaid’s chief medical officer abruptly cancelled an appearance at South by Southwest. In an interview Saturday, Andrey Ostrovsky said he was unable to attend “given my recent advocacy effort,” a comment he also posted on Twitter hours before he was scheduled to speak. (Evans, 3/11)

Richmond Times Dispatch: Medicaid Block Grants Embraced By GOP Candidates For Governor, But Not Some Republican Budget Leaders 
Politics and policy are clashing in the Virginia governor’s race as Republican gubernatorial candidates embrace Medicaid block grants that some GOP budget leaders regard as a dangerous approach that could shift federal health care costs to state taxpayers. Ed Gillespie, the presumed front-runner for the Republican gubernatorial nomination, told a campaign policy forum this month that he favors proposals to convert Medicaid from an entitlement program shared by the federal and state governments to a block grant that would cap federal spending on health care. (Martz, 3/12)

CQ HealthBeat: Trumpcare: Potential For Administrative Changes To The Health Law
Trump administration health officials will soon decide whether Kentucky may demand that Medicaid recipients meet work requirements similar to those imposed on welfare recipients in the 1990s. The action is one of many ways Republicans could make quiet, but substantial, regulatory changes to Medicaid, even if Democrats thwart their efforts to overhaul the health care program for the poor. Health and Human Services Secretary Tom Price will have opportunities to tip a decades-old national debate about the role of Medicaid toward views favored by fellow conservatives. (Young, 3/13)

As States Assess Fate Of Medicaid Expansion, Worries Grow 'Somebody Is Going To Lose'

Around the country, officials and advocates for low-income residents in states that have pursued the Medicaid expansion are concerned about the impact of the Republican effort to repeal and replace the federal health law.

Sacramento Bee: CA Insurance Chief: Trump To Blame If Millions Lose Health Care 
California Insurance Commissioner Dave Jones took a hard-line stance this week against the Obamacare repeal House Republicans are staking out, saying it could reverse advances California has made under the Affordable Care Act and strip 5 million Californians of their health coverage. The American Health Care Act that some are referring to as “Trumpcare” would gradually scale back federal dollars for Medicaid, known as Medi-Cal in California, and eliminate funding for the program’s expansion under Obamacare that allowed low-income adults without children to qualify for coverage. (Hart, 3/10)

The Philadelphia Inquirer/ Why The GOP Health Plan Could Be Especially Hard On Pa. Medicaid Patients
The GOP bill alters how Medicaid works, changing it from an open-ended entitlement program to one that is limited to a set amount per person each year, no matter if more people need help, or if costs go up. Policy analysts and advocates for numerous medical organizations project that cutting federal support will transfer the burden to the states, which will be faced with tough decisions among competing priorities. ... Gov. Wolf said last week that Pennsylvania would eventually lose $2 billion in federal funding for people who gained Medicaid coverage just since the ACA expanded the program. Harrisburg, which is already facing a $3 billion budget deficit, couldn’t possibly make up the difference, he said. (Sapatkin, 3/11)

Seattle Times: What The GOP Health-Care Plan Might Mean For Washington State 
The early prognosis for the Republican health-care plan in Washington state is gloomy if not grim. Unless state leaders come up with more than $1 billion a year in cuts or taxes, hundreds of thousands of Washingtonians, mostly low-income workers, would likely lose the coverage they gained under Obamacare. State and federal analysts are still modeling outcomes for the GOP bill unveiled last week, based on factors such as reduced federal support for the Medicaid expansion that gave 600,000 Washingtonians health insurance. (Young, 3/11)

Detroit Free Press: Health Care Future Uncertain For Low-Income Michiganders
In addition to the 656,744 low-income adults who have enrolled in Michigan’s expanded Medicaid plan since 2014 — dubbed Healthy Michigan — 1.2 million children, 380,000 people with disabilities and 148,000 seniors get their health care coverage through Medicaid. The expansion proved to be controversial for the state, one of 32 in the nation that accepted federal Medicaid expansion funds. It took months and several votes to pass the plan, which Gov. Rick Snyder championed, in 2013. The traditional Medicaid program basically covered children, the elderly and people with disabilities. But the expansion brought insurance to low-income adults, many of whom hadn't been able to afford insurance. (Gray, 3/12)

Atlanta Journal-Constitution: Why Georgia Republicans Are Nervous About House Health Plan
Georgia Republicans are sharply divided over the GOP proposal to replace the Affordable Care Act that’s galloping through the U.S. House of Representatives, raising concerns about the lack of a cost estimate for the overhaul and its impact on the state’s budget as it moves through Capitol Hill. As House lawmakers prepare to vote on the sweeping rewrite of health care policy, at least two GOP congressmen from Georgia said they won’t support the measure in its current form. And Gov. Nathan Deal has raised concerns about how it will affect Georgia and other states that refused to expand Medicaid. (Bluestein, 3/13)

Cleveland Plain Dealer: Ohio Could Lose Billions To Pay For Healthcare Under Obamacare Replacement, Studies Show 
Ohio boasts that it manages Medicaid costs well, helping it serve more people for each tax dollar spent. But the Republican replacement for Obamacare would give Ohio too little money to do that, a study released Monday shows. The state would fall behind by $19 billion to $25.6 billion by 2025 because the new formula would not keep pace with cost increases, says the analysis by the Center for Community Solutions, a nonpartisan Cleveland-based think tank. (Koff, 3/13)

Naples (Fla.) Daily News: Florida Republicans Want To Be Rewarded As If They Expanded Medicaid
Some Florida Republicans want to transform the state's health care system by cutting out insurance companies that act as a middleman between patients and doctors and upending how the Medicaid system serves the poor. The proposal to change Florida health care, pushed by House Republicans, would offer the same model to those on Medicaid that would be used by those in the private market. The plan has three parts: a subscription-type service for patients to see primary care doctors; a health savings account for patients to pay cash for the majority of their needs; and insurance that will cover catastrophic illnesses that can cover a broad range of health issues from appendicitis to brain cancer. (Glorioso, 3/12)

GOP 'Rescue Mission' Could Cause Collateral Damage To Parts Of Law That Are Working

The Associated Press looks at the aspects of the Affordable Care Act that may be affected by the repeal and replace plan.

The Associated Press: Some Parts Of ‘Obamacare’ Are Working Fairly Well
President Donald Trump and Republican leaders say drastic action is needed because the Obama-era health care overhaul is a disaster, with soaring premiums and insurers bailing out. It’s true that major parts of the 2010 law are clearly troubled, but others are working fairly well.The risk is that the GOP’s “rescue mission” will inflict collateral damage on what’s working and cause new problems. Or that promised solutions might disappoint. (Alonso-Zaldivar, 3/13)

The Associated Press: Health Law’s Woes, Real Or Perceived, Drive Call For Repeal
President Donald Trump and Republican leaders say drastic action is needed because the Obama-era health care overhaul is a disaster, with soaring premiums and insurers bailing out. It’s true that major parts of the 2010 law are clearly troubled, but others are working fairly well.The risk is that the GOP’s “rescue mission” will inflict collateral damage on what’s working and cause new problems. Or that promised solutions might disappoint. (Alonso-Zaldivar, 3/12)

Hospitals Worried About Being Walloped Financially By Repeal

“We are likely looking at situations where hospitals would close down service lines, shorten clinic hours and lay off staff,” said Beth Feldpush, a senior vice president at America’s Essential Hospitals.

The Associated Press: Hospitals Worry About Caring For Newly Uninsured In GOP Plan
When Colorado expanded Medicaid coverage under former President Barack Obama’s health care law, the largest provider in the Denver region hired more than 250 employees and built a $27 million primary care clinic and two new school-based clinics. Emergency rooms visits stayed flat as Denver Health Medical Center directed many of the nearly 80,000 newly insured patients into one of its 10 community health centers, where newly hired social workers and mental health therapists provided services for some of the county’s poorest residents. Demand for services at the new primary care clinic was almost immediate. (Kennedy, 3/12)

USA Today: Hospitals Fear Obamacare Repeal May Create Financial Strain
The Republican plan to overhaul Obamacare could have a dire impact on hospital finances, some health care experts warn, creating serious concerns about patient safety and health care quality. Josh Sharfstein, a pediatrician and former top health official for the city of Baltimore and the state of Maryland, says the impact of the Affordable Care Act (ACA) goes far beyond expanding health insurance coverage to millions of Americans so they can get the treatment they need. That insurance reimbursement also helps keep hospitals afloat, he says. (O'Donnell, 3/12)

Women's Health Services Would Be Cut Under Proposed Republican Plan

Sen. Patty Murray of Washington, the top Democrat on the Health, Labor, Education and Pensions Committee, says the legislation is a “slap in the face” to women.

The Associated Press: House GOP Health Bill Would Cut Women’s Services
Women seeking abortions and some basic health services, including prenatal care, contraception and cancer screenings, would face restrictions and struggle to pay for some of that medical care under the House Republicans’ proposed bill. The legislation, which would replace much of former President Barack Obama’s health law, was approved by two House committees on Thursday. (Jalonick, 3/10)

WBUR: Here's What GOP Bill Would (And Wouldn't) Change For Women's Health Care
The Affordable Care Act changed women's health care in some big ways: It stopped insurance companies from charging women extra, forced insurers to cover maternity care and contraceptives and allowed many women to get those contraceptives (as well as a variety of preventive services, like Pap smears and mammograms) at zero cost. Now Republicans have the opportunity to repeal that law, also known as Obamacare. But that doesn't mean all those things will go away. In fact, many will remain. (Kurtzleben, 3/10)

In other news about the American Health Care Act —

The Associated Press: Tax Credits Work Differently In ‘Obamacare’ And GOP Plan
Republicans hate “Obamacare,” so House GOP leaders freak out whenever their health care bill is compared to President Barack Obama’s law. But one reason some conservatives are branding the bill “Obamacare Lite” comes down to the tax credits to help consumers buy insurance. Both tax credits target people who don’t get health insurance from their employer or from the government. They are both available to people even if they don’t make enough money to owe any federal income tax. And they are both entitlement programs — if you meet the criteria, you are entitled to the benefit. (Ohlemacher, 3/11)

Milwaukee Journal Sentinel: GOP Health Care Plan Shifts Benefits Toward Higher-Income People
Almost 200,000 people in Wisconsin gained insurance coverage when the ACA took effect, most of them with very low or relatively low incomes — such as people making $14 an hour, or about $29,000 a year. Many of them eventually stand to lose their health insurance under the Republican plan that was released Monday. And others who are older and who have relatively low incomes are likely to end up paying more for less coverage. But the plan would benefit people with higher incomes who don’t receive health insurance through an employer and who haven’t been eligible for the subsidies available through the Affordable Care Act. (Boulton, 3/11)

CQ Roll Call: GOP Moves On Health Accounts Are Just The First Step On Savings
House GOP proposals to expand health savings accounts in the Obamacare replacement package are helping to set the stage for a broader push to spur thrift and investment by families as part of a sweeping tax overhaul. The House Republican legislation to partially repeal the 2010 health care law would increase contribution limits for HSAs and allows these accounts to be used to buy over-the-counter drugs. While sweeteners to encourage savings are generally popular, the fate of these proposals are tied to a repeal-and-replace package that so far has drawn criticism from conservative groups and lawmakers. (Ota, 3/13)

The Americans With The Most To Lose Under GOP's Plan? Trump Voters

The proposal will hit older, low-income rural people the hardest.

Los Angeles Times: Trump Voters Would Be Among The Biggest Losers In Republicans' Obamacare Replacement Plan
Americans who swept President Trump to victory — lower-income, older voters in conservative, rural parts of the country — stand to lose the most in federal healthcare aid under a Republican plan to repeal and replace the Affordable Care Act, according to a Times analysis of county voting and tax credit data. Among those hit the hardest under the current House bill are 60-year-olds with annual incomes of $30,000, particularly in rural areas where healthcare costs are higher and Obamacare subsidies are greater. (Levey, 3/12)

The Wall Street Journal: GOP Health Plan Would Hit Rural Areas Hard
The House Republican effort to overhaul the Affordable Care Act could hit many rural areas particularly hard, according to a new analysis, sharply increasing the cost for some residents buying their own insurance.In extreme cases, the amount a consumer might owe for a plan could exceed that person’s annual income. In Nebraska’s Chase County, a 62-year-old currently earning about $18,000 a year could pay nearly $20,000 annually to get health-insurance coverage under the House GOP plan—compared with about $760 a year that person would owe toward premiums under the ACA, an analysis by Oliver Wyman showed. (Wilde Mathews and Chinni, 3/13)

Los Angeles Times: The Life-And-Death Stakes Of An Affordable Care Act Repeal In One Of L.A. County's Poorest, Sickest Regions
Nurses and doctors rush through hallways, readying exam rooms. The clinic in Lancaster hasn’t yet opened for the day, but staff members know that once patients start filing in they won’t stop. In less than two hours, it will be standing-room only in the waiting areas. Eight years ago, the Antelope Valley Community Clinic was a mobile van that offered check-ups and employed fewer than 10 people. Today it’s a health system with two clinics, two vans and 235 employees, and treats 500 patients a day. (Karlamangla, 3/10)

CQ HealthBeat: Trumpcare: Big Bills In Small Towns
Across the country, small-town Americans are paying more than city dwellers for their insurance, with fewer options. Their prices are climbing faster, too: monthly premiums for insurance on the health care law’s exchanges spiked by an average 30 percent in rural areas last year, compared to an average 20 percent premium rise in urban areas. People in more than a third of U.S. counties, mostly rural, had just one insurance company from which they could buy Obamacare plans last year. In Georgia — home to the newly installed Health and Human Services Secretary Tom Price — and around the country, these are the Americans who have both the most to gain and the most to lose from repeal. And they are the ones Price and congressional Republicans will answer to as they craft their replacements. (Mershon, 3/13)

The Human Ramifications Of Repealing The Health Law

From a millennial with Parkinson's to a farmer with medical bills to seniors and Hispanics, America is watching and bracing for any changes that will come with the Republicans' plan to repeal and replace the Affordable Care Act.

NPR: Millennial With Parkinson's Wonders What The GOP Health Plan Would Mean
Many millennials have their hands full now, as they launch into adulthood — jobs, homes and partners. But 33-yr-old Ford Inbody is already thinking about a time when he won't be able to work. He has Parkinson's disease. Every night after work, he and his wife Cortney walk their two dogs through their neighborhood in Overland Park, Kan. For now, going out for an evening's stroll is easy. But many of their evening conversations revolve around a time they know is coming — when these walks will be more difficult. (Smith, 3/10)

The Wall Street Journal: GOP Health Plan Risks Backlash From Seniors
House Republicans’ health-care proposal is running into a new political problem: opposition from older people. One day after House GOP leaders unveiled their plan to repeal and replace the Affordable Care Act, AARP, the politically potent advocacy group for Americans over 50 years old, came out in opposition. (Peterson and Hackman, 3/11)

The Hill: High Stakes For Hispanics In Healthcare Fight 
As the debate over the fate of ObamaCare rages on Capitol Hill, few groups have more at stake than the nation’s Hispanics. Hispanics benefited more than any other group from the Affordable Care Act (ACA), partly because they occupy many of the informal and transient jobs that didn't previously offer health coverage but were required to do so under President Obama's signature healthcare law. As the Republican-led Congress and the Trump administration discuss a replacement for the ACA, many Hispanic leaders are worried their communities could be forced out of coverage and back into emergency rooms for primary care. (Lillis and Bernal, 3/13)

KUT: What The Affordable Care Act Repeal Could Mean For Startups 
As a bill to replace the Affordable Care Act, Obamacare, makes its way through Congress, entrepreneurs remind us that the federal health insurance marketplace has been a big help to them over the past few years — helping startups recruit talent and provide their workers with some security. (Lopez, 3/10)

Boston Globe: Medical Device Group Breaks Ranks, Backs Republican Health Care Overhaul 
Groups representing doctors, nurses, hospitals, and consumers have all lined up against the Republican bill to replace the Affordable Care Act, or ACA, arguing that the proposed changes being debated in Congress would eliminate health care coverage and benefits for millions of Americans. But one group conspicuously absent from the ranks of the opposition has been the organization representing medical device makers, a large sector in Massachusetts, which last week came out in support of the GOP alternative, the American Health Care Act. (Weisman, 3/12)

San Jose Mercury News: Bay Area Obamacare Critics: Are They Happy Now?
They’re all Republicans who voted for Donald Trump. And they all have one other thing in common: They despise the Affordable Care Act — “Obamacare." They call it everything from “the Unaffordable Care Act” to un-American. But are they happy now that GOP leaders in the House of Representatives have finally announced their plan to replace the law? (Seipel, 3/11)

The Hill: GOP ObamaCare Bill Energizes Town Hall Group
Progressive groups gearing up for another recess of combative town halls for Republican lawmakers say they’re getting new energy from the newly released House GOP ObamaCare replacement plan. Ahead of the April recess, groups like and Indivisible are already protesting the legislation to repeal and replace ObamaCare. (Hagen, 3/11)

Administration News

Trump Picks Bush Alum With Deep Ties To Pharma, Wall Street As FDA Nominee

Scott Gottlieb, a physician who left the Food and Drug Administration in 2007, is a consultant to GlaxoSmithKline’s product investment board; a managing director at T.R. Winston & Company merchant bank, which specializes in health care; and a clinical assistant professor at New York University School of Medicine.

The Washington Post: Trump To Select Scott Gottlieb, A Physician With Deep Drug-Industry Ties, To Run The FDA
President Trump announced late Friday that he will nominate Scott Gottlieb, a conservative physician and businessman with deep ties to the pharmaceutical industry, to be commissioner of the Food and Drug Administration. If confirmed, Gottlieb would bring a strong pro-industry, deregulatory approach to an agency that Trump has criticized as being overly restrictive. But he is also likely to support one of the agency's basic functions: to ensure that drugs are proven safe and effective before they are sold. (McGinley and Johnson, 3/10)

NPR: Trump Picks Dr. Scott Gottlieb For FDA Commissioner
An internist and hospitalist, Gottlieb has played leading roles in various government health agencies, including as deputy commissioner for medical and scientific affairs at the FDA during the George W. Bush administration. Before that, he was a senior policy adviser at CMS working on the implementation of Medicare's then-new drug coverage for seniors. (Neel, 3/10)

The New York Times: F.D.A. Official Under Bush Is Trump’s Choice To Lead Agency
The selection of Dr. Gottlieb, 44, who served as a top official at the agency during the administration of President George W. Bush, drew praise from industry executives, who had previously expressed concerns that another top contender, Jim O’Neill, held radical views that would have gutted standards for drug approval trials and testing. “I think Scott is science-based, he’s patient-focused, he’s got strong management skills and he’s intellectually tough, so he will use all of that to make sure the F.D.A. and industry are all acting in the interests of patients,” said Dr. Leonard S. Schleifer, the chief executive of Regeneron Pharmaceuticals. (Thomas, 3/10)

Bloomberg: Trump Picks Scott Gottlieb To Serve As FDA Commissioner
Gottlieb is a more mainstream nominee than some of the other candidates who were said to be under consideration. He’s a partner at one of the world’s largest venture capital firms, New Enterprise Associates, which has a portfolio of more than 300 businesses in the technology and health-care industries, according to its website. (Edney and Langreth, 3/10)

Stat: Five Things We Know About Scott Gottlieb, Trump's Pick For FDA
Gottlieb hasn’t advocated radical, baby-with-bathwater reforms, but he has proposed a tweak that would shake things up. As it stands, FDA drug reviewers are tasked with both vetting clinical data and making final decisions on applications. Because of that, Gottlieb wrote in 2012 in National Affairs, “reviewers feel an enormous weight of responsibility,” subject to “simultaneous and countervailing pressures to both speed up approval and prevent misuse of new drugs.” (Garde and Scott, 3/10)

Stat: Democrats (Mostly) Hold Their Fire As Trump Nominates Gottlieb For FDA
Democrats mostly held their fire after President Trump on Friday nominated Dr. Scott Gottlieb as FDA commissioner. Gottlieb has close ties to, and has been widely endorsed by, the pharmaceutical industry. That’s been a red flag for Democrats in the past. But leaders of the left in Congress were largely quiet about the pick, perhaps because they know Trump had flirted with far more radical choices — including a libertarian who once proposed replacing agency scrutiny of new medications with a “Yelp for drugs.” (Kaplan, 3/11)

After 3 Discussions With Trump, Rep. Cummings Says Drug Prices Are A Top Priority For President

However, the director of the Office of Management and Budget plays down the possibility of allowing Medicare to negotiate the cost of drugs. Also, the Columbus Dispatch examines the difficulties that seniors face in enrolling and navigating Medicare. And hospitals must now give Medicare patients official notice if they haven't been admitted to the hospital and are instead in observation care.

ABC News: Democrat: Trump 'Enthusiastic' About Call For Medicare To Negotiate Drug Prices
Democratic Rep. Elijah Cummings said President Trump in recent meetings was "enthusiastic" about proposals to lower drug prices by having Medicare negotiate with pharmaceutical companies and by importing less costly medicines from Canada or other foreign countries. Cummings said he met three times over the past week with the president about drug prices. (Scanlan, 3/12)

Columbus Dispatch: Many Have Trouble Navigating Medicare’s Complexities
More than 57 million seniors and disabled adults depend on Medicare, but too many people struggle to enroll and navigate the complexities of the federal health-insurance program, a national advocacy group says. And with half of all people on Medicare living on annual incomes of $24,150 or less, many can't afford the co-payments, co-insurance and deductibles associated with their coverage. (Pyle, 3/12)

Kaiser Health News: By Law, Hospitals Now Must Tell Medicare Patients When Care Is ‘Observation’ Only
Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting observation care and why they were not admitted — even if they stay in the hospital a few nights. For years, seniors often found out only when they got surprise bills for the services Medicare doesn’t cover for observation patients, including some drugs and expensive nursing home care.The notice may cushion the shock but probably not settle the issue. (Jaffe, 3/13)


Bill Could Require Employees To Submit To Genetic Testing Or Face Financial Penalties

The House Committee on Education and the Workforce approved legislation that would allow employers to ding workers up to 30 percent of the cost of their health insurance if they refuse to participate in genetic testing as part of a company's wellness program.

The Washington Post: Employees Who Decline Genetic Testing Could Face Penalties Under Proposed Bill
Employers could impose hefty penalties on employees who decline to participate in genetic testing as part of workplace wellness programs if a bill approved by a U.S. House committee this week becomes law. In general, employers don't have that power under existing federal laws, which protect genetic privacy and nondiscrimination. But a bill passed Wednesday by the House Committee on Education and the Workforce would allow employers to get around those obstacles if the information is collected as part of a workplace wellness program. (Sun, 3/11)

The New York Times: How Healthy Are You? G.O.P. Bill Would Help Employers Find Out
The bill, the Preserving Employee Wellness Programs Act, introduced by Representative Virginia Foxx, a Republican from North Carolina and the chairwoman of the House Committee on Education and the Workforce, would also significantly increase the financial costs faced by someone who does not join a company wellness program. The bill, which is under review by other House committees and has yet to be considered by the Senate, has already provoked fierce opposition from a wide range of consumer, health and privacy advocacy groups, as well as by House Democrats. Critics claim it undermines existing laws aimed at protecting an individual’s personal medical information from use by employer and others. (Abelson, 3/10)

Public Health And Education

Increasing Violence Against Health Care Workers Hurts Patient Care, Finances And Retention

Modern Healthcare reports on the problem of violence at work and the debate on how to protect nurses, doctors and other medical staff.

Modern Healthcare: Quelling A Storm Of Violence In Healthcare Settings 
Violence in healthcare settings has risen steadily in recent years. That has taken a growing financial and human toll on the nation's 15 million healthcare workers and on its hospitals and long-term care centers, and has prompted executives, providers and policymakers to take action in myriad ways. Hospitals have debuted technologies and launched awareness campaigns. States have proposed laws requiring workplaces, including in healthcare, to establish anti-violence protocols. Unions have pushed for minimum nurse-to-patient ratios. (Whitman, 3/11)

Police Wear Hats Of Drug Counselors, Social Workers In Face Of Growing Opioid Epidemic

In other news on the national crisis, a judge waives a California state law in order to allow registered nurses to administer overdose antidote to inmates. And Kaiser Permanente makes moves to review opioid prescriptions.

The Washington Post: As Opioid Overdoses Rise, Police Officers Become Counselors, Doctors And Social Workers
The nation’s opioid epidemic is changing the way law enforcement does its job, with police officers acting as drug counselors and medical workers and shifting from law-and-order tactics to approaches more akin to social work. Departments accustomed to arresting drug abusers are spearheading programs to get them into treatment, convinced that their old strategies weren’t working. They’re administering medication that reverses overdoses, allowing users to turn in drugs in exchange for treatment, and partnering with hospitals to intervene before abuse turns fatal. (Zezima, 3/12)

The Associated Press: Feds Override California To Aid Inmates With Drug Overdoses
A federal judge overrode a California state law on Friday to help combat a growing problem of inmates dying from drug overdoses.U.S. Judge Thelton Henderson of San Francisco approved waiving state law to allow licensed vocational nurses to administer the overdose antidote naloxone, which can reverse respiratory failures from opioid overdoses. (Thompson, 3/10)

Kaiser Health News: HMO Doctors Take Pains To Slash Opioid Prescriptions
On a summer afternoon in 2009, eight Kaiser Permanente doctors met in Pasadena to review the HMO’s most prescribed drugs in Southern California. Sun blasted through the windows and the room had no air conditioning, but what unsettled the doctors most were the slides a pharmacist was presenting. “We were doing so much work treating people with hypertension and diabetes, we thought those drugs would be on the list,” said Dr. Joel Hyatt, then Kaiser’s quality management director in Southern California. (Quinones, 3/13)

State Watch

State Highlights: Minn. Lawmakers Face Deadline To Stabilize Individual Insurance Market; Calif. To Revisit Whether Docs On Probation Should Notify Their Patients

Outlets report on news from Minnesota, California, Texas, Arizona, Colorado, Washington, Maryland, Connecticut, Georgia and Virginia.

Pioneer Press: Minnesota Leaders Want To Stabilize The Health Insurance Market — And Need To Act Soon
Minnesota lawmakers are facing a fast-approaching deadline to try to stabilize the state’s 2018 individual health insurance market. Any such package, which will likely cost hundreds of millions of dollars but could lower premiums by more than 20 percent, has to be passed by April 1 — and lawmakers are still trying to figure out the best approach...Less than 5 percent of Minnesotans get their health insurance through the state’s individual insurance market, but those roughly 190,000 people have been through a lot in recent years. Premiums have skyrocketed even as options have narrowed, and there’s a very real chance that the market could go away altogether. (Montgomery, 3/12)

San Francisco Chronicle: Sacramento Battle Over Telling Patients About Doctors’ Probation 
Dr. Wanda Heffernon, a former UCSF anesthesiologist, made headlines in 2001 when she pleaded guilty to stealing credit cards from her fellow physicians and forging prescriptions to feed her drug addiction. While facing those charges, she worked as a physical therapist at a nursing home in San Mateo County, where she was accused — and later convicted — of elder abuse after prying a diamond wedding ring off a 94-year-old patient, bruising the woman’s finger in the process. The judge who sentenced Heffernon to two years in prison noted the extreme vulnerability of the victim and remarked that there was “a dark side to Ms. Heffernon that is difficult to fathom.” (Gutierrez, 3/10)

Texas Tribune: Lawmaker Blasts Health Agency Over Contracting; Agency Fires Back 
The chairman of a legislative oversight panel chided Gov. Greg Abbott’s top health care appointee this week for allegedly failing to identify all of his agency’s high-dollar government contracts and gave him less less than a week to come into compliance. The health commission later fired back, saying the fault lay not with them but with the independent government body that operates the website where contract information is published. (Root and Walters, 3/10)

The Washington Post: Why Critics Say A Texas Bill Lets Anti-Abortion Doctors Lie To Pregnant Women
An ultrasound technician had just told Rachel Tittle that she was carrying a baby girl when things went terribly wrong. She was 20 weeks pregnant at the time and couldn't wait to become a mother. That's when a doctor walked into her examination room and delivered the news that still haunts her six years later. “They told me my baby's abdomen was full of fluid — and if nothing changed very soon, it was going to stop her heart,” Tittle told The Washington Post, recalling the 2011 incident. “It was a horrible, horrible experience.” (Holley, 3/11)

Sacramento Bee: California HIV Laws Could Go From Felonies To Misdemeanors
Democratic state Sen. Scott Wiener has proposed Senate Bill 239 to repeal the laws, saying they do not reflect current HIV medical practices, and have not helped stop the spread of HIV and AIDS... California law says it’s a felony for an HIV-positive person to have unprotected sex without informing their partner that they are infected. It is also a felony for HIV-positive people to donate blood, body organs or other tissue. Those convicted can spend up to seven years in prison if found guilty. Another law upgrades a misdemeanor for prostitution to a felony if the person charged has HIV or AIDS. (Ohsahl, 3/12)

Arizona Republic: Campaign Aims To Raise HIV And AIDS Awareness Among Women And Girls Through A Special Day
According to the Centers for Disease Control and Prevention, today 67 percent of all diagnoses involve gay or bisexual men, meaning about a third come from other populations — many of them heterosexual women like Dennis, she noted. Dr. Randy Gelow II, a family-medicine physician who focuses on the treatment of HIV in the gay, lesbian, bisexual and transgender community, is working to help raise awareness of the issue along with Banner Health in Phoenix. (Newman, 3/10)

Denver Post: Children's Hospital Colorado Offers Medical Day Treatment For Sick Kids
They are students at Medical Day Treatment, a school inside Children’s Hospital Colorado for kids who are too sick, or too “medically fragile,” to attend regular school. They enrolled here because they missed too much school for doctors’ appointments, physical therapy, chemotherapy or dialysis, or couldn’t last a seven-hour school day without needing a nap, or needed a nurse nearby to check the g-tubes or intravenous lines inserted into their stomachs and arms. Some are waiting for transplants. Many of them — including J.J., whose condition makes so much skin grow on his hands and face that it falls off around him but so little elsewhere that parts of him are nearly down to flesh — were bullied. (Brown, 3/12)

Seattle Times: At Cost-Plagued UW Dentistry School, Deficit Now Totals $35 Million 
Almost a year after the University of Washington mapped out a financial recovery plan for the deficit-ridden School of Dentistry, the school’s red ink has grown by another $6 million, and now totals $35 million. To try to erase the shortfall, the school is freezing reserves and most staff hiring, as well as travel and expenditures for conferences, food and beverages. It has audited its books, and hired a comptroller to oversee expenses. (Long, 3/12)

The Baltimore Sun: New Baltimore Wellness Center Works To Reduce Stigma Of Mental Illness 
Patients who receive mental health counseling at the new Simon Life and Wellness Center in Baltimore lie on white leather sofas with faux suede and fur pillows. Abstract art in warm hues adorns the walls and colorful flowers pop against the modern white interior design. It's not the typical decor for an urban mental health center, but the staff at Simon Life and Wellness in the Charles North neighborhood wants clients, many of them low-income, to see it as a cool and welcoming place. (McDaniels, 3/12)

The CT Mirror: Once Again, School Health Clinics Facing Cuts 
School-based health centers – which provide medical and mental health care and sometimes dental services and health education, often in schools with many low-income or high-risk students – have historically received widespread backing from policymakers in Connecticut. Research has linked them with improved academic performance and graduation rates, as well as better health measures, such as higher vaccination rates, reduced asthma complications and lower emergency department use. The report of the Sandy Hook Advisory Commission – established after the 2012 shootings – noted the clinics’ potential to make it easier for students to get behavioral health care without the stigma sometimes associated with mental health facilities. (Levin Becker, 3/10)

WABE: In Georgia, Rural Hospitals Struggle To Survive 
The Affordable Care Act was supposed to help by insuring more people, but Georgia and 18 other states did not expand Medicaid, which would have covered more low-income residents. At the same time, rural hospitals were also having to meet requirements imposed by the ACA, like digitizing medical records, said George Pink, director of the NC Rural Health Research Program at the University of North Carolina Chapel Hill... Nationwide, 80 hospitals have closed, and almost half of all rural hospitals are currently losing money, Pink said. (Yu, 3/10)

Texas Tribune: With Proposal To Penalize Men For Masturbating, Legislator Aims To Shake Up Health Debate 
When it comes to issues related to health, state Rep. Jessica Farrar says that men should have to undergo the same “unnecessary” and “invasive” procedures that she says Texas women are subjected to under recently passed state laws. That’s why the the Houston Democrat on Friday filed House Bill 4260, which would fine men $100 for masturbating and create a required booklet for men with medical information related to the benefits and concerns of a man seeking a vasectomy, a Viagra prescription or a colonoscopy. The bill would also let doctors invoke their "personal, moralistic, or religious beliefs" in refusing to perform an elective vasectomy or prescribe Viagra, among other proposed requirements in the bill. (Samuels, 3/12)

Austin American-Statesman: Texas Lawmaker Files Bill That Would Penalize Men For Masturbating
A Democratic lawmaker has filed a bill that would, among many provisions, create a $100 fine for men who masturbate and ejaculate outside of a woman’s vagina. The bill, called “A Man’s Right to Know,” was filed Friday, the filing deadline for the legislative session, and appears to satirize current and proposed laws and regulations that have been criticized for restricting women’s access to abortions and health care choices. (Chang, 3/11)

Dallas Morning News: Drinks At The Dentist Office? Texas Bill Takes Aim At Boozy Trend In Medicine 
Offering alcoholic beverages to patients as they wait to undergo procedures or while they are learning about a serious health care need is a practice that is both "appalling" and "irresponsible," Texas legislators said Thursday. The comments were made before the Senate Committee on Business and Commerce as state representatives reviewed SB 404, a proposed bill introduced by Sen. Lois Kolkhorst (R-Brenham). It would prohibit health care providers from offering alcoholic beverages and penalize them for doing so. (Rice, 3/10)

The Newnan Times-Herald: Toxic Dumping Into Waterways Raises Concerns
Last week the Georgia House Natural Resources and Environment committee did not pass legislation that would notify residents when toxic pollutants are being dumped into nearby rivers, lakes and landfills. One of the biggest concerns with this ruling is the dumping of coal ash, according to the Georgia Water Coalition. Coal ash is the waste left over from burning coal. (Bell, 3/10)

Editorials And Opinions

Perspectives: Bracing For The CBO's Estimates; What Would Change Under GOP Health Plan?

Opinion writers examine expectations of what the Congressional Budget Office might have to say about the Republican's plan to dismantle Obamacare, handicap how that repeal-and-replace effort is proceeding and take a hard look at how it could play out.

The New York Times: The Five Big Numbers To Look For In The C.B.O. Report On Health Care Reform
The Republican plan to replace the Affordable Care Act was released early last week, and it has already marched through consideration in two important committees. Yet members of Congress debated the policy details without essential information: The bill had not yet been “scored” by the Congressional Budget Office, a nonpartisan group of budget analysts and economists whose job is to forecast the bill’s consequences over the next decade or so. (Kevin Quealy and Margot Sanger-Katz, 3/12)

The Wall Street Journal: The House GOP Health Plan Makes ObamaCare Look Good
Speaker Paul Ryan, Rep. Kevin Brady and Rep. Greg Walden unveiled their plan to repeal and replace ObamaCare last week, and jammed it through Mr. Brady’s and Mr. Walden’s committees. Maybe they should have given it an out-of-town tryout first, because it bombed in Washington on opening night and is drawing bad reviews from left and right. (Alan S. Blinder, 3/12)

The New York Times: The Moral Failing Of Obamacare Repeal
Imagine a car crash. There’s twisted metal, broken glass and the low moaning of an injured human being. An ambulance arrives, and two emergency medical technicians get out. Now imagine this: One E.M.T. moves to the wreck, sees the wounded driver — a man, the one who’s moaning — and before doing anything else, flips down the driver’s seat visor, looking for an insurance card that isn’t there. Then he stands back up, frowns and shakes his head. (Theresa Brown, 3/11)

Chicago Tribune: Obamacare Is Floundering. Seize This Moment To Fix It.
[W]e agree with House Speaker Paul Ryan about the stakes here: "This is the closest we will ever get to repealing and replacing Obamacare," he says. "The time is here. The time is now. This is the moment." Lawmakers who don't seize it, especially Republicans, should expect the wrath of voters in 2018 and 2020. Sure, everyone wants to see the Congressional Budget Office scoring of the bill, which will show its impact not only on the budget but also on Americans who now have insurance under Obamacare. That's crucial. ... If the CBO says the GOP plan bounces too many Americans from coverage without giving them an affordable alternative, Republicans will have to retool, fast. ... But remember why we're in this situation. Obamacare isn't some health care panacea, gaining new insurers and covering exponentially larger numbers of Americans every year. It's floundering. (3/10)

The Washington Post: Millions Might Lose Health Coverage? Not To Hear Republican Leaders Tell It.
Depending on which outside analyst you ask, between 6 million and 15 million people would probably lose insurance coverage if the Republican alternative to the Affordable Care Act passes Congress and is signed into law. Or, actually, let’s revise that. Depending on whom you ask in Republican leadership, the real number is more like zero — or, perhaps, negative: People will gain coverage under the proposal. (Philip Bump, 3/12)

Detroit Free Press: Republicans' Health Care Proposal Is Doomed
Few folks on either side of the ideological divide would call Obamacare an unqualified success. And that's a fair assessment. The 2010 Affordable Care Act had two aims: Insure more Americans, and control and rationalize the health care market and its costs. The first, unquestionably, has happened. The second? It's complicated — premiums have increased, but maybe not so much as without the ACA's reforms. (Nancy Kaffer, 3/11)

The Oklahoman: GOP's Obamacare Replacement Plan Beats The Status Quo
The ironically named Affordable Care Act, better known as Obamacare, has been a mess since day one. Yet the slapdash way the law was drafted, combined with the logistical challenges of overcoming a Senate Democrat filibuster, make a clean repeal of the law unlikely. Thus, the replacement proposal unveiled by House Republicans left many disappointed. We share critics' concerns, but also see positive elements in the plan. The proposal would repeal many regulations and taxes that have created perverse incentives in U.S. health care. (3/13)

Los Angeles Times: Trumpcare: Is This What Populism Looks Like?
The battle in Congress over how to replace former President Obama’s healthcare law is about much more than health insurance. It’s the first legislative skirmish in a larger struggle over what Trumpism, Donald Trump’s presidential agenda, will turn out to be in practice. (Doyle McManus, 3/12)

Detroit Free Press: Why We Need Obamacare
I am the poster child for why we need Obamacare. If it had become law sooner, the Affordable Care Act would have meant no denial at my first application for coverage — and I could have received appropriate treatment right away, in a manner that would not pile up the debt. You don’t have to be bloodstained to know this could be you, too. It could be someone you care about. It could be a bunch of people in your neighborhood or the next town over who, if they could receive preventive care, could be taxpaying contributors to the economy. (Darci McConnell, 3/11)

Sacramento Bee: Republican ‘Health’ Bill Cruelly Takes Aim At Mentally Ill 
In their rush to dismantle the Affordable Care Act, congressional Republicans are engaging in a sleight-of-hand at the expense of people who are among the least able to fend for themselves, the severely mentally ill. A mere four months ago, in December, Republicans were patting themselves on the back for approving what they called major mental health care legislation, the 21st Century Cures Act, a measure to increase funding for mental health care and ensure more treatment for severely mentally ill people. (3/11)

Different Takes On How The Republican Health Plan Might Impact States, Individuals

In newspaper editorial pages from around the country take a look at how the GOP's American Health Care Act could affect local health care systems and the safety net.

The Lexington Herald Leader: Hoping Trump Makes Medicine Great Again
The Democratic response to President Donald Trump’s speech to Congress by our former governor of Kentucky does not represent an accurate perspective of medicine from the standpoint of a practicing internist. As a physician practicing in Kentucky over the last 15 years, I have experienced a lot of change, most of which unfortunately has occurred in the last five years. The push by the federal government to use the Electronic Health Record through the carrot of Meaningful Use requires physicians to tote around a computer from room to room. (Timothy A. Bratton, 3/10)

The Wichita Eagle: Senators: Follow Kansas House Lead And Expand KanCare
It is important to recognize our elected representatives when they do something good. Recently, 81 members of the Kansas House did something good for 150,000 hardworking Kansans when they voted in favor of expanding KanCare, the state’s Medicaid program. Timing of this vote was of the essence. Our state’s decision not to expand KanCare has cost Kansans $1.7 billion of our own tax dollars – money that is currently going to the federal government to help 31 other states expand their Medicaid programs. (Michael L. Mullins, 3/13)

Cleveland Plain Dealer: My Daughter's Fate, Living With Deadly Cystic Fibrosis, Already Is Uncertain And Her Care Costly. Please Don't Make It Worse
As a young father, I felt the uncertainties and fears of the unknown when my daughter was born, and they continue to be there as she grows up with cystic fibrosis. Living with a fatal genetic disease is difficult, but living with a rare genetic disease, such as cystic fibrosis, can be heartbreaking due to the lack of funding and lack of attention to developing a cure for all. ... I am concerned about her future medical coverage and worried about her future care. I hope the people who represent my daughter realize the changes they propose could affect how long my daughter lives. It is critical for the new administration to support efforts to have access to life-saving drugs while working on reducing the cost, and maintaining coverage for pre-existing conditions in the new health care law. (Patrick Kilbane, 3/13)

Santa Rosa (Calif.) Press Democrat: GOP Health Plan Fails Its Basic Test: Do No Harm
There isn’t an official calculation ... but health policy experts across the political spectrum concur that millions of people would lose their insurance if the House bill is enacted. No state would be as hard hit as California, where the uninsured rate has fallen to a record low of 7.1 percent, according to the Centers for Disease Control and Prevention. The national uninsured rate is 8.8 percent. (3/10)

Sacramento Bee: Republicans’ Health Plan Will Begin A New Era Of American Carnage
Say what you will about the Affordable Care Act – it is by no means perfect and does not cover everyone – but it has drastically increased the number of Americans with health insurance. Which means that I can at least get my patients on treatment for their diseases, and their families won’t be bankrupted by a trip to the emergency room. (Anthony Bhe, 3/10)

Viewpoints: A Doctor To Treat The FDA's Issues; Confronting The Nation's Drug Problem

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

The Wall Street Journal: A Doctor To Heal The FDA
Scott Gottlieb may have landed the toughest job in Washington: President Trump has selected the physician and policy expert to run the Food and Drug Administration, where a culture of control strangles innovation. An iron triangle of interest groups, the bureaucracy and the press will resist change, but Dr. Gottlieb could save lives by renovating FDA’s drug-approval processes. (3/12)

The Columbus Dispatch: Join Forces To Fight Drug Scourge
Government traditionally works in silos. An agency is created to address a very specific problem, and is given finite resources dedicated specifically to that problem. So we have agencies that deal with mental health. And agencies that deal with drug addiction. And agencies that deal with the rehabilitation of criminals. And some that deal with poverty or health care or affordable housing. (3/13)

Bloomberg: A Miracle Within Trump’s Reach: Universal Flu Vaccine
One of the high points in President Donald Trump’s speech to a joint session of Congress last week was his pledge to unleash a new era of drug development so grand that “our children will grow up in a nation of miracles.” Yet his main strategy for doing so -- slashing Food and Drug Administration regulations -- won’t solve one of the most pressing health challenges facing the country, and the world. (Bryan Walsh, 3/10)