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Doctors on the Hill
Have party’s ear, but do they
Speak for profession?

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Summaries Of The News:


Humana First Insurer To Quit ACA Marketplaces Amid Uncertainty Of Health Law's Future

President Trump and other opponents see the decision as a sign that the Affordable Care Act is failing, but many insurers cite the murkiness of the Republicans' plan for dismantling the legislation as a reason to be skittish about the marketplaces.

The New York Times: Humana Plans To Pull Out Of Obamacare’s Insurance Exchanges
Humana announced on Tuesday that it would no longer offer health insurance coverage in the state marketplaces created under the federal health care law, becoming the first major insurer to cast a no-confidence vote over selling individual plans on the public exchanges for 2018. President Trump immediately seized on the company’s decision as evidence that the Affordable Care Act needed to be repealed and replaced. “Obamacare continues to fail,” he said on Twitter. (Abelson, 2/14)

Los Angeles Times: Amid Obamacare Uncertainty, Insurance Giant Humana Plans To Leave Marketplaces In 2018
The company attributed its action to mounting losses caused by sicker-than-expected consumers. It is the first major insurer to pull back completely amid the mounting uncertainty over the GOP’s still undefined healthcare plans, though other leading health plans have exited marketplaces over the last year, citing losses. Humana’s move will also probably mean that some 150,000 policy holders in 11 states where Humana sells Obamacare plans will have to switch carriers in 2018; some may be left without any alternative. (Levey and Petersen, 2/14)

The Hill: Humana To Drop Out Of ObamaCare At End Of 2017
The decision came after Humana scaled back participation and raised premiums, among other changes. "All of these actions were taken with the expectation that the company’s Individual Commercial business would stabilize to the point where the company could continue to participate in the program," the company said in a statement. (Hellmann, 2/14)

Politico: Humana Becomes First Major Insurer To Quit Obamacare Exchanges
The decision makes Humana the first major insurer to fully exit Obamacare amid uncertainty about the GOP's undefined health care plans. Other major insurers said they could also withdraw from Obamacare marketplaces next year if Republicans don't take immediate steps to shore up the law before replacing it. (Cancryn, 2/14)

Bloomberg: Trump Points To Humana Exit From Obamacare As Sign Of Failure 
The insurer said in July that it was reducing its presence in the individual market for 2017. At the time, the company said it was halting almost all sales of individual health insurance off of Obamacare’s exchanges. Humana said that for 2017 it would offer individual plans in about 156 counties in 11 states, down from 1,351 counties in 19 states a year earlier. (Tracer, 2/14)

CQ Roll Call: Humana Will Not Participate In Obamacare In 2018
The health insurer, which had already withdrawn from many of the markets in which it was participating last year, attributed the full exit to early signs that the marketplaces remain unstable. Other companies, including Anthem and Aetna, have said they are considering a similar retreat from some of the exchanges on which they currently offer plans. (Mershon, 2/14)

Near-Simultaneous Deaths Of Two Insurance Mega-Mergers Signals Victory For Antitrust Officials

Within hours of each other, companies involved in the Aetna-Humana merger and the Cigna-Anthem deal threw in the towel.

The Associated Press: 2 Big Insurance Breakups On Valentine's Day
It was a rough day for the already-roiled U.S. health insurance market: One giant merger was abandoned, another is threatened by infighting, and a major insurer announced it will stop selling coverage on public exchanges in 11 states. Both merger deals had already been rejected by federal regulators and judges, but the companies were considering appeals to those decisions. Now they both appear to be off. (Murphy, 2/14)

Reuters: Aetna, Humana Drop Merger; Cigna Wants To End Anthem Deal
Health insurers Aetna Inc and Humana Inc walked away from their $34 billion merger on Tuesday and Cigna Corp sought to end its deal with Anthem, shelving the industry consolidation they charted to address former President Barack Obama's Affordable Care Act. (Humer and Bartz, 2/14)

USA Today: Aetna-Humana $37B Health Merger Dies, Cigna-Anthem Fight Over $48B Deal
Reacting to recent court rulings that blocked both transactions on antitrust grounds, Aetna on Tuesday abandoned its planned $37 billion merger with industry rival Humana in an agreement approved by both companies. But Anthem and Cigna battled each other over the fate of their planned $48 billion transaction. Cigna filed a court action to scuttle the tie-up and seek legal damages from its deal partner, while Anthem vowed to press ahead. The developments are the latest corporate fallout from the Obama administration's decision to challenge corporate mergers on anti-competition grounds and seek to block so-called tax inversion deals based on contentions they take unfair advantage of tax loopholes and would erode the nation's tax base. (Bomey and McCoy, 2/14)

Modern Healthcare: Cigna Seeks More Than $14 Billion In Formal Termination Of Anthem Deal
[Cigna] said the planned $54 billion merger, which was blocked by a federal district court last week on anti-competitive grounds, “cannot and will not achieve regulatory approval” and that calling it off is best for its shareholders. Cigna alleged that Anthem “willfully breached” the merger agreement in a way that made it unlikely the deal would be approved and has harmed Cigna's shareholders. (Livingston, 2/14)

The Washington Post: Cigna Demands Anthem Pay $14.8 Billion In Lawsuit To Terminate Merger Agreement
An Anthem spokeswoman said the company is still committed to closing its deal with Cigna, signaling the breakup could be messy. In a news release, Cigna announced it had filed a lawsuit in Delaware Chancery Court against Anthem seeking a judgment that the merger agreement had been terminated lawfully and seeking a $1.85 billion termination fee, along with an additional $13 billion in damages. ... Anthem spokeswoman Jill Becher said that Cigna's action was invalid and said the company "does not have a right to terminate the agreement." (Johnson, 2/14)

The CT Mirror: Cigna Sues To End Merger Deal, Seeks $15 Billion From Anthem 
The Justice Department blocked the merger last summer, saying a marriage of the insurers would kill competition in many markets for large-business health insurance policies, also known as “national accounts.” ... During the month-long antitrust trial that began in early December, Justice Department lawyers argued that, in addition to the antitrust issues, strained relations between the top executives of Anthem and Cigna doomed the merger to failure. (Radelat, 2/14)

The Wall Street Journal: Antitrust Rulings Put Chill On Health-Insurance Mergers
The fate of both deals represents a victory for the Obama administration’s antitrust officials, who were able to win the cases despite major differences between the two transactions. In the Aetna case, a judge in January said the merger could harm seniors who buy the private Medicare plans known as Medicare Advantage. The Anthem antitrust decision by a different judge last week focused closely on that acquisition’s potential impact on large, multistate employers that offer health coverage to their workers. Both acquisitions came together amid an insurance-industry merger frenzy in 2015, but the dynamics in each have been different. (Wilde Mathews and Kendall, 2/14)

Capitol Hill Watch

As Conservatives Dig In On Complete Repeal, GOP Leaders Warily Eye Growing Intra-Party Divide

The Freedom Caucus vows to block any legislation that doesn't go far enough. Meanwhile, Speaker Paul Ryan is making the rounds to try to gin up support.

The Hill: Rift In GOP Threatens ObamaCare Repeal 
House Republicans are facing a major split on ObamaCare repeal that threatens to stall the effort. Members of the conservative House Freedom Caucus late Monday vowed to oppose any ObamaCare repeal bill that doesn’t go as far as what Congress passed in 2015. But the bill being pushed by the Freedom Caucus would repeal ­­ObamaCare’s expansion of Medicaid, an option that centrist Republicans are wary of supporting, particularly in the Senate. (Sullivan, 2/14)

Roll Call: Coffman Promises Constituents No Repeal Of Obamacare Without Replacement
Colorado Republican Rep. Mike Coffman promised constituents that there would be no repeal of Obamacare without a replacement while others in his party are pressing for Congress to do the opposite. Coffman made the pledge while announcing a “listening tour” on the Affordable Care Act in his district. Coffman said he will hold meetings with members of the medical community, patients and constituents in order to discuss the issues and concerns. (Prater, 2/14)

The Washington Post: Ryan Faces Major Test In Selling Obamacare Repeal And Replacement
House Speaker Paul D. Ryan (R-Wis.) spent Tuesday on a door-to-door tour of the Capitol in hopes of salvaging his plan to repeal and largely replace the Affordable Care Act by spring. The day-long blitz comes as Republicans in Congress have made virtually no visible progress in recent weeks on overhauling the health-care system, according to interviews with several senior GOP aides. (Snell and DeBonis, 2/14)

The Associated Press: Conservatives Want Fast Health Law Repeal, Leaders Cautious
Conservatives have demanded a quick vote on erasing much of President Barack Obama's health care law, with some threatening to oppose less sweeping legislation. But House Republican leaders said they were working deliberatively as the party continued its struggle to find a replacement that could pass Congress. "This affects every person and every family in America," House Speaker Paul Ryan, R-Wis., told reporters on Tuesday. "That's why we're taking a step-by-step approach." (Fram, 2/14)

The Washington Post: Hill Republicans Are Eager To Talk Policy. But Trump Is Getting In Their Way.
One by one, Republican lawmakers stepped to the microphone and talked about the topic that was not consuming Washington on Tuesday morning: overhauling the health-care system. One committee chairman declared that Republican lawmakers were “working on solutions” to replace and repeal the Affordable Care Act. Another chairman was more cautious, explaining that Republicans were “taking our time” to “get it right.” House Speaker Paul D. Ryan spoke on each side of the issue, saying both that the health-care system is “collapsing” and needs a “rescue,” and promising a “step-by-step approach” leading to a “stable transition.” (Kane, 2/14)

Kaiser Health News: Influence Of GOP Doctors Caucus Grows As Congress Looks To Replace Health Law
The confirmation of Tom Price, the orthopedic surgeon-turned-Georgia congressman, as secretary of Health and Human Services represents the latest victory in the ascendancy of a little-known but powerful group of conservative physicians in Congress he belongs to — the GOP Doctors Caucus. During the Obama administration, the caucus regularly sought to overturn the Affordable Care Act, and it’s now expected to play a major role determining the Trump administration’s plans for replacement. (Galewitz, 2/15)

House Republicans Weighing Key Medicaid Change As Part Of Health Law Overhaul

Rep. Brett Guthrie, R-Ky., says Republican leaders are considering switching federal payments for Medicaid to per capita allotments, but it's not clear that proposal will win supporters in the Senate. Meanwhile, Politico looks at how GOP lawmakers who want to cut Medicaid spending may be forced to increase the funding for a bit.

The Hill: Key Republican: GOP Eyeing Major Change To Medicaid In ObamaCare Bill
A top House Republican on healthcare said Tuesday that lawmakers are looking to dramatically restructure Medicaid as part of an ObamaCare repeal bill. Rep. Brett Guthrie (R-Ky.), the vice chairman of the House Energy and Commerce health subcommittee, told reporters that Republicans are looking to include an idea known as "per capita caps" for Medicaid in the fast-track reconciliation bill used to repeal ObamaCare. The comments suggest that Republicans are dealing not just with ObamaCare, but also with restructuring Medicaid as part of their repeal efforts, adding another level of complication. (Sullivan, 2/14)

Morning Consult: GOP Considers Medicaid Reforms For Reconciliation Bill
House Republicans are weighing specific reforms to Medicaid that could be included in a reconciliation measure to overhaul the Affordable Care Act. How to deal with the federal expansion of Medicaid under the ACA is one of the main unanswered questions as Congress works to overhaul Obamacare .... Rep. Brett Guthrie (R-Ky.), the vice chairman of the Energy and Commerce Health Subcommittee, said Tuesday that lawmakers are considering what types of reforms — specifically shifting to per capita allotments or allowing states to choose block grants — could be included in a House reconciliation bill to repeal the ACA. (McIntire, 2/14)

Roll Call: Ambitious House Agenda On Medicaid Could Stall In Senate
Senators are warning that major changes to the Medicaid program may not survive the upper chamber, despite an aggressive push from House Speaker Paul D. Ryan to include a substantial overhaul of the program in the Republican measure to repeal the health care law. In the House, Ryan and House Energy and Commerce Chairman Greg Walden are pushing their colleagues to consider major Medicaid changes on a repeal bill this spring. Those include funding mechanisms like so-called block grants and per capita caps or a cap on Medicaid enrollment for states that expanded the program under the health care law, according to House aides. (Williams and Mershon, 2/14)

Politico: GOP May Boost Medicaid Spending In Order To Slash The Program
Republicans determined to cut Medicaid may first have to pour more money into it, to keep the peace between Republican governors who expanded health care for low-income people under Obamacare and those who resisted. It’s all part of the GOP’s long-term plan to dramatically revamp the health care entitlement for the poor in order to cap what they see as runaway federal spending. (Haberkorn and Pradhan, 2/15)

Health Law

Uninsured Rate Lowest On Record As Republicans Prepare To Dismantle Health law

The rate of uninsured in America is nearly half what it was before the Affordable Care Act was passed.

Los Angeles Times: As GOP Plows Forward On Obamacare Repeal, New Data Show The Nation's Uninsured Rate Hit A Record Low Last Year
The nation’s uninsured rate tumbled further last year, hitting the lowest rate on record, according to new government data that underscored what is at stake in the Republican effort to repeal the Affordable Care Act. In the first nine months of 2016, just 8.8% of Americans lacked health coverage, survey data from the federal Centers for Disease Control and Prevention show. (Levey, 2/14)

San Jose Mercury News: Obamacare: California's Uninsured Rate Drops To New Record Low
The Affordable Care Act, the same law that President Donald Trump and the Republican majority Congress are intent on replacing, has helped California reduce its uninsured rate to a  record low of 7.1 percent. That’s almost 10 percentage points less than in 2013, when 17 percent of Californians were uninsured and just before the health care law took full effect, according to a new survey released Tuesday by the Centers for Disease Control and Prevention. (Seipel, 2/14)

Math For Insurance Only Adds Up If Healthy Subsidize The Sick, Expert Says

Economist Jonathan Gruber, who worked on both the Massachusetts and federal health overhauls, joined other health experts on a panel looking at the obstacles Republicans will face when trying to craft something that's less expensive but still ensures people have access to coverage. Meanwhile, actuaries offer their take on stabilizing the marketplace.

Boston Globe: Health Care Experts Discuss Replacement For Obamacare 
None of the health care reform plans currently under discussion in Washington address the critical issue of paying for coverage for sick people, according to an MIT economist who had a hand in crafting the federal Affordable Care Act. ... [Jonathan] Gruber said health coverage could be expanded without an individual mandate if there was a reinsurance program instead that paid insurers for covering sick people. “That could work, if you spend enough money,” Gruber said, “But we’re going to have to increase the deficit to do that.” The math of insurance, he noted, doesn’t work unless lower-cost healthy people subsidize coverage for sicker people whose care is more costly. (Dayal McCluskey, 2/14)

In other news —

San Francisco Chronicle: Quiet IRS Change Could Undermine Obamacare, Supporters Say 
Following an executive order from President Trump to “minimize the economic burden” of the Affordable Care Act, the Internal Revenue Service said it is backtracking on its plan to reject 2016 tax returns that do not indicate whether the taxpayer complied with the act’s individual mandate. Supporters of the act, which is known as Obamacare, fear this behind-the-scenes change could undermine enrollment in health insurance. (Pender, 2/14)

The Philadelphia Inquirer: What 'Repeal And Replace' Could Mean For Pennsylvanians
If the debate in Washington over the future of Obamacare seems distant and abstract, a network of health foundations in Pennsylvania seeks to make it close and clear, at least statistically. The Pennsylvania Health Funders Collaborative, which supports the Affordable Care Act, drills down to the local level, detailing the impact by county, hospital, and congressional district (the elected representatives who will decide the issue). (Sapatkin, 2/14)

Administration News

AP Finds Potential Conflict Of Interest Issues Around CMS Nominee Seema Verma's Work In Indiana

In a review of documents, The Associated Press reports that Verma's consulting firm made millions through agreements with nine states -- work that may have conflicted with her public duties. And KHN reports on the reemergence of "death panel" fears.

The Associated Press: Pick For Medicare Post Faces Questions On Indiana Contracts
President Donald Trump's pick to oversee Medicare and Medicaid advised Vice President Mike Pence on health care issues while he was Indiana's governor, a post she maintained amid a web of business arrangements — including one that ethics experts say conflicted with her public duties. A review by The Associated Press found Seema Verma and her small Indianapolis-based firm made millions through consulting agreements with at least nine states while also working under contract for Hewlett Packard. (Slodysko and Johnson, 2/15)

Kaiser Health News: Docs Bill Medicare For End-Of-Life Advice As ‘Death Panel’ Fears Reemerge
End-of-life counseling sessions, once decried by some conservative Republicans as “death panels,” gained steam among Medicare patients in 2016, the first year doctors could charge the federal program for the service. Nearly 14,000 providers billed almost $35 million — including nearly $16 million paid by Medicare — for advance care planning conversations for about 223,000 patients from January through June, according to data released this week by the Centers for Medicare & Medicaid Services. Full year figures won’t be available until July, but use appears to be higher than anticipated. (Aleccia, 2/15)

Women’s Health

GOP Bill Would Roll Back Obama's Ban On States Defunding Planned Parenthood

Because the measure, which was sent to the House floor on Tuesday, is being moved through a law that allows Congress to rescind recently finalized rules, the bill cannot be filibustered in the Senate, raising its odds for success. Media outlets report on women's health news out of Oklahoma, Texas and Arkansas as well.

USA Today: Congress To Challenge Rule Protecting Planned Parenthood Grants
House Republicans are taking aim this week at an Obama-era rule that bans states from denying federal funds to Planned Parenthood and other health care providers that perform abortions. The House Rules Committee on Tuesday sent legislation to the House floor that would rescind the rule, which prohibits states from withholding family-planning funding from providers for reasons other than their ability to offer family-planning services. (Gaudiano, 2/14)

CQ Roll Call: Family Planning Rule Could Preview Planned Parenthood Debate
At issue is a regulation finalized last December by the Department of Health and Human Services after 13 states passed laws that would deny health centers who provide abortions from receiving federal family planning dollars, known as Title X funding. In some cases, funds were even routed away from family planning centers that didn’t provide abortions in favor of more general community health centers. The rule clarified that states could not deny a health center funds on any basis other than its ability to adequately provide health services. (Siddons, 2/14)

The Hill: Republicans Make First Move Targeting Planned Parenthood Funding
“It is not the role of politicians in Washington to usurp the states' 10th Amendment rights and subject our judgment for that of state and local leaders,” said Rep. Diane Black (R-Tenn.), sponsor of the resolution. But Democrats call the move a thinly shrouded attack on abortion providers. “It’s really about getting at Planned Parenthood, and this is the first salvo in doing so,” said Rep. Jim McGovern (D-Mass.). (Hellmann, 2/14)

The Washington Post: Lawmaker Who Called Pregnant Women A ‘Host’ Pushes Bill Requiring Fathers To Approve Abortion
A bill advancing in Oklahoma would require a woman to get the written consent of the fetus’s father before obtaining an abortion. The bill, which passed out of a House committee Tuesday, would also require a woman “to provide, in writing, the identity of the father of the fetus to the physician who is to perform or induce the abortion,” according to the bill’s language. “If the person identified as the father of the fetus challenges the fact that he is the father, such individual may demand that a paternity test be performed.” (Somashekhar and Wang, 2/14)

The Associated Press: Texas Anti-Abortion Efforts Renew After Supreme Court Defeat
Undeterred by a U.S. Supreme Court decision striking down sweeping abortion restrictions that were sold as protecting women's health, Texas Republicans are pushing new measures pitched as protecting fetuses, with a hopeful eye toward Washington. New anti-abortion measures are moving through the Legislature — where Democrats are virtually powerless to stop them — and opponents see a shift in GOP strategy after last year's 5-3 Supreme Court ruling that rejected the state's claims of trying to safeguard women and dismantled a 2013 law that prompted many of the state's abortion clinics to close. (2/14)

The Associated Press: Arkansas House Approves Ban On ‘Sex-Selection’ Abortions
The Arkansas House voted Tuesday 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, moving the state closer toward adopting a “sex-selection” ban that opponents say is unconstitutional. The prohibition adopted by the majority-Republican House on a 79-3 vote is the latest among a series of abortion restrictions advancing months after Republicans expanded their majorities. The bill now heads to the majority-GOP Senate. (Demillo, 2/14)

The Associated Press: Study: Most Texas School Districts Have Scant Sex Education
More than four-fifths of school districts offer no sex education or only teach abstinence in Texas, which has one of the country's highest teen birth rates, according to a study released Tuesday. The study commissioned by Texas Freedom Network, a left-leaning education watchdog group, found that 25 percent of roughly 1,000 school districts statewide didn't offer any sex education during the 2015-2016 school year and about 58 percent only taught students to abstain from sex. (2/14)


Decades-Long Quest To Battle Alzheimer's Dealt Latest Blow As Merck Pulls Plug On Anticipated Drug

Similar treatments from Eli Lilly, Pfizer and Johnson & Johnson have all come up short in recent years. Meanwhile, treatments for mental illnesses have seen few advances despite increased understanding of the diseases.

Stat: The Next Big Alzheimer's Trial Came Up A Dud
Merck pulled the plug on a closely watched trial in Alzheimer’s disease after finding out its in-development drug had no effect on patients with mild forms of the disorder. The drug, verubecestat, showed “virtually no chance” of meeting its goal in a 2,200-patient study, Merck said. The trial was meant to read out later this year, but Merck, on the advice of its independent data monitors, pulled the plug early. (Garde, 2/14)

Stat: Scouring The Brain For Clues To New Treatments For Mental Illness
While demand for mental health drugs has surged, big pharmaceutical companies have largely backed away from investing in the field; the number of psychopharmacological drug research programs has shrunk 70 percent in the last decade, according to NeuroPerspective...To advance the field, researchers say they need to find biomarkers — tangible biological clues that can help diagnose mental illness, just the way high blood glucose levels can signal diabetes. The hope is that those biomarkers could help pinpoint what’s gone wrong in the circuitry of a particular patient’s brain and offer clues for drug development — and, perhaps one day, even precision psychiatric therapies. (Keshavan, 2/15)

Public Health And Education

Advisory Panel, Tiptoeing Into Ethical Minefield, Reverses Guidance On Editing Human Embryos

The National Academy of Sciences and the National Academy of Medicine said that modifying genes in embryos is acceptable if the alterations are designed to prevent babies from acquiring genes known to cause “serious diseases and disability,” and only when there is no “reasonable alternative.”

The New York Times: Human Gene Editing Receives Science Panel’s Support
An influential science advisory group formed by the National Academy of Sciences and the National Academy of Medicine on Tuesday lent its support to a once-unthinkable proposition: the modification of human embryos to create genetic traits that can be passed down to future generations. This type of human gene editing has long been seen as an ethical minefield. (Harmon, 2/14)

The Washington Post: Ethicists Advise Caution In Applying CRISPR Gene Editing To Humans
Ethicists have been working overtime to figure out how to handle CRISPR, the revolutionary gene-editing technique that could potentially prevent congenital diseases but could also be used for cosmetic enhancements and lead to permanent, heritable changes in the human species. The latest iteration of this ongoing CRISPR debate is a report published Tuesday by the National Academy of Sciences and the National Academy of Medicine. The report, a series of guidelines written by 22 experts from multiple countries and a variety of academic specialties, presents a kind of flashing red light for CRISPR. (Achenbach, 2/14)

NPR: Editing Human Embryo Genes Could Be Allowed Someday, Scientific Panel Says
The academies determined that new gene-editing techniques had made it reasonable to pursue such controversial experiments down the road, though not quite yet. "It is not ready now, but it might be safe enough to try in the future," R. Alta Charo, a bioethicist at the University of Wisconsin-Madison who co-chaired the committee, said. "And if certain conditions are met, it might be permissible to try it." That conclusion counters a long-standing taboo on making changes in genes in human sperm, eggs or embryos because such alterations would be inherited by future generations. (Stein, 2/14)

In Effort To Stem Flood Of Opioids Into Country, Bill Would Tighten Up International Shipping Rules

The legislation would require packages shipped into the United States from foreign postal services and through the U.S. Postal Service to provide information on who is sending the package, where they are sending it from, who it’s being sent to, and what the package contains.

Stat: Bipartisan Bill Aims To Choke Off Opioid Shipments Into US
Aiming to choke off shipments of powerful synthetic opioids such as fentanyl, a bipartisan group of lawmakers is introducing legislation on Tuesday to require more information on packages mailed into the US. The bill, sponsored in the Senate by Republicans Rob Portman and Marco Rubio along with Democrats Amy Klobuchar and Maggie Hassan, was introduced late last Congress but never moved. A similar bill is expected to be introduced in the House by Representatives Pat Tberi, a Republican, and Richard Neal, a Democrat. (Scott, 2/14)

In other news on the opioid crisis —

Kansas City Star: Obamacare Repeal Would Gut Opioid Treatment Gains, Study Finds
A new study by Harvard Medical School and New York University shows that repealing the Affordable Care Act would cut $5.5 billion a year for substance-abuse and mental health treatment, creating a 50 percent spike in the number of people unable to address their opioid dependence. The lost funding would have sweeping implications as deaths from opioid abuse continue to rise across the nation and local governments struggle with the effects on their communities. (Pugh, 2/14)

WBUR: Fight Over Hyannis Needle Exchange Program Goes Before Mass. High Court 
The state's highest court is considering a case that could have implications for needle exchange programs across Massachusetts. Justices for the state's Supreme Judicial Court on Tuesday heard arguments in an almost year and a half long fight between the town of Barnstable and the Aids Support Group of Cape Cod over the group's needle exchange program in Hyannis. Barnstable officials issued a cease and desist order against the program back in 2015, saying it was behind the large numbers of discarded needles littered around Hyannis. (Becker, 2/14)

Cincinnati Enquirer: John Kasich Would Block Access To Heroin Death Reviews
Gov. John Kasich's budget would give counties a new way to review drug overdose deaths, but many components of those investigations into Ohio's drug epidemic could be shielded from public view. Ohio leads the nation in opioid overdose deaths. More than 3,000 people died in 2015 because of fatal drug overdoses – a number that has increased each year since 2009, according to state health department records. (Balmert, 2/14)

The Philadelphia Inquirer: Study: New Moms May Be Getting Opioid Painkillers They Don't Need
Twelve percent of low-income women in Pennsylvania filled an opioid prescription several days after a normal birth, even though most of them had no clear-cut medical need for an addictive painkiller, according to a new study. About 2,600 of those women filled a second opioid prescription up to two months later, even though most had no pain-causing obstetrical condition in their medical records, and some had a history of non-opioid substance abuse, the University of Pittsburgh analysis found. (McCullough, 2/14)

The CT Mirror: With Drug Deaths Up 44%, An Insurer Bankrolls A New Approach
Gov. Dannel P. Malloy urged a Hartford audience Tuesday to take up his grim new morning reading habit: He scans the obituary pages for the sudden deaths of young adults, too often the telltale sign of what he says is Connecticut’s raging opioid epidemic. Malloy talked about his new practice of decoding death notices for evidence of overdoses at the kickoff of a three-year effort in Hartford to test new ways to attack drug addiction before it takes root in vulnerable teens, a project financed by the charitable foundation of UnitedHealthcare. (Pazniokas, 2/14)

Public Education, Increased PrEP Use Credited For Big Drop In HIV Rates

Overall the numbers are improving, but some groups have double-digit increases.

The Washington Post: CDC Reports More Progress Against HIV, But Gay Latinos Contracted More Infections
The government reported more evidence of progress against HIV on Tuesday, citing an 18 percent decline in the number of U.S. infections between 2008 and 2014 and even sharper drops among heterosexuals and people who inject drugs. The Centers for Disease Control and Prevention said that the estimated number of infections fell from 45,700 in 2008 to 37,600 in 2014, after remaining at roughly the same level for more than a decade. Heterosexuals saw a 36 percent decline in HIV diagnoses during the same period, and intravenous-drug users experienced a 56 percent drop despite a burgeoning opioid epidemic. (Bernstein, 2/14)

In other public health news —

NPR: Cold Caps Reduce Hair Loss From Chemotherapy
It's no surprise that most women with breast cancer consider hair loss one of the most traumatic aspects of chemotherapy. That has led to a big market for cooling caps, which are purported to limit hair loss. But cooling caps haven't been extensively studied in the U.S., and womens' experiences with the caps have been hit or miss. And just one cooling cap, the DigniCap, is approved by the Food and Drug Administration. (Neighmond, 2/14)


Central Illinois Facing Adequacy 'Crisis' As Hospitals Reject Medicaid Managed Care Plans

At least three hospital systems have announced plans to cut ties with Molina Healthcare, which manages the state's Medicaid program in central Illinois, leaving tens of thousands of enrollees in a tough position. Also, legislators in Colorado begin to explore how to cover the expanding Medicaid budget.

Modern Healthcare: Central Illinois Facing Medicaid Network Adequacy 'Crisis'
Hospitals in central Illinois are rejecting managed Medicaid plans at such a troubling rate that lawmakers are calling it a “crisis.” Decatur Memorial Hospital, Memorial Hospital System and Hospital Sisters Health System have all announced plans to cut ties with Molina Healthcare of Illinois over the last few months. The decision puts tens of thousands of patients in central Illinois in a tough position as the region's other managed care plan, Health Alliance, exited the market last year. (Dickson, 2/14)

Denver Post: Rising Medicaid Costs Fuel Much Of Colorado Legislature’s $105 Million Spending Increase 
Colorado lawmakers are poised to approve an additional $105 million in spending for the current year, even as a budget shortfall looms. House lawmakers will begin considering a package of 18 supplemental budget bills this week as part of an annual mid-year spending adjustment to the $25.8 billion budget approved in 2016. The Senate approved the measures last week with little opposition. (Frank, 2/14)

And one Medicaid company is facing a storm of criticism over building plans --

St. Louis Post Dispatch: Clayton Rejects Centene Petition As Unconstitutional
A citizen-led initiative petition seeking to give residents a vote on large development projects is unconstitutional, violates the Clayton city charter and is “totally unworkable,” city officials said Tuesday night. ...The effort was the latest to stymie Medicaid managed care company Centene’s recently approved campus expansion. It would require public votes before permits were issued to buildings in excess of 200 feet or 10 stories in height or 200,000 square feet of space. The Clayton-based health care company plans to transform a corner of downtown with a $772 million complex of office towers, a parking garage, retail space, apartments and theater. Centene says it will add 2,000 people to its existing Clayton workforce of about 1,000 employees. (Barker, 2/14)

State Watch

State Highlights: Ga.'s 'Surprise' Medical Bill Legislation Hits Snag; Mass. Commission Urges State To Up Oversight Of Hospital Rates

Outlets report on news from Georgia, Massachusetts, Minnesota, Connecticut, Texas, Michigan, Kansas, California, Maine and Florida.

Georgia Health News: Proposal To End ‘Surprise’ Billing Tied Up Over Payment Formula 
The major snag is a lack of agreement on a formula to determine reimbursement rates for doctors, said Sen. Renee Unterman, the bill’s sponsor, at a legislative hearing Tuesday. Unterman, a Republican from Buford, is also a nurse and has been concerned about the problem for a long time. Surprise medical bills can come from ER doctors, anesthesiologists, radiologists, pathologists and others who are not in a patient’s insurance network — even though the hospital where they work is in the network. (Miller, 2/14)

Boston Globe: Special Panel Recommends Regulating Hospital Rate Increases
Commissioners said the Division of Insurance should have greater authority to oversee hospital-insurer contracts, including the amount hospital rates can increase each year. The controversial proposal comes after months of discussions at the commission, which was convened to study the wide variation in prices at Massachusetts hospitals. Studies have shown that price disparities contribute to higher health spending because the most expensive providers also tend to have the top reputations and attract the most patients. (Dayal McCluskey, 2/15)

The Star Tribune: Nursing Strikes Cost Allina $149 Million
Two contentious nursing strikes cost Allina Health more than $149 million last year — wiping out the year’s operating revenues for the Minneapolis-based hospital and clinic system. More than 4,000 nurses struck twice — for seven days in June and again for 37 days in the fall — after Allina demanded that they give up a union-backed health insurance plan and accept the same coverage offered other employees. (Olson, 2/14)

Georgia Health News: Flu Misery Continues Across The State 
The Department of Public Health said that through the week of Jan. 29 through Feb. 4, there had been 376 hospitalizations in metro Atlanta due to influenza so far this season. That’s up from 61 at the same time a year ago. The state reported last Friday that it had two confirmed flu-associated deaths this season, the same number as the same period a year ago. (Miller, 2/14)

Boston Globe: On Beacon Hill, A Fight Between Dentists, Hygienists 
Advocates for hygienists say that poor and disabled people, often minority children, struggle to find good dental care because of a shortage of dentists willing to serve them. The group is pushing for a new class of advanced hygienists, sort of nurse practitioners for the mouth, who could offer the kind of help that they say these patients aren’t getting. Traditional dentists, though, said such a role would endanger rather than help the poor by putting them in the hands of people who lack proper training and skills. (Krantz, 2/15)

Pioneer Press: Kids In Need Getting Free Sealants, Dental Care This Month 
Community Dental Care Program director Ann Copeland said it’s important for immigrant populations to see a diverse, welcoming staff. Copeland said 83 percent of their clients are on public assistance, and 8 percent are uninsured. More than half are children. Many of the refugee populations qualify for public assistance but have trouble navigating the healthcare system due to language and cultural barriers. Some are unfamiliar with modern dental hygiene, such as fluoride treatments, or don’t realize that soda contains sugars and acids that can lead to tooth decay. Legal status can also be a barrier. Some Mexican-American families are undocumented and resist applying for public assistance and making their presence known to state and county government, Copeland said. (Melo, 2/14)

The CT Mirror: With Demand Already Up, Free Clinics Anticipate More Need 
AmeriCares Free Clinics opened a new facility to treat the uninsured in Stamford last month, it didn’t take long to see what Executive Director Karen Gottlieb called the “unmet need." And Gottlieb figures that need will grow. Like others in health care, she and her counterparts at other free clinics are watching closely as Congress and President Trump look to repeal and replace the federal health law, and change how Medicaid is funded. (Levin Becker, 2/15)

The Star Tribune: That's A Wrap: New Gowns Make Their Way Into Local Hospitals 
Following months of study, officials with Methodist Hospital in St. Louis Park have decided to adopt new hospital gowns that feature sharper colors, a different mix of fabrics and a design that aims to keep patient posteriors under wraps. The key difference: Patients tie new gowns closer to their sides, so there’s less straining with knots at the middle of their backs. In focus groups, patients told hospital officials they feel exposed with current hospital gowns. (Snowbeck, 2/15)

Houston Chronicle: CHI St. Luke's Health Announces New Round Of Layoffs
CHI St. Luke's Health system has or will be closing four facilities and laying off 89 workers at locations in The Woodlands and Conroe, according to a letter from the Texas Workforce Commission. The Feb. 9 letter announced the CHI St. Luke's Health Woodlands Ambulatory Surgery Center closed on Jan. 27 and its 7 employees will be laid off effective next month. In addition The health system's Emergency center in The Woodlands will also close on March 3 and 29 employees will lose their job. The same day the CHI St. Luke's Health Pinecroft is closing its pharmacy, sleep lab and laboratories, also in The Woodlands, and 27 people there will be laid off. (Deam, 2/14)

Houston Chronicle: Federal Judge’s Order Hits State Hard Over Heat-Related Inmate Deaths 
A federal judge has ruled the Texas prison system and its top leaders must stand trial in a civil rights lawsuit over the heat-related death of an inmate, a sharp rebuke that focused new attention on the deaths of more than 20 other inmates in prison units that lack air-conditioning. The 83-page order by U.S. District Judge Keith Ellison - who personally visited a prison in the summer heat - cites the state's own records documenting a heat index of about 150 degrees inside the Hutchins State Jail near Dallas where inmate Larry Gene McCollum, 58, a cab driver from Bellmead near Waco, died during a heat wave in 2011. (Banks, 2/14)

KCUR: Court Rules Missouri Corrections Officials Did Not Violate Sunshine Law In Execution Cases 
Missouri corrections officials are not required to disclose the identities of the pharmacists who supply the state’s lethal execution drugs, an appeals court ruled Tuesday. Reversing a lower court judge who had ordered the Department of Corrections to reveal their names, the Missouri Court of Appeals found that the DOC did not violate the state’s Sunshine Law by refusing to provide them. The court cited a Missouri law that gives the director of the DOC discretion to select the members of the execution team, including those who administer the lethal chemicals or gas used in executions and those who provide them with “direct support.” (Margolies, 2/14)

San Jose Mercury News: What It Takes To Open A Senior Care Franchise
People also like the security of buying into a proven concept, which franchising provides, Fagan said. While food has always been a popular franchise model, essential services like home or auto repair, air conditioning and health care are strong franchise options. The projected growth of the elderly population is also fueling strong demand for in-home care, experts say, but it’s no small task to start a franchise in the sector. (Sciacca, 2/14)

The Associated Press: No Further Penalty For Nurse Who Let Patient Go In Snowstorm
The state has lost its effort to impose a greater penalty on a nurse whose license was suspended after letting a disoriented patient leave a hospital during a snowstorm. The 61-year-old patient was found dead the next day just 380 feet from the entrance of Down East Community Hospital in Machias, leading to an investigation of nurse John Zablotny’s actions and an effort by the Maine State Board of Nurses to revoke his license for two years. (2/14)

Tampa Bay Times: Lobbyist Muscle Will Be Major Force In Medical Marijuana Fight
Lobbyists, paid to represent various interests, are normally the ones watching as state lawmakers cast votes, but their interest in pot is so great that the first House subcommittee meeting on the subject was standing-room only. Sergeant-at-arms staffers blocked the door, turning people away. At the final stop in the Department of Health's statewide tour of public hearings, Chelsie Lyons, a Tallahassee-based activist with Minorities for Medical Marijuana called out the process that will turn Amendment 2 into a state laws and rules governing medical cannabis. (Auslen, 2/14)

Prescription Drug Watch

Next Up On The Pharma Rebranding Bandwagon: Generics

News outlets report on stories related to pharmaceutical drug pricing.

Stat: Generic Drug Lobby Rebrands Itself As Pricing Politics Intensify
The Generic Pharmaceutical Association is no more. Meet the Association for Accessible Medicines. Every industry group invested in the drug-pricing debate is gearing up and burnishing its brand. PhRMA, the brand-name pharmaceuticals lobby, has its “Go Boldly” campaign. Now the generics lobby is launching its own “education campaign” under a whole new name. (Scott, 2/14)

Stat: Will Pharma Use A Tax Break To Create Jobs? It Didn't Last Time
Drug makers are promising to create tens of thousands of American jobs if President Donald Trump follows through on his promise to give them a big tax break if they “repatriate” cash they’ve stashed overseas. But that’s not what happened last time pharma got a tax holiday. Instead, drug makers used the tens of billions they brought back to the US to enrich their CEOs and drive up their stock prices. Rather than adding jobs, they laid off thousands of workers. (Garde, 2/10)

Stat: What Might Pharma Buy With Its Repatriated Cash?
If President Donald Trump keeps his promise, the world’s biggest drug makers will soon get access to billions of dollars siloed overseas. And if investors and analysts are right, much of that money will go toward acquisitions. So what might pharma buy with its freed-up capital? According to a recent investor survey by EvercoreISI, these are 2017’s most likely takeout targets. (Garde, 2/10)

Reuters: Pharma Industry Shuns Trump Push For Radical Shift At FDA
U.S. President Donald Trump's vow to roll back government regulations at least 75 percent is causing anxiety for some pharmaceutical executives that a less robust Food and Drug Administration would make it harder to secure insurance coverage for pricey new medicines. The prospect of big change at the regulatory agency comes as drugmakers are under fire for high prices, including Marathon Pharmaceuticals LLC, which said Monday it was "pausing" the launch of its Duchenne muscular dystrophy drug after U.S. lawmakers questioned its $89,000 a year price. (2/15)

Bloomberg: CEO Under Fire For $89,000 Drug Has A History Of Steep Price Hikes 
The CEO of the latest drugmaker to face criticism over a product’s high price has a history of steep hikes on other drugs and at past companies. Marathon Pharmaceuticals LLC Chief Executive Officer Jeffrey Aronin, under fire for setting an $89,000 price on the company’s drug for a rare, deadly muscle disease, was questioned in a letter more than two years ago by Washington lawmakers about mark-ups on two heart drugs. Years earlier, as the leader of another company, Aronin took high price increases on a drug used to treat babies with a congenital defect. (Greifeld and Langreth, 2/14)

Bloomberg: Big Pharma Is Pointing Fingers, And Hoping Trump Will Listen 
In the fast-moving Washington game of who’s to blame for high U.S. drug prices, an often-overlooked industry is readying its defenses against pharmaceutical companies that fault other parts of the health sector for the costs faced by patients. Known as pharmacy benefits managers, or PBMs, the industry includes giants such as Express Scripts Holding Co. and CVS Health Corp., which negotiate prices with drugmakers, work with pharmacies and help set the co-pays patients pay out of pocket. Now these middlemen are now taking it from all sides. (Tracer, Langreth and Edney, 2/8)

Stat: SEC Plans To Review Some Pharma Industry Accounting Practices
Concerned about the way that some drug makers report earnings in their financial statements, the US Securities and Exchange Commission recently indicated plans to evaluate pharmaceutical industry accounting practices.The plans were disclosed in a Jan. 11 letter that the agency sent to Allergan over GAAP, or generally accepted accounting principles. (Silverman, 2/13)

The Baltimore Sun: Cost Of Overdose Drug Could Hamper Access In Maryland And Elsewhere 
The price of a drug that has saved the lives of more than 800 people overdosing on heroin or other opioids in Baltimore is rising rapidly.The antidote known as naloxone revives addicts after they've stopped breathing, with either a simple spray in their nose or an injection. The use of naloxone is a centerpiece of Baltimore public health officials' wide-ranging efforts to battle the growing heroin epidemic, but the rising price of the antidote could constrain the campaign to stop or at least slow the rate of overdose deaths. (Cohn, 2/13)

Stat: Former PBM CEO Pleads Guilty To Paying Kickbacks
Aformer head of a pharmacy benefits manager pleaded guilty in federal court in Texas on Monday to paying kickbacks in order to win business from government health plans. Between 2001 and 2013, Douglas Pick, who was once chief executive at Pharmaceutical Technologies, orchestrated nearly $3.6 million in combined payments to the head of a health plan, as well as several individuals who were hired to boost business for the PBM, according to court documents. Pick faces up to three years in federal prison, according to the US Department of Justice. (Siverman, 2/14)

Stat: Gilead Faces New Patent Challenges To Hepatitis C Drugs In India
After losing one challenge to Gilead Sciences patents on hepatitis C drugs in India, patient advocacy groups are now challenging still other patents the company holds for its drugs in the country. At the same time, the groups are also challenging Gilead patents in Argentina, moves that reflect an ongoing strategy to widen patient access to the medicines. (Silverman, 2/14)

Nashville Tennessean: Tennessee Bill Would Nix Drug Swaps By Insurers, Benefit Drug Industry
A coalition of Tennessee patient and health care provider groups backed by major U.S. drug companies is behind a bill that would stop insurance companies from switching the medications they cover to cheaper substitutes midway through a coverage year. The Reliable Coverage Act would require insurance companies to keep providing the same medication coverage they promise when enrollees sign up each year. Currently insurers can change the medications they cover midway through an enrollment year by ending coverage of a particular drug entirely, which increases out-of-pocket costs for a drug or requires additional approval by the insurance company before a drug is covered. (Wadhwani and Boucher, 2/13)

Kaiser Health News: Former FDA Chief Cites 5 Things To Watch On Drug Approvals, And Keeping Drugs Safe
The just-departed commissioner of the Food and Drug Administration has concerns about plans to speed up drug approvals and dramatically reduce regulations at the agency, as advocated recently by President Donald Trump. Dr. Robert Califf, who stepped down last month, shared his thoughts about keeping Americans safe — and making sure drugs actually work — after about a year overseeing the federal agency. (Lupkin and Tribble, 2/14)

The Associated Press: Ex-Drug Company CEO Shkreli To Speak At Harvard
Controversial former pharmaceutical executive Martin Shkreli is set to speak at Harvard while out on bail awaiting his federal securities fraud trial. The former CEO of Turing Pharmaceuticals is expected to talk about investing and healthcare at an event organized by the Harvard Financial Analysts Club. The talk on Wednesday is open to the Harvard community only. (2/12)

Perspectives: Drugmakers Hike Prices Because They Can. The How Gets A Little More Complicated.

Read recent commentaries about drug-cost issues.

Bloomberg: Games Drugmakers Play
One of my goals when I joined Bloomberg View a month ago was to dive into the contentious subject of drug pricing. I’d like to explain to readers why the pharmaceutical companies have been raising prices so relentlessly these past half-dozen years, even as the practice has become a huge issue on Capitol Hill and in the country. My friend Barry Werth, who has written two fine books about the biotech company Vertex, says the answer is simple: “Because they can.” But the details of how they do it can be murky, complicated — and sometimes underhanded. (Joe Nocera, 2/13)

The Washington Post: Why People Should Be Able To Buy Drugs Approved In Other Countries
For years, muscular dystrophy patients in the United States have been purchasing the drug deflazacort — used to stabilize muscle strength and keep patients mobile for a period of time — from companies in the United Kingdom at a manageable price of $1,600 a year. But because an American company just got approval from the Food and Drug Administration to sell the drug in the United States, the price of the drug will soar to a staggering $89,000 annually, the Wall Street Journal reported last week. (Robert Gebelhoff, 2/14)

The Wall Street Journal: Don’t Ignore Politicians’ Ire Over Orphan Drugs
The latest drug-pricing drama has pushed the debate in a new direction. It would be a mistake for biotech shareholders to dismiss the uproar as the same old story. Marathon Pharmaceuticals’ decision to list the old steroid deflazacort at an $89,000 annual price to treat Duchenne muscular dystrophy, and the resulting outcry, has had an immediate impact on the company. Marathon said Monday that it plans to delay the drug’s U.S. launch, scheduled for next month, after politicians in Washington expressed anger over the company’s plans. (Charley Grant, 2/14)

Los Angeles Times: Trump Needs To Be Careful In Deregulating The Drug Industry
In a recent meeting with pharmaceutical-industry bigwigs, President Trump declared that “we’re going to be cutting regulations at a level that nobody’s ever seen before.” He also said that “we’re going to have tremendous protection for the people.”It’s hard to see how he can do both. (David Lazarus, 2/10)

Fayette Tribune: President Trump Misunderstands What Government Drug Price Negotiations Entail
President Donald Trump recently pledged to let federal officials negotiate the prices of drugs covered under Medicare. He claims this will save taxpayers billions of dollars. Nobody doubts that Trump and his team are shrewd negotiators. But the sorts of “negotiations” that Trump refers to have nothing in common with haggling over a real estate deal. Instead, the action that Trump has proposed — repealing the non-interference clause, originally drafted by Democratic Senators Ted Kennedy and Tom Daschle — would result in Medicare drug prices going up and patient choice going down. (Peter J. Pitts, 2/10)

North Jersey: Overdose Rescue Drug Overpriced
There’s no dispute opioid addiction is an epidemic.More than 183,000 people have died from opioid overdoses since 1999, according to the federal Centers for Disease Control and Prevention. In New Jersey, Gov. Chris Christie and legislators have responded with proposals to expand treatment for addicts and to limit the amount of drugs physicians can prescribe. Other states are following suit. Unfortunately, not all responses are as constructive. (2/13)

Scranton Times-Tribune: End Gouging For Antidote
The national opioid epidemic now claims more lives each day than guns or car crashes — about 91 a day nationwide, according to the Centers for Disease Control and Prevention. As appalling as that is, the toll would be far worse but for naloxone, a drug approved in 1971 that stops the respiratory arrest produced by opioid overdoses. Public health agencies have credited the drug with saving many thousands of people who might otherwise have died due to heroin or prescription opioid overdoses. (2/14)

Stat: The Creative Science Of Coining Drug Names
Cialis, Eliquis, Jevtana, Xgeva. These drug names may sound silly, but the process of creating and testing them is anything but. With more than 30,000 proprietary drugs in the United States alone, coming up with a unique brand name is no easy task. And while these names may seem like they were created by over-caffeinated Scrabble players, they are usually the result of intense focus by creative name development professionals coupled with clear-eyed research designed to enhance the prospects of Food and Drug Administration approval. (Mike Pile, 2/8)

Bloomberg: Teva Tries Out 'Alternative Guidance'
Teva Pharmaceutical Industries Ltd. gave investors a nice surprise on its fourth-quarter earnings call Monday by maintaining its 2017 revenue and earnings guidance. Teva shares jumped about 4 percent on the news. Many investors had assumed Teva's guidance, already cut in January, would have to come down again after a U.S. court knocked out patents on its best-selling drug Copaxone, making generic competition much more likely. The company's CEO stepped down shortly afterwards. (Max Nisen, 2/13)

Editorials And Opinions

Perspectives On The Technicalities Of Repealing, Replacing Or Repairing The Health Law

Opinion writers offer their thoughts on a range of issues related to the health insurance marketplace, Medicaid and Medicare.

RealClear Health: Welcome Back To The Medical Underwriting Circle Of Hell
All leading Republicans who are committed to repealing all or key parts of the Affordable Care Act (ACA) also emphasize their commitment to maintaining the law’s most popular part: banning pre-existing condition exclusions and medical underwriting by preserving the ACA’s (also known as Obamacare) policy of “guaranteed issue.” But the fine print in Republican proposals betrays that commitment, including legislation filed on January 26 by House Energy and Commerce Committee Chairman Greg Walden (R-OR) threatening health security for tens of millions of Americans. (John McDonough and William Seligman, 2/15)

The Washington Post: Could The Most Conservative Members Of Congress Save Obamacare?
Try to wrap your head around this possibility: the House Freedom Caucus, the most conservative members of an extremely conservative Republican majority, might be the saviors of the Affordable Care Act. How is such a thing possible? The answer is their devotion to ideological purity, which it turns out may be as disruptive a political force when the GOP is the ruling party as it was when they were the opposition. (Paul Waldman, 2/14)

St. Louis Post-Dispatch: Senators Show Fundamental Differences On Health Care
I hope many people were able to watch the debate that CNN hosted last week between U.S. Sens. Bernie Sanders and Ted Cruz. They spent over an hour fielding questions from spectators and moderators about the present and future of health care in the United States. Sen. Cruz provided a couple misleading answers and suggestions that I believe are worth clarifying. First, he stated that his primary goal in repealing the Affordable Care Act was to remove government from the equation so that health care would be back in the hands of patients and their physicians. As appealing as he makes it sound, removing government-funded insurance would hardly make a dent in the amount of autonomy patients and their physicians have over their health care. (Jonathan Mizrahi, 2/15)

Health Affairs Blog: The Future Of Essential Health Benefits
The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and Congress seek to repeal and replace the law. Essential Health Benefits, which define what health care benefits plans in the Marketplaces and certain other health plans must cover, go to the heart of what it means to have health insurance and what health care we, as a society, want to ensure people can access. (Ian Spatz and Michael Kolber, 2/14)

The Washington Post: As A Christian, I Defended Obamacare. But I Really Support Single-Payer.
A video of me questioning Rep. Diane Black (R-Tenn.) about how her party will replace the Affordable Care Act went viral last Friday. I had gone to her town hall meeting on Thursday near my home to ask what the poor and sick would do once they’re left without the law’s protections. The next night, I had the really weird experience of seeing myself on national television, and the even weirder experience of hearing and reading other people’s interpretation of my own words. My town hall question has been described as a “Christian defense of Obamacare” and “an impassioned case for the ACA’s individual mandate.” (Jessi Bohon, 2/15)

Sacramento Bee: California Provides Model To Replace The Affordable Care Act 
The new administration and Congress are under intense pressure to craft a market-based alternative to the Affordable Care Act. It won’t be easy. To achieve the financial stability required to make the market work, reformers should heed some important lessons from California. (Leonard Schaeffer and Dana Goldman, 2/14)

The Wall Street Journal: Donald Trump’s Medicaid Promise
In the midst of the tumult that now grips Washington, it is easy to forget that President Trump has yet to send Congress either a budget or a single piece of legislation. When he does, some longstanding tensions within the Republican coalition are likely to occupy center stage. (William A. Galston, 2/14)

Lincoln Journal-Star: Americans Deserve Their Medicare
AARP believes Medicare is a deal with the American people that must not be broken. That’s why we will oppose proposals in Congress to turn Medicare into a voucher system, which would drive up costs for current and future retirees and erode protections that Americans have earned through a lifetime of hard work and taxes. Unfortunately, in a short-sighted attempt to save money vouchers are being promoted on Capitol Hill as an answer to rising costs. (David Holmquist, 2/15)

The Washington Post: We Created Medicare For The Elderly. Why Not Do The Same For Children?
With all eyes focused on the nation’s health-care system, our leaders have an opportunity to put the health and future of America’s children first. Congress should consider building a tailor-made national health-care plan just for children. Just as we created Medicare for the elderly, we need an approach to pediatric health care that not only provides coverage to every child but also ensures adequate funding for essential services that meet child-specific needs. (Kurt Newman, 2/14)

The Wall Street Journal: The ObamaCare Merger Deathblow
The conceit that the five major commercial health insurers will consolidate to three seems to be dissolving, as four of those insurers called off a pair of mega-mergers on Tuesday. The immediate reasons were legal objections, but perhaps this retreat is a sign of hope for insurance markets. (2/14)

Viewpoints: A Planned Mega Merger Breaks Up; Donating Organs And Health Data

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

Los Angeles Times: How Aetna Frittered Away $1.8 Billion On A Merger Destined To Fail
Breakups are always emotional, more so when they’re expensive. Let’s calculate the financial carnage of Aetna’s breakup with Humana, a $34-billion merger deal that was shut down by a federal judge three weeks ago and ended by the two big insurance companies on Tuesday. We figure that Aetna wasted roughly $1.8 billion, pre-tax, in pursuit of a merger that many experts said was so anti-competitive that it probably wouldn’t fly. (Michael Hiltzik, 2/14)

Stat: Why You Should Donate Your Health Data, And Your Organs, When You Die
Data might not seem important in the way that organs are. People need organs just to stay alive, or to avoid being on dialysis for several hours a day. But medical data are also very valuable – even if they are not going to save someone’s life immediately. Why? Because medical research cannot take place without medical data, and the sad fact is that most people’s medical data are inaccessible for research once they are dead. (David Martin Shaw, Basel. J. Valérie Gross and Thomas C. Erren, 2/14)

Stat: A Dying Patient Teaches A Young Doctor About The Limits Of Medicine
One purpose of medical school is to inspire action in the face of daunting illnesses, and to meld that action with compassion and humanity. The medical knowledge accumulated from textbooks and experience is intended to embolden a physician as he or she ventures into the realm of disease. All of this is designed to help physicians provide their patients with refuge and reassurance when faced with a malady like cancer. Yet standing there in front of Janice and her family, everything I knew about her cancer stopped me from offering them any possibility for further curative treatment. That stood in stark contrast to what I thought was my principal task as a physician: making things better again. (Jalal Baig, 2/14)

The New York Times: Disabled, Shunned And Silenced In Trump’s America
I’m a woman. I’m physically disabled. And I’ve never been more scared than I am right now. I sat there staring at my computer screen as the words “page not found” popped up on the White House website. My eyes did a double take and then my heart sank. I felt like I’d just been punched in the gut as I realized that the Disabilities section had been removed from the site in the wake of President Trump’s inauguration. (Melissa Blake, 2/15)

Stat: Humans Are Living Longer Than Ever. But We Aren't Necessarily Aging Well.
Worldwide, 901 million people are over the age of 60 today. That number is projected to reach 1.4 billion by 2030 and nearly 2.1 billion by 2050. But the success story of longer lives is a worthless prize if the quality of those lives is compromised because of poor health and a loss of autonomy. To ensure that people of all ages, but particularly older people, can do what they value, national health care systems must be able to respond to those with age-related chronic conditions such as type II diabetes to ensure timely access to education, screening, and appropriate treatment. (Jane Barratt, 2/14)

KevinMD: How Much Are Patients To Blame For ER Overuse?
The U.S. rings the bell on health care spending, and some point fingers at patients themselves. But why do patients choose the paths they choose? Just about every shift, I and my coworkers shake our heads, and wonder what may be driving our patients’ decisions. Parents who haven’t yet tried a drop of acetaminophen bring kids in at 2 a.m. with fevers. Patients show up with nose bleeds that have already stopped bleeding out in the car. Sprained ankles roll in by ambulance. (Sam Slishman, 2/14)

Pittsburgh Post-Gazette: The Right To Try: A National Law For Experimental Drugs Is Wise
The Trump administration has signaled support for a federal law to help terminally ill patients get access to drugs that might be their best hope but aren't fully approved by the Food and Drug Administration. It's a good cause. The FDA currently allows "compassionate use" of experimental drugs in certain cases, and its statistics show that almost every time it is asked to let someone take a drug under that program, it agrees; in fiscal 2015, the applications numbered more than 1,200. (2/15)