KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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From Kaiser Health News - Latest Stories:

Kaiser Health News Original Stories

Political Cartoon: 'Lighten The Load?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Lighten The Load?'" by Lisa Benson.

Here's today's health policy haiku:


Expand insurance
Or decrease the deficit?
Why can't we have both?

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Summaries Of The News:

Capitol Hill Watch

Increasingly Wary Senators Warn Bill Won't Pass Without Changes

The problems lawmakers have with the legislation include the potential loss of insurance coverage, changes to Medicaid, the trajectory of premium prices and the bill’s impact on costs paid by older, low-income and rural Americans.

The New York Times: G.O.P. Senators Suggest Changes For Health Care Bill Offered By House
A day after a harsh judgment by the Congressional Budget Office on the House plan to repeal the Affordable Care Act, nervous Senate Republicans on Tuesday suggested changes to the bill. They told Trump administration officials — including the health secretary, Tom Price — that they wanted to see lower insurance costs for poorer, older Americans and an increase in funding for states with high populations of hard-to-insure people. (Steinhauer and Kaplan, 3/14)

The Wall Street Journal: GOP Senators Say House Health Bill Won’t Pass Without Changes
Republican senators, alarmed by a nonpartisan report showing millions would lose insurance under the GOP health-care plan, warned Tuesday that the bill wouldn’t become law without fundamental changes. At least a dozen Republican senators, including some who had previously kept a low profile in the health debate, made clear they had concerns over the bill’s policy proposals, complicating House leaders’ hopes that the bill’s momentum would overpower internal GOP infighting over legislative details. (Peterson and Hackman and Radnofsky, 3/14)

Reuters: Republicans Weigh Health Bill Changes As Doubts Mount
The White House and congressional leaders said on Tuesday they were weighing changes to their plan to dismantle the Obamacare health law as Republicans' questions mounted following an estimate that it would cause 14 million Americans to lose insurance next year.Press Secretary Sean Spicer said White House officials and leaders in the Republican-controlled House of Representatives were considering whether to tweak their bill, which faces growing doubts within party ranks. (Heavey and Cornwell, 3/14)

The Hill: Pressure Mounts For Changes To ObamaCare Bill 
Yet any changes to the bill could further alienate moderate members who are worried about lost coverage and price spikes for lower-income and older people. Their fears were heightened by a Congressional Budget Office (CBO) report, released Monday, that found the bill could result in 24 million people becoming uninsured over the next decade. (Sullivan, Hellmann and Wong, 3/14)

The Associated Press: Ryan’s Gambit: Second Health Care Bill To Woo The Reluctant
House Republicans are working on a companion to their bill replacing “Obamacare,” a legislative second act that would ease cross-state sale of health insurance and limit jury awards for pain and suffering in malpractice lawsuits. The problem: the so-called “sidecar” bill lacks the votes in the Senate. (Alonso-Zaldivar and Fram, 3/15)

The Hill: Ryan: Trump And I Working To 'Stick The Landing' On Healthcare Plan 
Speaker Paul Ryan (R-Wis.) said Tuesday he had talked with President Trump about ensuring Republicans can "sick the landing" on their ObamaCare repeal-and-replacement proposal, the American Health Care Act. “We basically just talked about how we are executing, getting this done. We talked about dividing up labor, who does what and how do we make sure we just basically stick the landing and get it done,” Ryan told Fox News's Martha MacCallum of his Tuesday call with Trump. (Beavers, 3/14)

Roll Call: GOP Grapples With Path Forward For Health Care Plan
Senate Majority Leader Mitch McConnell, who is scheduled to be with President Donald Trump in Louisville, Kentucky, on Monday, said his chamber would bring up whatever legislation the House produces as its base bill. ... Some Republican senators are pushing for changes to be made in the House before the bill is sent to the Senate. “I’m doing all that I can to make the House bill as good as it can be,” said Tennessee Sen. Lamar Alexander, the Senate Health, Education, Labor and Pensions chairman, who is scheduled to rally with Trump in Nashville on Wednesday. (Bowman, 3/14)

The Washington Post: There Are Now More Than 50 Republicans Skeptical Of The GOP’s Obamacare Replacement Bill
To get their version of an Obamacare replacement through Congress and onto President Trump's desk, Republican leaders need only a simple majority in both chambers to approve it. But that could be difficult. The magic number to pass the legislation in the House is 218, and in the Senate, 50. Republicans conceivably have enough lawmakers to get to those majorities, but not by much. Assuming no Democrats support the bill, Republicans can lose only 21 votes in the House and just two in the Senate. (Phillips, 3/14)

The Hill: Top GOP Senators Call For More Low-Income Help In Healthcare Bill 
Some top Senate Republicans are backing a change to the House ObamaCare replacement bill to increase financial assistance for low-income people to purchase health insurance. Sen. John Thune (R-S.D.), a member of Senate GOP leadership, said Tuesday he is working on an amendment to increase the tax credits under the bill for low-income people. Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health Committee, and Sen. Roy Blunt (R-Mo.), another Senate leader, said they support the idea as well. (Sullivan, 3/14)

CQ Roll Call: Senators Suggest House Overhaul Obamacare Replacement Bill
Senators are pressuring House Republicans to change legislation that would overhaul the 2010 health care law after a damning federal report showed millions would lose coverage and pay more under the plan. Several senators suggested the revisions might be made before the measure clears the House. Senate Health, Education, Labor and Pensions Chairman Lamar Alexander, R-Tenn., said he is currently "focusing on amending it while it's still in the House." (Mershon and Williams, 3/14)

The Hill: Top GOP Senator To Democrats: Offer Your Own Bill To Fix ObamaCare 
Sen. John Cornyn (R-Texas) said Tuesday that if Democrats don't like a House bill to repeal and replace ObamaCare, they should offer their own legislation.  "if you don't like this proposal, then what's your suggestion? What's your suggestion?" he asked during a weekly Senate GOP leadership news conference. (Carney, 3/14)

Politico: 5 Obamacare Mistakes The GOP Is Repeating
Republicans took careful notes about the mistakes Democrats made as they passed Obamacare in 2010 and exploited them relentlessly to undermine support for the law. Now that they’re trying to repeal the law, they are walking into some of the same traps. (Haberkorn, 3/14)

The Washington Post: In Wake Of CBO Analysis Of Health-Care Bill, Ryan-Aligned Group Launches TV Ads Seeking To Give GOP Lawmakers Cover
A group closely aligned with House Republican leaders is hitting the airwaves Tuesday with a new round of television ads defending 15 GOP lawmakers for moving to overhaul the Affordable Care Act, a $1.5 million investment that coincides with the release of a key congressional forecast predicting 24 million fewer people would have health insurance coverage over the next decade under the House GOP proposal. (Sullivan, 3/14)

The Washington Post: In Virginia, Three GOP Congressmen Line Up Against GOP Health Care Plan
Three of Virginia’s seven Republican members of Congress have come out against House Speaker Paul D. Ryan’s plan to revise the Affordable Care Act - and the other four have yet to take a position. The dissent, from two hard-line conservatives and one moderate, illustrates the challenge House leaders face in pushing a proposal that the Congressional Budget Office said would reduce the deficit, but also leave 24 million Americans uninsured. (Portnoy, 3/14)

Minnesota Public Radio: After CBO Report, Here's Where The MN Delegation Stands On Health Bill
Minnesota Gov. Mark Dayton said Tuesday the Republican bill could cost the state "$2 billion in federal funds for Medicaid and MinnesotaCare within 18 months." The governor, a Democrat, added the cuts could affect more than a million children, seniors and people with disabilities. Congress' nonpartisan budget analysts released their findings Monday on the Republicans' bill to overhaul the nation's health care law. (Nelson, Lebens and Catlin, 3/14)

CQ Roll Call: House Budget Will Consider Motions On Obamacare Repeal
When the House Budget Committee marks up legislation on Thursday to partially repeal and replace the 2010 health care law, the rules of reconciliation will prevent any amendments. Nevertheless, the committee could have some influence over the measure through nonbinding motions aimed at the House Rules Committee...The latest repeal and replace proposal, written by the Ways and Means and Energy and Commerce committees, has drawn significant opposition from the conservative House Freedom Caucus, some of whose members sit on the Budget Committee. That suggests the path out of the panel could be more difficult this time around. (Krawzak, 3/15)

Intra-Party Scuffles Undercutting Republicans' Health Care Momentum

“The way I see this going right now, we’re probably going to head to the August recess with Obamacare. And that’s scary,” said one House Republican.

Politico: Republicans Can't Stop Feuding Over Obamacare
The scathing nonpartisan analysis of Republicans’ Obamacare repeal plan is hardening GOP divisions and raising doubts about whether the party in Congress can meet a self-imposed deadline to pass legislation by early April. (Everett and Bade, 3/14)

Los Angeles Times: GOP'S Stumbles Over Obamacare Underscore The Party's Competing Goals For Healthcare Reform
The House GOP effort to repeal and replace Obamacare appeared in deep trouble Tuesday, underscoring the limits of a party that has traditionally put a priority on cutting taxes and government spending over digging into the details of safeguarding Americans’ healthcare. Many Republicans in Congress remain in outright revolt over the bill, warning it does not have enough votes to pass the House or Senate against stiff Democratic resistance. (Mascaro, 3/15)

Stat: The Most Influential Players In The Debate Over Health Care
The politics of the health care debate have become byzantine. You have conservatives upset the Republican bill isn’t aggressive enough, moderates worried their constituents could be at risk, leadership eager to push the legislation through so they can move on, and a President Trump-shaped enigma at the center. ... STAT asked a half-dozen lobbyists and observers to name the most important people in the debate to watch right now. Of course, House Speaker Paul Ryan (the face of the plan) and Senate Majority Leader Mitch McConnell (who must contend with complex rules and a slim margin for error to pass the bill) made almost every list. (Scott, 3/15)

Pence, Price Dispatched To Capitol Hill In Attempt To Ease Concerns Over Health Law

President Donald Trump is making a push to get defectors back on board with the American Health Care Act.

The Washington Post: White House Tries To Salvage GOP Health-Care Proposal As Criticism Mounts
The White House launched an intensive effort Tuesday to salvage support for the Republican plan to revise the Affordable Care Act, even as a growing number of lawmakers weighed in against the proposal. One day after the Congressional Budget Office released its analysis showing that 14 million fewer Americans would be insured next year under the GOP plan, Vice President Pence and Health and Human Services Secretary Tom Price went to Capitol Hill to rally backing for the proposal. (Snell, Sullivan and DeBonis, 3/14)

The Washington Post: Defiant Conservatives Still Fighting Trump’s Health Bill
Undaunted by fellow Republicans’ defiance, GOP leaders and the White House redoubled their efforts Tuesday to muscle legislation overhauling America’s health care system through Congress following a sobering report about millions being shoved off insurance coverage. President Donald Trump, whose strong Election Day showing in GOP regions makes him the party’s ultimate Capitol Hill vote wrangler, discussed the legislation by phone with the House’s two top Republicans. He also dispatched Vice President Mike Pence and health secretary Tom Price to hear GOP senators’ concerns. (Fram, 3/14)

GOP Should Be 'Prepared For Backlash At The Ballot Box,' Dems Say After CBO Report

The Affordable Care Act walloped Democrats politically after it was passed. Republicans may be facing a similar fate over their version of the health law.

The Wall Street Journal: After CBO Report, Democrats See An Opening On Health Care
Democrats, after playing defense on health care for nearly a decade, are trying to turn the issue to their political advantage, targeting in particular lawmakers who have gone on record voting for a GOP plan to replace the Affordable Care Act. Republicans on the House Ways and Means Committee and the Energy and Commerce Committee, racing to advance the legislation, voted to approve the bill last week—before the Congressional Budget Office had analyzed its impact and found that the bill would leave 24 million more Americans without health insurance. (Hook, 3/14)

Politico: Republicans Bet The Future On Health Care Bill
The party in power has twice attempted to overhaul health care in the past quarter-century. And both times it ended up with politically catastrophic results. Now, the GOP attempt to replace Obamacare is shaping up to be the defining issue of the 2018 midterm elections — one big enough to rattle the foundations of Donald Trump-era Washington and beyond. (Debenedetti, 3/15)

The Washington Post: Trump Loyalists Sound Alarm Over ‘RyanCare,’ Endangering Health Bill
A simmering rebellion of conservative populists loyal to President Trump is further endangering the GOP health-care push, with a chorus of influential voices suspicious of the proposal warning the president to abandon it. From headlines at Breitbart to chatter on Fox News Channel and right-wing talk radio, as well as among friends who have Trump’s ear, the message has been blunt: The plan being advanced by congressional Republican leaders is deeply flawed — and, at worst, a political trap. (Costa and Rucker, 3/14)

Boston Globe: Obamacare Repeal Could Hurt Rural Areas — A Key Trump Constituency
Republicans from rural states increasingly are worried that their party’s plan to replace the Affordable Care Act would inflict damage on vulnerable communities, especially the poor and middle-aged in isolated areas whose votes helped catapult Donald Trump into the White House. The concerns are a byproduct of this week’s nonpartisan Congressional Budget Office analysis of the GOP replacement, which highlighted multiple ways that the health care plan falls far short of Trump’s campaign promise to keep Medicaid intact and to create a system that provides “insurance for everybody.’’ (Herndon and McGrane, 3/14)

The Hill: Medicaid Rollback Looms For GOP Senators In 2020 
House Republicans’ legislation to repeal and replace ObamaCare could loom large over the 2020 elections, when both President Trump and a handful of GOP senators in Medicaid expansion states will be up for another term. If the current legislation passes, millions of Americans who receive health insurance through ObamaCare’s Medicaid expansion are projected to lose coverage a year before the critical election, creating the potential for political backlash at the ballot box. (Hagen, 3/15)

San Francisco Chronicle: New Health Care Bill: Midterm Flak May Hit Republicans
Republicans don’t just have a policy problem with their proposed health care plan; they’ve got a political problem: It hurts some of the older and low-income voters who helped put Donald Trump in the White House, and helps younger voters who wanted little to do with him. Plus, features of the American Health Care Act are going to be tough to explain the next time members of Congress return home to face voters for the break that begins in April. (Garofoli, 3/14)

KCUR: Kansas Town Hall Crowd Gives Jenkins An Earful On Health Reform 
Kansas 2nd District Congresswoman Lynn Jenkins was jeered Monday at a town hall meeting in Lawrence for defending President Donald Trump and the Republican plan to replace the Affordable Care Act. Jenkins, a five-term Republican who has announced that she won’t run for re-election in 2018, maintained a tight smile throughout the raucous meeting at the Dole Institute of Politics on the University of Kansas campus. The crowd, estimated around 350 people, regularly interrupted her with boos and shouts of “that’s not true” as she attempted to defend the American Health Care Act, the ACA replacement bill backed by Trump and GOP congressional leaders. (McLean, 3/14)

Health Law

GOP Governors, A Key Constituency For ACA Replacement Effort, Remain Unconvinced On Bill

These governors are split on their opinions about the efforts on Capitol Hill. Some fear changes could hurt their state residents and others think the changes don't go far enough.

The Associated Press: GOP Health Overhaul Puts Pressure On State Governments
The Republican health care plan means less money for states and gives them a tough choice: Find a pot of cash to make up the difference or let coverage lapse for millions of lower-income Americans. Governors and state lawmakers analyzing the Republican plan to replace former President Barack Obama's Affordable Care Act fear a return to the past, when those without health coverage used emergency rooms for their medical needs. That uncompensated care that was written off by hospitals or billed to the state. (Mulvihill, 3/15)

The Associated Press: Governor Urges Congress To Keep Medicaid Expansion Amid Replacement Talks
Louisiana's governor sent a letter Tuesday to Republican and Democratic congressional leaders, in which he said he has "serious concern" with the GOP health plan because it would end the higher federal financing rate for Medicaid expansion in 2020. Edwards embraced the expansion, making Louisiana the 31st state to participate. More than 405,000 people have enrolled in the coverage. (3/14)

Milwaukee Journal Sentinel: Scott Walker Still Not Saying Whether He Supports Obamacare Replacement
Gov. Scott Walker again declined Tuesday to say whether he supports legislation in Congress to replace Obamacare, cut taxes and the deficit, and allow 24 million people to end up without health coverage over the next decade. Walker called for repealing Obamacare in each of his three successful runs for governor in 2010, 2012 and 2014, but he has declined to take a stance on the Affordable Care Act replacement being pushed by one of Walker's closest allies, House Speaker Paul Ryan, a Janesville Republican. (Stein and Spicuzza, 3/14)

Georgia Health News: Deal Supports Alternative To ACA . . . If It’s Fair To Georgia
Gov. Nathan Deal said Tuesday that he supports congressional Republicans’ effort to repeal the Affordable Care Act, but also said he wants more details on the GOP plan to replace the law – and its potential effects on Georgia. ... Deal, a Republican, summed up Georgia’s perspective on the proposed new health plan in a few words. “Our message to Congress is: We want to be treated fairly.” The GOP bill would eliminate the ACA’s requirement for individuals to have health coverage, instead implementing tax credits to induce people to have insurance. (Miller, 3/14)

Young People Would Get Some Relief From High Premiums Under GOP's Plan

Media outlets report on the Congressional Budget Office's projections for the American Health Care Act.

The Wall Street Journal: GOP Health Bill Will Lower Premiums For Young People, CBO Says
A federal analysis of a Republican health plan that shows it would leave millions more uninsured has a silver lining for GOP leaders: In general, premiums under their proposal would eventually come down for younger people. The report, which came out late Monday and was swiftly pounced on by Democrats as proof Republicans want to tear away health coverage from Americans, gives the clearest picture yet of the trade-offs in the GOP strategy to topple parts of the Affordable Care Act and replace it with a new plan. (Armour, 3/14)

Bloomberg: Trump Health Plan Helps Young Middle Class At Cost Of Old, Poor: CBO 
Among the biggest beneficiaries of President Donald Trump’s health care overhaul would be young, middle-class Americans. People over 50 and lower-income people would be the hardest hit, according to a Congressional Budget Office report issued Monday. Trump and House Republican leaders’ plan to repeal and replace Obamacare would change subsidies for health insurance under the law, basing the assistance on age rather than income. Changes in the structure of the program also would push up insurance premiums for older beneficiaries. (Pettypiece, 3/14)

The Hill: Five Key Findings From The CBO's Healthcare Score 
The Congressional Budget Office’s (CBO) analysis of the Republican plan to replace ObamaCare is sending shockwaves through Washington. Democrats have seized on the report, while Republicans have been split over whether to attack the CBO’s conclusions or focus on the more positive aspects of the analysis.  (Sullivan, 3/14)

The Washington Post: The GOP Health Bill Would Create More Insurance Plans That Trump Called ‘Practically Useless’
President Trump doesn't like high deductibles, and he's not alone. High deductibles, provisions of health insurance plans that leave people on the hook for thousands of dollars of medical costs before insurance coverage truly kicks in, are an unpopular part of health insurance. But if Republicans' health care bill becomes law, more people would land in insurance plans with high deductibles, according to the Congressional Budget Office analysis. (Johnson, 3/14)

Sacramento Bee: Californians’ Tax Subsidies Likely To Shrink With Obamacare Replacement Plan
The Republican plan to replace the Affordable Care Act would dramatically reduce tax credits for many Californians purchasing health insurance through public exchanges and make coverage unaffordable for hundreds of thousands of people, according to data released Tuesday by the state’s health exchange program, Covered California. Under the American Health Care Act, authored by House Speaker Paul Ryan and released last week, many of the 1.3 million Californians enrolled in plans through the exchange, especially older people, will struggle to afford health insurance if the proposal becomes law, said Covered California director Peter Lee Tuesday. (Caiola, 3/14)

California Healthline: What Does The House Health Care Bill Mean For California?
As the most populous state with the largest economy in the country, California stands to be dramatically affected by changes to the nation’s health law. About 1.5 million people buy health insurance through the state’s exchange, Covered California, and most get federal subsidies. About 4 million receive Medicaid (called Medi-Cal here) through the program’s expansion under the Affordable Care Act. Altogether, Medi-Cal covers 14 million people in the state, roughly a third of its population. (3/14)

Los Angeles Times: Health Premiums Would Leap For Many Californians Under GOP Plan
Health insurance premiums would leap substantially for many Californians, especially lower-income people living in high-cost cities, under the House Republican plan to replace Obamacare, according to an analysis released Tuesday. Californians purchasing insurance through the state’s Obamacare program known as Covered California received $4.2 billion in subsidies in 2016 to help them buy coverage. (Petersen, 3/14)

Cleveland Plain-Dealer: 24M More Uninsured Due To Republican Health Plan Could Crowd ERs, Force Hospitals To Slash Programs
Increasing the number of uninsured Ohioans will have a profound impact on hospitals and patients as well as on the quality and cost of care we all receive, local hospital systems and healthcare providers warn. A Congressional Budget Office report on the impact of the Republican's American Health Care Act estimates an extra 24 million people will be without insurance in the next decade. (Zeltner, 3/15)

St. Louis Public Radio: Cost Estimates Are Out For GOP’s Health Care Plan. How Does Missouri Fare?
The Republican plan to replace major tenets of the Affordable Care Act would reduce the federal deficit by $337 billion over 10 years, according to new numbers from the nonpartisan Congressional Budget Office. In that scenario, 24 million people would lose their health insurance, bringing the uninsured rate back up to nearly what it was before the Affordable Care Act. The White House has disputed these numbers. (Bouscaren, 3/14)

KQED: What Happens To San Francisco’s Medical Safety Net Under The Republican Bill?
Like many Californians in the health industry, Chen is struggling to understand the implications of the Republican health care bill, introduced last week in Congress and followed this week by sobering analyses of its effects: one from the national Congressional Budget Office (CBO) and another from Covered California, the state’s health care marketplace. Covered California Executive Director Peter V. Lee expressed immediate concern. (Klivans, 3/14)

Miami Herald: Miami Republican Opposes Health Plan That Leaves ‘Too Many’ Uninsured
Miami Republican Rep. Ileana Ros-Lehtinen plans to vote against the House GOP plan to replace the Affordable Care Act, becoming the first Florida Republican to reject the legislation outright... Ros-Lehtinen's 27th district, which includes Southeast Miami-Dade County, had the largest number of Obamacare enrollees in the country —about 96,300 — as of January, according to the Kaiser Family Foundation. (Mazzei, 3/14)

Springfield (Mo.) News-Leader: 5 Ways The House GOP Obamacare Bill Would Affect Missourians
With more Missourians uninsured, hospital officials fear they would have to provide more uncompensated care. Hospitals are required to serve patients who have no ability to pay their bills, but those costs have diminished under Obamacare, as fewer uninsured patients arrived at their doorstep. The GOP plan is not all bad news for hospitals, since it would restore payments to certain hospitals that serve a large number of Medicaid and uninsured patients. But the Missouri Hospital Association estimates that the Republican plan could cost the state’s hospitals $5.5 billion over the next decade. (Shesgreen, 3/14)

Medicaid Births Would Sharply Increase If Planned Parenthood Funding Is Cut

Defunding Planned Parenthood even for a year would increase Medicaid spending by $21 million in the first year and $77 million by 2026, the Congressional Budget Office projects.

CQ Roll Call: GOP Repeal Would Mean More Births Covered By Medicaid, CBO Says
Thousands of women will have unplanned pregnancies during the next year if a Republican proposal to defund Planned Parenthood becomes law, according to the Congressional Budget Office. "By CBO’s estimates, in the one-year period in which federal funds for Planned Parenthood would be prohibited under the legislation, the number of births in the Medicaid program would increase by several thousand, increasing direct spending for Medicaid by $21 million in 2017 and by $77 million over the 2017-2026 period,” according to the score. (Schutt. 3/14)

NPR: Planned Parenthood Would Lose Millions In Medicaid Payments Under Health Plan
The proposed American Health Care Act targets the health provider Planned Parenthood with a set of proposed limits on Medicaid payments to the organization. Monday, the nonpartisan Congressional Budget Office confirmed the magnitude of those limits. The Republican plan would block $178 million in Medicaid reimbursements to Planned Parenthood in 2017. (Hersher, 3/14)

In other news —

Politico: Planned Parenthood To Unleash Campaign Against Trump
Republicans have promised to strip funding from Planned Parenthood because the organization funds abortions. Now, in a bid to keep their federal funding, the group is highlighting cancer survivors who were treated at the organization's centers in a bid to tilt the debate in their favor. (Dawsey, 3/14)

Kansas City Star: Planned Parenthood Pressures Kansas City-Area Lawmakers To Oppose ‘Defunding’ Legislation
Planned Parenthood is urging Kansas City-area lawmakers to oppose a provision in the Republican-crafted bill to repeal the Affordable Care Act that would block the women’s health care provider from receiving Medicaid dollars. Planned Parenthood operates 12 health centers in Missouri, including three facilities in the Kansas City area, and two health centers in Kansas, including one in Johnson County. A provision in the ACA repeal bill being pushed by Republican leaders in the U.S. House would block these facilities from receiving Medicaid dollars. (Lowry, 3/14)

CBO Bears Brunt Of Displeasure When Projections Don't Work In Party's Favor

Both sides have touted and also tried to knock analysis by the Congressional Budget Office, depending on whether the projections fit their message.

The Associated Press Fact Check: Both Sides Loose With Facts In Health Debate
The Congressional Budget Office report on a Republican health care bill set off an intense reaction in Washington, and some on both sides of the debate are playing loose with the facts. Republicans are overlooking President Donald Trump’s promise to deliver “insurance for everybody,” which the CBO makes clear will not happen if the legislation becomes law. Democrats are assailing Republicans for “attacking the messenger,” seeming to forget all the times they assailed the budget office themselves. (Woodward and Drinkard, 3/14)

USA Today: White House Spokesman Sean Spicer Knocks CBO Report On Obamacare Repeal
The Trump administration continued to trash the Congressional Budget Office on Tuesday for its analysis of the Republican health care bill, while pledging to work with conservatives who say the proposed replacement of Obamacare includes too much government regulation. "All of that is part of a comprehensive strategy to engage with members who support us, who have ideas and want to be on board, who want to be constructive in the process and achieve the president's goal of having a patient-centric health care system," White House press secretary Sean Spicer said. (Jackson, 3/14)

The Washington Post: Fact-Checking The White House’s Rhetoric On The CBO Report
White House press secretary Sean Spicer offered a number of attacks and claims during a news briefing dominated by the new Congressional Budget Office report on the House Republican replacement bill for the Affordable Care Act. The report estimated that 24 million fewer people would have health insurance in 2026 if the law were approved in its current form, causing political headaches for the effort to replace Obamacare. Here’s a guide to his rhetoric. (Kessler and Lee, 3/14)

Bloomberg: Republicans Picked The CBO Chief. Now They’re Attacking The Office Over Obamacare. 
An hour after the Congressional Budget Office released its dire assessment of the GOP Obamacare plan, Donald Trump’s top health official went on the attack. "We disagree strenuously with the report," Tom Price said. "The CBO report’s coverage numbers defy logic." That initial Republican assault on Monday was the first of many that amounted to dismissing their own scorekeeper. Left unmentioned by Price, Trump’s Health and Human Services secretary: When he was in Congress, he recommended the CBO’s current director, Keith Hall, for the job. Hall took the helm at the CBO in April 2015, chosen by Republican House and Senate leaders to provide advice to a GOP-controlled Congress. (House, 3/14)

In other news, a look at what isn't in the report and the ramifications it had on hospitals —

The Washington Post: 4 Big Things Missing From The CBO Report On Republicans’ Health-Care Bill
Congress’s nonpartisan budget referees on Monday provides the first detailed study of the real-world effects of Republicans’ bill to overhaul health care. The GOP bill, the Congressional Budget Office found, would repeal hundreds of billions of dollars in taxes, especially on industry and wealthy households. It would make deep cuts into Medicaid and provide smaller subsidies to people looking to buy health insurance. And after eight years, 24 million more people would be uninsured as a result of the bill. There are a few urgent questions that the CBO report does not address, however. Here’s a look at what we still don’t know. (Ehrenfreund, 3/14)

Reuters: Hospital Stocks Fall After Republican Health Bill Seen Leaving 24 Million Uninsured
Shares of hospitals and health insurers fell on Tuesday after the U.S. Congressional Budget Office forecast that 14 million Americans would lose medical insurance by next year under a Republican plan to dismantle Obamacare. Among the hospitals, HCA Holdings slipped 1.6 percent, Tenet Healthcare fell 4.2 percent, Community Health Systems shed 1.5 percent and LifePoint Health was down 1.3 percent. (Davies, Erman, Valetkevitch and Krauskopf, 3/14)

The Public's Early Impression Of GOP's Plan: Deeply Skeptical

A new poll reveals that most Americans don't think the plan will lower health care costs.

Los Angeles Times: Americans Are Skeptical About The Republican Plan To Replace Obamacare, New Poll Shows
Americans are deeply skeptical about the current House Republican plan to replace the Affordable Care Act, and few think it will bring down costs or expand coverage, a new nationwide survey finds. In fact, nearly half the country thinks the GOP plan will increase the number of uninsured and raise prices for consumers who have to buy coverage on their own, according to the poll from the nonprofit Kaiser Family Foundation. (Levey, 3/15)

CNN: Americans Divided Over GOP Health Care Bill, Kaiser Poll Finds
Although President Donald Trump and Republicans in Congress promise that their plan will cover more people and cost less, nearly half of Americans don't believe it, according to a Kaiser Family Foundation poll released Wednesday. And while many Republicans are confident that defunding Planned Parenthood is the right move, the greater majority oppose that idea, it says. (Christensen, 3/15)

Kaiser Health News: Americans Not Sold On Cost And Coverage Claims In GOP’s Health Bill
A majority of the public is skeptical the Republican health plan would be an improvement over the Affordable Care Act, with widespread concerns that insurance costs would increase while people lost coverage, according to a poll released Wednesday. The dour public assessment, from interviews with 1,206 adults conducted March 6-12, came before the Congressional Budget Office released its projections on Monday. (Rau, 3/15)

Public Health And Education

Experts Fear That GOP Health Plan Could Harm Addiction Services Now Covered By Medicaid

In other news on the substance abuse crisis, two federal advisory panels take steps that could lead to a ban on Opana, a reformulated opioid billed as crush resistant, making it harder to snort. But instead people are injecting the drug, leading to fatal overdoses and the spread of HIV. And, The New York Times reports that teen drug use is down.

Stat: How Medicaid Pays For Addiction Treatment, State By State
More than 30,000 Americans are dying from heroin and painkiller overdoses every year. Hundreds of thousands of people covered by Obamacare’s expansion of Medicaid — more than a million, by at least one estimate — have mental health and substance abuse issues. The GOP plan could impact the program in two ways. First, it would eliminate in 2020 the requirement that states, which administer Medicaid and jointly fund it with the federal government, offer robust coverage of mental health and substance abuse services for people who enrolled in Medicaid under the Obamacare expansion. (Scott, 3/14)

USA Today: Federal Advisory Panels Agree Opana's Risks Outweigh Benefits
In a move that could lead to a national ban, two federal advisory panels voted Tuesday that the risks outweigh the benefits of a widely-abused opioid that was reformulated to deter addicts from snorting it. The new extended-release version of Endo Pharmaceuticals' Opana may even be more dangerous than the version it replaced, according to critics including the advocacy group Public Citizen. Two Food and Drug Administration advisory panels seemed to agree, voting 18 to 8 that it presents more risks than benefits to society. (Wise and O'Donnell, 3/14)


Federal Officials Pledge To Let States Add Medicaid Work Requirements, Other Changes

In a letter to governors, Health and Human Services Secretary Tom Price and Seema Verma, the newly installed head of the Centers for Medicare & Medicaid Services, said that they would consider waivers to revamp traditional Medicaid and narrow the parameters of the expansion allowed under the Affordable Care Act.

The Wall Street Journal: White House May Let States Put Work Requirements On Medicaid Recipients
The Trump administration will work with states that want to alter their Medicaid programs by imposing work requirements, premiums, emergency-room copayments and other changes, part of a Republican effort to give states more authority over the program’s implementation. The action is expected to allow states to obtain waivers from the federal government that some health analysts say could add several first-ever obligations for beneficiaries and pare back coverage. (Armour and Radnofsky, 3/14)

CQ Roll Call: HHS, CMS Signal Willingness To Let States Reshape Medicaid
President Donald Trump's new chief of Medicaid and Medicare, Seema Verma, told governors Tuesday she would seek to speed their bids to reshape Medicaid, including requiring people who get benefits to work. "We intend for this to be the beginning of a discussion on how we can revamp the federal and state Medicaid partnership to effectively and efficiently improve health outcomes," wrote Verma, the new administrator of the Centers for Medicare and Medicaid Services, and Health and Human Services Secretary Tom Pricein a joint letter. (Young, 3/14)

Meanwhile, news outlets look at one administration official's comment about efforts to change the Medicaid expansion and how the GOP plans are playing in two states --

PolitiFact: Mick Mulvaney's Misleading Claim That House GOP Health Care Plan Keeps Medicaid Expansion
If Congress repeals the law known as Obamacare and replaces it with the leading Republican proposal, there could be as many as 14 million fewer Medicaid enrollees by 2026, compared to projections under current law, according to an analysis by the nonpartisan Congressional Budget Office. Mick Mulvaney, director of the White House Office of Management and Budget, says the CBO analysis is wrong. ... We decided to fact-check Mulvaney’s claim that the leading House Republican proposal — the American Health Care Act — "doesn’t get rid of Medicaid expansion." We found his claim misleading. (Carroll, 3/14)

WBUR: Key In GOP Health Care Overhaul: Massive Changes To Medicaid
As a candidate, President Trump had promised "no cuts" to Medicaid. The Republicans' American Health Care Act, which Trump supports, would end an expansion of the coverage and restructure funding for it. The bill is the first part of a plan to repeal and replace the Affordable Care Act enacted under President Obama. (Naylor, 3/14)

Nashville Tennessean: TennCare Chief: Obamacare Replacement Holds 'Serious Budget Implications'
TennCare's chief is concerned about how the GOP proposal to replace Obamacare is structured to reduce Medicaid funding without loosening up regulations for states to further tailor programs. Speaking to the Tennessee House Finance Ways and Means Committee on Tuesday, Dr. Wendy Long told legislators that a funding mechanism such as the proposed per capita cap or a block grant "could have very, very serious budget implications for the state." As proposed, the American Health Care Act is projected to reduce federal spending on Medicaid by $880 billion by 2026, per the Congressional Budget Office. (Fletcher, 3/14)

Insurer Sues Minnesota Seeking Change In Medicaid Managed Care Contract

Medica says insurers are losing too much money under the agreement. It is not trying to overturn the 2017 contract but is asking the state to rebid 2018.

Pioneer Press: Health Insurer Medica Sues Minnesota Over Medicaid Contract 
One of Minnesota’s major health insurance companies says the state Department of Human Services broke the law when it negotiated new contracts with competing insurers to run Medicaid and MinnesotaCare. Medica, a Minnetonka-based nonprofit insurer, sued the state Tuesday over the Medicaid and MinnesotaCare contracts. It’s not trying to overturn the new 2017 contracts, which are already in the process of being implemented. Rather, Medica wants a judge to force DHS to bid out contracts again for 2018 instead of continuing the current contracts into 2019 or later. (Montgomery, 3/14)

Minnesota Public Radio: Medica Sues Minn., Alleging Competitors Got Better Rates
Medica on Tuesday sued Minnesota's Department of Human Services, alleging the state gave preferential treatment to competitors in contracts for state-sponsored health care. Medica and several other plans together serve the 1.2 million people enrolled in MinnesotaCare and Medical Assistance. Medica manages care for about 320,000 of those enrollees. (Sepic, 3/14)

And a surprise announcement from Mayo --

The Star Tribune: Mayo To Give Preference To Privately Insured Patients Over Medicaid Patients
Mayo Clinic’s chief executive made a startling announcement in a recent speech to employees: The Rochester-based health system will give preference to patients with private insurance over those with lower-paying Medicaid or Medicare coverage, if they seek care at the same time and have comparable conditions. The number of patients affected would probably be small, but the selective strategy reveals the financial pressures that Mayo is facing in part due to federal health reforms. (Olson, 3/15)

State Watch

State Highlights: Calif. Failing To Screen Social Services Workers Properly, Audit Finds; Ala. Investigating Possible Bird Flu Cases

Outlets report on news from California, Ohio, Kansas, Alabama, Georgia, Texas and Minnesota.

Sacramento Bee: Audit Slams Background Checks At California Care Facilities
The California Department of Social Services’ Community Care Licensing Division, which oversees and regulates nearly 75,000 facilities statewide, is charged with ensuring the safety of a wide range of people, including those with disabilities and illnesses, elderly adults and children. It reviews background checks from the state Department of Justice on applicants for jobs at the facilities and decides whether those with criminal convictions can be hired. But auditors found that the state Department of Justice stopped routinely providing social services with sentencing information in 2016 because state law didn’t explicitly require it. (Opsahl, 3/14)

Bloomberg: Bird Flu Cases Probed In One Of The Largest U.S. Chicken States
Alabama, one of the leading U.S producers of chicken meat, is investigating suspected cases of bird flu in three northern poultry flocks and has introduced some restrictions on the transportation of birds. A commercial chicken-breeding farm in Lauderdale County and a backyard flock in Madison County are among the facilities under investigation, the Alabama Department of Agriculture & Industries said in a statement Tuesday. The state is also probing a flea market in Jackson County and has issued an order limiting the movement of some poultry. (Dursin, 3/14)

Cleveland Plain-Dealer: Akron Children's Hospital Program Helps Kids With Asthma Breathe Easier, Avoid Hospital Visits
Community health assessments conducted in 2013 and 2016 have shown that asthma is a significant health need for children in Medina, Portage, Stark, Summit, Wayne, Mahoning, Trumbull, Columbiana and Richland counties. But thanks to an evidence-based asthma management program implemented by Akron Children's Hospital two years ago, the hospital has seen a has seen a significant decrease in the number of asthma-related ER visits and hospitalizations. The program, Easy Breathing, is helping to standardize the diagnosis and treatment of asthma in Akron Children's primary care offices throughout the region. (Becka, 3/14)

KCUR: Getting Innovators To Come To Work — At A Children's Hospital
Health care providers who work with kids are natural innovators, says Krista Nelson, Children’s Mercy Hospital’s director of innovation development. Nelson, an expert in innovation — not medicine, was hired by the hospital to run its new Center for Pediatric Innovation. “In the children’s hospital or pediatric environment, we really deal with every size of child from a premature baby all the up to the captain of the football team at one of our big high schools,” says Nelson. (Ellison, 3/15)

Columbus Dispatch: Virtual Reality Aids Medical Trauma Training
The virtual-reality experience is new for residents training in trauma care at the Downtown hospital... The virtual-reality scenarios — there are three — were filmed in July by a team from Ohio University that hung or mounted three softball-size camera and microphone units in the emergency department to capture 360-degree experiences, said Eric Williams, co-creator of the new Immersive Media Initiative at the Athens school. Patients consented to be in the videos. (Viviano, 3/15)

Georgia Health News: Can Mobile Apps Help Fill Sex Education Gaps?
The sex education course at Clarke Central in Athens is taught over two weeks during the first semester of ninth grade. Teachers will continue to talk about sex ed and health topics in the following years of high school, but STIs, birth control methods and HIV/AIDS probably won’t be mentioned again. However sporadic it may be, the F.L.A.S.H. curriculum taught in the Clarke County School District may be better than what’s taught in many other school systems around the state. (Knight, 3/14)

Texas Tribune: Texas Senate Tentatively Approves "Bathroom Bill"
The Texas Senate on Tuesday tentatively signed off on the “bathroom bill” on a 21-10 vote with one Democrat — state Sen. Eddie Lucio Jr. of Brownsville — voting in favor of the bill. Senate Bill 6, a legislative priority of Lt. Gov. Dan Patrick, would require transgender people to use bathrooms in public schools, government buildings and other publicly-owned facilities that match their “biological sex” and not gender identity. And it would preempt local anti-discrimination laws meant to allow transgender residents to use public bathrooms that match their gender identity. (Ura, 3/14)

The Star Tribune: Complaint Puts New Age Healers On Minnesota Regulators' Radar
Unconventional healing practices, from energy readers to faith healers, typically operate below the state’s radar screen unless a complaint is made... t’s a tricky issue. The Health Department’s mandate isn’t to evaluate whether a treatment is effective or fraudulent. It’s to determine whether the department has jurisdiction over a provider, and if so, to decide whether the provider is following state rules, such as providing a Client Bill of Rights and factual advertising. (Hopfensperger, 3/15)

Prescription Drug Watch

In Hospitals, High Drug Prices Spark Innovation Versus Cost-Savings Fight

News outlets report on stories related to pharmaceutical drug pricing.

Stat: Stung By Surging Drug Prices, Hospital Pharmacies Fight Back
Facing annual spikes in pharmaceutical costs, major hospitals nationwide are curtailing use of expensive drugs and rejecting new additions to their formularies, sometimes triggering tense debates with clinicians who want to offer cutting-edge medications to their patients. The conflict, involving a wide array of drugs, is bound to become more intense amid the specter of a GOP-led health care overhaul that could further undermine hospital finances. Already, hospitals are cutting down on use of certain pain medications and carefully scrutinizing requests to add expensive new drugs to treat conditions ranging from epilepsy to cancer. (Ross, 3/14)

The New York Times: Vaccine Makers Ranked On Pricing And Research
The pharmaceutical companies GlaxoSmithKline and Sanofi sell the most vaccines and earn the most money doing so, while the Serum Institute of India sells the most vaccines at a discount, according to the first Access to Vaccines Index, which was released last week. (McNeil, 3/13)

Modern Healthcare: Will The Cost Of Cancer Drugs Break The Economy?
If left unchecked, the rising cost of cancer drugs could have devastating implications for individuals, societies and national economies, a group of cancer physicians and researchers said. In a new paper published Tuesday in Nature Reviews: Clinical Oncology, the cancer experts excoriated the pharmaceutical industry for pricing oncology drugs at rates that make them inaccessible and are unjustifiably high given the often scant benefit some of these drugs bring patients. (Whitman, 3/14)

Kaiser Health News: Sticker Shock Forces Thousands Of Cancer Patients To Skip Drugs, Skimp On Treatment
With new cancer drugs commonly priced at $100,000 a year or more, [John] Krahne’s story is becoming increasingly common. Hundreds of thousands of cancer patients are delaying care, cutting their pills in half or skipping drug treatment entirely, a Kaiser Health News examination shows. One-third of Medicare patients who were expected to use Gleevec — a lifesaving leukemia medication that costs up to $146,000 a year — failed to fill prescriptions within six months of diagnosis, according to a December study in the Journal of Clinical Oncology. (Szabo, 3/15)

Stat: Winding Back The Clock, Scientists Hunt New Uses For Old Drugs
Headache, nausea, diarrhea: Side effects can be nasty. But a laundry list of adverse reactions can actually give scientists an important clue: It means the drug is potent in many different ways — and could, perhaps, be used to treat a different disease than the manufacturer intended. (Keshavan, 3/10)

Bloomberg: Drug CEO Has Problem With U.S. Patients Paying His Prices
Too many diabetics in the U.S. are inadvertently getting stuck with a big bill, making it imperative that drugmakers and middlemen at the heart of the country’s complex pricing system fix the issue before regulators step in, the world’s biggest maker of insulin said. “It was never the intention that individual patients should end up paying the list price,” Lars Fruergaard Jorgensen, who took over as chief executive officer at Novo Nordisk A/S at the start of the year, said in an interview Tuesday. “I have a big problem with that.” (Paton, 3/14)

Stat: Despite Discounts For Hep C Drugs, Coverage Denials Keep Rising
After pricey new hepatitis C treatments emerged a few years ago, public and private payers restricted coverage in order to ease the financial strain on budgets. But even as more competition among drug makers has prompted discounting, payers continue to deny coverage, including to patients who suffer from the most advanced forms of the disease, according to a new analysis. (Silverman, 3/8)

Stat: Regeneron CEO On Drug Prices: 'Bad Actors Not The Problem'
Len Schleifer made something of a splash at an industry conference last December. The Regeneron Pharmaceuticals chief executive chastised Pfizer chief executive Ian Read over drug prices while participating in a panel discussion. Not surprisingly, their exchange received notice, since pricing is such a hot-button issue. Schleifer remains adamant, though, that brand-name drug makers can do better and he hopes to prove the point when his company launches a medicine for severe eczema. We recently spoke with him about drug pricing and the FDA, too. (Silverman, 3/9)

The New York Times: William Ackman Sells Pershing Fund’s Stake In Valeant
William A. Ackman, a billionaire investor, staked his reputation as a savvy stock picker on his ability to oversee a turnaround at Valeant Pharmaceuticals International. When other hedge funds began to leave Valeant in 2015 as questions about its practices for pricing drugs and its accounting procedures mounted, Mr. Ackman bravely — some might say stubbornly — stood his ground. (Goldstein, 3/13)

The Hill: Sanders: Trump Must Stop French Company’s Exclusive Zika Vaccine Deal 
Sen. Bernie Sanders (I-Vt.) is pressuring President Trump to stop the Army from giving a French company the exclusive license to a vaccine against the Zika virus. In a New York Times op-ed published Saturday, Sanders criticized French pharmaceutical company Sanofi, noting the firm has already gotten $43 million from the Department of Health and Human Services to develop a vaccine with the Army and is expected to receive $130 million more in federal funding. (Smilowitz, 3/11)

Pioneer Press: Republican MN Lawmaker With MS Lashes Out At Fellow GOPers For Blocking Prescription Drug Bill 
It is personal for Rod Hamilton. The Minnesota state representative, a multiple sclerosis patient for 20 years, cannot get a committee chairman to consider a bill he says will help people like him who depend on prescription medicine...The person he talked about, but did not specifically name, is House Commerce Chairman Joe Hoppe, R-Chaska, who says he will not take up Hamilton’s bill written to allow patients to generally continue receiving prescription medicine throughout an insurance policy’s term. Hoppe said that Hamilton’s bill would increase the cost of health care, while Republicans who control the House want to cut the cost. (Davis, 3/14)

Stat: India's Pharma Industry Frets Over Exports To Trump's US
For India’s biggest drug makers, the Trump administration offers a mix of promise and peril. On one hand, these companies supply many lower-cost generics to the United States, a key advantage as President Trump accuses most brand-name drug makers of “getting away with murder” when it comes to pricing. But Indian drug makers also fret the Trump administration will place them at a disadvantage with any policies that favor domestic jobs stemming from products made in the US. (Silverman, 3/14)

Perspectives: To Pharma, Trump Starting To Look Like Boy Who Cried Wolf

Read recent commentaries about drug-cost issues.

Bloomberg: Trump Is Losing His Ability To Scare Biotech
For much of the past half year or so, President Donald Trump was the biotech bogeyman, set to impose draconian price curbs and crush industry profits. His fear factor is rapidly diminishing. I've previously suggested biotech investors don't take Trump's pricing threats seriously enough. But the wild inconsistency of his stances, along with Republican party divisions, have combined to make real price curbs less likely. Trump's tweets are still dangerous, but it appears increasingly likely he's just crying wolf. (Max Nisen, 3/10)

The Hill: Drug Costs Are Burning Holes Into Our Pockets — We Can Fix It
Each day, Americans are forced to make difficult decisions about their health. The high price of drugs has created an unfortunate reality — too often for the most vulnerable among us, those decisions are not about wellness but rather choosing between basic necessities and taking their daily prescription medications. Many need those drugs to survive. (Patricia A. Maryland, 3/9)

Statesman: Tackle Drug Monopolies To Bring Medication Prices Down
The news that President Donald Trump takes the anti-baldness drug Propecia has temporarily bumped his war against the pharma sector from the front pages. Before his doctor offered this juicy tidbit, the focus was on Trump’s comment that drug companies were “getting away with murder” and his threat to authorize Medicare to negotiate lower prices. Wall Street took Trump’s remarks seriously, causing pharma stocks to tank. Pharma CEOs did too. Several pledged to limit future price hikes to 10 percent per year. Not all pharma execs were cowed, though. (Charles Silver, 3/12)

KRWG: Lower Drug Prices Would Help New Mexico Taxpayers
As New Mexico struggles to cope with declining tax revenues and cuts to classrooms and health care, it is imperative for legislators to find new ways improve the state’s bottom line. That is why it is time to enact innovative policies to rein in the soaring cost of prescription drugs. It places a growing burden on our state budget each passing year. (State Sen. Jeff Steinborn, 3/14)

Editorials And Opinions

Outlooks And Assessments: Criticism Of The House GOP Health Plan Heats Up

In the aftermath of Congressional Budget Office estimates regarding the number of Americans who would lose health coverage under the American Health Care Act, editorial pages move deeper into the discussion with some scalding critiques of the plan and some defenses of how it could help reduce the nation's deficit.

The Washington Post: The Trumpcare Trap
What we learned from the latest “score” by the Congressional Budget Office of Obamacare and the Trump administration’s “repeal and replace” plan is what we should have known all along. To wit: If people have health insurance, they will use more health services — visits to doctors’ offices, tests, procedures and drugs — and health spending will rise. (Robert J. Samuelson, 3/14)

The Wall Street Journal: The Health Bill’s Fiscal Bonus
The furor over the Congressional Budget Office’s report on the House GOP health bill is concentrated on predictions about insurance coverage, which suits Democrats fine. Lost amid the panic is that CBO shows the bill is a far-reaching advance for the market principles and limited government that conservatives usually favor. (3/14)

Los Angeles Times: Every Single False Republican Criticism Of Obamacare Applies Perfectly To Trumpcare
The nonpartisan Congressional Budget Office on Monday released its analysis of the House GOP’s plan to repeal and replace the Affordable Care Act. The result is about as damning as it gets. ... I served on President Obama's healthcare reform team and worked on the Hill to get the legislation passed. It was apparent to me then that many of the Republicans’ criticisms of the ACA were wrong, and yet they now apply to the House GOP bill that Speaker Paul Ryan introduced last week. (Neera Tanden, 3/15)

The New York Times: Obamacare Isn’t In A ‘Death Spiral.’ (Its Replacement Probably Won’t Be Either.)
If you listen to a typical Republican politician, the Affordable Care Act’s insurance markets are in a “death spiral,” “imploding,” “collapsing” or “will fall of their own weight.” That’s part of the rationale behind the new House proposal to reshape the health care system. On Monday night, House Speaker Paul Ryan repeated this line, even in the face of projections that his plan could lead to 24 million fewer Americans with health insurance in 10 years. “Put this against the backdrop that Obamacare is collapsing,” he said in interview with Fox News. “This, compared to the status quo, is far better.” (Reed Abelson and Margot Sanger-Katz, 3/15)

The Washington Post: The GOP Masterminds Behind Obamacare’s ‘Death Spiral’
House Speaker Paul D. Ryan (R-Wis.) says Obamacare is in a “death spiral,” and he should know: He’s the one who cut the power to Obamacare’s engines and pointed its nose downward. President Trump says, “ObamaCare is imploding and will only get worse,” and he should know: He’s the one who placed the explosives under Obamacare’s foundation. (Dana Milbank, 3/14)

Cleveland Plain Dealer: Know The Basics Of Why Obamacare Stumbled Before Adopting Trumpcare
For all of the debate coming out of Washington on health care reform, there seems to be a lack of a fundamental understanding of the functioning of the health care market, and how and why it has stopped working for consumers. A major misunderstanding is the concept of health insurance. Health insurance is a simple idea -- we all agree to pay into a pool and to share the resources we collect for appropriate medical needs. In this manner, the healthy subsidize the sick, in the hopes that resources will be available for them should they ever be in need. (Kevin Schulman, 3/14)

The Washington Post: This May Be The Most Brutal Number In The CBO Report
Plenty has been made of the big Congressional Budget Office finding that 24 million people could lose their insurance under Republicans' Obamacare replacement over the next decade. ... But there's another number that paints a particularly dire picture for the GOP's alternative — especially in light of President Trump's populist rhetoric. According to the CBO, 64-year olds making $26,500 per year would see their premiums increase by an estimated 750 percent by 2026. (Aaron Blake, 3/14)

Arizona Republic: Ryancare Fails This Free-Market Test
Conservatives are up in arms over the Obamacare replacement principally designed and promoted by House Speaker Paul Ryan. Let’s call it Ryancare for symmetry. Most of the fire is aimed at the refundable tax credits in the bill. But those are a pragmatic necessity. Instead, the focus of the ire should be on the remaining Obamacare insurance market regulations and the Senate filibuster rule that makes getting rid of them a political impossibility. (Robert Robb, 3/14)

The Charlotte Observer: Obamacare Spawns A New Lie Of The Year
President Barack Obama told a whopper when he was pitching his health care reform bill. “If you like your health care plan, you can keep it,” was so far off the mark that PolitiFact designated it its Lie of the Year for 2013. Now we have a new contender for 2017, also spawned from Obamacare: President Donald Trump’s promise that no Americans would lose coverage in the Republicans’ repeal of the Affordable Care Act. (3/14)

Los Angeles Times: Seven New Ways The GOP's Obamacare Repeal Bill Would Wreck Your Healthcare
The headline findings in the Congressional Budget Office’s analysis of the Obamacare repeal bill produced by House Republicans are brutal enough: 24 million Americans losing their health coverage, healthcare costs soaring for many millions more, and the evisceration of Medicaid, all while handing the richest Americans a handsome tax cut. But in its fine print, the CBO report identified at least seven other ways the GOP proposal would damage the U.S. healthcare system. Some would have effects reaching far beyond the middle- and low-income buyers of insurance on the individual market who are the Affordable Care Act’s chief beneficiaries. (Michael Hiltzik, 3/14)

Chicago Tribune: Health Care 'Access' Is Not The Same As 'Coverage'
Watching top Republicans explain their proposed Affordable Care Act replacement can make you wonder who hijacked the English language. For example, if you're like me, you might have been shocked by the news that 24 million fewer Americans will have health insurance by 2026 if the Republican-proposed alternative passes, according to the nonpartisan Congressional Budget Office — including 14 million fewer people in the next year alone. (Clarence Page, 3/14)

Arizona Republic: 3 Trump Health-Care Lies? You Tell Me
Trump made promises during the campaign and now we're seeing comparisons to his actions. I've picked a few from those being reported about the repeal of the Affordable Care Act. Not alternative facts. Not fake news. Just information. The promise versus the reality. (EJ Montini, 3/14)

Los Angeles Times: How The GOP Heathcare Plan Would Worsen The Opioid Crisis
A drug epidemic is ravaging the United States, and it’s getting worse, not better. More than 52,000 Americans died from drug overdoses in 2015, more than died from automobile accidents or firearms. That’s far more than died from overdoses in any year during the crack epidemic of the 1980s. ... But you wouldn’t know that from the American Health Care Act of 2017, the House Republican proposal to repeal Obamacare and replace it with a smaller, cheaper health insurance program. (Doyle McManus, 3/15)

St. Louis Post-Dispatch: CBO Confirms The Disaster That Is Republicare
What’s most astonishing about the Congressional Budget Office analysis of the House Republicans’ health care plan is not the estimate that it would increase the ranks of the uninsured by 24 million over the next decade. Nor is it the savage price increases the bill would impose on low-income older Americans seeking to buy insurance. Nor is it the casual cruelty of cutting Medicaid services to 14 million Americans after 2020. What’s most astonishing is the blatant dishonesty of Republican leaders who Tuesday either denied that any of this would occur, or blithely skated past it. (3/14)

Voices On The Impact Of The American Health Care Act: Who's Talking? Who's Not?

Opinion writers take aim at comments made by some of the Republican plan's pitch men while also noting the interests that are staying silent as the debate continues. They also highlight the role of key players and personalities such as Health and Human Services Secretary Tom Price.

WBUR: IPhones Vs. Health Care: Demonizing The Poor
The day after [Jason] Chaffetz spoke, the Utah Republican walked this hateful and hate-filled statement back. But we know that such retractions are only the sleazy “part two” of an utterly cynical smear campaign.It’s open season now on all vulnerable groups, and taking target practice on poor people — who have absolutely no way to voice their point of view as widely as the congressman — is an old trick that doesn’t get any more appetizing when the accusations are updated from Cadillacs to iPhones. (Janna Malamud Smith, 3/15)

The Washington Post: No, There’s No ‘War On Men’ In Health Care
Last week, during a committee hearing on the Republicans’ health-care plan, Rep. Mike Doyle (D-Pa.) asked Rep. John Shimkus (R-Ill.) to name a mandated benefit in the Affordable Care Act to which he objected. Shimkus replied: “What about men having to purchase prenatal care?” Shimkus is probably not the only member in Congress who believes that forcing men to purchase health insurance that includes maternal care is unfair; it represents what some have characterized as a war on men, as several conservative health-policy wonks also have argued. (See, for example, Linda Gorman’s “Obamacare’s War on Men.”) (Tsung-Mei Cheng and Uwe Reinhardt, 3/14)

The Washington Post: Can You Guess Which Group Has Been All But Silent In This Latest Health-Care Debate?
Can you hear it? No, you can’t. Ever since the Republicans released their health-care plan, there’s been a lot of noise. Of course, the Democratic opposition has been crying foul. Right-wingers are saying it doesn’t go far enough. Free marketers and the insurance industry worry that it doesn’t give enough freedom to insurance companies. Doctors are complaining that there won’t be enough insurance money available to pay their bills. Medical students think we should have a single-payer system. Some believe the legislation is being pushed through too fast. Others lament the lack of bipartisanship in the bill. The Congressional Budget Office concludes that millions will be left without coverage. Everyone seems to have a big problem with it. (Gene Marks, 3/14)

Los Angeles Times: Trump Sells A Bill Of Goods To Obamacare 'Victims'
Not long after the Congressional Budget Office reported Monday that the House GOP leadership’s proposal to “repeal and replace” Obamacare would nearly double the number of uninsured Americans, President Trump held a meeting in the White House with about a dozen people he described as “victims” of President Obama’s 2010 healthcare law. (3/14)

Roll Call: TrumpCare Needs a New Doctor
Before Tom Price was Donald Trump’s Health and Human Services secretary, he was a conservative member of Congress. Before that, he was a mustachioed orthopedic surgeon in Atlanta, Georgia. For the sake of all that’s healthy, let’s hope that in his doctor days, Tom Price focused on the surgery and let his partners tell the patient the bad news. (Patricia Murphy, 3/15)

Thoughts On How Republican's Answer To Obamacare Plays Out On The State Level

Editorials from around the country take a hard look at how the GOP proposal would work within their states.

The Des Moines Register: GOP Health Plan Would Hit Iowa Especially Hard
After seven years, U.S. House Republicans have finally unveiled their plan to repeal and replace the Affordable Care Act. It immediately went over like a lead balloon with pretty much everyone, including doctors, hospitals, insurers and advocacy groups. Many conservatives cannot even feign support for it. (3/14) The Devil Is In The Details Of The American Health Care Act, And The Details Are Not Good For Alabama
Yes, there were issues with the Affordable Care Act (ACA). But any replacement should make it better, not worse. Many of the concepts in the proposed American Health Care Act (AHCA) are good, but the way they are being implemented is detrimental to Alabama. As always, the "devil is in the details," and many of the details are not good for Alabama. The American Health Care Act, as currently written, will harm Alabama by (1) increasing the need for state funding, a resource we don't have, (2) increasing the number of fellow citizens who are uninsured, and (3) harming Alabama hospitals' already shaky financial status. (Will Ferniany and Selwyn Vickers, 3/14)

Denver Post: Cuts To Colorado Hospital Funding Could Be Critical
The Colorado state government is proposing a large funding cut to state hospitals through the Hospital Provider Fee (HPF). The cut to Denver Health equals $48 million, which would result in reductions to vital, life-saving services. Beyond Denver, HPF funding cuts will curtail services at rural hospitals and even cause some to close, forcing entire communities to travel great distances to access care.This funding cut is avoidable and has nothing to do with federal health care reform. Action is needed now to safeguard essential health care services for all Coloradans. (Rus Heise and Carol Lewis, 3/14)

Seattle Times: Washington Loses Under Republican Answer To ACA 
Washington state stands to lose more than $1 billion a year in federal dollars if the House Republican plan to replace the Affordable Care Act becomes law. The proposed cure for the Affordable Care Act is worse than the illness. Congress should be focusing on giving more people access to health care for less money — as the president promised — instead of taking insurance away from millions. (3/14)

San Francisco Chronicle: Single-Payer Health Care Returns To Sacramento
Does it qualify as news when legislators file a bill that aims to do a lot but tells us very little about how? Yes, when the issue is single-payer health care and the state is California. There’s been no such proposal entertained in Sacramento for the past four years, and under normal circumstances, there probably wouldn’t have been this year either. But then came Bernie Sanders and Donald Trump. (Gallagher, 3/14)

Viewpoints: The Risks Of 'Reforming' Medicaid; Did The CBO Offer An 'Indictment' Of This Program?

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

Huffington Post: Medicaid Is About Grandma
Why don’t Democrats more often make the point Sen. Chuck Schumer made this week about the consequences of GOP efforts to scuttle Medicaid: "Medicaid is for poor people, but also 60 percent goes to people in nursing homes. And that affects not only them, but their kids. You’re a kid 45 or 50, your Mom or Dad is in a nursing home. They could be kicked out after this bill passes. What would you do? You have to take them at home, stop working to take care of them. Or you have to shell out thousands of dollars out of your pocket." (Craig Crawford, 3/14) Proposed Medicaid Reforms Could Devastate Young People With Complex Medical Needs
Current proposals to simultaneously repeal the Affordable Care Act and reform the federal Medicaid program would be devastating to children and young adults with disabilities and complex medical needs. Even if the final ACA replacement plan continues to allow young people to stay on their parents’ insurance plans until age 26 – which is a benefit largely supported on both sides of the political aisle – the most medically complex among them rely on Medicaid because of the extraordinary level and cost of care needed. (Anna Nguyen, Rebecca Kim, Sophie Jan and Ahaviah Glaser, 3/15)

RealClear Health: CBO: You Can't "Lose" Medicaid You Don't Have
The Congressional Budget Office (CBO) had to deal with two separate worlds when it analyzed the American Health Care Act (AHCA), the version of “repeal and replace” put forward by two House committees. While the CBO exists to provide numbers that relate to spending, deficits, and the economy, a different number got the most attention: the assessment that by 2026 24 million fewer people would have health insurance. (Hanns Kuttner, 3/15)

The Washington Post: The CBO Report Raises Five Serious Questions
The Congressional Budget Office report on the American Health Care Act — showing that as many as 24 million people could lose health insurance, Medicaid would be drastically cut and older, poorer Americans would suffer the most — leaves us with a number of questions. (Jennifer Rubin, 3/14)

USA Today: Arkansas Is A Role Model In Health Policy
In a recent meeting with our nation’s governors, President Trump voiced a revelation that health care “is an unbelievably complex subject.” The governors and their Congressional colleagues are calling for simple fixes and will soon face the same recognition. In addressing a Joint Session of Congress, the president called for sweeping changes to "save us from this imploding healthcare." Now with a plan on the table, the Republican led Congress faces a challenge not unlike the Democratic-led Congress faced eight years ago. (Joe Thompson, 3/14)