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Hey Donald and Chuck -
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Build bridges not walls.

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Summaries Of The News:

Capitol Hill Watch

A Hint From GOP Leaders: Replacement Plan May Not Maintain Health Law's Coverage Expansions

The Congressional Budget Office estimated in 2015 that an Obamacare repeal would result in about 19 million people losing their health insurance. Ideas offered so far do not provide as much financial aid to purchase coverage and could lead to an increase in uninsured people. This possibility is at odds with President-elect Donald Trump’s campaign assurances that people won't be left without.

Bloomberg: GOP Won’t Say If People Will Lose Insurance In Obamacare Repeal
Top Republicans in Congress are refusing to promise that their plans to replace Obamacare won’t result in more uninsured Americans, putting them on a possible collision course with President-elect Donald Trump. "Look, I’m not going to get ahead of our committee process," House Speaker Paul Ryan told reporters Thursday when asked if he can guarantee a GOP replacement would cover as many people as the Affordable Care Act. "We’re just beginning to put this together." House Majority Leader Kevin McCarthy was also reluctant to make that commitment when asked on Tuesday, saying, "There’s a lot of areas that you want to look at." (Kapur, 1/5)

The Hill: GOP Won't Promise ObamaCare Fix Will Cover All 
Republican leaders are refusing to commit to their ObamaCare replacement plan covering as many people as President Obama's health law. Congressional Republicans are quickly moving forward to pass a repeal of ObamaCare and say a replacement plan will come later this year. But it's unclear whether that eventual replacement will provide insurance options for at least 20 million people, the number who gained coverage under ObamaCare, amid worries that many could lose their health insurance. (Sullivan, 1/5)

In related news -

CQ Roll Call: Republicans Consider Keeping Some Obamacare Taxes Intact
Republicans are considering a package to repeal the 2010 health care law that could keep some of the law's taxes that remain unpopular with industry officials. The health care overhaul included several taxes to help pay for the tax credits and exchanges at the heart of Obamacare. Those include the so-called Cadillac tax on expensive health plans, the health insurance tax and medical device tax. Republicans are moving to repeal the health care law (PL 111-148, PL 111-152) through a complicated process known as reconciliation and have set out an aggressive timeline for moving forward on that process. They remain divided, however, on exactly which parts of the legislation they will be able to repeal, given political divisions about issues like Medicaid expansion. (Mershon, 1/5)

Health Law Replacement Plan Will Be Completed In 2017, Ryan Says

Senate Majority Leader Mitch McConnell, R-Ky., echoed the sentiments expressed by House Speaker Paul Ryan, R-Wis., regarding the need for swift action to repeal and replace Obamacare. But the effective date of those changes will likely be further down the road and some members of the GOP rank and file are concerned that the Affordable Care Act skirmishes ahead could hamstring other aspects of their legislative agenda.

The Associated Press: Ryan: Lawmakers Will Act This Year On Replacing Health Law
Lawmakers will act this year on bills not simply repealing President Barack Obama's health care law but replacing it as well, House Speaker Paul Ryan said Thursday. The remarks by Ryan, R-Wis., suggested a faster schedule than some had expected on reshaping the nation's health care system. While Republicans have said they plan to vote this year on dismantling Obama's law, Ryan went a step further, saying they also would write legislation to replace it in 2017. It won't be easy. (Fram, 1/5)

The Hill: Ryan: ObamaCare Replacement Coming This Year 
Republicans will put forward their plan to replace ObamaCare sometime this year, Speaker Paul Ryan (R-Wis.) said Thursday.  Republicans are planning to pass a repeal bill quickly without having a replacement ready, but Ryan said that the replacement would follow this year.  He said he did not yet know when the repeal bill and replacement bill would take effect, because Republicans are still working out how long to make the transition period. (Sullivan, 1/5)

Morning Consult: Ryan Says Obamacare Replacement Bill Will Be Done In 2017
House Speaker Paul Ryan says legislative work on repealing and replacing the Affordable Care Act will be completed this year, but exactly when the transition takes place on insurance exchanges is still to be determined. “Our legislating on Obamacare, our repealing and replacing and transitioning, the legislating will occur this year,” Ryan said at a Thursday news conference. “What date all of this gets phased in on is something we do not know now because we are waiting for the Trump administration to be stood up. We’re waiting for Tom Price to be confirmed.” (McIntire, 1/5)

The Wall Street Journal: Republicans Face Pressure For Push To Repeal Affordable Care Act
Senate Majority Leader Mitch McConnell on Thursday reiterated the need to move swiftly to repeal and replace the Affordable Care Act, as Republicans face growing questions about the turmoil that might ensue and the viability of crafting a replacement. ... But there are increasing signs that the final result of the intensifying battle over health care will be more complicated, and that the final health plan may retain or restore parts of the Affordable Care Act. (Armour and Hackman, 1/5)

The Hill: GOP Rep: No Changes To ObamaCare This Year, Next Year
Rep. Chris Collins (R-N.Y.) on Thursday said there will be no changes to ObamaCare in 2017 or 2018."Immediately, what we're saying, is we're not going to pull the rug out from under anyone. There's not going to be any changes in 2017. There's not going to be changes in 2018," Collins, a member of President-elect Donald Trump's transition team, said on CNN. "Those products have already been approved by the state insurance agencies, or for the 2018 time, are in negotiation right now," he continued. (Savransky, 1/5)

The Hill: Lawmakers Worry ObamaCare Fight Could Suck Air From Other Priorities
The future of the Affordable Care Act will be the legislative battle looming over all work in the new session. That's raising some worry from interest groups and lawmakers that the highly partisan atmosphere will spill over into other “must pass” healthcare bills — like pharmaceutical and medical device user fees and the Children’s Health Insurance Program (CHIP) — which usually enjoy bipartisan support. Both sides agree ObamaCare repeal will make other health priorities more complicated. (Weixel, 1/5)

For Some Republican Leaders, Repealing Without Replacing Is Cause For Caution

Sen. Tom Cotton, R-Ark., and Sen. Susan Collins, R-Maine, have doubts about the current strategy of repealing the health law quickly without a clear plan to move forward with a replacement. Ohio Gov. John Kasich, a Republican whose state pursued the measure's Medicaid expansion, also warned against this tactic.

The Hill: GOP Senator Warns Against Repealing ObamaCare Without Replacement 
GOP Sen. Tom Cotton (Ark.) on Thursday warned his party not to repeal ObamaCare without a replacement ready to go. "I think it would not be the right path for us to repeal ObamaCare without laying out a path forward," Cotton said on MSNBC Thursday evening. "I think when we repeal ObamaCare, we need to have the solution in place moving forward. ... I do not think we can just repeal ObamaCare and say we'll give the answer two years from now." Republican leaders have vowed to vote on repealing ObamaCare immediately and delay the repeal until a replacement plan is ready. (Hellmann, 1/5)

Bloomberg: Senate GOP Jitters Grow On Obamacare Repeal With No Replacement
Republican plans to repeal Obamacare without detailing a replacement are hitting resistance from at least three GOP senators, which would be enough to scuttle the strategy party leaders devised to deliver quickly on a central promise from President-elect Donald Trump. Only one of the senators -- Rand Paul of Kentucky -- has so far said he plans to vote against the procedural gambit that sets up Obamacare repeal, citing unrelated budget concerns. Paul and two others are concerned that Republicans haven’t said yet how they would replace the health insurance scheme after repeal, with one of them also opposing the plan to defund Planned Parenthood as part of the repeal. (Dennis and Kapur, 1/5)

The Hill: Kasich Warns Republicans On ObamaCare Repeal 
Republican Ohio Gov. John Kasich warned his party's lawmakers against repealing ObamaCare without a replacement on Wednesday, noting that Ohioans have gained coverage from the Medicaid expansion in his state. Kasich, who ran for president last year, has long been a supporter of ObamaCare’s Medicaid expansion, but his warning to Republicans about repeal on Wednesday was particularly forceful. (Sullivan, 1/5)

Senate Republicans Reject Democrats' Effort To Block Obamacare Repeal Resolution

Democrats fail in their attempt to offer an amendment to the budget resolution that would have prevented the chamber from taking up legislation to raise health insurance premiums or out-of-pocket costs. But what has become clear is that some of Congress's most stalwart conservatives are signalling their readiness to support a budget that would add more than $1 trillion to the deficit by the end of the decade. Sen. Rand Paul, R-Ky., is not among them and is pressing members of the House Freedom Caucus to join him in the opposition.

The Connecticut Mirror: Murphy Tries, But Fails, To Block ACA Repeal
Congress has taken the first step toward repealing the Affordable Care Act, and Sen. Chris Murphy on Thursday was on the front lines of Democratic efforts to stop, or at least slow, the process. ... His effort was shut down on a party-line vote, but Murphy and Virginia Sen. Tim Kaine launched the first legislative shot over the bow of the Republican efforts to eliminate the ACA. (Radelat, 1/5)

CQ Roll Call: Senate Rejects Democrats' Attempt To Attack Obamacare Repeal
The Senate on Thursday sidelined a Democratic amendment to the fiscal 2017 budget resolution that would have prevented the chamber from taking up legislation to raise health insurance premiums or out-of-pocket costs. The resolution would set up a separate bill to repeal the health care law. During an afternoon vote series, the amendment did not gain enough support to overcome an objection from Senate Budget Chairman Michael B. Enzi that it violated a section of the Congressional Budget Act. The vote was along party lines, with 52 Republicans voting to sustain the budget point of order and 48 Democrats voting to waive the point of order and add the amendment to the legislative package. (Shutt, 1/5)

The Washington Post: Conservatives Ready To Support $1 Trillion Hole In The Budget
Some of the most conservative members of Congress say they are ready to vote for a budget that would — at least on paper — balloon the deficit to more than $1 trillion by the end of the decade, all for the sake of eventually repealing the Affordable Care Act. In a dramatic reversal, many members of the hard-line House Freedom Caucus said Thursday they are prepared later this month to support a budget measure that would explode the deficit and increase the public debt to more than $29.1 trillion by 2026, figures contained in the budget resolution itself. (Snell and Weigel, 1/5)

Roll Call: Freedom Caucus Weighs Pitch To Block Obamacare-Killing Budget Resolution
Republican Sen. Rand Paul of Kentucky pressed House conservatives Thursday to block the budget resolution that starts the process to repeal the 2010 health care law because it would add trillions of dollars to the deficit. Freedom Caucus Chairman Mark Meadows told reporters that the group made no decisions Thursday but would stake out what it can support during a caucus meeting next week. The meeting between approximately two dozen caucus members and Paul was “ad hoc” and put together at the last minute, the North Carolina Republican said, adding, “I found it to be a very enlightening and good meeting that gave us food for thought.” (Bowman and McPherson, 1/5)

On Capitol Hill, Talk Of Collaboration And Compromise? Not So Fast...

Thirteen moderate Senate Democrats penned a letter Thursday to GOP leaders that included a "long-shot bid" to work together to find bipartisan fixes to Obamacare, rather than dismantle it. At the same time, though, President-elect Donald Trump and Senate Minority Leader Chuck Schumer, D-N.Y., traded verbal salvos.

The New York Times: Democrats Appeal For Compromise: Alter, But Don’t Gut, The Health Law
With Republican leaders pressing to dismantle the Affordable Care Act, possibly within weeks, moderate Senate Democrats reached out on Thursday to Republicans, appealing for them to slow down the repeal efforts and let lawmakers try to find acceptable, bipartisan changes to make the existing law work better. Democrats also had new reason to hope for possible Republican defections after Speaker Paul D. Ryan of Wisconsin said that the repeal measure would cut off federal funds for Planned Parenthood. But for now, Republican leaders are holding firm. Senator Mitch McConnell of Kentucky, the majority leader, denounced the law, President Obama’s signature domestic achievement, as “a lesson to future generations about how not to legislate.” (Kaplan and Pear, 1/5)

The Hill: Dems To GOP Leadership: Help Us To Fix ObamaCare 
Senate Democrats are making a long-shot bid to Senate GOP leadership urging them to work with them to fix — rather than repeal — ObamaCare. Thirteen senators sent a letter to Majority Leader Mitch McConnell (R-Ky.), Sen. Lamar Alexander (R-Tenn.) and Sen. Orrin Hatch (R-Utah) arguing for improvements to the Affordable Care Act but warning that repealing the law would have "negative impacts."  "The American people deserve a constructive bipartisan conversation about improvements we know need to be made to our health care system, and that will require time for the two sides to work together," the Democrats wrote. (Carney, 1/5)

Morning Consult: Senate Democrats Ask GOP Leaders To Collaborate On ACA
More than a dozen self-described moderate Senate Democrats sent a letter to top Republicans asking them not to repeal the Affordable Care Act and work with Democrats to fix the law. Led by Sen. Tim Kaine of Virginia, 13 Democrats wrote to Senate Majority Leader Mitch McConnell (R-Ky.); Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) and Finance Committee Chairman Orrin Hatch (R-Utah) Thursday urging them to abandon plans to repeal Obamacare using a budget resolution and the reconciliation tool, and to instead work in a bipartisan manner to improve the health care law. (McIntire, 1/5)

Bloomberg: Trump And Schumer Trade Barbs Over Health-Care Overhaul 
President-elect Donald Trump showed signs Thursday of frustration with top Senate Democrat Chuck Schumer even as he called for help from across the aisle in reshaping federal health care law. In a series of tweets, Trump described Schumer, who represents New York, as his party’s “head clown” and said that he knows the health-care law his party championed is in trouble. Schumer and other Democratic leaders on Capitol Hill Wednesday unveiled a new slogan they say encapsulates Republicans’ plan to repeal the Affordable Care Act: it would “make America sick again,” a play on Trump’s campaign slogan, “make America great again.” The name-calling between the two New Yorkers may be a sign of fractures in a relationship dating to the 1980s -- including a Schumer stint on Trump’s reality show, “The Apprentice.” (Epstein, 1/5)

The New York Times: Trump Takes On Democrats And Health Law In New Twitter Blitz
President-elect Donald J. Trump lashed out at Democrats on Thursday over their efforts to preserve President Obama’s health care coverage law, insulting their top legislative leader and denouncing the measure as a “lie” as he called for a less expensive and more effective system. “The Democrats, lead by head clown Chuck Schumer, know how bad ObamaCare is and what a mess they are in,” Mr. Trump wrote in the first of three early-morning posts on Twitter. (Hirschfeld Davis, 1/5)

Defunding Planned Parenthood Will Be Part Of Obamacare Repeal Bill, Ryan Says

Republicans plan to strip the women's health organization of federal money as part of its effort to repeal the health law, according to the House Speaker.

The Wall Street Journal: GOP Makes Fresh Effort To End Federal Funding For Planned Parenthood
That bill will use a budget maneuver known as reconciliation, which allows the Senate to pass legislation with a simple majority rather than the 60 votes typically needed. A similar clause stripping hundreds of millions of dollars away from Planned Parenthood appeared in a similar 2015 reconciliation bill, which passed both chambers of congress but which President Barack Obama vetoed. (Hackman, 1/5)

The Associated Press: Ryan: GOP To 'Defund' Planned Parenthood In Obamacare Repeal
House Speaker Paul Ryan said Thursday Republicans would strip federal dollars for Planned Parenthood as part of the GOP effort to repeal the health care law, prompting an outcry from the century-old organization and Democrats promising to fight the move. Ryan spoke a day after a special House panel issued a report criticizing the organization, which provides birth control, abortions and various women's health services, for its practices regarding providing tissue from aborted fetuses to researchers. (Taylor, 1/5)

CNN: Paul Ryan: GOP Will Defund Planned Parenthood
A push by Republican congressional leaders to defund Planned Parenthood could threaten passage of their top-priority legislation to repeal Obamacare because of opposition to the anti-abortion provision by two key GOP senators. House Speaker Paul Ryan announced Thursday that Republicans will move to strip all federal funding for Planned Parenthood as part of the process they are using early this year to dismantle Obamacare. (Walsh, Barrett and Raju, 1/5)

The Milwaukee Journal-Sentinel: Ryan: GOP To ‘Defund’ Planned Parenthood In Obamacare Repeal
U.S. House Speaker Paul Ryan said Thursday that Republicans would cut federal money for Planned Parenthood as part of their repeal of Obamacare — a move that could affect 50,000 Wisconsin patients of the group. Planned Parenthood has 21 clinics in Wisconsin providing services such as contraceptives, screening for cervical cancer and treatment of sexually transmitted diseases, with the majority of its patients covered through state and federal Medicaid programs. (Stein, 1/5)

CQ HealthBeat: Republicans Seek To Defund Planned Parenthood In Repeal Bill
House Speaker Paul D. Ryan on Thursday said Republicans would act to defund Planned Parenthood in upcoming legislation to repeal President Barack Obama’s signature health law. “The Planned Parenthood legislation would be in our reconciliation bill,” the Wisconsin Republican said at his weekly news conference in response to a question regarding how the GOP would seek to defund the women’s health care organization. A provision to defund Planned Parenthood for one year was included in the bill that Congress cleared last year to repeal the 2010 health care overhaul (PL 111-148, PL 111-152) that Obama vetoed. (Williams, 1/5)

Planned Parenthood, Democrats, and at least one Republican, voice objections to the move —

Morning Consult: Democrats Vow To Fight Planned Parenthood Defunding
Abortion rights groups and Democrats are girding for another battle over Planned Parenthood after House Speaker Paul Ryan said the House GOP conference plans to include provisions to defund the women’s health service provider in its legislation to repeal the Affordable Care Act. ... While the GOP may be able to pass their plan in the House without support from Democrats, it could prove a roadblock to Obamacare repeal in the Senate. Sen. Susan Collins, a Republican from Maine, told reporters Thursday she was “not happy” about Ryan’s plan to defund Planned Parenthood. (Yokley, 1/5)

The Hill: GOP Senator: Don't Link Planned Parenthood To ObamaCare Repeal 
Moderate Republican Sen. Susan Collins (Maine) is signaling she doesn't want congressional efforts to repeal ObamaCare tied to ending federal funding for Planned Parenthood.  "Obviously I'm not happy to hear that the Speaker wants to include defunding of Planned Parenthood, an extremely controversial issue, in the package," Collins told reporters on Thursday.  But she stopped short of saying the provision, if included, would force her to vote against the measure, pledging that she would "wait and see what happens." (Carney, 1/5)

The Hill: Top Dem Senator To Trump: Weigh In On Planned Parenthood Fight 
Sen. Patty Murray (D-Wash.) is calling on President-elect Donald Trump to weigh in on a looming fight over Planned Parenthood.  "I would ask the president elect to Twitter very loudly tomorrow morning ... that he stands behind women and that he wants to see the House back down," the No. 3 Senate Democrat told reporters.  House Speaker Paul Ryan (R-Wis.) said earlier Thursday that the House's ObamaCare repeal bill will defund the organization, though federal dollars are already prohibited from being used to cover abortions. (Carney, 1/5)

The Hill: Planned Parenthood Launches National Campaign To Take On Trump, GOP 
Planned Parenthood on Thursday launched a national effort aimed at pressuring the incoming Donald Trump administration and GOP to abandon efforts to "defund" the organization. Planned Parenthood, which has long been opposed by conservatives because it provides abortions in addition to other women's healthcare services, has planned nearly 300 events in 47 states that will include marches, rallies, letter-writing campaigns and other activities over the next few months. (Hellmann, 1/5)

In another funding issue, advocates are starting to express concerns about National Institutes of Health funding —

Stat: NIH Backers Fear Research Funding Will Falter
For advocates of the National Institutes of Health, this is their worst fear: Come April, when Congress needs to fund the federal government again, they’ll be so busy with other issues that they’ll simply pass a stopgap spending bill that lasts until October. And that would likely mean another year of flat funding for the NIH. For the scientists and companies invested in medical research, nothing could be worse. It’s early yet, but lobbyists around town who want to see more dollars for NIH cite several reasons to be concerned. (Scott, 1/4)

Health Law

Obama Derides GOP Plan To Delay Health Law Replacement As 'Reckless'

In a commentary in the New England Journal of Medicine, the president acknowledges that the Affordable Care Act has problems but says if Republicans' don't have a firm plan for replacing it when they seek to repeal the law, they could do immense damage to consumers.

Politico: Obama Warns 'Repeal And Delay' Is 'Reckless' In New England Journal Essay
Barack H. Obama, J.D. has penned another essay for the New England Journal of Medicine, warning the Republican plan to repeal Obamacare and delay replacement for several years is "reckless" and "irresponsible." "What the past eight years have taught us is that health care reform requires an evidence-based, careful approach, driven by what is best for the American people," the president wrote in an essay published this morning in the influential medical journal. "That is why Republicans’ plan to repeal the [Affordable Care Act] with no plan to replace and improve it is so reckless." (Kenen, 1/6)

The Associated Press: Obama Derides 'Reckless' Plan To Repeal Now, Replace Later
Obama sought to dispel the notion that Republicans could fulfill their campaign promises to gut the Affordable Care Act immediately without risking devastating consequences for consumers. Calling that approach "irresponsible," Obama urged Republicans to do the work now to develop an alternative. "Given that Republicans have yet to craft a replacement plan, and that unforeseen events might overtake their planned agenda, there might never be a second vote on a plan to replace the ACA if it is repealed," Obama wrote. "And if a second vote does not happen, tens of millions of Americans will be harmed." (Lederman and Lucey, 1/6)

The Hill: Obama Slams ‘Reckless’ ObamaCare Repeal Plan In Medical Journal
Obama expressed pride in his signature health law, but acknowledged it has issues that need to be addressed, “such as a lack of choice in some health insurance markets, premiums that remain unaffordable for some families, and high prescription-drug costs.” “But persistent partisan resistance to the ACA has made small as well as significant improvements extremely difficult,” the president added. (Smilowitz, 1/6)

Weighing Obamacare's Future: Which Provisions Are In Play? Which Stakeholders Are At Risk?

News outlets review key aspects of the 2010 health law, forecast how the debate this time around is shaping up and highlight some aspects of the health care system that are bracing for the outcome.

Los Angeles Times: 7 Things To Know About The Future Of Obamacare
You’ve seen the headlines and you’ve heard the slogans: Obamacare is on the chopping block and President-elect Donald Trump is going to replace it with “something terrific.” But what are the new president and Congress really going to do? How much of the current law will really go away? And what could “Trumpcare” look like? In case it’s been a while since you read about the Affordable Care Act and the GOP replacement plans, here’s a refresher on the biggest Obamacare issues. (Levey, 1/5)

The Washington Post: Why Obamacare’s Insurance Marketplaces Won’t Necessarily Collapse With A Repeal
Replacing the health-care law, commonly known as Obamacare, could take years, potentially destabilizing the nascent system designed to provide insurance to individuals who don't receive it through an employer. Several large insurance companies had already announced plans to pull out of some health-care insurance exchanges created by the law because of financial losses, and health policy experts fear that repealing the law without immediately replacing it could exacerbate the exodus by adding uncertainty. ... But other policy experts predict that Republicans will provide incentives for insurers to stay. (Johnson, 1/5)

The Fiscal Times: Obamacare Repeal Could Push Rural Hospitals To The Brink
Many of the rural hospitals and health centers serving 62 million Americans have operated on a shoestring for years. Since January 2010, 80 rural hospitals and health care facilities that provided treatment to large numbers of elderly and low-income families were forced to close for financial reasons. More than 670 of the remaining 2,078 facilities are vulnerable or “at risk” of closure, according to hospital industry experts. (Pianin, 1/5)

Reuters: Exhibit A For Republican Obamacare Repeal Challenge: People With HIV
Scientists have shown conclusively that treatment not only improves the health of people infected with HIV, it also stops transmission of the virus that causes AIDS. That public health issue is just one of the challenges Republicans face as they attempt to overhaul the Affordable Care Act, a law that brought health insurance coverage to some 20 million people -- including tens of thousands of Americans living with HIV. (Steenhuysen, 1/5)

Most Americans Don't Support Repealing Health Law Without A Replacement, Survey Finds

The poll by the Kaiser Family Foundation also found that nearly half the country does not favor repeal at all.

The Washington Post: Only 1 In 5 Americans Supports Republicans’ ‘Repeal And Delay’ Obamacare Strategy
The Republican plan to immediately do away with the Affordable Care Act and come up with a replacement later is out of sync with what most Americans want, according to a new poll. Only 1 in 5 people supports repealing President Obama's health-care law before the replacement is worked out. Republicans officially began the work to unravel the law this week, but a Trump transition team member told The Washington Post they had six months to come up with a replacement. The poll suggests the likely “repeal and delay” agenda, in which a replacement plan is crafted months after a vote to repeal parts of the law, isn't supported by most voters. (Johnson, 1/6)

Los Angeles Times: Americans Don't Want To Scrap Obamacare Without Something To Replace It, New Poll Shows
The vast majority of Americans do not support Republican plans to repeal the Affordable Care Act without enacting a replacement, a new nationwide poll finds. Nearly half the country does not want the law, commonly called Obamacare, to be repealed at all. Even among those who want to see the law rolled back, most say Congress should wait to vote on repeal until the details of a replacement plan have been announced. (Levey, 1/5)

Kaiser Health News: Only 20 Percent Of Americans Support Health Law Repeal Without Replacement Plan
The Republican strategy of repealing the Affordable Health Care Act before devising a replacement plan has the support of only one in five Americans, a poll released Friday finds. The Kaiser Family Foundation survey also disclosed that shrinking the federal government’s involvement and spending in health care — the long-sought goal of House Speaker Paul Ryan and other Republican lawmakers — is less important to most Americans than is ensuring medical care is affordable and available. (Kaiser Health News is an editorially independent project of the foundation.) (Rau, 1/6)

NPR: Americans Say: Don't Repeal Obamacare Without A Replacement Plan
An overwhelming majority of people disapprove of Republican lawmakers' plan to repeal the Affordable Care Act without having a ready replacement for the health care law, according to a poll released Friday. And judging by the letter-writing and lobbying in the first week of the new Congressional session, many health care and business groups agree. (Kodjak, 1/6)

Bay Area News Group: Obamacare: Poll Finds Few Americans Want Health Law Repealed Right Away
As President-elect Donald Trump and the Republican-controlled Congress this week began to repeal and replace the Affordable Care Act, a new poll shows that most Americans either don’t want the health care law repealed, or prefer to delay killing the law until details of the GOP’s substitute are revealed. The survey, conducted by the Menlo Park-based Kaiser Family Foundation in mid-December, found that three-fourths of those polled either oppose repealing the law (47 percent), or want to wait to repeal it until details of the replacement law are firmed up (28 percent). (Seipel, 1/6)

How The Repeal-And-Replace Debate Is Playing Out In The States

As the new GOP congressional majority holds a laser-like focus on plans to undo the 2010 health law, some state officials are reaching out to express ways in which the statute has been working for them.

New Orleans Times-Picayune: Louisiana Health Secretary: Medicaid Rollback Would Be 'Irresponsible, Inhumane' 
Advocates who fought for years to expand Medicaid eligibility in Louisiana are now gearing up for a new fight against a conservative U.S. Congress that has set its sights on repealing the Affordable Care Act. They're being joined this week by Gov. John Bel Edwards, who has sent a letter to members of Congress urging them to keep Medicaid expansion in place, and Louisiana's health secretary, Dr. Rebekah Gee. In an interview on Thursday (Jan. 5), Gee said Louisiana's progress made under Medicaid expansion — a key component of the Affordable Care Act — should give policy leaders pause in overhauling national health care policy. (Litten, 1/5)

Nashville Tennessean: ACA Repeal Without Replacement Could Cost Tennessee 57K Jobs
Tennessee could lose 57,000 jobs in 2019 and nearly $900 million in state and local taxes over five years if parts of the Affordable Care Act are repealed without a replacement package, according to a study. Repealing Medicaid expansion, even though Tennessee didn't expand the program, and eliminating the tax credits without plans for an alternative would hurt the bottom line of companies and state and local governments, said Leighton Ku, co-author of the study from George Washington University and the Commonwealth Fund. (Fletcher, 1/5)

California Healthline: How Will The Planned Repeal Of Obamacare Affect Californians?
As federal lawmakers debate the fate of Obamacare this month, health coverage for millions of Californians hangs in the balance. Covered California, the state health insurance exchange, and the expansion of Medi-Cal, the state’s Medicaid program for low-income residents, are products of the Affordable Care Act. Both could be at risk if the GOP-led Congress and President-elect Donald Trump gut key pieces of the health law. (1/6)

Also, an enrollment status check from Georgia -

Administration News

Trump's Pick For HHS Draws Democrats' Scrutiny Over Health Care Stock Trading

Senate Democrats are calling for a delay in the confirmation hearings for Rep. Tom Price, R-Ga., who has been tapped by President-elect Donald Trump to head the Department of Health and Human Services. Democrats want to investigate trades he made while handling legislation in Congress that could impact the value of those shares. A Trump transition team spokesman responded that similar questions could be aimed at Democratic senators who also own health-related stocks. Meanwhile, Trump reportedly is considering former Henry Ford CEO Nancy Schlichting to lead the Department of Veterans Affairs.

Bloomberg: Senate Democrats Want Probe Of HHS Nominee Price’s Stock Trades
Senate Democrats called for a delay in confirmation hearings for Representative Tom Price, Donald Trump’s pick to be secretary of Health and Human Services, for an investigation of his trades in health-care stocks while handling legislation that could affect the shares. “He did this repeatedly and in such large numbers he’s likely to have made tens of thousands of dollars in one trade alone,” Senate Minority Leader Chuck Schumer, a New York Democrat, said at a news conference. Schumer pointed to a complaint filed Thursday by the watchdog group Public Citizen. (Litvan, 1/5)

The Wall Street Journal: Senate Democrats Scrutinize Trump Cabinet Pick Over Possible Conflicts Of Interest
A spokeswoman for Mr. Price wasn’t immediately available to comment. A spokesman for the Trump transition said in a statement that questions raised about Mr. Price could also be directed at Senate Democrats who own drug and health-care stocks. “Hypocrisy is apparently alive and well this morning in Washington,” said spokesman Phil Blando. “Today’s stunt is simply an effort to deflect attention away from Obamacare’s dismal record.” (Hughes, 1/5)

The Associated Press: Dems Want Probe Of Trump Cabinet Pick Over Stock Sales
Top Senate Democrats said Thursday that the House ethics office should investigate whether stock sales by a congressman who is now one of President-elect Donald Trump's Cabinet picks broke any laws. The Democrats cited a Wall Street Journal report last month that Rep. Tom Price, R-Ga., Trump's selection to head the Department of Health and Human Services, had traded over $300,000 worth of shares in health care companies over the past four years while pushing legislation that might affect those stocks' values. (Fram, 1/5)

Reuters: Democrats Demand Probe Of Trump Health Nominee
Democratic Senator Patty Murray said lawmakers want to know what nonpublic information Price may have had when the transactions at issue were made. ... Price, asked by Reuters in a Capitol hallway for a reaction to Schumer's comments, replied, "We're looking forward to a positive and productive confirmation hearing." (Cornwell and Heavey, 1/5)

The Hill: Dems Demand Ethics Investigation Of Health Nominee
The Democrats said they did not know whether Price has broken any laws, but that they need an ethics investigation to find out. "Every American should be shocked by this," Schumer said. Democrats have also targeted Price over his stance on Medicare, calling for a set amount of government assistance to be given to seniors rather than the current more open-ended guarantee from the program. (Sullivan, 1/5)

Roll Call: Schumer Seeks Inquiry Into HHS Nominee’s Health Stock Trades
Waiting for the result of an Office of Congressional Ethics investigation into Price’s trades could delay the potential confirmation process for some time. The office declined to comment on Thursday. Information posted on the OCE website suggests that it could take several months to produce information on Price’s trading if the office decides to move forward with an investigation and refer the matter to the Ethics Committee for review. (Dooley Young, 1/5)

Modern Healthcare: Trump Vets Former Henry Ford CEO Nancy Schlichting For VA Post
Nancy Schlichting, the recently retired CEO of the Henry Ford Health System who last year chaired a commission tasked with finding ways to revamp the Veteran Affairs Department's health system, Thursday met with the Trump transition team in New York. President-elect Donald Trump is considering her for a post he's had trouble filling— VA secretary. Cleveland Clinic CEO Toby Cosgrove withdrew from consideration for that post earlier this week. Luis Quinonez, the other rumored pick, reportedly backed out over the weekend. Quinonez is the president of MAQ Diversified, a Virginia-based physician staffing company. (Barkholz, 1/5)

Also in the news, Katy Talento, a Senate aide with a history of opposing birth control and abortion, will be working on health care policy for the White House Domestic Policy Council; and Trump's cabinet pick for the Department of Defense resigns from the Theranos board --

Stat: What Trump’s New Health Policy Aide Says About Abortion And Birth Control
President-elect Donald Trump’s pick to help lead health policy in the White House is a Senate aide with a record of strong rhetoric against birth control and abortion. Trump’s transition team announced Thursday that Katy Talento would work on health care policy for the White House Domestic Policy Council, which coordinates domestic policy-making. She was most recently legislative director for Senator Thom Tillis of North Carolina, a Republican who is a fierce opponent of abortion. (Scott, 1/5)


Mylan Hopes To Sell EpiPens Directly To Consumers And Bypass Pharmacies

Bloomberg reports on the company's plans to expand its market and set up its own distribution network. In other health industry news, Walgreens' CEO talks to analysts about plans for the merger with Rite Aid and a judge rules against Regeneron Pharmaceuticals and Sanofi on a patent dispute.

Bloomberg: Mylan’s EpiPen Sales Plan: Schools Today, Everywhere Tomorrow
Mylan NV made a fortune, and stirred controversy, while getting EpiPen allergy shots stocked in schools across America. Now the drugmaker wants to sell EpiPens to restaurants, sports venues and potentially even Boy Scout troops -- by setting up its own pharmacy to cut out middlemen and lobbying for new laws that could expand sales of its biggest product. The plan, obtained by Bloomberg News through public records requests, would bypass small-town pharmacists and chains like CVS and Walgreens and let Mylan sell the drug directly to public places. (Hopkins and Langreth, 1/6)

The Wall Street Journal: Walgreens Boots CEO: No Plan B For Rite Aid Merger
Walgreens Boots Alliance Inc. has no backup plan should U.S. antitrust regulators reject a $9.4 billion tie-up with Rite Aid Corp. that has been held up amid scrutiny from the Federal Trade Commission, the drugstore giant’s chief executive said Thursday. “We don’t want even to think the deal could not be approved after so many months, after we have given so much information and have had a good relationship with the people of the FTC,” Walgreens CEO Stefano Pessina said during a call with analysts. (Terlep and Steele, 1/5)

Reuters: Walgreens Profit Beats Estimates On PBM Partnerships
Walgreens Boots Alliance Inc reported a better-than-expected quarterly profit as recent partnerships with pharmacy benefit managers (PBMs) and insurance companies helped boost sales of prescription drugs as well as non-drug items. The largest U.S. drugstore chain also raised the lower end of its adjusted profit forecast for the year ending August 2017. ( Ramakrishnan, 1/5)

Reuters: Regeneron, Sanofi To Appeal U.S. Judge's Ban On Cholesterol Drug Sales
Regeneron Pharmaceuticals Inc and Sanofi SA said on Thursday they would appeal the U.S. District Court ruling which banned the two companies from selling their cholesterol drug, Praluent, on grounds of patent infringement. A federal judge had earlier blocked Sanofi and Regeneron from selling the drug after Amgen Inc accused them of infringing its patents. (Pierson, 1/5)

The Wall Street Journal: Judge Rules Against Sanofi And Regeneron In Patent Case
A U.S. federal judge ruled Thursday that drugmakers Sanofi SA and partner Regeneron Pharmaceuticals Inc. infringed the patent that rival Amgen Inc. holds for its new cholesterol drug. The decision permanently blocks Sanofi and Regeneron from selling their drug Praluent in the U.S., which would provide a big boost to Amgen’s drug Repatha if the decision stands. (Rockoff, 1/5)

The Wall Street Journal: Biotech Stocks Find Reprieve In Options
After the worst year for American biotechnology stock since 2002, options traders are optimistic about the group, according to data compiled by Goldman Sachs Group. In a note Thursday, the firm showed how options positioning for two biotech exchange-traded funds was among the most positive. (Banerji, 1/5)


Medicare Advantage Enrollees Have A Short Window To Switch Out Of The Plan

People who signed up for the private Medicare Advantage option can switch back to original Medicare until Feb. 14. Also, government documents show that the federal government didn't recover millions of dollars in overcharges by Medicare Advantage plans.

Money Magazine: Regret Signing Up For Medicare Advantage? You Can Get A Do-Over Now
Medicare’s annual open enrollment period ended last month, but certain beneficiaries who regret their selection can get a do-over from now through mid-February. The Medicare Advantage disenrollment period runs from Jan. 1 through Feb. 14. During this time, beneficiaries in private Medicare Advantage plans can switch to Original Medicare and, if desired, select a Part D drug plan. (O'Brien, 1/5)

Kaiser Health News: Medicare Failed To Recover Up To $125 Million In Overpayments, Records Show
Six years ago, federal health officials were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage insurance plans that allegedly overcharged the government for medical services. An initial round of audits found that Medicare had potentially overpaid five of the health plans $128 million in 2007 alone, according to confidential government documents released recently in response to a public records request and lawsuit. But officials never recovered most of that money. (Schulte, 1/6)

Public Health And Education

Achoo! Flu Cases Spiking In More States

Meanwhile, concerns grow about the long-term efficacy of insecticides in the Zika fight, and new research finds that the Ebola virus can linger in the lungs.

NH Times Union: Widespread In NH, Flu Hits 2 VA Units
The Manchester Veterans Affairs Medical Center restricted visits to its elderly and palliative care units on Thursday, with state officials describing flu as widespread in New Hampshire. The VA said that two residents of its 31-patient Community Living Center displayed flu-like symptoms and later tested positive for Influenza A. Outpatient services at the VA Medical Center in Manchester have not been affected, officials said. Meanwhile, state epidemiologist Benjamin Chan has determined that influenza activity was widespread in the state for the 51st and 52nd weeks of the year, according to a weekly influenza surveillance report. (Hayward, 1/6)

The Wall Street Journal: In The Fight Against Zika, Insecticides Hit A ‘Dead End’
Health workers have a thinning arsenal of insecticides capable of killing mosquitoes that carry Zika and similar viruses as the Southern Hemisphere’s summer begins and as outbreaks persist in other areas. One reason: Eliminating disease-carrying mosquitoes is a niche business with costly barriers to entry. “We may be hitting a dead end,” said Doug Carlson, director of the Indian River Mosquito Control District in Vero Beach, Fla. “In the not-too-distant future, we may very well not have chemicals that are effective.” (Bunge and McKay, 1/5)

The Washington Post: Ebola Virus Found Hiding In Lungs Of Health-Care Worker
Ebola has proven itself a tricky foe to get rid of in the human body. In numerous cases in which it was thought to be gone and patients fully recovered, the virus has been found in the eyes, semen, amniotic fluid, placenta, breast milk and central nervous system. Now a paper published in the journal PLOS Pathogens describes another possible hiding place for the virus: the lungs. (Cha, 1/5)

With Advanced Treatments, Cancer Death Toll Drops 25% Over Last Quarter-Century

The numbers show a continuing gender gap though, with death rates 40 percent higher for men than women. In other cancer news, spending on oncology eclipses other diseases for first time.

Los Angeles Times: Death Rate From Cancer Now 25% Lower Than It Was 25 Years Ago, Report Says
In the year to come, an estimated 1,688,780 people in the United States are expected to get a cancer diagnosis, and cancer will claim the lives of a projected 600,920. That death toll, however grim, represents a death rate from cancer that is 25% lower than it was a quarter-century ago — a drop driven by steady reductions in smoking rates and advances in early detection and treatment. Between 1991 and 2014, that boost in cancer survivorship translates to approximately 2,143,200 fewer cancer deaths than might have been expected if death rates had remained at their peak. (Healy, 1/5)

The Washington Post: Cancer Death Rate Has Dropped Again. But It’s Still Higher For Men Than Women.
That gender disparity reflects differences in the kind of cancers that men and women develop. For example, liver cancer, which is often lethal, is three times more common in men, largely because of their higher rates of hepatitis C infection, smoking and excess alcohol consumption. The largest gender disparities are for cancers of the esophagus, larynx and bladder; incidence and death rates are four times higher in men, the report said. (McGinley, 1/5)

Time: Here’s Why The Cancer Death Rate Has Plummeted
The drop is fueled by decreasing death rates from the four largest types of cancer: lung, breast, prostate and colorectal. “It’s pretty exciting for us that the cancer death rate continues to decline,” says Rebecca Siegel, strategic director of surveillance information services at the American Cancer Society and lead author of the annual report, which was published in CA: A Cancer Journal for Clinicians. “We’re making a lot of progress.” (Oaklander, 1/5)

Bloomberg: Cheating Death Can Cost $200,000 As Cancer Tops Pharma Sales 
That cancer angst, combined with prices that have surpassed $200,000 a year for revolutionary new treatments, is poised to give oncology medicines the biggest share of the $519-billion global pharmaceuticals market this year, eclipsing drugs for cardiovascular and metabolic diseases for the first time. And while drugmakers claim the revenue will propel innovation, the costs are stoking patients’ distress and creating a rift between manufacturers, health authorities and payers in many markets. (Naomi Kresge, 1/5)

In other public health news —

PBS NewsHour: The Nation’s Birth Rate Declined In 2015, New Data Says
Fewer babies were born in the United States, the latest government data show, and new mothers relied less on cesarean deliveries. Women gave birth to nearly 4 million babies in the United States in 2015, down 1 percent from a year earlier, according to the most recent data from the Centers for Disease Control and Prevention. That means the nation’s fertility rate saw a small but noteworthy drop with 62.5 births for every 1,000 women ages 15 to 44. (Santhanam, 1/5)

State Watch

From The Legislatures: Ga. Debates Hospital 'Bed Tax'; Minn. Eyes Financial Assistance For Premium Hikes

State lawmakers in Georgia, Minnesota, Florida, Texas and Massachusetts consider health care measures.

Stat: Georgia Lawmakers Debating Hospital Tax With Medicaid Implications
GOP lawmakers in Georgia are facing a tough question when they reconvene Monday: Should the state continue to do what nearly every other state in the US does — tax its hospitals? Georgia collects what’s known as a hospital provider fee, also known as a “bed tax,” that’s set to expire halfway through 2017. The state’s health department takes in an estimated $280 million each year from its hospitals by levying a 1.45-percent tax on net profits (critical-access, psychiatric, and state-owned hospitals are exempt). The state then uses those funds to draw down nearly $600 million in matching federal Medicaid funds. (Blau, 1/6)

The Minneapolis Star Tribune: Gov. Mark Dayton Unveils $300 Million Tax Plan While GOP Unveils Health Care Blueprint
Gov. Mark Dayton and GOP legislative leaders volleyed competing, big-ticket spending proposals Thursday that if enacted would deliver tax cuts to farmers and families paying for child care, and provide quick financial assistance to people facing steep premium hikes on their health insurance. Combined, the proposals by the DFL governor and Republicans who control the Legislature would cost the state $600 million — about $300 million each. Coming in the first week of the session, they set an early framework for negotiations and possible clashes between Dayton and legislators in the coming weeks and months. (Lopez 1/5)

Pioneer Press: Lawmakers Are Trying Again To Pass Health Insurance Relief. Here’s What It Would Do:
Thousands of Minnesotans are facing a similar crisis this year: skyrocketing health insurance rates. After failing to reach agreement on a relief package last year, Minnesota legislative leaders on Thursday rolled out a new plan that includes immediate relief as well as some longer-term changes. But this proposal from House and Senate Republicans differs in some key ways from what DFL Gov. Mark Dayton wants to address the problems in the state’s individual health insurance market. (Montgomery, 1/5)

Stories Of Addiction Show Communities Searching For 'Way Out' Of Opioid Epidemic

The New York Times reports from multiple states on patients and families, each dealing with a wrenching crisis. In related news, hospital "cuddlers" help soothe dependent newborns, Indiana's new governor pledges to roll back Mike Pence's needle exchange restrictions and police in Wyoming are trained to use Narcan.

The New York Times: Snapshots Of An Epidemic: A Look At The Opioid Crisis Across The Country
Public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015. Overdose deaths were nearly equal to the number of deaths from car crashes. In 2015, for the first time, deaths from heroin alone surpassed gun homicides. And there’s no sign it’s letting up, a team of New York Times reporters found as they examined the epidemic on the ground in states across the country. From New England to “safe injection” areas in the Pacific Northwest, communities are searching for a way out of a problem that can feel inescapable. (1/6)

Stat: Call In The Cuddlers: Volunteers Soothe Opioid-Dependent Babies
And they need calm. These are newborns born dependent on opioids, the youngest victims of an epidemic that’s touched every corner of the country. Even when mothers seek treatment for their addictions early in pregnancy, they are typically urged to stay on methadone to minimize the risk of miscarriage. That means babies are often born experiencing symptoms of withdrawal — such as twitching and tremors, trouble feeding, and difficulty sleeping...Many babies born dependent on opioids get methadone to ease their symptoms, but this program puts an emphasis on non-pharmacologic care for babies suffering from neonatal abstinence syndrome, or NAS. Often, that starts with skin-to-skin contact. (Thielking, 1/6)

The Associated Press: Pence's Indiana Successor Backs Fewer Needle Exchange Limits
Indiana's incoming governor pledged Thursday to roll back some restrictions on needle exchanges that his predecessor, Vice President-elect Mike Pence, signed into law as part of the state's response to its largest HIV epidemic. Republican Eric Holcomb, who takes office next week, said he believes local officials — not the state — should be able to authorize needle exchanges, a move he characterized as a "prudent step." Health experts, who criticized Pence's response to the crisis, say exchanges can dramatically curtail deadly outbreaks by allowing intravenous drug users to swap dirty needles for clean ones. (Slodysko, 1/5)

Hospital Roundup: Layoffs At MD Anderson Cancer Center To Hit 5% Of Staff

In other hospital news, a Massachusetts network buys its first hospital in New Hampshire, plans for a replacement hospital in New Jersey take a step forward and a transgender man says a Catholic hospital refused to perform a hysterectomy.

The Wall Street Journal: MD Anderson Cancer Center To Lay Off Roughly 5% Of Workforce
MD Anderson Cancer Center said it would cut 800 to 900 jobs, or about 5% of its workforce, as the globally renowned Texas hospital struggles with financial losses. Chief Financial Officer Dan Fontaine attributed the losses to a drop in physician productivity as the Houston-based hospital began using new electronic health records last year. Doctors took time away from patients to learn the new computerized system, and continue to struggle with it, he said in an interview. (Evans, 1/5)

Houston Chronicle: MD Anderson Cutting Staff By 1,000 Workers Via Layoff, Retirement; No Doctors Affected
No doctors or clinical-care nurses will lose their jobs, as MD Anderson reduces costs to try to stem operating losses. The layoffs will save the cancer hospital about $120 million. The reduction, nearly 5 percent of MD Anderson's 20,000-employee work force, had been feared at the acclaimed cancer center since late last month when officials confirmed operating losses of more than $50 million in both September and October. (Ackerman, 1/5)

The Philadelphia Inquirer/ Planning Board Report Greenlights Inspira's Proposed $326M Glouco Hospital
The New Jersey Department of Health recommended that the State Health Planning Board approve Inspira Health Network's proposal to build a $326 million replacement hospital for Inspira Medical Center-Woodbury. At a meeting next week the planning board is scheduled to consider whether to grant a certificate of need to the proposed hospital in Harrison Township, according to an agenda released Thursday. A 25-page report by department of health staff said the replacement hospital is "in the best interest of the patients in the hospital's service area and for the future provision of quality health care services by the hospital." (Brubaker, 1/5)

The Associated Press: Transgender Man: Catholic Hospital Denied My Hysterectomy
A transgender man sued a Roman Catholic hospital on Thursday, saying it cited religion in refusing to allow his surgeon to perform a hysterectomy as part of his sex transition. Jionni Conforti's sex and gender discrimination lawsuit comes as new regulations hailed as groundbreaking anti-discrimination protections for transgender people are under legal attack from religious groups. (Cornfield, 1/5)

State Highlights: Ky. Bill Would Require Ultrasound Before Abortion; Long ER Waits For Mental Illness Problem In Mass.

Outlets report on health news from Kentucky, Massachusetts, Iowa, Pennsylvania and Kansas.

Reuters: Kentucky Moves Toward Requiring Ultrasound Before Abortion
Kentucky's new Republican House majority took the first step on Thursday toward requiring women seeking an abortion to undergo an ultrasound, acting swiftly to capitalize on winning control of the chamber for the first time in almost a century. ... The bill requires a physician or qualified technician to perform the ultrasound and position the screen so the woman may view the images. The medical staff will be required to describe what the images show, including the size of the fetus and any organs or appendages visible. (Bittenbender, 1/5)

Des Moines Register: Iowa Agency To Pay $1 Million To Settle Medicaid Billing Allegations
An Iowa agency that cares for children with disabilities has agreed to pay $1 million to settle federal authorities’ allegation that it overcharged Medicaid. The agency, based in West Des Moines, was known as Ultimate Nursing Services when the disputed bills were filed from 2011 to 2013. It now uses the name of a related company, Universal Pediatrics. The company and its owner, Steven Tucker Anderson, were accused of improperly billing Medicaid, according to settlement documents released by federal prosecutors Thursday. (Leys, 1/5)

The Philadelphia Inquirer/ Pa. Makes New Picks For HealthChoices Medicaid Program
Two of the nation's largest health insurance companies, UnitedHealthcare and Aetna, have lost bids to manage Medicaid benefits in Pennsylvania under contracts worth a total of $12 billion over three years. The contracts, which cover physical health under Pennsylvania's HealthChoices program, were first awarded in April, but had to go through a second procurement process after Aetna, which last year won only one of the state's five zones, was granted a preliminary injunction blocking the Pennsylvania Department of Human Services from implementing its choices. (Brubaker, 1/5)

KCUR: Kansas Mental Health Advocates To Push For Psychiatric Advance Directives 
If someone you loved had a psychiatric emergency, would you know what to do?Because many people wouldn’t, Kansas mental health advocates are pushing for the state to recognize psychiatric advance directives to guide care for patients in crisis who are unable to communicate. Patients most often use advance directives to specify the treatments they want at the end of life, but people with mental illnesses could use a similar document to outline psychiatric crisis treatments, said Mike Burgess, a member of the Kansas Mental Health Coalition. The issue is new in Kansas, although some other states have laws on advance directives for mental health care. (Wingerter, 1/5)

Editorials And Opinions

Thoughts On Repeal: Obama Warns GOP That Rushing Ahead Without Replacement Could Do Harm

Across the country, opinions writers, including the president, offer perspectives on the debate in Washington over the future of the federal health law.

The New England Journal of Medicine: Repealing The ACA Without A Replacement — The Risks To American Health Care
I am proud that my administration’s work, through the Affordable Care Act (ACA) and other policies, helped millions more Americans know the security of health care in a system that is more effective and efficient. At the same time, there is more work to do to ensure that all Americans have access to high-quality, affordable health care. What the past 8 years have taught us is that health care reform requires an evidence-based, careful approach, driven by what is best for the American people. That is why Republicans’ plan to repeal the ACA with no plan to replace and improve it is so reckless. ... This approach of ... could slowly bleed the health care system that all of us depend on. (And, though not my focus here, executive actions could have similar consequential negative effects on our health system.) If a repeal with a delay is enacted, the health care system will be standing on the edge of a cliff, resulting in uncertainty and, in some cases, harm beginning immediately. (President Barack Obama, 1/6)

Bloomberg: What's The Rush To Kill Obamacare?
For seven years, Republicans have yearned to dismantle the Affordable Care Act. Now that they have the chance, they seem wholly unprepared to do it right. Much work is still needed to figure out how to avoid destabilizing the health-insurance system. Yet, in their hurry, leaders in Congress seem to want to skip that part. What’s the rush? (1/5)

Los Angeles Times: Some Obamacare Advice For Republicans: First Do No Harm
[House Speaker Paul] Ryan promised “bold action” to make things better, but he and other Republican lawmakers can’t be more specific about their plans because they don’t know themselves. All they’re saying now is that they’ll take apart Obamacare in bits and pieces, and they’ll come up with a replacement in perhaps a few years. The insurance industry and most major medical groups say this is crazy. They’ve warned that all this uncertainty will destabilize insurance markets and will push many insurers to stop selling coverage to individuals, putting lives at risk. (David Lazarus, 1/5)

The Wall Street Journal: Lessons From Obama’s Failure
True enough, eight years ago congressional Republicans were clueless about health-care policy. But a great deal has changed in that time—in ideas, education and the quality of the GOP caucus. Witness Rep. (and Dr.) Tom Price, the nominee to be the next secretary of health and human services, who offered in Congress his own detailed replacement plan. Republicans already agree on the general contours of a free-market proposal—one based on tax credits, entitlement reform, freer insurance markets, portable policies and fewer mandates. The internal debates are over scope and details, not approach. (Kimberley A. Strassel, 1/5)

The Washington Post: Trump’s Health-Care Plan Has Already Been Tried. It Was A Disaster.
We don’t have the full details of Trump’s plan — or any Republican health-care plan, for that matter — but we are starting to see its bones develop. There will be no individual mandate or similar mechanism to bring healthy Americans into the system, but Trump has indicated he wants to retain the requirement that insurers cover everyone, including patients with serious preexisting conditions. Trump is telling Americans what he thinks they want to hear: that they can have all their dessert — consumer protections — without eating their vegetables — an individual mandate. This might be an effective rhetorical technique, but it is not the truth. The reality is that such an approach would result in devastation to the health-care system. (Jim McDermott, 1/5)

WSJ: Full Obamacare Repeal Has High Cost
Item number one on the Republican agenda is repealing Obamacare. Senate Budget Committee Chairman Michael Enzi has already introduced a budget resolution that includes reconciliation instructions to repeal President Barack Obama’s signature health law, the Affordable Care Act, and the House is planning to take it up next week. We still have no idea how much this will cost – or even if it will add to or subtract from the national debt. There are a number of approaches to repealing the law – all with differing price tags. (Maya MacGuineas, 1/5)

The New York Times: The Complex Mess Of Health Insurance
Obamacare looks the way it does because its designers wanted to cause the least possible disruption to the status quo while providing insurance to many more people. By that measure — and others, as a new Times editorial notes — the law has been a big success. But if it’s too complicated to have assured its own political survival and Republicans really do repeal it — throwing millions of people off of health insurance — the next push for health reform should probably be simpler. It should probably revolve around expanding the government programs that already exist. (David Leonhardt, 1/5)

The Washington Post: Questions For The ‘Repeal And Delay’ Crowd
Republicans are patting themselves on the back for “keeping their promise” and moving to repeal Obamacare with no replacement in sight. Is this really what they promised? Republicans ran on repeal and replace, not repeal and we’ll get back to you. They did not run on adding debt or on defunding coverage without an alternative. At times it is almost comical. (Jennifer Rubin, 1/5)

Los Angeles Times: Obamacare Repeal: A Bad Goal That’s Proving Hard To Achieve
Repealing the law is bad enough, but doing so without an alternative that could preserve coverage for the estimated 20 million Americans who gained it through Obamacare would be reckless and irresponsible. And that’s just one problem. Here’s another: Some Republicans are now questioning whether it’s wise to revoke all the tax increases in the Affordable Care Act, which offset some of the cost of the healthcare subsidies for lower-income and elderly Americans. In fact, there are at least two compelling reasons to leave those tax hikes in place. (1/5)

The New England Journal of Medicine: The End Of Obamacare
Donald Trump’s triumph in the 2016 presidential election marks the beginning of an uncertain and tumultuous chapter in U.S. health policy. In the election’s aftermath, the immediate question is this: Can Republicans make good on their pledge to repeal Obamacare? The Affordable Care Act (ACA) has persisted largely thanks to President Barack Obama’s protection. With Trump in the White House and Republicans maintaining House and Senate majorities, that protection is gone. (Jonathan Oberlander, 1/5)

Los Angeles Times: Obama’s Enduring Legacy: The Concept Of Universal Coverage
Donald Trump’s Republicans have vowed to repeal Obama’s healthcare law, abolish his financial reform law, and undo his executive orders on immigration and clean energy. ... But their No. 1 target, Obamacare, may be safer than it seems. The reason is simple but underappreciated: Because of Obamacare, Republicans have inherited an obligation to ensure access to affordable health insurance for every American — a duty the federal government didn’t have before. They could disavow the burden — but they haven’t. Indeed, Trump has embraced it. (Doyle McManus, 1/4)

Bloomberg: Republicans Should Save These 3 Unpopular Parts Of Obamacare
As Republicans consider repealing Obamacare, what bits should they be looking to keep? A lot of people will have different answers to this, of course, but to my mind the most important and unobjectionable bits of Obamacare are payment reform, comparative-effectiveness research and the tax on gold-plated health-care plans. These are not, you will notice, the most popular bits of Obamacare, the one that President-elect Donald Trump seems to favor. Nor are they the most famous. But all three attempt to tackle the biggest problem with our health-care system: its exorbitant cost. (Megan McArdle, 1/5)

Huffington Post: Public Wary Of GOP Plan To Repeal Obamacare Without A Replacement, Poll Shows
Americans have complicated feelings about Obamacare, according to a new poll, with voters divided over whether to keep the law, but only a minority supporting the Republican strategy of trying to eliminate it quickly. ... even many Republican voters seem unenthusiastic about eliminating the law before Congress crafts a replacement, as House Speaker Paul Ryan (R-Wis.) and other GOP leaders have proposed. Overall, according to the poll, just 20 percent of Americans say that is their preferred strategy for eliminating Obamacare. (Jonathan Cohn, 1/6)

The Washington Post: What Do Working Class White Trump Voters Really Want From Our Health System? Not What You Think.
As the Republicans set about dismantling the Affordable Care Act, they face a number of dangers, one of which is that they may have overestimated their own supporters’ commitment to their particular free-market version of health care. Most signs are that Donald Trump will sign a bill repealing the ACA, but in the debate over what Republicans will replace it with, a question presents itself: What do working-class Trump supporters really want from our health care system? (Paul Waldman, 1/5)

The Washington Post: Make Obamacare Great Again — Call It Trumpcare
Believe it or not, Americans like Obamacare. They just don’t know they like Obamacare. That is, the law known as “Obamacare” and “the Affordable Care Act” is relatively unpopular. But most of the things that this disreputable law does are incredibly popular. Consider the prohibition on denying insurance coverage due to preexisting conditions. Seven in 10 Americans, including 6 in 10 Republicans, support this provision, according to a recent Kaiser Family Foundation poll. (Catherine Rampell, 1/5)

Bloomberg: Republicans Really Can Pretend To Repeal Obamacare 
That is, instead of "repeal and delay," Republicans would try "pretend and delay" -- pass a nonbinding resolution and hail it as Mission Accomplished. Could Donald Trump and congressional Republicans really get away with such a brazen maneuver? I don't see why not. Democrats wouldn't complain much; they care more about preserving the substance of the policy than about drawing attention to the hypocrisy of a symbolic move. And most Republican voters care more about the symbolism. To avoid getting mired in repealing and replacing a complicated law in a complicated policy area, Trump and the Republicans in Congress could opt for ways to make the issue go away -- not unlike slapping your name on a building but not owning it. (Jonathan Bernstein, 1/5)

Viewpoints: GOP's 'Tunnel Vision' On Planned Parenthood; Concerns About Cures Act

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

The Washington Post: Republicans Look To Punish Planned Parenthood — Without Any Evidence
Fifteen months and nearly $1.6 million later, a Republican-run House panel investigating Planned Parenthood and fetal tissue research ended up where it started: with no evidence of wrongdoing. That has not deterred the Republicans from proposing a political agenda so extreme it should scare not only those who care about women’s health care but also anyone who values science and its contributions. ... To call the committee’s work a report is to give it undue respect. It was drafted in secret with no input from Democrats and released without a public vote. A one-sided tunnel vision has marked the committee since its formation in the aftermath of a controversy over sting videos purporting to show Planned Parenthood involved in the illegal sale of fetal tissue. The videos since have been completely discredited. (1/5)

The Wall Street Journal: Don’t Thank Big Government For Medical Breakthroughs
Americans who want better treatments for their diseases should be pleased that the lame-duck Congress passed the 21st Century Cures Act, which will promote medical innovation. They should be wary, however, of the $4 billion budget boost that the law gives to the National Institutes of Health. The assumption seems to be that the root of all medical innovation is university research, primarily funded by federal grants. This is mistaken. The private economy, not the government, actually discovers and develops most of the insights and products that advance health. The history of medical progress supports this conclusion. (Tom Stossel, 1/5)

JAMA: New “21st Century Cures” Legislation: Speed And Ease Vs Science
The 21st Century Cures Act was signed into law in December 2016. Praised by its advocates as a means of speeding drug development, the act covers several areas, but the provisions related to the US Food and Drug Administration (FDA) will be among the most problematic and potentially important. ... Even though the 21st Century Cures Act does not formally change the basic need for manufacturers to provide evidence of safety and efficacy of their drugs and high-risk medical devices to the FDA, enactment of some of its provisions could harm the drug and device marketplace by encouraging the FDA to emphasize speed over science and rely on less rigorous data for the approval of new products and indications. Ironically, it was the establishment decades ago of FDA standards for demonstration of efficacy and safety that transformed the US pharmaceutical industry from purveyors of uncertain remedies into one of the most successful industries in the world. (Aaron S. Kesselheim and Jerry Avorn, 1/5)

The New York Times: Let Opioid Users Inject In Hospitals
The problems presented by injection drug use are legion, but creative solutions exist. One is the provision of safe drug-use rooms. Cities as far-flung as Vancouver, British Columbia, and Paris and Berlin have opened safe, well-lit rooms where addicts can get clean needles and other equipment without fear of incarceration. In New York State, Ithaca and Manhattan are considering similar initiatives. Such facilities can also connect addicts to needed services like preventive testing, acute care and treatment for addiction. (Tim Lahey, 1/6)

Milwaukee Journal Sentinel: Shenanigans Cause Problems For Prisons, Taxpayers
Attorneys general from nearly every state and across the political spectrum agree that the makers of the drug Suboxone, a widely used treatment that reduces cravings for opiate addicts, violated state and federal antitrust laws. In the process, they have unnecessarily inflated the price of Suboxone and undermined security in prisons all over the country. Most critically, at a time when the nationwide opioid crisis has reached epidemic proportions, they have made it more difficult for patients to access a range of effective treatments. (Ike Brannon, 1/5)

The Washington Post: Reports Cite VA Progress, Despite Contrary Republican Rhetoric
During a period of growing Republican criticism and eagerness for major changes at the Department of Veterans Affairs, officials there might find some solace in two recent independent reviews of an agency that dishonored itself. A Harvard Business School case study, published in November and updated this month, concludes that the team assembled by VA Secretary Robert A. McDonald has “made impressive progress over the past year.” In July, a literature review in the Journal of General Internal Medicine found “the VA often (but not always) performs better than or similarly to other systems of care with regard to the safety and effectiveness of care.” (Joe Davidson, 1/4)

Raleigh News & Observer: Gov. Cooper’s Right On Medicaid Expansion
In declining to expand Medicaid, [North Carolina's] GOP lawmakers gave up tens of millions of dollars and thousands of jobs that would have been created to help run the expansion. And for what? For nothing more than the opportunity to defy President Obama and reject his signature program — no matter the damage it did to the very citizens they represented. Their behavior was nothing short of a disgrace. (1/4)

The New England Journal of Medicine: Intimate Choices, Public Threats — Reproductive And LGBTQ Rights Under A Trump Administration
In the weeks since the election of Donald Trump, many experts have begun assessing the likely implications of his administration in various realms, from immigration and education to financial institutions and international relations. My concerns are decidedly more quotidian, though no less important. I worry about what a Trump presidency will mean for the way we Americans structure our intimate lives — how we decide when and with whom to partner, whether and when to become a parent, how to identify our gender, and whether to come out at work — which directly affects our health and well-being. The freedom to make these decisions has always been contested, but it seems especially contestable in this new political landscape. (Melissa Murray, 1/4)