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Capitol Hill Watch

GOP Leaders Remain Resolute On Quick Repeal Vote Despite Unease Brewing In Ranks

The lawmakers are facing dissent from their own party by members who are concerned that there is no plan on how to replace the health law if Congress votes to repeal it.

The Washington Post: Republicans Scramble To Ease Concerns About Obamacare Replacement
Republican leaders on Capitol Hill are scrambling to ease growing concerns among GOP lawmakers about rushing to repeal the federal health-care law before plans for a replacement take firmer shape, addressing complications to the effort to deliver on one of the party’s signature campaign promises. In the Senate, where Republicans are using a budget package to move swiftly ahead with repeal, leaders are looking at ways to adjust their plans to address the skittishness that GOP senators have voiced in recent days. (Sullivan and Snell, 1/9)

The Associated Press: GOP Anxiety Mounts Over Voiding Health Law Without Own Plan
The burgeoning Republican divisions come as the GOP-led Senate pushed toward a final vote this week on a budget that would prevent Democrats from using a filibuster to block a later repealing Obama's overhaul. That's crucial because filibusters take 60 votes to halt in a chamber that Republicans control by only a 52-48 margin. (Fram, 1/10)

Politico: GOP Leaders Vow To Plow Ahead With Obamacare Repeal
House and Senate Republican leaders are forging ahead with plans to repeal Obamacare then replace it later — dismissing mounting pressure from their own party to delay the repeal vote until they have a fully formed alternative. But they’re hoping to ease internal concerns that Republicans will be attacked for acting hastily — worries that accelerated after libertarian-leaning Sen. Rand Paul (R-Ky.) bucked party leadership on the matter last week and received a blessing from President-elect Donald Trump. Speaker Paul Ryan (R-Wis.), Senate Majority Leader Mitch McConnell (R-Ky.) and their top lieutenants in both chambers are now considering a strategy that includes adding some replacement provisions to the repeal bill, according to lawmakers and aides. (Bade and Everett, 1/9)

The Hill: GOP Leaders Push Back At Critics Of ObamaCare Plan 
Senate Republican leaders are pushing back against the idea proposed by some in their caucus of passing an ObamaCare replacement at the same time that they repeal the law. Sen. John Cornyn (Texas), the Senate’s No. 2 Republican, indicated to reporters Monday that simultaneous repeal and replacement is not practical. (Sullivan, 1/9)

Politico: 5 Senate Republicans Seek To Slow Down Obamacare Repeal
A group of moderate Senate Republicans introduced an amendment Monday to give Republicans additional time to repeal Obamacare. Sens. Susan Collins, Bob Corker, Lisa Murkowski, Bill Cassidy and Rob Portman want to extend the deadline for a repeal bill until March 3 under an arcane budget procedure called reconciliation that prevents a Democratic filibuster. The existing resolution's deadline is Jan. 27, although none of the deadlines are binding. (Haberkorn, 1/9)

CQ Roll Call: Five Senate Republicans Push To Delay Obamacare Repeal
The five lawmakers are part of a larger group that is calling on their colleagues to agree on a replacement plan before repealing the health care law. Republican Sens. Rand Paul of Kentucky and Tom Cotton of Arkansas have expressed similar concerns. The cohort is large enough to derail an otherwise speedy process. With 52 seats in the Senate, Republicans can afford to lose just two votes on the reconciliation measure once Vice President-elect Mike Pence is available to break a tie after Inauguration Day on Jan. 20. (Mershon and Lesniewski, 1/9)

Politico: Freedom Caucus Looks To Delay Budget — And Obamacare Repeal
The House Freedom Caucus wants to delay a vote on a budget that includes Obamacare repeal instructions, a potential setback for the GOP’s — and Donald Trump’s — top priority. The group of hardline conservatives wants more information about what a repeal bill and Obamacare replacement would look like before they support the fiscal 2017 budget. (Bade, 1/9)

The Associated Press: GOP Turns To Arcane Budget Process To Repeal Obamacare
Yes, Donald Trump is taking charge and Republicans control both the House and Senate, having won an election promising to repeal President Barack Obama's health care law. But in Congress, getting from Point A to point B rarely consists of a straight line, and Democrats in the Senate can easily gum up the works with procedural blockades. Since Republicans hold the Senate with just 52 votes, they are forced to employ an arcane, fast-track budget process to avoid a Democratic filibuster. (1/9)

In other news —

The Associated Press Fact Check: Despite Woes Obamacare Not In 'Death Spiral'
President-elect Donald Trump says that President Barack Obama's health care law "will fall of its own weight." House Speaker Paul Ryan says the law is "in what the actuaries call a death spiral." And Senate Majority Leader Mitch McConnell says that "by nearly any measure, Obamacare has failed." The problem with all these claims: They are exaggerated, if not downright false. (Werner, 1/10)

Roll Call: Obamacare Tax on Wealthy Sparks Battle Over Fairness
Republicans and Democrats are squaring off in a fight over tax fairness as the GOP develops a timetable for repealing the 3.8 percent surtax on investment income under the health care overhaul. GOP lawmakers have long argued for elimination of the surtax, or the net investment income tax, that applies to income such as interest, dividends and capital gains for individuals making more than $125,000 or couples earning more than $250,000. (Ota, 1/9)

The CT Mirror: Insurers: Repeal Of ACA Should Go Slowly, Keep Subsidies Awhile 
As Republicans in Congress begin work on a repeal of the Affordable Care Act, the nation’s health insurers are telling lawmakers to keep paying subsidies to the companies and to low-income Americans so they can afford coverage. Insurers also want Congress to create a long transition period before the ACA is eliminated and a GOP plan replaces the health law. (Radelat, 1/9)

Trump Wants Simultaneous Repeal And Replace, Dissenting Senator Says

Sen. Rand Paul, R-Ky., says the incoming president is in agreement that there should be a vote on a replacement plan to go along with the one on dismantling the law.

The Wall Street Journal: Donald Trump Pressures Republicans To Repeal, Replace Health Law At Same Time
President-elect Donald Trump is increasing pressure on congressional Republicans to vote at the same time to both repeal and replace the Affordable Care Act, but party leaders haven’t indicated any shift in strategy to make that happen. Mr. Trump’s push, combined with doubts from different factions of Republicans, could end up slowing down party leaders’ efforts to rapidly overturn much of the law. (Peterson and Bender, 1/9)

The Washington Post: Rand Paul: Trump Open To Passing Obamacare Replacement Alongside Repeal
President-elect Donald Trump may be joining the growing ranks of Republicans in Washington who are getting cold feet about plans to rush through a vote to repeal Obamacare without a plan to replace it. Trump called Sen. Rand Paul (R-Ky.) this weekend to discuss Paul’s push to convince the rest of the GOP not to vote later this week on a budget resolution that includes a framework for a vote to repeal the Affordable Care Act without a replacement plan. Paul said he spoke with Trump for approximately 15 minutes Friday and the two agreed on the need for replacement. The only hitch: Republicans don’t have one yet. (Snell and Weigel, 1/9)

The Hill: Rand Paul Rolling Out ObamaCare Replacement This Week 
Rand Paul (R-Ky.) is pledging to roll out an ObamaCare replacement bill this week as GOP lawmakers rush to nix the healthcare law. The Kentucky senator argued Monday that the law must be replaced with "real market reforms." Paul's legislation comes as the Senate is expected to pave the way this week to repealing the healthcare law.  (Carney, 1/9)

CNN: How Trump Could Use His Executive Power On Obamacare
President-elect Donald Trump doesn't plan to sit back and wait for Congress to repeal and replace Obamacare. The soon-to-be dealmaker-in-chief intends to wield his executive authority to help shift the nation from the Affordable Care Act to a Republican vision for health care. "We're working on a strategy, in concert with the leadership of the House and the Senate, for both a legislative and executive action agenda to ensure that an orderly and smooth transition to a market-based health care reform system is achieved," said Vice President-elect Pence last week, emphasizing the shift will be "stable." (Luhby, 1/9)

In other news —

CQ Roll Call: Trump Promises Support For Coal Miner Health Fix, Manchin Says
Democrats sought President-elect Donald Trump’s backing in last month’s spending showdown that brought the federal government to the brink of a shutdown over health care coverage for retired miners, and a key participant said Monday that Trump has given an assurance that he supports the effort. Sen. Joe Manchin III, D-W.Va., announced Monday that Trump gave “assurance” that he will support the effort to permanently extend health care for retired miners and their spouses. (Dillon, 1/9)

Democrats Protest Repeal Efforts: 'We Cannot Allow Republicans To Make America Sick Again'

Senate Democrats took to the floor on Monday night for nearly six hours to criticize their colleagues' plans to dismantle the health law.

Roll Call: Senate Democrats Use The Floor And Facebook To Protest Obamacare Repeal
Senate Democrats launched the first of what will likely be numerous efforts to derail Republican plans to repeal the 2010 health care law, taking to the Senate floor and social media Monday night in a talk-a-thon to portray the move as reckless and chaotic for the health care system. “I think the point is to send a clear message to the country, to the American people that, No. 1, we’re going to do everything we can to prevent Senate Republicans from destroying the Affordable Care Act,” Maryland Sen. Chris Van Hollen said. “We’re focused on making sure that we get on the Senate floor and talk about the damaging consequences and the chaos that’s going to be created throughout the health care system.” (Bowman and Lesniewski, 1/9)

The Hill: Senate Dems End ObamaCare Repeal Protest After 5 Hours 
Senate Democrats ceded back the Senate floor early Tuesday morning, ending a more than 5-hour protest of GOP efforts to repeal ObamaCare. Democrats painted the late-night talkathon as the first test against a unified Republican-led government as the majority party works to nix the healthcare law without a replacement plan. (Carney, 1/10)

CQ Roll Call: Democrats' Budget Talkathon Aims To Slow Health Care Repeal
Senate Democrats Monday night spent nearly six hours delivering floor speeches criticizing Republican efforts to repeal the health care law. Starting around 6:40 p.m. and wrapping up at 12:17 a.m., the talkathon provided another opportunity for Democrats to object to Republican attempts to repeal the 2010 health care law, even as some House Republicans discussed postponing a planned vote. It also provided senators with a chance to tell stories about their own health care experiences as well as those of their constituents. One of the more personal speeches came from Sen. Angus King, a Maine independent, who spoke about being diagnosed with malignant melanoma, a form of skin cancer, in 1974 while working for the U.S. Senate as a staff member. (Shutt and McCrimmon, 1/9)

The Hill: Sanders: GOP ‘Damn Well’ Needs ObamaCare Replacement 
Sen. Bernie Sanders (I-Vt.) says Republicans cannot repeal ObamaCare without having an alternative first. “I’m going to do everything I can – and I believe I speak for virtually every member of the Democratic Caucus – that we’re going to do everything we can to improve the Affordable Care Act [ACA],” he said during a CNN town hall at George Washington University in Washington, D.C., on Monday. "It has problems.” (Hensch, 1/9)

The Hill: Schumer Flubs Dems’ ObamaCare Protest Slogan
Senate Minority Leader Charles Schumer (D-N.Y.) tweeted the wrong slogan Monday evening, while promoting his party’s protest against repealing ObamaCare. The tweet was quickly deleted and replaced, but not before Independent Journal Review reporter Joe Perticone snagged a screenshot. “Now deleted,” Perticone tweeted of Schumer’s gaffe. "Chuck Schumer accidentally tweeted ‘Don’t Make America Great Again.’” (Hensch, 1/9)

CNN: How The Tables Are Turning On Obamacare
Republicans warned seven years ago that a health care law passed only by Democrats -- with no support from the other party -- would struggle to survive. The party-line vote to pass Obamacare, they said, was arrogant and reckless. Now, the GOP is in charge, and poised to run afoul of its own warnings. (Lee, 1/9)

Health Law

'Silver Bullets, They Don't Exist': Burwell Warns GOP's Health Law Promises Too Good To Be True

In what is expected to be her last speech before leaving office, Health and Human Services Secretary Sylvia Mathews Burwell made a final plea for the health law.

The Wall Street Journal: Departing HHS Chief Makes Plea For Preserving Affordable Care Act
Ms. Burwell, in a speech at the National Press Club, sought to shore up public support for the existing health law by poking holes in Republicans’ suggestion that they can simultaneously lower costs, save money and expand health coverage. “As for silver bullets, they don’t exist,” she said. “If something sounds too good to be true, it usually is.” The public comments are expected to be Ms. Burwell’s last before she leaves office Jan. 20. (Hackman, 1/9)

Morning Consult: In Farewell Remarks, Burwell Warns Of Dangers Ahead
Health and Human Services Secretary Sylvia Burwell warned in a speech Monday that an Obamacare replacement could be “a step backwards.” If a replacement plan does not cover as many people, maintain the quality of coverage and “keep bending the health care cost curve in the right direction,” it would leave the health care system worse off than it was before the Affordable Care Act, Burwell said in what was billed as her farewell address at the National Press Club. (McIntire, 1/9)

Kaiser Health News: HHS Secretary: Give Medicare Authority To Negotiate Drug Prices
Giving Medicare authority to negotiate drug prices is the best way to keep those spiraling costs under control for the program’s recipients, departing Health and Human Services Secretary Sylvia Burwell said Monday. “Those drug costs are continuing to grow,” Burwell said at the National Press Club in Washington, D.C. The question, she said, is not whether Congress should give her department the necessary power, but rather “what is the alternative?” (Bluth, 1/9)

The Washington Post: Sylvia Mathews Burwell, Who Shepherded Obamacare, Talks About Its Uncertain Future
As secretary of the Department of Health and Human Services for the past two and a half years, Sylvia Mathews Burwell has overseen the Affordable Care Act, Medicare and Medicaid, the Food and Drug Administration and a wide range of social services from Head Start to family assistance programs. In a conversation with Tom Fox, Burwell discussed her concerns about impending changes to the Affordable Care Act, the presidential transition, her approach to leadership and playing basketball for President Obama’s national security adviser. (Fox, 1/9)

After Health Law Lifted Financial Burden Of Preventive Services, More Women Got Mammograms

The health law helped narrow the gap between low-income and high-income women receiving screenings. KHN also takes a look at the law's impact on community health centers.

CNN: More Women Got Mammograms When Obamacare Paid For Them
Obamacare eliminated the costs and out-of-pocket expenses for Americans wanting preventive health care services -- including mammography and colonoscopy, both tests able to detect cancer. Among older Americans, use of mammography increased under Obamacare, according to a study published Monday in the journal Cancer. But another preventive screen test, colonoscopy, didn't see a similar increase. (Scutti, 1/9)

Kaiser Health News: Obamacare Boosted Community Health Centers’ Reach. Now What?
For the patients and the employees of Mary’s Center, a community health center that serves Washington, D.C., and its Maryland suburbs, the 2010 health law had a big impact on business. The facility has always promised care to anyone who walks through its doors. But since Obamacare’s implementation, the patient population and the quality of care they receive has changed. (Luthra, 1/9)

In other health law news —

California Healthline: Shoppers On California Exchange Sidestep Soaring Premiums But Pass Up Subsidies
Californians tend to avoid the worst of premium hikes on the state exchange by choosing lower-cost plans, but many also miss out on financial assistance because they pick the wrong type of plan or buy coverage off the exchange, according to two studies published Monday in the journal Health Affairs. One of the studies shows that when consumers faced premium increases from 2014 to 2016, they chose cheaper plans to control their costs, without giving up benefits. For example, consumers who had a higher-cost plan in the silver tier — the second least expensive level of coverage — would switch to a lower-cost silver plan, receiving similar benefits while saving on premiums. (Feder Ostrov, 1/10)

NPR: North Carolina Residents With Obamacare Insurance Worry About Repeal
Darlene Hawes lost her health insurance about a year after her husband died in 2012. Hawes, 55, is from Charlotte, N.C. She ended up going without insurance for a few years, but in 2015 she bought coverage on, the Affordable Care Act marketplace, with the help of a big subsidy. (Tomsic, 1/9)

Pioneer Press: Will MN Legislature Pass Health Insurance Relief? This Week Is Key.
Minnesota lawmakers say they want to pass a relief package for Minnesotans facing soaring health insurance premiums by the end of this week. The next few days will determine whether that happens, or if Minnesota’s leaders yet again hit delays. DFL Gov. Mark Dayton and the Republicans who control both houses of Legislature all agree the state should provide relief to people affected by the “premium cliff” — earning too much money to qualify for federal subsidies but not enough to afford premiums as high as 30 percent of their annual income. But they disagree on certain important details of how to do it. (Montgomery, 1/9)


Burwell Says Obama Administration Could Act Quickly On N.C. Request To Expand Medicaid

North Carolina's new governor could face a time crunch if he tries to get an expansion plan approved before President Donald Trump is inaugurated. Also, The New York Times examines an effort to build a database of Medicaid patients around the country.

McClatchy: Swift Federal Action Vowed On NC Governor’s Medicaid Expansion Plan
The Obama administration pledged Monday to act quickly on North Carolina Gov. Roy Cooper’s plan to expand Medicaid under the Affordable Care Act, which Republicans want to repeal. Outgoing Health and Human Services Secretary Sylvia Burwell suggested Monday that North Carolina could see a quick answer on its request to expand Medicaid. She demurred on the dispute between Cooper and the Republican-controlled state Legislature over Medicaid, but said, “We will process the governor’s proposal as expeditiously as possible when we get it.” (Douglas and Clark, 1/9)

The New York Times: Medicaid’s Data Gets An Internet-Era Makeover
Jini Kim’s relationship with Medicaid is business and personal. Her San Francisco start-up, Nuna, while working with the federal government, has built a cloud-computing database of the nation’s 74 million Medicaid patients and their treatment. ... Andrew M. Slavitt, acting director of the Centers for Medicare and Medicaid Services, described the cloud database as “near historic.” Largely because Medicaid information resides in so many state-level computing silos, Mr. Slavitt explained, “we’ve never had a systemwide view across the program.” (Lohr, 1/9)

And in news from Virginia and Montana —

Richmond Times Dispatch: Virginia Looking For Medicaid Savings, But Fearing Cuts From Repeal Of Health Law 
Virginia could lose more than $314 million from its general fund budget if the new Congress and president make good on their promise to repeal the Affordable Care Act, according to estimates by the state’s Medicaid director... The projections primarily reflect losses in the state’s share of pharmacy rebates under the managed care program that Virginia is moving aggressively to reshape, as well as the loss of federal matching funds for the state’s child health insurance program and the reversal of reductions in indigent care. (Martz, 1/9)

Great Falls (Mont.) Tribune: State Panel Hears Report On Medicaid
Members of the Health and Human Services Appropriations Subcommittee on Monday heard a review of the state’s Medicaid program in which nearly 10 percent of Montanans are enrolled. ... A chart provided to the panel showed that in fiscal year 2015, 125,177 people were enrolled in Medicaid with 61 percent (76,515) of those being children. ... Mary Dalton, Medicaid and health services branch manager with the Department of Public Health and Human Services, said nearly $1 billion is spent in the state annually on Medicaid, a joint federal-state program. (Drake, 1/9)


UnitedHealth Continues To Shuck Traditional Insurer Model With Surgical Center Deal

The company is buying Surgical Care Affiliates in a $2.3 billion deal.

The Wall Street Journal: UnitedHealth’s Optum To Acquire Surgical Care Affiliates For $2.3 Billion
The deal, for a mixture of cash and stock, substantially expands the health-care provider footprint of UnitedHealth, which is already the parent of the biggest U.S. health insurer, UnitedHealthcare. The acquisition represents a continued bet on physician services at a time when Republicans’ plans to unwind the Affordable Care Act have created uncertainty for many health-care providers, particularly hospitals, which potentially stand to see a drop-off in insured, paying patients. (Wilde Mathews, 1/9)

Modern Healthcare: UnitedHealth's Optum To Acquire Surgical Care Affiliates For $2.3 Billion
In an effort to fulfill its mission to expand its provider footprint to serve about two-thirds of the U.S. population, OptumCare has agreed to acquire Surgical Care Affiliates for about $2.3 billion in a cash and stock deal. Deerfield, Ill.-based SCA owns or operates 190 ambulatory surgery centers and surgical hospitals, most as joint ventures with physicians and health systems. The company says SCA and its affiliates serve approximately 1 million patients per year in more than 30 states. In 2015, it had operating revenue of around $1.1 billion. (1/9)

Bloomberg: UnitedHealth Branches Out With $2.3 Billion Surgical Care Deal 
The U.S.’s biggest health insurer, UnitedHealth Group Inc., will buy Surgical Care Affiliates Inc. for about $2.3 billion, adding an outpatient surgery chain to its growing health care-delivery business. UnitedHealth will pay $57 a share, with with 51 percent to 80 percent of that in stock and the rest in cash, the companies said in a statement. The price is a 17 percent premium to Surgical Care’s closing value Friday. The two companies previously worked together as partners. (Tracer, 1/9)

Linking Doctors' Pay To Quality Measures May Improve Health Care For Low-Income Patients

A study in Health Affairs finds that one insurer's decision to link doctors' reimbursements to measures of quality showed improved care for all patients but the gains were greater for poorer patients. Another study looks at how small doctor practices and small insurers are being squeezed by their larger competitors.

Boston Globe: New Study Suggests Changing Way Doctors, Hospitals Are Paid Could Narrow Health Disparities 
A Harvard Medical School study suggests that changing the way doctors are paid could narrow some of the health disparities between poorer and wealthier patients. Poverty has long been linked to poorer health, an intractable problem that health care experts have long sought to address. The study suggests that one solution may lie in the way health care providers are compensated by insurers. ... The contract links what physicians are paid to dozens of health care quality measures. When patients score high on those measures and doctors stay under budget, they earn more money. (Dayal McCluskey, 1/9)

The Washington Post: It’s Hard To Be A Small-Time Family Doctor These Days, New Data Shows
The price of health insurance just keeps going up. Until recently, though, a crucial part of how those prices are set was invisible to the public: the negotiations between doctors and insurance companies that determine how much patients are charged. The story of that contest, carried on fiercely behind closed doors for decades, is now partially in public view, and the new data contains tantalizing clues about where prices for health care really come from. ... A survey of the numbers, published this week in Health Affairs, shows that small-time doctor's offices and insurance companies are getting squeezed by their larger competitors. (Ehrenfreund, 1/9)


In Effort To Soothe Public Concerns Over Gouging, J&J To Release Drug Pricing Report

The pharmaceutical company wants to show how much it is spending on research and that its sales growth isn't coming from raising prices on drugs. Meanwhile, an acquisition plan in the biotech world could be a sign of good things to come for the industry.

The Wall Street Journal: Johnson & Johnson To Report Average Increases In List Prices For U.S. Drugs
Johnson & Johnson is planning to issue a report next month outlining how much it has raised the U.S. prices of its prescription drugs, the latest pharmaceutical company effort to address intense public concern about the cost of medicines. The report will give the average increase in the list prices for all company drugs in the U.S., as well as their average price after the discounts given by the company, J&J officials said. (Rockoff, 1/10)

The Wall Street Journal: Drug Deal Is Bet Price Pressures Have Eased
Takeda Pharmaceutical Company announced Monday morning it plans to acquire cancer-focused Ariad Pharmaceuticals for about $4.7 billion in cash. That represents about a 75% premium to Friday’s closing price. The premium by itself is a good sign for small and midsize biotechs—deals like this one will go a long way toward helping biotech stocks rebound from last year’s dismal performance. (Grant, 1/9)

In other pharmaceutical news —

Stat: Memory-Boosting Prevagen Has No Scientific Backing, FTC Says
The Federal Trade Commission and the New York state attorney general Monday filed a complaint against a supplement company that claims its pills can help with age-associated memory loss. The supplement, Prevagen, is heavily advertised, with commercials —  including on national broadcast and cable networks such as CNN, Fox News, and NBC — claiming it can improve memory in 90 days. Ads feature charts depicting dramatic cognitive improvement among users. The FTC says these claims are deceptive. (Swetlitz, 1/9)

Boston Globe: Ariad Pharmaceuticals To Be Acquired By Takeda For $5.2 Billion 
Ariad Pharmaceuticals Inc. on Monday accepted a $5.2 billion takeover offer from Japan’s Takeda Pharmaceuticals Inc., making the Cambridge company the latest Massachusetts biotech to be gobbled up by a global drug company seeking to strengthen its product line. The 26-year-old Ariad has a blood cancer drug on the market and is seeking US approval for a lung cancer treatment. (Weisman, 1/9)

Stat: A Familiar Face Will Take Over As Acting Commissioner Of FDA
It may be one of the shortest tenures in FDA history. Dr. Robert Califf, who took office as FDA commissioner last February, is preparing to vacate the premises. Like other presidential appointees, Califf must resign effective Jan. 20th, Inauguration Day. In the absence of a new FDA chief, Dr. Stephen Ostroff, the FDA’s deputy commissioner for foods and veterinary medicine, will again become acting commissioner. It’s a role he’s familiar with; he  also served as acting commissioner from April 2015 to last February, when Califf was sworn in. (Kaplan, 1/9)

Public Health And Education

Biden Presses Health Care Leaders To Expand The Battle Against Cancer

In speeches on the West Coast, the vice president says he will continue his campaign to find cures for the deadly disease and extolled young researchers to find new remedies through their "overwhelming skepticism for orthodoxy."

The Associated Press: Biden Outlines Steps To Pursue Post-Obama ‘Cancer Moonshot’
Vice President Joe Biden is outlining how he intends to pursue his “cancer moonshot” agenda after the end of the Obama administration. Biden says in a San Francisco speech that he will be starting an organization that may be called the Biden Cancer Initiative to make progress in changing the way the nation conducts cancer research and development and providing care to those with the disease. (1/9)

San Francisco Chronicle: At SF Event, Biden Vows To Make Fighting Cancer His Cause 
With less than two weeks left in office, Vice President Joe Biden told health care leaders in San Francisco on Monday that he has “genuine reason for open optimism” about the state of cancer research — a special cause to him since his son’s death in 2015. Biden has led the Cancer Moonshot Initiative since it was announced by President Obama last January in his final State of the Union address. (Allday, 1/9)

Public Health Roundup: Tracing Genetic Defects In Families; Best Preventive Services Are Immunizations, Smoking Cessation

Other developments making headlines today include the search for a plague vaccine, mystery strokes, unnecessary breast cancer treatments and a health alert for chicken strips.

The New York Times: A Family’s Shared Defect Sheds Light On The Human Genome
They said it was their family curse: a rare congenital deformity called syndactyly, in which the thumb and index finger are fused together on one or both hands. Ten members of the extended clan were affected, and with each new birth, they told Stefan Mundlos of the Max Planck Institute for Molecular Genetics, the first question was always: “How are the baby’s hands? Are they normal?” (Angier, 1/9)

The Star Tribune: Best Preventive Care? Get Vaccines, And Don't Smoke 
Doctors giving regular checkups will get the most bang for their buck if they advise adults to quit smoking, convince teens to never start, and keep children up to date with immunizations, according to an influential report released Monday by the Bloomington-based HealthPartners Institute. The research findings, sponsored in part by the U.S. Centers for Disease Control and Prevention, could influence how doctors across the country conduct thousands of regular patient visits each year. Comparing 28 recommended preventive services, HealthPartners researchers found that tobacco counseling and pediatric immunizations outranked the others in cost-effectiveness and the potential to save lives. (Olson, 1/9)

Kaiser Health News: In Search Of A Vaccine To Vanquish The Plague
The plague is best known for wiping out as much as a third of Europe’s population during the Black Death pandemic of the 14th century, but it’s not entirely a thing of the past. It’s enough of a present-day threat — either as a bioterrorism weapon or because of antibiotic resistance — that scientists are trying to develop a vaccine. (Zuraw, 1/10)

The Washington Post: This Fit Young Woman Was Having Strokes, And Doctors Didn’t Know Why
As Diana Hardeman climbed into a New York City taxi with her boyfriend around midnight on May 31, she suddenly realized she had no idea where to tell the driver to go. The 33-year-old knew she had to get to a hospital — and fast. Hardeman was fairly sure she had just had a stroke, her second in less than three years. But she had never asked the neurologist she had seen after the first stroke where she should head in the event of a recurrence. (Boodman, 1/9)

Columbus Dispatch: FSIS Issues Public Health Alert For Chicken Strips Products 
The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns that ready to eat chicken strips products produced by House of Raeford, a Mocksville, N.C. establishment, may be contaminated with Listeria monocytogenes. A recall was not requested because it is believed that all products have now been consumed. The ready to eat, fully cooked, chicken breast strips items were produced and packaged on September 29, 2016 and served to consumers in December, 2016. (Gowans, 1/9)

Opioid Deaths Surging As Crisis Continues To Rage On

WTOP's series "Hooked On Heroin: Deadlier Than Ever" examines the drugs that are fueling the opioid epidemic in the Washington, D.C. area.

WTOP: Heart-Stopping: Death Toll Skyrockets As Designer Opioids Infiltrate Local Drug Trade
The crisis has reached a boiling point in the region, as a new breed of designer opioids has infiltrated the region’s drug market. As the deaths continue to be tallied, at least 1,600 people in D.C., Maryland and Virginia died from heroin or opioid overdoses in 2016, and that’s just a preliminary figure. Several months of data from last year have yet to be published. (Forzato, 1/9)

WTOP: The Octopus From Hell: How Pain-Management Practice Contributes To Heroin Epidemic
Experts say the over-prescribing of opioids in the last 15 years has contributed to the nation’s current heroin epidemic — a slippery slope from recovering patient to recovering addict. Four out of five heroin addicts first became addicted to painkillers, the Substance Abuse and Mental Health Services Administration says. New CDC guidelines advise doctors to prescribe fewer painkillers for acute pain. And some physicians have even been arrested for selling massive quantities of opioids to drug users. So is it the doctors’ fault? (Forzato, 1/10)

In other news on the substance abuse crisis —

Columbus Dispatch: Cardinal Health To Pay $20 Million To Settle Painkillers Suit 
Cardinal Health will pay $20 million in a previously announced settlement with the state of West Virginia in a 2012 lawsuit alleging that Cardinal failed to properly oversee and report a surge in orders of addictive painkillers. The failure took place over a five-year period from 2007 to 2012 and contributed to a rise in the opiate crisis, the state said in its suit against Cardinal and several other drug distributors. (Matzer Rose, 1/9)

Women’s Health

Kentucky Ultrasound Law Violates Doctors' Speech Rights, Opponents Say In Lawsuit

The ACLU and the state's only abortion clinic are taking action to overturn the new law that requires women to undergo an ultrasound and hear a description of the fetus before getting an abortion.

Reuters: ACLU And Kentucky's Only Abortion Clinic Sue Over Ultrasound Law
The American Civil Liberties Union sued Kentucky state officials on Monday to block a new law that requires women seeking an abortion to first undergo an ultrasound and hear a description of the embryo or fetus. ACLU lawyers filed the lawsuit in federal court in Louisville on behalf of EMW Women's Surgical Center, which the lawsuit said is the sole licensed abortion facility in Kentucky. (Bittenbender, 1/9)

CNN: Kentucky Abortion Bill Requires Ultrasound
Kentucky Gov. Matt Bevin on Monday signed two bills that put tighter restrictions on abortion, including one measure prohibiting the procedure at or after 20 weeks of pregnancy. The bills include an emergency provision, making them effective immediately after Bevin's signature. The first, House Bill 2, now requires a physician or technician to perform an ultrasound, describe and display the ultrasound images to the mother, and provide audio of the fetal heartbeat to the mother before she may have an abortion. The text of the bill says the pregnant woman may choose to avert her eyes from the images, and request the volume of the heartbeat be turned down or off. (Ansari and Croffie, 1/9)

In other news —

WBUR: Mass. Planned Parenthood Estimates Federal Defunding Would Cut $2 Million A Year In Payments 
Republicans on Capitol Hill are once again aiming to defund Planned Parenthood, and Beltway oddsmakers are wagering that they have the best chance of succeeding in a long time. What might defunding mean for Massachusetts, which has five Planned Parenthood clinics? Dr. Jennifer Childs-Roshak, president and CEO of the Planned Parenthood League of Massachusetts, says its clinics could no longer provide services to patients who get their health care through MassHealth, the state's Medicaid program. (Goldberg, 1/9)

St. Louis Public Radio: St. Louis Planned Parenthood Affiliates Brace For Possible Cuts 
Planned Parenthood affiliates in St. Louis are taking stock of the $700,000 hit they may absorb under a new state law and a shifting federal landscape. Last year, the Missouri legislature used a budgetary measure to cut the women’s health provider from the state’s Medicaid program. The process takes several months and requires federal approval, so the rule has yet to take effect. (Bouscaren, 1/10)

State Watch

Chicago Hospital Explores Merger Possibilities

In other state hospital news, a Minnesota lawsuit involving the dissolution of the North Suburban Hospital District has been dismissed, and Pennsylvania's Abington Memorial agrees to pay $510,000 in drug diversion settlement.

Chicago Sun Times: Little Company Of Mary Hospital Explores Merger, Affiliation 
Several local healthcare entities have responded to a late December request for proposals for a merger or affiliation put out by Little Company of Mary Hospital, officials said Monday. The independent, south suburban hospital — where the very first human organ transplant was performed in 1950 — is weighing offers that have come in within the last two weeks, all of them from nonprofit entities. (Ihejirika, 1/9)

Pioneer Press: Lawsuit To Keep Fridley’s Unity Hospital As Is Dismissed 
A lawsuit aimed at halting the dissolution of the North Suburban Hospital District and preserving existing operations at Unity Hospital in Fridley has been dismissed. The case was dismissed Monday in Anoka County District Court, according to Mike Hatch, the attorney who represented the five plaintiffs who filed the lawsuit. Hatch was Minnesota attorney general from 1999 to 2007. (Horner, 1/9)

The Philadelphia Inquirer: Abington Memorial Pays $510K In Drug Diversion Settlement
Abington Hospital — Jefferson Health agreed to pay $510,000 to settle allegations that failures in its internal controls allowed an employed pharmacist to steal more than 35,000 pills, including the highly addictive oxycodone and other painkillers, the U.S. Attorney for the Eastern District of Pennsylvania said Monday. The thefts occurred between Feb. 2010 and August 2013, when Abington, then known as Abington Memorial Hospital, discovered the theft and reported it to the Drug Enforcement Agency. The pharmacist, Renata Dul, pleaded guilty in 2015 and 25 counts of possession with the intent to distribute oxycodone and was sentenced to six years of prison. (Brubaker, 1/9)

State Highlights: Why States' Tobacco Taxes Were Rejected This Year; Conn. Governor Names State's Health Care Advocate

Outlets report on health news from Connecticut, New Hampshire, Colorado and Ohio.

Stateline: Tobacco Company Cash Crushes Tax Increases
Between 1980 and 2015, voters approved nearly 70 percent of the 32 tobacco tax hikes that appeared on statewide ballots, according to Ballotpedia, a nonpartisan research group that has tracked them. But in November, voters in North Dakota, Missouri and Colorado defeated measures that would have increased taxes by 23 cents to $1.76 on a pack of cigarettes. ... Tobacco taxes generally are among the least controversial taxes to raise because they affect a small number of voters and the dangers of tobacco use are widely known. State legislatures, in particular, are fond of raising so-called “sin” taxes, as opposed to approving increases in broad-based taxes such as those on income or property. But November’s electorate may have been especially tax averse. (Povich, 1/9)

Denver Post: Colorado Health Department Warns Of Possible Measles Exposure In Denver Metro Area
An unvaccinated adult may have exposed people to measles in the past month at several locations in Denver, Aurora, Englewood, Centennial and Boulder County, the Colorado Department of Public Health and Environment announced Monday. The adult, whose name was not released, contracted measles while traveling abroad and was hospitalized for three days at Parker Adventist Hospital starting on Dec. 29. The state Health Department has pieced together the patient’s errands in the days prior and is now warning people who were at those places at roughly the same time to be on the lookout for symptoms of measles. (Ingold, 1/9)

Columbus Dispatch: Zanesville Nursing Home Operator Ordered To Repay Fraudulent Medicare, Medicaid Money
A Zanesville nursing home operator has been ordered to repay tens of thousands of fraudulently obtained Medicare and Medicaid dollars, after an investigation by the Ohio Attorney General’s Office found that the owner and other employees habitually altered documents to make it appear patients were being properly cared for in order to receive government aid. Autumn Health Care of Zanesville must pay back $53,390 to the Ohio Department of Medicaid and $75,250 to the federal Centers for Medicare and Medicaid, as well as $40,000 in investigative costs, Attorney General Mike DeWine’s office announced Monday. (Smola, 1/10)

Cleveland Plain Dealer: Mother, Son Stand Trial In $7 Million Home Health-Care Scheme 
A mother and son are on trial in federal court this week on charges that they were part of a scheme to fraudulently bill government medical programs to the tune of more than $7 million through their home health-care company. Delores Knight, 71, of Cleveland Heights, and Isaac Knight, 29, of Macedonia are charged with conspiracy to commit health-care fraud and health-care fraud. Delores Knight also faces nine money laundering counts, and Isaac Knight is charged with making a false statement relating to health-care matters. (Heisig, 1/9)

Editorials And Opinions

Health Policy Perspectives: McConnell Says Voters 'Spoke Loudly' On Repeal; Medicare's Stake

Opinion writers offer their thoughts, advice and warnings on how to shape the repeal and replace effort.

Fox News: ObamaCare Failed Americans. Now It's Time For Relief
Americans continue to call for ObamaCare’s repeal. They spoke loudly again this November, and about 8 out of 10 favor changing ObamaCare significantly or replacing it altogether. We in Congress hear you, and we have already begun to act. ... We’re acting quickly because ObamaCare is collapsing under its own weight, and things will continue to get worse otherwise. That doesn’t mean the law will end overnight. There will be a stable transition period .... We plan to take on this challenge in manageable pieces, not another 2,700-page bill like ObamaCare. Some Democratic Senators have mused publicly about their role in that process. I hope they’ll work with us. We want their ideas to improve our health care system. (Senate Majority Leader Mitch McConnell, 1/9)

Chicago Tribune: Republicans Risk Chaos If They Repeal Obamacare Before They Replace It
Republicans are gearing up to repeal Obamacare — what House Speaker Paul Ryan calls "the first order of business" for the new Congress and the Trump administration. House and Senate committees will be under intense deadline pressure to write legislation before the end of the month that would undercut major pillars of Obamacare as part of a budget bill. Yes, the GOP is in a hurry to rid the nation of Obamacare. (1/9)

Los Angeles Times: Repealing Obamacare Could Be A Matter Of Life Or Death For Many Americans. Here Are Their Voices
For Julie Ross, the looming repeal of the Affordable Care Act isn’t an abstract political issue. It’s a life-or-death matter for her 4 1/2-year-old daughter, who was born with Down syndrome and a congenital heart condition and spent her first month in the neonatal intensive care unit. In the pre-Affordable Care Act era, when insurers could impose lifetime limits on benefits, hers was $500,000. “She would have reached that in her first two weeks,” Ross says. (Michael Hiltzik, 1/9)

The Washington Post: Republicans Are Over-Promising Again On Health Care
Many right-wingers — some who decided to champion the ideologically nihilistic President-elect Donald Trump — claim their anger at the GOP’s “establishment” has been fueled by its “betrayal” of the base.  In the right-wingers’ telling, they were led to believe that electing a GOP House and Senate majorities would get rid of Obamacare. Aside from a failure to identify any such definitive promise, their narrative makes no sense. Did they really think President Obama would ever sign such a thing? (They could only be betrayed if they had no clue how the legislative process works.) (Jennifer Rubin, 1/9)

The New York Times: The Fight For Health Care Has Begun
Now it’s the left’s turn to use public opinion, and the stakes in the next fight are bigger than the House ethics office. Even before Trump becomes president, Congress is taking steps to deprive millions of people of health insurance. Democrats in Congress should do everything they can to thwart the effort. And if you’re one of those people who despaired after last year’s election — who wondered whether facts still mattered and whether there was anything you could do — you should get involved, too. How? I’ll get to that in a moment. (David Leonhardt, 1/10)

RealClear Health: Medicare Cannot Be Used As America's Health Care Piggy Bank
In the current drive to “repeal and replace” the ACA, designers must be careful not to add to the burden of hospitals and clinics by ignoring the significant cuts to Medicare Democrats issued to make the ACA budget numbers work. The challenging economics of hospitals and physicians are being made even more difficult by the changes to Medicare mandated by the ACA. According to the National Center for Health Policy Analysis in a 2015 article, “21 percent [of physicians] are not accepting new Medicare patients.” But while a physician can opt out of Medicare or private insurance plans, a hospital cannot. (Rich Galen, 1/10)

Forbes: Which Tom Price Will Be Advising Donald Trump On Medicare?
Georgia Congressman Tom Price, President-elect Donald Trump’s nominee to run the Department of Health and Human Services, is a bundle of contradictions when it comes to Medicare. ... Here is where Price’s views start to fight with themselves. While he’d change Medicare in ways that would increase consumer demand for managed care, he seems to oppose many of the consequences of that change. For instance, has been an outspoken critic of many of Medicare’s efforts to control health care costs. ... He has strenuously opposed efforts by Medicare to shift from fee-for-service medicine to a system that pays for quality, low-cost outcomes rather than volume. (Howard Gleckman, 1/9)

Vox: Today In Obamacare: I Used To Think Obamacare Repeal Was For Sure. 2 Things Changed My Mind.
One month ago, as the surprise of the election wore off and the reality of a Republican-controlled Washington sunk in, I would have predicted that Obamacare repeal was a foregone conclusion. Republicans have spent six years promising to repeal the Affordable Care Act. They have maintained incredible party unity on the issue, not wavering even as millions of people gained coverage. Legislators quickly moved to make it their first agenda item in Congress. The matter felt settled. Except today, a month later, it doesn’t feel settled at all. (Sarah Kliff, 1/9)

The Washington Post: What Do You Hate Most About The Health System? Republicans Will Make It Worse.
As they try to stop Republicans from repealing the Affordable Care Act, Democrats have a few central arguments they’re making to explain why repeal would be so catastrophic, none more vivid than the simple fact that Republicans plan to kick somewhere between 20 million and 30 million Americans off their health coverage. This argument has the benefit of being true, and unlike many of the details of health reform, relatively easy to understand. So how are Republicans responding? With two arguments, both of which are meant to prey on people’s confusion and the complexity of this issue. Once you strip away the deception, both those arguments also reveal just how disastrous it will be if they succeed in their plans for the American health care system. (Paul Waldman, 1/9)

Vox: There Is No “Terrific” Replacement For Obamacare
Donald Trump likes to say he’s going to repeal Obamacare and replace it with “something terrific.” Sadly for everyone, that’s probably not possible. What is possible is repealing Obamacare and replacing it with something that makes a different set of equally painful trade-offs. Price’s plan, to its credit, is clear about its trade-offs. It costs less than the Affordable Care Act but covers far fewer people, and the people it does cover get much stingier insurance. (Ezra Klein, 1/9)

Sacramento Bee: Trump, Republicans At Odds Of Dealing With Provisions In Obamacare
Trump promised to guarantee coverage to all, not cut Medicaid and preserve protections for those who have pre-existing conditions. If he does all of that, he will be repealing Obamacare and replacing it with something that changes the name but not the program. That may be what he has in mind, but it’s not what his closest allies and advisers have said they intend to enact. (Daniel Weintraub, 1/9)

The Wall Street Journal: Obamacare Debate: Where GOP Governors Stand On Repeal And Replace
As the Republican Party’s debate over repealing and replacing Obamacare focuses on the Senate, the views of Republican governors have received little attention and will be important to watch. This group doesn’t like the Affordable Care Act, President Barack Obama’s signature health law, and will want to support the Republican effort to repeal and replace it. But for many of the governors the interests of their states could run counter to two central elements of the repeal and replace plans. (Drew Altman, 1/10)

Cincinnati Enquirer: Obamacare Repeal Good For Kentucky
Under Obamacare, many have learned that having health insurance isn’t the same as actually having health care. Many Kentuckians have been forced into plans their doctors won’t accept with the cost of premiums and deductibles so high that they fear they can’t afford to get sick. These aren’t the results Kentuckians wanted. These aren’t the results Obamacare promised. (Senate Majority Leader Mitch McConnell, 1/9)

Viewpoints: Venture Capital's Medical Technology Signals; Ky. Moves To Tighten Abortion Rules

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

Health Affairs Blog: Medical Technology: What Changing Venture Capital Investments Signal
The market for medical devices historically has been dominated by big-ticket “physician preference items” such as artificial joints, spinal implants, and cardiac pacemakers. Venture capital and private equity investors have been eager to fund new firms in this expanding and lucrative domain. Changes in physician payment and organization are reducing the demand for these cost-increasing innovations, however, and redirecting the flow of investment capital. (Josh Baltzell and James C. Robinson, 1/9)

Lexington Herald Leader: View From The Gallery: Ky.’s War On Women
In Kentucky we hear a lot about the war on coal. But on Saturday, during a special, emergency session that cost taxpayers $70,000, I had a front-row seat at our Capitol for Kentucky’s other war: the war on women. The Senate passed House Bill 2, requiring an invasive, humiliating, intra-vaginal ultrasound for any girl or woman seeking an abortion. (Teri Carter, 1/9)

The Wall Street Journal: Siri, Am I About To Have A Heart Attack?
ObamaCare was always about paying for health care—costs have outpaced inflation for decades—but seldom about keeping people healthy. As Republicans repeal and replace, they need a vision for the path to better care. Technology now exists to provide cheaper and higher-quality health care, but giant roadblocks stand in the way. (Andy Kessler, 1/9)

Stat: Massachusetts Postpartum Depression Program A Model For A National Plan
The Massachusetts Child Psychiatry Access Project (MCPAP) was launched in 2005 with an eye toward helping children receive psychiatric support and care. In 2014, MCPAP was expanded to MCPAP for Moms by creating a network of obstetric, pediatric, family medicine, and psychiatric providers along with a group of dedicated counselors to be resources for women, their families, and health care providers. Through this network, which also includes specialists who may see women outside of obstetric appointments, clinicians caring for women can identify symptoms of postpartum depression. MCPAP for Moms also creates a continuum of care for women to get timely access to recommended support and treatment. In the first 18 months of the MCPAP for Moms program, more than 1,100 women were screened and treated for postpartum depression. (Katherine Clark, James S. Gessner and Maryanne C. Bombaugh, 1/9)

Cleveland Plain Dealer: Cleveland Clinic Doctor's Anti-Vaccine Column: Q&A Explainer
The medical director and chief operating officer of the Cleveland Clinic Wellness Institute, who writes a monthly column for, created a firestorm over the weekend with a column in which he championed some of the discredited arguments of those who oppose vaccines. Word spread quickly, largely through social media, causing the medical establishment and health reporters across the county to question why a high-ranking doctor at such an august medical institution would write something so irresponsible. And, because Dr. Daniel Neides' column is published on, we're hearing questions about our role. Here, I offer some answers. (Chris Quinn, 1/9)