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Political Cartoon: 'Evel Knievel?'

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Take the "pre" out of
Pre-existing conditions,
With single-payer.

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Summaries Of The News:

Health Law

After Collins Officially Declares Opposition, Passing Health Bill Becomes 'Nearly Impossible'

Sen. Susan Collins (R-Maine) joins Sens. John McCain (R-Ariz.) and Rand Paul (R-Ky.) in opposition of Republicans' last-ditch efforts to repeal and replace the Affordable Care Act, naming the "dramatic, sweeping cuts" to Medicaid as her top reason to vote no. The Republicans only had two votes to spare, so unless leadership can persuade one of three to change his or her vote, the bill would fail if brought to the floor.

The New York Times: Health Bill Appears Dead As Pivotal G.O.P. Senator Declares Opposition
A last-ditch attempt by President Trump and Senate Republicans to dismantle the Affordable Care Act appeared to collapse on Monday as a pivotal senator announced her firm opposition to the latest repeal plan, virtually ensuring that Republicans would not have the votes they need for passage. The announcement by the senator, Susan Collins of Maine, effectively dooms what had been a long-shot effort by Republicans in the Senate to make one more attempt at repealing the health law after failing in dramatic fashion in July. (Kaplan and Pear, 9/25)

The Washington Post: Senate GOP Effort To Unwind The ACA Collapses Monday
While one top Republican senator held out the possibility that the Senate might still vote on the bill, others accepted the reality that the push had sputtered out after Sen. Susan Collins (R-Maine) joined two of her colleagues in formal opposition. “Everybody knows that’s going to fail,” said Senate Finance Committee Chairman Orrin G. Hatch (R-Utah), who led a raucous, five-hour hearing on the bill Monday afternoon. “You don’t have one Democrat vote for it. So it’s going to fail.” Monday’s developments amounted to a massive setback for Senate Majority Leader Mitch McConnell (R-Ky.) and President Trump, who spent the past week trying to rally support for a last-ditch attempt to fulfill a seven-year Republican promise. (Sullivan, Eilperin and Snell, 9/25)

Los Angeles Times: Latest GOP Obamacare Repeal Effort On Verge Of Collapse As Third Republican Comes Out Against Bill
Monday afternoon, Senate Finance Committee Chairman Orrin G. Hatch (R-Utah) said GOP leaders would probably not be able to hold a vote this week as planned. Even before Collins’ announcement Monday, President Trump sounded increasingly downbeat about the bill’s chances. “We’re going to lose two or three votes, and that’s the end of that,” Trump said Monday on Alabama radio’s “Rick and Bubba Show,” criticizing Republican senators for withholding their support after years of promising to repeal and replace the law. “They pander and they grandstand.” (Mascaro and Levey, 9/25)

The Wall Street Journal: Collins Becomes Third Republican To Oppose Graham-Cassidy Bill
The Republicans’ latest proposal would take much of the 2010 law’s funding and transform it into block grants, which states could use to shape their own health-care systems. Ms. Collins said the earlier and newer versions of the bill both “open the door for states to weaken protections for people with pre-existing conditions, such as asthma, cancer, heart disease, arthritis and diabetes. ”Ms. Collins said in a statement she was concerned by the rushed process used to consider the bill co-sponsored by her Republican colleagues, Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. (Armour and Peterson, 9/25)

Bloomberg: Latest GOP Health Bill Dies As Collins Says She Will Vote ‘No’ 
“It makes sweeping cuts and changes in the Medicaid program, which is a vital program for our low-income, vulnerable citizens, including disabled children and low-income seniors,” she told reporters Monday evening, adding that President Donald Trump and senior members of his administration had tried to woo her over the weekend. (Tracer, Litvan and Edney, 9/25)

Politico: Collins’ Opposition Dooms Latest Obamacare Repeal Effort
Senate Republicans are set to meet Tuesday on whether to try to open debate on health care again on the floor to show the GOP’s base that they are still trying to repeal Obamacare. The caucus is internally debating whether to hold a vote certain to fail later this week. “We’re going to need to have a meeting of our conference tomorrow at noon to see where we can see where everybody is,” said Senate Majority Whip John Cornyn (R-Texas). (Everett, Haberkorn and Dawsey, 9/25)

The Associated Press: Paul Still Opposes GOP Health Care Bill, Despite Changes
Kentucky U.S. Sen. Rand Paul says he will not vote for the latest Republican health care bill, calling last-minute changes that would send more money to his state and those of other undecided senators as "suspicious." Republican leaders over the weekend tweaked the bill to give more money to states including Alaska, Arizona, Maine and Kentucky. (Beam, 9/25)

The Hill: Cruz Still A No On ObamaCare Repeal Bill 
Sen. Ted Cruz (R-Texas) is still opposed to the latest ObamaCare repeal legislation despite the changes that have been made to the bill, according to a Cruz aide. Cruz's position further endangers the Republican ObamaCare repeal effort, which appears to be on the brink of failure. (Weixel, 9/25)

The New York Times: The Republican Senators Who Have Opposed The Many Bills To Repeal Obamacare
Three Republican senators firmly opposed the latest plan to repeal the Affordable Care Act, leaving Senate leaders short of the votes needed for passage. Thirteen Republican senators from 12 states have rejected at least one of the Senate’s five major repeal efforts in recent months. Opposition has come from the party’s moderates and hard-liners, but for different reasons. (Andrews, Park and Parlapiano, 9/25)

The Hill: Last-Ditch Repeal Bill Appears Dead 
It’s not clear whether Senate Majority Leader Mitch McConnell (R-Ky.) will still try to hold a floor vote later this week, something some GOP donors and the White House may want to see just to get senators on the record. (Carney, Sullivan and Roubein, 9/25)

Kaiser Health News: Sen. Collins Announces Opposition To GOP Bill To Replace Obamacare
Senate Majority Leader Mitch McConnell (R-Ky.) has said if someone brings him a health proposal that can gain the 50 votes needed to pass under the budget reconciliation process, he will resume consideration of the bill that he pulled from consideration in July. The Senate’s ability to use the fast-track process, however, expires at the end of the fiscal year, which is Saturday. (Rovner, 9/25)

The Philadelphia Inquirer/ For Rick Santorum, A Haircut, A Health Bill And A Return To The National Fray
More than 10 years and two presidential campaigns after leaving the Senate, Rick Santorum is back in the fray. Despite holding no political office, the polarizing Pennsylvania Republican has been in the middle of the latest Republican push to roll back the Affordable Care Act, an effort that faces a critical deadline this week in what reads like a horror movie for Democrats, starring an idea and a politician that keep coming back. (Tamari, 9/25)

Trump Says McCain's Opposition To Health Bill Was 'Slap In The Face To The Republican Party'

President Donald Trump in his Tweets and on a radio interview is pessimistic about the chances of the bill to replace Obamacare after Sen. John McCain (R-Ariz.) announced that he could not support the measure.

The Hill: Trump Pessimistic On ObamaCare Repeal: ‘That’s The End Of That’ 
President Trump sounded a pessimistic note Monday on the latest GOP effort to repeal ObamaCare, and blamed Sen. John McCain (R-Ariz.) for costing his party a victory. Trump did not give up all hope on the bill, but suggested it would not get the 50 votes — assuming a tie-breaking vote from Vice President Pence — it needed to clear the Senate because of opposition from McCain, Sen. Susan Collins (R-Maine) and other Republicans. (Weixel, 9/25)

The Washington Post: Trump Pins Blame On McCain As Latest GOP Health-Care Bill Sinks
With the latest Republican plan to overhaul the Affordable Care Act collapsing, President Trump focused his ire Monday night on Sen. John McCain, distributing a video that showed the Arizona Republican on board with the mission in the past.“ A few of the many clips of John McCain talking about Repealing & Replacing O’Care,” Trump said in a tweet that accompanied the video. “My oh my has he changed-complete turn from years of talk!” (Wagner, 9/25)

Cassidy Will Keep 'Plugging Along,' But There Will Be No More Tweaks Coming To Woo Senators

Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) defended their proposed bill at a Senate Finance Committee hearing, where they sparred with Democratic senators.

CQ: Health Repeal Bill Sponsors Defend Plan in Senate Hearing
Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., defended their proposal to overhaul the 2010 health care law during a Finance Committee hearing Monday. The pair, who have led a revival of the GOP push to repeal the health law this month, said they wanted to keep working to address the law because costs are rising. (McIntire, 9/25)

Politico: Cassidy Rules Out Revisions Even As He Pushes Obamacare Repeal Bill
Sen. Bill Cassidy on Monday pledged not to give up on his Obamacare repeal plan despite lacking GOP support to win its passage by a Saturday deadline. The Louisiana Republican told reporters he’ll “keep plugging away” to find the 50 votes needed to pass the bill using a budgetary procedure requiring only majority support. But he added that he’s done making tweaks aimed at winning over holdout senators. (Cancryn, 9/25)

Nashville Tennessean: Cassidy Said Tenn. Hospitals, Haslam Support Graham-Cassidy. Do They?
Sen. Bill Cassidy, R-La., said in a Senate Finance Committee that Tennessee hospitals, doctors and Gov. Bill Haslam are behind Graham-Cassidy, the latest Affordable Care Act repeal-and-replace bill. But support for the legislation in the Volunteer State isn't that clear or simple. The Senate is trying to pass Graham-Cassidy by the end of the month. The finance committee heard from the namesake authors as well as a few witnesses around the country. No one from Tennessee spoke. (Fletcher, 9/25)

McClatchy: Genial Lindsey Graham Suddenly Turns Partisan Bulldog On Health Care
Sen. Lindsey Graham has spent years crafting a reputation as a bridge-builder, a “consensus guy,” on policy areas that typically polarize the two parties. Now he’s leading one of the year’s most polarizing debates, and colleagues and constituents alike are seeing a more partisan side of the South Carolina Republican. (Dumain, 9/25)

'Kill The Bill, Don't Kill Us': Protests Erupt At Committee Hearing On GOP Health Measure

Police surrounded the protesters and escorted them out of the room, and more than 100 people were arrested at the hearing and on Capitol grounds.

The Hill: Protests Erupt At GOP ObamaCare Repeal Hearing 
Protests erupted at a Republican-led hearing on their ObamaCare repeal bill, leading Senate Finance Committee Chairman Orrin Hatch (R-Utah) to briefly recess the hearing, after police dragged several protesters out. "No cuts to Medicaid, save our liberty," attendees chanted.  Police surrounded the protesters and escorted them out of the room. Well over 100 people were arrested at the hearing and on Capitol grounds, police said later. (Roubein, 9/25)

The Washington Post: Protests Fill Senate Hallways As Cassidy-Graham Gets Its Hearing
In July, 56-year-old Joe Smith trekked 22 hours from his Harrison, Ark., home to protest the Senate Republicans’ attempt to repeal part of the Affordable Care Act. Thinking the fight was over, Smith went home. On Monday morning — after another 22-hour car and bus ride — Smith was back at the Senate, joining hundreds of protesters lined up outside the Senate Finance Committee’s hearing on Cassidy-Graham. “We can’t afford to lose our health care,” said Smith, who suffers from cerebral palsy, gets disability benefits and has insurance through Aetna. “Every time we go up here, I think it makes a difference. I personally think they shouldn’t do away with Obamacare, and I think they should fix it, so I’m here.” (Weigel, 9/25)

Kaiser Health News: Postcard From Capitol Hill: Health Care Hearing’s Action Was In Hallway
“Kill the bill, don’t kill us,” one woman screamed, inches from a U.S. Capitol Police officer’s face Monday afternoon in a marbled hallway of the U.S. Capitol at the start of the one and only public hearing on the GOP’s last-ditch effort to replace the Affordable Care Act. The protesters had begun lining up at 5:30 a.m. — some paid others to hold their places — and by 2 p.m., hundreds of people were waiting for a coveted seat for the Senate Finance Committee’s hearing in Room 215 of the Dirksen Senate Office Building. Around lunchtime, Sen. Ron Wyden (D-Ore.) strolled through, passing out slices of pizza to some in line. (Bluth, 9/25)

NPR: Graham-Cassidy Health Care Hearing Starts With Eruption Of Protests
Committee Chairman Orrin Hatch, R-Utah, suspended the hearing for about 15 minutes while the demonstrators — some in wheelchairs — were dragged from the room. "If the hearing is going to devolve into a sideshow or a forum for simply putting partisan points on the board, there's absolutely no reason for us to be here," Hatch said. (Horsley, 9/25)

'Millions' Of Americans Would Lose Insurance Under GOP Bill, CBO Projects In Partial Analysis

The nonpartisan Congressional Budget Office didn't have enough time to do a full projection and its score was estimated from an earlier version of the Graham-Cassidy bill. But the agency says “the direction of the effect is clear."

Reuters: Health Plan Would Cut U.S. Deficit, But Leave Millions Without Insurance: CBO
An earlier version of a healthcare bill Republican leaders are trying to push through the U.S. Senate would save at least $133 billion over 10 years, Congress' nonpartisan budget agency said on Monday, suggesting it meets requirements to clear the chamber on a simple majority vote. But the U.S. Congressional Budget Office did not assess the most recent version of the Graham-Cassidy bill, leaving it unclear whether it also complies with Senate rules expiring on Sept. 30 that permit approval by a simple majority. (Beech, 9/25)

The Washington Post: CBO Predicts ‘Millions’ Would Lose Coverage Under The Revised Senate Health Bill
The latest Senate Republican plan to tilt federal health-care law in a conservative direction would cause “millions” of Americans to lose insurance by 2026, while lessening the federal deficit by at least $133 billion, according to much-anticipated estimates by Congress’s nonpartisan budget scorekeepers. The partial analysis by the Congressional Budget Office, issued late Monday afternoon, said that the precise increase in people without health coverage “could vary widely,” because the Cassidy-Graham legislation would give each state great latitude to design its own health-care policies. (Goldstein, 9/25)

Politico: Graham-Cassidy Repeal Plan Would Leave 'Millions More' Uninsured
The nonpartisan scorekeeping agency said the legislation's effect on the uninsured rate could vary widely, depending on how states run their health care systems under the plan, which shifts federal Obamacare payments to a system of block grants to states. The plan would hit savings targets required under the expedited rules GOP leaders are using to try to pass repeal with a simple majority. (Bettelheim, 9/25)

The Hill: CBO Finds 'Millions' Will Lose Coverage From Repeal Bill 
CBO said the reduction in coverage would be felt in three areas: in Medicaid, because the bill repeals ObamaCare's expansion of Medicaid; in private coverage, because the bill repeals subsidies that help people afford it; and because the mandate to have coverage would be repealed. (Sullivan, 9/25)

Modern Healthcare: Revised GOP Repeal Bill Has Everyone Racing To Figure Out Its Impact
There also was confusion about the bill's amended provisions for letting states relax the ACA's insurance market rules that protect people with pre-existing conditions. Those rules require health plans in the individual market to accept all customers regardless of health status; provide essential benefits; charge everyone the same premium except for a permitted 3-to-1 variance based on age; and set no annual or lifetime caps on benefits. There is general agreement that under the revised Graham-Cassidy bill, states could let insurers discriminate against sicker people. (Meyer, 9/25)

Other organizations also analyze the effects the measure would have —

Health News Florida: Obamacare Replacement Would Cost Florida $9.7B Over 6 Years
A proposal to replace the Affordable Care Act would cost Florida $9.7 billion in federal funding over six years, according to a study from the Kaiser Family Foundation. More than $7.5 billion of that funding loss would come from a change in the way money is distributed to cover individual health insurance plans under the Graham-Cassidy legislation, named for Republican Senators Lindsay Graham, of South Carolina and Bill Cassidy, of Louisiana. (Ochoa, 9/26)

The Hill: S&P: Graham-Cassidy Bill Would Cost 580K Jobs 
The latest ObamaCare repeal bill would hurt the economy and reduce coverage levels, according to a new report released Monday. The S&P Global Ratings report found that the bill, sponsored by GOP Sens. Lindsey Graham (S.C.) and Bill Cassidy (La.), would reduce coverage levels among those making between 133 percent and 400 percent of the federal poverty line, or between $16,040 and $48,240 for an individual. (Hellmann, 9/25)

Arizona Republic: Arizona May Face Serious Job Losses Under 'Obamacare' Replacement Bill
Arizona would see Great Recession-type job losses next decade under a Senate Republican health-care proposal to replace the Affordable Care Act, a new report says. The report released Monday predicted Arizona would lose more than 21,000 jobs and nearly $1.9 billion in economic output in 2020, the first year that the Medicaid expansion's health financing would be converted to block grants under an 'Obamacare' replacement bill introduced by U.S. Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. (Alltucker, 9/25)

For People Covered By Medicaid Expansion, Health Law Debate In Washington Hits Home

Many people who gained insurance through the Affordable Care Act's expansion of Medicaid are fearful about suddenly losing that coverage. In other news, the National Association of Medicaid Directors makes clear that its opposition to a Republican plan to replace the ACA was issued as a consensus view of the board and not a unanimous decision by individual state directors, and The New York Times examines how a change in Medicaid compares to efforts to revamp welfare a generation ago.

The Associated Press: As Health Bill Teeters, Medicaid Recipients Watch Nervously
With the latest Republican health care overhaul teetering near collapse, one group in particular is watching with heightened anxiety. The debate in Congress is personal for many of those who gained coverage through Medicaid in the 31 states that expanded the program under former President Barack Obama's Affordable Care Act. (Cassidy and Mulvihill, 9/26)

Georgia Health News: Group Of State Medicaid Chiefs Clarifies Stand Against GOP Bill
The National Association of Medicaid Directors emphasized Monday that its attention-getting opposition to the Graham-Cassidy health reform legislation was a consensus view of the board, and not a unanimous decision by all Medicaid directors. ... The statement by the Medicaid directors did not go before the full membership for a vote, said Matt Salo, executive director of the National Association of Medical Directors (NAMD). (Miller, 9/25)

The New York Times: G.O.P. Points To Welfare Overhaul As A Model For Health Care. The Comparison Has Limits.
As they propose to give each state a wad of federal cash to replace the Affordable Care Act’s health insurance, Senate Republicans have a ready comparison to press their case: the overhaul of welfare adopted two decades ago. But the authors of the Senate’s latest bill to repeal President Barack Obama’s health law face one glaring flaw with the analogy: Few people would applaud a dramatic plunge in health insurance coverage the way they cheered the steep declines of the welfare rolls after the 1996 welfare law went into force. (Pear, 9/25)

Confused About What Exactly The Graham-Cassidy Bill Does? Here's A Cheat Sheet

Media outlets break down just what you need to know about the measure and what's coming next.

Stat: Here's Your Graham-Cassidy Cheat Sheet, As GOP Scrambles For Votes
The substance of the new proposal is substantially different from the repeal bills that nearly became law earlier this year. Nonetheless, many of the same questions remain. The bill would deregulate individual insurance markets, slash Medicaid spending, and make it much harder for states to preserve their existing health programs. It could raise costs for Americans with preexisting conditions, limit access to addiction treatment, and reduce spending on public health campaigns, such as childhood vaccinations. (Facher and Mershon, 9/25)

Los Angeles Times: Why Republicans Are Racing To Pass Healthcare By Sept. 30 And What's Next For Obamacare Repeal
Senate Republicans are struggling to pass their latest healthcare overhaul — a bill written by Sen. Lindsey Graham (R-S.C.) and Sen. Bill Cassidy (R-La.) — by a Sept. 30 deadline. But it’s not clear they will have the votes, meaning GOP leaders and President Trump may fail again to repeal the Affordable Care Act, also known as Obamacare. Here’s a look at why Republicans are rushing to pass a bill and what’s next if they fail. (Mascaro, 9/25)

Politico: GOP Already Eyeing Next Chance To Revive Obamacare Repeal
The supposedly hard deadline at the end of the month to repeal Obamacare might not be so hard after all. With their latest attempt to dismantle the health law on track to fail this week, GOP senators are already raising the prospect of going after it again with the same powerful tools that currently let them pass legislation with just 50 votes. (Kim, Haberkorn and Everett, 9/25)

A Recipe For Chaos: Even If Plan Passed, States Warn They Wouldn't Be Able To Implement It

"Honestly, I am really struggling to figure out how we would respond,” said Teresa Miller, Pennsylvania's acting secretary of human services, saying it’s “highly unlikely” Pennsylvania would be able to build a functioning insurance marketplace by the bill’s 2020 deadline. In other news, a look at what it would mean for consumers if the measure passed, The Washington Post fact checks remarks by Sen. Bill Cassidy (R-La.) on premiums, and critics focus on pre-existing conditions.

Politico: States Warn Latest Obamacare Repeal Plan ‘Impossible’ To Set Up
State officials are warning they face a daunting, near-impossible task of rebuilding their health care systems from the ground up in just two years under the GOP’s latest Obamacare repeal plan. It’s a recipe for chaos, say those officials, who fear the unforgiving timeline and minimal federal assistance could result in insurance market collapses that force millions of residents to lose coverage. (Cancryn and Rayasam, 9/25)

The Washington Post Fact Checker: Meet The Man Flagged By Cassidy As Paying $40,000 In Health-Care Premiums
In selling his plan to repeal the Affordable Care Act, co-sponsored with Sen. Lindsey O. Graham (R-S.C.), Sen. Bill Cassidy repeatedly has mentioned the case of a Louisiana resident who faces $40,000 in insurance premiums. There are actually two such cases, one of which Cassidy touted on Facebook in 2016, though the details are a bit fuzzy. He displayed an insurance sheet that shows a couple being quoted $3,300 a month in premiums for a plan with a $6,200 deductible and $13,000 cap on total expenses. Cassidy has not identified this person. (Kessler, 9/26)

The Hill: Critics Say Pre-Existing Conditions Protections Weakened In Updated GOP Bill
Critics of the updated ObamaCare repeal measure from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) say it goes further than their earlier bill in gutting protections for people with pre-existing conditions. The two lawmakers say they changed their legislation in a bid to win over holdout senators by giving the states more money and more freedom. (Weixel, 9/25)

With GOP Bill Nearly Dead Senators' CNN Debate Became More Theory Than Practice

When the debate was set with Sens. Bernie Sanders (I-Vt.) and Amy Klobuchar (D-Minn.) on one side and Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) on the other, the Graham-Cassidy bill was gaining momentum. But by Monday night it looked all but dead, so the event lost some of its urgency.

The Washington Post: With Lower Stakes, Sanders And Klobuchar Debate GOP Repeal Bill’s Sponsors On CNN
Halfway through CNN’s prime-time debate on the Affordable Care Act, Sen. Bernie Sanders (I-Vt.) went in for the kill. Sen. Lindsey Graham (R-S.C.) had taken his umpteenth swing at “bureaucrats,” telling viewers that “Bernie’s solution is more government, not less,” warning that the Vermont senator would pour millions of people into Medicare when the system could not handle them.“It is easy to beat up on big, bad federal government,” said Sanders. “Guys, do you know what the most popular health insurance program in America is? It’s not the private insurance industry. It is…” Graham decided not to dodge. “Medicare,” he said. “Medicare, yeah!” said Sanders. “Which is falling apart,” said Graham. (Weigel, 9/26)

The Hill: Sanders: America Must Guarantee Healthcare 'As A Right For All People' 
In his opening remarks during tonight's CNN healthcare debate, Sen. Bernie Sanders (I-Vt.) blasted Senate Republicans' latest attempt to repeal and replace ObamaCare by highlighting major opposition to the bill. "Every major health association in this country, whether it is the American Medical Association, the American Hospital Association, the American Cancer Society, the Alzheimer's Society, every single major medical organization in this county think this proposal is a disaster," Sanders said. (9/25)

The Star Tribune: Sen. Klobuchar Steers Health Care Debate To Middle Ground
U.S. Sen. Amy Klobuchar had 90 minutes on the national stage Monday to make her best case for protecting the Affordable Care Act. ... The 90-minute format gave senators a chance to discuss a fraught policy issue and to hear from Americans battling rising premiums and medical bills, or terrified that a change in the law could deprive a sick child of future coverage. (Brooks, 9/26)

Politico: Graham And Cassidy Vow In Debate To Continue Obamacare Repeal Effort
With their Obamacare repeal bill on the brink of failure, Sens. Lindsey Graham and Bill Cassidy squared off with Sens. Bernie Sanders and Amy Klobuchar in a nationally televised debate Monday night and vowed to keep up their effort. “We’re going to press on,” Graham said of his and Cassidy’s repeal bill, which appears all but dead amid firm opposition from three Republican senators. “It’s OK to vote. It’s OK to fall short.” (Schor, 9/25)

Public Health And Education

FDA, Interpol Crack Down On Hundreds Of Websites Illegally Selling Unapproved Drugs

The operation targeted more than 500 websites illegally selling unapproved versions of prescription medications, the Food and Drug Administratioin said. Also, a prosecutor in New York teams up with academics to find opioid treatment gaps, and a young man whose overdose left him with irreversible brain damage and shocked the Berkeley campus seven years ago has died.

The Washington Post: FDA Targets Hundreds Of ‘Rogue’ Websites Illegally Selling Opioids And Other Prescription Drugs
The Food and Drug Administration targeted more than 500 websites it said were illegally selling unapproved versions of prescription medications, including opioids, antibiotics and injectable epinephrine products, the agency said Monday. The action was part of a global operation called Pangea X, led by the international police organization Interpol. That group said the international enforcement effort, designed each year to identify the makers and distributors of illegal, counterfeit and substandard medical products on the Internet, occurred Sept. 12 to 19. (McGinley, 9/25)

San Francisco Chronicle: Ex-UC Berkeley Student Dies 7 Years After Catastrophic Drug Overdose
A UC Berkeley junior who suffered irreversible brain damage in 2010 when housemates at his university residence waited two hours to call 911 after he’d overdosed, has died. His mother, Madelyn Bennett, confirmed that John Gibson, 28, died Sunday in a San Diego hospice seven years after his tragedy — and Bennett’s lawsuit — set in motion changes to UC Berkeley’s emergency reporting policies and the transformation of a beloved, historic student residence called Cloyne Court. (Asimov, 9/25)

Nation's Organ Donation Network Wants To Make Liver Transplants 'A Little Bit More Equal'

Right now, the chance of receiving a liver greatly depends on where a patient lives, but the United Network for Organ Sharing is looking to change that. In other public health news: sepsis, the benefits of social programs aimed at low-income children, autism, doulas and more.

NPR: Liver Transplant Allocation Proposal Sparks Debate
Himanshu Patel ran a convenience store in Georgia until about a year ago, when his liver failure got so bad he had to quit. "I just couldn't stand up on my feet at all," says Patel, 39, of Waycross, Ga. "I just had to stop working." Now, he's waiting anxiously to find out if his doctors have found a liver for him so he can undergo a transplant. (Stein, 9/26)

Modern Healthcare: Sepsis Mortality Rate On The Rise
While the number of cases of sepsis—one of the most deadly and costly conditions at hospitals—remained flat over a five-year period, mortality from the condition was worse than previously estimated, a new JAMA study has found. Sepsis was present in 6% of hospitalizations from 2009 to 2014. At the same time, sepsis accounted for roughly 15% of in-hospital deaths and 6.2% of discharges to hospice. Prior estimates of sepsis-related deaths were around 10%. (Castellucci, 9/25)

The Wall Street Journal: The Benefits Of Early Childhood Education And Health Programs May Last Longer Than A Lifetime
New research suggests programs aimed at helping low-income U.S. children, such as Head Start early childhood education and Medicaid health coverage, may have benefits not only for participating children but for their children as well. A recent working paper found the 1980s expansion of Medicaid programs to cover more low-income pregnant women led, years later, to their children giving birth to healthier babies. Another working paper found childhood access to Head Start led to better long-term outcomes in the next generation, including higher high-school graduation rates and reduced criminal behavior. (Leubsdorf, 9/25)

Kaiser Health News: Nowhere To Go: Young People With Severe Autism Languish In Hospitals
Teenagers and young adults with severe autism are spending weeks or even months in emergency rooms and acute-care hospitals, sometimes sedated, restrained or confined to mesh-tented beds, a Kaiser Health News investigation shows. These young people — who may shout for hours, bang their heads on walls or lash out violently at home — are taken to the hospital after community social services and programs fall short and families call 911 for help, according to more than two dozen interviews with parents, advocates and physicians in states from Maine to California. (Jewett, 9/26)

The Washington Post: Doula Help With Pregnant Women Aims To Reduce Black Infant Mortality
This city has opened a new front in its effort to give black newborns the same chances of surviving infancy as white ones: training doulas to assist expectant mothers during pregnancy, delivery and afterward. The initiative is the latest salvo in the Baltimore City Health Department’s seven-year-old effort to combat high mortality rates among black newborns. (Ollove, 9/25)

The Washington Post: FDA Halts Monkey Research Denounced By Jane Goodall As ‘Shameful’
The Food and Drug Administration has suspended experiments on the effects of nicotine in squirrel monkeys, research aimed at better understanding one of the most pernicious of addictions. Two weeks ago, British primatologist Jane Goodall wrote to FDA Commissioner Scott Gottlieb, urging an end to what she called “cruel and unnecessary” and “shameful” research. (McGinley, 9/25)

State Watch

State Highlights: Fla. Lawmaker Raised Red Flag About Nursing Homes' Struggles After Irma; Judge Strikes Down Provisions In Ind. Abortion Law

Media outlets report on news from Florida, Indiana, Connecticut, California, Georgia and Kansas.

The Hill: Fla. Lawmaker Warned Officials Before Retirement Home Tragedy 
A day before eight residents from the same Florida nursing home died, Rep. Frederica Wilson joined other state and federal officials on a Hurricane Irma recovery conference call and warned the situation could quickly turn deadly if power is not restored to local senior facilities. The Florida Democrat’s phone had been ringing nonstop since Hurricane Irma knocked out power to much of South Florida on Sept. 10. Wilson has 100 long-term care facilities in her Miami-area district, and many were begging her to help get the power — and the air conditioning — back on. (Wong, 9/26)

The Associated Press: Federal Judge Permanently Blocks Indiana Abortion Limits
A federal judge permanently struck down provisions of an Indiana law passed last year that would have banned abortions sought due to fetal genetic abnormalities and required that aborted fetuses be buried or cremated. U.S. District Judge Tanya Walton Pratt's decision, issued Friday, found that those two provisions and a third one are unconstitutional. She granted an order permanently blocking all three from being enforced and granted summary judgment in favor of Planned Parenthood of Indiana and Kentucky, which had sued the state in April 2016 after then-Gov. Mike Pence signed the provisions into law. (9/25)

The CT Mirror: Key Budget Revenue-Raiser Faces Looming Expiration Date
Raising taxes on hospitals to leverage more federal dollars, a key component of all plans to solve Connecticut’s budget crisis, could be in jeopardy if legislators don’t reach agreement by week’s end. Gov. Dannel P. Malloy and the hospital industry — which agreed to endorse the tax hike under very specific conditions — urged state officials Monday to act quickly. (Phaneuf, 9/25)

Los Angeles Times: Blaze At Homeless Encampment In San Diego County May Have Exposed Firefighters To Hepatitis A
team of firefighters may have been exposed to hepatitis A while battling a vegetation fire early Sunday at a homeless encampment in Spring Valley, officials said. A “large amount” of urine and feces had accumulated at the encampment, prompting hazardous materials crews to require firefighters to decontaminate with soap and water before leaving the scene, according to the San Miguel Fire Protection District. (Tchekmedyian, 9/25)

The Associated Press: Advocates Want More Police Training For Mental-Health Issues
Supervisors for the Georgia Tech police officer who fatally shot a student thought the officer showed promise, but there is no evidence that he had received the kind of training that advocates say is crucial to effectively interact with people who have mental-health issues. Officer Tyler Beck fatally shot Scout Schultz on Sept. 16, the Georgia Bureau of Investigation has said. Beck and other officers responded after Schultz called 911 to report an armed suspicious person, investigators said. Police have said Schultz had a knife and refused to drop it after repeated commands. (9/25)

Los Angeles Times: Death Toll From West Nile Climbs To 7 In L.A. County, Officials Say
Los Angeles County health officials warned residents Monday to protect themselves against the mosquitoes that transmit West Nile virus, as the number of people killed by the disease in L.A. County this year reached seven. The department launched a campaign Monday called “It’s Not Just A Bite” to try to raise awareness about mosquito-borne diseases, including West Nile. (Karlamangla, 9/25)

Kansas City Star: Life Expectancy Going Down In Several Kansas City ZIP Codes
Kansas City Health Department data shows that in each of the last two years there were four ZIP codes in the city in which life expectancy was going down. Department officials aren’t yet sure why, but they think it may be related to socioeconomic changes within those ZIP codes because those factors tend to influence health outcomes even more than medical care. (Marso, 9/25)

Kansas City Star: Double-Murderer Sues For Prison Smoking Ban - And Wins
At the prison in Cameron, the asthmatic Washington kept being paired with heavy smokers, despite doctor’s orders that his quarters be smoke-free. Now, after a decade-long legal battle, Washington is declaring victory with a settlement that not only protects his health but orders the Missouri prison system to go smoke-free on or before April 1. (Hendricks, 9/25)

San Francisco Chronicle: Coffee Sold In California May Come With Warning Labels In Future
The long-running lawsuit that resumed Monday claims Starbucks and about 90 other companies, including grocery stores and retail shops, failed to follow a state law requiring warning signs about hazardous chemicals found everywhere from household products to workplaces to the environment. At the center of the dispute is acrylamide, a carcinogen found in cooked foods such as French fries that is also a natural byproduct of the coffee roasting process. (Melley, 9/25)

Editorials And Opinions

Politics And Process: Did Graham-Cassidy Collapse Because It Left Millions Uninsured? Was Crafted Behind Closed Doors? Or Because It Shifted Money, Power Away From 'The Swamp'?

Editorial writers offer harsh words and examinations of what caused the GOP's most recent repeal-and-replace effort to come undone.

The Washington Post: Why Republicans’ Latest Obamacare Repeal Attempt Was Doomed From The Start
Republicans’ health-care bill collapsed in the Senate Monday night in familiar fashion. Republicans tried to rush through an unpopular bill, largely crafted and edited behind closed doors, that would leave millions more uninsured than current law and that never had nor won the support of moderates and conservatives in their party. In the bill’s final days, changes were haphazardly slapped on that seem devised to attract votes rather than inspire confidence the legislation will improve health-care policy. (Amber Phillips, 9/25)

The New York Times: Trumpcare Is Dead. Long Live The Trumpcare Opposition.
It’s over. And it’s not over. The effort to take away health insurance from millions of people — known by the name it deserves, Trumpcare — seems to have failed again. The latest version, the Graham-Cassidy bill, looks doomed, with three Republican senators joining all 48 Democrats and independents in opposition. Three plus 48 equals 51, and 51 no votes equal defeat. (David Leonhardt, 9/25)

The Washington Post: Cassidy Is ‘Sorry’ About The Cassidy-Graham Process. He Should Be.
Maybe the Senate janitor’s closet was already booked? For Monday’s hearing on the Cassidy-Graham bill to repeal Obamacare — the one and only hearing scheduled on the measure — Republicans trying to hurry it through Congress gave every sign that they did not want to be noticed. Senate hearing rooms that could have fit hundreds were left idle Monday afternoon, and instead Republicans chose one that could fit just 30 members of the public, leaving hundreds waiting in the hall outside. Many reporters, too, were turned away — the better to avoid scrutiny. (Dana Milbank, 9/25)

The Wall Street Journal: Graham-Cassidy Vs. The Swamp
Whatever else it does, the health reform crafted by Republican Sens. Bill Cassidy and Lindsey Graham shifts money and power out of Washington. And the swamp is not pleased. But as angry as Beltway inhabitants are to see this idea get a fair hearing, their reaction suggests that the substance of the bill isn’t all that bad. How else to explain their argument against it? (James Freeman, 9/25)

The Washington Post: ‘Reasonable’ Republicans Are Betraying Us, Too
President Trump clearly has no clue what’s happening on health care, taxes or really any other major policy front. He has also made abundantly clear that he has no interest in getting up to speed. Unfortunately, Trump’s unseriousness has become so grotesque, so all-consuming, that it has distracted us from dozens of other dilettantes and demagogues in Washington — far too many of them other members of Trump’s own political party. (Catherine Rampell, 9/25)

The Des Moines Register: Will Grassley Keep His Promise On Health Care?
Here we go again. The GOP has cobbled together another half-baked plan to repeal the Affordable Care Act. Sen. Chuck Grassley’s rationale on the legislation is beneath the long-serving member of Congress. “You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Grassley said during a conference call with reporters last week. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.” (9/25)

Detroit Free Press: GOP, Dems Should Compromise On Health Care Reform
Two decades ago, with Democrats and Republicans sharing equal numbers of seats in the Michigan House of Representatives, House leaders constructed a unique power-sharing arrangement. Committees were co-chaired by one Democrat and one Republican. Agreements were constructed where neither party would try to ram through its agenda if special circumstances, like a seat unexpectedly becoming vacant, served to tilt the delicate balance of power. (Daniel J. Loepp, 9/25)

Slate: The Most Cynical Republican On Obamacare
Few American politicians are as skilled at marketing the unmarketable as Vice President Mike Pence. As Senate Republicans these past weeks made a final push to repeal the Affordable Care Act, Pence entered full salesman mode, pitching the Graham-Cassidy bill in TV appearances as the GOP’s “last, best chance” at health care reform. The bill, Pence asserted, “will allow states to innovate and to create better quality health care” rather than comply with “a one-size-fits-all program in Washington, D.C.” No part of that claim is true, and Pence surely knows it. (Mark Joseph Stern, 9/26)

Policy Perspectives: GOP Plan Would Create 'An Unworkable Quagmire'; Graham-Cassidy A 'Threat To Children'

Opinion pages across the country view the impact of the Republican health bill -- which currently appears to have failed under its own weight -- in harsh terms.

USA Today: Scrap Graham-Cassidy Health Bill Or Plunge America And GOP Into Misery
Take it from someone who has overseen the implementation of a massive new health care law: For all the promises Republicans have made about repealing and replacing the Affordable Care Act, a bill like the one they aim to pass this week would not just hurt people, it would enmesh the GOP in an unworkable quagmire. (Andy Slavitt, 9/25)

Stat: The Graham-Cassidy Bill Is A Threat To Children
As a physician whose job it is to provide lifelong care for babies like [Jimmy] Kimmel’s son, I agree with him — it is time for all of us to politicize our children’s health problem. But, it is also time to listen to each other. The American Academy of Pediatrics warns that the bill “may be disguised under a different name, but it contains the same dangerous policies as the legislation that failed to advance out of the Senate earlier this summer. In fact, Graham-Cassidy goes even further in its attacks on Medicaid.” (Angira Patel, 9/25)

Los Angeles Times: I Have A 1-Year-Old Son. If Cassidy-Graham Had Been In Place, He Probably Wouldn't Have Been Born
My son recently had his first birthday. He hates wearing clothes but loves eating cheese (“cheeee”). I don’t know that he’d be here if it weren’t for the Affordable Care Act. Republicans are once again jockeying to repeal and replace that law — this time through a bill from Republican Sens. Lindsey Graham and Bill Cassidy. The GOP has pitched Graham-Cassidy as a friendly and fair instance of federalism — a chance to turn Obamacare’s money and regulatory power over to the states. (Craig Fehrman, 9/26)

Seattle Times: Health-Care Reform That Cuts Medicaid Fails Children
Medicaid has earned broad bipartisan support since its inception in 1965 as a cost-effective safety net to keep children and families healthy. The program is critical to ensuring that children from low-income families and children with special health-care needs receive timely, quality health care. The Graham-Cassidy proposal would jeopardize health care for millions of children and families. (Rupin Thakkar and Elizabeth Meade, 9/25)

Lexington Herald Leader: If Health-Care Money Is Sent To States, Could We Trust Bevin With It?
Here is a question for Gov. Matt Bevin and his millionaire Republicans who now control the Kentucky legislature: If the new Republican health-care plan is approved, sending billions of federal dollars back to Kentucky, would he spend it on health care for the poor, the disabled, the aged? Or, would he find other uses, such as saving Kentucky’s under-funded pension plans, that do more to help higher-ups than the average working Kentuckian? (Frank Ashley, 9/25)

Viewpoints: Mohammad Ali's Experiences Offer Insights About Athletes And Brain Disease; What About That National Opioid Emergency?

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

The Washington Post: Muhammad Ali Shows Why Brain Disease Won’t Keep Football Players Off The Field
Because he was so well known and beloved — arguably the most famous man in the world — Ali was often asked whether he was concerned about brain damage. Early in his career, when he was young and fast, he said he wasn’t worried. But as he aged and slowed, he took more punishment, and it was easy to see the effects. ... But Ali kept boxing, unable to resist the money and public adoration. (Jonathan Eig, 9/25)

St. Louis Post-Dispatch: Whatever Happened To The National Emergency On Opioid Abuse?
There are 29 active national emergencies in place today in the United States. The latest is the one that President Donald Trump declared on Aug. 10: “The opioid crisis is an emergency, and I am saying, officially, right now, it is an emergency. It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis. It is a serious problem the likes of which we have never had.” ... Unfortunately, it’s been six weeks since the emergency was declared, and the only step the administration has taken is to form a public-private partnership on the issue with some of the drug companies that have profited mightily from the addiction crisis. (9/24)

Los Angeles Times: Paging Dr. Price, Come To The White House Courtesy Phone. The President Would Like To Berate You Now
If it hadn’t done so already, the clock started ticking Monday on Dr. Tom Price’s tenure as head of the Department of Health and Human Services. The signs are all there. On Sunday, after defending Treasury Secretary Steven Mnuchin against an ABC News report that he’d used a costly military jet to fly from New York to Washington, President Trump declined to offer similar support for his HHS secretary, who has run up huge bills chartering private jets for his business travel this year. “As far as Secretary Price is concerned, that’s different,” Trump told reporters. “We’re looking into it.” (Jon Healey, 9/26)

Reuters: How Congress Is Hacking Away At Disability Rights
On September 7, on a straight party-line vote, the Republican-controlled House Judiciary Committee moved forward a bill that would gut key protections for people with disabilities. Although versions of this legislation had been introduced in prior years, the bill did not go anywhere while President Barack Obama stood ready to veto it. But now that President Donald Trump, whose actions have demonstrated hostility to civil rights, occupies the White House, the proposal presents a real risk of passage. If Republicans in Congress do eviscerate the Americans with Disabilities Act (ADA), it will be the culmination of their recent abandonment of the bipartisan consensus in favor of inclusion and equality for disabled persons. (Samuel R. Bagenstos, 9/25)

Stat: The CDC Finally Reverses Course On Treatment For Chronic Fatigue Syndrome
For years, people with chronic fatigue syndrome have wrangled with the Centers for Disease Control and Prevention over information on the agency’s website about this debilitating illness. The website highlighted two treatments that became the de facto standards of care: a gradual increase in exercise and a form of psychotherapy known as cognitive behavioral therapy. The problem was that the evidence doesn’t support these treatments. This summer, after years of resisting pleas from patients, advocates, and clinicians, the CDC quietly dropped the treatment recommendations from its website. Its decision represents a major victory for the patient community — and for science. (Julie Rehmeyer and David Tuller, 9/25)

Los Angeles Times: Facing Criticism, UC Irvine Scrubs 'Homeopathy' From Its Roster Of Offered Treatments
As of late last week, visitors to the website of UC Irvine Health, that institution’s clinical arm, could learn that among its services to patients was “homeopathy.” That was a problem, because homeopathy is a discredited and thoroughly debunked “alternative medicine.” Even Howard Federoff, UCI’s vice chancellor for health affairs, agreed that the scientific basis for homeopathy was “lacking.” The issue is important because the donors of a $200-million gift to UCI’s medical schools, the billionaire couple Susan and Henry Samueli, are sworn believers in homeopathy and supporters of a raft of other “integrative” health treatments. As I reported, some medical authorities have raised questions about whether the Samuelis’ beliefs and their rare generosity will undermine UCI’s explicit commitment to science-based medicine. (Michael Hiltzik, 9/25)