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A rural town and
Hospital on the margins …
Bracing for more change.

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Summaries Of The News:

Capitol Hill Watch

Trump Insists On Quick Replace Vote: 'Long To Me Would Be Weeks'

To meet that timetable would be nearly impossible for lawmakers who took years to pass the health law in the first place and have no detailed plan as of yet for replacement.

The New York Times: Trump Tells Congress To Repeal And Replace Health Care Law ‘Very Quickly’
President-elect Donald J. Trump demanded on Tuesday that Congress immediately repeal the Affordable Care Act and pass another health law quickly. His remarks put Republicans in the nearly impossible position of having only weeks to replace a health law that took nearly two years to pass. “We have to get to business,” Mr. Trump told The New York Times in a telephone interview. “Obamacare has been a catastrophic event.” (Haberman and Pear, 1/10)

The Washington Post: Trump, Hill GOP Fret About Fallout From Repealing Obamacare So Quickly
After years of promising to repeal the Affordable Care Act, a growing number of Republicans are balking at the prospect of doing so quickly without a firm plan to replace it. As the Senate begins voting Wednesday on a path to eliminate the landmark health-care bill, some Republicans are worried about the political fallout and uncertainty of starting to roll back Obamacare without knowing how the process will end.President-elect Donald J. Trump was among the Republicans expressing concern Tuesday. (Snell, Sullivan and Goldstein, 1/10)

Morning Consult: Trump Calls For Swift ACA Repeal, But Senate GOP Split On Timing
Congressional Republicans have set up a multi-step process to repeal the law, starting with a budget resolution which the Senate is set to vote on by Thursday morning. The House expects to follow suit and vote on the resolution by the end of the week. The budget resolution doesn’t actually repeal the health care law, but instructs four congressional committees to draft reconciliation legislation that would allow the Senate to repeal Obamacare with a simple majority of 51 votes. (McIntire, 1/10)

Politico: Trump’s Obamacare Remedy Spurs More Confusion
Republicans on Capitol Hill are in disarray about how to repeal Obamacare and President-elect Donald Trump’s call on Tuesday to enact a replacement “very quickly” did nothing to clear up the turmoil. Trump told The New York Times that he wants a repeal to happen within days and “the replace will be very quickly or simultaneously, very shortly thereafter.” The statement took lawmakers on Capitol Hill by surprise. (Haberkorn and Cancryn, 1/10)

In other news on the president elect's relationship with the Republicans in Congress —

The Hill: Trump Medicare Promise Causes Heartburn For GOP 
Time and again on the campaign trail, Donald Trump pledged to his supporters that he wouldn’t gut Medicare as president. Trump’s incoming chief of staff, Reince Priebus, doubled down on that position over the weekend, insisting that his boss wouldn’t “meddle” with Medicare or Social Security. But a week before Trump’s inauguration, that campaign promise is already encountering fierce resistance from Republicans on Capitol Hill. For years, GOP lawmakers — led by Speaker Paul Ryan (Wis.) — have been sounding the alarm that a major overhaul to Medicare and other entitlements are needed to ensure they don’t go bankrupt. (Wong, 1/11)

Ryan Promises GOP Will Work On Repeal, Replace 'Concurrently' As Anxiety Continues To Mount

Some within the Republicans' own party have been wary about moving so quickly on repeal without a plan to replace the health law.

The Hill: Ryan: GOP's Goal Is To Replace, Repeal ObamaCare 'Concurrently'
“It is our goal to bring it all together concurrently,” Ryan told reporters after meeting with House Republicans behind closed doors. “We’re going to use every tool at our disposal through legislation, through regulation, to bring replace concurrent along with repeal, so that we can save people from this mess.” (Wong and Sullivan, 1/10)

CQ Roll Call: GOP Leaders Vow To Replace Health Care Law Along With Repeal
Ryan, R-Wis., said he doesn’t know how many replacement provisions will be in the repeal bill, which has yet to be written and would be passed through the fast-track budget reconciliation process. "That's a question that really is more of a Senate question, as to what you can put in reconciliation, what you cannot put in reconciliation,” he said. But he added: “We will pass as much as we can through whatever vehicle we've got. And then we will pass all the other things through regular order outside reconciliation that show you the full scope of what a real replacement effort looks like." (Krawzak and McCrimmon, 1/10)

CQ Roll Call: Alexander Outlines His Health Care 'Rescue Plan'
Republicans should take steps by March 1 to start work on relaxing health care overhaul rules requiring insurers to offer broad benefits, the chairman of the Senate Health, Education, Labor and Pensions Committee said Tuesday. Alexander  (CQ Roll Call)Tennessee Republican Lamar Alexander, who oversees one of the four committees that will lead the effort to repeal and replace the health care law (PL 111-148, PL 111-152), described what he called a “rescue plan” in a floor speech. Republican leaders, including Vice President-elect Mike Pence, have said the incoming Trump administration would pursue executive action to make some changes to Obamacare. (Siddons, 1/10)

Morning Consult: No. 4 House Republican: ‘No One’ Will Lose Coverage Over Obamacare Repeal
House Republican Conference Chairwoman Cathy McMorris Rodgers made a big pledge Tuesday on the GOP’s health care repeal plan, one that top congressional Republicans have so far shied from. “Let me be clear,” the Washington Republican told reporters after a House GOP conference meeting where lawmakers discussed how it would repeal President Barack Obama’s signature health care law. “No one who has coverage because of Obamacare today will lose that coverage. We’re providing relief. We aren’t going to pull the rug out from anyone.” The promise is reminiscent of a variety of vows made dozens of times by Obama and administration officials, both before and after the president signed the Affordable Care Act into law in 2010: “If you like your doctor, you can keep your doctor,” and, “If you like your health care plan, you can keep your health care plan.” (Yokley, 1/10)

Morning Consult: House Panel Launches Online Portal for Health Reform Info
The House Energy and Commerce Committee wants to be a go-to reference for all things related to the Obamacare repeal-and-replacement process, and its launching an online portal Wednesday meant to serve as “health care central” for inquiring minds. ... The online portal — which committee aides say is the only one to be put forth from any of the relevant committees — will compile fact sheets, infographics, blog posts and videos for a one-stop shop about the health law and the process to repeal and replace it. The items being released today focus on what Republicans say are problems with Obamacare and the reasons it needs to be repealed. (McIntire, 1/10)

Politico: How The GOP Plans To Repeal Obamacare
The Republican Party’s quest to kill Obamacare is about to get real. Here’s a step-by-step guide to how it will go down in the coming days and weeks — assuming they don’t manage to mess it up or get cold feet. (Weyl, 1/11)

Health Law

With Solid ACA Enrollment Numbers, Administration Proclaims 'Death Spiral' Claims False

Despite all the turmoil surrounding the law, 11.5 million Americans enrolled in the exchanges nationwide, which is about 290,000 more than the same time last year. "This market is not merely stable; it is on track for growth," said Aviva Aron-Dine, a senior adviser at the Department of Health and Human Services.

USA Today: Administration Releases Last Big Obamacare Sign-Up Report Amid Hill Fight
The numbers, up nearly 300,000 from the same point last year, come despite what HHS senior counselor Aviva Aron-Dine called "significant headwinds" on Capitol Hill. Congressional efforts to repeal the ACA without a replacement plan sets policymaking on a "dangerous path" that jeopardizes the health of up to 30 million people, [Health and Human Services Secretary Sylvia Burwell said in a statement.] (O'Donnell, 1/10)

Roll Call: Obamacare Markets See Growth Despite Premium Hikes
The total includes 8.7 million who signed up through and 2.8 million who enrolled through state-based marketplaces. The Congressional Budget Office estimated that the bill congressional Republicans cleared last year that would have repealed the health care law would have eliminated coverage for about 22 million people who receive coverage either through the marketplaces or Medicaid, the federal-state program for the poor. President Barack Obama vetoed that measure, which is now serving as a starting point in the current discussions about repealing the law. (Siddons, 1/10)

Los Angeles Times: Millions Sign Up For Obamacare As Trump And GOP Lawmakers Scramble For A Way To Roll It Back
As of Dec. 24, more than 11.5 million people had enrolled in a health plan through one of the insurance marketplaces created by the law, including and Covered California, federal data released Tuesday show. That is nearly 300,000 more sign-ups than at the same point a year earlier, signaling strength in the marketplaces despite GOP criticism and uncertainty about whether Republicans will scrap them. (Levey, 1/10)

Modern Healthcare: ACA Signups Continue To Outpace Last Year, Hitting 11.5 Million 
The HHS said it has received 35,000 calls from people asking if they should still get coverage or re-enroll. The agency reaffirmed that the ACA remains the law of the land and that coverage they signed up for before the end of the month would begin on Feb. 1. Officials believe a strong finish will bolster the case for preserving the ACA which helped reduce the nation's uninsured rate to a historic low of about 9%. (Dickson, 1/11)

The Hill: ObamaCare Enrollment Hits 11.5M For 2017 
The new numbers fall below HHS's projection for open enrollment, though there are still two and a half weeks left in the enrollment period. Burwell estimated that nearly 13.8 million people would sign up for ObamaCare in 2017. (Hellmann, 1/10)

And media outlets look at enrollment numbers in the states —

Miami Herald: More Than 1.6 Million Floridians Have Signed Up For Obamacare Coverage For 2017, HHS Says
With Congress poised to begin a fast-track repeal of the Affordable Care Act this week, and the Jan. 31 deadline approaching for consumers to enroll in a plan, the Obama administration on Tuesday reported, for the first time, the age, ethnicity and gender of the 11.5 million Americans who have signed up for 2017 coverage under the law better known as Obamacare. Enrollment in the 50 states plus Washington, D.C., has outpaced the same period from last year by about 286,000 people, according to the report — evidence of growth that the U.S. Department of Health and Human Services seized on to refute claims by congressional Republicans that the ACA’s insurance exchanges are in a “death spiral” and will eventually implode. (Chang, 1/10)

Atlanta Journal-Constitution: 480,000 Georgians Have Chosen Obamacare Health Plans So Far
More than 480,000 Georgians have selected health plans through the Affordable Care Act, aka Obamacare, insurance marketplace so far, new federal data shows. Nationally, upwards of 11.5 million Americans have chosen ACA plans for 2017 so far — up 2.5 percent from the same period during last year’s open enrollment, according to a Department of Health and Human Services report released Tuesday. (Williams, 1/10)

Chicago Sun Times: Future Of Obamacare In Doubt, But People Continue To Sign Up 
Large numbers of people continue to sign up for health care plans under the Affordable Care Act — both in Illinois and nationwide — but given the program’s uncertain future, local officials on Tuesday urged people not to delay in picking a plan...Some 351,000 Illinois residents have signed up for health insurance under the law during the current open enrollment period, running through Jan. 31, which is about 4,400 more people than at the same time last year, according to federal figures. (Esposito, 1/10)

Des Moines Register: Obamacare Marketplace Attracts 52,237 Iowans, Despite Controversy
Obamacare’s days may be numbered, but an increasing number of Iowans are signing up for its coverage. Federal officials reported Tuesday that 52,237 Iowans had enrolled in private insurance plans since Nov. 1 via the Affordable Care Act’s online marketplace, That’s 5 percent more than enrolled over a similar period a year earlier. (Leys, 1/10)

The Philadelphia Inquirer: Obamacare Enrollment In Pa., N.J., Spikes After Trump's Election
Despite promises from the president-elect and Congress that the Affordable Care Act will be repealed, and higher prices for coverage, enrollment in the Obamacare marketplaces increased after the November election both nationally and locally. A new federal report released Tuesday stated that 11.5 million people nationwide signed up for coverage through the health-insurance exchanges between Nov. 1 and Dec. 24, up from about 11.2 million during a similar period in 2015. The exchanges make it possible for people who are not covered by an employer to buy a health plan that for most is federally subsidized. (Wood, 1/10)

Kaiser Health News: Fewer Americans Paid Obamacare Tax Penalty In 2016
About 6.5 million Americans paid an average penalty of $470 for not having health insurance in 2015 — 20 percent fewer than the year before, according to data released Tuesday by the IRS. The IRS collected $3 billion, IRS Commissioner John Koskinen said in a letter to members of Congress. (Galewitz, 1/10)

Kaiser Health News: Obama’s Health Care Legacy: A Landmark Becomes A Question Mark
When President Barack Obama signed his landmark health care bill on March 23, 2010, he achieved what presidents and members of Congress had long tried and failed to do — to provide near-universal health insurance to Americans. Democrats were jubilant. Those in Obama’s inner circle, like Bob Kocher, a special adviser to the president on health care policy and one of the law’s architects, celebrated the victory at the White House. “It was a moment of total joy,” Kocher recalled. “We felt like we’d accomplished something hard and amazing and important that would go down in history as being an important step forward in American health care.” (Varney, 1/10)

For One Pa. Couple, Voting For Trump Meant Relief From 'Insane' Insurance Costs

The Schultzes made too much money for subsidies to help them, but not enough to be able to afford the high cost of health insurance when premiums spiked this year. In other health law news, lobbyists scramble to take advantage of the new landscape as repeal looms, rural hospitals prepare to be hit hard if there's no replacement in sight, and Tim Kaine wants to rebrand Obamacare.

NPR: Trump Promises On Health Insurance Appealed To Family Struggling With Cost
Abra and Matt Schultz, both 32, recently built a house in a middle class neighborhood in Pottsville, Pa. Matt works as a carpenter foreman for a construction company. He and Abra, his wife, are right in Trump's wheelhouse — Republicans in Republican Schuylkill County. The couple spent December trying to decide whether to buy health insurance or skip it for 2017. They voted for Trump because they were fed up with how much they are paying for health insurance. (Allen, 1/10)

The Hill: Healthcare Lobbyists Prepare For Frenzy 
Healthcare lobbying is about to shift into overdrive in Washington. With Republicans moving full-speed ahead with the repeal of ObamaCare, lobbyists on K Street are scrambling to come up with ways to influence the result. Few in the healthcare space expected President-elect Donald Trump’s election, and they are now playing catch-up as Republicans consider sweeping changes to the healthcare system that could rival the overhaul that Democrats passed in 2010. (Wilson, 1/11)

Kaiser Health News: Even In Trump Country, Rural Hospitals Brace For Damage From Health Law’s Repeal
Judy Keller, 69, has always relied on Highlands Hospital for medical care, just as her parents did before her. ... “This hospital all my life has been here,” said Keller, now retired. “[It] helps a lot of people who don’t have adequate health care coverage — and I don’t know what they would do without it.” Aside from providing health care to a largely poor population, it provides hundreds of jobs in a town that locals say never recovered after industries such as coal mining and glass manufacturing disappeared. But in the wake of this fall’s presidential election, Highlands — like many other rural hospitals — will likely face new financial challenges that will intensify longstanding struggles, experts say. (Luthra, 1/11)

Richmond Times Dispatch: For Kaine, Health Care, Cabinet Fights Are Campaign Do-Over 
Knowing Republican distaste for Obamacare includes its name, Tim Kaine is suggesting a rebranding that even the GOP could love: “Americare.” “I thought it up over the weekend,” said Kaine at the start of a big week for out-of-luck Democrats and in-your-face Republicans. The junior U.S. senator from Virginia — better known beyond its borders as the defeated Democratic nominee for vice president — is smack-dab in the middle of the early skirmish over repeal of Obamacare. He is a Democratic point man, proposing language to slow Republicans’ fast-track dismantling of the Affordable Care Act. (Jeff Schapiro, 1/10)

Administration News

Anti-Vaccine Crusader Says Trump Tapped Him To Lead Vaccination Safety Commission

The meeting between Robert F. Kennedy Jr. and Donald Trump is alarming scientists. “It gives it a quasi-legitimacy that I frankly find frightening,” said William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University. However, Trump's transition team has released a statement saying he is only exploring the option of forming a committee on autism.

The New York Times: Anti-Vaccine Activist Says Trump Wants Him To Lead Panel On Immunization Safety
A prominent anti-vaccine crusader said on Tuesday that President-elect Donald J. Trump had asked him to lead a new government commission on vaccine safety and scientific integrity — a possibility that spread alarm among medical experts that Mr. Trump could be giving credence to debunked conspiracy theories about the dangers of immunizations. The vaccine skeptic, Robert F. Kennedy Jr., a nephew of former President John F. Kennedy, said that Mr. Trump, who has repeatedly embraced discredited links between vaccines and autism, had asked him to lead the commission during a meeting with the president-elect at Trump Tower on Tuesday. (Shear, Haberman and Belluck, 1/10)

Stat: Donald Trump, Robert F. Kennedy Jr., And The Real Science Of Vaccines
News that President-elect Donald Trump and Robert F. Kennedy Jr. met on Tuesday rang alarm bells throughout the scientific community, because both have aggressively promoted discredited anti-vaccination theories...Despite these evident public health gains, skeptics have circulated a theory that childhood vaccines overtax the immune system in ways that can lead to neurological damage. People made nervous by that idea sometimes embrace an alternative vaccine schedule which recommends spacing vaccines out. But this alternative schedule is not based on science — and experts say it’s actually dangerous, because it extends the period of time during which children are not fully protected against diseases that can cause serious illness and can even kill. (Branswell, 1/11)

The Washington Post: The Truth About Vaccines, Autism And Robert F. Kennedy Jr.’s Conspiracy Theory
First things first: Vaccines do not cause autism. So say the Centers for Disease Control and Prevention, the World Health Organization, the National Academies of Sciences, Engineering and Medicine, and the American Academy of Pediatrics, along with dozens of studies published in prestigious, peer-reviewed journals. The scientific consensus on vaccines and autism is thorough and solid: There is no evidence of a connection. This is not new news. But it bears repeating now that Robert F. Kennedy Jr. says President-elect Donald Trump wants him to chair a new commission on vaccine safety. (Kaplan, 1/10)

Bloomberg: Trump Says He’s ‘Exploring’ Forming Commission To Study Autism 
Kennedy didn’t immediately respond to a request for comment on the Trump team’s statement. He opposes the use of a preservative called thimerosal in vaccines because it contains a form of mercury that he calls “a devastating brain poison.” He says the shots can cause autism and have created a public health crisis, disregarding scientific studies that have concluded they do not. Trump is also concerned about the issue, Kennedy told reporters earlier. (John and Cortez, 1/10)

The Hill: Vaccine Skeptic Says He's Been Asked To Lead Trump Vaccine Commission 
Scientists have repeatedly shot down any accusations about a link between vaccines and developmental disorders like autism, noting that there are various safeguards to ensure vaccines aren't dangerous. The Centers for Disease Control and Prevention believes there is "no link" between autism and vaccines, and points to a number of studies that back up that assertion. (Kamisar and Fabian, 1/10)

Rep. Price Faces Growing Scrutiny Over Health Care Stocks

Rep. Louise Slaughter, D-N.Y., has asked the Securities and Exchange Commission to investigate.

The Associated Press: Trump's HHS Pick Faces Calls For Probe Of Stock Trades
President-elect Donald Trump's nominee to be the nation's top health official is facing calls for investigation of whether his stock picks were guided by insider knowledge gleaned as a senior member of Congress. Rep. Tom Price, R-Ga., was chosen by Trump in part because of his plan to repeal "Obamacare," and his confirmation hearings are expected to be a spirited debate about the future of federal health insurance programs. Financial issues could take the hearings in a different direction, however, to determine whether there were any potential violations of federal law. (Alonso-Zaldivar, 1/11)

The Wall Street Journal: Lawmaker Asks SEC To Investigate Stock Trades Of HHS Nominee Tom Price
A veteran legislator who wrote a law to curtail abusive stock-trading in Congress on Tuesday asked securities regulators to open an investigation into President-elect Donald Trump’s nominee to be secretary of Health and Human Services. The request to investigate Rep. Tom Price, a Georgia Republican, comes after The Wall Street Journal reported last month that he made trades worth more than $300,000 in stocks of biomedical, pharmaceutical and health insurers while serving on the health subcommittee of the House Ways and Means Committee, sponsoring and advocating legislation that potentially could affect those companies’ stock. (Grimaldi, 1/10)

Veterans' Health Care

GAO Still Views Veterans' Health Care As 'High Risk' Issue

An auditors' report by the Government Accountability Office to be released next month will classify health care for veterans as an issue that threatens the federal budget and quality of care. These findings underscore the difficulties that will be faced by whomever President-elect Donald Trump chooses to head the Department of Veterans Affairs. Meanwhile, a U.S. Special Counsel says the Phoenix VA hospital is continuing to struggle with delays in care.

The Associated Press: Veterans Care Still 'High Risk' As Trump Mulls VA Head
Veterans health care remains a "high risk" issue threatening the federal budget and quality of care for former service members, auditors say in a forthcoming report. The nonpartisan Government Accountability Office will place the Veteran Affairs Department's health system once again on its "high risk" list when it's released next month. (1/11)

Arizona Republic: Phoenix VA Problems? More Than 2 Years Later, Struggles Continue, Reports Say
The independent U.S. Office of Special Counsel says Phoenix's VA hospital "continues to struggle" with delayed care for patients nearly three years after it became the focal point of a national health-care crisis for veterans. In a letter Tuesday to President Barack Obama and Congress, Special Counsel Carolyn Lerner noted that numerous allegations by another whistleblower at the Carl T. Hayden VA Medical Center had been largely verified by internal reviews. (Wagner, 1/10)


Sen. Sherrod Brown Offers Bill To Allow Medicare To Negotiate Drug Prices

The strategy, he says, would help lower prescription costs for the government and seniors. Also, Florida lawmakers are weighing a bill that would bar insurance companies from increasing a customer's prescription costs or changing the list of covered drugs during the contract year.

Miami Herald: Medicare Drug Prices Too High? Democrats And Donald Trump Have An Idea
Sen. Sherrod Brown, D-Ohio, reintroduced legislation that would give the Health and Human Services Secretary the ability to negotiate the price of prescriptions under Medicare. Under current law Medicare cannot do this. ... Brown hopes the bill will help government wield the bargaining power of nearly 41 million seniors to negotiate bigger price discounts, boosting savings for taxpayers and trimming costs for those enrolled in Medicare Part D. (Veciana-Suarez, 1/10)

Health News Florida: FL Lawmakers Propose Prescription Drug 'Bait And Switch' Bill
Two Florida lawmakers want health insurance companies to stick by their contracts when it comes to prescription medications. Currently, no law prevents health insurance companies from increasing a member's out-of-pocket prescription costs or changing the drugs they cover after the contract is signed. ... “I hear from constituents who sign up for a plan that covers the medicine they need, only to have their health plan force them to switch to a less effective drug just a few months later,” [Sen. Debbie] Mayfield said in a news release. “The ‘Bait-and-Switch Bill’ is about consumer protection. All we want is for Florida insurers to honor their contracts with patients. Floridians can’t change health plans throughout the year, so insurers shouldn’t be able to reduce the benefits they receive.” (Miller, 1/10)

For more news on high drug costs, check out our weekly feature, Prescription Drug Watch, which includes coverage and perspectives of the issue.

Public Health And Education

Abuse-Deterrent OxyContin Pills Simply Redirect People To Seek Out Heroin

A new study finds that the reformulated pills have not reduced overdose deaths. In other news, New Jersey Gov. Chris Christie promises to fight the epidemic in his state during his final year in office and Walgreens announces that it will install medication disposal kiosks.

Los Angeles Times: Heroin Resurgence An 'Unintended Consequence' Of Attempt To Curb OxyContin Abuse, Study Finds
In an attempt to stem abuse of OxyContin, Purdue Pharma spent a decade and several hundred million dollars developing a version of the painkiller that was more difficult to snort, smoke or inject. Since those “abuse-deterrent” pills debuted six years ago, misuse of OxyContin has fallen and the company has touted them as proof of its efforts to end the opioid epidemic. (Ryan, 1/10)

The Wall Street Journal: Christie Wants To Combat State’s Drug Crisis During Final Year In Office
New Jersey Gov. Chris Christie pledged Tuesday to use his final year in office to aggressively combat drug addiction, calling it a crisis that is “ripping the very fabric of our state apart. ”Mr. Christie, a Republican who is entering his final year of his second and final term in office, dedicated the majority of his 73-minute state-of-the-state address to outlining his plan for expanding drug prevention and treatment. (King, 1/10)

Consequence-Free Gun Violence Running Rampant In PG-13 Movies

The movies, which are consumed by a younger audience than R-rated ones, whitewash the damaging effects of gun violence, a new study finds.

The Washington Post: Gun Violence In PG-13 Movies Soars. Are ‘Superhero’ Movies To Blame?
In the climatic battle scene in "Rogue One: A Star Wars Story," basically everyone has a gun. ... The omnipresent guns in the latest Star Wars movie also reflect a trend in Hollywood over the past 30 years toward increasing gun violence in superhero/fantasy/comic book-type action flicks aimed at children and teens — a shift that has created confusion about what differentiates a PG-13 movie such as "Rogue One" from an R-rated film. (Cha, 1/11)

In other news —

Boston Globe: Mass. Had Lowest Gun Death Rate In The Country In 2015, Study Says 
Massachusetts had the lowest gun death rate in the country in 2015, newly released federal data shows, and advocacy groups on Tuesday attributed the state’s ranking to its tough firearm laws. There were 213 gun deaths in the state in 2015, for a rate of 3.13 per 100,000 residents, according to the US Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control. (Andersen, 1/11)

Not Just Flint: Replacing Nation's Lead Pipes Is Goal Of New Collaborative

Environmental, health and other public interest groups team up to help communities replace pipeline segments that are tainting the water supply. In related news, Illinois moves toward a requirement that all elementary schools and day care centers test drinking water for lead.

USA Today: Groups Unite To Create Roadmap For Replacing Lead Pipes That Poison Water
Nearly two dozen environmental, health, consumer and water utility groups are uniting to help communities replace old lead pipes that are the primary culprit behind the lead contamination of millions of Americans' drinking water. The Lead Service Line Replacement Collaborative won’t change out the pipes itself. But starting this week, it will provide communities with advice and tools to speed up pipe replacement. (Ungar, 1/10)

Chicago Sun Times: Bill Requiring Lead Testing In Schools Heads To Governor's Desk
A bill that will require Illinois elementary schools and day care centers to test for lead in drinking water now heads to the governor’s desk, and he is expected to sign it into law. The measure was approved by the Illinois Senate 55-0 on Tuesday. It was previously approved 48-5 in the Senate but it was reworked via amendments to include additional requirements.The bill requires school districts to collect and analyze water samples from drinking fountains and kitchen sinks in schools that serve pre-kindergarten through fifth graders in buildings that were built before Jan 1, 2000. Those samples must be tested for lead. (Sfondeles, 1/10)

Following Vaccination Controversy, Ohio Clinic Vows To Focus On Evidence-Based Medicine

Dr. Daniel Neides was slammed with criticism after penning an anti-vaccination rant last week.

Stat: Cleveland Clinic Reevaluating Alternative Medicine Offerings
After the director of its Wellness Institute was forced to walk back an anti-vaccine blog post over the weekend, the Cleveland Clinic revealed Monday that it has already spent months reevaluating the institute’s focus and expects to halt the sale of some alternative medicine products. Clinic spokeswoman Eileen Shiel told STAT that hospital administrators are concerned that the institute’s focus has grown too unwieldy and less connected to the clinic’s broader mission of providing the best, evidence-based medicine and services to patients. (Ross, 1/10)

Stat: What To Know About Cleveland Clinic Doctor Who Wrote Anti-Vaccine Column
In recent days, medical professionals and health watchdogs have slammed Dr. Daniel Neides, director of the Cleveland Clinic Wellness Institute, over an anti-vaccine rant he published on an Ohio news site. Neides has since apologized for the column. Meanwhile, a review of his career and published work offers a more nuanced picture of his views and motivations — he’s well-regarded among his patients, but also turns to therapies of questionable efficacy in treating them. After the flap over his column, STAT reported Tuesday that the clinic would be reevaluating some of the institute’s offerings. (Ross, 1/11)

Global Cost Of Smoking Totals $1 Trillion And 6 Million Lives Each Year, WHO Report Finds

And other public health stories cover affordable DNA sequencing, women's continued need for folic acid supplements during childbearing years, heartburn drug use during pregnancy and speeding up cancer clinical trials.

The Washington Post: Smoking Costs The World Economy $1 Trillion Per Year, World Health Organization Says
Smoking and its side effects cost the world's economies more than $1 trillion and kill about 6 million people each year — with deaths expected to rise by more than a third by 2030, according to a new report from the World Health Organization and the National Cancer Institute. Those losses exceed annual global revenue from tobacco taxes, estimated to be $269 billion in 2013-14, according to the report released Tuesday. Of that, less than $1 billion was invested in tobacco control. (Wang, 1/10)

Stat: Sequencing A Genome For Less Than The Cost Of An X-Ray? Not Quite Yet
When Illumina announced on Monday that it will begin shipping its two newest DNA sequencing machines as soon as March, president and CEO Francis deSouza said the technology “will enable the $100 genome.” That raised some questions: $100—really? A $100 genome will cost $100 in the same way that the $1,000 genome costs $1,000. As in, it won’t, at least not soon. (Begley, 1/11)

NPR: Women Still Need Folic Acid Supplements To Prevent Birth Defects
If you can get pregnant, you should be popping at least one pill a day: a folic acid supplement to lower the risk of a type of serious birth defect in any future offspring. So says the U.S. Preventive Services Task Force, which Tuesday reiterated its 2009 recommendation that all women who can conceive take 400 to 800 micrograms daily of the B vitamin in case their diet isn't providing enough of it. (Hobson, 1/10)

The New York Times: Heartburn Drugs In Pregnancy Tied To Asthma In Babies
Taking heartburn medicines during pregnancy may increase the risk for asthma in the baby, a review of studies has found. The analysis, in the Journal of Allergy and Clinical Immunology, combined data from eight studies that included more than 1.6 million patients. Follow-up ranged from five to 14 years. (Bakalar, 1/10)

The Washington Post: National Cancer Institute And Drug Companies Aim To Speed Up Clinical Trials
The National Cancer Institute launched an effort Wednesday to speed up clinical trials by getting researchers quicker access to the drugs they want to test. The NCI initiative creates a virtual “formulary” — a kind of clearinghouse — that initially will include 15 different medications donated by six manufacturers. The formulary will allow the institute to act as an intermediary between the drug companies and scientists at 69 NCI-designated cancer centers and to streamline the process by which researchers get the therapies. (McGinley, 1/11)


Kansas Advocacy Group Urges Members To Press Congress To Oppose Health Law Repeal

The Alliance for a Healthy Kansas is hoping to get Kansas to expand its Medicaid program under the federal health law. In other news, Oklahoma budget officials say the Medicaid program needs more money next year.

KCUR: Kansas Medicaid Expansion Advocates Among Those Lobbying Against Obamacare Repeal
The Alliance for a Healthy Kansas, a nonprofit advocacy organization with more than 100 members, on Tuesday began distributing a letter to its members and asking them to send it to the state’s two U.S. senators and four House members, whom the letter urges to “avoid repealing the Affordable Care Act without putting in place an adequate replacement.” David Jordan, executive director of the alliance, says there are growing indications that Republican congressional leaders are having second thoughts about their “repeal now and replace later” strategy. (McLean, 1/10)

State Watch

State Highlights: Texas Low-Cost Health Plan Expands; Calif. Gov. Presents Budget As 'Imperiled' Federal Health Care Funding Looms Large

Outlets report on health news from Texas, California, Washington, D.C., Massachusetts, Colorado, Minnesota, Georgia, Florida and Wisconsin.

San Antonio Express: Low-Cost Health Plan Expands In State
A Texas-based company that provides members access to primary and urgent care doctors for a small fee has added local clinics to its direct care network in Connecticut. Healthcare2U, which entered the state’s health care market in mid-2016, offers a non-insurance-based health plan for less than $100 a month that allows its members to visit primary and urgent care clinics in its network for $10 a visit, without the need to file a claim against the individual’s insurance plan. (Torres Ocasio, 1/10)

Sacramento Bee: Jerry Brown Presents 2017-2018 California Budget Proposal
California Gov. Jerry Brown, warning about the double-barreled fiscal risk posed by Republican-controlled Washington and an impending economic downturn, presented a $177.1 billion proposed budget Tuesday that assumes the state will take in billions of dollars less than lawmakers previously estimated. But the Democratic governor refrained from laying out how the state might react if it loses federal funding, saying it’s premature to predict how the Trump administration will act on climate change, illegal immigration and health care. (Miller and Cadelago, 1/10)

The Washington Post: After 40 Years, U.S. Court Ends Supervision Of D.C.’s Care For Mentally Disabled Citizens
A federal judge Tuesday ended 40 years of court supervision of the District’s care for people with intellectual and developmental disabilities, concluding what city leaders called the longest-standing U.S. class-action lawsuit of its kind. U.S. District Judge Ellen S. Huvelle’s order ended a legal odyssey for 479 surviving class members and a larger group of thousands of the city’s most vulnerable residents, many of whom over the years experienced abuse, neglect or whitewashed death investigations after they died while wards of the city. (Hsu, 1/10)

KCUR: Court: Doctors Who Misdiagnose Sexual Abuse Not Liable For Malpractice Under Kansas Law 
Kansas doctors who mistakenly diagnose a case of child abuse are not liable for malpractice, a court has ruled. In a case of first impression, the Kansas Court of Appeals found that the Kansas law requiring health providers to report suspected cases of physical, mental or emotional abuse of children protects physicians and other health providers from civil liability. The case involved the parents of a nine-month-old girl who brought her to The University of Kansas Hospital for a respiratory infection. (Margolies, 1/10)

California Healthline: Merger May Revitalize California’s Flagging Effort To Pool Medical Records
After a sluggish start, the Cal INDEX medical database has agreed to a merger that would create one of the largest repositories of patient records in the country. The nonprofit California Integrated Data Exchange, launched by insurers Blue Shield of California and Anthem Inc. with much fanfare in 2014, announced Tuesday that it intends to merge with the Inland Empire Health Information Exchange. Together, they would have insurance claims and medical records of 16.7 million people. (Terhune, 1/10)

Denver Post: Denver Creates Potential For Competition In City Tax Dollars For Developmentally Disabled 
For a dozen years, Denver tax funds tagged for people with developmental disabilities have gone to one agency. That could change following a Denver City Council decision this week that allows the money — $14.5 million annually — to go to agencies other than Rocky Mountain Human Services. Rocky Mountain is one of 20 community-centered boards in Colorado that determine who is eligible for city, state and federal benefit money and help people with developmental and intellectual disabilities receive services, including family respite care, therapy and job training. The council’s vote was the latest of the changes regarding Rocky Mountain since a city audit in 2015 found egregious misspending, including that the agency was using more than 15 percent of mill levy funds for administrative costs. (Brown, 1/10)

The Star Tribune: Reports Of Abuse And Neglect Among Vulnerable Minnesotans Rise Sharply
Reports of abuse and neglect in state-licensed services for vulnerable Minnesotans increased sharply last year, new state figures show, a result of statewide reforms that make it easier to report maltreatment. Maltreatment reports for vulnerable adults and children rose 35 percent, to 4,373, in the year ending June 2016, predominantly among people receiving services in their homes and community, according to a recent state report. Reports of neglect, the largest category of maltreatment, rose a startling 43 percent. (Serres, 1/11)

Georgia Health News: 1,300 On List To Get Medical Marijuana
More than 1,300 people have been registered as medical cannabis patients in Georgia, state officials said Tuesday. That patient number has grown since the first Georgia medical marijuana registration card was issued in July 2015. Sheila Pierce of the Department of Public Health told the agency board Tuesday that 311 physicians have registered to certify patients for medical cannabis. (Miller, 1/10)

Tampa Bay Times: Pinellas County Considers Moratorium On Medical Marijuana 
Amid passionate pleas from residents, Pinellas County commissioners took the first step Tuesday to consider enacting a sixth-month moratorium on medical marijuana facilities in the county. With a tentative ordinance being considered, 12 residents offered reasons why commissioners should pass and reject the proposal. It's rare for 12 residents to speak on any issue before the board. (Puente ,1/10)

Milwaukee Journal Sentinel: Patient Care To Be Sold
Patient Care, a Milwaukee company that helps employees navigate the health care system, has agreed to be bought by DirectPath, the companies announced Tuesday. DirectPath, based in Birmingham, Ala., provides health-benefit services to companies. Patient Care, founded in 2001 by Jane Cooper, contracts with employers to help employees and family members navigate the health care system and provides information on health care prices. (Boulton, 1/10)

Prescription Drug Watch

Big Pharma To Spend Millions To Rebrand Image As 'More Lab Coat, Less Hoodie'

News outlets report on stories related to pharmaceutical drug pricing.

BuzzFeed: Here’s How Big Pharma Plans To Clean Up After Martin Shkreli
Martin Shkreli was everywhere last year. After hiking the price of an antiparasitic pill from $13.50 to $750 as the then-CEO of Turing Pharmaceuticals, the unapologetic, indicted, and widely reviled “pharma bro” helped ensure that the issue of skyrocketing drug prices made news almost daily. No wonder Stephen Ubl, who runs the pharma industry’s lobbying group, said that moving on from Shkreli and doing damage control are the top priorities for drug makers in 2017. (Lee, 1/10)

Stat: Pharma's Plan To Combat A Bad Rep: More Ads
The drug industry’s top lobbying group has a plan for the $100 million in extra dues it will soon be collecting from members: a stepped-up ad campaign highlighting just how hard it is to invent new treatments. PhRMA, which just raised its annual fees by 50 percent, is hoping to counter the industry’s worsening reputation, brought on but increased public scrutiny of escalating drug prices. One facet of that effort will be a national ad campaign, PhRMA President and CEO said Monday at the J.P. Morgan Healthcare Conference. (Garde, 1/9)

Stat: A Year After Scantily-Clad Model Scandal, Mixer During JPM Tries To Help Women In Biotech Advance
A year ago here at the drug industry’s annual confab, the investor relations firm LifeSci Advisors infamously sparked outrage when it hired models in tight dresses in an effort to bring gender balance to its party. Things were different this year at the JP Morgan Healthcare Conference. Instead of a throwing a party, LifeSci’s founder Michael Rice sponsored a Women In Bio networking mixer. In brief comments to a small group of mostly women who attended, he earnestly championed the industry’s female professionals and emphasized the need to promote them, as LifeSci has made it a priority to do for the past year. (Robbins, 1/11)

MarketWatch: If Trump Tries To Lower Drug Prices, ‘God Help Him,’ Says Top Medicare Official
President-elect Donald Trump said on the campaign trail that Medicare should negotiate for lower drug prices. “God help him,” Acting Centers for Medicare and Medicaid Administrator Andy Slavitt said at the JP Morgan Health Care Conference in San Francisco on Monday. “He’s not wrong, but you need a lot of ... to coin a phrase that’s been used, a fair amount of stamina if you are going to deal with the pharmaceutical industry on this topic.” (Court, 1/10)

The Wall Street Journal: ‘Take Your Medicine’ Is Big Pharma’s Best Prescription
It may be time for big pharma to revisit an old, familiar problem: helping patients adhere to prescription drug regimens. Last year was a relatively fallow one for new drug approvals while attempted price increases on drugs already on the market attracted unwanted attention from politicians and regulators. But improving patients’ ability to stick with doctor’s orders marks an area of opportunity for drug companies to generate growth. (Grant,1/10)

Stat: Today's New Drugs Come Through The Pipeline No Faster Than 20 Years Ago
New drugs are moving more quickly to market today compared with those launched during the height of the Great Recession, but the pipeline is no faster than it was two decades ago. That’s a key finding of a new report, released jointly on Monday by QuintilesIMS Institute and STAT, that illustrates shifting forces that have high stakes for drug innovation and pricing. The report, which analyzed the lifespans of 667 new drugs launched in the United States over the past two decades, was prepared independently by the QuintilesIMS Institute, in consultation with STAT. (Robbins, 1/9)

Stat: Biopharma Expects A Lot Of M&A This Year
Despite the outcomes of both the presidential election and the Brexit vote, this could be a banner year for biopharma mergers and acquisitions, according to two new reports. Biopharma valuations leveled off substantially in 2016, which sets the stage this year for several new divestitures and megadeals, according to a new report from consulting firm EY. (Keshavan, 1/9)

CNN Money: Trump Threat Fails To Halt Drug Price Hikes In 2017
Will Donald Trump target his Twitter cannon on drug companies next? The president-elect put the pharmaceutical industry on notice last month about rising drug prices. "I'm going to bring down drug prices," Trump told Time. The warning immediately sent biotech stocks tumbling. However, in the first few days of 2017, drug companies have already put in place a wave of significant price hikes, despite Trump's cautionary comments. (Egan, 1/4)

Stat: Joe Biden Says He'll Push Pharma Companies To Make Drugs Affordable
Vice President Joe Biden on Monday told a packed ballroom of biopharma investors and executives that after leaving the White House he plans to push their industry to make drugs affordable for patients. “We’re going to convene a national conversation with pharmaceutical companies— many of you who are here … biotech companies and others — to ensure patients can afford treatments,” Biden said. “Too many Americans are forced to sell their homes, to go into bankruptcy, so their loved ones can get care and hope for a cure. This needs to change while still not undermining the profit motive making sure there’s a genuine reward for effort.” (Scott and Robbins, 1/9)

The CT Mirror: How Can States Tackle Rising Medication Prices?
States have a range of options when it comes to tackling rising prescription drug prices, an expert told Connecticut policymakers Tuesday. There’s a bully-pulpit approach – think President-elect Donald J. Trump and the auto industry – or the more industry-friendly concept of tying payments to whether the drugs deliver value, like fewer hospitalizations. There’s proposing legislation to increase transparency in drug pricing, or treating certain medications as critical goods that should be regulated like water and electricity. (Levin Becker, 1/11)

Bloomberg: Cheating Death Can Cost $200,000 As Cancer Leads Sales
Years before becoming a top cancer specialist, Eric Winer used to save money on his own medical care by talking U.S. pharmacists into giving him expired treatments for free. Winer, who has a bleeding disorder known as hemophilia, knew the drugs would still work for a brief time after the official use-by date. The young physician was trying to stay within his insurer’s spending limit and avoid having to pay out of pocket one day. Decades later, he recollects that anxious time as he tries to make sense of the soaring prices of drugs for his own cancer patients. (Kresge, 1/6)

Bloomberg: Valeant Sells $2.1 Billion In Assets To Ease Debt Burden
Valeant Pharmaceuticals International Inc. agreed to sell about $2.1 billion in assets in two deals, an important first step in the struggling drugmaker’s endeavor to get cash and begin easing its debt burden. L’Oreal SA, the Paris-based cosmetic giant, will pay Valeant $1.3 billion for three skin-care brands, according to a statement Tuesday. Valeant will also sell its Dendreon Pharmaceuticals unit to closely held Chinese conglomerate Sanpower Group Co. for about $820 million. Valeant’s shares and bonds jumped after the news. (Serafino and Koch, 1/10)

Bloomberg: Drought Of Biotech IPOs As Health Investors Await Trump 
Where are all the biotech IPOs? Last quarter was the slowest three-month period for drug company initial public offering in four years, according to Bloomberg data. And in all of 2016, only 36 biotech and pharmaceutical companies went public in the U.S., according to data gathered by Bloomberg, compared with 68 in 2015 and a record 85 in 2014. The long drought comes ahead of the health-care industry’s biggest gathering of companies and investors, the J.P. Morgan Healthcare Conference in San Francisco, which begins Monday. The week before the massive conference typically serve as a launchpad for fresh offerings. This year? Nothing. (Chen, Barinka and Greifeld, 1/9)

The Washington Post: Drugmakers Question The Future Of Drug Prices Under Trump
The biggest biopharmaceutical event of the year kicks off this week as 450 health-care companies and thousands of investors descend on this city for a week of dealmaking, networking and trying to read the tea leaves for what President-elect Donald Trump will do — or not do — about drug prices. The J.P. Morgan Healthcare Conference, held Monday through Thursday, brings together leaders from across the health-care ecosystem: drug companies that are household names, up-and-comers trying to launch the next big medicine and insurers who help pay for it all. At packed sessions and investor meetings scattered across a soggy, rain-soaked city, hundreds of companies will set the tone for the next year. But they face an added layer of uncertainty this year, trying to divine what a president-elect who has been critical of high drug prices and vowed to repeal the Affordable Care Act will mean for business. (Johnson, 1/9)

The New York Times: Specialty Pharmacies Say Benefit Managers Are Squeezing Them Out
From its storefront in Union City, N.J., Prime Aid Pharmacy caters to patients with a wide range of ailments, from rheumatoid arthritis to hepatitis C. The business prides itself on getting patients their necessary drugs, employs a staff that speaks 10 languages and delivers medications by car in New York and New Jersey. “Especially during the winter, when mail deliveries don’t always get there on time, it’s very important to have local delivery,” said Yana Shtindler, the pharmacy’s administrator. But these days, Prime Aid is struggling to stay in business. (Thomas, 1/9)

Stat: Should Both Sanofi And Regeneron Drugs Remain Available?
As Sanofi prepares a do-or-die appeal to continue selling a pricey cholesterol drug, a key issue may turn on the extent to which patient access to the medicine is considered to be in the public interest. The drug maker and its partner, Regeneron Pharmaceuticals, lost a stunner when a federal court judge late Thursday issued a permanent injunction preventing the companies from marketing their Praluent injectable cholesterol medicine. The judge did so in response to a jury verdict last year that found the product infringed patents held by Amgen on its own drug, which is called Repatha. (Silverman, 1/6)

Stat: FDA Wants To Know: Do Docs And Consumers Recognize Fake Ads
Deceptive pharmaceutical advertising has popped up before, but now the US Food and Drug Administration wants to know the extent to which doctors and consumers can actually recognize misleading or false promotions. And so, the agency plans to run a pair of studies to find out, according to a Federal Register notice that ran on Wednesday. (Silverman, 1/6)

KGW: New Oregon Coalition To Fight Rising Drug Prices
Some of Oregon’s most influential political, consumer and labor groups are taking a stand against prescription drug costs. The new coalition, called Oregonians for Affordable Drug Prices, wants state lawmakers to take action. In a poll, the coalition found 80 percent of Oregonians feel prescription drug prices are too high. (Iboshi, 1/5)

Perspectives: A New Tactic For Lawmakers To Try: Put Patients' Needs Ahead Of Industry's Greed

Read recent commentaries about drug-cost issues.

Des Moines Register: Handing Money To Generic Drug Makers Won't Stop Price Spikes
Isla Weston was two months old when doctors diagnosed her with a life-threatening parasitic infection in May 2015. Without immediate intervention, the parasite would attack cells in her brain, potentially causing lifelong cognitive problems or death. The standard treatment is a one-year course of a drug called Daraprim. The cost per tablet is $750. That's expensive. Daraprim must be a new, miracle medicine sold by a drug company that poured millions of dollars into its development, right? (1/5)

Bloomberg: Takeda Takes The Hard Road
After watching its major stock index fall 21.7 percent in 2016, biotech both needs and expects some optimism-building deal action at the J.P. Morgan Healthcare Conference, which began on Monday in San Francisco. But Takeda Pharmaceutical Co. Ltd.'s purchase of cancer drugmaker Ariad Pharmaceuticals Inc. for about $4.66 billion -- at a 75 percent premium to Ariad's Friday share price, according to Monday's announcement -- was an unexpected kick-off. (Max Nisen, 1/10)

The Hill: Government Interference In Medicare Part D Endangers Seniors
This week, the U.S. Senate will hold a "Vote-A-Rama" session to consider dozens of amendments to the budget. One of these amendments would allow the government to negotiate the prices of medicines covered under the Medicare Part D prescription drug program. Proponents of the amendment believe using the government's purchasing power would lower the price of drugs, benefiting patients. This is incorrect. (Bob Blancato, 1/10)

Fayetteville Observer: Drug Research Under Threat
The Raleigh suburb of Clayton. The plant, which is specifically designed to manufacture diabetes medications, is further evidence that North Carolina has grown into one of the world's premier places for drug innovation. Statewide, researchers are testing experimental medicines in about 900 clinical trials, half of which target debilitating chronic diseases like cancer and heart disease. However, this research is now under threat from the federal government. (Ricky Duck, 1/7)

Editorials And Opinions

Perspectives On Repealing And Replacing; Timing Issues; And Detailing Some Obamacare Facts

Opinion writers around the country offer their thoughts on the ongoing debate about the GOP Congress' efforts to dismantle the 2010 health law and how -- because of the measure's sweeping nature -- their efforts are no easy task.

The Wall Street Journal: A Repeal And Replace Explainer
Every important legislative reform has Perils of Pauline moments, but the early Republican anxiety over ObamaCare repeal and replace is less than promising. Liberals want to label the effort a failure before the hard work even begins, and President-elect Trump and Congress need to swiftly unite around a better health-care alternative and a political strategy to pass it. (1/10)

The New York Times: Seven Questions About Health Reform
On Tuesday, Donald J. Trump said he wanted Congress to repeal the Affordable Care Act right away and replace it with a new plan “very shortly thereafter.” But before they abandon all the work that has gone into the health care law since 2010, President-elect Trump and Republicans in Congress owe Americans a detailed explanation of how they plan to replace it. They should not repeal the law until they have submitted their replacement proposal for analysis by nonpartisan authorities like the Congressional Budget Office and the Tax Policy Center to determine how it will affect health insurance coverage, state and federal finances and individual tax burdens. (Harold Pollack and Timothy S. Jost, 1/10)

The New York Times: Some Republicans Try To Head Off A Health Care Calamity
President-elect Donald Trump and other Republican leaders may be determined to repeal the Affordable Care Act immediately, but a few more sensible members of the party are now trying to slow down this runaway train. They recognize the danger in destroying a program that directly benefits 22 million Americans — and indirectly millions more by controlling costs — without a plan to replace it. That perhaps obvious insight has yet to penetrate Mr. Trump’s reality distortion field. (1/11)

The Washington Post: Where’s The GOP’s Health-Care Plan?
For six years, Republicans have voted more than 60 times to repeal and replace the Affordable Care Act. “Repeal and replace” was a staple of Donald Trump’s stump speech. Give us control, Republicans promised, and what Mike Pence promises as the “first order of business” will be repeal and replace. Only one problem: There is no plan. (Katrina vanden Heuvel, 1/10)

The Washington Post: Trump To GOP: Obamacare Is A Disaster, Right? So Hurry Up And Replace It, Already!
This morning, I speculated that Donald Trump might blow up the congressional GOP strategy of “repeal and delay” by insisting that Republicans stick to his insistence, made in a post-election interview, that repeal and replace be done “simultaneously.” Trump seemed reluctant to sign a repeal measure that leaves the Affordable Care Act’s replacement open to doubt — since, after all, he repeatedly promised to replace it with “something terrific,” and suggested this would be easy to do. Well, now Trump has indeed weighed in again along those lines. (Greg Sargent, 1/10)

The Des Moines Register: Your Health Insurance Is In Republicans' Hands
Last week President Barack Obama made a rare appearance on Capitol Hill for a closed-door meeting with Democrats. Don’t “rescue” Republicans when it comes to repealing and replacing the Affordable Care Act, he reportedly told them. “If they want to break this, they own it,” Sen. Chris Murphy, a Democrat from Connecticut, said shortly after the meeting. He is exactly right. (1/10)

Health Affairs: To Get Dems On Board With ACA Replacement, Republicans Should Take Medicare Off The Table
Republicans have expressed interest in repealing and replacing the Affordable Care Act (ACA), restructuring Medicare to a premium support model, and reforming Medicaid through either block grants or per capita caps. Taking on all three programs is an extremely heavy lift — both politically and legislatively. If it is improbable to do all three, Republicans should openly acknowledge that they are taking Medicare restructuring off the table. ... Without Medicare as a rallying point, Democrats would be forced to defend the Affordable Care Act (ACA) which is relatively unpopular and in need of reconsideration. Refusing to engage might not be in their political interest. (Rodney Whitlock, 1/10)

RealClear Health: The Bipartisan Healthcare Hope Of Repeal And Replace
After eight years Republicans are finally in a position to repeal the Affordable Care Act (ACA). Many caution that repeal without concomitant replacement will lead to chaos in the insurance markets with millions losing coverage. These fears are overstated. Yet replacement should accompany repeal for another reason -- to maximize the chance that a good replacement package can be enacted. (Joel Zinberg, 1/11)

The Wall Street Journal: ObamaCare Facts Are Stubborn Things
Even if we live in a post-truth culture, which I doubt, we do not live in a fact-free zone. Underneath politicians’ unending efforts to frame issues and events to their advantage resides a world that is what it is, however they may choose to describe it. When rhetoric and facts diverge, the world has a nasty habit of reasserting itself. This real world helps explain the emerging Republican shift on ObamaCare. (William A. Galston, 1/10)

USA Today: Obamacare Repeal Helps The Rich And Hurts The Poor
Republican plans to repeal the Affordable Care Act (Obamacare) threaten the health care of 30 million Americans and would erode some rare progress made recently to reverse America’s growing economic inequality. By taxing rich households and big corporations to subsidize health care for working families, the ACA does what good public policy should: level the playing field to give everyone a shot, not just those at the top. Abolishing the ACA would only further tilt the field in favor of the wealthy and well-connected. (Frank Clemente and Ron Pollack, 1/11)

The Columbus Dispatch: Let's See The GOP Health-Care Plan
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. But remember the second half of the Republican mantra — “replace.” Where is the detailed GOP plan to help millions of Americans who have coverage now under Obamacare? (1/11)

Chicago Tribune: Repealed, Replaced Or Tweaked, The Essence Of Obamacare Will Endure
When it was merely an impotent gesture of rage and contempt sure to be blocked or vetoed, Republican members of the House voted some 60 times to repeal or seriously undermine the ACA. Their chance to do it for real is nigh, and Trump pressed Tuesday afternoon for a repeal vote "probably sometime next week." I suspect they'll chicken out. (Eric Zorn, 1/10)

Seattle Times: Obamacare Expert: ‘This Couldn’t Be A More Republican Policy’
Every day, it seems, the incoming Republican-led administration issues a new target in its planned repeal of the ACA (otherwise known as Obamacare), which provides health care to an estimated 20 million people. ... [Daniel E. Dawes, an Atlanta-based health-care lawyer] is the executive director of health policy and external affairs at the Morehouse School of Medicine, and founder and chair of the National Working Group on Health Disparities and Health Reform. He literally wrote the book on Obamacare — and can’t understand why it’s under fire. Republicans have said — and have been saying for years — they will tear the health-care plan down to the studs and replace it with a plan of their own. But we haven’t seen a word of that plan, Dawes said. (Nicole Brodeur, 1/10)

Cincinnati Enquirer: Doctor: Affordable Care Act A Lifesaver
For most of the last 15 years, my clinical practice as a physician has been exclusively with homeless men, women and children. The work is both energizing and distressing, heartwarming and heartbreaking. In 2013, Ohio expanded Medicaid under the Affordable Care Act, and the lives of my patients changed dramatically for the better. Suddenly poor and sick adults who previously had to choose between medicine and food, or health care and housing, had an opportunity to have both. (Nancy Elder, 1/10)

Tampa Bay Times: How To Fix The Health Care Market 
The market impact is clear. When healthier people don't buy insurance, premiums stay high because the pool of people who do buy insurance is riskier and costlier overall. The result is expensive insurance and a large number of people who remain uninsured — around 40 million before the Affordable Care Act. (Alan Green, 1/10)

Viewpoints: Trump, Science And Vaccines; Firsthand Experience With The Opioid Epidemic

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

The Wall Street Journal: Ignore Anti-Vaccine Hysteria, Mr. Trump
The environmental activist Robert F. Kennedy Jr., a vaccine skeptic, told reporters Tuesday in the lobby of Trump Tower that the president-elect has asked him to lead a commission “to make sure we have scientific integrity in the vaccine process for efficacy and safety effects.” Mr. Kennedy also suggested that Donald Trump “has some doubts about the current vaccine policies” and that “we ought to be debating the science.” This is insane. (Alex Berezow and Hank Campbell, 1/10)

Bloomberg: Trump's Dangerous Ideas About Vaccines
Donald Trump's views on vaccines have long been out of sync with science. Childhood vaccines cause autism, he asserted at a debate in 2015, echoing statements he had made in 2014 and 2012. But now the president-elect is poised to do more than just pass along misinformation: He has asked a die-hard "anti-vaxxer" to lead a commission on "vaccination and scientific integrity." (1/10)

The Washington Post: I’ve Seen The Opioid Epidemic As A Cop. Living It As A Patient Has Been Even Worse.
A year ago, I woke in the night with pain so severe I was crying before I was fully aware what was going on. A 50-year-old cop sobbed like a child in the dark. It was a ruptured disc and related nerve damage. Within a couple of months, it became so severe that I could no longer walk or stand. An MRI later, my surgeon soothingly told me it would all be okay. He would take care of me; the pain would end. After surgery, I never saw that surgeon again. A nurse practitioner handed me a prescription for painkillers — 180 tablets, 90 each of oxycodone and hydrocodone. (Nick Selby, 1/11)

Green Bay Press Gazette Media: Fighting Opioid Abuse Takes Innovation
As a former deputy sheriff, state legislator and director of the Door/Kewaunee Drug Task Force, I have seen up close the impacts of the opioid abuse crisis and efforts to combat it. Unfortunately, the crisis has reached epidemic proportions here in Wisconsin. Opioid abuse-related deaths have more than tripled since 2003, and more than 600 people died in the last year from an overdose. Law enforcement, from police and correctional officers to forensic crime labs and court prosecutors, are on the front lines of this battle. (Garey Bies, 1/10)

Fortune: MIA In The Medical Revolution: A Sense Of Urgency
There was a moment yesterday when Vice President Joe Biden’s words got caught in his throat. ... Beau Biden had been the state of Delaware’s attorney general and a decorated veteran who had served in Iraq. In 2013, a few years after returning from the war, the forty-four year old was diagnosed with Stage 4 glioblastoma, a diagnosis that the vice president said his entire family “knew was the equivalent of a death sentence.” So Joe, the Dad, set out to learn everything he could about the disease during his son’s year-and-a-half fight to survive. “The most important thing I learned,” he recounted, “was that we’ve reached — you all have reached in science — an inflection point in cancer …. I found myself realizing that maybe, although we couldn’t save our son, that maybe we could …" That’s when the words disappeared for a long moment and a father’s grief took over. (Clifton Leaf, 1/10)

The New York Times: A Fix For Gender Bias In Health Care? Check.
When Dr. Elliott Haut and his team at Johns Hopkins Hospital in Baltimore designed their blood clot prevention protocol back in 2006, they didn’t expect to discover systemic gender bias. But the data were clear and the implications were alarming: Women who were trauma patients at Johns Hopkins Hospital were in considerably greater danger of dying of preventable blood clots than men. Why? Because doctors were less likely to provide them with the appropriate blood clot prevention treatment. (Jessica Nordell, 1/11)

The New York Times: My Life With Paralysis, It’s A Workout
The alarm goes off at 4:30 a.m. Groggy, I turn on the lamp on my night stand and try to sit up. I put my right hand on the wall next to my bed to steady myself, and push my left into the bed. Right away, my abs and back seize up and my legs spasm and kick out straight, forcing me back down onto the bed. Clearly my body thinks it is too early to get up, but I don’t have time to argue with it. I have to get physical therapy out of the way so I can be on time for my medieval history class. (Valerie Piro, 1/11)

Miami Herald: Shut The Door On Medicare Scammers 
Miami-Dade will present President-elect Donald Trump’s administration with a unique international crime-and-punishment problem. The crime is the defrauding of taxpayer-funded Medicare. The corruption is being carried out here in Miami-Dade County by Cuban nationals recently arrived from their homeland. But the ability to punish these scammers is elusive. (1/10)

Arizona Republic: Season For Sharing: Giving Veterans The Help They Need
The average rental subsidy provided to military veterans through a Season for Sharing grant is about $200, which may not seem like much. But it was enough for a veteran to cover rent when he had a heart attack. It was enough for another veteran to purchase an airline ticket home. The support meant being able to recuperate and not have to worry about where the rent would come from, and being able to attend a daughter's funeral. (Carrie Walters, 1/10)