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Gov. Rick Snyder wants Republican President-elect Donald Trump and the GOP-led Congress to spare Michigan’s unique form of Medicaid expansion as they consider dismantling the Affordable Care Act, calling it a “successful” program that could serve as a national model. ... Snyder and Michigan’s GOP-led Legislature signed off on Medicaid expansion in 2013 but added unique requirements for recipients who earn between 100 and 133 percent of the poverty level, including Health Savings Account contributions and co-pays that can be reduced through healthy behaviors. (Oosting, 1/4)

[Joshua] Lapp is deeply worried about the push by President-elect Donald Trump and congressional Republican leaders to rapidly repeal the ACA and then craft a replacement system over the next several years. He's particularly nervous about whether the individual market he depends on will collapse in the interim, and whether Republicans will adequately replace the ACA's ban on insurance discrimination against people with pre-existing conditions like his. He and other young entrepreneurs don't like that the GOP repeal-and-delay strategy will leave them hanging in insurance limbo for several years. “If it's repealed, I might have to go back to working for a bigger employer,” he said. “The prospect of losing my business because I'm losing my insurance is sort of ridiculous to me.” (Meyer, 12/31)

As top Republicans see it, a medical malpractice crisis is threatening U.S. health care: Frivolous lawsuits are driving up malpractice insurance premiums and forcing physicians out of business. Doctors and hospitals live in fear of litigation, ordering excessive tests and treatments that make health care unaffordable for Americans. That’s why Republican House Speaker Paul Ryan and Rep. Tom Price, tapped to be the nation’s top health official by President-elect Donald Trump, are vowing to make tort reform a key part of their replacement plan for the Affordable Care Act. (Terhune, 1/4)

[April] Bean is part of the roughly 15 percent of Tennesseans who shop for a marketplace plan but don't qualify for tax credits. She'll be paying the full cost of the premium — and the deductible before insurance covers anything — so she's trying to take a different route: She's applied for an underwritten plan from Farm Bureau Health Plan in the individual "off-exchange" market. The premium is lower and the deductible is about $2,000. There are some unknowns: her application could be rejected for pre-existing conditions, and she might be facing a penalty from the Internal Revenue Service come tax season in 2018. [Fletcher, 1/3)