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Some Republican senators have introduced a bill they say could be a basis for bipartisan compromise on Obamacare. The basic idea is to hand the program’s money over to the states, and let them decide how to spend it. In many ways, it’s a typical Republican proposal. ... But the proposal also has two interesting twists. One is that state officials could choose to stick with the Affordable Care Act’s coverage scheme, or something very close to it, if that’s what they prefer. The other is that, at least provisionally, it leaves Obamacare’s taxes in place. (Jonathan Cohn and Laura Barron-Lopez, 1/23)

The 21st Century Cures Act, which President Obama signed Dec. 13, focuses mainly on helping patients obtain breakthrough drugs and medical devices. But it also includes provisions that will give small employers—those with fewer than 50 workers—more flexibility in the insurance marketplace. As Republicans debate how to replace ObamaCare, giving that same flexibility to all employers would be a perfect place to start. (John C. Goodman, 1/23)

Republicans see high-risk pools run by states playing a central role in their Affordable Care Act replacement plans as a fallback option for sick people who do not have insurance or lose coverage. Based on experience in the states, it’s clear that these pools will need to operate differently and be funded much more fully than they have been in the past if the sickest people who fall through the cracks are to be protected. (Drew Altman, 1/23)

As Donald Trump starts his first week as president, how he and congressional Republicans plan to proceed on their first priority of repealing and replacing the Affordable Care Act remains a mystery—even to Republicans. ... Some Republicans and nearly all healthcare stakeholders think the GOP better have some replacement plan ready very soon because Congress already passed a budget blueprint that could lead to expedited legislation to repeal the ACA on a party-line vote as soon as next month. “It's really irresponsible to repeal the law with no consensus on replacement, because you're playing games with people's lives,” said J.B. Silvers, a professor of healthcare finance at Case Western Reserve University and former health plan CEO. (Harris Meyer, 1/23)

Now that President Trump is in the Oval Office, thousands of American lives that were previously protected by provisions of the Affordable Care Act are in danger. For more than 30 years, we have studied how death rates are affected by changes in health-care coverage, and we’re convinced that an ACA repeal could cause tens of thousands of deaths annually. The story is in the data: The biggest and most definitive study of what happens to death rates when Medicaid coverage is expanded, published in the New England Journal of Medicine, found that for every 455 people who gained coverage across several states, one life was saved per year. Applying that figure to even a conservative estimate of 20 million losing coverage in the event of an ACA repeal yields an estimate of 43,956 deaths annually. (David Himmelstein and Steffie Woolhandler, 1/23)

It’s easy to feel neutral toward a program you have no experience with, but to me, Medicaid, the federal program that funds health care for nearly 70 million Americans in need, means a lot. Both of my children were delivered with Medi-Cal (California’s jointly administered Medicaid program) benefits, and they relied on those same benefits growing up. As a young mother in nursing school, I’m not sure how else I would have paid for my own health care. And now, looking back on a career of providing health care as a nurse, I’m more worried than ever for the future of our country’s health-care system. (Rita Lewis, 1/24)

No one is better positioned to see how the health care system is working — and how it can be improved — than the doctors, nurses, and support staff on the front lines. Clinical professionals understand the strengths and weaknesses of the law because they’ve had to live and work within the requirements of the Affordable Care Act. So they should have a say in its fate, or at least its replacement. (Rebecca Kolins Givan, 1/23)

The biggest mistake of [Barack] Obama’s presidency was punting health care “reform” to Congress. While he wanted to remain postpartisan after a historic campaign and stay out of the fight, Democrats on Capitol Hill argued over the specifics and took more than a year to get something to his desk. ... If Obama had been more assertive in the legislative process from the beginning and hit the campaign trail to highlight the benefits of Obamacare before the midterm elections, history may have been written differently. (Nathan Gonzales, 1/24)

My friend, Ms. C., had worked as a city bus driver for nearly 25 years when she lost her job in 2012. Nearing 60, she couldn’t find another, and her insurance coverage lapsed. Without insurance, she could no longer see her doctor or take her blood pressure medications. She wound up in the emergency room with dangerously high blood pressure and chest pain. Fortunately for her, she was able to get insurance under the Affordable Care Act, and get her blood pressure under control. She is in good company: As my colleagues and I found in a new study published in the Annals of Internal Medicine, she is one of 4 million American adults with chronic diseases who gained coverage under the ACA in its first year. (Nicole Mushero, 1/23)

The debate on repealing Obamacare has rightly focused on all those Americans who would be hurt – the estimated 18 million who could lose their health insurance in the first year. But there should be more attention on those who could benefit right away – the super rich who would get a huge tax cut. At the same time, millions of Americans – including 1.2 million Californians – would lose tax credits on health insurance premiums they now get under the Affordable Care Act. (1/23)

For all of its faults, former President Obama’s signature [health] law did accomplish one thing: it provided health coverage to some 20 million Americans who were previously not covered. It is critical to understand that most of this new coverage came from expanded Medicaid programs at the state level; not because of other aspects of this law that are more controversial. ... Is it possible to hold onto Medicaid-related coverage at the state level as the ACA is replaced? I think it’s possible, but Tennessee must prepare. (Rep. Michael Curcio, 1/23)

The swearing in of Donald Trump as president provides states with the best chance since the creation of Medicaid in 1965 to have meaningful control over the program. Now is the time for all Tennesseans to come together to design the best Medicaid program for our state. Regardless of our past views on Medicaid expansion, we must work together to seize this opportunity. (Republican Tenn. State Sen. Brian Kelsey, 1/22)