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House Speaker Paul Ryan called on Republicans Wednesday to unify and stop fighting each other as he tried steering his fractious party into an election year devoid of the collisions between conservatives and pragmatists that transformed parts of 2015 into a GOP nightmare. "We have to be straight with each other and more importantly, we have to be straight with the American people," Ryan, R-Wis., said at a Heritage Action for America policy meeting. "We can't promise that we can repeal Obamacare when a guy with the last name Obama is president. All that does is set us up for failure and disappointment and recriminations." (2/3)

A long-simmering dispute over how the Obama administration applied the Affordable Care Act to members of Congress and some of their staff has been revived and could hang up the confirmation of a new federal personnel chief. In advance of the scheduled Thursday confirmation hearing for Beth Cobert to become Office of Personnel Management director, Sen. David Vitter (R-La.) raised the prospect of putting a hold on her nomination. (Yoder, 2/4)

Federal officials on Wednesday outlined a plan to improve care at hospitals that treat Native Americans in four Great Plains states, including creating a multi-agency group to focus on quality and patient safety and designating a single organization to accredit Indian Health Service hospitals. The U.S. Department of Health and Human Services detailed the steps ahead of a Senate committee hearing on Wednesday afternoon in Washington that'll discuss the quality of care at IHS hospitals in the region. (2/3)

Senate testimony Wednesday painted a grim picture of the poor healthcare afforded Great Plains Indians — caught in a federal system plagued by substandard medical facilities and persistent problems in attracting health professionals. Despite promised reforms, three Indian Health Service hospitals in the four-state region are listed as seriously deficient by inspectors from the Centers for Medicare and Medicaid Services — leading to the sudden pre-Christmas closing of a critical emergency room facility in South Dakota. (Rogers, 2/3)

Government officials tangled on Wednesday over who was to blame for the crisis in Flint, Michigan, that allowed lead-contaminated water to flow to thousands of residents at a combative congressional hearing that devolved into a partisan fight over witnesses and no-shows. “A failure of epic proportions,” said Rep. Jason Chaffetz, R-Utah, chairman of the House Oversight and Government Reform Committee at the first Capitol Hill hearing since the crisis in Flint emerged last year. (Daly, 3/3)