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President Donald Trump on Tuesday promised big wins in the next stretch of his administration, glossing past the reality that the political newcomer will celebrate his first 100 days without a major legislative victory. In a speech that could be seen as a messaging test for that milestone, Trump hailed the opening days of his administration as a wild success and pledged to quickly deliver on health care, tax reform and infrastructure. (McCaskill, 4/18)

Health care dominated U.S. Sen. Chuck Grassley’s town meeting on Tuesday, as southeast Iowa constituents pressed him on insurance affordability and challenged him to embrace a single-payer solution. Congress is currently considering several proposals with the potential to lower insurance premiums, Grassley said, while a single-payer system in which government supplants private insurers is a nonstarter.  One woman described to Grassley how the insurance plan her family bought on the state’s Affordable Care Act exchange rose from $1,400 to $2,200 per month – and will go away altogether in 2018. (Noble, 4/18)

Allies of President Donald Trump this week are targeting Congressman Scott Tipton of Colorado with a new TV ad that uses an unusual tactic — reverse psychology — to get him to support a second effort to repeal and replace the Affordable Care Act. The 30-second spot, paid for by the Trump-aligned group America First Policies, urges viewers to call Tipton and thank him for “his courage and for standing with President Trump to repeal Obamacare now.” The oddity comes from the fact that Tipton, R-Cortez, was the only House Republican from Colorado to publicly declare that he would have voted against the GOP health-care plan that collapsed last month — telling The Daily Sentinel in Grand Junction afterward that he was opposed to the legislation. (Mattews, 4/18)

Since the Affordable Care Act was formally launched in 2014, taxpayers have had to check a box on line 61 of their 1040 federal tax returns declaring whether they or members of their family have qualified health insurance -- and provide documentation to prove it. This was required as part of Obamacare’s “individual mandate” to make nearly everyone without insurance eventually sign up. (Pianin, 4/18)

HHS Secretary Tom Price is facing a stark test of whether to keep Obamacare insurance markets afloat until Republicans come up with a potential alternative — a dilemma triggered by health plans fleeing 16 counties around Knoxville, Tenn. (Haberkorn and Pradhan, 4/18)

Insurers lost hundreds of millions of dollars figuring out how to cover Texans under Obamacare. The industry's painful lesson could be for naught if Republicans make good on their promise to scrap the law and upend the plans' carefully calibrated remedies. (Rayasam and Demko, 4/18)