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Confronted with the rising popularity of the Affordable Care Act, the White House, Congress and Republican governors are grappling with disparate strategies to repeal, replace or repair it. The confusion is increasingly disruptive to the individual insurance business, which has come to rely on Obamacare subsidies and rules. During this period of uncertainty, the Trump administration needs to ensure there's a working system in place when future policy is finally decided. (3/1)

President Trump in recent days has declared ObamaCare a “disaster” and suggested “nobody knew that health care could be so complicated.” Yet more than a month after taking the oath of office he still hasn’t announced a detailed plan to repeal and replace the Affordable Care Act. During his address Tuesday night to a joint session of Congress Mr. Trump stuck mostly to standard Republican talking points. Which raises a question: What would a truly populist approach to health-care reform look like? (Clark Havighurst, 3/1)

The health-care goals President Donald Trump mentioned in his address to a joint session of Congress Tuesday night were a high-water mark for policy specificity from this president. But that mark was a low bar. The lack of detail was still glaring, and Trump either skirted the alligators lurking in the morass of Affordable Care Act repeal and replacement, or just poked them with a long stick. The process remains as chaotic as ever. That's a threat to health insurers who focus narrowly on government programs. It may also hurt those who don't.  (Max Nisen, 3/1)

In a speech thin on policy specifics Tuesday, President Trump did mention one wonky term worth watching: tax credits. He outlined a five-point plan for health reform that was largely aspirational, and probably consistent with the goals of nearly every Republican listening. But the issue of tax credits is actually an important dividing line in the Republican caucus. And it represents a break from Mr. Trump’s own position during the campaign. (Margot Sanger-Katz, 3/1)

In January, Vadim Kondratyuk, a 26-year-old truck driver from California, died suddenly after harmful bacteria from a cavity spread to his lungs. He left behind a wife and two daughters. Cavities are a serious but overlooked problem in the United States. About half of all children have cavities, making them the country’s most common childhood disease. Unfortunately, health proposals under consideration by the Trump administration and Republican leaders in Congress could make the situation worse, with devastating consequences for millions of poor Americans. (Donald L. Chi, 3/1)

Proposals in Congress to turn Medicare into a voucher system would take health care in precisely the wrong direction - pushing up costs for current and future retirees, and eroding protections that Americans have earned through many years of hard work and taxes. Yet, in a short-sighted attempt to save money, vouchers are now being promoted on Capitol Hill as an answer to rising costs. (Candi Williams, 2/28)

Medicare has been a literal lifesaver for tens of millions of Americans, who might have died from a lack of medical care or fallen into dire poverty without it. With Social Security as another safety net (first payments made in 1940), the plain truth is that people are alive today, with a measure (however small) of security and safety they wouldn’t have otherwise. ... I don’t care for the views of steely-eyed “reformers” like House Speaker Paul Ryan, the young man from Wisconsin who appears to flirt with reforming Medicare and Social Security, “entitlement programs” they’re called, in the name of balanced budgets. We hear of phrases like “privatization,” or “raising ages,” or “reducing benefits” so as to “preserve” these programs. (Jim Jenkins, 3/1)

House Speaker Paul Ryan, R-Wis., long has wanted to change the way the federal government allocates money to Medicaid, the federal-state health program for children, the disabled, the poor and nursing home patients. Instead of paying for everyone who’s eligible, Ryan wants to give states block grants and let politicians decide how to spend them. Now that there’s a Republican in the White House — albeit one whose latest promise is to leave Medicaid and Social Security alone — Ryan’s block grant idea is getting some serious attention. It’s a terrible idea that would wreak havoc on millions of Americans. (3/1)

In a recent JAMA Forum, the authors discuss the Republican rationale for Medicaid reform, 2 specific Republican proposals, and some policy implications that result from these proposals. Although I agree with much of the analysis, it ignores a key difference between how Medicaid is nominally structured versus how it has actually been operating over the past several decades. An awareness of this difference may provide a more complete understanding of why Republicans seek to reform Medicaid through block grants. (Gail Wilensky, 3/1)