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The Senate early Friday approved the nomination of Representative Tom Price to be secretary of health and human services, putting him in charge of President Trump’s efforts to dismantle the Affordable Care Act. By a vote of 52 to 47, the Senate confirmed Mr. Price, Republican of Georgia, after a debate that focused as much on his ethics and investments as on his views on health policy. (Pear and Kaplan, 2/10)

Democrats prolonged the debate on the 62-year-old Price until nearly 2 a.m. Friday, in arguments tinged with bitter accusations, reflecting the raw feelings enveloping Washington early in Trump's presidency. Just four of 31 votes for then-President Barack Obama's Cabinet vacancies drew at least 40 "no" votes, as did only two of 34 votes for Cabinet positions under President George W. Bush. (2/10)

Lacking the votes to defeat his confirmation, Democrats instead marshaled a war of words. They used the hours leading to the 2 a.m. roll call to read testimonials from Americans with severe, expensive-to-treat illnesses and gratitude to the ACA, Medicare or Medicaid — cornerstones of federal health policy that the Democrats accused the nominee of wanting to undermine. Sen. Bernie Sanders (I-Vt.), who as a 2016 presidential candidate energized many progressive voters, accused the White House of hypocrisy. President Trump, he contended, had campaigned on promises not to cut the nation’s main entitlement programs but then chose as his HHS secretary a congressman who has long sought to weaken them. (Goldstein and Sullivan, 2/10)

Democrats view Price as a polarizing figure with a controversial history of trading health care stocks and whose policies will snatch insurance coverage from Americans. "He seems to have no higher priority than to terminate health coverage for millions of people,” said Sen. Jeanne Shaheen, D-N.H. She said his preference for limiting women’s access to free birth control was "not only wrong, it’s arrogant." (Hjelmgaard, 2/10)

“Make no mistake: In the dark hours of the early morning, with the confirmation of Secretary Price, the Republicans launch the first assault in the war on seniors,” said Senate Minority Leader Chuck Schumer (D-N.Y.). (Carney, 2/10)

Price, a former orthopedic surgeon and longtime ally of House Speaker Paul D. Ryan (R-Wis.), has been a leading champion of the repeal campaign and a favorite of the Republican base. He was an early supporter of the tea party movement and has sponsored legislation to overhaul the healthcare system, scaling back Medicaid and replacing Obamacare’s insurance marketplaces. (Levey, 2/9)

Mr. Price is also expected to follow through on an executive order, issued by Mr. Trump on the first day of his administration, directing federal agencies to pare back regulatory elements of the ACA in ways that don’t require congressional action. There is little evidence of action on that front so far, but Mr. Price’s installation could change that. One rule he could overturn, for example, is the Obama administration’s mandate that health plans include contraceptive coverage at no cost to the patient, a protection that isn’t explicitly written into the law. (Hackman, 2/10)

[T]he bitter opposition to Price’s nomination — which culminated with Democrats delaying a final vote for nearly 30 hours — served as a preview of the fight to come over the future of American health care. And Price could well start that fight immediately by using his authority as secretary to roll back or not enforce select pieces of Obamacare — the mandated benefit package, perhaps, or the hot-button birth control coverage rules. (Cancryn, 2/10)

Democrats also highlighted Price’s stock trades, which they said toed congressional insider trading laws and were misrepresented in Price’s testimony before two Senate committees. “The stock trades Congressman Price made while working on healthcare policy raise serious ethical and legal questions that deserve further inquiry,” said Oregon Democrat Ron Wyden, who previously pushed for ethics investigations into the timing of Price’s stock trades. (Hallerman, 2/10)

With Price's confirmation, HHS now has as its leader a budget hawk who has proposed replacing the Affordable Care Act subsidies that are tied to income, with tax credits to purchase insurance. Tax credits are not determined by an individual's income level. (Kodjak, 2/10)

After a bruising confirmation process, the Senate has confirmed Rep. Tom Price, R-Ga., to head up the Department of Health and Human Services. As secretary, Price will have significant authority to rewrite the rules for the Affordable Care Act, some of which are reportedly nearly ready to be issued. But there is much more now within Price’s purview, as head of an with a budget of more than $1 trillion for the current fiscal year. (Rovner, 2/10)

Confirmation of Rep. Tom Price gives President Donald Trump his desired point man for replacing Obamacare. Now what? ... Price, the Georgia Republican, is expected to hit the ground running as secretary of Health and Human Services, taking advantage of the fact that the 2010 health care overhaul gave significant discretion to the executive branch in implementation, meaning that HHS should be able to quickly ease coverage mandates and change eligibility requirements for those people seeking to join plans outside enrollment. (Lesniewski, 2/10)

The Senate Finance Committee is expected to hold a confirmation hearing next week for Seema Verma, President Donald Trump’s pick to head the Centers for Medicare and Medicaid Services, Chairman Orrin Hatch told Morning Consult on Thursday. ... Verma will likely face heavy scrutiny from Democrats for her work on conservative reforms to several state Medicaid programs. (McIntire, 2/9)

More than 12.2 million people have signed up for coverage nationwide this year under the Obama-era health care law even with the uncertainty created by President Donald Trump's vow to repeal and replace it. A count by The Associated Press shows that many consumers returned to the program despite its problems. Aside from the political turmoil, those difficulties include a spike in premiums, rising deductibles and dwindling choice of insurers. (2/10)

A record number of residents signed up for private insurance this year through Minnesota's health exchange, officials said Thursday, attributing the spike in part to uncertainty over the federal health care law and a novel state program that offsets skyrocketing premiums. MNsure, the health exchange Minnesota created through the federal Affordable Care Act, signed up more than 117,000 people during the three-month open enrollment period for 2017 that ended Jan. 31. (2/9)

Minnesota’s individual health insurance market isn’t in the clear yet.Tens of thousands of Minnesotans who purchased health insurance in 2016 are apparently going without this year, beset by soaring premiums, shrinking provider networks and political uncertainty about the future of health coverage. This poses a big risk not just for those individuals trying to make it through 2017 without health insurance but also to the unstable market they leave behind. (Montgomery, 2/9)

In leading the debate on the fate of President Barack Obama’s health care law one day last month, Democrat John Yarmuth of Kentucky confronted Republicans by citing the potential losses in jobs, gross state product, business output, as well as state and local tax revenues if the law were to be repealed.  The numbers, from a study by the Milken Institute School of Public Health at George Washington University, sounded devastating on the House floor, but the authors acknowledged that they didn’t take into account any replacement for the law that Republicans might enact. (Rosen, 2/13)

Associations for doctors are mainly sitting on the fence on Republicans’ plans to repeal and replace the 2010 health care law, neither endorsing nor condemning the GOP strategy, even though many have forcefully defended the law in the past. That approach could help them maintain their leverage to lobby on the GOP plans going forward. But there are some outliers, like the American College of Physicians, the trade group for internists, which has spoken out directly in opposition.The positions taken by the American Medical Association and the American Academy of Pediatrics are more typical. (Kelly, 2/13)

Premiums for Obamacare plans sold by New Mexico Health Connections could rise as little as 7 percent next year, says Martin Hickey, the insurance company’s CEO. Or they might soar as much as 40 percent, he said. It all depends on what happens in Washington. Such is the vast uncertainty about how the Trump administration and Republican-controlled Congress are approaching their promises to repeal, repair and replace the Affordable Care Act. (Hancock, 2/9)

Republicans in Congress made repealing the Affordable Care Act a priority during the first days of the new administration. But President Trump now says it may take until next year to repeal the law better known as "Obamacare." One of the architects of the ACA, former U.S. Secretary of Health and Human Services Kathleen Sebelius, says Republicans risk destroying the health insurance marketplace if they move too fast to gut the law without an adequate replacement on hand. (Hobson, 2/9)

The Trump administration has started removing language praising the Affordable Care Act from federal websites. It has made several changes to the online pages of the Health & Human Services Department, which oversees the law. Visitors to the federal Obamacare exchange, healthcare.gov, can still click on a link titled "About the Affordable Care Act." (Luhby, 2/9)

Jamie Gluch lumbered into the kitchen and pulled from the freezer a bag of corn, the only affordable analgesic he had for his swollen face. ... Gluch’s tooth had rotted weeks before, but seeing a dentist was an unthinkable expense after car trouble sucked up the family’s savings. The Gluchs had hoped it wouldn’t come to this — a car or a tooth — when former president Barack Obama announced his health-care plan years ago. But then Idaho chose not to expand Medicaid, as the law allowed, and then Idahoans chose not to come up with their own plan, even though state leaders keep trying. (Samuels, 2/9)

Ask anyone about their health care and you are likely to hear about ailments, doctors, maybe costs and insurance hassles. Most people don’t go straight from “my health” to a political debate, and yet that is what our country has been embroiled in for almost a decade. A study out Thursday tries to set aside the politics to examine how the insurance markets function and what makes or breaks them in five specific states. (O'Neill, 2/10)

California earns top marks as a model of how health care insurance exchanges can be run, according to a Brookings Institution analysis released Thursday. The report compared California’s state-run marketplace, Covered California, with health care exchanges under the Affordable Care Act in four other states: Florida, Michigan, North Carolina and Texas. Some states, like California, embraced the mandatory health program, while Texas and Florida actively opposed it, the study noted. (Buck, 2/9)

Last April, doctors told David Ponder, a 57-year-old gospel musician living near San Diego, that his heart was going to fail. He had already had quadruple bypass surgery; without a full transplant he and his music would likely die within months. Three months later, with the help of the National Academy of Recording Arts and Sciences’ MusiCares charity, he had a new heart. With it came a renewed faith in his music, his beliefs — and the necessity of the Affordable Care Act. (Brown, 2/9)

A hospital trade group is warning that if ObamaCare is repealed without a replacement, hospitals across the country would lose billions of dollars in funding. America’s Essential Hospitals (AEH), a trade group that represents hospitals serving low-income communities, released a report Thursday detailing $40.5 billion in potential losses from 2018 through 2026 if congressional Republicans repeal ObamaCare without a comparable replacement. (Hellmann, 2/9)

Town halls held by Republican Reps. Diane Black of Tennessee and Justin Amash of Michigan on Thursday also drew big numbers and tough questions. At earlier home-district events in states including Colorado, Florida, Virginia and California, GOP House members were surprised by rowdy crowds, often declaring support for the Affordable Care Act, which Republicans have vowed to repeal. The protests, some organized by activists, recall the opposition early in the Obama administration to that same Democratic-sponsored health-care law. That gave birth to the tea-party movement—a parallel not lost on some protesters. (Tau, 2/10)

Hundreds packed into a school auditorium Thursday evening for the chance to pose — and in many cases shout — questions to Republican U.S. Rep. Justin Amash of Michigan. ... Perhaps the most contentions moments at the town hall were created by questions about the future of the Affordable Care Act. Paul Bonis stood from his first-row seat and gave an impassioned endorsement of the federal health law, before telling Amash: "I am also a cancer survivor. I am scared to death that I will not have health insurance in the future." (Household, 2/10)

Instead of getting defensive or ducking for cover, though, the 36-year-old Michigan lawmaker leaned in, coolly explaining his position on the health care law. He made a point of trying to connect with the overwhelmingly Democratic room, jabbing President Donald Trump for what he called racially insensitive remarks and overreaching policies. Amash seemed to enjoy the give-and-take so much that he stayed 40 minutes longer than scheduled and promised to book an even bigger venue next time. It was a jarring juxtaposition from the hunkered-down, protective posture many GOP lawmakers have assumed in recent weeks as Democrats storm their town hall meetings and congressional offices. (Bade, 2/10)

Jessi Bohon, a 35-year-old high school teacher who lives in Cookeville, Tennessee, was visibly emotional as she stood up and posed her question. "As a Christian, my whole philosophy in life is pull up the unfortunate," Bohon said, a comment that drew verbal affirmation from others in the room. "The individual mandate: that's what it does. The healthy people pull up the sick." Bohon went on to ask how Congress could be OK with "punishing our sickest people" rather than trying to "fix what's wrong with Obamacare," the sweeping healthcare law that covers 20 million Americans. (Lee and Bradner, 2/10)

Anthem Inc. on Thursday appealed a federal judge’s decision to block its acquisition of Cigna Corp., but the future of the deal was unclear amid discord between the two partners. On Wednesday, U.S. District Judge Amy Berman Jackson said the proposed $48 billion deal between the two health insurers violated federal antitrust law because it would create an unacceptable reduction in the number of companies able to serve large multistate employers that offer insurance to their workers. (Wilde Mathews, 2/9)

In her ruling, Judge Amy Berman Jackson of the D.C. District Court sided with antitrust regulators in saying the merger would lead to a domination of employer-provided health coverage in the U.S. (Hellmann, 2/9)

“The company promptly intends to file a notice of appeal and request an expedited hearing of its appeal to reverse the Court’s decision so that Anthem may move forward with the merger, which was approved by over 99 percent of the votes cast by the shareholders of both companies,” Anthem said in a statement. (Radelat, 2/9)

Anthem and Cigna may have one fight left. Their $54 billion deal was nixed on Wednesday by a federal judge, who agreed with the Justice Department’s concerns about competition. In addition to fighting the government, the two health insurers had been squabbling with each other over the merger. That suggests that the payment of the breakup fee could be contentious, too. (Cyran, 2/9)

The relationship between Anthem and Cigna has deteriorated since the deal was struck a year and a half ago and even factored into the judge's decision. U.S. District Judge Amy Berman Jackson wrote that the animosity between the two was “the elephant in the room.” (Livingston, 2/9)

Although judges shot down Anthem Inc's $54 billion acquisition of Cigna Corp and Aetna Inc's $35 billion takeover of Humana Inc on anti-trust grounds, the rulings left scope for a possible combination of Cigna and Humana, industry insiders said. Cigna would have both the motives and finances to pursue an acquisition of Humana, these experts suggested. Because of its much smaller Medicare Advantage business, Cigna may have a better shot at winning a regulatory green light, they added. (O'Donnell, 2/9)

The Big Five are still the Big Five. After two years of merger talks, blockbuster deals and legal fights, the same five companies still dominate the national health insurance market. And despite being thwarted by courts, their push to consolidate in friendly or hostile deals remains strong, as the companies seek to exert leverage in negotiations with hospitals and doctors. (Demko, 2/9)

The proposed $48 billion merger between insurance giants Anthem and Cigna looks like it's dead, as does the $37 billion deal between Aetna and Humana, though Aetna said it will appeal. In both cases, federal judges ruled the mergers would hurt consumers, eliminating competition and driving up prices. So what now for four of the nation's five largest health insurers? These companies have billions on hand, and they've got to do something with it. (Gorenstein, 2/9)

Zenefits is laying off nearly half its staff as the software startup grapples with the fallout of insurance violations that resulted in hefty penalties from state regulators. The company, which offers free human-resources software to manage benefits and payroll while making its money as an insurance broker, said on Thursday that 430 employees would lose their jobs. That leaves 4-year-old Zenefits with about 500 employees, roughly a third of what it had a year ago. (Somerville, 2/9)

In a memo to staff, the company’s new chief executive, Jay Fulcher, wrote that “in 2015, the company grew too quickly, hiring employees to support revenue projections that far surpass where we are today. Today’s action aligns our costs more closely to our business realities.” (Winkler, 2/9)

Zenefits faced accusations that it allowed unlicensed employees to handle insurance transactions and failed to meet insurance agent education requirements. It eventually paid $3.7 million to settle the charges. (Livingston, 2/9)

Scientists may have figured out part of the reason why mosquitoes are drawn to people infected with malaria. Mosquitoes prefer biting people already sickened by malaria, apparently attracted by some kind of odor. Now, Swedish researchers say they’ve identified a substance pumped out by malaria parasites that triggers that smell, noticeable only to mosquitoes. (2/9)

California health officials are again warning winter travelers headed for Mexico to take precautions against the Zika virus, after an Ensenada man was reported testing positive for the mosquito-borne disease... Many Mexican states with popular tourist destinations, including Baja California and Sonora, near the Arizona border, continue to see reports of local Zika transmissions. The case in Ensenada, which is about 76 miles south of San Diego, was reported by Mexican officials this week. (Buck, 2/9)

Residents of the New Mexico village of Tularosa have long said those living near the site of the world's first atomic bomb test in 1945 weren't told about the dangers or compensated for their resulting health problems. Since then, they say, descendants have been plagued with cancer and other illnesses while the federal government ignored their plight. (2/9)

Hundreds of people with bullet fragments lodged in their bodies have suffered lead poisoning from the slugs, including several people who have extremely elevated levels of the highly toxic metal in their blood, health authorities reported Thursday. Researchers from the Centers for Disease Control and Prevention found 457 gunshot-wound victims with elevated levels of lead in their blood when they looked at reports from 41 states between 2003 and 2012. Seventeen people had blood lead levels more than 16 times the limit recommended by the CDC. (Bernstein, 2/9)

Lung cancer screening rates have barely budged in recent years, according to a new study, even though under the health law many people don’t have to pay anything out-of-pocket for them because the test is recommended by a panel of prevention experts. In 2010, just 3.3 percent of eligible smokers surveyed said they had received a low-dose computed tomography scan in the past year to check for lung cancer. In 2015, the percentage had inched up to 3.9 percent, or 262,700 people out of 6.8 million who were eligible. (Andrews, 2/10)

Two weeks  after New Jersey announced it was the first state to embark on an effort to make safe-sleep baby boxes available to all new and expectant parents, program leaders say nearly 12,000 people have visited the informational website that is at the heart of the initiative. The website, BabyBoxUniversity.com, includes articles about safe infant sleeping practices as well as information from several states, including New Jersey's safe sleeping syllabus. By  taking about 15 minutes  to review the course and complete a short quiz, Garden State parents qualify for a free baby box that serves as a portable crib and comes stocked with infant supplies. They can have it sent to their home or pick it up at locations including Cooper University Hospital. (Giordano, 2/10)

If a suspicious mammogram turns out to be a false alarm, the experience can change the woman's attitude toward breast cancer screening. A number of studies have found that women follow screening recommendations even more closely after a "false positive" mammogram, though ruling out cancer requires them to return for additional breast X-rays and, occasionally, a biopsy. But a large new study by Chicago researchers found just the opposite reaction. Compared with women whose mammograms correctly detected no cancer, those with false positives were more likely to delay their next breast-squishing exam -- or to stop showing up. (McCullough, 2/9)

Ohio abortion opponents will lobby state lawmakers to ban a common second trimester abortion procedure as part of its mission to chip away at abortion rights until the practice is illegal nationwide. Ohio Right to Life, the state's largest anti-abortion group, wants to eliminate dilation and evacuation, an abortion method typically used between 13 and 24 weeks of pregnancy. The proposed "Dismemberment Abortion Ban" is one of six pieces of abortion legislation the group plans to work on with lawmakers in the GOP-controlled General Assembly. (Borchardt, 2/9)

Arkansas would become the eighth state to ban abortions based solely on whether a woman wants to have a girl or a boy under a measure a House panel approved Thursday that is part of a Republican agenda that started with the party's takeover of the Legislature four years ago. Opponents said the measure is unconstitutional. Supporters said the ban on so-called sex-selection abortions would have a minimal effect because most abortions occur before the gender is known. (2/9)

Battle lines are drawn in this round of the Legislature's perennial fight over reproductive health care. Abortion rights groups and Democratic lawmakers are mapping out their strategy as Republicans work on legislation to further restrict the procedure in Texas. (Evans and Pollock, 2/9)

Colorado House Democrats on Thursday rejected two Republican-sponsored abortion bills and were expected to beat back one more, the most restrictive of which would have made it a crime for a physician to perform an abortion in most cases. The hearing stretched late into the night, with testimony from dozens of people, including medical experts, activists on both sides and women who had had abortions and later regretted it. Ten hours into the hearing, just two of the three bills had been voted on. (Eason, 2/9)

Even after the Supreme Court case Roe v. Wade legalized abortion at a federal level in 1973, states have since reserved the right to place regulations and restriction on the process — and Missouri has several such rules... In addition to the threats of cuts in federal funding to organizations like Planned Parenthood, hospitals in Missouri and other healthcare centers that perform abortions are also facing cuts to their Medicaid funding from the state due to a budget amendment introduced last year, as St. Louis Public Radio’s Durrie Bouscaren reported last month. (Moffitt, 2/9)

After President Trump blocked U.S. aid money from supporting any group that provides or "promotes" abortion in other countries, The Netherlands announced it would launch a fundraising initiative to support any affected organizations. Now, several other countries — including Sweden, Finland, Belgium and Canada — have signaled their participation. (Domonoske, 2/9)

Legislation that mandates Georgia health insurance agents be paid a commission for all sales passed the state House on Thursday.  House Bill 64 is the second attempt from state Rep. Shaw Blackmon, R-Bonaire, to protect agents. It passed the House by a vote of 172-1. (Gould Sheinin, 2/9)

Colorado’s attorney general has given her blessing to the proposed sale of Rocky Mountain Health Plans, a Western Slope insurer, to UnitedHealthcare. In an opinion issued Thursday, Attorney General Cynthia Coffman wrote that she had concluded the sale can proceed legally. Rocky Mountain Health Plans is a nonprofit, and the sale will require it to convert to a for-profit company and leave the proceeds of the sale — some $36 million, according to Coffman’s opinion — to the Rocky Mountain Health Plans Foundation, which will use that money for charitable projects on the Western Slope. (Ingold, 2/9)

Texas nurse practitioners are once again seeking independence from costly agreements that require them to sign contracts with doctors in order to treat and write prescriptions for their patients. State Rep. Stephanie Klick, R-Fort Worth, introduced House Bill 1415 Thursday, saying the bill would get rid of so-called prescriptive authority agreements that require nurse practitioners — who have advanced degrees in a nursing speciality — to pay up to six-figure fees to "delegating" doctors. (Alfaro, 2/9)

Supervisor Jane Kim is working on legislation to require that San Francisco pick up the tab for birth control for any woman living in the city whose free prescription stands to be cut off under President Trump. While Trump has so far focused mostly on immigration policy and working himself into a lather over “Saturday Night Live” skits, Kim said she is bracing for an anticipated crackdown on birth control access from the new administration. (Knight, 2/9)

State officials have decided to end the state-funded subsidies that since 2014 had helped Flint residents pay their water bills after the city's water system became contaminated with lead. Word of the subsidies' impending cutoff surfaced Thursday after a senior adviser to Gov. Rick Snyder sent a letter to Flint’s interim chief financial officer, saying the subsidies will stop after Feb. 28, according to a news release from the City of Flint. The reaction of Flint's mayor and other city officials was mild, characterizing the governor's decision as a sign that the city's water quality had improved although they stopped short of saying it was entirely safe. (Laitner and Zaniewski, 2/9)

A torrent of civil lawsuits over alleged sexual abuse by a former employee of the Department of Veterans Affairs hospital in Leavenworth is expected now that a federal judge has refused to dismiss one of the cases. Three more lawsuits were filed this week in federal court, bringing the total to 15 so far, and dozens more are expected to be filed in coming months. The suits by military veterans accuse Mark E. Wisner, a one-time physician’s assistant at the hospital who held himself out as a doctor, of sexually molesting them during physical exams. (Margolies, 2/9)

A bill that would restrict the funds available to Planned Parenthood clinics operating in Virginia has passed a state Senate committee. House Bill 2264, sponsored by Del. Benjamin L. Cline, R-Rockbridge, does not mention Planned Parenthood by name but proposes to restrict the state’s Department of Health from providing any funds to a Virginia clinic that provides abortions that are not covered by the state’s Medicaid program. (Demeria, 2/9)

Trump’s order was designed to stop terrorists and others who would commit violence in the United States. But it has also ensnared a highly educated community of Iranian scholars, researchers, and professionals who, over the last century of immigration, have risen to the top echelons of Boston’s academic, health care, and high-tech institutions. (Levenson, 2/10)

LCMC Health, the not-for-profit, academic health care system that includes Children's Hospital and University Medical Center in New Orleans, has purchased Fairway Medical Center in western St. Tammany Parish. LCMC Health bought the surgical hospital near Mandeville in partnership with several local, specialty surgeons, the system announced Thursday (Feb. 9). The joint ownership is effective immediately. In addition to Children's Hospital and the University Medical Center, LCMC is also comprised of New Orleans East Hospital, Touro Infirmary and West Jefferson Medical Center. The purchase price was not disclosed. (Chatelain, 2/9)

Humana, Florida’s largest Medicare managed-care company, says it will lay off hundreds of employees in April, including 328 in Florida. Of those, 260 are in the Tampa Bay area, according to Humana spokeswoman Nancy Hanewickel. (Gentry, 2/9)

[W]e examined patterns of health care use and spending by wage category during 2014 among 42,936 employees of four self-insured employers enrolled in a private health insurance exchange. When demographics and other characteristics were controlled for, employees in the lowest-wage group had half the usage of preventive care (19 percent versus 38 percent), nearly twice the hospital admission rate (31 individuals per 1,000 versus 17 per 1,000), more than four times the rate of avoidable admissions (4.3 individuals per 1,000 versus 0.9 per 1,000), and more than three times the rate of emergency department visits (370 individuals per 1,000 versus 120 per 1,000) relative to top-wage-group earners. (Sherman et al., 2/6)

This study used national survey data to test for differences between members of minority groups and non-Hispanic white workers in the risk of workplace injuries and the prevalence of work-related disabilities. Non-Hispanic black workers and foreign-born Hispanic workers worked in jobs with the highest injury risk, on average, even after adjustment for education and sex. These elevated levels of workplace injury risk led to a significant increase in the prevalence of work-related disabilities for non-Hispanic black and foreign-born Hispanic workers. These findings suggest that disparities in economic opportunities expose members of minority groups to increased risk of workplace injury and disability. (Seabury, Terp and Boden, 2/6)

We examined the complex relationship among work, health, and health insurance .... Stagnation or deterioration in employment conditions and wages ... has been accompanied by the erosion of health outcomes and employer-sponsored insurance coverage. ... we present data and discuss the research that has established these links, and we assess the potential impact of policy responses to the evolving landscape of work and health. The expansion of insurance availability under the Affordable Care Act may have helped reduce the burden on employers to provide health insurance. However, the act’s encouragement of wellness programs has uncertain potential to help contain the rising costs of employer-sponsored health benefits. (Buchmueller and Valletta, 2/6)

This brief draws on 2015 federal data on health centers and our 2016 Survey of Health Centers’ Experiences and Activities under the Affordable Care Act to provide a snapshot of health centers and their patients, analyze recent changes, and compare the experience of health centers in Medicaid expansion and non-expansion states. ... Key findings include: Health centers are a core source of primary care in the U.S., particularly for Medicaid beneficiaries and uninsured people. ... The Medicaid expansion strengthened health center finances and capacity. ... Health centers report increased numbers of insured patients who are unable to pay their deductibles and cost-sharing. (Paradise et al., 1/18)

This brief provides estimates of self-reported access to contraception among women at risk of unintended pregnancy and perceptions of the role of birth control in women’s lives. Most women are using contraception, the full cost of which is usually covered by health insurance or another program. Yet, some women report barriers to contraception access, many of which are related to cost. The majority of women agree that birth control has a positive effect on women’s lives. (Johnston, Courtot and Kenney, 1/23)

On January 23, President Donald Trump reinstated the Mexico City Policy via presidential memorandum. This explainer provides an overview of the policy’s history and how it has been applied in the past. ... The policy requires foreign non-governmental organizations (NGOs) to certify that they will not “perform or actively promote abortion as a method of family planning,” using funds from any source (including non-U.S. funds), as a condition for receiving U.S. government global family planning assistance and, as of Jan. 23, 2017, any other U.S. global health assistance. (1/23)

A study at UCSD's School of Medicine found that an incentive to increase patient risk scores could lead Medicare to overpay Medicare Advantage (MA) plans by roughly $200 billion over the next ten years. ... The problem is they provide more benefits when they enroll a patient expected to use a large volume of medical services and less when plans enroll low risk patients. For example, spending is expected to be greater for an 85-year-old than for a 65-year-old, and greater for a patient with heart disease or diabetes, said university officials. (Pollack, 2/6)

It’s bad enough that President Trump confined his Cabinet search to members of the 1%. But it’s particularly galling that his choice for secretary of the Department of Health and Human Services — an agency vital to poor and infirm Americans — may have used his congressional office to expand his personal fortune. That nominee — Rep. Tom Price (R-Ga.), an orthopedic surgeon who has served on two House committees that help shape healthcare policy — invested in more than half a dozen healthcare-industry companies even as he took steps as a legislator that benefited them. That’s a clear conflict of interest, and if Trump honestly wanted to drain the swamp of self-serving elites in Washington, he would have withdrawn Price’s nomination as soon as Price’s investing habits came to light. (2/9)

When Dave Hoppe recalls his first big health-care fight, one memory stands out. It was the summer of 1994, and Sen. George Mitchell, the Democratic majority leader, had canceled August recess to force a debate over his party’s health-care monster: HillaryCare. Senators weren’t happy about losing their break, remembers Mr. Hoppe, who at the time was an aide. “And yet, Republican senators were lining up in the cloakroom; they couldn’t wait to get to the floor,” he says. “They knew this issue. They’d studied it. They were better informed than Democrats about HillaryCare. There was such an esprit de corps. It was energizing.” (Kimberley A. Strassel, 2/9)

With the debate about the Affordable Care Act drawing so much scrutiny, a broader Republican agenda to fundamentally change the federal role in health care is flying under the radar. It’s the most important issue in health care we are not debating. Many Republicans in Congress want to convert Medicaid to a block-grant program and transform Medicare from a plan that guarantees care into one in which seniors would receive a set amount of money to purchase coverage. Meanwhile, Republicans would replace existing subsidies for premiums under the ACA with less generous tax credits — all while eliminating the expansion of Medicaid that enables states to cover low-income childless adults. (Drew Altman, 2/9)

Vicki Hopper, a constituent of Rep. Tom Price (R-Ga.) from Roswell, Ga., lost her job two years ago but has kept her insurance through the Obamacare exchange. She says the price is “high, but affordable” since the subsidy cuts her payment to $370 per month. On Wednesday, she met with staffers in the offices of  Sens. David Perdue (R-Ga.) and Johnny Isakson (R-Ga.). “I told them you just can’t repeal it fully,” she told me. “There’ll be chaos.” She’s convinced Republicans won’t really go through with repeal. (Jennifer Rubin, 2/9)

In the debate about the fate of the Affordable Care Act, one indispensable cog in our nation’s health care system has thus far been ignored — the safety net. These are the community health centers, public hospitals, clinics and programs that never turn anyone away, regardless of the ability to pay. They provide family planning to women and primary care to public housing residents. They serve homeless families, people with TB and AIDS and hemophilia, coal miners with black lung and those in the grip of opiate addiction. (Henry A. Waxman, 2/9)

Although there are still exceptions, Florida is no longer home to the flood of nursing home horror stories that Sunshine State residents heard so frequently, and from so many homes, in the early '80s. ... This may all be about to change. Earlier this month, AHCA submitted a plan to the governor and the Legislature for a new approach to nursing home Medicaid payments. The plan is intended to establish an equitable payment system that includes incentives for high-quality care, simplifies the payment process, controls costs and makes legislators' budgeting for Medicaid spending on nursing homes more predictable. What the plan will actually do is penalize the nursing homes that for the last three decades have invested in delivering the highest quality of care possible, while rewarding homes that have remained at the bottom of the quality barrel. (Steve Bahmer, 2/9)

Medicaid expansion cleared its first key hurdle this week when Wichita Rep. Dan Hawkins, the chairman of the House Health and Human Services Committee, agreed to allow a debate and committee vote next week. Committee members should heed the compelling testimony they heard and send a bill to the full House. (2/10)

Medicare is steadily shifting from volume-based fee-for-service payments to value-based payment models, including accountable care organizations, episode-based bundled payments, and penalties for hospitals with relatively high Medicare readmission rates.1 These models typically provide financial bonuses or penalties related to the efficiency and quality of care, thereby shifting more financial risk to hospitals, medical groups, and other providers. Through a star rating system, bonuses are also provided to high-quality health plans in the Medicare Advantage program. (Melinda B. Buntin and John Z. Ayanian, 2/9)

Early evidence suggests that bundled payments reduce the cost of knee replacements by an average of almost $1200 per procedure. With a million such procedures performed in a year, that reduction could save over $1 billion. Moreover, these savings don’t seem to come at the expense of quality, at least as far as we can tell. ... Same quality at a lower price – who could be against that?! Well, caution is in order. Healthcare systems that enrolled in the bundled payment system increased the number of knee replacements they performed – about three procedures more per hospital. (Peter Ubel, 2/10)

Sorry (not sorry) if this comes across as condescending, but I’m running out of ways to describe what should be self-evident: Nobody is “pro-abortion.” Aside from a few psychotics, nobody wants there to be more abortions. In that sense, the recent Women’s March and The March for Life were both anti-abortion demonstrations. That’s what I think many are not getting or, rather, choosing not to get. (Coleman Larkin, 2/9)

“Policymakers should be loath to tamper, even at the edges, with [the] elegantly balanced system of free-market drug development in the United States – one that encourages innovation and investment while generally working to stabilize prices at their lowest level possible.” Those words, written by the National Taxpayers Union (NTU) in a letter to Congress just two weeks ago, were meant to express opposition to a prescription drug importation scheme proposed as an amendment to the Senate’s FY 2017 Budget Resolution. Yet, they also apply to a number of other developments about federal policy toward pharmaceuticals. (Peter Sepp, 2/10)

Physicians have a special vantage point from which they can see the way that poverty, housing insecurity, a lack of health insurance, and other factors affect health. But most don’t know what to do with this information, or envision how they can make a difference. To create a truly healthy America, we need a new kind of medical training, one that prepares physicians for roles as health advocates. (Gaurab Basu and Danny McCormick, 2/9)

Some trials testing whether statins could reverse Alzheimer’s failed to produce conclusive evidence. But they did not address whether taking statins decades before Alzheimer’s symptoms arise might prevent the disease. Pharmaceutical companies lack the incentive to pay for expensive clinical trials to get older drugs approved for new uses. Why? Because many of them, like statins, are already off-patent, meaning they are sold at a low price. (Julie Zissimopolous, 2/9)

No, the city of Santa Cruz is NOT considering whether to hand out free methamphetamine to homeless people. A flier is circulating around town, complete with city logo, announcing the City Council will consider the proposal at its upcoming meeting. It’s a hoax, surf city officials insist, spread by a group opposed to Santa Cruz’s controversial outdoor sleeping ban. (Prodis Sulek, 2/9)