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Congress’s rush to dismantle the Affordable Care Act, once seemingly unstoppable, is flagging badly as Republicans struggle to come up with a replacement and a key senator has declared that the effort is more a repair job than a demolition. “It is more accurate to say ‘repair Obamacare,’” Senator Lamar Alexander, Republican of Tennessee and chairman of the Senate health committee, said this week. “We can repair the individual market, and that is a good place to start.” (Pear and Abelson, 2/2)

While insisting they've not abandoned their goal of repealing President Barack Obama's health care overhaul, Republicans are increasingly talking about "repairing" it as they grapple with disunity, drooping momentum and uneasy voters. The GOP triumphantly shoved a budget through Congress three weeks ago that gave committees until Jan. 27 to write bills dismantling the law and substituting a Republican plan. Everyone knew that deadline was soft, but now leaders are talking instead about moving initial legislation by early spring. (Fram and Alonso-Zaldivar, 2/3)

Two top Republicans long expected to lead the Senate’s role in repealing the Affordable Care Act said publicly this week that they are open to repairing former president Barack Obama’s landmark health-care law ahead of a wholesale repeal, which has been a GOP target for eight years. Coming one week after a closed-door strategy session in which Republicans expressed frank concerns about the political ramifications of repealing the law and the practical difficulties of doing so, statements this week by Sen. Orrin G. Hatch (R-Utah) and Sen. Lamar Alexander (R-Tenn.) brought into public view the political and policy challenges the GOP is facing. (Snell and DeBonis, 2/2)

The first legislative effort to make changes to Obamacare got underway in the U.S. House of Representatives, the beginning of what is expected to be a long and contentious process. The House Energy and Commerce Committee’s health panel is examining drafts of four bills Thursday that will likely serve as a basis for some of Republicans’ earliest moves to replace pieces of the massive health-care law that they’ve vowed to repeal. (Edney, 2/2)

Two top House conservatives are calling on Republican leadership to bring up for a vote the ObamaCare repeal bill that passed early last year, worrying that the party could pass a smaller bill that repeals less of the law. The bill that passed early last year and was vetoed by President Obama repeals many core elements of ObamaCare, including its subsidies, mandates, taxes and Medicaid expansion. (Sullivan, 2/2)

The chairman of the House Freedom Caucus and the conservative group’s former chair are calling for a vote on a 2015 bill that would repeal the Affordable Care Act, suggesting an emerging rift between conservatives and GOP leaders over how quickly to act on former President Barack Obama’s signature health care law. Republican leaders, including President Donald Trump, have emphasized taking time to craft a replacement plan for Obamacare before overturning the law. (McIntire, 2/2)

Vice President Pence on Thursday reaffirmed the Trump administration’s commitment to repeal and replace the Affordable Care Act amid calls from Republican lawmakers to merely "repair" the healthcare law. “We are absolutely committed to follow through on President Trump’s directive to repeal and replace ObamaCare and to have the Congress do it at the same time,” Pence told Fox News host Sean Hannity. “The president’s made it very clear we are having ongoing discussions with leadership, with the House and Senate. But this is the president’s leadership, Sean, I've got to tell you,” he continued. (Greenwood, 2/27)

The Energy and Commerce Health Subcommittee discussed drafts of four bills which each address piecemeal issues within the larger Affordable Care Act, including how to deal with people who have pre-existing health conditions, how much more to charge seniors compared to young people, and how to spur people to keep continuous coverage throughout their lives. Many Republicans, including Committee Chair Rep. Greg Walden (R-Ore.), have said that they won’t put forward one major Obamacare replacement bill but will instead replace the law with a set of smaller measures. (McIntire, 2/2)

Republicans have begun considering a handful of bills that could make up part of their plan to replace ObamaCare. The House Energy and Commerce Committee, a key player in the fight over ObamaCare, is considering legislation that will likely serve as guidance for the GOP as lawmakers seek to dismantle the healthcare law they vowed to repeal.   The drafts would change ObamaCare provisions related to pre-existing conditions and the age rating, which determines how much older people can be charged for insurance. (Hellmann, 2/2)

On Thursday, the Centers for Medicare and Medicaid Services, part of the Department of Health and Human Services, sent a proposed rule on shoring up the individual insurance market under the ACA to the Office of Management and Budget for White House review. The details of what the proposed rule would do still aren’t public, but people involved in the drafting of the proposal say it aims to help bolster the ACA exchange markets at least in the short term. That doesn’t suggest a full reversal of Republicans’ repeal-and-replace strategy, but GOP lawmakers say they are now considering moves to retain and prop up important parts of the law while they consider larger changes. (Armour, Peterson and Hackman, 2/2)

They are just three little words — “health savings accounts” — but they are generating a lot of buzz as Republicans contemplate plans to repeal and replace the Affordable Care Act. Expanding the use of such accounts, based on a long-held conservative view that consumers should be more responsible for their health care spending, is part of almost every GOP replacement plan under consideration on Capitol Hill. (Appleby, 2/3)

A powerful House lawmaker said he would push for legislation to stymie drug price-gouging by encouraging development of generic copies, after attending a meeting at the White House Tuesday with drug-company executives. Rep. Greg Walden (R., Ore.), chairman of the House Energy and Commerce Committee, announced at a hearing Thursday his support for a bill that was introduced last year largely with Democrat support but then languished. (Rockoff, 2/2)

The bill, which mirrors a similar effort that was introduced last year but languished, would provide incentives to drug makers to develop generics when there is a lack of competition or a shortage exists. The bill would allow the Department of Health and Human Services to review an application for a drug within six months and expedite inspection of any facility that would make the medicine. (Silverman, 2/2)

"Specifically the bill will require the [Food and Drug Administration] to prioritize, expedite and review generic applications of drug products that are currently in shortage, or where there are few manufacturers on the market," Walden said. (Hellmann, 2/2)

“President Trump made it clear in the White House meeting I attended with him and Vice President Pence: He wants competition that will bring lower drug prices and that is precisely what this measure will accomplish,” Walden said at an Energy and Commerce Health Subcommittee hearing, referring to a White House meeting with pharmaceutical executives. (McIntire, 2/2)

Drug companies often offer coupons or vouchers to take the sting out of certain medications' high price tags. But one Democratic lawmaker says such offers actually contribute to high healthcare costs — and is proposing legislation to limit their use. Assemblyman Jim Wood (D-Healdsburg) has introduced a measure that would prohibit the use of coupons for medications when there are cheaper drug options available. (Mason, 2/2)

[M]ore states are adopting policies that prevent insurers from ceasing to cover a medication in the middle of the year, when a patient is still locked in to a particular plan, unless there is a good medical reason for doing so. The laws also limit midyear increases in what patients must pay for a drug. In the last two years, California and Nevada have adopted such rules. Florida is considering and Tennessee is expected to consider similar legislation this year, and Massachusetts has created a commission to explore the idea. (Ollove, 2/2)

The House of Representatives approved its first effort of the new Congress to roll back gun regulations, voting to overturn a rule that would bar gun ownership by some who have been deemed mentally impaired by the Social Security Administration. The House voted 235-180 largely along party lines Thursday to repeal an Obama-era rule requiring the Social Security Administration to send records of some beneficiaries to the federal firearms background check system after they’ve been deemed mentally incapable of managing their financial affairs. (Gaudiano, 2/2)

Gun-control advocates say the rule was meant to affect only those found to have a mental illness that makes them a danger to themselves or others, but was written too broadly. The rule didn’t make certain people ineligible to buy a firearm, but was designed to ensure the background check system was comprehensive, accurate and flagged those already deemed ineligible. “We would oppose any efforts to undermine that,” said Kristin Brown, chief strategy officer for the Brady Campaign to Prevent Gun Violence. (Pane, 2/3)

Leading members of the University of Kansas Health System asked Kansas lawmakers Thursday to let them continue banning concealed handguns from the Kansas City, Kan., hospital and other buildings where they treat patients. Those guns will be allowed in the health system’s buildings starting in July unless the law is changed. (Woodall, 2/2)

The University of Kansas Hospital today will go it alone in trying to get the Legislature to roll back a law that would allow almost anyone to carry a concealed gun in almost any public building. The hospital is backing a bill (HB 2150) that carves out the facility in Kansas City, Kansas, even if lawmakers decide to let the concealed carry bill take effect on July 1. The measure does not carve out the adjoining KU Medical Center campus. (Zeff, 2/2)

President Trump's nominee to be the nation's top health official introduced legislation last May that benefited a health company he had recently invested in. The $15,000 purchase of shares in McKesson is but the latest financial action raising questions about possible conflicts of interest during the confirmation battle over Rep. Tom Price, R-Ga.  The orthopedic surgeon was approved by the Senate Finance Committee on Wednesday and his nomination will soon be voted on by the full Senate. (O'Donnell, 2/2)

The Senate on Thursday moved a step closer toward confirming the nomination of Rep. Tom Price to lead federal medical programs in a vote that split along party lines. As the likely next secretary of Health and Human Services, Price will help lead GOP efforts to undo and revise the terms of the Obama administration’s expansion of medical insurance coverage. The Senate voted 51-48 on a motion to proceed to executive session and allow consideration of the nomination of Price, a Georgia Republican, to lead HHS. Senate Majority Leader Mitch McConnell, R-Ky., then filed a debate-limiting cloture motion on the nomination, setting up a key procedural vote possibly as soon as next week.  (Young, 2/2)

Sen. Claire McCaskill will vote against Rep. Tom Price to become secretary of health and human services. Price, a medical doctor who has served in the House since 2005, would lead the department that oversees Medicaid, Medicare and is tasked with overseeing several aspects of the Affordable Care Act. McCaskill, D-Mo., said she would oppose Price because he didn't satisfactorily answer for his past proposals, which include turning Medicaid into a block-grant program. (Aton, 2/2)

For decades, foreign-born doctors like Rehman, Jumaa and Ali have played a vital role in shoring up American’s health care system. The doctors come to the United States for residency, drawn by cutting edge medical training and American ideals, then stay to fill the country’s growing need for doctors. But Trump’s executive order this week — and worries it may expand to other countries, such as Pakistan — has touched off a wave of anxiety, anger and dire predictions that immigrant doctors, faced with hostility or uncertainty, may go somewhere else. (Allen, 2/2)

There’s a big problem with doctors in rural areas — there aren’t enough to go around. One solution has been to hire foreign-born doctors, which is why President Donald Trump’s recent immigration ban has a lot of people in rural areas worried. How will this reduce the number of available physicians and other medical professionals when there’s already a shortage? (Dan Gorenstein, 2/2)

Hundreds of medical professionals are calling on the prominent Cleveland Clinic hospital system to cut its perceived ties to President Trump in light of a contentious executive order that has temporarily banned people from seven Muslim-majority countries from entering or returning to the United States — including a resident at the clinic. Doctors, nurses and students have signed an open letter pleading with the clinic to publicly condemn Trump's immigration ban and use its power to protect medical professionals from deportation. The letter also urges the hospital system to cancel a fundraiser set for later this month at Trump's Mar-a-Lago resort in Palm Beach, Fla. (Bever and Bernstein, 2/2)

About two dozen Cleveland Clinic doctors gathered this morning to show their support for colleague Dr. Suha Abushamma, a resident who was detained and unable to return to the United States over the weekend due to President Trump's executive order on immigration. Holding photos of Abushamma and signs reading "#BringSuhaBack," the group stood silently in the Clinic's Miller Pavilion at 7 a.m., only speaking to say the pledge of allegiance. (Zeltner, 2/2)

The White House schedule Friday calls for President Donald Trump to meet with prominent CEOs, including the Cleveland Clinic's Dr. Toby Cosgrove. Some call this Trump's CEO kitchen cabinet, and the group -- officially called the President's Strategic and Policy Forum -- was formed in December, before Trump was inaugurated and started signing executive orders. The council is supposed to advise Trump on ways in which this country can spur faster economic growth, expand technology and boost employment. Politic are not directly on its agenda. Regulation, taxes, trade and women in the workforce are. (Koff, 2/2)

Dr. Mohamed Abdalla is a nephrology fellow at Case Western Reserve University, a Sudan native and a permanent U.S. resident. For now, he knows he can stay in the United States, but President Donald Trump's ban on travel from seven Muslim majority countries has him worried about himself, his family and scores of others already here or with plans to emigrate here. (Heisig, 2/3)

Refugees across the US face similar strain as they seek to assimilate into their new homes. In a new effort to quantify the stress, researchers from Wayne State University — many of whom are themselves former refugees — are conducting psychological evaluations, stress tests, and genetic analyses on hundreds of new arrivals. The goal: To identify and measure the problems they face, and then to develop low-cost interventions to help. Home visits or phone calls with multilingual social workers, for instance, might ease stress — and help the refugees feel less alone. (Keshavan, 2/3)

The revelation by his longtime doctor that President Trump takes a medication to prevent hair loss has piqued curiosity about the drug. In an interview with The New York Times, the physician, Dr. Harold N. Bornstein, said that Mr. Trump takes finasteride, also marketed as Propecia. The drug, a one-a-day pill, is a popular treatment for so-called male-pattern hair loss, in which the hairline recedes and hair thins at the temples and crown, sometimes to the point of leaving just a horseshoe-shaped fringe around the sides and the back of the head. (Grady, 2/2)

The criticism of vaccines voiced by President Trump and some other public figures is at odds with the attitudes of most Americans, who overwhelmingly support requiring public school children to be vaccinated for measles, mumps and rubella, according to a Pew Research Center survey released Thursday. Overall, 82 percent of Americans support requiring students in public schools to be vaccinated for those three diseases. In addition, the survey found, their perceptions of the benefits of that combination vaccine are strongly positive, with about 88 percent saying the benefits outweigh any risks. About 73 percent of Americans see high preventive health benefits, and 66 percent say there is a low risk of side effects. (Sun, 2/2)

Many worry that up to 1 million Illinois consumers could lose their health insurance if Obamacare is repealed. But Chicago Department of Public Health leaders aren't just worried about that part of the Affordable Care Act being repealed. They're also concerned about the possible loss of funds used to vaccinate Chicagoans and deal with disease outbreaks. The Prevention and Public Health Fund created under the health care law has distributed about $12.8 million to the city's Department of Public Health since 2012 for programs to vaccinate thousands of Chicagoans and educate consumers on diseases, among other things. (Schencker, 2/2)

Cigna Corp. became the latest insurer to say it will review its participation in Affordable Care Act exchanges this spring, as it watches for what steps Republicans will take as they move to overhaul the health law. Cigna, which offers plans in seven states’ ACA marketplaces, said it expects its individual-plan enrollment of 168,000 to grow by about 100,000 this year. The insurer has been losing money on the ACA plans and said it still won’t be profitable in 2017, but the company expects some improvement. In the future, the results will either improve or Cigna will pull out of marketplaces, said Cigna Chief Executive David Cordani during a call with analysts. (Wilde Mathews and Hufford, 2/2)

Cigna's profit dropped 10.5% in the fourth quarter of 2016, despite building revenue from membership growth and higher premiums and fees. ... The lower results were largely due to higher medical costs from customers enrolled in its Medicaid and individual Affordable Care Act exchange plans. Profit totaled $1.8 billion in 2016, down 11.3% over 2015. Analysts said the results were slightly better than expected. (Livingston, 2/2)

The last major Republican stronghold in California is one of the nation’s most dependent areas on Obamacare, creating an enormous political risk for the GOP congressmen who represent the area and are eager to repeal the health care law. They represent the inland expanse from the Mojave desert through the Central Valley, an area emerging as an important flashpoint in the battle over Obamacare. The tension is so heightened that a conservative group tied to Republican House Speaker Paul Ryan is employing Spanish-language ads to build local support for replacing the health care law. (Cockerham, 2/2)

[John] Southwell is one of thousands of Southeast Texans who bought health insurance from a federal marketplace after the 2010 law was passed. He could be affected if President Donald Trump and a majority Republican Congress repeal the law, as they have promised. The president signed an executive order on Jan. 20 to "seek the prompt repeal" of ACA, also known as Obamacare. (Teitz and Krebs, 2/2)

The event, entitled “For a Time Such as This,” was put on at Bethel AME Church by the Greater Boston Interfaith Organization, and drew several city councilors and top state leaders, including Senate President Stanley Rosenberg. Nearly 900 people filled the church pews, and sat in adjacent rooms, to call on leaders to embrace criminal justice reform, create affordable housing, and more urgently, save the Affordable Care Act. (Geanous, 2/3)

Gov. Eric Greitens on Thursday blamed Obamacare for helping create the state’s “broken” budget. It was at least the third time since taking office on Jan. 9 that Greitens has publicly blamed former President Barack Obama’s health reform law without explaining how it contributed to the state’s fiscal woes. Greitens unveiled his budget proposal Thursday. On Thursday in Nixa, the new governor quantified the financial burden, asserting the state is “required by Obamacare” to spend an additional $350 million on health care. After the governor’s address, in an interview with the St. Louis Post-Dispatch and other media outlets, Dan Haug, Missouri’s acting budget director, attributed the higher costs to pharmaceutical spending within the Medicaid program. (Liss, 2/2)

Gov. Eric Greitens laid out his plan for the state’s $27.6 billion budget on Thursday, including an end to in-home care and nursing home services for more than 20,000 people with disabilities. Greitens, a first-term Republican, outlined his budget plan in a speech at a preschool near Springfield. He placed the blame for Missouri’s budget woes on “politicians, lobbyists and Obamacare” — a familiar theme from his 2016 campaign — and vowed to make the “difficult choices.” (Hancock and Pecorin, 2/2)

As Congress takes aim at the federal health law, some Connecticut legislators are raising questions about another aspect of Obamacare – how the state’s health insurance marketplace gets its money. Access Health CT is a quasi-public agency, funded through an assessment charged to insurance companies for each plan sold to individuals or small groups, whether the plans were purchased through the exchange or not. (Levin Becker, 2/3)

Medicare patients in U.S. hospitals were less likely to die when their doctors were educated outside the U.S., according to a study by researchers at Harvard University. The study, published in the journal BMJ, examined more than 1.2 million hospital admissions of Medicare patients between 2011 and 2014. It compared survival rates for patients of about 44,200 doctors who specialize in internal medicine. (Evans, 2/2)

The idea is that patients fare better when their families are more engaged in the care of their loved ones during the scary and stressful period when lives hang in the balance, said Dr. Giora Netzer, a critical care specialist at University of Maryland Medical Center. Studies show a focus on patients' families can lead in some cases to shorter hospital stays and lower costs, Netzer said...Those guidelines call for families in the ICU to have such things as unfettered access to patients and places to sleep. They also include staff dedicated to helping families understand hospital procedures, social and spiritual support, more consistent updates and inclusion in medical decision-making, and even advice on providing care after the patient is released from the hospital. (Cohn, 2/2)

In the world of cancer care, there's much to celebrate. In the last two years, the FDA has approved dozens of new treatments. The vast majority of those drugs are targeted therapies — the kind that require particularly complex medical care. At the core of that care is the oncology nurse. The job of the nurse in cancer care is now even more demanding — and in the next few years, that pressure could be compounded by a shortage of oncologists. (Mullins and Joliocoeur, 2/2)

HPV, or human papillomavirus, is a common sexually transmitted infection that can lead to cancers of some of the most private places: the cervix, vagina, penis and throat. Although there’s been a vaccine to prevent HPV for about a decade, vaccination rates among kids and teens have stayed relatively low, both in California and nationwide. Because HPV is sexually transmitted, some parents shy away from the vaccine, feeling it isn’t necessary for their preteens. Others contend the vaccine isn’t proven. (Buck, 2/2)

As states legalize marijuana or its medical use, expectant mothers are taking it up in increasing numbers — another example of the many ways in which acceptance of marijuana has outstripped scientific understanding of its effects on human health. Often pregnant women presume that cannabis has no consequences for developing infants. But preliminary research suggests otherwise: Marijuana’s main psychoactive ingredient — tetrahydrocannabinol, or THC — can cross the placenta to reach the fetus, experts say, potentially harming brain development, cognition and birth weight. THC can also be present in breast milk. (Saint Louis, 2/2)

Republicans on Thursday reignited their effort to change the Food and Drug Administration’s menu labeling rules, but their effort could be stymied by opposition from one of the restaurant industry’s leading trade groups. Restaurants must comply with Food and Drug Administration rules requiring the companies to display the calorie and nutrition content of their food by May 5, 2017. The agency finalized the rules last year. With the deadline so close, the National Restaurant Association thinks that the re-introduction of a bill that would water down those standards will sow confusion in the industry, which has already spent lots of time and money to adjust to the rules. (Siddons, 2/2)

Over the years, scientists have come up with a lot of ideas about why we sleep. Some have argued that it’s a way to save energy.  Others have suggested that slumber provides an opportunity to clear away the brain’s cellular waste. Still others have proposed that sleep simply forces animals to lie still, letting them hide from predators. A pair of papers published on Thursday in the journal Science offer evidence for another notion: We sleep to forget some of the things we learn each day. (Zimmer, 2/3)

From newborns to college students, children can be diagnosed with heart abnormalities that happened before birth. These defects, known as congenital heart defects or CHDs, can be life-threatening, medically complex and require lifelong treatment. And later in life, they can put a patient's own children at risk for the same conditions. (Maher, 2/2)

The University of South Florida will use a $1.1 million dollar state grant for Zika research to look at how the virus infects fetuses. Researchers want to know how Zika penetrates the placenta, which usually acts as a barrier to keep a fetus safe from viruses. When the virus gets through the placental wall it causes severe birth defects in the fetus. (Ochoa, 2/2)

One critical part of Gov. Sam Brownback’s budget-balancing plan is creation of a statewide health insurance pool that Kansas public school teachers would have to join. The governor’s budget proposal for the next fiscal year counts on $80 million a year in health care savings based on an efficiency study by Alvarez & Marsal consulting firm. But some legislators, including Republicans, are skeptical. (Zeff, 2/2)

Iowa legislators vowed Thursday to fix the situation that has allowed them to underpay on their government-provided health insurance by as much $450 a month, potentially violating state law. "Senate Republicans have long felt that we should be paying a larger share of our health insurance,” Senate Majority Leader Bill Dix told the Register. Dix told the Register on Thursday that he predicted the underpayments legislators are receiving will end during this year’s legislative session. (Clayworth, 2/2)

State lawmakers are considering allowing women 18 or older to get birth control pills without a prescription. Similar legislation is pending in both the Senate and the House. A House committee is recommending a study commission be formed to consider the proposed policy and questions about protocols and implementation. The Senate bill would allow pharmacies, including mail-order pharmacies, to dispense oral contraceptives without a prescription after an initial consultation with a licensed or certified health care provider. (Tuohy, 2/2)

The order seemed straightforward. Lawmakers mandated that by the end of January — seven months after the Legislature approved a wage increase for thousands of low-paid nursing home workers — the Baker administration would produce an analysis of how the money was spent. But the report, released this week, included no such information. Instead, the three-page analysis from MassHealth, the state’s Medicaid office, said the agency “anticipates completing its comprehensive analysis” by Dec. 1. (Lazar, 2/3)

A study by Minnesota Community Measurement found Minnesotans who are white and who live in the Twin Cities area tend to be healthier than residents of rural Minnesota. The third annual health equity study indicates American Indians and African Americans had the worst health outcomes. (Zdechlik, 2/2)

A prominent Republican lawmaker sent letters to colleagues this week saying five bills, most of them related to abortion, would not be taken up in committee, sparking outrage among abortion-rights advocates who said important legislation dealing with women’s health had been buried without a hearing. (Moomaw, 2/2)

The KU Health System joins St. Luke's Hospital — which performed 44 heart transplants last year, the most in this region — as the only Kansas City-area hospitals performing adult heart transplants. Children's Mercy Hospital, which did three transplants in 2016, launched a pediatric program two years ago. Last year, the area shipped about half its donor hearts to other regions. A second local transplant program should help keep some of those here, Abicht said. (McGuire, 2/2)

Fourteen recommendations in the Texas House County Affairs Committee's recent report to lawmakers – including calls for them to increase police officer training for de-escalation and mental health awareness, to back jail-to-treatment diversion programs, and eliminate consent searches during stops – will be the foundation for the Sandra Bland Act. State Rep. Garnet Coleman, D-Houston, announced last year that he would file the bill to address race, poverty, mental health and accountability in law enforcement and corrections. (Silver, 2/3)

Reports of influenza-like illness are on the rise in Massachusetts and across most of the United States, as what is typically the peak of flu season approaches. Rates of reporting of influenza-like illness — defined as having a fever of over 100 degrees Fahrenheit and a cough, sore throat, or both — were highest in a cluster of suburbs west of Boston roughly between the I-95 and I-495 belts and in the western part of the state, as of the week ending Jan. 21, the latest data from the state Department of Public Health. (Rocheleau, 2/2)

With more than 100 deep underground wells, Aliso Canyon is the largest natural gas storage site in the West and is considered crucial to the Los Angeles area for home heating and to power gas-fired electricity plants during energy spikes. However, the Southern California Gas Co. facility has been crippled more than a year since a blowout discovered in October 2015 released tons of methane into the air for four months, drove 8,000 families from their homes in and around the Porter Ranch neighborhood and led to mass complaints of health issues ranging from headaches to cancer. (2/2)

As Ward 86’s patients grow older, and as AIDS no longer looms as an imminent death threat, their medical needs are changing. Instead of worrying primarily about HIV and its related infections, they are now facing heart disease, cognitive decline, bone weakness and hearing and vision problems. They’re struggling with symptoms of aging that no one — not the patients or their caregivers — ever thought they’d live long enough to experience. (Allday, 2/2)

Kroger pharmacies in Virginia have now made Naloxone, an opioid overdose reversal medication, available without a prescription. According to a release, 64 of Kroger's Virginia pharmacies will have the drug available — including Staunton and Waynesboro. (Peters, 2/2)

People who live in Philadelphia Housing Authority apartments — many of them children and the elderly with asthma and other lung conditions — are taking in a lot less secondhand smoke these days, researchers are reporting. Exposure to others' cigarette smoke, connected with a long list of health woes, is about half what it was before the Housing Authority went smoke-free 18 months ago, according to a study that comes as smaller housing agencies prepare their own tobacco bans. (Sapatkin, 2/2)

A new bill filed Wednesday has the potential to completely revamp Florida’s medical marijuana system – and remove caps on the number of growers. St. Petersburg Republican Jeff Brandes filed the bill to implement Amendment 2, the medical marijuana amendment approved overwhelmingly by voters last November. (Aboraya, 2/2)

Using the Integrated Health Interview Series of the 2015 National Health Interview Survey (NHIS), we identified 3 groups of adults ... at risk to lose health insurance if premium tax credits are eliminated and Medicaid expansion is rolled back. ... Adults in the three groups at risk to lose insurance were significantly more likely to be minorities, poor, and unemployed than adults in the employer-sponsored insurance group, and had significantly less educational attainment. [They also] had significantly higher rates of self-reported poor health. (Karaca-Mandic, Jena and Ross, 1/20)

Insurers participating in the Affordable Care Act’s marketplaces are reassessing their participation and considering premium increases because of uncertainty over the law’s future. Through a series of interviews with 13 insurers participating in the marketplaces in 28 states, researchers explored how companies would respond to different repeal scenarios. They find that repeal of the individual mandate and a “repeal and delay” strategy without a concurrent replacement would lead insurers to exit the market or raise premiums. If payments for cost-sharing reductions cease, insurers would face significant financial losses; many would need to leave the market as soon as legally feasible. (Corlette et al., 1/24)

In our study, we evaluated the feasibility of applying active surveillance to assess the safety of a commonly used vascular-closure device through prospective monitoring of a national clinical registry. ... Our analysis showed a significantly higher risk of vascular complications, access-site bleeding, and transfusion requirement after PCI [percutaneous coronary intervention, or coronary angioplasty] among patients treated with the Mynx vascular-closure device than among those treated with alternative vascular-closure devices, although the absolute risk differences were small. ... a strategy of prospective, active surveillance of a representative clinical registry rapidly identified potential safety signals among recipients of an implantable vascular-closure device after PCI. (Resnic et al., 1/25)

Medicaid provides health and long-term care coverage to more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities in the United States. The program represents $1 out of every $6 spent on health care in the US and is the major source of financing for states to provide coverage to meet the health and long-term needs of their low-income residents. ... President Trump and other GOP leaders have called for fundamental changes in the structure and financing of Medicaid. ... This brief outlines five key questions to consider as the debate moves forward as well as some potential implications of these changes for states, beneficiaries and providers. (Rudowitz, 1/310

Legislation has been introduced in the House and Senate to make it easier for physicians and other practitioners to enter into private contracts with their Medicare patients and charge higher fees than are generally allowed under Medicare .... Private contracting provisions are also included in broader bills to repeal the Affordable Care Act (ACA) ... this brief: Summarizes the three options that physicians and practitioners currently have for charging Medicare patients for services they provide; Explains how the private contracting option works in Medicare under current law ...; Reviews current proposals on changes to private contracting in Medicare, and discusses the implications for Medicare patients, physicians, and the Medicare program. (Boccuti and Neuman, 1/23)

One of the stated aims of the Affordable Care Act (ACA) was to increase competition among health insurance companies. That goal has not been realized, and by several different measures the ACA’s exchanges offer less competition and choice in 2017 than ever before. Now in the fourth year of operation, the exchanges continue to be far less competitive than the individual health insurance market was before the ACA’s implementation. Moreover, insurer participation in the law’s government-run exchanges has declined over the past two years and is now at the lowest level yet. This lack of insurer participation leaves exchange customers in 70 percent of U.S. counties with no insurer choice, or a choice between merely two insurers. (Haislmaier and Senger, 1/30)

So powerful is the political appeal of entitlement programs that modern democracies routinely choose bankruptcy over curtailing them. That’s even true of ObamaCare. Despite surging premiums, lagging enrollment, the growing burden on the economy, and the enduring opposition of most voters, the debate is about replacing rather than simply repealing it. (Phil Gramm, 2/2)

Supporters of healthcare reform may feel disheartened as President Trump and Republican lawmakers prepare to repeal the Affordable Care Act and replace it with … well, something. They can’t even agree among themselves on what the U.S. healthcare system should look like. But there’s reason for hope, albeit a long shot. OK, a very long shot. (David Lazarus, 2/3)

Donald Trump’s statement that his preferred replacement for the Affordable Care Act (ACA) would provide health “insurance for everybody” surprised those who have followed the contentious debate over the health-care law since its passage in 2010. Rep. Tom Price (R-Ga.), Trump’s nominee for health and human services secretary, signaled agreement with the president when he said during his confirmation hearing that a Republican replacement for the ACA should cover more people. In recent years, though, Republicans have emphasized that gains in insurance coverage should not be the sole barometer by which health-care reform is measured. (Lanhee J. Chen and Tevi D. Troy, 2/2)

The Washington Post obtained a leaked audio recording of congressional Republicans at a closed-door retreat in late January. The topic of discussion: the GOP strategy to repeal and replace the Affordable Care Act. The 93-minute peek behind the political curtain instills no confidence in a listener that lawmakers have any idea what to do next. (2/2)

The results of the 2016 election portend a vigorous 2017 debate about the future of the Affordable Care Act (ACA). Both President Donald Trump and large fractions of the Republican majority party in the House and Senate campaigned on an explicit pledge to repeal and replace the ACA. At least part of the impetus for these promises is a general belief that the ACA’s state-based insurance marketplaces are unworkable and are resulting in higher prices and fewer choices. (Craig Garthwaite and John A. Graves, 2/1)

In the summer of 2016, Representative Paul Ryan (R-WI) released “A Better Way,” a wide-ranging proposal that included a plan for reforming Medicaid. Its fate depended heavily on the presidential election, and now that Republicans hold majorities in both the Senate and the House of Representatives and Donald Trump is President, Ryan’s plan seems much more likely to become reality. The proposal would eliminate many aspects of the Affordable Care Act and make fundamental changes to the entire Medicaid program by setting a limit — a per capita cap — on federal Medicaid spending. (Andrew J. Goodman-Bacon and Sayeh S. Nikpay, 2/1)

One of the great lessons learned from the implementation of Obamacare is the importance of building bipartisan support and broad support with patients and their physicians. Because of that lack of support, every hiccup created a mini-crisis. Perhaps that was unavoidable given the complexity of the problem. It’s been unsettling for our health care system and business, and health-threatening for some. Now, as President Trump’s administration and congressional leaders consider replacing Obamacare, there is little evidence they have learned this lesson. What a shame. (Hank Werronen, 2/2)

President Trump and other Republicans have talked about the greed of the pharmaceutical industry. Recently, Trump said (rightly) that Big Pharma is “getting away with murder.” But talk is cheap. The question is: Will Republicans really have the guts to join me and many of my colleagues in standing up to the drug companies to fight for American consumers and end the disgrace of having our country pay by far the highest prescription drug prices in the world? If Trump believes what he has said about the industry, he will rally his party to help save American lives. Here’s why. (Sen. Bernie Sanders, I-Vt., 2/2)

President Trump said he wasn’t like other politicians. He wouldn’t sell voters out to lobbyists in Washington. He would “drain the swamp.” One piece of evidence for this argument was his promise to break with GOP orthodoxy and support the government — especially Medicare — negotiating drug prices directly with the pharmaceutical industry, saving billions. In typical Trump fashion, he overestimated those savings, but the stand against the industry was nevertheless an important symbol, particularly to older voters. Less than two weeks in, Trump is already waffling on that stand. (James Downie, 2/2)

It was Tuesday morning. The new president was about to go into a meeting with chief executives from Johnson & Johnson, Merck and a handful of other major pharma companies. During his campaign, he often said that if he were elected, the federal government would start negotiating with the drug companies over the prices Medicare and Medicaid had to pay for drugs -- something it's now prevented from doing by statute. This is an issue that resonated with most Americans, the majority of whom want the government to do something about high drug prices. ... When [the doors] opened again, Trump had not only abandoned his promise to use the government's bargaining power to bring down drug prices, he was now totally against it! (Joe Nocera, 2/2)

On January 27, 2017, U.S. President Donald Trump signed an executive order banning nationals of seven countries — Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen — from entering the United States for at least 90 days, with the possibility of a wider “Muslim ban” in the works. Setting the broader ethical and political ramifications aside, this order will have a detrimental effect on graduate medical education (GME) and the U.S. health care system as a whole. (Ahmad Masri and Mourad H. Senussi, 2/1)

Although all medical specialties share the goal of preventing violence, including terrorist attacks, we — chairs of major academic departments of medicine — are concerned that the consequences of this approach for U.S. health care, and our field of internal medicine, are far reaching and damaging. (Katrina Armstrong, Mark E. Anderson, John M. Carethers, Joseph Loscalzo, Michael S. Parmacek, Robert M. Wachter, and Mark L. Zeidel, 2/1)

It was a measure of the dysfunction in Virginia’s tattered services for mentally ill people that Gov. Terry McAuliffe (D), even while facing a projected budget deficit that prompted him to propose an array of spending cuts, singled out mental-health care as the one major area for which he is seeking new funding this year. (2/2)

Many conservative Christians said that despite his long list of improprieties and morally questionable behavior, Donald Trump was the right choice for president because a Republican would be the best option on “life.” The numbers on the ground don’t back up that belief, though. (2/2)

Drugs and medical devices must be rigorously tested before they are approved by the U.S. Food and Drug Administration. However, health and wellness programs often include complementary and alternative treatments such as meditation, massage, acupuncture, reiki, and dietary supplements, which are not subject to similar testing and approval. (Ashwini Sehgal, 2/2)