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The House is expected to give final approval on Friday to a measure that would allow Republicans to speedily gut the Affordable Care Act with no threat of a Senate filibuster, a move that would thrust the question of what health law would come next front and center even before President-elect Donald J. Trump takes office. (Kaplan, Pear and Huetteman, 1/12)

The House will vote��Friday��on a budget resolution that would pave the way for ObamaCare's repeal despite some grumbling by some Republicans wary of moving forward without a firm replacement plan ready. The Senate approved the legislation early��Thursday��morning, and the House is expected to follow suit before adjourning until the inauguration. (Marcos and Wong, 1/13)

In a session that turned fiery, the House Rules Committee on Thursday advanced a rule that would set up floor action on a budget resolution aimed at repealing the 2010 health care law. The panel voted 9-3 along party lines, setting up a Friday vote on the budget document, with one Democratic amendment allowed. The vote on the resolution is expected around noon. The panel turned back 22 amendments filed by Democrats that would maintain certain aspects of the health care overhaul (PL 111-148, PL 111-152) and several entitlement programs, as well as two separate Republican amendments related to Medicare and federal deficits. (McCrimmon, 1/12)

A top House leader said Thursday that there’s enough support to approve the measure in Friday’s scheduled vote. “Oh yeah, we’ll be fine,” Majority Leader Kevin McCarthy of California said in a brief interview. (Dennis,1/12)

The incoming Trump administration and Republicans on Capitol Hill are “in complete sync” when it comes to repealing and replacing ObamaCare, Speaker Paul Ryan (R-Wis.) said Thursday. “We are in complete sync. We agree we want to make sure we move these things concurrently, at the same time repeal and replace,” Ryan told reporters at his weekly news conference in the Capitol. (Wong, 1/12)

House Republican leaders attempted to quell concerns of a skittish rank and file before a key vote Friday to begin unwinding the Affordable Care Act. The assurances came after lawmakers across the GOP’s ideological divides sounded anxious notes this week about advancing legislation that would repeal Obamacare without firm plans for its replacement. “We just want more specifics,” Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus, said Wednesday. “We need to know what we’re going to replace it with.” Meadows said he was personally undecided on his vote Friday and that other caucus members were leaning toward no. (DeBonis, 1/12)

The House Liberty Caucus, a collection of libertarian-minded lawmakers, is urging the House to reject the Senate-passed budget resolution meant to clear the way for the repeal of Obamacare. “This may be the worst budget ever seriously considered by Congress,” said caucus Executive Director Matt Weibel, in a statement announcing the recommendation. “It never balances, and it grows the national debt by more than $9 trillion over the next decade—to nearly $30 trillion—dwarfing debt increases proposed by even the most far-left budgets.” (Cheney, 1/12)

Senate Majority Leader Mitch McConnell is old enough to remember when reconciliation was the wrong tool for rewriting the rules of American health care. It was 2010, and Republicans were furious that Democrats were passing Obamacare (née “the Affordable Care Act”) via reconciliation — a budget maneuver that allowed them to pass much of the law through the Senate with 59 votes and sidestep a GOP filibuster. That March, 41 Republicans, 23 of whom are still in office today, sent a letter to then-Senate Majority Leader Harry Reid to chide the then-majority for using reconciliation to pass parts of the law. (Jackson, 1/12)

Republican governors who reaped the benefits of Obamacare now find themselves in an untenable position — fighting GOP lawmakers in Washington to protect their states’ health coverage. This rift between state and federal GOP officials is the real battle on Obamacare at a time when Democrats have only marginal power in Congress. The voices of even a handful of Republican governors intent on protecting those at risk of losing coverage could help shape an Obamacare replacement and soften the impact on the millions who depend on the law. (Pradhan, 1/13)

Gov. Scott Walker and state��health care executives are��pushing to ensure��that an Obamacare repeal doesn't disadvantage Wisconsin compared with states that embraced the law —��an issue with hundreds of millions of dollars at stake. (Stein, 1/12)

With the GOP-controlled Congress moving rapidly to dismantle President Obama’s health care law, Governor Charlie Baker is urging fellow Republicans to maintain several key provisions of the Affordable Care Act, including allowing Massachusetts to keep its first-in-the-nation mandate that all its residents have health insurance. In a letter to House majority leader Kevin McCarthy, made public Thursday, Baker laid out a position in stark contrast to his fellow Republicans in Washington, who, with President-elect Donald Trump’s backing, are already working to eliminate Obama’s health care plan. (Miller and Dayal McCluskey, 1/12)

Gov. Bill Haslam is calling on Congress to cede more control over health policy and regulation to the states, as the debate over repealing or replacing the Affordable Care Act rages on in Washington. In a��19-page blue-print of his vision, the Republican Tennessee governor��lays out what he and state officials think are cost drivers to rising health care and insurance costs, as well as encouraging Congress to "be flexible in the timing of any new reforms or revisions to health insurance statutes." (Fletcher and Ebert, 1/12)

States that fought and shunned the Affordable Care Act’s Medicaid expansion, hoping to avoid the cost of covering millions of working-poor families, will be left with substantial growth in the program even after the Republican-led Congress unwinds the law. From Florida and Texas to Georgia and North Carolina, enrollment in Medicaid and the Children’s Health Insurance Program has soared since the passage of the health care law, as the poor and uninsured have come out of the woodwork to apply for coverage. And those new enrollees – 2.4 million people across 19 states that decided not to expand Medicaid – aren’t going anywhere immediately after the incoming Donald Trump administration signs repeal legislation into law. (Pugh, 1/13)

Congress has begun the work of replacing the Affordable Care Act, and that means lawmakers will soon face the thorny dilemma that confronts every effort to overhaul health insurance: Sick people are expensive to cover, and someone has to pay.��... If policyholders don’t pick up the tab, who will? Letting insurers refuse to sell to individuals with what the industry calls a “pre-existing condition”—in essence, forcing some of the sick to pay for themselves—is something both parties appear to have ruled out. Insurers could charge those patients more or taxpayers could pick up the extra costs, two ideas that are politically fraught. (Wilde Mathews and Radnofsky, 1/12)

President-elect Donald Trump and GOP leaders on Capitol Hill pledged this week to move swiftly to not only repeal but also replace the Affordable Care Act. It will be a difficult promise to keep. Republicans’ legislative maneuvering to repeal and replace the health law involves two party leaders, four congressional committees, dozens of GOP proposals groomed over six years, one unpredictable president-elect and a vice president-elect emerging as a clear center of power on policy for the incoming administration. (Peterson and Radnofsky, 1/12)

Republicans are heading toward a bitter fight over two competing cornerstones of modern conservative ethos: the read-the-bill, take-our-time, Schoolhouse Rock mantra that fueled this decade’s tea party revolution, and their utter hatred for the Affordable Care Act. Back in 2009, as Democrats slogged through the final stages of passing the massive health-care law, Republicans took then-Speaker Nancy Pelosi’s statement that Congress would “have to pass the bill so that you can find out what is in it” as an admission that discussion and scrutiny had intentionally been thwarted. They vowed never again to allow laws of such enormous import to pass under such circumstances. (Kane, 1/12)

Under mounting pressure from Donald Trump and rank-and-file Republicans, congressional leaders are talking increasingly about chiseling an early bill that dismantles President Barack Obama's health care law and begins to supplant it with their own vision of how the nation's $3 trillion-a-year medical system should work. Yet even as Republicans said they will pursue their paramount 2017 goal aggressively, leaders left plenty of wiggle room Thursday about exactly what they will do. (Fram, 1/12)

House Republicans on Thursday emphasized that their efforts to repeal and replace the health care law will rely heavily on revised interpretations of the law that they can make administratively, a sign of the challenges in writing replacement legislation that can overcome the Senate's 60-vote threshold. "Let's not forget, we now have an HHS, an administration, that is ready to work with us to fix this problem," House Speaker Paul D. Ryan, R-Wis., said at his weekly press conference. (Mershon, 1/12)

An outside group affiliated with House GOP leadership is ramping up its advertising campaign for a Republican alternative to the 2010 health care law, running $400,000 in digital ads across 28 congressional districts. American Action Network, a conservative nonprofit advocacy organization, is launching its first digital campaign of the year Friday, when the House is expected to vote on the budget resolution that would begin the process of repealing President Barack Obama’s signature health care law. AAN debuted TV ads Thursday night during House Speaker Paul D. Ryan’s CNN town hall that promoted the party’s health care law replacement efforts. More than $1 million in TV ads are running in 15 districts, including those of some vulnerable GOP incumbents and committee chairmen. (Pathé, 1/13)

Ben Carson on Thursday said it would be unfair to “pull the rug out” from under people who rely on ObamaCare without having a suitable replacement.��“Yeah, I’ve said that many times,” Carson said during his Senate confirmation hearing. “I don’t think it’s reasonable to pull the rug out from anybody. We always have to make sure that we are taking care of our citizens, regardless of our political persuasions.”��Carson, a retired neurosurgeon, is President-elect Donald Trump’s pick to lead the Department of Housing and Urban Development (HUD). Trump has vowed to repeal large swaths of ObamaCare early on in his administration. (Devaney, 1/12)

House Minority Leader Nancy Pelosi (D-Calif.) is going after the GOP's "repeal-and-replace" ObamaCare strategy by offering a cheeky moniker of her own.��"I call it the 'cut-and-run' approach," she said Thursday.����"Cut the benefits and run away from it; cut the access to Medicaid and run away from it; cut the advantages to Medicare, and run away from it." (Lillis, 1/12)

Congress just took the first step toward repealing President Barack Obama’s signature domestic achievement in a budget vote that sets the unwieldy repeal train in motion. But Republicans are still divided about precisely how and when to replace Obamacare, given that the law, despite its flaws, is covering about 20 million people and has broadly influenced the American health care system. But Trump voters know what they want, and their intensity and immediacy was reflected in Trump’s announcement at his press conference this week that he wants to move rapidly on both repeal and replace — arguably more rapidly than is realistic given the nature of Congress and the complexity of the task. A full 85 percent of Trump voters said repealing Obamacare was extremely or very important — even more than those who cited stopping undocumented immigration (78 percent) or ending or modifying NAFTA (55 percent). (Kenen, 1/13)

As Congress takes up a new health-insurance overhaul, a major focus will be on the individual-insurance market, where consumers and families buy their own plans. Here are some key individual-insurance terms. (Wilde Mathews and Radnofsky, 1/12)

Could President-elect Donald Trump and congressional Republicans make good on their pledge to dismantle the Affordable Care Act, the repeal of a handful of tax increases on individuals and businesses and the elimination of a federal tax credit that subsidizes health insurance premiums likely would result in a massive windfall for wealthy households and a financial setback for low and moderate-income people, according to a new study. Indeed, the 400 highest income taxpayers in the country could receive millions of dollars in tax relief next year while middle and lower income Americans would come up empty or in the hole, according to the report by the liberal-leaning Center on Budget and Policy Priorities. (Pianin, 1/12)

Nashville isn't a health��insurance town, and it's not a hotbed of federal politics. Much of its energy and economy come��from its health care delivery companies, which care for tens of millions of Americans��or collaborate with the companies that do. The renewed fervor about health policy reform puts the city's industry, which generates $73 billion in revenue annually,��at a crossroads: It could either sit back��and read the tea leaves while the ideology-driven debate over policy reforms rages in Washington. Or, area leaders say, Middle Tennessee's massive health care apparatus��could work to find solutions, using the pragmatism and innovation that have been a hallmark of the fast-growing industry in recent years. (Fletcher, 1/12)

Growing numbers of U.S. states are seeking to ensure that women have continued access to free birth control in case the insurance benefit is dropped as part of President-elect Donald Trump's vow to repeal and replace the Affordable Care Act. (Mincer, 1/12)

Local religious leaders, mourning the U.S. Senate’s action Thursday on the Affordable Care Act, called on local citizens to agitate against an “irresponsible” and “immoral” decision to repeal the health-care law without having a substitute plan ready to go. The Rev. Damon Lynch Jr., pastor of New Jerusalem Baptist Church in Carthage, scolded Sen. Rob Portman, R-Ohio, for his vote in the early hours of Thursday to begin the ACA’s rollback. (Saker, 1/12)

As congressional Republicans look to repeal the Affordable Care Act (aka Obamacare), Washington’s experience with health-care reform in the 1990s offers an illustrative example of the possible consequences of repealing only the unpopular parts of a law designed with many interlocking pieces.��What began as the most ambitious health-care overhaul in the nation was hacked away to the point where it became impossible to buy individual health insurance anywhere in the state. (Guttman, 1/12)

Wyandotte County civic and government leaders are calling on the Kansas congressional delegation to oppose repeal of the Affordable Care Act. A statement from Kansas City, Kansas, Mayor Mark Holland says Obamacare is working, and repealing it would leave 6,000 Wyandotte County residents without health coverage. (Thompson, 1/12)

Senate Republicans are one step closer to repealing Obamacare. Early this morning they voted 51-48 to approve a budget blueprint that would let them repeal major parts of the law. There is no plan to replace the health care law yet, which is a concern for hospitals across the country. (Hobson, 1/12)

In a wide-ranging conversation Wednesday night at the Commonwealth Club in San Francisco, Dr. Ezekiel Emanuel, Obamacare’s main architect, talked about health care reform and the debate over President-elect Donald Trump’s pledge to repeal and replace the Affordable Care Act, which has helped insure at least 20 million more ��Americans, including five million Californians. Emanuel is still a strongly advocate of the law, saying it has contributed to keeping U.S. health care costs more under control than at any time in the last 50 years. But like many other health care experts, he acknowledges room for improvement — and hopes it can now be done a bipartisan fashion. (Seipel, 1/12)

Two people who got insurance through the 2010 health care law won’t be able to revive a legal fight between House Republicans and the Obama administration over appropriations for the law, a federal appeals court ruled Thursday. In a one-page order, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit declined a request from Gustavo Parker and La Trina Patton to intervene in the lawsuit. Parker and Patton asked to defend the continued payment of subsidies that go to approximately 5.9 million people in their situation, which is at the heart of the legal dispute. (Ruger, 1/12)

Darlene Hawes lost her health insurance about a year after her husband died in 2012. Hawes, 55, is from Charlotte, N.C. She ended up going without insurance for a few years, but in 2015 she bought coverage on HealthCare.gov, the Affordable Care Act marketplace, with the help of a big subsidy. “I was born with heart trouble and I also had, in 2003, open-heart surgery,” she said. “I had breast-cancer surgery. I have a lot of medical conditions, so I needed insurance badly.” After the results of the 2016 election, she was scared she’d lose her insurance immediately. (Tomsic, 1/13)

President-elect Donald Trump's nominee to be the nation's top health official will sell off stock holdings to avoid potential conflicts of interest, according to government documents released Thursday. Rep. Tom Price's ethics agreement and financial disclosure were posted online by the Office of Government Ethics. ... If confirmed by the Senate, Price said he would divest himself of stock in more than 40 companies. He'll also resign a position with the American Medical Association, as well as a managing role in a business partnership. (Alonson-Zaldivar, 1/12)

A letter dated Wednesday and addressed to an HHS ethics official lists 43 companies from which Price pledged to divest his interest within 90 days of his confirmation. Some, including Aetna, Amgen, Eli Lilly, and Pfizer, are major companies in the health care industry; others, including Amazon, Facebook, Delta Airlines, and Northrop Grumman, are not. (Facher, 1/12)

He also promised to resign as a delegate of the American Medical Association and not participate in any matters of which he knows the AMA is a party or represents a party for up to one year. Since his wife is a member of the Georgia state legislature, Price said he wouldn’t participate in matters connected to the state without gaining prior authorization on a case-by-case basis. (McIntire, 1/12)

"With regard to each of these entities, I will not participate personally and substantially in any particular matter that to my knowledge has a direct and predictable effect on the financial interests of the entity until I have divested it, unless I first obtain a written waiver," Price wrote. (Hellmann, 1/12)

Trump spokesman Phil Blando said Thursday, "Just as Dr. Price was compliant with congressional disclosure rules, Dr. Price will comply fully with the recommendations put forward by the ethics office. Given this agreement, we expect the Senate to move expeditiously with consideration of Dr. Price's nomination." (Young, 1/12)

When tiny Australian biotech firm Innate Immunotherapeutics needed to raise money last summer, it didn’t issue stock on the open market. Instead, it offered a sweetheart deal to “sophisticated U.S. investors,” company documents show. It sold nearly $1 million in discounted shares to two American congressmen sitting on House committees with the potential power to advance the company’s interests, according to company records and congressional filings. ... One of the beneficiaries was Rep. Tom Price, a Georgia Republican poised to become secretary of the Department of Health and Human Services, which regulates pharmaceuticals. (Hancock and Bluth, 1/13)

You may have never heard of the National Practitioner Data Bank, but there’s a good chance your doctor has. It’s the only national database that tracks professionally disciplined doctors across the country, ensuring that they can’t hop from state-to-state to escape their troubled pasts... Now, the data bank may become an issue again with the nomination of Georgia Congressman Tom Price – a physician – to lead the Department of Health and Human Services. In 2011, Price co-sponsored a bill called��the Health Care Professionals Protection Act that would have placed additional restrictions on reports to the data bank. (Ernsthausen, 1/12)

A U.S. judge on Thursday put on hold a new federal rule that dialysis providers have said would prevent dialysis patients from using charitable assistance to buy private health insurance. U.S. District Judge Amos Mazzant in Sherman, Texas stopped the rule from taking effect Friday as planned. The decision is a victory for dialysis providers Fresenius Medical Care, DaVita Inc and U.S. Renal Care Inc, which filed a lawsuit to block the rule last week. (Pierson, 1/12)

The order puts the fate of the rule into question, because the incoming Trump administration’s stance on it isn’t clear. A spokesman for the Department of Health and Human Services said officials there were “disappointed the court temporarily stayed implementation of this important rule while scheduling further proceedings to consider the parties’ positions.” A spokesman for DaVita said the ruling was “good news for the thousands of patients who would be harmed by the implementation of the rule.” (Wilde Mathews, 1/12)

Canada’s most populous province has long recognized the gravity of sexual misconduct by physicians. Two decades ago, Ontario passed laws mandating punishment for predatory doctors. But the reforms needed reforming, officials eventually decided. And that led to a long, tortured process that hasn’t left anyone completely satisfied. The complications experienced in Canada may serve as an object lesson for American medical regulators. (Hart and Judd, 1/12)

Planned Parenthood is grappling with how to survive in the era of Donald Trump. Republicans have long targeted the healthcare group for providing abortions, threatening to shut down the government if federal funding wasn’t pulled from the organization. Now that the GOP has majorities in the House and Senate and controls the White House, it has its best chance in years to win a defunding battle. (Hellmann, 1/13)

A federal appeals court has upheld a New Hampshire law allowing buffer zones around abortion clinics that supporters say protect women from harassment. The law allowing buffer zones up to 25 feet has been on New Hampshire’s books since 2014, but no clinic has set up a buffer zone. (Ramer, 1/12)

Virginia saw an unprecedented increase in babies born with exposure to dangerous drugs in 2016, state health officials told a panel of lawmakers Thursday morning. The number of children exposed to drugs in utero increased 21 percent to 1,334 in fiscal year 2016, said Carl Ayers, director of the Division of Family Services in the Department of Social Services. (Kleiner and Demeria, 1/12)

New Hampshire lawmakers are close to approving a federal grant to help the state Medical Examiners Office deal with a backlog of autopsies, mostly due to drug overdose deaths.��The Attorney General's office says annual drug deaths have increased in New Hampshire from 40 to approximately 500 over the last nine years. Those deaths have overwhelmed the two pathologists who perform autopsies for the state and sometimes testify during prosecutions. (Rodolico, 1/12)

The man responsible for more than two dozen heroin overdoses — which all occurred in one day��in a state deemed the ground zero for the opioid epidemic��— faces up to 20 years in federal prison. Bruce Lamar Griggs, 22, pleaded guilty on Monday to distribution of heroin, about six months after 26 people overdosed in Huntington, a city in the southwest corner of West Virginia.��The 911 calls came within hours of one another,��the majority of which concerned overdoses in and around one apartment complex. (Guerra, 1/12)

As lawmakers prepare for a showdown over health insurance legislation, a new report��finds that for rural Americans, a lack of coverage is just one of many reasons they are more vulnerable to early death than their urban counterparts. While the top five causes of death were the same for all Americans from 1999 to 2014—heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke—they were more likely to kill the 15 percent of Americans living in rural areas than their urban counterparts, according to research from the Centers for Disease Control and Prevention.��“This new study shows there is a striking gap in health between rural and urban Americans,” said CDC Director Tom Frieden. (Shanker, 1/12)

Rural Americans are more likely to die from heart disease, cancer and the three other leading causes of death than their urban counterparts, according to a new study from the Centers for Disease Control and Prevention. Those five top causes of death — heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke — accounted for 62 percent of the total 1.6 million deaths in the United States in 2014. Among rural Americans, more than 70,000 of the deaths were potentially preventable, the study found, including��25,000 from heart disease and 19,000 from cancer. (Sun, 1/12)

Public health officials from Nevada are reporting on a case of a woman who died in Reno in September from an incurable infection. Testing showed the superbug that had spread throughout her system could fend off 26 different antibiotics. “It was tested against everything that’s available in the United States … and was not effective,” said Dr. Alexander Kallen, a medical officer in the Centers for Disease Control and Prevention’s division of health care quality promotion. (Branswell, 1/12)

They are three women who have spent months getting an experimental vaccine in the name of science. On each date of a strict timetable, they’ve headed to windowless exam rooms in Bethesda, Md., Baltimore and Atlanta and stuck out their arms, to get an injection or to have blood drawn. Or both. How their bodies react will determine whether this clinical trial — one of the first — proceeds to the next stage in a long and complicated process. (Sun, 1/12)

When Nicole Lepke’s son was born, she listened to her pediatrician and kept peanuts away until the age of 2, but the toddler still developed a severe peanut allergy when he finally tried them. Now, 12 years later, health experts have reversed their advice on peanuts, urging parents to begin feeding foods containing peanut powder or extract during infancy in hopes of reducing a child’s risk for allergy. (Rabin and Peachman, 1/12)

With reports that a key ingredient in Nutella may cause cancer, you’re probably wondering: is anything safe to eat? The answer is yes, but you’re not going to like it. The way many Americans and people around the world eat, is literally killing them, according to a new CuriosityStream documentary on the life-saving value of eating a natural diet. (Bowerman, 1/12)

It’s no secret that American children have gotten fatter in recent decades. Now a new��study��joins earlier research showing the consequences: A sharp rise in insurance claims for youth with Type 2 diabetes, high blood pressure and other conditions more often associated with older adults. (Appleby, 1/12)

So far, more than half of all U.S. states have legalized marijuana for medical use, and eight (plus the District of Columbia) have legalized the drug for recreational use. Varieties of cannabis available today are more potent than ever and come in many forms, including oils and leaves that can be vaped, and lots of edibles, from brownies and cookies to candies — even cannabis gummy bears. (Neighmond, 1/12)

More than 22 million Americans use��some form of marijuana each month, and it’s now approved for medicinal or recreational use in 28 states plus the District of Columbia. Nationwide, legal sales of the drug��reached an estimated $7.1 billion last year. Yet��for all its ubiquity, a comprehensive new report says the precise health��effects of marijuana on those who use it remain something of a mystery —��and the federal government continues to erect major barriers to research that would provide much-needed answers. (Healy, 1/12)

The Minnesota Senate moved quickly Thursday to pass a $450 million bill responding to sharp spikes in premiums for people who buy health insurance on the individual market. "We are in a health care crisis in Minnesota," said the bill's chief author, Sen. Michelle Benson, R-Ham Lake. That crisis has played out in the way about 5 percent of the state's residents buy their health insurance. (Bakst, 1/12)

The Arizona attorney general is prepping for a lawsuit against Theranos, alleging consumer fraud by the embattled blood-testing startup. The office of Arizona Attorney General Mark Brnovich is looking to hire an outside firm to take legal action against Theranos and its subsidiaries according to a bidding contract filed Jan. 4. (Keshavan, 1/12)

The lawmaker who created Georgia’s new tax credit program for rural hospitals wants to boost the incentives for donors. State Rep. Geoff Duncan, a Cumming Republican, has introduced a House bill that would raise the tax credit from 70 percent to 90 percent for individuals and corporations who donate money to rural hospitals. (Miller, 1/12)

Pennsylvania will be testing a new payment model for rural hospitals designed to improve the health of residents and help the hospitals they depend on stay financially solvent. With $25 million funding from the U.S. Centers for Medicare and Medicaid, the Pennsylvania Rural Health Model will try an innovative payment structure in which hospitals will be paid a fixed amount each month, instead of being reimbursed for services provided. (Twedt and Langley, 1/13)

After years of wait, veterans who had been exposed to contaminated drinking water while assigned to Camp Lejeune in North Carolina may now be able to receive a portion of government disability benefits totaling more than $2 billion. Beginning in March, the cash payouts from the Department of Veterans Affairs may supplement VA health care already being provided to eligible veterans stationed at the Marine base for at least 30 days cumulative between Aug. 1, 1953, and Dec. 31, 1987. Veterans will have to submit evidence of their diagnosis and service information. (Yen, 1/13)

It’s one of the most high-profile, well-funded cancers out there, but breast cancer treatment is still hobbled by obstacles for thousands of California women who get diagnosed each year. That’s the prognosis by a UCLA research team that cited three main roadblocks: uneven insurance coverage, time limits on treatment programs and language/cultural barriers. (Buck, 1/12)

Kaiser Permanente held an official grand opening Thursday morning for��its new 185,000-square-foot call center in Gwinnett County. The health care giant has vowed that the facility off Duluth’s Breckinridge Boulevard will create 800 new jobs by 2020. Nearly 300 new employees have already been hired, officials said in a news release. (Estep, 1/12)

Access HealthNet, a Milwaukee startup founded in 2014, has developed a service to counter those flaws��and��potentially save��employers as well as employees thousands of dollars from a single episode of care. The service, which is layered over an employer’s existing health plan, doesn’t limit the choice of hospitals or doctors. Employees and family members still can go to anyone within the health plan’s network. (Boulton, 1/12)

What stands out upon entering Mai Dang’s nail salon, located on a busy street in Berkeley, Calif., is what’s missing —��the stinging smell of nail products. That wasn’t always the case. For a decade, Dang suffered from the effects of��the chemicals she used at work every day. “When you do nails, workers get itchy skin and watery eyes,” said Dang, 40. She also used to have frequent headaches, and one of her workers developed asthma. So when she heard about an opportunity to improve the safety at her salon, she signed up. (Gold, 1/13)

TriHealth and Xavier University, two of Greater Cincinnati’s leading health and educational institutions with a long relationship with each other, pledged Thursday to a broad, sweeping experiment to improve the health of a college campus. Beacon Orthopedic, a major regional private medical practice that provides medical services to XU athletics, will join the effort, officials announced at a news conference at the Cintas Center. (Saker, 1/12)

Floating in bright orange cold-water suits on Thursday were two medical residents acting out the part of victims who had fallen into the cold water. The water drill was part of a simulation put on by the fire department and OhioHealth to help doctors understand what patients and emergency responders go through before they reach the doors of an emergency department. (Viviano, 1/13)

St. Louis Park High School will screen students and staff for tuberculosis after someone at the school tested positive for the disease. The St. Louis Park School District mailed letters notifying families Wednesday about whether the Hennepin County Department of Health recommends their student be tested. The district was first alerted in late November when the Health Department found that an individual at the high school had active tuberculosis. (Dupuy, 1/12)

Georgia voters would decide whether medical marijuana could be grown and sold in-state, under legislation filed Thursday in the state House. House Resolution 36 is a long shot, but offers a glimpse of what advocates say is the best solution for hurdles faced by hundreds of families already legally allowed to possess a limited form of medical marijuana in Georgia. (Torres, 1/12)

We analyzed racial and ethnic disparities in health care outcomes among [accountable care organizations] to investigate the association between the share of an ACO’s patients who are members of racial or ethnic minority groups and the ACO’s performance on quality measures. Using data from Medicare and a national survey of ACOs, we found that having a higher proportion of minority patients was associated with worse scores on twenty-five of thirty-three Medicare quality performance measures, two disease composite measures, and an overall quality composite measure. However, ACOs serving a high share of minority patients were similar to other ACOs in most observable characteristics and capabilities, including provider composition, services, and clinical capabilities. (Lewis et al., 1/9)

We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations. The ACO-affiliated hospitals, however, were able to reduce rehospitalizations more quickly than other hospitals. The reductions suggest that ACO-affiliated hospitals are either discharging to the nursing facilities more effectively compared to other hospitals or targeting at-risk patients better, or enhancing information sharing and communication between hospitals and skilled nursing facilities. (Winblad et al., 1/9)

[Researchers sought to] evaluate whether passage of the [Medicare Hospital Readmissions Reduction Program] HRRP was followed by acceleration in improvement in 30-day RSRRs after hospitalizations for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia and whether the lowest-performing hospitals had faster acceleration in improvement after passage of the law than hospitals that were already performing well. ... After passage of the HRRP, 30-day RSRRs for myocardial infarction, heart failure, and pneumonia decreased more rapidly than before the law's passage. Improvement was most marked for hospitals with the lowest prelaw performance. (Wasfy et al., 12/27)

In 2014—after the implementation of most of the Affordable Care Act provisions, including Medicaid expansions in some states and subsidies to purchase Marketplace coverage in all states—adults who had been uninsured for more than three years represented a larger share of the newly insured, compared to adults who had been insured for shorter periods of time. (Decker and Lipton, 1/9)

This 15th annual 50-state survey provides data on Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in these policies in the past year. ... Medicaid and CHIP are the central sources of coverage for low-income children and pregnant women, with 49 states covering children and 34 states covering pregnant women with incomes at or above 200% FPL as of January 2017 .... During 2016, states continued to upgrade and streamline Medicaid eligibility and enrollment systems and processes under the ACA, using federal funding available to support system development. ... Use of premiums and cost sharing in Medicaid and CHIP varies across states and groups. (Brooks et al, 1/12)

The authors note that premiums are not high in all areas, and that many areas with large recent premium increases reflect needed corrections to very low premiums in the early years of reform. However, in sources with high premium levels, the causes differ, as should appropriate solutions. The first potential problem is that sicker people are more likely to enroll in marketplace plans. The second, premiums tend to be higher if an insurer or provider group has a monopoly in their area .... Third, inadequate risk adjustment, i.e., moving premium dollars from insurers with low-cost enrollees to insurers with high-cost enrollees, may also be a factor leading to high premiums in some areas. (Blumberg and Holahan, 1/1)

The excise tax on high-cost health insurance plans, a provision of the Affordable Care Act (ACA), has the potential to achieve two important goals by curbing the open-ended exclusion of employer-financed health insurance from personal income and payroll taxes. It will reduce the incentive to offer health insurance with features that permit or encourage excessive health care spending. It will also generate revenues that offset the costs of health insurance expansion. ... Now, with the election of a president who has pledged to repeal all or most elements of the ACA, even delayed implementation of the tax is in doubt. We believe that a modified version of the Cadillac tax can still play a valuable role both in fostering health care cost containment and in providing revenues to expand coverage, either under a modified version of the ACA or in an alternative that achieves a similar level of coverage. (Aaron et al., 1/4)

As the 115th U.S. Congress deliberates the future of the Affordable Care Act, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January. (1/10)

Senate Republicans took a major first step in repealing Obamacare this week. Consumers, though, should keep in mind that many steps remain before any changes will affect individuals with health insurance. If you’re one of the estimated 20 million Americans who gained coverage through the health law, you are extremely unlikely to lose coverage this year. (Margot Sanger-Katz, 1/13)

The Senate took a procedural vote in the early hours Thursday morning to proceed later this month with a reconciliation measure to “repeal” Obamacare. In other words they took a vote to take a vote by a set date, but they really did not do that either.��The House will vote on a similar resolution tomorrow. Sen. Susan Collins (R-Maine) explained from the floor. After recounting large premium increases in her state, she said, “Some of the ACA’s provisions – especially its consumer protections – enjoy bipartisan support and should be retained; however, its Washington-centric approach must be changed if we are ever to truly reform our broken health care system. Nevertheless, this task must be undertaken with care.” (Jennifer Rubin, 1/12)

Congressional Republicans are in a huge hurry to purge the nation of Obamacare. They're racing against a self-imposed Jan. 27 deadline to craft legislation to euthanize the 2010 law. ... These leaders act as if millions of Americans are clamoring to have their Obamacare coverage yanked away as soon as possible. That's absurd. Many Americans are disappointed and disillusioned by Obamacare. They seek affordable health care that covers the doctors and hospitals they choose. But they aren't demanding that the law be scrapped in a frenzied legislative rush before a better plan is in place. (1/12)

Believe it or not, we’re not really going to have to spend the next four years wading through wonky drudgery of Russian spy dossiers and hotel sex cameras. At some point we’re going to have a thrilling debate over the most scintillating question in health care policy. The Republicans are going to try to replace Obamacare. They’re probably going to agree to cover everybody Obama covered, thus essentially granting the Democratic point that health care is a right. But they are going to try to do it using more market-friendly mechanisms. (David Brooks, 1/13)

Some Republicans appear to be realizing that their long con on Obamacare has reached its limit. Chanting “repeal and replace” may have worked as a political strategy, but coming up with a conservative replacement for the Affordable Care Act — one that doesn’t take away coverage from tens of millions of Americans — isn’t easy. In fact, it’s impossible. But it seems that nobody told Mr. Trump. In Wednesday’s news conference, he asserted that he would submit a replacement plan, “probably the same day” as Obamacare’s repeal — “could be the same hour” — that will be “far less expensive and far better”; also, with much lower deductibles. This is crazy, on multiple levels. (Paul Krugman, 1/13)

But the implication is clear: “So we’re gonna do repeal and replace, very complicated stuff,” he said, repeating one of his favorite lines: “Obamacare is a complete and total disaster.” This, for some, raises the question: How much of the Obamacare-antipathy is about its namesake? Obamacare certainly has its warts, but Republicans have not coalesced around a replacement plan that would insure as many people while offering them the same choices and costing less. Would a health-care law by any other name be such a political lightning rod? (Olga Khazan, 1/12)

The Republican House and Senate have begun the process of repealing the Affordable Care Act (ACA) through the budget reconciliation process. Enacting a budget reconciliation bill is likely to take weeks, however, and at this point it seems likely that such a bill will delay repeal of some of the most important provisions of the ACA for much longer. (Timothy Jost, 1/12)

Republicans in the Senate voted Wednesday night on a bill that would significantly accelerate the repeal of key elements of the Affordable Care Act (commonly called Obamacare) through reconciliation. As Republican Sen. Susan Collins (Maine) has acknowledged, this will almost certainly mean that Republicans will effectively get rid of the health-care law before coming up with a replacement. On the face of it, this seems like terrible politics. If Obamacare looks like it is unraveling, insurance companies are likely to pull out quickly, potentially leaving millions of people without health insurance and leaving Republicans with the blame. It’s a very risky gamble, but one that may have a strategic logic behind it. (Henry Farrell, 1/12)

One focus of the planned repeal of Obamacare is maintaining coverage for people with preexisting conditions. Republican lawmakers say the current law’s safeguards won’t change, but they have yet to explain how they’ll accomplish this without also keeping the mandate that everyone buy insurance. (David Lazarus, 1/13)

What, if anything, congressional Republicans will propose as a replacement for Obamacare -- which President-elect Donald Trump labeled a "complete and total disaster" at his Wednesday news conference -- is unclear, likely even to Republicans themselves. One thing that is clear is that repeal without a true replacement will imperil the health care of many, many Ohioans -- a fact that has some Republicans��very concerned. (1/13)

No matter how we vote, I think we can all agree on the basics: Children shouldn’t have to beg on the streets for food. If we work hard, we should be able to provide for our families. And if someone in our family gets severely sick or injured, we shouldn’t face financial destitution on top of it all. (Andrea Lorenz, 1/12)

Did you know that the Declaration of Independence offers an open-ended list of our basic rights? All of us are created equal, the Declaration proclaims, and endowed with certain unalienable rights. Then the Declaration elaborates: “Among these are life, liberty, and the pursuit of happiness.” Among these? In listing these three rights, the Declaration simply offers a set of examples. Life, liberty and the pursuit of happiness are just three important cases among some larger set. What, then, are our other unalienable rights? Is health care by chance included? (Danielle Allen, 1/12)

More and more Massachusetts residents are signing up for MassHealth, the state’s Medicaid program — an average of 6,000 new people every month since mid-2015. And this really shouldn’t be happening, not when the economy is humming and Obamacare is long since implemented. MassHealth is supposed to be a safety net program .... So why is MassHealth growing? Partly because a growing number of people are no longer getting insurance from their employers. (Evan Horowitz, 1/12)

President-elect Donald Trump’s transition team tried to tamp down the report from leading vaccine skeptic Robert F. Kennedy Jr. that Mr. Trump had asked him to lead a new panel on the safety of childhood inoculations. The president-elect, we were told, is only exploring the possibility of forming a government commission on autism. But by even entertaining the idea, Mr. Trump — who has his own troubling history when it comes to vaccine safety — gives new life to debunked conspiracy theories tying autism to vaccines. That in turn endangers children’s lives. (1/12)

The Cures Act, formally known as H.R. 34 or the 21st Century Cures Act, passed overwhelmingly in the U.S. House of Representatives and Senate in the waning days of the 114th Congress and was signed into law by President Barack Obama on December 13, 2016. Weighing in at nearly 1000 pages, this bipartisan bill is the product of years of hard work by Republican and Democratic lawmakers, in collaboration with a broad array of diverse stakeholders. As with any landmark piece of legislation, the complex negotiations leading up to its passage were challenging and intense. But the final provisions are well worth heralding, including increased support for state efforts to combat opioid abuse, new steps aimed at improving mental health services, and important changes affecting the Food and Drug Administration and the National Institutes of Health. (Kathy L. Hudson and Francis S. Collins, 1/12)

Over the past year, we’ve seen the life-altering effects of the Zika virus on newborns. Images of babies with abnormally small heads and other birth defects have been shown in newspapers and on TV broadcasts. These images often show the hands of their parents feeding, bathing and comforting them, or the hands of doctors or nurses caring for them. These hands represent the intensive, potentially lifelong support that many of these children will need. For families, this will demand love, patience and hope. For doctors and nurses, it will demand learning new ways to treat patients. For the government, it will require funding, research and commitment. (Tom Frieden and Edward McCabe, 1/12)

The first time the sugar industry felt compelled to “knock down reports that sugar is fattening,” as this newspaper put it, it was 1956. Papers had run a photograph of President Dwight D. Eisenhower sweetening his coffee with saccharin, with the news that his doctor had advised him to avoid sugar if he wanted to remain thin. The industry responded with a national advertising campaign based on what it believed to be solid science. (Gary Taubes, 1/13)

Sugar may well be a killer. The conventional thinking is that it’s an “empty calorie” — it fills you up without providing nutrients. But there’s a growing body of research suggesting that sugar actually triggers a disorder known as metabolic syndrome, which the Centers for Disease Control and Prevention says now afflicts 75 million Americans. If it does, then it plays a critical role in virtually every major chronic disease, including obesity, diabetes, heart disease, cancer and even dementia. The catch is that the evidence is ambiguous. At this point, scientists can’t tell us definitively whether this accusation against sugar is true. Nor can they exonerate sugar. (Gary Taubes, 1/13)

If any more proof were needed that current laws and policies aren't separating the most deranged individuals from the most destructive weapons, it came in last week’s mass shooting at the Fort Lauderdale airport. (1/12)

My heart goes out to the victims of the gun violence in Florida and their families, but increasing forced psychiatric treatment is the wrong answer. More forced treatment won’t prevent such tragic events: Virtually every significant study has concluded that people with mental illness are no more likely to be violent than matched controls in the community. (Daniel Fisher, 1/12)

There are two quite different stories about why there is a prescription drug crisis in the United States, and why opioid-related deaths have quadrupled since 1999. At some level, you are probably aware of both. Earlier this year, I interviewed people in the New Hampshire towns worst affected by this crisis — from imprisoned addicts to grieving families. Even the people who were living through it would alternate between these stories, without seeing that, in fact, they clash, and imply the need for different solutions. Thousands of lives depend on which of these tales is correct. (Johann Hari, 1/12)

John Ashcroft stood in the place of Jeff Sessions the last time a new Republican administration came to power. Like Sessions, Ashcroft was a conservative senator who had been nominated to be attorney general. Also like Sessions, Ashcroft became a top target of Senate Democrats. ... One difference between the two nominees is that Ashcroft was more defensive about abortion. (Ramesh Ponnuru, 1/12)