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Ever since Republicans got down to the business of repealing the Affordable Care Act, the Senate has been singled out as the likely problem. Any plan that could zoom through the House would hit roadblocks among Senate Republicans, many of whom have resisted a wholesale repeal of the health law without a robust replacement plan. But after weeks of loud protests, boisterous town hall meetings and scores of quieter meetings with health care professionals, patients, caregivers and hospital managers in their districts, it is becoming increasingly likely that a consensus in the House may be just as hard to reach. (Steinhauer, 2/23)

Republican groups are putting increasing pressure on both Democratic and GOP lawmakers through new ad campaigns to urge them to repeal and replace ObamaCare. One Nation, an advocacy group aligned with Senate Majority Leader Mitch McConnell (R-Ky.), is launching TV ads in nine states as part of an existing $3 million ad campaign. The ads will run in Missouri, Florida, Wisconsin, Ohio, Maine, Arizona, Alaska, Utah and Nevada over the next 10 days. In the next wave of radio and digital ads, the group will target Michigan and Tennessee. (Hagen, 2/22)

Republicans working on the repeal and replacement of the health care law have assumed that they would not be able to easily roll back the law's extensive insurance regulations because they would run into problems with Senate rules. That may be the case. But a former public trustee for Social Security and Medicare argues that it should be possible, without taking a position on whether that's what Republicans should do. Charles Blahous, a senior research fellow at the right-leaning Mercatus Center of George Mason University and former National Economic Council official, says after his review of a Congressional Budget Office report that Republicans might have the option of using the expedited budget reconciliation process to repeal some insurance regulations in the 2010 health care law. (Krawzak, 2/22)

In brief remarks on Wednesday, President Trump reiterated his promise that the administration, in concert with Congressional Republicans, will release a plan to repeal and replace the Affordable Care Act within the next few weeks. If there is indeed a proposal on the way, Trump and Congress will have to find a way to pay for revamping a healthcare system that is now largely funded through taxes that are a core element of the ACA. (Garver, 2/22)

More than 60 mayors across the country plan to hold a national day of action Wednesday urging Congress not to repeal ObamaCare. Mayors from states including New York, South Carolina and Ohio will spend the day highlighting the impact repealing the healthcare law can have at the local level. "We urge Congress to take into consideration the effect that the repeal of the Patient Protection and Affordable Care Act of 2010 (ACA) will have on our nation’s cities large and small, urban and rural," the mayors wrote in a letter to congressional leadership.  (Hellmann, 2/22)

Mayors around the country are holding what they’re calling a “day of action” Wednesday to warn of the risks to their cities if Congress repeals the Affordable Care Act without an effective replacement. More than 50 mayors are hosting town halls and other events pressing lawmakers to preserve key parts of the law, which has helped reduce the country’s uninsured rate to a record low. (Scott, 2/22)

Health care under the Affordable Care Act is poised to change — again. The Republican-led Congress has vowed to “repeal and replace” the health law known as Obamacare. That has left many people anxious and confused about what will happen and when. So [we] asked listeners to post questions on Twitter and Facebook, and we will be answering some of them here and on the radio in the weeks ahead. (Rovner, 2/23)

The U.S. government may soon lean on someone new to help lower health care costs: you. The idea is that when your money is on the line — and not the insurance company's — you'll look for the best value and do your part to curb national health care spending. (Murphy, 2/22)

As Republicans struggle to coalesce around an ObamaCare replacement plan, they generally agree on one thing: It should expand access to health savings accounts. HSAs — special accounts for medical expenses that come with tax breaks — have long been a cornerstone of Republican healthcare plans. They argue giving people more direct control over their medical expenses will drive down healthcare costs. (Hellmann, 2/22)

It’s been a rocky few months for the health insurance marketplaces created by the Affordable Care Act. Even if you’re not one of the roughly 11 million Americans who rely on these online exchanges to get your health insurance, you’ve probably seen the headlines about rising premiums and insurance companies pulling out of the system. (Levey, 2/23)

When liberal California looks beyond the repeal of Obamacare, it sees a glimmer of single-payer on the horizon. Single payer or “Medicare-for-all,” the universal health care system long favored by the left and championed by Sen. Bernie Sanders as he ran for the Democratic presidential nomination, is getting another look in California as political leaders and health experts grapple with what post-Obamacare health coverage could look like under President Donald Trump. Legislation to create a Medicare-for-all system was introduced in the state Senate last week. (Colliver, 2/22)

In the politest possible way, Sen. Chuck Grassley (R-Iowa) asked his constituents to keep their voices down. ... It was Grassley’s second town hall of the day, the umpteenth of a political career that began with a 1958 race for state legislature. He wrote down each question as it was spoken to him. ... And he faced round after round of questions on the Affordable Care Act, from people who sometimes choked up as they described their specific, positive interactions with the law. After one woman emotionally described how her family would have been “destroyed” had the ACA’s subsidies not defrayed the cost of her husband’s illness, Grassley assured her that the law would not simply be repealed. (Weigel, 2/22)

The House GOP approach – loosely spelled out in a thin booklet of talking points -- would preserve a number of features of the existing Obamacare law, including preventing insurers from discriminating against applicants with pre-existing medical problems and allowing children to remain on their parents’ private health care plans until they turn 26. But the disparate talking points lack a coherent framework. And critics say they raise more questions than they answer. (Pianin, 2/22)

A combative crowd repeatedly challenged Arkansas Sen. Tom Cotton on Wednesday in the latest of a series of highly contentious Republican town halls. During the event, protesters in a packed auditorium at Springdale High School frequently stood and chanted denunciations of the senator's support of the Trump administration and the GOP's ongoing efforts to repeal the Affordable Care Act. (Lima, 2/22)

For the first few minutes of Republican U.S. Rep. Leonard Lance’s town hall meeting Wednesday evening, it almost looked like he had won over a passionate anti-Trump crowd of nearly 1,000. Lance, an eight-year incumbent, answered a question about repeal of the Affordable Care Act by saying he supports "repairing" the law and keeping some of its most popular provisions, including protections for pre-existing conditions, banning lifetime caps on coverage and allowing young people to stay on their parents' coverage until age 26. The crowd applauded. Then things changed. (Friedman, 2/22)

Boisterous town hall meetings have sent Republican lawmakers looking for cover in their home districts — with some representatives opting not to hold public meetings at all. On Tuesday, a group of Miami voters packed the waiting room at Republican Rep. Ileana Ros-Lehtinen's office to demand a town hall meeting to talk health care. (Moore Gerety, 2/22)

California protesters plan on Thursday to bring their criticisms of Republican policies on health and immigration directly to their representatives’ doorsteps. Health advocates, union members and liberal activists have organized evening candlelight vigils in front of the homes of seven congressional Republicans throughout the state, including House Majority Leader Kevin McCarthy. An eighth demonstration will be held at a district office. (Colliver, 2/22)

A small group of Case Western Reserve University medical students rallied this afternoon outside the Cleveland office of Sen. Rob Portman to speak out against repeal of the Affordable Care Act without a replacement plan. The rally, outside Portman's E. 9th Street office, is part of a "nationwide day of action" coordinated by Protect our Patients, a grassroots movement of about 4,700 medical students who oppose the repeal of the ACA, or Obamacare, and instead prefer that lawmakers work to improve the act. (Zeltner, 2/22)

Two days before Election Day, Donald J. Trump traveled to Sioux City, Iowa, and proclaimed that he was the protector of federal programs aimed at helping elderly and low-income Americans. It was Hillary Clinton, he said, who was an untrustworthy steward of the working class and who would slash vital benefits. “I am going to protect and save your Social Security and your Medicare,” Mr. Trump said. “You made a deal a long time ago, a long time ago.” The pledge followed earlier promises to enact a new paid-maternity-leave benefit and not to make cuts to Medicaid, the health insurance program for the poor. (Alcindor, 2/23)

President Trump said Wednesday that he expects a healthcare plan to come forward as soon as next month. “Maybe mid to early March we’ll be submitting something that I think people will be very impressed by,” Trump told reporters, according to a pool report. It remains unclear whether Trump is referring to a plan that the White House would release on its own, which could throw off congressional efforts, or simply a joint plan with lawmakers introduced in Congress. (Sullivan 2/22)

The White House on Wednesday declined to rule out that President Donald Trump could push his own plan to replace the 2010 health care law rather than pursue the course set by congressional Republicans. When asked whether there will be a single White House-congressional GOP plan, White House Press Secretary Sean Spicer left the door open for the president to roll out his own plan — no matter what lawmakers do. Minutes later, Spicer referred to “the president’s plan” when discussing how the administration intends to achieve one of its top campaign goals. Since Trump’s election, which also saw the GOP keep the House and Senate, Republican lawmakers on Capitol Hill have celebrated an era of “unified” GOP governance. (Bennett, 2/22)

An Arizona lab run by blood-testing firm Theranos Inc. put patients at risk and failed to quickly fix its deficiencies, the main U.S. lab regulator found, triggering a new round of sanctions last month against the company. The Centers for Medicare and Medicaid Services imposed some of the harshest penalties in its arsenal on the Arizona lab. The agency revoked the lab’s U.S. testing license, barred it from billing Medicare and ordered it to alert customers of its problems, according to a Jan. 27 letter obtained by The Wall Street Journal in a public records request. (Weaver, 2/22)

Aetna will spend $3.3 billion to buy back more than 20 million shares of its stock after the health insurer's board authorized more repurchases last week. The nation's third largest insurer said Wednesday that it entered into accelerated buyback agreements with two dealers for about 10.4 million shares from each. Aetna will pay each dealer $1.65 billion and is using available cash to fund the deals. (2/22)

Dialysis giant DaVita is accused in a federal lawsuit of misleading shareholders in an elaborate effort to inflate its financials by intentionally steering poor patients toward private insurers that paid 10 times more for dialysis treatments than the government. The lawsuit, by the Peace Officers’ Annuity and Benefit Fund of Georgia, claims Denver-based DaVita persuaded Medicare and Medicaid patients to dump the government plans for private insurance — some of it via Obamacare — and then directed the patients to apply for premium assistance from the American Kidney Fund, to which DaVita was a heavy benefactor. (Migoya, 2/22)

After failing to meet its financial goals for 2016, Fitbit is shifting its strategy to focus more on health care services and developing a smartwatch, marking a departure for the San Francisco company, which got its start making basic fitness trackers that counted steps. The company reported $2.1 billion in revenue in 2016, up from $1.9 billion in 2015. But growth slowed throughout the year, indicating that Fitbit is hitting market saturation. (Ho, 2/22)

On the heels of Washington state’s successful pushback of President Donald Trump’s immigration order, Oregon is readying for a court battle if the federal government tries to curtail abortion rights, the state’s attorney general said. The attorneys general of both Oregon and Washington said in interviews with The Associated Press that they are increasingly sharing information and consulting with each other and with other Democratic counterparts, as the White House and Congress try to roll back Obama policies and steer a conservative course for the nation. (Selsky, 2/22)

The Arizona Senate has approved a bill requiring doctors to use "all available means and medical skills" to try to save the life of every baby born — whether the child is born alive during an abortion, unexpectedly arrives months early or is delivered with a fatal defect and expected to live only minutes. Sen. Steve Smith, R-Maricopa, the bill's sponsor, said Senate Bill 1367 isn't about abortion. It's about what should happen when a baby is born alive as opposed to current "barbaric" practices. (Beard Rau, 2/22)

Vitamin IV infusions aren’t anything new. Celebrities from Simon Cowell and Rihanna to the Real Housewives have proclaimed their love for vitamin drips. They’re part of a huge — and wildly popular — supplement industry which goes largely unregulated. Supplement makers aren’t allowed to claim that their products can cure or treat a particular condition, but they are allowed to make sweeping claims that the products promote health. The infusion treatments can be traced back to an intravenous supplement known as the Myers’ cocktail, a slurry of magnesium, calcium, B vitamins, and other products developed decades ago by a Baltimore physician. There is a published review on the use of Myers’ cocktail — but it’s just a collection of anecdotal evidence. (Thielking, 2/23)

Federal and state officials in Maine said Wednesday they had shut down an elaborate scheme to deceptively market dietary supplements in which a company disguised 30-minute radio advertisements as a talk radio show and repeatedly promoted fake print newspapers ads. In fact, according to officials, the promotions for the two products featured fictitious consumers and purported medical experts who endorsed the supplements without actually having endorsed them. (Thielking, 2/22)

After his short film screened at the Sundance Film Festival in 2008, a euphoric Simon Fitzmaurice was walking the snowy streets of Park City, Utah, when his foot began to hurt. Back home in Ireland that summer, by then dealing with a pronounced limp, he received a shattering diagnosis: motor neuron disease, or M.N.D. (more commonly known in the United States as A.L.S., or Lou Gehrig’s Disease), a neurological disorder that causes increasing muscle weakness and eventual paralysis and is, in most cases, fatal. The doctor gave Mr. Fitzmaurice, then 33, three or four years to live. (Shattuck, 2/22)

As if parents of young children didn’t have enough things to worry about, here’s another: Some scientists think pet cats might increase kids’ risk of developing schizophrenia. But there’s good news out of this growing field of research, which focuses on the links between a cat-borne parasite that causes toxoplasmosis and mental health disorders. A new study of about 5,000 children in the United Kingdom found no evidence that cat ownership during gestation or childhood was associated with psychotic experiences that can be early signs of mental illness — such as hallucinations or delusions of being spied on — when they were teenagers. (Brulliard, 2/22)

Steve and Michelle were desperate. Their 6-year-old son, Sam, was diagnosed with ADHD soon after entering first grade. Sam’s behavior seemed outright defiant: He ignored adults when his name was called and was in constant motion. Sam let out bloodcurdling screams when forced to stop playing a game on the iPad. His teacher had struggled to manage similar behaviors in class, and his guidance counselor said Sam “needed to be on medicine.” Steve and Michelle weren’t so sure, but they wondered if they were being negligent by not putting him on Ritalin or something similar. But despite the relentless advertising for meds, and the occasional coercion by school personnel, your young ADHD child may not need Ritalin. At least not yet. (Griffin, 2/23)

Dozens of not-for-profit organizations have formed in the past decade to promote free or low-cost heart screenings for teens. These groups often claim such tests save lives by finding abnormalities that might pose a risk of sudden cardiac death. But the efforts are raising concerns. There’s no evidence that screening adolescents with electrocardiograms (ECG) prevents deaths. Sudden cardiac death is rare in young people, and some physicians worry screening kids with no symptoms or family history of disease could do more harm than good. The tests can set off false alarms that can lead to follow-up tests and risky interventions or force some kids to quit sports unnecessarily. (Jaklevic, 2/22)

For months, Teresa Christensen’s 87-year-old mother, Genevieve, complained of pain from a nasty sore on her right foot. She stopped going to church. She couldn’t sleep at night. Eventually, she stopped walking except when absolutely necessary. Her primary care doctor prescribed three antibiotics, one after another. None worked. “Doctor, can’t we do some further tests?” Teresa Christensen remembered asking. “I felt that he was looking through my mother instead of looking at her.” (Graham, 2/23)

Despite efforts to stem the tide of opioid overdose deaths in Massachusetts, the latest numbers suggest that a record number — some 2,000 people — died of overdoses last year. One of the grassroots groups working to make a dent in this crisis is called Magnolia New Beginnings. It was formed by parents on the North Shore a few years ago to provide support to other parents and to help financially, providing scholarships for long term substance use treatment, which typically is not covered by health insurance. (Mitchell and Becker, 2/22)

They came by the thousands – some from as far away as Cape May, some to wait in lines 100 people deep – seeking the autograph of the man inside a South Philadelphia storefront. The man with the sought-after signature was no movie star, sports phenom, or celebrity, but, rather, a soft-spoken doctor – one who admitted Wednesday that he had turned his substance-abuse clinic into one of the city’s most notorious sources for addicts and drug dealers of highly regulated prescription medications. Federal authorities likened Alan Summers’ now-defunct National Association for Substance Abuse-Prevention and Treatment, near Broad and Wolf Streets, to an open-air drug market. (Roebuck, 2/22)

The Anoka County Sheriff's Office says it'll now offer some inmates addicted to opioids a medication that can lessen cravings and block them from using opioids like heroin or prescription painkillers. The sheriff's office is partnering on the new program with drug manufacturer Alkermes, which makes the medication Vivitrol. (Collins, 2/22)

Piedmont Healthcare, a seven-hospital system in Atlanta, has agreed to take over and operate 27 Walgreens in-store retail clinics in the metropolitan area, the two companies announced Wednesday. Piedmont joins other hospital systems such as Advocate Health Care in Chicago and Providence Health in Renton, Wash., that have bought or leased retail clinics that Walgreens and other chains have opened inside their stores to provide convenience for patients with minor ailments. (Barkholz, 2/22)

Piedmont Healthcare will operate 27 retail health clinics in Walgreens stores across the Atlanta area. The transition to Piedmont management is planned for August, and the clinics will be known as Piedmont QuickCare at Walgreens. It’s the latest move by Atlanta-based Piedmont to extend its reach across metro Atlanta and North Georgia. Last year, Piedmont acquired Athens Regional Medical Center as its seventh hospital. (Miller, 2/22)

With a new wave of advertising and a new bill at the Georgia General Assembly, Cancer Treatment Centers of America has re-ignited its ongoing turf war with the rest of Georgia’s hospitals. The “destination cancer hospital” is again seeking to change the terms of a 2008 legislative deal that permitted the cancer-only hospital to come to Georgia, arguing that more in-state patients should be allowed to get treatment at the Newnan facility. (Teegardin, 2/22)

Johns Hopkins Medicine said Wednesday it will work with health real estate firm Welltower Inc. to come up with programs and explore developing facilities to serve and treat the elderly. Welltower develops assisted-living centers, memory care facilities and other medical institutions for the elderly. Company officials said programs and technology developed in those facilities said could be useful to Johns Hopkins, particularly as the trend in health care is to do more treatment outside hospitals. (McDaniels, 2/22)

New York Gov. Andrew Cuomo is proposing a $25 million reduction to programs that fight cancer, diabetes and other public health challenges — a move intended to eliminate inefficiencies that is being fought by some lawmakers and health advocates who oppose the cuts. (2/22)

Two years after falling short in a high-profile bid to crack down on bad nursing homes, some Texas state lawmakers are trying again. State Sen. Charles Schwertner kicked off the effort by introducing a trio of bills to make it harder for nursing homes and other long-term care facilities and home and community services agencies to avoid discipline and lawsuits when they are found to have done wrong. (Rosenthal, 2/22)

Despite growing concerns that Arizona legislation to protect the religious freedoms of health-care workers could undermine patients' end-of-life decisions, the Senate approved the bill Wednesday. Senate Bill 1439, which is sponsored by Sen. Nancy Barto, R-Phoenix, and pushed by the conservative Center for Arizona Policy, would protect from discrimination a health-care provider that refuses to participate in any service or provide any item that results in the death of an individual. (Beard Rau, 2/22)

Democratic State Senator Victor Torres filed a bill Tuesday to allow first responders to get worker’s compensation coverage for post-traumatic stress disorder. The bill makes PTSD and mental conditions more easily eligible, and it removes the requirement that first responders also be hurt physically. Jessica Realin’s husband was diagnosed with PTSD after cleaning up the Pulse Night Club tragedy. (Aboraya, 2/22)

Chanting “Medicare for all is our fight, health care is a human right,” nurses and healthcare activists rallied in Sacramento Wednesday to support a new bill that would create universal health coverage for Californians. State Senators Ricardo Lara (D-Bell Gardens) and Toni G. Atkins (D-San Diego) introduced Senate Bill 562 last week. The bill would cover all residents of the state, even those who are undocumented. (Klivans, 2/22)

Nurses at Delaware County Memorial Hospital will go on strike for two days next month to protest stalled labor contract bargaining and unfair labor practices, the Pennsylvania Association of Staff Nurses and Allied Professionals said Wednesday. The union, known as PASNAP, won the right a year ago to represent 370 registered nurses and technical employee at the Drexel Hill facility, which was purchased in July 2016 by Prospect Medical Holdings Inc. as part of the hedge-fund backed firm's acquisition of Crozer-Keystone Health System. (Brubaker, 2/22)

When he returned to his native Bermuda in the early 1990s to open a medical clinic, Dr. Ewart Brown felt as if he had stepped back in time. On the small island, care that was readily available to patients he treated in one of LosAngeles’s poorest neighborhoods was out of reach. That stark portrait eventually led Brown to a partnership with Lahey Hospital and Medical Center — one that is now the subject of a civil racketeering lawsuit that has uncovered a little-noticed relationship between the Burlington-based hospital and the small British territory. (Murphy and Dayal McCluskey, 2/23)

...Faculty and staff at LSU's Health Sciences Center (HSC) considered the flight simulators used by airplane pilots. The LSU team realized that a similar training system could be used in medical education, in order to more efficiently and ethically judge students' competency. As a result, in 2001, LSUHSC began using high-tech medical mannequins to simulate human patients. LSU faculty and staff helped develop life-size mannequins that breathe and blink, have heartbeats and blood pressure, talk and even have names. The mannequins are programmed to simulate various medical conditions and injuries, allowing medical students to engage with mock patients in a low-risk, controlled environment. (Harrison, 2/22)

Wondering how many children at your kid’s school aren’t vaccinated? If you live in Connecticut, there’s no way to find out.But that could change under a legislative proposal favored by the state Department of Public Health, which is currently prohibited from releasing data on immunization rates by school. The state health department already gets data from schools on the number of vaccine-exempt students, the number who have been fully immunized and those who have received some but not all vaccines. (Levin Becker, 2/22)

Gun injuries are a growing problem for Florida's children, rising along with the increasing availability of firearms across the state, the Tampa Bay Times has found. To determine how many kids are shot each year — accidentally, intentionally or during the commission of a crime — the Times looked at millions of hospital discharge records for patients across Florida, as well as data collected by the state's 24 medical examiners. The analysis found that, between 2010 and 2015, nearly 3,200 kids age 17 and under were killed or injured by firearms. Put another way, a child in Florida was shot, on average, every 17 hours. (McGrory and Humburg, 2/23)

A resident doctor at Dartmouth-Hitchcock Medical Center said he was “shocked, relieved, happy” when he was able to hug his Iranian wife Wednesday for the first time in nine months. Dr. Omid Moghimi said President Trump’s ban on residents of seven countries to travel to the United States meant his wife, Dorsa Razi, couldn’t get her final immigration interview in late January or a required visa needed to come to the United States. But a federal court blocked the travel ban, giving her a reprieve to gain the necessary approvals. Moghimi said he had worried he might not see his wife “for several more months if not for a year. (Cousineau, 2/23)

Despite the relatively mild 2016-2017 winter so far, Ohio is close to matching the number of children — six — who died during the 2014-15 flu season. One child died last flu season and none in 2013-2014. Adult flu deaths are not reported in Ohio, and health officials could not release whether the children who died had received a flu vaccine. (Viviano, 2/22)

Chronic pain may be added to the list of ailments that qualify for medical marijuana treatment in New Jersey, according to the chairman of a Health Department advisory panel that took emotional testimony from patients Wednesday in a crowded meeting room at the War Memorial. The panel will decide in the coming months whether to recommend that the health commissioner expand the list, which now has about a dozen ailments, including terminal cancer, multiple sclerosis, and epilepsy. (Hefler, 2/22)

Patients and their advocates made a return trip to the Iowa Capitol Wednesday, arguing once again for the legalization of medical marijuana in Iowa. A new bill is under consideration in the House to regulate the growing, manufacturing, and distribution  of cannabis oil. This is a working vehicle. -Rep. Jared KleinEarlier legislation is about to expire. It allows epilepsy patients to travel out of state to acquire the drug, which has created numerous obstacles. (Russell, 2/22)

The Republican effort to repeal the Affordable Care Act is not going well, in large part because it turns out that making sweeping changes to a system that encompasses one-sixth of the American economy turns out to be rather more complicated than they imagined. Their backtracking has an interesting character to it, in particular how they’ve been gobsmacked by the transition from shaking their fists at the system to being responsible for it. (Paul Waldman, 2/22)

The US Congress recently took its first steps toward repealing the Affordable Care Act (ACA). The Congressional Budget Office projected that repeal would increase the number of uninsured by 18 million people initially, and by 27 million after funding for Medicaid expansion and subsidies are eliminated. Repealing the ACA also threatens the safety net critical to health care access for economically vulnerable individuals and families. (Roy Grant, 2/20)

Much of the media coverage and public political battle has focused on regulations and subsidies that impact middle America and those with coverage. The program targeted at the poor — Medicaid —has received less attention but demands more. For now, it looks as if the Republican Congress will end up leaving the structure of Obamacare’s expanded Medicaid program intact and that Tom Price — President Trump’s secretary of health and human services — will use his administrative powers to grant states greater discretion in running their Medicaid programs. (Timothy Callaghan and Lawrence R. Jacobs, 2/22)

A fierce critic of Medicaid expansion has joined the White House team working on repealing and replacing the Affordable Care Act. White House staffers are expected to play a key role in helping craft the upcoming budget reconciliation bill to repeal and replace the ACA. One of those key aides is Brian Blase, who recently left the conservative Mercatus Center at George Mason University to serve as health policy adviser to Gary Cohn, director of President Donald Trump's National Economic Council and former president of Goldman Sachs. (Harris Meyer, 2/22)

Vaccine opponents, often the subject of ridicule, have found fresh energy in the election of a president who has repeated discredited claims linking childhood immunizations to autism and who has apparently decided to pursue them. With President Trump’s support, this fringe movement could win official recognition, threatening lives and making it urgent that health officials, educators and others respond with a science-based defense of vaccines. Vaccines have saved lives by protecting children and adults from diseases like measles, polio, smallpox, cervical cancer and whooping cough. And there is no evidence whatsoever that vaccines or a preservative used in flu shots cause autism. (2/23)

Writing recently in the New York Times, infectious disease physician Peter Hotez warned: “It’s looking as if 2017 could become the year when the anti-vaccination movement gains ascendancy in the United States and we begin to see a reversal of several decades in steady public health gains. The first blow will be measles outbreaks in America.” (Joshua M. Sharfstein, 2/22)

Fear of speaking and debating openly on controversial issues and inquiry is antithetical to science. So it has been chilling for me to listen to the fear expressed by medical students, resident physicians, faculty members, and administrators engendered by Trump’s actions. I’ve heard medical students say they are worried about speaking out because they might be branded as “activists” by residency programs. Faculty members worry about how their opposition to the Trump agenda may be perceived by philanthropists who fund their work. Administrators fear overstepping the line in response to Trump and struggle to balance supporting their staff’s concerns about how new policies affect their colleagues and families while avoiding perceived political conflict. (Duncan Maru, 2/22)

On January 19, 2017, the Office for Human Research Protections (OHRP), Department of Health and Human Services, and 15 federal agencies published a final rule to modernize the Federal Policy for the Protection of Human Subjects (known as the “Common Rule”).1 Initially introduced more than a quarter century ago, the Common Rule predated modern scientific methods and findings, notably human genome research. (James G. Hodge and Lawrence O. Gostin, 2/22)

While a handful of high-profile policy questions have preoccupied Americans since the election, one potentially catastrophic health-care change has quietly been taking shape without much media attention. The Accreditation Council for Graduate Medical Education — the professional body charged with overseeing the nation’s physician training programs is poised to eliminate the 16-hour limit on work shifts for first-year resident physicians (referred to as interns) that it implemented in 2011. It proposes allowing interns to return to working extreme shifts of 28 hours — twice each week. (Christopher P. Landrigan and Charles A. Czeisler, 2/22)

Using big data to improve health might seem like a great idea. The way private insurance works, though, it could end up making sick people -- or even those perceived as likely to become sick -- a lot poorer. Suppose a company offers you an insurance discount and a free FitBit if you agree to share your data and submit to a yearly physical. You're assured that the data will be used only in aggregate, never tied back to specific identities. If that makes you feel safe, it shouldn’t. (Cathy O'Neil, 2/23)

We represent the organizations that won leading Supreme Court cases in recent years on sexual and reproductive rights: Obergefell v. Hodges in 2015, which secured legal protections for the marriage of same-sex couples, and Whole Woman’s Health v. Hellerstedt in 2016, which struck down Texas’s attempt to use sham health regulations to shut down 75 percent of the state’s abortion clinics. President Trump has taken sharp aim at the rights affirmed in those cases. During the campaign, he attacked the Obergefell opinion and repeatedly and unambiguously promised to put justices on the Supreme Court who would overturn Roe v. Wade. According to the president, it’s the government, not each individual, that should hold the power to decide who can get married and whether women can terminate a pregnancy. (Nancy Northup and Rachel B. Tiven, 2/22)

Iowa Code allows state lawmakers to enroll in health insurance plans offered to executive branch employees “excluded from collective bargaining.” Those workers pay 20 percent of the total cost of their monthly premium. A few weeks ago, The Des Moines Register reported that legislators are instead enrolled in health plans negotiated by unions on behalf of union-covered state employees. Many lawmakers are paying as little as $20 in monthly premiums when they should be paying hundreds of dollars. (2/22)

During my nursing career, I have come across numerous heroes, but my first was Surgeon General Everett Koop. More than 50 years ago, he published the first report on Smoking and Health. ... Today, my new hero is another Surgeon Gen. Vivek Murthy, who released the first report on E-cigarette Use Among Youth and Young Adults in December 2016. We now have data and ammunition to halt the debate that e-cigarettes are harmless. The report lays out in clear, indisputable terms that e-cigarette use increases the risk of nicotine addiction, harm to brain development and future use of other tobacco products for young users. (Janie Heath, 2/22)

A new report from the World Health Organization suggests we’ve made some progress in reducing traffic fatalities through seat belt laws, improved highway and vehicle design, and campaigns to reduce drunk or drug-impaired driving. But motorcycles are bucking the trend, even in the world’s wealthiest and most developed countries, including the United States. (Fredrick Kunkle, 2/22)

More than at any time in history, good health for all is a real possibility. The technology, scientific advancement, and remarkable understanding of disease now available to the medical and nursing community show the progress we have made. As a career physician, I have seen modern medicine rescue people from the brink of death with the power of machines, medicines, and smart minds. The successes aren’t just in developed countries — they’re global. For example, the number of people newly infected with HIV around the world has stopped growing. There are now 18.2 million people undergoing treatment for HIV, up from 15.8 million in the last year alone. Equally encouraging, new infections in children are down 50 percent since 2010. (Vanessa Kerry, 2/22)