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Representative Tom Price, the man President-elect Donald J. Trump has chosen to lead the Department of Health and Human Services, promised on Wednesday to make sure people do not “fall through the cracks” if the Affordable Care Act is repealed, and set a goal to increase the number of people with health insurance But at a hearing before the Senate Health, Education, Labor and Pensions Committee, Mr. Price provided only vague reassurance to members of both parties who pressed him for specific policies. (Pear and Kaplan, 1/18)

Rep. Tom Price, R-Ga., told the Senate Health, Education, Labor and Pensions Committee that Trump is "absolutely not" planning to launch an overhaul of Medicare as he tries to revamp coverage under President Barack Obama's signature health care law. He acknowledged that high prescription drug costs are a problem, but did not endorse the idea of government directly negotiating prices. (Alonso-Zaldivar and Fram, 1/18)

Price began by laying out central elements of his years-long attempt to replace the Affordable Care Act. In doing so, he signaled ways in which Trump’s more populist message could collide with the core beliefs of congressional Republicans. He told senators that “it is absolutely imperative” for the government to ensure that all Americans “have the opportunity to gain access” to insurance coverage — a more modest goal than the “insurance for everybody” declaration that the incoming president made this past weekend. (Eilperin and Goldstein, 1/18)

During a testy four-hour hearing on Capitol Hill — which also featured several heated exchanges about Price’s ethics — Price also repeatedly dodged questions from Democrats seeking assurance that he would preserve basic protections required by law. Among other things, Obamacare bans lifetime limits on coverage, requires that health plans offer basic benefits such as substance abuse treatment and mandates that plans allow parents to keep their children on their insurance until they are 26. (Levey, 1/18)

Throughout the nearly four-hour hearing, Price offered few new details on what’s coming. He mentioned high-risk pools as a possible way to provide access to insurance, and said Republicans wouldn’t “pull the rug out” from anyone. (McIntire, 1/18)

Republicans referenced the replacement plan Trump alluded to over the weekend but offered no new details, and some in the party reportedly are not sure Trump's plan actually exists. Price said he shared Trump's goal of coverage for everyone and believed the Republicans' plan would accomplish that. But he emphasized the importance of access to coverage and the financial feasibility to buy it, dodging a question from Sen. Bernie Sanders (I-Vt.) about whether healthcare is a right. (Muchmore, 1/18)

A hearing on President-elect Donald Trump’s choice for health secretary became an arena Wednesday for key Republicans to stress their opposition to overturning the current health law without a clear replacement. ... Mr. Alexander, who chairs the Senate Health, Education, Labor and Pensions Committee, warned that the fragile insurance market in his state means he cannot support anything that would trigger further disruption. He finished on a similar note, telling Mr. Price he was confident he had secured his agreement. (Armour and Radnofsky, 1/18)

Price kept his cards close to his chest, parrying questions from Democrats by speaking in broad terms about wanting to provide access to healthcare coverage while providing few details. Here are five takeaways from the hearing. (Sullivan and Hellmann, 1/18)

Questioned by Sen. Bernie Sanders (I-VT) about Trump’s intentions to keep his campaign promises to safeguard Medicare, Medicaid and Social Security, Price said that while he hasn’t had extensive discussions with Trump about those comments, “I have no reason to believe that he has changed his position.” “So you are telling us that to the best of your knowledge, Mr. Trump will not cut Social Security, Medicare and Medicaid,” Sanders persisted. “As I say, I have no reason to believe that position has changed,” Price replied. (Pianin, 1/18)

Congressman Tom Price, the Republican nominated by Trump to lead HHS, was asked by Democratic lawmakers whether he would agree to support empowering Medicare to negotiate prices with drug companies. After initially sidestepping those questions, he seemed to suggest that the policy would at least be considered, given Trump’s outspoken support for it, but he expressed no enthusiasm for the proposal. (Scott, 1/18)

President-elect Donald Trump's nominee to head the U.S. Department of Health and Human Services defended his stock holdings and proposals to dismantle Obamacare on Wednesday, saying Americans would not suddenly lose health insurance. (Clarke and Cornwell, 1/18)

Price denied profiting from inside information, or benefiting from legislation he helped author. "Everything that we have done," Price said, "has been above board, transparent and legal." (Naylor, 1/18)

One factor making it easier for Trump’s nominees to prevail in the GOP-controlled Senate is a 2013 rule change — ironically, one that was engineered over Republican objections by the Democrats who were then in the majority. It ended the ability of senators to filibuster Cabinet nominees, which means that nominees can be confirmed with 51 votes. There are 52 Republicans in the chamber. “What’s different now is that [blocking a nominee] is going to require Republicans to stand up to their own president,” said Jim Manley, a longtime aide to former minority leader Harry M. Reid (D-Nev.). (Tumulty, Wagner and O'Keefe, 1/18)

Price said he learned of the drugmaker from Representative Chris Collins, a Republican who sits on the board of the company, but wasn’t privy to non-public information before purchasing the stock. He said he paid market price for Innate shares in 2015, but may have paid a lower price for three additional purchases. (Edney and Tracer, 1/18)

Sen. Elizabeth Warren (D-Mass.) demanded to know whether Price had actively tried to "help the company that you now own stock in." It was one of the only moments in the nearly four-hour grilling by the Senate HELP Committee when Price flashed anger. "I'm offended by the insinuation, senator," he responded. (Diamond, 1/18)

Price and his longtime friend, Senate Ethics Chairman Johnny Isakson, R-Ga., defended Price's purchases. Price said his broker bought shares in one medical device company without his knowledge and others were part of mutual fund or pension plan purchases that are made on behalf of many members. Sen. Christopher Murphy, D-Conn., raised the issue of Price's stock purchases in six companies that would have been hurt by a Centers for Medicare and Medicaid Services pilot project that Price led opposition to in the House. More ominously, Murray peppered Price for details on his purchase of stock in the company Innate Immunotherapeutics after discussing the company with Trump transition official Rep. Chris Collins, R-N.Y., a large shareholder who sits on the company's board. Price acknowledged he directed his broker to make the purchases. Murray pointed out that was soon before Senate action on the 21st Century Cures Act, which benefited drug companies. (O'Donnell, 1/18)

Rep. Tom Price, President-elect Donald Trump’s pick to run the Department of Health and Human Services, said he purchased stock in an Australian biomedical firm after discussing the company with a fellow congressman who sits on its board. (Grimaldi and Hackman, 1/18)

President-elect Donald Trump’s pick to run Health and Human Services is taking heat for his controversial stock holdings in companies affected by laws he’s worked on and voted for. But federal records show several senators who will take part in his confirmation hearings have substantial health-related holdings as well. (Lupkin, 1/18)

Republican governors who turned down billions in federal dollars from an expansion of Medicaid under President Barack Obama's health care law now have their hands out in hopes the GOP Congress comes up with a new formula to provide insurance for low-income Americans. (1/19)

As U.S. Congress moves ahead with repealing the Affordable Care Act, some Republican governors are reaching out to lawmakers and urging caution. In recent comments and letters to Republican House leaders who sought input from state officials on potential health-system changes, several governors have voiced concerns about the effects of abruptly scrapping the 2010 law. At least nine governors and two lieutenant governors have signed up for a Thursday round table held by Senate Finance Committee Republicans on the future of the health law’s Medicaid expansion. (Levitz and Kamp, 1/19)

Gov. Rick Snyder is expected to vouch for the state’s Healthy Michigan plan Thursday in Washington D.C., where he’ll join a Senate committee roundtable discussion on the future of the larger Medicaid health care program for low-income and other vulnerable residents. The Republican governor is a vocal proponent of Michigan’s unique form of expanded Medicaid eligibility funded through the Affordable Care Act. (Oosting, 1/18)

Gov. Rick Snyder fought to expand Medicaid in Michigan under the Affordable Care Act when some Republicans at the state level were opposed to it. Now, it's Republicans at the federal level he might find himself on the opposite side of. ... Michigan's Healthy Michigan plan, which Snyder signed into law in 2013, covers 638,845 people, according to statistics maintained by the Michigan Department of Health and Human Services. Snyder said in his speech that Michigan's Medicaid expansion had reduced uncompensated care by an average of 44 percent. (Lawler, 1/18)

Gov. Andrew Cuomo warned President-elect Donald Trump on Wednesday of a "dramatic impact" on New Yorkers if Trump moves ahead with a repeal and replace of the Affordable Care Act. The meeting at Trump Tower was the first face-to-face sit down between the two New Yorkers, who are both Queens natives, since Trump was elected. (Spector, 1/18)

A bill to expand the state Medicaid program has been introduced in the Kansas House, but lawmakers may have to rush in order to pass it before the Republican-controlled Congress repeals the federal Affordable Care Act that makes the expansion possible. In fact, while supporters believe the idea has more than enough support to pass the 125-seat Kansas House, all of whose members were just elected in November, the state's entire delegation in the U.S. House is on record supporting repeal of the federal law, even though they were all re-elected on the same ballot. (Hancock, 1/18)

Sen. Adam Morfeld of Lincoln on Tuesday introduced legislation to expand Medicaid coverage in Nebraska, suggesting it as a means of transitioning into a forthcoming Republican health care plan. "LB441 allows us to bring home $775 million (in federal funds) paid in part by hard-working Nebraska taxpayers to reduce health care costs, improve efficiency in our Medicaid system and make sure the workers who are the backbone of our state's economy are as healthy and productive as they can be," Morfeld said. (Walton, 1/17)

Rep. Greg Walden spent four years capitalizing on Americans’ unease with Obamacare to usher in the largest House Republican majority in 90 years. Now, he has to help figure out how to replace it. (Cheney and Bade, 1/18)

Vice President-elect Mike Pence said Wednesday that Republicans do not yet have a bill to replace Obamacare, but that he has "seen a lot of great ideas" and that transition officials and GOP leaders are "getting very close" to having a replacement. "It's being crafted right now," Pence said Wednesday in an interview with CNN's Dana Bash, when asked about a replacement to the President's signature health care law. "We're getting very close. We expect to have that plan come forward in the early days of the administration." Pence's comments came after Trump said in an interview Saturday with The Washington Post that his health care replacement plan "is very much formulated down to the final strokes." (Diamond, 1/18)

Seven years after unruly Democratic town halls helped stoke public outrage over the Affordable Care Act, Republicans now appear keen to avoid the kind of dustups capable of racking up millions of views on YouTube and ending up in a 2018 campaign commercial. One week after the Republican Congress kicked off the process of repealing the landmark health-care legislation, only a handful of GOP lawmakers have held or are currently planning to host in-person town hall meetings open to all comers — the sort of large-scale events that helped feed the original Obamacare backlash in the summer of 2009. (DeBonis, 1/19)

Sylvia Douglas twice voted for President Barack Obama and last year cast a ballot for Democrat Hillary Clinton. But when it comes to "Obamacare," she now sounds like President-elect Donald Trump. This makes her chuckle amid the serious choices she faces every month between groceries, electricity and paying a health insurance bill that has jumped by nearly $400. "It's a universal thing, nobody likes it," Douglas, a licensed practical nurse in Huntsville, Alabama, said of Obama's signature law. (Kellman and Swanson, 1/18)

Rep. Kevin Brady (R-Texas) on Tuesday had contentious exchanges with some constituents during a local meeting about the GOP plan to repeal and replace ObamaCare. Dozens showed up to a meeting with Brady, the chairman of the House Ways and Means Committee, meant as a chance for "local people affected by ObamaCare" to "share their experiences with rising costs and loss of coverage and choice," the Houston Chronicle reported. (Savransky, 1/18)

U.S. Rep. Kevin Brady, R-The Woodlands, faced a skeptical and at times testy crowd Tuesday as dozens of people arrived at an afternoon meeting to make sure he knew they would not let the Affordable Care Act end without a fight. The hourlong session, tucked away in a back meeting room at The Woodlands Area Chamber of Commerce headquarters, was not publicly announced and was billed by Brady's staff as a chance for "local people affected by ObamaCare" to "share their experiences with rising costs and loss of coverage and choice." ... But if he was expecting a completely friendly, like-minded group, he quickly found something else from many in the 50 or so who crowded the room. (Deam, 1/18)

No item on Donald Trump’s agenda seems to have received as much publicity as his desire to repeal the Affordable Care Act and replace it with “something terrific.” Since his election, the prospects for repeal have taken many a twist and turn. Two weeks ago, repeal suddenly appeared doubtful — as key Senate Republicans balked at the idea of repeal without a full-fledged replacement. (Sides, 1/19)

Government bureaucrats are not often Twitter celebrities. But Andy Slavitt, current head of the agency that runs Medicare and Medicaid, is making a name for himself with a barrage of fiery Tweets in defense of the Affordable Care Act, breaking with the traditionally mute posture taken by federal employees. As the Act — known as Obamacare — is coming under attack by the new Republican-controlled Congress and incoming Trump administration, Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, isn’t being shy online. (Bluth, 1/19)

California officials on Wednesday withdrew their request to sell unsubsidized insurance policies to people who can't prove they're legally in the United States after learning the decision would fall to President-elect Donald Trump's administration. (Cooper, 1/18)

California has withdrawn its request to the federal government for permission to allow undocumented people to obtain health insurance from the state exchange, with a lawmaker linking the decision to concerns about the incoming Trump administration. State Sen. Ricardo Lara, D-Bell Gardens, called the action “the first California casualty of the Trump presidency.” (Miller, 1/18)

Hospitals across the state could be forced to cut back services or even close if the Affordable Care Act is repealed without an adequate replacement, several health care executives in Colorado warned on Wednesday. A hospital in the San Luis Valley, for instance, may not be able to maintain a level of care that means patients currently don’t have to leave the valley for chemotherapy or to have surgery on broken bones, its CEO said. A hospital in Delta County — already with a profit margin only in the low single digits — could see its revenue dip dangerously close to the red, its CEO said. (Ingold, 1/18)

Surgeon Atul Gawande says we need to reconsider health care’s focus on generously rewarding physicians who practice heroic interventions, rather than those who practice incremental medicine for chronic conditions. Gawande talks with William Brangham about the value of that kind of care, and the potential effects of a Republican repeal of the Affordable Care Act. (Brangham, 1/18)

Evergreen Health, an innovative Baltimore-based health insurer, took a big step toward assuring its future by finalizing a deal to repay part of a federal startup loan and sever ties with the Affordable Care Act program under which it was founded. The deal with federal health regulators, made possible by an influx of cash from unnamed investors, allows Evergreen to move forward with plans to seek state approval to convert to a for-profit insurer. (Gantz, 1/18)

Thousands of Covered California enrollees face higher-than-expected bills from their insurers because the exchange sent incorrect tax credit information to the health plans. The exchange confirmed it gave insurers wrong subsidy information for about 25,000 policy holders, resulting in inaccurate bills. Insurers are now sending out new bills correcting the errors, and in most cases that means higher premiums than consumers had initially anticipated. (Bazar, 1/18)

Paula Wilson has seen some tough times in her 23 years as the CEO of Valley Community Healthcare, a clinic that provides care for the poor in North Hollywood, Calif. But nothing was quite like November 9, the day after the U.S. elections, when walking around the office “was like coming into a funeral,” she said. Her staff worried that a repeal of the Affordable Care Act, long promised by Republicans, would obliterate their jobs. Patients fretted it would jeopardize their care. (Brown, 1/19)

As Republicans seek to repeal and replace the Affordable Care Act, advocacy organizations around the nation are strategizing on how best to respond. Do they defend the law at all costs? Do they take part in the repeal conversation so they can help design an alternative? (Gorman, 1/19)

More than 8.8 million Americans signed up for 2017 insurance coverage through HealthCare.gov as of Jan. 14, 2017, about 100,000 more than over a similar time frame last year. The enrollment snapshot provided Wednesday by the Centers for Medicare and Medicaid Services is the final one of President Barack Obama’s administration. The numbers do not include people in the 12 state-based marketplaces that use their own websites. About 2.8 million people in these states were enrolled as of Dec. 24. (Willilams, 1/18)

With less than two weeks left to sign up for insurance under the Affordable Care Act, advocates and officials launched their last push to draw Maryland residents. The effort announced Wednesday involves enrolling people through churches and other faith-based groups, a campaign called "Extol & Enroll." "It is important to us that our people have adequate health care and are living healthy lives," said the Rev. Cleveland Mason, president of the United Baptist Missionary Convention of Maryland. He spoke during a news conference Wednesday that drew lawmakers, advocates from the Healthcare for All! Coalition and the NAACP, and officials from the state health exchange, the online market created to enroll people who do not get health insurance through work. (Cohn, 1/18)

With only two days left in office, the Obama administration on Wednesday issued new rules intended to protect people who participate in scientific research, stepping back from proposals that would have imposed significant new regulatory requirements on scientists. In particular, the administration abandoned a proposal that would have required researchers to obtain written consent before using cells, blood, tumor samples, DNA, or other “biospecimens” obtained during medical procedures, even when the samples were stripped of the person’s name and other identifying information, or obtained from earlier studies the person had participated in. That was intended to prevent outrages such as the unauthorized use of cancer cells from patients like Henrietta Lacks, the African-American tobacco farmer whose tissue was taken in the 1950s without her permission or even her (or her family’s) knowledge. (Begley, 1/18)

Patient privacy advocates are not pleased with the Obama administration's decision to release a final rule that lifts a burden on scientists working with human subjects. The revised Common Rule, as it's known, dials back a proposal requiring researchers to get written consent from patients before using any biospecimens obtained during medical procedures. The HHS issued the proposal in 2015. The draft drew more than 2,100 comments, mostly negative. (Conn, 1/18)

The Obama administration on Wednesday released a sweeping final rule that will update many long-standing federal protection measures for people who participate in medical research trials. The regulation, known as the Common Rule, has not been revised since 1991. Several contentious provisions were dropped or scaled back from a draft rule released in September 2015, including a measure that was vigorously opposed by academic medical interest groups pertaining to the use of blood, urine and other samples from the human body in research. Lobbyists say the exclusion of the provision will likely reduce any opposition to the rule from congressional leaders who were concerned about the impact it would have on medical research institutions. (Williams, 1/18)

One day before President-elect Donald Trump’s inauguration, the vast majority of House Democrats are warning him to think twice before supporting and signing Republican laws that they say would undermine women’s health care. A letter set to be delivered to Trump on Thursday urges the soon-to-be president to oppose GOP plans in Congress to repeal the Affordable Care Act — which includes measures to prohibit discriminatory insurer practices and expand access to breast-cancer screenings and birth control — and to strip Planned Parenthood of federal funding. It is signed by 173 of 194 House Democrats. (DeBonis, 1/19)

Vasectomies, which are not covered under President Barack Obama's health care law, are increasingly being included in state measures that would require insurers to provide cost-free coverage of birth control. Backers of laws and proposals in such states as Illinois, Vermont, Maryland and most recently New York say that if women can get tubal ligations with no out-of-pocket costs, men should be able to get their surgical sterilization covered cost-free as well. (1/18)

After a relative suffered a heart attack a few years ago, Silicon Valley entrepreneur Adrian Aoun got an unsettling look at a health-care system that he diagnosed as an inefficient and outdated mess. Now he believes he has a remedy. It's called Forward, a health-management service that charges a $149 per month — roughly $1,800 a year — to tend to all of its patients' primary-care needs. And not just with attentive doctoring, either; Forward plans to deploy body scanners, sensors, giant touch-screen monitors, infrared devices and other high-tech gizmos that could make a doctor's appointment feel more like a trip to an Apple store. (Liedtke, 1/17)

Most health-care startups try to fix things by spreading software across the analog parts of the medical industry. For Forward, founder Adrian Aoun is ditching that approach in favor of engineering a doctor's office from scratch. Forward doesn't replace your health insurance. Instead, members pay a steep $149 per month to have unlimited access to Forward's primary care services and its first office—a gleaming lobby in San Francisco's Financial District full of body scanners and infrared vein finders. Forward hopes that by making it easier and more pleasant to see a doctor, patients will do it more often—and catch expensive health issues like cancer and heart disease earlier. (Huet, 1/18)

Stung by the lack of vaccines to fight the West African Ebola epidemic, a group of prominent donors announced Wednesday that they had raised almost $500 million for a new partnership to stop epidemics before they spiral out of control. (McNeil, 1/18)

The partnership will be called the Coalition for Epidemic Preparedness Innovations, or CEPI. It grew out of the lessons from the world’s woeful lack of preparedness for the 2014 Ebola epidemic in West Africa, which killed more than 11,000 people and caused at least $2.2 billion in economic losses in the three hardest-hit countries. As a result of that and the current Zika epidemic in the Americas, a global consensus has steadily grown among an array of governments, public health leaders, scientists and vaccine industry executives that a new system is needed to guard against future health threats. (Sun, 1/18)

“Ebola showed how unclear it was who should step up and how and when,” said Bill Gates, co-chair of the Bill & Melinda Gates Foundation, which is contributing $100 million for the first five years. Other funders are the Wellcome Trust, with $100 million, as well as the governments of Norway, Japan and Germany. India and the European Commission are also planning donations. (McKay, 1/18)

Seven U.S. senators sharply criticized the Drug Enforcement Administration on Wednesday for failing to answer questions about enforcement actions against pharmaceutical companies accused of violating laws designed to prevent painkillers from reaching the black market. (Higham and Bernstein, 1/18)

At the lab, run by the Drug Enforcement Agency, chemists are analyzing these drugs and trying to identify them. More and more, they’re discovering new, deadlier varieties of opioids concocted overseas and sold on the street in the US. As the chemical compositions of these drugs are manipulated, they can become far more powerful. Fentanyl, a common synthetic opioid, is up to 100 times more potent than morphine and many times that of heroin. (Hogan, 1/19)

Insys Therapeutics Inc. of Chandler, Ariz., will pay the state $2.9 million to settle allegations that it aggressively marketed its opioid Subsys, a fentanyl spray approved for cancer patients, to New Hampshire residents. Additionally, it will pay $500,000 to the New Hampshire Charitable Foundation to be used for preventing and remediating problems related to abuse, misuse or misprescribing of opioid drugs in the state. The settlement comes as New Hampshire struggles with the highest per-capita fentanyl death rate in the country. As of Dec. 12, 2016, 369 people died from drug overdoses and 269 of them, or 72 percent, involved fentanyl. (Grossmith, 1/18)

The former chief of staff of the Tomah Veterans Affairs Medical Center has agreed to permanently surrender his license to practice medicine in Wisconsin, closing a two-year investigation into his narcotic prescription practices. The VA had already fired David Houlihan, after he was exposed as the “Candy Man” in a January 2015 investigation from Reveal from The Center for Investigative Reporting. We reported that veterans treated at the Tomah VA showed up to appointments stoned on painkillers and muscle relaxants, dozed off and drooled during therapy sessions, and burned themselves with cigarettes. (Glantz, 1/18)

A new study reveals that strains of tuberculosis that evade most of the drugs typically used to treat the bacterial infection have been spreading in South Africa, which already has a high rate of tuberculosis infection. Extensively drug-resistant tuberculosis — known by the short form XDR TB — is highly concerning to health authorities because of the way tuberculosis spreads. Infected people expel bacteria from their lungs when they cough, sneeze, even speak. The bacteria can float for hours under the right conditions, infecting people who breathe them in. (Branswell, 1/18)

Most people who are infected with drug-resistant tuberculosis catch it from an ill person who transmits the deadly bacteria by coughing or some other form of airborne transmission, rather than developing it from poor drug treatment, a new study suggests. (McKay, 1/18)

Scott Pruitt, the Oklahoma attorney general picked by President-elect Donald Trump to lead the Environmental Protection Agency, immediately drew blowback during his confirmation hearing on Wednesday for saying that he “hasn’t looked into the scientific research” on precisely how much lead exposure is unsafe for children. Critics slammed Pruitt’s response as an uninformed and dangerously naive perspective on a critical environmental health issue. But, in fact, Pruitt’s not alone in his uncertainty on this question. There’s an ongoing debate among scientists and regulators about how much lead is too much for kids to have in their bodies. (Robbins, 1/18)

The first results from a major project to measure the reliability of cancer research have highlighted a big problem: Labs trying to repeat published experiments often can't. That's not to say that the original studies are wrong. But the results of a review published Thursday, in the open-access journal eLife, are a sobering reminder that science often fails at one of its most basic requirements — an experiment in one lab ought to be reproducible in another one. (Harris, 1/18)

As policymakers and health officials sound the alarm on the nation’s obesity epidemic, a team of researchers want to improve health outcomes among the most vulnerable Americans by overhauling the federal food assistance program. (Heredia Rodriguez, 1/19)

Nearly one-third of Colorado’s hospitals are refusing to offer terminally ill patients the option of physician-assisted suicide — even though voters last fall overwhelmingly approved a ballot initiative legalizing the practice. And two of the state’s biggest health care systems, both faith-based, appear poised to bar their doctors from providing such services to patients at any of their facilities, under any circumstances — potentially running afoul of the new aid-in-dying law. (Graham, 1/19)

It’s been more than a decade since California launched an unprecedented experiment in medical research by direct democracy, when voters created a $3 billion fund to kick-start the hunt for stem cell therapies. The bold plan, a response to federal funding limits for embryonic stem cell research, was sold with a simple pitch: The money would rapidly yield cures for devastating human diseases such as Parkinson’s and ALS. That hasn’t happened. A major reason, a STAT examination found, is that the California Institute for Regenerative Medicine has been slow to move promising experimental therapies into clinical trials. (Piller, 1/19)

Supporters pushing a proposal to bring Colorado in line with most other states by requiring fingerprint-based criminal background checks for doctors, nurses and other health-care professionals say such checks are a key component of ensuring public safety...In addition to impacting those seeking a new health-care license, the new system also would send automatic alerts to state health-care licensing boards whenever a licensee is arrested. Those boards would have the power to revoke an existing license based on those alerts if a transgression is identified that’s a revocable offense, such as rapes or violent felonies. (Osher, 1/18)

Considering the vast uncertainty hovering over the future of health care at the federal level, Virginia’s hospitals are asking the state’s lawmakers to take a “do no harm” stance on state health policies. During a news conference at the General Assembly Building on Wednesday, the Virginia Hospital & Healthcare Association encouraged legislators to restrain themselves during this year’s session, particularly regarding Certificate of Public Need, or COPN, reform. (Demeria, 1/18)

Many employers, especially those in the health industry, agree that Gov. Charlie Baker has a problem. In the past five years, roughly 500,000 workers and their children who used to be on a company insurance plan have switched to government-funded free or subsidized coverage. That shift is busting the state budget, where almost 40 percent of spending this year will be on MassHealth. (Bebinger, 1/18)

Families seeking to prevent abuse or neglect of their loved ones in nursing homes by using hidden cameras, or “granny cams,” would face more restrictions under recommendations issued this week by a state work group. The 17-member group was asked to advise the Legislature on ways to regulate the growing use of hidden cameras and other electronic surveillance equipment in senior care facilities, while balancing privacy rights with efforts to deter abuse. (Serres, 1/18)

A former Kansas City doctor didn’t need a medical license to commit health care fraud. Wayne Williamson, who lost his license after a previous fraud conviction, pleaded guilty in federal court Tuesday to another count of health care fraud. (Rizzo, 1/18)

The St. Louis Board of Aldermen is considering a bill that would bar employers and landlords from discriminating against women who are pregnant, use contraception or have had an abortion. If approved, the bill would add pregnancy and reproductive health decisions to the city’s anti-discrimination ordinance, alongside protections based on race, sex or disability. (Bouscaren, 1/18)

Hoping to stave off cuts in the next state budget, nonprofit social service providers said privatizing an array of services for the intellectually disabled and mentally ill could save more than $1.3 billion in total over the next three years. The Connecticut Community Provider Alliance also released an industry poll showing 80 percent of nonprofit agencies anticipate laying off staff if state funding is cut by 10 percent or more. And while some municipal leaders and social services advocates have called for Gov. Dannel P. Malloy and the legislature to consider tax hikes to help close the $1.4 billion hole in the coming fiscal year, the alliance stayed out of the tax debate. (Phaneuf, 1/18)

One thousand days ago, the city of Flint shut off the tap to the Lake Huron water they had been receiving from the Detroit Water and Sewage Department and began drawing and treating water from the Flint River. That was April 25, 2014. And it was also the beginning of the Flint water crisis, another tragic chapter in the tumultuous history of Michigan's once-thriving industrial center. (Manzullo, 1/19)

Known as the PHIT Act, for Personal Health Investment Today, the proposal would enable workers to put up to $2,000 in health savings or flexible spending accounts to use toward fitness club fees, sports equipment, youth sports league fees, event registration costs and other activities. Individual expenses would be capped at $250, with some exceptions, such as for home fitness equipment. (Mirabella, 1/18)

A new study has concluded that nearly 30 percent of all the cigarettes smoked in Massachusetts in 2014 were smuggled into the state, a drastic increase that apparently followed a tax hike on cigarettes. Researchers at the Mackinac Center for Public Policy, a Michigan think tank, found that cigarettes illegally brought into Massachusetts jumped to 29.3 percent of all those smoked in 2014, up from 12 percent in 2013, the seventh-highest rate among states and largest year-over-year increase of any state. They hypothesized that the spike in black market sales resulted from an increase in the state’s tax on cigarettes from $2.51 per pack to $3.51 per pack in 2013. (Adams, 1/18)

A request for $235,109 to make nine bathrooms at a state mental-health hospital suicide-proof is prompting outrage from Republican lawmakers who suggest it is evidence of wasteful government spending. The reaction to the proposal in the context of a $28 billion budget illustrates the intensity of the spending battles expected in the 2017 session as Colorado lawmakers negotiate a deal to find more money for big-ticket priorities, such as a potential $500 million bond to improve roads and transit. (Brown, 1/18)

Flu cases are widespread across the state, with hospitalizations for flu-like symptoms almost doubling to 287 during the first week of January, according to the Ohio Department of Health. "Influenza-like illness is now widespread throughout Ohio for the first time this flue season, and the number of associated hospitalizations are rising," the department said in a written statement. (Bush, 1/18)

A group of nine children from the Havasupai Tribe at the bottom of the Grand Canyon are accusing the federal government of knowingly breaking its own laws by neglecting to provide them access to a fundamental education. The children and the Native American Disability Law Center filed the lawsuit in U.S. District Court in Phoenix last Thursday. (Cano, 1/18)

The flu now has tackled the Buckeye State, the Ohio Department of Health reported Wednesday in announcing that influenza now is “widespread.” The state said the number of hospitalizations due to flu are rising: On the first week in January, 287 new cases turned up compared to 157 the week before. There have been 654 total flu-associated hospitalizations since flu season began in October. (Saker, 1/18)

Rep. Tom Price (R-Ga.), President-elect Donald Trump’s choice to run the Department of Health and Human Services, just put down some potentially important markers on health care policy. During a Senate hearing Wednesday, Price said is “absolutely imperative” that people with insurance get to keep their coverage even if Republicans repeal Obamacare. Price also said that, as far as he knows, Trump continues to oppose cuts in Medicare and Medicaid. Making sure nobody loses coverage and maintaining existing funding for Medicaid isn’t consistent with what Republicans, including Price, have said or endorsed in the past. (Jeffrey Young and Jonathan Cohn, 1/18)

In the first of two hearings on his nomination to head the Department of Health and Human Services, Rep. Tom Price (R-Ga.) on Wednesday asked members of the Senate Health, Education, Labor and Pensions Committee to put him at the center of the Obamacare repeal-and-replace effort. To a nation increasingly nervous about the many dangers of ripping up the health law, Mr. Price offered some big promises — but scant reassurance. (1/18)

If the U.S. Senate confirms the nomination of Representative Tom Price to serve as the 23rd U.S. Secretary of Health and Human Services (HHS) he will be only the third physician to lead that department since its formation in 1953. ... All Americans — and physicians in particular, myself included — are looking to Rep. Price to work closely with Congress to develop a realistic plan for changing the Affordable Care Act in a way that actually improves the law, without interrupting Americans’ access to health insurance coverage and high-quality care. This will be Secretary-Designee Tom Price’s first, and possibly most important, test. (Louis W. Sullivan, 1/17)

Trump also has repeatedly said he wants Medicare to bargain for lower drug prices: "The other thing we have to do is create new bidding procedures for the drug industry, because they’re getting away with murder," Trump said. Does this mean that the GOP's long-sought objective to "repeal and replace" the Affordable Care Act and privatize Medicare will include some mechanism for the government to use its single-payer power to get the lowest-possible drug prices? ... allowing the government to lower drug costs by acting like a Wal-Mart -- the biggest buyer gets the best prices -- makes eminent sense. (John Wasick, 1/18)

The election of Donald Trump with a Republican-majority Congress is proving once again that conservative economic policy largely reduces to cutting taxes, mostly for the rich. But wait a second, aren’t they also wading into health-care reform? They are, and it proves my point. While much attention is reasonably focused on how they’re all repeal with no replace — and how that’s likely to reverse the coverage gains we’ve seen and undermine insurance markets — there’s something else going on here. And that is — you guessed it — a big tax cut for the rich. (Jared Bernstein, 1/18)

Last year, premium increases came in much higher than the program’s supporters had hoped or expected. A number of observers, including me, worried that we might be at the tipping point, where higher premiums cause healthier people to drop their insurance. When that happens, the average cost of covering the people who remain goes up, so premiums go up … which means that more people drop their insurance … which ultimately means disaster. (Megan McArdle, 1/18)

But even if the ACA stays in place, there will still be almost 30 million people without health insurance and another 20 million or so who all too often face deductibles that are unreasonably high for moderate-income families and provider networks that are much too narrow for people with serious medical problems. ... We believe the health care system is desperately in need of reform. But the focus of that reform should not be the Affordable Care Act. The initial goal should be: making sure everyone has access to health insurance that is affordable and that gives them dependable access to medical care. Further, we believe that goal can be accomplished with money already in the system. We don’t need any new taxes or any new spending programs. (Rep. Pete Sessions, R-Texas, Sen. Bill Cassidy, R-La., and John Goodman, 1/18)

As leaders working on state-based policy solutions across the country, we have seen the impact of Obamacare on our communities up close. That’s why we’ve produced a report, being released today, on the need to unwind the law’s disastrous expansion of Medicaid. ... many people don’t know that most of Obamacare’s coverage gains have come not through those exchanges, but through its new expansion of Medicaid to able-bodied, working-age adults. (Ellen Weaver and Caleb Crosby, 1/19)

But many key Republicans are especially interested in changing Medicaid, the nation’s health insurance program for the poor — including Trump, House Speaker Paul D. Ryan (Wis.) and Tom Price (Ga.), Trump’s nominee to head the Department of Health and Human Services. Each of those three has proposed converting Medicaid from a program funded jointly by the federal government and the states into a block grant program. Doing so would send a set amount of money to each state, thus capping total Medicaid spending, and would let each state decide how to disburse those funds. (Ryan LaRochelle, 1/18)

Anyone who followed the recent election cycle knows that President-elect Donald Trump made “repeal and replace” a cornerstone of his campaign — referring, of course, to the Affordable Care Act (ACA). He, like Mitt Romney and John McCain did in their respective bids for the presidency, has proposed permitting insurers to sell insurance plans across state lines as a possible alternative to the ACA, or at least as a component of a potential alternative. In this post, we’ll take a look at the possible advantages of allowing interstate insurance sales, as well as the reasons opponents say such a policy simply won’t work. (John Marchica, 1/18)

On Friday, the Centers for Disease Control and Prevention released a disturbing report about the death of an elderly woman in Washoe County, Nev. What killed her wasn’t heart disease, cancer or pneumonia. What killed her were bacteria that were resistant to every antibiotic doctors could throw at them. (Nicholas Bagley and Kevin Outterson, 1/18

Medicare works. It’s far more efficient, cost effective, and affordable than private sector health insurance. Not surprisingly, it’s also a lot more popular. It should be extended to all of us. Instead, House Speaker Paul Ryan is working hard to destroy Medicare and force seniors and people with disabilities into the arms of private, for-profit health insurers. Ryan wants to end Medicare as we know it and, instead, simply give seniors and people with disabilities fixed cash stipends to fend for themselves, unprotected, on the private market. (Nancy Altman, 1/18)

There are many good reasons to oppose Carson's nomination to lead HUD. He has questioned the agency's mission and previously devalued his own ability to lead a federal department given his lack of government experience. I certainly have significant doubts about his qualifications. Yet, in nominating such an unlikely candidate, President-elect Donald Trump may have inadvertently made a connection that too few policy makers and physicians recognize: Health and housing are inextricably linked. And our inability to successfully assist individuals who are homeless places a significant strain on our public resources. (Manik Chhabra, 1/19)

With early optimism surrounding the 2015 Paris agreement on climate change now fading into anxiety over potential changes to U.S. environmental policy under a Trump administration, many are looking for new leaders in the fight against global warming. Hospitals should step into the breach. Doing so could both slow climate change and improve healthcare systems globally. (Renzo R. Guinto, 1/18)

After years of academic debate over the role and value of patient-satisfaction scores and reviews of health care providers, Yelp, the online powerhouse of documenting customer satisfaction, is forcing the issue. With more than 102 million customer reviews to date, 6% of them in the health care arena, Yelp easily dwarfs longer-standing commercial physician-review sites such as Healthgrades and Vitals. (Vivian Lee, 1/20)

Medicare is poised to overhaul the way it pays for ambulatory care services. The Centers for Medicare and Medicaid Services (CMS) has published a final rule codifying the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which directed CMS to gradually replace fee-for-service reimbursement with value-based payment approaches. MACRA’s bipartisan passage may position it to play an outsized role in federal efforts to improve health care quality, rein in service volume, and control spending growth while not jeopardizing access to care. Can it deliver on these goals? (Eric C. Schneider and Cornelia J. Hall, 1/18)

Vaccines can prevent outbreaks of emerging infectious disease from becoming humanitarian crises. The WHO recently deemed 11 pathogens as the most likely to cause severe outbreaks in the near future and will regularly update its list. There are feasible vaccine candidates for some of these diseases. When such candidates exist, timely vaccine development can avert global public health emergencies, contain loss of life, and limit social and economic damage. An efficient global system of vaccine research-and-development preparedness is needed. (John-Arne Røttingen, Dimitrios Gouglas, Mark Feinberg, Stanley Plotkin, Krishnaswamy V. Raghavan, Andrew Witty, Ruxandra Draghia-Akli, Paul Stoffels, and Peter Piot, 1/18)