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Congressional Republicans laid plans Wednesday to act on a health care repeal bill by the end of March and rewrite the tax code by August as they sketched out an ambitious agenda for their first 200 days under President Donald Trump. Meeting in Philadelphia for their annual policy retreat, they also discussed action to raise the nation's borrowing limit, write an infrastructure package sought by Trump and push funding for defense and border priorities. (1/25)

Republicans have a plan to replace Obamacare. In fact, they have several. What they don't have is consensus on which one will guide the party's effort to reshape an insurance system that provides coverage for some 20 million Americans. (Davis, 1/26)

Speaker Paul Ryan (R-Wis.) on Wednesday mapped out the GOP’s 200-day legislative strategy, saying Republicans will repeal and replace portions of ObamaCare by spring and tackle tax reform before the August recess. During a private meeting of House and Senate Republicans at their annual policy retreat, Ryan said House committees will mark up a reconciliation package in the next couple of weeks that will both repeal President Obama’s healthcare law and replace portions of it, according to several lawmakers in the room. (Wong and Bolton, 1/25)

In an afternoon session at an annual GOP policy retreat, House Speaker Paul D. Ryan (Wis.) and Senate Majority Leader Mitch McConnell (Ky.) unveiled plans that put repealing and replacing the Affordable Care Act as the first order of business, with the target date for action within the next three months. Lawmakers also plan to move quickly on a broad rewrite of the tax code that is expected to include deep cuts in tax rates. The agenda sets a vigorous pace in an attempt to make good on key campaign promises made by President Trump. (Snell and DeBonis, 1/25)

As Republicans struggle to replace Obamacare, House Speaker Paul Ryan wants to make state high-risk pools part of the solution – but doing so would resurrect a failed coverage model that suffered from high premiums, poor funding and limits on coverage, say independent health care experts. Republicans are meeting in Philadelphia this week, and health care coverage is expected to be a major topic. GOP congressmen and senators plan to meet Thursday with President Donald Trump and Vice President Mike Pence. (Pugh, 1/25)

Two days before Republicans’ self-imposed deadline for producing legislation to repeal the Affordable Care Act, GOP lawmakers acknowledged they were unlikely to meet it. Both the GOP-controlled House and Senate passed budgets this month requiring four committees to deliver proposals by Jan. 27 to roll back major tenets of the 2010 health-care law. (Peterson, 1/25)

President Donald Trump's recent assertion he will deliver his own health care plan to Congress has antagonized many Republican lawmakers gathered at a retreat in Philadelphia, which could make it harder to reach agreement on a plan to repeal and replace Obamacare. Lawmakers have been blindsided by the president’s statements about the elements of an Obamacare replacement plan. Some are also unnerved by the prospect that the executive branch, rather than Congress, will write the legislation and potentially tread on the constitutional notion of separation of powers. (Haberkorn, 1/25)

Sen. Rand Paul (R-Ky.) unveiled an ObamaCare replacement bill Wednesday as part of his effort to urge the GOP to speed up work on an alternative to the healthcare law. Paul has been pushing his colleagues to have a replacement plan ready to pass simultaneously with repeal of ObamaCare, a demand that has recently been gaining support inside the party. His office noted that President Trump and Speaker Paul Ryan (R-Wis.) have also reacted favorably to that idea. (Sullivan, 1/25)

U.S. health insurers are making their case to Republican lawmakers over how Americans sign up for individual insurance and pushing for other changes to shape the replacement of former President Barack Obama's national healthcare law. The health insurers, including Independence Blue Cross and Molina Healthcare Inc, are also recommending ways to put more control over insurance in the hands of states as the federal oversight of Obamacare is dismantled. They emphasize that it is crucial to keep government subsidies for low income people. (Humer, 1/25)

A post-election survey of primary care physicians reveals that majorities of the doctors that first treat most Americans do not support some of the GOP’s most widely circulated plans to repeal and replace the Affordable Care Act. Conducted in December and January and published online Wednesday in the New England Journal of Medicine, the new survey shows that nearly three-quarters of general practitioners favored making changes to the Obama administration’s signature healthcare reform measure. (Healy, 1/25)

About 95 percent of all respondents said they did not believe insurers should be allowed to deny coverage to those with pre-existing conditions or charge these patients more; 88 percent supported a provision allowing parents to keep their kids on their plans until age 26; 91 percent supported tax credits for small businesses that offered employees health insurance; 75 percent supported tax subsidies for individuals to buy insurance; 72 percent supported the Medicaid expansion; and 50 percent supported tax penalties for people who don’t buy insurance. (Cohn, 1/25)

Proposals by Congressional Republicans to repeal the Affordable Care Act could cost the District government billions of dollars over the next decade, according to a report released Wednesday by D.C. Auditor Kathleen Patterson. The report paints a bleak picture for District officials as they prepare to weather GOP efforts to repeal and replace former President Barack Obama’s signature health-care law as well as revamp Medicaid, the federal government’s health-insurance program for the poor. (Jamison, 1/25)

Connecticut is expected to be one of the states most affected by the expected repeal of the Affordable Care Act, according to a new report from the website WalletHub. On Wednesday, the website released an in-depth analysis identifying the states that would face the biggest impact from the repeal and found that Connecticut would be the 10th-most affected state. Massachusetts was expected to be the state most affected, and Texas was expected to be the state least affected. (Cuda, 1/25)

In an unusually impassioned speech, Gov. Jerry Brown vowed Tuesday to protect California’s health care gains under Obamacare against Republican attempts in Washington, D.C., to roll them back. “More than any other state, California has embraced the Affordable Care Act,” Brown told state legislators and appointees in his annual State of the State address at California’s Capitol. “I intend to join with other Governors and Senators, and with you, to do everything we can to protect the health care of our people.” (Bartolone, 1/25)

In the first week of the Trump administration, California Democratic Gov. Jerry Brown is sending out a defiant message that his state will continue to defend its ideals, particularly when it comes to immigration, health care and climate change. Brown expressed his thoughts loud and clear Tuesday during his State of the State address. (Hobson, 1/25)

Anna Gorman reports: "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? Already, numerous groups are mobilizing patients and health care advocates to raise awareness of the impact of a repeal. (Gorman, 1/26)

Minnesota House and Senate negotiators on Wednesday finalized a compromise bill to deliver health insurance premium relief to thousands of Minnesotans. The Legislature is expected to pass it Thursday and send it to Gov. Mark Dayton, who's expected to sign it. The bill takes $327 million from the budget reserve to give a 25 percent rebate to anyone who purchases coverage on the individual market for 2017. It also includes important reforms, including a provision that helps people who've lost their coverage to keep seeing their doctor, said state Sen. Michelle Benson, R-Ham Lake. (Pugmire, 1/25)

The roughly 120,000 Minnesotans facing skyrocketing health insurance premiums on the individual health insurance market are about to get taxpayer-funded 25 percent discounts after Gov. Mark Dayton and Republican lawmakers overcame their differences this week. Minnesota Gov. Mark Dayton. Just a few final steps remain before the $325 million relief package becomes law.Both chambers of the state Legislature are likely to pass the relief bill Thursday, after a joint committee of lawmakers approved a compromise Wednesday afternoon.Dayton says he likely would sign it into law “as soon as I get my hands on the bill.” (Montgomery, 1/25)

President Donald Trump’s team made little effort to consult with federal agency lawyers or lawmakers as they churned out executive actions this week, stoking fears the White House is creating the appearance of real momentum with flawed orders that might be unworkable, unenforceable or even illegal. ... Just a small circle of officials at the Department of Health and Human Services knew about the executive action starting to unwind Obamacare, and they got a heads-up only the night before it was released. Key members of Congress weren’t consulted either, according to several members. And at a conference in Philadelphia, GOP legislators say they had no idea whether some of the executive orders would contrast with existing laws — because they hadn't reviewed them. (Arnsdorf, Dawsey and Kim, 1/25)

The Trump administration could just be getting started issuing directives to kill Obamacare. Rep. Chris Collins (R-N.Y.), who served as President Donald Trump’s congressional liaison, said today that the administration plans to use its powers to unilaterally overhaul as much of health care law as possible. That could include rolling back thousands of provisions written and implemented by federal agencies over the last several years. (Cancryn, 1/25)

The federal funding to help Flint, Mich., repair its lead poisoned drinking water system is operating outside the Environmental Protection Agency’s reported grant and contracting freeze, the agency confirmed Wednesday. The freeze does not pertain to “environmental program grants and state revolving loan fund grants,” which is where $100 million of the Flint aid package currently resides, according to agency spokesman. (Dillon, 1/25)

Former biotech executive Joseph Gulfo has been offering the Trump administration advice on how it could reshape the Food and Drug Administration. It seems the administration likes what he has to say. Gulfo, who sparred with the FDA over the approval of a medical device product from 2010 to 2013, is now on the list of candidates the new administration is vetting to lead the FDA. (Chacko, 1/25)

President Donald Trump said Wednesday he intends to announce his nominee for the Supreme Court on Feb. 2, and three federal appeals court judges are said to be the front-runners to fill the lifetime seat held by the late Justice Antonin Scalia, a conservative icon. The leading contenders, who have met with Trump, are William Pryor, Neil Gorsuch and Thomas Hardiman, according to a person familiar with the process who was not authorized to speak publicly about internal decisions and discussed the search on condition of anonymity. (1/25)

Opponents of the so-called Mexico City policy that prevents foreign aid organizations from receiving U.S. funds if they provide or offer information about abortions say the directive President Donald Trump issued this week could affect 15 times more funding than the policy did under previous Republican presidents. Previous versions of the rule applied to family planning programs funded by the State Department and the U.S. Agency for International Development, which comprise roughly $600 million in spending. (Schwartz, 1/25)

The clinic, tucked discreetly inside the student health center on the University of Dakar campus, prescribes birth control pills, hands out condoms and answers questions about sex that young women are nervous about asking in this conservative Muslim country. The clinic performs no abortions, nor does it discuss the procedure or give advice on where to get one. Senegal, by and large, outlaws abortion. But for other health services like getting contraceptives, said Anne Lancelot, the Sahel director at the organization that runs the clinic, “there is a very high demand.” (Searcey, Onishi and Sengupta, 1/26)

This week President Trump revived a ban on providing foreign aid to health providers abroad that offer abortion counseling as part of their family planning services. Caitlin Parks, a family planning fellow at Washington University in St. Louis, provides reproductive health services to women at clinics and a teaching hospital in western Kenya. Her clinics receive American funding, and she says that the ban, called by critics the global gag rule, could have a major impact on poor women and communities like the ones she serves. (Ingber, 1/26)

Democratic senators are moving to permanently repeal the so-called Mexico City policy after President Trump reinstated the ban on U.S. funding for international nongovernmental organizations (NGOs) that provide abortions. Forty-seven senators — led by Sen. Jeanne Shaheen (D-N.H.) — introduced legislation to prohibit the Trump administration from using "certain restrictive eligibility requirements" to keep nongovernmental organizations from getting funding. (Carney, 1/25)

On Jan. 23, 2017, President Trump signed a memo reinstating a Reagan-era policy that bans U.S. aid to international health groups that promote abortions. Supporters of the policy call it the Mexico City policy, named after the city in which the law was first announced. Opponents call it the “global gag rule,” for reasons we will explore in this fact check. (Lee, 1/26)

The U.S. abortion rate has hit its lowest point since the landmark Roe vs. Wade Supreme Court ruling made the procedure legal nationwide in 1973, according to a new study. ... Activists on both sides of the contentious abortion policy debate welcomed the findings but did not agree on what is causing the decline. (Agrawal, 1/25)

Leaders of Planned Parenthood Southeastern Pennsylvania quickly realized that they had vastly underestimated their supporters’ desire to gather in solidarity and a show of strength. More than 400 women and men packed a West Philadelphia church on Wednesday evening, eager to fight back against the Trump administration’s anti-abortion policies and GOP efforts to end federal funding of Planned Parenthood’s health services for low-income patients. (McCullough, 1/25)

A U.S. court has issued a preliminary injunction on a new federal rule that dialysis providers have said would prevent patients from using charitable assistance to buy private health insurance, Fresenius Medical Care (FMC) said on Thursday. (Sheahan, 1/26)

U.S. District Judge Amos Mazzant, in Sherman, Texas, issued an order delaying the rule indefinitely while he hears a suit opposing it filed by major dialysis providers and a patient group. The plaintiffs, which included  DaVita Inc. and Fresenius Medical Care North America, a subsidiary of a German company, argued that the Department of Health and Human Services had improperly rushed out the rule and that it could hurt patients. (Wilde Mathews, 1/25)

As part of an effort to roll back Obama-era regulations, Congress is expected to take up legislation as early as next week that would prevent the government from declaring some Social Security recipients unfit to own guns after they’ve been deemed mentally incapable of managing their financial affairs. (Gaudiano, 1/25)

The kind of test used to diagnose Lauren, an IgM test, has long been rejected by the Centers for Disease Control and Prevention but is still used by some clinicians. Meanwhile, the CDC and the US Preventive Services Task Force concur that the most widely available herpes test, called HerpeSelect, should not be used to screen asymptomatic people because of its high risk of false positives: Up to 1 in 2 positive tests could be false, according to the USPSTF’s most recent guidelines. That high failure rate isn’t, however, always communicated to patients. Online forums abound with stories like Lauren’s, of people who request herpes tests alongside those of other STDs and are shellshocked by the results. (Wessel, 1/26)

Women who get their first period when they were 11 or younger are more likely to hit menopause before the age of 40, a study finds. And women with early menstruation who had no children were even more likely to have premature menopause. (Boddy, 1/25)

After a spate of deaths from bird flu among patients in China, the World Health Organization has warned all countries to watch for outbreaks in poultry flocks and to promptly report any human cases. Several strains of avian flu are spreading in Europe and Asia this winter, but the most worrisome at present is an H7N9 strain that has circulated in China every winter since 2013. (McNeil, 1/25)

The NFL has been criticized both for the amount of money it has donated for head trauma research and trying to manipulate how it is spent. But at least it has donated.The NHL has not given money to any of the four centers leading research into neurodegenerative diseases, specifically the question of why so many football and hockey players develop chronic traumatic encephalopathy (CTE), USA TODAY Sports has found. (Armour, 1/25)

The promising trend of Americans giving up sugary drinks seems to have stalled, according to new data from the Centers for Disease Control and Prevention. The number of calories per day that children and adults have been getting from soda and other sugar-sweetened beverages has been dropping for steadily for nearly 20 years, but new data show that since 2009 that number has plateaued. (Sheridan, 1/26)

For years, the U.S. Dietary Guidelines urged Americans to drink less sugary beverages. And for years, many Americans listened. But after a decade of falling consumption, rates have stalled at well above the recommended limit, according to statistics released Thursday by the Centers for Disease Control and Prevention. The agency found that adults and children are both consuming roughly the same number of calories from soda, sports drinks and other sugary beverages now as they did in 2009-2010, the last time the CDC published comparable data. (Dewey, 1/26)

Naloxone — often referred to as Narcan — blocks opioid receptors in the brain to counteract the effects of an overdose. It comes in a spray and injectable form, and has long been used successfully by paramedics and hospital emergency room staff to treat overdoses. Despite evidence that training opioid users and those close to them to use the drug saves lives, the organizations that provide it say they haven’t been able to get the funding to purchase enough of the drug to keep up with demand. Yet as opioid-related deaths continue to mount, there are efforts in some areas to make the drug more widely available. (Drummond, 1/25)

A Rochester woman who became hooked on the powerful painkiller Subsys is suing its makers, the physician’s assistant who prescribed it for her and the pain center where he worked for medical negligence and violating the state’s Consumer Protection Act...She is suing Christopher Clough, a physician’s assistant who treated her from October 2012 to August 2015 and whose license was revoked by the state Board of Medicine last year; Dr. O’Connell’s PainCare Centers Inc. of Somersworth, and Insys Therapeutics Inc. of Chandler, Ariz., the maker of Subsys. (Grossmith, 1/25)

For decades the same test has been used to convict drunk drivers. Police ask a driver to stand on one leg, walk a straight line and recite the alphabet. If the driver fails, the officer will testify in court to help make a case for driving under the influence. But defense lawyers argue, science has yet to prove that flunking the standard field sobriety test actually means that a person is high, the way it's been proven to measure drunkenness. (Smith, 1/25)

Efforts over the years to add PTSD as a qualifying condition for medical marijuana in Colorado have been met with failure. The Colorado Board of Health denied multiple petitions for the inclusion, citing the need for more scientific evidence; bills’ trips through the General Assembly have been short-lived; and veterans and PTSD-sufferers’ legal bids were quashed. (Wallace, 1/25)

In recent weeks, the state Senate and the Florida Department of Health released proposals that would mostly keep control of the marijuana market in the hands of a few companies licensed to grow marijuana, process it and sell oils and pills to patients. Leaders in the Florida House, which have not yet released a plan, say they are inclined to do the same. Instead of creating a whole new marijuana system, the Senate and health department proposed adding new patients to an existing, limited program passed two years ago. It allows terminally ill people to use full-strength marijuana and certain patients, including children with severe epilepsy, to use strains of cannabis low in the chemical THC, which causes a high. (Auslen, 1/25)

As the Florida Legislature begins debating how to make medical marijuana available to patients, Miami Beach commissioners voted Wednesday to extend a moratorium on dispensaries to give city planners time to develop local zoning laws to govern where such businesses can open. (Flechas, 1/25)

A settlement last January between the ACLU of Pennsylvania and the Pennsylvania Department of Human Services called for the state to reduce treatment delays for defendants ordered by courts to receive mental-health care. The settlement followed an October 2015 lawsuit alleging that severely mentally ill defendants languished in Pennsylvania's county jails, sometimes for more than a year, while awaiting treatment to restore competence, so they could stand trial.Not much has changed. (Brubaker, 1/25)

California faces a $76.67 billion cost to provide healthcare and dental benefits to retired state employees, state Controller Betty Yee reported Wednesday, an increase of $2.49 billion over the previous year’s estimate. The unfunded liability – what it would cost to provide health and dental benefits that had been earned as of June 30, 2016 – would be about $1.45 billion more but for slower-than-expected growth in health care claims and lower costs, the report said. (Miller, 1/25)

The former CEO of a Richmond-based blood-testing company claims the accusations that she oversaw an illegal kickback scheme are “an apparent hindsight effort to rewrite the history of HDL” in her first public explanation after the company’s downfall. Tonya Mallory founded Health Diagnostic Laboratory in 2008 and built it into one of Richmond’s fastest-growing companies — with nearly 900 employees and profits topping $100 million a year — before a federal investigation over alleged kickbacks to doctors who used the company’s services forced it into bankruptcy in June 2015. (Demeria, 1/25)

Students at Sacramento State returned to school after winter break this week to find drinking fountains, bottle-filling stations and sinks in six classroom buildings and two dormitories shut down after elevated lead levels were discovered in the water. The high lead levels were found by students and professors working on a research project during their tests of 449 sinks and fountains on the campus over a three-day period earlier this month. The testing revealed 27 water sources had lead levels above the U.S. Environmental Protection Agency’s allowable limit of 15 parts per billion, according to California State University, Sacramento, officials. (Lambert and Chavez, 1/25)

The Dayton administration has launched a campaign to save and rebuild Minnesota's only state-operated psychiatric hospital for children and teens, arguing that private-sector facilities don't furnish the sustained, intensive care that some young patients require. The Child and Adolescent Behavioral Health Services (CABHS) facility in Willmar, which has struggled to stay afloat amid budget cuts and a shortage of professional staff, would be resurrected under an $8 million plan in Gov. Mark Dayton's bonding proposal. (Serres, 1/25)

In the seven months since California’s aid-in-dying law took effect, Dr. Lonny Shavelson has helped nearly two dozen terminally ill people end their lives with lethal drugs —  but only, he says, because too few others would. Shavelson, director of a Berkeley, Calif. consulting clinic, said he has heard from more than 200 patients, including dozens who were stunned to learn that local health care providers refused to participate in the state’s End of Life Options Act. (Aleccia, 1/26)

Kansas City University of Medicine and Biosciences is partnering with HCA Midwest Health to create additional clinical training for about 100 medical students. The training will be made available to third-year medical students, and the collaboration between the two training entities will be led by Bruce Williams, a KCU alumnus and a family physician with HCA Midwest. (Williams, 1/25)

A Houston physician was convicted in federal court Wednesday for his role in a $13 million fraudulent Medicare billing scheme involving hundreds of patients-for-hire. Eight co-defendants - including the clinic director - had previously admitted to helping bill for unnecessary tests for the patients who were recruited and delivered to the clinic by marketers, according to participants' sworn testimony. (Banks, 1/25)

Two Slidell residents who own psychological services companies have been convicted in a $25 million scheme to defraud Medicare by charging for nursing home services that were unnecessary or never performed. Rodney Hesson, 47, and Gertrude Parker, 63, were each convicted Tuesday (Jan. 24) of health-care fraud and conspiracy. The convictions capped a seven-day trial in U.S. District Court before Judge Carl Barbier, who has set a sentencing hearing May 4. The jury verdict included a judgment of $8.9 million as well as forfeiture of Hesson's home and at least $525,629 in seized currency, prosecutors said. (Chatelain, 1/25)

Prosecutors have accused a one-time Arizona resident of being the ringleader of an elaborate health-care fraud that netted him and eight others nearly $2 million in bogus health-insurance claims. Nicholas Scaffidi, 35, was charged earlier this month with fraud, money laundering and multiple counts of theft in connection with a scheme that prosecutors say began September 2014 during the first year of the Affordable Care Act marketplace. (Alltucker, 1/25)

Therapists thought Naika Venant might flirt, or flaunt herself or misbehave on Facebook, so child welfare administrators forbade her from using the platform. They never thought she would kill herself there. A survivor of physical and sexual abuse, Naika had bounced in and out of state care since 2009. Since April alone, her mother’s attorney says, the girl had hopscotched among 10 different homes and shelters, including a hotel and a child welfare office building. Her sojourn ended in the bathroom of a Miami Gardens foster home, where she hanged herself outside a shower stall — while live-streaming the event on Facebook. She was 14. (Teproff and Marbin Miller, 1/25)

Students from Gunn High School’s Investigative Medicine Club are again petitioning Palo Alto city officials to deal with toxins seeping from plumes into buildings. Brent Han asked the City Council on Monday to adopt a citywide vapor intrusion policy that requires testing when buildings are constructed or situated over toxic plumes. (Lee, 1/25)

Exhibit A for how Washington insiders have prospered is not one of the billionaires Trump has chosen for key posts but Tom Price, a Georgia congressman nominated to be Health and Human Services secretary. As a sitting congressman, Price repeatedly bought and sold shares in companies with businesses in areas where he was active legislatively. By the ridiculously low standards Congress sets for itself, this is not illegal. But it is the type of behavior that erodes confidence in government. (1/25)

When President Trump announced his selection of Dr. Tom Price to serve as secretary of the Department of Health and Human Services (HHS), I applauded the choice. Who better to lead one of our nation’s top health agencies than a physician and a public servant who has a real plan to replace a failing health care law that is hurting Americans? (Sen. Johnny Isakson, 1/25)

Much of the discussion about the ACA has centered around the legislative kabuki required to reform it. But as President Trump has already shown, swift action can be taken to address the ACA through executive order, just as executive orders were used in the previous administration to shape how the law was implemented. The pen may be more powerful than the legislative process. Many of the most impactful parts of the Affordable Care Act were decided on a Washington whim, by agency bureaucrats, resulting in a slew of regulations. In coordination with the president, Price, once confirmed, could immediately push forward regulatory reforms that would strengthen Georgia’s health insurance market on Day 1. The three are: 1) Encourage Continuous Coverage 2) Reclassify Agent Commissions under MLR Rule 3) Return Insurance Regulation to the states. (Graham Thompson, 1/25)

Now that Republicans control both the executive and legislative branches, their plans to replace Obamacare -- yes, they exist -- will amount to more than just hot air. One new proposal shows they’re beginning to take their newfound responsibility seriously. (1/25)

The executive order’s language—stopping anything in the law that creates “a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden”—should be music to the ears of congressional Republicans. They have been struggling with Senate procedural rules regarding reconciliation, which likely preclude repealing ObamaCare’s cost-increasing insurance regulations without Democratic support, while still allowing the repeal of the law’s mandates and subsidies. Why does this matter? Insurance companies cannot presently afford to sell the policies people actually want. The law imposes a $100-a-day penalty on insurers for every person to whom they sell a noncompliant policy. That effectively limits the individual market to nothing but ObamaCare-compliant plans, with premiums and deductibles driven sky-high by the law’s regulatory burdens. For many, even ObamaCare subsidies can’t keep up with these increasing costs. (Heather R. Higgins and Phil Kerpen, 1/25)

What’s more daunting than creating a massive federal entitlement program? Unwinding it with the least amount of damage to people and providers, as Republicans are learning about the Affordable Care Act. After seven years of opposing the ACA, forever known as Obamacare, the GOP finds itself in a position to finally fulfill their promises to repeal it entirely and replace it with market-based reforms. (Edward Morrissey, 1/26)

The nation is focused on what new leadership in Washington will mean for the Affordable Care Act (ACA), better known as Obamacare. Republicans won partly because of Obamacare’s implosion — including rising premiums, declining coverage quality, and diminished choices — and are expected to deliver fundamental changes to health-care policy. Nevertheless, Obamacare, though unpopular on the whole, contains several popular features. Hence the GOP’s path might seems relatively direct: keep the tolerable parts, repeal the unpopular ones, and move forward with replacement legislation. But the notion that a so-called “repeal and replace” approach can start by cherry-picking a few popular components is wrongheaded. (Tom Haynes, 1/26)

The US House of Representatives and Senate recently took initial steps towards repealing the Affordable Care Act (ACA), passing budget resolutions that pave the way towards a “budget reconciliation” measure that can repeal major aspects of Obamacare with a 51-vote majority in the Senate. (Larry Levitt, 1/24)

Congress is beginning to take a whack at untangling the snarl of mandates, guarantees and requirements in the flawed Affordable Care Act. It's time to stop arguing over the failures and work toward constructive revisions that fix the problems while preserving popular protections. (1/26)

The Trump Administration and congressional Republicans seem to be moving full speed towards capping federal payments for Medicaid. But they may be missing a key piece of the story: Two-thirds of the program’s dollars go to the frail elderly and younger people with disabilities. ... More than four out of every 10 Medicaid dollars are spent on people with disabilities, for both medical care and long-term services and supports (LTSS). One-quarter of program’s funding is used for older adults, mostly for nursing home care or personal assistance at home. In 2014, Medicaid spent as much as $150 billion on LTSS. While they are often ignored, these people would be profoundly affected if the program is redesigned. (Howard Gleckman, 1/25)

In urging Congress to repeal the Affordable Care Act “in its entirety,” Gov. Matt Bevin has put himself at odds with some of his fellow Republican governors and also with his own former position. House Majority Leader Kevin McCarthy asked governors to share their ideas for achieving the Republican goal of repealing and replacing the ACA. (1/25)

Last week, I went looking for the real Obamacare. Not the one that’s been vilified by President Trump and House Speaker Paul D. Ryan, but the Obamacare that’s otherwise known as the Affordable Care Act, the one providing health coverage to more than 5 million people in California. (Ed Hernandez, 1/26)

One of the first things our new president did Friday was sign an executive order urging his administration to fight the ACA. The executive order has no teeth. It simply states the Trump administration’s position, and, sure, that carries with it all the heft brought to bear by the Oval Office. But what is worrisome for proponents of the ACA is that the executive order follows current legislative efforts in Congress to obliterate the centerpiece of President Barack Obama’s legacy. With a newly installed majority, Republicans are poised to dismantle the historic law that helped 20 million uninsured Americans get affordable healthcare. (Adam Levin, 1/26)

The Physician Payment Sunshine Act has been a valuable tool for revealing industry payments to our nation’s physicians. Nearly $17 billion in payments from drug and device companies have been recorded since the act was passed as part of the Affordable Care Act. The publicly available data it has created lets consumers and other interested parties judge for themselves whether their doctors have important conflicts of interest that might affect their treatment decisions. (James Rickert, 1/25)

The reality is the mandate merely camouflages significant growth of government spending and control over health insurance. This has been the case in Massachusetts since day one: Spending has grown out of control despite many failed efforts to bend the cost curve. (John Graham, 1/25)

Last year, when Aetna announced that it was withdrawing from the bulk of its Obamacare exchange business, liberals were incandescent with rage. Many, Senator Elizabeth Warren among them, alleged that this was basically a thuggish threat, aimed at an administration that had sued to block the firm’s merger with Humana. ... This week, many of those people are feeling vindicated. ... But the people who think that their prior opinion has been vindicated should actually read the ruling. (Megan McArdle, 1/25)

After reading the CJ's on the judge’s decision to block the merger of Humana and Aetna, I wanted to share my view that this is a cloud with a silver lining for the company, its employees and the community. This view is based on personal experiences as the Chief Operating Officer of Humana Health Plans when it was launched in 1984 .... It is also informed by my involvement in the arts as President of the Louisville Orchestra, in helping to arrange the initial grant for the Humana Festival of American Plays and in spearheading corporate employee giving to the Fund for the Arts. (Hank Werronen, 1/25)

It followed the weekend’s stunning women’s marches: At least 3.2 million people apparently participated in all 50 states, amounting to 1 percent of the U.S. population. In a slap at all who marched, Trump this week signed an order that will cut off access to contraception to vast numbers of women, particularly in Africa. It will also curb access to cancer screenings and maybe even undermine vaccination campaigns and efforts against H.I.V. and the Zika virus. The upshot: Thousands of impoverished, vulnerable women will die. (Nicholas Kristof, 1/26)

In this issue of JAMA, Mokdad and colleagues report that cancer mortality has markedly decreased in the United States over the past 30 years. Based on data from the National Center for Health Statistics and from the US Census, the authors estimate that US cancer mortality decreased approximately 20% during the past 3 decades, from 240.2 per 100 000 population to 192.0 per 100 000 overall between 1980 and 2014. ... However, not everyone has enjoyed the benefit of this work. Despite major advances in science and care delivery related to cancer, the most vulnerable citizens have been left behind. (1/25)

It was profoundly distressing to hear Donald Trump on the campaign trail vowing a return to abusing prisoners with “a hell of a lot worse than waterboarding.” Those thoughts threaten to reverse the work that I and others have done over the last decade to end torture as an official US government policy and to prevent health professionals’ participation in detainee abuse. As a psychologist, I know the extreme damage that torture — the systematic infliction of severe pain and degradation — does to its victims and to its perpetrators. (Stephen Soldz, 1/25)