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U.S. Senate Majority Leader Mitch McConnell said on Monday the Senate will move to repeal President Barack Obama's healthcare law shortly after Jan. 1, but declined to give a timeline for a plan to replace it. (Zengerle, 12/12)

Senate Majority Leader Mitch McConnell on Monday indicated that Republicans won’t be putting forth their alternative to the Affordable Care Act before repealing parts of the health care law. “We’re going to move forward first, first with the Obamacare replacement resolution,” the Kentucky Republican said at a Capitol Hill press conference. “What comes next is what comes next.” (McIntire, 12/12)

Senate Majority Leader Mitch McConnell on Monday confirmed that Republicans will take steps early next year to repeal aspects of President Barack Obama’s signature health law before a replacement system is put in place. His comments come as some GOP lawmakers in Congress have said a blueprint for replacement should be established before any repeal action is taken to gut the 2010 health care overhaul (PL 111-148, PL 111-152). “We will move right after the first of the year on an Obamacare [repeal] resolution and then we will work expeditiously to come up with a better proposal than current law,” the Kentucky Republican told reporters. (Williams, 12/12)

Republicans in Congress say they'll vote to repeal much of the Affordable Care Act early next year — even though they don't yet have a plan to replace it. But they also insist that they don't want to harm any of the millions of people who got their health insurance under the law. (Kodjak, 12/12)

Though Republicans are itching to start on their promises to “repeal and replace” the Affordable Care Act, many of them worry about repercussions if the process stalls or takes too long. ... A new health care law might not take effect for up to three years, The Associated Press reported, in order to give Congress and President-elect Donald Trump enough time to come up with a feasible replacement. In the meantime, the uncertainty could leave Republican members up for reelection vulnerable. ... “There needs to be a reasonable transition period so people don’t have the rug pulled out from under them,” House Speaker Paul D. Ryan told reporters last week. But not all Republicans see eye to eye on the proposed time frame. (Braun, 12/12)

Rep. Peter King said he is meeting with President-elect Donald Trump later in the week to talk about the president's agenda. The New York Republican said the Trump team has shown a willingness to take on the Affordable Care Act early in the administration, a priority of his and other Republicans. (Dawsey, 12/12)

Red-state Senate Democrats are resisting the urge to vote for an Obamacare repeal to bolster their conservative bona fides — even those hailing from states where Donald Trump won big. While the united Democratic front won't change the likely outcome of a repeal vote — because Republicans will only need a simple majority of votes for repeal under the procedure they plan on using — keeping defections to a minimum may offer a measure of political victory for Democrats. And a strong vote against the GOP repeal means Democrats can highlight the lack of a plausible GOP replacement plan. (Haberkorn, 12/12)

A coalition of groups fighting ObamaCare repeal is launching a “seven-figure” ad-buy in selected states warning against the dangers of scrapping the law without a replacement. The coalition is called the Alliance for Healthcare Security, and includes liberal advocacy groups like Families USA and Physicians for a National Health Program. The print and digital ads are targeted to Alaska, Arizona, Maine, Nevada, Tennessee and Washington, D.C. (Sullivan, 12/12)

With a stroke of his pen on Tuesday, President Barack Obama will commit billions of dollars in federal funds to boost medical research, including money for Vice President Joe Biden’s “moonshot” to cure cancer. But the budget increase for the National Institutes of Health authorized in the 21st Century Cures Act is smaller than hoped for by some conservative lawmakers, including Rep. Kevin Yoder and Sen. Jerry Moran of Kansas and Missouri Sen. Roy Blunt. The three Republicans say the bill doesn’t go far enough, and they’ll keep working to build up the NIH’s budget. (Wise, 12/12)

GOP leaders of the House Energy and Commerce and Senate Finance committees are pressing the Centers for Medicare and Medicaid Services for more information about when agency officials first realized a popular allergy treatment was misclassified in the Medicaid program. CMS revealed earlier this year that Mylan’s EpiPen, which was at the center of a drug pricing controversy, had been classified as a generic drug in the program, instead of a brand name drug. That means Mylan has potentially paid millions of dollars less than it should have to state Medicaid programs and to the federal government. (McIntire, 12/12)

As the Republican-led Congress and the President-elect Donald J. Trump call for the repeal of the federal health care law known as Obamacare, insurance exchanges in Maryland and around the country continue to sign people up for coverage at a pace that could make it a banner year. Officials at the online marketplaces are making an extra push to enroll consumers ahead of Thursday's deadline for coverage beginning at the first of the year. (Cohn, 12/12)

Conflicting information about deadlines has created confusion for many of Evergreen Health's individual plan members as they scramble to find new health insurance. The Maryland Insurance Administration barred Evergreen on Dec. 8 from selling individual health plans as it waits for regulators to decide whether it can convert to a for-profit insurer, and it gave Evergreen's thousands of individual members until Dec. 31 to switch to a new plan. Yet Evergreen sent email and letter notices informing its 9,000 individual members that they needed to choose another insurer's plan by Thursday to ensure they have coverage starting Jan. 1. The insurer's website noted the same Dec. 15 deadline. (Gantz, 12/12)

One in four non-elderly adults has a medical condition, ranging from diabetes to pregnancy to severe obesity to arthritis, that would make them uninsurable under the health coverage rules that prevailed before the Affordable Care Act, according to a new study. (Johnson, 12/12)

The researchers noted that a large share of those individuals likely get their insurance through their employers, which does not take into consideration prior health issues. But if the health law were repealed and those people lost their health insurance for any reason, they could face problems. (Rodriguez, 12/13)

Some 52 million working-age adults have a pre-existing medical condition that would likely have left them unable to get health coverage before the Affordable Care Act, according to a new analysis by the Kaiser Family Foundation. Millions of others with similar conditions would likely have faced higher premiums, coverage exclusions or coverage limitations because of stiff underwriting standards faced by people buying insurance outside the workplace before the health law was enacted. This individual insurance market had long been problematic for consumers. It was known for high customer dissatisfaction and turnover, high coverage denial rates, lean benefits and premiums subject to frequent increases. (Pugh, 12/12)

A new study finds that 27 percent of adults under 65 have pre-existing health conditions that could lead to them being denied coverage if ObamaCare were repealed. ObamaCare banned insurance companies from rejecting people because of their pre-existing health conditions, but the study released Monday by the Kaiser Family Foundation found that if pre-ObamaCare rules returned, 52 million Americans could be denied coverage. (Sullivan, 12/12)

Nearly one in four Connecticut adults has a health condition that probably would make them unable to buy insurance through the individual market without protections for people with pre-existing conditions, such as those created by Obamacare, according to an analysis released Monday by the Kaiser Family Foundation. Overall, 52.2 million American adults under 65 have pre-existing conditions that could make them uninsurable in the individual market, including 522,000 in Connecticut, the analysis found. The estimates offer a glimpse at the stakes as Republicans seek to repeal and replace the Affordable Care Act, or ACA. (Levin Becker, 12/13)

A new report estimates as many as 558,000 people in Louisiana would lose health insurance if Republicans in Congress force a repeal of the Affordable Care Act, and Louisiana would lose $1.9 billion in federal Medicaid funding. In many ways, the report offers a glimpse from the edge of an abyss: It assumes that a Republican-led Congress, with support from President-elect Donald Trump, would repeal the Affordable Care Act and fail to replace it with any meaningful health care policy. And while it's not clear that will happen, the report by the Center on Budget and Policy Priorities offers a dark reminder of what health care providers and patients stand to lose under an overhaul of key policy changes. (Litten, 12/12)

Trump was harshly critical of VA on the campaign trail, calling it “the most corrupt agency” and charging that some veterans are “being treated worse than illegal immigrants.” Keeping McDonald, 63, would run counter to Trump’s promise that he would upend the status quo to provide better care for veterans. (Rein, 12/12)

The nation’s largest veterans groups are urging President-elect Donald J. Trump to keep President Obama’s secretary of veterans affairs, Robert A. McDonald, out of concern that his rumored candidates’ inexperience and ideological leanings could cripple the massive veterans health care system. (Philipps, 12/12)

Dr. Scott Gottlieb, a partner at one of the world's largest venture capital funds and a former deputy commissioner at the U.S. Food and Drug Administration, is being considered by President-elect Donald Trump to run the agency, according to sources close to the transition team. (Clarke, 12/12)

One of the first groups that rallied to Georgia Rep. Tom Price’s defense when he was tapped as Donald Trump’s new health secretary is also one of his most stalwart allies: The American Medical Association. And their strong endorsement has provoked a backlash from some doctors. More than 5,500 healthcare providers have signed a petition penned by a trio of physicians – Drs. Jane Zhu, Navin Vij and Manik Chhabra, that contends the “AMA has not aligned with the well-being of patients.” They called their piece “The AMA Does Not Speak for Us.” (Bluestein, 12/12)

One key piece of the Republican plan is turning Medicaid into a block grant program, which could mean less money for California to run Medi-Cal. A lot of people who have benefited from the Medi-Cal expansion are worried about losing their coverage, and the community clinics that serve many of them are concerned that they’ll have to cut back on some of their services. (Plevin, 12/12)

Aetna Inc. executives on Monday jousted with Justice Department lawyers over the health insurer’s reasons for sharply cutting its participation in Affordable Care Act exchanges, a potentially important issue in the antitrust trial over Aetna’s proposed merger with Humana Inc. (Kendall and Viswanatha, 12/12)

The Justice Department on Monday attacked Aetna's long-held position that its decision to withdraw from Obamacare insurance marketplaces this year wasn’t motivated by the government’s lawsuit blocking the insurer’s $37 billion purchase of Humana. Aetna maintained it exited the marketplaces because of financial concerns, but government lawyers at a hearing on the merger pointed to internal company discussions linking departures in three states to the federal lawsuit. The company withdrew from 11 state marketplaces in all this year. (Cancryn, 12/12)

Justice Department attorneys on Monday continued to try to undercut arguments by Aetna CEO Mark Bertolini that his company’s Medicare Advantage program competes with government-run Medicare. The government’s lawyers also spent the day using  Aetna’s internal documents and emails to try to prove the insurer’s decision to leave Affordable Care Act marketplaces was driven by the U.S. lawsuit against its planned merger with Humana. (Radelat, 12/12)

The U.S. Justice Department sought on Monday to knock down arguments by Aetna Inc's chief executive that Medicare Advantage competes with government insurance programs, making Aetna's proposed merger with Humana legal under antitrust law. Aetna CEO Mark Bertolini testified on Friday and returned to the witness stand Monday morning. The Justice Department sued to stop the merger in July. (Bartz, 12/12)

Efforts to make hospitals safer for patients are paying off, preventing 3.1 million harmful hospital-acquired conditions and the deaths of some 125,000 people, according to an HHS report released Monday. Those improvements saved close to $28 billion in healthcare costs from 2010 through 2015. Healthcare leaders touted this progress as a direct result of policies laid out in the Affordable Care Act, public-private partnerships such as the Partnership for Patients, which launched in 2011, and other quality improvement initiatives to target hospital-acquired conditions. These conditions include infections, falls, pressure ulcers and other adverse outcomes. (Whitman, 12/12)

The CMS has issued an interim final rule Monday that attempts to stop providers and organizations from steering patients eligible for Medicaid or Medicare into private insurance as a way to receive higher reimbursement rates. The rule issued Monday requires dialysis centers that help patients pay private insurance premiums either directly or through charities to clarify what plans in their region pay for and how that compares to Medicare or Medicaid. The notices must inform patients that some plans may not cover all costs typically covered by Medicare, such as necessary medical expenses for living donors. (Dickson, 12/12)

As the opioid epidemic sweeps through rural America, an ever-greater number of drug-dependent newborns are straining hospital neonatal units and draining precious medical resources. The problem has grown more quickly than realized and shows no signs of abating, researchers reported on Monday. (Saint Louis, 12/12)

When Dr. Alan Gora treats those in the grips of the heroin epidemic in the emergency department, he's reminded that much of the damage he sees there stems from a time when physicians freely prescribed pain pills. Now, doctors know the pills feed heroin addiction and have led to skyrocketing overdose deaths, and Gora thinks twice about handing out pills. (Viviano, 12/13)

The 35 people who are thought to have died of drug overdoses in just five days this month ranged in age from 19 to 66, the Philadelphia Department of Public Health said Monday. Sixty-nine percent of the victims were male and 60 percent were non-Hispanic whites. Emergency departments around the city reported treating a spike in  nonfatal overdoses over the same period, although the increase — 171 from Dec. 1 to 5— was not as extreme as the death count suspected by the Medical Examiner's Office. (Sapatkin, 12/12)

When the federal government reversed course last month, deciding not to regulate many genetic tests, one big winner was Proove Biosciences, a Southern California company that markets an unproven “opioid risk” test. Proove claims its test can predict, with 93 percent accuracy, which patients will become addicted to or misuse prescribed opioid pain pills. That’s been an irresistible sales pitch for many physicians, who struggle to treat pain patients compassionately but fear adding to the national epidemic of opioid addiction. The Irvine, Calif., company has recruited 400 doctors, who have used the test to guide their treatment of more than 100,000 patients in the last five years. (Piller, 12/13)

Kratom gained popularity in the U.S. over the past decade or so, as its availability spread online and in head shops. Two or 3 grams of powdered extract steeped in hot water or whipped into a smoothie offers a mild, coffee-like buzz; doses double or triple that size can induce a euphoria that eases pain without some of the hazardous side effects of prescription analgesics. Preliminary survey data gathered recently by Oliver Grundmann, a pharmaceutical sciences professor at the University of Florida, found that American users are mostly male (57 percent), white (89 percent), educated (82 percent with some college), and employed (72 percent). More than 54 percent are 31 to 50 years old, and 47 percent earn at least $75,000 a year. (Gruley, 12/12)

A new study suggests that your earliest years may be even more critical than previously thought: Your brain health before you're 3, it finds, may well predict how much you cost society in mid-life, including your health care bills. (Goldberg, 12/12)

In his widely cited 2009 study, Nobel Prize winning economist James Heckman documented a 7 to 10 percent annual return on investments in quality preschool programs for 3-and 4-year-olds. In a study released today, Heckman makes an even more compelling economic argument for programs that begin at birth. Heckman and his team found high-quality birth-to-five programs for disadvantaged children can deliver a 13 percent per-child, per-year return on investment through reduced crime and health costs and better outcomes in education, civic engagement and employment. (Downey, 12/12)

The study, released Monday, shows that the services offered by the two North Carolina programs led to an increase in lifetime earnings for the children and their parents. All the children, who were African American and lived in low-income families, received an array of services from birth to age 5, aimed at improving their education, nutrition and health. The study’s authors also linked such programs to a reduction in criminal behavior and improved health outcomes, and noted those benefits were particularly pronounced for males. (Morton, 12/12)

Dr. Frank Sacks, a professor of nutrition at Harvard, likes to challenge his audience when he gives lectures on obesity. “If you want to make a great discovery,” he tells them, figure out this: Why do some people lose 50 pounds on a diet while others on the same diet gain a few pounds? Then he shows them data from a study he did that found exactly that effect. (Kolata, 12/12)

Drinking eight glasses of water a day is a health myth and it is one of the hardest to undo. It is the original fake news of medicine. How it began isn’t really known, however some medical sleuthing published in the American Journal of Physiology in 2002 and in the British Medical Journal in 2007 suggested that it came from a 1945 Food and Nutrition Board recommendation that the body uses about 85 ounces of water a day. (Gunter, 12/12)

For the first time, researchers are seeing signs that American teens may be turning away from electronic cigarettes. An annual survey involving thousands of middle and high school students from across the nation found that use of e-cigarettes — both experimentally and on a regular basis — declined in 2016 after reaching an all-time high in 2015. (Kaplan, 12/12)

Republicans in the House are turning to Vice President-elect Mike Pence to help stop a rule from the Obama administration that requires most electronic cigarettes to go through a costly review process. In a letter to Pence on Monday, Sen. Ron Johnson (R-Wis.) and Rep. Duncan Hunter (R-Calif.) called the rule from the Food and Drug Administration “an example of a burdensome rule that could eliminate the entire emerging industry” and asked that the next administration consider repealing or suspending it. (Wheeler, 12/12)

Opponents and proponents of the so-called Heartbeat Bill — which would ban abortions once a fetal heartbeat can be detected — are lobbying Ohio Gov. John Kasich to favor their side in acting on the legislation. Groups that favor the legislation passed last week by majority Republicans in the General Assembly are asking Kasich to sign the bill into law, while others are asking him to veto the measure, according to communiques with the governor's office requested by The Dispatch. (Ludlow, 12/13)

Ohio abortion rights supporters and opponents have flooded Gov. John Kasich's office with emails, phone calls and protests in the days since state lawmakers passed two anti-abortion bills. One bill, called the "heartbeat bill," bans abortion after a fetal heartbeat is detected, as early as six weeks into a woman's pregnancy, possibly before she knows she is pregnant. The other bill bans abortions after 20 weeks post-fertilization, or about 22 weeks gestation instead of the current 24 weeks gestation. (Borchardt, 12/12)

In passing the so-called “heartbeat bill” – the country’s most-restrictive abortion legislation – Ohio Republicans are sending John Kasich a test. The Ohio governor based his unsuccessful 2016 Republican presidential campaign on principle over party, rejecting extremism and, more than that, rejecting the policies and rhetoric of Donald Trump. (Thompson and Balmert, 12/12)

Planned Parenthood officials are scrambling to prepare for the likelihood that Congress next year will cut off more than a half-billion dollars in federal funding to the group, fulfilling the wishes of abortion foes who are planning an aggressive push to roll back abortion rights under President-elect Donald Trump. (Somashekhar and Zezima, 12/12)

Several abortion providers sued Texas in federal court on Monday to halt a new regulation that requires them to dispose of aborted fetal tissue either through burial or cremation, saying the rule is designed to limit abortions in the state. (Herskovitz, 12/12)

Abortion providers filed a federal lawsuit Monday to block a Texas rule that will require fetal remains, whether from an abortion or miscarriage, to be buried or cremated. The lawsuit, filed one week before the regulation was to take effect, argued that the rule is a “pretext for restricting abortion access” that would do nothing to improve health or safety despite assertions from state officials to the contrary. (Lindell, 12/12)

Oklahoma plans to force hospitals, nursing homes, restaurants and public schools to post signs inside public restrooms directing pregnant women where to receive services as part of an effort to reduce abortions in the state. (12/13)

A new legislative report recommends that Virginia consider a tighter cap on profits for insurance companies that manage care for most people in the state’s Medicaid program. The report delivered Monday to the Joint Legislative Audit and Review Commission also suggests that the state Medicaid program increase its oversight of inefficient spending by managed-care companies — estimated at $17 million to $36 million last year compared with other states — and improve its forecasting of costs in setting rates that insurers charge on a monthly per-capita basis to manage care. (Martz, 12/12)

A new study of Virginia’s Medicaid program has identified ways to cut millions of dollars out of the yearly budget. Media outlets report that the Joint Legislative Audit and Review Commission, a watchdog group, released its report Monday. (12/13)

At 59 years old, Bill Miller is starting to have neck and back problems. Thirty-two years of bending over to check patients’ teeth and gums will do that, he said. Miller is the only dentist in Hill City, a community of about 1,500 people northwest of Hays. He has treated Medicaid patients his entire career, even as reimbursements increasingly have lagged the cost of providing care. Earlier this year the state cut those reimbursements another 4 percent as part of a host of emergency budget-balancing measures. Miller said that has him seriously considering dropping out of the Medicaid program. (Marso, 12/12)

Opponents of a new California state law requiring nearly all schoolchildren to be fully vaccinated have mounted another legal challenge — this time, setting the science of immunization aside and focusing on constitutional rights. Under California’s child vaccine law, one of the strictest in the nation, parents are no longer allowed to skip required immunizations for their children based on personal or religious beliefs. The new rules, the plaintiffs argue, force families to choose between three constitutionally protected rights: making medical decisions for their children; bodily autonomy, and a public education. (Murphy, 12/12)

The cost to insure Columbus city workers will grow again next year, as health-care expenses continue to rise. The City Council approved $195 million in appropriations Monday night to pay for coverage for about 8,300 employees expected to be on the city payroll next year. That’s about 6.5 percent more than for this year. (Rouan, 12/13)

A medical laboratory company based in New Jersey said Monday that it was investigating a recent hack that exposed the personal health information of about 34,000 people. (Chokshi, 12/12)

Aamir Siddiqi and Danish Siddiqui, former associate professors with the Aurora University of Wisconsin Medical Group, have seen firsthand the shortcomings of the U.S. health care system. Like many doctors and other clinicians, they have long been frustrated by the fragmentation of care, the lack of coordination and the limited time allotted for patient visits. (Boulton, 12/10)

A Tinley Park doctor convicted earlier this year of defrauding Medicare has been sentenced to 40 months in prison and ordered to pay $1.5 million in restitution. In January, Dr. Banio Koroma, 66, was found guilty by a federal jury of two counts of health care fraud and two counts of making false statements related to health care matters, according to the U.S. Attorney’s office. (12/12)

A heart specialist accused of performing medically unnecessary and costly cardiac procedures on thousands of patients at South Miami Hospital is negotiating a settlement in a whistleblower lawsuit alleging years of healthcare fraud. In a court order filed last week, U.S. District Judge Ursula Ungaro instructed one of the whistleblowers in the case, James A. Burks, to file a status report by Dec. 16 or risk dismissal of the case. (Chang, 12/12)

Patients in the intensive care unit at TriStar Skyline Medical Center will find a journal and pen in the room as the unit tries to get more people to ask questions. Paper and pens are found at any roadside motel, but have been largely absent from hospital rooms. And since most of Skyline's ICU patients come through the emergency room they haven't packed for an extended stay, said Christine Lunger, a nurse and director of the critical care unit. Nurses encouraged families, or patients when they were able, to write down their questions and notes for the next time the physician rounded, or as a follow-up to ask the nurses. (Fletcher, 12/12)

The U.S. Department of Justice has opened a federal civil rights investigation into Hampton Roads Regional Jail in Portsmouth over concerns about inmates’ access to medical and mental health care. The probe, announced Monday, will focus on whether inmates’ constitutional rights have been violated — particularly those with mental illness — by “secluding them in isolation for prolonged time periods” and “denying them access to services, programs and activities because of their disability,” the Justice Department said in a release. (Burnell-Evans and Kleiner, 12/12)

As the Ebola virus spread through Liberia with frightful speed in the fall of 2014, Roseville resident Shelley Spurlock was up at 4 a.m. daily, hoping she wouldn’t find news about another dead student or health worker in the war-torn country where she’s focused her work for the last decade. Spurlock has been helping the coastal African nation rebuild since its destructive civil wars in the 1990s and 2000s, mostly through her scholarship distribution nonprofit Raise Your Hand Foundation, which launched in 2007. With her help, Mercy General Hospital in Sacramento and other groups sent tons of syringes, lab coats, stethoscopes and latex gloves in 2014 to aid in the fight against Ebola. (Caiola, 12/12)

In his final Senate press conference of 2016, Majority Leader Mitch McConnell (R-Ky.) renewed his pledge to start repealing the Affordable Care Act on Jan. 3 even with no replacement in sight, declaring that “surely” the GOP revision will wind up covering Americans better than Obamacare. He declined to say when or how Republicans will pass their superior “replacement” plan. ... Exactly how Republicans intend to do better remains to be seen. ... That uncertainty doesn’t seem to be giving McConnell and his allies pause, however. (Michael McAuliff and Jonathan Cohn, 12/12)

There has been a lot of uncertainty about how Republicans are going to follow through on their long-held goal of repealing the Affordable Care Act, and in a press conference today, Senate Majority Leader Mitch McConnell offered a little more clarity — with some frightening implications for Americans’ health care. ... Repealing and replacing are going to be separate, and repeal will happen immediately in January. In other words, the Republican Congress is going to toss millions of Americans off a cliff, then shout down to them, “Don’t worry, we’ll get you some kind of parachute before you hit the ground! Probably!” (Paul Waldman, 12/12)

[T]here is reason to believe that the Trump administration, despite Trump’s campaign promises, could deliver on the longstanding conservative goals of not only repealing Obamacare (which Trump pledged to do) but also transforming Medicaid into block grants, turning Medicare into a “premium support” system (ending the program’s traditional open-ended commitment to pay for medical services) and sharply cutting funding for Great Society programs, including food stamps. “I’ve been working on these issues since 1972,” Robert Greenstein, the president of the Center on Budget and Policy Priorities, said in a recent interview. “This is by far the gravest threat to the safety net, and to low-income people, that I’ve seen in my close to half a century of working on these issues.” But if Republicans pursue a retrenchment agenda, they will quickly learn that shredding the safety net is much harder than it seems. (Julian Zelizer and Eric Patashnik, 12/12)

In the six years since President Obama signed the Affordable Care Act (ACA) into law, 20 million more people have health insurance, and, for the first time in our history, more than nine out of every 10 Americans are insured. Growth in both premiums for employer coverage and overall Medicare spending has also slowed. The Centers for Medicare and Medicaid Services’ Actuaries now project that we are on track to spend $2.6 trillion less over the ACA’s first decade than was projected without the ACA back in 2010. ... This work has gone on steadily for years — through political turmoil and challenges in the courts. Yet through each challenge, these reforms have endured. They must continue to endure. (Sylvia Mathews Burwell, 12/12)

California probably gained more than any other state from the Affordable Care Act, the federal health reform better known as Obamacare. Now, with the program facing an almost certain demise, the state and its low-income residents have the most to lose. (Daniel Weintraub, 12/12)

Privatizing Medicare, or turning it into a voucher system, would take seniors back to a time where they have to make difficult financial tradeoffs if they get sick and need good health coverage. It would mean higher out-of-pocket costs for seniors and higher insurance premiums for younger Americans. (Sen. Joe Donnelly, D-Ind., 12/12)

Ryan is a committed Catholic, and thus inspired by Christ’s command to see his face in the least among us. He is rightly concerned that health-care reform protect vulnerable prenatal children. But this commitment applies just as earnestly to the vulnerable populations hurt by his proposed policies above. ... Ryan’s commitment to the Catholic Church means that he ought to rethink his health-care reform proposals and make sure that — instead of privileging the young, wealthy and healthy — they instead lift up the sick, poor and old. (Charles Camosy, 12/13)

Stress, I've long suspected, may explain why lifespans have been lengthening for high-income Americans but have remained the same or even shortened for low-income and middle-income people. A new analysis from the Hamilton Project released today adds important evidence: Biomarkers of stress have risen much more rapidly for low-income people than for high-income ones. (Peter R. Orszag, 12/12)

Billions of dollars are spent every year on medications that reduce the risk of heart disease — the No. 1 killer in the United States. But some people feel powerless to prevent it: Many of the risk factors seem baked into the cake at birth. Genetic factors can have a huge impact on people’s chances of dying of heart disease, and it has long been thought that those factors are almost always outside of one’s control. Recent research contradicts this, though, and that should give us all renewed hope. (Aaron E. Carroll, 12/12)

Given the limited number of donor livers, in 2000 Congress established what’s called “the Final Rule” to guide the medical community in how to allocate them fairly. The Final Rule compels the transplant community to allocate donor organs based on best medical judgment, best use of the organs and avoidance of futile transplants. It also notes that a patient’s chance of getting a transplant should not be affected by where he or she lives. Balancing these various guidelines has always been tricky. But what has emerged — and is now the point of contention — is a marked geographic disparity in how sick a patient must be before rising to the top of a transplant list. For example, waiting lists at California transplant centers are significantly longer (and therefore patients in California get a lot sicker before possibly receiving transplants) compared with waiting lists in Oregon. That’s unfair to the Californians who need liver transplants, right? (Willscott E. Naugler, 12/13)

People with hearing loss usually pay out of pocket for hearing aids, and those pockets must be deep indeed. The average cost for a hearing aid is $2,300, and most people need two. They don’t last forever, and if your condition is progressive you may need to replace them as often as every four or five years. No matter what your income level, hearing aids for adults are not covered by health insurance. They are not covered by Medicare, and they are not covered by state Medicaid programs. The Affordable Care Act does not cover hearing aids. Some private insurers are beginning to pay, but it’s usually only a fraction of the whole. The V.A. and some state vocational bureaus do provide hearing aids. But essentially, you’re on your own. (Katherine Bouton, 12/12)

This kind of branding – one that lasts a lifetime – is what 21st-century puritans, also known as the pro-life movement, want to achieve. Theirs is a campaign for a nationwide ban on abortions, but it includes shaming of women who underwent the act. They want to burn a permanent mark on these women's conscience so they’ll never forget their “sin.” That’s the motive behind new rules in Texas requiring health-care facilities that perform abortions to bury the fetal remains instead of disposing of them. Beginning on Dec. 19, the burials must be done regardless of how long the fetal tissue has been gestating, according to The New York Times. (Elvia Diaz, 12/12)

More Americans died from heroin than gun homicides in 2015, according to data released last week by the Centers for Disease Control and Prevention. The number of opioid-related deaths surpassed 30,000 for the first time in recent history. “Prescription opioid misuse and use of heroin and illicitly manufactured fentanyl are intertwined and deeply troubling problems,” said CDC director Tom Frieden. Meanwhile a different story emerged in Iowa. (12/12)

To put the election results into perspective, the percentage of Americans now living in an area where recreational marijuana is legal, or will soon be, rose from 5 percent to 20 percent. Given the accelerated acceptance for the use of cannabis, it’s worth considering the consequences of these new laws. There has been plenty of hand-wringing about how these new laws might harm society, but I believe they have the potential to help in a range of societal issues. (Thomas Strouse, 12/12)

Last month, Florida voters passed Amendment 2 — a landmark change to the state Constitution that allows individuals, including children, to use marijuana for medical purposes. ... Now that the Florida Legislature is expected to discuss legislation to implement Amendment 2, it is incumbent upon state policy makers to consider the ways in which we can safeguard students in our schools. Miami-Dade County Public Schools is committed to advocating for students’ health and safety in light of the passage of Amendment 2. (Alberto M. Carvalho and Martin Karp, 12/12)

Wisconsin’s Group Insurance Board is proposing to limit competition in an effort to self-fund its State Group Health Program. This proposal is the exact opposite of the Wisconsin Act 10 legislation that opened up competition for school districts and their health insurance providers. Since Act 10 passed in 2011, the added competition has resulted in our school districts saving millions of dollars in health care insurance costs. (Cliff King, 12/12)

The Diagnostic and Statistical Manual of Mental Disorders — also known as the DSM and sometimes erroneously called the bible of psychiatry — is the authoritative guide to diagnosing depression, schizophrenia, and over a hundred other mental disorders. The latest version, published in 2013, was 19 years in the making. A new revision process put in place by the American Psychiatric Association, the DSM’s publisher, aims to make it easier for the manual to reflect changes in psychiatry. (Michael First, 12/12)