�鶹Ů��

Republican leaders on Capitol Hill are scrambling to ease growing concerns among GOP lawmakers about rushing to repeal the federal health-care law before plans for a replacement take firmer shape, addressing complications to the effort to deliver on one of the party’s signature campaign promises. In the Senate, where Republicans are using a budget package to move swiftly ahead with repeal, leaders are looking at ways to adjust their plans to address the skittishness that GOP senators have voiced in recent days. (Sullivan and Snell, 1/9)

The burgeoning Republican divisions come as the GOP-led Senate pushed toward a final vote this week on a budget that would prevent Democrats from using a filibuster to block a later repealing Obama's overhaul. That's crucial because filibusters take 60 votes to halt in a chamber that Republicans control by only a 52-48 margin. (Fram, 1/10)

House and Senate Republican leaders are forging ahead with plans to repeal Obamacare then replace it later — dismissing mounting pressure from their own party to delay the repeal vote until they have a fully formed alternative. But they’re hoping to ease internal concerns that Republicans will be attacked for acting hastily — worries that accelerated after libertarian-leaning Sen. Rand Paul (R-Ky.) bucked party leadership on the matter last week and received a blessing from President-elect Donald Trump. Speaker Paul Ryan (R-Wis.), Senate Majority Leader Mitch McConnell (R-Ky.) and their top lieutenants in both chambers are now considering a strategy that includes adding some replacement provisions to the repeal bill, according to lawmakers and aides. (Bade and Everett, 1/9)

Senate Republican leaders are pushing back against the idea proposed by some in their caucus of passing an ObamaCare replacement at the same time that they repeal the law. Sen. John Cornyn (Texas), the Senate’s No. 2 Republican, indicated to reporters Monday that simultaneous repeal and replacement is not practical. (Sullivan, 1/9)

A group of moderate Senate Republicans introduced an amendment Monday to give Republicans additional time to repeal Obamacare. Sens. Susan Collins, Bob Corker, Lisa Murkowski, Bill Cassidy and Rob Portman want to extend the deadline for a repeal bill until March 3 under an arcane budget procedure called reconciliation that prevents a Democratic filibuster. The existing resolution's deadline is Jan. 27, although none of the deadlines are binding. (Haberkorn, 1/9)

"By providing more time to come up with legislative solutions, we have a better opportunity to produce a thoughtful, workable replacement that ensures Americans have access to affordable, diverse insurance plans that meet their needs," Collins said in a statement. (Carney, 1/9)

The five lawmakers are part of a larger group that is calling on their colleagues to agree on a replacement plan before repealing the health care law. Republican Sens. Rand Paul of Kentucky and Tom Cotton of Arkansas have expressed similar concerns. The cohort is large enough to derail an otherwise speedy process. With 52 seats in the Senate, Republicans can afford to lose just two votes on the reconciliation measure once Vice President-elect Mike Pence is available to break a tie after Inauguration Day on Jan. 20. (Mershon and Lesniewski, 1/9)

The House Freedom Caucus wants to delay a vote on a budget that includes Obamacare repeal instructions, a potential setback for the GOP’s — and Donald Trump’s — top priority. The group of hardline conservatives wants more information about what a repeal bill and Obamacare replacement would look like before they support the fiscal 2017 budget. (Bade, 1/9)

"We just need to slow down the process so that we can understand a little bit more of the specifics of the timetable, replacement votes, reconciliation instructions, etcetera," said Rep. Mark Meadows, chairman of the group. "We're hopeful to get some of that clarity in the coming days." (Shutt, 1/9)

Yes, Donald Trump is taking charge and Republicans control both the House and Senate, having won an election promising to repeal President Barack Obama's health care law. But in Congress, getting from Point A to point B rarely consists of a straight line, and Democrats in the Senate can easily gum up the works with procedural blockades. Since Republicans hold the Senate with just 52 votes, they are forced to employ an arcane, fast-track budget process to avoid a Democratic filibuster. (1/9)

The speed of Republican efforts to repeal the Affordable Care Act has stunned health industry lobbyists, leaving representatives of insurance companies, hospitals, doctors and pharmaceutical makers in disarray and struggling for a response to a legislative quick strike that would upend much of the American health care system. (Pear, 1/9)

President-elect Donald Trump says that President Barack Obama's health care law "will fall of its own weight." House Speaker Paul Ryan says the law is "in what the actuaries call a death spiral." And Senate Majority Leader Mitch McConnell says that "by nearly any measure, Obamacare has failed." The problem with all these claims: They are exaggerated, if not downright false. (Werner, 1/10)

Republicans and Democrats are squaring off in a fight over tax fairness as the GOP develops a timetable for repealing the 3.8 percent surtax on investment income under the health care overhaul. GOP lawmakers have long argued for elimination of the surtax, or the net investment income tax, that applies to income such as interest, dividends and capital gains for individuals making more than $125,000 or couples earning more than $250,000. (Ota, 1/9)

As Republicans in Congress begin work on a repeal of the Affordable Care Act, the nation’s health insurers are telling lawmakers to keep paying subsidies to the companies and to low-income Americans so they can afford coverage. Insurers also want Congress to create a long transition period before the ACA is eliminated and a GOP plan replaces the health law. (Radelat, 1/9)

President-elect Donald Trump is increasing pressure on congressional Republicans to vote at the same time to both repeal and replace the Affordable Care Act, but party leaders haven’t indicated any shift in strategy to make that happen. Mr. Trump’s push, combined with doubts from different factions of Republicans, could end up slowing down party leaders’ efforts to rapidly overturn much of the law. (Peterson and Bender, 1/9)

President-elect Donald Trump may be joining the growing ranks of Republicans in Washington who are getting cold feet about plans to rush through a vote to repeal Obamacare without a plan to replace it. Trump called Sen. Rand Paul (R-Ky.) this weekend to discuss Paul’s push to convince the rest of the GOP not to vote later this week on a budget resolution that includes a framework for a vote to repeal the Affordable Care Act without a replacement plan. Paul said he spoke with Trump for approximately 15 minutes Friday and the two agreed on the need for replacement. The only hitch: Republicans don’t have one yet. (Snell and Weigel, 1/9)

Rand Paul (R-Ky.) is pledging to roll out an ObamaCare replacement bill this week as GOP lawmakers rush to nix the healthcare law. The Kentucky senator argued Monday that the law must be replaced with "real market reforms." Paul's legislation comes as the Senate is expected to pave the way this week to repealing the healthcare law.  (Carney, 1/9)

President-elect Donald Trump doesn't plan to sit back and wait for Congress to repeal and replace Obamacare. The soon-to-be dealmaker-in-chief intends to wield his executive authority to help shift the nation from the Affordable Care Act to a Republican vision for health care. "We're working on a strategy, in concert with the leadership of the House and the Senate, for both a legislative and executive action agenda to ensure that an orderly and smooth transition to a market-based health care reform system is achieved," said Vice President-elect Pence last week, emphasizing the shift will be "stable." (Luhby, 1/9)

Democrats sought President-elect Donald Trump’s backing in last month’s spending showdown that brought the federal government to the brink of a shutdown over health care coverage for retired miners, and a key participant said Monday that Trump has given an assurance that he supports the effort. Sen. Joe Manchin III, D-W.Va., announced Monday that Trump gave “assurance” that he will support the effort to permanently extend health care for retired miners and their spouses. (Dillon, 1/9)

Senate Democrats launched the first of what will likely be numerous efforts to derail Republican plans to repeal the 2010 health care law, taking to the Senate floor and social media Monday night in a talk-a-thon to portray the move as reckless and chaotic for the health care system. “I think the point is to send a clear message to the country, to the American people that, No. 1, we’re going to do everything we can to prevent Senate Republicans from destroying the Affordable Care Act,” Maryland Sen. Chris Van Hollen said. “We’re focused on making sure that we get on the Senate floor and talk about the damaging consequences and the chaos that’s going to be created throughout the health care system.” (Bowman and Lesniewski, 1/9)

Senate Democrats ceded back the Senate floor early Tuesday morning, ending a more than 5-hour protest of GOP efforts to repeal ObamaCare. Democrats painted the late-night talkathon as the first test against a unified Republican-led government as the majority party works to nix the healthcare law without a replacement plan. (Carney, 1/10)

Senate Democrats Monday night spent nearly six hours delivering floor speeches criticizing Republican efforts to repeal the health care law. Starting around 6:40 p.m. and wrapping up at 12:17 a.m., the talkathon provided another opportunity for Democrats to object to Republican attempts to repeal the 2010 health care law, even as some House Republicans discussed postponing a planned vote. It also provided senators with a chance to tell stories about their own health care experiences as well as those of their constituents. One of the more personal speeches came from Sen. Angus King, a Maine independent, who spoke about being diagnosed with malignant melanoma, a form of skin cancer, in 1974 while working for the U.S. Senate as a staff member. (Shutt and McCrimmon, 1/9)

Sen. Bernie Sanders (I-Vt.) says Republicans cannot repeal ObamaCare without having an alternative first. “I’m going to do everything I can – and I believe I speak for virtually every member of the Democratic Caucus – that we’re going to do everything we can to improve the Affordable Care Act [ACA],” he said during a CNN town hall at George Washington University in Washington, D.C., on Monday. "It has problems.” (Hensch, 1/9)

Senate Minority Leader Charles Schumer (D-N.Y.) tweeted the wrong slogan Monday evening, while promoting his party’s protest against repealing ObamaCare. The tweet was quickly deleted and replaced, but not before Independent Journal Review reporter Joe Perticone snagged a screenshot. “Now deleted,” Perticone tweeted of Schumer’s gaffe. "Chuck Schumer accidentally tweeted ‘Don’t Make America Great Again.’” (Hensch, 1/9)

Republicans warned seven years ago that a health care law passed only by Democrats -- with no support from the other party -- would struggle to survive. The party-line vote to pass Obamacare, they said, was arrogant and reckless. Now, the GOP is in charge, and poised to run afoul of its own warnings. (Lee, 1/9)

The Republicans’ strategy to repeal the Affordable Care Act risks sending health care in the United States “over a cliff,” the government’s top health official warned Monday as part of an unprecedented campaign by the Obama administration to use its final days to preserve the centerpiece of its domestic legacy. (Goldstein, 1/9)

Ms. Burwell, in a speech at the National Press Club, sought to shore up public support for the existing health law by poking holes in Republicans’ suggestion that they can simultaneously lower costs, save money and expand health coverage. “As for silver bullets, they don’t exist,” she said. “If something sounds too good to be true, it usually is.” The public comments are expected to be Ms. Burwell’s last before she leaves office Jan. 20. (Hackman, 1/9)

Health and Human Services Secretary Sylvia Burwell warned in a speech Monday that an Obamacare replacement could be “a step backwards.” If a replacement plan does not cover as many people, maintain the quality of coverage and “keep bending the health care cost curve in the right direction,” it would leave the health care system worse off than it was before the Affordable Care Act, Burwell said in what was billed as her farewell address at the National Press Club. (McIntire, 1/9)

Giving Medicare authority to negotiate drug prices is the best way to keep those spiraling costs under control for the program’s recipients, departing Health and Human Services Secretary Sylvia Burwell said Monday. “Those drug costs are continuing to grow,” Burwell said at the National Press Club in Washington, D.C. The question, she said, is not whether Congress should give her department the necessary power, but rather “what is the alternative?” (Bluth, 1/9)

As secretary of the Department of Health and Human Services for the past two and a half years, Sylvia Mathews Burwell has overseen the Affordable Care Act, Medicare and Medicaid, the Food and Drug Administration and a wide range of social services from Head Start to family assistance programs. In a conversation with Tom Fox, Burwell discussed her concerns about impending changes to the Affordable Care Act, the presidential transition, her approach to leadership and playing basketball for President Obama’s national security adviser. (Fox, 1/9)

Obamacare eliminated the costs and out-of-pocket expenses for Americans wanting preventive health care services -- including mammography and colonoscopy, both tests able to detect cancer. Among older Americans, use of mammography increased under Obamacare, according to a study published Monday in the journal Cancer. But another preventive screen test, colonoscopy, didn't see a similar increase. (Scutti, 1/9)

For the patients and the employees of Mary’s Center, a community health center that serves Washington, D.C., and its Maryland suburbs, the 2010 health law had a big impact on business. The facility has always promised care to anyone who walks through its doors. But since Obamacare’s implementation, the patient population and the quality of care they receive has changed. (Luthra, 1/9)

Californians tend to avoid the worst of premium hikes on the state exchange by choosing lower-cost plans, but many also miss out on financial assistance because they pick the wrong type of plan or buy coverage off the exchange, according to two studies published Monday in the journal Health Affairs. One of the studies shows that when consumers faced premium increases from 2014 to 2016, they chose cheaper plans to control their costs, without giving up benefits. For example, consumers who had a higher-cost plan in the silver tier — the second least expensive level of coverage — would switch to a lower-cost silver plan, receiving similar benefits while saving on premiums. (Feder Ostrov, 1/10)

Darlene Hawes lost her health insurance about a year after her husband died in 2012. Hawes, 55, is from Charlotte, N.C. She ended up going without insurance for a few years, but in 2015 she bought coverage on HealthCare.gov, the Affordable Care Act marketplace, with the help of a big subsidy. (Tomsic, 1/9)

Minnesota lawmakers say they want to pass a relief package for Minnesotans facing soaring health insurance premiums by the end of this week. The next few days will determine whether that happens, or if Minnesota’s leaders yet again hit delays. DFL Gov. Mark Dayton and the Republicans who control both houses of Legislature all agree the state should provide relief to people affected by the “premium cliff” — earning too much money to qualify for federal subsidies but not enough to afford premiums as high as 30 percent of their annual income. But they disagree on certain important details of how to do it. (Montgomery, 1/9)

This week, I answered questions from readers who were up in arms about having to repay premium tax credits or wait for insurer approval to fill a prescription. Another woman wanted details about the timing for switching from her Obamacare plan to her new husband’s employer plan after she gets married this summer. (Andrews, 1/10)

UnitedHealth Group, one of the largest and most diversified health insurance companies in the United States, said on Monday that it planned to buy Surgical Care Affiliates, a chain of outpatient surgery centers, for about $2.3 billion. The deal is expected to close in the first half of 2017. (Abelson, 1/9)

The deal, for a mixture of cash and stock, substantially expands the health-care provider footprint of UnitedHealth, which is already the parent of the biggest U.S. health insurer, UnitedHealthcare. The acquisition represents a continued bet on physician services at a time when Republicans’ plans to unwind the Affordable Care Act have created uncertainty for many health-care providers, particularly hospitals, which potentially stand to see a drop-off in insured, paying patients. (Wilde Mathews, 1/9)

In an effort to fulfill its mission to expand its provider footprint to serve about two-thirds of the U.S. population, OptumCare has agreed to acquire Surgical Care Affiliates for about $2.3 billion in a cash and stock deal. Deerfield, Ill.-based SCA owns or operates 190 ambulatory surgery centers and surgical hospitals, most as joint ventures with physicians and health systems. The company says SCA and its affiliates serve approximately 1 million patients per year in more than 30 states. In 2015, it had operating revenue of around $1.1 billion. (1/9)

The U.S.’s biggest health insurer, UnitedHealth Group Inc., will buy Surgical Care Affiliates Inc. for about $2.3 billion, adding an outpatient surgery chain to its growing health care-delivery business. UnitedHealth will pay $57 a share, with with 51 percent to 80 percent of that in stock and the rest in cash, the companies said in a statement. The price is a 17 percent premium to Surgical Care’s closing value Friday. The two companies previously worked together as partners. (Tracer, 1/9)

A Harvard Medical School study suggests that changing the way doctors are paid could narrow some of the health disparities between poorer and wealthier patients. Poverty has long been linked to poorer health, an intractable problem that health care experts have long sought to address. The study suggests that one solution may lie in the way health care providers are compensated by insurers. ... The contract links what physicians are paid to dozens of health care quality measures. When patients score high on those measures and doctors stay under budget, they earn more money. (Dayal McCluskey, 1/9)

The price of health insurance just keeps going up. Until recently, though, a crucial part of how those prices are set was invisible to the public: the negotiations between doctors and insurance companies that determine how much patients are charged. The story of that contest, carried on fiercely behind closed doors for decades, is now partially in public view, and the new data contains tantalizing clues about where prices for health care really come from. ... A survey of the numbers, published this week in Health Affairs, shows that small-time doctor's offices and insurance companies are getting squeezed by their larger competitors. (Ehrenfreund, 1/9)

Vice President Joe Biden is outlining how he intends to pursue his “cancer moonshot” agenda after the end of the Obama administration. Biden says in a San Francisco speech that he will be starting an organization that may be called the Biden Cancer Initiative to make progress in changing the way the nation conducts cancer research and development and providing care to those with the disease. (1/9)

With less than two weeks left in office, Vice President Joe Biden told health care leaders in San Francisco on Monday that he has “genuine reason for open optimism” about the state of cancer research — a special cause to him since his son’s death in 2015. Biden has led the Cancer Moonshot Initiative since it was announced by President Obama last January in his final State of the Union address. (Allday, 1/9)

They said it was their family curse: a rare congenital deformity called syndactyly, in which the thumb and index finger are fused together on one or both hands. Ten members of the extended clan were affected, and with each new birth, they told Stefan Mundlos of the Max Planck Institute for Molecular Genetics, the first question was always: “How are the baby’s hands? Are they normal?” (Angier, 1/9)

Doctors giving regular checkups will get the most bang for their buck if they advise adults to quit smoking, convince teens to never start, and keep children up to date with immunizations, according to an influential report released Monday by the Bloomington-based HealthPartners Institute. The research findings, sponsored in part by the U.S. Centers for Disease Control and Prevention, could influence how doctors across the country conduct thousands of regular patient visits each year. Comparing 28 recommended preventive services, HealthPartners researchers found that tobacco counseling and pediatric immunizations outranked the others in cost-effectiveness and the potential to save lives. (Olson, 1/9)

The plague is best known for wiping out as much as a third of Europe’s population during the Black Death pandemic of the 14th century, but it’s not entirely a thing of the past. It’s enough of a present-day threat — either as a bioterrorism weapon or because of antibiotic resistance — that scientists are trying to develop a vaccine. (Zuraw, 1/10)

As Diana Hardeman climbed into a New York City taxi with her boyfriend around midnight on May 31, she suddenly realized she had no idea where to tell the driver to go. The 33-year-old knew she had to get to a hospital — and fast. Hardeman was fairly sure she had just had a stroke, her second in less than three years. But she had never asked the neurologist she had seen after the first stroke where she should head in the event of a recurrence. (Boodman, 1/9)

One in three women with breast cancer detected by a mammogram is treated unnecessarily, because screening tests found tumors that are so slow-growing that they’re essentially harmless, according to a Danish study published Monday in Annals of Internal Medicine, which has renewed debate over the value of early detection. (Szabo, 1/9)

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns that ready to eat chicken strips products produced by House of Raeford, a Mocksville, N.C. establishment, may be contaminated with Listeria monocytogenes. A recall was not requested because it is believed that all products have now been consumed. The ready to eat, fully cooked, chicken breast strips items were produced and packaged on September 29, 2016 and served to consumers in December, 2016. (Gowans, 1/9)

The crisis has reached a boiling point in the region, as a new breed of designer opioids has infiltrated the region’s drug market. As the deaths continue to be tallied, at least 1,600 people in D.C., Maryland and Virginia died from heroin or opioid overdoses in 2016, and that’s just a preliminary figure. Several months of data from last year have yet to be published. (Forzato, 1/9)

Experts say the over-prescribing of opioids in the last 15 years has contributed to the nation’s current heroin epidemic — a slippery slope from recovering patient to recovering addict. Four out of five heroin addicts first became addicted to painkillers, the Substance Abuse and Mental Health Services Administration says. New CDC guidelines advise doctors to prescribe fewer painkillers for acute pain. And some physicians have even been arrested for selling massive quantities of opioids to drug users. So is it the doctors’ fault? (Forzato, 1/10)

Cardinal Health will pay $20 million in a previously announced settlement with the state of West Virginia in a 2012 lawsuit alleging that Cardinal failed to properly oversee and report a surge in orders of addictive painkillers. The failure took place over a five-year period from 2007 to 2012 and contributed to a rise in the opiate crisis, the state said in its suit against Cardinal and several other drug distributors. (Matzer Rose, 1/9)

The American Civil Liberties Union sued Kentucky state officials on Monday to block a new law that requires women seeking an abortion to first undergo an ultrasound and hear a description of the embryo or fetus. ACLU lawyers filed the lawsuit in federal court in Louisville on behalf of EMW Women's Surgical Center, which the lawsuit said is the sole licensed abortion facility in Kentucky. (Bittenbender, 1/9)

Kentucky Gov. Matt Bevin on Monday signed two bills that put tighter restrictions on abortion, including one measure prohibiting the procedure at or after 20 weeks of pregnancy. The bills include an emergency provision, making them effective immediately after Bevin's signature. The first, House Bill 2, now requires a physician or technician to perform an ultrasound, describe and display the ultrasound images to the mother, and provide audio of the fetal heartbeat to the mother before she may have an abortion. The text of the bill says the pregnant woman may choose to avert her eyes from the images, and request the volume of the heartbeat be turned down or off. (Ansari and Croffie, 1/9)

Republicans on Capitol Hill are once again aiming to defund Planned Parenthood, and Beltway oddsmakers are wagering that they have the best chance of succeeding in a long time. What might defunding mean for Massachusetts, which has five Planned Parenthood clinics? Dr. Jennifer Childs-Roshak, president and CEO of the Planned Parenthood League of Massachusetts, says its clinics could no longer provide services to patients who get their health care through MassHealth, the state's Medicaid program. (Goldberg, 1/9)

Planned Parenthood affiliates in St. Louis are taking stock of the $700,000 hit they may absorb under a new state law and a shifting federal landscape. Last year, the Missouri legislature used a budgetary measure to cut the women’s health provider from the state’s Medicaid program. The process takes several months and requires federal approval, so the rule has yet to take effect. (Bouscaren, 1/10)

Several local healthcare entities have responded to a late December request for proposals for a merger or affiliation put out by Little Company of Mary Hospital, officials said Monday. The independent, south suburban hospital — where the very first human organ transplant was performed in 1950 — is weighing offers that have come in within the last two weeks, all of them from nonprofit entities. (Ihejirika, 1/9)

A lawsuit aimed at halting the dissolution of the North Suburban Hospital District and preserving existing operations at Unity Hospital in Fridley has been dismissed. The case was dismissed Monday in Anoka County District Court, according to Mike Hatch, the attorney who represented the five plaintiffs who filed the lawsuit. Hatch was Minnesota attorney general from 1999 to 2007. (Horner, 1/9)

Abington Hospital — Jefferson Health agreed to pay $510,000 to settle allegations that failures in its internal controls allowed an employed pharmacist to steal more than 35,000 pills, including the highly addictive oxycodone and other painkillers, the U.S. Attorney for the Eastern District of Pennsylvania said Monday. The thefts occurred between Feb. 2010 and August 2013, when Abington, then known as Abington Memorial Hospital, discovered the theft and reported it to the Drug Enforcement Agency. The pharmacist, Renata Dul, pleaded guilty in 2015 and 25 counts of possession with the intent to distribute oxycodone and was sentenced to six years of prison. (Brubaker, 1/9)

Between 1980 and 2015, voters approved nearly 70 percent of the 32 tobacco tax hikes that appeared on statewide ballots, according to Ballotpedia, a nonpartisan research group that has tracked them. But in November, voters in North Dakota, Missouri and Colorado defeated measures that would have increased taxes by 23 cents to $1.76 on a pack of cigarettes. ... Tobacco taxes generally are among the least controversial taxes to raise because they affect a small number of voters and the dangers of tobacco use are widely known. State legislatures, in particular, are fond of raising so-called “sin” taxes, as opposed to approving increases in broad-based taxes such as those on income or property. But November’s electorate may have been especially tax averse. (Povich, 1/9)

Gov. Dannel P. Malloy has appointed Ted Doolittle to serve as the state’s healthcare advocate, tapping an attorney with a wide range of experience to lead an office that helps consumers with health care issues and works on policy matters. (Levin Becker, 1/9)

Emergency departments are often the doorstep to New Hampshire Hospital, the state’s psychiatric hospital in Concord. Andrew Dixon was eventually admitted there, but on any given day there’s an average of 28 people with acute mental health symptoms waiting to get in. And that number has been climbing, says Suellen Griffin, the president of West Central Behavioral Health. (Rodolico, 1/9)

An unvaccinated adult may have exposed people to measles in the past month at several locations in Denver, Aurora, Englewood, Centennial and Boulder County, the Colorado Department of Public Health and Environment announced Monday. The adult, whose name was not released, contracted measles while traveling abroad and was hospitalized for three days at Parker Adventist Hospital starting on Dec. 29. The state Health Department has pieced together the patient’s errands in the days prior and is now warning people who were at those places at roughly the same time to be on the lookout for symptoms of measles. (Ingold, 1/9)

A Zanesville nursing home operator has been ordered to repay tens of thousands of fraudulently obtained Medicare and Medicaid dollars, after an investigation by the Ohio Attorney General’s Office found that the owner and other employees habitually altered documents to make it appear patients were being properly cared for in order to receive government aid. Autumn Health Care of Zanesville must pay back $53,390 to the Ohio Department of Medicaid and $75,250 to the federal Centers for Medicare and Medicaid, as well as $40,000 in investigative costs, Attorney General Mike DeWine’s office announced Monday. (Smola, 1/10)

A mother and son are on trial in federal court this week on charges that they were part of a scheme to fraudulently bill government medical programs to the tune of more than $7 million through their home health-care company. Delores Knight, 71, of Cleveland Heights, and Isaac Knight, 29, of Macedonia are charged with conspiracy to commit health-care fraud and health-care fraud. Delores Knight also faces nine money laundering counts, and Isaac Knight is charged with making a false statement relating to health-care matters. (Heisig, 1/9)

Americans continue to call for ObamaCare’s repeal. They spoke loudly again this November, and about 8 out of 10 favor changing ObamaCare significantly or replacing it altogether. We in Congress hear you, and we have already begun to act. ... We’re acting quickly because ObamaCare is collapsing under its own weight, and things will continue to get worse otherwise. That doesn’t mean the law will end overnight. There will be a stable transition period .... We plan to take on this challenge in manageable pieces, not another 2,700-page bill like ObamaCare. Some Democratic Senators have mused publicly about their role in that process. I hope they’ll work with us. We want their ideas to improve our health care system. (Senate Majority Leader Mitch McConnell, 1/9)

Republicans are gearing up to repeal Obamacare — what House Speaker Paul Ryan calls "the first order of business" for the new Congress and the Trump administration. House and Senate committees will be under intense deadline pressure to write legislation before the end of the month that would undercut major pillars of Obamacare as part of a budget bill. Yes, the GOP is in a hurry to rid the nation of Obamacare. (1/9)

For Julie Ross, the looming repeal of the Affordable Care Act isn’t an abstract political issue. It’s a life-or-death matter for her 4 1/2-year-old daughter, who was born with Down syndrome and a congenital heart condition and spent her first month in the neonatal intensive care unit. In the pre-Affordable Care Act era, when insurers could impose lifetime limits on benefits, hers was $500,000. “She would have reached that in her first two weeks,” Ross says. (Michael Hiltzik, 1/9)

Many right-wingers — some who decided to champion the ideologically nihilistic President-elect Donald Trump — claim their anger at the GOP’s “establishment” has been fueled by its “betrayal” of the base.  In the right-wingers’ telling, they were led to believe that electing a GOP House and Senate majorities would get rid of Obamacare. Aside from a failure to identify any such definitive promise, their narrative makes no sense. Did they really think President Obama would ever sign such a thing? (They could only be betrayed if they had no clue how the legislative process works.) (Jennifer Rubin, 1/9)

Now it’s the left’s turn to use public opinion, and the stakes in the next fight are bigger than the House ethics office. Even before Trump becomes president, Congress is taking steps to deprive millions of people of health insurance. Democrats in Congress should do everything they can to thwart the effort. And if you’re one of those people who despaired after last year’s election — who wondered whether facts still mattered and whether there was anything you could do — you should get involved, too. How? I’ll get to that in a moment. (David Leonhardt, 1/10)

In the current drive to “repeal and replace” the ACA, designers must be careful not to add to the burden of hospitals and clinics by ignoring the significant cuts to Medicare Democrats issued to make the ACA budget numbers work. The challenging economics of hospitals and physicians are being made even more difficult by the changes to Medicare mandated by the ACA. According to the National Center for Health Policy Analysis in a 2015 article, “21 percent [of physicians] are not accepting new Medicare patients.” But while a physician can opt out of Medicare or private insurance plans, a hospital cannot. (Rich Galen, 1/10)

Georgia Congressman Tom Price, President-elect Donald Trump’s nominee to run the Department of Health and Human Services, is a bundle of contradictions when it comes to Medicare. ... Here is where Price’s views start to fight with themselves. While he’d change Medicare in ways that would increase consumer demand for managed care, he seems to oppose many of the consequences of that change. For instance, has been an outspoken critic of many of Medicare’s efforts to control health care costs. ... He has strenuously opposed efforts by Medicare to shift from fee-for-service medicine to a system that pays for quality, low-cost outcomes rather than volume. (Howard Gleckman, 1/9)

One month ago, as the surprise of the election wore off and the reality of a Republican-controlled Washington sunk in, I would have predicted that Obamacare repeal was a foregone conclusion. Republicans have spent six years promising to repeal the Affordable Care Act. They have maintained incredible party unity on the issue, not wavering even as millions of people gained coverage. Legislators quickly moved to make it their first agenda item in Congress. The matter felt settled. Except today, a month later, it doesn’t feel settled at all. (Sarah Kliff, 1/9)

As they try to stop Republicans from repealing the Affordable Care Act, Democrats have a few central arguments they’re making to explain why repeal would be so catastrophic, none more vivid than the simple fact that Republicans plan to kick somewhere between 20 million and 30 million Americans off their health coverage. This argument has the benefit of being true, and unlike many of the details of health reform, relatively easy to understand. So how are Republicans responding? With two arguments, both of which are meant to prey on people’s confusion and the complexity of this issue. Once you strip away the deception, both those arguments also reveal just how disastrous it will be if they succeed in their plans for the American health care system. (Paul Waldman, 1/9)

Donald Trump likes to say he’s going to repeal Obamacare and replace it with “something terrific.” Sadly for everyone, that’s probably not possible. What is possible is repealing Obamacare and replacing it with something that makes a different set of equally painful trade-offs. Price’s plan, to its credit, is clear about its trade-offs. It costs less than the Affordable Care Act but covers far fewer people, and the people it does cover get much stingier insurance. (Ezra Klein, 1/9)

Trump promised to guarantee coverage to all, not cut Medicaid and preserve protections for those who have pre-existing conditions. If he does all of that, he will be repealing Obamacare and replacing it with something that changes the name but not the program. That may be what he has in mind, but it’s not what his closest allies and advisers have said they intend to enact. (Daniel Weintraub, 1/9)

As the Republican Party’s debate over repealing and replacing Obamacare focuses on the Senate, the views of Republican governors have received little attention and will be important to watch. This group doesn’t like the Affordable Care Act, President Barack Obama’s signature health law, and will want to support the Republican effort to repeal and replace it. But for many of the governors the interests of their states could run counter to two central elements of the repeal and replace plans. (Drew Altman, 1/10)

Under Obamacare, many have learned that having health insurance isn’t the same as actually having health care. Many Kentuckians have been forced into plans their doctors won’t accept with the cost of premiums and deductibles so high that they fear they can’t afford to get sick. These aren’t the results Kentuckians wanted. These aren’t the results Obamacare promised. (Senate Majority Leader Mitch McConnell, 1/9)

Gov. Roy Cooper’s push during his first week in office to expand Medicaid raises at least two pressing questions: Should North Carolina expand Medicaid? And: Is Cooper going about it the right way? The answers: Yes and no. (1/6)

The market for medical devices historically has been dominated by big-ticket “physician preference items” such as artificial joints, spinal implants, and cardiac pacemakers. Venture capital and private equity investors have been eager to fund new firms in this expanding and lucrative domain. Changes in physician payment and organization are reducing the demand for these cost-increasing innovations, however, and redirecting the flow of investment capital. (Josh Baltzell and James C. Robinson, 1/9)

In Kentucky we hear a lot about the war on coal. But on Saturday, during a special, emergency session that cost taxpayers $70,000, I had a front-row seat at our Capitol for Kentucky’s other war: the war on women. The Senate passed House Bill 2, requiring an invasive, humiliating, intra-vaginal ultrasound for any girl or woman seeking an abortion. (Teri Carter, 1/9)

In a ruling upholding the latest tangential attack on the Affordable Care Act by religious activists, a federal district judge in Texas blocked regulations prohibiting insurers, doctors, or hospitals from discriminating against transgender patients or women with an abortion in their medical history. (Michael Hiltzik, 1/9)

ObamaCare was always about paying for health care—costs have outpaced inflation for decades—but seldom about keeping people healthy. As Republicans repeal and replace, they need a vision for the path to better care. Technology now exists to provide cheaper and higher-quality health care, but giant roadblocks stand in the way. (Andy Kessler, 1/9)

In almost every year since the 1960s, health care spending has grown at least as fast as the overall economy, and often much faster. Health economists have long debated why. Strange as it may sound, how we care for our pets offers some answers. (Austin Frakt, 1/9)

The Massachusetts Child Psychiatry Access Project (MCPAP) was launched in 2005 with an eye toward helping children receive psychiatric support and care. In 2014, MCPAP was expanded to MCPAP for Moms by creating a network of obstetric, pediatric, family medicine, and psychiatric providers along with a group of dedicated counselors to be resources for women, their families, and health care providers. Through this network, which also includes specialists who may see women outside of obstetric appointments, clinicians caring for women can identify symptoms of postpartum depression. MCPAP for Moms also creates a continuum of care for women to get timely access to recommended support and treatment. In the first 18 months of the MCPAP for Moms program, more than 1,100 women were screened and treated for postpartum depression. (Katherine Clark, James S. Gessner and Maryanne C. Bombaugh, 1/9)

The medical director and chief operating officer of the Cleveland Clinic Wellness Institute, who writes a monthly column for cleveland.com, created a firestorm over the weekend with a column in which he championed some of the discredited arguments of those who oppose vaccines. Word spread quickly, largely through social media, causing the medical establishment and health reporters across the county to question why a high-ranking doctor at such an august medical institution would write something so irresponsible. And, because Dr. Daniel Neides' column is published on cleveland.com, we're hearing questions about our role. Here, I offer some answers. (Chris Quinn, 1/9)