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A second Senate committee is ready to interrogate President Donald Trump's pick for health secretary, a nominee who's backed by Republicans but under fire from Democrats for his support for tearing down President Barack Obama's health care overhaul and his past stock trades. (Fram and Alonso-Zaldivar, 1/24)

A festering debate about who has been hurt or helped more by President Obama's health law comes as the Senate Finance Committee meets Tuesday to consider the nomination of physician and ACA opponent Rep. Tom Price, R-Ga. When he introduced an ACA replacement bill in 2015, Price said that "under Obamacare, the American people are paying more for health care and getting less — less access, less quality, and fewer choices." (O'Donnell, 1/24)

Rep. Tom Price, the Georgia Republican nominated by President Trump to lead the Department of Health and Human Services, is under increasing scrutiny for a trifecta of financial, campaign and legislative activities that some longtime ethics lawyers describe as “extremely rare” and revealing “an extraordinary lack of good judgment.” In recent years, Price has repeatedly traded stock in dozens of health-related companies while pushing bills that could have benefited many of them. At the same time, he has been uncommonly reliant on campaign contributions from the health-care industry, accepting more than $700,000 from physicians, hospitals, drug companies and insurers during his 2016 run for a seventh congressional term, according to the Center for Responsive Politics. (Kindy and Goldstein, 1/23)

Mr. Price, 62 years old and a third-generation physician, has attracted strong Democratic opposition because of his conservative views and outspoken opposition to the health law. He has supported curbing Medicaid spending and making changes to Medicare that critics say would shoulder seniors with more costs. Democrats also have called for an investigation into stock trades Mr. Price made in medical companies while he sponsored legislation that could have potentially benefited those companies. (Armour, 1/24)

Tuesday's hearing marks the second major test in a week for Price, who struggled at last week’s hearing to offer a clear blueprint for replacing Obamacare. Questioned by both Democrats and Republicans about his preferred replacement, he demurred, calling it a "legislative question" rather than an administrative one he'd handle as HHS secretary. At the same time, though, he assured lawmakers that the 20 million Americans insured through Obamacare wouldn’t lose coverage — a promise that could be hard to keep if Trump’s administration starts dismantling the law before Congress has readied a replacement plan. (Cancryn, 1/24)

The Senate Finance Committee’s investigation of the nominee to lead the Department of Health and Human Services turned up questions about his tax deductions and late property tax payments, as well as the value of his investment in an Australian biotechnology company. These revelations could add to Democratic protests about President Donald Trump’s choice of Rep. Tom Price to lead the nation’s federal medical programs. Price, a Georgia Republican, agreed to amend both his tax forms and his filing with the Office of Government Ethics to correct errors discovered by the Finance Committee, according to a staff memo obtained by CQ Roll Call. The staff prepared the Jan. 23 memo ahead of Tuesday’s hearing with Price. The Finance Committee has the responsibility of deciding whether to put the nomination before the full Senate. (Young, 1/23)

Tom Price, the Georgia congressman tapped for the nation’s top health job, pressed Medicare officials on a funding change that led to a windfall for the small biotech company run by one of his top campaign contributors, according to a document released under an open records request. Price is facing a Senate hearing Tuesday on his nomination to be secretary of Health and Human Services, a role that would put him at the helm of an agency overseeing billions in spending. His initial hearing revealed the depth of Democratic lawmakers’ concerns about Price’s investments in health care stocks. (Jewett and Taylor, 1/24)

With little warning or explanation, the Centers for Disease Control and Prevention recently canceled a major climate change conference that had been scheduled for next month in Atlanta. The Climate and Health Summit, which had been in the works for months, was intended as a chance for public health officials around the country to learn more about the mounting evidence of the risks to human health posed by the changing climate. But CDC officials abruptly canceled the conference before President Trump’s inauguration, sending a terse email on Jan. 9 to those who had been scheduled to speak at the event. The message did not explain the reason behind the decision. (Dennis, 1/23)

Dr. Patrick Soon-Shiong, an audacious biotech billionaire who has pledged to “solve health care,” has been in talks with the Trump administration about the possibility of serving in a senior role overseeing the US health care system, according to individuals familiar with the discussions. Soon-Shiong, a trained surgeon, has met with President Trump and his advisers at least twice in recent weeks. During those discussions, he raised the possibility that he could serve as a “health care czar” with a broad portfolio in the administration as it seeks to reshape the health care system and replace the Affordable Care Act, according to two individuals, who spoke on the condition of anonymity. (Scott, 1/24)

Several Republican senators on Monday proposed a partial replacement for the Affordable Care Act that would allow states to continue operating under the law if they choose, a proposal meant to appeal to critics and supporters of former President Barack Obama’s signature health law. (Pear, 1/23)

The plan by Sens. Bill Cassidy of Louisiana and Susan Collins of Maine would retreat from years of GOP cries to repeal Obama's law and replace it with a still undefined Republican alternative. It comes as GOP lawmakers face pressure from President Donald Trump to quickly void and replace the health law and as Republicans continue hunting for a proposal that would unite them. "It has been a Republican principle that power is best held by individuals and states, not the federal government," Cassidy told reporters. (1/23)

The bill relies on Obamacare’s taxes to offer states a new option that replaces mandates to buy insurance with automatic enrollment in new plans with more choices. Cassidy said that option could lower premiums and cover far more people. (Dennis, 1/23)

The legislation attempts to insulate Republicans in Congress from some of the difficult choices associated with overhauling the entire health care law. The proposal wouldn't fully repeal the law and would push many of the toughest decisions about coverage to the states. Its backers, including Sens. Shelley Moore Capito of West Virginia and Johnny Isakson of Georgia, are some of the Senate's more moderate Republicans. (Mershon, 1/23)

The Senate’s top Democrat, Charles Schumer of New York, blasted the GOP plan as unworkable and an “empty façade” that would create chaos in the marketplace. “Millions of Americans would be kicked off their plans, out-of-pocket costs and deductibles for consumers would skyrocket, employer-based coverage for working families would be disrupted, and protections for people with pre-existing conditions, such as cancer, would be gutted,” Schumer said. “It is nearly impossible to keep the benefits of the Affordable Care Act without keeping the whole thing.” (Shesgreen, 1/23)

But Ms. Collins and Mr. Cassidy argued that theirs is the only approach with a chance of attracting support not only from Republicans but from the handful of Democrats needed to enact a complete ACA replacement. “At some point in this process, we’re going to need a bill that would get 60 votes, OK?” Mr. Cassidy said. “Now, if you can say to a blue-state senator who’s really invested in supporting Obamacare, ‘You can keep Obamacare, but why force it upon us?’, we think that helps us get to 60.” (Radnofsky and Hughes, 1/23)

“We give states the option,” Cassidy said at press conference Monday. “California and New York — you love Obamacare, you can keep it.” (Terhune and Bartolone, 1/24)

The proposal is one of many GOP-written alternatives expected to be released in coming weeks as the party scrambles to avoid criticism for repealing the ACA without a viable replacement. Many of the proposals include similar elements, such as shifting the burden of administering insurance coverage to states through block-grant-style funding, and an emphasis on individual health savings accounts. The true test of any of these plans will be how they are received by President Trump, who has said he wants to see insurance for everyone. (Snell, 1/23)

In California, where health advocates after President Donald Trump’s election continued to aggressively push enrollment in Medi-Cal and Covered California, and state officials have vowed not to let years of enrollment efforts go to waste, there were questions about the details. Legislative language was only released late Monday. “For me, the absolute most important aspect of anything proposed at the federal level is the federal dollar and what’s going to be coming – is it less, or the same, or more?” said California state Sen. Ed Hernandez, D-Azusa, chairman of the California Senate Health Committee. “If they truly want to allow states to continue on within the (Affordable Care Act), then give us the same amount of money we’ve been receiving, and don’t block grant us, and we can make it work.” (Clark, Caiola, Lowry and Chang, 1/23)

Both Cassidy, a doctor, and Collins, a centrist, have been adamant that a replacement plan needs to quickly follow any vote to repeal ObamaCare. They have pushed back on Republican leaders’ idea of passing repeal first and replacing later. (Sullivan, 1/23)

Kentucky Republican Matt Bevin ran for governor on a platform devoted almost exclusively to killing Obamacare, including its expansion of Medicaid insurance to the poor. He didn’t do it. Following in the steps of eight Republican governors who sought to expand Medicaid without appearing to do so, he applied for federal permission to add Republican-friendly tweaks to the program instead. The decision was a nod to reality. By the time Bevin took office at the beginning of 2016, almost one in three Kentuckians had Medicaid or insurance through a federally subsidized Affordable Care Act plan. Many of them didn’t know it when they elected the new anti-Obamacare governor, a side effect of how Kentucky marketed the plans. (Newkirk, 1/23)

Deep in the Sandhills of rural Nebraska, where a two-lane highway curves between prairies and grass-covered dunes, there is a county full of surprises. It's home to Hyannis, a small village without stoplights, where fresh hot coffee is free, everyone waves and, in 1931, a news report named it "The Richest Town in America." (Ravitz, 1/24)

If the healthcare law is in a death spiral, it increases the need to repeal and replace it, since it suggests that health insurance markets will collapse without government action. That’s why it is a key argument for Republicans. Yet non-partisan healthcare groups that have studied the law say that while it has some serious problems and faces challenges, they do not see it as collapsing into a death spiral. (Sullivan, 1/24)

The outreach workers joined the line at a Michael “Air” Jordan shoe launch. They went to Denny’s after the District’s clubs had closed. They hung out at happy hours with $4 drinks and $7 bar food, laundromats, gyms, and Sunday brunches. This month, as Republicans in Congress moved to dismantle the Affordable Care Act and President Trump signed an executive order weakening its provisions, D.C. health insurance exchange officials were rushing to sign up millennials before the open enrollment period ends Jan. 31. (Brown, 1/23)

The Affordable Care Act includes special provisions that make the process of getting black lung benefits easier for coal miners. If the ACA is repealed, gaining these benefits could become much more difficult, effectively harming a group of people that President Donald Trump has promised to protect. (Lofton, 1/24)

From an upscale assisted living center here, 87-year-old Brendan Wall has some advice for members of Congress eager to repeal the Affordable Care Act: Slow down. “They haven’t said what they’re going to replace it with or how they’re going to replace it,” said Wall, who taught philosophy and religion for more than 30 years. (Aleccia, 1/24)

As President Donald Trump and Republicans in Congress devise a plan to replace the 2010 health law, new research suggests a key component of the law helped people with chronic disease get access to health care — though, the paper notes, it still fell short in meeting their medical needs. (Luthra, 1/23)

More than 200,000 King County residents get insurance through the ACA, said King County Executive Dow Constantine. That has helped cut the country’s uninsured rate by half since 2013, to 7.7 percent. Statewide, some 600,000 residents have gained coverage through Medicaid expansion. But many stand to lose coverage if Republicans in Congress follow through on vows to repeal parts of the ACA, such as Medicaid expansion and subsidies to individuals who enroll in coverage through the state insurance exchange. (Young, 1/23)

Top Pennsylvania officials  said Monday that they were bracing for "disastrous" consequences if Medicaid expansion under the Affordable Care Act is repealed - including the loss of health insurance for more than 670,000 Pennsylvanians, many from poor and rural areas. And 400,000 more residents who signed up for coverage through Obamacare's insurance exchange will also be left in the lurch, they said. (Couloumbis, 1/23)

Gov. Mark Dayton was seeking a more vigorous role for the state government and more requirements of the state’s insurance companies in response to the state’s health insurance crisis before he collapsed Monday. In his seventh State of the State address Monday night, Dayton was to propose letting Minnesotans buy unsubsidized insurance coverage from the state’s MinnesotaCare program, which could expand choice and save Minnesotans money. He did not get a chance to finish the speech, though, after apparently fainting. (Montgomery and Stassen-Berger, 1/23)

President Donald Trump can do plenty on his own to unravel the Obama health care law, but some of those actions would create disruptions that undermine his administration's early promises. Other less sweeping steps could open the way for big changes, but might not get as much notice. Suspending enforcement of tax penalties on people who remain uninsured would win Trump immediate cheers from the political right for taking down a widely unpopular requirement. But experts say it would destabilize insurance markets by allowing healthy people to opt out, raising costs for taxpayers and remaining consumers. (Alonso-Zaldivar, 1/23)

President Donald Trump signed an executive order Friday aimed at defanging the Affordable Care Act, also known as Obamacare, giving heads of federal departments more power to delay or grant exemption from regulations associated with the law. Its immediate effect remains unclear, but we’ve answered some of the most confusing questions. (Magness, 1/23)

Tens of thousands of consumers are inundating Obamacare call centers nationwide with questions about whether they can still sign up for insurance, or if their coverage will continue under President Donald Trump. With only eight days left to sign up for 2017 plans, many consumers — not to mention, insurers and brokers — were stunned and confused by Trump’s order Friday night encouraging federal agencies to dismantle parts of the law even before Congress repeals it. By authorizing agencies to roll back some provisions of the law — but not requiring them to do so — the order added to the uncertainty of already jittery consumers and insurers. (Colliver, 1/24)

Some prominent U.S. fund managers are betting that former President Barack Obama's signature healthcare law will not undergo the widespread changes that President Donald Trump promised on the campaign trail. Portfolio managers from Fidelity, Gamco, Thornburg and other large firms say they see the broad outlines of the Affordable Care Act - commonly known as Obamacare - remaining intact despite Trump's signing of an executive order on Friday, his first day in office, that sought to weaken it. (Randall, 1/24)

Key Republicans said Monday that legislation to repeal the 2010 health care law is unlikely to be reported until mid- to late February, pushing back action on GOP plans to dismantle the law. The fiscal 2017 budget resolution adopted by the Congress earlier this month set a Jan. 27 deadline for two committees in the House and two in the Senate to send reconciliation legislation to repeal the health care law to their respective Budget committees. Republicans are using the reconciliation budget process because passage requires just a simple majority of 51 votes in the Senate. (Krawzak, 1/23)

President Trump reinstated a policy on Monday that originated in the Reagan era, prohibiting the granting of American foreign aid to health providers abroad who discuss abortion as a family-planning option. United States law already prohibits the use of American taxpayer dollars for abortion services anywhere, including in countries where the procedure is legal. But Mr. Trump’s order takes the prohibition further: It freezes funding to nongovernmental organizations in poor countries if they offer abortion counseling or if they advocate the right to seek abortion in their countries. (Sengupta, 1/23)

The move drew immediate denunciations from family-planning groups and their Democratic allies and praise from pro-life officials and Republicans. Since its inception in 1984, the funding ban — officially known as the “Mexico City policy” and referred to as “the global gag rule” by its critics — has been repealed and reinstated every time a different political party has assumed power in the White House. (McGinley and Goldstein, 1/23)

“I think the president, it’s no secret, has made it very clear that he’s a pro-life president,” White House Press Secretary Sean Spicer told reporters at his first briefing Monday afternoon. “And I think the reinstatement of this policy is not just something that echoes that value, but respects tax payer funding as well, and ensures that we’re standing up not just for life of the unborn, but for also taxpayer funds that are being spent overseas to perform an action that is contrary to the values of this president.” (Hellmann, 1/23)

The full implications are not clear. The U.S. spends more than $10 billion annually on global health — including $607.5 million specifically on reproductive health. And it remains to be seen how much of that goes to groups that currently provide or promote abortion as defined by the policy — and that would opt to give up U.S. aid dollars rather than falling in line. But opponents of the policy are already warning that many groups will be forced to give up their funding. (Aizenman, 1/23)

The House Rules Committee on Monday reported out a rule (H Res 55) that would provide for floor consideration of a measure to permanently prohibit the use of federal funds and resources to provide for abortion or abortion coverage.The rule, approved in an 8-4 vote, would provide for no amendments to a bill (HR 7) that would also prohibit individuals and small businesses from receiving federal subsidies under the 2010 health care overhaul (PL 111-148, PL 111-152) to purchase health care plans that cover abortions. (1/23)

Abortion opponents expressed optimism Monday that President Donald Trump's early months in office would advance their cause as hundreds converged on the Kansas Statehouse to mark the 1973 Supreme Court decision that legalized abortion nationwide. Trump, inaugurated Friday, has promised to fill a vacancy on the Supreme Court with what he has called a "pro-life" justice and has said he would sign anti-abortion measures approved by the Republican-controlled Congress. (Hanna, 1/23)

GOP leaders are seeking to defund Planned Parenthood, President Donald Trump has vowed to appoint abortion foes to the Supreme Court and the Affordable Care Act is on track for repeal. What does it all mean for reproductive health care? (1/24)

A federal judge ruled on Monday that a $37 billion merger between the health insurance giants Aetna and Humana should not be allowed to go through on antitrust grounds, siding with the Justice Department, which had been seeking to block the deal. (Abelson and Picker, 1/23)

U.S. District Judge John Bates said in an opinion filed Monday that federal regulation would probably be "insufficient to prevent the merged firm from raising prices or reducing benefits," and neither new competitors nor an Aetna plan to sell some of the combined company's business to another insurer, Molina Healthcare Inc., would be enough to ease competitive concerns. (Murphy, 1/23)

The ruling is a victory for antitrust enforcement efforts initiated by the Obama administration. It may bode poorly for the planned $48 billion merger between Anthem Inc. and Cigna Corp., which was challenged by the Justice Department and is awaiting a ruling. Shares of all four companies declined. (McLaughlin, Tracer and Harris, 1/23)

Although the antitrust decision can be appealed, the outcome could have significant ramifications on how older Americans purchase government Medicare and private Medicare Advantage coverage in the rapidly changing U.S. healthcare market, as well as on the options available to individuals who don't have employer coverage. (McCoy, 1/23)

"We are reviewing the opinion now and giving serious consideration to an appeal, after putting forward a compelling case," Aetna spokesman T.J. Crawford said. The companies' merger agreement, which has already been extended twice, will expire Feb. 15. (Johnson, 1/23)

“Elderly patients were the big winners today as a federal court imposed an injunction on Aetna’s $37 billion acquisition of Humana,” the American Medical Association, which opposed the merger, said in a statement. (Sullivan, 1/23)

The Justice Department sued last summer to block the Aetna deal as well as Anthem’s separate, $48 billion purchase of Cigna. Both cases went to trial late last year. An opinion has yet to be rendered for the Anthem case. (Liss, 1/24)

The government’s challenge to the merger was among the last major law-enforcement actions taken by Obama administration antitrust officials. The administration also challenged Anthem Inc.’s proposed acquisition of Cigna Corp., and a ruling in that case is expected any day. Together the deals could have transformed an industry already facing uncertainty from Republican plans to dismantle the Affordable Care Act and replace it with another health-care plan. (Kendall and Wilde Matthews, 1/23)

Under the terms of the merger, Aetna will have to pay Humana a $1 billion “break-up” fee if the deal does not go through. The companies’ merger agreement, which has already been extended twice, is due to expire on February 15. (Radelat, 1/23)

Nearly 1 in 9 Ohioans age 45 or older reported increased confusion or memory loss over the previous 12 months, according to data released by the Centers for Disease Control and Prevention. But fewer than half talked to their doctors about their concerns, despite the benefits of early detection. Of the Ohioans surveyed, nearly 52 percent said their worsening memory interfered with work or social activities or caused them to give up activities, cooking, cleaning or paying bills. Almost 36 percent said they needed assistance with daily activities. (Pyle, 1/23)

The devastating impact of Alzheimer's disease on his own mother — and on his father, who struggled to care for her — first prompted Gerry Richman to take a hard look at the disease. As vice president of national productions at Twin Cities Public Television, he was the mastermind behind a 2004 Emmy-winning documentary called "The Forgetting: A Portrait of Alzheimer's." Now, Richman is back with another eye-opening film on the subject. (Shah, 1/23)

Researchers say they are cautiously optimistic about a small study that showed that fecal transplants improved both gastrointestinal and behavioral symptoms in children with autism disorders. Over several weeks, children experienced an improvement of about 80 percent in gastrointestinal symptoms and an improvement of about 25 percent in behavioral symptoms, said Ann Gregory, one of the study's authors and a microbiology graduate student at Ohio State University. Improvements remained even after treatment was stopped. (Viviano, 1/24)

Sleep apnea is on the rise in the US, as the obesity epidemic puts more people at risk of the condition. And tests for sleep apnea are big business, having helped an industry of thousands of sleep clinics sprout up across the country. But the first randomized trial on the subject adds to the growing evidence that at-home testing may be just as good as the laboratory kind, and at a cheaper cost. That’s great news for insurers, but it might spell more pain for for-profit sleep centers around the country. (Sheridan, 1/23)

A recent report from the Centers for Disease Control offers a stark example of the declining power of medicine’s most important weapons against infectious disease. The CDC noted that a patient who died at a Nevada hospital last year had an infection that was resistant to 26 different antibiotic treatments. That’s essentially the entire antibiotic arsenal doctors had. (Gillespie, 1/23)

Turns out that sitting too much is not only linked to a number of ailments, including obesity and diabetes, but a new study shows being a couch potato also ages your cells faster. The study, which focused on women, found that those who didn’t meet the recommended 30 minutes of moderate-to-vigorous physical activity daily and spent more time sedentary (about 10 hours or more sitting around) were aging at a quicker rate than those who, well, got on their feet and made something happen. (Veciana-Suarez, 1/23)

It seems many people tend to equate carbohydrates with weight gain and try to avoid them like the plague. Studies tell us that fatigue and a decrease in performance are associated with low-carbohydrate diets. When it comes to exercising, carbohydrates are considered to be the most efficient source of energy of all the nutrients. When the body does not receive adequate carbohydrates, it is forced to get fuel for exercising from protein, which can be broken down to create glucose to produce energy. However, the main role of protein is not to supply fuel for energy, but to build and repair muscles. (Anderson, 1/23)

It was the third time Heather Pereira had taken her golden retriever to the same neighborhood animal clinic in Kentucky. ... Police said Pereira had been intentionally wounding her dog and “vet shopping,” visiting vet after vet to obtain prescription medication for her pet, then taking it. Although these cases appear uncommon, authorities say they underscore the nation's widespread opioid epidemic, showing the lengths people go to obtain drugs for personal use or for sale on the street. They also say it's a concern — one they want to get ahead of. (Bever, 1/23)

A doctor handed Melissa Morris her first opioid prescription when she was 20 years old. She'd had a cesarean section to deliver her daughter and was sent home with Percocet to relieve post-surgical pain. On an empty stomach, she took one pill and lay down on her bed. "I remember thinking to myself, 'Oh, my God. Is this legal? How can this feel so good?' " Morris recalls. (Runyon, 1/23)

Mental health nursing facilities are unique to Kansas. Created for adults who need extensive mental health care but aren’t a danger to themselves or others, they fill a niche between community treatment and the two state psychiatric hospitals. Across Kansas, about 800 patients live in 10 mental health nursing facilities. Unlike geriatric nursing homes, they aren’t intended to house patients for the rest of their lives, said Cindy Luxem, president and CEO of the Kansas Health Care Association, which represents some of the state’s nursing facilities. (Wingerter, 1/23)

A state program that helps people pay for expensive, lifesaving HIV drugs is in disarray after the Oakland company that managed it for nearly 20 years was replaced by three out-of-state operators, say patients and AIDS advocacy groups. So far, the transition between contractors, which occurred last summer, has mostly proved stressful and time-consuming for patients and their caseworkers. But advocacy groups worry that patients could be delayed in obtaining HIV medications they rely on to stay healthy, which would be problematic not only for them but for programs designed to control spread of the virus. (Allday, 1/23)

Governor Branstad says the investigation continues into the abuse of patients at the state-run Glenwood Resource Center in western Iowa. But he says he will not second-guess the Department of Human Services for not reprimanding supervisors at the facility which cares for patients with profound mental disabilities. The majority of employees are hard-working, conscientious peopleSix employees were fired and others were disciplined for physically and verbally abusing patients, but that did not include managers. (Russell, 1/23)

The state agency that spends more than $2 billion a year to provide health coverage to 436,000 public employees, retirees, and their families is pushing changes that would allow it to slash what it pays the most expensive hospitals, a drastic move to try to rein in health care costs. The Group Insurance Commission voted unanimously last week to support capping its payments to health care providers at 160 percent of the rates paid by Medicare, the federal government’s insurance program for seniors. (Dayal McCluskey, 1/24)

Governor Charlie Baker on Tuesday is expected to urge state lawmakers to approve funding aimed at sweeping changes in mental health care for approximately 250 men held at troubled Bridgewater State Hospital. Baker will use his State of the Commonwealth address to request $37 million in additional spending to cement a deal with a Nashville firm to provide security and clinical services for men suffering from serious mental health disorders who have become involved in the criminal justice system. (Rezendes, 1/24)

For the millennials — or other adults — who want straighter teeth without going to the dentist, there's a way to get invisible aligners fit and delivered through the mail. SmileDirectClub, a nearly three-year-old company, is did more 75,000 evaluations in 2016. That's a daily average of 204 evaluations of people who want a "better smile" as co-founder Alex Fenkell describes the company's customers. (Fletcher, 1/23)

Rural Americans are sicker than urban Americans, and their health is declining, according to a new report from the Centers for Disease Control and Prevention (CDC). Researchers looked at the rates for the five leading causes of death in the United States: heart disease, cancer, chronic lower respiratory disease (CLRD), stroke and accidents. They found that not only are mortality rates for these causes significantly higher in rural areas, but the gap between urban and rural rates has been growing. (Balk, 1/23)

Continuum Health Alliance, a privately-health Marlton physician services company, has acquired a controlling stake in Partners in Care, an East Brunswick, N.J., an independent provider network and management company, Continuum said Monday. The deal, the price of which was not disclosed, will add a network of 600 doctors  to the 2,000 Continuum already serves, Continuum's chief executive Don McDaniel said. (Brubaker, 1/23)

To her friends, Pam Moon offers a solid, “I’m OK.“I’m just waiting.” The wait is familiar. She first experienced it when a senior at Anderson High School. That was the year the now 54-year-old Anderson Township woman was diagnosed with polycystic kidney disease and underwent her first kidney transplant. That kidney was the gift of life from a stranger. As Moon learned, however, a kidney transplant is not necessarily a one-and-done kind of solution. Over the years she’s received a total of three kidneys – the last two from relatives. Now she’s in need of a fourth. (Vilvens, 1/23)

Despite a promise of more access to dental care at lower costs, a push to license a new type of dental provider has stalled at the Arizona Legislature. Similar to physician assistants, dental therapists operate under the supervision of licensed dentists and can perform minor dental procedures such as fillings, crowns and extractions. These “midlevel providers” are allowed in Minnesota, Maine and Vermont and practice in tribal areas in Alaska, Oregon and Washington. (Alltucker, 1/23)

The city of Akron on Monday released public records and an interactive map that shows the locations of active lead pipe services and non-lead pipe services throughout the city. The map was released under a 2016 state law that requires public water systems to identify the locations of any lead piping in service areas and make that information available to the public. (Becka, 1/23)

Recently, the federal government dinged four local hospitals for having higher-than-allowed hospital-acquired infection rates. Christ Hospital was not among those penalized, but because the war on the bad bugs is non-ceasing, the hospital rolled out its new armament last week. Presenting: more efficient robots. Christ Hospital announced that it is the first hospital system in Greater Cincinnati to use five Xenex LightStrike Germ-Zapping Robots charged with the mission of “destroying hard-to-kill pathogens in hard-to-clean places.” (Saker, 1/23)

Central Texas is experiencing a sharp increase in cases of influenza A, a type of flu, according to Baylor Scott & White Health officials. Here are five things to know. (Toohey, 1/23)

Democratic senators, several of whom are themselves avid traders in healthcare stocks, were right to roast HHS secretary designee Dr. Tom Price for his unseemly plunges into individual healthcare equities. ... Conflicts of interest are a major issue in healthcare and on Capitol Hill. But trying to tie Price's stock trading to some kind of quid pro quo or campaign contribution misses the much larger problem with his nomination. Since getting elected to Congress in 2004, the former orthopedic surgeon has championed policies that further the interests of entrepreneurial surgeons in particular and unbridled fee-for-service medicine in general. Once installed at HHS, he will have the power to eliminate the CMS' most promising move toward value-based reimbursement—mandatory bundled payments. (Merrill Goozner, 1/21)

Tom Price faced off with the Senate during his recent confirmation hearing for the role of Secretary of Health and Human Services in the Trump cabinet. But he's been laying the groundwork for what he sees as the future of health care since 2015. A repeal of the Affordable Care Act has been front and center since the presidential campaign began. But many of the planned changes could affect an even bigger audience - Medicare and Medicaid enrollees. (Jennifer Fitzgerald, 1/23)

Aetna claimed this summer that it was pulling out of all but four of the 15 states where it was providing Obamacare individual insurance because of a business decision — it was simply losing too much money on the Obamacare exchanges. Now a federal judge has ruled that that was a rank falsehood. In fact, says Judge John D. Bates, Aetna made its decision at least partially in response to a federal antitrust lawsuit blocking its proposed $37-billion merger with Humana. (Michael Hiltzik, 1/23)

The Centers for Disease Control and Prevention issued new regulations this month that give it broad authority to quarantine Americans. The rules outline for the first time how the federal government can restrict interstate travel during a health crisis, and they establish in-house oversight of whether someone should be detained, without providing a clear and direct path to challenge a quarantine order in federal court. (Kyle Edwards, Wendy Parmet and Scott Burris, 1/23)

We have an opportunity this year to begin to fix a long-simmering problem in Virginia. That problem is our underfunded, inconsistent behavioral health system. Virginia has a patchwork system, made up of state-run institutional settings and locally run behavioral health clinics. This has long led to disparities in care in different areas of the state, as different Community Services Boards (CSBs) offer different services. As a result, access to treatment varies by geography. (Secretary of Health and Human Resources William Hazel, 1/23)

In the sad geography of America’s opioid-overdose crisis, Ohio is at the center of the map. In 2015, 2,700 of its people died from prescription and illicit opioids, a number far higher than any other state and one that shot up by 28 percent in one year. In response, Gov. John Kasich signed a bill this month to expand access to the treatment drug naloxone, therapy, and social supports. (Andrew L. Yarrow, 1/21)

The meteoric rise in opioid painkiller abuse may come as a surprise to some, but the problem is not lost on our elected officials, who are fighting back with new legislation on prescribing practices, expanded use of medication-assisted treatment, and easier access to naloxone, a drug that immediately reverses an opioid overdose. Gov. Doug Ducey and other Arizona leaders also are at the forefront of combating the problem by requiring doctors to check a statewide database before prescribing addictive pain medications, stepping up education of opioid abuse in our community, and offering a free training course for doctors on how to prescribe opioid drugs. The good news is that these strategies are beginning to work: Arizona has now dropped to 15th from sixth in the number of drug overdose deaths in the United States. (Peggy Chase and Will Humble, 1/23)

First and foremost, the WHO needs more effective political leadership to regain trust. It is the only organization charged exclusively with speaking for public health and for health care workers around the world, with a mandate that trumps the interests of individual countries. At a time when health budgets around the world are under increasing pressure, the new director-general must strengthen the case for investing in improving health outcomes. (Ed Whiting, 1/23)

Some Republican senators have introduced a bill they say could be a basis for bipartisan compromise on Obamacare. The basic idea is to hand the program’s money over to the states, and let them decide how to spend it. In many ways, it’s a typical Republican proposal. ... But the proposal also has two interesting twists. One is that state officials could choose to stick with the Affordable Care Act’s coverage scheme, or something very close to it, if that’s what they prefer. The other is that, at least provisionally, it leaves Obamacare’s taxes in place. (Jonathan Cohn and Laura Barron-Lopez, 1/23)

The 21st Century Cures Act, which President Obama signed Dec. 13, focuses mainly on helping patients obtain breakthrough drugs and medical devices. But it also includes provisions that will give small employers—those with fewer than 50 workers—more flexibility in the insurance marketplace. As Republicans debate how to replace ObamaCare, giving that same flexibility to all employers would be a perfect place to start. (John C. Goodman, 1/23)

Republicans see high-risk pools run by states playing a central role in their Affordable Care Act replacement plans as a fallback option for sick people who do not have insurance or lose coverage. Based on experience in the states, it’s clear that these pools will need to operate differently and be funded much more fully than they have been in the past if the sickest people who fall through the cracks are to be protected. (Drew Altman, 1/23)

As Donald Trump starts his first week as president, how he and congressional Republicans plan to proceed on their first priority of repealing and replacing the Affordable Care Act remains a mystery—even to Republicans. ... Some Republicans and nearly all healthcare stakeholders think the GOP better have some replacement plan ready very soon because Congress already passed a budget blueprint that could lead to expedited legislation to repeal the ACA on a party-line vote as soon as next month. “It's really irresponsible to repeal the law with no consensus on replacement, because you're playing games with people's lives,” said J.B. Silvers, a professor of healthcare finance at Case Western Reserve University and former health plan CEO. (Harris Meyer, 1/23)

Now that President Trump is in the Oval Office, thousands of American lives that were previously protected by provisions of the Affordable Care Act are in danger. For more than 30 years, we have studied how death rates are affected by changes in health-care coverage, and we’re convinced that an ACA repeal could cause tens of thousands of deaths annually. The story is in the data: The biggest and most definitive study of what happens to death rates when Medicaid coverage is expanded, published in the New England Journal of Medicine, found that for every 455 people who gained coverage across several states, one life was saved per year. Applying that figure to even a conservative estimate of 20 million losing coverage in the event of an ACA repeal yields an estimate of 43,956 deaths annually. (David Himmelstein and Steffie Woolhandler, 1/23)

It’s easy to feel neutral toward a program you have no experience with, but to me, Medicaid, the federal program that funds health care for nearly 70 million Americans in need, means a lot. Both of my children were delivered with Medi-Cal (California’s jointly administered Medicaid program) benefits, and they relied on those same benefits growing up. As a young mother in nursing school, I’m not sure how else I would have paid for my own health care. And now, looking back on a career of providing health care as a nurse, I’m more worried than ever for the future of our country’s health-care system. (Rita Lewis, 1/24)

No one is better positioned to see how the health care system is working — and how it can be improved — than the doctors, nurses, and support staff on the front lines. Clinical professionals understand the strengths and weaknesses of the law because they’ve had to live and work within the requirements of the Affordable Care Act. So they should have a say in its fate, or at least its replacement. (Rebecca Kolins Givan, 1/23)

The biggest mistake of [Barack] Obama’s presidency was punting health care “reform” to Congress. While he wanted to remain postpartisan after a historic campaign and stay out of the fight, Democrats on Capitol Hill argued over the specifics and took more than a year to get something to his desk. ... If Obama had been more assertive in the legislative process from the beginning and hit the campaign trail to highlight the benefits of Obamacare before the midterm elections, history may have been written differently. (Nathan Gonzales, 1/24)

My friend, Ms. C., had worked as a city bus driver for nearly 25 years when she lost her job in 2012. Nearing 60, she couldn’t find another, and her insurance coverage lapsed. Without insurance, she could no longer see her doctor or take her blood pressure medications. She wound up in the emergency room with dangerously high blood pressure and chest pain. Fortunately for her, she was able to get insurance under the Affordable Care Act, and get her blood pressure under control. She is in good company: As my colleagues and I found in a new study published in the Annals of Internal Medicine, she is one of 4 million American adults with chronic diseases who gained coverage under the ACA in its first year. (Nicole Mushero, 1/23)

The debate on repealing Obamacare has rightly focused on all those Americans who would be hurt – the estimated 18 million who could lose their health insurance in the first year. But there should be more attention on those who could benefit right away – the super rich who would get a huge tax cut. At the same time, millions of Americans – including 1.2 million Californians – would lose tax credits on health insurance premiums they now get under the Affordable Care Act. (1/23)

For all of its faults, former President Obama’s signature [health] law did accomplish one thing: it provided health coverage to some 20 million Americans who were previously not covered. It is critical to understand that most of this new coverage came from expanded Medicaid programs at the state level; not because of other aspects of this law that are more controversial. ... Is it possible to hold onto Medicaid-related coverage at the state level as the ACA is replaced? I think it’s possible, but Tennessee must prepare. (Rep. Michael Curcio, 1/23)

The swearing in of Donald Trump as president provides states with the best chance since the creation of Medicaid in 1965 to have meaningful control over the program. Now is the time for all Tennesseans to come together to design the best Medicaid program for our state. Regardless of our past views on Medicaid expansion, we must work together to seize this opportunity. (Republican Tenn. State Sen. Brian Kelsey, 1/22)