�鶹Ů��

Congressional Republicans recrafted their Obamacare replacement bill on Monday in hopes of satisfying critics as U.S. President Donald Trump prepared to promote his first major legislative initiative on Capitol Hill. In a sign of deepening concern among Republicans about the bill's future, Trump will speak to the party's lawmakers in Congress on Tuesday about the healthcare overhaul, two House Republican aides said. (Morgan and Cornwell, 3/20)

Under the modified version of the GOP replacement bill, states would be allowed to require able-bodied Medicaid recipients without dependents to work beginning in October — and would get a funding boost as a reward for doing so. States could also receive federal funding for the program as a lump sum — instead of a per capita allotment — for children and non-disabled, non-elderly adults. Taxes imposed by the ACA on the wealthy, sectors of the health care industry and others to pay for expanded coverage would be repealed in 2017 instead of 2018. (Groppe, 3/20)

The bill would repeal most of the Affordable Care Act’s taxes starting in 2017, a year earlier than in the prior version. A tax on generous employer health plans, known as a “Cadillac tax,” would begin in a year later, in 2026. (Armour, 3/21)

The bill also includes provisions nodding at anti-abortion GOP leaders. Among other changes to the repeal bill, the amendment would delete a provision that would have allowed consumers to move leftover tax credit money into a Health Savings Account. Anti-abortion groups had raised concerns that the provision might be eliminated under the Senate's strict budget rules and inadvertently allow for taxpayer funding of abortion. (Haberkorn, Pradhan and Dawsey, 3/20)

The revisions do not include any provisions targeting high drug prices, even though Trump told a rally in Louisville on Monday night that the bill would. (Mascaro and Levey, 3/20)

House Republican leaders, trying to lock down the votes of wavering upstate New York Republicans, inserted a last-minute special provision in their health care bill that would shift Medicaid costs from New York’s counties to its state government. (Kaplan and Pear, 3/20)

New York Republican lawmakers argue this will relieve counties from having to pay into Medicaid and lead to property tax relief for constituents. But Democrats are already labelling that change a “backroom amendment.” (Sullivan, 3/20)

House leaders praised the changes Monday night, with House Speaker Paul Ryan saying Republicans were “one step closer” to repealing Obamacare. “I want to thank the White House and members from all parts of our conference who have helped make this the strongest legislation it can be,” he said in a statement late Monday. (Edney, Edgerton and Tracer, 3/20)

The changes seem certain to further reduce the amount of deficit reduction linked to the bill, which was at $337 billion over ten years – now that figure may drop to under $200 billion. (Dupree, 3/21)

Republicans leaders want to push their bill repealing and replacing much of the 2010 health care law through Congress by April. But the GOP must navigate a complicated path to get the proposal to President Donald Trump's desk. (3/21)

Conservative House Republicans said Monday night that they have enough votes to block the GOP’s legislation to dismantle the Affordable Care Act, as House leaders proposed changes to the bill in a late effort to draw support. (Peterson, Andrews and Armour, 3/21)

There were signs Monday that the bill had growing support among the moderate wing of the House GOP. Rep. Tom MacArthur (R-N.J.), who had voted against the leadership in an early procedural vote on the health-care legislation, said that he was “satisfied enough that I will support the bill.” MacArthur said he was assured that the bill would do more for older and disabled Americans covered under Medicaid and that an additional $85 billion in aid would be directed to those between ages 50 and 65. (DeBonis, 3/20)

The conservative House Freedom Caucus has decided not to vote as a bloc to oppose the Republican plan to repeal and replace Obamacare, a decision that could pave the way for the legislation to pass the House this week. “We’re not taking any official positions,” Rep. Mark Meadows, R-N.C., chairman of the Freedom Caucus, told reporters Monday. “I’m going to encourage them to vote for their constituents.” (Collins, 3/20)

Look no further than Cincinnati’s congressional delegation to understand why Republican leaders are having so much trouble rallying their party around their Obamacare replacement plan. Cincinnati is represented by a quartet of rock-ribbed Republicans — and none of them has committed to vote for House Speaker Paul Ryan’s plan to repeal and replace the 2010 health care law. (Shesgreen, 3/20)

Democrats announced Monday morning that Vice President Joe Biden will headline a rally at the Capitol to save Obamacare the day before Republicans are scheduled to vote to dismantle the health law. Biden will join House Minority Leader Nancy Pelosi on Wednesday, in one of his first major appearances since leaving office. (Cancryn, 3/20)

In this corner of Appalachia, poverty takes a back seat to art galleries, country clubs, golf course communities, five-star restaurants and multimillion-dollar houses. From this perch, Rep. Mark Meadows, a real estate entrepreneur who capitalized on the area’s transformation into a prosperous retirement and vacation community, rose to political power quickly. Now the conservative Republican leads the House Freedom Caucus, controlling between 30 and 40 votes in Congress and showing few qualms about endangering his party’s best chance to repeal the Affordable Care Act. (Galewitz, 3/20)

The House is racing to find enough votes for its health-care bill this week, but even if it passes, prospects in the Senate have only darkened. More than enough Senate Republicans oppose the House bill to kill it -- with rival camps insisting on pulling the bill in opposite directions to meet their demands. With just a 52-48 majority, the bill would fail if three or more Republicans vote against it. (Dennis, 3/21)

The fate of the bill remains shaky in the Senate, where a number of Republicans have voiced strong concerns about its $880 billion in Medicaid spending cuts over 10 years and the projected increase in uninsured Americans by 24 million. But Joe Antos, a conservative health policy expert at the American Enterprise Institute, predicted that edgy Republicans in the House and Senate are likely to come around and back the bill because this will be the only vehicle for repealing and replacing Obamacare. (Meyer, 3/20)

President Donald Trump is rallying support for the Republican health care overhaul by taking his case directly to GOP lawmakers at the Capitol, two days before the House plans a climactic vote that poses an important early test for his presidency. Top House Republicans unveiled revisions to their bill in hopes of nailing down support. (Fram and Alonso-Zaldivar, 3/21)

On Tuesday morning, the president will head to Capitol Hill in an attempt to seal up House Republican support for the health insurance legislation, just two days before the most important congressional vote of his young presidency. “He’s been working. He’s the closer,” House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said Monday on MSNBC. “He knows how to put this together. He’s got great negotiating skills, and we’re coming together with it.” (Wong, 3/20)

“I think the president is the ultimate salesman on this,” Rep. Bradley Byrne (R-Ala.) said Friday. “I think there might be some members in there that it might be beneficial for him to call, if it gets down to that.” (McIntire, 3/20)

If Trump and Ryan lose the Freedom Caucus, they risk a stalemate in Congress over health care and potential backlash from the party’s base if they’re unable to do what Republicans have promised their voters for years: Get rid of Obamacare, repeal the mandate that most people must have health insurance or pay a fine, and loosen restrictions on insurance companies. (Douglas and Douglas, 3/20)

Failure of the health bill could foreshadow stiff challenges to plans to overhaul the tax code, reform immigration policy and rework financial services regulation, said Rep. Bill Huizenga (R-Mich.). "This is, I think, a leading indicator about whether we're going to have a functioning and workable majority," said Huizenga, who added that he expected Trump to reassure lawmakers Tuesday that he fully supports the House bill. (Cheney and Bade, 3/21)

On the precipice of the meatiest legislative fight of his young presidency, Donald Trump is increasingly talking about health care like the vegetables of his agenda — the thing he must begrudgingly finish in order to get to what he really wants: tax cuts, trade deals and infrastructure. (Goldmacher, 3/20)

Trump rallied supporters Monday night in Louisville, Kentucky, alongside Senate Majority Leader Mitch McConnell, R-Ky., after meetings and phone calls in Washington aimed at steadying the troubled legislation designed to erase President Barack Obama's signature health care law. He planned to court House Republicans on Tuesday. (Thomas and Bykowicz, 3/20)

"We want a very big tax cut, but cannot do that until we keep our promise to repeal and replace the disaster known as 'Obamacare,'" he told the crowd of thousands in Louisville. "This is our long-awaited chance to finally get rid of 'Obamacare.'" (Bykowicz and Thomas, 3/21)

In a speech peppered with shout-outs to Kentucky's congressional delegation — "Hey, Mitch," Trump asked Senate Majority Leader Mitch McConnell at one point, "we gonna be OK? ... That health care's looking good?" — the president warned the crowd that if the health bill did not pass, "the alternative is what you have [and] what you have is nothing." Trump also attempted conciliation toward Sen. Rand Paul, R-Ky., one of the bill's most outspoken opponents, saying, "I look forward to working with him so we can get this bill passed — in some form." (Chamberlain, 3/20)

A defiant President Donald Trump rallied support for the House's Obamacare repeal and replacement bill, predicting that the bill will "go back and forth" in Congress but that the end result will be "great." (Jackson, 3/20)

So far, Trump and his vice president, Mike Pence, have both taken a light touch promoting the House bill, suggesting the White House is more interested in maintaining some political distance in case it fails than in pushing it over the finish line. The Congressional Budget Office has estimated the legislation would lead to 24 million Americans dropping or losing their health insurance over 10 years, at a savings of $337 billion for the government. (Pettypiece, 3/20)

The U.S. economy would produce 1.8 million fewer jobs in 2022 if the Republican legislation to repeal the Affordable Care Act became law, according to a new analysis by the Center for American Progress. Two provisions in the legislation accounted for most of the projected job losses: repealing expanded eligibility for Medicaid coverage and cutting federal financial assistance for marketplace health coverage. Both measures were expected to eliminate 2.2 million jobs in 2022, according to the study by the left-leaning think tank. (Pugh, 3/20)

Talmadge Yarbrough had just sat down at his desk and opened a box of pecans when he let out a gasp that could have been his last breath. He'd gone into cardiac arrest in his office, a co-worker called 911, and an ambulance drove him two miles to the small hospital that serves this rural community in southeast Georgia. "I would have never lasted to get to Savannah or Statesboro," Yarbrough said of the biggest cities near Claxton — each 30 to 60 miles away. "I firmly believe if that hospital wasn't here, I wouldn't be here." (Bynum, Santana and Foody, 3/20)

In a bid to improve the health insurance purchasing clout of small businesses, Republicans have dusted off a piece of controversial legislation more than a decade old and reintroduced it as part of their effort to remake the market after they throw out the Affordable Care Act. (Andrews, 3/21)

As chairman of the House Budget Committee, Tom Price spent the last seven years trying to muscle through a repeal of Obamacare. Now, as Health and Human Services Secretary, that health-reform law, the Affordable Care Act, may give Price a lot of the leeway he needs to roll back its regulations... Health policy analysts say the ACA gives the secretary the most discretion when it comes to enforcing reporting regulations for insurers, hospitals and physicians, in particular. (Coombs, 3/20)

The Affordable Care Act’s tax penalty for people who opt out of health insurance is one of the most loathed parts of the law, so it is no surprise that Republicans are keen to abolish it. But the penalty, called the individual mandate, plays a vital function: nudging healthy people into the insurance markets where their premiums help pay for the cost of care for the sick. That has required Republican lawmakers to come up with an alternative. The GOP approach is called a “continuous coverage” penalty. It increases premiums for people who buy insurance if they have gone 63 consecutive days without a policy during the past 12 months. Their premiums would rise by 30 percent and that surcharge would last for a year. While the ACA assesses a fine for each year people don’t buy insurance, the GOP plan would punish those who decide to purchase it after not being in the market. (Rau and Gorman, 3/21)

In rural Vinton County, where 70 percent of voters backed President Donald Trump last year, there's a lot of support for scrapping the Affordable Care Act, also known as Obamacare. But if Obamacare is repealed, and the accompanying money to expand Medicaid coverage is rolled back, there could be major repercussions in this isolated, poor, rural county of 13,000 people. (Pelzer, 3/20)

Kenneth Peek had a rough year. The South Georgia farm where he and his wife grow corn, wheat and soybeans faced a drought and lost money in 2016. So he’s working construction jobs to make ends meet. The 64-year-old hoped to catch a break on his health care costs. He has insurance through the Affordable Care Act, better known as Obamacare, but the premiums and bills keep going up and up. That’s one reason he voted for Donald Trump. ... But like many older Americans and people with limited means, Peek is learning that the Republican plan to replace Obamacare doesn’t give him a break. It gives him a thumping. (Schneider and Williams, 3/20)

For years, Republicans in Congress have promised to repeal and replace the Affordable Care Act, claiming that its requirement for nearly everyone to buy insurance or pay a fine is burdensome and costly, and that it doesn’t give people enough flexibility to get the coverage they need.Now that they’re in charge, the bill they’ve released as an alternative (the American Health Care Act) would effectively eliminate the requirement to buy coverage and might open up more health care choices. (Kodjak and Rovner, 3/20)

[Don] Boyer and [Ann] Justi were getting married. Never mind the blizzard-like conditions that kept one set of friends home, and a bad cold that waylaid another. They were determined to tie the knot that afternoon. So they recruited their landlord from downstairs and a public radio reporter to be witnesses. Why the rush? Boyer and Justi had been listening to the news. They were planning to get married in the fall, but it occurred to them that there’s no knowing what could happen to health insurance if the Trump administration and congressional Republicans dismantle the Affordable Care Act. (Mogul, 3/21)

Health care stocks are performing better this year than investors might think, given the rancorous debate over the Republican plan to repeal and replace Obamacare. (Shell, 3/20)

Vital health care services for more than 17 million of the nation’s most vulnerable citizens could be on the chopping block if the Republican health care bill becomes law. If Medicaid home and community-based services are cut for children with special needs and adults and seniors with disabilities, many would either end up in costly nursing homes, require more assistance from struggling family members or simply do without the care that allows them to live independently. (Pugh, 3/20)

An under-the-radar provision in the Republican proposal to replace the Affordable Care Act would require the millions of Medicaid enrollees who signed up under the Obamacare expansion to renew their coverage every six months — twice as often as under current law. That change would inevitably push many people out of coverage, at least temporarily, experts say, and help GOP leaders phase out Medicaid expansion — a key goal of the pending legislation. (Bazar, 3/20)

Before nursing home patient Carmencita Misa became bedridden, she was a veritable “dancing queen,” says her daughter, Charlotte Altieri. “Even though she would work about 60 hours a week, she would make sure to go out dancing once a week — no matter what,” Altieri, 39, said. “She was the life-of-the-party kind of person, the central nervous system for all her friends.” (O'Neill, 3/21)

South Carolina’s must vulnerable citizens could lose access to health care if massive Medicaid cuts proposed by congressional Republicans become law. The American Health Care Act – President Donald Trump and the GOP House leadership’s plan to replace and repeal President Barack Obama’s signature healthcare law – would make big changes to Medicaid, the federal healthcare program for the poor. A quarter of S.C. residents — 1.2 million of 4.8 million — now get their healthcare via Medicaid. (Self, 3/20)

For the past three years, Republican Gov. Sam Brownback and legislative leaders were able to block debate on expanding health care for the disabled and working poor via Medicaid, a component of the 2010 Affordable Care Act. Not anymore. In last year's primary and general elections, Kansas voters — frustrated by chronic budget problems caused in large part by income tax cuts that Brownback pushed through the Legislature — replaced several conservative incumbents with moderate Republicans and Democrats who promised to stabilize the state's finances, fund public education and push for Medicaid expansion. (McLean, 3/20)

Proponents of expanding KanCare, the privatized Medicaid program in Kansas, think it should happen regardless of what changes to healthcare are coming at the national level. ... Health care advocates testified to a Senate panel Monday morning in favor of HB 2044, legislation that would expand health coverage to thousands of low-income Kansans if passed into law. (Woodall, 3/20)

House Speaker Paul Ryan told the National Review's Rich Lowry he has been hoping to reform health care for the poor since his frat-party days. "So Medicaid, sending it back to the states, capping its growth rate, we've been dreaming of this since I've been around — since you and I were drinking at a keg. ... I've been thinking about this stuff for a long time," Ryan said. "We're on the cusp of doing something we've long believed in." ... A video of the discussion was posted on YouTube on Friday.(Dahler, 3/20)

Every couple of years, unannounced visits by inspectors from the Joint Commission trigger a frenzied response in hospitals, in which clinicians are instructed to do everything by the book to avoid potentially embarrassing violations. (Ross, 3/20)

VIP patients may receive extra niceties, from an airy private room with a view to a special menu. But what about their medical treatment, and how do physicians see caring for these VIPs? A new study from the Journal of Hospital Medicine looked at hospital VIP care, and found that it may come at a cost: VIP patients may demand uncalled-for tests or treatments — and get them, possibly to their own detriment. (Rellosa, 3/20)

Safety advocates are worried that lawmakers are getting ready to make it harder to penalize companies that don't keep track of workers' injuries. Since 1971, the Occupational Safety and Health Administration has required many employers to keep careful records of any worker injuries or illnesses. (Greenfieldboyce, 3/20)

In the US, a rising number of babies are living to see their first birthday, according to a study released Tuesday by the Centers for Disease Control and Prevention. The data show that infant mortality has declined by 15 percent over the last decade, with the biggest gains concentrated in the south and east of the country. That’s good news given that the US has persistently had a higher rate of infant deaths than other wealthy nations. (Swetlitz, 3/21)

If the average temperature rises by 1 degree Celsius, sea levels will rise, crop yields will fall and vulnerable species will see their habitat shrink or disappear. And, a new study suggests, the number of American adults suffering from diabetes would rise by more than 100,000 a year. (Kaplan, 3/20)

Gerard Sanacora, a professor of psychiatry at Yale University, has treated hundreds of severely depressed patients with low doses of ketamine, an anesthetic and popular club drug that isn't approved for depression. This sort of "off-label" prescribing is legal. But Sanacora says other doctors sometimes ask him, "How can you be offering this to patients based on the limited amount of information that's out there and not knowing the potential long-term risk?" Sanacora has a simple answer. (Hamilton, 3/20)

When Char Zinda’s doctors discovered that she had had a couple of small, undiagnosed heart attacks, their instructions were to start walking. She was game. She tried going to the local university’s indoor walking track near her house. But she couldn’t even walk two-tenths of a mile. “The bottoms of my feet just felt like somebody had taken a sharp pencil and was poking it in,” said the 64-year-old, who lives in Morris, Minn. The pain was so bad it made her cry. (Boodman, 3/20)

Living alone can be tough for seniors. Some don’t have family nearby to check on them, and they worry that if they fall or suffer a medical emergency and can't get to the phone to seek help, no one will know. That’s why hundreds of police agencies in small towns, suburbs and rural areas across the country are checking in on seniors who live alone by offering them a free automated phone call every day. (Bergal, 3/21)

After learning he had early stage prostate cancer, Paul Kolnik knew he wanted that cancer destroyed immediately and with as little disruption as possible to his busy life as the New York City Ballet’s photographer. So Mr. Kolnik, 65, chose a type of radiation treatment that is raising some eyebrows in the prostate cancer field. It is more intense than standard radiation and takes much less time — five sessions over two weeks instead of 40 sessions over about two months or 28 sessions over five to six weeks. (Kolata, 3/20)

“What’s wrong with you?” Dianne Hull remembered her friend Vicky Weinstein asking, alarm evident in her voice. The two women had just finished lunch in December 2012, and Hull breathed heavily as she walked across the kitchen of her friend’s home. Hull’s audible breathing — and increasing breathlessness — had been shoved aside in her constellation of pressing concerns. For months, Hull had been focused on a medical crisis affecting her young son. But now Weinstein — a nurse — was delivering a forceful reminder: It was past time for Hull, then 38, to pay attention to her own health. (Boodman, 3/20)

The genomics pioneer who sequenced the human genome carved out a new niche just over a year ago, selling exhaustive $25,000 medical workups to apparently healthy people. Now Craig Venter’s trying to take one small piece of that business to a much wider audience — and to prove it’s worthwhile. (Robbins, 3/21)

Many people find the constant dings, rings, buzzes and beeps that come from their computers and cell phones impossible to ignore. Experts say its a sign of our dependency on technology, which validates and entertains us while also cutting into our productivity and altering our attention span for the worse. (Caiola, 3/20)

In his late 20s, Christopher Milford of East Boston, Mass., got high on some OxyContin his friend gave him. By the time he was in his early 30s, he was shooting heroin and Suboxone. Milford would reuse the same needle for a week or more. Then, one day, he was so sick he couldn't get out of bed. (Rodolico, 3/21)

In the midst of an opioid epidemic that continues to devastate families, a sliver of hope has arrived. Two long-term studies published Monday show that opioid use among teens and opioid poisonings among younger children are on the decline. (Haelle, 3/20)

With four fatal heroin overdoses this weekend, Harford County has reached the tragic milestone of 100 opioid-related deaths since the sheriff's office started keeping track at the start of 2015. And Sheriff Jeffrey Gahler said the worst is yet to come. The deaths this weekend – three Saturday and one Sunday – bring the total of opioid-related deaths this year to 20. With 56 in 2016 and 27 in 2015, that's 103 heroin deaths, according to statistics from the Harford County Sheriff's Office. (Butler, 3/21)

The University of Missouri study looked at two strains of the Zika virus – the African strain as well as the Asian strain, the latter of which has been linked to a neurological defect called microcephaly in human babies. Researchers used stem cells to create placental cells, and then infected two separate groups of those cells with the Asian or the African strain of the Zika virus, according to a news release about the study, which was published in the Proceedings of the National Academy of Sciences. The Asian strain of the virus entered the cell and replicated within the cells, but did not kill the cells, according to the release. (Caiola, 3/20)

Florida health officials on Monday reported one more locally acquired Zika infection in a person who felt no symptoms but who was tested for the virus in February. The person likely acquired Zika in Miami-Dade in 2016 after “multiple exposures” to areas where mosquitoes were spreading the virus, the Florida Department of Health reported, adding that the state had just received confirmation from the federal Centers for Disease Control and Prevention. (Chang, 3/20)

lorida health officials reported a new locally acquired Zika infection in Miami-Dade County on Monday, as well as four new travel-related cases in South Florida. The person infected in Miami-Dade had “multiple exposures” to areas where mosquitoes were spreading the virus and likely contracted the mosquito-borne Zika virus in 2016, according to the Florida Department of Health. The person did not feel any symptoms, but was tested for the virus in February and state health officials just received confirmation from the Centers for Disease Control and Prevention. (Piccardo, 3/20)

The House Insurance Committee on Monday passed revamped legislation to reduce “surprise billing,’’ in which patients using hospitals in their insurance network may still get unexpected bills from doctors who are not in the network. Consumers who have procedures or visit ERs at hospitals in their networks often get separate bills for hundreds or even thousands of dollars from non-network doctors who were involved. These bills can come from ER doctors, anesthesiologists and radiologists, among others. (Miller, 3/20)

Two GOP-backed anti-abortion bills passed the Texas Senate on Monday — one that would prevent parents from suing doctors if their baby is born with a birth defect and another that would require doctors to make sure a fetus is deceased before performing a certain type of abortion. Sen. Brandon Creighton's Senate Bill 25, a "wrongful births" bill designed to prevent doctors from encouraging abortions to avoid lawsuits, passed 21-9. Creighton said without it, doctors have "an invitation to be sued for just practicing medicine" and might not want to work in the state. (Evans, 3/20)

Spurred on by concerns that dangerous criminals are getting hired to care for ill, disabled and frail patients, legislation that would require fingerprint-based criminal background checks for health care professionals in Colorado passed key hurdles this month. House Bill 17-1121, sponsored by Rep. Janet Buckner, D-Aurora, recently cleared two key House committees and appears headed to the Senate for final consideration. (Osher, 3/20)

The Texas Health and Human Services Commission has opened an internal investigation into the bungled privatization of a program that transports poor Texans to medical appointments. The probe by the commission's inspector general, Stuart Bowen, will examine why officials gave lucrative contracts for administration of the program to companies and nonprofit organizations that did not provide cost information and, in some cases, scored poorly on the state's own rating system. (Rosenthal, 3/20)

It takes less time for a new patient to see a doctor in Houston than the national average, but a health care study also finds the percentage of physicians who accept Medicaid and Medicare remains much lower than in other major cities. Taken together, the two measurements could signal a widening disparity in access to health care based on income and insurance availability in Houston, said Phillip Miller, vice president of communications for Merritt Hawkins, a leading national physician search and health care consulting firm. (Deam, 3/20)

New Jersey health officials have identified 31 patients who became infected after receiving injections to treat knee pain at a clinic in Wall Township, Monmouth County. State and local investigators identified "infection control issues" during an inspection of the clinic on March 13, said Donna Leusner, a spokeswoman for the state Department of Health. At least 20 of the patients at Osteo Relief Institute Jersey Shore have needed surgery to treat their infections, said David A. Henry, health officer for the Monmouth County Regional Health Commission. The investigation is ongoing, he said. (Avril, 3/20)

[Nadia] Lugo was working as a community health worker, a role many people involved in health care in Connecticut see as a key way to improve care for high-need patients. The job involves bridging the medical and social service systems and the many other factors in people’s lives that can have as much or more impact on their health than medical care – things like housing, transportation and food. (Levin Becker, 3/21)

State revenue officials predicted taxes on marijuana could eventually bring in more than $100 million each year. The attorney general’s office encouraged lawmakers to clarify how cities and towns can prohibit pot stores. And a long bearded man argued that bills to adjust the state’s new marijuana law are “essentially shredding the will of the people.” (Miller, 3/21)

People who want to grow medical marijuana in Ohio are certain about one thing: they don't want outsiders coming in to take over. The vast majority of more than two-dozens speakers at a public hearing today on marijuana cultivation rules said there should be a residency requirement for those granted licenses to grow pot legally under a new state law. (Johnson, 3/20)

The uncertain future of Obamacare isn’t just wreaking havoc for insurers, hospitals and other companies in the health-care ecosystem. It’s paralyzing the lives of millions of regular Americans, too. (Catherine Rampbell, 3/20)

President Trump has mostly stayed on the sidelines of the messy policy debates regarding health care reform. But amid the war on Capitol Hill among Republican factions, he could seize the opportunity to provide leadership consistent with his campaign message to disrupt existing health policy. Instead of trying to satisfy the free-market wing of his party, Mr. Trump could push for a solution that delivers on his populist promises by proposing universal catastrophic coverage, ending the specter of medical bankruptcy for many Americans. (Benjamin Domenech, 3/21)

If you watch the Sunday shows you’ll quickly see the GOP’s circular reasoning: To drive down insurance premium costs you have to remove the insurance mandates, but that’s not in the bill. It comes later, they say, but their fellow Republicans candidly acknowledge that later means “never.” (Jennifer Rubin, 3/20)

The biggest gamble in the House health-care bill is whether it includes enough reform to arrest the current death spiral in the individual insurance market. No one knows for sure, but critics are overlooking important provisions that will help people who are now exposed to ObamaCare’s rapidly rising premiums. (3/20)

Following an exceedingly unfavorable report from the Congressional Budget Office, prospects of the House Obamacare repeal-and-replace bill becoming law in its original form have become bleak. In its wake comes talk of significant changes to the bill, and even the renewal of an old strategy: letting the Affordable Care Act implode on its own accord, then picking up the pieces anew. There’s only one problem. The predicted “death spiral” hasn’t happened yet, and there’s a reason it won’t. (Stan Veuger and Benedic Ippolito, 3/21)

“Obamacare is not going to last,” House Speaker Paul D. Ryan (R-Wis.) said Sunday when challenged to explain how he could support a replacement plan that independent experts project would result in millions of people losing health coverage. “There’s no way Obamacare could stick another two or three years, let alone 10 years.” This is the last rhetorical refuge for defenders of a shoddy GOP replacement plan: Practically any system would be better than the “collapsing” status quo. (3/20)

Last week the Congressional Budget Office made front-page headlines when it reported that the House proposal to replace Obamacare would throw millions of people off the insurance rolls. Apparently the future of the country’s health-care entitlement system is of profound importance. ... But the 10-year forecast is just as important, and adds crucial context to the debate over health care. For instance, it shows that the national debt is set to explode, growing from $20 trillion to $30 trillion by 2027. (3/20)

For individual marketplace insurance, the AHCA removes the requirement to cover specified percentages of the expected medical costs. This means that while plans are required to include the full set of benefits, they are free to raise the cost sharing for particular benefits — like mental health services or maternity and newborn care — to potentially prohibitive levels. (Richard G. Frank and Sherry A. Glied, 3/20)

It’s not often that a Donald Trump rally is the bottom story in the state he’s visiting. But when the state is Kentucky and it’s March Madness and the University of Kentucky Wildcats have just advanced to the NCAA’s Sweet 16 in college basketball, it’s understandable that local attentions are focused on hoops not politics. (William McGurn, 3/20)

Political opportunism and irrational ideology continue to dominate reason in our latest phase of the struggle over health care. Assuming there is an American future, the people living in it will look back in wonderment that in 2017 a few hundred adult, fairly well-informed, decently educated men and women had such difficulty solving a fundamental problem of governance and math. Why, they will ask, did so many people of that era not understand that every one of them had a financial – let alone moral and humanitarian – stake in everyone else’s physical well-being? (Davis Merritt, 3/21)

Congressional Republicans, President Trump and Vice President Mike Pence are united in support of "defunding" Planned Parenthood. Indeed, a provision in the GOP's American Health Care Act would end its eligibility as a Medicaid provider, meaning patients covered by the low-income insurance program could no longer choose Planned Parenthood clinics for care. ... Before unraveling Planned Parenthood, though, Republicans should look at why it’s so popular among Medicaid recipients — and whether any other organization is well-positioned to fill the gap. (Elizabeth Nolan Brown, 3/21)

The Food and Drug Administration last week shut shut down several Colorado dietary-supplement companies that it said were selling “misbranded and adulterated” products that wrongly purported to treat “high cholesterol, hypertension, diabetes, depression and muscle pain. ”The agency said violations such as these “put consumers’ health in jeopardy.” If President Trump has his way with the federal budget, it’s almost a sure thing that people increasingly will be at greater risk when it comes to the safety and effectiveness of over-the-counter supplements. (David Lazarus, 3/21)

Every so often, a bill comes before the Iowa Legislature that no single lawmaker would dare vote against. Enter Senate File 404. The legislation gives terminally ill Iowans the “right to try” drugs and devices not yet approved by the U.S. Food and Drug Administration by permitting manufacturers to legally provide them. ... “This gives patients hope,” said Sen. Rick Bertrand, R-Sioux City, who proposed the legislation in response to a friend’s battle with a degenerative illness. But that hope may be false. (3/20)

Home care workers provide valuable care for Missouri families, but it often goes unnoticed, behind closed doors. I take care of Ms. Linda, who has been in my care for five years. I prepare her food and medications, dress and help her get to doctor’s visits — everything she needs to stay happy and healthy in her own house, instead of a nursing home. I love my job because it gives me the opportunity to work with my clients one-on-one, which provides an unmatched quality of care that you don’t get in a nursing home. The work is hard but rewarding. ... But right now, the proposed $113 million budget cut from Gov. Eric Greitens threatens the care of Missourians like Ms. Linda. (Elinor Simmons, 3/21)