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The most hated piece of Obamacare is the mandate requiring most Americans to get health insurance. The Republican alternatives on the table may not prove any more popular. As the GOP weighs elements of a repeal-replace plan, one of lawmakers' biggest headaches is finding another way to persuade insurers to cover people with pre-existing health care problems. And all of the options under discussion would either raise the uninsured population or run afoul of GOP principles. (Demko, 2/8)

Ever since Democrats began pushing the Affordable Care Act through Congress more than seven years ago, Republicans have been trying to come up with an alternative. Candid conversations leaked from a conclave of Republican lawmakers in Philadelphia last month, and public comments since, show they are nowhere near agreement. (Pear, 2/7)

The U.S. House of Representatives' Republican leader said on Tuesday that legislation to replace former President Barack Obama's signature healthcare law would be completed this year, trying to dispel the idea that the party is retreating from its campaign promise to dismantle Obamacare quickly. (Cornwell, 2/7)

Speaker Paul Ryan (R-Wis.) said Tuesday that Congress’s work to repeal and replace ObamaCare will be finished “this year.” Ryan was responding to a question about President Trump’s comments on Sunday that “maybe it’ll take till sometime into next year” to roll out a Republican replacement plan. But the Speaker said legislation to repeal and replace ObamaCare will pass this year. When that legislation would go into effect that could possibly extend into future years, he added. (Sullivan, 2/7)

“We are going to be done legislating with respect to health care and Obamacare this year,” Ryan said, though he added that it could take time for the Trump administration to implement the changes. “The question about how long it takes to effectuate the change, how long it takes to put these things in place, that’s a question that the HHS [Department of Health and Human Services] can answer,” he said. (Reid and McIntire, 2/7)

Republicans remain deeply divided about how quickly they'll be able to repeal the 2010 health care law, even as insurance companies demand clarity before the end of next month. Some are pressing ahead with plans for a quick repeal. Senate Majority Whip John Cornyn of Texas said Monday he expects the reconciliation measure that will serve as the initial vehicle for repealing the health care law to be filed within the next 30 days. (Williams and Mershon, 2/7)

Republicans on Capitol Hill and within the Trump administration are scrambling to get Obamacare repeal efforts back on track by stuffing as much of a replacement policy as possible into a repeal bill. Four replacement measures are under consideration, with a goal of beginning work on the legislation in the relevant House committees by the end of February, according to congressional sources familiar with the tentative plans. (Haberkorn, 2/7)

A new ObamaCare replacement plan from Rep. Mark Sanford is viewed favorably by the conservative Freedom Caucus, Rep. David Brat (R-Va.) said Tuesday. While the caucus hasn’t taken a formal position on the bill, Brat said it is widely liked by its members. Brat said Sanford’s bill -- which has not been introduced yet -- is similar to one introduced by Sen. Rand Paul (R-Ky.) in the upper chamber. (Hellmann, 2/7)

House Republicans are discussing how to deal with protesters showing up at their town halls and other events in their home districts after angry confrontations this past weekend. GOP leaders told members at a closed-door meeting on Tuesday to be welcoming and polite while arranging for moderators and security. That's the word from Rep. Richard Hudson of North Carolina. (2/7)

[T]he tactics [House Democrats] plan to explore at the minority party’s issues conference starting Wednesday in Baltimore — aside from their intense opposition to President Donald Trump — will be on how they can amplify concerns from constituents in Republican districts. ... In recent weeks, several GOP lawmakers have faced backlash from people in their districts during town hall events over Republican efforts to repeal the 2010 health care law and over an executive order signed by Trump that temporarily restricted travel from seven Muslim-majority countries. ... Perhaps out of concern to avoid such incidents, and the sort of town hall spectacles that defined the summer of 2009, when Congress was debating the health care law, some Republicans are even refusing to have such constituent events at all. (Rahman, 2/8)

The AARP says it would consider suing the Trump administration if it went forward with a regulation that would allow insurers to charge older people more under ObamaCare.  The Department of Health and Human Services is in the process of putting forward a regulation on “stabilization” of the ObamaCare marketplaces, and The Huffington Post reported on Monday that one proposal in the regulation is to change the ratio set out under ObamaCare on how much more insurers can charge older people compared to younger people. (Sullivan, 2/7)

As the battle royale over the repeal of the Affordable Care Act—AKA Obamacare—heats up, access to health care for millions of Americans hangs in the balance. For those who get their health benefits through their employers, the repeal and/or replacement of the healthcare program may not hit as close to home. Yet the ACA does far more than many people realize, including guaranteeing new mothers the time and space to breastfeed at work. Before the Affordable Care Act, women in 28 states, including California, already had this guarantee, according to the National Conference of State Legislatures. The ACA made this requirement consistent nationwide, though state laws that offered greater protections were not preempted. (Landes, 2/7)

Tom Price is on a glide path to win Senate confirmation later this week as Health and Human Services secretary, where he would lead President Donald Trump’s effort to undo Obamacare, even as Democrats insist he still needs to answer questions about his stock trades. Senate Republicans have brushed off concerns raised by Democrats that Price, a Republican representative from Georgia, purchased stock in a few health-care companies and may have been financially motivated to develop or vote in favor of legislation that would benefit those businesses. (Edney, 2/8)

Health and Human Services secretary nominee Tom Price showed little restraint in his personal stock trading during the three years that federal investigators were bearing down on a key House committee on which the Republican congressman served, a review of his financial disclosures shows. Price made dozens of health industry stock trades during a three-year investigation by the Securities and Exchange Commission that focused on the Ways and Means Committee, according to financial disclosure records he filed with the House of Representatives. The investigation was considered the first test of a law passed to ban members of Congress and their staffs from trading stock based on insider information. (Taylor and Jewett, 2/7)

The Office of Government Ethics may “very soon” publicly post an agreement with Seema Verma, the Trump administration’s choice to run the Centers for Medicare and Medicaid Services, the Health and Human Services Department told CQ Roll Call. The deal would bring her nomination closer to Senate consideration. The agreement would address “all potential conflict issues,” HHS spokesman Matt Lloyd said. These agreements are a routine step in the vetting of people who serve in top federal posts, as they often have connections to firms and government agencies in their field of expertise. It’s possible that Verma’s agreement will address her widespread contacts with states from her work as a Medicaid consultant. (Dooley Young, 2/8)

When crippling back pain forced Robin Henderson to leave her job last year, Medicaid was a godsend. ... She gained coverage through the Healthy Indiana Plan — nicknamed HIP 2.0 — the state's version of Obamacare's Medicaid Expansion. ... The key architect behind HIP was consultant Seema Verma, the president and founder of Indianapolis, Indiana-based health policy consulting firm SVC. ... Now, Verma has been nominated by President Donald Trump to head the Centers for Medicare and Medicaid, or CMS, where she will be deeply involved in implementing the Trump administration's plans to repeal and replace the ACA. (Coombs, 2/7)

Sen. Ted Cruz urged fellow Republicans Tuesday to quickly "honor the promises" the party made over the years to repeal Obamacare. "2010, 2014, 2016, I believe were a mandate from the voters. We're tired of the premiums going up. We're tired of deductibles going up," Cruz said at a CNN town hall debate with Sen. Bernie Sanders over the future of Obamacare. "Should Congress move swiftly to repeal Obamacare? Absolutely." Cruz and Sanders -- two senators with diametrically opposed views of government's role in health care -- faced off at the debate moderated by CNN's Jake Tapper and Dana Bash and featuring questions from an audience consisting of both defenders and critics of the Affordable Care Act. (Lee and Watkins, 2/8)

Sens. Bernie Sanders and Ted Cruz debated the future of health care in the US Tuesday night, and CNN's Reality Check Team vetted the claims. The team of reporters, researchers and editors across CNN listened throughout the event and analyzed key statements, rating them true, misleading or false. (2/8)

A prime-time debate between Sens. Bernie Sanders (I-Vt.) and Ted Cruz (R-Texas) about the future of Obamacare ended up mostly being about the past as the two lawmakers fell back on their respective 2016 presidential campaign arguments about health care as a human right versus freedom-crushing government intervention. (Diamond, 2/7)

North Carolina ended the Affordable Care Act insurance exchange’s open enrollment period with more than a half-million enrollees for coverage this year – still, the number represented a significant decrease from last year. The 549,158 who signed up for North Carolina exchange coverage by Jan. 31 represents a 10.5 percent drop from the 613,487 who enrolled during open enrollment in early 2016. (Hoban, 2/7)

The open enrollment period for Connecticut’s health insurance exchange ended with 111,524 people signed up for private health plans – approximately 4,500 fewer than last year. That’s a 3.9 percent drop in enrollment in individual-market insurance sold through Access Health CT, the marketplace created by the federal health law. (Levin Becker, 2/7)

A bill to shut down the state’s marketplace where people buy health insurance plans under the Affordable Care Act passed its first committee vote Tuesday. Senate Bill 3 would push people and small businesses currently shopping for plans on Connect for Health Colorado to the federally run HealthCare.gov starting in 2018 — assuming there still is an Affordable Care Act then. The bill passed the state Senate Finance Committee on a 3-2 party-line vote, with Republicans supporting it and Democrats opposed. (Ingold, 2/7)

The provisions in the leaked rule are consistent with some of the changes sought by insurers to get a better balance of healthier and sicker people in the risk pool, bring down costs and premiums, and make the individual market a more profitable business. ... But the proposed changes don't address what insurance industry leaders say are their most important needs if they are going to remain in the individual market in 2018. Those include congressional funding for the ACA's cost-sharing reductions, preservation of generous premium subsidies to keep coverage affordable, and restoration of risk payments to protect insurers that sign up disproportionately sick members. (Meyer, 2/7)

The Trump administration is considering major changes to Obamacare that may help convince insurers to remain in the law's marketplaces while Congress drafts a replacement plan — but the proposals may also limit enrollment and increase costs for older Americans, according to documents obtained by POLITICO. The administration is looking to alter rules around insurers charging older customers more, how much cost they can shift onto customers, and who's allowed to sign up outside the standard enrollment window. ... POLITICO obtained two draft documents that were not identical but shared similar concepts. The administration is expected to soon release a proposed regulation — which may differ from these drafts — that it says will be an effort to stabilize Obamacare's insurance marketplaces. (Diamond, Haberkorn and Demko, 2/6)

The White House is giving a big boost to proponents of a federal Right to Try law that they contend would give terminally ill patients easier access to medicines that haven’t won approval from the Food and Drug Administration. Some supporters of the bill met Tuesday with Vice President Mike Pence, and last week they won a supportive statement from President Donald Trump, who has been contending that too many FDA rules in general pose unnecessary hurdles to drug approval. (Burton, 2/7)

In a potentially significant policy shift, the Food and Drug Administration plans to stop redacting portions of the resumes submitted by scientific and medical experts who serve on its advisory committees. The change comes in response to a lawsuit that was filed last year by Public Citizen, a consumer advocacy group, which argued the redactions were unlawful and robbed the public of the opportunity to understand the extent to which any of the expert advisors may have conflicts. (Silverman, 2/7)

The Environmental Protection Agency’s advisory panel on children’s health gathered last week to consider a few items that had long been on its agenda: getting lead out of water, cutting pollution-related asthma, and educating doctors about toxins in toys. The panel also took up an issue that few members could have foreseen several months ago: keeping the program off the chopping block. Caroline Cox, a member of the Children’s Health Protection Advisory Committee, suggested a letter to the incoming EPA chief, touting the economic benefits of protecting children from pollutants that can damage their brains or cause illness later in life. (Kaplan, 2/8)

More than 150 biotechnology executives and venture capitalists have voiced opposition to President Donald Trump’s immigration order, which they say threatens the U.S.’s thriving medical research industry. “If this misguided policy is not reversed, America is at risk of losing its leadership position in one of its most important sectors, one that will shape the world in the twenty-first century,” the executives wrote in a letter to the editor of Nature Biotechnology, a scientific journal, and published online on Tuesday. (Walker, 2/7)

In a clandestine mission that had the makings of a hostage rescue, the Cleveland Clinic and its lawyers arranged for medical resident Suha Abushamma to fly back to the United States yesterday, more than a week after she was forced to leave because of President Donald Trump’s travel ban. (Ornstein, 2/7)

A Cleveland Clinic resident who was barred from the US following President Trump’s immigration order made a triumphant return to the hospital Tuesday, receiving loud applause and cheers from her colleagues. Dr. Suha Abushamma told a crowd of clinic employees and journalists, “I want to say how happy I am to be back here in Cleveland with my friends, my fiance, and all the people I consider part of my family. I missed everyone so much.” (Ross, 2/7)

On Tuesday, the 9th Circuit Court of Appeals in California began hearing arguments in a case weighing whether to continue the suspension of President Trump's travel ban on immigrants from seven majority-Muslim countries. In Massachusetts, some health care workers say the uncertainty over the White House's immigration orders is directly affecting their immigrant patients. The workers say some patients aren't coming to their appointments because they're afraid. (Becker, 2/8)

American families aren’t as worried about terrorism or crime as they are about paying their health care bills, a new poll suggests. Health care costs have emerged as the No. 1 concern for American families, according to a new national Monmouth University poll. Health care costs outranked a variety of other concerns that registered in the single digits, including college tuition and taxes. (Clark, 2/7)

National security and immigration have been taking up much of the spotlight lately with Donald Trump in the White House, but what has Americans worried the most is their health care, according to a new Monmouth University Poll. About 25 percent of respondents in a nationwide poll said the cost of health care was the biggest concern facing their family, a 10-point jump over a similar poll conducted in 2015. By contrast, national security and immigration — issues that jumped to the forefront during the chaotic first weeks of the Trump administration — ranked very low in the survey. (Davis, 2/7)

All the doctor’s tricks were failing him. He’d tried neck massage, pressure to the eyes, ice on the face. But an hour in, Ashish Jha still couldn’t slow his racing heart. His wife asked what he’d recommend if a patient called with the same problem. “I said, ‘Oh, that’s easy.’ Go to the emergency department.” As a physician, Jha knew this tachycardia could possibly lead to a heart attack. Yet he felt caught by a decision he’d made in enrolling his family in a so-called high-deductible insurance plan. (Gorenstein, 2/8)

A Tennessee anti-abortion group is urging state lawmakers invigorated by Donald Trump's presidential victory to hold off on passing new abortion restrictions until the courts decide the fate of several major abortion laws.The wait-and-see approach seems odd for a Bible belt state after Trump's election emboldened U.S. social conservatives eager to roll back Roe v. Wade, the landmark 1973 ruling legalizing abortion nationwide. But the group Tennessee Right to Life is asking lawmakers to avoid passing more limitations until the courts weigh in on laws the state has already passed. (2/7)

The [Virginia] House of Delegates voted Tuesday to defund Planned Parenthood despite protests by women’s rights advocates on the Capitol grounds and in the House chamber. On a 60-33 party-line vote, the House approved HB 2264, which would cut off federal Title X funding for Planned Parenthood and any other groups that perform abortions in Virginia. Without the funding, the organization says it would have to shut its five clinics in the state. (Martin, 2/7)

Many conservatives have touted "defunding" Planned Parenthood as a goal for years, but a new bill targeting that organization potentially could affect a wider range of groups, including churches, if Kentucky's Republican-run legislature approves it. House Bill 149 would prohibit public funds from going to any organizations or individuals that provide abortion services or are affiliates of that type of group. It includes exceptions for hospitals, universities and medical schools. (Watkins, 2/7)

Legislation that bans the transfer or receipt of fetal tissues has passed out of subcommittee in the Iowa state Senate. Federal law already makes it illegal to sell fetal tissues for profit, but supporters of the bill say they don’t want aborted fetuses used in research. Iowa’s Board of Regents, the governing body of the state’s public colleges and universities, is one of several opponents of this legislation due to its impact on research. Keith Saunders, the board's state relations officer, says if the bill becomes law, university scientists would have to stop work on a more than 40-year-old line of human embryonic kidney cells known as HEK-293. (Boden, 2/7)

Doctors often fail to recommend genetic testing for breast-cancer patients, even those who are at high risk for mutations linked to ovarian and other cancers, according to a study published Tuesday. Researchers said the findings, which appear online in the Journal of the American Medical Association, are troubling because genetic tests can help guide women's choice of treatments for existing disease, as well as point to ways to reduce the risk of future cancer. (McGinley, 2/7)

When asked why they didn't get tested, the majority of the 773 high-risk patients said it was because their doctor didn't recommend it to them. Just 13.7 percent of them said the test was too expensive, and 10.7 percent said they didn't want it. The researchers say this suggests a disconnect between oncologist and patient, whether it be assessing BRCA risk isn't on the physician's radar, or that they just don't find it important. The study surveyed 2,529 women overall. (Boddy, 2/7)

The model was born out of the crack-cocaine era, when the women's health advocacy community, along with a few obstetricians, started realizing that the punitive and isolationist models of rehab - separating addicts from any possible triggers, including familiar people and places - wasn't working for pregnant women or mothers. The fix seemed intuitive: keep mother and children together so the family can recover as a unit. Today, nine women can live for an average of six to nine months with up to two children each at Family House NOW, which is operated by the nonprofit services provider Resources for Human Development. (Friedman-Rudovsky, 2/8)

This economically depressed city in the foothills of the Appalachian Mountains is an image of frozen-in-time decline: empty storefronts with faded facades, sagging power lines and aged streets with few stoplights.But there is one type of business that seems to thrive: pharmacies. (Galewitz, 2/8)

Spending hours each day online via either mobile devices or the stationary kind is not a mental illness. In fact, the original proposal, by the late Dr. Ivan Goldberg, was meant as a joke. More than any other behavior that people engage in compulsively, the digital version — from checking Facebook to texting — shows that just because you’re compulsive about something doesn’t mean you have a broken brain. To the contrary. As with other compulsions that fall well short of pathology, the allure of being online sheds light on some of the mind’s most salient, and utterly normal, operations, according to the latest research. (Begley, 2/8)

A widely used blood test to measure blood-sugar trends can give imprecise results, depending on a person's race and other factors. This test means diabetes can sometimes be misdiagnosed or managed poorly. Doctors have been cautioned before that results from the A1C test don't have pinpoint accuracy. A study published Tuesday underscores that shortcoming as it applies to people who carry the sickle cell trait. (Harris, 2/7)

Forty million American adults have lost some hearing because of noise, and half of them suffered the damage outside the workplace, from everyday exposure to leaf blowers, sirens, rock concerts and other loud sounds, the Centers for Disease Control and Prevention reported Tuesday. A quarter of people ages 20 to 69 were suffering some hearing deficits, the CDC reported in its Morbidity and Mortality Weekly Report, even though the vast majority of the people in the study claimed to have good or excellent hearing. (Bernstein, 2/7)

Surgical devices that can spread deadly uterine cancers were on the market for 22 years before a U.S. Food and Drug Administration system designed to catch such problems alerted the agency, a new watchdog report set for release soon confirmed. The report from the U.S. Government Accountability Office also said the FDA was aware of the potential cancer-spreading risk with laparoscopic power morcellators from the moment the agency first approved one in 1991, and that a series of medical-journal articles dating back to 1980 highlighted this risk. But the FDA believed there was a low risk of unsuspected cancers that could spread, according to the GAO. (Levitz and Kamp, 2/7)

Surprise billing of medical patients – when people go to a hospital in their insurance network but get surprised by a bill from an out-of-network doctor anyway – is a big problem. Legislators are still wrestling with a solution. On Tuesday the state Senate’s Health and Human Services Committee met to discuss one proposal on surprise billing: Senate Bill 8, sponsored by the committee’s chairwoman, Renee Unterman, R-Buford. (Hart, 2/7)

The Senate Health and Human Services Committee heard testimony on a proposal to halt these medical bills, which can come from ER doctors, anesthesiologists, radiologists, pathologists and others who are not in a patient’s insurance network — even though the hospital where they work is. “It’s a very complicated issue,’’ said Sen. Renee Unterman (R-Buford), who chairs the panel and is a nurse by profession. She is the sponsor of Senate Bill 8. Health insurers and medical providers can’t agree on a solution, she said. (Miller, 2/7)

Georgia’s limited medical marijuana law would be expanded to include autism, under legislation passed Tuesday in a state Senate committee. Senate Bill 16 is the first of several bills dealing with the law’s expansion to move this year, although medical marijuana advocates oppose the bill because it would also roll back the maximum THC level in the cannabis oil now allowed here. (Torres, 2/7)

Dartmouth-Hitchcock’s Norris Cotton Cancer Center properly used $6.1 million raised for cancer research, a state regulator has ruled, in a dispute that led its former director to file a whistleblower lawsuit. Thomas Donovan, head of the state Justice Department’s Charitable Trusts Unit, said the fundraising dollars, including money from the center’s signature fundraiser, The Prouty, were directed to be used for the cancer center’s benefit. The review did not find language restricting the gift from being used for the center’s operations, according to Donovan. (Cousineaug, 2/7)

The mild winter has meant less shoveling, fewer warm layers and something else — fewer outbreaks of the dreaded winter stomach bug. Beth Daly, chief of the state’s Bureau of Infectious Disease Control, said there’s been only 15 reported outbreaks of norovirus illness since December. The norovirus season usually runs from December until March and produces approximately 70 outbreaks, Daly said. While the numbers seem to be lower than usual, Daly said it’s too soon to predict if this season will be an easier one on Granite Staters’ bellies. (Grosky, 2/7)

A company that promised sick 9/11 responders and NFL players with concussion injuries that it could “cut through red tape” to get their payouts faster lured them into advances that meant hundreds of thousands of dollars in illegally high interest and fees, authorities said Tuesday. In a lawsuit filed Tuesday, New York’s attorney general and the Consumer Financial Protection Bureau allege that New Jersey-based RD Legal Funding and its founder Roni Dersovitz snared 9/11 responders who are struggling with cancer and respiratory illness as well as former NFL players with brain injuries into taking costly advances on their settlements. (Sweet, 2/7)

New medical marijuana regulations proposed by state health officials would block patients from timely and affordable access to medication, restrict physicians in treating their patients, and potentially undercut the development and distribution of quality medicine, an overflow crowd told Florida Department of Health officials Tuesday morning in Fort Lauderdale. (Smiley, 2/7)

A Culpeper cardiologist faces a misdemeanor assault and battery charge stemming from a reported confrontation with a female nursing director inside Novant Health UVa Health System Culpeper Medical Center last week. According to the official criminal complaint filed in Culpeper County General District Court, Dr. Zia Roshandel, 47, of Blue Ridge Cardiovascular Associates is accused of hitting Irene C. D’Gama in the shoulder following what she described as a heated argument inside her office Thursday. (Simmons, 2/7)

If you fax private medical information to a health management company in Ohio, you don't expect it to arrive instead at a small publishing firm in Milwaukee. But that's exactly what has been happening since the summer of 2015. (Stingl, 2/7)

Shawn Blazsek knew a string of concussions from high school football and boxing was catching up with him. He would go days without sleeping and was forgetting how to tie his shoes. Still, at age 33, he was stunned after being told he had Alzheimer’s disease. He started planning out who would take care of his four kids if something happened to his wife, and thought about how hard it would be for them when he could no longer recognize his family. So he stuffed fistfuls of sleeping pills into a bottle and wrote himself a note, vowing to swallow all of them when he wasn’t able to remember the names of his children. That day never came. (Seewer, 2/8)

Details of a long-running health care kickback scheme that allegedly featured prostitutes, cash-stuffed envelopes and private jet junkets began to unfold in federal court Tuesday as a 79-year-old physician went on trial. Dr. Bernard Greenspan isn’t alleged to have engaged in any of the seamier activities surrounding now-defunct Biodiagnostic Laboratory Services, but prosecutors painted him as eager to accept about $200,000 in bribes from the company over several years in exchange for sending his patients’ blood samples there. (Porter, 2/7)

Small sheets of healthy skin are being grown from scratch at a Stanford University lab, proof that gene therapy can help heal a rare disease that causes great human suffering. The precious skin represents growing hope for patients who suffer from the incurable blistering disease epidermolysis bullosa — and acceleration of the once-beleaguered field of gene therapy, which strives to cure disease by inserting missing genes into sick cells. (Krieger, 2/7)

Soon after the feds broke up a family-run chain of clinics that tried to steal $130 million from Miami-Dade Public Schools and a string of major U.S. companies, a trio of Cuban immigrants fled to Mexico and eventually back home to the island. For almost two years, the chain’s boss, Reynaldo Castillo, and his right-hand man, Jose Gerardo Gonzalez, hid in Cuba. Castillo and Gonzalez were wanted for their leading roles in an indictment charging a total 16 defendants with healthcare fraud in March of 2015. (Weaver, 2/7)

In uneasy news for medical marijuana users, UC Davis researchers have identified potentially lethal bacteria and mold on samples from 20 Northern California pot dispensaries, leading them to warn patients with weakened immune systems to avoid smoking, vaping or inhaling aerosolized cannabis. (Buck, 2/7)

Congressman Greg Walden, a key House Republican for pharmaceutical policy, suggested this week that President Trump wants to encourage drug makers to enter value-based contracts with private health plans and the government insurance programs. Maybe that’s what the president has meant all along in his vague promises to change bidding and negotiations. (Scott, 2/3)

Drug companies could be forgiven if they're confused about whether President Donald Trump thinks the government should get involved in negotiating the price of prescription drugs for Medicare patients. ... So on Tuesday, White House spokesman Sean Spicer cleared up the confusion, for now at least. When asked during his daily news briefing whether the president is in favor of having Medicare negotiate lower prices for prescription medicine, Spicer said, "He's for it, yes. Absolutely." (Kodjak, 2/7)

President Donald Trump supports Medicare drug price negotiations, his spokesman said Tuesday, remarks that sent pharmaceutical stocks swinging again as investors tried to assess whether drugmakers will be forced into bidding wars for government business. “He’s for it, yes,” White House spokesman Sean Spicer said at a press briefing in response to a question asking to clarify Trump’s position on the matter. Trump has given conflicting signals in the past weeks on whether he would let the government intervene directly in drug prices to reduce health-care costs. (Daurat and Olorunnipa, 2/7)

President Trump made a campaign promise to lower the price of prescription drugs. After meeting with several big pharmaceutical companies last week, the president emerged with different plans to do that, from reducing taxes to cutting back regulations. Here & Now's Jeremy Hobson speaks with Ian Read, the CEO of Pfizer, one of the biggest pharmaceutical companies in the world, about drug prices, the Food and Drug Administration and how Pfizer is adjusting to the new administration. (Hobson, 2/7)

President Donald Trump wants to stop the sharp hikes in prescription drug prices, but appears limited in what he can and will do. On the last day in January, Trump called the price hikes for medicine “astronomical” and met behind closed doors with chief executives from some of the nation’s biggest drug companies. (Radelat, 2/8)

American drug makers have been wary of criticizing President Trump for fear of provoking a nasty tweet. Here in Germany, however, the top trade groups for pharmaceutical industries have come out swinging — taking on the American president for both the tone and the substance of his remarks.Trump’s accusation that the drug industry is “getting away with murder” with sky-high prices has drawn particular scorn. (Feldwisch-Drentrup, 2/6)

Drug prices, on their face, rose by about 11 percent last year, according to Express Scripts, the largest U.S. pharmacy benefits manager. But costs for employers increased just 2.5 percent across all prescription drugs, Express Scripts said in its new Drug Trend Report, released Monday. The St. Louis-based PBM, which negotiates drug prices on behalf of insurers and employers, hailed the difference in figures as evidence that it saves the system money. (Tirrell, 2/6)

Pharmacy benefit managers, or PBMs, negotiate drug prices directly with drug companies. They work on behalf of insurance and employer groups that pay for drugs. The companies act as middlemen and collect rebates and other fees. PBMs say they are the ones trying to lower drug prices. Tim Wentworth, CEO of Express Scripts -- the largest PBM -- joins "CBS This Morning" to discuss rising drug prices and what role they play in the debate. (2/7)

The base price of the most commonly used brand-name drugs rose on average by nearly 11 percent in 2016, providing added grist to the debate over the need for government intervention to slow the rate of growth of pharmaceutical prices and eliminate blatant price gouging. A new study released on Monday by Express Scripts, a major pharmacy benefit management services based in St. Louis, found that the average price of brand name drugs has steadily risen by more than 200 percent since 2008, far outpacing the 11 percent overall cost-of-living increase during the same period. (Pianin, 2/6)

Last year PhRMA announced plans to save its political spending for lobbying against federal efforts to fight rising drug prices. But the pharmaceutical industry group found giving to political groups known as 527s a good way to channel money to political party operations in the states. Federal election reports filed for the end of 2016 show that PhRMA gave more than $1.77 million to Republican groups, including GOPAC, which supports both federal and state candidates. PhRMA donated slightly over $1 million to Democratic groups. (Kaplan, 2/1)

President Donald Trump says drug prices are astronomical and something needs to be done. Pharmaceutical giants have an answer that doesn’t involve lowering list prices: refunding some of the money to insurers if a drug doesn’t work as expected. The concept of pay-for-performance isn’t new in the industry. But the number of such agreements between drugmakers and insurers has grown in the past year as Big Pharma seeks to defuse criticism over the soaring prices of some brand drugs, which can cost $10,000 a month or more for cancer treatments. (Hopkins, Langreth and Paton, 2/6)

A company that makes a life-saving auto-injector for opioid drug overdoses has raised its prices significantly. Kaiser Health News reporter Shefali Luthra talks to NPR’s Scott Simon about the firm’s strategy. (2/7)

Lawmakers are pushing various ideas to combat high prescription drug prices. Some lawmakers have already introduced legislation or said they plan to introduce legislation on this issue. Solutions include allowing Medicare to negotiate with pharmaceutical manufacturers to lower prices, increasing access to generic drugs and importing less expensive drugs from other countries. (Mixter, 2/7)

On the heels of a recent failure of an Alzheimer’s drug clinical trial, Eli Lilly is eliminating about 200 research and development jobs, a company spokeswoman confirmed, although she maintained the cuts are strictly an effort to fine-tune its workforce and are not related to the recent flop. (Silverman, 2/3)

In an intriguing case, a federal court jury awarded nearly $8 million to the former top lawyer at a small life sciences company, who claimed he was fired after reporting that bribes were paid in China. The verdict, which was handed down on Monday, capped an unusual episode that was being closely watched by lawyers and companies nationwide, not just the pharmaceutical industry, because of an unusual twist — the former general counsel was also the whistleblower. It also arrives as a growing number of drug makers have been fined for paying bribes in foreign countries. (Silverman, 2/7)

Federal prosecutors have charged a former Merrimack Pharmaceuticals Inc. employee with conspiracy, part of a larger case alleging that another local biotech worker used confidential information about drug studies to buy stock. Songjiang Wang of Westford was arrested Tuesday on a charge of conspiracy, according to court records. His attorney did not respond to a message seeking comment Tuesday afternoon. (Woodward, 2/7)

Let’s be blunt: Your idea is half-baked. Why? Because it is much more complicated than you think. Unlike the United States, most other countries provide some form of insurance coverage for their populations and take responsibility for negotiating drug prices. Government agencies around the world have been pushing back against drug makers over the rising cost of medicines, a development that has proven not only popular with voters, but increasingly necessary given strained budgets. Some Americans, however, grumble that they are, in effect, subsidizing other countries. That may be true, but the US has failed to take any significant steps to lower prices. (Ed Silverman, 2/6)

It wasn't all that long ago -- though it seems that way, admittedly, with the never-ending flood of Trumpian news -- that I was prepared to acknowledge that President Donald Trump actually has a few good ideas. Or at least one. It was Tuesday morning. The new president was about to go into a meeting with chief executives from Johnson & Johnson, Merck and a handful of other major pharma companies. During his campaign, he often said that if he were elected, the federal government would start negotiating with the drug companies over the prices Medicare and Medicaid had to pay for drugs -- something it's now prevented from doing by statute. This is an issue that resonated with most Americans, the majority of whom want the government to do something about high drug prices. (Joe Nocera, 2/2)

Amid all the kerfuffle in the last week over immigration, the Supreme Court, Iran and Arnold Schwarzenegger’s TV ratings, too little attention was paid to an extraordinary meeting at the White House at which President Trump reneged on a campaign promise and sold out millions of “forgotten” Americans to giant drug companies. (Steven Pearlstein, 2/4)

Another runaway drug-pricing problem is putting an easy-to-use version of naloxone, a life-saving drug that can reverse an opioid overdose, out of reach for most drug addicts, their families and first responders. The cost of an auto-inject version of the drug, specifically approved for people without medical training to use in life-threatening situations, has increased more than 500 percent to $4,500 since 2014. The wholesale price of insulin, a life-saving drug for some 1.25 million Americans who suffer from Type 1 diabetes, increased from $45 for a highly concentrated monthly form in 2001, to $1,447 last year. This is life and death for patients whose pancreases can’t make insulin. (2/5)

One might first think that Acthar was an ancient civilization in Mesopotamia or a prison facility in upstate New York. In fact, it is the most expensive drug for the U.S. government. In 2015, Medicare paid $504 million for H.P. Acthar Gel, an average of $162,300 per patient. So then it must at least be the hottest new drug for cancer or dementia, right? Not so, unfortunately. (Dr. Hagop M. Kantarjian and Michael A. Carrier, 2/1)

Production costs are rarely the key factor in determining a price, because when your life depends on a drug, you will pay almost anything to get it.Just ask the 8,000 people in the U.S. and Europe who suffer from paroxysmal nocturnal hemoglobinuria, a disease that destroys red blood cells at night, causing life-threatening clots, anemia and organ failure. Alexion Pharmaceutical's drug Soliris is the only treatment available, and it can cost $440,000 a year, making it the most expensive drug sold in. (Chris Tomlinson, 2/7)

The epic battle between drug makers and the insurers and pharmacy benefit managers that pay for their medicines just opened a fascinating new front. Amgen Inc.'s earnings report Thursday afternoon was largely overshadowed by its announcement that its cholesterol-lowering drug Repatha succeeded in a clinical trial designed to prove it helps prevent heart attacks and other cardiovascular events. (Max Nisen, 2/3)

Donald Trump is well known to be no fan of the Trans Pacific Partnership. In fact, one of his first acts as president was to issue a notice that the U.S. is withdrawing from the agreement, citing concerns that the deal is unfair to American workers. While Trump was focused primarily on the trade aspects of the deal, there are other provisions of the agreement relating to pharmaceuticals and intellectual property that should be just as worrying. Now, as President Trump expresses a wish to make prescription medicine more affordable, he would do well to apply the same skepticism he had for trade to the sweetheart deals Big Pharma has traditionally received from government. (Logan Albright, 2/5)

When a CEO abruptly steps down after three years in charge, it's a safe bet the new guy isn't inheriting a corporate bouquet of roses. That's certainly the case at generics giant Teva Pharmaceutical Industries Ltd. Erez Vigodman's surprise exit Monday afternoon leaves interim CEO and ex-Chairman Yitzhak Peterburg with a struggling generics business, the likely loss of billions in sales from its best-selling product Copaxone after a court invalidated several patents, and a debt load that exceeds the company's market cap. (Max Nisen, 2/7)

Sen. Richard Pan (D-Sacramento) hasn’t submitted the official text yet of his proposed California Children’s Bill of Rights, but already the protests have begun. Largely, they come from anti-vaccine parents who vehemently opposed Pan’s SB 277, the law passed in 2015 that requires almost all children who attend school to get their routine childhood vaccinations. (2/7)

It’s looking as if 2017 could become the year when the anti-vaccination movement gains ascendancy in the United States and we begin to see a reversal of several decades in steady public health gains. The first blow will be measles outbreaks in America. (Peter J. Hotez, 2/8)

The Trump administration and the Republican-controlled Congress are pushing to prevent Planned Parenthood from receiving federal funds to pay for contraception and cervical and breast cancer screenings. Funding for the federal Title X program, which provides infrastructure support to a network of nearly 4,000 clinics across the country, could also be in jeopardy. Five years ago, we learned in Texas what can happen when efforts to defund Planned Parenthood are carried out: The network of health-care providers falls apart and women lose access to essential preventive services. (Joseph E. Potter and Kari White, 2/7)

If societies were measured by the health care they provide their most vulnerable members, then Texas wouldn’t have a leg to stand on. That point was brought home on Sunday by American-Statesman’s Mary Ann Roser’s report that hundreds of low-income patients in Travis County have to wait more than a year to see a specialist. While many people with private insurance also face long waits for a specialist, the poor are hit hardest because fewer doctors are willing to accept lower payments associated with government-sponsored coverage, such as Medicaid. A shortage of physicians exacerbates the problem. (2/7)

A perfect storm of political challenges hovers darkly over disabled people, especially children. It shouldn’t come as a surprise that a president who would mock a journalist with a disability should now be responsible for the trifecta of disability rights upheaval. Congress just confirmed Betsy DeVos as education secretary, even though she made it clear that she knows little about special education. The Supreme Court is getting ready to decide how low we can place the special education bar and remain within the law. And Supreme Court nominee Neil Gorsuch has a record for taking an unfavorable view on disability issues. (Susan Senator, 2/8)

In Kentucky, you don’t have to look far to see the negative impacts of smoking. With more than a quarter of Kentuckians regularly lighting up, we consistently lead the nation in smoking rates. As an ear, nose and throat specialist, I have treated many patients suffering the physical consequences of smoking. ... many insurers in Kentucky do not offer comprehensive, barrier-free smoking cessation coverage. This makes it extremely difficult for smokers to stay motivated to quit. Senate Bill 89 would ensure that physicians, not insurers, determine patient care. It would remove complicated barriers like prior authorization and step therapy that often inhibit patients from quickly and affordably getting the treatments they need. (Shawn Jones, 2/7)

It’s no surprise that the American Lung Association gave Kentucky straight “F’s” in its recent report card. Our state is the worst in the nation for smokers and cancer deaths. It has been that way for a long time. Because we are the worst, businesses moving into our state are surprised to find we allow employees to be subjected to the harmful effects of secondhand smoke. The majority of states now have smoke free laws in place. (Brent Cooper, 2/6)

How long, I’ve sometimes wondered, would my patients actually talk if I didn’t say anything at all? According to a group of Swiss researchers, when doctors did not interrupt, the average duration of their patients’ monologues was 92 seconds. Not exactly the deluge of historic proportions that most physicians fear. ... The day after reading that study I tried it out in my clinic. For each patient I saw, I quietly clicked on a stopwatch after saying, “How can I help you today?” My first patient took 37 seconds, the second 32. But these were basically healthy individuals. The third had more issues: unresolved back pain, plus his glucose, cholesterol, and weight were all creeping up. He took two minutes. (Danielle Ofri, 2/7)

Media pundits, academics, and commentators alike are scrambling to provide insights into the likely effects of President Trump’s policies. One of his most controversial policy goals concerns the mass deportation of millions of undocumented immigrants currently living and working in the United States. Experts have been grappling with how this policy will affect our food system and — most importantly — how much we will have to pay to put food on the table. (Sydney Giacalone and Julian Agyeman, 2/7)

President Trump and Republican lawmakers have never been able to explain how they would improve on the Affordable Care Act, which they’ve promised to quickly repeal and replace with something better. Now, it’s increasingly evident that they have no workable plan and might never come up with one. (2/8)

We don’t often see eye-to-eye with the right-wing Heritage Action, but in this case we agree with Dan Holler, vice president of communications and government relations, who is quoted as saying, “I think the longer this drags on, the more people are starting to understand the chance of a repeal is slipping away. Certainly it’s becoming harder and harder with each passing day.” (Jennifer Rubin, 2/7)

In Arizona, there are more than 80,000 people who get up each morning to do work that’s unquestionably worth doing — providing high-quality patient care and running our state’s hospitals in communities regardless of patient’s ability to pay. Unfortunately, hospitals in the United States are set to lose more than $400 billion in funding from 2018 to 2026 if the anticipated Affordable Care Act (Obamacare) repeal does not include changes to Medicare hospital payments. When the ACA was passed, hospital Medicare payments essential for ensuring treatment of Medicare patients were cut heavily to defray the costs of other parts of the law. (Jim Lane and Doug Nicholls, 2/7)

A sizable minority of Americans don’t understand that Obamacare is just another name for the Affordable Care Act. This finding, from a poll by Morning Consult, illustrates the extent of public confusion over a health law that President Trump and Republicans in Congress hope to repeal. In the survey, 35 percent of respondents said either they thought Obamacare and the Affordable Care Act were different policies (17 percent) or didn’t know if they were the same or different (18 percent). (Kyle Dropp and Brendan Nyhan, 2/7)

The Affordable Care Act forces millions of Americans to pay more than they should for health insurance policies that include mandated coverage they don’t want or need to see a doctor they don’t know. It needs [to be] replaced. It is critical that the replacement to the ACA, unlike the ACA itself, is passed with bipartisan support. The best way to do that is to build on a model that is already working: the Federal Employee Health Benefits program, which enables 8 million Americans (4 million government employees and their families) to secure health insurance coverage by choosing from 250 competitive plans offered by insurance companies, employee associations, and labor unions. (George White, 2/7)