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After seven years of waiting longingly to annul President Barack Obama’s signature health care law, Republican leaders on Tuesday faced a sudden revolt from the right that threatened their proposal to remake the American health care system. The much-anticipated House plan to repeal the Affordable Care Act also drew skepticism from some of the party’s more moderate members, whose constituents have benefited from expanded coverage in recent years. (Steinhauer, 3/7)

As they roll out their Obamacare replacement plan, Republicans are quickly finding out what Democrats learned eight years ago: Even if you win control of Congress and the White House, there are still plenty of obstacles to passing laws that, in principle, your whole party agrees with. Several factions within the Republican Party don't like some key details about this new health-care plan. In fact, there's enough opposition that these Republicans could derail the bill as it stands. It's something President Trump appeared to acknowledge when he offered up in a tweet Tuesday morning the opportunity for “review and negotiation.” (Phillips, 3/7)

The most imminent and serious threat to the plan crafted by House Speaker Paul D. Ryan (R-Wis.) was the growing backlash from conservative lawmakers and powerful outside groups who argue that the draft is nothing more than “Obamacare Lite,” a disparaging reference to the former president’s signature 2010 domestic achievement. The lawmakers do not represent a majority of Republicans in either chamber of Congress, but there could be enough of them to scuttle any health-care bill they oppose — and several said Tuesday they intend to use that leverage to force major changes to the measures. (DeBonis, Costa and Weigel, 3/7)

But major obstacles loomed as key Republican lawmakers announced their opposition, and one conservative group after another torched the plan. The Club for Growth, Heritage Action for America, Americans for Prosperity and Tea Party Patriots variously derided the new bill as Obamacare Lite, Obamacare 2.0 and even RyanCare, in a dig at House Speaker Paul Ryan of Wisconsin. (Werner and Fram, 3/7)

Opposition from conservative lawmakers and activist groups could derail the party’s highly prized bid to replace the Affordable Care Act. That could challenge Mr. Trump to decide whether to enter the fray explicitly and become the negotiator-in-chief he had styled himself as on the campaign trail, and if so, when to deploy himself in that capacity. White House officials said they were unfazed by the blowback, and that negotiations could resolve lingering objections from lawmakers they assume are ultimately unwilling to torpedo their chance to repeal the law. (Radnofsky, Peterson and Huges, 3/7)

House Speaker Paul Ryan has long been the darling of conservative policy wonks. But on one of the biggest days of his political career, when House Republicans released their much-anticipated Obamacare replacement, many of Ryan's closest friends in conservative intelligentsia expressed disappointment — if not outright dismay — with the legislation bearing the speaker's imprimatur. (Johnson, 3/8)

House Republicans are facing swift criticism that their sweeping plan to repeal and overhaul large swaths of the Affordable Care Act is too similar to the law it would replace. “Obamacare 2.0,” tweeted Republican Rep. Justin Amash of Michigan. “This is Obamacare-lite,” said Jason Pye, public policy and legislative affairs director at FreedomWorks, a conservative group associated with the tea party movement. (Armour, 3/8)

Conservative lawmakers worried about balancing the budget pushed back Tuesday against plans to mark up the health care repeal and replace reconciliation bill before the Congressional Budget Office can compute a score of the costs. "We don’t know how many people would use this new tax credit, we don’t know how much it will cost, and we don’t know if this bill will make health care more affordable for Americans,” Sen. Mike Lee, R-Utah, said in a statement. “This is exactly the type of back-room dealing and rushed process that we criticized Democrats for, and it is not what we promised the American people.” (Shutt and Mejdric, 3/7)

“This is not the Obamacare repeal bill we’ve been waiting for,” said Sen. Mike Lee (R-Utah), who is leading the GOP opposition with Paul and the House Freedom Caucus. Sen. Ted Cruz (R-Texas) has also raised objections. “We promised the American people we would drain the swamp and end business as usual in Washington. This bill does not do that,” Lee said. “This is exactly the type of backroom dealing and rushed process that we criticized Democrats for, and it is not what we promised the American people.” (Mascaro, 3/7)

But Energy and Commerce Committee Chairman Greg Walden of Oregon and Ways and Means Committee Chairman Kevin Brady of Texas on Tuesday pushed back against critics. They portrayed the legislation as a stark choice between either fulfilling the seven-year Republican pledge to repeal the law or not. “This is Obamacare gone. This is the first and most important step to giving relief to Americans from this terrible law,” Brady said. “As Republicans, we have a choice. We can act now or we can keep fiddling around and squander this opportunity to repeal Obamacare.” (Williams, 3/7)

“You have to get rid of ­ObamaCare completely,” said conservative Rep. Jim Jordan (R-Ohio) at a press conference with other Freedom Caucus members, along with Sens. Rand Paul (R-Ky.) and Mike Lee (R-Utah), who also object to the bill. Paul called the plan “dead on arrival.” (Sullivan, 3/7)

Given the swift opposition to the bill and a glaring lack of a political groundswell in its support, the plan’s future remains an open question. If the legislation fails to gain traction, the struggle over fulfilling the bedrock promise of President Trump and congressional Republicans to repeal the Affordable Care Act could consume the Republican agenda for weeks if not months, delaying action on tax reform and grinding the new administration’s legislative agenda to a halt. (Lochhead, 3/7)

Less than 24 hours after legislation was introduced, the plan put forth by House leadership won the approval of the White House, but sparked the ire of conservative organizations, health wonks and lawmakers. Still, GOP leaders are pressing forward with markups scheduled for Wednesday in two House committees, despite not having scoring from the nonpartisan Congressional Budget Office, which will calculate the bill’s costs and effects on health coverage. (McIntire and Reid, 3/7)

The Republican leadership’s plan was to fast-track their just-released proposal to repeal Obamacare. Republican leaders want to vote on it in the House of Representatives, send it to the Senate and put it on President Donald Trump’s desk within months. It could be their own party that stops it from happening. (Daugherty and Harrell, 3/7)

Congressional Republicans have put forth a new bill meant to replace the Affordable Care Act, also known as Obamacare. The new law would encourage people to buy health insurance by using tax credits, while also repealing the individual mandate penalty. (Hobson, 3/7)

Conservative lawmakers said Tuesday they will introduce their own ObamaCare repeal plan, objecting to House GOP leadership's proposal. Rep. Jim Jordan (R-Ohio) and Sen. Rand Paul (R-Ky.) said they will introduce a clean bill to repeal ObamaCare, as Congress did in 2015. The conservatives argue that they should vote on repeal as a separate measure from replacement, and then debate how to replace ObamaCare. (Sullivan, 3/7)

With two House committees set to take up the Republican replacement plan for the Affordable Care Act on Wednesday, party leaders have begun trying to sell the proposal to the American public. Leading the effort is President Trump, who met with Republican House leaders at the White House, saying he is "proud to support the replacement plan released by the House of Representatives." (Naylor, 3/7)

Members of the conservative House Freedom Caucus came out of a meeting with Office of Management and Budget Director Mick Mulvaney Tuesday night convinced the White House is open to changes in a health care repeal plan. They also said the former South Carolina congressman did not change the minds of those in the group who are opposed to the repeal plan endorsed by House Republican leaders. Leaders of the group have criticized refundable tax credits in the plan as a new entitlement. (Krawzak, 3/8)

Rep. Jason Chaffetz (R-Utah) made a comment Tuesday morning about health care coverage that he seemed to quickly regret."Americans have choices, and they've got to make a choice," Chaffetz said on CNN. "And so maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest in their own health care." (Blake, 3/7)

Republican governors complain that a GOP proposal to replace former President Barack Obama’s health care law would force millions of lower-income earners off insurance rolls or stick states with the cost of keeping them covered. Governors, especially those from political battleground states, were generally cool to the bill put forth in the Republican-controlled U.S. House. Some signaled that they would continue working on their own legislation to compete with the measure introduced Monday. (Beaumont and Noon, 3/7)

Ohio Gov. John Kasich on Tuesday became the latest GOP leader to oppose his party's bill in the U.S. House of Representatives to repeal and replace Obamacare. In theory, Kasich wants to repeal former President Barack Obama's health care law. But he said Tuesday he doesn't like the House Republicans' alternative plan. (Thompson, 3/7)

The liberal Center on Budget and Policy Priorities estimates that the House bill would shift $370 billion in Medicaid costs from the federal government to states over a decade. Of that total, $253 billion would result from states losing the higher federal contribution for Medicaid expansion enrollees, since enrollment in the enhanced-funding program would be frozen in 2020. The shift to per-capita caps would cut federal Medicaid payments to the states by an additional $116 billion, because the per-capita growth rate based on M-CPI would lag behind actual Medicaid costs, said Edwin Park, vice president for health policy at CBPP. (Meyer, 3/7)

The state and federally funded health plan for the poor and those with disabilities has repeatedly expanded its coverage and services to accommodate those struggling with HIV and AIDS, the opioid epidemic, high infant mortality rates, Zika and other public health scourges. But 70 percent of Medicaid’s spending growth is due to increased enrollment. In their new legislation to repeal and replace the Affordable Care Act, congressional Republicans would slash federal Medicaid spending by capping it at a predetermined amount per beneficiary beginning in 2019. (Pugh, 3/7)

[D]uring Trump’s first address to Congress on Tuesday, he pledged to give states more flexibility with Medicaid when he repeals and replaces Obamacare. This means that red states may finally be able to follow through with their goals that the Obama administration rejected or made more difficult to achieve. In addition, blue states may also use the added authority to enact more left-leaning policies without having to get federal approval. ... So here’s a look at what to expect if that promise becomes a reality. (Quinn, 3/6)

At least in the short term, a new health care bill from U.S. House Republicans contains some good news for the 375,000 Oregonians and 40,000 Lane County ­residents who became eligible and signed up for ­Medicaid health insurance under the Affordable Care Act. Amid fears that a repeal of Obamacare would mean an immediate or rapid rollback of its expanded eligibility for Medicaid, the Republicans’ bill would, in fact, preserve coverage for those people, unless they no longer needed the help, until 2020. (Hubbard, 3/8)

Florida stands to lose more than it gains under the bill unveiled this week by House Republicans to repeal and replace the Affordable Care Act — especially when it comes to the 4.3 million state residents who rely on Medicaid, advocacy groups reviewing the new legislation said Tuesday. The House bill, called the American Health Care Act, calls for, among other things, a spending limit — known as “per capita caps” — for each person enrolled in Medicaid beginning in 2019, with annual adjustments for medical inflation. Any amount spent above the cap would be at the state’s expense. (Chang and Pugh, 3/7)

Sen. Lisa Murkowski of Alaska and three other Republican senators warned Senate Majority Leader Mitch McConnell this week that they will not support a replacement of the Affordable Care Act if it does not protect people who gained insurance coverage under the law’s Medicaid expansion provision. ... Murkowski, in previously unpublished comments from a Feb. 4 interview with the News-Miner, noted Medicaid expansion has been positive for Alaska. She made the comment while explaining the status of the health care debate in the House and the Senate. “Medicaid is something, obviously; you have those states that have moved forward with expansion and we’ve clearly seen the benefit of that here,” she said. (Boyce, 3/8)

President Donald Trump is moving to quiet conservative opposition to the House GOP Obamacare replacement, drawing on his newfound bully pulpit to pressure but also coax rebellious lawmakers. Trump on Tuesday night turned his massive Twitter following on one of the most vocal opponents of the repeal bill: conservative firebrand Sen. Rand Paul. The Kentucky Republican had blasted Speaker Paul Ryan’s Obamacare alternative as Obamacare-lite. (Bade and Cheney, 3/7)

President Trump on Tuesday evening expressed confidence that Sen. Rand Paul (R-Ky.) would "come along" with the House GOP plan to repeal and replace ObamaCare." I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster!" Trump tweeted. (Savransky, 3/7)

President Trump said Tuesday that he was “proud” to support House Republicans’ plan to repeal and replace the Affordable Care Act, asserting that his party was committed to seeing the plan through. "Obamacare is collapsing," Trump said in remarks at the White House to Republican lawmakers responsible for building support for the plan in Congress. “It’s in bad shape, and we’re going to take action. There’s going to be no slowing down, there’s going to be no waiting and no more excuses by anybody.” (Memoli, 3/7)

[Trump] urged lawmakers to act “quickly” on the legislation, telling them he was elected “based on the fact [of] repeal and replace ObamaCare, and many of you people are in the same boat.” (Fabian, 3/7)

President Donald Trump said he was “proud to support” House Republicans’ proposal for replacing the Affordable Care Act,” though he noted that he considered it the first phase of his planned health care overhaul and the beginning of a “negotiation.” It’s not clear exactly how the White House would like to change the bill. Trump has never put forward a detailed health care proposal. Still, he has made plenty of promises on how he will improve the health care system. (Thomas and Lucey, 3/7)

As the GOP nominee, Trump made opposition to the healthcare law a major portion of his presidential campaign, at times making lofty claims about what the future of care would look like in his administration. ... Here are five of Trump’s most important campaign promises on healthcare and how they are being addressed — or aren’t — in the new legislative framework. (Kamisar, 3/8)

Facing the start of a conservative revolt over the GOP healthcare plan, Speaker Paul Ryan (R-Wis.) vowed Tuesday that the ObamaCare replacement bill would pass the House. “We will have 218 votes,” Ryan told reporters at a Tuesday-evening news conference that capped an extraordinary day, which saw the GOP break into open warfare over the health proposal. (Wong, 3/7)

The magic number in the House of Representatives is 218, and in the Senate 50. Republicans conceivably have enough lawmakers to get to those majorities, but not by much. Assuming no Democrats support the bill, Republicans can lose only 21 votes in the House and just two in the Senate. (Phillips, 3/7)

Sen. Roy Blunt (R-Mo.), a member of House leadership, said Tuesday the GOP's plan to repeal and replace ObamaCare as it stands may not be able to get the support needed to pass the Senate. "What I don't like is, it may not be a plan that gets a majority votes and let's us move on. Because, we can't stay where we are with the plan we've got now," Blunt said on KMBZ, as first reported by CNN. Blunt, a former vote counter, said the final plan would need to be negotiated. (Hellmann, 3/7)

Senate Majority Leader Mitch McConnell (R-Ky.) has only three weeks to unify conservatives and moderates in his conference behind an ObamaCare repeal and replacement bill. The American Health Care Act, which Vice President Pence on Tuesday declared “the framework for reform,” will move first in the House, but it faces perhaps an even steeper climb in the Senate. (Bolton, 3/7)

In June 2009, House Democratic leaders unveiled the first draft of legislation that would ultimately become the Affordable Care Act. A month later, three House committees began formally drafting the bill ahead of a House vote that came well into the fall, after the summer heat had dissipated and the leaves had begun to change. On Wednesday, the House Ways and Means Committee and the Energy and Commerce Committee will formally mark up legislation to repeal and replace the act — less than 48 hours after Republicans unveiled the bill to the public. (Pear, 3/7)

After more than 60 votes and seven years of promises, Republicans offered their long-awaited plan to repeal and replace the Affordable Care Act. Now, the real work begins. Republicans must navigate a complicated path to turn their 123-page proposal from legislation to law. A look at the process and the politics. (Lerer, 3/8)

House Democrats are gearing up to make Wednesday’s dueling health care committee debates as painful as possible for Republicans. The minority members on two committees, Ways and Means and Energy and Commerce, will march to the concurrent markups of the new Republican plan to overhaul the 2010 health care law armed with dozens of politically tough amendments, staffers and outside groups told CQ Roll Call. (Mershon and Williams, 3/7)

Former Democratic vice presidential nominee Tim Kaine (D-Va.) slammed what he called “Trumpcare” on Tuesday, charging that the GOP’s ObamaCare replacement plan would help the wealthy with tax cuts while financially burdening average Americans. The Democratic senator took to Twitter to make his case, posting multiple tweets that slammed the Republican healthcare proposal. One tweet implied the GOP repeal and replace proposal would benefit the Trump family’s healthcare coverage plan. (Beavers, 3/7)

Nancy Pelosi stands alone. As Republicans prepare to dismantle Obamacare, the longtime House Democratic leader is facing her biggest fight in years, perhaps the biggest since she twisted dozens of Democratic arms to pass the bill in the first place seven years ago. (Caygle and Bresnahan, 3/8)

At first glance, the new health care bill from House Republicans appears to have similarities to the Obama-era law, like tax credits, protections for people with health problems, and the ability of parents to keep young adults on their insurance. But in most cases those components would work very differently under the GOP framework than is currently the case with the Affordable Care Act, or Obamacare. (Alonso-Zaldivar, 3/8)

Obamacare is pretty complex. So it shouldn’t be a surprise that what the GOP is proposing in its place has a few knotty details. Here’s a short guide to what’s in the Republican plan and what it could mean for Americans’ health coverage. (Levey, 3/7)

The GOP plan also retains many of the features the public likes in the Affordable Care Act, like protections for people with existing health conditions. Here are seven provisions to look out for as the congressional debate unfolds over the next few weeks and months. (Fulton, 3/7)

On Monday, House leaders released legislation to replace the Affordable Care Act. If it passes, here’s what would change. (Cameron and Shapiro, 3/7)

After literally years of promises, House Republicans finally have a bill they say will “repeal and replace” the Affordable Care Act. Some conservative Republicans have derided the new proposal — the American Health Care Act — calling it “Obamacare light.”  It keeps intact some of the more popular features of the ACA, such as allowing adult children to stay on their parents’ health plans to age 26 and, at least in theory, ensuring that people with preexisting conditions will still have access to insurance. (Rovner, 3/8)

Since Republican leaders in Washington released their plan to replace the Affordable Care Act, also called Obamacare, there have been many questions about the specifics of the proposal and its impact on Californians. We’ve dug into the details to simplify this complex issue and create a cheat sheet for you. (Feibel, 3/7)

House of Representatives Republicans released their plan to replace the Affordable Care Act, or Obamacare, with a law they say will be less onerous. Most Democrats disagree, saying millions of Americans could lose health coverage or find it too expensive. The Congressional Budget Office has not yet determined the plan's cost or the number of people who might lose coverage. But the debate is underway. (Eaton and Koff, 3/7)

On Monday evening, House Republicans finally released their own health care proposal. It would replace Obamacare's mandate to buy insurance and his subsidies to bring down the cost with a fixed refundable tax credit that people can use to buy coverage. Nobody's required to have a health plan. But if you don't get covered at the outset, you'll pay a penalty to buy it later.So does it fix the problems Republicans have laid out? Likely not. (Kodjak, 3/8)

Republicans' main problem with Obamacare isn't that it insures more people. It's that it does it in a ham-handed way: To hear Republicans describe the 2010 Affordable Care Act is to hear about a knotted tangle of overly burdensome federal government regulations that are strangling the health-care market. Republicans say their version is much cleaner, clearer and simpler. (Phillips, 3/7)

After a day of bad reviews for the GOP leadership’s preferred Affordable Care Act replacement, the House Freedom Caucus was ready for the spotlight. Dozens of reporters and cameramen had set up at the House Triangle. Some cable networks were even taking the Freedom Caucus news conference live, harking back to the time when tea party protests could rattle or derail business in Congress. But a few reporters were being held inside the Capitol by security guards. Vice President  Pence was wrapping a visit to the Hill, talking to Freedom Caucus members, a few of whom had served with Pence when he was a congressman. When the vice president left, some of the conservative rebellion’s leaders were taking a measured — if still skeptical — tone about the American Health Care Act. (Weigel, 3/7)

Republicans' new health-care bill is a mass transfer of income that cuts taxes for the wealthiest Americans while cutting federal benefits for the middle and working class. Just two provisions in the Republican plan would allow the richest households to pay an average of nearly $200,000 less under the GOP plan, according to the nonpartisan Tax Policy Center. (Ehrenfreund, 3/7)

The bill would repeal a slew of taxes that would have cost insurance, medical device makers and other health care companies tens of billions of dollars over a decade. The repeal of just one such provision — the health insurer tax — is a tax cut of $145 billion over a decade, according to an analysis by the Joint Committee on Taxation. (Johnson, 3/7)

House Republicans have launched their first missive in the battle to slash individual tax rates by using the fast-moving reconciliation measure that would repeal or delay taxes, including several aimed at wealthy families, under the 2010 health care law. Ways and Means Chairman Kevin Brady, R-Texas, on Tuesday promoted the tax cuts for wealthy families in the GOP's legislation to replace Obamacare and the new tax credits in the proposal as a harbinger of the across-the-board rate cuts envisioned by the House GOP in its tax overhaul. (Ota, 3/7)

House Republicans’ plan to repeal and replace parts of the 2010 Affordable Care Act would seek to help households purchase health insurance with a measure called an advanceable refundable tax credit. Here’s an explanation of how that would work, and how it differs from the existing law. (Rubin, 3/8)

The GOP proposal would also eliminate the complex web of tax increases established by Obamacare on people and companies — everything from tanning salons to medical device manufacturers — that help pay for benefits in the current law, like free breast cancer screenings, preventative care, and allowing people to remain on their parents’ insurance until the age of 26. They’d also help underwrite the cost of prohibiting insurers from banning those with pre-existing conditions. The combination of maintaining the most popular and well-known portions of Obamacare — and cutting taxes — is expected to cost the federal government as much as $600 billion over ten years, according to the non-partisan Joint Committee on Taxation. (Snell, 3/8)

Here is a quick rundown of some of the taxes that would be repealed under the legislative package scheduled for markup on Wednesday. The information comes from the Ways and Means Committee’s section-by-section summary. If passed, most of these taxes would be repealed in 2018. (3/7)

Leaked older drafts of the GOP plan would have capped tax benefits for employer-based health insurance. If Republicans had made that change, putting the squeeze on employer coverage sooner or later, a half dozen experts told STAT that employer plans would likely start moving toward narrower health care provider networks to keep their costs down and stay under the cap. In other words, it would have extended the so-called “keep your doctor” problem to the much bigger employer market, which covers half of all Americans. The fallout could have been huge. (Scott, 3/8)

In their newly unveiled plan to reshape the US health care system, House Republicans propose increasing the amount of money people can put into tax-free health savings accounts, part of a broader push to make individuals more responsible for their own medical spending, and less reliant on government. Think of it as a twist on your 401(k) retirement plan. You set up a tax-exempt investment fund, deposit your money, watch it grow, and then use the proceeds to cover all manner of health care expenses, from lab tests to prescription drugs. (Horowitz, 3/7)

With the debate over the GOP replacement for the Affordable Care Act at full boil, a Republican nonprofit entity controlled by allies of Senate Majority Leader Mitch McConnell (R-Ky.) has launched a big ad buy to remind people what’s wrong with the ACA in the first place. The 60-second spots target five Democrats running for reelection in 2018, as well as seeks to support six Republicans who face challenges or might be considered uncertain on how they would vote on a replacement bill. But as is often the case, the language of the ads leaves a misleading impression that the problems that afflict the ACA exchanges extend to the entire insurance market. (Kessler, 3/8)

The GOP finally unveiled its own health care reform package on Monday. The American Health Care Act would preserve some popular aspects of the health reform passed under President Obama, but the Republican plan would also make some sweeping changes. Key House committees are scheduled to vote on the new plan Wednesday. (Sundt, Chakrabarti and Bologna, 3/7)

Opponents of abortion rights have long argued that public funds for services like cancer screenings and contraception should go solely to health clinics that don't provide abortions. They've made "defunding Planned Parenthood" — or, to be more precise — blocking the organization from receiving funding through federal programs like Medicaid — a major goal. (McCammon, 3/7)

Republicans have unveiled their long-awaited bill to repeal and replace the Affordable Care Act, or Obamacare. The GOP plan keeps many of the stipulations in place and changes others. But the real questions on peoples’ mind are "How much will it cost?" and "How many people will it cover?” Figuring out that scorecard out will fall to the Congressional Budget Office. (Allington, 3/7)

The effects of the long-promised measure to roll back Barack Obama’s signature 2010 legislation would fall mainly on the poor, a fact that has set off opposition from both left and the right. The bill would cut taxes to the tune of about $575 billion over a decade, mainly on the wealthy and health-insurance companies. It would limit money channeled to low-income people, raise costs for older Americans and wind down the expansion of Medicaid. (Trace and Edney, 3/7)

The architecture of the tax credits in the legislation, which House committees are to begin debating Wednesday morning, would offer less help to lower-income Americans than the subsidies provided by the current law. It would steer more money to young adults at the expense of older ones. And it would most benefit consumers living in states in which insurance prices already are relatively low. (Goldstein and Eilperin, 3/7)

Millions of people who get private health coverage through the Affordable Care Act would be at risk of losing it under the replacement legislation proposed by House Republicans, analysts said Tuesday, with Americans in their 50s and 60s especially likely to find coverage unaffordable. Starting in 2020, the plan would do away with the current system of providing premium subsidies based on people’s income and the cost of insurance where they live. Instead, it would provide tax credits of $2,000 to $4,000 per year based on their age. (Goodnough and Abelson, 3/7)

Some Republicans are arguing the rollback of Obamacare would put responsibility on Americans to make better choices as consumers, but one comment this morning didn’t get a great reception. House Oversight Committee Chairman Jason Chaffetz (R., Utah) told CNN Tuesday that lower-income Americans may have to prioritize spending money on health-care rather than electronic gadgets such as iPhones. (Peterson and Andrews, 3/7)

One Republican lawmaker is defending the replacement for the Affordable Care Act by urging those who can’t afford insurance to forgo purchases like iPhones. "Americans have choices and they’ve got to make a choice. And so maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest it in their own health care. They’ve got to make those decisions themselves,” Jason Chaffetz said on CNN Tuesday morning. Chaffetz was responding to criticism that the GOP replacement for the Affordable Care Act provides a better deal for higher income Americans while leaving poorer Americans worse off. (Prignano, 3/7)

Healthcare is a highly complicated issue that has plagued both political parties in the U.S. for years, not to mention everyday Americans who struggle under huge costs. But Rep. Jason Chaffetz, R-Utah, seemed to think there was an easy solution to affording healthcare when he appeared on CNN Tuesday morning – just stop buying iPhones. (Irby, 3/7)

The lottery is a famously bad bet. People are more likely to be zapped by lightning while drowning, canonized a saint or hit by an asteroid than win a jackpot. Very few people walk away from the Powerball with massively engorged bank accounts. ... Yet, ten pages into the American Health Care Act, the bill that House Republicans unveiled Monday as the replacement for the Affordable Care Act took aim at lottery winners who receive Medicaid, devoting roughly a tenth of the 60-odd-page bill to lottery winners. (Guarino, 3/8)

Hospitals could face a huge financial hit from the Medicaid overhaul as they grapple with lost payments and reduced volume. Republicans would freeze the expansion in 2020 (11 million people have gained Medicaid coverage under Obamacare) and impose block grants, or per capita limits in state funding, by 2020...The GOP replacement could also expose hospitals to greater financial risk from patients who buy insurance in the individual insurance market. The proposal would replace the current subsidy program by 2020 with age-based tax credits. Robert Huckman, a professor of business administration at Harvard Business School, said the change would broaden financial assistance across the income scale, but provide less assistance per person than Obamacare to the people most in need. (Ross, 3/7)

The long-awaited House Republican plan to replace the Affordable Care Act will hurt low-income consumers who rely on federal subsidies or Medicaid for their coverage, as well as the hospitals who are required to treat them whether or not they are insured, health care experts say. It's harder to find the winners under the new bill, a joint effort by House Republicans including Speaker Paul Ryan. (O'Donnell, 3/7)

The American Hospital Association announced Tuesday its opposition to the GOP's healthcare reform plan. The hospital association is the first health industry group to expressly come out against the legislation, dubbed the American Health Care Act, which House GOP leadership unveiled on Monday. (Wilson, 3/7)

For health-care companies, the new House Republican proposal to replace the Affordable Care Act carries significant risks, as it would likely mean a decline in insured patients and continued worries about an unstable market. Insurers, hospitals and medical-device manufacturers are still parsing the details of the draft legislation, which could change considerably as it moves through the House and Senate, and they are applauding moves like the elimination of some taxes. But the proposal’s pullbacks on Medicaid and federal insurance subsidies could significantly reduce the number of people with health coverage over time, analysts and industry officials said, a serious problem for health-care providers and insurers. (Wilde Mathews and Evans, 3/7)

There’s plenty for the health-care industry to like in the latest Republican proposal to repeal the Affordable Care Act, which would lower taxes and eliminate rules. There’s also plenty not to like because the plan would funnel less money into helping people pay for insurance and hospital visits. The GOP bill, which still has a long way before it may become law, would replace Obamacare with a more limited program of insurance subsidies. That would probably result in less comprehensive insurance, increasing the risk that people will be unable to pay hospitals and doctors when they show up for care. At the same time, the proposal would eliminate billions of dollars of taxes on the industry. (Tracer, Greifeld and Cortez, 3/7)

Insurance companies are calling on the Trump administration to rethink a proposal to shorten the open-enrollment period over their fears that it will result in only the sickest individuals signing up for coverage. Several insurers and providers including Kaiser Permanente weighed in on a Trump administration proposed rule aiming to stabilize the individual marketplace created by the Affordable Care Act, voicing concerns about several provisions of the wide-ranging rule. The CMS received more than 2,500 comments on the proposed rule before the deadline passed on Tuesday. (Dickson, 3/7)

The nation’s health insurers are weighing the GOP’s newly released bill to replace the Affordable Care Act, which contains things they wanted – and some things they may not like, but for now are keeping their opinions to themselves. While many big insurers, including Aetna, United Healthcare and Anthem, said they lost money on plans they sold in certain ACA exchanges, they had several years to come to terms with the Affordable Care Act’s weaknesses and pushed for reform of the health law, not its repeal. (Radelat, 3/7)

AARP is going on the warpath against the Republican proposal to repeal and replace ObamaCare. The lobbying group for seniors accused House Republican leaders of crafting legislation that increases insurance premiums for consumers, while giving a “sweetheart deal” to “big drug companies and special interests.”...Republicans unveiled the long-awaited healthcare reform proposal, called the American Health Care Act, on Monday. The AARP blasted several aspects of the legislation, including provisions that would scale back the Medicaid expansion and cut back the amount of federal funding per enrollee. (Wilson, 3/7)

Union president Richard Trumka slammed the Trump-backed GOP healthcare proposal, just hours after meeting with the president at the White House on Tuesday. The AFL–CIO president said he talked about a variety of topics with President Donald Trump, but he did not mention healthcare as one of them, according to a CNN report. (Beavers, 3/7)

The pharmaceutical industry has faced consistent warnings from President Donald Trump that lowering prescription drug prices would be a high priority. But among all the health industry players affected by the Republican legislation released Monday, drug manufacturers seem to have the least to worry about. Trump continued his threats in a tweet Tuesday.  “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” (Siddons, 3/8)

Health-insurance shares barely budged Tuesday morning, despite that negative change in policy. The muted share reaction is well founded. For starters, the final bill is bound to change; any law will have to pass the Senate, where the Republicans hold just a two-seat majority. Republican governors in states with expanded Medicaid coverage have bristled at the prospect of rolling back Medicaid. Those forces will likely cause some provisions of the bill to soften. (Grant, 3/7)

U.S. stocks declined for the third time in four days on Tuesday as health care companies took center stage. Drugmakers fell after President Donald Trump said he wants to bring drug prices down. Insurers rose and hospital companies dropped after Republicans in Congress introduced a bill intended to replace the 2010 Affordable Care Act. (Jay, 3/7)

Millions of Californians probably would lose health coverage under the Obamacare replacement bill released by House Republicans this week, experts say. The long-awaited GOP alternative removes the requirement that all Americans sign up for health insurance or pay a penalty, alters the amount of financial assistance offered for plans sold on the marketplaces and bans federal funding for Planned Parenthood. But what probably would affect the greatest number of Californians and raise the toughest questions for the state are proposed cuts to Medicaid, which covers more than a third of California’s residents. (Karlamangla, Mason and Myers, 3/7)

The bill dramatically reshapes the Medicaid program, known as TennCare in Tennessee. It would transition Medicaid from the federal match funding mechanism that is in place to a per capita program in which the state would get a lump sum per enrollee. A per capita cap is Gov. Bill Haslam's preference over a block grant, which is a set allotment to the state to run TennCare for a period of time, regardless of enrollment. A change to the funding mechanism, however, means states would have to make decisions on who or what benefits to cover. Right now, TennCare covers pregnant women, children and some people who are are disabled. Children are usually much cheaper to cover than other groups. (Fletcher, 3/7)

A section of the legislation pitched by Republicans in the U.S. House could open a path for people in the greater Knoxville area to access an insurance plan with a premium subsidy in 2018. The same provision would help people afford plans that cover Vanderbilt University Medical Center in the greater Nashville area. Premium tax credits could be used to purchase of "certain qualified health plans" off-exchange — where they are currently not available— under the legislation, which is called the American Health Care Act. (Fletcher, 3/7)

Hospital leaders and patient advocates say the bill, if passed, would lead to fewer people in Illinois with health insurance, creating a dangerous and costly situation for patients, hospitals and the state...Some hospital leaders and patient advocates in Illinois are nervous. A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital Association, said some Illinois residents might not be able to afford to continue buying coverage on the exchange under the House GOP plan. (Schencker, 3/7)

GOP lawmakers from the Philadelphia region said they were still reviewing the plan unveiled Monday night, neither supporting nor opposing a measure that could finally reshape the country’s health system to match Republicans’ vision and roll back much of what is widely called Obamacare. Sen. Pat Toomey (R., Pa.) said he was still combing through the 123-page measure: “I haven’t made a decision yet.” Rep. Tom MacArthur (R., N.J.) told a town hall audience Monday night that he was unsure how he would vote. He worried about changes that could limit the law’s Medicaid expansion, which, according to Gov. Christie, has helped cover 487,000 previously uninsured New Jerseyans, with federal funding that has saved the state $2 billion. (Tamari, 3/7)

The proposal prescribes a laundry list of changes to the 2010 health care package, better known as Obamacare. For Colorado, the most dramatic impact would be with Medicaid, a federal-state program that provides health insurance to disabled or low-income residents. Under the Affordable Care Act, states were allowed to expand the number of residents they cover through Medicaid — leading Colorado to add an estimated 407,000 residents to the rolls. The Republican plan would phase out this expansion starting in 2020 while changing the way the federal government pays for Medicaid by instituting a per-person cap — a switch that would mean “Colorado could expect less federal funding over the years,” according to the Colorado Health Institute, a local think tank. (Matthews, Frank and Ingold, 3/7)

As Congress debates the Republican proposal to replace the Affordable Care Act, Massachusetts is in a unique position. The state’s landmark 2006 health care overhaul resulted in near-universal coverage long before the federal law was enacted — so, no matter what Congress passes, it is likely to play out differently here. But Massachusetts is not immune to the tidal wave of change that could flow from the proposed legislation. In part, that’s because the state’s program now conforms to the federal Affordable Care Act, which the GOP plan would replace. (Freyer, 3/8)

Health care advocates and Democratic lawmakers in Maryland called a newly released GOP plan to replace the Affordable Care Act a threat to coverage for more than 400,000 state residents, while top Republicans, including Gov. Larry Hogan, argued that the law must be changed to preserve access to health insurance. "The governor doesn't want to see anyone losing health care," said Doug Mayer, Hogan's chief spokesman. "But he wants a system that works." (Cohn, 3/7)

Many policy watchers in Texas are worried that a reconfiguration in how people get help buying insurance will hit the poor and middle class hardest and lead to a spike in the state's already high uninsured rate...The long-awaited Republican plan, unveiled Monday evening, calls not only for elimination of the mandates that require people to carry insurance — a hallmark of the existing Affordable Care Act — but also propose swapping income-based federal subsidies to help people afford buy insurance for a refundable tax credit system that is age-based, with the amount of assistance rising as people age and presumably use more health care. (Deam, 3/7)

While Texas state leaders and legislators have been calling for the repeal of Obamacare since day one, the state has benefited from it. Texas’ uninsured rate went from 22.1 percent in 2013 to 17.1 percent in 2015, according to the latest U.S. Census data. But after Republicans in Congress unveiled their long-awaited plan to repeal the law on Monday, Curran said he was concerned that Texas patients and doctors would not want to understand how the changes will affect them. (Evans and Livingston, 3/7)

How would the new health care plan proposed by congressional Republicans affect Georgia? Much of the impact has yet to be analyzed. Under many of the plan’s elements, though, the states would be treated similarly. One striking change nationwide would fulfill a longtime GOP campaign promise: The newly unveiled American Health Care Act would eliminate the mandate for individuals to buy coverage or pay a penalty. (Miller, 3/7)

Though House Republicans late Monday finally revealed their plan to replace the Affordable Care Act after months of speculation, uncertainties still abound about how much the plan might save or cost the federal government, and how many may lose or gain insurance because of it. But health policy professionals, experts and advocates in Virginia have already noted that the newly proposed American Health Care Act, while retaining many of the most popular patient protection parts of the ACA, will shift costs onto the patient. (Demeria, 3/7)

Members of Congress will begin moving forward today with efforts to pass the American Health Care Act, a proposal to replace many of the major provisions of the Affordable Care Act, the health law commonly known as Obamacare. House Republicans say their plan will provide relief to those burdened by higher taxes, increased premiums and limited insurance options as a result of Obamacare. (Levin Becker, 3/8)

For better or worse, Californians who aren’t insured through their employers could see major changes in their health insurance costs under a Republican replacement for the Affordable Care Act. A House GOP proposal introduced Monday would provide substantially less financial help to many consumers in higher-cost areas of California, from San Francisco to Monterey. But people in lower-cost markets like Los Angeles could fare better. (Terhune, 3/7)

It stands to reason that if you know you’re overweight or obese, and you know your extra pounds are unhealthy, that you’ve made a stab at losing weight. Right? Not so much anymore, new research shows. The proportion of American adults who were either overweight or obese has been growing steadily for decades, rising from about 53% a generation ago to roughly 66% more recently. (Healy, 3/7)

No single bag of chips or bacon burger will kill you unless you choke on it. But in the big picture — the very big picture — how we Americans eat does often send us to earlier graves, and a new study out of Tufts University quantifies just how deadly our diets may be.It estimates that over 318,000 deaths a year, or nearly half of American deaths from major "cardiometabolic" killers — heart disease, stroke and diabetes — were hastened by unhealthy eating. (Goldberg, 3/7)

Few Baby Boomers have been tested for the liver-damaging hepatitis C virus, despite recommendations that all members of that generation have the blood test at least once, new research suggests. The share of boomers who had the test barely budged in the two years after health authorities first recommended it for everyone born between 1945 and 1965, according to a report published Wednesday in American Journal of Preventive Medicine. (Painter, 3/8)

About one in four adults in the United States suffers from arthritis, according to a new Centers for Disease Control and Prevention Vital Signs report published Tuesday. Of the 54 million people in the United States who have this debilitating condition, not all are elderly. About 60 percent of those with arthritis were between the ages of 18 and 64, that is, working age. Activity limitations from arthritis increased by 20 percent since 2002, the report found. Simple, everyday tasks, such as walking or lifting bags, are challenging for 24 million people affected by the condition in the United States. (Naqvi, 3/7)

Fifteen Democrats in Congress are seizing on momentum in the field of precision medicine, penning a letter Tuesday to Secretary of Health and Human Services Tom Price urging increased patient access to genetic testing. The letter was sent on the same day the Personalized Medicine Coalition hosted a congressional briefing, which featured Senator Edward Markey of Massachusetts, a Democrat. (Facher, 3/7)

NAACP training program is coming to Orlando this week to talk to the leaders of Orlando’s black churches about the importance of their institutions in tackling HIV infection in the African American community. Although rates of HIV infection have dropped over time, the virus continues to disproportionately affect African Americans in the U.S. and here in Central Florida. (Miller, 3/7)

Deaths in West Virginia have overwhelmed a state program providing burial assistance for needy families for at least the fifth year in a row, causing the program to be nearly out of money four months before the end of the fiscal year, according to the state's Department of Health and Human Resources (DHHR). Funeral directors in West Virginia say the state's drug overdose epidemic, the worst in the nation, is partly to blame. (Ingraham, 3/7)

The head of general surgery at Dartmouth-Hitchcock Medical Center had a remarkably simple idea not long ago: What if the department suggested that surgeons limit prescriptions of narcotic pain pills to a specific number for different kinds of operations? The results were dramatic: The number of pills prescribed by doctors for five common outpatient surgeries dropped by 53 percent, and patients didn't consume all the pills they were given, according to a study that will be published this week in the journal Annals of Surgery. (Bernstein, 3/7)

Firsts can be life-changing — think about your first kiss, your first time behind the wheel of a car. But what about the first time you got a prescription for a narcotic? James Hatzell, from Collingswood, N.J., is now a technology officer for a college addiction treatment program. He didn’t realize it at the time, but that spring day of his junior year of high school — seven years ago — was a pivotal moment in his life. (Gordon, 3/8)

Franklin County Coroner Anahi Ortiz is concerned that two of the area's most powerful politicians want to take the central role in a task force she helped create to fight the heroin epidemic... Franklin County Commissioner John O'Grady and Columbus Mayor Andrew J. Ginther have scheduled a meeting for Thursday with other public officials and agencies to organize greater involvement in the heroin-addiction battle. (Perry, 3/8)

As President Trump tweets yet another promise to lower drug prices, a new analysis offers an example of what can happen when the federal government negotiates with manufacturers. During a 12-month period ended November 2015, the Veterans Choice Program, which was created by the US Department of Veterans Affairs, paid a median price of $12,500 for a month’s supply of Harvoni, a hepatitis C drug sold by Gilead Sciences. Since most patients typically are treated for two to three months, the cost was closer to $25,000 to $37,500 per person, according to the analysis in Medical Care. (Silverman, 3/7)

Gilead Sciences Inc.’s hepatitis C cure set off a firestorm of criticism over high drug prices in 2014 that hasn’t let up since. Now an executive says the company can’t cut the product’s price because middlemen who manage drug benefits would refuse to cover it. ... Pharmacy benefit managers such as Express Scripts Holding Co. and CVS Health Corp. negotiate drug reimbursement, often in secrecy, for employers and health plans. While PBMs say they deliver lower prices for customers and patients, drugmakers have begun aggressively implicating the middlemen in high medication costs that have become a frequent target of Washington lawmakers and President Donald Trump. (Chen and Langreth, 3/3)

Rep. Elijah Cummings (D-Md.) will meet President Trump at the White House on Wednesday to discuss lowering prescription drug prices, an issue the top House Oversight Committee Democrat has long advocated for. The White House gathering comes shortly after Trump claimed that Cummings canceled a meeting last month because of partisan politics. (Marcos, 3/7)

Building on weeks of mounting pressure to address high prescription drug prices, three influential U.S. senators have asked the government’s accountability arm to investigate potential abuses of the Orphan Drug Act. In a March 3 letter to the U.S. Government Accountability Office, Sens. Orrin Hatch (R-Utah), Chuck Grassley (R-Iowa) and Tom Cotton (R-Ark.) raised the possibility that regulatory or legislative changes might be needed “to preserve the intent of this vital law” that gives drugmakers lucrative incentives to develop drugs for rare diseases. (Tribble and Lupkin, 3/7)

In the wake of the controversy over EpiPen pricing, lawmakers in several states are introducing bills that would allow pharmacists to substitute alternatives for the pricey allergic-reaction device without requiring a new prescription from a physician. The latest example was introduced last week in Ohio, where pharmacists are currently prohibited from making any substitutions for the device. Similar legislation was introduced in recent weeks in New York and Vermont, and last fall in New Jersey. A somewhat comparable was also introduced in Hawaii. (Silverman, 3/6)

For months, Dr. Patrick Soon-Shiong would continue to reap praise for his generosity in publicity put out by the university. Not mentioned in any of the tributes: $10 million of his donation would be sent right back to one of his companies. And the contract for his gift was worded in a way that left the University of Utah with no other choice. The university health system did get free and valuable information for genetics research through the deal. But a STAT investigation has found that Soon-Shiong benefited even more from his charitable donation. He got reams of patient data to help him build a new commercial product meant to assess patients’ risk of rare and inherited diseases. He got a stream of cash for one of his struggling companies. (Robbins, 3/6)

In the past three years, 33 U.S. states have passed laws aimed at helping dying people get easier access to experimental treatments. Supporters say these patients are just looking for the “right to try” these treatments. Such laws may sound compassionate, but medical ethicists warn they pose worrisome risks to the health and finances of vulnerable patients. (Feibel, 3/6)

Marathon Pharmaceuticals LLC is facing more criticism over the $89,000 price tag on its drug for a rare muscle disorder as a group of eight U.S. lawmakers said they’re concerned that it “exploits” patients. In a March 3 letter to Marathon Chief Executive Officer Jeffrey Aronin, seven Democratic U.S. senators and one independent demanded information on the closely held drugmaker’s pricing practices and product development costs for Emflaza, used to treat lethal Duchenne muscular dystrophy. (Greifeld, 3/6)

When Genentech sales reps gathered in late January in Las Vegas for their national sales meeting, they were rewarded with a treat — Gwen Stefani, the popular singer, performed for the crowd, according to photos posted online. It remains unclear what she was paid for her show at the Mandalay Bay Resort and Casino. A Genentech spokeswoman declined to comment, as did Stefani’s booking agent. However, Stefani has commanded upwards of $350,000 to perform at private events, according to data from Celebrity Talent International that was cited in a Business Insider story in 2014. (Silverman, 3/7)

President Donald Trump used his speech to a joint session of Congress Tuesday night to renew his call to contain soaring prescription drug prices. His demand comes as the pharmaceutical industry launches a public relations campaign aimed at reducing public anger and the threat of increased regulation. Trump, who once complained that the pharmaceutical industry is “getting away with murder” by overcharging consumers and government agencies, said that his administration and Congress must “work to bring down the artificially high price of drugs and bring them down immediately.” (Pianin, 3/1)

hen President Trump criticized the Food and Drug Administration drug approval process as “slow and burdensome” on Tuesday, you may have heard a mysterious noise. And that noise may have been the sound of thousands of agency staffers banging their heads against the wall. FDA officials have long bristled at the notion that they move too slowly to approve new drugs. Part of their job, after all, is to ensure that any drugs they approve are both safe and effective — and that, they point out, can take time. The standard review process now takes a median of 10 months, down from nearly 13 months in 2005, according to the FDA. Companies can shrink that process to eight months if they get a priority review. (Kaplan, 3/1)

A lot goes into getting a drug into a patient's hands, but the complexity of the distribution channel is only one reason why drug prices are high. As drugs get increasingly intricate, they're becoming more costly to develop, and that has an impact on prices, too. How can you determine if a drug price is fair? (Campbell and Harjes, 3/5)

Dear President Trump: During your speech to Congress last week, you took a whack at the Food and Drug Administration for its “slow and burdensome” approach toward approving medicines. You then suggested that if “we slash the restraints” on the agency, Americans will be blessed with more miracle cures. To be sure, the FDA is not infallible. Like any institution, the agency is a collection of people who sometimes make mistakes or exercise poor judgment. And the public is right to demand more new medicines more quickly. (Ed Silverman, 3/6)

The health-care goals President Donald Trump mentioned in his address to a joint session of Congress Tuesday night were a high-water mark for policy specificity from this president. But that mark was a low bar. The lack of detail was still glaring, and Trump either skirted the alligators lurking in the morass of Affordable Care Act repeal and replacement, or just poked them with a long stick. The process remains as chaotic as ever. That's a threat to health insurers who focus narrowly on government programs. It may also hurt those who don't. (Max Nisen, 3/1)

Over the last decade, private employers from Boeing to Xerox have led the nation in developing innovative strategies for delivering better health at less cost. Whatever the Trump administration and Congress decide to do about the Affordable Care Act in 2017, this business role won’t — and shouldn’t — change. In fact, it should expand, especially if employers are bold enough to ask the administration to roll back outdated regulations that prevent employers, insurers, and drug companies from linking drug prices to real-world health outcomes. (Paul Howard and Lauren Pickering, 3/3)

There is no shortage of outrageous examples of medication price hikes by pharmaceutical companies. Take your pick (and swallow with a full glass of water): “Pharma Bro” Martin Shkrelli, who jacked the price of a drug used to treat patients with malaria and HIV by 5,000 percent; Mylan, which raised the price of its EpiPen auto-injector for life-threatening allergy attacks to $365 for a generic drug that normally costs a dollar a dose; and more recently drugmaker Kaleo, which has increased the price for a two-pack of its “talking” Naloxone auto-injector — used to halt opioid overdoses — from $690 in 2014 to $4,500 today. (3/3)

Pharma Bro is back. In this case, it’s not a disgraced pharmaceutical executive but a drug firm looking to sell a life-saving drug for $89,000 a year, even though it’s available from overseas for less than $2,000. It’s an example of whipsawing drug prices that are infuriating both Democrats and Republicans and leading major pharmaceutical firms to promise to curb prescription drug costs... The pressure is building in ways that could produce sweeping changes in drug pricing. (3/1)

The story in the Sunday Journal Star, “Sworn to secrecy, drugstores stay silent as customers overpay,” cited examples in other states, but the same thing is happening in Nebraska. It’s a nationwide problem. At the heart of the controversy is the giant pharmacy benefit management industry -- perhaps the largest industry of which you have never heard, even though it has companies that are larger than some household names like Pepsi, Coca-Cola and Boeing. (3/3)

Roche Holding AG's blockbuster cancer drugs face a huge impending sales decline in the next few years. Its investors aren't worried. The company's ADRs spiked as much 6.8 percent on Thursday, in response to positive trial data for a combination of Herceptin -- one of those big blockbusters -- and a newer drug called Perjeta. (Max Nisen, 3/2)

House Republicans have finally rolled out their new health-care proposal, and it’s receiving heated criticism from both left and right—and not because it’s so good. Yet it does represent a better dog’s breakfast than the incoherent Obama scheme it would replace. Let’s start from the top. “Repeal” is a meaningless political gesture: New laws supersede or amend existing laws, so if Republicans have a health-care plan, they could just enact it. (Holman W. Jenkins, Jr., 3/7)

When I took the speaker’s gavel, I told my colleagues that it’s no longer good enough to just say what we’re against. We had to show what we’re for. That’s why last year we released a complete policy agenda — tracking closely with ideas from our presidential nominee, Donald Trump — to tackle all of the big challenges facing this country. The truth is, we have solutions to all of the many problems that Barack Obama left behind. (House Speaker Paul Ryan, 3/7)

Consideration of the measure is set to begin Wednesday in two House committees. If Republican leaders don’t pull the bill in the face of considerable internal opposition, the full House could vote on it within the next few weeks. In contrast, Obamacare was the subject of lengthy public hearings and private negotiations during the winter, spring and summer of 2009. The first House committee action came that July, after the CBO came out with its estimates of the cost and the number of people who'd gain insurance. (3/7)

The American Health Care Act would be the most consequential GOP social-policy reform since the welfare overhaul of 1996. Not only does the bill repair the failures of the Affordable Care Act, it starts to correct many of the government-created dysfunctions that have bedeviled U.S. health care for decades. Opening this critical legislative campaign is a test of how well Republicans can manage political and economic reality. (3/7)

House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell have begun a forced march of their members toward what they hope will be the enactment of legislation repealing and replacing the Affordable Care Act (ACA). Ryan and the chairman of the key committees in the House released their initial pieces of the legislation last evening (the plan is currently broken into two parts, reflecting the jurisdiction of the two main committees, Ways and Means and Energy and Commerce). It is clear from a quick review of the plan, and from initial reactions to it from others, that the task before them remains daunting. (James C. Capretta, 3/8)

House Republicans delivered a long-promised Obamacare replacement Monday night. It's a strong bid to replace an increasingly feeble law. President Donald Trump tweeted his support for the "wonderful new" bill. Some other Republicans are in open revolt. Let's slow down here. There are some huge blanks still to be filled in: Will people lose coverage because they won't be able to afford it as premium subsidies shrink, as critics claim? Will the plan cost the federal government more or less than an increasingly shaky Obamacare would? Health economists are busy at their calculators, so answers to those and other key questions should be forthcoming soon. (3/7)

The American Health Care Act, which House Republicans unveiled Monday night with White House support, is repeal and replace, kind of. It has some suspicious similarities to Obamacare. But it marks a sharp departure in at least one crucial respect: fiscal responsibility. The bill would repeal a vast array of the Affordable Care Act’s pay-fors — taxes on upper-income people and on health-care-related entities including drugs, insurance and medical devices. To finance the spending it still envisions, the bill would replace those by cutting Medicaid and other assistance to poor and near-poor people. (3/7)

It looks as if Republicans want to bring back health care rationing. In 2010, Mark Price, a 37-year-old resident of Goodyear, Ariz., was struggling to pay the bills for his leukemia treatment. His house was under foreclosure. He had insurance through Medicaid, and yet he died after the state said it would not pay for a potentially lifesaving bone marrow transplant. Facing a $2.6 billion budget deficit, Gov. Jan Brewer and Arizona Republicans had opted to ration care, eliminating state payments for bone marrow, liver, heart, lung and other transplants. Simultaneously, the state changed eligibility rules to cut health care for 47,000 low-income children and 310,000 low-income adults. (Ezekiel J. Emanuel, Aaron Glickman and Emily Gudbranson, 3/7)

Republican House leaders have spent months dodging questions about how they would replace the Affordable Care Act with a better law, and went so far as to hide the draft of their plan from other lawmakers. No wonder. The bill they released on Monday would kick millions of people off the coverage they currently have. So much for President Trump’s big campaign promise: “We’re going to have insurance for everybody” — with coverage that would be “much less expensive and much better.” (3/7)

Republicans have finally released their long-awaited alternative to the Affordable Care Act. As expected, the bill would give a huge tax cut to the wealthy and gut the federal spending that the poor and the middle class depend on for their health insurance. (Nicholas Bagley, 3/7)

The Republican alternative to the Obamacare is in, and the reviews are ... not good. “Dead on arrival,” according to Rand Paul. “Bad policy,” said the Heritage Foundation. “A train wreck waiting to happen,” according to the Cato Institute. And critics on the left were hardly any kinder. (3/8)

When he was a candidate for president, Donald Trump promised that Republicans would repeal the Affordable Care Act and replace it with “something terrific.” Now we finally have their plan, and I am sorry to report that it’s something other than terrific. In fact, it’s so far from terrific that there doesn’t seem to be anyone other than House Speaker Paul D. Ryan (R-Wis.) himself who thinks this bill isn’t a disaster. It’s being attacked not just from the left but from the right as well. Heritage Action and the Club for Growth, two groups that exist to browbeat Republicans into upholding hard-right principles, have just come out against it. (Paul Waldman, 3/7)

The House GOP leadership’s proposal for repealing and replacing Obamacare would actually leave much of the 2010 Affordable Care Act intact — except for the parts that make it work. Instead of fixing the problems Republicans have been complaining about, it would make them worse. And rather than making insurance affordable to more people, it would raise costs for lower-income Americans and cut them for everyone else. (3/7)

There’s a new rule in American politics: Whichever party owns healthcare will come to regret it. Seven years ago, Barack Obama’s Democrats passed a health insurance law that promised to cover almost everyone and make medical care more affordable. Best of all, Obama said, the new plan wouldn’t inconvenience anybody — except the high-income folks who got hit with a tax increase. (Doyle McManus, 3/7)

President Trump, long at the forefront of intellectual discovery, last week came up with a major finding: Health-care reform is hard. “Unbelievably complex,” in fact. “Nobody knew that health care could be so complicated,” the president said. (Dana Milbank, 3/7)

After the 1976 election, the Democratic Party seemed to enjoy a commanding position in American politics, with Jimmy Carter ensconced in the White House, a Senate supermajority and an advantage of nearly 150 seats in the House of Representatives. Yet over the next four years the Democrats achieved little of consequence, Carter passed into history as a failure, and Ronald Reagan ushered in a lasting rightward realignment. (Ron Douthat, 3/8)

After 2,500 days, the American Health Care Act is born. Congressional Republicans’ much-anticipated health-care bill may have a similar name to the Affordable Care Act it’s intended to replace, but it would have a dramatically different impact. Despite President Trump’s stated goals of covering at least as many people as the ACA, with more affordable policies, the plan put forward by the House on Monday would cut coverage for millions and make it more expensive for millions more. (Andy Slavitt, 3/7)

Concealed within the 123 pages of legislative verbiage and dense boilerplate of the House Republican bill repealing the Affordable Care Act are not a few hard-to-find nuggets. Here’s one crying out for exposure: The bill encourages health insurance companies to pay their top executives more. It does so by removing the ACA’s limit on corporate tax deductions for executive pay. The cost to the American taxpayer of eliminating this provision: well in excess of $70 million a year. In the reckoning of the Institute for Policy Studies, a think tank that analyzed the limitation in 2014, that would have been enough that year to buy dental insurance under the ACA for 262,000 Americans, or pay the silver plan deductibles for 28,000. (Michael Hiltzik, 3/7)

In other words, it's not exactly designed to pass and become a law that actually works. Speaker Paul Ryan might get the necessary 218 Republicans to close their eyes, hold hands, and jump over a cliff in order to get the bill to the Senate. It's still unlikely that the bill will pass in the Senate, where Republicans have a much slimmer majority. And that majority includes some senators who simply won't vote for significant cuts in Medicaid, since that would mean stripping health care away from people (voters!) who currently have it. Indeed, the bill is hardly certain to pass the House, where many Republicans want (among other things) much deeper Medicaid cuts. (Jonathan Bernstein, 3/7)

Republicans are playing games and using gimmicks as they struggle to repeal and replace the Affordable Care Act. The height of this chicanery is that two House committees are drafting the legislation without analysis of the budgetary and insurance-coverage implications other than partisan claims. An undertaking on that scale would usually have access to analysis from the nonpartisan Congressional Budget Office. But the CBO hasn't yet been able to score the hastily assembled legislation. And Republican leaders reportedly have not been encouraged by early discussions with the office, which is headed by Republican economist Keith Hall, who in the tradition of that job has a reputation for straight-shooting, detached analysis. (Albert R. Hunt, 3/7)

The American Health Care Act, introduced in the House Energy and Commerce and Ways and Means committees late Monday, was advertised as a bill to repeal and replace the Affordable Care Act. But the real focus of the legislation is not on health-care reform, not even on repealing the ACA as such. What the AHCA would in fact do is massively redistribute wealth from the poorest Americans to the wealthiest. (Timothy Stoltzfus Jost, 3/7)

Republicans in Congress are fond of calling Obamacare a death spiral of escalating costs and declining coverage. But their replacement plan could make those problems even worse. Tuesday, the morning after two House committees released legislation that would replace the Affordable Care Act with the American Health Care Act, the plan received a tepid, even hostile reaction from many outside conservative groups and Republicans in Congress. (Margot Sanger-Katz, 3/7)

The proposed bill manages to do about four things successfully: It cuts taxes for wealthy people, ends Medicaid as we know it to help pay for those tax cuts, reduces the number of Americans who can afford health insurance, and angers such a wide variety of voting constituencies that it is effectively dead on arrival. That's bad news for anyone hoping for a relatively quick and orderly transition from the ACA. But the dysfunction may actually be good news for hospitals and Medicaid-focused insurers. (Max Nisen, 3/7)

Less than a day after it was released, the House Republicans’ Obamacare replacement bill, the American Health Care Act, seems bereft of friends. Barely lifting a finger in opposition, Democrats may enjoy the demise of the AHCA before it leaves the House. (Jennifer Rubin, 3/7)

Replacing existing subsidies with tax credits does save the government money, but only if the credits are less than the subsidies. Getting even less help with insurance bills isn't going to make it any easier for my friends or my patients to get health care. Under the new proposal, people who benefited from Medicaid expansion would continue to have good insurance coverage, but only until 2020. After that, who knows? (Robert Needlman, 3/8)

It’s still early in the replacement game for the Affordable Care Act, but not too soon to ask Sens. John McCain and Jeff Flake if they’re willing to strip 400,000 Arizona citizens of their health insurance. That’s what would happen if the Republican plan to scrap Obamacare eliminates the Medicaid expansion. (EJ Montini, 3/7)

Nearly four years later, the restoration and expansion of Medicaid is working exactly as supporters said it would: Patients are getting the right care in the right place; hospital uncompensated care has been reduced dramatically; health-care employers are hiring; and taxpayers are getting more for their money. Today, Arizona’s taxpayers, patients, employers and their workforce are well-served by a vibrant health-care sector that provides the highest quality care and contributes mightily to the state’s economy. Anyone who wants to undo that truly doesn’t know what they’re doing. (Linda Hunt and Todd Sanders, 3/7)

he Center on Budget and Policy Priorities states 526,000 Tennesseans could lose insurance coverage by 2019 with full ACA repeal. This will largely affect families dependent on marketplace subsidies, and will also jeopardize the 2.8 million Tennesseans who have pre-existing conditions. For patients like Shawn, that means the healthcare reform debate is truly life and death. Nearly 15 percent of adult Tennesseans have diabetes, and medical expenses for diabetics are 2.3 times higher than those without the disease. If they are insulin dependent, how will they pay for it to live another 24 hours? (David H. Gouger, 3/7)

The Republican plan doesn't exactly do away with the expansion of Medicaid that Maryland and about three dozen other states adopted. Doing so would have immediately cast millions off the insurance rolls. But what the GOP is proposing is actually more drastic in the long run. In Maryland, the state and federal government have traditionally split the costs of Medicaid 50-50. (In poorer states, the federal government picks up as much as 70 percent of the tab.) Under the ACA, the federal government initially covered all the costs to expand the program to people making up to 138 percent of the federal poverty line and after a phase-in period paid 90 percent. (3/7)

The current healthcare debate is therefore a battle between the natural rights of man versus the “common-wealth.” Those who favor the former feel a younger individual should be able to choose to not purchase health insurance. This lack of preventative care can with time lead to chronic illness, which they deal with as well as they economically can. Individuals with chronic illness spiral into increasing healthcare costs and decreasing coverage until they become sufficiently disabled for government care, with those costs passed on to all taxpayers. As a surgeon in Kentucky, I have witnessed the effects of lack of coverage. (Ronald C. Burgess, 3/7)

For alleged fiscal hawks, U.S. House Republicans are acting recklessly in their haste to repeal and replace the Affordable Care Act. It looks as if they will be voting without any scoring by the Congressional Budget Office. This will leave factors unknown that should reasonably dictate how representatives vote — how much this replacement will cost and how many Americans will be getting coverage, how many will be getting lesser coverage and how many are stripped of coverage. (3/7)

On Monday, House Republicans unveiled their Obamacare "replacement" plan, which they claim eliminates the individual mandate. Yet a provision of the bill allows insurance companies to increase rates by 30% on those who allow their policies to lapse but then re-apply for insurance when they need it. That sounds an awful lot like a mandate that identifies as an incentive. It is what Chicago poet Gwendolyn Brooks referred to as an "identical disguise." And it allows the GOP to claim credit for keeping all the people who were forced to sign up for health care under Obamacare. (Christian Schneider, 3/7)

Fewer Americans will have health insurance if the Republican alternative to the Affordable Care Act is enacted. That’s the crucial takeaway from the American Health Care Act, because it goes to the heart of the health and financial stability of everyday Americans. The consensus from analysts from both sides of the political divide is 10 million or more people will lose coverage under the plan, reversing a trend from the past few years that saw the nation reach its lowest uninsured rate ever. (3/7)

It's pretty clear that a proposal floated by the White House to safeguard federal funding to Planned Parenthood if the group stopped providing abortions never stood a chance of even being considered by the group. “Non-negotiable,” said one Planned Parenthood official. But the fact that the idea was broached at all is significant as the latest sign that Republicans recognize the problems — and likely political repercussions — of cutting off funds to an organization that is held in high regard by the American public for providing critical health-care services. (3/7)

During one of the presidential debates candidate Donald Trump said, “Millions and millions of women – cervical cancer, breast cancer – are helped by Planned Parenthood. I would defund it because I’m pro-life, but millions of women are helped by Planned Parenthood.” That muddled logic is now public policy. Trump and the Republicans rewriting the health care law are willing to kill women in order to punish Planned Parenthood. (EJ Montini, 3/7)

I am writing on behalf of Pro-Choice Charlotte as an appeal to abortion protesters participating in the 40-week Love Life prayer walk outside A Preferred Women’s Health Clinic in Charlotte that started last weekend. While the stated purpose of Love Life Charlotte is “to create a culture of love and life that will bring an end to abortion,” please reconsider whether shaming, intimidating and harassing women arriving at the clinic is the best way to show love and compassion. You may not intend for the marching, shouting and posters to cause psychological distress, but this is the effect you have on many women. Not only does this not demonstrate love or respect for your fellow human, it is also not an effective way to reduce the number of abortions. I would like to offer three alternatives. (Brooke Adams, 3/7)

Sometimes reality presents us with two sets of facts that exist simultaneously, yet seem impossible to reconcile. Such is the case of a recent groundbreaking medical procedure at Nationwide Children's Hospital and the latest news about the effort to curb the Franklin County's appalling infant mortality rate. (3/8)

There is strong and consistent evidence that exposure to secondhand smoke causes heart attacks and that smokefree workplace and public place laws cut heart attacks (and other diseases). The most recent evidence comes from a large study in Sao Paolo, Brazil, where heart attack deaths dropped by 12 percent following implementation of its smokefree law. (Stanton Glantz, 3/7)