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President-elect Donald Trump says he wants to preserve health insurance coverage even as he pursues repeal of the Obama-era overhaul that provided it to millions of uninsured people. How his administration handles a pending lawsuit over billions of dollars in insurance subsidies will reveal whether Trump wants an orderly transition to a Republican-designed system or if he'd push "Obamacare" over a cliff. Stripping away the subsidies at issue in the case would put the program into a free-fall. (Alonso-Zaldivar, 11/16)

Ascendant Republicans who have put a repeal of the Affordable Care Act at the top of their to-do list face a set of early, key decisions that will test the party’s consensus on the issue. Among them: How much of the 2010 health law to strike early on, how soon and how closely to work with Democrats in shaping a replacement, and how much leeway to give consumers who might be caught without coverage in between a repeal and a new law. Lawmakers who weren’t necessarily expecting Donald Trump to win the presidency now see they can move ahead more boldly on the health law than they anticipated. (Radnofsky and Armour, 11/15)

Two top House Republicans on health policy reiterated promises Monday to replace the Affordable Care Act after repealing it. Rep. John Shimkus (R-Ill.), who is vying to lead the Energy and Commerce Committee next year, said the House GOP’s “Better Way” health plan will be the starting point for reform efforts. He referenced high-risk pools as the best way to require insurers to cover pre-existing conditions without having a mandate to purchase plans. Tax credits would help people afford coverage, he said. ... Rep. Tim Murphy (R-Pa.) said Republicans won’t repeal the Affordable Care Act without offering a replacement, but he expects that effort could take several months of hearings and legislative work. (McIntire, 11/15)

Starting in January, Republicans will control the white house and both chambers of Congress. After promising to repeal and replace the Affordable Care Act, president-elect Donald Trump has said he’d now like to keep some elements of the law. Republicans who have voted for years to repeal the law now have their chance to enact a replacement. Medicare and Medicaid might also see major changes under a GOP-controlled White House and Congress. (11/16)

The nation’s leading doctors group is warning the incoming Trump administration not to strip away a single person’s health coverage as it works to dismantle ObamaCare.  The American Medical Association (AMA) on Tuesday released a two-page document that outlines its top goals for healthcare reform under incoming President Trump. One of the top items is making sure that “any future proposals do not cause individuals covered as a result of [Affordable Care Act] provisions to become uninsured,” the AMA wrote." A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured,” the group said. (Ferris, 11/15)

The American Medical Association’s House of Delegates vowed Tuesday to work with the incoming Trump administration and Congress on health care reform, but said any new reforms shouldn’t result in people losing coverage. “A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured,” the group said in a statement. “We will also advance recommendations to support the delivery of high quality patient care. Policymakers have a notable opportunity to also reduce excessive regulatory burdens that diminish physicians’ time devoted to patient care and increase costs.” (McIntire, 11/15)

Republicans are still celebrating their election victories, but the country's GOP governors warned this week that they need to move fast on many of the changes that have been promised to voters. ... Most of the GOP governors mentioned health care when discussing their top priorities. But it became evident they are not in complete agreement on how to unwind President Barack Obama's health care overhaul that included an expansion of Medicaid, the nation's main safety net health care program for the poor. (Fineout, 11/16)

The expansion of Medicaid, a central pillar of the Affordable Care Act, faces immense uncertainty next year, with President-elect Donald J. Trump and top Republicans in Congress embracing proposals that could leave millions of poorer Americans without health insurance and jeopardize a major element of President Obama’s legacy. But influential figures in surprising quarters of the new administration might balk at a broad rollback of Medicaid’s reach, favoring new conditions for access to the government insurance program for the poor but not wholesale cutbacks. (Pear, 11/15)

Republican Gov. Dennis Daugaard said Tuesday that he won't pursue an expansion of Medicaid in 2017 after a discussion with Vice President-elect Mike Pence. The South Dakota governor said in a statement that his decision is based on a Monday meeting in which he and Pence talked about the Trump administration's plans for repealing or reforming the Affordable Care Act. (Nord, 11/15)

Plans to move forward on Medicaid expansion during the 2017 legislative session came to an abrupt halt Tuesday. Gov. Dennis Daugaard, one of the plan's key architects, in a statement said based on the election of Republican Donald Trump and the administration's plans moving forward, he would drop his request that the state Legislature weigh expanding the health insurance program for needy people. (Ferguson, 11/15)

Oscar Insurance Corp., the Silicon Valley-backed health-care startup, continued to lose tens of millions of dollars in the third quarter as the company exits some markets and works to diversify away from of its Obamacare business. The New York-based company sells health insurance to individuals in new markets set up by the Affordable Care Act. Its attempt to reinvent the insurance business has been marked by large losses -- in the third quarter, closely held Oscar lost $45 million in New York, Texas and California, according to filings with regulators. That follows losses of $83 million in those states during the first six months of this year. (Tracer, 11/15)

A federal judge has tossed out Land of Lincoln's lawsuit seeking more than $70 million that the now-defunct health insurer says it's owed by the federal government. The insurer shut down at the end of September amid financial woes, sending 49,000 Illinoisans scrambling to find new coverage for the last three months of the year. Shortly before the insurer's closure was announced, it sued the federal government in June for more than $70 million. (Schencker, 11/15)

It’s customary in the nation’s capital to hail members of the incoming administration by telling everyone in town how close you are to them. So many in conservative Washington lobbying circles and elsewhere are busy touting their relationships with President-elect Donald Trump and his advisers. There’s a benefit to proximity to power, especially now. At a time when nobody really knows how the Trump administration will regulate drugs and medical devices, fund scientific research, or repeal or replace the Affordable Care Act, relationships with the newcomers are viewed as critical to getting one’s issues on the table. (Kaplan, 11/15)

President-elect Donald Trump is considering Rep. Tom Price, the powerful Republican orthopedic surgeon from Georgia, as a potential HHS secretary, according to news reports. Politico first reported the story Tuesday. Price, an early Trump supporter, sits on the House Ways and Means Committee, which has jurisdiction over healthcare policy. Price has been an outspoken critic of the Affordable Care Act, which Trump promised to repeal on the campaign trail, but he has since softened on the idea of replacing it completely. Price sponsored healthcare legislation that would repeal the ACA and provide refundable tax credits adjusted by age, not income, to buy health insurance. (Herman, 11/15)

Retired neurosurgeon Ben Carson has told President-elect Donald Trump that he isn't interested in serving as secretary of Health and Human Services, a Carson ally confirmed to The Hill on Tuesday.  Business manager and close friend Armstrong Williams said Carson won't join the incoming Trump administration and would only serve as an unofficial adviser.  Circa on Tuesday reported that Carson had been offered the position, citing Williams. But Williams told The Hill that no specific offer had been made. (Kamisar, 11/15)

If Donald Trump’s Supreme Court of the future moves to overturn Roe v. Wade, access to legal abortion in the United States wouldn’t vanish. But it would likely become staggeringly unequal — an option only for women who happen to live in a liberal state or have the money to travel to one. For a glimpse of this possible fate, look to the recent past. In 1970, New York became the first state to allow any woman to end a pregnancy without proving she’d been raped or that her health would fail if gestation continued. “Women flocked there,” said Katha Pollitt, author of Pro: Reclaiming Abortion Rights. “But low-income women, disproportionately women of color, were trapped in anti-abortion states.” (Paquette and Soffen, 11/15)

Thousands of people have made donations to Planned Parenthood in the name of Vice President-elect Mike Pence, an abortion opponent, so that he will receive official acknowledgements from the women's health care provider, the group said on Tuesday. The idea of making donations in Pence's name arose and spread on social media as a protest after Republican Donald Trump won his bid for the U.S. presidency in a surprise victory last week. (Malo, 11/15)

“GET AN IUD TOMORROW.” That’s what Erin Gloria Ryan, the senior editor at The Daily Beast, posted on Twitter at 8:53 p.m. on Election Day, Nov. 8. Her tweet, which was retweeted more than a thousand times, was among the first calls to action for American women of reproductive age, and Seattle-area women appear to be among those listening. The next day, the Planned Parenthood call center that handles 28 health centers, including the ones in Seattle, fielded 200 more calls than usual. (Clarridge, 11/15)

A new study has found a close relationship between Agent Orange exposure during the Vietnam War and high blood pressure, a conclusion that could lead the U.S. Department of Veterans Affairs to dramatically expand the number of veterans eligible for compensation. The study, published last week by VA researchers in the Journal of Occupational and Environmental Medicine, found a higher rate of hypertension among members of the Army Chemical Corps who handled Agent Orange during the war compared to those who didn’t. (Ornstein, 11/15)

[Diane] Levesque shepherds veterans like Dominiq through the system, connecting them with resources like rides to appointments. She also monitors their progress. Neither she nor the court issues a guarantee that any given participant will avoid jail. They have to follow the program they agree to. (Biello, 11/15)

On the campaign trail, Donald J. Trump savaged the Department of Veterans Affairs, calling it a “disaster” and “the most corrupt agency in the United States.” He vowed to fire many workers at the department in an effort to fix a health care system fraught with delays. As he transitions to the White House, he has tapped the agency’s harshest critics to advise him. (Philipps, 11/15)

Nationally health care jobs take longer to fill than jobs in most other industries: 49 workdays as of the last count in September, according to DHI Hiring Indicators, a research group. It’s tempting to argue that nurse hiring difficulties, in Houston and across the nation, would go away if more people graduated from nursing programs. And many cities do need more graduates — but that’s not the only problem. Hospitals, nursing homes, home care agencies and doctor’s offices, like a lot of employers across the country, have a specific resume in mind. Employers often want new hires to have experience in a specialty such as operating room nursing. They may not be able to raise wages to easily attract that experience. Meanwhile many new nurses, armed with a degree that’s supposedly a ticket to the middle class, struggle to land their first job. (Quinton, 11/16)

Ten thousand dollar sign-on bonuses and generous benefits? No, we’re not talking about the tech industry; it’s nurses who are now in high demand. As the economy improves, many older nurses are cutting back hours or retiring, causing a major shortage across the country. (Allington, 11/14)

Ten years after Hurricane Katrina, patients were three times as likely to be admitted to Tulane Medical Center for heart attacks than they were in the years before the storm, according to a new study by Tulane University researchers. The study, released this week during the American Heart Association's Scientific Sessions 2016 in New Orleans, also found that patients were more likely to have risk factors for heart attack in the years after the hurricane....In addition to the risks for heart attack, the researchers also noted a rise in the rates of substance abuse and psychiatric disorders after the storm. Among the post-Katrina group, unemployment and lack of health insurance were also more pronounced than they had been previously. (Lipinski, 11/15)

Inpatient treatment programs for heroin and opioid dependence can be so difficult to get into in some parts of the country that drug users who want to quit are voluntarily asking judges to lock them up — just to guarantee they'll get help. (Brown, 11/15)

Mantis shrimp, a group of aggressive, reef-dwelling crustaceans, take more than one first-place ribbon in the animal kingdom. Outwardly, they resemble their lobster cousins, but their colorful shells contain an impressive set of superpowers. Now, scientists are finding that one of those abilities — incredible eyesight — has potential life-saving implications for people with cancer. (Kennerson and Boyle, 11/15)

Every three minutes, a food allergy reaction sends someone to the emergency department, according to estimates... In response, entrepreneurs from the Boston-area and across the nation — many with serious allergies themselves — are launching new startups and technologies to help allergy sufferers cope. (Zimmerman, 11/16)

As many as 25% of those infected with the Ebola virus during the recent four-year outbreak in West Africa may have experienced few if any symptoms and lived on without ill effects, new research suggests. Indeed, the immune systems of these people — the telltale sign of their infection — would allow them to withstand reinfection with the Ebola virus. (Healy, 11/15)

The Obama administration was the first to significantly raise the profile of food policy, championing laws and pushing through regulation to make food safer, more nutritious and better labeled. A look at some of those policies, and what may happen to them in a Trump administration. (11/15)

A report released Tuesday by the legislature's internal oversight agency recommends changes in how the state's Medicaid program goes after fraud and waste. The report noted that North Carolina is spending millions of dollars on claim reviews that are not fraudulent, and attorneys aren't able to follow up on many that are. In the 2013-14 fiscal year, for example, the state paid contractors $3.7 million to hunt out fraudulent claims, but the state was able to recover less than $500,000. (Leslie, 11/15)

Delaware’s Department of Health and Social Services is asking state budget officials for $42 million in additional funding to pay for Medicaid and other programs. The $1.22 billion budget request presented Tuesday represents an increase of 3.6 percent over the current year’s budget. It includes $13.3 million for Medicaid, which currently covers some 220,000 people, more than one-fifth of Delaware’s population. (Chase, 11/15)

A judge ruled Tuesday against a restraining order that would have stopped Anthem Blue Cross from switching 500,000 Californians to health insurance plans offering no coverage for out-of-network care. A consumer group had asked the judge for the restraining order after Anthem sent notices saying customers would be automatically switched into plans that paid nothing for doctors and hospitals outside the network if they did not change to another insurer by Dec. 15. (Petersen, 11/15)

A state commission working on ways to reduce the cost of health care in Colorado says greater transparency in pricing would help patients avoid costly doctors’ visits.That is just one of more than a dozen recommendations that the Colorado Commission on Affordable Health Care sent to lawmakers and the governor Tuesday in its second annual report. The commission’s first report, issued last year, found that Coloradans’ spending on health care had quadrupled over the past two decades. This year, the commission held seven public meetings across the state in the hopes of finding ways to control runaway health care costs. (Ingold, 11/15)

Water tests conducted at about 300 public school buildings in Massachusetts this year show that more than half had at least one sample with lead levels above regulatory limits, state officials announced on Tuesday. Steps are being taken to address the problems found in the 164 school buildings by flushing pipes, shutting off drinking fountains or taps, and making long-term plumbing repairs, officials said. (Rocheleau and Andersen, 11/16)

Elevated levels of lead have been discovered in the yards of 11 homes near a closed indoor gun range in south Sacramento’s Mangan Park, city officials said Tuesday. Tests of the soil in 29 yards near the city-owned James G. Mangan Rifle and Pistol Range last month found 11 with lead above the state’s Department of Toxic Substances Control screening level for residences. (Lillis, 11/15)

District of Columbia lawmakers have given final approval to a bill that would allow terminally ill patients to end their own lives with the help of a doctor. The “Death with Dignity” bill was approved Tuesday on an 11-to-2 vote and goes to Mayor Muriel Bowser for her signature. Once the bill becomes law, it will be sent to Congress for review. (Nuckols, 11/15)

South Carolina’s public health agency is holding off on recommending any changes to abortion clinic regulations after being inundated with responses to its drafted proposal. The state Department of Health and Environmental Control confirmed Tuesday the process is delayed indefinitely. It received nearly 460 comments on proposed changes put out in September for public review. (Adcox, 11/15)

Founder's Women's Health Clinic, one of two abortion providers in central Ohio and facing closure because of state requirements, could get a second chance. The Ohio Department of Health on Friday rejected Founder's request for an exception from having a "transfer agreement" with a local hospital for emergency care, a requirement under state law. (Johnson, 11/15)

The leader of a mental health crisis center in Kansas City told legislators Tuesday that the amount of money his facility is saving Kansas hospitals, prisons and jails is nearly double its total budget. Randy Callstrom is president and CEO of Wyandot Inc., a community mental health center that took over the former Rainbow Mental Health Facility state hospital in 2014. Callstrom told the Joint Committee on Corrections and Juvenile Justice that the facility, rebranded as Rainbow Services Inc., or RSI, saved $6 million last year by stabilizing people in crisis who otherwise would have ended up in state hospitals, local emergency rooms or jails and prisons. (Marso, 11/15)

Untreated mental illnesses can lead to repeat encounters with law enforcement. Now, Clermont police are joining forces with the Lake County Sheriff's Office and LifeStream Behavioral Center, the county's mental-health provider, to divert offenders with mental-health problems from the start to therapeutic options rather than the county jail. (Ruiter, 11/16)

Georgia Moore was diagnosed with leukemia the day after her 10th birthday. The fourth-grader began an intense chemotherapy regimen, which left her immune system vulnerable and kept her from attending her small, private Montessori school here. But her younger sister Ivy was in kindergarten at the same school, where a handful of families opted out of vaccinating their children. That meant 6-year-old Ivy might bring home germs that could pose a risk to Georgia. (Casey, 11/16)

Kylie’s [Orr] surgery was performed this year in Florida by Dr. Christopher Iobst, who has since become director of a new Center for Limb Lengthening and Reconstruction at Nationwide Children’s Hospital. The center opened about a month ago and will focus on repairing limb deformities and correcting limb-length discrepancies. Unlike most of Nationwide’s programs, it will offer consultations to adults as well as children. (Viviano, 11/16)

The Conservation Law Foundation is suing the Pease Development Authority over water contamination issues at the former Pease Air Force base in Portsmouth. The Conservation Law Foundation says the Pease Development Authority failed to seek required federal storm water runoff permits from the Environmental Protection Agency. (Moon, 11/15)

The patients here ask about the treatment by name. They’ve seen the crisp, alluring ads on TV and heard the soothing spots on the radio: Harvoni, they know, could cure their hepatitis C. But in this town, carved into the Appalachian mountains, in a state beset by hepatitis C rates seven times the national average, Harvoni and other new hepatitis C drugs remain largely out of reach. Over the past year, only 3 percent of the state’s Medicaid beneficiaries with the disease received treatment. (Joseph, 11/14)

A single sentence in President-elect Donald Trump's health-care platform sends a strong hint to the drug and medical device industry that they may have an easier time getting their products on the market under his administration. “Reform the Food and Drug Administration, to put greater focus on the need of patients for new and innovative medical products,” his health plan states. (Johnson, 11/14)

Donald Trump and his congressional allies are making big plans to repeal the Affordable Care Act and overhaul other government health programs. But the president-elect appears to have downgraded plans to act aggressively to control rising drug prices, handing the pharmaceutical industry an early victory and providing another illustration of the influence of lobbyists on the new Trump administration, despite Trump’s promise to “drain the swamp” of special interests in Washington. (Levey, 11/15)

Americans' growing alarm over rising prescription drug costs will pressure a new U.S. administration and Congress to take action on pharmaceutical pricing, industry executives and healthcare experts say. Drugmaker stocks, battered in recent months, soared this week after Republican presidential candidate Donald Trump's victory. (Beasley and Clarke, 11/11)

Even with a presumably business-friendly president-elect in Donald Trump, drugmakers that have been battered by criticism over high prices in the past year are bracing for Republican and Democratic lawmakers to take aim at the industry. Although Trump’s brief health plan released last week on his transition’s website doesn’t mention drug prices, he has previously voiced support for having the government negotiate prices in Medicare, and allowing the re-importation of cheaper treatments from other countries -- two proposals the pharmaceutical industry has long opposed. (Edney, 11/14)

The nation's largest physician organization is supporting value-based pricing for medications. The American Medical Association Tuesday announced it supports initiatives “aimed at changing the fundamentals of prescription drug pricing without compromising patient outcomes and access.” Its new policy was adopted at the AMA's interim meeting in Orlando, Fla., over the weekend. The AMA says it “seeks to blunt growing pharmaceutical spending rates” by incorporating a balance of benefits and cost when pricing drugs. The organization believes prices should be set by objective, independent agencies that use evidence and data. Processes to set those prices should be transparent, not burden physicians or patients and maintain affordability for patients, according to the AMA. (Rubenfire, 11/15)

Already under investigation by two federal agencies, the pharmaceutical company at the center of the EpiPen controversy is facing another Northern California-based class-action lawsuit over allegations of price gouging. The complaint against Mylan, filed in U.S. District Court in San Francisco last week on behalf of San Francisco resident Robin Kozelka and others affected, said the case arises out of “one of the most shocking and cruelest examples of corporate greed in recent memory.” (Seipel, 11/15)

The rising cost of medicines may be a growing problem for many Americans, but a new survey finds that cost is generally not a key factor when doctors decide which treatments to prescribe their patients. Among six different types of doctors queried, only primary care physicians cited cost as among their most important considerations. Forty-seven percent ranked the issue as a key concern, behind evidence that a drug is safe, effective and well-tolerated. (Ed Silverman, 11/15)

The in-house investigator at HHS has released a list of issues it hopes to tackle in 2017, and it shows a heightened focus on drug costs, an issue that has captivated the nation. The HHS Office of Inspector General released its 2017 Work Plan on Friday, which includes its priorities for HHS agencies like the CMS, the Food and Drug Administration and the National Institutes of Health. The drug price priority comes after intense public backlash over price hikes of drugs like Turning Pharmaceutical's Daraprim and Mylan Pharmaceutical's EpiPen. (Rubenfire, 11/11)

Seeking to defuse a nasty row, Pfizer has lowered the price of its pneumococcal vaccine to non-governmental organizations that supply poor countries. The company will sell the newest version of its Prevnar 13 vaccine for $3.10 a dose, which means the three-dose treatment to vaccinate a child will cost $9.30. (Silverman, 11/11)

The pharmaceutical industry is regularly chastised for failing to do enough to ensure that people in low and middle-income countries have access to its medicines. Yet the real picture is actually more nuanced, according to a newly released report that finds some — but not all — drug makers are making headway. Some companies, for instance, are partnering to develop needed medicines. Others are pledging to waive or abandon patent rights and granting licenses so that generic versions of their drugs become available. (Silverman, 11/13)

The pharmaceutical giant GSK, which has held first place in the Access to Medicine Index ever since its introduction in 2008, was ranked first again this week. The index measures how well the world’s top 20 pharma companies do at getting their drugs and vaccines — and often their scientific expertise — to the world’s poorest countries. (McNeil, 11/13)

Germany may stiffen up its already strict drug pricing rules, a move that could exacerbate the pharma industry’s sometimes-acrimonious relationship with health officials there. Under a proposal now up for debate by lawmakers, Germany would set a 250 million euro ($268 million) ceiling on new drugs for their first year on the market. As Bloomberg reports, price controls would begin after a product hit that limit. (Tracy Staton, 11/14)

President-elect Donald Trump has attempted to be more conciliatory than he was during his campaign, signaling flexibility on some of his most extreme campaign promises. For example, Trump 2.0 has been downright cuddly to pharma after frequently criticizing its pricing practices during his campaign. A health-care plan on his transition website has no mention of high drug prices, with only vague bullet points on supporting innovative research and softening the FDA. Biopharma stocks had plunged this year due partly to fears that a Hillary Clinton presidency might usher in drug-price controls; the Nasdaq Biotech Index was down as much as 26 percent for the year the week before the election. The index spiked 9 percent on the Wednesday after Trump won the election, its biggest jump since 2008. (Max Nisen, 11/15)

After a year of Pharma Bros and EpiPens, we certainly don’t need more proof that Americans are deeply frustrated with prescription drug prices. This frustration is rooted in a simple fact: Though most Americans can afford their medicines, some patients with serious chronic illnesses are struggling to afford their drug co-pays. Fixing that relatively discrete problem — the vast majority of drugs sold today are inexpensive generics that Americans can buy for less than two tickets to their local movie theater — should be the focus of the Trump administration and Congress in 2017. Together, they can not only expand access to more affordable and innovative medicines, but extend American leadership of a vital global industry and generate more high-paying, U.S.-based manufacturing jobs. (Paul Howard, 11/14)

A fact of life in the United States today is that patients suffer when their drug costs are too high.  That’s something on which a vast majority of Americans can agree, regardless of where one falls on the political spectrum.  In fact, according to the Agency for Healthcare Research and Quality, 71 cents of every dollar of healthcare spending goes to treating people with multiple chronic conditions. And it’s time Congress take swift and effective action to reduce the high burden of drug costs to patients. (Quardricos B. Driskell, 11/10)

According to the latest report from the Altarum Institute, "moderate 2016 health spending growth continues a slow downward trend." Unfortunately, this doesn't fit the narrative of those who want to talk about runaway trains -- especially for pharmaceuticals. Here are the numbers: Hospital spending represents 32 percent of American healthcare spending, 20 percent goes to physician and clinical services, 15 percent goes to "other health spending," and 10 percent is for prescription drugs. (Peter Pitts, 11/14)

Trump says he wants to replace Obamacare (most of it, anyway) with some arrangement of longstanding Republican proposals. Those include expanding health savings accounts, which let people set aside money tax-free; letting people buy health insurance across state lines, even if doesn’t comply with their own state’s rules; and creating state-run, high-risk pools of subsidized insurance for people who can’t buy private coverage. ... Those proposals, taken by themselves, aren’t objectionable. The question is whether they amount to a “replacement” of Obamacare. And that question turns on a deeper one about the goal of health-care reform. (11/15)

The Republican president-elect has vowed to move quickly to repeal Obamacare, which he has repeatedly called “a total disaster,” and replace it with a more modest plan. Democrats in the Senate say they'll do their best to block any bill to tear down President Barack Obama’s signature achievement. Before that fight is fully joined, it’s worth reviewing what the law has and hasn’t done to meet its sweeping goals: to give more people health insurance while reshaping a medical system that spends more and delivers less than that of any other wealthy country. (Zachary Tracer, 11/15)

In 2010 President Obama bucked popular opinion and the unanimous opposition of the Republican Party to fundamentally change the U.S. healthcare system by passing the Affordable Care Act (ACA), popularly known as Obamacare. The primary rationale for the legislation was to lower the number of Americans who lacked health insurance coverage. In that regard the ACA was a success — an estimated 20 million Americans have gained health insurance (although the White House had originally predicted 32 million would gain coverage). But an article in the New England Journal of Medicine by one of the legislation’s chief architects, economist Jonathan Gruber, holds an important message for the next president — much of the reduction in the uninsured could have been accomplished without the upheaval of the ACA. (Joel Zinberg, 11/16)

No one knows for sure what President-elect Donald Trump and congressional Republican leaders are going to do about repealing and replacing the Affordable Care Act when they take power in January. But that isn't stopping everyone from speculating non-stop and offering advice. (Harris Meyer, 11/14)

Democrats have been feeling many emotions over the last week — anguish, fear, rage, and despair, for starters. Now that their heads are clearing enough to begin asking themselves how they can mount an effective opposition to Donald Trump and the Republican Congress over the next four years. One of the first tasks is to find a battle to fight. It isn’t enough to just pick up the paper or check the internet in the morning and be horrified at whatever new appointments Trump is contemplating; for Democrats to regain their focus, they need a specific controversy around which they can organize and potentially notch a win. And it looks like they may have found it. I’m speaking of Paul Ryan’s wish to privatize Medicare, or phase it out, depending on how you want to look at it. (Paul Waldman, 11/15)

Value-based care isn’t a new concept. But it’s been used a bit bashfully, traditionally referring to carrot-and-stick-based incentive payments and penalties for physicians. Today these pale in comparison to the fee-for-service care that rewards reactive, episodic, paternalistic care — and lots of it. Here’s what I mean by true value-based care: fully capitated payment contracts in which a lump sum of money is available to treat a patient over the course of a year. No penalties or incentives, simply ownership of the total cost of care and the total cost of outcomes. The better the care, the more money the organization bearing the risk receives. This is how to best reward exceedingly efficient, effective health care. (Chris Storer, 11/15)

Statistics show that one out of every eight or nine of us in Kentucky has diabetes. Tens of thousands more are on track to get it. The crisis here, which is a pandemic around the world, begs for action. Great health care professionals give special care to people and families with diabetes every day. We honor them during this month of diabetes awareness. (Bob Babbage and Stewart Perry, 11/15)

The Florida Department of Health has intimated that, come January, patients who did not previously qualify, but do under Amendment 2, will be able to access medical cannabis very quickly. What remains unclear is both how that will work and if the existing "Dispensing Organizations" — a term that doesn't exist in Amendment 2 — will be able to fulfill even that initial demand. (Michael Bronstein, 11/16)

Like many of my neighbors, I was among the 6.5 million Floridians who voted to legalize medical marijuana on Nov. 8. People suffering from chronic illness should have access to a substance proven to relieve symptoms. As an elected official responsible for protecting the public’s health, quality of life and economy, I believe we must welcome medical marijuana in Miami Beach sensibly and safely. (Ricky Arriola, 11/15)

Congratulations Massachusetts, we just passed one of the worst pot bills in the country. ... Here’s the problem, which my colleague Joan Vennochi also warned about: This is a law written by the marijuana industry, and it’s got their best interests, not ours, in mind. (Shirley Leung, 11/16)

This week, the struggles are apparent at a UCF clinic where psychologists are having remarkable success helping veterans deal with the psychological scars of war — but who fear for the clinic's future. The clinic, you see, is running out of money. (Scott Maxwell, 11/16)