Viewpoints: Taking Stock Of The GOP Repeal-Replace-Repair Effort; Anti-Vaxxers See A Friend In President Trump

The Washington Post: Republicans Suddenly Realize Burning Down The Health-Care System Might Not Be A Great Idea
The Republican effort to repeal the Affordable Care Act is not going well, in large part because it turns out that making sweeping changes to a system that encompasses one-sixth of the American economy turns out to be rather more complicated than they imagined. Their backtracking has an interesting character to it, in particular how they’ve been gobsmacked by the transition from shaking their fists at the system to being responsible for it. (Paul Waldman, 2/22)

JAMA Forum: Replacing ACA Would Harm Economically Vulnerable Persons And The Health Care Safety Net
The US Congress recently took its first steps toward repealing the Affordable Care Act (ACA). The Congressional Budget Office projected that repeal would increase the number of uninsured by 18 million people initially, and by 27 million after funding for Medicaid expansion and subsidies are eliminated. Repealing the ACA also threatens the safety net critical to health care access for economically vulnerable individuals and families. (Roy Grant, 2/20)

The Washington Post: Under Trump, Obamacare’s Medicaid Enrollments May Actually Go Up
Much of the media coverage and public political battle has focused on regulations and subsidies that impact middle America and those with coverage. The program targeted at the poor — Medicaid —has received less attention but demands more. For now, it looks as if the Republican Congress will end up leaving the structure of Obamacare’s expanded Medicaid program intact and that Tom Price — President Trump’s secretary of health and human services — will use his administrative powers to grant states greater discretion in running their Medicaid programs. (Timothy Callaghan and Lawrence R. Jacobs, 2/22)

Modern Healthcare: Fierce Medicaid Critic Joins Trump's ACA Repeal Team
A fierce critic of Medicaid expansion has joined the White House team working on repealing and replacing the Affordable Care Act. White House staffers are expected to play a key role in helping craft the upcoming budget reconciliation bill to repeal and replace the ACA. One of those key aides is Brian Blase, who recently left the conservative Mercatus Center at George Mason University to serve as health policy adviser to Gary Cohn, director of President Donald Trump's National Economic Council and former president of Goldman Sachs. (Harris Meyer, 2/22)

The New York Times: The Anti-Vaccine Movement Gains A Friend In The White House
Vaccine opponents, often the subject of ridicule, have found fresh energy in the election of a president who has repeated discredited claims linking childhood immunizations to autism and who has apparently decided to pursue them. With President Trump’s support, this fringe movement could win official recognition, threatening lives and making it urgent that health officials, educators and others respond with a science-based defense of vaccines. Vaccines have saved lives by protecting children and adults from diseases like measles, polio, smallpox, cervical cancer and whooping cough. And there is no evidence whatsoever that vaccines or a preservative used in flu shots cause autism. (2/23)

JAMA Forum: Vaccines And The Trump Administration
Writing recently in the New York Times, infectious disease physician Peter Hotez warned: “It’s looking as if 2017 could become the year when the anti-vaccination movement gains ascendancy in the United States and we begin to see a reversal of several decades in steady public health gains. The first blow will be measles outbreaks in America.” (Joshua M. Sharfstein, 2/22)

Stat: Scientists Can’t Cower In The Face Of Trump Policies That Threaten Research
Fear of speaking and debating openly on controversial issues and inquiry is antithetical to science. So it has been chilling for me to listen to the fear expressed by medical students, resident physicians, faculty members, and administrators engendered by Trump’s actions. I’ve heard medical students say they are worried about speaking out because they might be branded as “activists” by residency programs. Faculty members worry about how their opposition to the Trump agenda may be perceived by philanthropists who fund their work. Administrators fear overstepping the line in response to Trump and struggle to balance supporting their staff’s concerns about how new policies affect their colleagues and families while avoiding perceived political conflict. (Duncan Maru, 2/22)

JAMA: Revamping the U.S. Federal Common Rule: Modernizing Human Participant Research Regulations
On January 19, 2017, the Office for Human Research Protections (OHRP), Department of Health and Human Services, and 15 federal agencies published a final rule to modernize the Federal Policy for the Protection of Human Subjects (known as the “Common Rule”).1 Initially introduced more than a quarter century ago, the Common Rule predated modern scientific methods and findings, notably human genome research. (James G. Hodge and Lawrence O. Gostin, 2/22)

The Washington Post: A Health-Care Change That Could Prove Catastrophic
While a handful of high-profile policy questions have preoccupied Americans since the election, one potentially catastrophic health-care change has quietly been taking shape without much media attention. The Accreditation Council for Graduate Medical Education — the professional body charged with overseeing the nation’s physician training programs is poised to eliminate the 16-hour limit on work shifts for first-year resident physicians (referred to as interns) that it implemented in 2011. It proposes allowing interns to return to working extreme shifts of 28 hours — twice each week. (Christopher P. Landrigan and Charles A. Czeisler, 2/22)

Bloomberg: That Free Health Tracker Could Cost You
Using big data to improve health might seem like a great idea. The way private insurance works, though, it could end up making sick people -- or even those perceived as likely to become sick -- a lot poorer. Suppose a company offers you an insurance discount and a free FitBit if you agree to share your data and submit to a yearly physical. You're assured that the data will be used only in aggregate, never tied back to specific identities. If that makes you feel safe, it shouldn’t. (Cathy O'Neil, 2/23)

The Washington Post: If Abortion Rights Fall, LGBT Rights Are Next
We represent the organizations that won leading Supreme Court cases in recent years on sexual and reproductive rights: Obergefell v. Hodges in 2015, which secured legal protections for the marriage of same-sex couples, and Whole Woman’s Health v. Hellerstedt in 2016, which struck down Texas’s attempt to use sham health regulations to shut down 75 percent of the state’s abortion clinics. President Trump has taken sharp aim at the rights affirmed in those cases. During the campaign, he attacked the Obergefell opinion and repeatedly and unambiguously promised to put justices on the Supreme Court who would overturn Roe v. Wade. According to the president, it’s the government, not each individual, that should hold the power to decide who can get married and whether women can terminate a pregnancy. (Nancy Northup and Rachel B. Tiven, 2/22)

The Des Moines Register: Lawmakers, You Still Owe Us For Illegal Health Plans
Iowa Code allows state lawmakers to enroll in health insurance plans offered to executive branch employees “excluded from collective bargaining.” Those workers pay 20 percent of the total cost of their monthly premium. A few weeks ago, The Des Moines Register reported that legislators are instead enrolled in health plans negotiated by unions on behalf of union-covered state employees. Many lawmakers are paying as little as $20 in monthly premiums when they should be paying hundreds of dollars. (2/22)

Louisville Courier-Journal: Dangers Lurking In E-Cigs
During my nursing career, I have come across numerous heroes, but my first was Surgeon General Everett Koop. More than 50 years ago, he published the first report on Smoking and Health. ... Today, my new hero is another Surgeon Gen. Vivek Murthy, who released the first report on E-cigarette Use Among Youth and Young Adults in December 2016. We now have data and ammunition to halt the debate that e-cigarettes are harmless. The report lays out in clear, indisputable terms that e-cigarette use increases the risk of nicotine addiction, harm to brain development and future use of other tobacco products for young users. (Janie Heath, 2/22)

The Washington Post: Helmets Save Lives So Why Don’t All States Require Them?
A new report from the World Health Organization suggests we’ve made some progress in reducing traffic fatalities through seat belt laws, improved highway and vehicle design, and campaigns to reduce drunk or drug-impaired driving. But motorcycles are bucking the trend, even in the world’s wealthiest and most developed countries, including the United States. (Fredrick Kunkle, 2/22)

Stat: Global Health Is An Investment We Can't Afford To Pass Up
More than at any time in history, good health for all is a real possibility. The technology, scientific advancement, and remarkable understanding of disease now available to the medical and nursing community show the progress we have made. As a career physician, I have seen modern medicine rescue people from the brink of death with the power of machines, medicines, and smart minds. The successes aren’t just in developed countries — they’re global. For example, the number of people newly infected with HIV around the world has stopped growing. There are now 18.2 million people undergoing treatment for HIV, up from 15.8 million in the last year alone. Equally encouraging, new infections in children are down 50 percent since 2010. (Vanessa Kerry, 2/22)