First Edition: February 6, 2017

Kaiser Health News: A Guide To Budget Reconciliation: The Byzantine Rules For Disassembling The Health Law
After capturing the White House, Republicans put repealing the health law at the top of their to-do list. But since they can’t get around a Democratic filibuster in the Senate, they are forced to use an arcane legislative tool called budget reconciliation to disassemble parts of the law. KHN’s Julie Rovner and Francis Ying explain the process. (2/6)

California Healthline: Hoping To Control Health Costs, California Lawmaker Targets Prescription Drug Coupons 
A California lawmaker has introduced a bill that would ban drugmakers from issuing coupons that lower patients’ prescription copayments for certain drugs. The bill by Assembly member Jim Wood, D-Healdsburg, would prohibit distribution of discount coupons for prescription drugs where a cheaper, FDA-approved equivalent exists. (Bartolone, 2/6)

The New York Times: Affordable Care Act Sign-Ups Dip Amid Uncertainty And Trump Attacks
The number of people who signed up for health insurance in the federal marketplace that serves most states dipped this year to 9.2 million, the Trump administration said Friday, as consumers struggled with confusion over the future of the Affordable Care Act. That represents a decline of more than 4 percent from the total of 9.63 million people who signed up through HealthCare.gov at this time last year. (Pear, 2/3)

The Associated Press: 'Obamacare' Sign-Ups Show Slippage In Trump Era
The report doesn't include figures from 11 states that run their own health insurance markets — including California and New York — so the final national number will be higher. But the preliminary report is being closely watched, because President Donald Trump and the GOP-led Congress have vowed to repeal the Obama-era health law and replace it with a plan yet to emerge. (Alonso-Zaldivar, 2/3)

The Washington Post: HealthCare.Gov Suffers First Enrollment Decline As GOP Works To Kill The ACA
The absence of the customary deadline surge “could very well be the result of tremendous confusion and uncertainty surrounding the future of the health law, as well as the last-minute pulling of some outreach advertising,” said Larry Levitt, senior vice president of the Kaiser Family Foundation. (Goldstein, 2/3)

Los Angeles Times: Final Obamacare Enrollment Figures Lag Under Trump
[T]he dramatic drop-off in the last two weeks fed rising criticism that the Trump administration is sabotaging the marketplaces to strengthen its political argument that the law must be scrapped. “There is no doubt that enrollment would have been even higher if not for the uncertainty caused by political attacks on the law, and the Trump administration’s decision not to provide consumers with all of the resources and support available to help them enroll,” said Anne Filipic, president of Enroll America, which helps consumers sign up for coverage. (Levey, 2/3)

The Wall Street Journal: About 9.2 Million Americans Sign Up For Health Plans On Federal Exchange
The figures are likely to further fuel the fight over the effectiveness of the health law known as Obamacare—with opponents pointing to the declining year-over-year enrollment as a sign of the law’s failure, and supporters saying the law succeeded at expanding coverage to broad swaths of the population, with an estimated 22 million people gaining coverage through the exchanges and the expansion of Medicaid. (Hackman, 2/3)

Politico: Obamacare Sign-Ups Fall Short After Slow Finish
Opponents of the law said the latest figures are further evidence that the health care law is falling apart. “Enrollment numbers are down and costs are up. These cost hikes are exactly the reason why Republicans are committed to repealing and replacing Obamacare,” Sen. Orrin Hatch, chairman of the Senate Finance Committee, said in a statement Friday. (Pradhan, 2/3)

The New York Times: Trump Says Health Law Replacement May Not Be Ready Until Next Year
President Trump said in an interview that aired on Sunday that a replacement health care law was not likely to be ready until either the end of this year or in 2018, a major shift from promises by both him and Republican leaders to repeal and replace the law as soon as possible. (Landler, 2/5)

Politico: Trump: Obamacare Replacement Might Take A Year
President Donald Trump walked back his recent vow that Obamacare would be replaced in short order, telling Fox News’ Bill O’Reilly that the process is “complicated” and “maybe it’ll take till sometime into next year.” "It statutorily takes a while to get," Trump said in a wide-ranging interview that aired Sunday during the Super Bowl pre-game show. "We’re going to be putting it in fairly soon, I think that yes I would like to say by the end of the year at least the rudiments, but we should have something within the year and the following year." (Palmeri, 2/5)

Politico: Tom Price Has His Finger On The Obamacare Destruct Button
Tom Price spent years railing against Obamacare. Now he’ll finally have sweeping power to do something about it.The Georgia Republican congressman is on the verge of becoming the Trump administration’s top health care official, armed with broad authority to begin unwinding Obamacare by using as much executive power as possible, even as Congress struggles to find consensus on a plan to repeal and replace the health care law. First, he could ax Obamacare's mandate ensuring coverage for contraception and give insurers more latitude to determine which health benefits they will — and won’t — pay for. Those changes will likely be paired with stricter monitoring of Obamacare enrollees, as the administration aims to win over jittery health plan executives with policies that prioritize insurance market predictability and profitability. (Cancryn, 2/6)

The Associated Press: GOP Mulls 'Repairing' Obamacare Law It Vowed To Repeal
Republicans are increasingly talking about repairing President Barack Obama's health care overhaul, a softer tone that comes as their march to fulfill a keystone campaign promise encounters disunity, drooping momentum and uneasy voters. GOP lawmakers insist they haven't abandoned their goal of repeal, though they face lingering disputes about whether that should come before, after or simultaneously with a replacement effort. (2/3)

The Associated Press: House GOP Lawmakers Face Tough Questions On Health Care
Angry constituents confronted Republican lawmakers at separate town halls in California and Florida, fearful of the GOP promise to repeal former President Barack Obama’s health care law without a comprehensive alternative. In California, Rep. Tom McClintock faced tough questions on Saturday about health care and President Donald Trump’s agenda and had to be escorted by police after his hour-long event. Protesters followed him, shouting “Shame on you!” In an equally conservative district in Florida, Rep. Gus Bilirakis answered questions from frustrated town hall attendees who worried about the loss of insurance and higher premiums if the law is repealed. (2/5)

Politico: Republicans Face Anger Over Obamacare Repeal During Town Halls
In Pinellas County, Fla., Gus Bilirakis, who represents a district Trump won, was on the defensive as voters packed a town hall on Obamacare. For more than two hours, Bilirakis listened to stories from his constituents — young, old, black and white — who implored him to not repeal the federal health care law without having a replacement ready. “To take away the Affordable Care Act is taking away my freedom and justice,” said Evan Thornton, a 21-year-old St. (Colliver, 2/4)

NPR: Health Insurers Say They Don't Want To Go Back To Being The Bad Guys
President Donald Trump and other Republican leaders have been working to repeal and replace the Affordable Care Act. And the millions of Americans who have health insurance through the Obamacare marketplaces aren't the only ones wondering about their fate. Leaders of insurance companies are, too. (2/3)

The Wall Street Journal: Hospitals Fear Changes To Health Law, Press GOP On Revenue Concerns
Hospital executives are descending on Washington with a message: They are concerned about losing insured patients and revenue under any plan to dismantle or significantly alter the Affordable Care Act. In a flurry of recent meetings, the executives have told lawmakers they don’t want Americans to lose insurance under any alternative the Republicans devise for the Affordable Care Act. If that happens, however, hospitals say they want Congress to restore billions of dollars in federal funding they lost when the ACA took force. (Evans, 2/5)

The New York Times: Trump’s F.D.A. Pick Could Undo Decades Of Drug Safeguards
President Trump’s vow to overhaul the Food and Drug Administration could bring major changes in policy, including steps to accelerate the process of approving new prescription drugs, setting up a clash with critics who say his push for deregulation might put consumers at risk. (Thomas, 2/5)

Los Angeles Times: Trump And Congress May Make It Easier To Get Drugs Approved — Even If They Don’t Work
In June, pharmaceutical giant Genentech sent doctors a letter saying they should no longer prescribe a blockbuster drug called Tarceva to most patients suffering from lung cancer. A study had found that only a small number of patients —  those with a certain gene mutation —  might be helped by the drug, the company said.The news upended a 2010 decision by the Food and Drug Administration to greatly expand use of the $94,000-a-year drug, despite warnings from a panel of experts that said there was little evidence it actually worked. (Petersen, 2/3)

The Washington Post: What CEOs Say Happened In Trump’s Closed-Door Meeting With Big Pharma
Since the early days of his campaign, President Trump vocally criticized rising drug prices. Occasionally, he faulted the government's inability to negotiate directly on drugs purchased through Medicare, a practice prohibited by law. But in a meeting Tuesday with pharmaceutical executives, Trump's words were less clear. The executives say, behind closed doors, Trump never brought up government intervention on drug pricing. Meanwhile, Trump's public remarks were loaded with conflicting signals. (Johnson, 2/3)

NPR: Heat, Humidity And Aging Make Medicine Less Potent
Most of us have reached for a painkiller, at one time or another, only to discover the date on the label shows it's expired. But what does an "expiration" date on medicine really mean? Is it dangerous if you take it anyway? Less effective? It turns out that date stamped on the label actually means a lot. It's based on scientific evidence gathered by the manufacturer showing how long the drug's potency lasts. (Neighmond, 2/6)

The New York Times: His Doctors Were Stumped. Then He Took Over.
They called him the Beast.David Fajgenbaum was the fittest of his friends at the University of Pennsylvania’s medical school, a 6-foot-3 gym addict and former quarterback at Georgetown. His mammoth hands seemed more suited to spiraling footballs than the fine fingerwork a doctor-in-training might need. He had endurance to match, taking multiple hits and returning to the field to play on. ... In July 2010, that all changed. (Thomas, 2/4)

NPR: Test For Rare Brain Disease Might Lead To Earlier Diagnosis Of Parkinson's, Alzheimer's
By the time Kay Schwister got her diagnosis last summer, she couldn't talk anymore. But she could still scowl, and scowl she did. After weeks of decline and no clue what was causing it, doctors had told Schwister — a 53-year-old vocational rehab counselor and mother of two from Chicago — that she had an incurable disease called Creutzfeldt-Jakob disease, or CJD. The disease was shrinking Kay's brain, and riddling it with holes. She would likely only live a few more weeks, the doctors said. (Bichell, 2/6)

The Associated Press: Wisconsin Fines 22 Hospitals Over Not Offering Emergency Contraception To Rape Victims
Wisconsin has fined 22 hospitals in recent years for not complying with a law requiring them to offer emergency contraception to rape victims. The 2008 law requires emergency rooms to give sexual assault victims information about the so-called “morning-after pill,” to provide the drugs on request, and to train staff about the drugs. (2/5)

Nashville Tennessean: For Small-Town Tennessee Judge, Opioid Crisis Is Personal
Judge Duane Slone has observed the arc of the opioid crisis firsthand since painkiller addiction began taking hold of lives in the rural northeast Tennessee counties he serves. Serving as a drug prosecutor in the 1990s before becoming circuit judge in 2009, Slone routinely jailed addicts who committed petty crimes to support their habits. That included pregnant women.  "How in the world could someone who has a child in her be addicted to drugs?” he remembers thinking. ... Then when a family friend asked Slone and his wife in 2011 to adopt a baby born with withdrawal symptoms, the crisis reached his home. (Wadhwani, 2/5)