First Edition: March 20, 2017

Kaiser Health News: Report: Fired U.S. Attorney Was Probing Tom Price’s Stock Trades
Preet Bharara, a former top federal prosecutor in Manhattan, was investigating stock trades by Health and Human Services Secretary Tom Price prior to Bharara’s ouster last week by President Donald Trump,  ProPublica reported Friday. The report, attributed to an unnamed person familiar with the U.S. Attorney’s Office of the Southern District of New York, revived questions about the propriety of Price’s investments in numerous health care companies that stood to benefit from legislation he voted for and sponsored as a Georgia congressman. Those concerns have dogged the former congressman since Trump nominated him to head HHS last November. (Kopp and Bluth, 3/17)

Kaiser Health News: Researchers Call Trump’s Proposed NIH Cuts ‘Shocking’
An estimated $5.8 billion in cuts to the National Institutes of Health in President Donald Trump’s proposed budget has California’s top universities and medical institutions sounding the alarm. Trump’s spending plan — running into opposition from Republicans and Democrats alike — would cut about 20 percent of the roughly $30 billion budget of the nation’s medical research agency that supports research on cancer, Alzheimer’s disease, Zika and other conditions. Research institutions nationwide decried the cuts as potentially devastating to their work. (Korry, 3/17)

The Associated Press: Ryan: More Help For Older People Needed In GOP Health Bill
Days before a pivotal vote, House Speaker Paul Ryan said Sunday he will seek changes to a GOP health care bill to provide more help to older people. The new willingness to compromise was a bid for more support from moderate Republicans, who expressed continuing unease about the plan to replace Barack Obama's health law unless significant changes were made. (3/19)

The Washington Post: House Health-Care Bill Will Change To Offer More Help To Seniors, Ryan Says
“We think that we should be offering even more assistance than what the bill currently does,” Ryan (R-Wis.) said in a “Fox News Sunday” interview, in which he confirmed that House leaders are eyeing a Thursday vote on its passage. Meanwhile, a key conservative senator said White House officials were continuing to negotiate through the weekend on even more dramatic revisions to the bill in hopes of winning over hard-liners who have threatened to tank the legislation. (DeBonis, 3/19)

The Wall Street Journal: Ryan Confident About Health Plan’s Passage, After Change To Help Seniors
House Speaker Paul Ryan on Sunday expressed confidence that the Republican health-care plan will pass the House later this week, saying his party’s lawmakers are working to make changes to the bill to address remaining concerns, including providing more assistance to older Americans. “I feel very good about it. This is exactly where we want to be,” the Wisconsin Republican said in an interview with “Fox News Sunday.” (Hayashi, 3/19)

Politico: Ryan: Health Care Bill Must Do More For Older People
Ryan's comments came in the wake of a Congressional Budget Office analysis showing that older people could pay higher premiums under the GOP bill. Ryan expressed skepticism about the CBO analysis but said his leadership team is looking at more ways to help older people under the new plan. (Kullgren, 3/19)

The Wall Street Journal: Key Bloc Of Conservative Lawmakers Endorse GOP Health Plan
The House Republican health-care plan picked up an important endorsement on Friday from leaders of a large bloc of conservative lawmakers, after President Donald Trump backed more stringent curbs on funding for Medicaid, as well as work requirements for its low-income beneficiaries. (Radnofsky, Hackman, Peterson, 3/17)

NPR: Trump Faces Critical Phase, As He Tries To Make His Rhetoric Reality
Donald Trump likes to move fast. But to this point, for all the bravado, executive actions and tweets, much of Trump's presidency has been showy without a lot of practical effect. For that to change, much of it could depend on the next three weeks. This critical phase could set his ambitious agenda on course or derail it. (Montanaro, 3/20)

Politico: White House Squeezes GOP Hard-Liners As Obamacare Vote Nears
During a meeting at Donald Trump’s Mar-a-Lago estate in Florida Saturday, the president’s top advisers told three of the most vocal conservative opponents of the bill — Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah) and House Freedom Caucus Chairman Mark Meadows (R-N.C.) — that they agree with some of their demands in principle, according to several sources familiar with the discussions. But it’s also become increasingly apparent to the White House that the conservatives’ requests, which include phasing out Obamacare’s Medicaid expansion earlier and deregulating the insurance industry, are unlikely to pass the Senate. (Bade, Dawsey and Everett, 3/19)

Politico: Cruz: I Negotiated Health Care At Mar-A-Lago
Sen. Ted Cruz said Sunday he spent three hours at the Mar-a-Lago estate of his former rival on Saturday, negotiating with President Donald Trump's team on changes to the Republican health care bill. (Kullgren, 3/19)

The New York Times: States Could Make Work A Medicaid Requirement Under G.O.P. Deal
President Trump and conservative lawmakers in the House agreed Friday to significant changes to Medicaid that could impose work requirements on able-bodied Medicaid beneficiaries in some states and limit federal funds for the program, as Republican leaders tried to rally balking lawmakers behind legislation to repeal the Affordable Care Act. “I want everyone to know, I’m 100 percent behind this,” Mr. Trump said at the White House, where he met with House members in the conservative Republican Study Committee. (Kaplan and Pear, 3/17)

The Associated Press: Republicans At Odds Over How To Overhaul Medicaid
The future of Medicaid could become a pivotal issue as the health care debate moves to the Senate. Kevin Smith, a spokesman for Sen. Rob Portman, R-Ohio, said his boss "shares (governors') concerns about the need to protect the Medicaid expansion population and give governors more flexibility to ensure they can design programs that meet the needs of their states." (3/18)

The Washington Post: Republicans Threaten To Deny Poor People Medical Care If They Aren’t Working
Many forms of public assistance, including food stamps, require recipients to work, look for work, volunteer or participate in vocational training. The work requirements vary from one program to the next and have varying requirements vary by the program and traits of the recipients, such as their ages and whether they have children. Yet when it comes to health insurance, such requirements would be nearly impossible to enforce, conservative and independent experts on the Medicaid program said Friday. (Ehrenfreund, 3/18)

The Washington Post: Trio Of GOP Proposals Would Overhaul Medicaid Dramatically, Starting With Job Requirement
Its Medicaid recommendations further highlighted the ideological cross-pressures on Ryan — and the Trump administration — in forging a set of Republican health policies that might pass both the House and the Senate. While the committee is trying to nudge the program toward the right, moderate GOP governors and senators are fighting to ward off the loss of millions of dollars in federal aid to the 31 states, plus the District of Columbia, that expanded their Medicaid programs. (Goldstein and Eilperin, 3/17)

The Associated Press: Republican Health Care Plan Creates Budget Problems For GOP
Republicans intent on scrapping Barack Obama's Affordable Care Act have a budget problem. As it turns out, repealing and replacing the law they hate so much won't save nearly as much money as getting rid of it entirely, the goal they've been campaigning on for seven years. That means trouble for the federal deficit and for Congress' fiscal conservatives who repeatedly warn about leaving their children and grandchildren worse off financially. (Taylor, 3/18)

The Wall Street Journal: Four Republican Governors Voice Opposition To House GOP Health-Care Legislation
Four Republican governors have announced their opposition to the House GOP legislation to replace the Affordable Care Act, another sign of the political challenges facing the bill. (Hackman, 3/17)

The New York Times: On Health Law, G.O.P. Faces A Formidable Policy Foe: House Republicans
Halfway through Congress’s 2013 summer recess, a letter landed on the desks of House Republican leaders demanding a new strategy to fight “one of the largest grievances in our time.” Give Congress the option to defund the Affordable Care Act, it said, or risk shutting down the government. Republican leaders condemned the idea, and the 80 House Republicans who signed the letter acquired a nickname, courtesy of the conservative commentator Charles Krauthammer — the “suicide caucus.” (Huetteman, 3/20)

The New York Times: G.O.P.’s Health Care Tightrope Winds Through The Blue-Collar Midwest
James Waltimire, a police officer on unpaid medical leave, has been going to the hospital in this small city twice a week for physical therapy after leg surgery, all of it paid for by Medicaid. Mr. Waltimire, 54, was able to sign up for the government health insurance program last year because Ohio expanded it to cover more than 700,000 low-income adults under the Affordable Care Act. He voted for President Trump — in part because of Mr. Trump’s support for law enforcement — but is now worried about the Republican plan to effectively end the Medicaid expansion through legislation to repeal the health care law. (Goodnough and Martin, 3/19)

Politico: How To Fix Obamacare With This One Amazing Trick
One simple way to fix Obamacare is to do something that no one is willing to do: Kick hundreds of thousands of young, mostly healthy Americans off their parents’ coverage. Obamacare allowed young adults to stay on their parents’ plans until they turn 26. It’s a wildly popular feature and a successful one. The uninsured rate for 18- to 25-year-olds has dropped by more than 50 percent since 2010 — a steeper decline than for any other age group. Taking away this provision of the law — even though it might help stabilize the broader health system — is politically toxic to both Democrats and Republicans because it would antagonize millions of middle-class voters. (Demko and Cancryn, 3/19)

Politico: GOP Assault On Obamacare Rattles Workers In California's 'Gig Economy'
Republican plans to scrap Obamacare and roll back its Medicaid expansion are sending tremors through the burgeoning "gig economy" — and nowhere more so than in California. With the Silicon Valley and on-demand companies like Lyft and Uber in its backyard, the Bay Area will be a laboratory for determining whether repeal efforts shift employment away from temporary jobs and startups into more traditional employment — potentially dampening innovation. (Colliver, 3/18)

NPR: How Millennials Lose And Win Under The GOP Health Bill
Designing skateboards is just one of Luke Franco's gigs. He has just enough time before his next shift to chat at a café in downtown Providence, R.I. "I work at the YMCA Monday through Friday with kindergartners through fifth graders. It's split shift; seven to nine, two to six daily," he says. "With the rest of my day, I also work at a local pizza place. And in addition to that, I also own and operate a small skateboard company." (Gourlay, 3/19)

Politico: Brat: 'There's Primaries Coming' Off Obamacare Repeal
If he were still Professor Dave Brat, he’d call the course he might teach about the last couple of months in Washington, “A Primer in Chaos Theory.” But he’s Congressman Dave Brat, and instead he’s been sowing some of that chaos himself. And he’s nowhere near done helping lead the intra-Republican revolt against the Obamacare repeal bill pushed hard by House Speaker Paul Ryan and President Donald Trump. He's already predicting conservative insurgents will primary GOP incumbents over the health care fight. (Dovere, 3/20)

The Associated Press: With Friends Like These: Trump Struggles To Win GOP
Congressional Republicans have a lot to say about their new president. Donald Trump's proposed budget is "draconian, careless and counterproductive." The health care plan is a bailout that won't pass. And his administration's suggestion that former President Barack Obama used London's spy agency for surveillance is simply "inexplicable." With friends like these, who needs Democrats? (Lerer, 3/18)

Politico: Ryan Stakes It All On Obamacare Repeal
Speaker Paul Ryan and President Donald Trump — those awkward, sometimes reluctant allies — face the biggest test yet of their unusual relationship as the House barrels toward a dramatic vote this week on repealing and replacing Obamacare. The stakes could not be higher for either of them. (Bresnahan and Bade, 3/20)

The Washington Post: An Architect Of The ACA Is Now Advising Trump As GOP Works To Level The Law
When bioethicist and oncologist Ezekiel Emanuel meets with President Trump at the White House on Monday, the session will reveal publicly what has been happening privately for months: A trusted ally of former president Barack Obama and chief architect of the Affordable Care Act is trying to help steer how Republicans rework it. (Eilperin and Goldstein, 3/20)

Reuters: Republican Healthcare Bill Would Harm State Finances: Moody's
The Republican-proposed bill to replace Obamacare would be a credit negative for U.S. states, according to Moody's Investors Service, because it would shift a greater share of the cost of Medicaid to the states. The bill, known as the American Health Care Act, aims to replace the Affordable Care Act, commonly known as Obamacare. (Respaut, 3/17)

The Associated Press: For Many Older Americans, Costs Rise Under GOP Health Plan
Among the groups hardest hit by the Republican plan to replace the Affordable Care Act is one that swung for Donald Trump during last year's presidential race — older Americans who have not yet reached Medicare age. Many of those who buy their own health insurance stand to pay a lot more for their coverage. That is especially true for the nearly 3.4 million older Americans who have enrolled through the government marketplaces, many of whom receive generous federal subsidies through the health care law enacted under former President Barack Obama. (3/19)

The Associated Press: Chaffetz' IPhone Gaffe Lands Him Well-Funded Utah Challenger
Rep. Jason Chaffetz has strolled to four easy re-election wins in his Republican-friendly Utah congressional district, but now he's facing a surprising challenge from a Democratic political newcomer who raised nearly a half million dollars — by tapping into anger over Chaffetz' recent comment suggesting people should spend their money on health insurance instead of iPhones. Dr. Kathryn Allen has been transformed from a political unknown into a liberal hero for calling out Chaffetz on Twitter, giving her an early boost in name recognition ahead of the November 2018 election. (McCombs, 3/17)

The Washington Post: Four Former FDA Commissioners Denounce Drug Importation, Citing Dangers To Consumers
The four most recent Food and Drug Administration commissioners are warning Congress that legalizing the importation of drugs from other countries — an idea that has drawn support from both Bernie Sanders and Donald Trump — is a risky approach that would endanger consumers by exposing them to fake, substandard and contaminated drugs. (McGinley, 3/17)

The Associated Press: Mayo Clinic Faces Questions After CEO Comments On Insurance
John Noseworthy's comments were made late last year in a videotaped speech to staff but surfaced only this week after a transcript of his speech was obtained by the Star Tribune newspaper. The Mayo Clinic has verified the transcript is accurate. Noseworthy said in a statement Friday that medical need will always be the top factor in scheduling an appointment. (Forliti, 3/17)

The Associated Press: Court Blocks Law That'd Close State's Only Abortion Clinic
A federal court on Friday permanently blocked Mississippi's law that threatened to close the state's only abortion clinic by setting a hospital-privileges requirement the clinic couldn't fulfill. The ruling comes eight months after the U.S. Supreme Court blocked a similar law in Texas. In a statement, Center for Reproductive Rights President and CEO Nancy Northup called the ruling the latest victory for women's health and rights. (3/17)