First Edition: March 3, 2017

Kaiser Health News: For New Medicaid Patients, The Doctor Is In (Generally). But You May Have To Wait.
More than 14 million adults have enrolled in Medicaid since the health law passed, and that has caused some hand-wringing over whether there would be enough primary care providers to meet the demand. But a study out this week suggests that the newly insured people are generally able to get timely appointments for primary care. (Andrews, 3/3)

Kaiser Health News: State Fires Contractor After Problems Put California HIV Patients At Risk
California’s public health department Wednesday fired the contractor responsible for enrolling patients in a state-run AIDS program, saying its poor performance threatened enrollees’ access to life-saving medications. The state announced it had terminated the contract with A.J. Boggs & Company because of several “material breaches,” including the failure to keep an online enrollment portal working properly. (Gorman, 3/3)

California Healthline: California Medical Board President Faces Questions Over Vote In Sexual Misconduct Case
The president of the Medical Board of California is facing questions from critics about a business deal he struck after the board decided to reinstate the license of a doctor who engaged in sexual misconduct with patients. In 2012, Dr. Dev GnanaDev, new to the board and not yet president, was part of a disciplinary panel that voted to reinstate Dr. Hari Reddy. The Victorville family physician had lost his license in 2003 after the board found he had engaged in sexual misconduct with four female patients, including a minor. (Gold, 3/3)

The Washington Post: House Leaders Forge Ahead With Health Bills, Hoping To Bulldoze Internal Strife
Key House committees are set to take up legislation to repeal and begin replacing the Affordable Care Act next week, with Republican leaders intent on overcoming internal GOP debates to quickly deliver on a central campaign promise. Those intraparty struggles were highlighted Thursday when a Republican senator joined Democrats in calling for more transparency in the legislation’s drafting and suggested that House leaders were keeping details under wraps to sideline conservatives. (DeBonis, 3/2)

The Washington Post: Conservative Groups And Lawmakers Demanding ‘Full Repeal’ Could Derail Obamacare Rollback
An array of conservative lawmakers, organizations and activists are demanding a swifter and more aggressive remake of the Affordable Care Act than many Republicans are comfortable with, raising questions about whether President Trump and the GOP are headed toward gridlock as they try to fulfill their promise to repeal the health-care law. Three conservative senators known for bucking GOP leadership during Barack Obama’s presidency — Ted Cruz (Tex.), Rand Paul (Ky.) and Mike Lee (Utah) — are raising the possibility of doing the same under Trump. (Weigel, Sullivan and DeBonis, 3/2)

Politico: House Leaders: Obamacare Repeal Will Pass This Month
Take it to the bank, GOP leaders are all but declaring: The House will vote to repeal and replace by the end of this month. Their confidence, coming after months of dead ends and false starts, is fueled by the belief that President Donald Trump has their back — even if some conservatives currently don't. (Bade, Cheney and Bresnahan, 3/3)

The Washington Post: Paul Ryan’s Feeling Confident About Repeal-And-Replace. McConnell Not So Much.
With each passing day, House Speaker Paul D. Ryan gets more confident that his troops are falling in line and that they will soon pass legislation repealing the Affordable Care Act. “I am perfectly confident that when it’s all said and done, we are going to unify,” Ryan (R-Wis.) told reporters Thursday. “Because we all — every Republican — ran on repealing and replacing [the ACA]. And we are going to keep our promises.” Yet over in the Senate, Majority Leader Mitch McConnell (R-Ky.) is much more circumspect. “The goal is for the administration, the House and the Senate to be in the same place,” McConnell told reporters Tuesday. “We’re not there yet.” (Kane, 3/2)

The Associated Press: GOP Health Bill: Less Government; But What About Coverage? 
Health insurance tax credits, mandates, taxation of employer coverage, essential benefits. Mind-numbing health care jargon is flying around again as Republicans move to repeal and replace the Obama-era Affordable Care Act. It’s time to start paying attention. The GOP plan emerging in the House would mean less government, and many fear that will translate to less coverage and a step backward as a nation. Still, there would be new options for middle-class people who buy their own policies but don’t now qualify for help under the ACA. Some popular provisions such as allowing young adults to stay on a parental plan remain untouched. (Alonso-Zaldivar, 3/3)

The New York Times: G.O.P. Accused Of Playing ‘Hide-And-Seek’ With Obamacare Replacement Bill
It was “find the Affordable Care Act replacement” day on Thursday as publicity-seeking Democrats — and one frustrated Republican — scampered through Capitol corridors, hunting for an elusive copy of a bill that Republican leaders have withheld from the public as they search for party unity. Just a week before two powerful House committees plan to vote on the measure, opponents spent hours making the point that almost no one has actually seen legislation that would affect the lives and pocketbooks of millions of Americans. (Pear, 3/2)

The Associated Press: GOP, Dem Foes Of Health Care Bill In Scavenger Hunt For Copy
Where’s the Republicans’ embryonic health care bill? A maverick GOP senator and top Democrats staged made-for-TV scavenger hunts across the Capitol on Thursday for a draft of the measure, momentarily overshadowing months of labor by Republicans out to reshape the nation’s health care system. Their goal: embarrass Republican leaders who have vowed to make the overhaul transparent and are struggling to solidify support. (Fram, 3/3)

The Washington Post: Rand Paul, A Copy Machine And A ‘Secret’ Obamacare Bill
The story of Rand Paul and the copy machine starts with a seemingly benign meeting. Paul got word that the members of a House Energy and Commerce Committee were gathering to talk about the legislation, as committee members with jurisdiction over health care sometimes do. Paul marched over from the Senate to the House side — a good quarter-mile walk, depending on where you start — to bang on the door and demand that his colleagues in the House show him the “secret” draft Obamacare bill. Never one to miss a posturing opportunity, Paul sent nearly a dozen tweets on his march over, ensuring that cameras and tweeting reporters greeted him when he showed up. He even brought his own copy machine — you know, just in case. (Phillips, 3/2)

Politico: Paul Blocked From Seizing GOP Obamacare Bill
The conservative senator from Kentucky went into a House hideaway in the Capitol, claimed he was told he could not remove the bill and make it public, and then held an impromptu news conference, complaining about House Republicans' lack of transparency. “If you recall where Obamacare was passed in 2009, 2010, Nancy Pelosi said we’ll know what’s in it after we pass it. The Republican Party shouldn’t act in the same way," Paul said in a circus-like atmosphere outside the offices of House leaders. (Everett, 3/2)

NPR: Republicans Finally Get A Look At GOP's Obamacare Replacement Bill, But Dems Shut Out
U.S. Rep. Frank Pallone, a Democrat from New Jersey, has been trying to get a look at the Republicans' bill to repeal and replace the Affordable Care Act, also known as Obamacare. He's the top-ranking Democrat on the House Energy and Commerce Committee, which will have to approve the bill before the whole House can vote on it. But as of Thursday afternoon, Pallone still couldn't get his hands on a copy. (Kodjak, 3/2)

The Associated Press: VP Pence Pledges To ‘Lift Weight’ Of Obamacare
Vice President Mike Pence promised small business executives in Ohio on Thursday that the Trump administration will “lift the weight of Obamacare” off them and U.S. families with a better plan that puts the American people first. “The Obamacare nightmare is about to be over,” Pence said at Frame USA, a picture frame manufacturer in in suburban Cincinnati. “We’re going to replace Obamacare with something that works.” (Sewell, 3/2)

Reuters: Governors Met On Obamacare Replacement Plan With Pence
Ten state governors seeking to avoid millions of dollars in federal healthcare cuts under Republican plans to replace Obamacare pressed their case in a meeting with Vice President Mike Pence on Sunday, according to two people briefed on the talks. The governors are worried that repealing former President Barack Obama's 2010 healthcare law without a detailed replacement will take coverage away from millions of Americans and land the states with a large financial hit. (Abutaleb and Cornwell, 3/2)

The Washington Post Fact Checker: Trump’s Fishy Suggestion That Nearly 20 Million Are Paying An Obamacare Penalty
“It has gotten so bad that nearly 20 million Americans have chosen to pay the penalty or received an exemption rather than buy insurance. That’s something that nobody has ever heard of or thought could happen, and they’re actually doing that rather than being forced to buy insurance," President Trump remarks in a meeting with health insurance executives. This number struck us as a bit curious when President Trump launched into one of his standard attacks on the Affordable Care Act, a.k.a. Obamacare, as he met with representatives of the health-insurance industry. Are 20 million Americans actually refusing to buy health insurance and instead pay a penalty? (Kessler, 3/2)

Politico: Science Could Suffer If Obamacare Protections Are Weakened
Scientists and tech experts are worried about an unanticipated casualty of Obamacare repeal: weaker innovation. More and more Americans have been confidently enrolling in clinical trials and using data-generating smartphone apps — for research and personal use — over the past eight years. But questions now arising about whether an Affordable Care Act replacement will maintain strong protection for people with pre-existing conditions risks dampening research and technology. (Tahir, 3/2)

USA Today/Nashville Tennessean: Lifetime Health Insurance Caps Worry Those Facing Chronic Illness
Many young adults who have come of age under the Affordable Care Act may not know there once were lifetime caps on how much an insurer would pay to treat them. Those lifetime limits were "one of those things in the fine print of your insurance plan," said John Graves, professor of health policy at Vanderbilt University Medical Center. "They don’t go out there and advertise these things.” (Fletcher, 3/2)

The Associated Press: GOP Health Plan Could Cost Minnesota Billions
Minnesota officials are bracing for billions of dollars in additional health care expenses if congressional Republicans enact a plan they’re discussing to replace the Affordable Care Act, according to a draft document obtained by The Associated Press. The planning document shows that the GOP proposal, a draft of which was circulated last week, would cut $1.3 billion next year from the state’s low-income health care program that covers roughly one-sixth of its 5.5 million residents. By 2021, the losses would accumulate to more than $5 billion, eventually costing the state $6 billion a year starting in 2029. That analysis was prepared by the state’s Department of Human Services, which runs those programs. (Potter, 3/2)

The Washington Post: CMS Nominee Moves On A Party-Line Vote Toward Confirmation
A sharply divided Senate Finance Committee on Thursday morning recommended the confirmation of Seema Verma, a health-care consultant who has reshaped Medicaid in several states, to run the nation’s Medicare and Medicaid programs. On a vote of 13 to 12, with every Democrat in opposition, Verma’s nomination now moves to the full Senate, where the Republican majority has been moving swiftly to give its seal of approval to each of President Trump’s nominees who have come to a floor vote. (Goldstein, 3/2)

The Associated Press: Trump’s Nominee To Run Medicare And Medicaid Advances
Verma would head the Centers for Medicare & Medicaid Services, an agency that oversees health insurance programs covering more than 130 million Americans. Known as CMS, it’s also responsible for administering the Obama-era health care law that Trump has vowed to repeal and replace. She’s a protégé of Vice President Mike Pence, after designing a Medicaid expansion along conservative lines for Indiana when he was governor. Her consulting business has about a dozen staffers, and if confirmed, she would run an agency with nearly 6,500 employees. (3/2)

The Washington Post: Trump Calls The FDA ‘Slow And Burdensome,’ But It’s Faster Than Ever
Two days before Christmas, the Food and Drug Administration gave Thomas Crawford an unexpected gift: approval of the first treatment ever for a devastating genetic disease that causes muscle wasting in babies and often results in death at an early age. The drug “is nothing short of oh-my-God amazing” when given to infants who have not yet had symptoms, said Crawford, a Johns Hopkins pediatric neurologist who was involved in the clinical trials for the drug for spinal muscular atrophy. (McGinley, 3/2)

The New York Times: Birth Defects Rise Twentyfold In Mothers With Zika, C.D.C. Says
American mothers infected with the Zika virus last year were 20 times as likely to give birth to babies with birth defects as mothers who gave birth two years before the epidemic, federal health officials said on Thursday. The Centers for Disease Control and Prevention concluded last April that Zika infection caused severe birth defects, including the abnormally small heads of microcephaly, but it had not previously estimated how common such defects were. (McNeil, 3/2)

The Washington Post: Rate Of Birth Defects In Zika Pregnancies 20 Times Higher Than In Pre-Zika Years, CDC Says
Researchers at the Centers for Disease Control and Prevention are trying to determine how common these birth defects, such as microcephaly, brain abnormalities, eye defects and central nervous system problems, were in the years before the Zika outbreak. Although a Zika infection during pregnancy is linked to a distinct pattern of birth defects, those abnormalities are not unique to Zika. Genetic factors and other viral infections may also cause these birth defects, although in many cases the causes are unknown, experts say. (Sun, 3/2)

Los Angeles Times: Pregnant Women With Zika Are 20 Times More Likely To Have A Baby With A Birth Defect, CDC Says
The upshot: For a pregnant woman outside of areas where mosquitoes are spreading the Zika virus, the risk of having (or losing) a baby with a defect such as microcephaly, neural tube defect, or brain or eye abnormality is pretty low, well under 1%. (Healy, 3/2)

NPR: More People Are Taking Opioids Despite Growing Fears
Prescribed narcotic painkillers continue to fuel a nationwide opioid epidemic—nearly half of fatal overdoses in the United States involve opioids prescribed by a doctor. But people don't seem to be avoiding the medications, despite the well-documented risks. In the latest NPR-Truven Health Analytics poll, over half of people surveyed, or 57 percent, said they had been prescribed a narcotic painkiller like Percocet, Vicodin or morphine at some point. That's an increase of 3 percent since we last asked the question in 2014 (54 percent), and of 7 percent since our 2011 poll (50 percent). (Boddy, 3/3)

NPR: Some Melanoma Survivors Are Still Getting Too Much Sun
People who have survived melanoma were more likely to protect themselves from sun exposure than those who hadn't experienced the disease, but a significant portion of them still reported getting a sunburn in the past year, among other behaviors that might increase the risk of a new cancer. The study, which appears Thursday in Cancer Epidemiology, Biomarkers and Prevention, included 724 cancer survivors who had been diagnosed with melanoma, a potentially deadly form of skin cancer, between July 2004 and December 2007. (Hobson, 3/2)