First Edition: May 4, 2017

California Healthline: Blue Shield CEO Says GOP’s ‘Flawed’ Health Bill Would Harm Sicker Consumers
The chief executive of Blue Shield of California, the largest insurer on the state’s insurance marketplace, issued a blunt critique of the Republican health care bill, saying it would once more lock Americans with preexisting conditions out of affordable coverage. In an interview with California Healthline on Wednesday, Paul Markovich said the GOP’s American Health Care Act is “flawed” and “could return us to a time when people who were born with a birth defect or who became sick could not purchase or afford insurance.” The bill is set to come up for a vote in the House of Representatives on Thursday. (Terhune, 5/3)

Kaiser Health News: Pseudoscience Fuels Fear Behind Minnesota Measles Outbreak
Health officials in Minnesota are scrambling to contain a measles outbreak that has sickened primarily Somali-American children. Officials have identified 34 cases as of Wednesday, and they’re worried there will be more. In Minnesota, the vast majority of children under age 2 get vaccinated against measles. But state health officials said most Somali-American 2-year-olds have not had the vaccine, about 6 out of 10. As the outbreak spreads, that statistic worries health officials, including Michael Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy. (Zdechlik, 5/4)

The New York Times: With $8 Billion Deal On Health Bill, House G.O.P. Leader Says ‘We Have Enough Votes’
House Republican leaders planned to hold a showdown vote Thursday on their bill to repeal and replace large portions of the Affordable Care Act after adding $8 billion to the measure to help cover insurance costs for people with pre-existing conditions. “We have enough votes,” Representative Kevin McCarthy of California, the House majority leader, said Wednesday night. “It’ll pass.” (Kaplan and Pear, 5/3)

USA Today: Obamacare Repeal: Republicans Scramble In 11th Hour With New Health Plan
House Republicans will take another crack at repealing Obamacare on Thursday in a high-stakes vote on legislation that would dramatically revamp the health care system and will serve as a major test for the GOP Congress and the Trump administration. The Republican bill, hotly contested and highly controversial, was the subject of 11th-hour negotiations and last-minute sweeteners, as GOP leaders scrambled for enough votes to push it through the House and send it to the Senate. (Shesgreen, 5/4)

The Washington Post: Republicans Plan Health-Care Vote On Thursday, Capping Weeks Of Fits And Starts
Rep. Fred Upton, an influential Republican from Michigan, introduced the amendment that was key to resolving a major sticking point this week. It provides more financial assistance — $8 billion over five years — to help people with preexisting conditions pay for medical costs. Those people are at risk of losing protections under the GOP plan, which seeks to repeal and replace major parts of the ACA. Just a day earlier, Upton said he could not support the Republican plan because of its stance on preexisting conditions. But he sounded an optimistic note after sketching out his fix Wednesday and meeting with President Trump at the White House. (Sullivan, Weigel and Snell, 5/3)

Politico: Decision Day For Obamacare Repeal
House Republicans will huddle Thursday morning for what amounts to a last-minute pep rally to buck up colleagues as they prepare to take a vote to remake health insurance for millions of Americans. ... Though Republican leaders insisted Wednesday they've secured the 216 votes needed to pass their bill, the roll call will still be nerve-wracking. At least 16 Republicans are still on record rejecting the proposal and about a dozen more are undecided. (Cheney and Bresnahan, 5/4)

The Wall Street Journal: U.S. House To Vote Thursday On Health-Care Bill
Thursday’s vote could redeem House Speaker Paul Ryan (R., Wis.) and deliver President Donald Trump his first major legislative win, coming just after the 100-day mark of his tenure passed with little accomplished on Capitol Hill. But it also will cast a long political shadow for House Republicans in the months leading up to next year’s midterm elections. Already, many GOP lawmakers face constituents back home incensed over the prospect of changes to health-care benefits that affect millions. (Peterson, Hackman and Radnofsky, 5/3)

The Associated Press: GOP Revives Struggling Health Care Bill And Plans House Vote
Passage would also send it to an uncertain fate in the Senate, where some Republicans consider the House measure too harsh. Polls have shown Obama's much-maligned law has actually gained in popularity as the debate over a replacement health care program has accelerated. "House Republicans are going to tattoo this moral monstrosity to their foreheads, and the American people will hold them accountable," said House Minority Leader Nancy Pelosi, D-Calif. (Fram and Werner, 5/4)

The New York Times: What Republicans Changed In Their Health Care Bill To Try To Get More Votes
In a scramble to garner enough votes for passage, House Republicans have added more revisions to their bill to repeal the Affordable Care Act (also known as Obamacare), more than a month after pulling their initial bill from the floor. Here’s a look at how the Republican bill compares with the Affordable Care Act. (Park, Sanger-Katz and Lee, 5/3)

The New York Times: What To Watch For: Nail-Biter On Repealing Health Law
After weeks of fits and starts, House Republican leaders plan on Thursday to try yet again to advance legislation to repeal and replace major parts of the Affordable Care Act. A sizable number of House Republicans have been either opposed to the bill or undecided in recent days. But Republican leaders now say they have the votes to pass the legislation, called the American Health Care Act. (Kaplan, 5/4)

The Wall Street Journal: Who Opposes The New Republican Health Care Bill In The House?
To understand who opposes the bill and why, it helps to put lawmakers in the context of how the people in their districts tend to vote and what it means for lawmakers' prospects in the 2018 elections. (Canipe and Yeip, 5/2)

The Associated Press: A Look At The House Republican Health Care Bill
House Republicans planned a vote Thursday on a revised bill rolling back much of former President Barack Obama's health care law. ... Here are key elements of the bill. (5/4)

The New York Times: Extra Billions For Health Bill? Researchers Say It’s Still Not Enough
Is $8 billion enough to get the House health bill passed? And is it enough to ensure that people with pre-existing medical conditions will still be able to get insurance if Congress repeals the Affordable Care Act? The answer to the first question is maybe. On the second, it’s very likely to be no. (Abelson and Sanger-Katz, 5/3)

The Washington Post: House GOP Strategy To Save Health-Care Bill Hinges On More Money For Preexisting Conditions
Even before the precise language was released Wednesday night, leading health policy experts said the amendment raises big questions about how — and how well — it would work in practice. Among the most significant: How many states would back away from the federal protections for people with medical conditions? And how many of those people would lose their coverage because of other changes in the House plan? “Does it really guarantee that all individuals who have preexisting conditions will be able to find insurance at affordable rates?” said Dan Mendelson, president of Avalere Health, a Washington-based consulting firm. (Goldstein, 5/3)

The Wall Street Journal: Jumping Into High-Risk Insurance Pools
The sickest 10% of Americans account for about two-thirds of health-care spending, according to the Kaiser Family Foundation. The ACA requires almost everyone to have insurance or pay a fine so healthy customers would subsidize sick ones. High-risk pools take a different approach, separating the sickest people into their own pool so premiums for healthy customers would fall. (Hackman, 5/3)

The New York Times: Pre-Existing Conditions: Evaluating Competing Claims
In the debate over how the effort to replace the Affordable Care Act would affect those with pre-existing health conditions, opponents and supporters alike have offered misleading talking points. Faced with polling indicating public support for protections, and after an emotional appeal by the television host Jimmy Kimmel that has gone viral, Republicans are making a dubious case that their updated bill provides similar coverage for those who are less healthy, while Democrats are overstating claims about how many are affected. Here’s an assessment. (Qiu, 5/3)

The Washington Post: Here’s What You Need To Know About Preexisting Conditions In The GOP Health Plan
Before the Affordable Care Act, insurance companies could consider a person’s health status when determining premiums, sometimes making coverage unaffordable or even unavailable if a person was already sick with a problem that required expensive treatment. The ACA prohibited that, in part by requiring everyone to purchase insurance. But that “individual mandate” was unpopular and Republicans would eliminate that requirement in their proposed American Health Care Act. (Kessler, 5/4)

Politico: Extra Cash In Health Bill Gets Votes — But Not Coverage
“Short answer, this does not make any meaningful difference,” said Chris Sloan, a senior manager at consultant Avalere Health, who did an analysis of the legislation’s stability fund. “High-risk pools are incredibly expensive and an additional $8 billion over five years doesn’t lead to that [many] more people being able to be covered. ”Even Rep. Fred Upton (R-Mich.), the lawmaker who got the extra money in the bill, said he didn’t know if $8 billion extra money — added to the $130 billion already included in the bill — was the right number. (Cancryn, 5/3)

NPR: House To Vote On GOP Health Care Bill Thursday, Majority Leader Kevin McCarthy Says It Will Pass
Several states have tried high-risk pools in the past, but they were typically underfunded, leaving millions of people with no access to adequate health care. Lawmakers hope that by putting the heft and money of the federal government behind them, they may work better. The federal government is already in the business. It pays for the health care of more than 40 percent of the population, through Medicare, Medicaid, the military and the Department of Veterans Affairs, according to the Census Bureau. (Kodjak, 5/3)

The Wall Street Journal: Top 10 States For Pre-Existing Conditions All Went For Trump
[The] “yes’’ votes on the bill are coming largely from lawmakers whose states have the largest shares of people likely to be affected by changes to coverage for pre-existing conditions, the Kaiser figures suggest. These lawmakers as a group are arguing that the bill will cut insurance costs while offering “layers of protections,’’ as House Speaker Paul Ryan put it, for those with medical conditions. Data from the Kaiser Family Foundation gives a broad sense of which states have the most at stake in the debate over whether the House GOP bill leaves people with medical conditions protected or disadvantaged. (Chinni, 5/3)

Los Angeles Times: California Shows Why The Republican Plan To Rely On States To Replace Obamacare May Not Work
Richard Figueroa still shudders at the memory of the calls he fielded as enrollment director of California’s special health plan for sick patients who’d been rejected by insurers. Desperate callers pleaded to get off the waiting list as cancer or other illnesses worsened. Enrollees struggled to understand why the plan would not cover all the treatment they needed. (Levey, 5/3)

The New York Times: Jimmy Kimmel Sheds Light On Health Coverage For Infants With Birth Defects
Jimmy Kimmel’s tearful description of his newborn son’s heart defect has galvanized parents across the country. A few shared his experience as a frantic new father; many more gave silent thanks that they had been spared this ordeal. But the talk-show host’s monologue has also focused new attention on how infants with such birth defects were cared for before passage of the Affordable Care Act, and what may lie ahead for them should the legislation be repealed. (Kolata and Goodnough, 5/3)

The Wall Street Journal: How Health-Care Bill Would Affect You
The Republican proposal to overhaul the Affordable Care Act, which is expected to receive a vote in the House on Thursday, would bring big changes to health-care coverage for many Americans. Here are some of the most important ones. (Armour and Hackman, 5/3)

The Wall Street Journal: Little-Noted Provision Of GOP Health Bill Could Alter Employer Plans
Many people who obtain health insurance through their employers—about half of the country—could be at risk of losing protections that limit out-of-pocket costs for catastrophic illnesses, due to a little-noticed provision of the House Republican health-care bill to be considered Thursday, health-policy experts say. The provision, part of a last-minute amendment, lets states obtain waivers from certain Affordable Care Act insurance regulations. Insurers in states that obtain the waivers could be freed from a regulation mandating that they cover 10 particular types of health services, among them maternity care, prescription drugs, mental health treatment and hospitalization. (Armour and Hackman, 5/4)

The New York Times: A Little-Noticed Target In The House Health Bill: Special Education
While House Republicans lined up votes Wednesday for a Thursday showdown over their bill to repeal the Affordable Care Act, Vickie Glenn sat in her Murphysboro, Ill., office and prayed for it to fail. Ms. Glenn, a Medicaid coordinator for Tri-County Special Education, an Illinois cooperative that helps more than 20 school districts deliver special education services to students, was worried about an issue that few in Congress were discussing: how the new American Health Care Act, with its deep cuts to Medicaid, would affect her 2,500 students. (Green, 5/3)

Politico: Tuesday Group Leader Under Fire Over Health Care Deal
Republican Rep. Tom MacArthur might have singlehandedly saved the Obamacare repeal effort. But rather than being hailed as a hero, the New Jersey lawmaker has come under fire from GOP centrists, who are incensed he negotiated with Freedom Caucus ringleader Mark Meadows. (Bade and Cheney, 5/3)

Politico: Deep-Pocketed Health Care Lobbies Line Up Against Trump
Just about every major health care group opposes President Donald Trump’s health care overhaul — and the self-styled negotiator-in-chief hasn’t tried cutting a deal with them. The opposition from the deep-pocketed health care industry — and patient advocacy groups from the American Heart Association to the March of Dimes — has made it hard for Republicans to push Obamacare repeal through the House. And they could be a persistent obstacle if the legislation makes it to the Senate. (Cancryn, Karlin-Smith and Demko, 5/3)

Politico: Trump Still Enforcing Obamacare Mandate
The Trump administration is still dutifully enforcing Obamacare's individual mandate, despite early signals it might undermine the unpopular linchpin of the health care law. Weeks after the close of tax season, the IRS continues to process penalties from potentially millions of taxpayers who refused to purchase health insurance last year. (Ehley and Lorenzo, 5/3)

The Washington Post: Iowa Obamacare Program On Verge Of Collapse As Congressional Uncertainty Takes Its Toll
Iowa’s last major Affordable Care Act insurer threatened on Wednesday to pull out from the state’s marketplace next year, the latest step in a sudden collapse of the state’s insurance marketplace that holds ominous signs for health care customers in states across the county. If Minnesota-based Medica follows through on its threat not to sell plans in 2018, Iowa could be the first state to lack any insurers on its exchanges in all but a handful of counties. (Johnson, 5/3)

The Associated Press: Arkansas Lawmakers Vote To Scale Back Hybrid Medicaid Plan
Arkansas lawmakers voted Wednesday to scale back the state's first-in-the-nation hybrid Medicaid expansion under a plan that would move 60,000 people off the program and require some remaining participants to work. The changes are part of an effort in Republican-leaning Arkansas to take advantage of President Donald Trump's willingness to give states more flexibility in restricting coverage. Arkansas is pursuing the changes despite GOP efforts in Washington to repeal the Affordable Care Act, which enabled the state's program. (5/3)

The Washington Post: Virginia’s Expansion Of Disability Services Leaves Fairfax County Short Of Funds
A Virginia effort to bring ­government-funded services to thousands more disabled people could, paradoxically, leave those in the state’s largest jurisdiction without funding for some types of aid. Fairfax County officials say they are likely to create a new waiting list or restrict aid for day-support and work programs because of a redesign of the state’s Medicaid waiver program that — in an effort to comply with the Americans With Disabilities Act — requires the county to accept several thousand people who weren’t previously eligible for government aid. (Olivo, 5/3)

The Associated Press: Measles Outbreak Sickens Dozens Of Minnesota Somalis
An outbreak of measles in Minnesota has sickened more than 30 children in recent weeks, primarily in the state's large Somali-American community, where many parents avoid the measles-mumps-rubella vaccine because of unfounded fears that it causes autism. Somalis are just the latest example of a tight-knit community in which the highly contagious disease has gained a foothold in the U.S. in recent years. (5/3)

NPR: Somali Community's Autism Fears Fuel Measles Outbreak
Even in the midst of the outbreak, Somali resistance to vaccination remains strong in Minneapolis. Minnesota is home to the largest Somali population in the United States. It's a relatively recent attitude that emerged alongside escalating fears about links between MMR and autism among the immigrant group. Understanding the history behind those fears — and the culture that reinforces them, contrary to abundant scientific evidence — is an important step toward overcoming them, research suggests, and not just in Minnesota. (Sohn, 5/3)

Los Angeles Times: Congressional Representatives Warn WHO Of OxyContin Maker's Global Push
Members of Congress called on the World Health Organization Wednesday to “do everything in its power” to stop the manufacturer of the highly addictive painkiller OxyContin from setting off “a worldwide opioid epidemic” with its rapid expansion into developing countries and other foreign markets. In a letter to the WHO’s director-general, a dozen U.S. representatives from areas devastated by opioid addiction urged the international medical community to be wary of Connecticut opioid maker Purdue Pharma and its international arm, known as Mundipharma. (Ryan, 5/3)

USA Today: Racism May Be Making Our Kids Unhealthy
Racism damages our children’s health, a recent study found, negatively affecting the wellness of wealthy white kids and poor minorities the most. The study, which will be presented this weekend by lead author Dr. Ashaunta Anderson, found kids who endured racism had lower levels of general health, including higher rates of anxiety, depression and ADHD. The study isn’t the first to explore racism’s link to physical health. (Rossman, 5/4)

The Washington Post: The Work Of Monitoring Violence Online Can Cause Real Trauma. And Facebook Is Hiring.
Steve Stephens filmed himself shooting a Cleveland bystander, then confessed to the killing on Facebook Live. A man in Thailand broadcast himself killing his infant daughter on Facebook Live before killing himself. There have been other live-streamed suicides and rapes, many lingering on the popular platform for hours. The first line of defense against those violent images spreading is, in most cases, a human being. After concern that Facebook doesn’t move quickly enough to address violence broadcast on its platform, the company announced Wednesday that it will nearly double the number of moderators it pays to monitor for inappropriate content. (Ohleiser, 5/4)

NPR: Spit Test May Reveal Concussion Severity In Children
A little spit may help predict whether a child's concussion symptoms will subside in days or persist for weeks. A test that measures fragments of genetic material in saliva was nearly 90 percent accurate in identifying children and adolescents whose symptoms persisted for at least a month, a Penn State team told the Pediatric Academic Societies Meeting in San Francisco, Calif. In contrast, a concussion survey commonly used by doctors was right less than 70 percent of the time. (Hamilton, 5/4)