First Edition: September 20, 2017

Kaiser Health News: Last-Ditch Effort By Republicans To Replace ACA: What You Need To Know
The Graham-Cassidy proposal would eliminate the federal insurance exchange, healthcare.gov, along with the subsidies and tax credits that help people with low and moderate incomes — and small businesses — pay for health insurance and associated health costs. It would eliminate penalties for individuals who fail to obtain health insurance and employers who fail to provide it. It would eliminate the tax on medical devices. (Rovner, 9/19)

Kaiser Health News: Nursing Home Disaster Plans Often Faulted As ‘Paper Tigers’
It does not take a hurricane to put nursing home residents at risk when disaster strikes. Around the country, facilities have been caught unprepared for far more mundane emergencies than the hurricanes that recently struck Florida and Houston, according to an examination of federal inspection records. Those homes rarely face severe reprimands, records show, even when inspectors identify repeated lapses. (Rau, 9/19)

Kaiser Health News: In Stark Contrast To ACA Plans, Premiums For Job-Based Coverage Show Modest Rise
Family health insurance premiums rose an average 3 percent this year for people getting coverage through the workplace, the sixth consecutive year of small increases, according to a study released Tuesday. The average total cost of family premiums was $18,764 for 2017, according to a survey of employers by the Kaiser Family Foundation and the Health Research & Educational Trust. That cost is generally divided between the employer and workers. (Galewitz, 9/19)

California Healthline: High On Drugs? Anthem Cites Soaring Drug Costs To Justify 35% Rate Hike In California
Health insurance giant Anthem predicts Californians will pop a lot more pills next year. To make the case for a hefty premium hike in the state’s individual insurance market, Anthem Blue Cross has forecast a 30 percent jump in prescription drug costs for 2018. Such a sharp increase is nearly double the estimates of two other big insurers, and it runs counter to industry trends nationally. (Terhune, 9/20)

The New York Times: Republican Leaders Defy Bipartisan Opposition To Health Law Repeal
Eleven governors, including five Republicans and a pivotal Alaskan independent, urged the Senate on Tuesday to reject a last-ditch push to dismantle the Affordable Care Act. But Republican leaders pressed toward a showdown vote. And they choked off separate bipartisan efforts to shore up health insurance markets under the Affordable Care Act, hoping to give Republican senators no alternative but to vote for repeal. (Pear and Kaplan, 9/19)

Politico: Backlash Throws Last-Ditch Obamacare Repeal Effort Into Doubt
Opponents of the proposal co-authored by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina seized on its plan to overhaul Obamacare’s subsidized insurance and Medicaid expansion and replace those with block grants to the states — a mass restructuring they warned would sow chaos in insurance markets. They panned its new regulatory flexibilities as a backdoor route to undermining key patient protections — including safeguards for those with pre-existing conditions. And in the biggest blow, several Republican governors urged the GOP to abandon a plan that would force states to swallow potentially billions in funding cuts — and instead to focus on stabilizing Obamacare. (Cancryn, 9/19)

The Washington Post: New Health-Care Plan Stumbles Under Opposition From Governors
Among the signers were Alaska Gov. Bill Walker (I), who holds some sway over Murkowski, a potentially decisive vote who opposed a previous Republican effort to repeal and replace the Affordable Care Act. Nevertheless, Murkowski said Tuesday afternoon that she was still weighing her options and explained how her position on the bill might ultimately differ from her opposition to the repeal effort that failed dramatically in July. “If it can be shown that Alaska is not going to be disadvantaged, you gain additional flexibility. Then I can go back to Alaskans, and I can say, ‘Okay, let’s walk through this together.’ That’s where it could be different,” she said. (Sullivan, Eilperin and Snell, 9/19)

The Wall Street Journal: Latest Push For A Health-Law Repeal Picks Up Speed In The Senate
The White House ... threw its muscle behind the legislation. Vice President Mike Pence flew back Tuesday to Washington from United Nations meetings in New York to publicly cheer on Republican senators, saying President Donald Trump and the administration are strongly behind the effort. (Armour, Peterson and Radnofsky, 9/19)

The Associated Press: A Last, Last Chance: Republicans Strain For Obamacare Repeal
Republicans must act by Sept. 30 in the Senate or face the prospect of a Democratic filibuster. That blocking action is currently staved off by budget rules that will expire at the end of the month. The new legislation, by Graham and Sen. Bill Cassidy of Louisiana, would undo the central pillars of former President Barack Obama’s health care law, and replace them with block grants to the states so they could make their own health care coverage rules. (Werner, 9/20)

The Hill: Graham Predicts ObamaCare Repeal Bill Will Get 50 Votes 
Sen. Lindsey Graham (R-S.C.) is predicting he will get enough votes on his bill to repeal ObamaCare and says House leadership has pledged they would also pass it. "I really believe we're going to get 50 Republican votes," Graham told reporters after a closed-door GOP caucus lunch on Tuesday. "I've never felt better about where we're at." (Carney, 9/19)

Politico: Republicans Rip Rand For Rejecting Obamacare Repeal
Rand Paul might soon go down as the Republican who saved Obamacare — and he couldn’t care less. "I'm actually happy to be out there as the leading advocate for repealing Obamacare, not keeping it," the Kentucky Republican said in an interview. Of his GOP colleagues, Paul added: "These people, they so totally do not get it." (Kim and Everett, 9/20)

Los Angeles Times: White House, Republican Leaders Join New Push For Obamacare Repeal As Bipartisan Effort Falters
House Speaker Paul D. Ryan (R-Wis.) made clear earlier Tuesday that House Republicans would not support the bipartisan Senate effort, further narrowing the options for those hoping for an alternative to the Graham-Cassidy bill. Ryan said the House instead was ready to approve the Cassidy-Graham bill. “He told me, ‘You pass it there, we’ll pass it here,’” said Graham, recounting a phone call with the speaker. (Levey and Mascaro, 9/19)

Politico: House GOP Under Pressure If Senate Passes Repeal
Though House GOP leaders are bullish that they can pull off a repeat performance on Obamacare repeal if given the chance, they’ll have to twist a lot of arms within the ranks to get there. Some conservatives want more flexibility for governors. At the same time, vulnerable centrists from states that would be hit hardest by the Senate bill, including California and New York, could face a severe backlash from constituents. (Bade and Cheney, 9/20)

Los Angeles Times: Obamacare 101: What Would The Graham-Cassidy Repeal Bill Do?
The Graham-Cassidy proposal shares some features of earlier repeal legislation approved in the House and debated in the Senate, including scrapping the requirement that Americans have health coverage and placing new restrictions on federal funding for Planned Parenthood. ... But the new repeal bill is substantially more sweeping and goes far beyond just repealing the 2010 healthcare law, often called Obamacare. The Graham-Cassidy proposal would completely restructure how the federal government provides healthcare assistance to some 80 million Americans and create a new system for distributing hundreds of billions of dollars of government aid. (Levey, 9/19)

The Wall Street Journal: Q&A: Explaining The Graham-Cassidy Repeal Bill
The Graham-Cassidy bill would lump together the money spent on two ACA programs to expand health coverage: subsidies for private insurance and an expansion of the Medicaid program. That funding would be redistributed as block grants to states, who could use it to fashion their own health systems. All of the bill’s health spending would end in 2027 and need to be reauthorized by Congress. The bill also makes structural changes to Medicaid by capping how much federal money states can get. (Hackman, 9/19)

The New York Times: Blue States Face Biggest Cuts Under New Republican Health Care Plan
A new Republican plan to repeal the Affordable Care Act would give each state a federal block grant for health care using a complex formula that cuts funding for some states — including many that were won by Hillary Clinton in 2016 — according to a New York Times analysis of estimates from the Center on Budget and Policy Priorities, a left-leaning think tank. (Park, 9/19)

Reuters: Factbox: Latest Obamacare Repeal Bill Would Block Grant Money To States, Gut Medicaid
Like previous repeal bills, the Graham-Cassidy proposal retroactively repeals the so-called individual mandate, the requirement that everyone purchase health insurance or else pay a fine. It also retroactively repeals the mandate that certain employers provide health insurance for their workers. Health policy experts say the individual mandate is needed to induce young, healthy people who may otherwise forgo coverage to buy insurance and offset the costs of sicker, more expensive patients. (Abutaleb, 9/19)

The Associated Press: Winners And Losers In GOP's Last-Ditch Health Overhaul
The GOP's last-ditch effort to repeal "Obamacare" would redistribute hundreds of billions of dollars in federal financing for insurance coverage, creating winners and losers among individual Americans and states in ways not yet fully clear. Independent analysts say the latest Senate Republican bill is likely to leave more people uninsured than the Affordable Care Act, and allow states to make changes that raise costs for people with health problems or pre-existing medical conditions. (Alonso-Zaldivar, 9/19)

Politico: Graham-Cassidy Health Care Bill: What You Need To Know
The liberal-leaning think tank Center on Budget and Policy Priorities released estimates of how federal funding would change if the bill became law. In its analysis, California would be hardest hit, losing $27.8-billion in funding. ... Cassidy's office released its own estimates. Massachusetts takes the hardest hit with a more than $5 billion loss in funding. Overall, Southern states that did not expand Medicaid are poised to receive more in federal funding. (Frostenson, 9/19)

The Hill: GOP Faces Risks, Rewards In Rushing To Repeal Vote Without CBO Score 
Senate Republicans are rushing toward a vote on an ObamaCare repeal bill without getting a full analysis from the Congressional Budget Office on how their legislation would affect coverage and premiums. It’s a risky move, as Sens. Susan Collins (R-Maine) and John McCain (R-Ariz.) have both said they’d prefer to have a full score before casting their votes. (Sullivan, 9/19)

The Washington Post: Democrats Ask Base For One More ACA Rescue Mission
Senate Democrats, who spent weeks thinking they would won the fight to keep the Affordable Care Act in place, are mobilizing alongside progressive activists for 11 more days on the defensive. “They’re going to hear from us one more time!” Senate Minority Leader Charles E. Schumer said at a Tuesday afternoon rally outside the Capitol. “Protesting, picketing, emailing — you name it!” The multilevel campaign to block the Republican bill consists of everything progressives did to stop previous iterations — from “melting the phones” of Republican senators to waging sit-ins at their offices. (Weigel, 9/19)

The Hill: Cruel September Shifts To Democrats 
Democrats feeling whiplash over the GOP’s new effort to repeal ObamaCare have sought to step up their opposition to the new bill, which could be headed for a vote next week. After a Monday night floor protest, Democrats pointed to a bipartisan letter from 10 governors on Tuesday as a reason to kill the GOP bill. (Carney, 9/19)

Politico: Did Democrats Jump The Gun With Single-Payer Splash?
Last week, a group of Senate Democrats rallied behind single-payer health care at a splashy news conference. This week, the same group is scrambling to beat back the GOP's latest Obamacare repeal blitz. The contrast shows the chasm between the two parties’ approach to health care: Republicans claim that Bernie Sanders’ “Medicare for All” pitch fueled their revived repeal effort, an argument that even Democratic single-payer foes dismiss as untrue. Yet some Democrats wish more attention had been paid to protecting the Affordable Care Act before some of the party's biggest names turned to single payer. (Schor, 9/19)

The Washington Post: Jimmy Kimmel Gets Heated About Health-Care Bill, Says Sen. Bill Cassidy ‘Lied Right To My Face’
In May, late-night host Jimmy Kimmel delivered an emotional monologue as he revealed that his newborn son, Billy, was born with a heart defect that required immediate surgery. The operation was successful, but Kimmel was deeply shaken by the experience, which happened amid the debate over replacing the Affordable Care Act. Kimmel delivered a passionate plea about the astronomical costs of health care: “No parent should ever have to decide if they can afford to save their child’s life.” (Yahr, 9/20)

The Hill: AARP Calls On Senators To Reject Latest ObamaCare Repeal Bill
The AARP on Tuesday slammed the latest ObamaCare repeal bill and called on senators to reject it. The bill from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) would increase health-care costs for older Americans with an age tax, decrease coverage and undermine protections for people with pre-existing conditions, the group said. (Weixel, 9/19)

The Hill: Hospitals Come Out Against New ObamaCare Repeal Bill 
The American Hospital Association is opposing the GOP’s last-ditch ObamaCare repeal bill, saying the legislation puts the health coverage of 10 million people at risk. “This proposal would erode key protections for patients and consumers and does nothing to stabilize the insurance market now or in the long term,” Rick Pollack, the group's president and CEO, said in a statement Tuesday. (Roubein, 9/19)

NPR: Republicans Try One Last Effort To Repeal Obamacare
"The Graham-Cassidy plan would take health insurance coverage away from millions of people, eliminate critical public health funding, devastate the Medicaid program, increase out-of-pocket costs and weaken or eliminate protections for people living with pre-existing conditions," says Georges Benjamin, executive director of the American Public Health Association, in a statement. (Kodjak, 9/19)

The Hill: GOP Chairman Declares Bipartisan ObamaCare Fix Dead 
The Senate Health Committee chairman on Tuesday released a statement ending a bipartisan effort to find an ObamaCare fix amid a new GOP push to repeal the law. "During the last month, we have worked hard and in good faith, but have not found the necessary consensus among Republicans and Democrats to put a bill in the Senate leaders’ hands that could be enacted," Senate Health Committee Chairman Lamar Alexander (R-Tenn.) said in the statement. (Sullivan, 9/19)

Politico: Ryan, White House Reject Bipartisan Health Fix
House Speaker Paul Ryan and the White House have informed Senate Republican leaders that they oppose a bipartisan plan to stabilize Obamacare being written in the Senate, according to Trump administration and congressional sources, in a clear bid to boost the Senate's prospects of repealing the health law. (Everett, Dawsey and Bade, 9/19)

The Wall Street Journal: Trump Administration Makes ACA’s Health-Insurer Payments For September
Health insurers will receive this month’s payments from the Trump administration reimbursing them for reducing copayments and deductibles for millions of low-income customers, the White House said Tuesday, once more shelving a standoff with insurers over the contested funds. “The September payment will be made,” a White House spokesman said. (Radnofsky, 9/19)

The New York Times: While Premiums Soar Under Obamacare, Costs Of Employer-Based Plans Are Stable
In sharp contrast to the soaring health insurance premiums in many Affordable Care Act marketplaces, the cost of coverage for the vast numbers of people who get insurance through their jobs rose relatively little this year, continuing a period of remarkable stability in the employer market, according to a national survey released Tuesday. The annual premium for family coverage rose an average of 3 percent to $18,764 this year, according the Kaiser Family Foundation, a nonprofit group, which conducted the annual survey of employers. (Abelson, 9/19)

The Associated Press: Health Benefit Offers From Small Businesses Keep Vanishing
Only half of America's smallest businesses now offer health coverage to their workers because many say steady cost hikes have made it too expensive to afford a benefit that nearly all large employers still provide. The Kaiser Family Foundation said Tuesday that 50 percent of companies with three to 49 employees offered coverage this year. That's down from 59 percent in 2012 and 66 percent more than a decade ago. (Murphy, 9/19)

The Wall Street Journal: The Hidden Obamacare Detail That Could Cost Hospitals Billions
Investors should get ready for more belt-tightening in the hospital industry. Maybe a lot more. Some aspects of  the Affordable Care Act, commonly known as Obamacare, were a blessing for hospitals. Expanded access to insurance has meant more customers who can pay for services they consume. That limits bad debt generated from bills that uninsured patients can’t afford to pay. (Grant, 9/19)

Politico: Price’s Private-Jet Travel Breaks Precedent
In a sharp departure from his predecessors, Health and Human Services Secretary Tom Price last week took private jets on five separate flights for official business, at a cost of tens of thousands of dollars more than commercial travel. The secretary’s five flights, which were scheduled between Sept. 13 and Sept. 15, took him to a resort in Maine where he participated in a Q&A discussion with a health care industry CEO, and to community health centers in New Hampshire and Pennsylvania, according to internal HHS documents. (Diamond and Pradhan, 9/19)

The Wall Street Journal: Senator Pushes For Hospital Inspections To Be Made Public
The chairman of the Senate Judiciary Committee is pressing for the public disclosure of hospital inspection reports, amid complaints that the nation’s largest hospital accreditation group doesn’t rigorously enforce health and safety standards. Sen. Chuck Grassley (R., Iowa) asked federal regulators in a letter Monday to outline specific statutory changes that would be needed to end the confidentiality of inspection reports done by accreditors, including the Joint Commission, a nonprofit organization based in Oakbrook Terrace, Ill. (Armour, 9/19)

The Wall Street Journal: States Need $645 Billion To Pay For These Promises, And That’s Not Counting What They Owe In Pensions
When Aurora, Ill., closed its books in December, about $150 million disappeared from the city’s bottom line. The Chicago suburb of 200,000 people hadn’t become poorer. Instead, for the first time it recorded on its balance sheet the full cost of health care promised to public employees once they retire. States and cities around the country will soon book similar losses because of new, widely followed accounting guidelines that apply to most governments starting in fiscal 2018. (Gillers, 9/20)

The Washington Post: Hurricane Aftermath: Death Toll Rises To 9 In South Florida Nursing Home That Overheated
A ninth patient from a South Florida nursing home that overheated during power outages following Hurricane Irma died on Tuesday, according to police. The death of Carlos Canal, the ninth patient, occurred nearly a week after the nursing home in Hollywood, Fla., became the focus of a criminal investigation when the air conditioning failed and eight other patients ultimately died. (Berman, 9/19)

The Wall Street Journal: Doctor’s Defamation Suit Highlights Online Patient Reviews
A defamation lawsuit filed by an Ohio plastic surgeon that is slated to go to trial early next year could have far-reaching consequences for disputes between doctors and their patients over online reviews about the quality of medical care, according to legal experts. Dr. Bahman Guyuron, former chairman of the department of plastic surgery at Case Western Reserve University School of Medicine, sued Marisa User in 2015 over anonymous reviews she had posted on the cosmetic-surgery website RealSelf and other sites where patients swap information about doctors. (Palazzolo, 9/19)

The New York Times: The Fatal Toll Of Cheap Cigarettes
A new study suggests that the availability of cheaper, off-brand cigarettes is associated with an increase in infant mortality. Researchers writing in JAMA Pediatrics studied the link between cigarette prices and infant mortality in 23 European countries from 2004 through 2014. During this time, there were more than 53 million live births. (9/19)

The New York Times: A Stress Link To Lupus
Psychological trauma is associated with an increased risk for lupus, a new study reports. Lupus is a potentially fatal autoimmune disease that causes inflammation of the skin, joints and internal organs. Its cause is unknown. (Bakalar, 9/20)

Los Angeles Times: Domestic Violence Homicide Rate Drops With Stricter Gun Law, Study Finds
When domestic violence offenders are required to relinquish their guns, instead of simply being barred from owning firearms, the risk that those offenders may kill their partners goes down, a new study finds. The paper, described in the Annals of Internal Medicine, highlights a simple method for lowering the risk women face of being killed by an intimate partner: Enforce the laws already in place. (Khan, 9/19)

The Washington Post: Poor, Sick And Still Traveling Long Distances For Health Care In D.C.
The District’s poorest residents are still forced to travel far outside their neighborhoods for their health care, according to a report released Tuesday by Mayor Muriel E. Bowser. Less than 25 percent of Medicaid patients living east of the Anacostia River see a primary-care doctor in their Zip code. Despite efforts to expand services in Wards 7 and 8, many still call 911 emergency services for their basic health needs. And residents needing specialty care must commute downtown where most of the medical specialists are clustered. (Itkowitz, 9/19)

The Associated Press: New Delaware Law Will Expand Cancer Treatment Options
Cancer patients in Delaware will soon have more treatment option under legislation being signed by Gov. John Carney. A bill to be signed Wednesday requires health insurers to cover any medically appropriate drug that has been approved by the Food and Drug Administration for the treatment of stage 4 metastatic cancer and other cancers without requiring proof that the patient failed to respond to a different drug or drugs. (9/20)

The Associated Press: Appeals Court Blocks San Francisco Warning Law For Soda Ads
A federal appeals court on Tuesday blocked a San Francisco law requiring a health warning on soda ads, saying the measure was misleading and would suppress free speech. A unanimous, three-judge panel of the 9th U.S. Circuit Court of Appeals stopped the 2015 ordinance from going into effect until a lawsuit filed by the American Beverage Association and other groups is resolved. (Thanawala, 9/19)

The Wall Street Journal: Appeals Court Blocks San Francisco Law Requiring Soda Health Warnings
The three-judge panel of the Ninth U.S. Circuit Court of Appeals found the ordinance stifles commercial speech and unfairly targets soda over other potentially unhealthy food and drinks. The panel blocked the rule from going into effect. The San Francisco ordinance, passed in 2015, requires advertisements for certain sugar-sweetened drinks to include a disclaimer that says “WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. This is a message from the City and County of San Francisco.” (Randazzo, 9/19)

Los Angeles Times: Federal Appeals Court Blocks San Francisco Law Requiring Health Warnings On Soda
“By focusing on a single product, the warning conveys the message that sugar-sweetened beverages are less healthy than other sources of added sugars and calories and are more likely to contribute to obesity, diabetes, and tooth decay,” wrote Judge Sandra S. Ikuta, an appointee of President George W. Bush. (Dolan, 9/19)

Los Angeles Times: Health Officials Declare Hepatitis A Outbreak In L.A. County
Los Angeles County health officials declared a hepatitis A outbreak Tuesday, days after a public health emergency was announced in San Diego County, where at least 16 people have died of the highly contagious virus. Case numbers are still small in L.A. County, with only 10 people infected as part of the outbreak, said Dr. Barbara Ferrer, director of the L.A. County Department of Public Health. By comparison, almost 450 people have contracted the virus in San Diego. (Karlamangla, 9/19)

The Associated Press: Cuba Again Denies Role In 'Health Attacks' On US Diplomats
The Cuban government on Tuesday again denied any involvement in or any knowledge of a mysterious series of health incidents that have affected American diplomats in Havana. ... At least 21 members of the American diplomatic community in Havana have suffered from symptoms, including brain damage, believed to have come from some sort of sonic attack since late last year. The most recent incident was in August. (9/19)