Politico: Obamacare Repeal Could Be Biggest 2017 Tax Cut For Wealthy
The big winners in Republican plans to repeal Obamacare are likely to be the rich. Rescinding the Affordable Care Act means not only taking away health coverage from some 20 million Americans. It also means scrapping two big tax increases Democrats imposed on the wealthy to help pay for it all. (Faler, 12/8)

Modern Healthcare: GOP Faces Tough Challenges In Replacing The ACA's Individual Mandate
Health insurers have reluctantly signaled that they will go along with congressional Republicans' plans to repeal most of the Affordable Care Act if the legislation includes a strong replacement for the ACA provision that pressures younger and healthier people to buy coverage. But it's highly uncertain – both procedurally and politically -- whether GOP leaders can quickly pass such a provision, which is widely viewed as necessary to avoid a chaotic meltdown in the individual insurance market where nearly 20 million Americans get coverage. (Meyer, 12/8)

In other health law news —

The Associated Press: New Coalition Will Push Back On Repeal Of Obama Health Law
Supporters of the 2010 health care law will launch a political coalition Friday to block its repeal. They're targeting Republican lawmakers whose constituents may now be at risk of losing health insurance. The initial goal is to stop Congress from repealing the law without simultaneously passing a replacement for some 20 million people covered through subsidized private health insurance and expanded Medicaid. Called "Protect Our Care," the group brings together organizations that helped pass the Affordable Care Act, also known as "Obamacare." (Alonso-Zaldivar, 12/9)

The Philadelphia Inquirer: Didn't Get An Obamacare Subsidy This Year? Try Again For 2017
About 8.8 million Americans (including 321,345 Pennsylvania residents and 205,242 New Jerseyans) who bought insurance through HealthCare.gov for the current year receive tax credits. But federal officials say many more people are eligible. These include people who didn't get a credit in 2016 but may be eligible for 2017 even if their income remains the same, because insurance rates have gone up. (12/9)

PolitiFact Florida: Rick Scott Misleads About The Inventors Of Obamacare By Ignoring Republicans' Roles
In a Nov. 30 op-ed in USA Today, [Florida Gov. Rick Scott] reiterated his 2010 campaign pledge to fight for repeal of the federal health care law. ... "It was sold on a lie. It was invented by liberal academic theorists who have no interaction with real families and businesses and therefore it doesn’t work." Scott’s piece leaves out that the Affordable Care Act of 2010 is based on ideas from not just Democrats but also Republicans. ... Most notably, Scott omits Republican Gov. Romney, who enacted a Massachusetts plan four years before the federal law passed, and the conservative Heritage Foundation, which was a strong advocate for the health care exchanges upon which both plans were based. We rate this claim Mostly False. (Sherman, 12/5)

The Hill: Obama Health Chief Huddles With Dems To Fight ObamaCare Repeal 
Secretary of Health and Human Services Sylvia Mathews Burwell met with congressional Democrats on Thursday to warn of the dangers of the Republican “repeal and delay” strategy for ObamaCare and discuss ways to fight back against repeal efforts. Burwell met with House Democrats in the morning and then Senate Democrats at their lunch in the afternoon. (Sullivan, 12/8)

Morning Consult: HHS Chief Warns Senate Democrats Of ‘Chaos’ Under ACA Repeal
The nation’s top health official spoke with Senate Democrats Thursday about the repeal of the Affordable Care Act, warning that undoing the law without having a replacement ready could be disastrous. “It’s very important to understand that a repeal and delay of a replacement is a situation where it is basically repeal and chaos,” Health and Human Services Secretary Sylvia Burwell told reporters after meeting with lawmakers. (McIntire, 12/8)

CQ Roll Call: Burwell Warns Senators That Chaos Would Follow Obamacare Repeal
Health and Human Services Secretary Sylvia Mathews Burwell privately rallied Senate Democrats on Thursday to warn the public about the dangers facing the U.S insurance market if Congress were to dismantle President Barack Obama’s 2010 health care law without implementing a replacement. “We talked about repeal and chaos,” Senate Minority Whip Richard J. Durbin of Illinois told reporters as he exited the meeting in the Capitol. The discussion focused on the potential detrimental impact both to insurers and consumers if lawmakers were to repeal the health care overhaul (Williams, 12/8)

Chicago Tribune: Medicare, Medicaid Head Says Repealing Obamacare Without Replacement Would Be 'Chaos'
[Andy] Slavitt, acting administrator at the Centers for Medicare & Medicaid Services, sat down with the Chicago Tribune Wednesday to discuss how the new administration's plans might affect consumers, where he'd like to see health care go in the future, and what he doesn't want to see. ... [Slavitt said,] We all ought to take a little bit of a deep breath and recognize there's a difference between what you have to say on the campaign trail and what you have to do when you're actually governing and when you're elected. I think we should give the new administration every opportunity and all the information they need to come to the decisions that are best for the country. (Schencker, 12/8)

And the timing of it all is still up in the air —

The Hill: Dems See ’18 Upside In ObamaCare Repeal
Democrats are hoping to turn the tables on ObamaCare for the 2018 midterm elections, exacting political revenge as the Republican Party turns its focus to repealing and replacing the program. The GOP successfully used the healthcare law to take control of the House from Democrats in 2010, framing the policy as a government takeover that would raise taxes. With ObamaCare’s repeal on the horizon, Democrats hope to make the process just as painful for Republicans, pointing to the 20 million people currently covered by the exchanges whose insurance could be at risk.  (Kamisar, 12/8)

Morning Consult: Price, Ryan Say Length Of Obamacare Transition Still Undetermined
The transition timeline is one of the biggest questions about the budget resolution. A reconciliation bill that was vetoed by President Barack Obama earlier this year would have allowed for two years to pass a replacement plan. But some GOP members want a replacement to happen faster, while others are pushing for three years. (McIntire, 12/8)

The Associated Press: House Passes Stopgap Measure As Senators Raise Objections
The House on Thursday cleared bills to keep the government running through April and authorize hundreds of water projects, but a Senate fight over benefits for retired coal miners threatened to lead to a government shutdown this weekend. House members promptly bolted home for the holidays and will return next month to a capital city in which Republicans will fully control all levers of power, with Donald Trump inaugurated as the nation’s 45th president. The stopgap spending bill passed on a 326-96 vote. (Taylor and Lardner, 12/8)

Bloomberg: Democrats Mull Shutdown Fight Over Coal Retirees’ Health Promise 
Senate Democrats were trying to decide Thursday whether to risk a short-term partial shutdown of the U.S. government this weekend unless Republicans agree to demands to protect the health benefits of retired miners. “There is no consensus yet, we are still working out the strategy,” said Connecticut Senator Christopher Murphy. During a caucus meeting, Senate Democrats discussed whether to withhold votes from a needed government funding bill in order to keep a promise to retired coal miners and demonstrate to constituents -- especially those in states carried by President-elect Donald Trump -- that they’re the party of working people, according to two aides who described the private conversations under condition of anonymity. (Rowley and Wasson, 12/8)

The Hill: Senate Dems Hold Out On Spending Deal, Risking Shutdown
Senate Democrats are holding out on backing a bill to keep the government funded through April 28, risking a government shutdown that would begin on Saturday. Democrats may still back the funding measure, but a demand to extend miners’ health care coverage for a full year is holding up a deal. (Bolton, 12/8)

CQ Roll Call:  White House Slams GOP Over Miners' Benefits, Flint Aid In CR
The Obama administration on Thursday harshly criticized Republican congressional leaders for not adequately addressing expiring health and pension benefits for coal miners, as well as aid for Flint, Mich., and its beleaguered water system, and would not rule out a partial government shutdown over the issues. With funding for federal programs and agencies due to expire Friday at midnight, Press Secretary Josh Earnest wouldn't say if President Barack Obama would sign a five-month continuing resolution (HR 2028) that easily passed the House Thursday afternoon. "It would be a shame to shut the whole thing down just a couple weeks before Christmas," Earnest said. (Bennett, 12/8)

Kaiser Health News: Retired Coal Miners At Risk Of Losing Promised Health Coverage And Pensions
Without congressional intervention, about 16,000 retired miners in seven states will lose their health care coverage by the end of the year. A proposal to temporarily extend the benefits is working its way through Congress. But two Senate Democrats, who have long been advocates for a more comprehensive plan, say the temporary provision isn’t enough.They are threatening to hold up a spending bill that needs to pass by Friday night to keep the government running. (Lofton, 12/8)

In other news from Capitol Hill —

The New York Times: Cures Act Gains Bipartisan Support That Eluded Obama Health Law
In recent years, few major bills have commanded as much support as the 21st Century Cures Act, which sailed to passage by votes of 392 to 26 in the House on Nov. 30, and 94 to 5 in the Senate a week later. Once it is signed by President Obama on Tuesday, as the White House has said it will be, the law will allow for money to be pumped into biomedical research and speed the approval of new drugs and medical devices. It also includes provisions to improve mental health care and combat opioid abuse. (Pear, 12/8)

The Wall Street Journal: In Antitrust Trial, Justice Department Questions Aetna-Humana Asset Sale Plan
The Justice Department hammered away in court Thursday at the viability of a plan by Aetna Inc. and Humana Inc. to sell off assets to alleviate antitrust concerns about their proposed $34 billion merger. The department, which is suing to block the merger, questioned the ability of the proposed asset buyer, California-based Molina Healthcare Inc., to keep the market for private Medicare plans for senior citizens competitive if Aetna and Humana combine. (Kendall, 12/8)

The Associated Press: Evergreen Won’t Renew Individual Health Benefit Policies
Evergreen Health Cooperative Inc. won’t be issuing or renewing individual health benefit policies on the Maryland Health Connection for the 2017 plan year, Maryland regulators announced Thursday. Evergreen, a start-up health maintenance organization that began as a nonprofit, is working to become a for-profit company. (Witte, 12/8)

The Baltimore Sun: Evergreen Removed From Individual Health Insurance Market Pending Approval Of Its Bid To Go For-Profit
The Maryland Insurance Administration barred Evergreen Health from selling health insurance policies for individuals until federal and state regulators decide whether to allow the cooperative to convert to a for-profit insurer and receive a much-needed cash infusion. Roughly 6,000 people who bought an Evergreen plan through the state's health insurance exchange last year now have only weeks to choose a new plan or automatically be assigned to another insurer's policy in order to have coverage starting Jan. 1. Another 3,000 people who bought individual plans directly from Evergreen will be on their own to pick a new insurer. (Gantz, 12/8)

USA Today: Internal Documents Detail Secret VA Quality Ratings
The Department of Veterans Affairs has for years assigned star ratings for each of its medical centers based on the quality of care and service they provide, but the agency has repeatedly refused to make them public, saying they are meant for internal use only. USA TODAY has obtained internal documents detailing the ratings, and they show the lowest-performing medical centers are clustered in Texas and Tennessee. (Slack, 12/7)

Stat: Fetal ‘Personhood’ Movement Seeks To Capitalize On GOP Wins
The push to confer full “personhood” status on every fertilized human egg has been rejected by voters and lawmakers in state after state, including deep-red Mississippi. But activists are cautiously hopeful that their cause could get a boost from Republicans who are about to assume leadership in Washington. Georgia Representative Tom Price, who has been tapped by President-elect Donald Trump to run the Department of Health and Human Services, has twice co-sponsored federal legislation that would define fertilized human eggs as legal persons — a move that would outlaw not just abortion, but also potentially the pill and other common methods of birth control. (Robbins, 12/9)

In other news from Ohio and New Hampshire —

Cleveland Plain-Dealer: 20-Week Abortion Ban Passed By Ohio Legislature, Headed To Gov. John Kasich
Ohio lawmakers on Thursday sent a second anti-abortion measure to Gov. John Kasich. The Ohio House voted 64-29, mostly along party lines, to advance a 20-week abortion ban, and the Senate later gave final approval. Lawmakers on Tuesday approved a ban on abortions after a fetal heartbeat can be detected, as early as six weeks into a woman's pregnancy. (Borchardt, 12/8)

Cincinnati Enquirer: 7 Things To Know About Ohio's Abortion Bans
Ohio lawmakers just passed one of the country's most-restrictive abortion laws that almost certainly violates current constitutional standards. If signed by Gov. John Kasich, the so-called "heartbeat bill" would ban abortions after a fetal heartbeat is detected, which can be as early as six weeks' gestation. (Balmert, 12/8)

New Hampshire Union Leader: Abortion Clinic 'Buffer' In Court 
A 2014 New Hampshire law that allows buffer zones around abortion clinics — a law that has yet to be implemented or enforced — went before a federal appeals court in Boston on Thursday. The First Circuit Court of Appeals heard a challenge to the law filed by self-described sidewalk counselors who have argued that a 25-foot buffer zone would impinge on their free speech rights. (Hayward, 12/8)

The Associated Press: Major Survey Of Transgender Americans Finds Pervasive Bias
The largest-ever survey of transgender Americans paints a grim picture of pervasive discrimination and harassment, to the point that many of them attempt suicide at some point. Released on Thursday by the National Center for Transgender Equality, the survey assesses input received in 2015 from 27,715 respondents from all 50 states, the District of Columbia, and three U.S. territories. The largest previous transgender survey, conducted by the center and a partner organization in 2008-09, had 6,450 responses. (Crary, 12/8)

In other mental health news —

Health News Florida: Duval Students Self-Report Higher Than Average Suicide Attempts, Feeling Hopeless 
Duval County high-school students are reporting higher-than-average rates of suicide attempts and feelings of hopelessness. Superintendent Nikolai Vitti addressed the report at Tuesday’s board meeting in a presentation. He said the district will be advocating for more mental health funding, and plans to expand services. (Kilbride, 12/8)

Georgia Health News: State Identifies Rural Hospitals In Biggest Need Of Donation Help
A South Georgia hospital has been ranked as the most financially stressed among 49 rural hospitals eligible for a new state tax credit program.State officials, after reviewing facility financials, have ranked Irwin County Hospital in Ocilla as the neediest among eligible rural hospitals. The program, created during the 2016 session of the Georgia General Assembly, allows tax credits to individuals and corporations that donate to struggling rural hospitals. The credits aim to help shore up rural health care, which has been under increasing financial pressure in the state. (Miller, 12/8)

Arizona Republic: Why White Deaths Are Outpacing White Births In Arizona: ‘Natural Decrease’
Arizona's white residents are dying faster than they are being born, a shift researchers say will further shake up the rapidly changing face of the state's population. The phenomenon, known as "natural decrease," is occurring in a record 17 states nationwide, according to a study released by the University of New Hampshire's Carsey School of Public Policy. Demographers analyzed data from 1999 through 2014 for the report. Arizona's non-Hispanic white deaths began to outpace births in 2012. (Polletta, 12/8)

Denver Post: Colorado’s Status As Healthiest State Under Threat, Research Finds 
About half of a person’s health and well-being is determined by the “lottery of life,” and in Colorado, the gap between the wealthy and the poor continues to widen. Without greater investment in housing, food programs and health care for impoverished and minority Coloradans, the state’s status as the healthiest in the nation will dwindle, says a new report from the Colorado Center on Law and Policy. (Brown, 12/8)

WABE: GBI: Rape Kits Testing Could Take Six Years Or More 
The Georgia Bureau of Investigation says it will take at least six years to process the thousands of rape kits that the agency has received if moving at its current rate. In a report released this month, the agency said there are more than 4,200 kits, which could contain DNA evidence in sexual assault cases, waiting to be tested. (Yu, 12/7)

The Philadelphia Inquirer: For Latinos In South Philly, Clinic Is A Bridge To Health And Much More
Puentes de Salud – “bridges to health” – now has three full-time and six part-time staffers, dozens of volunteers and an annual budget approaching $1 million. About half its patients come through the main clinic office at 17th and South Streets, a newly renovated building on Penn’s Rittenhouse campus. The other 3,000 come through the prenatal clinic at HUP operated by Ludmir. In certain situations such as deliveries and emergency room visits, many immigrants are eligible for the state’s Emergency Medical Assistance program. (Jablow, 12/9)

The Philadelphia Inquirer: New $6M Funding Effort For Digital Health Firms In Philadelphia
Ben Franklin Technology Partners of Southeastern Pennsylvania, Independence Health Group, and Safeguard Scientifics announced plans Thursday to spend a total of $6 million over the next for years funding early-stage digital health-care startups. Each of the partners has pledged $2 million. Ben Franklin will manage the effort, which is open to companies in Southeastern Pennsylvania. Investments will range from $50,000 up to $1 million per company. Separately, the partners are involved in the Health Innovation Collaborative, started in 2015 by the Greater Philadelphia Chamber of Commerce's CEO Council for Growth. (Brubaker, 12/8)

The Star Tribune: Minn. Students At UW-Madison Urged To Get Extra Shots After Meningitis Outbreak 
Minnesota students attending the University of Wisconsin-Madison are being urged to get additional vaccinations for meningitis after a small but potentially dangerous campus outbreak this fall. The Minnesota Department of Health said Thursday that undergraduates attending UW-Madison and returning home for winter break need a second dose of the vaccine to ward off meningococcal meningitis B. (Walsh, 12/8)

The Associated Press: Maryland Muslim Doctor Offers Free Clinics
For the past 10 years, Dr. Ashraf Meelu has paid out-of-pocket to offer basic health care in clinics open to the public. The 64-year-old Muslim doctor from Lothian, Maryland, along with a few volunteers, spends Friday mornings providing flu shots, measuring blood pressure and offering other health treatments at a Guatemalan consulate in Silver Spring, Maryland. (Connor, 12/8)

Cleveland Plain-Dealer: Three Ohioans Sentenced For $3.4 Million Home Health Care Scheme 
Three Ohio men were sentenced to prison this week for what the government described as a home healthcare scheme that cost the federal government more than $3.4 million. (Heisig, 12/8)

Arizona Republic: Embattled UA Medical School Director Abruptly Quits, Returns
Dr. Joe G.N. "Skip" Garcia, the embattled top administrator overseeing the University of Arizona's medical schools in Phoenix and Tucson, abruptly resigned Thursday in what he described as an "exceptionally difficult" decision, according to the university... Garcia, who had come under scrutiny for his agency's spending of public funds and the ethics of its leadership, said in a letter to his department that he was proud of the progress of the medical schools. (Alltucker, 12/8)

Health News Florida: Local Autism Center Meets The Needs Of Children 
For school age children with autism or other qualifying special needs, the local school district must create an IEP: Individualized Education Plan. Implementation of that plan is monitored and adjusted as needed. At the Autism Center, they try work with the school system to go further for their clients. (Barrett, 12/8)

Sacramento Bee: Stanford Doctors Describe Conjoined Twins' Separation Surgery 
Mixing hard medical facts with light-hearted humor, surgeons for conjoined twins Erika and Eva Sandoval recounted details Thursday of the risky and intricate surgery that cleaved the girls in two. Two days after the girls were wheeled into surgery at Lucile Packard Children’s Hospital Stanford, veteran pediatric surgeon Dr. Gary Hartman called the 17-hour separation a success and said the 2-year-olds are “recovering quite well.” He made his first public comments at a packed news conference with four other members of the 50-person medical team. (Caiola and Buck, 12/8)

Miami Herald: South Miami Hospital Pays $12 Million To Settle Medicare Fraud Charges 
South Miami Hospital, part of the nonprofit Baptist Health South Florida system, has agreed to pay about $12 million to settle federal charges of healthcare fraud arising from a whistleblower lawsuit alleging that a heart specialist performed medically unnecessary and costly cardiac procedures on thousands of patients dating back to 2007, the Justice Department reported this week. (Chang, 12/8)

Atlanta Journal Constitution: What Georgia Retirees Should Know About Choosing Health Insurance
Retirees who are looking for health insurance this enrollment season have several options, which largely depend on their age, income and circumstances.The following is what you need to know about the choices that may be available to you. (Caldwell, 12/8)

Columbus Dispatch: City, Anheuser-Busch Team Up To Reduce Harmful Drinking
The city of Columbus and Anheuser-Busch are teaming up to reduce the harmful use of alcohol in central Ohio. Organizers say it is the first-ever such citywide program in the United States and that it will involve studying dangerous behaviors and community needs and create initiatives to reduce harmful drinking. (Viviano, 12/8)

San Jose Mercury News: Wish Book: Asthma Camp Teaches Kids They Can Still Play, Exercise
Theresa Perry  hesitated at first to send her son Michael to a weeklong summer camp geared toward helping kids learn how to manage their asthma... The educational camp, held one week every summer at Mayfair Community Center in partnership with the City of San Jose, is geared to help teach kids with techniques to manage their disease. The curriculum includes helping kids understand the different aspects of the disease, recognize the triggers of attacks, know how and when to take their medication and learn how to talk to teachers, coaches and other adult caregivers about their needs related to asthma. (Gomez, 12/8)

JAMA Surgery: Association Between Surgeon Scorecard Use And Operating Room Costs
Question: What is the association between providing surgeons with individualized cost feedback and surgical supply costs? Findings: In this case-control study, surgeons in the intervention group received cost feedback scorecards during the study period, while those in the control group did not. The median surgical supply direct costs per case decreased 6.54% in the intervention group compared with a 7.42% increase in the control group. (Zygourakis et al., 12/7)

Health Affairs: After Medicaid Expansion In Kentucky, Use Of Hospital Emergency Departments For Dental Conditions Increased
Following the 2014 expansion of Medicaid eligibility in Kentucky, millions of adults became eligible to receive dental benefits. ... Based on our analysis of data for Kentucky from the State Emergency Department Databases, we found that the rate of discharges for these conditions from the [emergency departments] ED increased significantly, from 1,833 per 100,000 population in 2013 to 5,635 in 2014. Adults covered by Medicaid who used the ED for treatment of oral health conditions in 2014 had high levels of chronic comorbidities and were more likely to be male and nonwhite than those in earlier years. To avoid costly and inappropriate use of the ED, states considering adding an adult Medicaid dental benefit should consider also making changes to assist beneficiaries in obtaining access to the dental health care delivery system. (Chalmers, Grover and Compton, 12/5)

Health Affairs: Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options
Despite the wealth of evidence that oral health is related to physical health, Medicare explicitly excludes dental care from coverage, leaving beneficiaries at risk for tooth decay and periodontal disease and exposed to high out-of-pocket spending. To profile these risks, we examined access to dental care across income groups and types of insurance coverage in 2012. High-income beneficiaries were almost three times as likely to have received dental care in the previous twelve months, compared to low-income beneficiaries—74 percent of whom received no dental care. We also describe two illustrative policies that would expand access, in part by providing income-related subsidies. (Willink, Schoen and Davis, 12/5)

Preventing Chronic Disease/CDC: Understanding Barriers To Cervical Cancer Screening In Women With Access To Care, Behavioral Risk Factor Surveillance System, 2014
Cervical cancer screening can save lives when abnormal cervical lesions and early cancers are detected and treated; however, many women are not screened as recommended. We used the Behavioral Risk Factor Surveillance System survey to examine nonfinancial barriers to cervical cancer screening among women who reported having insurance and a personal doctor or health care provider. Among these women, a higher proportion who were never or rarely screened reported having multiple chronic conditions. The results of this study underscore the importance of incorporating preventive clinical services into the management of one or more chronic conditions. (Crawford et al., 11/10)

Morbidity and Mortality Weekly/CDC: Vital Signs: Trends In HIV Diagnoses, Risk Behaviors, And Prevention Among Persons Who Inject Drugs — United States
Persons who inject drugs (PWID) are at increased risk for poor health outcomes and bloodborne infections, including human immunodeficiency virus (HIV), hepatitis C virus and hepatitis B virus infections. ... During 2008–2014, HIV diagnoses among PWID declined in urban and nonurban areas, but have leveled off in recent years. Among PWID in 22 cities, during 2005–2015, syringe sharing decreased by 34% among blacks/African Americans (blacks) and by 12% among Hispanics/Latinos (Hispanics), but remained unchanged among whites. The racial composition of new PWID changed during 2005–2015: the percentage who were black decreased from 38% to 19%, the percentage who were white increased from 38% to 54%, and the percentage who were Hispanic remained stable. Among new PWID interviewed in 2015, whites engaged in riskier injection behaviors than blacks. (Wejnert et al., 11/29)

Kaiser Family Foundation: Key Medicaid Questions Post-Election
President-elect Trump supports repeal and replacement of the Affordable Care Act (ACA) and a Medicaid block grant. The GOP plan would allow states to choose between block grant and a per capita cap financing for Medicaid. The new Administration could also make changes to Medicaid without new legislation. ... The full implications of repeal will depend on whether the ACA is repealed in whole or in part, whether there is an alternative to the ACA put in place and what other simultaneous changes to Medicaid occur. However, examining the effects of the ACA on Medicaid provide insight into what might be at stake under a repeal. (11/23)

The Kaiser Family Foundation: What Coverage And Financing Is At Risk Under A Repeal Of The ACA Medicaid Expansion?
[T]his issue brief examines the changes in coverage and financing that have occurred under the Medicaid expansion to provide insight into the potential scope of coverage and funding that may be at risk under a repeal. It finds: In 2015, an estimated 11 million enrollees were adults made newly eligible by the expansion who could be at risk for losing Medicaid coverage. ... Loss of Medicaid coverage could reverse the progress in reducing the uninsured. ... As a result of the enhanced federal funding for expansion, expansion states have received $79 billion in federal funding from January 2014 through June 2015. (Rudowitz, Artiga and Young, 12/6)

Here is a selection of news coverage of other recent research:

Reuters: In Dementia, Care From Multiple Health Systems Poses Drug Safety Risks
Dementia patients who get prescriptions from multiple health systems may face a higher risk of drug mix-ups or unsafe interactions than people with cognitive problems who get all their medications from one place, a study of U.S. veterans suggests. Researchers examined data on more than 75,000 veterans with dementia and found that among patients who received all of their care at Department of Veterans Affairs (VA) facilities, 39 percent had potential safety issues with prescribed medications. Among those who got some care at the VA and some treatment elsewhere, however, 59 percent had possible drug safety issues, the study found. (Rapaport, 12/6)

Reuters: Generic Heart Failure Drug Costs Too High For Many Uninsured: Study
The cost of generic drugs that treat heart failure can vary so wildly, even among pharmacies within one area, that uninsured patients may not be able to afford them, according to research reported at the American Heart Association medical meeting in New Orleans on Tuesday. Researchers found that the combined cost for a month's supply of three commonly prescribed generic heart failure drugs ranged from $12 to $400, with an average price of about $70 in the greater St. Louis area, putting them out of reach for some patients who desperately need them. (Berkrot, 11/15)

Boston Globe: Repealing The Affordable Care Act — Fact Vs. Fiction
As the new administration and Republican allies in Congress plan their agenda for 2017, repeal of the Affordable Care Act is front and center. Senate Republicans last week put out a policy statement reiterating their plans to roll back the law and claimed — in part based on our research — that this would have only modest effects on the number of Americans without health insurance. Simply put, this is wrong and a misleading characterization of our work and that of others who have studied the ACA’s impact. (Jonathan Gruber and Benjamin Sommers, 12/8)

Forbes: Republicans Are In A Nasty Obamacare Trap
Republicans have been predicting (sometimes even gleefully) that Obamacare will end in a death spiral. As it turns out, the election of Donald Trump makes that unhappy ending more likely. But here is the irony: If Obamacare does crash and burn, Trump and the Republicans are likely to get the full blame for any suffering and misery that follows. (John C. Goodman, 12/7)

Weekly Standard: After Repeal
It’s the opportunity Republicans have been awaiting for six years, which invites the obvious question: Are they going to screw it up? In January, a united Republican Congress and Republican White House will finally have the ability to dispose of Obamacare, the unpopular and destructive health-insurance law. After running four straight national elections against the jammed-through, unconstitutional, failing, expensive, and disastrous Patient Protection and Affordable Care Act, the GOP finally has the power to do something about it. (Michael Warren, 12/8)

Health Affairs: Five Reasons The ACA Won’t Be Repealed
Since November 8, a chill has descended among individuals nationwide who are involved with or otherwise care about health care. Like sheep herded to their fate, there has been a resignation that the Affordable Care Act (ACA) will be repealed, taking with it coverage for over 23 million people, strong protections for consumers, and innovations in care delivery. But, if you take a closer look, the repeal and replace “two step” is fraught with difficulty, bolder than the ACA itself, and far from certain to succeed. So I think we all need to take a deep breath and refocus on what’s inside the sandwich we are about to be served, and resolve intentionally whether or not we’re going to eat it. (Billy Wynne, 12/7)

Stat: Donald Trump's Health Policies Could Turn My Patients Into 'Forgotten Ones'
Throughout his campaign, Trump vociferously championed “the forgotten ones.” All Americans, and especially health care providers, need to hold him to his word and make sure he acts as the president for everyone. But by overthrowing or radically altering the ACA, Trump will be creating a new legion of “forgotten ones.” With respect to health care access and coverage, “forgotten ones” aren’t necessarily minorities. Instead, they are individuals who will be affected by altering the ACA, including many working-class white Americans who voted for Trump. (Melissa Simon, 12/8)

Modern Healthcare: CBO Offers Republicans Ideas On Cutting The Deficit Beyond Repeal Of The ACA
Repealing all insurance coverage provisions of the Affordable Care Act without replacing them would reduce the federal budget deficit by $1.2 billion between 2017 and 2026, according a new Congressional Budget Office compendium of possible cost-saving moves across the entire U.S. government budget. Along with the cost-savings, repeal of the ACA would increase the number of uninsured Americans from about 23 million to 51 million, and lead to skimpier benefits in the individual insurance market and more denial of coverage to people with pre-existing medical conditions, the CBO projects. (Harris Meyer, 12/8)

Health Affairs: Trump Plan To Increase Health Savings Accounts Should Ensure That They Do Not Only Benefit The Wealthy And Healthy
One of the reforms proposed as part of the Trump health platform is to “allow individuals to use Health Savings Accounts (HSAs).” This increased emphasis on HSAs is a clarion call for more understanding about how to make HSAs work so that they are equitable, effective, and efficient. Although HSAs are conceptually appealing and can play an important role in health reforms, current evidence suggests that they primarily benefit the wealthy, the healthy, and the educated. (Kathryn Phillips, 12/8)

The New England Journal of Medicine: The Future Of Health Care Reform — Section 1332 Waivers And State-Led Reform
Actually repealing and replacing the entire ACA would be a complicated process, even with Republican majorities in both chambers. Gridlock over what a replacement plan would look like and procedural rules may limit what President-elect Donald Trump and Congress can achieve. Already, Republicans and interest groups have expressed concern about the effects of repealing the law in its entirety. The most likely effort will include congressional Republicans passing reconciliation legislation that will repeal a portion of reform while bypassing the threat of a filibuster. This approach, which was vetoed in 2015 by President Barack Obama, would leave some aspects of the ACA intact. One such component is state innovation waivers (Section 1332 waivers), which the Trump administration could use to strengthen state-led reforms or to further undercut the remnants of the ACA. (Phillip M. Singer, 12/7)

Alaska Dispatch News: Medicaid Expansion Proves Good For Alaska
It's not often that government has a chance to help thousands of people and save money at the same time. Medicaid expansion was one of these opportunities. Expansion is a bright spot in a dismal Alaska economy. Over 25,000 people now have health coverage at no cost to the state of Alaska. Alaska health care providers have received over $288 million in revenues since it started in September 2015. Health care jobs are the fastest growing sector in our economy, in part due to Medicaid expansion. (Chris Ashenbrenner, 12/8)

The New England Journal of Medicine: Cost Containment And The Tale Of Care Coordination
Nobody likes waste or fragmentation. Evidence that both are hallmarks of the U.S. health care system has fueled debate over how to redesign payment and delivery systems to root out inefficiencies. In the face of broader imperatives of cost containment and quality improvement, a narrative has emerged from this debate that now dominates policy: care coordination not only improves outcomes but lowers costs, too. Though attractive, this notion is not evidence-based. (J. Michael McWilliams, 12/8)

Stat: Mr. Trump: Don't Become The First Anti-Vaccine President
Dear President-elect Trump, Your record as a businessman is something of an open book to the people you will lead come Inauguration Day. But with no track record in governance, the policies you plan to put into effect are something of a black box. One that concerns me is what you will do about vaccination, a proven public health success story that has saved millions of children’s lives worldwide. ... There are unsettling signs that you plan to de-emphasize support for autistic people and their families, and at the same time erode mandatory vaccination laws because you subscribe to the misguided theory that vaccines are responsible for triggering a global autism epidemic. (Steve Silberman, 12/8)

The Washington Post: The Big Problem With Donald Trump’s Big Idea For Stopping The Flow Of Illegal Drugs
When asked during his presidential campaign how he would stop America’s raging opioid overdose epidemic, Donald Trump said “cut off the source, build a wall.” No one disputes that many drugs enter the United States via the Mexican border. But does this imply that trying to seal off the border would reduce the nation’s drug problem? The influence of a public policy change, for example tightening or loosening border security, varies depending on the baseline from which one is starting. Compared to having no border security, the United States' current, moderate level of drug law interdiction at its borders clearly has an impact. (Keith Humphreys, 12/8)

Miami Herald: Opioids Are Killing Us; Fight It Like Zika
The Zika epidemic in Miami-Dade is pretty much over and done with, Gov. Rick Scott announced on Thursday. Now another scourge with a higher human toll is showing up on our radar — an epidemic of opioid overdoses. As we close out 2016, things will likely only get worse in 2017 with this crisis. The county must brace itself. Law enforcement must attack. Social-service agencies must prepare. (12/8)

The New England Journal of Medicine: The Rising Price Of Naloxone — Risks To Efforts To Stem Overdose Deaths
Given the attention focused on naloxone [to help reverse opioid overdoses] and the initiatives broadening recommendations for its use, one would expect rapid increases in utilization. But between 2009 and 2015, the annual number of naloxone prescriptions increased only from 2.8 million to 3.2 million; while retail-prescription numbers were unchanged, the proportion attributed to clinics and EMS providers has grown from 14% to 29%. The relatively slow adoption of naloxone may be due in large part to stigmatization and lack of familiarity with the treatment among clinicians and opioid users. Another reason, however, may be its rising cost, which is probably enabled by the small number of manufacturers producing it. (Ravi Gupta, Nilay D. Shah and Joseph S. Ross, 12/8)

Los Angeles Times: What's The Prescription For A Hateful Patient? Connecticut Doctor Asks
I have been appalled by the swastikas, homophobic propaganda and lynching references mushrooming across the country, but the danger felt theoretical until recently, when I became a victim of hate speech from a patient. My patient's kidneys were failing and we needed to know why. After wheeling, dealing and pleading, my intern and I persuaded the MRI techs to do one last scan before they went home for the weekend. My heart beating triumphantly, I raced to update the patient. To be honest, I was dreading the conversation as he was a certified curmudgeon, but I felt relieved when I found him prattling pleasantly with some nurses. As I told him about the upcoming scan, he exploded. (Pranay Sinha, 12/8)

Miami Herald: Hype, Hope And The Truth About Alzheimer’s Disease
The good news about Alzheimer’s disease is that the rate of dementia in the United States appears to be declining. We hope this is a product of healthier lifestyles among baby boomers and portends a better future for many of us. The bad news is that another major experimental treatment for Alzheimer’s disease failed to show benefit — in line with 99 percent of all similar clinical trials in the past 15 years. Stuck in between these news items is yet another “miracle brain tonic” being hawked on social media, with the “last three trucks leaving the warehouse” so better order it fast. Given all these stories, what is one to actually believe about the current status of this late-life scourge? (Marc E. Agronin, 12/8)