The Hill: Ryan Brings Out Slideshow To Sell GOP Healthcare Bill 
Jacket off and sleeves rolled up, Speaker Paul Ryan (R-Wis.) on Thursday ditched the podium and delivered a 25-minute TED Talk-like presentation on why the new GOP health bill represents the best, and perhaps only, chance to repeal ObamaCare. “This is the closest we will ever get to repealing and replacing ObamaCare,” Ryan told reporters at the end of his slideshow presentation. “The time is here; the time is now. This is the moment.”The Speaker typically stands behind a podium and answers questions from reporters during his Thursday news briefings. But on this day, reporters in the room weren’t the intended audience. (Wong, 3/9)

NPR: House Speaker Paul Ryan Sells Health Care Bill As 'Once-In-A-Lifetime' Chance
"This is the chance. This is a once-in-a-lifetime opportunity," said the speaker, roving the stage with a wireless mic, gesturing at both the audience in front of him and the PowerPoint presentation behind him. TED Talk? Late-night infomercial? Nope — it was House Speaker Paul Ryan, making a hard pitch for his health care plan after a week of loud conservative criticism. (Detrow, 3/9)

USA Today: Republican Leaders Warn That Changing Health Care Bill Would Doom It In Senate
House Republican leaders warned their members Thursday that any major changes to the proposed GOP health care bill will prevent its passage in the Senate and kill their best shot at ending Obamacare. Those warnings came as both the House Ways and Means Committee and the Energy and Commerce Committee approved the GOP's American Health Care Act on Thursday without significant amendments after marathon debates. (Kelly, 3/9)

Morning Consult: GOP Leaders Say Republicans Won’t Get 2nd Chance On Health Care
Congressional Republican leaders are pushing back against party criticism of their plan to replace the Affordable Care Act. In media appearances on Thursday, House and Senate leaders drove home the message that their plan is Republicans’ best shot to make good on their No. 1 campaign promise. “The time is here, the time is now, this is the moment and this is the closest that will ever happen,” Speaker Paul Ryan said at his weekly press conference. “It really comes down to a binary choice.” (Reid, 3/9)

Politico: Three Misleading Claims From Paul Ryan's Obamacare Lecture
With his jacket off and sleeves rolled up, House Speaker Paul Ryan made the case for the Republican health care law Thursday, walking through a 35-minute PowerPoint presentation to a packed crowd of reporters and millions of viewers watching on the three cable TV networks. It was quintessential Ryan, calmly explaining the details of the American Health Care Act looking more like a college professor than a professional politician. But in making his case, Ryan made a series of misleading statements, both about the current state of Obamacare and the details of the replacement bill. (Vinik, 3/9)

The Wall Street Journal: Ads Push Conservatives To Get On Board With GOP Health Plan
A GOP outside group closely aligned with Speaker Paul Ryan (R., Wis.) is set to begin airing ads targeted at 30 members of the Freedom Caucus, urging their constituents to call them to vote in favor of Republican leadership’s bill to replace the Affordable Care Act. The ads, paid for by the American Action Network, a nonprofit not required to disclose its donors, mark the first time this year that a major outside group is spending money to keep members of the Republican Party in line. The group is spending $500,000 to air the ads for two weeks, bringing its total spending on the GOP health-care plan to over $8 million since January. (Hackman, 3/9)

The Hill: Ryan Pushes Back Against Critics Panning Health Plan As 'Entitlement' 
Speaker Paul Ryan (R-Wis.) on Thursday sought to push back against criticism from the right that the GOP leadership’s healthcare bill amounts to another “entitlement” program like ObamaCare. During an interview on Sean Hannity’s radio show, Ryan argued that replacing the 2010 law’s subsidies to help low-income people buy health insurance with tax credits was not the same as directly giving people federal aid. (Marcos, 3/9)

The Hill: Right Targets Ryan — Not Trump — On ObamaCare Plan 
President Trump has so far managed to avoid becoming a target for the conservative backlash to Speaker Paul Ryan’s ObamaCare repeal and replace plan, even as the White House vigorously whips support for the bill. Ryan hasn’t been so lucky. Breitbart News, which has long been one of Ryan’s most vocal foes, panned his American Health Care Act as “Speaker Ryan’s ObamaCare 2.0.” (Easley and Wong, 3/10)

Ryan also has other health-related items on his legislative to-do list -

Politico: Ryan Planning More Health Care Votes Alongside Repeal Effort
House Republicans will vote on a second health care bill the week they vote to repeal Obamacare, Speaker Paul Ryan told Sean Hannity on Thursday afternoon. The Wisconsin Republican did not divulge many details about the legislation, though he said it would likely allow people to purchase insurance through association health plans. Such a proposal has always been part of the GOP alternative, Ryan told Hannity, but Senate rules bar leadership from including it in their fast-tracked repeal bill. (Bade, 3/9)

The Wall Street Journal: GOP Health Plan Advances After Clearing Two House Committees
Republicans advanced legislation through two House committees on Thursday as part of their goal to dismantle the Affordable Care Act, but signs of discord spread around the capital as conservative lawmakers warned this version of the health-law overhaul won’t pass. ... Conservatives fired warning shots at Republican leaders in an open challenge to House Speaker Paul Ryan (R., Wis.), who said Republicans could either line up behind the House bill or renege on their promise to repeal the law. (Hughes, Armour and Peterson, 3/9)

The Washington Post: Obamacare Revision Clears Two House Committees As Trump, Others Tried To Tamp Down Backlash
The GOP proposal cleared the Ways and Means and the Energy and Commerce committees on party-line votes after marathon sessions that lasted through Wednesday night and into Thursday. It now heads to yet another panel, the Budget Committee, and it remains on track to land on the House floor by month’s end. But the proposal faces challenges with both GOP conservatives and moderates, in addition to Democrats, many of whom questioned the lightning-fast process and raised dueling qualms about its policy provisions. Even Senate Majority Leader Mitch McConnell (R-Ky.) appeared to echo a Democratic attack on the House legislation, saying lawmakers need to see the nonpartisan Congressional Budget Office estimate of how the bill will affect the federal deficit and the number of insured Americans. (DeBonis, Sullivan and Snell, 3/9)

The Associated Press: GOP Leaders Claim Momentum As Health Bill Clears Hurdles
Leaders are aiming for passage by the full House in the next couple of weeks, and from there the legislation would go to the Senate and, they hope, on to Trump's desk. The president has promised to sign it, declaring over Twitter on Thursday, "We are talking to many groups and it will end in a beautiful picture!" Yet at the same time the president is leaving himself a political out, privately telling conservative leaders that if the whole effort fails, Democrats will ultimately shoulder the blame for the problems that remain. That's according to a participant in the meeting Wednesday who spoke only on condition of anonymity to relay the private discussion. (Werner and Fram, 3/9)

Bloomberg: Republican Health Bill Clears Hurdle As House Panels Approve 
The House Energy and Commerce Committee, after a 27-hour session that saw tempers flare as Democrats tried to delay the legislation, approved the bill by a 31-23 vote with only minor changes. The vote came after the Ways and Means Committee wrapped up 18 hours of debate on its piece of the proposal, which it passed without any changes. The two measures will be combined and sent to the Budget Committee before heading to the floor. The bill, the American Health Care Act, would repeal Obamacare’s requirement that individuals have, and employers offer, health coverage and would eliminate many taxes on the wealthy, insurers and drugmakers used to fund Obamacare. The proposal includes a refundable, age-based tax credit to help people buy insurance and a wind-down of an expansion of Medicaid over a period of years. (Edney and Tracer, 3/9)

The Wall Street Journal: House GOP Leaders Surprised By Conservative Opposition To Health Plan
Rep. Mark Meadows, who leads a group of conservative House lawmakers, was home in North Carolina about two weeks ago when he learned details of the emerging Republican health-care plan. Mr. Meadows jumped in the car and drove back to Washington, where he said he warned White House officials he couldn’t support the bill being pushed by House Speaker Paul Ryan. (Armour, Hughes and Peterson, 3/9)

Politico: Conservative Demands Threaten To Derail Obamacare Repeal
Hill conservatives were just handed the opening they’ve been waiting for: An invitation from President Donald Trump to “negotiate” on an Obamacare replacement. There’s just one big problem: They’re all over the place on what they want. The discord on the far-right is becoming a real problem for Republicans. (Bade and Cheney, 3/10)

The Hill: GOP Rep On ObamaCare Replacement Plan: 'This Bill Is Not It' 
Rep. Raúl Labrador (R-Idaho) voiced his opposition to GOP leadership's plan to repeal and replace ObamaCare Thursday, saying that it doesn't go far enough. "The time is now, the time is today, we need to make sure that we repeal and replace ObamaCare. But this bill is not it," the lawmaker said in an interview with CNN. Labrador maintained that the GOP's American Health Care Act that advanced through a pair of House committees on Thursday merely "amends" former President Obama's Affordable Care Act. (Vladimirov, 3/9)

CNN: In Major Shift, White House Privately Backing Earlier Rollback Of Medicaid Expansion
The White House is privately lining up behind conservative calls to roll back Obamacare's Medicaid expansion sooner than the health care reform bill currently calls for, two senior administration officials and a senior House conservative aide told CNN on Thursday. White House officials are beginning to urge House GOP leadership to include an earlier sunset of the Medicaid expansion funds authorized under Obamacare than the 2020 date set by the current bill. The change comes just days after the bill was unveiled and follows a blitz of activism aimed squarely at the White House and President Donald Trump, who has met with conservative leaders in recent days. (Diamond, 3/9)

The Hill: Conservative Chairman: I'd Back Health Plan With Medicaid Changes
The chairman of the conservative Republican Study Committee says that if the House adopted two Medicaid amendments he is pushing, he would vote yes on GOP leadership's ObamaCare repeal bill, and if he got one, he would “lean yes.” Rep. Mark Walker (R-N.C.) is pushing amendments to move up the end of ObamaCare’s Medicaid expansion for new enrollees to 2018 instead of 2020, as it is in the current bill. (Sullivan, 3/9)

Morning Consult: Future of Medicaid Expansion Unclear as House Panels Advance ACA Repeal
A growing number of conservatives support tighter rules for Medicaid in states that chose to expand the federal program for low-income Americans under the ACA, but the proposal could alienate moderate Republicans. The Republican Study Committee on Thursday formally announced its support for an amendment filed by Rep. Joe Barton (R-Texas) that would freeze expansion enrollment at the enhanced match rate in those states at the end of this year, as well as one from Rep. Morgan Griffith (R-Va.) that would institute work requirements for able-bodied, childless adults on Medicaid. The Griffith amendment was never offered in the committee. (McIntire, 3/9)

NewsHour: Medicaid Cuts Are ‘Going To Affect Everyone,’ Insurance CEO Says
Dr. Mario Molina of Molina Healthcare, an insurance executive whose business is focused on Medicaid patients, is concerned about the way the Republican plan to replace the Affordable Care Act will not only affect patients on Medicaid, but cause major economic ripples for states and the health care system. Molina joins William Brangham to discuss what he sees as at stake. (3/9)

Modern Healthcare: GOP Medicaid Overhaul Will Hit Insurers Where It Hurts
The Affordable Care Act's insurance marketplace has been tough on payors looking to make a profit on that business, but Medicaid expansion funneled millions of new members to insurers, boosting revenue. That soon may change. Legislation passed in two House committees this week would repeal the ACA and essentially rollback Medicaid expansion. That could result in 4 million to 6 million beneficiaries losing insurance between 2020 and 2024, slashing health insurers' premiums and, by proxy, earnings. (Livingston, 3/9)

Modern Healthcare: Concerns Grow Over ACA Repeal Bill's Medicaid Provisions 
A national association representing hospitals — major employers in many districts — wrote lawmakers complaining about the bill's cuts in Medicaid and other programs. It said the bill is likely to increase the number of uninsured Americans, adding, "We ask Congress to protect our patients." Groups representing public, children's, Catholic and other hospitals also expressed opposition. America's Health Insurance Plans, representing insurers, praised the legislation's elimination of health industry taxes but warned that proposed Medicaid changes "could result in unnecessary disruptions in the coverage and care beneficiaries depend on." (Dickson, 3/9)

The Hill: States Warn Millions Could Lose Coverage Under ObamaCare Replacement
Democratic and Republican officials outside of Washington are warning Congress that millions will lose healthcare coverage if the House GOP’s proposal to replace ObamaCare becomes law. Almost all governors and state executive officers who object to the replacement hail from states that opted to accept federal funding to expand Medicaid under ObamaCare. The Republican replacement would roll back funding for the Medicaid expansion, forcing states to either shoulder the billions of dollars in costs themselves or drop new Medicaid recipients from the rolls. (Wilson, 3/9)

The Hill: Top Vote Counter On ObamaCare Bill: 'We're Gonna Get This Done' 
The top vote-counter in the House says there is no doubt that the Republican ObamaCare repeal and replace bill will pass. "We're gonna get this done," House Majority Whip Steve Scalise said with a smile on Thursday. Scalise had a good reason to be in a good mood, despite being awake for 33 straight hours, fueled by adrenaline and several cups of chicory coffee from New Orleans. He was elated the GOP healthcare bill just cleared his Energy and Commerce Committee after what may be the longest legislative markup in history. (Wong and Cusack, 3/10)

Politico: Budget Referee May Call Foul On Obamacare Repeal
The fate of Obamacare may lie in the hands of a number-crunching Republican appointee whose bottom line might single-handedly blow up the GOP quest to repeal and replace it. Congressional Budget Office Director Keith Hall was handpicked two years ago by top Republicans in Congress -- including now Health and Human Service Secretary Tom Price -- to lead a nonpartisan office that will soon release its estimate of how many Americans the Republican health care bill will cover and whether it shrinks or balloons the federal deficit. (Pradhan, 3/10)

CQ Roll Call: 11 House GOP Lawmakers To Watch On Obamacare Repeal
As House Republicans rolled out their plan to replace the 2010 health care overhaul this week, some members of the conference found themselves stuck between their constituents and their colleagues. Eleven House Republicans, who will be expected by party leadership and the White House to support the GOP's replacement plan, represent districts where at least 6 percent of their constituents are enrolled in government insurance exchanges set up by the law (PL 111-148, PL 111-152), according to a CQ Roll Call analysis of Kaiser Family Health Foundation and Census Bureau data. (McMinn, 3/9)

The Associated Press: AP Explains: How To Transform GOP Health Care Plan Into Law
Republicans' long-awaited plan to repeal and replace the Affordable Care Act has cleared a couple hurdles in the House. The GOP still must navigate a complicated path to turn its 123-page proposal from legislation to law. (Lerer, 3/9)

CQ Roll Call: Senate GOP Wants Input On House Health Care Bill
Republican senators are increasingly talking about needing to amend the House’s health care law replacement bill. Senate Republican Conference Chairman John Thune of South Dakota said it's possible the Senate will [add] changes to the House's health care bill through the budget reconciliation process on the floor. (Lesniewski, 3/9)

The Hill: Rand Paul Introduces ObamaCare Repeal Alternative 
Sen. Rand Paul (R-Ky.) is pushing an alternative ObamaCare repeal bill amid growing opposition to the House GOP leadership's plan.  Paul introduced a bill — known as the ObamaCare repeal bill — mirrored off a 2015 bill that cleared the Senate along party lines.  “The Republican Party is unified on Obamacare repeal,” Paul said in a statement. “We can honor our promise right away by passing the same language we acted on in the last Congress." (Carney, 3/9)

The Washington Post: GOP Health-Care Bill Would Drop Addiction Treatment Mandate Covering 1.3 Million Americans
The Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide. Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans. (Zezima and Ingraham, 3/9)

Modern Healthcare: Obamacare Replacement Bill Endangers Hospital Finances And Bond Ratings
Legislation that dismantles the Affordable Care Act and passed through two key House committees Thursday would hurt hospitals financially and possibly lead to debt downgrades, according to Moody's Investors Service and S&P Global Ratings. The bill relies on per-capita Medicaid caps and tax credits instead of mandates for individual insurance. The House GOP bill to repeal and replace Obamacare is likely to leave more older and sicker Americans unable to afford insurance than coax younger and healthier people to buy coverage, S&P said. (Barkholz, 3/9)

Morning Consult: Anthem CEO Praises GOP Health Bill, Calls For Swift Action
Anthem CEO Joseph Swedish called several provisions of the Republican health care bill “essential,” and called for their quick passage in a Thursday letter to two House committee chairmen obtained by Morning Consult. Swedish’s support for the proposal comes as many doctors and hospital groups have said they don’t support the bill as it’s currently written. Other advocacy groups like AARP and conservative organizations have also slammed the proposal. (McIntire, 3/9)

Cleveland Plain-Dealer: Obamacare Repeal Would Cancel Tax On Medical Device Industry
A controversial medical device tax imposed to help pay for the Affordable Care Act would be scuttled under the GOP proposal to repeal and replace it. The 2.3-percent excise took effect in 2013 and was suspended by Congress for 2016 and 2017. It will be back again in 2018, unless Congress acts. (Eaton, 3/9)

Cleveland Plain Dealer: Obamacare Replacement Bill Doesn't End Employers' Obligations 
The Republican replacement plan for Obamacare would end consumer fines for not having health insurance -- and for employers, the $2,000 to $3,000-per-worker fine for not providing insurance. Yet the underlying obligation for employers to provide that insurance would not disappear. Nor would all of the Affordable Care Act's red tape, which some human resources executives say adds significantly to their administrative burden. This is one of the oddities of the new American Health Care Act, which some are calling Trumpcare. (Koff, 3/9)

The New York Times: Tanning Industry, Taxed Under Obama, Cheers GOP Health Bill
The tanning industry found little to celebrate during Barack Obama’s presidency, but it’s starting to cheer up. Mr. Obama’s signature health law, the Affordable Care Act, put a 10 percent excise tax on indoor tanning services, and during his two terms, the federal government and states sought to deter the use of tanning beds by young people in particular, citing evidence that it causes skin cancer. ... But now, the bill Republicans proposed this week to repeal the A.C.A. would abolish the tanning tax. (Goodnough, 3/9)

The Associated Press: GOP Health Bill Would Cut CDC's $1B Disease Fighting Fund
A proposal to replace the Obama health care law would cut out a pillar of funding for the nation's lead public health agency, and experts say that would likely curtail programs across the country to prevent problems like lead poisoning and hospital infections. The Republican bill calls for the elimination of a $1 billion-a-year fund created for the Centers for Disease Control and Prevention by the Affordable Care Act in 2010. The fund's goal: Pay for public health programs designed to prevent illness and, therefore, reduce health care costs. (Stobbe, 3/9)

FiveThirtyEight: How Defunding Planned Parenthood Could Affect Health Care
The House Republicans’ plan to replace the Affordable Care Act, announced Monday, would bar reproductive health care providers who offer abortion from receiving federal Medicaid reimbursements for one year. Although no federal money is spent on abortions except in cases of rape, incest or where the mother’s life is at risk, about 40 percent of Planned Parenthood’s revenue for other services — including contraception, sexually transmitted infection testing and cancer screenings — comes from the government, mostly through Medicaid. (Thomson-DeVeaux, 3/9)

The Associated Press: Women's Health Services Face Cuts In Republican Bill
Women seeking abortions and some basic health services, including prenatal care, contraception and cancer screenings, would face restrictions and struggle to pay for some of that medical care under the House Republicans' proposed bill. The legislation, which would replace much of former President Barack Obama's health law, was approved by two House committees on Thursday. Republicans are hoping to move quickly to pass it, despite unified opposition from Democrats, criticism from some conservatives who don't think it goes far enough and several health groups who fear millions of Americans would lose coverage and benefits. (Jalonick, 3/9)

Bloomberg: This Obamacare Program Keeps You Out Of The Hospital And Saves Billions
The Republican replacement for the Affordable Care Act, now fighting its way through Congress, removes the individual insurance mandate at the heart of Obamacare and phases out the Medicaid expansion that accounts for millions of the newly insured. One piece it appears to have spared, so far: the Medicare Hospital Readmission Reduction Program. It's not a household name. But HRRP has been quietly improving the quality of health care—while saving the federal government billions of dollars—by penalizing hospitals that have too many readmissions within 30 days of patient discharge. (Shanker, 3/10)

In other health-policy news from Capitol Hill -

Stat: House GOP Would Let Employers Demand Workers' Genetic Test Results
A little-noticed bill moving through Congress would allow companies to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars, and would let employers see that genetic and other health information. Giving employers such power is now prohibited by legislation including the 2008 genetic privacy and nondiscrimination law known as GINA. The new bill gets around that landmark law by stating explicitly that GINA and other protections do not apply when genetic tests are part of a “workplace wellness” program. (Begley, 3/10)

Seattle Times: Gov. Inslee Asks State Agencies To Calculate Impact Of GOP Health-Care Plan 
A handful of state agencies are trying to calculate how the proposed Republican health-care plan would affect Washingtonians, Gov. Jay Inslee said Thursday. The number-crunching comes as the proposal to replace the Affordable Care Act is being pushed by GOP leaders through Congress. The Republican leaders say Barack Obama’s health-care law is collapsing and needs to be replaced quickly. (O'Sullivan, 3/9)

California Healthline: GOP Health Plan Could Be Bitter Pill For California’s Obamacare Exchange
Republicans are touting their health plan as the right medicine for ailing insurance markets across the country, from Arizona to Tennessee. But California never landed in sick bay. Its insurance exchange, Covered California, features the healthiest mix of customers nationwide, federal data show. That’s been instrumental in holding down rates and boosting enrollment to 1.5 million. Now state and insurance industry officials fear the replacement plan for the Affordable Care Act, introduced by GOP leaders this week, would threaten those gains. (Terhune, 3/10)

The Washington Post: ‘Is That Not Correct?’: Male GOP Lawmaker Asks Why Men Should Pay For Prenatal Coverage
In the 27 hours the House Energy and Commerce Committee spent debating Republicans’ Obamacare revision plan, a handful of moments stand out. This is one of them. At the start, Democratic Rep. Mike Doyle (Pa.) was talking with Republican Rep. John Shimkus (Ill.) about Shimkus’s objections to the Affordable Care Act’s requirements for health-insurance plans. ... “What about men having to purchase prenatal care?” Shimkus said. At that point, one could hear the room start to stir. “I’m just ... is that not correct?” Shimkus said. “And should they?” (Viebeck, 3/9)

The Washington Post: The Poor ‘Just Don’t Want Health Care’: Republican Congressman Faces Backlash Over Comments
A first-term congressman who spent three decades as a physician — and is now part of a group of Republican doctors who have a major role in replacing Obamacare — is facing backlash after saying that poor people “just don’t want health care and aren’t going to take care of themselves.” Rep. Roger Marshall, (R-Kan.), a member of the GOP Doctors Caucus, said comments he made to STAT were not meant to suggest that poor people take health care for granted. The comments were published in a story last week about his burgeoning role in the fight to replace the Affordable Care Act. (Phillips, 3/9)

Los Angeles Times: Many Of California's Republican Members Of Congress Are Saying Very Little About Their Party's Healthcare Bill
Many of California’s congressional Republicans represent districts with a large number of people who have insurance under Obamacare, and they’re taking a cautious approach to the House Republican plan to replace the healthcare law. A proposed replacement for Obamacare released earlier this week has drawn a firestorm of criticism on the left and the right. By Thursday, most of the 14 Republicans in the California delegation, including some of the seven who represent districts that backed Democrat Hillary Clinton for president, had said only that they were still assessing the proposed law. (Wire, 3/9)

As lawmakers get their talking points out to constituents, KHN teams up with ProPublica, Stat and Vox to fact-check those claims —

ProPublica/Kaiser Health News: Truth And Consequence: KHN Joins Team To Parse Lawmakers’ Lingo On Health Law
That led ProPublica to wonder about the accuracy of responses sent to constituents by other members of the House and Senate on the Affordable Care Act and its future. Today, ProPublica is teaming with journalists at Kaiser Health News, Stat and Vox to gather those missives from our readers. On Monday, House Republican leaders unveiled their official proposal to repeal and replace the law. As the legislative debate begins in earnest, we plan to look at the representations made by elected officials from both parties and share what we find. (Ornstein, 3/10)

The New York Times: After Halting Start, Trump Plunges Into Effort To Repeal Health Law
President Trump, after a halting start, is now marshaling the full power of his office to win over holdout conservatives and waffling senators to support the House Republicans’ replacement for the Affordable Care Act. There are East Room meetings, evening dinners and sumptuous lunches — even a White House bowling soiree. Mr. Trump is deploying the salesman tactics he sharpened over several decades in New York real estate. His pitch: He is fully behind the bill to scotch President Barack Obama’s signature domestic achievement, but he is open to negotiations on the details. (Haberman and Pear, 3/9)

The Hill: Trump: GOP Healthcare Push 'Coming Along Great' 
President Trump on Thursday insisted the GOP’s effort to repeal and replace ObamaCare “is coming along great,” pushing back on news reports detailing serious roadblocks for the plan. "Despite what you hear in the press, healthcare is coming along great. We are talking to many groups and it will end in a beautiful picture!” Trump tweeted. (Fabian, 3/9)

Politico: Trump's Obamacare Moves Cause Chaos In Congress
President Donald Trump's early efforts to court conservatives opposed to the GOP's Obamacare replacement is backfiring in Congress — emboldening the far right to demand changes that could repel centrists critical to its passage. While the president has given a full-throated endorsement of the bill, he's also suggested he's open to "negotiations." The mixed signals have allowed hard-line conservatives and leadership to hear what they want to hear. Each side is taking Trump's words and arguing he's in their corner. (Bade and Everett, 3/9)

Politico: White House Pushes Party Officials Nationwide To Mobilize On Health Overhaul
Facing mounting roadblocks on Capitol Hill, the White House is pleading with political supporters across the nation to pressure congressional Republicans to support President Donald Trump’s health care overhaul. During a national conference call Thursday evening, White House political director Bill Stepien told Trump backers and national Republican Party officials to pressure members of Congress to support key planks of the president’s agenda — notably his plan to replace Obamacare. (Isenstadt, 3/9)

Atlanta Journal-Constitution: Trump Tries To Sell Georgia Tea Party Leader On Healthcare Plan
President Donald Trump met with a Georgia tea party leader and other conservative groups upset with the House GOP’s healthcare plan, struggling to quell growing backlash from the right over the measure. Tea Party Patriots co-founder Jenny Beth Martin said she was encouraged that Trump heard her concerns about the healthcare plan, but said she left without any promises of changes that would ease her concerns. (Bluestein, 3/9)

Los Angeles Times: He Might Not Call It 'Trumpcare,' But The President Will Likely Own Any Obamacare Replacement
Trump and his advisors have yet to utter the term “Trumpcare,” and some still doubt his commitment to the latest congressional plan to alter President Obama’s signature healthcare law. But there’s little question that the outcome of the healthcare debate will play a major role in defining Trump’s first term in office, affecting his ability to deliver on other priorities such as a $1-trillion plan to rebuild public works, a multibillion-dollar border wall and a daunting challenge to rewrite the tax code. (Bierman and Mascaro, 3/9)

The Wall Street Journal: Will ‘Trumpcare’ Catch On? The Democrats Are Trying
One of the most effective branding campaigns in U.S. political history was the Republicans’ nicknaming of the Affordable Care Act “Obamacare.” ... Now that House Republicans have begun debate on their “repeal and replace” alternative, the American Health Care Act, the Democrats have been quick to take a lesson from the Republicans’ battle plan. “Trumpcare is finally available to the public and Democrats, a growing number of conservatives, and millions of Americans don’t like what they see,” Senate Minority Leader Chuck Schumer said in a Tuesday afternoon news conference. He and Democratic Sen. Patty Murray of Washington used the term a combined nine times. (Nasaw, 3/9)

The New York Times: White House Casts Pre-Emptive Doubt On Congressional Budget Office
President Trump showed an affinity for “working the referees” in his race to the White House, criticizing a federal judge as biased, panning polls as rigged and even questioning the aptitude of the nation’s intelligence agencies. Now, with Mr. Trump’s administration aggressively pitching the House Republican plan to repeal and replace the Affordable Care Act, Capitol Hill’s official scorekeeper — the Congressional Budget Office — is coming under intense fire. (Rappeport, 3/9)

And in the background -

The Wall Street Journal: The Wild Card Of Health-Care Reform
While the Republican plan to overhaul health care took a beating on Capitol Hill, nearby President Donald Trump was discussing something untouched by Congress: prescription-drug costs. Any effort to rein in drug costs, a favorite topic of the president, could seriously harm the pharmaceutical industry. (Grant, 3/9)

The Hill: Senate Advances Trump's Medicaid, Medicare Pick
The Senate is advancing Seema Verma, President Trump's nominee to lead the Centers for Medicare and Medicaid Services. Senators voted 54-44 Thursday on her nomination, which needed only a simple majority to overcome the initial procedural hurdle. (Carney, 3/9)

CQ Roll Call: Senate Advances Verma Nomination To Lead Medicare, Medicaid
The Senate voted 54-44 to shut off debate on the nomination of Seema Verma for the position of Centers for Medicare and Medicaid Services administrator. In that position, she is likely to bolster GOP efforts to shrink the federal footprint in delivering health care. A confirmation vote is scheduled for 5:30 p.m. Monday. As CMS chief, Verma would lead an agency that oversees about $1 trillion in federal spending. Democrats have used her nomination vote to make clear their objections to GOP bids to revise and scale back the 2010 health care law (PL 111-148, PL 111-152). (Young, 3/9)

ProPublica: What Hospitals Waste
In 2012 the National Academy of Medicine estimated the U.S. health care system squandered $765 billion a year, more than the entire budget of the Defense Department. Dr. Mark Smith, who chaired the committee that authored the report, said the waste is “crowding out” spending on critical infrastructure needs, like better roads and public transportation. The annual waste, the report estimated, could have paid for the insurance coverage of 150 million American workers — both the employer and employee contributions. (Allen, 3/9)

ProPublica: About $765 Billion Is Wasted Each Year On Health Care. Can You Help Us Find It? 
Experts say the United States might be squandering a quarter of the money spent on health care. That's an estimated $765 billion a year wasted on things like administrative red tape, high prices and overuse. We are all paying for this waste. (Allen, 3/9)

Stat: Change To Work Visa Program Draws Less Heat From Biotech Than Immigration Ban
Health and medical companies that employ many individuals who are not U.S. citizens seemed unfazed by a change to immigration policies that will increase the amount of time it will take to process their visas. While biotechnology executives slammed Trump’s executive order barring individuals from seven Muslim-majority countries from traveling to the United States, they have remained mum on a decision by the Department of Homeland Security to temporarily suspend a program that allowed companies to pay a fee to receive visas for employees in 15 days. Normally, it takes months. (Swetlitz, 3/9)

Kaiser Health News: To Save On Drug Costs, Insurer Wants To Steer You To ‘Preferred’ Pharmacies
One of California’s largest insurers has proposed a change in the benefits of commercial plans next year that would require consumers to pay more for drugs at pharmacies outside an established network. Blue Shield of California wants to create “a tiered pharmacy network” in its 2018 small- and large-group plans, according to preliminary proposals the company submitted to the California Department of Managed Health Care (DMHC), a state health insurance regulator. (Bartolone, 3/10)

Miami Herald: Caregiving Costs Associated With Alzheimer's Could Bankrupt Medicare, According To New Report 
While Washington discusses potential cuts to Medicare, a new report says that the growing number of Alzheimer’s patients could bankrupt the national insurance program that provides healthcare to more than 55 million Americans. As the baby boomer generation enters the high-risk years for the degenerative brain disease, the cost of care has already reached $259 billion, according to the report by the Alzheimer’s Association. (Veciana-Suarez, 3/9)

The Wall Street Journal: Zika Linked To Heart Problems
The Zika virus has already been linked to severe brain damage in babies and other conditions in babies and adults. Now there is evidence it may cause heart problems too. In a study conducted at the Institute of Tropical Medicine in Caracas, Venezuela, researchers identified nine patients who developed heart rhythm disorders and other serious cardiovascular complications while they had Zika. Only one had had cardiac problems previously—high blood pressure. (McKay, 3/9)

The Associated Press: Bird Flu Cases Revive Fear Of Repeat Of Major 2015 Outbreak
The detection of a highly pathogenic strain of bird flu at a Tennessee chicken farm has poultry farmers stepping up security in an attempt to prevent an outbreak like the one in 2015 that required the destruction of millions of chickens and turkeys in the Midwest. The appearance of milder forms of bird flu at a Wisconsin turkey farm and another Tennessee chicken farm has heightened concern. (Karnowski, 3/9)

Des Moines Register: Medicaid Dispute Could Prevent 220,000 Iowans From Using Mercy Hospitals, Clinics
More than 220,000 poor or disabled Iowans could lose access to one of the state’s largest hospital-and-clinic systems because of a payment dispute with a Medicaid management company. The affected Iowans receive Medicaid via AmeriHealth Caritas, one of three companies the state hired last year to run the public health insurance program. AmeriHealth recently mailed letters warning that it has been unable to negotiate new contract terms with Mercy Health Network. If the two sides can’t reach a deal by July 1, the Mercy system system would no longer be included in AmeriHealth’s network of health-care providers, the letter says. (Leys, 3/9)

Houston Chronicle: Bell's Bill Focuses On First Responder Mental Health 
State Rep. Cecil Bell filed House Bill 1794, which would create the Work Group on Mental Health Access for First Responders, a proposed 14-person panel that will study different issues first responders might have with obtaining mental health care, including stigmas, access and costs. The work group would provide its recommendations to the Texas governor, lieutenant governor and Legislature in late 2018. (Jordan, 3/10)

The Philadelphia Inquirer: Senior Centers Try Robotic Cats To Soothe Agitated Elders
Hasbro introduced the Joy for All Companion Pets line in November 2015. Three types of cats came first.  A puppy was added last fall. (Officials at both Abramson and Kendal prefer the cats.  Holt Klinger, a dog person, prefers the puppy.)   From the beginning, the robotic animals were meant to appeal to seniors. The roots of that idea go back 10 years to the introduction of FurReal Friends, a group of animatronic toys — Pax, My Poopin' Pup is one of them — meant for 4- to 8-year-old girls, said Ted Fischer, Hasbro's vice president of business development. The company noticed that 10 percent to 15 percent of its reviews were written by moms who had purchased a toy for an aging loved one. (Burling, 3/9)

NPR: States Wrestle With Legalizing Payments For Gestational Surrogates
The battle over womb rights is brewing in Minnesota. Last month, state legislators proposed a bill that would regulate gestational surrogacy — potentially adding legal oversight to fertility clinics that facilitate these pregnancies, when one woman carries a pregnancy for another. Minnesota's surrogacy legislation and the debates that surround it echo the larger national debate on reproductive rights. (Sohn, 3/10)

The CT Mirror: Once Again, School Health Clinics Facing Cuts 
School-based health centers – which provide medical and mental health care and sometimes dental services and health education, often in schools with many low-income or high-risk students – have historically received widespread backing from policymakers in Connecticut. Research has linked them with improved academic performance and graduation rates, as well as better health measures .... Gov. Dannel P. Malloy’s proposed budget calls for a 10 percent cut to grant funding for the 93 school-based health centers and associated sites that receive money from the state Department of Public Health. That follows a series of cuts in recent years. (Levin Becker, 3/10)

Boston Globe: Supreme Judicial Court Hears Case Of Woman Fired Over Use Of Medical Marijuana 
Lawyers for a woman who was fired over her use of medical marijuana brought her case before the state’s highest court on Thursday, arguing that the employer who terminated her had discriminated against her based on her use of a legal treatment. Cristina Barbuto of Brewster failed a drug test in 2014 after working for a single day at Advantage Sales and Marketing. She was let go, she claims, despite having disclosed that she uses marijuana, with her doctor’s legal permission, to combat symptoms of a digestive disorder. (Rosen, 3/9)

Sacramento Bee: Sacramento Food Bank And Family Services, Sutter Health Team Up To Provide Produce 
The bounty is available once a month at the Produce For All truck, a project of Sacramento Food Bank and Family Services, which delivers fresh fruit and veggies to Arden Arcade and about a dozen other low-income areas throughout the county. The truck’s flanks have pull-out bins that create a pop-up farmers market of sorts, which allows volunteers to quickly distribute the free produce. About 100 gathered in the church parking lot with bags in hand Thursday, anxious for their turn at the colorful food stand. (Caiola, 3/9)

San Francisco Chronicle: SF Health Officer Proposes New Benefits For Transgender Employees 
San Francisco has long led the nation when it comes to providing health insurance benefits for transgender residents. It is doubling down on that reputation. Health Service System Director Catherine Dodd is proposing to expand the health insurance benefits available to transgender employees of the city, school district, City College of San Francisco and Superior Court. (Green, 3/9)

Health News Florida: Nurses In Tampa Speak Out Against GOP Health Law Proposal 
[More] than 1,000 nurses from around the country met this week in Tampa at the American Nurses Association annual conference, and part of it was spend discussing the potential impact of repealing Obamacare. Much of the conversation focused on the newly released House plan, called the “American Health Care Act.” (Miller, 3/9)

Orlando Sentinel: UCF Startup's Product Could Bypass Drug Tests On Animals
Dr. James Hickman envisions a future when doctors can use a cancer patient’s own cells to find out which chemotherapy drug is most effective and when animals are no longer needed for researching new drugs or testing cosmetics. The UCF professor sees glimpses of it in a translucent plastic block that fits in the palm of his hand. And through the company he co-founded recently at UCF Business Incubation Program at Central Florida Research Park, he hopes to bring that future closer. (Miller, 3/9)

The New England Journal of Medicine: Health And Access To Care During The First 2 Years Of The ACA Medicaid Expansions
A total of 29 states and Washington, D.C., expanded Medicaid by September 1, 2015. In year 2 after implementation, uninsurance rates were reduced in expansion states relative to nonexpansion states ... and rates of Medicaid coverage were increased .... Expansions were not associated with significant changes in the likelihood of a doctor visit or overnight hospital stay or health status as reported by the respondent. However, as compared with nonexpansion states, expansion states had a decrease in reports of inability to afford needed follow-up care ... and in reports of worry about paying medical bills ... and an increase in reports of medical care being delayed because of wait times for appointments. (Sarah Miller and Laura R. Wherry, 3/9)

Health Affairs: Impact Of The YMCA Of The USA Diabetes Prevention Program On Medicare Spending And Utilization
The goal of the [YMCA] program is to help participants lose weight and increase physical activity. We tested whether the program reduced medical spending and utilization .... Using claims data to compute total medical costs for fee-for-service Medicare participants and a matched comparison group of nonparticipants, we found that the overall weighted average savings per member per quarter during the first three years of the intervention period was $278. Total decreases in inpatient admissions and emergency department (ED) visits were significant, with nine fewer inpatient stays and nine fewer ED visits per 1,000 participants per quarter. These results justify continued support of the model. (Alva et al., 3/6)

Health Affairs: Texas Medicaid Payment Reform: Fewer Early Elective Deliveries And Increased Gestational Age And Birthweight
In 2011 the Texas Medicaid program sought to reduce the rate of early elective deliveries by denying payment to providers for the procedure. We examined the impact of this policy on clinical care practice and perinatal outcomes by comparing the changes in Texas relative to comparison states. We found that early elective delivery rates fell by as much as 14 percent in Texas after this payment policy change, which led to gains of almost five days in gestational age and six ounces in birthweight among births affected by the policy. The impact on early elective delivery was larger in magnitude for minority patients. (Dahlen et al., 3/6)

JAMA Internal Medicine: Comparison Of Male Vs Female Resident Milestone Evaluations By Faculty During Emergency Medicine Residency Training
How does gender affect the evaluation of emergency medicine residents throughout residency training? ... In this longitudinal, retrospective cohort study of 33 456 direct-observation evaluations from 8 emergency medicine training programs, we found that the rate of milestone attainment was higher for male residents throughout training across all subcompetencies. By graduation, this gap was equivalent to more than 3 months of additional training. (Dayal et al., 3/6)

In news coverage of other recent research:

NPR: Are Routine Pelvic Exams A Must? Evidence Is Lacking, Task Force Says
An influential advisory panel says there's not enough evidence to determine whether annual pelvic exams should be routine for women who aren't pregnant and have no symptoms of disease. "We basically concluded that we didn't have enough evidence to recommend for or against," says Dr. Kirsten Bibbins-Domingo, an internist and epidemiologist at the University of California, San Francisco who chaired the U.S. Preventive Services Task Force panel asked to evaluate the best evidence on whether the exam is a good screening method. (Patti Neighmond, 3/7)

The Wall Street Journal: House Republicans Repeat An Obama Error
The GOP’s first big legislative endeavor, the repeal of ObamaCare, has been understood as a classic fight between party leadership and the more conservative and libertarian wings, and there’s truth in that. I wonder if it will not also become a struggle between the leadership and the Trumpian core. (Peggy Noonan, 3/9)

The Washington Post: The Republican Health-Care Plan Isn’t About Health Care At All
Let’s abandon the pretense. Republicans’ “health care” bill is not really about health care. It’s not about improving access to health insurance, or reducing premiums, or making sure you get to keep your doctor if you like your doctor. And it’s certainly not about preventing people from dying in the streets. Instead, it’s about hundreds of billions of dollars in tax cuts — tax cuts that will quietly pave the way for more, and far larger, tax cuts. (Catherine Rampell, 3/9)

Vox: Mitt Romney’s Former Policy Director Makes The Case For The GOP’s Health Bill
The reaction to the House GOP’s health care bill — the American Health Care Act ... — was swift and severe. Liberals hated it. But so did conservative health care wonks. One exception was Hoover Institute fellow Lanhee Chen, who served as Mitt Romney’s policy director. “It is a good start and big step in the right direction,” he tweeted. So I called him to hear his case for the bill. (Ezra Klein, 3/9)

The Washington Post: The American Health Care Act Is A Good Start
The ACA was a one-size-fits-all, top-down approach to policymaking. In contrast, the AHCA moves decision-making to the grass roots by providing funding, but permitting states flexibility in how to deal with costly preexisting conditions, provide reinsurance and other stop-loss protections that permit insurers to function effectively, and trusting state insurance regulators to run their markets. Even the significant Medicaid reform needed to ensure the program’s long-term sustainability carries enormous freedom for states to tailor their programs to their populations. (Douglas Holtz-Eakin, 3/9)

The Washington Post: The GOP Health-Care Plan Would Quietly Kill The Medicaid Expansion. Here’s How.
Republican leaders in Congress have at last unveiled their proposal to overhaul the Affordable Care Act. In a nod to a growing number of Republicans concerned that a full repeal would undo coverage gains in their home states, the new plan at first glance appears to protect coverage for those insured under the ACA’s Medicaid expansion. This is a shift from prior Republican health-care legislation — including a plan from new Health and Human Services Secretary Tom Price and the 2015 ACA repeal bill passed by Congress (and vetoed by President Obama), both of which explicitly eliminated the Medicaid expansion. But the fine print of the new proposal instead takes a more insidious approach to gutting the Medicaid expansion. (Benjamin Sommers, 3/9)

Roll Call: Put Up Your Own Plan, Democrats
Democrats have a golden opportunity to save Obamacare and pick up political credibility at the same time. With House Speaker Paul Ryan’s vision for the American health care system being rejected by the left, the center and the right, Democrats should offer their own plan to bring relief to those who are paying more or getting less under President Barack Obama’s signature law. (Jonathan Allen, 3/10)

The Washington Post: The GOP Can No Longer Claim It Believes In Fiscal Responsibility
It’s time to put an end to the myth that Republicans believe in fiscal responsibility. Saving taxpayer dollars takes a back seat to the ideological imperative of blaming and shaming the poor. Witness the GOP’s long-awaited plan to replace the Affordable Care Act. House committees are moving forward on the legislation before the Congressional Budget Office has even had a chance to estimate how much the measure will cost. Why the rush? Because if the plan doesn’t snatch away health insurance coverage from millions of people — and both President Trump and House Speaker Paul D. Ryan (R-Wis.) swear it won’t — then it’s surely going to cost a ton. (Eugene Robinson, 3/9)

Bloomberg: Republicans Should Kill Obamacare Or Let It Die
Some forms of government policy are built of political concrete. Once done, they cannot be renovated, added to or even destroyed without immense cost; for that reason, they tend to go on much as they always have, for good or for ill. This was the problem that Democrats faced with Obamacare. Other countries, it was often observed, had a national guarantee of health insurance; surely, we could build a system very much like those. But the other countries had built their systems earlier, when there weren’t so many concrete towers already in the way. (Megan McArdle, 3/9)

Bloomberg: Republicans Should Kill Obamacare Or Let It Die 
We cannot simply get rid of what Democrats built, and then perhaps, at some more convenient date, start over with a sounder design. The old structures are gone, and will not spring back up of their own accord if we knock down what’s there now.  All you get from a hasty demolition is a big pile of rubble. Very expensive rubble, for Republicans, who will have to face angry voters who now have neither their old home nor the new. The base may rejoice when they hear that Obamacare has been “repealed” (sort of). But their cries of glee will be drowned out by their wailing when they find that they cannot buy individual insurance at all. (Megan McArdle, 3/9)

Los Angeles Times: Paul Ryan’s 'Trumpcare' Does Not Entirely Repeal Or Replace Obamacare
The House Republicans’ newly unveiled plan to repeal and replace Obamacare is already in political trouble because it neither repeals nor replaces. Rather than being a complete repeal, it retains some elements of Obamacare — more properly known as the Affordable Care Act. This infuriates hard-line conservative members of Congress, as well as anti-government billionaires like the Koch Brothers, because they think it maintains new and unacceptable government entitlements. At the same time, the GOP proposal is anathema to moderate Republicans and pretty much all Democrats because it does not really replace the ACA’s approach to healthcare with an improved system. Rather, it radically changes the balance in who benefits. (David Horsey, 3/9)

Bloomberg: The Case Against The CBO
Republicans fear, and Democrats hope, that the Congressional Budget Office will eventually determine that the legislation would cause 10 million to 20 million fewer people to have coverage. That may be why Republicans are holding votes before the CBO can finish its work. But the CBO has gotten its estimates badly wrong before. Before Congress enacted Obamacare, the office projected that by this year, its exchanges would enroll 23 million people. As late as June 2015, the CBO was sticking to this projection. The actual number is about nine million. (Ramesh Ponnuru, 3/9)

Arizona Republic: Are Republicans Pulling A Pelosi On Health Care?
How many times have Republicans mocked those 15 words, spoken in 2010 by then-Speaker Nancy Pelosi as Congress was moving to pass the Affordable Care Act. Seven years later, President Donald Trump and House Speaker Paul Ryan are racing to repeal and replace the despised Obamacare and it appears, oddly, that they’re determined to pass the thing before we can find out what the heck it does. (Laurie Roberts, 3/9)

Richmond Times-Dispatch: The Republican Faceplant On Obamacare
Thanks to congressional Republicans, a divided nation has come together at last. Everybody hates their health-care plan. To its credit, the bill does away with the employer and individual mandates, which compelled companies and persons to buy insurance or face federal wrath. It cuts taxes, and it also slightly relaxes rules that forbade insurers to charge older customers more than three times what they charge younger ones. ... Unfortunately, the plan’s deficiencies overwhelm its merits. (3/9)

Cincinnati Enquirer: Unintended Consequences Of Health Reform 
The advocates for the American Health Care Act argue that even if the proposed reform package needs some improvement, it is far better than doing nothing and in any case, the government can always make mid-course corrections. This is a truly costly and unnecessarily risky approach. It is a false choice because there are better alternatives for improving access, lowering costs and improving quality. (Hank Werronen, 3/9)

San Francisco Chronicle: Defunding Planned Parenthood Is Ideology, Not Health Care 
Among the ill-considered features of the emerging Republican health care plan is the wholesale effort to hobble Planned Parenthood, the national family-planning organization that, yes, also performs abortions. It’s a case of strident ideology at odds with practical goals. Planned Parenthood delivers a range of family planning and disease-prevention services, including to low-income women using federal Medicaid funds. In California, the organization serves 850,000 residents each year. (3/9)

And some opinions not related to the health law debate —

Stat: Learning How To Be A Doctor In The Shadow Of Trump's Wall
Every Wednesday, my medical school classmates and I swarm the wards and primary care clinics of nearby teaching hospitals, taking histories, fumbling through physicals, and slowly learning to practice the art of medicine. As I talk with a patient and run through my standard list of questions, there’s always one section — place of birth, nationality, and immigration — that I skip. My reasons for not gathering that information are varied: potential embarrassment for the patient, an awkwardness that could disrupt the flow of the interaction, and now the acute anxiety that asking such questions raises. (Sandhira Wijayaratne, 3/9)

The New England Journal of Medicine: Chilling Effect? Post-Election Health Care Use By Undocumented And Mixed-Status Families
Navigating the health care system is particularly difficult for people with limited English proficiency and health literacy or without health insurance or a Social Security number. Many undocumented immigrants and their families therefore go without needed care, to their detriment and sometimes that of others .... Trump administration comments and actions regarding immigration policy and enforcement will most likely further dampen health care utilization. President Donald Trump has already signed several executive orders consistent with his anti-immigrant rhetoric. (Kathleen R. Page and Sarah Polk, 3/8)

JAMA: Medicaid Block Grants and Federalism: Lessons From Canada
Republican leaders are proposing a fundamental reform in Medicaid financing—a shift to block grants. Instead of a matching subsidy and federal oversight, block grants would give states an annual lump sum with minimal conditions attached. Block granting for social and health programs has been used with varying levels of success in welfare reform and in a modified version for the Children’s Health Insurance Program (CHIP), which provides federal matching funds up to a specified cap. But for such a large state-federal health insurance program, perhaps the most useful precedent is Canada, which made a similar shift to block grants several decades ago. (Benjamin D. Sommers and C. David Naylor, 3/9)

The New England Journal of Medicine: Getting Real About Health Care Costs — A Broader Approach To Cost Stewardship In Medical Education
In recent years, a growing number of medical schools have begun to provide training in cost stewardship, as part of efforts to improve the value of health care. Yet everyday patient encounters provide sober reminders of the unintended consequences of myopic physician education about costs. (Ravi B. Parikh, Arnold Milstein and Sachin H. Jain, 3/9)

JAMA: Addressing Physician Burnout
Observational studies suggest physician burnout may have important repercussions for the US health care delivery system. Physician burnout has been linked to self-reported errors, turnover, and higher mortality ratios in hospitalized patients. Indeed, studies suggest a link between burnout and a reduction in the amount of time physicians devote to providing clinical care to patients. Given the particularly high rates of burnout in some primary care disciplines (eg, family medicine and general internal medicine), burnout could amplify workforce shortages and affect access to care. Therefore, the high rates of burnout reported in US physicians can be considered both a marker of dysfunction in the health care delivery system and a factor contributing to dysfunction. (Tait D. Shanafelt, Lotte N. Dyrbye and Colin P. West, 3/7)

San Francisco Chronicle: Help Mentally Ill With Police Training And Treatment, Not Jail 
Violent encounters between police and individuals with mental illness — Sean Moore in San Francisco and Joseph Mann in Sacramento — have highlighted the use of lethal force. In both incidents, police were summoned to address dangerous or disorderly behavior of men who suffered from mental illness; both incidents ended with officers shooting the suspects, one fatally. Public attention has focused narrowly on perceived police mismanagement of these tragic situations. Unfortunately, it may be difficult to defuse a dangerous situation especially when the officers feel that their lives are at risk or a civilian may be injured. (Matthew E. Hirschtritt and Renee L. Binder, 3/9)

Stat: I Learned Personally That Colon Cancer Is On The Rise Among Younger People
Most people think of colorectal cancer as something that affects older folks. New research — and personal experience — shows that young people are affected, too. In November of 2015, at the age of 22, I had a colonoscopy as part of an extensive workup for a pancreatic condition I had been living with for almost five years. Much to my doctor’s surprise, the procedure turned up an adenoma, a precancerous growth in the lining of my large intestine. Had it not been for the colonoscopy, it would have grown undetected for years, and almost certainly turned into colon cancer. (Maia Dolphin-Krute, 3/9)