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In advertisements, in debates and on the campaign trail, Republican candidates are abandoning their promise to “repeal and replace” the Affordable Care Act and are swearing that they never voted to undo protections for people with pre-existing medical conditions — and never will. But as the candidates seek to assuage voters who say health care is their top issue, their leaders are staying the course, setting up a collision between campaign promises and the party’s agenda should Republicans emerge from the midterms in control of Congress. (Edmondson, 10/18)

Republican lawmakers and candidates across the country are suddenly telling voters they’ll protect preexisting conditions rules, brushing aside the fact that many voted to repeal the Affordable Care Act dozens of times and that GOP leaders pledge to resume that fight in 2019. The shift reflects the growing popularity of Obamacare and Democrats’ success in using the issue to make a compelling closing argument in the midterm races. (Haberkorn, 10/18)

Senate Majority Leader Mitch McConnell (R-Ky.) defended the Trump administration’s decision to join a lawsuit that seeks to overturn ObamaCare and its protections for people with pre-existing conditions. “It’s no secret that we preferred to start over" to repeal and replace Obamacare, McConnell said in a newly published interview with Bloomberg. “So no, I don’t fault the administration for trying to give us an opportunity to do this differently and to go in a different direction.” (Weixel, 10/18)

Cathy McMorris Rodgers got an earful about health care on a recent Friday afternoon knocking on doors in the suburban Balboa neighborhood of Spokane. McMorris Rodgers, the top-ranking Republican woman in the House facing the toughest reelection contest of her career, heard one resident complain his wife’s monthly insurance premiums have swelled to over $700 per month. Another agonized about affording long-term care for her elderly mother. Yet another worried whether Medicare would go bankrupt. (Demko, 10/17)

With their increasingly ardent campaign promises to protect health coverage for people with pre-existing medical conditions, House and Senate Republican candidates will face pressure to keep those commitments if they win in November. GOP leaders, including Vice President Mike Pence, say they want to try again in 2019 to repeal the Affordable Care Act. Last year's GOP repeal bills would have significantly weakened the law's provisions, letting states re-establish the use of medical underwriting by insurers. (Meyer, 10/18)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Republicans’ Preexisting Political Problem

Ensuring that people with preexisting health conditions can get and keep health insurance has become one of the leading issues around the country ahead of this fall’s midterm elections. And it has put Republicans in something of a bind — many either voted to repeal these coverage protections as part of the 2017 effort in Congress or have signed onto a lawsuit that would invalidate them. (10/18)

Hip-hop, health care and Brett Kavanaugh have emerged as issues in a tight congressional race in New York's Hudson Valley that pits a freshman Republican congressman against a rapper-turned-corporate lawyer seeking his first political office. Democrat Antonio Delgado is running on universal access to Medicare, creating good jobs and eliminating tax loopholes for the rich. But his supporters say Republicans have instead obsessed over his brief rap career more than a decade ago, portraying Delgado, who is black, as a thuggish "big-city liberal" who denigrated police, women and American values. (Esch, 10/18)

Hospital administrators found a natural ally in their efforts to thwart mandatory nurse staffing ratios: other executives. Question 1 looms large, with the statewide vote less than three weeks away. So prominent business groups are making their final push against the ballot question that would set standards for the maximum number of hospital patients that can be assigned to a nurse at any given time. (Chesto, 10/19)

Walker's state Department of Corrections sponsored 26 workshops for 135 guards and other prison staff on a concept called "trauma-informed care" — practices meant to sensitize government workers and social agencies to the prevalence of neurological trauma that stems from childhood exposure to neglect, abuse, violence, sexual assault, addiction or chronic stress. Data collected in the last decade show an epidemic of psychological trauma all across the American population — rural, urban and suburban. (Schmid, 10/18)

The Arizona Medical Association did not endorse Hiral Tipirneni, a former emergency-room doctor who now works as a cancer-research advocate, but it did take back an endorsement for what it said was the first time in its history. The move capped a week of unrest among its members as they saw Tipirneni attacked in yard signs as a "fake doctor" and on TV as recently as Thursday as a "phony." (Hansen, 10/18)