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Obama Care survived a GOP repeal attempt but the law’s prognosis remains poor—higher premiums and insurer flight. Some Republicans would be happy to dump money into the exchanges and move on, so credit the Trump Administration for a proposal that puts consumer choice ahead of politics. On Tuesday the Health and Human Services Department proposed a rule for short-term, limited duration health insurance as an alternative to the ObamaCare exchanges. Insurers would have to make clear that the plans, which could last for less than 12 months, would be liberated from the Affordable Care Act’s benefit and other mandates. (2/20)

It’s another day and the Trump administration is trying to stick another knife in the Affordable Care Act. This time it comes courtesy of a proposed expansion in the length of time a household can receive a lower cost, short-term health-coverage plan that does not meet the Affordable Health Care’s standards for insurance. Under the new proposal, households can purchase the more limited plan for a year — up from three months. (Helaine Olen, 2/20)

Despite the Trump administration's best efforts to undermine and bad-mouth Obamacare, it is not collapsing, as the president often claims. The state exchanges where insurers sell policies to Americans who don't get health benefits at work are stabilizing, and enrollment remained about the same last year even after administration actions drove up premiums, slashed marketing efforts and shortened the sign-up period. Yet the White House and congressional Republicans are undaunted, and their efforts to lay waste to Obamacare are continuing. They've taken a series of steps in recent months aimed at helping healthier people cut their spending on insurance. But in each case, their approach would rob Peter to save some bucks for Paul, shifting costs from the healthy onto those who need comprehensive health coverage. (2/21)

The CEOs of Amazon, Berkshire Hathaway and JPMorgan Chase certainly got America’s attention with their recent announcement of a joint health care initiative. Their immediate goal is to lower the costs over covering the 1.2 million people they collectively employ. But Wall Street quickly concluded that their creation — whatever it turns out to be — could resonate beyond their companies. The stocks of major health insurers and benefit managers sold off. And pundits started speculating on how BBD (Jeff Bezos, Warren Buffett and Jamie Dimon, three of the brightest minds in American business) might create a giant HMO or find new ways to mine health data to enable early interventions. (2/20)

The Amazon-Berkshire Hathaway-JPMorgan Chase initiative to provide health coverage a new way — details to follow — has justifiably generated excitement. But far from being feared, “disruption” is welcomed by individual and employer purchasers of health services as a spur to innovation. More puzzling is the assertion that this development suggests that the long-term play should be de-linking employers from health coverage. That would be a serious setback for 178 million Americans covered by employer plans. This system is made possible by enlightened, bipartisan policy promoting employer-provided coverage. (James A. Klein, 2/20)

Matters that seem arcane are often vitally important, because they can be worth tens of billions of dollars. Such is the case with “risk adjustment” in health care. Medical spending is not spread evenly across all people in society. Half the population uses hardly any care in a given year—only 3% of total spending. Conversely, 10% of Americans consume about two-thirds of all health-care spending. (Ezekiel J. Emanuel and Bob Kocher, 2/20)

A few years ago, the police brought a 21-year-old man into the crisis unit where I work as an emergency psychiatrist. His parents had called the police after seeing postings on his Facebook page that praised the Columbine shooters, referred to imminent death and destruction at his community college and promised his own “Day of Retribution.” His brother reported to the police that he had recently purchased a gun. (Amy Barnhorst, 2/20)

The benefits of this product to Facebook are clear. Instilling brand loyalty in young users is a way to ensure that they continue to use the social network as teenagers and adults. ... What's also clear is how bad the app could be for children. A growing body of research shows that excessive use of digital devices and social media is harmful to children and teens. Time spent on social media has been linked to adolescent depression and dissatisfaction with appearance, family and life in general. Teens who spend six to nine hours a week on social media are more likely to report being unhappy than kids who spend less time on social media, while kids who spend more time with friends in person are more likely to report being happy. For pre-teen girls in particular, time on social media is linked with idealizing thinness and discontent with their own bodies. (Susan Linn, 2/21)

For most of the past 20 years, prescription opioid abuse was treated like the weather: Everyone complained about it but no one ever did anything about it. As a result, it exploded into a national epidemic that killed 17,000 Americans in 2016. Add to that about 35,000 overdose deaths from heroin and synthetic opioids — often used by addicts when they can’t get prescription drugs any more — and you’re approaching a Vietnam War death toll every year. Public awareness and outrage are starting to change things. In that regard, a Senate Homeland Security Committee investigation led by Sen. Claire McCaskill, D-Mo., has been helpful, even though most of Congress hasn’t been. The committee’s latest report, released Feb. 12, detailed how opioid manufacturers spent almost $9 million between 2012 and 2017 supporting pain treatment advocacy groups that promoted use of the manufacturers’ products. (2/20)

A budget proposal from President Trump calls for replacing part of federal food stamp spending with boxes of groceries to be delivered directly to participants in the Supplemental Nutrition Assistance Program. The so-called U.S. Harvest Boxes would include canned and dried food like vegetables and pasta and items like shelf-stable milk; about half of the individual food stamp allocation — roughly $125 a month — would be cut in favor of the delivered food. The idea for what should be called the U.S. Heartless Boxes is so ludicrous that it seems designed to be a distraction rather than an actual proposal. Given the initial outcry, it’s unlikely to gain much traction. It’s still worth pointing out just how wrong the idea is. (2/21)

Senate Study Bill 3143 would ban abortions after the detection of a heartbeat. Any doctor who provides one after that point could be charged with a felony punishable by up to five years in prison. The heart and other organs of a fetus generally start to form about the sixth week of pregnancy, according to the Mayo Clinic. This could be before a fetus has lower limbs, a nose or retinas. It is also about the same time a woman realizes she missed a period and discovers she is pregnant. But the goal of lawmakers is, once again, to ban as many abortions as they can. And they never fail to concoct a sketchy rationale to accomplish that goal. (2/20)

By now, you’ve likely heard that breast-feeding is good. Women hear the mantra “breast is best” practically from the moment they conceive — both the World Health Organization and the American Academy of Pediatrics recommend exclusively breast-feeding babies for six months. With this kind of endorsement, which any nursing mother will tell you requires a mammoth commitment, you would think we know everything there is to know about the practice.In reality, we don’t. We aren’t even close. (Allison Yarrow, 2/21)