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Republican senators plan to write a health-care bill that could be radically different from the one passed last week by the House, including keeping some of the benefits and safeguards currently enshrined within Obamacare. The Senate’s different approach means there’s no clear timetable for producing a bill, and it likely ensures that President Donald Trump and House Republicans will eventually have to face legislation that doesn’t fully repeal the Affordable Care Act despite their repeated campaign promises to do it. (Strohm and Brody, 5/7)

Republican senators planned Friday to begin a formal full rewrite of the House GOP health-care bill, driven in part by a sense that the House version made insurance cheaper for young people but costlier for older Americans—an influential, mostly GOP voting bloc. Among the provisions senators are tackling is one that allows insurers to charge older Americans five times as much as younger people and lets states obtain waivers that could make that disparity even larger. (Armour and Peterson, 5/5)

Sen. Susan Collins said on Sunday the Senate will not be tied down by the Republican health care bill approved by the House. Asked on ABC's "This Week" whether she would vote yes on the House bill, the Maine Republican said she wouldn’t have to. "First of all, the House bill is not going to come before us," she said. "The Senate is starting from scratch. We're going to draft our own bill. And I'm convinced that we're going to take the time to do it right." (Gee, 5/7)

Collins said she thinks the Senate will "come up with a whole new fresh approach" that solves the "legitimate flaws that do exist" with the Affordable Care Act (ACA). (Savransky, 5/7)

Ms. Collins said the bill was difficult to assess, because the House passed it before the nonpartisan Congressional Budget Office had completed its latest estimate of how much the bill would cost and of how it would change the number of Americans with health insurance. She also said the bill “really hurts a state like Maine” by not having geographical adjustments for tax credits that the bill offers to help people buy health insurance. (Zumbrun and Sonne, 5/7)

Vermont Sen. Bernie Sanders on Sunday called the GOP-backed Obamacare repeal bill "one of the most disgusting pieces of legislation ever passed," and called it a "death sentence for thousands" of Americans who may not seek medical care when they get sick. (Mai-Duc, 5/7)

With the House passage of a bill to repeal and replace major parts of the Affordable Care Act, the work now shifts to the Senate. The Senate will take advantage of the work done by the House but will write its own bill, said Sen. Lamar Alexander, the Republican chairman of the committee that oversees health care issues. ... Meanwhile, Sen. Bob Corker, R-Chattanooga, told MSNBC on Thursday that the House version of the bill has "zero" chance of passing the Senate in its current form.  "No. Zero," Corker said. "That's not the way it is going to work." (Collins, 5/5)

Senator Jerry Moran (R-Kansas) says he hasn’t read the legislation the House passed Thursday to repeal and replace the Affordable Care Act. What’s more, he says, it doesn’t matter, because the Senate is going to reboot the whole issue. “What the House attempted to pass last time was not something that I found satisfactory,” says Moran, referring to the plan that was pulled before a vote in March. “So, we’ll take a look at this. But what I would say is, it doesn’t matter that much in the Senate, because we’re going to start from scratch.” (Morris, 5/5)

Senate Majority Leader Mitch McConnell (R-Ky.) said Saturday that the Senate does not expect any help from Democrats as it tries to pass legislation to repeal and replace ObamaCare. “We don’t anticipate any Democratic help at all, so it will be a simple majority vote situation,” McConnell told The Associated Press. McConnell’s comments come after the House on Thursday narrowly voted to pass the American Health Care Act, which repeals key elements of ObamaCare. (Shelbourne, 5/7)

The Republican split screen on health care revealed the frothing debate within the party about how to gut aspects of the Affordable Care Act, which became law in 2010 and whose demise has been promised by the Republican Party to its conservative base. (Costa and Wagner, 5/7)

The House’s passage of legislation to repeal and replace ObamaCare moves the issue to the Senate, where its future is far from certain. GOP senators have said they will overhaul the House bill, and that legislation won’t reach the floor until it has 51 votes. Here are the five key players to watch. (Hellmann, 5/6)

Senate Republicans get their shot at crafting a bill to repeal the Affordable Care Act. The version that narrowly passed the House on Thursday didn't win over many in the Senate, where lawmakers insist they'll come up with their own version. Majority Leader Mitch McConnell, R-Ky., spoke to President Donald Trump after the House vote and is now working with roughly a dozen other senators — all male — to write a new bill. (Jalonick, 5/5)

U.S. Democrats on Sunday criticized the lack of women on a working group in the Republican-led Senate that will craft a plan to pass legislation to repeal and replace Obamacare. As the Senate begins to wrestle with a Republican healthcare bill narrowly approved by the House of Representatives last week, senators questioned why the 13-member working group put together by Senate Republican leader Mitch McConnell does not include any of the chamber's five Republican women. (5/7)

President Donald Trump urged Senate Republicans on Sunday to "not let the American people down," as the contentious debate over overhauling the U.S. health care systems shifts to Congress' upper chamber, where a vote is potentially weeks, if not months, away. (Superville, 5/7)

The White House is hoping to harness insurance-market woes in some states to help lift the GOP’s health-care measure over the remaining hurdles in Congress, a strategy that reflects President Donald Trump’s own high-stakes approach to deal-making. With the House GOP health bill now before the Senate, White House aides say their job may become easier as health insurers in the next few weeks make final decisions about where to sell coverage next year and how to price it. Early signals have raised the prospect of no insurers offering coverage in parts of Iowa and Tennessee, and of premium surges in states such as Virginia and Maryland. (Radnofsky and Bender, 5/7)

White House Chief of Staff Reince Priebus said Sunday he doubts states will take the option of letting insurance companies charge sicker people more if the GOP health care bill the House narrowly passed Thursday becomes law. "It doesn’t affect anyone with continuous coverage, even if a governor — which I’m not sure that’s ever going to happen — takes the waiver option,” Priebus said on “Fox News Sunday.” (Groppe, 5/7)

Trump administration officials defended Sunday the president’s victory lap over a health care bill far from completion, and the fact that the Rose Garden news conference featured mostly men. “The president achieved something that no one thought he would,” White House Chief of Staff Reince Priebus said on “Fox News Sunday.” “I think we were right to give the Congress an attaboy in the Rose Garden. But we also know that this is just the beginning, it’s the first step.” (Groppe, 5/7)

Health and Human Services Secretary Tom Price on Sunday said President Trump is “absolutely” keeping his promises to the American people on healthcare. Americans will be "covered in a way that they want” under the new healthcare plan, Price told Andrea Mitchell on NBC’s “Meet the Press.” Price dismissed critics who say that the Republican plan, recently passed in the House, does not take care of individuals with pre-existing conditions. (Shellbourne, 5/7)

Speaker Paul D. Ryan said on Sunday that criticism of the way the House passed its health care bill — no hearings were held on the final version, and it has yet to receive an evaluation from the Congressional Budget Office — was “kind of a bogus attack from the left.” “This is a rescue mission” as “Obamacare is collapsing,” Mr. Ryan said on ABC’s “This Week.” “This is a crisis. We are trying to prevent this crisis.” (Weiland, 5/7)

House Speaker Paul Ryan declared on Sunday the Republican House health care bill was not only good policy but also good politics, fulfilling the long-standing GOP campaign promise to repeal and replace Obamacare. "Health care is a complicated and very emotional personal issue. And we completely understand that," the Wisconsin Republican said on ABC's "This Week." "The system is failing. We're stepping in front of it and rescuing people from a collapsing system. And more importantly, we're keeping our word." (Gee, 5/7)

From the moment the Republican-controlled House of Representatives approved a plan to overhaul the health care system, an onslaught of opposition to the bill has been focused on a single, compact term: pre-existing conditions. The Democratic Congressional Campaign Committee began running digital ads warning that the legislation would leave “no more protections” for people with a history of illness or injury. Pointing to the power that states could have to set the terms for insurers under the G.O.P. bill, Democratic leaders announced they would make pre-existing conditions an issue in every gubernatorial and state legislative race in the country. (Burns and Goodnough, 5/5)

With one hasty and excruciatingly narrow vote, House Republicans have all but guaranteed that health care will be one of the most pivotal issues shaping the next two election cycles — including congressional, gubernatorial and state legislative races in the 2018 midterms and President Trump’s likely reelection bid in 2020. (Rucker, 5/5)

Even though the Senate still has to act, Republicans now largely own a measure that would curtail, and in some cases take away completely, benefits Americans have embraced after seven years. Chief among them: a guarantee of paying the same amount for coverage regardless of health history. Budget analysts estimate 24 million people would lose insurance over a decade, 14 million in the first year, and older Americans would face higher costs. (Barrow and Peoples, 5/6)

In a suburban Chicago district, Kelly Mazeski, a breast cancer survivor, used the day of the vote to repeal the Affordable Care Act to announce her House candidacy, vowing to make Representative Peter Roskam pay for his vote “to make Americans pay more and get less for their health care.” In western New York, Lt. Gov. Kathy Hochul has stirred talk of a congressional race with her slashing criticism of Representative Chris Collins, who rallied fellow Republicans to vote for the health measure, then conceded in a national television interview that he had not read the bill. (Martin and Burns, 5/6)

Democrats “can start the ads now,” said Julius Hobson, an attorney and former lobbyist with the American Medical Association. “Now you get to attack every GOP House member and say he or she was the margin of victory to take away your healthcare benefits,” just like the Republicans did when ObamaCare passed. Accusations of hypocrisy flew fast and heavy from Democrats this week, as the House passed an ObamaCare repeal bill after struggling with the contents for more than two months. (Weixel, 5/7)

Some 23 House Republicans represent districts that Democratic presidential nominee Hillary Clinton carried last November, suggesting that those seats could be in play next year. Fourteen of those lawmakers voted for the House bill, while nine voted against it. Several groups said they were starting ad buys in those districts. (Andrews, 5/8)

Save My Care, a coalition of pro-Obamacare advocacy groups, is launching a $500,000-plus TV ad campaign in five congressional districts held by Republicans who backed the GOP plan, the American Health Care Act. The ads target Reps. Martha McSally (R-Ariz.), Bruce Poliquin (R-Maine), Don Young (R-Alaska), Mark Amodei (R-Nev.) and Tom MacArthur (R-N.J.). (Cheney, 5/8)

The Republican Party will be rewarded for doing "what's right" by voting to overhaul a "failing and collapsing" health care system. That's according to White House chief of staff Reince Priebus. Priebus made that claim as Democrats and at least one outside group began planning to challenge the GOP for control of the House in the 2018 midterm election. (Superville, 5/8)

A conservative Republican congressman from Idaho is drawing criticism for his response to a town-hall attendee’s concerns about how his party’s health-care bill would affect Medicaid recipients. “You are mandating people on Medicaid to accept dying,” the woman said. “That line is so indefensible,” said Rep. Raúl R. Labrador, a member of the influential House Freedom Caucus. “Nobody dies because they don’t have access to health care.” The boos instantly drowned him out. (Phillips, 5/7)

Rep. Tom MacArthur (R-N.J.), the centrist who negotiated the amendment that helped bring the House GOP’s healthcare bill over the finish line, expects his town hall next Wednesday could get rowdy. MacArthur noted the event is being held in Willingboro, N.J., where he only won 10 percent of the vote in the last election. “This is a not a town that’s going to perhaps be thrilled with this. But I will meet my constituents and talk to them and tell them why and help them understand that what they hear in the media and what fearmongerers are trying to whip up is simply not the truth,” MacArthur said just off the House floor after Thursday’s 217-213 vote on the healthcare bill. (Marcos, 5/6)

During House Speaker Paul D. Ryan’s push this week to pass legislation that would overhaul the nation’s health-care system, Northern Virginia Rep. Barbara Comstock stood alone as a “no” vote among her Republican Party colleagues in the Washington region. The reason Comstock gave is that the latest version of the American Health Care Act, which passed by a vote of 217 to 213, does not protect people with preexisting conditions and has too many other “uncertainties” in its aim to offer a better model than Obamacare. (Olivo, 5/5)

A Republican senator came up with a new phrase to promote a bill he has pitched to replace the Affordable Care Act. “Does it pass the Jimmy Kimmel test?” Sen. Bill Cassidy (R-La.), who introduced legislation that would replace Obamacare while keeping some of its most popular features, said Friday in an interview with CNN. “Would a child born with congenital heart disease be able to get everything she or he would need in the first year of life? I want it to pass the Jimmy Kimmel test.” (Phillips, 5/6)

A noisy but peaceful gathering outside U.S. Rep. John Culberson's west Houston office Sunday afternoon brought out dozens of chanting protesters determined to send a vote-shaming message to the long-time Republican Congressman... Culberson, who did not appear to be near his office as the protest unfolded, was among the 217 Republicans who last week narrowly approved a measure called the American Health Care Act, designed to replace the current health care law known as Obamacare. (Deam, 5/7)

Mailing human ash is not nearly as complicated as you might think. You basically just need some bubble wrap, a sturdy box and a special label, according the U.S. Postal Service’s handy guide. But why? ... Maybe you want a loved one’s ashes sealed inside blown glass. Or maybe (not in pamphlet) you want your own mortal remains shipped to one of the Republican House members who just passed a health-care bill widely expected to strip insurance from millions of people and hike medical costs — just in case that leads to your death. (Selk, 5/6)

James McLelland was born with a rare form of dwarfism and spent his first nine months in the hospital connected to tubes, machines and monitors. About seven months before his birth in 2011, a provision of the Affordable Care Act kicked in, prohibiting insurers from imposing lifetime limits on health coverage. “If Obamacare hadn’t been in effect, he would have hit the lifetime limit of $1 million before he ever left the hospital,” said his mother, Jennifer McLelland, 35, of Clovis, Calif., using a common nickname for the ACA. (Bazar and Ibarra, 5/5)

But as the pools draw new attention in Washington, those who managed and used the Maryland program say the state's experience shows the pros and cons of the approach. A high-risk pool amounts to a separate insurance system for the sickest patients. Maryland's program, which received praise from members of both political parties, will likely inform the debate over the future of health insurance as the GOP's Obamacare repeal effort moves to the Senate. (Cohn and Fritze, 5/6)

People enrolled in the pool [former insurance commissioner Marcy] Morrison oversaw, which was called CoverColorado, paid premiums that were as much as 50 percent higher than market average. Taken together, though, those premiums were only enough to pay for about half of CoverColorado’s expenses. Contributions from the state’s unclaimed property fund and charges passed on to every other health insurance customer in the state made up the rest. To keep costs down, CoverColorado imposed a $1 million lifetime benefit cap on enrollees and made people wait several months after joining before the plan would pay for expenses relating to a pre-existing condition. And Morrison said the plan still couldn’t accommodate everybody who wanted to join. (Ingold, 5/5)

Ohio Gov. John Kasich (R) mocked House Republicans’ ObamaCare repeal bill, saying its plan to establish high-risk pools for people with pre-existing conditions is “ridiculous.” “The business of these [high]-risk pools, they are not funded,  $8 billion dollars is not enough to fund,” Kasich said on CNN’s “State of the Union,” Sunday morning, laughing. “It’s ridiculous.” (Carter, 5/7)

Ohio Gov. John Kasich on Sunday knocked the Republican health care bill as inadequate, arguing the just-passed House measure would leave many Medicaid patients and those with pre-existing conditions wanting. "In the area of Medicaid, they are going to eliminate Medicaid expansion," Kasich said on CNN's “State of the Union." "And I cover in Ohio 700,000 people now, a third of whom have mental illness, drug addiction, and a quarter of whom have chronic disease." (Gee, 5/7)

Rumors that the Republican health care bill counts rape, domestic violence and ulcers as uninsurable pre-existing conditions are circulating among opponents of the bill. But these claims are overly simplistic. (Qiu, 5/5)

They promised you a rose garden, from the Rose Garden. This past week, President Donald Trump and Republicans legislators celebrated passage of a House bill seeking to replace the Affordable Care Act. At a White House event, they heaped praise on their effort and brushed off worries that health coverage could be imperiled for many people if the Senate is persuaded to go along with the legislation. (5/6)

Pregnancy, sexual assault and domestic violence could be considered "pre-existing conditions" that make it hard to keep insurance coverage under the Republican health care bill, according to a number of news articles and social media posts. The bill doesn't specifically refer to any of these things, and headlines suggesting that it does are misleading. (5/5)

Advocates and media reports highlighted individual stories of survivors of sexual assault or rape claiming they were denied coverage because of conditions relating to the abuse. One prominent example is Christina Turner, former insurance underwriter who was prescribed anti-AIDS medicine as a precaution after she was sexually assaulted. Turner, then 45 years old, was quoted in news reports in October 2009 saying she was unable to obtain insurance coverage because insurers told her that the HIV medication raised too many health concerns. Recent media coverage all linked back to one Huffington Post article, even though health coverage has changed since then. (Lee, 5/6)

Price defended the American Health Care Act, the House GOP plan to overhaul health-care system, in an interview with CNN. We’re going to focus on two statements in particular because they are rather misleading. (Kessler, 5/8)

One of the biggest criticisms of the new revamped health care bill is that it could weaken protections for those with pre-existing conditions, health conditions patients have before the date their new health coverage goes into effect. Some of these pre-existing conditions could include pregnancy, menstrual irregularities, cancer or sleep apnea. (Pirani, 5/5)

Former President Barack Obama, in his first public comments about the ongoing debate over his signature health care plan, implored members of Congress on Sunday to demonstrate political courage even if it goes against their party's positions. Obama briefly returned to the spotlight as he accepted the annual John F. Kennedy Profile in Courage Award at JFK's presidential library in Boston. (5/7)

Recalling the early fights in Congress for ACA at the beginning of his presidency, Obama on Sunday also took a jab at President Trump’s comment to governors last February, when Trump told them, "Nobody knew health care could be so complicated." Obama got a laugh on Sunday, telling the crowd, “There was a reason why healthcare reform had not been accomplished before: it was hard.” (Toppo, 5/7)

“I hope that current members of Congress recall that it actually doesn’t take a lot of courage to aid those who are already powerful … but it does require some courage to champion the vulnerable and the sick and the infirm and those who often have no access to the corridors of power." (Master, 5/2)

Citing those who lost their seats after voting for the healthcare law in 2010, Obama described his “fervent hope” that current members “recognize it takes little courage to aid those who are already powerful, already comfortable, already influential — but it takes some courage to champion the vulnerable and the sick and the infirm, those who often have no access to the corridors of power.” (Dovere, 5/7)

After Mr. Obama signed the ACA in March 2010, the midterm elections that November wiped out Democrats at nearly all levels of government. In the House, 63 Democratic seats were won by Republicans, giving the GOP a majority it has held ever since. (Epstein, 5/7)

"As everyone here now knows, this great debate is not settled but continues," Obama said. "And it is my fervent hope, and the hope of millions that, regardless of party, such courage is still possible." "That today's members of Congress, regardless of party, are willing to look at the facts and speak the truth even when it contradicts party positions." (Malone, 5/7)

From Akron to Youngstown and Canton to Cleveland, as in cities and towns across the country, workers who once walked out of factories at the end of each shift now stream out of hospitals. While manufacturing employment has fallen nearly 40 percent in northeastern Ohio since 2000, the number of health care jobs in the region has jumped more than 30 percent over the same period. In Akron, the onetime rubber capital of the world, only one of the city’s 10 largest employers still makes tires. Three are hospitals. (Schwartz and Abelson, 5/6)

As they take their victory lap for passing a bill that would repeal and replace much of the Affordable Care Act, President Trump and congressional Republicans have been largely silent about one of the most remarkable aspects of what their legislation would do: take a step toward dismantling a vast government entitlement program, something that has never been accomplished in the modern era. (Peters, 5/7)

By guaranteeing maternity care and making coverage available for people with pre-existing conditions, Obamacare largely did away with the markup on women's health insurance. Critics groused that this shifted the burden unfairly to men and women who didn't plan to have children; in March, for instance, Illinois Representative John Shimkus, a Republican, said one of his primary objections to Obamacare was "men having to purchase prenatal care." This could all change if the American Health Care Act passed by the House of Representatives on Thursday becomes law. (Suddath, 5/5)

The health care bill that Republicans in the House of Representatives passed this week could strip 7 million veterans of tax credits and place many of them in high-risk pools by classifying post-traumatic stress disorder as a pre-existing condition. Democrats seized on those possible effects to slam Republicans, saying they had voted for a bill that would, if it became law, end up punishing millions of veterans, a group that President Donald Trump fervently vowed to support during his campaign. (Bergengruen, 5/5)

Thursday's vote by most U.S. House Republicans to rewrite the Affordable Care Act demonstrated two things. One is that, on health care, Gov. John Kasich is among the few Republican adults in the room. The bill, he said in a Tweet posted after the congressional vote, "remains woefully short on the necessary resources to maintain health care for our nation's most vulnerable citizens." (Suddes, 5/6)

Statements from Massachusetts health care leaders denouncing the House GOP's health care bill began pouring in minutes after it narrowly passed, 217-213. The Massachusetts Hospital Association said "members are distressed." The state's largest health care union, 1199SEIU, called the vote "reckless." (Bebinger, 5/5)

The GOP measure would allow states to opt out of requirements for insurance companies that were put in place by the 2010 Affordable Care Act, including the prohibition on annual and lifetime caps for essential benefits like hospitalizations, and the ban on charging sick people more than healthy people. If a state were to seek such a waiver, insurance companies selling plans in that state would no longer have to comply with those rules. (Ho, 5/6)

Passage of the House Republicans' healthcare overhaul bill may have created political and policy complications for the popular Children's Health Insurance Program, whose funding will end in September unless Congress reauthorizes it. The Senate Finance Committee postponed a planned hearing on CHIP reauthorization scheduled for Tuesday, reportedly at the request of committee Democrats who didn't want work on the House GOP's American Health Care Act to overshadow efforts to extend the children's program. In addition, Republicans may seek to delay consideration of renewed funding for CHIP to use it as leverage to get Democrats and moderate Republicans to support their broad healthcare reform legislation, said Joe Antos, a conservative health policy expert at the American Enterprise Institute. (Meyer, 5/7)

Many if not most of the 31 states that expanded Medicaid to low-income adults likely would end those coverage expansions if Congress ultimately approves the House Republican healthcare reform bill passed Thursday, state policy experts say. Healthcare leaders and experts in Ohio, New Jersey, Pennsylvania, and West Virginia predicted their states would terminate their expansions if Congress passed the American Health Care Act with its Medicaid provisions intact. They and national policy experts said they see very few states having the financial capacity or political will to maintain the expansions if the bill's large cut in federal funding is enacted. (Meyer, 5/4)

Cutting nearly $1 trillion from Medicaid will give states the freedom to tailor the program to suit their needs, Health and Human Services Secretary Tom Price said Sunday, as he defended a narrowly passed House bill that aims to undo parts of the health care law enacted by the previous administration. (Superville, 5/7)

Governors are seeking to reshape Medicaid through new eligibility restrictions, while the passage of a House health care bill Thursday sets the stage for a Senate fight over the future financing of the giant state-federal program. The confluence of these efforts will have medical associations fighting on multiple fronts this year to maintain government health funding for people living near the poverty line. Hospitals fear that they will face unpaid bills if patients lose coverage. (Young, 5/8)

House Republicans this week pushed through legislation that seeks to dramatically overhaul the government-funded insurance program that covers nearly 2 million low-income and disabled Arizonans. If the repeal and replacement of the Affordable Care Act passes the U.S. Senate, it could put difficult and expensive health-policy decisions on the shoulders of Gov. Doug Ducey and the Arizona Legislature. (Alltucker, 5/6)

For nearly three years, Democrats and former President Barack Obama pointed to Kentucky as one of the Affordable Care Act’s biggest success stories. A poor, rural state that straddles the North and South, Kentucky was an early adopter of the healthcare law commonly known as Obamacare and saw one of the country’s largest drops in the uninsured rate. Now Kentucky is poised for a new distinction: to be the first state to save money by reducing the number of people on Medicaid, the government health insurance program for the poor and disabled and a central tenet of Obamacare. (Abutaleb and Respaut, 5/6)

Louisiana is eyeing an effort that would require able-bodied adults to get a job if they want to receive Medicaid benefits — mimicking efforts in other states that have been bolstered by ballooning Medicaid rolls and encouragement from the Trump administration. The state Legislature is expected to request that the idea be studied in the coming year to give them more insight and data before deciding to move forward with such a requirement. (Crisp, 5/6)

State lawmakers agreed late Thursday to cut $521 million from hospitals — with nearly a fifth of it coming from Tampa Bay. The cuts, which hit the Medicaid program, mostly impact the facilities that take on the largest number of Medicaid patients, including the state’s safety net hospitals. (Auslen, 5/5)

The health care bill approved by House Republicans this week with the support of President Donald Trump will aid the wealthiest Americans at the expense of everyone else and likely drive up the budget deficit, billionaire Warren Buffett said. "It is a huge tax cut for guys like me,” Buffett said Saturday at the annual meeting of his Berkshire Hathaway Inc. in Omaha, Nebraska. “And when there’s a tax cut, either the deficit goes up or they get the taxes from somebody else.” (Buhayar and Chiglinsky, 5/6)

"That is in the law that was passed a couple days ago," he added. "Anybody with $250,000 a year of adjusted gross income and a lot of investment income is going to have a huge tax cut." (Arnold, 5/6)

Buffett said healthcare costs have risen much faster in the United States than in the rest of the world and "will go up a lot more." "Medical costs are the tapeworm of American economic competitiveness," he said. "That is a problem this society is having trouble with and is going to have more trouble with." (Hunnicutt, 5/7)

The Senate on Monday evening is poised to take a procedural step toward confirming Scott Gottlieb to be Food and Drug Administration commissioner. Gottlieb, an FDA official during the administration of President George W. Bush, has since worked as an adviser to numerous pharmaceutical companies and been a prolific commentator on health policy at the right-leaning American Enterprise Institute. Though the nomination should receive the votes needed to limit debate with at least a few Democratic supporters, members of the minority party are likely to use their floor time to question Gottlieb’s past statements and potential for conflicts of interest. (Siddons, 5/8)

The rules were finalized a year ago by the Obama administration, but new officials at the FDA and the Department of Health and Human Services want time to review them. Cigar-makers were facing a May 10 deadline to submit plans for including health warning labels on their packaging. Companies that make e-cigarettes and the liquid nicotine that fuels the devices were facing deadlines of June 30 to register with the FDA and Aug. 8 to submit a list of their products and ingredients. The new rules would also require companies to file applications to the FDA to sell the products, but the first deadlines for that more stringent part of the rules aren’t until summer 2018. (Siddons, 5/5)

When he was running for office, Donald J. Trump promised to rid America of the scourge of drugs, vowing to crack down on dealers and invest heavily in programs to get heroin and other opioids off the streets. But on Friday, President Trump’s administration revealed plans to gut the 2018 budget of his Office of National Drug Control Policy. According to an Office of Management and Budget document obtained by The New York Times, the White House is proposing to slash the drug policy office budget by about 95 percent, to just $24 million from $388 million. (Rappeport, 5/5)

The eliminations involve the high-intensity drug-trafficking area program, which just received — under a catchall government-wide spending bill signed by President Donald Trump on Friday — $254 million for grants to help states and localities to fight drug trafficking, and the $100 million drug-free communities program, which helps local organizations battle drugs in their communities. The programs have widespread bipartisan support among lawmakers. (5/5)

“That budget wouldn’t pay the heating bill at the Pentagon,” said Barry R. McCaffrey, a retired U.S. Army general, who headed the office under President Bill Clinton between 1996 and 2001. “It sends a terrible message. Why send this bizarre political signal in the middle of what is without question a major health-care crisis in America? It’s very strange.” (Sun and Higham, 5/5)

“These moves fly in the face of President Trump’s promise to address the nation's opioid epidemic,” said Rafael Lemaitre, who was a senior official with the drug policy office across three administrations. "This is an epidemic that steals as many lives as the Vietnam War took during the entire conflict, and Trump's moves remove some of the most effective tools." (Diamond, 5/5)

There are few constituencies as pleased with President Trump’s three and a half months in the White House as the anti-abortion groups that rallied to his side during the 2016 campaign. He has signed legislation making it easier for states to deny funding to health centers that perform abortions. His recently confirmed Supreme Court nominee, Neil M. Gorsuch, has the unwavering backing of anti-abortion groups. And on Thursday, the House voted to repeal and replace the Affordable Care Act while also eliminating most public funding for Planned Parenthood, a central campaign promise of Mr. Trump’s. (Peters, 5/5)

The Iowa Supreme Court blocked an abortion restriction Friday less than two hours after Gov. Terry Branstad signed it, allowing dozens of women who had scheduled the procedure to move forward without waiting 72 hours as the new law requires. (Sanders, 5/5)

Alaska lawmakers on Friday demanded a public apology from a Republican legislator who said there are women in Alaska who try to get pregnant to get a "free trip to the city" for abortions. Pressure mounted on Rep. David Eastman, who has cited concerns with abortions being covered by state funds and Medicaid, a government program for lower-income people. (Bohrer, 5/5)

The advice to eat a healthy diet is not new. Back around 400 B.C., Hippocrates, the Greek doctor, had this missive: Let food be thy medicine. But as a society, we've got a long way to go. About one out of every two deaths from heart disease, stroke and Type 2 diabetes in the U.S. is linked to a poor diet. That's about 1,000 deaths a day. (Aubrey, 5/8)

The percent of children aged six to 12 who were physically active three or more times a week had its biggest drop in five years and is now under 25%, new data show. Making matters worse, households with incomes under $50,000 have much higher rates of inactivity than families making more than $75,000 annually, an analysis by the Sports and Fitness Industry Association and PHIT America found. (O'Donnell and Mitchell, 5/6)

Clinicians are starting to look at the role that poverty, race and other social determinants play in a person’s health, but what about social connectedness — how do friendship, family, and loneliness play into a person’s medical needs? Large health care systems have yet to take up the fight in a meaningful way, but that could be changing. On Monday, CareMore, a unit of Anthem Insurance that offers coverage and health care to more than 100,000 members across seven states, is introducing a campaign to help some of the US population’s most socially isolated people: seniors. (Tedeschi, 5/8)

The CDC is now suggesting that women thinking of getting pregnant, and who may be exposed to the Zika virus through travel or because of where they live, should consider having their blood tested for Zika antibodies before they get pregnant. Having a baseline reading would help to interpret Zika tests done during a later pregnancy. (Branswell, 5/5)

The phrase “suicide tapes” has been slithering through school hallways in whispers and giggles around Sacramento, and counselors and principals are worried. Some fear the new slang – a reference to the hit Netflix series “13 Reasons Why” – could inspire possibly deadly behavior among suggestible children who watch the show. (Caiola, 5/5)

One night last fall, Victoria Rodriguez, a pediatric hospitalist at the Ann & Robert H. Lurie Children’s Hospital of Chicago, was paged from the emergency room for a consultation on a case. An ER doctor had evaluated a 4-week-old infant, and although he couldn’t find anything wrong with the baby, he hesitated to send the anxious family home. His concern? During the night, the parents had received an alarm on their phones that the baby’s heart rate and blood-oxygen level were low. The alarm had been triggered by the baby’s high-tech sock, one of a new class of devices that continuously measure babies’ vital signs, but the ER doctor wasn’t sure how to interpret this information. (Callahan, 5/6)

Most estimates suggest that at least 60% of those seeking treatment for a substance use disorder also have a mental health condition. But it's not easy to untangle the two: sometimes substances can induce mental health disorder symptoms — and it's tough to clearly diagnose a mental health condition while someone is actively using substances. (Becker, 5/8)

For years, anti-vaccine activists have worked on the sizable Somali-American community in Minnesota, urging them to refuse to let their children receive the MMR vaccine. They’ve been successful: The vaccination rate has plunged. And now, the state is struggling to contain a large and growing measles outbreak that is spreading rapidly through the Somali community and threatens to move beyond it. (Branswell, 5/8)

Nearly three-quarters of private sector workers receive paid sick days from their employers, though there is no federal mandate requiring it. In recent years, dozens of states, cities and counties have passed their own ordinances, which typically require employers to provide between three and seven paid sick days a year. The business community is fighting against the proliferation of these laws, saying that the landscape for paid-leave regulation is getting way too complex. (Noguchi, 5/6)

In another blow against decades of accepted medical wisdom, one of the most prestigious, long-running studies reports that lowering sodium intake doesn’t reduce blood pressure. The study also implies that most Americans are consuming a perfectly healthy amount of salt, the main source of sodium. But those who are salt-sensitive — about 20 percent to 25 percent of the population — still need to restrict salt intake. (Fikes, 5/4)

It has become an annual springtime ritual in Massachusetts, one of the states most heavily affected by Lyme disease and other tick-borne illnesses, to wonder whether the emerging tick population is bigger than ever. This year, those concerns gained added fuel from an ecologist's prediction that this will be a particularly heavy tick year in the Northeast, and thus heavy for the diseases they carry as well. (David Scales, 5/5)

Senate Bill 562, which would create a universal, publicly funded health care system in California, is generating tremendous enthusiasm among liberals and its supporters, including unionized nurses who backed Sanders’ presidential campaign with millions of dollars. But even some of the state’s leading Democrats, including Gov. Jerry Brown, have raised questions about whether this is the right time for single-payer or how the plan would be paid for. (Cadelago, 5/6)

Mounting costs and shrinking payments are threatening to shutter hospitals around the state, as the expense of providing Tennesseans with vital health care increasingly outweighs the revenue coming in. Hospitals use gross charges — or the money they charge for services before applying discounts for insurance contracts and Medicare payments, among others — as an indicator of what they need to function. They aren’t getting it. (Fletcher, 5/7)

The state board that licenses professional counselors and therapists took up to a year to tell the Maryland attorney general's office about cases of sexual misconduct and practicing without a license, a state audit released last week found. The delayed notifications allowed the violators to continue seeing patients. The Board of Professional Counselors and Therapists investigates complaints but must submit its findings to the attorney general before it can mete out punishment, including revoking or temporarily suspending a professional license, putting a practitioner on probation. (McDaniels, 5/6)

There are no surveillance cameras at Soldier On, which is a nonprofit organization that is separate from the VA facility. There also are no scheduled drug tests, and residents can come and go until a midnight curfew. Even some of the scheduled medications for veterans are distributed by fellow addicts and alcoholics. (MacQarrie, 5/8)

Georgia schools have been short-changing themselves as much as $50 million annually in federal funding for school nurses. The state Department of Education realized this recently and is working with another state agency to tap the money, which would come from Medicaid. (Tygami, 5/5)

It’s been two long months since the state’s Medicaid department went live with a new computer system to pay doctors, caregivers for the disabled and others who treat needy people with government insurance. Medical clinics, children’s mental health centers and therapists say the new payment system is broken. And despite complaining to lawmakers, the governor’s office and state Medicaid officials, and spending hours on hold with the computer system’s help line, they still are suffering without income they rely on to keep their businesses open. (Brown, 5/7)

At least 42 men and women have died by suicide in Massachusetts county jails since 2012, more than twice the number of suicides in the state prison system over the period, even though both systems house roughly the same number of inmates. And while state prison suicides have declined in recent years, the rate of suicides in the state’s 13 county jails has doubled, according to an investigation by The Eye, the online news site of the New England Center for Investigative Reporting. (McKim and Sajadi, 5/6)

Harborview Medical Center’s executive director said Friday the hospital could lose more than $627 million a year starting in 2026 when the full impact of the health-care bill passed Thursday by the House of Representatives would be felt. Hospital officials said the potential loss would come through a combined decrease in federal revenue and increase in costs of charity and uncompensated care. (Morton and Young, 5/5)

Jack Ivie, president of Dignity Health Glendale Memorial Hospital, will retire at the end of next month after more than four decades at the hospital, according to a statement released on Friday. Ivie served as the assistant executive director and vice president of hospital operations from 1980 to 1992 before taking the role as the hospital’s president in 2012. All four of his children were born at Glendale Memorial, according to the statement. (Landa, 5/5)

Many families whose kids are diagnosed with DIPG at least want to try a clinical trial after finishing radiation, hoping that pioneering drug treatment will ease symptoms and grant their children additional months or years. But out-of-pocket costs can be high, even with insurance coverage. And for those who look to trials outside the country — the Bandavanis family might join one in Monterrey, Mexico — parents generally are on their own for the entire tab. (Price, 5/7)

As behind-the-scenes negotiations broke down in the final hours of their annual session Friday, the Florida Legislature failed to pass legislation putting medical marijuana, passed overwhelmingly by voters, into effect. A dispute over technical parts of the bill became too much for negotiators to overcome. At issue were restrictions on growers and dispensaries, a topic important to those who wanted a piece of what experts say could become a $1 billion a year market. (Auslen, 5/5)

It’s spring planting time in Ohio, but companies hoping to dive into the business of growing medical marijuana must wait months to put crops into the ground. It appears that it will be a mad rush to get medical marijuana to customers by September 2018, as is anticipated in House Bill 523, a state law that took effect on Sept. 8, 2016. (Johnson, 5/5)

Recent expansions in health insurance coverage have raised concerns about health care providers’ capacity to supply additional services and how that may have affected access to care for people who were already insured. When we examined data for the period 2008–14 from the Medical Expenditure Panel Survey, we found no consistent evidence that increases in the proportions of adults with insurance at the local-area level affected access to care for adults residing in the same areas who already had, and continued to have, insurance. This lack of an apparent relationship held true across eight measures of access, which included receipt of preventive care. It also held true among two adult subpopulations that may have been at greater risk for compromised access: people residing in health care professional shortage areas and Medicaid beneficiaries. (Abdus and Hill, 5/2)

Employers and health plans are increasingly using tiered provider networks in their benefit designs to steer patients to higher quality and more efficient providers in an effort to increase value in the health care system. We evaluated the impact of a tiered-network health plan on total health care spending and on inpatient, outpatient, and outpatient radiology spending for nonelderly enrollees in a commercial health plan in 2008–12. The tiered network was associated with $43.36 lower total adjusted medical spending per member per quarter ($830.07 versus $873.43), which represented about a 5 percent decrease in spending, relative to enrollees in similar plans without a tiered network. (Sinaiko, Landrum and Chernew, 5/1)

[T]he pharmaceutical industry has been hesitant to initiate early-stage programs to treat so-called orphan diseases. ... In the past two decades, disease-focused foundations ... have formed partnerships with industry and federal agencies to share the financial risk of therapeutic development, shorten the early translational pipeline, and advance research .... In addition, foundations and their academic partners have accelerated early development by providing access to patient populations for clinical trials and assistance from disease-specific experts in study design .... In this review, we will focus on three diseases — cystic fibrosis, multiple myeloma, and type 1 diabetes mellitus — to illustrate how collaborations among academic institutions, foundations, and industry partners have evolved to address the therapeutic challenges of these conditions. (Ramsey et al., 5/4)

We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data .... Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period. During the study period, among the 2084 patients who had cardiac arrests that were not witnessed by emergency medical services (EMS) personnel, the rate of bystander CPR increased from 66.7% to 80.6% ..., the rate of bystander defibrillation increased from 2.1% to 16.8% ..., the rate of brain damage or nursing home admission decreased from 10.0% to 7.6% ..., and all-cause mortality decreased from 18.0% to 7.9% .... In adjusted analyses, bystander CPR was associated with a risk of brain damage or nursing home admission that was significantly lower than that associated with no bystander resuscitation. (Kragholm et al., 5/3)

Seniors and people with disabilities account for a minority (23%) of Medicaid program enrollment but a majority (64%) of spending. This is due to their greater health and long-term care needs and more intensive services use compared to adults and children whose eligibility is not based on old age or disability. ... Medicaid spending per enrollee for seniors and people with disabilities also varies substantially across states and reflects the fact that many eligibility pathways and services relevant to seniors and people with disabilities are optional. ... A per capita cap could lock in historical state differences in the scope of coverage and spending for seniors and people with disabilities. (Musumeci and Young, 5/1)

After voting to repeal and replace Obamacare last week, House Republicans rode up Pennsylvania Avenue to celebrate with President Trump in the Rose Garden. The reveling was premature: The bill still has to go to the Senate and back to the House, and analysts have already highlighted the immense electoral risks that come with rushing through an overwhelmingly unpopular bill. But there’s another, more immediate, level of risk involved in the bill’s passage: what it means for the rest of the party agenda. (Sarah Binder, 5/8)

We should never forget May 4, 2017. It should forever be marked as the day when the House of Representatives descended to a new level of cruelty, irresponsibility and social meanness. The lower chamber has always claimed to be “the people’s house.” No more. It should now come to be known by other names: the house of selfishness, the house of suffering, the house of the wealthy, the house of expediency, the house of untreated illness. Perhaps also: the house of Trump. (E.J. Dionne Jr., 5/5)

Republicans celebrated on TV with cheers and a Rose Garden ceremony, but many Americans reacted with disbelief and outrage when the House voted to dramatically scale back access to health care for millions. The narrow party line vote, and the public high-fiving by Congress and the White House, comes despite polls showing that by large majorities, Americans want to keep and repair Obamacare — not turn back coverage for millions of families as House Republicans voted to do. (Andy Slavitt, 5/5)

There have been many bad laws in U.S. history. Some bills were poorly conceived; some were cruel and unjust; some were sold on false pretenses. Some were all of the above. But has there ever been anything like Trumpcare, the health legislation Republicans rammed through the House last week? It’s a miserably designed law, full of unintended consequences. It’s a moral disaster, snatching health care from tens of millions mainly to give the very wealthy a near-trillion-dollar tax cut. (Paul Krugman, 5/8)

House Republicans have been engaging in this charade for seven years. They voted to repeal the Affordable Care Act, aka Obamacare, more than 40 times between 2011 and 2016, knowing full well that the incumbent president would veto their initiative, even in the extremely remote event the U.S. Senate rubber-stamped it. Like the 6-year old who grandiosely announces that the restaurant bill for his parents' party of 12 is "on me," House Republicans knew they were in no danger of being taken seriously. (Brian Dickerson, 5/6)

The Republican effort to take health insurance from millions and slash Medicaid to fund a massive tax cut for the rich was a testosterone-laden affair on Thursday. ... So many very white men, laying waste to people’s health care, especially female people’s health care, and poor people’s. (Yvonne Abraham, 5/5)

The Republicans’ health bill is an act of supreme hypocrisy and insensitivity to the experience of Americans. It will damage — not improve — the U.S. health system. Obamacare was a failure because it passed with only Democratic votes — so charged Republicans. All through 2009, Democrats tried to get Republicans to engage in discussions about health-care reform. Remember the “Gang of Six” or the “Gang of Eight” that Sen. Max Baucus (D-Mont.) ran to try to craft a bipartisan bill? After Sen. Olympia Snowe (R-Maine) voted for the bill in committee, she reversed herself under extreme Republican pressure. Now, given their own opportunity for a bipartisan health reform bill, Republicans passed a totally partisan bill, and they never even tried reaching out to Democrats to see if there could be consensus. (Ezekiel Emanuel, 5/5)

The primary rallying cry for this week’s passage of the American Health Care Act was the claim that the Affordable Care Act was “imploding.” Republicans argued the rapidity and lack of clarity with which this radical bill passed the House was necessary given how quickly the ACA was “falling apart.” They cited as evidence the recent large premium increases and the growing number of counties with no insurers. What supporters of the AHCA are not admitting, however, is that the ACA’s current failings are due to the misguided policies of Republicans and particularly the Trump administration. (Jonathan Gruber, 5/5)

I hope you read this letter. I doubt you will. I know you’re busy rebuilding Washington, reshaping the international order and doing a lot of other weighty stuff. Full disclosure, I voted for you. Not because you promised to repeal the Affordable Care Act, or because you tweeted at me about it, but because our healthcare system is hopelessly broken and requires an overhaul that does not simply convert over to a single payer system. (Niran Al-Agba, 5/5)

Now that the House has passed its big health care bill, it will find out what that bill could actually do. The Congressional Budget Office, Washington’s nonpartisan scorekeeper, did not have time to evaluate the effects of the American Health Care Act before Thursday’s vote, since the bill was being amended until just before passage. But the budget office will not ignore the health law, and next week it is expected to release detailed estimates of how many people will be covered by the bill, and at what cost to the government. (Margot Sanger-Katz, 5/5)

The obscene spectacle of House Republicans gathering last week in the Rose Garden to celebrate the House’s passage of a bill that would likely strip insurance coverage from tens of millions of Americans, while simultaneously serving as a massive tax break for the wealthy, had the callous feel of the well-heeled dancing on the poor’s graves. (Charles M. Blow, 5/8)

Years of promising to repeal and replace the Affordable Care Act took a major step last week with the House passing the American Health Care Act. The years of rancorous debate leading to this vote have highlighted the profound divisions in our political system. But, it has also obscured the encouraging reality that most Democrats and Republicans actually share a common goal – the creation of a high quality, high-performance, high-value health care system. We cannot continue to spend more than $3 trillion a year on health care, yet lag behind much of the developed world in overall health outcomes. (Tom Daschle and Mike Leavitt, 5/8)

In 2010, after a Democratic-controlled Congress passed and President Barack Obama signed the Affordable Care Act, Republicans denounced what came to be known as Obamacare with critiques that were often borne out. U.S. Rep. Darrell Issa, R-Calif., for one, has long had on his website a statement ripping the law because it was “passed on a partisan vote with the rationale that we would have to pass it to find out what was in it. Now that the bill is law, the American people are finding out that what’s in it is completely contrary to what they were promised.” (5/7)

House Republicans, including all four from Kansas, fulfilled a key campaign promise by advancing a bill Thursday that repeals much of the Affordable Care Act. But the measure seems unlikely to pass the Senate, at least in its present form. And in their rush to pass the bill without even knowing its cost or impact, the Republicans were guilty of legislative malpractice – worse than when Democrats forced through the Affordable Care Act. (5/7)

The only thing surprising about yesterday's partisan, razor-thin vote to gut Obamacare was that it took so long. As I noted two months ago, well before the failure of the first iteration of the American Health Care Act, President Donald Trump and House Speaker Paul Ryan are playing the long game. All they needed in the House was a bill—any bill—so they could throw the legislation into the more moderate Senate. (Merrill Goozner, 5/5)

Now that the Obamacare replacement bill has passed the House and is moving on to the more centrist Senate, the real debate begins. What is the true purpose of health insurance, and what is our government’s goal in ensuring we have it? (Marc K. Siegel, 5/5)

Hooray, Republicans have saved America’s health-care system. OK, we exaggerate, but there are inklings of a salvation. Let’s start with pre-existing conditions. In principle, this should be a transitional problem in a world where everyone has access to attractive, fairly priced health insurance. By giving new options to the states, the House bill would make subsidizing pre-existing conditions a general obligation of the taxpayer as it always should have been. (Holman W. Jenkins Jr., 5/6)

On Thursday, House Republicans passed a health care bill that fulfilled both of Obama's heartfelt "principles" of eight years ago. And yet while Democrats in 2009 would have built a statue outside the White House if Obama had fulfilled this promise, liberals spent most of this week accusing Republicans of wanting to see people die in the streets. (Christian Schneider, 5/5)

Thursday's vote by most U.S. House Republicans to rewrite the Affordable Care Act demonstrated two things. One is that, on health care, Gov. John Kasich is among the few Republican adults in the room. The bill, he said in a Tweet posted after the congressional vote, "remains woefully short on the necessary resources to maintain health care for our nation's most vulnerable citizens." (Thomas Suddes, 5/6)

Last week, the House of Representatives passed the American Health Care Act, which would cut Medicaid considerably and allow insurance companies to charge people with preexisting conditions significantly more for coverage. As a mom of four kids — two with Type 1 diabetes, an unpreventable, incurable and expensive disease — I am terrified that this bill will put my children’s lives at risk if it becomes law. (Jennifer Reilly, 5/8)

No per-capita grant is going to cover fantastically expensive nursing home care. And nursing home care is not some rare expense that can be easily absorbed in the general pool; it accounts for about a third of annual Medicaid spending. Since I really doubt that states are going to kick seniors out of nursing homes, they will probably end up having to top up the federal grants with their own money, and/or shift more and more resources away from younger patients. (Megan McArdle, 5/5)

President Donald Trump and House Republican leaders gathered in the White House Rose Garden at mid-afternoon Thursday to celebrate House passage of the American Health Care Act a couple of hours earlier. The scene was bewildering. Here were people who had just voted to destroy health care coverage for up to 14 million Americans next year — and as many as 24 million in 10 years. It would do so by generating a $600 billion tax cut for wealthy Americans. (5/6)

But there’s no component of the American Health Care Act more detrimental to public health and the soul of this nation than an amendment which will allow health insurance companies to discriminate against individuals with “pre-existing conditions.” Why? Because nearly all of us have pre-existing health conditions — and there’s no telling which ones might price us out of the health insurance marketplace tomorrow, a year from now, or farther down the road. (Miles Howard, 5/5)

On Thursday, Republicans in the House of Representatives, including Steve Chabot and Brad Wenstrup, succeeded. They succeeded on their pledge to once again devastate the lives of their constituents in the name of the almighty political win. As they glad-handed in the Rose Garden and celebrated their callous act of craven political expediency with one another, constituents of all political persuasions across the nation with pre-existing conditions likely felt sick to their stomach. (Neil Kelly, 5/5)

We live in a society that treats health care as a commodity — like gasoline — rather than a human right. The problem with that model is that no matter how much money you have or what kind of job you have, gas costs basically the same at Casey's General Stores as it does at Kum & Go. Health care costs, however, vary greatly based on socioeconomic status. Poor people tend to pay more and, because they often cannot afford insurance, they seek the most expensive kind of care: emergency room service. (Daniel P. Finney, 5/5)

Foes of the Republican bill say relaxing current rules regarding pre-existing conditions, as the GOP bill would do, is tantamount to killing people. Interestingly, they never explain exactly why that might be so. If people with pre-existing conditions are denied insurance coverage, or are charged so much for coverage that they can’t afford it, then they might end up with medical bills they cannot pay, leading to bankruptcy — and perhaps even have to go without life-saving treatment. (5/6)

Instead, they shoved through a downright diabolical bill to quite literally eliminate insurance coverage for some 20 million Americans in order to cut taxes for the most obscenely wealthy among us. If passed by the Senate, the bill would also re-create the pre-ACA death trap of allowing insurers to deny coverage to people with pre-existing conditions. If you’re wondering what all would qualify as such, it’s a long list, but suffice to say you’re out just for being a woman, for getting pregnant, for being sexually assaulted, for getting sick, or even just for being born. Lifetime limits would come back, meaning that an infant in need of NICU care might hit their cap within weeks of being alive and never be able to get coverage again. All of this coming from legislators among whom many claim to be “pro-life. (Emily Mills, 5/5)

The biggest political news coming out of the House’s passage of the American Health Care Act (AHCA) is that most members of the Freedom Caucus voted for it. This is legislation that extends age-adjusted, refundable tax credits to all Americans without access to employer coverage, much of which will count as new spending in the federal budget. The bill also largely retains the Affordable Care Act’s (ACA) insurance regulations in the individual insurance market, despite what is being said in the press. There was a time when Freedom Caucus members would never have voted for such legislation. It seems the blowback on the caucus following the failure to pass the bill in March had a major effect on their outlook. (James C. Capretta, 5/8)

Laast week, the House of Representatives passed a bill to repeal and replace the Affordable Care Act. That was only the first act in a legislative drama that now moves to the Senate. It’s far too early to guess what the outcome will be, but one thing’s for sure: Republicans are making wildly optimistic promises on healthcare that they can’t possibly keep. (Doyle McManus, 5/7)

Dear Sen. Rubio, Remember where you come from. You come from the state where, in 2015, more people signed up for the benefits of the Affordable Care Act — Obamacare — than in any other. You come from Greater Miami, which has the most Obamacare participants of anywhere in the country. Simply put, you come from Ground Zero (5/6)

If there’s a lesson to be reminded of this week as the American Health Care Act moves to the U.S. Senate, it’s this: Republicans really want to vote yes to repeal Obamacare. That might seem self-evident, as it’s exactly what Republicans have been saying the past six years. But in passing the ACHA on Thursday, House Republicans showed just how far they’re willing to go to. (5/7)

The Ohio House got rid of some troubling proposals in Ohio's two-year operating budget, including required business internships for teachers. But House members -- whose budget now goes to the Ohio Senate -- more than made up for it with a long list of wrongheaded moves, led by a proposed "Poisoning Ohio's Children Act." It's not called that, of course, but the budget amendment does just that by taking away the right of municipalities to pass laws aimed at ridding rental housing of lead that can poison young children's minds and rob their futures. (5/6)

The same day that the US House of Representatives voted to strip access to medical insurance for millions, President Trump also signed an executive order that authorized an indefensible attack on women’s reproductive rights. ... Although the order did not go as far as social conservatives hoped — language that would have rolled back protections for gay and lesbian employees was dropped at the last minute — it’s a continuation of Price’s crackpot campaign to eliminate insurance coverage for birth control. (5/6)

Late in the 2016 legislative session, Iowa lawmakers quietly approved a massive, taxpayer-funded giveaway designed to provide 400 of the state’s privately operated nursing homes with hundreds of millions of dollars. It was one of the biggest corporate hand-outs in Iowa history. But when asked about the bill after the Legislature adjourned for the year, the governor and state lawmakers professed ignorance, claiming they had no idea that over five years the bill would result in a billion-dollar windfall for Iowa’s nursing homes owners, courtesy of the Medicaid program. (5/7)

Between Congress and Sacramento, it is now clear that the capacity to play politics with health insurance is boundless. Not so the resilience of those who most need coverage. A week-and-a-half ago – as Washington plotted another cruel shot at the Affordable Care Act and state lawmakers fought over a cigarette tax windfall – a clinic that for 30 years had been a refuge for Sacramento-area women quietly closed, thanks to a scenario that is all too familiar to Medi-Cal providers. (5/5)

Reducing senior hunger in Ohio is one of The Center for Community Solutions' top public policy priorities. We believe that state lawmakers have an opportunity to make things better. They can invest in better health through increasing support for the senior community services block grant, or they can invest more in Medicaid to pay for increased hospitalizations and nursing home stays. (John Corlette, 5/5)