�Թϲ�����

The Senate bill to repeal the Affordable Care Act was edging toward collapse on Monday after the nonpartisan Congressional Budget Office said it would increase the number of people without health insurance by 22 million by 2026. (Kaplan and Pear, 4/26)

Senate Republicans’ bill to erase major parts of the Affordable Care Act would cause an estimated 22 million more Americans to be uninsured by the end of the coming decade, while reducing federal spending by $321 billion during that time, according to the Congressional Budget Office. (Goldstein and Snell, 6/26)

The CBO says low-income Americans in their 50s and early 60s would be disproportionately likely to lose their health care coverage under the Senate bill. Although people buying insurance in the individual market would see lower premiums in many cases, the policies would cover less, and out-of-pocket costs would be higher. (Horsley, 6/26)

Under the Senate bill, average premiums for plans for single individuals would be about 20 percent higher in 2018 than under current law, in large part because the penalty for not having insurance would be eliminated, so fewer healthy people would enroll. Premiums would be about 10 percent higher than under current law in 2019, CBO said in its analysis of the Senate bill. Younger people would pay less for plans, CBO said. But in 2020, the year of the next presidential contest, average premiums for benchmark plans for single individuals would be about 30 percent lower than under current law, CBO said. (Young, 6/26)

The bill also allows states to repeal ObamaCare's requirements on what an insurance plan must cover, known as essential health benefits. That move could make certain services extremely expensive. (Sullivan, 6/26)

The CBO also analyzed the Senate bill provision that would allow states to use waivers to modify the health law’s essential health benefits that include items like prescription drugs, maternity coverage, mental health and substance abuse. In states where such waivers were granted, consumers could experience substantial cost increases for supplemental premiums or out-of-pocket spending, or choose to forgo services. Nearly half the population, the CBO estimates, would reside in states that seek these waivers.(Carey and Galewitz, 6/26)

The estimated coverage losses are just slightly less than for the House-passed version of the Obamacare repeal bill, which concern Republican moderates who have pushed Senate leaders to craft a more generous bill. (Cancryn, 6/26)

CBO previously estimated that 23 million fewer people would be covered under the bill passed by the House in May. President Trump told senators two weeks ago that the House bill was "mean" and he wanted the Senate bill to have more "heart." (Collins, 6/26)

The biggest increase in the uninsured would come from the bill’s rollback of Medicaid, the state-federal program that covers the poor. The GOP bill cuts spending on Medicaid by $772 billion over a decade, which would result in 15 million fewer people enrolled in the program in 2026 than under current law. Another 7 million wouldn’t have coverage in the individual insurance market. (Tracer, Edney and Dennis, 6/26)

Overall, 49 million people would be uninsured by 2026, the CBO estimated, compared with 28 million under current law. Some of the impact comes fast: 15 million more would be uninsured next year. By 2026, around 15 million fewer would be enrolled in Medicaid. (Tamari, 6/26)

Most people are focused on how many people would lose insurance under the Senate health-care bill compared with current law: an estimated 22 million, according to the new Congressional Budget Office analysis. But the report digs deeper into the kind of insurance that people, especially poor people, would be able to access -- and finds that it would be so financially burdensome with high deductibles that many people would choose not to sign up. (Johnson, 6/26)

A single person who earns about $26,500 a year now has an $800 deductible because of cost-sharing reductions paid to insurers. That would climb to $6,000 in 2020 after cost-sharing reductions end and the subsidies are linked to bronze rather than silver plans. Even though an average 40-year-old's monthly premiums would drop from $141 to $133, it wouldn't be a good trade-off. (Lee, 6/26)

“The CBO and Joint Committee on Taxation expect that this legislation would increase the number of uninsured people substantially,” the agency’s report said. “The increase would be disproportionately larger among older people with lower income — particularly people between 50 and 64 years old with income of less than 200 percent of the federal poverty level.” (Radelat, 6/26)

The Congressional Budget Office on Monday projected Senate Republicans' bill to repeal the Affordable Care Act would leave an estimated 22 million additional Americans without health insurance in the coming decade, as well as cut federal spending by $321 billion by 2026. That insurance prediction apparently didn't sit well with the White House, as the Trump administration put out a statement questioning the CBO's credibility, arguing that its analysis of the Affordable Care Act -- Democrats' 2010 health-care law also known as Obamacare -- was so flawed it proved the agency can't be trusted. (Ehrenfreund, 6/26)

[Here] are the four big numbers from the Congressional Budget Office’s analysis of the Senate Republican plan to repeal and replace the Affordable Care Act. (Park and Andrews, 6/26)

The Senate’s Obamacare repeal bill would drive up the uninsured rate across all demographics, CBO estimates, but hit low-income Americans the hardest. (Cancryn, Fisher, Frostenson and McClure, 6/26)

Here are five of the CBO’s top-line findings. (Hackman, 6/26)

The Congressional Budget Office has released its analysis and score of the Senate GOP’s ObamaCare repeal bill.The big finding? The Senate bill would leave 22 million more people without insurance over the next decade compared to current law. Here are five takeaways from a report that will play a big role in the Senate’s discussions on ObamaCare. (Roubein, Hellmann and Weixel, 6/26)

The White House slammed the Congressional Budget Office after its analysis showed the Senate Republicans’ healthcare bill would leave 22 million more people uninsured over the next decade.“ The CBO has consistently proven it cannot accurately predict how healthcare legislation will impact insurance coverage,” the White House said in a statement on Monday evening. (Fabian, 6/26)

President Donald Trump would like Congress to send him a final health care measure by the time lawmakers depart for their annual August recess — but he is not, for now, taking a position on whether the Senate has to vote on its version this week. White House Press Secretary Sean Spicer announced the president’s desired timeline at his Monday briefing, which was held with the television cameras turned off, as is becoming the norm. But Spicer did not take a position on Trump’s behalf when asked if the president wants the Senate to vote on its health bill this week no matter what. (Bennett, 6/26)

President Trump has phoned several Republican holdouts on the Senate healthcare bill to try to get them on board.  White House press secretary Sean Spicer said Monday that Trump spoke by phone this weekend with Sens. Rand Paul (Ky.), Ted Cruz (Texas) and Ron Johnson (Wis.).  Those three GOP senators, along with Utah’s Mike Lee, oppose the Senate bill released last week because it does not go far enough to repeal ObamaCare and lower insurance premiums. (Fabian, 6/26)

[The] assessment threw into doubt whether the bill would make it past an initial procedural hurdle as Senate Majority Leader Mitch McConnell (R., Ky.) is engaged in last-minute negotiations with more than a half-dozen GOP lawmakers wavering in their support of the bill. Sen. Susan Collins (R., Maine) said she would vote against the bill, citing the CBO report. (Armour, Peterson and Radnofsky, 6/26)

Senate Majority Leader Mitch McConnell hoped to start procedural votes by Wednesday, and President Trump called key senators over the weekend as support splintered. It's the same political dynamic that stalled the House Republican bill last month, as conservative and centrist factions wrestle for dominance. Conservatives want a more complete repeal of the Affordable Care Act, which they hope will lower premium costs, while centrists are trying to avoid leaving millions of Americans without health coverage. (Mascaro, 6/26)

The CBO analysis suggested some ammunition GOP leaders could use, saying the Senate bill would cut federal deficits by $202 billion more over the coming decade than the version the House approved in May. Senate leaders could use some of those additional savings to attract moderate votes by making Medicaid and other provisions more generous, though conservatives would rather use that money to reduce red ink. (6/27)

Republicans in the White House and in Congress were pleasantly surprised that the bill included more savings than they expected — and are trying to figure out if they can dole it out for votes. The Senate has about $188 billion to play with. (Dawsey and Everett, 6/26)

The GOP is well short of the votes needed to bring its bill to the floor, and party leaders and President Donald Trump are kicking into overdrive to save their imperiled health care overhaul. (Everett and Haberkorn, 6/26)

President Donald Trump's campaign promise to repeal and replace "Obamacare" is now in the hands of a key group of GOP senators who are opposing —or not yet supporting — legislation Senate Majority Leader Mitch McConnell is pushing to bring to a vote this week. These lawmakers range from moderate to conservative Republicans, and include senators who were just re-elected and a couple facing tough re-election fights. (6/27)

The week begins with a number of questions about the Senate health care bill, chiefly whether it has enough votes to pass this week, as Senate Majority Leader Mitch McConnell wants. (Hobson, 6/26)

When it comes to the Senate health care bill, count Susan Collins out. The Republican US senator from Maine had been on the fence about the GOP bill in recent days, saying she wanted to wait for a Congressional Budget Office evaluation before making her decision. (Reiss, 6/26)

Collins was joined by several other Republicans in publicly saying that without changes, they are not ready to begin debate this week. (Dupree, 6/26)

Even before Collins made her feelings known, the CBO analysis was raising alarm bells for centrist Republicans. “It certainly makes me more concerned,” Sen. Bill Cassidy (R-La.) said of the analysis on CNN. “It makes me want to explore this more.” (Sullivan, 6/26)

In a series of interviews and an op-ed Monday, Senate Republican Ron Johnson of Wisconsin bluntly laid out his objections to the GOP Senate health care bill and to his party’s hurried push to get it passed this week... The Wisconsin Republican slammed the bill drafted by GOP Senate leaders for retaining some Obamacare mandates, such as the rule requiring insurers to cover people with pre-existing conditions — a rule Johnson blames for driving up premiums. (Gilbert, 6/26)

Sen. Marco Rubio has been bombarded with phone calls, emails and on Monday, protests took place outside his offices in Doral and Palm Beach Gardens. But while the effort is most unlikely to dissuade the Florida Republican from voting for the Obamacare replacement -- if it even comes up for a vote this week -- he remains noncommittal. (Leary, 6/27)

Amid growing doubts about quick Senate passage of the GOP's revised health care "discussion draft," Texas Republican John Cornyn and other Senate leaders on Monday were digesting a new estimate showing that their plan would increase the number of uninsured Americans by 22 million. Cornyn, the Senate's No. 2 Republican, issued a statement focusing on the part of the new Congressional Budget Office estimate that favors the GOP plan: It would save $321 million over the next decade, more than the version that passed the House last month. (Diaz, 6/26)

Sen. Lisa Murkowski (R-Alaska) said Monday evening that she does not have enough information yet to vote in favor of the upper chamber’s legislation to repeal and replace ObamaCare. “Today I don’t have enough information, I don’t have enough data, in terms of the impact to my state, to be able to vote in the affirmative,” Murkowski, considered a key swing vote on the bill, told CNN’s Dana Bash. (Shelbourne, 6/26)

“If you’re on the fence, if you’re looking at this as a political vote, this CBO score didn’t help you,” said Sen. Lindsey Graham, R-S.C. “So I think it’s going to be harder to get to 50 — not easier.” (McIntire, 6/26)

The biggest single change called for by the Republican health-care bill that may be voted on by the U.S. Senate this week is its reduction in federal spending on Medicaid, the program for poor and disabled Americans. The bill is being championed by Majority Leader Mitch McConnell and backed by U.S. President Donald Trump as a way to "repeal and replace” the Affordable Care Act, also known as Obamacare. The Senate bill, like one passed in May by the House of Representatives, would roll back Obamacare’s expansion of Medicaid and make other far-reaching changes to the program as well. (Greifeld and Tracer, 6/27)

Somewhere along the way, the Republican crusade to repeal "Obamacare" also turned into an effort to limit the future growth of Medicaid. That bit of mission creep is complicating prospects for the GOP, and could lead to deadlock. (Alonso-Zaldivar, 6/27)

Medicaid is the government health care program for the poor. That's the shorthand explanation. But Medicaid is so much more than that — which is why it's become the focal point of the battle in Washington to repeal and replace the Affordable Care Act. President Obama expanded Medicaid under his signature health care law to cover 11 million more people, bringing the total number of people covered up to 69 million. (Kodjak, 6/27)

The National Association of Medicaid Directors on Monday objected to Senate Republicans' health bill, arguing it would provide too little funding for the giant federal program. The bipartisan protest added to the swelling chorus of opposition to the bill, which Senate GOP leaders intend to pass as early as this week. ... The Medicaid directors’ group left open the question of whether it potentially could support a switch to capped funding if the amount of money were increased. "While NAMD does not have consensus on the mandatory conversion of Medicaid financing to a per capita cap or block grant, the per capita cap growth rates for Medicaid in the Senate bill are insufficient and unworkable," the group of state officials said. (Young, 6/26)

Rachel Martin talks to Diane Rowland of the Kaiser Family Foundation, about a misconception: If a person on Medicaid gets a job, than their health insurance needs will be taken care of. (6/27)

In an interview Sunday, ABC news host George Stephanopoulos brought up the bill’s projected $800 billion in Medicaid savings and asked Conway if that undermined the president’s campaign promise to spare Medicaid from cuts. "These are not cuts to Medicaid, George," Conway said on This Week on June 25. "This slows the rate for the future." ... on one level, she has a point, we at PolitiFact found. Future savings are not always "cuts." But in the case of the GOP health care bill, there are indeed cuts that go beyond dollars spent. (Greenberg, 6/26)

An analysis of the Senate health care bill shows its changes to the way Medicaid is funded would cost Virginia’s program at least $1.4 billion over seven years. The Virginia Department of Medical Assistance Services released the estimate Monday. It says the Senate bill would cost Virginia almost double what the House version would from 2020 to 2026. (6/26)

The estimate the Department of Medical Assistance Services released on Monday is double the projected effect on Virginia’s Medicaid program of health care legislation the U.S. House of Representatives adopted on May 4. The difference reflects a lower annual growth rate than the Senate proposal, the Better Care Reconciliation Act, assumes in federal spending on Medicaid under a proposed system of per-capita caps. (Martz, 6/26)

The U.S. Senate’s proposal to rein in the Affordable Care Act could devastate Iowa nursing homes and hospitals, industry leaders are warning Iowa’s senators. Nursing homes could be particularly vulnerable to deep Medicaid cuts the bill would bring, said Steve Ackerson, president of the Iowa Health Care Association. More than half of all residents in Iowa nursing homes are covered by Medicaid, which pays an average of about $172 per day. On average, the nursing homes lose $26 per day on each of those residents, said Ackerson, whose association represents the industry. (Leys, 6/26)

Education advocates and school superintendents are petitioning lawmakers to reject a draft Republican health care bill that they say could reduce services to students with disabilities. Schools providing students medical services such as specialized equipment or speech therapists have been able to have eligible expenses reimbursed through Medicaid since 1988, so long as the student is signed up for the program. Annually, schools receive about $3 billion through reimbursements, according the National Alliance for Medicaid in Education. (Wilkins, 6/26)

Local hospital officials are watching with trepidation as the U.S. Senate works on its bill that would repeal parts of the Affordable Care Act. Their concern: If thousands of Medicaid patients across Greater Cincinnati get thrown off the government health plan, hospital spending on millions of dollars of uncompensated care will explode and put renewed stress on budgets. (Saker and Tucker, 6/26)

The Association for Community Affiliated Plans announced it plans to start airing 30-second cable TV ads in Cleveland, Columbus, and Cincinnati starting Tuesday through July 11. The group, which represents Medicaid-managed health plans for the poor and other public health programs, also will run online ads statewide asking Ohioans to urge Republican U.S. Sen. Rob Portman not to cut Medicaid. (Pelzer, 6/26)

Texas hospitals stand to lose billions under the Republican-backed health plan,  as federal Medicaid dollars shrink, leading to a rise in uncompensated care, according to a new analysis by the Commonwealth Fund, a national health policy foundation. The study looked only at the U.S. House plan passed last month. It has not yet examined the impact of the U.S. Senate's version unveiled late last week, which experts have predicted will bring even deeper cuts to Medicaid. (Deam, 6/26)

Changes to Medicaid in Republican proposals for health care reform could cause insurance rates to go up for everyone, according to Rep. Kathy Castor. That’s because millions would lose health insurance, said Castor, a Tampa Democrat who spoke out against the changes Monday at the American Cancer Society Hope Lodge in Tampa. (Ochoa, 6/26)

Overall, people with disabilities and seniors make up 25 percent of Medicaid enrollees in Georgia, and account for about 60 percent of the program’s costs. ... This includes two waiver programs that provide home- and community-based services for about 12,500 Georgians with intellectual or developmental disabilities. (Miller, 6/26)

Abused and neglected children in Tennessee will suffer from Medicaid cuts proposed under the Senate health care bill, warned state child welfare advocates on Monday, painting a potentially dire picture of victims without access to treatment and a deepening of an opioid crisis that has pushed more kids into foster care because they lack a functioning parent. TennCare, the state's version of Medicaid, is the principal provider of medical, mental health and special-needs services for about 8,000 kids in foster care, most as a result of abuse or neglect. (Wadhwani, 6/26)

Anthem Inc. said it believes that the Senate Republicans’ health bill will bolster the individual insurance market, an endorsement for the legislation as many other insurers have suggested it could undermine the marketplaces created by the Affordable Care Act. In a statement, Anthem said it believed the bill “will markedly improve the stability of the individual market and moderate premium increases,” because it allots billions to help stabilize the markets, eliminates a tax on health insurance plans and works on “aligning premium subsidies with premium costs.” (Wilde Mathews, 6/26)

Health insurance giant Anthem Inc. endorsed the Senate GOP's healthcare legislation Monday, saying it believes the bill will stabilize the individual market. The endorsement comes as doctors, hospitals, patient groups and even other health plans have slammed the legislation as harmful, and outside experts have warned it could destabilize the individual marketplace. (Weixel, 6/26)

It’s time again for Senate Democrats to burn the midnight oil. Senate Democrats launched yet another night of floor speeches on Monday night castigating the GOP’s plan to repeal and replace Obamacare — a talk-a-thon led by Sens. Patty Murray of Washington and Mazie Hirono of Hawaii that ran several hours after the Senate’s 5:30 p.m. votes. (Kim, 6/26)

On Monday night, Sen. Cory Booker (D-N.J.) gathered colleagues on the steps outside the Senate, where they talked for hours into a Facebook feed as activists filed in and out to watch the debate. The tone alternated between grim stories of people who would lose access to Medicaid, and in-jokes between the senators. “We've brought in Papa Smurf!” said Booker when Sen. Charles E. Schumer (D-N.Y.) arrived to join the Facebook Live talk. (David Weigel, 6/26)

Senate Democrats are stepping up their attacks on the GOP effort to repeal and replace ObamaCare ahead of a vote on the plan that could come later this week.  Democrats launched a talkathon on Monday night from the Senate chamber, speaking for more than three hours and urging supporters to help kill the Senate legislation, which could face its first hurdle as soon as Tuesday. (Carney, 6/26)

Democrats are planning an hours-long protest from the Senate floor on Monday night as they gear up ahead of a vote on the GOP plan to repeal and replace ObamaCare.  Ben Wikler, the Washington director for the progressive outside group MoveOn.org, urged supporters to come to the Capitol on Monday night to watch the floor speeches from inside the Senate chamber. (Carney, 6/26)

U.S. Sen. Cory Gardner was on the hot seat even before a new report estimated 22 million Americans would lose their health insurance by 2026 under a Republican bill the U.S. Senate could vote on this week. Now the stakes are even higher for the Colorado Republican, who has not said whether he would back a GOP health care proposal he helped shape — though Gardner spoke more positively than not about the measure in a brief interview Monday on Capitol Hill. (Matthews, 6/26)

The health care bill unveiled Thursday by Senate Republicans has been out in the open for less than a week, and there are many obstacles to clear before it can become law: an uncertain Senate vote, a return to the House for final approval, a presidential signature. But in newspapers and on radios and TV stations from Anchorage to Miami, the effects of the bill are already being contemplated. These could vary considerably from region to region, state to state, even family to family. (Robertson, 6/26)

One of the nation’s largest healthcare lobbying groups Monday announced its opposition to the Senate's ObamaCare repeal plan, warning that it could hurt the "most vulnerable citizens." The American Medical Association (AMA) wrote a letter to Senate Majority Leader Mitch McConnell (R-Ky.) and Minority Leader Charles Schumer (D-N.Y.) warning against cuts to Medicaid and changes to ObamaCare's subsidies and regulations. (Hellmann, 6/26)

When people talk about jobs in Ohio, they often talk about the ones that got away. "Ten years ago, we had steel. Ten years ago, we had coal. Ten years ago, we had plentiful jobs," says Mike McGlumphy, who runs the job center in Steubenville, Ohio, the Jefferson County seat. (Siegel and Cheung, 6/26)

People in the state’s health industry, from advocates to clinic directors, were left reeling by the new CBO report, which estimated the Senate Republican health plan would create an additional 22 million uninsured Americans by 2026... The Republican bill would radically cut federal funding for Medicaid, even more deeply than what was proposed in the House bill. (Feibel, 6/26)

Governor Charlie Baker warned Monday that the US Senate Republicans’ sweeping health care proposal would cost Massachusetts more than $8.2 billion and cause 264,000 residents to lose their health insurance coverage by 2025. The families and individuals who would lose coverage “are among our lowest-income residents,” the governor said in a letter to the state’s congressional delegation. (Dayal McCluskey, 6/26)

As Senate Republicans work to pass a health care bill, Alison Chandra thought it would be “fitting” to shed light on the financial realities of her son’s care at Boston Children’s Hospital... From more than $47,00 for “coronary care” to nearly $43,000 for supplies and implants, the striking figures quickly pile up. (DeCosta-Klipa, 6/26)

Arizona health-care and business leaders warn that Senate Republicans' bill to replace the Affordable Care Act would trigger deep cuts to the health-care system that could ripple through the state's budget and economy. Hospital leaders said the Senate bill, called the Better Care Reconciliation Act, would eliminate coverage for low-income families on Medicaid and would significantly increase uncompensated care at hospitals. (Alltucker, 6/26)

The Senate’s version of the GOP health care bill would reduce the amount the federal government provides in tax credits to help people buy health insurance by $424 billion over the next decade, according to the Congressional Budget Office’s report Monday. What do these reductions mean in practical terms for Colorado? The nonpartisan Kaiser Family Foundation has estimated tax credit amounts and premium costs for every county in the country. (Ingold, 6/26)

U.S. Senate Republicans on Monday released changes to their healthcare bill, including a six-month waiting period for people who have let their insurance coverage lapse for over 63 days - about two months - and want to get insured again. (Cornwell, 6/26)

The change, intended to satisfy insurers and minimize the number of Americans who may drop their plans if the bill becomes law, received measured praise from some industry officials but sharp criticism from patient advocates. The move — the first in a series of changes Senate Majority Leader Mitch McConnell (R-Ky.) plans to make in the next few days — underscores the degree to which Republicans need to retool their health bill if they hope to pass it this week. (Eilperin and Sullivan, 6/26)

The Senate GOP health bill would repeal large portions of the Affordable Care Act, including a requirement that most people have coverage or pay a penalty. Without that mandate, insurers have been concerned that young and healthy people, who help offset the costs of older and sicker consumers, wouldn’t obtain coverage. That would push premium costs higher because the Senate legislation also requires insurers to cover people with pre-existing health conditions. Senate Health Bill's CBO Score Complicates PathThe Congressional Budget Office estimates that the Senate Republican health bill would leave 22 million more uninsured but cut $321 billion from federal deficit. WSJ's Shelby Holliday reports.The addition of the waiting period aims to fix that gap, mandating that people wait six months before getting coverage on the individual market. (Armour and Peterson, 6/26)

The most significant change is the inclusion of a new provision to encourage Americans to maintain continuous health-care coverage that would replace Obamacare’s individual mandate. The new provision would impose a six-month waiting period before new insurance goes into effect for anyone who had a break in coverage lasting 63 days or longer in the prior year. It would take effect beginning in 2019. (Litvan and Dennis, 6/26)

The only exceptions to the six-month waiting period would be for a child enrolled in coverage within 30 days of being born or for an adopted child under the age of 18 who is enrolled within 30 days of being adopted. (McIntire, 6/26)

Tim Jost, an emeritus law professor at Washington and Lee University, said the six-month lockout is likely to drive up bad debt for providers because many people who try to sign up after a cancer diagnosis, for instance, will still get treatment during that waiting period. "It will create some bankruptcies," he said, for people who went without insurance and then got sick. (Lee, 6/26)

Congressional Republicans’ dash to undo Obamacare is about fulfilling a seven-year promise to voters. But it’s also about seizing what may be the party’s last chance to wipe out the 2010 law’s tax hikes on upper earners. The Senate version of the health-care bill released last week would reduce federal revenue by $700 billion over a decade, the Congressional Budget Office estimated on Monday, by repealing tax hikes imposed by the Affordable Care Act. One of the biggest revenue declines would come from retroactively repealing a 3.8 percent tax on investment income for individuals earning more than $200,000 or couples above $250,000. (Kapur, 6/27)

Nearly $1 trillion of taxes imposed by the Affordable Care Act will remain in place if the Senate fails to adopt legislation to dismantle the law known as Obamacare, the top Republican on tax policy in the House of Representatives said on Monday. House Ways and Means Committee Chairman Kevin Brady told reporters there are no plans to use future tax reform legislation as a secondary route for abolishing the Obamacare levies, should the Senate healthcare effort stall. (Morgan, 6/26)

When Democrats enacted two taxes on wealthy families to help finance the 2010 health care law, Republicans predicted the levies would be politically unpopular and would not survive. Now, the GOP faces a partisan messaging battle over plans to end a Medicare payroll surtax and a separate tax on investment income that are both levied on taxpayers earning more than $200,000 for an individual and $250,000 for a married couple. (Ota, 6/27)

At least one influential donor has informed congressional Republicans that the "Dallas piggy bank" is closed until he sees major action on health care and taxes. Texas-based donor Doug Deason has already refused to host a fundraiser for two members of Congress and informed House Majority Leader Kevin McCarthy, R-Calif., his checkbook is closed as well. (6/26)

Consumers Union, the political arm of product ratings organization Consumer Reports, announced Monday that it’s expanding a six-figure radio ad campaign against Senate Republicans’ health care bill to a total of five states. The $100,000 ad buy targets vulnerable and centrist Republicans who are seen as most likely to buck their party and oppose the bill, which Senate GOP leaders aim to pass this week. The ads highlight the bill’s cuts to Medicaid and possible coverage losses. (Reid, 6/26)

The authors of Senate Bill 562, Democrats Ricardo Lara and Toni Atkins, didn’t include a way to pay for the far-reaching legislation, which was estimated to cost $400 billion to start... So when Assembly Speaker Anthony Rendon, a policy wonk who says he supports universal health care, announced late Friday he was holding the bill in committee, he merely expedited the inevitable. (Cadelago and Luna, 6/27)

The California Nurses Association lashed out at Assembly Speaker Anthony Rendon, who announced on Friday that the single-payer legislation would not advance in the Assembly in 2017. Rendon hit back on Monday, criticizing the legislation that passed the Senate earlier this month. (Marzorati, 6/26)

For all the promises of genomics ushering in a new era in medicine, with scientists regularly urging people to get their DNA sequenced, it appears that the revolution will be postponed: A first-of-its-kind study published Monday found that most of the adults who underwent genome sequencing and were told they had a disease-causing DNA variant did not in fact have that disease. And few of them got information that improved their health. (Begley, 6/26)

Advances in technology have made it much easier, faster and less expensive to do whole genome sequencing — to spell out all three billion letters in a person's genetic code. Falling costs have given rise to speculation that it could soon become a routine part of medical care, perhaps as routine as checking your blood pressure. But will such tests, which can be done for as little as $1,000, prove useful, or needlessly scary? (Stein, 6/26)

It was the sort of bad news every patient fears. Merlin Erickson, a 69-year-old retired engineer in Abingdon, Md., was told last year that a biopsy of his prostate was positive for cancer. Mr. Erickson, worried, began investigating the options: whether to have his prostate removed, or perhaps to have radiation treatment. But a few days later, the doctor called again. (Kolata, 6/26)

Dr. Luke Smith drove slowly through the unlit streets of a neighborhood filled with immigrants, searching for an address among small houses with windows ribbed by iron bars. Pharmacy bags lay at his feet.His mission: to deliver medication to patients too frightened to pick up their prescriptions. (Hoffman, 6/26)

A big hurdle to developing new treatments is that there can be a big gap between a drug’s effectiveness in the laboratory, compared with the complexity of the human body. Several research labs have recently uncovered ways bacteria can elude the standard test, making invulnerable microbes appear susceptible to treatment. But in a new study in mice, scientists at the University of California-Santa Barbara may have hit on a way to make the test more accurate, and it involves using the most pedestrian of household items. They took the standard antibiotic susceptibility test and added sodium bicarbonate, a chemical better known as baking soda. In addition to that small box containing it in the back of your refrigerator, it’s also found in human tissue—so researchers hypothesized that using it to test superbugs would better simulate how they behave in humans.  (Tozzi, 6/27)

We rub, pour, sprinkle and spray them all over our bodies, so you'd hope cosmetics would undergo serious safety oversight before they get into our hands. But in fact, the cosmetics industry is largely self-regulated, with no requirements for approval before going on the market. And once on the market, there are few systems in place to monitor the safety of personal care products. (Higa, 6/26)

Over the last decade, American donations to fight malaria in Africa have saved the lives of nearly two million children, according to a new analysis of mortality rates in 32 countries there. The study, published by PLOS Medicine this month, looked at the long-term effects of the President’s Malaria Initiative, a program started by President George W. Bush in 2005 that has spent over $500 million a year since 2010. (McNeil, 6/26)

The adolescent years are when people's bodies are supposed to start the ascent to their physical peak. Teenagers are growing like beanstalks. Their hormones are raging. They're eager for new experiences. By all accounts, this should be among the most active periods in a person's lifetime. Except it turns out it's not. (Cha, 6/26)

A new study suggests that people with anxiety and depression are consuming a disproportionate share of prescription painkillers, a finding that could add a new wrinkle to the epidemic of opioid use in the United States. Researchers at Dartmouth-Hitchcock Medical Center and the University of Michigan found that nearly 19 percent of the estimated 38.6 million people with those two most common mental health disorders received at least two prescriptions for opioids during a year. And more than half the prescriptions for the powerful, highly addictive painkillers went to individuals in that group, the researchers asserted. (Bernstein, 6/26)

Adults with a mental illness receive more than 50 percent of the 115 million opioid prescriptions in the United States annually, according to a study released Monday. The results prompted researchers to suggest that improving pain management for people with mental health problems “is critical to reduce national dependency on opioids.” People with mental health disorders represent 16 percent of the U.S. population. (Connor, 6/26)

“More than half of all prescriptions being prescribed in the United States are going to patients with mental health disorders, and the reason why this is so striking is because adults with mental health disorders only represent 16% of the population,” explains Dr. Brian Sites, who co-authored the paper being published next month in the Journal of the American Board of Family Medicine. “So there is a big discrepancy.” (Bookman, 6/26)

“If you want to come up with social policy to address the need to decrease our out-of-control opioid prescribing, this would be the population you want to study, because they’re getting the bulk of the opioids, and then they are known to be at higher risk for the bad stuff,” he said. (Caruso, 6/26)

A state appeals court Monday heard arguments over whether secret records regarding the marketing of the powerful prescription opioid OxyContin should be released to the public. A three-judge panel of the Kentucky Court of Appeals is considering a request from OxyContin maker Purdue Pharma to overturn a lower court ruling ordering the release of the documents — the result of a motion filed by STAT. The records include a deposition of Dr. Richard Sackler, a former president of Purdue and a member of the family that owns the privately held Connecticut company. (Armstrong, 6/26)

The 9th U.S. Circuit Court of Appeals ruled Monday that the U.S. Drug Enforcement Agency does not need a court order to subpoena a prescription drug database kept by the state of Oregon, but the ruling did not specify whether those subpoenas would violate constitutional protections. The ruling reverses a 2014 judge's ruling finding that the agency must obtain warrants to access the database, which Oregon uses to help healthcare providers identify abuse. (6/26)

Fifteen opioid-suspected deaths were recorded last week in Arizona, the state Department of Health Services said Monday. Those deaths were among the 191 opioid overdose cases overall recorded from June 15-22, the agency said, further highlighting a problem that has drawn national attention in the past year. (Destin, 6/26)

The tainted injection left Rachelle Shuff with pain that requires 15 medications to manage and, she said, perhaps only two years to live. Scott Shaw and Anna Shaw Allred had to bury their mother, Elwina Shaw, who at 77 was healthy, they said, until she got a tainted injection of a steroid and a debilitating illness followed. (Bidgood, 6/26)

Mr. Cadden co-owned the New England Compounding Center, a now-closed Framingham, Mass., pharmacy that made injected steroid pain medication that caused 750 cases of fungal meningitis in 20 states, including at least 64 deaths, according to the Centers for Disease Control and Prevention. (Levitz, 6/26)

“This reality haunts me now and will do so for the rest of my life,” Cadden told U.S. District Judge Richard G. Stearns at his sentencing Monday in Boston federal court. “It breaks my heart to read about how painful their deaths have been.” (Lawrence, 6/26)

Cadden was convicted in March of fraud and racketeering charges stemming from the public health crisis triggered when NECC sent tainted medicines around the country, causing a fungal meningitis outbreak that killed at least 60 and sickened hundreds. The jury did not convict him of second-degree murder charges. (Arsenault and Ellement, 6/26)

An annual report by U.S. News & World Report ranks the nation's top 50 children's medical centers by 10 pediatric categories including cancer, neurology, diabetes and endocrinology. U.S. News has ranked children's hospitals since 2006, and awards rankings based on measures such as clinical outcomes, patient volume, staffing adequacy and compliance with best practices, to name a few. (Bowerman, 6/27)

Ducey and the Legislature this year, with a push from the conservative Center for Arizona Policy, placed into the budget the requirement that the state try to take control of Arizona's $4.5 million share of federal family-planning funds. For more than 30 years, the non-profit Arizona Family Health Partnership has overseen the federal Title X program in Arizona, working with Planned Parenthood and other community clinics. (Beard Rau, 6/26)

Glyphosate, an herbicide and the active ingredient in Monsanto Co's popular Roundup weed killer, will be added to California's list of chemicals known to cause cancer effective July 7, the state's Office of Environmental Health Hazard Assessment (OEHHA) said on Monday. (Plume, 6/27)

Summa Health plans to eliminate 300 positions and change its service offerings as the health system faces $60 million in operating losses. In an internal memo to employees Monday, Interim President and CEO Dr. Cliff Deveny said the Akron-based system in the next month would need to eliminate positions and discontinue and consolidate services to shore up financial losses from low inpatient and outpatient numbers. (Christ, 6/26)

One in four Ohio children will experience domestic violence before reaching adulthood, according to a new study. The study by Case Western Reserve University researchers, conducted on behalf of the HealthPath Foundation of Ohio, sought to determine the extent and expense of domestic violence, as well as gaps in addressing its roots and aftermath, CWRU said. (Farkas, 6/26)

An associate vice president in the human resources department at San Francisco State University told faculty she worried that an employee of the college recovering from cancer had “chemo brain,” according to a lawsuit filed last month... A statement from the university’s lawyer said the school is fighting the claims. (Deruy ,6/26)

Britany Kuhn recently led her six children on a 20-minute walk to get lunch from a local meal program. Such programs are made possible by the Children’s Hunger Alliance, a nonprofit organization working to keep children from going hungry through a project focused on Jackson, Lawrence, Pike, Ross, Scioto and Vinton counties in southeastern Ohio. (Henry 6/27)

This week, these senators will face a career-defining choice. It is not an easy one for many of them. Republicans have spent years promising to repeal Obamacare. Now the Senate is nearing a decision on whether to do so. Opposing the bill risks marking any Republican as a traitor to the party. By late Monday, enough Republicans were nonetheless expressing skepticism about the bill to put its success in serious doubt. Susan Collins of Maine, Rand Paul of Kentucky and Dean Heller of Nevada have all distanced themselves from the bill. But we’ve seen a version of this story before. (David Leonardt, 6/27)

Senate Republicans are headed for a vote on their health-care bill as soon as this week, and Majority Leader Mitch McConnell is still scrambling for 50 votes. What the holdouts should understand is that this is a defining political moment. They may never have a better chance to improve U.S. health care and reform government, and the window is closing. (6/26)

There are two central problems facing Senate Republican leaders this week as they try to rush through a health-care bill that's gaining opposition by the day: 1. It's gaining opposition by the day. ... 2. Not all of their concerns are the same. (Amber Phillips, 6/26)

Senate Majority Leader Mitch McConnell (Ky.) and the GOP leadership are scrambling this week to corral 50 out of 52 Republican votes for an historically unpopular health-care bill. Why did so many House Republicans already vote for a bill that large majorities in every state detest? And why are their Senate colleagues considering walking the same plank, given the electoral risk? (David C. Barker and Christopher Jan Carman, 6/27)

In Democratic circles, I hear many wondering how Republican senators could vote for a health care bill that, according to the non-partisan Congressional Budget Office, will cause an estimated 22 million people to lose coverage by 2026 and deals a severe blow to tens of millions of vulnerable people insured by Medicaid. Prominent Republicans I interact with have a different lens. They are not primarily focused on covering more people. To the extent they have a focal point in health care, it’s more likely to be costs. They point to premium and deductible increases under the Affordable Care Act (ACA) in some markets and say this demonstrates the need to repeal the law. (Andy Slavitt, 6/26)

This is a week to keep focused on the most urgent question in domestic policy and politics: Will Republicans snatch health insurance from millions of Americans and slash the vital Medicaid program by $770 billion , all to enable massive tax cuts for the wealthy and powerful? (Eugene Robinson, 6/26)

President Donald Trump isn’t the kind of guy to be humble about his accomplishments. Yet his Twitter persona paid relatively little attention to what could be the biggest step toward one of his campaign promises so far: the emergence of a Senate bill that aims to roll back much of Obamacare. Maybe he's not so sure he likes what he sees? (Mark Whitehouse, 6/26)

The Congressional Budget Office’s highly anticipated scoring of Senate Republicans’ health-care bill was released Monday. To no one’s surprise, it leaves about as many more Americans uninsured (22 million) as the House version (23 million) by 2026; in fact the shock is greater under the Senate’s bill that would prompt 15 million to lose coverage in the first year. The CBO forecast states, “By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.” (Jennifer Rubin, 6/26)

How many people would lose their lives if the Republican effort to repeal the Affordable Care Act succeeds? Estimates of this inherently murky statistic vary, but the range is from about 28,000 to nearly 100,000 a year. That’s a shocking toll from an effort that is essentially aimed at gifting the wealthiest Americans with hundreds of billions of dollars in tax cuts by slashing healthcare. So no one should be surprised that Republican and conservative supporters of the House and Senate repeal bills have spent a lot of time claiming that nothing of the sort will happen. The effort moved into high gear this weekend, following Thursday’s unveiling of the Senate GOP’s version of ACA repeal. (Michael Hiltzik, 6/26)

The official numbers on the Senate health-care bill are in, and they are grim: The Congressional Budget Office (CBO) found Monday that the Better Care Reconciliation Act would result in 22 million fewer people with health-care coverage in a decade. “By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” the experts concluded. (6/26)

In dry, stark language, the Congressional Budget Office on Monday punctured many of the stated goals for the Republican health care bill. The budget analysis gave Republican senators just a few happy talking points. It found that average insurance premiums would be lower in 2020 than they are today. The bill would reduce the deficit by more than $300 billion over a decade. And it would produce a huge tax cut, albeit mostly for wealthier Americans. (Margot Sanger-Katz, 6/26)

The Senate Republicans’ health-care plan, like the House Republicans’ health-care plan, is objectively terrible. It would result in 22 million Americans losing insurance. It would dramatically raise premiums for the poor and old. Its Medicaid cuts would harm people with disabilities, nursing home residents and even babies. But we knew all that was coming. The surprising thing about this bill is not that it forsakes the indigent, elderly and vulnerable. It’s that it forsakes so many of the Republicans’ own vaunted values. (Catherine Rampell, 6/26)

One of the most bizarre developments in the debate over the Republican health-care plan has been the surge in politicians and pundits taking to the airwaves and social media to declare that the GOP's Obamacare rollback, which cuts roughly $800 billion in Medicaid spending over the next 10 years, does not actually cut Medicaid. (Christopher Ingraham, 6/26)

Medicaid, the government program that provides health insurance coverage to low-income and disabled Americans, is the largest payer for health care in the United States in terms of enrollees and the second-largest payer (behind only Medicare) in terms of spending. Escalating health care costs, a growing federal budget deficit, and fiscal challenges in many states have led to calls to reform the program to decrease spending growth. Recent federal reform proposals from House and Senate [Republicans] would change the current financing system in which the federal government guarantees a share of total program spending to states to one limiting federal cost exposure by setting a per capita cap on federal payments to a state. (Timothy Layton, Ellen Montz and Thomas McGuire, 6/26)

[Republicans] main goal isn’t to preserve the coverage gains achieved by the ACA, it’s to cut the premiums paid by those who aren’t covered by large employer health plans. And on that front, the CBO offers what looks at first blush like good news for the GOP. After an initial spike in premiums in 2018 (projected to be 20% higher than if current law were left in place), rates would head in the other direction .... Now for the reality check. First off, we’re not talking about rates being lower in 2020 than they are today — just that they wouldn’t be as high as they would be under current law. And second, the main reasons premiums would be comparatively lower, the CBO predicts, are that the policies would be worth less, and federal taxpayers would be kicking in more. (Jon Healey, 6/27)

Senate Republicans made only one big change in a new version of their Senate health bill released Monday: They added a penalty for Americans who let their insurance lapse for 63 days or more. Under the new provision, those who go without insurance will be locked out of getting coverage for at least six months after they sign up. (Margot Sanger-Katz, 6/26)

I've been spending a lot of time these past years in hospital lobbies, infusion rooms, scanning stations and oncology exam rooms. Like countless others diagnosed each year with cancer in America, I was well one day and in the land of the mortally sick the next. Fortunately for me, I entered the disease's demanding treadmill — surgery, chemotherapy and radiation — with a devoted husband, fierce family and friends and good medical care. But my cancer went metastatic anyway in June 2015. At age 59, I was declared terminal and given "six months to a year" to live. I'm still here today because I'm one of the lucky ones to respond, at least partially, to immunotherapy — a breakthrough set of new drugs that help the body fight cancer. (Melinda Welsh, 6/26)

For decades American conservatives have sought to restore meaning to the 10th Amendment, which recognizes the states’ right to manage their affairs free from Washington’s interference. Passing the Republican Senate’s health-care bill would represent historic progress toward that goal. (Avik Roy, 6/26)

In 2010, when Democrats passed the Affordable Care Act, Republicans complained that they did so with no Republican support. Democrats responded by pointing out that the centerpiece of their plan — tax credits to buy private insurance — came from a Republican governor, Mitt Romney of Massachusetts. Something similar is happening today. Democrats are denouncing the partisan nature of the Republican effort to repeal and replace Obamacare. They’re right to note that if the new bill passes the Senate, it will do so along party lines. But the core planks of the Senate Republicans’ health bill — the Better Care Reconciliation Act — borrow just as much from Democratic ideas as Obamacare borrowed from Republican ones. (Avik Roy, 6/26)

This bill is bad for Texas and bad for the country. A Congressional Budget Office analysis of the measure, released Monday, makes that clear. Some 22 million more Americans will be uninsured by 2026, only a slight improvement of the 23 million estimated in a House bill. (6/26)

If three caring, courageous Republican senators — out of 52 — do not step forward this week, the Affordable Care Act will be renamed. But finis Obamacare? Not so fast. This is not the definitive, wholesale repeal the GOP promised for seven long years. Instead, the GOP approach is piecemeal. It repeals the taxes on wealthy people and insurance companies and the mandate that everyone either have health coverage or pay extra taxes. (Davis Merritt, 6/27)

Will cutting Medicaid help the federal deficit? To a point. But the cuts are in the Senate bill largely to pay for tax reductions, which will cost the government $541 billion through 2026, according to CBO. The tax cuts in the Senate bill are aimed primarily at high-income earners and investors. This might not mean much to most Americans who aren’t on Medicaid and aren’t high-income earners. But for Americans of a certain age, the Senate bill should be pretty scary because Medicare and Social Security are probably next. (Dave Helling, 6/26)

If Republicans succeed in passing this legislation, millions of parents who work hard but struggle to make ends meet will find it prohibitively expensive to get their children the care they need... And suffering most of all will be the 60 percent of children with disabilities — and their families — who currently receive Medicaid coverage. (Henry Waxman, 6/26)

This budget devalues the needs of many low- and moderate-income Americans and would severely damage the nation’s social safety net. With its reduction of $1.7 trillion in social services, it severely constricts or eliminates programs that are essential to the health and welfare of families and individuals. The budget includes major cuts to Medicaid, the critical health care program that protects children, low-income single adults, older Americans, and Americans with disabilities. Medicaid covers nearly one in four Americans and, according to the Kaiser Family Foundation, accounts for one of every six dollars spent on health care in the country. (Terry Werner, 6/27)

Under the Senate bill being pushed by Price and other Republicans, deductibles would soar even higher. They would soar not by accident, but as a result of conscious, deliberate policy decisions written into the bill that are designed to drive those deductibles higher. (Jay Bookman, 6/26)

It’s now been three days since we learned the disastrous impact the bill would have on Arizona. That our leaders would be faced with an impossible, untenable choice. (Laurie Roberts, 6/26)

Baker has been warning that Massachusetts will lose money if a Senate health care bill, which essentially phases out Medicaid, passes and becomes law. But other Republican governors are stating the truth more bluntly: Those federal spending cuts will mostly hurt the poor, the elderly, women, and children. (Joan Vennochi, 6/27)

For a stronger, more prosperous Ohio where children have a chance to thrive, low-income working Ohioans have the dignity of health care, and those caught up in the opioid tsunami can be supported in recovery, here is what Ohioans need from lawmakers now in conference committee finalizing the next 2017-19 state budget:. (6/27)

Over the weekend Hillary Clinton tweeted that if Republicans pass the health-care bill, they should be called “the death party.” Senator Bernie Sanders had his own tweet .... Republicans denounced these remarks. ... My own reaction to the Democrats’ words was to consider calling a copyright attorney about Clinton, since a decade ago I wrote a book about abortion and related issues titled "The Party of Death." Liberals were outraged by my title then, as conservatives are by Clinton and Sanders now. It seems to me that today’s outrage is, as yesterday’s was, misdirected. A healthy democratic culture would not consider any of this rhetoric out of bounds. (Ramesh Ponnuru, 6/26)

Earlier this month a political zealot went to a baseball practice with the intention of killing as many Republican congressmen as he could. As often happens after such horrible events, various politicians and media figures suggested that we should tone down the rhetoric and not paint everything in apocalyptic terms, casting Republicans or Democrats as villains with traitorous or evil intent in their hearts. Words have consequences, they sagely said into the TV cameras. Two weeks later, many of the very same people are describing the Republicans as murderers for proposing changes to Medicaid. (Jonah Goldberg, 6/27)

Still, fighting this epidemic is one of the few things that unites people across the political divide these days. In fact, Sens. John McCain and Kirsten Gillibrand have introduced bipartisan legislation to prevent overprescribing for acute pain, one attempt to limit the scope of the problem. And yet, the Better Care Reconciliation Act, the reworked version of the American Health Care Act currently waiting for a vote in the Senate, is poised to allow insurers to stop covering care for the mental health problems that often lead to addiction. This could make coverage excessively expensive. It would make it harder for these people to access the right health care that could help them and protect them from addiction. (Jen Simon, 6/26)

It can be hard for physicians to follow current thinking of experts on medical care. It must be exponentially harder for the public to make sense of it. Recently, the United States Preventive Services Task Force changed its recommendation on prostate cancer screening from a D (that is, don’t do it) to a C (discuss it with your doctor). (Aaron E. Carroll, 6/26)

Fifteen percent to 25 percent of women with iron deficiency actually have a bleeding disorder. While boys with hemophilia experience joint and muscle bleeding, girls and women with a bleeding disorder have unusually heavy reproductive bleeding, including menstrual periods or bleeding after childbirth. (Joanna Davis, 6/26)