—Former HHS Secretary Sylvia M. Burwell

• How Trump can use Obamacare to kill Obamacare Politico by Dan Diamond—Conservatives who railed against Barack Obama's vast powers to build up the Affordable Care Act declared vindication Saturday with President Donald Trump’s executive order to tear it apart. Trump's order, which encourages Health and Human Services, the IRS and other agencies to work toward dismantling the ACA, doesn't confer any new powers on the executive branch. But Trump explicitly instructs his agencies to use their existing powers to weaken the law “to the maximum extent permitted by law,” regardless of congressional action to repeal it.
  
  
• Obamacare Repeal Heads to Committees Modern Healthcare—Congress has approved the first step toward dismantling the Affordable Care Act. By a near party-line 227–198 vote, the House approved a budget Friday that prevents Democrats from using a Senate filibuster to derail a blueprint that would repeal and replace President Barack Obama's signature healthcare law. Friday's passage was critical because it takes 60 votes to end filibusters, while Republicans have a 52-48 Senate majority. Now, Republicans in Congress must decide which parts of Obamacare to end and how to help protect up to 30 million people who received coverage under the ACA's provisions and its Medicaid expansion.
  
  
• Republicans Move to Spend Billions on Obamacare—Before They Kill It Politico by Jennifer Haberkorn—On their way to killing Obamacare, Republicans are leaning toward funding up to $9 billion in health care subsidies this year to keep the program afloat—even though they sued the Obama administration to stop those exact payments. The move is the most significant sign yet that the GOP is serious about propping up Obamacare temporarily to provide a smooth transition to a yet-to-be disclosed Republican replacement. The irony is deep.

• Fear Spurs Support for Health Law as Republicans Work to Repeal It New York Times by Robert Pear—President-elect Donald J. Trump and congressional Republicans appear to have accomplished a feat that President Obama, with all the power at his disposal, could not in the past seven years: They have galvanized outspoken support for the Affordable Care Act. People who benefit from the law are flooding Congress with testimonials. Angry consumers are confronting Republican lawmakers. And Democrats who saw the law as a political liability in recent elections have suddenly found their voice, proudly defending the law now that it is in trouble.
  
  
• Cancer Survivor Who Once Opposed Federal Health Law Challenges Ryan on Its Repeal Washington Post by Amy Goldstein—The distance between health-policy ideology and life-or-death health care narrowed to a few feet at a nationally televised town hall meeting this week when a small-business man from Arizona stood up and faced House Speaker Paul D. Ryan. "Just like you, I was a Republican," Jeff Jeans began. Standing on the stage, the Wisconsin congressman broke into a grin as Jeans said he had volunteered in two Republican presidential campaigns and opposed the Affordable Care Act so much that he'd told his wife he would close their business before complying with the health-care law. But that, he said, was before he was diagnosed with a "very curable cancer" and told that, if left untreated, he had perhaps six weeks to live. Only because of an early Affordable Care Act program that offered coverage to people with preexisting medical problems, Jeans said, "I am standing here today alive."
  
  
• Obamacare at Its Most Popular on Eve of Repeal Politico by Madeline Conway—On the eve of its possible repeal, Obamacare is at its most popular, according to a poll from NBC and the Wall Street Journal released Tuesday. Forty-five percent of Americans surveyed said they think Obamacare, the outgoing president's signature legislative achievement formally called the Affordable Care Act, is a "good idea." Forty-one percent think it is a bad idea. The poll, conducted between Jan. 12 and 15, started asking about Obamacare in April 2009, and this month marks both the highest percentage of respondents who signaled their approval for the law and the first time that more people surveyed said they like it than dislike it.

• Congressional Budget Office: Obamacare Repeal Could Lead to 32 Million Fewer Insured Politico by Jennifer Haberkorn—In the first year after repeal, 18 million people would lose insurance and premiums in the non-group market would spike up to 25 percent, the report states. A Republican bill to repeal huge parts of Obamacare would result in 32 million people losing health insurance and would double the price of insurance premiums within a decade, according to a new Congressional Budget Office report.
  
  
• Democrats Use CBO Report to Message Against Obamacare Repeal Roll Call by Lindsey McPherson—Democrats gained a useful messaging tool Tuesday in their efforts to thwart the GOP's plan to dismantle the 2010 health care law, as the Congressional Budget Office released a report saying up to 32 million people would lose their insurance under a previous Republican proposal. The CBO also estimated that marketplace premiums would nearly double under the GOP repeal legislation President Barack Obama vetoed last year. Republicans are using that prior budget reconciliation bill as a model for legislation they are drafting.
  
  
• Obamacare Repeal Threatens Public Health Funding to States USA Today by Jayne O'Donnell—Funding for many state public health and prevention programs is in jeopardy along with insurance for 20 million people as Congress moves to repeal the Affordable Care Act (ACA). While the ACA requires insurers to cover mammograms, colonoscopies, and other preventive care, a less prominent provision authorized a federal fund to prevent the soaring incidence of chronic diseases including diabetes and heart disease. It also funds education targeting college suicides, smoking, and low-income new mothers. The ACA's Prevention and Public Health Fund has survived about 60 votes in Congress, and it was tapped to help pay for the recently enacted 21st Century Cures Act, which funds pharmaceutical research and development and opioid treatment.

• Trump Vows 'Insurance for Everybody' in Obamacare Replacement Plan Washington Post by Robert Costa & Amy Goldstein—President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Obama's signature health-care law with the goal of "insurance for everybody," while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid. Trump declined to reveal specifics in the telephone interview late Saturday with The Washington Post, but any proposals from the incoming president would almost certainly dominate the Republican effort to overhaul federal health policy as he prepares to work with his party's congressional majorities. Trump's plan is likely to face questions from the right, after years of GOP opposition to further expansion of government involvement in the health care system, and from those on the left, who see his ideas as disruptive to changes brought by the Affordable Care Act that have extended coverage to tens of millions of Americans. In addition to his replacement plan for the ACA, also known as Obamacare, Trump said he will target pharmaceutical companies over drug prices. "They're politically protected, but not anymore," he said of pharmaceutical companies.
  
  
• California Withdraws Bid to Allow Undocumented to Buy Unsubsidized Plans Kaiser Health News by Ana B. Ibarra and Chad Terhune—Lawmakers in Sacramento have halted a first-in-the-nation effort by California to expand access to health coverage for immigrants living in the state without legal documents. At the behest of the state legislature, Covered California, the state's insurance exchange, withdrew its request to sell unsubsidized health plans to people who are here illegally. The withdrawal was first reported by the Sacramento Bee.

• Ryan and Trump Set for Medicare Showdown Politico by Rachael Bade—House Republicans are praying the president-elect comes around to their plans for overhauling entitlements. Tax reform could be in trouble if he doesn't.- Since the election, Paul Ryan has accommodated and deferred to Donald Trump on all sorts of issues they don't see eye-to-eye on. But when it comes to Ryan's career-defining cause—overhauling Medicare and other entitlements—the speaker has held his ground. The clashing philosophies between the GOP's two top pols—Trump once called Ryan's doctrine "political suicide"—is about to come to a head. Left unresolved, it threatens to sink tax reform, a top priority for both men.
  
  
• Why Trump Faces Stiff Fight to Slash Drug Prices Bloomberg by Doni Bloomfield—Trump would need to get a Congress dominated by Republicans on board to permit the U.S. to negotiate prices. So far, Republicans in Congress don't seem receptive to the idea, and Trump's own nominee to lead the Department of Health and Human Services has opposed Medicare price negotiation. Democrats have been more enthusiastic—President Barack Obama proposed letting Medicare negotiate prices for injectable medicines and other expensive drugs. The powerful pharmaceutical lobby opposes such measures and has said it will pour tens of millions of dollars into advertising to boost the industry's image.

• Trump's Health Plan Would Convert Medicaid to Block Grants, Aide Says New York Times by Robert Pear—President Trump's plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday. A block grant would be a radical change. Since its creation in 1965, Medicaid has been an open-ended entitlement. If more people become eligible because of a recession, or if costs go up because of the use of expensive new medicines, states receive more federal money.
  
  
• GOP Governors Who Turned Down Medicaid Money Have Hands Out  AP by Thomas Beaumont—Republican governors who turned down billions in federal dollars from an expansion of Medicaid under President Barack Obama's health care law now have their hands out in hopes the GOP Congress comes up with a new formula to provide insurance for low-income Americans. The other GOP governors who agreed to expand state-run services in exchange for federal help— more than a dozen out of the 31 states—are adamant that Congress maintain the financing that has allowed them to add millions of low-income people to the health insurance rolls. These two groups of Republicans embody the difficulty the emboldened GOP congressional majorities face: Make good on their promises to repeal the 2010 health care law while preserving popular provisions.
  
  
• Why GOP Governors Like Medicaid Under Obamacare. Hint: $ CNN by Tami Luhby—Some Republican governors who have expanded Medicaid, along with their Democratic peers, don't want Congress to kill the provision that has allowed 11.3 million low-income adults nationwide to gain health care coverage. Several GOP governors met with the Senate Finance Committee on Thursday to discuss the future of Medicaid and the Affordable Care Act. Also, House Majority Leader Kevin McCarthy has asked all governors to submit the changes they'd like made to Medicaid and Obamacare.

• CMS Announces New Participants for Alternative Payment Models in 2017 Modern Healthcare by Elizabeth Whitman—The Centers for Medicare and Medicaid Service (CMS) expects 359,000 clinicians to participate in four alternative payment models this year, the agency said Wednesday, touting those numbers as evidence of success in shifting away from fee-for-service and into value-based care. Those alternative payment models include accountable care organizations—the Medicare Shared Savings Program, the Next Generation ACO Model, and the Comprehensive End-Stage Renal Disease Care Model—and the Comprehensive Primary Care Plus Model. "By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine—caring for the patient," said CMS Acting Administrator Andy Slavitt, in a statement.
  
  
• The Heroism of Incremental Care The New Yorker by Atul Gawande—"In this era of advancing information, it will become evident that, for everyone, life is a preexisting condition waiting to happen. We will all turn out to have—like the Silver Bridge and the growing crack in its critical steel link—a lurking heart condition or a tumor or a depression or some rare disease that needs to be managed. This is a problem for our health-care system. It doesn't put great value on care that takes time to pay off. But this is also an opportunity....We can give up an antiquated set of priorities and shift our focus from rescue medicine to lifelong incremental care. Or we can leave millions of people to suffer and die from conditions that, increasingly, can be predicted and managed. This isn't a bloodless policy choice; it's a medical emergency."

• Physician Aid in Dying Gains Acceptance in The U.S. New York Times by Paula Span—In recent months, physician aid in dying has become available to a growing number of Americans. Last June, aid-in-dying legislation took effect in California, the most populous state. In November, Colorado voters approved a ballot measure by nearly a two-thirds majority. The District of Columbia Council has passed a similar law, and the mayor quietly signed it last month….The laws, all based on the Death With Dignity Act Oregon adopted in 1997, allow physicians to write prescriptions for lethal drugs when patients qualify. The somewhat complicated procedure involves two oral requests and a written one, extensive discussions, and approval by two physicians. Patients must have the mental capacity to make medical decisions.
  
  
• Abortion Rate Declines to Historic Low, with Obamacare a Likely Contributor, Study Says Los Angeles Times by Nina Agrawal—The U.S. abortion rate has hit its lowest point since the procedure became legal nationwide in 1973, according to a new study. The researchers estimated that there were 926,200 abortions in 2014, or 14.6 abortions for every 1,000 women of reproductive age. That was down 14 percent from three years earlier...Though the study did not look at the reasons for the decline, the authors and other experts suggested that improved access to contraception played the biggest role by preventing unintended pregnancies.
  
  
• 1 in 4 US Men Have Cancer-Linked HPV Genital Infections AP by Lindsey Tanner—The first national estimate suggests that nearly half of U.S. men have genital infections caused by a sexually transmitted virus and that one in four has strains linked with several cancers. Most human papillomavirus infections cause no symptoms and most disappear without treatment. And most adults will get an HPV infection at some point in their lives. The study "just underscores that you need to vaccinate boys as well as girls, " said Debbie Saslow, an HPV specialist at the American Cancer Society.