"More than any other state, California has embraced the Affordable Care Act. I intend to join with other governors and senators, and with you, to do everything we can to protect the health care of our people." -  California Governor Jerry Brown

• Behind Closed Doors, Republican Lawmakers Fret About How to Repeal Obamacare Washington Post by Mike DeBonis—Republican lawmakers aired sharp concerns about their party’s quick push to repeal the Affordable Care Act at a closed-door meeting Thursday, according to a recording of the session obtained by The Washington Post.
  
  The recording reveals a GOP that appears to be filled with doubts about how to make good on a long-standing promise to get rid of Obamacare without explicit guidance from President Trump or his administration. The thorny issues with which lawmakers grapple on the tape—including who may end up either losing coverage or paying more under a revamped system—highlight the financial and political challenges that flow from upending the current law.
  
  
• Trump Can Do Plenty on His Own to Unravel Obama Health Law AP by Ricardo Alonso-Zaldivar— President Donald Trump can do plenty on his own to unravel the Obama health care law, but some of those actions would create disruptions that undermine his administration's early promises. Other less sweeping steps could open the way for big changes, but might not get as much notice. Suspending enforcement of tax penalties on people who remain uninsured would win Trump immediate cheers from the political right for taking down a widely unpopular requirement. But experts say it would destabilize insurance markets by allowing healthy people to opt out, raising costs for taxpayers and remaining consumers. It would also risk a protracted court battle. Less visible but just as important, the administration appears to have wide latitude to let states experiment with Medicaid funds and other federal financing. That could provide a pathway for GOP-led states to try their ideas.
  
  
• Obama Makes Health Care Plea in Handoff Letter to Trump The Hill by Mike Lillis—In the tradition of departing presidents, Barack Obama left a letter for incoming President Donald Trump.  The thrust of the message, which Trump relayed to congressional leaders during their White House meeting Monday evening, was a plea to salvage ObamaCare—or swap it for something at least as generous. "I haven't seen the letter," Rep. Steny Hoyer (D-Md.), who attended the meeting, told reporters Tuesday. "But President Obama correctly…stated that, 'Look, we believe the Affordable Care Act is a very important piece of legislation which has given Americans better health, better access, more reliability. And if you have a bill … that improves upon all this, well, you know, maybe I could support it." "I don't know what the verbiage of President Obama's was," he added. "But his point was: 'If you've got something that's really better and we see it and we think it's better, then we could support that.'"
  
  
• Is the Health Care Law Really Going into a ‘Death Spiral’? The Hill by Peter Sullivan—If the health care law is in a death spiral, it increases the need to repeal and replace it, since it suggests that health insurance markets will collapse without government action. That’s why it is a key argument for Republicans. Yet nonpartisan health care groups that have studied the law say that while it has some serious problems and faces challenges, they do not see it as collapsing into a death spiral. The American Academy of Actuaries is a prime example. The group, which represents the people who analyze data for insurance companies, says there is no evidence that Obamacare is in a death spiral or that it is on the verge of collapse. “I don’t really see evidence of that happening right now,” said Cori Uccello, the organization’s senior health fellow.
  
  
• Senators Propose Giving States Option to Keep Affordable Care Act New York Times by Robert Pear—Several Republican senators on Monday proposed a partial replacement for the Affordable Care Act that would allow states to continue operating under the law if they choose, a proposal meant to appeal to critics and supporters of former President Barack Obama’s signature health law. But the plan was attacked by Democrats as a step back from the Affordable Care Act’s protections, and it was unlikely to win acceptance from conservative Republicans who want to get rid of the law and its tax increases as soon as possible. If anything, the proposal—by Senators Bill Cassidy of Louisiana, a medical doctor, and Susan Collins of Maine, a moderate Republican—may show how difficult it will be for Republicans to enact a replacement for the Affordable Care Act.
  
  
• Republicans Divided Over Whether Millions of Americans Should Lose Government-Subsidized Health Coverage Los Angeles Times by Noam Levey—As Republicans scramble for a strategy to repeal and replace the health care law, they are reckoning with a fundamental question the party has never settled: whether to foot the multi-trillion-dollar bill to ensure millions of Americans retain the coverage they obtained under Obamacare. GOP lawmakers for years ducked that issue as they unified behind cries to roll back the program, but were assured President Obama would block them. Now, the power to actually repeal and replace the law is exposing deep divisions in the party.
  
  
• Ryan Maps Out GOP Timeline for ObamaCare, Tax Reform The Hill by Scott Wong And Alexander Bolton—Speaker Paul Ryan (R-Wis.) on Wednesday mapped out the GOP’s 200-day legislative strategy, saying Republicans will repeal and replace portions of ObamaCare by spring and tackle tax reform before the August recess. During a private meeting of House and Senate Republicans at their annual policy retreat, Ryan said House committees will mark up a reconciliation package in the next couple of weeks that will both repeal President Obama’s health care law and replace portions of it, according to several lawmakers in the room. Then, Ryan will bring the final reconciliation package to the House floor by late February or early March.

• Reversing Course, Trump Administration Will Continue Obamacare Outreach Politico by Rachana Pradhan and Paul Demko The Trump administration has reversed plans to scrap all Obamacare outreach in the finals days of the law's enrollment period, a day after the move sparked outcry from the law's supporters and health insurers.
  
  HHS officials on Friday said automatic phone calls and other online and digital outreach—including Twitter messages and emails—would continue through the Jan. 31 deadline for obtaining coverage.
  
  Officials also said they were unable to pull back some HealthCare.gov radio and TV advertising that had been purchased by the Obama administration. HHS was able to cancel about $4 million to $5 million in ads, a spokesman said.
  
  
• The Rush to Get Millennials Health Insurance Before the Possible Repeal Of Obamacare Washington Post by DeNeen L. Brown—This month, as Republicans in Congress moved to dismantle the Affordable Care Act and President Trump signed an executive order weakening its provisions, Washington, D.C., health insurance exchange officials were rushing to sign up millennials before the open enrollment period ends Jan. 31. Forty-one percent of new customers are ages 26 to 34,” Kofman said. “When we first started, we looked at the uninsured data in the District. We tried to focus on populations that tend to not have coverage. In D.C. more than 60 percent of the uninsured were 40 and under.” The D.C. exchange opened in 2013, and they deployed all kinds of unconventional strategies to encourage millennials to sign up for health care.

• GOP Split over Medicaid Imperils Obamacare Plans Politico by Burgess Everett, Rachael Bade and Racha Pradhan—Top GOP lawmakers and President Donald Trump are coalescing around a plan to turn Medicaid over to the states as part of their Obamacare replacement. But the push is already driving a wedge between congressional Republicans and could gum up the repeal process altogether. Conservatives have long called for block-granting Medicaid, which would cap spending and give states direct control over the program that provides health care coverage for low-income Americans. That goal is finally within reach now that Republicans control both chambers of Congress and the White House. But divisions over how to do it are already causing tension. At the crux of the matter is an impossible task set forth by Trump: In recent interviews he has said he wants to block-grant Medicaid funding to the states but also ensure the roughly 11 million people who received coverage under the Affordable Care Act’s Medicaid expansion do not lose it.

• Congress to Challenge Gun Ban for Some Mentally Impaired USA Today by Nicole Gaudiano—As part of an effort to roll back Obama-era regulations, Congress is expected to take up legislation as early as next week that would prevent the government from declaring some Social Security recipients unfit to own guns after they’ve been deemed mentally incapable of managing their financial affairs. At the urging of the National Rifle Association, a rule requiring the Social Security Administration to send records of such individuals to the federal background check system for firearms is among a host of regulations the group says is being targeted by the Republican Congress for repeal under the Congressional Review Act, which allows Congress to dismiss actions an outgoing administration initiated in the last six months.
  
  
• Dying from Cancer: Could Your Location Determine Your Fate? AP by Lindsey Tanner—Americans in certain struggling parts of the country are dying from cancer at rising rates, even as the cancer death rate nationwide continues to fall, an exhaustive new analysis has found. In parts of the country that are relatively poor, and have higher rates of obesity and smoking, cancer death rates rose nearly 50 percent, while wealthier pockets of the country saw death rates fall by nearly half.
  
  
• Limiting Antibiotics Curbs Deadly Hospital Infections New York Times by Nicholas Bakalar—Hospitals try to control Clostridium difficile, a bacterium that can cause deadly infections, by careful cleaning and meticulous washing of the hands. But limiting the use of antibiotics may be even more effective, a British study suggests. The incidence of C. difficile infection in England declined by 80 percent after 2006, when strict hospital sanitation and antibiotic prescription controls were both implemented. The study, in The Lancet, found that in regions where fluoroquinolone antibiotics were used widely, the more virulent and deadly resistant strains of C. diff became the dominant type of infection, while susceptible strains continued to enter the hospital from the community.
  
  
• Americans Were Making A Lot of Progress Cutting Back on Sugary Drinks. Now That’s Stopped. Washington Post by Caitlin Dewey—For years, the U.S. Dietary Guidelines urged Americans to drink less sugary beverages. And for years, many Americans listened. But after a decade of falling consumption, rates have stalled at well above the recommended limit, according to statistics released Thursday by the Centers for Disease Control and Prevention (CDC). The agency found that adults and children are both consuming roughly the same number of calories from soda, sports drinks, and other sugary beverages now as they did in 2009-2010, the last time the CDC published comparable data.
  
  
• Did IUD Insertions Spike After Trump’s Election? A Big New Data Set Says Yes. Vox by Sarah Kliff—Donald Trump’s election may have inspired a birth control boom. Intrauterine device (IUD) prescriptions and procedures increased 19 percent between October and December of this year, according to a data set compiled by analysts for the electronic health record AthenaHealth. No similar pattern was observed at the end of 2015. At Vox’s request, AthenaHealth compiled data from 2,500 doctor offices across the country that use its electronic medical record and have provided IUDs over the past 15 months (92 percent of these doctors are OB-GYNs). It then showed us the month-by-month trends in IUD demand. The data showed an increase from 10,850 IUD-related appointments in October to 12,938 in December. The increase showed up in conservative and liberal areas of the country, although it was steeper in areas that supported Clinton in the 2016 election…. The health care law required insurance companies to cover IUDs and other contraceptives at no cost to the consumer. But if the mandate goes away, IUDs could once again become an especially expensive contraceptive.