• Dazed GOP Bolts Washington In Health Care Disarray Politico by Burgess Everett, Seung Min Kim and Sarah Karlin-Smith—Senate Republicans are still divided on their bill to repeal Obamacare, and a weeklong recess won't offer much respite—Senate Republicans skipped town on Thursday afternoon facing stiff internal opposition to their health care proposal and a Fourth of July recess in which critics will pummel their effort to repeal Obamacare. Though the Senate whirred to life with deal-making between Senate Majority Leader Mitch McConnell and his members, senators were dazed by the up-and-down week and nowhere near a plan that could get 50 votes. The GOP is planning to write new language to be analyzed by Friday, but were far from reaching a broad agreement as senators had hoped.
  
  
• Trump Urges GOP to Repeal Obama Law Now, Replace Later Associated Press by Alan Fram—President Donald Trump barged into Senate Republicans' delicate health care negotiations Friday, declaring that if lawmakers can't reach a deal they should simply repeal "Obamacare" right away and then replace it later on. Trump's tweet revives an approach that GOP leaders and the president himself considered but dismissed months ago as impractical and politically unwise. And it's likely to further complicate Majority Leader Mitch McConnell's task as he struggles to bridge the divide between GOP moderates and conservatives as senators leave Washington for the Fourth of July break without having voted on a health care bill as planned. "If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!" Trump wrote.
  
  
• As Affordable Care Act Repeal Teeters, Prospects For Bipartisanship Build New York Times by Robert Pear and Thomas Kaplan—With his bill to repeal the Affordable Care Act in deep trouble, Mitch McConnell, the Senate majority leader, raised an alternate possibility on Tuesday: Either Republicans come together, or he would have to work with Democrats to shore up the deteriorating health law. That raised a tantalizing prospect: bipartisanship. The idea is not so far-fetched. For years, Republicans and Democrats have explored avenues for changing or improving President Barack Obama's health care law, from tweaks to the requirement for employers to offer health insurance to revisions involving how the marketplaces created under the law operate.
  
  
• "Repeal And Replace' Was Once a Unifier For The GOP. Now It's an Albatross. Washington Post by Dan Balz—For Republicans, Obamacare was always the great unifier. In a fractious party, everyone agreed that the Affordable Care Act was the wrong solution to what ailed the nation's health-care system, with too much government and too little freedom for consumers. Replacing Obamacare has become the party's albatross, a sprawling objective still in search of a solution. The effort to make good on a seven-year promise has cost the Trump administration precious months of its first year in office, with tax restructuring backed up somewhere in the legislative pipeline, infrastructure idling somewhere no one can see it and budget deadlines looming….What are the party's options? Fail and be held accountable by a conservative base that for years has been promised that Obamacare would be gone once the GOP held power. Pass something that looks like either the House or Senate bills and be left with the potential political consequences of being accused of eliminating coverage for 20 million more Americans.
  
  
• How Governors From Both Parties Plotted to Derail the Senate Health Bill  New York Times by Alexander Burns—A once-quiet effort by governors to block the full repeal of the Affordable Care Act reached its climax in Washington on Tuesday, as state executives from both parties—who have conspired privately for months—mounted an all-out attack on the Senate's embattled health care legislation hours before Republicans postponed a vote. At the center of the effort has been a pair of low-key moderates: Gov. John R. Kasich, Republican of Ohio, and Gov. John W. Hickenlooper, Democrat of Colorado, who on Tuesday morning called on the Senate to reject the Republican bill and to negotiate a bipartisan alternative.
  
  
• Polls Show GOP Health Bill Bleeding Out Politico by Steven Shepard—Republican efforts to craft a new health care bill just hit another roadblock: An avalanche of public polling data dropped Wednesday, showing support for the legislation is under 20 percent. That's bad enough, but it's not just the topline numbers that are near rock-bottom. Few voters think the bill will make the health care system or their own care better. And many of the policy changes in the various versions of GOP health legislation—like decreasing federal funding for Medicaid—are profoundly unpopular.

• CBO: Medicaid Spending Falls 35 Percent In 20 Years Under Senate Health Bill Politico by Rachana Pradhan - The drop-off stems from stricter limits Republicans want to enact beginning in 2025 to control the entitlement's growth. Under the Senate bill, federal Medicaid outlays would be 26 percent less in 2026 compared to current law. The gap widens to 35 percent in 2036. The drop-off stems from stricter limits Republicans want to enact beginning in 2025 to control the entitlement's growth. Under the Senate bill, federal Medicaid outlays would be 26 percent less in 2026 compared to current law. The gap widens to 35 percent in 2036.

• Senate GOP Health Bill Would Slash Medicaid. Here's How. CNN by Tami Luhby—Republicans have wanted to repeal Obamacare for years—but they've wanted to overhaul Medicaid for far longer. They are now getting their chance. The health care legislation working its way through Congress would do much more than its stated purpose of repealing and replacing Obamacare. It would make the most far-reaching changes and deepest cuts to Medicaid in the program's 52-year history. But the general thrust of both chambers' plans is clear: Lawmakers would effectively end Obamacare's expansion of Medicaid to low-income adults and would dramatically curtail federal support for the overall program, which covers more than 70 million low-income Americans. They would give states more control and flexibility in administering the program, but also require governors and legislators to foot much more of the bill.
  
  
• Ohio Lawmakers Vote To Freeze Medicaid Expansion Reuters by Kim Palmer—Ohio's Republican-controlled legislature voted on Wednesday to freeze enrollment in the state's Medicaid healthcare insurance for the poor, setting the stage for a showdown with Republican Governor John Kasich, who favors expanding the program. The proposed Medicaid freeze, which would deny coverage to hundreds of thousands of Ohio residents who lack job-related health insurance and cannot afford to purchase their own, was adopted as part of a $65 billion two-year budget plan. Kasich, a moderate Republican who sought the 2016 Republican presidential nomination and has been a vocal supporter of Medicaid expansion, could use a line-item veto against the freeze while he considers signing the broader budget legislation before a Friday deadline, his office said.

• Medicare Halts Release Of Much-Anticipated Data ProPublica by Charles Ornstein—In the past few years, many seniors and disabled people have eschewed traditional Medicare coverage to enroll in privately run health plans paid for by Medicare, which often come with lower out-of-pocket costs and some enhanced benefits. These so-called Medicare Advantage plans now enroll more than a third of the 58 million beneficiaries in the Medicare program, a share that grows by the month. But little is known about the care delivered to these people, from how many services they get to which doctors treat them to whether taxpayer money is being well-spent or misused. The government has collected data on patients' diagnoses and the services they receive since 2012 and began using it last year to help calculate payments to private insurers, which run the Medicare Advantage plans. But it has never made that data public. Officials at the Centers for Medicare and Medicaid Services have been validating the accuracy of the data and, in recent months, were preparing to release it to researchers. The grand unveiling of the new data was scheduled to take place at the annual research meeting of AcademyHealth, a festival of health wonkery, which just concluded in New Orleans.  But at the last minute, the session was canceled.

Editor: Peter Van Vranken