"There is no way that I can personally support a bill that is going to result in 23 million Americans losing their health insurance coverage, that will cause an 850 percent premium increase of a low-income adult aged 64, of which there are many in my state, and that does nothing to ultimately bend the cost curve of health care."

—Sen. Susan Collins (R-Maine)

• GOP Health Bill Would Raise Deductibles, Lessen Coverage, and Leave 23 Million More Uninsured, Analysis Finds Los Angeles Times by Noam Levey - The Republican health care bill that passed the House earlier this month would nearly double the number of people in the U.S. without health insurance over the next decade, according to a new analysis by the nonpartisan Congressional Budget Office (CBO). The much-anticipated report cast a new shadow over the controversial legislation and is expected to complicate Republican efforts to get the bill through the Senate, where it already faces difficult prospects. The House bill would be particularly harmful to older, sicker residents of states that waive key consumer protections in the current law, including the ban on insurers charging sick consumers more.
  
  
• 10 Key Points from the CBO Report on Obamacare Repeal Politico by Joanne Kenen - Here are some key facts and figures from the new CBO report on the American Health Care Act, the House-passed bill to repeal and replace Obamacare. CBO stressed the uncertainty of its estimates, given that it's hard to know which states would take up the chance to opt out of certain key parts of Obamacare. 

• Poor and Disabled Big Losers in Trump Budget; Military Wins AP by Stephen Ohlemacher—The poor and the disabled are big losers in President Donald Trump's $4.1 trillion budget proposal while the Pentagon is a big winner. Trump's plan for the budget year beginning Oct. 1 makes deep cuts in safety-net programs, including Medicaid and the Children's Health Insurance Program. The proposal also includes big cuts in Social Security's disability program.
  
  
• Icy Reception to Trump Budget from Fellow Republicans AP by Erica Werner—President Donald Trump's first budget proposal got an icy reception on Capitol Hill Tuesday, and that was just from the Republicans. Longtime GOP Rep. Hal Rogers of Kentucky declared proposed cuts to safety net and environmental proposals "draconian." "I don't think the president's budget is going anywhere," said Republican Sen. Bill Cassidy of Louisiana, asked if he's concerned about the message sent by slashing the Medicaid program for the poor and disabled. 

• Trump Undermines Senate GOP's Medicaid Backers Politico by Burgess Everett and Adam Cancryn–A group of Republican senators is fighting desperately to preserve health coverage for millions of low-income constituents who have benefited from Obamacare. And the president of their own party seriously undercut their negotiating position with his budget Tuesday. By proposing hundreds of billions of dollars in Medicaid cuts in combination with the House-passed health care bill's more than $800 billion in Medicaid spending reductions, President Donald Trump is effectively throwing in with fiscal conservatives looking to constrain the program's growth and wind down its coverage as quickly as possible. 
  
  
• Fact Check: Medicaid a Target for Cuts Despite Assurance AP by Josh Boak–Medicaid is clearly in line for cuts under President Donald Trump's budget despite assurances to the contrary from his budget chief.  Mick Mulvaney, director of the Office of Management and Budget, while introducing the budget Tuesday: "There are no Medicaid cuts in the terms of what ordinary human beings would refer to as a cut. We are not spending less money one year than we spent before." THE FACTS: Mulvaney is being artfully evasive about the health care program for families and the poor. By any conventional measure of federal financing, the program is on the chopping block.
  
  
• In One Chart: Trump Plans To Cut Medicaid After Promising Not To New York Times by Haeyoun Park–President Trump has long promised not to cut Medicaid, Medicare and Social Security. But in his budget released on Tuesday, he proposes making massive cuts to Medicaid. Mr. Trump is proposing to cut $610 billion from Medicaid benefits. This could come on top of more than $800 billion in cuts to Medicaid sought in the health care overhaul bill passed by the House on May 4.

• GOP Turns Gloomy over Obamacare Repeal Politico by Burgess Everett and Jennifer Haberkorn–Senators reported that they made little progress on the party's most intractable problems last week, such as how to scale back Obamacare's Medicaid expansion and overall Medicaid spending. Republicans are near agreement on making tax credits for low-income, elderly Americans more generous, but that might be the simplest matter at hand. 
  
  
• Senate Staff to Draft Health Bill During Recess The Hill by Nathaniel Weixel–Senate Republican staff will be working on a draft version of the Senate's ObamaCare repeal-and-replace legislation during the recess, according to multiple senators. "Over the break, initial legislation will be drafted and then we'll have more time, actually have a basis to discuss" specific policies, Sen. Ron Johnson (R-Wis.) said Thursday after leaving a meeting of the Senate Republicans' health care working group.
  
  
• McConnell Frets About Health Care, Hopeful on Tax Overhaul Reuters by Susan Cornwell and Yasmeen Abutaleb–U.S. Senate Majority Leader Mitch McConnell said on Wednesday he does not yet know how Republicans will amass the votes needed to pass legislation now being crafted to dismantle Obamacare but expressed some optimism on another top priority, overhauling the tax code. In an exclusive interview with Reuters, McConnell said health care and taxes still top the Republican legislative agenda, and he added that he will not reach out to the minority Democrats on either one because differences between the two parties are too stark. 

• House Dems Demand Trump Make ObamaCare Insurance Payments The Hill by Nathaniel Weixel–Nearly 200 House Democrats are demanding President Trump fund Obamacare's cost-sharing reduction payments to insurers. "The law requires, and it is your obligation under the law" to make the payments "and to stop other acts of sabotage that undermine Americans' access to affordable, quality health insurance," the House Democrats wrote in a letter to Trump. "The [Affordable Care Act] is not dead; however, your failure to commit to paying these subsidies is destabilizing the marketplaces, and will directly result in higher costs and fewer consumer choices."
  
  
• Insurers Continue to Hike Prices, Abandon ACA Markets AP by Tom Murphy–People shopping for insurance through the Affordable Care Act in yet more regions could face higher prices and fewer choices next year as insurance companies lay out their early plans for 2018. Blue Cross and Blue Shield of North Carolina is asking regulators for a 23 percent price hike next year because it doesn't expect crucial payments from the federal government to continue. Other insurers around the country, such as Aetna and Humana, have already said they will not offer coverage on exchanges next year, though several, including Centene, say they will.

• A 'Hard Tradeoff': Pricey Teaching Hospitals Have Lowest Death Rates for Older Patients Stat by Andrew Joseph – At a time when insurers are steering patients away from expensive academic medical centers, a new study counters the idea that the quality of care is consistent across hospitals, concluding that major teaching hospitals have lower mortality rates for older patients than community hospitals. Using millions of Medicare records, researchers found that the 30-day mortality rate—the percentage of patients who died within 30 days of hospitalization and one common way to gauge quality—was 8.3 percent at major teaching hospitals, compared with 9.2 percent at minor teaching hospitals and 9.5 percent at non-teaching hospitals. 

• U.S. Drug Prices Are So High That Canada Wants Other Countries as Reference Points STAT by Ed Silverman–How high are drug prices in the U.S.? So high that the Canadian government may remove the U.S. from its long-standing list of countries that are used as a guide for determining whether prices are excessive. In a proposal issued last week, Health Canada said it wants to overhaul the framework used by the Patented Medicine Prices Review Board, which assesses therapeutic benefits and sets ceiling prices. Right now this is accomplished, in part, by benchmarking prices against what drug makers currently charge in seven other countries — the U.S., France, Germany, Italy, Sweden, Switzerland, and the U.K.

Editor: Peter Van Vranken