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4. Political Cartoon: 'Trigger Warning'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Trigger Warning'" by Steve Kelley.

Here's today's health policy haiku:


Pence giveth … and then
Could taketh away. What is
Next for Medicaid?

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Summaries Of The News:

Health Law Issues And Implementation

5. Promises Are Dangerous Things, And Other Lessons Trump Can Learn From Obama's ACA Mistakes

The road to overhauling the health care system in America has not been smooth for President Barack Obama. Meanwhile, Politico talks with Heritage Foundation health policy analyst Ed Haislmaier about health care's next chapter under President-elect Donald Trump's administration, and a survey reveals the industry's anxieties about Trump's positions.

The Associated Press: What Trump Can Learn From Obama's Rough Ride On Health Care
President Barack Obama took on the problems of a lack of access to health care and high cost, but he and Democrats paid a political price. President-elect Donald Trump has promised to undo much of what Obama put in place, and pledged to make the system better. Although Trump is lacking in specifics, he seems to want to make costs his priority. States, insurers, businesses, and individuals would get more leeway to sort out access. Health care keenly reflects the country's deep political divide. A look at some lessons Trump might learn from Obama's rough ride. (Alonso-Zaldivar, 11/27)

Politico: How Heritage Is Influencing Trump And Health Care's Next Chapter
As a candidate, Donald Trump vaguely promised to fix health care by repealing Obamacare and "getting rid of the lines." But as president-elect, his health policy is getting more robust — and there's a straight line to the Heritage Foundation. "Our view … it's about giving people choices. It's about having the markets work well, the structure and the incentives," Heritage health policy analyst Ed Haislmaier said on POLITICO's "Pulse Check" podcast this week. "It's not about products." (Diamond, 11/23)

Bloomberg: Trump Health-Care Plans Trouble Industry, Jefferies Survey Finds 
Health-care stocks jumped just after Donald Trump’s victory in the U.S. presidential election, yet few in the pharmaceutical industry surveyed by Jefferies Group LLC are celebrating now. Almost 80 percent of participants who answered questions about the sector’s outlook at the Jefferies Global Healthcare Conference in London last week said that they believe Trump’s positions on health care will be negative, or at best, neutral. Pricing reform was the primary concern. Nearly nine in 10 people, meanwhile, said they expect an increase in health-care deals next year, driven by biotech transactions. At the top of this year’s list of deals was Teva Pharmaceutical Industries Ltd.’s $40.5 billion purchase of Allergan Plc’s generics unit. (Patton, 11/23)

Reuters: Trump's Shifting Positions Since U.S. Election Win
After firing up crowds with boisterous and sometimes divisive campaign rhetoric, Donald Trump has appeared to moderate some stances since he won the U.S. presidential election on Nov. 8. ... During the campaign, Trump said he would repeal President Barack Obama's signature Affordable Care Act. He called Obamacare a "disaster" and said he would replace it with a plan that would give states more control over the Medicaid health plan for the poor and allow insurers to sell plans nationally. In an interview with the Wall Street Journal published on Nov. 11, Trump said he was considering keeping parts of the law, including provisions letting parents keep adult children up to age 26 on insurance policies and barring insurers from denying coverage to people with pre-existing conditions. "Either Obamacare will be amended, or repealed and replaced," Trump told the Journal. (Kerry, 11/25)

And Americans react to all the uncertainty —

The Washington Post: Trump Spurs Fears, Hopes Among Americans Insured By The Affordable Care Act
A 30-year-old cancer survivor in a small West Virginia town worries how she would pay for treatment if a tumor returned. A Chicago doctor wonders whether her hospital would cut back on care for ill or premature infants. In Northern Virginia, the head of a small nonprofit clinic lies awake at night fearing a surge of uninsured patients she couldn’t afford to take in. Two weeks after the unexpected election of Donald Trump, the incoming administration and the Republicans who control Congress have defined few specifics for how they will carry out their promise to eliminate the Affordable Care Act. Yet the shift in Washington’s political geometry already is stoking anxiety among many of the 11 million people who have gained private insurance under the law, as well as among those who help care for them. (Goldstein, 11/23)

The New York Times: Many In Florida Count On Obama’s Health Law, Even Amid Talk Of Its Demise
Florida helped hand Mr. Trump the presidency when he narrowly won the state, but it has also provided more customers for the federal health insurance marketplace than any other state. This makes Florida a window to the complex and delicate task Mr. Trump and congressional Republicans face in deciding whether to scrap the entire law, which has brought coverage to more than 20 million people, and what to replace it with. ... Jay Wolfson, a professor of public health and medicine at the University of South Florida, said that while many Floridians would be happy to see the law disappear, and the state’s Republican leaders have never shied away from attacking it, failing to come up with a substantive replacement could be politically risky. (Goodnaugh, 11/25)

NPR: Worries About Health Insurance Cross Political Boundaries
This month's election results could have big implications for those who now have insurance because of the Affordable Care Act — either through the exchanges or Medicaid expansion. President-elect Trump and Republicans in Congress have made it clear they want to scrap the law, but it's unclear what may replace it. That gap between repeal and replacement has left many unsure of what will happen with their medical care. We have these reports from around the country from people who could be affected by changes. (11/26)

The CT Mirror: ‘We’re In Limbo:’ For Many In CT, Obamacare’s Uncertain Future Is Personal 
The uncertainty over the health law’s future also means uncertainty for many Connecticut residents who have relied on it. To some, like Jalbert, it means waiting anxiously to see what will happen to benefits they had come to count on, or planned to use. Others are hopeful that there could be fixes to what they see as the shortcomings of Obamacare, particularly when it comes to affordability. (Levin Becker, 11/28)

6. Medicaid Expansion's Unlikely Defenders: Republican Governors

The GOP governors who opted to expand Medicaid are now having to fight to retain a part of the health law that is so unpopular with other Republicans.

The Associated Press: Republican States That Expanded Medicaid Want It Kept
Former Arizona Gov. Jan Brewer fought her own Republican party in the state Legislature for months to push through a Medicaid expansion under the Affordable Care Act. That was three years ago. Now, as an early Donald Trump supporter who has his ear, Brewer hopes one of the pillars of President Barack Obama’s health care law can be saved as Trump pushes to dump much of the overhaul. (Christie, 11/27)

Wall Street Journal: Planned Medicaid Overhaul Could Put GOP Governors In An Awkward Spot
President-elect Donald Trump has proposed converting the federal-state [Medicaid] program into block grants to the states in an effort to give them more latitude over how the program is run. This would jibe with many leading Republicans in Congress, who for years have wanted a Medicaid overhaul that hands more control over to the states. But such a move is likely to expose divisions among Republicans over how significantly to peel back coverage protections for the more than 12 million people who gained Medicaid in the 31 states, as well as Washington, D.C., that expanded the program. (Armour, 11/24)

The Hill: Governors Planning 'Very, Very Active' Role In ObamaCare Rewrite
State leaders are positioning themselves to have a key voice in a potential rewrite of ObamaCare next year. With the election of Donald Trump, Republican leaders in Congress have promised a dramatic overhaul of President Obama’s signature policy. The National Governors Association (NGA), a proudly bipartisan group representing every state, is now eyeing a more public — and more aggressive — role alongside GOP leaders as they attempt to gut the massive federal program. (Ferris, 11/26)

Kaiser Health News: Pence Expanded Health Coverage As Governor, Now Threatens To Take It Away
Chris Cunningham was so thrilled with Indiana Gov. Mike Pence’s Medicaid expansion under the Affordable Care Act, she readily accepted his invitation to an event celebrating its first anniversary in January. Gaining Medicaid ended her eight years without health coverage and paid for her treatment of a thyroid problem, her lung disease and prescription drugs to help both. She stopped working in 2008 to care for her disabled husband. (Galewitz, 11/28)

Columbus Dispatch: Fate Of Ohio’s Medicaid Expansion Tied To Obamacare’s Future 
Nearly 71,000 low-income Franklin County residents could lose their tax-funded health insurance if President-elect Donald Trump and congressional Republicans make good on promises to repeal and replace the federal Affordable Care Act. The residents are among the 692,532 Ohioans who gained coverage under Republican Gov. John Kasich’s 2014 expansion of Medicaid. How the Medicaid expansion, a key piece of Obamacare, might change is creating uncertainty and angst. (Candisky, 11/28)

Capitol Hill Watch