In This Edition:

From Kaiser Health News:

Kaiser Health News Original Stories

1. Experts Tell Congress How To Cut Drug Prices

Some of the nation’s most influential scientists recommend eight steps to lower drug prices. KHN takes the political temperature and tells you the chances of Congress acting on them. (Sarah Jane Tribble, 12/12)

2. Sign-Up Deadline Is Friday, But Some People May Get Extra Time

Although in most states the insurance marketplace deadline is Friday, some consumers might be entitled to a special enrollment period if their 2017 plan is being discontinued or they are from states designated by the federal government as hurricane disaster areas. (Michelle Andrews, 12/12)

3. An Overlooked Epidemic: Older Americans Taking Too Many Unneeded Drugs

Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions. But some doctors are trying to teach others about “deprescribing” or systematically discontinuing medicines that are inappropriate, duplicative or unnecessary. (Sandra G. Boodman, 12/12)

4. Political Cartoon: 'Redeeming Feature?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Redeeming Feature?'" by John Deering.

Here's today's health policy haiku:


What about that deal?
Her final vote …  still in play.
And it could be key.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law

5. Automatic Re-Enrollment Could Leave Customers On Hook To Pay Thousands For Plans They Don't Want

“It’s as if I went to a Ford dealer to buy a Ford car, and then I get a call from Chevy saying, ‘Your Chevy truck is ready, and we need the money,'" said Robert Holub after he received a bill for $3,483 to pay for a plan he didn't choose. Like many other enrollees, Holub's current coverage will not be available in 2018 so the government automatically switched him over to a new one. Meanwhile, the deadline for the federal and some state exchanges is quickly coming up.

The New York Times: An Obamacare Surprise In The Mail: New Insurers And New Costs
Meg and Robert Holub were surprised to receive a letter last week welcoming them to a new health insurance plan and telling them to pay $3,483 by Jan. 8. “We have received your application for individual and family coverage effective 1/1/2018,” the letter said. The only problem: They never applied for the coverage, did not want it and could not afford it. “I worried, did someone hack my account to sign me up for this?” Mr. Holub said. “And I wondered, what are the implications if I don’t pay for this plan? Will I be hounded by a credit agency?” (Pear, 12/11)

The Associated Press: Some Glitches Seen In Deadline Week For 'Obamacare' Sign-Ups
Consumer advocates reported some glitches Monday in the final days for "Obamacare" sign-ups, although the Trump administration largely seemed to be keeping its promise of a smooth enrollment experience. In Illinois, some consumers who successfully completed an application for financial assistance through got a message saying they would likely be eligible to buy a health plan, "but none are available to you in your area." (Alonso-Zaldivar, 12/11)

The Hill: Obama Urges ObamaCare Signups Ahead Of Deadline
Former President Barack Obama on Monday urged people to sign up for ObamaCare ahead of Friday’s deadline and denounced Republican efforts to roll back the law. Obama joined a call with navigators and volunteers who help people sign up for coverage under the law, his office said, and made an appeal on Twitter and Facebook. (Sullivan, 12/11)

The Hill: Ex-CMS Staffer Buoys ObamaCare
Since leaving the administration, [Lori] Lodes and other Democrats have come to believe that the Trump administration is actively working to sabotage the Affordable Care Act and health coverage gains made under Obama. The White House has moved to shorten ObamaCare’s enrollment period, cut its advertising budget by 90 percent and reduced by 41 percent funding for outside groups assisting with sign-ups — all while pushing Congress to repeal and replace the law. (Roubein, 12/12)

Kaiser Health News: Sign-Up Deadline Is Friday, But Some People May Get Extra Time
Open enrollment on the federal health law’s marketplace ends Friday, and most people who want a plan for next year need to meet the deadline. But some consumers who miss the cutoff could be surprised to learn they have the opportunity to enroll later. “While a lot of people will be eligible … I am still worried that a lot of consumers won’t know it,” said Shelby Gonzales, a senior policy analyst at the Center on Budget and Policy Priorities. (Andrews, 12/12)

Nashville Tennessean: How Risky Is It Not To Have Coverage At Vanderbilt?
Nashville consumers have two carrier options for individual ACA plans in 2018 — Cigna and Oscar Health — but only Cigna offers coverage at Vanderbilt. Does every consumer need to be covered at the city’s academic medical center? Realistically, no. Some consumers may have no healthcare needs next year, or only very basic needs that do not require going to Vanderbilt. (Tolbert, 12/11)

Capitol Hill Watch

6. With CHIP Funds In Limbo, Parents Worry They'll Have To Ask: 'Are They Sick Enough To Merit Doctors' Visit?'

For some families, the Children's Health Insurance Program makes the difference between being able to get their children care or not. Meanwhile, the government's CHIP funding delay prompts Jimmy Kimmel to once again speak out about health care on his show.

NPR: Parents Worry Congress Won't Fund The Children's Health Insurance Program
It's a beautiful morning in Pittsburgh, but Ariel Haughton is stressed out. She's worried her young children's health insurance coverage will soon lapse. "So, we're like a low-middle-class family, right?" she says. "I'm studying. My husband's working, and our insurance right now is 12 percent of our income — just for my husband and I. And it's not very good insurance either." (Kodjak, 12/12)

The Washington Post: Jimmy Kimmel Holds His Baby Son, Post-Heart Surgery, In Emotional Health-Care Monologue
Jimmy Kimmel was absent from his ABC late-night show last week while his 8-month-old son, Billy, recovered from his second heart surgery. Ever since Billy was born with a heart defect and required immediate surgery, Kimmel has become an outspoken advocate for universal health care, occasionally using his monologue to plead with (or deliver scathing criticisms of) members of Congress. “No parent should ever have to decide if they can afford to save their child’s life,” he said tearfully in May. On Monday, Kimmel returned to the stage with his son in his arms. Billy, wearing a tiny sweater vest, stayed remarkably calm on camera as Kimmel choked up once more while talking about his son. (Yahr, 12/12)

The Hill: Virginia Warns Children Could Lose Coverage Without Action On CHIP
Virginia is planning to send a letter to enrollees in the Children’s Health Insurance Program (CHIP) on Tuesday that they could lose their coverage on Jan. 31 if Congress does not renew the funding. CHIP’s authorization expired on Sept. 30, and states are now nearing the point where they will run out of funds. Congress is expected to renew funds for the program either this month or next, but the uncertainty from not having acted yet is leading some states to warn enrollees about the possibility of losing coverage if Congress does not act. (Sullivan, 12/11)

Arizona Republic: Ducey Was Quiet On Funding Request For Kids Health Care, Until He Heard From The Media
It took media inquiries in late October to figure out Gov. Doug Ducey's position on whether Congress should renew funding for a children's health-insurance program. The short answer: He supports kids. But a records request by The Arizona Republic filed before talking to the governor found Ducey wasn't doing much outreach to the folks who could make a difference — at least not until reporters started asking about it. (Pitzi, 12/11)

Dallas Morning News: Texas Families Distraught About Losing Children's Health Care If Congress Doesn't Fund CHIP
Congress has two more weeks to fund CHIP after the House and Senate approved a spending bill Thursday that keeps the government open until Dec. 22. The stopgap legislation also gives money to several states that are running out of funds to keep CHIP going. On Friday, El Paso Rep. Beto O’Rourke and 98 other Democratic representatives sent a letter to Congressional leaders urging them to approve CHIP funding quickly. (Wang, 12/11)

The Hill: Vermont, NH Senators Call For Renewal Of Lapsed Health Center Funding
Vermont and New Hampshire’s senators are urging Senate leaders to work to pass legislation funding community health centers after a major source of their federal dollars lapsed Sept. 30. Community health centers are a large source of comprehensive primary care for some of the nation’s most vulnerable, serving 27 million people. They take any patient who walks in their doors, regardless of if they have insurance, and Congress let a fund expire that represents 70 percent of their federal grant revenue. (Roubein, 12/11)

7. Despite Ryan's Enthusiasm To Overhaul Medicare, GOP Senators More Wary Just Months Before Elections

“We’re talking about Medicare, and that’s a pretty big bite in the middle of an election year. I’m not saying no, but there are other things that could happen," said Sen. Pat Roberts (R-Kan.).

The Washington Post: Senate Republicans Are Divided Over Whether To Pursue Medicare Cuts In 2018
Senate Republicans are divided over whether they should use the months before the 2018 elections trying to cut spending on social programs, including Medicare. Sen. John Thune (R-S.D.), the third-ranking Republican in the Senate, said that Congress should consider reducing long-term spending on these federal programs next year. “If we’re going to do something about spending and debt, we have to get faster growth in the economy — which I hope tax reform will achieve. But we have also got to take on making our entitlement programs more sustainable,” including Medicare, Thune said on Thursday. “I think there is support, generally, here for entitlement reform.” (Stein, 12/11)

Meanwhile, a look at the revenue that can be expected from the GOP tax bill —

Administration News

8. Sen. Murray Questions CDC Chief's Ability To Perform Role Due To Financial Conflicts

Centers for Disease Control and Prevention Director Brenda Fitzgerald is legally obligated to maintain some investments in cancer detection and health information technology. Sen. Patty Murray (D-Wash.) raises concerns since, as a result, Fitzgerald must recuse herself from "matters pertaining to cancer and opioids, two of the most pervasive and urgent health challenges we face as a country."

The Washington Post: New CDC Head Faces Questions About Financial Conflicts Of Interest
After five months in office, President Trump’s new director of the Centers for Disease Control and Prevention has been unable to divest financial holdings that pose potential conflicts of interest, hindering her ability to fully perform her job. Brenda Fitzgerald, 71, who served as the Georgia public health commissioner until her appointment to the CDC post in July, said she has divested from many stock holdings. But she and her husband are legally obligated to maintain other investments in cancer detection and health information technology, according to her ethics agreement, requiring Fitzgerald to pledge to avoid government business that might affect those interests. Fitzgerald provided The Post with a copy of her agreement. (Sun and Crites, 12/11)

The Hill: Leading Dem: CDC Director's Financial Investments Pose Conflict Of Interest
The new director of the Centers for Disease Control and Prevention (CDC) has had to recuse herself from involvement in significant health issues because her investments might pose a conflict of interest, says Sen. Patty Murray (D-Wash.) Murray, ranking Democrat of the Senate Health Committee, wrote in a letter to CDC Director Brenda Fitzgerald that her remaining investments prevent her from engaging in matters relating to cancer and the opioid crisis. (Hellmann, 12/11)

CQ HealthBeat: Top Health Democrat Wants CDC Director to Clear Up Conflicts
Murray and her staff obtained copies of Fitzgerald’s government ethics agreement and financial disclosure form, which are not publicly available because the CDC director is not a Senate-confirmed position. Fitzgerald apparently is “unable to divest from certain investments,” according to a letter from Murray released Monday. “In order to ensure the CDC is led by an individual who can engage on all issues under its purview, it is imperative that you resolve the issues that are currently limiting your ability to divest from these holdings,” Murray wrote. She asked Fitzgerald to make her ethics agreement public and brief the committee on her recusals. (Siddons, 12/11)

9. FDA's Plans To Speed Medical-Device Approval Process Has Some On Edge Over Patient Safety

Doctors are also worried about the lack of oversight after the product gets to the market. "The [Food and Drug Administration’s] track record on post-market surveillance is not reassuring, most post-marketing studies are not started or not completed, and the data remains unavailable to clinicians and patients," said Rita F. Redberg, editor of JAMA Internal Medicine.

The Wall Street Journal: FDA Plans New Medical-Device Approval Processes
The Food and Drug Administration plans new medical-device approval processes to speed products’ entry to the U.S. market, mirroring the desires of industry and President Donald Trump to clear barriers to new business. FDA commissioner Scott Gottlieb, who has long espoused speedier steps to promote innovation, in an interview called for “progressive,” or stepped, approvals of certain devices that would allow them to go to market with initial approvals, with further evidence to assess performance coming later. That would entail more risk to patients initially than current procedures where clinical trials or other evidence come before market launch. (Burton, 12/11)

CQ: Device-Makers Hope Coverage Rule Promotes Fast Approvals
The medical device industry is pushing the Trump administration to propose a policy soon to expedite Medicare coverage of some new devices. But the attempt to get these products covered more quickly raises some safety concerns and follows another similar effort that some observers found disappointing. A proposed rule is currently under review at the Office of Management and Budget with the title “Expedited Coverage of Innovative Technology.” The proposal has been waiting at OMB since late April, but industry groups don’t think its publication is imminent. (Siddons, 12/11)


10. With Flurry Of Mergers, Hospitals Are Building Muscle, But They Face Uphill Battle In Industry

Mergers can only accomplish so much for struggling hospitals in the ever-evolving landscape that is the health industry these days.

Bloomberg: Hospitals Are Merging To Face Off With Insurers
A spate of hospital deals stands to further remake the U.S. health-care landscape, pushing up prices for consumers and insurers and changing how individuals get care. Just this month, health systems with at least 166 hospitals and $39 billion in combined annual revenue have announced merger plans. There’s likely more to come: The Wall Street Journal reported on Sunday that Ascension and Providence St. Joseph Health, a pair of nonprofits that together have 191 hospitals and nearly $45 billion in annual revenue, are in deal talks. (Tracer, 12/11)

The Wall Street Journal: Despite Mergers, Hospitals Are In Serious Condition
American hospitals have a target on their backs. The latest merger talk is an attempt to rally their strength, but industry payers’ battle against high health-care costs shows no sign of letting up. Two major nonprofit hospital chains, Ascension and Providence St. Joseph Health, are in talks to combine, the Wall Street Journal reported on Sunday. A deal would create a chain of 191 hospitals in 27 states with annual revenue of about $45 billion. (Grant, 12/11)


11. Medical Labs Sue Over Reductions In Medicare Payments

The trade association that represents clinical labs says the administration is misapplying a 2014 law that sought to set market-based pricing for certain lab tests.

Modern Healthcare: Tired Of Talking, Labs Sue CMS Over Planned Cut
Clinical labs are suing the CMS over a planned multibillion-dollar cut to their reimbursement. They expect to lose $670 million next year as part of a CMS effort to pay the same rate for tests as private payers. Medicare's fee schedule for lab tests has been largely unchanged since it was established in 1984. Each lab determines its own rates based on market prices. Medicare has historically paid 18% to 30% more than other insurers for some tests, HHS' Office of Inspector General found. The program shells out about $7 billion a year for clinical diagnostic laboratory tests. (Dickson, 12/11)

Reuters: Medical Lab Trade Group Sues Over U.S. Reimbursement Cuts
The lawsuit came after CMS last month rolled out deep cuts to reimbursement rates for some lab tests under Medicare that could save the government as much as $3 billion over five years but could hurt laboratory companies’ margins. In its lawsuit, ACLA argued that while [the Protecting Access to Medicare Act] required all “applicable laboratories” report market information on private payors, CMS had arbitrarily exempted 99.3 percent of the laboratory market from the reporting requirement. (Raymond, 12/11)


12. Maine Governor Reiterates New Taxes Can't Pay For Medicaid Expansion

Maine voters approved a referendum in November to expand Medicaid but Gov. Paul LePage again laid out his objections in a letter to lawmakers. In Michigan, a new study looks at the number of Medicaid enrollees who are working.

The Hill: Maine Governor Lays Out Demands For Medicaid Expansion Voters Approved
An expansion of Medicaid in Maine must be paid for without raising taxes or tapping the state’s budget stabilization fund, Gov. Paul LePage (R) told the state Legislature in a letter Monday. The letter reiterated demands that LePage first made in November, after voters in the state overwhelmingly passed a ballot initiative to accept the Medicaid expansion under ObamaCare. (Weixel, 12/11)

Bangor (Maine) Daily News: LePage Digs In For Medicaid Expansion Funding Battle
LePage also wrote that the money appropriated by the Legislature for Medicaid expansion must be based on the Department of Health and Human Services estimates of the state’s share of the cost, not on what the Office of Fiscal and Program Review estimated. The nonpartisan Office of Fiscal and Program Review pegged the cost after full implementation at more than $54 million a year, which would be matched with $525 million in federal matching funds. The Department of Health and Human Services has estimated the cost of expansion will be at least $63 million next year, $82 million in fiscal year 2020, $97 million in 2021 and more than $100 million every year after that, according to the governor’s office. (Cousins, 12/12)

Portland (Maine) Press Herald: LePage Issues Letter To Lawmakers Reiterating Medicaid Expansion Demands
On the Republican side, some lawmakers have at least hinted at paying for expansion by cutting funds for K-12 education. The Legislature boosted education funding by $162 million in the current two-year state budget. That additional funding was provided after the Legislature repealed a law approved by voters in 2016 that added a 3 percent tax charge on household income above $200,000 to fund education. (Thistle, 12/11)

Maine Public: In Letter, LePage Says He Opposes Many Ways To Fund Voter-Approved Medicaid Expansion
House Speaker Sara Gideon, a Democrat from Freeport, has long supported expansion. She says the voters endorsed the expansion of Medicaid at referendum and that it will be carried out, despite the governor’s threats to veto certain funding mechanisms the Legislature might consider. “The person who is writing four-page letters telling us every way that we cannot do it is a person living in a taxpayer-funded house with taxpayer-funded health care,” she says. Gideon says the expansion is already state law, and she expects LePage’s administration to start taking steps in February to begin rulemaking to implement the expansion to about 80,000 Mainers. (Leary, 12/11)

The Associated Press: Study: Half Of Michigan Medicaid Expansion Enrollees Work
A study released Monday finds roughly half of those enrolled in Michigan's Medicaid program since its expansion have jobs and another quarter who are unemployed are likely to be in poor health, raising concerns about potential work requirements for enrollees. Authors of the study by the University of Michigan Institute for Healthcare Policy and Innovation say the findings suggest that such requirements could disrupt health coverage for vulnerable people with chronic health conditions, and states will incur administrative costs of launching such a work requirement effort "to identify and enforce employment for relatively few individuals." (Karoub, 12/11)

Public Health And Education

13. Segregation Patterns Are Deeply Embedded In Boston Health Care, Spotlight Investigation Finds

The Boston Globe's Spotlight investigations team reports on the racial divide in care that's plaguing the city. Meanwhile, Native Americans are getting lost in the health care system, and many point to the role racism plays in the problem.

Boston Globe: Color Line Persists, In Sickness As In Health
Though the issue gets scant attention in this center of world-class medicine, segregation patterns are deeply imbedded in Boston health care. Simply put: If you are black in Boston, you are less likely to get care at several of the city’s elite hospitals than if you are white. (Kowalczyk, Wallack Dungca et. al., 12/12)

NPR: Native Americans Feel Invisible In U.S. Health Care System
The life expectancy of Native Americans in some states is 20 years shorter than the national average. There are many reasons why. Among them, health programs for American Indians are chronically underfunded by Congress. And, about a quarter of Native Americans reported experiencing discrimination when going to a doctor or health clinic, according to findings of a poll by NPR, the Robert Wood Johnson Foundation and Harvard T.H. Chan School of Public Health. (Whitney, 12/12)

In other public health news: birth control pills can protect against cancer; uterine transplant gives hope to struggling women; Americans aren't taking their pills; company recalls arthritis gel; and more —

The New York Times: Birth Control Pills Protect Against Cancer, Too
After a Danish study last week reported finding more breast cancer cases among women who use hormone-based birth control methods, many women were left wondering: How significant is the risk, and what are the alternatives? The answer will be different for each woman and will depend on such factors as her age and general healthand her other risks for breast cancer. But many doctors who prescribe contraceptives say there’s no cause for alarm — and no one should throw away her pills and risk an unwanted pregnancy. (Rabin, 12/11)

The New York Times: People Don’t Take Their Pills. Only One Thing Seems To Help.
For all that Americans spend on prescription drugs — $425 billion last year — you’d think we’d actually take our medicine. But one of the frustrating truths about American health care is that half or more of prescribed medication is never taken. It’s called medication nonadherence, and it’s a well-documented and longstanding problem, particularly for patients with chronic conditions. The drugs they’re prescribed are intended to prevent costly complications, reduce hospitalization, even keep them alive. But even when the stakes are high, many patients don’t take their meds. (Frakt, 12/11)

Stat: Sales Of Antibiotics Used In Food-Producing Livestock Unexpectedly Dropped
In an unexpected development, sales of antibiotics used in food-producing livestock fell in the U.S. in 2016 although drawing any firm conclusions from the data is likely premature, since a new program designed to limit usage did not go into effect until this year. Last year, sales dropped 14 percent from 2015, the first time since data collection began in 2009 that there has been a year-over-year decrease in the sale of medically important antibiotics used in food-producing animals, according to a report from the Food and Drug Administration. “Medically important” refers to antibiotics that are also used to treat people. (Silverman, 12/11)

Kaiser Health News: An Overlooked Epidemic: Older Americans Taking Too Many Unneeded Drugs
Consider it America’s other prescription drug epidemic. For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79. Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders. (Boodman, 12/12)

14. The Quandary Physicians Face Because Of The Potency Of Fentanyl

In other opioid news, a county in Tennessee is looking to join nearly 200 other jurisdictions in a lawsuit alleging that some drug manufacturers and distributors contributed to the nation's addiction crisis.

PBS NewsHour: Fentanyl Is So Potent Doctors Don't Know How To Fight It
This surge in illicit fentanyl presents a new challenge for families and medical professionals trying to keep loved ones from the harm of opioid misuse. And it’s unclear if the most validated defense for opioid misuse — medication-assisted therapies like naloxone, methadone and buprenorphine — can stem the surge of overdoses caused by fentanyl. (Akpan, 12/11)

Nashville Tennessean: Williamson County May Join Lawsuit Against Opioid Industry
Williamson County may join nearly 200 other counties and cities in a lawsuit against certain pharmaceutical manufacturers and distributors of prescription opioids. County commissioners authorized the mayor Monday to execute a contract with a law firm leading potential litigation against manufactures and distributors alleged to be contributing to drug addiction. The mass tort seeks compensation for cities and counties for economic harm caused by the opioid crisis, such as the costs of addiction treatment, law enforcement and health care delivery systems. (Balakit, 12/11)

State Watch

15. State Highlights: Texas Set Spending Record For Abstinence-Only Education; Single-Payer System Cost Tempers Calif. Enthusiasm

Media outlets report on news from Texas, California, Maryland, Massachusetts, Tennessee and Wisconsin.

Modern Healthcare: Johns Hopkins Health Names Duke's Sowers As Next President
Johns Hopkins Health System, Baltimore, named Duke University Hospital President Kevin Sowers as its own president. Sowers replaces Ronald son, who announced in June that he planned to retire at year-end. Sowers, who has been at Duke for 32 years and was president of the hospital for eight, also will serve as executive vice president of Johns Hopkins Medicine. He will start at the organization on Feb. 1, becoming the second president ever of the system. Prior to his current position at Duke, Sowers was chief operating officer for Duke University Hospital, and had experience in other administrative positions. (Barr, 12/11)

The Baltimore Sun: Hopkins Taps Duke Executive To Help Head Medical System
Johns Hopkins Health System stepped outside its ranks and tapped Kevin W. Sowers, a nurse and career executive with the Duke University Health System, as the new president and executive vice president of Johns Hopkins Medicine. He will succeed Ronald R. son, who is retiring at the end of January after 44 years at the medical institution. He will be an adviser for a year to help with the transition. (McDaniels and Cohn, 12/11)

Nashville Tennessean: Drug, Cardiovascular Deaths Push Tennessee Down To 45th In Health Ranking
The number of deaths from drugs and deaths from cardiovascular disease are among the reasons Tennessee slipped a spot in the annual health ranking from United Health Foundation. The number of drug deaths nationally increased 7 percent over the last five years, but those in Tennessee jumped 27 percent in the same time, said Dr. Rhonda Randall, chief medical officer of UnitedHealthcare Retiree Solutions. (Fletcher, 12/11)

Editorials And Opinions

16. Viewpoints: The Tax Bill As The GOP's Obamacare; What About This Massive Merger?

A selection of opinions on health care from news outlets around the country.

Los Angeles Times: Will Tax Reform Be The GOP's Obamacare?
For years, Republicans mocked Rep. Nancy Pelosi — and other Democrats — for dismissing the need to read the text of the Affordable Care Act before passing it. This time around, Republicans have insisted that we must pass tax reform to know what’s in it, and Democrats have denounced the sausage-making. The more important similarity lies in the fact that both parties pursued long-term ideological goals in the face of public opposition. President Obama gave dozens of speeches in favor of the Affordable Care Act and yet it was never popular with voters before passage or after — at least not until Donald Trump was elected, which just shows you how policy preferences take a backseat to partisanship. (Jonah Goldberg, 12/12)

The Washington Post: Susan Collins Is Wrong About The Tax Bill And Obamacare
Of all the votes for the Senate GOP tax bill, those of Sens. Susan Collins (R-Maine), John McCain (R-Ariz.) and Lisa Murkowski (R-Alaska) were perhaps the most puzzling. These lawmakers killed an Obamacare repeal bill last summer because it was hastily drafted and poorly designed. Yet they each just endorsed a tax bill that contains a hastily drafted and poorly designed repeal of a key piece of Obamacare, the law’s “individual mandate” requiring all Americans to carry health-care coverage. (12/11)

Los Angeles Times: CVS And Aetna Say Their Massive Merger Is Needed To Keep Prices Down. That Remains To Be Seen
American consumers aren’t the only ones struggling with higher healthcare costs. CVS Health’s proposed $69-billion purchase of health insurer Aetna is driven in part by the companies’ efforts to get control over more of the costs they face, and to make their operations more efficient. The question for regulators, though, is whether the combination results in a company that uses its clout to help consumers or squeeze more dollars out of them. (12/11)

Bloomberg: Hospital Consolidation Is No Panacea
In the face of increasing consolidation among insurers, hospitals are themselves linking up at ever-greater rates. The Wall Street Journal reported Monday that we may see one of the biggest hospital deals yet: a possible merger of non-profit giants Ascension and Providence St. Joseph Health, which would create the largest hospital group in the U.S. But while consolidation seems like a rational response to the issues facing hospitals, it isn't a surefire solution. (Max Nisen, 12/11)

Roll Call: One Year Later — Why 21st Century Cures Still Matters
One year ago this week, President Obama signed into law one of the most consequential bills passed by the 114th Congress: the landmark, bipartisan 21st Century Cures Act. ... When FDA Commissioner Scott Gottlieb and NIH Director Francis Collins testified before the Subcommittee on Health earlier this month on the implementation of this law, they told us that Cures is already having a monumental impact at these vital government agencies. We are following through to ensure that in spite of proposed budget cuts, the programs supported through our bill, with widespread support in both chambers of Congress, can continue to do their vital work. (Reps. Fred Upton (R-Mich.) and Diana DeGette (D-Colo.), 12/12)

Stat: Your Smartphone As Medicine: Digital Therapy Is Here To Stay
The FDA recently approved the first prescription digital therapy, Pear’s Reset app and program, which is focused on substance abuse. Others are likely to follow. That means your next trip to the doctor could include a prescription for a mobile app in addition to, or instead of, medicine. Digital therapy represents a powerful yet provocative new idea in health care. Software brings a precision to therapy and with it an ability to personalize treatment. This gives digital therapy a big role to play as we transition to value-based care. (Stephanie Tilenius, 12/11)

The Kansas City Star: Missouri Veterans Finally Get Needed Attention From Gov. Eric Greitens. What Took So Long?
Finally, Missouri Gov. Eric Greitens has taken long overdue steps to improve treatment for 1,300 military veterans in seven state-run skilled nursing care facilities. On Monday, Greitens called for the firing of Rolando Carter, the administrator of the St. Louis Veterans Home, where allegations of mistreatment of veterans surfaced last spring. Greitens also said he had found replacements for five members of the Missouri Veterans Commission whose terms have expired. He said he wants to replace Larry Kay, the commission’s executive director. (12/11)

RealClear Health: Telemedicine: Answering The Call Of Those Who Need It Most
Many veterans aren't receiving the health care they desperately need. Among them was Iraq War veteran Curtis Gearhart, who committed suicide last year. Gearhart, who had suffered from PTSD and recurring headaches from a tumor, sought out care but was told by the Veterans Affairs (VA) office that it would be five to six weeks before they could see him for medical care. (Raymond March, 12/11)

Los Angeles Times: Fixing America's Food Deserts Alone Won't Fix Our Terrible Diets
You are what you eat. It's an expression with roots in the early 1800s that has come to mean if you consume what's good for you, you will be healthy, and if you don't, well, watch out. But our latest research on what influences consumers to make unhealthy food choices has compelled us to turn that axiom on its head: You eat what you are. (Christine A. Vaughan and Tamara Dubowitz, 12/11)

St. Louis Post-Dispatch: Make Critical Anti-Cancer Treatments Accessible, Affordable
You’d probably be surprised to hear someone living with cancer say they consider themselves lucky. But, that is how I feel. For one, just a few years ago, that statement, “living with cancer” wasn’t something you heard very often. But, it’s more than just luck that is keeping me and thousands of other patients’ cancer at bay; it’s science. It’s access to breakthrough medications that have changed the ways we each treat our individual diseases. I’m also lucky that I’ve had affordable access to these life-saving medications, but that’s not the case for everyone. (Karen Coulson, 12/9)

Cleveland Plain Dealer: Women's Health Matters All Year Long
At the Cuyahoga County Board of Health, we champion women's health and access to medical care all year long. We think it is important to continue the conversation around women's health issues beyond October--and to encourage and empower all women to prioritize their own health care needs. (Sharon Verhotz, 12/10)