A bipartisan group of governors is calling on the Senate to adopt a bipartisan approach on healthcare while denouncing the ObamaCare repeal bill that passed the House.

Senate Republicans are currently moving forward with crafting a repeal bill that they expect will only get GOP votes, arguing that Democrats are not interested in compromise. But the governors are instead calling for an approach where both parties work together.

While we certainly agree that reforms need to be made to our nations health care system, as Governors from both sides of the political aisle, we feel that true and lasting reforms are best approached by finding common ground in a bipartisan fashion, the governors wrote in a letter to Senate leaders of both parties.

Kasich and Sandoval are particularly notable for their warning against the current Senate GOP approach, given that senators from their states, Rob PortmanRob PortmanKey GOP senators to watch on ObamaCare Governors from both parties slam House healthcare bill, call for bipartisan Senate approach Murkowski: 'I just truly do not know' if I can support GOP health bill MORE (R-Ohio) and Dean HellerDean HellerKey GOP senators to watch on ObamaCare Liberal group targets potential Republican healthcare swing votes Governors from both parties slam House healthcare bill, call for bipartisan Senate approach MORE (R-Nev.), are key votes on the bill.

Kasichs office said the governor has been in regular touch with Portman on the healthcare bill.

The governors sharply criticized the House-passed ObamaCare repeal bill.

Improvements should be based on a set of guiding principles, included below, which include controlling costs and stabilizing the market, that will positively impact the coverage and care of millions of Americans, including many who are dealing with mental illness, chronic health problems, and drug addiction, the governors write.

Unfortunately, H.R. 1628, as passed by the House, does not meet these challenges, they add. It calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states.

The governors are particularly concerned about the bill's Medicaid provisions. All of governors who signed the letter are from states that expanded Medicaid under ObamaCare, but the Republican bill in both chambers is set to end the federal funding for that expansion.

Sandoval, in particular, has said publicly he wants to keep the expansion as it is. That represents a break with Heller, the most vulnerable Senate Republican on the ballot in 2018, who said he supports a seven-year phaseout of the expansion funding.

Portman also supports the seven-year phaseout. Kasich has said he could agree to a phaseout of the funding if there is enough flexibility.

We stand ready to work with you and your colleagues to develop a proposal that is fiscally sound and provides quality, affordable coverage for our most vulnerable citizens, the letter states.

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Governors from both parties slam House healthcare bill, call for bipartisan Senate approach - The Hill

"Late Show" host Stephen Colbert joked on Friday night that the Republican healthcare legislation that is in the works is so classified it is the only thing that hasn't leaked in Washington D.C., a nod to multiple leaks that have come out of the Trump administration.

"What's in it? Colbert facetiously asked during his Friday night monologue on CBS. "Who knows? All we know so far is their foolproof plan for getting it passed, 'keeping their healthcare bill secret.'"

The late night talk show host joked that the plan is so secretive and anticipated it is like the new season of "Game of Thrones," but "somehow, more people will die."

Republicans gave themselves a "self-imposed" deadline of July 4 to hold a healthcare vote, according to Politico. A deadline that is quickly approaching, leaving many questioning whether they will be able to hold on to their campaign promise of replacing Obamacare.

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Stephen Colbert: GOP healthcare bill like new season of 'Game of Thrones' except 'more people will die' - Washington Examiner

First Read is your briefing from Meet the Press and the NBC Political Unit on the day's most important political stories and why they matter.

The long-awaited congressional runoff in Georgia takes place on Tuesday, and one way to look at the contest is as a referendum of sorts on the health-care debate, especially now with Senate Republicans working on their own bill. Democrat Jon Ossoff opposes the repeal-and-replace legislation the House passed last month, while Republican Karen Handel supports it. Heres an exchange from their debate earlier this month:

Handel: The system we're under now under Obamacare is collapsing. And I know because my husband and I get our insurance on the exchange. The premiums are skyrocketing and we are seeing a complete collapse in choice of plans, as well as physicians. Steve and I have seen our monthly premium go up from about $350 a month to nearly $1,200 a month. Our deductible from $2,500 to $10,000. So the status quo is unacceptable

Ossoff: I met a little boy about a month ago named Matt who came out to canvass with us, knock on some doors. He is 7 years old, and he was born with a heart condition -- a pre-existing condition. And he is able to get coverage right now because there are protections for children like that with pre-existing conditions. But Secretary Handel supports a bill that would gut the protections for Americans with pre-existing conditions

Handel: My sister has a pre-existing condition; she was born without an esophagus, and for you to suggest that I would do anything that would negatively affect her is absolutely outrageous and unacceptable. The facts are, ladies and gentlemen, that the bill in the Senate right now it provides more protections for individuals with pre-existing conditions...

Ossoff: When it comes to pre-existing conditions, I'm afraid you're mistaken. The bill that passed the House guts protections for pre-existing conditions for Georgians.

According to the recent Atlanta Journal-Constitution poll of this race, more than 80% of likely voters said health care is an extremely important or very important issue regarding their vote, and just 1-in-4 voters said they approved of the House health-care plan. And remember, this is the race to fill the seat vacated by Republican Tom Price, who is now Trumps HHS secretary and thats another way health care is an issue in this contest.

Given Rosensteins statement above, dont forget this reporting from MSNBCs Ari Melber: An FBI inquiry of the Comey firing makes it more likely Rosenstein could be a witness, and thus potentially meet the parameters for recusing himself from overseeing Mueller's investigation. Rosenstein told The Associated Press in an article published on June 3 that he would rescue himself if he were to become a subject of Muellers investigation. I've talked with Director Mueller about this, Rosenstein told the AP. Hes going to make the appropriate decisions, and if anything that I did winds up being relevant to his investigation then, as Director Mueller and I discussed, if theres a need from me to recuse I will.

Yesterday, we noted that Trumps closing argument in the final days of the 2016 election was that Hillary Clinton presidency would result in endless investigations and scandals. Now? Well, Trump finds himself under investigation for possibly obstructing justice. And NBCs Alex Seitz-Wald writes that Trump took to Twitter on Thursday to lash out at Hillary Clinton.

Tweet #1: Why is that Hillary Clintons family and Dems dealings with Russia are not looked at, but my non-dealings are?

Tweet #2: Crooked H destroyed phones w/ hammer, 'bleached' emails, & had husband meet w/AG days before she was cleared- & they talk about obstruction?

At 1:10 pm ET, President Trump gives remarks from Miami about his changes to Barack Obamas policies toward Cuba. In an overhaul of one of his predecessors signature legacies, President Donald Trump will redraw U.S. policy toward Cuba on Friday, tightening travel restrictions for Americans that had been loosened under President Barack Obama and banning U.S. business transactions with Cubas vast military conglomerate, the Miami Herald writes. Trumps changes are intended to sharply curtail cash flow to the Cuban government and pressure its communist leaders to let the islands fledgling private sector grow. Note, however, that Trumps change of policy isnt popular with Congress, including Republicans from outside of Florida. We have a bill to lift the travel ban completely, to have no restrictions at all. That has 55 co-sponsors, Sen. Jeff Flake (R-AZ) said on MTP Daily yesterday. If it came to a vote on the Senate floor, I'm convinced we would be between 65 and 70 votes in favor of that.

NBCs Benjy Sarlin: Despite the stakes, some Democrats and activists opposed to the GOP plan say Republican efforts to hide the legislative process and a relentless tide of major news elsewhere have made it harder to draw attention to the issue. If youre a voter sitting at home looking at your newspapers front page, its possible to have no idea the 'Trumpcare' train is barreling down the tracks at you, Ben Wikler, Washington director of MoveOn, told NBC News in an interview. MoveOn and a variety of other grassroots groups are warning members that a bill is imminent and sounding the alarm with events, petitions and phone calls to senators. Democrats have been giving floor speeches, holding town halls, and tweeting all week about the expected legislation. But some are expressing frustration that their message is getting lost in the noise.

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How Health Care Is Playing in Georgia's Special Election - NBCNews.com

U.S. Sen. Deb Fischer, R-Neb., endured a slew of boos and hisses Friday as she faced questions from Omahans and others upset at the secrecy in which Republicans are crafting a health care bill in Congress.

One man told Fischer that he believed Republicans were hiding the bill because they knew it would drive up health care costs for many Americans.

Fischer did not condemn the process, but she also did not aggressively defend the Senate GOP leaders who are writing the bill. She told about 140 people gathered at a town hall meeting in Omaha that she would prefer a public hearing be held or Democrats be allowed to be involved in the process or both.

But Fischer made it clear it was not her call.

Im from Nebraska, where we have a public hearing on every bill introduced in the Legislature. I think thats a system that I would, of course, always endorse. But that doesnt (always) happen in Congress, Fischer said.

Senate Majority Leader Mitch McConnell and others are currently writing the Senates own version of a repeal of Obamacare with no plans to hold either a public hearing or a public drafting process. So far, Fischer indicated, only Republicans have been a part of the process.

Fischer held her meeting at Metropolitan Community College in north Omaha with a heavy police presence because of this weeks shooting at an Alexandria, Virginia, ballfield, during which a Republican congressman was shot. One police officer said it was better to be safe than sorry.

Fischer appeared unfazed by the sometimes raucous crowd, even when she felt compelled to gently chide people for being loud and interrupting her answers. I would hope we can continue to show respect here. Were in Omaha. Were in Nebraska, she said.

A core group of the people who attended the meeting were there to express their concerns about health care and Republican efforts in Congress to repeal the controversial Affordable Care Act, also known as Obamacare. They argued that the law has made it much more affordable for people with pre-existing conditions to acquire health care.

Several also argued to thunderous applause that the time had come in this country to adopt a public health care system similar to other developed countries such as Canada and Sweden.

Theres a lot of people who make a lot of money off of our health and I dont think thats right, one man told Fischer.

Fischer made it clear she did not support universal health care or Obamacare.

She said that although she may not be totally comfortable with the way in which the current bill was being written in Congress, she believed that there had been plenty of discussion and debate over the years and that Republicans have been clear where they stood: They want repeal of Obamacare and its requirement that all Americans acquire insurance or face a penalty.

I am supportive of the marketplace, she said.

But Fischer said any bill must include provisions to ensure that Americans with pre-existing conditions have access to health insurance.

She also appeared to assure the crowd that she would not vote on a bill until its price tag and its impact on this nations health care system had been analyzed by the Congressional Budget Office and was known to the public.

We need a CBO score. I want to see a CBO score before I vote, she said.

Health care wasnt the only issue that prompted the boos to rain down upon Fischer. She also earned a round of heckling and hisses when she commented on President Donald Trumps proposed travel ban.

Fischer said the U.S. should never ban people for religious reasons but it should be able to ban people from countries such as Syria, where it is difficult to do background checks on its people. We cannot vet people right now from Syria, she said, because you have a country right now in chaos.

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Raucous crowd quizzes Deb Fischer on health-care bill being crafted in Senate - Omaha World-Herald

"Heath care is kind of a privilege right now but it needs to be a right. When it comes to humanity I feel like I a lot of people gotta step up to make it better," the rapper told CNN's #GetPolitical series.

"I feel like a lot of artists and a lot of actors and people that have a platform like mine don't like to touch them kind of subjects because they real risky," French said, adding that it's crucial to take action when you're passionate about something and not just talk about it or post about it on social media.

While many in the US remain uninsured, the Grammy-nominated rapper came face-to-face with a situation that is much more dire after a serendipitous trip to the east African country of Uganda in March.

The Moroccan-born rapper, who grew up in the South Bronx, was inspired to visit the country in February after coming across Uganda's "Triplets Ghetto Kids," whose dancing videos on YouTube went viral last year.

"I listen to a lot of African music, so me just scrolling through the computer I seen them kids and I saw something that I never saw before," French said. "I saw art; I saw kids that were rich on the inside. I saw a lot of love."

The rapper said that he was supposed to shoot his music video for his single "Unforgettable," featuring California rapper Swae Lee, "in Hawaii or something like that but I decided I wanted to go to Africa, especially because that's my roots."

"Once we got there, I saw life for what it was out there. Three-hundred thousand people, they have two rooms and one ambulance," French said, describing the medical facility. "I feel like every kid and mother need the proper health care and it kind of hurt me. It made my heart heavy for them ... it touched me so much I said I'm going to make a change, probably not for the whole world but at least right here."

"I feel like especially with artists like me and other artists that have a platform to showcase this kind of message and show a difference and really go out there and do it -- not just speak about it and post about it on Instagram," French said. "I feel like we gotta show action nowadays."

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French Montana: Health care should be a right, not a privilege ... - CNN

The Latest on a settlement with Genesis HealthCare to resolve allegations that the company and its subsidiaries filed false claims with the U.S. government (all times local):

1 p.m.

Genesis HealthCare says it is pleased to resolve allegations that the company and its subsidiaries had submitted false claims for unnecessary therapy and nursing care.

Company spokeswoman Jeanne Moore confirmed Friday that Genesis agreed to pay a $53.6 million settlement with the U.S. Justice Department.

Moore says the company, which is headquartered in Kennett Square, Pennsylvania, operates in a heavily regulated industry.

Prosecutors said the company had been accused of submitting false claims to Medicare and Medicaid for medically unnecessary therapy, hospice service and substandard nursing care. The settlement also resolved allegations that some services provided by nursing homes owned by Genesis were "grossly substandard and/or worthless and therefore ineligible for payment."

12:20 p.m.

Federal prosecutors say Genesis Healthcare has agreed to pay $53.6 million to settle allegations that it submitted false claims for unnecessary therapy and nursing care.

The U.S. Justice Department announced the settlement Friday.

Prosecutors say the company submitted false claims to Medicare and Medicaid for medically unnecessary therapy, hospice service and substandard nursing care.

The company headquartered in Kennett Square, Pennsylvania owns and operated nursing facilities, senior living facilities and rehabilitation centers.

The settlement also resolved allegations that some services provided by nursing homes owned by Genesis were "grossly substandard and/or worthless and therefore ineligible for payment."

A phone message seeking comment left with a media representative for Genesis Healthcare was not immediately returned.

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The Latest: Genesis HealthCare pleased to resolve probes - ABC News

The U.S. health-care system is full of things that don't make much sense. A lot of them are extremely profitable.

One of these, recently highlighted by legendary short-seller Jim Chanos,is dialysis, a market largely split in the U.S. between two large firms,DaVita Inc. andFresenius Medical Care AG & Co KGaA.If the Senate passes a health-care bill similar to one the House of Representatives passed last month, then it may become easier for private insurance plans to stop covering dialysis, cutting off a big source of profit for these companies.

This is just one of the more extreme risks, of many, looming over health-care companies these days. And yet shares of the two biggest dialysisfirms have outpaced the broader stock market since the election, and the rest of health care is keeping up.

Holding Up

Health care stocks, including the two biggest dialysis providers, have held up well to the threat of Republican health care reform

Source: Bloomberg

Dialysis is a costly procedure that is mostly paid for by government programs -- people with end-stage kidney disease become eligible for Medicare, regardless of age. Trouble is, those programs reimburse dialysis companies at a significantly lower rate than private insurers. According to a Bloomberg Intelligence analysis, DaVita made 95 percent of its Ebitda from patients with private insurance from 2013 to 2016. The profit margin for these patients is 77 percent, versus 2 percent for government patients.

Doing the Splits

A DaVita slide deck shows how much more profitable commercially covered patients are for the dialysis firm

Source: DaVita

Though eligible for Medicare, some dialysis patients prefer private insurance because it can be more flexible. The Affordable Care Act made that insurance easier to get. It requires insurers to cover such patients, says insurers can't charge those patients more, caps out-of-pocket expenses and helps less-wealthy patients cover premiums.

The Republican replacement for the ACA, the American Health Care Act, seems designed to be a pain for dialysis firms. The law may let states apply for waivers of the regulations that have made private insurance more attainable.If given the opportunity, insurers would likely make plans covering dialysis patients prohibitively expensive, to help keep such people out of their risk pool.

Dialysis companies have already been curtailed in their ability to nudge patients toward commercial insurance by funding third-party charities that help pay for it. The AHCA has the potential to enhance theirwoes by pricing patients out of the private insurance market, charity or no.

Not Dead Yet

Trumpcare

Not every part of the health-care sector is quite as exposed to the AHCA as dialysis is. But most companies have similar risks, for which stock prices have failed to fully account.

Drugmakers, for example, also spend significant amounts of money funding charities that help cover out-of-pocket drug costs for patients on expensive medicines. Those costs are expected to rise substantially if the ACA is repealed, hitting revenue and increasing the political and public pressure over high drug prices.

A Kaiser Family Foundation analysisfound that 75 percent of individual insurance plansin the pre-ACA era didn't cover maternity care, 45 percent didn't include substance-abuse services, 38 percent didn't include mental and behavioral health services, and 17 percent had prescription-drug restrictions. The ACA brought those percentages down significantly. Under the AHCA, the individual insurance market is likely to head back to those bad old days in some states, pricing people out of comprehensive coverage -- and hurting companies that provide these services and products.

That will have widespread and unpredictable knock-on effects throughout health care. People who don't get mental-health care also don't get prescribed medication, and so on.

This is not a small-scale or narrowly concentrated problem. Twenty-three million people are expected to lose health coverage outright under the AHCA, according to the Congressional Budget Office. An unknown number will have substantially skimpier coverage or higher out-of-pocket costs that may dissuade them from getting care. Millions of Americans with employer-sponsored coverage may once again face annual and lifetime coverage limits.

Yet health-care stocks in the Russell 3000 index of the largest U.S. companies are outperforming the index as a whole since the election.A few stocks with ACA exposure are down since the election, but many more are up.

Giddy

Health care stocks have outperformed the Russell 3000 since Donald Trump's election, despite the threat of GOP health care reform

Source: Bloomberg

It's become increasingly clear health-care investors can't rely on the Senate to save them. The Senate has gone from publicly decrying the House bill to reportedly working on something that copies it in many respects. There's not all that much room to soften the House bill, anyway, despite President Donald Trump apparently having come to believe the House bill is "mean."The revised bill is being designed in secrecy and hastened to a vote (again) for a reason.

The consequences aren't always as obvious as they are for dialysis firms. But they're there, and health-care investors appear to be in some denial about it.

Peter Grauer, the chairman of Bloomberg LP, the parent company of Bloomberg News, is a member of DaVitas board.

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

To contact the author of this story: Max Nisen in New York at mnisen@bloomberg.net

To contact the editor responsible for this story: Mark Gongloff at mgongloff1@bloomberg.net

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Health-Care Investors Are in Denial - Bloomberg

Sen. Elizabeth WarrenElizabeth WarrenTrump probe puts spotlight on Justice's No. 3 Conway blames lawmaker shooting on 'personal attacks' against Trump Warren rips Senate GOP for secretive work on healthcare bill MORE (D-Mass.) on Friday ripped Senate Republicans in an interview with "CBS This Morning" for drafting their version of the bill to repeal and replace ObamaCare behind closed doors without any input from Democrats.

"Right now, the Senate Republican leadership has 13 men locked behind doors, negotiating what they're going to do on a healthcare bill won't let Democrats in the room to even see the bill," Warren said.

Prompted by CBS host Jeff Glor that President Trump had called the House bill "mean," Warren responded by blasting the president for holding a Rose Garden celebration with GOP lawmakers following its passage.

"This is a bill that's going to touch every American family," Warren continued. "Everybody who's got an elderly relative in a nursing home, everybody who has a child with special needs, these cuts to Medicaid will touch millions of families."

On Sunday, Republicans announced that they saw a path to repealing ObamaCare through the Senate. If the Senate bill passes, the two bills will go through a reconciliation process.

Warren, one of the most liberal members of the Senate, ripped the House bill shortly after it passed.

"A health care bill that destroys care & affordable coverage for millions seriously? What planet are these guys living on?!" Warren tweeted in March.

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Warren rips Senate GOP for secretive work on healthcare bill - The Hill

U.S. Sen. Pat Toomey isn't sure any issue in modern American politics has been as publicly litigated as Obamacare.

Now working on a bill to replace the existing health care law, the Lehigh County Republican spoke Friday about those efforts, alleged Russian tampering with U.S. elections, congressional security and other issues at WFMZ-TV. He took questions from anchor Rob Vaughn, other reporters and social media.

People submitting questions were most interested in health care, Vaughn said, and Toomey's one of about a dozen senators working on replacing the Affordable Care Act. Specifically, he's been tasked with working out changes to Medicaid, which covers low-income, elderly and disabled individuals.

Toomey noted that health care discussions revolve around changes to Medicaid and the individual markets created under Obamacare, and not the employer-provided health insurance or Medicare that cover the bulk of America. Given Democrats won't support a bill that repeals the heart of Obamacare, the Republican authors must hold the support of virtually every member of their party to be successful.

The group has been criticized for working in private, but Toomey said he can't imagine the bill his group produces wouldn't become a public document that would be evaluated by the Congressional Budget Office before the Senate votes on it. The House voted last month on its own health care bill without waiting for CBO.

Funding for the Medicaid program is one area where the Senate bill is likely to differ from the House's. The outcome is important for Pennsylvania, which is among 31 states that expanded Medicaid under Obamacare, allowing a new category of adults to access coverage beyond the traditional program.

The federal government has been paying the full cost for the new category, but those payments will drop to 90 percent by 2020. While both the House and Senate are looking to reduce how much the federal government kicks toward Medicaid, the House wants to make the change abruptly, Toomey said, while the Senate wants that change to be more gradual. Toomey said the federal government should eventually pay the same percentage for the the new category of the Medicaid population as it does the old, which in Pennsylvania is 52 percent.

Getting there would cost some recipients coverage, critics warn. Under Obamacare 700,000 more Pennsylvanians signed up for coverage, and the state is running a deficit.

Toomey said a measure of the new bill's success will be whether premiums decline, something he said wasn't seen under Obamacare. He noted some people under Obamacarehave one choice of insurer.

There has to be a viable health insurance market, Toomey said, and the new bill will have to make sure people aren't "gaming the system" by only signing up for health care after they have a problem.

"Let's get the policy right," he said. "If we get it right, people are going to want to have health insurance and they will and it will be available and affordable."

Toomey also spoke Friday about the investigation into alleged Russian interference with the United States elections. Addressing a comment he'd made previously on CNN, Toomey said the "media obsession" with the idea that the Trump campaign colluded with the Russians was "overblown," noting two Democrats close to the investigation have said there's no evidence of it. Toomey said he's not aware of evidence of obstruction of justice, either.

But, he said, Russia's actions are a problem and their behavior has been "outrageous."

"I don't have any doubt that Russia tried to interfere with our elections," he said. "They are generally trying to discredit western democracies in the United States particularly."

Speaking to reporters after the televised interview, Toomey called the Wednesday shooting incident during a GOP baseball practice that injured House Majority Whip Steve Scalise, two Capitol Police officers and two others, "extremely concerning." He said there's reason to believe this was an isolated action of a "deranged individual."

"If that's the case then hopefully this sort of thing will remain exceedingly rare and we don't have a lot to worry about," he said.

The interview came a few hours after President Donald Trump fired off a series of tweets about reports of an investigation into whether he colluded with the Russians, calling it a "witch hunt."

Toomey was asked what he thought of such Twitter activity.

"Generally, I think we'd be better off if there were fewer tweets. I don't think it's helping to advance the agenda I want to get [done]," he said. "Fewer tweets wouldn't hurt."

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Pat Toomey talks health care, Russia, and security during Lehigh Valley stop - Allentown Morning Call

BEAVER -- The Sister of St. Joseph organized a pray-in event for health care in front of the Beaver County Courthouse on Friday.

About 20 community members and sisters were there, standing up against federal health-care legislation that they say could negatively impact senior citizens, the disabled and children if passed.

It's not a political issue. It's a moral issue, said Sister Jeanette Bussen, who spoke in front of the group with signs and posters.

There are more than 160 members at Sister of St. Joseph in Baden. About 80 of those women use Medicaid as their health insurance.

Our mission is to serve God and the dear neighbor without distinction, said Sister Barbara Czyrnik, who is on the leadership team of the Sisters of St. Joseph. We found out that this moment in our history, probably one of the greatest needs right now, is to advocate for health care for everyone.

Many residents at Villa St. Joseph rely on self-pay or Medicaid, as well as other senior-care facilities. In Pennsylvania, nearly 75 percent of Medicaid funding is spent on care for seniors and people with disabilities.

According to the Pennsylvania Department of Human Services, more than 35,000 Beaver Countians were enrolled in Medicaid as of December 2015, which is more than 20 percent of the county's population.

Following prayers and speeches, the sisters urged that others contact U.S. Sens. Pat Toomey and Bob Casey to speak out against the American Health Care Act.

The bill was passed in the House of Representatives in May and awaits a Senate vote.

Katy Wilcox of South Beaver Township attended the event with her husband, David, in solitary with the sisters message about health care. Three years ago, her adult son Dan had serious complications following surgery, which led to him being in a seven-week coma. She held a large poster with photos of her son during his lengthy hospital stay and a recent photo of him doing well.

She credits the Affordable Care Act and prayer as the reasons her son is alive. She said she feels certain that he wouldnt be if the American Health Care Act were law instead.

He now works part time, but his health insurance could be at stake if the AHCA is signed into law.

I'm here for his sake, but our story is just one story, Wilcox said. We understand now, on a personal level, how health problems can devastate your savings. Our life savings has been just about wiped out. We do have retirement and Social Security, but our means are not what we anticipated they would be at this part of our life. And we're very proud of our son ... and the work he's done and the progress he's made.

Its stories like hers that further motivate the sisters.

When you take it to a personal level, it always affects you in terms of motivation to do more, Bussen said. Because that makes it real, and when it becomes real, then you're in the position of wanting to do something about it and to work with people. Otherwise, they become statistics and they become news briefs and they become something that people are doing in Congress, but they don't affect us. ...

"This particular bill is going to affect us greatly. And hearing those stories should motivate people to really want to take some action and make phone calls.

Wilcox said she hopes that both sides of the political health-care argument can unite, quoting one of her favorite Bible verses.

"Let justice roll down like a river. Righteousness, like a mighty stream, she said.

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Sisters of St. Joseph stand up against federal health-care legislation - Timesonline.com

On May 4, 2017 the U.S. House of Representatives passed a bill seeking to repeal and replace the Affordable Care Act (ACA). The debate is now in the U.S. Senate. The Affordable Care Act (ACA), at this time, remains the law of the land with all of its consumer protections for people with pre-existing conditions, women, and small businesses. DC Health Link is established in District law, locally managed and controlled, financially sound and going strong. Legislative action on May 4 doesnt impact your ability to enroll in affordable quality health insurance for 2017. You may also be eligible for premium reductions. DC Health Link has 20 private health insurance options to choose from for residents and their families from CareFirst and Kaiser Permanente. For 2017 small businesses have 151 health plan options from Aetna, CareFirst, Kaiser and United. Individuals and families can enroll if they qualify for a special enrollment due to a change in their life like getting married. Small businesses can sign up throughout the year. Residents can apply for Medicaid throughout the year.

Visit link:

DC Health Link - Welcome to DC's Health Insurance Marketplace

At least 20 million Americans with employer-provided health insurance could find themselves one devastating accident or diagnosis away from financial ruin if the Senate health care bill is passed as expected, according to a report released Thursday by the Center for American Progress.

Lawmakers have been working behind closed doors on their American Care Act (ACA) replacement bill, whose primary focus is reshaping the individual insurance market and rolling back the ACAs expansion of Medicaid. Yet the bill may also include a provision that would weaken protections for millions of Americans with employer-sponsored health coverage, Axios reports.

Senators havent released a draft of their legislation, and media reports have said they dont intend to ahead of a vote that could happen before Congress breaks for July 4. The Center for American Progress assumed that the bill would include a waiver provision that could weaken patient protections and used survey and census data to estimate the number of workers and dependents in large company plans who would be affected.

The waiver was also included in the House version of the health care bill, the American Health Care Act, which passed on May 4.

This provision would allow employers to bring back annual and lifetime caps on health coverage. In 2009, before the ACA, 59% of workers with employer-provided health insurance were in a plan with a lifetime limit on how much the plan would cover. That cap could be set as low as $1 million, which wouldnt be hard for certain patients to hit. For example, a baby who spent months in the neonatal intensive care unit or someone who was born with hemophilia, developed an aggressive form of cancer, or got paralyzed in a car accident would all easily reach that sum.

Once a person hit his lifetime cap, the health plan would stop paying his expenses. Someone who hit his annual cap would have to wait until the following year for coverage. To a lot of people, it probably came as a surprise, says Emily Gee, a health economist at the left-leaning Center for American Progress and co-author of the report.

The Senate bill could expose workers to these caps by allowing states to apply for a waiver to define their own list of essential health benefits. The Affordable Care Act required most plans to include a robust list of 10 essential benefits, including prescription drug coverage, mental health and maternity care. The law banned annual and lifetime limits for essential health benefits, which in effect meant that most care wasnt subject to any caps.

But if states could pick and choose their essential health benefits, then employers could do the same, bringing back caps for any care that doesnt fall under their new definition of "essential." Individual and small group (generally, under 50 workers) plans in a particular state would be bound by their local regulationsso if their state mandated a full slate of essential health benefits, then they wouldnt have the option of choosing a health plan that excluded one.

By contrast, regulations allow large employers to base their benefit structure on any given states. Since essential health benefits are standard under the Affordable Care Act, this ability isnt currently that meaningful. However, if variations in essential health benefits become the norm, then employers that want to cut health costs could gravitate toward the state that offers them the most flexibility to do so.

To be sure, not all large employers will choose to set caps. Plenty of companies see comprehensive health insurance as a way to attract and keep talented employees, says Zack Pace, senior vice president of CBIZ, a benefits consulting firm. But the relentlessly rising cost of medical care and prescription drugs means that some firms may have no choice but to limit their workers coverage, Gee says.

The Center for American Progress based its estimates on a survey by Willis Towers Watson in which 20% of large employers said they would impost annual limits and 15% would impose lifetime limits if the ACA protections were repealed. Authors then used U.S. Census data to estimate the number of large-company workers and their dependents who would be affected: nearly 27 million would be subject to annual limits, and about 20 million would be subject to lifetime limits.

This worries advocates for people with pre-existing conditions. Imagine being the individual in active cancer treatment, says Anna Howard, principal in policy development at the American Cancer Society Cancer Action Network, and being told that, in effect, were not going to be paying for the products and services that are keeping you alive.

Excerpt from:

The Senate Health Care Bill Could Hurt You Even If You Get Insurance Through Work, Report Says - Money Magazine

The Republican-controlled U.S. Senate has received constant waves of criticism over its secret tinkering with the controversial and widely panned American Healthcare Act (AHCA)even from President Donald Trump, who reportedly said it was mean and asked that it be more generous.

Trumps characterization of the bill, which passed the House of Representatives last month, could very well be correct, and may even affect one of his top campaign promises: boosting the economy and jobs.

A study examining how each state could be affected if it passes the Senate and is written into law, published Wednesday by The Commonwealth Fund,found that by 2026 nearly one million jobs could be lost, state gross domestic product could shrink by $93 billion and businesses could suffer a $148 billion bite.

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When the House passed the bill on May 24, critics focused in particular on the Congressional Budget Offices estimate that 23 million Americans would be uninsured by 2026 and Medicaidwould see $880 billion in cuts during the same eight years.

But the new study appears to be focusing directly on the presidents main concernthe economyone of the few places hes claimed success after five months in office.

Should the bill be passed this year and enacted in 2018, there would be initial job growththat would gradually taper off. The bill ultimately would result in the loss of jobs in as many as 10 states, according to the study.

Initially, the repeal of Obamacare would raise the federal deficit following a tax cut, and then lead to the creation of 864,000 jobs by 2018. But due to the rising costs of health care, coupled with the bills tax cuts, over time more sectors of the economy would be affected, and eventually 924,000 jobs would be lost.

Combined, tax repeal and coverage-related changes lead to initial economic and employment growth but eventual losses, the study reads.

Coverage and spending-related policies are directly related to funding for health services (e.g., Medicaid, premium tax credits, high-risk pools). The reductions directly affect the health sectorhospitals, doctors offices or pharmaciesbut then flow out to other sectors.

Thus, about two-fifths of jobs lost due to coverage policies are in the health sector, while three-fifths are in other sectors. Tax changes affect consumption broadly, spreading effects over most job sectors, the study said.

If the current version of the bill passes, job losses could significantly hit 10 states, some of which went with Trump in the Electoral College last year. Florida, Pennsylvania and New York would be affected the worst, with upwardof 80,000 jobs or more lost, while Michigan could dip by 51,000, and New Jersey, Illinois, Ohio and North Carolina by more than 40,000 each.

It also appears the entire country could have serious problems with the AHCA. ANew York Times composite of eight national polls found that on average, only 29 percent of Americans support the bill and not a single state is in favor of its passage.

Link:

Republicans' 'Mean' Health Care Plan: The Real Cost of Trump's AHCA Is Jobs, Study Finds - Newsweek

The CDC released a Morbidity and Mortality Weekly Report (MMWR)(www.cdc.gov) and an accompanying Vital Signs report on June 6 that analyzed the prevalence of Legionnaires' disease in the U.S. health care system and found that 76 percent of facilities studied reported health care-associated cases of the disease.

Seventy-two health care facilities in 16 of the 21 U.S. jurisdictions the CDC studied reported definite health care-related cases of Legionnaires' disease, which is known to kill one-quarter of patients who are infected.

Legionnaires' disease is a severe pneumonia typically acquired through inhalation of aerosolized water containing Legionella bacteria. Legionella can grow in the complex water systems that supply many buildings, including health care facilities, when those systems are not well managed. Thus, effective water management programs could prevent the growth of Legionella in these building water systems.

Most healthy patients who are exposed to Legionella don't develop Legionnaires' disease. Some patients, however, are at increased risk for the disease, including those 50 or older and those who have certain risk factors, such as being a current or former smoker or having a chronic disease or weakened immune system.

Legionnaires' disease in hospitals is widespread, deadly and preventable," said CDC Acting Director Anne Schuchat, M.D., in a June 6 news release.(www.cdc.gov) "These data are especially important for health care facility leaders, doctors and facility managers because it reminds them to think about the risks of Legionella in their facility and to take action.

"Controlling these bacteria in water systems can be challenging, but it is essential to protect patients."

All 50 states, two large U.S. metropolitan areas and five territories report basic demographic information to the CDC's National Notifiable Diseases Surveillance System (NNDSS) for all cases of legionellosis, which manifests as one of two distinct clinical presentations: Pontiac fever (a mild influenza-like illness) and Legionnaires' disease. NNDSS makes no distinction between the two presentations.

In 2015, a total of 6,079 cases of legionellosis were reported to NNDSS, although the CDC noted that this estimate may be low due to underdiagnosis. The Supplemental Legionnaires' Disease Surveillance System (SLDSS) receives additional epidemiologic information, including whether patients were exposed to health care facilities, and distinguishes Legionnaires' disease from Pontiac fever, but reporting to SLDSS is less widespread.

The MMWR analysis aimed to define which Legionnaires' cases were associated specifically with health care facilities using data from the 21 U.S. jurisdictions. Definite health care-associated disease was defined as including hospitalization or long-term care facility residence for 10 days preceding symptom onset; possible health care-associated disease was defined as including any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other cases were considered unrelated to health care.

The MMWR analysis aimed to define which Legionnaires' cases were associated specifically with health care facilities using data from the 21 U.S. jurisdictions. Definite health care-associated disease was defined as including hospitalization or long-term care facility residence for 10 days preceding symptom onset; possible health care-associated disease was defined as including any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other cases were considered unrelated to health care.

Of the more than 6,000 confirmed legionellosis cases reported to NNDSS in 2015, 3,516 (58 percent) were also reported to SLDSS, including 3,459 Legionnaires' disease cases. Of those Legionnaires' disease cases, 2,809 (81 percent) were reported by the 21 jurisdictions included in the MMWR analysis, including 553 (20 percent) that were health care-associated (either definite or possible).

Of the 85 Legionnaires' disease cases that were determined to be definitely health care-associated, 80 percent were associated with long-term care facilities, 18 percent with hospitals and 2 percent with both.

Definite health care-associated Legionnaires' disease cases were reported in 72 facilities -- 15 hospitals and 57 long-term care facilities -- and included one to six cases per facility. Almost 90 percent of these definite cases occurred in patients 60 or older.

Of the 468 possible health care-associated cases, 49 percent were thought to be associated with hospitals, 26 percent with clinics, 13 percent with long-term care facilities, 3 percent with other settings such as outpatient laboratories, and 9 percent with more than one setting.

The MMWR report's authors said preventing the first case of Legionnaires' disease from arising in any health care facility should be the goal, and that is best achieved by establishing and maintaining an effective water management program. To this end, the CDC and its partners have created a best practices guide(www.cdc.gov) for these facilities to use.

In general, the CDC said the principles of effective water management include maintaining water temperatures that are not conducive to Legionella growth; preventing water stagnation; ensuring adequate disinfection; and maintaining equipment to prevent scale, corrosion and biofilm growth, which provide a habitat and nutrients for Legionella.

"Safe water at a health care facility might not be on a physician's mind, but it's an essential element of health care quality," said Nancy Messonnier, M.D., director of the CDC's National Center for Immunization and Respiratory Diseases, in the agency's release. "Having a water management program that focuses on keeping facility water safe can help prevent Legionnaires' disease."

In related news, CMS released a survey and certification memo(www.cms.gov) on June 2 that requires health care facilities to develop and adhere to policies and procedures to reduce the risk of disseminating Legionella and other waterborne pathogens.

According to the CDC, health care professionals play a critical role in preventing and responding to Legionnaires' disease by rapidly identifying and reporting cases.

Unfortunately, Legionnaires' disease is clinically indistinguishable from other causes of pneumonia. But failing to diagnose a health care-associated case could result in a missed opportunity to prevent subsequent cases.

Therefore, "Legionella should be considered as a cause of health care-associated pneumonia, especially for groups at increased risk, when other facility-related cases have been identified, or when changes in water parameters might lead to increased risk for Legionnaires' disease," the MMWR report advised.

The preferred diagnostic procedure for Legionnaires' disease is to concurrently obtain a lower respiratory sputum sample for culture and perform a Legionella urinary antigen test.

The CDC said ideally, sputum should be obtained before antibiotics are administered and shouldn't be rejected based on specimen quality (e.g., lack of polymorphonuclear leukocytes or contamination with other bacteria), because sputa produced by patients with Legionnaires' disease might not be purulent, and contaminating bacteria will not negatively affect isolation of Legionella on selective media.

"This report demonstrates that Legionnaires' disease continues to result from exposures to health care facility water systems," said the MMWR report. "The high case fatality rate of health care-associated Legionnaires' disease underscores the need for effective prevention and response programs.

"Implementation and maintenance of water management programs, combined with rapid case identification and investigation, could reduce the number of health care-associated Legionnaires' disease cases."

More From AAFP American Family Physician: Recreational Waterborne Illnesses: Recognition, Treatment, and Prevention

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Legionella Poses Risk for Patients in Health Care Facilities - AAFP News

Photo courtesy MGN Online

SALEM, Ore. (AP) A $670 million health care tax package designed to help sustain Medicaid services for the next two years and avoid the shuttering of a newly-built psychiatric hospital passed the Oregon House Thursday.

The 36-23 decision vote exceeded the constitutionally-required supermajority by just one vote.

House Bill 2391 is among the most high-profile pieces of legislation in Salem this year. Without it, lawmakers would have less than a month to solve a large chunk of the state's upcoming $1.4 billion shortfall, a psychiatric hospital in Junction City, Ore. with 100 beds and 400 workers would be on the chopping block and more than 350,000 low-income Oregon residents could lose health insurance under the federal Medicaid expansion almost immediately.

The package is among Gov. Kate Brown's top priorities she wants lawmakers to get done before the required July 10 adjournment. In a briefing with the state capitol press Wednesday, Brown noted she'd continue to fight the GOP minority's efforts in Congress to derail the Medicaid expansion and repeal President Barrack Obama's legacy legislation, the Affordable Care Act.

"The conversation, at least from what I've been able to read and in my conversations most recently with Sen. (Jeff) Merkley, is that the proposal will likely starting kicking people off after the 2020 elections," Brown said. "I find that appalling that we would keep people on for a year or two to get past the 2018 election cycle and then devastate 23 million Americans."

Passage of the so-called "provider" tax is also essential for the Oregon Health Authority's nearly $20 billion budget, proposed as a companion bill, for the 2017-19 biennium. House lawmakers approved the OHA budget, House Bill 5026, immediately following the provider tax, which squeaked by on a narrow three-fifths vote after Republican Rep. Sal Esquivel broke with his party to help majority Democrats advance the bill the next stage.

Both health care bills now head for final approval to the state Senate. The provider tax has broader support among Republicans in the Senate than it did in the House, so it's expected to clinch supermajority support more easily.

The package includes raising an existing tax on hospitals' net patient revenue 4 percent on small, rural hospitals and 6 percent on large hospitals and imposes a new 1.5 percent tax on health plans provided by some insurers as well as coordinated-care organizations that facilitate the state's Medicaid program, called the Oregon Health Plan.

The proposal has been several months in the making among Democrats, Republicans and key health care industry players, who worked in good faith toward the common goal of ensuring that billions of federal Medicaid matching-dollars, which begin tapering off next year, continue flowing into Oregon's local economy.

But negotiations were ongoing up until hours before the vote, with House Republicans opposing the premium tax as being too high.

"The inclusion of a tax on insurance premiums will result in higher health care costs for small businesses, college students and everyone in between," said Republican Rep. Cedric Hayden, who played a key role in negotiating the provider tax package. "It's disappointing that bipartisan alternatives were not given the consideration they deserved by the majority party."

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Oregon House advances $670M health care provider tax - KATU

Apple has been in talks with hospitals and other healthcare organizations to explore the possibility of bringing health records together via iPhones, media outlets reported.

The effort to make all personal health information available via its devices would be a first for Apple, which until now has focused it healthcare work on fitness and wellness with its Apple HealthKit. Apple has been typically mum on the developments and CNBC, which first reported Apples latest intentions for healthcare, said the works has thus far been secretive.

[Also:Will Apple buy athenahealth? Jonathan Bush calls rumor baseless]

Unnamed sources told CNBC Apple is looking at startups in the cloud-hosting space to give it a foothold in healthcare.

The company has already acquired personal health data startup Gliimpse, which has a secure platform for consumers to manage and share their own medical records.

The entrepreneur Anil Sethi, who built Gliimpse and sold it to Apple three years later, is now working at Apple. His title, according to his LinkedIn page, is Director, Apple Health.

More recently, Apple recruited Sumbul Desai, MD, from Stanford, where she has been involved in several successful digital projects. Apple executives have not released what role Desai will play, whether she might join the team working on ResearchKit, HealthKit and CareKit, or work on another project altogether.

Also, Apple insiders reportedly talked with people at The Argonaut Project, which is promoting the adoption of open standards for health information, and to "The Carin Alliance," an organization that advocates for giving patients a central role in controlling their own medical data.

Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

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Apple reveals plans to put health records on the iPhone - Healthcare IT News

President Donald Trump hosts a working lunch with members of Congress, including Sen. Lisa Murkowski (left), at the White House on June 13. | Getty

President Donald Trump directed Senate Republicans to pass a generous health care bill at a meeting with more than a dozen GOP senators on Tuesday, arguing that the austere House health care bill is difficult to defend, according to people familiar with the meeting.

The president also said Republicans risk getting savaged in the 2018 midterms if they fail to repeal Obamacare after a seven-year campaign against the law.

Story Continued Below

But he made clear that the Senate needs to pass a bill that Republicans are able to more easily defend and is not viewed as an attack on Americans from low-income households, as the House bill has been portrayed by critics, the sources said. He also advocated more robust tax credits for people who buy insurance on the individual market, a move that would increase the bills cost.

Sen. Rob Portman (R-Ohio), who is pushing the Senate to slow the repeal of Medicaid expansion, indicated Trump is concerned about the people who are enrolled in the program for low-income Americans.

He talked about the need to take care of people, Portman said of the president.

The gathering included 13 GOP senators of varying ideological stripes, from the moderate Sens. Susan Collins of Maine and Lisa Murkowski of Alaska to the conservative Mike Lee of Utah and Ted Cruz of Texas. The meeting left some Republicans on Capitol Hill with the impression that Trump is siding with more moderate Republicans, particularly when it comes to winding down Obamacares Medicaid expansion, which brought insurance coverage to millions of people.

Trump has told associates that news coverage of the House health care bill was terrible, in the words of one associate who has spoken with him.

Trump threw a party in the Rose Garden celebrating the passage of the House bill and has publicly called it terrific.

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But aides and associates said he has not liked the news coverage and has shown little interest in what is in the bill but wants it to be received well.

Conservatives want to wind down the expansion quickly and curtail future Medicaid spending, while more centrist senators are trying to preserve as much coverage as possible. Republicans said Trump spent a significant portion of the meeting observing senators disagreeing over the matter.

Murkowski, who, like Portman, is from a state that expanded Medicaid, said she made it clear to the president that she is concerned about repealing the expansion.

I reinforced that I think Medicaid expansion has been very important to the state of Alaska, she said.

Sen. Pat Toomey (R-Pa.), who is arguing to constrain future Medicaid spending to a rate lower than the House bill provides, said finding the sweet spot remains a challenge.

It feels like were making a little bit of progress. Its slow, but it was always going to be a tough slog, said Toomey, who attended the meeting.

A White House official said Trump did not take a firm position on Medicaid, which is the subject of much deliberation within the Senate Republican Conference. Seema Verma, administrator of the Centers for Medicare and Medicaid Services, attended both the White House meeting and a subsequent GOP lunch on health care, playing point for the administration on the matter.

And rather than instructing senators to meet hard deadlines, Trump urged Republicans to have a more orderly process than the chaotic one in the House. Senate Majority Leader Mitch McConnell is trying to call for a vote this month, though it may slip until July due to ideological disagreements and the difficulty of drafting such a complex bill.

The president asked Republicans to set aside their vast policy differences and find consensus.

The message really was, I know you have your differences, but work through them and lets figure out a way to get it done, said Sen. John Thune (R-S.D.). We have to get a product.

He wants us to pass this bill and improve this House bill, Senate Finance Chairman Orrin Hatch of Utah told reporters.

Republican senators believe it will be at least a week before a coherent blueprint emerges for the GOP to chew over. Leaders are still going back and forth with the Congressional Budget Office to lay out options for Medicaid and tax credits and how much each option would cost.

Hatch told reporters that he doesnt think there will be a bill this week. If that prediction holds, it would be difficult for the Senate to vote on legislation before the Fourth of July recess.

McConnell refused to tell reporters when a bill might be released or how long it would be available to the public before a vote.

Well let you see the bill when we finally release it, McConnell said. Nobodys hiding the ball here.

Trump has taken a much more hands-off approach to the Senate bill than he took with the House version. Many senators expect the president to weigh in with more one-on-one or group lobbying as the GOP gets closer to moving a bill to the Senate floor.

Hell be a big help, but I think the timing is important. And hell be an important part of this, said Senate Majority Whip John Cornyn (R-Texas). We need to consult among ourselves and come up with a consensus.

Adam Cancryn contributed to this report.

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Trump knocks House health care bill as too harsh - POLITICO

Donald Trump looks to House Speaker Paul Ryan of Wis., and other House congressmen in the Rose Garden after the House pushed through a health care bill.

By Jabin Botsford/Getty images.

Last month, after weeks of browbeating and cajoling wary lawmakers, Donald Trump threw a party on the White House lawn to celebrate the passage of the American Health Care Act through the House. A brass band was on hand for the Rose Garden ceremony as dozens of Republicans lined up behind the president to take turns praising each other for crafting a bill that would slash subsidies for the sick and elderly and was estimated to cover 24 million fewer people. More than a dozen politically vulnerable congressmen in swing districts ultimately changed their votes and went out on a limb for the president, who was then eager to score a legislative win in the wake of his 100th day in office. But now, as Senate Republicans deliberate in secret as they race to hold a vote ahead of their July 4 recess, Trump appears to be having second thoughts about the G.O.P. health-care plan, which is supported by just 24 percent of voters.

In a lunch meeting with more than a dozen Republican senators at the White House on Tuesday, Trump started off with praise. I really appreciate what youre doing to come out with a bill thats going to be a phenomenal bill for the people of our country: generous, kind, with heart, he said, according to The New York Times. He then went on to suggest that the Senate should actually put additional money into the House plan, which he described as mean. CNNs Jim Acosta reported that the president went on to call the legislation cold-hearted and a son of a bitch.

While it is unclear what aspects of the repeal bill the president was specifically referring to, his private comments mark a sharp departure from his public approval last month. At the time of the health-care bills slim 217-213 passage in the House, Trump seemed blissfully unaware of what was in the bill or the potential impact it could have on his own supporters, reportedly viewing the vote primarily as the fulfillment of his campaign promise to dismantle Obamacare. But the fierce backlash to its passage, as well as the Congressional Budget Offices estimate that the G.O.P. plan would cover 24 million fewer people than current law, reportedly changed his view. Politico reports the president has told associates that the coverage of the bill was terrible and wants the Senate to pass a bill that will be better-received by the public.

Humoring the president is presumably not a top priority for Republicans, who already have their hands full. The Senate G.O.P. has been locked in back-room negotiations for weeks over the Republican bill, which they began rewriting immediately after receiving it from the House. I dont know how we get to 50 [votes] at the moment, Senate Majority Leader Mitch McConnell conceded last month. It was only in the last few days that Republican senators began putting the finishing touches on their version of the bill, which they have so far refused to make public (We arent stupid, one aide recently said, by way of explanation). And they dont appear particularly amenable to starting over just because Donald Trump, who has admitted that health-care policy is much more complicated than he originally assumed, is expressing doubts. The Times reports that senators are growing increasingly indifferent to Mr. Trumps policy interests and did not seem moved by his entreaties.

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Trump Throws His Own Health-Care Plan Under the Bus - Vanity Fair

Executive Summary

Most data-driven healthcare IT (HCIT) providers arent going to survive. Their business models are at serious risk of failure as health data becomes more widelycollected and freely shared. To beat those odds, they need to evolve dramatically, and fast, to a point where they are not selling data but providing insight. There are two common ways to provide insight: one is to focus on specific use cases, and the other is to focus on particular patient populations.The marketplace is rapidly moving in this direction. For example, Proteus Digital Health is engaging with health systems to provide insights into health patterns and treatment effectiveness for patients with uncontrolled hypertension and diabetes.The late economist and marketing professor Theodore Levitt famously said People dont want to buy a quarter-inch drill, they want a quarter-inch hole. In health care, providers dont want data, they want solutions that lower costs and improve outcomes. HCIT firms that deliver those solutions are the ones that will be around in five years time.

Most data-driven healthcare IT (HCIT) providers arent going to survive. Their business models are at serious risk of failure in the next three to five years. To beat those odds, they need to evolve dramatically, and fast, to a point where they are not selling data at all.

Like any number of industries, healthcare is being transformed by the explosion of low-cost data. In healthcare, the transformation is driven in large part by electronic medical record adoption and digitization. There have been many benefits. End users can take advantage of quantities of newly available information to solve problems in population health, clinical decision support, and patient engagement, among other applications. And ease of access means ease of market entry: Emerging data providers can get on their feet quickly and create new sources of competition. For example, AiCure and Propeller Health are using very different methods to generate patient medication adherence data. Competition leads to better offerings and more choice. What could go wrong?

Plenty, actually. End users can be overwhelmed by the flood of raw data and reports that may not fit well with their existing workflow or answer their specific question. And for data providers, ubiquitous availability of information and low barriers to entry means that the competitive advantage gained from the data itself can be quickly eroded.

Yet too many HCIT providers are still pursuing that data-centric advantage. The bulk of HCIT investment supports startups that sell data clinical or operational information that is otherwise difficult for clients to obtain or to organize. These firms regard data as the source of business value. But as more data and more data providers flood the market, a competitive position based solely on data becomes impossible to defend. Consider the move by the Centers for Medicare and Medicaid Services to publish extensive Medicare enrollment and utilization data, and to make it accessible and easy to interpret via the CMS website. Information that would once have been proprietary and premium-priced is now widely available, for free. CMSs move illustrates a broad trend. Increasingly, for most HCIT firms, data is a commodity.

Whats a data provider to do?

One solution is to become the authoritative source for a particular kind of information. Some firms have managed it, in healthcare and in other arenas think of QuintilesIMS as a source of pharmaceutical sales data, Nielsen as the authority on TV viewer habits, and the U.S. Census for information about U.S. demographics. In theory, a healthcare IT provider can follow their lead and try to corner the market on a data set. But to do this in todays landscape is a tall order. The same dynamics weve described widespread access, low costs, low barriers to entry, commoditization of data sets mean its an open question whether this strategy can work.

A better option is to evolve from providing data to providing insight.

Companies moving this direction aim to solve problems within a use case, for example, decision support. They might focus on a specific population such as cancer, diabetes, or Alzheimers patients and a specific insight about disease progression, pain management or treatment options. They address an underlying stakeholder need such as managing the total cost of care. Clients get whats really needed raw data transformed to support better decisions. And HCIT providers escape the commodity trap.

The marketplace is rapidly moving in this direction. IBM established its Watson Health business unit to apply cognitive computing analyses to healthcare and in 2016 announced plans to acquire Truven Health Analytics for $2.6 billion. IBM plans to leverage Truvens vast data collection sourced from more than 8,500 insurers, hospitals and government agencies to support specific use cases, using Watsons analytical capabilities. For example, some Watson Health initiatives focus on improving oncology diagnostics and identifying the most effective treatment protocols for specific cancer patient subgroups.

Another solution provider, Proteus Digital Health, is engaging with health systems to provide insights into actual medication use and resulting health patterns. Understanding treatment effectiveness for at-risk patients in particular for patients with uncontrolled hypertension and diabetes is a priority for many health plans. Proteus analytics support patient and family engagement and care-team coaching to drive clinical improvement. Other data analytics services based on accurate medication-intake information, in combination with physiological measures, also promise to improve clinical decision-making, reduce doctors workload, and improve outcomes.

The transformation from data provider to data analytics services is hard. It requires significant changes in business models, staffing and management approach. But we believe its the only option. The late economist and marketing professor Theodore Levitt famously said People dont want to buy a quarter-inch drill, they want a quarter-inch hole. In health care, providers dont want data, they want solutions that lower costs and improve outcomes. HCIT firms that deliver those solutions are the ones that will be around in five years time.

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To Survive, Health Care Data Providers Need to Stop Selling Data - Harvard Business Review

Forbes

How About This Health Care Act That Both Democrats And Republicans Support Forbes Think Democrats and Republicans can't agree on anything healthcare related? Well, here's something that has a good amount of bipartisan support in Congress: the ''Personal Health Investment Today Act'', otherwise known as the ''PHIT Act.'' You know ...

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How About This Health Care Act That Both Democrats And Republicans Support - Forbes