"Simply put, if there’s a chance you might get sick, get old, or start a family—this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation." 

— Former President Barack Obama

“We don’t have the courage in Washington, the honesty, to talk about this issue with real facts. There’s no way we should be voting on [the bill] this next week, no way."

—Senator Ron Johnson (R-WI)

• Senate Health Bill Would Revamp Medicaid, Alter ACA Guarantees, Cut Premium Support Kaiser Health News by Julie Rovner— Republicans in the U.S. Senate on Thursday unveiled a bill that would dramatically transform the nation's Medicaid program, make significant changes to the federal health law's tax credits that help lower-income people buy insurance and allow states to water down changes to some of the law's coverage guarantees. The bill also repeals the tax mechanism that funded the Affordable Care Act's benefits, resulting in hundreds of billions of dollars in tax cuts for the wealthy and health care industry. 
  
  
• Senate Leaders Try to Appease Members as Support for Health Bill Slips New York Times by Robert Pear and Thomas Kaplan—Senate Republican leaders scrambled Sunday to rally support for their health care bill as opposition continued to build inside and outside Congress, and as several Republican senators questioned whether it would be approved this week. President Trump expressed confidence that the bill to repeal the guts of the Affordable Care Act would pass.
  
  
• Senate Health Care Bill Faces Serious Resistance from GOP Moderates Washington Post by by Juliet Eilperin and Amy Goldstein—A small group of moderate Republican senators, worried that their leaders' health-care bill could damage the nation’s social safety net, may pose at least as significant an obstacle to the measure’s passage as their colleagues on the right. The vast changes the legislation would make to Medicaid, the country’s broadest source of public health insurance, would represent the largest single step the government has ever taken toward conservatives’ long-held goal of reining in federal spending on health-care entitlement programs in favor of a free-market system.
  
  
• Health Care Groups Issue Scathing Criticism Of Senate Bill The Hill by Rachel Roubein and Jessie Hellmann—Leading health care advocacy groups are urging the Senate to make substantial changes to its healthcare plan released Thursday, warning it could have negative consequences for people across the country. The proposal includes deep cuts to Medicaid and fundamentally reshapes the program from an open-ended government commitment to a system of capped federal payments that limit spending. 

• GOP Medicaid Cuts Would Hit States Fighting Opioid Epidemic  Associated Press by Ricardo Alonso-Zaldivar—The Republican drive to roll back Barack Obama's health care law is on a collision course with a national opioid epidemic that's not letting up. Medicaid cuts resulting from the GOP legislation would hit hard in states deeply affected by the addiction crisis and struggling to turn the corner, according to state data and concerned lawmakers in both parties. The House health care bill would phase out expanded Medicaid, which allows states to provide federally backed insurance to low-income adults previously not eligible. Many people in that demographic are in their 20s and 30s and dealing with opioid addiction. Dollars from Washington have allowed states to boost their response to the crisis, paying for medication, counseling, therapy and other services.

• Trump Administration Pays June Obamacare Subsidies to Insurers The Hill by Jessie Hellmann—The Trump administration has made critical Obamacare subsidy payments to insurers for the month of June but won't provide any certainty about whether they'll continue in the future. The payments, known as cost-sharing reductions, reimburse insurers for providing discounts to low-income customers.  Insurers have been threatening to raise premiums—or leave the Obamacare markets—if they don't receive certainty about the payments from Congress or the White House. But the Trump administration continues to say they have not made a decision about future payments.
  
  
• Insurers Make Obamacare Deadline Decisions but Can Still Drop Out USA Today by Jayne O'Donnell, Holly Fletcher, and Frank Gluck—The Trump administration has refused to commit to reimburse insurers for the subsidies about 7 million consumers get to defray the costs of deductibles and other cost-sharing. It is also not clear that it will enforce the ACA-mandated tax penalty for those who don't have health insurance.  Without that assurance, insurers fear they won't get enough healthy people to sign up to offset the cost of insuring the sick. Actuaries at the health consulting firm Oliver Wyman estimated last week that two-thirds of the rate increases in 2018 are due to this uncertainty, while ACA supporters including Charles Gaba of ACASignups.net say it's a major reason for the insurer exits. Hilferty says Democrats share some of the blame.
  
  
• Government Health Insurance Markets Holding Up—Barely Associated Press by Tom Murphy—Enough insurers are planning to sell coverage on the Affordable Care Act's insurance exchanges next year to keep them working—if only barely— in most parts of the country. Competition in many markets has dwindled to one insurer—or none in some cases—and another round of steep price hikes is expected to squeeze consumers who don't receive big income-based tax credits to help pay their bill. "What we're seeing is a deterioration in these markets, but the markets haven't imploded, they haven't gone into a rapid downward decline," said Dan Mendelson, president of the consulting firm Avalere.

• Hospitalization Rate for Opioid Abuse Doubled in 10 Years, Report Says Los Angeles Times by Deborah Netburn and Karen Kaplan—The opioid epidemic continues to devastate Americans, and a new report shows that it has only gotten worse in recent years. In 2014, abuse of prescription painkillers such as OxyContin and street drugs such as heroin sent users to hospitals at record rates. That is true in emergency rooms, and even more true in rooms for patients who have been admitted to the hospital. The report, released Tuesday by the federal Agency for Healthcare Research and Quality, reveals that the rate of emergency room visits resulting from problems with opioids roughly doubled over a decade. Inpatient stays also grew, by 64 percent.

Editor: Peter Van Vranken