“Despite repeated attempts by the Trump administration and the Republican Congress to sabotage the Affordable Care Act, it remains the law of the land. We’ve moved to intervene today to protect critical federal payments that support health care in our states. In Massachusetts, we believe that everyone should have access to health care, and we will use our state authority to defend the law and our values.”

—Massachusetts Attorney General Maura Healey

• Progress Reducing U.S. Uninsured Rate Comes to a Halt AP by Ricardo Alonso-Zaldivar—Five years of progress reducing the number of Americans without health insurance has come to a halt, according to a government report out Tuesday. More than a factoid, it shows the stakes in the Republican drive to roll back the Affordable Care Act (ACA). The report from the Centers for Disease Control and Prevention estimates that 28.6 million people were uninsured in 2016, unchanged from 2015. It was the first year since passage of the health care overhaul in 2010 that the number of uninsured did not budge. Now, the number of uninsured could start climbing again under policies being considered by President Donald Trump and congressional Republicans.
  
  
• 15 States Sue in Bid to Preserve Key Aspect of Federal Health Law Boston Globe by Felice Freyer—Attorney General Maura Healey has joined 15 other attorneys general in a bid to preserve a crucial component of the ACA—the subsidies that help people cover their copays and deductibles. In a suit filed Thursday, the attorneys general are asking for a role in ongoing litigation over those subsidies, known as cost sharing reductions.

• House May Need to Vote Again on GOP Obamacare Repeal Bill Bloomberg by Billy House—House Republicans barely managed to pass their Obamacare repeal bill earlier this month, and they now face the possibility of having to vote again on their controversial health measure. House Speaker Paul Ryan hasn't yet sent the bill to the Senate because there's a chance that parts of it may need to be redone, depending on how the Congressional Budget Office estimates its effects. House leaders want to make sure the bill conforms with Senate rules for reconciliation, a mechanism that allows Senate Republicans to pass the bill with a simple majority. 
  
  
• Senators Hold Back-Channel Talks on Bipartisan Obamacare Fix Politico by Burgess Everett and Elana Schor—As Republicans try to repeal Obamacare on party lines, there are flickers of bipartisanship in the Senate—and they could become a lifeline if the GOP's party-line efforts collapse and lawmakers come under pressure later this year to respond to crippled insurance markets and rising premiums. Any cooperation on health care undercuts both parties' political strategy. Republican leaders are wary of handing any bipartisan accomplishments to the dozen or so vulnerable Senate Democrats up for reelection next year. And Democratic leaders want the GOP to fully own the beleaguered health care system going into the midterms. 
  
  
• Health Care Lobbyists Wait to See If Senate More Pliable Than House on ACA Repeal Modern Healthcare by Harris Meyer—Health care industry groups are guardedly hopeful they will have more influence on the Senate's health care overhaul bill than they had on the House bill passed earlier this month. That's not saying much, given how House Republicans shut them out. And it's far from a sure thing, because Senate GOP leaders hope to push through their legislation rapidly to clear the way for passing a major tax overhaul in late summer or fall.
  
  
• Obamacare Replacement Threatens Kids' Health Coverage USA Today by Jayne O'Donnell and Ken Alltucker—The nearly $1 trillion in federal cuts to the Medicaid program approved by House Republicans threaten the record success getting these children covered by insurance and on a path to healthier lives, health experts warn. Their angst is magnified by the Sept. 30 deadline for CHIP reauthorization, which some worry will be used as a bargaining tool to get the House-passed American Health Care Act (AHCA) through the Senate. With cuts anywhere near that size, "there's absolutely no way kids can stay out of harm's way," says Joan Alker, executive director of the Georgetown University Center on Children and Families.

• Medicaid Expansion, Reversed by House, Is Back on Table in Senate New York Times by Robert Pear—Senate negotiators, meeting stiff resistance to the House's plans to sharply reduce the scope and reach of Medicaid, are discussing a compromise that would maintain the program's expansion under the Affordable Care Act but subject that larger version of Medicaid to new spending limits. With 62 senators, including 20 Republicans, coming from states that have expanded Medicaid under the Affordable Care Act, the House's American Health Care Act almost certainly cannot pass the Senate. 
  
  
• Six States Hoping to Revamp Medicaid in the Trump Era Governing by Mattie Quinn—To customize their Medicaid programs, states have been able to ask the federal government for waivers for decades. The Obama administration rejected many waivers, concluding that they were unconstitutional or would drastically limit poor people's ability to afford health insurance. For example, many states sought to make employment a requirement for Medicaid, but the Obama administration declined every such request. With Donald Trump in the White House and Tom Price leading the Health and Human Services (HHS) Department, conservative states will likely see their long-denied wishes come true. Both officials support giving states more flexibility than the Obama administration, and a final bill to replace the ACA would likely increase states' power as well. So in the early days of the Trump administration, some governors enthusiastically submitted waivers.
  
  
• Medicaid is Helping Poor Patients Get Needed Care, Even as Republicans Push to Cut it, Study Finds Los Angeles Times by Noam Levey—As the Trump administration and congressional Republicans push for sweeping cuts to the Medicaid safety net, a study released Wednesday provides new evidence the program is significantly improving poor Americans' access to vital medical care. Low-income patients in Arkansas and Kentucky, two states that expanded Medicaid under the Affordable Care Act, are getting check-ups more regularly and delaying care because of cost less frequently. Perhaps most encouraging, poor patients with chronic illnesses such diabetes are also seeking more regular care for their disease, according to the study, published in the journal Health Affairs.

• Health Insurers Plan Big Obamacare Rate Hikes—And They Blame Trump Los Angeles Times by Noam Levey—Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration's erratic management, inconsistent guidance and seeming lack of understanding of basic health care issues. At the same time, state insurance regulators—both Democrat and Republican—have increasingly concluded they cannot count on the Trump administration to help them ensure that consumers will have access to a health plan next year. 
  
  
• Health Care IPOs Weighed Down by Obamacare Uncertainty MarketWatch by Caitlin Huston—The number of health care initial public offerings are at their lowest level since 2012, which experts attribute, in part, to the uncertain nature of health care under the Trump administration.  Kathy Smith, principal at Renaissance Capital, which invests in IPOs, said part of the reason for the decline comes down to perceived risk in the space. "Interest in health care IPOs has declined since then due to uncertainties surrounding the possibility of regulating pharma prices and the repeal of the [Affordable Care Act] ," Smith said.
  
  
• A Whistle-Blower Tells of Health Insurers Bilking Medicare New York Times by Mary Williams Walsh—When Medicare was facing an impossible $13 trillion funding gap, Congress opted for a bold fix: It handed over part of the program to insurance companies, expecting them to provide better care at a lower cost. The new program was named Medicare Advantage. Nearly 15 years later, a third of all Americans who receive some form of Medicare have chosen the insurer-provided version, which, by most accounts, has been a success. But now a whistle-blower, a former well-placed official at UnitedHealth Group, asserts that the big insurance companies have been systematically bilking Medicare Advantage for years, reaping billions of taxpayer dollars from the program by gaming the payment system. 

• 800,000 Docs Get a Pass on MACRA Requirement Modern Healthcare by Virgil Dickson—More than 800,000 clinicians will not have to comply with Merit-based Incentive Payment System reporting requirements outlined in the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, which may save them millions collectively in compliance costs.  The majority of physician practices were expected to use the Merit-based Incentive Payment System, known as MIPS, to comply with MACRA as opposed to alternative pay models. Under MIPS, payments would be based on a compilation of quality measures and use of electronic health records.  

• The Painful Truth About Teeth Washington Post by Mary Jordan and Kevin Sullivan—As the distance between rich and poor grows in the United States, few consequences are so overlooked as the humiliating divide in dental care. High-end cosmetic dentistry is soaring, and better-off Americans spend well over $1 billion each year just to make their teeth a few shades whiter. Millions of others rely on charity clinics and hospital emergency rooms to treat painful and neglected teeth. Unable to afford expensive root canals and crowns, many simply have them pulled. Nearly 1 in 5 Americans older than 65 do not have a single real tooth left. 

Editor: Peter Van Vranken