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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Mental health report does not paint rosy picture, as governor claims
Mental Health America recently issued its State of Mental Health Care in America report, based on data from 2014. The governor’s office widely distributed a press release, stating that Iowa’s overall ranking had moved from 13th to 7th in the nation with respect to a combination of 15 measures. The premise is that states with higher rankings have lower prevalence rates and higher rates of access. However, the report is based on data obtained between 2011 and 2014 and, therefore, does not take into account Iowa’s transition to a privatized managed care system. How will Iowa rate once 2016 data is taken into account? (Des Moines Register)

DMACC and Iowa Wesleyan University enter innovative nursing partnership
Des Moines Area Community College (DMACC) and Iowa Wesleyan University signed an innovative agreement resulting in the first-ever bachelors of science in nursing (BSN) completion program in the state of Iowa. This partnership enhances health care across Iowa and advanced health care education. As a result of this agreement, DMACC nursing graduates will be able to complete their BSN degrees in one year online, allowing them to stay in central Iowa and work. Also, there are financial aid opportunities through the Iowa Tuition Grant program. (DMACC)

Trump tags consultant who helped Iowa privatize Medicaid
A national consultant who helped the state of Iowa make the controversial shift to private Medicaid management is Donald Trump’s choice to run the federal government’s giant health insurance programs. Seema Verma leads an Indianapolis consulting firm that works with state governments on health care programs. Trump announced Monday that he would nominate her to lead the Centers for Medicare & Medicaid Services. Iowa’s Department of Human Services has twice hired Verma’s firm, SVC Inc., to help the state redesign its Medicaid program. (Des Moines Register)

Meet the nuns bringing prayers, smiles to Mercy patients
Nuns started working at Mercy Medical Center back in 1893, but they haven’t walked the halls there for 25 years until now. Sister Rose Hellen works as a patient care tech on the oncology floor at Mercy Medical Center. She is one of four nuns from a congregation in Kenya who traveled all the way to Des Moines to work at the bedside of some of the sickest Iowans. “When we are caring for the sick, we are fulfilled and we feel happy,” Hellen said. Nuns have been a part of Mercy since they started the hospital more than 120 years ago, but this is the first time in 25 years they are serving patients at the hospital. (KCCI)

National News

After decades of rivalry, Charlotte hospitals partner to help the poor
Chief executives of Charlotte’s two competing health systems – Carolinas HealthCare System and Novant Health – have launched a first-of-its-kind partnership that appears to signal a new era after decades of sometimes bitter rivalry. The hospital CEOs have met several times to talk about ways their systems can collaborate to improve access to health care for under-served communities in Charlotte. They invited leaders from more than 40 businesses, religious and educational institutions, local government agencies and nonprofits to meet Monday night to discuss ways to improve the health of Charlotte’s communities. (Charlotte Observer)

GE, Children’s Hospital form medical software venture
Boston Children’s Hospital is teaming up with General Electric Co. (GE) to produce software that will help doctors more accurately interpret brain scans of young patients. Under a deal set to be announced Monday, Children’s and Boston-based GE’s health care division will develop the system over the next 18 months, then market it to hospitals around the world. The effort is part of GE’s Health Cloud, which is launching this week and is expected, over the next three to five years, to house hundreds of different “apps” that doctors can use to sort through medical data. (Boston Globe)

Legislation to improve mental health care for millions faces congressional vote
Efforts to strengthen the country’s tattered mental health system, and help millions of Americans suffering from mental illness, are getting a big boost this week, thanks to a massive health care package moving through Congress. Key provisions from a mental health bill approved last summer by the House of Representatives have been folded into the $6.3 billion 21st Century Cures Act, which aims to speed up drug development and increase medical research. The legislation also aims to make mental health a national priority and coordinate how mental health care is delivered. (Kaiser Health News)

CMS’ star ratings for hospitals linked to social, economic factors
The Centers for Medicare & Medicaid Services (CMS’) hospital quality star ratings have been strongly criticized by industry stakeholders and Congress as unfairly tarnishing the reputations of hospitals in low-income communities. A new study reinforces the concerns, concluding that a hospital’s rating is heavily influenced by its location’s socio-economic conditions. Hospitals with relatively low star ratings from the CMS were located in cities with high “stress” levels, according to the study, published Monday in JAMA. The stress levels of cities were determined using an analysis that measured socio-economic conditions like unemployment and poverty rates in 150 cities across the country. (Modern Healthcare)

Paul Ryan’s plan to change Medicare looks a lot like Obamacare
President-elect Donald Trump and House Speaker Paul Ryan agree that repealing the Affordable Care Act (ACA) and replacing it with some other health insurance system is a top priority. But they disagree on whether overhauling Medicare should be part of that plan. Medicare is the government-run health system for people aged 65 and older and the disabled. Trump said little about Medicare during his campaign, other than to promise that he wouldn’t cut it. Ryan, on the other hand, has Medicare in his sights. The irony of the Ryan Medicare plan is that it would turn the government program into something that looks very much like the structure created for insurance plans sold under the ACA. (NPR)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Psych hospital firm to forego next state meeting
It will be at least another six months before a Tennessee company that has been trying to build a psychiatric hospital in the Iowa Quad-Cities will go before a state board for approval. Jim Shaheen, president of Strategic Behavioral Health LLC, of Memphis, confirmed Monday that the company will not seek the approval of Iowa’s State Health Facilities Council at the panel’s February meeting. Strategic has been trying for more than a year to build a 72-bed psychiatric hospital in the Quad-Cities. The company has failed to get a certificate of need from the state, a requirement before new health care facilities can be built. (Quad-City Times)

GRMC announces plans for unique partnership with UnityPoint and University of Iowa
Grinnell Regional Medical Center (GRMC), UnityPoint Health Des Moines and University of Iowa (UI) Health Care have begun exclusive negotiations about forming a new relationship. While details of the proposed relationship remain to be determined, the vision for Grinnell is clear. The goal is to bring the best of UnityPoint Health Des Moines and UI Health Care to Grinnell to enhance the care that is offered to the Grinnell community. Examples include enhancing specialty services, telemedicine, research, and educational opportunities, as well as introducing insurance products and direct-to-employer programs. (Tama News Herald-Toledo Chronicle)

UI receives $45 Million to support Iowa Neuroscience Institute
The Roy J. Carver Charitable Trust has committed a transformational $45 million grant to the University of Iowa that will allow for the creation of a comprehensive and cross-disciplinary neuroscience center within the University of Iowa (UI) Roy J. and Lucille A. Carver College of Medicine. The new Iowa Neuroscience Institute will conduct research to find the causes of, and preventions, treatments and cures for, the many diseases that affect the brain and nervous system. This gift from the Carver Charitable Trust also is the largest in the UI’s For Iowa. Forever More. fundraising campaign, which started in 2008 and continues through December 2016. (University of Iowa Foundation)

Mercy donates AED’s to area schools, organizations 
Mercy Medical Center, Cedar Rapids, is donating Automated External Defibrillators (AEDs) to 12 area schools, churches and community organizations in December. The AEDs will be placed in readily-accessible locations at the schools and organizations, to be used in case of an emergency. The AED donation program at Mercy is designed to equip local non-profits demonstrating financial need with the life-saving devices.  The non-profits must also exhibit a need for AED coverage for their facility and participate in an application process. (Corridor Business Journal)

National News

What happens in New Jersey if Trump kills Medicaid expansion?
If President-elect Donald Trump and the Republican Congress carry out their promise to repeal the Affordable Care Act, the loss of federal Medicaid funding could mean a loss of health coverage for more than 500,000 New Jersey residents. Hospitals already accepted reduced reimbursement for Medicare as part of the grand bargain that led to enactment of the health care law. They did so expecting to see fewer uninsured patients, as Medicaid covered more people. If funding to expand Medicaid is cut, they will take a double financial hit, said Neil Eicher, a vice president of the New Jersey Hospital Association. (Newark Star-Ledger)

Alabama Medicaid change to managed care postponed till October
Alabama Governor Robert Bentley says Medicaid’s shift to managed care will be pushed back from July to October amid uncertainty about funding and what changes the Trump administration might bring to Medicaid. The governor said he is committed to moving forward with the switch to managed care, but said there are a few unknowns, including funding for next fiscal year and if the Trump administration will give states block grants allowing more flexibility to write the rules for their programs. Alabama since 2013 has been working on a plan to shift some of the state’s 1 million Medicaid patients to managed care. (Associated Press/AL.com)

North Carolina legislators face full agenda with public health, Medicaid updates
Two joint legislative oversight committees on health care in North Carolina will receive this week an update on how the state’s Medicaid program is performing, along with progress reports on two high-profile behavioral health initiatives. The morning session covering Health and Human Services will focus on how the state is doing in diverting individuals having a behavioral health crisis from a hospital emergency department to other care settings. The afternoon session will review a waiver request with an end goal of Medicaid oversight being placed in the hands of three statewide managed care organizations. (Winston-Salem Journal)

Rural health care access at risk
Health care remains an issue of debate across the country. However, when it comes to rural health care, the issue is complicated further by geography and a lack of providers, resulting in a loss of competition and ultimately costly burdens being placed on patients. There are a number of medical issues that affect rural communities at a greater rate than their urban counterparts. The majority of those living in rural regions receive their health care coverage through private payers or public programs like Medicaid, with many using a combination of both to bridge the gaps in care. Yet rural communities are now faced with a push by insurance companies to limit prescription drug coverage. (The Hill)

Tom Price tapped as HHS head
President-elect Donald Trump has selected Georgia Representative Tom Price, a leading critic of President Barack Obama’s sweeping health care law, to head the Department of Health and Human Services (HHS). A key Senate Democrat immediately criticized the choice. If confirmed by the Senate, Price would play a central role in Republican efforts to repeal and replace the current health care law. Trump has pledged to move quickly on overhauling the landmark measure, but has been vague about what he hopes to see in a replacement bill. Also, Seema Verma was picked to become administrator of the Centers for Medicare & Medicaid Services. (Associated Press/U.S. News & World Report)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

New UnityPoint building serves patients where they live
UnityPoint-Pinnacle Prairie, UnityPoint Health’s latest move — and part of a trend in the health care industry — will bring health care to people where they live. It’s 90,000 square feet, or 30,000 per floor over three floors. The building was scheduled to open in December and a grand opening celebration is anticipated for January. “There’s a number of specialty offices and urgent care, primary care,” UnityPoint CEO Pam Delagardelle said. “It’s all clinic based and ancillary based, but it’s not hospital-based services. It’s really a health and wellness campus. We’re really set up to deliver care to keep people healthy.” (Waterloo-Cedar Falls Courier)

Obstetric unit to come to Marengo hospital
A unanimous vote was collected after hearing the Marengo Memorial Hospital’s (MMH) presentation before the State Health Facilities Council on Tuesday October 11, to propose converting two medical/surgical beds to add a two-bed obstetrics unit. The application included a written analysis that would help provide obstetric services for women with low risk pregnancies in and around the surrounding communities of Marengo. The formal letter for approval was received last week. According to MMH, the closest location for delivery is approximately 32 miles from Marengo, requiring women to travel more than 60 miles roundtrip for their numerous prenatal visits and to deliver their babies. (Iowa City Press-Citizen)

Sioux City hospitals delivered $42M in benefits
The two hospital systems based in Sioux City contributed a total of $41.6 million in community benefits in 2015, according to a new report. UnityPoint Health – St. Luke’s provided nearly $15.6 million in benefits and Mercy Medical Center—Sioux City provided another $26 million in benefits in Siouxland, according to a recently completed assessment of those programs and services by the Iowa Hospital Association. Mercy provided $6.2 million in uncompensated care and St. Luke’s provided $4.5 million in uncompensated care. (Sioux City Journal)

GOP’s state trifecta has its own challenges
It’s a Republican reunion, 20 years in the making. In 2017 and 2018, at the least, the Iowa Capitol will be ruled by Republicans. After the November 8 elections, the GOP took control of the state government trifecta — majorities in the Iowa House and Iowa Senate and a Republican in the governor’s office. Republicans who were on the legislative front lines 20 years ago say there is much professional joy in being able to advance a policy agenda without political opposition, but that intraparty challenges remain. “You can get some good things done, but it’s not all roses and sunshine,” said Brent Siegrist, the House majority leader then. (Cedar Rapids Gazette)

National News

Small-town hospital closings leave rural Texans far from medical care
Since 2013, 15 rural hospitals — located in counties with no more than 60,000 residents — have closed across Texas. Rural hospitals face many challenges, including competition for doctors from larger cities and ever-increasing student debt for doctors coming out of medical school. There’s also uncertainty about another round of government reimbursement cuts. If Texas legislators cut Medicaid payments in the upcoming session as they did in 2011, more rural hospitals could fail. At a September 13 hearing of the state’s Senate Committee on Health and Human Services, legislators discussed the future of rural health care. (Fort Worth Star Telegram)

Nevada’s rural residents face fraying safety net
The dearth of hospitals is just one of the issues threatening the well-being of the roughly 300,000 Nevadans who live in small towns and rural communities. A shortage of medical professionals, an increasingly strained emergency care network and escalating costs of health care are threatening to turn them into health care “have-nots” who pay a steep price for their rural lifestyle. Across the nation, residents of rural areas are experiencing health-outcome disparities, including “higher incidence of disease and disability, increased mortality rates, lower life expectancies and higher rates of pain and suffering,” according to the Rural Health Information Hub. (Raleigh News & Observer)

Republican states that expanded Medicaid want it kept
Former Arizona Governor Jan Brewer fought her own Republican party in the state Legislature for months to push through a Medicaid expansion under the Affordable Care Act. Arizona is one of 31 states that expanded Medicaid, many of them run by Democrats. Republicans have blocked expansion in the remaining 19 states. Among the GOP-led states that expanded Medicaid, many officials are strong proponents of the program that has brought insurance to about 9 million low-income Americans who can’t possibly afford to buy it themselves. States that strongly oppose Medicaid expansion, however, continue to do so. (Associated Press/Washington Post)

Managed care plans increasingly taking over Medicaid long-term care
States are increasingly turning to private firms to provide managed long-term supports and services (MLTSS). Their goal is to rein in costs and increase budget predictability. Officials say it enables delivery of more coordinated care and prevents sending people to expensive nursing home settings. But some advocates are claiming that they are seeing care suffer under the model. Until recently most state Medicaid programs have excluded people with disabilities from managed care because of their complex needs. Twenty states now have shifted their MLTSS program to private managed care companies. (Modern Healthcare)

A frenzy of lobbying on 21st Century Cures Act
The 21st Century Cures Act set for a House vote Wednesday is one of the most-lobbied health care bills in recent history, with nearly three lobbyists working for its passage or defeat for every member on Capitol Hill. More than 1,455 lobbyists representing 400 companies, universities and other organizations pushed for or against an earlier House version of a Cures bill this congressional cycle, according to federal disclosure forms compiled by the Center for Responsive Politics. A compromise version was released over the holiday weekend. (Kaiser Health News)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

DHS claims Medicaid privatization will save $118 Million
Chuck Palmer, director of the state Department of Human Services (DHS), said Tuesday his agency projects the state’s savings from switching its Medicaid system to privately managed care will be $118.7 million for the current fiscal year. DHS director told Governor Terry Branstad the savings are one way his agency is helping to meet the governor’s goal of reducing the size and cost of state government. According to DHS calculations, the state would have spent over $1.716 billion in fiscal 2016 had it not switched to Medicaid “modernization” versus the nearly $1.694 billion in state medical assistance expenditures. (Mason City Globe Gazette)

Too soon to tell what would happen in Iowa with health care law repeal, state officials say
How would Iowans who have purchased health insurance through state or federal programs be impacted if Republican lawmakers and President-elect Donald Trump fulfill their campaign promise to repeal the federal health care law known as the Affordable Care Act, or Obamacare? It is too soon to know, top state officials say. Roughly 145,000 Iowans participate in the Iowa Health and Wellness Plan, according to the state, and 55,000 Iowans purchased health insurance through the federal health care program, according to federal statistics. (Cedar Rapids Gazette)

Iowa insurance commissioner outlines potential effects of repealing Obamacare
One of the first things Donald Trump says he’ll do as president is repeal the Affordable Care Act. That’s made a lot of people nervous about what might come next, including some Republicans who aren’t keen on Obamacare. Iowa Insurance Commissioner Nick Gerhart is one of them. In an interview with NPR, Gerhart talks about the potential effects of repealing the ACA would have for Iowans and people across the country. (NPR)

A sweet Homecoming for Le Mars Nurse
After more than 20 years away from her hometown, a familiar face has returned to the halls of Floyd Valley Healthcare (FVH). Lorrie Mortensen, RN, BS, MSN, MBA, has returned to FVH as the Director of Patient Care. In her position, she will be in a senior management position overseeing the nursing care services at FVH. Her first position was with Floyd Valley Hospital from 1978-1983 as a staff nurse. She then spent three years with Medical Associates as a clinic nurse and returned to Floyd Valley from 1986-1995 as a nursing supervisor. “Home is a great place to be,” Mortensen said about returning to FVH. (Le Mars Daily Sentinel)

National News

In depressed rural Kentucky, worries grow over Medicaid
Kentucky’s enrollment has doubled since late 2013 when Medicaid was expanded. Kentucky’s achievement owed much to the success of its state-run health insurance exchange, Kynect, in promoting new coverage options under the health law. Kynect was launched under Governor Matt Bevin’s Democratic predecessor, Steve Beshear, and dismantled by Bevin this year. Bevin has threatened to roll back the expansion if the Obama administration doesn’t allow him to make major changes. Those would force Kentucky’s beneficiaries to pay monthly premiums of $1 to $37.50 and require non-disabled recipients to work or do community service for free dental and vision care. (Kaiser Health News)

KanCare renewal efforts slow in anticipation of federal changes
Anticipating significant changes in federal health care policy, Kansas officials are slowing their timeline for renewing KanCare, the state’s privatized Medicaid program. Given the lack of clarity at the federal level, Mike Randol, director of the Division of Health Care Finance in the Kansas Department of Health and Environment, told members of the Legislature’s KanCare oversight committee on Friday that the agency intends to slow the KanCare renewal process. A request for proposals that had been scheduled to go to managed care companies before the end of the year is being delayed indefinitely, he said. (Kansas Health Institute)

California braces for Medi-Cal’s future under Trump and the GOP
California grabbed the first opportunity to expand Medicaid and ran with it, helping cut the number of uninsured people in half in a few short years. Thanks in part to billions of dollars in federal funding, a third of California’s residents — including half its children — are insured by Medi-Cal, the state’s version of Medicaid. Now, with the election of Donald Trump and a Republican-controlled Congress, the state that bet so heavily on the Medicaid expansion is bracing to see how much of its work will be undone. While no one knows yet exactly what will happen, many policymakers and advocates fear the federal government will end or severely limit funding for the expansion. (Kaiser Health News)

Trump’s win puts Medicaid expansion on hold in red states
Several states led by Republican governors appear to be putting Medicaid expansion under the Affordable Care Act on hold given talk by the incoming administration of Donald Trump to scrap the law or move to federal block grants to cover poor Americans. State elected officials in Idaho, Nebraska and South Dakota and political pundits in Georgia are saying talk of expanding Medicaid before the election has now subsided at least for the 2017 legislative sessions. That means more than 500,000 Americans will have to wait for health benefits. (Forbes)

Giving patients an active role in their health care
As payment and care delivery models shift in the US from episodic, fee-for-service care toward population health and value-based reimbursement, health care leaders are focused more than ever on patient engagement as a key to driving down costs and improving outcomes. What’s needed is a fundamental redesign of the patient’s role — from that of a passive recipient of care to an active participant charged with defined responsibilities, equipped to dispatch them and accountable for the results. In other words, to view the patient’s role as a job and then design that job in such a way as to drive the best health outcomes possible. (Harvard Business Review)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Branstad says Medicaid expansion ‘remains to be seen’
Iowa’s governor expects the Republican-led congress and President-elect Donald Trump to quickly repeal the Affordable Care Act and Governor Terry Branstad today said it’s unclear what may happen to the 145,000 low-income Iowans who now are covered by Medicaid because of the law. “That remains to be seen,” Branstad said. “I think we’ve got to see how that works.” However, Branstad says those 145,000 Iowans who are on Medicaid due to “ObamaCare” are unlikely to completely lose coverage. Branstad suggested “more flexibility” for how states run the Medicaid program can yield cost savings. (Radio Iowa)

Branstad doesn’t plan to close more state facilities
Governor Terry Branstad said Monday that he does not intend to shutter more state mental hospitals or other state institutions next year. “At this point, we’re just beginning the budgeting process, but there is no plan at this point to close additional facilities,” he told reporters. “We’re always looking for ways we can have a smaller and smarter government,” he added, but his emphasis is likely to be on such things as cutting regulations and outdated programs instead of closing more facilities. The Republican governor sparked controversy in 2015, when he ordered the closures of two of the state’s four mental hospitals. (Des Moines Register)

New Solution Emerging to Ease Mental Health Treatment Problems in Iowa
The prison system has been forced into becoming mental health facilities because in many cases, mental health services are lacking on the outside. Doctors at Broadlawns Medical Center deal with the crisis daily. No one is turned away but often patients must wait for a bed to open up. “We have patients in the emergency department for up to 120 hours,” said Jeff Jarding, Nursing Director, Emergency Department & Crisis at Broadlawns Medical Center. Integrated Telehealth Partners (ITP) is trying to eliminate that wait by connecting patients with psychiatrists from around the country. ITP currently works with 22 health facilities around the state. The Boone County Hospital started using it over a year ago. (WHO)

National News

South Carolina mental health system making progress, but much more to do
South Carolina’s mental health care system is slowly making progress but has a long way to go before it can meet the needs of those who suffer with mental illness in this state, a new report concludes. The analysis from the South Carolina Institute of Medicine & Public Health comes about a year since the group took stock of the state of mental health care in South Carolina and made 20 recommendations for improving it. It outlines areas of forward momentum as well as those where little progress has been made, said Maya Pack, associate director for research and strategic initiatives with the institute. (Greenville News)

To get disability help in Kansas, thousands face a 7-year Medicaid waitlist
in Kansas, there’s now a long waitlist — a seven-year wait — for people with intellectual disabilities to get the services they need. This year, families have been speaking out about that long waitlist and about other Medicaid problems at public forums like one held at the Jack Reardon Convention Center in Kansas City, Kansas, in May. Hundreds of people with disabilities, their families and caseworkers railed against KanCare — the state Medicaid program. The state has been gathering feedback because it needs the federal government’s permission to continue running KanCare. (Kaiser Health News)

Rural hospitals, clinics in Virginia likely to suffer if Obamacare repealed
West Virginia University Professor Simon F. Haeder fully expects the Republican-led government to nix Medicaid expansion and the insurance marketplace. Haeder shared his concerns that if the repeal takes place, thousands of West Virginians will lose coverage and rural hospitals will be forced to close their doors. “Even with the Affordable Care Act, rural hospitals are operating on razor thin margins. We’ve seen closures already. That’s going to get worse.” The American Hospital Association said across the U.S., there are 1,855 rural hospitals that support nearly two million jobs and reported 26 of West Virginia’s 54 hospitals are rural. (Beckley Register-Herald)

Clinics help keep people with serious mental illness out of ER
More than half of emergency room (ER) physicians said their local mental health system has gotten worse in the past year, according to a survey of 1,716 members of the American College of Emergency Physicians, released in October. Seventy-five percent of ER doctors said on their last shift, they saw at least one psychiatric patient who needed to be hospitalized. But clinics can helps the mentally ill avoid winding up in the ER, where round-the-clock activity and confusion is ill-suited to the needs of patients who are already agitated, suicidal or psychotic. (Kaiser Health News)

For Trump and GOP, ‘Obamacare’ repeal is complex and risky
With Republicans controlling the White House and Congress in January, they’re faced with delivering on their long-time promise to repeal and replace “Obamacare.” But there probably won’t be anything fast about Congress’ effort to replace Obama’s law, which is likely to take many months. While the replacement effort is underway, Republicans will risk aggravating up to 30 million people who are covered by the law or buy policies with prices affected by its insurance marketplace. Democrats will be sure to accuse the GOP of threatening the health care of millions. (Associated Press/Statesman)

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