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

Iowa News

Iowans with mental illness find courage to take the stage
Hillary Hippen-Leek put out a casting call last winter for a public storytelling event about mental illness, she was overwhelmed with volunteers. Sixteen plan to take the stage Friday at the Temple Theater in downtown Des Moines. For several participants, this will be the first time they have ever talked publicly about these things. And they’ll be speaking to a full house. The 300 seats are already sold out. Friday’s event is part of a national effort encouraging people to talk openly about mental illnesses. A “This is My Brave” event was held in Iowa City last year and one is scheduled for Cedar Rapids April 22. (Des Moines Register)

Safe haven bill approved by Senate
Iowa’s Safe Haven law would be expanded under a bill approved by the state Senate yesterday. The law currently allows parents — or another person who has the parent’s authorization — to leave an infant up to 14 days old at a hospital or health care facility without fear of prosecution for abandonment. Senate File 360 would expand the safe haven time period to 30 days. Also, a person could call 911 to have first responders pick up the baby. The new law would allow for the infant would be taken to the nearest health facility with no repercussions for the person relinquishing the child. (KIMT)

How Iowa’s midsize cities have been left behind
Since the recession, metropolitan areas in Iowa have grown, gathering political influence and government funding. But micropolitan areas, with 10,000 to 50,000 population, such as Clinton, Keokuk, Fort Madison and Mason City, have collectively suffered population and job loss and have not recovered as well as their larger counterparts. Eleven of Iowa’s micropolitan areas have lost jobs since 2008, and nine of them have lost population. Christine McManus of Clinton takes a free sack lunch and food bank items given by the Franciscan Peace Center. “But mental health keeps getting cut by the government, and people can’t get jobs if they have mental health problems,” she said. (Des Moines Register)

UIHC, nursing school faces nurses short
The nursing shortage has not only affected the University of Iowa Hospitals and Clinics (UIHC), the UI College of Nursing has also felt its effects in faculty. “We would like to address the nursing shortage by educating as many nurses as we possibly can, but the problem is there’s even a greater nursing-faculty shortage,” said Mary Dirks, a UI clinical professor and assistant dean for Graduate Practice Programs. UIHC has around 200 positions that are vacant or will be in the near future, said Emily Wynn, an interim co-chief nursing officer at the UIHC. (Daily Iowan)

Robotic surgery benefits colorectal cancer patients, surgeons
Back in 2000, only about 1,000 surgeries world-wide were done robotically, but since then, the number has skyrocketed. Mercy Medical Center obtained Siouxland’s first robot in 2008. Seven years later, the hospital upgraded to the da Vinci Xi, the newest surgical robot on the market. The da Vinci Si is a computer-enhanced surgical system often used for colorectal surgeries. St. Luke’s acquired its first robot, the da Vinci Si, in the fall of 2012 and added single-site technology to it in 2014. Patients who undergo robotic surgery spend less time in the hospital and recover faster. (Sioux City Journal)

Pella Regional expansion to be finished in fall
The Pella Regional Health Center (PRHC) relocated and expanded their Obstetrics Unit to accommodate for the influx of patients and the increase of births as reported since 2010. Pella Regional Health Center delivered 539 babies in the Obstetrics Unit in 2016, and births have continued to increase by more than 40 percent since 2010, according to PRHC. Plans for the new addition include seven labor rooms, three postpartum rooms and two triage rooms. (Knoxville Journal-Express)

From surgery to student: Former patient returns to UI, pursuing medical career
In 2005, New Jersey native Jesse Weiss was referred to the University of Iowa Hospitals and Clinics (UIHC) for a brain-related diagnosis. After staying several months in Iowa City, Jesse returned home to Glen Rock, New Jersey, but the relationships he forged during his time in Iowa City brought him back at least once a year. Those friendships and the medical care played a major role during college consideration. Jesse was recently hired by the Ronald McDonald House, and now works as a night manager in the place he once called home for two months more than a decade ago. (CBS2Iowa)

National News

Kansas Governor Sam Brownback vetoes Medicaid expansion bill
Governor Sam Brownback has vetoed legislation that would have expanded Medicaid to cover 150,000 low-income Kansans. Brownback’s veto, which was announced Thursday morning on Twitter, had been highly anticipated and comes amid speculation that he will take a job in President Donald Trump’s administration. Kansas has missed out on nearly $1.8 billion in federal aid since 2014 by not expanding Medicaid. The closure of a hospital in Independence, Kansas in 2015 was largely blamed on the state’s failure to expand the program. (Kansas City Star)

Celebration and frustration as Georgia legislative session closes
The final day of the Georgia General Assembly brought last-minute approval of some health care bills Thursday. The hospital industry was among the winners early in the session when the Legislature swiftly approved the renewal of the “provider fee,’’ a funding mechanism that draws an extra $600 million in federal funding for the state’s Medicaid program. And the industry successfully fought off challenges to the state’s certificate of need regulatory apparatus for health care facilities. Additionally, a bill that would raise the tax credit from 70 percent to 90 percent for individuals and corporations who donate money to rural hospitals was created. (Georgia Health News)

Florida universities plead for mental health funding
Florida’s universities say they need more money to hire additional mental health counselors and law enforcement officers. University officials said they’re seeing a dramatic rise in students needing help coping with anxiety, depression and academic stress. Board of Governors Chairman Tom Kuntz said the university system needs $30 million over two years to hire more than 100 mental health professionals and police officers. Its goal is two officers and one mental health counselor per 1,000 students. (Health News Florida)

Psychiatric services ‘crisis’ spurs call for reform
Psychiatric services are in a state of crisis nationwide and stakeholders across the health care industry have roles to play in fixing the multifaceted problem, the National Council for Behavioral Health (NCBH) says. A report released this week was prepared by the nonprofit’s Medical Director Institute and a 27-member expert panel drawn from providers, payers, government agencies and psychiatric organizations. In 77 percent of US counties, health care officials are reporting a severe psychiatrist shortage and the aging psychiatrist workforce also poses a daunting challenge. (HealthLeaders Media)

Six changes the Trump Administration can still make to Obamacare
Although Republicans failed to repeal and replace the Affordable Care Act last week, that doesn’t mean the health care drama is over. “There are things the Trump administration might do that could prop up the markets, and there are things they might do that could help the markets explode, if that’s what they want to happen,” says Cynthia Cox, who studies Obamacare’s effects on private insurance at the Kaiser Family Foundation. Making changes to regulations and how Obamacare is administered doesn’t even require Congress’ help. And those changes could make or break the health law. (NPR)

Tom Price defends proposed cuts at NIH, citing ‘indirect’ expenses
Secretary of Health and Human Services Tom Price on Wednesday defended the Trump administration’s proposed cuts to medical research, saying that the National Institutes of Health (NIH) budget is plagued by unnecessary expenses. Republicans and Democrats alike questioned Price on the nature of the cuts at a health appropriations subcommittee hearing on Wednesday. Members of Congress from both parties have expressed either skepticism or flat unwillingness to support President Trump’s initial 2018 budget recommendations. (STAT)

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

Iowa News

Pharmacies start selling heroin antidote without prescription
Some Iowa drugstores have started to sell a narcotics-overdose antidote without requiring prescriptions. Top Iowa officials gathered at a southside Des Moines CVS pharmacy Wednesday to congratulate the chain on helping lead the way toward the change. CVS’s Iowa stores have started selling the naloxone, or Narcan, to any Iowa adult without requiring a specific prescription. The medication, delivered by a shot or by nasal spray, can quickly reverse the effects of an overdose of heroin, pain pills or other narcotic drugs, also known as opioids. (Des Moines Register)

Mercy Cedar Rapids hires doctor to build open heart surgery program
Dr. CC Lee is no stranger to building a heart surgery program from scratch. And come June he’ll do the same at Mercy Medical Center in Cedar Rapids. “It gives me excitement to start something new, to be able to put my imprint on it,” said Lee, who was recently named the hospital’s medical director of its cardiac, thoracic and vascular surgery services. In November, the hospital was given a certificate of need by the State Health Facilities Council to start an open heart surgery program. (Cedar Rapids Gazette)

Knoxville Hospital expands, adds new technology
Knoxville Hospitals & Clinics has undergone many changes over the past year. From becoming one of few hospitals around the region to offer robotic knee surgery to a $15 million modernization project being completed, the hospital is much different than it was just a few years ago. The most recent change to be implemented is a robotic surgical unit called the Navio. Knoxville is the second hospital in Iowa to add the technology. The other is in Cedar Rapids at St. Luke’s Hospital, which implemented the robotic knee replacement unit in 2014. (Knoxville Journal-Express)

Covenant Medical Center unveils new nuclear medicine department
Covenant Medical Center’s new state-of-the-art nuclear medicine department is easily three times the space of its previous location deep in the halls of the hospital. “We were landlocked,” said Michelle Wright, Covenant’s nuclear medicine supervisor. “New technology requires bigger space.” With a $3.4 million project, the department got both space and technology. Covenant Medical Center unveiled its new nuclear medicine department at an open house Tuesday morning. (Waterloo-Cedar Falls Courier)

14 million Hawarden Community Hospital project nearing completion
Construction continues in Hawarden on a $14 million hospital construction and renovation project. Hawarden Community Hospital Administrator Jason Pullman gives provided an update on the project for which planning began several years ago. He said they’re planning on a grand opening and ribbon cutting, which will be sometime between late May and mid-June. The hospital is also looking at adding outreach services and expanding their operating room to keep services close to home for area residents. (KIWA)

National News

Colorado lawmakers give initial nod to $26.8 billion budget that threatens hospitals
A handful of rural Colorado hospitals are facing the risk of closure from the spending cuts embedded in the $26.8 billion state budget bill that won preliminary approval Wednesday in the state Senate. The budget package cuts more than $500 million in payments to the state’s hospitals for uncompensated care in part of an effort to balance a spending bill in a year mired by fiscal constraints and increasing demands. The hospital cuts dominated the initial discussion as Democrats fought to eliminate them from the spending bill. (Denver Post)

Texas House budget writers send budget to full House with massive health care cut
Just one day after the Texas Senate passed its two-year budget, a key House committee sent their own spending proposal to the full House – but not before cutting $2.4 billion from the state’s largest health care program for the poor and disabled. Emboldened by the election of President Donald Trump, Texas House budget writers voted to cut $1 billion in state funding for Medicaid. The proposal could mean reducing the amount doctors and other health care providers get paid by the public insurance program, or restricting patients’ eligibility for health care services. (Texas Tribune)

Americans dislike GOP’s, Trump’s plan on health care
Sixty-two percent of Americans turned thumbs down on Trump’s handling of health care during the initial weeks of his presidency, according to a poll by the Associated Press-NORC Center for Public Affairs Research released Wednesday. An overwhelming eight in 10 opposed the Republican proposal to let insurers boost premiums on older people. Seven in 10 disapproved of premium surcharges for people whose coverage lapses. Overall, just over half in the poll said they worry many Americans would have lost coverage had the GOP bill become law. (Associated Press/ABC News)

GOP revival of health care repeal makes little progress
House Republicans insist they aren’t leaving for dead their effort to repeal Obamacare. But days after failing to move the American Health Care Act forward, there are no discernible signs of progress in bridging the differences within the Republican conference that led to an embarrassing retreat last week. Some centrist GOP lawmakers are pushing back on reviving the House bill, but some say they want to begin working with Democrats to reform the health care law instead of trying to find votes from conservatives who want to see a repeal of Obamacare’s insurer regulations and requirements. (The Hill)

Justice department joins lawsuit alleging massive Medicare fraud by UnitedHealthcare
The Justice Department has joined a California whistleblower’s lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans. Justice officials filed legal papers to intervene in the suit, first brought by whistleblower James Swoben in 2009, on Friday in federal court in Los Angeles. On Monday, they sought a court order to combine Swoben’s case with that of another whistleblower. UnitedHealth spokesman Matt Burns denied any wrongdoing by the company. (Kaiser Health News)

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

Iowa News

Feds’ tab could hit $225 million to help Medicaid firms cover Iowa losses
Iowa’s decision to help Medicaid managed-care companies shoulder deep financial losses would only cost the state government about $10 million, but it could cost the federal government up to $225 million, state officials say. Much of the federal money would come via the Affordable Care Act, which Governor Terry Branstad opposed but which his administration has repeatedly tapped to pay for health care for poor Iowans. The state’s recent agreements to help the three private management companies mop up their red ink were disclosed last week. (Des Moines Register)

Fewer Quad-Citians without health insurance
The number of uninsured people in the Quad-Cities has fallen dramatically since the major provisions of the Affordable Care Act (ACA) kicked in, new government figures say. The local declines have been particularly noticeable for the lower-income population. In both Scott and Rock Island counties, the uninsured rate for people making 138 percent of poverty ($16,243 for an individual) or less dropped by roughly half between 2013 and 2015. ACA tried to boost insurance coverage by expanding Medicaid eligibility and providing subsidies to people farther up the income ladder to make insurance more affordable in the private marketplace. (Quad-City Times)

It’s time to embrace and fix Affordable Care Act
“I have to tell you, it’s an unbelievably complex subject,” President Donald Trump told governors during a meeting last month. “Nobody knew that health care could be so complicated.” Nobody except everyone else. It is time for Washington Republicans to move forward. That means abandoning the tired, anti-Obamacare rhetoric they’ve been spewing for eight years. It means recognizing the law has been implemented in every state and has insured more than 20 million previously uninsured Americans. The GOP can embrace the law. And for the sake of the country, it should. (Des Moines Register)

Branstad reduces proposed budget by $173 million
Governor Terry Branstad is responding to a shortfall in state revenue by cutting $173 million in spending from a budget blueprint he previously proposed to the Iowa Legislature for the fiscal year that begins July 1. Branstad aides released a revised budget package Tuesday night that totals $7.283 billion for fiscal year 2018. That’s a decrease of 2.3 percent compared with the budget the Republican governor proposed in his Condition of the State address in January. The biggest reduction from the governor’s previous budget proposal is in health and human services funding, which faces a decrease of $86.2 million. (Des Moines Register)

Safe haven for abandoned newborns expanded under Iowa Senate bill
Iowa’s Safe Haven law that allows newborn babies to be voluntarily released at hospitals for adoption would be expanded under a bill approved Tuesday by the Iowa Senate. At least 20 babies have been covered under a state law took that effect in 2002 to protect newborns, according to the Iowa Department of Human Services. The law currently allows parents to leave an infant up to 14 days old at a hospital or health care facility without fear of prosecution for abandonment. Senate File 360, which was approved on a 48-0 vote, would expand the safe haven time period to 30 days. (Des Moines Register)

National News

House Republicans say they are still negotiating Obamacare repeal
The House Freedom Caucus, which was a critical force behind the implosion of the Republican repeal and replacement bill last week, is now actively trying to resurrect a similar bill. The group of more than 30 hardline conservatives defied Republican leadership and the White House when they said they’d vote no on the legislation without major changes. Their refusal to back the bill, coupled with a handful of moderate members, ultimately caused President Trump and House Speaker Paul Ryan to cancel a vote on the legislation Friday. The group is working with leadership and moderate Republicans to try to bring back the bill in a different form. (USA Today)

Senate GOP leaders push for health care effort after house plan implodes
Senate Republican leaders are pushing for a bipartisan health care effort after the implosion of the House GOP’s Obamacare repeal legislation, but Democrats remain wary. “I think that’s the lesson of last week – that it needs to be done on a bipartisan basis and so we’re happy to work on it with Democrats if we can find any who are willing to do so rather than those who just want to stand back and enjoy the show,” said the Senate’s No. 2 Republican, John Cornyn of Texas. It’s not clear whether Democrats, who largely sat back and let the repeal effort collapse on its own, have much incentive to negotiate yet. (Bloomberg)

Governors eye changes to state Medicaid programs
To some governors, the GOP’s decision to pull the American Health Care Act (AHCA) presents them with an opportunity to usher in changes to their states’ Medicaid programs, including Medicaid eligibility expansion and more conservative policies. Such is the case in Virginia, where Democratic Governor Terry McAuliffe has introduced a budget amendment that would restore his authority to pursue planning for Medicaid expansion. Other states, though, are mulling different types of changes to their Medicaid programs in the wake of AHCA’s demise. (Fierce Healthcare)

Pretending there is equal coverage for mental and physical illnesses is a joke
Almost a decade after mental health care parity became the law of the land, much of the wider culture simply doesn’t accept it. Reimbursement rates for behavioral health therapists remain so low that few take insurance, and many have found it necessary to maintain cash-only practices to survive. Someone trying to access mental health care is twice as likely to be denied coverage by a private insurer than someone seeking surgical or other medical care, according to a survey of 84 insurance plans in 15 states by the National Alliance on Mental Illness. (Boston Globe)

OIG will investigate Trump administration decision to end ACA marketing campaign
US Health and Human Services Inspector General Daniel Levinson informed Senators Elizabeth Warren (D-MA) and Patty Murray (D-WA) in a recent letter that the Office of Inspector General (OIG) would review a decision to end halt outreach efforts aimed at insurance exchange enrollment. Democrats criticized the decision to pull advertising and outreach in the final days of open enrollment for 2017 as an early act to undermine the Affordable Care Act (ACA). But as those efforts came to an abrupt halt Friday, supporters of the act are watching for signs that President Donald Trump’s administration may continue to work against ACA’s intentions. (Healthcare Dive)

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Helping others has always been a passion for Carroll native Jamie Waller. It’s why she pursued a career in nursing at Iowa Central Community College in Fort Dodge and it’s why she participated in a three-week mission trip to Tanzania in Africa following her freshman year of nursing school.

“After going to Africa, I discovered that nursing was my true passion in life,” Waller said. “It confirmed my interest in serving others and solidified my decision to become a nurse.”

Today, Waller is a registered nurse and six-year veteran of St. Anthony Regional Hospital in Carroll. She works on the medical, surgical and pediatric floor and often serves the role as charge nurse. But her commitment to serving others extends beyond her daily shifts.

In November 2016, newlyweds Jamie and her husband, Cory, ventured to Haiti with Grace4Haiti, a medical mission group based in Omaha. The couple joined the team’s 15th trip with the purpose to work in a hospital setting, perform medical services, prepare patients for surgery, assist surgeons, and care for patients in a hospital.

Jamie shares that she grew both personally and professionally from the experience.

“We saw many, many patients in the clinic every day and performed small procedures in the clinics if able,” Waller said. “I realized on this trip that we have many luxuries we take for granted here in the in U.S. – things as simple as running water and electricity in every health care facility, and features as complex as all of the technology and supplies we have available. It was an eye-opening experience.”

Yet, most memorable of all, Jamie recalls two premature infants the medical mission workers saved during their stay.

One afternoon several of the mission team members walked to the beach during a short break from the hospital. As they were walking back, additional group members met them with the urgent message that an abandoned, premature baby had just been dropped off at the hospital.

“Luckily, we had the biggest group at the hospital that week, because at the same time this baby was struggling to breathe, another mother was having a scheduled C-section,” Waller said. “Once we delivered the baby via C-section, we knew right away the baby was not 40 weeks along. We had to cardiopulmonary resuscitate the baby for a short while and perform other medical techniques for this child to survive.”

At St. Anthony Regional Hospital, Jamie Waller (left) is a preceptor for nursing student Morgan Neary.

Within hours, the medical team had both babies stabilized and transferred them to a nearby hospital, a couple hours away. The infants were transported in the missionaries’ vans, because there is no organized ambulance service in Haiti.

“I truly felt the difference our team was making in that moment to help those babies,” Waller said. “We used the resources and skillsets we had available to provide great care. Had our team not been there, I don’t believe they would have lived.”

Waller is grateful for the support of St. Anthony, which provided supplies and a mission trip support fund to match her employee vacation hours.

“St. Anthony’s generous donations were an invaluable asset for our trip,” Waller said. “We used many supplies while there. Every little bit counts and each donation helps to lessen the burden of providing health care in Haiti. The vacation match program also helped my husband and me financially with the trip. It meant the world to us.”

Jamie encourages others to partake in the same types of endeavors. She and Cory are leading by example, returning to Haiti in April with the hopes of spending more time in orphanages to show their support of Haitian children and continuing the relationships they built in November.

“I felt God’s presence many times while there – whether it was getting to know the people around me or guiding my hands while working with patients,” Waller said. “I truly believe that everything happens for a reason. My husband and I went on this trip to serve God and show love to other parts of the world by hugging someone that needs a hug or providing life or death care to a newborn baby. I am incredibly blessed and grateful for the opportunity to help others.”

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

Iowa News

Branstad defends pledge to help Medicaid firms cover losses
Governor Terry Branstad on Monday defended his administration’s decision to help private Medicaid managed care organizations (MCOs) shoulder huge financial losses, and he said it doesn’t mean the project is in trouble. “We’re partners in this and we’re going to continue working with MCOs with regard to what makes the most sense going forward,” Branstad said. The three companies have complained they’ve lost hundreds of millions of dollars in Iowa and the Department of Human Services has signed contract amendments under which the state agreed to help the companies cover some of those losses. (Des Moines Register)

UnityPoint’s Trinity pumps more than $70M into FD economy, study says
Trinity Regional Medical Center is proving to be a valuable commodity in not only stimulating the local economy, but also attracting new businesses to the Fort Dodge region. According to the latest study by the Iowa Hospital Association, Trinity generates 1,156 jobs that add more than $70 million to Fort Dodge’s economy, an increase of about $10 million from 2015. “It is extremely rewarding to see the positive impact we have on the economic growth taking place for Fort Dodge and our surrounding communities,” Mike Dewerff, president and CEO of UnityPoint Health — Fort Dodge, said. (Fort Dodge Messenger)

Prominent advocate for poor, disabled Iowans dies
Rhonda Shouse, who championed the health-care rights of poor and disabled Iowans, died Saturday, her family said. The Marion resident, who was 49, was a Medicaid recipient and a leading critic of Iowa’s shift to private management of the $4 billion program. “We want to make sure Iowans are being taken care of,” Shouse said in an interview shortly before three for-profit companies began running the program in April 2016. “She was the voice for thousands of Iowans who felt like they weren’t being heard by the governor or the administration,” said Senator Pam Jochum, a Dubuque Democrat. (Des Moines Register)

National News

Kansas Senators back Medicaid expansion to aid vulnerable hospitals
Financially fragile hospitals in Kansas — especially facilities in rural areas of the state — have a lot to lose in the Kansas Legislature’s debate about expanding Medicaid services. The Alliance for a Healthy Kansas reported 31 of the state’s 107 hospitals are financially vulnerable because each must grapple with costs of providing care to people who are uninsured. According to the Kansas Hospital Association, Kansas has forfeited more than $1.7 billion in federal funds since January 2014 by declining to expand Medicaid under the Affordable Care Act. (Topeka Capital-Journal)

A depleted Massachusetts system fails many with serious mental illness
While thousands with serious mental illness in Massachusetts struggle to get any help, the roughly 21,000 Department of Mental Health clients are promised treatment at state-run facilities and state-funded programs in the community that are operated by private vendors. But the department is releasing a steady stream of people with serious mental illness to live in the community without proper supervision. Part of the problem is the continuing pressure to move patients from inpatient units into the community. Some patients are released before they’re ready, employees say, and, once back in the community, they get little oversight. (Boston Globe)

As US hospital stocks soar, the industry’s many ills linger
With the failure of the Republicans’ overhaul of the Affordable Care Act, hospital administrators from every corner of the US have been breathing a sigh of relief. But the respite will likely be short-lived. True, 24 million Americans won’t be losing their insurance, a fact that has investors buoying hospital stocks for now. Even so, the industry is up against market forces that will compel hundreds of hospitals to shrink, remake themselves or even close in the months and years to come. Obamacare made big strides in providing health coverage, cutting the US uninsured rate almost in half. But more than 220 US counties still have uninsured rates at or above 20 percent. (Bloomberg)

White House looks to bounce back after health care loss
Regrouping after a rocky few weeks, the White House declared Monday that President Donald Trump doesn’t consider the health care battle to be over, suggesting he may turn to Democrats to help him overhaul the system after his own party rejected his proposal. The sudden interest in bipartisanship is a shift for a president who has spent months mocking Democratic leaders as inept. And Democrats indicated they have no interest if his intent is still to dismantle “Obamacare.” But Trump’s interest reflects the strained state of his relations with conservatives in his party and his search for a way to regain his footing after the painful withdrawal of his health care legislation. (Chicago Tribune)

With AHCA defeat, some Democrats see chance to push for universal coverage
At their first town meeting since the Republicans’ surprise surrender on the Affordable Care Act, progressives in blue America celebrated — then asked for more. “We have to look harder at a single-payer system,” said Representative Jim Langevin (D-R.I.), using a term for universal coverage. “I supported single payer since before you were born,” said House Minority Leader Nancy Pelosi (D-Calif.), who has argued since the passage of the Affordable Care Act that it could be a bridge to European-style universal coverage. (Washington Post)

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