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Covered California & The Health Law

The Americans With The Most To Lose Under GOP's Plan? Trump Voters

The proposal will hit older, low-income rural people the hardest.

Los Angeles Times: Trump Voters Would Be Among The Biggest Losers In Republicans' Obamacare Replacement Plan
Americans who swept President Trump to victory — lower-income, older voters in conservative, rural parts of the country — stand to lose the most in federal healthcare aid under a Republican plan to repeal and replace the Affordable Care Act, according to a Times analysis of county voting and tax credit data. Among those hit the hardest under the current House bill are 60-year-olds with annual incomes of $30,000, particularly in rural areas where healthcare costs are higher and Obamacare subsidies are greater. (Levey, 3/12)

Los Angeles Times: The Life-And-Death Stakes Of An Affordable Care Act Repeal In One Of L.A. County's Poorest, Sickest Regions
Nurses and doctors rush through hallways, readying exam rooms. The clinic in Lancaster hasn’t yet opened for the day, but staff members know that once patients start filing in they won’t stop. In less than two hours, it will be standing-room only in the waiting areas. Eight years ago, the Antelope Valley Community Clinic was a mobile van that offered check-ups and employed fewer than 10 people. Today it’s a health system with two clinics, two vans and 235 employees, and treats 500 patients a day. (Karlamangla, 3/10)

In other news on the Republicans' health plan and California —

Los Angeles Times: The Healthcare Debate Comes To California In This Week's Politics Podcast 
The stakes are high for California in the effort by congressional Republicans to replace existing healthcare rules. But few prominent California leaders are speaking out, for now. On this week's episode of the California Politics Podcast, we take an early look at the policy and political choices facing state lawmakers with repeal of the Affordable Care Act now coming into focus in Washington. (Myers, 3/12)

East Bay Times: Bay Area Obamacare Critics: Are They Happy Now? 
The reaction from Obamacare critics in the Bay Area ranges from hopeful to cautiously optimistic to downright disgusted — no doubt an indication of why the House Republicans’ American Health Care Act is drawing so much controversy in Washington, D.C. “If this is the best they can come up with after eight years of bitching and complaining, I would have to say we have a bunch of incompetents running the party,” said Phil La Scola, a retired finance manager at Oakland International Airport. “That includes Paul Ryan,’’ the speaker of the House. (Seipel, 3/11)

San Diego Union-Times: Issa, Hunter Face Raucous Anti-Trump Crowds At Town Hall Meetings 
Some 50 days into the Trump administration, Reps. Duncan Hunter and Darrell Issa faced tough questions about the president they campaigned for and the future of health care, immigration and relations with Russia in separate, raucous town hall meetings on Saturday. About 1,000 people poured into an Oceanside community center for two back-to-back forums with Issa. About that many showed up in Ramona for Hunter’s single session, but only about 400 could fit in the concert hall where it was held. (Figueroa and Stewart, 3/11)

Republicans Expecting Bad News From CBO's Coverage And Costs Analysis

The Congressional Budget Office is expected to release its projections on the Republicans' new health care plan as early as Monday.

The Associated Press: Republicans Brace For Downbeat CBO Analysis Of Health Bill
Republicans pushing a plan to dismantle Barack Obama’s health care law are bracing for a Congressional Budget Office analysis widely expected to conclude that fewer Americans will have health coverage under the proposal, despite President Donald Trump’s promise of “insurance for everybody.” House Speaker Paul Ryan said he fully expects the CBO analysis, set to be released as early as Monday, to find less coverage since the GOP plan eliminates the government requirement to be insured. (Yen, 3/13)

Politico: Budget Referee May Call Foul On Obamacare Repeal
The fate of Obamacare may lie in the hands of a number-crunching Republican appointee whose bottom line might single-handedly blow up the GOP quest to repeal and replace it. Congressional Budget Office Director Keith Hall was handpicked two years ago by top Republicans in Congress— including now Health and Human Service Secretary Tom Price — to lead a nonpartisan office that will soon release its estimate of how many Americans the Republican health care bill will cover and whether it shrinks or balloons the federal deficit. (Pradhan, 3/10)

In other national health care news —

The Washington Post: GOP Infighting Over Health Care, Other Issues Belies Victory
Less than 24 hours after Donald Trump had won the White House, House Speaker Paul Ryan triumphantly proclaimed the start of a new era of Republican leadership that would “hit the ground running.” Six weeks into Trump’s administration, Republicans are running — just in different directions. As congressional leaders move forward with efforts to undo former President Barack Obama’s health care law, conservative activists and GOP lawmakers are slamming the proposal as “Obamacare lite,” ‘’Obamacare 2.0” and “RINOcare” — RINO standing for Republicans In Name Only, a term of derision. (Lerer and Beaumont, 3/13)

The New York Times: The G.O.P.’s High-Risk Strategy For Health Law Repeal
President Trump and House Republicans are pressing forward with a high-risk strategy to repeal and replace the Affordable Care Act, disregarding the views of medical professionals and potentially imperiling the party’s political future in conservative states where many voters stand to lose their health care. The effort could cause upheaval in an already roiled insurance market next year, as Republicans face voters for the first time with Mr. Trump in the White House — though that turmoil would happen only if the plans manage to clear a divided Senate. (Pear and Kaplan, 3/11)

The Wall Street Journal: Trump Administration Officials Defend GOP Health Bill Amid Party Disagreement
Trump administration officials sought to buck up support for House Republican plans to overhaul the Affordable Care Act on Sunday amid vocal dissension within the party about the measure. “We strongly support the plan,” Health and Human Services Secretary Tom Price said on NBC’s Meet the Press, adding it would bring coverage to more people without raising costs. “I firmly believe nobody will be worse off financially in the process that we’re going through.” (Harrison and Harris, 3/12)

The Wall Street Journal: Donald Trump Plays Background Role In Health-Care Battle
The course of Donald Trump’s presidency will be defined by his ability to seal a deal to rework the U.S. health-care system, but so far he has outsourced the job of hammering out the details to about a dozen Republican leaders and White House advisers while he serves in the background as a pitchman. (Radnofsky and Bender, 3/10)

The Washington Post: Sleeper Issue Of Medicaid’s Future Could Prove Health-Care Plans’ Stumbling Block
As House Republicans hurtle toward shifting the nation’s health-care system onto a more conservative path, nearly lost so far in the roiling debate over their plans is the profound impact they would have on insurance for the nation’s poorest and most vulnerable residents. The proposed American Health Care Act would break with the government’s half-century-old compact with states in helping to finance Medicaid, which covers 68 million low-income people, including children, pregnant women and those who are elderly or disabled. (Goldstein and Eilperin, 3/12)

The Wall Street Journal: GOP Health Plan Risks Backlash From Seniors
House Republicans’ health-care proposal is running into a new political problem: opposition from older people. One day after House GOP leaders unveiled their plan to repeal and replace the Affordable Care Act, AARP, the politically potent advocacy group for Americans over 50 years old, came out in opposition. (Peterson and Hackman, 3/11)

Sacramento Watch

With Bill, State Lawmaker Wants To Move Away From Criminalizing HIV

California law says it’s a felony for an HIV-positive person to have unprotected sex without informing their partner that they are infected.

Sacramento Bee: California HIV Laws Could Go From Felonies To Misdemeanors
Democratic state Sen. Scott Wiener has proposed Senate Bill 239 to repeal the laws, saying they do not reflect current HIV medical practices, and have not helped stop the spread of HIV and AIDS... California law says it’s a felony for an HIV-positive person to have unprotected sex without informing their partner that they are infected. It is also a felony for HIV-positive people to donate blood, body organs or other tissue. Those convicted can spend up to seven years in prison if found guilty. Another law upgrades a misdemeanor for prostitution to a felony if the person charged has HIV or AIDS. (Ohsahl, 3/12)


Judge Waives Law Barring Vocational Nurses From Administering Naloxone

The California prison system, which is facing an epidemic of opioid overdoses, employs about 2,000 registered nurses and about 1,800 licensed vocational nurses. Previously, only registered nurses could administer the anti-overdose medication.

The Associated Press: Feds Override California To Aid Inmates With Drug Overdoses
A federal judge overrode a California state law on Friday to help combat a growing problem of inmates dying from drug overdoses.U.S. Judge Thelton Henderson of San Francisco approved waiving state law to allow licensed vocational nurses to administer the overdose antidote naloxone, which can reverse respiratory failures from opioid overdoses. (Thompson, 3/10)

Hospital Roundup

Expected Infusion Of Cash For Purchase Of Sonoma West Medical Center Is MIA

The hospital has been under financial strain for several years now.

Santa Rosa Press Democrat: Sonoma West Medical Center Buyer Does Not Fulfill Agreement To Inject Money 
A startup seeking to purchase Sonoma West Medical Center has not yet fulfilled its agreement to inject much-needed funds into the cash-strapped Sebastopol hospital, bogging down negotiations over the sale, hospital officials said Friday. At a Feb. 15 board meeting, the public health care district that owns Sonoma West approved a “letter of intent” to transfer the hospital, its property and the equipment inside to Americore Health, a Florida-based hospital management, investment and acquisition firm. In exchange for entering into negotiations with the hospital, Americore was expected to provide an infusion of $500,000, officials with the hospital and the Palm Drive Health Care District, which owns the hospital, said Friday. (Espinoza, 3/10)

Health Care Personnel

Travel Ban Would Hit LA's Doctors Particularly Hard

"Los Angeles is actually the metro area in the United States which has the highest number of doctors from the banned countries," according to Jonathan Roth, a Harvard PhD student and one of the researchers who worked on the Immigrant Doctors Project.

KPCC: Hundreds Of Doctors In LA County Could Be Affected By New Travel Ban 
Among those who will feel the impact of President Trump's revised travel ban are hundreds of doctors in Los Angeles County who come from the six majority-Muslim countries named in his executive order... The executive order, which is due to go into effect on Thursday, temporarily blocks visas from being issued to citizens of Iran, Libya, Somalia, Syria, Sudan and Yemen to "to protect the Nation from terrorist activities by foreign nationals." The ban does not include permanent residents and those who already have visas, but doctors applying for new visas or seeking to renew expired ones would require a waiver. (Lavender, 3/13)

In other medical personnel news —

Los Angeles Times: Young Doctors Can Work 28 Hours Straight Under New Rules 
Despite concerns from the public about safety, the private group that oversees physician training voted to allow young doctors to work shifts as long as 28 hours. The new rules, which begin on July 1, relax work restrictions put in place in 2011, when mounting evidence showed that exhausted residents — the term for doctors in training — were endangering both patients and themselves. Currently, first-year residents are restricted to 16-hour shifts. (Petersen, 3/10)

San Francisco Chronicle: Sacramento Battle Over Telling Patients About Doctors’ Probation 
Dr. Wanda Heffernon, a former UCSF anesthesiologist, made headlines in 2001 when she pleaded guilty to stealing credit cards from her fellow physicians and forging prescriptions to feed her drug addiction. While facing those charges, she worked as a physical therapist at a nursing home in San Mateo County, where she was accused — and later convicted — of elder abuse after prying a diamond wedding ring off a 94-year-old patient, bruising the woman’s finger in the process. The judge who sentenced Heffernon to two years in prison noted the extreme vulnerability of the victim and remarked that there was “a dark side to Ms. Heffernon that is difficult to fathom.” (Gutierrez, 3/10)

Around California

$10M Community Clinic Will Be Designed To Serve Mentally Disabled

The new Santa Rosa clinic will feature physical therapy and specially designed dental operating rooms to accommodate wheelchairs and gurneys, as well as sedation dentistry, a medical procedure where patients are given sedative drugs to reduce patient fear and anxiety.

Santa Rosa Press Democrat: New Santa Rosa Community Health Centers Clinic To Care For Developmentally Disabled
Santa Rosa Community Health Centers has landed a $2.5 million contract to provide specialized services to Sonoma Developmental Center residents affected by the facility’s planned closure. The bulk of the funds will be used to purchase property in west Santa Rosa where SRCHC plans to build a new community clinic. That clinic, a $10 million project, will be specially designed to serve patients who are developmentally disabled but will be open to all...With the scheduled closure of Sonoma Developmental Center in 2018, its remaining 350 residents will be transferred to community-based housing in Sonoma, Solano and Napa counties. That would leave many of them without in-house medical, dental, mental and adaptive services. (Espinoza, 3/10)

In other news from across the state —

The San Diego Union-Tribune: Forensic Exam Made Available To Domestic Violence Victims 
For decades in San Diego County, victims of sexual assault and child abuse have been examined by specially trained forensic nurses who expertly document their injuries to aid in prosecution. Now, due to a grant from the state Office of Emergency Services, some domestic violence victims will get the same treatment...The grant will fund 130 domestic assault forensic examinations, which will be conducted by forensic nurses with Palomar Health. Any law enforcement agency in the county can request the service, free of charge. It won’t be enough to supplement every felony domestic violence case, but it’s a start, officials said. (Winkley, 3/12)

Santa Rosa Press Democrat: Local Athletic Trainers Back Push For State Licensing Program 
A football player bangs helmets with another during a high school game. One gets up slowly, a little stunned. Off the field, someone asks him how he is...Who determines that, particularly in California, wields a huge influence on that athlete’s future — possibly even his life. A certified athletic trainer would likely pull him and send him through a weeklong concussion protocol with a step-by-step return-to-play checklist that monitors his symptoms. But California doesn’t require its athletic trainers to be licensed, which allows just about anyone on the sideline to make that determination...California is the only state in the nation that does not require licensure or regulation of such medical professionals, entrusted with the care of hundreds of thousands of high school, college and professional athletes who play in the state every day. (Carter, 3/11)

Capital Public Radio/KXJZ: Sacramento Food Bank Unveils New Produce Truck 
The Sacramento Food Bank is going mobile. It just unveiled its new produce truck. Food bank organizers say adding the mobile produce stand will help it reach people who have difficulty getting to their other distribution points. Monica from Carmichael was one of the first people in line to get produce at the unveiling event at Arcade Church. (Schilling, 3/10)

National Roundup

Trump Picks Bush Alum With Deep Ties To Pharma, Wall Street As FDA Nominee

Scott Gottlieb, a physician who left the FDA in 2007, is a consultant to GlaxoSmithKline’s product investment board; a managing director at T.R. Winston & Company merchant bank, which specializes in health care; and a clinical assistant professor at New York University School of Medicine.

The Washington Post: Trump To Select Scott Gottlieb, A Physician With Deep Drug-Industry Ties, To Run The FDA
President Trump announced late Friday that he will nominate Scott Gottlieb, a conservative physician and businessman with deep ties to the pharmaceutical industry, to be commissioner of the Food and Drug Administration. If confirmed, Gottlieb would bring a strong pro-industry, deregulatory approach to an agency that Trump has criticized as being overly restrictive. But he is also likely to support one of the agency's basic functions: to ensure that drugs are proven safe and effective before they are sold. (McGinley and Johnson, 3/10)

Stat: Five Things We Know About Scott Gottlieb, Trump's Pick For FDA
Gottlieb hasn’t advocated radical, baby-with-bathwater reforms, but he has proposed a tweak that would shake things up. As it stands, FDA drug reviewers are tasked with both vetting clinical data and making final decisions on applications. Because of that, Gottlieb wrote in 2012 in National Affairs, “reviewers feel an enormous weight of responsibility,” subject to “simultaneous and countervailing pressures to both speed up approval and prevent misuse of new drugs.” (Garde and Scott, 3/10)