(CBS/WBTW) More Americans now have access to health care than in decades past, but the cost and quality of service can vary widely depending on where someone lives.

With the continuing battle in Washington over thefuture of health care in the United States, experts at personal-finance website WalletHub decided to do some digging into the quality of health care on a state-by-state basis.

According to the latest data from the Centers for Medicare & Medicaid Services, the average U.S. adult spends nearly $10,000 per year on personal health care, and that number is expected to continue to increase over time.

But as costs rise, the United States remains well behind other wealthy nations when it comes tolife expectancy, quality of life, and overall health coverage.

To determine in which states Americans receive the best and worst health care overall, the analysts at WalletHub compared all 50 states plus the District of Columbia across 35 measures of cost, accessibility, and outcome.

Among the factors they took into consideration were the cost of medical and dental visits; average monthly insurance premiums; quality of hospital care systems;life expectancy;cancer rates; heart disease rates; and infant, child, andmaternal mortalityrates.

Hawaii topped the list with the lowest heart disease rate in the nation and a particularly high number of insured adults aged 18 to 64. Iowa, Minnesota, and New Hampshire also ranked high on the list.

According to the analysis, the top 10 best states for health care are:

In contrast, Louisiana was rated the worst state for health care overall, with the highestheart diseaserate in the nation, the third highest cancer rate, and a low number of dentists per capita.

North Carolina ranked 5th on the worst state list (47th overall), with the highest average monthly insurance premiums.

South Carolina ranked 7th on the worst state list (45th overall), but WalletHub offered no explanation as to why.

The 10 worst states for health care include:

To see how the other states stack up, seeWalletHubs full report.

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SC, NC rank among 10 worst states for healthcare - WBTW - Myrtle Beach and Florence SC

President Donald Trump signed into law Saturday legislation that extends a program allowing veterans to receive private health care.

The bill, which allocates $2.1 billion for the six-month extension of the Choice Program of the Department of Veterans Affairs, was signed by the president at his private golf club in Bedminister, New Jersey, where he is on a 17-day working vacation, according to the White House.

The program, which was set to run out of funds earlier than expected in mid-August, pays for veteran visits to private doctors if they are facing lengthy waiting periods or travel times. The program was created in 2014 in response to a scandal at the VA hospital in Phoenix, Arizona, where patient wait times had been manipulated.

VA Secretary Dr. David Shulkin has made it a priority to eliminate a rule requiring veterans to live at least 40 miles from the nearest VA facility or wait more than 30 days for an appointment to be eligible for the Choice program.

The law also authorizes an additional $1.8 for the VA to lease 28 major medical facilities and to strengthen a program overseeing the recruitment and training of VA employees.

Congress passed the bipartisan legislation before it began its August recess, but not before raising concerns among veterans groups and Democratic lawmakers about the trend toward privatization of the VA.

Several veterans groups, including Disabled American Veterans and Iraq and Afghanistan Veterans of America, expressed concern to Congress in a letter on July 26.

"If new funding is directed only or primarily to private sector 'choice' care without any adequate investment to modernize [the] VA, the viability of the entire system will soon be in danger," the groups said.

Shulkin has maintained the administration is not trying to privatize the VA, but to modernize and strengthen the agency's operations.

"President Trump is dedicated to maintaining a stronger VA, and we will not allow VA to be privatized on our watch," Shulkin wrote in an op-ed published July 24 in USA Today. "What we do want is a VA system that is even stronger and better than it is today. To achieve that goal, VA needs a strong and robust community care program."

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Trump Signs Bill Extending Veterans Health Care Program - Voice of America

The House of Representatives passed the American Health Care Act. Though advertised as their repeal-and-replace bill, the AHCA amended and in some waysenhanced ObamaCare. In July, the Senate just said no to any action whatsoever on our failing healthcare system.

Congressional Republicans seem unable to envision a solution for healthcare that restores the proper relationship between doctors and patients where the payer is the patient.

The Obama administration promised byexpanding MedicaidAmericans would be freed from job lock and able towork less. This is another example of Washingtons attempt to orchestrate peoples behavior and its refusal to admit the purpose of any healthcare system is to improve access to quality care.

In a recent survey of businesses with fewer than 50 employees, economist Casey Mulligan found that ObamaCare contributed to killing at least250,000 jobs. These losses, whether direct fires or fewer hires, are driven by ObamaCares mandate that small businesses must guarantee workers health insurance.

If people cant find jobs, they either drop out of the labor force or apply for disability, which remains near record levels at8.8 millionAmericans.

Businesses higher cost from soaring insurance premiums for hiring that 50thworker explains more terminations and fewer new hires. But what is reducing current workers desire to work? Mulligan attributes this to theimplicit marginal income tax.

This implicit tax is not explicit like income tax, whereby raising your income to where you lose free government insurance reduces your incentive to work and earn more. A Medicaid recipient who works extra hard and increases his income could be rewarded by losing of thousands of dollars in welfare payments.

To pay the$2 trillion price tagfor ObamaCare,additional taxeswere levied on American workers. Many people decided to leave the workforce, collect benefits, and avoid paying income taxes. This promoted a vicious downward spiral with an ever-expanding Medicaid pool and an ever-shrinking taxpayer pool.

More ominous even than ObamaCare suppressing job growth, wage growth, and economic output, is the ACAs effect on care.

Healthcare discussions always seem to focus on the number of insured individuals with no proof that having insurance will lead to timely care.After paying the huge bureaucratic and administrative costs of ObamaCare, there is too little money remaining to pay for care. Already low doctor reimbursement schedules continue to fall.The hardest hit is theMedicaid population:only 53 percent of U.S. physicians acceptnew Medicaidpatients.

The experience of New Mexico Medicaid proves that ObamaCare reduces access to care. With expansion, New Mexico Medicaid added more than 300,000 new enrollees, causing a shortfall of $417 million. To balance the state budget, they had tocut low doctor reimbursementseven lower. The result is more insured people with fewer doctors to provide care.

Americans now experience the worst possible scenario. National spending is up, productivity is discouraged, and insurance premiums are more unaffordable. While more Americans have insurance, care is increasingly difficult to access.

Washington, D.C., should return healthcare to long-excluded free market principles instead of continuingfailed government controlslike ObamaCare.

There is no better example of an effective policy choice than the Texas model of limited government. Ranking as nearly the most economically free state according to theFraser Institute, Texas leads the nation ineconomic growthandjob creation, wherealmost 30 percentof all U.S. jobs were created in the last decade in a state with only 9 percent of the population.

Unleashing major economic activity comes from a host of pro-growth policies. However, the key decision is to limit the size and scope of government. Healthcare is a policy area that desperately needs the same key: less government.

Congressjust threw awayan opportunity to repeal oppressive ObamaCare. Eliminating its onerous mandates would have restored jobs, reduced bureaucratic waste in healthcare, and increased access to care.

America needs a system that puts patients back in the driver seat so they can shop for their health care and make their own health decisions. Healthcare should not be a system that de-incentivizes work, discourages risk-taking and innovation, keeps people dependent on federal handouts, and letsAmericans diewaiting inline for care. Its time for a market-based, patient-centered approach.

Dr. Deane Waldman, MDMBA, is Director of the Center for Health Care Policy at the nonprofit Texas Public Policy Foundation, Professor Emeritus of Pediatrics, Pathology and Decision Science, and the author of The Cancer in the American Healthcare System.VanceGinn,PhD, is senior economist in the Center for Fiscal Policy at the Texas Public Policy Foundation.

The views expressed by contributors are their own and are not the views of The Hill

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The Senate's healthcare double whammy: fewer jobs and less care - The Hill (blog)

Both liberals and his GOP primary opponent quickly seized on the comment, blasting it out to reporters and on Twitter.

The Republican from Nevada, who faces one of the toughest 2018 re-election battles in the Senate, was lobbied hard by both sides in the recent effort to repeal and replace the Affordable Care Act.

He ultimately sided with President Donald Trump and his party's leadership by deciding to support the "skinny repeal" bill, a vote that could help him in the GOP primary but could complicate his general election bid next November in his purplish home state.

"I wake up every morning trying to figure out what's best for the state of Nevada, what can I do for Nevada families. And obviously we got in the middle of this health care battle and I feel real pleased at the way this thing turned out and we're turning the page now to tax reform," he said, according to video from CNN affiliate KRNV.

Throughout the summer, Heller expressed concerns about earlier efforts by conservatives to curb the provision of Obamacare that expanded Medicaid in many states, including Nevada.

The "skinny" bill, however, would have only repealed parts of Obamacare like the individual mandate but left in place Medicaid expansion, which was a big reason why Heller supported it in the end.

Heller campaign spokesman Tommy Ferraro said in a statement that Heller's comments to KRNV reflected his satisfaction at voting for a bill that repealed what they considered the "onerous provisions" of Obamacare.

"When asked about the health care debate, Dean Heller reaffirmed that he stands by his vote to repeal the most onerous provisions of Obamacare that hurt Nevadans who can least afford it," he said.

After his comments on KRNV, in which he said he was "pleased" at the outcome, the liberal group American Bridge started circulating video of Heller's comments, calling him "spineless."

"Fake news: I'm pleased with my vote to repeal Obamacare, a bill the @POTUS wanted to sign and @DannyTarkanian criticized."

While Republican leaders have said they're now ready to transition to tax reform, Trump ramped up pressure this week on the Senate to figure out a health care solution too.

Heller teased the upcoming tax reform fight, saying he'll be heavily involved. "You think I was in the front of that battle, wait 'til I sit on the finance committee, I'll be right on the front of finance for tax reform also," he said.

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Dean Heller on health care: 'I feel real pleased at the way this thing turned out' - CNN

Of the 20 states -- and DC -- where preliminary 2018 premiums and insurer participation are available, premiums will rise in every location but one, according to the Kaiser analysis. The lone exception is in Rhode Island where premiums in Providence are expected to dip by 5% as compared to 2017. The premium increases range from 3% in Detroit, Michigan to 49% in Wilmington, Delaware. Fifteen of the locations are projected to see a premium increase of double digit percentages.

Those rate increases are, according to the Kaiser study, the direct result of the uncertainty around the law and its future. Here's the key bit from Kaiser on that:

"In the 20 states and DC with detailed rate filings included in the previous sections of this analysis, the vast majority of insurers cite policy uncertainty in their rate filings. Some insurers make an explicit assumption about the individual mandate not being enforced or cost-sharing subsidies not being paid and specify how much each assumption contributes to the overall rate increase. Other insurers state that if they do not get clarity by the time rates must be finalized -- which is August 16 for the federal marketplace -- they may either increase their premiums further or withdraw from the market."

It doesn't -- or shouldn't -- take a political genius to see how those numbers could translate into a political context. Close your eyes and imagine seeing this ad:

[images of sick, sad looking patients on screen]

Narrator: "Donald Trump and Republicans in Congress are gutting our health care. Premiums are spiking. And Trump? 'Let Obamacare fail...I'm not going to own it."

Add in a little localized factoid -- "in Pennsylvania, premiums are surging by 25%" -- and you have the makings of a devastatingly effective ad.

And, unlike, say the Russia investigation, which remains difficult to weaponize in a political context because of its abstractness and complexity, health care is a tremendously potent issue in a campaign.

It touches everyone on a daily, weekly or, at a minimum, monthly basis. It is not some pie-in-the-sky idea. It is a real-life struggle and challenge. It impacts lives. Those are the sorts of issues that really matter in politics -- ones that speak to the heart more than the head.

We've seen proof of health care's power as an issue in both the 2010 and 2014 midterm elections. In 2010, conservative outrage at what they viewed as major overreach by the federal government into their health care fueled the Republican takeover of the House. In 2014, the broken promise of "If you like your health care plan, you'll be able to keep your health care plan" led to the Republican takeover of the Senate.

This Kaiser study is the sort of thing that you will see in lots and lots of Democratic ads over the next 15 months. And it's a line of attack Republicans -- at least to this point -- have no obvious answer to.

Excerpt from:

This health care study might be a silver bullet for Democrats in 2018 - CNN

Hard-line conservatives began an uphill fight Friday to force a fresh House vote this fall on erasing much of President Barack Obama's health care law without an immediate replacement, the latest instance of Republican rifts in what's been a fractious week for the GOP.

The effort by the House Freedom Caucus seemed to have no chance of passing Congress. The GOP-led Senate turned down a similar repeal-only bill last month, and top House Republicans have little interest in refighting a health care battle they were relieved to put aside after their chamber approved legislation in May.

With the party's repeal effort collapsing last month in the Senate, the conservatives' push gives them a fresh chance to show hard-right voters they've not surrendered. It also provides a chance to call attention to Republican lawmakers who've pledged to tear down Obama's law but haven't voted to do so with Donald Trump in the White House.

"It's not about calling out anyone, it's about doing what we said," said Rep. Jim Jordan, R-Ohio, a Freedom Caucus leader. "And I do think people deserve to see if their member of Congress is going to do what they campaigned on."

The conservatives filed a petition Friday calling for a House vote on dismantling Obama's law that would not take effect until January 2019. They say that would give Congress time to enact a replacement and pressure Democrats to cooperate, a premise Democrats who oppose the repeal effort reject.

To force a House vote, conservatives need signatures of 218 lawmakers, a majority. That seems like an uphill task because many GOP moderates oppose annulling Obama's law without a replacement they'd support, and all Democrats are opposed.

Asked how Speaker Paul Ryan, R-Wis., views the conservatives' push, spokeswoman AshLee Strong said, "The House has already passed a plan to repeal and replace Obamacare."

This week has also featured an extraordinary verbal barrage by Trump against Senate Majority Leader Mitch McConnell, R-Ky., over the Senate crash of the health care drive.

After tweeting caustic criticisms of McConnell, Trump insinuated to reporters that McConnell should consider resigning if he can't push health care, tax and infrastructure legislation through his chamber. McConnell had said Trump had "excessive expectations" about how quickly Congress could pass complicated bills.

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House conservatives want fresh health care repeal vote - ABC News

(Bastien Inzaurralde/The Washington Post)

BRUNSWICK, Ga. The long August congressional recess, which Republicans hoped would begin a conversation about tax reform and must-pass budget measures, has so far seen another round of angry town halls focused on President Trump and the stalled effort to repeal the Affordable Care Act.

Over just one day, in three small towns along Georgias Atlantic coastline, Rep. Earl L. Buddy Carter (R-Ga.) spent more than four hours answering 74 questions, many of them heated. Just three focused on tax reform; nearly half of all questions focused on health care.

We did our job in the House, Carter said at the top of a town hall at Brunswicks College of Coastal Georgia. It got over to the Senate, and it hit a stumbling block there. Now its in their court, and they need to get something done. Folks, were not giving up.

Carters town halls he is hosting nine total, more than any member of the House mirrored what was happening in swing and safe Republican districts across the country. The failure of the repeal bill kick-started a tax reform campaign, backed by Republican leaders and pro-business groups, who have booked millions of dollars in TV ads to promote whatever might lead to an uncomplicated tax code.

In the first spots, paid for by the American Action Network, a laid-off steelworker worries that without lower taxes for working families, more jobs will be lost to China. At rallies and forums in several states, Americans for Prosperity has pitched tax reform as a way to unrig the economy. And in a polling memo made public this week, the AAN found 65 to 73 percent of voters responding favorably to reform if it was pitched as a way to restore the earning power of the middle class and save billions of dollars per in year on tax preparation services.

But at town-hall meetings since the start of the recess, tax reform has hardly come up; health care has dominated. At a Monday town hall in Flat Rock, N.C., Rep. Mark Meadows (R-N.C.) pitched a plan to devolve ACA programs to the states, then found himself fending off constituents who backed universal Medicare.

[Bipartisan health policy coalition urges Congress to strengthen the ACA]

You can take the top one percent and tax them fully, and it still wont pay for Medicare, said Meadows.

At a town hall in Chico, Calif., in the most Democratic portion of a deep red district, Rep. Doug LaMalfa (R-Calif.) found himself fending off furious complaints about the repeal vote, with constituents accusing him of acting to bring about their death.

I hope you suffer the same painful fate as those millions that you have voted to remove health care from, one constituent told LaMalfa. May you die in pain.

Carters town halls did not reach that boiling point, but they revealed what the tone of congressional listening sessions has become angry, wistful and loaded with progressive activists.

The 1st congressional District, stretching from Savannah to the Florida border, has been held by his party since 1993. In 2016, the Trump-Pence ticket carried the district by 15.5 points, while Democrats could not find a candidate to run against Carter.

(Nolan Ford/North State Public Radio)

But on Tuesday, the constituents who signed up for the meetings on Eventbrite and walked past local police officers to take their seats seemed to skew left. Two groups founded after the 2016 election, Speak Up Now and Savannah Taking Action for Resistance, had members at town halls in Darien and Brunswick.

Carter, who peppered his answers with self-deprecating jokes, sometimes called on activists whod dogged him before. In Brunswick, he quickly pivoted from a question about Zionist influence in our foreign policy by promising to put America first. After three different constituents asked him to say whether he supported the presidents decision to ban transgender men and women from military service, he went from deferring to our commander in chief to saying what he believed.

I dont want em serving in the military, Carter said, as dozens of constituents booed and more than a dozen walked out. Im sorry.

At each town hall, Carter provided fact sheets to advance two messages one about how much work Congress had done in 2017, and one about how his party would not give up on repealing the ACA. A one-pager titled Health Care Reform: Myth vs. Fact, with citations from the Department of Health and Human Services, revealed just how much the party had suffered from Democratic attacks. Instead of rebutting the line that the AHCA would cut Medicaid, it framed the ACAs Medicaid expansion as a departure from the programs mission that denied choice to the working poor.

Medicaid was designed to provide a vital health care safety net for elderly, children, pregnant women, and individuals with disabilities, it read. Low and middle-income adults capable of holding down a job should have health care choices.

Behind the microphone, Carter found himself making that same point repeatedly, about a slew of ideas for expanded government programs, as Democrats cheered and Republicans simmered. In Brunswick, after Carter told a college student that free tuition was a pipe dream weve got a $20 trillion debt an older man took the mic and advised the student to get a job.

It wasnt the only time Carter stood back and watched as his constituents argued among themselves. Mary Nelson, 73, used her question time at Carters Darien town hall to insist that Republicans were all wrong about single-payer health care. She walked through an experience that her Australian relatives had gone through, and described a cheap system with no hoops to jump through that could be copied in America.

They are taxed out the wazoo in Australia, interjected Adrienne Stidhams, 48, a Trump supporter.

How much do we pay for premiums? Nelson asked rhetorically.

Like Meadows, Carter suggested that Democrats and Republicans could work together on health-care bills while the repeal effort stalled. When multiple constituents asked if he would let the probe of Russian meddling in the 2016 election play out, Carter defended the president and suggested that special counsel Robert S. Mueller III, a good man, would likely find out the facts before long.

Im worried about some of the people he has around him, Carter said, apparently referring to lawyers hired for the probe who have been attacked in conservative media for donating to Democrats.

There were no questions about the debt limit, which must be raised when Congress returns to avoid default. The three questions about tax reform focused on the possibility of the Fair Tax, a national sales tax to replace taxes on income, about whether companies keeping profits overseas could be taxed, and about tax fairness in general.

Carter jumped at the opportunity to talk about it. Whats being proposed right now is to bring our corporate tax down from 35 percent one of the highest in the world down to 15 percent, he said, citing a tax reform blueprint released this spring and a positive analysis from the conservative Tax Foundation. That will create jobs.

No constituents followed up with questions. Instead, there was more skepticism about the president and his plans, countered by constituents who asked Carter to defend the president from media attacks.

I tell ya, I dont think Ive ever seen a president thats been disrespected by the media like this, said Carter. He had more to say, but drowned out by booing, he moved on.

Read more at PowerPost

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At raucous town halls, Republicans have faced another round of anger over health care - Washington Post

USA TODAY Published 10:36 a.m. ET Aug. 11, 2017

Johnny J. Hollis, Jr., pastor of Mercy Baptist Church in Montgomery, Ala., talks to classmates, Dorothy McAdory, right, and Darlene Cotton last week after a session on health disparities at the Greater Shiloh Missionary Baptist Church in Birmingham.(Photo: Deborah Barfield Berry, USA TODAY)

Some black churches in the South have taken a dramatic step: banning fried chicken from their Sunday menus.

It is part of a broad effort to combat the persistent truth that blacks suffer from conditions like heart disease and diabetes at much higher rates than whites.

USA TODAY's Deborah Berry visited an event in a Birmingham, Ala., church last week where the Alabama Baptist State Congress of Christian Education convened a training for community leaders on ways to bring better health care to people in church, in barbershops, and in neighborhood grocery stores. But participantssaid they are concerned that any roll back of the Affordable Care Act could make their jobs harder.

Berry joined us on USA TODAY's Cup of Politics podcast to talk about the effort.

Read or Share this story: https://usat.ly/2wPlJ2q

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Podcast: Black churches take on the fight against racial disparities in health care - USA TODAY

We are, too.

We're freshman members of Congress from different political parties, but we know there is more that unites us than divides us. That's why we're part of the Problem Solvers Caucus: a group of more than 40 lawmakers, split evenly between Democrats and Republicans, committed to -- you guessed it -- solving problems.

As it stands, the Affordable Care Act is unsustainable. For too many Americans, health care is still too expensive. Premiums are rising and people are scared. This is a life-and-death issue for many Americans. They deserve to know that when they get sick, or their child falls ill, that a system will be in place to ensure they have access to high-quality, affordable health coverage. That should be the goal for any lawmaker, regardless of party.

We know that the Affordable Care Act isn't perfect, but we need to keep what works and fix what doesn't. The bottom line is: we need to stabilize the individual market right now -- and that is what our proposal does.

Second, we must stabilize the individual marketplace by creating a dedicated fund for states to use to bring down premiums and limit losses for providing coverage, especially for people with pre-existing conditions.

Third, our plan calls for an adjustment to the employer mandate from businesses that have 50 employees to those with 500 employees. The current mandate puts too many burdens on small businesses, making it almost impossible to grow beyond 50 employees.

Finally, our proposal will provide technical changes and guidelines for states seeking to improve their exchanges and offer better coverage for consumers.

This isn't the silver bullet solution to our healthcare troubles, but it's a start -- and it's the exact kind of common sense leadership that Americans are looking for. Instead of focusing on scoring political points, the Problem Solvers Caucus' goal is simple: get things done.

We both happen to have been trained as CPAs and lawyers. We're both freshmen members from suburban districts. One is from Long Island and Queens in New York and the other from outside Philadelphia, but we are joined by other members from all over our nation with varying backgrounds and years of service.

When we came to Congress earlier this year, each of us signed a freshman pledge to civility. That's what being an elected official is about. We chose to set aside our petty differences, look at the big picture, and realize that we have a sacred duty to improve the lives of the people who have entrusted us with the responsibility of representing them -- and our country -- in Congress.

We know that this is serious business. Ramming through legislation with support from only one party is not how the legislative branch of government was meant to operate, and as we've seen before and we're seeing again now, it just doesn't work.

We need leaders sobered by their responsibilities and individuals committed to stopping the nonsense that dominates our current national discourse and elevating the debate to the serious, responsible level our times demand.

Instead of focusing on areas of disagreement, let's focus on goodwill and compromise where we can find common ground. We believe our health care proposal is the start of many good bipartisan conversations. It is not only our duty, but our only hope.

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Congressmen: Our bipartisan plan for health care - CNN

By THOMAS BEAUMONT , Associated Press August 11, 2017 - 1:30 PM

CEDAR RAPIDS, Iowa Democrats used a bus emblazoned with the words "Drive for our Lives" to gin up opposition to vulnerable House Republicans who voted against Obamacare with the aim of upending the GOP's majority in next year's midterm elections.

The vote to repeal and replace the Obama health care law looms large for 21 GOP lawmakers, including Iowa Reps. David Young and Rod Blum. They represent competitive congressional districts where Democrat Hillary Clinton won or came close in last year's presidential election.

The collapse of the yearslong Republican quest to dismantle Obamacare has been a bitter pill for House Republicans who voted for the legislation in May only to see the drive fall apart recently in the Senate when the GOP failed to muster enough votes.

Now all that some lawmakers have to show for the politically tough vote is the word "mean" President Donald Trump's description of legislation that would have made deep cuts in Medicaid, allowed states to opt out of coverage for essential benefits and knocked 23 million Americans off insurance.

The bus motored into Iowa on Friday, stopping in Cedar Rapids, the largest city in Blum's eastern Iowa district.

The black-and-gray motor coach was parked in downtown Cedar Rapids as Diane Peterson urged Blum to listen to his district's independent voters, who outnumber those affiliated with either major party.

"Of course there are things in the ACA that need fixing," said Peterson, referring to the Obama health law's name, the Affordable Care Act. The 61-year-old Democrat and coffee shop owner from Hiawatha added, "But Republicans now need to reach out."

While Blum has allied himself with the House's conservative Freedom Caucus, Young angered conservatives when he initially opposed a House GOP health care bill, then weeks later swung behind it. Independents were frustrated with the two-term congressman's embrace of a partisan approach to repealing and replacing Obamacare.

"David Young is not as conservative as some would like here in southwest Iowa," said Council Bluffs Republican David Overholtzer, a 56-year-old accountant.

"Things need to get done," said Jeff Jorgensen, a western Iowa Republican county chairman. "He's doing OK, but his chances for re-election are tied to Trump's popularity."

The Des Moines Register's Iowa poll last month showed Trump's disapproval climbing to 52 percent. The increase was driven largely by independents, 59 percent of whom disapproved of Trump's job performance, compared to 50 percent in February.

Independents, who hold sway in Young's politically diverse district, want a bipartisan approach to health care.

"That's what I and others like me have been saying: Because of this fail, people might reach across the aisle and craft something together," said Mark Scherer, a 65-year-old manufacturing representative and political independent from a north Des Moines suburb.

Now, Young is threading the needle, talking bipartisanship as he faces the reality that Democrats are gunning for him in a state where Trump's approval is sinking and neither can boast a major legislative achievement.

"We've got to pivot for the good of the country to a more bipartisan solution," the 49-year-old Young, a former chief of staff to Iowa Sen. Chuck Grassley, told The Associated Press during a visit to far western Iowa. "It's probably an easier, clearer path."

A national poll released Friday by the nonpartisan Kaiser Family Foundation found that around 4 in 5 want the Trump administration to take actions that help Obama's law function properly, rather than trying to undermine it. Just 3 in 10 want Trump and Republicans to continue their drive to repeal and replace the statute.

Young defended his vote for the House GOP bill, arguing that Republicans added billions of dollars more to help people with preexisting conditions.

Democrat Janet Norris from Red Oak, who met privately with Young in her western Iowa hometown last week, called his reasoning "doublespeak."

"You need to assure me you care about us in the Third District, and not what Republican leadership tells you to do," she recalled telling Young during their private chat at the Red Oak fire station.

Norris doesn't rule out voting next year for Young, who has drawn seven potential Democratic challengers, but cringed and said, "I just don't feel like he's independent enough."

Young's newly expressed, less-partisan view is music to the ears of Republican Christi Taylor, 46, a physician from Waukee in Des Moines' burgeoning western suburbs, heavy with moderate Republicans and independents.

But she lamented Republicans' attempt to quickly pass legislation with support from only GOP lawmakers. "This is not something any one party should ram through," Taylor said, describing the House's effort as "naive and arrogant."

Democrat Bryce Smith from nearby Adel agrees with Young that the 2010 law needs tweaking, not shredding. The 26-year-old bowling alley owner complains that Young's bipartisan tone is convenient, in light of the spectacular collapse of Republican efforts.

"All of a sudden, now that this failed, we need to approach it in a bipartisan way?" Smith said in disbelief. "If it would have passed the first time, we would have never heard from him that we need to work on a bipartisan solution."

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Dems target swing-district House GOP on health care - Minneapolis Star Tribune

(Jenny Starrs/The Washington Post)

President Trump stepped up his criticism of Senate Majority Leader Mitch McConnell on Thursday for not muscling through a health-care bill, escalating an extraordinary fight with a key leader of his own party.

Can you believe that Mitch McConnell, who has screamed Repeal & Replace for 7 years, couldnt get it done, Trump wrote on Twitter. Must Repeal & Replace ObamaCare!

Trumps morning tweet was his second in 24 hours targeting McConnell for remarks the Kentucky Republican made earlier in the week suggesting that Trumps lack of political experience had led toexcessive expectations for passing major legislation.

[Trump takes issue with McConnells accusation that he had excessive expectations for Congress]

Trump has remained bitter about the failure of congressional Republicans to pass a bill overhauling the Affordable Care Act, a pledge the party has made since 2010 and a marquee campaign promise for Trump.

The sparring with McConnell was the latest sign of increasingly strained relations between Trump and Republicans in Congress, who have had few victories since January despite the GOPs control of the White House and both the House and Senate.

Since the collapse of a health-care bill, Trump has belittled GOP senators as looking like fools and suggested they change the chambers rules to make it easier to pass bills.

The presidents attacks on a leader popular among Senate Republicans comes as lawmakers are poised to try to tackle other shared but challenging priorities in the fall, including a tax overhaul. They also are faced with trying to craft a budget and raise the nations debt ceiling.

Discerning a particular strategy or goal from these tweets is hard, said Doug Heye, a Republican consultant and former Capitol Hill staffer. It just doesnt help enact any part of his agenda, and it sends a further troubling sign to Capitol Hill Republicans already wary of the White House.

Heye said that with Trumps job approval numbers declining among the Republican base, now is the time to build support within the party.

White House aides said Trump has a general frustration with McConnell that extends beyond the health-care debate.

You can see the presidents tweets, White House press secretary Sarah Huckabee Sanders told reporters Thursday. Obviously theres some frustration. I dont have anything more to add.

Barry Bennett, an adviser to Trump during last years campaign, said the president was speaking to a Republican Party that has become a firmly anti-Washington party.

It may not be a winning tactic, but its certainly a winning message, Bennett said.

McConnell, to this point, has been one of the most steadfast supporters of Trumps agenda in Congress, and at least publicly, Trump has enjoyed a smoother relationship with McConnell than House Speaker Paul D. Ryan (R-Wis.) and other GOP congressional leaders.

In April, McConnell orchestrated the confirmation of Trumps Supreme Court pick, Neil M. Gorsuch, changing the Senate rules so that Democrats could not block the nomination. The Gorsuch confirmation remains Trumps largest victory on Capitol Hill to date.

McConnells wife, Elaine Chao, another prominent Washington figure, also serves in Trumps Cabinet as transportation secretary.

In his remarks Monday to the Rotary Club of Florence, Ky., McConnell said, Our new president had of course not been in this line of work before. He added: I think he had excessive expectations about how quickly things happen in the democratic process.

[Can this marriage be saved? Relationship between Trump, Senate GOP hits new skids.]

McConnell said people think Congress is underperforming partly because artificial deadlines, unrelated to the reality of the complexity of legislating, may not have been fully understood.

Sanders confirmed that Trump and McConnell spoke by phone Wednesday, a conversation in which Trump made clear he wants to continue to press for passage of a health-care bill. The call was first reported by the New York Times.

The same day, while on a 17-day working vacation at his private golf club in Bedminster, N.J., Trump took his first shot at McConnell on Twitter.

Senator Mitch McConnell said I had excessive expectations, but I dont think so, the president wrote. After 7 years of hearing Repeal & Replace, why not done?

Earlier Wednesday, Dan Scavino Jr., the White House social media director, also went after McConnell on Twitter.

More excuses, wrote Scavino, an outspoken Trump loyalist. @SenateMajLdr must have needed another 4 years in addition to the 7 years to repeal and replace Obamacare.....

Sean Hannity, a Fox News host often sympathetic to Trump, also weighed in following McConnells remarks, writing on Twitter: @SenateMajLdr No Senator, YOU are a WEAK, SPINELESS leader who does not keep his word and you need to Retire!

In another sign of frayed relations between Trump and Republican senators, one of the presidents largest political benefactors is providing a $300,000 contribution to a super PAC that aims to unseat Sen. Jeff Flake (R-Ariz), who has been critical of the president.

Politico first reported that Robert Mercer, a hedge fund billionaire heavily involved in Trumps political ascendancy, is making a donation to a group supporting former Arizona state senator Kelli Ward, who is challenging Flake in a Republican primary next year.

Flake has been on a book tour promoting Conscience of a Conservative, in which he argues that the GOP is in denial about the Trump presidency.

Despite the public criticism, Trump and McConnell are in frequent contact, usually by telephone, to discuss legislative strategy, aides said. The last time they met in person was July 19, when Trump hosted Republican senators at the White House and implored them to continue working to repeal and replace the Affordable Care Act.

Privately, senior GOP congressional aides across Capitol Hill have said its Trump and his team not McConnell who deserve the blame for the collapse of the GOPs health-care plan. The aides gripe that Trump seriously damaged relationships with key Republican senators over the course of the months-long debacle.

Trump has singled out certain senators either via Twitter or by placing them next to him during staged White House meetings to make it look like hes squeezing them a visual that often leads to awkward still photos of the senators facial reactions.

At one point this summer, Trump was flanked at a White House meeting by Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), who both voted against the health-care measure. At the mid-July meeting, it was Sen. Dean Heller (R-Nev.) seated next to Trump. The president called him out with cameras rolling for wavering on the health-care bill.

Look, he wants to remain a senator, doesnt he? Trump said as Heller laughed uncomfortably.

Heller ultimately voted for the bill, but the exchange with Trump is a scene that Democratic aides have vowed will appear prominently in future campaign attack ads against the senator, who is the most vulnerable GOP incumbent facing reelection next year.

Trumps long-standing feud with Sen. John McCain (R-Ariz.) hasnt helped the overall dynamic either. The senator voted against the health-care plan in a closely-watched late night vote even after Trump made a direct last-minute appeal by phone.

The pair have been at loggerheads on several occasions since Trump two years ago criticized the senator for being captured during the Vietnam War and refused to apologize despite a national outcry.

In addition to criticizing Trump and McConnell for the contours of the health-care debate, McCain this week has blasted the presidents comments on North Koreas nuclear ambitions in interviews with Arizona radio stations.

On Thursday, he also released legislation that would implement a new military strategy in Afghanistan a proposed amendment to the annual defense policy bill that McCain said he unveiled in the absence of a new coherent strategy from Trump.

Sen. Ron Johnson (R-Wis.), who has had a contentious relationship with McConnell, said Thursday that he was sympathetic to Trump in the wake of the health-care bills failure.

President Trump is at his desk with a pen ready to sign what Congress was going to send him and we didnt, Johnson said during an interview on CNN. And I completely feel his frustration. Im every bit as frustrated.

Asked whether he thought taking aim at McConnell on Twitter was the right tactic, Johnson demurred.

Ill let this president speak for himself and his tactics, he said.

Trumps social media firestorm marks his first concerted attacks against McConnell. Throughout the 2016 campaign, while other GOP lawmakers wavered in their support of the GOP nominee, McConnell never did. He criticized some of Trumps more outlandish statements, but it was usually muted compared with other Republicans, and McConnell preferred to deliver his critiques in private.

So when Trump lashed out at fellow Republicans, it was directed mostly at Ryan and McCain, who frequently criticized Trump in public. Trump even threatened to support primary opponents running against Ryan and McCain last year.

Behind the scenes during the campaign, McConnell served almost as a tutor to Trump on the key issue of handling the Supreme Court vacancy after the February 2016 death of Justice Antonin Scalia.

At McConnells urging, Trump released lists of more than 20 potential nominees, names that were culled by Trumps advisers from discussions with the Federalist Society, the conservative group focused on judicial matters that is close to McConnell.

Trumps handling of the court vacancy helped rally evangelical conservatives to his side, a key factor in his narrow victory last fall over Democrat Hillary Clinton.

However, inside the White House, Trump has a collection of advisers who have had antagonistic relationships with McConnell and Senate GOP leadership.

Stephen K. Bannon, Trumps chief strategist, came from Breitbart, where his news organization regularly antagonized McConnells leadership team. Stephen Miller, chief policy adviser to Trump, was not considered an ally to the Senate leaders staff when Miller was a top adviser to Jeff Sessions in the Senate.

Moreover, one of Trumps top legislative affairs advisers is Paul Teller, who served as Sen. Ted Cruzs top aide during a period when the Texas Republican accused McConnell of lying about trade legislation.

And Mick Mulvaney, Trumps budget director, was a constant critic of the Senate during his three terms in the House, regularly opposing fiscal compromise deals that McConnell brokered with the Obama White House.

Phil Rucker and Kelsey Snell contributed to this report.

Continue reading here:

Trump steps up attacks on McConnell for failure on health-care reform - Washington Post

MSNBC

Trump's political antics push consumers' health care costs higher MSNBC At a press briefing a few weeks ago, White House Press Secretary Sarah Huckabee Sanders said there's all kinds of evidence that the Affordable Care Act is facing a collapse. To prove her point, Donald Trump's principal spokesperson told reporters, ... Study says uncertain future of health care will spike premium costsChristian Science Monitor Trump's 'mixed signals' on health care could lead to big premium increases, study findsThe Week Magazine Uncertainty over Trump's health-care policies driving double-digit insurance price hikesCNBC all 24 news articles »

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Trump's political antics push consumers' health care costs higher - MSNBC

Source: National Business Group on Health

Marcotte said that the cost can vary depending on where the treatment is administered (i.e., a hospital or doctor's office or even in the home). The survey shows that 44 percent of companies plan to combat pharma costs in part by better managing where patients receive those high-price medicines.

Employers also increasingly have been offer high-deductible plans as a way to control costs. The study shows that by next year, 90 percent of large companies will offer this option.

Under these plans sometimes called consumer-driven health plans in industry lingo employees can put away tax-deductible savings in a health savings account, or HSA. For 2017, contribution limits are $3,400 for individual coverage and $6,750 for family plans. An extra $1,000 is allowed for people age 55 or older.

HSA balances can carry over from year to year, and withdrawals are tax-free as long as they go toward qualified medical expenses.

The survey also says that without such various cost-cutting measures being implemented by employers, overall costs would increase by 6.6 percent next year instead of the anticipated 5 percent.

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Employers to spend about $10000 on health care for each worker - CNBC

Story Highlights

WASHINGTON, D.C. -- Americans cited the U.S. government itself as the most important problem facing the U.S. this month (20%). This is down five percentage points from June, but still elevated amid the tension between the Trump White House and Congress.

What do you think is the most important problem facing this country today? [open ended]

Issues mentioned by 4% or more of respondents

The "government" category of responses includes many mentions of President Donald Trump, specifically, as the country's top problem, as well the Democratic Party, government gridlock and politics in general.

These findings are from an Aug. 2-6 Gallup poll.

Mentions of racism/race relations as the most important problem were at 7% this month, up from 4% in July. Yet mentions about the economy continued to drop, at only 6% in August. Immigration, a contentious issue throughout the presidential campaign and into the Trump presidency, held at 7%.

Before the latest escalation in souring relations between the U.S. and North Korea on Tuesday, 4% of Americans named North Korea as the most important problem. The war of words between Trump and North Korea's leader Kim Jong Un has been ratcheting up with North Korea recently declaring it has the capability to attack the U.S. and threatening to attack U.S. military installations on Guam. Trump on Tuesday warned the nation that these threats could be met with U.S. "fire and fury."

Government as the most important problem may be down from June, but mentions of it are still higher than was true for much of 2016. The highest percent mentioning government in the past five years was in October 2013 during the partial shutdown of the federal government. Factors that may have an impact on this choice include the Senate failing to pass a bill to repeal and replace the Affordable Care Act (ACA) and Congress passing sanctions against Russia over meddling in the 2016 presidential election.

Democrats (27%) are more likely than Republicans (15%) to say the government is the nation's top problem, however both figures are down slightly from 31% and 24% in June, respectively.

Healthcare Remains Significant Problem in Past Month

Seventeen percent of Americans this month identify healthcare as the most important problem, essentially unchanged from 16% last month. With the Republican ACA replacement plan dead, at least for the moment, along with reports of healthcare premiums rising, it is clear that healthcare remains on Americans' minds.

Mentions of healthcare have been generally higher in the past four months than at the start of Trump's term, except for a dip to 7% in June. That temporary drop occurred in the time between the House passing an ACA repeal bill and the beginning of Senate work on repeal legislation.

Republicans and Democrats are nearly tied in their citation of healthcare being the most important problem, with 21% of the GOP mentioning it and 19% of Democrats.

Bottom Line

So far this year, the U.S. government has consistently been top of mind when Americans are asked to name the most important problem in the U.S. The economy in general, which was the dominant concern during the Great Recession and its aftermath, remains far lower ranked today.

Healthcare may recede as a top problem if it falls out of the news because of Congress' reluctance to continue with Obamacare repeal legislation in the near term. On the other hand, if rising premiums continue, and the doomsday scenarios Trump is predicting come to pass, healthcare could remain as a most important problem. With discussions about tax reform looming on the congressional agenda, taxes, now at 2%, may rise as a most important problem in the next month or two. Military action with North Korea, or an intensification of words with the U.S., may vault that situation higher as well.

Advanced Analytics Predict business outcomes and build a data-driven culture to shape your company's future.

Results for this Gallup poll are based on telephone interviews conducted Aug. 2-6, 2017, with a random sample of 1,017 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia. For results based on the total sample of national adults, the margin of sampling error is 4 percentage points at the 95% confidence level. All reported margins of sampling error include computed design effects for weighting.

Each sample of national adults includes a minimum quota of 70% cellphone respondents and 30% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods.

View survey methodology, complete question responses and trends.

Learn more about how the Gallup Poll Social Series works.

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Government, Healthcare Most Important Problems in US - Gallup

A medical organization in the U.S.that datesback hundreds of yearsis embarking on a blockchain pilot.

The Medical Society of Delaware,first formed in 1776, has revealed it willbuild a proof-of-concept focusing on the pre-authorization process for care providers and medical insurers. By improving the efficiency of that step, the society said it hopes care can be delivered more quickly.

As a further benefit, the trial will also create a chain of patient records that can be accessed by insurers and medical care providers.

Partnering on theproject ishealthcare tech startup Medscient, which itself leverages technology developed by blockchain-focused startup Symbiont.

Andrew Dahlke, vice president of the Medical Society of Delaware, said in a statement:

"We are confident that this proof-of-concept will not only address this particular pain point, but will lay the groundwork for streamlining other healthcare administrative issues as well."

Those involved with the project are due to make a presentation at theMedicaid Enterprise Systems Conference, to be held later this month in Baltimore,Maryland.

The newscomes shortly after Delaware became the first U.S. state to pass a law allowing the use of blockchain to create and store business records, including stock ledgers an effort that wasfirst unveiledin 2016.

Medical files image via Shutterstock

The leader in blockchain news, CoinDesk is an independent media outlet that strives for the highest journalistic standards and abides by a strict set of editorial policies. Have breaking news or a story tip to send to our journalists? Contact us at [emailprotected].

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Medical Society of Delaware Tests Blockchain to Improve Healthcare Access - CoinDesk

In his Aug. 4 letter to The Advocate, Stanford Bardwell makes quite clear his opinion we should each mostly look after our own health care and pay for what we can afford, supplementing personal savings with major-medical insurance for catastrophes. This concept worked fairly well for a brief period in our history. People with low-paying or no jobs may have lacked adequate care because they couldnt afford it, but that is still the case for many today.

Here are just two of the many reasons a return to such a system would not work today:

1. Medical inflation. I suggest anybody who has been to the doctor, had lab tests, taken prescription drugs or received medical care for any number of conditions take out the bills and look at the totals stated. For the sake of argument, lets assume the charges bear some semblance to the actual cost of the services. Do you honestly believe most people could easily pay these bills, in full, from savings or any other liquid assets?

Kudos to Lloyd Ray for his letter of July 24 on solving the health care debate in Congress.

2. Changes in services ordered. Go to a doctor for something he or she cannot immediately treat. Note the number of expensive tests, specialist referrals and ancillary treatments physicians now order. This was not always the case not by a long shot, and not least because many of these options simply did not exist. Do you believe all these extras are essential? Do you believe most people could afford to pay to pay for these, even if the costs were more reasonable? At what level should major-medical insurance kick in?

Bardwell is a well-respected and successful person. His letter reflects a disturbing lack compassion for those less privileged. Comparing easy health care access to opioid addiction is appalling. Attacking Hillary and the last administration with unfounded conspiratorial allegations about the ACA is ridiculous. The ACA was a compromise neither Clinton nor Obama would have proposed.

Our current health care system is expensive, irrational, inefficient, ineffective and inequitable. The ACA provides for more coverage, but it does little to address any of these issues. Mr. Bardwell presents a simple solution, but as Einstein is credited with saying, Things should be made as simple as possible, but no simpler. Mr. Bardwells letter does not meet that test.

We live in neither a third-world nor a let them eat cake country, and we should all hope we never do.

Stephen Winham

retired state budget director

St. Francisville

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Letters: Don't oversimplify health care - The Advocate

I am a father, husband and board-certified clinical psychiatrist at St. Josephs Hospital in Syracuse and medical director of CPEP (Comprehensive Psychiatric Emergency Program).

I strongly believe health care is a right for all. It should be available without a cost burden as a healthy person is a productive person. Also, health care is not a commodity like an iPhone but essential to our wellness as a society. Yet the United States is the only industrialized country where health care is a commodity where people make profits on the back of sickness. Health care coverage for millions of Americans continues to be up in the air with little focus on long term solutions, as seen in "Bipartisan experts urge next steps on health care push" (auburnpub.com, 8/7/2017).

The president and many Republicans continue their obsession with getting rid of Affordable Care Act (ACA) despite polling and activism that shows the public prefer improving and expanding coverage. All parties seem to agree that the ACA in its current form is not affordable for many businesses and individuals. I continue to see working class people at my clinical practice who are suffering under this system. Often their employers cannot afford these health care costs. Medications are unaffordable and appointments are skipped. Emergency room care drives expenses up. Meanwhile, health insurance CEO salaries continue in the millions on the backs of those who are helping society.

We need to follow the most efficient model for administering healthcare: improved, expanded Medicare for all. Traditional Medicare has 2-percent administrative costs, as compared to private insurance company which can be as high as 12 percent and are profit oriented. Profits should not be the driving force to health care. It allows disparity of care and brings immeasurable hardship to the needy. Senators like Kirsten Gillibrand and others are supporting Medicare for all. There are 116 co-sponsors for the bill in the U.S. House of Representatives. In New York, we are one state senator away from passing the New York Health Act, which would also provide universal coverage using the improved Medicare model. State Sen. Valesky is a co-sponsor, along with 30 other senators, and deserves praise. Our businesses and our patients demand that we cover everyone without wasting money. Let U.S. Rep. John Katko and state Sens. John DeFrancisco, Patty Richie and Pam Helming know they need to act now to support improved and expanded Medicare.

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Letter: Profits should not drive health care - Auburn Citizen

Rep. Doug LaMalfa (R-Calif.) held a contentious town hall in Chico, Calif., on Aug. 7. (Nolan Ford/North State Public Radio)

The people of Californias 1st Congressional District made their congressman see red Monday morning.

Like other Republican lawmakers before him, Rep. Doug LaMalfa (Calif.) held a town hall on the ongoing health-care debate and the effort, led by President Trump and the GOP, to repeal and replace the Affordable Care Act.

And like some of his colleagues, LaMalfa was met with boos, catcalls and verbal barbs shouted from the 400-person-strong audience at the Chico Elks Lodge in Northern California, recorded on video and audio by North State Public Radio.

It was the most recent of a declining number of health-care-focused town hall meetings charged byemotional pleas and debates between constituents and their representatives, meetings that have sparked anxiety among GOP lawmakers heading home to face tough questions.

The audience was armed with blunt questions, harsh comments and red placards they used to signal their disapproval of audience queries or LaMalfas responses. Green cards were used to show approval.

LaMalfa saw his fair share of red over his responses. He did not help himself, occasionally veering into sarcasm over concerns ranging from health care to climate change.

[To hold a town hall or not? Its a lose-lose situation for many Republicans right now.]

Out of a sea of moments threatening to boil over, one stood out as particularly tense.

I think that your vote to throw 22 million people off of health is reprehensible and in the service of the rich, a resident told LaMalfa on his efforts to defund Planned Parenthood.

I hope you suffer the same painful fate as those millions that you have voted to remove health care from. May you die in pain, he added.

The comments drew a stream of groans from the audience in a rare moment of sympathy for LaMalfa.

We pray for our constituents too, sir, LaMalfa, who took office in 2013, quickly countered.

Once dotted on Republican lawmakers schedules early in the Trump administration,town halls in VFW halls, rotary clubs and school gyms have become flash points of partisan politics, where local activists marshaledopposition against conservativeleaders in the months leading up to Julys vote, when the Senate rejected a partial repeal of Obamacare.

Town halls have become a damned-if-you-do, damned-if-you-dont situation for GOP lawmakers hoping to sell their message to voters, some in reliably red districts where constituents have used new health-care laws to their advantage, such as receiving coverage for preexisting conditions.

[GOP lawmakers wouldnt come to a town hall so voters brought literal empty suits]

Some lawmakers have refused to hold the meetings. Others have prescreened participants in the hopes of excluding activists who do not live in their districts. That decision has drawn fire.

Even when you had the conservative outrage over Obamacare, I dont recall anyone trying to preselect attendance. The unwillingness to take criticism or any heat from a legislative decision is really unusual,Norm Ornstein, a congressional ethics expert, told The Washington Post in May.

Videos and tweets from events have gone viral, prompting Congress to slow the pace of town halls in recent months. Over the July 4 recess, only three GOP senators announced decisions to hold town halls. Sens. Ted Cruz (Tex.), Jerry Moran (Kan.) and Bill Cassidy (La.) all voiced concern over the health-care bill. Only Cassidy broke ranks to vote against the full repeal-and-replace measure.

LaMalfas district is comfortably red. He cruised to his last victory by 15 percentage points, and Trump soundly defeated Hillary Clinton in the presidential election there.And for his part, LaMalfa has held other town halls recently, with one each in March and April, according to the Los Angeles Times. LaMalfa spokesman Parker Williams told The Post that he plans to hold more town halls in the coming weeks and months.

I think things went about as well as could be expected, given the high emotions in our country at present, Williams said, calling the town hall alargely cordial and productive conversation.

[A town hall in Kansas shows Republican struggles with health-care bill]

Mondays meeting might be a test case in how to manage a crowd. As the audience appeared to get agitatedduring LaMalfas meandering explanation of Medicaid costs, he stopped to address the civility of the participants.

Ive got the mic, folks, okay? If we want to have a positive interaction, if you want to do any more of these, then we need to have LaMalfa said, before being cut off by boos, hisses and laughter among audience members who appeared to take his tone as a condescending lecture. Scores of red cards waved back and forth.

The districts voters have also watched LaMalfas voting record to roll back environmental regulations.

A Chico woman who identified herself as Barbara Richman told LaMalfa that 50 years ago, she could see uninterrupted views of Mount Shasta, a towering nearby volcano buttressed by glaciers. Those views are now filled with haze, she said.

Unlike what you have said, mankind is playing some role in this, she said.

LaMalfa took aim at regulations in response.

Indeed, mankind is preventing forest management that keeps our forests from burning.

He barely finished the sentence. Boos erupted, and red cards shot up.

Iowa congressman walks out of a TV interview and into an angry town hall meeting

A Republican senator defended Betsy DeVos at a town hall. Boos drowned her out.

Originally posted here:

'May you die in pain': Another GOP lawmaker grilled at health-care town hall - Washington Post

Health and Human Services Secretary Tom Price indicated Tuesday that the Trump administration still believes Congress should act on healthcare.

Republicans in Congress failed in late July to pass a healthcare bill that would repeal and replace portions of Obamacare. Though the administration pressed them to continue the effort, Senate leaders have said they are prepared to move on to other priorities. They are expected to hold bipartisan hearings in September aimed at stabilizing the exchanges where people can buy tax-subsidized coverage, but divisions already have emerged over which approaches might receive bipartisan support.

Price made the statements after conducting a press briefing in Bedminster, N.J., on the opioid epidemic. When he was finished with his remarks, reporters asked him about planned cuts to Medicaid in the Senate healthcare bill, which advocates have decried as counterproductive to tackling the opioid epidemic.

"Nobody is interested in cutting Medicaid," Price said. "The fact of the matter is that the president's budget and the proposals that were before Congress were an effort to try to secure and make a Medicaid system work for patients. That's the goal we had."

One version of the Senate healthcare bill aimed to tie the growth in Medicaid spending to the standard rate of inflation, rather than to medical inflation, which is higher. The Congressional Budget Office estimated that the change, which would be scheduled to go into effect in 2025, would result in cuts to the program of $770 billion over a decade. The plan also would have rolled back Obamacare's Medicaid expansion, which covered low-income people, beginning in 2021.

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Tom Price: 'Healthcare challenge is not dead' - Washington Examiner

Saul Loeb/AFP/Getty Images

Politics

By MATT LATIMER

August 08, 2017

Its easy these days to disparage President Donald Trumps instinctshow, after all, could he get rid of The Mooch, easily the best character on his reality TV show? But there is one thing the president was right about from the start: The Republican Party probably should have left Obamacare repeal well enough alone. At least, that is, until the party had gotten its act together.

When the president decided to go against his instincts and support Obamacare repeal, he was thinking undoubtedly what pretty much everyone who didnt live and work in Washington, D.C., thought: that members of Congress did have their act together. That those who voted over and over again to repeal Obamacare in meaningless show votes would actually repeal it when they had their first real chance. That a party vowing to swiftly enact a plan to replace Obamacare once in full control of Congress would have an actual replacement plan in mind. That when an ailing Senator John McCain was flown in to cast a decisive vote on the bill, the decision would have worked in Republicans favor instead of leaving them at the receiving end of a bracing censure. Or that when Senator Lisa Murkowski voted in favor of allowing debate on Obamacare repeal and replacement, she wouldnt then vote no on every method to accomplish it. Who is running strategy now? Jamie Lannister.

Story Continued Below

And yet, ironically, the GOPs complete, even historic, ineptitude has managed to work in the partys favoras the president might saybig league. Quite unbelievably, the party has an opportunity to emerge in a better position from this mess. Of course, its hard to argue that a GOP-led Congress, currently with an approval rating even lower than that of O.J. Ive lived a conflict-free life Simpson, can do much worse.

First, lets give the president his due: From the earliest days of the administration, perhaps sensing Washingtons love affair with inertia, Trump called for letting Obamacare fail on its own. One might strongly disagree with various methods that might lead to this failuresuch as refusing to shore up wobbling health care marketsbut his point, from a political perspective at least, was valid. If the federal government is to enact something as sweeping and controversial as a total rewrite of Americas health care policy, a sense of national crisis is essential. Over the past few months, the crisis mentality worked against the Republicansbecause Americans were convinced that the crisis was Republicans trying to take away something theyve been given (such as one of Obamacares most popular provisionsprotection for pre-existing conditions). Voters tend not to like losing things they think theyve gained. This explains in part why Obamacare, which has dragged down the Democratic Party through multiple election cycles, is suddenly more popular than ever.

Yet it is astonishing how determined Republicans seem to have been to replicate the very process that led to Obamacares enactment in the first place. For the past several election cycles, the consistent GOP complaint, after all, was that the villainous Obamacare was a rushed law, cobbled together in secret and passed without a single vote from the other party. If anything, this years Republican effort was more rushed, more secret and far less popular. According to one congressional historian, Trumpcare, as the House plan was called, was the most unpopular bill contemplated by Congress in at least three decades (and there were some doozies over that period, let me remind you.)

Indeed, the Republicans missed the most important lesson of Obamacare: Because the law passed without a single Republican vote in the House or the Senate, all of Obamacares miscues or early, inevitable missteps fell on one party. And one party alone. At least one study, and there are others, found that those Democrats who voted for Obamacares passage lost an average of about 6 points in polls, costing Democrats 66 House seats in 2010 alone.

Had Congress actually passed an Obamacare replacement law, with a bare majority of votes, loved by nearly no one, endlessly assailed by the new media, its consequences would be the GOPs to bear. And unless the health care of Americans vastly improved, premiums magically went down, and editorial writers across the country suddenly proclaimed they had been wrong and that Trumpcare was the elixir we needed after all, the GOP would pay an ugly price. When Obamacare was passed, Republicans warned about death panels determining whether patients lived or died. If Trumpcare had passed, the death panels could have been applied to their own political future. Having escaped that fate by the thinnest of margins, the GOP now has an opportunity to turn things around. How would they do this? Through an approach that has become increasingly un-Washingtonlike in recent years: focusing on what that people actually want and, heres the real surprise, giving it to them.

So what does the GOP do now?

First, the Republican Congress can show Americans that it knows how to run a railroad, so to speak, by actually fixing railroads. And bridges. And highways. Oh, and the tax code. You know, things that are popular, needed, and just might get at least a handful of the Democrats to pick up a phone call from the White House every once in a while.

Second, if elected Republicans truly want to enact a massive rewrite of the health care system (and lets be honest, many dont), then they need to wait for a new health care crisis to develop. This will come. And soon. Americas health care system, as it is currently structured, is unsustainable. Premiums will continue to rise. Insurers will continue to shut down operations in various locales. There will continue to be complaints and horror stories from governors and mayors about the toll being taken on their communities. Only when there is a mass consensus that something sweeping needs to be done to fix the system will Congress find the fortitude to act. And at that point, you might at least get help from a Democrat or two. If Obamacare taught anything to anyone in Washingtona city allergic to lessonsbipartisan buy-in, no matter how minimal, is crucial.

Until then, Obamacare is more secure than ever. That, ironically, may turn out to be the biggest legacy of the largest Republican congressional majority in nearly 90 years. If they dont start getting something meaningful accomplished soon, it may be their only legacy.

Matt Latimer is a former speechwriter for President George W. Bush. He is currently a co-partner in Javelin, a literary agency and communications firm based in Alexandria, andcontributing editor at Politico Magazine.

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The GOP's Monstrous Health Care Fail Might Just Have Saved the Party - POLITICO Magazine