As Trump Targets Carbon Rules, Green Groups Promise a Legal Fight

With President Trump poised to issue an executive order aimed at undoing a key pillar of the Obama administration’s climate-change agenda, environmental activist groups have joined forces for what they say will be a tooth-and-nail legal battle that could drag on for years. “Altering a final rule, like the Clean Power Plan, isn’t as simple as the stroke of a pen. It will likely require the EPA to undertake a new rulemaking process including public notice and comment that could last a few years,” says Tim Profeta, director of the Nicholas Institute for Environmental Policy Solutions

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Millions Risk Losing Health Insurance in Republican Plan

Millions of people who get private health coverage through the Affordable Care Act would be at risk of losing it under the replacement legislation proposed by House Republicans, analysts said Tuesday, with Americans in their 50s and 60s especially likely to find coverage unaffordable. The result, says health policy professor Donald Taylor, is that people who buy coverage are sicker, causing the cost of premiums to soar. “This looks like to me adverse selection on steroids,” he says. “I don’t see how it doesn’t crater the individual market.”

Read More in The New York Times

Trump’s Criticism Of Drug Approval Process

President Donald Trump has called the approval process “slow and burdensome” and said he wants to speed it up. Dr. Mark McClellan, director of the Margolis Center for Health Policy at Duke and a former FDA commissioner, talks about whether that’s feasible.

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Focus On Trump’s Acts, Not His Psychology

“Many people still don’t understand that Trump can be a world class narcissand still not qualify for a mental disorder. … Lumping him with the mentally ill is an insult to them, not him. … Opposition to Trump’s power grab must be based on politics, not psychology,” writes Allen Frances, professor emeritus of psychiatry and behavioral sciences.

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Research: How Medicare Could Save Millions

Medicare has long struggled with the most efficient way to reimburse hospitals for the care they provide. Professor Ryan McDevitt, an economist at The Fuqua School of Business, studied stays at long-term care hospitals and found on average they discharge patients based on when they get federal payments rather than for medical reasons. His research also shows an alternative payment system could save Medicare millions of dollars without affecting standards of care.

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Former Affordable Care Act Chief Offers Health Care Prescription

Andy Slavitt was the point person in the Obama administration for the federal Affordable Care Act. He’s now trying to save it. “He’s both a good communicator and a technical expert, as well as a committed supporter of improving health care,” Dr. Mark McClellan, a former administrator of the Centers for Medicare & Medicaid Services now director of Margolis Center for Health Policy at Duke, says of Slavitt. “So, all that’s a good combination for having an impact.”
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Obamacare on the Ropes

Is the unraveling of the Affordable Care Act imminent, as many Republicans predict? “The Affordable Care Act is fundamentally stable in most states. Enrollment has been increasing and insurers are projecting better results. Insurers with effective strategies tailored to local demand for high-quality, low-cost health care have been able to show profitability on the exchanges,” says David Anderson, an analyst at Duke’s Margolis Center for Health Policy.

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Trump Signs Sweeping Order That Could Gut Obamacare

President Donald Trump signed a sweeping executive order that encourages federal agencies to dismantle large parts of Obamacare, possibly including the hugely unpopular mandate requiring most Americans to purchase insurance. Such steps would make the market “sicker and on average more expensive,” says David Anderson, a health policy analyst who’s studied the law’s insurance regulations. “It may lead to carriers reconsidering their participation for the 2018 plan year.”

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Global Health Advice for Trump Administration

Nationalism and isolationism that marked the president-elect’s campaign are a concern if they continue, says one faculty member, Gavin Yamey, professor of the practice of global health. “Those of us working in global health will need to pay very close attention to whether the U.S. starts retreating from its impressive record on global health research and development,” Yamey says.

Read More at DGHI

Exhibit A for Republican Obamacare Repeal Challenge: People with HIV


HIV experts in Republican states have already been wrestling with the issue of caring for patients with HIV. Earlier this year, North Carolina became the 48th U.S. state to permit the use of federal grant money via the Ryan White HIV/AIDS program to pay insurance premiums for people with HIV. “We’re late to the party, and now the party may be over,” says Allison Rice, director of the Health Justice Clinic at Duke Law.

Read More in The New York Times



NC Governor Pledges to Expand Medicaid, Despite State Law

Gov. Roy Cooper may want to get expansion approved before Obama leaves office, given Medicaid expansion’s uncertain future under a Trump administration — and before the state negotiates details of the ongoing reform with the federal government, says Don Taylor, a Sanford School of Public Policy professor specializing in health care policy.

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Why Health Care Leaders are Worried About Their Industry

“However the Trump administration and the Republican U.S. Congress replace or revamp the Affordable Care Act, it is unlikely to halt America’s ongoing move from the rightfully maligned fee-for-service payment system to one that pays for ‘value'” — the quality of outcomes relative to the price, write Dr. Kevin Schulman and a colleague from Johns Hopkins.

Read More in Harvard Business Review