Republicans in Congress and the Trump administration failed to fulfill their commitment to repeal and replace the Affordable Care Act (ACA) in 2017, but they did succeed in repealing the tax penalties enforcing the law’s individual mandate, starting in 2019.

The GOP still might try again to fully repeal and replace the ACA in 2018, perhaps with a modified version of the Graham-Cassidy legislation. However, with Republicans now down to a 51-seat majority in the Senate and some House and Senate members facing difficult mid-term elections this November, it will be even more challenging to get a sweeping rollback of the ACA through Congress in 2018 than it was in 2017.

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Democrats and activists fought off Obamacare repeal last year by stoking public outrage and stirring protests. Now they want to make the health law the defining issue in 2018 races at the congressional, state and local levels. The grassroots groups at the forefront of the Obamacare fight are expanding their focus to rally opposition to virtually all Republican efforts to alter the health care system, hoping to capitalize on the backlash to repeal and turn it into a wave of victories come November.

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Concerned about soaring health care costs, Idaho on Wednesday revealed a plan that will allow insurance companies to sell cheap policies that ditch key provisions of the Affordable Care Act.

It’s believed to be the first state to take formal steps without prior federal approval for creating policies that do not comply with the Obama-era health care law. Health care experts say the move is legally dubious, a concern supported by internal records obtained by The Associated Press.

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The Trump administration is exploring ways to allow more Americans toqualify for exemptions from the Affordable Care Act’s individual mandate, which goes away in 2019 but is still in effect this year. The Centers for Medicare and Medicaid Services is reportedly working on guidance that would expand “hardship” exemptions from the mandate that would apply this year, meaning they could be cited by filers preparing their 2018 taxes next year.

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Thousands of Medicaid recipients in Mississippi would be required to work to be eligible for the program if the Trump administration approves a controversial state waiver request that recently opened for public comment.

The proposal is likely to set off a firestorm of criticism from Democrats and health advocates, who argue that work requirements, combined with Mississippi’s strict Medicaid eligibility requirements, will result in thousands of people losing their coverage.

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Sen. Ted Cruz, R-Texas, on Wednesday said Republicans needed to “finish the job” on repealing and replacing Obamacare in 2018, and he is pushing his colleagues to use one last reconciliation bill before the midterms to deliver on their long-running promise.

In a meeting with the Washington Examiner in his Senate offices, Cruz said he has had long conversations with the Republican senators who blocked legislation last time around, and still thinks they can get something across the finish line. He also said there has been talk of asking the Congressional Budget Office to rescore repeal legislation now that the individual mandate is off the books, which is expected to drive down the CBO’s estimate of the number of individuals who would be uninsured under Republican legislation.

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Oregon approved taxes on hospitals, health insurers and managed care companies in an unusual special election Tuesday that asked voters — and not lawmakers — how to pay for Medicaid costs that now include coverage of hundreds of thousands of low-income residents added to the program’s rolls under the Affordable Care Act.

Measure 101 was passing handily in early returns Tuesday night. The single-issue election drew national attention to this progressive state, which aggressively expanded its Medicaid rolls under President Barack Obama’s health care reforms. Oregon now has one of the lowest rates of uninsured residents in the nation at 5 percent. About 1 million Oregonians — 25 percent — now receive health care coverage from Medicaid.

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Now that Congress has passed a bill funding the Children’s Health Insurance Program — more than three months after funding expired — the clock is ticking as lawmakers work at putting together a package to stabilize the individual insurance market.

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Congress is apparently not done cutting taxes, even after passing a $1.5 trillion tax overhaul last year.

The deal struck by Democrats and Republicans on Monday to end a brief government shutdown contains $31 billion in tax cuts, including a temporary delay in implementing three health-care-related taxes.

Those delays, which enjoy varying degrees of bipartisan support, are not offset by any spending cuts or tax increases, and thus will add to a federal budget deficit that is already projected to increase rapidly as last year’s mammoth new tax law takes effect.

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War On Drugs: We recently speculated that ObamaCare might have contributed to the nation’s opioid epidemic, which has in turn driven down life expectancy in this country for the past two years. A new Senate report adds further support to this connection.

The report, produced by the Homeland Security and Government Affairs Committee’s majority staff, provides convincing evidence that ObamaCare’s Medicaid expansion is at least partly to blame for the recent opioid epidemic.

The Senate report notes that those with a Medicaid card can get prescriptions for opioids, such as oxycodone, for as little as $1 for up to 240 pills. Those pills, however, can be sold on the street for up to $4,000.

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