Republicans in Congress are plowing ahead on tax reform, and one obstacle is the complexity of Senate budget rules that limit how much taxes can be cut. The good news is that for once Washington’s fiscal fictions could be deployed to improve policy by repealing ObamaCare’s individual mandate as part of tax reform.

The Senate Finance Committee on Thursday released the details of its tax proposal, which includes a permanent 20% corporate rate and more. Senators Pat Toomey and Bob Corker cut a budget deal to allow for $1.5 trillion in net tax cuts over 10 years without accounting for faster economic growth (and more revenues) as a result of reform.

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President Trump has selected Alex Azar, a former pharmaceutical executive and a top health official during the George W. Bush administration, to lead the Health and Human Services Department.

In announcing that he is nominating Azar to be secretary of the government’s largest civilian department, the president turned to a health-policy insider and conservative thinker. Azar spent a decade at Eli Lily and Co., including five years as president of Lilly USA, its biggest affiliate, before stepping down in January to work as a health-care consultant. He previously was HHS general counsel, then served for two years as the department’s second-in-command.

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The Trump administration will encourage states to pursue work requirements for certain Medicaid beneficiaries, a top official said Tuesday.

The remarks by Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma would signal a significant departure from the Obama administration’s approach to such requests.

Several states have already proposed work requirements, and Verma’s comments indicate a willingness to fast-track those approvals.

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Repealing ObamaCare’s individual mandate will save $338 billion over 10 years, according to a new analysis from the Congressional Budget Office. The CBO said Wednesday it is changing the way it analyzes the mandate (and likely reducing the assumed cost impact) but said it is holding off on making those changes because the work is not complete.

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Emboldened by election wins, Democrats are starting to see a political edge in health care, particularly widening Medicaid access for more low-income people.

In Virginia, Democrat Ralph Northam promised a vigorous push as governor to expand Medicaid. Voters who said health care was important went decisively for Northam, according to political analysts. In Maine, voters defied Republican Gov. Paul LePage’s determined opposition by passing a referendum to expand Medicaid to cover an estimated 70,000 more residents.

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Voters in Maine approved a ballot measure on Tuesday to allow many more low-income residents to qualify for Medicaid coverage under the Affordable Care Act, The Associated Press said. The vote was a rebuke of Gov. Paul LePage, a Republican who has repeatedly vetoed legislation to expand Medicaid.

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The Trump administration is moving ahead with Obama-era requirements to post calorie counts in restaurants, supermarkets, convenience stores and pizza delivery chains nationwide next year.

Despite years of opposition by some food sellers, the Food and Drug Administration is offering only minor compromises to industry complaints about the difficulties of displaying calories at takeout chains, self-service buffets and other non-restaurant food locations.

The FDA posted a preliminary guidance online Tuesday to help businesses comply with the law.

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House Ways and Means Committee Chairman Kevin Brady, R-Texas, isn’t giving up on including a repeal of Obamacare’s individual mandate in the GOP’s tax reform bill.

Brady told radio host Hugh Hewitt Tuesday that he is still considering including mandate repeal in the tax bill, which was being marked up by his committee on Tuesday. Brady said he is expecting an updated score from the nonpartisan Congressional Budget Office on the impact of including repeal.

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Dr. Ezekiel Emanuel, recently described in the Chicago Tribune as “a trusted ally of former President Barack Obama and chief architect of the Affordable Care Act” has proposed in this week’s Journal of the American Medical Association (JAMA) a new “Affordability Index” to measure trends in the affordability of employer-provided health coverage.  Tracking the affordability of employer-sponsored insurance (which I will shorthand as ESI) is certainly worthwhile and important given that over half of the nation’s population relies on such coverage.

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Californians better get comfortable. The wait time to see a doctor in the Golden State may be about to skyrocket.

Last week, California Assembly Speaker Anthony Rendon and a select committee of representatives held two days of hearings in Sacramento on Senate Bill 562 — the Healthy California Act — which promises to enroll all Californians in a government-run, single-payer healthcare system.

The controversial bill passed the state Senate on June 1. But Speaker Rendon “parked” it because he said it did not give enough details on cost and coverage. The California Nurses Association is pushing hard for the Assembly to pass the bill early next year. It is unclear whether Governor Brown would sign it.

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