Washington Post: “A total of 11.8 million Americans signed up for Affordable Care Act health insurance for 2018, a drop of just 400,000 from the previous year despite widespread predictions that enrollment would plummet amid political and insurance industry turbulence surrounding the law.”

“The final figures, released Tuesday by the Centers for Medicare and Medicaid Services, show that the proportion of first-time customers for this year dipped slightly, from 31 percent to 27 percent, while the high proportion qualifying for government subsidies that help consumers afford their insurance premiums stayed level at 83 percent.”

Gallup: “Fifty-five percent of Americans worry ‘a great deal’ about the availability and affordability of healthcare, topping concerns about 14 other issues Gallup tested. Slim majorities also worry about crime and violence, federal spending and the budget deficit, and the availability of guns.”

“The Trump administration is finalizing a long-awaited plan that it says will solve the opioid crisis, but it also calls for law enforcement measures — like the death penalty for some drug dealers — that public health advocates and congressional Republicans warn will detract from efforts to reverse the epidemic,” Politico reports.

“The ambitious plan, which the White House has quietly been circulating among political appointees this month, could be announced as soon as Monday when President Donald Trump visits New Hampshire, a state hard hit by the epidemic.”

Ron Brownstein: “The most immediate effect of the recent steps taken by Donald Trump and congressional Republicans to unravel the Affordable Care Act will be to create an even deeper gulf between red and blue states in the availability and quality of health insurance. An array of blue states are exploring ways not only to blunt Trump’s moves, but also to reach beyond the ACA with new mechanisms to expand coverage. Simultaneously, many red states are leaning into the rollback—both by seeking to limit access to Medicaid, and by embracing Trump’s efforts to deregulate insurance markets in ways that will restore the pre-ACA separation between the healthy and sick…”

“That means health insurers are likely to announce major premium increases during the next ACA open-enrollment period—just weeks before the midterms. In a January national Kaiser poll, three-fifths of Americans said they would blame Trump and the GOP for any further ACA problems. By creating the conditions for big premium hikes this fall, Republicans in Washington and the states appear determined to test that proposition.”

A new Kaiser Family Foundation poll finds 54% of Americans have a favorable view of the Affordable Care Act, as compared to just 42% who have an unfavorable view.

A new Urban Institute report finds that by 2019, 6.4 million fewer Americans are expected to have health insurance as a result of the GOP’s decision to get rid of the individual health care mandate and other policy changes made by President Trump.

Axios: “The report is the first serious study to analyze the combined effects of several major health policy changes made under the Trump administration. Note that the effect is far off from what we’d see under a full repeal of the Affordable Care Act, but represents the real-world significance of the pieces they were able to kill.”

Politico: “Though the GOP still controls both chambers of Congress and maintains the ability to jam through a repeal-and-replace bill via a simple majority, there are no discussions of doing so here at House and Senate Republicans’ joint retreat at The Greenbrier resort. Republicans doubt they can even pass a budget providing for the powerful party-line ‘reconciliation’ procedure used to pass tax reform last year, much less take on the politically perilous task of rewriting health care laws in an election year.”

“Republicans’ decision to abstain from another attempt at gutting Barack Obama’s health law — at least this year — goes back on a pledge the party has made to voters since 2010. And it underscores how Republicans overpromised in their ability to reform the nation’s health care and never fully recognized how divided the party is over key Obamacare planks like protecting pre-existing conditions and preserving the law’s Medicaid expansion.”

Brenda Fitzgerald, the embattled director of the Centers for Disease Control and Prevention, has resigned after facing questions about including her purchase of tobacco stocks while leading the nation’s anti-smoking efforts.

Politico: “Fitzgerald had also come under congressional scrutiny because of financial conflicts that led her to recuse herself from speaking to Congress about issues including cancer detection and aspects of the opioid crisis.”

“The Trump administration issued guidance to states early Thursday that will allow them to compel people to work or prepare for jobs in order to receive Medicaid for the first time in the half-century history of this pillar of the nation’s social safety net,” the Washington Post reports.

“The new rules come as 10 states are already lined up, waiting for federal permission to impose work requirements on able-bodied adults in the program. Three other states are contemplating them. Health officials could approve the first waiver — probably for Kentucky — as soon as Friday, according to two people with knowledge of the process.”

Politico: “Early last year as an Obamacare repeal bill was flailing in the House, top Trump administration officials showed select House conservatives a secret road map of how they planned to gut the health law using executive authority. The March 23 document, which had not been public until now, reveals that while the effort to scrap Obamacare often looked chaotic, top officials had actually developed an elaborate plan to undermine the law — regardless of whether Congress repealed it.”

““The blueprint, built off the executive order to minimize Obamacare’s ‘economic burden,’ that Trump signed just hours after taking the oath of office, shows just how advanced the administration’s plans were to unwind the law — plans that would become far more important after the legislative efforts to repeal Obamacare failed.”

“A bipartisan effort to stabilize the U.S. health-insurance markets collapsed last month after anti-abortion groups appealed directly to Vice President Mike Pence at the 11th hour,” the Daily Beast reports.

“Amid opposition from conservatives in the House of Representatives, a group of pro-life activists met with Pence to lobby the Trump administration against supporting a health-insurance market-stabilization bill on the grounds that it does not contain sufficient language on abortion restrictions.”