Wednesday's health stories

Moderate Republican details 3-phase plan for Obamacare repeal and replace
Sen. Lamar Alexander, chairman of the Senate health committee, has a new plan for how to repeal and replace Obamacare. It might be something the growing coalition of Republicans nervous about repealing now and replacing later can support.
This is how it would work:
- First would be the "rescue" phase (detailed below)
- Next, the GOP would come up with a replacement once markets stabilize
- Then they'd repeal what's left of Obamacare
Will it work?: From a policy perspective, Alexander's plan, which uses both legislation and executive action, makes a lot of sense. Politically, many of its components will be way too much for conservatives to stomach. Watch to see how many moderates get on board. It won't take many to tank the leadership's plan.

Trump adds chaos to already chaotic Obamacare repeal plan
Donald Trump told the NYT he supports repealing Obamacare first, then replacing it very quickly. He apparently didn't get on the same page with other Republicans before picking up the phone.
- Minority Whip John Cornyn has said all along that Obamacare will be repealed and replaced separately, but dismissed Trump's timeline: "Given the fact you have 535 members of Congress, it may take us a little while longer."
- Sen. Bob Corker, who has been one of the most vocal Republican members on the need to repeal and replace Obamacare at the same time, didn't know of Trump's comments until I asked him about them. He'd just talked to people in Trump's inner circle this morning, and that's not the message he got from them. "Maybe they have some thoughts that developed from this morning to that being said," he said.
- And Sen. Rand Paul, who talked to Trump last week and said the president-elect shared his views about repealing and replacing the law at the same time: "You can define what simultaneous means."

Obamacare is getting more signups, but not young adults
It's a good-news-bad-news day for Obamacare enrollment, according to the latest figures released by the Department of Health and Human Services Tuesday:
- More than 11.5 million people have signed up for 2017 coverage — 286,000 more than at this time last year.
- But the share of young adults age 18-34 hasn't grown. It's still 26%.
What it means: The Obama administration is making progress toward its total enrollment goal of 13.8 million — but there's no sign yet that they're enrolling more healthy people, as they'd hoped. (The share of young adults is a pretty good proxy for health.)
But no death spiral: The new figures are proof that Obamacare enrollment is "not merely stable – it is actually on track for growth," HHS official Aviva Aron-Dine told reporters.

House conservatives get cold feet on Obamacare repeal
The hard-line conservative group wants to put off the vote — technically on the budget resolution beginning the Obamacare repeal process — until there's more information about the replacement, Politico reports.
Why it matters: This is yet another sign the votes might not be there to repeal Obamacare without a replacement. The Freedom Caucus joins a group of GOP senators who also are publicly concerned about leadership's repeal-and-delay plan.
What's next: If Republicans can't pass a repeal bill without a replacement, Obamacare repeal might take a lot longer than everyone thought it would. And getting the Freedom Caucus on the same page on a replacement as moderates like Sens. Susan Collins or John McCain won't be easy.

