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Pelosi signals healthcare will be top priority for new Democratic House. House Speaker Nancy Pelosi on Thursday pledged to make healthcare one of the top priorities in the 116th Congress, just moments after being elected to lead the House for the second time. Pelosi has repeatedly cited healthcare as one of the main issues that helped return Democrats to the majority as they threatened that if Republicans were elected, they would repeal rules preventing insurance companies from denying coverage to individuals with pre-existing conditions. As Pelosi moves forward on healthcare, she’ll have to navigate tricky waters. A restive liberal base is eager to pursue some sort of socialized health insurance program, promoted under the slogan “Medicare for all.” But not all of the caucus is behind that campaign, preferring more incremental steps to build on Obamacare.

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Democratic AGs appeal ruling declaring Obamacare unconstitutional. Seventeen Democratic attorneys general on Thursday appealed a federal court ruling that would strike down all of Obamacare. The attorneys general are putting the case back into the spotlight as candidates gear up for the 2020 elections. The fight is likely to continue over months or years, and it could land before the Supreme Court. “Our goal is simple: to stand up for the law of the land — the Affordable Care Act — in order to keep healthcare affordable and accessible for millions of Americans,” California Attorney General Xavier Becerra said in a statement. “This shouldn’t be a debate; the ACA has been the law for nearly a decade and is the backbone of our healthcare system.” The ruling will be appealed to the U.S. Court of Appeals for the 5th Circuit in New Orleans.

Shortly after taking power, Democrats position House counsel to defend Obamacare, forcing GOP to take tough vote. House Democrats passed a rule Thursday to have the chamber’s counsel defend Obamacare in a legal case seeking to undo it. Only Democratic votes were needed to pass the rules, which also touched on issues from voting rights to spending, and three Republicans supported them. The specific resolution dealing with Obamacare, called the Restoring Congress For The People Resolution, paves the way to authorize the House counsel to defend the lawsuit on behalf of the House. A formal vote is expected next week. The action was one of the first orders of business for Democrats in the House as they took power on Thursday. Their goal was to put the spotlight on Republicans who ran campaigns telling voters they were devoted to keeping in place Obamacare’s protections on pre-existing illnesses. They plan to argue that votes rejecting the resolution demonstrate Republicans aren’t really committed to the promises they made.

House Democrats overrule progressives, institute ‘pay-as-you-go’ rule. House Democrats passed new rules Thursday requiring that legislation creating new entitlement programs also include pay cuts or tax increases to prevent an increase in the federal deficit. The rule’s imposition is a loss for some liberals, including Reps. Ro Khanna of California and Alexandria Ocasio-Cortez of New York, and activists on the Left who opposed it on the grounds that it could hinder efforts to introduce new programs, such as expanding Medicare coverage to all age groups. “I just think that it has a difference to do with how we actually pay for these things when you pair it with the fact that dynamic scoring is being removed as well, which I think is completely understandable. You’re not including the macroeconomic impact of ‘Medicare for all’ or tuition-free public colleges and universities,” said Ocasio-Cortez in a brief interview Thursday. The new “pay-as-you-go” or “PAYGO” rule is not an impossible hurdle for progressives. House Democrats can elect to waive the rule on future votes. A similar rule is enshrined in federal law, and it too has proved surmountable in cases of major deficit-increasing legislation in past congresses.

House Democrats pass spending bill opposed by anti-abortion advocates. The spending bill, which is the same legislation passed the Senate Appropriations Committee but has not gone before the full Senate, covers many of the remaining programs that haven’t been funded, but it also makes changes to a couple of family planning programs and therefore has drawn the ire of anti-abortion groups. The bill would repeal a provision instituted by President Trump that requires foreign nongovernmental organizations to certify that they will not “perform or actively promote abortion as a method of family planning.” The provision, formally known as the Protecting Life in Global Health Assistance policy, was once called the Mexico City Policy, or the “global gag rule” by critics. The spending bill also would increase funding by $5 million for the United Nations Population Fund, to $37.5 million. Anti-abortion organizations oppose the program because they say it participates in coercive abortions and involuntary sterilizations. The bill passed mostly along party lines, with seven Republicans supporting it. Susan B. Anthony List blasted Pelosi for bringing the bill up for a vote.  “While many lawmakers are focused on getting the government funded and running, Nancy Pelosi did not waste a moment trying to force American taxpayers to prop up the abortion industry,” said SBA List President Marjorie Dannenfelser. “Her first act as speaker leaves no doubt about House Democrats’ senseless priorities for the next two years.”

New Energy and Commerce Chairman Frank Pallone sets hearing dates. New Energy and Commerce Committee Chairman Rep. Frank Pallone, D-N.J., said Thursday after being sworn in that he intends to hold hearings about the impact the decision to declare Obamacare unconstitutional will have on people. The hearing is the second of three he announced. The first hearing will be about climate change and the second will look into the Trump administration’s practice of separating families who cross the U.S.-Mexico border illegally.

Committees also plan to hold hearings on the Medicare for All Act. Rep. Pramila Jayapal, D-Wash., co-chair of the Medicare for All Caucus, told reporters Thursday that she secured a commitment from Democratic leaders to hold hearings on the legislation, which would roll everyone in the U.S. onto the Medicare program. The hearings would likely occur in Rules, Budget, as well as Energy and Commerce Committees, she said. “It’s an enormous step forward for us and we feel good about it,” Jayapal said. Rep. Jim McGovern, D-Mass., Chairman of the House Rules Committee, said, “These are going to be serious hearings on a very serious matter… There are a lot of people across this country that support Medicare for all.”

Obamacare sign-ups slip further as customers cancel plans. The number of people enrolled in Obamacare plans dropped slightly at the ushering in of the new year, partly because some customers canceled plans they were automatically enrolled in. Final enrollment landed at roughly 8.4 million people, compared to the 8.5 million total reported in December. Last year’s final tally was 8.7 million. The latest drop was expected because some customers canceled their plans within hours of the deadline, while others canceled plans they were automatically enrolled in. Another cohort was likely not approved because of problems with verifying their identities. Such patterns are common with every open enrollment. The final tally also represents a net change because the Centers for Medicare and Medicaid Services had reported in December that it was returning calls to 200,000 people who left their information to receive a call back and enroll.

New Republicans join the HELP Committee. GOP Sens. Mitt Romney of Utah and Mike Braun of Indiana are the latest to join the Senate Health, Education, Labor, and Pensions Committee. The committee is key to crafting legislation on a range of healthcare policies, including on drug spending, Obamacare, and medical research.

New Maine Gov. Janet Mills immediately reverses GOP predecessor, pursues Obamacare Medicaid expansion. Democrat Janet Mills used her first executive order as governor of Maine to implement an Obamacare expansion of the Medicaid program to the poor. The action puts into effect a ballot measure that state voters supported in 2017, which makes the government-funded insurance available to anyone making less than roughly $17,000 a year. The expansion of Medicaid had been held up by former Republican Gov. Paul LePage, who said that he would block it until the legislature found a way to fund it. He continued to delay the expansion despite a judge’s orders to implement it. Mills said Thursday that she was seeking “expedited” approval for the program from the Trump administration, and added that she would seek for the benefits to stretch back to July 2, 2018, when the plan was originally supposed to take effect. Expanding Medicaid was one of her campaign promises. “More than a year ago, the people of Maine voted to expand Medicaid,” Mills said in a statement. “Today, my Administration is taking the long-awaited steps to fulfill their will.” The executive order tasks Maine’s health agency with coming up with a “sustainable” way to pay for the expansion costs. Mills hasn’t said what she would do about a plan submitted by LePage and approved by the Trump administration that would require certain Medicaid beneficiaries work or train for work as a condition of staying enrolled in the program.

Nurses union demands all 2020 campaigns set sexual harassment guidelines.  One of the first major unions to support Sen. Bernie Sanders’ 2016 White House bid has called on all 2020 campaigns to take steps to rid their organizations of sexual harassment and ensure equal pay.

National Nurses United, the country’s largest union of nurses, backed the independent Vermont senator over Hillary Clinton in 2015, citing his “proven track record of uncompromised activism and advocacy for working people, and a message that resonates with nurses.”

RUNDOWN

Politico Democrats won the House on Obamacare. Here’s how they plan to defend it.

Bloomberg This bottle of pills costs $20 in one state and $130 in another

The Associated Press Governor-elect commits to Medicaid expansion

Modern Healthcare AHA data show hospitals’ outpatient revenue nearing inpatient

New Food Economy The biggest food recall of 2018 is one you still haven’t heard about

Iowa Public Radio Gov. Reynolds: Allowing birth control without prior prescription is ‘the right thing to do’