“Medicare-for-all” makes a good first impression, but support plunges when people are asked if they’d pay higher taxes or put up with treatment delays to get it.

The survey, released Wednesday by the nonpartisan Kaiser Family Foundation, comes as Democratic presidential hopefuls embrace the idea of a government-run health care system, considered outside the mainstream of their party until Vermont independent Sen. Bernie Sanders made it the cornerstone of his 2016 campaign. President Donald Trump is opposed, saying “Medicare-for-all” would “eviscerate” the current program for seniors.

House Speaker Nancy Pelosi is laying out her strategy on health care and first up is improvements to “Obamacare” and legislation to lower prescription drug costs. “Medicare for all” will get hearings.

Pelosi and President Donald Trump have been sounding similar themes about the need to address the high drug costs. But her plans to broaden financial help for health insurance through the Affordable Care Act are unlikely to find takers among Republicans.

Either way, Democrats believe voters gave them a mandate on health care in the midterm elections that returned the House to their control.

The Trump administration approved Arizona’s request to attach work requirements to Medicaid coverage, making it the eighth state to condition benefits on seeking a job, going to school or otherwise engaging in the community.

Enrolled members of federally recognized Indian tribes — who noted their sovereignty — will be exempt from the rules, which will take effect in January 2020, the Centers for Medicare and Medicaid Services said.

The CMS issued a proposed rule on Thursday that would cut Affordable Care Act user fees and laid the groundwork to eliminate “silver-loading.” 

In its proposed notice of benefit and payment parameters for ACA exchanges in 2020, the agency proposed reducing the exchange user fee that is charged to health insurers to fund the health insurance exchanges. That would help lower premiums in 2020, the agency said. 

Litigation continues in Texas v. Azar, a lawsuit over the constitutionality of the individual mandate and, with it, the entire Affordable Care Act (ACA). This post provides a brief update on the status of the case in the district court and the Fifth Circuit Court of Appeals, as well as some new positions taken by states in the lawsuit following the midterm elections. For now, the Texas litigation is on hold pending the end of the partial government shutdown, after which the case will proceed in the Fifth Circuit.

Last year, Canadians waited a median of almost 20 weeks to receive specialist treatment after being referred by a general practitioner, according to a new report from The Fraser Institute. In practical terms, that’s the equivalent of getting a referral this week and waiting until May for treatment.

Such waits are endemic to government-run healthcare systems.

Canada’s single-payer system, which prohibits private insurance for medically necessary procedures, is a prime example of the pitfalls of total government control. Twenty weeks of waiting is bad enough. But some areas in Canada fare even worse. The median wait for treatment from a specialist following referral from a GP in New Brunswick is nearly a year.

For several months, the Trump administration has been engaged in an internal debate over the merits of allowing states to partially expand Medicaid under the terms of the Affordable Care Act (ACA). Now, after losing the House to Democratic control (and thus also losing any opportunity to repeal and replace the ACA until at least 2021), the administration is said to be ready to make a decision in favor of allowing partial Medicaid expansion to proceed under state waiver requests.

In October, the Trump administration proposed a new rule that would expand the ways employers can use health reimbursement arrangements (HRAs) to provide their employees with high-quality, low-cost health coverage. The United States Department of the Treasury estimates that once the new rules go into effect, 800,000 employers will take advantage of HRAs, which could affect coverage for more than 10 million employees.

In the wake of Republicans failing to repeal and replace Obamacare and the Democratic takeover of the House, where will the health care debate go from here?

No important health care legislation will come out of this gridlocked Congress. But the run-up to the 2020 presidential campaign will produce at least a Democratic health care plan out of the nominating process.

The Trump administration is readying guidance that could let states remodel their Medicaid programs to more closely resemble block grant proposals favored by Republicans during their failed effort to repeal the Affordable Care Act, according to people familiar with the discussions.

States would still have to adhere to certain requirements but could get far more leeway in how they design their programs, likely in exchange for some type of cap on federal funding, the people said. The guidance would lay out how states could satisfy federal requirements to get waivers to pursue the changes, they said.