Obamacare repeal has been replaced by rebrand as Trump administration plans to use ACA’s Medicare demonstration powers to send discount cards to seniors, one of a slew of health care announcements that include Rx importation, pre-existing conditions, insulin and EpiPens.

With gene therapies for sickle cell disease looming and two new expensive therapies of to a slow start, access challenges could prevent a large portion of patients from receiving treatment, a report from the US National Academies of Sciences, Engineering and Medicine concludes. The report urges development of new payment models, offering five ideas.

Industry balks at President Trump’s latest effort to force biopharma to negotiate a drug pricing solution, but investors may be pushing for concessions that could head off more onerous policies supported by a Biden White House.