This week, Washington was focused on shutdown drama, while in the background, the Trump Administration and Republicans across the country continued their unprecedented assault on the American health care system.

Here’s a what happened this week in Republicans’ war on health care – plus, read down to see how some states are fighting back.

SABERS RATTLE ON CAPITOL HILL

This week, Senator Ted Cruz (R-Texas) told reporters Republicans need to “finish the job” and repeal the Affordable Care Act through budget reconciliation, and that he has been lobbying GOP senators who opposed repeal in 2017.

Apparently those efforts aren’t bearing much fruit: when asked about Cruz’s call to action, Senator Lisa Murkowski (R-Alaska) told reporters, “I don’t think we should be spending time trying to do repeal and replace of ObamaCare” in 2018.

STATE SABOTAGE EFFORTS

Yesterday, Idaho Governor Butch Otter announced his (plainly illegal) intent to let insurance companies in Idaho sell bare-bone plans that don’t include the essential health benefits now required by the Affordable Care Act and again discriminate against people with pre-existing conditions. Experts were … confused:

And in Virginia, a State Senate committee rejected legislation to expand Medicaid on a party-line vote. Just two months ago, Virginians delivered sweeping victories to pro-Medicaid expansion candidates up-and-down the ballot, putting Ralph Northam in the governor’s mansion and flipping delegate seats across the state. A Washington Post exit poll found that 39% of Virginia voters listed health care as the number one issue in their vote. The Virginia GOP may have chosen to keep ignoring the will of the people, but thankfully, this week was only the beginning of Virginia’s fight for Medicaid expansion in 2018.

TROUBLE AT TRUMP’S HHS

On Wednesday, Alex Azar became the Trump Administration’s new HHS Secretary. Throughout his confirmation process, Azar refused to acknowledge the Trump Administration’s ongoing Affordable Care Act sabotage, let alone promise to stop it and stand up for Americans’ health care. Instead, he embraced the Republican agenda to take coverage from millions of Americans, raise costs for millions more, and gut protections for people with pre-existing conditions. Right out of the gate, newly-confirmed Secretary Azar faces a major test: will he block Idaho’s attack against the law of the land, or drive HHS even further away from its mission to protect Americans’ health?

Meanwhile, in the wake of HHS’s quiet renewal of its public health emergency declaration, with little to show for the first 90 days, a member of Trump’s Opioid Commission said the Administration’s efforts to address the epidemic are “tantamount to reshuffling chairs on the Titanic.” Other leading advocates joined him to speak out against the Administration’s failure to address to the nation’s most pressing public health crisis:

CNN: Opioid commission member: Our work is a ‘sham’

The Republican-led Congress has turned the work of the president’s opioid commission into a “charade” and a “sham,” a member of the panel told CNN. “Everyone is willing to tolerate the intolerable — and not do anything about it,” said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. “I’m as cynical as I’ve ever been about this stuff.”

Vox: Trump has had a year to confront the opioid epidemic. He’s done almost nothing.

There has been no move by Trump’s administration to actually spend more money on the opioid crisis. Key positions in the administration remain unfilled, even without nominees in the case of the White House’s drug czar office and the Drug Enforcement Administration (DEA). And although Trump’s emergency declaration was renewed last week, it has led to essentially no action since it was first signed — no significant new resources, no major new initiatives.

… AND THE STATES THAT ARE FIGHTING BACK

On Tuesday night, Oregon residents issued a stern rebuke to the GOP’s war on health care. Oregonians went to the polls to vote on Measure 101, an initiative Republicans worked to get on the ballot, which could have denied health care to thousands of their fellow citizens. Instead, Oregonians “overwhelmingly approved” continuing the state’s successful Medicaid expansion. Oregon sent a clear message to the rest of the country: Republicans who continue sabotaging health care should be wary.

And in a sign of how dramatically the politics around health care have shifted, Wisconsin Governor Scott Walker, once an outspoken foe of the Affordable Care Act, has embraced a plan he says will strengthen the law in his state. The about-face comes soon after a national Protect Our Care poll showed that health care is a top priority for most voters going into the 2018 election cycle.