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The Trump administration on Thursday issued a final rule that will shorten the Obamacare enrollment period and give insurers more of what they say they need in the individual insurance market, likely making it harder for some consumers to purchase insurance, healthcare experts said. It could also raise out-of-pocket medical expenses, the experts said, because it gives insurers more flexibility in determining the value of their coverage. (Abutaleb, 4/13)

The Centers for Medicare and Medicaid Services, a division of the Department of Health and Human Services, published its final rule aimed at steadying the individual market, which has seen large premium increases and insurers retreating from unprofitable markets across the country. President Donald Trump’s administration is pitching the move as a temporary fix, while it continues to work with Congress to strike an elusive deal to dismantle large portions of the health law known as Obamacare. But after GOP leaders yanked their health plan off the House floor late last month, the administration’s moves to either bolster or undercut the existing health-care law have come under increased scrutiny. (Hackman, 4/13)

The 2018 open enrollment period will be reduced to run from Nov. 1, 2017, to Dec. 15, 2017, a shift from an earlier cutoff date of Jan. 31, 2018, the Centers for Medicare and Medicaid Services said in its final published rule. The earlier deadline will limit the number of people who can purchase insurance after learning they have a health condition that requires medical care, blocking such signups in late December and January, CMS said. Thus, this move will help improve the so-called risk pool for insurers, or the balance of their healthier customers to those in need of costly medical services, the agency said. (Young, 4/13)

“These actions are necessary to increase patient choices and to lower premiums,” said Seema Verma, administrator for the Centers for Medicare and Medicaid Services Administrator, which oversees the health insurance program. “While these steps will help stabilize the individual and small group markets, they are not a long-term cure for the problems that the Affordable Care Act has created in our health-care system.” (Tracer and Edney, 4/13)

The controversial proposal by the Health and Human Services Department drew letters from nearly 4,000 organizations and individuals during an unusually short, 20-day public comment period that ended in early March. In their comments, consumer groups hated it, saying it would wreak havoc by making it harder to get coverage, while insurers were generally supportive. But such experts as Christopher Condeluci of CC Law & Policy in Washington, D.C., saw the initial proposal released in February by HHS as helpful for insurers, though he also thinks more adjustments are necessary. (Appleby, 4/13)

The rule, however, does not address the insurance industry's major concern regarding continued enforcement of the individual mandate. It does continue and even increase subsidies for people who buy coverage on the Affordable Care Act's individual coverage exchanges. Both requests were made in a letter sent Wednesday to President Donald Trump that was co-signed by the U.S. Chamber of Commerce, which previously supported a rollback of the ACA. Other signers included America's Health Insurance Plans, the American Academy of Family Physicians and the American Hospital Association. (Dickson, 4/13)

As it stands, Cara Kelly, a vice president at Avalere Health, warned the changes may not be enough to keep more insurers from dropping out of marketplaces next year. “These changes likely are not significant enough to sway health plan decisions for the upcoming plan year,” she said. “Losing health plans from the exchanges is still a risk for 2018.” (McIntire, 4/13)

While calling the administration action a step in the right direction, the industry is looking for a guarantee that the government will also keep paying billions in “cost-sharing” subsidies that help consumers with high deductibles. President Donald Trump says he hasn’t made up his mind on that. (Alonso-Zaldivar and Murphy, 4/14)

Marilyn Tavenner, the president and CEO of America's Health Insurance Plans (AHIP) and the former Centers for Medicare and Medicaid Services administrator, praised the rule for adopting "important changes" to "improve the functioning of the individual market" but said insurers still need to hear about the cost-sharing reduction subsidies. (Hellmann, 4/13)

After losing a fight to revamp the health-care system, President Donald Trump said last month he was prepared to put the setback behind him and move on to the next challenge, rewriting the tax code. Three weeks later, he said he is determined to resurrect the health-care bill even if it means delaying the tax overhaul, telling The Wall Street Journal in an interview: “I want to get health care done…I think I will get it done.” (Radnofsky, Nicholas and Rubin, 4/13)

In the weeks since President Trump’s attempts to replace the Affordable Care Act collapsed, the administration has debated what to do: Try again? Shore up the insurance marketplaces? Or let the whole system collapse? Mr. Trump has failed to get enough support from his own party, but he hopes to get the Democrats’ help by forcing them to the negotiating table with hints about the chaos he could cause. (Pear, 4/13)

Under current law, the federal government repays some money to insurance companies for covering people with very low income. President Trump said he was still considering what to do about those payments. Bob Atlas, president of healthcare consultancy EBG Advisors, said legally speaking, Trump can do that. (Uhler, 4/13)

Congressional Democrats said Thursday they won’t be coerced into negotiating a repeal of the Affordable Care Act by President Donald Trump’s threats to withhold federal payments critical to maintaining the stability of the insurance market. But the president’s comments could have a more immediate effect on Capitol Hill, thrusting the payments to insurers into negotiations over a spending bill needed to keep the government running beyond April 28, when its current funding expires. (Peterson and Hughes, 4/13)

Party leaders want the issue addressed in the current talks on the spending bill to keep the government open. The bill is due at the end of the month. (Taylor, 4/13)

“The President’s comments on stopping the Cost Sharing Reduction payments will increase costs, is a threat to the good health of the American people and a threat to keeping government open,” an aide to House Democratic Leader Nancy Pelosi (Calif.) said in a written statement. Democrats say Pelosi and Senate Democratic Leader Charles Schumer (N.Y.) are in agreement that the payments must be included in the spending bill being negotiated ahead of an April 28 deadline. Democrats want the funds to become mandatory spending, which would provide the certainty insurance companies have requested. (Sullivan, 4/13)

"Given the threat, we'll be pushing for a robust cost-sharing reduction appropriation," a Senate Democratic aide said. The aide declined to say how much funding Democrats would insist upon. Others have estimated that full funding for one year would require between $7 billion and $8 billion. Funding for the program "must be included" as "permanent mandatory spending," a Pelosi aide said. (Haberkorn and Ferris, 4/13)

“This is a very potent threat, because the administration has the authority unilaterally to do this, and this is really a kill switch. This makes the program unprofitable for the majority of health plans operating in it today,” said Dan Mendelson, chief executive of Avalere Health, a consulting firm. “The timing of this threat is really curious, in the sense that now is the time that the plans have to be deciding whether to bid on 2018. If you’re on the bubble and the president is making a threat like this . . . this just puts more uncertainty on the program." (Johnson, 4/13)

The Democratic aides made clear that the payments could become a potential shutdown issue, since Democratic votes will be needed to pass the bill in the Senate, and perhaps in the House. (House, 4/13)

The head of the House Democratic Caucus is accusing President Trump of “political blackmail” for threatening to withhold ObamaCare funds that lower health costs for poor Americans. Rep. Joseph Crowley (D-N.Y.) said the recent suggestion that Trump may halt billions of dollars in insurance subsidies to force Democrats to negotiate a healthcare overhaul “is a blatant attempt to undermine the Affordable Care Act and manufacture a crisis.” (Illis, 4/13)

President Trump escalated fears this week by saying he may not authorize payment of the Affordable Care Act-required subsidies that up to 7 million people use to help pay their health care deductibles and co-payments. Trump said the move should prompt Democrats to negotiate on health care reform. But now, a bipartisan group including high-level former members of Congress and regulators is fighting back. (O'Donnell, Fletcher, Leys and Alltucker, 4/13)

Republicans in Congress for the first time are lowering expectations for how much of Obamacare they can repeal and how quickly they can do it. As they meet constituents back home, GOP lawmakers seem trapped between the reality of their failed repeal effort and President Donald Trump’s renewed promises this week to finish off Obamacare before taking on tax reform. Vice President Mike Pence is also still trying to keep the repeal dream alive, working with conservatives on new tweaks to the stalled House bill. But even if the ultra-conservatives come on board, there’s no sign that the moderate Republicans needed to pass a bill are ready to sign on. (Haberkorn and Cheney, 4/14)

A House committee chairman who's a leading author of the mired Republican health care bill said Thursday he's skeptical about proposals the Trump administration and conservative GOP lawmakers have discussed in hopes of breathing life into the legislation. Rep. Greg Walden, R-Ore., directed his skepticism at suggestions that states be allowed to sidestep the ban in President Barack Obama's health care law against insurers charging seriously ill people higher premiums than healthy customers. (Fram, 4/13)

“Why don’t you go back to Washington, [and] in the spirit of bipartisanship, grow a pair, sit down with [House Democratic leader] Nancy Pelosi and say, ‘Let’s fix Obamacare,’ ” said one middle-aged man at Columbia Gorge Community College, where about 500 people gathered. A few in the rowdy crowd at the next town hall seemed to know that Walden, as the chairman of the House Energy and Commerce Committee, played a pivotal role in crafting the GOP’s American Health Care Act, which would have rolled back Obamacare’s system of subsidies and phased out that law’s Medicaid expansion. (Winfield Cunningham, 4/13)

President Trump signed legislation on Thursday aimed at cutting off federal funding to Planned Parenthood and other groups that perform abortions, a move cheered by conservatives who have clamored to impose curbs on reproductive rights. (David, 4/13)

Thursday’s bill signing was quickly condemned by Planned Parenthood and other abortion-rights groups. Dawn Laguens, the organization’s executive vice president, said it would make it harder for Americans to access health care. “We should build on the tremendous progress made in this country with expanded access to birth control, instead of enacting policies that take us backward,” Ms. Laguens said in a statement. “Too many women still face barriers to health care, especially young women, women of color, those who live in rural areas, and women with low incomes.” (Andrews, 4/13)

Anti-abortion activists cheered the move as a way to return some measure of discretion to states, which will now have the latitude they once did in deciding how to mete out Title X funds. "This is promise kept," said the Susan B. Anthony List's Marjorie Dannenfelser, who attended the signing which was conducted without media present. "This puts an end to the outgoing gift that Obama gave the Trump administration which was to disallow states from being in charge of its own family planning funds." (Dwyer, 4/13)

The move marked the 12th time that Trump has signed a resolution under the 1996 Congressional Review Act (CRA) to abolish a rule issued under President Barack Obama. Less than two hours later on Thursday, Trump signed a 13th measure, this one abolishing a Labor Department regulation aimed at expanding retirement savings accounts. (Eilperin, 4/13)

Obama's rule required that state and local governments distribute federal Title X funding for services related to contraception, fertility, pregnancy care and cervical cancer screenings to health providers, regardless of whether they also perform abortions. (Hellmann, 4/13)

The legislation is part of a broader effort by Republicans to cut off federal funding from health-care organizations that perform abortions, a fight that could resurface as Congress tries to avoid a government shutdown at the end of the month. (Olorunnipa, 4/13)

President Donald Trump has signed legislation that allows states to withhold federal funds for family-planning services from clinics that also provide abortions. But the change won't impact Arizona, even though Planned Parenthood — the law's primary target — provides many of the services in the state. (Beard Rau, 4/13)

Abortion providers in Texas that receive federal dollars to offer reproductive health services to low-income people are likely to lose that funding under a measure President Trump signed Thursday. The measure allows states to exclude Planned Parenthood and other women's health organizations that provide abortions at some of their clinics from receiving federal "Title X" money, which funds family planning services such as contraceptive counseling, pregnancy tests and STD testing. (Evans, 4/13)

The medical device maker St. Jude Medical played down the failure of some batteries in its defibrillators, shipping them for years before recalling the devices last fall, according to a warning letter the Food and Drug Administration issued this week. The company, acquired by Abbott Laboratories in January, also failed to tell its own management and a medical advisory board that the battery problems had led to the death of a patient, the agency found. (Thomas, 4/13)

The devices, implanted in the chest, can provide pacing for hearts that beat too slowly and deliver shocks to stop dangerously fast rhythms. Normally the devices alert patients, through a series of vibrations in the chest, months before they need to be replaced. Batteries in some of the devices, however, ran out sooner than expected, giving patients, in some cases, as little as 24 hours' notice before the batteries died. (Schencker, 4/13)

Abbott Laboratories agreed to buy Alere Inc. at a lower price than previously offered, ending a legal battle over the merger between the two U.S.-based health-care companies. Abbott will buy Alere for $51 per share, the companies said Friday in a statement. The new transaction values Alere’s equity at $5.3 billion, or 8.6 percent less than its initial offer. The companies said they expect the deal to close by the end of third quarter, pending shareholder and regulatory approval. (Robinson, 4/14)

Plaintiffs’ lawyers have long solicited clients through television advertisements that warn of a drug’s potentially harmful side effects. Now, a powerful congressman, backed by the leading doctors’ group and some drug companies, is pushing back, saying the ads are to blame for patients suffering harm or even dying after dropping treatment. Rep. Bob Goodlatte (R., Va.), chairman of the House Judiciary Committee, wants the ads to include a warning that patients should talk with their doctors before adjusting medication. (Randazzo and Rockoff, 4/14)

The FDA approved the drug, sold as Ocrevus, two weeks ago. The approval comes after a series of clinical trials across the nation, including at the University of South Florida’s Multiple Sclerosis Center in Tampa. Health News Florida’s Stephanie Colombini talked with Dr. Janice Maldonado, Assistant Professor of Neurology at the center to learn more about Ocrevus and its development. (Colombini, 4/13)

A bipartisan Senate bill unveiled Thursday would impose strict limits on some opioid prescriptions, a small tweak to federal law that is part of an ongoing effort in Congress to curb overuse of the drugs. The legislation, introduced by Sens. John McCain (R-Ariz.) and Kirsten Gillibrand (D-N.Y.), would bar doctors from supplying more than a week’s supply of an opioid drug to patients suffering from acute pain. Refills for those patients would also be prohibited, but prescriptions to treat chronic illnesses and end-of-life care would not be subject to the rules. Several states, including New York and Arizona, have already enacted similar policies. (Reid, 4/13)

Fatal drug overdoses increased 38 percent in Virginia between 2015 and 2016, an alarming jump that state health officials attribute to abuse of synthetic opioids, heroin and prescription fentanyl. A new report from the state medical examiner found an even bigger increase — 175 percent — in deaths from several varieties of fentanyl, a pain medication significantly more potent than morphine. (Sullivan, 4/13)

After years of delay, Massachusetts is taking another crack at a job that has proven especially tough: creating a one-stop online shop to help consumers make educated choices about their health care. The state’s Center for Health Information and Analysis has hired a vendor to design and launch a user-friendly website that includes the average prices of dozens of common health care procedures, safety and quality measures for individual hospitals, and basic information about obtaining insurance and getting care. (Dayal McCluskey, 4/14)

If you're insured, ask your provider or check the company's website for pricing tools. Many insurers now offer them, though not all are extremely useful. Some states have terrific pricing tools, such as Minnesota and New Hampshire, but a lot of the state resources are not so great. In Ohio, for example, the prices are simply the list or "chargemaster" prices, which are the top-end rates, and thus not very useful. The National Conference of State Legislatures has a scorecard of those resources. (4/13)

Silicon Valley has audacious plans for shaking up the way we diagnose — and cure — disease. But the life sciences are far more challenging than the tech titans of this world might realize: There are countless regulatory hurdles, health care delivery obstacles, and — most of all — the challenge of untangling the extraordinarily complex biology of the human body. Still, giants like Apple, Google, IBM, Intel, and Microsoft are charging ahead. (Keshavaan, 4/13)

The controversial laboratory tool known as CRISPR may have found a whole new world to conquer. Already the favored method of editing genes, CRISPR could soon become a low-cost diagnostic tool that could be used practically anywhere to determine if someone has an infectious disease such as Zika or dengue. (Achenbach, 4/13)

For years, health experts have bemoaned the rise of childhood obesity in the United States. About 17% of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s, according to data from the Centers for Disease Control and Prevention. A report in this week’s edition of the New England Journal of Medicine lays out one of the consequences of all this excess weight: a corresponding increase in childhood cases of type 2 diabetes. (Kaplan, 4/14)

One of the nation’s largest homeopathy companies announced Thursday that it was recalling all of its infant teething tablets at the request of US regulators, following reports that the tablets had caused seizures and other severe complications in hundreds of infants. The company, Standard Homeopathic, said it was recalling the tablets at the request of the Food and Drug Administration, which had concluded that they contained inconsistent amounts of belladonna, an herb known colloquially as “deadly nightshade.” (4/13)

Saying it was another way that Ohioans help each other, Gov. John Kasich on Wednesday held a ceremony to celebrate passage of an autism-coverage bill that has been years in the making. House Bill 463 requires insurers to cover autism-spectrum disorders. It took effect last week. (Schladen, 4/13)

Calling it an honor, Governor Branstad today signed into law what’s being called the most expansive gun  rights bill in Iowa history, to the applause of a roomful of supporters. The bill expands self-defense rights for gun owners, so-called Stand Your Ground. It also allows gun owners with permits to carry weapons into the statehouse. (Russell, 4/13)

Breast cancer survivors and their supporters were at the capitol Thursday for a bill-signing of legislation known as Patty’s Law, named for a West Des Moines cancer patient. The new law directs mammogram providers to let a woman know if she has dense breast tissue, so she can get an ultrasound in addition to a mammogram. (Russell, 4/13)

An anti-drug group opposed to medical marijuana is helping craft Florida laws on pot’s expanded use — a cause its founders tried and failed to defeat during last year’s elections. The St. Petersburg-based Drug Free America Foundation is one of several anti-drug groups tied to conservative financiers Mel and Betty Sembler that opposed constitutional amendments legalizing medical marijuana in 2014 and 2016. (Auslen, 4/13)

A Michigan doctor has been accused of performing genital cutting on two 7-year-old girls at a medical clinic, in a case that federal officials believe to be the first prosecution under a law banning the brutal practice. The doctor, Jumana Nagarwala, 44, was arrested on Wednesday on charges that she performed the genital cutting at an unnamed medical clinic in Livonia, Mich.; transported minors with intent to engage in criminal sexual activity; and lied to federal agents. (Fortin, 4/13)

A Detroit emergency room doctor is accused of performing genital mutilation on two 7-year-old girls from Minneapolis. Dr. Jumana Nagarwala is charged with performing the procedure out of a clinic in Livonia, Mich., in February, according to charges filed in U.S. District Court on Thursday. It’s believed to be the first case to be brought under the federal law criminalizing female genital mutilation of girls. The investigation suggests there are “multiple” other child victims of Nagarwala.  (Legge, 4/13)

Four years ago, after more than a decade of litigation and negotiation, New York State officials agreed that the system of often dismal and dangerous adult homes was no place for the mentally ill. They agreed to move as many as 4,000 mentally ill residents out of their apartments and into supportive housing, a hard-fought recognition that people with disabilities should have the opportunity to live independently and participate in all aspects of community life. (Santora, 4/14)

Secretary of Veterans Affairs David Shulkin personally intervened and appointed a member of his own staff to lead the VA Medical Center in the nation's capital Thursday, after a scathing interim report from federal investigators. “We will not put veterans at risk, and you will see in this administration when we believe there is unnecessary or unacceptable risk, we will take decisive action,” Shulkin said in a press call with reporters. A VA Office of Inspector General report publicized Wednesday revealed patients at the Washington hospital were being placed at risk because of the sloppy management of medical supplies and equipment. (Mejdrich, 4/13)

Tennessee's attorney general has agreed that the state will drop two abortion limits similar to Texas laws struck down by the U.S. Supreme Court, according to federal court filings Thursday. One of the requirements mandated that abortion providers have hospital admitting privileges. The other forced abortion clinics to meet hospital-level surgical standards. (Mattise, 4/13)

First, investigators contacted the couple's clients — all maintained they had never heard of them. Next, investigators talked to physicians who supposedly worked on Medicaid bills for the couple's home health care companies but they, too, had never heard of the Amoses. These discoveries were among the clearest signs to prosecutors that Oluyemisi Amos, 35, and her husband Felix Amos, 66, would represent the latest scam in a string of Houston health care fraud cases. The couple pled not guilty in Houston federal court Thursday following an indictment for multiple counts of health care fraud totaling more than $24 million. (Meyer, 4/13)

Over the course of eight months, a lethal bacteria infected 10 already critically ill infants in UC Irvine Medical Center’s neonatal intensive care unit – an outbreak that the public is only finding out about now. None of the infants have died, hospital officials said. (Petersen, 4/13)

The Minnesota Department of Health is investigating three measles cases. All three patients are toddlers from Hennepin County. State health officials say they haven't figured out how the children contracted the disease and are trying to track down anyone who may have had contact with them. (Richert, 4/13)

With the announcement of MetroHealth System's decision to sponsor the Greater Cleveland Regional Transit Authority's newest Bus Rapid Transit (BRT) route, all three major health systems in the county soon will be on board with public transit. The new BRT line will start rolling in October. At that time, what is known as the No. 51 line will be rebranded as the MetroHealth Line - a new BRT line sponsored by the MetroHealth System for the same fare as existing routes. (Christ, 4/14)

LSU Health Sciences Center and medical school in New Orleans have lost research dollars and struggled to restore faculty to pre-Hurricane Katrina levels as a result of state budget cuts over the past decade, says Larry Hollier, the school's chancellor. Now they're facing another round of cuts unless the Legislature raises taxes or reduces other public services. Over the past eight years, Louisiana has trimmed funding for health sciences centers in New Orleans and Shreveport by $38 million. At the same time, state-mandated costs on the centers have increased by $22 million, causing more fiscal problems, Hollier said. (O'Donoghue, 4/13)

Virtua Health can proceed with its plans to build a $1 billion hospital complex in Westampton,  Burlington County, as long as it meets 13 conditions, the New Jersey Health Planning Board decided Thursday after reviewing the proposal. The board voted unanimously to approve the plans but also adopted 12 recommendations made by the staffers of the Health Department who analyzed the proposal.  The board then added one additional stipulation – that Virtua obtain approval from the state Department of Environmental Protection prior to construction. (Hefler, 4/13)

Worcester Polytechnic Institute is opening a new medical and technology development center it hopes will speed up the production of cutting edge medical devices and therapies for patients. PracticePoint at WPI, a public/private partnership announced Thursday, will include several testing suites to allow clinical researchers, engineers and manufacturers to more easily collaborate and commercialize robotic and other smart devices and systems. (Zimmerman, 4/13)

Three metropolitan areas in Northeast Ohio were among 72 areas in the U.S. that suffered through more than 100 days of unhealthy air pollution in 2015, according to a report released today by the Environment America Research & Policy Center. The Akron area paced Northeast Ohio with 188 days of moderate to unhealthy levels of soot particles in the air, followed by Cleveland-Elyria with 175, and Youngstown-Warren-Boardman with 142. (McCarty, 4/13)

Every time Traci Smith walked into chemotherapy at Lankenau Medical Center in 2013, she made sure she was looking her best. When Smith arrived, patients, nurses, and doctors complimented her, telling her she didn’t look sick, which, given that she had lost all her hair, fingernails, and appetite, felt good. “It was important to me,” says Smith, 48, who cofounded the nonprofit Traci’s B.I.O. (Beautiful Inside and Out) with business partner Phyllis Young in 2014. The organization works to support, educate, and pamper African American women with breast cancer. (Rush, 4/14)

Partners HealthCare, one of Massachusetts’ largest companies and biggest energy users, has signed an agreement with a New Hampshire wind farm to help power its hospitals and other facilities. Partners said the deal will reduce its greenhouse gas emissions by 110 million pounds per year. The agreement is with New York-based Walden Green Energy LLC, which is building a wind farm in Antrim, N.H. Construction is expected to be completed in 2019. (Dayal McCluskey, 4/13)

Get ready for another big congressional fight over Obamacare. The flashpoint this time is a key funding stream for the program ― one that subsidizes insurers so they can offer low-income consumers plans with reduced out-of-pocket expenses. President Donald Trump suggested in a Wednesday Wall Street Journal interview that he and other Republicans might cut off the funds. Now Democrats are saying they’ll fight this by demanding that Congress include the money as part of a spending bill that is supposed to keep the government running past April. (Jonathan Cohn, 4/13)

Three weeks have passed since the Trumpcare debacle. After eight years spent denouncing the Affordable Care Act, the G.O.P. finally found itself in a position to do what it had promised, and deliver something better. But it couldn’t. And Republicans, President Trump very much included, had nobody but themselves to blame. (Paul Krugman, 4/14)

Cost-sharing reductions seem like an arcane aspect of the Affordable Care Act, but they could now make or break the Obamacare insurance marketplaces. Even President Trump is talking about them, as a possible bargaining chip for a new health bill. (Reed Abelson and Margot Sanger-Katz, 4/14)

In an interview with Fox Business that aired on Wednesday, President Donald Trump said it's been "misreported" that his administration has failed in its efforts reform health care. He suggested that his party's reforms will result in $900 billion in government savings, and that an ACA repeal will come before an attempt at tax reform. Hospitals and Medicaid insurers, stocks that are most exposed to changes to the ACA, saw shares fall once again yesterday. A repeal is still unlikely, despite the President's continuing optimism. But continuing to tilt at that windmill doesn't enable tax reform, it renders it more distant and difficult to count on. That's a bigger issue than repeal for much of the health care sector. (Max Nisen, 4/13)

Republicans haven't been able to replace Obamacare, because they think the problem with it, metaphorically speaking, is that the food is terrible and the portions are too small. That, of course, is what Woody Allen had to say about life in “Annie Hall.” But the same kind of contradiction — you hate something, and want more of it — is why Republicans haven't been able to agree on anything other than that they want to be able to say that they repealed Obamacare. (Matt O'Brien, 4/14)

President Trump and congressional Republicans finally goaded the health insurance industry into defending the Affordable Care Act this week — sort of. But the industry’s pusillanimous response to the GOP’s point-blank threat to Obamacare’s survival is a reminder that health insurance companies, which have made hundreds of millions of dollars from the law, have in many ways been its worst enemies. (Michael Hiltzik, 4/13)

In February, the full U.S. Court of Appeals for the Eleventh Circuit issued its long-awaited ruling in Wollschlaeger v. Governor, State of Florida, invalidating parts of Florida’s Firearm Owners’ Privacy Act (FOPA) and affirming that the First Amendment applies to the speech between physicians and patients. The decision ensures that physicians may continue to make efforts to protect their patients from gun-related injuries, many of which are fatal and which in aggregate account for approximately as many deaths annually as do motor vehicle accidents. (Wendy E. Parmet, Jason A. Smith and Matthew Miller, 4/12)

President Trump was moved to launch an attack on an air base in Syria in part because of images he saw of the youngest victims of Syrian dictator Bashar al-Assad’s most recent chemical assault on civilians. “Even beautiful babies were cruelly murdered in this very barbaric attack. No child of God should ever suffer such horror,” Trump said while explaining the strike, as if he were learning of such atrocities being committed at the hands of the Assad regime for the first time. While I commend his rare public display of empathy, I hope he will give the same direct and forceful action to avert the deaths of hundreds of thousands of children a year from HIV/AIDS. (C. Nicholas Cuneo, 4/13)

Human intelligence has long powered hospitals and health care. We rely on doctors, nurses, and a variety of other clinicians to solve problems and create new solutions. Advances in artificial intelligence are now making it possible to apply this form of computer-based “thinking” to health care. As the chief technology officer for a new state-of-the-art advanced medical learning facility, I have been closely watching developments in artificial intelligence. Here are three areas — training, surgical robots, and data mining — in which I believe it will begin making a difference sooner rather than later. (Roger Smith, 4/13)

Just after World War II, there were 1.4 million hospital beds available in the U.S. The most recent estimates show fewer than 900,000 beds, even though the nation’s population has grown by 120% over the same period. Better care delivery, technology, and changing financial incentives have driven much of this decrease, with hospitals continuing to downsize their staff and operations, making for less-flexible bed management. Also shrinking in number are emergency rooms (ERs), even while demand increases. ... In the past few decades, an additional burden has been placed on the ER with major implications for patient care: boarding. (Howard Forman, 4/11)

I spent 11 years after medical school training for my first career as a surgeon and scientist, and received little formal preparation for my eventual career as an institutional leader. Extensive training makes sense for a role in which you literally hold patients’ lives in your hands. But beyond the necessary technical skills, becoming a surgeon is a matter of absorbing deep and urgent responsibility for another’s life into a core part of yourself. In some ways, that training has helped me in my current administrative role. ... Other lessons don’t translate as readily. (Lloyd B. Minor, 4/11)

Having followed the events at Standing Rock, North Dakota, I was drawn to go there during Thanksgiving week — amazed by the unlikely fact that a tribe suffering from poverty and health disparities could take such a principled, powerful stand, galvanizing attention for environmental justice and the perfidy of continued carbon exploitation. I thought experiencing Standing Rock, and perhaps contributing, could teach me something about caring for the [traditional Navajo, or] Diné in Chinle. ... The Standing Rock movement is about both environmental justice and racism: it aims to protect Native American lands, reduce exploitation of carbon-based energy to slow climate change, and defend access to safe water for a vulnerable community. ... Medicine has a proud history of water protection. (David Goldberg, 4/13)