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Donald J. Trump calls for “a full repeal of Obamacare” but says that “everybody’s got to be covered.” Initially, he liked “the mandate,” a central feature of the Affordable Care Act that requires most Americans to have insurance or pay a penalty, but he backed off that position under fire from conservatives. He would allow individuals to take tax deductions for insurance premium payments. But aides acknowledge that this tax break would not be worth much to people whose income is so low they pay little or nothing in federal income taxes. For them, Trump aides say, there would be Medicaid, which the billionaire businessman says he would not cut but would turn into a block grant to state governments. This whipsaw of ideas is exasperating Republican experts on health care, who call his proposals an incoherent mishmash that could jeopardize coverage for millions of newly insured people. (Pear and Haberman, 4/8)

The uninsured rate for Americans has tumbled dramatically over the past few years in the wake of Obamacare and expanded Medicaid coverage. Only 11 percent of adults and children are still without healthcare coverage, according to a new survey by Gallup and Healthways. Gallup said on Thursday that the rate of uninsured is at the lowest level in eight years, especially among African-Americans and Hispanics. ... the latest figures for the first three months of 2016 are remarkable, according to Gallup: The 11 percent rate of uninsured Americans who aren’t old enough to qualify for Medicare is down nine-tenths of a percentage point from the fourth quarter of 2015 overall and by a much larger margin for minority groups that have long gone without health insurance coverage. (Pianin, 4/7)

In a move called both symbolic and practical, the Covered California board took the first step Thursday toward allowing undocumented residents to purchase health plans – with no state or federal subsidies – through California’s Obamacare marketplace. The board can’t officially enact that change, which requires state legislation and federal permission, but Covered California officials indicated they were ready to lend support if California lawmakers ask them to. (Buck, 4/7)

Moving into a realm usually reserved for health care regulators, Covered California Thursday unveiled sweeping reforms to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers. Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards. (Ana B. Ibarra and David Gorn, 4/8)

Legislation to continue providing health coverage for more than 267,000 low-income Arkansans under the state's expanded Medicaid program cleared the state House and Senate on Thursday, but by smaller margins than will be needed next week to approve funding for the program beyond June 30. Opponents of the program vowed to try to block funding during the fiscal session, which starts Wednesday, and said they have the votes to do it. (Davis, Fanney, Wickline and Willems, 4/8)

Advocates for poor people and Medicaid expansion hammered Louisiana lawmakers Thursday (April 7) for what they said was legislation aimed at limiting access to health insurance and charging co-pays. The testimony, which was at times unusually harsh, came during a House Health and Welfare Committee meeting that Chairman Frank Hoffmann, R-West Monroe, said was the most difficult held this legislative session. After 2 1/2 hours of work, the committee succeeded in passing no legislation. Several lawmakers killed their own bills rather than bring them up for a vote. (Litten, 4/7)

Legislative support appears to be crumbling for plans to charge Medicaid recipients copays for receiving health care services. Gov. John Bel Edwards threw his support behind copays after Republicans pushed for the measure as part of Medicaid expansion. But two legislators interviewed Wednesday (April 6) said there are serious doubts about whether there is enough support to get the plan out of committee after health care providers began lobbying against the bill. (Littens, 4/7)

Proposals to charge Medicaid patients copays for some health care services and prescription drugs have fizzled in the Louisiana Legislature, including a measure backed by Gov. John Bel Edwards. Hearings on three Medicaid copay bills sponsored by Republicans were scrapped Thursday in the House Health and Welfare Committee, including on the bill by Rep. Jack McFarland, R-Winnfield, which is supported by the Democratic governor. (Deslatte, 4/7)

The day Gov. Maggie Hassan signed the bill extending Medicaid expansion for two years, the federal Health and Human Services secretary rejected the state of Arkansas’ work requirement, a key element in New Hampshire’s bill. The biggest debate among lawmakers over reauthorizing the New Hampshire Health Protection Program was the 30-hour work requirement for more than 48,000 low-income adults. During House and Senate debates, supporters of HB 1696 said the requirement is important but backed a provision needed to allow the program to continue if the federal Center for Medicaid Services denies the requirement, as it has for other states. (Rayno, 4/7)

A Florida woman who was caught on camera Tuesday blasting Gov. Rick Scott at a Starbucks in Gainesville for cutting Medicaid and signing a bill to defund clinics like Planned Parenthood, is now responding to the viral video that garnered her national attention. (Luibrand, 4/7)

Federal investigators found significant cybersecurity weaknesses in the health insurance websites of California, Kentucky and Vermont that could enable hackers to get their hands on sensitive personal information about hundreds of thousands of people, The Associated Press has learned. And some of those flaws have yet to be fixed. The vulnerabilities were discovered by the Government Accountability Office, the investigative arm of Congress, and shared with state officials last September. (4/7)

California’s system, known as Covered California, is the nation’s largest state-run exchange. Both California and Kentucky have been touted as a national model, though Vermont has had a documented history of issues with its exchange. The GAO’s investigation was released in March, but without naming the states. That information was reported Thursday by the Associated Press, in response to a Freedom of Information Act request. Federal officials said their findings in the investigation, which was initially limited to those three states, likely means that other states’ websites have faced similar cyber issues. (Farris, 4/7)

Three weeks ago, a debilitating digital virus spread quickly in computer networks at three Southern California hospitals owned by Prime Healthcare Services. Using a pop-up window, hackers demanded about $17,000 in the hard-to-trace cybercurrency called Bitcoin to destroy the virus they had implanted. The virus had encrypted medical and other data so it was impossible to access. ... The attempted extortion by criminal hackers was the latest case of what the FBI says is a fast-growing threat to vulnerable individuals, companies and low-profile critical infrastructure, from hospitals and schools to police stations. (Hennigan and Bennett, 4/8)

Hospitals' use of digital medication orders have dramatically reduced the number of dangerous drug errors, but their computer systems still fail to flag 13% of potentially fatal mistakes, a report released Thursday shows. Medication errors are by far the most common mistakes made in hospitals — and hospital errors are the third leading cause of death in the United States. Digital drug ordering is part of so-called "computerized physician order entry," or CPOE, which was designed to address the problem. (O'Donnell, 4/7)

Within the last two years, many hospitals across Michigan have improved the way that patients get prescription drugs during their hospital stays — improvements that should lead to fewer physician errors and fewer adverse drug reactions, according to results from a national report. The report, called “Preventing Medication Errors in Hospitals,” reviewed data on how many hospitals across the country use newer computerized systems that are fully set up to prevent medication errors — which are the most common type of error to happen in hospitals, according to a news release from the Economic Alliance for Michigan. (Bethencourt, 4/7)

The Lee Memorial Health System fully meets a safety group's standards for using computer systems to prevent medication errors and the NCH Healthcare System is nearly there, according to findings. The national nonprofit Leapfrog Group, which focuses on health care quality and safety, has released a new analysis on how well hospitals nationwide use computerized physician order entry systems to prevent medication errors. (Freeman, 4/7)

Antitrust scrutiny of hospital consolidation in the Chicago area isn't stopping Northwestern University's academic medical center from pursuing another merger. Chicago-based Northwestern Memorial is in talks with Centegra Health System, based in northwest suburban Crystal Lake, to explore a potential combination. There's no guarantee that the discussions will lead to a full-blown merger, but Northwestern has been more successful than not in closing deals. (Sachdev, 4/7)

Poor financials, a deteriorating stock price and investor unease over a difficult nine-month stretch have pushed hospital chain Tenet Healthcare Corp. out of the Standard & Poor's 500, a blue-chip stock index. Ulta Salon, Cosmetics & Fragrance, a beauty store chain, will replace Dallas-based Tenet in the S&P 500. Tenet will move to the S&P MidCap 400. “Tenet Healthcare has a market capitalization that is more representative of the mid-cap market space,” according to a news release from the S&P Dow Jones Indices.Tenet's market capitalization was about $2.8 billion as of Thursday. (Herman, 4/7)

Supervisors instructed employees to falsify patient wait times at Veterans Affairs' medical facilities in at least seven states, according to a USA TODAY analysis of more than 70 investigation reports released in recent weeks. Overall, those reports — released after multiple inquiries and a Freedom of Information Act request — reveal for the first time specifics of widespread scheduling manipulation. (Slack, 4/7)

The director of the Manchester VA Medical Center apologized Thursday to veterans for scheduling issues at the facility included in a report released last week by the Veterans Affairs Inspector General. According to the report, staff at the Manchester VA manipulated appointment dates and refused to schedule referrals beyond 14 days in some specialty departments, in an effort to give the appearance that patients were being seen quickly by center staffers. (Feely, 4/7)

New reports from the Veterans Administration Office of Inspector General have revealed evidence of wait time record manipulation at the VA hospitals in Manchester, New Hampshire and White River Junction, Vermont. Multiple sources involved in scheduling veterans for appointments reported fudging numbers by offering veterans the first available appointment, rather than allowing the veteran to determine how soon they need to be seen. This allowed schedulers to show a wait time of "zero," when in fact veterans could have been waiting much longer to be seen. (Biello, 4/7)

The city of Pueblo — a gateway to the Southwest and home to gangs that span generations — is caught up in a wave of violence that has alarmed everyone from the baby gangsters and their families to local and federal officials. Pueblo had 13 homicides in 2014 and another 13 in 2015, giving the city the unfortunate distinction of having the highest per-capita murder rate in the state. At 12 murders per 100,000 people, its homicide incidence is three times that of New York City, and twice that of Brooklyn, New York’s deadliest borough. ... By nearly all accounts, the surge in violence is driven by a phenomenon rolling through communities from Long Island to St. Louis and Los Angeles: a flood of cheap heroin from Mexico and an eager base of customers from a range of economic backgrounds, some of whom switched to the drug after using prescription painkillers. (Turkewitz, 4/7)

House Republican leaders plan to hold a vote next month on legislation tackling heroin and painkiller abuse, a key issue to many members whose districts have been hit hard by the opioid epidemic. House Majority Leader Kevin McCarthy (R-Calif.) announced the plan on Thursday, saying the vote will occur after committees working on the issue complete their work in the next few weeks. (Demirjian, 4/7)

Republican Sen. Rob Portman of Ohio took the floor of the upper chamber Thursday to put pressure on his House colleagues, condemning inaction that has left the Senate’s sweeping heroin legislation to languish. (Grim, 4/7)

Some private equity investors are getting into the business of substance abuse treatment. They're putting big money into building treatment centers, promising to fundamentally change the industry. It's estimated that 22 million Americans need help with substance abuse. Deborah Becker member station WBUR reports on the huge private equity investment behind eight new facilities in the Northeast. (Becker, 4/7)

The opioid epidemic is claiming thousands of lives each year. The Centers for Disease Control and Prevention says more than 10,000 Americans died of heroin overdoses in 2014 alone. The crisis has hit hard in Massachusetts, where nearly four people are dying each day from opioids. (Craig, 4/7)

Addiction experts, police, public officials and former users are coming together to discuss New York state's heroin and opioid problem. State Assemblyman Angelo Santabarbara, a Rotterdam Democrat, said Friday's event at the state Capitol is intended to raise awareness about drug abuse and the resources out there to help users get clean. Representatives from the Schenectady County Sheriff's Department, local substance abuse experts and former users are expected to participate. (4/8)

If there's one thing Deputy Naperville Police Chief Brian Cunningham doesn't want, it's for drug users and members of their families to be too intimidated to look into the police department's new "Connect For Life" opiate abuse treatment program. "It's not our goal to create an amnesty program for addicts," Cunningham said of Connect For Life, which was officially launched on March 28. "What the program is about is for us to help people who need that connection" to counselors, medical professionals and addiction treatment centers, he said. (Bird, 4/7)

Thirty people died in fentanyl-related overdoses in Milwaukee County during the first three months of this year, matching the total number of fentanyl deaths in 2015 — a year that itself saw an unprecedented number of deaths from the drug. Those grim numbers, compiled by the medical examiner's office, come as the city Health Department on Thursday released a slew of its own troubling health statistics. (Stephenson, 4/7)

Americans don't know a lot about the Zika virus that is linked to birth defects and creeping steadily closer to the U.S., according to a new poll that found about 4 in 10 say they've heard little to nothing about the mosquito-borne threat. Even among people who've been following the Zika saga at least a little, many aren't sure whether there's a vaccine or treatment — not yet — or if there's any way the virus can spread other than through mosquito bites. (Neergaard and Swanson, 4/8)

Planned Parenthood of Indiana and Kentucky on Thursday filed a lawsuit against the state of Indiana, saying a new state law restricting abortion was unconstitutional. The law, which was signed last month by Indiana Governor Mike Pence and goes into effect on July 1, prohibits abortion in the early stages of a pregnancy based on genetic abnormalities and mandates a fetus be buried or cremated, according to the lawsuit filed in U.S. District Court. (Madden, 4/7)

"The United States Supreme Court has repeatedly stressed that a woman, not the state, is to determine whether or not to obtain an abortion," ACLU of Indiana Legal Director Ken Falk said at a news conference midday Thursday. "The State of Indiana's attempt to invade a woman's privacy and to control her decision in this regard is unprecedented and unconstitutional." Planned Parenthood of Indiana and Kentucky president and CEO Betty Cockrum said the law, which was passed by the GOP-led Legislature and signed by Gov. Mike Pence last month, shows the state doesn't respect women. (Chokey, 4/7)

Michigan's attorney general filed a civil suit on Thursday to shut down a Detroit abortion clinic the state claims is not owned by a medical professional. Summit Women's Center's sole officer, director and owner, David Lipton, is not a licensed physician, the attorney general said in a statement. Additionally, the company's annual report to the state in 2015 falsely certified that Lipton was licensed to provide professional medical services. (Weinraub, 4/7)

Michigan Attorney General Bill Schuette announced that his office filed a lawsuit Thursday in an effort to close an “illegally operating Detroit abortion clinic.” But the lawsuit has nothing to do with medical malpractice or how the clinic staff performed their duties. Instead, the state’s lawyers alleged that Summit Women’s Center, at 15801 W. McNichols, had an out-of-state owner who was not a “licensed professional” such as a medical doctor, as required by the Michigan health code. (Laitner, 4/7)

Under orders from lawmakers, a divided Arkansas State Medical Board voted Thursday to replace the term "fetus" with "unborn child" and "unborn human individual" in proposed regulations implementing abortion-related laws passed by the state Legislature. The board had presented the wording governing abortion procedures for doctors in January, changing the Legislature's language to "fetus" because its members said that was an accepted medical term, while "unborn child" was not. A subcommittee of the Arkansas Legislative Council sent the proposed rules back to the board with directions to restore the original language. The board did so Thursday on a 9-4 split vote. (Lauer, 4/7)

Planned Parenthood officials have been called to speak before Congress, had officials show up at their office demanding documents and have been the center of abortion opponents ire since this summer, when an undercover group accused them of illegally selling fetal tissue for profit. But this week marks the first time a Planned Parenthood official could face jail time in that debate. (Phillips, 4/7)

In Utah, a doctor performing an abortion will soon have to administer anesthesia after 20 weeks of pregnancy. The new law is the first of its kind in the nation, and it's based on the controversial notion that a fetus at that stage in development may feel pain during the procedure. Abortion providers are adapting to this change in the law. (Smardon, 4/7)

California Atty. Gen. Kamala Harris is drawing fire from supporters of an anti-abortion activist whose undercover videos and identity cards were seized by the state Department of Justice this week after Harris' political campaign sought to drum up support for Planned Parenthood. David Beltran, a spokesman for Harris' Department of Justice, said the agency would have no comment. Nathan Click, spokesman for her political campaign, referred questions to that agency. Harris seeks the Democratic nomination for the U.S. Senate seat being vacated by Barbara Boxer. Her campaign website includes a page that asked supporters to sign a petition "to defend Planned Parenthood." (St. John, 4/7)

A leading anti-abortion group is calling on California Attorney General Kamala Harris to resign and end her Senate campaign after her office raided the home of anti-abortion videomaker David Daleiden. Susan B. Anthony List called on Harris to resign and drop out of the race after Daleiden, the maker of controversial undercover videos targeting Planned Parenthood, posted a Facebook message Tuesday saying California authorities had raided his home and seized video footage. (Sullivan, 4/7)

Iowa House Republicans unveiled a comprehensive plan to provide oversight of Gov. Terry Branstad's controversial shift of the state's Medicaid health care program to private management companies. House Speaker Linda Upmeyer said Thursday the proposal will add consumer protections and accountability measures to ensure that patients receive high-quality care, and to prevent fraud and waste of taxpayer dollars. (Petroski, 4/7)

House Republicans on Thursday announced a new proposal for state oversight of Iowa’s privatized Medicaid program, which they say emphasizes transparency. But it’s unclear whether Senate Democrats will fully embrace the plan. The proposal would require the three private companies now running the program to provide information for quarterly and annual progress reports to lawmakers. The data also would be posted online. (4/7)

State Medicaid regulators pursuing orthodontists who they claim bilked Texas out of tens of millions of dollars suffered another decisive setback Thursday, when an appeals court ruled investigators hadn’t proven any fraud had occurred in one of the state’s largest cases. Unless the state appeals the decision to the Texas Supreme Court, it means Texas must return millions of dollars in payments it has withheld from the Houston-based Antoine Dental Center. (Dexheimer, 4/7)

State lawmakers are proposing a plan meant to ease the transition of some mental health patients in Maine who stand to lose access to intensive community mental health services. The Portland Press Herald reports that under Wednesday's proposal, the transition period for clients currently receiving daily living assistance would be extended to 120 days. Additional 90-day extensions would be offered through June 2017 for those who can't access other programs within MaineCare. (4/7)

Cash-strapped Illinois needs to provide in-home nursing care to more than 1,200 children with disabilities and severe medical conditions, a federal judge ordered Wednesday, responding to a lawsuit alleging the state has failed to fulfill its Medicaid obligations. "This is a systemic problem," said Robert Farley, one of the attorneys suing the state. (Moreno, 4/7)

Abused children in Texas are being left in psychiatric facilities longer than they were six years ago as the state's child protective services system grapples with federal court scrutiny and diminishing options, according to data obtained by The Texas Tribune. Last year, 17,151 Texas children were removed from abusive homes. While the agency could not say exactly how many were placed in private and state psychiatric hospitals, data from 2009 to 2015 shows roughly 4,000 psychiatric admissions for foster care children each year. (Langford, 4/7)

About dawn one Sunday morning, a health official at a small Jesuit college in California got an alarming phone call: A student had been rushed to the hospital. The ER staff quickly suspected meningitis. And while they treated and tested for the highly contagious, often fatal disease, scores of other students were streaming into the emergency room, frightened by their own symptoms. “It’s everyone’s worst fear in college health,” said Joshua M. Sharfstein, associate dean at Johns Hopkins Bloomberg School of Public Health. “Meningitis strikes very quickly. Someone looking well one day could be dead the next.” (Svrluga, 4/7)

Twenty-eight students in a University of Minnesota residence hall have gotten sick with what's suspected to be a viral infection. Minnesota Department of Health spokesman Doug Schultz said Thursday that 28 students in Frontier Hall have suffered from what's suspected by state health officials to be a norovirus strain. He says reports of the illnesses starting coming into his department Wednesday. (4/7)

Kentucky health officials say that the flu is continuing to rage across the state and is expected to continue to be a problem well into next month. The Kentucky Department for Public Health sent out a health alert Wednesday, announcing flu activity in the state to be "widespread" for the ninth consecutive week, with flu-like activity or outbreaks having been reported in at least half of the state's regions. (4/8)

Starting in 2017, all state and federal health insurance exchanges will present quality data on health plans in addition to cost information. We analyzed variations in the current design of information on state exchanges to identify presentation approaches that encourage consumers to take quality as well as cost into account .... Using an online sample of 1,025 adults, we randomly assigned participants to view the same comparative information on health plans, displayed in different ways. We found that consumers were much more likely to select a high-value plan when cost information was summarized instead of detailed, when quality stars were displayed adjacent to cost information, when consumers understood that quality stars signified the quality of medical care, and when high-value plans were highlighted with a check mark or blue ribbon. (Greene, Hibbard and Sacks, 4/4)

In December 2008 the Centers for Medicare and Medicaid Services (CMS) launched a five-star rating system of nursing homes as part of Nursing Home Compare, a web-based report card detailing quality of care .... We used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. We found that consumers were receptive to using Internet-based information about quality ... but that choice was limited by the need for specialized services, proximity to family or health care providers, and availability of Medicaid beds. Consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited. (Konetzka and Perraillon, 4/4)

This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. .... Among 294 748 children, 40 932 (15%) received a mental health diagnosis and 39 695 (14%) were prescribed psychotropic medication. Attention deficit/hyperactivity disorder was most commonly diagnosed (1%–16% per practice). The proportion of children receiving any psychotropic medication (4%-26%) and the proportion receiving ≥2 medication classes (1%-12%) varied across practices. Prescribing of specific medication classes also varied .... Variability was partially explained by community availability of psychiatrists (significantly higher odds of a diagnosis or prescription when not available) but not by colocation of mental health professionals or percentage of children in foster care. (Mayne et al., 4/1)

Prescription drug spending rose sharply in 2014, driven by growth in expenditures on specialty drugs, including medications to treat cancer and hepatitis C. Medicare’s spending on prescription pharmaceuticals also has risen: between 2004 and 2014, the program’s share of US drug expenditures increased from 2% of $193 billion to 29% percent of $298 billion. ... The majority of the public favors 4 policy actions to hold drug prices in check: requiring pharmaceutical companies to publicly release information on how they set prices; allowing Medicare to negotiate medication prices; limiting charges for high-cost drugs; and allowing people in the United States to buy drugs imported from Canada. (Cox et al., 4/5)

Under federal law and in many states, [Medigap] insurers are not required to participate in an annual open enrollment period, and are only required to sell a policy under specific circumstances, such as when applicants first enroll in Medicare at age 65 or within a year of trying a Medicare Advantage plan. In other words, consumer protections, such as an annual open enrollment period without pre-existing condition exclusions, do not apply to the Medigap market as they do for Marketplace and Medicare Advantage plans. This means that seniors who opt for a Medicare Advantage plan when they first go on Medicare can forever be locked out of the Medigap market. ... [if seniors] choose Medicare Advantage from the start, as more and more Boomers are doing, they may be making an irrevocable decision by giving up their right to purchase supplemental insurance later in life. (Neuman, 3/31)

[I]nsurers generally do not appear to be using telemedicine to fill gaps in plan networks or to meet state network adequacy standards. There is uncertainty about how state and federal regulators would assess the use of telemedicine, particularly where telemedicine encounters could be perceived as replacing, rather than supplementing, face-to-face access to a physician. In addition, the lack of payer and provider investment in the necessary technology, as well as concerns from organized medicine, has led to a lack of infrastructure and integration into medical practice. Specifically, some respondents question the cost efficiency of using telemedicine within provider practices because of the need for resources to support both the technology and the patient with a telemedicine visit. (Ahn, Corlette and Lucia, 4/6)

[T]he US Centers for Disease Control and Prevention (CDC) hasn’t funded research into gun violence prevention for 2 decades, ever since Congress included these 3 lines—named the Dickey Amendment for then-representative Jay Dickey (R, Ark), who introduced it—on page 245 of the 750-page Omnibus Consolidated Appropriations Act of 1997: “None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” The amendment was in response to a CDC-funded study that concluded having a gun in the home was associated with a higher risk of homicide by a family member or intimate acquaintance. ... the same language has also applied to the National Institutes of Health (NIH). However, as part of a funding opportunity for violence research announced in 2013, the NIH awarded Wintemute a total of about $850 000, from May 2015 through April 2017, to study whether gun owners with a history of alcohol and drug convictions are more likely to commit violence than gun owners without such a criminal history. Why the 2 federal agencies have interpreted the same rider so differently is not clear. (Rubin, 4/6)

More than 640 million people globally now weigh in as obese and the world has more overweight than underweight people, according to an analysis of global trends in body mass index (BMI). A startling increase in rates of obesity in the past 40 years means the number of people with a BMI of more than 30 has risen from 105 million in 1975 to 641 million in 2014, the study found. More than one in 10 men and one in seven women are obese. (Kelland, 3/31)

Many baby boomers may be unaware they need screening for the hepatitis C virus, a small study suggests. In a survey of 81 emergency room patients born during the “baby boom” from 1945 to 1965, only 29 percent of participants knew their risk for the virus was higher than for people born in earlier or later generations, the study found. (Rapaport, 4/6)

Family physicians and internists were the most likely among specialists to choose medicine as a career again (73% and 71%, respectively), but were the least likely to choose their own specialty (29% and 25%, respectively), according to the latest Medscape Physician Compensation Report. Again this year, the two disciplines had nearly the lowest pay among specialists in the survey, but satisfaction with compensation ranked in the middle for both. (Frellick, 4/7)

For breast cancer survivors, the risk of recurrence may be tied to how many hours they fast at night, a new study suggests. Women in the study were more likely to have their breast cancer come back if they fasted overnight for less than 13 hours, researchers found. (Seaman, 3/31)

Hispanic and Latino people in the U.S. have a high risk of heart pumping problems that can lead to heart failure, but most who have these disorders don’t know it, a recent study suggests. (Rapaport, 4/6)

Legislators in Arkansas, New Hampshire, South Dakota and elsewhere have spent the past three months considering whether they should expand Medicaid under the terms of the Affordable Care Act, or renew their previous commitment to do so. But new projections by the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) indicate the federal government’s cost of Medicaid expansion over the next decade will be significantly higher than originally expected. This raises serious questions about the program’s financial viability. (Justin Haskins, 4/7)

Even before Obamacare became the law of the land, the U.S. health-care system was undergoing a dramatic transformation. Millions of people were shifting from generous health-insurance plans to consumer-directed ones that pair low monthly premiums with high out-of-pocket costs. This shift has been encouraged by employers eager to reduce the cost of employee benefits. It has also been encouraged by market enthusiasts who contend that the U.S. health-care system needs to be more like the traditional consumer economy. (Peter Ubel, 4/8)

When it announced its record-setting $160-billion merger with Allergan, the maker of Botox, last November, the giant drug company Pfizer tried valiantly to pretend that the deal wasn't mostly about cutting its tax bill. "We are doing this because of the strategic importance of the franchises, the revenue growth we believe we can get within the U.S. and internationally, and the importance to combine the research approaches," Pfizer CEO Ian Read told investment analysts on Nov. 23, after the merger was announced. He also said, a bit lamely: "I want to stress that we are not doing this transaction simply as a tax transaction." (Michael Hiltzik, 4/6)

Donald J. Trump wants to build a bricks-and-mortar wall to keep immigrants out of the United States. President Obama wants to build a virtual wall to keep companies from leaving. Neither is likely to work. On Monday, the Treasury Department issued new regulations in an attempt to limit “inversions” — in which American companies are acquired by foreign companies, legally lowering the tax burden of American companies. Speaking at the White House, Mr. Obama said, “We shouldn’t make it legal to engage in transactions just to avoid taxes.” (Diana Furchtogott-Roth, 4/7)

The signs directing people to a big nonprofit gala at a downtown hotel last week were oddly neutral. Stylized placards with a pretty bluebonnet motif announced “2016 annual awards luncheon.” They didn’t say what luncheon. Times being what they are, it was understandable. It wasn’t a secret that this was the big spring fundraiser for Planned Parenthood of Greater Texas, but it wasn’t overtly publicized, either. (Jacquielynn Floyd, 4/7)

Thirty years ago Paul Simon immortalized one of the first animal-human transplants with the lyrics, “These are the days of miracle and wonder.… Medicine is magical and magical is art. Thinking of the boy in the bubble and the baby with the baboon heart.” Today we face the possibility of babies getting organs grown in human/nonhuman chimeras — beasts that are pigs except for a single human organ. To the uninitiated, this may sound more like the dark arts than modern medicine, but pursuing careful research and potential clinical use of these chimeras is both proper and important. Every day about 30 Americans die because they can't get an organ transplant. Upward of 120,000 Americans are on transplant waiting lists. We are, medically, on the cusp of being able to save these lives in new ways: repairing failing organs with new genes or stem cells, building mechanical organs and growing replacement organs. (Henry T. Greely, 4/7)