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In states that expanded eligibility for Medicaid, hospitals that handle large numbers of low-income patients are faring better under the Affordable Care Act than those in states that haven't, according to two new reports released Thursday by the Kaiser Family Foundation. (Pugh, 4/30)

When patients show up in the hospital without health insurance, they often receive charity care — the hospital treats the person and then swallows some or all of the costs. ... Hospitals are able to recoup some of the costs of this care, but it can still put a financial strain on some systems. One of the goals of the Affordable Care Act was to reduce the burden of charity care, which totaled nearly $85 billion in 2013. A new study by the nonprofit Kaiser Family Foundation suggests that Medicaid — a government health insurance program that covers many people who don't make much money — might be doing just that. (Kelto, 4/30)

Catholic bishops in Kansas are calling on lawmakers to expand Medicaid. Expanding the program would provide health coverage for 130,000 low-income Kansans who are uninsured now, a statement from the bishops said Thursday. “We, the Catholic Bishops of Kansas, support expanding Medicaid to cover these individuals,” the statement reads. “Indeed, many of our brothers and sisters who cannot currently afford health insurance would gain access to it, bringing an end to the uncertainty and fear that the uninsured of our society must live with daily.” (Lowry, 4/30)

Maine's Health and Human Services Committee is considering several bills that would expand Medicaid coverage under the Affordable Care Act. From flat-out expansion, to various compromises, to putting the issue to referendum, they're the latest attempts in a now-annual battle to extend insurance coverage to about 20,000 low-income Mainers. ... Proponents of expansion ranged from uninsured Mainers, to a sheriff lamenting the need for coverage for mental health and substance abuse services, to providers, like Dr. Amy Madden of Belgrade. (Wight, 4/30)

The Louisiana Legislature once again refused measures to expand Medicaid, a component of President Barack Obama's health care overhaul that would provide coverage for 290,000 Louisianans without insurance. ... with Gov. Bobby Jindal's commitment to squash expansion, anyway, many Republican lawmakers who may have considered accepting the federal dollars decided to put off expansion of the program until a governor who's open to the idea takes office, [expansion supporter Rep. John Bel] Edwards said. The issue is seen as highly partisan -- some Republicans do not want to risk casting a vote some might view as aligning them with the Affordable Heath Care Act. (Lane, 5/1)

A 40-year old state lawmaker, the architect of Arkansas’s “private option,” is plotting the transformation of American health care in a cramped, windowless office here in the State Capitol. In a series of interviews with POLITICO, David Sanders tries to set the record straight about the future of the state’s unique Medicaid expansion. His short answer: It will live on beyond its sunset in 2016 as part of a broader Medicaid overhaul, even though many of his fellow Republicans claimed their vote a few months ago on the program served the purpose of shutting it down in less than two years. (Wheaton and Pradhana, 4/30)

When Kevin Patterson saw Colorado’s health exchange board floundering earlier this month as their only CEO finalist backed out and the search for a new leader was failing, he decided he might be able to provide some answers. ... Currently [Gov. John] Hickenlooper’s chief administrative officer, Patterson will wrap up that job and take over as interim CEO at the exchange on May 8. He’s clear on his mission. “It’s a turnaround. We’ve got to make sure we’re going in the right direction,” Patterson said. “We can do this, but it’s going to be hard work.” (Kerwin McCrimmon, 4/30)

Gov. Rick Scott and a bitterly divided Legislature darted in four different directions Thursday as Scott called for budget talks, senators suggested a special session in June, the House did not favor either idea and Democrats sued the House. As Senate President Andy Gardiner, R-Orlando, proposed a three-week session starting June 1 to craft a state budget, Senate Democrats marched to the Florida Supreme Court with an emergency petition that asks justices to rule on whether the House violated the state Constitution by adjourning Tuesday afternoon. Senators say it's unconstitutional for one chamber to shut down for more than 72 hours without the other's consent. (Bousquet and McGrory, 4/30)

Lawmakers took the first step Thursday toward a special session to resolve their bitter budget impasse over health-care spending for the poor. Senate President Andy Gardiner, R-Orlando, proposed a three-week special session beginning June 1, giving the federal government enough time to determine whether to extend a billion-dollar program that pays hospitals for care for the poor and uninsured, a major sticking point in the stalemate. (Rohrer, 4/30)

Gov. Rick Scott weighed in on the essentially dead legislative session Thursday, saying he will set up a commission to look at taxpayer support for hospitals, as well as how to reduce health care costs and increase access. He reiterated his opposition to Medicaid expansion under Obamacare and suggested lawmakers should pass a budget without it or the $1.3 billion in federal Low Income Pool funds. The federal government has not extended the Medicaid program paying hospitals for care for the poor and uninsured. (Rohrer, 4/30)

With the Florida Legislature at a healthcare impasse, the state Agency for Health Care Administration took to the road Thursday to hear public comments on its request to continue a $2.1 billon federal program that may help solve some of Florida’s healthcare money issues — for now. ... The agency’s proposal includes extending the program until June 30, 2017, and redesigning portions of it .... The redesign would aim to distribute funds more equally and allow more hospitals to benefit, as well as reduce the link between local government contributions and the money distributed to each hospital. (Herrera, 4/30)

Sen. Ron Johnson was elected to Congress in 2010 as an adamant foe of President Barack Obama’s health care overhaul. Yet facing a Supreme Court decision that could disrupt how that law functions, the Wisconsin Republican is among many in the GOP who want Congress to react with caution. ... “Neither politically nor practically can we end those” subsidies, said Johnson, who faces a potentially tough re-election next year. “So let’s just recognize those realities. Let’s set up the 2016 election as the contest, the discussion, the debate” over repealing the law. (Frum, 4/30)

The second chance to sign up for 2015 Obamacare coverage ends in most states today — but it doesn’t appear that the special enrollment period for those penalized by the law’s individual mandate will significantly boost 2015 sign-up numbers. (Villacorta, 4/30)

The House Thursday adopted a compromise GOP budget that promises to speed repeal of the President Barack Obama's health care law while giving the Pentagon an additional $38 billion next year. (Taylor, 4/30)

Republican leaders have pointed to the budget framework, which balances in a decade by cutting more than $5 trillion from spending, as yet more proof that an all-GOP Congress is governing effectively. The Senate is expected to pass the combined budget next week. ... Republicans also seek $430 billion worth of cuts to Medicare, though the joint framework drops the controversial plan from Rep. Paul Ryan (R-Wis.) that offered seniors the chance to use subsidies to purchase private insurance. Medicaid, food stamps and other safety net programs would face cuts as well under the GOP plan. But for many conservatives, the major draw of the plan was the chance to repeal the Affordable Care Act through a budgetary maneuver known as reconciliation, which requires only 51 votes in the Senate. (Becker, 4/30)

The chamber passed the framework, 226-197. It would balance the budget in 10 years without raising taxes, and pave the way for sending an Obamacare repeal to the president’s desk. The Senate will take up the measure next week. (Bade, 4/30)

The joint budget agreement calls for cutting that amount over 10 years from programs under the House Oversight and Government Reform Committee. It oversees federal employee issues in its broad portfolio. But the agreement gives no instructions on reaching the budget savings. Just where the ax might fall remains to be seen. Given the committee’s oversight, however, federal pension benefits and the Federal Employees Health Benefits program are likely targets. (Davidson, 4/30)

The House voted late Thursday night to overturn the District of Columbia's law prohibiting workplace discrimination based on reproductive health choices. Passage of the resolution formally disapproving of Washington's local law fell mostly along party lines on a vote of 228-192. Thirteen Republicans joined the opposition, and three Democrats voted in favor. It marked the first time either chamber of Congress has passed legislation to stop a D.C. law since 1991, when the House voted to disapprove of the city council's action to amend a law that restricts the height of the District's buildings. (Marcos, 4/30)

Republicans pushed legislation through the House Thursday that would revoke a District of Columbia law barring discrimination in the city against workers who have abortions, the latest clash pitting claims of religious freedom against reproductive rights. (4/30)

Hillary Clinton is accusing congressional Republicans of planning to "overrule the Democratic process" in Washington with a Thursday night vote to block a D.C. law banning discrimination by employers against employees who have had abortions. (Jaffe, 4/30)

Sales of Gilead Sciences’ drugs to treat hepatitis C reached $4.55 billion in the first quarter, far exceeding already lofty Wall Street expectations but likely to focus attention once again on the overall costs to the health care system of the medicines. (Pollack, 4/30)

Cigna Corp. reported better-than-expected revenue and profit growth in its first quarter, as the health insurer benefited from higher premiums and fees. Shares, up 23.1% this year, gained 0.3% in premarket trading. The company also increased outlook on a key earnings metric for the year. (Dulaney, 4/30)

HealthSouth Corp. said Thursday its first-quarter earnings fell 9% on an increase in the company’s bad-debt provision and litigation-related expenses that offset revenue growth that was mostly fueled by a recent acquisition. Birmingham, Ala.-based HealthSouth operates inpatient rehabilitation hospitals, which serve patients recovering from serious conditions such as stroke, cardiac conditions and brain injuries. (Stynes, 4/30)

The parent company of Assurant Health said it will sell or shut down the insurer, which has struggled financially since the introduction of the federal Affordable Care Act. Assurant Health, headquartered in Milwaukee, is expected to report an operating loss of up to $90 million in the first quarter following a loss of $64 million last year. The company specializes in health insurance for small employers and individuals. (4/30)

The White House has rejected a proposal to largely replace the military's TRICARE health care system, but has agreed to further study a proposal that would let service members participate in retirement savings plans like a 401(k). (4/30)

Leaders of the U.S. Department of Veterans Affairs asked Congress for more than $15 billion to end long wait times for medical care for tens of thousands of vets. They got the money, but little has changed. The agency has been slow to spend the funds, and instead of speedier care for the former soldiers the holdups have persisted. The centerpiece of the legislation Congress passed last year — a $10 billion program to allow veterans to seek care outside the VA system — has been so underused that the agency wants to divert some of the money to other purposes. (Miller, 5/1)

A new Urban Institute study shows “there has been a decline in birth rates between 2007 and 2012 for all American women ages 20 to 29.” It’s being called the biggest drop of any generation in U.S. history. The effect on Social Security and Medicare could mirror what the programs are facing now with more than 75 million baby boomers retiring in the coming years but there being fewer millennials paying into the retirement and health care systems to keep them afloat financially. Millennials, who also are having fewer children now largely because of the Great Recession and the relentlessly weak economy, may have to confront the same underfed Social Security and Medicare problem. (Diuguid, 4/30)

Renowned journalist and media entrepreneur Steven Brill came face to face in Detroit on Thursday with two high-level local executives within the industry -- health care -- that is lately in his crosshairs. With a mix of real life anecdotes and bold assertions, the founder of Court TV told a Detroit Economic Club audience why he believes health care costs are so high in the U.S. in comparison to other developed nations. (Reindl, 4/30)

Hackers may have accessed medical and personal information, including Social Security numbers, about 3,300 patients at Partners HealthCare, the health system said Thursday. The breach happened when some Partners employees responded to phishing e-mails, which allowed unauthorized access to their e-mail accounts. Some of the e-mails contained private patient information, including Social Security numbers, addresses, phone numbers, and information about medical treatments and health insurance. (Dayal McCluskey, 4/30)

On Wednesday Sherwood residents Lester and Nora Brock were surprised to learn that personal data entrusted with their health insurer, Oregon's Health CO-OP, might be compromised. Even more surprising? They learned this not from a letter addressed to them, but from five different letters addressed to other people – each in separate envelopes delivered to the Brocks' address. (Budnick, 4/30)

Nine hospitals in the Jacksonville, Fla., area and a local ambulance company agreed to pay a total of $7.5 million to settle civil allegations that they defrauded Medicare with ambulance rides that were medically unnecessary. The case could have national implications, federal prosecutors say, because hospitals around the country often rely on ambulances to ferry patients to and from their facilities, at times with little regard for the cost or medical need. (Carryrou, 4/30)

There’s still a budget to settle, but to Senate Minority Leader Len Fasano, the sense of urgency as the legislative session approaches its final weeks lies in addressing the state’s health care landscape, particularly the growth of large health systems that control multiple hospitals and physician practices. At stake, he said, are health care costs, consolidation, concentrated market power and hospital closures. (Levin Becker, 5/1)

Oregon's health insurers are already submitting proposed rates for 2016, and some consumers could be in for a shock. (Budnick, 4/30)

The rate of Texans without health insurance has fallen 8 percentage points since enrollment in the federal Affordable Care Act began, according to a new study. ... But Texas remains the state with the highest percentage of uninsured people, the study found, and for the first time, the state has the largest raw number of uninsured residents in the country. (Walters, 4/30)

It's the $285 million question: how much waste, fraud and abuse is there in Minnesota's public health programs? In a health and human services budget passed 72-60 early Wednesday morning, House Republicans bank on $300 million in savings from a concerted crackdown on waste in Medicaid and other programs -- and believe the actual savings could be even higher. But an analysis prepared by the Department of Human Services and trumpeted by DFL lawmakers has a much lower savings estimate: $16.5 million in the next biennium. (Montgomery, 4/29)

The board members of the Destination Medical Center group approved Thursday two new projects: construction of a Hilton hotel with special amenities tailored for medical clientele and the purchase of Chateau Theatre in downtown Rochester, [Minn.]. The four-star hotel will stand 23 stories tall on the corner of Broadway and Center Street. Developers said construction will start within weeks, and will have unique features like places for in-building blood draws for patients of nearby Mayo Clinic. (Jeffries, 4/30)

After 45 years of providing health care in rural western Missouri, Sac-Osage Hospital is being sold piece by piece. ... Sac-Osage is one of a growing number of rural U.S. hospitals closing their doors, citing a complex combination of changing demographics, medical practices, management decisions and federal policies that have put more financial pressure on facilities that sometimes average only a few in-patients a day. (Lieb, 5/1)

There are more than 4,700 hospitals in the U.S, spread about evenly between urban and rural areas. But that number has been dwindling. More than 100 hospitals have closed since 2010, and the pace has quickened in the past couple of years. Hospitals are closing at about the same rate in urban and rural areas, but health care analysts say the effect often is more pronounced in small towns, where residents typically must travel farther to get to the next nearest hospital. (Lieb, 5/1)

In just over a month, a new state rule is set to kick in that could undercut the business model of Dallas-based Teladoc, a rapidly growing telemedicine company that connects patients and doctors over the telephone and internet. With the clock ticking, the company is brandishing every weapon in its arsenal, deploying teams of lobbyists and lawyers to fight a Texas Medical Board rule change that it says is more about stifling competition than protecting patient health. The board's rule, set to start June 3, would prevent doctors from treating people over the phone — making a diagnosis or prescribing medicine — unless another medical professional was physically present to examine the patient. (Walters, 4/30)

A debate over medical marijuana legislation is getting acrimonious at the Iowa Capitol, and is even spilling over into a fight over anti-abortion legislation. ... The bill would allow Iowans with a range of health problems to obtain medical marijuana. Those conditions could include cancer, multiple sclerosis, Crohn's disease, post-traumatic stress disorder, and other chronic and debilitating ailments. (Petroski, 4/30)

After being brought together just nine weeks ago, Governor Raimondo's Reinventing Medicaid working group released a report on Thursday that, at the governor's request, offers recommendations on cutting $91 million in state spending on the health care program for people of low incomes. The two biggest cuts in the report, which the governor has already included in her 2016 budget proposal, would hit hospitals and nursing homes. These include cutting Medicaid payments to hospitals by 5 percent, saving the state $15.7 million, and 3 percent to nursing homes, for $13.3 million in savings. (Salit, 4/30)

Poverty, administrative red tape and politics stand in the way as the number of confirmed cases continues to climb. Health policy experts are calling for a needle-exchange program to be expanded. (Harrington, 5/1)

Cataract surgery is the most common elective surgery among Medicare beneficiaries, with 1.7 million procedures performed annually. It is also very safe, with less than a 1% risk of major adverse cardiac events or death. ... since 2002, guidelines from multiple specialty societies have deemed routine preoperative testing unnecessary. ... In this national assessment of variation in routine preoperative testing before cataract surgery, we found that more than half of Medicare beneficiaries undergoing cataract surgery underwent at least one preoperative test, despite strong evidence about the lack of benefit of preoperative testing. This represents a substantial increase in testing over levels during the baseline period and is most likely an unnecessary Medicare expense. (Chen et al., 4/16)

Federal regulations establish special enrollment periods—times outside of open enrollment periods—during which people may enroll in or change their health insurance plans .... To be eligible, a person must experience a shift in income or another “qualifying life event,” such as a change in marital status or the number of dependents .... We produced an upper-bound estimate that 3.7 million nonelderly adults with coverage through a federal or state Marketplace could have ... become eligible for a special enrollment period because of income shifts. In addition, more than 8.4 million nonelderly adults who did not have Marketplace coverage—three-quarters of whom had no insurance—became eligible for a special enrollment period as a result of other qualifying life events. Many ... may be unaware of their eligibility. (Hartman et al., 4/29)

6.7 million people were insured through marketplace plans as of October 15, 2014. However, it has been unclear precisely how many of these Marketplace enrollees were previously uninsured or how many would have purchased individual coverage directly from an insurer in the absence of the ACA. Kaiser Family Foundation analysis of recently-submitted 2014 filings by insurers to state insurance departments (using data compiled by Mark Farrah Associates) shows that 15.5 million people had major medical coverage in the individual insurance market – both inside and outside of the Marketplaces – as of December 31, 2014. Enrollment was up 4.8 million over the end of 2013, a 46% increase. (Levitt, Cox and Claxton, 4/29)

We examine changes in insurance coverage for nonelderly adults (ages 18 to 64) overall and by state Medicaid expansion status going back to the first quarter of 2013. ... Fifteen million nonelderly adults gained coverage between September 2013 and March 2015 as the uninsurance rate fell from 17.6 percent to 10.1 percent. ... There have been large coverage gains for low- and middle-income adults targeted by key ACA provisions. ... There were gains in coverage for adults in each age, gender, and racial and ethnic group examined, but adults who are young, nonwhite, or Hispanic saw especially large percentage-point gains. (Long et al., 4/16)

Since the Affordable Care Act’s health insurance marketplaces opened and states began to expand Medicaid eligibility, uninsured rates among Latinos have begun to decline for the first time in decades. ... the Commonwealth Fund Biennial Health Insurance Survey finds Latinos continue to have the highest uninsured rates among major U.S. racial or ethnic groups. ... While about one-quarter of Latino adults who live in states that expanded their Medicaid programs were uninsured by the end of 2014, nearly half remain uninsured in states that, so far, have not expanded their Medicaid program. ... Texas and Florida, neither of which have expanded eligibility for their Medicaid programs, are home to the largest proportion of Latinos who are uninsured. (Doty et al., 4/27)

Disasters often impact fundamental elements of a community -- physical infrastructure, health and social services, social connections -- that affect the health of its residents. Accordingly, the recovery period ... presents an important opportunity to redesign physical and social environments in a manner that will improve a community's long-term health status .... In response to concerns that health considerations are not adequately incorporated into disaster recovery decision making, the Institute of Medicine assembled an ad hoc committee to develop recommendations and guidance on strategies for mitigating disaster-related health impacts and optimizing the use of recovery resources to pursue more deliberately and thoughtfully the goal of healthier, more resilient and sustainable communities. (Tuckson et al., 4/15)

This research studies county-level Medicaid managed care (MMC) penetration and health care outcomes among nonelderly disabled and nondisabled enrollees. Results for nondisabled adults show that increased penetration is associated with increased probability of an emergency department visit, difficulty seeing a specialist, and unmet need for prescription drugs, and is not associated with reduced expenditures. We find no association between penetration and health care outcomes for disabled adults. This suggests that the primary gains from MMC may be administrative simplicity and budget predictability for states rather than reduced expenditures or improved access for individuals. (Caswell and Long, 4/16)

Though most patients wish to discuss end-of-life (EOL) issues, doctors are reluctant to conduct end-of-life conversations. Little is known about the barriers doctors face in conducting effective EOL conversations .... [In this study] 99.99% doctors reported barriers with 85.7% finding it very challenging to conduct EOL conversations with all patients and especially so with patients whose ethnicity was different than their own. ... The biggest doctor-reported barriers to effective EOL conversations are (i) language and medical interpretation issues, (ii) patient/family religio-spiritual beliefs about death and dying, (iii) doctors’ ignorance of patients’ cultural beliefs, values and practices, (iv) patient/family's cultural differences in truth handling and decision making, (v) patients’ limited health literacy and (vi) patients’ mistrust of doctors and the health care system. (Periyakoil, Neri and Kraemer, 4/22)

The Japanese American population is leading the nation in aging. According to the 2010 U.S. Census, the number of adults 65 and older among Japanese Americans (23.6%) was nearly twice the number of adults in that age group in the general population (12.9%). The same trend has also been observed in California. ... Using data from the California Health Interview Survey (2003, 2005, 2007, 2009, and 2011- 2012), this report contributes to the understanding of the health status and health-related characteristics of Japanese Americans. ... This study shows that for a majority of the indicators (9 out of 15), the Japanese American adult population experiences lower risk. As such, their health and health behaviors may be a source of future study for examining healthy aging, not only in California but also in the United States in general. (Meng et al., 4/29)

Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their sheer number, as well as their lack of focus, consistency, and organization, limits their overall effectiveness in improving performance of the health system. To achieve better health at a lower cost, all stakeholders -- including health professionals, payers, policy makers, and members of the public -- must be alert to what matters most. ... Vital Signs identifies the need for a standard set of core measures as a tool for improving health in the United States. This book explains the current use of metrics in health and health care and then proposes a streamlined set of 15 standardized measures, with recommendations for their application at every level and across sectors. (Blumenthal et al., 4/28)

Despite 2009 recommendations to stop giving women under 50 screening mammograms, the rate of first mammograms occurring at age 40 is on the increase, according to a new study. ... [Dr. Soudabeh Fazeli Dehkordy of the University of Michigan Health System in Ann Arbor and a team of researchers] used data from surveys in the years before and after the ... recommendation – 2007, 2008, 2010 and 2012 -- to look at patterns in women’s use of mammograms by age. Screening rates were lower overall in 2010 and 2012 than in previous years, the authors report in the American Journal of Preventive Medicine, but the proportion of women who began getting screened at age 40 increased, and was highest after the ... recommendations were issued in 2009. (Doyle, 4/24)

We've all heard that an aspirin a day can keep heart disease at bay. But lots of Americans seem to be taking it as a preventive measure, when many probably shouldn't. In a recent national survey, more than half the adults who were middle age or older reported taking an aspirin regularly to prevent a heart attack or stroke. The Food and Drug Administration only recommends the drug for people who've already experienced such an event, or who are at extremely high risk. (Singh, 4/27)

A comparison of three treatments for narcotic painkiller addiction found that patients given the medication buprenorphine in the emergency department do better than those given only referrals. Addiction to prescription narcotic painkillers such as Oxycontin or Vicodin is "a huge public health problem," study first author Dr. Gail D'Onofrio, chair of emergency medicine at Yale School of Medicine in New Haven, Conn., said in a university news release. Drug overdoses account for more deaths each day in the United States than car crashes, she and her colleagues noted. (Dallas, 4/28)

Few U.S. adults with sickle cell anemia are getting a recommended medication that can help them manage pain, breathing problems and other debilitating symptoms, according to a new study. Using a national database, researchers found that less than one-quarter of sickle cell patients who should have been taking a drug called hydroxyurea actually were. (Norton, 4/28)

College women who choose an intrauterine device (IUD) for long-term contraception say it hurts to have the device inserted at first, but they are otherwise very happy with it more than a year later, according to a new U.S. survey. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) have both endorsed IUDs as first-line contraception for young women who have never had children, but many providers, especially in the U.S., still are not comfortable giving IUDs to these women, said lead author Dr. Alexandra M. Hall of the University of Wisconsin in Menomonie. (Doyle, 4/23)

Requiring precertification from private insurance companies delays hospital discharge of stroke patients to a nursing facility or rehabilitation, a new study shows. Researchers found that patients who required insurance precertification had an average delay in discharge of 1.5 days compared with 0.8 day for those not requiring such precertification, a statistically significant difference of 0.7 day. (Anderson, 4/28)

Shortages of antibiotics, including those used to treat drug-resistant infections, may be putting patients at risk for sickness and death, according to a new report. Between 2001 and 2013, there were shortages of 148 antibiotics. And the shortages started getting worse in 2007, researchers found. (Reinberg, 4/23)

Patients admitted to the hospital on weekends are more likely to get a preventable illness or injury during their stay than people admitted during the week, a large U.S. study finds. Even after adjusting for patient characteristics, including the severity of the condition that brought them to the hospital, weekend admission was still linked with more than a 20 percent increased likelihood of hospital-acquired conditions when compared to weekday admissions, lead author Dr. Frank Attenello, a researcher at the University of Southern California, said by email. (Rapaport, 4/21)

The Great Recession saw the number of adults in the United States suffering from major depression rise significantly and remain higher, according to a new Loyola University Stritch School of Medicine study touted as the first to examine the recession’s impact on mental health. Writing in the Journal of Clinical Psychiatry, the researchers said it’s not a stretch to think that the impact of the recession, which officially began in December 2007 and lasted 18 months, on economic security contributed to that. (4/25)

Finding doctors at U.S. teaching hospitals who consider themselves competent to care for lesbian, gay, bisexual and transgender (LGBT) patients may be difficult, suggests a new study. Few such hospitals reported having ways to identify doctors knowledgeable about LGBT health, and only a few hospitals offered comprehensive LGBT-competency training to their staffs, researchers report in the American Journal of Public Health. (Seaman, 4/21)

Congress has over the past few decades passed a series of special approval pathways for important drugs that treat life-threatening or rare diseases. This week, a new bill introduced in the House could add two more. (Margot Sanger-Katz, 5/1)

Experts estimate that in five years we will generate 50 times more health information than today. Diagnoses, treatments, DNA, medical images and vital signs already are being analyzed and stored. Health apps, thermometers and scales, and even devices implanted in our bodies, are connected and streaming data. In the not-too-distant future, our lives will depend upon how our health information is accessed and used. (David J. Brailer, 4/30)

We oppose expanding Medicaid because it is a broken system with poor health outcomes, high inflation, unseverable federal strings and no incentive for personal responsibility for those who are able to provide for themselves. Under current law, Florida provides for our most vulnerable: low-income children, pregnant women, the elderly and disabled people. Under federal law, other low-income Floridians have access to healthcare subsidies to buy private insurance for less than the average cost of a wireless phone bill. In fact, if we choose Obamacare expansion, 600,000 will lose eligibility for their subsidies, of which 257,000 would be forced into Medicaid. (Florida House Speaker Steve Crisafulli, 4/29)

Politico reports this morning that there is a real shift underway among red state governors towards Obamacare: A number of them are newly open to accepting the Medicaid expansion — as long as they can couple it with some kind of work requirement. ... I’m going to suggest that this is, on balance, a good development — in the sense that more GOP governors appear open to finding terms upon which they are willing to take the money to cover their constituents. (Greg Sargent, 4/30)

The notable success of Obamacare has been the growth in Medicaid enrollees --10 million concentrated in states that accepted the federal government’s incentives for expansion. But will the promise of continued federal funding for the expansion be kept? A report published April 9, 2015 by the Foundation for Governmental Accountability, the FGA, warns in its title: “Promises made, promises broken: State’s cannot trust Washington’s promise to fund Obamacare Medicaid expansion.” The FGA has few liberal friends, and the content of the report is unlikely to appear in the popular press. So, you get an opportunity to learn about it here. (Howard Peterson, 5/1)

The recent measles outbreak that infected children vacationing at California's Disneyland focused our attention on a potential public health crisis in our own backyard: Too few children are receiving potentially life-saving immunizations. Despite a high-quality health-care system and wide availability of immunization programs, the commonwealth has among the lowest vaccination rates in the country. In Pennsylvania, it is reported that only 86 percent of children entering kindergarten have the necessary vaccinations, compared with roughly 95 percent in the rest of the country. (Karen Murphy, 5/1)

You've seen the billboards up and down the state: "Pregnant and scared?" Well, Dania Flores wasn't pregnant but she was a little bit scared the first time she visited a crisis pregnancy center. A recent high school graduate, she was working undercover, posing as a pregnant teen to gather intel on these operations, which have but one goal: to prevent abortion. ... Flores said she was never informed that abortion was a safe, legal alternative to childbirth. She was never told that California's Medi-Cal program covered the cost of reproductive services, including abortion. Nor that time was of the essence. Instead, she says, she was misled and shamed by anti-abortion activists masquerading as concerned healthcare providers. (Robin Abcarian, 5/1)

The recent announcement by President Obama of a precision medicine initiative created excitement in the medical community. ... In one sense, medicine has always been personalized (if not always as precise as physicians and patients would like). Clinicians integrate signs and symptoms, evidence, their experience, and patient preference to facilitate decision making. What is new is that biomedical technology now allows a deeper understanding of many diseases. Drug development costs have increased sharply, leading pharmaceutical companies to focus on rarer diseases. In parallel, the significant decrease in the cost of genome sequencing has facilitated the discovery of many new, rare genetic diseases. Together, these advances have provided the necessary and sufficient conditions for the new model of precision medicine. (Euan A. Ashley, 4/30)