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Democrats pushed legislation buttressing the 2010 health care law and curbing prescription drug prices through the House Thursday, advancing a bill that has no chance of surviving in the Senate or getting President Donald Trump's signature and seemed engineered with next year's elections in mind. The measure forced Republicans into the uncomfortable political position of casting a single vote on legislation that contained popular drug pricing restraints they support, plus language strengthening President Barack Obama's health care statute that they oppose. (Fram, 5/16)

By combining the bills to shore up the Affordable Care Act with several bipartisan measures to address high drug prices, Democrats had hoped to lure in some Republican support. But the minority party did not bite, calling the package “a bailout” for the health law and instead introducing a Republican bill that included only the drug-pricing measures, plus an extension of funding for community health centers and the National Health Service Corps. “By jamming together our bipartisan efforts to lower drug costs with clearly partisan bills to bail out Obamacare, Democrats are once again putting politics — and partisanship — over bipartisan policy,” said Representative Greg Walden, Republican of Oregon. “Sadly, House Democrats couldn’t pass up a chance to play gotcha politics.” (Goodnough, 5/16)

The 234-to-183 vote, with every Democrat and five Republicans casting ballots in favor, gave a partisan hue even to three strategies to boost the availability of generic drugs that initially attracted GOP support. Those were merged, however, with measures that would block several Trump administration policies that Democrats characterize as “sabotaging” the ACA. The upshot was a barbed debate: Democrats accused Republicans of disregarding consumers’ need for affordable, quality health care, and Republicans accused Democrats of thwarting a rare opportunity for bipartisanship. (Goldstein, 5/16)

The legislation includes three bipartisan drug pricing provisions restricting anti-competitive behaviors by pharmaceutical companies alongside a slate of proposals reversing Trump administration policies designed to undermine the Affordable Care Act. That combination infuriated Republicans who spent months negotiating the drug pricing measures, and even prompted some grumbling from moderate Democrats eager to show some semblance of bipartisanship on a top health care priority. “I’m not very happy at all,” said Rep. Buddy Carter (R-Ga.), whose bill limiting generic drugmakers’ ability to block competitors was included in the package. “They know that we’re not going to be able to support this, and for them to put that in there I think is just poor policy.” (Cancryn and Owermohle, 5/16)

Before the bill passed, the House approved a long list of amendments, mostly by voice votes. The changes included everything from studies on health disparities and prescription drug prices to additional requirements for navigators, who help exchange enrollees understand their options. One amendment would prevent the Department of Health and Human Services from banning the practice of “silver-loading,” which states adopted to blunt the effect of lost cost-sharing subsidies, while another would block HHS from terminating coverage for exchange enrollees who were automatically enrolled. (McIntire and Siddons, 5/16)

President Trump, who has made lowering drug prices a key priority, said he supports the drug pricing provisions but would veto the ObamaCare legislation if it ever passed the Senate. The drug pricing bills included the long-stalled Creates Act, as well as one that would crack down on brand-name drug companies paying generic companies to delay introducing their competing drugs — a practice called “pay-for-delay.” (Weixel, 5/16)

In other action on Capitol Hill —

House Democrats and Republicans have united behind the goal of curbing maternal mortality and are likely to pass legislation this year intended to reduce the rate in the United States. Maternal-related deaths claim about 700 lives per year, with the Centers for Disease Control and Prevention estimating three-fifths of those deaths may be preventable. (Raman, 5/16)

Despite the rave reviews, CBD is giving Washington a major headache. The Food and Drug Administration has different rules for regulating medicines and dietary supplements like vitamins — and it isn’t perfectly clear yet which category CBD, or cannabidiol, an extract of cannabis used as a home remedy for everything from anxiety to back pain, falls into. Congress, too, has struggled. Lawmakers passed a bill last year that officially legalized hemp, the plant from which CBD is extracted, but left the FDA will little guidance on how to regulate CBD. (Florko, 5/17)

Even before Alabama passed one of the nation’s most restrictive bans on abortions in decades, the procedure had been in decline in the state after years of limits. The remaining doctors who perform abortions — they have dwindled to a handful — work at only three clinics in a state where there once were more than a dozen. Dr. Yashica Robinson, who provides abortions in Huntsville, said she had been the target of a letter-writing campaign to have her hospital privileges revoked. Even some fellow medical workers, she said, have showed signs of hostility toward her. (Williams and Blinder, 5/16)

Two years ago, I got a text from a cousin I love announcing that she had moved to New Orleans, leaving behind a one-bedroom apartment in Brooklyn and a job of millennial fever dreams. At 26, Tess was head of research and development for Christina Tosi and her baking empire, Milk Bar, the great 21st-century dessert disrupter. At the age of 12, Tess was already selling her brownies to a gourmet market on Cape Cod; her ascent seemed the equivalent of an anointment at J.P. Morgan for the child who went to bed calculating short positions on foreign currencies. (Bellafante, 5/16)

With a quick scribble of her pen Wednesday afternoon, Alabama Gov. Kay Ivey (R) essentially made abortion in her state illegal in all circumstances, with zero exceptions for rape or incest. Doctors who perform the procedure face a penalty of up to 99 years in prison. As other Republican-controlled states are rubber-stamping abortion restrictions in a legal gambit to challenge Roe v. Wade, Alabama’s new law has left even some staunch abortion opponents tepid. On Wednesday, televangelist Pat Robertson called the bill “extreme” and said Alabama politicians had “gone too far.” (Swenson, 5/16)

The passage of Alabama’s strictest-in-the-nation abortion bill has renewed calls to overhaul Northern Ireland’s abortion regulations, which are among the most restrictive in the developed world. Under the Alabama abortion legislation, signed by Republican Gov. Kay Ivey on Wednesday, doctors who perform abortions could face up to 99 years or life in prison, but a pregnant woman would not face penalties. In Northern Ireland, both women who have abortions and those who assist them can face up to life in prison. (Adam, 5/16)

With grisly claims that Democrats promote “birth day abortions” and are “the party of death,” the Republican Party and its conservative allies have aggressively reset the terms of one of the country’s most divisive and emotionally fraught debates, forcing Democrats to reassess how they should respond to attacks and distortions that portray the entire party as extremist on abortion. The unusually forceful, carefully coordinated campaign has created challenges that Democrats did not expect as they struggle to combat misinformation and thwart further efforts to undercut access to abortion. (Peters, 5/16)

Democratic U.S. Sen. Doug Jones condemned Alabama's new abortion ban as "extreme" and "irresponsible" Thursday, a day after the state's Republican governor signed the most restrictive abortion measure in the country into law. "I think this bill, frankly, is shameful. It is callous," Jones told reporters. "This bill uses rape victims and victims of incest at all ages, even minors, as political pawns." (Chandler and Paterson, 5/16)

Democratic presidential candidate Kirsten Gillibrand says that, as president, she'd seek to write into law the U.S. Supreme Court's landmark ruling that legalized abortion. During a rally at Georgia's state Capitol on Thursday, the New York senator criticized recent abortion bans signed into law in Mississippi, Kentucky, Ohio, Georgia and Alabama as "a nationwide assault on women's constitutional rights by ideological extremists." (Nadler, 5/16)

Senate Republicans are scrambling to distance themselves from a harsh new Alabama law that bans nearly all abortions, even in cases of rape and incest, and carries a penalty of up to 99 years in prison for anyone performing the procedure. Most GOP senators are trying their best to steer clear of the firestorm, arguing it’s a state-level issue that doesn’t involve Congress. (Bolton, 5/16)

Many Democrats running for president denounced the legislation. Sen. Elizabeth Warren (D., Mass) called it “an unconstitutional attack on women.” Sen. Kamala Harris (D., Calif.) said “women’s health care is under attack.” Sen. Kirsten Gillibrand (D., N.Y.) said “this is a war on women” and will speak at an event condemning anti-abortion legislation in Georgia, which this month passed a law banning abortion once a fetal heartbeat is detected, as early as six week. The Democratic Legislative Campaign Committee, a national group that supports Democratic candidates for state legislatures, sent out a fundraising plea tied to the bill’s passage. (Duehren, 5/16)

House Minority Leader Kevin McCarthy (R-Calif.) said Thursday he believes an Alabama law banning nearly all abortions goes too far. “It goes further than I believe, yes,” McCarthy said during a press conference when asked about the restrictive policy. ...The comments from the GOP House leader came just a day after Alabama Gov. Kay Ivey (R) signed into law the most restrictive abortion policy in the nation. (Wise, 5/16)

Sweeping state-level abortion restrictions present a direct test of whether the newly constituted Supreme Court is willing to revisit Roe v. Wade, the landmark abortion-rights precedent that has spurred deep divisions for nearly 50 years. States with antiabortion legislative majorities have long been weighing how to prompt a Supreme Court review of the 1973 ruling, but generally have preferred a strategy aimed at reducing the procedure’s availability through incremental restrictions that hamper providers, or by forbidding late-term abortions. (Kendall and Bravin, 5/17)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ States Race To Reverse ‘Roe’
Alabama is the latest in a growing list of states passing bans on abortion in an attempt to get the Supreme Court to weaken or overturn Roe v. Wade, the 1973 ruling that legalized abortion nationwide. Unlike most of the other state laws that have passed this year, however, the Alabama law would completely ban abortion except when the woman’s life was in danger from the pregnancy. (5/16)

As abortion opponents cheer the passage of fetal heartbeat laws and other bans on the procedure, abortion-rights groups have been waging a quieter battle in courthouses around the country to overturn less direct restrictions passed in recent years. At least a dozen lawsuits have been filed over the last two years challenging what abortion-rights groups call TRAP laws, Targeted Restrictions on Abortion Providers. (5/16)

The Senate confirmed Louisiana lawyer Wendy Vitter as a federal judge Thursday, overcoming opposition from Democrats who criticized her anti-abortion stance and accused her of trying to hide her record on the issue. Maine Sen. Susan Collins was the only Republican to oppose Vitter's nomination, which was approved 52-45. (Daly, 5/16)

Many other states have created new laws this year to limit abortion or even try to ban it altogether in the hope that the Supreme Court with President Trump’s two appointees will be more likely to approve them. Most of the new restrictions are in the South and Midwest. In contrast, New York removed old restrictions and affirmed access to abortion. Vermont approved the first step to amend its constitution to protect abortion rights. (Keating, Tierney, Meko and Rindler, 5/15)

Abortion opponents in Missouri have cleared the biggest hurdle to restrict access to most abortions — Senate approval. A bill passed in the Senate early Thursday morning bans abortion as early as eight weeks into a pregnancy. But the bill also saw some last-minute changes, under threat of a filibuster. Wednesday morning, the Senate commenced debate on a bill that would ban abortions after as little as six weeks into a pregnancy - the first version of the bill, which passed the house, would ban abortion once a heartbeat was detected. Nick Schroer, a Republican representative from O'Fallon is the bill’s sponsor. (Okeson-Haberman, 5/16)

Missouri's Senate passed a bill on Thursday to ban abortions eight weeks after conception, except for medical emergencies, the latest attempt in a Republican-controlled state legislature to restrict the rights of women to terminate their pregnancies. The vote came a day after Alabama's governor signed into law the country's most restrictive abortion bill, outlawing nearly all abortions, absent a medical emergency. (5/16)

The Missouri House is expected Friday to pass and send to Gov. Mike Parson the sweeping anti-abortion bill that would ban procedure after eight weeks of pregnancy, with no exceptions for rape or incest. Parson has said he will sign the measure, the latest in a series of near-total bans on abortion recently passed by Republican-controlled state legislatures. (Thomas, Hancock and Vockrodt, 5/16)

Missouri's Republican-led House is expected to pass a sweeping bill to ban abortions at eight weeks of pregnancy on lawmakers' final day in session Friday, joining Alabama and several other states that have moved recently to severely restrict the procedure. If enacted, the ban would be among the most restrictive in the U.S. It would include exceptions for medical emergencies, but not for pregnancies caused by rape or incest. Doctors would face five to 15 years in prison for violating the eight-week cutoff. Women who receive abortions wouldn't be prosecuted. (5/17)

Several Republican-controlled states, including Alabama, have in recent days moved ahead with sweeping abortion restrictions — steps likely to face legal challenges that could prompt the U.S. Supreme Court to reconsider Roe v. Wade, the 1973 decision that created a national right for women to seek an abortion. (Harrison, 5/16)

The marble halls of the State House rang with chants of “Praise the Lord!” and “Shame! Shame!” Abortion-rights advocates lined a hallway dressed in “Handmaid’s Tale” costumes. And antiabortion activists thronged the rotunda, celebrating a legislative victory. That scene might not be surprising in deep-red Alabama, where the governor signed a near-total abortion ban on Wednesday. But it took place in deep-blue Rhode Island, where a state Senate committee on Tuesday rejected a bill to codify the right to an abortion in state law. (Fitzpatrick, McGowan and Milkovits, 5/15)

The Texas Senate approved a bill Thursday that would impose criminal penalties on doctors who fail to treat babies born alive after failed abortion attempts — extremely rare cases — a month after the House approved the same measure. If the House concurs with the Senate's minor changes to House Bill 16, it will then head to the governor's desk. (Sundaram, 5/16)

Colorado’s top elections official is restricting staff in her department from traveling to Alabama after the state passed what she called an “egregious law” that restricts abortion. Alabama Gov. Kay Ivey signed the legislation into law Wednesday night, saying in a statement that the new law “stands as a powerful testament to Alabamians’ deeply held belief that every life is precious and that every life is a sacred gift from God.” (Gilmour, 5/16)

As a constellation of states pass laws to restrict or ban nearly all abortions, Connecticut lawmakers took aim Thursday at faith-based centers that deceive women seeking medical assistance for a pregnancy. The state House voted to advance a measure that prohibits deceptive advertising practices by the so-called crisis pregnancy centers. Critics say staff at the facilities sometimes pose as medical professionals to lure women and hand out misleading information about abortions. (Carlesso, 5/16)

The Trump administration on Thursday backed off a controversial Medicare drug pricing proposal that would have allowed insurers to exclude certain drugs if prices rise faster than inflation. In a final rule, the administration said it was leaving in place the current policy about Medicare’s “protected classes” of drugs. (Weixel, 5/16)

The initial proposal, which would have allowed private Medicare plans to refuse to pay for certain drugs for chronic conditions that spiked in price, was met with widespread criticism almost as soon as it was proposed last November. The Trump administration had suggested the change would help lower drug prices by giving private Medicare plans more leverage over high-cost drugs. But patient advocates and drug makers said it would jeopardize patient care in life-threatening situations. (Florko, 5/16)

But pharmacy groups were not happy with the decision by the CMS to back off on changes to such price concessions, which are called direct to renumeration fees. Pharmacists charge that pharmacy benefit managers and insurers often assign an expensive copay for a drug well beyond its actual price. The PBM or insurer then claws back the extra money, pharmacy groups charge. "In its proposed rule the administration cited the recent 45,000% increase in pharmacy price concessions, an increase that is unsustainable," according to a statement from the National Community Pharmacists Association and National Association of Chain Drug Stores. "Pharmacies are in a tenuous situation, and our organizations are exploring all options to accomplish desperately needed reforms to pharmacy DIR." (King, 5/16)

In other drug pricing news —

With just four days left in the legislative session, Minnesota lawmakers struck an agreement to license and regulate pharmacy benefit managers. Will that impact what you pay for your medicine? Pharmacy benefit managers, or PBMs, negotiate with drug makers on behalf of insurance plans. They manage drug pricing and decide which medications are covered by insurance companies. (Faircloth, 5/16)

At a press conference at Laguna Honda Hospital in San Francisco on Thursday, Mayor London Breed announced that San Francisco, Alameda and Santa Clara counties would join Gov. Gavin Newsom's plan to collectively bargain with pharmaceutical companies for lower drug prices. ...Since being sworn in, Gov. Newsom has made expanding health coverage in the state a key part of his agenda. (Wiley, 5/16)

Open conflict broke out among U.S. liver transplant centers Thursday, with doctors and patients in less populous parts of the country seeking a contempt of court order against the Health and Human Services Department and the nonprofit organization that runs the transplant system. Hospitals and patients on the waiting list for livers in places such as Georgia, Michigan, Kansas, Missouri and elsewhere accused the government and the United Network for Organ Sharing of defying a judge’s order to temporarily halt a new way of distributing those organs for transplant. (Bernstein, 5/16)

Amid the legal fight over the new national liver distribution policy, a federal judge on Wednesday ordered HHS to pause implementation efforts until an appellate court can weigh in. U.S. District Judge Amy Totenberg granted a request from a group of health systems to delay the policy while they appeal her earlier decision that HHS could move forward with the plans. HHS was set to start implementing the new liver distribution system May 14. (Luthi, 5/16)

A bipartisan group of senators on Thursday introduced legislation to protect patients from massive, unexpected medical bills, as momentum grows around the issue. The legislation, led by Sens. Bill Cassidy (R-La.), Maggie Hassan (D-N.H.) and Michael Bennet (D-Colo.), comes as the House also introduced legislation this week, and President Trump called for action last week. (Sullivan, 5/16)

The new bill from Sens. Bill Cassidy (R-La.) and Michael Bennet (D-Colo.) has been in the works nearly a year. Under the proposal, a patient's insurer would automatically pay the out-of-network doctor or hospital about the same rate it would pay if the service were in network. But adding arbitration gives industry an appeals process that hospitals and specialty physicians want. (Luthi, 5/16)

The updated version combines two proposals. If the measure is enacted, providers would be prohibited from balance billing patients, or charging them for the remaining cost for treatment that insurance would not cover, and would instead pay the in-network rate and cost-sharing for the treatment, according to a summary. Under the proposal, providers would automatically be paid the difference between the patient’s in-network cost-sharing and the median in-network rate. Providers and insurance companies could then appeal that payment through arbitration, where both sides would propose their best offer and an independent third party would choose one based on commercially reasonable rates in that geographic area. (McIntire, 5/16)

Sen. Ron Wyden (D-Ore.) on Wednesday proposed a bill requiring insurers to tell people what they would have to pay out of pocket for any in-network treatment or prescription drug. The bill is part of the broader push in Congress and from the Trump administration to force healthcare prices out in the open. (Luthi, 5/16)

A rare point of potential common ground for U.S. President Donald Trump and members of Congress from both parties has emerged on the topic of medical bills. Much of the debate over health care in America -- which unlike most rich nations doesn’t provide treatment for all citizens -- is what to do about the tens of millions of people who lack coverage. The latest issue to flare involves people who do have coverage, yet still can be financially imperiled by sky-high "surprise billing." (Ruoff and Parnass, 5/17)

The chief executive of Gilead Sciences, the nation’s leading manufacturer of HIV drugs, defended the high cost of a key drug that prevents the lethal infection, telling a House committee Thursday that its hefty profits pay for continued research. “We have taken the disease from a death sentence to a manageable clinical condition, but we’re not done yet,” Gilead CEO Daniel O’Day told committee members. “We have to be sure that Americans get our medicines at a price that allows us to invest in research.’’ (Rowland, 5/16)

The latest attempt to spotlight Gilead Sciences and its business practices shifted on Thursday to Congress, where a sometimes contentious hearing was held to explore the cost of an HIV prevention pill the company sells and the role the federal government played in discovering the pricey medicine. The three-hour session was punctuated by a mix of bipartisan sparring that, at times, addressed the larger issue of patients versus profits as much as the Gilead pill, which is called Truvada and has been the focus of intense controversy in recent weeks. (Silverman, 5/16)

Rep. Alexandria Ocasio-Cortez (D-N.Y.) confronted a CEO Thursday for pricing a drug designed to reduce the risk of HIV transmission at $8 in Australia but over $1,500 in the U.S. ..."I think it's important here that we notice that we the public, we the people, developed this drug. We paid for this drug, we lead and developed all the patents to create Prep and then that patent has been privatized despite the fact that the patent is owned by the public, who refused to enforce it," Ocasio-Cortez said. (Rodrigo, 5/16)

Five more state attorneys general announced legal filings Thursday seeking to hold the company that makes OxyContin responsible for an opioid addiction crisis that's now the leading cause of accidental deaths across the country and in many states. The company, Connecticut-based Purdue Pharma, blasted the claims, saying they're based on "stunningly overbroad legal theories, which if adopted by courts, will undermine the bedrock legal principle of causation." (Izaguirre and Mulvihill, 5/16)

The lawsuits were announced six days after a North Dakota judge dismissed that state's lawsuit accusing Purdue Pharma of overstating the benefits and trivializing the addiction risks of prolonged opioid use. North Dakota is expected to appeal. Purdue Pharma called the new lawsuits "misleading attacks," and said it will defend itself against them. (Stempel, 5/16)

“Even when it became apparent that thousands of people were dying of opioid abuse, Purdue doubled down by continuing its relentless and deceptive campaign” to persuade doctors to write prescriptions for OxyContin, Morrisey said. Maryland Attorney General Brian Frosh said his state’s efforts were based on “two foundational falsehoods” that Purdue promoted widely: That the risk of becoming addicted to Purdue’s drug was very low and that under-treating pain could cause great harm. (Bernstein, 5/16)

Prescription opioid overdoses killed 217,530 people in the U.S. from 1999 to 2017, according to the Centers for Disease Control and Prevention. Total opioid-related deaths in that period reached nearly 400,000. A Purdue spokesman on Thursday denied the new allegations, calling them “stunningly overbroad legal theories.” He said the lawsuits “are part of a continuing effort to try these cases in the court of public opinion rather than the justice system.” All told, 44 states and another 1,700 local municipalities and Native American tribes have brought claims against the makers and distributors of prescription opioids. (Randazzo, 5/16)

The makers of the powerful and addictive painkiller OxyContin used deceptive marketing to persuade doctors to prescribe the opioid that contributed to a national epidemic of addiction, a lawsuit filed by Wisconsin Attorney General Josh Kaul alleges. Wisconsin is one of a handful of states that filed lawsuits this week alleging Purdue Pharma and Richard Sackler — creators of the drug — peddled false information to downplay the risky side effects of using OxyContin to kill pain and inflated the drug's benefits. (Beck, 5/16)

Purdue Pharma LP and its billionaire owners are being sued by five more states alleging the company’s aggressive marketing of the OxyContin painkiller triggered a vast addiction epidemic that has claimed hundreds of thousands of lives in the U.S. The attorneys general of Maryland, Wisconsin, Iowa, West Virginia and Kansas announced the latest suits on Thursday in a joint statement. Filed by both Republicans and Democrats, the complaints add to a wave of litigation accusing Purdue and the Sackler family, which owns the company, of knowingly pushing doctors to prescribe OxyContin even for minor pain. (Larson and Feeley, 5/16)

In other news on the national drug crisis —

State officials in Texas and Louisiana have launched multiple probes into the Cenikor Foundation following an investigation by Reveal that found the prominent drug rehab has turned patients into an unpaid labor force for private companies. Reveal from The Center for Investigative Reporting found that the nonprofit has sent thousands of patients to work without pay at hundreds of for-profit companies over the years – including Exxon, Shell and Walmart – in likely violation of federal labor law, according to former federal labor officials. (Walter, 5/16)

Exactly half of Massachusetts voters support the idea of opening supervised consumption sites in the state. A WBUR poll found 43 percent oppose such clinics, where drug use is monitored to prevent or reverse an overdose. And 8% of 660 adults (topline results, crosstabs) declined to respond or were undecided. (Bebinger, 5/17)

Millions of Americans who buy individual health insurance, and don't qualify for a federal subsidy, have been hit with sticker shock in recent years. Instability and uncertainty in the individual market — driven in part by changes Congress and the Trump administration made to the Affordable Care Act — have resulted in double-digit premium increases. Now Washington state has passed a law designed to give consumers another choice: a new, "public option" health insurance plan that, in theory, will be cheaper. (Jenkins, 5/16)

This week, state treasurer Dale Folwell released the details of the contracts he wants North Carolina’s health care providers to sign if they want to participate in the health plan covering state employees, retirees and their families. The contracts, part of what Folwell is calling the Clear Pricing Project, reworks the way that health care providers are reimbursed. Some providers, in particular hospitals, will feel the pinch under the plan, which pegs prices paid by the State Health Plan to those paid by the federal Medicare program for services. (Hoban, 5/17)

Jim Beck, Georgia’s insurance commissioner, is now officially suspended from office in the wake of his federal indictment Tuesday on charges of fraud and money laundering. Beck announced Thursday that he was voluntarily taking a suspension. The insurance department said that in his absence, Drew Lane, the chief deputy commissioner, would perform the duties of commissioner as outlined under state law. (Miller, 5/16)

Houston employer-based health plans are paying hospitals more than double, and in some cases quadruple, what Medicare would pay for the same treatment, a new national study has found. The findings by the RAND Corporation, released last week, examined what hospitals charged employer health plans in 25 states from 2016 to 2018. The biggest gap came in out-patient payments, which in Houston were as high as 448 percent of Medicare. That means a procedure that be might cost Medicare $1,000 would cost an employer-based plan $4,480. (Deam, 5/16)

Kaiser Health News: ‘Sham’ Sharing Ministries Test Faith Of Patients And Insurance Regulators
Sheri Lewis, 59, of Seattle, needed a hip transplant. Bradley Fuller, 63, of nearby Kirkland, needed chemotherapy and radiation when the pain in his jaw turned out to be throat cancer. And Kim Bruzas, 55, of Waitsburg, hundreds of miles away, needed emergency care to stop sudden —and severe — rectal bleeding.Each of these Washington state residents required medical treatment during the past few years, and each thought they had purchased health insurance through an online site. But when it was time to pay the bills, they learned that the products they bought through Aliera Healthcare Inc. weren’t insurance at all — and that the cost of their care wasn’t covered. (Aleccia, 5/17)

At least six million obese teenagers in the United States are candidates for weight-loss surgery, experts estimate. Fewer than 1,000 of them get it each year. Many of these adolescents already have complications of obesity, like diabetes or high blood pressure. But doctors have been uncertain just how well surgery works for young patients, and whether they can handle the consequences, including a severely restricted diet. (Kolata, 5/16)

Teens who have obesity surgery lose as much weight as those who have the operation as adults and are more likely to have it resolve other health problems such as diabetes and high blood pressure, a study finds. The results suggest there's a benefit from not waiting to address obesity. Researchers say longer study is still needed to know lifetime effects of this radical surgery and that it's a personal decision whether and when to try it. (Marchione, 5/16)

In recent years, many nutrition experts have linked the obesity epidemic to the spread of ultra-processed foods that are engineered to have a long shelf life and irresistible combinations of salt, sugar, fat and other additives. These foods tend to make people overeat because they are full of refined carbohydrates, added sugars and fat that appeal to the human palate, experts say. Most of these foods, however, tend to lack fiber, protein, vitamins and other important nutrients. (O'Connor, 5/16)

The findings, published Thursday in the journal Cell Metabolism, will force scientists to rethink the complicated relationship between dietary habits and health. “I thought it was all about the nutrients,” said study leader Kevin Hall, a section chief at the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health. (Baumgaertner, 5/16)

About 7 to 21 days after exposure, the person will have a mild to moderate fever, cough, runny nose, red eyes and sore throat. Two to four days after the initial symptoms, tiny white spots may appear inside the mouth. And three to five days after initial symptoms, a red or reddish-brown sandpaper-like rash appears, usually on the face, that then spreads. There may be a fever that spikes to 104. (Corwell, 5/16)

The United States’ birthrate fell for a fourth consecutive year in 2018, bringing the number of people born in the country to its lowest level in 32 years, according to provisional figures published on Wednesday by the federal government. It said the fertility rate in the United States also fell to a record low. There were an estimated 3,788,235 people born in the United States last year, a 2 percent decrease from 2017 and the lowest number of births in any year since 1986, according to the report, published by the National Center for Health Statistics. (Stack, 5/17)

Mental health care is accounting for a growing number of private insurance claims, according to a new report out Friday. But experts caution that more than anything else, the new data underscores just how tricky it is to tease out what’s driving increases in mental health care use. The report found that claims related to depression, anxiety, and a handful of other mental health conditions are on the rise. There were notable increases in those claims among young people, who accounted for a disproportionate share of mental health claims. Experts said the findings could reflect increased access to treatment — but cautioned that it’s difficult to determine the factors at play. (Thielking, 5/17)

On the eve of the American Physical Society’s annual March meeting, a Sunday “stitch ‘n bitch” session convened during happy hour at a lobby bar of the Westin Boston Waterfront hotel. Karen Daniels, a physicist at North Carolina State University, had tweeted notice of the meet-up earlier that day: “Are you a physicist into knitting, crocheting, or other fiber arts?” she asked. “I’ll be the one knitting a torus.” (A torus is a mathematized doughnut; hers was inspired by a figure in a friend’s scientific paper.) (Roberts, 5/17)

If you talk to cancer researchers about barriers to scientific progress, you’ll probably hear this statistic: Only about 8% of people with cancer actually take part in clinical trials. This being 2019, a lot of people think the problem can be solved with mobile apps that connect patients to the trials that might be right for them. But — this being 2019 — the use of such technology raises some thorny questions about privacy, consent, and conflict of interest. (Garde and Robbins, 5/17)

Emergency room patients increasingly leave California hospitals against medical advice, and experts say crowded ERs are likely to blame. About 352,000 California ER visits in 2017 ended when patients left after seeing a doctor but before their medical care was complete. That’s up by 57%, or 128,000 incidents, from 2012, according to data from the Office of Statewide Health Planning and Development. (Reese, 5/16)

Mallory Smith was diagnosed with cystic fibrosis, a genetic disease affecting the lungs and digestive system, at age 3. She was living on borrowed time, and she knew it: Cystic fibrosis puts patients at an increased risk of serious infection, and the average life expectancy is about 37, according to the Cystic Fibrosis Foundation. (Ellin, 5/17)

Denying children a hot meal apparently isn't a popular way for schools to deal with unpaid lunch money. After a flood of angry Facebook comments and phone calls, a Rhode Island district last week abandoned its plan to serve cold sandwiches to students whose families owe money."The outcry was global," said Catherine Bonang of Warwick Public Schools. (5/17)

Oregon is spending $40 million to dramatically expand its federal free breakfast and lunch program, ensuring that more than 60 percent of its 400,000 public school students will be included, the largest statewide effort in the country. The program is based on providing free meals to any child whose family lives at up to three times the poverty level, which is $75,000 for a family of four. (Zimmerman, 5/16)

A year after a high school mass shooting near Houston that remains one of the deadliest in U.S. history, Texas lawmakers are on the brink of going home without passing any new gun restrictions, or even tougher firearm storage laws that Gov. Greg Abbott backed after the tragedy. A Republican governor pushing even a small restriction on firearms kept at home in gun-friendly Texas was a landmark shift after two decades of loosening weapons regulations. And it put Texas in line with other states exploring ways to prevent not just mass shootings, but thousands of lethal gun incidents involving minors. (Vertuno, 5/17)

Police and other officials trying to understand the District’s rising homicide count have attributed it in part to shootings becoming more lethal, and now they say they may know why. A new study found that more victims are being struck by multiple bullets. The report by the D.C. Office of the Chief Medical Examiner found that 57 people killed in shootings in the city in 2017 were struck multiple times. That number rose to 74 last year. (Hermann, 5/17)

John Hopkins Hospital has filed more than 2,400 lawsuits in Maryland courts since 2009 against patients with unpaid bills, including a large number of residents from distressed neighborhoods surrounding the East Baltimore medical campus. The number of cases has been increasing, from 20 in 2009 to a peak of 535 in 2016, according a report released by the Coalition for a Humane Hopkins, which includes patients and neighborhood, faith and activist groups such as the AFL-CIO and National Nurses United, a union involved in a contentious organizing effort at Hopkins. (Cohn and Mirabella, 5/17)

After more than three hours of debate, the House approved a bill Thursday that would raise the age from 18 to 21 for anyone purchasing cigarettes, tobacco products and electronic nicotine delivery systems. Rep. Jonathan Steinberg, D-Westport and co-chairman of the legislature’s public health committee, said the bill was one of the most important to be considered this year. (Megan, 5/16)

egislators who in recent weeks had accelerated efforts to repeal Connecticut’s religious exemption on mandatory immunizations reversed themselves Thursday, abandoning their quest amid concerns about what to do with unvaccinated children who are already enrolled in school. The change would not have forced children to be immunized, but it would have prohibited kids who are not vaccinated on religious grounds from enrolling in the state’s public schools. (Carlesso, 5/16)

By taxing the sale of sugary drinks, as recently suggested by a City Council member, Cleveland could combat multiple health issues, including lead poisoning, diabetes and heart disease. The tax could raise much needed money to abate lead hazards in thousands of city homes while reducing the consumption of soda, fruit punches and other sugar-laden beverages that research shows contribute to early death. (Higgs, 5/16)

Boston Medical Center's new screening tool has shown promise for addressing patients' social needs in primary-care settings and developing better clinical strategies, according to a study published Wednesday. The hospital has embedded a screening program for identifying social needs within its electronic health record system that automatically processes responses and prints out a list of appropriate resources. (Johnson, 5/16)

Bayer AG plans to argue that a $2 billion jury award and thousands of U.S. lawsuits claiming its glyphosate-based weed killer Roundup causes cancer should be tossed because a U.S. regulatory agency said the herbicide is not a public health risk. Some legal experts believe Bayer will have a tough time convincing appellate courts to throw out verdicts and lawsuits on those grounds. Bayer has a better shot if a business-friendly U.S. Supreme Court takes up the case, experts said. But that could take years. (5/16)

New York City is set to get a new radiation-treatment center, nearly a decade in the making, that uses proton beams to treat cancerous tumors. Called the New York Proton Center, it is a for-profit partnership of Memorial Sloan Kettering Cancer Center, Montefiore Health System and Mount Sinai Health System, managed by the ProHEALTH company. Financing for the center was provided in part by the hospitals. (West, 5/16)

A Houston-area police officer knew his neighbor suffered from mental illness and should have offered assistance when that was apparent, but instead he fatally shot the 44-year-old woman, a lawyer for the victim's family said Thursday. Pamela Turner had struggled with paranoid schizophrenia since her diagnosis in 2005, and may have been in crisis the night she was killed, attorney Ben Crump said during a press conference. (5/16)

A 71-year-old man, inspired by his work last year at a park where veterans were camping because they were homeless and struggling with addiction, embarked on a 3,600-mile, coast-to-coast walk this week to draw attention to their plight. William Shuttleworth, toting a 25-pound backpack and singing "America the Beautiful," departed his hometown of Newburyport, of Massachusetts, on Wednesday for what he estimates will be a 7½-month trek to Vandenberg Air Force Base in Lompoc, California. (5/16)

Leaders at Ascension noticed that nearly 10% of patients in their hospitals who were diagnosed with sepsis died, five times the average mortality for all inpatients. They decided to prioritize the goal of improving sepsis outcomes at all their hospitals during fiscal year 2019. That's no easy task in a company with 151 hospitals in 21 states and the District of Columbia. (Meyer, 5/16)

State officials outraged by self-dealing contracts between the University of Maryland Medical System and its board members are calling on the health network’s affiliate hospitals to reform their board practices, as well, after a Baltimore Sun investigation revealed similar business ties. UMMS has endured the wrath of lawmakers upset that the medical system entered into contracts with the companies of nearly a third of its board of directors — particularly because several of them were no-bid deals. The outcry resulted in the resignations of seven board members, including the UMMS CEO and Baltimore’s mayor. (Donovan and Rector, 5/16)

California is spending millions of dollars to stem the tide of homelessness without much to show for it. The latest evidence of that arrived Thursday, when several Bay Area cities and counties reported that their latest tallies of homeless people revealed big increases. San Francisco saw a 17% jump in the number of homeless residents over the last two years, according to preliminary results of the city’s point-in-time count. (Oreskes, 5/16)

The University of Pittsburgh Medical Center has spun out a specialty telemedicine company focused on infectious disease care, the health system announced Thursday. The new company—Infectious Disease Connect—formed following the success of UPMC's tele-infectious disease program, which launched in 2013. The telemedicine program connects infectious disease specialists at UPMC with patients and physicians at rural community hospitals for consultation and treatment services. (Cohen, 5/16)

After facing criticism over safety concerns, the Arizona Department of Corrections moved hundreds of inmates from a Buckeye prison to other facilities across the state. The department completed the move of 716 close-custody inmates — those requiring intensive supervision — from the Lewis prison Thursday, it announced. (Castle, 5/16)

Roughly 4,000 mental health clinicians at Kaiser Permanente have authorized their union, the National Union of Healthcare Workers, to declare an open-ended strike as early as June if they have not secured a new contract with their employer. ...John Nelson, Kaiser’s vice president of communications, said NUHW’s announcement is another tactic in the union leadership’s ongoing campaign to create pressure for management to agree to their financial demands. (Anderson, 5/17)

Picketing outside UC Davis Medical Center on Thursday, unionized workers again hammered home their displeasure over UCD’s plan to allow Kindred Healthcare to staff a new rehabilitation hospital planned for the Aggie Square development on the corner of Stockton Boulevard and Broadway in Sacramento. (Anderson, 5/16)

Michigan State University quietly cut funding from tuition going to its student health and wellness department in the fall of 2018, forcing the department to run on other sources of income, including its reserves. In an internal memo, department leaders say they were not consulted on the cut. The cut was part of an ongoing plan to redo how the department is funded, which could include a new student health fee and billing students for more services, according to documents provided to the Detroit Free Press by sources within the university's administration. (Jesse, 5/17)

Since late January, U.S. immigration officials have been forcing some Central American asylum seekers to wait in Mexico for judges to decide their cases; the controversial program took effect at the Calexico border crossing in mid-March. Now, as migrants crowd into shelters in Mexicali, facility operators and Mexican state health officials are dealing with a new challenge: At one shelter, at least a dozen adults and children, including Briseba Aracely, have developed chickenpox in the past month. (Plevin, 5/16)

Beginning and attending college or graduate school can be a major life transition for many students. It especially becomes difficult, however, for students with mental illness who move away from home and care designed to deal with their specific health care problem. One of every three U.S. college students shows symptoms of a mental health problem such as depression, generalized anxiety disorder or being suicidal, a study by Sara Oswalt, of the University of Texas at San Antonio, and other researcher said in a 2018 report, “Trends in college students’ mental health diagnoses and utilization of services, 2009-15.” Depression and anxiety are the two most common mental illnesses among college students, anxiety having surpassed depression, affecting between 38 and 55 percent of college students, the study, published in the Journal of American College Health, showed. (Bohlke, 5/16)

Both the Georgia and Alabama laws are sure to be challenged in court, but the legal climate surrounding abortion is different than it was just last year. After the replacement of the Supreme Court Justice Anthony Kennedy with Justice Brett Kavanaugh, Chief Justice John Roberts is the swing vote, and many conservatives have reason to hope that the Court will rule in favor of new restrictions on abortion and eventually even overturn Roe v. Wade. (Isaac Chotiner, 5/14)

Drug prices are still increasing. While growth in spending on drugs has slowed in recent years, total national spending continues to grow. Americans spend more than anyone else in the world. The average person spends $1,025 per year on medication—an inflation-adjusted increase of elevenfold since 1960. (James Hamblin, 5/10)

The political aim of so-called heartbeat bills is pretty clear. Some Americans would like to ban abortion altogether, but the Supreme Court says that’s unconstitutional. So they advocate for increasingly draconian laws that walk up to that line. Less straightforward, though, is the science. What the bills call a heartbeat—it's not that. (Adam Rogers, 5/14)

When Catherine Jacobson first heard about the promise of cannabis, she was at wits’ end. Her 3-year-old son, Ben, had suffered from epileptic seizures since he was 3 months old, a result of a brain malformation called polymicrogyria. Over the years, Jacobson and her husband, Aaron, have tried giving him at least 16 different drugs, but none provided lasting relief. They lived with the grim prognosis that their son — whose cognitive abilities never advanced beyond those of a 1-year-old — would likely continue to endure seizures until the cumulative brain injuries led to his death. (Velasquez-Manoff, 5/14)

Wherever you go in the art world, you’ll run into one prominent name: the Sackler family. The Smithsonian has the Arthur M. Sackler Gallery. The Metropolitan Museum of Art has a Sackler Wing; the Louvre does, too (the Sackler Wing of Oriental Antiquities). There’s a Sackler Museum at Harvard and a Sackler Center for Arts Education at the Guggenheim. (Kelsey Piper, 5/15)

You can tell which side of the aisle is optimistic about the politics of the abortion bans in Alabama, Georgia, Missouri and elsewhere. When asked about the Alabama ban, Sen. Martha McSally (R-Ariz.) (who lost her race for Senate but was then appointed to the seat originally held by the late senator John McCain) ducked. “That’s a state issue. I’m focused on my work here," she insisted. In a press call Thursday morning NARAL Pro-Choice America executives, NARAL’s president Ilyse Hogue rebuked McSally. (Jennifer Rubin, 5/16)

When Alabama Gov. Kay Ivey signed that state’s obnoxious new bill criminalizing abortion Wednesday afternoon, she offered a little toast to victory on Twitter. Or maybe we should call it a partial victory, since the ban was enacted as a ploy to try to get the right to abortion, affirmed in the 1973 Roe vs. Wade decision, back before the retooled conservative majority on the U.S. Supreme Court. (Scott Martelle, 5/16)

Roe v. Wade may still be the law of the land, but states such as Georgia and Alabama are moving aggressively to change that. The draconian bills both states recently passed reveal the legal strategy at work here: Even if the court of appeals and Supreme Court do not let these highly restrictive laws stand, the states are giving the court cover to dramatically cut back on reproductive rights without having to explicitly overturn Roe. Roe , which was decided in 1973, established the principle that a woman has a right to an abortion. The court has refined that principle over time; a woman now has a right to an abortion before her fetus could viably survive outside the womb. (Leah Litman, 5/16)

Beyond the general outrage among progressives over Alabama’s passage Tuesday of the nation’s most restrictive abortion law, some activists and commentators have voiced additional anger over the fact that the state legislature is nearly 85 percent male, with a mere four women in the state Senate. But given the domination of conservative Republicans in state politics, it’s unlikely that more women would have changed the outcome of the vote. The bill passed the Senate along party lines, 25 to 6. The House sponsor of the legislation, which bans abortion at the moment of conception, and provides no exceptions in the case of rape or incest, was a woman. The measure was quickly signed Wednesday by the state’s female governor, Kay Ivey (R). (Vanessa Williams, 5/17)

The commonwealth has an opportunity to respect the dignity of women in Massachusetts and to trust them to make their own medical decisions by passing the ROE Act (An Act to Remove Obstacles and Expand Abortion Access), which would change existing laws that restrict abortion. But some leaders, including Governor Baker, seem intent on interfering in a woman’s personal medical decisions by opposing the legislation. (Aaron Hoffman, 5/16)

Like the southern states that enacted Jim Crow laws after the Civil War, the anti-abortion movement is a force to be reckoned with. But the generations of women liberated by Roe v. Wade are as unlikely to resume their former status without a fight as the slaves freed by the 13th Amendment.In the short term, though, many Republicans legislators have decided they have little to lose by appeasing the vital bloc of GOP voters who want to turn the clock back to 1972. They know the hurdles they erect will impede only those who lack the means to travel; as long as unrestricted abortions remain legal elsewhere, the legislators' know, their own wives, daughters and girlfriends will have access to them. (Brian Dickerson, 5/15)

As a pediatrician, I still want to save babies. And as we look at the high rates of maternal morbidity and mortality in this country, especially as we celebrate National Women’s Health Week, I’m reminded again that we must also continue to focus on saving their mothers.America’s future depends on the health of mothers and their children. Not only do we want more babies to reach their first birthday, we want their mothers to be there to celebrate with them. Promoting health across a woman’s life course gives us the best opportunity to do that. (Michael D. Warren, 5/16)

While legislation is critical in preventing health plan barriers, consumers also play a role. By knowing their rights, appealing denials, and fighting back, patients can stand up for themselves. But first they need to know that is an option. A recent Kaiser Family Foundation report looked at data on claim denials and appeals from the Centers for Medicare and Medicaid Services. Among other findings, the report showed that consumers rarely appeal claims that have been denied. In 2017, 121 major health insurance issuers denied a total of more than 42 million claims. Consumers appealed less than 200,000 (0.05%) of these denials. Although consumers have the right to bypass their insurer’s internal appeals process and go directly to an external review, this happens in fewer than 1 in 11,000 denied claims (0.009%). (Liz Helms, 5/17)

Surprise medical bills are in the news almost daily. Last Thursday, the White House called for legislation to protect patients from getting surprise doctor bills when they are rushed to the emergency room and receive care from doctors not covered by insurance at an in-network hospital. The financial burden on patients can be substantial — these doctor charges can amount to hundreds or even thousands of dollars.  What’s behind this explosion of outrageous charges and surprise medical bills? Physicians’ groups, it turns out, can opt out of a contract with insurers even if the hospital has such a contract. The doctors are then free to charge patients, who desperately need care, however much they want. (Eileen Appelbaum, 5/16)

As calls for radical health reform grow louder, many on the right, in the center and in the health care industry are arguing that proposals like “Medicare for all” would cause economic ruin, decimating a sector that represents nearly 20 percent of our economy. While exploring a presidential run, the former Starbucks chief Howard Schultz called Medicare for all “not American,” adding, “What industry are we going to abolish next — the coffee industry?” He said that it would “wipe out the insurance industry.” (Elisabeth Rosenthal, 5/16)

In 2015, after extensive public and congressional pressure, the National Institutes of Health (NIH) cut funding for experiments on chimpanzees and began retiring them to sanctuary. Now, in a historic move, Congress is asking the NIH to begin to do the same for the thousands of other primates in its taxpayer-funded laboratories, and it’s about time. Last year, approximately 7,000 baboons, marmosets, macaques and other primates were confined and experimented on by the NIH. Unfortunately, primate research at the NIH is growing despite policies requiring the reduction and replacement of animal testing. (Stacy Lopresti-Goodman, 5/16)

A national for-profit marijuana industry is expanding substantially in the United States. Thirty-three states have legalized medical marijuana, 10 of which (where 1 in 4 individuals reside) have also legalized recreational marijuana. Sales of marijuana are projected to increase from $8.5 billion to $75 billion by 2030, rivaling current tobacco sales ($125 billion). The initial marijuana marketplace was limited to a few states, but emerging brands have developed sophisticated national marketing campaigns that could potentially have an effect across state lines. This marketplace expansion, along with questionable marketing practices, introduces a need for federal action. (John W. Ayers, Theodore Caputi and Eric C. Leas, 5/16)

Health care is lagging behind other industries in its approaches to data science, in part because it is relatively new to big data. By learning from the intelligence community, the health sector can accelerate progress and capitalize on existing innovations. (Kevin Vigilante, Steve Escaravage and Mike McConnell, 5/16)

Underfunding the public defender is politically popular because it’s hard to find much sympathy for people who get arrested. But a fair criminal justice system does more than prosecute the guilty. It also protects the innocent, which means all of us. (5/15)