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Many House conservatives backed the budget last month and spared GOP leaders another showdown with their right flank for one big reason: They were under the impression the spending blueprint would help them — finally — get an Obamacare repeal to the president’s desk. Now they’re concerned that Speaker John Boehner and company have other plans. (Bade, 4/27)

Deficit hawk lawmakers have found something they want to spend money on: medical research. They say they want to cure cancer and other diseases by boosting the budget for the National Institutes of Health, and they argue that investing in those cures now will save taxpayer money later by lowering health care costs over time. Spearheaded by conservatives in the Republican-controlled Congress, the unlikely campaign has the potential to unite both parties in a common cause and give the NIH its best chance at substantial budget growth in more than a decade. At stake is billions of dollars in grant money that could end up at research institutions in lawmakers’ own backyards. (Wise, 4/24)

Sources said the budget would focus on repealing Obamacare through the fast-track budgeting procedure known as reconciliation, which allows the bill to clear the Senate with just 51 votes. But it was unclear if it would specifically require only a repeal of the president’s signature health care law. House negotiators were pushing to keep their options open when it comes to how Republicans will use reconciliation. (Bade, 4/24)

Aiming to acquire more budget powers and take a swipe at Obamacare, Republicans will likely scrap a proposal that stirred controversy and helped launch Wisconsin congressman Paul Ryan on the national stage: privatizing the Medicare health program. Ryan's bold Medicare "premium support" plan would be sacrificed to ensure passage of Congress' first full budget in six years and allow Republicans a rare opportunity to use a powerful procedural tool to ease passage of other legislation. (Lawder, 4/24)

The House Energy & Commerce Committee this week is expected to unveil a revised version of controversial legislation overhauling the Food and Drug Administration's regulatory process, with a hearing scheduled for Thursday. But as of late last week, there were still unresolved issues. The 21st Century Cures Act, supported by the drug and device industries, would make sweeping changes in the regulation of drugs, devices, health information technology and telehealth. Backers say its provisions would accelerate review of new products, make promising medications and devices available to the public faster, and significantly cut costs associated with product development. (Tahir, 4/25)

The Obama administration is dialing up the pressure on a handful of states that have resisted expanding Medicaid coverage for their low-income residents under the federal health care overhaul. The leverage comes from a little-known federal fund that helps states and hospitals recoup some of the cost of caring for uninsured patients. The administration says states can just expand Medicaid, as the health care law provides, and then they wouldn't need as much extra help with costs for the uninsured. (Kennedy, 4/24)

House and Senate leaders weren’t backing off their opposing positions on Medicaid expansion Friday during tense budget negotiations leading into the final week of the Legislative session. But they did manage to find enough common ground to jump-start negotiations early in the day, only to watch them grind to a halt by evening. (4/26)

Gov. Tom Wolf's administration plans to begin transferring more than a million adult Medicaid enrollees into a single, new benefits program that it touts as a more efficient and effective way of providing health care for the poor, disabled and elderly. The Department of Human Services will start moving more than 100,000 people Monday into the program, called Health Choices. It also will stop admitting new enrollees into plans that had been created by Wolf's predecessor, Tom Corbett, as part of Pennsylvania's expansion of Medicaid's income eligibility guidelines under the 2010 federal health care law. (Levy, 4/24)

A new analysis highlights that it is often cheaper for people to pay ObamaCare’s penalty for not having health insurance than to buy coverage, meaning the penalty might be too low to spur middle-income people to get covered. The analysis from the consulting firm Avalere Health finds that for people making less than 200 percent of the poverty line, or about $23,000, purchasing insurance is usually cheaper because of income-based subsidies under the law. (Sullivan, 4/24)

Imagine Apple's first iPhone is still on sale today. Now imagine it costs many times its original price of $599, and that the price goes up every time a new, competing phone is released. That bizarro world is what the market for multiple sclerosis drugs looks like, as described in a new paper in the journal Neurology. And doctors are calling for it to change. (Tozzi, 4/24)

There has been an “alarming rise” in the cost of multiple sclerosis treatments over the past dozen years and the cost of these drugs increased at rates well beyond the overall growth in prescription drug prices, according to a new study. (Silverman, 4/24)

A group of Oregon researchers have issued what amounts to an indictment of pharmaceutical industry pricing, with a new study showing that people with multiple sclerosis have been hit with skyrocketing bills for medicines introduced long ago. Instead of competition driving prices down when superior competing drugs were introduced, costs in the U.S. went up even faster than before, according to the study conducted by researchers at Oregon State University and Oregon Health & Science University. It was published today in the journal Neurology. (Budnick, 4/24)

On Feb. 10, Valeant Pharmaceuticals International Inc. bought the rights to a pair of life-saving heart drugs. The same day, their list prices rose by 525% and 212%. Neither of the drugs, Nitropress or Isuprel, was improved as a result of costly investment in lab work and human testing, Valeant said. Nor was manufacture of the medicines shifted to an expensive new plant. The big change: the drugs’ ownership. (Rockoff and Silverman, 4/26)

Total compensation for some of the highest-paid CEOs in the healthcare industry increased faster than their companies' profits last year, a Modern Healthcare analysis of the first firms to report executive pay found. Corporations with the most richly rewarded CEOs by sector in 2014 included Community Health Systems, a Franklin, Tenn.-based hospital operator; Centene Corp., a St. Louis-based insurer; CVS Health Corp., a retail pharmacy and pharmacy benefit manager based in Woonsocket, R.I., and Regeneron Pharmaceuticals, a New York City-based biotechnology company. (Evans, 4/25)

Atrius Health, the state’s largest independent doctors group, is pouring $10 million into an “innovation center” that will study ways to shake up how health care is delivered. ... Atrius executives said they must rethink traditional doctor-patient relationships and office visits as the health care industry moves toward payment models that demand greater efficiency and better performance. Atrius’s innovation team will study ways to change care, for example by allowing patients to video chat with doctors and deploying health coaches to help patients manage their diseases. Dr. Karen DaSilva, vice president of innovation at Atrius, said the new team will start by interviewing staff and patients to find areas that need improvement. (McCluskey, 4/27)

Jane Maier was one of a select group of patients invited in early 2012 to help Partners HealthCare, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million. The system, which is now being phased in, will help coordinate services and reshape how patients and doctors find and read medical information. The fact that Partners sought the perspective of patients highlights how hospitals increasingly care about what their customers think. ... Patient advisory councils, like the one Maier belongs to, often serve as sounding boards for hospital leaders – offering advice on a range of issues. Members are usually patients and relatives who had bad hospital experiences and want to change how things work, or who liked their stay and want to remain involved. (Luthra, 4/27)

For first-year Temple nursing students, a recent classroom session on how to cover rent, child care, food, medicine, and transportation on a bare-bones budget was an academic exercise. In Philadelphia, a staggering 28 percent of residents live in poverty. For many, deprivation also means a life of poor health. Without decent housing, access to medical care, healthful food, and safe exercise outlets - and with the stress that comes with deprivation - the poor face major hurdles to getting and staying well. So nursing programs such as Temple's are spending more time on what academics call the "social determinants of health" to make a real impact on patients' lives and health. (Rush, 4/26)

There are 26 barbers and stylists at The Shop in Hyattsville, Md. Between them, they cut the hair of more than 100 people each day. That’s around 600 people each week, 31,000 heads each year. Over the last two years, 29 of those customers received a colonoscopy as a direct result of conversations they had with their barbers at The Shop. One of those people, says owner Fredie Spry, was already showing symptoms of colon cancer and is now getting treated. Many more of Spry’s African-American clients learned that the cancer is one of the few that are preventable and — given blacks’ higher-than-average risk for the disease — they should consider getting a first colonoscopy at 45. (Stein, 4/24)

When Lauryn Santiago’s grades started to slip two years ago, her mother, Linda Diaz, suspected something was wrong. Diaz called her daughter’s high school and asked the counselor to meet with Lauryn. But the meeting never happened. A month later, Diaz found her 15-year-old daughter hanging from the banister of their home. Lauryn, a freshman at Laurel High School in Prince George’s County, had taken her own life. (Wiggins, 4/26)

New national guidelines indicate health insurers will face tougher regulatory scrutiny over how they protect customers from data breaches. But the guidance likely won't do much to prevent cyberattacks in the first place. The National Association of Insurance Commissioners on April 16 adopted a dozen principles for “effective cybersecurity insurance regulatory guidance.” The guidelines were issued in response to the massive data breaches that burned health insurers this year, including at Anthem and Premera Blue Cross, involving data on more than 90 million people. (Herman, 4/25)

One day soon, you may be waiting in line for a coffee, eyeing a pastry, when your smart watch buzzes with a warning. Flashing on the tiny screen of your Apple Watch is a message from an app called Lark, suggesting that you lay off the carbs for today. Speak into the Apple Watch's built-in mic about your food, sleep and exercise, and the app will send helpful tips back to you. (Farr, 4/25)

A business startup targeting tech-savvy parents in Frisco and Plano will soon have nurse practitioners making house calls for sick kids. Using an Uber-like app on their iPhone, parents can put in a request for service from PediaQ. Within minutes a nurse practitioner will call for details and make sure it’s not an emergency that warrants a trip to the ER. For urgent care cases, she’ll arrive at the family’s home, the babysitter’s house or even a hotel room within an hour. Nurse practitioners can treat a long list of ailments, from coughs and colds to allergies and rashes. (Wigglesworth, 4/24)

Surgeon General Vivek Murthy was officially sworn in this week. His confirmation was held up for more than a year because of comments he made about gun violence. Murthy talks with NPR's Scott Simon. (4/25)

Six recovering substance abusers sat in an inner-city treatment center, sharing their stories. When Michael’s turn came around, he spoke of his former drug of choice, alcohol, and mentioned the night years ago when he drove drunk on the Massachusetts Turnpike, caused an accident and was arrested before passing out. ... “You are my people,” he said, wiping one eye. Catharsis is common in treatment centers, but Michael is not the typical former substance abuser: He is Michael Botticelli, the director of the White House Office of National Drug Control Policy, informally known as the drug czar. Mr. Botticelli is the first person in substance-abuse recovery to hold the position. (Schwartz, 4/25)

Last spring Cardinal Innovations Healthcare Solutions took control of more than $200 million in Medicaid spending for Mecklenburg County residents with mental illnesses, addictions, autism and similar issues. It was a controversial mandate from the state. County officials wanted to keep local control. Clients and their families feared the focus on cost control would erode care. (Helms, 4/27)

One of the largest providers of mental health services to poor North Siders is closing — just as the state braces for massive mental health care cuts. And Cook County Sheriff Tom Dart’s office is warning that means there will soon be more mentally ill people in jail. (4/24)

The CMS is proposing that inpatient psychiatric facilities get a 1.6% rate increase from Medicare in fiscal 2016 under a proposed rule issued Friday. The proposed policy means Medicare would spend $80 million more on psychiatric facilities in fiscal 2016 than in fiscal 2015. However, the increase is smaller than the 2.5% raise they received for the current year. (Dickson, 4/24)

Should drug makers be required to disclose their costs to justify rising prices? This is what a growing number of state legislatures are considering. Over the past several weeks, lawmakers in a handful of states stretching from California to Massachusetts have introduced bills in a bid to force the pharmaceutical industry to conduct an economic striptease. (Silverman, 4/24)

A union claimed victory Friday in its effort to organize 20,000 home health aides in Pennsylvania, even as two pending lawsuits seeking to block the union drive may not be resolved for months. Home health aides voted 2,663 to 309 in favor of being represented by the United Home Care Workers of Pennsylvania, according to the union, which is a joint partnership of the Service Employees International Union and the American Federation of State, County and Municipal Employees. (Maher, 4/24)

Blue Shield of California fired a top executive last month after he spent more than $100,000 on his corporate credit card, the company says, including on trips with girlfriend and "Sharknado" actress Tara Reid. The details surfaced in a countersuit the health insurance giant filed Tuesday alleging fraud by Aaron Kaufman, the company's former chief technology officer. (Terhune, 4/24)

The Florida Senate approved a bill on Friday mandating a 24-hour waiting period for women seeking abortions, with all Republicans voting in favor and all Democrats opposed. The bill is now headed to Republican Governor Rick Scott, who is expected to sign it into law. (Cotterell, 4/24)

The case against Dr. Alwin Lewis started with a patient’s complaint about his unorthodox diet plan. But it landed at the California Supreme Court with a much broader issue at stake: Whether regulators should have unrestricted access to a state database detailing doctors’ prescribing practices. (Tillman, 4/27)

With Obamacare in its second year, health officials are still working out the kinks in expanding health coverage to millions of Californians. In the latest fix, members of a health plan for low-income Los Angeles County residents now can pay their premiums with cash at neighborhood stores, a more convenient option for some people without bank accounts. (Karlamangla, 4/24)

The number of cases of HIV tied to injection drug use in a rural Indiana county has continued to climb, and federal officials on Friday alerted health departments, hospitals and doctors across the country to be on the lookout for similar outbreaks in their communities. “Urgent action is needed” to prevent further HIV and hepatitis C transmission in Indiana and to control any similar occurrences elsewhere, according to a health advisory issued by the Centers for Disease Control and Prevention. (Campo-Flores, 4/24)

A year after the children of radio personality Casey Kasem had to seek court action to see their ailing father, a new law in Iowa aims to ensure that adult children can see their sick parents — granting them visitation rights unless the person's guardian goes to court to stop them. Gov. Terry Branstad signed the bill into law Friday. (Lucey, 4/24)

[Gov. Kate] Brown signed the overwhelmingly bipartisan House Bill 2395 on March 23, extending a $1.9 billion tax on hospitals for the next four years to make sure Oregon receives an additional $5.4 billion in federal matching money over that same span. Two years ago, Republicans had sought to use the extension as a bargaining chip in the debate over public employee pension reforms. But this time, only three, between the House and the Senate, voted no. (Theriault, 4/24)

Hoping to finally close a significant gap in the region’s emergency medical network, Los Angeles County officials are proposing a new trauma center to serve residents of Pomona and the eastern San Gabriel Valley. Officials have been trying for years to put a trauma center in the area, saying patients now travel too far to receive care for the most critical injuries. The nearest trauma center to Pomona is 28 miles away, at County-USC Medical Center in Boyle Heights. (Karlamangla, 4/26)

The Texas legislature is working on reforms to crack down on overprescribing and prescription drug dealing, which contribute to the toll. ... Last summer, Dr. David Lakey, then the Texas Department of State Health Services commissioner, told a Senate committee studying the problem that Texas has one of the nation's lowest prescription drug fatality rates and that his data showed deaths had peaked in 2006. But Lakey was referring only to deaths involving certain painkillers, not all prescription drugs. His report did not include information from medical examiners, who use drug screens to identify many more overdoses, according to a joint investigation by the Houston Chronicle and the Austin American-Statesman. (Olsen and Roser, 4/25)

There's a quiet medical crisis going on in this country: the number of women dying in childbirth. The United States is the only advanced economy in the world with a rising maternal mortality rate. Deaths related to childbirth in the United States are nearing the highest rate in a quarter-century. An estimated 18.5 mothers died for every 100,000 births in 2013, compared with 7.2 per 100,000 in 1987. This means a woman giving birth here is twice as likely to die than in Saudi Arabia and three times as likely than in the United Kingdom. (Paquette, 4/24)

Nearly two decades after voters passed a medical-marijuana law that often left police, prosecutors and even patients confused about what was allowed, Gov. Jay Inslee signed a bill Friday attempting to clean up that largely unregulated system and harmonize it with Washington’s new market for recreational pot. Among the law’s many provisions, it creates a voluntary registry of patients and, beginning next year, eliminates what have become in some cases large, legally dubious “collective gardens” providing cannabis to thousands of people. (LaCorte and Johnson, 4/24)

A Hammond, Louisiana doctor has admitted to writing false home-healthcare referrals as part of a multimillion-dollar Medicare fraud scheme, Louisiana federal prosecutors announced Thursday. Winston Murray, 62, pleaded guilty to one count of conspiracy to commit healthcare fraud and two counts of healthcare fraud. (Pierson, 4/24)

It’s widely assumed that Americans will become increasingly diligent and informed health-care consumers as higher deductibles and other forms of cost sharing push them to be more prudent purchasers and as they become aware of comparative provider quality and price information. That may well happen–but findings from the Kaiser Family Foundation’s April Health Tracking Poll show that the effort to bring provider quality and cost information to consumers is still in its infancy. (Drew Altman, 4/27)

Imagine yourself as a regular commentator on public affairs — maybe a paid pundit, maybe [a] supposed expert in some area, maybe just an opinionated billionaire. You weigh in on a major policy initiative that’s about to happen, making strong predictions of disaster. The Obama stimulus, you declare, will cause soaring interest rates; the Fed’s bond purchases will “debase the dollar” and cause high inflation; the Affordable Care Act will collapse in a vicious circle of declining enrollment and surging costs. But nothing you predicted actually comes to pass. What do you do? You might admit that you were wrong, and try to figure out why. But almost nobody does that; we live in an age of unacknowledged error. (Paul Krugman, 4/27)

Give the Department of Veterans Affairs some credit for realizing the challenges it faces. Now, if it just could open its eyes to the obvious resolutions. ... Yes, the VA needs to expand, but as a military version of Medicare, directing qualified vets to the private-sector health-care providers of their choice and paying the bills it is responsible for paying. It doesn't need to create a government version of a health-care system that already exists. To [VA Secretary Robert] McDonald's credit, part of his expansion plans include more emphasis on the Veterans Choice program, which refers some veterans to private-sector providers. The bad news is that enlarging the VA fiefdom is his primary mission. (4/25)

A more careful look, however, at the merits of the supposed case against [Dr. Mehmet Oz] makes it start to look weaker than a cup of green coffee. ... Much of what Dr. Oz talks about is pretty anodyne stuff: Eat fruit! Exercise! Sleep right! Diet features prominently on every show .... Different doctors take different approaches to issues like whether or not to prescribe statin drugs to patients with high cholesterol, or how to treat people with pre-diabetes. Some are quick to prescribe medications, whereas Dr. Oz tends to favor less interventionist, more natural approaches based on diet and exercise. (Bill Gifford, 4/25)

It’s about time. For three years, I’ve been getting on the federal government to stop imprinting Social Security numbers on Medicare cards, a practice that placed millions of people at risk for financial losses from identity theft. I’m finally getting my wish. (Pamela Yip, 4/26)

A new crop of specialty drugs holds great promise for treating or even curing some devastating diseases, but their high cost challenges health insurers and taxpayer-funded health programs. In California, Gov. Jerry Brown has asked for $300 million in the coming fiscal year's budget just for specialty hepatitis C medications such as Sovaldi, which can cost Medi-Cal or the state prison system more than $80,000 for a course of treatment. Before policymakers can figure out how to cope with the costs over the long term, they need to know more about why these drugs are priced as high as they are. That's where a new proposal by Assemblyman David Chiu (D-San Francisco) comes in. (4/26)

No state in this nation has been more quietly terrorized by heroin than Maryland, my Maryland. Hopefully, the state’s attempt to hush the national media’s branding of Baltimore as “the heroin capital of America” is over. Maryland Gov. Larry Hogan (R) announced plans to launch a strong counteroffensive in his state’s heroin war. Now a game-changing pushback on the pushers can finally begin. (Milton Emmanuel Williams Jr., 4/24)

Naloxone isn't magic, but its power to rescue a heroin user from the brink of death can certainly seem miraculous. The anti-overdose drug, also known by the brand name Narcan, is easy to administer and has saved thousands of lives. ... in Massachusetts, as in most other states, the price of naloxone is up sharply. A 2-milliliter dose that used to cost the state $19.56 has more than doubled to $41.43. ... The price jump may be unwelcome — no one likes to pay more for vital supplies — but it is hard to see anything unfair or unethical, let alone unlawful, about it. That hasn’t stopped [Attorney General Maura] Healey from demanding that companies selling naloxone in Massachusetts provide detailed explanations for the higher costs of the drug, and account for “any changes in prices over time” since the opioid crisis was declared a public emergency. Healey’s spokesman insists the attorney general “isn’t suggesting anything nefarious.” ... But the innuendo is hard to miss. (Jeff Jacoby, 4/26)

The entire nation shuddered at the story of Daequan Norman, the 21-year old man with severe cerebral palsy who was abandoned in a West Philadelphia park by his mother. He was wrapped in a blanket with a Bible in this spring's cold, helpless because he cannot move his arms or legs, and cannot speak. His mother has been charged with attempted murder and other offenses. In searching for some meaning in this tragic situation, let's take an unflinching look at the exceptional demands upon parents of children with severe disabilities. (Diane Gallagher, 4/27)