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President Trump expressed confidence Sunday — both on social media and the golf course — that he and aides can somehow resurrect their attempt to repeal President Barack Obama's health care law. Hours before hitting the links with one of his critics on health care — Republican Sen. Rand Paul of Kentucky — Trump tweeted: "Anybody (especially Fake News media) who thinks that Repeal & Replace of ObamaCare is dead does not know the love and strength in R Party!" (Jackson, 4/2)

Trump added in a subsequent tweet that talks are ongoing. "Talks on Repealing and Replacing ObamaCare are, and have been, going on, and will continue until such time as a deal is hopefully struck." (Balluck, 4/2)

President Donald Trump brought Sen. Rand Paul to his Virginia golf course on Sunday to talk health policy with the outspoken critic of the failed plan to repeal and replace so-called Obamacare. The outing to Trump National Golf Club came hours after Trump tweeted that talks on replacing the law have been going on and "will continue until such time as a deal is hopefully struck." (4/2)

Senator Rand Paul of Kentucky and White House budget director Mick Mulvaney golfed with the president at Trump National Golf Club in Potomac Falls, Virginia. “We had a great day with the president. Played some golf and we talked about a little bit of health care,” Paul told reporters on the White House’s South Lawn after returning from the outing. “I continue to be very optimistic that we are getting closer and closer to an agreement on repealing Obamacare.” (Talev, 4/2)

Paul, an eye doctor and Tea Party favorite, has his own ObamaCare replacement plan, which he argues goes further than the Republican House leadership plan to fully repeal and replace the 2010 health care law, under which consumers are facing rising costs and fewer policy options. (Weber, 4/2)

The Kentucky Republican clashed with the president over the Republicans' initial plan to repeal and replace ObamaCare, which Republican leaders ultimately pulled in defeat before there was a vote. Paul was among lawmakers adamant the bill would not have enough support in the House nor the Senate. Paul had knocked the plan as "ObamaCare Lite" and insisted that Conservatives in Congress would not have allowed it to pass. (Firozi, 4/2)

The crash of the House Republican health care bill may well have transformed an issue the party has long used to bash Democrats into the GOP's own political nightmare. Since former President Barack Obama's health care overhaul was enacted in 2010, Republicans have blamed Democrats for rising premiums and diminished choices of insurers and doctors in many markets. Repealing Obama's law has been a paramount GOP campaign promise that helped them grab control of the House that year, the Senate in 2014 and elected Donald Trump to the White House last November. (Fram, 4/1)

Republican aides are reeling from the implosion of their attempt to repeal President Barack Obama’s health care law, according to the latest CQ Roll Call Capitol Insiders Survey. Paul D. Ryan’s approval rating among House GOP staffers has dropped to its lowest level since he became speaker in 2015, plummeting from 85 percent three weeks after Election Day to 44 percent in March. Those are levels not seen — for either party’s congressional leaders — since the ouster of Ryan’s predecessor, John A. Boehner of Ohio, a year and a half ago. (Zeller, 4/3)

A group of conservative organizations on Friday circled the wagons for the House Freedom Caucus in the face of attacks by President Donald Trump and other Republicans over the failure of the House GOP’s health care plan. On Friday morning, a week after the bill’s failure and day after some HFC members were name-checked by the president on Twitter, representatives from nine conservative groups held a conference call for reporters to offer the lawmakers political cover. (Yokley, 3/31)

Conservatives are feuding with the White House over health care. House Speaker Paul Ryan is warning President Trump against doing a deal with Democrats. If there's a path to health reform, it may run through moderate Republicans — and on this PULSE CHECK, you’re going to hear from two of the most prominent in Congress. (Diamond, 3/31)

Anthem is the latest major insurer to voice its displeasure with the uncertainty and political gamesmanship roiling the Affordable Care Act markets, and is now sending signals that it may pull out of the system next year. (Pianin, 3/31)

Obamacare repeal may be dead, but health industry interests aren’t giving an inch in their assault on the law’s many taxes. High profile targets like the excise tax on medical devices, the "Cadillac tax" on expensive health plans and the tax on insurance premiums — as well as a number of other measures that business found onerous — would have all been terminated or delayed for years under the repeal bill that collapsed in the House. (Demko, 3/31)

When Republicans pulled their Affordable Care Act replacement bill, Lauren Lake’s primary reaction was relief. But like a lot of people who depend on state exchanges for coverage, the 51-year-old consultant also was wary. That’s because she knows the Trump administration could still undo an important part of the law she depends on to afford health care. (Ibarra, 3/31)

Democrats eying the 2020 presidential contest could soon face a "Medicare-for-all" litmus test from the party's progressive base. After last month's failure of President Donald Trump and congressional Republicans to repeal Obamacare, progressives are going on offense, mounting a new push for single-payer health insurance. (Bradner, 4/3)

House Minority Leader Nancy Pelosi (D-Calif.) is pressing Democrats to hold back on specific ObamaCare fixes a week after President Trump and House Republicans failed spectacularly in their bid to repeal the landmark law. Pelosi has told members to bring any suggestions to leadership before making them public, a stance intended to prevent Republicans from putting a target on them and avoid freelancing by her own members. (Illis and Marcos, 4/1)

About two hundred people on Saturday attended a town hall event in Olathe where they questioned nine Republican lawmakers about their positions on Medicaid expansion and school financing. Many held placards expressing support for more Medicaid funding. All of the lawmakers present were opposed to expanding the program and agreed with Gov. Sam Brownback’s decision to veto an expansion bill passed overwhelmingly last month by the Legislature. (Wood, 4/2)

Supporters of expanding Medicaid eligibility in Kansas are preparing to mount an intense lobbying campaign over the weekend to get the votes they need to override Gov. Sam Brownback’s veto of an expansion bill. The governor vetoed the bill on Thursday, citing concerns about the cost of expanding KanCare, the state’s privatized Medicaid program, to cover an estimated 180,000 additional low-income Kansans. He also objected to extending coverage to “able-bodied” adults as long as thousands of Kansans with disabilities remained on waiting lists for support services. (McLean, 3/31)

Brownback argued in his veto message that the Medicaid expansion bill is bad because it doesn't include a strict requirement that all able-bodied adults find a job. “We cannot help our citizens build better lives without also incentivizing them to find a permanent path out of poverty,” he wrote. But Krista Postai, CEO of the Community Health Center of Southeast Kansas, said that's the wrong way to look at the issue. Her clinic treats many working people who don't seek preventive care because they lack insurance and can't afford to pay for those services. Even with the clinic's help, they often can't access needed specialty care. “We have people working three jobs with no coverage,” she said. “If you want to maintain a healthy workforce, they need to have preventive care.” (Meyer, 3/30)

For the rest of his time in office, Kansas Gov. Sam Brownback will face a series of veto fights with a state Legislature elected on the promise of undoing his legacy. This will be the case whether Brownback remains in office through the end of 2018 or whether he leaves in the next few months for a job in President Donald Trump’s administration, a prospect that has been highly speculated. Brownback has used his veto power this session to block lawmakers from rolling back his signature income tax cuts and to prevent the state from expanding Medicaid through the Affordable Care Act to provide health coverage for 150,000 low-income Kansans. (Lowry, Shorman and Woodall, 4/1)

Some Republican-led states are rethinking their refusal to expand Medicaid in the aftermath of the failed House effort to bulldoze the Affordable Care Act. Insurers that operate Medicaid plans are seeing dollar signs. But expansion to low-income adults continues to face resistance from some GOP governors, state lawmakers and conservative advocacy groups, who say states can't afford it and it creates welfare dependency. (Livingston, 4/1)

In all, 31 states and the District of Columbia have expanded Medicaid after the Affordable Care Act passed in 2010. The majority acted so that the expansion went into effect in 2014. A handful of states, including Louisiana and Montana, that first rejected the expansion have since embraced it. But those efforts face the same political and ideological fights that have plagued health care policy in Washington, You could hear the echoes in Topeka last week. (Kodjak, 3/2)

Tennessee Democrats describe the death of the American Health Care Act in Washington last week as a gift from God and a new opportunity for the state to expand Medicaid to provide health insurance to as many as 400,000 additional low-income Tennesseans. But Republicans have been much more reserved, suggesting a more strategic approach might be the best route forward. House Minority Leader Craig Fitzhugh, D-Ripley, said Thursday that the tabling of the Republican plan to repeal and replace the Affordable Care Act, commonly known as Obamacare, was unexpected. He said the move offers state lawmakers an opportunity to start collecting $2.5 million per day in federal funding the state has foregone by not expanding Medicaid as called for under Obamacare. (Lowary, 3/31)

Now that House Republicans have squandered their shot at reordering Medicaid, governors who want conservative changes in the health program for ­low-income Americans must get special permission from the Trump administration. Near the front of the line is Wisconsin Gov. Scott Walker, a Republican who not only supports work requirements and premium payments but also a new additional condition: to make applicants undergo a drug test if they’re suspected of substance abuse. (Winfield Cunningham, 4/2)

Indiana’s alternative Medicaid program enabled one Hoosier to get life-saving back surgery. ... “If it wasn’t for HIP 2.0, I would be dead,” one patient wrote in comments the U.S. Department of Health and Human Services collected as part of the agency’s consideration of Indiana’s request to continue the program, which has been touted as a model for other states. Criticism, however, was more prevalent than praise in the nearly 100 comments submitted. (Groppe, 4/3)

More than 1 million Minnesotans get coverage from Medicaid, the joint state-federal program to provide medical care to needy Americans. The majority are families with children, eligible for taxpayer-supported coverage because of their low income. But Medicaid — also called “Medical Assistance” in Minnesota — also covers people like David Bender, a 30-year-old St. Paul resident with severe mental and physical disabilities. ... But this life-saving care for some of Minnesota’s more vulnerable citizens doesn’t come cheap. The Medicaid programs covering elderly and disabled Minnesotans account for about 20 percent of enrollment — but almost 60 percent of the $11 billion Minnesota spent on Medicaid last year. (Montgomery, 4/2)

[For] some of the 3,814 non-US citizens who graduated from foreign schools and who won coveted residencies in the United States, it’s unclear whether they’ll be able to start work on time in the summer. That’s because a program that allows employers to fast-track H-1B visa applications for their employees has been suspended as of Monday. US immigration officials announced the change just a month ago — and Match Day, when new residents learn where they will be placed was March 17 — leaving some hospitals rushing to figure out who needed this kind of visa and to apply before “premium processing” would no longer be an option. (Boodman, 4/3)

The Trump administration’s proposal to slice nearly $6 billion from the $32 billion budget of the National Institutes of Health was met with a near universal outcry from researchers, patient advocates and, most importantly, Republican appropriators. But one lawmaker in particular defended the idea: Rep. Andy Harris, a Maryland Republican and former physician whose name was previously floated as NIH director...But Harris — a member of the House Appropriations subcommittee that controls NIH funding — has a proposal to trim the NIH budget that could gain traction as lawmakers look at belt-tightening options across the government. (Siddons, 4/3)

Kellyanne Conway received almost $13,000 for a recent consulting arrangement with the American Association for the Advancement of Science, a group playing a central role in organizing the upcoming March for Science in Washington. Financial disclosure forms released Friday evening by the White House showed that Conway, a senior counselor to President Trump, made thousands of dollars in the past year from a number of consulting arrangements, including jobs with advocacy organizations that oppose abortion and with the trade group that represents dietary supplements and over-the-counter medications. (Facher, 4/1)

Cecile Richards, the president of Planned Parenthood Federation of America, was poring over a spiral notebook in her bare-bones office here when she was asked about President Trump’s latest attempt to cut a deal on abortion. Days earlier, the Trump White House had floated a trial balloon: If Planned Parenthood would quit performing abortions, it could keep roughly $550 million in annual federal funding. (Stolberg, 3/31)

Governor Branstad is throwing his full support behind anti-abortion legislation making its way through the Republican-controlled legislature, saying the new GOP majority in the Iowa Senate is making it possible. Branstad backs a bill to ban abortion after 20 weeks of pregnancy that has passed the Iowa Senate and is now awaiting a vote in the full House. (Russell, 4/3)

Gov. Doug Ducey has signed into law a bill regulating how doctors must care for a baby born alive during an abortion. His office announced the action on Senate Bill 1367 without any comment. It was folded into a list of 12 other bills the governor acted on. (Rau and Pitzl, 3/31)

It sounds like science fiction, but a cap-like device that makes electric fields to fight cancer improved survival for the first time in more than a decade for people with deadly brain tumors, final results of a large study suggest. Many doctors are skeptical of the therapy, called tumor treating fields, and it's not a cure. It's also ultra-expensive — $21,000 a month. (4/2)

A wearable medical device that delivers electrical fields through the scalp helped to extend the survival of patients with lethal brain tumors, according to data presented Sunday. In a study involving major medical centers in the United States and abroad, the novel treatment was used to administer alternating, low-intensity “tumor-treating fields” to newly diagnosed glioblastoma patients who also were getting chemotherapy. Such electrical fields may block the division of cancer cells and cause their demise, according to Roger Stupp, the study's lead investigator and a neuro-oncologist at the Northwestern University Feinberg School of Medicine. (McGinley, 4/2)

When actor Michael Douglas told a reporter that his throat cancer was caused by HPV contracted through oral sex, two themes emerged that had nothing to do with celebrity gossip. The first was incredulity — since when was oral sex related to throat cancer? Even the reporter thought he had misheard. The second was embarrassment. This was too much information, not only about sexual behavior but also about one’s partners. Douglas apologized, and maybe the world was not ready to hear the greater truth behind what he was suggesting. That was four years ago. (Schaaff, 4/2)

The first time cardiologist Sonia Tolani performed CPR outside a hospital was in 2009.She was on the subway in New York City, headed home from work, when she saw a man slump to the ground and stop breathing. "It was super crowded, it was like rush hour," she remembers. "I just decided we needed to do something, and dragged him out into the center of the subway train [and] I just started doing CPR." (Hersher, 4/3)

One in four middle school and high school students report that they have been exposed to secondhand smoke from e-cigarettes in the past 30 days, according to a new study by researchers at the Centers for Disease Control and Prevention. (Naqvi, 3/31)

Eighteen months after joining a study on using marijuana to treat post-traumatic stress disorder, Johns Hopkins University has pulled out without enrolling any veterans, the latest setback for the long-awaited research. The university said its goals were no longer aligned with those of the administrator of the study, the Santa Cruz, Calif.-based Multidisciplinary Association for Psychedelic Studies (MAPS). MAPS said the dispute was over federal drug policy and whether to openly challenge federal rules that say medical cannabis research must rely on marijuana grown by the federal National Institute on Drug Abuse. (Gregg, 4/2)

Bristol Hospital President and CEO Kurt Barwis has been sending policymakers a report that paints a grim picture of the future of small community hospitals like the one he runs. Based on more than a year of research, the report from the Massachusetts Health Policy Commission suggests community hospitals in that state face something of a downward spiral: Patients are increasingly seeking routine care at large academic medical centers or teaching hospitals, drawn by perceptions of quality or referred by doctors who are now affiliated with the larger hospitals. (Levin Becker, 4/3)

Across Tennessee, 61 hospitals help keep small towns healthy and bustling through access to a variety of health care services and salaries. The hospitals have a combined economic impact of $994.7 million and support 15,654 jobs, according to the Tennessee Hospital Association. Many of the facilities, and smaller communities, are struggling amid a confluence of factors, including changes in how hospitals are reimbursed, expensive technology and challenges in physician recruitment. Since 2013, eight hospitals have closed or drastically changed their services. This often leaves a crater in the community as jobs and emergency care disappear. (Fletcher, 3/31)

A long-pending plan to bring more federal Medicaid dollars to more than two dozen private Virginia hospitals has run into opposition from Gov. Terry McAuliffe and General Assembly budget leaders who now fear the plan could cost the state big money in the long run. (Martz, 4/2)

A New Jersey lawmaker wants to offer tax credits to organ donors, but his no-strings approach is meeting opposition from groups who believe the practice runs afoul of federal law. While the National Organ Transplant Act makes it illegal for hospitals to pay for organs, 19 states provide either a tax credit or deduction for verifiable, unreimbursed expenses related to living organ donations, said Troy Zimmerman, of the National Kidney Foundation. In some states, the benefit also includes the donor's lost wages. (4/2)

The Florida House on Thursday overwhelmingly approved a bill that would clear the way for doctors and patients to enter into "direct primary care" agreements. The bill (HB 161), which passed in a 107-6 vote, is backed by physician and small-business groups. Under direct primary-care agreements, patients would make regular payments to physicians to cover routine care, cutting out the role of insurers. (3/31)

Ironically, all of the universal health care buzz is coming after the GOP’s plan to replace the Affordable Care Act with a bare-bones substitute plan collapsed. The Congressional Budget Office had estimated that the Republican plan would have decreased the federal deficit by more than $300 billion, but increased the ranks of uninsured Americans by 24 million by 2026. (Seipel, 4/2)

Dozens of families remained at a lead-contaminated public housing complex in northwest Indiana despite a Friday target date to move them out so the city could tear down the buildings. More than 270 families have left the housing development, West Calumet Housing Complex in East Chicago, and officials hope to have the remaining 50 or so families out within a week. (4/1)

The initiative that became known as Proposition 106 passed in Colorado last November by roughly a 2-1 margin. An emotionally charged campaign weighed a terminally ill individual’s desire to end their own suffering against religious and ethical opposition as well as concerns about protecting the elderly and people with disabilities...When Herb first began to pursue the end-of-life option for his wife, he thought Kathy’s hospice care would be on board with providing a doctor. But that proved not to be the case. (Simpson, 4/2)

In the latest ruling in Florida's "certificate of need" battles, an administrative law judge said this week that the state should reject a proposal by Baptist Hospital of Miami to establish an inpatient bone-marrow transplant program. (4/2)

Students’ mental health, anxiety — and the drugs they take to cope — were up for discussion during a Burbank school board study session Thursday, nearly one year after the board established a mental health and wellness plan. Since the plan was approved last April, Burbank officials have opened a mental health and wellness office at John Burroughs High School, trained teachers in suicide prevention and hired John Costanzo to serve as a mental health and wellness coordinator to oversee districtwide efforts. (Corrigan, 3/31)

Currently, about 14 percent of Georgians are uninsured. And many of these people have problems — such as mental health issues — that need highly specific care. They often turn to charitable organizations for help. (Martin, 4/2)

His face flushed from the effort, Jered Chinnock straightened his back after a therapist helped position his feet on the floor of a Mayo Clinic hospital lab. He paused, concentrating, before he gently loosened his grip on the metal railing at his side. (Louwagie, 3/31)

Plunk down a pack of cigarettes at the cash register and be prepared to pay up, way up. As of April 1, Californians are forking over an extra $2 per pack. Some smokers this past week said they were stocking up on cartons, ahead of Saturday’s price hike. Others said it’s jolting them into finally snuffing out cigarettes for good. (Buck, 4/1)

California’s $2-per-pack cigarette tax increase, which goes into effect Saturday, is causing tension between the state’s Medicaid providers and Gov. Jerry Brown. (Colliver, 3/31)

Last month, President Trump demonstrated how not to bring a health care bill before Congress. Fifty-two years ago, President Lyndon B. Johnson — a parliamentary wizard with more than three decades of Capitol Hill experience — established a model for how to do it with his landmark program for Medicare. ... This year, while House Speaker Paul D. Ryan helped to shape the Trump proposal, the president did not show deep knowledge of the bill and relied largely on congressional Republicans to manage its progress. By contrast, Mr. Johnson mastered the details of his own legislation, and through inspiration, arm twisting and other maneuvering, pushed it through the House and Senate despite powerful opponents like the American Medical Association. (Michael Beschloss, 3/31)

The failure of the Republican Party to parlay its control of the White House and Congress into a repeal of Obamacare launched a predictable blame game in Washington. The Tea Party-inspired House Freedom Caucus, which opposed its party’s “repeal and replace” substitute, faulted House Speaker Paul Ryan. Turns out these three dozen conservatives were always more about “repeal” than “replace.” (Carl M. Cannon, 4/2)

But if anything has become clearer as the dust settles, it's that neither side in the health care debate can afford a continuing standoff that preserves the status quo. Sooner or later, our elected leaders in Washington are going to have to make a choice: Either they construct a new health care system that strips coverage from tens of millions who obtained it under the Affordable Care Act, or take proactive steps to support and strengthen the superstructure that supports the current health care scheme. (Brian Dickerson, 4/1)

By now it has become clear that the Trump administration, much like its predecessor, imagined that its health care mission was to devise another universal insurance plan to optimally distribute limited health care resources (like Obamacare only better). But had the Administration’s proposal actually passed, it would have likely guaranteed the GOP ownership of both old and new failures because the current occupants of both the Whitehouse and the Congress still fail to understand the difference between a health care crisis and a crisis in health care financing — a distinction that demands better medicine before better law. (Anthony J. Nania, 4/2)

The conventional wisdom—repeated by President Trump—is that the right-wing House Freedom Caucus is singlehandedly blocking Republican attempts to repeal and replace Obamacare. In fact, Freedom Caucus members have been reaching out to the larger bloc of “no” votes—GOP moderates—to find a path forward. Moderates are rebuffing them. Here’s why. (Avik Roy, 4/2)

After the collapse of the Republican health-care bill, President Trump said he wanted to work with Democrats on a bipartisan deal to improve the Affordable Care Act. A historic deal is possible, one that would lower premiums and expand coverage — simply by extracting and passing just two parts of the GOP’s measure. (Topher Spiro and Emily Gee, 4/3)

On a beautiful spring day five years ago, a blood vessel burst in the back of my brain. I was airlifted to the hospital for emergency brain surgery. Neurosurgeons repaired the aneurysm — a balloon-like bulge in an artery that had exploded. During the operation, doctors discovered two other aneurysms, both waiting to blow. (Melanie Ormand, 4/3)

What will Paul Ryan and the Trump administration do now that they have failed to repeal Obamacare? They’ll try to sabotage it. After their legislative debacle, they said they would let Obamacare explode on its own, after which, they hope, the Democrats will come crawling to them, pleading for a new plan. “I’m open to that,” President Trump announced. (Donald M. Berwick, 4/1)

Parts of the country are in jeopardy of not having an insurer offering Obamacare plans next year. Many counties already have just one insurer offering health plans in the Obamacare marketplaces, and some of those solo insurers are showing signs that they are eyeing the exits. (Margot Sanger-Katz, 3/31)

When the Affordable Care Act passed in 2010, few provisions were more controversial on both sides of the aisle than the Independent Payment Advisory Board. This board was created to cap Medicare spending growth, proposing cuts that automatically take effect unless Congress passes similar reductions. Congress can adjust the types of cuts, but it cannot change the dollar amount. Since ACA’s adoption, the advisory board has not received much attention because Medicare spending has not increased enough to spur it to action. But that is about to change. (Sara Radcliffe, 4/2)

There seems to be little that people agree on these days regarding the Affordable Care Act. Perhaps, though, there could be a consensus that insurers need to behave honestly, all the more so when we punish people for not having insurance. Previously unexamined data released last month from data.healthcare.gov exposes a problem with Obamacare insurers: they are varying hugely in their willingness to pay claims and their willingness to admit claims processing mistakes. Although there may be innocent explanations for the variation, the alternative possibility -- some insurers are systematically chiseling on claims -- can not be dismissed. The federal government and the states, who retain primary regulatory authority over health insurers, need to examine with greater care ACA insurer claims adjusting practices. (Seth Chandler, 3/31)

Republicans in Congress and statehouses across the country harbor an antipathy to Medicaid that is impossible to explain, except as hostility to the poor families that are its chief beneficiaries. Sam Brownback, the GOP governor of Kansas, translated ideology into action on Thursday when he vetoed a bill that would have made Kansas the 32nd state to expand Medicaid under the Affordable Care Act. The measure would have brought health coverage to as many as 180,000 of his state’s residents, with the federal government picking up 95% of the tab this year. Yet in his veto message Brownback called the expansion an “irresponsible” budget-buster. (Michael Hiltzik, 3/31)

Medicaid expansion in deep red Kansas? It could happen, and if it could happen there, it could happen anywhere, including North Carolina. Health care advocates planned to spend the weekend deluging Kansas legislators with phone calls and emails, urging them to expand Medicaid to some 150,000 residents. The House and Senate – each controlled by Republicans – approved the expansion easily last week, and now will try to override a veto from Gov. Sam Brownback. (4/2)

Republicans in Richmond have a choice to make. They can choose to stand up for health and opportunity for their constituents and a stronger Virginia economy, or they can allow divisive partisan politics to continue to hurt their commonwealth. For the past 3½ years, Virginia has been engaged in a discussion about joining the 31 states that accepted federal funding to expand Medicaid and offer more citizens access to quality health care. If you are a taxpayer in Virginia, Republicans in Richmond have so far blocked your federal tax dollars from coming home, even as you have been paying for Medicaid expansion in West Virginia, Maryland and the District. (Virginia Gov. Terry McAuliffe, 3/31)

Last week, Missouri Gov. Eric Greitens appeared to open the door, however slightly, to expanding Missouri’s Medicaid program now that Republican efforts to repeal and replace the Affordable Care Act have stalled. This would be an excellent idea, and long overdue. Missouri is one of 19 states that failed to expand Medicaid after the enactment of Obamacare in 2010. The decision has cost a state’s struggling economy billions of dollars and thousands of jobs — to say nothing of improved health outcomes for 150,000 to 300,000 Missourians who could have become eligible for coverage. (4/1)

With Trumpcare dead for now, expect Republican governors to begin submitting waiver proposals to the Department of Health and Human Services to move their Medicaid programs in a more conservative direction. Medicaid "work requirements" are likely to be an element of many of those waiver requests, possibly from Republican-led states now looking to expand Medicaid under the Affordable Care Act. (Drew Altman, 4/3)

Medicaid is an efficient and effective health coverage program for Texas children, and federal and state governments should continue to stabilize and improve the program’s coverage and benefits for children. About 3.5 million children in Texas are enrolled in Medicaid or the Children’s Health Insurance Program, or CHIP. That’s about half of the children living in Texas, yet children don’t drive Medicaid costs. Nondisabled children make up about 70 percent of the Medicaid caseload in Texas but account for only 30 percent of the spending. (Stacey E. Wilson, 4/2)

The state’s Medicaid program, the Arizona Health Care Cost Containment System, has dodged a couple of bullets recently. But there is a bullet inevitably coming that it will not be able to dodge. (Robert Robb, 3/31)

Last week, just a few days after the White House proposed dramatic cuts to health and development aid, I headed to Indonesia. The timing was coincidental — the trip had been planned for months — but the reason I was going happened to be especially relevant to our country’s national debate. Indonesia has strategically used foreign aid to transform itself from a poor nation into a middle-income one. I was there to talk about the role that smart investments in contraceptives have played in the transformation. (Melinda Gates, 4/2)

While success is important, so is trying: Trying to make a difference. Trying to make a change. Trying to speed up the progress of what we know will eventually come but is taking too long. Trying to spare another family from the horrific conversation that there’s nothing that can be done for their dying loved one. Disruption is always uncomfortable, and it doesn’t happen overnight. (Howard Krein, 3/31)

He is breathing better and the doctors say his lungs will recover, but he can’t remember his appointments or where he put his keys. It has been months since the surgery and the scars are fading, yet she still wakes almost nightly to the sound of phantom alarms. Those are the sorts of stories I heard one morning at a support group for patients who had survived a critical illness and their family members. ... And it was among the first times that I — then a doctor in my final year of critical care training — had heard directly from them about their lives after the I.C.U. (Daniela J. Lamas, 4/1)

Jim Durgeloh, 59, was desperate to avoid surgery. After a career as a construction contractor and hours of leisure time spent on a motorcycle around his Longview, Wash., home, he was facing an operation to replace his left hip. “That’s pretty invasive,” he said, nervous about a surgery that would require being cut open and implanted with an artificial hip; Jim’s brother had died from complications after a similar operation. In the search for an alternative, he and his wife, Janet, happened upon the website for La Jolla-based StemGenex Medical Group, which touts itself as “the world’s first and only Stem Cell Center of Excellence.” (Michael Hiltzik, 3/31)

Millions OF Americans, seeking improved health, take “natural product” dietary supplements, from Gobi berries to Echinacea. With little or no evidence that these products confer health benefits, ongoing struggles between the supplement industry and the medical science community are hardly surprising. So why did seven Nobel laureates associate with a company that markets an unproven dietary supplement — especially at a time when the integrity and reproducibility of bioscience research is being questioned? In this case, the product was marketed as an “anti-aging” supplement that improves “cellular health,” a description that connects it to a lineage of “cures,” remedies, and “miracle drugs” that extend back at least as far as the Fountain of Youth. (Jeffrey S. Flier, 3/31)