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A bipartisan group of negotiators worked through the weekend in hopes of striking a year-end spending deal by Monday so Congress has enough time to pass the legislation before Dec. 11 and avert a government shutdown. The weekend sessions came after Democrats rejected an initial proposal from Republicans last week that included dozens of policy riders that GOP lawmakers wanted to attach to the must-pass legislation. ... The biggest issue facing negotiations on the omnibus spending bill is the policy riders being pushed by Republicans. ... Democrats said they will not budge on any riders aimed at attacking abortion rights, curbing funds for Planned Parenthood or undermining President Obama’s executive actions on immigration. (Snell, 12/7)

Congress has until Friday to pass a $1.15 trillion spending bill to keep the government running once its current funding expires Friday. Lawmakers agreed to the bill’s overall spending level when they passed a two-year budget agreement in late October, during Mr. Boehner’s final week in office. But Republicans and Democrats have found plenty to disagree over since then as they hashed out funding for individual government programs and sparred over which other policy measures should get attached to the bill. ... Conservatives said they also need to see some antiabortion measures included in the spending bill. Rep. Jim Jordan (R., Ohio), chairman of the Freedom Caucus, said more than 100 Republicans signed a letter to GOP leaders backing antiabortion provisions, including one permitting states to decide whether to withhold federal Medicaid funding from Planned Parenthood Federation of America. (Peterson, 12/6)

Dramatic price increases for several medicines are scheduled to be the subject of a congressional hearing in the coming week. Companies including Valeant Pharmaceuticals International Inc. and Turing Pharmaceuticals AG have been under fire this year from doctors, patients and lawmakers over rising drug costs. Such increases have prompted investigations by congressional committees, and House Democrats have established a task force to probe drug pricing. On Wednesday, the Senate Special Committee on Aging is scheduled to hold a hearing further exploring the matter. (Rockoff, 12/5)

A former hedge fund manager, Mr. Shkreli drew the wrath of consumers, became a talking point in the presidential campaign, and spurred federal and state inquiries as well as a dialogue about how and whether to control rising drug prices. As proof of Mr. Shkreli’s toxicity, Bernie Sanders rejected his $2,700 campaign donation, turning it over to a health clinic instead. ... Mr. Shkreli’s price increase is likely to take another pummeling at a Senate committee hearing investigating skyrocketing drug prices next Wednesday. Rather than cower as he takes a beating, Mr. Shkreli seems to relish his time in the ring. (Creswell and Pollack, 12/5)

Senate Republicans have finally fulfilled their long quest to pass legislation repealing President Obama’s landmark health care law, and Congress will soon send the measure to the White House, where it might have a chance of being folded into origami or a fleet of paper airplanes, but no possibility of being signed into law. ... So, what next? It is unclear that lawmakers have drawn constructive lessons from the experience, and there is no sign that either party will use the repeal vote as a cathartic turning point onto a more cooperative path. (Herszenhorn, 12/4)

Senate Republicans Thursday employed a special budget maneuver to pass a bill that would repeal the 2010 health care law and strip Planned Parenthood of federal funding for a year. The tactic allowed them to get around the Senate’s usual 60-vote threshold; this one could pass with a simple majority. The White House has said President Barack Obama would veto the bill, so the measure is largely symbolic. At the same time, the open amendment process involved in passing the bill, known as a reconciliation measure, ended up putting some senators on the record on some hot-button issues and on aspects of the health care law itself. The votes could provide a window into the kind of support some of these measures could get as standalone bills, if senators were to bring them up. They also could be used by the opponents of incumbents running for re-election next year (or running for president). As a result several of these votes could have meaning down the line. (Armour and Hughes, 12/4)

Standing in the shadow of the towering rebuilt World Trade Center, scores of firefighters and police officers, led by Mayor Bill de Blasio and two United States senators from New York, rallied on Sunday to press Congress to extend a 9/11 health bill. The bill would pay for medical care for emergency medical workers and others, including police officers, firefighters and construction workers who risked their lives on Sept. 11, 2001, or in the weeks and months after to recover bodies and begin the cleanup. They were exposed to toxic chemicals that have sickened or killed many of them. (Foderaro and Schlossberg, 12/6)

Lawmakers, however, are pushing for the Zadroga Act to be included in one large bill, known as a omnibus, that must be passed by Dec. 11, when the congressional session ends for the holidays. “We will not, we cannot, we won’t walk away without a permanent 9/11 bill to protect the health care and the lives of our first responders,” said U.S. Sen. Charles Schumer. (Morales, 12/6)

The New York health exchange says it's partnering with CVS Pharmacy, Kinney Drugs and TOPS Markets around the state to educate New Yorkers about insurance coverage available through the online exchange. (12/7)

After spending hours at a recent meeting talking about the costs of Louisiana's health care costs without discussing Medicaid expansion, the Senate Finance Committee now plans to prepare a report on the implications of expanding the federal program. The effort to gather and report information on Medicaid expansion is significant because accepting more federal money to pay for health care for the poor has been off the table for years. As a result, Legislators have not really grappled with the complexities of changing the state's approach to health care until it became clear the next governor would accept Medicaid expansion -- one of the key elements of the Affordable Care Act. (Litten, 12/5)

As Gov. Dennis Daugaard considers whether to expand Medicaid coverage to more low-income South Dakota residents, he is seeking assurances the expansion can be paid for, and may add a requirement that new recipients must have jobs. Daugaard may reveal his intentions in his budget address to the state next week, a top aide said Thursday. The governor has been seeking definite proof that the $46 million annual cost for Medicaid expansion starting in 2020 can be covered by savings on current spending on Medicaid services in South Dakota, a member of his senior management team said. (Mercer, 12/4)

Wyoming's Legislature has for several years rejected Medicaid expansion, despite studies indicating it would save the state money. Now, with the state facing a major budget shortfall, Gov. Matt Mead is recommending lawmakers expand Medicaid, arguing that accepting federal money for the program will help the state weather the economic downturn. But many of the Wyoming lawmakers who resisted expansion in the past say they are likely to continue to oppose it, even as the state looks for ways to save money. (Hancock, 12/6)

Kaiser Permanente has agreed to acquire a major health insurer in Washington state, signaling a more aggressive expansion strategy for the big California-based managed-care operator at a time when its integrated model is increasingly fashionable. The nonprofit’s acquisition of Seattle-based Group Health Cooperative, which like Kaiser includes both an insurance arm and health-care providers, would bring about 590,000 new members and a far broader geographic footprint in the state of Washington. (Wilde Mathews, 12/4)

Healthcare giant Kaiser Permanente has agreed to acquire a big insurer in Washington state and signaled the pursuit of similar deals across the country. The nonprofit HMO and health system said Friday that it was buying Seattle-based Group Health Cooperative, which insures nearly 600,000 people. Because the deal involves two nonprofit organizations, Kaiser said it would contribute $1.8 billion to a new foundation in Washington to complete the transaction. (Terhune, 12/4)

A study published last year in the Journal of the American Geriatrics Society, supported by other research, found that home-based primary care lowered costs as well as emergency room visits and hospitalization rates while increasing patients’ satisfaction with care. Now, a group of doctors — including Hernandez’s — is pushing to bring house calls to the nation’s 2 million oldest, frailest and costliest patients, saying it has the potential to save the government billions of dollars. Independence at Home was developed by a group of doctors around the country who were already making house calls to such patients. (Bahrampour, 12/6)

The ranks of older and frail adults are growing rapidly in the developed world, raising alarms about how society is going to help them take care of themselves in their own homes. Naira Hovakimyan has an idea: drones. ... Her research is just one example of many approaches being studied to use technology to help aging people. (Markoff, 12/4)

Since 2003, strict rules have limited how long medical residents can work without a break. The rules are supposed to minimize the risk that these doctors-in-training will make mistakes that threaten patients' safety because of fatigue. But are these rules really the best for new doctors and their patients? There's been intense debate over that and some say little data to resolve the question. So a group of researchers decided to follow thousands of medical residents at dozens of hospitals around the country. (Stein, 12/7)

A national campaign for electronic health records is driving business for at least 20 companies with thousands of workers ready to help stressed doctors log the details of their patients’ care — for a price. Nearly 1 in 5 physicians now employ medical scribes, many provided by a vendor, who join doctors and patients in examination rooms. They enter relevant information about patients’ ailments and doctors’ advice into a computer, the preferred successor to jotting notes on a clipboard as doctors universally once did. (Gillespie, 12/7)

One of the most difficult things about losing her son was not knowing why. Rosanne Carruthers needed to understand how an active, outdoorsy man with no apparent health problems could drop dead at 34. Carruthers, a nurse, performed CPR after her son, Neil, collapsed in their suburban Boston home. For more than a year, she wondered: Was there something more she could have done? And were her daughter and her grandchildren at risk, too? For the Carruthers family and others across the country, long delays in receiving death certificates and autopsy reports from medical examiners can not only compound grief, but also can create financial hardships by holding up life insurance payouts and other benefits. The delays are driven largely by underfunding, a severe shortage of medical examiners and relatively low pay when compared with other medical specialties. (Lavoie, 12/7)

A new report from Fitch Ratings shows the outlook for nonprofit hospitals, which makeup the bulk of the nation’s inpatient health facilities, have built a “solid financial cushion to absorb potential operating volatility” in 2016. “Clinical volumes in 2015 were higher than anticipated, primarily reflecting the benefits of increased coverage under the ACA, as well as growth in the Medicare population and a higher level of activity from commercial beneficiaries,” Fitch said in its report. “Providers in Medicaid expansion states experienced particularly higher clinical volumes with material reductions in charity care and bad debt expense. Clinical volumes from Medicare and commercial payors were also fairly solid with inpatient admissions holding steady year over year and higher levels of outpatient activity.” (Japsen, 12/6)

A new Obama administration report out this week showing that federal government spending on Medicare, Medicaid and Obamacare surged in 2014 by 11.7 percent after years of relative stability is rekindling a controversy over generational disparities in the government’s spending priorities. While a considerable chunk of the $844 billion of federal health care spending last year went for children and younger adults, Medicare spending for seniors hit a total of $618.7 billion in 2014 and accounted for 20 percent of total health expenditures. (Pianin, 12/4)

A group seeking to lead a broad national effort by consumers to make health care more affordable and available has formed in Washington, contending that even with more widespread insurance coverage under the Affordable Care Act, many people cannot obtain the care they need. Partners for Better Care claims it already represents 10 million patients through affiliations with other advocacy groups such as AIDS United, the Parkinson’s Action Network and United Cerebral Palsy. The organization also is hoping to enlist larger health care advocacy groups. (Bernstein, 12/4)

At the Iowa Taxpayers Association's annual symposium on Friday, elected officials discussed Medicaid and the program's transition into management by four private, for-profit companies. The change is scheduled for January 1st, but many say this is a rushed deadline. State Senate Majority Leader Mike Gronstal, a Democrat from Council Bluffs, says he anticipates that during the next legislative session, a lot of focus will be devoted to resolving Medicaid-related issues. (Boden, 12/4)

Treyner [Ramus], adopted by his Bondurant family as a 3-year-old through Iowa’s foster care program, was exposed to methamphetamine and cocaine before and after birth, causing brain injury. ... Now 8, the child’s extensive health care, much of which is covered by Medicaid, is essential to his survival and development, his parents say. They have so far been unable to determine which one of the four companies hired by the state to manage the program is best for their child. Kelly Ramus will tell her son’s story on behalf of her family and other families to a legislative oversight committee Monday. She plans to ask state leaders to delay the transition. The next day, officials from the federal Centers for Medicare and Medicaid Services are scheduled to arrive in Iowa to conduct a review. They could scuttle the planned Jan. 1 launch if they find the state isn't ready for the changes. (Clayworth, 12/6)

The fight between Connecticut’s hospitals and Gov. Dannel P. Malloy over $240 million in cuts to state aid is getting personal. The hospitals have made Malloy the target of a television ad blitz decrying the cuts, and the governor is returning the favor by shaming health care executives over their salaries and profit margins. Grappling with a $350 million budget deficit, Malloy said he has no sympathy for his critics in what he called the “hospital industrial complex.” (Vigdor, 12/6)

Hutcheson Medical Center closed its doors to patients Friday morning, after being unable to strike a deal to avoid a shutdown. The northwest Georgia hospital’s closure came after months under bankruptcy protection. ... Hutcheson is the fifth rural hospital to close in Georgia since the beginning of 2013. (Miller, 12/4)

Roosevelt. Love it or hate it, the name resonates in American history. ... And in New York City, since the years just after the Civil War, it has meant an important hospital on the West Side of Manhattan. No longer. In November, the Mount Sinai Health System, into which Roosevelt Hospital was merged two years ago, formally dropped the Roosevelt name. After 146 years, it announced, the hospital would now be called Mount Sinai West. (Dunlap, 12/4)

Hospital chains in Phoenix and Tucson that are owned by a Dallas-based corporation are on the verge of ending contracts with Blue Cross Blue Shield of Arizona in a dispute that could create costlier medical bills for some consumers and prompt others to switch health providers. Abrazo Community Health Network and Carondelet Health Network said that negotiations with Blue Cross Blue Shield of Arizona are at an impasse, with contracts set to expire Dec. 31. (Alltucker, 12/4)

Last year, a specially equipped ambulance began taking stroke care beyond hospital walls and into greater Cleveland. This month, a similar vehicle will begin to do the same in parts of the Toledo metro area. OhioHealth announced last week that it is working with Columbus fire officials to operate a similar type of ambulance, equipped and staffed to deliver the clot-busting drug tPA to stroke patients. But other local hospitals, caught off-guard by the announcement, are not yet on board. (Sutherly, 12/6)

Bulletproof glass and armed security are nothing new at medical clinics that provide abortions. But in the wake of a deadly shooting last week at a Planned Parenthood clinic in Colorado, clinics nationwide are redoubling security efforts, checking surveillance cameras and reviewing evacuation plans. Police say they're adding patrols to clinics to guard against those who might be inspired to mimic a shootout that killed three people and injured nine. (Wyatt, 12/4)

The national head of Planned Parenthood called for an end to violence against women, doctors and clinicians who seek or offer reproductive healthcare, saying "enough is enough" during an appearance in Denver Saturday marking a day of unity for the organization. (Maycan, 12/5)

The Supreme Court denied a request from the activist behind the Planned Parenthood sting videos to block a federal judge’s order to turn over the names of people who supported his work. Lawyers representing David Daleiden had asked Associate Justice Anthony Kennedy on Friday evening to block the order from the district judge, which was upheld by an appeals panel Thursday. (Haberkorn, 12/4)

Americans almost universally believe anti-abortion violence is wrong, a new survey finds -- but there's less agreement on how wrong such violence is, with most abortion opponents saying it's no more egregious than abortion itself. (Edwards-Levy, 12/4)

More Columbus women, including those with no insurance or co-pays they can’t afford, are receiving various forms of long-acting birth control thanks to efforts to increase accessibility and pick up the tab when necessary. (Crane, 11/6)

A House panel on Wednesday unanimously approved a bill aimed at keeping Floridians with mental illnesses out of the criminal-justice system. The House Children, Families & Seniors Subcommittee supported the measure, filed by Rep. Charles McBurney, R-Jacksonville, that would create a statewide framework for counties to offer treatment-based mental health courts. Many counties have mental-health courts, but they have varying eligibility and program requirements. (Menzel, 12/3)

Top state and federal leaders in Ohio say much work is needed to combat a largely hushed public-health crisis: suicide. The Dispatch explored suicide’s toll in a six-day series, “Silent Suffering,” published Nov. 17-22. Those stories, available online at Dispatch.com/suicide, detail a mental-health-care system that doesn’t have the money or resources it needs to combat this growing problem. Suicide-prevention experts offered solutions, but many require that all levels of government — local, state and federal — invest in the solutions to save lives. (Riepenhoff, Wagner, Kurtzman and Rowland, 12/6)

For Rev. Donna Allen’s congregation in West Oakland, the New Revelation Community Church is a place to share with other African-Americans and to find support when facing life’s small and big crises. And for Allen, one of the most important messages is that their community has too often ignored the scourge of mental illness. (Day, 12/7)

Six-year-old Aref Shabaneh is almost entirely blind, able to read only in Braille, walks with a cane, and is so sensitive to light his parents turn them off when he's home. For two years, he was enrolled in a taxpayer-funded health care program that provided specialists to help protect what little is left of his eyesight. In June, Florida health administrators declared in a memo that the little boy was "NOT clinically eligible." His severely detached retina had not been miraculously cured by doctors. Instead, state records show, Aref had been tossed from the program by state health employees looking to cut costs. They made the move after his mother failed to see the trap door hidden in a questionnaire from the Florida Department of Health — a "screening tool" that one judge declared invalid in September, but the Department of Health is fighting to reinstate. (Miller, 12/6)

Surrounded by stacks of packages in a brightly lit room, Michael Palone gingerly folded a box and taped it shut. His eyes averted, he shuffled to the front of the warehouse to retrieve scissors, skirting by people and tables in his path. Palone, 26, has Asperger's and mild autism that makes it nearly impossible for him to socialize with others and adjust to the constant changes of a full time job. Instead, he assembles packages with about 40 others at a Union City, Calif., work center run by The Arc of Alameda County. (Hellmann, 12/4)

More than 88,000 people in the Houston area have lost plans from Blue Cross and Blue Shield of Texas for 2016, potentially cutting off some of the most seriously ill from the top-tier medical care the city has built its reputation on. (Deam, 12/5)

A New Hampshire drug treatment program wants to give people a way to exchange used needles for clean ones, but the plan could require a change to state laws on the possession of drugs and drug paraphernalia. Jeff DeFlavio, founder of the Lebanon-based Recover Together treatment network, hopes to start piloting a community-based needle exchange service in 2016. DeFlavio is scouting locations for the program, but says he's waiting for more clarity on state law. Proponents argue that the exchanges serve an important public health benefit by reducing the risk for outbreaks of infectious diseases like HIV or Hepatitis C, which can be spread through needle sharing. (McDermott, 12/4)

One word carries a lot of weight in Minnesota health officials' decision to expand its medical marijuana to pain patients: intractable. The state's definition of what qualifies as "intractable pain" has big implications starting in August for how many new people will begin buying via the state program. Here's a look at what that means for the state's struggling program and the people who hope to buy medical marijuana to soothe their pain. (Potter, 12/6)

Jose Campos wakes each morning suspended between present and past. He lies in bed in his San Antonio home as the pain in his body wrenches his mind back to Afghanistan. Campos, 38, has waited more than 30 days for appointments on multiple occasions when seeking medical treatment from the Veterans Affairs Department. (Kuz, 12/6)

Still, [Sens. Ron Wyden and Chuck Grassley] have done a kind of service [with their findings of their 18-month investigation into Gilead Sciences and the drug Sovaldi]. The price-control lobby claims to favor “transparency,” and the 134-page report and in particular the documents in the supporting exhibits provide perhaps the most transparent look ever into pricing decisions in the modern drug business. Far from the gouging of political lore, the report shows Gilead deliberatively and rationally set a price for the therapy sofosbuvir (commercially name Sovaldi) on the basis of “clinical attributes, value determination, market research will payers and the cost of current product regimens.” (12/6)

Last week, the drug giant Pfizer announced its plan to become an Irish drug company, moving its corporate headquarters abroad as part of a complex business maneuver that would allow it to skirt billions in U.S. taxes. That came on top of more general outrage over the soaring prices of many drugs — made by Pfizer and other companies — which are often many fold higher in America than overseas.‎ Pharmaceutical companies often claim that the profits they earn from high U.S. prices fuels U.S. innovation. But that’s not the whole story. Non-U.S. drug companies also benefit from our high prices, and that would be true for the new Ireland-based Pfizer too. (Dr. Peter Bach, 12/6)

For years, we’ve heard from Obamacare’s supporters that the law has been a success, because, they say, it has provided more people with health insurance, and slowed the growth rate of health spending. Well, the returns are in. Last week, the Obama administration’s Centers for Medicare and Medicaid Services released its official estimates of the uninsured population and of health spending. And in 2014, we learned, Obamacare’s coverage expansion fell between 6 and 12 million short of expectations, while driving the growth of health spending to its highest rate in 7 years. (Avik Roy, 12/6)

Sky-high drug prices have been in the news lately, but it's not just drug prices that pose a risk to retiree savings. Health-insurance and long-term care costs are increasing, too, and that has more Americans worrying about their financial security in retirement than ever before. According to the Centers for Medicare and Medicaid Services (CMS) office of the actuary, total spending on healthcare in America grew by 5.3% last year -- the fastest increase in five years. The 5.3% increase comes on the heels of a 3.7% increase in 2013, and a 2.9% increase in 2012. (Todd Campbell, 12/6)

Virginia hospitals, especially in those poor and rural areas, have been struggling to manage a financial crunch of their own caused by the GOP’s refusal to expand Medicaid, along with the mandate that they provide free or low-cost care to poor and uninsured patients. Increasingly desperate for federal funding under Obamacare — the same funding the GOP blocked — the hospitals have embraced a tax they’ve long opposed. The tax would be assessed on hospital revenue, which hospitals now say they’d support if the funds yielded were earmarked for health care, thereby drawing down federal matching funds under Medicaid. The hospitals also insist that the state would commit to maintaining its planned subsidies for health care. That’s a win-win proposition. (12/6)

Current law provides a tax exclusion for employer-paid insurance. This is how nearly half the public gets insurance, but the exclusion subsidizes overutilization of health care, causes “job lock” by linking work and insurance, and redistributes income upward because tax breaks increase in value for higher income brackets. According to the Congressional Budget Office, 34 percent of the benefits go to the top 20 percent of income earners. Repealing the exclusion would have been a progressive way to curb health-care costs and raise revenue for coverage expansion. Taxing high-value plans was a second-best solution that would claw back $87 billion in revenue between 2018 and 2025, according to the CBO. Corporations and labor unions hate the tax, however. (12/6)

President Barack Obama and some of his allies are trying to transform an ugly piece of tax legislation into something that gives critical help to millions of low-income Americans. ... The legislation is a big bundle of tax breaks that could be worth somewhere between $700 billion and $800 billion over the next 10 years, depending on how negotiations go. ... concerns may still cause negotiations to unravel. So could arguments among the bill’s supporters. Congressional Democrats, for example, want the bill to include postponement of the Affordable Care Act’s “Cadillac tax” -- a levy on expensive health insurance policies that economists say helps to hold down health costs, but that is highly unpopular with just about everybody else. The White House opposes that. (Jonathan Cohn, 12/5)

American health care workers contributed enormously to the successful effort to stop the Ebola epidemic in West Africa that flared up in 2014, but they were treated horrendously when they came home. The reason: Irrational fears and politicians eager to show toughness in protecting constituents led to needless quarantines on doctors, nurses and other workers, even when they had no symptoms of the disease and no chance of infecting others. ... Health experts around the world are assessing the epidemic in West Africa for clues about how to respond to the next outbreak of an infectious disease that could spread to other countries. Health officials in the United States should study our own response to the epidemic. (12/5)

For several years in the 1990s, I worked at a small Planned Parenthood clinic in Kansas. I started as a secretary, became a community sexuality educator and, along the way, helped with the mundane tasks of keeping a health center open. ... Our tormentors weren't always satisfied with phone calls. On more than one occasion they poured butyric acid under the clinic doors and into the ventilation systems, forcing patients to reschedule appointments. For low-income people taking unpaid time off work for medical appointments, it was one more obstacle to receiving care. When a clinic closes, for a day or forever, those are the people who are disproportionately affected. (Bryn Greenwood, 12/4)

Though most people tend to think of obesity as the product of sloth and gluttony, most of us accept as “biological” the fact that fatter parents tend to have fatter children. But the link goes deeper than that. Children can inherit tendencies towards weight gain in the same way that they may have their mother’s nose or father’s chin. Body fatness, response to overfeeding, how efficiently we burn calories, and even our food choices are all very much inherited and all potentially influenced by what happens to us in the roughly nine months before birth. (Michael Rosenbaum, 12/2)

The Coca-Cola Company has finally been shamed into backing away from a research program that sought to deflect attention from the role of sugary soft drinks in the nation’s obesity crisis. The research was conducted by a nonprofit organization Coke helped found to emphasize exercise, not calorie-reduction, as the best way to control obesity. The organization returned a big grant to Coke early this month and announced this week that it was discontinuing operations because of “resource limitations.” Coke also announced the retirement of its chief science and health officer, Dr. Rhona Applebaum, who was involved in the creation of the group, the Global Energy Balance Network. (12/4)