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A new study finds that although the public remains stubbornly split on the Affordable Care Act, a slight shift may be occurring beneath the surface — with a growing minority of people coming around to the opinion that the law is having a real impact on access to health care. To be clear, the analysis is based on two-year-old data, and it shows more people are opposed to the law (45.6 percent) than in favor of it (36.2 percent). It also shows that most Americans — albeit a shrinking majority — still think the law has had "no/little impact" on any of the following: increased access to health care, insurance coverage for young adults, assistance for drugs to seniors or insurance subsidies. (Johnson, 4/13)

California would be the first state in the nation to ask the federal government to allow immigrants in the country illegally to purchase health insurance through a state exchange under new proposed legislation. Sen. Ricardo Lara (D-Bell Gardens) authored a bill that would have the state formally request the federal government to give permission for immigrants to pay for coverage through Covered California without cost to the state or federal government. (McGreevy, 4/14)

House Republicans say they’re edging closer to releasing an alternative to Obamacare, more than six years after President Barack Obama signed his health plan into law. (Haberkorn, 4/13)

The Maine House voted to approve an expansion of Medicaid on Wednesday, but still fell well short of the margin needed to overcome an inevitable veto from Gov. Paul LePage. The 85-64 vote was largely along party lines and came one day after the Republican-controlled Senate narrowly endorsed using federal funds to purchase coverage for more low-income Mainers. The measure, however, appears headed for a sixth-straight defeat by LePage, who has argued expansion would cost the state more money down the line. (Miller, 4/13)

A bill that would use federal Medicaid dollars to expand access to drug addiction treatment and mental health services passed narrowly in the Senate Wednesday and was approved almost entirely along party lines in the House. Rep. Charlotte Warren, a Hallowell Democrat, told her seat mates they should listen to Maine’s law enforcement community who say the bill would provide financial assistance to the state’s cash-strapped county jails. (Higgins, 4/14)

A bill to appropriate funding for the state Medicaid program, including the governor’s plan for Medicaid expansion, advanced out of committee on Wednesday, the first day of the Arkansas Legislature’s fiscal session. The bill cleared the Joint Budget Committee in a voice vote and is expected to be voted on Thursday in the Senate. Legislators on both sides of the debate over Medicaid expansion said the bill was unlikely to pass in the Senate. (Lyon, 4/14)

Legislation reauthorizing the use of federal Medicaid funds to purchase private health insurance for low-income Arkansans cleared the Legislature's Joint Budget Committee on Wednesday and will be considered today by the Senate. Senate Bill 121 would grant spending authority totaling $8.4 billion in state and federal funds for various Medicaid programs. That includes $1.6 billion in spending authority for the Medicaid expansion to those of low income, including $43 million in state funds to match the federal funds, said state Department of Human Services spokesman Amy Webb. (Fanney and Wickline, 4/14)

Officials at the Centers for Disease Control and Prevention said on Wednesday that there was now enough evidence to definitively say that the Zika virus could cause unusually small heads and brain damage in infants born to infected mothers. The conclusion should settle months of debate about the connection between the infection and these birth defects, called microcephaly, as well as other neurological abnormalities, the officials said. (Belluck and McNeil, 4/13)

The study marks a turning point in the current Zika outbreak, says Dr. Tom Frieden, chief of the CDC. "There's still a lot that we don't know, he says. "But there is no longer any doubt that Zika causes microcephaly." A causal link between the bite of a mosquito and brain malformations is unprecedented, he says. "And it is because this was so unprecedented that we have until now waited to say that we have concluded that there is a causal link." (Bichell, 4/13)

The announcement comes at a critical time for the Obama Administration, which has been urging the Republican-controlled Congress to grant nearly $1.9 billion in emergency funds to fight the virus, which is already affecting Puerto Rico and is expected to hit parts of the United States with the coming of mosquito-friendly warmer weather. (Steenhuysen, Berkrot, Cornwell and Gardner, 4/13)

"We do know that a lot of people aren't concerned about Zika infection in the United States, and they don't know a lot about it," said Sonja Rasmussen, director of CDC's division of public health information. "It's my hope that we can be more convincing that Zika does cause these severe birth defects in babies and hope that people will focus on prevention more carefully." The research is likely to help scientists developing a vaccine for Zika, she said. (Sun, 4/13)

For now, the CDC’s guidance for pregnant women remains the same. They recommend that pregnant women avoid travel to Zika-hit regions. Infected men, with or without symptoms, can pass Zika virus to sexual partners. So, the CDC recommends abstinence or condom usage for couples if a male partner has traveled to a Zika-impacted region. (Akpan, 4/13)

Amid a prescription opioid abuse and heroin use epidemic largely fueled by overprescribing among doctors, President Obama has suggested allocating $1.1 billion to expand affected individuals’ access to care— a proposal that has garnered bipartisan support. Although some experts question whether throwing money at the issue will be enough, many believe that, if used properly, the funding has the potential to save lives. (Cartensen, 4/14)

Boston's top hospitals is seeing an increasing number of drug abusers shoot up on its property, a tactic experts say opioid addicts hope will save them from lethal overdoses. Massachusetts General Hospital has equipped its security guards with the overdose antidote Narcan after seeing an increase in the past 18 months of addicts shooting up in MGH walkways, parking garages and bathrooms, where addicts tie emergency pull cords to their bodies in case they collapse. (4/14)

In the battle against America's surging opioid drug addiction, 49 states, the District of Columbia and even Guam have all implemented some kind of [prescription drug monitoring program]. Missouri is the only state that hasn't. A protracted political battle has kept the state from passing a law to establish one. That leaves pharmacists with few options. [They] can only check the prescription history of patients on Medicaid, which tracks such data. But when a patient pays cash there is no record to check leaving pharmacists to guess whether the patient is in genuine pain, feeding an addiction or maybe looking for pills to sell. (Sable-Smith, 4/14)

Just days after hinting that fentanyl overdoses in the Sacramento region were tapering, the county’s health department announced Wednesday one more death and two more overdoses likely caused by the potent synthetic opioid. (Caiola, 4/13)

The Environmental Protection Agency’s top water regulator said Wednesday that officials are working urgently to strengthen a federal rule limiting lead and copper in drinking water — a key focus in the ongoing lead-contamination crisis in Flint, Michigan. But Joel Beauvais, acting chief of the EPA’s water office, said proposed changes will not be released until next year, with a final rule expected months after that. (Daly, 4/13)

Chicago's North Broadway Street is always bustling, but in the past few weeks, it has been noisier than ever. There is water flowing from an open fire hydrant, and as traffic inches by, a cement truck backs up and pours concrete down into a big hole in the street. ... It's part of the city's sweeping plan to update and replace miles of the city's aging water lines that was announced four years ago. But while there has been praise about the long overdue new infrastructure, there has also been criticism — and a lawsuit from residents who say the city's work is causing unsafe lead levels in the city's drinking water. (Corley, 4/14)

Department of Environmental Services will expand their testing radius for PFOA, a contaminant found in drinking water near the Saint-Gobain Performance Plastics plant in Merrimack. The Department is now testing all drinking-water wells within a mile and a half radius of the plant: that’s a half-mile more than the department had been testing. The expanded radius includes Londonderry and Manchester, in addition to Merrimack, Bedford, and Litchfield. (Corwin, 4/14)

Federal health regulators have proposed banning Theranos Inc. founder Elizabeth Holmes from the blood-testing business for at least two years after concluding that the company failed to fix what regulators have called major problems at its laboratory in California. In a letter dated March 18, the Centers for Medicare and Medicaid Services said it plans to revoke the California lab’s federal license and prohibit its owners, including Ms. Holmes and Theranos’s president, Sunny Balwani, from owning or running any other lab for at least two years. That would include the company’s only other lab, located in Arizona. (Carreyrou and Weaver, 4/13)

Federal regulators have threatened a series of stiff sanctions against Theranos, the embattled blood-testing company, including closing down its flagship laboratory and potentially barring its chief executive from owning or operating its labs for two years. The sanctions, which have not been made final, were included in a strongly worded letter from officials from the Centers for Medicare and Medicaid Services. It is the latest blow to the credibility of Theranos and Elizabeth Holmes, its chief executive, who seemingly became a self-made billionaire by promising to upend the clinical testing industry. (Abelson and Pollack, 4/13)

Theranos has responded to the letter and is waiting for the agency to finish reviewing the privately held company's proposed solutions, Theranos spokeswoman Brooke Buchanan said. In the meantime, "CMS has not imposed any sanctions on Theranos or its executives," and the sanctions proposed by the agency in its letter were "the worst-case scenario," Buchanan said. The Centers for Medicare and Medicaid Services declined to comment, noting that the letter was not intended to be made public. (Peltz, 4/13)

Theranos has positioned itself as a cheaper, more efficient alternative to traditional medical tests. It claimed it could process up to 70 lab tests on just a few drops of blood. It is valued at more than $9 billion and has been billed as a classic industry disruptor. But in October 2015, a scathing report in the Wall Street Journal called much of its technology and testing methods into question. CMS's concerns became public in January, after the agency conducted a routine survey of the lab and found five areas in which it fell short of compliance standards. Theranos responded and said it had addressed the issues, but in the March letter, CMS said it wasn't adequate. (O'Brien, 4/13)

The state budget proposed by House leaders Wednesday includes a new $250 million annual tax on hospitals to help fund the state’s big and growing Medicaid program. (Dayal McCluskey, 4/13)

Florida hospitals continue to have some of the highest Caesarean delivery rates in the country, according to a new analysis out from Consumer Reports. “People might find differences in nearby hospitals, so they really have to look at a map and at the rates and see what stories the numbers are telling,” said Doris Peter, director of the Consumer Reports Health Ratings Center. (Mack, 4/13)

Peoria-based OSF HealthCare, a nonprofit Catholic health system, is spinning off a corporate investment arm to financially back new technology and devices. The health system issued a news release Wednesday to announce the launch of OSF Ventures. OSF HealthCare CEO Kevin Schoeplein says the strategy will give the health system earlier access to technology. (4/13)

Blue Cross Blue Shield of Texas is threatening to drop medical facilities run by Hospital Corporation of America, including San Antonio’s Methodist Healthcare System, from its provider network in the vast majority of its group health plans come May 1 — potentially affecting several hundred thousand Texans. (O'Hare, 4/13)

Florida Gov. Rick Scott is appealing a judge's order that the governor reinstate the chairman of the board that oversees several public hospitals in Broward County. (4/13)

Hospital groups may soon learn whether they’ve made progress in bids to change how their customers’ unpaid bills factor into Medicare reimbursement calculations. The program for the elderly and disabled is poised to begin unveiling a series of its annual payment rules. (Young, 4/13)

Ian Burkhart, now 24, was paralyzed in 2010 after diving into a wave in shallow water. The accident left him with some arm movement but no use of his hands. Then, about two years ago, scientists in Ohio equipped Burkhart with a system that allowed him to control his right wrist and hand with his thoughts. "The first time moving my hand — that was really just like that flicker of hope," Burkhart told reporters during a media briefing Tuesday. The briefing was held to publicize a study in this week's issue of Nature, which describes Burkhart's progress since he started using the system. (Hamilton, 4/13)

Burkhart's case is described in a paper released Wednesday by the journal Nature. It's the latest report from research that has let paralyzed people operate robotic arms, computers and other devices with signals picked up by brain implants, or regain use of paralyzed muscles by sending signals from other muscles they still control. (Ritter, 4/13)

If Arizona lawmakers decide to restore the KidsCare program during state-budget negotiations, it would deliver $75 million in economic benefits to Arizona next year as well as extend health coverage to 30,000 or more kids, a new report concludes. (Alltucker, 4/13)

Telemedicine experts speaking at a national health journalism conference were split on the usefulness of Kansas legislation aimed at expanding health care access in underserved parts of Kansans through videoconferencing technology. (Marso, 4/13)

The top-ranking Democrats on the House and Senate insurance committees want the state to conduct its own investigation into the proposed mergers involving four of the nation’s five largest health insurance companies. (Siegel, 4/14)

An Ohio House committee recommended passage of two bills Wednesday that would require abortion providers to bury, cremate or incinerate fetal remains. The moves raised concerns about the privacy of women who undergo the procedure and arguments that the legislation creates additional obstacles for those obtaining an abortion. (Candisky, 4/14)

Gov. Tom Wolf says he'll sign medical marijuana legislation and make Pennsylvania the 24th state to legalize a comprehensive medical marijuana program. Wolf said he'll sign the bill Sunday. (4/13)

Leaders of Iowa’s Medicaid program tried to convince skeptical state legislators Wednesday that the first two weeks of private management have gone well. “We’re pleased to report we have not had any major system issues,” Medicaid Director Mikki Stier told a Senate committee. She said when complications have cropped up, they are “responded to with compassion, and resolved as quickly and immediately as possible.” (Leys, 4/13)

Officials with Iowa Medicaid and the three private insurance companies managing the system said the program's first week and half under privatization came with expected glitches but no system-wide failures. A Senate committee continues to meet with Medicaid leaders to request information about the transition and talk about problems they hear from Iowans. Wednesday, one senator who is not a part of that committee asked for a seat at the table after receiving two letter from constituents who said the system switch has delayed their cancer treatment. (McCarthy, 4/13)

A spot survey by state analysts found low-income Medicaid patients in New Mexico are waiting on average from three weeks to nearly two months to get an appointment with a doctor, prompting new concerns about barriers to health care access for the poor and disabled. Staff at the Legislative Finance Committee on Wednesday released results of a “secret shopper” survey that they devised after struggling to find any other meaningful measure of wait times in multiple Medicaid contract evaluations for managed care organizations. (Lee, 4/14)

Texas should be allowed to move forward with cutting payments to therapy providers who serve children with disabilities, a lawyer for the state argued in court Wednesday. The state is asking the Texas 3rd Court of Appeals to override a lower court’s decision temporarily blocking officials from implementing sweeping budget cuts to a state-funded therapy program. (Walters, 4/13)

A proposal to stop upcoming Medicaid reimbursement cuts by raising cigarette taxes has the backing of two Oklahoma health care associations. The Oklahoma Hospital Association and the Oklahoma Association of Health Care providers want lawmakers to approve a $1.50 per pack tax hike, which would raise $182 million — enough to halt reimbursement cuts slated for June 1. (Trotter, 4/13)

Medicaid providers on Wednesday urged lawmakers to raise the cigarette tax by $1.50 per pack to shore up the health care delivery system. ... Such an increase would require a three-fourths vote in both chambers or a vote of the people. The recently proposed Medicaid Rebalancing Act of 2020 would move thousands of people who are on Medicaid into the private market through an expansion of Insure Oklahoma. It would also reduce the number of people who are uninsured by providing options in the private market through Insure Oklahoma. (Hoberock, 4/13)

Two pending mega-mergers, if approved, would tighten an already compressed health insurance market in Georgia, a state insurance department document suggests. The combination of Aetna and Humana would have the greater impact of the two deals, according to a letter that a state insurance official wrote to a law firm. (Miller, 4/13)

The state’s public health commissioner announced Wednesday that she is shoring up the beleaguered ranks of nursing home inspectors, having hired 19 newcomers since July and actively pursuing 10 more, amid concerns about serious gaps in state oversight. (Lazar, 4/13)

Anti-abortion groups on Wednesday rallied outside Attorney General Kamala Harris’ office to call for her resignation – a week after her agents seized equipment from the apartment of activist and citizen journalist David Daleiden. (Cadelago, 4/13)

People living in poverty are often at greater risk for serious health problems. And for many, legal problems can be a contributing factor to those medical issues. (Brindley, 4/14)

Community Health Centers has opened a 16,000-square-foot facility near Maitland Blvd. to replace its two older and smaller clinics at Eatonville and Rosemont. (Miller, 4/14)

During a moment of silence late Wednesday afternoon on the University of Pennsylvania campus green, some of the dozens gathered there held posters that read, "You Are Not Alone," and, "This Is a Safe Space." On Tuesday, students published a change.org petition outlining six steps the university is asked to take to address mental illness on campus, including easing the process for withdrawing from classes, requiring mental health training for residential advisers, and increasing resources for counseling services. (Castellano, 4/13)

Leon County Commissioner Bill Proctor is pushing for an assessment of available resources in Leon County to address mental health and substance abuse. The move comes after Proctor’s son was arrested this past weekend on drug charges. Commissioner Proctor says his son’s recent arrest is a catalyst for him to speak about mental health. (Hatter, 4/13)

For decades, emergency staff in the nation's urban hospitals have acknowledged a sad fact about the violently injured kids, teens and young men they treat: If their patients survive to leave the hospital, they'll likely be back. (Zeltner, 4/13)

A death in Illinois has been tied to the Elizabethkingia bacteria outbreak that started in Wisconsin and has left state and federal health officials searching for the source of the issue. The Illinois case, reported Tuesday, involves the same strain of the bacteria, Elizabethkingia anophelis. No other details were provided. Last month, officials said a death in Michigan was tied to the outbreak. (Rutledge, 4/13)

An administrative law judge has rejected a challenge to a Florida Department of Corrections decision to award a $268 million contract for health services at the majority of the state's prisons. (4/13)

Nurses for Newborns is a local organization that seeks to improve the outcome of infants in at-risk families. Since the organization was founded over 20 years ago, the nurses have helped over 100,000 families raise healthy babies. At any given moment, the nurses are helping over 1,000 babies under the age of two and their families. (Moffitt, 4/13)

A state employee filed a class-action lawsuit against Gov. Bruce Rauner and several other high-ranking state officials Wednesday, alleging the state’s budget impasse has effectively left some state employees without health insurance. (Charles, 4/14)

Calling access to paid sick leave "just a baseline of decency," Ald. Ameya Pawar joined like-minded lawmakers and advocates Wednesday in announcing a proposed ordinance that would require almost all Chicago employers to let their workers earn at least five sick days a year. (Elejalde-Ruiz, 4/13)

The prescribed prairie fires that mark Kansas’ smoky rite of spring continued to wreak havoc on Lincoln’s air Wednesday. The haze initially prompted public health concerns Tuesday evening. Lincoln Public Schools officials -- who upon the advice of Lincoln-Lancaster County health officials and district health staff kept students inside Wednesday -- said they were comfortable with the decision even though the haze was mostly gone by afternoon. (Roberts, 4/14)

From its initial discovery in Ugandan forests nearly 70 years ago, Zika virus has emerged as a worldwide public health crisis, with active transmission in more than 40 countries in the Americas and Caribbean. On February 1, 2016, the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC), concerned about clusters of microcephaly and Guillain-Barré syndrome (GBS). A week later, the Centers for Disease Control and Prevention (CDC) triggered the highest “level 1” activation of its emergency operations center, and President Obama requested $1.86 billion in emergency funding.1 On April 7, the WHO reported there is scientific consensus that Zika is a cause of microcephaly and GBS. (Lawrence O. Gostin and James G. Hodge Jr, 4/13)

You’ve been there. When the subject of guns is brought up in “mixed” company, the conversation either becomes volatile or stops altogether. When it comes to reducing gun violence, people seem to stand clearly on one side of the issue or the other: minimize access to firearms, require background checks, close the loopholes, and get rid of assault weapons or enforce current laws, allow people to protect themselves and their property, keep arms away from the mentally ill, and open carry so people know you have protection. (State Sen. Jill Schupp and State Rep. Deb Lavender, 4/14)

In 1854, British physician John Snow famously wrote, “The most terrible outbreak of cholera which ever occurred in this kingdom, is probably that which took place in Broad Street, Golden Square, and the adjoining streets, a few weeks ago.” Snow linked cholera to polluted water flowing from the Broad Street pump. City officials removed the pump handle and the cholera epidemic suddenly ended. Cholera is one of many gastrointestinal illnesses caused by drinking water carrying disease-causing microbes. In 2000, for example, hundreds of Milwaukee residents became ill when they drank city water contaminated with cryptosporidium. (Lawrence Gostin, 4/13)

The rich get richer and the poor die younger. Too many Americans shrug these off as the facts of life. A new study in the Journal of the American Medical Association puts hard numbers on the life-threatening realities of poverty in this country while challenging assumptions about our ability to change things. For all of America’s bragging about exceptionalism, technological advancement and high living standards, the fruits of our success aren’t doing much to help the country’s poor. On average, their life expectancy is about the same as citizens of Peru and Colombia. (4/13)

Michigan has a public health problem. This is perhaps both a conservative diagnosis and, for many state residents, an obvious statement. Yet, too often, public health is significantly underfunded. Flint’s lead-contaminated drinking water reinforces the importance of a functional public health infrastructure in safeguarding communities. But Flint is not the only city with public health challenges in Michigan. (Anand Parekh and Marianne Udow-Phillips, 4/14)

If you live in Miami, you enjoy great year-round weather and plenty of places to take advantage of the sunshine. It’s no wonder Miami is regularly voted as one of the nation’s healthiest cities. But as good as things are, Miami-Dade County still needs to invest in its parks and open spaces to make sure it stays ahead of ever-increasing population demands. It is the same challenge many of our nation’s major cities face: The population increases, and people want more services. At about 2.7 million, Miami-Dade’s population is expected to reach 3 million by 2025 and 4.5 million by 2060. (Adrian Benepe, 4/13)

Ever since passage of the Affordable Care Act, a fierce debate has been waged over whether the law would work as advertised. While advocates promised that the design of new insurance markets would transform the way consumers buy health insurance, critics warned that the new market would never succeed. Reed Abelson and Margot Sanger-Katz have had front-row seats to the debate, and the two reporters took a few minutes to discuss when — and if — the market would stabilize. (Reed Abelson and Margot Sanger-Katz, 4/13)

Well, the hammer has fallen: The largest health insurer in the U.S. has started pulling out of select Obamacare exchanges. (Megan McArdle, 4/13)

The 2016 U.S. presidential campaign has produced many surprises. One unexpected turn is the reemergence of single-payer health insurance on the public agenda. Senator Bernie Sanders has made Medicare for All a centerpiece of his platform. His opponent for the Democratic party’s presidential nomination, former Secretary of State Hillary Clinton, has criticized Sanders’s plan as unrealistic. An old debate has thus reopened. What are the virtues and vices of single-payer reform? Is it a realistic option for the United States or a political impossibility? (Jonathan Oberlander, 4/14)

Paying doctors a fee for each service they provide gives them incentive to offer the maximum number of treatments, as well as pay less attention to how well patients recover. This is why the Barack Obama administration -- and just about everyone else -- wants to change the way doctors get paid. (4/13)

If we paid for homes or college education the way that we pay for curative drugs, much fewer Americans would own a home and America’s tertiary education attainment rate wouldn’t be fifth highest in the OECD. So despite the problems in our student loan system, and the (obvious) concerns about promoting too much home ownership, perhaps our pharmaceutical reimbursement systems can benefit from some outside “disruption.” (Yevgenly Feyman, 4/13)

The decision by House Speaker Paul Ryan to bow out of any attempt to draft him as the Republican presidential nominee in Cleveland and press ahead with his domestic policy agenda could be significant for health care. The next big debate might not be about Republican proposals to repeal and replace the Affordable Care Act. It might focus more on the future of the two largest public health-care programs, Medicare and Medicaid. As the chart above shows, Medicare covered 55 million and Medicaid covered 66 million people in 2015 at a cost of more than $1 trillion. Together, they represented 23% of the federal budget. (Drew Altman, 4/13)

Consistent with the goals of the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015, the Centers for Medicare & Medicaid Services (CMS) is increasingly paying for health care through alternative payment models that reward value and quality.1 These models include accountable care organizations, bundled payments, and advanced primary care medical homes. In this Viewpoint, we focus on advanced primary care medical homes. (Laura L. Sessums, Sarah J. McHugh and Rahul Rajkumar, 4/11)

In his smart opinion piece last week, “A Mason-Dixon Line of Progress,” Timothy Egan noted the “retreat to bigotry” sweeping across the old South as politicians clinging to the past (under the banner of religious freedom) line up to authorize discrimination against gay people. The column prompted me to think about whether the battlegrounds in the never-ending abortion wars display a similar geographic concentration. The answer is that to a startling degree they don’t. The battleground is much bigger. With the exception of the West Coast and most (but not all) of the Northeast, recently enacted abortion restrictions can be found almost everywhere. (Linda Greenhouse, 4/13)

For more than half a century, the clinical development of anticancer drugs has followed a predictable and orderly set of sequential stages: phase 1 trials were designed to determine the drug’s safety, tolerability, and dose; phase 2 trials then explored the drug’s activity in a variety of cancers; and phase 3 trials compared the new drug with existing treatments and served as the basis for regulatory approval. Advances in our understanding of cancer biology in the past decade have led to both development of more effective drugs and improved patient selection made possible by early biomarker discovery and companion diagnostic development. Desire for early access to transformative new anticancer drugs has resulted in increased demand for patient entry into first-in-human trials, as well as calls for expediting the drug development and approval process. The three distinct sequential phases of drug development have therefore become increasingly blurred. (Tatiana M. Prowell, Marc R. Theoret and Richard Pazdur, 4/13)

Supporters of Arkansas' Medicaid expansion say it's worth preserving for the sake of improving people's health and shoring up hospitals' finances. A pivotal group of Republican state lawmakers isn't buying that. But Gov. Asa Hutchinson is betting they will be swayed by the prospect of rutted roads. (Harris Meyer, 4/13)

How do you justify withholding a wonder drug from patients infected with a liver-killing virus until the disease starts to ravage their bodies? Why, in other words, do they have to become seriously ill before receiving help? Although biomedical advances have given rise to a new class of drugs that can cure hepatitis C, which is often fatal, a basic socioeconomic problem remains to be solved: Because of the high cost of the medicine, many public and private health insurers restrict access to treatment until the onset of liver damage. It’s a short-sighted approach that causes suffering and is at odds with a basic tenet of modern medicine — early intervention. (4/14)

Thirty-three years ago ago, the U.S. Congress passed the Orphan Drug Act, which was signed into law by President Reagan. This act provided incentives for the development and commercialization of drugs to treat orphan or rare diseases, defined as those illnesses affecting fewer than 200,000 individuals. In the decade prior to its passage, 10 such drugs became available. After the act’s signing, 400 novel therapies entered the market. In the past year (2015) alone, the Food and Drug Administration approved 21 new entities. (Howard Forman, 4/13)

“We don’t do hospitals. We do jail.” That, we are told, is what a Chicago police sergeant said in 2012 when the parents of man who was exhibiting bizarre and aggressive behavior asked the police to take their son to a hospital. (4/13)

Imagine rushing an acutely ill friend or loved one to a local emergency room, having your worst fears confirmed by the doctor, and then being told that it could be days before they can be admitted to the right hospital for treatment because of a waiting list. In the meantime, the critically ill person is left in or near the emergency room receiving less than adequate care and treatment for several more days. (John Broderick and Ken Norton, 4/14)

Investors have not had their fill of digital health deals, according to new fundraising reports from Rock Health and Startup Health, two outfits which have led the digital health revolution and produce complementary reports on how much capital is flowing into the sector. While other sectors have wobbled recently, digital health (which was only defined as a market five or six years ago) continues to attract venture capital. (John Graham, 4/13)