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Anthem Inc. made preliminary filings indicating it will offer plans on the Affordable Care Act marketplaces in Virginia and Kentucky next year, providing an early signal on the insurer’s exchange business. Cigna Corp.and Aetna Inc., which like Anthem have said they are reconsidering their exchange offerings, are among the insurers that made similar filings in Virginia. But one current Virginia ACA insurer, UnitedHealth Group Inc., didn’t file 2018 forms, and a spokesman confirmed it would leave the state’s marketplace next year. (Wilde Mathews and Radnofsky, 4/20)

President Trump is pressuring Congress to sink parts of the Affordable Care Act. But now that the first attempt at a GOP health-care overhaul has failed, he must decide whether to throw the law a line. The White House and Republican lawmakers are facing key decisions that could either improve the insurance marketplaces established by the ACA next year or prompt insurers to further hike rates or withdraw from those marketplaces entirely. Republicans had hoped to protect those with marketplace coverage while lawmakers replaced Obamacare. (Winfield Cunningham, 4/19)

The deadline to keep the federal government open is just about here, but a deal is far from done. With just five workdays left until government funding expires, lawmakers return next week to all the same sticking points that have made full-year funding so elusive and now threaten a government shutdown. ��... Democratic leaders declared that any spending bill must provide money for a key Obamacare subsidy program after Trump threatened to defund the cost-sharing subsidies; the president sees the program as a way to force Democrats to the negotiating table. (Scholtes and Ferris, 4/20)

Democrats’ demand that ObamaCare subsidies be wrapped into a must-pass spending package is complicating GOP efforts to prevent a government shutdown at the end of next week. Speaker Paul Ryan (R-Wis.) has signaled no plans to include the subsidies in a bill to keep the government open, but President Trump’s recent threat to withhold the subsidies to insurers has led several top Republicans to intervene. (Lillis and Marcos, 4/19)

Rural areas would be hit particularly hard if Congress and the Trump administration don’t send clear signals that they’re committed to helping keep ObamaCare’s insurance marketplaces stable next year, advocates warn. Insurers are in the midst of deciding which ObamaCare markets to enter, and they need assurances that they won’t have to pay billions for out-of-pocket costs for certain low-income consumers. Rural areas already have fewer care options than their urban peers. ��(Roubein, 4/19)

President Donald Trump signed an extension of a Department of Veterans Affairs law on Wednesday to continue a program that helps veterans seek health care outside the VA system. The original legislation, commonly known as the Veterans Choice Act, was slated to expire in August.��The measure signed Wednesday by Mr. Trump extends the program until the remaining funds are used, which is expected to happen by the end of the year. (Kesling, 4/19)

President Donald Trump on Wednesday moved a step closer to fulfilling his campaign promise to reform the troubled Veterans Affairs department, but some veterans groups are concerned that the administration may be working toward privatizing their healthcare. (Lambert, 4/19)

Almost half a million veterans gained health care coverage during the first two years of the Affordable Care Act, a report finds. In the years leading up to the implementation of the ACA's major coverage provisions, from 2010 to 2013, nearly 1 million of the nation's approximately 22 million veterans didn't have health insurance. (Boddy, 4/19)

Documents released this week by Mr. Trump’s inaugural organizers provide a glimpse of the big-dollar frenzy of influence-seeking and peacemaking surrounding Mr. Trump’s swearing-in, which raised $107 million, twice as much money as any other inauguration. ...�� While Mr. Trump promised during the campaign to give Medicare and Medicaid the power to negotiate prices they pay for prescription drugs, two of the biggest drugmakers, Pfizer and Amgen, gave a combined $1.5 million in December. (Confessore, Fandos and Shorey, 4/19)

Drugmaker Pfizer gave $1 million to help finance the inauguration, according to documents filed with the Federal Election Commission. Amgen, another pharmaceutical company, donated $500,000. Health insurers Anthem, Centene and Aetna all gave six-figure contributions. They joined a surge of corporate donors from multiple industries to break inauguration-finance records even as then-President-elect Donald Trump promised to “drain the swamp” of Washington influence-peddling. (Hancock, Lupkin and Lucas, 4/19)

Two law firms with large health care practices also chipped in. Holland & Knight, which lobbies for the Alliance for Regenerative Medicine, America’s Essential Hospitals, and the Biosimilars Forum, among other clients, donated $100,000 and Mintz Levin Cohn Ferris Glovsky and Popeo, which has a busy health law group, gave $35,000. (Kaplan, 4/19)

Donald J. Trump made coal miners a central metaphor of his presidential campaign, promising to “put our miners back to work” and look after their interests in a way that the Obama administration did not. Now, three months into his presidency, comes a test of that promise. (Scheiber, 4/19)

The Senate Health, Education, Labor and Pensions Committee will vote Wednesday on the nomination of Scott Gottlieb to serve as the commissioner of the Food and Drug Administration. If confirmed, Gottlieb, a former deputy commissioner at the FDA, would oversee an agency that President Donald Trump has vowed to reform. (McIntire, 4/19)

Cancer patients are locked in an intensifying struggle with insurers, who sometimes force them to try less expensive drugs before moving to more expensive ones, even against doctors’ wishes. Now the American Society of Clinical Oncology, or ASCO, is deepening its involvement in the fight, issuing a set of recommendations Tuesday that it hopes insurers will follow as they confront a growing lineup of expensive cancer drugs. (Tedeschi, 4/20)

After a three-hour visit to the emergency room, a young girl left with a headache and a $4,875 bill. A Southern California hospital charged the girl and her family three times the fair and customary price for a CT scan — about $2,000 — to see if the girl's fall caused head trauma, according to Lisa Berry Blackstock, a patient advocate the family hired to negotiate a lower fee. The family's high-deductible health plan meant they had to cover the entire cost. (Kacik, 4/19)

Opening on April 19, the study is called Baseline, as in a starting point for what healthy biometric data should look like. It’s the first serious public test for Verily Life Sciences, formerly Google Life Sciences. While Verily has separated from Google’s internet business within the Alphabet Inc. holding company, it’s taking a page from the playbook of its former parent, which aims to collect and organize information online. Verily wants to collect data from our bodies, using it to guide better health decisions. While that sounds ambitious, it’s much more modest than the missions Verily promoted when it was officially part of Google. Years ago, the biotech division promised projects such as glucose-monitoring contact lenses and all-in-one medical scanners; those remain in the lab. (Chen and Bergen, 4/19)

In partnership with both Duke University School of Medicine and Stanford Medicine, the landmark study, part of its Project Baseline, aims to collect health data from 10,000 participants over the course of at least four years, the company announced in��a news release Wednesday...��Using physical and biochemical traits of the study population, researchers hope to better understand how people get sick, when they get sick and identify any additional risk factors and biomarkers leading up to disease, including diseases related to both cardiovascular disease and cancer. (Pirani, 4/19)

Jeff Merkley, now one of Oregon's U.S. senators, remembered the difficulty his family had after his father had back surgery in the 1990s. Physicians wanted him moved to a care center from the hospital. But the state had no quality comparison that people could quickly search on a computer. "This is really hard on families," Merkley said. "You have to make a decision right now and you don't have any information. Why not?" A site eventually went online, but it lacks about 8,000 records, around 60 percent of all substantiated complaints. Merkley was stunned when The Oregonian/OregonLive told him in March that the site was far from complete. He had spent years in the Oregon House pressing for online records. (Terry, 4/19)

For years, cybersecurity startup Tanium Inc. pitched its software by showing it working in the network of a hospital it said was a client, according to people familiar with the matter and videos of the demonstrations. That and other efforts helped the company grow quickly, notching a valuation of $3.5 billion and a big investment from Andreessen Horowitz, one of Silicon Valley’s most prominent venture firms. But Tanium never had permission to present the demos, the hospital said, meaning a company selling security actually was giving outsiders an unauthorized look at information from inside its customer’s system. (Winkler, 4/19)

You leave your car in a vast, crowded parking lot, and when you return, you have no idea where it is. The ensuing search is frustrating, time-consuming and a little embarrassing. That experience occurs more frequently as we get older, because the functions of the part of the brain that encodes spatial and episodic memories — the hippocampus — decline with age. But now neuroscientists at the Stanford University School of Medicine have shown that — in mice — an infusion of plasma taken from human umbilical cords improves the hippocampus's functioning, resulting in significant gains in memory and cognition needed for tasks such as finding a car in a full parking lot. (Bernstein, 4/19)

Harvested at the time of an infant’s birth, cord blood is a rich source of many known regenerative substances, including hematopoietic stem cells, the kind found in bone marrow. Cord blood is capable of treating more than 80 diseases, including blood cancers, inherited blood diseases such as sickle cell and thalassemia, and a range of immune deficiencies. (Healy, 4/19)

From the beginning, the findings were exciting, complex and, sometimes, contradictory. For example, scientists have shown that young blood can restore cell activity in the muscles and livers of aging mice. They've also found that linking old mice to young ones helped reverse heart muscle thickening. On the other hand, researchers weren't able to replicate some of the most eye-catching findings and another study concluded that, in mice that swapped blood without being connected surgically, the negative effects of being exposed to old blood outweighed the benefits of getting young blood. (Bichell, 4/19)

Nearly one and a half million Americans were treated for addiction to prescription opioids or heroin in 2015, according to federal estimates, and when those people get seriously hurt or need surgery, it's often not clear, even to many doctors, how to safely manage their pain. For some former addicts, what begins as pain relief ends in tragedy. (Lemoult, 4/20)

Women who take antidepressants early in pregnancy are not at a higher risk of having children who develop autism or attention deficit hyperactivity disorder (ADHD), contrary to earlier reports, a study published Tuesday found. The new study, published in the Journal of the American Medical Association, found only a slight increase in the risk of premature birth for infants of mothers who used antidepressants during the first trimester of their pregnancy. But the researchers found��no increase in the risk of autism, ADHD or reduced fetal growth among children exposed to antidepressants during fetal development. (Naqvi, 4/19)

Lynn Whittaker stood in the hallway of her home looking at the framed photos on the wall. In one, her son, Andrew, is playing high school water polo. In another, he’s holding a trombone. The images show no hint of his life today: the seizures that leave him temporarily paralyzed, the weakness that makes him fall over, his labored speech, his scrambled thoughts. Andrew, 28, can no longer feed himself or walk on his own. The past nine years have been a blur of doctor appointments, hospital visits and medical tests that have failed to produce answers. (Gorman, 4/20)

Antibiotic-resistant infection is a rising issue in American society and thousands of people die each year when they develop infections that no antibiotic can control...��A person is most vulnerable to antibiotic-resistant infection in the hospital, because that is a place that is more likely to harbor bacteria that has become resistant … and people in the hospital are more vulnerable and unable to fight the infection off. (Moffitt, 4/19)

Alzheimer’s disease has an unusual distinction: It’s the illness that Americans fear most — more than cancer, stroke or heart disease. The rhetoric surrounding Alzheimer’s reflects this. People “fade away” and are tragically “robbed of their identities” as this incurable condition progresses, we’re told time and again. (Graham, 4/20)

Dr. Gabriela Bronson-Castain, a pediatric psychologist in Oakland, said most of the kids she sees who are experiencing this fear have families who immigrated to the U.S. from Central America or families who are Muslim. (Klivans, 4/19)

From A to Zrect, Organic Herbal Supply has recalled its sexual assistance pills for men and women. The men’s pills — Uproar, Monkey Business, Zrect, Rectalis, Cummor, Tornado, ZDaily, Enhancerol, BigNHard — all contain tadalafil, the active ingredient in Cialis. While tadalafil is FDA-approved for dealing with male erectile dysfunction, the recall notice says, “the presence of tadalafil in these male enhancement products renders it an unapproved drug for which safety and efficacy have not been established and, therefore, subject to recall.” (Neal, 4/19)

A federal judge followed through on his promise Wednesday and blocked abortion-restricting rules in Missouri, saying he's bound by a U.S. Supreme Court ruling and that the state is denying abortion rights "on a daily basis, in irreparable fashion. "Missouri's attorney general swiftly pledged an appeal, calling the ruling "wrong." (Suhr, 4/19)

“The abortion rights of Missouri women, guaranteed by constitutional rulings, are being denied on a daily basis, in irreparable fashion,” Sachs wrote of Missouri’s abortion restrictions. “The public interest clearly favors prompt relief.” In Hellerstedt, the Supreme Court found that, “in the face of no threat to women’s health,” Texas had required women to travel to distant surgery centers. (Margolies, 4/19)

Amid a historic impasse and financial crisis in state government, the early campaign for Illinois governor has quickly shifted to the always-volatile issue of abortion rights following Republican Gov. Bruce Rauner's vow to veto a bill aimed at keeping the procedure legal while expanding taxpayer-subsidized coverage for it. Rauner's decision helps him shore up support from conservative Republicans in a legislature that has seen the number of socially moderate GOP lawmakers dwindle, as well as from groups opposed to abortion rights. (Pearson, 4/19)

Campaigning as a pro-choice Republican in 2014, Bruce Rauner said he would sign legislation to ensure abortion remains legal in Illinois and to expand abortion coverage for state workers and Medicaid recipients. But last week Rauner said he would veto a measure pending in the Legislature that supporters say would do both, citing "sharp divisions of opinion of taxpayer funding of abortion." (Burnett, 4/19)

The Iowa House on Wednesday approved a $1.77 billion health and human services budget that blocks state funding from going to Planned Parenthood and other clinics that provide abortions. ...The bill calls for Iowa's Department of Human Services to discontinue the federal Medicaid family planning network waiver, foregoing about $3 million in federal funding. Instead, the state will use about $3.3 million to recreate its own family planning network so that it can prohibit the funding of clinics that provide abortions. (Pfannenstiel, 4/19)

Public workers could not use their government-sponsored health insurance plans for abortions in most cases, under a bill Republicans in the��Legislature are considering. Republicans are seeking to advance the measure more than three years after abandoning an earlier version of the legislation that state Sen. Jon Erpenbach (D-Middleton) said at the time would unleash "all out hell" in the Senate. (Marley, 4/19)

Mayor Bill de Blasio pledged his support on Wednesday to a series of initiatives to cut tobacco use, proposing to raise the minimum price of a pack of cigarettes in New York City to $13 and vowing to sharply reduce, over time, the number of stores that may sell tobacco products. Raising the minimum price of a pack to $13, from the current $10.50 minimum, would make New York the most expensive place in the nation to buy cigarettes, city officials said. (Neuman, 4/19)

That proposed local law is one part of a handful of legislative proposals city officials hope will work to reduce the number of smokers in the city by 160,000 over three years. Currently there are 900,000 smokers in the city, including 15,000 youths, according to figures from the New York City Department of Health and Mental Hygiene. (West and Gay, 4/19)

More than seven months after a Dignity Health hospital refused a hysterectomy to a Sacramento-area transgender patient, the American Civil Liberties Union filed a lawsuit Wednesday on his behalf. The lawsuit, filed in San Francisco Superior Court, alleges that Dignity discriminated against Evan Michael Minton, 35, a former state Capitol legislative aide, when he sought a hysterectomy as part of his transition from female to male. (Buck and Caiola, 4/20)

The State of New Jersey is moving to revoke or suspend the license of a prominent psychologist, accusing him of failing to prevent details of patients’ mental health diagnoses and treatments from being disclosed when his practice sued them over unpaid bills. The complaint against the psychologist, Barry Helfmann, a past president of the New Jersey Psychological Association, followed a ProPublica story published in The New York Times in December 2015 that described the lawsuits and the information they contained. (Ornstein, 4/19)

No one is supposed to sleep or spend more than a few hours in this little building at the Harris County Youth Services Center, called the Point of Entry... But Texas’ embattled child welfare system doesn't have enough��available beds, so��office spaces like the Point of Entry are now being used as temporary homes for foster kids that nobody else wants. (Satija, 4/20)

The mother of one of 10 infants hit by a potentially lethal superbug at UC Irvine Medical Center disputed this week the hospital administration’s claim that parents were told about the outbreak. Briana Walker of Mission Viejo said the hospital staff did not explain when her son tested positive for the bacteria last month that other infants were already being treated for the same infections. She had begun to believe, she said, that her husband or another family member had unknowingly brought the superbug into the intensive care unit from outside. (Petersen, 4/19)

Now, the Trump administration is proposing to cut more than $16 million from Environmental Protection Agency efforts to protect kids like Alex from lead paint. If Congress approves the cuts, successful EPA programs that train contractors on the safe way to remove the lead would be axed. (Tolan, 4/19)

The Benefit Services Group Inc., a benefit consultant and data analytics company in Pewaukee, and Hausmann-Johnson Insurance, an insurance agency in Madison, have merged. The merger brings additional diversification to both companies. (Boulton, 4/19)

Siemens Healthineers, of Malvern, has agreed to buy Medicalis Corp., a health care technology company based in San Francisco and Kitchener, Ontario, Siemens said Wednesday. The price was not disclosed. Medicalis is expected to add to Siemens's services in population health management, which is a term used to describe the practice of keeping track of patients even when they are not in the clinic, Siemens said. (Brubaker, 4/19)

The number of confirmed measles cases in an outbreak that began last week in Hennepin County has now risen to 11. The first three cases were reported last Thursday, and the number of cases has slowly ticked up since then. All of the cases are children ages one through five. (Kraker, 4/19)

State health officials confirmed two additional measles cases on Wednesday, bringing the total to 11 in an outbreak first detected last week. With the case count still rising, public health officials have asked more than 200 people to voluntarily quarantine themselves if they might have been exposed to the highly contagious virus. (Howatt, 4/20)

Beauty salon workers who paint the nails and treat the hair of millions of Californians are regularly exposed to toxic chemicals — and they may not know it, advocates say. The advocates are asking California lawmakers to approve legislation requiring cosmetic companies to list the ingredients of beauty products used in professional salons. The bill, which passed the Assembly health committee Tuesday, will next be heard by the environmental safety committee. (Bartolone, 4/20)

Polk County is a place of so many contradictions. It's the home of beautiful lakes, charming downtowns and historic landmarks. But this birthplace of several of Florida's governors, was also named by one recent study as having the country's second largest percentage of people struggling to avoid hunger. (Colombini, 4/19)

CJE SeniorLife will close its Personal Care Program later this month due to inadequate state funding and the financial crisis in Springfield, officials recently announced." For eligible older adults, CJE provides personal care services at home through a subsidized program for low income seniors administered by the Illinois Department on Aging," CJE SeniorLife says about the program on its website. "These services, for those who qualify, include assistance with bathing, grooming, dressing, errands, light housekeeping, meal preparation and respite." (Isaacs, 4/20)

Waste Control Specialists, which currently stores low-level radioactive waste in Andrews County, has asked the U.S. Nuclear Regulatory Commission to temporarily suspend a review of its application to store tens of thousands of metric tons of spent nuclear fuel currently scattered at reactor sites throughout the country. The Dallas-based company pitched the massive expansion as a solution to a problem that has bedeviled policymakers for decades. (Malewitz and Collier, 4/19)

An audit by independent investigators with the U.S. Justice Department has determined a New Mexico program that helps crime victims allowed federal grant funds to be used to reimburse the purchase of medical marijuana by crime victims. The review released this week by the agency’s inspector general identified $7,630 in questionable costs for four marijuana purchases. (Bryan, 4/19)

GOP moderates and conservatives are nearing a deal on health care that in theory could get the Republican alternative to the Affordable Care Act out of the House and over to the Senate. The changes also might move Republicans even further away from passage ― no one really knows. The deal, brokered between House Freedom Caucus chairman Mark Meadows (R-N.C.) and Tuesday Group co-chairman Tom MacArthur (R-N.J.), would allow states to get waivers eliminating the so-called community rating provision ― the rule that prohibits insurers from charging higher premiums to people with pre-existing conditions. In order to obtain the waiver, states would have to participate in a federal high-risk pool or establish their own, and satisfy some other conditions. (Matt Fuller and Jonathan Cohn, 4/19)

After Republican leaders in Congress failed to destroy the Affordable Care Act last month, President Trump tweeted that the law would “explode.” Now he seems determined to deliver on that prediction through presidential sabotage. Mr. Trump is threatening to kill a program in the A.C.A. that pays health insurers to offer plans with lower deductibles and out-of-pocket expenses to about seven million lower-income and middle-class people. The president thinks that this will get Democrats to negotiate changes to the 2010 health law. This is cruel and incredibly shortsighted. (4/19)

President Trump's threat to withhold Affordable Care Act payments to insurers shows how he thinks of health care: Everything is negotiable, like it is in a real estate deal. In this case, it's his bargaining chip to get Democrats to negotiate on an ACA replacement plan. But in reality, it could panic insurers and crash the marketplaces. (Drew Altman, 4/20)

[T]he reality of healthcare remains for many Americans:��As a country, we spend an��average��of $10,000 per person per year on health care, and that growth will continue at a faster rate than our overall economy over the next decade. Health care is an issue that demands immediate attention from our national leaders. Yet as the White House and congressional leaders regroup after the failure of the AHCA, reports indicate that they are currently working on a health care deal with members of the House Freedom Caucus that would severely weaken politically popular and policy savvy protections for America’s most vulnerable patients. (Michael Steele, 4/20)

All the elements of a debacle will be in place next week when congressional authorization expires for financing the U.S. government. Lawmakers, on recess now, will have only four days to iron out a deal. Right-wing Republicans see a chance to enact abortion curbs and anti-immigrant measures that opponents won't countenance. Democrats are in no mood to offer concessions. And the administration of President Donald Trump has trouble getting its act together. Sound like a government shutdown in the making? It's very unlikely. (Albert R. Hunt, 4/19)

When Ebola began to spread in West Africa in December 2013, it was invisible. A 2-year-old who had been playing near a bat-filled tree in southeastern Guinea died, apparently the first victim, but it took months for health workers to detect and report the spread of a disease with a high mortality. Soon it raged across Guinea, Sierra Leone and Liberia, sickening 28,000 people and killing 11,000. Scientists have now tracked the pathways of the virus in once-unimaginable detail, providing important lessons for preventing another outbreak. This is a terrific example of science at work for society, and it shows why this weekend’s March for Science is relevant. (4/19)

The April 22 March for Science, focused on Washington, D.C., but accompanied by some 400 complementary events worldwide, promises to be a motley affair. According to one of the young scientist-organizers, it is intended to help inexperienced science advocates develop the skills they need “to make their concerns heard” and to “have an effect on politics,” while maintaining a nonpartisan atmosphere. Nonpartisan atmosphere? They’re about to discover what Dr. Victor Frankenstein felt like when his creation ran amok. It’s clear that the march will be hyper-partisan, an outlet for Trump-haters of every description. (Julie Kelly and Henry I. Miller, 4/20)

When Ohio announced in 2009 that it planned to abandon the three-drug lethal injection protocol that virtually all jurisdictions had employed for the past three decades, many assumed that most other states would soon follow suit. After all, Ohio’s new protocol, which involved an overdose of a single barbiturate, was touted as being easier to administer and less risky. Eight years later, however, the three-drug protocol is still very much in use, and its current application likely violates the 8th Amendment’s prohibition on cruel and unusual punishment. (Ty Alper, 4/20)

On a crisp morning in the struggling Bay Area city of Richmond, Calif., Doria Robinson prepares a community vegetable garden for an onslaught of teenagers who will arrive that afternoon. Beyond the farm, a Chevron refinery pumps plumes of smoke into the atmosphere. The farm won’t remove the pollution, but Robinson believes it can make the city’s residents healthier in other ways, specifically by showing them that “their actions have an impact.” (Amy Maxmen, 4/19)

About 115,000 individuals in Wisconsin age 65 and older are living with some form of clinically diagnosable dementia, and by 2040 that population is expected to grow to 240,000. ... Unfortunately, all of the progress we’ve seen as a result of these efforts is at risk, as the 2017-'19 state budget removes funding for dementia care specialists throughout Wisconsin. (Chris Abele and Troy Streckenbach, 4/19)

Before dementia, my sweet 90-year-old mama taught elementary school, sang in a Yiddish chorus, told great stories, had lots of friends, entertained often and with ease, and did volunteer work. Her one aggravating quality was the watchful worrier that lurked within, ready to explode into full, undistractable panic at any moment. ... And now that she has forgotten so much and lost so many parts of herself — her charm, her humor, her musicality and her ability to befriend — you’d think it only fair she’d finally be rid of her anxiety. But no. The last reverberation of her personality is the one trait that brought her and those she loved the most unhappiness. Like a cruel joke, she has been whittled down to her core, and her core is worry. (Amy Koss, 4/20)