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Top Senate negotiators said an effort to renew expired healthcare subsidies had effectively collapsed, likely ending the hopes of 20 million Americans that the tax-credit expansion could be revived and lower their monthly insurance premiums. Talks had centered on a proposal from Sens. Bernie Moreno (R., Ohio) and Susan Collins (R., Maine) to extend a version of the enlarged Affordable Care Act subsidies for at least two years, while cutting off higher-income people from participating and eventually giving enrollees the option of putting money into health savings accounts. It also would eliminate zero-dollar premium plans. But lawmakers from both parties now say the chances of a deal have all but evaporated. “It’s effectively over,” Moreno said Wednesday. Sen. Bill Cassidy (R., La.)—the architect of an adjacent plan—agreed. While Collins declined to be as definitive, she did say that it was “certainly difficult.” (Hughes and Bhutani, 2/4)

Huge premium increases on the health insurance exchanges mean opportunity for companies selling cheaper, skimpier plans. Companies such as UnitedHealth Group, Medi-Share, CrowdHealth and LendingTree flooded social media platforms, advertised on radio and promoted products such as short-term, limited duration plans and Christian sharing ministries. The campaigns targeted consumers, especially young adults, who found they couldn’t afford exchange coverage or don’t perceive value in comprehensive medical insurance. (Tepper, 2/3)

The next big thing in health insurance might be stymied by the last big thing in health insurance. Insurers such as Centene and Oscar Health and venture capital-backed startups have been aggressively promoting individual coverage health reimbursement arrangements, or ICHRAs, as a solution to rising employer health benefit costs over the past several years. But while companies like those are outwardly confident about the market’s prospects, there’s reason to believe they should be more worried. (Tong, 2/4)

Related news about the high cost of health care —

Prices rose 11% at ambulatory surgery centers after they were bought by Optum, probably because the newly acquired providers were able to negotiate higher prices with insurers, according to a new study highlighting how vertical consolidation drives up healthcare spending. (Parduhn, 2/3)

On prescription drug prices —

The Federal Trade Commission announced on Wednesday that it had reached a settlement with Cigna’s Express Scripts, one of the nation’s largest pharmacy benefit managers, over its role in driving up insulin prices. Express Scripts will not pay a fine or face a financial penalty as part of the deal and did not admit to any wrongdoing. But the company agreed to a range of changes to its business model. (Robbins and Abelson, 2/4)

The pharmacy benefit manager reforms that President Trump signed into law on Tuesday could lead to employers buying drugs directly from drugmakers, just like the administration is encouraging individual consumers to do through its pending website TrumpRx. (Wilkerson, 2/4)

Autism has historically been viewed as a condition that affects men and boys more frequently than women and girls. But a massive new study based on data from millions of people suggests this isn't actually the case, at least in Sweden. While boys are diagnosed with the condition at higher rates during childhood, by adulthood, the ratio is roughly 1:1. This suggests it's not a case of fewer women having autism: it's just that they aren't diagnosed until later in life. (Cockerill, 2/5)

The largest study to date of leucovorin’s effectiveness for treating autism traits has been retracted because of data inconsistencies and statistical issues, according to a notice posted last week by the European Journal of Pediatrics. The study included 77 autistic children and is one of only five randomized clinical trials that have tested leucovorin, also known as folinic acid, in autistic people. (Lopez Lloreda, 2/3)

The FDA removed a webpage that warned consumers about potentially dangerous products and therapies marketed as autism treatments. An archived version of the page said the agency had warned or taken action against companies that made improper claims that their products could treat or cure autism or autism-related symptoms. (George, 2/4)

In updates from the NIH —

Many researchers are surprised and relieved over an unusual step taken by the US National Institutes of Health (NIH): the agency is rolling back the red tape on a host of basic-science experiments that involved human participants and had been classified as clinical trials. The decision, which was announced on 29 January and is part of a broader NIH effort to reduce the administrative burden, should free such research from the heavy bureaucratic requirements that are designed for clinical trials but are sometimes ill-suited to other fields, such as basic psychology and behavioural studies. “It was definitely a nuisance,” says Jeremy Wolfe, a cognitive psychologist at Harvard Medical School in Boston, Massachusetts. (Ledford, 2/4)

The National Institutes of Health wants to transition at least one of seven national primate research centers into an animal sanctuary, aiming to move away from animal testing in favor of alternative methods. The NIH-funded centers, hosted by universities and research institutions, conduct primate research on conditions and diseases that affect human health. They have been a primary target of animal rights organizations, like People for the Ethical Treatment of Animals. (Gardner, 2/4)

Flames shot from the roof of Lehigh Valley Hospital-Dickson City on Wednesday night forcing patients and employees to evacuate and prompting a massive response from about 100 firefighters and first responders from throughout the region. Lackawanna County Emergency Management Agency Director Tom Taylor said 77 patients were evacuated and relocated to area hospitals. Dickson City Fire Chief Richard Chowanec said there were no injuries. The extent of the damage to the hospital was not clear late Wednesday, but its closure, even temporarily, would add pressure to an already strained local health care landscape, including in terms of emergency department beds. (Gibbons, Horvath and Tomkavage, 2/5)

More health care industry updates —

DaVita Kidney Care and private equity firm Ares Management are acquiring Elara Caring in a deal that could represent a new approach to growing the kidney and home care sectors. DaVita said this week it plans to spend $200 million for an unspecified minority stake in the home health and hospice company. The deal would bring together one of the nation’s largest kidney services providers by revenue and a major player in the home health and hospice sector. A spokesperson for Ares would not disclose the size of the private equity firm’s majority stake. (Eastabrook, 2/4)

Kaiser Permanente and Renown Health have wrapped the paperwork on a deal forming an insurance and outpatient care joint venture in northern Nevada. (Muoio, 2/3)

Health systems are looking to profit from the expertise of their employees, bringing innovations for the industry to market through the formation of companies. Several health systems recently have commercialized technologies created internally. Experts say the strategy comes with a separate set of challenges than traditional venture investing. (Perna, 2/3)

The arms race over the future of cancer care in Boston intensified on Wednesday when Dana-Farber Cancer Institute announced the largest single gift in its 79-year-history, for its planned $1.68 billion, 300-bed cancer hospital. Dana-Farber, which wants to build the hospital on the site of Joslin Diabetes Center in the Longwood Medical Area as part of a partnership with Beth Israel Deaconess Medical Center, didn’t disclose the size of the gift. The donors, Josh and Anita Bekenstein and the Jonathan and Jeannie Lavine family, want to keep the amount private. (Saltzman, 2/4)

Also —

More than one-fourth of doctors enrolled in Medicaid didn’t actually deliver care to any Medicaid beneficiaries in 2021, according to new research adding to worries about low physician participation in the safety-net insurance program. (Parduhn, 2/4)

Several people became sick from an alleged bio lab running out of a Las Vegas home that also served as an Airbnb, according to documents the 8 News Now Investigators at Nexstar’s KLAS obtained Tuesday. Metro police and the FBI searched the Sunrise Manor home on Saturday, Jan. 31, finding a “possible biological laboratory,” including “refrigerators with vials containing unknown liquids,” police said. (Charns, 2/4)

Health news from Idaho, Utah, Texas, and Louisiana —

Idaho is taking steps to bolster its antiquated coroner system following stories by ProPublica that documented how lawmakers have repeatedly failed to fix problems that harm grieving families. An advisory panel created last year at the request of Gov. Brad Little is developing legislation to require autopsies in a variety of circumstances, including the unexplained death of a child. It would help coroners pay for those autopsies as long as they get a national certification that proves they can meet certain standards. (Dutton, 2/4)

Few Utahns have witnessed the effects of withdrawing transgender kids’ access to care as Collin Kuhn, a clinical child and adolescent psychologist who specializes in helping their clients navigate challenges and questions related to gender. The difference between receiving care and not receiving care, they said, is “night and day.” (Stern, 2/4)

A Travis County judge on Wednesday ruled against two voters trying to challenge a new $3 billion dementia research fund, which still can’t go into effect despite Texas voters overwhelmingly approving it last November. (Langford, 2/4)

�鶹Ů�� Health News: Poison At Play: Unsafe Levels Of Lead Found In Half Of New Orleans Playgrounds
Sarah Hess started taking her toddler, Josie, to Mickey Markey Playground in 2010 because she thought it would offer a refuge from lead. After a routine doctor visit revealed Josie had lead poisoning, Hess quickly traced the source to the crumbling paint in her family’s century-old home in the Bayou St. John neighborhood. While it underwent lead remediation, the family stayed in a newer, lead-free house near Markey. “Everyone was telling us the safest place to play was outside at playgrounds, so that’s where we went,” Hess said. Josie became a Markey regular, playing on the swings and slides. (Baurick and Parker, 2/5)

From California —

A cluster of new measles cases reported across California has been linked to a visit to Disneyland late last month, with public health officials warning that thousands of people may have been exposed. Four measles cases have been reported in California in the past five days, and three of the infected people visited Disneyland around Jan. 28, according to a notice issued Tuesday by Plumas County Public Health. (Vaziri, 2/4)

�鶹Ů�� Health News: Newsom Walks Thin Line On Immigrant Health As He Eyes Presidential Bid
California Gov. Gavin Newsom, who is eyeing a presidential bid, has incensed both Democrats and Republicans over immigrant health care in his home state, underscoring the delicate political path ahead. For a second year, the Democrat has asked state lawmakers to roll back coverage for some immigrants in the face of federal Medicaid spending cuts and a roughly $3 billion budget deficit that analysts warn could worsen if the artificial intelligence bubble bursts. (Mai-Duc, 2/5)

From New York —

Two weeks after the Trump administration formally withdrew the United States from the World Health Organization, the New York City Health Department joined a W.H.O. network aimed at countering new pathogens and emerging outbreaks. (Goldstein, 2/4)

In six months, terminally ill New Yorkers will have the ability to request life-ending medication, as a decade-long fight to pass the measure comes to a close. New York will become the fourteenth state in the country to legalize Medicaid Aid in Dying for terminally ill patients expected to have less than six months to live. Illinois and Delaware legalized similar measures late last year. (Cordero, 2/4)

Seventeen people have died outside in New York City since Jan. 19, as the region experiences an unusually long stretch of ultra-cold temperatures. At least 13 of the deaths were likely caused by hypothermia, Mayor Zohran Mamdani said on Wednesday. Three fatalities appear to be overdoses while the cause of one is unknown, he said. Since the middle of January, the city placed 1,100 people into shelter beds and has involuntarily transported 20 people “who were determined to be a danger either to themselves or to those around them” to city health-care facilities, according to Mamdani. (Nahmias, 2/4)

Novo Nordisk said Wednesday that demand for its Wegovy pill got off to a strong start after it launched in the U.S. in early January. By Jan. 23 — less than three weeks after it became available — about 50,000 prescriptions were being filled each week, according to the drugmaker. In total, more than 170,000 people are taking the drug. Roughly 9 in 10 of those prescriptions were paid for out of pocket, rather than through insurance. (Lovelace Jr., 2/4)

Oral semaglutide (Rybelsus) protected against heart failure events in type 2 diabetes patients with a history of heart failure and either atherosclerotic cardiovascular disease, chronic kidney disease, or both, according to findings from a randomized trial. (Monaco, 2/2)

Jason Krynicki will never forget how obesity made him a target for vicious bullying from the time he was little. Those memories haunt him even now, even though he weighs a willowy 127 pounds at age 43. "You try to eat, and in the back of your mind, your mind still goes back to what people said to you 20 years ago," Krynicki says, recalling how he was derided for his large appetite or the food he ate. Other kids — his doctors, even — called him fat, and worse. (Noguchi, 2/4)

Novo Nordisk A/S hired a new US chief charged with turning around the company’s most important market where mounting pricing pressure and intensifying competition are eroding its grip on the obesity-drug boom. Jamey Millar joins the maker of Ozempic and Wegovy Thursday as executive vice president of US operations. He succeeds Dave Moore, who is leaving the company for personal reasons after just a year in the role. (Wass and Kresge, 2/4)

Hims & Hers is returning to the Super Bowl one year after its controversial ad sparked a backlash from lawmakers and pharmaceutical companies. The telehealth company, which offers medications and treatments for weight loss, hair loss and mental health, is returning to the Big Game with a 60-second spot on the economic gaps that exist within the healthcare delivery system. They aren’t the only healthcare company willing to dig deep into their pockets to get in front of viewers. Ad rates for a 30-second spot this year have surged to as much as $10 million, according to media reports. (Perna, 2/4)

In other pharmaceutical developments —

Food and Drug Administration officials are advising drug developers to study the long-term effects of using CAR-T to treat patients with autoimmune conditions, out of concern the therapies could cause cancer or fertility issues. (DeAngelis, 2/2)

Vertex executives warned that Casgevy, its curative treatment for sickle cell disease, would be slow to reach patients. But few expected it to be this slow. (Mast, 2/5)

A new kind of pill sharply reduced artery-clogging cholesterol in people who remain at high risk of heart attacks despite taking statins, researchers reported Wednesday. It’s still experimental but the pill helps rid the body of cholesterol in a way that today can be done only with injected medicines. If approved by the Food and Drug Administration, the pill, named enlicitide, could offer an easier-to-use option for millions of people. (Neergaard, 2/4)

Chronic exposure to pollution from wildfires has been linked to tens of thousands of deaths annually in the United States, according to a new study. The paper, published Wednesday in the journal Science Advances, found that from 2006 to 2020, long-term exposure to tiny particulates from wildfire smoke contributed to an average of 24,100 deaths a year in the lower 48 states. “Our message is: Wildfire smoke is very dangerous. It is an increasing threat to human health,” said Yaguang Wei, a study author and assistant professor in the department of environmental medicine at Icahn School of Medicine at Mount Sinai. (Pineda, 2/4)

In other health and wellness news —

Nearly four in 10 cancer cases diagnosed around the world in 2022 can be traced back to risks people and societies have the power to change, according to a sweeping new global study. The analysis, published in Nature Medicine, examined 36 cancer types across 185 countries and linked today’s cancer diagnoses to how common certain risk factors were about a decade earlier. The time lag reflected the reality that cancers often take years to develop after exposure. (Gray, 2/4)

Pink noise, a staticky sound that’s supposed to help people fall asleep, may actually worsen your rest, a new study found. Pink noise — like white noise — contains all the frequencies humans can hear, but it plays lower frequencies more prominently. Sounds that are used for different types of brain stimulation or relaxation are assigned a color based on how their noise spectrum matches with a colored light spectrum. White noise plays all frequencies at the same intensity, and white light combines all the visible light colors. (Ozcan, 2/4)

Preventive cholera vaccination programs will restart globally after they were halted for nearly four years due to a vaccine shortage, the World Health Organization said Wednesday. In a joint statement, WHO, vaccine alliance GAVI and the United Nations Children’s Fund said stocks of oral cholera vaccines in the global stockpile they manage had improved to nearly 70 million doses last year. The vaccines are distributed free to countries that need them, but they had to be used only in reaction to outbreaks rather than preventative campaigns after a shortage was announced in 2022 because of a surge in demand. (2/4)

In reproductive health news —

A study led by University of California, Los Angeles (UCLA) anthropology professor Molly Fox has found that pregnancy and breastfeeding are linked with stronger cognitive function in postmenopausal women. Specifically, the team reports that greater cumulative time spent pregnant and breastfeeding correlates with better global cognition, as well as verbal and visual memory, later in life. (Gray, 2/4)

Women who underwent opportunistic bilateral salpingectomy (OBS) with hysterectomy had almost an 80% lower risk of developing serous ovarian cancer versus hysterectomy alone, a large retrospective cohort study showed. (Bankhead, 2/4)

Menopause clinics across the U.S. are hearing from women who are having trouble filling prescriptions for estrogen patches, a common hormone replacement therapy. “There’s just more demand for these medications, and I think it’s exponentially risen over the last three or four years,” said Dr. Rajita Patil, director of UCLA Health’s Comprehensive Menopause Program. “I don’t think that the supply chain was ready for that.” Hormone replacement therapy prescriptions for women 50-65 have increased 86% since 2021, according to Epic Research, which analyzes electronic health records nationwide. (Kopf, 2/3)

Before Ivey Cross was ever expecting, she was glued to TikTok videos of women describing their experiences of giving birth at home. Twenty-five weeks into her own pregnancy, she decided to do so herself. She took an online home-birthing class, watched YouTube videos, reached out to midwife practices to assemble her care team and hired a doula. (Ashley O'Brien, 2/3)

It was after seeing a friend go through multiple miscarriages that Kristin Spaans decided to help. With two children of her own, the now 38-year-old offered to become a surrogate and carry her friend’s baby — for which her friend is paying her just under $13,000, she said, on the low-end as far as typical compensation goes. The experience has not been without hiccups. Spaans needed a medical exemption to continue taking an SSRI for anxiety, and there were other delays. “Since surrogacy is such a process of trying to eliminate risk, they just take all the precautions,” she said. (Klotz, 2/5)

Patients with advanced non-small cell lung cancer who received immunochemotherapy in the morning or early afternoon had better survival outcomes compared with patients who received treatment later in the day, a phase III randomized trial showed. (Bassett, 2/2)

Sanofi’s Cerezyme has long been used as a treatment for Gaucher disease, a rare illness that can cause enlarged spleens and livers, bone pain, and fatigue. Patients with the kind of Gaucher that causes neurological problems, however, haven’t had a treatment option to address their symptoms. (Joseph, 2/2)

Abnormally high levels of lung-injury biomarkers in the blood after COVID-19 infection may flag patients at risk for ongoing lung disease, an Imperial College London–led study suggests. The team analyzed concentrations of lung-injury biomarkers in the plasma of 957 COVID-19 survivors participating in the observational Post HOSPitalisation-COVID study five months after hospital admission. Patients had similar COVID-19 severity on hospitalization. (Van Beusekom, 1/29)

The 2024-25 COVID-19 vaccine was an estimated 40% effective against hospital admission and 79% effective against invasive mechanical ventilation (IMV) or death, with similar efficacy against the KP.3.1.1 and XEC variants, although with considerable uncertainty, researchers from the US Centers for Disease Control and Prevention (CDC) reported yesterday in JAMA Network Open. (Van Beusekom, 2/4)

Adults hospitalized with an acute respiratory syncytial virus (RSV) infection may face a sharp risk of cardiorespiratory events such as heart attack or stroke in the weeks afterward, according to a retrospective self-controlled case study. (Rudd, 2/4)

For older patients with acute dissections affecting the ascending aorta, a more extensive arch reconstruction surgery was not necessarily better, according to nationwide data. (Lou, 2/2)

Medical assistance in dying—a euphemism for physician-enabled suicide—has been gaining legislative ground in jurisdictions around the country. Twelve states and Washington, D.C., allow doctors to prescribe lethal dosages of medications to patients with terminal illnesses, and a new law takes effect in New York this year. (Elizabeth Bruenig, 2/4)

Activists won the legal battle. Are they losing the culture war? (Ross Douthat, 2/5)

The Trump administration is preparing to launch TrumpRx.com, an initiative aimed at lowering drug costs by aggregating direct-to-consumer access to branded prescription medications at discounted cash prices. The promise is seductive: lower prices on brand-name medications, available to anyone willing to bypass their insurance and pay out of pocket. (Sean D. Sullivan and Ryan N. Hansen, 2/5)

Tens of millions of seniors have recently wrapped up Medicare’s open enrollment period, and the Centers for Medicare and Medicaid Services is touting premium stability in the Medicare Advantage (MA) program. But it’s pitching a deceptively calm picture, like a duck gliding across the water, its feet churning furiously below the surface. (Donna Shalala, HHS chief under President Bill Clinton, and Tommy G. Thompson, HHS chief under President George W. Bush, 2/5)