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House Republicans on Wednesday pushed through a $622 million bill to battle the Zika virus, setting up challenging negotiations with the Senate and the White House. The 241-184 House vote broke mostly along party lines as Democrats lined up in opposition, heeding a White House veto threat and a warning from a top government health official that the bill wouldn’t do enough to respond to the growing threat from Zika. “It’s just not enough,” Centers for Disease Control and Prevention Director Tom Frieden said of the House measure. (5/19)

House Republicans on Wednesday overwhelmingly approved a $622 million bill to combat the Zika virus, creating a pot of funds about one-third the size requested by the White House. All but four Republicans who cast votes were in favor of the bill, which funds federal research, prevention and treatment efforts for the next six months. (Ferris, 5/18)

Democrats and the White House have been hammering at Republicans for dragging their feet on Zika, but the political tempest in Washington hasn't been matched by fear among the public, at least according to recent polling. GOP leaders see a political imperative to act as the summer mosquito season heats up. The House bill, however, provides one-third of the request and limits the use of the money to the current budget year, which ends Sept. 30. It cuts funds provided in 2014 to fight Ebola to help offset the additional Zika money. (5/19)

A group of Democrats is objecting to the House’s bill funding a response to the Zika virus in part because it continues restrictions on federal funding for abortions. (Sullivan, 5/18)

The man who led the successful White House response to the Ebola outbreak says the Zika virus is a slow-motion public health disaster — and Congress is to blame. Ron Klain, who served as White House Ebola czar and as Vice President Joe Biden’s chief of staff, told POLITICO's “Pulse Check” podcast that Congress has failed to heed the lessons of the Ebola epidemic and that the Zika funding battle has become unforgivably partisan in the face of such dire human costs, including severe brain defects in infants. “The babies being born are neither Democrats or Republicans,” he said. “They're babies.” (Diamond, 5/18)

When an outbreak strikes, the Epidemic Intelligence Service is the calvary. The Centers for Disease Control and Prevention ships this branch to the front lines, where they investigate the causes and set up defenses. (Akpan, 5/18)

With the rainy season about to arrive and 45 confirmed Zika cases this year, more than any other county in Florida, Miami-Dade commissioners will consider changing the county’s legal code on Tuesday to empower mosquito control workers during public health emergencies to act within two days instead of the current five to clear empty containers and other breeding grounds for the disease-spreading insects when located on private property. Speaking on the lawn of Miami-Dade’s government center, Mayor Carlos Gimenez said the county’s Zika preparedness plans rely as much or more on residents’ cooperation as they do on spraying and surveillance efforts. (Chang, 5/18)

A Wisconsin woman has the first confirmed case of the Zika virus in the state, the Department of Health Services said Wednesday. The woman recently traveled to Honduras, where mosquitoes carrying the Zika virus are present. There have been no locally acquired cases of the Zika virus infection in Wisconsin or in the continental United States, the department said in a news release. (Stephenson, 5/18)

"Careful" describes the approach many women in the South say they’re taking as mosquito season starts up in the region. The CDC has linked Zika to microcephaly, a birth defect where babies are born with smaller heads and smaller brains that don’t develop properly. The World Health Organization says as of the middle of May 2016, more than 1,300 cases of microcephaly and other neurological disorders believed to be Zika-related had been reported from nine countries, including the U.S. Georgia has seen 13 Zika cases so far, all of them in people who have traveled to one of the 55 countries where the WHO says Zika is active. None of the cases were in pregnant women. (Eloy, 5/19)

New York health insurers have proposed premium increases averaging 17 percent for next year in the market for individuals and 12 percent for small groups. The Department of Financial Services often reduces proposed increases before approving them. Approved rates are expected in early August. The amounts posted Wednesday by the department are averages for an insurer's various plans, including those offered on the New York Health Exchange. (5/18)

New York health insurers are seeking to raise the premiums that customers pay for individual Affordable Care Act plans by an average of 17.3 percent for next year, the latest in a wave of double-digit increases for the government health program. (Tracer, 5/18)

New Mexico regulators are unveiling details about the health insurance premiums proposed by insurers for next year, and there are indications the state will not escape the hefty increases expected nationwide. (Montoya Bryan, 5/19)

California state legislators and advocates are racing to get federal approval in the waning months of the Obama administration for a proposal to allow immigrants living in the U.S. illegally onto the California insurance exchange. Fearful that a new administration will torpedo their plans, they are working hard to win legislative support in California and clear other hurdles at the state and federal level. California state Sen. Ricardo Lara is carrying a bill to allow people living in the country illegally to purchase health insurance — on their own dime — through the state exchange. (Bartolone, 5/19)

Enrollment in individual health care plans, now dominated by the Affordable Care Act exchanges, fell 15.4 percent in the first quarter for the parent of Blue Cross and Blue Shield of Illinois. At the end of March, Chicago-based Health Care Service Corp. had 1.39 million individual members, compared with 1.64 million as of Dec. 31. (Sachdev, 5/18)

Federal data shows West Virginia had the greatest percentage drop among the states over a two-year period for adults without health insurance. The Centers for Disease Control and Prevention issued the findings this week. West Virginia's rate of uninsured adults ages 18 to 64 was 8.9 percent in 2015, down from 28.8 percent in 2013. (5/19)

Nine out of 10 working-age adults in the United States were covered by health insurance last year, and the number of uninsured continues to decline, according to new figures released by the federal government. (Ba Tran, 5/19)

Indiana's uninsured rate hit a historic low of 14.8 percent in 2015 — a decrease of more than 3 percent from 2014 — according to newly released survey data from the U.S. Department of Health and Human Services. (Lazerus, 5/19)

The Supreme Court has gone into hibernation, withdrawing from the central role it has played in American life throughout Chief Justice John G. Roberts Jr.’s decade on the court. The court had leaned right until the death of Justice Antonin Scalia in February. According to the conventional wisdom, the court is now evenly divided and large numbers of 4-to-4 ties are inevitable. But the truth is more complicated. The court is not deadlocked so much as diminished. The justices will continue to issue decisions in most cases, but many will be modest and ephemeral, like Monday’s opinion returning a major case on access to contraception to the lower courts for further consideration. (Liptak, 5/18)

In an effort to better provide healthcare to Georgia's exploding population and as a way to balance the state's budget, conservative lawmakers are renewing temporary Medicaid payment increases and looking at expanding the program, according to a Republican state Senate leader. Sen. Renee Unterman, chairwoman of the Senate's Health and Human Services committee, said that while she's been critical of Medicaid expansion, she's seeing hospitals close and people waiting to see providers. Unterman added that she is not alone, and that she believes there is enough support in the Senate for a conservative expansion model, similar to the one in place in Arkansas. (Dickson, 5/18)

The Arkansas Department of Human Services on Wednesday opened for public comment a draft of the request it will submit to the federal government to allow changes to the state's private option Medicaid program and extend the waiver authorizing it through 2021. ... The proposed changes, which would take effect Jan. 1, include charging premiums of about $19 a month to enrollees with incomes above the poverty level, providing coverage to some enrollees through subsidized employer plans and offering an extra benefit, such as dental coverage, as an incentive for enrollees to pay premiums and receive annual wellness exams. The state would also eliminate retroactive coverage for enrollees to "better align" the program with commercial insurance coverage, according to the extension application. (Davis, 5/19)

Louisiana’s health department is withdrawing a request for the ethics board to determine if donations helping to pay for the rollout of Gov. John Bel Edwards’ Medicaid expansion comply with state ethics laws. While Health and Hospitals Secretary Rebekah Gee told lawmakers recently that no request had been made of the ethics board, a Jan. 25 letter posted on the Board of Ethics website shows the health department asked for the opinion. The request was revoked in a Feb. 1 letter, after the Department of Health and Hospitals received federal permission for the financial arrangement, which involves a private foundation collecting donations from health providers to help cover DHH’s administrative costs associated with the coverage expansion. (Deslatte, 5/18)

Millions of full-time healthcare workers will be eligible for overtime pay under a new federal rule that nearly doubled the threshold at which companies can deny it. But not all in the healthcare industry are cheering the news. (Castellucci, 5/18)

Theranos Inc. has told federal health regulators that the company voided two years of results from its Edison blood-testing devices, according to a person familiar with the matter. The Edison machines were touted as revolutionary and were the main basis for the $9 billion valuation attained by the Palo Alto, Calif., company in a funding round in 2014. But Theranos has now told regulators that it threw out all Edison test results from 2014 and 2015. The company has told the Centers for Medicare and Medicaid Services that it has issued tens of thousands of corrected blood-test reports to doctors and patients, voiding some results and revising others, according to the person familiar with the matter. (Carreyrou, 5/18)

Theranos spokeswoman Brooke Buchanan said Wednesday that no patients suffered harm due to the inaccurate tests, citing an analysis conducted by the company. She declined to provide details of the analysis. (McLean, 5/19)

South Carolina has become the latest state to restrict women’s access to abortion, with legislators passing a bill that bans women from obtaining an abortion at 20 weeks or later, even if she has been raped or is a victim of incest. ... Sixteen other states, including Alabama and Wisconsin, have passed legislation similar to South Carolina's. Most have applied the limit at 20 weeks post-fertilization (22 weeks after the woman’s last menstrual period), but two states – Arizona and Mississippi – have banned abortions after 18 weeks. ... Momentum has reached an unprecedented level in the last six years, as conservative legislators, predominantly in the Southeast and the Midwest, have drawn up an unprecedented number of laws that limit women’s abortion access – from tightening clinic regulations, introducing mandatory waiting periods, and placing limits on minors’ access to abortion. (Jarvie, 5/18)

An Ohio law that strips government funding from Planned Parenthood is forcing some local health officials to scramble to find replacement providers for certain services. The law targets the more than $1 million that Planned Parenthood gets through Ohio's health department. The money, which is mostly federal, supports a variety of programs including initiatives that seek to reduce infant mortality and provide cancer screenings. The law bars such public funds from going to entities that perform or promote abortions. (5/19)

Ed White has had a devilish time getting his painkiller prescription filled for intense back pain since a federal crackdown on opioid sales battened down the pharmacy shelves at the Walgreens near his home in Port Richey, Fla. Across the state in Fort Lauderdale, Maureen Kielian just put her son into a residential treatment facility to try to break his life-threatening opioid addiction. To suggest that the federal authorities have been too aggressive amid an opioid epidemic killing 29,000 people a year is absurd, she said. Faced with these competing stories, Congress has whipsawed between ensuring access to narcotic painkillers for people like Mr. White and addressing the addiction epidemic linked to those drugs. (Harris and Huetteman, 5/18)

Amid a raging opioid epidemic, there’s a plea for more treatment options. The Food and Drug Administration expects to have a decision on one by May 27. It’s an implant. Four rods, each about the size of a match stick, inserted in the upper arm. This new device, called Probuphine, delivers a continuous dose of an existing drug, buprenorphine but with better results, says implant maker Braeburn Pharmaceuticals. (Bebinger, 5/19)

As the population of people diagnosed with autism spectrum disorder keeps growing, so does the number of people with that diagnosis who aren't finding employment. Though many young adults on the spectrum are considered high functioning, recent research shows 40 percent don't find work — a higher jobless rate than people with other developmental disabilities experience. Research scientist Anne Roux, of the A.J. Drexel Autism Institute in Philadelphia, studies young adults with autism and was the lead author of that study. (Noguchi, 5/18)

More than a quarter of gay and bisexual men in some cities and states in the South are living with H.I.V., according to a new study — a far higher rate than in the country as a whole. The study shows how much more common H.I.V., the virus that causes AIDS, is among gay black men, especially in the South, as well as how little is being done to prevent its spread in a group whose members face discrimination and are less likely to have medical insurance. (McNeil, 5/18)

A single question asked at an annual checkup — whether parents have trouble making ends meet — could help pediatricians identify children at risk for serious health problems associated with poverty and the chronic levels of stress that often accompany it. The American Academy of Pediatrics urges members to ask if their patients' families are struggling financially and then commit to helping them get the resources they need to thrive. And some communities are trying to make that happen. Since almost half of young children in the United States live in poverty or near poverty, it's no small challenge. (Korry, 5/18)

A handful of scientists around the United States are trying to do something that some people find disturbing: make embryos that are part human, part animal. The researchers hope these embryos, known as chimeras, could eventually help save the lives of people with a wide range of diseases. One way would be to use chimera embryos to create better animal models to study how human diseases happen and how they progress. (Stein, 5/18)

Single mothers, untenured professors, young reporters and on-call doctors might have a thin silver lining for their hurried days and response for the people who insist on slowing down: All that hustling may translate into superior brain power as you get older, as a study finds that the busiest people perform best on cognitive tests. Sara Festini, a postdoctoral researcher at the University of Texas, Dallas, and her adviser, Denise Park, published the study in Frontiers in Aging Neuroscience on Tuesday. They tested over 300 people between the ages of 50 and 89 on cognitive functions including memory, reasoning and mental quickness. (Chen, 5/18)

You don't want to get colon cancer, of course, but it turns out you really don't want to get cancer on the right side of your colon. New research suggests that where a tumor blooms on the colon matters quite a bit — and that patients might benefit from different treatment depending on which side is afflicted. (Kurtzman, 5/19)

A decadelong study of patients diagnosed with terminal colon cancer has yielded a remarkable conclusion: Patients can expect to live more than a year longer if their tumor started on the left side of their colon rather than the right side. (Seipel, 5/18)

Robert Schreiber and Dr. Graham Colditz of Washington University were named to advisory committees for the National Cancer Moonshot Initiative. The initiative is led by Vice President Joe Biden to streamline government, academic and business efforts toward cancer research and treatments. (Bernhard, 5/18)

Oregon hospitals took a step toward price transparency on Wednesday, promising to provide cost estimates for scheduled procedures within three days. The initiative aims to give uninsured patients and those who are out-of-network a better idea of what a procedure will cost. (Terry, 5/18)

More than 7,300 patients at a San Diego-area hospital may have been exposed to infection from contaminated medications last year, state records show. The problems were traced to the compounding pharmacy lab at Paradise Valley Hospital in National City, California, where inspectors found “dust, stains and foreign material” in a supposedly sterile environment in which thousands of intravenous medications were prepared over eight months — from Jan. 1 to Aug. 18. During their investigation into the pharmacy, California health inspectors found that oversight of infection control was lacking throughout the hospital, according to documents obtained by a reporter through the California Public Records Act. (Terhune, 5/19)

The Kansas Legislature will have to approve any plans to privatize the state’s two mental health hospitals after Gov. Sam Brownback signed a bill that limits a state agency’s ability to go it alone. (Hart, 5/18)

St. Louis Children's Hospital is opening a new center that will allow young patients enduring long hospital stays to reunite with their pets. The Purina Family Pet Center officially opened Wednesday with a golden retriever mix named "Happy Jack" tugging away the ribbon. The hospital said the room gives patients a chance to see their pets without leaving the building and the medical technology that is important in their treatment and recovery. (5/18)

It’s called “community benefit,” the money that hospitals spend on treating patients who can’t pay their bills and providing additional services, like health fairs, to their surrounding community. (Hoban, 5/19)

Now that Maryland Gov. Larry Hogan has signed legislation allowing established hospital operators to open a freestanding medical facility without going through the state's lengthy certificate of need process, significant changes in Harford County's health delivery system are expected. (Anderson, 5/18)

Kansas will forgo more than $120 million in combined state and federal money for its Medicaid system in the wake of state budget cuts that spared public education. Gov. Sam Brownback’s office simultaneously announced his signing of the budget and $97 million in cuts to state spending on Wednesday. More than half of that will come out of the state’s Medicaid system, which provides health coverage for low-income Kansans and accounts for 20 percent of the state’s general fund budget. (Lowry, 5/18)

Gov. Sam Brownback trimmed more than $56 million from Medicaid in Kansas as part of larger budget cuts announced Wednesday, raising concerns that health care providers may decide not to take unprofitable patients. About $38.2 million of the $56.4 million in budget cuts comes from reducing reimbursements by 4 percent for providers who treat patients covered by KanCare, the state’s privatized Medicaid program launched in 2013. The remaining $18.2 million comes from cuts in other areas of the Medicaid program. (Hart, 5/18)

The governor also warned that more cuts could be made to Medicaid and the higher education system if the Kansas Supreme Court orders an additional $40 million or more in school funding. A ruling is pending on whether a school funding measure that passed earlier this year provides equitable funding to the state's 286 school districts. (Hellman, 5/18)

The administration gave no hint that it would reconsider its tax policy, which many say has contributed to the state’s inability to meet revenue expectations. ... The Medicaid provider rate cut spares community-based service providers and nearly 100 rural and critical access hospitals. Sean Gatewood, with the KanCare Advocates Network, expressed gratitude that community-based service providers had been spared but said acting like cuts will not have an impact is “not living in reality.” Senate Minority Leader Anthony Hensley, D-Topeka, slammed the reductions. He argued Brownback is shielding his tax policy while harming Medicaid recipients. (Shorman, 5/18)

Dr. Kevin Hoppock said he gets roughly 50% reimbursement for every service he does to a patient with Medicaid compared to a patient with commercial insurance. He said a cut could harm patients ability to find care. "You see if you reduce reimbursement rates to docs, you're going to reduce participation which obviously makes it difficult for patients to find a doctor," he said. Hoppock said doctors don't often turn away patients but this change could make that more difficult. (Fasbinder, 5/18)

Some providers say states such as Oklahoma and North Dakota may be cutting Medicaid rates by as much as 25% and 47% respectively, as a way to cover up how much future payment cuts would affect beneficiaries. In a letter to the CMS, the American Academy of Pediatrics, American College of Physicians, American Medical Association and American Osteopathic Association say they believe the states may be dropping their rates now in anticipation of new rules that require the states to assess how payments affect access to care. (Dickson, 5/18)

Colorado's Medicaid agency is expanding a chronic pain management program that connects primary care providers with specialists to guide treating clients with pain issues as well as those struggling with opioid addiction. (5/18)

State and federal officials have reached agreement on how Georgia can improve and expand services for people with developmental disabilities and mental illness, building on the terms of a landmark 2010 pact. (Miller, 5/18)

Lawmakers scrambling to find money to fix Illinois' multibillion dollar deficit are looking to sugary drinks as one potential source of revenue. Taxing distributors of sodas, energy drinks and other sugary beverages was among the revenue-generating ideas a group of lawmakers proposed to Gov. Bruce Rauner and other legislative leaders last week to try to finally end a nearly yearlong impasse that's left the state without a budget. (5/18)

The Oklahoma House rejected a proposed $1.50-per-pack tax on cigarettes to help stave off cuts to the state's health care system, with Democrats uniting against the plan until it includes an expansion of Medicaid for the working poor. (Murphy, 5/18)

Late last month Tennessee Governor Bill Haslam signed legislation allowing counselors and therapists to use their "sincerely held personal beliefs" as a basis for rejecting patients, the first law of its kind. (Konrad, 5/19)

Health Diagnostic Laboratory is attempting to avoid getting dragged back into a federal lawsuit that it settled its way out of last year. (Demeria, 5/18)

Nearly 90 percent of Colorado residents infected with hepatitis C, now the deadliest infectious disease in the United States, are going untreated, a new report estimates. (Olinger, 5/18)

The South Carolina House will decide whether companies can offer prescriptions for glasses and contacts after online eye exams. The Senate voted 39-3 Wednesday to override Gov. Nikki Haley's veto of a bill banning the practice. An override in the House would bar prescriptions based solely on a computerized eye test. That chamber passed the bill 100-1 last month. (Adcox, 5/16)

Whether working as a drag queen or a government employee, LeQuan Edwards always managed to find a bathroom to use. Edwards, 52, is transgender. From where she’s been sitting these past few months — a hospital bed in Des Moines — her struggle to be treated like anyone else has never been so great. Her current problem is a national one and arguably more critical than the one a Florida congressman recently dubbed The Great Bathroom Debate. Iowa’s Civil Rights Act expressly prohibits discrimination based on gender identity. Still, Edwards’ caregivers have been unable to find a place for her to live. (Rood, 5/18)

Heather Meadows will never know what it’s like to see her infant daughter and 6-year-old son grow up. She won’t reach mid-life... Instead, the 29-year-old mother has become the latest face of an issue that merits serious and determined action from authorities: the growing death toll at South Florida’s shadowy cosmetic surgery clinics. (Santiago, 5/19)

A Florida man killed his wife earlier this week because he said he could no longer pay for her medication, according to authorities. William Hager, 86, told the St. Lucie County sheriff’s officials that his wife of more than 50 years was in poor health and pain. He said he could no longer afford to pay for Carolyn Hager's medication, so he shot her in the head on Monday with a .32-caliber revolver as she slept. He put the gun down, drank coffee and then contacted family members and told them that he killed the 78-year-old. (Greenlee, 5/18)

The Senate is expected to make a handful of changes on Wednesday to a House-passed medical marijuana bill, including who is responsible for crafting the rules and regulations. (Siegel, 5/18)

In February, U.S. Sen. Bill Nelson became one of the first voices in Washington to warn against the threat posed by Zika. He wanted the Obama administration to appoint a “Zika czar” to coordinate the government’s response to the virus. Unfortunately, few listened. Many even scoffed at what they considered his unduly alarmist outlook. (5/18)

Surely the Obama administration could find a way to provide contraception to women without involving a group of Catholic nuns. This has been the refrain of the administration's critics since 2012, when it announced that most employers would have to offer health coverage that included contraceptives. The Supreme Court has just unanimously made the same point as the critics, if in softer language. (Ramesh Ponnuru, 5/18)

The justices of the Supreme Court have taken an important step that should result in protecting the religious liberty of all Americans. With their new order in the case of Zubik v. Burwell, they have, in effect, ordered the government to come up with an accommodation to the Obamacare Health and Human Services mandate that does not force religious non-profit groups to violate our faith. (Frank Pavone, 5/17)

Whatever faults Obamacare may have — and it's been no panacea for the shortcomings of health care in this country — even its harshest critics must recognize those 16 million to 17 million people (depending on whose estimates one uses) who have received a literal lifeline from health care reform. (5/18)

The upcoming California primary offers an opportunity for Sen. Bernie Sanders to add substance to his call for a single-payer health care system with little risk of losing voters because broad support exists here for universal health care. Indeed, our California Legislature approved such a plan and I am the nurse who wrote it. I applaud Sanders for injecting meaningful health reform into the campaign and offer six policies to better define his plan and provide a foundation for negotiating the Democratic Party platform at the convention. (Judy Spelman, 5/17)

There are few more wasteful and counterproductive endeavors on Capitol Hill than the Republican bloc's efforts to undermine the Affordable Care Act. Two lawsuits point to how the cost of these efforts is destined to trickle down to innocent consumers. No, we're not talking about the more than 60 times the GOP voted to repeal all or part of the law. We're talking about its efforts to block funding for essential provisions of Obamacare designed to help patients and insurance customers. (Michael Hiltzik, 5/18)

For the past two years, I have begun to bridge my two worlds: my PhD training as a sociologist specializing in discrimination and racial and health disparities and that of a physician, a budding psychiatrist. I have begun to examine medical trainee experiences of discrimination based on race, gender, and sexual orientation. I hope to document the accumulation of microaggressions that underrepresented trainees experience during their training and demonstrate the impact this has on their mental health and well-being. (Roberto E. Montenegro, 5/17)

The internal mechanisms of the Washington lobbying game were inadvertently placed on public display Tuesday during a House committee hearing on an Obama Administration move to reduce prescription drug costs. Two witnesses opposing the proposal, ostensibly from two different interest groups, somehow submitted statements that contained identical passages. They were outed by Rep. Jan Schakowsky (D-Ill.), who said she found the similarities "very curious." (Michael Hiltzik, 5/18)

The right of patients to be informed about care decisions in clinical practice is yet again under scrutiny, both in the United States and around the world. The well-ingrained ethical-legal process of informed consent, so fundamental to patient autonomy—or the patient’s right to self-determination—was the subject of a 2015 UK Supreme Court case (Montgomery v Lanarkshire Health Board).1 In that case, a woman with insulin-dependent diabetes, claimed that her obstetrician failed to communicate the risk of shoulder dystocia during vaginal delivery (a complication associated with fetal macrosomia) that ultimately resulted in severe fetal brain anoxia. She claimed that had she received full information about the risks, she would have opted for a cesarean delivery. Yet the treating obstetrician (and other expert physicians called to trial) claimed that the ensuing risk was very small and thus appropriately not communicated because a cesarean delivery is not in the maternal interest. The obstetrician reported that “…had I raised it [the risks of shoulder dystocia] with her then yes, she would have no doubt requested a caesarean section, as would any diabetic today. (Erica S. Spatz, Harlan M. Krumholz and Benjamin W. Moulton, 5/17)

By law, patients have a right to obtain electronic copies of their medical records, but should they also have a right to access those records by using software applications of their choosing? It was a question Tuesday that divided two federal panels reviewing the use of application programming interfaces in healthcare. Their lack of consensus means the decision is still up for debate. (Joseph Conn, 5/18)

If my recent experience is any gauge, many health care professionals and hospitals don’t pay enough attention to family caregivers. But states are beginning to pass laws to ensure that they do so, and some of the presidential candidates are talking about expanding the Family and Medical Leave benefit. (Mason, 5/18)

Experts estimate a shortage of 20,000 primary care providers in the next few years. Advanced practice nurses could fill this void, but state regulations often stand in their way. (Rudner, 5/18)

No government -- federal or state — can afford to ignore the nation’s destructive opioid abuse epidemic, and Maryland’s is no exception. The recently concluded General Assembly session resulted in a significant step forward, in the form of a bill requiring that all prescribers of opioids participate in the state’s Prescription Drug Monitoring Program (PDMP) as a condition of their state licenses. In essence, a PDMP is a database that tracks patients’ past access to prescription opioids, enabling physicians to confirm or deny suspicions that a particular patient might be “doctor shopping” to fuel an addiction. With appropriate privacy protections, the programs may also help authorities identify doctors who are engaged in inappropriate or even illegal practices. (5/18)

The contrast is striking – and frustrating. While Oklahoma is now working on a plan to expand Medicaid, Kansas refused to even hold a hearing on the issue this legislative session. While Oklahoma wants to provide health insurance to about 175,000 of its citizens, Gov. Sam Brownback just cut funding to Medicaid – which could make life even harder for low-income Kansans. (Phillip Brownlee, 5/19)

Fighting the inappropriate prescribing of opioid painkillers has been a priority for the North Carolina Medical Board for at least the past decade, but we can and should do more. The Observer’s story accurately noted that NCMB is expanding its efforts to investigate potentially unsafe opioid prescribing. However, increased enforcement is just one aspect of the board’s efforts. We believe the best way to address inappropriate prescribing is to prevent it. (Dr. Pascal O. Udekwu, 5/18)

You know Colorado has a serious problem taking care of people experiencing a mental health emergency when the legislature passes a bill to extend the period they can be involuntarily warehoused in a jail. (5/18)

It's 1 a.m. A young mother approaches me during my hospital shift. She asks if her 2-year-old son will survive the night. He has been given a diagnosis of severe tuberculous meningitis, months after her husband was found to have drug-resistant TB. We suspect the child acquired the infection from his father. The mother was tormented by guilt and worried about her child’s future. The disease usually affects the lungs, but it can also strike the brain, kidneys and other parts of the body. How do I tell the mother that the fluid in her baby’s brain is terribly elevated and we need to drill holes into his skull to release the pressure? How do I tell her that, if he survives, he will probably have some brain damage and that the prospects that he’ll be able to lead an independent life are questionable? (Uvistra Naidoo, 5/19)