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Justice Antonin Scalia’s death will complicate the work of the Supreme Court’s eight remaining justices for the rest of the court’s term, probably change the outcomes of some major cases and, for the most part, amplify the power of its four-member liberal wing. ... In the major abortion case the court will hear next month, Justice Scalia’s absence may have no consequence. Abortion rights groups already had reason to think, based on an earlier vote on a stay application in the case, that there are five votes to strike down some of the law’s restrictions. A 4-to-4 split in the case, Whole Woman’s Health v. Hellerstedt, No. 15-274, would be a loss for those groups, as the restrictions in Texas would then go into place. But Justice Scalia’s death seems to make a more restrictive revision of the constitutional standards nationwide quite unlikely, as the court’s four liberals would not go along. (Liptak, 2/14)

Some of the major cases heard or scheduled to be heard this term by the Supreme Court. Justice Antonin Scalia's death casts uncertainty on the court's term. No rulings have been issued in any of these cases. ... In a case argued in November, faith-based hospitals, colleges and charities objected to the process the Obama administration had devised to spare them from paying for contraceptives for women covered under their health plans while ensuring that those women can obtain birth control at no extra cost. The groups complain that they remain complicit in making available the contraceptives in violation of their religious beliefs. (2/14)

The death of Supreme Court Justice Antonin Scalia casts a cloud of uncertainty over a Supreme Court term filled with some of the most controversial issues facing the nation: abortion, affirmative action, the rights of religious objectors to the contraceptive mandate in the Affordable Care Act, and the president’s powers on immigration and deportation. ... Before the court is another challenge to the Affordable Care Act, this time over whether religiously affiliated organizations such as universities, hospitals and charities can be free from playing any role in providing their employees with contraceptive coverage. Most appeals courts that have decided the controversy found in favor of the Obama administration. But one did not. Presumably, a split court would mean the law is interpreted differently depending on the region of the country. (Barnes, 2/14)

The Supreme Court abhors even numbers. But that's just what the court will have to deal with, perhaps for many months, after the death of Justice Antonin Scalia. Eight justices will decide what to do, creating the prospect of 4-4 ties. ... The Supreme Court will be looking at the health care law for the fourth time since its 2010 enactment. ... A tie vote here would sow rather than alleviate confusion because the appellate courts that have looked at the issue have not all come out the same way. That prospect suggests that Justice Anthony Kennedy will join the court's four liberal justices to uphold the arrangement, Supreme Court lawyer Thomas Goldstein said. (2/15)

The U.S. Supreme Court next month is scheduled to hear its biggest abortion case in at least a decade, and the reach of that decision will likely be impacted by the absence of Justice Antonin Scalia, who died over the weekend. A Texas law requires that doctors have local admitting privileges, and that clinics make costly building upgrades to operate like out-patient surgical centers. Numerous other states have passed similar laws, and Scalia was widely expected to provide a fifth vote to uphold such restrictions. Without him, it may not change much for Texas. A 4-4 split in the court would leave in place the 5th Circuit Court of Appeals ruling that upheld these provisions. (Ludden, 2/15)

The death of U.S. Supreme Court Justice Antonin Scalia, who famously said the Affordable Care Act should be called “SCOTUScare,” leaves in limbo a number of healthcare-related cases. The news also quickly sparked a debate over who would replace him amid the presidential campaign. (Schencker and Rubenfire, 2/13)

For most presidents, choosing a Supreme Court nominee is a puzzle. For President Barack Obama, the chance to pick a successor to Justice Antonin Scalia is more like a Gordian Knot. ... His nominee would almost certainly support abortion rights, consideration of race in college admissions and other areas of public life, limits on campaign contributions and stronger rights of labor unions — all issues that have divided the court's liberal and conservative justices on a 5-4 margin. (2/15)

Justice Antonin Scalia’s death will have an immediate effect on some of the country’s most contentious legal questions, undercutting conservative hopes of winning sweeping victories in pending U.S. Supreme Court cases on abortion, immigration, affirmative action and unions. (Stohr, 2/13)

Senate Republicans on Monday began to close ranks behind a vow by Senator Mitch McConnell, the majority leader, to block consideration of any nominee to replace Justice Antonin Scalia, who died over the weekend, for the remainder of President Obama’s term. ... The coming clash on Capitol Hill is a testament to the stakes: A president has a chance to establish a clear liberal majority on the Supreme Court. That could shift the direction of legal thought on a wide variety of issues like climate change, gay rights, affirmative action, abortion, immigration, gun control, campaign finance and labor unions. (Shear and Steinhauer, 2/15)

The rancorous debate over picking a replacement for Justice Antonin Scalia reflects in many ways a growing public skepticism toward the U.S. Supreme Court itself, as its image has evolved from impartial arbiter of the laws to yet another politicized institution. ... In part, the Republicans’ determination to block President Obama’s chance at a nomination that could leave a lasting mark on the court reflects their fury over how its current conservative majority has allowed same-sex marriage to become the law of the land and has refused to gut the health-care law that is Obama’s signature domestic achievement. (Tumulty, 2/15)

The Republican candidates debated on Saturday night as if it were one last chance to break through and take down their opponents — and for a few of them, it probably was. ... [Donald Trump] ridiculed Lindsey Graham, South Carolina’s senior senator, and described Planned Parenthood as a group that provides important health services to women. (He said he disapproved of its role performing abortions.) ... Mr. Kasich continued to call for a lower-key and more genial race, defended his decision to expand Medicaid under the Affordable Care Act and said that government has a compassionate role to play in people’s lives, arguing, “Economic growth is not an end unto itself.” (Burns, 2/14)

Donald Trump, facing his toughest scrutiny to date, made his biggest gamble yet in a campaign defined by his convention-busting tactics: trying to win the Republican nomination by attacking the last GOP president. During a heated exchange with former Florida Gov. Jeb Bush, Mr. Trump blamed Mr. Bush’s brother for not stopping the Sept. 11, 2001 terrorist attacks. ... The ninth Republican presidential debate Saturday in Greenville, S.C., was the most personal, with the candidates frequently shouting over each other and calling each other liars. Mr. Bush locked horns with Ohio Gov. John Kasich over the latter’s decision to expand Medicaid in his state. (O'Connor, Reinhard and Hook, 2/13)

The Columbus Dispatch has you covered. Ohio Gov. John Kasich took his presidential campaign to the state up north Monday and will have another stop there today. (Everhart, 2/16)

John Kasich has an Obamacare problem. The Ohio governor is facing a barrage of attacks over his decision to accept the Medicaid expansion under Obamacare in the wake of his second-place showing in the Republican New Hampshire primary. (Sullivan, 2/13)

Hillary Clinton stepped up a criticism of her Democratic presidential opponent, Bernie Sanders, on Sunday night, telling supporters at a rally in the Las Vegas suburbs that the senator from Vermont would replace their insurance plans with something more expensive. "We both share the goal of universal health-care coverage, but he wants to start all over again," Clinton said. "And he wants to have a new system that would be quite challenging because you would have to give up the insurance you have now, and it would cost a lot of money." (Weigel, 2/14)

With his expansive plans to increase the size and role of government, Senator Bernie Sanders has provoked a debate not only with his Democratic rival for president, Hillary Clinton, but also with liberal-leaning economists who share his goals but question his numbers and political realism. The reviews of some of these economists, especially on Mr. Sanders’s health care plans, suggest that Mrs. Clinton could have been too conservative in their debate last week when she said his agenda in total would increase the size of the federal government by 40 percent. That level would surpass any government expansion since the buildup in World War II. (Calmes, 2/15)

All of them agree on the need to overhaul the scandal-riddled U.S. Department of Veterans Affairs and end delays in accessing the health care that veterans were promised. ... White House hopefuls have stressed the issue in debates and town halls. But a closer look at their public platforms shows a vast discrepancy in the level of detail in their plans, ranging from footnoted documents of seven-step plans to bullet points to a single flashcard. (Bergengruen, 2/14)

Five years into Medicare spending cuts that were supposed to devastate private Medicare options for older Americans, enrollment in private insurance plans through Medicare has shot up by more than 50 percent, confounding experts and partisans alike and providing possible lessons for the Affordable Care Act’s insurance exchanges. When Congress passed President Obama’s signature health law nearly six years ago, it helped offset the cost by cutting payments to Medicare Advantage plans, offered by private insurers operating under contract with the government. Insurers and Republicans said the cuts — about $150 billion over 10 years — would “gut” the program, a major theme in the 2010 and 2012 elections. The Congressional Budget Office predicted that enrollment would fall about 30 percent. (Pear, 2/12)

The number of people who signed up for health insurance for 2016 on the state and federal exchanges was up to 40% lower than earlier government and private estimates, which some say is evidence that the plans are too expensive and that people would rather pay a penalty than buy them. Just 12.7 million signed up for plans by the end of open enrollment Jan. 31 and about 1 million people are expected to drop their plans — or be dropped when they don't pay their premiums. (O'Donnell, 2/15)

As the 2015 tax filing season gets underway, tax preparers said a delay in new health law tax forms is causing confusion for some consumers, while others want details about exemptions from increasingly stiff penalties for not having insurance. ... This is the first year that employers, insurers and government programs are required to send consumers tax forms that report whether they offered or provided health insurance that was considered affordable and adequate under the law. (Andrews, 2/16)

The House on Friday easily passed, 266-144, a bill that would weaken menu-labeling requirements set out in the 2010 health care overhaul. The legislation (HR 2017) takes aim at a mandate that menus of establishments with 20 or more locations must list calorie counts of the food that they serve. The Food and Drug Administration, which is tasked with enforcing the rule, has extended the deadline to be in compliance from the end of 2015 until the end of this year. (Siddons, 2/12)

The number of uninsured children in Texas fell by almost 100,000 during the first year of full implementation of the Affordable Care Act, signalling a potential trend across all age groups, a new study by the Robert Wood Johnson Foundation finds. (Dean, 2/15)

A recent national report credits the Affordable Care Act, or Obamacare, for helping to reduce racial and ethnic inequalities in health insurance coverage. But Kansas has not made as much progress as other states. Before the Affordable Care Act, blacks, Hispanics, American Indians and Asian-Americans were much more likely than whites to be uninsured. But an analysis by the nonprofit Center for Global Policy Solutions shows that gap has narrowed because of the health reform law. (Thompson, 2/15)

Milwaukee won the White House's Healthy Communities Challenge, a contest among 20 cities to enroll people in health plans sold on the marketplaces set up through the Affordable Care Act, the White House announced Friday. President Barack Obama promised to visit the city that won the challenge. (Stephenson, 2/12)

Pushed by once-unthinkable shifts in how they are reimbursed, Baltimore’s famous medical institutions say they are trying harder than ever to improve the health of their lower-income neighbors in West Baltimore. But dozens of interviews with patients, doctors and local leaders show multiple barriers between the community and the glassy hospital towers a few blocks away. (Hancock, 2/16)

In a city renowned for medical schools and research, there's a striking contrast in the dismal health and life expectancy in some Baltimore neighborhoods. There's a deep distrust of the medical system among many African-American residents, dating back to the 1800s. (Varney, 2/15)

The doctor told Sharlene Adams to get a blood pressure cuff, so Adams set out to buy one. For Adams, who lives in West Baltimore, that meant four bus rides, a stop for a doctor’s signature, two visits to a downtown pharmacy for other medical supplies, a detour to borrow money for a copay, a delay when a bus broke down, and, at last, a purchase at a pharmacy on the east side of town. The one-way, 7-mile trip took 5 1/2 hours. Then she had to get back home. (Bluth, 2/16)

In Baltimore’s poorer neighborhoods, where problems are plentiful and solutions scarce, Total Health Care strives to correct disparities in access and treatment long faced by people who struggle to get by. Total Health Care is the result of the 1989 merger of West Baltimore Community Health Care Corporation and Constant Care Community Health Center, Inc. Its mission is to provide comprehensive, quality care to the low-income, medically underserved population. (Burns, 2/16)

Dr. Samuel Ross had been CEO of Bon Secours Health System for three months when he went to a dinner party in 2006 and first heard the name some Baltimoreans use for the hospital. They called it “Bon Se-Killer.” Ross says the reputation is based partially on urban myth, spread largely by people who’ve never walked through the hospital’s doors. ... But Joyce Smith, who has been an activist in West Baltimore for 30 years, said the nickname reflects larger problems with medical services in her neighborhood." (Bluth and Greenwald, 2/16)

Scientists and doctors seeking to unravel some of the mysteries behind the deadliest form of breast cancer have put out a call to patients diagnosed with the disease: Please send us your DNA. These researchers are creating a national database of patients’ blood and tumor samples, along with their medical records, to better understand what triggers metastatic, or stage IV, breast cancer and how it might be stopped. (Westervelt, 2/15)

The Oncology Research Information Exchange Network began nearly two years ago as a joint effort between the Ohio State University Comprehensive Cancer Center and the Moffitt Cancer Center in Tampa, Fla. ORIEN aimed to build a database like nothing cancer researchers had seen before — a huge collection of detailed patient records and blood and tissue samples from cancer patients across the country. Ohio State and Moffitt put up $2 million to establish the network. (Kurtzman, 2/13)

Doctors who supervise cancer treatments have long been concerned about side effects, including fatigue, hair loss and depression. To that list, some now add the potentially harmful effects of costly treatments. Researchers call it “financial toxicity.” The financial burdens that some patients suffer as a result of the cost of their treatments can cause damage to their physical and emotional well-being. Repercussions can include delaying or forgoing the treatment and only partly filling or even avoiding taking prescribed medication. (Ward, 2/15)

Global health authorities and government officials are mobilizing to battle the fast-spreading Zika virus, sending rapid-response teams to affected regions, issuing travel warnings for pregnant women, accelerating vaccine trials and even deploying mosquito-fighting troops to hard-hit areas in Brazil. Stung by criticism that the world’s response to the Ebola epidemic was halting and disjointed, officials in Latin America, the United States and Europe say they are determined to do better against a new foe that, in some ways, is more daunting than the hemorrhagic virus that killed 11,000 people in West Africa. (Sun and Dennis, 2/13)

In the crowded waiting room of the Vargas de Caracas hospital, the walls are decorated with peppy pro-government slogans: “It’s only possible with socialism.” But the Zika epidemic has struck as the socialist-ruled country is spiraling into economic chaos and the public health system has been stripped of many basic tools of modern medicine. Hospital patients get wheeled past closets overflowing with trash. Stray dogs wander the hospital grounds. Doctors perform surgery without sutures and gauze. (Partlow, 2/15)

These days, the virus has sparked a gold rush of its own: companies are touting products from vaccines not even tried in mice to devices that filter Zika from the blood -- leaving public health experts to determine which proposals can help halt the mosquito-borne disease’s explosive spread. (Spalding and Torsoli, 2/15)

Scientists are “weeks, not years” from developing a test for the fast-spreading Zika virus, but large-scale clinical trials for a potential vaccine are at least 18 months away, the World Health Organization announced on Friday. The W.H.O. declared Zika a global public health emergency on Feb. 1, only the fourth time it had raised such an alert. (Chan, 2/12)

As the Zika virus spreads in Latin America, Catholic leaders are warning women against using contraceptives or having abortions, even as health officials in some countries are advising women not to get pregnant because of the risk of birth defects. The challenge posed by Zika for the Roman Catholic Church comes as Pope Francis is making his first trip to Mexico, where the virus appears to be spreading. After a period of saying little, bishops in Latin America are beginning to speak up and reassert the church’s opposition to birth control and abortion — positions that in Latin America are unpopular and often disregarded, even among Catholics. (Goldstein, 2/13)

There are currently more than 200 suspected cases of Zika virus in American Samoa, local officials say, announcing that the U.S. territory has at least four confirmed cases — including one patient who is pregnant. The territory's acting governor, Lt. Gov. Lemanu Peleti Mauga, "declared a Zika epidemic for American Samoa" after consulting with health officials at the end of last week, Samoa News reports. (Chappell, 2/15)

A Baltimore-based research consortium is forming a task force of leading scientists from around the world, including renowned AIDS researcher Dr. Robert Gallo, to better understand the Zika virus and quickly develop a vaccine. The task force is being convened by the Global Virus Network, a group of 35 scientific research centers across the globe that work to prevent the spread of deadly viruses. (McDaniels, 2/15)

More than 200 people died in hospitals and nursing homes in Louisiana after Hurricane Katrina in 2005, leading to widespread agreement that health care preparedness in the United States needed dramatic improvement. The chaotic evacuations of more than 6,400 hospital and nursing-home patients in New York City after Hurricane Sandy in 2012 reinforced concern about the readiness of health care providers during emergencies. Despite repeated calls for change, however, and billions of dollars in disaster-related costs for health care providers, federal rules do not require that critical medical institutions make even minimal preparations for major emergencies, from hurricanes, earthquakes and tornadoes to bioterrorist attacks and infectious epidemics such as Ebola and Zika. (Fink, 2/13)

Nicole Lamoureux needs about 1,200 volunteers to help complete her mission: transforming a Dallas convention center into what she calls “the largest doctor’s office in the world—for the one day it’s open.” This temporary mega-doctor’s office—a pop-up clinic, if you will—is part of a growing trend representing an increasingly important piece of the medical safety net in the U.S. Such clinics, staged by nonprofits and funded mostly by individual donors, are an opportunity for doctors to care for patients without worrying about insurance, and for those patients to see a doctor they wouldn’t otherwise get to see. (Simon, 2/15)

When it comes to getting people to participate in workplace weight loss programs, financial rewards may not be much of an incentive. Penalties, on the other hand, work great. (Greenfield, 2/15)

Only a small number of Americans have undergone genetic testing to detect their or their future children’s disease risks, according to a new STAT-Harvard poll, but a majority say they would be interested in one day taking a genetic test that showed their risk of developing Alzheimer’s or cancer. (Begley, 2/12)

Next-generation sequencing technology became commercially available only recently, after the first test was given approval by the Food and Drug Administration in 2013. But scientists and clinicians say it has already identified multiple cases where a patient’s puzzling symptoms turned out to be signs of a rare disease. As this technology gets cheaper and faster, experts say more patients will get tested and find they have rare diseases. They will have the satisfaction of finding out what is causing their symptoms but then will often face a frustrating question: What do you do when diagnosed with a rare disease that has been studied little and has no known treatment, and few other patients to turn to for support? (Mullin, 2/15)

Experts have long known that rich people generally live longer than poor people. But a growing body of data shows a more disturbing pattern: Despite big advances in medicine, technology and education, the longevity gap between high-income and low-income Americans has been widening sharply. The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. (Tavernise, 2/12)

Perhaps it’s not surprising that many families know little about palliative care; it only became an approved medical specialty in 2007. It has grown rapidly in hospitals: More than 70 percent now offer palliative care services, including 90 percent of those with more than 300 beds. But most ailing patients aren’t in hospitals, and don’t want to be. (Span, 2/12)

When Marcella Lafayette started having really bad heartburn, she went to her doctor to see if there was anything that might help. Her doctor diagnosed her with gastroesophageal reflux disease, or GERD, and prescribed a drug called a proton pump inhibitor, or PPI. The drug worked, but Lafayette soon started having other problems, such as muscle weakness and severe leg cramping. ... Many people have trouble discontinuing PPIs because the amount of acid in their digestive systems surges when they stop taking the drug. (Stein, 2/15)

Activists on both sides of the abortion debate now have a common enemy — the use of a powerful new gene editing technology to tinker with the human race. That may seem like an idea from a sci-fi flick, but it’s already here. The gene-editing technique is already used in research and has the potential to modify human DNA with unprecedented ease in the not-too-distant future. British regulators approved limited experiments in human embryos earlier this month. The technology holds promise to cure diseases like cystic fibrosis or sickle cell and even revive extinct species. But critics fear it could also be harnessed to craft “designer babies,” who are more intelligent, beautiful or athletic and to “edit” embryonic cells to change an inherited trait forever. (Karlin, 2/16)

A special House committee formed amid the debate over Planned Parenthood’s handling of fetal tissue has launched a broad investigation into the matter, requesting documents from more than 30 agencies and organizations, including some of the nation’s most prominent research institutions. Critics have raised concerns about the breadth of the ­Republican-led inquiry and are worried about the privacy implications of the wide-ranging requests. (DeBonis, 2/15)

Florida’s insurance regulator approved Aetna Inc.’s acquisition of Humana Inc., and required no divestitures, an important win for the companies from a state that is a key market. The $34 billion deal still needs to win approval from the federal Justice Department’s antitrust officials, likely the most important hurdle, as well as other states. But Florida is a cornerstone of Humana’s Medicare franchise, so its review was closely watched. (Wilde Mathews, 2/15)

More than one million Floridians covered by Humana and CarePlus health plans will not have to change insurance after state regulators on Monday gave conditional approval to a plan by rival Aetna to purchase the companies. The Florida Office of Insurance Regulation, which reviewed the sale, will not require Humana and CarePlus policy holders to move to an unaffiliated company because of “its potential to disrupt quality of services, benefits, networks, and cost-sharing provisions,” according to the announcement. No transaction price was given. (Chang, 2/15)

Express Scripts Holding Co. is carefully scrutinizing prescriptions for products made by Valeant Pharmaceuticals International Inc., making sure the pharmacy manager’s rules are being followed. ... Valeant last year was accused of working with a network of pharmacies to boost sales of its drugs and get them reimbursed by health insurers and pharmacy benefit managers like Express Scripts, even when there were cheaper generics available. (Langreth and Koons, 2/12)

Theranos Inc. filed a plan to U.S. regulators to fix serious deficiencies at the company’s blood-testing lab in Newark, California, as founder Elizabeth Holmes works to regain credibility for her struggling startup. The company submitted the proposed plan of correction late Friday to the Centers for Medicare and Medicaid Services, CMS spokesman Aaron Albright said in an e-mail. (Tracer and Chen, 2/12)

Embedded within President Barack Obama's 2017 budget for HHS is a provision to “eliminate surprise out-of-network healthcare charges for privately insured patients.” Details are scant, but the administration would try to solve the problem by requiring physicians who “regularly provide services in hospitals” to accept in-network rates, even if they aren't in the insurer's network. Hospitals would also have to “take reasonable steps” to ensure patients see in-network physicians. (Herman, 2/11)

The current turmoil between the White House and Senate Republicans over an upcoming Supreme Court appointment appears to introduce the possibility of a higher level of legislative gridlock on the annual spending bills. The court vacancy also will likely influence current Supreme Court deliberations on abortion and contraception services mandate cases. ... Any reductions in non-defense discretionary spending targets could threaten any plans for funding increases for medical research programs and other health care funding priorities. Changes to set spending levels for fiscal 2017 likely will prompt Senate Democrats to block action on the annual spending bills. Additionally, recent budget plans offered by the GOP-led House have proposed major changes to the beneficiary structure of Medicare and federal funding for Medicaid. (2/16)

Even though lawmakers in the Iowa Senate voted to stop privatization of the state's Medicaid program last week, the measure is unlikely to pass in the Iowa House. The system is still slated to switch to private management on March 1 unless the federal government steps in. (Moon and Kieffer, 2/15)

A bill aimed at providing comprehensive legislative oversight to the state’s Medicaid privatization program was approved without opposition Monday by the Iowa Senate Human Resources Committee. Senate File 2107 cleared the panel with bipartisan support. That was in sharp contrast to a Senate floor vote last week when Republicans all lined up against a Democratic bill to repeal Gov. Terry Branstad’s plan to have private companies manage the Medicaid program. (Petroski, 2/15)

A company ejected from Iowa’s controversial plan to privatize Medicaid management failed to show the state acted improperly, a judge said in a ruling made public Monday. WellCare’s lucrative multi-million contract was terminated by Iowa in December following court testimony and records showing company officials — including former state representatives-turned WellCare operatives Christopher Rants and Renee Schulte — engaged in prohibited communications, including an effort to uncover the secret identities of committee members reviewing the bids. (Clayworth, 2/15)

After months of uncertainty, the Legislature appears poised to approve a tax on health care plans that would generate $1.27 billion annually and could substantially boost funding for developmentally disabled Californians for the first time in more than a decade. (Calefati and Seipel, 2/14)

The House of Delegates on Monday backed two bills to revamp or dismantle the certificate of public need program, the state’s lengthy application and approval process for big-ticket health care services. (Cain, 2/15)

Nursing-home representatives and advocates for people with Alzheimer’s disease squared off Monday over whether the state should require care-facility employees to show they understand how to serve people with dementia. About 20 lobbyists surrounded three legislators giving an initial review to a bill on the matter. House Study Bill 566 would require training about dementia for new employees and would require that they demonstrate they understand the training. Supporters of the bill said the second part would be its main change. (Leys, 2/15)

A Kentucky lawmaker fed up with anti-abortion laws in her state has introduced a bill that would require men seeking erectile dysfunction drugs to visit a doctor twice, get a note from their wives and swear on the Bible to be faithful. Representative Mary Lou Marzian, a Democrat from Louisville who has been a lawmaker for 22 years, told Reuters on Monday the bill is symbolic but she is glad that it has gotten attention because she is trying to make a point about government intrusion. (Ortiz, 2/15)

A Kentucky legislator has introduced a bill that would require men to get signed permission from their spouses and visit a doctor twice before they could receive drugs for erectile dysfunction. Louisville Democratic State Rep. Mary Lou Marzian said her bill, House Bill 396, was filed in direct response to a series of anti-abortion bills offered by Kentucky lawmakers. (Barajas, 2/15)

A Pennsylvania state legislator said Friday he would introduce a package of bills to increase lead testing in the commonwealth. The first bill would require children under 6 to be tested for elevated blood levels of the toxic metal, said State Rep. Angel Cruz (D., Phila.). (2/13)

Community Health Systems Inc., the U.S.’s second-largest chain of for-profit hospitals, reported an unexpected fourth-quarter loss as admissions were hurt by falling numbers of patients during a slow flu season. Total hospital admissions fell 3.6 percent from a year earlier, and fell 3.4 percent on a same-facility basis, Franklin, Tennessee-based Community Health said in a statement on Monday. (Lauerman, 2/15)

Gov. Rick Snyder is asking the federal government to expand Medicaid coverage to people under 21 and pregnant women who have been exposed to Flint's lead-contaminated water. In a statement released Sunday, Snyder says about 15,000 more Flint residents would benefit if the government approves the request. The governor says the state would help by lining up doctors and behavioral health specialists and providing other services. (2/14)

Michigan Gov. Rick Snyder announced Sunday that he has asked for expanded Medicaid support for about 15,000 Flint residents, especially for pregnant women and those under 21, in the wake of the city’s water crisis. (Bethencourt, 2/14)

The Connecticut Insurance Department has blocked UnitedHealthcare’s plan to stop paying broker commissions for plans sold through the state’s health insurance exchange, but will let them pay a lower rate. (Levin Becker, 2/12)

Missouri could be one of the first states in the nation to test a new mental health care program designed to expand access to treatment. The pilot program was created by the Excellence in Mental Health Care Act, co-sponsored by U.S. Senator Roy Blunt (R-Mo) and signed into law in 2014 as part of a broader Medicare reform measure. It sets quality standards for community mental health centers in participating states and more fully funds treatment for Medicaid patients. (Phillips, 2/13)

There are two New Jerseys, particularly when it comes to public health. There are the urban hubs, older cities in the north and central Jersey with their mix of poverty and prosperity, often sitting side by side with affluent suburbs. And there are the vast rural stretches, including much of the state's south, with its farming communities and former waterfront factory towns. (Stainton, 2/15)

The family’s struggle is one that many in the autism community face: The best treatments often don’t have insurance coverage. That will change on July 1 when a new state law will require all state-regulated insurance plans to cover Applied Behavior Analysis, or ABA, and other treatments. (2/12)

The combined cost of two common surgeries — knee and hip replacement — is twice as high in northeast Colorado as in Denver and Colorado Springs, according to a new study that puts numbers to the state's rural health cost problem. The Center for Improving Value in Health Care used data supplied by health insurance providers on the two procedures and found stunning variations by region of the state. (Olinger, 2/15)

Big changes are in store for emergency medical care in central Ohio, but there’s debate over whether they will be of greater benefit to patients or the corporate bottom line. (Sutherly, 2/14)

Urgently, yet methodically, they are experimenting with immune therapies to try to save [Amy] Reed from leiomyosarcoma, a ferocious uterine cancer that has spread through her body despite repeated surgeries and chemotherapy. ... At the same time, they continue to push the U.S. Food and Drug Administration to outlaw the gynecological surgical device that likely worsened her prognosis by spreading her cancer. (McCullough, 2/15)

The Florida Department of Corrections’ attempt to restore normalcy to its troubled prison healthcare system is now tangled in a legal dispute over the agency’s decision to award up to $31 million in fees to a politically well-connected company as part of a $268 million no-bid contract. (Klas, 2/12)

The Centers for Disease Control has released a report into how an adult film actor in California infected two sexual partners with HIV in the weeks after he contracted the virus but before it was detected by lab tests. The report bolsters an already heated push for porn actors to wear condoms on set. (Tozzi, 2/12)

Chicago startup is working with nursing homes using Google Glass, texts and live video chats to keep residents from making unnecessary trips to the hospital. Traditionally, if a patient needed medical attention, nurses have paged a physician, who might send a patient to the hospital if unsure of the patient’s condition. With Third Eye Health, a nurse could be at a patient’s bedside running software and connecting the physician with information to determine whether the patient had a medical emergency or something less serious, CEO Dan Herbstman said. (Graham, 2/15)

On many counts, the health of children in North Carolina improved in recent years, but even with gains, some areas such as infant mortality and suicide rates continue to be a concern. That’s according to the 2016 North Carolina Child Health Report Card released Tuesday by the North Carolina Institute of Medicine (NCIOM) and NC Child. For 20 years, the report has tracked health concerns from prenatal care and breastfeeding to teenage risk factors such as alcohol and substance abuse. (Schlemmer, 2/16)

For the smallest marijuana possession cases – involving less than a half ounce – police can write a citation or make an arrest. CMPD doesn’t have a policy on what officers should do. Over the past several years, police have been writing more citations and making fewer pot arrests. That trend has affected all racial groups, including African-Americans. But in cases involving only marijuana possession, African-Americans are far more likely to be arrested than whites. (Harrison, 2/15)

Under a law expected to go into effect by April, women in California will be able to stop by their neighborhood pharmacy and buy birth control pills without a prescription. Proponents argue that easing women's access to birth control will reduce unintended pregnancies, which make up as many as half of all pregnancies nationwide. (Karlamangla, 2/14)

With exterior walls still carrying the bullet scars of a Nov. 27 shooting that killed three, the Colorado Springs Planned Parenthood clinic reopened for business Monday. Leaders say the clinic has a full docket of appointments this week for services including abortions, which accused shooter Robert Lewis Dear has said motivated his rampage. (Roeder, 2/15)

It is often said that good policy makes for good politics. And we still want to believe that, despite the history of the “Cadillac tax” in the Affordable Care Act. Current law excludes employer-paid health insurance from taxation, which is how nearly half the public gets coverage. This subsidy, which costs $250 billion per year, according to the Congressional Budget Office, nevertheless promotes overutilization of health care, thus driving cost inflation. It causes “job lock” by linking work and insurance and redistributes income upward because tax breaks are worth more to higher income brackets. Nothing would improve U.S. health care more than to repeal the exclusion and use the savings to fund a more rational system. That’s politically impossible, however. So the ACA, passed in 2010, incorporated a second-best solution: a 40 percent levy on relatively plush “Cadillac” employer-paid plans (above $10,200 for individuals; $27,500 for families), effective 2018. (2/13)

We now have a government that’s doing less and costing more. By doing less, I mean that many traditional government programs — from defense to federal courts — are being slowly and systematically strangled by the costs of an older population (higher Social Security) and the related health-care spending (higher Medicare and Medicaid). How severe is the squeeze? The answer is in table S-7, buried in the back of the budget. Almost one-third of the federal budget consists of “discretionary spending,” which covers defense, courts, parks and all programs requiring annual congressional appropriations (essentially, permission to spend). Most of the rest of the budget goes to “mandatory” programs — Social Security is the biggest — for which people qualify if they meet eligibility requirements. (Robert J. Samuelson, 2/14)

Buried deep within President Obama's $4-trillion budget plan are a couple of healthcare proposals that could change everything for U.S. consumers. The fact that the drug industry wasted no time in dismissing the ideas — and that their Republican friends in Congress said they wouldn't even look at them — should tell you something big was afoot. (David Lazarus, 2/16)

Sanders’ idea of a universal, Medicare-like health system must be viewed through the prism of political reality. With Republicans incessantly attacking the Affordable Care Act, how would Sanders’ more-progressive blueprint, with a price tag in the trillions of dollars, get past their suffocating filibusters? Democrats would be nominating a man who has no chance to enact his signature plank because it would be politically unachievable. We prefer the pragmatism embraced by Clinton: to further develop the foundation of Obamacare that already is law. It has extended the security of health insurance to 17.6 million Americans and brought down to 10 percent the number of Americans without insurance, thanks in part to the law’s requirement that everyone be allowed coverage no matter what their pre-existing conditions might be. Honing the law is more achievable than starting anew with a plan that would be dead on arrival on Capitol Hill. (2/14)

By advocating “Medicare for all,” Sen. B ernie Sanders has rekindled the progressive dream of government-run health care. Yet Washington can’t even manage the health bureaucracy it already controls. Take a look at the sad circus surrounding the doctor nominated to lead the Food and Drug Administration—a qualified man whose confirmation is being blocked for political reasons. (Joel M. Zinberg and Thomas P. Stossel, 2/12)

Martin “Pharma Bro” Shkreli’s testimony – or lack thereof – at a House Oversight Committee hearing (or lack thereof) justifiably angered many people. The infamous former hedge fund CEO turned pharma executive raised the price of a generic anti-parasitic drug – Daraprim – by 5,000 percent last year simply because he could. Overnight, he became the embodiment of a pharmaceutical industry routinely accused of putting profit-seeking before patient health. But policymakers shouldn’t jump to conclusions, let alone legislation. There are many important differences between the “Pharma Nerds” developing innovative life-saving drugs – including Gilead Sciences’ Sovaldi – and the “Pharma Bros” exploiting loopholes to profit from generics like Daraprim. And addressing patient access challenges for one requires very different solutions than the other. First and foremost, it requires understanding why we make a distinction between generics and branded medicines in the first place. (Yevgeniy Feyman, 2/16)

For almost 40 years, I practiced general internal medicine and geriatrics in my own office. I had tens of thousands of face-to-face interactions with a group of folks who, with time, grew to trust me. I respected them as well; many I came to love — a term that I hesitate to use in this hypersensitive age. Given how geographically dispersed families are today, for many of my older patients I functioned as a surrogate son. There is no doubt that the kind of medicine I was fortunate to practice is disappearing. (Jerald Winakur, 2/12)

Dementia and Alzheimer’s disease are the leading fears among baby boomers, countless of whom have seen their parents’ brain health deteriorate. While many feel paralyzed when considering the possibility of developing an unhealthy brain themselves, much can and must be done to support cognitive health during every step of the aging process. Since pharmacology does not yet offer a solution to a deteriorating brain, each one of us must act before it is too late. This important subject is addressed by a symposium on Mild Cognitive Impairment in Miami this week. (Dharma Khalsa and Simran Stuelpnagel, 2/15)

It is encouraging to note data from the United Network for Organ Sharing that show more than 30,000 organ transplants were performed in the United States last year, reaching the highest total in the country’s history. Nevertheless, the supply of organs — donated by living and deceased donors — will fall short of the number of patients added last year to the transplant waiting lists. With the persistent shortage, there are those who would seek to increase the organs available for transplantation by providing financial incentives as a motivation for organ donation. These financial incentives would represent a monetary gain or “valuable consideration” and are currently prohibited by the National Organ Transplant Act of 1984 (NOTA) to buy and sell organs. (Francis Delmonico, 2/16)

There are more than 120,000 people waiting for organs in the United States. More than 100,000 of these individuals need kidneys. Kidneys are unique because most people have two, and it is possible for healthy individuals to donate one to someone in need. But there aren’t enough donated organs for everyone waiting, so clearly changes are needed. The National Kidney Foundation believes there are effective, proven methods to increase donation and transplantation that are underused, and that addressing those issues would significantly increase the number of kidney transplants. (Jennifer Martin, 2/16)

America’s drug crisis, which now kills more people each day than car crashes or gun violence, has challenged the conventional wisdom about recovery. With addiction inside the homes of families who thought themselves immune, we are starting to embrace the idea that addiction is a not a character flaw but a chronic disease requiring long-term management — the subject of last week’s Fixes column. This week, another idea whose time has come: trying to kick opioid addiction without medicines is as smart as relying on willpower to overcome diabetes or asthma. Medicines greatly increase the chance of success and reduce the risk of death. (Tina Rosenberg, 2/16)

Virginia should dismantle its mental-health system and replace it with one that serves Virginians who are sick rather than the bureaucrats who should be helping them. From 2010 to 2014, I served as Virginia’s inspector general for behavioral health and developmental services, which required me to cast a critical eye on the state’s mental-health services and recommend changes to improve the commonwealth’s system of care. I found a complex, dysfunctional and ineffective bureaucracy that was system-centered instead of person-centered. (G. Douglas Bevelacqua, 2/12)

Chuck Engholm arrived at the emergency room at Genesis Medical Center on Nov. 9, 2014, complaining of nausea. Engholm was 63 years old and a long-time resident of Davenport’s Handicapped Development Center, a group home where he was known for his love of horses and cowboys, and where he worked as a sander in the facility’s workshop. (2/14)

Governor Branstad says that privatizing Iowa’s Medicaid program will provide more doctors for Medicaid patients, but when it comes to the 37,000 kids on Hawk-I health insurance, children will have far fewer health care providers to choose from. (State Sen. Janet Petersen, 2/15)

[T]he most difficult part of caring for teenagers is not the wide range of medical and emotional issues they may have but, often, the legal limitations put on me by HIPAA. These limitations often lead to unsolvable situations. Unfortunately, in adolescent medicine, these situations are all too common and usually involve emotional or sexual health. (Rima Himelstein, 2/15)