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President Donald Trump said he would keep pressing to enact a health-care overhaul even if it means delaying another one of his policy goals: revamping the tax code. Last month, House Republicans conceded they didn’t have enough votes to pass their health-care bill, despite an aggressive lobbying effort by the White House. Mr. Trump and congressional Republicans say they haven’t given up and are still working to assemble the votes needed to overturn major pieces of former President Barack Obama’s Affordable Care Act. (Nicholas and Rubin, 4/11)

"We are going to have a phenomenal tax reform but I have to do healthcare first. I want to do it first to really get it right," Trump said in an interview with Fox Business Network's Maria Bartiromo set to air on Wednesday. (Vladimirov, 4/11)

Trump told Fox Business he did not want to “put deadlines” on either legislative goal, but he insisted that “health care's gonna happen at some point” and said that passing health care legislation could save money and make it easier to pass a tax overhaul afterward. Still, the president suggested that he was not fully committed to that chronology. “Now, if it doesn't happen fast enough, I'll start the taxes,” Trump said. “But the tax reform and the tax cuts are better if I can do health care first.” (Conway, 4/11)

House Republicans left for spring break last week, without reaching a deal to repeal and replace the Affordable Care Act. Their bill to overhaul the health care system collapsed on the House floor last month, amid divisions in the caucus. Even without Congress, however, President Trump has the authority to modify important provisions of the health law, including many that House Republicans sought to change or repeal. Here are some examples of actions he could take (or has already taken). (Park and Sanger-Katz, 4/12)

Insurance plans really, really want to know what the White House plans to do on this particular program. But the administration isn't providing any clarity. Over the past 24 hours, it has sent reporters two statements that are difficult to parse — and definitely do not deliver on the certainty that insurers say would stabilize the Affordable Care Act marketplaces. (Kliff, 4/11)

The Department of Health and Human Services on Tuesday seemed to walk back a promise that the Trump administration would continue paying health insurance subsidies that insurance companies serving the individual market through the Affordable Care Act’s health insurance exchanges rely on to balance the cost of serving patients that consumer a large amount of healthcare. The administration, in a statement to The New York Times on Monday, had said that the plan was to continue paying the subsidies while courts adjudicate the claim, brought by Republicans in Congress, that the payments are illegal because they were not specifically authorized by the law. (Garver, 4/11)

The federal government spends $7 billion a year on these subsidies nationwide, and about $750 million of it goes to help low-income residents of California, like [Adeeba] Deterville. The future of the subsidies is in limbo: A lawsuit challenging the legality of the payments is on hold before a federal appeals court. The outcome is largely in the hands of the Trump administration, which has the power to continue or halt the stream of money. (Ho, 4/11)

Health insurers want more certainty about whether the government plans to keep paying them subsidies in order to decide whether to participate in the individual market exchanges next year. In a statement provided to Morning Consult last week, the Department of Health and Human Services said it hasn’t changed the precedent that it would keep paying the Affordable Care Act’s cost-sharing reduction payments to health insurers while a lawsuit about the subsidies continues. But that indication alone isn’t enough guidance for insurers that are preparing their premium rate requests. (McIntire, 4/11)

The bond ratings agency Standard & Poor’s analyzed Blue Cross plans in 32 parts of the country and found that most are figuring out how to better set premiums to meet the cost of new enrollees as the Affordable Care Act exchanges begin their fourth year. Blue KC is a prime example. Insurance companies use a “medical loss ratio” to measure how much revenue they get in premiums versus how much they pay in policyholders’ medical costs. (Marso, 4/11)

The leader of the House Freedom Caucus says Republicans are "close" to agreement on a plan to repeal ObamaCare, indicating that discussions are still continuing while Congress is in a two-week recess. Rep. Mark Meadows (R-N.C.) on Tuesday told a local radio station that he expects to hear back from Speaker Paul Ryan (R-Wis.) by noon about "two options" on the table. He did not elaborate. (Hellmann, 4/11)

Republicans at both ends of Pennsylvania Avenue are facing a big question this spring: What now? As President Trump approaches his 100-day mark at the end of this month, congressional Republicans have few accomplishments to point to and are divided over how to proceed on his two biggest priorities: healthcare and tax reform. (Bolton, 4/12)

Conservatives in the House Freedom Caucus have shouldered the majority of the blame for the GOP’s failure to repeal and replace the 2010 health care law, but moderates may be equally — if not more — responsible for the impasse. There are arguably more hard “no” votes (members not likely to be convinced to move to “yes”) for the GOP leadership’s plan among moderate Republicans than there are among the members of the Freedom Caucus. (McPherson, 4/12)

Representative Joe Wilson, the South Carolina Republican who gained a measure of infamy after shouting “you lie” at President Barack Obama during a joint session of Congress in 2009, had that memorable catchphrase hurled back at him by a group of his constituents at a town hall event on Monday. The audience at the event, held at Aiken Technical College in Graniteville, S.C., near the state’s western border, was antagonistic from the start, booing audibly as he stepped to the lectern. But the conflict between Mr. Wilson and the crowd came to a head toward the end of the 40-minute question-and-answer period, when he responded to a question about Mr. Obama’s health care law. (Bromwich, 4/11)

Often drowning in jeers from liberal critics in his heavily conservative district, U.S. Rep. Andy Biggs maintained that the nation’s current health-care system is failing and insisted he wants more dramatic changes than those sought by Republican leaders in Washington. Biggs, a freshman holding his first town hall since taking office in January, expressed other views, from skepticism about climate change to broad support for the private sector over government, that were a flop with most of the 600 people gathered at Without Walls Church in Mesa. (Hansen, 4/11)

U.S. Sen. David Perdue said Republicans must strike a compromise with Democrats on a healthcare overhaul after the House GOP’s plan to go it alone ended in a disastrous failure... He didn’t offer any specifics on how he would cobble together enough bipartisan support behind a new healthcare proposal to replace the Affordable Care Act, but he chastised Republicans for making the “same mistakes the Democrats did” after Barack Obama’s election. (Bluestein, 4/11)

Sen. Joni Ernst told constituents in Elkader Monday that health care has been the biggest topic at town hall meetings, and Congress needs to work hard on new health care legislation. She says she is worried the one remaining statewide health insurance carrier on Iowa's individual market will be free to raise its prices or will also pull out of the state. (Sostaric, 4/1!)

Seven vulnerable Republican lawmakers are being targeted with $1 million in television spots by a liberal group backed by labor and progressive interests. The ads generally focus on the lawmakers’ apparent support for the American Health Care Act (AHCA), the failed House bill that was designed to replace the Affordable Care Act, a.k.a. Obamacare. The ad tries to capitalize on the interesting shift in public sentiment about Obamacare, suddenly more popular as it has come under legislative assault by the Trump administration. Let’s walk through the claims in the ad aimed at Issa. (Kessler, 4/12)

The Conservative Club for Growth today launched a $1 million ad buy targeting moderate Republicans who oppose the latest changes to the House GOP repeal plan. The ads will target Reps. Adam Kinzinger (R-Ill.) and Chris Collins (R-N.Y.), as well as eight other moderates not yet identified. (Ehley, 4/11)

Rep. Martha McSally and at least four other potentially vulnerable Republican members of Congress are being pressed during the two-week Easter recess over their support for the GOP's evolving health-care plan. The members targeted by the group Save My Care hold seats where voters chose Democrat Hillary Clinton over President Donald Trump in last year's general election. (Hansen, 4/11)

The next national drug czar is likely to be a congressman who was an early supporter of President Donald Trump, the head of the Pennsylvania Republican Party said Tuesday. Party chairman Val DiGiorgio said "any day now" he expects an announcement from the White House that four-term U.S. Rep. Tom Marino has been nominated to be the next director of national drug control policy. (4/11)

As drug czar, Marino would oversee the Office of National Drug Control Policy, a branch of the White House that advises the president on drug policy issues. More than anything else, the office sets the tone of an administration's drug policy. Under President Barack Obama, for instance, the office quite publicly retired the phrase “war on drugs,” preferring rhetoric centered more on public health than criminal justice. Whether that approach continues is something of an open question. (Ingraham, 4/12)

Marino is perhaps best known in the drug policy realm for co-sponsoring a bill known as the Ensuring Patient Access and Effective Drug Enforcement Act of 2016. Ostensibly, the law was crafted to increase coordination between the DEA, pharmacies, and distributors. But critics argued it effectively limits the DEA’s power by requiring the agency to follow a new process to shut down distribution centers or other parties it suspects are contributing to the illegal sale and use of prescription drugs. (Ross, 4/11)

The Department of Veterans Affairs has a new message on public scrutiny: Bring it on. President Trump’s pick to lead the agency, VA Secretary David Shulkin, is unveiling a new web site that will reveal for the first time exactly how care at every VA hospital and clinic across the country compares with nearby private-sector hospitals and national averages. The site set to go live Wednesday, accesstocare.va.gov, also shows if veterans are satisfied with wait times at each facility and how long they are actually waiting on average. (Slack, 4/12)

The burn unit at the U.S. Army Institute of Surgical Research in San Antonio, Texas, is hot. Sometimes, it gets up to 102 degrees in there, among the patients. People with severe burns can't regulate their own body temperatures well, so the air has to keep them warm. "We see a lot of gruesome stuff," says physical therapist Melissa Boddington. At the height of the fighting in Iraq and Afghanistan, more than one thousand wounded service members were flown to the hospital. (Rigby, 4/11)

Faced with an urgent need to recruit more patients of color into clinical trials, researchers are trying a flurry of new ideas — including training black pastors in Chicago to serve as recruiters and sending a bus outfitted with exam rooms throughout rural Georgia. The outreach comes from medical schools, pharma companies, tech entrepreneurs, and even the federal government, which aims to recruit a million volunteers willing to share their genetic and health data with the Precision Medicine Initiative. (Blau, 4/11)

The field of organs-on-chips scored an early victory Tuesday: Boston organ-on-a-chip startup Emulate has partnered with the Food and Drug Administration to test whether the technology works for toxicity screening purposes. (Keshavan, 4/11)

When he first saw the results from his 23-year-old patient with a painful leg clot, Paolo Simioni assumed the test was botched and angrily told his lab technician to repeat it. But the number came back the same: A key protein in the man’s blood was almost eight times more powerful than normal. (Bloomfield, 4/11)

Should middle-aged men get routine blood tests for prostate cancer? An influential health panel that once said no now says maybe. It says certain men may benefit as long as they understand the potential harms. Some key things to know about the U.S. Preventive Services Task Force's draft recommendations. (Tanner, 4/11)

Running may be the single most effective exercise to increase life expectancy, according to a new review and analysis of past research about exercise and premature death. The new study found that, compared to nonrunners, runners tended to live about three additional years, even if they run slowly or sporadically and smoke, drink or are overweight. No other form of exercise that researchers looked at showed comparable impacts on life span. (Reynolds, 4/12)

Legislators passed measures that eased certain firearm restrictions over the 10 General Assembly sessions since Seung-Hui Cho’s rampage left 32 people dead — which at the time was the deadliest shooting by a single gunman in modern U.S. history. (Bowes, 4/11)

As a parent, the trick to preventing excessive alcohol consumption is understanding what puts your child at risk. Parental or sibling substance use, trouble interacting with others, poor self-control, aggression and hyperactivity may contribute to alcohol use. (Julie Furst, Samantha Saltz and Judith Regan, 4/11)

People are still dying of cancer linked to asbestos, the U.S. Centers for Disease Control says, despite decades of regulations meant to limit dangerous exposure. Starting in 1971, the Occupational Safety and Health Administration has regulated how much asbestos workers can be exposed to, because it contains tiny fibers that can cause lung disease or cancer if they are swallowed or inhaled. (Hersher, 4/11)

One of the most common reasons people go to the doctor is lower back pain, and one of the most common reasons doctors prescribe powerful, addictive narcotics is lower back pain. Now, new research published Tuesday in the Journal of the American Medical Association offers the latest evidence that spinal manipulation can offer a modestly effective alternative. (Neighmond, 4/11)

Three years ago, the state passed a law that encourages people to summon help when they are in danger or see someone else in trouble. Police and emergency workers say this “Good Samaritan’’ law is saving lives. (Griffith, 4/11)

Assemblywoman Susan Talamantes Eggman’s AB 186 would authorize governments in eight counties to test “safe injection sites” in areas with heavy opioid consumption. Adults could bring drugs they had already obtained and use them with clean needles and emergency care available. (Koseff, 4/11)

With more than 30,000 West Virginians already in drug treatment, lawmakers struggling with the state's addiction crisis have voted to spend $24 million from recent court settlements with opioid distributors to increase inpatient beds. The bill passed by the House and Senate and awaiting Gov. Jim Justice's consideration would authorize the Department of Health and Human Resources to ensure that treatment beds are available in the highest priority areas throughout the state. (Virtanen, 4/11)

Prescribers now have an updated system to search for patient records and help prevent drug addiction. Appriss Health's system went live this month. It replaced the Michigan Automatic Prescription System that prescribers had used since 2003. The Legislature last year allocated $4.5 million to begin replacing the old system and provide routine maintenance. President of Appriss Health Rob Cohen said the project began in last October and went live on April 4. Some of the new features include faster record response times, less than five minutes. Before it would take anywhere from five to ten minutes to get data for users. (Ehrmann, 4/11)

Florida Gov. Rick Scott announced steps to begin combating the state's rising opioid usage cases on Tuesday, but stopped short of declaring a public health emergency as he has done in other cases. Scott said during a news conference that he is directing three state organizations to hold workshops statewide. The state's Department of Children and Families, Department of Health and the Florida Department of Law Enforcement will hold workshops in Palm Beach, Duval, Manatee and Orange counties. Scott spokeswoman Jackie Schutz said the schedule is expected to be announced in the coming weeks. (Reedy, 4/11)

Florida's Department of Health, Department of Children and Families and Department of Law Enforcement will in the coming weeks begin workshops in Palm Beach, Manatee, Duval and Orange counties. Scott and Attorney General Pam Bondi announced the initiative, a deal with drug companies to provide Narcan spray and their support for legislation related to the opioid crisis at an event in the state Capitol on Tuesday. (Auslen, 4/11)

This town of the Tennessee Delta, seat of a county that once grew the most cotton east of the Mississippi, relied for decades on a little public hospital built during the Great Depression a few blocks from the courthouse square. The red-brick building was knocked down in the 1970s when a for-profit chain came along and opened a modern stucco hospital on the north side of town. There, thousands of babies were born, pneumonias and failing hearts were treated and the longtime family doctor across the parking lot could wheel the sickest patients who arrived at his office right into the emergency room. (Goldstein, 4/11)

House Republicans said Tuesday they will remove a controversial proposal from Gov. John Kasich's budget that would make major changes in state support for medically fragile children. Kasich proposed moving the Bureau of Children with Medical Handicaps program from the Department of Health to the Department of Medicaid and slashing household income eligibility limits to address an $11 million shortfall. ... Currently, families earning up to 500 percent of the federal poverty level, or $123,000 for a family of four, qualify for assistance. Kasich proposed capping eligibility at 225 percent of poverty, or $55,350 for a family of four. About half of the current participants meet that criteria. The rest would be grandfathered in until age 21. (Borchardt, 4/11)

Proposed budget cuts that would eliminate some state contracts with agencies that support foster families will undo years of progress and put Nebraska's most vulnerable children at risk, child welfare advocates said Tuesday. Gov. Pete Ricketts' proposed budget would cut about $15 million over two years from child welfare programs, and eliminate one that provides post-adoption services to help families stay together. (Shumway, 4/11)

What appeared to be a minor change on Iowa income tax forms erupted into a heated debate Tuesday in the Iowa Senate with Democrats accusing Republicans of a mean-spirited move to deprive low-income children of government-funded health insurance. Sen. Randy Feenstra, R-Hull, the bill's floor manager, said the legislation would eliminate a requirement that Iowans indicate on their state tax returns the presence or absence of health care coverage for their dependent children. (Petroski and Pfannenstiel, 4/11)

Counties across Colorado, urban and rural, struggle to hire and keep child protection caseworkers, a high-stress, sometimes traumatic job with low pay. Solving this problem is the target of new legislation from a state lawmaker who is a former caseworker. A bill from Rep. Jonathan Singer, D-Longmont, would create caseworker “resiliency programs” to help them handle the “secondary trauma” brought on by their jobs. (Brown, 4/11)

When Rep. Matt Rinaldi, R-Irving, laid out his amendment to ban abortion providers from receiving any funds from the state budget, House members had already been in the chamber for more than 12 hours to debate amendments on the proposed two-year state budget. Rinaldi's amendment passed in part because lawmakers agreed to bypass floor debates on dozens of other amendments and instead insert them into a non-binding portion of the budget known as "the wish list." ... Sarah Wheat, chief external affairs officer for Planned Parenthood of Greater Texas, said it's unclear how affiliates would be affected. “I assume his goal is to create new barriers, but we’re not clear yet on how he’s trying to achieve that,” Wheat said of Rinaldi. Wheat pointed out that state and federal laws already prohibit taxpayer dollars from being spent on abortions. (Evans, 4/11)

A statewide effort to alleviate Minnesota’s chronic shortage of psychiatric beds by freeing up space at state mental hospitals would be jeopardized under budget proposals before the Legislature, the head of Minnesota’s largest state agency warned Tuesday. During a visit to a community mental hospital in Baxter, Minn., Human Services Commissioner Emily Piper said a proposed $600 million reduction in the Human Services budget would force the state to reduce staffing and capacity at state-operated mental facilities, reversing a year of progress in expanding access to treatment for psychiatric patients. (Serres, 4/11)

With just 25 days left in the legislative session this year, a bill to give workers’ compensation coverage to first responders with post-traumatic stress disorder has stalled. Several police officers have come forward with post-traumatic stress disorder diagnoses after the Pulse nightclub shooting. (Aboraya, 4/11)

[Geneva] Reed-Veal, an Illinois resident, was one of a number of witnesses, a vast majority of whom spoke in support of the Sandra Bland Act, which is pending before the [Texas] House Homeland Security and Public Safety Committee. The comprehensive legislation's changes include requiring law enforcement agencies to test for profiling by documenting the race and ethnicity of drivers stopped; mandating people experiencing mental health crises and substance abuse be diverted to treatment instead of jail; and creating more de-escalation training for law enforcement personnel and serious incident reporting requirements for county jails. (Silver, 4/11)

The head of the Legislative Black Caucus said Tuesday her organization wants Gov. Larry Hogan to recall the General Assembly to Annapolis for a one-day special session to pass a law expanding the medical marijuana industry. That legislation failed in the waning minutes of the annual 90-day session on Monday night, ending a months-long fight to grant lucrative medical cannabis growing licenses to companies owned by minorities. (Cox, 4/11)

Washington Gov. Jay Inslee said Tuesday that he's encouraged by changes made to ensure the state's largest psychiatric hospital is safer for patients and staff, but some workers are critical of the efforts. The Centers for Medicare and Medicaid Services cited Western State Hospital last year over health and safety violations and gave it until July 2 to fix the problems or lose millions of federal dollars. (Bellisle, 4/11)

The state’s centers for independent living, already reeling from deep cuts, appealed Tuesday for legislators to reject a proposal to eliminate all state funding for their facilities. The five centers, first established under state law in 1988, provide a wide array of training, counseling and referral services to thousands of residents with physical and mental disabilities, the elderly and the poor. (Phaneuf, 4/11)

Health benefits broker Zenefits was fined $1.2 million with New York's financial services regulator on Tuesday for letting unlicensed employees solicit, negotiate and sell insurance policies, the latest regulatory blow for the software startup. (Stempel, 4/11)

The closure of an abortion clinic in northwestern Louisiana leaves just three other such clinics in the state. The Bossier City Medical Suite's phone number was no longer in service Tuesday and the website was down. State business records show the company's officers are the same Texas-based principals of Causeway Medical Suite, a suburban New Orleans facility that closed last year. They could not be reached for comment. (4/11)

The state Attorney General’s Office has probed consumer billing complaints involving Gilbert Hospital, a for-profit facility that once promoted itself as “always in-network” for emergency health services, even though it does not contract with most private health insurance companies. A spokesman for the Arizona Attorney General Mark Brnovich confirmed that the agency investigated consumer complaints about Gilbert Hospital's billing but declined to specify details. (Alltucker, 4/11)

In a recent decision, Anoka County Judge Sean Gibbs upheld the right of a family to sue an assisted-living facility over the sudden death of an 89-year-old man, Gerald Seeger, who died of complications related to a common hernia. The facility, Lighthouse of Columbia Heights, had argued in court that, despite the man’s death, the family had forfeited the right to a jury trial by signing an arbitration agreement at the time of his admission. (Serres, 4/11)

Starting in about a year, United Way of Greater Cleveland will begin deploying its 2-1-1 specialists into seven area hospitals and health clinics to offer low-income patients screening for social service needs such as housing, food and transportation. With a $4.5 million, five-year grant from the Centers for Medicare and Medicaid Services (CMS), United Way will partner with the Cleveland Clinic, MetroHealth, St. Vincent Charity Medical Center and Care Alliance Health Center to screen 75,000 patients a year and connect them to community resources. (Zeltner, 4/12)

Only one Valley hospital earned a top grade for patient safety in a nationwide report card released Wednesday. Kaweah Delta Medical Center in Visalia was one of 823 hospitals nationwide to earn an “A” from the Leapfrog Group, which gave grades to 2,639 hospitals nationwide. The group gives report-card grades to hospitals twice a year, in spring and fall. Kaweah has earned an “A” grade since spring 2015. (Anderson, 4/11)

Just three years ago, Michigan had the fourth-highest rate of unvaccinated kindergartners in the nation. But when a charter school in northwestern Traverse City reported nearly two dozen cases of whooping cough and several cases of measles that November, state officials were jolted to action. Without much fanfare — or time for opponents to respond — they abandoned the state’s relatively loose rules for getting an exemption and issued a regulation requiring families to consult personally with local public health departments before obtaining an immunization waiver. (Gugliotta, 4/12)

The Orange County Board of Commissioners is looking to update sidewalks to make them comply with the Americans with Disabilities act. The commission votes Tuesday on a contract worth up to $2.7 million in construction over three years, but only the first year’s funding is guaranteed. Orange County has 3,000 miles of sidewalks that don’t comply with the Americans with Disabilities Act. (Aboraya, 4/11)

Tapping into San Diego’s biotech talent pool, a Michigan-based developer of an experimental therapy for liver disease is moving its administrative headquarters here. Cirius Therapeutics of Kalamazoo also has hired three experienced biomedical executives in San Diego to lead the company in connection with the opening. (Fikes, 4/11)

Mumps is in no hurry to leave students at Pennsylvania State University alone. The number of probable and confirmed cases has reached 68, said Shelley Haffner, infectious disease manager at Penn State's student health center.  She said she hopes the end of the school year — finals week is the first week of May — will break the cycle of exposures, but said outbreaks at some other colleges have lasted more than a year. (Burling, 4/11)

Spark Therapeutics Inc., which developed the gene therapy to cure a rare form of childhood blindness called RPE65-mediated inherited retinal disease, is among the first to face this question. Spark’s treatment, voretigene neparvovec, delivers a functioning piece of DNA directly to the eyes to preserve remaining sight and even restore some vision. Other companies, including GlaxoSmithKline Plc and BioMarin Pharmaceutical Inc., have also been grappling with the pricing problem. (Chen, 4/6)

The General Assembly passed a bill that would give the state attorney general powers to sue drug manufacturers that dramatically raise prices, a first-in-the-nation measure aimed at protecting patients from what the measure brands "price gouging." The bill was the top priority for health care advocates during this year's session. (Duncan, 4/10)

No one seems to like drug companies these days, whether because their products are too expensive, their leaders are overpaid, or their marketing is sometimes less than legal...The campaign, and PhRMA by extension, is taking up a difficult task. The explicit message is that the industry’s scientists are dedicated to the time-consuming, difficult, and expensive work of finding new cures. But the public backlash is almost entirely tied to high drug prices, which the industry insists are necessary to fund all that telegenic science. (Garde, 4/6)

Once again, congressional lawmakers have introduced a bill that would end a practice that generic drug makers complain is used by brand-name rivals to thwart competition. Known as the Fair Access for Safe and Timely Generics Act, the bipartisan legislation comes amid ongoing complaints that brand-name drug makers sometimes refuse to provide samples to generic companies. They need samples to prove their copycat versions are equivalent to brand-name drugs in order to win regulatory approval. The issue has also caught the eye of the Federal Trade Commission. (Silverman, 4/7)

More than two years after hedge fund manager Kyle Bass started his quixotic crusade to challenge pharmaceutical patents he said lead to inflated drug prices, he doesn’t have much to show for it. Patents on only three of the 14 medicines Bass’s Coalition for Affordable Drugs targeted at the U.S. patent office were invalidated. None led to lower drug prices. Short-term share drops in companies he petitioned didn’t endure. And late last month a generic-drug company achieved what Bass could not: Patents he unsuccessfully challenged on Acorda Therapeutics Inc.’s multiple sclerosis drug Ampyra were thrown out in a court case, opening the door to cheaper versions as soon as next year. (Decker, 4/10)

Drug manufacturers and the companies that pay for drugs are once again squabbling over why medicines are so expensive. That has the potential to upend the opaque and very profitable three-way relationship among pharma companies, insurers and pharmacy-benefit managers. Shares of all three are vulnerable. (Grant, 4/9)

Greenleaf Health may be the most influential FDA consulting firm you’ve never heard of. Operating out of the Georgetown end of K Street, on Washington Harbour, Greenleaf has built an enormous business advising life science companies how to get their products through FDA review, fend off enforcement actions, and otherwise stay out of trouble. (Kaplan, 4/11)

Hedge fund manager Kyle Bass appears to be wrapping up a generally unsuccessful patent-law assault on drug manufacturers. “In the end, lobbying and special interests pay,” Bass told Bloomberg in a defeatist-sounding email. “Medicare and U.S. consumers pay the ultimate price for the evergreening of bad patents by the pharma cabal.” (Barrett, 4/10)

Don’t believe everything you read on the internet — especially if a small, thinly traded biotech stock is involved. So says the Securities and Exchange Commission, which charged 27 people and companies with misleading investors by pushing promotional articles without disclosing that the authors had been paid for their pumping. (Garde, 4/10)

In November, California voters defeated a ballot proposal that would have given state government more control over drug prices. It was a victory for pharmaceutical companies, which spent more than $100 million campaigning against the measure. Now the industry is fighting new efforts by state lawmakers to impose regulations. Drugmakers are watching Senate Bill 17, in particular. Instead of direct price controls, it calls for price transparency. Drug companies would have to announce large price hikes and give detailed justifications to explain why the prices are going up. (Feibel, 4/11)

Last month, a group of Democratic lawmakers introduced a far-reaching bill designed to combat the rising cost of prescription drugs. One provision would allow Americans to import “qualifying” medicines that are manufactured at FDA-inspected facilities from licensed Canadian sellers and, after two years, from OECD countries that meet standards comparable to US standards. (Silverman, 4/7)

That’s what investors seem to think, as the news that Axovant Sciences hired an industry veteran sent the shares of biotech’s most polarizing company up nearly 30 percent on Monday. But while the market sees potential for a big buyout that would rescue an otherwise tepid year for biotech, Axovant says it’s settling in for the long haul, suggesting investors may have outpaced reality. (Garde, 4/10)

The theory is that generic drugs should be less expensive than the original. By the time a generic hits the market, the drug’s patent has expired, allowing competition from companies that didn’t spend millions of dollars to develop it. As more options become available, prices are supposed to drop. But because of quirks in America’s regulatory system, it doesn’t always work out this way. (Mark L. Baum, 4/5)

Rising drug prices are one of the top three health care challenges we face today. Considering that President Donald Trump and state elected leaders in California and across the country have voiced concern over this growing problem, it is baffling that the issue was absent from policy discussions during the Congressional “repeal and replace” effort. (Jeffrey Lewis, 4/5)

One of the most highly prized quality that biotech investors seek in a CEO is the ability to sell one's firm to big pharma at a huge premium. The current king is David Hung, the former CEO of cancer drugmaker Medivation, who stoked a bidding war that led Pfizer to acquire the company for $14 billion at a 118 percent premium to its unaffected share price. On Monday, Hung became CEO of Axovant Sciences Inc., a biotech focused on an Alzheimer's treatment, picking the company over what he says were more than 20 other job offers. (Max Nisen, 4/11)

No parents should have to watch their child die, yet my former colleague “Will” and his wife “Mary” watched powerless as two of their children succumbed to spinal muscular atrophy (SMA). “Isaac” and “Lizzy” were never able to sit, talk, or eat on their own, and each passed away as toddlers. (A. Gordon Smith, 4/7)

Members of Congress conducted hearings last year and justly pilloried executives for several pharmaceutical companies who had exponentially increased the prices of lifesaving medicines. Then, they did nothing.Monday, the Maryland Legislature stepped up and overwhelmingly passed a bill authorizing the state attorney to act against price-gouging. (4/11)

The National Institutes of Health is in the business of curing diseases. For more than a century, NIH scientists have improved American lives by making important discoveries that benefit public health. That is why we remain extremely wary of any budget proposals that impose dramatic cuts to NIH. The administration recently requested budget cuts to NIH in fiscal year 2017 and FY 2018. The proposed cuts would slash NIH research and Institutional Development Award grants by more than $1.2 billion for the remainder of this year. And for next year, the proposed cuts would amount to $5.8 billion – roughly 20 percent of NIH’s budget. (Reps. Fred Upton (R-Mich.) and Diana DeGette (D-Colo.), 4/12)

For those lucky enough not to have had a child, friend or other loved one afflicted by the deadly rampage of opioids, reports of the epidemic might seem overblown. But it’s not: Addiction to heroin and other opioids is so widespread that it is afflicting American workers and students alike. That this crisis is all around us is driven home by two stories in Tuesday’s Dispatch. In the first story, The Washington Post reports colleges are being given free 40,000 doses of Narcan nasal spray, a life-saving antidote, by the Clinton Foundation and Adapt Pharma. (4/12)

From 2007 to 2014, private insurance claim lines with opioid abuse and dependence diagnoses increased 487 percent in New York State. The greatest increase occurred in the New York City suburbs (Nassau, Rockland, Suffolk and Westchester), where the rise was 1,459 percent—compared to 324 percent for New York City and 310 percent for the rest of the state. These dramatic trends were identified when we investigated recent opioid-related data from New York State in our FAIR Health database of over 23 billion privately billed healthcare claims, the largest such repository in the country. (Robin Gelburd, 4/12)

Looks like the War on Drugs is back. The Washington Post reported Sunday that the new attorney general, Jeff Sessions, is preparing a return to the same hardline strategies that have so spectacularly failed to reduce drug use since 1971. Indeed, the nation has spent over a trillion dollars, made itself the biggest jailer on the planet and yet seen the use, availability and quality of drugs rise like a rocket from a launch pad while the cost dropped like a watermelon from a skyscraper. (Leonard Pitts Jr., 4/11)

The right of privacy is a constitutional right in California. The law prohibiting taping of private conversations without consent was enacted 50 years ago. David Daleiden and Sandra Merritt broke the law not once but 14 times. Anyone who breaks the law in California should be held accountable. (Kathy Kneer, 4/11)

What would it mean for us to commit ourselves as a society to caring for the development of human life? What would be the best way to stop abortions and protect human life? As an embryologist, I’m glad to say that the interventions needed are low tech and readily available: Curb pollution and protect social safety net policies. (Scott Gilbert, 4/11)

Thomas Groome’s op-ed, “To Win Again, Democrats Must Stop Being the Abortion Party,” argued that Hillary Clinton lost the Catholic vote in part because of her stance on abortion, which did not do enough to address moral and religious concerns. “If Democrats want to regain the Catholic vote, they must treat abortion as a moral issue, work for its continued reduction and articulate a more nuanced message than, ‘We support Roe v. Wade,’ ” Groome wrote. (Thomas Groome and Steven A. Krueger, 4/11)

With TrumpCare’s ignominious defeat in March, countless North Carolinians breathed a sigh of relief. Under that legislation, tens of millions of Americans would have lost access to health care, basic protections would have been cut, and out-of-pocket expenses would have risen for many. However, just when we thought we were done with this poorly conceived bill, its reanimated corpse seems to have risen from the grave. Recent reports indicate that Rep. Mark Meadows of Asheville has been meeting with the White House and congressional leadership to devise an even more draconian piece of legislation that could attract the support of the far-right Freedom Caucus. (Wayne Goodwin, 4/11)

After Gov. Sam Brownback vetoed a Medicaid expansion bill at the end of March, an override vote in the House failed (the final tally was 81 to 44). The possibility of Medicaid-related hospital closures – particularly in rural parts of the state – has long been a major concern for legislators, the Kansas Hospital Association (KHA), health care providers and hospital administrators. Kansas is one of 19 states that didn’t expand Medicaid, and KHA says this has cost more than $1.8 billion in federal funds since 2014. Much of this wasted money would have been funneled into the state’s hospitals. (4/11)

Give House Majority Leader Jonathan Shell credit for honesty, if not integrity. He shrugs off smoking’s intolerable toll on Kentucky because, as he told the Associated Press’ Adam Beam, tobacco “has bought and paid for everything (in) my life. My house, my education.” Shell, 29, part of a Garrard County farm family, is following in the steps of Kentucky politicians before him who defended the tobacco industry on economic grounds, while it killed their constituents at the nation’s highest rate from cancer and one of the highest rates from heart disease. (4/12)

The point of prescription drugs is to help us get or feel well. Yet so many Americans take multiple medications that doctors are being encouraged to pause before prescribing and think about “deprescribing” as well. The idea of dropping unnecessary medications started cropping up in the medical literature a decade ago. In recent years, evidence has mounted about the dangers of taking multiple, perhaps unnecessary, medications. (Austin Frakt, 4/10)

Not long ago I had an experience that most authors wish for. Someone recommended my book. A librarian at the Toronto Public Library had included my book on a list, along with five others, in celebration of International Day of Persons With Disabilities. Two of the other authors have autism, one is deaf, one was born without legs, and the fifth, a woman who has cerebral palsy, endured a 16-month escape from her native Syria in a wheelchair. I should have felt proud to be in their company. I should have sent the link to my parents, as I’ve done with other lists my book has made. But I didn’t. I felt confused. (Howard Axelrod, 4/12)