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Senate negotiators on Tuesday moved closer to an agreement to provide at least $1.1 billion in emergency financing to combat the rapidly spreading Zika virus, which public health officials warn poses an imminent threat in the United States, but House Republicans said they were still not ready to approve additional funds. ... Senator Roy Blunt of Missouri, a Republican who has led negotiations for his party, said Tuesday that his talks with Senator Patty Murray of Washington, a Democrat, had produced the outlines of an agreement that would provide about $1.1 billion in additional financing. Mr. Blunt said negotiators were still discussing details, including how much money would need to be restored for work on Ebola. (Herszenhorn, 4/26)

Senate Republican leaders entered this week hoping to act quickly to fight the Zika virus, but ran into internal feuding and now face the prospect of political fallout in election battleground states like Florida. Talks with Democrats on an emergency spending package stalled and lawmakers now anticipate doing nothing before they leave on a one-week recess at the end of the week. Republican leaders say they will bring a bill to the Senate floor at some point as they continue to negotiate on the details, but it remains unclear when and how such a measure would advance. (Dennis, 4/26)

Congressional Republicans are split on whether to provide emergency funding to fight the Zika virus. House Majority Leader Kevin McCarthy (R-Calif.) cast doubt on the emergency request Tuesday, saying he thinks the issue should be dealt with through the regular appropriations process. That would mean new funds have to wait until Oct. 1. (Sullivan, 4/26)

The growing threat of Zika — a virus linked to severe birth defects when pregnant woman are infected — has vaulted the pest to scary new levels and sent health officials scrambling to mount a defense against the possible spread of the disease in the United States. With a Zika vaccine nowhere in sight, prevention efforts largely have turned to the insects primarily responsible for transmitting the virus. Which is why dozens of people sat in a room talking about mosquitoes today at the Ohio Department of Transportation. (Kurtzman, 4/26)

Twenty-four Senate Democrats are asking their colleagues in Congress to help schools pay for the testing of lead levels in drinking water, calling it an investment to ensure the health and safety of the nation’s children. The move comes in the aftermath of the drinking-water crisis in Flint, Mich., which helped shine a light on a loophole in federal law that exempts many schools from having to test their water for lead contamination. Many schools don’t have the resources for voluntary testing, leaving children vulnerable to the possibility of undetected toxins in the water they drink from school fountains. (Brown, 4/26)

For the second time in two months, the Senate has reached a bipartisan deal to address a water crisis in Flint, Michigan, where lead-contaminated pipes have resulted in an ongoing public health emergency. (Daly, 4/26)

Animas River headwaters contamination exceeds state standards for cadmium, copper, lead and other toxic acid metals draining from inactive mines, officials from the Environmental Protection Agency and Sunnyside Gold Corp. revealed Tuesday.(Finley, 4/26)

As expected, opponents of Gov. Asa Hutchinson’s Medicaid expansion plan made an unsuccessful last-ditch effort Tuesday to kill [the] program. ... Passage of the motion would have cleared the way for a vote to override the veto, but the motion failed in a voice vote. With only 10 of the 35 senators opposed to Arkansas Works, any attempt for a veto override was expected to fail. (Lyon, 4/26)

About 267,000 Arkansans are provided health insurance coverage through Arkansas' Medicaid expansion, and most of them receive the coverage under the "private option," which uses federal dollars to purchase private health insurance. ... Arkansas' Medicaid expansion has deeply divided Republicans ever since the GOP-controlled Legislature and then- Democratic Gov. Mike Beebe authorized its creation in 2013. The House and Senate have narrowly authorized the use of federal funds for the program during each of the past four years. (Wickline, 4/27)

Most Utahns want the Legislature to expand Medicaid further, according to a UtahPolicy poll — the first survey on the topic since state lawmakers decided to extend Medicaid to around 16,000 of the poorest Utahns. The poll, conducted by Dan Jones & Associates, found that 51 percent of respondents believe Medicaid should be expanded to cover all remaining low-income uninsured Utahns. ... Chris Karpowitz, co-director of the Center for the Study of Elections and Democracy at BYU, said the results are consistent with previous polls. (Chen, 4/26)

U.S. health insurer Centene Corp reported a better-than-expected quarterly profit, helped by lower medical costs in certain patient populations and the acquisition of rival Health Net. The company's health benefits ratio, or the amount it spends on medical claims compared with its income from premiums, improved to 88.7 percent in the first quarter from 89.9 percent a year earlier. (Penumudi, 4/26)

UnitedHealth Group may be abandoning most of the Affordable Care Act's insurance exchanges due to steep losses. But Centene Corp. is doing just fine in the marketplaces. Centene, which just closed on its $6 billion takeover of Health Net last month, did not disclose its profit margin on the ACA exchange plans, but it is “achieving margins at the higher end of our targeted range,” Centene CEO Michael Neidorff said on a call with investors and analysts Tuesday. UnitedHealth, by comparison, estimates ACA losses north of $1 billion for 2015 and 2016. (Herman, 4/26)

Anthem Inc., the No. 2 U.S. health insurer, posted first-quarter profit that beat analysts’ estimates as medical membership increased. Earnings were $3.46 a share, excluding some items, Anthem said Wednesday in a statement, compared with the $3.32 average of 19 predictions compiled by Bloomberg. (Tracer, 4/26)

Pharmacy benefit manager Express Scripts Holding Co's top executive said on Tuesday that despite its contract dispute with Anthem Inc over pharmaceutical price cuts Anthem says it is owed, it aims to keep the health insurer as a customer. "We want to make clear that we are confident that we have negotiated in good faith," Express Scripts Chief Executive Officer George Paz said during a conference call with analysts to discuss the company's first-quarter earnings, which were announced Monday evening. (Humer, 4/26)

Her name is passed from one desperate family to another like an amulet. In phone conversations and online chat rooms, she’s mentioned at moments when the devout might call on a patron saint. A baby born with a deformed skull? “Call Laurie.” An impossibly expensive cancer treatment? “Call Laurie.” Laurie Todd isn’t a doctor, or a lawyer, or a hospital chaplain. She’s a 66-year-old former massage therapist. Most of the time, she sounds cheerful and efficient. But if someone tries to pull the wool over her eyes, her voice gets low and a little bit threatening. “Do you know what I do for a living?” she asks. “I’m known as the Insurance Warrior.” (Boodman, 4/25)

Melinda Belleville stood outside a courtroom at Fayette District Court in Lexington, Ky., in 2012, shocked by what had just transpired. It seemed like something off television, a plot similar to that of “Breaking Bad.” One of her closest friends — one to whom she felt like a surrogate mother — was in jail, being held on $30,000 bond. “I could never believe in a million years that she would be involved in something like this,” Belleville told the Herald-Leader. “I want everyone to know this is not Crystal Little.” But it was Crystal Little, the same woman who worked for the University of Kentucky’s Office of Research Integrity, an organization obsessed with rules and guidelines in the pursuit of “support[ing] the institution in promoting ethical conduct of research.” The same woman who served as the primary caretaker for her mother, who suffered from multiple sclerosis. (Andrews, 4/27)

After James Happli of Mosinee, Wisconsin, was diagnosed with pancreatic cancer, he was referred to a surgeon at a local hospital where he had been treated for lymphoma 28 years earlier. The surgeon told Happli and his wife that although she had never successfully performed a Whipple procedure -- the pancreatic cancer operation widely regarded as among the most difficult in surgery -- she believed she could do it with the help of a second surgeon. But Happli's operation had to be aborted after it proved too difficult. Several months later, the pipe fitter, now 58, traveled to Froedtert Hospital in Milwaukee, 175 miles from his home. His operation, one of 127 Whipples done at Froedtert last year, was performed successfully by chief surgeon Douglas B. Evans. (Boodman, 4/27)

The latest Hospital Safety Scores released by the not-for-profit watchdog Leapfrog Group show less than 25 percent of general, acute-care hospitals in Florida earned an A. Last year, nearly half earned As. Over the past four years, the Leapfrog Group has issued grades, which are determined largely by Medicare data. The group calculates the grades twice a year on using data on errors, injuries, accidents and infections, and posts the results in a searchable database. (Miller, 4/26)

Sacramento’s Sutter Health and its Valley Area arm have been named among the top-performing health systems in the country by Ann Arbor, Mich.-based Truven Health Analytics. (Glover, 4/26)

Alan Eller has spent more than a decade trying to convince the Department of Veterans Affairs that his bladder cancer was the result of exposure to Agent Orange almost 50 years ago in Vietnam. The Army vet has filed three claims with the agency, most recently in 2014, since a doctor told him the cancer was likely tied to the toxic herbicide. (Hixenbaugh, 4/27)

A consumer advocacy group has filed an ethics complaint against the VA Portland Health Care System over a clinical trial involving kidney transplants. Public Citizen accused the Portland medical center and the University of California, San Francisco of violating the rights of kidney recipients by enrolling them in the study without their consent. The study was led by Dr. Darren Malinoski of the Portland VA and the university's Dr. Claus Niemann. (Terry, 4/26)

The U.S. is generally prepared to manage public health emergencies like the Houston floods, a Zika virus outbreak or a potential bioterrorist attack, but health protections aren’t distributed evenly across the country, according to a new state-by-state analysis. The 2016 National Health Security Preparedness Index, which measures how communities respond to and recover from “large-scale emergencies,” shows states getting better in areas like health security and engaging their communities than 2014 and 2015. But the national index score of 6.7 on a 10-point scale shows plenty of room for improvement. (Japsen, 4/25)

The index tracks the nation's progress in preparing for, responding to, and recovering from disasters and other emergencies at both a state and national level. It uses more than 100 different measures, from influenza vaccination rates to hazard planning for public schools, to get a composite score that "reflects the most comprehensive picture of health security preparedness available," according to a news release. (Brooks, 4/26)

As with nearly all of New England the Northeast, Vermont's overall health security and preparedness is above the national average. Vermont stands at 7.3 for the 2016 Index release. (4/26)

A new index released Monday ranks Oregon among the 10 best states across the nation for emergency preparedness in the area of incident and information management. The National Health Security Preparedness Index, released Monday evening by The Robert Wood Johnson Foundation and prepared by the University of Kentucky, gave the Beaver State a 7.0 out on 10.0 scale for overall preparedness, which beat the national average of 6.7. However, the assessment shows the state still needs to improve in the area of health care delivery should a disaster, such as a Cascadia Subduction Zone earthquake, strike. (Currie, 4/26)

Missouri scores slightly better than the national average for its preparations for a national health emergency such as a Zika virus outbreak, according to a new report. (Bernhard, 4/26)

Kentucky is one of 18 states scoring above the national average when it comes to preparedness for health-related emergencies. ... A University of Kentucky team manages the index. Health Police Professor Glen Mays says Kentucky’s health surveillance efforts are sound. “The state’s ability to use existing data to give early warning signals of where there may be health problems that are popping up, spikes in disease or injury that may signify a growing emergency,” explained Mays. (Johnson, 4/27)

Georgia is improving on its preparedness for health emergencies, but its overall rating remains below the national average, according to a new report. The 2016 National Health Security Preparedness Index shows the United States as a whole scoring 6.7 on a 10-point scale for preparedness — an improvement since the ratings began three years ago. Georgia scored a 6.2. (Miller, 4/26)

Hospitals and health care providers in West Virginia have made significant improvements in their emergency preparedness since 2013, but the state lags behind in areas of surveillance that could help prevent an emergency, according to a new study. The Robert Wood Johnson Foundation released its 2016 National Health Security Preparedness Index this week, and West Virginia and 15 other states scored below the national average. (Nuzum, 4/26)

It was first developed in a Canadian lab more than three decades ago, promising and potent — and intended to relieve pain in a less addictive way. Labeled W-18, the synthetic opioid was the most powerful in a series of about 30 compounds concocted at the University of Alberta and patented in the U.S. and Canada in 1984. But no pharmaceutical company would pick it up, so on a shelf the recipe sat, the research chronicled in medical journals but never put to use. The compound was largely forgotten. Then a Chinese chemist found it, and in labs halfway around the world started developing the drug for consumers in search of a cheap and legal high — one experts say is 100 times more potent than fentanyl and 10,000 stronger than morphine. (Mettler, 4/27)

Fourteen people in the Sacramento, California, area have fatally overdosed on a pill disguised as a popular painkiller, and now the drug has turned up in the San Francisco Bay Area. Bay Area hospitals have treated seven patients who ingested what they thought was the painkiller Norco in recent weeks, according to a report released Tuesday by the U.S. Centers for Disease Control and Prevention. The patients all survived, though at least some experienced nausea, vomiting and difficulty breathing. (4/26)

The growing number of patients who claim marijuana helped them drop their painkiller habit has intrigued lawmakers and emboldened advocates, who are pushing for cannabis as a treatment for the abuse of opioids and illegal narcotics like heroin, as well as an alternative to painkillers. It’s a tempting sell in New England, hard hit by the painkiller and heroin crisis, with a problem: There is very little research showing marijuana works as a treatment for the addiction. (Casey, 4/26)

When it comes to reversing the obesity epidemic, there have been glimmers of hope that the U.S. might be making headway, especially with young children. For instance, back in 2013, the Centers for Disease Control and Prevention documented declines in obesity rates among low-income preschoolers in many states. And case studies in cities including Kearney, Neb., Vance, N.C., and New York , N.Y., have reported progress, too. (Aubrey, 4/26)

Rates of childhood overweight and obesity have not decreased in the U.S. in recent years, and severe obesity is on the rise, especially for minority children, according to a new study. Ten percent of teens now have severe obesity, lead researcher Asheley Skinner of the Duke Clinical Research Institute told Reuters Health by phone. (Doyle, 4/26)

New Mexico's Human Services Department has released an outline of proposed cuts to reimbursement rates for Medicaid health care providers aimed at trimming up to $160 million in annual state and federal spending. ... New Mexico is seeking to close an $86 million state funding gap for Medicaid services between now and mid-2017, under budget restrictions linked to a downturn in energy markets and other spending priorities. (Lee, 4/26)

Faced with limited dollars and skyrocketing Medicaid enrollment, the New Mexico Human Services Department announced Tuesday it plans to generate as much as $33.5 million in savings by cutting provider rates for doctors, hospitals and dentists around the state. The rate cuts, which would take effect in July, include several changes from a recommendation rolled out earlier this month by an 11-member panel that was made up of health care industry executives and practitioners from around the state. (Boyd, 4/26)

Andy Martin’s body had rejected another HIV medication, and now his viral load was spiking. Sitting in his living room, Martin told a nurse and a social worker that he’d recently spent three days in the hospital with a high fever. The social worker, Scott Blackburn, told him that if his viral load didn’t drop, he could end up there again. ... The visits to Martin, 61, are part of a Medi-Cal program designed to help HIV and AIDS patients avoid costly hospitalizations and nursing home stays. Medi-Cal is California’s version of Medicaid. (Gorman, 4/27)

New York legislators say they are discussing how to tighten regulation of nurses after a recent ProPublica investigation found dangerous gaps in the state’s oversight of the profession. Deborah Glick, who chairs the Committee on Higher Education in the state assembly, said she has asked the education department to determine what powers it needs to better oversee the profession. Nurses are regulated by the Office of the Professions, which is part of the state’s education department. (Adams, Huseman and Porat, 4/26)

By 2030, or possibly sooner, there may be no emergency medical services in Berkeley. Alta Bates Summit Hospital will close its acute care facility and emergency department in south Berkeley sometime between 2018 and 2030, hospital officials said, confirming rumors swirling around the city for years. (Scherr, 4/25)

Federal officials have moved to ban the controversial electric shock device a Boston-area group home and school has used for decades on its disabled clients. In a 124-page document proposing the ban, the Food and Drug Administration accused The Judge Rotenberg Center of underreporting adverse effects from the device, using flawed studies to defend its approach, and misleading families about alternative treatments. (Vogell, 4/26)

Insurance companies would not be allowed to discriminate against transgender patients under a bill passed by the Hawaii Legislature. The bill passed Tuesday by the House of Representatives prohibits denying, canceling or limiting coverage based on a person’s gender identity. “That’s something that’s really critical, especially now when you have states around the country moving the other direction, explicitly placing into law the ability to discriminate based on who people perceive themselves to be,” said Democratic Rep. Chris Lee, who introduced the bill. (Bussewitz, 4/26)

Mayor Bill de Blasio says New York City will triple the number of intensive-care mental health units at its Rikers Island jail complex. The move announced Tuesday is part of the city's overhaul of mental health care for inmates. Correction Commissioner Joseph Ponte says the specialized units can improve safety by reducing jail violence. (4/26)

In the largest-ever gift to UC San Francisco, philanthropists Joan and Sandy Weill have donated $185 million to establish a new institute to speed the development of new therapies for diseases affecting the brain and nervous system, including psychiatric disorders. (Seipel, 4/26)

Augmedix Inc, a startup that uses Alphabet Inc's Google Glass to provide documentation services to doctors and other healthcare workers, said on Monday it had closed a $17 million funding round led by investment firm Redmile Group. Augmedix's employees transcribe doctors' notes and update patients' electronic medical record through Google Glass. (4/25)

Members of a health care task force assigned with proposing alternatives to Republican Gov. Bill Haslam's Insure Tennessee plan on Tuesday stressed their desire to include "circuit breakers" to prevent out-of-control costs. (Schelzig, 4/26)

Georgia can give state money to "pregnancy resource centers" that offer medical and other services to pregnant women while discouraging them from getting abortions, under legislation signed Tuesday by Republcan Gov. Nathan Deal. (4/26)

The former pharmacy supervisor of the University of Connecticut's Student Health Services faces 173 charges for allegedly forging prescriptions and ordering items through the pharmacy for his personal use. Michael Olzinski was charged last week and is free on $30,000 bond pending a May 2 court appearance. No defense lawyer was listed in online state records. (4/26)

A Granite City chiropractor is accused of submitting about $500,000 in false benefit reimbursements and then depositing some of the money into her bank account. Bridget Brasfield was charged Tuesday with health care fraud and money laundering in the U.S. District Court for the Southern District of Illinois. (Schremp Hahn, 4/26)

From the campaign trail to the halls of Congress, drug makers have spent much of the last year enduring withering criticism over the rising cost of drugs. It doesn’t seem to be working. In April alone, Johnson & Johnson raised its prices on several top-selling products, including the leukemia drug Imbruvica, the diabetes treatment Invokana, and Xarelto, an anti-clotting drug, according to a research note published last week by an analyst for Leerink, an investment bank. Other major companies that have raised prices this year include Amgen, Gilead and Celgene, the analyst reported. (Thomas, 4/26)

If you thought drug makers might hunker down in the face of public outrage over pricing, think again. Given the clamor over the cost of prescription drugs, most manufacturers were expected to avoid drawing attention to themselves by boosting price tags. But several companies have been hiking prices for their medicines at a rate that one Wall Street analyst found surprising. “The price increases for established brands [sold by drug makers that he follows] have been substantial, indeed,” wrote Leerink analyst Geoffrey Porges in an investor note. He tracked price hikes on various drugs that are sold by several companies since the beginning of 2015. (Silverman, 4/22)

The soaring cost of prescription drugs has generated outrage among politicians and patients. Some cancer drugs carry price tags of more than $100,000 a year, and health plans are increasingly asking people to shoulder a greater share of the cost. In surveys, Americans regularly cite drug prices as a top health care concern, which may be why presidential candidates keep bringing them up. Congress has jumped into the debate, holding a series of hearings on the issue. But there are no simple answers. (Thomas, 4/27)

States across the country have been battling it out with Big Pharma over drug pricing, with some introducing bills that take aim at skyrocketing costs. People on both sides of the issue are wondering whether the states’ efforts will pay off, and now, some analysts have an answer: “probably not.” “It seems the current wave of state legislations brought up to address the increase in drug costs is a very modest risk to pharma, if at all,” Bernstein analysts said in a report. The proposed legislation coming from the states seems “to be more rhetoric than imminent pricing concern,” the analysts said. (Wasserman, 4/22)

Increased transparency and competition in the pharmaceutical industry and expanded value-based payment models would help address rising prescription drug prices, according to a coalition aimed at containing costs. (Muchmore, 4/25)

Calls for containing soaring prescription drug costs are all the rage on the campaign trail, and lawmakers from both parties have been conducting hard-hitting hearings on Capitol Hill to expose the worst pricing practices of major pharmaceutical companies. But with a powerful, well-financed drug industry strongly opposed to major reforms, the prospects for any significant change in the way drug companies do business is relatively slight, at least for the foreseeable future. (Pianin, 4/25)

Germany, Europe’s largest market for drugs, is emerging as a new front in the battle on drug pricing for pharmaceutical companies already engaged in skirmishes with U.S. health insurers and legislators. (Koch, 4/24)

Eli Lilly & Co. said revenue rose nearly 5% in its latest quarter as sales of new drugs helped offset declines in some established products, while profit dropped 17% due to higher expenses for research and development and a currency devaluation in Venezuela. The earnings fell short of analysts’ expectations, sending Lilly’s shares down 1.9% to $76.45 in late-morning trading Tuesday. (Loftus and Hufford, 4/26)

Relax, Teva and Allergan investors. The companies are on track to close their whopper knockoffs deal in the first half of June or so, one analyst says. According to Bernstein’s Ronny Gal, Teva has now sold off all the already-marketed products it needed to jettison in order to close its $40.5 billion buy of Allergan’s generics unit. It’s started casting off pipeline assets, too, and once it’s officially selected buyers for all of its candidates, it’ll submit a data package to the FTC and the body will vote on approving the transaction. Timeline: three to four weeks, Gal figures. (Helfand, 4/25)

American spending on retail prescription drugs hit $425 billion, according to a report by the IMS Institute for Healthcare Informatics. That, and year-over-year growth of around 12 percent is likely to capture headlines. But dig a little deeper and you’ll find that rebates and other discounts that pharmaceutical companies offer insurers slashed that spending to $310 billion. For patent-protected-drugs this is especially important – these price concessions cut price growth by between 77 and 81 percent. That’s great news for the health care system and for insurers – but unfortunately, the neediest patients with the highest costs don’t benefit much from these concessions. That’s due for a change. (Yevgenity Feyman, 4/26)

Read the headlines these days and you’d think the health insurance companies are going broke. It’s true most insurers offering Obamacare are losing money on it. UnitedHealth Group, the nation’s largest insurer, announced it will all but exit Obamacare next year because of those loses. But insurance companies have not fallen on hard times. Anything but. (Paul Alexander, 4/25)

No argument against the proposed Trans-Pacific Partnership trade agreement packs more emotional punch than the claim that the deal would be bad for people's health — and even result in avoidable deaths — both in the United States and in the 11 other signatory nations. The argument, repeated most recently in a letter to Congress from the U.S. branches of Doctors Without Borders, Oxfam America and about 50 other organizations, is that the TPP would unduly extend U.S. patent and intellectual property protections for the pharmaceutical industry, thus driving up prices for lifesaving medicines. In fact, the letter argues, the "TPP would do more to undermine access to affordable medicines than any previous U.S. trade agreement." (4/26)

Medicare drug plans are governed by federal law. But for the rest of us with a drug plan, the state in which we reside generally regulates drug plans and pharmacy benefits. When pharmacists descend on state capitols they often find a sympathetic ear in state legislators. (Devon Herrick)

Humans have been “repurposing” for centuries. Today we turn old churches into museums, schoolhouses into condos, old tires into artificial turf, and plastic bottles into dress pants. Drugs have become a new and exciting target for this activity. Two high-profile examples in the drug world are sildenafil and minoxidil. Both began as medications for cardiovascular issues. But along the way, it became clear that they did other things even better. Sildenafil, rebranded as Viagra, helps some men with erectile dysfunction get and sustain erections. Minoxidil helps hair grow, which spawned Rogaine. (David E. Potter, 4/26)

In the aftermath of the anthrax attacks of 2001, the Ebola outbreak of 2014 and now Zika, it is no longer a question of if but when the next biosecurity threat will occur. In fact, experts believe a pandemic, not nuclear terrorism or climate change, is most likely to cause 10 million or more deaths in a single event. (Tom Daschle and Ron Klain, 4/26)

Recent developments have once again prompted some to declare that the insurance marketplaces developed as part of the Affordable Care Act (ACA) are unsustainable and collapsing. And once again, these reports are overstated. What has prompted this latest round of recriminations is the report that UnitedHealthcare, the nation’s largest health insurance company, will be pulling out of the ACA’s marketplaces except in a “handful of states” in 2017. The company cites financial losses in its plans sold to individuals as the impetus for its withdrawal. The insurer is still quite profitable overall, earning $3 billion in operating profits in the first quarter of 2016. (Larry Levitt, 4/26)

Here’s some bad news for the insurance industry: Unexpectedly generous corporate subsidies didn’t save companies selling Obamacare policies from bleeding red ink. The worse news: Those subsidies are set to expire in 2017, meaning that insurers will have to make ends meet without billions in handouts. (Doug Badger, 4/26)

It has been more than six years since the Affordable Care Act became law. During that time, Republicans in the U.S. House have voted dozens of times to repeal, defund or dismantle it. Never have they voted on a bill to replace the health reform law. Now we know why: They’re still working on coming up with a plan. (4/26)

Three years ago, Walgreens (b. 1901) arrived in Silicon Valley for the same reason many old economy companies do: to hurry and join the digital vanguard before it was left behind. Walgreens quickly made a deal with Theranos (b. 2004), the medical diagnostics company and media darling that promised a revolutionary approach to blood tests. (Randall Stross, 4/27)

The $150 billion federal disability program is a mess. It almost went broke (Congress had to give it an emergency infusion). It discourages employment and can be gamed. But woe to the office-seeker who tries to fix it. (Paula Dwyer, 4/26)

If we hope to move to an efficient healthcare system that is fair to everyone, Congress will have to take on the largest subsidy in the tax code. Despite strong opposition from unions and employers, it is possible to reform the tax break for employment-based health insurance without destroying that market. (Joseph Antos, 4/26)

Margins on hospital Medicare business are expected to deteriorate this year, bottoming out at a negative 9% on average, according to a report by the commission that advises Congress on Medicare payments. But the good news is that hospitals are making healthy profits and surpluses overall on the strength of productivity gains, cost-cutting and their commercial business, the Medicare Payment Advisory Commission said in a little-reported study in March. (Dave Barkhotz, 4/26)

I remember driving to the hospital with my mother when I was 6 or 7. We pulled up to the physician parking lot, but the attendant refused to open the gate, telling my mother the lot was for physicians only. “I am a physician,” she said, “and I work here.” (Jennifer Adaeze Anyaegbunaum, 4/27)

I’m not always the best spokeswoman for autism. I toggle between wanting people to understand our daughter and wanting to behave like a normal family running errands on a Saturday. Some days I don’t feel like having to explain to strangers in line at the grocery store that she doesn’t speak, or having to identify myself at a school board meeting as a parent of a special-needs child. (Katherine Osnos Sanford, 4/26)

Imagine a veterans’ hospital with no waiting list to see a doctor. One where veterans can book their appointments online 24 hours a day, seven days a week. Where the red carpet is rolled out for our heroes to receive world-class care for their world-class service the very next day — before it’s too late. And where the men and women who accepted the call of duty can choose to continue seeing the doctor they’ve seen their entire lives. (Rep. Cathy McMorris Rodgers, 4/26)

KidsCare is not a trap or a trick or part of some sinister federal strategy to undermine Arizona’s independence. It is a trip to the doctor for a sick child. It is a well-baby check for an infant. It is ongoing care for a chronic childhood ailment, like asthma. (4/26)

You knew this was coming. The governor promised tax cuts so there were going to be some form of tax cuts, no matter what. Perhaps because somewhere down the line when he is running for something else he'll be able to say he cut taxes. (E.J. Montini, 4/26)

Up to 30 million Americans are suffering from eating disorders such as anorexia nervosa, bulimia nervosa and binge eating, according to the National Eating Disorder Association. Kentucky is 25th in the nation, with approximately 149,000 individuals afflicted with such devastating disorders. For those seeking treatment, there are zero inpatient facilities and there is only one outpatient therapy program in this state. (Kristy Klueh, 4/26)

As Congress and the Drug Enforcement Administration weigh whether marijuana should be rescheduled, public faith in the drug classification system continues to erode. Debate rages between those who emphasize the strangeness of marijuana being on the highly restrictive Schedule I alongside far more harmful drugs like heroin, and those who emphasize how strange it would be to put crude plant matter on a less restrictive schedule alongside well-specified FDA-approved medications. (Keith Humphreys, 4/26)