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Rep. Pramila Jayapal (D-Wash.), co-chair of the Congressional Progressive Caucus, is expected to release legislation Wednesday that incorporates key policy demands of single-payer activists, aiming to overhaul the U.S. health-care system even faster and more dramatically than legislation proposed in 2017 by Sen. Bernie Sanders (I-Vt.). Jayapal’s Medicare-for-all would move every American onto one government insurer in two years, while providing everyone with medical, vision, dental and long-term care at no cost. Similar proposals have been projected to increase federal expenditures by at least $30 trillion but virtually eradicate individuals’ health spending by eliminating payments such as premiums and deductibles. (Stein, 2/26)

Democrats in the U.S. House of Representatives unveiled an ambitious proposal on Tuesday to move all Americans into the government's Medicare health insurance program, tapping into public frustration over the rising cost of healthcare that has become a key issue for the party as it seeks to gain control of Congress and the White House in 2020. The bill, unveiled by Democratic Representative Pramila Jayapal from Washington state, would transition the U.S. healthcare system to a single-payer "Medicare for All" program funded by the government in two years. (Abutaleb, 2/26)

It would expand the Medicare program for seniors to younger Americans, replacing Medicaid for the low income and disabled and most employer-sponsored coverage. Employers and private insurers would be barred from providing benefits or selling coverage that duplicates benefits, but they could provide supplemental coverage. Benefits would include primary care, outpatient services, prescription drugs, dental care, substance-abuse and mental-health treatment, full reproductive services, as well as long-term care and services. The transition to the new system would take place over about two years. Existing medical benefits or services under the Department of Veterans Affairs and the Indian Health Service would continue. (Armour and Peterson, 2/26)

The 2020 presidential candidates have taken a variety of stances on what “Medicare for all” means, with some favoring more incremental steps like allowing people 55 and over to buy into Medicare. Jayapal emphasized Tuesday that Medicare for all means a full-scale, government-run health insurance system for everyone. “This medicare for all bill really makes it clear what we mean by Medicare for all,” Jayapal said. “We mean a system where there are no private insurance companies that provide these core comprehensive benefits.” (Sullivan, 2/26)

For now, Medicare for all has no chance of becoming law in a divided Congress. Democrats control the House but Speaker Nancy Pelosi and a number of party moderates are resisting the idea. On Tuesday, a member of the House Democratic leadership, Hakeem Jeffries of New York, kept his distance from the proposal, saying the Democratic caucus supports universal coverage but wants to focus on strengthening the 2010 Affordable Care Act and lowering drug costs. (Kapur and Tozzi, 2/26)

Centrist Democrats who helped their party win back the House majority with victories in key swing districts last fall are sounding the alarm that the liberal push for “Medicare for all” could haunt them as they try to defend their seats and keep control of the House. Instead, these moderates — many of whom will face tough reelection bids in 2020 — are pressing their party leaders to work with President Trump and Republicans to deliver to voters back home a bipartisan victory on lowering prescription drug prices and other health efforts rather than focus on an aspirational Medicare for all messaging bill. (Wong, 2/27)

The basic idea of “Medicare for all” is that all Americans should get access to the popular, government-run program. But a new bill toward this goal, the first introduced in the current Congress, would also drastically reshape Medicare itself. The bill, from Representative Pramila Jayapal of Washington and more than 100 Democratic House co-sponsors, would greatly expand Medicare and eliminate the current structure of premiums, co-payments and deductibles. (Sanger-Katz, 2/26)

At separate hearings on Capitol Hill, Democratic lawmakers hammered the Trump administration Tuesday over the “zero tolerance” prosecution policy that split thousands of migrant children from their parents last year and devolved into a political fiasco for the White House. Several Trump officials acknowledged to the House Judiciary Committee that they did not speak up to supervisors or attempt to stop the implementation of the family separations at the border, despite warnings it probably would traumatize children. Facing aggressive and sometimes angry questions from Democrats, the officials who formulated and carried out the separation system recognized communication failures among their agencies, but defended their actions as an attempt to uphold immigration laws. (Miroff, Sacchetti and Sonmez, 2/26)

The controversial former head of the HHS Office of Refugee Resettlement told a House panel Tuesday that he did not pass along warnings about the psychological impact of separating children from their families. Under questioning from Democrats on the House Judiciary Committee, Scott Lloyd said he did not tell his superiors that separating children from families could have lasting health consequences. (Weixel, 2/26)

Thousands of accusations of sexual abuse and harassment of migrant children in government-funded shelters were made over the past four years, including scores directed against adult staff members, according to federal data released Tuesday. The cases include allegations of inappropriate touching, staff members allegedly watching minors while they bathed and showing pornographic videos to minors. Some of the allegations included inappropriate conduct by minors in shelters against other minors, as well as by staff members. (Long, 2/26)

The allegations include rumors of sexual relationships between staff and minors and reports of staff forcibly touching the genitals of minors, as well as inappropriate touching between staff and minors. Deutch said the agency provided the documents in response to a request for information from the House Judiciary Committee. During a committee hearing Tuesday about the Trump administration’s “zero tolerance” policy of separating families at the border, Deutch questioned agency officials about the findings. (Weixel, 2/26)

Meanwhile —

Detainees confined to federal immigration detention facilities located in California have inadequate access to health care, lawyers and family, state Attorney General Xavier Becerra said Tuesday. Becerra was discussing the findings of a 147-page report prepared by his office that also found that detainees face long periods of confinement without breaks and language barriers in the 10 detention facilities state authorities inspected in 2017. (Elias, 2/26)

Many immigrants held in federally overseen detention centers in California are confined in their cells for up to 22 hours a day, have trouble accessing medical and mental health care and face significant barriers in obtaining translators and lawyers, the state attorney general’s office said Tuesday. (Sanchez, 2/26)

A House committee voted Tuesday to subpoena Trump administration officials over family separations at the southern border, the first issued in the new Congress as Democrats have promised to hold the administration aggressively to count. The decision by the Oversight Committee will compel the heads of Justice, Homeland Security and Health and Human Services to deliver documents to lawmakers. The committee’s chairman, Democratic Rep. Elijah Cummings of Maryland, has pledged to press the administration for documents and testimony on a wide swath of issues, but family separation was among his first priorities. (Long, 2/26)

Democrats on the committee said they have requested information for seven months from the agencies, including a request earlier this month. While the agencies have sent some documents, the Democrats said, the administration hasn’t fulfilled the requests of the committee, which is asking for specific information about each child separated from a parent or guardian at the border. “I did not make this decision lightly,” said committee Chairman Elijah Cummings (D., Md.) at Tuesday’s meeting.  “When our own government rips vulnerable children, toddlers, and even infants from the arms of their mothers and fathers with no plan to reunite them, that is government-sponsored child abuse.” (Andrews and Radnofsky, 2/26)

Rep. Jim Jordan (Ohio), the committee’s top Republican, said he didn’t think subpoenas should be necessary, because the agencies are cooperating. Jordan said the committee has been given hundreds of pages of documents in response to previous requests, and the administration should be granted more time. HHS spokeswoman Caitlin Oakley said the agency "has communicated regularly and in good faith" with Oversight Committee members, and has provided 792 pages of documents related to the Committee’s request. Oakley said HHS has also offered committee staff a review of the Office of Refugee Resettlement portal, which is used to help track the children in HHS custody. (Weixel, 2/26)

The Trump policy of prosecuting all adults crossing the border led to the practice of separating families and caring for the children in licensed facilities while trying to place them with a relative, because a previous court settlement had restricted the detention of children. The Department of Homeland Security struggled to track families and their children after the policy was put in place last spring — and did not create a comprehensive family reunification policy until a federal judge intervened. Mr. Trump eventually relented on the family separations, and a federal judge in California halted them in June. But in January, the inspector general of the Department of Health and Human Services reported that thousands more families might have been separated than previously reported. (Thrush, 2/26)

The House this week is set to pass the first major gun control legislation in over two decades, with Democratic lawmakers expected to approve two measures strengthening background checks for all firearms sales. The last time the House put high-profile legislation expanding gun control laws to a vote was in 1994, when it passed the Federal Assault Weapons Ban and made it illegal to manufacture a number of semiautomatic weapons for civilian use. That legislation expired after a decade and was not renewed by a Republican-controlled Congress. (Edmondson, 2/27)

In other gun safety news —

An Arizona Republican has offered a proposal to allow millions of people cleared by the Transportation Security Administration’s Precheck program — designed to make getting through airports easier — to buy a gun without additional investigation. Rep. Debbie Lesko offered the TSA Precheck amendment during the debate over the House Democratic-sponsored bill requiring background checks for all gun sales, including private transactions. Her amendment is set to be voted on on Wednesday. (Bresnahan, 2/26)

The Pentagon has spent nearly $8 million to treat more than 1,500 transgender troops since 2016, including 161 surgical procedures, according to data obtained by USA TODAY. As of Feb. 1, 1,071 service members have been diagnosed with gender dysphoria in the Army, Navy, Air Force, Marine Corps, Coast Guard and Public Health Service on active duty and in the reserve force. Most of them are senior enlisted personnel, but there are 20 senior officers – majors and lieutenant commanders and higher – as well. (Brook, 2/27)

Lindsey Muller served in the Army as a man for nearly a decade before telling her commanders in 2014 that she identified as a woman and would resign because military policy barred transgender personnel. Her superiors, citing her outstanding performance, urged the decorated attack helicopter pilot to stay so she did. After then-President Barack Obama changed the policy, she started dressing in uniform as a woman. Muller went on to be recommended for a promotion as the surgery to complete her gender transition was scheduled, but the operation was postponed in 2017 when President Donald Trump announced on Twitter that he was reinstituting the ban. (2/27)

The latest battle in the nation’s continuing war over abortion involves a federal bill called the Born-Alive Abortion Survivors Protection Act. Senate Democrats this week blocked the bill from reaching a vote, and President Trump responded with an angry tweet. (Grady, 2/26)

Missouri's Republican-led House on Tuesday advanced a bill that would ban almost all abortions in the state if the U.S. Supreme Court overturns Roe v. Wade. And if the high court doesn't switch course, the Missouri bill would ban most abortions after a fetal heartbeat can be detected. That can be as early as six weeks into a pregnancy. (2/26)

A bill that would ban most Tennessee women from obtaining abortions once a fetus’ heartbeat is detected cleared a key hurdle Tuesday, advancing for a full House vote in the GOP-dominated Legislature. The move comes amid a national movement from anti-abortion legislators and activists who hope that President Donald Trump’s appointments to the Supreme Court will increase their chances of undermining abortion rights. (Kruesi, 2/26)

Abortion opponents in Kentucky notched a new legislative victory Tuesday when the state House passed a bill that would ban the procedure for women seeking to end their pregnancies because of the gender, race or disability of the fetus. The measure cleared the chamber on a 67-25 vote that sends it to the Senate. It's part of an aggressive agenda by the Republican-dominated legislatures in Kentucky and several other states to restrict abortion. (2/26)

The Wyoming Senate has passed a bill that would allow the Board of Medicine to sanction doctors who don't tell the state that they performed an abortion. Supporters say they are trying to put teeth into a law that currently exists. (Beck, 2/26)

Connecticut will join other states in suing to block a new Trump administration mandate that bars federal family-planning money from going to health care groups that offer abortion referrals.Attorney General William Tong said he would take “swift legal action” to preserve the federal funding for organizations like Planned Parenthood. (Carlesso, 2/26)

Among the bills making their way through the Missouri legislature — most of which have also been proposed in past years — are proposals to outlaw abortion completely, to ban abortion contingent upon Roe v. Wade being overturned, to limit abortion at a certain number of weeks when a fetus is “pain capable,” to limit abortion when a heartbeat is detected and to require notification of both parents before a minor can seek an abortion. (Okeson-Haberman, Lewis and Rosen, 2/26)

The Food and Drug Administration plans new steps to combat the abuse of opioid painkillers, ranging from new dosage forms to small-quantity packaging and new research requirements on drugmakers. The new FDA measures are a further effort to stem the opioid-addiction crisis that has led to an estimated 47,000 opioid-painkiller overdose deaths in 2017 alone. The agency plans for the first time to require makers of opioid pain pills to conduct long-term studies of their drugs’ long-term effectiveness. The FDA has long mandated studies about safety, but the testing for possible long-term loss of effectiveness is a new authority for the agency in a law passed by Congress last fall. (Burton, 2/26)

The Harm Reduction Commission, at its seventh and final meeting, agreed on language explicitly calling for pilot sites where people can consume illegal drugs in hygienic surroundings with trained staff who can revive those who overdose. The report also specifies that any such site should receive local approval and calls for “rigorous evaluation and data gathering” to measure its effectiveness, but provides no suggestions on where such centers would be located. (Freyer, 2/26)

San Francisco is receiving a $3 million state grant to expand badly needed mental health and substance abuse services for homeless people over the coming 18 months. The grant from the California Department of Health Care Services will fund a range of outreach, social work and case management expansions aimed at shepherding intensively troubled homeless people into programs that will help them get off the streets and into healthy, housed lives. (Fagan, 2/26)

Helping students do better in school, get punished less often and miss fewer days are all things the administration is hoping for — which is why Gov. Tim Walz is asking for more than $4 million a year for children's mental health care in his budget proposal. One piece of that is to offer mental health care in school for as many as 7,500 more students through the state's "school-linked" mental health services. (Roth, 2/26)

A team of researchers at Stanford University are scanning the brains of stimulant users like Dee Dee to better understand one of the most intractable and frustrating questions in addiction treatment: Who is most likely to relapse and why? Current studies show that 60 percent of people in rehab for meth addiction relapse within a year of discharge, a stat that has health officials on edge as meth use in San Francisco is again surging. (Dembosky, 2/26)

Six days after Thanksgiving last year, a 73-year-old woman showed up at Baylor St. Luke’s Medical Center in Houston. Her body was retaining too much fluid after a dialysis treatment, and she was in need of emergency medical care. What happened next could have killed her. Hospital staff put in a request to give the woman a blood transfusion, but the order was meant for another patient with a different blood type. Fortunately, the St. Luke’s laboratory caught the error, sparing the woman from harm. (Hixenbaugh and Ornstein, 2/26)

Baylor St. Luke's Medical Center staff made more than 100 mistakes in the labeling of blood during a four-month period reviewed by federal inspectors, according to a report released Tuesday. The inspection was prompted by the December death of a 73-year-old woman suffered repeated heart attacks after being given the wrong blood type. (Hixenbaugh, 2/26)

In other news on health care quality —

Surgeons are known for their busy schedules — so busy that they don't just book surgeries back to back. Sometimes they'll double-book, so one operation overlaps the next. A lead surgeon will perform the key elements, then move to the next room — leaving other, often junior, surgeons to finish up the first procedure. A large study published Tuesday in JAMA suggests that this practice of overlapping surgeries is safe for most patients, with those undergoing overlapping surgeries faring the same as those who are the sole object of their surgeon's attention. (Ellis, 2/26)

A large study examining patient outcomes for surgeons who run multiple operating rooms at the same time has found that the practice is likely safe for most patients but may put vulnerable patients at an increased risk of harm. The examination published Tuesday in the Journal of the American Medical Association comes amid a national discussion in the world of medicine about the practice of double-booked surgeons. Two years ago, The Seattle Times detailed as part of its “Quantity of Care” series how some brain and spine surgeons at the Swedish Neuroscience Institute in Seattle were regularly running two operating rooms at the same time and patients had been unaware. (Baker, 2/26)

The U.S. Environmental Protection Agency's enforcement chief on Tuesday pushed back on "the myth" that the regulator is soft on polluters as Democratic lawmakers pressed her on the big decline in civil penalties and site inspections last year. (2/26)

Assistant administrator Susan Bodine, who heads the office of enforcement, said the idea that EPA is soft on enforcement is "absolutely not true," adding that the agency is giving states a greater role in regulation and enforcement and stressing education and voluntary compliance by companies. (2/26)

U.S. environmental regulators on Tuesday announced they are leaving intact an air quality standard for power plant pollution that can worsen asthma in children, despite calls by health advocates for a tougher rule. The move keeps in place a threshold for sulfur dioxide pollution established in 2010 by the U.S. Environmental Protection Agency under President Barack Obama. Sulfur dioxide comes from burning coal to produce electricity and from other industrial sources. (2/26)

Senator Amy Klobuchar’s nascent campaign is fending off a stream of stories from former staffers that she was a volatile, highhanded boss who often demeaned and humiliated people who worked for her. She has one of the highest rates of turnover in the Senate. “Am I a tough boss sometimes? Yes,” she said in a recent CNN forum. “Have I pushed people too hard? Yes.” The presumption that tough bosses get results — and fast — compared with gentler leaders is widespread, and rooted partly in the published life stories of successful C.E.O.s. Bobby Knight, the Indiana University basketball coach and author of “The Power of Negative Thinking,” was notoriously harsh, and enormously successful. So was Steve Jobs, the co-founder of Apple. (Carey, 2/26)

The decision to invite only female speakers to the microbiome conference at the University of California, San Diego, this week was meant to make a statement about how scientific meetings ought to be organized. Instead, the move has ignited a minor controversy, thrusting a gathering about a technical scientific subject into the culture wars. The inaugural International Microbiome Meeting, put on by UCSD’s Center for Microbiome Innovation, is expected to have 27 microbiome experts — all women — take the stage as presenters over two days this week. (Robbins, 2/27)

China has unveiled draft regulations on gene editing and other potentially risky biomedical technologies after a Chinese scientist's claim of helping to create gene-edited babies roiled the global science community. Under the proposed measures released Tuesday, technology involving gene editing, gene transfer and gene regulation would be categorized as "high-risk" and managed by the health department of the State Council, China's Cabinet. (2/26)

In cancer immunotherapy these days, technology is advancing so fast that 2017’s buzzy new treatment may soon be passe: Only 18 months after approval of the first CAR-T, pharmaceutical companies and biotechs are already talking about next-generation cancer therapy. Called bispecific antibodies, they’re being developed by some two dozen companies large and small, with a version cleverly branded as BiTEs already constituting 60 percent of Amgen’s oncology pipeline. The appeal: Bispecifics make the immune system kill tumor cells like first-gen immunotherapy, but, unlike the weeks it takes to laboriously manufacture CAR-Ts, they can start being infused almost as quickly as an oncologist can write a prescription. (Begley, 2/27)

A few minutes of brief, intense exercise may be as effective as much lengthier walks or other moderate workouts for incinerating body fat, according to a helpful new review of the effects of exercise on fat loss. The review finds that super-short intervals could even, in some cases, burn more fat than a long walk or jog, but the effort involved needs to be arduous. I have written many times about the health, fitness and brevity benefits of high-intensity interval training, which typically involves a few minutes — or even seconds — of strenuous exertion followed by a period of rest, with the sequence repeated multiple times. (Reynolds, 2/27)

The story of Keira Ball, a sprightly 9 year old, did not end in the summer of 2017, when she was fatally injured in a car accident in England. Her parents consented to donating her organs, saving the life of Max Johnson, also 9, whose heart was failing because of an infection. Pictures of these two children, who never met in life, have been on newspaper front pages and news broadcasts in Britain this week, the most highly publicized of the cases that have helped win passage of what has been called Max and Keira’s law. It is intended to boost Britain’s low rate of organ donations by making most adults presumed organ donors by 2020. (Karasz, 2/26)

The actress Selma Blair appeared at the Vanity Fair Oscar party on Sunday evening wearing a diaphanous Ralph & Russo gown and carrying a custom-made cane covered in black patent leather. It was her first public event since she announced in October her diagnosis of multiple sclerosis, a chronic and often disabling disease affecting the central nervous system. (Fortin, 2/26)

Multiple sclerosis is a disease of the central nervous system that sparks the immune system to attack the protective myelin sheath covering the nerves. The resultant damage disrupts the body’s ability to communicate with itself. Throughout the interview, Blair’s voice shook due to spasmodic dysphonia, a symptom of the chronic disease caused by involuntary muscle movements of the voice box. "It is interesting to put it out there, to be here, to say, 'This is what my particular case looks like right now,'" she said. (Lee, 2/26)

The bill would allow Iowans to get birth control pills and some other forms of contraception directly from a pharmacist without visiting a clinic first. Patients would have to complete a health screening, and pharmacists could refer them to a doctor if there are any concerns. (Sostaric, 2/26)

Assemblyman David Chiu and state Sen. Scott Wiener, both of San Francisco, announced a bill Monday that would prevent public hospitals from charging emergency room patients whose insurance won't cover their medical bills. This practice is called “balance billing,” and according to Chiu, it’s costing Californians thousands of dollars. Even if a patient has private insurance, an ambulance might transport them to an out-of-network hospital that doesn’t accept it — like Zuckerberg San Francisco General Hospital. (Champlin, 2/26)

The House Special Committee on Access to Quality Health Care easily approved House Bill 198. It is the broadest of several bills under discussion in the Legislature this year to ease the regulation called Certificate of Need, or CON. (Hart, 2/26)

Many California Democrats say they support single-payer health care, but none introduced a new version of the state’s landmark single-payer bill before a key deadline last week. Stephanie Roberson, a lobbyist for the California Nurses Association, said the union was in talks with Sen. Mike McGuire about running a bill this year, but those discussions fell through. (Bollag, 2/27)

A New Hampshire House subcommittee today voted unanimously to support a bill that would allow medical marijuana patients to grow their own cannabis. The bill would make it legal for qualified patients and caregivers to cultivate three mature plants and twelve seedlings, provided they're secured with a lock or other security device. (Garrova, 2/26)

Union leaders for roughly 10,000 research and technical workers are contemplating whether to strike against the University of California after their union bargaining team rejected the last, best and final offer presented last week by the administration. ...The UC has been negotiating with UPTE-CWA 9119 since May 2017, and its last contract offer expired Friday. (Anderson, 2/27)

The study, based on feedback from over 280 prominent business leaders, academics, and digital health care experts, provides no backup data but shares general findings. It says it will take work for the state to overtake Silicon Valley as the epicenter for digital health care. (Saltzman, 2/27)

The latest report from the federal monitor of the state Department of Children and Families shows that the agency maintained compliance with five of 10 measures that are part of a court supervised exit plan, but is still failing to meet the remaining five – including those related to hiring and caseloads. (Megan, 2/26)

Tenet Healthcare Corp. is in exclusive talks over a potential deal for its revenue cycle subsidiary, Conifer Health Solutions, the hospital chain's CEO said on the company's earnings call Tuesday morning. Dallas-based Tenet has been shopping around Conifer for more than a year now, and executives have acknowledged the process is taking longer than expected. In announcing the exclusivity talks, Tenet CEO Ron Rittenmeyer said there is no assurance the development will result in a transaction. (Bannow, 2/26)

The University of Missouri on Tuesday sued a professor who has been accused of exploiting student labor, alleging he defrauded the university of at least $1.5 million by stealing a student’s research and selling it. The suit, filed in federal court in Kansas City, accuses UMKC pharmacy professor Ashim Mitra of stealing a more effective formulation to deliver drugs to the eye from one of his graduate students, Dr. Kishore Cholkar. (Margolies, 2/26)

Gov. Mike DeWine on Tuesday filled the final vacancy in his cabinet, naming Dr. Amy Acton of suburban Bexley as his choice to lead the Ohio Department of Health. Acton, who most recently served assenata community research and grants administrator at the non-profit Columbus Foundation, vowed at a news conference to tackle a wide-ranging list of public health issues, from substance abuse to youth health. (Pelzer, 2/26)

Earlier this month, county commissioners unanimously agreed to remove that “Three Strikes ‘‘policy, a controversial eligibility requirement for Hillsborough’s health care plan that was enacted in 2005. The policy change, championed by Commissioner Sandra Murman, will go into effect March 15. (Dawson, 2/26)

LifeBridge Health, which operates Sinai Hospital in North Baltimore, announced Tuesday that it will acquire Bon Secours Hospital, a primary provider of medical and behavioral health services to underserved residents of West Baltimore. The move, less than six months after Bon Secours merged with the Catholic health provider Mercy Health of Ohio, continues the consolidation of hospital ownership within Maryland. The larger health systems say aligning their facilities puts them on more solid financial footing by cutting operating costs while widening access to medical specialties, but the moves also stoke fears in local communities about changes to long-provided services. (Cohn, 2/26)

Dr. Huong Le spends an average of 45 minutes with each of her dental patients during their visits, so she gets to know them well, especially the older ones who come in more than twice a year. She hears about their families, stories from their home countries and, often, how lonely they feel. More than once, Le and her staff at Asian Health Services have heard their patients express suicidal thoughts. (Ibarra, 2/26)

A federal jury convicted a Texas physician and former hospital administrator of running a $20 million healthcare fraud scheme that involved billing insurers for unnecessary medical tests, some of which were not even performed. The U.S. Department of Justice's Criminal Division announced the conviction late last week of internal medicine physician Dr. Harcharan Narang and Dayakar Moparty of one count of conspiracy to commit healthcare fraud, 17 counts of healthcare fraud and three counts of money laundering. They face up to 10 years in federal prison for each count of healthcare fraud and up to 20 years for each count of money laundering. (Bannow, 2/26)

The state of North Carolina, like many other employers, is trying to get a handle on the rising cost of health care. The state is taking a step toward lowering costs for state workers by taking control of how much it pays for each visit to mental health and primary care providers. (Olgin, 2/26)

Two states fighting an escalating hepatitis C crisis will soon pay a flat fee for unlimited drugs — Netflix style — to treat prisoners and low-income residents suffering from the deadly liver disease, with the goal of all but eliminating the infection. Netflix, the popular DVD and video streaming service, charges customers a monthly fee that entitles them to view all the movies they want. Louisiana and Washington state want to do something similar with the expensive medications that provide a cure for hepatitis C. (Ollove, 2/25)

A nonprofit founded to address a pressing U.S. health-care problem by manufacturing much-needed drugs that have fallen into short supply, or that are too expensive, will start out with a different approach: buying the drugs from pharmaceutical companies. Civica Rx was launched amid fanfare last year, backed by philanthropic donors and hundreds of hospitals. Fed up with shortages or skyrocketing prices for products like saline solution and epinephrine, Civica said in September that it planned to “directly manufacture generic drugs or sub-contract manufacturing to reputable contract manufacturing organizations.” (Koons, 2/20)

Bhanu Patel couldn't believe the news. The cost of the medication that allows her to move -- the one that enabled her to walk stairs again -- shot up to $375,000. Fear gripped her: What would this mean for her independence? Would she become a financial burden on her family? How is this possible in the country that's given her so much? The past three years, she said, the medication had been completely free as part of a specialty program. Until recently, the drug was known as 3,4-DAP made by Jacobus Pharmaceutical. But late last year, Catalyst Pharmaceuticals won FDA approval for a slightly modified version of the drug after two small clinical trials and announced an annual list price of $375,000 for the new drug, called Firdapse. (Drash, 2/20)

Two medicines designed to treat spinal muscular atrophy, a rare and often fatal genetic disease affecting muscle strength and movement, would have to carry much lower price tags than the manufacturers prefer in order to be considered cost effective, according to an updated analysis. And the estimates are likely to intensify ongoing debate over the cost of new treatments, especially for highly select patient populations. One is a forthcoming gene therapy from Novartis (NVS) that the company has indicated may be priced at $4 million to $5 million. (Silverman, 2/22)

Biotech company Amgen Inc said on Monday a U.S. jury confirmed the validity of patents on its cholesterol drug Repatha, rejecting a challenge by Regeneron Pharmaceuticals Inc and Sanofi SA. Sanofi and Regeneron had stipulated that if the two Amgen patents were valid, their jointly developed cholesterol drug Praluent infringed them. Amgen Chief Executive Robert Bradway said in a statement that the company was "thankful that the jury weighed the evidence carefully and recognized the validity of Amgen's patents." (2/25)

Blackstone Group LP is partnering with Novartis AG to develop drugs to treat blood clots, the first investment by the private-equity firm’s new life-sciences business. The two companies plan to announce Wednesday that they will form a new company called Anthos Therapeutics. Blackstone Life Sciences is contributing $250 million to the venture and will control the company. Anthos will use a Novartis antibody that targets two clotting factors. Novartis will have a minority stake in Anthos. (Gottfried, 2/26)

After three widely used rheumatoid medicines began facing new competition a decade ago, annual treatment costs for the older drugs rose faster than if the rival medications had not been launched, according to a new analysis, which suggested “opportunism” by manufacturers caused patients and taxpayers to shoulder higher expenses. Here’s the background: Prior to 2009, just three so-called TNF inhibitors —Remicade, Humira, and Enbrel — were used to treat various inflammatory maladies, but the competitive landscape began changing that year when two more medicines were launched — Simponi and Cimzia. By 2013, an intravenous version of Simponi also became available. (Silverman, 2/20)

rench healthcare company Ipsen has agreed to buy U.S. peer Clementia Pharmaceuticals in a deal worth up to $1.31 billion, the companies said on Monday, helping to boost Ipsen's portfolio of products treating rare diseases. Ipsen's shares dipped 0.6 percent after the company said the takeover would initially weigh on margins due to the costs of forthcoming trials for Clementia products, but it hoped they would recover later on. (2/25)

A bipartisan proposal in the Wisconsin Legislature attempts to lower prescription drug costs and provide more information to consumers about the true cost of their medication. The bill unveiled Tuesday targets middlemen called pharmacy benefit managers. They bargain drug prices on behalf of insurers and employers, manage plans and process claims. (Bauer, 2/26)

A former Novartis (NVS) employee was awarded nearly $1.5 million in damages over claims that she was fired in retaliation for complaining that a proposed drug study appeared to be a kickback, although the jury agreed that she violated a company policy. Min Amy Guo, who had been executive director of the Health Economics and Outcomes Research Group, objected to a study that would have examined unapproved, or off-label, uses of the Affinitor breast cancer treatment, according to the lawsuit she filed in a New Jersey state court in 2014. (Silverman, 2/26)

Drug company executives faced tough questions from Congress on Tuesday as they attempted to explain why, thanks to high drug prices, per capita spending on pharmaceuticals in the United States is double the average of other advanced countries. For decades, American drug makers have justified these high prices by asserting that the higher profits they generate fund research that accelerates the development of new medicines. Our data shows, however, that these companies spend every penny of their profits on distributions to shareholders in the forms of cash dividends and stock buybacks. (William Lazonick and Oner Tulum, 2/26)

Tuesday’s Senate Finance Committee hearing on drug pricing didn’t cause much of a stir on Wall Street. Nevertheless, investors in drug stocks, as well as the drug supply chain, would be wise to note the tough tone. For the first time in recent memory, seven executives from major drug manufacturers testified about the high price of prescription drugs on Capitol Hill. (Charley Grant, 2/26)

Most of the efforts out of Washington to fight rising drug prices amount to all-talk-no-action. But there’s one government campaign that has worked — and that the government just expanded. This is the government's attack on so-called pay-to-delay schemes, in which the marketer of a brand-name drug pays off generic drug makers to keep their competing products off the shelves, sometimes for years. The Federal Trade Commission, which has scored a string of courtroom victories against pay-to-delay in recent years, estimated in 2010 that these deals were costing consumers $3.5 billion a year. (Michael Hiltzik, 2/20)

Health and Human Services Secretary Alex Azar’s announcement of a plan to end kickbacks in the pharmacy distribution chain could shake up the multibillion-dollar prescription drug market. If put into effect by 2020 as proposed, the so-called list prices of drugs will likely plummet in the Medicare Part D system.Some Democrats and Republicans expressed hope that the plan could be expanded to the commercial sector. But with so much at stake, don’t expect the middlemen known as pharmacy benefit managers who profit from the kickbacks to go quietly. They are marshaling an argument that could prove particularly scary to seniors who watch their Part D premiums closely. (Erin E. Trish and Dana Goldman, 2/21)

One of the world's biggest drugmakers is betting on some very expensive medicines. On Monday,  Roche Holding AG said it will buy Spark Therapeutics Inc., a Philadelphia-based biotech firm focused on potentially curative one-time treatments that modify human genes, for $4.8 billion. Spark's first medicine, Luxturna, can stave off blindness in people with a rare eye disease. Its late-stage hemophilia gene therapies could help people live without a lifetime of expensive infusions. (Max Nisen, 2/25)

Soaring insulin prices are a genuine emergency in America. Many diabetics, suddenly unable to afford their prescribed doses, are self-rationing or using expired supplies. In the world’s most advanced nation, some are dying because they can’t afford a simple injection. (2/24)

The phrase “win-win deal” has become trite, but General Electric ’s GE 6.39% bombshell on Monday morning rises to that level. The troubled conglomerate’s shares rallied by 8% in early trading on the announcement that Danaher would buy its biotechnology business for $21 billion in cash. GE’s shares are up by nearly 70% since their mid-December trough. Danaher’s shares also rose by about 8%, signifying what the market perceives as a good price and a good fit for the company once run by current GE boss Larry Culp. (Spencer Jakab, 2/25)

What’s a year of life worth? That question is at the heart of a metric called the quality-adjusted life year that is increasingly being used to make decisions about paying for new drugs. If I was asked that question about one of my children, my answer would be “limitless,” and no one could persuade me otherwise. But others are putting a discrete price tag on it. (William S. Smith, 2/22)

Trump’s rebranding of the Gag Rule marks a frontal assault on human rights — not just for the four million patients that Title X providers serve annually, but also the community-based health care providers that struggle to narrow abysmal gaps in healthcare services. (The new domestic gag rule is a reflection of a similar anti-abortion rule for international aid funding instituted by every Republican administration since Ronald Reagan.) By muddling medicine and religious orthodoxy, moreover, the Gag Rule also threaten to erode the ethical integrity of the health care workforce, imposing the impossible choice on clinicians to either obey the law that funds their programs, or to uphold ethical responsibilities to their patients. (Michelle Chen, 2/25)

Planned Parenthood wants to be considered a benevolent health-care provider rather than the nation’s largest abortion business, and it wants the cachet of the federal government’s treating it as a valued and non-controversial partner. Hence the frequent, though long-debunked, claim that abortion makes up a mere 3 percent of the organization’s activities. Planned Parenthood’s own annual report tells the real tale: Last fiscal year alone, its facilities performed upwards of 332,000 abortion procedures, well over one-third the estimated abortions in the entire country. Its new president, Leana Wen, was more candid last month when she said that “protecting and expanding access to abortion” is the group’s “core mission.” (2/26)

In its continuing assault on reproductive rights, the Trump administration has issued potentially devastating changes to the nation’s nearly 50-year-old family planning program, Title X, which allows millions of women each year to afford contraception, cancer screenings and other critical health services. Health clinics have long been barred from using Title X money, or any federal funds, to pay for abortions, but they have been able to provide abortions and other family planning services under one roof. (2/26)

Republicans have long used their party’s opposition to abortion as a rallying cry and a way to turn out voters. Now, they seem to be gearing up to make abortion a core issue in the 2020 race. A key component of that strategy: painting Democrats as radical baby-killers. This week, Senate Republicans advocated a bill that seemed designed to do just that. (Eugene Scott, 2/26)

Trump announced that his administration will bar organizations that provide abortion referrals from participating in the $286 million Title X federal family-planing program that serves more than 4 million patients, mostly low-income women. Congress can’t make it right. Not with Trump poised to veto corrective legislation. (2/26)

On Feb. 5, during the State of the Union address, President Trump implied that women like me executed our babies after birth. On Tuesday, he repeated that same lie on Twitter after the nonsensical Born-Alive Abortion Survivors Act failed to gain enough votes in the Senate to move forward. The bill would have put in place requirements for the care of infants born after failed abortions and might have locked up doctors who failed to comply. It is unclear how this bill might affect situations where parents decline, for medically appropriate reasons, to have their newborns resuscitated. The threat of criminal prosecution does not enhance anyone’s medical care. (Jen Gunter, 2/26)

As a growing pantheon of Democratic politicians pledge their support for “Medicare for all” and its variants, the pharmaceutical and biotechnology industries are gearing up for an epic and expensive battle to kill these proposals. As someone who has worked at the highest levels of the pharmaceutical and biotechnology industries, I think this opposition is a huge mistake. (Jim Tananbaum, 2/27)

Last April, The Baltimore Sun ran an op-ed essay by a woman in mourning. Her sister, a “middle-class suburban mom,” had become addicted to alcohol and opioids and died. Two years earlier, The Wall Street Journal published the names and photographs of some of the 300,000 Americans who had died of opioid overdoses since the 1990s. Smiling faces stared back at the reader with eyes full of promise. The families of the dead described how their once-vibrant loved ones had fallen into opioid use, how an injury or divorce led to medication, which then spiraled into addiction. In 2016, the NPR podcast “Embedded” told the heartbreaking story of a nurse with three children who hurt her back at work and was soon hooked on opioids. (Abdullah Shihipar, 2/26)

We know that each day, 10,000 people around the world die of substance abuse and that addiction affects one in five people over the age of 14. So far, substance use disorders are costing society almost five times the cost of HIV/AIDS and twice as much as cancer. As physicians specializing in addiction treatment, our efforts to serve our patients are best assisted by policies which, as outlined by the American Society of Addiction Medicine, place an emphasis on teaching addiction medicine to increase and strengthen our workforce, standardizing the delivery of addiction medicine and expanding access to high-quality, evidence-based care. (Brent Boyett and Stephen Taylor, 2/26)

Did Immigration and Customs Enforcement turn a blind eye to abusive conditions confronting thousands of immigrants jailed without being convicted of a crime? Apparently so, according to a report by the Department of Homeland Security’s Office of Inspector General. Instead of using all the tools available to hold operators of immigrant detention facilities accountable for rampant health and safety violations, ICE did not impose financial penalties when it could have. Agency officials gave operators a pass in many cases by allowing them to avoid inmate facility requirements, the inspector general found. (Joe Davidson, 2/26)

Concerted efforts by political leaders, health officials, educators and manufacturers have driven underage use of conventional tobacco products to historic lows. Unfortunately, from 2017 to 2018, use of e-vapor products among high schoolers increased almost 80 percent and almost 50 percent for middle schoolers. FDA Commissioner Scott Gottlieb has called this an alarming “epidemic” and said that more must be done. I agree. Now is the time to act. (Howard A. Willard, 2/26)

When Medicare was signed into law in 1965, it did not include any coverage for hearing aids. They were considered “routinely needed and low in cost” and most Americans didn’t live long enough to actually need them. Even though the costs are now high and the need great, Medicare still doesn’t cover hearing aids. Today, hearing loss affects one-third of adults over the age of 65 and has a significant impact on health. Those experiencing it are at increased risk for depression, loneliness, and dementia, and may become socially isolated. Hearing loss also affects physical health, putting individuals at higher risk for falls and disability and possibly causing functional limitations such as reduced mobility or balance. (Elsa Pearson and Austin Frakt, 2/27)

My mother has lived with Alzheimer’s for almost 10 years. Caring for her has been like raising a child in reverse—every month she does less for herself. That’s heartbreaking. But keeping her with us, instead of in a nursing home, has been more enriching than I imagined. Mom was a 75-year-old widow in Florida when my siblings and I learned of her dementia. We’d flown in for a family vacation and walked into an intervention by her friends. After the vacation, she flew straight to my sister’s home in New York. (Brian Gaffney, 2/26)

Eliminating the distance between agency decision-making and political pressure, as this proposal does, begins to introduce a patronage system. Health care for veterans shouldn’t have to flow through a congressional office. (Robert Robb, 2/26)

My public health colleagues and I will continue the work we’re doing in our individual states and jurisdictions to raise immunization rates, provide science-based information and answer parents’ questions. But if we’re going to eliminate vaccine-preventable diseases in Washington, New York, Texas, or your home state, we have to see the big picture. That big picture means adequately funding governmental public health — this country’s community prevention system, working globally for our health security, funding our school nurse partners and making public policy that protects our most vulnerable. (John Wiesman, 2/26)

When it comes to health care in Massachusetts, there’s good news and bad news. The good news? The state recently announced that individuals who buy health care through the Health Connector, our health care exchange, pay the second lowest premiums in the country. The bad news? According to the Massachusetts Health Policy Commission, small businesses and their employees in the state have the second highest premiums in the country. (Jon B. Hurst, 2/26)

Others have noticed what a foolish thing the Utah Legislature did in rolling back the Medicaid expansion that was approved by the voters in November. (George Pyle, 2/26)