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In a heated confirmation hearing that focused on ethical issues, President Trump’s nominee for secretary of health and human services, Representative Tom Price, defended his trading of medical and pharmaceutical stocks on Tuesday, saying, “Everything that I did was ethical, aboveboard, legal and transparent.” Democrats accused Mr. Price of a potential conflict of interest at a hearing of the Senate Finance Committee, saying he held more than $100,000 in stock in companies that could have benefited from legislation he promoted. Mr. Price, a Georgia Republican, denied any wrongdoing. (Pear and Kaplan, 1/24)

Democrats began a key hearing on President Donald Trump’s pick to overhaul Obamacare by attacking his aggressive investing in health-care companies, an attempt to derail the nomination by hammering on ethics even though Republicans can force a confirmation with a party-line vote. Senator Ron Wyden, the top Democrat on the Finance Committee, slammed Georgia Representative Tom Price’s “abuse of his position” by buying privately offered shares in Innate Immunotherapeutics Ltd. as Congress weighed bills that could affect his investments. Democrats need to persuade Republicans on the panel to oppose Price in order to block his appointment as secretary of the Department of Health and Human Services; so far they have defended Price, and none have indicated they’d vote him down. (Edney and Tracer, 1/24)

President Donald Trump's selection to become health secretary told a Senate committee Tuesday that the new administration believes people with existing illnesses should not be denied health insurance, but committed to no details on that or any aspects of how Republicans will reshape President Barack Obama's health care law. Rep. Tom Price, R-Ga., who would be at the center of GOP efforts to scuttle Obama's statute and create new programs, frustrated Democrats probing for details of what Republicans will do. Instead, he repeatedly told them that the GOP goal is making health care affordable and "accessible for every single American" and to provide choices. (Fram and Alonso-Zaldivar, 1/24)

[Price] told a congressional panel on Tuesday that he does not support the privatization of Medicare and defended his ethics record. Speaking before the Senate Committee on Finance, one of two committees that oversee the health department, Representative Tom Price said his position was consistent with that of Trump, who has stated he does not want to cut the federal health program for the elderly. (Clarke and Cornwell, 1/24)

“The Medicare trustees … have told all of us that Medicare, in a very short period of time, less than 10 years, is going to be out of the kind of resources that will allow us as a society to keep the promise to beneficiaries,” Price said Tuesday before the Senate Finance Committee. “We will not be able to provide the services to Medicare patients at that time — which is very, very close — if nothing is done.” (McIntire, 1/24)

President Trump’s choice for health secretary declined Tuesday to promise that no Americans would be worse off under Trump’s executive order to ease provisions of the Affordable Care Act — and distanced himself from the president’s claim to have an almost-finished plan to replace the law. At a testy Senate confirmation hearing on his nomination to lead the Department of Health and Human Services, Rep. Tom Price (R-Ga.) sought to play down the influence he would have on reshaping the health-care system along conservative lines, while attempting to deflect accusations from Democrats about his ethics. (Goldstein and Eilperin, 1/24)

The nominee to head HHS wouldn’t say if he would use the directive to scrap Obamacare’s unpopular requirement that most Americans get health coverage or pay a fine. Price also dodged questions about whether he backs converting Medicaid into block grants, despite supporting the idea as House Budget Committee chairman. And he gave vague assurances he wouldn’t “abandon” people with pre-existing conditions who can no longer be denied coverage under Obamacare while disputing a 2012 report that quoted him criticizing the law's requirement that insurers cover that population. (Cancryn, 1/24)

Democrats argued that Price's approach would result in many Americans losing their access to medical care. Lawmakers and Price tussled intensely over the future of Medicaid, which serves more than 70 million people, or more than one-fifth of the U.S. population. Sen. Maria Cantwell, D-Wash., said the Trump administration appears to be “creating a war on Medicaid,” referring to recent comments such as those from the president’s senior adviser Kellyanne Conway in favor of block grants. (Young, 1/24)

Democrats on the finance panel repeatedly quizzed Price about what would happen to patients. Price kept his answers vague. In a round of questions about Medicare, Sen. Bob Menendez  (D-N.J.) asked: “Are you willing to commit that we won’t see increased costs or less coverage for seniors under a revision of Medicare that you might advocate or that the president might pursue?” Price responded: “Our goal is to make certain that seniors have access to the highest quality healthcare possible at an affordable price.” (Levey, 1/24)

Mr. Trump has sent sometimes conflicting messages about the stamp he intends to place in shaping the debate over repealing the ACA, urging Congress to act quickly but also saying he has his own plan that he intends to release soon. Mr. Price declined to say whether he would hold back on acting on Mr. Trump’s executive action until Republicans had coalesced around any replacement for the law. Asked by Democratic Sen. Michael Bennet of Colorado if Republicans’ proposals to repeal the ACA also included repealing the law’s expansion of Medicaid, he replied: “I, if I’m fortunate to serve as the Secretary of Health and Human Services, will carry out the law that you pass. That’s a decision that you all will make.” (Radnofsky and Armour, 1/24)

Rep. Tom Price refused to say how aggressively he'll implement President Donald Trump's order instructing federal agencies to pare back Obamacare — and he refused to promise that Obamacare enrollees wouldn't lose coverage as a result of the order. (Pradhan and Demko, 1/24)

Trump's pick, Rep. Tom Price, R-Ga., sounded unfamiliar with the legislation that Trump said would be released after Price is confirmed by the Senate when he was asked about it by Sen. Sherrod Brown, D-Ohio, during his confirmation hearing before the Senate Finance Committee. "It’s true that he said that," Price said to laughter. "I’ve had conversations with the president about health care." (O'Donnell, 1/24)

The question of what to do with Medicaid -- particularly how to handle the low-income adults who gained coverage thanks to Obamacare's expansion provision -- came up repeatedly during the hearing. Trump senior adviser Kellyanne Conway said Sunday on ABC News that the president is looking at turning Medicaid into a block grant program. (Luhby, 1/25)

President Donald Trump’s administration made explicit this weekend its commitment to an old GOP strategy for managing Medicaid, the federal-state insurance plan that covers low-income people — turning control of the program to states and capping what the federal government spends on it each year. It’s called “block granting.” ... But what would this look like, and why is it so controversial? Let’s break down how this policy could play out, and its implications — both for government spending and for accessing care. (Luthra, 1/24)

When asked about the CMS Innovation Center, he said that it had gotten “off track” but could be a tool for improving healthcare with programs that do not mandate provider participation. He later said that “for certain payment populations, bundled payments make a lot of sense.” (Muchmore, 1/24)

Rep. Tom Price (R-Ga.), President Donald Trump’s nominee to lead the Department of Health and Human Services, suggested he would want to preserve a Medicare and Medicaid innovation lab created in the Obama administration. Price told the Senate Finance Committee on Tuesday that innovation is important to medicine, and that the Center for Medicare and Medicaid Innovation “is a vehicle that might” support innovation. The CMMI was created under the Affordable Care Act to test new ways of delivering health care, with the goal of increasing quality and lowering costs. (McIntire, 1/24)

Not a single Democrat has said they will vote for Price, raising the possibility that he could be the first member of President Trump's Cabinet to be approved on a strict party-line vote. (Sullivan and Hellmann, 1/24)

Despite some withering criticism from Democrats about his stock trades and questions about Price’s plans for the health law, Republicans appear to be solidly supporting Price. (1/24)

Social Security, Medicare and Medicaid need significant changes to be preserved for future generations, President Donald Trump's pick to head the White House budget office told Congress Tuesday. Rep. Mick Mulvaney's comments at his confirmation hearing stand in sharp contrast to Trump's campaign pledges not to cut the programs. (Ohlemacher, 1/24)

As promised, President Trump has moved to dismantle the Affordable Care Act. It's a concern for those who might be left without health insurance — and especially for the Department of Veterans Affairs, which may have to pick up some of the slack. Carrie Farmer, a health policy researcher at the Rand Corporation, says 3 million vets who are enrolled in VA usually get their health care elsewhere — from their employer, or maybe from Obamacare exchanges. If those options go away, she has no idea just how many of that 3 million veterans will move over to the VA. (Lawrence, 1/25)

A federal hiring freeze imposed by President Trump on Monday affects thousands of open jobs at the Department of Veterans Affairs, despite the half-million veterans still waiting longer than a month for VA appointments. White House press secretary Sean Spicer confirmed Tuesday that the VA is covered under the freeze, which exempted the military and other positions deemed necessary for national security and public safety. (Slack, 1/24)

Republican lawmakers are heading to Philadelphia Wednesday for two days of intensive work on replacing Obamacare with hopes that some of the biggest questions can be answered by the often confounding President Donald Trump. House and Senate Republicans will pack the city, not far from where Democrats nominated Hillary Clinton just six months ago, for their annual retreat -- and crafting a replacement plan for Obamacare is at the top of their list. (LoBianco, 1/25)

Republicans in Congress hope to leave this week's GOP policy retreat in Philadelphia with a clearer picture of how they will repeal and replace the landmark 2010 health care law, even as they tamp down expectations that they will reach broad consensus on detailed policy proposals by week's end. President Donald Trump is scheduled to attend and speak at the retreat, and lawmakers hope he will flesh out what he'd like to see them achieve legislatively. The meeting will also give Senate and House members dedicated time to clarify their policy positions on a bicameral basis. (Williams and Mershon, 1/25)

In a sign that Republican lawmakers are set to move swiftly on plans to repeal and replace the Affordable Care Act, key House committees are scheduling hearings and drafting legislation to unravel former president Barack Obama’s major domestic achievement. On Tuesday, the House Budget Committee is holding a hearing titled “The Failures of Obamacare: Harmful Effects and Broken Promises,” while the Ways and Means Committee is set to examine the “effectiveness” of the individual mandate to buy insurance, a linchpin of the ACA’s model to expand insurance and make it more affordable. (DeBonis, 1/24)

As Republicans push forward with the repeal of ObamaCare, the House Energy and Commerce committee will examine a handful of bills that could play a role in the law's replacement during a hearing next week, according to a committee aide. The bills, which are some of the first healthcare measures beyond repeal to be considered by a committee, could fit into the Republicans' idea of a step-by-step replacement. (Sullivan, 1/24)

The House Energy and Commerce Committee could look to attach legislation intended to overhaul the 2010 health care law onto several other bills expected to advance this year, panel chairman Greg Walden said Tuesday. Walden, speaking at an event hosted by the Republican Main Street Partnership, said repealing and replacing Obamacare would be the top health care priority for his panel in 2017. But a handful of other major programs under the committee’s purview are expected to be reauthorized by Congress before they expire at the end of the year. (Williams, 1/24)

A House GOP-aligned outside group is rolling out a $2.6 million media blitz urging lawmakers to repeal and replace Obamacare — a move aimed at proving Republicans support as they craft a health care alternative. American Action Network on Wednesday will unveil the new spending on TV, digital and print ads as well as mailers in 41 districts. That brings the group’s total Obamacare ad spending to just over $4 million in January alone, a huge investment they hope will preempt Democratic attacks for their efforts. (Bade, 1/25)

Several Senate Republicans have proposed a plan that offers three options for changing health care coverage under the Affordable Care Act, also known as Obamacare. One option allows states to continue using the existing law. The other two options would change it in these ways. (Park and Lee, 1/24)

So what would a Republican replacement plan actually look like? And would it maintain some of the more popular pieces of the ACA? To find out, we spoke with leading conservative health care expert Lanhee Chen co-author of the influential American Enterprise Institute replacement proposal. Chen previously served as the policy director for Gov. Mitt Romney during his presidential campaign and is currently a fellow at the Hoover Institution at Stanford University. (Gold, 1/25)

Native Americans, Alaska Natives and a bipartisan group of their allies — including current and former Arizona lawmakers — are worried that repeal of the Affordable Care Act will also eliminate a non-controversial portion of that law that commits federal funding for tribal health care around the country, a move that the National Indian Health Board warns would be “catastrophic.” ... Arizona Democratic Reps. Raul Grijalva and Tom O’Halleran are both writing letters to Republican leadership in an attempt to convince them to keep the law. (Collins, 1/24)

Like any college student, Vanessa Ramirez never expected chemotherapy would be part of her busy school schedule. "I don't have any history of cancer in my family, so it wasn't something I was on the lookout for," Ramirez says, sitting outside the library of her alma mater, Arizona State University, in Tempe. Ramirez was diagnosed with ovarian cancer when she was 23. Now, more than a decade later, she's healthy and so are her children. "But there are also emergencies that happen," Ramirez says, explaining the priority she places on health insurance. (Stone, 1/24)

The sprint to dismantle the Affordable Care Act has Houston's hospital leaders worried about a potential fallout that could sweep beyond the poor if the uninsured rate rises again. Texas already leads the nation with more than 4  million uninsured, with Harris County topping the state at about 740,000. A recent analysis by the Urban Institute predicts that the Texas uninsured rate could climb to as high as 6.9 million by 2019 should the law also known as Obamacare be repealed without a swift and comparable replacement. (Deam, 1/24)

People are still signing up for health insurance through the Affordable Care Act despite its uncertain future. During an enrollment event at the University of South Florida on Tuesday people were worried about losing their health care. Peter Hill was one of them. He needs health insurance in order to live a normal life. The 26-year-old USF student was born with a movement disorder called myoclonic dystonia that caused his body to jerk uncontrollably. (Ochoa, 1/24)

Aetna and Humana would consider all available options for their proposed $34 billion merger, the two U.S. health insurers said on Tuesday, a day after a court ruled against the deal due to fears it would lower competition. The deal would "substantially lessen competition" in the sale of Medicare Advantage plans in 364 counties in 21 U.S. states and on the Obamacare exchange in three Florida counties, the U.S. District Court for the District of Columbia ruled on Monday. (Humer and Banerjee, 1/24)

"We continue to believe a combined company will create access to higher-quality and more affordable care and deliver a better overall experience for those we serve," Aetna Chairman and CEO Mark Bertolini and Humana CEO Bruce Broussard said in a joint statement. (McCoy, 1/24)

Aetna announced it would pull out of most of the state exchanges where it sold health insurance under the Affordable Care Act last August, citing financial losses. But a U.S. District Court judge who rejected the company's proposed merger with Humana on Monday revealed in his opinion that profitability wasn't the only concern driving the company's decision -- Aetna also exited several markets as part of an effort to "improve its litigation position." (Johnson, 1/24)

A federal judge said Aetna worsened its chances for closing its $37 billion merger with Humana when it pulled out of several Affordable Care Act insurance exchanges. Aetna had said it was due to financial losses. U.S. District Judge John Bates Monday blocked the $37 billion tie-up. According to his opinion, Aetna leadership made good on repeated threats to the U.S. Justice Department and then-HHS Secretary Sylvia Mathews Burwell to curtail its participation in the exchanges if the merger were blocked. (Livingston, 1/24)

The day after a federal judge dealt a crusing blow to Aetna’s plans to merge with Humana, the insurance companies’ CEOs said they were still mulling whether to appeal the decision. ... U.S. Circuit Court Judge John Bates on Monday enjoined the insurers from merging, agreeing with the U.S. Justice Department, which sued to block the deal, saying it would result in a lack of competition, higher premium, less choice and poorer care. (Radelat, 1/24)

An anti-abortion group released a video this week purporting to show that Planned Parenthood does not offer comprehensive prenatal services, an accusation that the women’s health organization said deliberately misrepresented its mission. The group, Live Action, said that of 97 Planned Parenthood centers it had contacted, only five said they provided prenatal care, one of the many medical services offered by the organization, which has approximately 650 health centers operated by 57 affiliates across the country. (Bromwich, 1/24)

Emboldened by a Republican in the White House, the GOP-led House on Tuesday backed legislation that would permanently bar federal funds for any abortion coverage. The measure, which passed 238-183, would also block tax credits for some people and businesses buying abortion coverage under former President Barack Obama's health care law. Republicans passed a similar bill in 2015 under veto threat from Obama and the legislation went nowhere. (1/24)

It does allow exceptions for cases of rape, incest or if the mother’s life in danger. (Marcos, 1/24)

Even if the bill is signed into law, the current status quo won't substantially change. Similar language restricting abortion funding, known as the Hyde Amendment, has been included in annual spending bills since 1976. It says that no appropriated funds can be used for abortions or for health plans that include abortion coverage except for pregnancies caused by rape or incest or if the pregnancy threatens the life of the mother. (Siddons, 1/24)

When the GOP announced the bill last week, Democrats vowed to fight it and decried federal interference with a local issue. But on the House floor, just three Democratic members of Congress — and the District’s non-voting delegate, Eleanor Holmes Norton — stood up on behalf of the city. (Portnoy and Davis, 1/24)

One of President Trump’s first foreign policy decisions is set to affect some of the world’s poorest people: women seeking health services in places such as sub-Saharan Africa and South Asia, where government hospitals are sometimes scarce. On Monday, the Trump administration announced that it would revive a Reagan-era policy that bans American assistance to organizations that offer abortion services, including counseling and referrals. In practice, experts say, that policy will freeze millions of dollars in funding that has gone to critical health treatment, including HIV testing and neonatal care. (Sieff, 1/24)

Dr. William Horgan has seen his share of patients go through life-changing experiences – and the changes that come from them. “A chronic smoker who has a heart attack and then recovers, the likelihood of them picking a cigarette back up is so infinitesimally small,” said Horgan, the associate chief of emergency services at Backus Hospital in Norwich. But heroin is different, Horgan says: Its grip is so strong, it seems to defy that logic. (Levin Becker, 1/25)

Gov. Larry Hogan and Lt. Gov. Boyd Rutherford announced Tuesday they are rolling out new legislation that would counter Maryland’s growing opioid addiction crisis. The Prescriber Limits Act would prevent doctors from prescribing more than seven days’ worth of opioid painkillers during a patient’s first visit or consultation. The law exempts patients going through cancer treatment and those diagnosed with a terminal illness. (Taylor, 1/24)

The Arizona health community distributed 305 million pain reliever pills last year – enough to provide 24-hour medication for every adult in the state for two straight weeks, according to the Arizona Criminal Justice Commission. As those pills are taken or tossed, some of the chemicals found in them can end up in the water supply. Chemical contaminants, ranging from prescription drugs to hygiene products, can enter the environment through landfills, flushed waste and shower drains. (Maki, 1/24)

Jackson County announced Tuesday that it will join St. Louis County in a prescription drug monitoring program as a way to fight abuse of painkillers. Missouri is the only state in the nation without a system to track the sales of prescription drugs. Despite repeated attempts over the past decade and wide support from health advocates, law enforcement and others, the General Assembly has been unable to pass legislation that would set up a statewide program. A small number of opponents have blocked those bills, citing privacy concerns. (Hendricks, 1/24)

The RV belongs to the Atlanta Harm Reduction Coalition, which administers Georgia’s only “above-ground” syringe and needle exchange program. Bennett, who co-founded the organization, is careful not to call the program “legal,” because, she admits, “there’s a question of legality.” But it operates out in the open. Under Georgia law, it is not permitted to distribute syringes or needles without a “legitimate medical purpose,” and Bennett says AHRC has such a purpose. The group is trying to stop the spread of HIV, hepatitis C, and other blood-borne infections, she says, “and just promote general health and wellness.” (Landman, 1/24)

Americans in certain struggling parts of the country are dying from cancer at rising rates, even as the cancer death rate nationwide continues to fall, an exhaustive new analysis has found. In parts of the country that are relatively poor, and have higher rates of obesity and smoking, cancer death rates rose nearly 50 percent, while wealthier pockets of the country saw death rates fall by nearly half. (Tanner, 1/24)

The mortality rate due to cancer is falling nationwide, but worrisome pockets of deadly malignancy persist — and in some places have worsened — in regions throughout the country, according to the first-ever county-by-county analysis of cancer deaths across the United States. The death rate attributed to various types of cancer declined 20% between 1980 and 2014, according to research published Tuesday in the Journal of the American Medical Assn. During that time, the number of cancer deaths per 100,000 Americans dropped from 240.2 in 1980 to 192 in 2014. (Healy, 1/24)

It was once seen as the disease of kings, afflicting only the lazy and gluttonous. These days, however, gout is everywhere — and a bitter battle has broken out among physicians about how best to treat it. A form of arthritis, gout is characterized by unsightly bulges under the skin and incredible pain in the joints. Typically seen in older men, the disease now increasingly afflicts women and younger adults, often accompanied by obesity, diabetes, and high blood pressure. (McFarling, 1/25)

Drugs approved in recent years that can cure hepatitis C may have severe side effects, including liver failure, a new report suggests. The number of adverse events appears relatively small, and the findings are not conclusive. But experts said the report was a warning that should not be ignored. It involves nine widely used antiviral drugs that were heralded as a huge advance because they greatly increased cure rates, seemingly with few side effects. (Grady, 1/24)

To stay in the United States, asylum-seekers need to prove that they are at risk of persecution in their home countries. But often they have little evidence to back them up. The paper trails from their past lives — such as hospital or police records — are often inaccessible. If they were tortured in a secret government prison or persecuted by the police, that kind of official record may not exist at all. Instead, what remain are the stories that migrants tell, and whatever marks those experiences have left on their bodies and minds. So these cases depend on doctors and psychologists who can translate scars and symptoms into evidence — and who can tell when a person’s ability to testify may have been altered by trauma. (Boodman, 1/25)

Hundreds of people around the country are still suffering from complications linked to injections of tainted medicine produced at a Massachusetts pharmacy in 2012. A nationwide outbreak of fungal infections was tied to the shipment of nearly 18,000 contaminated vials of preservative-free methylprednisolone, a steroid, made by the New England Compounding Center in Framingham, Mass. (Jolicoeur, 1/24)

Pertussis is a highly contagious bacterial respiratory infection that’s spread by coughing, sneezing or being at a breathing space near someone who’s infected. Although it can be treated with antibiotics, it can lead to severe complications and sometimes death in babies. Meanwhile adults may not even know that they have pertussis and chalk up the pesky cough to the flu virus. Nearly 21,000 cases of pertussis were reported in the United States in 2015, according to the Centers for Disease Control and Prevention. It’s a drop from a high of 48,000 in 2012, but also much higher than a total of 4,600 in 1994. (Miller, 1/24)

According to the American Academy of Pediatrics, even FDA-approved cardiorespiratory monitors — the kind doctors prescribe for use at home to detect apnea or abnormally low heart rates — have not been shown to save babies from dying suddenly in their cribs. What's more, routine in-hospital monitoring hasn't been shown to detect which infants are at risk of sudden infant death syndrome (SIDS) when they go home. (McCullough, 1/24)

About 100,000 Marylanders and 5 million people nationwide live with Alzheimer's, and many are dependent on family and friends to help with everyday tasks. The cost of caring for those with the disease and other forms of dementia was about $236 billion in 2016, according to the Alzheimer's Association. Without a cure, that cost could escalate to $1.1 trillion by 2050. (McDaniels, 1/24)

For several years, researchers have been fiercely debating how many campus rapes are committed by serial offenders. A 2002 study based on surveys of 1,882 college men and published in Violence and Victims, an academic journal, found that as many as 63 percent of those who admitted to behaviors that fit the definition of rape or attempted rape said they had engaged in those behaviors more than once. But in 2015, a study of 1,642 men at two different colleges was published in JAMA Pediatrics and found that while a larger number of men admitted to behaviors that constituted rape, a smaller percentage of them, closer to 25 percent, were repeat offenders. The difference could affect how universities approach rape investigations and prevention. (Saul, 1/24)

Scores of California hospitals with high rates of patient infections have not been inspected within the last five years, according to a petition filed Monday by Consumers Union. California law requires hospitals to be inspected every three years, but the state has fallen so far behind that the period has stretched to at least five years for 131 hospitals, the group said. (Peterson, 1/24)

A House Health, Welfare and Institutions subcommittee on Tuesday threw out a bill that would have mandated all sixth-graders in Virginia be vaccinated against diseases like bacterial meningitis. The bill was backed by the Virginia Department of Health and was sponsored by Del. Patrick A. Hope, D-Arlington. It would have required that Virginia students receive a vaccine to protect against the bacteria that causes meningococcal diseases like meningitis. (Demeria, 1/24)

Months of testing have found that the water in Flint, Mich., no longer contains lead levels that exceed federal limits, officials announced Tuesday. But though the city has reached that positive threshold, residents are still being advised to use filtered water for drinking and cooking, while the city continues to replace thousands of lead service lines. Last week, Flint marked its 1,000th day without reliably clean drinking water. (Berman and Dennis, 1/24)

An Arizona lawmaker has introduced a pair of bills that would prohibit gender-reassignment surgeries for Medicaid recipients and prison inmates, saying he is "always in favor of personal freedoms … but never at the expense of the taxpayer." Arizona taxpayers don't currently fund gender-reassignment surgeries for such individuals. Nonetheless, Rep. Anthony Kern sees House bills 2293 and 2294 as a crucial pre-emptive strike given recent shifts in transgender rights and protections. (Polletta, 1/24)

Last year we reported on a little-known hardship facing Nebraskans struggling to pay their medical debts: They were being sued over doctor bills of just a few hundred dollars. Unheard of in most states, such lawsuits are filed in Nebraska by the tens of thousands, typically against low-income workers, in part because filing fees are so inexpensive. Last week, a Nebraska lawmaker introduced a bill that would curb what collectors can take from debtors after filing suit and obtaining a court judgment. The bill would automatically protect the first $2,000 in a debtor’s bank account from garnishment, among other reforms. Currently, collectors are allowed to clean out debtors’ bank accounts. (Kiel, 1/24)

Prosecutors have accused a former Florence man of being the ringleader of an elaborate health-care fraud that netted him and eight others nearly $2 million in bogus health-insurance claims. Nicholas Scaffidi, 35, was charged earlier this month with fraud, money laundering and multiple counts of theft in connection with a scheme that prosecutors say began September 2014 during the first year of the Affordable Care Act marketplace. Investigators identified Scaffidi as the leader of a group that included his wife and seven accomplices, who they allege routinely visited out-of-network hospital emergency rooms with vague complaints of illnesses and demanded that doctors order a series of expensive tests. (Alltucker, 1/25)

Gov. Christie joined Democratic power broker George Norcross in Camden on Tuesday to tout improved emergency response times in the city last year, after Christie signed a law that allowed Cooper University Health Care to begin providing paramedic and ambulance services. While the action spurred a legal battle with Marlton-based Virtua Health System, Christie said it was a “fight” that was “worth having.” The Republican governor also endorsed a call by Norcross – who is chairman of the board of trustees at Cooper – to require greater “accountability” from other emergency services providers. (Hanna, 1/24)

Thirty-five percent of Lake County adults have been diagnosed with hypertension, or high blood pressure, according to the Lake County Health Department — more than 181,000 people. That's above the national rate of 29 percent. About 320,000 Lake County adults are overweight or obese, the department said, which is more than half of all adults. An average obese person decreases his or her life expectancy by more than nine years as a result of the condition. (Hammill, 1/24)

There are likely more than 313,000 victims of labor and sex trafficking in Texas, and roughly a fourth of them are children and people under the age of 26 who have been forced into prostitution, based on estimates from a University of Texas study. These estimates “remain a conservative understatement of the prevalence of human trafficking in Texas,” wrote the team of professors and others with UT’s Institute on Domestic Violence and Sexual Assault and the university’s School of Social Work who authored the report, published last month. They also concluded that labor trafficking is a significant issue in Texas that “is woefully under-studied and perhaps ignored as a policy area.” (Hall, 1/24)

For two hours, Nakia Venant broadcast from the bathroom of her Miami Gardens foster home, eventually fashioning a homemade noose from her scarf. The live feed ended abruptly. Nakia, a petite 14-year-old with long hair and a sweet smile, killed herself overnight Sunday while live-streaming the event. Administrators with the Florida Department of Children & Families would offer little detail Tuesday about Nakia’s death, other than to confirm that both child welfare administrators and the Miami Gardens Police Department were investigating the suicide death of “a child … in the care of a foster family.” (Miller and Burch, 1/24)

The black Labrador Retriever is part of a growing trend in service dogs primed to protect allergy sufferers from potentially deadly encounters with everything from soy to nuts. “I know she’s got my back,” Hayes said of the playful but obedient pooch that returned with her this week to college in New York. When Andromeda pinpoints any odor of latex, she drastically increases sniffing, brackets the source of the latex with her body, then sits and stares at the item to alert Hayes to stay away. Her owner rewards the dog’s efforts with lavish praise, big hugs, and a delicious treat. (Seipel, 1/24)

Californians legalized recreational marijuana in November, and the state is expected to begin distributing licenses to businesses by January 1, 2018. But least one state senator, who represents California’s marijuana-rich northern counties, doubts the state will be able to write regulations fast enough to hit the deadline. (Luna, 1/24)

J&J, the world’s biggest health-care company, also said it’s evaluating potential strategic options for its diabetes care business that could include a sale, partnerships or joint ventures, according to a statement Tuesday. The profit for this year will be $6.93 to $7.08 a share, excluding some items, J&J said, lower than the $7.11 average of estimates compiled by Bloomberg. Fourth-quarter earnings were $1.58 a share, topping projections of $1.56. (Hopkins, 1/24)

Johnson & Johnson's chief executive officer said on Tuesday that responsible drug pricing is a priority and discussed changes he would like to see on the U.S. tax code and healthcare policy, one day after meeting with President Donald Trump. The diversified healthcare group got off to a rocky start to the year, forecasting 2017 sales and profit below Wall Street estimates and reporting 2016 fourth-quarter sales short of expectations. J&J shares fell 2.1 percent to $111.52. (1/24)

The company is in talks to buy Actelion Pharmaceuticals Ltd., a Swiss maker of rare-disease drugs that had about $1.8 billion in sales during the first nine months of last year. On a conference call, J&J Chief Executive Alex Gorsky declined to comment on the Actelion discussions other than to acknowledge them. Mr. Gorsky also said J&J is assessing a wide range of options, including potential sales, for its diabetes businesses that sell devices such as blood-glucose meters and insulin pumps. (Rockoff and Hufford, 1/24)

Lackluster fourth-quarter drug sales have quickly propelled Johnson & Johnson square into a debate about drug pricing that the company has sought to head off. Nearly half of Johnson & Johnson sales are in pharmaceutical drugs, which increased U.S. revenue in the latest quarter by only 2% year-over-year, according to Leerink analyst Geoffrey Porges. Growth was slightly better outside the U.S., at 3.5% net of the effect of currency, Porges said. (Court, 1/24)

In his harsh comments about the drug industry at a press conference earlier this month, President Trump declared that “pharma has a lot of lobbies and a lot of lobbyists and a lot of power.” But how much, exactly? STAT analyzed lobbying disclosure filings updated this week to build an in-depth portrait of how the drug industry wielded its influence on the federal government in 2016. (Robbins, 1/25)

The pharmaceutical and biotechnology industry lobbying giants ramped up their advocacy spending in the final three months of 2016, just as Congress was finalizing a new law aimed at speeding drug development and research. The Pharmaceutical Research and Manufacturers of America dropped $4.9 million in the fourth quarter of 2016, up from $3.8 in the same quarter in 2015, a CQ analysis of new lobbying filings shows. The Biotechnology Innovation Organization spent $2.3 million to influence policymakers over the same three months, up from $2.1 million the year before. (Mershon, 1/25)

President Trump has made it clear that he thinks drug prices are too high and that the pharmaceutical industry, as he put it at a news conference this month, is “getting away with murder.” He joins a host of lawmakers and others who have excoriated drug makers in recent years for high-priced drugs that are out of the reach of many Americans. On Monday, Sean Spicer, Mr. Trump’s press secretary, reaffirmed that the issue would be a priority. (Thomas, 1/23)

The pharmaceutical and medical-device industries are deeply unsettled about their future under Republican control in Washington, which presents threats as well as opportunities, according to industry officials and advisers. The companies and their trade groups want to develop ties with key players in the Trump administration on health care to push their agendas and protect their interests, according to people familiar with company efforts. Yet who those key players will be remains largely a mystery, the people said. (Rockoff, 1/24)

When Biogen received regulatory approval last month to sell the Spinraza rare disease drug, the company surprised Wall Street by setting a price that few expected — $750,000 for the first year of treatment and $375,000 each year thereafter. At the time, at least one analyst suggested the price tag amounted to “sticker shock” that may cheer investors, but also invite criticism at a time of growing outrage over drug pricing. Already, the scrutiny has begun. (Silverman, 1/24)

Four separate bills have been filed in the state Legislature that are aimed at controlling the price of prescription medicines by requiring drug makers to disclose the cost of their research, marketing, and manufacturing. Similar accountability legislation — strongly opposed by the drug industry — failed last year on Beacon Hill. But the new proposals, which would expand the state’s role in monitoring drug pricing, come amid stepped-up efforts to rein in medical costs, and President Donald Trump’s call for Medicare to negotiate drug prices. (Weisman, 1/24)

As promised, President Trump has promptly abandoned the Trans-Pacific Partnership. What might this mean for biopharma? Nixing the so-called TPP could spell trouble for the biopharmaceutical industry moving forward when it comes to market exclusivity, according to Kevin Noonan, a partner at Chicago-based intellectual property law firm McDonnell Boehnen Hulbert & Berghoff. (Keshavan, 1/24)

A new study conducted by the Berkeley Research Group provides some fresh insight into how the pharmaceutical supply chain works, who pays what, and where the profits go. There is one major caveat to note upfront: The study was funded by PhRMA, an industry lobbying group for biopharmaceutical companies. Taking that into account, the data and discussion still add valuable context and another perspective to the drug price debates. (Preston, 1/19)

In a move that may hearten the pharmaceutical industry, the US Supreme Court will review a case that decided people from anywhere in the United States can file product-liability lawsuits against drug makers in California, where the courts are seen as more hospitable to consumers. (Silverman, 1/20)

In a bid to widen access to medicines, a pair of US senators introduced a bill to speed approvals for treatments when little competition exists – at least under certain circumstances — and temporarily permit prescriptions drugs to be imported in order to mitigate shortages. Specifically, the bill would allow the Health and Human Services Department to grant faster reviews and inspections, and temporarily permit imports when there are fewer than five competitive drugs that have been on the market for at least 10 years. (Silverman, 1/23)

State Comptroller Kevin P. Lembo unveiled a five-point plan Tuesday to develop new legislation to reduce “skyrocketing” pharmaceutical drug costs in Connecticut... Lembo said the legislation still is being developed, adding that he also would consult with Attorney General George Jepsen’s office regarding what types of sanctions Connecticut might impose against drug companies that can’t justify sharp price increases. (Levin Becker and Phaneuf, 1/24)

Andrew Witty, chief executive officer at GlaxoSmithKline, discusses the debate on U.S. drug pricing, focusing on innovation and access to medicines. (1/19)

Celgene Executive Chairman Bob Hugin discusses drug pricing and the future for affordable health care. He speaks on "Bloomberg Markets." (1/23)

The pharmaceutical industry wants you to know that it’s not “getting away with murder. ”That was the accusation leveled by President Trump two weeks ago, and it stunned industry executives, who were already on the defensive after sustained and increasingly harsh criticism of drug prices that has lowered their reputation among consumers and politicians. (Ed Silverman, 1/23)

President Donald Trump recently took a swat at one of his favorite pinatas, Big Pharma, vowing to revamp federal rules for buying prescription drugs. "They're getting away with murder," he said of drugmakers. "Pharma has a lot of lobbyists and a lot of power and there is very little bidding. We're the largest buyer of drugs in the world and yet we don't bid properly and we're going to save billions of dollars." (1/20)

Last week, Donald Trump complained about drug prices in a press conference. Drug companies, he said, are “getting away with murder.” During that presser, pharma and biotech stocks lost over $20 billion in value. Investors should have learned an important lesson. They probably didn’t. Trump’s targeting of drug sellers was not a fluke. Hillary Clinton's "price gouging" tweet last September had the same type of impact on markets. For those who understand the big picture, these two events offer clues about the future of the drug business. (Patrick Cox, 1/19)

Anyone in biopharma hoping for Johnson & Johnson's fourth-quarter earnings to dispel their Trump-related gloom was disappointed Tuesday morning. J&J's revenue missed expectations, and its 2017 profit guidance fell short. It's no time to panic; J&J's CFO chalked the guidance disappointment up to foreign-exchange issues. But the warning highlights how hard it is for a company of J&J's size to generate growth and why it is considering a big, complicated deal for Swiss biotech Actelion Ltd. (Max Nisen, 1/24)

The United States faces a major problem with prescription drug prices. Even as the prices of most goods and services have barely budged in recent years, the cost of drugs has surged. During the presidential campaign, both Hillary Clinton and Donald Trump cited the high cost of prescription drugs as an issue that needed to be addressed. Most recently, the president took direct aim at the pharmaceutical industry, saying it’s “getting away with murder” and arguing “new bidding procedures” are necessary to lower drug prices. (Marcelle Arak and Sheila Tschinkel, 1/21)

It didn't take long for the first specialty pharma scandal of 2017 to materialize. Mallinckrodt PLC on Wednesday disclosed it will pay $100 million to settle FTC charges that Questcor Pharmaceuticals, which Mallinckrodt bought in 2014, illegally raised the price of its best-selling drug Acthar by 85,000 percent and bought the rights to a cheaper competing drug to keep it out of the U.S. market. The settlement forced Mallinckrodt to give a free limited U.S. license for that cheaper drug to a competitor, Marathon Pharmaceuticals. (Max Nisen, 1/19)

Right now, private insurers bargain individually over drug prices for millions of senior citizens in Part D. That was a major concession to drugmakers in the current law, which took effect in 2006. Critics say the government could drive down prices with its potentially enormous leverage at the bargaining table. (1/25)

Bristol-Myers Squibb Co. started 2016 as the acknowledged king of immune-boosting cancer drugs. That position has never looked shakier. Thursday evening, Bristol announced it won't seek accelerated FDA approval for a combination of its leading cancer drug Opdivo and another immune-oncology (IO) drug called Yervoy in treating newly diagnosed lung-cancer patients. (Max Nisen, 1/20)

Modern conservatism, at least in its pre-Donald Trump incarnation, evolved to believe in a marriage of Edmund Burke and Milton Friedman, in which the wisdom of tradition and the wisdom of free markets were complementary ideas. Both, in their different ways, delivered a kind of bottom-up democratic wisdom — the first through the cumulative experiments of the human past, the second through the contemporary experiments enabled by choice and competition. In health care policy, however, conservatives tend to simply favor Friedman over Burke. That is, the right’s best health care minds believe that markets and competition can deliver lower costs and better care, and they believe it even though there is no clear example of a modern health care system built along the lines that they desire. (Ross Douthat, 1/25)

If you’re following the health insurance debate—and since the coverage of more than 20 million Americans is under threat from the Trump White House and the Republican congressional majority, you should be—you’re going to be hearing a lot in the coming weeks about Cassidy-Collins. That’s an Obamacare replacement plan just introduced by Sens. Bill Cassidy (R-La.) and Susan Collins (R-Maine). Dubbed the Patient Freedom Act, It’s the first such proposal that indicates that the GOP is becoming increasingly panicked about the political price of repealing the Affordable Care Act outright, and increasingly desperate to reassure voters that the provisions of Obamacare they actually value can be retained without a break. (Michael Hiltzik, 1/24)

I’m just not professionally or temperamentally wired for policy discussions. I am, however, temperamentally and professionally wired for doctoring, and here's what I see: Undoing the Affordable Care Act with such rapid and angry vehemence will be bad for our health. (Steve Schlozman, 1/24)

The Department of Health and Human Services has discretion under the ACA to offer states waivers, formally “state innovation waivers,” from many of the law's most expensive and onerous regulations. The Trump administration can immediately signal its commitment to promoting market competition and empowering patients and consumers by offering such waivers. Along with new reforms to promote transparency on pricing and quality, the administration and Congress can facilitate a health care revolution from the ground up. ... Trump’s pick for HHS secretary, Tom Price, can put even more punch behind this approach by allowing states to merge ACA and Medicaid funding, via so-called “1115 waivers,” and granting greater flexibility to state Medicaid programs. (Tom Coburn and Paul Howard, 1/24)

The repeal of Obamacare is nigh, agree Republican leaders in Congress, but there’s plenty of dissent in the ranks over a repeal-and-replace strategy. Those same GOP leaders are in the dark about President Trump’s vow to substitute a plan that offers “insurance for everybody” — which pretty much describes how Obamacare was supposed to work all along. Not to be overlooked in the unpredictable debate over health care coverage and costs is the need to preserve quality of care. (Tom Still, 1/24)

On January 23, 2017, Senator Bill Cassidy (R-LA), joined by Senator Susan Collins (R-ME), Johnny Isakson (R-GA) and Shelly Moore Capito (R-WV), introduced the Patient Freedom Act of 2017 (PFA), their proposal for partially repealing and replacing the Affordable Care Act (ACA) (here are the press release, one-page description, and section-by-section summary). The legislation combines features of the Healthcare Accessibility, Empowerment, and Liberty Act, which Senator Cassidy introduced into Congress with Congressman Pete Sessions (R-TX) in 2016, and earlier Patient Freedom Acts which Senator Cassidy introduced as potential responses had the Supreme Court held in King v. Burwell that the federal marketplace could not issue premium tax credits. (Timothy Jost, 1/24)

President Donald Trump isn’t delaying his promise to repeal and replace Obamacare. On his first business day in office, he signed an executive order offering some relief from the law’s oppressive regulations. Congress is equally eager to take action, but any major shakeup will create challenges for the states — especially the ones that expanded Medicaid under the Affordable Care Act. Michigan must be ready for a plan B, depending on how Congress acts. ... Repeal of the Affordable Care Act will likely roll back federal assistance for Medicaid expansion, if not scrap it completely. Michigan will have two choices: pay the higher bill or drop coverage for some, or all, of the 640,000 people enrolled in the Medicaid expansion. That’s more than 30 percent higher than originally projected. The state government needs to begin saving for increased Healthy Michigan costs — something it was supposed to do from the beginning — while preparing to close the plan in the long run. It’s too costly and hasn’t delivered on its promises. (1/24)

Republican leaders in Congress in recent years have championed the idea of transforming Medicaid from a fully shared federal-state program with matching federal payments to one where Washington provides block grants to the states, leaving each state to manage its own Medicaid program. If Congress now proceeds in this direction, it should do so with utmost care. Under most scenarios, block granting will likely have disastrous implications for current Medicaid patients, providers, as well as state finances. (Kenneth L. Davis, 1/25)

A serious threat to seniors and those with disabilities is being ignored in the debate over repealing the Affordable Care Act. We must not forget that the Medicaid program dates back to 1965, not the ACA expansion for the working poor. This half-century-old safety net is responsible for more than three-fifths of all nursing home patients, and it, too, is imperiled. (Brendan Williams, 1/25)

Colorado needs to have an honest and immediate conversation about Medicaid, a simple talk that before now was avoided in favor of political vitriol and defensiveness over the Affordable Care Act. Medicaid makes up 26 percent of the state’s general fund and is estimated to cost $2.65 billion of the state’s fungible budget in the 2017-18 fiscal year. ... As lawmakers face a budget crunch, those numbers have created an easy target for some Republicans to claim there is money in the budget for transportation and education, if Democrats were only willing to cut Medicaid. But Republicans have to be honest about what that money is and isn’t paying for, and what the state can and can’t do. (Megan Schrader, 1/24)

Ever since the Brownback administration privatized Medicaid, there has been a disconnect between its rose-colored assessments of KanCare’s success and the complaints of many service providers and those receiving (or not receiving) care. So it wasn’t a huge surprise when federal officials denied Kansas’ request to extend KanCare contracts beyond this year, saying the state was “substantively out of compliance with federal statutes and regulations, as well as its Medicaid state plan.” Nor was it particularly surprising that the Brownback administration lashed out in response, saying the denial was “politically motivated.” (1/24)

But what also pops out at you is how many of those companies are in the health-care arena: Pfizer, Athena Health, Gilead Science, Eli Lilly, and so on. Did the broker overweight Price's portfolio with health care stocks without his client's knowledge? That's a lot harder to believe. And Price -- or his broker -- traded those stocks: according to the Wall Street Journal, Price bought and sold $300,000 worth of shares in health-care companies over the past four years...Are these all "coincidences?" Even if the answer is yes, the fact that Price has been so cavalier about owning health-care stocks while taking action that can move these stocks makes it nearly impossible to accept his claims of innocence at face value. (Joe Nocera, 1/24)

President Trump’s choice to lead the Department of Health and Human Services, Rep. Tom Price (R-Ga.), held stock in dozens of companies in the health-care, biomedical and pharmaceutical industries even as he was voting on, and often sponsoring or promoting, legislation that could affect the value of his investments. Some of his stock purchases have sparked concerns under the Stop Trading on Congressional Knowledge (Stock) Act of 2012, which makes clear that the insider-trading prohibitions arising under the federal securities laws apply to members of Congress. I testified in Senate and House hearings on the act. As then, I believe it did not go far enough. (Donna M. Nagy, 1/24)

President Trump’s pick to run the Department of Health and Human Services, is a walking, talking example of the ways in which congressional ethics requirements are too lax. While in Congress, Mr. Price traded hundreds of thousands of dollars in health-care-related stocks. In at least one case, a trade coincided with legislative efforts from Mr. Price that, if successful, would have affected the company he owned a piece of. In another case, the congressman was one of a select group of investors offered a private stock-purchasing deal in an Australian biotechnology company. Making the picture only more unattractive, Mr. Price apparently learned about the company from another House member, Chris Collins (R-N.Y.), who was on the firm’s board. (1/24)

It is not impossible to want to reduce abortions, while supporting women’s reproductive choices. These are not incompatible views: You can want to uphold access to rights, while hoping that a person does not need to access them. The problem is, the move to defund Planned Parenthood is absolutely incompatible with a desire to reduce abortions, and with a desire to limit public funding of abortion. Further, such a move has disastrous public health outcomes for women. (Renee Ann Cramer, 1/24)

Our community cannot resign itself to the rising death toll among mentally ill persons who encounter Cincinnati police. An Enquirer story, "Mentally ill make up nearly half of those killed by CPD" (Jan. 22), revealed that nearly half of the individuals recently killed by Cincinnati officers were in the midst of a mental health crisis. We can and must do better for this vulnerable population. (Al Gerhardstein, 1/24)

The link between transportation access and health has been recognized for at least half a century. Medicaid, established in 1965, required each state to include in its plan a provision for assuring transportation of recipients to and from providers of services. This transportation guarantee for disadvantaged population has been affirmed time and again in federal court .... nonemergency medical transportation (NEMT) has evolved into an enormous system that spends more than $3 billion each year nationwide to help millions of low-income, elderly and disabled patients reach care. Transportation assistance is both cost-effective and cost-saving. (Imran Cronk, 1/25)

Those who receive medical degrees elsewhere — often called international medical graduates — face obstacles ranging from visa limitations and additional tuition costs to physical relocation and its myriad accompanying social and cultural implications. Foreign medical licenses often don’t transfer to the US, requiring physicians to spend up to $15,000 over a three-to-five-year period for duplicative training. Resource constraints force some foreign-trained physicians to alter their career paths to become nurses or physician assistants in the US. (Jason J. Han and Neha Vapiwala, 1/24)

The Kansas Personal and Family Protection Act goes into effect in July, allowing adults to carry a concealed handgun on college campuses and in hospitals in Kansas, without a background check and with absolutely no training. I’m an emergency physician. I’m comfortable with guns because I grew up around them in rural western Kansas. Some of my best memories are of the hunting trips taken with my dad and brother when we were young. However, many people I work with in the medical center do not share this level of comfort around guns. For most, the thought of sitting down with a patient who has a hidden gun or dealing with an angry patient or family member who may be carrying a gun is absolutely terrifying. (Andrew Park, 1/24)

Marijuana is now legal in some form in 30 states and the District of Columbia. Even if you are among the shrinking number of Americans who still live in a state in which marijuana remains illegal, your children will likely travel to places where pot is legal – Venice Beach in Los Angeles, the mall in Washington, D.C., or the Las Vegas strip. (Mike Lynn, 1/24)

Over the past half-century, the rate of obesity in America has nearly tripled, while the incidence of diabetes has increased roughly sevenfold. It’s estimated that the direct health care costs related to obesity and diabetes in the United States is $1 billion a day, while economists have calculated the indirect costs to society of these epidemics at over $1 trillion a year. (David Bornstein, 1/25)

Imagine what a typical American might do for breakfast: Fry a few slices of bacon, slather Nutella on a piece of toast, and pour a hot cup of coffee while checking e-mail on a smartphone. If we are to believe everything we read in the news, then that rather common daily ritual could cause you to die from cancer. (Alex Berezow, 1/24)