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Under extreme pressure from conservative activists, House Republican leaders and the White House have restarted negotiations on legislation to repeal the Affordable Care Act. But efforts to revive the legislation in the House could take weeks, lawmakers conceded, as Congress moves forward with a full plate of other time-consuming issues. And the renewed push did not meet with much enthusiasm from Senate Republicans, who said they had other priorities at the moment. (Pear and Peters, 3/28)

Speaker Paul Ryan said Tuesday he's going to give battered House Republicans another crack at a health care overhaul. But he offered no timeline, and leaders haven't resolved how to overcome the deep GOP divisions that crumpled their legislation last week in a humiliating retreat for themselves and President Donald Trump. (Fram, 3/28)

Still smarting from last week’s meltdown on a bill to overhaul the Obama health law, House Republicans used a closed door “family meeting” in the U.S. Capitol to both clear the air, and see if there was a way to push forward again on a plan to make major changes to Obamacare. (Dupree, 3/28)

After the failure of the bill and some weekend reflection, Freedom Caucus Chairman Mark Meadows, R-N.C., and his caucus are trying to do things differently. The group is working with leadership and moderate Republicans to try to bring back the bill in a different form. Meadows had a meeting with Ryan on Tuesday, which was unusual because the Freedom Caucus had largely gone around leadership during the negotiation process and dealt directly with the White House. (Collins, 3/28)

Representative Tom MacArthur of New Jersey, a co-chairman of the GOP’s Tuesday Group of moderates, said he participated in a meeting brokered by House Speaker Paul Ryan with some members of the House Freedom Caucus where they reopened the conversation on how to repeal and replace Obamacare. “We as a conference are still trying to get to yes,” MacArthur said, adding that the “framework would largely be the same” as the bill that Ryan abruptly pulled from the House floor on Friday. (House and Wasson, 3/28)

White House press secretary Sean Spicer on Tuesday acknowledged talks but no imminent plans for reviving the bill. “Have we had some discussions and listened to ideas? Yes,” he told reporters. “Are we actively planning an immediate strategy? Not at this time.” (DeBonis, 3/28)

Any action before the upcoming April recess would be a huge undertaking. Attention on Capitol Hill has now largely shifted to other issues, such as finding a way to fund the government beyond April 28 when the current continuing resolution expires. (Mershon, Williams and McPherson, 3/28)

[L]awmakers and aides acknowledge the odds are not in their favor. The conference is still deeply divided, and members are seething over the demise of their replacement bill — with most fingers pointing at members of the arch-conservative Freedom Caucus. During a meeting with several dozen whips Monday night, Republican allies of leadership vented about how they want to punish members of the conservative group who “don’t play with the team.” (Bade, Cheney and Bresnahan, 3/28)

Sen. John Cornyn (R-Texas), the No. 2 Senate Republican, on Monday called for working with Democrats, rather than trying to pass a fast-track “reconciliation” bill with only Republican votes. “If they can get 216 votes, that's great,” Cornyn added to reporters on Tuesday. “We'll take it up over here." (Sullivan and Hellmann, 3/28)

Senate Majority Leader Mitch McConnell, R-Ky., made his views clear after a closed-door lunch with fellow Senate Republicans and Vice President Mike Pence. "It's pretty obvious we were not able, in the House, to pass a replacement. Our Democratic friends ought to be pretty happy about that because we have the existing law in place, and I think we're just going to have to see how that works out," McConnell said. "We believe it will not work out well, but we'll see." (Werner, 3/28)

Rep. Peter Roskam (R-Ill.), a former member of House Republican leadership, is leading a charge to bury Speaker Paul Ryan’s Obamacare replacement once and for all and start over, multiple sources told POLITICO. The move by the senior House Republican who sits on the Ways and Means committee could complicate any GOP leadership attempt to resurrect the bill that Ryan pulled from the floor Friday. (Bade and Bresnahan, 3/28)

Senate Republican leaders still say that if the House somehow finds a way to pass a repeal and replacement bill, they could consider it. But they are not sounding hopeful. Asked about the prospects of a healthcare bill, Sen. John Thune (S.D.), the No. 3 Senate Republican, put the burden solely on the House. "It’s going to be entirely up to them, what they can pass," he said. (Sullivan, 3/28)

In his first bipartisan outreach since the implosion of his health-care bill in the House on Friday, President Donald Trump hosted more than half the Senate members at the White House on Tuesday for an evening of music and political banter that at times seemed to overlook their recent history of partisan standoffs. (Andrews, Ballhaus and Radnofsky, 3/28)

President Donald Trump still sees a deal on health care. In fact, he told senators he has “no doubt that that’s going to happen very quickly.” Speaking in brief remarks at a White House reception for senators and their spouses, Trump brushed off the recent collapse of a House-led bill to repeal and replace Obamacare. (Jackson, 3/28)

U.S. Sen. Ted Cruz reiterated to a group of conservative lawyers on Tuesday that "failure is not an option" when it comes to GOP efforts to overhaul former President Obama's 2010 health care law. "That's had a rocky few days," he told members of the Federalist Society, referencing the House GOP's futile attempt to repeal the law. "But it's important to keep in mind, No. 1, we have got to get it done." (Livingston, 3/28)

A spirited Hillary Clinton took on the Trump administration Tuesday in one of her first public speeches since she lost the presidential election, criticizing the country's Republican leaders on everything from health care to the shortage of women appointees in top administration positions. Cracking jokes about her November defeat and her months out of the limelight since, Clinton spoke to thousands of businesswomen in San Francisco, joking there was no place she'd rather be, "other than the White House." (Knickmeyer, 3/28)

U.S. hospital stocks dropped on Tuesday as Republicans in the U.S. House of Representatives said they were considering a renewed push to repeal and replace Obamacare, after the effort failed last week. (Erman, Cowan and Abutaleb, 3/28)

President Trump says that Obamacare is going to explode. But if that happens, it is likely because his administration supplies the spark that detonates the marketplaces. The White House could decide at any time to eliminate subsidies relied upon by insurers to lower costs for Obamacare’s poorest customers, as a result of a court win by House Republicans last spring. (Demko, 3/29)

President Trump and his fellow Republicans have failed, at least for now, in their bid to repeal Obamacare entirely, but they still have plenty of ways to cripple the law without pulling it off the books. By blocking funding for subsidies or refusing to enforce the individual mandate, the administration and congressional Republicans could undermine the law's insurance exchanges -- government-established marketplaces where individuals can buy health insurance from private companies, often with the help of federal subsidies. The exchanges and an expanded Medicaid program are the main programs in Obamacare, officially known as the Affordable Care Act, aimed at expanding coverage to the uninsured. (Johnson, 3/28)

Key House Republicans on healthcare say they want to find a way to fund ObamaCare payments that they previously sued the Obama administration over. The payments, known as cost-sharing reductions, reimburse insurers for providing discounted deductibles for low-income ObamaCare enrollees. If the payments were canceled, insurers warn they could pull out of the market because of the hole left in their budgets, causing chaos. (Sullivan, 3/28)

While President Trump touts his prediction that ObamaCare will soon “explode,” insurers are making decisions about whether to participate in the law’s marketplaces in 2018. Insurers have about six weeks to finalize their plans and rates or to decide to leave the marketplace altogether as they await word from Trump and Congress about the future of insurer payments created under the Affordable Care Act. The president, however, is signaling that he has little interest in taking steps to keep insurers from dropping out of ObamaCare. (Hellmann, 3/29)

Health insurers have between two and three months to plan out what they’re doing in individual health markets next year, but last week’s implosion of the GOP health care bill has only added to uncertainty about the future of the marketplaces. With Republicans pulling their health care bill from the floor last week, insurers must figure out their 2018 plans and rate requests for participation in the Affordable Care Act exchanges without knowing whether the Trump administration will be friendly or hostile to the health care law that remains the law of the land, at least for now. (McIntire, 3/28)

We've said it, President Trump said it, even House Speaker Paul Ryan said it. Obamacare is here to stay — for now. Conservatives must work within the confines of the Affordable Care Act. But Tom Price, as head of Health and Human Services, can still make lots of changes on his own. (Gorenstein, 3/28)

On Friday, House Republican leaders failed to secure enough support to pass their plan to repeal and replace the Affordable Care Act. Reporters with Kaiser Health News and California Healthline (produced by KHN) have appeared on numerous radio and television shows in recent days to assess what’s next for the health law. Listen to what they had to say below. (3/28)

Some say Trump and the Republicans will let the Affordable Care Act collapse, while others think the ACA will be amended piece by piece. But both sides are asking the wrong questions – or rather, aren’t asking the right one: How can the U.S. health care system be reconstructed for an aging population? Answering this question could provide the opportunity to forge fresh, bipartisan solutions for the most important health care megatrend of the 21st century. (Hodin, 3/28)

The White House is proposing a $1.2 billion cut this year to the National Institutes of Health’s budget, targeting research grants. The proposed NIH cut is part of $18 billion in spending reductions that President Trump’s team is proposing to Congress for the current fiscal year, which ends in October, according to a summary obtained by STAT. Congress ultimately decides the federal government’s spending. Government funding is currently set to expire at the end of April; the White House is proposing these non-defense spending cuts for the remainder of the fiscal year. (Scott, 3/28)

The $1.2 billion cut to the National Institutes of Health’s 2017 budget, proposed today by the White House, seems like a nonstarter in Congress. “Not going to happen,” Representative Tom Cole of Oklahoma, the Republican who chairs the House appropriations health subcommittee, told STAT. The proposed cut — a surprise given that Congress long ago reached a framework for a broader spending plan through April — comes on top of a $5.8 billion hit to the NIH proposed in President Donald Trump’s budget for 2018. (Facher, 3/29)

The threat of a $5.8 billion cut to the National Institutes of Health in President Trump’s early budget recommendations has spawned a new advocacy group aimed at preserving research funding. Carrie Jones, a principal at JPA Health Communications in Washington, said the group she’s helping pull together — The Coalition to Save NIH Funding — is still taking stakeholders’ temperature to determine the most effective path forward to avert a nearly 20 percent reduction in the NIH budget. (Facher, 3/27)

An executive order being prepared by the Trump administration would set an ambitious timetable for new recommendations to address the nation’s opioid crisis and appoint top administration officials to oversee the effort, according to a draft obtained by STAT...The panel’s mission would be to identify federal funding streams that could be directed to address the crisis, for everything from medical treatments to long-term support services. The commission would also aim to identify areas in the United States with limited treatment options, review ways to prevent opioid addiction — including possible changes to prescribing practices — and consider changes to the criminal justice system to provide support for incarcerated individuals after their release from prison. (Scott, 3/28)

Democrats and other critics of a draft executive order intended to address opioid abuse are raising concerns that the order is seeking information that is already easily available. The order is circulating on Capitol Hill. (Siddons, 3/28)

An influential Democratic lawmaker has begun a probe into the marketing of opioid drugs, sending letters to Purdue Pharma LP, Johnson & Johnson and other big sellers of the pain medicines for materials detailing sales practices. Sen. Claire McCaskill (D.-Mo.), the top-ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee, said she aims to clarify “the challenges industry practices pose to efforts to curb opioid addiction.” (Rockoff, 3/28)

“This epidemic is the direct result of a calculated sales and marketing strategy major opioid manufacturers have allegedly pursued over the past 20 years to expand their market share and increase dependency on powerful — and often deadly — painkillers,” McCaskill, who is the ranking Democrat of the Homeland Security and Governmental Affairs Committee, wrote to company executives. “To achieve this goal, manufacturers have reportedly sought, among other techniques, to downplay the risk of addiction to their products and encourage physicians to prescribe opioids for all cases of pain and in high doses.” (Bernstein and Higham, 3/28)

At every school in New Rochelle, just north of the Bronx, in Westchester, there is a locked medicine cabinet in the nurse’s office, stocked with things like EpiPens for allergic reactions, inhalers for asthma, Tylenol for aches and pains. Now, those cabinets also include naloxone, an antidote for people who are overdosing on opioids like heroin. Given as an injection or a nasal spray, naloxone can quickly revive someone who is not breathing. The city keeps it in every nurse’s office, including in its elementary schools. (Harris, 3/29)

Premature deaths among those aged 25-44 were way up in 2015, due in large part to a surge of drug overdoses in suburban areas, a report out Wednesday shows. Drug deaths are also accelerating among 15- to 24-year-olds, but almost three times as many people in this age group died by homicide, suicide or in motor vehicle crashes, according to the new report from the Robert Wood Johnson Foundation (RWJF). A rural and urban divide, along with racial differences, were also evident in the data. Young white adults in rural areas were more likely to die by suicide or overdose, while homicides by firearms were much more common for young black victims. (O'Donnell, Gluck and Carter, 3/29)

Legislation to address Iowa’s deadly opioid epidemic passed the Iowa House today by a wide margin, but lawmakers turned down a Democratic amendment to make it harder to fraudulently acquire prescription painkillers. The bill will require all doctors to register with the state’s Prescription Drug Monitoring Program. (Russell, 3/28)

More than 5,000 Cuyahoga County residents each year die before they should, often due to gunshot wounds, car accidents and drug overdoses. Of these, more than 1,000 (19 percent) could be avoided if residents here had the same social, economic and health opportunities as those living in Ohio counties with the lowest premature death rates, including neighboring Geauga County. (Zeltner, 3/29)

Opioid addiction is a tough enemy to fight, but public officials are hoping for a growing army of private-sector allies in the battle as a new group seeks to raise $50 million to address the problem. The launch of RIZE Massachusetts drew a mix of business leaders, elected officials, and health care professionals to the Taj Boston hotel on Tuesday morning to rally behind the cause. (Chesto, 3/28)

California prosecutors on Tuesday charged two anti-abortion activists who made undercover videos of themselves trying to buy fetal tissue from Planned Parenthood with 15 felonies, saying they invaded the privacy of medical providers by filming without consent. The charges against David Daleiden and Sandra Merritt of the Center for Medical Progress come eight months after similar charges were dropped in Texas. (Dalton, 3/29)

In announcing the charges against David Robert Daleiden and Sandra Merritt on Tuesday, California Attorney General Xavier Becerra said the duo used manufactured identities and a fictitious bioresearch company to meet medical officials and covertly record the private discussions they initiated. “The right to privacy is a cornerstone of California’s Constitution, and a right that is foundational in a free democratic society,” Becerra said. “We will not tolerate the criminal recording of confidential conversations.” (Schmidt, 3/29)

An affidavit filed in San Francisco Superior Court alleges that Daleiden and Merritt used phony California driver’s licenses and a fabricated medical research company, BioMax Procurement Services, to attend the National Abortion Federation’s 2014 conference in San Francisco. At the conference, the pair posed as BioMax representatives, offered fake names and surreptitiously recorded eight attendees and speakers, according to court papers. (Hamilton, 3/28)

Daleiden’s sting videos, released two years ago through the Center for Medical Progress, accused Planned Parenthood clinics of profiting from the sale of fetal tissue. Planned Parenthood has strongly denied the accusations, and numerous investigations into the organization since the videos were released haven’t found any wrongdoing. The videos strengthened efforts in Congress to cut off federal funding to Planned Parenthood — efforts that are still underway. (3/28)

Speaker Paul Ryan (R-Wis.) said Tuesday that Congress shouldn’t try to defund Planned Parenthood in a measure to fund the government, but instead should use a separate healthcare reform bill...Funding for the government expires on April 28, and conservative lawmakers are likely to push for long-sought cuts to federal spending in the next bill to keep the government running. A protracted showdown over whether to fund Planned Parenthood — which receives federal reimbursement for other health services but not for abortion — could trigger a partial government shutdown. (Lane, 3/28)

Republicans in the Iowa Legislature are backing newly filed legislation that would ban abortions once a fetal heartbeat is detected, which would be the strictest ban in the country if enacted. A GOP-led House committee had been set to vote on the provision Tuesday night but lawmakers later adjourned without a decision. It's expected to be taken up again Wednesday. (3/28)

A new Missouri rule will strip state family planning funds from organizations that provide abortions, including hospitals. But several facilities are choosing to go without the money, instead of providing the state with a letter to certify that they do not offer the procedure. At issue is a $10.8 million portion of the state’s Medicaid program, which covers pelvic exams, tests for sexually transmitted diseases and family planning services for about 70,000 low-income Missouri women. (Bourscaren, 3/28)

Sarah Riback doesn’t have personal experience with getting the pills on campus. But the 19-year-old at the University of Maryland knows peers who have needed them. “This is a common thing that a lot of other female students have had to do,” she said. She’s talking about emergency contraception. Riback and other advocates say morning-after pills should be available on college campuses at all hours. At U-Md., they’re available at a student health center pharmacy that is open 36 hours a week, Monday through Friday. (Larimer, 3/28)

Children with elevated blood-lead levels at age 11 ended up as adults with lower cognitive function and lower-status occupations than their parents, according to new research that offers one of the clearest looks yet at the potential long-term health impact of the potent neurotoxin. (Dennis, 3/28)

"It's toxic to many parts of the body, but in particular in can accumulate in the bloodstream and pass through the blood brain barrier to reach the brain," says the study's first author, Aaron Reuben, a graduate student in clinical psychology at Duke University. (Bichell, 3/28)

By the time study participants reached age 38, a pattern emerged: Children who were exposed to lead early in life had worse cognitive abilities, based on how their exposure level. The difference was statistically significant. They were also more likely to be worse off, socioeconomically, than those who had not been exposed to lead. The study found that no matter what the child’s IQ, the mother’s IQ, or the family’s social status, lead poisoning resulted in downward social mobility. That was largely thanks to cognitive decline, according to the research. (Luthra, 3/28)

Last year marked the second-highest annual case count of mumps in more than a quarter-century. All but 13 states have reported mumps so far this year. The reason for the resurgence is a mystery. But officials fear that it could undermine the public’s faith in immunizations, critical public health tools that are already under attack from people who believe vaccines are more dangerous than the diseases against which they protect. In Arkansas, health departments sometimes resorted to giving extra doses of the mumps vaccine to try to build immunity in certain people — and some of them still got sick. (Branswell, 3/29)

Health experts have devised an aggressive plan to stamp out a viral disease that is fueling a sharp rise in liver cancer in the United States and killing 20,000 Americans per year. Their national strategy for eliminating two types of hepatitis by 2030 hinges on persuading the federal government to purchase the rights to one or more of the costly new medications that can essentially cure hepatitis C. (Healy, 3/28)

President Donald Trump's executive order to roll back Obama-era rules to address climate change will set back public health initiatives, environmental advocates said Tuesday. Trump on Tuesday is expected to sign an executive order that eliminates the Clean Power Plan, which aimed to reduce carbon emissions from power plants by 32% below 2005 levels by 2030. (Johnson, 3/28)

More than 600 activists and allies from across the country gathered at the U.S. Capitol on Tuesday to push for HIV funding from their congressional leadership and spread awareness of issues facing people with HIV and AIDS. (Choi, 3/28)

Celiac disease, the autoimmune disorder that prevents people from digesting gluten, affects about 1 percent of the population. But there's not enough evidence to recommend screening everybody to find that 1 percent, an advisory panel said Tuesday. (Hersher, 3/28)

Scientists say they've made a device in the lab that can mimic the human female reproductive cycle. The researchers hope the device, assembled from living tissue, will lead to new treatments for many medical problems that plague some women, ranging from fibroids and endometriosis to infertility, miscarriages and gynecologic cancers. (Stein, 3/28)

We've heard it before: learning machines, or artificial intelligence, is going to change the tech industry. These smart algorithms are going to take incredibly huge data sets and come up with incredible things to do with them. But what happens when those data sets are our bodies, and the incredible things they predict are our deaths? (Wood and McHenry, 3/28)

Jasmin Floyd was on her way to kindergarten in northeastern Connecticut, buckled into the back seat of her mother's car. On the way, she called out, “Mommy, my neck hurts,” her mother, RoJeanne Doege, recently recalled. Doege said she peered through the rearview mirror and tried to reassure her, “Honey, it's probably just how you slept. ”But it wasn't — and, not long after that, Floyd's father noticed that their 5-year-old's neck was tilted ever so slightly to the side. (Bever, 3/28)

Most of us can employ our nerves and muscles to nibble a snack or swig a latte without much effort. But for Bill Kochevar, who is paralyzed below the shoulders, being able to do these things for the first time in years was mind-blowing. Experimental implants called BrainGate2 allowed Kochevar to grasp a cup for the first time since he suffered a major spinal cord injury in a 2006 bike accident. (Washington, 3/28)

Doctors say it all started eight years ago, when a urology clinic in Oregon ran an ad promoting the benefits of scheduling a vasectomy in March. “You go in for a little snip, snip and come out with doctor’s orders to sit back and watch nonstop basketball,” the voice-over promised. “If you miss out on this, you’ll end up recovering during a weekend marathon of ‘Desperate Housewives’!” (Dembosky, 3/28)

Republican state lawmakers unveiled a package of six bills Tuesday aimed at improving job training and healthcare services for California veterans. "Our veterans have served this country bravely and it is only right for us to recognize their contribution and see that when they do come home they receive the care and assistance they deserve," said state Sen. Janet Nguyen of Garden Grove, who authored three of the measures. (Dillon, 3/28)

While partisan politics has bogged down many state legislative debates, Democratic and Republican leaders announced Tuesday they can agree on how to better support and plan the growth of Connecticut’s bioscience industry. Top leaders in the Senate and on the Commerce Committee highlighted three bills that develop a strategy to elevate Connecticut to a national leader in biomedical research. (Phaneuf, 3/28)

Baltimore is the least healthy jurisdiction in Maryland followed by several Eastern Shore counties, according to an annual ranking that has changed little over the past several years despite improvements in some of the city's worst statistics.Wealthier suburban counties such as Montgomery and Howard were ranked as the healthiest in the state. The 2016 rankings by the Robert Wood Johnson Foundation and the University of Wisconsin show a striking gap in the rate of premature death between the healthiest and least healthy areas of the state. Those living in Baltimore lost three and a half times the number of years of life than those in Howard. (Cohn, 3/29)

The two counties at the bottom of Kansas’ health rankings this year share a great deal: high rates of poverty and smoking, and difficulty accessing providers. But the latest rankings suggest the counties might be starting to diverge on one important factor: how likely their residents are to die prematurely. Residents of Labette County in southeast Kansas took the unenviable title of Kansas’ least-healthy people from Wyandotte County in the 2017 County Health Rankings released Wednesday. (Wingerter, 3/29)

California could become one of almost a dozen states in the country to require higher staffing levels at dialysis clinics that help treat tens of thousands of these patients if a bill by a Southern California legislator becomes law. The proposal also would mandate annual inspections of each facility. (Seipel, 3/28)

A state health inspector cited Crozer-Chester Medical Center for allowing an improperly cleaned  endoscope to be used in a surgical procedure, exposing the elderly patient to possible infection. Endoscopes — a group of tubular instruments used to look at various organs inside the body during procedures — are notoriously hard to clean and have been linked to  infections, some fatal, at hospitals around the country in recent years.  The American Journal of Infection Control reported last month that microbes grew on 60 percent of endoscopes in a small study even after rigorous cleaning. (Sapatkin, 3/29)

Organogenesis Inc., a Canton company that sells wound care and tissue regeneration products, is scheduled to announce Tuesday that it’s buying a leading supplier of tissue products used in many spinal and orthopedic surgeries. It did not disclose how much it’s paying for NuTech Medical Inc., of Birmingham, Ala. The acquisition will give Organogenesis entry into a market where annual sales total an estimated $450 million and are projected to reach more than $750 million by 2020. (Weisman, 3/29)

A controversial bill to limit benefits for injured Iowa workers won final legislative approval last night, passing the Iowa Senate on a partisan vote of 29 to 21. Backers say the current system has become biased against employers. (Russell, 3/28)

When [the Iqbals] came to Texas Children's Hospital more than a year ago, there was no guarantee doctors here would be able to save their daughter, who was born with cystic fibrosis. Just to get on the transplant list as an international patient, the family needed to raise $650,000. After months of fundraising, a surge of donations in January pushed them past the goal following a story in the Houston Chronicle. One reader cut a check for more than $100,000, and within days, Maira was added to the waiting list. (Hixenbaugh, 3/28)

Steadily increasing deductibles mean American consumers pay an ever-larger slice of their health-care bills out of their own pockets. That may be a bummer for family finances, but it is exactly what Bill Marvin and Chris Seib banked on in 2004 when they founded InstaMed, a payments network for the health-care industry based in Philadelphia and Newport Beach, Calif., after a 2003 federal law created Health Savings Accounts, which allow consumers to save pre-tax dollars to pay for health care expenses. It was immediately clear, InstaMed chief executive Marvin said, that the money flow in health care was going to completely change if deductibles went to more than $2,000 dollars and the consumer had to pay the first claims because of the deductible. (Brubaker, 3/28)

A powerful Florida House Republican said Tuesday he'll consider revising his plan for medical pot after drawing criticism from marijuana supporters. House Majority Leader Ray Rodrigues, R-Estero, who's shepherding the lower chamber's bill (HB 1397) to expand the distribution of voter-approved medical marijuana, said he's willing to compromise to ensure the Legislature puts something into law. (Auslen, 3/28)

In Good Health, which was the state’s second medical marijuana dispensary when it opened in Brockton in 2015, is set to become the first to offer home delivery of the drug across most of Massachusetts. Beginning Monday, the nonprofit said, registered medical marijuana patients everywhere except the islands will be able to order marijuana buds, edibles, and oils on In Good Health’s website for delivery the next business day. (Adams, 3/29)

A new analysis from the drug industry’s top lobbying group asserts that many Americans are feeling more of a pinch paying for their prescription drugs because customers are not fully benefitting from health insurers’ negotiations with drug makers. The new report, shared exclusively with STAT by the Pharmaceutical Research and Manufacturers of America, is the latest in an ongoing volley between drug makers, health insurers, and pharmacy-benefits managers. They are the major players, along with public officials, in the debate over drug affordability. (Scott, 3/29)

Parents of children with a rare disease called spinal muscular atrophy were thrilled two days before Christmas, when regulators approved the first drug to treat the condition that often kills patients before their second birthday. But in the three months since, some parents in Massachusetts have fought to get their insurer, Neighborhood Health Plan, to pay for the medicine, an enormously expensive drug called Spinraza and made by Cambridge-based Biogen Inc. (Weisman, 3/28)

The insurance industry defends the need for what it calls “utlilization management” techniques like prior authorization and step therapy, which requires patients to first fail on what are known as preferred drugs, which are generally less expensive, before they can be approved for others. Those practices, said Kristine Grow, spokeswoman for the America’s Health Insurance Plans (AHIP), the lobbying organization for the country’s commercial health plans, “can help ensure that patients are aware of treatments that may be as effective and less expensive.” ... But many health advocacy groups say utilization management is simply a form of obstructionism that forces practitioners to spend countless hours battling bureaucrats over medical issues. (Ollove, 3/27)

Among the drug industry’s least-escapable buzzphrases is “value-based contracting,” a system under which payers shell out for pricey drugs only when they work, creating a theoretical win-win that increases access and cuts costs all the while. So why hasn’t the idea caught on? (Garde, 3/23)

Pfizer Inc., the world’s largest drug manufacturer, is no stranger to the growing controversy over price gouging and anti-competitive practices that have drawn sharp criticism from President Trump and prompted calls for government intervention. Last December, for example, Pfizer and Flynn Pharma Ltd. were hit with record fines totaling more than $110 million in Great Britain after they were found to have conspired to increase prices by as much as 2,600 percent for unbranded versions of the anti-epilepsy drug Epanutin. (Pianin, 3/27)

Alexion Pharmaceuticals Inc. named a new chief executive Monday, months after the company’s top leadership abruptly stepped down amid an internal investigation into sales practices. Drug-industry veteran Ludwig Hantson will succeed interim CEO David Brennan. Mr. Brennan, who is now expected to serve as chairman of the board, took the helm in December after former CEO David Hallal stepped down abruptly after about 20 months on the job. (Moise, 3/27)

The amount that drugmaker Mylan NV avoided paying the U.S. government in Medicaid rebates for its EpiPen emergency allergy treatment since 2007 likely exceeds a proposed $465 million settlement the company announced in October, according to a study by private drug pricing experts published on Monday. (3/27)

High drug prices are personal for Senator Joe Manchin: He’s seen his daughter, Mylan CEO Heather Bresch, pilloried in the press for raising the cost of EpiPen, the top-selling auto-injector used to treat life-threatening allergic reactions...But Manchin wasn’t defending Mylan, which nearly quintupled the price of a two-pack of EpiPen to over $600 in 2016, leading to widespread criticism, a heated congressional hearing, and calls for a federal investigation into potential antitrust violations. (Blau, 3/29)

Acting on a request from three influential U.S. senators, the government’s accountability arm confirmed that it will investigate potential abuses of the Orphan Drug Act. The Government Accountability Office still must determine the full scope of what it will look into and the methodology to be used. Determining the scope will take some months, said Chuck Young, GAO’s managing director for public affairs. (Tribble, 3/21)

Once again, Gilead Sciences is facing a challenge to a European patent over its Sovaldi hepatitis C treatment, which is a building block for subsequent medicines the drug maker has launched. (Silverman, 3/27)

The GOP's Obamacare replacement plan got pulled from a vote in the House on Friday, and healthcare stocks have been rallying ever since. But when it comes to drug pricing, pharmaceutical companies might not be out of the woods yet. (Ramsey, 3/27)

Why are drugs cheaper in Europe than in the US? Because other countries are leeching off American ingenuity and blackmailing its innovators, according to the CEO of the nation’s largest drug company. Pfizer CEO Ian Read, rarely one to mince words, said socialized medicine in Europe has stacked the cards against the US’s $1.2 trillion pharma industry. (Garde, 3/23)

Spain’s antitrust watchdog has opened an investigation into six large drug makers over long-standing accusations from wholesalers that the companies engage in unfair pricing schemes. (Silverman, 3/23)

Michael Pearson, former chief executive of Valeant Pharmaceuticals International Inc., is suing the embattled drugmaker for refusing to pay him more than 3 million company shares that he said he is owed. In a lawsuit filed Monday in the U.S. District Court of New Jersey, Mr. Pearson said Valeant breached his contract by not paying him 580,676 shares and 2.5 million performance shares that were due last November under the terms of his separation agreement. (McNish, 3/27)

Over the past year, a string of would-be best-sellers, expected to generate billions in sales, have wilted into commercial disappointments amid a fractious debate about the cost of medicine. Another highly touted — and highly priced — treatment won approval on Tuesday, and the industry may soon find out whether those failures were aberrant blips or a frightening glimpse of the new normal. That test case: Dupixent, a powerful treatment for severe eczema that Wall Street believes will bring in more than $5 billion a year at its peak. But the drug’s list price, $37,000 a year, could derail such bullish predictions. (Garde, 3/29)

Friday’s withdrawal of the Republican health care bill from Congress must have created considerable relief in many corners of the health care industry. Not only had Democrats and many moderate Republicans expressed concern over the bill’s potential consequences for patients, but interest groups lined up almost uniformly against the bill. The American Hospital Association, American Medical Association, AARP, and dozens of other groups representing hospitals, providers, and patients all opposed the bill. (Rachel Sachs, 3/28)

If the current discussion about fake news has taught us anything, it’s that things on the internet are often not what they seem. All too easy to create and disseminate globally, fake news has invaded our homes and eroded our trust in the internet as a source of legitimate information and products — and yet, every day, fake news stories succeed in duping countless readers. The same dynamic is also at work when it comes to medicines sold online, and policymakers in Congress should consider the fake news phenomenon when advocating that U.S. citizens access prescription drugs from Canada. (Mary Bono, 3/27)

Pharmacy benefit managers (PBMs) administer prescription drug plans on behalf of insurers and employers. In the process, they negotiate reimbursement terms with pharmacies and drug prices with drug manufacturers. While plan sponsors face the direct financial costs of the prescription plans being offered to its members or employees, PBMs act as middlemen in the process. This creates an environment for conflicts of interest that drives PBMs to work for their own self-interests and not the sponsors that hired them – all while pushing up higher drug prices for consumers. (Steve Pociask, 3/28)

When you rush any kind of massive project, you raise the risk that people get hurt. That's certainly the case with health-care reform. As President Donald Trump and congressional Republicans scramble to save their troubled attempt to repeal and replace the Affordable Care Act, they are considering last-second changes -- including one that could add Big Pharma to the list of those damaged by the bill. This would further immiserate an industry already dogged by the president's repeated drug-pricing broadsides. (Max Nisen, 3/23)

While attempts at repealing Obamacare appear dead (at least for the foreseeable future), US president Donald Trump still has an opportunity to tackle the soaring costs of American-style healthcare by addressing one of its biggest problems—the high cost of prescription drugs. (Oliver Staley, 3/28)

It was a symbolic act that spoke volumes. On stage with other pharmaceutical executives to talk about drug pricing at the Forbes Healthcare Summit last December, Regeneron cofounder, chairman and chief executive Leonard Schleifer physically moved his chair away from those of his peers. “If you look at the prices of drugs, they have gone up, sometimes double digits, twice a year as a very efficient way of increasing profits without being coupled to any innovation,” Schleifer said then. “It's ridiculous." (Matthew Herper, 3/28)

Delaying the inevitable always feels good in the moment. But it's a short-lived high. Valeant Pharmaceuticals International Inc. late Tuesday announced it had completed a multi-billion-dollar orchestra of can-kicking, with a series of refinancing transactions to ease its near-term debt burden. (Max Nisen, 3/22)

With our nation’s fight over the Affordable Care Act in the rear-view mirror, it’s time for Donald Trump and Congress to focus on a genuinely bipartisan issue: drug prices. According to the Kaiser Family Foundation, 8 in 10 Americans want to allow the government to negotiate prices for people on Medicare. By the same margin, Americans want to limit the amount drug companies can charge for high-cost drugs that treat illnesses like cancer. Hefty majorities from both parties support these steps. (David Mitchell, 3/27)

As an Iowan and a former nurse, I have witnessed firsthand the extraordinary transformation of our health care system over the past several decades. These changes have been challenging to patients, families and health care providers. Even today, this dynamic continues as lawmakers in Washington, D.C., debate the nation’s overall approach to delivering health care. Regardless of the ongoing debate, we believe the goal is to provide access to quality, affordable and local care to individuals within a system that responds to each individual’s unique health care needs. (Kim Foltz, 3/27)

President Trump’s young administration is not yet at a crossroads, but finger-pointing over the now-tabled Republican plan to replace the Affordable Care Act — also known as Obamacare — will only help the Democrats’ presidential nominee in 2020. Instead, conservatives should relish the opportunity to reset the debate. (Michael A. Needham, 3/28)

Now that the Republican Party has beclowned itself on health care, now that Obamacare repeal lies in rubble, now that every G.O.P. policy person who ever championed a replacement plan is out wandering in sackcloth and ashes, wailing, “The liberals were right about my party, the liberals were right about my party,” beneath a harsh uncaring heaven … now, in these hours of right-wing self-abnegation, it’s worth raising once again the most counterintuitive and frequently scoffed-at point that conservatives have made about Obamacare: It probably isn’t saving many lives. (Ross Douthat, 3/29)

President Trump last week pressured Republicans to repeal and replace the Affordable Care Act. If they didn’t, he warned, they would lose their seats in the next election. Speaker Paul D. Ryan ultimately withdrew the bill, where seven years prior, on the same House floor, I voted to pass the Affordable Care Act into law. (Tom Perriello, 3/29)

Last Friday, the Republicans finally gave up on “repealing and replacing” Obamacare. Their surrender shows the power and effectiveness of public protest. If you doubt that, you should have been in attendance at the previous week’s angry meeting between U.S. Rep. Andy Barr and his constituents in Richmond. It no doubt scared the hell out of the congressman, as have similar encounters with similar congressional delegates across the country. (Mike Rivage-Seul, 3/28)

Alongside reports about which programs to eliminate for the poor (emergency services? maternity? prescription drugs?) there were the slick photos of Ivanka Trump and her family on the ski slopes of Aspen, reportedly trailed by a hundred Secret Service agents. As Ivanka skied, her unearned, controversial West Wing office vacant, the vote to cut the health-care safety net for 24 million Americans loomed. (Teri Carter, 3/28)

There's a new paper out looking at how the Affordable Care Act has transformed health-care access, and in turn, what that has done for health. The authors' first answer probably won’t surprise you: when millions more people became insured, more got checkups and primary care doctors. But it’s not obvious that these people got any healthier. As the paper puts it: “No statistically significant effects on risky behaviors or self-assessed health emerge for the full sample.” (Megan McArdle, 3/28)

California dodged a multibillion-dollar fiscal bullet last week when Congress stalled an overhaul of the Affordable Care Act — but perhaps just temporarily. State officials had estimated that California would lose billions under the proposed American Health Care Act that would cap federal spending on Medi-Cal, the state’s health care system for the poor. (Dan Walters, 3/28)

President Trump has convinced himself that the Affordable Care Act is collapsing of its own accord, and once it does, Democrats will fall on their knees before him and grovel for a deal in which they will help remake the health-care system on Trump’s own terms. As his new tweet on the topic puts it: “The Democrats will make a deal with me on healthcare as soon as ObamaCare folds — not long.” Thus, the GOP health-care fiasco will be miraculously transformed into a Trump victory. But despite all the bravado, what’s really happening now is that the failure to pass the GOP repeal-and-replace plan has ensnared Trump and Republicans in a trap. (Greg Sargent, 3/28)

In his very first executive order, directing federal agencies to "waive, defer, grant exemptions from, or delay" various parts of the Affordable Care Act, President Donald Trump stated his intention to repeal the law. Two months later, with that effort in shambles, the order has become the administration’s entire game plan on health care. That’s not only inadequate, but reckless. With no Republican replacement for the ACA on the horizon, every step taken to weaken the individual insurance market and Medicaid risks destabilizing a health-care system in need of reinforcement. (3/28)

“Enforce 1402! Enforce 1402!” That’s what those who want to head off President Trump’s sore-loser vow to let the Affordable Care Act “explode” should be chanting — perhaps at rallies in front of the Department of Health and Human Services. (Steven Brill, 3/28)

The House GOP’s epic failure to repeal and replace Obamacare last week is being viewed mostly through a political lens — which party is up, which is down; what GOP faction is up/down; and how damaged President Donald Trump is as a result. But there is a better way to look at this — through a bipartisan lens that puts American health care consumers first. (3/28)

When the repeal and replace plan for the Affordable Care Act failed in the House of Representatives President Donald Trump didn’t call of meeting of all the interested parties, including Democrats, to find some middle ground. Instead, he headed to Virginia to play golf. (EJ Montini, 3/28)

The failure to move forward with the American Health Care Act (AHCA) in the House of Representatives seems likely to postpone legislative activity on repeal and replacement of the Affordable Care Act (ACA) for some period of time. Still, it is premature to assume health care legislation won’t be brought up again this year; there is too much instability in the individual insurance market under the ACA to expect the problem to resolve itself without a significant policy intervention. (James C. Capretta and Tom Miller, 3/29)

With Obamacare repeal efforts by Republicans dormant for now, there's lots of hopeful talk about how the Trump administration and bipartisan groups in Congress may push to fix problems with the Affordable Care Act. Experts have ideas about what can be done to stabilize the ACA's individual insurance markets and enable states to better control Medicaid costs. These include steps to encourage more young, healthy people to sign up for insurance, while discouraging people from enrolling only when they need medical care, then dropping coverage. (Harris Meyer, 3/27)

In a 2010 speech at the Competitive Enterprise Institute, less than a year after the passage of the Affordable Care Act, conservative legal scholar Michael Greve summed up the game plan for opponents of the law: “This bastard [the Affordable Care Act] has to be killed as a matter of political hygiene. I do not care how this is done, whether it’s dismembered, whether we drive a stake through its heart, whether we tar and feather it and drive it out of town, whether we strangle it.” It may seem surprising that Republicans, after seven years of righteous anger, have failed to repeal and replace the ACA. (Philip Rocco, 3/28)

Ah, but there's been a Plan B all along! And it's every bit as morally repellent and politically obtuse as Plan A, which would have knocked an estimated 24 million people off their health care policies, weakened the coverage provided by existing insurance and implemented a massive tax cut to benefit mostly higher earners. "I've been saying for years that the best thing is to let Obamacare explode and then go make a deal with the Democrats," Trump told the Washington Post on Friday when it became clear that Republican party infighting had left the administration short of the votes needed to pass what late-night host Seth Meyers calls "the least popular bill since Cosby." (Eric Zorn, 3/28)

More than 140,000 Kansans are tantalizingly close to qualifying for Medicaid, the federal-state program providing health insurance coverage for poor and low-income Americans. Now, all that stands between those Kansans and health care is Gov. Sam Brownback. (3/28)

Gov. Sam Brownback signed a bill into law in 2014 that required an act of the Legislature to expand Medicaid in Kansas. Well, both the Kansas House and Senate have now acted – approving an expansion bill with large bipartisan majorities. Brownback should respect the will of the Legislature – and the overwhelming public support for Medicaid expansion – and allow the bill to become law, either with his signature or without. (3/28)

Lawmakers should override Gov. Matt Bevin’s veto of a bill allowing judges to order outpatient treatment for mental illness. This humane option is available in almost every state and has long been sought by advocates for the mentally ill in Kentucky, including Kelly Gunning, whose adult son has bounced between psychiatric hospitals and jails. Despite her futile efforts to get him help — “we know when he is spiraling down” — he is in jail now. Under the delusion that his parents were conspiring against him, he violently assaulted them last year, using a rock as a weapon. (3/28)

For five years, advocates of people with severe mental illness have fought for legislation in Kentucky designed to break the revolving cycle of hospitals, jails and homelessness. This session, their effort paid off — almost. Stunningly, Gov. Matt Bevin vetoed the legislation over concerns that it encroaches on individual civil liberties. (3/28)

Governor Matt Bevin announced his veto of Tim’s Law, a commonsense bill passed nearly unanimously by the legislature to provide needed care for the most severely mentally ill. Unfortunately, the veto evidences both a misunderstanding of both the nature of the bill and the public health crisis it would address. (John Snook, 3/28)

Here is what it took for common sense about prescription drug addiction to gain traction in Jefferson City: more than five years of legislative wrangling, embarrassing national press painting Missouri as backwards and federal maneuvers allowing counties to act because state lawmakers would not. (3/28)

The U.S. white working class is in big trouble. The data is piling up. Economists Anne Case and Angus Deaton have a new paper out, exploring mortality trends in the U.S. The results confirm the finding of their famous 2015 study -- white Americans without college degrees are dying in increasing numbers, even as other groups within and outside of the country live longer. And the negative trends continued over the past year. (Noah Smith, 3/29)

Percocet, my patient announced, was the best antidepressant she’d ever had. An orthopedist had prescribed her the drug for back pain resulting from a fall. When the patient, who suffered from depression, asked for more, I refused, explaining the opioid’s high addictive potential. Still, I worried that if I didn’t give her a prescription, another doctor would. (Marc Siegel, 3/28)

The opioid epidemic ravaging the nation does not discriminate against any state, gender, income bracket or ethnicity. More than 33,000 people died in 2015 from opioid overdoses, including over 1,000 Missourians. Every day, a mother loses her son or a father loses his daughter to a drug overdose. Each lost life is a future missed wedding, birthday party or graduation. As a former Republican governor and secretary of Health and Human Services, I was responsible for protecting the health and well-being of the American people. I also never lost sight of how closely linked that mission was to our economic growth and prosperity. (Tommy G. Thompson, 3/28)

My son passed away six months ago due to an opioid overdose. Nothing prepared me for that Sunday morning when I found Ryan in his bedroom. Since then, our family is struggling and learning to live without him. Addiction rocked our family’s core to unfathomable levels and forever changed our lives. As with many other people affected by opioids, my son’s risky behavior began in middle school when he experimented with diverted pills from a friend. His addiction progressed and eventually became a disease that could not be controlled. I often think of what could have been different if he hadn’t started with those pills. Like many families, we didn’t realize the danger lurking in our own medicine cabinets until it was too late. (Elaine Moffatt, 3/28)

The Grayken Center is being established by a $25 million gift from billionaire investor John Grayken and his wife, Eilene. They want to destigmatize drug addiction, in addition to supporting research into its causes and treatment. The search for someone to lead the program wasn’t lengthy. Botticelli resigned from his White House post during the presidential transition, and he was a widely respected figure with close ties to Boston Medical Center. (Adrian Walker, 3/29)

Public health efforts appear headed for the chopping block under the Trump administration’s recently released budget. That’s a threat to national security.A warning to the president and Congress: A nation cannot be great if it isn’t healthy. Public health, that often invisible science that promotes the well-being of families and communities, is a bulwark of strong defense. We need the hard power of health to keep Americans safe. (Ruth J. Katz, 3/28)

We live in a time when pandemics cross borders faster than ever. Yet to the horror of many of us working in global health, President Trump’s budget would completely eliminate the National Institutes of Health’s Fogarty International Center — one of the most effective tools we have to fight global diseases. (Michele Barry and Derek Yach, 3/28)

When I first started my career as an oncology/hematology nurse practitioner and educator more than 25 years ago, the main goal of cancer treatment was usually to extend life, no matter what the quality of that extra life was. Joey’s experience made me face a moral dilemma — was this the right approach, or should we ensure that whatever extra time we are giving to patients is actually worth living? (Jennifer Simpson, 3/28)

A major study of the grocery-buying habits of millions of Americans released late last year found that people using food stamps generally make the same unhealthy food choices as everyone else in America. Too many sweets, salty snacks and prepared desserts. Junk food, in other words. (3/29)

With the signing of executive orders Tuesday, President Donald Trump made clear his intention to scrap the centerpiece of President Obama’s climate change agenda, ostensibly to aid the moribund U.S. coal industry and create jobs. Killing the Clean Power Plan, the set of Obama-era regulations that strictly limit greenhouse gas emissions from power plants, makes no sense. This is purely an ideologically motivated move that will benefit a tiny segment of the economy and hamper the nation’s efforts to fight climate change. (Frederick Hewett, 3/29)