The Washington Post: At Trump’s Request, House May Tweak Health-Care Bill Before Recess
House Republican leaders are making last-minute plans to modify their stalled health-care bill Thursday in response to pressure from the Trump administration to show progress toward passing the bill before lawmakers leave for a two-week recess. Four people familiar with the plans, including a House member who has been involved in the health-care discussions, said an amendment providing for “high-risk pools” — a mechanism to subsidize insurance coverage for the seriously ill — will be added to the health-care bill at a Rules Committee meeting Thursday. (By Winfield Cunningham, Eilperin and DeBonis, 4/6)

The Hill: House GOP Moves To Add Change To Health Bill Before Recess
House Republicans will move Thursday to add an amendment to their ObamaCare replacement bill as a way to show progress before recess, despite the lack of a major breakthrough. The House Rules Committee will meet Thursday to add language creating a “risk-sharing fund” to subsidize care for people with high medical costs, a senior House GOP aide said. The idea functions like a high-risk pool that Republicans have long supported. (Sullivan, 4/6)

Bloomberg: Trump Pushing House To Aid Gravely Ill In Health-Care Bill, Sources Say
The White House prodded House Republican leaders to make last-minute tweaks to their Obamacare replacement bill Thursday to protect “high-risk” patients before lawmakers leave Washington for their two-week spring break, according to an administration official and a House leadership aide. The House Rules Committee is making last-minute plans to hold a meeting Thursday to consider an amendment to create a new risk-sharing fund for the seriously ill. The move doesn’t indicate the overall bill will go to the floor immediately, but committee action on the amendment is intended to show momentum toward a deal on a bill is building, said the aide. (Jacobs and House, 4/6)

Politico: House GOP Mulls Emergency Meeting To Push Obamacare Repeal
House Republicans are considering an emergency committee meeting Thursday to keep their Obamacare replacement plan afloat, sources told POLITICO — a last-minute decision that comes just as the GOP repeal effort was seen as all but dead for the foreseeable future. (Bade, 4/5)

The Hill: Meadows: Freedom Caucus Would Back Bill That Got Rid Of 3 ObamaCare Regs
The majority of the House Freedom Caucus would vote for a healthcare bill that gets rid of three of ObamaCare's insurer regulations, the group’s chairman Rep. Mark Meadows (R-N.C.) said Thursday. The caucus has withheld its support from the GOP's ObamaCare repeal bill last month, saying it does nothing to drive down insurance premiums. But in an effort to sway the caucus, Vice President Pence offered this week to get rid of three regulations: essential health benefits, which mandate what services insurers must cover; community rating, which says insurers can't charge sick people more for insurance; and guaranteed issue, which says insurers must cover people with pre-existing conditions. (Hellmann, 4/6)

The New York Times: As Latest Health Plan Dies, Republicans Can’t Agree On A Culprit
The new bill to repeal the Affordable Care Act is dead, killed off by House Republicans who never actually read the legislation — because in fact, it never actually existed. Conservative groups moved quickly on Wednesday to shift the blame for the failure of a seven-year promise to repeal the law onto some not-as-conservative Republicans, after a small but powerful group of hard-line House conservatives failed again to come to a meeting of the minds with the Trump administration over how best to repeal and replace President Barack Obama’s signature achievement. (Steinhauer and Pear, 4/5)

The Wall Street Journal: GOP Talks To Relaunch Health Law Sputter
President Donald Trump has said on Twitter he still wants to pursue passage of the GOP health-care bill, but lawmakers are unlikely to reach an agreement before they leave Washington Thursday for a two-week recess. “I think it’s difficult to finish one by the end of the week,” said House Majority Leader Kevin McCarthy (R., Calif.) (Peterson and Andrews, 4/5)

Bloomberg: GOP Points Fingers At Each Other As Health Deal Prospects Fade 
Let the blame game begin -- again -- with House Republicans saying Wednesday they still can’t reach a deal on reviving their health-care bill, likely delaying any chance of action until at least May...The White House made another run at delivering on GOP promises to repeal and replace Obamacare, with Vice President Mike Pence spending Monday and Tuesday nights meeting with House lawmakers. But Republicans concede they still aren’t ready to vote, meaning that action is very unlikely this month. (House, Edgerton and John, 5/5)

The Associated Press: GOP Health Deal Elusive As House To Take Easter Break
"There's no suggestion we should be changing our flights," moderate Rep. Chris Collins, R-N.Y., said Wednesday afternoon, a day before lawmakers were slated to leave Washington for their two-week recess. "We're going home ... without a deal. "From the party's right flank, Freedom Caucus member Rep. Mark Sanford of South Carolina said: "I've heard nothing of substance at this point that would break the logjam." (Alonso-Zaldivar and Fram, 4/6)

USA Today/Milwaukee Journal Sentinel: Speaker Paul Ryan Says Republicans' Obamacare Repeal May Take Months
A new push to pass a GOP health care bill will take weeks, not days, House Speaker Paul Ryan indicated Wednesday, as the latest talks among Republicans produced no apparent breakthrough. “We’ve got a couple months at least,” Ryan said in an interview with the Milwaukee Journal Sentinel Wednesday. “We’ve gotten pretty far in coming together,” he said, “but I also think we’re not there yet — because the stakes are so high, and people are just having to get used to” being the governing party. (Gilbert, 4/5)

Atlanta Journal-Constitution: House GOP To Go Home For Easter Break Without Health Care Deal
“It just doesn’t bode well for tax reform,” said Rep. Chris Collins (R-NY), as the top ally of President Trump in the Congress blasted more conservative members of the House Freedom Caucus, and openly wondered whether that same group would find a way not to support a Trump tax reform bill. (Dupree, 4/5)

CQ Roll Call: Republicans Ramp Up Blame Game As Hopes For Health Deal Fade
[T]he factions in the party now are blaming each other for what they see as negotiating in bad faith or "moving the goalposts," after a late Tuesday meeting failed to produce a deal. A subsequent meeting between the key lawmakers, planned for Wednesday, had not been scheduled by mid-afternoon. Moderates were vehement that the House Freedom Caucus had again suggested they could support a deal, only to later demand more conservative changes. Rep. Chris Collins, R-N.Y., a member of the Tuesday Group, said the changes the White House was discussing would "not be helpful" to earn moderate support. The 36 or so members of the Freedom Caucus were the obstacle, he said. "Their definition of perfect is standing in the way of compromise, and that's why I'm not optimistic right now." (Mershon, 4/5)

The Hill: Ryan Takes Backseat To Pence In Latest ObamaCare Effort 
Two weeks ago, Speaker Paul Ryan (R-Wis.) left it all on the field in trying to pass his ObamaCare repeal-and-replace bill. He talked up the legislation during dozens of TV interviews. The former Ways and Means Committee chairman treated reporters to a half-hour presentation detailing why the current health insurance law was failing. And Ryan hosted countless meetings in his ornate office in the Capitol in a bid to flip members from no to yes.    Now, Ryan’s taking a more hands-off approach. (Wong and Sullivan, 4/5)

The Hill: Heritage Action Blames GOP Moderates For Collapse Of New Health Deal 
The leader of the conservative group Heritage Action on Wednesday accused moderate House Republicans of blocking a deal on a new ObamaCare replacement bill. Heritage Action CEO Michael Needham said in a call with reporters that prospects for a deal this week have fallen apart and proposed that lawmakers go back to their districts over the recess to regroup. (Sullivan, 4/5)

The New York Times: Trump Weighs Infrastructure Bill But Keeps New York Up In The Air
President Trump said he was considering “accelerating” the introduction of his $1 trillion infrastructure bill — but he pointedly refused to say whether he planned to include two major New York City transportation projects that his budget for next year would defund. Mr. Trump, speaking in a wide-ranging interview in the Oval Office on Wednesday, described the infrastructure package as a high-value legislative sweetener that he could attach to a revived Affordable Care Act repeal bill or tax code overhaul to attract bipartisan support that thus far he had neither sought nor received. (Thrush and Haberman, 4/5)

Politico: White House Divided On Obamacare Payments
The disintegration of the latest Obamacare repeal bid in the House has thrown the health law’s fate back to a divided circle of White House advisers wrestling with whether to pay out key subsidies — or cut them off and blow up the health law. The aides have limited time to figure things out; health plans must decide in June whether to stay in Obamacare insurance markets next year or pull out. (Dawsey, Kenen and Haberkorn, 4/5)

Modern Healthcare: Thousands Of Brokers Exit HealthCare.Gov As Plan Commissions Go Unpaid 
Each year since the launch of HealthCare.gov, insurance broker Craig Paulson faces a difficult question: Should he continue to sell individual market plans even though insurance companies increasingly refuse to pay commissions? If his Utah-based insurance brokerage firm, Altura Benefits, stops selling exchange plans, consumers may be left with lower quality coverage or none at all. In the past year, Aetna announced it would stop paying any commissions on the individual market in Utah. Molina Healthcare later announced that it wouldn't pay for commissions on special enrollment plans. (Dickson, 4/5)

Georgia Health News: People Who Got Coverage Through ACA Wonder About The Future 
Like many residents of the Athens area, both women have gotten advice from Harold Weber, a health care navigator at the Athens Neighborhood Health Center, a safety net clinic supported partly by a federal grant... For many of Weber’s clients, health insurance is a novelty and not a given. The reality that government action could end the coverage they have now is taken as a fact of life. (Lichtenwalter, 4/5)

The Associated Press: Virginia Republicans Reject Medicaid Expansion
Republican lawmakers in Virginia rejected another bid to expand Medicaid, saying the cost of providing new health coverage to thousands of poor adults would cripple the state. The House of Delegates voted against Medicaid expansion Wednesday as lawmakers reconvened for a one-day session to consider Democratic Gov. Terry McAuliffe’s amendments and vetoes. (Suderman and Rankin, 4/5)

The Washington Post: Va. Legislature Sustains McAuliffe Vetoes
In the House, delegates soundly rejected the governor’s effort to restore language in the budget that would allow him to begin the expansion of Medicaid under the Affordable Care Act. Del. R. Steven Landes (R-Augusta) said he doubted the ACA would still be in place by the end of the year and argued that expanding Medicaid would blow a hole in Virginia’s budget. Under the ACA, the federal government would pay 100 percent of the expansion to an estimated 400,000 Virginians through next year; after that, the state would be on the hook for about 10 percent of the additional cost. (Vozzella and Schneider, 4/5)

The Wall Street Journal: Virginia Legislators Stop Gov. McAuliffe’s Attempt To Expand Medicaid
Mr. McAuliffe has made Medicaid expansion a priority since taking office in 2014, saying 400,000 people would be covered if the state accepted the federal aid that was part of the Affordable Care Act. In light of the recent congressional decision to pull a bill to repeal and replace the health-care law, Mr. McAuliffe said Virginia “has no excuses left to hold out on Medicaid expansion.” But Republican legislators on Wednesday blocked a McAuliffe amendment meant to allow expansion, saying the state cannot afford it. “We rejected expansion in 2013, 2014, 2015, 2016, and again in 2017 because it was the wrong policy for the Commonwealth,” they said. (Bauerlein, 4/5)

Richmond Times-Dispatch: Medicaid Expansion Blocked Again, But New Health Care Debate Takes Shape
Gov. Terry McAuliffe’s latest bid to expand Virginia’s Medicaid program died on a party-line vote in the House of Delegates on Wednesday. But Republican opponents left open the option of finding ways to improve health care for uninsured Virginians in impending discussions by a new joint legislative subcommittee. (Martz and Moomaw, 4/5)

And in news from North Carolina —

Winston-Salem (N.C.) Journal: Judge Allows Extra Time For Negotiation Over Medicaid Expansion Lawsuit
A federal judge has given the parties additional time — through mid-April — to negotiate Gov. Roy Cooper’s request to expand North Carolina’s Medicaid program. N.C. Senate leader Phil Berger, R-Rockingham, and N.C. House Speaker Tim Moore, R-Cleveland, sued both the federal and state departments of health and human services on Jan. 13. At that time, the federal DHHS was under the Obama administration. The lawsuit is an attempt to prevent Cooper from submitting an amendment request to the federal Centers for Medicare and Medicaid Services, or CMS, that would affect a state Medicaid waiver request submitted June 1 by the administration of Cooper’s predecessor, Pat McCrory. (Craver, 4/5)

The New York Times: F.D.A. Nominee Deflects Criticism About Ties To Drugmakers At Hearing
Dr. Scott Gottlieb, President Trump’s nominee to lead the Food and Drug Administration, told Congress on Wednesday that he could speed the approval of new drugs without compromising safety or increasing risks, deflecting questions about his past writings, drug-company investments and Mr. Trump’s controversial positions. “We should reject a false dichotomy that it all boils down to a choice between speed and safety,” Dr. Gottlieb said at his confirmation hearing before the Senate Health, Education, Labor and Pensions Committee. (Pear, 4/5)

Stat: Scott Gottlieb Says FDA Must Strike Right Balance On Risk, Regulation
The 44-year-old doctor, investor, and conservative policy wonk, nominated to run the Food and Drug Administration, appeared before a Senate panel for a confirmation hearing, telling lawmakers that he would be an “impartial and passionate advocate for public health.” “We need to make sure we’re getting the most bang for our regulatory buck,” Gottlieb said in his opening statement. “That means being cognizant of risks and being sure that we’re not adding to consumer costs without improving consumer safety.” (Kaplan, 4/5)

The Wall Street Journal: FDA Nominee Scott Gottlieb Commits To ‘Gold Standard’
Dr. Gottlieb, who was nominated in March, said he sees the need for new laws and FDA regulatory action to get complex-formulation drugs—like those used topically or with inhalers—more quickly approved as lower-cost generics. While he also said there are ways to speed up some clinical trials, “I think there are ways to modernize clinical studies without sacrificing the gold standard.” (Burton, 4/5)

The Washington Post: FDA Nominee Says Nation’s Opioid Crisis Is As Serious As Ebola, Zika Threats 
During his confirmation hearing before the Health, Education, Labor and Pensions Committee, Gottlieb described the FDA as “complicit, even if unwittingly,” in helping to fuel the opioid epidemic. Officials, he said, “didn't fully recognize the scope of the emerging problem” several years ago and needed a new strategy to combat the issues involved. (McGinley, 4/5)

The Associated Press: Trump's FDA Pick Says Tackling Opioid Crisis A Top Priority
Gottlieb said opioid addiction is "the biggest crisis facing the agency" and as serious a public health challenge — for the entire government, not just FDA — as infectious diseases like Ebola or Zika. He said tackling the crisis would be his first priority and will "require dramatic action," including finding ways to spur development of non-addictive alternative painkillers as well as addiction treatments. (Neergaard, 4/5)

Morning Consult: Gottlieb Calls Opioid Epidemic ‘Biggest Crisis’ Facing FDA
“The opioid epidemic in this country is having staggering human consequences,” Gottlieb said. “I think this is the biggest crisis facing the agency and is going to require dramatic action on the part of whoever steps into the agency.” The issue was a focal point during the hearing, with several lawmakers raising concerns about the role of the FDA, which regulates opioid medication, in responding to the crisis. (McIntire, 4/5)

The Hill: Senators Battle Over FDA Nominee's Financial Ties
President Trump’s nominee to lead the Food and Drug Administration faced repeated questions Wednesday over possible conflicts of interest related to his financial ties to an industry he would be tasked with regulating. Democrats on the Senate Health, Education, Labor and Pensions Committee peppered Scott Gottlieb with questions about whether he would be unable to separate himself from the interests of more than two-dozen drug and medical device companies he’s either invested in or consulted for. (Wheeler, 4/5)

The CT Mirror: FDA Nominee Gottlieb Says He’d Challenge Trump On Vaccines
Gottlieb also said he would not be influenced by any sector of the health care industry, despite his job at New Enterprise Associates, a large venture capital firm that is heavily invested in medical technology and healthcare companies. “I want to earn and keep the public’s trust,” Gottlieb told the Senate Health, Education, Labor and Pensions committee. (Radelat, 4/5)

Modern Healthcare: Gottlieb Favors Regulations That Empower Doctors While Keeping FDA Standards
Adding to concerns over patient protections, Sen. Richard Burr, (R-N.C) asked Gottlieb whether he thought the clinical trial process was burdensome to physicians. “In 2017, should there still be double blind studies where the doctor doesn't even know if the patient is getting a placebo or not?,” Burr said. Gottlieb responded the FDA should consider multiple new clinical trial standards to bring innovative products to the market without sacrificing safety and efficacy standards. (Dickson, 4/5)

Bloomberg: Opioid Epidemic Is FDA's Top Priority, Says Pick To Head Agency
Gottlieb is likely to be confirmed by the full Senate when he eventually gets a vote. His comments to the committee Wednesday seemed to assuage concerns by some senators on the drug crisis as well as other issues, including potential conflicts of interest that come from his work as a consultant and investor. (Edney, 4/5)

Politico Pro: Gottlieb Wants To Prevent Drug Makers From Gaming FDA 
FDA commissioner nominee Scott Gottlieb said he wants to craft policies to prevent drug companies from abusing the FDA approval process to prevent competition, leading to higher drug prices. "We should try to design policies that prevent those abuses because we don't want to be playing whack-a-mole with companies and going after them one-by-one," Gottlieb told Sen. Tammy Baldwin during a Senate HELP Committee hearing on his nomination. (Karlin-Smith, 4/5)

The Wall Street Journal: FDA Nominee Not All Good News For Drug Makers
An industry-friendly commissioner seems to be coming to the Food and Drug Administration. While he is favored by many executives, not all drug makers will be happy once he gets on the job. Such is the takeaway from Scott Gottlieb’s confirmation hearing to take the helm of the agency Wednesday. (Grant, 4/5)

The Washington Post: Conservatives Fall Short Of Another Goal: Defunding Planned Parenthood
Antiabortion groups thought they had a sure way to slash funding for the country’s largest abortion provider as part of the health-care overhaul proposed by the House Republican leadership. But the overhaul failed — a nascent effort to revive it has also stalled — dampening conservatives’ once-high hopes to achieve one of their dearest goals: defunding Planned Parenthood. (Cunningham, 4/5)

Politico: Ivanka's Secret Planned Parenthood Outreach
In the weeks following her father’s inauguration, Ivanka Trump quietly reached out to the president of Planned Parenthood seeking common ground on the contentious issue of abortion. ... Their under-the-radar meeting — a rarity between a well-known Democratic activist and a close adviser to a Republican president — has not been previously reported. (Karni, 4/6)

And in the states —

KCUR: Judge Plans To Strike Down Missouri Abortion Restrictions 
A federal judge says he plans to block Missouri’s abortion clinic restrictions in the wake of a U.S. Supreme Court decision last June. In a “Memorandum to Counsel” on Monday, U.S. District Judge Howard Sachs said he would grant the preliminary injunction requested by Planned Parenthood, but would give the state additional time to avoid “unintended damage” to standard medical regulations. (Margolies, 4/5)

The Associated Press: Judge Plans To Block Missouri's Abortion-Restricting Rules
A federal judge says he plans to issue a preliminary injunction to block abortion-restricting rules in Missouri similar to ones in Texas that the U.S. Supreme Court struck down last year. U.S. District Judge Howard F. Sachs announced his move in a memo filed Tuesday in Kansas City, Missouri. He said he would give the state time to craft a plan for patients to avoid unintended "collateral damage" from the injunction, which was sought by Planned Parenthood. (Suhr, 4/5)

Houston Chronicle: Wendy Davis: Women's Health Is Under Attack 
Hundreds of people clad in pink rallied and roamed around the state capitol Wednesday to tell lawmakers about why they support Planned Parenthood, an organization many conservative lawmakers would like to see disappear. At a rally on the steps of the Texas Capitol, former gubernatorial candidate Sen. Wendy Davis, who is known for her 2013 filibuster to block an anti-abortion bill, urged women to tell their stories about the role Planned Parenthood played in their reproductive care. She added that women and advocates are facing "the worst political attacks on women's health in a generation." (Zelinski, 4/5)

Reuters: Abortion Rights Activists Rally At Texas Capitol Against Restrictions
Hundreds of abortion rights activists rallied at the Texas Capitol on Wednesday, saying a raft of proposed legislation placing restrictions on the procedure in the most populous Republican-controlled state would endanger millions of women. (Herskovitz, 4/6)

Texas Tribune: Planned Parenthood Supporters Rally For Reproductive Health Access 
More than 400 people rallied in front of the Texas Capitol on Wednesday, calling on state legislators to stop trying to block Planned Parenthood from offering reproductive health services. Clad in pink and holding signs reading, "I Stand with Planned Parenthood," "We March for Women's Rights" and "Don't Take Away Our Care," supporters of the women's health provider got charged up for Planned Parenthood's lobby day in Austin. (Evans, 4/5)

Boston Globe: Sending Anti-Abortion Ads By Phone Is Creepy, But Not Illegal 
Massachusetts has built a new buffer zone around reproductive health clinics to fend off protesters. Granted, this one is digital, but it’s just as debatable as the physical buffer zone law that was struck down in 2014 by a unanimous US Supreme Court.On Tuesday, Attorney General Maura Healey struck a deal with Boston-based Copley Advertising that bars the company from using smartphone location tracking to detect people approaching clinics and send them antiabortion ads. (Bray, 4/5)

Houston Chronicle: Texas Masturbation Bill Is Now In The Hands Of The Texas State Affairs Committee 
In March, Texas State Rep. Jessica Farrar, D-Houston, filed a bill that would penalize men for "unregulated masturbatory emissions" and the bill has now made its way into the hands of the Texas State Affairs Committee on Tuesday. The committee is typically the panel that hears abortion-related legislation and it will now address Farrar's House Bill 4620, which is named the "Men's Right to Know Act." (Leighton, 4/5)

Stat: House Bill Would Give Boost To Contracted Research Industry
The booming contract research industry would get a financial gift under a bill recently introduced in Congress. The measure, dubbed the Domestic Research Enhancement Act of 2017, would give companies a 35 percent tax credit for research expenses when they are conducting contract research. Tax credits for research and development do not currently extend to research done under such contracts. (Joseph, 4/5)

CNN: Global Pandemics: 7 Reasons We're More At Risk
It could take just one cough, one kiss, one touch or even one bite to change not only your life, but the lives of everyone around you -- and for months or even years. In most cases, the closer those people are to you, the greater the risk. But it isn't always that simple. The risk at hand: an infectious outbreak. (Senthilingam, 4/5)

CNN: The Virus Hunters In Search Of The Next Outbreak
It is a slow and cumbersome descent hindered by head-to-toe protective suits. A wooden ladder dips down the side, as two researchers in white suits and respirators make their way into Grootboom cave in South Africa. The suits make the journey more cumbersome, but they are the only things standing between safety and exposure. (Bresnahan, 4/6)

CNN: Diseases You Thought Were Gone
This year, the United States has recorded 16 cases of plague, while recent figures have revealed that in the UK, cases of "19th-century" diseases such as scurvy and scarlet fever are on the rise. Changes to our living conditions and the development of medicines have affected the rise and fall of diseases, but they seldom disappear. To date, smallpox remains the only disease to have ever been eradicated. (Eastaugh and Senthilingam, 4/6)

CNN: The Untold Stories Of 'Patients Zero'
When a researcher's scrawling of the letter O was misinterpreted as a zero in reference to a HIV patient in the early 1980s, the provocative term "patient zero" was born. It triggered a wave of events in which the patient, Gaëtan Dugas, a French-Canadian flight attendant, was erroneously blamed for bringing the human immunodeficiency virus, or HIV, to the United States. (Howard, 4/6)

The Washington Post: More Than 1 In 5 U.S. Adults Were Infected By A Type Of High-Risk HPV, CDC Report Shows
During a recent two-year period, almost 23 percent of U.S. adults ages 18 to 59 had a type of genital human papillomavirus (HPV) that put them at high risk of certain cancers, according to a Centers for Disease Control and Prevention report published Thursday. That percentage jumped to more than 42 percent during 2013 to 2014 if any type of genital HPV was included, the CDC found. In both groups, prevalence was higher in men than in women, and it was sharply higher among blacks compared to other racial and ethnic groups. (Naqvi, 4/6)

The Washington Post: Long-Term Aspirin Use Associated With Reduced Risk Of Dying From Cancer, Study Shows
Long-term use of aspirin is associated with lower risk of dying from various types of cancers, including colorectal, lung, breast and prostate cancer, according to a study presented at the 2017 American Association for Cancer Research Annual Meeting on Monday. The longitudinal study analyzed the association of aspirin, with varied doses and duration of use, on overall mortality risks and mortality risks from cancer over a nearly 32-year period. (Naqvi, 4/5)

Cleveland Plain Dealer: Premature, 'Pre-Viable' Babies Were Large Portion Of Recent Infant Deaths In Cuyahoga County, First Year Cleveland Finds 
More than half of the babies born in Cuyahoga County in 2015 who died before reaching a first birthday were born premature, and most of those infants were born so early they had almost no chance of surviving. More than two thirds of the premature babies who died in the county that year were black, and many were born to mothers who had early access to good prenatal care. (Zeltner, 4/5)

The Washington Post: First Evidence Found Of Popular Farm Pesticides In Drinking Water
Of the many pesticides that American farmers have embraced in their war on bugs, neonicotinoids are among the most popular. One of them, called imidacloprid, is among the world’s best-selling insecticides, boasting sales of over $1 billion a year. But with their widespread use comes a notorious reputation — that neonics, as they are nicknamed, are a bee killer. A 2016 study suggested a link between neonicotinoid use and local pollinator extinctions, though other agricultural researchers contested the pesticides' bad rap. (Guarino, 4/5)

Stat: For A Trip To The ER, Some Are Opting For Uber Over An Ambulance
Millions of Americans take an ambulance trip every year; others get rides from willing friends or, tempting fate, drive themselves. But in recent years a new trend has arisen: Instead of an ambulance, some sick people are hailing an emergency Uber. Though firm numbers are hard to come by, drivers for Uber and Lyft say it happens with some regularity. In an online chatroom for Uber drivers, dozens of posters share experiences with passengers who hail a ride with bloody cuts, asthma, anaphylaxis, or broken bones. (Samuel, 4/5)

NPR: Six Questions Help Predict Adult ADHD
Do you pop up from your seat during meetings and finish other people's sentences? And maybe you also procrastinate, or find yourself zoning out in the middle of one-on-one conversations? It's possible you have adult ADHD. (Hersher, 4/5)

NPR: Emergency Room Caregivers Are Picking Noses — For Drug Delivery, That Is
In emergencies, administering drugs quickly and easily can be a matter of life and death. This has emergency departments turning to the nose as a delivery route because it's so accessible and doesn't require direct contact with a needle. Using the nose as a passage for steroids like Flonase and vaccines like FluMist has been common practice for decades. In recent years, more Americans have also become aware of the emergency drug naloxone, which is used to reverse the effects of an opioid overdose, even when someone has stopped breathing. (Boddy, 4/5)

NPR: Pressure To Publish Leads To Shoddy Science And Bad Medicine
A surprising medical finding caught the eye of NPR's veteran science correspondent Richard Harris in 2014. A scientist from the drug company Amgen had reviewed the results of 53 studies that were originally thought to be highly promising — findings likely to lead to important new drugs. But when the Amgen scientist tried to replicate those promising results, in most cases he couldn't. "He tried to reproduce them all," Harris tells Morning Edition host David Greene. "And of those 53, he found he could only reproduce six." (4/6)

WBUR: Massachusetts Medical Society Trustees Ask Members To Support Safe Injection Facilities For Drug Users 
At the end of April, physicians who set policy for the Massachusetts Medical Society (MMS) will vote on a recommendation that the group advocate for a supervised injection facility (SIF) pilot program in Massachusetts. The recommendation was approved by a unanimous vote of the board of trustees in February. If approved, the Massachusetts Medical Society says it would become the first statewide physicians group to endorse the idea of a room where a doctor or nurse is on duty while drug users inject, swallow or smoke an illegal substance and ride out a high. (Bebinger, 4/5)

New Hampshire Public Radio: Home-Based Drug Treatment Program Costs Less, Can Deliver Results
Treating addiction is a growing business in New Hampshire. But a lot of the treatment that’s available is expensive and patients often relapse. A Connecticut-based company is expanding in New Hampshire with the promise of helping some people pay less money for better results. (Rodolico, 4/6)

Detroit Free Press: Doctors Convicted Of Operating Ann Arbor 'Pill Mill'
Two doctors face sentencing of up to 20 years in prison after being found guilty of helping to operate what federal prosecutors say was a Washtenaw County “pill mill.” Federal officials say Dr. Anthony Conrardy, 61, and Dr. William McCutchen III, 46, wrote medically unnecessary prescriptions to hundreds of individuals, charging $250 for a 30-day supply of narcotics. The pair of doctors worked at the Meghnot Comprehensive Center for Hope on Golfside Road in Pittsfield Township where physicians regularly wrote prescriptions for Oxycodone, Dilaudid, Vicodin and other narcotics “to drug-seeking individuals purporting to be patients,” according to Acting U.S. Attorney Daniel L. Lemisch. (Pepple, 4/5)

Stat: Against A History Of Medical Mistreatment, African-Americans Are Distrustful Of Hospice Care
Medical researchers who are working to unpack the issue view minority access to hospice care as a matter of social justice. It’s typically paid for by the government, can reduce patient suffering, and relieve family members of the burdens of caring for a dying loved one. Why should African-Americans continue to suffer more at life’s end than others? There’s a lot to sift through, starting with the medical industry’s long and at times ugly history of neglect and abuse of blacks. Doctors can also fail to account for the pervasive belief among many African-American faithful that God has an ability to heal the sick through miracles. (Tedeschi, 4/5)

Previous KHN Coverage: A Racial Gap In Attitudes Toward Hospice Care

Kansas City Star: Sebelius Speaks On End-Of-Life Care At Center For Practical Bioethics Dinner 
Former Kansas Gov. Kathleen Sebelius said doctors and government should back off and let patients drive end-of-life care decisions at the Center for Practical Bioethics’ annual dinner Wednesday at the Kansas City Marriott Downtown. Sebelius said she tried to encourage that approach in 2009 as secretary of the U.S. Department of Health and Human Services under President Barack Obama by proposing a reimbursement for discussing end-of-life decisions with patients under the Affordable Care Act. (Marso, 4/5)

Kaiser Health News: To Help Ward Off Alzheimer’s, Think Before You Eat
Diets designed to boost brain health, targeted largely at older adults, are a new, noteworthy development in the field of nutrition. The latest version is the Canadian Brain Health Food Guide, created by scientists in Toronto. Another, the MIND diet, comes from experts at Rush University Medical Center in Chicago and Harvard T.H. Chan School of Public Health. (Graham, 4/6)

Stat: She's Hellbent On Solving The Organ Shortage With 'Designer Pigs'
Where other people see bacon, biologist Luhan Yang sees lifesaving organs — hundreds and thousands of them, pig livers and pig kidneys and diabetes-curing pancreases, and possibly hearts and lungs, all growing inside droves of pampered swine. More established scientists than Yang have dreamed of creating animal organs that are suitable for transplantation into people waiting for a human donor. But until recently, experts said it would take decades to genetically alter pig organs to make them work safely in people. (Begley, 4/6)

And in other news —

KCUR: Missouri Researchers Join Hunt For One Of Medicine’s Elusive Quarries: Artificial Blood
Medical researchers have made a lot of progress developing artificial versions of organs like the heart, lungs and kidneys, but one thing has stumped them: artificial blood. Blood is especially hard to recreate because it does so many things, from carrying oxygen to helping the immune system to heating and cooling the body. Now, some Missouri researchers may have taken a big step forward in creating artificial blood. But the question remains: Will  science ever be able to replace the real thing? (Smith, 4/5)

The CT Mirror: CT Hospitals Rally To Block Tax Hikes 
Connecticut’s hospitals intensified their push Wednesday to block hundreds of millions of dollars in tax increases recommended for their industry by Gov. Dannel P. Malloy. But the administration fired back that hospital executives are exaggerating the burdens they face while ignoring the benefits Connecticut’s poorest communities would reap from the governor’s plan. (Phaneuf, 4/5)

Columbus Dispatch: State Rethinks Work-Hour Rule For Home-Care Providers
The Ohio Department of Developmental Disabilities has pulled a controversial proposal that aimed to prohibit Medicaid-funded independent care-providers from being paid for more than 40 hours a week. Public outcry over the proposed overtime rule was swift and sustained, with dozens of consumer advocates and families turning out during a hearing in February to oppose the change. (Price, 4/5)

Houston Chronicle: Senate Panel Approves Crackdown On Nursing Home Violations 
The Senate Health and Human Services Committee voted unanimously in favor of advancing a proposal by Sen. Charles Schwertner, R-Georgetown to crack down on widespread violations at the state's nursing homes. Senate Bill 932 would increase regulatory oversight of nursing homes, raise penalties and sharply limit the ability of nursing home operators to self-correct violations. Committee members present voted 5-0 to send the bill to the full Senate for consideration. (Canaves, 4/5)

The Washington Post: Long Shadow Cast By Psychiatrist On Transgender Issues Finally Recedes At Johns Hopkins
Nearly four decades after he derailed a pioneering transgender program at Johns Hopkins Hospital with his views on “guilt-ridden homosexual men,” psychiatrist Paul McHugh is seeing his institution come full circle with the resumption of gender-reassignment surgeries. McHugh, the hospital’s chief of psychiatry from 1975 to 2001, still believes that being transgender is largely a psychological problem, not a biological phenomenon. ... Hopkins, however, is moving beyond McHugh. This summer, it will formally open a transgender health service and will resume, after a 38-year hiatus, an accompanying surgical program. (Nutt, 4/5)

California Healthline: While Washington Fiddles, California Leaders Forge Ideas For Universal Health Care
As the nation’s Republican leaders huddle to reconsider their plans to “repeal and replace” the nation’s health law, advocates for universal health coverage press on in California, armed with renewed political will and a new set of proposals. Organized labor and two lawmakers are leading the charge for a single, government-financed program for everyone in the state. Another legislator wants to create a commission that would weigh the best options for a system to cover everyone. And Democratic Lt. Gov. Gavin Newsom, who hopes to become the next governor, has suggested building on employer-based health care to plug holes in existing coverage. (Bartolone, 4/6)

The Associated Press: Police Object To California Marijuana Regulation Revamp
California law enforcement officials objected Wednesday to Gov. Jerry Brown’s proposed streamlining of the state’s marijuana regulations, saying his plan could endanger public safety. Brown’s administration released documents late Tuesday outlining proposed changes to square the state’s new recreational pot law with its longstanding law on medical marijuana. (Blood and Elias, 4/5)

Miami Herald: Canadian Company Buys Into Florida' Marijuana Market 
A major player in Canada’s cannabis industry is acquiring one of only seven legal Florida medical marijuana cultivators through a complicated purchase that according to one analysis values a state cannabis license at close to $200 million. Aphria, a publicly traded firm based out of Ontario, plans to invest $25 million in a shell that will purchase most or all of the assets of Chestnut Hill Tree Farm, the Alachua nursery that operates CHT Medical. (Smiley, 4/5)

The Washington Post: Trumpcare II Predictably Fails
Perhaps the Freedom Caucus believed the resumed talks on health-care reform were “real” and could lead to a new agreement. Alternatively, this may have been a thinly disguised attempt to shift blame to moderate Republicans and escape the ire of Republicans who blame their intransigence for failure of the America Health Care Act. The latter theory got some support when Heritage Action’s Dan Holler went on a tweet storm blaming the Tuesday Group of moderates for shying away from repeal of Obamacare. (Jennifer Rubin, 4/5)

Bloomberg: Groundhog Day, But For Repealing And Replacing Obamacare
The driving force behind this round of negotiations appears to be the same as it’s been since Republicans took charge of the government: A need to shift the blame elsewhere for utterly failing to repeal and replace Obamacare, their solemn vow to voters for seven years now. Even the House Freedom Caucus, which is normally proud of its role in stopping imperfect conservative legislation, may be somewhat skittish about taking responsibility for keeping Obamacare in place. So is every other Republican faction. And, yes, that's true even though the bill they considered is profoundly unpopular and aimed at replacing something that is now polling at nearly 50-percent favorability.  (Jonathan Bernstein, 4/5)

Real Clear Health: Health Care Reform On Hold: Now What?
The American Health Care Act (AHCA) was pulled from the House floor before an expected vote and efforts to repeal or reform the Affordable Care Act, or “Obamacare,” could be suspended for some time. The future of health care law reform efforts remains uncertain — but confusion is nothing new to Americans navigating the complexities of health care delivery and payment. No matter the outcome last week, Americans were still going to wake up this morning with complicated decisions to make about their health care. As we move forward, continuing to make these difficult decisions, individuals and policymakers will grapple with managing and navigating intricate inter-related health care delivery and payment systems. These policy decisions should be taken seriously as they affect individuals, families, and the health and wealth of our nation. (Robin Gelburd, 4/6)

USA Today: On Health Care, Trump Hopes For The Worst
“Obamacare unfortunately will explode,” Trump said in a later interview, adding that “It’s going to have a very bad year.” Trump predicted that after premiums increase, Americans will blame Democratic leaders for passing the Affordable Care Act in the first place. “I think the losers are Nancy Pelosi and Chuck Schumer because now they own Obamacare,” he said. These preceding passages represent an extraordinary moment in presidential rhetoric. An American president is now actually wishing a program fails — punishing millions of Americans — in order for him to benefit politically. The leader of the Republican Party is wishing misery on the people who voted for him, hoping they will blame the authors of a law he broke his promise to change. (Christian Schneider, 4/5)

The Washington Post: How Americans Learned To Stop Worrying And Love The ACA — Sort Of
Democrats should give credit where credit is due — to President Trump. He has accomplished what they and President Barack Obama could not, namely make the Affordable Care Act popular, if not actually loved. (Jennifer Rubin, 4/5)

The Charlotte Observer: Did You Hear? Obamacare Is Officially Popular
Let’s take a moment from the latest Republican attempt to repeal the Affordable Care Act for some breaking news: Obamacare is popular. Actually, it has long been more popular than many people thought, but now it’s official. On Tuesday, Gallup announced that for the first time since it’s been tracking public opinion on the Affordable Care Act, a majority of Americans support the law. (4/5)

Cincinnati Enquirer: Is It Time To Self-Insure?
Health insurance companies have ruined the lives of many policyholders by denying coverage, citing pre-existing conditions or by actually practicing medicine, by wanting to use less costly drugs or treatment methods than the physician has recommended as being prudent. ... Health insurance is a “needless markup” in the health care system. ... The plan exists that can solve our medical delivery problem. It has been in use for many years and works quite well. ... The program is Medicare. (James Baker, 4/5)

Real Clear Policy: Single-Payer Health Care Is Not The Answer
Fellow Canadian F.H. Buckley caused a maelstrom in conservative circles last week when he called on President Trump to advance a single-payer model for U.S. health care. A chorus of conservatives were quick to condemn this marked departure from long-time right-wing orthodoxy. While the critics are correct that single payer is not the answer, Mr. Buckley is nevertheless posing the right question to guide meaningful and durable health-care reform. (Sean Speer, 4/6)

The Wall Street Journal: The Man Who Knows Too Much
Politicians aren’t always as dumb or cynical as they sound, but you wouldn’t know that from Wednesday’s confirmation hearing for Scott Gottlieb. Democrats criticized the nominee to run the Food and Drug Administration for the “conflict of interest” of knowing too much about the industries he’d regulate. (4/5)

The Washington Post: Trump’s Nominee For The FDA Could Be The Leader The Agency Needs
As an investor in early-stage life-science companies, Gottlieb has presumably developed a hard-won, highly valuable understanding of the nuance of product development. This will help him identify opportunities for accelerating the approval process, as well as to head off any nefarious attempts to game the system at the expense of patients. If Gottlieb can leverage his experience as a company builder (along with his experience as a doctor, policy wonk and cancer patient), he might be able to unleash the latent passion within the FDA and inspire its innate creativity. With the right leadership, the FDA — however improbably — might lead us out of our present health-care miasma. (David Shaywitz, 4/5)

The Wall Street Journal: How FDA Rules Made A $15 Drug Cost $400
The theory is that generic drugs should be less expensive than the original. By the time a generic hits the market, the drug’s patent has expired, allowing competition from companies that didn’t spend millions of dollars to develop it. As more options become available, prices are supposed to drop. But because of quirks in America’s regulatory system, it doesn’t always work out this way. (Mark L. Baum, 4/5)

JAMA: The Prescriptions I Write
I write prescriptions most days in my work as a family physician. These prescriptions are often for commonly used medications, such as antihypertensives, antibiotics, and antiglycemics. Writing the prescription is a small part of what happens between a physician and a patient. Recently, I have started to write a different type of prescription. In some situations, these unconventional prescriptions may be as important, if not more important, as traditional prescriptions. (Norah Neylon, 4/4)

JAMA: Prime Time For Shared Decision Making
The recognition that informed patients often choose more conservative and hence less expensive medical options has made shared decision making a focus of value-based care. In 2007, Washington State passed legislation incentivizing shared decision making as an alternative to traditional informed consent procedures and forms for preference-based treatment decisions that include an elective procedure, such as joint replacement for hip or knee osteoarthritis. (Erica S. Spatz, Harlan M. Krumholz and Benjamin W. Moulton, 4/4)

Stat: To Fight Physician Burnout, I'm Making A Binder Of Medical Successes
This doctor was once a student like me. Now she is using vulgar language to describe a patient and flying into a rage because a sub-intern called her. The interaction shook me, mostly because I knew I wasn’t immune to becoming a doctor like her. I started looking for answers about how or why this transformation takes place. An abundance of articles in medical journals made me realize that the health care system can be harmful to doctors’ mental health. Burnout affects all medical specialties, at rates climbing higher than 50 percent. Doctors get worn out by daily battles with insurance companies, cumbersome electronic medical records, and increased patient caseloads. The lack of job control coupled with low reward and high demands increase exhaustion. (Erin Barnes, 4/5)

Stat: Why President Trump Needs To Finally Name A Science Advisor
Insights from science and technology are relevant to many of the decisions about actions and policies that a president must make — whether they deal with the economy, public health, urban issues, transportation, agriculture, land use, the environment, or national security. What are the potential benefits of new gene-editing technologies, and what are the risks? What effect does hotter weather have on agricultural productivity? Could terrorists make an effective nuclear bomb if they were able to steal or buy plutonium or highly enriched uranium? While scientific insights won’t be the only factors the president considers in any given decision, it would be foolish for him to make policy or take action without having the relevant scientific facts. If access to those facts is to be timely, the president needs people close at hand, in the White House, who can find, vet, and explain them. (John P. Holdren, 4/5)

St. Louis Post-Dispatch: Children Are The Collateral Damage Of Nation's Opioid Epidemic
Foster care programs across the country are overwhelmed by an influx of children dubbed by health care officials as “opioid orphans,” collateral damage from the nation’s opioid-addiction epidemic. They are youngsters who have been literally orphaned or left in the care of aging grandparents or other young siblings because of parental drug abuse. Statistics are slim in Missouri, where state Department of Social Services officials have refused to acknowledge or speculate about whether drug abuse has caused the four-year uptick in foster care needs. The department’s latest annual report, with data from 2015, indicates the system is strained. It said more children were entering foster care than leaving, and that social workers need manageable caseloads to help find permanent homes for children. (4/5)

JAMA Forum: Safe Injection Facilities Reduce Individual And Societal Harms
Last winter, the mayor of Ithaca, New York, Svante Myrick, proposed to provide a safe and legal space in which people could inject heroin. It may sound like a radical and desperate way to reduce the harms of drug use. But its effectiveness — and cost-effectiveness — is well supported by research. Supervised injection facilities (SIFs) such as the one proposed by Mayor Myrick are a close cousin to syringe exchange programs (SEPs). The difference is that SIFs don’t just provide clean injection equipment, as SEPs do, but also medical staff for supervision of injection of preobtained drugs, which can prevent unsafe techniques and drug overdoses. (Austin Frakt, 4/5)