The Associated Press: Lawmakers Settle On Hard-Fought $1 Trillion Spending Bill
Congressional Republicans and Democrats have reached agreement on a huge $1 trillion-plus spending bill that would fund most government operations through September but denies President Donald Trump money for a border wall and rejects his proposed cuts to popular domestic programs. Aides to lawmakers involved in the talks disclosed the agreement Sunday night after weeks of negotiations. The bill was made public in the pre-dawn hours Monday. ... The measure funds the remainder of the 2017 budget year, through Sept. 30, rejecting cuts to popular domestic programs targeted by Trump such as medical research and infrastructure grants. (Taylor, 5/1)

The Washington Post: Congress Reaches Deal To Keep Government Open Through September
Democrats fought to include $295 million to help Puerto Rico continue making payments to Medicaid, $100 million to combat opioid addiction, and increases in energy and science funding that Trump had proposed cutting. If passed, the legislation will ensure that Planned Parenthood continues to receive federal funding through September. (Snell, 4/30)

Stat: NIH To Get A $2 Billion Funding Boost As Congress Rebuffs Trump
The National Institutes of Health will get a $2 billion funding boost over the next five months, under a bipartisan spending deal reached late Sunday night in Congress. The agreement marks a sharp rejection of President Trump’s proposal to cut $1.2 billion from the medical research agency in the current fiscal year. The deal does not address funding for 2018, when Trump has called for a slashing the NIH’s budget by about a fifth, or $5.8 billion. (Facher, 5/1)

CQ Roll Call: Spending Package Would Provide $2 Billion Bump For NIH
Senior Republican appropriators already had indicated that they were not swayed by White House proposals seeking to cut NIH in fiscal 2017, the budget year that began Oct. 1. An Office of Management and Budget spreadsheet that was circulating in Washington last month suggested a $1.2 billion reduction for the NIH. (Young, 4/30)

CQ Roll Call: Omnibus Averts Puerto Rico Medicaid Shortfall
Lawmakers agreed to funnel $295.9 million to Puerto Rico’s Medicaid program in a fiscal 2017 omnibus to avert a funding shortfall that lawmakers say could have put about 900,000 poor people at risk of losing health care coverage. But without legislative changes to the way Puerto Rico’s Medicaid program works, the funding boost is likely not the last chunk of money Congress will need to agree to send the island territory, which is crippled by a $72 billion debt crisis. The financial fallout is the subject of a 2016 law (PL 114-187) that established an oversight board to help deal with the problem, but the Medicaid issue was not addressed. (Mejdruch, 5/1)

The New York Times: Pushing For Vote On Health Care Bill, Trump Seems Unclear On Its Details
After two false starts on President Trump’s promise to repeal the Affordable Care Act, Trump administration officials are pressing the House to vote on a revised version of the Republican repeal bill this week, perhaps as soon as Wednesday, administration officials said. And on Sunday, Mr. Trump insisted that the Republican health legislation would not allow discrimination against people with pre-existing medical conditions, an assertion contradicted by numerous health policy experts as well as the American Medical Association. (Pear, 5/1)

CNN: Trump: GOP Health Care Bill 'Guarantees' Coverage For Pre-Existing Conditions
President Donald Trump says the Republican plan to repeal and replace the Affordable Care Act "guarantees" coverage for Americans with pre-existing conditions -- a claim that could undercut the legislation the White House is currently pushing on Capitol Hill. (Bradner, 4/30)

USA Today: Trump Dominates The 101st Day With Tweets, Tough Talk About Health Care
Trump maintained there is yet another version of the American Health Care Act, House Republicans' plan to replace the Affordable Care Act, and blamed obstruction by Democrats for Congress' failure to pass the legislation before his 100th day in Congress, although Republicans control both chambers of Congress. Trump also maintained that "preexisting conditions are in the bill. I mandated it."  Coverage with people with existing medical conditions has to be included, he continued, because "Obamacare is dead." (O'Donnell, 4/30)

The Wall Street Journal: Trump Issues Health ‘Guarantee,’ Sidesteps Affordability Concerns
Interviewer John Dickerson repeatedly asked Mr. Trump if the Republican plan—being negotiated among GOP lawmakers in the House—would guarantee coverage to people in every state, regardless of their medical history. Mr. Trump said that it would, but he didn’t directly address the possibility that some states could opt to charge more to people with such pre-existing conditions, the current sticking point in negotiations between GOP centrists and conservatives. (Radnofsky, 4/30)

The Hill: Trump Says Coverage Of Pre-Existing Conditions Will Be In Healthcare Plan 
He said the GOP's new healthcare bill is "much different than it was a little while ago." "This bill has evolved. And we didn't have a failure on the bill," he said. "You know, it was reported like a failure. Now, the one thing I wouldn't have done again is put a timeline. That's why on the second iteration, I didn't put a timeline," he continued. (Savransky, 4/30)

The Associated Press Fact Checker: Are Trump's Health-Plan Protections Real?
President Donald Trump is promising that the latest Republican health care legislation will cover people with pre-existing conditions "beautifully." Such reassurance is not to be found in the bill that's been under review. (Woodward and Drinkard, 5/1)

The Associated Press: Fears Of Losing Pre-Existing Conditions Protection Under GOP
From cancer to addiction, doctors and patient groups are warning that the latest Republican health care bill would gut hard-won protections for people with pre-existing medical conditions. Some GOP moderates who may seal the legislation's fate are echoing those concerns. In a strongly worded statement this week, the American Medical Association said the Republican protections "may be illusory." The American Cancer Society Cancer Action Network said the plan could take the nation back to a "patchwork system" that pushes costs on people with life-threatening conditions. (Alonso-Zaldivar and Fram, 4/28)

The Hill: Trump: I Won't Touch 'Concept Of Medicare'
President Trump during an interview that aired Sunday said he will not touch the "concept of Medicare." "I'm not going to touch it, because I said it," the president said during an interview on CBS's "Face The Nation." "Now, waste, fraud and abuse, I'm going to touch. If there's something in Medicare that's been abused, I will touch that." (Savransky, 4/30)

Politico: Trump In Tweets: ‘New Healthcare Plan Is On Its Way’
President Donald Trump isn't giving up on a new plan to repeal and replace the Affordable Care Act. In Sunday morning tweets, Trump said a new health care plan is on its way, adding: "Obamacare is dead." (Morin, 4/30)

The Hill: Trump Blasts 'Dead' ObamaCare: New Healthcare Plan 'On Its Way' 
"Dems want billions to go to Insurance Companies to bail out donors....New...healthcare plan is on its way. Will have much lower premiums & deductibles while at the same time taking care of pre-existing conditions!" [he tweeted.] (Savransky, 4/30)

Politico: GOP Faces Make-Or-Break Moment On Obamacare Repeal
House Republican leaders and White House officials are increasingly confident about passing their long-stalled Obamacare replacement bill: More lawmakers than ever are committed to voting “yes," they say, and GOP insiders insist they’re within striking distance of a majority. But the window of opportunity for Speaker Paul Ryan and his leadership team is closing fast. The House is scheduled to leave town for a one-week recess on Thursday, and some senior Republicans worry that failing to get it done by then would fritter away critical momentum. Skittish Republicans would return home to face a barrage of pressure from Democrats and progressive outside groups. (Bade, Bresnahan and Cheney, 4/30)

The Wall Street Journal: New Plan, Same Hurdle In GOP’s Quest To Gut Obamacare
After weeks of debating and arm-twisting, Republicans intent on toppling the Affordable Care Act remain vexed by the same obstacle they faced when they tried to overturn the law last month: Taking away people’s guaranteed health insurance is hard to do. A renewed effort to bring a House Republican plan to the floor faltered by week’s end, a blow to President Donald Trump’s hopes of landing a health-care deal in his first 100 days. Republicans are vowing to push ahead with the bill, saying it has stalled but not died. (Armour and Peterson, 4/28)

The Wall Street Journal: Trump Pushing For Vote On Health Bill, But Stumbling Blocks Remain
Both President Donald Trump and Vice President Mike Pence in television interviews Sunday suggested confidence that they could win enough votes to pass a bill to undo the Affordable Care Act. But skepticism among centrist members of the party remains a stumbling block, and it’s unclear that congressional leaders have made enough progress to call a roll, as they grapple with Republicans who have expressed concern that recent changes to satisfy more conservative lawmakers may push coverage costs higher. (Radnofsky and Peterson, 4/30)

The Hill: ObamaCare Repeal: GOP Seeks New Game Plan 
GOP leaders say they won’t call a vote until the new legislation has enough support to pass, and that new version appears to have lost the votes of centrists as it has gained endorsement from conservatives. (Sullivan and Hellmann, 4/28)

The Associated Press: Personal Tragedy Shaped Congressman's Effort On Health Care
New Jersey Rep. Tom MacArthur has experienced personal tragedy and understands the need for health insurance. "I lost my mother at 4 years old. My father had no insurance and I watched him until I was in college pay off medical bills," says the two-term Republican lawmaker. Years later, MacArthur suffered the anguish over the death of his 11-year-old daughter, Gracie. "We had over $1 million of medical bills. I had insurance, but I still had a lot of uncovered expenses, and it's brutal," he says. (Freking, 4/28)

Bloomberg: If Republicans Can’t Get This Lawmaker, Obamacare Repeal May Be Dead 
Representative Fred Upton helped guide dozens of Obamacare repeal measures through the House in recent years, but he has deep reservations about the GOP’s current bill. ... Until five months ago, Upton, a Michigan Republican, chaired the Energy and Commerce Committee, which has jurisdiction over much of health care policy. Now, he’s not ready to support the current bill and said the most recent revisions have made it worse. (John and House, 4/28)

Arizona Republic: Health Care Illustrates Divide Between GOP Moderates, Hard-Liners
Arizona’s Republican delegation offers an example of the ideological tug of war between the party's more moderate wing and its far-right flank as highlighted by GOP debate of the American Health Care Act. Four of the state’s five Republicans are members of the Freedom Caucus, the right-most hard-liners with about 33 members. (Hansen, 4/30)

The Hill: Dems, Not Trusting Trump, Want Permanent ObamaCare Fix
Rank-and-file Democrats in the House aren’t satisfied with President Trump’s offer to make critical ObamaCare payments as part of a deal to keep the government funded and prevent a shutdown. They’re seeking a permanent legislative fix to the issue, something they believe would stabilize the healthcare law. And they say they don’t trust Trump to stick to his word in making the payments, which if withheld could cause havoc in ObamaCare’s exchanges. (Lillis, 4/30)

Cleveland Plain Dealer: Congressional Republicans From Northeast Ohio Undecided On Newest Health Care Reform Draft
The conservative House Freedom Caucus has signed off on the newest Republican effort to alter the Affordable Care Act, but other Northeast Ohio Republicans aren't convinced that they'll vote for it. Which means it might be tough to pass in the U.S. House of Representatives. (Eaton, 4/28)

And in California --

Sacramento Bee: ‘Trump Rates’ Or Obamacare Rates? Health Plans Can Send Both To California Regulators
When California health insurance companies begin setting 2018 rates, they’ll be able to offer two different projections without committing to either one. Insurance Commissioner Dave Jones is inviting the 15 or so health insurance providers the state regulates to draw up rates based on different scenarios centered on how the Trump administration enforces the Affordable Care Act. (Ashton, 4/28)

California Healthline: Running Short On Time, Covered California And Insurers Seek Obamacare Answers From GOP
With a major deadline looming, California’s health exchange and a key insurer pressed Republican leaders in Washington to clear up confusion over their commitment to key provisions of the Affordable Care Act. Health insurers participating in the Covered California exchange for individuals and families must submit initial rates for 2018 on Monday. Peter Lee, the exchange’s executive director, warned in a conference call Thursday that rates could jump by more than 40 percent if the Trump administration and Republican-led Congress walk away from crucial elements of the health law. (Terhune, 4/28)

The Washington Post: Lawmakers’ Questionable Stock Trades Prompt New Bill
Rep. Louise M. Slaughter introduced a bill Friday to close “ethics loopholes” in a five-year-old law that has failed to stop members of Congress from taking advantage of exclusive stock deals that are not available to the general public. Slaughter (D-N.Y.), a co-author of the 2012 Stock Act, said she decided that amendments to the law are needed because of controversial, discounted stock purchases that were made by Reps. Chris Collins (R-N.Y.) and Tom Price (R-Ga.), now the secretary of health and human services,  in 2015 and 2016. (Kindy, 4/28)

The Washington Post: The Therapeutic Fraud Prevention Act Of 2017 Was Introduced By Democrats In Congress
Democratic lawmakers this week introduced a bill that would ban the practice of “conversion therapy,” treatments that historically have targeted the LGBT community and claim to be able to change a person’s sexual orientation or gender identity. The Therapeutic Fraud Prevention Act of 2017 was introduced Tuesday by Rep. Ted Lieu (D-Calif.), along with Sens. Patty Murray (D-Wash.) and Cory Booker (D-N.J.). About 70 other members of Congress, all Democrats, have said they support the bill, which would allow the Federal Trade Commission to classify conversion therapy and its practitioners as fraudulent. (Wang, 4/27)

The Washington Post: Trump Appoints Antiabortion Champion To HHS Post
President Trump announced Friday that he will appoint Charmaine Yoest, one of the nation’s most prominent antiabortion ­activists, to a high-level post in the Department of Health and Human Services. Yoest, a former Reagan administration official who until last year was president of Americans United for Life, will serve as assistant secretary of public affairs. In that position, she will help develop a communications strategy for the sprawling agency that includes Medicaid, Medicare, the Affordable Care Act and family planning programs. (Somashekhar, 4/28)

Stat: Appointment Of Yoest At HHS Adds To Anti-Abortion Ranks
Yoest, formerly president and CEO of the law firm Americans United for Life, is currently a senior fellow at American Values, a conservative group that on its website laments America’s “culture of death.” She also spent three years as a policy analyst and then vice president of the Family Research Council, another advocacy group opposed to abortion rights. (Facher, 4/28)

Politico Pro: Anti-Abortion Activist Expected To Lead HHS Family Planning Agency
The Trump administration is expected to name anti-abortion activist Teresa Manning to oversee federal family planning funding, according to several sources familiar with the appointment. Manning, a law professor and former employee of two prominent anti-abortion groups, is expected to be named deputy assistant secretary for population affairs at HHS. (Haberkorn, 4/30)

And in Texas —

The Associated Press: Austin Abortion Clinic Reopens Following High Court Ruling
A medical provider whose legal challenge led the U.S. Supreme Court to strike down much of Texas' tough abortion law has reopened an Austin abortion clinic. Whole Women's Health reopened in the state capital Friday. It had been among roughly 20 abortion clinics that closed after Texas passed a law in 2013 requiring such facilities to make costly upgrades to meet the standards of ambulatory surgical centers. (4/28)

The Associated Press: Appeals Court Upholds Decision To Block Anthem Bid For Cigna
A federal appeals court on Friday left in place a decision blocking Blue Cross-Blue Shield insurer Anthem’s bid to buy rival Cigna, saying that a bigger company is not better for consumers. The 2-1 decision upholds a federal judge’s ruling in February that said the proposed $48 billion acquisition would further reduce competition in the already concentrated health insurance market. Anthem argued the combination would save $2.4 billion in medical costs and lead to lower consumer premiums. But the Justice Department said Anthem had no real plan to reach those savings. (Hananel and Murphy, 4/28)

Bloomberg: Anthem Loses Appeal To Overturn U.S. Block Of Cigna Takeover 
The decision is a likely final blow to Anthem’s bid to complete the $48 billion merger, which a lower-court judge had said should be stopped because it risked undermining competition in health-insurance markets. The two companies have since sued one another, with Cigna seeking a $1.85 billion breakup fee and Anthem blaming its rival for undermining its legal defense of the deal. (McLaughlin and Harris, 4/28)

Modern Healthcare: Anthem Loses Appeal To Seal $54B Cigna Deal
"We hold that the district court did not abuse its discretion in enjoining the merger based on Anthem's failure to show the kind of extraordinary efficiencies necessary to offset the conceded anticompetitive effect of the merger in the 14 Anthem states: the loss of Cigna, an innovative competitor in a highly concentrated market," the opinion, penned by Judge Judith Rogers, states. (Livingston, 4/28)

The CT Mirror: Appeals Court Blocks Anthem-Cigna Merger 
In a statement released late Friday Anthem said, “We are committed to completing the transaction and are currently reviewing the opinion and will carefully evaluate our options.” Anthem still has the option of trying to save the deal by asking the appeals court to re-consider the case or appealing straight to the U.S. Supreme Court. (Radelat, 4/28)

WBUR: As Opioid Epidemic Rages On, Massachusetts Medical Society Backs Supervised Injection Rooms
The Massachusetts Medical Society, representing 25,000 physicians and medical students, says it's time to try a new tool to stop overdose deaths: rooms where drug users would inject heroin or other drugs under medical supervision. The society's House of Delegates approved a pilot project of supervised injection facilities (SIFs) during the group's annual meeting Saturday..."I'm tired of losing my patients," said Dr. Mark Eisenberg, a primary care physician. (Bebinger, 4/29)

The Wall Street Journal: Opioid Epidemic Takes Its Toll On Camden
Police in Camden, N.J., are fielding more calls for overdoses than for homicides this year. Fatal opioid overdoses this year in the city of about 76,000 had surged to 35 as of Friday afternoon compared with 10 at the same point in 2016, and will likely eclipse last year’s 12-month total of 40 deaths within weeks, according to Police Chief J. Scott Thomson. “The pace is really alarming,” he said. (King and Kanno-Youngs, 4/29)

Cleveland Plain Dealer: Ohio's Spending On Opioid Addiction Treatment Drugs Vivitrol And Suboxone Spikes, Spurs Debate On What Treatments Work 
Judges, doctors and lawmakers on the front lines of the opioid addiction crisis have a problem: Three types of medications are available to help the estimated 200,000 Ohioans struggling to recover from addiction and yet there are no clear answers as to which, if any, drug works best. (Dissell, 4/30)

Richmond Times-Dispatch: As Overdose Death Toll Rises, VCU Program Tries To Help Pregnant Women Overcome Addiction
VCU launched a multidisciplinary pilot project last year aimed at helping pregnant women with substance use disorders overcome their addictions and prepare for motherhood. Through that program — which providers are now working to expand — Webb received medical assistance as well as extensive one-on-one and peer counseling. (Demeria, 4/30)

Meanwhile, a new documentary follows four people whose lives were destroyed by addictions that all began with legitimate prescriptions —

The Wall Street Journal: Unsparing Look At The Opioid Crisis In ‘Warning: This Drug May Kill You'
When director Perri Peltz’s son was diagnosed with a severe case of strep throat last year, his emergency-room doctor sent him back to college with 30 Percocet pills. Ms. Peltz couldn’t believe it. She had just begun filming “Warning: This Drug May Kill You,” a documentary about opioid addiction in the U.S. “If I hadn’t started working on this I might not have thought twice about the prescription,” Ms. Peltz says. “He was going back to a dormitory, and I realized that this moment in the ER was in a way ground zero for how opioid addiction can begin.” (Wolfe, 4/30)

NPR: Stroke Procedure Results In Miraculous Recovery For Some Patients
On July 17, 2014 Kurt Hinrichs, of Gladstone, Mo., went to bed early. As often happens, he woke in the middle of the night. When he tried to get out of bed, he crashed to the floor, which woke his wife, Alice. "At first it was like, 'What's going on?'" Alice says. "Are you dreaming? Are you sleepwalking?" Kurt wasn't responding to anything Alice asked him, so she called 911. "I [was] thinking, 'this is a nightmare,'" Kurt says. (Zhorov, 5/1)

The Washington Post: What Makes Someone Donate A Kidney To A Stranger?
Would you donate a kidney to someone you've never met? The idea is layered with soul-searching judgments — questions of risk and benefit, sacrifice and selfishness, not to mention the physical pain of the surgery itself. But a small number of people have done this, and researchers at Georgetown University are studying them, providing a window on altruism in a world seemingly dominated by a me-first philosophy. (Bernstein, 4/28)

The Philadelphia Inquirer/Philly.com: Surgeons Transplant Hep C-Infected Kidneys, Then Cure The Virus
It was a daring experiment aimed at expanding the supply of donor organs:  Transplant  kidneys infected with hepatitis C into uninfected patients, then give them a powerful new drug to banish the virus. The strategy worked flawlessly in separate pilot studies at the University of Pennsylvania and Johns Hopkins University, researchers reported Sunday at the American Transplant Congress in Chicago. The insidious virus was eradicated in all the kidney transplant recipients — 10 each at Penn and Hopkins — with a 12-week course of Zepatier. The maker, Merck, donated its $55,000 drug. (McCullough, 4/30)

NPR: Yo-Yo Dieting Could Be Harmful To The Heart
So-called 'yo-yo dieting' — where people lose weight and gain it back again – doubles the risk of a heart attack, stroke or death in people who've already got significant heart disease. That's the conclusion of an international study published recently in the New England Journal of Medicine. (Neighmond, 5/1)

NPR: U.S. Supply Of Yellow Fever Vaccine Will Run Out By Midsummer
Come July, the yellow fever vaccine could be tough to find. So, if you're traveling this summer to a place with the disease, you probably want to schedule a trip to a clinic sooner rather than later, the Centers for Diseases for Control and Prevention tells NPR. "Take heed of our warning: Plan ahead," says CDC spokesperson Tom Skinner. "It may be difficult to get this vaccine. And if you can't get it, then you should postpone your trip." (Doucleff, 4/28)

Los Angeles Times: Tea Made From Deer Antlers May Cause Botulism; Health Officials Issue Alert
Tea made from deer antlers may have sickened two Orange County residents with botulism, a serious illness caused by a bacteria that can cause paralysis, breathing difficulty and is potentially deadly. One adult has a confirmed case of botulism, and the other has a suspected case, the Orange County Health Care Agency said Friday. An investigation by the Los Angeles County Department of Public Health suggests the botulism illnesses may be connected with drinking deer antler tea obtained in March. (Lin, 4/29)

The Philadelphia Inquirer: Compulsory Flu Shots For Health Workers: How Far Should Policies Go?
Get an annual flu shot or get fired.That policy has become fairly standard in recent years at hospitals and medical facilities across the country. The need to protect patients from influenza overrides employees’ personal preferences, health officials say. But what about someone who isn’t in contact with patients, and isn’t even technically an employee? (McCullough, 4/28)

The Star Tribune: Mayo Looks To Shake Up Cancer Care With Single Test To Find Multiple Types
Mayo Clinic is in a race against itself on a project that could revolutionize cancer care, as two research teams pursue a “pan cancer” test that could detect the presence and severity of multiple types of the disease. On one side is Dr. David Ahlquist in Rochester and his partnership with Exact Sciences, which together already produced a home test for colon cancer known as Cologuard. (Olson, 4/30)

Columbus Dispatch: Birth-Certificate Insert Offers Tips On Safe Sleep, Pregnancy Spacing
As part of an ongoing effort to reduce preventable infant deaths, birth certificates in Franklin County now will be accompanied by information about safe sleep and how to space out pregnancies. It’s an initiative of Columbus Public Health and the Ohio Better Birth Outcomes collaborative, which are partners in the county’s CelebrateOne effort to prevent the deaths of babies who never reach their first birthday. (Viviano, 4/28)

The Washington Post: Waiting And Watching With ‘Stage 0’ Breast Cancer Put To Nationwide Test
Barbara Nickles and Ligia Toro de Stefani are both women in their early 60s who were diagnosed with abnormal cells in a breast, or Stage 0 breast cancer, as it’s sometimes labeled. Nickles decided to have a double mastectomy. Toro de Stefani opted for “active surveillance” and a twice-yearly battery of tests. “I wish I had breasts, but I am also happy they are gone so that I don’t have to worry so much about breast cancer,” says Nickles, whose grandmother had the disease. “Quality of life is the most important thing to me,” says Toro de Stefani, an avid traveler and scuba diver. (McGinley, 4/29)

In related news —

The Washington Post: You Just Learned You Have Breast Cancer. What’s Next?
Steven Katz, an internist at the University Michigan, researches how medical decisions are made. Over the last dozen years, he has surveyed 10,000 patients and their doctors to better understand how they discuss a diagnosis and decide to proceed. “Women have taught me a lot,” says Katz. Sorting out various options can be “very confusing and very tough.” He has distilled what he has learned and offers the following suggestions for women suddenly confronted with breast cancer. More than a quarter-million women in the United States are diagnosed with the disease every year. (McGinley, 4/29)

The Washington Post: Facing Pressure, More Schools Scramble To Confront Dangers Of Lead In Water
Tests last summer showed troubling levels of lead in the water at Summit Township Elementary School, perched on a quiet hilltop outside Butler, Pa. But for the next five months, no one told the parents of Summit’s 250 students. When officials alerted families to the potential lead contamination in January, the dominoes fell quickly. (Dennis, 4/30)

The New York Times: Most New York City Schools Had High Lead Levels, Retests Find
Last year, with fears about lead poisoning running high in the wake of the water crisis in Flint, Mich., New York City officials said that they had tested the water in all the city’s public schools and that the results should be reassuring: Only 1 percent of outlets had lead levels above the Environmental Protection Agency’s action level of 15 parts per billion. (Taylor, 4/28)

Stat: Feud Erupted Between CDC, Puerto Rico Over Reporting Of Zika Cases
US health officials have privately expressed deep concern that Puerto Rico is downplaying the extent of its Zika problem and have struggled to get a grasp on the issue because of a protracted and ugly dispute with health officials in the territory, according to a document obtained by STAT. The rift was so contentious that, at one point, health leaders in Puerto Rico refused to meet with their counterparts from the Centers for Disease Control and Prevention. The multipage document suggests that the dispute has obscured the extent of the territory’s Zika problem for more than half a year. (Branswell, 5/1)

California Healthline: Federal Money For State-Level Zika Tracking, Prevention May End This Summer, Worrying Health Officials
Money that has helped states with Zika tracking and education may come to an end by this summer, putting at risk efforts to better understand the mostly mosquito-borne virus and the devastating birth defects associated with it. The Centers for Disease Control and Prevention told state health officials in a meeting last month that Zika funding is running out and that additional support should not be expected, according to a news report. (Ibarra, 5/1)

Georgia Health News: Georgians With Disabilities Don’t Get Required Help To Renew Benefits, Suit Says 
Three Georgians with disabilities have filed a lawsuit alleging that state agencies have failed to provide accommodations to help them maintain their eligibility for food stamps and Medicaid. Thousands of Georgians with disabilities face a similar risk of a benefits cutoff, the lawsuit contends. (Miller, 4/30)

The Augusta Chronicle: State Improving But Concerns Remain About Care For Patients Moving Out Of Gracewood  
The state of Georgia is doing a better job of moving medically fragile developmentally disabled patients out of state hospitals such as the Gracewood wing of East Central Regional Hospital, a court-appointed observer said in a recent filing. But it is still not investigating and reporting deaths promptly when they occur, including one man who died just days after being moved from Gracewood, and it cannot follow its own procedures for reporting on and safeguarding those it deems at high risk of injury or death. (Corwin, 4/29)

The Oregonian: Oregon No. 1 In Hepatitis C Deaths Per Capita
In the hepatitis C epidemic across the country, Oregon is No. 1.Oregon has a higher hepatitis C death rate than any other state, national data published this week show. The state also has a high ratio of people infected with the virus, which can cause cirrhosis and cancer of the liver. Many don't know it...The data show that the overall U.S. rate is six deaths per 100,000 people from hepatitis C. But in Oregon, the death rate is 15 per 100,000 -- more than 500 people a year. (Terry, 4/28)

ProPublica: Independent Monitor Faults New York State For Delays In Aiding Mentally Ill 
Under the terms of a landmark settlement, the New York State Department of Health in 2014 was ordered to assess and then relocate residents of many of the state’s scandal-scarred adult homes — facilities that had for years been warehousing the mentally ill in squalid and often violent conditions... Earlier this month, in the latest critical report, the monitor warned that the relocation process had bogged down in delays, with the number of residents stuck in the assessment phase nearly doubling, many of them for months on end. (Sapien, 4/28)

WBUR: Brigham And Women's Hospital Offers Buyouts. Here Are Some Forces Behind Them 
The offer arrived Thursday morning in the inbox of all staff at Brigham and Women's Hospital, the state's largest maternity hospital. Those 60 or older would be eligible for a voluntary buyout the hospital plans to finalize by late July. (Bebinger, 4/28)

Des Moines Register: Mercy Iowa City Joins Statewide Health Network
Mercy Iowa City officials announced recently that the hospital has entered into a strategic affiliation agreement with with the statewide Mercy Health Network, headquartered in West Des Moines. In a statement released Friday afternoon, hospital officials report that the agreement will allow Mercy Iowa City to retain its name and local control. The new affiliation, which takes effect June 1, also gives the Iowa City hospital access to the Mercy ACO, the largest accountable care organization in the state.  (Berg, 4/28)

The New York Times: Lincoln Center To Host Theater Festival For Autistic Audience
While many theater productions are driven by showy visuals, loud bangs and huge plot twists, Lincoln Center’s new Big Umbrella Festival is striving to deliver the exact opposite. The monthlong festival, coming in April 2018, is designed to cater to children on the autism spectrum. The festivals organizers hope to educate and inspire, and to make theater a safe space for those who may have previously found it less than inviting. (Chow, 4/28)

Sacramento Bee: CA Assembly Speaker Talks Single-Payer Health Care, Donald Trump
Assembly Speaker Anthony Rendon, D-Paramount, visited The Bee Capitol Bureau on Wednesday to discuss some of the biggest issues facing the California Legislature this year. Here’s what he had to say. (Koseff, 4/28)

Los Angeles Times: The Amputation Rate For Diabetics In Poor Areas Is High. This Boyle Heights Clinic Is Trying To Change That
Maria Valdez didn’t have a lot of options. A wound on her foot that had become infected wasn’t healing because of her diabetes. She started using a wheelchair to get around. A year and a half ago, it seemed likely she was going to lose part of her leg. On a recent weekday, Valdez lay on a bed in a clinic in Boyle Heights. Her doctor, Stanley Mathis, pulled off her sock and lifted her foot toward the ceiling. The heel, which once was so decayed he could see the white of the bone, was now covered in smooth skin. (Karlamangla, 5/1)

Nashville Tennessean: Unhealthy Workers Cost Nashville Businesses $500M
The impacts on productivity from workers with diabetes, hypertension and obesity cost Nashville-area businesses $500 million annually, a new study reveals. The financial drag of absenteeism and "presenteeism" (coming to work with reduced energy and output due to being unwell), coupled with costs of medical treatment, promise to be an impediment to the future economic vitality, according to the Nashville Area Chamber of Commerce's study. The study is a follow-on to a a 2015 report that compared Nashville to peer cities on a variety of health and behavior measures. (Fletcher, 4/30)

Milwaukee Journal Sentinel: Milwaukee Health Systems To Propose Mental Health Hospital
Three nonprofit health systems in the Milwaukee area plan to present a joint proposal next week to replace the Milwaukee County Behavioral Health Division’s acute-care psychiatric hospital in Wauwatosa. The three health systems are Ascension Wisconsin, Children’s Hospital of Wisconsin, and Rogers Behavioral Health. (Boulton, 4/28)

Des Moines Register: Des Moines Man's Disability Payments Falter During Feds' Probe
Roughly 15 million Americans receive Social Security Disability. That number has skyrocketed over the past 30 years in part because of an aging population, but also because Congress has expanded the kinds of disabilities, like pain and mental illness, eligible for benefits. Fraud has grown along with those numbers, but no one knows how much. Last week, the assistant deputy commissioner at the Social Security Administration’s budget office told the U.S. House’s Ways and Means Committee he could not estimate how much fraud takes place. (Rood, 4/30)

Denver Post: Live-Donor Liver Transplant Saves Girl At Children's Hospital Colorado
At 3, Peri [Erikson] hasn’t been hitting the gym, but she’s definitely feeling stronger. On March 21, she underwent a liver transplant at Children’s Hospital Colorado that has helped solve medical problems that began at birth with her diagnosis of biliary atresia, a rare and life-threatening disease of the liver and bile ducts. And though her condition wouldn’t have placed her high on the list of patients seeking potential deceased liver donors, Peri took a different route. She found a living donor — and she didn’t have to look far. (Simpson, 5/1)

Richmond Times-Dispatch: Economic Impact: Health Care And Retail Jobs Will Be In Demand During The Next 10 Years
What jobs will be in hot demand in the Richmond region during the next decade? Jobs in the health care and social assistance sector and in the retail industry top the list. For instance, the health care and social assistance sector is expected to need nearly 40,000 workers in the Richmond metro area over the next decade, according to Chmura Economics & Analytics’ JobsEQ technology platform. (Chmura, 4/30)

The Philadelphia Inquirer/Philly.com: Philadelphia Jury Awards $20M To Cinnaminson Woman In Pelvic-Mesh Trial
A Philadelphia Common Pleas Court jury has awarded $20 million to a Cinnaminson woman who charged that a vaginal-mesh product made by Johnson & Johnson failed to work as advertised, caused her chronic pain, and necessitated multiple corrective surgeries. The award Friday — which included $17.5 million in punitive damages — followed a three-week trial in which the victim’s lawyers argued not only that the mesh was defective, but that Johnson & Johnson and its subsidiary Ethicon had concealed the risks of the product even as they were marketing it. (Mondics, 4/28)

The Associated Press: California Seeks Control Of Unruly Medical Pot Industry
California is trying to get control of its unruly medical marijuana industry. State regulators released draft regulations Friday intended to impose order on the loosely organized marketplace created over two decades ago. The proposal would establish the first comprehensive rules for growing, testing, transporting and selling medical pot in the state that is home to 1 in 8 Americans. (Blood, 4/28)

Milwaukee Journal Sentinel: HPS Unites, Simplifies Patients' Medical Bills
Health Payment Systems provides its service, which is sold by insurance brokers, to employers who self-insure, or pay most of the medical bills of employees and their family members. That includes most employers with 200 or more employees, as well as many smaller employers. (Boulton, 4/29)

Boston Globe: Fifteen People Taken To Hospital After Possible Chemical Spill At Malden Healthcare Facility
Seventeen employees at a Malden healthcare facility were treated at local hospitals Friday after a hazmat team was called to the building to investigate complaints of a chemical smell, according to authorities. All of the workers had been released by Friday night, but authorities said they were still trying to determine what triggered the incident. (Gans and Corpuz, 4/28)

The Charlotte Observer: Another Obamacare Repeal Fail - Or Is It?
It seemed unlikely that U.S. House Republicans could propose something worse than the American Health Care Act, the Obamacare replacement that collapsed under its own unpopularity just weeks ago. It seemed implausible that Republicans would craft a bill that took the parts of the AHCA that were awful for Americans – higher premiums and deductibles plus 24 million fewer people getting insurance coverage – and make something even harsher. And yet, House Republicans did exactly that last week. (4/29)

Vox: An Interview Suggests Trump Doesn't Know What's In His Health Bill
[John] Dickerson is the first journalist I have seen grill Trump on what, exactly, is in the Republican plan. He isn’t asking about the politics of the bill and whether it will pass. Rather, he focuses on what are arguably basic questions: what elements are in this bill, and what do you think of them? Trump stumbles. He says that people with pre-existing conditions will be protected. Under the latest amendment to the American Health Care Act — the one that got the Freedom Caucus on board — they won’t be. He says that deductibles will go down under the Republican plan. Non-partisan analysis expects deductibles would go up. (Sarah Kliff, 4/30)

The Huffington Post: Trump Still Thinks Obamacare Repeal Will Cover People ‘Beautifully’
That bill would definitely help some people ― in particular, younger, healthier and wealthier people who buy insurance on their own today and end up paying high prices because they get little or no financial assistance from the Affordable Care Act. But the proposal would cause real hardship for many millions of Americans ― whether by raising their premiums or deductibles or both, or depriving them of coverage altogether. And it’d be the poor and the sick struggling the most, even as the wealthiest Americans walked away with a sizable tax break. (Jonathan Cohn, 4/30)

Los Angeles Times: Crowdfunding For Medical Expenses Is Rising — When It Should Be Eradicated
It should be obvious as a fundamental principle that in a civilized country, crowdfunding for direct medical expenses should be utterly unnecessary. You get sick or injured, your medical care should be covered by the community at large. Yet public appeals by families or individuals for help paying basic medical bills seem to be on the rise in the United States. Crowdfunding websites such as GoFundMe.com report that medical expenses rank as their largest single category of appeals; other sites such as HelpHopeLive have sprung up specifically for medical expense appeals. (Michael Hiltzik, 4/28)

The Wall Street Journal: Personalized Medicine Is Here
The Food and Drug Administration recently approved 10 of the personal-genomics company 23andMe’s screening tests for genetic health risks, including one for Alzheimer’s and one for a rare blood disorder. The decision represents a turning point in the democratization of personalized medicine. It’s also a turnaround for the FDA, which had pulled the tests from the market in 2013. The company had blamed itself for that episode, admitting that it failed to follow up on promised communications with agency staff. (Peter Huber and Paul Howard, 4/30)

KevinMD: Telemedicine: A Cure For Physician Burnout?
At the end of my daughter’s first week of preschool, she came home with a burning question: “Mom, my friend at school says that she has two days in a row when she and her mommy and daddy are all home at the same time. They call it a weekend. Will we ever have a weekend?” I was floored. That simple question encapsulated the only life she had known as a doctor’s daughter. In the four years since she was born, she had never had a consistent, secure time when I would be home. I had her while I was still in residency, and 80-hour workweeks were more common than 40-hour ones. When I graduated from residency, in an effort to spend more time with my family, I took a shift work position in a hospital. Working 12- and 24-hour shifts meant that I could be home on my off days, but it also meant that nights, weekends, and holidays were all fair game. In addition, driving to the hospital required significant commuting time; my drive home after a 24-hour shift could easily be over an hour, compounding my exhaustion. (Sylvia Romm, 4/29)

The Des Moines Register: Wellmark Abandons Iowans Instead Of Working To Fix Health Care
An April 4 Des Moines Register headline announced, “Wellmark leaving market.” The accompanying article stated more than 21,000 Iowans who bought health insurance policies from the company in the past three years will need to find another carrier. I would like to put a face on one of those 21,000. Here is my story. (Karen DeHaven, 4/30)

Cleveland Plain Dealer: Deficiencies In Ohio Nursing-Home Inspections Must Be Addressed
[A]s The Plain Dealer's John Caniglia and Jo Ellen Corrigan recently reported after a monthslong investigation, Ohio's nursing homes don't measure up, ranking well below national averages in quality of care. Not only did federal officials recently rate two of every five Ohio nursing homes substandard but at least 31 Ohio nursing home deaths in the last three years have been attributed by federal officials to issues of care. There could be many reasons for this. Some in the industry say it's because of the challenges of caring for the sickest in skilled nursing facilities. But Caniglia and Corrigan also have found that Ohio is fourth worst in the United States (tied with Massachusetts) in terms of the average interval between inspections of the same nursing facility. (4/30)

Los Angeles Times: To Right Their Political Ship, Democrats Need To Welcome Pro-Life Liberals
The Democratic Party is in serious trouble. It has lost more than 900 state legislative seats, 12 governors, 69 House seats and 13 Senate seats over the last decade, and a recent poll indicates that it has a lower approval rating than President Trump. To right this political ship, it must recapture pro-life liberals such as my mother, who was a loyal Democrat until 1996, when President Clinton vetoed the bill banning partial-birth abortions. (Janet Robert, 5/1)

The Chronicle of Social Change: Pregnant Women, Newborns On Front Lines Of Arizona’s Opioid Epidemic
When Jessica Sanchez tested positive last year for heroin, her probation officer sent her to an Arizona detox center for treatment. But before Sanchez could be admitted, she needed to take a pregnancy test. That’s how Sanchez, 25, discovered she was expecting her first child. She was four and-a-half months pregnant and had been abusing heroin for four years, following two years of opioid pain pill abuse. The surprise pregnancy gave Sanchez a deep desire to get clean. (Jonathan Polakoff, 4/26)

San Jose Mercury News: Alzheimer's Research Endangered By Trump Budget Cut
Today, Alzheimer’s ranks as the 6th leading cause of death in the U.S. In California, 630,000 have the disease and it is estimated that the number will grow to 840,000 by 2025. ... Cuts to our scientific institutions will harm us all, but the NIH is one of our best resources for responding to the Alzheimer’s epidemic. (Diana Hull, 4/30)

The Chronicle of Social Change: Pregnant Moms Face Generations Of Poverty And Addiction In New Mexico
From 2004 to 2013, the proportion of infants born exposed to drugs — mainly opioids — increased nearly sevenfold in rural counties, almost double the increase in urban areas, according to a study published in JAMA Pediatrics in 2017. While the rate of drug-exposed babies born in New Mexico soared, so did the number of children entering foster care, which rose 16 percent from 2012 to 2015. Though seemingly connected, the correlation between pregnant moms struggling with addiction and children entering the foster care system is difficult to untangle in a majority rural state plagued by cycles of poverty and addiction. (Zachary Siegel, 4/27)

WBUR: How Yogurt Science Could Lead To A Cure For Sickle Cell Anemia 
A very few people with sickle cell anemia have successfully been cured with a transplant. ... But there is basic research going on right now -- here in Boston and in labs across the United States and around the world -- that has the potential to revolutionize how we treat sickle cell anemia. (Julie Losman, 4/28)