The Wall Street Journal: Trump Threatens To Withhold Payments To Insurers To Press Democrats On Health Bill
Nearly three weeks after Republican infighting sank an overhaul of the Affordable Care Act, President Donald Trump dug back into the battle on Wednesday, threatening to withhold payments to insurers to force Democrats to the negotiating table. In an interview in the Oval Office, Mr. Trump said he was still considering what to do about the payments approved by his Democratic predecessor, President Barack Obama, which some Republicans contend are unconstitutional. Their abrupt disappearance could trigger an insurance meltdown that causes the collapse of the 2010 health law, forcing lawmakers to return to a bruising debate over its future. (Bender, Radnofsky and Nicholas, 4/12)

Bloomberg: Trump Threatens Health Subsidies To Poor To Force Talks 
Those payments to lower-income people, called cost-sharing-reduction subsidies, have been at the center of an almost three-year legal battle between Republicans and Democrats. The payments are used to help poorer people in Obamacare afford copays and other cost sharing for medical services. Without them, they might not be able to afford to get care. Trump’s administration has threatened to stop making the payments. (Pettypiece and Tracer, 4/12)

Politico: Trump Dangles Obamacare Payments To Force Dems To The Table
Democrats are adamant that they won’t negotiate on subsidies, which lower medical costs for nearly 7 million Obamacare customers. “Failing to make these payments would be a direct effort by the administration to further undermine the health care system in this country, putting care for millions of Americans at risk,” said Matt House, a spokesman for Senate Minority Leader Chuck Schumer. "President Trump has an obligation to drop his attempts to repeal the Affordable Care Act, and instead work with Democrats to strengthen it.” (Diamond and Dawsey, 4/12)

Meanwhile, industry groups warn of the dangers of getting rid of the subsidies —

Morning Consult: Health Groups Warn Of Higher Costs If ACA Subsidies Not Financed
A coalition of eight health groups is making a direct appeal to the Trump administration and congressional leaders to fund the Affordable Care Act’s cost-sharing reductions for this year and next, calling it “the most critical action” that could be taken to stabilize health insurance exchanges. The future of the payments has been a source of uncertainty for insurers, who are preparing their policy proposals for the ACA exchanges in 2018. (McIntire, 4/12)

The Hill: Leading Healthcare Groups Urge Trump To Fund ObamaCare Payments 
Leading healthcare industry groups are urging Republicans to fund key ObamaCare payments that could lead to chaos if discontinued. Groups including America’s Health Insurance Plans, the American Medical Association, and the American Hospital Association wrote letters to President Trump and congressional leaders saying the payments, known as cost-sharing reductions should continue. (Sullivan, 4/12)

McClatchy: Industry Groups Push Trump’s HHS And Congress To Fund Marketplace Subsidies
“Without funding of the (cost-sharing reductions) by Congress and the administration, there could be a ripple effect in the individual insurance market raising coverage costs for everyone,” said a statement by Chip Kahn, President and CEO of the Federation of American Hospitals. (Pugh, 4/12)

USA Today: Freedom Caucus Leader Brat Predicts Health Care Passage Within Weeks
Rep. Dave Brat, one of the conservative Freedom Caucus leaders whose resistance helped undermine the Republican health care proposal last month, says White House and congressional negotiators are close to a compromise that he predicts will pass the House in the next three weeks. “Within a few weeks, I think D.C. is going to be a little bit shocked,” he said in an interview with Capital Download. “We’re going to get to yes.” (Page, 4/12)

Des Moines Register: Rod Blum: Congress Will Act On Health Care This Year
Efforts to reform the health care law known as Obamacare are ongoing in Washington and will result in a plan to lower insurance premiums for Iowans, U.S. Rep. Rod Blum pledged on Wednesday. Blum, the Republican representing northeastern Iowa, was a “no” vote on the GOP proposal offered as a replacement to the Affordable Care Act and then abandoned last month when it became clear it would not pass. On Wednesday, he couched that opposition largely as a disagreement over process: the bill was advanced too quickly with insufficient debate, he said, and ultimately did too little to reduce premiums for people who get health care through their employer. (Noble, 4/12)

The Associated Press: Conservative Group's Health Ads Slam Top GOP Lawmakers
The conservative Club for Growth is targeting powerful committee chairmen and other top Republicans, part of an aggressive ad campaign to rally support for the GOP's struggling health care overhaul effort. The television and digital ads, unveiled earlier this week, pressure Republicans to a back a revised version of the GOP health care bill that Speaker Paul Ryan abruptly withdrew last month because it lacked the votes. (4/13)

CQ Roll Call: Conservative Group Takes Aim At GOP Lawmakers On Obamacare
The conservative Club for Growth is set to launch on Thursday a new series of digital ads targeting Republican lawmakers who it says do not support a revised plan to repeal and replace the 2010 health law backed by the White House and the House Freedom Caucus. The campaign — the second in a series funded by the anti-tax group — is aimed at 10 House GOP members, including Energy and Commerce Chairman Greg Walden of Oregon, Appropriations Chairman Rodney Frelinghuysen of New Jersey, and Ways and Means Health Subcommittee Chairman Pat Tiberi of Ohio. (Williams, 4/13)

Politico: Coffman Pummeled At Town Hall For Backing GOP Obamacare Replacement
During a roughly two-hour town hall here on the outskirts of Denver Wednesday night, nearly every other constituent brought up health care. But not a single one did it to thank Rep. Mike Coffman for backing the beleaguered House GOP Obamacare replacement. Instead, dozens of local inhabitants in this swingiest of swing districts — both Democrats and Republicans — pummeled the Colorado Republican for supporting legislation they believe would harm their community. (Bade, 4/13)

The Associated Press: Iowa Voters Credit GOP Lawmaker For Opposing Health Bill
Rebuffing President Donald Trump and Republican leaders on the GOP health care bill seemed like a major political misstep for Iowa Rep. David Young, who quickly was punished by a political action committee linked to Speaker Paul Ryan. Nearly three weeks later, voters in Young's southwestern Iowa district — Republicans and Democrats — say the GOP congressman made the right move. (4/13)

Politico Pro: Walden Faces A Testy Crowd At Eastern Oregon Town Hall
In his first town hall following the meltdown last month of the GOP’s health bill, Oregon Rep. Greg Walden kept his cool, but got a contentious reception Wednesday in The Dalles in Trump country’s eastern Oregon. Walden, who in his role as chairman of the House Energy and Commerce Committee was instrumental in drafting the failed American Health Care Act, remains committed to trying to “fix” health care, an effort the GOP has made clear it's not abandoning and continues to discuss. (Colliver, 4/12)

The Philadelphia Inquirer/Philly.com: MacArthur Defends Support Of GOP Health-Care Bill, Calls Critics 'Dishonest'
The lone New Jersey congressman to support the failed GOP health-care bill, Rep. Tom MacArthur, defended his efforts Wednesday, accusing activists and interest groups targeting him of dishonesty...MacArthur, who represents the Third District, covering parts of Burlington and Ocean Counties, referred to advertising launched this week by Save My Care. The group, which opposes repealing the Affordable Care Act, is spending $200,000 on television advertising targeting him, MacArthur’s office said. MacArthur called the ad’s characterization that he “isn’t fighting” to protect coverage for preexisting conditions “a blatant falsehood” and noted that he had also been targeted by the conservative Club for Growth. (Hanna, 4/12)

The (Baton Rouge, La.) Advocate: Poll: Louisiana Residents Largely Support Medicaid Expansion But Find 'Obamacare' Unfavorable
Nearly three-fourths of Louisiana residents approve of the state's decision to expand Medicaid, a new poll suggests, even as President Donald Trump, who remains widely popular in the state, continues his quest to repeal the federal Affordable Care Act that made expansion possible. The 2017 Louisiana Survey's findings on health care suggest a disconnect in the relationship between Medicaid health care coverage and the ACA. While even a majority of Republicans (51 percent), and most Democrats (91 percent) and independents (73 percent) support the expansion of the health care program for the poor, which Gov. John Bel Edwards implemented last year after taking office, more than half of the state has an unfavorable opinion of President Barack Obama's signature health care law. (Crisp, 4/11)

New Orleans Times-Picayune: Poll: Louisiana Residents Like Medicaid Expansion But Not Obamacare 
LSU pollsters experimented with describing the law as Obamacare when referring to Medicaid expansion and found that fewer people approved of Medicaid when it was explained that way. Even so, pollsters found that the number of people who disapprove of the Affordable Care Act is shrinking. In 2014, 58 percent of people disapproved of the law. In 2017, that number fell to 51 percent. Also, the share of people who approve of the law increased 11 points. (Litten, 2/12)

North Carolina Health News: A 'Unique' Plan For Expanding Insurance Coverage 
For four years Republicans at the North Carolina General Assembly have, as a body, staunchly refused to consider Medicaid expansion. But on Tuesday morning, four House Republicans outlined a way to increase health insurance access for people who have fallen into the Medicaid “gap” – they make too much to qualify for Medicaid outright and too little to qualify for insurance subsidies offered through the Affordable Care Act. ... In broad language, House Bill 662 seeks to build on the ability to draw federal funding for expanding the Medicaid population to North Carolina. The bill’s sponsors propose using those funds to pay for more than 90 percent of the cost, the remainder would come from assessments to hospitals around the state and some amount in the form of premiums totaling 2 percent of a beneficiary’s annual income. (Hoban, 4/12)

Tampa Bay Times: Another Shot At Medicaid Expansion In Florida, But Same Result
It was already pretty clear politically that the Florida Legislature wasn't much in the mood to expand Medicaid, especially while national Republicans have been try to dismantle the Affordable Care Act. For two years the Florida Senate has considered the idea, only to see the Florida House block them each year. But there were Democrats in the Florida Senate on Wednesday giving it one more effort to convince Republicans who control the Legislature to once again pass an expansion of Medicaid to cover 800,000 Floridians that currently don’t have health care coverage. ... It failed. (Wallace, 4/12)

Kaiser Health News: As Some Holdout States Revisit Medicaid Expansion, New Data Show It Pays Off
Although the GOP-controlled Congress is pledging its continued interest — despite stalls and snags — to dismantle Obamacare, some “red state” legislatures are changing course and showing a newfound interest in embracing the health law’s Medicaid expansion. And a study out Wednesday in Health Affairs adds to these discussions, percolating in places such as Kansas, Georgia, Virginia, North Carolina and Maine. Thirty-one states plus the District of Columbia already opted to pursue the expansion, which provided federal funding to broaden eligibility to include most low-income adults with incomes up to 138 percent of the federal poverty level (about $16,000 for an individual). (Luthra, 4/12)

And in Medicaid news from Kansas —

Kansas City Star: UnitedHealthcare Hires New Leaders For KanCare, Private Plans
UnitedHealthcare hired new CEOs to run its KanCare plan and its private-sector employer and individual health insurance plans this month. UHC hired Kevin Sparks to lead its Community Plan of Kansas, which covers about 130,000 Kansans on Medicaid. UHC is one of three companies Kansas contracted with starting in 2012 to administer Kansas Medicaid, which was rebranded “KanCare.” (Marso, 4/12)

Stat: On The New FDA Chief’s Agenda: A Bipartisan Bill To Regulate Diagnostic Lab Tests
One of the first big issues Scott Gottlieb will have to weigh in on if confirmed as Food and Drug commissioner is what to do about the booming field of diagnostic tests. Gottlieb, a physician and libertarian scholar, has been lukewarm on whether to regulate in vitro clinical tests, a category that includes finished products such as test kits and platforms as well as laboratory developed tests (LDTs), which are lab protocols used for diagnostics. (Kaplan, 4/12)

Modern Healthcare: Bill Looks To Address Dearth Of Underserved Areas With Foreign Doctors
A bipartisan group of senators wants to address the need for doctors in rural and poor areas by increasing the number of foreign physicians allowed to practice in the U.S.This week, Sens. Amy Klobuchar (D-Minn.), Susan Collins (R-Maine), and Heidi Heitkamp (D-N.D.) re-introduced legislation that would expand the number of physicians who could participate in the Conrad Waiver 30 program. (Johnson, 4/11)

Nashville Tennessean: Can Tennessee’s U.S. Senators Help Healthcare Consumers?
A new bill filed by U.S. Senators Lamar Alexander and Bob Corker could give some relief to Tennesseans who are facing a bleak individual health insurance market in 2018. Called “The Health Care Options Act of 2017,” the bill aims to do two things. First, it aims to waive the federal penalty for individuals who don’t get qualified coverage because no carrier offers it on the exchange in their county. Second, it aims to allow individuals to apply any federal subsidy for which they qualify to non-qualified and off-exchange health plans. It is not a coincidence that this bill is sponsored by the senators from Tennessee. The dynamics of the individual health insurance market in Tennessee are extremely challenging right now and the state is at risk of not having any options on the exchange at all in 2018. (Tolbert, 4/12)

Stat: How A Low-Level Drug Dealer Caused Two Dozen Overdoses
Last May, a low-level drug dealer named Bruce Griggs was released from an Ohio prison. He had served a short sentence stemming from a possession conviction so routine that his former defense attorney would later have trouble recalling it. Just three months later, though, Griggs would travel 250 miles to Huntington, W.Va., where he would distribute opioids that, in a span of a few hours, triggered two dozen overdoses, overwhelming the city’s emergency response system and serving as a stark symbol of the nation’s opioid crisis. (Joseph, 4/12)

Modern Healthcare: Trump's Rumored Pick For Drug Czar Panned By Addiction Experts 
President Donald Trump is expected to nominate U.S. Rep. Tom Marino of Pennsylvania to lead the nation's efforts to curb drug addiction, according to news reports. Addiction experts immediately panned the pick, saying Marino's legislative history shows preference for drugmakers. ... Marino was elected to the House in 2010. He represents a mostly rural district in central and northeastern Pennsylvania.  A former U.S. attorney, Marino introduced the bipartisan Ensuring Patient Access and Effective Drug Enforcement Act, which was signed by President Barack Obama in 2016.  The law is supposed to foster greater collaboration between law enforcement and drug companies, pharmacies and distributors in an effort to allow offenders to correct their situation before their rights to distribute opioids are suspended or revoked. (Johnson, 4/12)

And in the states —

Cleveland Plain Dealer: Kasich's Push For Opioid Addiction Research Doesn't Address Immediate Needs, Critics Say
A new state effort to boost technology targeting Ohio's opioid crisis could curb future addiction and overdose deaths, but reaction is mixed as to whether it's the best way to solve the problem. Gov. John Kasich announced last week that up to $20 million will be earmarked for possible solutions through the Ohio Third Frontier, which awards grants to projects that bring research to market. (Borchardt, 4/12)

Columbus Dispatch: Fentanyl Keeps Drug-Overdose Deaths Soaring In Franklin County
About two people a day are dying from drug overdoses in Franklin County, as fatalities from the highly potent and deadly synthetic opioid fentanyl doubled last year. First responders are dispensing dozens of doses a week of a lifesaving drug, averting an even-higher toll. (Johnson and Candisky, 4/12)

St. Louis Public Radio: Fentanyl-Related Deaths Surge Across St. Louis Region
Fentanyl, a synthetic opioid painkiller, made up almost half of drug overdose deaths in parts of the St. Louis region last year, according to county coroners in Missouri and Illinois. The drug is up to 50 times more powerful than heroin, and inhaling just a few grains can be lethal. (Bouscaren, 4/13)

The Washington Post: Risk Of A Rare But Deadly Mouse-Borne Virus Increases In The Spring
As the weather warms and people turn to spring-cleaning and outdoor activities such as camping and hiking, they need to beware of a rare but deadly virus that is spread through mouse droppings and kills up to 40 percent of people who become infected, public health officials said. (Sun, 4/12)

Stat: Petition To FDA: Get The Lead Out Of Consumer Hair Dyes
Back in 1980, when the Food and Drug Administration approved the use of lead acetate in hair dyes, little was known about the way skin absorbs toxic chemicals. The skin — and the scalp in particular — were considered tough barriers to break, and many public health officials believed that even if small amounts of lead got through, or were inhaled, it couldn’t really hurt anyone. But in science, 37 years is an eon. So a coalition of environmental groups, academics, and consumer advocates is pushing FDA to take lead acetate off the market. It is now permitted as a color additive. (Kaplan, 4/12)

The Baltimore Sun: Encouraging Mom And Baby Bonding In The NICU 
Premature babies with health problems often end up in neonatal intensive care units and separated from their mothers. This once standard practice can be emotionally taxing on mothers and, doctors say, it may not be the best care option for babies. The babies often stay in the hospital long after their mothers are discharged, which means parents have to travel back and forth to see their children. Intensive care units for babies are often in tight quarters with little privacy, making it hard for bonding between mom and child. (McDaniels, 4/13)

Cincinnati Enquirer: Giving Parental Hope: Raising Infertility Awareness
According to the most recent National Survey of Family Growth conducted by the Center for Disease Control, one in eight couples have trouble getting pregnant and suffer some form of infertility. About 6.9 million or 11.9 percent of all women receive some form of infertility treatment in their lifetime. Infertility is defined by RESOLVE: The National Infertility Association as the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive. (Reinert, 4/12)

Iowa Public Radio: ISU Researchers Find Evidence Media Violence Affects Aggressive Behavior Across Cultures
Media violence researchers at Iowa State University published a study this month that finds media violence affects aggressive behaviors across a variety of cultures. More than 2,100 participants from Australia, China, Croatia, Germany, Japan, Romania and the U.S. named three of their most frequently-watched or played TV shows, movies or video games, and then rated how often they used each title. (Boden, 4/12)

The Associated Press: Trans Fats Ban Linked With Fewer NY Heart Attacks & Strokes
Local bans on artery-clogging trans fats in restaurant foods led to fewer heart attacks and strokes in several New York counties, a new study suggests. The study hints at the potential for widespread health benefits from an upcoming nationwide ban, the authors and other experts say. The U.S. Food and Drug Administration in 2015 gave the food industry until next year to eliminate artificial trans fats from American products. (Tanner, 4/12)

Stat: Banning Trans Fats In New York Prevented Thousands Of Heart Attacks, Study Finds
Trans fats, or partially hydrogenated oils, have long been tied to heart disease risk. And starting next summer, the Food and Drug Administration will prohibit food manufacturers from adding trans fats to foods like cookies, crackers, and microwave popcorn...Between 2007 and 2011, 11 counties in the state — most of them in the greater New York City area — banned restaurants from preparing food with partially hydrogenated oils. Using population estimates and state department of health data, a research team looked at the number of hospitalizations for heart attack or stroke in counties that implemented these laws compared to counties that didn’t. (Samuel, 4/12)

In other heart health news —

Minnesota Public Radio: Study: Most Major Heart Attacks Not Linked With High Cholesterol
A new Minneapolis Heart Institute Foundation study found most major heart attacks happen to people with normal cholesterol levels. Researchers studied more than 1,000 heart attack patients, analyzing their cholesterol, other risk factors, and medical history. Half of them had not seen a doctor in at least two years prior to suffering a heart attack. (Zdechlik, 4/12)

The Star Tribune: Minneapolis Heart Attack Study Finds Surprising Trend Among Victims
A group of Minneapolis cardiologists is recommending that more people take statin medications after a review of more than 1,000 heart attack victims found a high number who weren’t taking the cholesterol-lowering drugs. Among patients in the study group who suffered their first heart attacks, only one in five were taking statins — meaning that many were defying the latest guidelines about who should be taking the medications, according to the cardiologists’ research, which was published in the latest edition of the Journal of the American Heart Association. (Olson, 4/12)

The Associated Press: Running Behind: Marathons May Delay Medical Care For Others
Marathons can be risky for hearts, but not necessarily those of the runners. It takes longer for nearby residents to get to a hospital for emergency heart care on the day of a race and they’re less likely to survive, a U.S. study finds. Any event that draws a crowd and causes traffic detours — parades, ball games, concerts, fairs — may cause similar problems, researchers warn. (Marchione, 4/12)

The Wall Street Journal: Marathons Can Be Dangerous For The Elderly—Who Aren’t Even Running
The research, published in the New England Journal of Medicine, found ambulances took 4.4 minutes longer, on average, to get elderly patients to the hospital before noon on marathon day during the 11 largest U.S. marathons, compared with travel times in the weeks before and after the races. Ambulances didn’t experience similar delays on the evenings of marathon days, when roads typically reopen. (Evans, 4/12)

Boston Globe: Marathons May Be Risky — For People Who Live Nearby 
“City planners and emergency medical personnel should be aware of the unintended consequences that these kinds of events have,” said Jena, an associate professor of health policy at Harvard Medical School. “Most of the preparations are around making sure participants at events have a good experience and are safe. . . . We probably never thought of what happens to people who actually need to get to the hospital.” (Freyer, 4/12)

Stat: Virtual Reality Takes Doctors On A 'Fantastic Voyage' Inside Hearts
Stanford University offers doctors a “room” with a unique view — the inside of an infant’s beating heart, valves opening and closing, blood cells rushing past. (Well, it’s unique if you discount the campy 1966 sci-fi thriller, Fantastic Voyage.) The virtual reality project tackles what has always been a major challenge for medical trainees: how to visualize a heart in action in three dimensions. Through VR goggles, they can now travel inside the heart and explore congenital heart defects as if they have been shrunken to the size of a peanut. (Piller, 4/13)

The Washington Post: Self-Funded Team Led By An ER Doctor Wins ‘Star Trek’-Inspired Competition
A seven-member, self-funded team consisting of four siblings won the international X Prize tricorder consumer medical competition — yes, inspired by the “Star Trek” gizmo — besting 312 entrants from 38 countries, many with corporate and government backing. Final Frontier Medical Devices, led by Basil Harris, a suburban Philadelphia emergency room doctor, won the $2.6 million top prize. The open competition, launched in 2012, challenged applicants to produce a lightweight, affordable health kit that diagnoses and interprets 13 health conditions and continuously monitors five health vitals. (Heller, 4/13)

Stat: Gloves Armed With Glowing, Green Bacteria May Detect Toxins
[Xinyue] Liu and her lab-mates ... managed to keep the bacteria alive in gloves and bandages, parts of which glow when they detect certain chemicals. The technology is not yet perfect, but Liu’s hope is that it could at some point be used to pick up dangerous toxins or the chemical signs of disease. (Boodman, 4/13)

Kansas City Star: Physician-Entrepreneur Testing App That Serves As A GPS For Medical Emergencies
Technology had already condensed thousands of pages of maps into turn-by-turn directions to almost anywhere on earth. [Jeff] Dunn figured it could do the same for the lengthy Code Blue checklists. So he left medicine, started a company in Olathe called Redivus Health and teamed with four other doctors and a few programmers to develop an app called Code Blue that tells you what to do and when to do it. (Marso, 4/12)

Los Angeles Times: Did A New, Tough Law Boost The Percentage Of Vaccinated California Kindergartners?
Vaccinations of California’s kindergartners jumped this fall from the previous year, boosting the percentage of students with all required vaccinations to 96% from 93%. It was the highest vaccination rate among kindergartners since 2001, the California Department of Public Health said. (Karlamangla and Lin, 4/12)

San Francisco Chronicle: Vaccination Rates For California Kindergartners Continue To Rise
Nearly 96 percent of children were fully vaccinated when they started kindergarten in the fall, according to a report released by the California Department of Public Health. That’s up from 93 percent in the previous school year and 90 percent in 2014-15. (Allday, 4/12)

San Jose Mercury News: California’s Kindergarten Vaccination Rates Hit New High
“It is gratifying to see that in the course of just one school year, more children and the public at large are now more fully protected from preventable diseases,” said Sen. Ben Allen, D-Santa Monica, who co-authored Senate Bill 277, which fueled one of Sacramento’s most vitriolic legislative debates in years. (Seipel, 4/12)

Sacramento Bee: California Vaccine Rates Increase After Legislature Toughens Rules For Children 
Senate Bill 277, signed in 2015, required children without medical exemptions to receive all their shots before enrolling in school and eliminated a provision that allowed parents to seek personal and religious belief exemptions. (Luna, 4/12)

CQ HealthBeat: VA Medical Center In D.C. Found To Have 'Serious' Deficiencies
Veterans seeking care at the VA Medical Center in Washington were placed at unnecessary risk by shortages of oxygen tubes, dialysis bloodlines, needles and other surgical equipment, federal watchdogs said in a scathing interim report released Wednesday. VA officials told CQ that they were thankful for the Office of Inspector General’s “quick work” in the review and “considers this an urgent patient-safety issue.”“Effective immediately, the medical center director has been relieved from his position and temporarily assigned to administrative duties,” the agency said in a statement. (Mejdrich, 4/12)

The Associated Press: Indiana Senate OKs New Hurdle For Minors Seeking Abortions
The Indiana Senate sent Gov. Eric Holcomb a measure Wednesday that would make it tougher for a minor to have an abortion without her parents knowing about it, after legislators changed the wording to leave open the possibility that the procedure could still be kept private under some circumstances. (Costello, 4/12)

Georgia Health News: Georgia Slips Lower In Leapfrog Ratings On Hospital Safety
Less than 20 percent of Georgia hospitals earned an “A” grade on patient safety in the latest ratings from the Leapfrog Group. The 17.6 percent figure put Georgia in 40th place among states ranked on percentages of top-safety hospitals. (Miller, 4/12)

New Hampshire Union Leader: NH Hospitals Ranked 7th In U.S. In Patient Safety 
New Hampshire hospitals ranked seventh nationally in patient safety, according to a survey released Wednesday by a nonprofit group that has been grading hospitals across the country on patient safety measures. Of the 13 major New Hampshire hospitals included in the Leapfrog Group hospital grades for spring of 2017, seven received an A — the highest mark possible in the analysis based on factors including errors, accidents and infections. Three Granite State hospitals included in the survey received a B and the remaining three got a C. (Alden, 4/13)

The Star Tribune: Child Abuse Reports Soar Across Minn., Straining System
A dramatic surge in child maltreatment reports is putting new strains on Minnesota’s child protection system, as local agencies struggle with soaring caseloads and stagnant funding, according to state and county officials. Maltreatment reports to county and tribal governments rose 25 percent last year, with 39,531 children suspected of being abused and neglected, according to state data released Tuesday. (Serres, 4/12)

Miami Herald: Good News For Jackson Health. Feds, State Renew Program That Pays To Treat Uninsured
The federal government agreed on Wednesday to renew a state program that repays hospitals for care they provide to the uninsured, a move that could offset state cuts to hospitals and bridge a gap in the state budget. Gov. Rick Scott announced that the Trump administration would allow a $1.5 billion Low Income Pool in next year’s state budget. (Auslen, 4/12)

Kaiser Health News: In Remote Idaho, A Tiny Facility Lights The Way For Stressed Rural Hospitals
Just before dusk on an evening in early March, Mimi Rosenkrance set to work on her spacious cattle ranch to vaccinate a calf. But the mother cow quickly decided that just wasn’t going to happen. She charged, all 1,000 pounds of her, knocking Rosenkrance over and repeatedly stomping on her. “That cow was trying to push me to China,” Rosenkrance recalls. Dizzy and nauseated, with bruises spreading on both her legs and around her eye, Rosenkrance, 58, nearly passed out. Her son called 911 and an ambulance staffed by volunteers drove her to Lost Rivers Medical Center, a tiny, brick hospital nestled on the snowy hills above this remote town in central Idaho. (Gorman, 4/13)

Texas Tribune: Texas To Lose Brazos Valley Children's Therapy Provider
Approximately 230 children in the Brazos Valley area are slated to lose a provider offering speech, physical and occupational therapy at the end of August. The state's Early Childhood Intervention program has already lost a dozen providers in recent years as state lawmakers have cut program funds. (Evans, 4/12)

Richmond Times-Dispatch: Virginia Voters Back Restoration Of One-Gun-A-Month Limit, Poll Finds
Nearly two-thirds of Virginians support Virginia's former law that restricted handgun purchases to one a month, according to a Quinnipiac University survey out today. By nearly 2-to-1 respondents back increasing the number of people eligible for Medicaid coverage in Virginia, with 59 percent saying it is a good idea and 30 percent saying it is a bad idea. (Cain, 4/12)

The Philadelphia Inquirer/Philly.com: Penn Medicine's New Deal With Independence Blue Cross Focuses On Quality And Cost
A new contract between the University of Pennsylvania Health System and Independence Blue Cross contains a guarantee that neither IBC nor the IBC member will be charged for a hospital readmission within 30 days of an inpatient stay or surgery. That is one example of how the five-year deal, announced Wednesday, between the Philadelphia region’s largest health system and its largest health insurer attempts to shift toward shared accountability and risk for quality and cost of care in place of a legacy system that could enrich health-care providers for redoing their work. (Brubaker, 4/12)

California Healthline: State Lawmakers Seek $2M To Boost Valley Fever Research, Monitoring
New state legislation that would allocate $2 million to support valley fever research and monitoring is the most recent effort to increase awareness of the fungal disease, which is typically mild but can be very dangerous in some cases. The bill, authored by Assemblyman Rudy Salas (D-Bakersfield), would take the money from the state’s General Fund and allot it to an already existing valley fever fund operated by the state’s Department of Public Health. The fund supports research for a vaccine to protect against valley fever. The new money would be used to buy research equipment, develop a tracking method and conduct community outreach, according to the text of the legislation. (Ibarra, 4/12)

St. Louis Public Radio: State Senate Passes Bill To Buy Homes Near West Lake Landfill
A bill to create a buyout program for homes near the West Lake Landfill Superfund site in Bridgeton has been overwhelmingly approved by the state Senate... As many as 91 families could have the option to move away from the World War II-era radioactive contamination at the West Lake Landfill, which sits about 600 feet from the underground smoldering fire at the Bridgeton Landfill. (Chen, 4/12)

The Washington Post: Md. Legislative Leaders In Stand-Off Over Special Session On Medical Marijuana
Advocates who want to diversify and expand Maryland’s medical marijuana industry are calling on the General Assembly to hold a one-day special session to get the job done. But the top politicians in Annapolis are again at odds on the issue, imperiling the chances for a deal. Democratic lawmakers agree that the state should approve five new minority growers to join the 15 mostly white-owned companies already pre-approved to open cultivation sites. (Nirappil, 4/12)

Iowa Public Radio: Advocates Plead For Medical Marijuana; Senate Committee Approves Bill
A Republican-dominated committee in the Iowa Senate today, on a nearly unanimous voice vote, approved a bill to legalize the production and sale of medical marijuana in Iowa to provide treatment for a wide range of medical conditions. The bill is similar to legislation approved in the past when Democrats controlled the Senate. (Russell, 4/12)

The Wall Street Journal: Give Medicaid Dollars Directly To Patients
As Republicans take another crack at devising a plan to replace ObamaCare, here’s an idea they should consider: Give each Medicaid patient a health savings account — and put $7,000 in it every year. Under ObamaCare, Medicaid has become the only option for millions of Americans. But that doesn’t mean much if the doctors in their communities don’t accept new patients through the program — and 30% of physicians don’t. (Justin Haskins and Michael Hamilton, 4/13)

The Atlantic: How GOP Voters Are Getting In The Way Of A Medicaid Rollback
President Trump on Wednesday signaled his determination to mount another drive to repeal the Affordable Care Act, but he faces a surprising obstacle: unexpectedly widespread Republican resistance to cutting Medicaid. That hesitation, following decades of GOP efforts to retrench the program, powerfully demonstrates how the party’s growing reliance on economically strained and older white voters is disrupting its ideological compass. (Ronald Brownstein, 4/13)

The Washington Post: What The Freedom Caucus Stands For
Rep. Mark Meadows, a North Carolina Republican, is an unlikely object of the caterwauling recently directed at him and the House Freedom Caucus he leads. The vituperation was occasioned by the HFC’s role rescuing Republicans from embracing an unpopular first draft of legislation to replace Obamacare. ... Although just a little over two years old, the HFC signals a revival of congressional resistance to the dangerous waxing of executive power under presidents of both parties. The HFC is a rarity, a heartening political development: People giving priority to their legislative craft and institution rather than to a president of their party barking at them. (George Will, 4/12)

Sacramento Bee: Here’s A Bipartisan Approach Of Simple Fixes To Reform Health Care 
If Obamacare is here “for the foreseeable future,” as [House Speaker Paul] Ryan forecasts, there are some simple fixes that can make a big difference. For the 20 million Americans who depend on the individual health insurance marketplace for their coverage, inaction is unacceptable. (John Kabateck and David Panush, 4/12)

JAMA: Vital Directions And National Will
If the United States had undertaken road building or space exploration in the same way it is chasing health system reform, there would be neither an interstate highway system nor footprints on the moon. The successes depended on clear, bold, shared aims; strong investments in technical mastery; continuity of purpose over time; and continual learning at a large scale — not to mention considerable celebration. Health care reform has had none of these. The reasons for the difference are many. The National Aeronautics and Space Administration (NASA) undoubtedly faced political headwinds, but they were not gale force, because NASA was not dealing with $3 trillion of the US economy, a panoply of stakeholders with financial interests in the status quo of health care, professional fragmentation, or a viciously complicated legacy payment system designed by no one at all. (Donald M Berwick, 4/11)

The Des Moines Register: Branstad's Private Medicaid 'Success' That Wasn't
Gov. Terry Branstad doesn’t have much to say about problems caused by his privatization of Medicaid. Low-income Iowans report losing health services. Providers are not being paid by managed care companies. The origins of the governor’s “savings” estimates remain a mystery. Taxpayers don’t understand why they’re bailing out for-profit insurers contracted with the state. (4/12)

The New York Times: Answer To Better Health Care: Behavioral Economics?
Consider the following. I’m a physician at the end of more than a decade of training. I’ve dissected cadavers in anatomy lab. I’ve pored over tomes on the physiology of disease. I’ve treated thousands of patients with ailments as varied as hemorrhoids and cancer. And yet the way I care for patients often has less to do with the medical science I’ve spent my career absorbing than with habits, environmental cues and other subtle nudges that I think little about. (Dhruv Khullar, 4/13)

The Wall Street Journal: Cut This One Regulation–And Save $500 Million In Health-Care Costs
Johns Hopkins ophthalmologist Oliver Schein has found a simple way to save a half a billion dollars a year from our country’s health-care bill, with no negative effect on patient health.  The only thing standing in the way is a stubborn government requirement. (Peter Pronovost, 4/11)

JAMA: The Evidence-Based Metaphor
It’s a situation that many pediatricians encounter on a regular basis: a parent who is resistant to the idea of childhood vaccinations for a son or daughter. The only difference here is that Jeremy isn’t really an anxious parent but a standardized patient—an actor trained to re-create this scenario—and I’m not a physician but a medical student. We’re in the midst of an OSCE, an “objective structured clinical examination,” designed to train medical students in the real-life practice of medicine. (Brit Trogen, 4/11)

RealClear Health: It’s Time To Check The Safety, Not Price, Of Imported Drugs
In December 2016, the Government Accountability Office released its report on the Food and Drug Administration’s oversight of foreign drug production. Strikingly, the report found that most FDA infractions occur in overseas pharmaceutical production sites, primarily in India, while a third of all production locations go without any oversight at all. (Roger Bate, 4/13)

Cleveland Plain Dealer: Saving Babies' Lives In The Cleveland Area - How Can The Region Address This Persistent Problem? Talk It Out
A preliminary dive into the data surrounding infant mortality in the Cleveland area reveals some disturbing trends: a shockingly high level of prematurity contributing to early infant deaths, and evidence that many young mothers aren't accessing the prenatal care they need. (4/12)

Lexington Herald Leader: Volunteer Group Offers Support For Parkinson’s Patients, Families
“You have Parkinson’s disease.” Hundreds of residents in the Lexington community have heard those words. Delivered to me by a neurologist five years ago, they were shocking and bred all sorts of questions. Was this disease terminal? How could it be me? Was there a cure? How would I tell my family, friends and co-workers? (David M. Smith, 4/12)

JAMA Forum: Hunger, Health, And Compassion
The juxtaposition of headlines must have sent shivers down the spines of the global humanitarian and human rights communities. Even as headlines warned of 20 million people in Africa and the Mideast facing starvation, the Trump Administration was proposing unprecedented cuts in foreign assistance. While the drastic cuts may not come to pass, US values of compassion are being eroded. Secretary of State Rex Tillerson warned other countries to provide a larger share of assistance. Perhaps signaling what is to come, in the first quarter of 2017, US contributions to humanitarian appeals decreased by nearly one-half from the level for 2016. And even small cuts to humanitarian assistance are more than the world’s most desperate people can afford, with United Nations humanitarian appeals already routinely underfunded. (Lawrence Gostin, 4/12)