The New York Times: Amazon Offers Prime Discount For Medicaid Recipients
Amazon has had no problem getting affluent households to buy from its online store. But people with low incomes have been less loyal to the retailer. Now, Amazon is taking another step to persuade them to spend their money on the site. Starting Tuesday, the company will offer a discount on its Prime membership program to the millions of recipients of Medicaid, the public health insurance program for low-income Americans. They can receive the benefits of Prime — including free fast shipping and video streaming — for $5.99 a month, less than half the standard monthly fee of $12.99. (Wingfield, 3/7)

Reuters: Amazon Offers Discount Prime Membership To Medicaid Recipients
Any push by Amazon into poorer demographics comes at a time when traditional brick-and-mortar suppliers like Walmart Inc have been fighting the online shopping giant's arrival by seeking to attract more high-spending shoppers. The Medicaid connection may also stir more nerves among healthcare companies worried about tentative moves by Amazon to sell and distribute some medical supplies and drugs. (Mathias, 3/7)

The Wall Street Journal: Amazon Targets Medicaid Recipients As It Widens War For Low-Income Shoppers
Lower-income consumers have been the fastest-growing segment of online shoppers, analysts say, but still face potential impediments. They may lack internet access, banking resources like credit cards—SNAP cards can’t be used to pay online—and safe places to deliver a package. (Stevens, 3/7)

The Wall Street Journal: Cigna Agrees To Buy Express Scripts For More Than $50 Billion
Health insurer Cigna Corp. plans to buy Express Scripts Holding Co. in a cash-and-stock deal worth $52 billion, excluding debt, that the companies say will expand their health care offerings and help them control costs. ... The deal has a total transaction value of $67 billion, which includes Cigna’s assumption of $15 billion of Express Scripts’ debt. (Mattioli and Cimilluca, 3/8)

Bloomberg: Cigna Near Deal To Buy Express Scripts, WSJ Says 
Express Scripts is the largest remaining independent drug middleman. Its biggest competitors are the pharmacy-benefits management companies run by CVS Health Corp. and UnitedHealth Group Inc. Pharmacy-benefits managers have come under increasing political pressure in recent weeks as the Trump administration looks for ways to lower medical costs. The president’s Council of Economic Advisers, in a recent report, criticized the companies’ market power and the opacity of their drug-price contracts. (Langreth and Vercoe, 3/7)

The New York Times: Cigna Agrees To Buy Express Scripts In Major Health Care Deal
Express Scripts is the largest pharmacy benefit manager in the United States, responsible for the drug plans of more than 80 million Americans, including on behalf of large employers like the Department of Defense. (Bray and Thomas, 3/8)

Reuters: Health Insurer Cigna To Buy Express Scripts For About $54 Billion
The companies said the combination will save $600 million due to administrative efficiencies. They can cut costs as they better coordinate pharmacy and medical claims. It could also increase their leverage in price negotiations with drugmakers. (Banerjee, 3/8)

In other industry news —

Modern Healthcare: UnitedHealth Tightens Reins On Emergency Department Reimbursement
The nation's largest health insurer, UnitedHealth Group, is following rival Anthem's footsteps with a new payment policy aimed at reducing its emergency department claims costs. Under the policy, rolled out nationwide March 1, UnitedHealth is reviewing and adjusting facility claims for the most severe and costly ED visits for patients enrolled in the company's commercial and Medicare Advantage plans. (Livingston, 3/7)

The Wall Street Journal: Hospitals Fund Potential Game-Changers In Health Tech
Luis F. Romo is chasing the startup dream, developing a device that disinfects operating rooms and stretchers by zapping them with ultraviolet rays. The 30-year-old Mr. Romo has a catchy name for his invention, “PurpleSun,” and a solid but untraditional backer: a hospital. Northwell Health, of New Hyde Park, N.Y., has put about $3 million into Mr. Romo’s idea and may invest more in coming years. As hospital-acquired infections have become the scourge of modern institutions, Northwell officials are eager to put the germ-fighting device to work in their 23 hospitals. They also hope to make back their investment—and more—if other hospitals want to use PurpleSun. (Lagnado, 3/7)

In other hospital news —

Modern Healthcare: Not-For-Profit Hospital Downgrades Surged In 2017 
The ratio of not-for-profit hospital and health system credit downgrades to upgrades rose in 2017 to levels that were even higher than during the Great Recession in 2008 and 2009, according to a new report from Moody's Investors Service. There were 41 downgrades and 12 upgrades in 2017, a ratio of 3.4-to-1. That's compared with 2.8-to-1 and 2-to-1 in 2008 and 2009, respectively. Last year's ratio was also higher than in 2016, a year that saw 32 downgrades and 21 upgrades, or a 1.5-to-1 ratio, according to Moody's. (Bannow, 3/6)

The Associated Press: Watchdog Report: Failed VA Leadership Put Patients At Risk
"Failed leadership" at the Department of Veterans Affairs during the Obama years put patients at a major hospital at risk, an internal probe finds — another blow to Secretary David Shulkin, who served at the VA then and is fighting to keep his job. The 150-page report released Wednesday by the VA internal watchdog offers new details to its preliminary finding last April of patient safety issues at the Washington, D.C., medical center. (Yen, 3/7)

The Washington Post: VA Chief Outlines Changes At Hospitals Nationwide Following Report On Alleged D.C. Center Mismanagement
Veterans Affairs Secretary David J. Shulkin on Wednesday announced an overhaul of the senior leadership overseeing almost two dozen troubled hospitals across the country following the release of a searing investigation into what the agency watchdog said were management failures that put patients at VA’s flagship medical center in the District at risk. Shulkin said one senior regional official has been reassigned and two others retired as the agency cleans up management of large hospitals and clinics in the Washington area, New England, Phoenix and parts of California. He also said he has appointed 24 new facility directors in the last year, including in Maryland and Virginia, after outside teams identified low-performing hospitals. (Rein and Wax-Thibodeaux, 3/7)

Modern Healthcare: Shulkin Announces VA Medical Center Shakeup, VA Choice Reforms A Little Closer 
"Secretary Shulkin made very clear following a news conference this morning, that the IG's interim report demonstrated failures on a number of levels including medical facilities, hospital networks, and the VA Central Office," the VA wrote in a news release. Shulkin made the announcements at the Washington Medical Center, the site called out this week in a new, scathing report from the VA's Inspector General's Office that said the VA's flagship center consistently failed to meet quality of care, fiscal and management standards. Problems around equipment led to excruciating situations described in detail, such as a skin grafting procedure that had to be done manually and led to the graft not adhering. (Luthi, 3/7)

Concord (N.H.) Monitor: After Calls For Ouster, New England VA Official To Step Down
Another high-ranking Veterans Affairs official in the region is stepping down. VA Secretary David Shulkin announced Wednesday that Dr. Michael Mayo-Smith, the director for the VA New England Healthcare Network, will resign in the coming weeks. The move comes just one day after Democratic U.S. Reps. Annie Kuster and Carol Shea-Porter publicly called for Mayo-Smith’s removal following reports last year of substandard care at New Hampshire VA facilities.His resignation also arrives on the heels of a new report, released Wednesday by the Inspector General, about widespread problems with oversight at the VA. (Duffort, 3/7)

In other news —

Politico: ‘We Took A Broken System And Just Broke It Completely’
President Donald Trump last year hailed a multibillion-dollar initiative to create a seamless digital health system for active duty military and the VA that he said would deliver “faster, better, and far better quality care.” But the military’s $4.3 billion Cerner medical record system has utterly failed to achieve those goals at the first hospitals that went online. Instead, technical glitches and poor training have caused dangerous errors and reduced the number of patients who can be treated, according to interviews with more than 25 military and VA health IT specialists and doctors, including six who work at the four Pacific Northwest military medical facilities that rolled out the software over the last year. (Allen, 3/8)

New Orleans Times-Picayune: New Orleans VA Hospital Is Looking To Hire 107 Registered Nurses 
The New Orleans VA hospital is looking to hire 107 registered nurses. ...One factor contributing to the boom in nursing positions is the country's population of aging adults, which continues to grow and demand more care. The population of American seniors is expected to grow 60 percent by 2030, from 43.1 million in 2012 to 69 million, according to U.S. Census Bureau estimates. available in the garage at the corner of Galvez Street and Tulane Avenue. (Clark, 3/7)

Modern Healthcare: Lawmakers Soldier On With Insurance Stabilization After White House Memo 
Lawmakers are moving forward with final negotiations on an individual market stabilization measure despite the Trump administration's latest requests in exchange for its support. In a memo leaked Tuesday, the Trump administration suggested it would support funding cost-sharing reduction payments for insurers if Congress includes several other provisions in the upcoming spending omnibus, including anti-abortion language and expanding access to health savings accounts. Two proposals in particular concern insurers. (Luthi, 3/7)

The Hill: Dem AGs Rip Proposed Trump Rule On Health Plans 
A coalition of 17 Democratic state attorneys general is blasting a proposed Trump administration rule to allow health plans to circumvent certain ObamaCare rules. The group, led by New York Attorney General Eric Schneiderman and Massachusetts Attorney General Maura Healey, said the proposal is a thinly veiled attempt to undermine the health-care law. (Weixel, 3/7)

Des Moines Register: Farm Bureau Could Skirt Obamacare Under Bill Passed By Iowa Senate
The Iowa Senate voted Wednesday to let the Iowa Farm Bureau Federation and Wellmark Blue Cross & Blue Shield sell health insurance plans that don't comply with the federal Affordable Care Act. The new coverage could offer relatively low premiums for young and healthy consumers, but people with pre-existing health problems could once again be charged more or denied coverage. (Leys and Petroski, 3/7)

And in other news —

The Baltimore Sun: Governor Hogan, Legislative Leaders Press Congress For Help Stabilizing Obamacare Market 
Describing recent health insurance premium increases in Maryland as “unsustainable,” Gov. Larry Hogan and the state’s legislative leaders on Wednesday embraced the idea of a federal reinsurance program that would help offset the expense of the sickest patients. In a letter to Maryland’s mostly Democratic congressional delegation, the Republican governor said the state is working to address premium increases caused by “recent federal actions,” but said the state has limited power to stem rate increases for the approximately 150,000 people buying private coverage through the Affordable Care Act, also known as Obamacare. (Fritze, 3/7)

Politico: Planned Parenthood Defunding Threatens Government Spending Package
House Republicans are demanding a series of controversial abortion and health care policies in the annual health spending bill, setting up a showdown with Democrats and threatening passage of an omnibus spending package to keep the government open. Democrats are vowing to block the slew of long-sought conservative priorities. The riders would cut off federal funding to Planned Parenthood, eliminate a federal family planning program and ax the Teen Pregnancy Prevention Program, according to sources on Capitol Hill. Republicans also want to insert a new prohibition on funding research that uses human fetal tissue obtained after an abortion. (Haberkorn and Ferris, 3/7)

Meanwhile —

The Hill: House Conservatives Brace For ObamaCare Payments In Funding Bill 
House conservatives are bracing for ObamaCare payments to be included in a coming government funding bill, despite their opposition. Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus, said Wednesday that he expects the controversial ObamaCare payments aimed at stabilizing markets to be included in the omnibus government funding bill, which must pass by March 23 to avoid a shutdown. (Sullivan, 3/7)

The New York Times: Florida House Passes Gun Control Bill, Defying N.R.A.
Florida lawmakers gave final passage to a $400 million gun control and school safety bill on Wednesday in defiance of the National Rifle Association, which opposed the legislation’s firearm restrictions. ... The legislation, which passed the State Senate on Monday and now heads to the governor, would raise the minimum age to purchase any firearm to 21 from 18; impose a three-day waiting period on gun purchases; fund school police officers and mental health counselors; and allow local school districts and sheriffs to arm certain school personnel. It would also ban so-called bump stocks, which make guns fire faster, and give law enforcement more power to commit people deemed a threat. (Mazzei, 3/7)

The Washington Post: Florida Legislature Backs New Gun Restrictions After Parkland School Shooting
Florida Gov. Rick Scott (R), who supports most but not all of the provisions in the state bill and is exploring a U.S. Senate bid, reiterated his opposition to arming teachers Wednesday but stopped short of threatening a veto. “I am going to read the bill, and I am going to talk to parents,” he told reporters in the state capitol. “My goal is that this never happens again to a parent in our state.” (Scherer, 3/7)

The Wall Street Journal: Florida Lawmakers Approve Gun-Control Bill
Gun-rights groups denounced the new firearm restrictions as violating the Second Amendment. Marion Hammer, the National Rifle Association’s Florida lobbyist, implored members to pressure lawmakers to vote against the measure. “House leadership is trying to bully Second Amendment supporters,” she wrote in one email. (Campo-Flores, 3/7)

The New York Times: Florida Gun Bill: What’s In It, And What Isn’t
The gun control bill that the Florida Legislature passed on Wednesday was, in many respects, a major victory for the new activists of Marjory Stoneman Douglas High School. It was passed in defiance of the National Rifle Association and, if Gov. Rick Scott signs it, will be the first successful gun control measure in Florida in more than 20 years. But it left out many of the biggest provisions the students and their supporters had sought, including bans on assault weapons and high-capacity magazines. Here is a look at what is in the final bill, and what is not. (Astor, 3/8)

In other news —

The Washington Post: Why More Civilians Are Now Learning Military-Grade Techniques To Save Lives
Laura Auel winced as Clif Castleman tightened a bright orange training tourniquet around her upper arm. “There we go,” Castleman said as he constricted the veins and arteries in the 21-year-old college student's right arm. “In some cases, and in some I’ve done in real life, people have said the tourniquet hurts more than the wound itself,” Castleman explained to nearly 50 residents of Poolesville, Md., gathered in an elementary school cafeteria. (Martin, 3/7)

CNN: Lessons From War At Marjory Stoneman High School
In the northern Israel town of Alon HaGalil one recent afternoon, a clinical psychologist and former Israeli special forces member named Yotam Dagan was worrying about how the students at Marjory Stoneman Douglas High School in Parkland, Florida, are going to react the next time the school holds a fire drill. "If it's just done without any early preparation or warning, the sound of the bell is going to reactivate the traumatic response," Dagan told me, remembering that the shooter who slaughtered 17 innocent people on February 14 at the school is said to have pulled the fire alarm to empty the classrooms. "There are going to be meltdowns. There are going to be panic attacks." (Tapper, 3/8)

The CT Mirror: Rubio To Introduce 'Red-Flag' Bill, As Will Blumenthal
Sen. Marco Rubio on Wednesday said he is introducing a bill that would provide federal grants to states for establishing gun violence restraining orders – and said he doubted a broader one Sen. Richard Blumenthal plans to introduce Thursday would pass the Senate. The issue of removing guns from people who, like Parkland shooter Nikolas Cruz, had raised “red flags”– had indicated they were a danger to themselves or others — has gained support after the massacre of 17 at a Florida high school on Valentine’s Day. (Radelat, 3/7)

Bloomberg: Opioid Judge Allows Trial Prep As Settlement Talks Hit Snag 
A push to resolve more than 350 lawsuits against the makers and distributors of opioid painkillers has hit a snag, so a federal judge cleared the way for lawyers to start collecting evidence for trials. U.S. District Judge Dan Polster in Cleveland said Wednesday “substantial progress’’ has been made in talks between U.S. cities and counties and Purdue Pharma LLP and other opioid makers and distributors, but both sides have found “barriers to a global settlement.’’ (Feeley and Hopkins, 3/7)

In other news on the crisis —

CQ: Governors Hunt For More Funding To Fight Opioid Addiction
Governors who are anxiously awaiting funding to fight opioid addiction are eyeing $6 billion set aside in the two-year budget deal (PL 115-123) for the epidemic that has yet to be appropriated or divvied up between federal agencies and the states. Two governors from opposite sides of the country and political spectrum, Maryland Republican Larry Hogan and Oregon Democrat Kate Brown, plan to ask for more funding in their testimony before the Senate health committee on Thursday. (Raman, 3/7)

The Hill: Opioid Crisis Spurs Medicaid Funds Push
Doctors, governors and health-care advocates are pressing Congress to lift a decades-old rule that greatly restricts Medicaid from being used to fund care for opioid addiction. Lifting the limits could help thousands of people — but could cost as much as tens of billions of dollars over a decade, a daunting sum to try to pay for. (Roubein and Sullivan, 3/7)

NPR: Human Brains Unable To Add Neurons After Adolescence
A major study is challenging the widely held view that adult human brains make new neurons. The study of brain samples from 59 people of various ages found no immature neurons in anyone older than 13, scientists report online Wednesday in the journal Nature. "In all of the adult samples we looked at, we couldn't find any evidence of a young neuron," says Shawn Sorrells, the study's lead author and a senior researcher in the lab of Arturo Alvarez-Buylla at the University of California, San Francisco. (Hamilton, 3/7)

Stat: Adult Brains Do Not Make New Neurons, Controversial New Study Claims
Neuroscientists at the University of California, San Francisco, had a hunch their findings would be controversial, as tends to happen when you challenge popular, world-changing brain research. They were right. Their study, published in Nature on Wednesday, concludes that the adult human brain does not produce any detectable new neurons in the area that’s supposedly ground zero for neuronal creation, contrary to dozens of experiments over the last 20 years. (Begley, 3/7)

The Washington Post: ’He Was Happy. So Far As I Know Of’: A Family Reels After An 11-Year-Old’s Suicide
After 11-year-old Rylan Thai Hagan hanged himself with a belt from his bunk bed three days before Thanksgiving, people wanted to know why he did it. He was a model sixth-grader at Perry Street Prep in Northeast Washington, where he received a stipend to tutor other students. He was a basketball player whose team had just qualified for a tournament at Walt Disney World. He played the trumpet. Standing in the room where her only child had taken his life less than two months earlier, that question tortured Nataya Chambers. The apartment, where she had not slept since his death, was in disarray, belongings spilling out of boxes as she prepared to search for a new start. (Moyer, 3/7)

Los Angeles Times: Male Doctors Are Disappearing From Gynecology. Not Everybody Is Thrilled About It
Some patients wait until Dr. Jerome Chelliah snaps on his gloves to make the request. Others blurt it out as soon as he walks in the exam room. “I’d rather see a female doctor,” they say. Chelliah thinks he can be a sensitive obstetrician-gynecologist even though he’s a man. But he has no choice but to comply. “I’ve been rejected many times over,” he said. “As a person of color, I face discrimination in other ways, but it’s not so blatant.… People have no problem saying they don’t want you.” (Karlamangla, 3/7)

The New York Times: Probiotics And Fish Oil During Pregnancy May Curb Allergies In Kids
Probiotics and fish oil supplements during pregnancy and breast-feeding may reduce the risk for food allergies and eczema in early childhood, researchers report. In a review of hundreds of studies, they found 19 randomized controlled trials with strong evidence showing that compared to no supplements, probiotics taken after the 36th week of pregnancy and the first months of lactation were associated with a 22 percent reduction in the risk for eczema in children. (Bakalar, 3/7)

CNN: Cancer Treatment Guidelines Questioned In New Study
The National Comprehensive Cancer Network often publishes clinical practice guidelines that help shape the course of treatment for cancer patients and insurance coverage. However, a new study has called those guidelines into question. The strength of evidence referenced by the US-based group, referred to as the NCCN, when formulating guidelines and making recommendations appears to be weak, according to the study published in the journal BMJ on Wednesday. (Howard, 3/7)

Kaiser Health News: Mind Over Body: A Psychiatrist Tells How To Tap Into Wisdom And Grow With Age
We’ve all seen it happen: An older friend or family member retires, is diagnosed with a serious illness or loses a spouse. Suddenly, this individual’s world is altered, sometimes seemingly beyond recognition. He has reached a fork in the road; will he get stuck or find a way to regroup and move on? In a new book, “The End of Old Age,” Dr. Marc Agronin, a geriatric psychiatrist, calls this moment an “age point” — an event that disrupts an older person’s life and challenges the person’s ability to cope while also offering the potential for new growth. (Graham, 3/8)

The Associated Press: Mississippi Could Test How Soon State Can Restrict Abortion
For decades, the U.S. Supreme Court has been telling states that they can't ban abortions before a fetus can survive outside the womb on its own. But states continue to try to restrict abortion before viability. One of the most recent is Mississippi, where lawmakers are on the brink of approving a measure that would ban most abortions after 15 weeks. (3/8)

The Associated Press: Indiana Legislature Approves Bill Toughening Abortion Rules
The Indiana Legislature on Wednesday sent a bill to Gov. Eric Holcomb's desk that would require medical providers who treat women for complications arising from abortions to report detailed patient information to the state. Though the bill is not as expansive as Indiana abortion laws passed in recent years — some of which have been thrown out in court — debate has unfolded along familiar lines. (3/7)

The Associated Press: Doctor-Assisted Suicide Measure Advances In Hawaii
The Hawaii House has approved a bill that would allow physicians to prescribe life-ending medication to terminally ill patients. The House’s action on Tuesday sends the measure to the Senate, which last year overwhelmingly approved a similar bill. The proposal would allow physicians to prescribe life-ending medication to a mentally-capable patient with less than six months to live. (3/7)

Georgia Health News: HIV Preventive Drug Gets Low Use In Georgia Despite Big Need
Georgia has the highest rate of new HIV diagnoses in the nation, but the use of a prophylactic drug in the state lags behind the U.S. average. The new data on the drug regimen known as PrEP, or pre-exposure prophylaxis, come from AIDSVu, an interactive mapping tool produced in a partnership by Emory University’s Rollins School of Public Health, Gilead Sciences, state health departments and the CDC. (Miller, 3/7)

The Associated Press: Herbalist Charged In Death Of Diabetic Boy Treated With Oils
An herbalist who touted natural cures that helped him overcome cancer has been charged in the death of a 13-year-old diabetic boy who prosecutors said he treated with herbal oils instead of insulin. Timothy Morrow, 83, was charged with practicing medicine without a license and child abuse causing a death, the Los Angeles city attorney said Wednesday. His lawyer said he disputes the charges. (3/7)

The New York Times: Columbia Removes Thomas Jessell, Renowned Neuroscientist, From His Posts
Columbia University on Wednesday removed a top neuroscientist from his posts and announced plans to dissolve his lab after an internal investigation uncovered violations of “university policies and values. ”The scientist, Thomas Jessell, a professor of biochemistry, biophysics and neuroscience, is one of the world’s foremost researchers into the basic biology of brain cells. His work at Columbia focused on how sensory and motor neurons coordinate movements. (Carey, 3/7)

Health News Florida: Orlando Health Challenges Denial Of Pediatric Program
The hospital system Orlando Health is challenging a state decision that rejected a proposal to start a pediatric heart-transplant program at Arnold Palmer Hospital for Children. The Agency for Health Care Administration on Feb. 16 turned down a key regulatory approval, known as a certificate of need, for the transplant program. The hospital system challenged the decision, with the case sent this week to the state Division of Administrative Hearings. The Arnold Palmer Hospital for Children is part of the Orlando Health system. (3/7)

The Washington Post: Md. House To Vote To Add Medical Marijuana Grower Licenses
The Maryland House of Delegates is scheduled to vote on whether to expand the number of licenses allowed to grow medical marijuana to increase minority business ownership. The House is set to vote on the bill Thursday. The number of allowed growers would rise from 15 to 20. The measure also would cap the number of marijuana processors at 25. (Witte, 3/8)

San Jose Mercury News: The Fight Against Fake Service Dogs, Emotional Support Pets
The final straw might actually have been a colorful feather — attached to a peacock. A woman who tried to board a United Airlines flight in late January with a peacock, claiming it was an emotional support animal (ESA), set off a bunch of alarm bells. And not all of them were at the security check point. United told her “no” three times before she even arrived at Newark International Airport, but the encounter earned her 15 minutes of fame and spurred new travel guidelines by the airlines. It’s part of a crackdown on suspected phony ESAs and service animals — a problem that people with legitimate, highly-trained service animals have been complaining about for quite a while. (Morris, 3/7)

Kaiser Health News: Wildfire Smoke Pollutes Indoor Air And Fuels The Need For Filters To Protect Public Health
As dense smoke from wildfires spread through communities across western Montana last summer, public health agencies faced an indoor problem, too: Residents suddenly needed filters to clean the air inside homes and public spaces, but there was no obvious funding source to pay for it. Ellen Leahy, the health officer in charge of the Missoula City-County Health Department, said that in the past, when wildfire smoke polluted the air outside, nobody really talked about air filters. (Saks, 3/8)

Sacramento Bee: Evacuations Lifted At UC Davis Medical Center After Reports Of Gas Odor
Fire and hazardous materials crews determined diesel exhaust from a generator at the UC Davis Medical was the source of a gaseous odor that prompted the evacuation of the facility Wednesday morning, said Chris Harvey, a Sacramento Fire Department spokesman. No one was injured in the incident, though two people initially complained of headaches. They later declined transportation to the emergency room after reporting feeling better. (Sorci and Chavez, 3/7)

The Hill: A Lack In Affordable Care May Lead To HIV Resurgence
In just five years, from 2011 to 2015, the number of new HIV diagnoses among women in the U.S. fell by 16 percent and HIV-related mortality continues to decline due to the availability of high-quality treatment and prevention tools. But this progress is being jeopardized as women are losing access to affordable health insurance and necessary services. Recent actions by the Trump administration to dismantle the Affordable Care Act of 2010 (ACA) will reduce access to health care for many, and has placed dangerous restrictions on women’s reproductive rights. Additionally, proposed budget cuts to federal health programs will put women’s health at risk. (Susan Blumenthal and Ijeoma A. Egekeze, 3/7)

The Hill: White House Opioid Summit Failed To Deliver Any Real Solution
In some ways, the White House opioid summit provided hope that we could make progress in alleviating the opioid crisis. Some of the people who took a leadership role seemed to understand what we need to do in order to solve the problem. However, the summit fell short of reaching its full potential because of the unhelpful attitudes some of the key players projected. However, the collective attitudes of the people at the meeting who have been directly affected by the disease stood in stark contrast to what we have been hearing from Attorney General Jeff Sessions. He didn't wait for the Opioid Summit to tout drug policy reform as the best way to address the opioid epidemic. To him, this means escalating the war on drugs. (Lynn Webster, 3/7)

The Hill: Deaths From Drugs, Alcohol And Suicide Are Skyrocketing — What Can We Do To Respond?
The rise in deaths from drugs, alcohol, and suicide are now reaching numbers that threaten to desensitize us to their magnitude. In one year alone we saw 142,000 die — which equates to one every four minutes. These numbers are staggering and preventable; however, like many problems our country will face for health care, we have a choice as to how we respond. (Benjamin Miller, 3/7)

JAMA Forum: Redesigning Medicaid Managed Care
When it comes to health care, California is often considered a bellwether state. California has experienced the largest gain of any state in the number of individuals who are covered by insurance following the implementation of the Affordable Care Act (ACA). It has also been a leader in the use of managed care. As of 2016, almost 23 million Californians (58% of the population) received care delivered through a health maintenance organization (HMO). This includes the state Medicaid program (Medi-Cal), through which 10.3 million beneficiaries (about 80%) receive services through managed care. Nationwide, 1 in 5 Medicaid beneficiaries who are in managed care reside in California. (Andrew B. Bindman, 3/7)

The Washington Post: We Still Haven’t Made Things Right In Flint
Lead causes irreversible damage to a developing brain, so it is especially harmful to children 5 or younger. Symptoms include developmental delays, dyslexia and behavioral problems. Thus lead exposure adds one more serious adversity to the multiple challenges associated with urban poverty, including nutritional deficiencies, reduced access to quality medical care, community violence and poor-performing public schools. Now, the heartbreaking data is starting to come in. It was recently reported that between 2013 and 2017, the portion of Flint’s third-graders who tested as proficient in reading at grade level fell from 41.8 percent to 10.7 percent. (Irwin Redlener, 3/7)

Stat: A Doctor Without Health Insurance? What Could Go Wrong?
When I finally couldn’t put it off any longer, and was barely able to get out of bed, I ended up in the emergency department I work in. A colleague, looking at my chest X-ray showing extensive pneumonia, asked why I waited so long to see a doctor. In tears, I tried to explain. Later, hospital bill in hand, the explanation became easier. The bill for my emergency department visit totaled $10,282.34. (Jessica K. Willett, 3/7)

JAMA: What Clinicians Need To Know About Vitamins And Mineral Supplements
Dietary supplementation is approximately a $30 billion industry in the United States, with more than 90 000 products on the market. In recent national surveys, 52% of US adults reported use of at least 1 supplement product, and 10% reported use of at least 4 such products.1 Vitamins and minerals are among the most popular supplements and are taken by 48% and 39% of adults, respectively, typically to maintain health and prevent disease. Despite this enthusiasm, most randomized controlled trials of vitamins and mineral supplements have not demonstrated clear benefits for primary or secondary prevention of chronic diseases not related to nutritional deficiency. (JoAnn E. Manson, 3/6)

Lexington Herald Tribune: It’s Time To Legalize Medical Marijuana In Kentucky
For years, Kentucky veterans have approached us with a question that has no good answer: “Why are my comrades in other states able to treat PTSD and pain with medical cannabis while I cannot?” Frustrated and confused, these men and women struggle daily with the effects of post-traumatic stress triggered by the horrors of war and chronic pain from injuries suffered in combat. (Alison Lundergan Grimes and Dakota Meyer, 3/7)

The Courier-Journal: Raising Kentucky's Cigarette Tax Is Good Health Policy
Health advocates are calling for a $1 per pack increase in Kentucky’s state tax on cigarettes because it will reduce tobacco use, particularly among youth and pregnant women. Less smoking means healthier babies and youth and a significant reduction in the health care costs paid by taxpayers. (William Hackler, 3/8)

The Courier-Journal: Cigarette Tax Increase Unfair To Kentucky Smokers And Businesses
As a long-time Kentuckian and business owner, I appreciate our elected officials’ efforts in Frankfort to identify new revenues, close budget gaps and fund important government programs. But large, targeted cigarette taxes rarely deliver the expected revenue and rely on a small group of Kentuckians – adult smokers – to pay more for government programs that benefit everyone. Having worked over 23 years in the retail consumer products industry, I’ve seen first-hand the unintended consequences tax increases can have on local businesses. (Gerald Stith, 3/8)

Seattle Times: Let’s Invest More Equitably In Homeless Programs That Work
I, like you, see the vestiges of a system that has failed to address the scale of the interrelated crises of affordability, addiction and homelessness. There is universal agreement that homelessness has reached a breaking point, and the status quo is unacceptable. But that shared understanding ends there. While neighbors, business owners, policymakers and service providers may agree that addressing homelessness is our city’s top priority, we may have widely differing views on how to solve this issue, how to fund chosen interventions and what outcomes to demand. (Lorena Gonzalez, 3/7)