The Associated Press: Speaker Ryan's Legacy To Include New Tax Code, Busted Budget
House Speaker Paul Ryan will leave Congress having achieved one of his career goals: rewriting the tax code. On his other defining aim — balancing the budget and cutting back benefit programs like Social Security, Medicare and Medicaid — Ryan has utterly failed. Ryan, a budget geek with a passion for details who announced Wednesday that he would retire next year, proved adroit in drawing up budget plans that balanced on paper but didn't get beyond the hypothetical. (Taylor, 4/12)

Modern Healthcare: House Speaker Ryan To Retire With A Mixed Legacy On Health Policy
House Speaker Paul Ryan will leave office in January likely without having achieved two of his top health policy priorities: repealing the Affordable Care Act and tackling entitlement reform. The Wisconsin Republican confirmed Wednesday that he won't seek re-election in November. He is now one of 38 sitting Republican House lawmakers who won't seek re-election in a cycle that retiring Rep. Charlie Dent (R-Pa.) described as a referendum on President Donald Trump "and his conduct in office." Ryan leaves an uncertain legacy when it comes to healthcare policy. (Luthi, 4/11)

The New York Times: Ryan Found Himself On The Margins As The G.O.P. Moved Right
Once described as “the intellectual center of Republicans in the House,” Mr. Ryan has styled himself as a master of policy, someone who understood the arcane details of budgeting, the tax code and health care. ... By that time, Mr. Ryan had carved out a niche as a rare creature in the House: someone who was admired in most conservative circles, and who had the respect of nearly everyone in his conference. He also presented himself as a younger and more modern face of the Republican Party. (Stolberg and Kaplan, 4/11)

The Washington Post: Fiscal Hawk Ryan Leaves Behind Growing Deficits And A Changed GOP
Fiscal issues have long been Ryan’s focus, as chairman of the Budget Committee and then the Ways and Means Committee, and it’s there that his failure to deliver looks most glaring, given years of promises and budget proposals aimed at slashing spending and reining in entitlements. Ryan acknowledged Wednesday that “more work needs to be done. And it really is entitlements.” But he added that he was proud that the House had passed what he described as “the biggest entitlement reform bill ever considered in the House of Representatives,” a reference to legislation repealing the Affordable Care Act and remaking the Medicaid program. That bill was rejected by the Senate. (Werner, 4/11)

The Wall Street Journal: With Paul Ryan's Exit, GOP Loses Advocate For Changes To Retirement, Healthcare
When House Speaker Paul Ryan leaves Congress, the Republican party will lose its most influential advocate for changes to Social Security, Medicare and Medicaid. As Budget committee chairman, a vice presidential running mate to Mitt Romney in 2012, Ways and Means chairman and finally House speaker, Mr. Ryan had pressed for curbs on federal spending on the three programs. These retirement and health care programs are popular with voters, but their costs are rising faster than the funds to pay for them. (Radnofsky and Timiraos, 4/12)

Elsewhere on Capitol Hill —

CQ: Indian Health Service Bill Heads To Senate Floor
A Senate panel on Wednesday approved a bill by voice vote that would give the Indian Health Service more authority for hiring and firing employees, although committee Democrats expressed concern that it would give the agency powers that could undermine its employees' rights. Republicans on the Indian Affairs Committee promised to address those concerns before the bill (S 1250) reaches the Senate floor. (Siddons, 4/11)

Kaiser Health News: Make Room For Baby: After Giving Birth, Duckworth Presses Senate To Bend Rules
It is so common that it likely will have happened at least once somewhere in the United States by the time you finish reading this sentence. But it took more than 230 years for it to happen to a senator. On Monday, Tammy Duckworth became the first sitting senator to give birth, forcing Senate leaders to face how ill prepared they may be to accommodate the needs of a new mother. (Huetteman, 4/11)

Modern Healthcare: Where The ACA Health Insurance Exchanges Stand In 2018
Though enrollment in the exchanges slipped and insurers hiked premiums by an average of 30%, the size of the premium tax credits available to most exchange enrollees ballooned enough that the average subsidized shopper paid a lower premium for coverage than the year before. Even so, the individual on-exchange ACA plans remain unaffordable for millions of people who aren’t eligible for financial help. Congress has yet to pass legislation to bolster the market and bring down premiums, and is unlikely to do so before insurers must file 2019 rates later this spring. (Livingston, 4/11)

And in the states —

Politico Pro: Massachusetts To Tout Its Individual Mandate After Congress Axes Obamacare’s
The looming demise of Obamacare’s individual mandate is prompting a scramble among health officials in Massachusetts, where a requirement to purchase coverage remains very much alive in the state that pioneered the idea. Massachusetts health officials for the first time in years are making plans to nudge residents to buy insurance or face a penalty, as they worry that Congress’ decision to repeal Obamacare’s mandate will sow confusion and risk unwinding the state’s historic coverage gains. (Pradhan, 4/11)

The Star Tribune: Minnesota Health-Plan Shoppers Used $137 Million In State Rebates 
Consumers in the individual health insurance market used about $137 million worth of financial help last year, less than half the sum set aside by legislators, according to final figures for the state’s one-time premium rebate program. Minnesota Management and Budget (MMB) released numbers this week showing that 118,000 people in the individual market received rebates, with an average value of $136 per person per month. (Snowbeck, 4/11)

Stat: NIH Looking At Alcohol Industry Influence 'In A Very Aggressive Way'
The controversy over research conducted by the National Institutes of Health on the health impacts of moderate drinking has reached Capitol Hill, where a lawmaker on Wednesday stridently questioned the agency’s director, Francis Collins, over the NIH’s reportedly cozy relationship with the alcohol industry. In response to a question about reports that the NIH had allowed industry partnerships to influence research into alcohol use and the impact of alcohol marketing, Collins told Rep. Lucille Roybal-Allard (D-Calif.) that the NIH is “looking into this in a very aggressive way.” (Facher, 4/11)

The Hill: NIH Investigating 'Alarming' Report On Funding For Alcohol Study: Official
Public health advocates argue the fundraising violates NIH policy, which prohibits employees from soliciting or suggesting donations to support activities. "I am also very concerned about the materials that have been reported ... about these circumstances, which I agree are alarming," Collins said Wednesday during a congressional hearing on the NIH's budget request. "We are looking at this in a very aggressive way." (Hellmann, 4/11)

Stat: ‘Therabros’ And ‘Disappeared’ Staffers: The 8 Juiciest Things We Learned From John Carreyrou’S New Theranos Book
Theranos this week laid off all but about two dozen of its remaining employees — the latest indignity for the once-fabulously rich blood-testing company that’s become a parable for Silicon Valley hubris. As with much of the flood of bad news for Theranos, word of the layoffs came from John Carreyrou, the investigative reporter at the Wall Street Journal who was the first to break the story of the company’s troubles in October 2015 and who later landed a string of Theranos-related scoops. (Robbins, 4/12)

Bloomberg: Asbestos In Talc Products Verdict Means J&J, Imerys Owe Millions
Johnson & Johnson and a talc-mining company were ordered by jurors to pay $80 million in punitive damages for hiding that their products, including J&J’s iconic baby powder, had been tainted by asbestos and posed a cancer risk. The New Jersey jury’s award brings to a total of $117 million that J&J and a unit of Imerys SA must pay investment banker Stephen Lanzo III over his claims the companies’ asbestos-laced talc products caused his cancer in what may be a precedent-setting case for U.S. talc litigation. (Feeley and Fisk, 4/11)

The Philadelphia Inquirer: Baby Powder Nets Banker With Cancer An $80M Verdict
The jury’s decision was the first to find that the health-care company’s baby powder led to a mesothelioma diagnosis and the first talcum powder case to involve a male plaintiff. More than 6,600 women have filed suit claiming the firm’s product caused them to contract ovarian cancer. (Wood, 4/11)

The Associated Press: In Opioid Epidemic, Some Cities Strain To Afford OD Antidote
An overdose-reversal drug is a critical tool to easing America's coast-to-coast opioid epidemic. But not everyone on the front lines has all they need. Baltimore's health department is rationing its supplies of naloxone because it says it can't afford an adequate stockpile. City Health Commissioner Dr. Leana Wen says they are forced to make hard decisions weekly about who gets the life-saving drug. (McFadden, 4/12)

The Hill: Poll: More Americans View Opioid Addiction As Serious Problem 
More Americans see opioid addiction as a significant issue in their communities than did two years ago, according to a new poll. Forty-three percent of Americans say the use of prescription pain drugs is an extremely or very serious problem in their communities, up from 33 percent two years ago, according to an Associated Press-NORC poll released Wednesday. (Hellmann, 4/11)

CQ: House And Senate Panels Plan To Act Soon On Opioids Bills
The Senate health panel plans to approve legislation to curb the opioid addiction crisis in less than two weeks, Chairman Lamar Alexander said Wednesday. “Our intention is to mark up the bill and report legislation to the full Senate by the end of the month,” said the Tennessee Republican, identifying April 24 as the target date. The remarks came during the seventh hearing that the Senate Health, Education, Labor, and Pensions Committee convened since October on the opioid crisis. (Raman, 4/11)

New Orleans Times-Picayune: Stopping Long-Term Opioid Therapy Has No Effect On Pain Levels: Study 
Patients taking opioids to manage their pain reported no change in their level of pain after discontinuing long-term opioid use, according to a new study that will be presented at the Society of Behavioral Medicine's annual conference in New Orleans on Thursday (April 11). Researchers examined the electronic health records of 600 patients in a national database maintained by the U.S. Department of Veterans Affairs for a year. They found that patients on average experienced no difference in pain after stopping long-term use of opioid to help manage their pain. (Clark, 4/11)

The Associated Press: Kentucky School Wins $150K For Device That Picks Up Needles
A Kentucky middle school has won a nationwide competition for creating a device that can safely pick up used needles and other drug paraphernalia. News outlets report Ashland Middle School won $150,000 Wednesday from Samsung. The hand-held device looks like a plastic box with flexible teeth that first responders and others can use to avoid touching needles. (4/11)

The CT Mirror: CT Opioid Lawsuits Advancing In Face Of Settlement Effort
Nearly two dozen Connecticut cities and towns are scheduled to soon confront Purdue Phama and other opioid makers in court over what they say are the pharmaceuticals’ deceptive practices. Meanwhile, a federal judge in Ohio is trying to resolve through a massive settlement more than 400 federal lawsuits brought by cities, counties and Native American tribes against central figures in the national opioid tragedy. (Radelat, 4/12)

Kaiser Health News: Medical Marijuana’s ‘Catch-22’: Fed Limits On Research Hinder Patients’ Relief
By the time Ann Marie Owen turned to marijuana to treat her pain, she was struggling to walk and talk. She also hallucinated. For four years, her doctor prescribed the 61-year-old a wide range of opioids for her transverse myelitis, a debilitating disease that caused pain, muscle weakness and paralysis.The drugs not only failed to ease her symptoms, they hooked her. (Taylor and Bailey, 4/12)

The Associated Press: Federal Lawsuit Seeks To Block Kentucky's New Abortion Law
Kentucky lawmakers and the American Civil Liberties Union are again locked in battle over abortion rights. The ACLU filed a federal lawsuit Tuesday shortly after Republican Gov. Matt Bevin signed a new law banning a common second-trimester abortion procedure known as "dilation and evacuation. "Kentucky's GOP-led legislature passed the bill overwhelmingly. It is the second abortion law in as many years to draw a court challenge. (Schreiner, 4/11)

The Hill: ACLU Sues Kentucky Over Ban On Common Abortion Method After 11 Weeks 
“We’re suing Kentucky yet again — this time to stop state politicians from banning a safe abortion method,” said Talcott Camp, deputy director with the ACLU Reproductive Freedom Project. “This law disregards a woman’s health and decisions in favor of a narrow ideological agenda.” Dilation and evacuation involves dilating the cervix and removing the fetus using suction and surgical tools. (Hellmann, 4/11)

The Courier-Journal: ACLU Sues Over Kentucky Abortion Law Banning D&E
The D&E procedure is generally performed after 11 weeks of pregnancy and accounted for 537 of about 3,300 abortions performed in Kentucky in 2016, according to state statistics. It involves dilating the cervix and removing the fetus using suction and surgical tools. A fetus is about 2 inches long and weighs almost a third of an ounce at 11 weeks, according to the Mayo Clinic. (Costello, 4/11)

And in other news —

The Hill: Arizona House Passes Bill Requiring Women To Provide Reason For Abortion
The Arizona state House of Representatives passed a bill requiring women to provide the reason why they’re obtaining an abortion. The bill, passed on party lines Monday, would require women to fill out an extensive questionnaire about their reasons to obtain the abortion, HuffPost reported. (Thomsen, 4/11)

The New York Times: Morning People May Live Longer Than Night Owls
Morning people may live longer than night owls, a new study suggests. Researchers studied 433,268 people, aged 38 to 73, who defined themselves as either “definite morning” types, “moderate morning” types, “moderate evening” types or “definite evening” types. They followed their health for an average of six-and-a-half years, tracking cause of death with death certificates. The study is in Chronobiology International. (Bakalar, 4/12)

Los Angeles Times: Bad News For Night Owls. Their Risk Of Early Death Is 10% Higher Than For Early Risers, Study Finds
Scientists have long studied whether night owls are saddled with health impacts — some research has linked a preference for sleeping late to higher rates of diabetes, heart disease and obesity, among others. But little was known on whether there was a link between sleeping late and the ultimate outcome: an earlier death. "We wanted to see whether this translated also into an increased risk of mortality and no one had done that before," said lead author Kristen Knutson, an anthropologist at Northwestern University. (Khan, 4/11)

The Associated Press: Risk Of Zika Infection Through Sex May Last Only A Month
Signs of Zika infection can be seen in semen for as long as nine months, but the risk of sexual transmission appears to end in one month, according to a study published Wednesday. The study suggests health officials have been overly cautious in advising couples to abstain from sex or to use condoms for at least six months after a male partner comes down with Zika. (Stobbe, 4/11)

Stat: Study Suggests Risk Of Sexual Transmission Of Zika May Dissipate Quickly
When Zika infections flared throughout Latin America, there was enormous concern that men carrying the virus could transmit it to women through sex — potentially infecting developing fetuses, if the women were pregnant. But it was unclear how long the risk might last. A new study from scientists at the Centers for Disease Control and Prevention does not definitely answer the question, but it offers public health agencies data to assess — and suggests infected men might not shed the virus in their semen for as long as was once thought. (Branswell, 4/11)

Stat: Could CRISPR Create Monster Animals? STAT Reviews 'Rampage'
We here at STAT cover CRISPR a lot. But it’s not every day we get to cover Dwayne “The Rock” Johnson. The Rock and the genome-editing technology meet in a new movie, “Rampage,” coming out Friday. Through a freak accident, a gorilla, a wolf, and a crocodile ingest some CRISPR complexes. The animals — whose genomes become edited to make them stronger, bigger, faster, and more aggressive — soon wreak havoc on the city of Chicago. (Thielking and Joseph, 4/12)

The New York Times: Why Exercise Alone May Not Be The Key To Weight Loss
If you give a mouse a running wheel, it will run. But it may not burn many additional calories, because it will also start to move differently when it is not on the wheel, according to an interesting new study of the behaviors and metabolisms of exercising mice. The study, published in Diabetes, involved animals, but it could have cautionary implications for people who start exercising in the hopes of losing weight. (Raynolds, 4/11)

NPR: Does The U.S. Need More Male OB-GYNs?
As she leaves a 12-hour-day on the labor and delivery shift, Dr. Katie Merriam turns off her pager."I don't know what I'd do without it, you know? It's another limb. I always know where it is," she says and laughs. The third-year resident in obstetrics and gynecology at the Carolinas Medical Center hospital in Charlotte, N.C., works in a medical specialty dominated by women, treating women. Merriam says she feels a special connection to her patients. (Olgin, 4/12)

The Washington Post: Heart Surgery: Sadie Rutenberg And The World's Smallest Mechanical Heart Valve
When Sadie Rutenberg was born, she had a gaping hole between the two sides of her heart, and her heart valves were malformed and leaking. In her first few months of life, she had already undergone two open-heart surgeries; but the damage was too extensive to repair, and the blond-haired, blue-eyed infant was failing to thrive. Her parents said there was no choice — they would have to take a risk, or their child might not survive. (Bever, 4/11)

Kaiser Health News: What We Know And Don’t Know About Memory Loss After Surgery
Two years ago, Dr. Daniel Cole’s 85-year-old father had heart bypass surgery. He hasn’t been quite the same since. “He forgets things and will ask you the same thing several times,” said Cole, a professor of clinical anesthesiology at UCLA and a past president of the American Society of Anesthesiologists. “He never got back to his cognitive baseline,” Cole continued, noting that his father was sharp as a tack before the operation. “He’s more like 80 percent.” (Graham, 4/12)

Texas Tribune: More Questions Than Answers In Texas Maternal Mortality Study, Lawmakers Say
In the wake of a study that found the state overcounted the number of Texas women who died from pregnancy complications in 2012, state legislators are cautiously moving forward. They expressed a mixture of surprise, relief, frustration and piqued curiosity after an Obstetrics & Gynecology medical journal study published Monday revealed that a new state methodology for counting and confirming maternal deaths reduced the number of Texas mothers who died in 2012 from 147 to 56. (Evans, 4/12)

Denver Post: Colorado Health Department Confirms Surgical Infections At Porter Adventist Hospital
The head of Colorado’s Health Department announced Wednesday that officials have confirmed surgical infections in “a number of patients” at a Denver hospital at the center of an investigation into sterilization practices. The infections occurred between July 21, 2016, and April 5 in patients who had orthopedic or spine surgery at Porter Adventist Hospital. The hospital suspended all surgeries after officials at the Colorado Department of Public Health and Environment found problems with how the hospital was cleaning its instruments after surgeries. CDPHE also raised concerns about residue on the tools after they were cleaned — which Porter attributed to a possible water-quality problem, according to a CDPHE statement Wednesday. (Ingold, 4/11)

Georgia Health News: Home Medical Equipment Firms Say Blue Cross Squeezing Them
Piedmont Healthcare isn’t the only entity battling Georgia’s biggest health insurer over reimbursement rates.Companies that supply medical equipment to home care patients say they have seen double-digit percentage rate reductions from the insurer, Blue Cross and Blue Shield of Georgia. MRS Homecare, based in Albany, says it faces a 17 percent to 33 percent pay reduction for home oxygen and sleep apnea equipment from Blue Cross. (Miller, 4/11)

The Associated Press: Nurse Fired, Arrested After Patient Dies At Texas Hospital
A former nurse who was fired last month from a Texas hospital has been charged with murder in the death of a patient last year and will likely face additional charges for hurting other patients in six other cases, police announced Wednesday. William George Davis was being held on a $2 million bond after he was arrested Tuesday evening in the August death of 47-year-old Christopher Greenaway. Police say aggravated assault charges could also be filed against Davis. (4/11)

Arizona Republic: Mandatory Abuse Reporting In Arizona: What Are Their Obligations?
Arizona requires anyone who suspects child abuse to report it. But certain professionals, including teachers, doctors and social workers, are mandated by law to report suspected abuse or neglect. If they fail to report it, they could face criminal charges. (Náñez, 4/12)

inewsource: Hustling Hope: San Diego Doctor Runs Controversial Diabetes Clinic
Just about every Tuesday morning around 7:30, John McCreary of Poway can be found waiting for Dr. James Novak’s office to open. Almost always, McCreary said, he’s the first one there. Novak’s practice is listed as the only one in the San Diego area offering Trina Health’s “Artificial Pancreas Treatment,” a four-hour IV insulin infusion procedure for people with diabetes. Some people like McCreary, 69, who has wrestled with diabetic nerve pain for years, said they think the procedure is working for them. (Clark, 4/11)

Cincinnati Enquirer: More Babies Are Seeing Their First Birthdays In Hamilton County.
The targeted push in the Avondale neighborhood to reduce the number of baby deaths has been so successful that Ohio will commit another $850,000 to launch similar drives in Winton Hills and North College Hill. Officials of Cradle Cincinnati will announce the new state grant at a Thursday news conference, where they also will unveil the group’s annual report on the state of infant mortality in Hamilton County. (Saker, 4/11)

The Baltimore Sun: Community Will Feel Loss Of Some Pediatric Services At Medstar Franklin Square Hospital, Many Say
MedStar Health announced the decision last week, citing declining pediatric admissions amid a statewide effort to reduce hospitalizations to save money in the health care system. But the decision has caused an uproar from the community and hospital staff, who say MedStar has abandoned its mission to serve the community in the pursuit of profits. (McDaniels, 4/12)

Nashville Tennessean: Cleveland, TN Doctors Plead Guilty Guilty In Health Care Fraud Scheme
Two Tennessee doctors have pleaded guilty to federal charges in a $65 million military health care fraud scheme. Drs. Carl Lindblad, 53, and Susan Vergot, 31, both of Cleveland, pleaded guilty Wednesday to conspiracy to commit health care fraud, according to the U.S. Attorney's Office for the Southern District of California. Prosecutors say the pair prescribed "thousands of exorbitantly expensive compounded medications," or those specially mixed by a pharmacist to meet a person's unique medical need, to patients they never saw or examined. (Allison, 4/11)

St. Louis Public Radio: SLU Researchers Work To Prevent Chemotherapy Pain
Chemotherapy patients often experience burning and tingling in the hands and feet, known as “chemotherapy-induced neuropathic pain.” The condition has no known treatment, but new research offers a reason to hope. In a recent study, a team of SLU researchers successfully “turned off” the pain associated with a common chemotherapy drug. (Farzan, 4/11)

Cincinnati Enquirer: Cincy Archdiocese, Mercy Health Agree To Condom Ban At Needle Exchange
Catholic hospital system Mercy Health has switched its decision about condom giveaways at a mobile needle exchange that makes a weekly stop in its Clermont County hospital parking lot. ...The turnaround came after a Catholic News Agency reporter asked the archdiocese about Mercy's decision to leave the syringe exchange to do its own thing, which includes providing condoms to clients. (DeMio, 4/11)

Chicago Tribune: Rush, Little Company Of Mary Hospital Call Off Merger Plan 
The Chicago-based Rush hospital system and suburban Little Company of Mary Hospital and Health Care Centers have called off their plan to merge. Representatives of the health systems on Wednesday declined to answer questions about why discussions ended or make their CEOs available. The organizations “mutually agreed” to back away from the idea of Rush acquiring Little Company of Mary, according to a memo sent to Rush employees Wednesday by Rush CEO Dr. Larry Goodman and Rush President Michael Dandorph. (Schencker, 4/11)

Cleveland Plain Dealer: First Round Of Ohio Doctors Approved To Recommend Medical Marijuana
The state medical board on Wednesday approved 37 physicians to recommend medical marijuana to Ohio patients. Most of the physicians approved as part of the first round of "certificate to recommend" applications are located in Northeast Ohio. (Borchardt, 4/11)

The Associated Press: Nixon: Support For Legalizing Marijuana Use A Racial Issue
A week after telling two interviewers her support for legalizing recreational use of marijuana in New York was revenue-based, Democratic candidate for governor Cynthia Nixon said Wednesday that it's now foremost a racial justice issue for her. The "Sex and the City" star posted a 90-second video on YouTube in which she stated that it's time New York joined eight other states and the District of Columbia in legalizing recreational use of marijuana. (4/11)

The Washington Post: John Boehner's Reversal On Cannabis: Former Speaker Of The House Joins Acreage Holdings, Says Thinking On Drug Has Evolved
John A. Boehner, the former Republican speaker of the House who once said he was “unalterably opposed” to decriminalizing marijuana laws, has joined a board of directors for a cannabis company with an eye on rolling back federal regulations. The former Ohio congressman has been appointed to the board of advisers of Acreage Holdings, invoking the need for veterans to access the drug legally to explain his change of heart, Boehner said in a statement Wednesday. The company grows and sells legal weed and operates in 11 states. (Horton and Ingraham, 4/11)

Tampa Bay Times: Judge: Joe Redner Can Legally Grow His Own Marijuana
A court ruled Wednesday that Tampa strip club owner Joe Redner can grow his own marijuana for medical purposes, a decision that lawyers say could lead to a wave of similar cases. The ruling by Leon County Circuit Judge Karen Gievers applies only to Redner, 77. The Florida Department of Health responded quickly, filing an appeal. (Griffin, 4/11)

Los Angeles Times: Paul Ryan Came In As A 'Young Gun' With Big Ideas. He'll Leave As A Pushover
But when it came to translating ideas into law, many of Ryan's ambitious proposals never made it past the roadmap stage. That's particularly true of his signature issue, entitlement reform. Members of Congress who were ready and willing to vote for nonbinding, conceptual 10-year plans to wind down the federal deficit by slashing tens of billions of dollars from Medicare and safety-net programs weren't quite so eager to take up the legislation necessary to put such changes into law. ...Instead, Ryan's main accomplishments as speaker — slashing tax rates and busting open the budget caps he helped negotiate in 2011 — are the legislative equivalent of skipping dinner and going straight to dessert. Such costly acts of largesse are a piece of cake in comparison to the tough work of overhauling immigration laws or reining in healthcare costs.(4/11)

St. Louis Post Dispatch: Paul Ryan, Budget Hawk Turned Deficit Buster, Pulls The Rip Cord
The good news, such as it is, is that Ryan won’t be around to argue that the deficits he helped create must be fixed by cutting Medicare and Medicaid. Ryan made his reputation as a policy wonk with lengthy “road maps” designed to reform entitlement programs. His ideas included turning Medicaid into a capped block grant program and giving seniors vouchers for private health insurance in place of traditional Medicare. He wasn’t wrong that growth in health care spending is driving the nation’s budget problems. He was wrong in thinking that tax cuts heavily weighted to wealthy Americans and corporations would create enough growth to pay for themselves and everything else the government has to do. (4/11)

The New York Times: Republicans Couldn’t Knock Down Obamacare. So They’re Finding Ways Around It.
The Trump administration has always seen Obamacare as an abominable roadblock to the less regulated insurance market it prefers. Last year, it tried to knock it down and failed. Now, it’s building a set of detours. More customers who want to avoid buying health insurance can now find a way out of the law’s individual-mandate penalty, which will disappear completely next year. Those who want skimpy plans not covering maternity care or bills exceeding a set annual amount may soon have that option in many states — provided they don’t have pre-existing conditions. (Margot Sanger-Katz, 4/11)

Axios: The Left Is Getting More Active On Health Care
Activism and political protest is on the rise on the left in the U.S., and support for the Affordable Care Act is one of the biggest issues motivating the protesters, according to the latest survey on activism and protest by the Kaiser Family Foundation and the Washington Post. Why it matters: It's a reversal from the last election cycle, when public opinion about the ACA was more negative than positive and Tea Party protests against the ACA were commonplace. It's clear that the political energy in health is switching from right to left. (Drew Altman, 4/12)

The Wall Street Journal: Do What Works To Help Welfare Recipients Work
President Trump issued an executive order Tuesday encouraging federal agencies to adopt more-stringent work requirements for various welfare programs. What can Congress do to encourage work? Two possibilities are increasing the minimum wage and expanding the earned-income tax credit. My recent research shows that these two policies can have very different, and perhaps unintended, effects on the ability to become economically self-sufficient over time. (David Neumark, 4/11)

The Wall Street Journal: Working On Food Stamps
A common refrain from businesses is that they can’t find enough workers. The unemployment rate is a low 4.1%, but one reason for the shortage are government benefits that corrode a culture of work. So credit to House Republicans for trying to fix disincentives in food stamps amid what are sure to be nasty and dishonest attacks. (4/11)

USA Today: Food Stamp Work Requirements Will Lift Americans Out Of Poverty
People want to believe the American dream is attainable. That’s why we need to shift the conversation on poverty in this country from one focused purely on benefits to one about improving futures. And as the House Agriculture Committee releases its new farm bill — legislation that governs the policy for our nation’s nutrition programs — that is precisely what we aim to do. Our proposal is straightforward: help those on the Supplemental Nutrition Assistance Program (SNAP) who are work-capable find employment to support their households. (Rep. Mike Conaway and Lee Bowes, 4/12)

NH Times Union: What Trump Gets Right And Wrong About Opioid Crisis
President Trump has it partially right on the opioid crisis, specifically with his plans to hold drug companies responsible and increase spending on treatment. But like much of America, the President has it wrong on the root causes of addiction and just how we should attack it. The death penalty won’t deter drug dealers. And scary TV ads won’t deter addicts. Addiction doesn’t listen to reason and drug dealers don’t decide whether to make money or not based on the potential penalty they could face if caught. We need to start thinking about addiction differently. (Eric Spofford, 4/11)

Chicago Tribune: Overdose Deaths Are The Product Of Drug Prohibition
During Prohibition, drinkers never knew what they would get when they set out to slake their thirst. Bootleggers often sold products adulterated with industrial alcohol and other toxins. Some 10,000 people were fatally poisoned before America gave up this grand experiment in suppressing vice. So it was a tragedy but not a total surprise when three deaths were reported in Illinois from synthetic marijuana laced with an ingredient (possibly rat poison) that caused severe bleeding. Nationally, in 2015, says the Drug Policy Alliance, “poison control centers received just under 10,000 calls reporting adverse reactions to synthetic cannabinoids, and emergency rooms received tens of thousands of patients.” People consume synthetic cannabis for the same reason people once consumed bathtub gin: Their drug of choice is illegal. (Steve Chapman, 4/11)

JAMA: Association Of Medical And Adult-Use Marijuana Laws With Opioid Prescribing For Medicaid Enrollees
Medical and adult-use marijuana laws have the potential to lower opioid prescribing for Medicaid enrollees, a high-risk population for chronic pain, opioid use disorder, and opioid overdose, and marijuana liberalization may serve as a component of a comprehensive package to tackle the opioid epidemic. (4/2)

JAMA: Association Between US State Medical Cannabis Laws And Opioid Prescribing In The Medicare Part D Population
This longitudinal analysis of Medicare Part D found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened. Meaning: Medical cannabis policies may be one mechanism that can encourage lower prescription opioid use and serve as a harm abatement tool in the opioid crisis. (4/2)

The New York Times: To Save Abortion Rights, We Have To Think Beyond Roe
When Gov. Phil Bryant of Mississippi, a 53-year-old Republican man, delivered his State of the State address in 2014, he said, “On this unfortunate anniversary of Roe v. Wade, my goal is to end abortion in Mississippi.” Last month, Bryant signed into law the Gestational Age Act, which bans abortion after 15 weeks (when the fetus is about four inches long and, according to the pregnancy resource “What to Expect,” “the eyes are moving from the sides of the head to the front of the face”) “except in medical emergency and in cases of severe fetal abnormality,” making no exception for rape or incest. A judge has temporarily blocked the law, citing its “dubious constitutionality.” (Lindy West, 4/11)

Stat: What Facebook's Public Scrutiny Can Teach Us About AI In Health Care
[T]he recent firestorm over Facebook’s involvement in the Cambridge Analytica scandal is less about the data breach and more about the right to privacy and the limits to that right. It is also highlighting the ethical conflicts of implementing artificial intelligence without thoroughly considering societal norms. This scandal has some important bioethics lessons for health care leaders who are building machine learning and artificial intelligence models for clinical decision-making. The biggest bioethical challenge in building these models is how we prevent algorithms from imitating human biases in decision-making. (Junaid Nabi, 4/11)

USA Today: End-Of-Life Care Is The Same Whatever Your Doctor's Political Views
We combined data on political donations made by physicians with data on the type of care they provide to Medicare patients at the end of life, and found no differences in the end-of-life care patients receive depending on the political affiliation of the doctor treating them. Among patients who die in the hospital, patients treated by Republican doctors don’t get more feeding or breathing tubes, don’t receive dialysis more often and don’t have higher end-of-life spending compared to patients treated by Democratic doctors. For patients who survive hospitalization but are expected to die within months, those treated by Democratic doctors aren’t any less likely to be discharged from the hospital directly to hospice care. Total end-of-life medical spending is the same whether doctors are Democrats, Republicans or neither. (Dhruv Khullar and Anupam B. Jena, 4/12)

The Hill: ​An Evidence-Based Approach To The Tobacco Conundrum
The path to successful innovation is never easy, especially in hotly controversial industries.  The Food and Drug Administration (FDA) is now considering whether to approve the first of a new  generation of tobacco products, one designed to heat rather than burn tobacco. This technology produces far less inhalation of harmful chemicals than cigarettes, making it an attractive and safer alternative for current smokers. The purist elites in the tobacco wars of the past 25 years will do anything to prevent advancement and innovation from tobacco companies. Tobacco is harmful, but when blocking the use of less harmful products are the purists tossing the baby out with the bathwater? (Lindsay Mark Lewis, 4/11)