Politico: Killing Obamacare Kills Trump’s Health Agenda, Too
President Donald Trump wants to eliminate HIV in the U.S., contain the opioid crisis and lower the cost of prescription drugs — but all of those need Obamacare to be successful. And Trump just promised to kill it. His HIV plan relies on key pieces of Obamacare to expand access to prevention and treatment services for Americans at risk of contracting the deadly virus. Expanding opioid prevention relies heavily on Medicaid, which expanded under Obamacare. And Trump’s push to lower drug prices would use an innovation program that tests drug cost modeling — and was created by Obamacare. (Karlin-Smith and Ehley, 4/1)

CQ: Trump Drug Proposal Relies On Health Care Law He Wants To End
President Donald Trump's support for the wholesale repeal of the 2010 health care law could undermine his own plan on prescription drug prices and his messaging on an important issue ahead of the 2020 election: the climbing cost of medicines. Less than two weeks before the midterm elections last year, Trump delivered a proposal to rein in the costs of outpatient drugs by pegging them to the lower prices paid by foreign countries. (Kopp, 3/29)

The Associated Press: Trump's Battle With 'Obamacare' Moves To The Courts
After losing in Congress, President Donald Trump is counting on the courts to kill off "Obamacare." But some cases are going against him, and time is not on his side as he tries to score a big win for his re-election campaign. Two federal judges in Washington, D.C., this past week blocked parts of Trump's health care agenda: work requirements for some low-income people on Medicaid, and new small business health plans that don't have to provide full benefits required by the Affordable Care Act. (Alonso-Zaldivar, 3/31)

The Hill: Trump's Health Overhaul Efforts Hit Legal Roadblocks 
Key aspects of President Trump's health care agenda are struggling to overcome legal challenges in the courts. The administration, unable to repeal ObamaCare or enact conservative changes through Congress, has used its regulatory authority to try to push through changes to the Medicaid program and private insurance. (Weixel, 3/30)

The Hill: Five Major Court Battles Over Trump's Health Agenda 
The Trump administration has found itself in court time and time again defending the president’s efforts to overhaul the American health care system. Here’s a rundown of where the major lawsuits stand, from cases challenging the administration’s approval of Medicaid work requirements to a lawsuit arguing the Affordable Care Act is unconstitutional. (Hellmann, 3/31)

The Hill: Mulvaney: No One Will Lose Health Care Coverage If Courts Rule Against ObamaCare
Acting White House chief of staff Mick Mulvaney said Sunday that he could guarantee no Americans would lose health care coverage if President Trump eliminates ObamaCare. “Yes,” he said when asked by ABC's "This Week" host Jon Karl if he could guarantee that those with  current health coverage under ObamaCare would keep their coverage even if the administration is successful at getting a court to rule the health law unconstitutional. (Rodrigo, 3/31)

Politico: House Democrats Move To Condemn Trump's Obamacare Flip
House Democrats introduced a resolution today condemning President Donald Trump's support for a lawsuit that would strike down Obamacare, according to text shared first with POLITICO. "Americans are facing higher health care costs than ever, but this administration’s lawsuit would drive up prices and put coverage out of reach for thousands of Texas families," said Rep. Colin Allred (D-Texas), who introduced the resolution with the backing of House leadership. Democrats are planning to vote on it as soon as Tuesday, a spokesperson for Allred told POLITICO. (Diamond, 3/29)

The Hill: Sanders: 'Thousands Of People Will Literally Die' If Trump 'Gets His Way' On Health Care 
Sen. Bernie Sanders (I-Vt.) said Sunday that "thousands of people will literally die" if President Trump does away with the Affordable Care Act, also known as ObamaCare. "If Trump gets his way, the cost of health insurance ... will be so high that many people literally will not be able to afford it. Thousands of people will literally die. That’s Trump’s health insurance plan," Sanders said during an interview on CBS's "Face the Nation." (Burke, 3/31)

The Washington Post: For Trump’s ‘Party Of Healthcare,’ There Is No Health-Care Plan
Republicans have no intention of heeding President Trump’s urgent demands for a new health-care plan to replace the Affordable Care Act, fearing the potential political damage that such a proposal could cause in 2020 and hoping he will soon drop the idea, according to interviews with numerous GOP lawmakers, legislative staffers and administration aides. Not only is there no such health-care overhaul in the works on Capitol Hill — there are no plans to make such a plan. (Kim and Dawsey, 3/30)

The Washington Post: Republicans Maintain That They Are ‘Working On A Plan’ To Replace Obamacare
White House counselor Kellyanne Conway maintained Sunday that Republicans are “working on a plan” for replacing the Affordable Care Act, days after President Trump surprised members on both sides of the aisle when he declared that the Republican Party “will soon be known as the party of health care.” In an appearance on “Fox News Sunday,” Conway told host Chris Wallace, “The Republican plan is manifold.” But she did not provide specifics, instead going on to attack Democrats over the Medicare-for-all ideas that some in their party have embraced. (Sonmez, 3/31)

The Associated Press: Senate GOP Wary In Trump's Revived Health Care Battle
President Donald Trump's decision to revive the fight over the Affordable Care Act has stirred a political and policy debate among Republicans on how best to approach the divisive issue heading into the 2020 election. Failing to repeal and replace the ACA, otherwise known as Obamacare, is one of the biggest shortcomings of the president's first term in meeting its goals. It left Republicans with a broken campaign promise, dismal approval ratings and a narrative they haven't been able to shake — that they don't support protecting those with pre-existing medical conditions from high-cost care. In some races, it cost Republican seats last fall, flipping House control to Democrats. (Mascaro and Lucey, 3/30)

Politico: Collins Urges Barr Not To Work To Kill Obamacare
Sen. Susan Collins wants Attorney General Bill Barr to reverse the Justice Department's aggressive move seeking to obliterate the Affordable Care Act. In a letter to Barr sent Monday, the Maine Republican argues that if the Trump administration wants to change the health care law, it should come to Congress and ask. Otherwise Barr's department should be defending the law from a lawsuit seeking to cripple it, she says. (Everett, 4/1)

Politico: Millions In Family Planning Grants Given To Groups And States Fighting Trump's Policy Changes
The Trump administration announced Friday that it's awarding about $250 million in Title X federal family planning grants to states and providers across the country. The providers include an anti-abortion chain of clinics, as well as several states and provider groups that are threatening to drop out of the program if conservative-led changes go into effect in a few weeks. The new rules — designed largely to partially achieve conservatives' long-sought goal of cutting off public funding for Planned Parenthood — would block Title X grants from going to groups that make abortion referrals, potentially leaving gaps in care for low-income women. It's already illegal to use federal taxpayer dollars for abortion, with very limited exceptions. (Roubein and Ollstein, 3/29)

The New York Times: Trump Administration Gives Family Planning Grant To Anti-Abortion Group
The Trump administration took an important step on Friday in its push to restrict access to abortion and contraception, announcing that it would give as much as $5.1 million in family planning funds to a nonprofit organization funded by allies of the Catholic Church. The grant from the Department of Health and Human Services went to the Obria Group, a Southern California-based nonprofit that describes itself as being “led by God” and that aims to siphon patients — and money — away from Planned Parenthood. (Vogel and Pear, 3/29)

Politico: States Struggle To Replace Planned Parenthood As Trump Rules Loom
President Donald Trump’s sweeping changes to federal family planning policy may not hit anywhere harder than Utah, which has $2 million at stake and would be hard pressed to Planned Parenthood if the organization makes good on a threat to pull out of the state rather than operate under the new rules. “We’re the only game in town,” said Planned Parenthood Association of Utah President and CEO Karrie Galloway. “We’re a unique and challenging state, and people don’t have a lot of options for comprehensive, non-judgmental reproductive health care.” (Ollstein and Roubein, 3/29)

Bloomberg: Trump Urges End To Suit Against Contraception-Coverage Opt-Out 
The U.S. government asked a judge to throw out a lawsuit by two Democrat-led states challenging a Trump administration policy allowing companies with religious or moral objections to opt out of an Obamacare rule mandating employee health-care plans include free birth-control services. Pennsylvania and New Jersey can’t sue because the states haven’t been harmed by the exemption policy finalized in November, and “allegations of possible future injury do not suffice,” the U.S. Department of Health and Human Services said in a filing Thursday in federal court in Philadelphia. (Larson, 3/29)

And more news on abortion comes out of Georgia and Minnesota as well —

The New York Times: Georgia Is Latest State To Pass Fetal Heartbeat Bill As Part Of Growing Trend
Tensions over a growing movement to ban abortion after a fetal heartbeat can be detected intensified this week as lawmakers in Georgia passed a bill that stands to become one of the most restrictive abortion laws in the country. The bill, which narrowly passed in the Republican-controlled legislature on Friday, is expected to be signed into law by Gov. Brian Kemp, a Republican. The measure generally prohibits the procedure after doctors can discern a fetal heartbeat, a milestone that happens around six weeks of pregnancy — before some women know they are pregnant. (Mervosh, 3/30)

WBUR: Georgia's 'Uneasy Truce' On Abortion Ends
Hales' clients were worried they might no longer be able to receive abortion services, after Georgia lawmakers approved a bill that would ban abortions once a heartbeat is detected in an embryo, which is typically about six weeks into a pregnancy. Currently, women in Georgia can seek an abortion during the first 20 weeks of pregnancy. (Schuknecht, 3/30)

Pioneer Press: 20-Week Abortion Ban Bill Advances In MN Senate
A proposal to ban abortion 20 weeks after fertilization took another step forward in the Minnesota Legislature on Friday. The Senate Committee on Judiciary and Public Safety Finance and Policy advanced the bill on a voice vote after passing on a discussion about the proposal. The bill moves now to the Senate Health and Human Services Committee. The bill would ban abortions on women after 20 weeks post-fertilization except in cases of possible death or serious physical harm. Risk of substantial and irreversible psychological or emotional conditions would not be included. (Ferguson, 3/29)

The New York Times: Migrant Girl’s Autopsy Shows She Would Have Been Visibly Sick For Hours, Doctors Say
A 7-year-old Guatemalan girl who died in United States custody last December was suffering from a bacterial infection that was so advanced she probably would have been visibly sick for many hours, said several physicians who reviewed a newly released autopsy report of her death. By the time the girl, Jakelin Caal Maquin, arrived at a children’s hospital in El Paso with seizures and difficulty breathing, she already had severe blood abnormalities, according to a part of the report that summarized her condition in the emergency room of the Children’s Hospital at the Hospitals of Providence Memorial Campus. (Fink, 3/29)

Reuters: Guatemalan Migrant Girl In U.S. Custody Died Of Sepsis: Autopsy Report
The release of Caal's autopsy and the pinpointing of her cause of death are unlikely to resolve the larger questions about how migrants are treated in the hands of authorities. "The clinical course and autopsy findings are those of a rapidly progressive infection, with prompt systemic bacterial spread and substantial clinical deterioration," the report said. The strep bacteria were found throughout Caal's major organs, including her lungs, adrenal gland, liver, and spleen, the report said. (3/29)

The Associated Press Fact Check: Trump Twists Facts Of A Migrant Girl's Death
President Donald Trump is misrepresenting the circumstances of a 7-year-old migrant girl's death as he seeks to steer any potential blame for it away from his administration. Trump, after mockingly painting asylum seekers as a "con job" in a rally the previous night, asserted on Friday that Jakelin Caal Maquin was given no water by her father during their trek to a remote border area and that the dad acknowledged blame for his daughter's death on Dec. 8. Those assertions are not supported by the record. (3/29)

Meanwhile —

The Associated Press: 24 Immigrants Go On Hunger Strike To Protest US Detainment
Two dozen immigrants detained in Louisiana are on a hunger strike to protest being locked up as many seek asylum in the United States. Immigrant advocates say the strike started last week with about 150 people, but U.S. Immigration and Customs Enforcement says only 24 people have continuously denied meals. (Galvan, 3/29)

The Associated Press: Senate Barrels Toward Showdown Vote On Disaster Relief
A fight between President Donald Trump and Democrats over hurricane relief for Puerto Rico is imperiling a widely backed disaster aid bill that is a top priority for some of Trump's Southern GOP allies. The amount of money in dispute is relatively small, but Trump feels antipathy toward the U.S. territory's government and Senate Republicans are taking a hard line — for now — in denying Democratic demands for more aid for Puerto Rico, which was devastated by back-to-back hurricanes in 2017. (Taylor, 4/1)

The Associated Press: Puerto Ricans Struggle To Buy Food Amid Funding Shortfall
Iraida Vargas can no longer afford the two kinds of insulin her aging mother needs and has stopped buying fresh fruit and vegetables as billions of dollars in federal funds that help Puerto Ricans buy food, get medical treatment and recover from Hurricane Maria dwindle despite pleas from the U.S. territory that Congress take action. Vargas and her family are among the hundreds of thousands of Puerto Ricans feeling the sting of what the territorial government says are insufficient federal funds to help the island recover from the Category 4 storm amid a 12-year recession. (Coto, 3/29)

And in other news from Capitol Hill —

Bloomberg: Democrats Urge HHS Watchdog To Probe Verma’s Use Of Funds 
House and Senate Democratic committee leaders ask the Health and Human Services’ inspector general to review if Centers for Medicare and Medicaid Services Administrator Seema Verma followed federal rules when it came to awarding millions of dollars in “questionable CMS contracts to Republican communications consultants for her own benefit.” The request was made in a March 29 letter from House Energy and Commerce Chairman Frank Pallone, House Oversight and Reform Chairman Elijah Cummings, Senate Finance top Democrat Ron Wyden and Senate Health top Democrat Patty Murray, according to a statement. (Chipman, 3/29)

Politico: Bennet, Kaine Set To Introduce ‘Medicare X’ Plan To Expand Health Care
As Democrats debate how best to expand health coverage, Tim Kaine and Michael Bennet are trying to ensure the party doesn’t swing too far to the left. The Virginia and Colorado senators next week will reintroduce their “Medicare X” plan, which would create a new public option for health insurance — an idea that was originally part of Obamacare but was jettisoned for being seen, at the time, as too progressive. (Levine, 3/29)

The Philadelphia Inquirer: How ‘Medicare For All’ Went From Pipe Dream To Mainstream
What was once seen as a long-shot pitch from Sen. Bernie Sanders, I-Vt., during his 2016 presidential campaign is now a proposal for a single-payer health care plan that at least four of his Senate colleagues also running for the party’s 2020 nomination supported in the last Congress. The issue is driving the national political health care debate. But to succeed in enacting a single-payer system such as the “Medicare for All” plan Sanders backs, liberals would need a grassroots movement propelling the effort and would have to work out complicated policy details affecting nearly one-fifth of the nation’s economy. (McIntire, 3/31)

Miami Herald: Medicare For All Is Not The Answer, Industry Leaders Say
Speaking at the University of Miami’s Watsco Center for the annual Business of Health Care Conference on Friday, a panel of trade group leaders representing the nation’s hospitals, doctors, nurses, health insurers and healthcare financial managers agreed that America’s healthcare system needs to be simpler to navigate and more affordable. But they all disagreed that a universal expansion of Medicare, the national health insurance program for Americans 65 and older, would accomplish those objectives. (Chang, 3/29)

The New York Times: Lawsuits Lay Bare Sackler Family’s Role In Opioid Crisis
The Sacklers had a new plan. It was 2014, and the company the family had controlled for two generations, Purdue Pharma, had been hit with years of investigations and lawsuits over its marketing of the highly addictive opioid painkiller OxyContin, at one point pleading guilty to a federal felony and paying more than $600 million in criminal and civil penalties. But as the country’s addiction crisis worsened, the Sacklers spied another business opportunity. They could increase their profits by selling treatments for the very problem their company had helped to create: addiction to opioids. (Hakim, Rabin and Rashbaum, 4/1)

Stat: Purdue’s New Subsidiaries Raise Questions In Potential Bankruptcy
As Purdue Pharma grapples with thousands of lawsuits blaming the company for contributing to the opioid crisis, the drug maker has signaled it may file bankruptcy. If that happens, some newly created subsidiaries are likely to come under scrutiny. Over the past several months, Purdue has launched two limited partnerships that are now marketing or developing drugs that were previously listed as part of the Purdue product portfolio. Several former Purdue executives run these companies, both of which the drug maker refers to as operating subsidiaries. And a Purdue entity holds trademark rights for their names. (Silverman, 4/1)

USA Today: Addiction Seeps Into The Office As Workers Abuse Opioids, Pot, Alcohol
After Chris Tullock got promoted from washing dishes to busing tables at a restaurant in Northampton, Massachusetts, she got a second offer that was hard to turn down: smoking weed. It wasn't something she'd done often, she says. “I walked in a circle with a pie plate for, like, 15 minutes on a busy night,” says Tullock, 47, a 30-year veteran of the restaurant industry. “One of the waitresses said, ‘Please don’t ever smoke pot at work again.’" (Jones and O'Donnell, 3/29)

Bloomberg: Teva Wins Patent Case Related To Orexo Opioid-Treatment Drug 
A U.S. jury on Friday rejected a claim by Sweden’s Orexo AB that two generic opioid-addiction treatments created by Teva Pharmaceutical Industries Ltd. infringed a patent for Orexo’s biggest drug, Zubsolv. A Teva unit had created copies of the drugs Suboxone and Subutex, which are made by a third company, Indivior Plc, which wasn’t party to the lawsuit. Orexo had argued that the Teva products used the same essential formula as that covered by the patent for Zubsolv. After a trial in Wilmington, Delaware, federal court jurors disagreed. (Yasiejko, 3/29)

The Washington Post: An Overdose And A Mother’s Search For Truth
She had spent the past 13 months retelling the story of her daughter to anyone who would listen, and now Susan Stevens, 53, sped down the highway, needing to tell it again. Thirty people were gathered at a Cracker Barrel restaurant to hear a local sheriff discuss the opioid epidemic. Maybe, Susan thought, she could talk to the sheriff about her daughter, Toria. Maybe this would be the time when the pieces fit together and the ending finally made sense. The car had belonged to Toria, and as Susan pulled into the restaurant’s parking lot, she could hear Toria’s lip gloss rattling around under the front seat. Her anti-overdose medication was still in the glove box, unused. (Saslow, 3/31)

The Associated Press: DC To Distribute 76K Anti-Overdose Drug Kits By Fall 2019
Officials of Washington, D.C., say the city plans to distribute 76,000 kits to help counter area opioid overdoses by the end of September. The Washington Post reports the distribution would drastically increase the availability of the anti-overdose drug naloxone, as the city distributed only about 2,400 kits during the last nine months of 2017. (4/1)

The Associated Press: China To Regulate All Fentanyl Drugs As Controlled Substance
China said Monday it would begin regulating all fentanyl-related drugs as a class of controlled substances, in a change U.S. officials had long advocated as a way to stem the flow of lethal opioids from China. The sweeping change in the way China regulates drugs that mimic fentanyl takes effect May 1 and could help end the game of regulatory whack-a-mole with chemists who can manufacture novel opioids faster than they can be banned. (McNeil and Kinetz, 4/1)

Boston Globe: Surprise Medical Bills: The Doctor Is Not In Your Insurance Plan
Getting an out-of-the-blue medical bill — such as when a hospital uses doctors that are outside a patient’s insurance network — has become a nationwide phenomenon. It’s one that has forced exasperated patients to fight with medical providers and insurers at a time when they are already paying for a greater share of their health care. (Kowalczyk, 3/29)

Modern Healthcare: Surprise Medical Bills Burden 1 In 7 Patients
About 1 in 7 patients received a surprise bill despite obtaining care at an in-network hospital, according to new data that fuels the momentum behind potential fixes to the fragmented billing process. The share of in-network hospital admissions with at least one out-of-network claim ranged from 1.7% in Minnesota to 26.3% in Florida, according to the Health Care Cost Institute's analysis of nearly 620,000 in-network inpatient admissions and associated claims across 37 states and the District of Columbia in 2016. (Kacik, 3/28)

In case you missed it: Make sure to check out Kaiser Health News' special coverage on surprisingly high medical bills. 

The New York Times: An Outbreak Spreads Fear: Of Measles, Of Ultra-Orthodox Jews, Of Anti-Semitism
Erica Wingate was working at a clothing store in town this week when a male customer, with the black hat and sidelocks typically worn by ultra-Orthodox Jews, started coughing. Another shopper standing next to him suddenly dropped the item she had been holding and clutched her child. “She was buying something, and she just threw it down,” Ms. Wingate recalled. “She said, ‘Let’s go, let’s go! Jews don’t have shots!’” (Nir and Gold, 3/29)

Seattle Times: Fear, Resentment — And More Demand For Vaccines As One Washington County Grapples With Measles Outbreak 
For a solid month, Ashley Matzie took her newborn almost nowhere. Not to the grocery store, or to the park or even for a walk on her block in Camas, Washington, just east of Vancouver. ...As dozens of measles cases broke out in Clark County, totaling 73 by late March and prompting a visit from the U.S. surgeon general, Matzie and her partner took every precaution. As soon as he walked in the door from work, he changed his clothes and washed his hands. (Shapiro, 3/30)

NPR: Mumps Outbreak: MMR Vaccine's Protection Against Mumps Can Fade
A mumps outbreak that began at Philadelphia's Temple University in February has snowballed, with the city's health department now reporting 106 cases associated with the flare-up. University officials say the vast majority of students involved had been immunized previously with the MMR vaccine, which protects against measles, mumps and rubella. So why are so many still appearing on campus with the mumps' signature swollen cheeks? (Ellis, 3/28)

Cincinnati Enquirer: Boone County Student's Fight Against Chickenpox Vaccine Heads To Court
Boone County Circuit Judge J.R. Schrand will hear arguments from a senior at Assumption Academy in Walton who objected to the demand of public health officials for vaccinations against chickenpox when 32 students at his small Catholic school came down with the illness this year. All 50 states require the chickenpox vaccine for school children. (Saker, 3/31)

Stat: How Patients In Alzheimer's Trials Are Coping With Treatment's Failure 
When Biogen and its partner Eisai announced that they were stopping two phase 3 trials of the Alzheimer’s treatment aducanumab because the drug did not appear to be working, it shattered the faith that a truly effective therapy — one that could decelerate the descent that came with the disease — was finally in reach. It ignited reckonings both for Massachusetts-based Biogen and for the underlying scientific theory of Alzheimer’s on which aducanumab was constructed. (Joseph, 4/1)

The New York Times: Inside America’s Black Box: A Rare Look At The Violence Of Incarceration
The contraband is scary enough: Homemade knives with grips whittled to fit particular hands. Homemade machetes. And homemade armor, with books and magazines for padding. Then there is the blood: In puddles. In toilets. Scrawled on the wall in desperate messages. Bloody scalps, bloody footprints, blood streaming down a cheek like tears. (Dewan, 3/30)

The Washington Post: DNA Testing Is Being Used To Help Prescribe Antidepressants.
Grit alone got Linda Greene through her husband’s muscular dystrophy, her daughter’s traumatic brain injury, and her own mysterious illness that lasted for three years and left her vomiting daily before doctors identified the cause. But eventually, after too many days sitting at her desk at work crying, she went to see her doctor for help. He prescribed an antidepressant and referred her to a psychiatrist. When the first medication didn’t help, the psychiatrist tried another — and another and another — hoping to find one that made her feel better. Instead, Greene felt like a zombie and sometimes she hallucinated and couldn’t sleep. In the worst moment, she found herself contemplating suicide. (Marcus, 3/31)

NPR: Deep Brain Stimulation For Depression, Mood Disorders Could Be Ethically Fraught
Our thoughts and fears, movements and sensations all arise from the electrical blips of billions of neurons in our brain. Streams of electricity flow through neural circuits to govern these actions of the brain and body, and some scientists think that many neurological and psychiatric disorders may result from dysfunctional circuits. As this understanding has grown, some scientists have asked whether we could locate these faulty circuits, reach deep into the brain and nudge the flow to a more functional state, treating the underlying neurobiological cause of ailments like tremors or depression. (Spiegel and Lambert, 3/29)

NPR: Eating More Fish Might Mitigate Pollution's Effects On Asthma
It's long been known that air pollution influences the risk — and severity — of asthma. Now, there's emerging evidence that diet can play a role, too. A new study finds that higher consumption of omega-3 fatty acids, found in oily fish such as salmon, sardines and lake trout, and in some plant sources such as walnuts and flaxseed, is linked to reduced asthma symptoms in city kids who are exposed to fairly high levels of indoor air pollution. (Aubrey, 3/30)

The Associated Press: Immune System Therapy Shows Wider Promise Against Cancer
A treatment that helps the immune system fight deadly blood cancers is showing early signs of promise against some solid tumors, giving hope that this approach might be extended to more common cancers in the future. The treatment, called CAR-T therapy, involves genetically modifying some of a patient's own cells to help them recognize and attack cancer. Richard Carlstrand of Long Key, Florida, had it more than a year ago for mesothelioma, an aggressive cancer of the lining of the lungs. (3/31)

The Associated Press: Emails Show FDA Worry After Romaine Outbreaks
After repeated food poisoning outbreaks tied to romaine lettuce, a U.S. food safety official shared his concerns in an internal email, saying the produce industry's water testing "failed in an epic and tragic way." How the industry tests water to grow leafy greens is "unacceptable" and needs to change, James Gorny, a senior adviser for produce safety at the Food and Drug Administration, wrote to agency leaders. (3/29)

The New York Times: Brain Booster In A Bottle? Don’t Bother
Attention all consumers seeking to protect brain health: You can save hundreds of dollars a year and enhance the health of your brain and body by ignoring the myriad unproven claims for anti-dementia supplements and instead focusing on a lifestyle long linked to better mental and physical well-being. How many of these purported brain boosters have you already tried — Ginkgo biloba, coenzyme Q10, huperzine A, caprylic acid and coconut oil, coral calcium, among others? The Alzheimer’s Association says that, with the possible exception of omega-3 fatty acids, all that were properly tested thus far have been found wanting. (Brody, 4/1)

Stat: Microbiome Companies Look Beyond The Gut For New Therapies 
As more pivotal clinical trials for microbiome-based therapies begin, some people are already asking where these drugs might go next. One set of experts speaking at MassBio’s annual meeting on Thursday thought they had the answer — actually, two answers.  The relationship between microbes and cancer-fighting drugs will likely be the area of microbiome science that sees the most progress over the next five years, they speculated — which they hope will lead both to new treatments and diagnostic tools. (Sheridan, 3/29)

The Washington Post: Burnout Caused By Chronic Stress Is Widespread
A common ailment is going around, and you probably know someone plagued by it. Caused in part by social media, the 24-hour news cycle and the pressure to check work email outside of office hours, it could hit you, too — especially if you don’t know how to nip it in the bud. Burnout is everywhere. (Rough, 3/30)

The Washington Post: Why Many Shy Away From Hearing Aids And Over-The-Counter Devices
Jen Durgin’s dad once ordered a pair of $20 hearing aids through the mail but gave up on the devices when they did not work well without getting them adjusted by an audiologist. Durgin, who has two deaf children, tried to persuade her dad to see an audiologist for testing and fitting, but to no avail. “I think he just views hearing loss as a normal part of aging,” said Durgin about her 77-year-old father, who lives in New England. “For someone who never went to the doctor as a child and almost never as an adult, he just doesn’t view it as necessary.” (Neumann, 3/30)

The New York Times: Where There’s Rarely A Doctor In The House: Assisted Living
The patient moved into a large assisted living facility in Raleigh, N.C., in 2003. She was younger than most residents, just 73, but her daughter thought it a safer option than remaining in her own home. The woman had been falling so frequently that “she was ending up in the emergency room almost every month,” said Dr. Shohreh Taavoni, the internist who became her primary care physician. “She didn’t know why she was falling. She didn’t feel dizzy — she’d just find herself on the floor.” At least in a facility, her daughter told Dr. Taavoni, people would be around to help. (Span, 3/29)

In other health care personnel news —

The New York Times: Med Students Get An Extra Match On ‘Match Day’
Match Day at the University of Mississippi Medical Center is always a big deal. It’s the day medical students in their final year learn where they will be doing their residencies for the next three to five years. The nationwide system works a little like rushing for a college sorority or fraternity. Medical institutions rank their preference of medical students, and the students do the same. An algorithm determines “a match,” which the students are contractually obligated to abide by. (Krueger, 3/30)

The New York Times: Nurses Strike In New York: Threat Increases Over ‘Safe Staffing’ Levels
At Morgan Stanley Children’s Hospital in New York City, the 58 tiny beds for sick newborns are almost always filled. But nurses who work there say there are often too few of them to provide all of the care the babies, and their worried families, need. One of those neonatal intensive care nurses, Shanna Murphy, says she has not forgotten the new mother who got upset when she felt her crying infant was being ignored. Ms. Murphy, 28, said she wanted to soothe the baby, but she had her hands full with another patient whose condition had become unstable and required near-constant monitoring. (McGeehan, 3/30)

NPR: Training A Computer To Read Mammograms As Well As A Doctor
Regina Barzilay teaches one of the most popular computer science classes at the Massachusetts Institute of Technology. And in her research — at least until five years ago — she looked at how a computer could use machine learning to read and decipher obscure ancient texts. "This is clearly of no practical use," she says with a laugh. "But it was really cool, and I was really obsessed about this topic, how machines could do it." (Harris, 4/1)

NPR: Black-Box Algorithms: Ready For Medical Use?
Some computer scientists are enthralled by programs that can teach themselves how to perform tasks, such as reading X-rays. Many of these programs are called "black box" models because the scientists themselves don't know how they make their decisions. Already these black boxes are moving from the lab toward doctors' offices. The technology has great allure, because computers could take over routine tasks and perform them as well as doctors do, possibly better. But as scientists work to develop these black boxes, they are also mindful of the pitfalls. (Harris, 4/1)

WBUR: Electronic Health Record 'Gag Clauses' May Soon Come Off
The types of restrictions Bates is highlighting are widely referred to as "gag clauses" in the contracts that hospitals and medical practices sign with the vendors of electronic health records. As the federal government proposes new rules for medical records, there's reason to believe that those gags may soon come off. (Goldberg, 3/29)

Stat: CRISPR Companies Embrace Hope And Pressure Of Rapid Advances 
The genome-editing technology CRISPR has raced from the lab to the bedside, but the biotech companies translating the revolutionary tool into human medicine say they’re not cutting corners or ignoring the ethical implications of rewriting human life. “Something that, for me, inspires hesitation and pause is that when you edit someone, in some respects, that’s forever,” said Dr. John Leonard, CEO of Intellia Therapeutics, at a STAT Plus event on the future of CRISPR. (Garde, 3/29)

Bloomberg: Birth Control App Natural Cycles Is More Effective Than The Pill 
With $38 million in funding, Natural Cycles has outraised many of its women-focused tech peers. It’s still a bit player in terms of active users, though, counting only a few hundred thousand, primarily in the U.K., U.S., and Sweden. While there’s no standard definition for “active user,” and thus no accurate way to compare, free fertility apps tend to boast many times more. (Deprez, 4/1)

Boston Globe: This Robot Makes Sure You Remember To Take Your Pills
Wyman, serial entrepreneur Emanuele Musini, and physician Aiden Feng came up with Pillo Healthcare Assistant, a robot managed via an app to securely store and dispense medication for one person (that person or a caregiver has to load the bot). It has Alexa-like elements — it will tell you the weather, or answer wellness-related questions. (Rosen, 3/29)

Los Angeles Times: In Gentrifying Echo Park, The VA Is Forcing These Homeless Veterans To Leave
For six years, dozens of homeless veterans have recovered from trauma in nine cottages along a winding residential road in Echo Park. The Billets — military jargon for civilian quarters — has been a model. The 72-bed program places as much as 70% of its chronically homeless veterans — male and female — in permanent housing, according to Volunteers of America, which operates the program. It’s based in a tranquil, leafy and gentrifying neighborhood of families and young professionals a short walk from a doughnut shop, a grocery store and multiple bus lines. (Holland, 3/31)

Boston Globe: With Health Care Bill, Baker Is Diving Into A Policy Fight He Knows Well
After closed-door talks crumbled last summer, Beacon Hill is hitting reset on its pursuit of sweeping health care legislation, with one major difference: This time, Governor Charlie Baker, a former health insurance executive, will push his own plan. His proposal, expected to be unveiled this spring, would come almost a year after the House and Senate couldn’t reconcile controversial and drastically different versions of legislation designed to buttress community hospitals and rein in medical spending statewide. (Stout and Dayal McCluskey, 3/31)

The New York Times: With Guns Drawn, Officers Raided Home To Get Feverish Child
With guns drawn, the police officers broke down the door of the suburban Phoenix home in the early hours of a February morning. “Come out with your hands up!” an officer yelled, with the dark front porch and foyer inside suddenly flooded with light from the officers’ flashlights. The target of the raid: an unvaccinated 2-year-old boy with a high fever. (Hassan, 3/29)

The Washington Post: Creativity Festival Held At Smithsonian
The acronym STEM, which stands for science, technology, engineering and math, probably rings a bell. But do you know what SEAD means? After attending ACCelerate: ACC Smithsonian Creativity and Innovation Festival, a free event that runs Friday through Sunday, you just might. The acronym stands for science, engineering, arts and design — a vibrant collision of disciplines with the potential to change technology and stimulate creativity and innovation. (Blakemore, 3/30)

KQED: Trial Begins: Livermore Couple Alleges Monsanto’s Roundup Caused Cancer
Just one day after a federal jury decided that Monsanto must pay $80 million in damages to a Santa Rosa man, and less than a year after a state jury awarded $300 million in damages to a Vallejo groundskeeper in a similar case, opening statements were delivered Thursday in a new trial involving Monsanto in Alameda County Superior Court. This time, it’s the case of Alva and Alberta Pilliod, a Livermore couple in their 70s who used Monsanto’s herbicide Roundup on their three Northern California properties for more than 30 years. (Wolffe, 3/29)

Modern Healthcare: Fresenius Pays $231 Million To Resolve Federal Bribery Charges
Kidney-care giant Fresenius has agreed to pay $231 million to resolve federal criminal allegations that it paid bribes to officials to win business in Angola and Saudi Arabia and willfully failed to maintain records on transactions in those countries and others. "Fresenius doled out millions of dollars in bribes across the globe to gain a competitive advantage in the medical services industry, profiting to the tune of over $140 million," assistant Assistant Attorney General Brian Benczkowski said, citing alleged Foreign Corrupt Practices Act violations by the company between 2007 and 2016. (Meyer, 3/29)

Nashville Tennessean: Tennova Lebanon: Vanderbilt To Buy Middle Tennessee Hospital From Community Health Network
Vanderbilt University Medical Center will purchase Tennova Healthcare-Lebanon, a 245-bed hospital in Wilson County, VUMC announced Friday. The purchase is set to include the two-campus facility, including related businesses like physician clinic operations and outpatient services, to VUMC.  Formerly known as University Medical Hospital, Tennova Healthcare-Lebanon became part of the Tennova hospital network in 2016. Tennova is owned by Community Health Systems, Inc., which announced several planned divestitures in the fourth quarter of 2018, according to a release from the company. (Timms, 3/29)

The Hill: LGBT Group Sues Arizona Over Law Barring HIV, AIDS Instruction In Schools 
An LGBT rights group filed a lawsuit against Arizona this week over the state's prevention on HIV and AIDS education that “promotes a homosexual life-style.” Equality Arizona and an unnamed student argue in court that the state's 1991 law discriminates against LGBT students and puts their health at risk. (Frazin, 3/30)

KCUR: Fixing Crooked Teeth Is Not Just About Looks: Kansas City Nonprofit Seeks To Change Lives 
The Kansas City-based non-profit is devoted to the idea that fixing misaligned teeth and cross bites is not just an aesthetic frill for the self-involved, but a necessity for proper digestion and speaking, says co-founder Tom Brown. And, just as important, the newfound confidence of kids who had been teased about their teeth helps them succeed in a competitive world. Unlike other non-profits that target the lowest income groups, Smiles Change Lives sets its sights on people who fit under the umbrella of “working families” – the police officers, teachers, single parents and foster caregivers for whom braces, especially for more than one child, are often out of reach. (Hammill, 3/31)

Cleveland Plain Dealer: State-Wide Hepatitis A Outbreak Is Expected To Last Another Year
Ohio should brace for a second year of a hepatitis A outbreak that has killed seven Ohioans and hospitalized more than 1,000 since 2018, health officials said recently. The state declared a hepatitis A outbreak in June 2018 when it saw the number of cases rise to 79, which is nearly double the yearly average, said Sietske de Fijter, state epidemiologist with the Ohio Department of Health. (Washington, 3/29)

Bloomberg: Houston Fire Chemical Plant: Disaster Zone Remains No-Go 
Two weeks after a chemical storage complex near Houston erupted in flames and menaced tens of thousands of people with dangerous fumes, the site remains too hazardous for investigators to approach. Intercontinental Terminal Co. is still trying to drain millions of gallons of volatile oil byproducts from tanks damaged in the four-day blaze that began on March 17. The ground around the tanks is also saturated in dangerous fluids, severely restricting access to the facility 20 miles (32 kilometers) east of downtown Houston. On Friday, the company said they may be able to allow some access early this week. (Carroll and Crowley, 3/31)

California Healthline: Heavy Rains, End Of Drought Could Help Keep West Nile Virus Subdued — For Now
The end of California’s drought, announced earlier this month amid one of the rainiest winters in memory, could offer a surprising benefit: reduced transmission of the mosquito-borne West Nile virus. Longer term, however, more severe droughts associated with climate change could contribute to an increase in the number of infections in the state and nationally. Drought is the most important weather-related factor that affects the rate of West Nile infection, researchers say. Even though mosquito eggs need water to hatch, dry conditions tend to spur greater transmission of the virus. (Rowan, 3/29)

The Oregonian: Flu Season Came Late This Year, Primarily Affecting Older Oregonians 
Oregon is experiencing an unusually late flu season that’s primarily affecting people older than 50, according to reports from the Oregon Health Authority. Of the 144 cases of influenza reported in the Portland metro area this week, about 100 of them occurred in people over the age of 50. Almost 60 of those were 65 or older. (Campuzano, 3/30)

Boston Globe: Urgent Care Chain To Pay $2M Settlement In Billing Probe
CareWell Urgent Care, a fast-growing chain of walk-in clinics, will pay $2 million to settle allegations that it gave patients overly thorough exams and then billed government insurers for the unnecessary care. The investigation by the Massachusetts and Rhode Island attorneys general and the US attorney in Boston was prompted by a whistle-blower complaint filed by a former CareWell nurse practitioner. (Kowalczyk, 3/29)

San Jose Mercury News: East Bay Critics Blast Area Emergency Housing Plan
More than 120 people at a town hall meeting Thursday night heard criticism of Bay Area emergency policies to address the housing crisis — known as the CASA Compact — that speakers maintained could lead to higher-density housing structures, alter the city’s population and semi-rural character, and take local control out of the hands of city officials. Dennis Richards, a San Francisco Planning Commission member and one of the speakers, gave a detailed criticism of SB 50 by state Sen. Scott Weiner, D-San Francisco, saying the bill “will have the biggest impact on your lives since Prop. 13,” and could potentially lead to housing that would double or triple Orinda’s population and affect all its neighborhoods. (Kawamoto, 3/29)

NH Times Union: Elliot Health System Bond Rating Improves After Joining Forces 
SolutioNHealth, a regional health care system encompassing the Elliot and Southern New Hampshire Health systems, received a “stable outlook” and an “A-” rating from S&P Global Ratings. Both Elliot Health System and Southern New Hampshire Health also received “A-” ratings with a “stable” outlook, according to S&P. (Cousineau, 3/29)

Health News Florida: Lawmakers Look At Limiting Marijuana Highs
The House is considering a proposal that would cap THC levels in medical marijuana at 10 percent, Rep. Ray Rodrigues, R-Estero, said in an interview with The News Service of Florida. No bill has been filed, and Rodrigues, who’s shepherded medical-marijuana legislation in the House since low-THC cannabis was first authorized in 2014, said legislation is still “up in the air.” (Kam, 3/29)

The Washington Post: Republicans’ Missing Health-Care Plan
The Justice Department’s decision Monday that the entire Affordable Care Act is unconstitutional has sparked many questions, such as “Didn’t Republicans get killed in the midterms on health care?” and “Really? This again?” Combined with a federal judge’s ruling Thursday blocking the Trump administration’s “association health plans,” which the judge called “clearly an end-run around the ACA,” the biggest question is "What is the Republican Party’s health-care plan?” Judging from the party’s representatives on the Sunday talk shows, the answer is “whatever you want it to be.” (James Downie, 3/31)

The Hill: Juan Williams: Trump Allies Warn Of Health Care Folly
If you are a Trump voter, why trust me? Let’s go to President Trump’s toadies in Congress and see what they have to say about his Justice Department’s call last week to push the federal courts to kill the Affordable Care Act (ACA). Rep. Tom Reed (R-N.Y.), one of Trump’s strong backers, bluntly told The Washington Post that the president’s order to the Justice Department is “not the smartest move.” He explained that doing away with the current law without having a replacement ready to go “leaves millions of Americans in harm’s way and they didn’t do anything.” (Juan Williams, 4/1)

Axios: The Winning Health Care Message Will Be About Out Of Pocket Costs 
As the 2020 campaign ramps up, Democrats may be able to rally their base by talking about universal coverage and making health care a right through Medicare-for-all. Republicans may be able to motivate their core voters by branding progressive Democratic ideas as socialism.The catch: But it’s the candidates who can connect their plans and messages to voters’ worries about out of pocket costs who will reach beyond the activists in their base. And the candidates aren’t speaking to that much, at least so far. (Drew Altman, 4/1)

Arizona Republic: If Obamacare Is Killed People Will Die, And You Will Pay
If the lawsuit were to prevail, and Obamacare would suddenly cease to exist, more than 20 million Americans could find themselves without health care. Just like that. If that were to occur, with no replacement plan in place (and there is none), people would die. There is no way around it. (EJ Montini, 3/30)

The Hill: 2019 Medicaid Funding Cliff Could Cause Mass Migration From Puerto Rico
“Chronicle of a disaster foretold” — an ominous phrase coined by author Gabriel Garcia Marquez that no longer characterizes a fictional novel, but a very real and terrible occurrence that may happen in Puerto Rico at the end of this year. Puerto Rico is still recovering from the historic destruction caused by Hurricanes Irma and Maria and now, to add insult to injury, close to one million residents are in peril of losing their Medicaid coverage in 2019. A man-made, perfect storm that could impact not just Puerto Rico, but also states like Florida and other states where residents could potentially relocate to maintain their Medicaid coverage. (Jaime R. Torres, 3/30)

CQ: Health Matters: Opening Medicare To All Could Open A Pandora's Box
The discussion about Medicare buy-in options or other plans to expand coverage “could very well bring attention back to questions about what’s going on with the Medicare program today, both its strengths and its limitations,” says Medicare expert Tricia Neuman, a senior vice president at the Kaiser Family Foundation. Already, advocates for a single-payer health plan are proposing a massive Medicare overhaul. A plan (HR 1384) from Washington Democratic Rep. Pramila Jayapal would change how hospitals are reimbursed for their services and would cover more services, including vision, dental, mental health and long-term care. (Mary Ellen McIntire, 4/1)

The Hill: Not All Solutions To Surprise Medical Bills Are Cost-Effective 
U.S. senators on both sides of the aisle and President Trump have declared a need to protect patients from surprise medical bills. Insured patients who try to stay within their insurers’ networks can be hit with these bills when they unknowingly receive care from out-of-network physicians in emergencies or at hospitals in their insurers’ network where the doctors are not in the insurer’s network. Out-of-network physicians bill the patient’s insurer their list price, which is similar to the sticker price of a car — a price few people actually pay. (Mark Friedberg and Chapin White, 3/31)

The New York Times: Opioid Overreaction
Some Americans suffering from chronic pain have recently lost access to medicines that helped them live normal lives. Other patients have had to turn to invasive and dangerous treatments, like spinal injections. “Consequently, patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use,” more than 300 medical experts, including three former White House drug czars, wrote in a letter this month. “Others have experienced preventable hospitalizations or medical deterioration.” The experts sent the letter to the Centers for Disease Control and Prevention, urging officials there to take action. (David Leonhardt, 3/29)

The Washington Post: Vape Makers Must Do More To Stop Kids From Using E-Cigarettes
Health and Human Services Secretary Alex M. Azar and Food and Drug Administration Commissioner Scott Gottlieb were right when they argued in The Post on March 21 that vapor products present an opportunity to move adult smokers off combustible cigarettes, the leading cause of preventable death. They are right that use by minors of vapor products, including Juul products, is a serious problem that threatens the opportunity our industry offers. They are right also that companies such as ours must step up with meaningful measures to limit access and appeal of vapor products to young people. (Chief executive of Juul Labs Kevin Burns, 3/30)

The Hill: Why Are Lawmakers More Concerned With Youth Vaping Than Opioid Abuse?
In the latest installment of the youth vaping fear-mongering campaign, U.S. Sen. Jeanne Shaheen (D-N.H.) has called the reported increase in the number of young people trying e-cigarettes as a “national crisis." Apparently, Shaheen feels the need to add more alarmism to a debate that’s already fueled by misleading research and commentary. Shaheen’s declaration comes on the heels of her recently introduced legislation that would apply fees to e-cigarette products at a national level. This is a peculiar move considering Shaheen represents a state with the second highest opioid overdose rate in the country. (Lindsey Stroud, 3/31)

The New York Times: The Abortion Divide Gets Deeper
This week, a Georgia state representative, Ed Setzler, the sponsor of a bill that would ban most abortions as soon as a fetal heartbeat could be detected, spoke to a conservative group in the Atlanta suburbs about the legal fight he’d embarked on. “We need to maximize our influence over the next couple of weeks and then close this deal,” he said. Then, he continued, conservatives must mobilize behind Georgia’s Republican governor, Brian Kemp, as “he recruits the best legal team in the nation to take this to the highest court in the land. ”With the ascension of Brett Kavanaugh to the Supreme Court, as well as a host of other judges appointed by Donald Trump to lower courts, anti-abortion forces are engaged in a game of legislative whack-a-mole. Sensing their chance to either eviscerate or overturn Roe v. Wade, Republicans are pushing a barrage of anti-abortion measures at the state level, seeing which one goes all the way to the top. (Michelle Goldberg, 3/29)

The Wall Street Journal: Jackpot Junk Science 
The vagaries of American tort law were on display in San Francisco last week as six jurors decided that Bayer AG is liable for $80.3 million in damages for allegedly causing a Sonoma man’s non-Hodgkin lymphoma. The scientific consensus is that Bayer’s Roundup herbicide is safe, but the company is now open for looting as it faces lawsuits from some 11,200 similar plaintiffs. (3/31)

The Washington Post: How To Tell If Your Doctor Is Too Old
When are you going to retire, Doc? It’s a question I was asked several times a week. When it didn’t elicit a satisfactory answer, I would receive a variation on the same theme the next visit: How long are you going to do that commute? My patients knew that we had sold our house and moved to a condo closer to the city, which led to a 45-minute drive to and from my suburban office each day. I was in my late 60s and had been a family doctor in the same town for nearly 40 years. I had taken care of several generations within the same families. (Jonathan Maltz, 3/31)

Stat: Grasping The Multidimensional Narrative Of Topol's 'Deep Medicine'
Depth is all about discovering a new dimension. When you add width to length and height, you create volume, which just happens to be a synonym for “book.” I’ve just finished Eric Topol’s latest tome, “Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again,” and was fascinated by its multidimensional narrative. Although artificial intelligence (AI) is more than human, Topol took great pains to make “Deep Medicine” a book of human dimensions. (Ken Gordon, 4/1)

San Francisco Chronicle: Insight: We Need A Plan To Care For Aging Californians
Our city’s cost of living increases show no sign of slowing, adding to the financial squeeze that plagues California’s older adults. We cannot continue to ignore this problem. (Jeannee Parker Martin and David Berg, 3/29)

Cleveland Plain Dealer: Mental Disorders Are Not Diseases: David A. Hancock
The mind is not a physical organ; it cannot have a disease. While one can have a diseased brain, one cannot have a diseased mind. The DSM is simply a manual of symptoms elicited from thoughts, feelings and behaviors as a conscious choice or as responses to psychological stress, anxiety, frustration, anger, fear and perceptions. (David A. Hancock , 3/31)

Sacramento Bee: Four Labor Unions Work To Avoid A Sac School Strike. Why Can’t Teachers?
A statewide takeover of Sac City Unified would undoubtedly hurt programs kids need to read at grade level and achieve developmental steps to be ready for high school and beyond. This is a train wreck waiting to happen, and if it does happen, you can blame the leaders of SCTA for the destruction that will surely follow if the district runs out of money. (Marcos Bretón, 3/31)