The Associated Press: Government Headed For Close To Half Of Nation's Health Tab
Even without a history-making health care remake to deliver "Medicare-for-all," government at all levels will be paying nearly half the nation's health care tab in less than 10 years, according to a federal report released Wednesday. The government growth is driven by traditional Medicare, which is experiencing a surge in enrollment as aging baby boomers shift out of private coverage, according to the analysis from the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services. (Alonso-Zaldivar, 2/20)

The Washington Post: Spending Forecast Offers Ammunition — And Some Alarm — For Democrats Pushing Medicare Expansion
Aging baby boomers will consume an ever-larger share of the nation’s health-care spending over the coming decade, regardless of the success of Democrats running for president with ambitious plans to broaden Medicare. The number of people covered through Medicare — and spending on the federal insurance program for older and disabled Americans — is expected to grow more rapidly than private insurance or Medicaid, eating up a larger chunk of health spending, according to a yearly forecast of U.S. health-care expenditures released Wednesday. (Goldstein, 2/21)

The Wall Street Journal: Health-Care Spending Projected To Accelerate As Population Ages
The report from actuaries at the Centers for Medicare and Medicaid Services is likely to add to the pressures making health care a significant issue in the 2020 election. Health care’s share of the economy is projected to climb to 19.4% by 2027 from 17.9% in 2017, assuming no legislative changes to the U.S. health system. The faster rate of growth would follow a slower tempo seen in 2017, when increases decelerated to a pace not seen since just after the 2007-09 recession. “While Medicare spending is expected to accelerate the fastest among payers and contribute to the increase, growth in health prices and disposable personal income are also significant contributors,” said Andrea Sisko, an economist at CMS and lead author of the study published in the journal Health Affairs. (Armour, 2/20)

PBS NewsHour: Health Spending Could Rise 5.5 Percent A Year Through 2027. Here’s Why
By 2027, nearly 90 percent of Americans are projected to be insured under Medicare, Medicaid or private insurance — a stable rate at pace with population growth but a slight dip from the 90.9 percent of insured Americans today. But spending on Medicare is expected to grow at a faster rate than Medicaid or private insurance, according to the study, offering a clue about why overall spending is likely to increase. (Santhanam, 2/20)

Modern Healthcare: Healthcare Spending Will Hit 19.4% Of GDP In The Next Decade, CMS Projects 
These spending trends could boost public support for policy proposals to regulate prices and boost competition for healthcare services and drugs. For instance, Democratic proposals for Medicare-for-all and public plan options would pay providers at Medicare prices, which generally are significantly lower than what private insurers pay. "The cost trend will make it easier to fund a Medicare-for-all or public option plan, because the price differential between what Medicare and the private sector pay allows you to save money by paying Medicare rates," said Gerald Anderson, a health policy professor at Johns Hopkins University. (Meyer, 2/20)

Stat: Drug Spending Could Rise 6.1 Percent Annually By 2020, Federal Projections Show 
Spending on prescription drugs is expected to increase at an accelerating rate over the next 10 years, according to government estimates released Wednesday — ramping up to as much as 6.1 percent growth by 2020. The Office of the Actuary at the Centers for Medicare and Medicaid Services annually forecasts how much money patients, insurance companies, and the government will spend on health care in the coming decade — so-called national health expenditures. Broadly, they predict total health spending in the U.S. will increase by an annual average of 5.5 percent until 2027. (Swetlitz, 2/20)

PBS NewsHour: How Americans Spend Much More On Health Care Than They Realize
U.S. households spent $980 billion on health care in 2017, which works out to more than $3,200 per person, according to the Centers for Medicare and Medicaid Services’ annual report on health spending. While that may have been a bitter a pill to swallow, you might be as surprised as I was to learn that consumers directly paid for only a third of the nation’s $2.9 trillion personal health care costs. (Moeller, 2/20)

And take a deeper look at the "Medicare for All" plans that are out there —

The New York Times: Build Your Own ‘Medicare For All’ Plan. Beware: There Are Tough Choices.
“Medicare for all” is popular, and not just among Democrats. Most Republicans favor giving people under 65 at least the choice to buy into Medicare. But when people hear arguments against it, their support plummets. It turns out that most people don’t really know what Medicare for all means. Even asking three policy experts might yield three different answers. By our count, there are at least 10 major proposals to expand Medicare or Medicaid. (Frakt and Carroll, 2/21)

The New York Times: U.S. Investigating Johnson & Johnson Over Baby Powder’s Safety
The Justice Department and Securities and Exchange Commission are investigating Johnson & Johnson over concerns about possible asbestos contamination of its popular baby powder and other talc-based products, the company said Wednesday. In a securities filing, Johnson & Johnson said it was “cooperating with these government inquiries and will be producing documents in response” to subpoenas it had received. In a separate statement, the company said that “the inquiries are related to news reports” about the welter of lawsuits it faces from consumers who claim its talc products caused cancers. (Hsu, 2/21)

Reuters: Johnson & Johnson Receives Federal Subpoenas Related To Baby Powder Litigation
The company said it intends to "cooperate fully with these inquiries and will continue to defend the Company in the talc-related litigation." The disclosure in Johnson & Johnson's annual report on Wednesday is the first time that the company disclosed it had received subpoenas from federal agencies regarding its talc powder products. The Justice Department declined to comment and the SEC did not immediately respond to requests for comment. (2/21)

The Wall Street Journal: Johnson & Johnson Is Subpoenaed For Talc Safety Information
The talc-powder litigation threatens J&J’s carefully cultivated image. At least 13,000 lawsuits against the company claim that use of Johnson’s Baby Powder and other talc products caused ovarian cancer and mesothelioma, as the lawsuits allege. J&J says decades of testing have shown its baby powder is safe and asbestos-free, and that it doesn’t cause cancer. (Loftus, 2/20)

The Hill: Johnson & Johnson Subpoenaed By DOJ And SEC, Company Says
Late last year, the company launched a national ad campaign defending itself following an investigation from Reuters that said the company knew for decades its talc baby powder contained traces of asbestos. (Weixel, 2/20)

The New York Times: Critic Of Waste At Veterans Affairs Now Faces Questions About His Travel Costs
A top adviser at the Department of Veterans Affairs, who was an outspoken critic of wasteful practices there before he joined the department, has come under fire for billing the government for the cost of commuting between the department’s headquarters in Washington and his home in California. The adviser, Darin Selnick, who is spearheading a controversial plan to shift billions of dollars from government-run veterans’ hospitals to private health care providers, spent more than $13,000 on his bicoastal commute in three months, including airfare, hotel stays and other outlays, according to expense reports published by the nonprofit news organization ProPublica. (Philipps, 2/20)

CNN: FDA Chief: Federal Government Might Step In If States Don't Change Lax Vaccine Laws
The head of the US Food and Drug Administration says that if states don't require more schoolchildren to get vaccinated, the federal government might have to step in. Nearly all states allow children to attend school even if their parents opt out of vaccines. These vaccine exemptions are especially popular in Washington state, where a measles outbreak started last month that has now sickened at least 67 people in four states. And New York has been working to contain its largest outbreak in decades, which began in October and has sickened more than 200 people. (Cohen and Bonifield, 2/20)

The Washington Post: Some Anti-Vaccination Parents Cite Religious Exemptions. Measles Outbreaks Could Change That.
Recent measles outbreaks in states such as Washington, New York and New Jersey have cast a spotlight on a group of Americans who receive exemptions from immunizing their children on the grounds that the vaccines violate their religious freedoms. Now the states that suffered outbreaks are taking aim at those exemptions. In recent weeks, lawmakers in the New Jersey, New York, Iowa, Maine and Vermont state legislatures have proposed eliminating religious exemptions for vaccines. A Washington state representative has proposed tightening the state’s religious exemption while eliminating a separate law that allows for a personal or philosophical exemption from immunization. (Pulliam Bailey, 2/21)

NPR: Vaccine Discussions May Be Most Helpful During Early Pregnancy
In 2017, Kim Nelson had just moved her family back to her hometown in South Carolina. Boxes were still scattered around the apartment, and while her two young daughters played, Nelson scrolled through a newspaper article on her phone. It said religious exemptions for vaccines had jumped nearly 70 percent in recent years in the Greenville area — the part of the state she had just moved to. She remembers yelling to her husband in the other room, "David, you have to get in here! I can't believe this." (Olgin, 2/20)

The Oregonian: Vancouver-Area Measles Outbreak Grows To 68
Another Vancouver-area child was diagnosed with measles Wednesday. That brings the total number of local measles cases to 68. ... There is also one person suspected of having measles, but bloodwork has not yet confirmed the diagnosis. The vast majority of the cases are in Clark County, but the outbreak has spread to four people in Oregon and one in the Seattle area. (Harbarger, 2/20)

Stat: Facebook's Controversies Now Extend To Health And Medicine Issues
The Facebook controversies have come to the world of health and medicine. After last year’s scandals involving Cambridge Analytica and Russian trolls, this time the controversies concern anti-vaccine information and health privacy. It all started last week when journalists reported that Facebook allows advertisers to target users who have demonstrated interest in anti-vaccine information — and that anti-vaccine ads promoted on the site have been viewed millions of times. Democratic Rep. Adam Schiff of California also sent a letter to the company urging it to stem the flow of vaccine misinformation. (Robbins, 2/20)

Stat: Unsealed Testimony Reveals A Goal Of Atul Gawande Venture: ‘Make Health Insurance Intelligible’
Making insurance intelligible is the core mission of the health care venture led by Atul Gawande and founded by Amazon, Berkshire Hathaway, and J.P. Morgan Chase, according to testimony unsealed on Wednesday from the venture’s chief operating officer. The COO, Jack Stoddard, also focused on the venture’s approach to prescription drug prices — and to the flaws and foibles of a notoriously opaque system. “You can imagine our employers are — just given who supports us — are incredibly allergic to market inefficiencies,” Stoddard said. (Sheridan, 2/20)

The Wall Street Journal: New Details Of Amazon, Berkshire Hathaway, JPMorgan Health Venture Emerge In Court Testimony
A health-care joint venture launched by Amazon.com Inc., Berkshire Hathaway Inc. and JPMorgan Chase & Co. is looking at how to redesign health insurance, among other efforts, according to newly unsealed court testimony from an executive at the health startup. The three companies announced the venture last year with stated goals of trying to improve health care and rein in costs for their employees. The still-unnamed venture has released few specifics, however, about its long-term aims. (Kamp and Wilde Mathews, 2/20)

Bloomberg: Buffett’s About To Reveal If His Cash Headache Found Any Relief 
[Charles] Munger has called health care one of the hardest tasks on Berkshire’s agenda. The company announced last year that it was teaming up with JPMorgan Chase & Co. and Amazon.com Inc. to tackle the problem for employees of the three companies.In June, the venture named Atul Gawande, a surgeon and journalist, to lead it and has since hired key employees. Buffett has said the effort will try to deliver better medical service at a lower cost, but has also acknowledged the challenges. The trio haven’t divulged too many secrets about how the venture is working, so any commentary from Buffett could influence investors’ perceptions on the push. Signs of success would reverberate throughout the industry. (Chiglinsky, 2/21)

The Associated Press: Trouble At CVS Health Long-Term Care Business Weighs Heavily
CVS Health is setting 2019 earnings expectations well below Wall Street forecasts, as the company struggles to fix part of its business while blending in a major acquisition and attempting to change how customers use its stores. The drugstore chain and pharmacy benefit manager also is dealing with industry-wide pressure to reduce what customers pay for prescriptions. (Murphy, 2/20)

The Wall Street Journal: CVS Gives Downbeat Earnings Outlook For First Year As Merged Company
The Woonsocket, R.I.-based company, which in November completed its nearly $70 billion acquisition of insurer Aetna Inc., said that it was taking rapid steps to address the problems, including a cost-cutting effort, and that its ambitious deal positioned it for long-term growth. CVS, which has said that its deal to bring together drugstores, pharmacy-benefit management and insurance would help it cut health-care costs and improve care, said it was building new offerings. (Wilde Mathews and Al-Muslim, 2/20)

Bloomberg: CVS Sees Dire 2019 As Deal From 2015 Turns Out To Be A Lemon 
Facing challenges to its business from all around, CVS on Wednesday dangled the possibility of cutting expenses to get profits back in line. “We see additional opportunities to continue to manage our cost base and reduce our core to help mitigate those headwinds,” Chief Financial Officer Eva Boratto said on a call with analysts. In a phone interview, Chief Executive Officer Larry Merlo said the main focus of new merged company is growth, not cost-cutting. He described the issues holding down profits at retail drugstores this year -- including a paucity of new generic drug introductions -- as transitory. And he said that CVS is committed to the nursing-home pharmacy arena despite the disappointing results so far. (Langreth, 2/20)

Modern Healthcare: CVS' Bottom Line Sags After Aetna Takeover 
Still, CVS CEO Larry Merlo hailed 2018 "a milestone year for CVS Health as we successfully completed our transformational merger with Aetna, began effective implementation of our integration strategy, and took important steps toward building the integrated healthcare model that will bring substantial value to our various stakeholders." (Livingston, 2/20)

Modern Healthcare: Nearly A Quarter Of Rural Hospitals Are On The Brink Of Closure 
More than a fifth of the nation's rural hospitals are near insolvency, according to a new report. Twenty-one percent of rural hospitals are at high risk of closing, according to Navigant's analysis of CMS data on 2,045 rural hospitals. That equates to 430 hospitals across 43 states that employ about 150,000 people and generate about $21.2 billion in total patient revenue a year. (Kacik, 2/20)

Stateline: Fed Up With High Health Care Costs, A Community Asks For A Better Deal
A hospital visit in this ski town costs about 40 percent more than a visit less than 100 miles away in Denver. In 2015, an overnight hospital stay cost 80 percent more, according to a study commissioned by the Summit Foundation, a local community group with a mission to help working families. High prices for medical services — here in Summit County and across rural Western Colorado — have left many residents struggling financially. (Quinton, 2/21)

Denver Post: Colorado Hospital Prices Jump Despite Medicaid Expansion, Reports Say
When Colorado began to consider expanding Medicaid under the Affordable Care Act, some advocates pitched what they believed would be a key benefit: Hospital prices and premiums for people covered by private policies would drop once more people were insured. The theory was that by increasing Medicaid payments and reducing Colorado’s uninsured rate, hospitals would no longer need to shift as much of their costs to individuals with private insurance, thereby bringing their rates down. (Seaman, 2/20)

The CT Mirror: Lamont's Health Budget Vs Connecticut Hospitals
After watching his predecessor, Gov. Dannel P. Malloy, spar with Connecticut’s hospitals for much of the past eight years, Gov. Ned Lamont got off to a rough start with the industry himself on Wednesday. Lamont’s new budget canceled a previously approved tax cut for hospitals, replacing it with an effective tax hike of about $43 million per year. (Phaneuf and Silber, 2/20)

Georgia Health News: Extension Of Hospital Provider Fee Advancing Swiftly Through House
In a normal year for health care legislation, House Bill 321 would have attracted a ton of attention at the state Capitol. But with bills to provide a Medicaid waiver and to reform the state’s health care regulatory structure already drawing an intense spotlight, legislation to extend the hospital provider fee passed quietly – and swiftly — in the House Appropriations Committee on Wednesday. (Miller, 2/20)

Atlanta Journal Constitution: Ga Warm Springs Hospital Built By FDR Threatened By Medicare Dispute
Lawyers for the hospital said the bureaucracy surrounding a disputed $585,000 in bills has cut off ongoing Medicare payments to the institution, payments that are the hospital’s lifeblood. Moreover, the hospital says, the government will likely take years to process the hospital’s appeal. By then, it will be too late. (Hart, 2/20)

The Associated Press: Advocates Say US Still Separates Migrant Families Needlessly
Months after the Trump administration announced an end to its widescale separation of migrant parents and children, the policy remains a heated issue in the courts and at the border as critics contend the government is still needlessly breaking up immigrant families. The Texas Civil Rights Project released a report Thursday that counts 272 separations at a single Texas courthouse since June, when President Donald Trump issued an executive order ending widespread separations amid public outrage. (2/21)

Denver Post: Aurora's ICE Detention Site Sees Another Rash Of Illnesses
A rash of illnesses. A lack of medical providers to serve a growing number of immigrant detainees. And no communication from the federal agency at the center of it all. These were some of the issues highlighted by U.S. Rep. Jason Crow, a freshman Democrat from Aurora, on Wednesday as he took Immigration and Customs Enforcement to task for the conditions at the Aurora detention facility. Crow, along with Aurora city councilwoman Allison Hiltz, showed up unannounced Wednesday at the detention facility — which is run by the private, for-profit Geo Group — and were denied a request to tour the building. (Tabachnik, 2/20)

The Wall Street Journal: Is It Time For A Better Hospital ID Bracelet?
The pesky but essential hospital ID bracelet is getting a makeover. At hospitals across the country, the wristband bearing a patient’s name and date of birth is going high tech or super sleek. And if some doctors have their druthers, it will disappear altogether. Critics say ID bracelets collect germs and can be hard to read, leading to mistakes. They can fall off and get lost. While high-tech wristbands allow hospitals to track patients at all times, some doctors say the best bracelet is none at all. (Lagnado, 2/20)

In other health and technology news —

The New York Times: The Medical Tech That Helps You When Your Doctor Can’t
You (or your employer) pay for health insurance every month. In exchange, you assume that if you have any health-related needs, they’ll be covered. Yet there are gaps in the system that your provider may not want to pay for. Now, a wave of medical start-ups want to fill in those gaps. As Silicon Valley looks for the next big thing to pour money into, health care looks like an increasingly tantalizing field. According to Forbes, more than $2.8 billion worth of venture capital was invested in health care start-ups in September 2018 alone. An increase of 70 percent over the previous year. (Ravenscraft, 2/20)

The Wall Street Journal: Nonprofits Grow Uneasy With Philanthropy Tainted By Opioid Proceeds
Two prominent institutions, the New York Academy of Sciences and Columbia University, are joining the list of universities, museums and nonprofits currently reviewing their philanthropic relationships with members of the Sackler family, owners of pain-pill maker Purdue Pharma LP. Forbes ranked the Sacklers the 19th-richest family in America in 2016 at $13 billion. While a total assessment of the family’s philanthropy is unclear, millions have been given away by family entities. (Hopkins, 2/20)

In other news on the epidemic —

California Healthline: More States Say Doctors Must Offer Overdose Reversal Drug Along With Opioids
In a growing number of states, patients who get opioids for serious pain may leave their doctors’ offices with a second prescription — for naloxone, a drug that can save their lives if they overdose on the powerful painkillers. New state laws and regulations in California, Virginia, Arizona, Ohio, Washington, Vermont and Rhode Island require physicians to “co-prescribe” or at least offer naloxone prescriptions when prescribing opioids to patients considered at high risk of overdosing. (Ostrov, 2/21)

Nashville Tennessean: Pain Clinic Doctor, Accused Of Drug Dealing, Prescribed Pills On The Internet
A Tennessee doctor and pastor who federal prosecutors say is a prolific drug trafficker once wrote suspicious prescriptions for an addictive muscle relaxer to patients on the other side of the country who he appears to have never examined, according to health officials. Dr. Samson Orusa, who owns and operates a pain clinic in Clarksville, was indicted on charges of drug trafficking and health care fraud last year. Court records state that an undercover federal investigation found Orusa rarely examined patients and prescribed opioids to large groups through what authorities referred to as “cattle calls.” (Kelman, 2/20)

The Wall Street Journal: WHO Reacts To Chinese Gene-Edited Twins With Plan For Global Guidelines
The World Health Organization established a new committee to set guidelines for scientists editing human DNA, just months after the controversial births of the world’s first gene-edited babies in China. The WHO’s 18-member committee of scientific experts, which includes a Chinese bioethicist, will meet in Geneva next month to “examine the scientific, ethical, social and legal challenges associated” with editing human genes and it will make recommendations, the organization said in a statement. (Rana, 2/21)

CNN: Heart Attacks Rising Among Young Women, Study Shows
The risk of having a heart attack appears to be rising among young women, according to a new study, and researchers are trying to figure out why. When analyzed across five-year intervals, the overall proportion of heart attack-related hospital admissions in the United States attributable to young patients, ages 35 to 54, steadily climbed from 27% in 1995-99 to 32% in 2010-14, with the largest increase observed in young women, according to the study, published recently in the journal Circulation. (Howard and Nedelman, 2/19)

Boston Globe: What To Know About Child Flu Deaths
The death of a third Massachusetts child from the flu this season — identified Wednesday as a 4-year-old girl from Lowell — has stirred concern about the dangers of the contagious respiratory illness among young people. Last flu season, only one pediatric flu death was reported in the state, public health officials said. (Kempe, 2/20)

The New York Times: Teenagers Say Depression And Anxiety Are Major Issues Among Their Peers
Most American teenagers — across demographic groups — see depression and anxiety as major problems among their peers, a new survey by the Pew Research Center found. The survey found that 70 percent of teenagers saw mental health as a big issue. Fewer teenagers cited bullying, drug addiction or gangs as major problems; those from low-income households were more likely to do so. (Zraick, 2/20)

The New York Times: Sleepless Flies Lived Long Lives. Why Not Us?
Sleep — that absurd, amazing habit of losing consciousness for hours on end — is so universal across the animal kingdom that we usually assume it is essential to survival. Now, however, scientists who repeatedly disturbed the sleep of more than a thousand fruit flies are reporting that less slumber may be necessary for sustaining life than previously thought, at least in one species. A handful of studies involving dogs and cockroaches going back to the late 19th century suggest that being deprived of sleep can result in a shortened life span. (Greenwood, 2/20)

Tampa Bay Times: Just 9 Percent Of Female Medical Students Want To Be Surgeons. What One Group Is Doing About It.
Fifty percent of medical students in 2018 were women, but only 9 percent of female medical students pursued a career in surgery, according to the Association of American Medical Colleges. Women make up less than 20 percent of all general surgeons, the group says, and fewer than 5 percent of surgical program chairs. (Griffin, 2/21)

Kaiser Health News: Trump Administration Plan To Beat HIV Hits Rough Road In Rural America
One of the goals President Donald Trump announced in his State of the Union address was to stop the spread of HIV in the U.S. within 10 years.In addition to sending extra money to 48 mainly urban counties, Washington, D.C., and San Juan, Puerto Rico, Trump’s plan targets seven states where rural transmission of HIV is especially high. Health officials and doctors treating patients with HIV in those states say any extra funding would be welcome. But they say strategies that work in progressive cities like Seattle won’t necessarily work in rural areas of Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina. (Fortier, 2/21)

Los Angeles Times: California Lawmakers Propose Soda Tax, Outlawing Super-Size Sugary Drinks
California restaurants and stores would be prohibited from selling “Big Gulp”-style sodas and consumers would face taxes on sugar-sweetened soft drinks under bills announced Wednesday by five state lawmakers to address a “public health crisis” of obesity in the Golden State. The proposals include a ban on the sale of unsealed "sugar-sweetened beverage" portions larger than 16 ounces at food-service businesses, including restaurants with self-service soda fountains, stores such as 7-Eleven, and sports arenas. (McGreevy, 2/20)

The Hill: Connecticut Governor Pitches Statewide Soda Tax
Connecticut Gov. Ned Lamont (D) wants his state to become the first to levy an extra tax on sugary drinks and sodas. In a budget proposal rolled out Wednesday, Lamont asked legislators to impose a new 1.5 cents per ounce tax on sugar-sweetened beverages. The tax would generate about $163 million in new revenue for the next fiscal year, Lamont's office estimated. (Wilson, 2/20)

The Associated Press: Oregon House Advances Medicaid Funding Protections
The Oregon House has approved a measure to protect a revenue stream that injects more federal funds into the state’s Medicaid program. Legislators voted 44 to 15 Tuesday to extend the expiration date of the state’s health care assessment program to 2025. The program is a tax on health care providers and is common practice by states to draw down extra federal Medicaid funds. The bill also extends the state’s tax on health insurers which proponents say will further stabilize preventative healthcare costs. (2/19)

Atlanta Journal-Constitution: Georgia House Democrats Oppose Medicaid Waiver Bill
Georgia Democrats in the state House of Representatives on Wednesday stood together to denounce Gov. Brian Kemp’s health care proposal to deal with poor and middle-class Georgians struggling with health care costs. At a press conference called on the steps inside the state Capitol, they said the bill falls short of a cheaper, stronger, faster solution the state ought to enact but hasn’t because of Republican ideology. (Hart, 2/20)

Palm Springs Desert Sun: Health Insurance: California Bills Would Reinstate Individual Mandate
Lawmakers in California have introduced bills that would reinstate the individual mandate, requiring all state residents to have health insurance starting in 2020 or pay a tax penalty. Identical bills introduced in the state Senate and Assembly are an attempt to reverse the revocation by Congress of the federal mandate that was part of the Affordable Care Act. (Hayden, 2/20)

The New York Times: As Colorado Moves To Bar Abstinence-Only Sex Education, Teenagers Take The Lead
Last year, when Clark Wilson was in eighth grade, his sex education teacher repeatedly rolled a piece of tape on a table until it lost its stickiness, using words like “tainted” and “impure” to describe those who engage in premarital sex. The lesson: “People are like tape and once they have sex they’re dirty and can’t have meaningful relationships,” said Clark, now 15 and a freshman at a Colorado high school in the Denver suburb of Highlands Ranch. (Levin, 2/21)

The Associated Press: Mormon Church Won't Oppose Gay Conversion Therapy Ban
The Mormon church won't stand in the way of a proposal to ban gay conversion therapy for minors in its home base of Utah, leaders said Wednesday, a position that advocates heralded as a milestone in the conservative state. The announcement is key in part because LGBT members have historically reported that church leaders encouraged them to attend therapy aimed at changing their sexual orientation, said Troy Williams with the group Equality Utah. (2/20)

The Washington Post: Gender-Neutral Licenses: Maryland Senate Gives Initial Approval Despite Republican Objections
The Maryland Senate gave initial approval Wednesday to a bill allowing gender-neutral driver’s licenses, an option already available in five states and the District. The legislation would give applicants the option to identify as male, female or unspecified. For applicants who request it, the Motor Vehicle Administration would be required to issue licenses or identification cards that show an “X” instead of an “M” for male or an “F” for female. (Wiggins, 2/20)

Arizona Republic: DNA Database Legislation: New Version Of Bill Passes Senate Committee
The controversial bill that initially proposed an unprecedented statewide DNA database passed an Arizona Senate committee Wednesday after being stripped practically beyond recognition. The third iteration of Senate Bill 1475 in less than 72 hours now focuses specifically on testing samples obtained via a rape kit using Rapid DNA technology. But it appears to benefit a single company that provides the technology to the state. (Burkitt, 2/20)

Miami Herald: FL Senate Advances Bill To End Ban On Smoking Medical Pot
With several amendments, heated debates and about three weeks to spare, the Senate’s bill to repeal a ban on smokable medical marijuana is headed to the floor before the March 15 deadline set by Gov. Ron DeSantis. DeSantis in January tasked the Legislature with amending Florida law to allow smoking medical marijuana. If legislators don’t by the deadline, the governor said he will do so with litigation. (Gross, 2/20)

CNN: For Nearly 2 Decades, Grand Canyon Tourists Were Exposed To Radiation Beyond The Federal Limit, Safety Manager Says
Uranium ore stored at the Grand Canyon National Park museum may have exposed visitors and workers to elevated levels of radiation, according to the park's safety, health and wellness manager. Elston Stephenson told CNN that he began asking officials from the National Park Service and Department of the Interior last summer to warn workers and tourists they had possibly been exposed to unsafe levels of radiation. After his requests were ignored, he said he sent an email to all park staff at the Grand Canyon on February 4. (Boyette and Moshtaghian, 2/20)

The Washington Post: Nurse Charged In Fatal Drug-Swap Error Pleads Not Guilty
A Tennessee nurse charged with reckless homicide after a medication error killed a patient pleaded not guilty on Wednesday in a Nashville courtroom packed with other nurses who came in scrubs to show their support. The error happened at Vanderbilt University Medical Center in December 2017 when RaDonda Vaught injected 75-year-old Charlene Murphey with the paralytic vecuronium instead of the sedative Versed. (Loller, 2/20)

ProPublica: New Jersey Said 10 Years Ago It Would Rank Its Most Contaminated Sites. It Never Did.
A decade after legislators mandated that the Department of Environmental Protection rank every contaminated site in order of urgency and severity, the agency has yet to act. The rankings were supposed to ensure that the most dangerous sites remained a priority even as the state gave private companies — and effectively private developers — a bigger role in the cleanup process. (Buford, 2/21)

The Associated Press: Maryland Doctor Accused Of Sex Misconduct Loses License
A Maryland allergy doctor has lost his license over what the state Board of Physicians determined was immoral and sexual misconduct with three teenage girls. The Baltimore Sun reports the board says it began investigating Surender K. Vaswani in 2017 and made a final determination in January after reviewing the girl’s allegations. (2/21)

Seattle Times: UW Medicine Mistakenly Exposed Information On Nearly 1 Million Patients 
The medical files of nearly 1 million patients of University of Washington Medicine were visible on the internet for at least three weeks in December, UW Medicine said Wednesday. The files, which were exposed Dec. 4 because of “an internal human error,” were records the hospital system uses to document when it shares patient information, for instance with public-health authorities or law enforcement. (Fields and Gutman, 2/20)

The Associated Press: Baltimore Mayor Names City’s Next Health Commissioner
Baltimore’s mayor has named an African American pediatrician as the city’s next health commissioner. Dr. Letitia Dzirasa will take over the role next month, overseeing a department with some 800 employees and a $150 million annual budget. Dzirasa earned a doctorate of medicine from Meharry Medical College in Tennessee. She did her residency at Johns Hopkins School of Medicine. She most recently worked as a “health innovation officer” at a Baltimore-based software company she founded with her husband. (2/20)

The Baltimore Sun: Baltimore Names Dr. Letitia Dzirasa, A Pediatrician, As New Health Commissioner
Dr. Letitia Dzirasa, a Johns Hopkins-trained Baltimore pediatrician with experience in high-tech information systems and community-based health care, will take over as the city’s health commissioner on March 11. Mayor Catherine Pugh announced Wednesday that Dzirasa will succeed Dr. Leana Wen, who left the Baltimore Health Department in September after four years to head Planned Parenthood. (Cohn, 2/20)

Arizona Republic: Arizona Student Caitlin Secrist Can't Get Copies Of Medical Records
Caitlin Secrist can't eat, can't work, can barely go to school online and is in constant pain from a severe illness. Now, the 21-year-old college student could die because she can't get copies of her own medical records. The files are locked away in a repossessed electronic-records system while creditors of bankrupt Florence Hospital at Anthem and Gilbert Hospital bicker over who should pay for access to them. (Sanders, 2/20)

Nola.com: Possible Layouts Emerge For Charity Hospital Redevelopment 
Developers leading the project to repurpose Charity Hospital into a mixed-use development have begun community outreach efforts that they expect will continue throughout the project expected to last until at least the end of 2021. The development team 1532 Tulane Partners, comprising New Orleans-based CCNO Development Inc. and El Ad U.S. Holdings, began that outreach at an LSU Board of Supervisors real estate committee meeting Monday night (Feb. 18). The committee took public comments and project architect Mark Heck of New Orleans-based Williams Architects gave the audience an overview of how they plan to use the 1 million-square-foot building. (Litten, 2/20)

KCUR: Overland Park ER Doc Who Won $29 Million In Whistleblower Suit Fights To Keep The Whole Amount 
A physician who won one of the biggest jury awards in Missouri last year in a whistleblower case over emergency room staffing is going back to court after a judge slashed his award by more than half. Dr. Raymond Brovont had worked in the regular emergency room and the pediatric emergency room at Overland Park Regional Medical Center. Technically, his employer was an emergency-room staffing company called EmCare. After he raised concerns that only one physician was being used at night to cover both ERs – a policy he believed endangered patient safety — Brovont was fired. (Margolies, 2/20)

Texas Tribune: Republicans Join Texas Death Penalty Bill After Supreme Court Ruling
On Wednesday, state Reps. James White and Jeff Leach became joint authors to Rep. Senfronia Thompson’s House Bill 1139, which would establish a pretrial procedure to determine if a capital murder defendant is intellectually disabled and therefore ineligible for the death penalty. White chairs the House Corrections Committee, and Leach leads the House Judiciary and Civil Jurisprudence Committee. (McCullough, 2/20)

California Healthline: Teachers Strike In US Cities To Demand More School Nurses, Better Pay
As teachers across the country walk out of their classrooms, hit the picket lines and demand higher pay, they’re keeping school nurses in mind — asking for more of them or, at the very least, better pay for them. Oakland, Calif., teachers plan to strike Thursday if they can’t hammer out a deal with the district that includes a “living wage” and more nurses and counselors. Last week in Denver, thousands of educators and school nurses went on strike and marched to the state Capitol asking for a significant raise — and got it. (Ibarra, 2/20)

The Baltimore Sun: Bon Secours Joins Effort To Build, Sustain Affordable Housing Projects 
Bon Secours Mercy Health System has joined five other hospital systems and a set of nonprofit groups to bring more affordable housing to communities including Baltimore. The hospitals are working with the Center for Community Investment at the Lincoln Institute of Land Policy, a nonprofit group that works for social change, and the Robert Wood Johnson Foundation, which focuses on health care. The groups support the idea that housing promotes stable, healthy communities. (Cohn, 2/21)

The Star Tribune: University Of Minnesota Survey Links Regular Pot Use To Lower Grades 
College students who use marijuana regularly have lower grades — whether or not they think it affects them, according to a first-of-its-kind analysis of Minnesota student survey data. Mean grade-point averages dropped from 3.33 to 3.01, comparing male students who didn’t use marijuana at all with students who used it daily. The comparable gap for female students was 3.4 to 3.18 Researchers at Boynton Health, the student health service at the University of Minnesota, conducted the analysis after seeing a significant increase in marijuana use in initial data from a 2018 student survey. (Olson, 2/21)

Health Affairs: Access To E-Prescriptions And Related Technologies Before And After Hurricanes Harvey, Irma, And Maria
Hurricanes Harvey, Irma, and Maria devastated parts of the US mainland and Puerto Rico during the 2017 hurricane season, causing loss of life and substantial damage and interrupting access to health care for many people in the hurricane impact zones. Using data on e-prescriptions and medication history transactions from a large health information network for the period August 2017–May 2018, we examined providers’ access to these technologies across affected areas. Although e-prescribing and medication history transactions decreased considerably during each hurricane, transaction volumes returned to normal levels in the days immediately following Hurricanes Harvey and Irma in Texas and Florida. E-prescribing activity in Puerto Rico did not return to baseline levels at all during the study period, and medication history transactions returned to normal only after an extended period following Hurricane Maria. (Smith and Sow, 2/4)

JAMA Internal Medicine: Association Of Primary Care Physician Supply With Population Mortality In The United States, 2005-2015.
Primary care physician supply increased from 196 014 physicians in 2005 to 204 419 in 2015. Owing to disproportionate losses of primary care physicians in some counties and population increases, the mean (SD) density of primary care physicians relative to population size decreased from 46.6 per 100 000 population (95% CI, 0.0-114.6 per 100 000 population) to 41.4 per 100 000 population (95% CI, 0.0-108.6 per 100 000 population), with greater losses in rural areas. In adjusted mixed-effects regressions, every 10 additional primary care physicians per 100 000 population was associated with a 51.5-day increase in life expectancy (95% CI, 29.5-73.5 days; 0.2% increase), whereas an increase in 10 specialist physicians per 100 000 population corresponded to a 19.2-day increase (95% CI, 7.0-31.3 days). (Basu et al, 2/18)

The Henry J. Kaiser Family Foundation: 'Partial Medicaid Expansion' With ACA Enhanced Matching Funds: Implications For Financing And Coverage
The Affordable Care Act (ACA) provides enhanced federal matching funds to states that expand Medicaid to nonelderly adults up to 138% of the federal poverty level (FPL, $17,236/year for an individual in 2019). The ACA enhanced match (93% in 2019, and 90% in 2020 and thereafter) is substantially higher than states’ traditional Medicaid matching rate. A few states have sought Section 1115 demonstration waiver authority from the Centers for Medicare and Medicaid Services (CMS) to receive the substantially higher ACA enhanced match while limiting coverage to individuals at 100% FPL, instead of covering the full 138% FPL ACA group. (Rudowitz and Musumeci, 2/20)

Commonwealth Fund: Market Concentration Potential Competition Medicare Advantage
Medicare Advantage (MA), the private option to traditional Medicare, now serves roughly 37 percent of beneficiaries. Congress intended MA plans to achieve efficiencies in the provision of health care that lead to savings for Medicare through managed competition among private health plans. (Frank and McGuire, 2/14)

The New York Times: A Better Path To Universal Health Care
As a Canadian living and studying health policy in the United States, I’ve watched with interest as a growing list of Democratic presidential candidates — Senators Bernie Sanders, Kamala Harris, Elizabeth Warren, Kirsten Gillibrand and Cory Booker — have indicated support for a Canadian-style single-payer plan with little or no role for private insurance. Approval of such a system has become almost a litmus test for the party’s progressive base. But rather than looking north for inspiration, American health care reformers would be better served looking east, across the Atlantic. (Jamie Daw, 2/20)

Miami Herald: Medical Community Must Sound Alarm About Climate Change’s Negative Effects On Health
Hearing that 2018 was the fourth hottest year on record reminded me of a family I visited a few years earlier.I was with the medical and nursing students of FIU’s Herbert Wertheim College of Medicine NeighborhoodHELP, which provides home healthcare visits to Miami’s underserved communities. This household visit was supposed to be like any other. But when I stepped out of my car in Little Haiti and felt the stifling June heat coming off of the pavement, I knew, unfortunately, what to expect. (Cheryl L. Holder, 2/20)

Los Angeles Times: As Age-Obsessed Billionaires Turn To ‘Vampire’ Therapies, The FDA Takes A Stand
The federal government finally took a stand this week on vampires feasting on the blood of the young. It’s against the practice. Actually, the Food and Drug Administration issued a warning about older people injecting themselves with the blood plasma of young donors — a fringe therapy that’s marketed as a way to fight aging and a variety of illnesses, including dementia, Parkinson’s disease and Alzheimer’s disease. (David Lazarus, 2/20)

Miami Herald: Trump Wants To End HIV Transmission By 2030. That Means, He Should Withdraw Proposal That Undercuts Treatment.
Currently, Medicare Part D has six “protected classes” of medications, which includes antiretroviral drugs used to manage HIV. People living with HIV are able to access this life-saving treatment without insurance interference. Under the Trump administration’s proposal, insurance companies would be able to create bureaucratic hoops through which people living with HIV and their doctors would have to jump before getting the treatment best for them. (Nadine Smith and Alejandro Acosta, 2/19)

Los Angeles Times: Health Insurers Are Exacting Their Revenge For The GOP’s Sabotage Of Obamacare
It turns out that the federal government cannot, in fact, order individuals or businesses to do something, then refuse to pay for it. Who knew? Several cases working their way through the U.S. Court of Federal Claims illustrate this point. One set involves the Affordable Care Act mandate that insurers reduce the out-of-pocket payments for lower-income customers buying policies on the Obamacare exchanges. The act also requires the federal government to reimburse insurers for these discounts, and here’s where the fire started. (Jon Healey, 2/20)

Salt Lake Tribune: Prop 3 Repeal Is A Cruel Lie To The People Of Utah 
The Utah Legislature, assisted by an overly meek governor and a stunningly silent medical establishment, has shown us all what it thinks is important: Having a state where far too many people have no access to health care. (2/20)

Des Moines Register: Iowa Should Abolish Its Tampon Tax; Too Many Women Can't Afford Them
This year, the Iowa Legislature will have a chance to do right by some 1 million women in Iowa by passing a bill to exempt the sale of feminine hygiene products and diapers from sales taxes.It comes as no surprise to women that feminine hygiene products are essential, not a luxury item. Yet tampons and pads are subject to sales tax, making them difficult to access for women on limited budgets. They are also ineligible for families on WIC or SNAP assistance programs, forcing women and girls to make choices that can threaten their health or force them to stay home from school. (Andrea Cohen, 2/20)

Columbus Dispatch: Anti-Choice Lawmakers Start New Fight They Won't Win
So here’s another reason why it’s important to pay attention to what happens in your state capital.Last week, two Pennsylvania state lawmakers — both Republicans — fired the opening rounds of the 2019 culture war, announcing plans to reintroduce legislation that would ban abortion based on a diagnosis of Down syndrome. (John L. Micek, 2/20)

Louisville Courier-Journal: Kentucky Abortion Battle: Louisville Woman Tells Her Story
Politicians tell voters their voice matters. But at times like this, it’s clear only certain voices are heard and respected by the majority party in our General Assembly. Two bills that would eviscerate a woman’s ability to make her own informed decisions about health care are rocketing through the 2019 General Assembly. House Bill 148 would criminalize all abortions in Kentucky if the U.S. Supreme Court overturned Roe v. Wade. Senate Bill 9 would criminalize abortion at 6 weeks gestation, which is before many women even know they are pregnant. (Kim Greene, 2/20)

San Francisco Chronicle: California Lags In Seizing Weapons From Owners On Banned List
California, with some of the toughest laws in the nation, faces an Illinois-scale problem. Since 2013 state authorities are directed to seize firearms from people with criminal convictions and mental health problems. At that time, the forbidden list totaled 20,000, but it’s only been whittled down to 9,000 through the administrations of two state attorneys general, Kamala Harris, who is now a U.S. senator and running for president, and Xavier Becerra, who now holds office. (2/29)