Reuters: Trump Administration Issues Rule Further Watering Down Obamacare
The Trump administration took additional steps to weaken Obamacare on Monday, allowing U.S. states to relax the rules on what insurers must cover and giving states more power to regulate their individual insurance markets. The Centers for Medicare and Medicaid Services issued a final rule that allows states to select essential health benefits that must be covered by individual insurance plans sold under former President Barack Obama's healthcare law. The 2010 Affordable Care Act requires coverage of 10 benefits, including maternity and newborn care and prescription drugs. Under the new rule, states can select from a much larger list which benefits insurers must cover. (Abutaleb, 4/9)

The Washington Post: Trump Administration Rewrites ACA Insurance Rules To Give More Power To States
The rules add two broad exemptions from the ACA’s requirement that most consumers be insured. The change offers escape hatches that will be retroactive two years, even before a recent tax law ends the penalties completely starting in 2019. People living in areas where only one insurer is selling plans in the marketplace now can qualify for a “hardship exemption.” So can people who oppose abortion and live in places where the only available plan covers abortion services. Federal health officials and private researchers have shown that about half of U.S. counties have only one ACA insurer this year. (Goldstein, 4/9)

The Hill: Trump Officials Create New Exemptions To ObamaCare Mandate 
The administration is also stepping up eligibility checks to make sure people are supposed to receive financial assistance under the law. Officials said they worried some low-income people in states that have not expanded Medicaid were overestimating their income, so that it becomes over the poverty level, thereby qualifying them for tax credits to help afford premiums on the law’s private marketplaces. (Sullivan, 4/9)

The Associated Press: Abortion Objectors May Get A Pass On Health Law Penalty
Object to abortion? You may be able to get an exemption from the Affordable Care Act tax penalty for people who don't get health insurance. The Centers for Medicare and Medicaid Services announced final rules Monday for the ACA's health insurance marketplaces, and expanded exemptions were part of the package. Last year's GOP tax bill repealed the health law's unpopular requirement to carry health insurance or risk fines from the IRS — but that doesn't happen until next year. (Alonso-Zaldivar, 4/9)

The Wall Street Journal: ​Trump Administration Allows States To Narrow ACA Coverage
Democrats and some consumer groups denounced the rule as another effort by the administration to undermine the ACA. They have said that weakening the scope of the benefits offered in ACA plans will hurt consumers by reducing coverage. The new rule will “undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health-benefit coverage guarantee,” said Brad Woodhouse, campaign director of Protect Our Care, a group that is an advocate for the ACA. (Armour, 4/9)

Modern Healthcare: CMS Issues Final Rule Allowing States To Pick Essential Health Benefits 
Health insurers have anxiously been waiting for the rule, which is usually released in mid-March. It follows on the heels of other actions taken by the Trump administration aimed at easing Affordable Care Act regulations in the name of promoting consumer choice, including a proposal to extend the duration of short-term medical plans and expanding access to association health plans that don't comply with ACA consumer protections. (Livingston and Luthi, 4/9)

CQ: Trump Administration Expands Exemptions From Individual Mandate
CMS Administrator Seema Verma touted the changes as a way of increasing access and reducing premiums for consumers under the health care law. But she also stressed that it was simply an option, not a requirement. “These are just options for states,” she told reporters Monday. “If they don’t want to do this, they can stick with what they have.” (Clason, 4/9)

The Associated Press: Democratic Attorneys General Fight Texas Health Care Lawsuit
Sixteen Democratic attorneys general pushed back Monday against a Texas lawsuit aimed at striking down former President Barack Obama's health care overhaul. California Attorney General Xavier Becerra led 14 other states and the District of Columbia in filing a motion to intervene in the Texas case and defend the law, suggesting the Trump administration wouldn't take such action. (Ronanye, 4/9)

Los Angeles Times: California Seeks To Intervene To Defend Obamacare In Court
“It is an irresponsible action,” Becerra said of the Texas lawsuit. “It is a legally unsound action, and it is a dangerous action for millions of Americans who left the bad days of pre-existing conditions and the inability to get care for their children. ”The lawsuit by Texas challenges Obamacare as unconstitutional, arguing that because Congress has set the penalty for going without insurance at zero, it does not count as a tax. A 2012 Supreme Court decision had upheld the law as a tax. The motion to intervene by California, New York and other states argues that Texas’ lawsuit is legally insufficient and would cause chaos in the healthcare market. (McGreevy, 4/10)

The New York Times: F.D.A. Restricts Sales Of Bayer’s Essure Contraceptive Implant
The Food and Drug Administration on Monday said it would require Bayer to restrict sales of its Essure birth control implant to medical practices like doctors’ offices that agree to fully inform women about the device’s risks. Since the implant became available 16 years ago, thousands of women have sued Bayer, Essure’s manufacturer, with many claiming they suffered severe injuries, including perforation of the uterus and the fallopian tubes from the metal implant. (Kaplan, 4/9)

The Associated Press: FDA Puts Restrictions On Birth Control Implant But No Recall
The Food and Drug Administration said only women who read and have the opportunity to sign a brochure about the risks of the device will be able to receive the implant made by Bayer. The checklist of risks must also be signed by the woman's doctor. The new requirement comes almost two years after the FDA added its strongest warning to Essure, citing problems reported with the nickel-titanium implant. The agency also ordered Bayer to conduct a study of the device's safety. (Perrone, 4/9)

The Washington Post: FDA Restricts Sale Of Essure Contraceptive Device, Requires That Women Be Informed Of Risks
FDA Commissioner Scott Gottlieb said in a statement that the agency was making the checklist mandatory because some women were not being adequately informed of Essure's risks “despite previous efforts to alert women to the potential complications ... That is simply unacceptable. Every single woman receiving this device should fully understand the associated risks.” (McGinley, 4/9)

The Hill: FDA Restricts Sale Of Essure Birth Control After Thousands Of Complaints 
“We take the concerns of all women affected by Essure very seriously," FDA Commissioner Scott Gottlieb said in a statement Monday. "I’ve personally had the opportunity to meet with several women and hear their important concerns about this product. Despite previous efforts to alert women to the potential complications of Essure, we know that some patients still aren’t receiving this important information. That is simply unacceptable. Every single woman receiving this device should fully understand the associated risks.” Patient advocacy groups and lawmakers have called for the FDA to remove the device from the market. (Hellmann, 4/9)

The Wall Street Journal: FDA Adds Restrictions On Sale Of Bayer’s Essure
Women who had testified before a panel of independent medical advisers described fatigue, hair loss and depression, as well as persistent pelvic or abdominal pain after taking Essure. There were also reports of rash, hives, nausea, swelling and increased symptoms of asthma and arthritis that women attributed to the implant. Since adding the warnings in 2016, the FDA said sales of Essure have declined roughly 70% in the U.S. Essure gained FDA approval for sale in 2002. (Moise, 4/9)

Meanwhile, in other news from the agency —

Stat: Here’s What’s In The FDA Plan To Include Pregnant Women In Clinical Trials
The FDA has taken a big step in encouraging drug companies to include pregnant women in clinical trials, issuing a draft guidance outlining how to do so safely and ethically. Nearly 4 million women in the U.S. give birth each year, but few drugs have been approved as safe and effective to use during pregnancy. The new guidance aims to help drug companies address those information gaps “through judicious inclusion of pregnant women in clinical trials and careful attention to potential fetal risk.” (Thielking, 4/10)

Kaiser Health News: C-SPAN: FDA Commissioner Scott Gottlieb Talks To KHN 
Kaiser Health News reporter Sarah Jane Tribble sat down with Dr. Scott Gottlieb, commissioner of the Food and Drug Administration, on C-SPAN’s “Newsmakers” program, which aired Sunday. Tribble was joined by Bloomberg correspondent Anna Edney. The conversation ranged from how the nation should combat the opioid epidemic to reining in drug prices. Gottlieb said competition in the drug market remains key to lowering prices. (4/9)

USA Today: FDA's Scott Gottlieb Pushes For More Food Safety To Improve Health
The Trump administration’s top food and drug regulator is pushing for less salt in food, more nutrition information on labels and innovative ways to communicate healthy ways of eating, all of which Scott Gottlieb says could make more of a difference than anything else his agency could do, short of curing cancer. Gottlieb, the Food and Drug Administration commissioner, has positively surprised critics of the administration’s regulatory agenda elsewhere. (O'Donnell and Parker, 4/6)

Stat: How To Reduce Health Care Costs? Experts Say Lots Of Ideas, Few Successes
Most countries have systems in place to evaluate drugs and their value, unlike the U.S. [Steven] Pearson, whose nonprofit group conducts similar analyses, argues that studies of whether one drug is demonstrably better than another will push progress. “If we do a better job discriminating, it will make companies go for the home run. The business model will reward those that try to innovate.” His organization concluded that a $475,000 drug for pediatric leukemia was worth its price. But a $75,000 drug for tardive dyskinesia, piggybacking on another rare-disease drug, was not. (Cooney, 4/9)

In other health industry news —

Bloomberg: 30,000 Strong And Counting, UnitedHealth Gathers A Doctor Army 
Disruptors are circling the health-care industry. UnitedHealth Group Inc., the biggest U.S. health insurer, has built an army of tens of thousands of physicians to fend off invaders. Health care in the U.S. has been plunged into a high-speed reconfiguration that could redraw longstanding relationships between patients, doctors, drugmakers and insurers. Outsiders such as Amazon.com Inc. and Walmart Inc. are looking for ways to shake up the business. (Tracer, 4/9)

Bloomberg: Hedge Fund Adage Reaps Big Initial Gain On Health-Care Takeover 
Adage Capital Management, a $30 billion hedge fund founded by two former money mangers from Harvard University’s endowment, reaped an initial gain of more than $100 million Monday after Swiss drugmaker Novartis AG agreed to acquire AveXis Inc. AveXis, which has a promising drug to treat a rare disease that afflicts infants, rose 80 percent to $208.05 a share at 9:32 am in New York trading. Novartis’ $8.7 billion offer represented an 88 percent premium to AveXis’ Friday closing price. (Stein, 4/9)

The Associated Press: California Bill Would Create Health Care Price Controls
California's government would set prices for hospital stays, doctor visits and other health care services under legislation introduced Monday, vastly remaking the industry in a bid to lower health care costs. The proposal, which drew swift opposition from the health care industry, comes amid a fierce debate in California as activists on the left push aggressively for a system that would provide government-funded insurance for everyone in the state. (4/9)

California Healthline: California Aims To Tackle Health Care Prices In Novel Rate-Setting Proposal
Supporters of the legislation, called the Health Care Price Relief Act, say California has made major strides in expanding health insurance coverage, but recent changes haven’t addressed the cost increases squeezing too many families. To remedy this, Assembly Bill 3087 calls for an independent, nine-member state commission to set health care reimbursements for hospitals, doctors and other providers in the private-insurance market serving employers and individuals. The bill faces formidable opposition from physician groups and hospitals. (Terhune, 4/10)

Stat: Companies, Academics Search For Better Overdose-Reversal Drugs
Naloxone is the only widely available drug to reverse opioid overdoses. But anecdotal reports of its limitations against synthetic opioids are on the rise. Spurred by that public health threat — as well as a booming commercial market for the antidote — drug companies, researchers, and health officials are eagerly eyeing the development of new treatments to augment the use of naloxone or, in some cases, potentially replace it. (Blau, 4/10)

CQ: Congress Prepares For Week Of Opioid Hearings
Four different hearings on combating aspects of the opioid crisis are set for Wednesday, as the House and Senate ramp up efforts to pass legislative packages this spring. Legislative action is scheduled in both chambers. The Senate Health, Education, Labor, and Pensions Committee plans to discuss a bipartisan legislative package revealed last week and the House Energy and Commerce Health Subcommittee will consider 34 bills. (Raman, 4/9)

And in the states —

The Associated Press: Court To Decide If Drug Use While Pregnant Is Child Abuse
Pennsylvania's highest court will decide whether a woman's use of illegal drugs while pregnant qualifies as child abuse under state law. The Supreme Court recently took up the case of a woman who tested positive for suboxone and marijuana at the time she gave birth early last year at Williamsport Hospital. (Scolforo, 4/9)

Concord (N.H.) Monitor: Officials Push For More Medication-Assisted Opioid Treatment In N.H.
It’s become a central component of the state’s opioid response. People in the throes of substance abuse disorder are given new medications, targeted to cut off any chemical enjoyment of the drugs doing them harm. Combined with peer support, therapy and sheer willpower, “medication-assisted treatment” can give those suffering addiction a better life – and let them hold onto it. But even with the growing popularity of Suboxone, the most commonly used “blocking” pharmaceutical, New Hampshire faces an elemental problem: physicians. The number of doctors and nurses actually trained to prescribe the medications is far from enough, advocates say. (DeWitt, 4/9)

The Associated Press: New Way Of Defining Alzheimer's Aims To Find Disease Sooner
Government and other scientists are proposing a new way to define Alzheimer's disease — basing it on biological signs, such as brain changes, rather than memory loss and other symptoms of dementia that are used today. The move is aimed at improving research, by using more objective criteria like brain scans to pick patients for studies and enroll them sooner in the course of their illness, when treatments may have more chance to help. (Marchione, 4/10)

NPR: Some Scientists Want Brain Changes, Not Symptoms, To Define Alzheimer's
Instead of defining the disease through symptoms like memory problems or fuzzy thinking, the scientists want to focus on biological changes in the brain associated with Alzheimer's. These include the plaques and tangles that build up in the brains of people with the disease. But they say the new approach is intended only for research studies, and isn't yet ready for use by most doctors who treat Alzheimer's patients.If the new approach is widely adopted, it would help researchers study patients whose brain function is still normal, but are likely to develop dementia caused by Alzheimer's. (Hamilton, 4/10)

The Washington Post: With $2 Million, Kaiser Permanente Wants To Help Revive Underfunded Gun-Violence Research
Kaiser Permanente announced Monday that it will begin studying gun violence — a long-ignored issue because of the political pressures surrounding firearms in this country — by investing $2 million in research that will involve doctors and other professionals across its hospitals and centers nationwide. Officials at the giant health system said they hope the move will encourage other systems to wade into this field of research, which has had lack of funding and data in the more than two decades since the federal government virtually abandoned such studies. (Wan, 4/9)

Cleveland Plain Dealer: Ohio Should Approve 'Red Flag' Laws For Gun Confiscation, Cleveland City Council Says
City Council on Monday urged the Ohio General Assembly to adopt "red flag" laws that allow police or family members to seek to have guns confiscated from individuals dangerous to themselves or others. (Higgs, 4/9)

Reuters: Flint School Children To Be Screened For Effects Of Lead After Agreement
School children in Flint, Michigan, will receive screening and in-depth health assessments to measure the effects of lead-tainted drinking water on their ability to learn, under a more than $4 million legal agreement reached on Monday. The agreement partially settled a federal lawsuit related to a water crisis in Flint that drew international attention and prompted dozens of other civil lawsuits and criminal charges against former government officials. (Dobuzinskis, 4/9)

Detroit Free Press: Flint Water Crisis: Up To 30,000 Kids To Get Screened For Lead Effects
As part of the settlement, the State of Michigan will pay $4.1 million to cover the cost of the screenings, according to lawyers for the plaintiffs, which include more than a dozen children and parents. The screening could impact between 25,000 and 30,000 school-age children, as well as younger children who may have been exposed. "It's a win for our kids," said Dr. Mona Hanna-Attisha, director of the MSU-Hurley Pediatric Public Health Initiative, who is already leading an effort to identify children and adults exposed to lead and get them connected to any resources they may need. (Higgins, 4/9)

And in other news —

Milwaukee Journal Sentinel: Barrett: Paint Remains The Primary Source Of Lead Poisoning For Kids
Paint remains the primary source of lead poisoning for Milwaukee children, Mayor Tom Barrett said Monday.And he again accused the paint industry of trying to shift the blame to contaminated water in an effort to create a controversy over the city's lead pipes — and avoid tens of millions of dollars in settlements or court judgments. (Spicuzza and Bice, 4/9)

Dallas Morning News: Taking The Pulse Of Texas Hospitals, Revenue Is Up, But Rural Care Is Down 
The past five years have been a strong period for the hospital industry in Texas, according to a recent report from market research firm IBISWorld. And while the demand for health care services has risen nationwide as people became insured through the Affordable Care Act, the demand statewide grew faster than the number of available facilities. (Rice and Joseph, 4/9)

The Baltimore Sun: Mixed Reviews For Maryland's Unique Hospital Payment System
An audit by independent consultants found Maryland’s experimental program to curb health care spending has saved money and improved the health of citizens, but another evaluation by professors from Harvard University and the University of Pittsburgh painted a less rosy picture. The state entered into an agreement with the Centers for Medicare and Medicaid Services four years ago to implement a system that scrapped the fee-for-service payment model for hospitals. (McDaniels, 4/6)

Marketplace: What Happens When A Hospital Sells Its Debt?
[Richard] Boykin is one of a few Cook County politicians that recently have started wondering whether taxpayers can get a better return on the roughly $170 million of unpaid medical bills the health system has that's now with collection agencies. Boykin wants the hospital system to sell the right to collect that debt to a private company instead. (Bryan, 4/9)

Boston Globe: Nurses At Greenfield Hospital Plan Second Strike In Past Year
For the second time in less than a year, nurses at Baystate Health’s community hospital in Greenfield are preparing to go on strike amid a stalemate in contract negotiations. About 200 members of the Massachusetts Nurses Association are planning a 24-hour walkout on Wednesday. (Dayal McCluskey, 4/9)

Chicago Sun Times: U. Of C. Medicine Set To Open South Side Trauma Center May 1 
U. of C. Medicine is set to launch the first adult trauma center on the South Side in decades next month after gaining approval from the Illinois Department of Public Health. The Level 1 adult trauma center will fill the hole left in trauma care since Michael Reese Hospital closed its center in 1991. (Whitehair, 4/9)

Chicago Tribune: U. Of C. Trauma Center Gains Final State Approval, Set To Open May 1 
For the first time in 27 years, Chicago’s South Side will soon have a Level I adult trauma center, now that University of Chicago Medicine has gained the final stamp of approval from the state. The program, scheduled to open May 1, will treat people with traumatic injuries, such as from gunshots, vehicle crashes, burns and falls. (Schencker, 4/9)

Boston Globe: More Scrutiny Needed On Massive Beth Israel-Lahey Merger
The Massachusetts Department of Public Health recently recommended approval of a 13-hospital merger led by Beth Israel and Lahey Health, which will dramatically alter our health care landscape for generations to come. As the impact of this mega merger is largely unknown, the DPH’s recommendation is both unfortunate and premature. (Jennings, 4/9)

Reuters: In Key Kentucky House Race, Healthcare Anxieties Loom Large
Andy Barr, a Republican lawmaker representing central Kentucky, won his last three elections promising to repeal and replace Obamacare. This year, his Democratic challengers for Congress in Kentucky's sixth district are betting that message will ring hollow. Their hopes lie with voters like Joyell Anderson, who went for President Donald Trump in 2016 and said she generally votes Republican. This year, she is not sure who to support for Congress, but she knows what her top priority is: healthcare. (4/9)

Reuters: Mississippi's Last Abortion Clinic Expands Lawsuit On Restrictions
Mississippi's last remaining abortion provider expanded a federal challenge on Monday to laws that ban abortions in the state after 15 weeks of pregnancy and block access to the procedure in myriad ways, it said. The ban on abortions after 15 weeks, signed into law last month by Mississippi Governor Phil Bryant, put the strictest time limit on legal abortions in the United States. (Woodall, 4/9)

The Star Tribune: Families Of Abuse Victims Intensify Push For Elder Care Reforms In Minn. 
Frustrated by what they see as legislative foot-dragging, family members of abuse victims are intensifying their push for new laws to protect tens of thousands of vulnerable adults who live in senior care facilities across the state. A grass roots coalition of abuse victims and their relatives, Elder Voice Family Advocates, descended on the State Capitol early Monday and distributed 1,850 summaries of maltreatment reports — including descriptions of beatings, sexual assaults and thefts — to legislators ahead of key hearings this week. The reports represent just a small fraction of the more than 20,000 allegations of maltreatment received by the Minnesota Department of Health each year from individuals and facilities across the state. (Serres, 4/9)

New Orleans Times-Picayune: Measles Case Confirmed In New Orleans, Health Officials Say 
State health officials are investigating a confirmed case of measles in New Orleans. Measles is a highly contagious viral illness that can spread quickly among people who have not been vaccinated. In extreme cases, it can lead to hospitalization and even death. The person who tested positive for measles is currently hospitalized in New Orleans, according a Department of Health press release. Officials are trying to identify and notify people that the patient may have come in contact with to prevent the spread of the virus. (Clark, 4/9)

Minnesota Public Radio: Flu Season Hit Minnesota Hard, And It's Not Over Yet
The flu has hit Minnesotans hard this year, with more than 6,000 flu-related hospitalizations, more than any other year since the state government started tracking such cases 10 years ago. A health department official says the season is not yet over. (Gunderson, 4/9)

KCUR: Jackson County Jail's Health Care Provider Leaving Contract A Year Early 
The Nashville-based company that provides health and dental care for the 1,000 inmates at the Jackson County Detention Center has told the county it is pulling out of its three-year contract early. The county's $3.2 million yearly contract with Correct Care Solutions (CCS) was supposed to run through June 2019. But according to a joint statement, the company told Jackson County last month that it was using an option in the contract to end the relationship early. No details were given in the joint statement. (Zeff, 4/9)

Texas Tribune: Report: Texas' Maternal Deaths Were Dramatically Lower In 2012 Under New Methodology
The number of Texas women who died from pregnancy complications in 2012 is being cut by more than half through a new state method for counting and confirming maternal deaths — which made Texas the subject of national news coverage over its high death rate. Several of the state’s top health experts released a report in the medical journal Obstetrics & Gynecology on Monday showing that by using the new method, the number of women who died dropped from 147 to 56. (Evans, 4/9)

Milwaukee Journal Sentinel: Milwaukee City Lead Manager Suspended For Mismanagement
The head of Milwaukee's troubled program to prevent lead poisoning among Milwaukee children "failed in her ability to manage" those efforts, a newly released suspension notice says. Lisa Lien, the home environmental health manager, was suspended for 10 days in December after city officials found she was "ineffective," "insubordinate" and "incompetent or inefficient" in her work for the Milwaukee Health Department. (Spicuzza and Bice, 4/9)

Minnesota Public Radio: How Culturally Centered Care Could Help Mothers And Babies
Many social scientists and medical researchers agree that the disparities in maternal mortality is due to racism, not race. And there's a growing consensus that racial discrimination experienced by black mothers during their lifetime makes them less likely to carry their babies to full term. (Combs and Yang, 4/9)

Arizona Republic: Arizona Center For Cancer Care Faces Suit For Medicare Fraud
An Arizona medical company that serves thousands of cancer patients is battling a federal lawsuit alleging that it ripped off Medicare and other government programs with millions of dollars in fraudulent charges. The whistleblower complaint moving through U.S. District Court says principals at Arizona Center for Cancer Care improperly collected nearly $8 million from U.S. health care agencies since 2011. (Wagner, 4/9)

Texas Tribune: Three Fired At Texas Health Commission After Another Contracting Error
A health commission spokeswoman said three employees had been fired after Republican Gov. Greg Abbott on Monday penned a sharply worded letter to Executive Commissioner Charles Smith bemoaning his “failure to ensure the integrity” of the state’s procurement process. At issue was an award granted to a health insurance company to administer the Children’s Health Insurance Program in rural parts of the state. (Walters, 4/9)

The Associated Press: Salmonella In Chicken Salad Kills 1, Sickens 265 In 8 States
Chicken salad made by an Iowa food processing company and distributed by Fareway Stores in the Midwest sickened 265 people in eight states and caused one death in Iowa from salmonella contamination, the U.S. Centers for Disease Control and Prevention said. The outbreak which sickened people from Jan. 8 through March 20, appears to have ended, the CDC said in an update posted on Friday. Ill people ranged in age from less than 1 year to 89 years. Sixty-seven percent were female. (4/9)

Los Angeles Times: L.A. County Unveils New Budget, Emphasizing Homeless Services And Other Safety-Net Programs
Los Angeles County officials released a proposed $30.8-billion budget for the next fiscal year Monday, emphasizing the need to combat and prevent homelessness and to provide crucial safety-net services. "Of all of the issues confronting the county none is more urgent and complex than homelessness," Sachi Hamai, the county's chief executive, said at a news conference. (Agrawal, 4/9)

The Washington Post: At Last, Virginia Republicans Might Allow Their State Better Medicaid
For the past four years, Virginia has thumbed its nose at billions of dollars in federal funding while leaving hundreds of thousands of residents without health insurance, all in service to Republican lawmakers’ antipathy toward Obamacare. The irrationality of their stance, and the damage it has done to their constituents, has been manifest. Now GOP obstruction has begun to crack under the weight of its own illogic. (4/9)

The Washington Post: Will Virginia Finally Do The Right Thing For 400,000 People Desperate For Health Care?
Watch this, America. A state may be about to do something sensible, bipartisan and even humanitarian to take care of its people.It could still fall apart, as it has before. But Virginia’s lawmakers appear to be on the verge of insuring about 400,000 low-income residents by expanding Medicaid after years of refusing to do so. Remember, Virginia is a place where thousands of people queue up before dawn on one weekend every summer to get free treatment from volunteers who turn livestock pens into medical crash units at the Wise County Fairgrounds because people are so desperate for care. (Petula Dvorak, 4/9)

USA Today: Trump And GOP Hypocrisy On Mental Health And Medicaid
A mental health problem at the highest level,” President Trump said after a shooting in Sutherland Springs, Texas left 26 parishioners dead. “Mental health is often a big problem underlying these tragedies,” House Speaker Paul Ryan said after a gunman killed 17 students and teachers at Marjory Stoneman Douglas High School. If Republican leaders are talking about mental health, it’s generally for one reason — to avoid talking about guns. By any measure, the claim that mental illness is to blame for gun violence is false. (Rep. Joe Kennedy, 4/9)

Los Angeles Times: Walmart And CVS Have 15,000 Combined Stores. Why Are Both Trying To Buy Health Insurance Companies?
The economics of healthcare in America is making for some strange bedfellows. CVS, the behemoth pharmacy chain, plans to buy Aetna, a 22-million member health insurer, for $69 billion. Less than two weeks ago, it became public that Walmart, where one in four Americans shop each week, is considering an acquisition of another insurer, Humana. Why would these two massive retailers want to buy health insurers? Think millions of customers under one roof buying insurance, visiting health clinics and — importantly — filling prescriptions. These merged insurer-retailers could have lots of price-setting leverage in dealing with pharmaceutical companies and hospitals. But consolidation like this also can threaten competition — and in healthcare markets, that is a demonstrated danger. (Dana P. Goldman and Erin E. Trish, 4/10)

Bloomberg: The Medical Marketplace Is Changing Fast
Marketplace disruption is reshaping health care in the U.S., with headline-grabbing mergers and the formation of new companies. These moves are breaking down traditional silos in health care. And further change can be expected, as calls grow louder for better health-care value for the dollar. Four trends are driving the shift: an ongoing movement toward value-based payments; improved health-care data analytics; innovations in medical science; and increasing demand from consumers for greater convenience and value. Although health-care costs have been growing more slowly than they once did, the U.S. still spends far too much, and there's great variation across the country in both prices (especially for employer-sponsored insurance) and utilization (especially for Medicare). Fee-for-service payment is a major reason spending is so high and varies so much from region to region. The shift toward value-based payments -- including bundled payments and accountable care organizations -- is a necessary though not complete solution. (Peter R. Orszag and David Gluckman, 4/9)

The New York Times: Obamacare’s Very Stable Genius 
Front pages continue, understandably, to be dominated by the roughly 130,000 scandals currently afflicting the Trump administration. But polls suggest that the reek of corruption, intense as it is, isn’t likely to dominate the midterm elections. The biggest issue on voters’ minds appears, instead, to be health care. (Paul Krugman, 4/9)

Portland Press Herald: Health Insurance Rate Increases Were Avoidable
This fall, millions of Americans who are already struggling to afford health insurance will once again experience double-digit premium increases because of election-year politics at its worst. What is most regrettable is not only that those increases could have been prevented but also that the cost of health insurance actually could have declined by as much as 40 percent in the individual market over the next two years. (Sen. Susan Collins, 4/8)

The Baltimore Sun: Maryland's Year Of Health Care
The General Assembly session that ends at midnight on Monday has seen its share of controversial issues, from gun control to medical marijuana, and of memorable moments, perhaps the most notable of which was when Republican Del. Meagan Simonaire gave a floor speech endorsing a ban on so-called “conversion therapy” for gay youth, which she said her father, Republican state Sen. Bryan Simonaire, suggested she try after she came out as bisexual. The session has had some election-year political jockeying, too, as Gov. Larry Hogan sparred with Democrats over changes to the state school construction program. But the most significant thing that’s likely to emerge from the 90 days of lawmaking came with little fanfare or controversy — one of the most aggressive efforts in the country to protect the state’s Affordable Care Act insurance exchange from collapsing under a series of blows from the Republican Congress and President Donald Trump. (4/6)

The Wall Street Journal: Food Stamps Shouldn’t Pay For Junk
The Food Stamp Program started as a way to help people whose shelves were empty. It certainly helped my family. My mother was a single parent who struggled to make ends meet in wealthy Darien, Conn., during the 1970s. We relied on food stamps until I was 16. Since then, the program has grown considerably. Renamed the Supplemental Nutrition Assistance Program, it supported more than 40 million Americans in 2017. Even though SNAP is generally well-intentioned, what it puts on shelves is not always helpful or healthy. SNAP rules allow stores to distribute candy, soda, cheese products, energy drinks, processed meats and lots of other items that end up seriously compromising the health of SNAP recipients. (Moby, 4/9)

The Philadelphia Inquirer: What I Did After Getting A Fetal Diagnosis Of Down Syndrome Should Be No One Else's Business
State legislators in Harrisburg believe they are empowered to make decisions about what women can and cannot do during pregnancy. Legislation before both the state House and Senate would prohibit a woman to have an abortion because of a fetal diagnosis of Down syndrome. This legislation – House Bill 2050 and Senate Bill 1050 – is unconstitutional, unenforceable, and wrong. (Jennifer Schrad, 4/9)

Columbus Dispatch: Childbirth Presents Great Risk To Black Women
The anticipation of bringing a new bundle of joy into the world — and all that comes with it — can be both exciting and stressful for moms-to-be. But if you are an expectant black mother, there is much more at stake, according to a recent study and last Sunday’s Dispatch.com article “Central Ohio hospitals ramp up efforts to reduce maternal mortality deaths amid growing national crisis.” Having a baby comes with several risk factors, and too many black moms die during and shortly after childbirth. (Linda Post, 4/9)

Portland Press Herald: Gov. LePage To Blame For Maine's Protracted Fight Over Overdose Antidote
Gov. LePage wrote this week of the state’s response to the opioid epidemic: “The Legislature’s focus on naloxone as the most important tool is sadly misplaced.” Sometimes, you’ve got to wonder where he’s been. (4/6)