The New York Times: The Final Obamacare Tally Is In. About 400,000 Fewer People Signed Up This Year.
The Trump administration said on Tuesday that 11.8 million people had signed up for health insurance through the Affordable Care Act marketplaces for 2018 — roughly 400,000 fewer than last year. The drop was relatively small, given that Mr. Trump had sharply cut federal outreach efforts and the open enrollment period was half as long as in past years. Virtually the entire decrease came in the 39 states that use the marketplace run by the federal government, HealthCare.gov. (Goodnough, 4/3)

The Wall Street Journal: Nearly 12 Million People Enrolled In Health Coverage Under The Affordable Care Act
Many analysts had expected a lower sign-up figure because of the abbreviated enrollment window. Groups that support the ACA said the figures showed that Americans are embracing the health law despite Republican efforts to dismantle it. “The American people don’t want to go back to a time when insurers could deny them health care for having a pre-existing condition or be priced out of the market based on their age, gender or medical history,” said Brad Woodhouse, campaign director for the advocacy group Protect Our Care. (Armour, 4/3)

The Washington Post: Nearly 12 Million People Enrolled In 2018 Health Coverage Under The ACA
In an uncharacteristic move, CMS Administrator Seema Verma announced the fifth-year tally in a series of tweets shortly before the report was issued late Tuesday afternoon. The tweets were a blend of praise for what she called “the most cost-effective and successful open enrollment to date” and the Trump administration’s characteristic naysaying about the marketplaces that were created by the sprawling 2010 health-care law it has been seeking to dismantle. (Goldstein, 4/3)

Reuters: U.S. Obamacare 2018 Exchange Enrollment Drops 3 Percent: CMS
U.S. President Donald Trump in October cut off billions of dollars in subsidy payments to insurers that help people pay for medical costs, causing insurers to raise 2018 premiums or drop out of selling plans in the Obamacare marketplace. His administration also halved the enrollment period to six weeks and cut the federal advertising and outreach budget by 90 percent. It also has proposed putting cheaper insurance policies offering bare-bones medical coverage on the Obamacare market in 2019 or 2020. (Erman and Humer, 4/3)

The Associated Press: Premiums Shoot Up, But Many Are Paying Less For 'Obamacare'
Consumers getting financial assistance under former President Barack Obama's health care law will pay lower premiums this year, even though the "list price" for their health insurance shot up. That odd result is reflected in a report issued Tuesday by the Trump administration. After federal aid, the average monthly premium paid by subsidized customers on HealthCare.gov is dropping to $89 from last year's $106. That's a 16 percent savings even though the "list price" premium went up about 30 percent, now averaging $639 for those subsidized customers. (Alonso-Zaldivar, 4/3)

CQ: Enrollment In Health Insurance Marketplaces Fell
Policy experts expected monthly premiums would rise this year, in part, because of the Trump administration’s October decision to cut off reimbursements to insurers for the divisive cost-sharing reduction subsidies. Those subsidies help low-income consumers afford certain out-of-pocket costs. But regulators in most states allowed insurance companies to engage in a practice referred to as “silver loading.” Insurers increased premiums for benchmark silver plans, which the consumer tax credits are based on, and the higher premiums led to larger credits for many consumers.(McIntire, 4/3)

The Hill: Poll: Just 30 Percent Know ObamaCare Mandate Was Repealed
Just 30 percent of the public knows that ObamaCare’s individual mandate has been repealed, according to a new poll. The poll from the Kaiser Family Foundation shows that, even after Congress repealed the mandate to have insurance as part of tax reform in December, much of the public is still confused about whether there is a requirement to have health insurance. (Sullivan, 4/3)

Meanwhile, in the states —

Modern Healthcare: Ohio Seeks First-Ever Individual Mandate Waiver 
Ohio officials asked the Trump Administration on Friday to formally waive the Affordable Care Act individual mandate that requires residents to have health insurance, making it the first state to make such a waiver request. Ohio's Legislature called for the 1332 waiver last summer, and Congress zeroed out the financial penalty for not having coverage in its tax bill in December. (Dickson, 4/3)

The Star Tribune: Health Insurers Return To Profitability In Minnesota
Minnesota’s nonprofit health plans saw their financial performance rebound in 2017, driven in part by a surprisingly large profit margin in the market where individuals buy coverage. Margins in the individual market were so high that one health insurer could be providing $30 million in consumer rebates, while an official with another health plan hinted that flat or discounted premiums could be on the horizon. (Snowbeck, 4/3)

USA Today: FDA Orders Kratom Distributor To Do Recall Over Salmonella
Federal drug regulators issued their first-ever mandatory recall Tuesday to a company selling several products containing the herbal supplement kratom and contaminated with Salmonella. The Food and Drug Administration (FDA) said it issued the order because Triangle Pharmanaturals of Las Vegas refused to cooperate. (O'Donnell, 4/3)

The Associated Press: FDA Orders Recall Of Salmonella-Tainted Herbal Supplement 
The Food and Drug Administration said Tuesday that it took the rare step of ordering the recall because Triangle Pharmanaturals refused to cooperate with U.S. regulators. Companies typically comply with government requests and voluntarily recall tainted products. Calls and an email to the company were not immediately returned Tuesday morning. (Perrone, 4/3)

The Washington Post: In A First, FDA Orders Recall Of A ‘Contaminated Food’ — Kratom With Salmonella
The FDA doesn't have the authority to order mandatory recalls for drugs and seeks voluntary recalls if it sees a safety problem. But it got mandatory-recall authority for tainted food under the Food Safety and Modernization Act that went into effect in 2011. “This action is based on the imminent health risk posed by the contamination of this product with salmonella, and the refusal of this company to voluntarily act to protect its customers and issue a recall, despite our repeated requests and actions,” FDA Commissioner Scott Gottlieb said in a statement. (McGinley, 4/3)

Buzzfeed News: Grindr Will Stop Sharing Users' HIV Data With Other Companies
The popular gay hookup app Grindr said late on Monday that it would stop sharing information about its users' HIV status with third-party analytics companies. The announcement came after BuzzFeed News revealed that Grindr had been securely providing two companies — Apptimize and Localytics, commonly used services to help optimize apps — with some of the information that Grindr users include in their profiles, including HIV status and "last tested date." (Ghorayshi, 4/2)

The Washington Post: Grindr Will Stop Sharing HIV Data To Third-Party Firms Amid Backlash
Bryce Case, Grindr’s head of security, said that sharing information with Apptimize and Localytics is “standard industry practice for rolling out and debugging software” and was done securely to test and optimize the app’s features, such as HIV testing reminders. “Any information we provide to our software vendors including HIV status information is encrypted and at no point did we share sensitive information like HIV status with advertisers,” Case said in a statement. “As the testing of our feature is completed, any information related to HIV status has been removed from Apptimize and we are in the process of discussing removal of this data from Localytics.” (Phillips, 4/3)

The Associated Press: Gay Dating App Grindr To Stop Sharing HIV Status
Grindr says it’s important to remember it is a public forum and users have the option to post information about their HIV status and date when last tested. It says its users should carefully consider what information they list in their profiles. (4/3)

The New York Times: Grindr Sets Off Privacy Firestorm After Sharing Users’ H.I.V.-Status Data
An increasing number of online users in the United States, along with some members of Congress, are questioning the tech industry’s largely unfettered collection and data-mining of consumers’ personal details. The Grindr controversy also highlights the widening regulatory gap between the United States, which lacks a comprehensive federal consumer privacy law, and Europe, where privacy is viewed as a fundamental human right, with laws to back it up. (Singer, 4/3)

Buzzfeed News: Two Senators Just Demanded That Grindr Explain How It's Sharing Its User Data
Two Democratic senators sent letters to the popular gay dating app Grindr on Tuesday, asking for detailed information about how they handle sensitive user data. Letters also went to Apptimize and Localytics, the two analytics companies that Grindr sent its users' HIV status data to. “Simply using an app should not give companies a license to carelessly handle, use, or share this type of sensitive information,” the letter, written by Sen. Edward Markey of Massachusetts and Sen. Richard Blumenthal of Connecticut, stated. “Grindr and those with whom it shares its users’ sensitive information has an obligation to both protect this data and ensure users have meaningful control over it.” (Ghorayshi, 4/3)

Stat: New Alcohol-Advertising Research Stopped With NIH Branch Director's Arrival
The branch of the National Institutes of Health that studies alcohol abuse has not funded any new research by outside scientists specifically on the effects of alcohol advertising since its current director took over in 2014, according to a STAT analysis of grants. At least seven such studies were funded in the decade before George Koob became director of the National Institute on Alcohol Abuse and Alcoholism in 2014. No new grants have been awarded since. (Begley and Joseph, 4/4)

In other public health news —

The Hill: NIH Director: Sports Leagues Should Rethink Sponsoring Unhealthy Foods 
The director of the National Institutes of Health (NIH) is calling on major sports leagues to re-examine their sponsorship deals with unhealthy foods, out of fear they are fueling the country’s obesity problem. Dr. Francis Collins in a blog post pointed to NIH-funded research showing that more than 75 percent of foods promoted by major sports leagues are unhealthy. (Sullivan, 4/3)

Kaiser Health News: Older Americans Are Hooked On Vitamins Despite Scarce Evidence They Work
When she was a young physician, Dr. Martha Gulati noticed that many of her mentors were prescribing vitamin E and folic acid to patients. Preliminary studies in the early 1990s had linked both supplements to a lower risk of heart disease. She urged her father to pop the pills as well: “Dad, you should be on these vitamins, because every cardiologist is taking them or putting their patients on [them],” recalled Gulati, now chief of cardiology for the University of Arizona College of Medicine-Phoenix. (Szabo, 4/4)

The New York Times: All The Amenities Airlines Are Offering For Healthier Flights
Wellness isn’t a concept that seems synonymous with the ever-growing hassles of flying, but that could finally be changing. Some airlines are embracing the idea of healthier flying, offering calorie-conscious menus and new exercise videos. According to Beth McGroarty, research director for The Global Wellness Institute, a nonprofit organization for the wellness industry, even as seats shrink and flights get more crowded, many carriers want air travel to be more bearable (and even enjoyable). They believe wellness is the way to do that. “It’s part of the larger wellness movement happening in the travel industry,” she said. (Vora, 4/4)

The Associated Press: CDC: Drug-Resistant 'Nightmare Bacteria' Pose Growing Threat
"Nightmare bacteria" with unusual resistance to antibiotics of last resort were found more than 200 times in the United States last year in a first-of-a-kind hunt to see how much of a threat these rare cases are becoming, health officials said Tuesday. That's more than they had expected to find, and the true number is probably higher because the effort involved only certain labs in each state, officials say. (Marchione, 4/3)

The Wall Street Journal: Rare Superbugs More Widespread Than Thought, Says CDC
The bacteria samples were from patients with pneumonia, urinary-tract infections, and other conditions in hospitals, nursing homes and other health-care facilities in 27 states, the CDC said. “CDC’s study found several dangerous pathogens, hiding in plain sight, that can cause infections that are difficult or impossible to treat,” said Anne Schuchat, the CDC’s principal deputy director. She said she was surprised by the large numbers. “This was more than I was expecting,” she said. (McKay, 4/3)

The Hill: CDC Finds 'Nightmare Bacteria' Spreading Across The Country 
More than 23,000 Americans die each year from infections caused by germs resistant to antibiotics, the CDC said. The agency has developed a new system aimed at quickly identifying the superbugs, including helping staff at state health departments and lab facilities to test samples and isolate infected patients. (Weixel, 4/3)

NPR: CDC Reports Efforts To Track 'Nightmare Bacteria' Is Turning Up
But detecting these rare germs also presents an opportunity. Once a case is detected, the CDC, along with state and local health officials, can swoop in and reduce the chance that these germs will spread. Infection control measures in nursing homes and hospitals can be ramped up. Medical personnel and family members who have been in close contact with these patients can be tested rapidly to see if they are also carrying the dangerous bacteria. "Because of the additional testing capacity that we have, we have found a lot of these scary bacteria around the country but we've found them in ones and twos and not everywhere," Schuchat says. "So there's a chance to keep them from becoming widespread." (Harris, 4/3)

Kaiser Health News: ‘Nightmare Bacteria’ Stalk U.S. Hospitals
Although the CDC has warned of the danger of antibiotic-resistant bacteria for years, the new report helps illustrate the scope of the problem. Dr. Anne Schuchat, the CDC’s principal deputy director, said she was surprised by the extent of the spread. “As fast as we have run to slow [antibiotic] resistance, some germs have outpaced us,” Schuchat said. “We need to do more and we need to do it faster and earlier.” (Szabo, 4/3)

Stateline: New Momentum For Addiction Treatment Behind Bars
From the moment they are arrested, people with an addiction to heroin and prescription painkillers and those who are taking medications to beat their addictions face the prospect of painful opioid withdrawal. At least a quarter of the people in U.S. prisons and jails are addicted to opioids. Those who are released rejoin their communities with dangerously reduced tolerance and nothing to blunt their drug cravings, making them highly susceptible to a deadly overdose. (Vestal, 4/4)

The Hill: CMS Tweaks Opioid Proposal After Backlash 
The Centers for Medicare and Medicaid Services (CMS) has released a sweeping final Medicare rule that included altering a draft proposal aimed at curbing the opioid epidemic that had proven controversial. The agency had received pushback on a proposal that would have meant a prescription for high doses of opioids (90 milligrams of morphine per day or more) automatically wouldn’t be filled and the patient would need special permission from their private insurance company in order to receive the medication. (Roubein, 4/3)

The Associated Press: Gov. Murphy Wants New Opioid Spending But Not For Commercials
Gov. Phil Murphy said Tuesday he wants $100 million in new spending to address New Jersey's opioid crisis while shutting down the prospect of any Chris Christie-style public service announcements to promote substance abuse treatment. Murphy, a Democrat, outlined the budget proposal Tuesday at the Rescue Mission of Trenton, a recovery house for poor residents and those with drug addiction that Christie, the Republican former governor, also visited throughout his two terms. (4/3)

Health News Florida: SWFL State Senator Says Opioids Are Hurting Newborns
Known as neonatal abstinence syndrome, babies born to mothers who’ve taken opioids during pregnancy themselves must endure the painful symptoms of withdrawal during their first days of life. Risks and symptoms include premature birth, tremors, irritability and almost constant inconsolable crying, hyperactive reflexes, poor feeding, dehydration and even seizures to name a few. (Lacovone and Kiniry, 4/3)

Boston Globe: A Quest For Addiction Treatment That Works, And The Data To Prove It
Column Health joins a shift in emphasis in Massachusetts toward outpatient care and the use of medication in treating addiction. This year, for example, the state funded eight new programs in doctor’s offices to expand access to such care. (Freyer, 4/3)

Los Angeles Times: A Sudden Loss Of Wealth May Be Hazardous To Your Health
Your financial health may have more bearing on your physical health than you realize. American adults who experienced a sudden and substantial loss of wealth were 50% more likely to die in a 20-year period than were others in their age group whose financial picture remained relatively stable, or improved. (Kaplan, 4/3)

NPR: Loss Of Wealth Tied To Higher Death Risk
An analysis involving more than 8,000 Americans found that those who suffered a "negative wealth shock" — defined as losing at least 75 percent of their wealth in two years — faced a 50 percent increased risk of dying over the next two decades. "That was surprising," says Lindsay Pool, a research assistant professor of preventive medicine at Northwestern University. "A 50 percent increased risk of mortality over a 20-year period is a lot." (Stein, 4/3)

Politico: California’s Path To Universal Health Care Pits Pragmatists Against Single-Payer Holdouts
It’s the pragmatists versus the idealists in California’s latest quest for universal health care. Increasing numbers of lawmakers and advocates are pushing for policy goals that realistically can be accomplished this year. But there’s an unrelenting camp clinging to single-payer-or-bust. The Golden State, which has been pushing back against the Trump administration on multiple fronts, is leaning toward the more incremental approach. This includes bills and budget items that would cover everything from insuring undocumented adults to preventing Medicaid work requirements and shielding the state from insurance products favored by the GOP, such as short-term plans. (Colliver, 4/3)

The New York Times: Inside A Private Prison: Blood, Suicide And Poorly Paid Guards
On the witness stand and under pressure, Frank Shaw, the warden of the East Mississippi Correctional Facility, could not guarantee that the prison was capable of performing its most basic function. Asked if the guards were supposed to keep inmates in their cells, he said, wearily, “They do their best.” According to evidence and testimony at a federal civil rights trial, far worse things were happening at the prison than inmates strolling around during a lockdown: A mentally ill man on suicide watch hanged himself, gang members were allowed to beat other prisoners, and those whose cries for medical attention were ignored resorted to setting fires in their cells. (Williams, 4/3)

Pioneer Press: State Faults Eagan Assisted Living Facility After Resident Found Dead 
Debbie Singer walked up to her mother’s apartment at an Eagan senior living community to find multiple packages and two newspapers outside the door. Her mother’s bed and bathroom looked as if they hadn’t been used in days. Medication for the past two days had not been taken, and her mother was wearing the same clothing she’d been in two days earlier.June Alice Thompson, 92, was dead, and most likely had been for two days. ...The Health Department alleges that while Thompson’s death was most likely natural, Commons on Marice failed to complete the daily checks the privately operated facility advertises and did not notice Thompson’s death for two days. The name of the victim and her daughter were included in the Eagan Police Department report on the incident, but not in the state report. (Chavey, 4/3)

Milwaukee Journal Sentinel: Gov. Scott Walker Removes Most Abortion Coverage For Public Workers
Most abortions for state and local workers would not be covered by their public insurance plans, under legislation signed by Wisconsin Gov. Scott Walker Tuesday. Assembly Bill 128 prohibits government-provided health insurance plans from paying for abortions except in cases of rape or incest or to preserve the life of the mother. (Stein, 4/3)

New Orleans Times-Picayune: 3 New Orleans Health Providers Named Leaders In LGBT Care 
Three New Orleans healthcare providers have been recognized as "LGBT Healthcare Equality Leaders" by the Human Rights Campaign Foundation for their commitment to provide inclusive environments for their LGBT (lesbian, gay, bi-sexual, transgender) patients and employees. A total of seven Ochsner locations -- including Ochsner Baptist, the Ochsner Medical Centers on Jefferson Highway, Kenner, North Shore and its West Bank Campus -- as well as the New Orleans Veterans Administration Hospital and the Crescent Care Community Health Center were recognized in the HRC Foundation's annual Healthcare Equality Index (HEI) released March 27. (Clark, 4/3)

The Washington Post: Ancestry.Com DNA Test Revealed A Woman’s Biological Father Was Her Family’s Fertility Doctor, Lawsuit Says
When Kelli Rowlette received the results from a DNA sample she had sent to a popular genealogy website, she assumed there had been a mistake. The test showed that her DNA matched a sample from a doctor more than 500 miles away — and, though she had never heard of him, Ancestry.com predicted a parent-child relationship between the two. At the time, Rowlette was not aware that more than 36 years ago, her parents had struggled to conceive. (Bever, 4/3)

New Orleans Times-Picayune: Proposal Could Force All Louisiana Bars And Gaming Facilities To Go Smoke-Free
It's been three years since a smoking ban cleared the air in New Orleans' bars and entertainment venues. Now, a proposal could expand the ban statewide. A measure that will be introduced Tuesday (April 3) by Representative Dustin Miller calls for a statewide comprehensive smoke-free policy that would make all workplaces, including bars, casinos and gaming facilities smoke-free. (Clark, 4/3)

The Washington Post: New D.C. Public Hospital Will Be Half As Large As Current Facility, Report Says
D.C. Mayor Muriel E. Bowser’s plan to replace United Medical Center, Southeast Washington’s troubled public hospital, calls for a new facility less than half its size, according to proposals to be released Tuesday. The new medical center would be built by the city on the sprawling campus of St. Elizabeths Hospital — a 19th-century psychiatric facility that today is home to a small public hospital for the mentally ill and a large swath of land slated for redevelopment — and would have 106 beds, at a cost of $248 million, according to the reports. (Jamison, 4/3)

Houston Chronicle: Texas Intensifies Efforts To Boost Maternal Health Care 
Hoping to curb the state’s continuing crisis with pregnancy-related deaths, Texas health officials are ramping up efforts to impose new guidelines credited with reducing the number of mothers dying during childbirth by up to 22 percent in other states. In December, Texas became one of 23 states across the country to join the Alliance for Innovation on Maternal Health, or AIM, a national data-driven program focused on improving the safety and care of pregnant women by partnering with state health departments. The guidelines come in the form of “bundles,” or standardized sets of plans and instructions that participating hospital staff can use when patients have severe pregnancy complications, like hemorrhaging or hypertension. (Milburn, 4/3)

Georgia Health News: Governor Comes To Aid Of State Workers Hit By Insurance Standoff
Gov. Nathan Deal, continuing his public pressure on Piedmont and Blue Cross in their contract stalemate, said Tuesday that the state and University System of Georgia will absorb out-of-network costs for employees for up to 30 days to reduce their potential financial burden. The extraordinary step comes in the wake of Sunday’s lapse of a contract between Piedmont Healthcare and Blue Cross and Blue Shield of Georgia. Since the beginning of this week, Piedmont hospitals and doctors are out of network for Blue Cross members. (Miller, 4/3)

Pioneer Press: MN Needs New Computer System To Track Elder Abuse. How Should It Work? 
The Minnesota Department of Health wants public input on the best way to manage electronic records related to complaints of elder abuse. The health department’s Office of Health Facility Complaints released a nine-page “request for information” Tuesday to help determine what attributes its new case-management system needs to best serve the public. (Magan, 4/3)

Houston Chronicle: New Practice Focuses On Women's Health In The Heights
Total Women's Care has opened and is seeking appointments geared toward women's health in the Heights. Total Women's Care of the Heights offers a full range of care for women of all ages and stages of life. Dr. Vonne Jones, a Houston native and obstetrics and gynecology specialist, has practiced in Houston since graduation from Georgetown University School of Medicine in 2008. (4/3)

Pioneer Press: Allina Health To Run Clinics In Eagan And Lakeville Hy-Vee Stores 
Allina Health is partnering with Hy-Vee to operate clinics in the grocer’s Eagan and Lakeville stores. An Allina Health Everyday Clinic opened Monday at the Eagan store on Central Park Commons Drive, and the Lakeville store on Pilot Knob Road will have a clinic later this spring. The clinics will be staffed by Allina Health board-certified advance-practice clinicians, offering care for minor illnesses and rapid laboratory testing for patients ages 18 months and older. Hours will be 8 a.m. to 8 p.m. Monday through Friday and 9 a.m. to 5 p.m. Saturday and Sunday. (Ferraro, 4/3)

Detroit Free Press: Blue Cross Reverses Decision, Will Pay For Knee Arthritis Shots
Blue Cross Blue Shield of Michigan has reversed its decision to stop covering an anti-arthritis injection for knees that some doctors insist helps patients but others contend is little better than a placebo. Blue Cross told medical providers last week that it will continue paying for hyaluronic acid injections, also known as viscosupplementation therapy, as it reviews additional information about the injections' effectiveness. (Reindl, 4/4)

Modern Healthcare: Health Systems Overlook Potential Of Real Estate Assets
While Memphis-based Baptist Memorial Health Care owns the land that its 49-bed rehabilitation hospital sits on in Germantown, Tenn., it rents the facility from commercial real estate developer Duke Realty Corp. Duke paid for the $33 million construction cost, freeing up capital for Baptist to spend on equipment, physicians and other investments aimed at improving care. Baptist also operates the hospital in a joint venture with Kindred Healthcare, which specializes in post-acute care. (Kacik, 4/3)

Georgia Health News: Plan For Georgia Rural Hospital’s Future Has As Many Twists As A Mountain Road
Northeast Georgia Health System, based in Gainesville, announced Friday that it has agreed to buy the hospital property and some equipment from DL Investment Holdings LLC, a company based in Florida that currently owns Chestatee Regional.But another transaction is already in the planning stages. State lawmakers have earmarked dollars in Georgia’s fiscal 2019 budget for the Board of Regents eventually to buy the current Chestatee Regional property from Northeast Georgia Health System. (Miller, 4/3)

Kaiser Health News: Atlanta Struggles To Meet MLK’s Legacy On Health Care
While public safety commissioner Bull Connor’s police dogs in 1963 attacked civil rights protesters in Birmingham, Ala., leaders in Martin Luther King Jr.’s hometown of Atlanta were burnishing its reputation as “the city too busy to hate. ”Yet 50 years after the civil rights leader was killed, some public health leaders here wonder whether the city is failing to live up to King’s call for justice in health care. They point to substantial disparities, particularly in preventive care. (Anderson, 4/4)

San Jose Mercury News: Fight Over Sexual Education In Fremont Schools Intensifying
Until further review, a sex education curriculum criticized by many as too graphic for children in grades 4-6 won’t be taught later this month as initially planned. At a March 28 meeting packed by hundreds of parents, teachers and students, the Fremont school board voted 3-2 to examine the course and possibly order modifications before offering it to elementary school students. (Geha, 4/3)

The Washington Post: Synthetic Cannabinoids Linked To Severe Bleeding, Deaths In Chicago And Central Illinois
Health officials in Illinois are warning people about mock marijuana that is spreading across Chicago and the central part of the state, causing severe bleeding among users and, in some cases, death. Synthetic cannabinoids, also known as K2 or Spice, has been linked to 56 cases in which people in the state experienced severe bleeding after using the substance, officials with the Illinois Department of Public Health said in a statement. The users were hospitalized — and two of them died — after coughing up blood, finding blood in their urine or bleeding from their noses or gums, officials said. (Bever, 4/3)

Los Angeles Times: Judge Threatens To Bar O.C. From Enforcing Anti-Camping Laws If It Can't Shelter Homeless
The political crisis over homelessness in Orange County approached a crucial moment Tuesday as a federal judge raised the prospect of barring local governments from enforcing anti-camping ordinances if officials cannot create temporary shelters for hundreds being swept out of tent cities. The county for weeks has been struggling to find locations to place the homeless after removing them from an encampment along the Santa Ana River. A plan to place temporary shelters in Irvine, Laguna Niguel and Huntington Beach died amid loud protests from residents last week, and the problem is expected to get worse as officials move to clear out another tent city at the Santa Ana Civic Center. (Fry, 4/3)

Tampa Bay Times: Medical Marijuana Provider Sues Department Of Health Over Caps On Dispensaries
Florida medical marijuana provider Trulieve is challenging a state law that caps how many dispensaries it can open and where, saying it unfairly restricts its constitutional right to open storefronts "without arbitrary and unreasonable limits." The Gadsden County-based business filed a lawsuit against the state Department of Health, dated late last week in Leon County circuit court, asking a judge to exempt Trulieve from a provision in a 2017 law that limits businesses to 25 dispensaries for medical marijuana. (Koh, 4/3)

Miami Herald: Former President Bill Clinton Secures Millions For Hurricane-Struck Caribbean
Caribbean islands struck by last year’s hurricanes Irma and Maria are getting some much needed help with their recovery — from rebuilt schools and improved healthcare to mental health access and solar lights. The commitments — coming less than 60 days before the June 1 start of hurricane season — were announced Tuesday by former President Bill Clinton at the University of Miami as part of the newly launched Clinton Global Initiative Action Network on Post-Disaster Recovery. (Charles, 4/3)

Stat: Amgen's Money-Back Guarantee For Its Pricey Cholesterol Drug May Not Deliver
Over the past couple of years, drug makers have increasingly explored outcomes-based contracting as a way to convince payers to cover their medicines. Basically, this notion revolves around the idea that an insurer will get a drug at a lower cost if a patient does not benefit as planned. But not all deals are likely to deliver, and a new analysis argued that an agreement offered by Amgen (AMGN) is a notable example. To wit, Amgen sells Repatha, a new type of cholesterol medicine approved in 2015 to treat patients who struggle to control cholesterol using statins, particularly those with an inherited disorder known as familial hypercholesterolemia. Around the same time, Sanofi (SNY) and Regeneron Pharmaceuticals (REGN) won regulatory approval to market a competing treatment. (Silverman, 4/2)

The Wall Street Journal: Drug Price Hike Sparks Senate Probe
Three U.S. senators are seeking more information from a Florida company that has steadily increased the price of a 40-year-old cancer drug, lomustine, in recent years. Sens. Susan Collins (R., Maine), Claire McCaskill (D., Mo.) and Catherine Cortez Masto (D., Nev.) sent a letter dated March 22 to Tri-Source Pharma LLC Chief Executive Robert DiCrisci, saying, “We would like to better understand the factors contributing to the rising cost of lomustine.” Mr. DiCrisci also is CEO of NextSource Biotechnology, the Tri-Source unit that markets the drug under the brand name Gleostine. (Loftus, 4/2)

The Hill: Senators Launch Probe Into Why Price Of Cancer Drug Increased 1400 Percent
Three U.S. senators are asking why a 40-year-old cancer drug has increased in price by 1,400 percent since 2013. The drug in question, lomustine, was introduced in 1976 to treat brain tumors and Hodgkin lymphoma. Lomustine, which has no generic competition, cost $50 for a capsule with the highest dose in 2013. Now a capsule with the same dose costs $768.  (Hellmann, 4/2)

Columbus Dispatch: Ohio Bans 'Gag Orders' On Cheaper Cash Prices For Prescriptions
State regulators ordered health insurers and their pharmacy benefits managers Wednesday to cease enforcement of gag orders preventing pharmacists from informing consumers of the lowest drug price available. In addition, the Ohio Department of Insurance prohibited charging consumers more for their prescription medication than it would cost if they paid without insurance, or out of pocket. (Candisky and Rowland, 4/4)

Bloomberg: Walmart Is In Takeover Talks With Pharmacy Startup
Walmart Inc. is in early talks about a deal for closely held PillPack, an online startup that could help grow the retail giant’s pharmacy offerings, according to people familiar with the situation. PillPack and Walmart declined to comment. CNBC first reported the talks Monday, and said the price being discussed was less than $1 billion. It’s not clear if the talks will lead to a deal. (Langreth and Boyle, 4/2)

Stat: Kite Pharma Veterans Launching New Firm To Develop Off-The-Shelf CAR-T
The two former Kite Pharma executives behind a game-changing cancer-killing technology are launching their next act: a new company to develop a suite of so-called off-the-shelf CAR-T therapy assets, designed so that they do not need to be personalized for each cancer patient. Allogene Therapeutics, which was unveiled Tuesday morning, has raised $300 million to acquire and advance a portfolio of experimental cell therapies previously controlled by Pfizer. As a consequence of the deal, Pfizer is getting out of the business of being a major CAR-T player, though it will take a 25 percent ownership stake in Allogene. (Robbins, 4/3)

CNN: Big Pharma's Cash Flood Is Drowning Seniors
Big Pharma is jacking up prices for one reason -- because it can. This is why the National Committee to Preserve Social Security and Medicare advocates that Medicare be required (or at least allowed) to negotiate prescription drug prices with Big Pharma -- an idea Republicans have by and large opposed since the Medicare Part D program was enacted in 2003. In fact, the original Medicare Part D legislation forbade the government from negotiating drug prices with manufacturers. (Richtman, 4/3)

Stat: Houston Aspires To Become The 'Third Coast' Of Biotech. Can It Pull It Off?
It was a banner achievement for MD Anderson Cancer Center. Top biotech investors had licensed some of its research to launch a high-profile cancer diagnostic and therapeutics company, backed by more than $80 million. (Joseph, 3/29)

Bloomberg: Allergan Weighs Options For Women's Health Unit
Allergan Plc, which has been looking for ways to counter its stock slump as new threats to its top-selling skin and eye drugs have emerged, is considering options for its women’s health unit, according to people with knowledge of the matter. The specialty pharmaceuticals product maker has held talks with advisers about strategic options for the unit, including a sale, said the people, who asked not to be identified because they weren’t authorized to speak publicly. A sale, which would likely to attract interest from private equity firms, could value the business at more than $5 billion, the people said. (Porter and Baigorri, 4/2)

Forbes: Pharma Middlemen Have Targets On Their Backs
What’s a great way for Amazon to prove it can make America’s healthcare system better for consumers? Cut the cost of a high priced generic drug by getting it out of the reimbursement structure dominated by middlemen called pharmacy benefit managers (PBMs), according to Julie Grant, a partner at VC firm Canaan Partners and board member of the Biden Cancer Initiative. (Kincaid, 3/28)

Cincinnati Enquirer: P&G Reportedly Interested In Pfizer Consumer Health Unit
Cincinnati-based Procter & Gamble is reportedly negotiating with Pfizer Inc. over the sale of the largest U.S. drugmaker's consumer health business. CNBC reported the talks late Tuesday morning, citing unnamed sources. P&G did not immediately respond to a request for comment. (Tucker and Coolidge, 4/3)

Bloomberg: Health-Care M&A Balloons In Busiest Start In More Than A Decade 
Health-care companies have revved the deals engine back into high gear. Takeda Pharmaceutical Co.’s possible acquisition of Shire Plc, with its market value of $45 billion, would boost the sector’s year-to-date deals to well above $200 billion, the most for a first quarter in at least a dozen years. Announced health-care transactions have already reached about $156 billion this year, according to data compiled by Bloomberg. (Baigorri, 3/28)

Stat: Sanofi And Regeneron Encounter More Payer Resistance Over New Eczema Drug — This Time, In The U.K.
Once again, Sanofi (SNY) and Regeneron Pharmaceuticals (REGN) are running into roadblocks trying to win over payers with their new drug for severe eczema. The latest frustration is occurring in the U.K., where a government watchdog decided the drug would not be cost effective. The cost estimates for the drug, which is known as Dupixent, were considered “too high” to be a “good use of National Health Services resources,” according to a draft guidelines that were released on Tuesday by the National Institute for Health and Care Excellence. The annual cost, based on list price, would be about $23,000 per year for 26 injections, according to a briefing report. (Silverman, 4/3)

Bloomberg: Shire Surges On News Of Possible Takeda Bid
Takeda Pharmaceutical Co. said it’s considering an approach for Shire Plc that would boost its position in drugs for cancer, gastrointestinal diseases and nervous-system ailments. An acquisition, which would be the Japanese drugmaker’s biggest purchase, would widen its capabilities in key areas and provide it with treatments that are approaching the market, Takeda said in a statement Wednesday. Shire, which is based in Lexington, Massachusetts, but listed in London, gained as much as 26 percent after the announcement, giving it a market value of nearly 35 billion pounds ($50 billion). (Lauerman and Paton, 3/28)

Reuters: Platinum Equity Lines Up US$1.9 Billion Of Debt For J&J Diabetes Care Unit Bid
Private equity firm Platinum Equity’s US$2.1 billion (£1.4 billion)offer to acquire blood glucose monitoring systems maker LifeScan, Inc from US health care products company Johnson & Johnson is backed by US$1.875bn of loans, according to two sources familiar with the matter. J&J has been evaluating strategic options for the troubled unit, as well as its other diabetes care businesses, which include insulin pumps maker Animas Corp and wearable insulin pumps maker Calibra Medical Inc, since January 2017 amid falling sales. The company last October announced it would close down Animas after failing to find a buyer. (Berlin, 3/27)

Stat: Drug-Loaded Hydrogel Responds To Arthritis Flare-Ups In Real Time
Scientists have created a drug-loaded hydrogel that can be injected into a joint and respond in real time to an arthritis flare-up. Biomedical engineer Jeff Karp and his colleagues at Brigham and Women’s Hospital in Boston tucked an arthritis drug, triamcinolone acetonide, inside a hydrogel that breaks down as inflammation in the knee joints of arthritic mice ramps up. Alivio Therapeutics — a biotech company co-founded by Karp — is working to use the technology on a range of inflammatory diseases. (Thielking, 4/3)

FierceHealthcare: Massachusetts Healthcare Cost Growth Beat Its Benchmark, But Commission Says Drug Prices Are Still A Concern
For the seventh year in a row, the growth of medical spending in Massachusetts was slower than in the rest of the country. Massachusetts’ total healthcare costs grew 2.8% in 2016, below the national growth rate of 3.5%, according to the Massachusetts Health Policy Commission (HPC). State healthcare spending also fell below the 3.6% benchmark set by the HPC, an independent state agency. (Caramenico, 4/3)

Stat: Doctors Need To Factor In Cost When Prescribing Medications
Mr. Jones enters the pharmacy expecting to pick up his prescription. But when he gets to the window, he gets a rude awakening. His acne cream is $200, much too expensive for him to afford. Mr. Jones (not his real name) was told that his doctor needed to fill out paperwork for the insurance to pay for his medication. He leaves the pharmacy upset, and without the prescription. A study my colleagues and I recently published in JAMA Dermatology found that when patients like Mr. Jones do not pick up their prescriptions, out-of-pocket costs are the primary reason why. (Jules Lipoff, 4/3)

The Hill: Our Willful Ignorance On Drug Prices
This week, Sen. Claire McCaskill (D-Mo.) released a report that sent another shot across the bow of the pharmaceutical industry. List prices for the most common Medicare drugs were found to have risen at nearly 10 times the inflation rate over the last five years. But as usual, we are all fixated on the wrong price. This type of finding is not unique or surprising. It comes on the heels of a similar study showing pharmaceutical prices rose faster than that of all health-care sectors, with a nearly 25 percent increase in merely four years. All for what? (Benedic Ippolito, 3/30)

Bloomberg: Humana's Medicare Advantage Boost Could Cost Walmart
The good news just keeps piling up for Humana Inc. The health insurer's shares jumped after a report on Friday that Walmart Inc. may be interested in acquiring it, capping a 251 percent increase over the past five years. And on Monday, the U.S. government announced it would boost payments to insurers who run private Medicare Advantage (MA) plans by nearly twice as much as the government had previously estimated. As the nation's second-largest MA insurer, Humana will be among the largest beneficiaries. (Max Nisen, 4/3)

Forbes: The Call For Drug-Price Transparency Is Growing Louder -- But Will It Matter?
Last week, in a speech with President Donald Trump at Manchester Community College in New Hampshire, newly appointed Health and Human Services Secretary Alex Azar declared that one of his priorities is to lower drug prices. He said he would roll out “a whole slate of” proposals for doing so in about a month. Azar didn’t elaborate, but in an address to the Federation of American Hospitals earlier this month, he did say that that a crucial piece of addressing high drug costs would be to force pharmaceutical companies to be more transparent about their pricing practices. (Arlene Weintraub, 3/30)

The Hill: Medicines Cost Me $10,000 Annually — I Suffer Enough Without The Burden Of High Drug Prices
Every eight weeks when I take out my IV pole from the back of my closet, I am overcome with anxiety. Not because of the ice-cold biological medicine that will run through my veins over the next two hours. Not because of the potentially fatal allergic reaction that could occur. But because of how much this treatment on which I depend is going to cost me. I receive seven Remicade infusions a year to help manage the symptoms of my Crohn’s disease. Even with insurance, I’m asked to pay more than $1,500 for a single infusion. That’s on top of the cost of doctor’s visits, blood work, imaging tests and other prescription drugs I need to take. (Emily Miller, 3/29)

Huffington Post: Americans Need Safer Access To Canadian Online Pharmacies
For years, the internet has made it possible for Americans to fill their prescription medications in other countries at significantly lower cost. And this is a good thing, because despite years of public debate and promises from lawmakers to take action, little has been done to bring down pharmaceutical costs in the U.S. Skyrocketing drug prices have created a serious health and economic crisis for millions of Americans. Approximately one-fourth of Americans find it difficult to afford their daily medications, according to a December 2017 Kaiser Family Foundation report. (Tracy Cooley, 4/2)

Bloomberg: Alkermes FDA Rejection: The Red Flags Were There
Pulling success from the jaws of disaster is a fantastic plot twist. It's just not always a good foundation for a biotech investment. Angling for an unlikely happy ending for its depression drug, Irish biotech Alkermes PLC hoped the FDA would ignore its failure of two Phase 3 trials in 2016 and would focus instead on a third, successful test. But the agency rejected the company's attempt to file the drug for approval, Alkermes disclosed Monday. The FDA also may want the company to run several expensive new trials before it reconsiders. (Max Nisen, 4/2)

Detroit Free Press: On Fuel Economy Standards, White House Shows Opposite Of Leadership
We all want to buy less gasoline for our daily commute, grocery run or trip to the beach. We want to promote innovation, create jobs and leave our children a livable world. Why on Earth, then, would President Trump and EPA Administrator Scott Pruitt slam the brakes on commonsense standards that advance those goals? That’s just what they’re trying to do. (Rhea Suh, 4/3)

The Wall Street Journal: The Fuel Economy Fraud
The Environmental Protection Agency on Monday took the Obama fuel economy rules off autopilot. This is good news for consumers, automakers and the U.S. economy, but the Trump Administration’s big test will be negotiating around the political potholes. (4/3)

USA Today: On MPG Standards, Let California Be California
For just shy of a decade, a set of tough emissions standards have required vehicles in America to burn fuel more efficiently — increasing miles per gallon, saving each driver hundreds of dollars at the pump and lowering carbon emissions that threaten the planet. On Monday, the Trump administration announced plans to roll back these fuel efficiency standards for the years ahead. It’s being done in the spirit of President Trump’s anti-regulatory agenda, but this would be a major mistake for the planet and for drivers’ pocketbooks. (4/2)

Bloomberg: California Should Stand Its Ground On Auto Emissions
As the federal government moves ahead with its promise to weaken car-emissions limits, California should keep its vow to stand in the way -- and maintain America's progress in the fight against climate change.California didn't ask for this fight. Six years ago, the state agreed with the federal Environmental Protection Agency and the National Highway Traffic Safety Administration to gradually double the fuel efficiency of new cars and light trucks through 2025. But on Monday, EPA Administrator Scott Pruitt announced that his agency will dial back the limits -- and consider revoking California's permission to set its own standards. (4/3)

The Hill: Scott Pruitt’s Trojan Horse Transparency Proposal Would Undermine Public Health Safeguards
In the past 50 years, we’ve taken real and important steps to keep America’s air and water clean. Emissions of toxic pollutants like lead, sulfur dioxide, and particulate matter have all fallen. In addition, we have taken several strides forward to clean up our rivers, lakes, and streams from harmful chemicals and waste.  Those advances didn’t happen by accident. They happened because of laws like the Clean Air Act and the Safe Drinking Water Act, which provided the Environmental Protection Agency (EPA) the tools it needed to put public protections in place to limit pollution. And, critically, these agencies were able to look at the best available science to craft those safeguards.A new policy change under consideration by EPA Administrator Scott Pruitt would put all of that at risk. (Yogin Kothari, 4/3)

The Washington Post: People Think Obamacare Is Failing, But They Want It Anyway
President Trump unabashedly tries to create his own reality, urging Americans to ignore facts and even their life experience. When it comes to their health care, however, he’s having only minimal success convincing Americans that he has already destroyed Obamacare. The Kaiser Family Foundation’s latest poll tells us: “About one-fifth of non-group enrollees (19 percent) are aware the [Affordable Care Act] mandate penalty has been repealed but is still in effect for this year. Regardless of the lack of awareness, nine in ten non-group enrollees say they intend to continue to buy their own insurance even with the repeal of the individual mandate. About one-third (34 percent) say the mandate was a ‘major reason’ why they chose to buy insurance.” (Jennifer Rubin, 4/3)

Axios: The Politics Of ACA Rate Hikes Will Be 2016 In Reverse
We are about to see a replay of the 2016 election fight over premium increases, but this time in reverse. Last time, it was the Republicans hammering Democrats for the rate hikes. This time, it will be Democrats accusing Republicans of driving up premiums by sabotaging the Affordable Care Act. What to watch: It's going to be a balancing act for the Democrats. They can (and will) score political points by blaming Republicans for the coming premium increases, but another campaign debate about rising premiums could also undermine the ACA by focusing on its continuing problems. (Drew Altman, 4/4)

USA Today: Trump And The GOP Are Botching Health Care. We Need Medicare For Anyone.
Congressional Republicans missed their best and probably last chance this year to stabilize the Affordable Care Act when they passed a government funding package without a health deal. As a result, repeal of the individual mandate and the Trump administration’s proposal to expand non-ACA plans are projected to spike premiums by 18% beyond medical inflation next year. At the same time, the Trump administration is encouraging waivers to the Medicaid program that put up barriers to enrollment, limit benefits and increase costs for the poor. States can take action to mitigate coverage losses and premium increases, and most of the ACA’s historic coverage gains will persist. But it is imperative to chart a path forward for the health care system — a path of expansion and greater security rather than retrenchment. That path is the idea of “Medicare for anyone.” (Topher Spiro, 4/3)

San Francisco Chronicle: Single-Payer Plan Is Within Reach Of California
There is great desire and public support for health care coverage for every person in California. In our study, “Financing Universal Coverage In California: A Berkeley Forum Roadmap,” we identify three changes in the California health care system that can generate enough reductions in health spending to finance universal health coverage in the next few years. (Richard Scheffler, 4/3)

Des Moines Register: Lawmakers Undermine Iowans' Health Insurance And The Insurance Market
Iowa has only one remaining health insurer offering coverage in the state’s insurance exchange this year. Two other companies have exited, leaving Minnesota-based Medica as the only insurer of Iowans who are self-employed or retired early and buy plans in the marketplace created by the Affordable Care Act. So one would think elected officials would be bending over backward to help the company succeed and remain here. But the GOP-controlled Iowa Legislature and Gov. Kim Reynolds have other ideas. (4/3)

Los Angeles Times: State Senator Says It May Be Time For Law Requiring Easily Understood Medical Bills
[B]ills from hospitals, doctors and insurance companies are frequently indecipherable with their codes, abbreviations, misleading descriptions and lack of any explanation for why charges are so high. State Sen. Steve Glazer (D-Orinda) agrees. He told me he's looked at his family's own medical bills and scratched his head repeatedly over what they were being charged for. ... He said he and his staff will explore the issue and see if an existing regulation can be applied to making medical bills more transparent and easily understood. "If not," Glazer said, "then we'll look at the possibility of a new law." (David Lazarus, 4/3)

St. Louis Post Dispatch: Legislature's Food Stamp Work Rules Are Worse Than We Thought
In an editorial published Monday, we erred in criticizing bills being considered by the Missouri Legislature because they’d require more able-bodied adults without dependents to meet work requirements to receive food stamps. In fact, the bills are worse than that. Lawmakers want to require able-bodied adults who have school-age dependents — most of them single women raising children — to work for their food stamps.In other words, we underestimated the harshness of Senate Bill 561 and House Bill 1486. We also underestimated how much they could cost a state that already can’t make ends meet. (4/3)

San Jose Mercury News: Stop Trump From Discriminating Against Patients
Caregivers must advocate for patients, not discriminate against them. I’ve seen firsthand how people suffer when health care workers discriminate against patients on “moral grounds,” as President Donald Trump is now giving them the green light to do. (Sal Rosselli, 4/3)

Columbus Dispatch: Who Better To Help Addicted Parents?
Trying to help opioid addicts who have children requires understanding more than just the facts of addiction. Most likely, no one who hasn’t lived in that special hell — seeing your children suffer and knowing you are the cause of it, but being powerless to change your behavior — can fully empathize.Likewise, it’s doubtful anyone can get through to such an addict as well as someone who has lived that hell and emerged from it.That makes Fairfield County’s START project — it stands for Sobriety, Treatment and Reducing Trauma — an especially promising dot in the constellation of efforts to tackle Ohio’s opioid crisis. (4/3)

USA Today: Fix The Opioid Crisis Without Taking Prescriptions Away From Patients
President Trump’s new proposal to combat opioid addiction included some very tough talk about a tragic problem, so it was easy to miss one ambitious goal: slashing legal opioid prescriptions by one-third. Similarly, when Attorney General Jeff Sessions suggested that part of the problem is that not enough people are willing to “tough it out,” and that they should be just taking aspirin instead, he quickly got my attention. Recently, I tried to do just that. (Steven Horwitz, 4/2)

Bloomberg: Humana's Medicare Advantage Boost Could Cost Walmart 
The good news just keeps piling up for Humana Inc. The health insurer's shares jumped after a report on Friday that Walmart Inc. may be interested in acquiring it, capping a 251 percent increase over the past five years. And on Monday, the U.S. government announced it would boost payments to insurers who run private Medicare Advantage (MA) plans by nearly twice as much as the government had previously estimated. As the nation's second-largest MA insurer, Humana will be among the largest beneficiaries. (Max Nisen, 4/3)

The Hill: Do We Want Another Spanish Influenza Epidemic? Reauthorizing Preparedness Act Could Prevent It
This year is the 100th anniversary of the 1918 Spanish influenza pandemic. It comes with the disturbing realization that the impacts of an outbreak — similar to what remains the deadliest pandemic in human history — would be even more catastrophic today, in a world made smaller and more crowded by trade, travel and explosive population growth.While public health and science have made great strides in the last century, our preparedness for the next pandemic is now compromised by a decline in the numbers of public health experts. Fortunately, this is a problem we can do something about. (Jeffrey S. Duchin, 4/3)