The New York Times: Democrats Pivot Hard To Health Care After Trump Moves To Strike Down Affordable Care Act
The Trump administration’s decision to ask a federal appeals court to invalidate the Affordable Care Act has given House Democrats a new opening to pursue what they see as a winning political strategy: moving past talk of impeachment to put kitchen-table issues like health care front and center. The notice to the court, filed late Monday by the Justice Department, could not have come at a more opportune time for Democrats. The finding by Robert S. Mueller III, the special counsel, that there was no evidence of a criminal conspiracy between the Trump campaign and Russia, dashed the hopes of the most partisan Democrats that the House would impeach the president. (Stolberg and Pear, 3/26)

The Wall Street Journal: Democrats Signal Renewed Focus On Health Care After Mueller Findings
“We’ve never taken our focus off the for-the-people agenda,” House Speaker Nancy Pelosi (D., Calif.) told reporters on Tuesday after meeting with the Democratic caucus. She said the party would push to lower the cost of health care, build infrastructure and clean up government. Rep. James Clyburn (D., S.C.), the House majority whip, appeared to go a step further. “I believe that the Mueller report has been done. It’s a chapter that’s closed,” Mr. Clyburn said. Pointing to a filing by the Justice Department late Monday that asked a court to invalidate the Affordable Care Act, Mr. Clyburn said health care is “the No. 1 thing on people’s minds.” (Hughes and Peterson, 3/26)

The Washington Post: Trump Surprises Republicans — And Pleases Democrats — With Push To Revive Health-Care Battle
In a new court filing, the Justice Department argued that the ACA, also known as Obamacare, should be thrown out in its entirety, including provisions protecting millions of Americans with preexisting health conditions and allowing young adults to stay on their parents’ health-care plans. President Trump praised the move during a lunch with Senate Republicans, and suggested the GOP should embrace a new congressional battle over health-care policy ahead of the 2020 elections. “Let me tell you exactly what my message is: The Republican Party will soon be known as the party of health care,” he told reporters before the lunch. “You watch.” (Olorunnipa and Kim, 3/26)

Reuters: Trump Administration Steps Up Obamacare Attack, Asks Court To Overturn Law
Democrats said the move to overturn Obamacare would overshadow Republican President Donald Trump's claim of victory following the conclusion of Special Counsel Robert Mueller's probe of Russian interference in the 2016 presidential election. The legal filing gave Democrats a natural opening to focus on an issue they say is more important to voters than the Mueller investigation. "We always felt that the issues that affect average Americans - healthcare, climate change, jobs - (are) far more important to them, and to us, than what happens in an investigation," Senate Minority Leader Chuck Schumer told reporters. (3/26)

The Associated Press: Trump's Attack On 'Obamacare' Gives Democrats A Fresh Issue
"This is something that Americans care deeply about," said Sen. Amy Klobuchar of Minnesota, a White House hopeful. "I may not have been asked about the Mueller report at town hall meetings, but I was sure asked about health care." Other Democrats appeared to relish the chance to shift to health care. Asked if the Trump administration's court filing allowed Democrats to turn the page on Mueller, House Speaker Nancy Pelosi said she would have been talking about health care no matter what. "We have been dealing with health care constantly," the California Democrat said. "The public attention has been on the Mueller report, but we have been focused on health care." (3/26)

The Hill: Dems Unveil Plan To Build Up ObamaCare As Trump Steps Up Attacks 
The House plans to vote on the bill this year, positioning it as a follow-through on campaign promises to defend ObamaCare. (Hellmann, 3/26)

CQ: House Democrats Unveil Health Care Bill As Texas Case Looms
House Democrats, highlighting the differences between their positions and the administration’s, unveiled draft legislation Tuesday that seeks to lower health care costs for people who get insurance coverage through the federal and state marketplaces. The unnumbered draft bill builds on Democrats' 2018 campaign message that they would protect coverage for pre-existing conditions and increase the financial assistance people receive under the law. Top Democrats on Tuesday indicated they hope to keep that focus ahead of the 2020 election, setting up a contrast with the Trump administration after it broadened its call to weaken the law by saying that all of it — not just part of it — should fall. (McIntire, 3/26)

Los Angeles Times: Trump Reopens Obamacare Repeal Debate, And Democrats Are Thrilled
In a closed-door lunch with the senators, the president issued a vague call to them to address healthcare to lower costs, according to several lawmakers in the room. “He led off on that and he spent a good bit of time on it. It’s clearly on his mind, and it’s clear to me he wants us to take another run on it,” said Sen. John Kennedy of Louisiana. “I thought that he’d immediately start talking about the Mueller report or China,” the country at the center of Trump’s trade agenda. (Bierman, Haberkorn and Levey, 3/26)

The Hill: Surprise ObamaCare Move Puts GOP In Bind 
For the GOP, it shifted the political discussion from a more welcome storyline about the end of special counsel Robert Mueller’s probe to health care — the issue Democrats believe helped them win back the House majority last fall. House Minority Leader Kevin McCarthy (R-Calif.) deflected a question about the ObamaCare case at his leadership press conference and told reporters to call his office. Senate Majority Leader Mitch McConnell’s (R-Ky.) office had no immediate comment. (Sullivan, 3/27)

Kaiser Health News: Trump Administration And Democrats Return Health Law To Political Center Stage
Trump has repeatedly called for the law to be repealed and replaced, but when Republicans controlled Congress they could not muster the necessary votes. Just last week, the president lashed out Sen. John McCain (R-Ariz.), who died in August, for failing to support that effort. (Rovner, 3/26)

Politico: White House Obamacare Reversal Made Over Cabinet Objections
The Trump administration’s surprising move to invalidate Obamacare on Monday came despite the opposition of two key cabinet secretaries: Health and Human Services Secretary Alex Azar and Attorney General Bill Barr. Driving the dramatic action were the administration’s domestic policy chief, Joe Grogan, and the acting director of the Office of Management and Budget, Russ Vought, according to three sources with direct knowledge of the decision. Both are close allies of White House acting chief of staff Mick Mulvaney, who helped to engineer the move. (Johnson and Everett, 3/26)

The New York Times: What Happens If Obamacare Is Struck Down?
The Affordable Care Act was already in peril after a federal judge in Texas invalidated the entire law late last year. But the stakes ramped up again this week, when President Trump’s Justice Department announced it had changed its position and agreed with the judge that the entire law, not just three pieces of it, should be scrapped. A coalition of states is appealing the ruling. If it is upheld, tens of millions more people would be affected than those who already rely on the nine-year-old law for health insurance. Also known as Obamacare, the law touches the lives of most Americans, from nursing mothers to people eating at chain restaurants. (Abelson, Goodnough and Pear, 3/26)

Bloomberg: Trump Turns Back To Health Care, But What Comes Next Is Unclear 
The failure by Republicans to overturn the Affordable Care Act has been a sore point for the president. In recent weeks, Trump has taken to Twitter to attack the late Senator John McCain, who in 2017 cast the decisive vote against a bill packaged as a “skinny repeal” of the health law. The following year, Republicans lost control of the House, as many Democrats campaigned on a promises to shield Obamacare from its GOP critics. (Tozzi and Wasson, 3/26)

The CT Mirror: As DOJ Asks Court To Invalidate The ACA, Connecticut Joins Legal Fight To Defend It
In a filing Monday with the 5th U.S. Circuit Court of Appeals, the Justice Department said it agreed with 15 Republican attorneys general that the elimination of the “individual mandate,” the requirement that most Americans have health insurance, invalidated the entire ACA. That was a surprising shift in policy for the Trump administration, which had argued in a brief in June that the tax penalty for not buying insurance — repealed by Congress in a federal tax overhaul — was legally distinct from other provisions of the law, which could still stand. (Radelat and Carlesso, 3/26)

Meanwhile —

KCUR: Missouri, Kansas Enrollment Declines As Trump Administration Seeks To End Obamacare 
Even as it seeks to have the Affordable Care Act declared unconstitutional, the Trump administration on Monday reported that about 11.4 million people signed up for coverage in 2019 on the act’s state- and federally run exchanges. That represents a dip from about 11.8 million in 2018, defying fears of a more precipitous drop after the Trump Administration cut promotion and outreach efforts and Congress eliminated the tax penalty for not having coverage. (Margolies, 3/26)

Politico: White House, Pelosi In Talks On Drug Pricing Legislation
The Trump administration has held early-stage conversations with Speaker Nancy Pelosi's staff about drug-pricing legislation that could provide each side with a domestic policy victory, according to White House and congressional sources. Democrats and the Trump administration have made reducing drug costs a priority, but accomplishing anything could be difficult, especially since the administration has taken an aggressive stance to overturn Obamacare in federal court. (Karlin-Smith and Cancryn, 3/26)

Reuters: Trump Wants To Work With Democrats On Drug Prices, Infrastructure: Aide
U.S. President Donald Trump is willing to work with congressional Democrats to lower drug prices for Americans and on infrastructure funding, White House adviser Kellyanne Conway said on Tuesday. Conway said the Trump administration considered those two issues as areas of cooperation between Democrats and the Republican president. (3/26)

Prescription Drug Watch: For news on rising drug costs, check out our weekly roundup of news coverage and perspectives of the issue.

Reuters: Purdue Pharma Agrees To $270 Million Settlement In Oklahoma Opioid Case
OxyContin maker Purdue Pharma LP and members of the wealthy Sackler family that own the company reached a $270 million settlement to resolve a lawsuit brought by the state of Oklahoma accusing the drugmaker of fueling an opioid abuse epidemic. The settlement unveiled by Oklahoma Attorney General Mike Hunter on Tuesday was the first to result from a wave of lawsuits accusing Purdue of deceptively marketing painkillers, helping create a deadly crisis sweeping the United States. (3/26)

The New York Times: Purdue Pharma And Sacklers Reach $270 Million Settlement In Opioid Lawsuit
The payment, negotiated to settle a case brought by the state of Oklahoma, was far larger than two previous settlements Purdue Pharma had reached with other states. It could jolt other settlement talks with the company, including those in a consolidated collection of 1600 cases overseen by a federal judge in Cleveland. “Purdue appears to have concluded that it was less risky to settle the Oklahoma case than have the allegations publicly aired against it during a televised trial and face exposure to what could have been an astronomical jury verdict,” said Abbe R. Gluck, a professor at Yale Law School who directs the Solomon Center for Health Policy and Law. (Hoffman, 3/26)

The Washington Post: Purdue Pharma, State Of Oklahoma Reach Settlement In Landmark Opioid Lawsuit
Under the terms of the Oklahoma settlement, Purdue will immediately contribute $102.5 million to establish a new foundation for addiction treatment and research at Oklahoma State University. Members of the Sackler family, who own the company but were not defendants in the case, will pay an additional $75 million in personal funds over five years. Purdue also will provide $20 million worth of treatment drugs, pay $12 million to cities and towns and cover about $60 million in litigation costs. (Bernstein and Zezima, 3/26)

The Hill: Purdue Pharma Settles With Oklahoma In Landmark Opioid Lawsuit 
Attorneys suing Purdue on behalf of local governments across the country on Tuesday praised the settlement. "This settlement is another reflection of the extraordinary importance and strength of the claims against Purdue Pharma," Paul Hanly, Paul Farrell and Joe Rice said in a joint statement. "There are nearly two dozen other defendants with pending allegations against them in federal court. We believe all of these defendants—opioid manufacturers, distributors, and pharmacies—must be held responsible for their role in the epidemic,” the attorneys said. (Weixel, 3/26)

Politico: Purdue Pharma Agrees To $270M Opioid Settlement With Oklahoma
The $275 million for 6,700 Oklahoma deaths comes out to roughly $41,000 per death — which would mean Purdue and the Sacklers could end up paying a staggering $16 billion if these numbers were spread across the nation, although the settlements aren’t likely to follow a precise pattern. Purdue agreed to spend $102.5 million to create the center, located in the university's wellness and recovery department, and to donate $20 million worth of medicines to support treatment over the next five years. Purdue will also give $72.5 million to state and local governments combating the opioid crisis. Of that, $12.5 million is for local government and up to $60 million will be for costs and fees related to the litigation. (Goldberg, 3/26)

NPR: Purdue Pharma Settles Opioid Lawsuit In Oklahoma
"The agreement reached today will provide assistance to individuals nationwide who desperately need these services — rather than squandering resources on protracted litigation," the Sackler family said in a statement. "We have profound compassion for those who are affected by addiction and are committed to playing a constructive role in the coordinated effort to save lives." (Bebinger, 3/26)

The Associated Press: Oklahoma Attorney General's Statement On Opioids Settlement
Oklahoma Attorney General Mike Hunter confirmed at a news conference Tuesday that the state has reached a $270 million settlement with the company that produces the painkiller OxyContin, blamed in part for a local and national opioid crisis. Hunter also released a statement outlining how the money will be used to counter an opioid epidemic that claimed 400 lives in Oklahoma in 2017 — the same year the state sued Purdue Pharma and other drugmakers. (3/26)

The Associated Press: Anger, Hope From Families And Survivors Of Opioid Crisis
A multimillion-dollar settlement in the nation's deadliest drug crisis brought no relief to Jodi Barber, whose 19-year-old son died of a prescription drug overdose. He became addicted to painkillers after breaking his collarbone. "The pain is always going to be there as a parent," said Barber of Orange County, California. "Knowing that it was preventable really hurts. All these deaths are preventable and that hurts." (3/26)

In other news on the crisis —

The Associated Press: Vermont Sues 2 Prescription Opioid Distributors
Vermont filed a lawsuit Tuesday against two pharmaceutical distributors, accusing them of selling ever-increasing amounts of prescription opioids in the state while failing to effectively monitor and control the sales and acknowledge the quantity of pills was outpacing the need. The lawsuit alleges Cardinal Health, Inc. and McKesson Corporation committed unfair and deceptive acts and practices, were negligent, and that their behavior constitutes a public nuisance. (3/26)

New Hampshire Union Leader: Five Babies Dead From Exposure To Drugs In 15 Months In NH 
Five babies born exposed to illegal drugs and then sent home have died over the last 15 months, according to New Hampshire Child Advocate Moira O’Neill, who on Tuesday announced a wholesale review of procedures involving follow-up care for drug-exposed newborns once they leave the hospital. The review will be the first ever for the Office of Child Advocate, which was created last year as an independent arm of state government to monitor and critique child protective services. The review will concentrate on what happens after a drug-exposed newborn goes home. (Hayward, 3/26)

The Wall Street Journal: Senate Panel Considers ‘Red Flag’ Gun Laws In Aftermath Of Mass Shootings
A GOP-led Senate committee held a rare gun-control hearing Tuesday on measures aimed at temporarily blocking dangerous people from accessing firearms, following a wave of states’ decisions to allow such curbs. The Senate Judiciary Committee focused Tuesday on extreme-risk protection orders, also known as red-flag laws, aimed at allowing courts to temporarily take guns from people deemed dangerous. Extreme-risk protection orders are designed to generally let family members or law-enforcement officials petition a court for an order that would temporarily block that person from being able to buy a firearm, or enable officials to remove his or her weapons. (Peterson, 3/26)

WBUR: In The Shadow Of Suicides, Senate Panel Makes Rare Move To Consider Gun Control
Days after three separate suicides in Parkland, Fla., and Newtown, Conn., left those communities reeling, the Senate did something rare for a GOP-led chamber: It held a hearing on gun control. Tuesday, in the previously scheduled hearing, the full Senate Judiciary Committee heard from experts on extreme risk protection orders, commonly referred to as red flag laws. (Booker, 3/26)

Reuters: U.S. Expands Abortion 'Gag Rule,' Cuts Funding To Regional Bloc: Pompeo
The Trump administration on Tuesday expanded its anti-abortion policies, cutting funding to the Organization of American States (OAS) and prohibiting the use of U.S. tax dollars to lobby for or against abortion rights. Trump in 2017 reinstated a policy known as the "Mexico City Policy," requiring foreign nongovernmental organizations (NGOs) that receive U.S. family planning funds to certify they do not provide abortions or give abortion advice. (3/26)

The New York Times: U.S. Expands Anti-Abortion Policies With New Overseas Funding Rules
“We will enforce a strict prohibition on backdoor funding schemes and end-runs around our policy,” Mr. Pompeo said. “American taxpayer dollars will not be used to underwrite abortions.” The move builds on a 2017 announcement by the Trump administration that it was reinstating and expanding the so-called Mexico City policy. The executive action dating to 1984 — and described by critics as the “global gag rule” — requires foreign nongovernmental organizations to refuse to perform abortions in exchange for receiving American funding. (Wong, 3/26)

The Wall Street Journal: Trump Administration Expands Global Anti-Abortion Policy
The policy has been a political football for decades, with presidents of opposing parties reversing course at the start of their administrations, twice on the anniversary of the Supreme Court’s Roe v. Wade decision, the 1973 ruling that recognized abortion as a woman’s constitutional right. President Obama shelved the policy in 2009, though opting not to do so on the day chosen by some of his predecessors. President Trump reinstated the “Mexico City policy” shortly after taking office in January 2017, doing so the day after the ruling’s anniversary. (McBride, 3/26)

The Hill: Pompeo Says US To Expand Ban On Foreign Aid To Groups That Provide Or Promote Abortion 
Democrats who opposed the original Mexico City Policy said its expansion will be even more dangerous for women around the world. “This administration’s obsession with attacking women’s reproductive health is egregious and dangerous," said Sen. Jeanne Shaheen (D-N.H.), the only woman on the Senate Foreign Relations Committee. (Hellmann, 3/26)

The Associated Press: Panel To Review Indian Health System's Treatment Of Children
The Trump administration is creating a task force to investigate how an Indian Health Service doctor was able to sexually assault children in his care. The White House announced Tuesday that the Presidential Task Force on Protecting Native American Children in the Indian Health Service System will be co-chaired by President Donald Trump's domestic policy adviser and the U.S. attorney for the Northern District of Oklahoma. (3/26)

The Wall Street Journal: White House Launches Investigation Of Indian Health Service Failures Over Sexual Abuse
The team of law enforcement and other government officials will examine why the IHS failed to stop the doctor, Stanley Patrick Weber, and also how better to protect Native American children under the care of the federal health agency, senior administration officials said. The committee will be co-chaired by Trent Shores, U.S. attorney for the northern district of Oklahoma, and Joe Grogan, the White House’s domestic policy council chairman, the officials said. (Frosch and Weaver, 3/26)

In other news from the administration —

The Washington Post: Puerto Rico Faces Food-Stamp Crisis As Trump Privately Vents About Federal Aid To Hurricane Maria-Battered Island
At the Casa Ismael clinic for HIV-positive men with severe health complications, the staff used to immediately change patients’ diapers after they were soiled. But last week, clinic administrator Myrna Izquierdo told the nurses that had to stop. To save money, the nonprofit clinic, which relies on its patients’ food-stamp money for funding, will ask patients to sit in diapers in which they have repeatedly urinated, sometimes for hours. The Casa Ismael clinic is short on funds in part because of cuts in food stamps that hit about 1.3 million residents of Puerto Rico this month — a new crisis for an island still struggling from the effects of Hurricane Maria in September 2017. (Stein and Dawsey, 3/25)

Stat: CMS Proposes Changing Requirements For Less-Invasive Heart Valve Procedure 
The Centers for Medicare and Medicaid services proposed a new set of policies that appear to expand the use of a procedure that allows doctors to replace the aortic heart valve without performing open-heart surgery. The procedure, called transcatheter aortic valve replacement (TAVR), was first introduced as an alternative to surgical aortic valve replacement (SAVR) for the sickest patients, but its use has gradually expanded to more and more patients as clinical trials showed that the catheter-based approach was as good or, in some ways, better. The two leading makers of TAVR are Edwards Lifesciences, the market leader, and Medtronic. (Herper, 3/26)

In other news on Medicare —

Modern Healthcare: Medicare Is Working To Fix Inappropriate Lab Test Billing
CMS Administrator Seema Verma told Senate Finance Chair Chuck Grassley (R-Iowa) the agency is scrutinizing lab test bills submitted to Medicare to make sure the government hasn't been overpaying laboratories because of inappropriate coding. In a letter to Grassley, Verma noted that Medicare is required to pay a separate amount for each clinical diagnostic test under law. That rate has to be equal to the "weighted median of the private payer rates" for each test, based on the data reported by the labs that administer to the test. (Luthi, 3/26)

Modern Healthcare: HHS' Hargan: Medicare Cuts Will Shore Up Program
HHS Deputy Secretary Eric Hargan assured U.S. House of Representatives lawmakers on Tuesday that the $845 billion Medicare spending cut over the next decade won't amount to slashing care. A large portion of the seeming cuts stems from a change in how hospitals are paid for uncompensated care and graduate medical education. Instead of taking those dollars from the Medicare trust fund, they will come from the general fund, shrinking the gap to around $500 billion, Hargan said during a House Budget Committee hearing. (King, 3/26)

The Associated Press: North Carolina's 20-Week Abortion Ban Ruled Unconstitutional
A federal judge has declared unconstitutional a North Carolina law banning women from having abortions after the 20th week of pregnancy except in an urgent medical emergency. The decision Monday by U.S. District Judge William Osteen in Greensboro gave state legislators 60 days before his ruling takes effect to allow them to amend abortion restrictions or appeal his ruling to a higher court. (3/26)

The Washington Post: North Carolina’s 20-Week Abortion Ban Is Unconstitutional, A Federal Judge Rules
Under the ruling — which will take effect in 60 days, pending an appeal from the state or revised legislation — women will be able to seek abortions at any point before a doctor determines the fetus is “viable” and could be able to survive outside the womb. Those pushing for greater access to abortions cheered the decision, which comes amid a swell of new restrictions from GOP-led statehouses elsewhere. (Thebault and Wax-Thibodeaux, 3/26)

The Associated Press: Utah Bans Abortions After 18 Weeks, Teeing Up Legal Showdown
Utah Gov. Gary Herbert has signed a law banning most abortions after 18 weeks of gestation, setting the stage for a legal showdown. Though the Republican governor said the measure signed late Monday strikes a balance, opponents said it is unconstitutional and promised to sue. The law is expected to take effect in May. (3/26)

The Associated Press: Abortion Flap Could Cost Kansas Governor Her Commerce Chief
Democratic Gov. Laura Kelly could be forced to replace Kansas' top business development official because of two small grants to a nonprofit group he previously managed from a fund tied to a late physician known nationally for doing late-term abortions. Acting state Commerce Secretary David Toland has no role in regulating abortion providers, but the state's most influential anti-abortion group has joined an effort by some Republican legislators to oust him. (3/26)

Dallas Morning News: Proposed Ban On Abortion If Fetal Heartbeat Is Detected Might Not Survive In Texas
On abortion this year, there’s near-unanimity in the Texas Capitol in a way that few might expect. Advocates for Republicans to continue a multi-year course of stiffening abortion restrictions are taking heart from a few measures blessed by Lt. Gov. Dan Patrick. However, they lack optimism about the fate of House Bill 1500, by Rep. Briscoe Cain, R-Deer Park, which would bar abortions once a fetal hearbeat is detected — like a measure that became law in Mississippi last week. (Selby, 3/26)

Atlanta Journal-Constitution: Anti-Abortion Group Says ‘Heartbeat’ Bill Not Restrictive Enough
A leading anti-abortion group is urging the Georgia House to reject the “heartbeat bill” that cleared the Senate last week because it is not restrictive enough. Georgia Right To Life, an anti-abortion political group, said it disagrees with exceptions included in House Bill 481 that would allow abortions in some instances. (Prabhu, 3/26)

The New York Times: New York Suburb Declares Measles Emergency, Barring Unvaccinated Children From Public
An executive order pulled close to 6,000 unvaccinated children out of schools. Nearly 17,000 doses of the measles-mumps-rubella (M.M.R.) vaccine were given in 26 weeks. There was a public health campaign in which community officials, doctors and rabbis testified to the importance of immunizations. None of those efforts stemmed the severe measles outbreak that has been plaguing Rockland County in New York since October. (Gold and Pager, 3/26)

The Associated Press: County Bans Unvaccinated Minors In Public As Measles Spreads
"It's an attention grab, there's no question about it," Rockland County Executive Ed Day said at a news conference, noting that he didn't believe such a drastic step has ever been tried in the U.S. before. Day said he was taking the action in hopes of reversing a recent uptick in cases amid disturbing reports that health workers were encountering resistance when investigating cases. Rockland's outbreak has most heavily affected Orthodox Jewish communities, in which vaccination rates tend to be lower. (3/26)

The Wall Street Journal: County In New York Facing Measles Outbreak Bans Unvaccinated Minors From Public Spots
As health inspectors have tried to vaccinate children, Mr. Day said, they’ve faced “increasing resistance” from unvaccinated families. Some parents have hung up their phones on inspectors calling to ask about vaccinations, and unvaccinated children have been seen in public places. “It endangers the health and well-being of others, and displays a shocking lack of responsibility and concern for others in our community,” he said. (Honan, 3/27)

Stat: N.Y. County, Coping With Measles, Bans Unvaccinated From Public Places
Caught in the grips of a persistent and long-running measles outbreak, a New York county on Tuesday took the extraordinary step of announcing it would ban children who have not been vaccinated against the disease from enclosed public places as part of a 30-day state of emergency. Schools, houses of worship, shopping malls in Rockland County — anywhere that people who are not related to one another congregate indoors — will be off limits for unvaccinated children, officials said. (Branswell, 3/26)

Westchester Journal News: Measles Outbreak In Rockland, New York, Leads To State Of Emergency
Citing pockets of resistance that are impeding the county's efforts to stem a measles outbreak that has risen to 153 cases since October, Rockland officials today declared a state of emergency. Starting at midnight, anyone who is under 18 and not vaccinated against measles will be banned from public places. This ban will last until the declaration expires in 30 days or until people are vaccinated. (Spillane, Goldblatt and Cutler, 3/26)

Detroit Free Press: 22 Measles Cases In Oakland, Wayne Counties As Outbreak Grows
Michigan's most severe measles outbreak in years continues to grow and has sickened 22 people in metro Detroit, health officials announced Tuesday. The confirmed cases — 21 in Oakland County, where the outbreak began, and one in Wayne County —  are all believed to be linked to a sickened traveler who visited the area earlier this month. Two other suspected cases are under investigation. (Zaniewski, 3/26)

Politico Pro: California Bill Would Crack Down On 'Fake' Anti-Vaccine Exemptions
California’s vaccination laws could become among the strictest in the nation if a bill introduced Tuesday to stop bogus medical exemptions becomes law. State Sen. Richard Pan (D-Sacramento), a pediatrician and author of California’s 2015 law to eliminate personal and religious exemptions from childhood immunizations, introduced CA SB276 (19R), which would require state public health officials to approve medical exemptions requested by physicians. (Colliver, 3/26)

Sacramento Bee: CA Bill Cracks Down On Anti-Vax Doctors, Medical Exemptions
“Some schools are reporting that more than 20 percent of their students have a medical exemption,” Sen. Richard Pan, D-Sacramento, said in a statement introducing the bill. “It is clear that a small number of physicians are monetizing their exemption-granting authority and profiting from the sale of medical exemptions.” Pan, a doctor, has been one of the most vocal proponents of vaccination in the Legislature. He sponsored the 2015 law that required children to receive vaccines if they attend school, day care or development centers. (Sheeler, 3/26)

San Francisco Chronicle: Childhood Vaccine Exemptions In California Would Need State OK Under New Bill
The bill would also mandate the creation of a statewide database of medical exemptions, including those that doctors have already approved. State and local public health officers would have access to the database and could revoke exemptions that do not meet the new guidelines. Pan, a pediatrician, said the change is necessary to combat doctors who sell fraudulent medical exemptions to parents. (Koseff, 3/26)

Sacramento Bee: Calaveras ‘Dodged Bullet’ On Measles; No Verdict Yet In Placer
Calaveras County Health Officer Dean Kelaita said he believes the public “dodged a bullet” on measles transmission, but in Placer County, public health officials are still investigating potential exposures to a family fighting three cases of measles. Michael Romero, a public health official with Placer County, said the family is at home fighting off the deadly virus. (Anderson, 3/26)

San Jose Mercury News: Measles Risk: Santa Clara County Reveals Where Tourist Went
An international traveler infected with measles visited 20 places across the South Bay — including the Apple Park Visitor Center in Cupertino, Hoover Tower at Stanford and the Great Mall in Milpitas — over an eight-day period, triggering a Santa Clara County warning of possible public health exposure. People who were at the same stores, restaurants or other visitor attractions as the infected person was between March 16 and 23 and who haven’t been vaccinated or had measles before should watch for symptoms of the highly contagious respiratory disease, including a high fever, runny nose, cough, and red eyes, followed by a rash that spreads all over the body. (Vo, 3/26)

Stat: After Their Baby Died, Medical Bureaucrats Deepened Their Anguish 
When an infant unexpectedly stops breathing during sleep, the usual bureaucracy of death is multiplied, the paperwork thickened with accusation. Investigations are triggered with the local police, the state police, the agency that checks for child abuse. In some jurisdictions, officials appear soon afterward, asking parents to re-enact what happened, a doll standing in for their baby. The medical examiner or coroner takes the body, to determine a cause of death, looking for hints of “foul play.” These protocols are designed to protect. Often they do. But how an officer or medical examiner carries them out can sharpen the suspicion inherent in any investigation, heightening parents’ self-blame even when there’s no evidence of wrongdoing. (Boodman, 3/27)

The Wall Street Journal: This Old Mouse: ‘Golden Girls’ Unlock The Mysteries Of Aging
Grace and Blanche, two old mice who were second cousins, reached relative fame before dying within months of each other at their home in Bar Harbor, Maine. Known fondly as the Golden Girls at Jackson Laboratory, a nonprofit that specializes in research and mouse production, the two were believed to be the oldest living mice in the world just before their passing in 2016. (Ansberry, 3/26)

The New York Times: What Your Exercise Habits Might Say About How Long You’ll Live
A new study offers both hope and a subtle nudge to anyone who has slacked off on exercise in recent years. It finds that if people start to exercise in midlife, even if they have not worked out for years, they can rapidly gain most of the longevity benefits of working out. But the reverse is also true, the study finds. Stop exercising and those longevity benefits shrink or evaporate. (Reynolds, 3/27)

The Philadelphia Inquirer: African Americans More Likely To Be Misdiagnosed With Schizophrenia, Rutgers Study Finds
African Americans with severe depression are more likely to be misdiagnosed as having schizophrenia than white patients, a new study from Rutgers University found. The finding builds on years of evidence that clinicians’ racial biases — whether conscious or unconscious — affect the types of mental health diagnoses African-American patients receive. (Pattani, 3/27)

Atlanta Journal-Constitution: Paternal Smoking And Child Risk: Smoking Tied To Newborn Heart Defects
Maternal smoking during pregnancy has long been associated with congenital heart defects in offspring, but new research published this week in the European Journal of Preventive Cardiology suggests parental smoking during a mother’s pregnancy — both maternal and paternal — increases risks in newborns. (Pirani, 3/26)

The Philadelphia Inquirer: Selling CBD In Food Is Illegal, FDA Says. So Why Are So Many Retailers Selling It?
The U.S. Food and Drug Administration prohibits the addition of CBD to prepared foods. That’s despite language in the 2018 Farm Bill that loosened restrictions on the interstate commerce of hemp — cannabis that contains less than 0.3 percent of THC — and its derivatives such as CBD. Even advocates and researchers advise caution before consuming it.If you’re confused, join the club. (Wood, 3/26)

Nashville Tennessean: Plight Of Families Raising Kids With Disabilities Moves Lawmaker To Tears
After testimony brought one lawmaker to tears and inspired emotional commentary from several others, the House Insurance Committee moved the bill forward. The Senate Commerce and Labor Committee also unanimously approved the legislation. The bill will next be taken up in the House and Senate finance committees, but any further action will likely be delayed until after Gov. Bill Lee's supplemental budget appropriation is announced in the coming weeks. Supporters of the legislation are hopeful Lee might include some funding for the bill in that budget. Currently in Tennessee, nearly all children with severe disabilities who come from middle- and high-income families do not qualify for the state's Medicaid program. As a result, many parents shoulder the burden of thousands of dollars in medical bills for the therapies and vital equipment that private insurance does not cover. Others simply cannot provide their children the care they need because the cost is too much. (Bliss and Ebert, 3/26)

The Associated Press: Hospital Using Drones To Fly Blood Samples Between Buildings
A pioneering use of drones to fly blood samples across a North Carolina hospital campus launched Tuesday in the latest move to expand their roles in business and health care. The short trips between WakeMed buildings in Raleigh mark the first time the Federal Aviation Administration has allowed regular commercial flights of drones carrying products, according to UPS and drone company Matternet, which partnered with the hospital on the program. (3/26)

Modern Healthcare: WakeMed Using Drones In Pilot With UPS, FAA
Medical staff at WakeMed Health & Hospitals are testing a new way to transport lab samples across the health system's Raleigh, N.C., facilities: drones. The program, part of the Federal Aviation Administration's pilot program to assess drone use for various applications, kicked off in August. Spearheaded by the North Carolina Department of Transportation, the first arm of the project involved testing drones from aerial delivery company Matternet on WakeMed's campus. (Cohen, 3/26)

The Washington Post: United Medical Center Needs $40 Million Taxpayer Bailout, D.C. Officials Say
The District’s only public hospital will require a $40 million taxpayer subsidy to stay afloat, city officials have determined, the latest and largest in a series of government bailouts for the struggling facility over the last several years. United Medical Center — the only hospital east of the Anacostia River and a key provider of medical services for low-income residents of Southeast Washington — is running a projected annual operating deficit of tens of millions of dollars, hospital officials testified at a D.C. Council health committee hearing Tuesday. (Jamison, 3/26)

New Hampshire Public Radio: N.H.'s Child Advocate Reviewing How DCYF Handles Cases Of Infants Born Exposed To Drugs
The state Office of Child Advocate has announced it is currently reviewing how the Department for Children Youth and Families handles cases of infants born exposed to drugs. The Office of the Child Advocate says it opened the review in December of last year after it received concerns about how DCYF was handling the cases. In two cases in 2018 infants, died after DCYF closed assessments for neglect as unfounded. (Moon, 3/26)

Concord (N.H.) Monitor: Infant Deaths Prompt DCYF Review By State Child Advocate 
The state’s child advocate has opened a review into the Division for Children, Youth and Families’ response to babies born exposed to drugs after several children died after the agency opened investigations into the families. Director of the Office of the Child Advocate Moira O’Neill said a full report on DCYF’s handling of babies born exposed to drugs is expected to be released in July 2019. (Willingham, 3/26)

Pioneer Press: Hastings Treatment Center Had ‘Management Issues,’ Now Being Run By Nonprofit NuWay 
A Minneapolis nonprofit has taken over the management of Hastings’ Cochran Recovery Services. The 42-bed drug and alcohol treatment center is now being operated by NuWay, a South Minneapolis-based provider of recovery services. In a statement this week, NuWay said Cochran’s board of directors hired them to manage the Hastings nonprofit two weeks ago and then stepped down “in the face of management issues.” Before dissolving, the board fired Cochran’s executive director, Richard Terzick, according to NuWay. (Ferraro, 3/26)

The Wall Street Journal: Mayor De Blasio’s Wife Defends Mental-Health Initiative
ThriveNYC officials defended the funding and effectiveness of the city’s mental-health initiative during a New York City Council hearing Tuesday, as lawmakers pushed to understand how the sprawling program is structured and if it reaches the seriously mentally ill. Chirlane McCray, wife of New York City Mayor Bill de Blasio, said her signature three-year-old initiative with a $250 million annual budget is designed to “fill the gaps” in the city’s mental-health programs, as well as introduce innovations. (West, 3/26)

Los Angeles Times: L.A. County Expands Smoking Ban To Vaping Tobacco And Smoking Pot In Public
It's about to get harder to find a place to vape and smoke cannabis in Los Angeles County. The Board of Supervisors updated the county’s legal definition of "smoke" and "smoking" on Tuesday, expanding an existing ban on using tobacco products at beaches, parks and government buildings to include electronic cigarettes and pot. The supervisors also clamped down with new restrictions on smoking at beach parking lots, bus stops, outdoor bars and some common areas of county-owned golf courses in unincorporated areas. (Stiles, 3/26)

Georgia Health News: Push For Hospital Transparency Gets New Energy, Platform
This year’s legislative fight over Georgia’s certificate-of-need system is different from those in the past, which focused almost entirely on typical CON battles over hospital building projects or authorization of medical services. State Reps. Matt Hatchett (R-Dublin) and Terry England (R-Auburn), among others, have now emphasized a new issue in the push to change CON: financial transparency. They are stressing the importance of disclosure of non-profit hospitals’ financial holdings. (Miller, 3/26)

Arizona Republic: Judge Orders Hacienda Rape Suspect To Take HIV Test
A Maricopa County Superior Court Judge ordered the former Hacienda HealthCare nurse accused of raping and impregnating an incapacitated woman under his care to undergo testing for HIV and sexually transmitted diseases Tuesday. The state motioned for Nathan Sutherland, who turns 37 at the end of the month, to give the test results to the victim. Judge Roger Hartsell signed off on the order last month, but defense attorney Edward Molina requested a hearing on the matter as he argued the move was unconstitutional. (Burkitt, 3/26)

MPR: Two More Minnesota Cities Make 21 The Legal Age For Tobacco Purchases
As state lawmakers consider banning tobacco sales statewide to people under 21, city councils in Albert Lea and Arden Hills passed their own ordinances Tuesday. The two Minnesota cities joined more than two dozen other cities and counties across the state in adopting policies requiring people to be 21 years old to buy tobacco products. (Zdechlik, 3/26)

Boston Globe: On Beacon Hill, Lawmakers, Advocates Push To End Child Marriage
Senator Harriette Chandler, a Worcester Democrat and lead sponsor, said parents sometimes allow — or even encourage — children to marry before they have the legal resources or financial independence to navigate the world. ...Representative Kay Khan, a Newton Democrat, noted that it’s difficult for a teenager to extract herself from a problematic marriage. (Ebbert, 3/26)

Bloomberg: Centene Holds Takeover Discussions With WellCare 
Centene Corp. has held discussions about a potential takeover of managed-care provider WellCare Health Plans Inc., according to people familiar with the matter. There’s no guarantee that talks will lead to an agreement, said the people, who asked not to be identified as the details aren’t public. WellCare shares rose as much as 15 percent to $265 in late trading in New York. Based on Tuesday’s closing price of $231.27, the company has a market valuation of about $11.6 billion. (Hammond, 3/26)

Austin American-Statesman: Rise In Homelessness Comes Amid New Efforts To Tackle Issue
An annual “point in time” count found 2,255 unsheltered homeless people in Austin and nearby Travis County this year, up 5 percent from 2018, city and community leaders said Tuesday at a news conference. The count, performed Jan. 26, involved more than 500 volunteers counting the number of people sleeping on streets, in parks, under bridges and in cars and tents throughout the city. (Findell, 3/26)

Modern Healthcare: Fired Cardiologists Sue DMC, Tenet, Alleging Retaliation For Quality Complaints
Two cardiologists who contend they were fired for reporting quality problems over a four-year period at Detroit Medical Center have sued the six-hospital system, parent company Tenet Healthcare Corp. and four executives for alleged retaliation. Dr. Mahir Elder and Dr. Amir Kaki, who held various positions at DMC and were top admitters and proceduralists for patients with heart problems, said they reported to DMC executives multiple problems of dirty instruments, unnecessary procedures on patients performed by other doctors, lack of nursing staff, cutbacks of critical lab and support services and failure of top DMC and Tenet executives to investigate alleged incidents of Medicare and Medicaid fraud, according to a 41-page lawsuit filed Monday in U.S. District Court in Detroit. (Greene, 3/26)

Dallas Morning News: Expert Witnesses Differ Over What Medical Data Mean In Forest Park Bribery Trial
Data is only as good as who's crunching it. Jurors hearing the Forest Park Medical Center bribery and kickback trial in Dallas have gotten two very different conclusions from the same medical billing and claims data for certain surgeries that are at the heart of the case. An expert witness for the defense told jurors Monday and Tuesday that her analysis of the data shows that surgeries Dr. Michael Rimlawi and Dr. Douglas Won performed at Forest Park fluctuated over the years and revealed no clear patterns. (Krause, 3/26)

The New York Times: Drug Prices On TV? They May Be Coming.
The Trump administration is moving ahead with its proposal to require drug companies to disclose the often sky-high prices of their products in television commercials, despite strenuous objections and the threat of legal challenges by drug makers and TV broadcasters. The White House is reviewing the text of a final rule to impose the requirement, contending that the disclosures “will provide manufacturers with an incentive to reduce their list prices by exposing overly costly drugs to public scrutiny.” (Pear, 3/23)

The Washington Post: Gilead Profits From Tuvada HIV Treatment Funded By Taxpayers And Patented By The U.S. Government
Thomas Folks spent years in his U.S. Centers for Disease Control and Prevention lab developing a treatment to block deadly HIV in monkeys. Then San Francisco AIDS researcher Robert Grant, using $50 million in federal grants, proved the treatment worked in people who engaged in risky sex. Their work — almost fully funded by U.S. taxpayers — created a new use for an older prescription drug called Truvada: preventing HIV infection. But the U.S. government, which patented the treatment in 2015, is not receiving a penny for that use of the drug from Gilead Sciences, ­Truvada’s maker, which earned $3 billion in Truvada sales last year. (Rowland, 3/26)

Stat: Gilead And Louisiana Agree To A 'Netflix' Model For Hepatitis C Drugs 
After months of planning, the Louisiana Department of Health has chosen a new Gilead Sciences (GILD) subsidiary to supply a hepatitis C medicine under a so-called Netflix payment model. The deal revolves around subscription-based payments. Asegua Therapeutics, the Gilead unit, has agreed to provide the state Medicaid program and Department of Corrections with unlimited access to an authorized generic version of the Epclusa treatment for a fixed amount of money for five years, according to the state Department of Health. A contract is expected to be finalized by June 1. (Silverman, 3/26)

USA Today: Diabetes And Insulin Costs: Diabetics Struggle As Drug Prices Soar
Meaghan Carter died alone on the sofa of her suburban Dayton, Ohio, apartment last Christmas. Like most people with Type 1 diabetes, the 47-year-old nurse had a kit of essential supplies within reach. It contained two empty vials of her preferred insulin, a partial vial of inexpensive Walmart insulin and a half-filled container of testing strips to measure blood glucose levels. Uninsured, between jobs and with $50 in a bank account, Carter probably had attempted to stretch a limited supply of insulin until she got a final paycheck from her last job, family members say. She was scheduled to begin a new nursing job the following week that offered health insurance. (Alltucker, 3/22)

Stat: Mark Of A Job Well Done For A CRISPR Lobbyist? Silence In Congress 
It’s arguably the most cutting-edge and potentially lucrative area of biomedical science and now, to protect their investments, companies commercializing CRISPR genome editing technology are looking to shore up their Washington bonafides. But unlike their comrades in the conventional drug world, CRISPR lobbyists aren’t blitzing every office on Capitol Hill with a slate of pro-industry proposals. The goal is more understated: to make sure the companies with experimental treatments just now entering the clinic are unimpeded by government bureaucracies. (Florko, 3/27)

Modern Healthcare: As A Cure For High Drug Prices, Outcomes-Based Deals Aren't Delivering Yet
Facing growing calls for regulating prescription drug prices, the pharmaceutical industry has touted a preferred alternative for making drugs more affordable—private deals in which health plans pay them more or less for a drug depending on how well it works for plan members. But insurers and independent experts say outcomes-based contracting has made slow and uncertain progress since it was introduced in the past decade, with few if any published results. While it may help on the margins with some drugs, many observers doubt it offers a viable solution to the broad problem of prescription drug affordability in the U.S. (Meyer, 3/23)

Stat: Esketamine May Solve Depression Need, But Not Be Cost-Effective
FacebookLinkedInEmailDoximityPrintThe first major depression treatment to hit the U.S. market in decades may be a new option for patients who fail to respond to existing therapies, but a preliminary analysis shows the price of the medicine would have to be shaved by 25 percent in order to be cost effective. Known as esketamine and marketed as Spravato, the nasal spray was developed by Johnson & Johnson (JNJ), which set a list price of $590 to $885 per treatment session, depending on dosing and number of sessions, which can vary by patient. (Silverman, 3/22)

Modern Healthcare: Dignity Launches Its Own Specialty Pharmacy
Dignity Health is the latest health system to enter the specialty pharmacy market. The not-for-profit provider launched its own program to distribute medications for more than 20 complex diseases, and it plans to expand services to its broader national network of CommonSpirit Health. Peggy Sanborn, vice president of strategic growth, mergers and acquisitions, and partnership integration at Dignity Health, said the health system began its specialty pharmacy program at the end of last year in its Phoenix market and has since expanded into Sacramento, Calif. (Johnson, 3/26)

CNBC: Eli Lilly Discloses Pricing Data For Its Popular Insulin Humalog
Pharmaceutical giant Eli Lilly pulled the curtain back on the confidential pricing structure for one of its blockbuster drugs Monday, disclosing for the first time what it charges wholesalers versus what many patients typically pay. The company’s list prices for its popular insulin injection Humalog, versus what most patients are charged after insurance company rebates and other discounts, highlight the disparity in prices between uninsured and insured patients. The move is also a pre-emptive one as the Trump administration and Congress pressure drugmakers for more transparency and to lower drug costs. (Lovelace, 3/25)

The Wall Street Journal: Thermo Fisher To Buy Brammer Bio For $1.7 Billion
Thermo Fisher Scientific Inc. said it is buying Brammer Bio for $1.7 billion in a move that would expand the lab-equipment company’s presence in the rapidly growing field of gene therapy. Closely held Brammer Bio, owned by private-equity firm Ampersand Capital Partners, provides pharmaceutical companies developing gene therapies and gene-modified cell therapies with outsourced research and drugmaking services. (Hopkins and Lombardo, 3/24)

Stat: Thermo Fisher Gets Into Gene Therapy With Deal For Brammer Bio
Thermo Fisher Scientific is buying Brammer Bio of Cambridge, Mass., for about $1.7 billion as the giant Waltham, Mass.-based laboratory equipment supplier moves into the fast-growing area of gene therapy. Brammer Bio makes viral vectors that are used to deliver genetic material into defective cells in the hopes of treating or possibly even curing an inherited disorder. Brammer, a contract development and manufacturing organization hired by drug companies to assist them, has nearly 600 employees in Massachusetts and Florida. (Saltzman, 3/25)

Stat: With A NASH Treatment, NGM Aims To Be The Next Billion-Dollar Biotech
NGM Biopharmaceuticals wants to be the next billion-dollar biotech on Wall Street, and so it’s moving forward with an IPO that offers a springtime referendum on investor sentiment. Back in September, South San Francisco-based NGM filed paperwork to go public but fell silent as biotech indices tumbled in the fourth quarter. Now, apparently pleased with the state of the market, NGM has revived those plans and is pitching an offering that would value the company at about $1.1 billion. (Garde, 3/26)

The Atlantic: Do Prescription Drugs Really Have To Be So Expensive?
How is it that pharmaceutical companies can charge patients $100,000, $200,000, or even $500,000 a year for drugs—many of which are not even curative? Abiraterone, for instance, is a drug used to treat metastatic prostate cancer. The Food and Drug Administration initially approved it in 2011 to treat patients who failed to respond to previous chemotherapy. It does not cure anyone. The research suggests that in previously treated patients with metastatic prostate cancer, the drug extends life on average by four months. (Last year, the FDA approved giving abiraterone to men with prostate cancer who had not received previous treatment.) At its lowest price, it costs about $10,000 a month. (Ezekiel J. Emanuel, 3/23)

The Hill: States Are Tackling America's Drug Pricing Problem
Congressional hearings into America’s drug pricing problem reveal the challenges policymakers face as they confront a powerful industry’s pricing practices, but states have been on these front lines for years. Dozens have passed laws to lower the pharmaceutical price trajectory, and their work can inform the current debate. Unlike Congress, states must balance their budgets every year and know firsthand the impact of high and unpredictable drug prices. They began addressing drug cost increases years ago, becoming what the late Supreme Court Justice Louis Brandeis called “laboratories of experimentation” and what today’s economists call “business disruptors.” (Trish Riley,3/23)

CNBC: Here's Why Drug Prices Are So Difficult To Bring Down
Talk about a dichotomy. These both happened last week. The AARP launched its “Stop Rx Greed ” campaign to lower drug prices. The message is that Americans are spending an excessive amount on prescription drugs, the cost of which likely topped $330 billion in 2018. By comparison, the highly lucrative NFL generated less than $15 billion during the 2017 season. On the same day this message blasted out, I was attending a health care conference where biopharma management enthralled the crowded room with descriptions of potential curative therapies for rare diseases that would generate sales of $1 billion annually. The patient population for some of these products is only 1,000, implying a cost per person of $1 million. (Karen Firestone, 3/24)

The Hill: Drug Prices Are A Matter Of Life And Death
Few issues are more pressing today than out-of-control drug prices. One in four Americans are unable to afford their medications, and many of them are rationing — or altogether giving up — the very treatments they need to live, sometimes with fatal consequences. As Kathy Sego — whose diabetic son, Hunter, was rationing his insulin to save money — put it earlier this year before Congress, addressing the drug pricing crisis is "literally a matter of life and death." (Lauren Aronson, 3/21)

Stat: Biosimilar Approval And Adoption In The U.S. Needs To Be Expedited
Generic versions of brand-name small-molecule drugs saved Americans more than $1 trillion between 1999 and 2010. Biosimilars now have the potential to create substantial savings on complex biologic drugs, but only if we can remove the unnecessary barriers that stall their approval and adoption. (Carlos Sattler and Sheila Frame March, 3/20)

Bloomberg: Trump’s Miss On Obamacare Ruling Gives Democrats Perfect Pivot
Just as things were starting to look better for President Donald Trump, he seems intent on squandering any political advantage. Republicans lost big in the 2018 midterm elections due in large part to failed efforts to dismantle the increasingly popular Affordable Care Act. Instead of learning a lesson, the Trump administration is doubling down. The Justice Department took a more extreme position in an ongoing legal challenge to the law Monday night, saying that the whole thing should be thrown out instead of just in part. If the lawsuit succeeds, millions would lose coverage and many millions more would again face discrimination and higher costs based on pre-existing conditions. (Max Nisen, 3/26)

The Washington Post: The Trump Administration Just Handed Democrats Their Best 2020 Issue
When you’re the opposition party, much of what the administration does will make you angry, even horrified, but you often struggle to make the public share your outrage. Yet every once in a while, the administration will do something so obviously awful that you can only see it as a political gift. (Paul Waldman, 3/26)

The New York Times: Republicans Really Hate Healthcare 
Of all the political issues that divide us, health care is the one with the greatest impact on ordinary Americans’ lives. If Democrats hadn’t managed to pass the Affordable Care Act, around 20 million fewer Americans would have health insurance than currently do. If Republican-controlled states hadn’t refused to expand Medicaid and generally done as little as possible to support the act, national progress might have tracked progress in, say, California – so another 7 or 8 million people might have coverage. You obviously know where I stand on this political divide. But I’m starting to believe that I misjudged Republican motives. (Paul Krugman, 3/26)

San Franciso Chronicle: The Trump Administration Is Attacking The Affordable Care Act Yet Again 
California, along with more than a dozen other states, has intervened in court to defend the ACA. As important as that fight is, it’ll take place against the backdrop of a much larger war in this country over the extent to which Americans want government support for health care.In 2020, the Democrats are betting that the country wants far more support than we have now. The Trump administration is betting — against all available evidence — that we want none at all. The final decision will be made by the voters, not by the courts. (3/26)

USA Today: Trump Administration's Latest Attack On Health Care Hurts Us All
The Justice Department of Justice announced on Monday its support of a federal district court ruling that would strike down the entire Affordable Care Act, leaving more than 20 million people without health insurance. I’ve practiced medicine before and after the ACA, and I have seen the profound impact it has had on the health and well-being of patients. In the emergency room before the ACA, I treated a young woman who died from cardiac arrest because she couldn’t afford treatment for the heart condition with which she was born. (President of Planned Parenthood Leana Wen, 3/26)

The Washington Post: The Administration’s Renewed Focus On Eliminating Obamacare Is A Baffling Political Move
President Trump clearly recognizes, at least in the abstract, that providing affordable health care is a political winner. During the 2016 campaign, he embraced his party’s push to repeal the Affordable Care Act (a.k.a. Obamacare) but couched it in sweeping, almost Bernie Sanders-ian language. On “60 Minutes” in 2015, he declared that he would “take care of everybody . . . much better than they’re taken care of now.” How? He’d make a deal with hospitals, and the government would pay the bill. Up until a few days before his inauguration, his rhetoric was similar: “We’re going to have insurance for everybody.” (Philip Bump, 3/26)

USA Today: Trump Wants To Kill Obamacare, That Gives 2020 Voters A Clear Choice
Only 24 hours after what he sees as a vindication of his presidency by Attorney General William Barr, President Donald Trump took the most radical, aggressive and harmful move of his presidency when he filed papers to ask the courts to support the complete elimination of the Affordable Care Act.And in doing so, Trump just framed the stakes of the 2020 election. In an administration that has attempted to ban Muslims from entering the country and separated small children from their parents, this stands out in some ways as an even more defining step because the impact reaches to nearly every American family. (Andy Slavitt, 3/27)

The Hill: HHS Moves Forward With Game-Changing Health Care Innovations
It would be easy to think the flurry of congressional investigations of the White House, the politics of the 2020 presidential campaign, and the paralyzing partisanship on Capitol Hill would combine to make it impossible for anything to get done in Washington. Think again. Flying somewhat under the radar, the Department of Health and Human Services (HHS) has ramped up efforts to move towards a more innovative way to reimburse health care providers, which has caused a flurry of behind-the-scenes lobbying from all sides of the health care industry. (Jason Altmire, 3/26)

Stat: The Opioid Crisis Is Partly Fueled By Insurers' Approach To Back Pain 
At some point in their lives, 80 percent of adults will experience lower back pain. It’s the second most common reason that adults see a doctor and the most common reason for disability. It’s also a microcosm of all the things that are wrong with the U.S. health care system, including its contribution to the opioid crisis.Having experienced lower back pain myself, I know that it can be truly debilitating. I would have done almost anything to rid myself of it. Lower back pain puts people in desperate and vulnerable positions, and it puts doctors under pressure to Do Something Now. From such a confluence arise many poor and potentially devastating treatments and choices. Among the worst is doctors’ decisions to write opioid prescriptions as a treatment for lower back pain and their patients taking these drugs. (Dave Chase, 3/27)

The New York Times: Want To Reduce Opioid Deaths? Get People The Medications They Need
The federal government released a report last week that came to a striking conclusion: More than 80 percent of the roughly two million people struggling with opioid addiction in the United States are not being treated with the medications most likely to nudge them into remission or prevent them from overdosing. This denial of care is so pervasive and egregious, the report’s authors found, that it amounts to a serious ethical breach on the part of both health care providers and the criminal justice system. (3/26)

The Hill: Sandy Hook And Parkland Survivors Need Not Suffer In Silence
In the past week, three people, who were closely affected by mass shootings in this country, are believed to have died by suicide. First, it was two teens who were students at Marjory Stoneman Douglas High School in Parkland, Fla. when a gunman opened fire last year killing 17 students and staff and injuring others. Yesterday it was Jeremy Richman, whose 6-year-old daughter, Avielle, was killed in the 2012 Sandy Hook Elementary School shootings in Newtown, Conn. What I’m about to say is in no way intended to minimize the traumas these three individuals experienced or to diminish their emotional pain. These losses are heart-breaking; tragic. And, it didn’t need to be this way. (Joan Cook, 3/26)

Los Angeles Times: Puerto Rico Needs More Than An AOC-Inspired Morale Boost To Recover From Its Disasters 
After a stretch of disastrous years that included a recession, a debt crisis, bankruptcy, a hurricane and the exodus of thousands of residents from the island, 2019 is shaping up to be a good year for Puerto Rico — or at least for Puerto Rican morale. Several things came together, mostly by chance, to lift the island’s spirits and give Puerto Ricans a sense of hope. That is due, in important measure, to two New York Puerto Ricans, Lin-Manuel Miranda and Alexandria Ocasio-Cortez, who have brought the world’s attention to the island. (Luisita Lopez Torregrosa, 3/27)

The Washington Post: Trump Seems To Inflate The Price Tag For Puerto Rico’s Recovery To Deny Funding Puerto Rico’s Recovery
President Trump is frustrated by two numbers that emerged after Hurricane Maria laid waste to Puerto Rico in 2017. The first is 2,975, the number of people estimated to have died as a result of the storm, according to analysis conducted by George Washington University. This number, Trump has insisted, is far higher than reality. When he visited the island shortly after the storm struck, the death toll was only 16 — though that number had more than doubled by the time Air Force One began heading back to the mainland. As weeks passed and recovery efforts continued, the toll increased dramatically. (Philip Bump, 3/26)

Stat: I'm Trying To Reverse African-Americans' Distrust Of Medicine
African-Americans have historically received less-than-optimal medical care, in part because they don’t trust physicians or the health care system. They come by this distrust honestly: think of the exploitation of African-American men in the Tuskegee experiment, or the unauthorized use of Henrietta Lacks’s cells for scientific discovery and monetary gain.I’m trying to change this dynamic one patient and one blood drive at a time. As a pediatric hematologist, I treat children with blood disorders like anemia, leukemia, thalassemia, and sickle cell disease. The latter affects about 100,000 Americans, most of whom are African-American. (A. Kyle Mack, 3/27)

Boston Globe: Hold Buyers Accountable In Sex Trafficking
The usual tactic for law enforcement officers when we detect signs of illegal brothel activity is to go in with a couple of undercover agents, arrest the women, shut down the operation, and move on. But when a health department inspector noticed suspicious activity in a massage parlor last July in Martin County, Fla., we sensed a chance to go beyond a storefront bust and find out who else was involved upstream. (William Snyder, 3/26)

The Hill: Mueller Report: The Rhetoric Of Rage And Division Continues 
The rhetoric of rage and division continues. As a physician I can tell you that fear and hatred lead to an outpouring of stress hormones which causes health problems, including high blood pressure, heart disease, strokes, as well as anxiety and depression. The entire Trump presidency has been shrouded in special counsel Mueller’s report and now that it is over, it is time to heal the public psyche. Debate is one thing, but the constant climate of threat, name calling and back and forth accusations is unhealthy. (Marc Siegel, 3/26)

The Wall Street Journal: Where Did The Schizophrenics Go?
Wondrous are the ways of Washington. In a single day, the federal government officially reduced the number of people with schizophrenia in the United States from 2.8 million to 750,000. With a change of the National Institute of Mental Health website in 2017, two million people with schizophrenia simply disappeared. The 2.8 million estimate, or 1.1% of the adult population, had been the official standard for the U.S. since the 1980s, when the last major prevalence survey was carried out. The figure was provided to Congress in 1993 and used for national estimates such as the cost of schizophrenia. (E. Fuller Torrey and Wendy Simmons, 3/26)