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Congress gave final approval Friday to a giant $1.3 trillion spending bill that ends the budget battles for now, but only after late scuffles and conservatives objections to big outlays on Democratic priorities at a time when Republicans control the House, Senate and White House. Senate passage shortly after midnight averted a third federal shutdown this year, an outcome both parties wanted to avoid. But in crafting a sweeping deal that busts budget caps, they've stirred conservative opposition and set the contours for the next funding fight ahead of the midterm elections. (Mascaro and Fram, 3/23)

Action by the Senate shortly before 1 a.m. capped a day of suspense, including the late-night revelation that the legislation had been stalled for hours partly because Sen. James E. Risch (R-Idaho) objected to the renaming of a federal wilderness area after a deceased political rival. Sen. Rand Paul (R-Ky.) also held out against the bill for much of the day Thursday, voicing objections to what he viewed as unnecessary deficit spending while keeping colleagues in the dark about whether he would delay action on the legislation and force a brief government shutdown, as he did last month over an earlier spending deal. (Werner and DeBonis, 3/23)

“This is ridiculous. This is juvenile,” fumed Sen. Bob Corker (R-Tenn.), who asked McConnell for an explanation of why the chamber was in at midnight. “What has occurred over the last 11 hours that keeps us here voting on a bill that we all know is going to pass?” McConnell didn’t go into detail but acknowledged the difficult path he took to getting the spending bill across the finish line. “My principal responsibility is begging, pleading and cajoling. I have been in continuous discussions, shall I say, with several of our members who were legitimately unhappy,” McConnell said. (Everett, 3/22)

Senate Majority Leader Mitch McConnell (R., Ky.) depicted the bill as “legislation that neither side sees as perfect, but which contains a host of significant victories and important achievements on behalf of the American people.” Among them, he said, are a 15% increase in military spending and funding to combat an opioid epidemic as well as a down payment toward Mr. Trump’s border wall. (Peterson and Hughes, 3/23)

The bill allots additional funds to the National Institutes of Health, including a $414 million increase for Alzheimer's disease research, $40 million more for research on developing a universal flu vaccine and $17 million more for antibiotic-resistance bacteria research. Separately, it earmarks an additional $2.8 billion to fund treatment and prevention of opioid addiction and research into the subject. (Becker and Cowan, 3/23)

Abstinence-only education would see a $10 million funding boost under the spending bill released by Congress Wednesday night and advanced by the House Thursday morning. Under the $1.3 trillion omnibus bill, the Sexual Risk Avoidance Education (SRAE) grant program would receive a 67 percent increase in funding, bringing it up to $25 million. (Hellmann, 3/22)

New Hampshire’s congressional delegation is cheering a significant increase in federal funds for fighting the opioid epidemic included in the federal spending deal released Wednesday. The draft bill contains an additional $3 billion over 2017 funding levels to fight opioid and mental health crises nationally. (Greene, 3/22)

Here's the rundown of what's included in the 2,232-page spending bill, now in the hands of a Senate vote, based on summaries released by the House and Senate appropriations committees. (Kodjak, 3/22)

When the 2,232-page government spending bill posted on Wednesday night, Rep. Gary Palmer (R., Ala.) divided it into four sections and broke out the sugar. “I’m not a big dessert eater, but I confess, after one section I finished, I ate a pack of Bud’s Best Cookies,” Mr. Palmer said, referring to the Alabama-made treats he gives away in his office. “And then I finished another section, I got up and walked around, got hot tea and then I go back and do another section.” (Andrews and Peterson, 3/22)

In a blow to health insurers, the House on Thursday passed a $1.3 trillion, two-year omnibus spending bill that didn't include funding for cost-sharing reduction payments or a federal reinsurance program. Insurers had been lobbying hard to get something included in the massive spending bill. Absent that lifeline, insurers will likely be raising premiums and rethinking their participation in the individual market in 2019. The omnibus bill, which the Senate must pass by midnight on Friday to avoid a government shutdown, marks what most feel was a final shot at passing measures to bring down premiums in the individual market before plans must decide where to sell and how to price coverage next year. (Livingston, 3/22)

Senate Majority Whip John Cornyn (Texas), the No. 2 Senate Republican, said Thursday "there will be a vote" on a GOP bill to lower ObamaCare premiums. Cornyn would not say whether the vote would come as an amendment to the must-pass government funding bill or as a stand-alone measure. (Sullivan, 3/22)

A proposal to allow the Iowa Farm Bureau Federation to sell plans that don’t meet Obamacare’s coverage requirements has cleared the Senate and looks poised to become law. It’s a lot like the Tennessee farm plans, which have been around a lot longer than the Affordable Care Act and aren’t subject to its rules because they aren’t classified as insurance under state law. (Demko, 3/22)

Centene Corp. still hasn’t fixed problems in Washington that led the state to briefly bar the health insurer from selling Obamacare plans, the insurance regulator there said Thursday. Washington will fine Centene’s Coordinated Care unit $100,000 for not complying with a December agreement to boost coverage of physicians such as anesthesiologists, Steve Valandra, deputy commissioner for public affairs at the state’s Office of the Insurance Commissioner, said by phone. (Tracer, 3/22)

On Saturday, Rebecca Schneid plans to pull on her sneakers, sling a camera over her shoulder and march down Pennsylvania Avenue in Washington with thousands of other students demanding an end to the gun violence that has cut through so many American communities. But to Ms. Schneid, a survivor of the school shooting that killed 17 people last month in Parkland, Fla., the march is just the beginning — a moment of political awakening, she hopes, that will put the nation on notice that young people plan to be a greater, more organized force than teenagers and college students in the past. (Burns and Turkewitz, 3/22)

Before the assembly, before the mayor spoke and people cheered, before TV cameras packed the gymnasium at Thurgood Marshall Academy in Southeast Washington on Thursday, Dakota McNeely drew a purple heart on her hand in ink. Then, through its center, she carved a crack.It was an homage to her friend, James Smith, 17, who was shot dead in an apparent robbery a few days before Christmas last year. It was a way to feel Smith’s presence as she joined her classmates and Parkland, Fla., teenagers in calling for stricter gun laws. (Lang, 3/22)

Hussein Abdi, 19, had never given much thought to the gunmaker down the street from his high school. He often passed the Smith & Wesson factory and its flashing marquee touting the company’s deep ties to the city, “Since 1852.” Nyasia Jordan, 18, knew it only as the place where her mom used to work. It’s one of the city’s largest employers. Others saw Smith & Wesson’s presence as another detail central to Springfield’s identity, the place where basketball was invented, Dr. Seuss was born and guns are made. (Frankel, 3/22)

Transfusing young blood and freezing heads may get most of the anti-aging and life-extension buzz, but don’t count out the molecule hunters: After setbacks and stumbles and what critics called debacles, these scientists are figuring out which biochemicals might potentially, possibly be fountains of youth in pill form. In the latest advance, biologists reported on Thursday that a molecule already sold by supplement makers (even as scientists scramble to understand it) restored youthfulness to blood vessels in 20-month-old mice, an age comparable to 70 years in people. The research supports the idea that boosting certain genes and molecules that fade with age could keep people functional, resilient, and even spry well into their 80s, even without living longer. (Begley, 3/22)

The Pap test has already reduced the incidence of cervical cancer by more than 60%. Now it may become a key step in the early detection of two other gynecological malignancies — ovarian and endometrial cancers — that have been notorious killers because they're typically caught so late. A new study has found that by genetically analyzing the harvest of cells from a Pap smear, doctors could identify 81% of endometrial cancers and 33% of ovarian cancers.Some of those cancers were in their earliest stages, when they're more likely to respond to treatment. (Healy, 3/22)

The first rigorous study of its kind finds that sequencing people’s genomes might not lead to extensive and expensive follow-up care, researchers reported on Thursday. “That’s been the critical question that has the field [of medical genetics] very concerned: Will whole-genome sequencing drive up downstream costs?” said Kurt Christensen of Brigham and Women’s Hospital in Boston, lead author of the study in Genetics in Medicine. (Begley, 3/22)

Are omega-6 fatty acids, the fats found in nuts, seeds and many vegetable oils, including those used in many processed and junk foods, helpful or harmful? It has been believed that omega-6s generally increase inflammation, while omega-3s, the fats in fish oil, lower it, and some studies suggest that a high omega-6 intake increases the risk for heart disease. But a new long-term study suggests omega-6s can be good for the heart. (Bakalar, 3/22)

Shawsheen Tech buys the social media scanning service from a Vermont-based company called Social Sentinel. It's one of many technology firms doing some form of social media scanning or monitoring. Social Sentinel claims it's the only one with expertise in protecting schools. (Joliocoeur and Mullins, 3/22)

Netflix has added a warning video that will play before its series “13 Reasons Why” and will promote resources to help young viewers and their parents address the show’s themes, the streaming service announced Wednesday. After being criticized for how the series’ first season depicted suicide, which had already led the network to add warning messages to the show, Netflix commissioned a study by the Northwestern University Center on Media and Human Development to gauge its impact on viewers. The show’s second season will be released this year. (Libbey, 3/22)

Music and art are increasingly being used as tools for therapy for high school students who have faced trauma — from sexual abuse to homelessness — and have been proven to help students cope, both physically and psychologically. Studies have shown that participating in music and art can alleviate pain, help people manage stress, promote wellness, enhance memory, improve communications, aide physical rehabilitation, and give people a way to express their feelings. (Payne, O'Donnell and Doty, 3/22)

In a refrigerator in the coroner's office in Marion County, Ind., rows of vials await testing. They contain blood, urine and vitreous, the fluid collected from inside a human eye.In overdose cases, the fluids may contain clues for investigators. "We send that off to a toxicology lab to be tested for what we call drugs of abuse," said Alfie Ballew, deputy coroner. The results often include drugs such as cocaine, heroin, fentanyl or prescription pharmaceuticals. (Harper, 3/22)

Federal officials said they are working to get new non-opioid painkillers onto the market, along with opioid treatment drugs, part of the administration's strategy to address an addiction epidemic that shows no signs of abating. To those who became addicted after they were prescribed or tried pharmaceutical opioids as teens, the alternatives come too late but are still welcome news. (O'Donnell, 3/21)

A group of Republicans wants to bolster mandatory minimum sentencing for trafficking fentanyl, a move that comes as President Trump advocates for harsher punishments for drug traffickers. Fentanyl is “as much a weapon of mass destruction as it is a drug,” Sen. Tom Cotton (R-Ark.) said at a Thursday press conference, holding up a nearly empty salt shaker and explaining how that amount — less than 40 grams — of fentanyl could kill thousands of people. (Roubein, 3/22)

There were more than four times the number of drug-related deaths in Jefferson Parish in 2017 than homicides. There were 173 overdose deaths, according to the Jefferson Parish Coroner's office, and 42 homicides in 2017. A total of 139 of the overdose deaths were opioid/ opiate related. Suicides are included in some of the overdose deaths reported last year. (Clark, 3/22)

A doctor from Dover who admitted to defrauding Medicare and other health insurers out of millions of dollars and spending it on a extravagant lifestyle was sentenced Thursday to eight years in federal prison, officials said. Fathallah Mashali, 62, who once ran pain management clinics in Massachusetts in Rhode Island, was also sentenced to three years of supervised release, and ordered to pay $8.7 million in restitution, according to a statement from the US Attorney’s office. (Levene, 3/23)

John Bardis, a top HHS official who signed off on ex-Secretary Tom Price's charter jet flights, is resigning effective April 6, the agency confirmed Thursday. The health care entrepreneur and longtime friend of Price's from Georgia served as HHS assistant secretary of administration since March 2017 and was responsible for departmental operations. He also helped oversee the ReImagine HHS project, an initiative to overhaul the agency and cut costs. (Diamond, 3/22)

The post was one of the highest in command at the agency and was charged with oversight of maintaining security of the medical information of more than 100 million Americans. The office also is a liaison to the intelligence community. "As assistant secretary for administration, Bardis initiated and led a number of ambitious efforts to rapidly advance the department's work in acquisitions, human resources and other critical management areas. Both HHS Secretary Alex Azar and I have been happy to see these plans bear fruit already," Deputy Secretary Eric Hargan said. (Aguilar, 3/22)

Idaho will require abortion providers to report how many times their patients have terminated a pregnancy in the past and other personal information under the latest anti-abortion law approved in the conservative state. Gov. C.L. "Butch" Otter signed the legislation Thursday, just two days after approving a measure requiring women seeking abortions to be informed that the drug-induced procedures can be halted halfway. That is despite opposition from medical groups that say there is little evidence to support that claim. (Kruesi, 3/22)

Kansas is asking the U.S. Supreme Court to overturn a federal appeals court ruling that prevents the state from cutting off Medicaid funds to a Planned Parenthood affiliate. Republican Gov. Jeff Colyer said Thursday that the state is seeking to reverse a 10th U.S. Circuit Court of Appeals decision last month. Colyer is a strong abortion opponent. (3/22)

In February, the 10th U.S. Circuit Court of Appeals upheld a lower court ruling that Kansas improperly sought to end Planned Parenthood’s Medicaid funding. The appeals court said states may not cut off health care providers from Medicaid “for any reason they see fit, especially when that reason is unrelated to the provider’s competence and the quality of the healthcare it provides.” (Margolies, 3/22)

Cunningham’s classes are funded by the federal Teen Pregnancy Prevention Program, which was established in 2010 by the Obama administration to help reduce the number of teen pregnancies. ... But under the Trump administration the program has faced mounting uncertainty. (Santhanam, 3/22)

The Kentucky Senate overwhelmingly approved legislation on Thursday to ban a common abortion procedure once the patient reaches her 11th week of pregnancy, in what would amount to one of the strictest abortion limits yet in the United States. The Senate voted 31-5 in favor of the measure, which now goes back to the state's House of Representatives for final approval of changes to a version of the bill it passed 71-11 vote on March 12. Both bodies are controlled by Republicans. (Bittenbender, 3/23)

A bill allowing pharmacists to prescribe contraceptives without the need for a doctor’s visit passed the New Hampshire House by voice vote Thursday, as legislators sought to reduce access barriers to birth control. The bill, House Bill 1822, does not allow pharmacists to begin prescribing automatically; they must first be issued standing orders by physicians. Once empowered, the pharmacists would be guided by a national training program for hormonal contraceptives. (DeWitt, 3/22)

Psychiatry’s growing popularity as a career choice comes as the nation grapples with a stubborn shortage of psychiatrists that some fear will continue to deepen. The shortage is most acute in rural areas and poor urban neighborhoods that often aren’t the first choice for in-demand doctors with plentiful options, but is also being felt across big cities as the need for mental health professionals outpaces supply. (Elejalde-Ruiz, 3/22)

The Northern Arapaho Tribe has announced it will no longer use the Federal Employee Health Benefits Program but instead will self-insure tribal employees in hopes of moving toward greater tribal sovereignty. Last year, the tribe took over the management of their health clinics, too. (Edwards, 3/22)

The Rehabilitation Center at Hollywood Hills usually required 125 tons of cooling capacity to keep its residents safe. But the nine functioning portable “chillers” administrators installed could muster only about 15 tons, not nearly enough. ...The testimony, released late Thursday, came during ongoing litigation between the state health care agency and the nursing home over the loss of its license to operate. (Nehamas, Chang, Blaskey and Marbin Miller, 3/22)

Ascension is restructuring as it pursues new strategic direction, hinting at transitioning from a hospital-oriented system to one that's focused on outpatient care and telemedicine, the largest Catholic health system told its 165,000 employees early Friday morning via a video featuring Ascension President and CEO Anthony Tersigni that Modern Healthcare has exclusively obtained. Earlier this month, the Ascension board of directors unanimously endorsed its new "advanced strategic direction," Tersigni told his employees, as it faces dwindling reimbursement from government and commercial payers, regulatory complexity, skyrocketing pharmaceutical costs, a shift from inpatient to outpatient care and fee-for-service to volume-based care, and increasing competition. (Kacik, 3/22)

The Minnesota Firefighter Initiative recently launched a peer support help line for firefighters who are thinking about suicide. Any Minnesota Firefighter can call if they're thinking about or planning to take their own life. (Wurzer, 3/22)

Nashville General Hospital officials on Thursday requested $46.6 million to operate the city's safety net hospital next year, a request new Mayor David Briley met with measured support. "Our city has a very long commitment to providing a safety net for health care in the community," Briley said during a budget hearing. "That will not change this year." But Briley stressed he will bring a high level of scrutiny to the city's funding of its public hospital. (Wadhwani, 3/22)

Federal regulators are urging neuro­surgeons to exercise extreme caution when using a Minnesota-made brain probe to kill cancer cells, following reported problems that included a patient death potentially linked to the device. The Food and Drug Administration on Thursday issued a Class I recall alert on about 50 NeuroBlate systems for MRI-guided brain surgery made by Plymouth-based Monteris Medical. (Carlson, 3/22)

Florida legislators have put an end to a long squabble over trauma centers in Pinellas County, squashing a request by hospital operator HCA to open a center at Northside Hospital in St. Petersburg. A bill passed by the Legislature overhauls regulations overseeing the state’s trauma system by setting new standards for what can be designated as a trauma center while grandfathering in some that have been subject to lawsuits. (Griffin, 3/23)

About 50 Lawrence High School band members in Orlando, Fla., for a performing arts competition at Disney World fell ill with a gastrointestinal illness thought to have been the norovirus. A third of the 150 students on the 6-day trip to participate in Festival Disney ended up sick after they arrived March 14 at an Orlando hotel. (Williams, 3/22)

Martin Health System, in Florida, said Thursday it is exploring becoming a full member of the Cleveland Clinic. The Clinic in January established a cardiovascular affiliation with Martin Health, its first cardiovascular affiliation in Florida. At that time, the two organizations said they were considering "other opportunities to work together more closely," outside of the cardiac affiliation. (Christ, 3/22)

A medical marijuana dispensary in western Maryland has banned at least four customers because they posted complaints online about pricing or other issues, sparking concern from advocates and potentially violating state rules for the emerging industry. Joy A. Strand, the executive director of the Maryland Medical Cannabis Commission, said registered dispensaries have the right to decline marijuana to patients or caregivers if they appear to be under the influence of drugs or alcohol. (Chappell, 3/22)

Volusia and Flagler counties are trying to combat high fetal and infant mortality rates. Dixie Morgese, executive director of The Healthy Start Coalition of Flagler and Volusia Counties said a report from 2016 found that more than eight out of every one thousand births resulted in death. (Lyons, 3/22)

The Marcus Foundation has donated $15 million to create a network for stroke care to help reduce disability and death from the disease in theSoutheast. A wide swath of the South is known as the Stroke Belt, due to the 11-state region’s unusually high incidence of strokes and other forms of cardiovascular disease. (Miller, 3/22)

Aurora Health Care and Advocate Health Care have cleared the final regulatory review needed for their proposed merger and are on track to merge on April 1. (Boulton, 3/22)

Kaiser Health News: For One Father And Son In Puerto Rico, Hurricane Maria’s Cloud Has Not Lifted

To reach the Martinez home in Puerto Rico’s central mountains, social worker Eileen Calderon steers around piles of dirt, treacherous potholes and power company trucks that block the road. Finally, she pulls up to a sagging, cement home, its roof done in by Hurricane Maria. Laundry hangs under a tarp, and a cat is tied to a leash outside the door. Calderon, who is based in San Juan, and works for VarMed, a company that handles complex medical cases in Puerto Rico, has brought two colleagues — a nurse, Anamelia Velazquez, and a primary care physician, Dr. Carla Rossotti — to check in on Osvaldo Martinez and his son, Osvaldo Daniel Martinez. (Varney, 3/23)

This study examines how the need for long-term services and supports and their use vary by socioeconomic status and simulates the potential impact of various financing options. Our results show that older people with limited financial resources are more likely to develop serious needs and receive paid help than their counterparts with more financial resources. People with little wealth also tend to need and receive help for a relatively long time. The simulations reveal that the impact of alternative financing options, such as caregiver tax credits, subsidized respite care, and expanded social insurance, varies with income. (Favreault and Johnson, 3/22)

In this population-based analysis, Medicare ACO enrollment resulted in significant improvements in appropriateness of breast and colorectal cancer screening, namely improving screening rates among those likely to benefit and withholding screening from those unlikely to benefit. Conversely, ACO enrollment was associated with significant reductions in prostate cancer screening regardless of age or predicted survival. (Resnick et al, 3/19)

High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. (Franklin et al, 3/22)

Prescribing of psychotropic medications to patients in long-term care has declined, although the partnership did not accelerate this decrease. However, the use of mood stabilizers, possibly as a substitute for antipsychotics, increased and accelerated after initiation of the partnership in both long-term care residents overall and in those with dementia. Measuring use of antipsychotics alone may be an inadequate proxy for quality of care and may have contributed to a shift in prescribing to alternative medications with a poorer risk-benefit balance. (Maust et al, 3/17)

Patients with early gastric cancers that are limited to gastric mucosa or submucosa usually have an advanced loss of mucosal glandular tissue (glandular atrophy) and are at high risk for subsequent (metachronous) development of new gastric cancer. The long-term effects of treatment to eradicate Helicobacter pylori on histologic improvement and the prevention of metachronous gastric cancer remain unclear. (Choi, 3/22)

First, given the evidence that poverty and functional status, among other factors, strongly influence patient outcomes, [alternative payment models] could include these factors in risk adjustment. Failing to account for them means underestimating the quality of care provided by clinicians serving high-risk populations and overestimating the quality provided by those serving low-risk populations; in many programs, the result is a transfer of money from clinicians caring for high-risk patients to ones caring for low-risk patients. (Maddox, 3/15)

As tens of thousands of students gear up to march Saturday in the nation’s capital and from Burlington, Vt., to Salem, Ore., a pivotal question looms: Can they push an immovable Congress to do more to fight gun violence? Emma Gonzalez, 18, a survivor of the shooting at Douglas High School in Parkland, Fla., tweeted Thursday that the students are going to “make history together. ”They’ve already had some successes. They’ve focused the nation’s all-too-short attention span for more than a month on the massacre of 17 students and teachers at their high school. And they’ve beaten the odds in the Florida Legislature, which raised the age to 21 to buy assault-style weapons, over opposition from the National Rifle Association. (3/22)

In light of the recent call for the government to “do something” to prevent gun violence, maybe the paranoia has subsided enough that Courier Journal readers can entertain a little logic being injected into the problem. First, let me say that gun owners hate what has happened as much as anyone, but they realize that just passing more regulatory bureaucracy will do nothing to curb the problem. Any time a person wishes to break the law, they can find the means to do so. It doesn’t matter how much you regulate or make something illegal, it doesn’t prevent someone with a deranged mind from doing what they want to do. (Mike O'Brien, 3/22)

They're self-absorbed, consumeristic, politically disconnected, addicted to spouting their opinions on Facebook, and never show up when it counts. They seem unable to complete the most basic, practical tasks. Adults really are ruining America. (Ann Friedman, 3/23)

We need stricter gun-control laws that are strongly enforced. We know from our experience in Massachusetts that such a regulatory regime makes a meaningful difference in health outcomes. But we cannot wait for Congress or other states to take action. We also need to invest in strategies that promote interventions in other venues, including the doctor’s office. That is why we led a collaboration among researchers, clinicians, public health advocates, and law-enforcement officials, developed through a partnership between the Massachusetts Medical Society and the Massachusetts Attorney General’s Office, to equip providers with tools to counsel patients and families on risk mitigation for firearms. This tool kit was designed to help providers feel more comfortable in engaging in a conversation, without judgment, about firearm safety and to provide them with real-world information necessary to take part in problem-solving with patients about minimizing exposure to unwanted harms, just as doctors do in countless other contexts. We need to normalize discussions about firearm violence and the threat it presents to public health, wherever those discussions happen, whether in the school administrator’s office, on the playing fields, in community settings, or among parents. (Charles A. Morris and Jonathan B. Miller, 3/22)

In the weeks since we at Dick’s Sporting Goods announced plans to stop selling assault-style rifles, plans to only sell firearms to those over 21 and other new policies, we have been striving to keep this conversation going. We have met with a number of lawmakers and have talked with many of our peers in the retail industry. We have spoken with strong-willed advocacy groups and visited with families in Parkland. It is becoming increasingly apparent through our conversations that there continues to be deep skepticism that anything of substance will be done. (Edward Stack, 3/22)

If gun control becomes the gateway issue that entices distrustful millennials into the voting booth, America is in for a makeover. Never before has this country produced a generation with political views and demographic traits so different from those of its elders. On nearly every important issue — immigration, health care, climate change, gender equality, racial disparity, sexual identity, economic inequality, size of government, use of military force, presidential disapproval — millennials are by far our most liberal adult generation. (Paul Taylor, 3/22)

A few weeks ago, I was looking through my third-grade writer’s notebook and found a pro-and-con diagram I had drawn for each side of the gun control debate. On the left I gave the pro-gun argument where I argued that guns are used for recreation and defense. On the right I said in response to those points “assault weapons are not necessary for this. ”While my entry is not dated, I assume I wrote it shortly after 20 children were killed at Sandy Hook Elementary. (Satchel Walton, 3/22)

If gun violence has not yet touched your life, I can tell you there is no pocket of privilege safe enough that it can’t happen to you or your kids. I am 45, and in the past decade, I lost three classmates from Harvard College to three separate gun shootings in three states. I have been to memorial lectures and film screenings and talked to Harvard administrators about honorary benches and scholarships. But these early deaths of my classmates are not like young cancer deaths that we can only mourn over and are powerless to avert. (Vineeta Vijayaraghavan, 3/23)

Students and much of the nation have been misled, and worse. The students’ grief is being exploited for political gain in the wake of the atrocity in Parkland, Fla. The “solutions” being fed to well-intentioned people will do nothing — and can do nothing — to prevent another attack like Parkland. We feel the same grief and frustration. The difference is that we understand that the gun control proposals being put forward won’t save a single life. Not one. (Chris and Jeff Knox, 3/22)

My beautiful daughter was only 14 when she was shot and killed in her classroom at Marjory Stoneman Douglas High School. ...In honor of Alyssa, and all the other young men and women and educators who were shot and killed in Parkland, Fla., a group of surviving students from Stoneman Douglas started the March for Our Lives. On Saturday, I will march in my daughter’s honor in Washington. I am moved beyond words that student organizers from across the country and the world will host more than 800 sibling marches that day. In Alyssa’s name, I ask our lawmakers: Why hasn’t anything been done? There is so much elected officials can do to make our children safer in their schools. And they can make all Americans safer by strengthening our gun laws. (Lori Alhadeff, 3/22)

Now that Congress has failed to shore up Obamacare in the massive spending bill it is considering, it is all the more urgent for states to fill the gap. Maryland can lead the way, if state leaders embrace two critical Obamacare fixes under consideration in the General Assembly. (3/22)

Few Washington practices are creepier than the exploitation of the desperately ill for ideological ends. That hasn't stopped the sponsors of the egregious federal 'right to try' bill from scheduling the measure for a crucial House vote Tuesday. ... Fernandez Lynch and Steven Joffe, her colleague at Penn, warned in a recent article in the New England Journal of Medicine that granting patients with life-threatening illnesses a "right to try" experimental drugs without FDA oversight is a steep, slippery slope. "This logic could ultimately extend to patients with serious chronic illnesses and… to all patients who find their approved treatment options unsatisfactory." (Michael Hiltzik, 3/22)

As a physician, I have worked hours in a row in Emergency Departments (ED) caring for patients, some of whom were seriously ill and waited hours to see me. Maybe some of them were like you. Unless Congress acts, that next trip you make to the ED may take even longer — if you can even get in the door. (Arthur Tim Garson, Jr., 3/22)

Six months ago, the Senate had a bipartisan health care deal with a good chance of becoming law. But now that deal appears to be dead — derailed by abortion politics, policy disagreements and months of lawmakers dragging their feet while the health care landscape shifted underneath them. Why this matters: Premiums are almost certainly going up in October, and insurers will be deciding whether to keep participating in the marketplace. (Caitlin Owens, 3/22)

Hospitals and clinics serving high-risk, high-need patient populations, including low-income and uninsured individuals, have long benefitted from a federal program that allows them to buy medicines from drug makers at a steep discount. But as a debate over drug pricing rages in Congress, there’s mounting evidence the 340B program has been exploited for profit under the guise of “doing good.” (Elsa Pearson and Austin Frakt, 3/22)

Dr. Redd, a 76-year-old practicing physician, sought help for memory loss at an Alzheimer’s disease research center. After being diagnosed with Alzheimer’s, she became distressed when she was instructed to stop working immediately. Abrupt retirement would leave patients in her highly subspecialized practice without care. (Gayatri Devi, 3/22)

he union wants to use the threat of a ballot initiative to scare dialysis providers into complying with their demands. It is irresponsible and dangerous for UHW to use patients as pawns. The proposed measure would impose unprecedented limits on what health insurance companies are required to pay community dialysis clinics. (Bryan Wong, 3/22)

Baltimore City joined a lawsuit brought by Healthy Teen Network against President Trump, challenging a decision by the U.S. Department of Health and Human Services (HHS) to cut funding from evidence-based teen pregnancy prevention education. ...This cut is not just cruel — it’s unprecedented. Funding for Teen Pregnancy Prevention Initiatives (TPPI) was appropriated by an act of Congress — a statutory mandate — specifically dictating to HHS the parameters under which the funding was to be distributed. The funding appropriated is still available for the five-year grant period. (Leana S. Wen, 3/23)

The opioid crisis is being called the worst addiction epidemic in American history. The statistics tell a grim story: 33,000 drug overdoses in 2016 — equating to 91 American deaths every day and rising. ...For those who are already addicted, technology can help block difficult withdrawal symptoms and prevent overdoses. Innovation in medication management supports responsible stewardship, helping to prevent drug diversion and inappropriate access to opioids. Medical technology companies are also developing innovations that are minimally invasive, enabling patients to return to their daily lives quickly with less pain and discomfort after surgery. (Scott Whitaker, 3/22)

While the department has tried to prevent and manage disruptive behavior, these programs go only so far, and their effectiveness is undermined by the lack of funding, staffing and support from the president and VA and congressional leaders. The tragic events at Yountville present the nation and its leaders with an opportunity to finally thank VHA caregivers for their service. (Suzanne Gordon, 3/22)