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Plunging ahead despite paralyzing partisanship in the nation's capital, senior lawmakers of both parties Thursday proposed legislation to tackle surprise medical bills and other concerns, from prescription drug costs to uneven vaccination rates. The draft bill from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., echoes a time when health care issues often led to dialogue and cooperation between political parties. Alexander chairs the Health, Education, Labor and Pensions committee, while Murray is the ranking Democrat. (Alonso-Zaldivar, 5/23)

Washington finds itself having a genuine policy debate that isn’t driven by party line. The president gave a speech this month about the need for action, standing in front of patients who’d received huge surprise bills. Various lawmakers from the House and the Senate have introduced bills with solutions — all bipartisan. Some of them include elements that might seem unusual for Republican proposals: setting prices, if only in limited circumstances. Surprise bills — which occur when a hospitalized patient is treated by a doctor who is not in the same insurance network as the hospital, and is billed for the difference — aren’t tied to any of the political controversies about Obamacare. (Sanger-Katz, 5/24)

Kaiser Health News: Sen. Alexander Releases Bipartisan Plan To Lower Health Costs, End Surprise Bills

“These are common sense steps we can take, and every single one of them has the objective of reducing the health care costs that you pay for out of your own pocket,” Alexander said in a statement. “We hope to move it through the health committee in June, put it on the Senate floor in July and make it law.” It would be a mammoth piece of legislation, targeting nearly every area of the health care industry for reform, including surprise medical bills, prescription drugs, transparency, public health and health information. Alexander said at a White House event earlier this month that he hopes to get the package to the Senate floor by the end of July. (Bluth, 5/23)

The package contains nearly three dozen specific bipartisan provisions that will reduce the cost of what Americans pay for health care, Alexander said. It sidesteps controversial issues like ObamaCare repeal, Medicare for All and abortion funding. Aside from surprise billing, the package also aims to provide transparency to rebates between drug companies and the pharmacy benefits manager “middlemen.” The goal is to bring the package to the Senate floor this summer, and Alexander and Murray requested members submit comments on the bill by June 5. (Weixel, 5/23)

There would be no more "all-or-nothing" clauses where hospitals force insurers to contract with all their facilities by saying if they don't contract with all of them they can't contract with any. Hospitals could also no longer hide certain anti-competitive contract features from the employer plans they contract with. Plan sponsors would have to sign off on all contract terms before entering into an agreement with a hospital network or third-party administrator. The Government Accountability Office would be mandated to investigate profit-sharing between hospitals, contract management groups, specialty physicians and specialty physician contractors. (Luthi, 5/23)

But the draft legislation includes several aggressive proposals that have the potential to upend the controversial business model of drug industry middlemen known as pharmacy benefit managers. Most notably: The package would ban “spread pricing,” an industry practice that allows PBMs to pocket the difference between a pharmacy price and wholesale price from a drug maker. The surprisingly weighty drug-pricing policies in the Alexander-Murray package offer one of the best barometers yet of Congress’s willingness to pursue aggressive pharmaceutical industry reforms. And they stand a real chance of becoming law: The duo is known for advancing policies that eventually become law, and the White House in recent months has emphasized both high drug costs and surprise medical bills as priorities. (Florko and Facher, 5/23)

Landmark Texas legislation to protect unsuspecting patients from surprise medical bills and shield them from disputes between insurers and health care providers will soon head to the governor's office to become law. Gov. Greg Abbott has signaled support of the bill and is expected to sign it. The law would go into effect Jan. 1, 2020. ...The sweep of the law's scope has caught national attention as health economists have long tagged the state as having one of the worst records for surprise medical bills in the United States. But suddenly, with the passage of the law and others this session, Texas has been catapulted into having some of the strongest patient protections in the nation. (Deam, 5/23)

President Trump is expected to release an executive order as early as next week to mandate the disclosure of prices in the health-care industry, according to people familiar with the discussion. The order could direct federal agencies to pursue actions to force a host of players in the industry to divulge cost data, the people said. The administration is also looking at using agencies such as the Justice Department to tackle regional monopolies of hospitals and health-insurance plans over concerns they are driving up the cost of care, according to two people familiar with the discussions. (Armour, 5/24)

U.S. House of Representatives health committee leaders have drafted new reforms to Medicare Part D as Congress prepares for a final legislative sprint on drug pricing. On Thursday, the Democratic chairs and ranking Republicans of the Ways and Means and Energy and Commerce panels released the discussion draft of a bill to cap what people have to pay out-of-pocket for medications under Medicare Part D. (Luthi, 5/23)

The House Energy and Commerce and the Ways and Means committees’ draft bill would cap out-of-pocket costs in Medicare Part D, while increasing health plans’ share of costs in the catastrophic phase. The draft bill would cap patient cost-sharing at Medicare’s catastrophic spending threshold — set at $8,140 in 2019 — after which Medicare currently picks up 80 percent of the tab. The bill would also reduce the government’s obligation from 80 percent to 20 percent over four years, increasing financial pressure on health plans. Energy and Commerce Chairman Frank Pallone, D-N.J.; ranking member Greg Walden, R-Ore.; Ways and Means Chairman Richard Neal, D-Mass.; and ranking member Kevin Brady, R-Texas, released a joint statement touting the proposal. (Clason, 5/23)

Speaker Nancy Pelosi of California began taking House Democrats’ temperature this week on an approach to one of their long-held promises — government negotiation on Medicare prescription drug prices. But the outlines of the proposal leaders are discussing might not go far enough for many Democratic lawmakers.  In Medicare’s prescription drug benefit, Part D, private health insurers that administer the drug plans currently negotiate with drugmakers on price and coverage of their products. (Siddons, 5/23)

Both Reps. Dan Crenshaw of Texas and Pete Stauber of Minnesota have retreated from their campaign pledges on the issue — a sign, experts said, of both the political appeal of pledging to lower drug prices and the trepidation that comes with crossing the party line on a divisive issue. The political liability that comes with quickly abandoning a campaign-trail promise, too, could be substantial. (Facher, 5/24)

President Trump's new vow to cut off work with Democrats is threatening recent progress in bipartisan talks to lower drug prices. Staffers for the White House and Speaker Nancy Pelosi's (D-Calif.) office have been in discussions for months about potential legislation to lower the cost of prescription drugs, and sources say the White House has expressed openness to some form of Medicare negotiating drug prices, a major Democratic goal that Trump supported during the 2016 campaign before backing off. (Sullivan, 5/24)

Diabetics in Colorado who use insulin to control their blood sugar levels won’t pay more than $100 per month for the drug starting in January thanks to a bill signed into law by Gov. Jared Polis on Wednesday. “Today, we will declare that the days of insulin price gouging are over in Colorado,” Polis said in his office as he signed the bill, according to CBS Denver. Insulin has been around for nearly a century, but the price that patients with Type 1 and Type 2 diabetes pay for the drug has doubled since 2012, according to the Healthcare Cost Institute. The cost of insulin can creep up toward $1,000 for those whose health care coverage requires significant cost-sharing. (Staver, 5/23)

The Senate on Thursday passed a long-delayed disaster relief package, a step toward ending a monthslong impasse that had prevented the release of billions of dollars in aid for farmers and communities struggling to recover from an onslaught of natural disasters over the last two years. Minutes after a tornado warning blared through the Capitol chambers, the Senate voted 85 to 8 to allocate $19.1 billion for recovery efforts across the country. (Cochrane, 5/23)

The stalled aid package had faced several setbacks — including over Trump’s reluctance to provide more money to hurricane-ravaged Puerto Rico. More recently, talks stalled over a White House request for more border funding. The bill does not include the additional border funds the president sought. Among the Senators who voted against the bill — all Republicans — were Sens. Marsha Blackburn of Tennessee, Mike Crapo of Idaho, James Risch of Idaho, Mike Braun of Indiana, Mike Lee of Utah, Mitt Romney of Utah, Martha McSally of Arizona and Rand Paul of Kentucky. (Levine, Everett and Bresnahan, 5/23)

Shortly before the Senate voted on the plan, the president told reporters at the White House he did not want to hold up the disaster aid to get additional funding for his immigration priorities. (Mak and Snell, 5/23)

Republicans and Democrats both agree that the tobacco purchasing age should be raised from 18 to 21. But not everyone is on board with how to do it. A bipartisan tobacco bill Senate Majority Leader Mitch McConnell (R-Ky.) is pushing forward — that he’s called a top priority — is already running into roadblocks with some Democrats who argue it would allow the tobacco industry to unduly influence state laws on vaping and other products. (Levine and Owermohle, 5/23)

Connecticut Gov. Ned Lamont and fellow Democratic lawmakers reached an agreement Thursday to create a public option that will allow individuals and small businesses to purchase health insurance through the state. The proposal also calls for re-establishing the individual mandate—a centerpiece of the Affordable Care Act that required people to have health insurance or pay a penalty—that has since been eliminated at the federal level by Congress. The bill would also have the state seek permission from the federal government to buy prescription drugs from Canada and calls for taxing opioid manufacturers. (De Avila, 5/23)

To help pay for it, lawmakers want to re-establish the penalty for failing to comply with the federal health coverage mandate. The bill would effectively reverse– in Connecticut– Congress’ decision to remove the edict in the Affordable Care Act that all adults have health insurance, either through their jobs, Medicaid or by purchasing it directly. The statute would create a state mandate, which proponents estimate would raise $25 million annually in penalties paid by those who don’t comply with the requirement. (Carlesso and Phaneuf, 5/23)

A court has scheduled a July 9 hearing on a Texas-based judge's ruling that former President Barack Obama's signature health care law is unconstitutional. The 5th U.S. Circuit Court of Appeals in New Orleans set the hearing date Tuesday. The law's opponents want a 5th Circuit panel to uphold U.S. District Court Judge Reed O'Connor's 2018 ruling striking down the law. (5/23)

As Republican-led states pass laws restricting abortion in hopes the Supreme Court will overturn its Roe v. Wade decision, supporters of abortion rights are pushing back. Thousands of women who've had abortions have taken to social media to share their experience. Many argue they would have been worse off economically, had they been forced to deliver a baby. "I didn't know what I would do with a baby," said Jeanne Myers, who was unmarried and unemployed when she got pregnant 36 years ago. (Horsley, 5/23)

The Los Angeles County Board of Supervisors voted this week to impose a one-year restriction on travel to the state of Alabama for official county business in response to a new law in the Southern state that bans abortion in nearly all cases, including instances of rape and incest. Los Angeles County Supervisor Hilda L. Solis, who authored the motion to restrict travel to the state, said in a statement that Alabama's new anti-abortion law is an "attack not only confined to the residents of those states, but an act of aggression upon all of us." (Folley, 5/23)

In April, the Kansas Supreme Court said the state’s constitution gives women a right to abortion. That landmark ruling bolsters an ongoing lawsuit to expand access to abortion in Wichita. The case aims to clear the way for a clinic there — unable to find any willing, local doctors — to lean more on physicians in other states. Trust Women runs one of three clinics in Kansas where women can get abortions. It wants a district judge in Topeka to block the Sedgwick County district attorney and the Kansas Board of Healing Arts from prosecuting or taking other action against doctors who help it. (Llopis-Jepsen, 5/23)

Nearly one-third of abortions nationwide use pills; here in Massachusetts, that rate is even higher: about 40% are medication abortions.Primary care doctors prescribe plenty of other types of pills for patients. Lately, it seems more doctors are learning how to provide abortion pills as well. (Goldberg, 5/23)

The White House is pushing ahead with rules to tighten access to public benefits for immigrants, weeks after top aides to President Trump complained of slow-walking by Department of Homeland Security officials on such issues. A presidential memorandum published late Thursday instructed cabinet secretaries to seek repayment in cases where legal immigrants access means-tested services such as Medicaid, food stamps and cash payments in the Temporary Assistance for Needy Families program. (Radnofsky, 5/23)

Advocates are worried about two Medicaid programs that need additional funding before the end of the fiscal year — U.S. territories' programs and funding for safety net hospitals. The end of September marks a number of government deadlines, but advocates and government officials worry that a lack of funding for these two Medicaid programs would be worrisome and could be overlooked. (Raman, 5/24)

A lawsuit filed Thursday by a legal aid organization seeks damages against four Arkansas Department of Human Services officials in their personal capacities, contending they have failed to respond to requests to fix a problem in the way the department handles Medicaid recipients' appeals of benefit terminations. According to the lawsuit by Jonesboro's Legal Aid of Arkansas, the department routinely terminates the benefits of recipients who are found to be ineligible for services even when a recipient asks for the services to continue during an appeal of the department's determination. (Davis, 5/24)

Women are being passed up for promotions in healthcare as few make it to leadership roles, according to a new survey. More than half (55%) of nearly 200 hospital and health system executives said women in their organization have been overlooked due to gender, executive search firm Korn Ferry found. Nearly two-thirds ranked their development programs for women as fair, poor or non-existent, and 76% said their company does not have sponsorship programs to help women advance. (Kacik, 5/22)

Atrius Health reported a $38.7 million operating surplus in 2018, the largest not-for-profit independent medical group in New England announced Thursday. The operating income and 2.1% operating margin on revenue of $1.89 billion builds on Atrius' $24.4 million operating surplus in 2017. While the industry as a whole slowly tests payment models requiring them to take on risk, Atrius' performance validates its model, said Dr. Steve Strongwater, president and CEO of Atrius Health. (Kacik, 5/23)

The hearing, one of many held by Cleveland County District Judge Thad Balkman in the lead-up to next week’s trial, served as a sort of dress rehearsal for opening arguments Tuesday in Oklahoma v. Purdue Pharma, the first public trial to emerge from roughly 2,000 U.S. lawsuits aimed at holding drug companies accountable for the nation’s raging opioid crisis. It will be the first time Americans will hear the full scope of arguments on both sides in any of the lawsuits claiming that false and aggressive marketing by U.S. painkiller manufacturers caused an opioid overdose crisis that the U.S. Centers for Disease Control and Prevention says killed nearly 218,000 Americans between 1999 and 2017. (Vestal, 5/24)

JPMorgan Chase & Co has cut ties with Purdue Pharma LP over the OxyContin maker’s alleged role in the U.S. opioid crisis, forcing it to find a new bank to manage cash and bill payments, people familiar with the matter said on Thursday. The move makes JPMorgan, the largest U.S. bank by assets, the most high-profile corporation known to have distanced itself from Purdue and its wealthy owners, the Sackler family, amid thousands of lawsuits alleging the company pushed addictive painkillers while downplaying their abuse and overdose risks. (Spector and DiNapoli, 5/23)

Weighed down by the cost of opioid litigation, the American Pain Society is considering filing for bankruptcy and a decision is expected next week. In a May 20 letter to its members, the APS board of directors blamed financial problems that have been exacerbated by the mounting expenses associated with defending lawsuits filed by local, city, and state governments over the opioid crisis. Along with drug makers and wholesalers, the professional society was named as a defendant in many of the cases. (Silverman, 5/23)

Buprenorphine, a relative newcomer in the treatment of opioid addiction, is growing in popularity among California doctors as regulatory changes, physician training and other initiatives make the medication more widely accessible. The rate of Medi-Cal enrollees who received buprenorphine nearly quadrupled from the end of 2014 to the third quarter of 2018, according to data released by Medi-Cal, the state’s Medicaid program. The rate for methadone — an older and more commonly used drug — was almost unchanged from the end of 2014 through the last quarter of 2017, the most recent period for which data are available. (Rowan, 5/23)

Health officials in five states have warned people believed to be infected with measles and planning to travel that they could prevent them from getting on planes. All eight individuals agreed to cancel their flights after learning the officials could ask the federal government to place them on a Do Not Board List managed by the Centers for Disease Control and Prevention, said Martin Cetron, director of the agency’s Division of Global Migration and Quarantine, which tracks disease outbreaks. (Sun, 5/23)

Some fans attending Sunday's Indianapolis 500 can get measles vaccines at the track's infield medical center. IndyCar medical director Geoffrey Billows said Thursday a "very limited supply" of vaccines will be available at the medical building near the Indianapolis Motor Speedway museum. He says most insurance companies will cover the cost. (5/23)

Sen. Pat Roberts is partnering with two Midwestern Democrats to fight the spread of misinformation about vaccines in the face of measles outbreaks throughout the country. The Kansas Republican introduced legislation Thursday to instruct the Centers for Disease Control and Prevention to award competitive grants for public information campaigns aimed at combating the anti-vaccine movement. (Lowry 5/23)

The Keene-area child believed to be infected with measles was probably experiencing a reaction from the measles vaccine, and the public is not at risk of a measles outbreak, state health officials said. Earlier this week, state officials said that the child had visited a church and school in the Keene area and warned that those near the child were at risk of exposure. It was New Hampshire’s only supposed case of measles, and the news piggybacked on outbreaks in New York and California, where health officials blamed parents who did not immunize children against the disease. (Hayward, 5/23)

New York State health officials are considering rigorous new requirements for hospitals and nursing homes to prevent the spread of a deadly drug-resistant fungus called Candida auris. The requirements could include mandatory pre-admission screening of patients believed to be at-risk and placing in isolation those patients who are infected, or even those just carrying the fungus on their skin. (Richtel, 5/23)

[Alexandra] Glorioso is a reporter for Politico. She’s based in Tallahassee, Fla., and she writes about health care, insurance, and the state legislature. She covers stories like the push to expand Medicaid in Florida and legislative proposals to rein in drug costs. Last summer, at age 31, Glorioso was diagnosed with stage 2 breast cancer. She underwent chemotherapy, participated in a clinical trial with an experimental drug, and had surgery. Then, in March, she announced she was in remission, with no evidence of disease. This week, Glorioso talked with STAT about what the whole experience has been like — and how it shaped her thinking as a health care reporter. (Robbins, Garde and Feuerstein, 5/24)

An autistic man walks out of a store without paying for a toy he picked up. He's followed by a storekeeper demanding he come back inside. The situation quickly escalates, and police are called. Officers arrive, their patrol car's lights flashing and sirens blaring, to find the man in the parking lot, yelling and not responding to their commands. They have a choice: confront the man and risk having the situation turn violent or regroup to figure out a different approach. (Balsamo, 5/24)

Scientists have discovered yet another way that single-celled organisms have outsmarted us. The tiny bacteria that live inside our guts have an ingenious way of withstanding the onslaught of antibiotics we throw at them, according to a report published Thursday in the journal Science. The two-part system allows bacterial cells to stay alive until another bacterium can deliver a lifeline, packaged in a snippet of DNA. (Baumgaertner, 5/23)

She called it her “deepest, darkest secret,” one she had never even shared with her husband. When Saffiatu Sillah was growing up in the West African nation of Sierra Leone, her clitoris was cut off in a ritual circumcision. She was left with scar tissue that caused pain during sex and agony during childbirth. After her second child was born, Ms. Sillah, a pharmacist then living in Philadelphia, searched for medical help. Dr. Ivona Percec, a plastic surgeon at the University of Pennsylvania, said she thought an operation could ease the pain but might fail to uncover any remnant of the clitoris beneath the scarring. (Belluck, 5/24)

The National Institute for Occupational Safety and Health (NIOSH) is offering free and confidential screenings for black lung disease. NIOSH is traveling throughout the West and is in the Gillette area through Saturday as part of its Coal Workers' Health Surveillance Program. NIOSH is a part of the Centers for Disease Control. Black lung disease is an illness that affects a person's ability to breathe. Coal miners can develop the disease from breathing in dust in the coal mine environment. (Wheeler, 5/23)

Last spring, a study set the internet ablaze with sensational headlines promising an early death for those with nontraditional sleep schedules. It wasn’t the conclusion of the study, or its researchers. But in the bombastic world of science reporting, it didn’t really matter. Originally published in the journal Chronobiology International, the study looked at the chronotypes — a means of classifying one’s predisposition for sleeping at certain hours — of more than 430,000 people over a six-and-a-half-year period. (Clark, 5/23)

Earlier this month, a California jury awarded a couple more than $2 million in a dispute against Monsanto, ruling that the plaintiffs contracted non-Hodgkin lymphoma because of their use of Roundup. This is the third such case to end this way in California in the last two years. Bayer continues to defend the safety of the product and it's hard to know what to believe. (Woodbury, Nebbe and Nobriga, 5/23)

With exercise and everyday activities, and even our normal body weight, we are constantly putting stress on our bones. But that isn’t necessarily a bad thing, since stress causes microdamage to our bones that our body naturally repairs, and that continual repair process helps to make the bones stronger. However, “if you don’t give bones long enough to catch up, instead of getting stronger they’ll break down, and you accumulate enough injury that the bones can break,” Dr. Terry said. (Miller, 5/24)

Long before high school basketball star Anthony Harris tore his ACL in December, his father was doing his best to prevent his son from suffering the serious knee injury. Anthony Harris Sr. visited multiple doctors and trainers and asked what workouts were best for strengthening the knee. He had them run tests to see how vulnerable his son — a senior at Paul VI Catholic High in Fairfax City, Va., who is signed to play at the University of North Carolina next season — was to getting hurt. He built rest time into his training schedule. (Pell, 5/23)

It’s a question that the two 52 Places Travelers have fielded from readers and colleagues alike: How do you stay healthy when crisscrossing the world for nearly 365 days? And what do you pack in case you get sick? Each location has its own set of challenges, recommended vaccines and access to pharmacies. (Minsberg, 5/23)

It's easy for healthy lifestyles to go to the wayside when you're traveling, especially if you're on vacation. But it really is possible to have a good time, enjoy local cuisine and get in some exercise without depriving yourself of a true vacation. We’ll show you how to combine pleasure with wellness when you're on the road, because isn’t living your best life the point of a vacation in the first place? (Vora, 5/23)

The World Health Organization is publishing its first-ever global strategy to tackle the problem of snake bites, aiming to halve the number of people killed or disabled by snakes by 2030. Nearly 3 million people are bitten by potentially poisonous snakes every year, resulting in as many as 138,000 deaths. Last week, Britain's Wellcome Trust announced an 80 million-pound ($100 million) program to address the problem, saying there were new potential drugs that could be tested. (5/23)

After decades of complaints about a campus gynecologist, USC administrators hired a team of medical experts to evaluate him. The experts came back with a disturbing report saying there was evidence Dr. George Tyndall was preying on vulnerable Asian students and had signs of “psychopathy.” Still, the university did not fire Tyndall or notify the state medical board. (Hamilton and Ryan, 5/23)

Ohio State University and the state board that regulates physicians are trying a new strategy in hopes of being able to make more information public from the board's old investigation involving a team doctor who sexually abused students for two decades. Details about the mid-1990s State Medical Board investigation involving the late Dr. Richard Strauss have remained confidential under state law, but that might change if the parties involved waive their confidentiality. (Franko, 5/23)

The University of Maryland will have medical staff tending to the school's sports teams employed outside of the athletics department. This would include the head team physician, athletic trainers, nutritionists and mental health practitioners. The directive, announced Thursday, fulfills recommendations from an external safety review following the death last year of Maryland offensive lineman Jordan McNair, who collapsed during practice and subsequently died of heatstroke. (5/23)

The acting chief executive of the University of Maryland Medical System is pledging “significant changes” to senior staff after a scandal involving financial arrangements. The Baltimore Sun reports system CEO John W. Ashworth III met with Gov. Larry Hogan and House Speaker Adrienne A. Jones on Thursday. Ashworth III said the hospital network needs to undergo a “cultural shift” away from an environment in which board members won contracts for their private companies. (5/23)

Authorities have charged a Department of Veterans Affairs employee with secretly recording women in bathroom stalls in an office in downtown Washington, according to court documents filed in the case. Alex Greenlee, 24, of Alexandria, was charged with four misdemeanor counts of voyeurism. A D.C. Superior Court judge freed him Wednesday, pending a hearing June 25. (Hermann, 5/23)

Staff at a psychiatric hospital in San Leandro were punched, slapped, spit on and kicked — mostly by patients — in at least 80 separate instances over the last year, according to records kept by the agency that operates the facility. ...The union representing workers at John George Psychiatric Hospital has for years called for safer workplace conditions and more staffing, and is now pointing to the new data to cast light on the dangers of the job. (Goldberg, 5/23)

An incapacitated woman who gave birth after being a patient at an Arizona health care facility for more than two decades had been raped repeatedly and may have been impregnated before, her lawyers say. In documents filed Wednesday, the 29-year-old woman's attorneys cite a medical exam in alleging that she suffered multiple sexual assaults. The exam found that the birth of a baby boy last December was "a non-nulliparous event," the documents say, meaning she may have been pregnant before. (Romo, 5/23)

They proposed taxing soda, banning Big Gulps, prohibiting in-store discounts on soft drinks, banishing them from the front of convenience stores and slapping safety warning labels on all sugary beverages from Coca-Cola and sports drinks to sweet tea and chocolate milk. The soda industry responded by drastically ramping up its lobbying in the statehouse, more than tripling the amount it spent in the first three months of this year, compared with the same period last year. Now, as the Legislature hits the session’s halfway point, three of the anti-soda measures have fizzled. (Rosenhall, 5/23)

The federal government in recent months has banned transgender people from joining the military and made plans to roll back protections that could lead to insurance companies and doctors refusing to provide them health care. Colorado, meanwhile, is heading the opposite direction. ... the state Division of Insurance added a new regulation to the books that makes it against the law for an insurance company in Colorado to deny coverage for transgender care deemed medically necessary by a doctor, including hormones and surgeries. (Brown, 5/23)

SPIRIT serves people who cannot get help at the emergency room because their conditions, while life-altering, don’t rise to the level of life-threatening — at least not yet. Across the state and the country, charity groups, hospitals and community clinics are working to try to connect these patients to complex care that would otherwise be unattainable. For some, it means months — or years — of waiting for help. (Caiola, 5/24)

Exeter Health Resources, Wentworth-Douglass Hospital and Massachusetts General Hospital said Thursday their boards have agreed to a proposed merger agreement and that the parties have filed with the New Hampshire Charitable Trusts Unit, based on the letter of intent signed in May 2018. The agreement calls for the formation of a new, New Hampshire-based, regional, not-for-profit that will serve as the parent of both Exeter Health Resources and Wentworth-Douglass Hospital and will be part of the Massachusetts General Hospital family, according to a release. (5/23)

The deadline is awfully close. By law, June 1 is the day for most of the state’s hospitals, physician’s offices, mental health providers and others to be hooked into the state’s growing health information exchange, known as NC Health Connex. But for many small physicians’ offices and mental health providers that deadline was looking more like a dead end. If they were not able to get online or at least sign a participation agreement that obligated them to have an electronic health record system and be connected with NC Health Connex by June 2020, they would be unable to submit bills to state-funded health care systems, such as Medicaid and the health plan for state employees. (Hoban, 5/23)

Springfield, Ill.-based Memorial Health System is set to take on Decatur (Ill.) Memorial Hospital, the organizations announced Thursday. The 300-bed Decatur would be the second-largest hospital in Memorial's network, which includes Memorial Medical Center in Springfield, Passavant Area Hospital in Jacksonville, Abraham Lincoln Memorial Hospital in Lincoln and Taylorville Memorial Hospital in Taylorville, as well as Memorial Physician Services, Memorial Behavioral Health and Memorial Home Services. (Kacik, 5/23)

The rural Tennessee hospital purchased by a struggling Florida lab company last year is veering dangerously toward closure. West Palm Beach, Fla.-based Rennova Health bought Jamestown (Tenn.) Regional Medical Center from Community Health Systems in June 2018. It was a perplexing deal given Rennova had reported a $51 million net loss from continuing operations in 2017 and was being sued by landlords, contractors and employees over unpaid bills and wages. (Bannow, 5/23)

Drivers across the country are more likely to die on rural roads than city streets — but in these states, rural crash deaths are even more common than the national average, a new study finds. South Carolina had the highest rate of rural road deaths of any state in 2017, followed by California in the No. 2 spot, and then Arizona, Rhode Island, West Virginia, Tennessee, Kentucky, Louisiana, Kansas, Oregon and North Carolina, according to a report released on Wednesday by TRIP, an industry-funded transportation research nonprofit. (Gilmour, 5/23)

For almost five hours, the infant girl remained strapped in her car seat, forgotten in a day-care center van that was parked in the sun on a 91-degree day. According to authorities, the 4-month-old was picked up from her home on Wednesday morning along with other children headed to the Ewing’s Love and Hope Preschool and Academy in Jacksonville, Fla. But when her mother called at about 1 p.m. to make arrangements for her children, day-care employees realized the baby had never been checked in. (Epstein, 5/23)

Smoke 'em if you've got 'em — but not on the beach in New Jersey this summer. Smoking and vaping will be banned on nearly every public beach in the state this summer under tougher new restrictions. Nonsmokers are rejoicing over the ban, which also applies to public parks. But some smokers are feeling discriminated against by the law, which took effect in January. (Parry, 5/23)

Officials from the California Department of Justice on Thursday visited two of Los Angeles County’s troubled juvenile halls — a sign that conditions inside the facilities are drawing the attention of state monitors. The officials toured Barry J. Nidorf Juvenile Hall in Sylmar, where staff complaints and damage caused by detainees were the subject of a story in The Times on Sunday. The officials spent the morning at the facility with detention supervisors and county lawyers before heading to the Central Juvenile Hall, northeast of downtown L.A., about lunchtime. (Stiles, 5/23)

The toll – business and personal – had been high for the 41 people at Paradise Medical Group: They had lost the largest building on their small campus to the fire. The hospital where the group’s 12 physicians regularly saw patients was ravaged by fire and closed. (Anderson, 5/24)

After admitting they failed to adequately screen prisoners for the highly contagious disease, Florida corrections officials are challenging a federal judge’s order that found the agency was “deliberately indifferent” to inmates infected with hepatitis C. The state Department of Corrections last week filed a notice of appeal at the 11th U.S. Circuit Court of Appeals, the latest move in a drawn-out legal battle over the state’s handling of thousands of inmates with the liver-damaging disease. (Kam, 5/23)

A federal health agency says backyard chickens and ducks are the likely source of a multi-state salmonella outbreak that has sickened 52 people, including at least one person in Michigan. The Centers for Disease Control and Prevention (CDC) saidthat there have been 52 reported cases across 21 states. Five people have been hospitalized. No deaths have been reported. Those who became ill, the CDC said, reported being in contact with backyard poultry such as chicks and ducklings. More than a quarter of those infected are children under 5 years old. (Selasky, 5/24)

The push for these laws didn’t come out of nowhere. They’re part of an aggressive new strategy in the legal fight over abortion, which has escalated since Republican lawmakers swept state legislatures in 2010. Because of these efforts, it’s already more difficult to get an abortion in some parts of the country than it was a decade ago. (Amelia Thomson-DeVeaux, 5/21)

APRIL GROVE DOYLE, a 40-year-old single mom with metastatic breast cancer, pulled her car to the side of the road. Her face was flushed and her eyes puffy from crying, but she looked into the phone mounted on her dashboard and pressed the record button. (Michele Cohen Marill, 5/21)

Republican reluctance to embrace health care, despite the president’s best efforts, is understandable. (5/22)

Along the highways of states where support for abortion is at its lowest, it’s not uncommon to see road signs that say choose adoption and similar messages. The signs capture a preferred anti-abortion retort to outcries over abortion restrictions, like the kind Georgia and Alabama just passed: Women with unwanted pregnancies should find adoptive families. (Olga Khazan, 5/20)

A first-of-its-kind Obamacare “public option” will be implemented in Washington state after Gov. Jay Inslee last week signed into law a bill creating the new health care program. (Dylan Scott, 5/20)

The fight for gender equality is the great global cause of our time, affecting every man, woman, boy and girl. As a political appointee in the Trump administration, I spend my days supporting the president’s National Security Strategy, which calls on the United States to empower women as key drivers for global growth and stability. ... Full sexual and reproductive-health rights are a key factor in achieving women’s empowerment. We know that when women can choose whether to have children and how many children to have, their lives are improved. They are more likely to participate in the labor force and more likely to stay in school longer. They increase their earning potential. But, suddenly, the United States is in danger of moving in the opposite direction. (Kathryn C. Kaufman, 5/23)

I happened to be in Dublin last week when the Alabama Legislature voted to ban abortions. Foreign travel tends to enhance a person’s perception of what’s happening back home, and that was certainly true for me on this trip. It’s almost exactly a year since Irish voters, by an overwhelming two-thirds majority, threw off the shackles of the Roman Catholic Church and repealed the country’s constitutional provision banning abortion. (Linda Greenhouse, 5/23)

In the summer of 2016, it felt like all my ships were coming in: I’d secured a teaching job, and I was dating someone new. “Buy a lottery ticket!” a friend said. I did. Then, unexpectedly, I got pregnant. I’ve wanted to be a mom for as long as I can remember. Two years earlier, I’d had an IUD removed when a longtime boyfriend and I began discussing kids. Instead of having a baby, we broke up. And then things worsened: My finances crumbled. My dad got cancer.But then that golden summer came along. I almost believed I could win the lottery. (Alena Graedon, 5/23)

Regardless of when life begins, when it is viable, the state has a compelling interest in protecting it. Thus, when Hillary Clinton said in 2016 that an unborn child had no rights under the Constitution even up to the point of natural birth, she was basically arguing against the Roe v. Wade framework. Democratic political strategists have welcomed the Alabama law as a way to fire up their base and reset the abortion argument going into the 2020 election. But the simultaneous push for late-term abortion clearly works against them. (James S. Robbins, 5/24)

My 12-year-old daughter recently asked me what I think about abortion. She walked into the kitchen, poked around the refrigerator, then spun around and blurted it out: “I can’t decide what I think about abortion. I want to know what you think.” ... I took a deep breath. Her question took me by surprise, and yet I had been waiting for it since the day she was born. I always knew the time would come when I would have to tell my daughters the truth: I was raped. And I had an abortion. One day, you may face these challenges too. (Michelle Alexander, 5/23)

My iPhone’s Face ID function stopped recognizing me the day after my miscarriage, a hilariously modern alert that I’d never be the same person again. My cruel phone was home to three apps that informed me of every aspect of my pregnancy: The fetus was the size of a strawberry, recently graduated from raspberry status, which felt significant, fruit-wise. It was developing eyes and, more important, elbows. I knew everything there was to know about my growing baby, and I knew I was 10 weeks and six days pregnant when it came to an end. (Kristin Smith Sauchak, 5/23)

U.S. Customs and Border Protection announced Monday the death of a 16-year-old boy from Guatemala who had just days earlier crossed the southern border illegally as a so-designated “unaccompanied minor.” While only minimal details were released, the young man was likely headed to relatives waiting for him somewhere in the United States. CBP oversees the Border Patrol which, as required, had custody of the boy when he was noticed to be sick with respiratory symptoms and fever. He was seen by a nurse practitioner who diagnosed him with the flu and prescribed an anti-viral medication and fever control. (Irwin Redlener, 5/23)

A Guatemalan teen-ager died this week while in the care of the United States government — the sixth time this has happened since September. Once again, the government did not do its job. This matters to me because that child could have been me. My birth family is still in Guatemala. My birth mom cannot read, and with three children to care for, she has trouble finding and keeping a job. (Meir Stein, 5/24)

Vaccines don’t kill, but insisting otherwise can. Facebook, Google and Twitter know that — which is why, as measles outbreaks send children to intensive-care units across the country, they have all decided to do something about it. “Do something!” is exactly what people around the world have been saying to social media sites that, until recently, refused to accept responsibility for what happened on their platforms. That attitude is changing, but what “something” means is still up in the air. Do what, exactly, to whom? And will it help? (Molly Roberts, 5/23)

I sat silently in a school staff meeting recently while our faculty debriefed after last month’s active shooter training. All kinds of thoughts and emotions ran through me as I listened to colleagues brainstorming possible ways to prepare for an armed intruder roaming our building. Should we stash a hammer in our desk drawer for use as an improvised weapon? Keep a supply of feminine hygiene products on hand to stop the bleeding if someone is shot? Have students ready to throw books at the attacker? But the absurdity of the entire conversation really hit home for me when a well-meaning staff member suggested teachers be given bags of marbles to throw down in the hallway in the event of an armed prowler. Have we completely lost our marbles? (Justin Parmenter, 5/23)

During a recent and engaging presentation for patients on Medicare, I received a pamphlet listing crucial tests for people of a certain age. One recommendation rattled me: Men from age 65 to 75 who had smoked more than 100 cigarettes should have an ultrasound to rule out an abdominal aortic aneurysm. As a teenager, I did my share of stupid things, including smoking. Shouldn’t women be screened too? This felt like one more sign that medical bias is still seeping into women’s healthcare. (Emily Dwass, 5/23)

Mwende, a smart 13-year-old girl who dreams of being an engineer, was picking tomatoes in her backyard in the outskirts of Nairobi when a venomous puff adder bit her on the right arm. Although her father rushed her to the hospital, it lacked antivenom medication and the only way to save her life was to amputate her arm. This wasn’t an isolated incident. Mwende (not her real name) became part of an exploding global problem of snakebites. (Walter Ochieng, 5/24)

New York Times columnist David Brooks’ book, The Second Mountain, documents how he moved from midlife despair to personal fulfillment by seeking out individuals and groups who are rebuilding their communities through empathy-driven community action. ... Decades ago, prominent sociologists like Christopher Lasch (The Culture of Narcissism) and Robert Putnam (Bowling Alone) sounded alarm bells about the long-term consequences of rampant individualism. They feared the evisceration of the institutions that brought people together would undermine democracy. Those seeking to build a better healthcare system need to internalize that message. Our healthcare institutions routinely perform miracles for individuals who are sick. But it will remain a Sisyphean task as long as the patient pipeline is constantly refilled by social conditions that breed chronic disease, and providers’ sole strategy is to cure those ills one patient at a time. (Merrill Goozner, 5/23)

Senate Bill 1255, which was blocked in the Arizona Senate, would create a civil window for survivors of childhood sexual abuse to sue their perpetrators within the latter of 7 years from either turning 18, or from first reporting the abuse to licensed medical or mental health professionals.The current law provides that survivors have until age 20 to seek civil justice. That's not enough. (Gregory Kelly, 5/22)