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They each remember that moment, just after dawn on a September day in 1991, when they walked out of the Frontier Hotel and Casino. There was music and singing — “Solidarity forever,” went the song. That first day, the atmosphere was more like a celebration than a work protest. But the strike would go on to last six years, four months and 10 days — one of the longest labor disputes in American history. There were fights along the picket line, with tourists throwing water and food at the strikers, who were more than willing to fight back. There were dozens of arrests. So much time went by that 107 babies were born to pickets and 17 people died during the strike. (Medina, 2/22)

In the days leading up to Saturday's Democratic presidential caucuses in Nevada, Bernie Sanders withstood one attack after another over his Medicare for All plan – both from his rivals and the state's powerful hotel and casino workers' union. But entrance polls from Edison Research showed more than 60% of caucus-goers favored replacing private insurance with a government-run plan, suggesting Sanders' sweeping proposal helped deliver his decisive win in Nevada rather than damaging his bid. (Ax, 2/23)

Members of Nevada’s most politically powerful labor group were warned by union leaders that Bernie Sanders’ plan would doom their prized health care, but they voted for him anyway. The casino workers of the Culinary Workers Union Local 226 are powerful enough in Nevada Democratic politics that special caucus sites are set up in Las Vegas Strip casinos to accommodate them. In at least four of those seven caucus sites Saturday, workers threw their support behind Sanders. (Price, 2/23)

Bernie Sanders struggled to provide details on exactly how he would pay for his sweeping proposals to expand health care, child care and more, and also brushed off questions about his age in an interview broadcast by CBS’ “60 Minutes” on Sunday. The Vermont senator heads to the South Carolina primary on Feb. 29 after crushing the field in Nevada and is considered the front-runner among the 2020 Democratic presidential field. (Dennis, 2/23)

Medicare for All is one of the most talked-about policy proposals of the 2020 Democratic primary — but could it ever happen?According to Paul Starr, a Pulitzer Prize-winning health economist who worked on the failed Bill Clinton health-care plan in the 1990s, the answer is: not any time soon. For one thing, extending the program for older and disabled Americans to everyone would consume so much of the federal government’s resources, it would require massive tax increases and turn the government into “a health insurance company with armed forces,” the Princeton economist said Friday at a health care cost conference held by the University of Pennsylvania’s Leonard Davis Institute. (Gantz, 2/21)

Under a system like "Medicare for All," there are questions about job loss and older insurance workers. Studies show that job retraining is less effective for older workers. (Jaffe, 2/22)

Kaiser Health News: Getting To The Heart Of Presidential Fitness: How Much Do We Need To Know?

Differences in health policy weren’t the only bones presidential candidates had to pick last week. They also sparred over details of their personal health. And with the next debate and Super Tuesday primaries fast approaching, these skirmishes are likely to escalate. In the run-up to the Las Vegas Democratic presidential primary face-off, Vermont Sen. Bernie Sanders’ national press secretary, Briahna Joy Gray, told CNN that opponents are trying to use his October heart attack against him. (Appleby, 2/24)

Sen. Elizabeth Warren said she would reduce federal funding to states that refuse to legalize marijuana and prevent “Big Tobacco“ from dominating the burgeoning industry in her wide-ranging plan to overhaul the country’s drug laws, which she announced Sunday in Denver. Warren‘s plan is not as detailed and aggressive as the blueprint outlined by Sen. Bernie Sanders, the frontrunner for the Democratic presidential nomination, who eviscerated the field in Saturday’s Nevada caucuses. (Fertig, 2/23)

The California Democrats who fought to flip Republican congressional seats in 2018 used health care as their crowbar. The Republicans had just voted to repeal the Affordable Care Act in the U.S. House — and Democrats didn’t let voters forget it. Two years later, Democrats are defending the seven seats they flipped from red to blue in California. And once again, they plan to go after their Republican opponents on health care in this year’s elections. (Ibarra, 2/21)

At least 34 people in the United States are infected with the coronavirus spreading from China, federal health officials said on Friday. “This new virus represents a tremendous public health threat,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said at a news briefing. But so far there has been no community spread of the infection in the United States, she added; all of the cases have been linked to overseas travel. But so far there has been no community spread of the infection in the United States, she added; all of the cases have been linked to overseas travel. (Grady, 2/21)

U.S. health officials on Friday said they are preparing for the possibility of the spread of the new coronavirus through U.S. communities that would force closures of schools and businesses. The United States has yet to see community spread of the virus that emerged in central China in late December. But health authorities are preparing medical personnel for the risk, Nancy Messonnier, an official with the Centers for Disease Control and Prevention (CDC) told reporters on a conference call. (Steenhuysen and Hay, 2/21)

"The day may come when we may need to implement such measures as seen in Asia," Nancy Messonnier, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said in a press conference, referencing the closing of businesses, schools, and churches in multiple countries where transmission is now occurring within the community. (Stephanie Soucheray, 2/21)

The White House will soon ask Congress for emergency funds to fight the coronavirus outbreak, after weeks of hesitation by the administration to press for additional funding, said four individuals with knowledge of the pending request. However, the amount could be significantly lower than some public health officials have argued is necessary — potentially as little as $1 billion, said two individuals, which could be rapidly exhausted by development of potential vaccines, widespread lab tests and numerous other investments. (Diamond, 2/22)

A group of Senate Democrats, led by Senate Minority Leader Charles Schumer (D-N.Y.), last week sent a letter to Health and Human Services (HHS) Secretary Alex Azar and Office of Management and Budget Director Mick Mulvaney urging the administration to request emergency funds to fight the spread of the virus. “We strongly urge the Administration to transmit an emergency supplemental request that ensures it can and will fully reimburse states for the costs they are incurring as part of this response — including costs associated with the enactment of travel screening and quarantine policies laid out by the Federal government,” the senators said. (Wise, 2/23)

The Trump administration is bracing for a possible coronavirus outbreak in the United States that could sicken thousands — straining the government's public health response and threatening an economic slowdown in the heat of President Donald Trump’s reelection campaign. That stark realization has taken hold in high-level White House meetings, during which some administration officials have voiced concerns the coronavirus is already spreading undetected within U.S. borders, two officials told POLITICO. (Diamond and Cancryn, 2/21)

President Trump was infuriated that 14 American citizens who had tested positive for coronavirus were permitted to return this week to the United States, said two senior administration officials. The decision had taken the president, a self-declared “germophobe,” by surprise. Officials at the State Department decided to bring back the citizens, who had been quarantined on the Diamond Princess cruise ship in Japan, after consulting with a senior official at the Department of Health and Human Services. (Wong and Rogers, 2/22)

The Trump administration has backed off plans to quarantine patients from the Diamond Princess cruise ship stricken with coronavirus at a federal facility in Alabama, the state's governor and a U.S. senator said on Sunday. The news came as worry grew over the spread outside China of the sometimes fatal virus, with a spike in the number of cases found in South Korea, Iran and Italy. Experts were baffled over outbreaks with no clear link to China. (Whitcomb, 2/24)

A court temporarily blocked the U.S. government from sending up to 50 people infected with a new virus from China to a Southern California city for quarantine after local officials argued that the plan lacked details about how the community would be protected from the outbreak. A federal judge issued a temporary restraining order late Friday to halt the transportation of anyone who has tested positive for the new coronavirus to Costa Mesa, a city of 110,000 in the heart of Orange County. U.S. District Judge Josephine L. Stanton scheduled a hearing on the issue Monday. (2/22)

The lawsuit’s allegation that as many as 50 people were diagnosed with coronavirus does not match up with the number of confirmed cases reported by the federal government on Friday. It remains unclear whether the lawsuit conflates with actual confirmed cases the people at risk of contracting the infection because they were in environments with greater exposure to the virus. (Abutaleb, 2/22)

Naval Base Ventura County at Point Mugu might be a landing spot for Americans suspected of being infected with the new strain of coronavirus. Late Sunday night, the U.S. Department of Health and Human Services said in a statement that the base could house travelers coming through Los Angeles International Airport. There, doctors would assess whether patients had contracted the COVID-19 virus, which has killed more than 2,600 people — mostly in China. (Oreskes, 2/23)

The scramble to find places to quarantine American coronavirus patients is beginning to run into resistance from local officials who do not want the patients housed in their backyards. The city of Costa Mesa, Calif., has gone to court to block state and federal officials, at least temporarily, from placing dozens of people evacuated from Asia in a state-owned residential center in their community. (Stockman, 2/23)

In the fraught months and years after the 9/11 attacks and the anthrax cases that followed, federal and state health officials began planning for the unthinkable — a disease outbreak that could affect millions and strain health care systems to the limit. Now health officials say that same planning has New Hampshire well-positioned to handle an outbreak of the coronavirus that has sickened tens of thousands of people and killed more than 2,200, the overwhelming majority of them in China. (Wickham, 2/22)

Two cases of coronavirus have been confirmed among evacuees from the Diamond Princess cruise ship quarantined at Joint Base San Antonio-Lackland, raising the total in San Antonio to three, the Centers for Disease Control and Prevention said Friday. (Caruba, 2/21)

As cases of the new coronavirus continue to spread around the world, Michigan health officials confirmed Friday that about 325 people in the state are being monitored for symptoms. Those people are not in a quarantine facility, said Lynn Sutfin, a spokeswoman for the Michigan Department of Health and Human Services. Rather, they are being asked to self-isolate at home because they are considered at moderate risk or low risk for contracting the virus now named COVID-19. (Shamus, 2/21)

The genetic code of the coronavirus that causes COVID-19 is only about 30,000 characters long, but what a story it tells. Those nucleotides conceal secrets of the virus’ past, including its origins, its passage among families and its journey to distant ports. They signal how long it has been at large and whether it can hide by infecting people who show no outward signs of illness. And they can point the way to medicines, vaccines and public health strategies that might bring a runaway crisis under control. (Healy, 2/22)

Top health experts from around the world are mobilizing to combat the novel coronavirus that has infected more than 77,000 people worldwide. The global health threat posed by the coronavirus has kicked the world's scientific community into overdrive as it races to develop a life-saving vaccine to fight the epidemic that has killed more than 2,300 people to date. (Cannon, 2/22)

A worsening coronavirus outbreak reportedly could threaten shortages of about 150 prescription drugs, several of them with no alternatives. China’s role in supplying the ingredients used in medications means that decreased Chinese production capability amid the outbreaks could threaten supplies of the drugs, which include antibiotics, generics, and branded drugs, two sources familiar with a Food and Drug Administration (FDA) list of at-risk drugs told Axios. (Budryk, 2/23)

The coronavirus outbreak in China has pulled vital medical resources and personnel away from regular procedures. This is causing complications for people who need treatment for other diseases. (Feng, 2/22)

China’s leaders postponed the biggest event on their political calendar, the National People’s Congress, as the country’s battle against the deadly coronavirus outbreak disrupts the ruling Communist Party’s agenda and hammers the domestic economy. Officials said Monday the key political meetings, originally due to take place from March 5, would be rescheduled. Analysts said the government in Beijing was worried about the optics of holding a large-scale public event while others lived under lockdown and thousands were sick. (Taylor, 2/24)

As of Monday, China's National Health Commission said it has received 77,150 reports of confirmed cases and 2,592 deaths on the Chinese mainland. More than 83% of the cases and all but one death were in Hubei province, where the outbreak emerged in its capital, Wuhan, back in December. Chinese authorities have since placed the city under lockdown. (Winsor, 2/24)

In a meeting on an unprecedented scale, Chinese President Xi Jinping said the coronavirus epidemic was the country’s most serious public health crisis and promised more pro-growth policies to help overcome it. According to state news agency Xinhua, Xi’s address via teleconference on Sunday was open to every county government and every military regiment throughout the country. He said the epidemic was “the fastest spreading, with the most infected and was the most difficult to prevent and control” since the founding of the People’s Republic. (Zheng, 2/23)

Chinese President Xi Jinping defended China’s efforts to contain the “grim and complex” coronavirus epidemic in the country Sunday. The Chinese president addressed officials leading anti-disease efforts in a video conference calling for them to take more steps to prevent the virus, revitalize the economy and stop the disease from affecting the planting of spring crops, according to the the Xinhua News Agency, The Associated Press reported. (Coleman, 2/23)

Earlier this month, the hard-hit town of Caohe, near the center of the coronavirus outbreak in central China, received an unexpected gift: a large donation from a Taoist nunnery 550 miles away. Another Taoist temple, this one in Caohe itself, contributed tens of thousands of dollars worth of medical equipment to help those sickened by the virus. “The moment believers heard the news, they called us and asked how to help,” said a nun who organized one of the fund-raising drives. (Johnson, 2/23)

Clutching a gray plastic suitcase filled with most of his belongings — a blanket, a toothbrush, a pair of white sneakers and a comb — Wang Sheng goes from factory to factory in southern China begging for a job. The answer is always no. Mr. Wang, 49, used to be able to find work in Shenzhen, a sprawling industrial megacity. But factories are turning him away because he is from Hubei Province, the center of China’s coronavirus epidemic, even though he hasn’t lived there in years. (Hernandez, 2/23)

A nurse called the 24-hour hotline to complain about a constant headache. A doctor said he was feeling ostracized by the public, even as he worked to save patients from the epidemic. One caller said she was feeling suicidal. The volunteers at Yong Xin Kang Yi (“Use your heart to fight the virus”), a crisis line established for the overworked, overstressed medical staff on the front lines of the coronavirus outbreak in China, listen to it all. (Kwai, 2/23)

Zhang Meng, a college student from Changchun, in China's eastern Jilin province, was concerned that her sudden weight loss was related to fear and anxiety over the coronavirus outbreak sweeping the country. So she called a hotline offering mental health assistance. (Baculinao, Shi, Wu and Talmazan, 2/23)

It wasn’t that Cai didn’t want to go back to work. The small factory owner had been anxious to get his 40 or so employees back to business, making electronic wires for sound systems, phone chargers and earphones. But the list of required documents to reopen his factory in Shenzhen in southeastern China was staggering: application for return to work, temperature records for every employee, protective equipment supply and distribution charts, records of workers’ travel, factory disinfection and inspection chart, case files on every employee’s disease prevention training. (Su, 2/21)

There are worrying signs the coronavirus outbreak is entering a new phase, with spread outside of China — until recently at low levels — beginning to rapidly pick up steam. Experts point to the sharp rise of the number of cases in South Korea, which went from 30 on Monday to 204 by Friday, and in Italy, which had no cases at the start of Friday and 16 at the end of it. Five of the infected people in Italy are health workers. (Branswell, 2/21)

Europe confronted its first major outbreak of the coronavirus as an eruption of more than 150 cases in Italy prompted officials on Sunday to lock down at least 10 towns, close schools in major cities and cancel sporting events and cultural touchstones, including the end of the Venice carnival. The worrisome spike — from fewer than five known cases in Italy before Thursday — shattered the sense of safety and distance that much of the continent had felt in recent months even as the virus has infected more than 78,000 worldwide and killed more than 2,400, nearly all in China. (Horowitz and Povoledo, 2/23)

Most of the 200 people who have been infected in Italy are in the wealthy region of Lombardy, concentrated in an area south of Milan. In 11 towns at the center of the outbreak—10 of them in Lombardy with a combined population of 50,000—residents are banned from leaving the area. The virus had also spread to other northern regions, prompting authorities to ban or restrict activities in an attempt to limit new infections. The regions affected by restrictions are home to more than 25 million people and include Italy’s core industrial regions around Milan, Turin and the hinterland of Venice. (Stancati and Sylvers, 2/24)

Officials have yet to track down the first carrier of the virus in the country. "We still cannot identify patient zero, so it's difficult to forecast possible new cases," Borrelli said at an earlier press conference. Strict emergency measures were put in place over the weekend, including a ban on public events in at least 10 municipalities, after a spike in confirmed cases in the northern regions of Lombardy and Veneto. (Borghese and John, 2/24)

Italy announced it would cancel its Venice Carnival, which would have run through next Tuesday, amid concerns about the novel coronavirus. The famed celebration was called off as part of measures in the region to prohibit large public gatherings after a third person in the country died from the virus, The Associated Press reported. Italy has seen 152 total cases, the largest number outside of Asia. (Budryk, 2/23)

President Moon Jae-in on Sunday put South Korea on the highest possible alert in its fight against the coronavirus, a move that empowers the government to lock down cities and take other sweeping measures to contain the outbreak. “The coming few days will be a critical time for us,” he said at an emergency meeting of government officials to discuss the outbreak, which in just days has spiraled to 763 confirmed infections and six deaths. “The central government, local governments, health officials and medical personnel and the entire people must wage an all-out, concerted response to the problem.” (2/23)

Cafes here demanded orders must be takeout or delivery. A typically bustling market hollowed out. The rare flicker of activity occurred at stores selling face masks, though most had run out. These are the scenes of eerie silence unfolding in Daegu, South Korea’s fourth-largest city and an epicenter for a coronavirus outbreak that skyrocketed to 763 cases on Monday morning—a roughly 25-fold rise in just five days. In response, President Moon Jae-in raised the country’s virus-alert system to the highest of four levels, calling it a severe situation that requires “unprecedented, powerful” measures. (Yoon and Martin, 2/23)

The World Health Organization (WHO) no longer has a process for declaring a pandemic, but the COVID-19 coronavirus outbreak remains an international emergency, a spokesman said on Monday. Fears of a coronavirus pandemic grew on Monday after sharp rises in new cases reported in Iran, Italy and South Korea, although China relaxed restrictions on movement in several places including Beijing as its rates of new infections eased. (Nebehay, 2/24)

The Geneva-based World Health Organization (WHO) said it no longer had a process for declaring a pandemic but the coronavirus outbreak remained an international emergency. "We are specially concerned about the rapid increase in cases in ... Iran, Italy and the Republic of Korea," WHO head Tedros Adhanom Ghebreyesus told a news conference in Sweden via video link. (2/24)

At the beginning of any disease outbreak, public health experts painstakingly trace the contacts of every person who becomes sick. The experts build a family tree of possible illness, with branches that include anyone who might have shaken hands with, or been sneezed on, by an infected person. But with confirmed infections approaching 80,000 people, tracing contacts on a case-by-case basis could soon be impractical. (Johnson, Sun, Wan and Achenbach, 2/22)

In South Korea, Singapore and Iran, clusters of infections are leading to a jump in cases of the new viral illness outside China. But it’s not the numbers that are worrying experts: It's that increasingly they can't trace where the clusters started. World Health Organization officials said China's crackdown on parts of the country bought time for the rest of the world to prepare for the new virus. (Ghosal and Neergaard, 2/21)

The inability to identify the first patient in mini-outbreaks outside China has officials concerned that the virus may be spreading too quickly for standard public health measures to be effective.(Johnson, 2/22)

Iran said on Sunday an Iranian infected by the new coronavirus died in the country, head of the Medical Science University in the Mazandaran province was quoted as saying, bringing the number of deaths to seven in the Islamic Republic. (2/23)

Pakistani officials said Sunday that the country had sealed its land border with Iran as a result of the outbreak there, though Islamabad made no official announcement. Pakistan is estimated to have the world’s second biggest Shiite population and about 500 people a day cross the border to Shiite-majority Iran. Travelers are being turned back by Pakistani authorities on the road as they approach the border, officials said. “This really is a new virus and we’re learning as we go along,” said Margaret Harris, a spokeswoman for the World Health Organization. “We’re seeing some cases that don’t have a clear epidemiological link,” she said. (Purnell, 2/24)

Countries around the world are working to contain the spread of the coronavirus. Here’s how masks and quarantines fight the virus. (Fox, Shin and Emamdjomeh, 2/19)

The Supreme Court on Friday allowed the Trump administration to move forward with plans to deny green cards to immigrants who are thought to be likely to become “public charges” by making even occasional and minor use of public benefits like Medicaid, food stamps and housing vouchers. As in a similar case last month, the vote was 5 to 4, with the court’s conservative justices in the majority. As before, the court’s brief order included no reasons for lifting a preliminary injunction that had blocked the new program. (Liptak, 2/21)

Sotomayor, who joined fellow liberal Justices Ruth Bader Ginsburg, Stephen Breyer and Elena Kagan in the minority, argued that cases have repeatedly been rushed to the Supreme Court without being “ventilated fully in the lower courts.” She went as far as to say that the practice is “putting a thumb on the scale in favor” of the party that won a stay -- a pointed dig at the Trump administration and her conservative colleagues. “Claiming one emergency after another, the Government has recently sought stays in an unprecedented number of cases, demanding immediate attention and consuming limited court resources in each,” Sotomayor wrote. “And with each successive application, of course, its cries of urgency ring increasingly hollow.” (Waller, 2/22)

Critics say the rules, which the administration plans to begin enforcing Monday, replace decades of understanding and would place a burden on poor immigrants from non-English-speaking countries. A judge had blocked the administration from implementing the new standards in Illinois, and the Supreme Court’s decision dissolves that order. As is common in such emergency applications, the majority did not explain its reasoning. (Barnes, 2/21)

"It's the administration saying let's get as close as we can to the 1924 act that restricted immigration from everywhere but Northern Europe," said Doug Rand, co-founder of Boundless Immigration who formerly worked on immigration policy in the Obama White House. (Kight, 2/23)

The court's move is a win for the Trump administration, and the White House said Saturday that it's "gratified" by the ruling. "This final rule will protect hardworking American taxpayers, safeguard welfare programs for truly needy Americans, reduce the Federal deficit, and re-establish the fundamental legal principle that newcomers to our society should be financially self-reliant and not dependent on the largess(e) of United States taxpayers," the statement released by the Office of the Press Secretary said. (De Vogue, 2/22)

The case heard by the court, Wolf v. Cook County, sought to reject the policy’s effect in Illinois. The district court filed a preliminary injunction, which temporarily halted the policy in the state and sent the case to the Supreme Court. On Friday, the five conservative justices ruled in favor of the stay, while the liberal justices opposed it. (Moreno, 2/22)

Since the rule was finalized in August, it has been the subject of multiple lawsuits over whether the Department of Homeland Security had the authority to issue the policy. Federal immigration officials may consider legal immigrants' use of public benefits, such as Medicaid, housing and other programs as a strongly negative factor in their permanent resident applications. The rule was set to go into effect on Oct. 15, 2019. (Teichert, 2/22)

The Trump administration dropped its appeal of a federal judge’s order Friday and agreed to provide mental health care to thousands of immigrant parents and children who were separated at the Mexican border by the administration’s “zero tolerance” policy. U.S. District Judge John Kronstadt of Los Angeles issued the injunction in November requiring the government to promptly provide mental health screenings for the parents and their families, and treatment for those who needed it. (Egelko, 2/21)

President Trump’s immigration policies — like travel bans and visa restrictions or refugee caps and asylum changes — have begun to deliver on a longstanding goal: Legal immigration has fallen more than 11 percent and a steeper cut is looming. While Mr. Trump highlights the construction of a border wall to stress his war on illegal immigration, it is through policy changes, not physical barriers, that his administration has been able to seal the United States. Two more measures were to take effect by Monday, an expansion of his travel ban and strict wealth tests on green card applicants. (Kanno-Youngs, 2/24)

Before the 2018 midterm elections, Senator Dean Heller stood with President Trump in the glittering Trump International Hotel near the Las Vegas Strip, looking out from the top floor, and pointed. “I said, ‘See those railroad tracks?’” Mr. Heller, a Nevada Republican who lost his seat later that year, recalled in an interview. Nuclear waste to be carted to Yucca Mountain for permanent storage would have to travel along the tracks, within a half-mile of the hotel, Mr. Heller said. “I think he calculated pretty quickly what that meant,” Mr. Heller said. “I think it all made sense. There was a moment of reflection, of, ‘Oh, OK.’” (Haberman, 2/23)

More than 50 personnel at McConnell Air Force Base in Kansas may have been exposed to dangerous levels of a compound linked to cancer that was found inside an aircraft hangar last year, according to internal memos. Contamination by hexavalent chrominium, the subject of the case featured in the movie "Eric Brockovich”, was documented in multiple base memos from October 2019 to January 2020, McClatchy reported. (2/21)

Over the past month, people in the Georgia town of Juliette have expressed fears that nearby Plant Scherer, America’s largest coal-fired plant, has caused their water to be contaminated with coal ash. Their outcry, along with a flood of statewide media coverage, has led local officials to offer free water to any local residents who need it. (Blau, 2/23)

HHS on Friday acknowledged that electronic health records pose a significant burden on clinicians and suggested tactics the federal government can pursue to ease the pain. The strategy, published by the CMS and the Office of the National Coordinator for Health Information Technology, was mandated by the 21st Century Cures Act. The agencies have been working on the strategy since mid-2017. A draft strategy was released in late 2018 and elicited more than 200 comments from the public. (Castellucci, 2/21)

HHS leaders in recent weeks have had harsh words for critics of two landmark—and controversial—proposals to regulate health data. That charged language signals the Trump administration’s commitment to finalized rules on interoperability and data blocking coming down the pike, said Dr. David Brailer, chairman of the healthcare education firm Health Evolution and former head of HHS’ Office of the National Coordinator for Health Information Technology. The ONC and the CMS released their companion proposals last February but have yet to publish final versions. (Cohen, 2/22)

California disputed a Trump administration assertion that the state is violating U.S. law by requiring insurers to cover abortion, after federal officials threatened to withhold funding if it doesn’t change its policy. California Democratic Attorney General Xavier Becerra wrote in a letter to the Department of Health and Human Services that the state’s abortion-coverage requirement wasn’t in violation of federal law. It also noted that California provided a religious exemption in 2015 to the mandate. (Armour, 2/21)

A coalition of church-affiliated pension funds and other religious investment groups that leverages billions of dollars in shareholdings to push for change in corporate boardrooms may be disrupted as the debate over abortion comes to a head in the U.S. Pressing for environmental, social and governance (ESG) change is a role religious investment groups have played since at least the 1970s, using their shares to press companies to lead when politicians won’t. The movement has enjoyed successes on issues auch as curbing the opioid epidemic, addressing climate change and President Donald Trump’s immigration policies. (Weiss, 2/21)

Severalstates have begun picking up the tab for family planning services at clinics run by Planned Parenthood, which last year quit a $260 million federal funding program over a Trump administration rule prohibiting clinics from referring women for abortions. States including New Jersey, Massachusetts and Hawaii already are providing new funding, and Democratic governors in Connecticut and Pennsylvania have proposed carving out money in state budgets to counter the effects of the national provider’s fallout with the Republican presidential administration. (Haigh, 2/21)

U.S. regulators on Friday approved a new type of cholesterol-lowering drug aimed at millions of people who can't tolerate — or don't get enough help from — widely used statin pills like Lipitor and Crestor. The Food and Drug Administration approved Esperion Therapeutics Inc.’s Nexletol for people genetically predisposed to have sky-high cholesterol and people who have heart disease and need to further lower their bad cholesterol. The daily pill is to be taken in conjunction with a healthy diet and the highest statin dose patients can handle, the FDA said. (Johnson, 2/21)

The drug, bempedoic acid, is the first in a new class of drugs to treat low-density-lipoprotein cholesterol, also called “bad” cholesterol, which causes the buildup of fatty deposits in the arteries, reducing blood and oxygen flow. Cardiologists said the new drug, which is taken as a pill once a day, will be used primarily as an add-on therapy for people who are taking as high a dose of statin medications as they can tolerate but still have higher-than-desired cholesterol. Studies showed that bempedoic acid reduced cholesterol by an average of 18 percent in patients taking moderate- or high-dose statins, compared with the placebo group, said the manufacturer, Esperion Therapeutics. (McGinley, 2/21)

The FDA approved this drug based on the fact that it can lower cholesterol, but it's still being studied to see if it will lower the risk of stroke and heart attack in patients who can't tolerate statins. Nexletol works by inhibiting cholesterol production. Compared to a placebo, the drug reduced LDL cholesterol by an average of 18% in patients who were also on a statin, studies showed. The company has also applied for FDA approval to use the drug as a combination pill with ezetimibe, another non-statin. In studies, that combination reduced cholesterol between 38% to 44%, the company said. That FDA decision is expected soon. (Christensen, 2/24)

Heart drugs have had a tough go of it in recent years. Repatha and Praluent, expected to be multibillion sellers, instead saw sales stagnate. Their makers took the unusual step of cutting the drugs’ prices by 60%. Entresto, a Novartis heart failure drug, had a slow start before sales took off. But now there is broadened interest. Amarin expects sales of its fish-oil-derived pill, Vascepa, of upwards of $650 million this year. And, early this year, Novartis spent $9.7 billion to buy The Medicines Company, which is developing a long-acting cholesterol lowering medicine. (Herper, 2/21)

The U.S. Food and Drug Administration approved Lundbeck A/S' migraine prevention therapy, which the Danish drugmaker acquired through its near $2 billion deal for Alder BioPharmaceuticals in 2019, the company said on Friday. For Lundbeck, the approval opens doors to a lucrative but competitive market dominated by already approved rivals from Amgen Inc, Teva Pharmaceutical Industries Ltd and Eli Lilly and Co. (2/21)

Kadmon (KDMN), the New York-based biotech, is developing the first drug designed specifically to target chronic [graft-versus-host disease.] In new but still preliminary clinical trial results presented Sunday, the Kadmon drug, a pill called KD025, showed meaningful reductions of chronic GVHD in two-thirds of patients — nearly all of whom entered the pivotal clinical trial after current treatment options stopped working. (Feuerstein, 2/23)

Pharmacy employees at Walgreens told consultants late last year that high levels of stress and “unreasonable” expectations had led them to make mistakes while filling prescriptions and to ignore some safety procedures. But when the consultants presented their findings at Walgreens’s corporate offices this month, there was no reference to the errors and little mention of other concerns the employees had raised. (Gabler, 2/21)

Kaiser Health News: Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids

Dr. Sudeep Taksali, an orthopedic surgeon, became worried that his 8-year-old daughter had already grown taller than his 12-year-old son. And sometimes she had an attitude more befitting a teenager. Something seemed wrong. Taksali and his wife, Sara, realized their daughter had grown 7 inches in two years and was showing signs of puberty. They took her to the doctor, who referred her to a pediatric endocrinologist for a work-up. (Lupkin, 2/24)

It was like any other convention in this city of neon and slot machines, except for all the guns. At the Shot Show, an annual gathering of the firearms industry in Las Vegas, flash drives shaped like military rifles were handed out. Influencers with large followings on Instagram and TikTok posed for selfies, Glocks in hand. Visitors took turns sitting in the “Freedom Throne,” an eight-foot chair made out of shell casings and other munitions from a company called Lucky Shot USA. (Hsu, 2/23)

The FBI would no longer be able to purge incomplete gun background checks from its systems if legislation by Rep. Jimmy Panetta becomes law. The California Democrat introduced the bill Friday in response to a CQ Roll Call report that revealed the bureau purges hundreds of thousands of background checks each year — a practice that could allow gun sales without a completed background check. (Eaton, 2/22)

Despite calls from civil rights groups to veto the legislation, Gov. Andy Beshear signed a bill requiring school police to carry guns. After Senate Bill 8 cleared the House earlier this month, Beshear had until Friday to either sign the bill, veto it or let it become law without his signature. (Krauth, 2/21)

In 1979, a man named Jerome Stone, frustrated with the lack of options and information about Alzheimer’s disease following his wife’s diagnosis, brought together experts and families affected by dementia to launch the Alzheimer’s Association. One of their goals: find a cure for the disease.Forty years later, an estimated 5.8 million Americans have Alzheimer’s, with a new person developing the condition about every minute of every day. There is still no treatment that slows progression of the disease, let alone stops or reverses it. (Joseph, 2/24)

Carrying around a lot of belly fat could not only create short term health problems but also put you at risk for dementia or Alzheimer’s disease as the fat itself creates inflammation in the brain... It turns out there is a connection between that extra fat and how the brain functions. Obesity seems to trigger inflammation in the brain that can affect cognitive function, according to research at the Medical College of Georgia at Augusta University. (Corwin, 2/22)

Millions of senior citizens in America are living with dementia, with the heavy burden of caregiving often left to family members. But a new adult day care center for those with dementia, called Town Square, may serve as a model for helping families cope with the costs and stresses that can come along with caregiving. (Murthy and Martelli, 2/23)

Yeming Shen called 911 on Feb. 10. He was alone in his Troy, N.Y., apartment, dying of the flu. But the garbled call was unintelligible to the operators, and police couldn’t pinpoint the phone’s location. For 45 minutes after Shen called 911, five police officers, three firefighters and a police dog searched in vain for the student. All they had was a general area encompassing two apartment buildings. They eventually gave up without finding Shen. Six hours later, the Rensselaer Polytechnic Institute student’s roommate discovered his body, the Times Union first reported. (Kornfield, 2/22)

One night in 2009, Madelaine Sattlefield lifted an 80-pound tray of letters carefully sorted by Missouri ZIP code. She had done this task thousands of times in nine years, but on this night, her arm seared with pain and went limp by her side. The tray crashed and sent envelopes cascading around her. She could barely move but immediately worried about what an injury might mean for her job. “Anxiety had kicked in. I was like, what are they going to say, what are they going to do?” Sattlefield said. (Jameel, 2/24)

ADNA microscope. A gene therapy for “bubble boy” disease.  The restoration of cellular activity in pig brains four hours after death. Nano-robots that might clean teeth better than flossing. These are just some of the 64 important discoveries and inventions included in this year’s STAT Madness, a bracket-style competition to honor the best biomedical research published in 2019. (2/24)

Nationwide, most people picked up by police for a misdemeanor while in a psychiatric crisis are taken directly to a hospital emergency department, where they typically are held for hours or days, often involuntarily confined, according to emergency department surveys. Many are charged and held in jail with no mental health professional to talk to and no access to psychiatric medicines. The same goes for people with drug addiction. In the past five years, that’s become a rarity in Arizona. As in other parts of the country, Arizona’s crisis centers are open 24 hours, seven days a week, and everyone is accepted, regardless of whether they have health insurance. (Vestal, 2/24)

We’ve long been schooled on the lifesaving value of early detection of a potentially deadly cancer. So when a simple blood test was introduced in 1994 that could detect the possible presence of prostate cancer, the second leading cause of cancer deaths among American men, it’s not hard to understand why it quickly became hugely popular. (Brody, 2/24)

If she hadn’t tripped over her neighbor’s dog, causing her to miss the step down into a sunken living room where she landed squarely on her left hip, Lynda Holland still might not know what was wrong. Holland scrambled to her feet, shaken and grateful she hadn’t been injured: Her puffy down coat had cushioned her fall onto the hardwood floor. Then she realized the pain that had dominated her life for the previous six years had suddenly diminished. (Boodman, 2/22)

Nicole Dodds first noticed her son, Rowan, was having trouble using the right side of his body when he was about 6 months old. Babies typically use both hands to pick up toys and lift their chest off the floor at that age, but Rowan was mostly using his left arm and hand, keeping his right hand balled in a fist. That started a string of doctor visits. Around Rowan’s first birthday, doctors did an MRI and diagnosed his one-sided weakness as hemiplegia, probably caused by a stroke he sustained in utero. This surprised Dodds, since as far as she knew she’d had a totally normal pregnancy and birth. (Witman, 2/22)

For women who haven’t gone into labor by 42 weeks, just about every medical and birth professional recommends induction — a jump-start to labor from medicines that ripen the cervix or contract the uterus. But Judith, an artist and freethinker who believes in “all that hippy jazz,” had a different kind of birth plan — one that dismissed medical recommendations and relied on nature and intuition, that rejected a sterile hospital for a warm pool in her own home and that avoided doctors and midwives. Instead, Judith wanted to be with only her husband and her closest friend, a plan known as freebirth, or unassisted birth, by the tiny subculture of women who practice it. (Zadrozny, 2/21)

It was about five years ago when Dallas-Fort Worth photographer Elaine Baca photographed her first birth. Until then, she had been primarily working weddings... According to the Centers for Disease Control and Prevention, the risk of pregnancy-related deaths for black women is 3 to 4 times higher than those of white women. "It's important for people to see and understand that black women and babies who are dying in childbirth are not just statistics put out by the CDC," Baca told "GMA." (Brown, 2/24)

Medicine is serious business. But for a growing number of patients, a trip to the hospital may include a laugh with a clown. Medical clowns — health-care workers who dress up and act like clowns to help make medical procedures and hospital stays less stressful — can be found around the world. The growing field relies on the age-old performance art of clowning to help lift the strain that can pervade the treatment of all-too-serious health concerns. (Blakemore, 2/22)

Though chocolate is typically divided into three categories: dark, milk and white, the latter two really should just be called “highly-processed interpretations of chocolate,” because that’s basically what they are. And it’s the processed sugars, salts and fats that make these varieties so tasty — which is also what makes them so addictive. (Spector, 2/23)

Older adults may have better success at losing weight if they do it with the help of intensive behavioral therapy from dietitians, a new study suggests. Intensive behavioral therapy for obesity, or IBTO, is a customized treatment that helps people change their eating and exercise behaviors through a series of one-on-one counseling sessions. (Rogers, 2/21)

Lydia Denworth wants you to make more time for your friends. We don't fully appreciate our friendships, says the science writer and author of the new book Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond. If we did, we'd take cultivating those intimate bonds as seriously as working out or eating well. Because, she writes, a new field of science is revealing that social connections play a vital role in our health. (Renken, 2/22)

Faith Trznadel was born without a tibia bone, and when she was 10 months old, doctors had to amputate her lower leg. “The hardest part is the staring, the snickering,” said Faith’s mother, Sheila Trznadel, about how other people treated her daughter. “One message to get across to people is it’s okay to ask questions. . . . It’s better to ask questions than just stare. [It’s] getting rid of that stigma.” (Furby, 2/23)

Is there such a thing as a healthful beverage? In truth, there’s not much of a health case to drink any beverage other than water after the age of 2 — despite the marketing and advertising you might have seen on the benefits of things like dairy milk, plant-based milks, juices and more. (Carroll, 2/24)

Downstairs at the medical examiner's office, the bodies lay side by side on stainless-steel tables and shelves, shrouded and anonymized in white bags, each person identifiable only by a protruding foot that had been toe-tagged. Upstairs, Luke Rodda, the chief forensic toxicologist, looked over his morning docket and the terse reports from first responders. Male, 33, "prior history of fentanyl overdose," found at bus stop. (Achenbach, 2/21)

She was in medical school. He was just out of prison. Sarah Ziegenhorn and Andy Beeler's romance grew out of a shared passion to do more about the country's drug overdose crisis. Ziegenhorn moved back to her home state of Iowa when she was 26. She had been working in Washington, D.C., where she also volunteered at a needle exchange. She was ambitious and driven to help those in her community who were overdosing and dying, including people she had grown up with. (Stone, 2/24)

Jocelyne Wood knows the effects that the opioid addiction crisis has had on lives across New Hampshire. Wood, the state director of Groups Recover Together, an opioid abuse treatment organization, said she was approached to come work for the organization a few years after her father died from an opioid overdose. (Fisher, 2/23)

Purdue Pharma, in bankruptcy and embroiled in thousands of lawsuits for its role in the opioid crisis, paid Connecticut doctors and nurse practitioners $394,662 in 2018, a slight drop of 9% from $433,246 the prior year, federal data show. But more significantly, the number of doctors and nurse practitioners who reported receiving payments shrunk by 51%, from 204 to 99. (Srinivasan, 2/21)

The parents of a 26-year-old California man who died of an opioid overdose have sued the Waltham manufacturer of Vivitrol, the medication he took to treat his addiction, in a case that highlights the controversies surrounding the response to the nation’s opioid crisis. The wrongful-death suit alleges Alkermes failed to warn of the high risk of overdose when patients stop taking Vivitrol and then relapse into opioid use. It also claims Vivitrol is ineffective and deceptively marketed. (Freyer, 2/23)

Four recent cases of neonatal herpes infection following a Jewish circumcision ritual have health officials once again urging parents in New York City’s ultra-Orthodox population to avoid the practice or at least limit its risks. Health officials on Sunday said there have been three cases of herpes simplex virus 1 infections in infant boys reported to the New York City Department of Health and Mental Hygiene since Dec. 1, 2019. The fourth case was reported in September 2019. (West, 2/23)

A controversial statewide bill inspired by two Millersville teenagers who suffer seizure disorders could ensure students across Maryland who qualify for medical marijuana get easier access during the school day. House Bill 617 would require the State Department of Education and the Natalie M. LaPrade Medical Cannabis Commission to develop written guidelines for public schools on administering medical cannabis during school hours, at school sponsored after-school events, and on school buses. (Sanchez, 2/24)

An investigation into inappropriate conduct at America's oldest school for deaf people corroborated multiple allegations of sexual and physical abuse that stretched decades, school officials said say. In a report, officials at the American School for the Deaf, in West Hartford, Connecticut, said Friday that the allegations involved former dorm supervisors, a maintenance worker, a dean and the school's longtime executive director. (Stelloh, 2/23)

Researchers at the University of New Hampshire took a closer look at the hippocampus, the part of the brain critical for long-term memory formation, and found that the neurons involved in so-called Pavlovian learning shift their behavior during the process and become more synchronized when a memory is being formed. According to a UNH news release, this finding helps people better understand memory mechanisms and it provides clues for the development of future therapies for memory-related conditions like dementia, autism and post-traumatic stress disorder. (2/23)

Lilia Garcia-Brower spent the past two decades fighting to make sure janitors got paid fairly. As executive director of Los Angeles’ Maintenance Cooperation Trust Fund, a statewide watchdog, she oversaw probes into unfair and illegal practices in the cleaning industry. Now as California labor commissioner, she is taking that same mission to the entire state, enforcing labor laws to ensure just pay and fair treatment for workers. Her staff of 700 investigates and adjudicates workplace violations ranging from unpaid wages to retaliation. (Said, 2/22)

It was a bewildering moment for Zach Jump, the American Lung Assn.’s national director of epidemiology and statistics. The numbers leaped off the computer screen and prompted an immediate question: How could California, a leader in reducing lung cancer cases, fall so short on early diagnosis and treatment of the disease? “It’s like you’d found the needle in the haystack of results,” Jump said. “I don’t know if anyone knew this was going to show up.” (Kreidler, 2/21)

A fourth person in Michigan has died from a vaping-related lung injury, the Michigan Department of Health and Human Services (MDHHS) announced. The department was notified of the death of an adult female on Feb. 19. No further information has been released for confidentiality reasons, according to MDHHS. (Spelbring, 2/21)

Wellstar Health System is looking for a partner to help transform Atlanta Medical Center... The nonprofit Wellstar took over the AMC facilities in its 2016 acquisition of five Tenet Healthcare hospitals in the area. The Marietta-based health system said it will explore a variety of strategic options for Atlanta Medical Center, which experts say could include a joint venture or even a sale. (Miller, 2/21)

It was long a common practice among some Baltimore-area police departments: Offer sexual assault victims a waiver form to document that they didn’t want to go forward with their case. Now some Maryland lawmakers want to ban police from using such waivers in sexual assault cases so that victims aren’t discouraged to report and prosecute the crimes. In some instances, experts say, detectives misused waiver forms to pressure victims to stop pursuing charges or to get cases off their plate without a thorough investigation. (Knezevich, 2/24)

Since 2013, at least nine maternity units across the state have closed and a 10th is slated to shutter in the coming months. Addressing this growing crisis requires a systems approach, providers in western and eastern North Carolina say. (Engel-Smith, 2/24)

After two high-profile cases of domestic violence, concerned Milwaukee leaders came together three times this week to talk about possible solutions. A critical question emerged: Had they diverted too many resources away from domestic violence? Last year, Milwaukee saw a continued decline in homicides, with 97 victims. Nevertheless, nearly 20% of those cases — one in five — had a link to domestic violence, a proportion that appears to be higher than before. (Luthern, 2/21)

When the new coronavirus COVID-19 first broke out, China’s healthcare system was unprepared. Hospital waiting rooms were so packed with prospective patients that hundreds more had no choice but to line up outside. Many waited several hours, only to be turned away and urged to self-quarantine. More troubling, experts say, is that the chaos of this initial surge likely did more to spread the disease than stop it. The same fate awaits us here if the new virus becomes a global pandemic. Hospitals in the United States are already so overburdened, and their staffs so overworked, that one bad flu season is enough to push them over capacity. (William Haseltine, 2/24)

If you’re looking for something to be on the edge of your seat about, the Centers for Disease Control and Prevention will start testing people with flu symptoms in five cities (New York, Los Angeles, Chicago, Seattle and San Francisco) to see if the Wuhan coronavirus has slipped around our defenses and taken root in the U.S. Or they could just wait for Bernie Sanders to come down with something. A 78-year-old man with a heart condition will be conducting five or six public events a day in coming weeks. In fact, he and his fellow Democratic candidates ought to be monitored as virtual blotters for any transmissible respiratory ailments that may be at large. (Holman W. Jenkins, Jr., 2/21)

On Tuesday, Feb. 18, no coronavirus cases had been reported in Iran. On Sunday, the government announced 43 cases and eight deaths. Some 152 cases (and at least three deaths) were confirmed in Italy on Sunday, up from three cases on Thursday. The number of infected people in South Korea jumped to 763 (and six deaths) in just days. As of Monday, Covid-19 was detected in at least 29 countries. In nations with few or no reported cases so far, particularly in South America and Africa, the absence of evidence shouldn’t be interpreted as evidence of absence. More likely, it reflects lack of testing. (Michael T. Osterholm and Mark Olshaker, 2/24)

Chinese authorities have placed an estimated 760 million people into lockdown as part of an epic campaign to contain the spread of covid-19, the novel coronavirus. As of Sunday, there were over 77,000 confirmed cases and more than 2,500 deaths in China, mostly in Hubei province. Wuhan, the provincial capital and the epicenter of the outbreak, has been hard hit. Why did China’s CDC system, once touted as among the world’s best disease control programs, fail to help contain the virus early on? And what has the crisis exposed about China’s system of governance? Here’s what you need to know. (Dali L. Yang, 2/24)

President Trump praises a “strong, sharp and powerfully focused” Chinese President Xi Jinping for his handling of the coronavirus outbreak. “President Xi strongly leads what will be a very successful operation,” Trump said. This offended some Americans. At a time when many Chinese are criticizing Xi for initially covering up the outbreak, should America’s president really side with a dictator who punished doctors rather than listening to them? (Nicholas Kristof, 2/22)

The COVID-19 coronavirus outbreak has made clear the urgency of developing a vital yet overlooked antidote to pandemics — democracy. While the virus spreads, China's crackdown on freedom of expression has created an environment where doctors are stifled, the free flow of information is curtailed, health recommendations are ignored and the death toll rises. This isn’t the first time I have witnessed how the authoritarian Chinese state has fueled the spread of deadly disease. (Adam Nelson, 2/23)

New research by Alyasah Sewell, a professor of sociology at Emory University, shows that stop-and-frisk and related police activity in New York City have a “spillover” effect — damaging the physical and mental health of residents in targeted neighborhoods. Combining New York City health survey data with a police database of stops, Sewell and co-author Kevin Jefferson found poorer health outcomes in neighborhoods with more street stops — including psychological distress, diabetes, and high blood pressure. (Akilah Wise, 2/21)

In August, the U.S. Food and Drug Administration proposed a rule to require 13 new warnings for cigarette packages and advertisements. The rule would place images on tobacco materials that warn of risks like cancer or heart disease, which would help spread important information to the general public. Many countries have already required such “graphic warnings.” And this isn’t the first time the FDA has attempted to require graphic warnings. In 2012, a similar effort was shot down by the DC Circuit Court, on the ground that the required warnings violated the First Amendment. (Patricia J. Zettler, Theodore L. Wagener, and Y. Tony, Yang, 2/21)

Republican voters have moved on from the Affordable Care Act, shifting their focus and opposition instead toward Medicare for All. By the numbers: In our latest Kaiser Family Foundation tracking poll, 19% of registered Republicans said opposition to Medicare for All is their top health care issue, compared to just 3% who said the same for opposition to the ACA. Republicans’ top issue overall is the same as the overall public’s: Reducing health care costs. Repealing the ACA was Republicans' top health care priority as recently as 2016. Yes, but: This does not mean attempts to repeal the ACA are over. (Drew Altman, 2/24)

Americans love stories about immigrants — especially when they are about our parents, grandparents, and great-grandparents. We admire these people’s courage and grit. We acknowledge their sacrifices and the vital roles they played in getting us where we are and building this country. My own grandfather, an immigrant from Mexico, worked as a taxi driver and a gravedigger, among other occupations, to support his family. Today we count professors and lawyers among his progeny. (Catherine S. Ramirez, 2/24)

As the father of three teenagers, as a son whose father lost his battle with cancer, and as a physician-scientist who specialized in cancer research for more than four decades, I was heartened by the recent and welcome news of continued declines in US cancer mortality rates, driven by continued reductions in tobacco use, increased early detection strategies, and the development of immune therapies. Even sharper declines can be realized by implementing more aggressive and comprehensive proven cancer prevention and control strategies. Up to half of cancers are preventable — they never have to occur. While cancer typically afflicts older individuals, most of cancer’s instigators plant their seeds during childhood. That means decisive action early in life can prevent cancer-related suffering and death for countless individuals as adults. (Ronald A Depinho, 2/24)

America's dreamland, California, has more recently acquired an association in the public mind with the social nightmare known as homelessness. In 2019, California’s homeless population grew by 21,306 people — more than the combined increase in all 49 other states — according to the U.S. Department of Housing and Urban Development. The California total of roughly 150,000 represents just over a quarter of the national figure, in a state that has one-eighth of the U.S. population. (2/23)

Two months have elapsed since my dear friend and housemate received a dreaded diagnosis. She has an advanced stage of Alzheimer’s disease. Since then, our most frequent topic of conversation, which she always initiates, is about her desire to end her life. My friend’s mind is still lucid enough to know what lies ahead, and it is not the final years she envisioned. She faces a long, slow journey into darkness .And here’s what’s frustrating: If she had gotten a diagnosis of cancer or another terminal disease, she would have had a way of sparing herself and her loved ones from prolonged pain and misery. (Ralph Shaffer, 2/23)

ObamaCare turns 10 next month, and one piece of its legacy was a nationwide surrender on controlling health-care costs. The law has accelerated consolidation among insurers and providers, who have in turn concealed prices and increased costs. Indiana is trying to change that. The state is planning final votes in the coming month on a slate of bills that would increase competition among providers and transparency on prices. In January, the state Senate passed a ban on gag clauses that insurers and providers sometimes use to keep employers in the dark about price and quality details. (2/23)

The Kaiser Family Foundation, a nonprofit organization based in San Francisco, just issued a state-by-state report called “Snapshots of health care in the U.S.”North Carolina wasn’t quite ready for its close up. In a range of categories, North Carolina — the nation’s 10th largest state with a population just over 10 million — is faring worse than the national average. (Ethan Hyman, 2/23)

Because of an unscripted, candid interaction I had a few weeks back with Vice President Mike Pence drew more than 4 million views online, I have the dubious distinction of being another target of the Trump Administration. This time, President Trump’s Medicare and Medicaid czar, Seema Verma – who also happened to be Pence’s Medicaid chief when he was Indiana’s governor – dismissed me as an “activist doctor.” Though Verma probably didn’t mean that as a compliment, I’ll happily wear the “activist doctor” label if it means standing up for my patients when policymakers threaten their healthcare. (Rob Davidson, 2/21)