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The House Judiciary Committee passed a measure Wednesday that would require background checks for all gun sales and most gun transfers within the United States, the most significant gun-control legislation to advance this far in Congress in years. The committee spent more than nine hours debating the bill before voting 21 to 14 to advance it Wednesday night. Next, it will face a vote on the House floor. The measure was among the first actions taken by the newly elected Democratic majority, which pledged to make gun control a top issue. The bill also has the support of at least five Republicans, a rare feat given the issue often has cleaved along party lines. (Zezima, 2/13)

The Judiciary Committee approved two bills that would expand federal background checks for firearm purchases. The legislation, which now heads to the House floor but stands virtually no chance in the Senate, makes good on Democrats’ promises to move swiftly to combat gun violence since taking control of the chamber this year. “There is a clear consensus among academics, public health experts and law enforcement personnel that universal background checks would greatly enhance public safety,” said Judiciary Chairman Jerry Nadler (D-N.Y.). “Despite the obvious need to take action, however, Congress, for too long has done virtually nothing.” (Stratford, 2/13)

Legislatures around the country have passed dozens of bills to address gun violence in the year since the 17 people died in a mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla. Many of the new laws already in effect added restrictions on owning a firearm. (Cotorno, 2/13)

On Feb. 14, 2018, a former student slaughtered 17 people at Marjory Stoneman Douglas High School in Parkland, Fla. The next day, David Hogg, a student who survived the attack, expressed his frustration at the pattern of political inaction that seems to follow mass shootings in the United States. He was not surprised that there had been another school shooting, he said, and that fact alone “says so much about the current state that our country is in, and how much has to be done.” “We need to do something,” he said. In the course of the next year, students would change the way the nation handles mass shootings, spurring new gun legislation and school safety measures, and holding to account the adults they felt had failed them. (Kramer and Harlan, 2/13)

Psychologist John Van Dreal has spent almost 30 years working with troubled kids. Still, it's always unsettling to get the kind of phone call he received one morning eight years ago as he was on his way to a meeting. "I got a call from the assistant principal at North [Salem] High, reporting that a student had made some threats on the Internet," remembers Van Dreal, the director of safety and risk management for Salem-Keizer Public Schools in Salem, Ore. (Chatterjee and Davis, 2/13)

The name “Parkland” has become a shorthand for the tragedy that many hoped would mark the beginning of the end of school massacres. But ask the survivors of the shooting at Marjory Stoneman Douglas High School in more quiet moments about the awful year since last Feb. 14, and they tell you a different, more personal story. About innocence lost. Dreams undone. Grief delayed. (Mazzei, 2/13)

The Marjory Stoneman Douglas High School massacre a year ago renewed the national debate on guns and school safety, turned some victims' parents and surviving students into political activists and at least temporarily ended the local sheriff's career. But Thursday's anniversary will primarily be about remembering the 14 students and three staff members who died in the third high-profile mass shooting in Florida since 2016. (Spencer, 2/14)

For a few weeks after their daughter Carmen was murdered at Marjory Stoneman Douglas High School on February 14, 2018, a week shy of her 17th birthday, April and Phil Schentrup could barely leave the house. They didn’t go to the vigils; they didn’t watch the CNN town hall on U.S. gun policy; they couldn’t even go to work. “We were just trying to get through a normal day, trying to get out of bed,” April told me when I spoke to her over the phone in January. (Deutch, 2/13)

In the despair after the Parkland school shooting, a single devastating moment shook so many Americans – when grieving mom Lori Alhadeff took a reporter’s microphone, looked at the camera and shared her pain with the world. “The gunman, a crazy person, just walks into the school, knocks down the window of my child’s door and starts shooting, shooting her and killing her,” Alhadeff said, her outrage growing with each word. (Adely, 2/13)

Events on Thursday, including art displays, tree plantings and candlelight vigils, will honor those who died. In Broward County, schools plan to observe a moment of silence at 10:17 a.m., the 17 representing the victims who were killed and the additional 17 people wounded. Some cities in the area plan the moment of silence at 2:21 p.m., the time the gunman first fired bullets in the rampage. Members of March For Our Lives, the student-led group that organized demonstrations after the shooting, said they planned to go dark—online and offline—for four days starting Thursday. “Like many in the Parkland community, March For Our Lives will be spending time with friends and family, remembering those we lost,” the group said in a statement. (Campo-Flores, 2/14)

Kimberly Krawczyk says she would do anything to keep her students safe. A year ago Thursday, the Parkland, Fla., high school math teacher barricaded students behind her classroom door during one of the deadliest mass shootings in U.S. history. But one of the unconventional responses that Broward County Public Schools said could stop another tragedy has left her deeply unnerved: an experimental artificial-intelligence system that would surveil her students closer than ever before. (Harwell, 2/13)

Some students have difficulty trusting classmates outside their circle. Parents say interactions with school staff are more impersonal. Teachers worry that added security detracts from learning. The Parkland massacre a year ago upended school life in Florida. In the year since a gunman fatally shot 14 students and three school staffers, the state's districts have reshaped the K-12 experience, adopting new rules for entering campus, hiring more police and holding frequent safety drills. Some schools trained teams of armed employees to confront attackers. (Gomez Licon, 2/14)

House and Senate Democrats unveiled a plan Wednesday that would allow anyone over age 50 to buy into Medicare — an incremental step to expand health coverage beyond Obamacare's gains that offers an alternative to the ambitious restructuring progressives envision in their push for Medicare for All. "I have always supported universal health care but we are not there yet," said Tammy Baldwin (D-Wis.), one of the co-sponsors. "Medicare at 50 is a very bold step in the right direction." (Ollstein, 2/13)

“This is something that is not pie in the sky or aspirational,” said Rep. Joe Courtney (D-Conn.), a co-sponsor of the buy-in bill. “This is a piece of legislation where you could turn the switch on overnight.” The measure was introduced by Sens. Sherrod Brown (D-Ohio), Debbie Stabenow (D-Mich.) and Tammy Baldwin (Wis.) and Reps. Courtney, Brian Higgins (D-N.Y.) and John Larson (D-Conn.). Meanwhile, progressive House Democrats are preparing their Medicare for all bill, which would largely eliminate the private insurance industry and move everyone into a single-payer, government-run system. (Hellmann, 2/13)

[Sen. Debbie] Stabenow, called it "an effort that could both be implemented right away … and has a lot of support and enthusiasm in the country." Stabenow has pushed similar legislation in the past but it hasn't gone anywhere. It still faces long odds in the Senate, which is controlled by a Republican majority, but a companion bill in the House has better odds this time around." (Spangler, 2/13)

Democrats behind the Medicare buy-in proposal don’t believe there is a tension between their approach and the push for a single-payer system. But they say their proposal is an alternative that is both workable and necessary, and wouldn’t require the same kind of drastic changes required for a broader overhaul. (Siddons and McINire, 2/13)

The concept of expanding Medicare coverage to not only seniors and disabled people but just about everyone, has recently shot up in popularity among Democrats and party activists at the national level. Among proponents of so-called Medicare for All, there are varying ideas for how such a government-paid and government-administered health insurance system would work and how exactly it would affect patients, doctors, hospitals and insurance companies. (Reindl, 2/14)

Democrats and Republicans on the House Energy and Commerce Committee on Wednesday signaled they could band together to slap clear consumer warnings on short-term limited-duration health plans. The bill by Health Subcommittee Chair Anna Eshoo (D-Calif.) aims to temper the Trump administration's move to let people keep short-term plans for up to three years. These plans offer limited benefits and the insurers can deny claims they deem as a symptom of a pre-existing condition. (Luthi, 2/13)

The Energy and Commerce Health Subcommittee on Wednesday offered a first glance at the type of legislation House Democrats will prioritize in their effort to shore up the 2010 health care law. The legislation would target a trio of Trump administration actions that Democrats say weaken the health law and may run counter to the statute. Those include Trump's expansion of short-term insurance plans; a guidance for states seeking to change their insurance markets; and budget cuts for outreach and enrollment programs. (McIntire, 2/13)

A coalition of state lawmakers and health organizations gathered in Annapolis Wednesday to rally support for a bill that would require Maryland residents to have health insurance or face a fine — money that could then be used to help them and others afford coverage on the state’s exchange. The proposed legislation, which is supported by groups representing the state’s doctors and hospitals, is being considered by the General Assembly as the federal government has stopped enforcing the Affordable Care Act’s requirement to have insurance, known as the individual mandate. (Wood, 2/13)

President Trump reportedly fumed at Sen. Chris Coons (D-Del.) last week at a private event before the National Prayer Breakfast, tearing into him over bills in New York and Virginia to extend abortion rights. Politico, citing three sources, reported that Trump "leaned in close" to Coons during the exchange. ... A White House official told Politico that the exchange shows how Trump “genuinely views abortion … and isn’t afraid to make the Democrats defend their extreme positions.” The official did not witness the interaction, and the White House declined to comment further, according to Politico. (Burke, 2/13)

The private episode underscored Trump’s recent public focus on abortion, which has delighted his evangelical Christian supporters. During his State of the Union address last Tuesday, Trump used vivid imagery to claim that New York’s new abortion law would “allow a baby to be ripped from the mother’s womb moments before birth.” And he accused Virginia Gov. Ralph Northam, who’s backed similar legislation in his state, of wanting to allow medical providers to “execute” babies after birth. Abortion is a somewhat unlikely new cause for a president who years ago called himself “very pro-choice” and did not make the issue a central theme of his 2016 campaign. But people close to Trump say that he has developed an increasingly sincere passion for the cause. (Orr, 2/13)

A Republican lawmaker in Arkansas, which has some of the strictest abortion prohibitions in the country, wants the state to go even further with a measure that would prohibit the procedure 18 weeks into a pregnancy. The proposed 18-week ban filed this week would further prohibit abortions in a state where the procedure is already banned at 20 weeks. The latest measure includes an exception for medical emergencies, but not for rape or incest. (DeMillo, 2/13)

Mississippi is working toward enacting one of the strictest abortion laws in the nation, in a race with other states to push a legal challenge to the more conservative U.S. Supreme Court. The Republican-controlled Mississippi House and Senate passed separate bills Wednesday to ban most abortions once a fetal heartbeat is detected, about six weeks into pregnancy. Efforts to pass similar bills are underway in Florida, Kentucky, Ohio, South Carolina and Tennessee. (Wagster Pettus, 2/13)

A bill introduced in the Kansas House this week would require abortion providers to inform patients that the effects of the abortion pill can be reversed, but pro-choice advocates and medical organizations say it’s not proven science. Medical, or non-surgical, abortions actually involve a sequence of two pills, the first being Mifepristone, better-known as RU-486. (Korte, 2/13)

Health and Human Services Secretary Alex Azar called for a review of the Indian Health Service following an investigation that revealed the agency’s mishandling of a pedophile doctor. The investigation, by The Wall Street Journal and the PBS series Frontline, detailed the career of Stanley Patrick Weber, a pediatrician who in 2018 was convicted of sexually assaulting Native American boys. The IHS transferred him from one agency-run hospital to another after officials concluded he was molesting children in 1995, and he continued working for the federal agency for 21 years. (Weaver and Frosch, 2/13)

Frontline and The Wall Street Journal investigate the decades-long failure to stop a government doctor accused of sexually abusing Native American boys for years, and examine how he moved from reservation to reservation despite warnings. (2/12)

The U.S. Environmental Protection Agency will announce on Thursdays limits on how much toxic chemicals from cookware and carpeting are allowed in drinking water. The agency will announce a plan to control a group of chemicals known as PFAS that are linked to cancer, liver and thyroid damage, and other health and fetal effects. The substances, which include PFOA and PFOS, are found in non-stick cookware, stain-resistant carpeting and other manmade materials. (2/13)

So-called forever chemicals, perfluoroalkyl and polyfluoroalkyl compounds, or PFAS, pose “a very important threat,” acting EPA Administrator Andrew Wheeler said in an interview with ABC News Live ahead of a scheduled briefing Thursday in Philadelphia. Wheeler said the agency was moving forward with the process under the Safe Drinking Water Act that could lead to new safety thresholds for the presence of the chemicals in water, but he did not commit in the interview to setting standards. (Knickmeyer and Flesher, 2/14)

A day after releasing two significant proposed regulations, leaders from the CMS and the Office of the National Coordinator for Health Information Technology spread out across HIMSS19 in Orlando to talk up what they say will finally put patients in the driver's seat. ...Through the two proposed rules—724 pages from ONC and 250 from the CMS—regulators intend to push the industry to make use of application programming interfaces to speed up how patients can access information on their mobile devices. (Weinstock, 2/12)

The CMS may use its innovation center to push early adoption of newly proposed transparency and data-blocking rules. While there are many ways to encourage transparency, HHS Deputy Administrator Adam Boehler said the center's models could "drive that sooner" with their advanced models. ...In his dual roles—heading CMMI and deputy administrator—Boehler has a comprehensive view of how the department can take on the cost problem. He noted that HHS has been studying kidney care, which could be addressed in CMMI or by looking at how the Health Resources and Services Administration impacts organ transplant. (Weinstock, 2/13)

A looming CMS final rule is expected to make clear that long-term care facilities can require residents or their families to agree — before a dispute arises — to settle complaints through arbitration rather than litigation. The rule, which late last month arrived at the White House budget office for review, could mark the end of a lengthy fight over legal protections for some of the most vulnerable patients in the health care system. (Roubein, 2/13)

U.S. Senators scolded real estate executives and Pentagon leadership over "unacceptable" conditions in privatized military housing on Wednesday, vowing urgent reform to protect service families from widespread health and safety hazards in base homes. At Senate Armed Services Committee hearings in response to Reuters reports describing U.S. military families facing squalid living conditions, lawmakers proposed fixes to hold private landlords and military branches accountable for hazards including peeling lead paint, mold and vermin infestations. (2/13)

A new survey of military families living on U.S. bases found most are dissatisfied with their housing, often citing serious health and safety hazards – results that counter years of Pentagon reports claiming soaring satisfaction rates among military housing tenants. The survey results, collected from nearly 15,000 families currently or recently living in privatized military housing, were released hours before Senate hearings called to probe living conditions on U.S. bases. (Pell and Schneyer, 2/13)

Thousands of migrant children continue to arrive at the Southern border every month, without their parents, to ask for asylum. The government sends many of them to an emergency intake shelter in South Florida. That facility has come under intense scrutiny because it's the only child shelter for immigrants that's run by a for-profit corporation and the only one that isn't overseen by state regulators. The Homestead "temporary influx facility" is the biggest and most controversial shelter for migrant children in the country. Critics say the government is warehousing kids in a makeshift prison camp. But on a recent tour, the shelter director took pains to show a different perspective. (Burnett, 2/13)

Journalists were given a glimpse Wednesday of a newly expanded south-Florida detention facility where nearly 150 teenage migrants sleep in rows of bunk beds in a large windowless room and use portable toilets housed in adjacent tents. The sleeping area in a converted Job Corps building in Homestead, Florida, is just part of the growing detention center operated by a private company for the U.S. Department of Health and Human Services. (Gomez Licon, 2/13)

Johnson & Johnson ’s Ethicon unit has reached a deal to buy medical technology firm Auris Health Inc. for about $3.4 billion in cash, expanding J&J’s push into the use of robotic technology for medical procedures and surgery. J&J said Wednesday that Auris’s technology will help it develop a digital solution addressing different parts of patients’ lung-cancer treatment. If certain milestones are reached, Auris could also receive as much as $2.35 billion more in the deal. (Prang and Loftus, 2/13)

Auris Medical Holding AG got a surprise boost to its stock price Wednesday as investors mistakenly bought shares of the drug developer after Johnson & Johnson agreed to buy a similarly named robotics company for $3.4 billion. Auris Medical rose 9.4 percent at 10:40 a.m. in New York after earlier rising as much as 30 percent. The last time the stock rose more than that was Jan. 23, when Bloomberg News first said that J&J was pursuing an acquisition of closely held Auris Health Inc. (Flanagan, 2/13)

Columbia Pacific Management Inc. is trying to sell a collection of hospitals in Asia for close to $2 billion, according to people familiar with the matter. The Seattle-based owner of hospitals and health-care facilities in the U.S. and around the world recently started a formal sale process for its Columbia Asia business, the people said. The first round of bids is due by the end of March, they added. Morgan Stanley is advising Columbia Pacific. (Venkat, 2/14)

Imerys Talc America Inc., which supplies talc for products including Johnson & Johnson’s baby powder, filed for bankruptcy protection in an effort to end nearly a decade’s worth of lawsuits claiming its product causes cancer. The unit of Paris-based Imerys SA and two other subsidiaries filed for Chapter 11 protection in Delaware Wednesday, citing the more than 14,000 claims the company faces in U.S. courts. Most have been brought by women alleging Imerys’s talc caused their ovarian cancer. Others say they have mesothelioma, brought on by asbestos in the talc. (Feeley, Fisk and Church, 2/13)

Monsanto Co. has been sued by thousands of farmers and others who blame their cancers on its massively popular Roundup weedkiller. Now Germany’s Bayer AG, which bought the agriculture giant last year, faces a claim that it deceived home gardeners about Roundup’s impact on their gut bacteria and their health. The lawsuit, filed Wednesday in federal court in Kansas City, Missouri, claims that labels on products such as Roundup’s Weed & Grass Killer falsely assured consumers that they target an enzyme not found “in people or pets.” (Mulvany and Shanker, 2/13)

At a minimum, the Oklahoma trial would for the first time give the press and the American public full access to evidence and arguments aimed at showing that drug companies flooded local markets with opioid painkillers for more than a decade while knowing that the pills were highly addictive. In the case, which was filed in 2017, attorneys representing Oklahoma will present evidence and expert testimony to support the state’s claim that OxyContin, Vicodin, Percocet and other prescription pain medicines that drugmakers falsely claimed were safe led to the deaths of thousands of Oklahomans. (Vestal, 2/14)

Aaron Francisco Chavez swallowed at least one of the sky blue pills at a Halloween party before falling asleep forever. He became yet another victim killed by a flood of illicit fentanyl smuggled from Mexico into the Southwest — a profitable new business for drug gangs that has pushed the synthetic opioid to the top spot for fatal U.S. overdoses. Three others at the party in Tucson also took the pills nicknamed “Mexican oxy” and police flagged down by partygoers saved them by administering naloxone overdose reversal medication. But the treatment came too late for Chavez, who died at age 19. (Snow, 2/14)

While the state and nation are seeing fewer deaths tied to heroin overdoses, synthetic opioids like fentanyl are contributing to more deaths, and there are concerns they're appearing in other non-opioid drug supplies. An analysis released Tuesday by the University of Minnesota has found that overdose deaths that involve heroin may be leveling out in the country, although states are seeing an increase in overdose deaths involving drugs like cocaine and methamphetamine. (Collins, 2/13)

Federal prosecutors alleged in court on Wednesday that a company at the center of a criminal investigation stemming from the nation's opioid epidemic used a music video to motivate employees to push sales of a highly addictive fentanyl spray. Former executives and managers of Insys Therapeutics are accused of bribing doctors to prescribe the drug. Those former Insys executives and managers are charged with conspiring with one another to use bribes and kickbacks for doctors who wrote large numbers of prescriptions. The video shown in court Wednesday is just one piece of mounting evidence in the case. (2/13)

Two young Insys Therapeutics salesmen wearing sunglasses and hoodies danced next to a giant spray bottle depicting the drug firm’s opioid product, in a thumping rap video made to prod sales representatives to get more doctors to prescribe the addictive painkiller. “Insys Therapeutics, that is our name,” the associates sang. “We’re raising the bar and we’re changing the game. To be great it takes a decision, to be better than the competition.” (Saltzman, 2/13)

Insys Therapeutics Inc. founder John Kapoor was so determined to get back the millions he spent launching the company that he led Insys on a disastrous path of pushing its addictive opioid drug on patients who didn’t need them, his former chief executive officer testified. The way Kapoor ignored his subordinates, “you really don’t want to push back because once he makes up his mind, the decision is done,” Michael Babich told a Boston jury at Kapoor’s racketeering trial on Tuesday. His demands contributed to a shift in marketing strategy after the company’s fumbled launch of its Subsys painkiller in March 2012, Babich said. (Lawrence and Feeley, 2/13)

A top U.S. health official said Wednesday that the government will launch an “artificial intelligence health outcomes challenge” to spur private investment in the technology and help rethink the delivery of medical care. Adam Boehler, head of Medicare and Medicaid’s innovation institute, said the goal of the initiative is to drive broader uptake of AI to help root out wasteful care, improve quality, and cut costs. (Ross, 2/13)

By now everyone’s heard about the potential of artificial intelligence in medicine to revolutionize things like interpreting medical data and predicting patient outcomes. And everyone’s probably heard plenty, too, about how much hype is out there about what these algorithms can actually do. But what does the evidence say? Dr. Eric Topol, a cardiologist and geneticist at the Scripps Research Institute in San Diego, recently published a review article in the journal Nature Medicine in which he sifted through the research available on AI in medicine. He wasn’t impressed. (Robbins, Feuerstein and Garde, 2/14)

Distrust of vaccines may be almost as contagious as measles, according to medical anthropologist Elisa Sobo. More than 100 people have been infected with measles this year, according to the Centers for Disease Control. Over 50 of those cases have occurred in southwest Washington state and northwest Oregon in an outbreak that led Washington Gov. Jay Inslee to declare a state of emergency on Jan. 25. Some public health officials blame the surge of cases on low vaccination rates for this highly infectious disease. (Gordon, 2/13)

As a disturbing number of measles outbreaks crop up across the United States, Facebook is facing challenges combating widespread misinformation about vaccinations on its platform, which has become a haven for the anti-vaccination movement. The World Health Organization recently named “vaccine hesitancy” as one of the biggest global health threats of 2019. But on Facebook, in public pages and private groups with tens of thousands of members, false information about vaccines — largely stemming from a debunked 1998 study that tied immunizations to autism — is rampant and tough to pin down. In the bubble of closed groups, users warn about alleged dangers of vaccinations, citing pseudoscience and conspiracy theories. (Telford, 2/13)

In early October, three cases of measles were confirmed in Antanarivo, the capital of Madagascar. The highly contagious virus quickly spread across the island nation; by the next month, thousands of cases had been confirmed. The crisis only grew from there. Madagascar has poor health-care infrastructure and a low vaccination rate. But public health experts say its dangerous measles outbreak still offers a warning for anti-vaccination campaigners in the United States, where a smaller-scale flare-up has led to more than 100 confirmed cases since the beginning of the year. (O'Grady, 2/13)

Modern science is largely a team sport, and over the past few decades the makeup of those teams has shifted, from small groups of collaborators to ever larger consortiums, with rosters far longer than that of the New England Patriots. Answering big questions often requires scientists and institutions to pool resources and data, whether the research involves detecting gravitational waves in deep space, or sorting out the genetics of brain development. But that shift has prompted scientists to examine the relative merits of small groups versus large ones. Is supersizing research projects the most efficient way to advance knowledge? What is gained and what, if anything, is lost? (Carey, 2/13)

Nobody likes a cockroach in their house. But before you smash the unwelcome intruder, consider this: that six-legged critter might one day save your life. That's right. Insects—long known to spread diseases—could potentially help cure them. Or rather, the microbes living inside them could. Scientists have discovered dozens of microorganisms living in or on insects that produce antimicrobial compounds, some of which may hold the key to developing new antibiotic drugs. (Chisholm, 2/13)

On March 7, 2016, doctors at the Cleveland Clinic introduced the nation to Lindsey McFarland, the first person to undergo a successful uterus transplant in the United States. Within hours, however, McFarland was back in surgery: A life-threatening infection forced the organ’s removal, crushing hope she might one day give birth. McFarland later learned the culprit was Candida albicans, a fungus common in women’s reproductive tracts. In her, it flared into a raging infection that damaged at least two of her arteries, including one that supplied blood to the newly implanted uterus. (Bernstein, 2/13)

Chronic inflammation in middle age may lead to memory and thinking problems later in life. Unlike acute inflammation, which arises in response to injury, chronic inflammation persists over months or years. Autoimmune disease, lingering infection, exposure to polluted air, psychological stress and other conditions can all promote chronic inflammation. (Bakalar, 2/13)

A kindergarten boy’s behavior could predict his income as an adult, a new study has found. Kindergarten teachers in the poorest neighborhoods of Montreal rated 920 6-year-old boys using scales measuring inattention, hyperactivity, defiant behavior, aggression and prosociality (the tendency to help someone being hurt, stop quarrels or invite a bystander into a game). Researchers then gathered information on earnings from tax returns at ages 35 to 36. The study is in JAMA Pediatrics. (Bakalar, 2/13)

Kaiser Health News: Seniors Aging In Place Turn To Devices And Helpers, But Unmet Needs Are Common

About 25 million Americans who are aging in place rely on help from other people and devices such as canes, raised toilets or shower seats to perform essential daily activities, according to a new study documenting how older adults adapt to their changing physical abilities. But a substantial number don’t get adequate assistance. Nearly 60 percent of seniors with seriously compromised mobility reported staying inside their homes or apartments instead of getting out of the house. (Graham, 2/14)

A jury ruled Wednesday that an Iowa prison warden discriminated against a transgender employee by denying him the use of men’s restrooms and locker rooms in a verdict that advocates call “historic.” Jurors also found that the state executive branch discriminated against Jesse Vroegh by offering medical benefits that would not cover his gender reassignment surgery. After making those findings, the eight-member jury awarded $120,000 in damages for emotional distress to Vroegh, 37, a former nurse at the Iowa Correctional Institution for Women in Mitchellville. (Foley, 2/13)

Gender identity — or the gender a person identifies as, no matter what sex organs he or she was born with — has been included in the Iowa Civil Rights Act since 2007, meaning transgender Iowans have legal protections against discrimination in education, employment, housing and public accommodations. (Crowder, 2/13)

The piercing wail of an ambulance, the one that disturbs sleep and triggers dogs to howl, should be replaced with the more European, two-tone sound, according to New York City council members who are expected this week to introduce legislation that would mandate a citywide siren change. (West, 2/13)

New Mexico reversed course Wednesday on its plans to charge some patients covered by Medicaid a monthly insurance premium of $10 and co-payments of $8 on certain brand-name drugs and visits to the emergency room for routine medical care. Democratic Gov. Michelle Lujan Grisham announced in a new release that the state will seek federal approval to reverse cost-sharing and enrollment provisions instituted by her Republican predecessor that were designed to conserve state spending on Medicaid. (Lee, 2/13)

Akron’s Summa Health System announced this week it achieved the Healthgrades 2019 America’s 250 Best Hospitals Award. The distinction places Summa Health’s clinical performance in the top five percent of more than 4,500 hospitals assessed nationwide as measured by Healthgrades, a Denver-based online resource for information about physicians and hospitals. (Goist, 2/13)

California Gov. Gavin Newsom says he’s done waiting for the federal government to curtail the rising cost of prescription drugs. Newsom has his own plan to ease that financial burden — one he hopes other states can join or replicate. The Democratic governor said he intends to use California’s might as the world’s fifth-largest economy to demand lower prices directly from drug companies for millions of Medicaid enrollees, state government workers and, eventually, Californians in the private sector. (Young, 2/14)

The agency that accredits the nation’s hospitals has asked the University of Maryland Medical Center for a review of the Feb. 4 shooting of an employee in the affiliated School of Medicine just outside the hospital. The 24-year-old victim was near an ambulance bay off Redwood Street when he was shot in the face and buttocks by a man police say he knew. He was taken into the medical center’s Shock Trauma Center in critical condition, roiling both the university and hospital staffs as well as the larger Baltimore medical community. (Cohn, 2/14)

Officials at Massachusetts’ health care watchdog agency Wednesday indicated that they will not conduct a rigorous review of Partners HealthCare’s latest proposed acquisition, saying the deal would have little effect on residents in the state.Partners, Massachusetts’s largest network of doctors and hospitals, is seeking a takeover of Care New England Health System of Providence. The Massachusetts Health Policy Commission has studied — and has criticized — Partners’ past expansion plans. But this transaction is different because its greatest effects would be felt in Rhode Island. (Dayal McCluskey, 2/13)

In the run-up to the 2019 legislative session, the leaders of both the House and the Senate asked committees to study the state jail system, which holds around 21,500 inmates in 17 jails, according to the House Committee on Corrections. That led to a report from the House Committee on Criminal Jurisprudence that referred to the system as a “complete failure,” and lawmakers in both chambers listed bolstering local pretrial and probation initiatives as a top priority. (Marfin, 2/14)

The insurer drug protocols that the Atlanta family faced are known as “step therapy.’’ They require that a patient “try and fail” on one or more meds before insurers provide coverage for a drug that was originally prescribed. The House Insurance Committee on Wednesday passed legislation that would help patients obtain exceptions to these drug requirements. (Miller, 2/13)

Despite concerns about safety and potential effects of competition on hospitals, the Senate Health Policy Committee this week unanimously passed a measure (SB 448) by Chairwoman Gayle Harrell, R-Stuart, that would authorize “advanced birth centers” and allow them to offer certain women access to Caesarean deliveries and epidurals. The bill would allow the facilities to keep women for up to three days. (Rodriguez, 2/13)

House Bill 19-1122 would make several significant changes to Colorado’s Maternal Mortality Review Committee. The most important change, according to the bill’s sponsors, is giving committee members protection from being subpoenaed in malpractice lawsuits, which means they could get better, more honest answers and review deaths as they happen rather than waiting at least three years to investigate. (Staver, 2/13)

Connecticut is taking a slightly different approach in its litigation against Purdue Pharma than Massachusetts, whose amended lawsuit against the Stamford-based company detailed scandalous allegations against its owners, saying they personally contributed to the nation’s opioid epidemic. But both states say they are after the same thing– they want to hold Purdue Pharma and the enormously wealthy Sackler family accountable for their role in a national epidemic. (Radelat, 2/13)

Called the ABLE Savings Plan, it allows parents and adults to set aside money in a special account for a broad range of living and educational expenses without jeopardizing disability funding, such as Medicaid, Supplemental Security and other federal benefits. The account’s growth is tax-free, and the money is invested in the account-holder’s choice of a blend of stocks and bonds. Starting in June, the plan will charge a $35 annual maintenance fee. State legislation required that ABLE had to be self-supporting, and the money goes to the state and the company that runs the program, Sumday, for administrative costs. (Long, 2/13)

Dr. John Noseworthy, the Mayo Clinic chief executive who retired in December, has been named to the board of directors at UnitedHealth Group, the Minnetonka-based company that stands alongside Mayo as one of Minnesota’s most prominent health care organizations. UnitedHealth Group made the announcement Wednesday morning. In a statement, the board’s Executive Chairman Stephen Hemsley called Noseworthy “an exceptionally talented and compassionate physician.” (Snowbeck, 2/13)

Wisconsin school districts spend about $1 billion a year on special education costs not reimbursed by the state, forcing them to dip into general funds intended for all students, according to a new report by the Wisconsin Policy Forum. The low reimbursement rates, it said, place "a considerable burden on local districts," particularly those with high numbers of poor and minority students, where they exacerbate already existing inequities. (Johnson, 2/13)

A Dania Beach licensed mental health counselor with memberships in multiple national professional organizations became a multilevel healthcare fraudster. And for keeping the fraud rolling at Margate’s Reflections Treatment Center, Tina Marie Barbuto was sentenced in federal court in West Palm Beach to three years in federal prison for attempt and conspiracy to commit mail fraud. (Neal, 2/13)

Thrown together as disaster-response teammates in the new era of wildfires, California and federal officials have not exactly gotten along. The state’s emergency services chief last summer accused the feds of “re-victimizing” wildfire survivors in Sonoma and Napa counties by allowing cleanup crews to damage property and over-scrape the remnants of homes destroyed in the blazes. (Bizjak, 2/13)

Medical marijuana is not yet available for purchase in Missouri, but patients may be able to jump start the process and get it with the help of a newly opened clinic. The Green Clinic opened for business in a loft in the River Market in Kansas City on Wednesday afternoon, with two full-time doctors on staff to determine whether patients qualify to obtain medical marijuana. (Smith, 2/13)

We examined trends in per capita spending for Medicare beneficiaries ages sixty-five and older in the United States in the period 1999–2012 to determine why spending growth has been declining since around 2005. Decomposing spending by condition, we found that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Using estimates from the medical literature of the impact of pharmaceuticals on acute disease, we found that roughly half of the reduction in major cardiovascular events was attributable to medications controlling cardiovascular risk factors. Despite this substantial cost-saving improvement in cardiovascular health, additional opportunities remain to lower spending through disease prevention and control. (Cutler et al, 2/4)

Early identification and intervention hinge on reliable and valid assessment of suicide risk. The high prevalence of parental unawareness and adolescent denial of suicidal thoughts found in this study suggests that many adolescents at risk for suicide may go undetected. These findings have important clinical implications for pediatric settings, including the need for a multi-informant approach to suicide screening and a personalized approach to assessment based on empirically derived risk factors for unawareness and denial. (Jones et al, 2/1)

Does a text message-based intervention (Caring Contacts) reduce suicidal thoughts and behaviors among active-duty military personnel? Findings: In this randomized clinical trial of 658 Soldiers and Marines, augmenting standard care with Caring Contacts did not reduce current suicidal ideation or suicide risk events at 12-month follow-up. However, Caring Contacts reduced the odds of having any suicidal ideation (80% vs 88%) and making a suicide attempt (9% vs 15%). (Comtois et al, 2/13)

The Affordable Care Act (ACA) coverage expansions provided an opportunity to increase coverage and address longstanding racial and ethnic disparities in health coverage.1 This brief examines changes in health coverage by race and ethnicity between 2013 and 2017, providing insight into how coverage has changed since implementation of the ACA. It is based on Kaiser Family Foundation analysis of the nonelderly population using American Community Survey data. (Artiga, Orgera and Damico, 2/13)

In prescription drug monitoring program data from 2011 through 2015, 44.2% of all adults in California in the regions with the lowest-income/highest proportion–white population received at least 1 opioid prescription annually compared with 16.1% in the regions with the highest-income/lowest proportion–white population and 23.6% across California. Opioid overdose deaths were concentrated in lower-income, mostly white regions, with a 10-fold difference in overdose rates across the race/ethnicity–income gradient. (Friedman et al, 2/11)

The evidence for cannabis’s treatment efficacy across different conditions varies widely, and comprehensive data on the conditions for which people use cannabis are lacking. We analyzed state registry data to provide nationwide estimates characterizing the qualifying conditions for which patients are licensed to use cannabis medically. We also compared the prevalence of medical cannabis qualifying conditions to recent evidence from the National Academies of Sciences, Engineering, and Medicine report on cannabis’s efficacy in treating each condition. Twenty states and the District of Columbia had available registry data on patient numbers, and fifteen states had data on patient-reported qualifying conditions. (Boehnke, 2/4)

In this systematic review and meta-analysis of 11 studies and 23 317 individuals, adolescent cannabis consumption was associated with increased risk of developing depression and suicidal behavior later in life, even in the absence of a premorbid condition. There was no association with anxiety. (Gobbi et al, 2/13)

Mass shootings in affluent white communities dominate news cycles, but it’s the everyday gun violence that dominates the gun death rate — especially in marginalized communities. These include suicides by firearm, women shot by intimate partners and people killed in accidental discharges. Our #EnoughIsEnough and #NeverForget hashtags rarely apply to these forms of gun violence, but they should. (Austin Michael, 2/14)

Well, it’s been a year. ...But the ripple effect coming out of Parkland didn’t stop at Florida’s northern border. Rather it turned into a wave of action nationwide. According to the Giffords Law Center to Prevent Gun Violence, legislators, both Republican and Democrat, passed 67 new gun-control laws in 26 states and Washington, D.C. Several states, Florida included, passed red-flag, letting judges and other authorities temporarily remove guns from people deemed to be a danger. In fact, these measures made so much sense that even the NRA said it supported them. That is influence, powerful and enduring — we hope. (2/13)

A year ago 17 students and staff members lost their lives, gunned down in what should have been the sanctity of their own high school. But gun violence knows no sanctuary. The students at Marjory Stoneman Douglas High School, in Parkland, Fla., now know that better than most. It changed their lives. It turned many of them into activists, preaching the gospel of stricter gun control laws. And they in turn have kept up the pressure on their elders. Today that activism is beginning to show results. (2/14)

The police picked the teenager up from his high school after a terrified classmate told her principal he had threatened to slit her throat. The classmate showed them his Instagram account, where he had posted pictures of the Charleston church gunman with the word “hero” underneath it, and a picture of their school captioned “Columbine 2.0.” The officers didn’t find any guns or explosives in his house, and couldn’t arrest him for the threat, because the girl was too scared to be interviewed. So they brought him in to our mental health crisis unit for an evaluation. (Amy Barnhorst, 2/13)

On Feb. 13, 2018, our son Joaquin Oliver watched his idol, Shaun White, win another gold medal at the Winter Olympics. He tweeted: “I love you Shaun White.” That was his last tweet. Then he asked his Dad to help him put together some flowers that he was bringing to Tori, his girlfriend, for Valentine’s Day. Joaquin was shot four times by a 19-year-old boy who used his credit card to purchase a Smith and Wesson AR-15, plus enough ammunition to kill our son and 16 others as well as injure 17 more during a rampage of less than 7 minutes inside his high school in Parkland, Fla. Joaquin (“Guac”) was 17, a senior at Marjory Stoneman Douglas High School. A fun, happy kid, always surrounded by friends and by us. (Manuel and Patricia Oliver , 2/13)

When I arrived at school on Feb. 14, 2018, like any junior, I was mostly caught up in Valentine’s Day chatter and events. But that all changed in the space of a few minutes that afternoon when a gunman opened fire on my classmates and my teachers, killing 17 of them and injuring just as many.Despite the countless tragedies you see on TV, nothing prepares you for the day it happens to your community. (Jaclyn Corin, 2/13)

The most intense policy debate going on in the Democratic Party right now concerns health care, but it’s about more than just what sort of specific reform should be pursued. It’s also about how to approach both policy and politics, about what it means to be a Democrat, and about competing theories of change. Though at times it can get heated, there’s nothing wrong with that — Democrats argue passionately about this issue because they care about people who don’t have coverage and people who are ill-served by the system we have now. (Paul Waldman, 2/13)

‘'A lot of people still think e-cigarettes are not harmful,” U.S. Surgeon General Jerome Adams said last week. “But studies show that nicotine is, pound for pound, as addictive as heroin.” Dr. Adams, speaking to the Community Anti-Drug Coalitions of America, was making an appeal to fear, not science. Drug consumption is measured by the dosage, not the pound. More fundamentally, the concept of “addictiveness” is so vague that it can easily be manipulated. (Sally Satel, 2/13)

Gone are the days of the rebellious, rugged Marlboro Man hawking cigarettes with little more than a smile and a tip of his wide-brimmed, 10-gallon hat. The iconic cowboy, who was created to reposition Marlboro from a mild cigarette marketed to women to a brand with wider appeal, rode off our television screens and disappeared from our radio broadcasts for the last time more than five decades ago, never to return.His leaving wasn’t a choice. It was required by federal law: the Public Health Cigarette Smoking Act. (Jessica Rosenworcel, 2/13)

Polio, measles, epiglottitis, pertussis — all preventable by immunizations. As a pediatrician, I have experienced the supreme joy of seeing childhood diseases that had caused such suffering and loss in earlier generations become absolutely preventable, consigned to history. But this amazing public health success story is being undercut by the modern anti-vaccination movement, which was built on discredited research published in 1998 that associated the measles, mumps and rubella (MMR) vaccine with autism. (Howard A. Zucker, Opinion 2/13)

High charges for out-of-network care are demonstrably unfair when health plans have inadequate networks and when patients are treated by providers they don’t choose. An integrated approach for addressing both circumstances could involve streamlined dispute resolution. (Mark A. Hall, Loren Adler, Paul B. Ginsburg and Erin Trish, 2/14)

Few places in the United States have been as hard hit by the opioid crisis as Philadelphia, where about 1,150 people died from overdoses last year. So it is fitting that this is where the nation’s first “safe injection facility,” where addicts can use drugs under medical supervision without fear of arrest, is likely to open its doors. At least, it was going to open. Now its future, and that of the addicts it would serve, is less certain. (2/14)

The truth is there are better ways to ensure coverage for Americans with pre-existing conditions than the wholesale hijacking of the U.S. health care system embodied by the ACA, or even worse, a "Medicare for All" scheme. Market-based principles and more freedom of choice can help keep Americans covered and protect the long-term health of our nation’s health care system. (David Balat, 2/13)

“Now we sit and wait to see if the cancer comes back,” my doctor said as she unhooked the hanging bag of chemotherapy. That moment marked the end of my nine months of treatment for osteosarcoma, a rare bone cancer disproportionately afflicting children and young adults like me. There have been no therapeutic advances in treating osteosarcoma in the United States since the advent of chemotherapy nearly 40 years ago. The cancer affects fewer than 1,000 Americans annually, and it has a five-year survival rate of 60 to 80 percent if the cancer remains localized, according to the American Cancer Society; if the cancer has spread, the survival rate drops to 15 to 30 percent. (Olivia Egge, 2/13)

February is quite a month for advertisers with major events like the Super Bowl and the Academy Awards ushering in a new crop of big-budget TV spots. However, another kind of advertisement flooding the airwaves should be raising our concerns — the nearly omnipresent “bad drug” advertisements. We’ve all seen them. These ads with their sirens and faux public service announcement posturing are effective — bad news for fearful Kentuckians who may be compelled to stop a prescribed treatment. (Kim Moser, 2/12)

Out of all the kids that are in foster care in Pennsylvania, 14 percent entered for inadequate housing, These removals raise important flags about the stress points in the city’s families, especially those in poverty – which can often be confused for neglect. In fact, it’s a disturbing coincidence that the city with the highest poverty rate also has the highest child removal rate. (2/14)

It has become obvious over the past few years that the Affordable Care Act has the power to cloud Republicans’ minds. But few are as befuddled as the legislature and governor of Utah, who just enacted a partial expansion of Medicaid under the ACA that will cover 60,000 fewer residents while costing the state more than full expansion. (Michael Hiltzik, 2/13)

Big Pharma is getting very annoyed with Governor Charlie Baker. Good for Baker. His plan to rein in the cost of prescription drugs in the state Medicaid program will “punish success,” complained Robert K. Coughlin, president and CEO of the Massachusetts Biotechnology Council, which represents 1,200 biopharma companies. (Joan Vennochi, 2/13)