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Denouncing the profit motive in health care, more than 100 House Democrats rallied on Wednesday around a bill to replace most private health insurance with a national single-payer system, “Medicare for all.” The chief sponsor of the bill, Representative Pramila Jayapal, Democrat of Washington, said it would cure “a deep sickness within our for-profit system” of health care. But the bill highlights Democrats’ split over health policy going into the 2020 elections. (Pear, 2/27)

Rep. Pramila Jayapal (D- Wash.) told reporters that the goal of the Medicare for All Act of 2019, which has more than 100 co-sponsors, is to completely overhaul the U.S. healthcare system and convert it to a government-run entity. The legislation provides an outline of the thinking of some congressional Democrats on "Medicare for All," an issue that has been highly debated among Democrats running for president in 2020. (King, 2/27)

Kaiser Health News: There’s A New ‘Medicare-For-All’ Bill In The House. Why Does It Matter?

In many ways, the proposal sounds familiar: The government would establish a health plan that pays for basically all forms of medical care for all citizens. That’s how it gets the moniker “Medicare-for-all.” Under this plan, patients would not be responsible for any cost sharing of medical expenses, and the government coverage would include hospitals, doctors, preventive care, prescription meds and dental and vision care. Private insurers would not be allowed to sell plans that compete with the government program. Senior citizens would be folded into the new Medicare plan, which would be more generous than their current coverage, and the government would make sure any medical care they are getting is not disrupted. The bill leaves two other government health care payers intact: the Veterans Health Administration and the Indian Health Service. (Luthra, 2/27)

Last year, a record 62 percent of Democrats backed the House single-payer “Medicare-for-all” bill. Roughly 46 percent of House Democrats have so far signed onto the measure to be unveiled Wednesday. The downturn in support reflects in part the risks for any politician that proposes dramatic change and uncertainty in a system that is central to Americans’ well-being. It underscores the political calculations Democrats face now that the party controls the House and hopes to capture the White House in the 2020 presidential election. And as the party gains power, its ideas will be taken more seriously. (McIntire, 2/27)

Health insurers are leading declines among health-care stocks as investors turned their focus to Democrats’ new “Medicare for all” bill that would replace almost all private plans and assessed the implications of a Senate hearing on surging drug prices. The S&P 500 Managed Health Care Index plunged as much as 4.9 percent, the most since Dec. 6, led by UnitedHealth Group Inc., Humana Inc. and WellCare Health Plans Inc. The broader health sector index fell 0.8 percent. (Darie, 2/27)

More than 100 House Democrats on Wednesday, led by Rep. Pramila Jayapal, unveiled their sweeping Medicare for All legislation. So what comes next — and why is the health care industry so opposed to it? First, POLITICO's Alice Miranda Ollstein joins Dan Diamond (starts at the 1:05 mark) on Capitol Hill to explain the state of play. (2/28)

The U.S. House of Representatives on Wednesday passed a bill that would expand background checks for gun sales to include firearm purchases at gun shows and over the internet, a measure likely to face Senate and White House opposition. The background check bill, which was approved by a 240-190 vote, is the first gun control measure taken up by Democrats since they regained control of the House in the 2018 congressional midterm elections. (Becker, 2/27)

The background checks legislation faces stiff opposition in the GOP-controlled Senate, and President Donald Trump — who has strong backing from the National Rifle Association and other gun rights groups — has vowed to veto the bill if it ever reaches his desk. But House Democrats insist that some federal action must be taken to address the growing toll of gun violence. In addition to Wednesday's vote, they will move legislation on Thursday to close the "Charleston loophole," which allows people to buy guns before background checks are completed, and extend the time period for any background checks from three days to as long as 20 days. White supremacist Dylann Roof was able to buy a gun in 2015 despite pending drug charges, and he later killed nine African-Americans at the Emanuel AME Church in Charleston, S.C. (Bresnahan, 2/27)

For six years, Rep. Mike Thompson’s job as House Democrats’ point man on combating gun violence amounted to stretches of obscurity punctuated by tragedy. As leader of the House Gun Violence Prevention Task Force, he convened countless meetings of lawmakers, experts, advocates and victims, trying to build support for some kind — any kind — of gun control legislation. And when a mass shooting occurred, he stepped forward alongside Democratic leaders to explain the need for the kind of action the House Republican majority had no interest in taking. (DeBonis, 2/27)

Transgender troops testifying for the first time to Congress on Wednesday said transitioning to another sex made them stronger, while Pentagon officials defended the Trump administration's desire to bar people like them from enlisting in the future. Army Capt. Alivia Stehlik, an infantry officer and graduate of the U.S. Military Academy at West Point, N.Y. and Ranger School, told lawmakers she became a more "effective soldier" after she transitioned from male to female in 2017. (2/27)

Army Capt. Alivia Stehlik commissioned as an infantry officer from the U.S. Military Academy at West Point, N.Y., graduated from Ranger School and lived a “soldier’s life,” she said, spending long periods in the field before becoming a physical therapist in the service. After the Obama administration rescinded a ban in 2016 on serving while transgender, she wanted to do something else as a soldier, too: transition from male to female. (Lamothe, 2/27)

House Democrats blasted the Pentagon policy on Wednesday that bans most transgender troops from serving, charging that barring them would damage military readiness by cashiering seasoned troops. Rep. Jackie Speier, chairman of the House Armed Service Committee's personnel panel, branded the Pentagon policy "bogus." The Pentagon has been seeking to overturn a 2016 policy that allowed transgender troops to serve openly and receive treatment. (Brook, 2/27)

Nearly 60 percent of Americans said transgender people should be allowed to serve in the U.S. armed forces, according to a Reuters/Ipsos opinion poll conducted ahead of a congressional panel's review, set for Wednesday, of Trump administration curbs on transgender service. The U.S. Supreme Court on Jan. 22 ruled in favor of letting the Trump administration enforce its policy of barring many transgender people from the military. Implementation of the policy has been delayed by legal wrangling in a lower court case that the Supreme Court did not directly address. (2/27)

In her more than two terms as a U.S. senator representing Minnesota, Amy Klobuchar has built a reputation as an effective champion for consumer safety, sponsoring bills that improve swimming pool safety, ban lead in children's products and tackle the nation's opioid crisis. "Consumers deserve products that have been tested and meet strong health and safety standards," her website declares. (Forliti and Woodman, 2/28)

All 12 official Democratic candidates, as well as the potential Republican hopeful and former Massachusetts governor Bill Weld, told the Globe they now support full nationwide legalization, Canada-style. President Trump, meanwhile, has said he supports states’ rights to legalize. (Martin and Pindell, 2/27)

A group of moderate House Democrats will make a push this year to stabilize ObamaCare's markets, reviving an effort that fell to partisan bickering in 2017. The New Democrat Coalition, a caucus of 101 centrists, says the House should "immediately" work with Republicans to bring down ObamaCare premiums and reverse the Trump administration's "sabotage" of the health care law. (Hellmann, 2/27)

The Trump administration is considering action two fronts that could loosen up the reins on health savings accounts. HHS Secretary Alex Azar on Wednesday pushed the idea of funneling Affordable Care Act subsidies into HSAs for people in the individual market to pay for premiums and other out-of-pocket health spending. At the same time, the administration is exploring a proposal that would allow high-deductible plans with HSAs to cover preventive services such as providing free insulin. (Luthi and King, 2/27)

The FBI says a 59-year-old U.S. Army veteran has shot and wounded a doctor just before a mental health evaluation at a U.S. Department of Veterans Affairs hospital in Riviera Beach, Florida. The FBI told news outlets Wednesday night that Larry Ray Bon, of Michigan, arrived at the West Palm Beach VA Medical Center that morning and was combative for hours. They say he was about to undergo the evaluation that evening when he pulled out the gun and shot the doctor in the neck. (2/28)

The F.B.I. took over the investigation of the shooting because it occurred in a federal building, Agent Leverock said. Mr. Bon was scheduled to appear in federal court on Thursday. The West Palm Beach V.A. Medical Center, about 75 miles north of Miami on Florida’s eastern coast, is a general medical, psychiatric and surgical facility, according to its website. The 153-bed facility opened in 1995 and “provides health services to veterans throughout South Florida,” both at the main facility in West Palm Beach and six contractor-operated outpatient clinics, a 2017 report said. The facility also operates a 108-bed “community living center” and a 13-bed “blind rehabilitation service,” according to the report. During the 2017 fiscal year, the facility served about 60,000 veterans, the report said. (Jacobs and Stevens, 2/27)

The law expands a popular caregiver program and will examine VA's aging infrastructure. But the most controversial plank is a drastic increase in the number of veterans who will be eligible to use a private health care provider and bill the VA, in what's known as the Veterans Choice Program. (Lawrence, 2/27)

The Missouri House on Wednesday took steps to outlaw most abortions in the state should the U.S. Supreme Court overturn Roe v. Wade, an effort that's part of a broader Republican push amid renewed optimism that the high court might be more open to increased restrictions, and possibly an outright ban, on the procedure. (Ballentine, 2/27)

Supporters of the legislation called it the “strongest pro-life bill in the country” at a time when Missouri has only one abortion provider. “I think here in Missouri, we know that life is precious. We want to give women, men, young people the choice: the choice to live,” Schroer said. Several amendments were added to the bill during Tuesday’s debate. (King, 2/27)

Days after the Trump administration issued a rule barring many health centers from providing abortion referrals, Planned Parenthood of Illinois said that it expects to continue offering such services despite the prospect of losing millions of dollars in funding. Under the new rule, finalized by the Trump administration last week, health providers such as Planned Parenthood will no longer be allowed to directly refer patients for abortions if they accept Title X money. That funding supports family planning services and related preventative care, especially for low-income patients. (Schencker, 2/27)

Kaiser Health News: Despite 1991 Ruling, Foes Of New Family Planning Rules See Law On Their Side

State attorneys generals and women’s health advocates hoping to block in court new Trump administration rules for the federal family planning program face one major obstacle: The Supreme Court upheld very similar rules in 1991. Those rules were summarily canceled after a change in administrations. But the court is arguably more conservative than it was 28 years ago.Still, those who oppose the rules say that the ground has shifted enough to help them succeed this time. (Rovner, 2/28)

Gov. Tony Evers' pick to lead the Wisconsin Department of Health Services on Wednesday defended naming a former vice president at Planned Parenthood as a top deputy, saying she won't have any involvement in lawsuits challenging the state's abortion laws. Secretary-designee Andrea Palm was asked about the pick of Nicole Safar during a confirmation hearing before the state Senate's health committee. (Bauer, 2/27)

Three weeks after President Donald Trump announced a campaign to end the U.S. HIV epidemic by 2030, new government data show that progress against the disease stalled recently. After declining for several years, the estimated number of new HIV infections held about steady from 2013 to 2016, the latest available data, the Centers for Disease Control and Prevention said Wednesday. (Stobbe, 2/27)

The report comes three weeks after President Trump announced a new campaign to end the HIV epidemic in the U.S. within 10 years. Eugene McCray, director of the CDC's Division of HIV/AIDS Prevention, framed the report as evidence the campaign is needed. “After a decades-long struggle, the path to eliminate America’s HIV epidemic is clear,” McCray said in a statement. “Expanding efforts across the country will close gaps, overcome threats, and turn around troublesome trends.” (Rodrigo, 2/27)

Although public health researchers and advocates have been largely welcoming of the initiative, some have said that the administration has an uneven track record on HIV policy. Trump, for example, went a year after firing his HIV/AIDS advisory panel before new members were sworn in, and the administration has also turned back health protections for LGBT Americans. Men who have sex with men account for about 70 percent of new HIV infections, the new CDC report said. Among men who have sex with men, infections fell 16 percent from 2010 to 2016 for whites, stayed flat for blacks, and increased 30 percent for Latinos. (Joseph, 2/27)

Public health officials say the spread of misinformation about the safety and efficacy of vaccines has fueled a series of measles outbreaks across the country. There have been more than 159 cases in 10 states since January. Testifying before the House Committee on Energy and Commerce, Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, called false information distributed through social media about the use of the Measles, Mumps and Rubella vaccine a 'threat' to public health that could only be counteracted with a sustained public education effort. (Johnson, 2/27)

The U.S. has counted more measles cases in the first two months of this year than in all of 2017 — and part of the rising threat is misinformation that makes some parents balk at a crucial vaccine, federal health officials told Congress Wednesday. Yet the vaccine is hugely effective and very safe — so the rise of measles cases "is really unacceptable," said Dr. Anthony Fauci, infectious disease chief at the National Institutes of Health. (2/27)

Amid a relentless anti-vaccine movement and measles outbreaks across the United States, a Texas lawmaker has falsely suggested that antibiotics can be used to treat the deadly childhood disease. Texas state Rep. Bill Zedler (R), an anti-vaxxer who is promoting legislation to allow parents to more easily opt out of vaccinations for their children, said he had measles when he was a child. "When I grew up, I had a lot of these illnesses,” Zedler recalled, according to the Texas Observer. “They wanted me to stay at home. But as far as being sick in bed, it wasn’t anything like that.” (Bever, 2/27)

The number of pedestrians killed on U.S. roads last year was the highest in 28 years, according to a report from a safety organization. Using data reported by states, the Governors Highway Safety Association estimates that 6,227 pedestrians were killed last year. That’s up 4 percent from 2017 and 35 percent since 2008. The association blames the increase on factors that include distracted or impaired drivers, more people walking to work, and more SUVs on the road, which cause more severe injuries in collisions with people on foot. (2/28)

Pedestrian deaths now account for about 16% of motor-vehicle crash deaths, up from 12% a decade ago. In that span, all other traffic deaths grew by less than 5%. “We’re killing way too many pedestrians. This has got to be a high priority,” said Jonathan Adkins, executive director of the nonprofit Governors Highway Safety Association, which represents state highway-safety offices and commissioned the report. (Calvert, 2/28)

Over the past year, at least 17 people have been hospitalized after being injected with products made from umbilical cord blood, a little-known but fast-growing segment of the booming stem cell industry, according to state and federal health officials and patient reports. Sold as a miracle cure for a variety of in­trac­table conditions, the injections have sickened people in five states, prompting new warnings from health officials about the risks of unproven stem cell treatments. (Wan and McGinley, 2/27)

Michelle Lowry was a healthy baby until a pea-sized lump appeared on her neck when she was two. Within weeks it had swelled into a life-threatening tumor obstructing her breathing and she was hospitalized at Children’s Hospital Los Angeles. “Her right arm and hand stopped working,” recalled her mom, Christina Lowry, who lives in Simi Valley, Calif. “Her face was swollen, her eye was almost swollen shut. The tumor was almost all the way around her neck.” A test showed her tumor was caused by a so-called NTRK fusion, which happens when a gene known as NTRK fuses with another unrelated gene. (Reddy, 2/27)

For years, the cost to decode a full human genome has been falling much like computer processing costs -- from hundreds of thousands of dollars per person to about $1,000 today. With a $100 genome getting closer, the CEO of the top maker of DNA sequencers thinks the world may not be ready. Illumina Inc.’s first machines, introduced in 2006, could decode a full human genome for about $300,000. A model released in 2014 can do so for about $1,000, and has made DNA sequencing widespread, helping diagnose diseases and find new drugs. The company’s latest machines could one day bring the cost close to $100. (Brown, 2/27)

A new study looking at whether women who are pregnant face an increased risk of a miscarriage if they get a flu shot found no link between the vaccine and pregnancy loss. The reassuring finding contradicts an earlier study by the same researchers that raised questions about the safety of getting a flu shot during pregnancy. An overview of the study findings was presented Wednesday at a meeting of the Advisory Committee on Immunization Practices, which guides vaccination policy for the Centers for Disease Control and Prevention. (Branswell, 2/27)

Kaiser Health News: Listening To Older Patients Who Want To Stop Dialysis

Dr. Susan Wong sat down with an 84-year-old patient in the hospital, where he’d been admitted with a flare-up of a serious autoimmune condition and deteriorating kidney function. The older man told her he wanted to go home; he’d had a good life and was ready for its end. He didn’t want aggressive care — including dialysis — having witnessed his wife and son die painfully in intensive care years ago. (Graham, 2/28)

Could a blood test help more lung cancer patients get drugs that are targeted to the genetic weaknesses of their tumors? Yes, according to summary results of a 282-patient clinical trial being made available Wednesday. The result is a boon for Guardant Health, the San Francisco-based startup that sells the test, Guardant360, which is a “liquid biopsy” that works by detecting fragments of DNA in the bloodstream. The full study will be presented in full at the annual meeting of the American Association for Cancer Research in early April. (Herper, 2/27)

Twelve-year-old Hannah Piedad first encountered vaping — an electronic form of smoking — at a New Year's party. It was the smell that got her attention. "I was intrigued because it smelled just like maple syrup," she said. Now the student at Johnson County Middle School in eastern Kentucky has testified before lawmakers in this tobacco state that e-cigarettes have become commonplace at her school despite a state law requiring a person to be at least 18 to buy them. (2/27)

Ray and Tom Magliozzi, better known as "Click and Clack, the Tappet Brothers," stopped recording new episodes of NPR's Car Talk in 2012. Tom passed away shortly thereafter, in 2014. But the spirit of the show lives on. And if you visit a doctor's office, you just might benefit from it. As it turns out, Ray and Tom's step-by-step method of diagnosing car trouble can be applied to more than just your broken down old jalopy. A handful of physicians are using the show to teach medical students how to diagnose disease. (Chisholm, 2/27)

High blood pressure in adolescence is associated with kidney failure in adults, a new study reports. Israeli researchers studied health records of more than 2.6 million healthy 16- to 19-year-old candidates for military service from 1967 to 2013. Almost 8,000 had a diagnosis of hypertension. Over an average follow-up of 20 years, 2,189 developed renal disease requiring dialysis or kidney transplant. (Bakalar, 2/27)

It’s an especially difficult time to be a survivor of sexual abuse or assault. On top of the daily struggle to stay safe and healthy, sexual abuse survivors also have to contend with an endlessly triggering news cycle. If you’re not a survivor yourself but you’re close to one — maybe a partner, friend or family member — you may not be able to fully understand what they’re going through, and you may feel confused or lost about how to best support them. Here’s what you need to know, and how you can be supportive. (Marin, 2/27)

Is there any legal way to establish centers where people could use illicit drugs under medical supervision? That is one of the top questions legislators will ask if they take up a bill to allow “safe consumption sites,” as the state’s Harm Reduction Commission has recommended. (Freyer, 2/28)

A newly published study shows that the opioid epidemic is occurring in waves, but Ohio may be a model in stemming the tide. The study, recently published in the Journal of the American Medical Association (JAMA), found that Ohio had a 121 annual percent increase in people who died as a result of overdosing on synthetic opiates, such as fentanyl or carfentanil, between 1999 and 2016. (Bruner, 2/27)

Addiction treatment is up. Prevention efforts are going full steam. Sterile syringes and naloxone are more accessible than ever in Hamilton County and narcotics officers are seeing fewer opiates on Cincinnati-area streets. The Hamilton County Heroin Coalition reported progress on Wednesday in their State of the Heroin Crisis news conference, but its members don't think the heroin and fentanyl epidemic in the region is anywhere nearly over. (DeMio, 2/27)

A bill that would require New Hampshire schools to provide at least two hours of suicide prevention training for staff each year is one step closer to becoming law. The House of Representatives took up dozens of issues Wednesday and will continue its work Thursday, moving some bills to the Senate, others to committees and many to their swift demise. (Willingham and DeWitt, 2/27)

Advocates for Iowa children on Wednesday praised a new bill to set up a children’s mental health system, but they said they hope legislators add details and money to the effort. Peggy Huppert, Iowa executive director of the National Alliance on Mental Illness, told a Senate subcommittee Wednesday that the bill does not include deadlines to accomplish its goals, including new services for children with mental illness. (Leys, 2/27)

[Khrystyna] Greene is among the thousands of Texans who, despite their best efforts to determine costs and coverage before treatment, still get slammed with surprise medical bills. For 10 years, Texas lawmakers have promised to fix the problem, passing consumer protections, creating and then tweaking a state-sponsored mediation system for disputed charges, and trying to crack down on deceptions involving insurance coverage. But, as Greene’s experience and dozens of patient bills reviewed by the Chronicle show, the surprises keep coming. Lawmakers say they will try again this year. On Thursday, state Sen. Kelly Hancock, a Fort Worth Republican, is scheduled to announce sweeping legislation to further combat surprise medical billing. “It’s time to take consumers out of this,” he said Tuesday. (Deam, 2/27)

A bill to help patients reduce their health insurance premiums by shopping for healthcare received the endorsement on Wednesday of Florida Gov. Ron DeSantis, who said the proposal will build on the state’s efforts to make public the prices charged by hospitals and other medical providers. (Chang, 2/27)

Senate Bill 15 would require routine threat assessments and drills in public schools and would mandate coordination between state agencies and local authorities and schools. It also would establish a program for certifying current or former military or public safety personnel as school safety coaches. (Tagami, 2/27)

A federal report says a viral outbreak that killed 11 children at a New Jersey nursing home was made worse because those in charge didn't plan for such an outbreak and didn't react fast enough. The Record reports the pediatric medical director of the Wanaque Center for Nursing and Rehabilitation didn't know how many children were infected with adenovirus or what his job entailed at the time of the outbreak last fall. (2/27)

Arizona is in the midst of a syphilis oubreak among women and newborns that caused the deaths of 10 babies last year, state data shows. Deaths from congenital syphilis — syphilis passed from a mother to her baby during pregnancy or delivery — are completely preventable. (Innes, 2/27)

Jaleyah Collier had just said goodbye to Kevin Cleveland outside a doughnut shop a few blocks from Hawkins High School on a spring afternoon in 2017. Get home safe, she told him before walking away. Minutes later someone drove into an alley nearby, got out of the car and asked Kevin, 17, and two others about their gang affiliation. The gunman then sprayed them with at least 10 rounds, killing Kevin and injuring the others. Jaleyah, then a high school sophomore, barely had time to grieve when a month later, her best friend, Alex Lomeli, 18, was shot and killed when someone tried to rob a market about a mile from the same high school, located at 60th and Hoover streets. (Kohli and Lee, 2/27)

Medical City Dallas announced Wednesday that it's spending about $92 million to turn a vacant Dallas health care facility into a heart hospital and spine hospital that will open in October. Medical City Heart Hospital and Medical City Spine Hospital will be across the highway from the health system's Dallas campus, which is at North Central Expressway and Forest Lane. The specialty hospitals will be located in the former flagship hospital of Forest Park Medical Center, a chain of doctor-owned hospitals that filed for bankruptcy after its doctors were accused of accepting millions of dollars in bribes and kickbacks to perform surgeries. (Repko, 2/27)

In 2017 in Missouri,  75 children and teenagers killed themselves — the most on record, according to an analysis of the most recent available data for the state. That same year in Kansas, 99 young people took their own lives. Another record.It’s difficult to compare youth suicides in Kansas and Missouri because the two states track the data differently, and some places supress the numbers so that individuals aren't identifiable in the statistics. (Ryan, 2/27)

Since last March, Apple has been rolling out a feature that allows people to store their medical records in its Health app. UC San Diego Health, where Cavaliere sees his doctors, is one of more than 200 health care providers around the United States using the health records feature. (Sydell, 2/27)

Wellspring of Milwaukee, a nursing home and rehabilitation center, is scrambling to find new homes for its residents this week after a vendor won a court judgment that froze its bank account. The nursing home, 9350 W. Fond du Lac Ave., learned on Monday that its bank account was frozen. (Boulton, 2/27)

Cases of Legionnaires’ disease have quadrupled in Georgia over the past 10 years, public health statistics show. That increase mirrors a national trend, with U.S. cases up fivefold since 2000. (Kanne, 2/27)

Officials for the city’s ThriveNYC program, a mental health initiative, struggled to tell members of the New York City Council during testimony Wednesday how its annual budget of $250 million is spent and exactly how New Yorkers have benefited from the city’s services. The ThriveNYC initiative, now three years old, is the signature effort of Chirlane McCray, the wife of New York City Mayor Bill de Blasio. In January, Ms. McCray announced that the program would become its own office, which now has 21 employees with a $2 million office budget, according to Susan Herman, appointed to lead the office. (West, 2/27)

For the second time, a Brentwood-based nursing home company has agreed to pay millions of dollars to the federal government to settle a lawsuit alleging the company submitted bogus Medicare and Medicaid claims for reimbursement while neglecting patients. Vanguard Healthcare agreed this week to pay more than $18 million to resolve a federal lawsuit brought by the U.S. Department of Justice and state of Tennessee for billing Medicare and Medicaid programs for "grossly substandard" nursing home services, according to a news release. (Sauber, 2/27)

Hundreds of inmates at the Terminal Island federal prison on the harbor front spent one of the coldest periods in decades in frigid cells with no heat and only blankets for warmth before they were transferred temporarily to another facility. As outside temperatures plunged into the low 40s at night, two units that housed more than 200 inmates lost heat after an underground steam line failed in January at the low-security federal lockup that sits at the entrance to Los Angeles Harbor in San Pedro. (Winton, 2/27)

In Minnesota and around the country, many schools are shifting away from nuggets and fries to fresher, locally-grown foods. More than half of Minnesota school districts now have some kind of farm-to-school program. It's not an easy change. It requires schools to rethink everything when it comes to feeding children. (Shockman, 2/28)

This would be a first for California: state government buying insurance to protect itself against overspending its budget. But before you start pelting the politicians and screaming fiscal irresponsibility, know that the budget-busting would be for fighting wildfires. (Skelton, 2/28)

A central Ohio couple have pleaded guilty to federal health-care fraud charges for conspiring with others to sell a bogus cream to those seeking pain relief, including attendees at the Arnold Sports Festival and Columbus first-responders. Officials with the U.S. attorney’s office in the Southern District of Ohio said Amy M. Kirk, a nurse practitioner in Columbus, and Ryan D. Edney, of Plain City, each signed plea deals involving conspiracy to commit health-care fraud, according to court records. (Sullivan, 2/27)

In this cohort study and descriptive analysis of 9330 episodes of low-value use of 7 procedures (ranging from 56 low-value spinal fusions to 3963 low-value knee arthroscopies), depending on the procedure, between 0.2% and 15.0% of patients receiving these low-value procedures developed at least 1 of 16 hospital-acquired complications, the most common being health care–associated infection. (Badgery-Parker, 2/25)

The Affordable Care Act (ACA) provides enhanced federal matching funds to states that expand Medicaid to nonelderly adults up to 138% of the federal poverty level (FPL, $17,236/year for an individual in 2019). The ACA enhanced match (93% in 2019, and 90% in 2020 and thereafter) is substantially higher than states’ traditional Medicaid matching rate. A few states have sought Section 1115 demonstration waiver authority from the Centers for Medicare and Medicaid Services (CMS) to receive the substantially higher ACA enhanced match while limiting coverage to individuals at 100% FPL, instead of covering the full 138% FPL ACA group. (Rudowitz and Musumeci, 2/20)

The luckiest among us have family and friends to lean on when times get tough. For those who develop a serious illness — an often painful and tumultuous experience — family and friends offer crucial emotional support and help with day-to-day activities. A recent survey of the sickest adults in America, conducted by the Harvard T. H. Chan School of Public Health, the New York Times, and the Commonwealth Fund, found that seriously ill adults also rely on their family and friends to organize their health care, helping them navigate an often complex, confusing, and inefficient system. Focus groups and in-depth interviews conducted by the Commonwealth Fund since 2016 revealed that while taking care of a seriously ill family member or friend can bring meaning and satisfaction to caregivers, it also can become a complex and serious responsibility that burdens them. (Lewis et al, 2/21)

Hypertension is a leading risk factor of cardiovascular morbidity and mortality. The role of nonmalignant hypertension as the sole initiating factor of end-stage renal disease (ESRD) in non–African American populations has recently been questioned. (Leiba, 2/25)

In this analysis of the randomized clinical trial, at 2 years, mortality and all stroke were similar between valves. Disabling stroke and paravalvular leak were less while pacemaker requirement and valve thrombosis were more frequent after using the mechanically expanded valve. (Reardon, 2/27)

America’s fascination with Medicare for all is born of good intentions. Americans are hurting and in search of relief. Nearly 30% of U.S. adults struggle to pay their medical bills, and more than 20% say they’ve put off treatment or filling a prescription because of cost. Unfortunately, in our search for a magic pill, we’ve missed the key point. Government-run programs work well in the rest of the world because the cost of medical care delivery — what doctors, nurses and drug companies get paid — is considerably less than in the United States. Lowering the cost of care would mean reining in drug prices, eliminating unnecessary procedures, and closing small, inefficient hospitals. Until we do, every approach, including Medicare for all, will fail. There is no painless solution, no magic pill. (Robert Pearl, 2/28)

Sen. Charles Grassley (R-Iowa), chairman of the Senate Finance Committee, held a hearing on drug prices and several CEOs of the largest pharmaceutical companies in the world testified. Ostensibly, the hearing is to look at why drug prices are so high in the United States and discuss laws that could be implemented by Congress, or regulations imposed by the Trump administration, to help reduce the cost of medicine for the American people. As someone who believes that drug costs in this country are out of control, on the one hand, I am pleased that this congressional took place. However, I strongly doubt that Republicans on Capitol Hill or President Donald Trump, are serious about doing anything about the costs of medicine because they probably don’t want to threaten drug companies’ profits or stock prices. (Former Rep. Silvestre Reyes (D-Texas), 2/27)

People focus on the health costs that are most tangible and sometimes outrageous to them: their deductibles, and drug costs, and surprise medical bills, and the annual increase in the share of the premium they pay. But there's more that gets less attention because it's not as visible to them. (Drew Altman, 2/28)

At least she was honest about it. I once sat on a panel evaluating candidates for public office. One candidate told us her solution to solving America’s health-care crisis: require that all residents purchase health insurance at market rates, with “government” subsidizing those who needed financial help. Then, anyone without coverage would be denied service. “What if,” I asked, “some people slip through the insurance cracks and show up at the ER very sick or seriously injured?” (Larry Lowenthal, 2/25)

Mr. Johnson, a middle-aged man with salt and pepper hair, wasn’t sleeping well. At first, the two pillows he wedged beneath his back helped, but now he was getting short of breath even in his La-Z-Boy. ...That’s where I, a cardiologist in training, saw him. He didn’t need me to tell him the news he already knew. His heart failure was getting worse. He hadn’t been taking his medications, he reluctantly confessed. It wasn’t for a lack of trying. His wife explained that they had to take turns buying medications. They could not afford their prescriptions nor their health insurance, and they did not qualify for Medicaid. The couple would buy his heart medications at times and her insulin the other times. Now they were taking turns being admitted to the hospital. (Taimur Safder, 2/27)

In 2018 the Centers for Disease Control and Prevention released a report showing that for the first time in a century, average life expectancy in the U.S. fell. The decline, fueled by a rise in drug overdoses and suicides, sends a loud warning that we, as a nation and a city, must continue to invest in public health. Protecting people from disasters and disease outbreaks. Providing immunizations. Screening people for disease. Promoting on-the-job health and safety. These are all investments that save lives. Today in Louisville, that investment is threatened by a $65 million budget shortfall over four years, driven largely by an increasing state pension obligation. (Karen Cost, 2/27)

Poor nutrition is a leading cause of poor health and spiraling health care spending. Research from the Tufts Friedman School suggests that poor eating causes nearly 1,000 deaths each day in the United States from heart disease, stroke or diabetes. In 2016, the direct and indirect costs of chronic diseases as a result of obesity were $1.72 trillion — almost 10 percent of the nation’s gross domestic product. (Joon Yun, David A. Kessler and Dan Glickman, 2/28)

Former model and restaurateur B. Smith is a likely representation of life with Alzheimer’s disease. Beyond the gasps over Smith’s home life — she lives with her husband and his live-in girlfriend — her situation points to real-world challenges faced by black families caring for loved ones who have this life-altering condition. Alzheimer’s is a public health crisis for which Congress has thankfully put aside its differences long enough to pass the Building Our Largest Dementia Infrastructure for Alzheimer’s (BOLD) Act. Now the question is whether the money and resources directed toward African-Americans, a group disproportionately affected by Alzheimer’s, is bold enough. (Karen D. Lincoln, 2/28)

The U.S. has long had two distinct applications of federal gun law. One applies to people who shop at federally licensed gun dealers: They must pass a background check before purchasing a firearm. The other is for those who arrange a private sale from an unlicensed seller, via the internet or at a gun show: They are under no obligation to prove they are legally qualified to make their purchase. A 2015 survey found that more than one-fifth of Americans who obtained a gun in the two years prior to the study did so without a background check. The disparity is absurd, especially when you consider how often people who are legally barred from buying guns try to buy them. (2/27)

Public health officials’ goal should always be to build awareness of the risks associated with smoking and educate the public on the products that can help smokers quit. Yet the public health community has failed to build awareness of how switching to e-cigarettes can reduce the harm associated with smoking by as much as 95 percent, according to the Public Health England and multiple independent reviews. (Julie Gunlock, 2/28)

Clinical trials are not enough to prove any drug is safe and effective – especially one that could be as widely used as Johnson & Johnson’s depression drug esketamine, a slightly altered form of the street drug ketamine. The FDA approval process is a balancing act, weighing safety and efficacy testing against the need to get potentially life-saving drugs out as soon as possible. An advisory panel to the FDA decided this month that the benefits outweigh the risks, and approval is expected soon. But scientists who study depression say there’s a lot more to learn about esketamine’s long-term effects. (Faye Flam, 2/27)

A complex web of legal, policy, and structural barriers has led to persistent gaps in access to treatment for opioid use disorder in jail facilities in the United States and prevented the delivery of coordinated care. (Ingrid A. Binswanger, 2/27)

In 2014, U.S. officials imposed a moratorium on experiments to enhance some of the world’s most lethal viruses by making them transmissible by air, responding to widespread concerns that a lab accident could spark a global pandemic. Most infectious-disease studies pose modest safety risks, but given that these proposed experiments intended to create a highly contagious flu virus that could spread among humans, the government concluded the work should not go on until it could be approved through a specially created, rigorous review process that considered the dangers. (Marc Lipsitch and Tom Inglesby, 2/27)

When the polar vortex froze out residents in much the United States in January, it also sent chills through the U.S. blood system, especially for people who needed platelets.“ If you are safely able to leave your house, please consider giving blood for hospital patients,” tweeted the Red Cross of Massachusetts. “Polar vortex blamed for critically low blood supply,” reported Minnesota’s Northwest Community Television. (Jonathan Thon, 2/28)

A New Jersey detention center houses asylum seekers who have fled persecution in their home countries. Even the U.S. physician who comes to examine them must tread carefully to be allowed to do her job in this loud, gray place where guards’ decisions seem arbitrary. (Katherine C. McKenzie, 2/27)