�Թϲ�����

Republicans are hoping to land support for a short-term spending bill by agreeing to delay some Affordable Care Act taxes and renewing funding for the Children’s Health Insurance Program, a gamble that shows the continuing resonance of health-care issues in the national debate. House GOP leaders, seeking to soften Democratic opposition to the spending bill, have included six years of renewed funding for CHIP, which Democrats urgently want. At the same time, they have inserted a repeal of ACA taxes on medical devices, generous employer plans, and health insurance, likely to appeal to conservatives. (Armour, 1/17)

The House will vote on a fourth short-term budget patch Thursday that includes a six-year funding extension of the Children's Health Insurance Program and delays of the Affordable Care Act's health industry taxes. Congress must pass the continuing budget resolution by Friday to avert a government shutdown. The expired Medicare programs that rural hospitals especially rely on, as well as a delay for the disproportionate-share hospital cuts that went into effect Oct. 1, will wait until a big spending omnibus, GOP lawmakers said Wednesday after their briefing with leadership. (Luthi, 1/16)

President Trump on Thursday appeared to break with GOP congressional leaders on the morning of a key vote in the House, saying he did not want children's health insurance funded in the short-term funding bill now being considered. "CHIP should be part of a long term solution, not a 30 Day, or short term, extension!" Trump tweeted, referring to the Children's Health Insurance Program. (Sullivan, 1/18)

House Republicans are short of the votes they need to avoid a government shutdown, but Speaker Paul Ryan and GOP leaders remain confident they will pass a stopgap funding measure when it comes to the floor on Thursday. President Donald Trump is personally leaning on GOP lawmakers to fall into line, especially hard-line conservatives who are opposed to virtually anything Ryan and his leadership team propose. (Bresnahan, Ferris and Caygle, 1/17)

Senate Democrats are pushing for additional health-care measures like funding for community health centers to be included in a short-term funding bill this week ahead of a impending government shutdown. Sen. Ron Wyden (Ore.), the top Democrat on the Senate Finance Committee, said at a press conference with Democratic leaders on Wednesday that he wanted the community health center funding added, as well as an extension of programs for home visits from nurses and for rural healthcare. (Sullivan, 1/17)

Lawmakers are considering adding a measure aimed at fighting high drug prices to an upcoming spending deal, in what would be a rare defeat for the powerful pharmaceutical industry. The measure, known as the Creating and Restoring Equal Access to Equivalent Samples Act, is intended to prevent branded drug companies from using tactics to delay competition from cheaper generic drugs. It is co-sponsored by a set of unusual bedfellows in both parties. (Sullivan, 1/17)

Opponents of a tax on health insurance are urging lawmakers to suspend the ObamaCare tax starting this year after House Republican leadership unveiled a stopgap spending measure that included a one-year delay only for 2019. GOP leaders unveiled the measure late Tuesday as part of their plan to avoid a government shutdown. It included a six-year reauthorization of the Children’s Health Insurance Program (CHIP) as well as a two-year delay of a tax on high-cost insurance plans knows as the Cadillac tax and a medical device tax in an effort to get their members on board with another short-term spending bill. (Roubein, 1/17)

Late-night host Jimmy Kimmel sparred with a spokesman for Speaker Paul Ryan (R-Wis.) on Wednesday over legislation to fund a children's health program. Doug Andres, the press secretary for Ryan, included Kimmel on his retweet of a health-care reporter who said it would be "interesting" to see how many Democrats will vote against a short-term spending bill that could include a six-year extension for the Children's Health Insurance Program (CHIP), a longtime Democratic objective. (Delk, 1/17)

Unless Republicans coalesce this week around a short-term spending deal, the federal government will shut down — a scenario that will likely have widespread and long-lasting consequences for public health. The Food and Drug Administration would likely have to forego updating mislabeled medications or conducting routine food safety inspections. The Centers for Disease Control and Prevention would furlough key staff amid one of the most severe flu seasons in recent memory. And the National Institutes of Health might have to stop enrolling hundreds of patients in clinical trials. (Mershon and Swetlitz, 1/17)

A Senate committee has signed off on President Donald Trump's pick for health secretary, clearing the way for final confirmation of Alex Azar. The Finance Committee voted 15-12 on Wednesday to send Azar's nomination to the full Senate. Although the panel's vote was largely along party lines, Azar's confirmation hearings weren't nearly as contentious as the deliberations over his predecessor, Tom Price. (1/17)

If approved by the full Senate, Azar, a former executive for the Eli Lilly pharmaceutical company, would succeed President Trump’s first HHS secretary, Tom Price. The former congressman from Georgia resigned under pressure in September during an investigation of his use of private charter planes at taxpayer expense to attend official events. “Mr. Azar is well-credentialed to lead such a critical department at a time America’s health care system is facing difficult challenges,” Committee Chairman Orrin G. Hatch (R-Utah) said in a written statement. (Bernstein, 1/17)

Sen. Rand Paul (R-Ky.) is the lone Republican to have expressed concerns with Azar's nomination, stemming from the lack of an endorsement from Azar for allowing drugs to be imported from overseas. (Roubein, 1/17)

Azar — who as head of the mammoth agency will oversee the Medicare and Medicaid programs, the Food and Drug Administration, the National Institutes of Health and the Centers for Disease Control and Prevention — has pledged to prioritize key issues important to both Republicans and Democrats, including the opioid epidemic, the burden of healthcare costs on Americans and the rising price of pharmaceuticals. "Drug prices are too high," Azar told the Senate Committee on Health, Education, Labor and Pensions in November, pledging to look at ways to increase competition and stop drugmakers from gaming the system. But Azar's work at Lilly, which dramatically raised prices on its insulin product while he was at the company, has made many consumer advocates skeptical he will take on the powerful pharmaceutical industry. (Levey, 1/17)

The Trump administration will create a new conscience and religious freedom division within the Health and Human Services Department to ease the way for doctors, nurses and other medical professionals to opt out of providing services that violate their moral or religious beliefs. Specific details are scheduled to be announced Thursday. But the new policy appears to be broad and aimed at protecting health-care workers who cite those reasons for refusing to take part in abortions, treat transgender patients or participate in other types of care. (Eilperin and Cha, 1/17)

The Department of Health and Human Services sent the proposal on Friday to the White House for review, said a person on Capitol Hill familiar with the matter. The HHS will also establish a division of “conscience and religious freedom protections” within its Office for Civil Rights, people familiar with the matter said. Mr. Trump might take the opportunity to tout the changes when he addresses the March for Life on the National Mall by satellite on Friday, the White House said. Friday’s march is this year’s version of an annual event by antiabortion activists to mark the anniversary of the Roe v. Wade Supreme Court decision that broadly established a right to an abortion. If not Mr. Trump, acting HHS Secretary Eric Hargan may announce the new initiative on Thursday, officials said. (Armour and Radnofsky, 1/17)

A year ago, throngs of abortion opponents gathered in Washington for the March for Life on the Mall and to celebrate the promises of a newly sworn-in President Trump — wins they’d been seeking for decades: Defunding Planned Parenthood, permanently banning federal money for abortion, and overturning Roe v. Wade, something he said would happen “automatically” if he got to pick judges he wanted. On Friday, Trump will address the march from the White House Rose Garden via satellite, according to organizers. But as marchers return for the major annual antiabortion gathering, almost none of the core vows the president made have been fulfilled and there’s no clear sign they’ll be attained soon. (Boorstein and Zauzmer, 1/17)

Trump will become the first sitting president to address the rally via a live video. The stream is set to take place from the Rose Garden, White House press secretary Sarah Huckabee Sanders said on Wednesday. "The president is committed to protecting the life of the unborn and he is excited to be part of this historic event," she said. “Since his first day in office, President Trump has remained steadfast on his campaign promises to the pro-life cause and has actively worked to protect the unborn,” said March for Life President Jeanne Mancini said in a statement. (Greenwood, 1/17)

The Trump administration is running months behind in supplying basic information on how organizations that provide birth control and other reproductive health services to low-income women and families can apply for federal family planning grants, raising new uncertainties over the program. The delays at the Health and Human Services Department (HHS) are putting additional stress on organizations that depend on funding through Title X, a nearly 50-year-old program focused solely on family planning grants. (Hellmann, 1/18)

The head of the Iowa Department of Human Services Wednesday admitted problems with Iowa’s new family planning program that takes the place of Planned Parenthood clinics around the state. After lawmakers said no state money should go to clinics that perform abortions, the state is redirecting funds to other clinics for subsidized birth control. (Russell, 1/17)

Cardiologists not associated with the White House said Wednesday that President Trump’s physical exam revealed serious heart concerns, including very high levels of so-called bad cholesterol, which raises the risk that Mr. Trump could have a heart attack while in office. Dr. Ronny L. Jackson, a rear admiral and the White House physician, said Tuesday in his report on the president’s medical condition that Mr. Trump was in “excellent” cardiac health despite having an LDL cholesterol level of 143, well above the desired level of 100 or less. (Shear and Kolata, 1/17)

Unless someone swipes one of President Trump’s used forks from the Mar-a-Lago dining room and sends it to 23andMe for DNA analysis, the world will simply have to guess what the White House physician meant when he told reporters on Tuesday that Trump “has incredible genes, I just assume.” “Incredible genes” may seem like hand-waving, but there’s no question some genetic variants protect against heart disease, hypertension, diabetes, and other killers. And Trump chose his parents well: His father died of pneumonia at 93 after developing Alzheimer’s disease but apparently avoiding cancer and heart disease. His mother lived to 88; her cause of death was not reported, but her only known ailment was osteoporosis. (Begley, 1/17)

Drawing a clock. Counting backward by sevens. Rattling off words that begin with "F'' before a minute's up. They may not sound like difficult tasks, but they're part of a cognitive exam that's getting a lot of attention because President Donald Trump aced it. For all their apparent simplicity, 10-minute quizzes like the Montreal Cognitive Assessment offer doctors a snapshot of someone's memory and certain other neurologic functions, one piece of information to help determine if trouble's brewing. (1/17)

Long-term-care insurance was supposed to help pay for nursing homes, assisted living and personal aides for tens of millions of Americans when they became unable to take care of themselves. Now, though, the industry is in financial turmoil, causing misery for many of the 7.3 million people who own a long-term-care policy, equal to about a fifth of the U.S. population at least 65 years old. Steep rate increases that many policyholders never saw coming are confronting them with an awful choice: Come up with the money to pay more—or walk away from their coverage. (Scism, 1/17)

Health insurer Humana said it will be raising the hourly minimum wage for all of its employees as a result of the GOP tax bill. The legislation signed by President Trump last month slashed the corporate tax rate in an attempt to boost wages and add new jobs in the U.S. (Weixel, 1/17)

Health insurer Aetna has agreed to pay $17 million to settle claims that it breached the privacy of thousands of customers who take HIV medications. Attorneys for the plaintiffs announced the settlement Wednesday in Philadelphia. Court documents say the Hartford, Connecticut-based company sent a mailing in envelopes with large, clear display windows that revealed confidential HIV information. The mailing was sent to about 12,000 customers in at least 23 states. (1/17)

"Through our outreach efforts, immediate relief program and this settlement we have worked to address the potential impact to members following this unfortunate incident," Aetna wrote in a statement. "In addition, we are implementing measures designed to ensure something like this does not happen again as part of our commitment to best practices in protecting sensitive health information." (Gordon, 1/17)

Minnesota’s individual health insurance marketplace, MNsure, saw record enrollments and the smoothest annual sign-up period since the agency’s troubled launch in 2013. MNsure announced Wednesday that more than 116,000 people purchased insurance through the state market created under the Affordable Care Act, commonly called Obamacare. That’s slightly higher than last year, when 114,810 people bought plans, but it falls short of the 5 percent growth agency officials anticipated. (Magan, 1/17)

The uptick came at a time when the federal government website that serves as the health exchange for most states saw a 4 percent decline in sign-ups for 2018 coverage. (Snowbeck, 1/17)

MNsure CEO Allison O'Toole said the results show how far the agency has come since the website's bungled roll-out in 2013. "Five years into this business people are realizing the value and we are doing better and serving them better and our numbers are growing," she said. Although MNsure enrollment is up, the size of Minnesota's individual-market health insurance pool is down sharply over the past few years, fueling concerns about its future stability. (Zdechlik, 1/17)

The preliminary tally of Texans who signed up for 2018 health coverage under the Affordable Care Act was just shy of the previous year even though the enrollment period was cut nearly in half. About 1.1 million people in the Texas enrolled for plans as of Dec. 23. That is 100,00 fewer than the 1.2 million who had signed up for 2017 plans, although it does not include all Texans who live in the wide swath of the state affected by Hurricane Harvey and were given an extra two weeks to sign up beyond the Dec. 15 deadline. (Deam, 1/17)

Fewer people selected health insurance plans this year on Colorado’s Obamacare exchange, the first time open enrollment numbers have dropped year-over-year in the state and in keeping with a nationwide dip in people buying insurance on such exchanges. Colorado health care advocates said the decline may in part be due to recent decisions by the Trump administration to chip away at provisions of Obamacare, officially known as the Affordable Care Act. But the overall reason for the decline is unclear. Also unclear is whether there are now more people without health insurance in Colorado. (Ingold, 1/17)

Fewer Michigan residents are enrolling in health insurance through the Affordable Care Act, which loses its Obama-era penalty next year for individuals who fail to buy insurance. There were 293,940 Michigan sign-ups on the Healthcare.gov exchange for 2018 individual and family plans, down nearly 9% from last year, according to federal figures, which showed nationwide sign-ups down 5%. (Reindl, 1/17)

In an effort to help fight the nation’s opioid epidemic, Walmart is giving its pharmacy customers a free drug disposal product to help customers safely discard of painkillers they don’t want or need. A small packet of DisposeRX powder will be automatically handed to customers filling new Class II opioid prescriptions, and those with chronic prescriptions will be given a free packet every six months, Walmart announced in a statement Wednesday. Officials said the product is a quick and secure way for people who might be concerned about someone abusing their excess pills to throw them away: Just fill the 2/3rds of the prescription vial with water, add the DisposeRX powder and screw on the cap before shaking the vial for about 30 seconds. (Eltagouri, 1/17)

The move comes as the U.S. grapples with the scourge of opioid addiction, an affliction that often begins when chronic-pain sufferers fill a prescription at a retail pharmacy chain like Wal-Mart, CVS or Walgreens. More than two out of three people misusing prescription opioids get them from family and friends, according to federal data. Opioid overdose deaths rose 28 percent in 2016, to 42,000 men, women and children. (Boyle, 1/17)

Opioid abuse has skyrocketed in the United States in the last 25 years and accounts for the greatest proportion of prescription drug abuse, according to the National Institute on Drug Abuse. By 2002, death certificates listed opioid poisoning as a cause of death more commonly than heroin or cocaine. (Sullivan, 1/17)

A new congressional report suggests that Medicaid is helping drive the nation’s opioid crisis by making it easier for enrollees to abuse and then resell the highly addictive painkillers. At least 1,072 people have been convicted or charged nationwide since 2010 for improperly using Medicaid to obtain prescription opioids, some of which were then resold on the nation’s streets, according to the report by Republicans on the Senate Homeland Security and Governmental Affairs Committee. (Collins, 1/17)

Health experts have an intriguing suggestion for reducing opioid overdoses and deaths — asking doctors to prescribe bigger doses of the powerful painkillers. It may sound counterintuitive, but providing more pain relief to patients right away might allow them to stop taking the pills sooner. And reducing the total amount of time that patients are on opioids could ultimately reduce the risk of addiction and abuse, new research suggests. (Kaplan, 1/17)

The U.S. Securities and Exchange Commission agreed to allow AmerisourceBergen shareholders to vote on a proposal demanding the wholesaler provide more information on steps taken to manage financial and reputational risks associated with the opioid crisis. The agency also allowed another proposal to proceed in which the company would have to disclose if its board clawed back compensation from senior executives due to misconduct. The decisions are a victory for a coalition of 40 institutional investors that are pressuring drug makers and distributors to investigate how the companies are responding to increased business risks caused by the opioid crisis. The investors noted that AmerisourceBergen (ABC) reached a $16 million settlement last year with the West Virginia attorney general for failing to report suspicious orders of controlled substances. (Silverman, 1/17)

Top Democrats in the Senate are questioning the Trump administration over its decision to end a national registry for evidence-based mental health and substance abuse programs. The Substance Abuse and Mental Health Services Administration (SAMHSA) ended the contract for the National Registry of Evidence-Based Programs and Practices (NREPP) earlier this month, calling it a flawed and ineffective system. (Hellmann, 1/17)

Nearly a dozen people were indicted Wednesday for trafficking heroin and fentanyl throughout New York City, prosecutors said. The 11 suspects are accused of distributing heroin laced with fentanyl, a deadly synthetic opioid driving fatal overdoses, in Staten Island, Brooklyn, Manhattan and New Jersey from 2015 to this month, according to the indictment unsealed by the U.S. Attorney’s Office for the Southern District of New York. Eight of the 11 suspects were arrested Wednesday morning. (Kanno-Youngs, 1/17)

Philadelphia has filed a lawsuit against drug companies that make prescription opioids, saying they’ve created “an unprecedented public health crisis. ”It seeks to halt what the city calls deceptive marketing practices and force the drugmakers to pay for treatment costs and reimburse it for the money it has spent responding to the addiction epidemic. (1/17)

As suicide rates have climbed in recent years, so have instances of employees ending their lives at the workplace. It happened at a Bank of America Corp. call center in New Mexico in November, at a Ford Motor Co. plant outside Detroit in October, and at Apple Inc.’s Cupertino, Calif., headquarters in April 2016. Nationwide, the numbers are small but striking. According to the Bureau of Labor Statistics, suicides at workplaces totaled 291 in 2016, the most recent year of data and the highest number since the government began tallying such events 25 years ago. (Feintzeig, 1/17)

The country that put the starch in "stiff upper lip" has made companionship, conversation and human contact a national priority. On Wednesday, British Prime Minister Theresa May announced the creation of a new ministerial portfolio in her Cabinet: combating loneliness. With more than 9 million British adults reportedly experiencing chronic loneliness — and a stack of studies documenting the corrosive health effects of such social isolation — May said it was time that a high-level government official coordinate a "first-ever strategy" to address the scourge. (Healy, 1/17)

After nearly four decades of rising body weights in the United States and across the world, medical experts are still casting about for the best way to treat obesity and the diseases that come with it. The answer may depend on which contributes more importantly to ill health: not enough fitness, or too much fatness? (Healy, 1/17)

Many physicians will tell you their path to medicine began in their youth. But for others, a career as a doctor was a later-in-life decision, a change of plans, a new challenge — for whatever reason, career number two. Indeed, recent years have seen an increase in first-year medical residents over the age of 29 in the U.S. and Canada, according to data from the Association of American Medical Colleges. As the number of first-year medical residents has increased overall, the percentage of first-year residents over age 29 also increased — from 35 percent of the total to 35.2 percent from 2012 to 2016. That amounts to about 40,000 additional medical trainees who made the later-in-life switch. (Samuel, 1/18)

Here's yet another reason to floss, and to end the baffling distinction that health insurers make between our mouths and the rest of our bodies: A big study of more than 7,000 people out in the Journal of the National Cancer Institute reports that people found to have severe gum disease had a 24 percent higher risk of cancer compared with those with mild or no gum disease. (Goldberg, 1/17)

New Hampshire is one of 49 states reporting “widespread” flu activity, meaning the virus is rearing its head in more than half of the state. And according to the latest data from the Department of Health and Human Services, at least 10 adults have died from the virus in New Hampshire since September. (McDermott, 1/17)

After two relatively mild seasons, the flu virus is once again proving its unpredictable nature, peaking earlier than usual in Central Florida and on track to become the most widespread outbreak in recent history, affecting the entire country. Local emergency departments, urgent care centers and intensive care units, where more severe cases of flu end up, are reporting higher traffic than usual because of the spike in the number of flu cases. (Miller, 1/17)

A 10-year-old Connecticut boy attending a hockey tournament in neighboring New York state has died from complications caused by the flu. Nico Mallozzi, of New Canaan, Conn., started feeling ill last week but wanted to be with his team, the RoughRiders, in Buffalo for the weekend, local media reported. However, the boy began feeling sicker and was taken to the emergency room at a Buffalo hospital, where he was diagnosed with Influenza B, New Canaan Director of Health David Reed said, according to the New Canaan Advertiser. (Diebel, 1/17)

Kinsa’s thermometers connect to smartphones and can take a fever and other symptoms like cough and sore throat entered into a mobile app to track suspected case of flu. Its latest analysis estimates that about 5.2 percent of Missourians were sick last week, the highest rate in the country. (Marso, 1/17)

The California case in which 13 siblings were found imprisoned at home earlier this week is shocking, but not without precedent. Lurid cases have come to light over the years of children locked in closets and basements, held captive by parents who have crumbled under the weight of drugs, extreme religious conviction, personality disorders or their own abusive backgrounds. The good news, trauma experts say, is that recovery is indeed possible. Victims can reclaim their lives. (Hoffman, 1/17)

There were no toys and no bicycles on the front lawn — only weeds that sometimes reached six feet tall. Neighbors rarely saw the 13 siblings who lived inside the home in a quiet neighborhood in Southern California, because they never went outside to play. Instead, authorities said, they were held captive in a dirty and foul-smelling house, some shackled to the furniture with chains and padlocks. (Schmidt and Bever, 1/16)

The political battle lines over single-payer healthcare in California are growing starker, with an alliance of doctors, dentists, nurse practitioners and other health providers ramping up their opposition to the proposal. In a letter to legislators, the coalition, unveiled Wednesday, blasted Senate Bill 562 as a proposal that “would dismantle the healthcare marketplace and destabilize California’s economy.” (Mason, 1/17)

The attorney for a woman left outside a Baltimore hospital wearing only a patient gown and socks on a cold night last week said the medical institution turned its back on her when she was having a psychotic episode. J. Wyndal Gordon, who said Wednesday that he was hired to represent the patient on behalf of the family, said the woman named Rebecca was now at an undisclosed inpatient facility undergoing mental health treatment. (McDaniels and Cohn, 1/17)

Some call it Medicare-for-all or single-payer health insurance, but the concept is the same: A system that provides everyone with health care regardless of their ability to pay. Patients at the free clinics would benefit from such a system because they can’t afford health insurance. (Ochoa, 1/18)

Public health officials are reporting a second case of measles in a person who was at Chicago's O'Hare International Airport, the nation's third-largest airport by passenger volume. The Illinois Department of Public Health said Wednesday that the case is unrelated to one reported last week. The department says there's no measles outbreak at O'Hare, which served 78 million passengers in 2016. (1/17)

In what looks like a typical doctor’s office, Gary Newcomer, 26, waited to have his blood drawn for the last time as a participant in a trial for a Zika virus vaccine.Newcomer has visited Saint Louis University’s Center for Vaccine Development 16 times since November 2016. But a cut in federal funding is bringing a halt to the trial before a vaccine can be developed. (Chen, 1/17)

Mathilde Krim, who crusaded against the scourge of AIDS with appeals to conscience that raised funds and international awareness of a disease that has killed more than 39 million people worldwide, died Monday at her home in Kings Point, N.Y. She was 91. (McFadden, 1/17)

One nursing home resident died after becoming trapped between a mattress and the bed’s grab bar. A resident of a different nursing home died after a staff member failed to follow the physician’s orders for care. In both cases last year, allegations of neglect by the east metro nursing homes were substantiated, according to reports released by the Minnesota Department of Health last week. Both nursing homes, in Roseville and Stillwater, respectively, are appealing the decisions. The identities of the residents were not released in either case. (Chavey, 1/17)

With babies placed in incubators with tubes and monitors, it can be hard for new mothers to bond with them when they have serious medical conditions, as Tristan and the other infants in the NICU do. To help overcome that difficulty, Children’s Hospital has offered a program since 2016 that teaches families ways to bond with their medically fragile children. (Richman, 1/17)

The vote to honor a tax-increment-financing (TIF) subsidy promise to Illinois largest Catholic health system was 31 to 18. (Spielman, 1/17)

The Massachusetts Cannabis Control Commission is plowing ahead with its preparations for the debut of recreational pot sales in July, despite a recent change in federal law enforcement policy that has put a cloud of uncertainty over the marijuana industry. The commission has voted to negotiate a contract with Franwell Inc., a Florida-based software firm whose “Metrc” product tracks all the marijuana sold legally in Colorado and most other states with recreational markets. (Adams, 1/17)

Amid much fanfare last October, President Trump declared that the nation's opioid crisis was a “public health emergency” and spoke movingly of losing his older brother to alcohol addiction. That 90-day declaration is set to expire Tuesday. And while some promising plans are taking shape, the federal follow-through is falling far short of what is needed. (1/17)

President Trump directed the Department of Health and Human Services (HHS) to declare a historic public health emergency regarding the opioid crisis last Oct. 26. But every day since I arrived to run the federal government’s behavioral health agency, the Substance Abuse and Mental Health Services Administration (SAMHSA), and every day since the president took office, America’s opioid crisis has been treated as an emergency situation.As the former chief medical officer of a state struggling with the crisis and former chief medical officer of SAMHSA, I can say with confidence that this administration has brought a new, desperately needed level of urgency to the crisis our families and communities are suffering from every day. (Elinore F. McCance-Katz, 1/17)

Before Joe Thompson switched treatments for his opioid addiction, he was a devoted stay-at-home father, caring for his infant son after his wife returned to work. His recovery was aided by the anticraving medication buprenorphine. But after over two years free of heroin, Mr. Thompson, a former United Parcel Service worker from Iowa, relapsed and decided to try another kind of treatment program. Unfortunately, his new counselors insisted that continuing his buprenorphine, though it was approved by the Food and Drug Administration, was just as bad as using heroin, according to his wife, Deborah. He wasn’t even allowed to start therapy until he’d been abstinent for several weeks. Stressed by withdrawal, he went to a third center. It, too, banned medication. Within a week of entering the program, he was dead from a heroin overdose. He was 35. (Maia Szalvitz, 1/17)

Washington tourists with time on their hands Wednesday could have popped into the Capitol to witness an ancient phenomenon: Senators doing their darndest to prove a partisan fantasy. In this case, the fantasy was that Medicaid expansion is to blame for the opioid crisis in the United States. The ringmaster was Sen. Ron Johnson (R-Wis.). Johnson has been flogging this notion for the better part of a year, or longer, despite the utter lack of evidence that it's true — and plenty of evidence that the opposite is true. (Michael Hiltzik, 1/17)

Six years ago, when JAMA last published a theme issue on obesity, there was optimism that progress was being made in preventing and treating obesity. As time has passed, so too has the optimism, as reports continued to show that the prevalence of obesity was increasing and, most important, rapidly increasing in children. A year and a half ago, there was a call to reconsider obesity and view it in new ways with the hope of better managing this very consequential clinical problem. In response, JAMA has revisited obesity in the form of a theme issue. (Edward H. Livingston, 1/18)

If they ever finish arguing about immigration and the budget, members of Congress can be expected to turn to food stamps, which conservative Republicans want to cut and Democrats don't. For their own sake and to promote public health, both sides might want to focus on a simple reform that deserves bipartisan support: Require that food stamps be used for food. (1/17)

Life expectancy in the U.S. declined slightly in 2016, as it did in 2015, and — at least as important — the overall trends continue to mask increasing disparities across socioeconomic groups. Carol Graham of the Brookings Institution helps explain why. Her important new book is the empirical version of "Hillbilly Elegy." I have long suspected that stress and lack of hope are to blame for widening the gap in life expectancy between lower and higher earners. Graham uses survey data to support this explanation, documenting striking differences in stress and optimism across segments of the population. (Peter R. Orszag, 1/17)

I have decided to join what seems to be a national pastime: predicting in January what will happen in health policy during the course of the year. This year, such forecasting may be easier than is typical; not much health-related legislation (or any other substantive legislation) is likely to pass in 2018, partly because it is a midterm election year for Congressional seats, and partly because the balance of Republican vs Democrat votes in Senate has shifted from 52 to 48 to an even closer 51 to 49 split after Doug Jones (D, Alabama) won a seat in Senate in December. (Gail Wilensky, 1/17)

Examining the White House physician’s briefing on President Trump’s physical, I was alarmed — not about the president’s health, but the doctor’s. Rear Adm. Ronny Jackson was so effusive in extolling the totally amazing, surpassingly marvelous, superbly stupendous and extremely awesome health of the president that the doctor sounded almost Trumpian. "The president’s overall health is excellent,” he said, repeating “excellent” eight times: “Hands down, there’s no question that he is in the excellent range. . . . I put out in the statement that the president’s health is excellent, because his overall health is excellent. . . . Overall, he has very, very good health. Excellent health.” (Dana Milbank, 1/17)

Sen. Bernie Sanders will hold an online town-hall meeting next Tuesday regarding his single-payer health-care legislation. Mr. Sanders calls it “Medicare for All.” But the text of the bill itself reveals a more accurate name: Medicare for None. The Orwellian way in which Mr. Sanders characterizes his plan speaks to the larger problem facing the left, whose plans for health care remain so radical that speaking of them honestly would prompt instant repulsion from most voters. (Chris Jacobs, 1/17)

The Republicans are right. We should cut Medicare. And I know how: Keep Medicare’s funding for actual health care but eliminate bureaucratic waste, profits, and the expensive and preposterous ban on negotiating drug prices. In other words, get rid of Part C and Part D and absorb the extra features into traditional Medicare. (Ed Weisbart, 1/17)

They were attacking the Trump administration’s decision last week to allow states to impose work requirements on Medicaid beneficiaries. But far from being a “cruel” action designed to inflict “pain” on the vulnerable, the administration’s decision is completely reasonable. Let’s start with the facts. First, the work requirements are targeted for able-bodied adults of working age. They do not apply to the elderly, to pregnant women or to the disabled. In addition, “work” is construed broadly to include community service, education, job training, volunteer service and treatment for substance abuse, among other potential forms of community engagement or self-betterment. (Michael R. Strain, 1/17)

The last thing Washington state should do is accept the Trump administration’s invitation to add a work requirement to Medicaid. Contrary to an administration letter, working itself does not help improve the health of poor people. Medicaid health insurance can help ailing people get healthy enough to work. (1/16)

Many years ago, as a fledgling social worker in New York City, one of us (JB) helped a single mom with a young son suffering from asthma get Medicaid coverage for her son. When I told her the news, she cried with relief. As young, privileged white guy, I was surprised by her reaction. I soon came to understand it. For this mother, as for millions of other low-income people, Medicaid coverage means access to health coverage for a sick child or a family member with a chronic illness, or long-term care for an elderly parent. (Jarred Bernstein and Hannah Katch, 1/17)

In 2003, Washington State was facing a budget crisis and wanted to reduce spending on Medicaid. Instead of requiring people to establish their eligibility annually, the legislature began requiring them to do so twice a year, and added some paperwork. It worked: Enrollment in the health insurance program fell by more than 40,000 children in a year. In the early 2000s, Louisiana wanted to maximize the number of eligible children who signed up for coverage, so officials simplified the sign-up process. It also worked: Enrollment surged, and the number of administrative cancellations fell by 20 percentage points. (Margot Sanger-Katz, 1/18)

For at least 25,000 Missouri children and their parents, the question of when their coverage under the Children’s Health Insurance Program could end is a matter of pressing consequence. Will it be at the end of February, as a study by Georgetown University’s Health Policy Institute estimates? Or the end of March, as the Medicaid and CHIP Access Commission reckons? Or is it June, as the state official in charge of the program told a conference in December? When the Post-Dispatch’s Samantha Liss put the question to the state Department of Social Services, she got a vague but encouraging emailed reply: “CHIP ending is not an imminent issue in Missouri.” (1/17)

A significant amount of progress has been made in reducing alcohol-impaired driving fatalities since the 1980s, yet progress began stalling in 2009 and fatalities started increasing again in 2015. Despite diminishing attention to this persistent, completely preventable issue, alcohol-impaired driving is by far the leading cause of motor vehicle fatalities. Among developed nations, the U.S. has the highest proportion of alcohol-impaired driving fatalities. This is unacceptable. (M. Kit Delgado, 1/17)

As STAT recently reported, trial sponsors had disclosed only 72 percent of required results on ClinicalTrials.gov as of September 2017, and 40 percent of those reports were made after the legal deadline. On the plus side, this reflects a positive trend, compared to 58 percent compliance two years earlier, prompted in large part by “naming and shaming,” as well as some attention from Congress and then-Vice President Joe Biden. Nevertheless, even the upswing still leaves quite a bit of the glass empty: Results from more than 1 in 4 trials have still not been properly reported. The ethical consequences are substantial, and the government should be using its considerable enforcement authority to put an end to it. But it isn’t. (Holly Fernandez Lynch, 1/17)

Last year was hard for the California Primary Care Association.  ...As if that wasn’t enough, Congress failed to reauthorize federal funding for the community health center program by the Sept. 30 deadline, despite traditional bipartisan support. Health centers, which could lose 70 percent of their federal funding, are in a state of limbo. (Carmela Castellano-Garcia, 1/17)

Laguna Beach residents Al Roberts and Ken Jillson founded AIDS Services Foundation (ASF) in 1985, eventually turning it into one of the county’s most respected HIV/AIDS nonprofit organizations. But the organization has changed its name to Radiant Health Centers — and some longtime board members are displeased. Mark Gonzales, vice president of Radiant’s board of directors, tells me the name change is part of “expanding services.” (Barbara Venezia, 1/18)

Drowning is the second leading cause of death for California children 1 to 4 years old, behind birth defects, according to both the federal Centers for Disease Control and the state Department of Public Health. And most of those drownings occur in home swimming pools. (Nadina Riggsbee, 1/17)