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Republicans in the state of Washington didn’t wait long in the spring of 1995 to fulfill their pledge to roll back a sweeping law expanding health coverage in the state. Coming off historic electoral gains, the GOP legislators scrapped much of the law while pledging to make health insurance affordable and to free state residents from onerous government mandates. It didn’t work out that way: The repeal left the state’s insurance market in shambles, sent premiums skyrocketing and drove health insurers from the state. It took nearly five years to repair the damage. (Levey, 5/31)

As a thyroid cancer survivor battling nerve damage and other complications, Lisa Dammert was in such dire financial straits in 2014 that she and her husband did the unthinkable: They let their health insurance lapse for a while. If the Dammerts and some of the millions of other Americans like them do that under the Republican health care plan now making its way through Congress, they could end up paying a heavy price. (5/31)

Senate Republicans crafting an Obamacare replacement are delaying one of their toughest decisions: whether to keep all of the House measure’s $664 billion in tax cuts that mostly benefit well-off Americans. The House in a bill passed May 4 voted to end taxes enacted under the Affordable Care Act, including those on investment income, expensive "Cadillac" health plans and even indoor tanning. Yet some moderate senators want to keep part of that revenue to soften the House plan’s deep health-care cuts that are estimated to leave 23 million fewer people with insurance by 2026. (Litvan, 5/31)

Uncertainty about whether the Trump administration would enforce the Affordable Care Act’s individual mandate is causing heartburn for some insurers — and it’s evident in their requests to set premiums. Rate filings show some insurers believe the Trump administration could stop enforcing the mandate — or it’s already not being enforced, Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute, said at an event on Wednesday. (McIntire, 5/31)

Skeptics of Republican Sen. Bill Cassidy's alternative to the Affordable Care Act moaned and jeered at him during a town hall in Louisiana Wednesday, and when he said he's "neutral" on the Paris Accords to combat climate change, members of the audience groaned. One shouted, "Take a stand." The Republican senator had his supporters among the more than 200 people who jammed a meeting hall in Covington, north of New Orleans. They applauded loudly when he said insurance premiums and deductibles for health insurance have skyrocketed for some under President Barack Obama's health care law. (5/31)

The last time U.S. Sen. Bill Cassidy held a town hall meeting in the metro New Orleans area, he ran into a buzzsaw of boisterous constituents.His town hall meeting in Covington Wednesday (May 31) was hardly as raucous as that February gathering in Metairie, but the capacity crowd nonetheless came with pointed questions, mostly about health care. Even more people gathered outside the building, unable to fit into the 220-seat auditorium at the St. Tammany Parish School Board office. The Associated Press reported that some of those outside chanted "Health care, not wealth care.''...Most of the questions posed during the hour-long forum focused on the health care plan the U.S. House of Representatives recently approved to replace Obamacare and what version the U.S. Senate will eventually come up with. (Warren, 5/31)

The Tuesday of Memorial Day recess was a busy one for members of Congress interacting with constituents. It could be just the start, considering many more public meetings are planned for later this week or over the weekend. For instance, Rep. Leonard Lance, R-N.J., distanced himself from Trump in front of angry town hall attendees demanding he do just that. While across the country in California, Republican Rep. Darrell Issa may have hidden from his protesting constituents on top of his district office roof. A little farther north in California, Trump supporters disrupted an immigration town hall with Democratic Rep. Lou Correa, resulting in the arrest of one man and the detention of two women. (Breiner, 5/31)

Politically, Sens. Rob Portman (R-Ohio) and Mark Warner (D-Va.) are not all that far apart. Both are moderates who rejected proposed cuts in Medicaid funds. And yet, in the highly polarized atmosphere of Washington, D.C., they find themselves rallying constituents along diametrically opposed positions. The dialogue has become President Obama’s Affordable Care Act versus a new GOP bill, called (for now) the American Health Care Act. A love-it-or-leave-it mentality pervades both sides. As angry voters at town halls express their concerns about the state of American health care, the senators are reaching out for patient stories to prove their respective viewpoints. (Bluth, 6/1)

The prospect of a universal single-payer healthcare system in California — in which the state covers all residents’ healthcare costs — has enthralled liberal activists, exasperated business interests and upended the political landscape in the state Capitol. But some are still trying to sort out what exactly all the fuss is about. (Mason, 6/1)

A longshot California proposal to replace insurance companies with government-funded health care for all of the state's residents could be paid for with a sales tax hike and a new tax on business revenue, according to a report released Wednesday. (Bollag and Cooper, 5/31)

A pending state Senate bill would provide government-funded universal health care for California's 39 million residents. The bill faces a Friday deadline for passage out of the Senate if it is to be considered by the state Assembly. Here's how University of Massachusetts-Amherst researchers, in a study commissioned by the influential California Nurses Association, suggest the state pay for it. (5/31)

As the California Senate considers voting this week on a proposal to replace private health insurance with a statewide health plan that covers everyone, the bill’s main backers on Wednesday heralded a new study that says the plan could save Californians $37.5 billion annually in health care spending — even after adding the state’s nearly 3 million uninsured. (Murphy, 5/31)

Democratic gubernatorial candidate Antonio Villaraigosa said he supports universal healthcare but advocates for a state-sponsored single-payer system may be “creating false expectations” given the enormous costs involved. (Willon, 5/31)

Somewhere in Iowa, a teenager with a severe bleeding disorder holds the answer to a nationally debated riddle: How could anyone rack up more than $1 million per month in medical bills? Iowa’s largest health insurer, Wellmark Blue Cross & Blue Shield, has cited the case as an extreme example of exploding health care costs. Wellmark has said the single member’s bills amplified fast-rising premiums among tens of thousands of other Iowans who buy their own insurance. (Leys, 5/31)

Blue Cross and Blue Shield of North Carolina reported a dramatic increase in profit in 2016 and paid two top executives bonuses of more than $1 million despite a technology fiasco that triggered complaints from thousands of customers and a record fine from the North Carolina Department of Insurance. The state’s largest health insurer, which is based in Durham, reported Wednesday that it generated net income of $185 million last year, up from $500,000 in 2015. This year’s profit amounted to 2.4 cents for every dollar of premium received. (Ranii, 5/31)

In 2015, Washington filed a breach of contract lawsuit in Orange County Superior Court against his insurer, Aetna, arguing that the company had improperly denied him the medication. The case is set for trial this month. From 35,000 to 50,000 people in the U.S. are estimated to be dependent on medications to treat primary immunodeficiency diseases — about 300 rare conditions in which the immune system doesn’t function properly, or at all. The medication, known as immunoglobulin replacement therapy, replaces antibodies that the body doesn’t make. It can cost tens of thousands of dollars each year. (Gorman, 6/1)

On May 2, J. Mario Molina walked into the boardroom of Molina Healthcare Inc., the company founded by his father, which he had run for more than two decades, ready for a routine meeting. The first shock came quickly. A board member made a motion to remove Dr. Molina as chairman. The rest of the board, except Dr. Molina and his brother, John Molina, agreed, and the vote passed. They weren’t finished. Next came a motion to fire Dr. Molina as CEO of the health insurer, one of the country’s biggest players on the ACA marketplaces. And then, to dump John Molina as CFO. Both motions carried, with only the Molinas opposed. (Wilde Mathews, 5/31)

Insurance companies in about half a dozen states have filed for premium increases ranging from 6 percent to 58 percent for 2018, citing rising medical costs and taxes as well as uncertainty surrounding the new Trump administration's implementation of the health care law. The increases would only affect plans sold on the marketplaces established by the 2010 law (PL 111-148, PL 111-152). They are still preliminary. Federal and state insurance review rate requests throughout the summer and fall and often negotiate different increases — sometimes lower, sometimes higher. Federal subsidies also blunt the impact on consumers of high rate increases. (Mershon, 6/1)

Aetna Inc., whose founding more than 150 years ago helped turn Hartford, Connecticut, into the insurance capital of the U.S., is thinking about leaving. The health insurer is in negotiations with several states about relocating its headquarters, and will make a decision by early summer, T.J. Crawford, an Aetna spokesman, said in a statement Wednesday. Luke Bronin, Hartford’s mayor, called the insurer’s departure “a hard blow for the state and for the greater Hartford region.” (Tracer, 5/31)

The State of Ohio filed a lawsuit on Wednesday against the pharmaceutical industry over the opioid epidemic, accusing several drug companies of conducting marketing campaigns that misled doctors and patients about the danger of addiction and overdose. Ohio’s attorney general, Mike DeWine, sued the drug makers in a case similar to one that was filed by Mississippi in 2015 and is still pending. In another case, West Virginia went after major drug distributors and has reached settlements that will pay the state tens of millions of dollars. The City of Chicago, and counties in New York, California and West Virginia, have all started litigation. (Perez-Pena, 5/31)

Attorney General Mike DeWine said the companies created a deadly mess in Ohio that they now need to pay to clean up. “This lawsuit is about justice, it’s about fairness, it’s about what is right,” DeWine said in announcing the complaint filed in Ross County, a southern Ohio community slammed by fatal drug overdoses from painkillers and heroin. (Smyth, 5/31)

“These drug manufacturers led prescribers to believe that opioids were not addictive, that addiction was an easy thing to overcome, or that addiction could actually be treated by taking even more opioids” [DeWine] said in a statement. “They knew they were wrong, but they did it anyway — and they continue to do it. Despite all evidence to the contrary about the addictive nature of these pain medications, they are doing precious little to take responsibility for their actions and to tell the public the truth.” (Silverman, 5/31)

The complaint, filed in state court in Ross County on Wednesday, targets parent companies and various subsidiaries, including Purdue Pharma L.P.; Johnson & Johnson; Teva Pharmaceutical Industries Ltd.; Allergan PLC; and Endo International PLC’s Endo Health Solutions unit. Johnson & Johnson denied the allegations. The other companies either declined to comment or said officials were reviewing the allegations. (Whalen, 5/31)

Ohio is among the first states to sue drug companies in the middle of a growing national battle with opioid addiction and overdose deaths, with Ohio at the epicenter. (Borchadt, 5/31)

Top federal health officials said Wednesday that they will launch a joint effort with pharmaceuticals companies to accelerate the development of drugs aimed at helping to curb the U.S. opioid epidemic. Francis S. Collins, director of the National Institutes of Health (NIH), and Nora D. Volkow, who heads one its components, the National Institute on Drug Abuse (NIDA), announced a public-private partnership aimed at cutting in half the time ordinarily needed to develop new therapies. (Bernstein, 5/31)

Researchers at the National Institutes of Health will collaborate with the drug industry to address aspects of the opioid abuse and overdose crisis, two agency leaders announced Wednesday. The main goals of the partnership will be to develop improved overdose-reversal and addiction treatments and researching non-addictive alternatives to opioid painkillers. Separately, the administration announced Wednesday it would make available funding first authorized nearly a year ago by a law to address opioid abuse. (Siddons, 5/31)

A company that manages prescription drug plans for tens of millions of Americans has sued a tiny drug maker that makes an emergency treatment for heroin and painkiller overdoses, increasing the tension between the companies that make drugs and those that decide whether they should be covered. Express Scripts, the nation’s largest pharmacy benefits manager, is suing Kaléo, the manufacturer of Evzio, the injectable overdose treatment whose price quintupled last year, drawing widespread outrage and inquiries from members of Congress. Express Scripts claims it is owed more than $14.5 million in fees and rebates related to Evzio, and it has dropped the drug from its preferred list. (Thomas and Ornstein, 5/31)

Close to 200,000 Americans have died by overdosing on prescription painkillers, and a new report traces some of the blame to five simple sentences written nearly 40 years ago. The sentences, containing just 101 words, appeared in a 1980 issue of the New England Journal of Medicine. They formed a letter to the editor that described a rudimentary analysis of 11,822 hospital patients who took a narcotic painkiller at least once. The vast majority of those patients tolerated the drugs without incident, according to Jane Porter and Dr. Hershel Jick of the Boston Collaborative Drug Surveillance Program. (Kaplan, 5/31)

These customers have been on heroin, hydrocodone, Oxycontin — and they swear that the greenish powder dispensed by this machine is what allowed them to escape their addictions. It’s called kratom. It is the pulverized version of a plant from Southeast Asia. And it’s got thousands upon thousands of fans, who credit it with everything from ending their opioid habit to treating their anxiety to controlling their arthritis pain. In a single hour, some five people stop by, and the servers say it gets even busier right around opening and closing. (Boodman, 6/1)

For the majority of us, it’s not a question of whether we’ll someday experience back pain; it’s a question of when. But searching for solutions can lead sufferers into an expensive and sometimes dangerous maze of ineffectual treatments, procedures and pills. (Venton and Brooks, 5/31)

Stripped of basic rights, addicts are told by the people who run their boarding houses — called recovery houses — what facility to attend, when to go, and for how long. If addicts don’t take the van rides, house operators threaten them with eviction...In exchange for herding people into centers, recovery house operators pocket illegal, under-the-table payments – ranging from $100 to $400 per person monthly – that keep them in business. The centers, in turn, bill the government for a piece of the $680 million in Medicaid and state money disbursed in 2016 by a nonprofit contracted by the city to combat addiction and mental health issues. (Lubrano, 6/1)

Baltimore Health Commissioner Dr. Leana Wen will sign a new standing order making an antidote that reverses the effects of opioids available over the counter. Wen will sign the order on Thursday at 9 a.m. at Fibus Drug Store. The order will make the medication, called naloxone, readily available to residents. Previously, a training session was required to receive a naloxone prescription. (6/1)

Police dogs simply follow their noses to sniff out narcotics. But inhaling powerful opioids can be deadly, so officers have a new tool to protect their four-legged partners: naloxone, a drug that has already been used for years to reverse overdoses in humans. Law enforcement officers have started carrying naloxone with them on drug raids, when K-9s are often sent into houses or cars to find narcotics. Three police dogs in Florida were rushed to an animal hospital last year when they ingested fentanyl, a powerful painkiller that is often mixed with street heroin but 50 times more potent. (Lavoie, 6/1)

Doctors in the United States have been reducing the amount of opioids they prescribe for pain as the nation grapples with a deadly addiction epidemic. The frequency of opioid prescriptions written in Maryland dropped 13.3 percent from 4.2 million in 2013 to 3.6 million in 2016, according to MedChi, the state medical society. In July, a new state policy will require doctors to get prior authorization in certain cases to prescribe opioids to Medicaid patients. The hope is to get doctors to look at others ways of treating pain. One alternative form of pain treatment touted by some health care practitioners is acupuncture. (McDaniels, 5/31)

All four were homeless or living without permanent shelter when they died, according to the Medical Examiner’s Office. Recent figures show the numbers of such deaths are trending, and not in the right direction. With 48 homeless deaths recorded at the end of April, the county is more than halfway toward the total number in all 2016. The numbers have been moving upward for several years. In 2010 there were 47 homeless deaths, while in each of the past two years the number was 91. (Coleman, 5/31)

The rate of hospital inpatient stays in Ohio because of opioid use increased 52 percent from 2009 to 2014, according to the latest available data from the Agency for Healthcare Research and Quality. It’s just another piece of grim proof that the abuse of heroin and narcotic painkillers has hit alarming levels, officials say. (Pyle, 6/1)

Federal investigators and prosecutors in northern Ohio are seeking to create a new "strike force," a designation that would put more money toward combating the heroin scourge and violent crime in northern Ohio through aggressive law enforcement. (Heisig, 5/31)

One paramedic remembers when the hair on the back of his neck would stand on end as he headed out on an overdose call. Not anymore. This is the classic definition of compassion fatigue, when typically caring people find themselves unable to empathize anymore because the frequency of the appeals for their help is so overwhelming. (5/31)

A judge has rescinded permission for a physician — representing himself in a drug case that could net him hundreds of years in prison — to commute to a law library. Scranage, 62, is awaiting an Aug. 7 trial on 19 counts alleging he ran a lucrative Richmond-area oxycodone “pill mill.” He is representing himself and last week Novak approved his request to travel to the library to assist in his own defense. (Green, 6/1)

The tweet came, as they often do, when many others on the East Coast are sleeping. But when President Trump complained to the twitterverse about all the "negative press covfefe," just after midnight Wednesday, sleep experts saw it as more than just a laughable lapse. "Cognitive tasks like spelling are impaired by poor sleep," says neurologist Chris Winter, author of the new book The Sleep Solution. "I would think something’s up, to put it mildly." (O'Donnell, 5/31)

Trump’s tweet did raise concerns about the health of a president who is 70 years old, overweight and just returned from a jam-packed eight-day trip across the Middle East and Europe. Conservative writer David Frum, a former aide to President George W. Bush, tweeted his speculation that Trump may have experienced a spasm while his Twitter feed was live, and lost consciousness. “Because typos are rapidly fixed. This looks as if the president spasmed, passed out — and nobody on staff noticed,” wrote Frum, who has been a frequent critic of Trump. However innocent the truth of this matter, speculation about Trump’s mental and physical health follows a long history of presidents hiding the facts about troubling medical conditions from the public. (Bennett, 5/31)

Even as IVF has made technological advancements, an outdated measurement system and weak consumer protections continue to obscure the differences between the best doctors in the business and those who run troubled clinics. (Yeung and Jones, 6/1)

Depression is usually considered an issue parents have to watch out for starting in the turbulent teenage years. The CW channel, full of characters with existential angst about school, friends and young love, tells us so, as do the countless parenting books about the adolescent years in every guidance counselor's office. But what if by that time it's already too late? (5/31)

Trying to make out what someone is saying in a noisy environment is a problem most people can relate to, and one that gets worse with age. At 77, Linda White hears all right in one-on-one settings but has problems in noisier situations. "Mostly in an informal gathering where people are all talking at once," she says. "The person could be right beside you, but you still don't hear them." (Siegel and Hsu, 5/31)

A new analysis of dozens of clinical trials found that lowering systolic (the upper reading) blood pressure below traditional targets may significantly reduce the risk of cardiovascular disease as well as dying from any cause. The new analysis published Wednesday in the journal JAMA Cardiology looked at 42 clinical trials and systolic blood pressure involving 144,000 patients treated for high blood pressure. (Fauber, 5/31)

Earlier this year, 30 senior citizens convened in a living room to talk about growing older and needing more help.Who will be my allies as I go through this process, they asked. Many were unmarried, without children, living alone. Some had adult children living elsewhere, with demanding jobs and busy lives. Others had spouses who were ill or temperamentally unsuited to the task. (Graham, 6/1)

The Food and Drug Administration (FDA) has announced two unrelated nut recalls — Kroger’s Simple Truth Dry Roasted Macadamia Nuts and Ava’s Organic Cashews Roasted & Salted — because they may be contaminated with the bacterium Listeria monocytogenes. (Carstensen, 5/31)

Veterans Affairs Secretary David Shulkin urged Congress on Wednesday to pass a law that would let him respond more quickly to employee misconduct, such as the case of a psychiatrist who was caught watching pornography on an iPad while seeing a patient. Shulkin, in a briefing on the state of the department, said that veterans' access to medical care had improved significantly since a scandal over wait times three years ago prompted the resignation of a VA secretary and forced major reforms. (Alexander, 5/31)

Dr. David Shulkin, the secretary of the U.S. Department of Veterans Affairs, said Wednesday that medical marijuana may benefit veterans dealing with post-traumatic stress disorder, and encouraged lawmakers to debate the issue. “There may be some evidence that this is beginning to be helpful, and we’re interested in looking at that,” Dr. Shulkin told reporters at the White House when asked about medical marijuana. (Bender, 5/31)

This dream scenario explains the optimism behind market research firms’ predictions that home health devices will grow into a $100 billion industry in five years. Companies have noticed delivering results in less than 24 hours — results that right now can take weeks — could be a gold mine. (Gornstein, 6/1)

A mind-controlled robotic glove under development by Washington University scientists could give hope to those whose hands have become paralyzed due to a stroke. In the journal Stroke, researchers reported some success with using the device, called the Ipsihand, to help stroke patients regain the ability to grasp objects. (Chen, 5/31)

At least 504 terminally ill Californians have requested a prescription for life-ending drugs since a state law allowing physician-assisted deaths went into effect in June 2016, marking the first publicly released data on how the practice is playing out in the nation's most populous state. The number represents only those who have contacted Compassion & Choices, an advocacy group that provides information on the process. The organization believes the overall figure to be much higher. (6/1)

The Obamacare exchange may survive next year in rural Georgia. But patients who depend on its last remaining insurer are now learning there’s a catch. ... Blue Cross Blue Shield of Georgia, the only insurer on the exchange for 96 of the state’s 159 counties, is telling patients with individual policies that if they go to the emergency room and it’s not an emergency, they’ll be stuck with the bill. (Hart, 5/31)

The state Senate on Wednesday voted to no longer make it a felony for someone infected with HIV to knowingly expose others to the disease by having unprotected sex without telling his or her partner about the infection. (McGreevy, 5/31)

Children's Hospital is expanding to Austin with an extensive outpatient network that would be the latest extension of its brand beyond the Texas Medical Center. The elite Houston hospital plans over the next five years to open four pediatric urgent-care clinics, three pediatric specialty clinics, 18 pediatric primary-care practices and two maternal-fetal medicine practices, leaders said Wednesday. The first to open will be an urgent-care clinic in south Austin next spring. (Ackerman, 5/31)

The New Hampshire House votes Thursday on a bill that would allow fetuses older than twenty weeks to be considered people in cases involving murder, manslaughter and negligent homicide. (6/1)

“We have increased our lab capacity so that the turnaround time for results will be much shorter, and we have the ability to do all testing within our state, so we will not have to send samples out to the CDC lab in Colorado at this point," Florida Surgeon General Celeste Phillip says. (Aboraya, 5/31)

One reason for the shortage of psychiatrists and psychologists, [Dr. Mike] Neitzel said, is that it’s hard to convince an urban-trained professional to relocate to a more rural area. There are cultural reasons, and reasons of convenience—and sometimes, Neitzel said, the professionals have already had children by the time they finish residency, and don’t want to move their families. A high turnover rate in Missouri’s mental health workforce isn’t helping matters. (Moore, 5/31)

One of the country's largest vendors of electronic health records will pay a $155 million settlement to resolve allegations it caused health care providers to submit false claims to the federal government, the U.S. Department of Justice and federal prosecutors in Vermont announced Wednesday. The acting U.S. attorney for Vermont said eClinicalWorks, of Westborough, Massachusetts, and three executives will pay the settlement to resolve allegations the company misrepresented the abilities of its software and paid kickbacks to some customers in exchange for promoting its products. (5/31)

United provides health insurance for some of the region's largest local governments, including Pinellas County government and the cities of St. Petersburg and Tampa. ... United used to have a contract with All Children's that allowed members to pay in-network rates. But when it came time to renegotiate last fall, All Children's asked United to pony up more money. (McGory, 5/30)

A trustee for a Bronx-based chain of drug and alcohol rehabilitation clinics pleaded guilty on its behalf to stealing millions of dollars from Medicaid, New York Attorney General Eric Schneiderman said on Wednesday.The plea came 2-1/2 years after the attorney general accused Narco Freedom and some of its officials of trying to plunder the nonprofit and defraud Medicaid of at least $27 million. (Stempel, 5/31)

In the American Health Care Act (AHCA), recently passed by the House of Representatives as a replacement for the Affordable Care Act (ACA), a key element is restructuring how Medicaid is financed. One effect of this legislation is focusing attention beyond how Medicaid’s financing is structured, to examine how well it has been performing as a public insurance program. (Gail Wilensky, 5/31)

In 2016, state tax revenues declined for the first time since the Great Depression. The decrease in this critical funding source, coupled with sharp increases in drug prices, and the addition of nearly 17 million new enrollees since 2013, has put enormous pressure on the nation’s largest healthcare program. There are currently 74.6 million people enrolled in Medicaid and CHIP (Children’s Health Insurance Program), the state-administered programs that provide healthcare to low-income individuals and families; and the downward revenue and upward cost trajectories have threatened the sustainability of these essential services. (Bill Lucia, 5/31)

Improving health takes time. Almost everyone has struggled to improve their health in one way or another – whether it’s trying to achieve a healthier weight, recover from a serious illness, reduce anxiety and stress, or overcome an addiction – and we don’t expect overnight results. But when we find something that truly helps, we know we ought to stick to it and see it through to real results. Expanding the Medicaid program in Kentucky to cover more low-income, and predominantly working, people is truly making a difference in our population’s health, and we ought to stick to it. (Ben Chandler, 5/31)

Leaders of North Carolina’s General Assembly can’t silence the truth by arresting the messengers and sending them off to jail. The legislators’ refusal to accept federal funds to expand Medicaid, denying health care coverage to half a million North Carolinians, should be of far more concern than the protesters who interrupted their comfort and convenience. The state budgets from both the Senate and House fail to take any significant action to extend health care to North Carolinians in need. Things aren’t much different in Washington where the “American Health Care Act,” the GOP-backed repeal and replacement for Obamacare will result in 23 million Americans losing health care coverage they have now. (5/31)

In its ongoing effort to dismantle everything about the Affordable Care Act that Americans like, the Trump administration is going after the ACA’s requirement that insurance plans include coverage for preventive health care with no cost-sharing, including birth control. While we knew this would be coming in some form, a draft of the regulation obtained by Vox shows that the administration may go farther than most people realized. (Paul Waldman, 5/31)

The American Health Care Act, the bill recently passed by the U.S. House, is a storm rolling in from Washington, D.C. Obscured by foggy notions of improved fiscal flexibility for states and broader insurance choices for individuals, the AHCA will in fact hamstring state budgets and wipe out coverage in ways that endanger the health of thousands of Iowans and the financial viability of the 118 community hospitals they count on. (Kirk Norris, 5/31)

The Founding Fathers purposely made it difficult for elected officials to enact sweeping legislation. Our Constitution’s separation of powers demands coordination and consensus to pass especially meaningful and impactful laws. For that reason, most of the significant pieces of legislation passed in the last 60 years, after lengthy debate, ultimately achieved bipartisan majorities on final passage. (Mike Mullins, 6/1)

President Trump’s proposed budget for fiscal 2018 is being condemned, right and left, for the cuts it imposes on various federal programs. Too little attention is being paid to the necessary economizing the Trump budget avoids — specifically, with regard to Medicare. (Charles Lane, 5/31)

With a week to sift through the Trump administration’s first full-fledged budget proposal, two inescapable realities have come into sharper focus: the enormous magnitude of the desired cuts in many domestic programs and an utter disdain for numerical integrity. First, no budget in my 40 years of following fiscal policy has attempted to reallocate outlays as radically as this budget does. Most of the commentary has focused on the cumulative spending changes over the next decade; look instead at the proposed outlays for 2027 to understand the full extent of the proposed shifts. (Steve Rattner, 5/31)

She’s gone, peacefully and quietly. In my ICU, this is a “good” death. Without shocks, chest compressions, or drama. Her family at her bedside throughout. Yet we failed her. We could have done better. We should have done better. We failed her in medical school. We spend countless hours in the anatomy lab but barely a few hours learning communication skills and palliative care. We read books on diseases and their cures, but only a few handouts on how to provide comfort. Eager and enthusiastic future doctors are well-prepared to treat sickness but ill-equipped to face the challenges of managing death. (Jeremy Topin, 5/31)

Too often, individuals suffering from serious mental illnesses — those in greatest need of care — have been isolated and cared for outside of traditional health care, as in the asylums of the past. There, mental health care was separate from, and far from equal to, traditional health care. Why the disconnect? Psychiatry has been hampered by an inability to observe and record the physical workings of the brain. Because of that, psychiatric assessments and treatments have been viewed as somewhat mysterious. (John Campo, 5/31)

Some observers have expressed concern about the recent appointment of Scott Gottlieb as head of the Food and Drug Administration because of his past work with pharmaceutical companies. However, it’s important to remember that the FDA handles a lot more than drugs and biologics. In fact, addressing the Food Safety Modernization Act (FSMA) regulations will be a critical issue for Dr. Gottlieb. (Richard Williams, 5/31)

During the first few months of the Trump presidency, as in previous Republican administrations, there have been numerous restrictions, limitations, and debates regarding sexual and reproductive health. These have included the following: reinstating the Mexico City Policy, which prevents US federal foreign funding for nongovernmental organizations that provide counseling or referrals for abortion-related services; provisions in the proposed American Health Care Act that would have excluded Planned Parenthood from Medicaid reimbursements, restricted access to plans that cover abortions, and eliminated essential health services such as maternal care; and a congressional resolution allowing states the right to deny Title X federal family planning grant money to any organization that provides abortion services or is associated with a clinician or center that performs abortions. With Republican control of Congress and the White House, measures and attempts to limit access to selected sexual and reproductive health services will undoubtedly continue. (Divya Mallampati, Melissa A. Simon and Elizabeth Janiak, 5/30)

Until a few decades ago, the popular but falsely reassuring belief was that babies in the womb were perfectly protected by the placenta and that children were just “little adults,” requiring no special protections from environmental threats. We now know that a host of chemicals, pollutants and viruses readily travel across the placenta from mother to fetus, pre-polluting or pre-infecting a baby even before birth. (Frederica Perera, 6/1)