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The Trump administration announced Wednesday that the federal government would sharply curtail federal spending on medical research that uses tissue from aborted fetuses, mainly by ending fetal-tissue research within the National Institutes of Health. The move goes a long way toward fulfilling a top goal of anti-abortion groups that have lobbied hard for it; it is just the latest in a string of decisions that have pleased such groups. But scientists say the tissue is crucial for studies that benefit millions of patients. (Goodnough, 6/5)

The Department of Health and Human Services said it has discontinued all internal research that involves fetal tissue, which is obtained through elective abortions. External fetal-tissue projects that receive government funding will continue, but any grant application that is either new or up for renewal will require the approval of an ethics advisory board, the department said in a statement. “Promoting the dignity of human life from conception to natural death is one of the very top priorities of President Trump’s administration,” HHS said in a statement. (Garde, 6/5)

As part of the new restrictions, HHS said it is conducting a comprehensive review of all research involving fetal tissue “to ensure consistency with statutes and regulations governing such research, and to ensure the adequacy of procedures and oversight of this research in light of the serious regulatory, moral, and ethical considerations involved.” (Weixel, 6/5)

There are 200 external government-funded projects that use fetal tissue that will not be affected by the decision, an HHS spokeswoman said. The new policy affects three of NIH's 3,000 internal projects, she said, adding that they will be allowed to continue until fetal tissue material runs out. (Abutaleb, 6/5)

The determination to tighten federal support for an ideologically polarizing aspect of medical research was made by President Trump himself, a White House spokesman confirmed. “This was the president’s decision,” said spokesman Judd Deere, calling it “another important policy . . . to protect the dignity of human life.” The change represents a victory for antiabortion advocates, who immediately lauded the change, and a major disappointment to scientists who say the tissue collected from elective abortions has been instrumental to unlocking the secrets of diseases that range from AIDS to cancers to Zika, as well as to developing vaccines and treatments for illnesses such as Parkinson’s disease. (Goldstein, 6/5)

The new restrictions had been closely guarded and fiercely debated within the Trump administration. Acting White House Chief of Staff Mick Mulvaney and domestic policy chief Joe Grogan had pushed for the outright ban on NIH using fetal tissue obtained from abortion, said the two officials with knowledge of those conversations. HHS Secretary Alex Azar had argued for a less restrictive policy that would have allowed ongoing research on tissue acquired from research institutions, those officials told POLITICO. (Johnson and Diamond, 6/5)

Critics said the administration was caving to conservative religious groups at the expense of science. “Ideologues should not be allowed to stand in for real doctors and scientists when the government is making decisions about lifesaving medicine,” said Megan Donovan, senior policy manager at the Guttmacher Institute, a policy group that supports abortion rights. (Armour, 6/5)

“The United States is the most innovative nation in the world; alternatives to fetal tissue research exist and should be pursued,” said House Minority Whip Steve Scalise, R-La., in a statement. "It is reprehensible for anyone to profit from the tragedy of abortion and the Trump Administration is making that clear by saying no to this ethically tainted research." (Raman, 6/5)

In a turnabout, the government said Wednesday it will start posting a list of some 400 troubled nursing homes , days after senators released the "secret" document along with a report questioning oversight of poor-quality facilities. Dr. Kate Goodrich, chief medical officer with the Centers for Medicare and Medicaid Services, said the agency soon will post the list and update it regularly. She didn't set a date. (Alonso-Zaldivar, 6/5)

The National Institutes of Health has referred 16 allegations related to foreign influence of U.S.-funded research to investigators and contacted 61 research institutions about such concerns, federal health officials said at a hearing Wednesday. Dr. Lawrence Tabak, the NIH’s principal deputy director, said the problem stems from “a small proportion of scientists” who, among other concerns, have failed to disclose ties to foreign governments on grant applications. But he and others noted the contributions foreign-born researchers generally make to U.S. innovation, discoveries, and the economy. (Joseph, 6/5)

Former Vice President Joseph R. Biden Jr., who has shunned today’s Democratic Party orthodoxy on issues from crime to compromising with Republicans, again broke with his party’s base and many of his campaign rivals on Wednesday when his campaign confirmed that he still backs the Hyde Amendment, a measure that prohibits the use of federal funds for abortion with exceptions for cases involving rape, incest and when the life of the mother is in danger. (Glueck, 6/5)

The campaign statement came one month after Biden suggested in a conversation with a South Carolina voter that he had dropped his past support for the policy. “Biden misheard the woman on the rope line,” the campaign statement explained. “He has not at this point changed his position on the Hyde Amendment.” The statement added that he would be “open to repeal” if women lost access to abortion in the future — presumably because of a Supreme Court decision or other change in law. (Hook and Haberkorn, 6/5)

Biden, who is currently leading in early polls for the 2020 Democratic presidential nomination, would back repealing the amendment “if abortion avenues currently protected under Roe were threatened,” his campaign told NBC News. In a statement Wednesday, Ilyse Hogue, president of the abortion rights group NARAL, said there is “no political or ideological excuse” for Biden’s support for the amendment, which she said “translates into discrimination against poor women and women of color plain and simple.” “His position further endangers women and families already facing enormous hurdles and creates two classes of rights for people in this country, which is inherently undemocratic,” Hogue said. Stephanie Schriock, the president of Emily’s List, a political action committee that works to elect Democratic women who support abortion rights, also issued a statement calling it “unacceptable” for a major Democratic White House contender to support the Hyde Amendment. (Sonmez, 6/5)

Planned Parenthood's lobbying arm slammed former Vice President Joe Biden on Wednesday for his support of the Hyde Amendment, which prevents federal money from being used to cover some abortion costs. The Planned Parenthood Action Fund (PPAF), the reproductive health organization's advocacy group, called the policy "discriminatory" and "strongly encouraged" Biden to rethink his position. (Frazin, 6/5)

The criticism from abortion-rights organizations, a key Democratic constituency and a connection to women voters in the party, is the latest example of the former vice president’s lengthy political history complicating his pitch to members of his own party. Mr. Biden leads in early polling but has faced complaints from primary voters about some of his moderate views, stances that might damp turnout among rank-and-file Democrats in a general election matchup against President Trump. (Armour and Thomas, 6/5)

Senator Elizabeth Warren of Massachusetts, slowly gaining ground in the crowded Democratic presidential primary, appeared on MSNBC on Wednesday for a friendly town-hall event, which gave her ample opportunity to describe her signature policies and deliver some of her most reliable applause lines. But first came a question about the political news of the day: that former Vice President Joseph R. Biden Jr. still supports the Hyde Amendment, which has banned federal funding for abortions since 1976. Several Democratic candidates, including Ms. Warren, had previously called for repealing the amendment, and Mr. Biden’s announcement brought more of them forward on Wednesday. When asked directly on air if Mr. Biden was wrong, Ms. Warren said yes. (Astor, 6/5)

The hedging prompted intraparty outcry, with top Democrats reaffirming their commitment to abortion rights and scrapping the Hyde Amendment. The pushback marked the first significant instance in which virtually the entire crowded 2020 field united to critique Biden, who has emerged as an early Democratic front-runner. (Weissert, Barrow and Schor, 6/5)

“There is #NoMiddleGround on women’s rights. Abortion is a constitutional right. Under my Medicare for All plan, we will repeal the Hyde Amendment,” Sanders, who has consistently finished second to Biden in polling, tweeted. "No woman's access to reproductive health care should be based on how much money she has. We must repeal the Hyde Amendment," Harris said. (Axelrod, 6/5)

Prominent liberals in Congress such as Progressive Caucus Co-Chairwoman Pramila Jayapal (D-Wash.) were visibly taken aback when asked about Biden's stand, though they held off criticizing Biden directly. "This is a constitutional right for women to be able to access abortions and be able to make decisions about their own bodies, and the things that get in the way of that — particularly for low-income women, for rural women, for women who live in states where those rights have been trampled on — is a serious issue for the entire country," Jayapal said. "I hope our presidential candidate will be bold about recognizing that.” (Ollstein, 6/5)

Biden’s stance that he supports a law sharply limiting the use of federal funds for abortions created one of the clearest indications yet of a growing division among Democrats and a feistiness in the field, which on Wednesday displayed newfound willingness to criticize the front-runner. Recent days have laid bare potential vulnerabilities for Biden, whose greatest strength has been the perception that he is the most electable candidate, and the extent to which he is testing the leftward Democratic Party thrust that is embraced by many of his opponents. (Viser, Lee and Johnson, 6/5)

Biden has held a clear lead in early Democratic polls despite taking some positions that are more moderate than progressive activists demand. (Kapur, 6/5)

Democratic presidential candidate Kirsten Gillibrand (KEER’-sten JIHL’-uh-brand) has a plan to legalize marijuana and expunge all nonviolent criminal charges associated with it. The New York senator says in a Medium post on Wednesday she’d work with Congress to decriminalize recreational marijuana use and tax nonprescription marijuana products. Gillibrand says she wants to use the proceeds to support job training and other programs for communities “disproportionately harmed by marijuana laws,” especially helping small businesses owned by women and minorities. (6/5)

Kaiser Health News: On Campaign Trail, Joe Biden Highlights Nation’s Lack Of School Psychologists

Outlining his education platform on May 28, former vice president and 2020 Democratic presidential contender Joe Biden put the spotlight on an often-ignored mental health problem: kids’ access to mental health care. In a policy paper released at a town hall in Houston, Biden said, “The current school psychologist to student ratio in this country is roughly 1,400 to 1, while experts say it should be at most 700 to 1.” That matters because children’s mental health care issues are often detected in school settings. (Luthra, 6/5)

North Carolina Republicans failed on Wednesday to override Democratic Gov. Roy Cooper's veto of legislation that would have created a new crime against doctors and nurses who fail to care for an infant delivered during an unsuccessful abortion. Enough Democrats sided with Cooper to block the override, which required 72 votes of support. The vote was 67-53 in favor of the override. The Senate had voted to override in April. (Robertson, 6/5)

Doctors are already held to a 2002 federal law that protects fetuses that survive abortions. In a statement on Wednesday, Mr. Cooper reiterated his position that the bill, the so-called Born-Alive Survivors Protection Act, was redundant. “It’s important to protect the lives of all children, and laws already exist to protect newborn babies,” Mr. Cooper said. “Instead of passing unnecessary legislation for political purposes, we need to move on from divisive social issues and focus on the needs of North Carolina families: education, health care and good-paying jobs.” (Fausset, 6/5)

Lawyers for Missouri’s only abortion provider told a St. Louis Circuit Court judge on Wednesday that it has been unable to renew the clinic’s annual license because state health officials have not followed proper procedures. Planned Parenthood has asked Judge Michael Stelzer to issue a temporary injunction barring the state Department of Health and Senior Services from delaying or denying a renewed license to Reproductive Health Services of Planned Parenthood of the St. Louis Region. (Fentem, 6/5)

Wisconsin's Republican-controlled Senate on Wednesday sent four abortion bills to Democratic Gov. Tony Evers, who has promised to veto all of them. One measure addresses the extremely rare occurrence in which a baby is born alive during an abortion attempt. It would impose criminal penalties on doctors who fail to give medical care to such babies. Organizations representing obstetricians and gynecologists, along with Democratic opponents, say existing laws already provide protections to every healthy newborn, whether born during a failed abortion or under other circumstances. (Bauer and Richmond, 6/5)

The network behind a show that's become part of Georgia's pop-culture fiber says it will "reevaluate" its activity in the state if a new abortion law goes into effect. "The Walking Dead" is an economic powerhouse and brings streams of tourists to the Georgia towns where it has been filmed. AMC Networks calls the abortion legislation "highly restrictive" and says in a statement it will be closely watching what's likely to be "a long and complicated fight" over the law. (Martin, 6/5)

This year has brought an unprecedented wave of new state laws that only allow abortions to be performed early in pregnancy — if at all. Most of the new laws — known as early abortion bans — explicitly outlaw abortion when performed after a certain point early in the pregnancy. The laws vary, with some forbidding abortion after six weeks of pregnancy, and some after eight weeks. Alabama's law is the most extreme: It aims to outlaw abortion at any point, except if the woman's health is at serious risk. (Gordon and Hurt, 6/5)

The Department of Veterans Affairs on Thursday will begin allowing a broad section of its nine million enrollees to seek medical care outside of traditional V.A. hospitals, the biggest shift in the American health care system since the passage of the Affordable Care Act nearly a decade ago. While department officials say they are ready, veterans groups and lawmakers on Capitol Hill have expressed concerns about the V.A., which has been dogged for years by problems with its computer systems. (Steinhauer, 6/5)

The Veterans Affairs Department finalized a rule spelling out which veterans are eligible for the new, expanded Community Care program mandated by Congress last year. It also issued a final rule granting veterans coverage for urgent care outside VA facilities, without prior VA approval but with a copayment. Under the Community Care rule issued Tuesday, veterans must be enrolled in the VA healthcare system and meet at least one of six conditions to be eligible for VA-paid care outside the VA system. There were no significant changes from the proposed rule issued in February. (Meyer, 6/5)

Lawmakers will be watching over the next few weeks to see whether problems arise with critical functions, such as scheduling appointments or paying claims. House Veterans' Affairs Committee Chairman Mark Takano, D-Calif., said he is worried that some medical centers weren’t yet ready for the rollout. “Let’s just say that we’re skeptical,” he said, adding that he thinks the VA has not been sufficiently transparent. “I’m of course looking forward to working with the secretary and his top administrators to address any unforeseen challenges that may arise.” Takano worked with ranking member Phil Roe, R-Tenn., to dispatch committee staffers across the country to monitor the launch despite VA Secretary Robert Wilkie’s requests to hold off on oversight visits. (Clason, 6/6)

President Donald Trump said his administration reinstituted a ban against most transgender people serving in the military because some of them take prescription medicine, claiming erroneously that the armed services prohibit drug use. Trump was asked why he implemented the ban, which took effect in March, during an interview with ITV’s “Good Morning Britain” broadcast earlier on Wednesday. ... The military doesn’t prohibit service members from taking prescription medicines, including drugs prescribed for conditions such as depression and anxiety. The Navy, in fact, changed its policy late last year to allow pilots and other aircrew on such drugs to continue flying. (Wayne and Tritten, 6/5)

The opioid manufacturer Insys Therapeutics agreed to pay $225 million to settle federal criminal and civil charges that it illegally marketed a highly addictive fentanyl painkiller to doctors, federal prosecutors said on Wednesday. As part of the deal, a subsidiary of Insys will plead guilty to five counts of mail fraud and the company will pay a $2 million fine and $28 million in forfeiture, according to a statement from the United States attorney’s office in Massachusetts. The company will also pay $195 million to settle allegations that it violated the federal False Claims Act, which involves defrauding the federal government through drug sales to health care programs like Medicare. (Thomas, 6/5)

The settlement stems from criminal and civil probes into Insys Therapeutics Inc.'s scheme to pay doctors in exchange for prescriptions of the drug meant for cancer patients with severe pain. It comes a month after Insys Founder John Kapoor and four other former executives of the Chandler, Arizona-based company were convicted of bribing doctors across the country to prescribe the drug known as Susbys. (Balsamo and Durkin Richer, 6/5)

The release noted the story of a physician assistant who worked at a pain clinic in New Hampshire. The PA, who was not named, joined Insys’s program the second year the drug was on the market — he hadn’t written a prescription the first year it was — and wrote 672 prescriptions for Subsys, for which he received $44,000 in kickbacks, the release said. (Rosenberg, 6/5)

An Ohio doctor was charged with 25 counts of murder for administering high and sometimes fatal doses of opioid painkillers to dozens of very sick patients, prosecutors said on Wednesday. The doctor, William Husel, turned himself in to Columbus police following a six-month long investigation into what Mount Carmel Hospital called his administration of "inappropriate" doses of fentanyl to patients, Franklin County prosecutor Ron O'Brien said at a news conference. (6/5)

A spike in recent fatal overdoses could be tied to fentanyl-laced drugs in Davidson County, public safety officials have warned. Since June 10, the Davidson County Medical Examiner's office has investigated at least 10 deaths believed to be fatal drug overdoses, according to Metro Public Health. Of those deaths, half have been associated with an unknown white or brown powder. (Timms, 6/5)

The Trump administration is suspending educational, legal and recreational programs for migrant children in its custody, saying an influx of children crossing the border without a parent or legal guardian was putting a "tremendous strain" on the resources of the agency tasked with housing them. The agency that houses migrant children - the Office of Refugee Resettlement (ORR) - asked Congress for an additional $2.88 billion to increase shelter capacity, HHS spokeswoman Evelyn Stauffer said on Wednesday. ORR is part of the Department of Health and Human Services. (6/5)

The government’s plans were swiftly rebuked by civil rights lawyers representing unaccompanied children, who have been crossing the border in ever-larger numbers this year to flee poverty and violence in their home countries, mainly in Central America. And the chief of at least one large shelter operator said he would continue to offer education and sports at his network’s facilities. Some 13,200 migrant children, including adolescents who crossed the border alone and young children who were separated from their parents, are currently housed in more than 100 shelters across the country. (Jordan, 6/5)

"Basic educational, recreational, and legal services for unaccompanied children are imperative for their physical and mental well-being. ORR’s cancelling of these services will inflict further harm on children, many of whom continue to languish for months without being placed safely and expeditiously into a sponsor’s care," said Rep. Rosa DeLauro (D-Conn.), chair of the House Appropriations HHS subcommittee. "That is not only unacceptable, it could be in violation of the law." (Weixel, 6/5)

The state’s Medicaid program paid more than $60,000 for sexual and erectile dysfunction drugs for 47 sex offenders over a six-year period, a state audit released Wednesday found. In total, Medicaid made more than $930,000 in payments for erectile dysfunction drugs for recipients, including sex offenders, that are barred under the program, Comptroller Thomas DiNapoli said. “There are clear rules about what conditions Medicaid will cover when it comes to erectile dysfunction drugs," DiNapoli said in a statement. (Spector, 6/5)

Federal rules bar Medicaid coverage of sexual treatments for all recipients, not just sex offenders. Yet state Medicaid officials approved $930,000 in improper payments for the drugs between 2012 and 2018, according to the audit released by state Comptroller Thomas DiNapoli and first reported by The Associated Press. (Klepper, 6/5)

The state Department of Health fired back after the audit’s release, saying it “strongly disagrees with the Comptroller’s conclusions,” adding that it believes only about $8,000 of the payments from 2012 to 2018 were questionable. (Campisi, 6/5)

A Senate-passed bill to substantially weaken the work requirement in New Hampshire’s expanded Medicaid program cleared the House in a 207-143 party line vote on Wednesday, without a single Republican in support. The bill, SB 290, faces a likely veto from Gov. Chris Sununu, and did not pass in either chamber with veto-proof majorities. Among other things, it would end the work requirement entirely if it resulted in more than 500 people losing their benefits out of 50,000 in the expanded version of the federally funded health insurance program for low-income households. (Solomon, 6/5)

Medicaid – the $14.6 billion health care program managed by the N.C. Department of Health and Human Services – is one of the state’s biggest expenditures and funded with a mix of federal and state dollars. With size, however, comes complexity, and the particulars of the Medicaid program and how it affects the low-income seniors, disabled persons and children and their families can often become lost among the figures about growth and cost. (Ovaska-Few, 6/6)

Wyoming is the only state not using Medicaid to cover special education services in schools, and that could be costing the state money. The Joint Education Committee asked the Wyoming Department of Health and the Department of Education to explore using Medicaid funds for services like speech, occupational, and physical therapy. That's what other states do. (Watson, 6/5)

A powerful Senate Republican heralded on Wednesday a slate of policies aimed at lowering the price of prescription medicines — and outlined a clear path forward for passing them into law with bipartisan, bicameral support. Sen. Chuck Grassley, the Iowa Republican who chairs the Senate Finance Committee, said his “good working relationship” with ranking member Sen. Ron Wyden (D-Ore.), along with his conversations with other key lawmakers in the House and on the Health, Education, Labor, and Pensions Committee, present a “real opportunity” for a collaborative product — brought by both committees to the Senate floor — by the end of this year. (Hailu, 6/5)

House Democratic leaders are facing deep skepticism from their progressive wing over a plan empowering the government to limit prices for some expensive prescription drugs — a rift that could hurt the party on an issue that has also been embraced by President Donald Trump. Liberal lawmakers and like-minded advocacy groups say the preliminary drug pricing plan pitched by House Speaker Nancy Pelosi is far too timid a response to spiraling U.S. drug costs, and could fail to leverage the government’s massive purchasing power in demanding cheaper medicines. (Cancryn, 6/6)

The controversial role that pharmacy benefit managers play in prescription drug pricing is under fresh attack in a pair of new reports issued by two of the largest states by population in the U.S. — New York and Massachusetts — both of which are exploring ways to curtail various business practices used by these little-understood middlemen. The efforts come as a growing number of states are grappling with the rising cost of medicines, a pocketbook issue that is vexing Americans and straining government budgets. In response, state lawmakers are pursuing legislation and regulations targeting not only drug makers, but also PBMs, which occupy an important but perplexing part of the opaque pharmaceutical supply chain. (Silverman, 6/5)

Pharmacy benefit managers charge Massachusetts' Medicaid managed-care and commercial plans significantly higher prices for generic drugs than their actual cost, according to a new report. PBM prices for generic drugs in the MassHealth managed-care organization program were higher than the acquisition prices for 95% of the pharmaceuticals analyzed in the fourth quarter of 2018 and exceeded Medicaid fee-for-service prices for 42% of the products, the Massachusetts Health Policy Commission found in its analysis. MCO prices exceeded fee-for-service prices by an average of $15.97 per drug, which in many cases is passed onto consumers. (Kacik, 6/5)

Amid a growing number of probes into the pharmaceutical industry, Mallinckrodt (MNK) tentatively agreed to pay $15.4 million to settle charges of illegal marketing by Questor, a company that it purchased five years ago and was infamous for dramatically raising the price of a treatment for infantile spasms. At the same time, however, the drug maker vowed to fight new claims by the Department of Justice that Questcor illegally used a charity to pay kickbacks aimed at encouraging Medicare patients to use the pricey medicine, which is known as Acthar Gel. (Silverman, 6/6)

A hack of health-care data involving a medical bill collector and two major diagnostics companies has grown to almost 20 million people, and is now attracting more questions from key members of Congress. American Medical Collection Agency, an Elmsford, New York-based collections firm, has now been identified by two large medical companies as the victim in a large health-care data breach. On Tuesday, Laboratory Corporation of America Holdings said that 7.7 million patients’ accounts at AMCA were stored in the vulnerable computer system. The disclosure follows a similar warning by Quest Diagnostics Inc. that 11.9 million people were exposed. (Langreth, 6/5)

House Democrats plan to hold an event intended to highlight what they say is President Trump’s deteriorating mental health. House Budget Committee Chairman John Yarmuth (D-Ky.) said he and Rep. Jamie Raskin (D-Md.) will host Dr. Bandy Lee, a Yale School of Medicine psychiatrist who edited the best-selling book “The Dangerous Case of Donald Trump: Psychiatrists and Mental Health Experts Assess a President.” (Weixel, 6/5)

One of the leaders behind the Dr. Atul Gawande-helmed health venture Haven has dropped the pretense the new company will only focus on the founding companies’ employees J amie Dimon, the CEO of JPMorgan Chase, said Wednesday that Haven will take aim at health care problems that extend beyond his employees and those at Amazon and Berkshire Hathaway, the other two titans behind the joint venture. (Sheridan, 6/5)

The role of CVS’ pharmacy benefit manager business again emerged as a key concern Wednesday during a federal court hearing on a possible merger between the pharmaceutical giant and health insurer Aetna. During the second and final day of what was slated to be a three-day hearing on the proposed merger, witnesses called by CVS and by the Department of Justice, which supports the merger, argued that CVS Caremark has ample competition from other PBMs, and they dismissed the idea that gaining Aetna’s 22 million customers would give CVS an unfair advantage. (Wehrman, 6/5)

Anthem Blue Cross and Blue Shield has agreed to allow its Pathway health plan members to visit WellStar Health System doctors at network rates through the end of the year. The consent order, announced Wednesday, partially ends the long-running dispute over the health insurance exchange plan run by Anthem. (Miller, 6/5)

The state Department of Insurance has accepted an agreement from Anthem to cover some WellStar Health System services again for the rest of 2019. But not all.Early this year, the insurer previously known as Blue Cross Blue Shield stopped covering WellStar services for individual policyholders after those Georgians were already locked in to the health insurance plans they obtained through the state’s Affordable Care Act exchange. (Hart, 6/5)

The Blue Cross and Blue Shield Association announced Wednesday its longtime CEO will retire at the end of 2020. The Blues board of directors is working to identify Scott Serota's replacement to ensure a smooth transition, according to the release. For the time being, Serota will continue to focus on the organization's business and policy priorities. (Bannow, 6/5)

In general, when policymakers use the term “public option,” they mean a health plan with significant government control. That might mean programs created and operated by government, as Medicare and Medicaid originally were, or programs largely under government control but run by private entities. ...The term “public option” emerged a decade ago during the debate over the Affordable Care Act, when Democrats proposed including a government-run insurance option alongside privately run insurance on the exchanges. But the version of the ACA that President Barack Obama eventually signed did not include it. (Ollove, 6/6)

A watered-down public option health care bill, neutered after fierce debate and pushback from the state’s insurers, failed to win passage in the Senate late Wednesday. The bill’s long slog and eventual death caps months of contentious discussion on efforts to change Connecticut’s health care landscape. (Carlesso, 6/6)

The United States has recorded 1,001 measles cases so far this year in the worst outbreak of the highly contagious disease in more than a quarter-century, federal health officials said on Wednesday as they issued a new plea for parents to vaccinate their children. The U.S. Centers for Disease Control and Prevention said 61 new cases have been reported since May 27 of the sometimes deadly disease. It is the highest number of cases since 1992, when the CDC recorded 2,126 cases. (6/5)

Anti-vaccine activists held their second rally here in several weeks Tuesday night, questioning vaccine safety in a community battling its worst measles outbreak in nearly 30 years, amid protests by health officials and pro-vaccine parents. The event, which barred reporters, featured conspiracy theorist Rabbi Hillel Handler and Del Bigtree, head of one of the nation’s most active anti-vaccine groups and producer of a film alleging the government suppressed a link between the measles vaccine and autism (studies involving hundreds of thousands of children have repeatedly disproved such a link). (Guarino and Sun, 6/5)

As the rate of new measles cases in New York City has slowed, so too has the momentum behind a legislative bill in Albany that would repeal the religious exemption to New York’s school vaccination requirements. The bill, which would repeal an exception to school vaccination requirements for parents’ “genuine and sincere religious beliefs,” has stalled in the health committee of the state Assembly with just two weeks left before the legislature breaks for the summer. (West, 6/5)

Close to 75 percent of 1,713 surveyed adults think that parents should vaccinate their children, a new Public Policy Institute of California poll released on Wednesday showed. Nearly eight in 10 said they worry a recent nationwide outbreak of 981 measles cases will continue to spread. There are 47 reported cases in California. (Wiley, 6/5)

The fate of the most promising Alzheimer’s drug in decades was sealed with a text message. It was sent to Al Sandrock, one of the most celebrated drug developers of his generation. He and his employer, Biogen, the pioneering biotech firm, had spent a dozen years and hundreds of millions of dollars developing the drug. It was the talk of neuroscience; it had been featured on the cover of Fortune — a sign of hope for the entire field. The text message said his team needed to see him urgently. He didn’t know why. He didn’t know that Biogen’s head of research was getting the same message, and would be calling into the meeting on a secure line from an international trip. (Herper, 6/6)

For decades, climate scientists have been designing models to predict global warming’s long-term ecological effects: sea level rise, coral bleaching, extinctions of entire species. Researchers have now taken a step that hits closer to home, characterizing for the first time how various climate scenarios outlined in the Paris agreement could affect heat-related deaths in humans. (Baumgaertner, 6/5)

When Shawna Peters, a cybersecurity recruiter in St. Paul, Minn., heard about a V.I.P. night including chair massages and goody bags with mints, lip balms and pedicure accessories, she signed right up. Nevermind that she’d have to get a mammogram to earn those perks. Mammograms are such a literal pain — unless you are the kind of person who likes having her breast smashed against squeezing plates — that Ms. Peters, 44, said she always puts off getting one. (Clifford, 6/6)

People who are currently paying student loans have a much higher score on the Marketplace-Edison Research Economic Anxiety Index® than those who don’t have student loans — about two thirds higher. This is pretty much in line with what we know about indebtedness and psychological well-being: they don’t go hand in hand. (Ben-Achour, 6/5)

In response to a USA TODAY NETWORK-Wisconsin online questionnaire, parents across Wisconsin and across generations shared stories of how bullying had torn their child apart and consumed their family’s attention. They talked about issues on the playground, in the classroom, on the bus and online. They talked about schools with great support mechanisms and those where they felt helpless. (Shastri and Litke, 6/5)

Smartphones, tablets and video consoles can be addictive. They interfere with sleep. They draw kids into an alternate universe, often distracting them from more productive — and healthier — real-world activities. And they are linked to anxiety and depression, learning disabilities and obesity. That’s according to a growing body of research emphasizing the physical and psychological dangers of heavy screen use.“Nobody should spend eight or nine hours doing anything except sleeping and working,” says Dr. Sina Safahieh, medical director of ASPIRE, the teen mental health program run by Hoag Hospital in Orange County, Calif. (Wolfson, 6/5)

Some sex offenders in Alabama could be chemically castrated before being released on parole, under a bill approved by state lawmakers. Lawmakers gave final approval to the bill last week and sent it to Gov. Kay Ivey. Chemical castration involves taking medication that blocks testosterone production in order to decrease the person's sex drive. At least eight states allow the procedure — including California, Florida and Texas— but it is unclear how often it is used. (6/5)

“Chemical castration” is a misnomer, as the process leaves the testes intact, can be reversed and does not prevent a man from reproducing. It does not guarantee a man’s sexual urge will be eliminated. (There’s no consensus on whether chemical castration would be effective for women.) Experts warn the treatment is not a panacea and should be used with caution. And there are few studies that attempt to determine the success rate of the treatment. A review of several of these studies shows that some found success in offenders who show sexual desire toward children. Others found no significant effect. (Iati, 6/5)

Gov. Greg Abbott on Wednesday vetoed a widely supported bill to protect domestic violence survivors, calling it a “laudable effort” that lost his support when “someone slipped in an ill-considered giveaway to a radioactive waste disposal facility,” he said. ...The measure, Senate Bill 1804, by state Sen. Lois Kolkhorst, R-Brenham, would have required that bond information about domestic violence offenders be entered into a statewide data repository. (Najmabadi, 6/5)

Even though Ohio and Indiana have cheaper auto insurance rates for now, Michigan is a low-cost state in at least one area: hospital care prices. A study released last month that examined hospital billing in 25 states found that Michigan hospitals were paid the lowest prices of all by private health insurance companies. Insurers paid Michigan hospitals on average 156% of what the federal Medicare program paid for similar services and procedures, or well below the 241% average for all hospitals in the study, which was conducted by the nonprofit RAND Corp. and based on employer-sponsored health plans. (Reindl, 6/6)

Boston-based Partners HealthCare has obediently bowed out of its planned merger with Care New England after Rhode Island's governor signaled her strong desire that the Providence health system retain local control. Partners' decision puts a cap on what had been a tumultuous, years-long process of trying to acquire CNE, a deal that was still under regulatory review in Rhode Island. (Bannow, 6/5)

About 4,000 therapists, social workers and psychologists at Kaiser Permanente’s California locations, including 1,200 clinicians in the Bay Area, plan to begin striking Tuesday in protest of what they say are long wait times for patients seeking mental health appointments. The planned action by the National Union of Healthcare Workers, the union that represents the Kaiser workers, is expected to begin Tuesday at Kaiser facilities in San Francisco, San Leandro, Santa Clara and Sacramento. (Ho, 6/5)

Top Republican legislators on Wednesday blocked nearly $10 million that Kansas corrections officials argue they need to deal with prison overcrowding and said lawmakers might reject Democratic Gov. Laura Kelly's choice to be the prison system's next leader. The actions by Republican legislative leaders decrease the number of male inmates that the Department of Corrections can transfer for now to private prisons out of state and halt the agency's plans to move female inmates into empty space at a juvenile detention center in Topeka. (6/5)

New legislation aims to support the families of Wisconsin police officers killed in the line of duty. The bipartisan legislation to be introduced soon would aid the spouses and children of fallen officers by requiring municipalities to continue to pay the health insurance premiums they had paid to the officers. (Andrea, 6/5)

The medical device industry, a big player in the Minnesota economy, is bracing for the financial fallout from tariffs on goods imported from Mexico, which are set to begin Monday. The U.S. imports more medical devices and device components from Mexico than any other country, and barring a diplomatic breakthrough, the cost of those devices could increase by tens of millions of dollars a month. (Carlson, 6/6)

Umatilla County is taking control of the school heath centers in Pendleton. The county operates one center at the high school and the other at the middle school. The county last year contracted with Columbia River Health to staff the centers. The Boardman-based health organization in February notified the county it would not renew that contract. (Wright, 6/5)

Minnesota's largest doctors' group is responding to physicians' desire for information about the implications of legalizing recreational marijuana use with a forum for its members Thursday evening. The Minnesota Medical Association represents physicians and doctors-in-training in the state. (Zdechlik, 6/6)

A growing number of states seek to establish work requirements in their Medicaid programs.  Using pooled data from the September 2018 and March 2019 rounds of the Health Reform Monitoring Survey, this study assesses potential barriers facing Medicaid enrollees in meeting these requirements through employment on a sustained basis. Compared with privately insured adults, Medicaid enrollees who would potentially be subject to work requirements are more likely to face employment barriers, including low educational attainment, health problems, limited transportation and internet access, criminal records, and residence in high-unemployment or high-poverty neighborhoods. (Karpman, 5/30)

Family caregivers often serve as unpaid members of the home and community-based care workforce for people with serious illness; as key partners in the home-clinic continuum, they should be included in health care teams. The Campaign for Inclusive Care is an initiative within the Veterans Affairs health care system to improve provider practices for including caregivers of military members in treatment planning and decisions. We defined inclusive care using a literature review, provider interviews, and a caregiver survey. We found that inclusive care involves clear definition of the caregiver role, system policies for inclusion, assessment of caregivers’ capacity, explicit involvement of caregivers, and mutuality in caregiver-provider communication. We recommend solutions based on this definition that can inform development of a national caregiver strategy, required of the Department of Health and Human Services by the Recognize, Assist, Include, Support, and Engage Family Caregivers Act of 2018. (Sperber, 6/3)

Crash rates were higher for drivers with ADHD regardless of licensing age and, in particular, during the first month of licensure (adjusted rate ratio: 1.62 [95% confidence interval: 1.18−2.23]). They also experienced higher rates of specific crash types: their 4-year rate of alcohol-related crashes was 2.1 times that of drivers without ADHD. Finally, drivers with ADHD had higher rates of moving violations (for speeding, seat belt nonuse, and electronic equipment use) and suspensions. In the first year of driving, the rate of alcohol and/or drug violations was 3.6 times higher for adolescents with ADHD. (Curry et al, 6/3)

Sedative-hypnotic medications are frequently prescribed for hospitalized patients with insomnia, but they can result in preventable harm such as delirium, falls, hip fractures, and increased morbidity. Furthermore, sedative-hypnotic initiation while in the hospital carries a risk of chronic use after discharge. Disrupted sleep is a major contributor to sedative-hypnotic use among patients in the hospital and other institutional settings. Numerous multicomponent studies on improving sleep quality in these settings have been described, some demonstrating an associated reduction of sedative-hypnotic prescriptions. This selected review summarizes effective interventions aimed at promoting sleep and reducing inappropriate sedative-hypnotic initiation and proposes an implementation strategy to guide quality improvement teams. (Soong et al, 6/3)

As the US wrestles with immigration policy and caring for an aging population, data on immigrants’ role as health care and long-term care workers can inform both debates. Previous studies have examined immigrants’ role as health care and direct care workers (nursing, home health, and personal care aides) but not that of immigrants hired by private households or nonmedical facilities such as senior housing to assist elderly and disabled people or unauthorized immigrants’ role in providing these services. Using nationally representative data, we found that in 2017 immigrants accounted for 18.2 percent of health care workers and 23.5 percent of formal and nonformal long-term care sector workers. More than one-quarter (27.5 percent) of direct care workers and 30.3 percent of nursing home housekeeping and maintenance workers were immigrants. (Zallman et al, 6/3)

Children born into poverty had greater odds of not being ready for school than children not born into poverty (adjusted odds ratio = 1.54, 1.59, 1.26 for children born in household and neighborhood poverty, household poverty only, and neighborhood poverty only, respectively; all significant at P < .05). Similar patterns were seen across outcomes. For those born into neighborhood poverty, the odds of school readiness were higher only if children moved before age 2. (Roos, Wall-Wieler and Lee, 6/3)

During the first five months of 2019, lawmakers across the country passed a slew of antiabortion laws, including a near-total abortion ban in Alabama. And as each piece of deliberately unconstitutional legislation has been signed into law, 2020 Democratic presidential candidates have forcefully opposed them. Many have also revealed plans to protect Roe v. Wade and to expand access to abortion care should they be elected the next president. It’s the right thing to do, but it’s also good politics: these laws have galvanized female voters , who were the key to the Democrats’ strong performance in November’s midterm elections. (Danielle Campoamor, 6/5)

Democrats — most of them, at least — are done apologizing for their support of abortion rights. The proximate cause is the unprecedented assault on Roe v. Wade now being waged in statehouses and the courts, with the serious likelihood that in the near future the Supreme Court could either overturn the decision entirely or gut it beyond recognition. The threat to the right to abortion has produced both fear and a new reexamination of how Democrats have talked and acted about this issue for years. Which is why the Hyde Amendment is suddenly an issue in the race for the Democratic presidential nomination. (Paul Waldman, 6/5)

Though former vice president Joe Biden is ahead of the crowded 2020 presidential field in every poll, his greatest vulnerability presents itself again and again: He is a man out of step with his party. His record on crime has already put him at odds with the Democratic base, as has his praise of bipartisan compromise at a time when there is little appetite for appeasement. But Biden has proved surprisingly skillful at balancing the doubts that Democrats have about his record against a presumption that he might be their strongest bet to oust President Trump from the White House next year. (Karen Tumulty, 6/5)

Missouri finds itself in the national spotlight for all the wrong reasons again — this time, by giving new rights and opportunities to rapists. By signing House Bill 126, which bans abortions even in the case of rape, incest or human trafficking, Gov. Mike Parson has spoken loud and clear. He wants rapists in Missouri to have more power over their victims. He wants a woman’s decisions over her health care to be criminalized. These positions are extreme and cruel. (Nicole Galloway, 6/3)

The public widely supports access to contraception. Nearly eight in 10 adults, and the majority of voters in both main political parties, consider birth control a fundamental part of women’s health care.Unfortunately, a vocal minority that considers birth control immoral is now setting the nation’s health-care agenda at the Department of Health and Human Services, and we are seeing the impact. Most recently, HHS directed millions of dollars in federal funding for birth control to California-based Obria, a self-described “ministry” that opposes the use of contraception yet purports to be a women’s health-care provider.  (Alice Huling, 6/5)

I will continue to make sure that reproductive rights are discussed in LGBTQ+ spaces. But please, remember that we’re all fighting for a person’s right to choose. Not all women have a uterus, and not all people with a uterus are women. How we frame the conversation is important. (Mason Dunn, 6/6)

Senator and presidential candidate Kamala Harris (D-Calif.) reintroduced her 2018 bill that seeks to address rising maternal mortality rates, particularly among black women. Harris’s Maternal CARE Act, and the accompanying House version, would authorize $150 million toward programs that seek to help medical professionals identify high-risk pregnancies and establish implicit-bias training curriculum for medical schools.Her bill seeks to address a deeply troubling development: Severe maternal complications have more than doubled in the past 20 years and the U.S. maternal mortality rate has become the highest among high-income countries. (Arielle Kane, 6/5)

Erica Rice calls her 2017 V.B.A.C., or vaginal birth after cesarean, “a herculean team effort.” Not least of which because she delivered twins.The team on call at the Beth Israel Deaconess Medical Center in Boston provided Ms. Rice with support and comfort measures, like turning her side to side, and gave her a well-placed mirror to encourage her. “They did whatever it took,” Ms. Rice, a 37-year-old lawyer in Jamaica Plain, Mass., told me. “I was blown away by the support.” (Allison Yarrow, 6/5)

Painted on the side of a health post in this rural town in Guatemala’s western highlands is a simple message: Breast-feeding is a lifelong gift. But around the world, breast milk is a gift that many children are given incorrectly or not given at all — and the results are devastating. Health scholars report that a child dies more than once a minute somewhere in the world for lack of proper breast-feeding. (Mia Armstrong, 6/5)

The current outbreaks of measles are largely a result of parents being afraid to vaccinate their children—a fear that increased dramatically after a 1998 study in the Lancet falsely linked the vaccine with autism. It took 12 years for the journal to retract the study, which was based on only 12 children. The lead author lost his medical license, but the damage had been done. Parents may not know about the study or not believe it was bogus. How do doctors persuade them? No matter what clinical specialty you go into, somebody’s going to question or ignore your advice. How do you approach patients who disagree with you? (Jon LaPook, 6/5)

From my home in Idjwi, an island in Lake Kivu between the Democratic Republic of Congo and Rwanda with a population of 300,000, I’ve been watching the U.S. measles outbreak with a mixture of astonishment and incredulity.The U.S. outbreak, with nearly 1,000 reported cases so far, is due in large part due to parents who have not vaccinated their children against this highly contagious disease. In Idjwi, many parents would give anything for their children to receive a measles vaccination, because they know all too well what can happen to unvaccinated children. (Jacques Sebisaho, 6/6)

As hurricane season begins, activists monitoring the Homestead Temporary Shelter for Unaccompanied Children posed a question: “Do the feds have a hurricane plan?” The recent response was dispiriting: “We’re working on it” and “We can’t tell you what it is” aren’t sufficient answers. The camp houses about 3,000 underage teens who entered the United States without permission and in many cases have been separated from their parents. (6/6)

At least two migrant children died in May at the U.S.-Mexico border, including a boy with the flu and a 10-month-old who drowned in the Rio Grande. President Trump is misguided in using tariffs against Mexico to solve the border mess, but he’s right about the crisis of families with children arriving to exploit U.S. asylum law. He’s also right that Democrats refuse to help. The statistics tell a story of border mayhem, and these aren’t invented by White House aide Stephen Miller. In the first eight months of fiscal 2019, border agents apprehended nearly 56,300 unaccompanied children at the southern border, as well as nearly 333,000 migrants traveling as part of a family. (6/5)

Though community attitudes and the decisions of individuals contribute to how outbreaks spread, a broken health system seems to be the single largest contributor to how susceptible a country might be to an outbreak, and how quickly it can be stamped out. During the West Africa outbreak, which was considerably larger and more deadly than the outbreak in Congo, most people who fell ill never had Ebola. (Jonathan Lascher, 6/6)

While most have heard of the recommendation, many of us aren’t quite as obsessed about getting 10,000 steps of daily activity as satirist and author David Sedaris. He describes trudging obsessively along the roads in Sussex, England just to feel that gratifying buzz from his wrist-worn device when he reached 10,000 steps. That is why the release of a large study reporting that the health benefits of physical activity are apparent at levels far below 10,000 steps has the scientific community and the public buzzing with equal intensity. (Mercedes Carnethon, 6/5)

California’s regulatory regime is enough to give anyone the jitters, so good news that the state signed off Monday on a new rule admitting that coffee won’t kill you. Roasted coffee beans contain a chemical called acrylamide, which is also found in roughly 40% of calories Americans consume, according to the Grocery Manufacturers Association. But acrylamide is one of hundreds of chemicals listed as carcinogens or reproductive toxins under California’s 1986 Safe Drinking Water and Toxic Enforcement Act, known as Proposition 65. (6/5)

Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) introduced a bipartisan bill to finally end the money games of medicine — games that have relied on secrecy, kickbacks and ruling class rules to overcharge everyday Americans at a time when they are most vulnerable. One in five Americans now has medical debt in collections and frustration with health-care’s pricing failures has finally hit a boiling point.While surprise bills are one manifestation of the power struggle, they are a symptom of a larger problem — the absence of information to shop for medical care. The new bill, which is in line with the White House’s goal to increase transparency in health care, would shed light on the negotiated prices that hospitals and insurers keep secret, hindering competition. (Marty Makary, 6/4)

Parents this year were introduced to a goblin for the digital era: Momo, a bird-woman with an eerie grin who commanded the children who watched her videos on YouTube to harm themselves. The story turned out to be essentially a hoax, but it went viral in the first place because it seemed to validate a widely held belief: Our kids are in danger because of threats associated with the dark corners of social media and risk of addiction to phones and tablets. The annual American Family Survey found last fall that “overuse of technology” had risen to the top of the list of concerns for parents of teenagers, above drugs, sexual activity and mental health. (Kamenetz, 6/5)

Despite bearing financial burdens for more of our health-care expenses, many people do not feel or function as true health-care customers, with a sense of entitlement to get a health-care system that works for them. But in mental health care, patients are already consumers and customers, often out of necessity. Only 55 percent of psychiatrists accept insurance, so many consumers who need care must pay out of pocket. This financial burden can make needed mental health care inaccessible for many. Yet operating outside the insurance system means that those who can afford it may get better, more personalized care. (Deb Gordon, 6/4)

Recently, there has been a debate about the role that Medical Assistants should play in the healthcare field. Connecticut and New York are the only two states that do not allow Medical Assistants to administer vaccines and medications. The Connecticut Society of Medical Assistants (CTSMA) has petitioned the Connecticut legislature for many years. (Tabitha Opie, 6/5)