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A leading AIDS researcher and proponent of medication-assisted therapy for addiction was appointed Wednesday to oversee the Centers for Disease Control and Prevention. Alex M. Azar II, secretary of the Health and Human Services Department, announced that the agency’s new director would be Dr. Robert R. Redfield, a professor at the University of Maryland School of Medicine in Baltimore and co-founder of the Institute for Human Virology. (Kaplan, 3/21)

"Dr. Redfield has dedicated his entire life to promoting public health and providing compassionate care to his patients," Azar said in a statement. Redfield's appointment doesn't need Senate approval, and he'll start at the CDC on Monday. Redfield, 66, is a medical school professor at the University of Maryland, where he co-founded the Institute of Human Virology. He has extensive experience treating HIV patients as well as heroin addicts and has been praised for his work in Maryland on the opioid crisis. (Stobbe, 3/21)

Azar said Redfield’s scientific and clinical background is “peerless” and noted that during his two-decade tenure at the Walter Reed Army Institute of Research, Redfield made “pioneering contributions to advance our understanding of HIV/AIDS.” He also praised his more recent work running a treatment network in Baltimore for HIV and hepatitis C patients, which Azar said prepares Redfield “to  hit the ground running on one of HHS and CDC’s top priorities, combating the opioid epidemic.” (Sun, 3/21)

Dr. Redfield, a professor of medicine at the University of Maryland School of Medicine, weathered criticized in the 1990s for his stance on mandatory HIV testing for patients that some saw as adding to the stigma around AIDS. He was also criticized in the 1990s by consumer health organizations and some congressional Democrats for his work on an experimental AIDS vaccine, according to several news reports. Critics said his analysis and statement created false hope for patients. An investigation at the time by the U.S. Army determined there was no evidence to support scientific misconduct, but some Democrats have already said they oppose his nomination. (Armour, 3/21)

The Center for Science in the Public Interest also protested the selection of Redfield because of what it says is a history of scientific misconduct. The group said he doesn’t have important relationships with local health departments. Dr. Peter Lurie, the organization’s president, called the appointment “disastrous.” He noted that Redfield was investigated by the military for scientific misconduct for exaggerating the benefits of a “putative” HIV vaccine. Researcher disputed his findings that the vaccine worked and Congress stopped plans for a large clinical trial. Smaller studies later proved the vaccine ineffective, but the investigation cleared Redfield. (McDaniels, 3/21)

Redfield’s colleagues defended his record, saying he was motivated by a desire to help his patients. “He took a position not caring about the politics,” said Robert Gallo, who co-founded the Institute of Human Virology and has worked closely with Redfield for decades. “That was a time of a lot of panic and a lot of pressure politically in a lot of directions. Bob, in his position in the Army, was concerned about soldiers and I’m sure he acted in the best interest of his patients.” (Ehley, 3/21)

Rep. Elijah Cummings (D-MD), an often critic of the Trump administration, approved the choice. "Both sides of the aisle should be pleased that this deeply experienced and compassionate public health physician is willing to take the helm of the CDC," Cummings said in a statement. (Johnson, 3/21)

Congressional leaders have finalized a sweeping $1.3 trillion budget bill that substantially boosts military and domestic spending but leaves behind young immigrant "Dreamers," deprives President Donald Trump some of his border wall money and takes only incremental steps to address gun violence. (Taylor and Mascaro, 3/22)

Left out of the bill was a health-care measure sought by GOP Sens. Susan Collins (Maine) and Lamar Alexander (Tenn.) that would have allowed states to establish high-risk pools to help cover costly insurance claims while restoring certain payments to insurers under the Affordable Care Act. Trump, who ended the “cost-sharing reduction” payments in the fall, supported the Collins-Alexander language. But Democrats opposed it because they claimed it included language expanding the existing prohibition on federal funding for abortions. (DeBonis, O'Keefe and Werner, 3/21)

Of the $88 billion HHS appropriation announced Wednesday night, not a penny is going toward Obamacare. Instead, Congress is slapping oversight requirements on HHS regarding its administration of the health exchanges. Congressional leaders released the long-awaited $1.3 trillion, two-year spending omnibus after days of wrangling behind closed doors over contentious policies that included an embattled stabilization package for the individual market that would fund cost-sharing reduction payments and a $30 billion reinsurance pool. (Luthi, 3/21)

Sen. Susan Collins (R-Maine) said Wednesday it is "extremely disappointing" that a bill she backed to stabilize ObamaCare markets was left out of a must-pass government funding bill. Collins voted for the tax reform legislation in December after securing a commitment from Senate Majority Leader Mitch McConnell (R-Ky.) to support the ObamaCare fix. Collins had worried about the repeal of ObamaCare's individual mandate in the tax bill, and the resulting premium increases. She wanted the stability measures to try to make up for that. (Sullivan, 3/21) 

The push to get the cost-sharing payment bill passed took on greater importance after the tax bill signed into law by Trump late last year eliminated the individual mandate in Obamacare, putting more pressure on insurers working in state health exchanges. The impact of the the loss of the mandate and the cost-sharing payments won’t fully be known until insurance companies submit their rates to state insurance commissioners later this spring. (Blethen, 3/21)

Republicans denounced Democrats on Wednesday for opposing a bill aimed at lowering ObamaCare premiums, saying Democrats walked away from a deal so they could blame the GOP for premium increases ahead of the midterm elections. Sen. Lamar Alexander (R-Tenn.), a leader of the push for the bill to stabilize ObamaCare markets, said Democrats were blocking the measure from must-pass government funding legislation this week solely because of abortion-related objections, despite support for the measure from President Trump, Speaker Paul Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.). (Sullivan, 3/21)

The release of the 2,000-plus-page bill Wednesday evening, after a two-day delay, touched off a legislative sprint as lawmakers try to pass it before Friday night, the deadline to avoid a government shutdown. And with a key senator unwilling to say whether he would agree to accelerate the deal’s consideration, it remained uncertain whether they would be able to meet the challenge. (DeBonis and Werner, 3/21)

“No bill of this size is perfect,” House Speaker Paul Ryan (R., Wis.) said in a statement Wednesday night. “But this legislation addresses important priorities and makes us stronger at home and abroad.” (Peterson and Meckler, 3/22)

Congressional leaders are hoping to avoid the need for a short-term spending bill to keep the government open for a few days beyond Friday. But if the spending bill is released Wednesday as planned, the House will likely vote on the measure Thursday, giving the Senate just one day to clear the deal before funding expires. (Caygle, Everett, Bade and Ferris, 3/21)

HHS would receive approximately $98.7 billion, compared to the $87.1 billion enacted for fiscal 2017, according to the bill, explanatory language and a Senate summary. That includes $5.1 billion for the Food and Drug Administration and $5.5 billion for the Indian Health Service, whose funds are provided respectively in the bill's Agriculture and Interior titles. (Siddons, 3/21)

The government funding bill unveiled Wednesday night boosts funding for medical research at the National Institutes of Health (NIH) by $3 billion, an investment touted by both parties. The increase, which brings total funding for the fiscal year to $37 billion, is a reflection of the bipartisan support for the NIH. (Sullivan, 3/21)

FDA received just a small boost to its taxpayer dollars — $134 million — bringing its total taxpayer money for fiscal 2018 to $2.9 billion. When combined with industry user fees, FDA’s total funding would stand at $5.2 billion, or nearly $500 million more than the previous year. (Cancryn, 3/21)

Congress is adding a several billion dollar boost to the omnibus in order to combat the opioid epidemic — an effort to bolster prevention, treatment and law enforcement initiatives to combat the crisis killing thousands of people each year. The $1.3 trillion spending package allocates around $4 billion to the opioid epidemic, much of which is new money appropriated this year.  (Roubein, 3/21)

VA medical care accounts would receive $68.8 billion of the new money allotted in the omnibus. In the final bargaining, appropriators provided a $2 billion increase for VA hospital maintenance and construction to help fix aging infrastructure and shore up in-house facilities so veterans don't need to make as much use of the existing private care alternative, known as the Veterans Choice Program. Choice, as it is known, has perennially run short of cash since its inception in 2014. The fiscal 2018 spending bill doesn't provide any additional funds for the program. For fiscal 2019, the administration is asking for $85.5 billion for the VA, which would amount to a $4 billion increase over this year's proposed funding, which is nearly six months late. (Mejdrich, 3/21)

Congressional leaders — at the urging of President Donald Trump — have reached a tentative deal to pass modest gun legislation as part of a broader spending package, three sources familiar with the talks told POLITICO on Wednesday. Senate Minority Leader Chuck Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) endorsed the inclusion of narrow, bipartisan legislation aimed at improving records and information-sharing in the FBI’s National Instant Criminal Background Check System — even though gun control advocates say the provision barely moves the needle on firearms restrictions. (Bade, Everett, Ferris and Caygle, 3/21)

The bill also incorporates legislation promoted by the GOP to respond to the mass shooting last month at a Parkland, Fla., high school. The measure, the Student, Teachers and Officers Preventing (STOP) School Violence Act, would authorize $50 million in grants to help schools increase security and learn how to better identify potential threats. (Radelat, 3/21)

In a victory for Democrats, the provision will partially alter the 1996 ban, known as the “Dickey Amendment,” which the CDC has interpreted as a blanket prohibition on gun-violence research. The legislation will explicitly allow the agency to conduct public-health research on gun use, though it would still be barred from advocating tighter gun control. Supporters of the Dickey provision say it ensures that the federal government doesn’t become enmeshed in a contentious political issue. But Democrats and some centrist Republicans contend that the amendment has had a chilling effect on scientific research into the issue, interfering with a greater understanding of the causes of gun violence. (Hackman, 3/21)

Many Republicans argue the CDC has essentially engaged in self-censorship, but advocates say the agency can’t do research when there hasn’t been any money appropriated for it. When the Dickey Amendment was first passed, CDC researchers stopped working on gun-related projects, and federal funding disappeared. Congress shifted the $2.6 million CDC had earmarked for studying gun violence and prevention into a fund for studying traumatic brain injuries. (Weixel, 3/21)

Congress has rebuffed drug companies’ appeals to reduce how much they have to pay for some seniors’ prescription costs — a rare defeat for the industry after a frenzied lobbying campaign. Drug makers had pressed Republicans to use a sprawling appropriations deal to roll back a policy that makes them responsible for 70 percent of the prescription costs for seniors who reach the so-called “donut hole” in 2019. The “donut hole” is a gap in Medicare drug coverage in which beneficiaries are on the hook for sky-high prescription costs, up to a certain dollar amount. (Mershon, 3/21)

A tiny eye drug company is about to walk away from Congress with a great big win: an extra two years of charging Medicare higher prices for its cataract surgery drug. Tucked into some of the final pages of the sprawling, 2,232-page spending package congressional leaders unveiled late Wednesday are five pages detailing a complicated policy that represents a major win for Omeros, the Washington state-based company behind the cataract surgery drug Omidria. In fact, the language is painstakingly worded to ensure the policy affects Omeros and its product and almost no other drug companies. (Mershon, 3/21)

Congressional leaders released the long-awaited $1.3 trillion, two-year spending omnibus after days of wrangling behind closed doors over contentious policies that included an embattled stabilization package for the individual market that would fund cost-sharing reduction payments and a $30 billion reinsurance pool. Here's what did and did not make it into the bill. Total HHS appropriation: $88 billionWinners:Insurers who fought to keep a new policy that phases down their share of the cost of prescription drugs not covered by Medicare while raising it for drugmakers. The National Institutes of Health which received a $3 billion boost in funding, bringing its total budget to more than $37 billion. (Luthi, 3/21)

The House, spurred on by President Trump, passed a bill on Wednesday that would give patients with terminal illnesses a right to try unproven experimental treatments. The measure, which was approved by a vote of 267 to 149, appears to have a good chance of becoming law. The Senate approved a similar proposal last year. (Pear, 3/21)

The legislation failed March 13 after Republicans brought it to the floor under suspension of the rules, an approach typically reserved for noncontroversial bills that requires two-thirds support for passage. The vote was 259 to 140, prompting the Wall Street Journal’s GOP-friendly editorial board to blame Republicans for “political malpractice.” Wednesday’s vote required only a simple majority for passage. The bill now needs approval from the Senate, which passed its own “right-to-try” legislation over the summer by unanimous consent. Thirty-eight states have approved similar measures, according to a national “right-to-try” advocacy group. (Viebeck, 3/21)

Proponents say the bill is necessary because desperately ill patients need help getting investigatory drugs. But critics say the measure could undermine clinical research into new prescription drugs. They also point to FDA data that show the regulator already approves more than 99% of such requests. The Senate version of the legislation carried a broad definition of which patients could qualify for such unproven drugs. It would allow access by a patient “diagnosed with a life-threatening disease or condition.” Critics of the legislation contend such language could potentially jeopardize much of FDA law by allowing unapproved drugs for non-terminal disease. (Burton, 3/21)

With a final law all but assured, health policy advocates who have vigorously opposed the idea are now looking toward the broader anti-regulatory health agenda being pushed by the Goldwater Institute. Arizona-based Goldwater has a handful of other ideas that could dramatically weaken the authority of the FDA to oversee the safety and effectiveness of medicines and has already made progress getting one of those ideas — giving drug companies more freedom to market their products — on state lawmakers' agenda. Goldwater spearheaded passage of a law in Arizona's legislature last year that allows companies to promote non-FDA-approved uses of their products to doctors without fear of repercussions by state officials. It helped get similar bills introduced in Colorado and Missouri's legislative sessions this year and expects other states to follow suit soon. (Karlin-Smith, 3/21)

It’s not clear what’s next for the legislation, which has been a priority for President Trump and Vice President Mike Pence. The Senate unanimously passed a broader right-to-try bill last fall, but did so largely to satisfy the demands of the bill’s sponsor, Sen. Ron Johnson (R-Wis.) as he held up another priority law. A single senator could similarly choose to block or hold up consideration of the now House-passed bill. (Mershon, 3/21)

Opponents of the bill also point to the FDA’s compassionate use program, saying the agency approves 99 percent of requests to let a patient use an experimental drug. They argue the legislation provides “false hope,” as drug manufacturers aren’t required to provide the drug to patients who ask. (Roubein, 3/21)

U.S. Attorney General Jeff Sessions instructed federal prosecutors on Wednesday to seek the death penalty in drug-related cases whenever it is "appropriate," saying the Justice Department must boost efforts to counter America's epidemic of opioid abuse. His mandate to prosecutors followed a plan announced by President Donald Trump earlier this week that called for executing opioid dealers and traffickers, and for stiffer sentencing laws for opioid trafficking. (Lynch, 3/21)

“I strongly encourage federal prosecutors to use these statutes, when appropriate, to aid in our continuing fight against drug trafficking and the destruction it causes in our nation,” Sessions wrote. The memo points to statutes where the death penalty can be used, including certain racketeering activities, the use of a gun that resulted in a death during a drug trafficking crime, murder in advancing a criminal enterprise and dealing in “extremely large” quantities of drugs. (Roubein, 3/21)

The House Energy and Commerce Health Subcommittee launched a two-day hearing Wednesday on the opioid crisis that includes discussion of 25 public health bills and features 19 witnesses. Full committee chairman Greg Walden, R-Ore., spoke highly of President Donald Trump’s speech Monday addressing the crisis, noting that his committee was working on many of the same priorities. Walden hopes to pass a package to curb opioid addiction by Memorial Day. (Raman, 3/21)

Kaiser Health News: Graphic: Opioid Painkiller Is Top Prescription In 11 States

Americans fill about 4.5 billion prescriptions each year, at a cost of more than $323 billion. But what are we actually buying? In 11 states, the top prescriptions are opioid pain pills that are mixtures of acetaminophen and hydrocodone (brand names Vicodin and Norco), according to new data from GoodRx, an online prescription cost service. (Gold, 3/22)

An emergency room doctor with Lehigh Valley Health Network in Pennsylvania last year treated two people who nearly died from taking large quantities daily of an over-the-counter anti-diarrhea medication in an effort to get high or stave off the effects of opioid withdrawal. The two people who overdosed on loperamide, the active ingredient in the anti-diarrhea medication sought by opioid addicts when they cannot get their drug of choice, so alarmed Dr. Kenneth Katz that he contacted a manufacturer of loperamide. He told the company its product represented “a public health hazard.” (Lehman, 3/21)

Iowa regulators blocked Nathan Hardage from treating drug addicts in 2014 amid allegations he assaulted a patient, allowed others to drink alcohol and let recovering drug abusers watch people smoke marijuana while in treatment. But the self-described “wounded healer” found a more lenient regulatory environment in Colorado. He owns two addiction rehab clinics in Colorado Springs and Aurora and 16 sober-living homes in Colorado despite a growing list of allegations against him, including sexual harassment, abuse of patients and inappropriate billing practices at his CoreVision program. (Osher, 3/21)

Sponsored by Rep. Tony Rivero, R-Peoria, House Bill 2389 called for the legalization of syringe-access programs, which currently operate under the radar and afoul of Arizona drug paraphernalia laws. According to the proposed legislation, which passed unanimously out of the state House last month, programs could legally exist if the goal is to reduce the spread of disease, minimize needle pricks to law-enforcement officers and encourage people to enroll in treatment programs. (Pohl, 3/21)

Information about LGBT health was removed from a Department of Health and Human Services (HHS) website last fall, according to new reports from a watchdog group. The HHS Office of Women’s Health (OWH) removed a webpage with extensive information about lesbian and bisexual health, and links that correspond to that webpage, according to reports the Sunlight Foundation released Wednesday. (Weixel, 3/21)

More cases of an unusual cancer linked to breast implants have been reported to the Food and Drug Administration, the agency said on Wednesday. The case count rose in the past year, to 414 cases from 359, the agency said in an update on its website. The number of deaths it has recorded, nine, has not changed from one year ago; a professional society of plastic surgeons is now reporting 16 related deaths. (Grady, 3/21)

It was her last chance. MaryJo Dunn had been trying to get pregnant through in-vitro fertilization for 20 months. At age 45, she expected it to be challenging. But giving up wasn’t easy. She and her husband had lost their only child, a 17-month-old son, two years earlier to a rare type of cancer. The Dunns were running out of time and money. They had already spent more than $70,000 on fertility treatments and taken out a loan. But the doctor recommended against implanting Ms. Dunn’s two remaining embryos, she recalls, because of the results of genetic tests on them. (Reddy, 3/21)

Abrain scanner now used to guide treatment of patients with epilepsy and other neurological disorders is bulky and challenging to use on fidgety young children — but researchers hope it might soon be replaced by a new machine that’s not much bigger than a bike helmet. Scientists at University College London have created a prototype of a lightweight, easier-to-use version of a magnetoencephalography, or MEG, brain scanner. These machines monitor the magnetic field created when neurons communicate with each other, allowing physicians to see how the brain functions from one second to the next. (Thielking, 3/21)

When Health and Human Services Secretary Margaret Heckler announced that scientists had discovered the virus that caused AIDS at a press conference in 1984, the disease was still mysterious and invariably fatal. Perhaps with a vaccine, AIDS could be ended like smallpox or contained like polio, two scourges that yielded to intense public health interventions. Heckler suggested that experimental vaccine trials were just two years away. (Fitzsimons, 3/21)

Mumps is resurging. And it may be because the immune response provoked by the mumps vaccine weakens significantly over time, and not because people are avoiding vaccination or because the virus has evolved to develop immunity to the vaccine, a new study has found. (Bakalar, 3/21)

Eighteen-year-old Devin Coats was fighting for a second chance to live. His brother, Nicholas, was waiting to die. The identical twin brothers had both been diagnosed last year with Stage 4 cirrhosis of the liver — severe scarring commonly associated with alcoholism. In this case, it was the result of a gene mutation, and both brothers needed new livers to survive it. (Bever, 3/21)

A high level of physical fitness during middle age may significantly reduce the risk of dementia, new research suggests. The findings, which were published this month in the scientific journal Neurology, showed that women with a high level of cardiovascular fitness during middle age had a nearly 90 percent lower risk of dementia than women who were just moderately fit. (Lemon, 3/20)

Alzheimer’s disease is among the most expensive illnesses in the U.S. There’s no cure, no effective treatment and no easy fix for the skyrocketing financial cost of caring for an aging population. Spending on care for people alive in the U.S. right now who will develop the affliction is projected to cost $47 trillion over the course of their lives, a report issued Tuesday by the Alzheimer’s Association found. The U.S. is projected to spend $277 billion on Alzheimer’s or other dementia care in 2018 alone, with an aging cohort of baby boomers pushing that number to $1.1 trillion by 2050. (Levingston, 3/20)

A woman in Spain died after undergoing a supposedly routine “bee acupuncture” treatment and then suffering an allergic reaction that put her in a coma. The alternative medicine procedure is more or less what its name conjures up: Instead of a needle, an acupuncture practitioner injects bee venom into the body at certain points. In some instances, live bees are used to sting and inject venom into the person directly. (Wang, 3/21)

The two bills that would establish an individual mandate in Connecticut have failed to make it out of committee, but Senate President Pro Tem Martin M. Looney said Wednesday he would consider reviving the proposal by offering an amendment to other legislation. ...The proposals would impose radically different fines for those who fail to buy health insurance coverage. (Rigg, 3/21)

A new report finds that health insurance premiums available on the state's MNsure exchange in 2018 are significantly lower than last year due in large part to a state government program. The average monthly premium for a 40-year-old nonsmoker buying the lowest priced "silver" health plan in Minnesota is $365, a decline of 15 percent compared with last year, according to a report Wednesday from researchers at the Urban Institute. (Snowbeck, 3/21)

Women in conservative Utah will soon be able to get birth control directly from a pharmacist rather than visiting a doctor each time they want to obtain or renew a prescription, a move taken by only a few other states, many of them liberal. Republican Gov. Gary Herbert signed a measure into law Tuesday allowing those 18 and older to get pills, the patch and some other contraceptive devices, putting Utah in line with a handful of other states that have passed similar laws, including California, Colorado and Oregon. (3/21)

Sweeping legislation aimed at making comprehensive changes to Iowa's often-criticized mental health system is headed to Gov. Kim Reynolds desk. House File 2456 was approved 49-0 in the Iowa Senate on Wednesday. The bill previously passed the Iowa House, and Reynolds is expected to sign it. Patient advocates have cheered the legislation, which is intended to improve a system many believe has fallen short of serving Iowans in need, sometimes with tragic consequences. A recent Des Moines Register/Mediacom Iowa Poll, showed 73 percent of Iowans believe the state’s mental health system is in crisis or is a big problem. (Petroski, 3/21)

A school safety bill requiring all districts to be prepared for active shooters and other emergencies is making its way through the Iowa legislature, as lawmakers grapple with the tragedy of school shootings across the country. (Russell, 3/21)

Harrold ISD was the first of more than 172 Texas school districts — mostly in rural or isolated areas — to arm educators and other employees to prevent a possible tragedy. ...But since the Feb. 14 shooting at Marjory Stoneman Douglas High School in Parkland, Florida, in which 17 people died, districts with such a policy have come under national scrutiny as more politicians have pushed for arming teachers or other school personnel. (Dugyala, 3/22)

Eight measles cases have now been identified in Johnson County, with another two in Linn and Miami counties, according to the Kansas Department of Health and Environment. Health departments in the three counties have pinpointed where and when the individuals were infected. Because people can acquire measles anywhere from a week to three weeks after exposure, KDHE said there are concerns that additional cases may be identified. (Margolies, 3/21)

In a major boost to downtown Kansas City, Kan., the long-vacant former EPA office building will be converted to a mental and behavioral health facility employing 400 people. The University of Kansas Health System plans to invest $61 million converting the unique 220,000 square-foot office building, vacant since 2011, into what’s being described as a “state-of-the-art” healthcare facility. (Collison, 3/21)

The first human milk bank in the state opened this week at Ochsner Baptist in New Orleans. The Mothers' Milk Bank became accredited in March and accepts donated human milk following a detailed screening process of a lactating woman. The milk is then given to infants born prematurely and unable to get enough milk from their birth mothers. (Clark, 3/21)

Alertgy, a real-time blood-glucose monitoring and alert system that works through a smartphone application, won $36,000 during the New Orleans Health Innovators Challenge on Tuesday (March 20). The New Orleans Business Alliance partnered this year with Ochsner Health System and Blue Cross Blue Shield to find startups nationwide that are developing new technology to innovate diabetes care. Three startups, including Alertgy, were chosen to pitch their ideas Tuesday at the first Health Innovators Challenge. (Clark, 3/21)

A smiling baby with a thick head of black hair, Ingrid Ronan Johnson was born to a Miccosukee mother and a white father, inside Baptist Hospital in Kendall. Two days later, police detectives arrived at the hospital acting on a court order to remove the baby from the new parents. ...The incident is the latest test of the legal authority of the court and police department with the sovereign Miccosukee tribe, which has clashed with state authorities for years over jurisdiction. (Ovalle, 3/21)

An Arkansas judge on Wednesday struck down the state's decision to issue its first licenses to grow medical marijuana, ruling that the process for awarding the permits and the rankings of applicants were unconstitutional. Pulaski County Circuit Judge Wendell Griffen granted a preliminary injunction preventing the state Medical Marijuana Commission from awarding cultivation licenses. Griffen last week issued a restraining order preventing the state from awarding licenses to five companies. (3/21)

People sick with a bacterial infection that resists antibiotic treatment might be able to fight off their illness in a different way. It involves infecting people with a virus that will in turn target bacteria, according to a study published in the journal Evolution, Medicine, & Public Health. (Magness, 3/21)

Cannabidiol is available in Colorado health food stores, but the state’s marijuana laws prevent the cannabis compound from being sold in pharmacies. A bill moving through the Statehouse would open the doors for GW Pharmaceuticals’ CBD-centric Epidiolex drug to be prescribed and sold in pharmacies across the state. A House committee passed the “Food and Drug Administration Cannabidiol Drug Use” late Tuesday in a 9-0 vote. The unanimous approval of House Bill 1187 followed three hours of public comments and debate that saw amendments added to address concerns raised by the hemp and marijuana industries. (Wallace, 3/21)

When Republicans failed to repeal ObamaCare last year, it recalled the old line about snatching defeat from the jaws of victory. That loss, however, should not be allowed to overshadow an important Republican success on health care. Millions of Medicare beneficiaries now get their coverage through private plans under Medicare Advantage—a quiet step forward that brings real benefits. To ensure continued progress, Republicans must resist the temptation to choose short-term savings over long-term reform. (Bobby Jindal, 3/21)

Most Americans would agree that gun violence is one of the defining societal problems of our time. But it is also a public-health problem that we can solve — and we can do it without infringing on the rights of law-abiding citizens to have guns.Science alone won’t be able to solve gun violence, which claimed 38,658 lives in 2016 and injured many more. But viewing gun violence as a public-health problem worthy of research has a lot to offer, and can provide a way forward that brings together advocates on both sides of the gun violence debate. (Victor J. Dzau and Mark Rosenberg, 3/21)

When you get really sick, the medical bills may not be your biggest financial shock. New research shows that for a substantial fraction of Americans, a trip to the hospital can mean a permanent reduction in income. Some people bounce right back, but many never work as much again. On average, people in their 50s who are admitted to the hospital will experience a 20 percent drop in income that persists for years. Over all, income losses dwarfed the direct costs of medical care. (Margot Sanger-Katz, 3/21)

A common, sad sentiment was sounded in the aftermath of Tuesday’s shooting at Great Mills High School in Southern Maryland:“The notion of ‘it can’t happen here’ is no longer a notion,” said St. Mary’s County Sheriff Timothy K. Cameron. “If you don’t think this can happen at your school, you are sadly mistaken,” said St. Mary’s Schools Superintendent James Scott Smith. And from parent Shonita Somerville: “I never thought something like this would happen here. St. Mary’s is a small little place. Now I can say, ‘You think it wouldn’t happen? It can happen to anybody.’ ” (3/21)

Something came awake in them. That has to be the explanation. As they cowered in closets, as they said goodbyes and waited, with gunfire echoing down the halls, to die, something inside stirred itself.And when they didn’t die, when these teenagers left the campus of Marjory Stoneman Douglas High in Parkland alive — something 17 of their classmates and teachers did not do — this newly awakened thing drove them like a truck, and they pulled out their cellphones and got to work. The latest results of that work will coalesce in Saturday’s “March For Our Lives” in Washington. (Leonard Pitts, 3/21)

A Republican governor in a conservative state is willing to fight politically for a civil process to separate the violently mentally ill from guns. Get it done. (Robert Robb, 3/21)

The opioid crisis is a complicated problem, for which President Trump offered his usual simplistic approach Monday. His comments emphasized force and punishment, including, as expected, the death penalty for drug traffickers — as well as an attempt to link the drug crisis to immigration by blaming it on “sanctuary cities” supposedly swarming with foreign drug dealers. He offered no new funding for drug treatment beyond the welcome but still inadequate $6 billion two-year program moving through Congress, though to his credit he recommended repeal of a 1970s-era law that prevents Medicaid from paying for care at large inpatient facilities. One reason the president’s rhetoric was so inappropriate is that the drugs at issue are not all illegal. Illicit heroin and fentanyl use has indeed surged in the past half-decade; those two drugs account for the lion’s share of the 64,000 drug overdose deaths in the United States during 2016, according to the Centers for Disease Control and Prevention (CDC). However, if you eliminated them all, the country would still have a massive problem. The epidemic began two decades ago with legally prescribed opioid analgesics such as oxycodone and hydrocodone. And those drugs caused more than 17,000 overdose deaths in 2016. (3/21)

President Trump made big news in New Hampshire this week with his call for applying the death penalty to big drug dealers — and that only goes to show that bad policy makes for easy headlines. The best explanation of why that’s a thoroughly wrong-headed approach is also the simplest: Western societies don’t execute people for those kinds of crimes. Nor should we start. (3/21)

President Donald Trump has finally outlined a comprehensive approach for dealing with the nation’s opioid crisis. He appears to understand that the issue is complex. But his plan to address it is precisely backward in its priorities, underfunded and vague about how it would be carried out. (3/21)

The Senate HELP Committee hearing last week examining the 340B drug discount program, another example of a well-intentioned government scheme gone awry, shows that Washington is finally getting serious about passing much-needed modernization and reform. (Lindsay Boyd Killen, 3/22)

We may be in the early days of a changing political ideology. For decades, politicians on both sides have espoused the belief that copayments and other out-of-pocket charges are necessary to reduce consumer demand for health care. The simple economic argument goes: If patients “feel” some of the health-care cost, those patients will make more prudent health-care choices and forego unnecessary care. (Christopher Robertson and Victor Laurion, 3/21)

Justin Volpe became an all-too-common statistic. Living in Florida in 2006 without medication for his schizophrenia, he descended into a haze of hallucinations, paranoia and substance abuse — ultimately culminating in an arrest for grand larceny. He was taken to the notorious ninth floor of the Miami-Dade County Jail, the “forgotten floor” for people with serious mental illnesses, where inmates were often kept in crowded, unsanitary and perpetually lit cells. In the United States, more than half of adults with a mental illness and more than 90 percent of adults with a substance-use disorder did not receive treatment in the last year. This public-health crisis has now become a criminal-justice crisis. (Steven Leifman and Miriam Krinsky, 3/21)

Recent estimates indicate that approximately 57% of the 36.7 million people living with HIV worldwide are in care and receiving antiretroviral treatment (ART). Although this represents a 20-fold increase in less than 2 decades in the number of people receiving ART, these findings also demonstrate that the global community is still far from achieving the targets laid out by the Joint United Nations Programme on HIV/AIDS (UNAIDS) called 90-90-90—specifically, 90% of all people living with HIV knowing their status; 90% of those diagnosed receiving sustained ART; and 90% of those receiving ART achieving viral suppression by 2020. Accomplishing this ambitious agenda requires sustainable approaches in countries with the highest burden of HIV. (Ingrid T. Katz, Peter Ehrenkranz and Wafaa El-Sadr, 3/20)

Although the good doctor’s name remains obscure in the history of medicine, every person who has visited their dentist since the 1884 discovery of local anesthesia should thank Dr. Carl Koller, who proposed numbing our gums and other exposed body tissues with cocaine. (Howard Markel, 3/21)

Seventeen years have passed since the US National Academy of Medicine (NAM) (then the Institute of Medicine) published Crossing the Quality Chasm, a major effort to outline an approach to improving health care quality. One of the recommendations for improving care envisioned the broader use of evidenced-based clinical practice guidelines (CPGs) as a pathway toward standardization and improved outcomes. The success of this strategy would depend on the supply of trustworthy CPGs and the demand by both clinicians and organized health systems to deploy those CPGs. Quality metrics derived from CPGs were expected to be guideposts for health systems to gauge performance. (David Grossman, 3/21)

The Missouri GOP is going after welfare recipients again. From dictating how recipients can spend their benefits to barring them from withdrawing cash from ATMs, Missouri Republicans are working overtime to crack down on society’s neediest citizens. Under legislation moving through the General Assembly, those on welfare could no longer buy cigarettes or six-packs with benefit money. While that may sound like a healthy mandate, it also ignores reality, which is that poor citizens also need respites from life’s harsh realities. (3/21)