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A bill to dismantle the Affordable Care Act that narrowly passed the House this month would leave 14 million more people uninsured next year than under President Barack Obama’s health law — and 23 million more in 2026, the Congressional Budget Office said Wednesday. Some of the nation’s sickest would pay much more for health care. (Pear, 5/24)

The Congressional Budget Office report, issued Wednesday, also found that average premiums would fall compared with President Barack Obama's health care overhaul, a chief goal of many Republicans. But that would be partly because policies would typically provide fewer benefits and sicker people would be priced out, it concluded. (Fram and Alonso-Zaldivar, 5/25)

The legislation would reduce the federal budget deficit by $119 billion over 10 years. That’s $32 billion less than the estimated savings for the previous version of the bill. (Pugh and Clark, 5/24)

The largest savings would come from cutting Medicaid and reducing tax credits for middle-income insurance buyers. (Park and Quealy, 5/24)

The House bill would be particularly harmful to older, sicker residents of states that waive key consumer protections in the current law, including the ban on insurers charging sick consumers more. The budget office estimates that about one-sixth of the U.S. population live in states that would seek such waivers, which would be allowed under the House bill. “Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance,” the report notes. (Levey, 5/24)

The effects of the bill would be immediate. In 2018, 14 million more people would be uninsured if the bill became law. Premiums would rise by an average of about 20 percent in 2018, CBO said. However, average premiums starting in 2020 would partially depend on changes states might seek to Obamacare insurance requirements. (Young and Raman, 4/24)

The report incorporates the changes to the bill made just before it narrowly passed the House on May 4. Those changes included an amendment offered by Rep. Tom MacArthur (R-N.J.) that would let states waive some key provisions of the health law, including requirements to cover “essential health benefits” and to offer insurance to people with preexisting conditions at no extra cost. (Rovner, 5/24)

The waivers states are allowed to take would let insurers offer plans that don’t cover some benefits, such as maternity care. That would mean people would have to pay for those treatments on their own, or buy separate insurance coverage for them. An add-on policy that covers maternity care could cost $1,000 a month or more, CBO said -- raising both up-front and out-of-pocket costs for women. (Edney, Tracer and Litvan, 5/24)

Congressional analysts concluded that one change to the House bill aimed at lowering premiums, by allowing states to opt out of some current insurance requirements, would encourage some employers to maintain coverage for their workers and get younger, healthier people to buy plans on their own. But those gains would be largely offset by consumers with preexisting conditions, who would face higher premiums than they do now. “Their premiums would continue to increase rapidly,” the report found. (Eilperin and Snell, 5/24)

The total is slightly less than the CBO’s accounting of a previous version of the bill. (Sullivan, 5/24)

It’s a slightly better number than the GOP’s first plan that failed in March. Under that plan, the CBO found 24 million or more would have lost insurance. That figure stirred protests and played a major role in tanking support for the plan. (Hart, 5/24)

The bill will now move on to the Senate, and should it pass that chamber, it will not look like this current AHCA version. (Kurtzleben, 5/24)

Here are some key facts and figures from the new CBO report on the American Health Care Act, the House-passed bill to repeal and replace Obamacare. CBO stressed the uncertainty of its estimates, given that it's hard to know which states would take up the chance to opt out of certain key parts of Obamacare. All figures are for the decade spanning 2017-2026 unless otherwise specified. (Kenen, 5/24)

An estimated 23 million additional Americans will become uninsured over the next decade if the current version of the Republican health care bill goes into effect, according to a Congressional Budget Office analysis released Wednesday. This is only slightly lower than the 24 million predicted in March, before Republicans tweaked the bill to pull in critical votes from both moderate and hard-right Republicans. (Feibel, 5/24)

Here's what the CBO reported on the cost and coverage impact of the House Republicans' bill to repeal and replace the Affordable Care Act. ... Prompt a few million people to use premium tax credits to buy plans that don't cover major medical costs. ... Result in 4 million more people in employer-based health plans by 2026, mainly because employers would see the individual market as a less desirable option for their workers. (Meyer, 5/24)

But what does that mean to most Americans? The CBO helpfully broke down how much insurance premiums would cost for people at two income levels — $26,500 and $68,200 annually — at three ages. The upshot is that people making $68,200 a year who are in the two younger ages (21 and 40) will pay less in premiums annually because they will get a tax credit not available to people at their income level under Obamacare. But for older and poorer Americans, the effect will mostly be worse. (Bump, 5/24)

For a week now, some congressional insiders had been whispering that the critical “score” from the Congressional Budget Office, on the legislation that narrowly passed the House earlier this month, might not provide any real deficit savings. Such a finding would have violated the Senate’s more arcane rules for considering budgetary items under fast-track rules — and it might have forced House Speaker Paul D. Ryan (R-Wis.) to redraw the legislation and hold another vote. So there were a few sighs of relief late Wednesday afternoon when the CBO declared the legislation would find $119 billion in savings over 10 years, more than enough to allow it to pass muster under the Senate’s so-called reconciliation rules, which allow a simple majority for passage rather than the usual 60-vote majority. That’s an important feat for Senate Republicans, who control just 52 seats. (Kane, 5/25)

Under budget rules, the health bill must cut the federal deficit (the House’s first version did that to the tune of $337 billion), so that is an important number. It is also important to look at how much of the budget savings would come from reduced Medicaid spending, because steep cuts mean more people without insurance. That is another key figure: the increase in the uninsured compared with leaving the ACA in place. The more uninsured, the harder it may be for Republicans to sell their plan to the public. And effects on premiums matter, since Senate GOP lawmakers have said their main goal is to bring down premium costs. (Armour, 5/24)

The findings provide ammunition for the two competing factions that Senate Republican leaders need to pull together to pass a bill. Centrist Republicans, concerned about the number of uninsured, hope to make the House bill less far-reaching, while conservatives want to double down on measures the CBO suggests will lower premiums on average. (Armour and Peterson, 5/25)

Obamacare repeal is in trouble in the Senate, and a nonpartisan analysis of the House’s repeal legislation issued Wednesday only reinforced that reality. Within minutes of the release of the report showing 23 million fewer Americans would be insured over a decade, two Senate Republicans blasted the estimate and the House bill, underscoring just how much the legislation will have to change to get through the upper chamber. (Demko and Haberkorn, 5/24)

In a flurry of statements, Senate Republicans stressed that they are starting fresh on the healthcare bill and that it will be changed significantly — and scored again by the CBO — before it becomes law. “While I am in favor of repealing ObamaCare, I am opposed to the American Health Care Act (AHCA) in its current form,” Sen. Dean Heller (R-Nev.), who faces a close reelection race next year, said in a statement. “This bill does not do enough to address Nevada’s Medicaid population or protect Nevadans with pre-existing conditions.” (Sullivan 5/24)

Republican senators quickly distanced themselves from a House-passed ObamaCare repeal and replacement bill after a new analysis of the legislation was released on Wednesday. The American Health Care Act (AHCA) would result in 23 million more uninsured Americans over a decade, according to the Congressional Budget Office analysis. The CBO also found that in states that would let insurers charge sick people more, some could be priced out of being able to afford insurance. (Carney, 5/24)

Senator Bill Cassidy, a Louisiana Republican, said the House bill failed to meet what he called the “Jimmy Kimmel Test,” a reference to the late-night talk-show host’s infant son, who was born with a heart defect, and the idea that any new health law should provide generous-enough insurance to cover critical medical needs. “Congress’s focus must be to lower premiums with coverage which passes the Jimmy Kimmel Test. The AHCA does not,” he said in a statement. His Republican colleague, Senator Susan Collins of Maine, likewise said that the GOP bill would “disproportionately affect older, low-income Americans.” (Edney, Tracer and Litvan, 5/25)

President Trump’s healthcare chief slammed the CBO score of the GOP healthcare bill as “wrong again” minutes after its release on Wednesday, immediately dismissing the conclusion that it would substantially raise premiums for sick people. “The CBO was wrong when they analyzed ObamaCare’s effect on cost and coverage, and they are wrong again,” Health and Human Services Secretary Tom Price said in a statement. (Hellmann, 5/24)

U.S. Senate Majority Leader Mitch McConnell said on Wednesday he does not yet know how Republicans will amass the votes needed to pass legislation now being crafted to dismantle Obamacare, but expressed some optimism on another top priority, overhauling the tax code. In an exclusive interview with Reuters, McConnell said healthcare and taxes still top the Republican legislative agenda, and he added that he will not reach out to the minority Democrats on either one because differences between the two parties are too stark. (Cornwell and Abutaleb, 5/24)

Senate Majority Leader Mitch McConnell on Wednesday said the path forward for the legislation to repeal and replace Obamacare remains unclear, adding that he is unsure at the moment how such a measure will secure the requisite 50 votes from the GOP’s 52 senators. (Nelson, 5/24)

No Democrats are expected to vote to repeal former President Obama's signature healthcare insurance law. Republicans have a 52-vote majority in the Senate, so they can only lose two GOP votes and still have the 50 votes needed to pass a bill. (Sullivan, 4/24)

Many House Republicans avoided specifics of the analysis and instead focused on the overall picture which was "that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit," House Speaker Paul Ryan, R-Wis., said. “We’re on a rescue mission, and today’s CBO report reinforces what we’ve said before — our American Health Care Act will lower premiums and reduce the deficit," said House Republican Conference Chair Cathy McMorris Rodgers, R-Wash. "The CBO report doesn’t tell the whole story when it comes to the benefits of this bill, but we’re one step closer to keeping our promise to repeal and replace Obamacare." (Collins, 5/24)

Speaker Paul D. Ryan is acutely aware that Republicans will be attacked over the health care bill that his chamber passed a few weeks ago, but the Wisconsin Republican felt that inaction was not an option. “I’ll accept that we will get hit for this,” Ryan said Wednesday at an Axios’ News Shapers event. “But we’re in leadership. We don’t have a choice. … What are we supposed to do, just sit back and let this thing collapse?” The speaker has consistently made the case that the 2010 health care law is collapsing and it’s incumbent upon Republicans to fulfill their campaign promise to repeal and replace it. (McPherson, 5/25)

Senate Democrats on Wednesday seized on a new projection that 23 million more Americans would be uninsured under the House GOP’s Obamacare repeal to hammer the Republican senators now crafting their own plan. Led by Minority Leader Chuck Schumer, Senate Democrats staged a fiery press conference less than 45 minutes after the non-partisan Congressional Budget Office released its report on the House-passed Obamacare repeal. Schumer argued that Senate Republicans are making a mistake similar to their House counterparts’ hasty passage of a bill before its CBO score emerged. (Schor, 5/24)

Senate Democratic Leader Charles Schumer (N.Y.) on Wednesday denounced the House-passed healthcare reform bill after an analysis by the Congressional Budget Office (CBO) showed it would cause millions of Americans to lose health coverage. "Republicans in Washington and the president should read this report cover to cover, throw their bill in the trash can and begin working with Democrats on a real plan to lower costs for the American people,” Schumer said at a press conference held shortly after the CBO released its report. (Bolton, 5/24)

But Sen. Kamala Harris, D-Calif., called the bill “nothing short of a disaster,” and House Minority Leader Nancy Pelosi, D-San Francisco, took aim at provisions in the bill that the CBO said repeal $664 billion in taxes on high-income earners and insurers. “Trumpcare is a billionaire’s tax cut disguised as a health care bill: one of the largest transfers of wealth from working families to the rich in our history,” Pelosi said. (Lochhead, 5/24)

Illinois Democrats in Congress called House Republicans' health care plan approved this month a "disaster" and a "zombie bill" after a new analysis predicted it would mean 23 million more people will be uninsured by 2026. Democrats didn't vote for the plan and have used it to try to put political pressure on Republicans. The proposal is likely to change in the U.S. Senate. (Skiba, 5/24)

Colorado lawmakers feuded Wednesday night over the release of a new report which estimated the Republican health care plan that passed the U.S. House in early May would lead to a loss of insurance for up to 23 million Americans by 2026. The analysis by the Congressional Budget Office, a nonpartisan government research group, also found the measure to replace the Affordable Care Act would reduce the federal deficit by $119 billion over the next 10 years while providing lower premiums for some consumers — as compared to a previous Republican proposal — though that decline would be driven by less robust insurance coverage. (Matthews and Ingold, 5/24)

The Democratic Party is embroiled in a debate over where they should focus their efforts to win back political power: health care or Russia. The party’s campaign committees and many of Democrats’ leading super PACs have spent virtually all their energy this year on shaming Republicans for their push to repeal Obamacare, an issue that clearly touches voters’ daily lives. (Robillard and Schor, 5/24)

An analysis of the likely impact of the final House GOP bill to repeal and replace the Affordable Care Act says it would leave an additional 23 million uninsured and reduce the federal deficit by $119 billion over the next decade. The bill’s impact in Connecticut would depend on how the state decides on choices the legislation provides for changing insurance regulations. (Radelat, 5/24)

Democrats in the U.S. Senate used the CBO statistics to forecast that the bill would cause 292,982 Ohioans to lose private insurance coverage next year, and would increase the cost of uncompensated care to Ohio hospitals by $263,684,124 in 2018. They said it would also increase premiums for Ohioans who buy insurance through the ACA exchanges by $550 next year. Ohio Democratic Sen. Sherrod Brown said millions of Americans will lose their health insurance if the GOP bill becomes law, leaving them with "no real path" to gain insurance. (Eaton, 5/24)

Though the budget analysis released Wednesday on the GOP health care bill didn’t address California specifically, both the state’s Medicaid program and its individual market could be seriously harmed if the legislation passes, according to legislators, consumer advocates and other critics. “I feel like I am in a bad dream,” said Sen. Ed Hernandez, the West Covina Democrat who chairs the state Senate Health Committee. (Gorman, 5/25)

The House's version of the Affordable Care Act repeal-and-replace bill would leave 23 million more people uninsured and save the federal government $119 billion, according to the Congressional Budget Office. And that has hospitals wondering how they'll care for those uninsured. In its highly anticipated scoring of the American Health Care Act, the CBO said the bill, by 2026, would reduce the federal deficit by $32 billion less than an earlier version of the bill that the nonpartisan budget office analyzed. (Lee, 5/24)

The AARP has been outspoken in its opposition to the American Health Care Act, which was passed by the House earlier this month. The organization, which represents nearly 38 million adults age 50 and over, says the bill creates an age tax, harms people with pre-existing conditions and weakens Medicare. (Ochoa, 5/25)

A Republican candidate for the US Congress has lost the support of two newspapers in his state after he was charged with the assault of a Guardian reporter who tried to ask him about his party’s healthcare plan. Greg Gianforte, who is running for Montana’s congressional seat in a special election to be held on Thursday, was charged with misdemeanour assault after Ben Jacobs made a complaint to police about the incident at Gianforte’s campaign headquarters on Wednesday. (Gayle, 5/25)

"He took me to the ground," Jacobs told his paper. "This is the strangest thing that has ever happened to me in reporting on politics. "The audio file provided by Jacobs backs up his account of the incident and so did accounts by other journalists who witnessed the incident. (Byers and McLean, 5/25)

The incident rocked a closely watched contest, just hours before voters cast their ballots in Thursday’s special House election in Montana to replace Ryan Zinke, who is now the Trump administration's secretary of the interior. Gianforte, a technology executive, is running against Democrat Rob Quist, a folk singer and first-time candidate. The race in the traditional Republican stronghold is turning out to be closer than many thought it would be. (Gold and Debenedetti, 5/25)

Blue Cross and Blue Shield of Kansas City plans to pull out of the Affordable Care Act health insurance exchanges next year, a move that leaves a region in northwestern Missouri at risk of having no available marketplace plans. The nonprofit said that after losing more than $100 million on ACA plans through 2016, it will stop offering exchange plans in 30 counties in northwestern Missouri and two counties in Kansas. (Wilde Mathews, 5/24)

About 25 counties in Missouri might have no insurers on the ObamaCare exchanges next year after Blue Cross Blue Shield of Kansas City (Blue KC) announced Wednesday it won’t participate. Blue KC cited losses and uncertainty as a reason it decided to exit the individual markets both on and off the exchanges. The move comes as insurers are deciding whether to offer plans in the ObamaCare marketplaces next year and are asking Congress and the administration for certainty that they’ll continue to get crucial payments from the federal government. (Roubein, 5/24)

Danette Wilson, Blue KC’s president and CEO, said the company has lost more than $100 million total on its exchange plans since the Affordable Care Act rolled out in 2014. “This is unsustainable for our company,” Wilson said. “We have a responsibility to our (customers) and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation.” (Marso and Lowry, 5/24)

The company was the lone insurer offering ACA plans in 25 western Missouri counties, which means when residents there look on HealthCare.gov for insurance plans for 2018, they might not find any. (Savle-Smith, 5/25)

Anthem Inc on Wednesday said its plans for selling 2018 Obamacare individual plans are still up in the air because of political and regulatory uncertainty, making it the latest health insurer to say questions about continued funding of government subsidies will affect consumers next year. Anthem, the biggest provider of individual health plans, is looking at all 14 states where it sells Obamacare coverage to determine to what extent it will participate next year, given the continued uncertainty around subsidies and regulations, its chief executive said on Wednesday. (Humer, 5/24)

Nearly 200 House Democrats are demanding President Trump fund ObamaCare's Cost Sharing Reduction (CSR) payments to insurers. "The law requires, and it is your obligation under the law" to make the payments "and to stop other acts of sabotage that undermine Americans' access to affordable, quality health insurance," the House Democrats wrote in a letter to Trump. (Weixel, 5/24)

An HHS report released late Tuesday paints a grim picture of the rising health insurance premiums under the Affordable Care Act. But health policy experts explained that while premiums may have gone up since the ACA was implemented, consumers are also getting more bang for their buck. The report, which is the first ACA report out of HHS' Office of the Assistant Secretary for Planning and Evaluation published under the direction of the Trump administration, concluded that individual health insurance premiums grew 105% on average between 2013—before the ACA exchange went into effect—and 2017. (Livingston, 5/24)

The House Ways and Means Committee on Wednesday evening advanced three health care bills that make up a small part of the Republicans' larger Obamacare replacement strategy. The bills, all approved largely on party lines, are part of the GOP's "third bucket" of its health reform plan, which is expected to include other measures. They were written to work in conjunction with the GOP's repeal bill, which is being fast-tracked through the budget reconciliation process. (Ehley, 5/24)

As Congress grapples with possible repeal of the Affordable Care Act, political uncertainty is prompting some health-technology startups to revamp their sales pitches or products, while others are finding it tougher to attract fresh capital. The challenges are likely to be greatest for very young firms with limited resources, companies tied directly to the insurance market or that sell to hospitals facing potential cuts in Medicaid, say some investors and others that work with startups. (Simon, 5/24)

Medicaid is clearly in line for cuts under President Donald Trump's budget despite assurances to the contrary from his budget chief. Mick Mulvaney, director of the Office of Management and Budget, while introducing the budget Tuesday: "There are no Medicaid cuts in the terms of what ordinary human beings would refer to as a cut. We are not spending less money one year than we spent before." (5/25)

Mulvaney gave an unapologetic defense of Trump proposals to slash programs related to the environment, education, health care for the poor and foreign aid. The former tea party congressman told the Budget Committee that he went line by line through the federal budget and asked, “Can we justify this to the folks who are actually paying for it?” Democrats charged that Trump’s cuts would rip apart the social safety net. Rep. Pramila Jayapal, D-Wash., told Mulvaney that the proposed cuts to food stamps, payments to the disabled, and other programs are “astonishing and frankly immoral.” (Taylor, 5/24)

President Trump has long promised not to cut Medicaid, Medicare and Social Security. But in his budget released on Tuesday, he proposes making massive cuts to Medicaid. Mr. Trump is proposing to cut $610 billion from Medicaid benefits. This could come on top of more than $800 billion in cuts to Medicaid sought in the health care overhaul bill passed by the House on May 4. (Park, 5/24)

President Trump’s proposal to slash more than $600 billion over 10 years from Medicaid would cut deep into the government health program for low-income people that insures nearly one-third of Rhode Island residents. Hospital officials and health care analysts said Tuesday it’s too soon to quantify the impact of the proposed cuts on Rhode Island. But the direction of the latest plan, they say, is painfully clear. ... The prospect of more uninsured patients worries hospital officials. Lifespan, the state’s largest health system, reports that its charity or so-called uncompensated care has fallen by more than half during the last five years. “Clearly, the sheer size of the proposed Medicaid cuts ... would be detrimental to health care here and throughout the nation and in addition a hardship for hospitals and other health care providers,″ David Levesque, a spokesman for Lifespan, said in an e-mail. (Arditi, 5/23)

When President Trump's budget director, Mick Mulvaney, unveiled the administration's budget blueprint earlier this week, which calls for significant cuts to food stamps, he noted that the aim of the budget was to get people working... But the reality is, many people (44 percent) who rely on SNAP — the Supplemental Nutrition Assistance Program, as food stamps is now known — have at least one person in the family working, according to the latest figures from the U.S. Department of Agriculture. (Godoy and Aubrey, 5/24)

Advocates for the poor — in Boston and beyond — are lambasting the federal budget proposed by President Trump. The $4.1 trillion spending plan released Tuesday seeks to eliminate the deficit in a decade but proposes cutting programs ranging from Medicaid to food stamps to disability payments. (Brown, 5/24)

For decades, therapists, patient advocates and countless families have worked to elevate mental health care in the political conversation. Their cause recently received a big boost when a new law created a federal mental health “czar” to help overhaul the system and bridge more than 100 federal agencies concerned with mental health. But the White House’s choice for the first person to fill that position has already been divisive, exposing longstanding rifts within the field that may be difficult to mend. (Carey and Fink, 5/24)

Veterans Affairs Secretary David Shulkin touted new efforts Wednesday to expand urgent mental health care to thousands of former service members with less-than-honorable discharges, even while acknowledging his department isn’t seeking additional money to pay for it. Testifying at a House hearing, Shulkin offered new details on his initiative announced in March to stem stubbornly high rates of suicide. Stressing a need at that time for “bold action,” he noted the additional coverage would help former service members who are more likely to have mental health distress. Of the 20 veterans who take their lives each day, about 14 had not been connected to VA care. (Yen, 5/24)

A Washington consultant, three hedge fund workers and a government employee were blamed Wednesday by federal prosecutors for an insider trading scheme that converted government secrets into hedge fund profits. ... Acting U.S. Attorney Joon H. Kim said the defendants used "highly sensitive and confidential information" from the Centers for Medicare & Medicaid Services, part of the U.S. Department of Health and Human Services, to enable three hedge fund workers to make over $3.5 million illegally for their company from 2012 through 2014. The Securities and Exchange Commission said the profits reached $3.9 million. (Neumeister, 5/24)

The tips concerned information about government-funding levels for cancer treatments and kidney dialysis from 2012 to 2014, according to prosecutors. Christopher Worrall, a senior technical adviser to the Centers for Medicare and Medicaid Services, allegedly passed information about the funding to a consultant in the political-intelligence business, David Blaszczak, who in turn told the traders. (Mullins and Pulliam, 5/24)

Prosecutors said that from 2012 to 2014, [hedge fund employees Rob] Olan, [Ted] Huber and [Jordan] Fogel schemed to get confidential information about CMS's internal decision-making from Blaszczak, who previously worked there. Blaszczak in turn got the information from his former colleague and "close friend" Worrall, prosecutors said. (Pierson, 5/24)

The man's losing battle with heroin was laid out right there on the nightstand of the halfway house. There were three morning devotionals, including “God Calling,” geared toward keeping a person's thoughts pointed heavenward. Then there was the nicotine: two packs of cigarettes, a vaporizer and a case of snus to quell cravings. And near the edge: empty packets of heroin, a spoon and a syringe half full of the last hit the man would ever inject. (Wootson, 5/24)

A new report from the Tennessee Department of Health on drug overdose deaths sheds new light on the opioid epidemic plaguing the state, darkening the lines of an emerging portrait of the typical abuser killed by the powerful painkillers. The drug overdose fatalities are overwhelmingly white, mostly male and increasingly less likely to have prescriptions for the drugs that kill them. And, across Tennessee, those killed are more likely to overdose on opioids — including heroin and fentanyl — than on any other kind of drug. (Fletcher, Nelson and Wadhwani, 5/24)

A few decades ago, doctor-assisted suicide was considered a fringe idea despite surveys showing many physicians support the idea under certain circumstances. The face of euthanasia at that time was Jack Kevorkian, a Michigan pathologist nicknamed “Dr. Death.” By his own admission, he helped 130 people end their lives. He was convicted of homicide and served eight years in prison. While doctor-assisted suicide remains a polarizing issue, some countries and states have begun to accept it. Belgium, the Netherlands, Luxembourg and Switzerland have legalized voluntary euthanasia. In 2016, Canada legalized “medically assisted death.” Australia, France, South Africa and the United Kingdom are considering similar measures. (Cha, 5/24)

At least nine states now ban “conversion therapy” for minors, a discredited method meant to change a person’s sexual orientation or gender identity, after Nevada and Connecticut this month joined others in prohibiting the practice. Gov. Brian Sandoval of Nevada last week signed Senate Bill 201, making it illegal for any licensed medical or mental health care professional to provide sexual orientation or gender conversion therapy to anyone under 18 years of age, a statement from his office said. (Hauser, 5/24)

Last year's Zika outbreak in Miami likely started in the spring of 2016, with the virus introduced multiple times before it was detected, researchers say. And most of those cases originated in the Caribbean. The study, published Wednesday in Nature, examined more than 250 cases of local Zika transmission in three Miami neighborhoods. Researchers analyzed 39 Zika virus genomes isolated from 32 people who had been infected and seven Aedes aegypti mosquitoes, the species that carries Zika. (Allen, 5/24)

In most places tuberculosis is a disease from the past. But in the small county of Perry, Alabama it’s a near outbreak... It was so bad, the county finally paid residents to get tested. It all comes down to racial divides. (Yellin, 5/24)

Sleek, high-tech wristbands are extremely popular these days, promising to measure heart rate, steps taken during the day, sleep, calories burned and even stress. And, increasingly, patients are heading to the doctor armed with reams of data gathered from their devices. "They're essentially asking us to digest the data and offer advice about how to avoid cardiovascular disease," says cardiologist Euan Ashley, associate professor of medicine at the Stanford University Medical Center and Stanford Hospital and Clinics in northern California. (Neighmond, 5/24)

Researchers have found yet another benefit of a high-fiber diet: It is associated with a reduced risk for arthritis of the knee. Knee osteoarthritis, which is common in aging populations, can be both painful and debilitating. (Bakalar, 5/24)

With a three-day weekend upon us, several Texans will be stocking up on beer and wine for weekend cook-outs. That also means more drunk drivers on the road. One new study suggests that young drivers could be more dangerous on roadways today than ever before, since they're engaging in "high-intensity" drinking, which is defined as consuming 10 or more drinks in a row...The May 2017 report indicates that "one in nine young adults (11 percent) were classified as high-intensity drinkers from 2005 to 2015" with "similar prevalence" among high school-aged students. (Guillen, 5/24)

An oil derived from the marijuana plant sharply reduces violent seizures in young people suffering from a rare, severe form of epilepsy, according to a study published Wednesday that gives more hope to parents who have been clamoring for access to the medication. Cannabidiol cut the median number of monthly convulsive seizures from 12.4 to 5.9 in 52 children with Dravet syndrome who took the medication over a 14-week test period, according to research published in the New England Journal of Medicine. Fifty-six children using a placebo saw the number of seizures drop only from a median of 14.9 to 14.1 per month. (Bernstein, 5/24)

“This is the first solid, rigorously obtained scientific data” that a marijuana compound is safe and effective for this problem, said one study leader, Dr. Orrin Devinsky of NYU Langone Medical Center. He said research into promising medical uses has been hampered by requiring scientists to get special licenses, plus legal constraints and false notions of how risky marijuana is. “Opiates kill over 30,000 Americans a year, alcohol kills over 80,000 a year. And marijuana, as best we know, probably kills less than 50 people a year,” Devinsky said. (Marchione, 5/24)

Vermont Governor Phil Scott, a Republican, said on Wednesday he was vetoing a bill to legalize marijuana, and sending it back to the legislature for changes... Though he said he views the issue "through a libertarian lens," Scott vetoed the bill due to concerns about detecting and penalizing impaired drivers, protecting children, and the role and makeup of a Marijuana Regulatory Commission. (Wamsley, 5/24)

Teresa Miller, nominated Tuesday by Gov. Wolf to be the inaugural secretary of the proposed Pennsylvania Department of Health and Human Services, said she is a big believer in her boss’s “government that works” mantra.“...Advocates worry that initiatives, such as heightened oversight of nursing homes by the Department of Health, could fizzle because of the proposed consolidation of the departments of health, human services, aging, and drug and alcohol programs. (Brubaker, 4/24)

Today, Oceanview has taken on a distinctive role in the latest act of the legal saga surrounding the adult homes. Lawyers for the adult home industry have sued the state on behalf of a single former resident at Oceanview, a man who had taken advantage of the judge’s plan and moved into alternative housing, but who the lawyers say now wants to return. The man missed his friends and the conveniences of the Coney Island neighborhood, the lawyers argue. (Sapien, 5/24)

An Annandale nursing home resident developed internal bleeding and died after being denied crucial blood-thinning medication for 15 days, according to a state investigation that blamed the death on the facility’s procedural shortcomings. The state Health Department’s investigation into the stroke patient’s Nov. 28 death concluded that the nonprofit Annandale Care Center “had no system, policies or procedures in place” to ensure that certain medications and some other services were being provided as prescribed. (Walsh, 5/24)

A prominent Boston neurosurgeon was illegally forced out of his previous job at a New York hospital for strongly objecting to a policy that allowed another surgeon to perform complex spine surgeries on two patients simultaneously, a judge ruled. Double-booking, as the practice is sometimes called, triggered a fierce dispute among doctors at Massachusetts General Hospital in recent years, leading to the 2015 dismissal of an orthopedic surgeon who opposed it. But Dr. James Holsapple may be the first doctor to win a lawsuit alleging he faced retaliation for challenging the practice. (Saltzman, 5/24)

At least 26 patients in advanced heart failure have died after replacing the controller for an Abbott Laboratories blood pump while out of the hospital. Abbott has issued an alert for 28,882 HeartMate II controllers that includes new software and alarm guides, after reports of 70 incidents in which the life-preserving device malfunctioned after a patient changed out the controller at home. Those incidents included 26 deaths and 19 injuries. (Carlson, 5/24)

The Texas Senate unanimously passed a priority House bill Wednesday that would make several changes to the foster care system, including keeping children at risk of entering foster care with their parents. House Bill 7, filed by Rep. Gene Wu, D-Houston, would, among several other provisions, bar a court from taking children away from parents on the grounds that they home-schooled their children, were economically disadvantaged, had reasonably disciplined their children or had been charged with a nonviolent misdemeanor. (Chang, 5/24)

The country’s foremost researchers on botulism in dairy products are calling the recent outbreak at a gas station in Walnut Grove a “perfect storm” of circumstances that left one dead and nine sickened... Although extremely rare, Northern California has seen two deaths from foodborne botulism in the last few months. Within the last month, Napa County has had one death from botulism related to canned goods, according to county health officials. (Davis, 5/24)

According to the SF-Marin Food Bank, 23 percent of San Francisco residents struggle with hunger. The number is a striking amount, and much higher than the city’s homeless population, which the city said was 6,886 in 2015 (though others estimate it to be much higher), making it less than 1 percent of the population. (Duggan, 5/24)

In the name of Jamycheal Mitchell on Wednesday, the state’s highest elected official signed a bill in Richmond strengthening oversight of Virginia’s 60 local and regional jails, and a prosecutor in Portsmouth requested a special grand jury convene to investigate how the mentally ill 24-year-old wasted away behind bars... Still, no information has been provided publicly that explains what led to Mitchell’s death. His family has said he was physically healthy but had been diagnosed with schizophrenia and bipolar disorder. (Kleiner, 5/24)

Childhood traumatic experiences have strong links to dozens of adult health conditions, such as HIV, heart disease and cancer. In states that track such data, childhood trauma is considered a cause in between 11 and 89 percent of those health conditions. On average, whenever a toxin impacts more than 10 percent of health conditions, awareness grows and lawmakers, advocates and public health officials become interested in how to stop it to save lives, said Allison Sampson-Jackson. (O'Connor, 5/24)

A fact sheet presented by the anti-marijuana group Arizonans for Responsible Drug Policy, which helped defeat Prop. 205 last November, mentions projected social costs outweigh the revenue provided by legalization... Merilee Fowler, vice chair of ARDP, said via email that “there are many unintended consequences of legalization that produce costs for the state.” (Jarvis, 5/24)

Obamacare is not “collapsing under its own weight,” as Republicans are so fond of saying. It was sabotaged from the day it was enacted. And now the Republican Party should be held accountable not only for any potential replacement of the law, but also for having tried to starve it to death. The Congressional Budget Office on Wednesday released its accounting of the House Republicans’ replacement bill for the Affordable Care Act, and the numbers are not pretty: It is projected to leave 23 million more Americans uninsured over 10 years, through deep cuts to insurance subsidies and Medicaid. The report underscores how the bill would cut taxes for the rich to take health care away from the less well-off. (Abbe R. Gluck, 5/25)

The political world waited with rapt attention Wednesday for the oracles at the Congressional Budget Office to release their cost-and-coverage predictions for the revised House health reform bill, which arrived late in the afternoon. But while Washington stood by, two reports emerged from the real world that are far more consequential. (5/24)

The Department of Health and Human Services seemed mightily pleased with a statistic it issued Tuesday. The agency’s figures showed that premiums on the Affordable Care Act exchanges “doubled” from 2013 through this year. This might not sound like good news for the people buying their coverage on those exchanges, but to HHS it was vindication. “This report is a sobering reminder of why reforming our healthcare system remains a top priority of the Trump administration,” agency spokesperson Alleigh Marré said. (Michael Hiltzik, 5/24)

Weren’t we focused on health care reform just a few weeks ago? Yes we were. And as it turns out, while we’re all looking at other things, lawmakers in Washington are still working on a rewrite of the Affordable Care Act. There were two important developments over the last two weeks we should think about. (Dave Helling, 5/24)

America has broken several centuries worth of promises to its indigenous people. And we’re poised to do it again. ... The Affordable Care Act provided a way to improve the health of thousands of Native Americans through Medicaid expansion. It provided a much-needed injection of funding to the long-neglected Indian Health Service and tribal health facilities by raising the income level needed for eligibility. With the poverty rate at 28 percent among Native Americans, this group disproportionately benefited from Medicaid expansion. (Kevin Duan and Aaron Price, 5/25)

Wisconsin has been a leader in covering its residents with high-quality health care and providing community supports so people with disabilities and frail elders can stay in their homes and communities and out of costly facilities. The American Health Care Act poses a particularly dangerous threat to our state’s residents, in part because we have done so much right. (Barbara Beckert, 5/24)

The United States spends more per person on health care than any other country, but our health outcomes are far from the best. Simply put, the challenge facing Congress is how to get more value for all that money. Yes, the details are complex, but we’re a big, complex country with a big, complex economy. Our elected leaders should engage that complexity and produce practical reforms and solutions that inspire confidence in the future. That is a reasonable expectation. (5/24)

Phony math is a time-honored tradition in the Washington world of budget making, but the first full fiscal plan from the Trump administration breaks new ground. The bottom line: A budget that the White House says will be in balance by 2027 would, in reality, remain deeply in red ink throughout the coming decade and ultimately add trillions of dollars to the national debt. ... This budget’s blatant disregard for intellectual integrity is matched by the extraordinary extent to which it seeks to slash social welfare programs, including another $616 billion out of Medicaid on top of $800 billion that would be sliced as part of the Republicans’ health care plan. That’s a 28 percent reduction to the existing Medicaid budget plan. (Steven Rattner, 5/24)

The plan has been assailed by Democrats and various activist groups for coddling the rich, punishing the poor and shortchanging important functions. Trump proposes to cut outlays for Medicaid, food stamps, Head Start and Social Security disability. Ditto for Environmental Protection Agency enforcement and State Department security. He would close the National Endowment for the Arts, the National Endowment for the Humanities and the Corporation for Public Broadcasting. (Steve Chapman, 5/24)

The best that can be said about President Trump’s 2018 budget and older adults: It could have been worse. In a fiscal plan focused on historic domestic spending cuts, programs for older adults were hit by substantial reductions, though not slashed as deeply as other domestic programs. Medicare was largely untouched. So was Social Security for seniors, although Trump would tighten eligibility and reduce some benefits in the Social Security disability program. (Howard Gleckman, 5/23)

The best way to think about the fiscal 2018 budget released by the White House is as a Trump political campaign rally on paper. The budget was clearly developed to make a statement to President Trump’s base of voters in the hope that they will see it as him keeping his campaign promises. According to Office of Management and Budget Director Mick Mulvaney, the budget will be in surplus in 10 years, construction will start on the wall between the U.S. and Mexico, there will be more money for enforcing immigration laws, and there will be much more for the Pentagon. Meanwhile, wasteful government spending will be cut and taxes will be reduced. (Stan Collender, 5/24)

“A preferential option for the poor” is a fundamental concept in Catholic social teaching. Though the phrase itself is only 50 years old, it derives from Jesus’ Gospel message to pay special attention to poverty. ... The concept is shared by many religions and has become part of the ethos of the United States. Whether through Social Security, Medicaid, food stamps or foreign aid, our nation has recognized that our worth is judged by how we treat the most vulnerable among us. ... The U.S. Congress is now considering a budget proposal by the current administration. So many helped in this country and abroad would be devastated by this budget. (Archbishop Joseph E. Kurtz, 5/24)

Republicans sold the American Health Care Act (AHCA), the Obamacare repeal-and-replace plan that the House passed last month, with a number of untruths, chief among them that Obamacare is collapsing and the GOP effort is nothing short of a rescue plan. The Congressional Budget Office, Congress’s official scorekeeper, found Wednesday that the Republicans’ bill is no such thing. Not only would it result in 23 million more people lacking health insurance in a decade, but it would destabilize some states’ individual health-care insurance markets for all but relatively healthy people. (5/24)

The Congressional Budget Office’s analysis of the House health care bill is a devastating indictment.The new report shows that millions of Americans would lose health insurance and the quality of insurance for millions more would deteriorate. The savings from that carnage — to borrow a favorite word of President Trump’s — would pay for tax cuts for the wealthy. (David Leonhardt, 5/24)

In promising to repeal and replace the Affordable Care Act, many Republicans cited headlines from last year such as “Obamacare Premiums to Soar 22 Percent” and “As Obamacare Choices Dwindle, Feds Face Consumer, Political Backlash.” Yet based on a new analysis by the nonpartisan Congressional Budget Office, headlines would be even worse under the health care bill to repeal Obamacare, which was passed by the House this month. (Jeanne Lambrew, 5/24)

The Congressional Budget Office has spoken: The Obamacare repeal bill passed by the House GOP earlier this month could destroy the individual insurance markets in states where one-sixth of the population resides. It would cost 23 million people their insurance coverage within 10 years. And in many states it would be terrible for any but the most healthy Americans. That’s the CBO’s score of the latest version of the House bill, which only passed after it was amended to allow individual states to eviscerate consumer protections written into the Affordable Care Act. The CBO’s bottom line is that the bill is still a train wreck that will cost millions of Americans their coverage and sharply raise costs for millions more. (Michael Hiltzik, 5/24)

The Senate now has a clearer sense of who would win and lose under the health bill the House sent them. It also got a startlingly direct message from government analysts about how destabilizing one of the House ideas could be. The Congressional Budget Office published its assessment of the House health bill on Wednesday, and warned that a last-minute amendment made to win conservative votes would result in deeply dysfunctional markets for about a sixth of the population. In those places, insurance would fail to cover important medical services, and people with pre-existing illnesses could be shut out of coverage, the budget office said. (Margot Sanger-Katz, 5/24)

When the Congressional Budget Office finally released its scoring of the American Health Care Act, it seemed anti-climactic, if not irrelevant. The Senate is not bothering to take up the AHCA at all. The CBO score, to the delight of Democrats, does remind us how counterproductive is the GOP House bill, which every member will have to defend in 2018. (Jennifer Rubin, 5/24)

[T]he reasons why health insurance would be less expensive for some aren’t much to cheer about, the budget report makes clear. Prices would come down for healthy people because those who are sick or have illness in their medical histories would have less access to coverage ― and the policies available on the market would tend to be a lot less comprehensive. In other words, the price for lower premiums would be some combination of higher out-of-pocket costs, fewer covered services, and coverage that would be harder to get for the people who need it most. (Jonathan Cohn and Jeffrey Young, 5/24)

The much-anticipated Congressional Budget Office (CBO) score of the American Health Care Act (AHCA), the GOP’s effort to dismantle the Affordable Care Act (ACA) released yesterday, indicates that the bill would cause 23 million people to become uninsured while reducing the federal deficit by $119 billion. In that sense, there is little change from their assessment of the original version of AHCA. (Billy Wynne, 5/25)

Now we know why House Republicans were so quick to ram through an Obamacare repeal-and-replace bill last month, not waiting for an estimate of its impact or holding any public hearings. On Wednesday the non-partisan Congressional Budget Office got around to “scoring” the bill, and the results are not pretty. By next year, 14 million fewer people would have health insurance. Within a decade, 23 million fewer people would be covered. (5/24)

Every so often a “national moment” takes us out of our day-to-day and helps shape our national thinking. The Exxon Valdez oil spill helped forge our national opinion about environmental responsibility. Terry Schiavo’s life-support case made the public contemplate a dignified death. Someday, when we look back on the current health care debate, we may see how a national moment helped us articulate a new consensus when late night TV host Jimmy Kimmel told the poignant story of the birth of his son Billy. (Andy Slavitt, 5/24)

he latest report from the Congressional Budget Office once again exposes the sharp and bitter truth about the House Republican efforts to “repeal and replace” President Obama’s Affordable Care Act. The American Health Care Act — now in the hands of the Senate — represents a glaring transfer of wealth, security and opportunity from low-income to high-income individuals. Should the AHCA or anything close to it become law, the students we serve in the California State University system and California Community Colleges system will be among the hardest hit. (Zelman Epstein, 5/24)

Anyone who knows anything about healthcare didn't need a Congressional Budget Office scorecard to understand the disastrous consequences of the American Health Care Act. That legislation, now before the Senate, passed the House in early May in a straight party-line vote without hearings or a CBO score. Now we know the score. 23 million would lose their health insurance over the next decade, including 14 million by the end of next year. (Merrill Goozner, 5/24)

U.S. Attorney General Jeff Sessions has announced he’s reigniting the “war on drugs,” ordering prosecutors to seek the toughest possible charges and sentences, even for minor drug crimes. What he’s really doing is declaring war on people of color, because his harsh policies will eviscerate struggling black and brown families across America. He is resurrecting a war that has destroyed generations of minority families without eradicating the commerce of illegal drugs or Americans’ appetite for them. (Benjamin Crump, 5/25)

Since 2010, 78 of the more than 2150 rural nonspecialty US hospitals have closed. While the closure rate has recently declined, the proportion of financially struggling rural hospitals has increased. When a rural hospital closes, the economic losses can devastate an already stressed community through loss of health care workers, emergency services, and primary care capacity, as well as higher unemployment and lower per-capita income, a drop in housing values, poorer health, and increasing health disparities. An urgent look at how to prevent these closures is merited, but it may also be time to rethink what a rural hospital should be. (Diana Mason, 5/24)

Hey, Kansans: Brace yourselves. Your state is about to change in a consequential way. Barring the unexpected, concealed weapons soon will be allowed in state hospitals, psychiatric institutions and on the state’s public university campuses. That’s happening in just 38 days unless pro-common-sense lawmakers pull a rabbit out of their hats and muscle through a new law. But that looks increasingly unlikely as the Legislature struggles with big issues in its ongoing wrap-up session. (5/24)

There is broad consensus that the quality of care that is delivered in the United States is uneven and too often inadequate. For more than a decade, the approach to remedying deficiencies in health care quality has been through measurement, incentives, and accountability. But now consensus is emerging that efforts have not worked particularly well, and that doing more of the same is unlikely to lead to progress. It may be time to try a radically simple idea: let patients decide what comprises high-quality health care. (Ashish K. Jha, 5/22)

In a nation as divided and contentious as our own, it is rare to find a belief we all share. But trust in the transformative power of marriage is close to universal — and it has endured for decades. This isn’t just a matter of faith, we’ve been assured. It’s science. Research is said to have established what our fairy tales promised: Marry and you will live happily ever after. And you will be healthier, too. A new study challenges the claim that people who marry get healthier. (Bella DePaulo, 5/25)

Four years ago, after nearly 20 years in practice, I walked out of the familiar world of infectious disease and into the world of palliative care. In the world I left, I cared for hundreds of patients, educated countless learners, led dozens of infection prevention efforts. But that world felt increasingly superficial, fragmented, isolated, a hard place to find joy and meaning in my work. (Kathryn B. Kirkland, 5/23,30)

A hospital policy with wide-ranging consequences for patients of Mercy Medical Center in Des Moines, Iowa, was made public recently through a Facebook post on a page for mothers. It came from a woman who was denied a tubal ligation after having a cesarean section because Mercy is a Catholic hospital. In verifying that prohibition, I discovered other religious-based restrictions at Mercy and 547 other Catholic hospitals across the U.S., which make up 14.5 percent of all acute care hospitals in the country. It raises a question of whether these institutions are fulfilling their legal and professional obligations to their patients and the taxpayers who subsidize them with billions of dollars. (Rekha Basu, 5/25)

The Missouri Legislature has for many years demonstrated a commitment to protecting the health and safety of women and the dignity of the unborn, passing various laws to further these ends. A number of recent developments, though, have dealt serious blows to these laws and merit immediate attention in a special session of the Legislature. On Monday, the maternity home Our Lady’s Inn, Archdiocesan Elementary Schools of the Archdioceses of St. Louis, and St. Louis businessman Frank O’Brien filed a federal lawsuit against the “abortion sanctuary city” ordinance passed by the city of St. Louis in February. As the plaintiffs note, the bill, which purports to be an anti-discrimination ordinance for those making “reproductive health decisions,” is so broad that it would “force nonprofit organizations like Our Lady’s Inn, whose mission is to promote and facilitate abortion alternatives, to hire abortion advocates, despite their opposition to the ministry’s reason for existence.” (State Sen. Bob Onder, 5/25)