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House Republicans will take another crack at repealing Obamacare on Thursday in a high-stakes vote on legislation that would dramatically revamp the health care system and will serve as a major test for the GOP Congress and the Trump administration. The Republican bill, hotly contested and highly controversial, was the subject of 11th-hour negotiations and last-minute sweeteners, as GOP leaders scrambled for enough votes to push it through the House and send it to the Senate. (Shesgreen, 5/4)

House Republicans will huddle Thursday morning for what amounts to a last-minute pep rally to buck up colleagues as they prepare to take a vote to remake health insurance for millions of Americans. ... Though Republican leaders insisted Wednesday they've secured the 216 votes needed to pass their bill, the roll call will still be nerve-wracking. At least 16 Republicans are still on record rejecting the proposal and about a dozen more are undecided. (Cheney and Bresnahan, 5/4)

House Republican leaders planned to hold a showdown vote Thursday on their bill to repeal and replace large portions of the Affordable Care Act after adding $8 billion to the measure to help cover insurance costs for people with pre-existing conditions. “We have enough votes,” Representative Kevin McCarthy of California, the House majority leader, said Wednesday night. “It’ll pass.” (Kaplan and Pear, 5/3)

Rep. Fred Upton, an influential Republican from Michigan, introduced the amendment that was key to resolving a major sticking point this week. It provides more financial assistance — $8 billion over five years — to help people with preexisting conditions pay for medical costs. Those people are at risk of losing protections under the GOP plan, which seeks to repeal and replace major parts of the ACA. Just a day earlier, Upton said he could not support the Republican plan because of its stance on preexisting conditions. But he sounded an optimistic note after sketching out his fix Wednesday and meeting with President Trump at the White House. (Sullivan, Weigel and Snell, 5/3)

House Freedom Caucus Chairman Mark Meadows said Thursday that legislation to repeal and replace Obamacare currently making its way through Congress would not leave in its wake any “losers” who would be worse off than under the current law. Pushed on the issue during an interview on MSNBC’s “Morning Joe,” Meadows (R-N.C.) conceded that perhaps not every single American would benefit from repeal-and-replace, but insisted that the “vast majority” of those in his district would be better off. (Nelson, 5/4)

Thursday’s vote could redeem House Speaker Paul Ryan (R., Wis.) and deliver President Donald Trump his first major legislative win, coming just after the 100-day mark of his tenure passed with little accomplished on Capitol Hill. But it also will cast a long political shadow for House Republicans in the months leading up to next year’s midterm elections. Already, many GOP lawmakers face constituents back home incensed over the prospect of changes to health-care benefits that affect millions. (Peterson, Hackman and Radnofsky, 5/3)

Passage would also send it to an uncertain fate in the Senate, where some Republicans consider the House measure too harsh. Polls have shown Obama's much-maligned law has actually gained in popularity as the debate over a replacement health care program has accelerated. "House Republicans are going to tattoo this moral monstrosity to their foreheads, and the American people will hold them accountable," said House Minority Leader Nancy Pelosi, D-Calif. (Fram and Werner, 5/4)

Even if the bill manages to pass the House, it faces a very tough road in the Senate. At least eight Senate Republicans are strongly opposed to different elements of the measure, which also faces potential procedural hurdles. Representative Alcee Hastings, a Democrat from Florida, warned Republicans during a House Rules Committee meeting to expect changes to the bill if it is taken up in the Senate. “I think they take health security a little more seriously and it’s a more moderate body than we are, and so you can reasonably expect that when you pass this tomorrow on the slimmest of margins, you shall not see it again, and you will not see it in the form that it’s in,” Hastings said Wednesday night. (House and Edgerton 5/4)

The amendment released Wednesday night listed as co-sponsors four lawmakers who were either undecided or had previously planned to vote no on the bill. It's unclear if their co-sponsorship means California Reps. David Valadao, Jeff Denham and Steve Knight, and Iowa Rep. David Young are now willing to vote 'yes.' (Sullivan and Hellmann, 5/3)

[McCarthy] estimated the vote on the bill (HR 1628) will take place around 12:30 p.m. or 1 p.m. on Thursday. (Mershon and McPherson, 5/3)

House Republicans are once again fast-tracking consideration of their ObamaCare replacement bill without knowing the full impact of the legislation they’ll vote on Thursday. The nonpartisan Congressional Budget Office (CBO) is not expected to have completed its analysis detailing the effects of the latest changes to the legislation overhauling the nation’s healthcare system in time for the Thursday vote. (Sullivan and Marcos, 5/3)

As Republicans rush to vote on their latest ObamaCare repeal-and-replace plan, it appears to still include a waiver exempting members of Congress and their staffs from losing the healthcare bill's popular provisions. House GOP leaders worked Wednesday night to fast-track consideration of their ObamaCare replacement bill without posting the bill text and without a Congressional Budget Office analysis detailing the effects of the latest changes to the legislation. (Beavers, 5/3)

The House Rules Committee cleared a path Wednesday night for Republicans to bring their health care bill back to the floor, giving the GOP a second shot at passing the Trump administration's overhaul after a major setback in March. The committee approved a rule (H Res 308) for the bill (HR 1628) in an 8-3 vote, split along party lines. The rule would incorporate three amendments into the base GOP health bill and also provide for a closed rule for consideration of a related measure (HR 2192). (Young, 5/3)

In a scramble to garner enough votes for passage, House Republicans have added more revisions to their bill to repeal the Affordable Care Act (also known as Obamacare), more than a month after pulling their initial bill from the floor. Here’s a look at how the Republican bill compares with the Affordable Care Act. (Park, Sanger-Katz and Lee, 5/3)

House Republicans planned a vote Thursday on a revised bill rolling back much of former President Barack Obama's health care law. ... Here are key elements of the bill. (5/4)

Republican senators say they don’t see a way to get healthcare reform over the finish line, even if the House passes a bill this week. A senior GOP senator said the chances of getting 51 votes for legislation based on the House healthcare bill are less than 1 in 5. The senator also put the chances that the House bill will meet Senate budgetary rules preventing a filibuster at less than 1 in 5, meaning portions of the legislation would have to be removed. (Bolton, 5/4)

To understand who opposes the bill and why, it helps to put lawmakers in the context of how the people in their districts tend to vote and what it means for lawmakers' prospects in the 2018 elections. (Canipe and Yeip, 5/2)

After weeks of fits and starts, House Republican leaders plan on Thursday to try yet again to advance legislation to repeal and replace major parts of the Affordable Care Act. A sizable number of House Republicans have been either opposed to the bill or undecided in recent days. But Republican leaders now say they have the votes to pass the legislation, called the American Health Care Act. (Kaplan, 5/4)

Donald Trump really, really wants a victory on healthcare. Speaker Paul Ryan (R-Wis.) might need one. The president and Speaker, still desperate for their first major legislative win in this new Republican era, are pulling out all the stops to corral 216 votes and pass a long-stalled healthcare bill through the House. GOP leaders voiced confidence Wednesday night that the vote would happen on Thursday and that their legislation would be approved. (Wong and Bolton, 5/3)

President Trump and House GOP leaders leaned hard Wednesday on undecided Republicans, including vulnerable Californians in swing districts, in a last-ditch effort to pass their proposed repeal of the Affordable Care Act this week. By late in the day, Republican leaders expressed confidence they had the support they needed to repeal former President Barack Obama’s signature legislative victory, and said the House would vote Thursday. (Lochhead, 5/3)

Nearly six weeks after Republican leaders in the House canceled a vote on a controversial replacement for the Affordable Care Act because they lacked the votes, they are set to try again on Thursday. And California’s 14 Republican members of Congress will be critical in deciding its fate. (Seipel, 5/3)

Republican efforts to overhaul the nation’s healthcare system gained traction Wednesday with GOP members of Colorado’s congressional delegation. Headed into the morning, only one of the state’s seven House members, Ken Buck, R-Windsor, had voiced support for the latest proposal. All three Democrats, Diana DeGette, Ed Perlmutter and Jared Polis, were opposed, and Colorado’s three remaining House Republicans, Mike Coffman, Doug Lamborn and Scott Tipton, were on the fence. (Matthews, 5/3)

Three Republican congressmen who represent Chicago suburbs have so far declined to preview how they would vote on the latest measure to repeal key parts of the Affordable Care Act amid signs the House plans to make another run at the proposal Thursday. All three — Reps. Peter Roskam of Wheaton, Randy Hultgren of Plano and Adam Kinzinger of Channahon — have been sharp critics of former President Barack Obama's health reforms. They've also been the target of angry protests and pressure tactics from supporters of the law commonly known as Obamacare. (Skiba, 5/3)

Is $8 billion enough to get the House health bill passed? And is it enough to ensure that people with pre-existing medical conditions will still be able to get insurance if Congress repeals the Affordable Care Act? The answer to the first question is maybe. On the second, it’s very likely to be no. (Abelson and Sanger-Katz, 5/3)

Even before the precise language was released Wednesday night, leading health policy experts said the amendment raises big questions about how — and how well — it would work in practice. Among the most significant: How many states would back away from the federal protections for people with medical conditions? And how many of those people would lose their coverage because of other changes in the House plan? “Does it really guarantee that all individuals who have preexisting conditions will be able to find insurance at affordable rates?” said Dan Mendelson, president of Avalere Health, a Washington-based consulting firm. (Goldstein, 5/3)

Before the Affordable Care Act, insurance companies could consider a person’s health status when determining premiums, sometimes making coverage unaffordable or even unavailable if a person was already sick with a problem that required expensive treatment. The ACA prohibited that, in part by requiring everyone to purchase insurance. But that “individual mandate” was unpopular and Republicans would eliminate that requirement in their proposed American Health Care Act. (Kessler, 5/4)

The sickest 10% of Americans account for about two-thirds of health-care spending, according to the Kaiser Family Foundation. The ACA requires almost everyone to have insurance or pay a fine so healthy customers would subsidize sick ones. High-risk pools take a different approach, separating the sickest people into their own pool so premiums for healthy customers would fall. (Hackman, 5/3)

Some insurers are skeptical as well. "It's unclear what difference the amendment makes, besides leaving the funding for high-risk pools and pre-existing conditions marginally less underfunded," said Meg Murray, CEO of the Association for Community-Affiliated Plans. The additional funding "is a blip compared with the damage the bill does to the healthcare system." (Meyer, 5/3)

In the debate over how the effort to replace the Affordable Care Act would affect those with pre-existing health conditions, opponents and supporters alike have offered misleading talking points. Faced with polling indicating public support for protections, and after an emotional appeal by the television host Jimmy Kimmel that has gone viral, Republicans are making a dubious case that their updated bill provides similar coverage for those who are less healthy, while Democrats are overstating claims about how many are affected. Here’s an assessment. (Qiu, 5/3)

“Short answer, this does not make any meaningful difference,” said Chris Sloan, a senior manager at consultant Avalere Health, who did an analysis of the legislation’s stability fund. “High-risk pools are incredibly expensive and an additional $8 billion over five years doesn’t lead to that [many] more people being able to be covered. ”Even Rep. Fred Upton (R-Mich.), the lawmaker who got the extra money in the bill, said he didn’t know if $8 billion extra money — added to the $130 billion already included in the bill — was the right number. (Cancryn, 5/3)

Several states have tried high-risk pools in the past, but they were typically underfunded, leaving millions of people with no access to adequate health care. Lawmakers hope that by putting the heft and money of the federal government behind them, they may work better. The federal government is already in the business. It pays for the health care of more than 40 percent of the population, through Medicare, Medicaid, the military and the Department of Veterans Affairs, according to the Census Bureau. (Kodjak, 5/3)

[The] “yes’’ votes on the bill are coming largely from lawmakers whose states have the largest shares of people likely to be affected by changes to coverage for pre-existing conditions, the Kaiser figures suggest. These lawmakers as a group are arguing that the bill will cut insurance costs while offering “layers of protections,’’ as House Speaker Paul Ryan put it, for those with medical conditions. Data from the Kaiser Family Foundation gives a broad sense of which states have the most at stake in the debate over whether the House GOP bill leaves people with medical conditions protected or disadvantaged. (Chinni, 5/3)

Richard Figueroa still shudders at the memory of the calls he fielded as enrollment director of California’s special health plan for sick patients who’d been rejected by insurers. Desperate callers pleaded to get off the waiting list as cancer or other illnesses worsened. Enrollees struggled to understand why the plan would not cover all the treatment they needed. (Levey, 5/3)

Jimmy Kimmel’s tearful description of his newborn son’s heart defect has galvanized parents across the country. A few shared his experience as a frantic new father; many more gave silent thanks that they had been spared this ordeal. But the talk-show host’s monologue has also focused new attention on how infants with such birth defects were cared for before passage of the Affordable Care Act, and what may lie ahead for them should the legislation be repealed. (Kolata and Goodnough, 5/3)

Healthcare experts are panning the change to the House's ObamaCare repeal-and-replace bill on coverage for pre-existing conditions, saying it would not make much of a difference. The amendment from Rep. Fred Upton (R-Mich.) would add $8 billion over five years to help people with pre-existing conditions in states that elect to waive certain ObamaCare protections.  (Sullivan, 5/3)

Republican Rep. Tom MacArthur might have singlehandedly saved the Obamacare repeal effort. But rather than being hailed as a hero, the New Jersey lawmaker has come under fire from GOP centrists, who are incensed he negotiated with Freedom Caucus ringleader Mark Meadows. (Bade and Cheney, 5/3)

"There is dissension in the ranks," said one Tuesday Group member who backs MacArthur's ouster. "The Tuesday Group, to me, is a group of concerned, like-minded representatives who discuss issues, not negotiate positions on behalf of the group, but have meetings on Tuesday and have lunch and discuss the pending issues of the day." (Wong, 5/3)

The Republican proposal to overhaul the Affordable Care Act, which is expected to receive a vote in the House on Thursday, would bring big changes to health-care coverage for many Americans. Here are some of the most important ones. (Armour and Hackman, 5/3)

Many people who obtain health insurance through their employers—about half of the country—could be at risk of losing protections that limit out-of-pocket costs for catastrophic illnesses, due to a little-noticed provision of the House Republican health-care bill to be considered Thursday, health-policy experts say. The provision, part of a last-minute amendment, lets states obtain waivers from certain Affordable Care Act insurance regulations. Insurers in states that obtain the waivers could be freed from a regulation mandating that they cover 10 particular types of health services, among them maternity care, prescription drugs, mental health treatment and hospitalization. (Armour and Hackman, 5/4)

While House Republicans lined up votes Wednesday for a Thursday showdown over their bill to repeal the Affordable Care Act, Vickie Glenn sat in her Murphysboro, Ill., office and prayed for it to fail. Ms. Glenn, a Medicaid coordinator for Tri-County Special Education, an Illinois cooperative that helps more than 20 school districts deliver special education services to students, was worried about an issue that few in Congress were discussing: how the new American Health Care Act, with its deep cuts to Medicaid, would affect her 2,500 students. (Green, 5/3)

Just about every major health care group opposes President Donald Trump’s health care overhaul — and the self-styled negotiator-in-chief hasn’t tried cutting a deal with them. The opposition from the deep-pocketed health care industry — and patient advocacy groups from the American Heart Association to the March of Dimes — has made it hard for Republicans to push Obamacare repeal through the House. And they could be a persistent obstacle if the legislation makes it to the Senate. (Cancryn, Karlin-Smith and Demko, 5/3)

The chief executive of Blue Shield of California, the largest insurer on the state’s insurance marketplace, issued a blunt critique of the Republican health care bill, saying it would once more lock Americans with preexisting conditions out of affordable coverage. In an interview with California Healthline on Wednesday, Paul Markovich said the GOP’s American Health Care Act is “flawed” and “could return us to a time when people who were born with a birth defect or who became sick could not purchase or afford insurance.” The bill is set to come up for a vote in the House of Representatives on Thursday. (Terhune, 5/3)

White House press secretary Sean Spicer said Wednesday it is “literally impossible” to predict the effects of the House Republican plan to repeal and replace ObamaCare. “There are so many variables that are unknown,” Spicer told reporters. “It seems almost impossible.” Spicer was pushing back on critics who accuse Republicans of moving too fast on a proposal that could reshape the U.S. healthcare system without knowing its true impact. (Fabian, 5/3)

Iowa’s last major Affordable Care Act insurer threatened on Wednesday to pull out from the state’s marketplace next year, the latest step in a sudden collapse of the state’s insurance marketplace that holds ominous signs for health care customers in states across the county. If Minnesota-based Medica follows through on its threat not to sell plans in 2018, Iowa could be the first state to lack any insurers on its exchanges in all but a handful of counties. (Johnson, 5/3)

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today,” Greg Bury, a company spokesman, said by email. “We are examining the potential of limited offerings, but our ability to stay in the Iowa insurance market in any capacity is in question at this point.” (Tracer, 5/3)

If Medica leaves, all but five counties in the state would have no insurers to choose from on the exchanges. Medica's announcement comes as insurers continue to get mixed signals from the Trump administration. (Hellmann, 5/3)

Medica’s announcement comes on the heels of word last month that Aetna and Wellmark Blue Cross & Blue Shield would pull out of Iowa’s individual health insurance market for 2018. Those are the only three choices for individual health insurance in most areas of the state this year. (Leys, 5/3)

One Iowan who will likely be affected if Medica leaves is Geoff Wood, who has purchased insurance through the exchange for every year that it’s been available. Wood owns a co-working space called Gravitate in downtown Des Moines, and often talks with people who are thinking about starting their own businesses. "That’s something that we talk a lot about, is what that’s going to be like to insure yourself for the first time," he says. "I’ve been very concerned about all the changes for that reason, just really stunting the growth of new business in our state. As people are kind of job-locked into their existing employment situations." (Boden, 5/3)

Aetna Inc. is quitting Virginia’s Obamacare market for 2018, the second state that Chief Executive Officer Mark Bertolini is exiting as he seeks to limit his insurer’s risks from the beleaguered health law....UnitedHealth Group Inc., which has largely stopped selling ACA health plans, said last month it was pulling out of Virginia. Also in April, Aetna said it wouldn’t sell Obamacare plans on Iowa’s market next year. (Tracer, 5/3)

Self-insurance, in which companies pay employee medical costs directly rather than buy a plan from a health insurance company, has traditionally been the realm of large corporations. It helped them avoid the hassle of navigating different insurance regulations for employees in different states, and having more employees helped them spread the risk of medical costs. But self-insurance has become more cost-competitive for smaller companies since certain employer mandates in the Affordable Care Act, commonly known as Obamacare, went into effect. (Marso, 5/3)

The Trump administration is still dutifully enforcing Obamacare's individual mandate, despite early signals it might undermine the unpopular linchpin of the health care law. Weeks after the close of tax season, the IRS continues to process penalties from potentially millions of taxpayers who refused to purchase health insurance last year. (Ehley and Lorenzo, 5/3)

Members of Congress called on the World Health Organization Wednesday to “do everything in its power” to stop the manufacturer of the highly addictive painkiller OxyContin from setting off “a worldwide opioid epidemic” with its rapid expansion into developing countries and other foreign markets. In a letter to the WHO’s director-general, a dozen U.S. representatives from areas devastated by opioid addiction urged the international medical community to be wary of Connecticut opioid maker Purdue Pharma and its international arm, known as Mundipharma. (Ryan, 5/3)

Four years into an opioid epidemic that has claimed thousands of lives in Florida, Gov. Rick Scott officially declared a public health emergency Wednesday. An emergency declaration gives Scott the power to spend immediately without the Legislature’s approval and for public health officials to move quickly to respond to a crisis. It also allows the state to accept a federal grant awarded two weeks ago for prevention, treatment and recovery services that will total more than $54 million over the next two years. (Auslen, 5/3)

The order gives the state access to more than $27 million in federal grant money from the U.S. Department of Health and Human Services. The state was awarded a $54 million on April 21 through the department’s Opioid State Targeted Response grant. The money will be used to provide prevention, recovery and support services, including the drug Naloxone, which reverses overdoses. (Ochoa, 5/3)

Deaths from heroin and fentanyl overdoses have more than doubled in unincorporated Orange County. Orange County Sheriff Jerry Demings says the sheriff’s office has responded to more than 160 heroin overdoses in the first three months of 2017 alone – a 132 percent increase over last year. (Aboraya, 5/3)

Deaths caused by synthetic opioids increased by 72 percent nationwide from 2014 to 2015, according to the Centers for Disease Control and Prevention. President Trump signed an executive order to set up a new national opioid commission to combat opioid abuse. But what can a commission reasonably accomplish? (Weber, 5/3)

First responders in Northern Kentucky have a chance to pin overdoses to an electronic map immediately with technology offered from a federal High Intensity Drug Trafficking Area (HIDTA) program. State Rep. Kim Moser, R-Taylor Mill, arranged a session Wednesday between Northern Kentucky first responders and Washington-Baltimore HIDTA Deputy Director Jeff Beeson to see a secured mobile application that, Beeson said, can "make sure we have real-time data that is cross-jurisdictional." (DeMio, 5/3)

There’s now no reliable way to tell a lethal prostate cancer from one that’s so slow-growing it can safely be left alone: the prostate specific antigen (PSA) test can’t, and neither can looking at the cancer cells under a microscope. But researchers are developing genetic tests, imaging tests, and algorithms like those in face-recognition software in an effort to reduce the 1 million US men a year who have prostate biopsies and, even more important, reduce the thousands who get treatment they don’t need. (Begley, 5/4)

Racism damages our children’s health, a recent study found, negatively affecting the wellness of wealthy white kids and poor minorities the most. The study, which will be presented this weekend by lead author Dr. Ashaunta Anderson, found kids who endured racism had lower levels of general health, including higher rates of anxiety, depression and ADHD. The study isn’t the first to explore racism’s link to physical health. (Rossman, 5/4)

A little spit may help predict whether a child's concussion symptoms will subside in days or persist for weeks. A test that measures fragments of genetic material in saliva was nearly 90 percent accurate in identifying children and adolescents whose symptoms persisted for at least a month, a Penn State team told the Pediatric Academic Societies Meeting in San Francisco, Calif. In contrast, a concussion survey commonly used by doctors was right less than 70 percent of the time. (Hamilton, 5/4)

Steve Stephens filmed himself shooting a Cleveland bystander, then confessed to the killing on Facebook Live. A man in Thailand broadcast himself killing his infant daughter on Facebook Live before killing himself. There have been other live-streamed suicides and rapes, many lingering on the popular platform for hours. The first line of defense against those violent images spreading is, in most cases, a human being. After concern that Facebook doesn’t move quickly enough to address violence broadcast on its platform, the company announced Wednesday that it will nearly double the number of moderators it pays to monitor for inappropriate content. (Ohleiser, 5/4)

Why do we sleep? Why do we dream? And what happens to our brains at night? (Shortal and Shockman, 5/3)

The report estimated that 40 percent of family caregivers are men, up from 34 percent eight years ago. The men are slightly younger on average than female caregivers — 47.8 vs. 49 — and provide slightly less care per week — 23 vs. 24.4 hours. They do similar things, from paying bills and driving to medical appointments, to hands-on care such as bathing and using medical equipment.  Many wish they had more training. Male caregivers were more likely than women to be employed, but 37 percent did not tell their bosses about their caregiving responsibilities even though many said they had to come in late, leave early, or take days off to take care of a loved one. (Burling, 5/3)

An outbreak of measles in Minnesota has sickened more than 30 children in recent weeks, primarily in the state's large Somali-American community, where many parents avoid the measles-mumps-rubella vaccine because of unfounded fears that it causes autism. Somalis are just the latest example of a tight-knit community in which the highly contagious disease has gained a foothold in the U.S. in recent years. (5/3)

Health officials in Minnesota are scrambling to contain a measles outbreak that has sickened primarily Somali-American children. Officials have identified 34 cases as of Wednesday, and they’re worried there will be more. In Minnesota, the vast majority of children under age 2 get vaccinated against measles. But state health officials said most Somali-American 2-year-olds have not had the vaccine, about 6 out of 10. As the outbreak spreads, that statistic worries health officials, including Michael Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy. (Zdechlik, 5/4)

Even in the midst of the outbreak, Somali resistance to vaccination remains strong in Minneapolis. Minnesota is home to the largest Somali population in the United States. It's a relatively recent attitude that emerged alongside escalating fears about links between MMR and autism among the immigrant group. Understanding the history behind those fears — and the culture that reinforces them, contrary to abundant scientific evidence — is an important step toward overcoming them, research suggests, and not just in Minnesota. (Sohn, 5/3)

Tomorrow afternoon, Planned Parenthood of the Heartland and the ACLU of Iowa are asking a judge for an emergency injunction to stop a law that requires women wait 72-hour before receiving an abortion. The law is slated to go into effect Friday morning, unless the Polk County District Court intervenes. (Boden, 5/3)

Planned Parenthood, the reproductive rights organization targeted by conservatives for providing abortion services, is turning the tables and going after Rep. Martha McSally for seeking to cut off its federal funds. Citing polling it conducted last week, Planned Parenthood is running an ad in McSally's Tucson-based district, saying she supports defunding its services and wants to overturn former President Barack Obama's Affordable Care Act, positions it claims are unpopular with residents there. (Hansen, 5/3)

Democrat Antonio Villaraigosa likes to say healthcare is a right, not a privilege. ... But now as a candidate for governor, Villaraigosa said he isn’t prepared to embrace single-payer without first identifying a way to pay for it, putting him at odds with his Democratic opponent, Lt. Gov. Gavin Newsom, who says he would push a universal, single-payer system, and is working with allies on such a proposal. (Cadelago, 5/3)

Almost 25,000 college students across Florida last year needed mental health services. But on some campuses, students are forced to wait weeks for help. While Florida lawmakers don't argue the need, neither the House nor the Senate this session have set aside money specifically for mental health funding at the 12 state universities, which have requested $14.5 million this year for mental health. (Miller, 5/4)

Colorado State University researchers have developed a new way to identify the Zika virus — a breakthrough that could lead to easier, lower-cost field tests to find the disease in mosquitoes and, one day, diagnose it in humans. The test uses an existing technology called loop-mediated isothermal amplification, or LAMP. The method uses heat and a mixture of chemicals in a tube to find the presence of a targeted pathogen within an hour. Similar tests have already been developed to search for other viruses or parasites. For instance, one of the CSU researchers involved in the Zika project, Connie Brewster, has used LAMP to test for pneumonia in bighorn sheep herds. (Ingold, 5/3)

When it opens its doors on Monday, the Roots Community Health Center on The Alameda will be the first primary care service provider in the South Bay aimed at improving the health and well-being of African-Americans... Santa Clara County is home to about 55,000 African-Americans, but the black community here — like those nationwide — continues to face serious health disparities compared with other racial and ethnic groups. (Seipel, 5/3)

Against the odds, House Republicans have regained momentum on health-care reform, and they’re nearing a majority coalition. While there may be more swerves before a vote, they ought to appreciate the importance of demonstrating that a center-right Congress—working with President Trump —can govern. (5/4)

When Massachusetts expanded health insurance a decade ago, state officials unknowingly created an experiment. It’s turned out to be an experiment that offers real-world evidence of what would happen if the House Republicans’ health bill were to become law. The findings from Massachusetts come from an academic paper being released Thursday, and the timing is good. Until now, the main analysis of the Republican health bill has come from the Congressional Budget Office, and some Republicans have criticized that analysis as speculative. The Massachusetts data is more concrete. (David Leonhardt, 5/3)

Republicans are engaged in a frantic effort to assemble enough votes in the House for the latest version of the American Health Care Act, their bill to repeal the Affordable Care Act. After so many pratfalls and so much public disgust with what they’re attempting, can they actually pull this off? It’s possible. So it’s worth running through the various scenarios to see how things might proceed from here, if they do. (Paul Waldman, 5/3)

Thanks to a horribly constructed Republican bill that satisfies no one and a late-night TV host, we are finally having the debate we need on health care. The Republicans who have for seven years promised to repeal the Affordable Care Act — but keep the parts they like such as protection for those with preexisting conditions — are now scrambling to pass a bill that does not really do either. Faced with the prospect of actually passing a bill and its impact on tens of millions of people, the GOP realized it couldn’t really repeal Obamacare. (Jennifer Rubin, 5/3)

About half of American adults under age 65 have at least one preexisting medical condition, by the federal government’s count. According to a Kaiser Family Foundation analysis, more than half of those adults could have been denied coverage by health insurers in the days before Obamacare if they weren’t included in a large employer’s plan. (5/4)

Those of us in the world of column-writing and policy wonkery ought to be humbled: It often takes a celebrity, preferably a comedian, to break through with an argument that transforms public understanding. In particularly successful cases, the celebrity demolishes conventions and blurts out a deep truth that only occasionally makes it into the day-to-day arguments and journalistic accounts. (E.J. Dionne Jr., 5/3)

Former Congressman Joe Walsh was acting very presidential Tuesday afternoon. By which I mean he was impulsively tweeting venomous, half-baked thoughts — in this case his reaction to late-night comedian Jimmy Kimmel's monologue Monday about his newborn son's dramatic battle for life at Children's Hospital Los Angeles. True compassion demands that we minimize the role of luck in access to necessary health care, not layer on hope for charity and pity. Expand Kimmel's idea that "no parent should ever have to decide if they can afford to save their child's life" to include spouses, parents, siblings and selves. That's what Democrats are fighting for. And they owe Joe Walsh thanks for so clearly illustrating what they're fighting against. (Eric Zorn, 5/3)

I've been lucky. I was born a healthy baby. Other than childhood rounds of measles and chicken pox and annoying yearly bouts with springtime pollen, I’ve enjoyed a disease-free life. So far, no hereditary predispositions toward any awful affliction have shown up. Other than a weakness for doughnuts and cheeseburgers, I eat pretty well and haven’t gotten fat. I exercise sporadically, but stay in reasonably good shape. Occasionally I drink enough to regret it in the morning, but I’ve never smoked or abused drugs. (David Horsey, 5/3)

The debate over reform of the 6-year-old national health reform bill is quickly being defined not as right vs. left, or Republican vs. Democrat, but as decent vs. indecent. That’s a harsh assessment, no doubt, and one that we don’t make lightly. (Stephen Henderson, 5/4)

With 1 in 5 of our neighbors suffering from mental illness, the time for tinkering around the margins of our broken system is over. American families and communities need deep and dramatic reform. Instead, congressional Republicans are moving forward with efforts to make it harder and more costly for the average American to access mental health care. (Joe Kennedy III, 5/3)

Critics are calling into question the ability of Republicans’ health-care reform bill to effectively provide accessible mental health and addiction services to Americans nationwide. “This is an abomination of a bill,” said Democratic Sen. Chris Murphy, whose 2016 Mental Health Reform Act was signed into law one day before the 2012 Sandy Hook Elementary School shooting. “It doesn’t solve a single problem in our health-care system; it makes existing problems worse, and Republicans know it.” (Ford Carson, 5/4)

Under a single-payer system, health care would be financed through taxing people to support a government-run program rather than through having them or their employers pay for private health insurance coverage. Doing that would require a massive tax increase on California families along with huge pay cuts for nurses, doctors and other health care professionals. And, it would spell the end of the employer-sponsored insurance that half the state relies on and values. (Jim Wunderman, 5/3)

The Food and Drug Administration announced on Monday that the agency would delay a May 5 enforcement date for a rule that requires restaurants with more than 20 locations to post calorie counts on menu boards, ostensibly to encourage healthy choices and prevent a patchwork of state labeling schemes. The mandate was included in the Affordable Care Act in 2010. (5/3)

The progressive mind is forever telling people how to run their lives, but every so often the people tell them to get lost. That’s what the voters did Tuesday in Santa Fe, New Mexico as the hoi polloi revolted against an attempt to tax sugary drinks. Mayor Javier Gonzales, enlightened progressive that he is, proposed the levy of two cents an ounce on sugar-sweetened beverages. That’s roughly 25 cents for a 12 ounce Coke. The tax would have been one of the nation’s highest, on par with the socialist nirvana of Boulder, Colorado. (5/4)

America is the undisputed leader in biopharmaceuticals and medical innovation, at least for now. In countries around the world, governments are taking steps to weaken their U.S. competitors while advancing their own domestic industries – hampering continued investment in innovative new therapies for patients. This is why it is so vital that America’s trade negotiators ensure that we enter into deals with true reciprocity and tough enforcement – something echoed by both the recently released Special 301 Report and President Trump’s April 29 executive order targeting trade abusers. We are happy to compete on a level playing field, but we have to do so with our eyes wide open – recognizing that other countries may not always share our commitment to fair play. (Stephen J. Ubl, 5/4)

The day after being fired, Murthy confirmed on Facebook that he had refused to abandon his commitment to “a healthier and more compassionate America.” Faced with a conflict between personal or career interest and the interests of his patient — the American population — he chose principle over paycheck, like a doctor should. On Wednesday, seven US senators wrote to President Trump asking why Murthy was removed from his position before his term had expired “in light of (the) Administration’s pattern of politically motivated and ethically questionable personnel decisions.” Had it been his stance on gun control? Criminal drug policy? Affordable health care? Or was he dismissed for being the kind of fellow who joined forces with Elmo to debunk the anti-vaccination myths President Trump has given credence to? The public needs to know why Murthy was asked to resign. Doctors do, too. We are often at the intersection of politics, ethics, and health and, when confronted by a conflict of interest, should act like Murthy. (Hakique Virani, 5/3)

Is it possible to be a good progressive and oppose abortion? This long-simmering question was brought to the fore recently when Democratic National Committee Chairman Tom Perez and Sen. Bernie Sanders (I-Vt.) announced their support of Heath Mello, a candidate for mayor of Omaha who is also, inconveniently, antiabortion. (Christine Emba, 5/3)

America’s Democrats are having a bit of an identity crisis, which isn’t surprising given their loss of both the White House and Congress. But with little going right for the Democratic Party, its leaders and stalwarts really can’t afford to squander an opportunity by looking insincere or uninformed, as a recent internal dust-up makes them appear. Broadly speaking, the divide is over whether to back candidates who don’t share the party’s pledged commitment to reproductive choice. That’s a legitimate area of debate, to which many of us would answer a simple no. At a time when abortion rights are being eroded with new state restrictions, funding cuts to Planned Parenthood and a conservative new Supreme Court justice who has yet to show how far he’d go, Democrats must fight to preserve a woman’s right to decide when or if to become a mother. Especially as the Republican Party shows no room for choice. (Rekha Basu, 5/4)

In their zeal to restrict abortion, House Republicans could once again put the federal government on a collision course with California over the rights the state guarantees its residents. The GOP leadership’s healthcare bill, which is headed for a crucial vote this week, would replace the Affordable Care Act’s premium subsidies with new tax credits available to a broader range of Americans. But it would flatly bar the credits from being spent on any policy that covers abortions. And under California law, all insurance policies offered in the state must include such coverage. (5/4)

First, Kansas lawmakers passed legislation that will allow guns in state psychiatric hospitals. Now they expect taxpayers to cover the bill for keeping guns out of those same hospitals. Changing course isn’t cheap. (5/3)

Judgment and integrity are 2 hallmarks of professionalism. Conflict of interest (COI), bias, and dishonesty represent a spectrum of threats to judgment and integrity. COI, a conflict between a professional responsibility and a personal interest, is at one end of this threat spectrum. COI creates a risk of bias. Bias, a prejudice for or against something, is in the middle of this spectrum. If a COI results in bias, the bias may affect a professional judgment. Dishonesty is deceit or fraud. Dishonesty is at the opposite end of this spectrum from COI. Each of these threats exists on a continuum. COI may be present or perceived. Bias may be conscious or unconscious. Dishonesty may be intentional or unintentional. (William W. Stead, 5/2)

A fundamental task of physicians is to guide patients through illness, a process that involves collecting information and then seeking balance between the risks and benefits of treatments and between the length and quality of life. The work of physicians draws on an expanding base of medical knowledge, and there is always more to learn than time to read. Understandably, help is appreciated. It is easier when educational opportunities are convenient and enjoyable such as when they are combined with meals brought into clinic by pharmaceutical representatives and others. (Colette DeJong and R. Adams Dudley, 5/2)

Conflict of interest (COI) affects every aspect of medicine, including clinical care, teaching, and research. According to one definition, “A conflict of interest exists when professional judgment concerning a primary interest (such as patients' welfare or the validity of research) may be influenced by a secondary interest (such as financial gain). Perceptions of conflict of interest are as important as actual conflicts of interest.” Over the past decade, there has been increasing attention to virtually every aspect of COI in medicine, including reports from authoritative national committees, federally mandated reporting of industry payments to physicians, enhanced policies and procedures governing COI at academic medical centers and research institutions, and efforts to harmonize reporting of COI overall and in scientific publications. (Phil Fontanarosa and Howard Bauchner, 5/2)

Individual researchers are accustomed to declaring conflict of interest (COI), if it exists, when submitting manuscripts for publication or in public presentations. In this Viewpoint we focus on an equally important issue—whole-institution COIs, specifically financial COIs in schools of public health, and address 2 interlinked questions: When does this funding represent an important conflict and what can schools of public health do about it? (Sandro Galea, and Richard Saitz, 5/2)

I went digital 11 years ago and embraced an electronic health record. In addition to storing vital information about my patients, this technology let me revamp the revenue cycle management of patient payments, share patient data, and more. I bought into the promise of improved efficiency, enhanced connectedness, and even a better experience that comes with most technology, and was happy with my decision. While things aren’t perfect, they’re very good. Yet now I’m being told by the managers of my affiliated group that I and all of the other physicians in the affiliated group must adopt and use the same new electronic health record platform. (Peter Masucci, 5/3)

With solutions to Illinois' fiscal crisis seemingly blocked by partisan politics, it's time to start looking at new ideas. That's why we have introduced a bill to legalize the purchase of up to an ounce of marijuana, regulating and taxing it as we already do with alcohol. The revenues would help the worst victims of our budget crisis, such as the elderly and ill who rely on social programs and our state colleges and universities that are leaking students and staff. (Kelly Cassidy and Heather Steans, 5/3)