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Democrats are confidently running on Obamacare for the first time in a decade. They’ve got a unified message blaming Republicans for “sabotaging” the health law, leading to a cascade of sky-high insurance premiums that will come just before the November midterm elections. They’re rolling out ads featuring people helped by the law. And Tuesday, they’re starting a campaign to amplify each state’s premium increases — and tie those to GOP decisions. (Haberkorn, 5/15)

Medica's status as the last health plan selling coverage on government-run insurance exchanges for Iowa and Nebraska helped the insurer double its individual market enrollment for 2018. In the market where self-employed people under age 65 buy coverage, Medica saw enrollment grow to 196,479 people as of March across Minnesota and five other states where the insurer sells the coverage. Last year, the comparable tally was about 91,000, according to a Star Tribune analysis of regulatory filings. (Snowbeck, 5/14)

The historic gains in Texas and the rest of the nation are now slipping away as the uninsured rate starts to rise again, a new national health care report has found. The rate of working age adults without health coverage — those between age 19 and 64 — has ticked up to about 15.5 percent so far in 2018, up from 12.7 percent in 2016, according to the latest Commonwealth Fund tracking survey released this month. That translates to about 4 million people nationwide once covered who no longer are insured, the survey found. (Deam, 5/14)

More than 200 Democratic lawmakers from the House and Senate are warning the Trump administration against making changes to a federal family planning program for low-income Americans. Anti-abortion groups and Republicans have urged the administration to bring back Reagan-era regulations that banned organizations receiving Title X funding from promoting or referring patients for abortions. It would also require funding recipients have a physical and financial separation from abortion facilities. (Hellmann, 5/15)

President Trump will speak at a campaign event next week held by a national anti-abortion group. The Susan B. Anthony List announced Monday that Trump will keynote its 11th annual "Campaign for Life" gala on May 22.  ... Anti-abortion groups have cheered the Trump administration for taking many actions targeting abortion, including his reinstatement of the so-called Mexico City policy, which prohibits federal funds from going to international organizations that discuss, provide or offer referrals for abortion services. (Hellmann, 5/14)

A new research letter reports that doctors who received free meals and other kinds of payments from pharmaceutical companies tended to prescribe more opioid painkillers to their patients over the course of a year. Meanwhile, doctors who didn’t get such freebies cut back on their opioid prescriptions. (Kaplan, 5/14)

The U.S. Department of Justice has joined whistleblower litigation accusing Insys Therapeutics Inc of trying to generate more profit by paying kickbacks to doctors to prescribe powerful opioid medications. The government's involvement was disclosed in a filing made public on Monday. It adds firepower to the civil litigation as Insys tries to resolve a federal probe into its marketing of Subsys, a spray form of fentanyl. (Raymond, 5/14)

Drug shortages are nothing new in U.S. hospitals. The American Society of Health System Pharmacists, or ASHP, has been monitoring shortages since 2000. ...But Joseph Hill, director of government relations for ASHP, said the shortages this year of injectable hydromorphone, fentanyl and morphine is actually kind of frightening. (Schachter, 5/14)

Delaware officials are set to release an initial report on how the state can best confront drug addiction. The report to be released Tuesday is the work of an advisory body tasked with assessing the problem and outlining a plan to address prevention, treatment, and recovery for mental health, substance use, and related disorders.The panel is developing both short-term and long-term strategies and initiatives to address the state’s major addiction and mental health challenges. (5/15)

Colorado launched a nearly $1.8 million public awareness campaign Monday aimed at ending the stigma around opioid addiction, with the hopes of encouraging more people to seek treatment. ... The “Lift the Label” campaign will include print, television and digital advertisements designed to educate the public about opioid dependency through stories of addiction and recovery in Colorado. They will “provide a message of hope from people who used to feel hopeless,” according to a news release. (Paul, 5/14)

Providers welcome a disruptor like Amazon to shake up the medical supply space, and most think the giant e-tailer will deliver lower prices, according to a new survey. Some 62% of 152 CEOs, materials managers, operations directors and other executives said they support Amazon's growing presence in the medical supply sector, according to a Reaction Data survey. Nearly the same amount said the company could deliver medical supplies faster and at a lower price than current medical supply companies. (Kacik, 5/14)

Elliott Management Corp. said it has heard nothing from Athenahealth Inc. or its board after proposing on May 7 to acquire the health technology company for $6.46 billion. “Since that time, we have heard nothing from the company beyond its cursory, boilerplate press release,” Jesse Cohn, an Elliott partner and senior portfolio manager, said in a letter to Athenahealth’s board Monday. The New York hedge fund run by billionaire Paul Singer offer would take the company private for $160 a share. (Deveau, 5/14)

Maryland officials on Monday announced federal approval of a new contract for the state’s unique all-payer health care model. Maryland is the only state that can set its own rates for hospital services, and all payers must charge the same rate for services at a given hospital. The policy has been in place since the 1970s, though Maryland modernized its one-of-a-kind Medicare waiver four years ago to move away from reimbursing hospitals on a fee-for-service basis to a fixed budget. “The new Maryland Model will expand health care access and affordability — and ultimately improve quality of life — for Marylanders, especially those with chronic and complex medical conditions,” said Gov. Larry Hogan, a Republican. (Witte, 5/14)

The Centers for Medicare and Medicaid Services has been closely watching the state’s pilot program, first implemented in 2014, as a possible model for other states. The program scrapped a hospital payment model that reimbursed them for the volume of services they provided in favor of annual spending budgets that hospitals were not allowed to exceed. The medical institutions began working with doctors, social workers, community groups and others to ensure patients took their medications, made follow-up visits and took other preventive measure that would keep them out of hospitals. The pilot program resulted in substantial cost savings and improved care for patients, state officials said. The program saved $586 million in health costs between 2014 and 2016 and is now expected to continue to save an additional $300 million a year. (McDaniels, 5/14)

First Lady Melania Trump underwent successful surgery to treat a kidney condition on Monday and is expected to remain in the hospital for the duration of the week, the White House said. The first lady had “an embolization procedure” at Walter Reed National Military Medical Center in Bethesda, Maryland, to treat “a benign kidney condition,” the White House said in a statement. The White House didn’t otherwise describe her medical diagnosis. (Sink and Cortez, 5/14)

The White House announced that First Lady Melania Trump underwent an embolization procedure Monday to treat a benign kidney condition. According to the statement, the treatment was a success. However, she is expected to remain at the Walter Reed National Military Medical Center for the rest of the week. To find out what an embolization procedure entails and why it might be necessary, we spoke to Dr. Mark S. Litwin, professor and chairman of urology at UCLA. (Netburn, 5/14)

As a teenager, Keoni Gandall already was operating a cutting-edge research laboratory in his bedroom in Huntington Beach, Calif. While his friends were buying video games, he acquired more than a dozen pieces of equipment — a transilluminator, a centrifuge, two thermocyclers — in pursuit of a hobby that once was the province of white-coated Ph.D.’s in institutional labs. “I just wanted to clone DNA using my automated lab robot and feasibly make full genomes at home,” he said. (Baumgaertner, 5/14)

When future historians look back on the 21st century, one of the most iconic photos may be of a smiling, dark-haired man in blue scrubs protectively holding a newborn — the world’s first commercially produced “three-parent” baby. This is John Zhang, the Chinese-born, British-educated founder and medical director of a Manhattan fertility center that is blowing up the way humans reproduce. In 2009, Zhang helped a 49-year-old patient become the world’s oldest known woman to carry her own child. In the not-too-distant future, he says, 60-year-old women will be able to do the same. (Cha, 5/14)

A new survey finds significant anxiety and fear among teenagers who identify as lesbian, gay, bisexual, transgender or queer. The survey findings, released Tuesday, are based on the answers of roughly 12,000 youth ages 13 to 17 who responded to an online solicitation by the Human Rights Campaign Foundation and other advocacy groups. Researchers say they reveal the depth of challenges that LGBTQ teens face. At home, at school, in social circles and communities, these teens are experiencing high levels of anxiety, feelings of rejection and fears for their safety, according to a report on the survey findings. (Nutt, 5/15)

The whole point of the game-changing cancer immunotherapies is to get armadas of T cells sailing into battle against tumors. But for some patients there’s a fundamental problem: Their T cells aren’t armed — or, in bio-speak, “activated,” a big reason why many patients aren’t helped by much-hyped new therapies. If a new technique reported on Monday works in people as well as it does in lab mice, however, physicians will be able to tell almost immediately if a patient’s immune system is armed and, if it’s not, quickly switch therapies, increase dosages, or just spare patients often-serious side effects. (Begley, 5/14)

When freshman Eden Hebron wanted to capture the searing experience of being in a classroom where a fellow student killed her best friend and three other people, she turned to poetry. The result was "1216," named after the number of the room at Marjory Stoneman Douglas High School: "The screams blasting in my ear. The blood still won't disappear. I scream for their names, call for my friends. Nothing else to do, they are gone, they are dead." (5/15)

It was 2 p.m., and the seventh stroke patient of the day, an elderly woman, was just flown in by helicopter to Erlanger Medical Center. Neurologist Emily DeCroos asked her a series of questions. “What time did you wake up?” “What day is it? What month? ”Repeat after me: ‘No ifs ands or buts.’” Other common commands: Close your eyes and stick out your tongue. Show me two fingers on your right hand. (Burton, 5/14)

Sen. Charles Schumer is urging the House of Representatives to pass legislation creating a national firefighter cancer registry. The Democrat says the registry to be managed by the Centers for Disease Control and Prevention would help medical professionals more effectively track and treat firefighters with cancer. The registry bill has been approved by the Senate. (5/15)

Babies exposed to more air pollution are more likely to face elevated blood pressure, according to a study published Monday in the American Heart Association's journal Hypertension. The study found that air pollution is associated with higher risk of high blood pressure in adults and children. (Sanchez, 5/14)

The stuff in beauty creams is appearing in foods, as companies launch pricey snacks and drinks containing collagen—and many consumers are eating it up despite little hard evidence that it works. Valerie Grogan, a 53-year-old teacher’s aide in Torrance, Calif., three years ago began making a collagen-rich bone broth in her crockpot every week, hoping it would help soothe aches and smooth her skin. Recently, she discovered a vanilla-coconut collagen powder, which she mixes into coffee and smoothies. (Chaker, 5/14)

Call them tip-of-the-tongue moments: those times we can’t quite call up the name or word that we know we know. These frustrating lapses are thought to be caused by a brief disruption in the brain’s ability to access a word’s sounds. We haven’t forgotten the word, and we know its meaning, but its formulation dances teasingly just beyond our grasp. Though these mental glitches are common throughout life, they become more frequent with age. Whether this is an inevitable part of growing older or somehow lifestyle-dependent is unknown. But because evidence already shows that physically fit older people have reduced risks for a variety of cognitive deficits, researchers recently looked into the relationship between aerobic fitness and word recall. (Reynolds, 5/15)

Kaiser Health News: Will We Still Be Relevant ‘When We’re 64’?

A gnawing sense of irrelevancy and invisibility suddenly hits many aging adults, as their life roles shift from hands-on parent to empty nester or from workaholic to retiree. Self-worth and identity may suffer as that feeling that you matter starts to fade. Older adults see it in the workplace when younger colleagues seem uninterested in their feedback. Those who just retired might feel a bit unproductive. New research suggests this perception of becoming irrelevant is very real. And that’s why some seniors are determined to stay social, remain relevant and avert the loneliness often linked with aging. (Jayson, 5/15)

Nineteen people have died of Ebola in Congo as health officials plan to send an experimental vaccine to prevent the spread of the virus that killed thousands in West Africa a few years ago. The World Health Organization said there have been 39 confirmed and suspected cases of Ebola over the past five weeks as the virus spreads across three rural areas covering nearly 40 miles in the northwest part of the country. Among the dead were three health-care workers. Health officials are following up with nearly 400 people identified as contacts of Ebola patients. (Phillips, 5/14)

The number of cases of sexually transmitted diseases in California reached a record high last year and officials are particularly concerned by a spike in stillbirths due to congenital syphilis, state health authorities said Monday. More than 300,000 cases of chlamydia, gonorrhea and syphilis were reported in 2017, a 45 percent increase from five years ago, according to data released by the California Department of Public Health. (Weber, 5/14)

Texas Attorney General Ken Paxton last week asked two federal agencies to move quickly to fund the state’s Healthy Texas Women program. The program was cut off from Medicaid funding by the Obama administration in 2012 after the Texas Legislature enacted a law preventing taxpayer money from going to abortion providers. (Sterling, 5/14)

Three years into a campaign to shift attitudes about end-of-life planning in Massachusetts and to make sure residents get the care they want, there are a few signs of improvement — and lots of room for more. WBUR's Bob Oakes spoke to Dr. Atul Gawande, author of "Being Mortal," about the initiative his book helped launch and the third annual end-of-life care survey, conducted by UMass Medical School. (Oakes and Bebinger, 5/15)

Memorial Hermann Health System, the largest health care system in southeast Texas, has agreed to pay $1.9 million to resolve allegations over billing Medicare for patient care, the U.S. Attorney's Office in the Southern District of Texas announced Monday. The allegations include billing the federal government for in-patient services for scheduled surgeries that should have been handled as less expensive out-patient treatment or with observation, U.S. Attorney Ryan Patrick said in a statement. (Deam, 5/14)

TriStar Health is planning more than $500 million of expansion projects at six Middle Tennessee hospitals over the next three years, including adding beds and entire floors to one of the Nashville's largest medical facilities. The additions are a direct result of Nashville’s dramatic growth, which is projected to continue both in the city and surrounding communities like Mt. Juliet and Smyrna, said Heather Rohan, TriStar CEO. (Kelman, 5/14)

Through the technology of telehealth, the health system’s personnel based at a center in Perth, Australia, are delivering intensive care services over a distance of 11,000 miles – to Emory patients back in Atlanta. ... So while Emory doctors and nurses stationed in Perth are working during the day, they are monitoring ICU patients in Atlanta, where it’s late at night or in the “wee hours” of the morning. (Miller, 5/14)

Without foreign doctors, proponents of the H-1B program worry patient care, research and medical education could suffer — especially in rural states like Missouri. America has faced a doctor shortage for many years, they say, and immigration has allowed the U.S. to collaborate with top physicians all over the world, ensuring it remains a global leader in medical research. According to a 2017 report by the Missouri Department of Insurance, Financial Institutions and Professional Registration, there are 507 licensed doctors in the state who graduated from foreign medical schools, including an unknown number of H-1B visa holders. (Mai, Maity and Saha, 5/12)

Students at MIT are now part of a project to give a face and voice to a growing crisis across U.S. campuses. When a computer science professor noticed more and more students were coming to discuss their mental health issues, he turned to photography to bring the stigmatized problem of depression into the open. (Brown, 5/14)

It may soon be illegal in Minneapolis to sell tobacco to anyone under the age of 21. Council members are expected to vote next week on a measure that would make the city the latest in Minnesota to treat smoking like drinking in the eyes of the law. (Sepic, 5/15)

Nicklaus Children's Hospital, the only pediatric trauma center in Miami-Dade County, is suing the state to challenge a law that would permanently allow another hospital to operate a competing trauma center without having to undergo the same kind of scrutiny, saying that the competition could functionally put Nicklaus' facility out of business. (Koh, 5/15)

New Hampshire’s U.S. senators are criticizing the Trump administration for reportedly blocking the release of new data about chemicals called PFCs, which have raised contamination concerns in the state. Emails obtained by Politico reportedly show White House and Environmental Protection Agency officials citing public relations fears in delaying publication of a PFC study from the Centers for Disease Control and Prevention. (Ropeik, 5/14)

The California Air Resources Board is finalizing a plan to spend $423 million of Volkswagen's money on financial incentives to persuade trucking companies, mass-transit agencies, tugboat operators and other major polluters to upgrade their fleets and buy greener vehicles. The idea is to eventually take as much pollution out of California's air as Volkswagen's dirty cars put in — especially the heavy volume of smog-forming nitrogen oxide, or NOx, caused by the VW vehicles. (Kasler, 5/14)

[Consent] and paperwork are meaningless if no one understands the concepts she’s trying to impart. So, [Susan] Abdel-Rahman, who is also a professor at the University of Missouri-Kansas City, decided to try something unconventional in her world of 20-page, text-heavy parental consent and child assent forms: pictures. Her initial idea, in 2014, was simple: work with the Kansas City Art Institute to create graphics that explain medical procedures; no language needed. Now in the fourth year of their partnership, and at the end of a National Endowment for the Arts grant with hundreds of graphics in a database, Rahman and her counterpart at the Art Institute know these graphics are anything but simple. (Kniggendorf, 5/14)

Republicans in this Congress have failed to tame federal spending—on either entitlements or the discretionary accounts that won a big increase in this year’s omnibus bill. Perhaps they can now impose at least a little restraint on money that the government isn’t even spending. ...About half the package is a rescission to the Children’s Health Insurance Program. Every year Congress dedicates more money to the program than is spent, and appropriators pocket the rest to spend elsewhere. In 2016 Congress appropriated about $23 billion, including a contingency fund, but only spent a bit more than $14 billion. No child will lose health care. ...That won’t stop Democrats from claiming the worst, and Senate Minority Leader Chuck Schumer wasted no time saying Republicans are “looking to tear apart” the program, “hurting middle-class families and low-income children.” Republicans have to call out the Democrats for wanting to keep these funds in reserve so they can spend it later on pork. (5/13)

This is what the start of a death spiral looks like. Three states have announced preliminary 2019 premium-rate requests for Obamacare individual-market policies, and the numbers don’t look good.In Virginia, the first state out of the gate, insurers requested hikes as high as 64.3 percent. Across all insurers, and weighted for current enrollment, the average increase is likely to be “only” 13.4 percent , according to calculations from health-care analyst Charles Gaba. (Catherine Rampell, 5/14)

Exhorted by President Trump, federal administrators and many Republican state officials are drafting rules requiring people to work in exchange for Medicaid, housing aid and food assistance. But what happens when the poor live where work is hard to find? In Michigan, the state’s Senate has passed a proposal that would exempt Medicaid recipients from a work requirement partly on the basis of geography — if they live in a county where unemployment exceeds 8.5 percent. (Emily Badger and Margot Sanger-Katz, 5/15)

Those who are mothers, grandmothers, great-grandmothers would surely have preferred a card and a handwritten note of affection in the mail. But instead, just in time for Mothers's Day, tens of thousands of elderly or disabled residents in Louisiana were sent notices that their time in their nursing home might run out July 1. (Jarvis DeBerry, 5/12)

With Gov. Larry Hogan's signature on a bill, Maryland last week joined Washington and New York as one of the few states requiring insurance companies to be more diligent before insuring the lives of children. Like those states, Maryland was spurred to act by a high-profile instance of a child killed for insurance money. It should not take the murder of a child to wake lawmakers to the need to act on this issue. Other states now should follow Maryland’s lead to protect vulnerable, young lives. (5/14)

Farmers in the Central Valley have been waiting for a federal farm bill that makes the investments that will ensure California’s agricultural industry continues to lead the nation, and the world. Unfortunately, the proposed bill moving through the U.S. House leaves behind the people who harvest, sort, sell, prepare and serve the Valley’s agricultural bounty. It would make it more difficult for millions of Californians, including working parents and many low-wage workers, to put food on the table by cutting their assistance through CalFresh. (Jared Call, 5/14)

Last week we learned that Novartis, the Swiss drug company, had paid Michael Cohen — Donald Trump’s personal lawyer — $1.2 million for what ended up being a single meeting. Then, on Friday, Trump announced a “plan” to reduce drug prices. Why the scare quotes? Because the “plan” was mostly free of substance, controlled or otherwise. (O.K., there were a few ideas that experts found interesting, but they were fairly marginal.) During the 2016 campaign Trump promised to use the government’s power, including Medicare’s role in paying for prescription drugs, to bring drug prices down. But none of that was in his speech on Friday. And if someone tries to convince you that Trump really is getting tough on drug companies, there’s a simple response: If he were, his speech wouldn’t have sent drug stocks soaring. (Paul Krugman, 5/14)

After President Trump announced his plan for reining in prescription drug prices, shares in drug companies and pharmacy benefit managers spiked. Why? Based on Trump’s campaign rhetoric — drug companies are “getting away with murder,” Medicare should bargain down prices, etc. — Wall Street feared that big changes were afoot. But Trump’s plan (titled “American Patients First“) doesn’t propose any big changes, so investors were relieved and stock prices jumped up. Trump even endorsed two policies that could modestly increase drug makers’ profits. (Charles M. Silver and David A. Hyman, 5/14)

In the steadily growing U.S. economy, with tax reform and regulatory relief leading businesses to invest more in both facilities and people, the unemployment rate stands at 3.9 percent, the lowest since 2000. A record number of business owners say now is a good time to expand, but our workforce needs are going unmet. I see this in Ohio, where employers increasingly tell me that their biggest challenge is finding workers. ... Some new data suggest that the most significant factor contributing to this labor-force decline is the opioid epidemic. (Sen. Rob Portman, 5/14)

For many of the Americans devastated by opiates — whether through their own addiction or the pain of a loved one’s suffering — no apology from Cardinal Health Chairman George Barrett can be sufficient. The Dublin-based drug distributor’s role in the tsunami of opiate addiction that has overtaken the U.S. will be debated for a long time in courts of law and public opinion. Drug distributors didn’t cause the opiate crisis; unethical manufacturer/marketers, prescribers and pharmacists bear the biggest share of blame. But the fact remains that Cardinal and a few other major drug distributors failed to notice or took no action when filling small pharmacies’ orders for preposterously large shipments of highly addictive opiates. The company occupied a pivotal place in the chain that conceivably could have allowed it to head off the growing scourge of addiction years ago, preventing who-knows-how-much suffering. (5/15)

Have you ever heard an idea so good and obvious that you can’t believe it hadn’t been thought of before?That’s the case with a program at Mid Coast Hospital in Brunswick that grabs people with substance abuse disorder when they are most likely to be ready for help, and gets them treatment before their addiction chases that readiness away. The program – the first of its kind in Maine – changed how the hospital deals with people who show up at the emergency department because of their drug use, most often following an overdose. (5/14)

Is state-level medical cannabis access mitigating or fueling America’s opioid crisis? Testifying before Congress last week, Drug Enforcement Agency (DEA) acting administrator Robert Patterson claimed the latter. But when he prompted to provide evidence in support of the agency’s position, he acknowledged that he could not.His failure to substantiate this claim is unsurprising. That is because numerous peer-reviewed studies show that increased cannabis access is associated with declining rates of opioid use, abuse, hospitalizations, and mortality. (Paul Armentano, 5/14)

Eating too much added sugar has become one of the riskiest health behaviors in the modern world. None too soon, governments are waking up to the fact. Staggering under the burden of increasingly overweight populations, more than 30 countries have put new taxes on sugary beverages, most in just the past four years. This is good policy, and it needs to be taken further. (5/14)

My condition is not life-threatening and my baby is healthy, but there are some days when life is downright miserable. But with Iowa's six-week abortion ban — and the possibility of overturning Roe v. Wade — how many women will be forced to make a sacrifice for something they don’t want? I can’t imagine living life in such a torturous way if I didn’t have a choice in the matter. ... Abortion is an essential part of women’s health care. This choice should always be between a woman and her doctor. (Alyssa Reynolds, 5/14)

I’m proud to be the executive vice president of a medical device company I co-founded 16 years ago. I love my industry and the innovative changes it creates that improve people’s lives around the world. And yet I’m dismayed to see how few female executives there are in the medtech and biotech industries — roughly 1 for every 4 male executives and senior officers. That imbalance is bad for women and the future of these industries, because women make up half of the population and represent more than half of health care consumers. Despite positive changes in family responsibilities and greater shared parenting, in most households women are still the primary decision-makers when it comes to family and health. (Melissa Burstein, 5/15)