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The Trump administration took another swipe at the Affordable Care Act on Tuesday, proposing new rules that would make it much easier for consumers to buy less expensive health insurance policies that do not comply with coverage requirements of the law. Under current rules, such “short-term, limited-duration insurance” cannot last for more than three months. Under the proposal, the limit would be 364 days. (Pear, 2/20)

The proposed regulations would expand an alternative to the comprehensive medical plans required under former President Barack Obama's health law. Individuals could buy so-called "short-term" policies for up to 12 months. But the coverage would omit key consumer protections and offer fewer benefits, making it unattractive for older people or those with health problems. The plans would come with a disclaimer that they don't meet the Affordable Care Act's safeguards, such as guaranteed coverage, ten broad classes of benefits, and limits on how much older adults have to pay. Insurers could also charge more if a consumer's medical history discloses health problems. (Alonso-Zaldivar, 2/20)

Kaiser Health News: Trump Administration Proposes Rule To Loosen Curbs On Short-Term Health Plans

The new rule is expected to entice younger and healthier people from the general insurance pool by allowing a range of lower-cost options that don’t include all the benefits required by the federal law — including plans that can reject people with preexisting medical conditions. Most short-term coverage excludes benefits for maternity care, preventive care, mental health services or substance abuse treatment. (Appleby, 2/20)

“It’s one step in the direction of providing Americans with health insurance options that are both more affordable and more individualized for families’ circumstances,” Azar said in a conference call with reporters to announce the proposed rule. Seema Verma, administrator of the Centers for Medicare and Medicaid Services, echoed that portrayal of the rewrite as health reform. “While in the past these plans have been a bridge, now they can be a lifeline,” she said. (Goldstein, 2/20)

With the proposal, the HHS said it is targeting the nearly 28 million people who are uninsured. "There are healthy people who are sitting on the sidelines without coverage and this is an opportunity to provide them an opportunity for coverage whereas right now they might not have that," Verma said. (Livingston, 2/20)

Under the Affordable Care Act, or Obamacare, short-term plans can last up to three months. But the Trump administration wants to extend that time limit to a year, or more. "In 2008, one of the important policy motivators for what ultimately became the ACA was protecting people from so-called mini-med plans that provided coverage in name only," says Rodney Whitlock, a health care consultant with ML Strategies who worked as a Republican staffer on the Senate Finance Committee when the Affordable Care Act was written. "But in a world without the individual mandate, short-term health plans make perfect sense. Now people who have no utilization can go out and buy coverage with no benefits." (Kodjak, 2/20)

Republicans say allowing the extension of short-term plans would lower premiums by fostering competition and giving consumers more choices. Critics say it would allow for the sale of “junk” plans that have limited benefits and have been subject to fraud in the past, returning the market to the days before the ACA. “Bottom line: This is a green light to discriminate against Americans with pre-existing conditions that’s going to make quality health insurance more expensive and less accessible,” said Oregon’s Ron Wyden, the top Democrat on the Senate Finance Committee, which oversees many health-care issues. (Armour, 2/20)

“The way that you get to lower premiums is to reduce benefits,” said Kevin Lucia, a professor at Georgetown University’s Center on Health Insurance Reforms. “It’s a quick fix, but ultimately those products don’t help consumers who need them.” (Demko, 2/20)

Among the other leading patient groups that condemned the proposed new rules are the American Heart Assn., the American Lung Assn., the Arthritis Foundation, Consumers Union, the Cystic Fibrosis Foundation, the Leukemia and Lymphoma Society and the March of Dimes. The administration is already under fire for proposing last month to make it easier for self-employed Americans, small businesses and others to band together to get health insurance through what are called association health plans. Association plans do not have to offer a comprehensive set of so-called essential health benefits, a key requirement of the 2010 health law. (Levey, 2/20)

UnitedHealth Group Inc., the biggest U.S. health insurer, already offers short-term coverage, and has said it would explore expanding offerings. Two major industry lobby groups, America’s Health Insurance plans and the Blue Cross Blue Shield Association, have warned that the short-term plans could harm state insurance markets. (Tracer, 2/20)

Three high-ranking Democrats blasted the Trump administration’s move Tuesday to expand access to plans that don’t meet ObamaCare’s requirements, calling it the “latest step” in the White House’s “effort to sabotage our nation’s healthcare system.” The Department of Health and Human Services (HHS) announced a proposed rule Tuesday that would increase the maximum length of short-term health plans from less than three months to nearly a year. The three-month limit had been set by the Obama administration. (Roubein, 2/20)

Hundreds of companies face prospective fines for violating Obamacare’s employer mandate by the same Trump administration that has done virtually everything in its power to abolish the federal health care law. Internal Revenue Service notices recently began arriving in corporate mailboxes, in some cases demanding millions of dollars in fines — an awkward development as the White House touts its business-friendly tax package. The notices will likely spur another legal fight over the health law — this time featuring the administration defending a statute that President Donald Trump has repeatedly declared dead. (Demko and Haberkorn, 2/20)

HHS Secretary Alex Azar said he’s not aware of any other states that are looking to copy Idaho's plan to let health insurers skirt the Affordable Care Act's coverage requirements. Azar also said he’s had no discussions with Idaho officials about their plan, which many legal experts believe violates federal law. Azar has said it would be premature to comment on Idaho's move. (Demko, 2/20)

President Trump — under pressure from angry, grieving students from a Florida high school where a gunman killed 17 people last week — ordered the Justice Department on Tuesday to issue regulations banning so-called bump stocks, which convert semiautomatic guns into automatic weapons like those used last year in the massacre of concertgoers in Las Vegas. (Shear, 2/20)

In private, [Trump] has indicated that he might do more, telling advisers and friends in recent days that he is determined to push for some sort of gun-control legislation, according to people familiar with the conversations. In one such discussion, during dinner with television commentator Geraldo Rivera at Trump’s Mar-a-Lago Club in Palm Beach, the president listened with interest as Rivera suggested raising the minimum age at which a person could buy a semiautomatic weapon from 18 to 21. White House press secretary Sarah Huckabee Sanders told reporters Tuesday that the idea is “on the table for us to discuss.” (Johnson, Berman and Dawsey, 2/20)

She was tired of catching herself staring blankly at the wall, so Hannah Karcinell sent a group text to her friends: “Hi, I’m thinking of having a thing at my house.” Those friends invited their friends, and now she was waiting for everyone on her back patio, wearing a Marjory Stoneman Douglas High School cheerleading tank top. She heard a thud. Her whole body tensed. “Should I put the food out now?” her mom called from the house. Hannah turned. The sound, she realized, had just been Jodi Karcinell pushing open the back door, which sticks. (Contrera, 2/20)

Students who survived the Florida school shooting prepared to flood the Capitol Wednesday pushing to ban the assault-style rifle used to kill 17 people, vowing to make changes in the November election if they can't persuade lawmakers to change laws before their legislative session ends. About 100 Marjory Stoneman Douglas High School students arrived at a Tallahassee high school to extended applause late Tuesday after a 400-mile trip on three buses. They told the 500 students and parents waiting for them that they are fighting to protect all students. (Farrington, Replogle and Lush, 2/21)

House Republicans on Tuesday decisively blocked a move by Democrats to debate a ban on assault weapons in Florida, six days after a massacre that took 17 lives at Marjory Stoneman Douglas High School in Parkland. The bill (HB 219), which would ban the sale and possession of semiautomatic weapons and high-capacity magazines like the kind used by Nikolas Cruz, has been mired in a House subcommittee for months and has not been heard. (Koh and Bousquet, 2/20)

After a teen’s deadly assault on his former high school in Parkland last week, Republican leadership is considering legislation to restrict access to assault rifles, donors are threatening to pull funding unless gun control is once again on the table, and scores of teenagers, the faces of the next generation of voters, are descending on the state Capitol this week. ...Heading into a key November election, Florida politicians are facing political fallout over gun control in the aftermath of the shootings at Marjory Stoneman Douglas High School. (Smiley, 2/20)

In his first public comments since last week's Florida school shooting, Gov. Greg Abbott on Tuesday called for fixing the federal background check database for gun buyers and identifying mental health issues that could lead to gun violence. ...The governor said Texas gun safety standards should be reviewed to see whether they need updating. (Dugyala and Svitek, 2/20)

Campaigning to keep his job, Veterans Affairs Secretary David Shulkin said Tuesday he had no intention of quitting despite blistering findings of travel abuses connected to his 11-day trip to Europe. He issued an extraordinary warning to VA staff rebelling against him: Get back in line or get out. Speaking after a Tuesday meeting at the White House, Shulkin told The Associated Press that White House chief of staff John Kelly affirmed he still had the trust of President Donald Trump. (Yen, 2/20)

Shulkin’s new chief of staff, Peter O’Rourke, is meeting with each staffer suspected of defying Shulkin “individually and as a group to determine, now that there is a clear direction where we are going, where people are going to stand," he said. "Those who crossed the line in the past are going to have to be accountable for those decisions." Shulkin and the White House on Friday named O’Rourke, who previously led an accountability office at VA, to replace Vivieca Wright Simpson after she retired last week. An IG report accused her of falsifying an email to get the VA to pay for Shulkin’s wife to accompany him on a trip to England and Denmark over the summer. (Allen, 2/20)

More than 300 health workers have complained to the Health and Human Services (HHS) Department over the last month, saying that their religious or conscience rights have been violated by their employer. The complaints follow the creation of a new division within HHS that focuses on enforcing those rights and investigating complaints from employees who say their rights have been violated. (Hellmann, 2/20)

An official with the Department of Health and Human Services (HHS) has been placed on leave while the department looks into inflammatory social media posts, CNN reported Tuesday. Jon Cordova, the principal deputy assistant secretary for administration at HHS, previously shared stories on his social media accounts that included false claims about Gold Star father Khizr Khan, Sen. Ted Cruz (R-Texas) and Hillary Clinton, CNN found. (Samuels, 2/20)

A lesbian married couple from Texas is suing the federal government after they say that a Catholic nonprofit that receives taxpayer funding denied them the opportunity to serve as foster parents for refugee children because of their sexual orientation. Fatma Marouf, 41, and Bryn Esplin, 33, both professors at Texas A&M University in Fort Worth, said they were beginning the process to become refugee foster parents last year when they were told by a local charity, Catholic Charities of Fort Worth, that they did not qualify after it became clear that they were a same-sex couple, according to a complaint filed Tuesday in district court in Washington. (Rosenberg, 2/20)

A group of Democratic senators want the Trump administration to reverse its steady rollback of regulations on nursing homes. In a letter sent to Alex Azar, the secretary of the Department of Health and Human Services, as well as Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), the Democrats allege that the regulatory rollback “will inevitably weaken the safety of our nation’s nursing homes and put patients, many of whom are elderly and wholly reliant on this care, at greater risk.” (Weixel, 2/20)

A bipartisan group of New York lawmakers called on White House budget director Mick Mulvaney to scrap a proposal in President Trump's proposed budget plan they say could threaten the health treatment of 9/11 first responders.  New York Reps. Pete King (R), Jerrold Nadler (D) and Carolyn Maloney (D) said they were "shocked and disturbed" by the proposal, which would see a realignment involving the World Trade Center Health Program (WTCHP). (Manchester, 2/18)

A group focused on recruiting and training scientists to run for office is reserving nearly $2 million in TV ads in three states that house highly competitive House races in 2018. 314 Action, named after the first three digits of pi, reserved $1 million in broadcast TV ads in the Los Angeles media market, $500,000 in the Detroit media market and $350,000 in the Seattle media market. (Hagen, 2/21)

The supermarket operator Albertsons said Tuesday morning that it would buy the remnants of the Rite Aid drugstore chain. By the end of the day, Walmart saw its stock drop by more than 10 percent on weak profit. Both can blame Amazon. (Corkery and Bray, 2/20)

Supermarket giant Albertsons is buying part of Rite Aid, the nation's third-largest pharmacy chain, as the companies try to navigate sweeping shifts in the food and health care industries. Rite Aid (RAD) and Albertsons, the private-equity backed company that operates Safeway and several other grocery chains, said the deal would create a company with expected 2018 revenue of $83 billion and potential annual earnings of $3.7 billion before interest, taxes, depreciation and amortization. The deal is aimed at sparking Rite Aid's expansion as the company competes with retailing giant Amazon, which is eyeing a potential entry into health care, as well as Walmart. (McCoy, 2/20)

The drugstore chain and Albertsons have a combined value of around $24 billion, including debt, the companies said Monday. Rite Aid, which comprises thousands of drugstores and a benefits-management company with millions of members, has a market value of about $2.3 billion and is in the process of selling a chunk of its stores to Walgreens. (Haddon, 2/20)

Retailers have been under growing pressure from online competitors like Amazon.com Inc., and the corner drugstore has been no exception. While the prescription drug businesses at pharmacies has been relatively stable, front-of-the-store sales have been in decline. Giant retailers like Walmart Inc. are also looking to play a bigger role. (Levingston, 2/20)

Healthcare in the United States is really expensive, and one of the reasons is that managing healthcare bills is really, really expensive. Just how expensive? At one large academic medical center, the cost of collecting payments for a single primary-care doctor is upward of $99,000 a year. And billing for primary-care visits is a bargain compared with billing for trips to the emergency room, a hospital stay or a surgical procedure, according to a report published Tuesday in the Journal of the American Medical Assn. (Kaplan, 2/20)

Kaiser Health News: Bad Bedside Manna: Bank Loans Signed In The Hospital Leave Patients Vulnerable

Laura Cameron, then three months pregnant, tripped and fell in a parking lot and landed in the emergency room last May — her blood pressure was low and she was scared and in pain. She was flat on her back and plugged into a saline drip when a hospital employee approached her gurney to discuss how she would pay her hospital bill. Though both Cameron, 28, and her husband, Keith, have insurance, the bill would likely come to about $830, the representative said. If that sounded unmanageable, she offered, they could take out a loan through a bank that had a partnership with the hospital. (Luthra, 2/21)

Coloradans pay significantly more for health care than people in four other states that were analyzed as part of a new study, and the reason shows how difficult it will be to lower costs here. Overall, when compared to other states in the study, health care costs in Colorado are 17 percent above average — making the state the biggest outlier, higher or lower, in the study. (Ingold, 2/20)

One of the places many people are first prescribed opioids is a hospital emergency room. But in one of the busiest ERs in the U.S., doctors are relying less than they used to on oxycodone, Percocet, Vicodin and other opioids to ease patients' pain. In an unusual program designed to help stem the opioid epidemic, the emergency department at St. Joseph's University Medical Center in Paterson, N.J., has been exploring alternative painkillers and methods. That strategy has led to a 58 percent drop in the ER's opioid prescriptions in the program's first year, according to numbers provided by St. Joseph's Healthcare System's chair of emergency medicine, Dr. Mark Rosenberg. (Wang, 2/20)

More than half of Marylanders say they personally know someone who has been addicted to opioids, according to a Goucher College poll released Wednesday that also found strong support for imposing term limits on state lawmakers and raising the minimum wage to $15 an hour. The finding that 52 percent have direct ties to opioid abuse illustrates the growing scope of a crisis that was declared a state of emergency last year by Gov. Larry Hogan (R) and was a major focus of the 2017 legislative session. A Washington Post-University of Maryland poll in late 2015 found that nearly 30 percent of Marylanders had a close friend or relative who was addicted. (Wiggins, 2/21)

Gov. Bill Haslam’s plan to address the opioid epidemic focuses on addiction prevention and rehabilitation for addicts — a combo attack many hope will put a significant dent in the number of residents affected. About $25 million of the $30 million in the governor's budget, if passed, will go toward treatment. In addition to the governor's two signature bills, lawmakers have introduced at least 15 other pieces of legislation dealing with opioids. (Buie, 2/20)

Hope for N.H. Recovery officials said the nonprofit has been without state aid since the start of this fiscal year in July and will close centers in Franklin, Claremont and Berlin, as well as Concord. “When we were initially asked to open centers in these communities, we intended for them to be sustained via a blended funding stream. This stream was to consist of support from local businesses, organizations, and individuals as well as some state funding,” Scott Bickford, HOPE’s board chairman, wrote in the release. (Willingham, 2/21)

A Senate legislative committee has approved two bills intended to help address the state’s opioid problem. One bill sets up a task force to determine what the problem is and what could be done about it and the other sets up tracking for controlled substance prescriptions in the state. (Beck, 2/20)

The opioid epidemic in Ohio is taking a particularly heavy toll on construction workers, according to a study released Tuesday by the Midwest Economic Policy Institute. Based on federal and state data, the study estimates that 380 Ohio construction workers died from opioid overdoses in 2015 — more than double the 164 estimated for the next-highest state in the Midwest — Illinois. (Matzer Rose, 2/20)

The Centers for Disease Control and Prevention, the Food and Drug Administration and several states are investigating an outbreak of salmonella illness linked to kratom, an unregulated herbal supplement that is sometimes used for pain, anxiety and opioid-withdrawal symptoms, the CDC said Tuesday. The agency, which urged consumers to not use kratom in any form because of the possibility of contamination, said the infections started in October and have affected 20 states. Eleven people have been hospitalized, and no one has died. Most of the people sickened have reported consuming kratom in pills, powder or tea, according to the CDC, which didn't name any specific brands or suppliers. (McGinley, 2/20)

So far 28 people in 20 states are believed to have been sickened by contaminated kratom, a plant native to Southeast Asia that’s variously ingested as pills or powder or brewed into tea. Eleven people have been hospitalized. (Branswell, 2/20)

A precision nutrition approach to weight loss didn't hold up in a study testing low fat versus low carb depending on dieters' DNA profiles. Previous research has suggested that a person's insulin levels or certain genes could interact with different types of diets to influence weight loss. Stanford University researchers examined this idea with 600 overweight adults who underwent genetic and insulin testing before being randomly assigned to reduce fat or carbohydrate intake. (Tanner, 2/20)

Despite some earlier studies claiming that genetic variants predict whether someone has a better chance of shedding pounds on a low-carbohydrate or a low-fat diet, and despite a growing industry premised on that notion, the most rigorous study so far found no difference in weight loss between overweight people on diets that “matched” their genotype and those on diets that didn’t. The findings make it less likely that genetics might explain why only some people manage to lose weight on a low-carb diet like Atkins and why others succeed with a low-fat one (even though the vast majority of dieters don’t keep off whatever pounds they lose). Unlike cancer treatments, diets can’t be matched to genotype, the new study shows. (Begley, 2/20)

Anyone who has ever been on a diet knows that the standard prescription for weight loss is to reduce the amount of calories you consume. But a new study, published Tuesday in JAMA, may turn that advice on its head. It found that people who cut back on added sugar, refined grains and highly processed foods while concentrating on eating plenty of vegetables and whole foods — without worrying about counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year. (O'Connor, 2/20)

The thought of a vaccine might conjure up memories of that flu shot you get each year, or taking your kids to get their immunizations against polio or measles. Cancer rarely comes to mind when most people think of vaccines, but that appears to be changing. Over several decades, cancer vaccines have emerged as a form of immunotherapy, a treatment approach that stimulates or restores the body's own immune system to either help prevent cancer from developing or help treat an existing cancer. (Howard, 2/21)

The bar for clinical trials involving children, by design, is set higher than it is for adults. Before a drug can be given to children in a Phase 1 trial, it must have already been tested in adults and shown some signals about its safety and clinical promise. That, however, does not mean the outcomes will be any better, according to a new study. Scientists conducted a systematic review and meta-analysis of Phase 1 clinical trials involving children with cancer and found, on average, only 1 in 10 will see their condition improve. About 1 in 50 children will die from complications related to the drug. (Cooney, 2/20)

They call it the “Proteus effect.” Researchers tracking clinical trials have long been aware that the first studies to be published sometimes show benefits that aren’t borne out in later trials. Like Proteus, the Greek god of the sea who could change his shape, evidence can shift over time to show more modest improvements. A new study of clinical trials testing treatments for several chronic conditions has found that more than 1 in 3 of the earliest-to-publication trials reported benefits much greater than later research showed. (Cooney, 2/21)

Round and round the short-track speedskaters go, crouched low on the ice as they carve counterclockwise ovals, over and over. They lean so hard to the left that their fingers glide on the ice at the turns. The straightaways are so short that there is room for only one or two strides before the skaters lean hard into the next 180-degree curve, again and again. They spend their training hours in that position, their torsos torqued to the left, their weight on their left legs as their right legs sweep powerful strides. (Branch, 2/20)

Race across the snow on skis as fast as you can. Now stop and shoot a target the size of an Oreo about 54 yards away. If you miss, you’ll ski penalty laps before you are allowed to race to the next set of targets. Most of us will never try the biathlon, a uniquely stressful sport that demands both physical intensity and emotional calm. But that doesn’t mean we can’t learn from it. Talking to an Olympic biathlete about how she trains for competition can offer a life lesson in managing stress and dialing back intensity and aggression in an instant. (Parker-Pope, 2/21)

The first attempts to use a groundbreaking gene-editing technology in people will likely target patients with sickle cell disease, a crippling inherited disorder that in the U.S. predominantly strikes African-Americans. That should be welcome news, after decades of sickle cell patients being neglected by the health care system, scientists, and drug companies. But the long and ugly history of unethical experimentation and mistreatment of black patients could make recruiting volunteers to try largely untested CRISPR therapies a tough sell. (McFarling, 2/21)

Shaorong Deng is sitting up in bed at the Hangzhou Cancer Hospital waiting for his doctor. Thin and frail, the 53-year-old construction worker's coat drapes around his shoulders to protect against the chilly air. Deng has advanced cancer of the esophagus, a common form of cancer in China. He went through radiation and chemotherapy. But the cancer kept spreading. (Stein, 2/21)

This flu season has closed schools and cost Dallas-Fort Worth businesses millions in lost productivity. It's also been deadly — more than 110 people in Dallas-Fort Worth have died from the flu during this season, and others have lived through frightening complications. We used our Curious Texas project to ask you what you wondered about the flu in North Texas this year, and we took your questions to experts at Parkland Memorial Hospital, Children's Health and Dallas County Health and Human Services for answers. Here are the answers we found for you. (Branham, 2/20)

Excessive alcohol use could increase your risk for all types of dementia, particularly early-onset dementia, according to a new study. The study, published Tuesday in the journal Lancet Public Health, looked at over 1 million adults released from French hospitals between 2008 and 2013 who were diagnosed with dementia, a clinical syndrome characterized by a progressive deterioration in cognitive ability. (Lieber, 2/20)

The first treatment to help prevent serious allergic reactions to peanuts may be on the way. A company said Tuesday that its daily capsules of peanut powder helped children build tolerance in a major study. Millions of children are allergic to peanuts, and some may have life-threatening reactions if accidentally exposed to them. Doctors have been testing daily doses of peanut, contained in a capsule and sprinkled over food, as a way to prevent that by gradually getting them used to very small amounts. (2/20)

Responding to the federal repeal of the individual mandate requiring everyone to have health insurance, Maryland lawmakers are considering legislation that would impose the requirement at the state level. “We need to find some way to stabilize the individual insurance market. The premium increases we are facing are really high if we don’t,” said Sen. Brian J. Feldman, a Montgomery County Democrat and sponsor of the bill. (McDaniels, 2/20)

3M Co. will pay $850 million to settle Minnesota’s lawsuit, claiming the manufacturer contaminated water in the state for at least five decades. The deal reached by the company and state’s attorney general was announced hours after a trial over the suit was slated to begin Tuesday. (Tangel, 2/20)

When Nicole Herivaux was born at Coney Island Hospital in New York in 1980, doctors made a mistake that left one of her arms useless. Ms. Herivaux’s family sued and reached a settlement on the infant’s behalf. It provided $2,200-a-month in lifetime income paid out by an insurance firm, and lump sums of as much as $200,000 were sprinkled in to help, say, with college costs. (Scism, 2/21)

Inmates at the David Wade Correctional Center in Homer filed a federal class action lawsuit Tuesday (Feb. 20) against the Louisiana Department of Corrections and the prison, alleging they "are being held in extreme, abusive conditions." Lawyers from the Advocacy Center and the McArthur Justice Center are representing the prisoners in the suit, which was filed in U.S. District Court for the Middle District of Louisiana in Baton Rouge. (Nolan, 2/20)

The original proposal would have let advanced nurses work more independently in rural areas of Georgia. ...The Senate Health and Human Services Committee approved legislation relating to advanced practice registered nurses (APRNs), yet it was much narrower than what Sen. Renee Unterman, chair of the panel and the bill’s lead sponsor, had sought. (Miller, 2/20)

The rate of Minnesotans without health insurance surged last year to 6.3 percent, one of the largest one-time increases since 2001. There are now about 349,000 Minnesotans without health insurance coverage, according to a Minnesota Department of Health and University of Minnesota survey released Tuesday. Minnesota’s uninsured rate stood at 4.3 percent in 2015, the last year the study was conducted. There are now 116,000 fewer Minnesotans with health insurance than then, according to the study. (Nelson, 2/20)

A Missouri health care company on Tuesday said a pharmacy it recently bought won't provide execution drugs to the state, a pledge that came after media reports that the suburban St. Louis business had been the state's secret source of the drugs for years. (2/20)

Dr. John Noseworthy, president and CEO of Mayo Clinic, will retire at the end of the year, the organization announced Tuesday. Noseworthy has been with the Rochester, Minn.-based health system for 28 years, serving the past nine as president and CEO. The health system plans to identify a new chief executive by early fall. Noseworthy told Modern Healthcare that Mayo Clinic is committed to a rotational leadership tradition, with a new president or CEO coming in every seven to 10 years, and the time is right to transition to a new leader. "Mayo Clinic is in a very strong position," he said. "We have clarity and alignment on our future direction, and we have a cadre of proven Mayo Clinic physicians who are ready to lead." (Kacik, 2/20)

Mayo Clinic CEO Dr. John Noseworthy will step down at the end of this year after 28 years with the clinic, including nine as president and CEO. He has led Mayo through challenging times that included the Great Recession, skyrocketing health care costs, the Affordable Care Act and the launch of the ambitious economic development project known as the Destination Medical Center. (Moylan, 2/20)

CrescentCare's new comprehensive health center at 1631 Elysian Fields Ave. will combine four of its current service sites in New Orleans and add space for expanded dental, primary health and behavioral health services. The facility is expected to open in early 2019. The 65,000 sq. ft. facility includes 32 examination rooms, another eight for dental services as well as space for behavioral health therapy and psychiatric services. (Clark, 2/20)

A pediatric rheumatologist who once worked at Children’s Mercy Hospital is facing new charges in Michigan after losing his license over sexual misconduct allegations. Mark Franklin Hoeltzel, 46, was charged last month in a criminal complaint for receiving and possessing child pornography. He was arrested at Detroit Metro Airport last week after undergoing treatment for addiction at a clinic in Philadelphia. (Margolies, 2/20)

The Trump Administration has proposed replacing SNAP benefits with blue apron style food boxes, and calls for cutting food assistance for Iowans drastically in his proposed budget. During this hour of River to River, host Ben Kieffer talks with Ann Keimig of Des Moines about how the supplemental food and nutrition assistance program helped her as a young, single mother. (Moon and Kieffer, 2/20)

Following a quarter of strong sales, but diminished profit margins, Medtronic officials on Tuesday suggested one key to future growth is contracts that link payments for medical devices to good patient outcomes. Medtronic now has more than 1,000 hospitals operating under contracts for a certain combination of heart devices and “antibacterial envelopes” that lower payments to the medical device manufacturer depending on whether patients get infections, said Omar Ishrak, the Medtronic chief executive, during a Tuesday call with investors. (Snowbeck, 2/20)

Commercial sales of cannabis to recreational users began Jan. 1 in California. It hasn’t been even two months in this brave new world, but new questions about marijuana’s health impacts are already popping up. Is smoking cannabis bad for your health? (Ortega-Welch, 2/20)

A Maryland bill that would make the state a national test case for controlling prescription drug costs has garnered broad legislative support in Annapolis but could put the state on a legal collision course with the pharmaceutical industry. The proposal, introduced by Sen. Joan Carter Conway (D-Baltimore City) and Del. Joseline A. Peña-Melnyk (D-Prince George’s), would create a commission to decide the maximum amount that health plans, pharmacies and state programs could shell out for the most expensive brand-name and patented medications. The state has a similar rate-setting commission that determines how much hospitals can charge for their services. (Hicks, 2/16)

Angered by rising prescription drug prices, legislatures in two states — Utah and Vermont — this week advanced bills that would create programs to help residents purchase medicines from Canada. In Utah, a bill that was sponsored by a Republican lawmaker and received notable GOP backing passed the House and now goes to the Senate for approval. In Vermont, legislation passed a key Senate committee and will now be reviewed by other committees before going to the full Senate floor. (Silverman, 2/16)

Maine lawmakers are expected to consider a bill aimed at the high cost of prescription drugs. Democratic Sen. Eloise Vitelli's bill is set for a Tuesday work session, where a legislative panel could vote to support or kill the legislation. The bill as originally proposed would require more disclosure of the costs of drug production, research, development, marketing and advertising. The Attorney General's office would also be allowed to investigate violations of such provisions. (2/18)

As Washington’s interest in drug prices has spiked in recent years, a largely invisible industry has suddenly found itself in the spotlight. Pharmacy benefit managers, or PBMs, are the middlemen who stand between manufacturers and consumers in the nation’s drug business. And they’ve been blamed by pharma companies for being the real profiteers in the current pricing system. It seems at least some of that message is resonating with politicians. Last week the president’s council of economic advisers released a report on drug prices that raised alarms about PBM consolidation and called for policy changes to encourage competition. (Ross, 2/16)

Doctors and other health interests are sharpening their knives for another fight over the $26 billion Medicare program that pays for drugs administered in providers' offices — part of a broader, and so far fruitless, push against the high cost of medicines. A recent White House report on drug prices and President Donald Trump’s 2019 budget request augur a new attempt to overhaul Medicare Part B drug payments. (Pittman and Karlin-Smith, 2/19)

The treatment regimen for rabies was first developed in the late 1800s, and it hasn’t changed much over the last 100 years. But the price of survival has gone up rather dramatically — nearly 400% over the last decade for those shots. (Goodman and Miller, 2/20)

A trial under way in federal court in Philadelphia is testing the power of U.S. competition regulators to crack down on drugmakers’ alleged moves to thwart the sale of low-cost generics. The trial, which began Feb. 7, stems from a 2014 Federal Trade Commission lawsuit accusing AbbVie Inc. ABBV -0.52% of filing baseless patent-infringement lawsuits against two generic-drug companies to delay competition for its testosterone-replacement therapy AndroGel. AbbVie denies the allegations. (Loftus, 2/20)

The sticker shock for Horizon Pharma's Vimovo drug is magnified by the fact that the painkiller's two main ingredients can be purchased separately -- for just $36. Although patients typically pay just a fraction of the price for Vimovo, the dramatic price increase underlines what critics describe as a murky and wasteful system that ultimately leads to higher health care costs for all Americans. (Egan, 2/15)

The number of class-action lawsuits claiming securities fraud committed by life sciences companies climbed again last year, continuing a trend in which drug and device makers remain juicy targets for investors, according to a new analysis. A total of 88 class action securities lawsuits were filed against life sciences companies in 2017, a 31 percent rise from the 67 lawsuits filed the year before and a 225 percent increase from 27 such lawsuits filed in 2012, according to the Dechert law firm, which conducted the latest analysis. (Silverman, 2/15)

Merger mania has gripped health care. The generic drugs sector might have trouble joining the party. Generic drugmakers are being squeezed from both sides. Prices are falling because the companies that buy the drugs have consolidated, putting the relatively fragmented drugmakers at a disadvantage. And, the Food and Drug Administration has sped up approvals for new generic drugs, adding new competition to the market. (Grant, 2/21)

Bob Hugin helped build a pharmaceutical powerhouse. As he seeks to claim the seat of an embattled Democratic senator in New Jersey, that legacy could be both a blessing and a burden. Raised in Union City, a blue-collar town at the mouth of the Lincoln Tunnel, Hugin, 63, was the first member of his family to go to college. Princeton was followed by the Marine Corps and a successful stint on Wall Street. He left in the dot-com era to join what was then a small and, as Hugin tells it, near-bankrupt biotechnology firm. (Spalding, 2/20)

Hold on to your wallets — the growth in spending on prescription drugs is forecast to more than double this year. Spending will increase by 6.6 percent in 2018, compared with a 2.9 percent increase last year, according to new estimates released by the Centers for Medicare and Medicaid Services. In actual dollars, spending on medicines is projected to reach $360.2 billion, up from $338.1 billion. The expected increase is being attributed to several factors. (Silverman, 2/14)

The latest victory in a years-long hepatitis C patent battle between Gilead Sciences and Merck goes to Gilead. On Friday, a federal judge overturned a $2.54 billion verdict against the biotech on grounds that a key Merck patent used to support the infringement lawsuit is invalid. U.S. District Judge Leonard Stark in Delaware wrote that Merck's '597 patent is invalid, even after "taking all the evidence in the light most favorable to Idenix and drawing all reasonable inferences in favor of ldenix," a Merck subsidiary. (Sagonowsky, 2/20)

In a reversal of fortunes, a federal judge overturned a jury verdict ordering Gilead Sciences (GILD) to pay $2.54 billion to Merck (MRK) for infringing a patent in order to develop a pair of blockbuster hepatitis C treatments. In a 52-page opinion, U.S. District Court Judge Leonard Stark ruled late Friday that a Merck patent at issue was invalid, because the inventions did not meet a requirement for disclosing how to make and use the treatment it covered without undue experimentation. (Silverman, 2/17)

Two things happened after the FDA approved a novel new treatment for hereditary blindness in December, neither of which was surprising. First the company that makes the drug announced they would charge nearly a million dollars for it. Next, the uproar began. No one asked what the costs research and regulation were, but it didn't matter: No matter what, the price was going to be too high. (Former Sen. Tom Coburn, 2/15)

One of the few policy priorities that Democrats share with President Trump is reducing prescription drug prices. At his recent State of the Union address, Trump said he wants his administration “to make fixing the injustice of high drug prices one of our top priorities.” Health and Human Services (HHS) is taking up Trump's call by fixing an existing prescription drug discount program known as 340B to benefit patients. (Terry Wilcox, 2/16)

A tidal wave of cash due from the repatriation of overseas reserves as a result of tax reform threatens to exacerbate pharma’s already serious excess money problem. The country expects companies to use those profits to make more drugs, not indulge a flurry of share buybacks (Pfizer already has two in the works). Yet, for all its success, pharma doesn’t know how to profitably invest in drug discovery. The industry is in the grip of an innovation crisis. While 2017 set records with 51 new drugs approved, taken together with 2016’s 22, they barely exceed the industry average of 36 for the past 40 years. (Standish Fleming, 2/15)

It will be the moment of truth for the expensive new cholesterol drugs known as PCSK9 inhibitors. Next month we will learn much more about the PCSK9 inhibitor class of cholesterol drugs. A lot of the remaining uncertainty about the efficacy— or lack of efficacy— of these drugs will be resolved when a large cardiovascular outcomes trial (CVOT), the ODYSSEY Outcomes trial, is presented in Orlando, Florida at the annual meeting of the American College of Cardiology on March 10. (Larry Husten, 2/15)

Investors love it when a company's value booms, but they may not always love the consequences. Take San Francisco biotech Nektar Therapeutics. Its market cap soared to $14 billion earlier this month, from about $2 billion a year ago, driven partly by tantalizing early trial results for a combination of its lead medicine with Bristol-Myers Squibb & Co.'s blockbuster cancer drug Opdivo. Bloomberg News reported on Feb. 2 that Nektar was exploring options, "including a sale." But its swollen valuation made a takeover less likely. Instead, Bristol on Wednesday announced a deal to pay as much as $3.6 billion for a stake in Nektar's medicine.  (Max Nisen, 2/14)

Americans are suffering pharmaceutical sticker shock. But the remedy Democrats are backing -- price controls on prescription drugs -- would inflict more harm by halting new discoveries and dooming patients waiting for cures. Since 1950, our increasing longevity -- an amazing 10 extra years of life for the average American -- has been mainly the result of pharmaceutical breakthroughs. If someone in your family has an incurable illness -- cystic fibrosis, multiple sclerosis, Alzheimer’s -- the idea of slowing the pace of new cures is unthinkable. (McCaughey, 2/15)

Roche's recently announced acquisition of the oncology data company Flatiron Health for $2.1 billion represents a robust validation of the much-discussed but infrequently realized hypothesis that technology entrepreneurs who can turn health data into actionable insights can capture significant value for this accomplishment. (David Shaywitz, 2/18)

Obama Care survived a GOP repeal attempt but the law’s prognosis remains poor—higher premiums and insurer flight. Some Republicans would be happy to dump money into the exchanges and move on, so credit the Trump Administration for a proposal that puts consumer choice ahead of politics. On Tuesday the Health and Human Services Department proposed a rule for short-term, limited duration health insurance as an alternative to the ObamaCare exchanges. Insurers would have to make clear that the plans, which could last for less than 12 months, would be liberated from the Affordable Care Act’s benefit and other mandates. (2/20)

It’s another day and the Trump administration is trying to stick another knife in the Affordable Care Act. This time it comes courtesy of a proposed expansion in the length of time a household can receive a lower cost, short-term health-coverage plan that does not meet the Affordable Health Care’s standards for insurance. Under the new proposal, households can purchase the more limited plan for a year — up from three months. (Helaine Olen, 2/20)

Despite the Trump administration's best efforts to undermine and bad-mouth Obamacare, it is not collapsing, as the president often claims. The state exchanges where insurers sell policies to Americans who don't get health benefits at work are stabilizing, and enrollment remained about the same last year even after administration actions drove up premiums, slashed marketing efforts and shortened the sign-up period. Yet the White House and congressional Republicans are undaunted, and their efforts to lay waste to Obamacare are continuing. They've taken a series of steps in recent months aimed at helping healthier people cut their spending on insurance. But in each case, their approach would rob Peter to save some bucks for Paul, shifting costs from the healthy onto those who need comprehensive health coverage. (2/21)

The CEOs of Amazon, Berkshire Hathaway and JPMorgan Chase certainly got America’s attention with their recent announcement of a joint health care initiative. Their immediate goal is to lower the costs over covering the 1.2 million people they collectively employ. But Wall Street quickly concluded that their creation — whatever it turns out to be — could resonate beyond their companies. The stocks of major health insurers and benefit managers sold off. And pundits started speculating on how BBD (Jeff Bezos, Warren Buffett and Jamie Dimon, three of the brightest minds in American business) might create a giant HMO or find new ways to mine health data to enable early interventions. (2/20)

The Amazon-Berkshire Hathaway-JPMorgan Chase initiative to provide health coverage a new way — details to follow — has justifiably generated excitement. But far from being feared, “disruption” is welcomed by individual and employer purchasers of health services as a spur to innovation. More puzzling is the assertion that this development suggests that the long-term play should be de-linking employers from health coverage. That would be a serious setback for 178 million Americans covered by employer plans. This system is made possible by enlightened, bipartisan policy promoting employer-provided coverage. (James A. Klein, 2/20)

Matters that seem arcane are often vitally important, because they can be worth tens of billions of dollars. Such is the case with “risk adjustment” in health care. Medical spending is not spread evenly across all people in society. Half the population uses hardly any care in a given year—only 3% of total spending. Conversely, 10% of Americans consume about two-thirds of all health-care spending. (Ezekiel J. Emanuel and Bob Kocher, 2/20)

A few years ago, the police brought a 21-year-old man into the crisis unit where I work as an emergency psychiatrist. His parents had called the police after seeing postings on his Facebook page that praised the Columbine shooters, referred to imminent death and destruction at his community college and promised his own “Day of Retribution.” His brother reported to the police that he had recently purchased a gun. (Amy Barnhorst, 2/20)

The benefits of this product to Facebook are clear. Instilling brand loyalty in young users is a way to ensure that they continue to use the social network as teenagers and adults. ... What's also clear is how bad the app could be for children. A growing body of research shows that excessive use of digital devices and social media is harmful to children and teens. Time spent on social media has been linked to adolescent depression and dissatisfaction with appearance, family and life in general. Teens who spend six to nine hours a week on social media are more likely to report being unhappy than kids who spend less time on social media, while kids who spend more time with friends in person are more likely to report being happy. For pre-teen girls in particular, time on social media is linked with idealizing thinness and discontent with their own bodies. (Susan Linn, 2/21)

For most of the past 20 years, prescription opioid abuse was treated like the weather: Everyone complained about it but no one ever did anything about it. As a result, it exploded into a national epidemic that killed 17,000 Americans in 2016. Add to that about 35,000 overdose deaths from heroin and synthetic opioids — often used by addicts when they can’t get prescription drugs any more — and you’re approaching a Vietnam War death toll every year. Public awareness and outrage are starting to change things. In that regard, a Senate Homeland Security Committee investigation led by Sen. Claire McCaskill, D-Mo., has been helpful, even though most of Congress hasn’t been. The committee’s latest report, released Feb. 12, detailed how opioid manufacturers spent almost $9 million between 2012 and 2017 supporting pain treatment advocacy groups that promoted use of the manufacturers’ products. (2/20)

A budget proposal from President Trump calls for replacing part of federal food stamp spending with boxes of groceries to be delivered directly to participants in the Supplemental Nutrition Assistance Program. The so-called U.S. Harvest Boxes would include canned and dried food like vegetables and pasta and items like shelf-stable milk; about half of the individual food stamp allocation — roughly $125 a month — would be cut in favor of the delivered food. The idea for what should be called the U.S. Heartless Boxes is so ludicrous that it seems designed to be a distraction rather than an actual proposal. Given the initial outcry, it’s unlikely to gain much traction. It’s still worth pointing out just how wrong the idea is. (2/21)

Senate Study Bill 3143 would ban abortions after the detection of a heartbeat. Any doctor who provides one after that point could be charged with a felony punishable by up to five years in prison. The heart and other organs of a fetus generally start to form about the sixth week of pregnancy, according to the Mayo Clinic. This could be before a fetus has lower limbs, a nose or retinas. It is also about the same time a woman realizes she missed a period and discovers she is pregnant. But the goal of lawmakers is, once again, to ban as many abortions as they can. And they never fail to concoct a sketchy rationale to accomplish that goal. (2/20)

By now, you’ve likely heard that breast-feeding is good. Women hear the mantra “breast is best” practically from the moment they conceive — both the World Health Organization and the American Academy of Pediatrics recommend exclusively breast-feeding babies for six months. With this kind of endorsement, which any nursing mother will tell you requires a mammoth commitment, you would think we know everything there is to know about the practice.In reality, we don’t. We aren’t even close. (Allison Yarrow, 2/21)