�Թϲ�����

Senate Republicans raced Tuesday to bridge divisions over rickety insurance markets and billions of dollars in insurance subsidies in their pursuit of a health-care deal. While President Donald Trump predicted a deal would emerge, hard work remained behind the scenes. (Peterson, Radnofsky and Armour, 6/13)

President Donald Trump told Republican senators Tuesday that the House-passed health care bill he helped revive is "mean" and urged them to craft a version that is "more generous," congressional sources said. Trump's remarks were a surprising slap at a Republican-written House measure that was shepherded by Speaker Paul Ryan, R-Wis., and whose passage the president lobbied for and praised. At a Rose Garden ceremony minutes after the bill's narrow House passage on May 4, Trump called it "a great plan." (Fram, 6/13)

During the portion of the lunch open to reporters, Trump told the lawmakers their healthcare bill would need to be "generous" and "kind." "That may be adding additional money into it," he said, without offering details on how much money might be needed or how it might be used. (Cornwell and Roscoe, 6/13)

Trump’s labeling of the House bill as “mean” was a significant shift of tone that followed months of private and public negotiations, during which he called the bill “great” and urged GOP lawmakers to vote for it. Following the House vote, Trump hosted an event in the Rose Garden to celebrate its passage. Senate Republican Conference Chairman John Thune (R-S.D.), who attended the lunch, said Trump talked about “making sure that we have a bill that protects people with preexisting conditions” and how to design a tax credit for purchasing insurance that works for lower-income and elderly people in particular. (Snell and Sullivan, 6/13)

Democrats and some moderate Republicans have attacked the House bill for eliminating a requirement that insurers cover people with pre-existing conditions and for rolling back the Obamacare expansion of Medicaid to cover millions of poor people. The Congressional Budget Office has estimated that the House bill will result in 23 million more people being uninsured by 2026. (Collins, 6/13)

The president also said Republicans risk getting savaged in the 2018 midterms if they fail to repeal Obamacare after a seven-year campaign against the law. But he made clear that the Senate needs to pass a bill that Republicans are able to more easily defend and is not viewed as an attack on Americans from low-income households, as the House bill has been portrayed by critics, the sources said. He also advocated more robust tax credits for people who buy insurance on the individual market, a move that would increase the bill’s cost. (Everett, Haberkorn and Dawsey, 6/13)

It is unclear what effect Trump's comments about the House bill might have. Senate Republicans were already planning to make the bill more generous, for example by increasing tax credits for low-income people. (Sullivan, 6/13)

Trump said before the lunch that he wants senators to pass a health care overhaul "as soon as we can do it." The president praised Republican senators for “working very, very hard” to reach consensus on a version of a health bill to repeal and replace the 2010 health law. Without getting into policy specifics, Trump predicted the Senate eventually will pass a “phenomenal bill” that will feature a “great health care plan” that will be "far better” than the Obama-era law. (Young and Bennett, 6/13)

President Donald Trump used a visit Tuesday to southeastern Wisconsin to hint a major manufacturer could be coming to the state and declare the Affordable Care Act a catastrophe that must be reversed... On a whirlwind trip, Trump talked health care at Mitchell International Airport, touted apprenticeships at WCTC and returned to Milwaukee to raise campaign cash for Walker. (Marley, Glauber and Liu, 6/13)

About 13 million people will lose health insurance in the next 10 years if the House-passed Affordable Care Act replacement plan is enacted, according to a new report out Tuesday from the Centers for Medicare and Medicaid Services' office of the actuary. The estimate, while hardly rosy, is still about 10 million fewer people than the Congressional Budget Office (CBO) estimated would lose coverage under the American Health Care Act (AHCA), now being considered by the Senate. (O'Donnell, 6/13)

The coverage estimate is well below the 23 million more uninsured that the CBO has projected under the American Health Care Act. The congressional scorekeeper additionally estimated that the American Health Care Act would reduce spending by only $119 billion over a decade. The disparity is a result of differing assumptions about whether cost-saving measures in the House bill will work. The CMS actuary and CBO have disagreed in the past on the budgetary effects of legislation, including surrounding the enactment of Obamacare. The new actuary's analysis does not estimate the effects of taxes repealed. (Demko, 6/13)

The CMS actuary's report projected that the AHCA, narrowly passed by House Republicans last month with no Democratic votes, would reduce federal Medicaid spending by $383.2 billion from 2017 through 2026. The spending reductions would stem mainly from repealing the Affordable Care Act's Medicaid expansion to low-income adults. That's far less than the $834 billion in Medicaid cuts projected by the CBO. (Meyer, 6/13)

The actuary noted, however, that allowing states to waive out of some ObamaCare regulations could lead to a "deteriorating or possibly failing individual market," which is similar to a conclusion made in the CBO report. "If such actions were implemented, we would expect that the individual market in these areas would destabilize such that premiums for comprehensive coverage for a significant proportion of the population would become unaffordable and the coverage would cease to be offered," the actuary wrote. (Hellmann, 6/13)

CMS also said in its analysis that the average gross premiums in the individual insurance market would be roughly 13 percent lower by 2026 under the House-passed bill than under current law. But that estimate may provide little comfort for consumers who are wondering what would happen to their insurance costs under the GOP bill. The average net premiums, which are what’s left after federal and state subsidies weighted, would be roughly 5 percent higher than under the current law. (Young, 6/13)

Tennessee stands to lose more than 28,000 jobs by 2026 under the GOP's health care reform bill, which would reduce the health care workforce in the state and nationally, per a new study. In the short term, the tax repeal under the American Health Care Act would add 864,000 jobs nationally, but the gains would be stripped away in subsequent years as changes to coverage and cuts to Medicaid funding took effect, according to a study from The Commonwealth Fund and the George Washington University Milken Institute of Public Health. (Fletcher, 6/13)

The Republican attempt to reshape the nation’s health-care system has grown increasingly dependent this week on the fragile alliance between Senate GOP leaders and a man they have clashed bitterly with for years: Sen. Ted Cruz (R-Tex.). Senate leaders are struggling to build conservative support for their emerging bill, with GOP aides and senators voicing growing skepticism that hard-right Sens. Rand Paul (R-Ky.) and Mike Lee (R-Utah) can be persuaded to back it. Conservative organizations, meanwhile, are complaining that Majority Leader Mitch McConnell (R-Ky.) is offering proposals that would not sufficiently dismantle the law known as Obamacare. (Sullivan and Snell, 6/13)

A Republican congressman who helped shepherd the party’s health-care overhaul bill through the House last month predicted Tuesday that a final bill will pass the Senate and land on the president’s desk before August. House Energy and Commerce Chairman Greg Walden’s estimate, described at The Wall Street Journal’s CFO Network meeting in Washington, suggests he is optimistic that Senate leaders will be able to meet a self-imposed July 4 deadline for passing their health legislation. (Hackman, 6/13)

Senate Democrats are introducing legislation that would ban Republicans from bringing up their ObamaCare repeal and replace bill without holding a hearing on the bill. The legislation, known as the "No Hearing, No Vote Act," would require a bill being passed under reconciliation — the fast-track process being used to repeal and replace ObamaCare — to be voted on by at least one committee and have had at least one hearing. (Carney, 6/13)

Senate Democrats on Tuesday assailed Republican leaders' closed-door efforts to craft legislation to overhaul the U.S. health care system, calling it “legislative malpractice” and using Republican leaders’ own statements from years past to make their point. While GOP members routinely criticize the manner in which Democrats passed the 2010 health law on a strictly party-line vote, there are stark differences between that process and the current one. (Williams, 6/13)

Debates over press freedom and secret deliberations of healthcare legislation roiled the US Senate Tuesday, indicating signs of strain about public scrutiny within a bastion of American democracy. Republicans who control the Senate Rules Committee abruptly banned TV reporters from conducting videotaped interviews and filming in Capitol corridors without advanced permission — then, after an outcry, appeared to quickly back down. (Herndon and McGrane, 6/13)

Reporters complained on Tuesday that they were no longer allowed to interview senators in the Capitol without prior approval of the Senate Rules Committee. ... Members of Congress who don’t wish to participate are free to continue walking or turn down interview requests. (Welsh, 6/13)

The Obamacare insurance markets aren’t as shaky as President Trump seems to believe. On Tuesday, the insurer Centene announced plans to expand aggressively into the state marketplaces established under the Affordable Care Act. Centene said it intended to sell individual policies for the first time in Nevada, Missouri and Kansas, and to grow its presence in six other states, including Ohio and Florida. (Sanger-Katz and Abelson, 6/13)

This growth spurt could fill some big holes that have developed in the exchanges, the only place where people can buy individual coverage with help from an income-based tax credit. Currently, 25 counties in Missouri, 20 in Ohio and another two in Washington have no insurers lined up to sell coverage on the exchange in 2018. (Murphy, 6/13)

Mr. Neidorff said that Centene’s expansion reflects that “we do very well in the exchanges; it’s been a good business segment for us.” Despite the lack of clarity around the future of the ACA, as Republicans in Congress work to pass a health-care bill, Mr. Neidorff said Centene is making its calls based on the information it has now, rather than the possible changes to come. “We think we have the agility to deal with the various regulatory environments,” he said. “We tend to make decisions around the facts that are known at that point in time.” (Wilde Mathews, 6/13)

It's a notable move because other insurers have announced they may not participate in 2018, citing uncertainty in the marketplaces that they say has been ginned up by the Trump administration. (Hellmann, 6/13)

Centene is quitting the ACA market in Massachusetts, where it had relatively low enrollment. (Tracer, 6/13)

Three weeks after Blue Cross and Blue Shield of Kansas City said it will pull out of the Affordable Care Act exchange in 2018, Centene Corp. says it plans to offer coverage through the exchange in Missouri and Kansas. The St. Louis-based insurer already has a presence in both states administering Medicaid plans, but the move to sell individual and small group health plans is new. (Margolies, 6/13)

Aetna has agreed to participate in the state's exchange in order to better the company's chances of winning a contract to offer Medicaid policies there, CNN Money reported Tuesday. In August, Aetna announced that it would significantly scale back its participation in the ObamaCare markets to just four states, down from 15 the year before. Nevada was one of the state exchanges that Aetna announced it would depart. In a statement Tuesday, Aetna wouldn't commit fully to offering plans next year. (Bowden, 6/13)

Anthem Inc.’s business is swirling with uncertainty as Congress debates new health-care legislation. That means tough choices are looming for the insurer’s chief executive, Joseph R. Swedish. One of those difficult decisions was revealed last week, when Anthem said it will withdraw from the Ohio insurance marketplace in 2018. Anthem’s departure leaves 18 Ohio counties poised to have no plans available through the marketplace next year. (Wilde Mathews, 6/13)

Next year, dozens of counties across the country could be left with no insurance companies offering insurance in the Affordable Care Act marketplaces. Nationwide, that leaves 35 thousand marketplace enrollees living in a county with no affordable way to purchase insurance (As it stands, people who receive subsidies can only use them to purchase coverage in the marketplace.), and 2.4 million would be left with just one insurer’s plan to choose from. That’s out of 12.2 million enrollees total. (Soffen and Uhrmacher, 6/14)

An AP Fact Check finds that the Trump administration is being selective with its information when it argues Obamacare is in a "death spiral." Vice President Mike Pence made that case Tuesday in remarks to federal employees. He correctly cited statistics showing 10.3 million people are enrolled in subsidized health insurance markets, far fewer than the 23 million projected for 2017. But he left out the fact that the law's Medicaid expansion is covering an estimated 12 million people. (Alonso-Zaldivar, 6/14)

Members of the White House cabinet took turns praising President Trump at a gathering on Monday, adopting the commander in chief’s evaluations of himself. Their mimicry was not limited to a day of flattery; several have also adopted Mr. Trump’s rhetorical style of doubling down on false claims and pushing so-called alternative facts. At least four Trump administration cabinet secretaries have defended austere budget cuts and policy shifts at their departments with misleading statements in congressional testimony and other official settings. Here’s an assessment. (Qiu, 6/13)

The District has one of the highest rates of health-insured children, with 98 percent covered, according to the latest Kids Count annual survey released Tuesday by the Annie E. Casey Foundation. Coverage rates nationwide also reached a new high, with 95 percent of children insured in 2015, the report stated. (Chandler, 6/13)

A report released Tuesday ranks Georgia 42nd in overall child well-being for the second year in a row. The annual Kids Count report from the Annie E. Casey Foundation compared state data from 2010 to 2015 based on four factors: children’s economic well-being, education, health, and family and community. (Hensley, 6/13)

Florida has made significant improvements in providing for its children, a recent study shows. But the annual Kids Count study by the Annie E. Casey Foundation says Florida is still well below average compared to other states. (Ochoa, 6/13)

Despite a decrease in the number of uninsured kids in Florida, the state ranked 40th in overall child well-being — the same as last year and down from 37th in 2015, according to a report released Tuesday. The ranking is based on data from four categories — economic well-being, education, health and family and community — compiled by Kids Count, a project of the Annie E. Casey Foundation. (Kumar, 6/13)

Virginia has inched up in an annual childhood health rankings report — from 11th to 10th — but advocates say there still is significant room for improvement. In 11 out of 16 categories that the Annie E. Casey Foundation used to compile its 2017 Kids Count Profile, Virginia performed better than it did in 2010. (O'Connor, 6/13)

Congress approved long-sought legislation Tuesday to make firing employees easier for the Department of Veterans Affairs, part of an effort urged by President Donald Trump to fix a struggling agency serving millions of veterans. The House cleared the bill, 368-55, replacing an earlier version that Democrats had criticized as overly unfair to workers. The Senate passed the bipartisan legislation by voice vote last week. It will go to Trump later this week for his signature. (Yen, 6/13)

The act, which won bipartisan support and endorsements from veterans’ groups, is the latest attempt by Capitol Hill to respond to the 2014 VA scandals involving long wait times for medical care and attempts by VA employees to cover up the delays. (Rosenblatt, 6/13)

The best medicine for a person who goes into sudden cardiac arrest is an electric shock. That jolt temporarily stops the heart, along with its rapid or erratic beat. When the heart starts itself up again, it can revert to its normal rhythm and resume pumping blood to the brain and the rest of the body. The sooner this happens, the better. When a patient is shocked within one minute of collapse, the chance of survival is nearly 90%. But if it takes 10 minutes to administer a shock, the odds or survival fall below 5%. (Kaplan, 6/13)

More than 350,000 cardiac arrests happen across the U.S. in places other than hospitals each year, according to the American Heart Association — and a person's chance of surviving is about 1 in 10. Drone-delivered AEDs beat ambulance trip times to the scenes of cardiac arrests, the researchers say in a letter published Tuesday in the Journal of the American Medical Association. (Columbus, 6/13)

In fact, in some cases, drones could carry defibrillators to heart attack victims faster than an ambulance, according to a paper published Tuesday in the Journal of the American Medical Association. Researchers simulated emergency situations and found they could get automatic external defibrillators to the scene an average of 16 minutes faster by drone than by ambulance. If bystanders were willing and able to use the devices, the shorter response time could save lives, said lead author Andreas Claesson, a registered nurse. Restrictions on drones have limited their use in medicine. But that’s starting to change, Claesson said. “We’re getting there — showing this save lives and costs,” he added. (Blau, 6/13)

Former Apple CEO John Sculley, who had a famously hot-and-cold relationship with Apple founder Steve Jobs, says the next multibillion-dollar opportunity to change the world is in digital health care. Sculley has surfaced as chief marketing officer at the Southborough, Mass., startup RxAdvance, a cloud-based software company where he is working with founder and CEO Ravi Ika to disrupt the giant industry of managing pharmacy benefits. (Scully, 6/13)

Attendees at the American Diabetes Association’s Scientific Sessions in San Diego this year — many of them young researchers who are active on social media — were surprised to be greeted with the following: “Thanks for joining us at #2017ADA! Photography isn’t allowed during presentations — we’d appreciate it if you’d delete this tweet.” For many, the essence of gathering at conferences is the sharing of scientific information, a peek at interesting research in progress. (Kopp, 6/13)

State and local leaders fighting a worsening opioid-abuse epidemic are studying tactics used in the tobacco lawsuits of the 1990s, as they try to claw back billions from the companies who make and sell the powerful painkillers. More than 20 U.S. states, counties and cities have sued firms including Johnson & Johnson, Purdue Pharma Inc., and McKesson Corp. in the past year, claiming they fueled a public-health crisis with misleading marketing and aggressive distribution of opioids. Attorneys general in Alaska and Tennessee are also considering lawsuits as their health and legal budgets are stretched to a breaking point by the surge in addictions, overdoses and crime. (Feeley and Lauerman, 6/14)

A new lawsuit invokes the plight of a baby born dependent on opioid drugs, as three Tennessee prosecutors and the baby's guardian accuse several drug manufacturers of unleashing an epidemic through deceptive marketing about the risks of addiction to painkillers. "Baby Doe spent his first days in the neonatal intensive care unit writhing in agony as he went through detoxification," according to the suit filed Tuesday in the Sullivan County Circuit Court in Kingsport, Tennessee. The infant boy, who is not identified, was born in March of 2015. (Burke, 6/13)

In an unprecedented move, three Tennessee prosecutors are taking aim at drugmakers who supplied the opiates that addicted millions, using the state’s long-ridiculed and rarely used “crack tax” law. The district attorneys general for three east Tennessee judicial districts collectively representing nine counties filed a lawsuit Tuesday in Sullivan County Circuit Court against opioid drugmakers Purdue Pharma, Mallinckrodt and Endo Pharmaceuticals. (Satterfield, 6/13)

The right to medical privacy is enshrined in the Health Insurance Portability and Accountability Act (HIPAA) and a host of other confidentiality rules. But a White House-appointed panel is now considering whether to recommend that those privacy regulations be relaxed in a bid to help contain the country’s rising tide of opioid overdoses. New Jersey Gov. Chris Christie, who is leading President Trump’s opioid task force, this week told reporters the panel is discussing ways to ensure family members know when a person is revived with naloxone following an overdose. The goal would be to ensure that, after a near-death experience, those struggling with addiction have a support system to help steer them toward treatment. (Mershon and Joseph, 6/13)

The Food and Drug Administration is ramping up scrutiny of anti-abuse features on opioid painkillers to try to determine if they actually do what they're intended to do. On Tuesday, the agency announced a two-day public meeting that will focus on whether the agency has “the right information to determine whether these products are having their intended impact on limiting abuse and helping to curb the epidemic,” according to an accompanying statement by FDA Commissioner Scott Gottlieb. (McGinley, 6/13)

Endo International Plc is working with the U.S. Food and Drug Administration to address the agency’s unprecedented request that it pull the powerful opioid pain medication Opana ER off the market because of potential abuse, Chief Executive Officer Paul Campanelli said. The FDA asked Endo to stop selling the drug last week, the first time the agency made such a move amid what it calls a public-health crisis. The agency is trying to contain an outbreak of dangerous infections by addicts who abuse drugs like Opana ER that are approved for legitimate pain relief. (Cortez, 6/13)

Former heroin user Kendra Williams, 24, knows she’s lucky. She recalls sharing dirty syringes to shoot up, risking hepatitis C and HIV. More than two years into recovery, she knows about 30 people who have died from drug overdoses — this year. Over the past five, she guesses, it’s close to 50. Against that grim backdrop, Williams has joined an unlikely coalition — composed of public health advocates, former addicts and the law enforcement officers who used to harass and arrest them — bent on battling sky-high rates of opioid abuse. With the goal of curbing the spread of disease and preventing overdose, the North Carolina Harm Reduction Coalition (NCHRC) has helped legalize needle exchanges, enabled safe disposal of used syringes and enacted protections for people who carry drug paraphernalia. (Luthra, 6/14)

Gov. Doug Ducey issued an executive order Tuesday seeking to bolster reporting of data on suspected opioid deaths and overdoses across the state. The sweeping executive order requires all licensed doctors, pharmacists, hospitals, correctional facilities, emergency medical responders, ambulance providers and medical examiners to report within 24 hours information on suspected deaths, overdoses and use of the overdose-reversal drug naloxone. (Alltucker, 6/13)

Under the latest changes to the new two-year state budget, which takes effect July 1, $176 million would go to battle drug addiction that killed at least 4,149 Ohioans last year... But that Senate plan includes the transfer of about $35 million over two years out of the state local government fund, which city officials use for basic operations as well as new costs incurred by the startling rise of drug overdoses. (Siegel, 6/14)

Inmates at the Strafford County Jail will no longer be able to receive personal letters in the mail. The policy change comes just days after multiple inmates overdosed inside the jail. (Moon, 6/13)

The campaign’s message: “When it comes to postpartum depression, silence sucks.” It features close-up photos of distressed, tearful women who can’t speak — because they have pacifiers stuck in their mouths. The images have been plastered on bus stops, buses, conference booths, and on a dedicated website. The ads don’t specifically mention Sage’s drug, which still needs further testing before the company can bring it to the Food and Drug Administration for possible approval. Instead, they urge women to talk “openly and honestly” about postpartum depression.  An estimated 600,000 women in the U.S. alone experience symptoms, which range from insomnia and irritability to difficulty bonding with their baby. (Thielking, 6/14)

Researchers are working to revive a radical treatment for Parkinson's disease. The treatment involves transplanting healthy brain cells to replace cells killed off by the disease. It's an approach that was tried decades ago and then set aside after disappointing results. Now, groups in Europe, the U.S. and Asia are preparing to try again, using cells they believe are safer and more effective. (Hamilton, 6/13)

After decades of lawsuits, public campaigns and painful struggles, Americans have finally done what once seemed impossible: Most of the country has quit smoking, saving millions of lives and leading to massive reductions in cancer. That is, unless those Americans are poor, uneducated or live in a rural area. (Wan, 6/13)

An industry-funded study led by a Kansas City doctor found that a new type of long-acting insulin reduced hypoglycemic diabetic emergencies by 40 percent in people with Type 2 diabetes. Hypoglycemia, also known as low blood sugar, can cause seizures and loss of consciousness in severe cases. (Marso, 6/13)

Airport noise could raise the risk for high blood pressure, a new study suggests. Greek researchers studied 420 people living near Athens International Airport, where an average of 600 airplanes take off and land every day. Maps made during construction of the airport divided the surrounding area by noise level: less than 50 decibels, 50 to 60 decibels (60 decibels is about the noise level of a room air-conditioner), and more than 60 decibels, so researchers could track noise exposure precisely. (Bakalar, 6/13)

For Gearoid Mannion and his wife, Michelle, who live in County Clare, Ireland, air travel with their two autistic sons, Conor, 9, and Darragh, 7, is usually nothing short of a nightmare. The noise level, crowds and announcements at airports overwhelm the boys, and waiting in security and boarding lines is a concept that they don’t understand, Mr. Mannion said. “They get red in the face and start running around and crying and screaming or run toward the exit, because they want to go back home,” he said. The family’s recent experience at Shannon Airport in Ireland, when they were en route to a vacation in Málaga, Spain, however, gave them hope that flying didn’t have to be so stressful. (Vora, 6/13)

Public water systems for towns and cities that provide about 80 percent of the supply and are tested regularly. But there are only minimal requirements for private well owners to monitor the safety of their own drinking water. (Steil, 6/14)

The vast majority of Colorado schoolkids are receiving the recommended immunizations, but the state Health Department on Tuesday released a new tool to help parents look more locally. The department collected vaccination data for more than 850,000 kids in 1,801 schools during the 2016-17 school year. The research found that 93.4 percent of students were up-to-date on their recommended immunizations. Only 2.6 percent of students’ parents or guardians had claimed an exemption from vaccinations, the large majority of those falling under the “personal exemption” heading. Exemptions for religious or medical reasons each made up less than 10 percent of the total exemptions. (Ingold, 6/13)

California Atty. Gen. Xavier Becerra said Tuesday that he supports a proposal for California to adopt a single-payer health plan and believes it will eventually be enacted because consumers will become “fed up” with the current system that he said is unaffordable to many. The state Senate approved a bill two weeks ago that would create a system where the state government would replace private insurance companies, paying doctors and hospitals for healthcare. The measure, pending in the Assembly, does not yet include a way to cover the $400-billion annual cost. (McGreevy, 6/13)

A panel of Missouri senators on Tuesday advanced legislation to create new abortion regulations — including annual inspections of clinics — requested by Republican Gov. Eric Greitens in his call for a special session focused solely on abortion laws. Members of the Senate Committee on Seniors, Families and Children voted 4-2 along party lines in favor of a package of proposals that would place new restrictions on abortion clinics. (6/13)

Health-care technology startup Xealth has reeled in $8.5 million in funding, just months after it spun out of Providence Health & Services. The Seattle company aims to help doctors easily deliver digital services to patients. Xealth is led by Mike McSherry, co-founder of fast-texting keyboard app Swype. After Swype was acquired by Nuance Communications for $102.5 million in 2011, McSherry joined the buyer for a couple years before leaving and eventually joining Providence Health & Services as an entrepreneur-in-residence. (Lerman, 6/14)

The Cleveland Clinic has received a $6 million grant from the National Institutes of Health to create a national research consortium to investigate the causes underlying Dementia with Lewy Bodies (DLB). The new consortium will serve as a national registry for data on the disease, and a place for centralized research efforts, the Clinic said in a written statement released Tuesday. (Washington, 6/13)

Last year, a national survey of water utilities estimated that Georgia could have as many 86,000 lead service lines. Even state regulators charged with protecting the public from high levels of lead in water don’t know where they are. (Miller, 6/13)

The KU center is one of 31 nationally designated Alzheimer’s centers and has about 25 active clinical trials on prevention and treatment underway...And to obtain that proof, the center needs volunteers – lots of them. To be precise, about 650 over the next three years. And it’s mainly looking for people without symptoms – in other words, people who wouldn’t necessarily be as inclined as Terrie Huntington to sign up. (Margolies, 6/14)

A cancer scientist has spent much of the past three years in court arguing to preserve research she oversaw at St. Elizabeth’s Medical Center in Brighton, and blaming Steward Health Care System for triggering a series of events that led to the destruction of her laboratory. (Dayal McCluskey, 6/14)

In an 11-hour operation, surgeons at Children’s Hospital of Philadelphia last week separated 10-month-old twin girls who were joined at the top of their heads, the rarest type of conjoined twins, the hospital disclosed Tuesday. The separation and reconstructive operations on Erin and Abby Delaney of North Carolina followed months of imaging studies and planning by a large team from Children’s. The hospital says it had separated 22 other sets of conjoined twins over the last 60 years, but never siblings joined at the head. (McCullough, 6/13)

In a sweeping rewrite of the voter-passed marijuana legalization measure, House leaders will advance a bill Wednesday that would more than double the total tax on recreational pot and give municipal officials — instead of local voters — the power to ban cannabis shops and farms. The legislation immediately faced blowback from advocates, who said “it insults voters,” and from elected officials, who said the bill would ensure that the illicit market would continue. (Miller, 6/13)

The recreational marijuana debate is tabled for now, but 18,000 Connecticut residents are using the drug to help with specific debilitating medical conditions. Medical marijuana was legalized in May of 2012 and put into practice in September of 2014. (Beaudoin, 6/14)

Over the past several months, drug makers have been particularly vocal in blaming pharmacy benefit managers — the middlemen who negotiate favorable insurance coverage for medicines — for rising prices. PBMs and insurers, in turn, blame drug makers. The truth lies somewhere in between, according to Linda Cahn, a consultant who advises health plans and employers on PBM contract negotiations. However, she does fault PBMs for a lack of transparency and certain contracting practices. So we asked her to briefly explain some of these issues. This is an edited version. (Silverman, 6/13)

The ads have been popping up on billboards, buses and subways and in glossy magazines, with portraits of attractive men and women and a simple question in bold letters: What is Vivitrol? Five years ago, Vivitrol was a treatment for opioid addiction that was struggling to find a market. Now, its sales and profile are rising fast, thanks to its manufacturers’ shrewd use of political connections, and despite scant science to prove the drug’s efficacy. (Goodnough and Zernike, 6/11)

Two years ago, a mental health advocate named Steve McCaffrey stood at a lectern in the Indiana statehouse, testifying in favor of an addiction treatment bill. After years of rising overdose rates, lawmakers in the health committee were taking action to combat the opioid epidemic. And they often turned to McCaffrey, who leads Mental Health America of Indiana, to advise them. His brief testimony appeared straightforward. "We rise in support, urge your adoption," said McCaffrey. He said the legislation would move the state "toward evidence-based treatment." But the bill wouldn't do that. (Harper, 6/12)

U.S. sales of blockbuster prostate-cancer drugs have dropped sharply since the start of a federal investigation into charities that help patients pay for these drugs, as the manufacturers have reduced donations to the charities and instead given away the medicines for free. Drugmakers donate hundreds of millions of dollars a year to charities that help U.S. patients cover out-of-pocket costs for drugs. In turn, the drugmakers rely on the charities to effectively boost the sales of those drugs. The assistance ensures patients fill their prescriptions, and insurance pays the rest of the tab. (Rockoff, 6/11)

Seeking to put a lid on rising drug prices, U.S. Sen. Ron Wyden has introduced a bill that would require drug makers to justify hefty price hikes, a move that resembles legislation being introduced in a growing number of state legislatures around the country. In this instance, the U.S. Department of Health and Human Services would track increases in list prices and notify manufacturers when those prices exceed certain benchmarks. At that point, drug makers would have to justify the increases — and may also have to provide information on R&D funding and marketing costs — or they can lower their prices. (Silverman, 6/13)

A Tuesday discussion on drug prices that was supposed to be bipartisan quickly veered to Democrats' criticism of the Republican plan to overhaul the health care system and the lack of hearings held on the issue. It was the first Senate hearing on drug prices held by a committee that can actually legislate on the subject since drug prices became a hot issue in the fall of 2015. At the outset of the Senate Health, Education, Labor and Pensions Committee hearing, Chairman Lamar Alexander, R-Tenn., stressed that the intent was to “better understand this complex subject and agree on some basic facts.” The hearing, he noted, was convened at the request of committee Democrats and Republicans alike. (Siddons, 6/13)

At least 28 million Americans have experienced a spike in the cost of their prescription medications in the past 12 months. And for 4 million of them, the price was so high they walked away without their prescription altogether, according to a new Consumer Reports survey. “We are nearing a crisis point with what Americans can afford for medication, and it's scary," concluded Consumer Reports. "And honestly, as far as we can tell, there are no brakes on it right now. Congress may have a few things up its sleeve, but we're still waiting.” (Velshi, Girvin, Popken and Cappetta, 6/11)

Amgen may face yet another setback with its controversial Repatha cholesterol-lowering drug because an influential nonprofit may soon lower its value rating for the medicine. In a new report, the Institute for Clinical and Economic Review indicated that recently released clinical trial results prompted a reassessment, which will be lower than an initial cost-effective analysis issued two years ago. At the time, ICER pegged the value of the drug at between $5,400 and $7,700, which was notably lower than the $14,000 list price. (Silverman, 6/13)

A corporate dispute over a price-discount program for diabetes patients taking Eli Lilly & Co.’s insulin has resulted in an industry middleman’s exit from the deal—the latest sign of discord among players in a prescription-drug supply chain facing criticism for high prices. Blink Health LLC, a provider of consumer price discounts for prescription drugs, said it has terminated its relationship with Express Scripts ESRX 0.18% Holding Co., a pharmacy-benefit manager that helped arrange the new price break for Lilly’s insulin. (Loftus, 6/13)

Biotechnology company Biogen Inc. has completed an experiment that shows that quantum computers have the potential to speed up drug discovery for diseases such as multiple sclerosis, Alzheimer’s and Parkinson’s. The Cambridge, Mass.-based firm, which declined to be interviewed for this story, is the latest company to experiment with cutting-edge technology that harnesses the power of quantum mechanics to solve complex problems in nanoseconds. Experts say that within five yearsquantum computing will be powerful enough to solve problems that are currently beyond the scope of today’s most advanced computers. (Castellanos, 6/13)

A group of prominent cancer doctors is planning a novel assault on high drug costs, using clinical trials to show that many oncology medications could be taken at lower doses or for shorter periods without hurting their effectiveness. As Exhibit A, they point to their pilot study involving a widely prescribed drug for advanced prostate cancer. Cutting the standard dose of Zytiga by three-quarters was as effective as taking the full amount — as long as patients swallowed the medication with a low-fat breakfast rather than on an empty stomach, as directed by the label. (McGinley, 6/8)

A French pharmaceutical company developing a Zika vaccine funded with millions of dollars in research grants from American taxpayers has rejected a request from the U.S. Army to set an affordable price for the drug once it becomes available. Sanofi Pasteur has already received $43 million in research grants from the Department of Health and Human Services, and the U.S. Army intends to award an exclusive contract to the company to license and sell a vaccine based on technology discovered with American taxpayer funds. (Chang, 6/12)

In a study of 10 high-income countries with universal health care, costs for prescription drugs in 6 of the largest categories of primary care medicines varied by more than 600%, according to research published in CMAJ (Canadian Medical Association Journal). (6/12)

The Senate Committee on Health, Education, Labor, and Pensions is holding a hearing Tuesday on how the drug delivery system affects what patients pay for prescriptions. With Republican plans for health care reform stalled, and scrutiny surrounding prescription drug costs intensifying, a White House in desperate need of a policy victory may soon sharpen its focus on drug pricing. Since working with Congress on health care is proving to be difficult, President Trump may decide to do it via the executive branch. (Marc Samuels and Lindsay Bealor Greenleaf, 6/13)

Every day, countless people across America order prescription drugs from pharmacies in other countries as they hunt for something increasingly elusive — affordable medications. But there’s a problem. Under most circumstances, importing medicines is illegal. And it is time to scrap this prohibition, unless Congress finds another way to drive down drug costs. (Ed Silverman, 6/12)

Sometimes you just want a clean slate. After several groups called for a board shakeup at Mylan NV, leading proxy adviser Institutional Shareholder Services Inc. has done them one better by taking the unusual step of advocating a full Etch-a-Sketch: removing the company's entire incumbent board. These directors will be hard to unseat; ISS thinks it would take two-thirds of shareholder votes to do it. Mylan has called the advice "simply irrational" and disputed the ISS report before it was even released. But enough resonates in this outburst of shareholder criticism that the board needs to consider a strategy other than combativeness. (Max Nisen, 6/13)

It’s hard not to like the notion of value-based pricing for prescription drugs. It aims to ensure that the prices we pay for drugs reflect the benefits they provide, either in terms of longer life or better quality of life. And what could be more American than letting the market determine the right price through the intersection of demand and supply? (Dana Goldman and Anupam Jena, 6/8)

There's been a lot of talk in Washington about what to do about drug prices. Hillary Clinton tweeted about it, and President Donald Trump said he wanted to get prices under control. There's the occasional hearing on Capitol Hill. And we're getting another on Tuesday. But that's about it. The bipartisan desire to keep Americans alive and healthy at a cost we can afford always seems to get bogged down in the Washington sludge fest. (Linette Lopez, 6/13)

One issue where most Americans — 76 percent of them — find common ground is the high price of prescription drugs. President Donald Trump campaigned on the issue, and since his inauguration repeatedly has promised to bring drug prices down. Most Democrats and many Republicans in Congress agree. So why has nothing happened? In a word, money. Hundreds of millions of the dollars that Americans spend on drugs find their way into campaign funds and lobbying efforts on Capitol Hill. In the past decade, the pharmaceutical industry has spent more than $2.5 billion lobbying Congress. Opensecrets.org reports that in 2016, the industry spent $245 million on lobbyists; the next biggest industry sector, insurance, spent nearly $100 million less. (6/12)

Why, in the early 21st century, are so many drugs that were cheaply available in the 20th century becoming prohibitively expensive? The past few years have seen a series of dramatic price hikes on essential off-patent medications, from albendazole to albuterol, digoxin to naloxone, Daraprim to EpiPen. In the storm of allegations and indignation that has followed each of these revelations, one explanation has remained consistent. To paraphrase Senators Susan Collins (R-ME) and Clare McCaskill (D-MO), who were the chair and the ranking member of the Senate Special Committee on Aging, firms that corner the market on off-patent medications and raise prices wildly often do so simply because they can. When the committee issued a 130-page report last December documenting the parallel strategies used by firms to engage in monopolistic price gouging on older essential drugs, the senators pointed out that these actions, though arguably unethical, have so far not been found to be illegal. (Jeremy A. Greene and William V. Padula, 6/7)

It’s no secret that the American Health Care Act is unpopular. In recent national polls, only about 29 percent of Americans support the bill. It is the most unpopular piece of major legislation Congress has considered in decades — even more unloved than TARP (“the bailout”), and much more unpopular than the Affordable Care Act, also known as Obamacare. Will Republican senators vote yes on a bill this unpopular? To hang on to their jobs, senators have to keep only voters in their own states happy, not the whole nation. (Christopher Warshaw and David Broockman, 6/14)

Like a thief in the night, Senate Republicans are trying to take healthcare from tens of millions of people to pay for a massive tax cut. What we don’t know is exactly how many people will lose coverage or how much rich people will save in taxes — because Republicans are refusing to make their version of the American Health Care Act public. If you had any doubts that the bill would be a substantive and political disaster, this secretiveness should remove them. (Scott Lemieux, 6/13)

Senate Majority Leader Mitch McConnell and other Republicans are bragging because health insurers are abandoning some individual markets, leaving consumers with no choices. It’s as if the Republicans have forgotten they’re in charge now. Aside from dodging responsibility for the disruptions in people’s lives, Republicans also are trying to dodge this reality: Their actions and inaction sabotaged the insurance exchanges created by the Affordable Care Act. They caused the uncertainty cited by insurers such as Anthem Inc. when it announced that it would leave the Ohio market next year. (6/14)

The fate of the American health-care system now rests with a group of allegedly “moderate” senators, who are getting ready to approve a bill to repeal the Affordable Care Act, a repeal bill so monumental in its cruelty that they feel they have no choice but to draft it in secret, not let the public know what it does, hold not a single hearing or committee markup, slip it in a brown paper package to the Congressional Budget Office, then push it through to a vote before the July 4th recess before the inevitable backlash gets too loud. (Paul Waldman, 6/13)

The bars opened early in Washington and elsewhere last Thursday, as more than 19 million Americans tuned in when the networks and cable news channels carried live former FBI director James B. Comey’s riveting testimony in the intensifying scandals around President Trump. The media covers Trump’s derelictions 24/7. Not surprisingly, Democrats tend to talk about what grabs the most airtime. (Katrina vanden Heuvel, 6/13)

Health and Human Services Secretary Tom Price was quick off the mark Monday after his agency released fresh data on “effectuated enrollments” — that is, Americans who not only chose an Affordable Care Act individual health plan for 2017, but secured coverage by paying their first monthly installment. The data, according to HHS, “show a decline in the number of Americans who have actually purchased coverage on the exchanges, with cost being a primary concern.” Price used that conclusion to assert in a statement, “Not surprisingly, as costs continue to go up, fewer Americans can afford to pay more and get less for healthcare.” (Michael Hiltzik, 6/13)

Here are some findings about Obamacare repeal that congressional Republicans and Health and Human Services Secretary Tom Price will have trouble explaining away: Under the GOP’s Affordable Care Act repeal bill, individuals will be paying an average 27% more for their insurance by 2026 than under current law. That’s $162 per month more, on average. (Michael Hiltzik, 6/13)

Progressives and conservatives actually agree on health care: A crazy idea? Perhaps not. California, the West Coast bastion of progressivism, is pushing to create a single-payer health care system for its 39 million citizens. State Sens. Toni Atkins and Ricardo Lara have introduced Senate Bill 562 called the Healthy California Act, or HCA, which seeks to “establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state.” After the California Senate passed the HCA on June 1, the state Assembly and Gov. Jerry Brown are the only barriers from realizing this progressive dream. (Deane Waldman and Vance Ginn, 6/14)

If the quality of nursing homes is determined by fines for violations, Iowa has some of the worst facilities in the country. Only five other states imposed more financial penalties on homes last year, according to federal data. As this editorial board recently reported, when industry representatives complained to the Department of Inspections and Appeals, state officials blamed the federal government for “insisting” on fines, even over recommendations of the agency. (6/13)

In Cartersville, Ga., two highly regarded obstetricians, Hugo Ribot and Malcolm Barfield, hoped to add a second room to their one-room surgery center. But the plan hit a snag. They needed to obtain a “certificate of need” from Georgia’s Department of Community Health. Three large hospitals in the area—which provide similar services at far higher cost—blocked their application. Dr. Ribot and Dr. Barfield are now suing the state for restraint of trade. (Hal Scherz, 6/13)

In one of Walker Percy’s brilliant novels, “The Second Coming,” protagonist Will Barrett keeps falling down for no apparent reason. He also suffers trances during which he contemplates existential questions. Barrett comes to mind in the era of Donald Trump. (Kathleen Parker, 6/13)

The opioid crisis is national in scale, but it varies greatly at the regional level. Drawing on our national database of 23 billion private health care claims, we recently explored the regional variation in the opioid crisis during the ten-year period 2007-2016 in a new white paper. Preceded by reports on national trends in opioid-related diagnoses and on the epidemic’s impact on the health care system, this report is important because it suggests the need for policy flexibility in dealing with the varying regional manifestations of the opioid crisis. (Robin Gelburd, 6/14)

Some cities are experimenting with paying panhandlers to clean public spaces. But for national policy, a less bureaucratic strategy for fighting poverty — giving the poor direct cash, enough for a living income — notched stunning gains in Brazil. Testing that approach with America’s needy would be much better use of our national time and treasure. (Rich Barlow, 6/14)