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Another year of big premium increases and dwindling choice is looking like a distinct possibility for many consumers who buy their own health insurance — but why, and who’s to blame? President Donald Trump has seized on early market rumbles as validation of his claim that “Obamacare” is a disaster, collapsing of its own weight. Democrats, meanwhile, accuse Trump of “sabotage” on a program he’s disparaged and wants to dismantle. It’s more complicated, say some independent experts. As for blame, there’s enough to go around. (Alonso-Zaldivar, 5/17)

President Trump has been saying in recent weeks that the Affordable Care act, or Obamacare, is "dead." So he's threatened to cut off crucial payments to health insurance companies that help low-income customers pay day to day health care expenses. That plan, however, may just end up bringing more people into the Affordable Care Act insurance markets. (Kodjak, 5/16)

New Hampshire’s health insurance marketplace continues to fare well compared to other states struggling in the face of uncertainties about the future of the Affordable Care Act, since all four companies currently selling policies in New Hampshire have applied to do so again next year. The New Hampshire Insurance Department said in a press release Tuesday that it has received initial filings from insurance companies to offer various medical and dental plans on the 2018 New Hampshire Marketplace on healthcare.gov through the ACA. (Brooks, 5/16)

Oregonians in the individual insurance market should brace themselves for yet another year of double-digit rate hikes. Eight insurance companies are seeking increases ranging from 6.9 percent to 21.8 percent over 2017. The companies had until Tuesday to submit their 2018 rate requests with the Oregon Insurance Commission. Some consumers will also face dwindling choices for insurance. In Lane, Lincoln and Tillamook counties, just two insurance companies applied to do business in the individual market. (Manning, 5/16)

Oscar Insurance Corp. is starting to stem the bleeding after years of reporting large losses. The privately held health insurer, created to sell plans under the Affordable Care Act, lost $25.8 million across three states in the first three months of this year, compared with a loss of $48.5 million a year earlier, according to regulatory filings Tuesday. The company is beginning to get a handle on its medical costs, as the premiums it collected exceeded what it spent on health services. The Affordable Care Act’s markets for individual health insurance plans have presented challenges for even experienced insurers. (Tracer, 5/16)

Bill Cassidy has taught medical students; led efforts to vaccinate thousands of Louisiana schoolchildren; founded a community clinic that pairs uninsured patients with doctors willing to treat them; and after Hurricane Katrina helped to transform an abandoned KMart in Baton Rouge into a makeshift hospital wing. The first-term Republican has effectively spent his career on health care. Now, for the first time in his political life, with Republicans in control of Washington and intent on replacing Obamacare, he’s in a position to play a pivotal role in reforming the nation’s heath care system. (Facher, 5/17)

Sen. Dick Durbin (Ill.), the No. 2 Senate Democrat, said Tuesday it is alright if Democrats talk with two GOP authors of a more centrist Republican plan on healthcare because the pair is looking “beyond repeal.” Democratic leaders said Republicans must drop their efforts to repeal ObamaCare before any bipartisan talks can happen. Some centrist Democrats, though, met with Republicans in a meeting organized by Sens. Susan Collins (R-Maine) and Bill Cassidy (R-La.) on Monday night. (Sullivan, 5/16)

More than 6 million people with pre-existing conditions could face higher insurance premiums under the GOP’s ObamaCare repeal bill because of gaps in coverage, according to a new analysis by the Kaiser Family Foundation (KFF). Under the American Health Care Act (AHCA), which narrowly passed the House last month, states would be allowed to waive the community rating provision of ObamaCare, which prevents insurers from charging more for those with pre-existing conditions. (Weixel, 5/17)

Passing an Obamacare replacement won’t be any easier in the Senate than in the House, Senate Majority Leader Mitch McConnell said Tuesday while refusing to guarantee that his chamber’s plan will keep all of the House bill’s tax cuts. "This is a really tough issue," the Kentucky Republican said in an interview with Bloomberg News. "You all covered extensively the difficulty of getting a bill out of the House. It won’t be any easier getting it out of the Senate." He acknowledged concerns by moderate Republican Susan Collins of Maine and other senators who say the House bill’s tax cuts are too large, but McConnell said he didn’t want to discuss specific approaches as Republicans seek consensus. (Dennis and Litvan, 5/16)

Senate Republicans are coalescing around the idea of giving more generous subsidies to lower-income and older people than what’s laid out in the House-passed GOP healthcare reform bill. Many Republicans in the upper chamber generally agree that the skimpier subsidies contained in the House bill need to be beefed up for groups that need more help buying insurance. (Hellmann, 5/17)

As the GOP health care bill moves from the U.S. House of Representatives to the Senate, many consumers and lawmakers are especially worried that people with preexisting conditions won’t be able to find affordable health coverage. There are a number of strategies under consideration, but one option touted by House Republicans borrows an idea that Maine used just before the Affordable Care Act went into effect. It’s called an “invisible high-risk pool” — invisible because people in it didn’t even know they were.The Maine pool earned higher marks than most state high-risk pools because it had a key ingredient: enough money. (Wight, 5/17)

Many Democrats are hoping the GOP health care bill that narrowly passed the U.S. House of Representatives is going to push political momentum their way, and result in big gains in the 2018 midterm elections. A special election next week in Montana may be an early test for this theory. President Trump won Montana by 20 points in the November 2016 election, and the May 25 special election is being held to replace the state's only congressman, Rep. Ryan Zinke, whom Trump nominated to be interior secretary. (Whitney, 5/16)

A GOP outside group allied with Speaker Paul Ryan (R-Wis.) is investing further in its effort to provide cover for House Republicans supporting the legislation to reform ObamaCare. American Action Network is to date the only major outside group defending the GOP’s healthcare plan on the airwaves. The advocacy nonprofit has spent more than $3.1 million on ads following the bill’s narrow passage in the House earlier this month, including a new $400,000 wave unveiled Tuesday of radio ads. (Marcos, 5/16)

Moral Movement Tennessee held a candlelight vigil Tuesday outside the West Nashville home of U.S. Sen. Lamar Alexander, R-Tenn. to protest the efforts to dismantle the Affordable Care Act. More than 100 people, many holding signs, gathered for the demonstration at Elmington Park on West End Avenue. The group said the demonstration was organized after they were unable to deliver information about those at risk of losing healthcare access under the AHCA to Sens. Alexander and Bob Corker, R-Tenn., last week. (Sawyer, 5/16)

Freedom Partners, a conservative advocacy group with close ties to the Koch brothers, is launching a new digital advertising push focusing on proposed premium hikes for plans offered through the Affordable Care Act in 2018. The ad, which is airing online this week as Senate Republicans try to craft their own Obamacare replacement legislation, highlights proposed premium hikes in Maryland, Connecticut, Virginia and Washington, D.C. Republicans have branded the proposed rate increases as evidence that Obamacare is failing. (Reid, 5/15)

Three-fifths of troops discharged from the military for misconduct in recent years had a diagnosis of post-traumatic stress disorder, traumatic brain injury or another associated condition, according to a report released Tuesday by the Government Accountability Office. The report, mandated by Congress, for the first time combined military medical and staffing data, as well as data from the Department of Veterans Affairs, to show that tens of thousands of wounded troops were kicked out of the armed forces and severed from benefits designed to ease their transition from service in war. (Philipps, 5/16)

The Choice program allows veterans to get health care in the private sector if they face a long wait time or live far from the nearest VA Medical Center. This was a key provision in the August 2014 Veterans Access, Choice and Accountability Act — a bipartisan response to the scandal that erupted over veterans’ delayed access to medical care at VA facilities across the country. Veteran watchdogs have criticized VA for not acting quickly enough to use the appropriated money to improve patients’ access to medical care. Is it true that veterans have received 42 percent more approvals to get non-VA health care through the Choice program? (Lee, 5/17)

Expanding telemedicine coverage and changing rules that govern Medicare Advantage, ACOs and value-based insurance designs would all help improve health and reduce spending on Medicare patients with multiple chronic conditions, said witnesses at a Senate Finance Committee hearing on Tuesday. The Senate's bipartisan Chronic Care Working Group has already gotten six of its policy proposals realized through CMS rulemaking and the 21st Century Cures Act. ... Currently, Medicare reimburses telemedicine only in rural areas and immediate access to care can sometimes make a huge difference. (Lee, 5/16)

The Senate Finance Committee will mark up on Thursday a bipartisan bill designed to change certain Medicare payment policies to improve the care of people with chronic conditions, such as diabetes. Committee members say they intend to advance the bill this week, although the Senate is immersed in partisan fights over a GOP bid to revise Democrats’ 2010 health care law. The Finance Committee appears on track to approve its Medicare bill (S 870) Thursday, although it’s uncertain what will happen next. Lawmakers could seek to attach the measure, or parts of it, to other bills that face deadlines later this year. These include the renewal of the Children’s Health Insurance Program and the extension of caps on Medicare therapy payments. (Young, 5/16)

A top Republican House appropriator suggested Tuesday that a federally funded Native American health program should be reprogrammed from discretionary to mandatory funding. In addition, he said, lawmakers might consider moving it from the Interior-Environment Appropriations bill to the Labor-HHS-Education bill. Oklahoma Rep. Tom Cole, the chairman of the Labor-HHS-Education panel, made the remark at a hearing where tribes raised alarm about proposals to cut fiscal 2018 funding vital to their communities. (Mejdrich, 5/16)

The Office of Congressional Ethics is examining New York Rep. Chris Collins’ role in attracting U.S. investors to an Australian biotech company in which he is the largest shareholder, The Buffalo News reported Tuesday. The story cited unnamed sources who told the newspaper that the office began sending letters to investors seeking information about a month ago. Legally, they are not required to provide it or submit to interviews. (Bluth and Kopp, 5/16)

Hundreds of doctors signed a letter Tuesday calling on the Department of Homeland Security to allow about 58,000 Haitians affected by the country’s 2010 earthquake to stay in the United States for at least another year. The letter, signed by 552 doctors from across the country, asked Secretary John F. Kelly to extend their participation in a program known as temporary protected status for another 18 months. (Cramer, 5/16)

Every few minutes, Abril begins to choke. Diagnosed as a baby with severe cerebral palsy and epilepsy, the Santa Cruz, Calif., 8-year-old has never spoken, or walked or cleared her own throat. Dozens of times a day, her parents, Rafael and Sonia, use a special machine to suction out saliva and phlegm from their oldest daughter’s mouth. Because choking and seizures can strike Abril anytime, a parent is always by her side. Rafael and Sonia, both from Mexico, have lived in this country without permission for more than a decade. But only since the recent presidential election has a question haunted them: If they are deported, what will happen to Abril? (Wiener, 5/17)

Texas officials say they've been "encouraged" to ask President Donald Trump's administration to hand over millions of dollars the previous administration withheld from the state for cutting Planned Parenthood centers from a key family planning program. States aren't supposed to cut out willing eligible providers from federal Medicaid programs, according to federal law. (Zelinski, 5/16)

Texas has long looked to limit the operation and scope of Planned Parenthood, focusing its efforts both on the arm of the organization that performs elective abortions and the one that offers general health care and family planning services. "The state is now testing the current administration to see if they're going to be able to get away with it," said Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes. "It really opens up a huge can of worms that could be very destructive." (Mekelburg, 5/15)

The Trump administration will soon review Texas' proposed plan to regain federal funding for its family planning program that does not include Planned Parenthood or providers that support or perform abortions. If the CMS approves the waiver, other states could seek similar permissions and risk millions losing access to care. Texas lost federal funding for its family planning program known as Healthy Texas Women in 2013 after it stopped reimbursing for services performed at Planned Parenthood. Since then, the program has been totally state-funded. Now facing a $2 billion budget shortfall, Texas is looking for ways to reduce spending. (Dickson, 5/16)

The state's pending request for Medicaid to fund a women's health program that excludes abortion providers will be the first major test of the Trump administration's willingness to let states cut off dollars to Planned Parenthood. Texas' health agency will ask the feds to restore funding for a family planning Medicaid waiver the state dropped six years years ago when the Obama administration insisted states couldn't block abortion providers from their programs. (Rayasam, 5/16)

Wyoming’s only Planned Parenthood clinic will close this summer because of financial reasons, the organization confirmed Tuesday. “This is a challenging decision,” said Planned Parenthood of the Rocky Mountains official Adrienne Mansanares. Planned Parenthood’s lone health center in Wyoming is in Casper. It opened in 1975 and serves around 500 patients per year, Mansanares said. It will close July 21. (Rosenfeld, 5/16)

Medical abortions done at home with online help and pills sent in the mail appear to be just as safe as those done at a clinic, according to a new study. The research tracked the outcomes of 1,000 women in Ireland and Northern Ireland, who used a website run by a group called Women on Web to get abortion pills. The Netherlands-based nonprofit provides advice and pills to women seeking an early abortion in more than 140 countries where access to abortion is restricted. Ireland and Northern Ireland have some of the world's strictest laws, often only granting approval when a woman's life is at risk. (5/16)

The rate of complications was similar to that of women using the abortion pill with the help of doctors in traditional, face-to-face office settings in countries were abortion is less restricted, the study found. Still, there were some problems. Ninety-three women were referred for further treatment by local doctors because of more severe symptoms, seven needed a blood transfusion, and 26 had to get antibiotics. Researcher Abigail Aiken of the University of Texas at Austin and her collaborators in several other countries concluded that “self sourced medical abortions using online telemedicine can be highly effective, and outcomes compare favorably” with clinical protocols. (Cha, 5/16)

A state House committee is poised to begin consideration of a bill to ensure abortion remains legal in Delaware if the U.S. Supreme Court ruling in Roe v. Wade is ever overturned. The bill, which narrowly cleared the Senate last week and is up for discussion by House members Wednesday, revises Delaware’s current abortion law, which remains on the books despite being superseded by federal law. (5/17)

Lawmakers left Tallahassee last week without accomplishing an agenda item that has been at the forefront for years: They passed no legislation restricting abortions or targeting abortion clinics. It’s the first time in eight regular sessions of the Legislature — since 2010 — that abortion bills haven’t passed. (Auslen, 5/16)

In the day room at St. Ann's Corner of Harm Reduction, which runs a needle exchange program in the Bronx, a group of guys are playing dominoes and listening to salsa music while they wait for lunch. And Van Asher, one of the staffers in charge of "transactions" — that means he gives out needles — is talking up his latest idea for how to keep the users here safe. He wants to tell them what's really in their stash. "If you're doing dope," he says to one client, "we'll give you a test strip so you can test and see if there's fentanyl." (Harris, 5/16)

IBM Watson Health and MAP Health Management, a population health software maker, have teamed up to create new software that uses cognitive computing to treat long-term addiction and substance abuse. The new version of the MAP Recovery Network platform is driven by IBM's Watson technology, which adds cognitive computing and machine learning to the population health software, allowing it to process unstructured data and to learn as it goes, thereby becoming more and more accurate. (Arndt, 5/16)

After one of his officers accidentally overdosed during a search and seizure, the police chief of the opioid-besieged town of East Liverpool, Ohio, is calling for stronger penalties for transporting fentanyl and related drugs, and his officers are no longer field testing what they find while on duty. “It’s just too dangerous,” East Liverpool Police Chief John Lane told STAT on Tuesday. “It’s not worth the risk.” It’s been eight months since the town’s opioid crisis made national news, and Lane said very little has changed. Patrolman Chris Green collapsed on Friday after brushing a small amount of white powder from his shirt hours after a field test. (Ross, 5/16)

Addiction experts are up in arms over remarks by Health and Human Services Secretary Tom Price in which he referred to medication-assisted treatment for addiction as "substituting one opioid for another." Nearly 700 researchers and practitioners sent a letter Monday communicating their criticisms to Price and urging him to "set the record straight." (Harper, 5/16)

As a presidential candidate, Donald Trump pledged to tackle prescription drug abuse and the flow of illegal drugs into the country. But his White House efforts are off to a rocky start so far. ... while Republican members continue to hold out hope Trump will keep his pledge to combat the opioid epidemic, a number of GOP senators are becoming more vocal in their criticism of his early actions on the issue. “I am alarmed at the defunding [of ONDCP] because that, to me, signals less emphasis on what I think is a deep problem,” West Virginia Sen. Shelley Moore Capito said. “I think we need an overarching policy and I would like to see it remain in the White House where it would get the ultimate attention.” (Williams, 5/16)

Nearly 40 years after the world was jolted by the birth of the first test-tube baby, a new revolution in reproductive technology is on the horizon — and it promises to be far more controversial than in vitro fertilization ever was. Within a decade or two, researchers say, scientists will likely be able to create a baby from human skin cells that have been coaxed to grow into eggs and sperm and used to create embryos to implant in a womb. (Lewin, 5/16)

The opioid epidemic and recent media attention on suicide have put teen mental health under a spotlight, which  raises concerns and questions among parents. The percent of high school students who considered and attempted suicide increased slightly between 2013 and 2015,  federal data show, while the percent of high school students reporting symptoms of depression remained the same. Still, the numbers are startling: One in five teens has a mental health condition. (O'Donnell and Barry, 5/15)

For the first time, women in their early 30s are having more babies than younger moms in the United States. Health experts say the shift is due to more women waiting longer to have children and the ongoing drop in the teen birth rate. For more than three decades, women in their late 20s had the highest birth rates, but that changed last year, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention. (Stobbe, 5/17)

By the end of December, a lethal bacterium had swept through UC Irvine Medical Center’s intensive care unit, sickening seven infants. Dr. Susan Huang, the hospital’s infection control expert, had a plan. The strategy — which she had promoted so successfully that most U.S. hospitals now use it — included bathing all infants in the ICU with a powerful disinfectant, and swabbing inside their noses with an antibiotic. (Petersen, 5/16)

Doctors often prescribe steroid injections for the pain of knee arthritis, but a rigorous trial has found they work no better than a placebo. Researchers randomly assigned 140 men and women over 45 with painful knee osteoarthritis to injections of either a corticosteroid or a saline placebo. The subjects were injected every three months for two years, with neither the patients nor the people who gave the shots knowing who got the placebo. The study is in JAMA. (Bakalar, 5/16)

Eating yogurt may lead to stronger bones. Researchers tracked 4,310 Irish adults 60 and older, gathering information on diet and lifestyle with questionnaires. They measured bone density and joint deterioration with X-rays and M.R.I., and tested participants’ physical ability. The study is in Osteoporosis International. (Bakalar, 5/16)

Davis Cripe left home April 26 an active and healthy teenage boy, but in art class that afternoon he fell to his knees and told worried classmates that he felt lightheaded. He passed out on the floor and was rushed to a nearby hospital. By 3:30 p.m., around the time the final bell rang at school, he was dead.His sudden death may have remained a medical mystery, the coroner who conducted his autopsy said, if friends hadn't described what Davis ingested during lunch: Enough caffeine to disrupt and ultimately stop his heart. (Wootson, 5/16)

A U research team gave away sunscreen at fair information booths in 2015 in an experiment to see if people really protect themselves against sunburn and skin cancer as doctors recommend. In results released Tuesday, they said the answer is often no. (Olson, 5/16)

Democrats in the New York Assembly are relaunching a push for a statewide single-payer health-care program in hopes that the national debate over health care will give their legislation new momentum. The “Medicare-for-all” bill—designed to provide health insurance to all state residents—passed the predominantly Democratic Assembly Tuesday afternoon following several hours of partisan back-and-forth on the chamber floor. (Vilensky, 5/16)

According to the Georgia Nurses Association, more than 50 percent of the nursing workforce is nearing retirement age. Meanwhile, the aging of the population as a whole means that more nurses and health professionals are needed to act as caregivers. In the Northwest Georgia mountains, Blue Ridge Area Health Education Center (AHEC) is scrambling to relieve the nursing shortage. (Thomas, 5/16)

The Service Employees International Union signed an agreement that allows the union to seek to organize about 500 workers at Partners HealthCare’s hospital in Northampton. The deal with Partners applies to service and technical workers at Cooley Dickinson Hospital. (Dayal McCluskey, 5/16)

This investigation involved a 10-month analysis of court and police records, medical histories, media reports and dash and body camera footage, much of it obtained under the Texas Public Information Act. The research revealed shortfalls in police protection statewide: a need for improved mental health training for officers and better communication between law enforcement agencies about potentially violent individuals with mental health issues. (Hinkle and Barer, 5/16)

The optometry bill, which for a few weeks reignited the so-called “eyeball wars” between doctors of optometry and doctors of medicine, died in the Legislature this year, but that doesn’t mean the war is over. The state optometry association will decide later this year if it’s going to once again pursue efforts to expand the scope of practice for optometrists in Florida. (Miller, 5/16)

Like many older people on a fixed income, Ed Slavik knew he couldn't keep up with the high cost of dental care. So a few years ago, the retired school teacher was relieved to find the Dental Division at Stickney Public Health District, where he had fillings and other routine dental work done for free...But public health researchers are hoping to persuade legislators to add a dental benefit to Medicare by highlighting the many seniors forgoing care until their dental health has deteriorated, sometimes causing trouble eating, swallowing or speaking, and igniting other health problems. (Neumann, 5/16)

State officials have approved Maryland's first apprenticeship for environmental care supervisors, who work in hospitals cleaning areas such as surgical rooms...Apprentices will receive technical instruction through the Community College of Baltimore County and be paired with mentors Baltimore-area hospitals. Trainees' wages will increase when they show proficiency in a list of predetermined job functions. Johns Hopkins Hospital will be the first institution to offer the on-the-job training. (Mirabella, 5/16)

The malicious software that quickly spread across six continents last week and locked more than 200,000 computers, including U.K.’s National Health Service, has not affected Central Florida’s two major health systems, officials told the Orlando Sentinel. But their relief is by no means a reassurance for protection from future cyberattacks. (Miller, 5/16)

Sacramento County health officials have confirmed five cases of botulism in patients who ate at the Valley Oak Food and Fuel gas station, and are investigating three other probable cases and one suspect case, with all nine patients still hospitalized. Officials believe the outbreak is linked to nacho cheese sauce that was served at the station, but the exact cause of the poisoning is still under investigation, officials said. (Caiola, 5/16)

The boards of Fairview and HealthEast have approved the merger of the two metro-area hospital systems, and the deal is now expected to be completed June 1, the two organizations announced Tuesday. The combined system will be led by Fairview President and CEO James Hereford. HealthEast CEO Kathryn Correia will join the senior executive team as chief administrative officer. (5/16)

A Wisconsin state lawmaker has proposed legislation that would make “stealthing” — removing a condom during sexual intercourse without permission — an act equivalent to sexual assault. If passed, the bill introduced by Democratic Rep. Melissa Sargent, would change the definition of consent under Wisconsin law. (Mettler, 5/17)

A private equity firm’s confidential pitch deck obtained by the Miami Herald shows that only days ago Surterra Florida was seeking investors to buy a $10 million minority stake while also arguing against limits on the number of retail outlets any licensed operator can open. Some potential investors were lured with projections that show Surterra grossing $138 million in sales by 2021 thanks largely to the operation of 55 retail outlets — nearly four times the cap desired by the Florida Senate. (Smiley and Auslen, 5/16)

A Coos Bay day care center shut down Monday in the aftermath of an insecticide-spraying incident that left at least a half-dozen children and two staff members suffering from inflamed eyes and breathing problems. State regulators opened an inquiry into the May 5 incident but have not sent anyone to visit the Coos Bay Children's Academy Inc., which had an enrollment of about 80 kids. Instead, the owner voluntarily closed the center Monday as several key employees quit and parents pulled children en masse over concerns about transparency and safety. (Schmidt, 5/16)

Amid increasing calls for curbs on U.S. drug pricing, some of the most aggressive legislative action is happening at the state level—and industry lobbyists are fanning out to fight back. Lawmakers have introduced bills in about 30 state legislatures this year, seeking to regulate drug prices; require manufacturers to justify price increases; or to form purchasing groups with other states to negotiate lower prices, according to the National Academy for State Health Policy, a nonprofit policy group that has drafted model drug-pricing bills for state use. (Loftus, 5/17)

Poll after poll shows Americans are increasingly concerned about the price of prescription drugs. With each new survey, the debate about importing drugs from Canada seems to gain steam. At least four different bills have been introduced this year in Congress, and while the fate of legislation to replace the Affordable Care Act dominates the agenda on Capitol Hill, buying drugs across the border is an idea that won’t go away. (Sheridan, 5/11)

There’s no shortage of ways to rank pharma CEOs: Drug sales. Corporate profits. Even haircuts. Here at STAT, we chose to look at it from a shareholder’s perspective. We calculated shareholder returns over the past three years at the 25 biggest drug companies in the world. Then we compared that with CEO compensation. Five outliers popped out: chief executives who got raises well out of step with what they delivered to investors. (Garde, 5/16)

Branded drugmakers weren't the only ones working through a tumultuous 2016. Generics companies faced pricing pressure, too. And while branded companies suffer pricing pain on costly cutting-edge therapies, generics outfits feel the pinch with already-thin margins, making pressure all the more agonizing.How is the industry responding? By consolidating and hoping to save money, for one. Take a look at FiercePharma's 2014 ranking, and it's clear that some companies have made leaps too big to depend on organic growth alone. (Sagonowsky, 5/16)

Could changing up regulatory requirements for Alzheimer’s drugs help give desperate patients new options for treatment? A group of researchers and patient advocates think so. They authored a paper that argues that the Food and Drug Administration should evaluate Alzheimer’s drugs for efficacy in either cognition or function — but not both. Efficacy and cognition are the main endpoints measured in Alzheimer’s disease. The hallmark of cognitive impairment is memory loss, while functional impairment involves losing the ability to perform tasks of daily living — from reading to going to the bathroom to getting dressed in the morning. Currently, FDA expects drugs to improve both cognition and function. (Keshavan, 5/15)

Desperate patients are swapping pricey pharmaceutical drugs on Facebook. Doctors say it's dangerous. But when you need a drug every day to survive, you're going to find a way to get it. It shouldn't be that surprising. You can buy, sell or trade almost anything on Facebook, from designer sneakers to unwanted fishing boats to antique medical cots. Now, even life-saving insulin. (Popken, 5/11)

Roughly 60,000 older Missourians will lose state aid to help them pay for prescription drugs starting in July. But lawmakers hope the cut won’t be permanent. Seniors who earn less than 85 percent of the federal poverty level, or roughly $10,000 a year for an individual, qualify for both Medicaid and Medicare. (Hancock, 5/11)

Priced at $10,000 per person, the cost totaled roughly $10 billion during that time. To some, this would appear to be a bargain for a drug that combats a pernicious disease, yes? But what if it turns out the drug later failed yet another trial and patients with a mild form of Alzheimer’s weren’t helped, after all? The money —much of it spent by Medicare — would have been wasted and patients’ hopes dashed. (Silverman, 5/12)

Upon receiving information that Aspen Pharmacare has taken steep price increases on lifesaving cancer meds in Europe and threatened to pull its products in order to get the hikes through, EU antitrust regulators have pledged to take a close look at the South African drugmaker’s business practices. Europe’s competition authority opened an investigation into Aspen on Monday, seeking to learn whether the company “abused a dominant market position in breach of EU antitrust rules,” according to a release. It noted this is the first time it has looked into excessive pricing in pharmaceuticals. (Sagonowsky, 5/15)

That is the lesson that the management at Vikshara Trading & Investments learned the hard way when the company tried to forestall an agency inspection last year by insisting that its workers were on strike and its plant in Gujarat, India, was inaccessible. But were they really on strike?...A year ago, the FDA scheduled an inspection, but last June, Vikshara said employees went on strike and blocked the entrance to the facility. As a result, the agency canceled a planned June 27 inspection. Last July, Vikshara said the strike was ongoing and, in August, provided purported evidence, such as employee resignation letters and a photograph of striking employees blocking the entrance. (Silverman, 5/9)

An aspiring biosimilar manufacturer is employing a citizen’s petition in a novel way in hopes of setting regulatory approval standards. In a May 3 letter, Apotex asked the Food and Drug Administration to set a specific requirement for other biosimilar companies that, depending upon what the agency decides, may serve as a barrier to regulatory approval of their treatments. (Silverman, 5/11)

Generic drugs are a boon in health care. Typically lower in cost and as effective as their branded counterparts, they help control pharmacy spending and increase access to important therapies for patients who could be deterred by the high cost of some branded drugs. In fact, research shows that the use of generic drugs produces annual savings in excess of $200 billion. (Troyen Brennan, 5/14)

Last week, the Senate confirmed Scott Gottlieb to lead the Food and Drug Administration. That puts the new commissioner in the hot seat to tackle several high-profile issues that are critically important to patients and consumers. Among the most important decisions he’ll have to make early on is whether to accept industry proposals to reduce standards under which drugs can be advertised — regulations that have protected patients for more than 50 years. (William B. Schultz, 5/16)

I agree with Gov. John Kasich, we cannot allow Washington politicians with taxpayer-funded health insurance to rip coverage away from Ohioans who are battling cancer, getting regular checkups for the first time, or finally getting treatment for their opioid addiction. Of course we need to do more to lower costs for Ohioans, and I’m ready to work with anyone on commonsense ideas to make our health care system work better. (Sen. Sherrod Brown, 5/25)

Negotiated pricing is the common-sense solution to reining in the costs of prescription drugs. It has been in use for many decades, for drugs bought by the Veterans Administration, General Services Administration, all military branches, and the Defense Supply Center Philadelphia; why not Medicare? There is no acceptable reason for these laws. (James Baker, 5/10)

The financial insecurity experienced by many Americans certainly figures into any root-cause analysis for why President Trump was elected. But for most Americans, the "biggest tax cut ever" will do little to reduce that insecurity. Driving down health care costs -- and making them more predictable -- is far more important. (H. Gilbert Welch and Elliott Fisher, 5/11)

This week’s non-Comey news file contains an encouraging development for U.S. medical innovation amid the running political debate over pharmaceutical prices. The main drug lobby ousted 22 members and adopted corporate governance reforms. (5/10)

Merck & Co.'s 2017 just got a whole lot brighter. The company announced Wednesday evening that its immune-boosting cancer drug Keytruda can now be prescribed in combination with chemotherapy, vaulting it ahead of its rivals in the space. It's huge news. But exactly how huge it is going forward is largely out of Merck's control. (Max Nisen, 5/11)

Prescription drugs may not be the costliest part of our health system, but they’re the fastest-rising charge that hits individual pocketbooks directly. The demand for legislative reform is palpable; every politician in Washington has an interest in defusing the drug price explosion. But as close as victory sits, it’s also just out of our grasp. (David Dayen, 5/16)

I find it is despicable the House of Representatives is blaming the high cost of health care on the poor, elderly and chronically ill. They need to address the real reasons for increasing costs of health care, the increasing costs of health care. Take drug costs, for starters. The total drug expenditures for 2015 in America rose 12.2 percent during the previous year. (Michael Bernhardt, 5/11)

Republican leaders in Congress are trying to pass legislation rolling back and replacing key features of the Affordable Care Act (ACA) without securing any Democratic support in the effort. ... In political terms, it might be best for Republicans if their effort stalls. The ACA was passed in 2010 with only Democratic votes, and that is a major reason the law remains politically and, to a degree, programmatically unstable. ... It would be better for the United States if a broad consensus could be reached on health care. A bill that passed with support from some Republicans and some Democrats has a better chance of political survival than a bill passed by just one party. It should be possible to reach a broader consensus on health policy because both sides of the debate are forced to work within the significant constraints of existing arrangements. (James C. Capretta, 5/15)

Senate Republicans have spent the last 10 days or so promising not to tackle health care in the same hurried, irresponsible way that their House counterparts did. “We are not under any deadlines,” Sen. John Cornyn (R-Texas) said last week, “so we are going to take our time.” ... All of that is probably true ― and less meaningful than it sounds at first blush. It’s possible to write a bill in a slower, more deliberative manner than the House did without allowing the kind [of] lengthy, open public debate that legislation of such magnitude would seem to require. It’s also possible to pass less disruptive, less extreme legislation that would nevertheless take away insurance from many millions of people, causing widespread hardship. (Jonathan Cohn, 5/13)

The easiest prediction to make about the healthcare business was that the efforts by Congress and the Trump administration to sabotage the Affordable Care Act would produce a flood of rate hikes by insurers for 2018. We are now standing on the edge of the water. Early rate requests have come in from insurers in five states, according to ace ACA-tracker Charles Gaba, who calculates the weighted average rate request increase in those states at about 30% (that is, weighted for the enrollment of each insurer). (Michael Hiltzik, 5/16)

At the same moment I was caring for more patients struggling with addiction and its devastating health effects, House Republicans passed the American Health Care Act (AHCA). Sadly, the AHCA would replace President Barack Obama's Affordable Care Act with a law that would end Medicaid expansion and simultaneously make health care more expensive for my most vulnerable patients and reduce important protections for them. (Robert Bonacci, 5/17)

Should women have to pay more for health insurance than men? That has been a critical question for opponents of Republican health-care reform, and it requires grappling with the fundamental nature of insurance, market prices and fairness. Related are questions about how much older people should pay relative to the young, or to what extent individuals with pre-existing conditions should be vulnerable to higher premiums. (Tyler Cowen, 5/16)

I often wonder why President Obama, when he was promoting the Affordable Care Act to millennials, didn't bring out a young person like me to help my peers understand why it matters... As politically aware, or "woke" as my peers seem to me, I worry that making the effort to understand and sign up for health insurance is low on people's priority list. (Aditi Juneja, 5/17)

The Democratic base wants a single-payer system, a slight majority of Independents are warming to the idea and even some conservative voters appear to be growing amenable to cutting insurance companies out of the picture. Thanks to the GOP health care bill's creation and advancement, the Republican Party’s dream of turning American health care over to the private sector is becoming our new, shared reality. (Miles Howard, 5/17)

The need for criminal justice reform is one of the precious few policy areas that garners widespread bipartisan agreement. Yet, Attorney General Jeff Sessions — a former U.S. attorney and longtime anti-drug crime warrior — reversed an Obama-era policy aimed at keeping non-violent drug offenders out of the federal prison system. Sessions ordered federal prosecutors to charge forward with a policy that has generated enormous human and economic pain with no quantifiable benefits. Kentuckians can be proud that our junior U.S. senator, Rand Paul, called Sessions out on his disastrous decision. (5/16)

The War on Drugs has been such an abject failure — the get-tough approach having served to crowd prisons with non-violent offenders who are disproportionately African-American while having little to no discernible impact on actual narcotics use — that the country's elected leaders seemed to have reached a bipartisan consensus in recent years that it was better to focus on prevention and treatment. Prosecutors should throw the book at violent, repeat criminals, but they should not pursue long mandatory, minimum sentences for suspects who don't fit that description. (5/15)

One attempted small fix is the Over-the-Counter Hearing Aid Act of 2017 that was introduced on March 21 by Sens. Elizabeth Warren (D-MA), Chuck Grassley (R-IA), Maggie Hassan (D-NH), and Johnny Isakson (R-GA). This bill, which was reported out of the Senate Health Education Labor and Pensions Committee on May 11 — together with a companion measure introduced in the House by Reps. Joe Kennedy III (D-MA) and Marsha Blackburn (R-TN) — has the admirable intent of expanding access to hearing aids for some of the 37.5 million Americans with varying degrees of hearing loss. The bill would for the first time create an over-the-counter (OTC) hearing aid category, allowing the devices to be sold directly to the customer like cheap drug-store eyeglasses. (Andrew Yarrow, 5/17)

Last year, the former chief of the Santa Fe, N.M., police department, Donald Grady II, said something that stuck with me. “There’s a thing that we call freedom of movement,” he said in an interview with The Atlantic, “which is really revered in this country — that we should have the right to move freely without impingement from the police simply because.” He was speaking as both a black man and a police officer about the ways racial discrimination can limit a basic right. But I related to this on more than one level. (Luticha Doucette, 5/17)

Hope springs eternal on Beacon Hill — and unfortunately, that’s particularly true when it comes to the politically powerful ambulance companies and their desire to leverage higher rates for their services. This year, those companies and their legislative allies are once again hoping to use the budget to advance goals that have otherwise gone nowhere through the more traditional legislative process. (5/17)

The United States can take pride in one indisputable marker of racial equality: The gap in life expectancy between the white and black populations has narrowed over time. What was a disparity of more than eight years for Americans born in 1950 has closed to just over three years for those born in 2014, according to actuarial estimates. But let’s not pat ourselves on the back. A different disparity has opened up: The gap in life expectancy between wealthy and low-income Americans is wide and growing wider. And that has implications not only for lifetime health and wealth, but for Social Security. (Michael Hiltzik, 5/16)

When I set out to make this film in late 2015, the battle over restricting access to abortions in Texas was a national news story. Coverage featured graphs charting the hours women had to drive to find an abortion clinic in the state and maps tracing their paths. Experts weighed in on both sides of a gaping moral divide — politicians made pleas, doctors wrote op-eds. But amid the debate I felt a critical perspective was missing — that of the women across the country who were actually experiencing the effects of these laws. (Gina Pollack, 5/16)