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Representative Fred Upton of Michigan was only the latest Republican defector, but he carries more sway than most. The former chairman of one of the House committees that drafted the American Health Care Act, as the Republicans call their measure, Mr. Upton said the latest version of the health care bill “torpedoes” protections for people with pre-existing medical conditions. (Kaplan and Pear, 5/2)

Top House Republicans scrambling to prevent another collapse of their push to repeal much of the Obama health care law may have found a way to win over some moderate GOP holdouts. Rep. Fred Upton, R-Mich., an influential centrist who'd initially announced opposition to his party's health care bill, said he's crafting an amendment with the backing of party leaders that could gain crucial support for the languishing measure. (Fram, 5/3)

On Capitol Hill, influential Rep. Fred Upton (R-Mich.) came out against the plan, dealing a major blow to proponents trying to secure enough votes to pass it in the House. Across the country, late-night host Jimmy Kimmel’s emotional story about his newborn son’s heart condition reverberated on television and the Internet. And former president Barack Obama, who signed the bill Republicans are trying to dismantle, took to Twitter to defend it. All three voiced concerns about losing a core protection in the Affordable Care Act for people with preexisting conditions, as is possible under the latest GOP plan. (Sullivan and Weigel, 5/2)

“I’m not at all comfortable with removing that protection. I’ve supported the practice of not allowing pre-existing illnesses from being discriminated against from the very get-go,” Upton said in the interview. “This amendment torpedoes that. And I told leadership I cannot support this bill with this provision in it. (Wong, 5/2)

Mr. Upton’s opposition expanded political cover for centrists to oppose the bill, including some facing tough re-election battles in swing districts. In recent years, many of these lawmakers have complained that House leaders were catering too much to the party’s conservative faction. The show of defiance suggested that GOP leaders may not be able to count on the cooperation of their centrist flank on upcoming bills that could prove just as thorny as the health measure, including the president’s plan to overhaul the tax code. (Peterson and Armour, 5/2)

House Republicans worked late into the night Tuesday on last-minute changes to their Obamacare repeal bill, as President Donald Trump began rallying support to muscle the stalled legislation across the finish line. Senior Capitol Hill and White House officials said a new amendment being drafted Tuesday night would address concerns from key moderates about how the legislation treats individuals with pre-existing conditions. (Dawsey, Bresnahan and Bade, 5/3)

House Republicans voted Tuesday to give themselves flexibility to rush through their legislation to repeal and replace ObamaCare later this week. GOP leaders are still scrounging for enough support to pass their revised healthcare plan and haven’t scheduled any floor vote yet. But in the event GOP leaders convince enough of their members to endorse the bill, they’ll have the option of fast-tracking a vote through Friday. (Marcos, 5/2)

Paul Ryan has a major math problem. The House speaker and his leadership team can lose only 22 Republicans and still pass their Obamacare repeal bill. But roughly 20 GOP members are on record in opposition, and at least another two dozen are undecided. (Bade and Cheney, 5/2)

House Speaker Paul Ryan told Republicans Tuesday to “pray” as they try to win over the remaining holdouts on the health-care bill with leaders pushing for a vote later this week. Representative Dennis Ross of Florida, a senior member of the House vote-counting team, described Republicans’ closed-door meeting and said they are about “five votes away” from the number needed to pass the bill. (House, 5/2)

In one major indication that things were not going well, Vice President Mike Pence skipped a planned appearance at a trophy ceremony for the Air Force to dash to the Hill and meet with hesitant members, none of whom emerged ready to change their minds. (Mershon and McPherson, 5/2)

Personal lobbying by President Donald Trump and Vice President Mike Pence have not swayed U.S. Rep. Dave Reichert to commit to voting for the beleaguered Republican health-care overhaul legislation. The Trump administration has been appealing to moderate Republicans to rescue the GOP plan, which is teetering on the edge of a second high-profile defeat. (Brunner, 5/2)

[Here] is a list of Republicans who had opposed, remained silent on or switched to supporting the latest version of the legislation. Members of the far-right House Freedom Caucus are bolded. Click on a lawmaker’s name to learn more about their position. (Phillips, Schaul, Soffen and Uhrmacher, 5/2)

The list of undecided or opposed members includes incumbents used to tough reelection fights, like Rep. Carlos Curbelo of Florida, and members who represent districts that flipped to Clinton in 2016, like Rep. Ryan Costello of Pennsylvania. “Each of us individually is evaluating it based on commitments we have made, public statements we have made,” said Costello, who is opposed to the bill. “I voted the bill out of committee and I made certain representations during committee and to my constituents so that if a bill is ultimately going to get to the floor that contradicts statements that I’ve made, that becomes very problematic.” (Daugherty, 5/2)

Rep. Darrell Issa (R-Calif.) refused to share his position on the House GOP’s revised healthcare bill in a tense exchange on Tuesday. As Issa waited for an elevator to leave the House floor, reporters asked Issa what his position is on the GOP’s latest healthcare proposal. “None of your business,” Issa replied tersely. (Marcos, 5/2)

Here’s how the proposed Republican American Health Care Act—along with an amendment introduced this week—compares to the 2010 Affordable Care Act. (Levey and Kim, 4/26)

New Jersey breast cancer survivor Barbara Blonsky on Tuesday delivered a petition with more than 34,000 signatures to the district office of her congressman, Rep. Tom MacArthur, the man most responsible for reviving the floundering GOP health care bill. A moderate Republican, MacArthur sponsored a controversial amendment to the legislation that would make it easier for insurers to charge higher rates to people like Blonsky with a troubled medical history. (Pugh, 5/3)

Hospital groups and some health insurers are lobbying hard to convince House Republicans to drop their current drive to repeal and replace the Affordable Care Act, warning of dire harms to patients and the healthcare industry. Opponents of the American Health Care Act claim the House GOP bill's provisions could unravel protections for people with pre-existing conditions, roll back the ACA's Medicaid expansion, leave millions more Americans uninsured, and significantly reduce overall Medicaid spending through per-capita growth caps. Nevertheless, President Donald Trump and House GOP leaders are pressing for a House vote on the bill this week, because the House is scheduled to take a weeklong recess starting Thursday. (Meyer, 5/2)

In an impassioned monologue, late-night TV show host Jimmy Kimmel talked Monday about how Congress might change insurance rules for individuals with preexisting medical conditions, like his newborn son. The boy was born 10 days ago with a heart defect. Here’s the difference between provisions of the Affordable Care Act and what House Republicans propose to do. (Eilperin, 5/2)

Former President Barack Obama, 2016 Democratic presidential candidate Hillary Clinton and Democratic Senate leader Chuck Schumer have said Mr. Kimmel’s story shows the ACA and its protections for people with pre-existing conditions should be preserved. Republicans have argued their current bill would maintain such protections and that critics are portraying it in an inaccurate negative light. Former Republican Rep. Joe Walsh, who is now a conservative talk radio host, on Tuesday wrote on Twitter: “Got a big problem with ‘we need gov-run healthcare cuz of my sad story.’” (Hackman, 5/2)

Raise your hand if you had never heard of Tetralogy of Fallot with pulmonary atresia before Monday's episode of ABC's Jimmy Kimmel Live. Awareness of this serious congenital heart defect got a big bump after the late-night host shared the story of his newborn son's diagnosis and open-heart surgery. (Deerwester, 5/2)

Tetralogy of Fallot is a rare congenital heart condition characterized by four main problems, including a hole in the wall between the lower chambers of the heart, changing the normal blood flow to the body, according to the American Heart Association. The National Institutes of Health says the condition occurs in about five out of every 10,000 babies. (Bever, 5/2)

Years of Republican efforts to repeal Obamacare might end up failing thanks to a very compelling constituency: the sickest Americans. Democratic activists have turned the health care law's guarantee to cover people with pre-existing conditions into Republicans' Achilles' heel, using the issue to slow and, potentially, even thwart what the GOP hoped would be a quick repeal effort. (Haberkorn, 5/2)

As they scramble to get votes to advance legislation to roll back the Affordable Care Act, President Trump and House Republican leaders insist their bill would protect Americans who have preexisting medical conditions. But most healthcare experts and patient advocates dispute this, noting that the House GOP plan would allow states to scrap many protections put in place by Obamacare, as the law is often called. (Levey, 5/2)

Rep. Fred Upton (R-Mich.) on Tuesday became the latest House Republican to come out against the ObamaCare repeal-and-replace bill, underlining how the legislation is losing support from lawmakers who fear it could hurt people with pre-existing health conditions.  Some lawmakers expressed doubts that the healthcare bill would come up for a vote this week despite a push from House leaders to get it to the floor before a one-week recess. (Sullivan and Hellmann, 5/2)

“They’re scared,” said Rep. Tom Rooney (R-Fla.), whose district voted for President Trump. “[They] feel like they’re about to lose it and they’re going to die. And if we cannot explain to people that is not going to happen, then it’s going to be very difficult to ever bring a bill to the floor.” Many lawmakers expressed frustration at having to figure out on their own how the recent changes to the bill would affect consumers. (Mascaro, Levey and Wire, 5/3)

Fran Cannon Slayton, a children’s book author with brain cancer, has summoned a hopeful energy since her diagnosis last year. But she is near despair about the resurfaced Republican plan to repeal and replace the Affordable Care Act, which the White House and Republicans are pushing for a vote as soon as this week. “I don’t think people really understand how serious this is,” said Ms. Slayton, 50, of Charlottesville, Va. (Goodnough and Abelson, 5/2)

If their latest Obamacare repeal efforts fail, Republicans really have only a few options. And each means political peril for President Donald Trump and Republican congressional leaders. (Cancryn and Demko, 5/3)

House Democrats think they’ve finally found their path back to power: Republicans voting to repeal Obamacare. Yes, the best thing to happen to House Democrats since they pushed through the sprawling health care law — and lost the majority as a result — could be the Republican drive to dismantle it. (Caygle, 5/3)

House leaders stressed that they are still working to muster a majority to pass the bill, which was originally scheduled for a full floor vote in March. Here are some possible ways the effort could play out. (Rovner, 5/3)

Republicans voted more than 60 times to dismantle the Affordable Care Act when Barack Obama was president. But now that the GOP finally holds the White House and can take the law apart, they’ve spent months failing to get enough votes for a repeal bill to even clear the House of Representatives. Why is repealing Obamacare so complicated? Start with these five factors. (Diamond, 5/2)

Senate Republicans are backing off their criticism of the House Republicans’ Obamacare repeal proposal, wary of the consequences that a second failure would have for the party’s quest to gut the law. (Everett, 5/2)

More people getting health insurance under the Affordable Care Act didn’t lead to challenges in accessing care for those who were already insured, a new Health Affairs study shows. The findings could assuage concerns about how access to doctors was affected under the ACA. They suggest that having more insured people in a geographical area does not make it more difficult for others in the same area to access preventative care and specialists. (McIntire, 5/1)

The Trump administration has not decided if it will make key ObamaCare payments to insurers after this month. The payments, known as cost-sharing reduction subsidies, reimburse insurers for providing discounted deductibles and copays to low-income individuals. If the administration doesn't make the payments, it could cause chaos in the insurance exchanges. (Hellmann, 5/2)

Minnesotans are evenly divided over Republican steps in Washington to replace the Affordable Care Act, although a larger number say it has done more good than harm, according to a new Star Tribune Minnesota Poll. Those findings come as a debate over federal health insurance policies continues to grip Congress and preoccupy the Trump White House. (Golden, 5/2)

Amid ongoing federal debate over the future of America’s health care laws, Colorado’s health insurance regulators have officially given companies an extra month to file their 2018 plans for approval. The Colorado Division of Insurance has announced that insurers won’t have to submit drafts of their next-year plans until June 19. The division will review those plans preliminarily, then release them on July 14 to the public for comment. The public will have until August to offer opinions on the plans, which will be approved by early fall. (Ingold, 5/2)

Aetna recorded a loss of $381 million in the first three months of 2017, thanks to costs related to its failed tie-up with insurer Humana. Even so, Aetna's first-quarter results beat Wall Street's financial estimates despite further losses from the insurer's Affordable Care Act exchange plans. In the first quarter of last year, Hartford, Conn.-based Aetna's profit totaled $737 million. (Livingston, 5/2)

Aetna Inc. will again scale back its presence in the Affordable Care Act exchanges in 2018, saying it expects losses on the business this year despite sharply reduced enrollment in its individual plans. (Wilde Mathews and Moise, 5/2)

Like other U.S.-based health insurers including Anthem Inc and Molina Healthcare Corp, Aetna faces deadlines to file 2018 plans but is uncertain about components of premium rates such as the continuation of government subsidies and the mandate for Americans to have insurance. (5/2)

Aetna has roughly 255,000 members in the ObamaCare market nationwide, a significant reduction from the 964,000 members it had last year. The company lost $450 million in the market in 2016 and said that losses are projected to be higher than expected this year. (Clason, 5/2)

Dr. J. Mario Molina, the outspoken chief executive of the California health insurance company founded by his father, was abruptly removed from his position at Molina Healthcare, according to an announcement by the company on Tuesday. His brother, John, the company’s chief financial officer, was also immediately replaced. (Abelson, 5/2)

The company cited disappointing financial performance and its need to improve its operations and profits for the shake-up. Out are CEO Dr. Mario Molina, 58, who replaced his father as president and CEO in 1996, and John Molina, 52, who had served as chief financial officer since 2003. (5/2)

Dale Wolf, Molina's newly appointed chairman of the board, blamed poor financial results as the reason for kicking the Molina brothers out of the eponymous company their father built. But Molina's first quarter 2017 earnings released later on Tuesday seem at odds with Wolf's stated reason. Molina delivered a strong quarter. Its profit more than doubled to $77 million compared with $24 million at the same time in 2016. Revenue grew by 12.9% to $4.9 billion in the first quarter year over year. (Livingston, 5/2)

Chief Accounting Officer Joseph White will serve as CFO and interim CEO. The company has begun a search for a permanent CEO. Shares hit a 52-week high on the news, closing at $59.75, a move that analysts said may partly reflect the belief that the company is now more likely to be acquired. (Wilde Mathews and Hufford, 5/2)

The growing, Long Beach-based health insurer has nearly 5 million customers in 12 states and Puerto Rico, most of them insured through Medicaid, the government program for the poor. In California, Molina currently insures 765,000 people and operates its own clinics around the state. The company also has Medicare programs, and more than 1 million customers who purchased a plan on one of the marketplace exchanges created by the Affordable Care Act, or Obamacare. (Petersen, 5/2)

Molina has been a vocal critic of the GOP's ObamaCare repeal and replace process. He threatened to leave the ObamaCare exchanges if key insurer payments weren't funded. (Hellmann, 5/2)

The shares jumped 18 percent to $59.75 at the close in New York, the biggest one-day advance since June 2012. (Tracer, 5/2)

A group of Democratic senators is pushing back against the dismissal of former Surgeon General Vivek Murthy, requesting more information from President Trump in a letter that cites what they call a “pattern of politically motivated and ethically questionable personnel decisions.” The White House requested Murthy’s resignation in late April; when he refused to resign, he was formally relieved of his duties. (Facher, 5/3)

Lawmakers weighed a bill to permit the sale of over-the-counter hearing aids on Tuesday at a hearing on ways to ease regulations on medical technology. The Over-the-Counter Hearing Aid Act of 2017, a measure with bipartisan support offered by Rep. Joseph Kennedy (D-Mass.) and co-sponsored by Rep. Marsha Blackburn (R-Tenn.), would order the Food and Drug Administration to draft regulations allowing companies to sell the devices in retail settings, including online. Under the proposed law, hearing aids could be sold to adults with “mild to moderate hearing impairment.”  (Eagan, 5/2)

Susan Barrett has been on an emotional roller coaster — from anxiety to elation — as Congress dithered in recent weeks over whether to let health insurance lapse for thousands of coal miners and their widows. “I have no one to help me,” said the 77-year-old Coshocton, Ohio, resident, a miner's widow who received a notice last month saying her insurance was about to expire. She felt a wave of “panic” as she tried to imagine how she would pay for her blood thinner or heart medications. (Shesgreen, 5/2)

Senate Democrats are joining their House counterparts in criticizing the slew of recent anti-abortion actions taken by the Trump administration. The effort, led by Sen. Patty Murray of Washington and signed by 30 other Senate Democrats, comes after a nearly identical letter authored by House Pro-Choice Caucus Chairs Diana DeGette of Colorado and Louise M. Slaughter of New York was issued Monday.  (Ramam, 5/2)

Planned Parenthood on Tuesday announced the reopening of its first abortion clinic in Texas since the U.S. Supreme Court last year struck down strict regulations that prompted more than half of the state’s abortion facilities to close. The location was notable: Waco, which like many rural and midsized cities in Texas lost its only abortion clinic after then-Gov. Rick Perry signed the regulations in 2013. (Weber, 5/2)

A conservative state lawmaker has successfully tacked an anti-abortion message onto an otherwise innocuous resolution in the Alaska House aimed at raising awareness about sexual assault and child abuse. The amendment from Republican Rep. David Eastman of Wasilla refers to abortion as "the ultimate form of child abuse." (5/2)

After securing a court order blocking two Missouri abortion restrictions, Planned Parenthood now wants the licensing process for abortion facilities speeded up – a proposal opposed by the state. Planned Parenthood is proposing a 45-day period for Missouri to complete the licensing process for its clinics in Kansas City and Columbia, a deadline the state calls artificial. The organization also wants the court to impose a 60-day timeframe for its Joplin and Springfield clinics. Neither has applied for a license to perform abortions but both plan to do so. (Margolies, 5/2)

A few months ago, if you lived in Virginia, relied on Medicaid, and were seeking a residential treatment program for substance abuse, you had few to choose from. To be precise, you had four. Today, you would have 71. That increase was made possible in part by a new type of “waiver” from federal rules that has dramatically expanded treatment options for Medicaid beneficiaries here. It has also shed light on the ways in which, in much of the country, the program has limited opportunities for many people seeking help overcoming addictions. (Joseph, 5/3)

An estimated 2 million people in the U.S. are addicted to prescription opioids, and an average of 91 Americans die every day from an overdose of those painkillers or their illicit cousin, heroin. This grim spiral often starts in the hospital. A Harvard study published in the New England Journal of Medicine in February raised the troubling prospect that for every 48 patients newly prescribed an opioid in the emergency room, one will use the pills for at least six months over the next year. And the longer they're used, the higher the risk for becoming dependent. (Neergaard, 5/2)

For the first time, Baltimore police have begun investigating overdoses in an effort to trace drugs back to dealers, joining a wave of Maryland law enforcement agencies showing up at 911 calls previously left to medics. A task force of five detectives will operate out of the homicide unit, responding when possible to fatal and nonfatal overdose scenes. More than 1,000 patrol officers are also being trained by the Drug Enforcement Administration on how to respond to overdose scenes. (Fenton, 5/2)

In the northwest corner of Georgia, where cows and crops vastly outnumber people, a small cluster of privately owned treatment centers have sprung up in recent years for heroin and prescription painkiller addicts. And most of the patients aren’t even from the state. (Kaplan, 5/3)

The city plans to open an around-the-clock walk-in center in North Philadelphia over the summer where addicted drug users in crisis could be stabilized and perhaps begin medication as a bridge to treatment. The center would go a step beyond the five behavioral health-crisis response centers in the city that can see and assess patients, but must refer them elsewhere for treatment — often to places with no space available.  (Sapatkin, 5/2)

More money is needed to stop overdose deaths, Manatee County leaders told state officials during an opioid workshop Tuesday. Emergency responders need funding for Narcan, a medication that reverses overdoses. (Ochoa, 5/2)

Central Florida’s heroin epidemic continues to escalate wildly, local officials testified Tuesday, and one of the few signs of progress — a jail intervention pilot program — is about to have its funding cut by the Florida Legislature. Before a capacity crowd of about 150 at the Orange County Commission Chambers, a panel of state government representatives hosted the latest in a series of community workshops on Florida’s opioid crisis, hearing pleas from parents, recovering addicts and treatment providers that more resources are needed to keep the death toll from rising. (Santich and Lemongello, 5/2)

Black Americans still have a higher death rate over all than whites, but the gap is closing, the Centers for Disease Control and Prevention reported on Tuesday. Black Americans who live to 65 may now expect to live longer than whites of the same age, the federal researchers also found. (Kolata, 5/2)

Blacks experienced a 25 percent drop in their overall death rate, compared to a 14 percent decrease for whites, between 1999 and 2015. Deaths from heart disease, cancer and stroke declined sharply among blacks 65 and older, and in that age group, blacks now have a lower death rate than whites, the CDC said. But its report shows that the United States has a long way to go before it achieves health equity. Blacks in every age group under 65 continue to have significantly higher death rates than whites. Black life expectancy at birth is about 3½ years lower than that of whites. (Achenbach, 5/2)

"This report is definitely good news," says Joseph Betancourt, who runs the Disparities Solutions Center at the Massachusetts General Hospital in Boston, Ma. "Efforts over the last 15 to 17 years that have focused on addressing and eliminating disparities have definitely provided some significant results." (Stein, 5/2)

The Trump administration has delayed enforcement of a rule finalized last year that imposed strict oversight over electronic cigarettes and cigars for the first time. The move, which the Justice Department revealed in court filings Monday night in both the District and Alabama, comes as the vaping and tobacco industries are launching a concerted effort to roll back the Food and Drug Administration regulation through both legislation and litigation. (Eilperin, 5/2)

Zika's primary victims are developing babies in the womb, but a new survey suggests that many pregnant women don't know basic information or take recommended steps to prevent the spread of the mosquito-borne virus. The survey, conducted by researchers at the University of Texas Medical Branch at Galveston, found that most pregnant women in southeast Texas were unaware the birth defect-causing virus can be spread by sex even if their partner has no symptoms. Many also had little knowledge where they shouldn't travel because of Zika outbreaks. (Ackerman, 5/2)

Essential oils are a hot item in today’s holistic healing world — touted as a natural way to improve your mood, ward off sickness and treat ailments such as arthritis, dry skin and allergies. Now, a growing number of hospitals are jumping onto the essential-oils bandwagon, offering them to patients to help manage pain, nausea and anxiety. (Shah, 5/2)

With a key budget deadline looming late Tuesday, lawmakers’ negotiations were stalled in large part over disagreement on one of the largest issues the state funds: Hospital funding. While the House and Senate came to an agreement last week that would cut $650 million from hospitals’ payments through Medicaid, they still haven’t agreed on how to put those cuts — or a potential $1.5 billion boon in Low Income Pool funds approved by the federal government — into effect. (Auslen, 5/2)

President Donald Trump and Republican leaders in Congress are promising to take another vote this week to repeal the Affordable Care Act, otherwise known as Obamacare. But Sen. Claire McCaskill says rural hospitals in the state could be forced to close if the health reform measure is repealed. McCaskill says she met with leaders of several of Missouri’s rural hospitals earlier this year, and many of them say Missouri’s failure to expand Medicaid has had a harmful impact on their financial health. (Margolies, 5/2)

The hospital’s closing came after a 2010 settlement agreement with the U.S. Department of Justice that spurred the state of Georgia to move mentally ill and developmentally disabled patients to surrounding communities. ... Transitional apartments, rent vouchers and new construction were part of the plan. But sometimes things happened that were not part of the plan, such as former patients who battle mental illness living on the streets and being arrested repeatedly. (Martin, 5/2)

For the past three years, Florida Hospital has been running a clinic for patients who have dementia and Alzheimer’s. But the hospital is waiting to see if amid the chaotic last few days of this legislative session, lawmakers will pass a bill that would designate it as a memory disorder clinic. (Miller, 5/2)

Toxic stress occurs when children are abused or neglected, or exposed to violence, serious turmoil or economic hardship. In young kids, the repeated activation of the nervous system can have a lasting effect on the developing brain. In older children, it can increase the risk for disease. (McGrory, 5/3)

A Delaware lawmaker has reintroduced legislation allowing doctor-assisted suicide. Democratic Rep. Paul Baumbach of Newark admitted Tuesday that he does not expect to win passage of the legislation, which was tabled in committee two years ago, but wants to continue to shine light on the issue. (Chase, 5/2)

A payment processing issue over the weekend caused an unknown number of Florida Blue customers to be charged multiple times for the same bill, Florida Blue spokeswoman Christie Hyde DeNave said. The nonprofit company found out about the glitch Monday and immediately started working on a fix. (McGrory, 5/2)

Approximately 9,500 members were affected by Florida Blue’s payment system problem over the weekend, which led to multiple withdrawals from their bank accounts, insurance company officials said on Tuesday. The problem happened over the weekend, through a vendor, according to the insurance company. (Miller, 5/2)

More than 4,000 New York residents are treated each year under Kendra's Law, a controversial program that requires a person dealing with serious mental illness to attend outpatient psychiatric treatment as a condition for living in the community. It was passed in 1999 on a trial basis after 32-year-old Kendra Webdale was pushed in front of a subway train by a man with untreated schizophrenia. It is has since been temporarily reauthorized twice, but New York lawmakers have balked at making the 18-year-old law permanent. It is set to expire in June unless lawmakers grant yet another extension. (Gronewald, 5/2)

A wide-ranging proposal to increase the number of mental health beds throughout the state and improve services at the Division for Children, Youth and Families was unanimously endorsed by the Senate Health and Human Services committee on Tuesday. The amendment to House Bill 400 will provide much-needed relief to the state psychiatric hospital and the Department of Health and Human Services, which has struggled to keep pace with the number of patients suffering from mental illness. (5/2)

While the maternal health of black mothers has been studied nationally for years, researchers and advocates have been baffled by recent reports showing black women in Texas are twice as likely to die after a pregnancy-related hospital stay than any other group of women. Though black women accounted for only 11 percent of all Texas births in 2012, they made up 29 percent of maternal deaths, according to a July 2016 report from the state’s Task Force on Maternal Mortality and Morbidity. (Evans, 5/2)

The House of Representatives voted 141 to 8 Tuesday to pass and send to the Senate a bill that would make Connecticut one of a half-dozen states barring conversion therapy, the discredited practice of trying to change the sexual orientation of young homosexuals... The bill would enshrine in state law the conclusions of the American Medical Association, the American Psychiatric Association and other national associations of health professionals: Homosexuality is not a disease, and forcing conversion therapy on a minor can be harmful. (Pazniokas, 5/2)

The Senate Criminal Justice Committee on Tuesday approved its version of the Sandra Bland Act, which aims to comprehensively change the way police and civilians interact. The Senate version of the bill, authored by Criminal Justice Committee Chairman John Whitmire, D-Houston, would mandate that county jails route people with mental health and substance abuse issues to treatment and install electronic sensors or cameras to better monitor inmates. (Silver, 5/2)

Ohio held steady while Kentucky fell in a national ranking of day-to-day preparedness to manage health emergencies, according to a new study by the Robert Wood Johnson Foundation... The foundation’s National Health Security Preparedness Index analyzes more than 130 measures, such as hazard planning in public schools, monitoring food and water safety, wireless 911 capabilities, flu vaccination rates and numbers of paramedics and hospitals, to calculate a measure of health security and preparedness. (Saker, 5/3)

Alegislative watchdog in Utah has launched an investigation of a controversial donation to the state’s flagship public university from biotech billionaire Dr. Patrick Soon-Shiong. The probe, requested by the Utah House speaker, comes at a tumultuous time for the University of Utah. Soon-Shiong’s donation, which ended up boosting his business interests while advancing medical research at the university, has raised eyebrows in the broader research community. (Robbins, 5/3)

The Ohio Department of Health has followed up on a promise to make public a list of homes across the state with known lead hazards that have not been addressed by landlords or property owners. The list of 540 homes represents only the properties that have received an order to vacate from public health investigators, one of the last steps officials can take when a property owner refuses to clean up an identified source of lead poisoning in a home where a child has been poisoned. (Dissell, 5/2)

In the summer of 2014, a farmer from Bourbon County in southeast Kansas was transferred to the University of Kansas Hospital with an unknown disease that was causing his organs to fail... Three years later, as another tick season approaches, little more is known about the mysterious disease. (Marso, 5/2)

More than 50 new and expecting moms in San Antonio received a free “baby box,” in which their infants can safely sleep, during a Baby Box Company launch event at the DoSeum on Tuesday. The San Antonio moms are the first in the state to receive the boxes, which will soon be available for free online to every new and expecting mom in Texas. (Martin, 5/2)

Nashville-based HCA Holdings will be renamed HCA Healthcare later this month — a move that reflects trends around the industry. The change better reflects how the company interacts with patients, said CEO Milton Johnson on an earnings call about first quarter results. The company will continue to trade as HCA. Branding is increasingly important as hospital operators continue to adapt to retail and consumer-driven changes. Its patients in many markets can choose from a variety of facilities, including urgent care facilities and freestanding emergency rooms. (Fletcher, 5/2)

Hanover County-based Owens & Minor Inc. is planning to buy a New York-based distributor of medical supplies for about $380 million in cash. The acquisition will extend the company’s sales of medical supplies beyond hospital settings and into home health care. (Blackwell, 5/2)

Cooper Health System, which owns 20 percent of AmeriHealth New Jersey,  said its share of the health insurer's 2016 loss was $5.29 million, down sharply from a $9.26 million loss the year before. Based on Cooper's 20 percent stake, that would translate into overall AmeriHealth New Jersey losses of $26.43 million last year and $46.28 million the year before, but the New Jersey insurer's majority owner, Independence Health Group, disputed the magnitude of the losses. (Brubaker, 5/2)

Milner-Fenwick, a Hunt Valley firm that makes educational films for medical professionals, has been acquired by The Wellness Network, which owns in-hospital television and digital channels. Under the deal, the 65-year-old family-owned business will maintain its offices in Hunt Valley and continue producing videos as a part of The Wellness Network, which is based in Wisconsin. Financial terms were not disclosed. (Gantz, 5/2)

The yellow pill is dubbed “PriceGougi$ol,” and the activists who dreamed it up want it to become a new face of the backlash against high prescription drug prices. A spoof ad for the fake drug made its debut Tuesday as part of the launch of a multimillion dollar push to call attention to “out-of-control” price increases. The organizer, the Campaign for Sustainable Rx Pricing, a project from the Washington, D.C.-based National Coalition on Health Care, plans in the coming months to put out more ads and promote the stories of Americans impacted by high drug prices. (Robbins, 5/2)

When teaching hospitals put pharmaceutical sales representatives on a shorter leash, their doctors tended to order fewer promoted brand-name drugs and used more generic versions instead, a study published Tuesday in JAMA, the journal of the American Medical Association, shows. The results were significant compared to doctors who worked at hospitals that did not limit sales reps from freely walking their halls or providing meals or gifts, according to research by Ian Larkin, an assistant professor of strategy at the University of California, Los Angeles Anderson School of Management, and colleagues. (Ornstein, 5/2)

A majority of Americans continue to believe that lowering prescription drug costs should be a top priority for the Trump administration and Congress, and most overwhelmingly favor taking several steps — such as allowing Medicare to negotiate or importing medicines from Canada — as a potential solution. Specifically, 60 percent want the federal government to take action, according to a new Kaiser Family Foundation poll. This is virtually the same percentage of Americans who responded to the last such poll in December. (Silverman, 5/1)

Entrepreneur Jeffrey Aronin said a few years ago he hoped to eventually sell Marathon Pharmaceuticals LLC, which he controls and runs, for billions of dollars, according to a person who heard the comment. Some employees have said they now expect him to shut down the company. His deflated ambition is a sign of the increasingly hostile reaction to drug companies that specialize in sharply raising the prices of old medications. Mr. Aronin did that over and over again for 15 years, most recently after Marathon won approval in February to sell a drug for muscular dystrophy in the U.S. (Walker, 5/2)

As the cost of health care rises, academic and industry leaders batted around ideas to make medicine more affordable by having people pay for the benefit they accrue rather than the specific services they receive. Called “value-based care,” the concept is complicated and amorphous — but it touches all areas of health care, from hospital procedures to medical research to pharmaceutical pricing. (Swetltitz, 5/2)

BioMarin Pharmaceutical Inc. won approval from U.S. regulators for a treatment for an ultrarare pediatric brain disorder. The therapy will have an extraordinary price tag. At $27,000 per biweekly infusion, the drug, called Brineura, will cost about $702,000 a year. BioMarin said Thursday that most patients who have the disorder, known as Batten disease, are on federal assistance programs like Medicaid, and that the price after mandatory government discounts will be $486,000. Even with discounts, Brineura would be one of the most expensive drugs in the world. Treatments for rare genetic diseases, such as Horizon Pharma Plc’s Ravicti for urea cycle disorders, carry some of the highest prices in the industry. Ravicti has a list price of $556,000, according to the company. (Chen 4/27)

Drug makers may want to strap on their parachutes — another patent cliff lies ahead. The phrase, of course, refers to the loss of patent protection on big-selling drugs that ravaged the pharmaceutical industry several years ago. As the companies began facing generic competition, many cut jobs and closed plants, refocused research efforts, and scrambled for deals to replenish pipelines. (Silverman, 4/26)

Mylan disclosed that its chairman received nearly $100 million last year, among the largest pay packages disclosed this year for any public company, even as the drugmaker was buffeted in 2016 by a public furor over hefty price increases on its lifesaving EpiPen. The disclosed pay for Robert J. Coury doesn’t include an additional $66.3 million in retirement benefits and other payments that Mr. Coury received last year in connection with what Mylan called his transition from executive chairman to a nonemployee chairman role. (Maremont and Francis, 5/2)

Critics have said for years that pharmacy benefit managers’ business practices are so opaque that employers and insurers who hire them can’t know whether the powerful middlemen are saving them money or driving up costs. News that insurer Anthem Inc. may drop Express Scripts Holding Co. after accusing it of $3 billion annual overcharges shows that view is gaining traction in corner offices. Express Scripts said this week that Anthem was planning to discontinue its contract after 2019, although Anthem’s chief executive officer said Wednesday no decision was final. (Langreth and Weinberg, 4/26)

After concerns mounted a decade ago over financial ties between drug makers and doctors, various institutions took steps to limit potentially undue influence over medical research and practice. The federal government created a website where companies are required to report payments. And many academic medical centers and physician practices barred or restricted visits by drug sales reps. But to what extent have these efforts made a difference?For one thing, consumers now have more information about their physicians. (Silverman, 5/2)

Pfizer beat Wall Street expectations for first-quarter profit thanks to reduced spending on operations and legal costs, plus strong sales of key new drugs and longtime blockbuster pain treatment Lyrica. But revenue at the top U.S. drugmaker dipped 1 percent as competition intensified from rival brands and generic copycats. Pfizer is near the end of a years-long stretch in which generic competition cut into revenue from its one-time blockbuster drugs, including cholesterol, heart and pain drugs. Near-copies of Enbrel, an injected immune disorder drug it sells overseas, cut sales 18 percent to $588 million in the quarter, for example. (Johnson, 5/2)

Novo Nordisk A/S has agreed to settle a U.S. probe of its marketing of diabetes drugs that allegedly included disguising salespeople as medical educators and paying kickbacks to persuade doctors to prescribe its medicines. The allegations were disclosed when a whistle-blower lawsuit was unsealed by a judge. The U.S. Justice Department investigation, which began in 2011, focused on claims of illegal marketing of the Danish insulin supplier’s top-selling Victoza diabetes drug and other products, according to Novo’s 2016 annual report. (Feeley and Cortez, 4/28)

Is the Trump administration siding with consumer groups over drug makers in the fight over patient access and patent rights? The US trade representative on Friday released its annual 301 Watch List, which identifies and ranks countries based on their willingness to protect intellectual property. The annual list is of great concern to drug makers, which argue that some countries fail to sufficiently protect and enforce patent rights. As a result, they complain that revenues are hurt and innovation is discouraged. (Facher, 4/28)

Aiming to rein in soaring prescription drug prices, an unlikely Nevada coalition is trying to force pharmaceutical companies to disclose how they set insulin prices — and issue refunds to diabetics or their insurance companies if annual price hikes surpass inflation. Las Vegas casino owners have banded together with their employees' unions of cooks, servers and other resort workers to support the unprecedented legislation in their effort to control their own medical insurance costs. (Noon, 5/1)

A Londonderry man recently visited Washington, D.C., to advocate for better diabetic health care. Jay Dunigan of Londonderry has had Type 1 diabetes for 45 years and worked in the diabetes medical technology sector for more than 28 years. Three hundred volunteers from 30 states were invited by the American Diabetes Association to talk to congressional representatives on March 28 about the issues that directly affect diabetes patients. (Hogan, 4/26)

If signed into law, insurers could not change out of pocket prescription costs, create more restrictions, or remove coverage of them during a health plan year. It does not prevent health plans from being able to add brand and generic medications to their formularies or to make coverage changes if the FDA announces drug safety concerns or if there are medications removed from the market. (Miller, 5/1)

As I stood up to end our visit, Frank indicated he had one more question. "You know those commercials for Cialis?" he asked. "Would that be all right for me to try?" Here we go with the bathtubs again, I think to myself. Toned silver-hairs in side-by-side bathtubs on a deck somewhere looking out at the sunset. Give me a break. (John Henning Schumann, 4/29)

Americans are divided along party lines in terms of the presidents they like, the news networks they watch, and even where they live. They disagree sharply on the Affordable Care Act and almost everything else in health care. But there is one issue Republicans and Democrats agree on: They want to lower the costs or prescription drugs. (Drew Altman, 5/2)

Around Washington, there’s a lot of talk about the prices of prescription drugs. But a new player has emerged into the public debate known as Pharmacy Benefit Managers (PBMSs) that is drawing considerable attention to their role in rising prices. PBMs serve as the middlemen in drug pricing system, by making deals with manufacturers and pharmacies. Their impact on our drug pricing system is enormous, in fact the three largest PBMs control an astounding 75-85 percent of the market and have upwards of $250 billion in estimated revenues. (Matthew Kandrach, 5/2)

Iowa, it turns out, is the envy of the nation for a unique lifesaving, cost-saving and environmentally friendly approach to providing no-cost medicines to people in need. It's based on reclaiming and redistributing unused prescription drugs through a drug donor repository. In its 10 years, the program, which will get $521,000 in state funding this year, has provided $20.2 million worth of drugs to people in need while saving money for taxpayers who subsidize government medical programs. The program keeps unused medicines out of sewer systems, landfills and waterways, and saves providers the expense of incinerating them, which can run between 50 cents and a dollar per pound. (Rekha Basu, 4/27)

In a biotech M&A desert, investors go crazy for any sign of water. That makes it tempting to dismiss the burst of M&A speculation around Sarepta Therapeutics Inc. that erupted on Friday. The company announced CEO Ed Kaye's planned departure in September, which spurred rumors of a possible buyout, pushing Sarepta shares up as much as 13 percent.  (Max Nisen, 4/28)

Many of us have found generic medicines to be good alternatives to more expensive brand-name drugs. But sometimes, they are not available. If we need a certain pharmaceutical, we have no choice but to pay the higher price for the brand-name version. There may be good, acceptable reasons for that in many situations. But sometimes, there are not. (5/1)

Now is a good time for Republicans in Congress and the president to take a step back from their divisive efforts to repeal the Affordable Care Act, or ACA, and start working to solve the real problems people face, including rising prescription drug prices. To do that, we have to start by listening to Minnesotans and people across the country. (Sen. Al Franken, 4/29)

You'll have to excuse Merck & Co. Inc. investors for being distracted on Tuesday; it's a little hard for them to focus on a somewhat fluky earnings report when the trajectory of a multi-billion-dollar cancer-drug market is about to be decided. Merck's first-quarter results topped analyst expectations, helped by the government and favorable foreign-exchange rates. (Max Nisen, 5/2)

Two decades ago, our system for getting drugs from doctors’ prescription pads to their patients was in desperate need of a revamp. If someone had told the health care industry then that electronic prescribing would become common practice, many would have been skeptical at best. Yet this method is now the way that most people get and fill their prescriptions. (Larry Blandford, 4/27)

The nation faces a health-care emergency. But it is not, as President Trump and other Republicans have described it, that Obamacare is on the verge of imminent, unavoidable collapse. It is that Mr. Trump and the Republican Congress are sabotaging Obamacare, which millions of people rely on. (5/2)

As Trump has demonstrated time and again, he doesn’t consider factuality a stumbling block to his political goals. Alas for him, at least some Republicans who have to live with the consequences of his action do. Which is why ACA repeal is about to start its latest careening journey back down the hill, there to lie in shambles on the floor of the House or Senate, another Trump effort thwarted by the gravity of truth. (Scott Lehigh, 5/2)

The Republican plan is a far cry from what Trump promised Americans – affordable, high-quality coverage for all. If it becomes law, it will be a medical and financial disaster. People with serious conditions, but no insurance coverage, will live shorter and sicker lives, face financial distress and often be forced into bankruptcy. (Drew Halfmann, 5/2)

I am a Medicaid welfare queen. When Republicans talk about safety net programs like Medicaid, Social Security and food stamps, they evoke images of people like me gabbing on their smartphones, eating steak and watching TV from the comfort of home. Political rhetoric and media coverage paints us as unmotivated and undeserving individuals, passive consumers of taxpayer dollars who are out to “game the system,” taking resources away from hard-working people. (Alice Wong, 5/3)

Medicaid is our nation’s largest health care plan, serving 65 million Americans and nearly a million Missourians. Importantly, Medicaid is the only public program that provides long-term care for the elderly and disabled. Two-thirds of Medicaid spending supports these vulnerable populations and their caregivers. (Christine E. Crouch, 5/2)

We might think that the desperate conditions of the institutions like the Fernald, Dever and Willowbrook are part of a hellish but distant past. But if House Speaker Paul Ryan's American Health Care Act is passed as originally proposed, we may see adults with developmental or intellectual disabilities reduced to drastically insufficient care again, with state agencies no longer able to maintain the staff or the homes themselves. (Susan Senator, 5/3)

Dear senators and representatives of the 115th United States Congress,The media tell me that you will once again be taking up legislation to repeal and replace Obamacare. If you do this, please make sure that whatever new law you come up with keeps three key features of the Affordable Care Act that I need to keep my daughter, Wendy, alive. (Darcy Daniels, 5/2)

Before November 8, no one anticipated that health care would be the predominant focus of the next president's first 100 days. Now, let the record reflect, that is precisely what has happened. What have we learned in the process and what do we have to show for it? The latter question is easier to answer: nothing, save for considerable uncertainty and burgeoning disruption for the health care system. As for the former, Republicans have hoisted their own petard in epic fashion. (Billy Wynne, 5/3)

Let’s be clear, rather than a compromise, the new version of the American Health Care Act (AHCA) makes a deeply harmful plan even more destructive. The original proposal, the House’s plan to repeal and replace Obamacare, failed in part because some members were rightly worried about 24 million people losing health coverage, as projected by the Congressional Budget Office. The so-called “Meadows-MacArthur amendment” is the only change in Congress’ second attempt. This new version keeps all of the damaging components of the first bill while threatening coverage for even more Americans by scrapping protections for people with pre-existing conditions. (Dustin Pugel, 5/2)

Democrat Jay Sidie had a simple strategy last year when he ran against U.S. Rep. Kevin Yoder in Kansas’ 3rd Congressional District. He linked Yoder with Gov. Sam Brownback. Sidie knew Brownback was unpopular in the state, historically so. That was particularly true in the 3rd District, where school funding is a major issue. (Dave Helling, 5/1)

In 2005, the board of directors of the American Academy of Pediatrics (AAP) adopted a policy supporting relationships with companies that, “through their products, activities, and/or their philosophy, enhance the quality of life for children and their families and are aligned with the AAP’s values and mission” .... In doing so, the organization chose to apply a higher standard than simply asking whether corporate funding can be put to good use. Under this policy, the AAP should reassess its engagement with companies that sell infant formula. (Joshua M. Sharfstein and Dana L. Silver, 5/2)

[W]e’re worried that many kids won’t reach a healthy future because they aren’t active enough today and won’t be as they grow older. Based on results from a model we just published in the journal Health Affairs, too little physical activity among children now and later will translate into heart attacks, diabetes, cancer, and billions of dollars of avoidable health care costs. Fewer than one-third of children are “active to a healthy level.” (Bruce Y. Lee and Marie Ferguson, 5/2)

The leadership of the Department of Health and Human Services is getting an anti-abortion makeover. Charmaine Yoest, the former head of Americans United for Life, was named assistant secretary of health and human services in charge of public affairs late last week. (The post used to require Senate confirmation, but no longer does.) And Teresa Manning, a former lobbyist for the National Right to Life Committee, is said to have been chosen for the post of deputy assistant secretary for population affairs. (Emily Bazelon, 5/2)