51��Ƶ

A federal judge on Thursday struck down a Trump administration rule that allows small businesses to band together and set up health insurance plans that skirt requirements of the Affordable Care Act. The rule is “clearly an end-run around the A.C.A.,” said the judge, John D. Bates, of the Federal District Court for the District of Columbia. The ruling was the second big defeat this week for President Trump on a top-priority item on his health care agenda as he has sought to use the courts to obliterate his predecessor’s signature achievement. Another judge on Wednesday blocked Medicaid work requirements in Arkansas and Kentucky. (Pear, 3/28)

The 43-page ruling, submitted by U.S. District Judge John D. Bates of the District of Columbia, blocks new rules from the Trump administration overseeing “association health plans,” which would allow small businesses to combine their forces to offer less expensive plans outside the ACA that would be both less expensive and provide fewer health protections. “The final rule is clearly an end-run around the ACA,” Bates, an appointee of President George W. Bush, wrote in the Thursday ruling. “Indeed, as the president directed, and the secretary of labor confirmed, the final rule was designed to expand access to AHPs to avoid the most stringent requirements of the ACA.” (Bella, 3/29)

The rule, put forward by the U.S. Department of Labor, would have allowed small businesses and those who are self-employed to band together and buy lower-cost health insurance policies, similar to large employers. In the suit filed by 11 states and the District of Columbia, the judge found the department unreasonably expanded the definition of employers to include groups without any real commonality of interest as well as business owners without employees. (3/28)

“We are pleased that the District Court saw past the Trump Administration’s transparent effort to sabotage our health care system and gut these critical consumer protections in the service of its own partisan agenda,” New York Attorney General Tish James, one of the parties to the suit, said in a statement. It was not immediately clear if the administration would appeal. (Demko, 3/28)

An additional four million people were expected to enroll in these less comprehensive plans by 2023, according to the Labor Department, which issued the final rule. “We disagree with the district court’s ruling and are considering all available options,” Justice Department spokeswoman Kelly Laco said. “The administration will continue to fight for sole proprietors and small businesses so that they can have the freedom to band together to obtain more affordable, quality health-care coverage. The Association Health Plan rule opened health-care options for dozens of associations representing thousands of small businesses and sole proprietors and provided them with access to the same type of affordable health-care options offered by other employers.” (Armour, 3/28)

The Department of Labor expanded access to AHPs through an ERISA regulatory change. The agency has authority over group insurance regulation through that law. The judge said this change ran counter to "Congress's clear intent that ERISA cover benefits arising out of employment relationships." During oral arguments in January, Judge Bates homed in on the Trump administration's intent, noting it seemed like a dispute between the executive branch and Congress. He frequently invoked the paper trail of ACA criticism from President Donald Trump and his top deputies as clear intent that the rule was meant to change the ACA insurance markets. (Teichert and Luthi, 3/28)

The ruling comes amid a whirlwind week for the Trump administration and its efforts to tear down Obamacare. On Monday, the Justice Department said the entire Affordable Care Act should be struck down in a filing with a federal appeals court, a dramatic reversal of a stance it took last year. And on Wednesday, a federal district court judge blocked the administration's efforts to allow states to impose work requirements on Medicaid recipients. Trump now says that his administration will roll out a new health care plan this year. (Luhby, 3/29)

The decision is the second blow to Trump’s health agenda in as many days. It follows twin rulings Wednesday by another Washington judge who blocked administration-sanctioned plans to impose work requirements for some Medicaid recipients in Kentucky and Arkansas. (Larson and Tozzi, 3/28)

Republicans on Capitol Hill pointed to association health plans this week as their policy alternative for more affordable health care than the plans sold under the Democrats’ health care law. "These association health plans, the number of people that are signing up for them is pretty big," Sen. John Barrasso, R-Wyo. told reporters before the ruling came out on Thursday. (McIntire, 3/28)

President Trump continued to reach out to Republican lawmakers Thursday to take the lead on crafting a health plan to replace the Affordable Care Act, working to hand off the politically sensitive effort ahead of the 2020 elections. Senate Republicans, meanwhile, want the administration to take the lead on developing a plan while they remain on politically safer ground, working on popular voter issues such as lowering drug prices and ending surprise medical bills. (Armour and Peterson, 3/28)

Mitch McConnell has no intention of leading President Donald Trump’s campaign to transform the GOP into the “party of health care.” “I look forward to seeing what the president is proposing and what he can work out with the speaker,” McConnell said in a brief interview Thursday, adding, “I am focusing on stopping the ‘Democrats’ Medicare for none’ scheme.” (Everett, 3/28)

President Trump said Thursday that a group of GOP senators will come up with a "spectacular" plan to replace ObamaCare if the courts strike down the law. Trump told reporters at the White House that lawmakers including Sens. John Barrasso (R-Wyo.), Bill Cassidy (R-La.) and Rick Scott (R-Fla.) are working on the plan, at Trump's request. (Sullivan, 3/28)

“They are going to work together, come up with something that’s really spectacular,” Trump said. “Maybe we’ll even get support in the House from Democrats. But it’s going to be far better than Obamacare,” the president added, calling the law a “disaster.” (Epstein, 3/28)

Rep. Mark Meadows (R-N.C.), one of President Trump’s closest congressional allies, on Thursday said any plan to replace ObamaCare will come from Congress, rather than the administration. “It’s my impression there will be a plan the president and White House endorses, but I think it will be a collaborative effort between House and Senate Republicans,” Meadows told reporters. (Weixel, 3/28)

Republicans face an uphill battle in their bid to fulfill President Trump's prophecy that the GOP will become "the party of health care." The presidential directive, handed down in a tweet on Tuesday, came at an inopportune time for Republicans, less than a day after the Trump administration called for the courts to invalidate the Affordable Care Act in its entirety. (Greenwood, 3/29)

President Trump’s decision to call for ObamaCare’s complete dismantling in court is shining the spotlight on Mick Mulvaney, the acting White House chief of staff who reportedly pushed for the action. Mulvaney, a former member of the conservative House Freedom Caucus, argued in favor of backing a lawsuit to nullify the Affordable Care Act during a White House meeting with other officials, according to two published reports. (Sullivan and Fabian, 3/28)

Days after the Trump administration ramped up its attack on the Affordable Care Act, health officials and lawmakers in Connecticut were still decrying the move and exploring its impacts should a repeal succeed. Co-chairs of the legislature’s Insurance and Real Estate Committee called on the president Thursday to reverse himself and leave the health law alone, while detailing the ways Connecticut residents would be impacted if the ACA disappears. (Carlesso, 3/28)

Gov. Mike DeWine has said that if the entire Affordable Care Act is ruled unconstitutional, he guarantees that his administration would seek state-level rules to ensure that Ohioans with pre-existing conditions can’t be denied insurance coverage. But if Obamacare falls, there’s no guarantee that state lawmakers would agree to pass such rules. (Pelzer, 3/28)

The Trump appointee who oversees Medicare, Medicaid and Obamacare quietly directed millions of taxpayer dollars in contracts to Republican communications consultants during her tenure atop the agency — including hiring one well-connected GOP media adviser to bolster her public profile. The communications subcontracts approved by CMS Administrator Seema Verma — routed through a larger federal contract and described to POLITICO by three individuals with firsthand knowledge of the agreements — represent a sharp break from precedent at the agency. Those deals, managed by Verma’s deputies, came in some cases over the objections of CMS staffers, who raised concerns about her push to use federal funds on GOP consultants and to amplify coverage of Verma’s own work. CMS has its own large communications shop, including about two dozen people who handle the press. (Cancryn and Diamond, 3/29)

It was a new era in Washington in 1981, and abortion rights activists were terrified. With an anti-abortion president, Ronald Reagan, in power and Republicans controlling the Senate for the first time in decades, social conservatives pushed for a constitutional amendment to allow individual states to overturn Roe v. Wade, the Supreme Court ruling that had made abortion legal nationwide several years earlier. The amendment — which the National Abortion Rights Action League called “the most devastating attack yet on abortion rights” — cleared a key hurdle in the Senate Judiciary Committee in March 1982. Support came not only from Republicans but from a 39-year-old, second-term Democrat: Joseph R. Biden Jr. (Lerer, 3/29)

When House Speaker Nancy Pelosi introduced legislation this week to strengthen the Affordable Care Act, Democrats across the ideological spectrum were quick to express their support: moderates, liberals, even Representative Alexandria Ocasio-Cortez, the often uncompromising progressive freshman. But not Bernie Sanders. When asked on Tuesday night whether he, too, supported the House bill, Mr. Sanders was defiant. “No,” he said tersely. “No,” he said again, when pressed. “The incremental reform that I support is phasing in ‘Medicare for all.’” (Ember, 3/29)

From April through December 2018, outside inspectors found deficiencies that caused “actual harm” to veterans at 52 out of the 99 VA nursing homes they reviewed. In three facilities, they found veterans’ health or safety in “immediate jeopardy.” In eight, inspectors found veterans both harmed and in jeopardy. (Estes and Slack, 3/28)

Arizona’s U.S. House delegation has come together behind bipartisan legislation designed to improve the Phoenix VA hospital, one of the lowest-ranking facilities in the VA system. Rep. Andy Biggs, R-Ariz., introduced the Phoenix VA Congressional Oversight Act in October, but the last Congress ran out of time to take action. (Egeland, 3/28)

The House delivered a rebuke to President Donald Trump on Thursday by voting to condemn his administration's move to restrict transgender men and women from military service. A non-binding resolution opposing Trump's transgender ban passed 238-185. Every Democrat supported the resolution, while nearly every Republican voted against it. Five Republicans broke ranks and voted in favor: Brian Fitzpatrick of Pennsylvania, Trey Hollingsworth of Indiana, Will Hurd of Texas, John Katko of New York and Tom Reed of New York. (3/28)

As investigators closed in on Purdue Pharma, the maker of the opioid painkiller OxyContin, more than a decade ago, members of the family that owns the company began shifting hundreds of millions of dollars from the business to themselves through offshore entities, the state of New York alleged in a lawsuit on Thursday. The legal complaint, released at a news conference by the state attorney general Letitia James, was heavily redacted. Even so, it contains striking details alleging systematic fraud not only by the Sacklers but by a group of large but lesser-known companies that distributed alarming amounts of prescription painkillers amid a rising epidemic of abuse that has killed hundreds of thousands of people nationwide. (Rabin, 3/28)

Members of the Sackler family who control OxyContin-maker Purdue Pharma LP allegedly used a web of corporate entities to transfer funds from the company to themselves, moves the New York attorney general says were fraudulent, on the basis that the company was already insolvent or close to it. An amended lawsuit filed Thursday by New York Attorney General Letitia James against Purdue and eight individual Sackler family members is pushing a novel argument that profits paid to Purdue’s owners should be clawed back because of mounting litigation filed against the company. The claims hinge on a legal theory meant to protect creditors from debtors that try to stash or shield assets for their personal benefit. (Hopkins and Randazzo, 3/28)

The lawsuit alleged Purdue and other manufacturers engaged in deceptive marketing that downplayed the dangers of the addictive painkillers and accused distributors of failing to detect the diversion of the drugs for illicit purposes. "As the Sackler family and the other defendants grew richer, New Yorkers' health grew poorer and our state was left to foot the bill," James said in a statement. (3/28)

“We found that pharmaceutical manufacturers and distributors engaged in years of deceptive marketing about the risks of opioids and failed to exercise their basic duty to report suspicious behavior, leading to the crisis we are living with today," James said in a statement. (Burke, 3/28)

The suit in New York state court, which James said is the most extensive of its kind in the U.S., adds to the potentially massive legal liability that has led Purdue to threaten filing for bankruptcy. Meanwhile, states and local governments have targeted the Sackler family’s wealth in an effort to recoup billions spent on the social costs of opioid addiction. More than 1,600 suits against opioid makers have been consolidated in federal court Ohio, and other cases are pending in state courts. (Larson, 3/28)

Pharmaceutical companies should have to prove that any new opioids work better or are safer than current painkillers, the departing head of the Food and Drug Administration said, laying out a vision for replacing the drugs blamed for sparking an overdose epidemic. FDA Commissioner Scott Gottlieb, who plans to leave his job at the agency next week, wants companies to develop pain drugs that could eventually allow older opioids to be restricted or to come off the market entirely. (Edney, 3/28)

The outgoing Food and Drug Administration commissioner on Thursday suggested to senators some areas that are ripe for legislation if they want to achieve certain public health goals. In a wide-ranging hearing before the Senate Appropriations Agriculture Subcommittee, which provides funding for the FDA, Commissioner Scott Gottlieb told lawmakers that the agency needed a new framework for the way it approves prescription opioid painkillers to ensure that new products would have to represent improvements over existing ones. (Siddons, 3/28)

D.C. officials have purchased 66,000 naloxone kits, part of a plan to dramatically increase the supply of a lifesaving opioid-overdose antidote that has been scarce on the streets of a city with one of the nation’s highest rates of drug deaths. D.C. officials also intend to buy 10,000 more kits in the coming months, the deputy mayor for health and human services, Wayne Turnage, said in an interview Thursday. The goal is to distribute those 76,000 kits — through community health organizations and police officers — by Sept. 30, the end of the fiscal year, he said. (Jamison, 3/28)

Michigan has enacted   a new  law that allows people to refuse opioid medications by placing a non-opioid advance directive in their medical file. The goal of the new law — which was signed by former Gov. Rick Snyder late last year and went into effect Thursday  — is to prevent more people from becoming addicted to opioid pain medication, which is most often a gateway to heroin, and to prevent recovering addicts from being exposed to opioidsand relapsing. (Kovanis, 3/28)

The immediate goal of the city’s ambitious Getting to Zero campaign is to reduce new HIV diagnoses by 90% between 2013, when there were 394 cases, and 2020. San Francisco is only about halfway there but is moving faster than the nation as a whole and any other big city. (La Ganga, 3/28)

LGBT groups sued Arizona Thursday asking a federal judge to strike down a state law prohibiting HIV and AIDS instruction that “promotes a homosexual lifestyle.” The lawsuit, filed on behalf of Equality Arizona, alleges the 1991 law constitutes unconstitutional discrimination and restricts educational opportunity for LGBT students. It says it enshrines in state law that LGBT students can only be discussed in a negative light and communicates to students and teachers “that there is something so undesirable, shameful, or controversial about ‘homosexuality’ that any positive portrayals of LGBTQ people or same-sex relationships must be explicitly barred.” (3/28)

Two gay-rights organizations are suing Arizona over its so-called "No Promo Homo" law, which bans public district and charter school HIV/AIDS instruction that "promotes a homosexual lifestyle." The National Center for Lesbian Rights and Lambda Legal filed the lawsuit Thursday in federal court on behalf of Equality Arizona, a nonprofit that advocates for LGBT residents. (Altavena, 3/28)

Surgeons in Baltimore have performed what's thought to be the world's first kidney transplant from a living donor with HIV, a milestone for people with the AIDS virus — and one that could free up space on the transplant waiting list for everyone. Nina Martinez of Atlanta traveled to Johns Hopkins University to donate a kidney to an HIV-positive stranger, saying she "wanted to make a difference in somebody else's life" and counter the stigma that too often still surrounds HIV infection. (3/28)

“Society perceives me, and people like me, as people who bring death,” Martinez said in an interview Saturday before the operation. “And I can’t figure out any better way to show that people like me can bring life. ”Martinez, who acquired HIV from a blood transfusion as an infant, appeared at a Hopkins news conference Thursday to announce the surgery, the first of its kind. She said she feels well and is looking forward to training to run in this October’s Marine Corps Marathon in Washington. (Bernstein, 3/28)

Kaiser Health News: World’s First HIV-To-HIV Kidney Transplant With Living Donor Succeeds

The world’s first kidney transplant from a living HIV-positive donor to another HIV-positive person was successfully performed Monday by doctors at a Johns Hopkins University hospital. By not having to rely solely on organs from the deceased, doctors may now have a larger number of kidneys available for transplant. Access to HIV-positive organs became possible in 2013, and surgeries have been limited to kidneys and livers. (Knight and Heredia Rodriguez, 3/28)

New York City’s worst measles outbreak in decades continues to grow in the Orthodox Jewish community, where some families have resisted vaccinating their children, health officials said. There have been 33 cases confirmed in the past week, bringing the total to 214 cases of measles since October, a spokesman for the New York City Department of Health and Mental Hygiene said Thursday. (Brody, 3/28)

Facing an outbreak that is now among the largest in the country — and the focus of newfound concerns about a national resurgence of the measles — the Rockland County executive this week took a step seemingly without precedent in the United States. Beginning Wednesday, all unvaccinated children were banned from enclosed public spaces, including schools and synagogues, as part of a 30-day state of emergency. Parents found to have violated the directive could be charged with a misdemeanor and face fines or jail time. (Facher, 3/29)

A mumps outbreak that began at Philadelphia's Temple University in February has snowballed, with the city's health department now reporting 106 cases associated with the flare-up. University officials say the vast majority of students involved had been immunized previously with the MMR vaccine, which protects against measles, mumps and rubella. So why are so many still appearing on campus with the mumps' signature swollen cheeks? (Ellis, 3/28)

The Macomb County Health Department announced Thursday that a person with a confirmed case of the virus may have exposed others to it while visiting a Macomb Township Bank of America branch on March 19. Anyone who visited the bank at 45194 Romeo Plank Road in Macomb Township between noon and 2 p.m. on March 19 may have been exposed to measles. (Shamus, 3/28)

These viruses weren’t supposed to affect humans. They were supposed to ride along inside bacteria — unobtrusive hitchhikers taking advantage of another microbe’s machinery. But that wasn’t what Dr. Paul Bollyky and his colleagues saw in their lab dishes three or four years ago. The viruses seemed to be changing the behavior of human immune cells. Instead of gobbling up bacteria as they normally did, white blood cells just sat there. (Boodman, 3/28)

She’d been told that childbirth was going to be painful. But as the hours wore on, nothing bothered her — even without an epidural. “I could feel that my body was changing, but it didn’t hurt me,” recalled the woman, Jo Cameron, who is now 71. She likened it to “a tickle.” Later, she would tell prospective mothers, “Don’t worry, it’s not as bad as people say it is.” It was only recently — more than four decades later — that she learned her friends were not exaggerating. (Murphy, 3/28)

Across the U.S., 6,227 pedestrians died in traffic accidents in 2018, the highest number in nearly 30 years. The findings from a Governors Highway Safety Association report show that many of these deaths occurred in big cities like Houston and Miami. The signs are all over most cities — stretches of road without crosswalks and people needing to walk on roads built for rush-hour traffic. But the real increase, experts say, comes from larger trends: drivers and pedestrians distracted by their phones and a growth of larger vehicles on the road. (Stachura, 3/28)

Even therapists need someone to talk to sometimes. Lori Gottlieb is a psychotherapist who started seeing a therapist herself five years ago, when the man she thought she would marry unexpectedly broke up with her, shattering her sense of the present and the future. "My reaction was the reaction of everybody that I told at the time, [which] was 'This guy's a jerk! You dodged a bullet!' " Gottlieb says. "But once I go to therapy, I start to see — or I'm forced to see — the situation, and my role in it too." (Gross, 3/28)

Doctors have long suspected a connection between allergies and the psyche. In 1883, Dr. Morell Mackenzie, a pioneer in the field of ear, nose and throat medicine, observed, “It has long been noticed that attacks of prolonged sneezing are most apt to occur in persons of nervous temperament.” In the 1940s, doctors discovered that allergic patients could be tricked into experiencing allergy attacks. In one case, a doctor exposed a patient to a goldenrod plant, without telling the patient that the plant was artificial. The patient immediately developed sneezing, runny nose and nasal congestion. These symptoms resolved quickly once the doctor revealed his deception to the patient. (Klasco, 3/29)

The rate of commercially insured children diagnosed with ADHD climbed 32 percent in Pennsylvania and 25 percent in New Jersey in less than 10 years, according to a new study by the Blue Cross Blue Shield Association. The Greater Philadelphia area, including South Jersey and Delaware, saw a 33 percent increase. The national increase was 31 percent. (Giordano, 3/28)

Among all the beasts in the animal kingdom, perhaps none is more dangerous to humans than the mosquito. The whiny insects aren't just irritating — they can be deadly. In fact, the U.S. Centers for Disease Control and Prevention reckons that mosquitoes are responsible for at least 700,000 deaths worldwide each year, thanks to their ability to transmit diseases such as malaria and yellow fever with a single bite. (Netburn, 3/28)

Targeting this receptor might offer a new way to foil blood-seeking mosquitoes and prevent the transmission of diseases including malaria, Zika virus and dengue, according to the study published Thursday in the journal Current Biology. "We found a receptor for human sweat, and we found that acidic volatiles that come off of us are really key for mosquitoes to find us," says Matthew DeGennaro, a neurogeneticist at Florida International University in Miami. (Greenfieldboyce, 3/28)

From pathology labs to intensive care units, artificial intelligence is playing an increasingly direct role in the diagnosis and treatment of patients, according to medical specialists who gathered here this week for a meeting on the widening array of uses for data and analytics in medicine. Academy Health’s Datapalooza conference, an annual rallying cry for the use of data to improve care, is typically a place where government leaders and digital technology experts discuss wonky policy changes that could help liberate patient information walled off by an array of health organizations. (Ross, 3/29)

Bristol-Myers Squibb (BMY), seeking to re-energize its cancer pipeline, is turning to an artificial intelligence startup for help, inking a deal to use the firm’s analytical tools and “real-world” patient data to better target and accelerate clinical trials. The deal with Concerto HealthAI, a Boston-based firm backed by the $1 billion SymphonyAI fund, is an effort to infuse real-world evidence from medical practices across the U.S. into Bristol’s research. Concerto uses data from CancerLinQ, a national repository of information on cancer patients, to search for patterns that may inform drug development. (Ross, 3/28)

Electronic medical records — from a variety of vendors, not just Epic — are the bane of many doctors' existence. Amid its jokes, the parody site also shared serious, real-life findings that dealing with electronic records takes up about half of a primary care doctor's day, and that a 10-hour shift in an Emergency Department can require up to 4,000 clicks. (Goldberg, 3/29)

An abortion-rights group is asking a federal judge to block a Mississippi law that will ban most abortions once a fetal heartbeat can be detected, about six weeks into pregnancy. The Center for Reproductive Rights on Thursday expanded a lawsuit it filed last year challenging a Mississippi law that banned abortions after 15 weeks’ pregnancy. A federal judge declared that law unconstitutional. Republican Gov. Phil Bryant signed the heartbeat bill March 21, and it is set to become law July 1. It’s one of the strictest abortion laws in the nation. (Pettus, 3/28)

After 15 inmates killed themselves within 15 months, a federal judge will weigh whether the Alabama prison system is doing enough to prevent suicides. U.S. District Judge Myron Thompson on Thursday began a mini-trial on suicide prevention measures. It comes almost two years after his initial 2017 ruling that the Alabama prison system provides "horrendously inadequate" mental health care. (3/28)

A federal judge in Montgomery is again hearing arguments over efforts to stop a wave on inmate suicides in Alabama's overcrowded and understaffed prison system. U.S District Judge Myron Thompson is hearing testimony on whether the state has adequately responded to 15 suicide deaths in the past 15 months. (Gonzales, 3/28)

The first state to limit tobacco and electronic cigarette sales to people 21 and older is contemplating a new nicotine crackdown: outlawing flavored electronic cigarette liquids and flavored tobacco to combat a spike in teenage vaping. Hawaii would be the first state to adopt such a ban under a bill before the Legislature. San Francisco was the first U.S. city to do so. The proposal would ban flavored e-cigarette liquids such as Maui Mango and Cookie Monsta, along with cloves and other flavored tobacco products, but it would exempt menthol cigarettes and vaping liquids. (McAvoy, 3/29)

Late last year, Johns Hopkins All Children’s Hospital made a striking admission to state regulators: It had failed to report at least nine cases where its care had hurt patients. Worse, All Children’s had gotten in trouble for not disclosing similar issues just months before. (McGrory and Bedi, 3/29)

Nearly two thirds of Tennesseans favor raising the legal age for smoking tobacco and e-cigarettes from 18 to 21, a dramatic shift in what has long been one of the nation’s most smoking-friendly states, according to a new poll from Nashville health leaders. Sixty-three percent of participants supported raising the smoking age, with 48 percent supporting the proposal "strongly," poll results show. Concern about young adults smoking was consistent across demographics, political affiliation and all regions of Tennessee. (Kelman, 3/28)

A report released Thursday identified serious flaws at Somerville Hospital and its parent company, after a 34-year-old woman dying from an asthma attack was locked outside the emergency room, but the review stopped short of blaming any individuals for the 2016 tragedy. The report criticized hospital officials for failing to share key details about the death of Laura Levis with her family and with hospital board members, and describes Cambridge Health Alliance, the parent of Somerville Hospital, as beset by internal divisions. (Dayal McCluskey, 3/28)

An Overland Park weight-loss hospital that lost its Medicare certification last year remains in legal limbo. On Wednesday, a federal appeals court upheld on procedural grounds a lower court’s dismissal of Blue Valley Hospital’s lawsuit challenging the loss of its certification. The hospital’s lawyer, Randy Schultz, said it would now attempt to make its case before the Centers for Medicare & Medicaid Services (CMS), the federal agency that revoked its certification. (Margolies, 3/28)

The state Senate passed legislation Thursday banning so-called gay conversion therapy for minors, moving Massachusetts closer to being the 16th state to outlaw a practice critics have likened to child abuse. The Senate approved the bill, 34 to 0, with five Republicans voting “present,” weeks after the House overwhelmingly approved the measure. (Stout, 3/28)

A group of lawmakers that championed a law closing the state's long-troubled youth prison is now proposing to delay the facility's closure to give county governments more time to build facilities to replace it. The closure of the Lincoln Hills School for Boys and Copper Lake School for Girls and the completion of smaller, regional facilities would be delayed by six months under a bill being circulated among lawmakers for support. (Beck, 3/28)

The $170 blood test, called BeScreened-CRC, was developed by Phoenix-based diagnostics laboratory Beacon Biomedical and is a screening tool for colon cancer, its developer says. Sonora Quest Laboratories in Arizona has offered the test since December, and no doctor's order is required. It's not covered by Medicare. Coverage by commercial insurance plans varies. (Innes, 3/28)

Two suicides in the span of a week involving student survivors of the Parkland school shooting have sparked a new question at the Florida Capitol: How much mental-health money should the state provide to schools? The Senate has proposed setting aside $100 million for schools to offer mental-health services next year, $30 million more than what the House has recommended. (Ceballos, 3/28)

A former night shift employee of a mental health treatment center in unincorporated Washington County was arrested Tuesday on suspicion of sexually abusing a patient last year. Christopher Zeisler, who worked as a mental health technician at Cedar Hills Hospital, remained held Thursday at the Washington County Jail on suspicion of first-degree sexual abuse. (Bailey, 3/28)

Between 2016 and 2017, operators answered 882 suicide calls at Headrest, Ford said. From 2017 to 2018, it was 1,218. And so far in the first three months of 2019, there have been 898 suicide calls. Callers from Concord make up the third-largest group of suicide-related calls Headrest answered in the state behind Manchester and Nashua, [Headrest executive director Cameron] Ford said. (Willingham, 3/28)

The city didn’t seem to be doing enough. Neither were the nonprofit groups. But maybe she — as nothing more than another human who cared — could accomplish what they couldn’t. Maybe she could get this couple out of a tent where they’d lived for more than two years, at the base of Union Station, and into housing. When The Washington Post published a profile Friday of Monica Diaz, a fast-food restaurant employee simultaneously navigating the homeless and working worlds, Howard University law student Gabriela Sevilla immediately got to work. (McCoy, 3/28)

News about a current lawsuit against Obamacare has come out within a few days of news about an old one from which it grew. The Donald Trump administration put itself on record urging the courts to strike down the entire Affordable Care Act. And a new book by Supreme Court reporter Joan Biskupic revealed details about the curious path that Chief Justice John Roberts took in the 2012 case. (Ramesh Ponnuru, 3/28)

A single-payer health-insurance system can finance good-quality coverage for all U.S. residents while still reducing overall health-care spending by roughly 10%, according to a study I co-authored last November. All Americans would be able to get care from their chosen providers without having to pay premiums, deductibles or copayments. Other countries currently provide good health care to residents at a fraction of the U.S. cost. As of 2017, the U.S. spent $3.3 trillion on health care—17% of gross domestic product. Germany, France, Japan, Canada, the U.K., Australia, Spain and Italy spent between 9% and 11% of GDP on health care. Yet some measures—like those based on the amenable mortality rate, which tracks medically preventable deaths—rank the U.S. well below those countries. (Robert Pollin, 3/28)

Wanna know the reason Republicans have had so much trouble coming up with a “replacement” plan for Obamacare? Because if Republicans actually tried to devise a health-care system that fulfilled both conservative principles and their public promises, they’d probably propose something that looks too much like . . . Obamacare. For reasons few can fathom, President Trump has revived the GOP’s disastrous, nearly decade-long effort to destroy the Affordable Care Act. (Catherine Rampell, 3/28)

It’s already clear how the 2020 election campaign will be waged. Republicans will claim, falsely, that Democrats want to take away your hamburgers. Democrats will assert, truthfully, that Republicans want to take away your health care.I guess we’ll see which argument wins. On Monday, the Trump administration adopted a new position on a lawsuit over the Affordable Care Act, telling a federal appeals court that it now supported the complete elimination of the law, which has made health insurance available to many Americans who wouldn’t have it otherwise. (Paul Krugman, 3/28)

President Trump says he wants to make the Republican Party “the party of health care.” There’s reason to be skeptical Republicans want that given their failure to reform or replace Obamacare after nearly a decade loudly opposing it. But if they do, there’s one principle they need remember: Put care above cost. Republican health-care policy almost always comes back to cost control. Former House speaker Paul Ryan (R-Wis.) rose to fame in part for his proposal to turn Medicare into a “premium support” program. In simple terms, that meant the federal government would no longer ensure that seniors received care when they need it; rather, it would ensure the payment of a certain amount of money that each senior would use to purchase an insurance plan that, in theory, would provide the same or a better level of care. (Henry Olsen, 3/28)

U.S. universal coverage can be achieved by expanding Medicaid in all states, increasing assistance for buying coverage in the marketplace, ensuring that people enroll in affordable coverage for which they’re eligible, and addressing coverage for undocumented immigrants. (Matthew Fiedler, Henry J. Aaron, Loren Adler, Paul B. Ginsburg and Christen L. Young, J.D., 3/27)

Iowa does not need approval from state lawmakers to pursue imposing work requirements on Medicaid recipients. But Republicans apparently needed to look tough on poor people who rely on government health insurance. So the GOP-controlled Senate passed Senate File 538. The misdirected bill directs the Iowa Department of Human Services to seek federal permission to require “able-bodied” Iowans to work, engage in community activities or be enrolled in school to utilize Medicaid. Now, legislative leaders say the legislation is not expected to pass this year. That's good but even so, the 32 Republican senators who supported this have some explaining to do to voters. Namely, how they’re expected to pay for all the bureaucracy created by their idea. (3/27)

When the law goes into effect, Kentuckians will face fewer obstacles to access the care and treatments they need. Patients and providers will receive responses on prior authorizations within 24 hours for urgent health care services and within five days for non-urgent services — a significant departure from existing prior authorization guidelines in Kentucky that could delay care for weeks. In addition, patients’ prescriptions for maintenance drugs will be valid for one year or until the last day of coverage, and any change in dosage during the period of authorization will be covered — no need for another prior authorization. (Bruce Scott, 3/26)

Black mothers in Texas are dying at a rate 2.3 times as high as white mothers regardless of income, education, marital status or other health factors. The good news is that we can change this because in almost 80 percent of pregnancy-related deaths, there is at least some chance of preventability. (Michele A. Rountree, 3/28)

President Trump and his minions cooked up a fake national security crisis to justify diverting billions of dollars to build a bigger, wider border wall to keep out of the hordes of immigrants he imagines marching across the deserts, hills and prairies between established ports of entry. It’s bad enough that he’s wasting money and time on a manufactured crisis, but it’s all the worse that he’s doing so when the U.S. is facing an actual crisis — one that is killing tens of thousands of Americans every year — and doing little to stop it. (3/29)

From my perspective as someone who entered the treatment industry as a patient in 1989 and who has remained in this space since then as a therapist and later as an academic, the stigma of addiction — or more specifically its branding — is powerfully negative. Physicians whose practices focus on patients with opioid use disorder don’t have to worry about their “brand” being harmed because it is tied to this treatment and this patient population. But a typical primary care physician in Manhattan or suburban Atlanta or rural Nevada might worry about the potential trouble that patients with addictions might cause in their waiting rooms. (David A. Patterson Silver Wolf, 3/29)

Tens of thousands of students recently walked out of classes around the world demanding action on climate change. It’s depressing that our children have to take to the streets to beg lawmakers to protect our planet. (Joni Ashbrook, 3/28)

Monday, April 1, marks the start of the American Public Health Association’s (APHA) annual National Public Health Week. The APHA has dedicated a day this year to the topic of violence prevention, including gun violence prevention. This important day comes on the heels of a congressional hearing on whether to provide funding for gun violence research to the Center for Disease Control for the first time in two decades. (Timothy Fabian, 3/28)

Early detection efforts always have the downside of turning more people into patients. Whenever doctors look for early forms of disease, they regularly find more people with it than they would have otherwise. In some, the detected disease is destined to intensify and cause symptoms, or even death. Earlier treatment may help them — or it may not. Others are overdiagnosed, told they have the disease yet it is not destined to ever bother them. Many more have findings that falsely suggest disease and require a battery of tests to attest to their health. (H. Gilbert Welch, 3/29)

A complex web of legal, policy, and structural barriers has led to persistent gaps in access to treatment for opioid use disorder in jail facilities in the United States and prevented the delivery of coordinated care. (Ingrid A. Binswanger, 3/38)

If your monthly income suddenly dropped by $1,500 — or even more — would you be able to weather the sudden change? For how long? For many Americans, a single unexpected financial hit like that would force them to borrow money or sell something; the prospect of seeing your monthly income suddenly and unexpectedly plummet for months — or even years to come — could be completely overwhelming. That is exactly what has happened to a significant number of veterans. (Kayla Williams, 3/28)

With all that’s going on in the world of law, I didn’t plan on writing about abortion again so soon. But as the tide of Supreme Court-bound abortion cases turns rapidly into a flood, it’s become a challenge even for people with a deep interest in the future of the abortion right to keep track of what’s happening and of which cases to worry about most. Thus, this column. Within the next few weeks, a challenge to Louisiana’s abortion law, which I wrote about last month, will arrive at the court as a formal appeal. Louisiana requires that doctors who perform abortions in that deeply anti-abortion state do the impossible by getting admitting privileges in local hospitals. (Linda Greenhouse, 3/28)

Department of Child Safety Director Greg McKay has finally broken his silence on the YouTube mother and her house of horrors.His message: don’t blame us for not catching on to the fact that Machelle Hobson was, according to police, basically treating her seven adopted children like slaves. (Laurie Roberts, 3/27)