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President Trump said on Thursday that he was directing a bipartisan group of lawmakers to create legislation that would provide relief for people who were surprised by bills they receive from out-of-network health care providers after both emergency and scheduled medical visits. During a rambling 45-minute speech that veered into matters of foreign policy and his anger over the special counsel’s report, Mr. Trump pushed for a measure that he said would be bipartisan, even as House Democrats — some of whom the president also attacked by name — took up legislation to fortify a law he reviles, the Affordable Care Act. (Rogers, 5/9)

Under principles unveiled by Mr. Trump, patients receiving emergency services wouldn’t get separate, out-of-network bills. Billing emergency-room patients more than their in-network allowed amount would be banned. Payments would then be determined by negotiations between providers and insurers. About one in seven patients wind up with surprise bills despite getting care at in-network hospitals, according to a March analysis by Health Care Cost Institute, a research collaborative. (Armour, 5/9)

In instances of nonemergency, scheduled treatment, the White House wants patients to be informed ahead of time if any of the care will be out of network. They want to require a written estimate upfront of all out-of-pocket costs, along with a single bill from all providers. (Weixel, 5/9)

With polls showing that voters trust Democrats over Republicans on health care, Trump has been hitting pocket-book medical issues that resonate with the middle-class, like prescription drug costs. He was joined at a White House event by patients, one who got a $110,000 bill after a heart attack, and another who got a bill for $17,850 for a test her insurer would have paid $100 for. "So this must end," Trump said. "We're going to hold insurance companies and hospitals totally accountable." The president said he wants to get it done "quickly," and Sen. Lamar Alexander, R-Tenn., chairman of the Health, Education, Labor and Pensions Committee, said he hoped to deliver a bill in July. (Freking and Alonso-Zaldivar, 5/9)

The president said that Democrats and Republicans alike should work quickly to stop “surprise” billing in the health-care industry. The unexpected bills are often high charges from doctors or facilities that are outside an insurer’s network, often unbeknown to patients. Trump said these practices are bankrupting patients through “health-care costs that are absolutely out of control. No family should be blindsided by outrageous medical bills.” (Goldstein, 5/9)

Senator Lamar Alexander, the Tennessee Republican who chairs the Senate’s Health, Education, Labor and Pensions Committee, told Trump during the news conference that he expects to send the president a bill in July. (Tozzi, 5/9)

Kaiser Health News: Surprise! Fixing Out-Of-Network Bills Means Someone Must Pay

A bipartisan group of senators has been working to come up with a plan for the past several months. They said Thursday that they hope to have a bill to the president by July. But will bipartisanship be enough? Even political will might not overcome divisions within the health industry. (Rovner, 5/9)

“We are committed to working together on bipartisan legislation that protects patients and families from surprise medical bills and the crippling financial debt that comes with them,” Energy and Commerce Chairman Frank Pallone Jr., D-N.J., and ranking member Greg Walden, R-Ore., said in a joint statement. “No family should be left in financial ruin through no fault of their own, which is why we have been working together on a bipartisan solution to protect patients that we hope to announce soon.” (McIntire, 5/9)

Trump also said another major announcement on healthcare transparency is coming in the next few weeks, although he did not offer details. (Luthi, 5/9)

Many in that congressional hearing and today at the White House agreed that the legislative solution can't rely on patients to file complaints or negotiate their bills down or, for that matter, turn to the media to draw attention to their particular story. In other words, it should be up to insurers, doctors, hospitals and other providers to solve this issue, not up to patients. (5/9)

Half of Americans say shielding people from surprise medical bills should be a top priority for Congress, according to an April Kaiser Family Foundation poll. That ranks behind lowering drug costs and protecting those with preexisting conditions, but ahead of major changes to the nation's health care system, such as repealing the Affordable Care Act or implementing a national "Medicare for All" plan. (Luhby, 5/9)

In a move sure to get attention in a 2020 battleground state, President Donald Trump indicated Thursday that his administration may approve a Florida plan to import lower-cost prescription drugs from abroad for use by residents. It's the latest flashpoint in a confrontation between the Trump administration and the pharmaceutical industry, which for years successfully has fought off importation proposals. Drugs in other economically advanced countries are often much cheaper because governments set prices. (Alonso-Zaldivar and Anderson, 5/9)

Trump’s own secretary of Health and Human Services, Alex Azar, expressed concerns with the idea in a meeting at the White House on Monday, and Sen. Lamar Alexander (R-Tenn.), who chairs the Senate committee overseeing the issue, questioned whether the imported drugs would be safe. But Trump appears eager to push forward in his pursuit of lowering drug prices, embracing an idea that is one of the signature proposals of progressives like 2020 Democratic presidential contender Sen. Bernie Sanders (I-Vt.). (Sullivan, 5/9)

In biotechnology, the rank and file are well-to-do. Many of the highest-paying employers in the health-care sector—and the entire S&P 500—were biotech companies, according to an analysis by The Wall Street Journal of annual disclosures for hundreds of big U.S. companies as provided by MyLogIQ. (Thomas, 5/9)

Ascension called on U.S. House of Representatives lawmakers Thursday to encourage more biosimilar use, claiming it could lower staggering drug costs that are hampering care. Although Ascension is the biggest not-for-profit hospital chain, it claims it has trouble obtaining volume-based discounts for drugs and only 18.6% of its drug spending involves products that have steady prices for an entire year. (King, 5/9)

Worries that Amazon.com Inc. will crush the retail pharmacy market can be shelved for now. That’s the view according to survey results from Evercore ISI. The findings showed that just 7% of U.S. households ordered over-the-counter drugs online instead of visiting a brick-and-mortar store, the survey of 2,500 adult consumers revealed. While online sales of over-the-counter medicine sales rose by 21 basis points from 2017, the growth is at a considerably slower rate than other industries and offers a glimmer of hope for the likes of CVS Health Corp. and Walgreens Boots Alliance Inc. (Lipschultz, 5/9)

Kaiser Health News: Is It A Feminist Right To Want More Sex? One Company Thinks A Pill Is The Answer

Studies have never defined a “normal” level of sexual desire. Despite that, there’s a website and an online quiz to help you decide if you’ve got a problem. Called “Right to Desire,” it brands libido as a feminist “right,” and its home page offers the defiant, in-your-face prompt: “Yes, I want my desire back.” Click a few boxes and you’re instantly directed to a remedy (and an online doctor to prescribe it): a pill called Addyi from Sprout Pharmaceuticals. “This particular product should not have been approved by FDA, but it was, and it is not a product that adds value to women’s lives,” said Susan Wood, assistant commissioner for women’s health at the Food and Drug Administration from 2000 to 2005. (Bluth, 5/10)

When health care workers feel they have been forced to do something they disagree with on moral or religious grounds, they can file complaints with the Department of Health and Human Services' Office for Civil Rights. Some high-profile cases have involved nurses who objected to providing abortion services. For a decade, the agency got an average of one of these complaints of conscience violations each year. The complaints can include doctors, nurses or other health care workers who feel a hospital or clinic that receives federal funds has discriminated against them because of their moral position. Groups of health care providers also can file complaints. (Simmons-Duffin, 5/9)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ ‘Conscience’ Rules, Rx Prices And Still More Medicare

In a new set of rules, the Trump administration wants to let not just doctors but almost any health care worker or organization decline to provide, participate in or refer patients for any health service that violates their conscience or religion. Also this week, the Trump administration is ordering prescription drugmakers to include list prices in their television ads for nearly all products. (5/9)

The Health and Human Services Department says a major drugmaker has agreed to donate medications that reduce the risk of HIV transmission for up to 200,000 people a year in support of the government's plan to end the epidemic in the U.S. The pledge by California-based Gilead Sciences may last up to 11 years, said HHS Secretary Alex Azar. Gilead will donate its Truvada prevention pill until a second-generation version becomes available. (5/9)

The donation is part of President Trump’s initiative to reduce HIV transmission in the United States by 90 percent by 2030. “The majority of Americans who are at risk and who could protect themselves with PrEP are still not receiving the medication,” Health and Human Services Secretary Alex Azar said in a statement. “This agreement will help close that gap substantially.” (Bernstein, 5/9)

In an unexpected development, Gilead Sciences (GILD) disclosed that a generic version of its Truvada pill for preventing HIV will be sold by Teva Pharmaceuticals (TEVA) starting in September 2020, roughly a year earlier than had been expected. Nonetheless, the news did little to assuage AIDS activists, who have been clamoring for a lower-cost version of the drug for the past few years, underscoring ongoing controversy over the cost of prescription medicines. Activists have complained that the price Gilead charges for its medicine has been a barrier to wider use and consequently thwarted efforts to eradicate the virus. (Silverman, 5/9)

The Democratic-controlled House has voted to prevent the Trump administration from easing health care coverage rules required by President Barack Obama's health care law. Under guidance the administration issued last year, states might allow insurers to offer low-cost, low-coverage policies that could deny coverage for people with pre-existing medical conditions. Democrats say that by blocking that language, Thursday's bill would protect patients with pre-existing conditions. (Fram, 5/9)

In October, the administration released a guidance to give states more flexibility by exempting them from some of the waiver requirements. The administration later suggested ways states could change their insurance markets, including revising the rules for consumers to qualify for premium subsidies, allowing those subsidies to go toward plans that don’t comply with all of the 2010 law’s regulations or setting up high-risk pools or reinsurance programs to help cover the most expensive patients. (McIntire, 5/9)

Next week, the House will vote on a package of seven health-care bills, several of which would reverse administration actions that Democrats have described as efforts to sabotage former president Barack Obama’s signature domestic achievement. The votes come as President Trump recently renewed his vow to repeal the 2010 law and directed the Justice Department to intervene in a lawsuit aimed at invalidating the law entirely — including its popular protections for Americans with preexisting medical conditions. (DeBonis, 5/9)

Other measures include a restoration of funding used to help consumers find and sign up for coverage under the health law, new disclosure requirements for prescription drug rebate programs, several measures intended to reduce drug costs and increase access to advanced medications known as biologics, and the allocation of $10 billion per year in new “reinsurance” payments that would help lower health care premiums by offsetting the costs of the most expensive insurance claims. Taken in total, the package is intended to build on the system established by the health law without disrupting the health care system for Americans who get coverage through work or a government program. (Thrush, 5/9)

“This legislation should not be necessary, but unfortunately the Trump Administration continues to take actions that undermine the health care of millions of Americans, including the more than 133 million people with pre-existing conditions,” said House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.). (Sullivan, 5/9)

Scrap "Obamacare"? Well, maybe not all of it. The Trump administration is arguing in court that the entire Affordable Care Act should be struck down as unconstitutional. But at the same time, Justice Department lawyers recently suggested that federal judges could salvage its anti-fraud provisions, raising questions about keeping other parts as well. (Alonso-Zaldivar, 5/10)

While much of the stock market sprints ahead powered by economic gains and investor confidence, the health care sector is limping behind. Drugmakers and health insurers have been on the defensive most of the year as politicians criticize the high cost of prescription drugs and medical care. The issue is acting like an anchor for their share prices, especially heading into an election cycle where health care costs will be a key topic. (Troise, 5/9)

A new report finds that improved profitability for insurers selling Affordable Care Act coverage to individuals last year means health plans could be issuing a record $800 million in rebates to consumers — a national finding that fits with the financial results in Minnesota. The study from the California-based Kaiser Family Foundation suggests that insurers overshot when setting premiums for 2018 because of uncertainty over the future of the federal health law, given moves at the time by the Trump administration. (Snowbeck, 5/9)

In Indiana, a local hospital system, Parkview Health, charged private insurance companies about four times what the federal Medicare program paid for the same care, according to a study of hospital prices in 25 states released on Thursday by the nonprofit RAND Corp. Colorado employers were shocked to learn they were paying nearly eight times what the federal government did for outpatient services like an emergency room visit, an X-ray or a checkup with a specialist at Colorado Plains Medical Center, northeast of Denver. (Abelson, 5/9)

Private employer-sponsored health plans paid hospitals 241% of Medicare prices, on average, for the same services at the same hospitals in 2017, according to a RAND Health study of prices across 25 states. That average price relative to Medicare has increased since 2015 when it was 236%. The study also found that relative prices in 2017 for outpatient care far exceeded prices for inpatient services. (Livingston, 5/9)

Prices have long been a closely guarded secret between hospitals and the health insurers that negotiate them. But more employers are sharing the data to curb rising costs. Hospital inflation accounts for about one-fifth of the overall growth in U.S. health-care spending since 1960, according to the Centers for Medicare and Medicaid Services. Supporters of greater transparency say releasing pricing data will help control spending on care by arming the companies who pay hospitals with better information to negotiate reimbursement rates. (Evans, 5/9)

Kaiser Health News: Market Muscle: Study Uncovers Differences Between Medicare And Private Insurers

The gap between Medicare and private plans — and how it plays out across the country — underscores a key point in how American health care is priced. Often, it has little to do with what it costs hospitals or doctors to provide medical care. “It’s about how much they can charge, how much the market can take,” said Ge Bai, an associate professor at the Johns Hopkins University Carey Business School who studies hospital prices but was not affiliated with the study. (Luthra, 5/9)

The young models and the candy-colored graphics that helped propel Juul to the top of the e-cigarette market are gone. In their place are people like Carolyn, a 54-year-old former smoker featured in new TV commercials touting Juul as an alternative for middle-age smokers. "I don't think anyone including myself thought that I could make the switch," Carolyn says, sitting in a suburban living room as piano music quietly plays in the background. (Perrone, 5/9)

The nation's largest insurer, UnitedHealthcare, has launched a nationwide bundled-payment model for maternity care, closely following the lead of Cigna and Humana, which have had the option since early last year. The Minnetonka, Minn.-based payer announced Thursday that its new bundled-payment program already has two provider groups participating, and plans to add as many as 20 by year-end. (Castellucci, 5/9)

Johnson & Johnson failed to get 2,400 state-court cancer lawsuits tied to its baby powder immediately transferred to a federal court in Delaware, where it could forge a single defense strategy. U.S. District Judge Maryellen Noreika in Wilmington dismissed J&J’s request on Thursday, noting that the world’s largest maker of health care products is partly responsible for the boomlet of litigation over its transfer strategy that it now characterizes as a crisis. (Feeley and Fisk, 5/9)

After a shouting match broke out, the Alabama Senate on Thursday abruptly delayed a vote on a bill that would outlaw most abortions in the state and make performing the procedure a felony punishable by up to 99 years imprisonment. The tumult and yelling on the Senate floor began when some Republicans attempted to remove amendments that would have allowed women to get abortions in cases of rape or incest. (Wax-Thibodeaux and Cha, 5/9)

In the Alabama Senate on Thursday, discord flared over consideration of an amendment that would create exceptions to the bill in the case of rape or incest. The House version passed without such a provision, but one was added in a Senate committee. Lt. Gov. Will Ainsworth, who presides over the Senate, removed the amendment on rape and incest in a voice vote, setting off screaming denunciations by Democratic Sen. Bobby Singleton. Shortly after, senators agreed to adjourn until Tuesday, when the bill and the amendment could be taken up again.“This is just a red meat kind of bill for the Republican party nationally,” Mr. Singleton said earlier during debate. “Think about what we’re about to do here in this state, and how we’re going to deal with the ability for a woman to make her choice.” (Campo-Flores, 5/9)

This week, the governor of Georgia signed one of the most restrictive abortion laws in the country. It effectively outlaws the procedure after six weeks of pregnancy. Republican governors in three other states — Mississippi, Kentucky and Ohio — have signed similar laws this year, marking a new and more severe tactic by the anti-abortion movement. The current constitutional standard under the Supreme Court’s Roe v. Wade decision is that abortion is legal up until the point when the fetus could survive outside a woman’s womb — usually about 24 weeks into the pregnancy. (Belluck, 5/9)

Many states have created new laws this year to limit abortion or even try to ban it altogether in the hope that the Supreme Court with President Trump’s two appointees will be more likely to approve them. (Keating, Tierney and Meko, 5/9)

Emboldened by a newly conservative U.S. Supreme Court, abortion opponents across the country are pushing some of the most restrictive anti-abortion legislation in recent years — like “heartbeat bills” that would ban the procedure after six weeks of pregnancy. With new legislative restrictions, they hope to incite a legal battle to overturn, or at least gut, the landmark Roe v. Wade ruling that was spurred by a Texas abortion law. But three of Texas' biggest anti-abortion groups want to avoid legislation that takes direct aim at Roe v. Wade, fearing such an approach could backfire and justices could uphold women's rights to the procedure. Instead, they want to take a more incremental approach with bills that would erode abortion protections more slowly. (Sundaram, 5/10)

The Texas Senate passed a bill on Tuesday that would ban abortions on the basis of the sex, race or disability of a fetus, and criminalize doctors who perform what opponents call “discriminatory abortions. ”Current state law prohibits abortions after 20 weeks of pregnancy, but there are certain exceptions, such as when the pregnancy is not viable or the fetus has "severe and irreversible" abnormalities. (Sundaram, 5/7)

Elizabeth Warren is set to visit a state that hasn’t been friendly to Democrats lately to pitch her plan to combat the opioid addiction crisis by boosting taxes on the wealthy. The Massachusetts senator and Democratic presidential candidate will travel to Kermit, West Virginia, on Friday before moving on to Chillicothe and Columbus, Ohio. By starting in West Virginia, she’ll be in a place that President Donald Trump carried by 42 points in 2016, but one that is suffering from the nation’s highest death rate from prescription drugs. (Raby, 5/10)

Democrats got a surprising compliment from the Trump administration’s top drug control official at a Thursday hearing as they discussed boosting opioid addiction treatment funding, while Republicans promoted efforts to stem illegal drugs through securing the southern border. House Oversight and Reform Government Operations Subcommittee Chairman Gerald E. Connolly, D-Va., who presided at the full committee hearing, touted a bill (HR 2569) that Chairman Elijah E. Cummings of Maryland released withMassachusetts Sen. Elizabeth Warren on Wednesday that would authorize $100 billion over 10 years to address the crisis. The bill, which is supported by all of the committee’s Democrats, faces a tough path to becoming law without Republican support. (Raman, 5/9)

The volume of opioids prescribed in the U.S. fell 17% last year, the most in more than a quarter-century, as doctors have become increasingly cautious about giving out large amounts of the drugs amid an epidemic of abuse. Opioid prescriptions are down 43% overall since their 2011 peak, according to a broad report published Thursday by IQVIA Holdings Inc., a health research firm that sells its services to drug companies. The report looks at the active opioid ingredient dispensed, after adjusting for how potent the various drugs are. (Langreth, 5/9)

Opioids again killed a record number of people in Maryland last year, but state officials said Thursday the unprecedented epidemic now fueled by fentanyl deaths is starting to show signs of slowing. Preliminary data found 2,114 opioid-related deaths in Maryland in 2018, a 5.2 percent increase from the year before. (Cox, 5/9)

A former North Texas doctor whose unnecessary prescriptions for powerful painkillers reportedly contributed to at least seven deaths has been sentenced to 20 years in federal prison. Howard Gregg Diamond, 58, pleaded guilty in October to charges of conspiracy to possess with intent to distribute controlled substances and health care fraud and aiding and abetting. He had faced up to life in prison but reached a plea agreement for 20 years, which a judge approved Thursday morning. (Steele, 5/9)

Noah Abdullah hasn’t immunized his 4-year-old son, Michael, saying that he’d read vaccines might be “no good” and that he’d “rather do natural things” to strengthen his child’s immune system. “I need to see more information before I start shooting him up with stuff,” Mr. Abdullah said. Donna Mosley said her 3-year-old grandson also did not have his vaccinations, though she wishes he did. His mother is afraid the shots could cause autism, she said, and his father’s Muslim beliefs have made him “totally against it.” (Otterman and Piccoli, 5/9)

Vaccine resistance in America has frequently coincided with periods of great angst and resentment toward a government that seems bent on micromanaging citizens’ lives. As the country faces the largest outbreak of measles since the disease was deemed eliminated in 2000, epidemiologists and medical ethicists say they are not surprised to see an us-versus-them mentality fueling the rise of vaccine opponents once again. “This is a broader symptom of distrusting our institutions,” said Richard Carpiano, a medical sociologist at UC Riverside. Those who object to the measles vaccine aren’t just questioning the safety of the shot. They’re challenging the state’s authority to require it. (Baumgaertner, 5/9)

A Kentucky teenager banned from school earlier this year because he lacked the chickenpox vaccine contracted the disease last month, according to his father, who says it’s the “best thing to do” to become immune. Eighteen-year-old Jerome Kunkel returned to class Monday for the first time since March 14, when the Northern Kentucky Health Department barred students without proof of vaccination or immunity against the chickenpox virus from attending Assumption Academy, a Catholic school in the northern part of the state, following an outbreak that had infected 32 students. (Brice-Saddler, 5/9)

More than a dozen states have moved to declare pornography a public health crisis, raising concerns among some experts who say the label goes too far and carries its own risks. The Arizona Senate approved a resolution this week calling for a systemic effort to prevent exposure to porn that's increasingly accessible to younger kids online. At least one legislative chamber has adopted a similar resolution in 15 other states. (Whitehurst and Cooper, 5/9)

It may be possible to pass gonorrhea through kissing, challenging the widely accepted notion that the sexually transmitted disease is spread almost exclusively through sexual contact, a new study says. Researchers in Australia found that kissing with tongue may be a way to transmit oropharyngeal gonorrhea, or oral gonorrhea, particularly among gay and bisexual men. (Bever, 5/9)

Michael Fenlon’s company is one of the nation’s biggest employers of newly minted college grads. He’s watching a tidal wave approach. College presidents and deans tell him repeatedly that they’ve had to make managing students’ anxiety and other mental-health issues a priority. “They’re overwhelmed with the demand for mental-health services on their campuses. I hear this again and again. It’s really striking,” says Mr. Fenlon, chief people officer for PricewaterhouseCoopers, which hires thousands of college grads each year. (Shellenbarger, 5/9)

Scientists are gearing up a major study to find out whether a drug can silence the gene that causes a devastating illness called Huntington's disease. This development follows the discovery that the experimental drug reduced levels of the damaged protein that causes this mind-robbing ailment. The new study will determine whether that drug can also stop progression of the disease. (Harris, 5/9)

Menopause blindsided author Darcey Steinke. The hot flashes and insomnia were uncomfortable. The depression was debilitating. And the cultural expectations — that postmenopausal women are no longer interested in sex — made her both frustrated and angry. "I feel like in the world we live in, the patriarchal world, women are most valued for their sexuality and their motherhood," Steinke says. "Once menopause comes, there's a feeling of shame that comes for a lot of women." (Chang and Gordon, 5/9)

Two students at a high school outside Denver allegedly opened fire during class on Tuesday, killing another student. In North Carolina just a few days earlier, two students were killed and four injured by a gunman at UNC Charlotte. Amid a pattern of school violence that has become all too familiar, Judy Woodruff talks to John Ferrugia of Denver’s Rocky Mountain PBS and Education Week’s Evie Blad. (5/9)

Amazon has agreed to make sure school supplies and children’s jewelry sold on its website do not contain excessive levels of lead or cadmium. Washington Attorney General Bob Ferguson said an investigation found dozens of items that tested above legal levels for the dangerous metals. Some pencil pouches had parts containing 80 times the legal limit for lead and about 30 times the limit for cadmium. (5/9)

“Oh my God, this is going to be amazing,” a preadolescent wearing a gray hoodie exclaimed as he dashed in to The Yard, a 50,000-square-foot adventure playground on Governors Island in New York Harbor. The Yard, for kids 6 through 13, lacks the usual monkey bars, slides and swings. It is, however, well-stocked with dismembered store mannequins, wooden packing crates, tires, mattresses, an old piano and assorted other detritus of the modern world. (Schiffman, 5/10)

More good news about cholesterol-lowering statin drugs: They may reduce the risk for glaucoma. Previous studies of the link between statin use and glaucoma have produced conflicting results. Now a large study, published in JAMA Ophthalmology, offers long-term data. Researchers followed 136,782 health care workers for up to 15 years, tracking statin use and the incidence of glaucoma, the fluid buildup in the eyeball that damages the optic nerve and can lead to blindness. (Bakalar, 5/9)

Parents in San Francisco are rallying around a second-grade teacher with breast cancer who will have to cover the cost of a substitute to replace her while she's on extended sick leave. A Glen Park Elementary school teacher, who did not want to be identified, will likely be on leave for the rest of the year, the San Francisco Chronicle reported Tuesday. She could have as much as $240 per day deducted from her salary to pay for a substitute thanks to a 1976 change to the California education code, the newspaper reported. (Yancey-Bragg, 5/9)

The California law forcing a teacher with cancer to pay for her own substitute shocked parents and students — but it wasn’t much of a surprise to teachers themselves. “Parents were outraged and incredulous — like, this can’t be,” said Amanda Fried, a parent with kids at San Francisco’s Glen Park Elementary, according to the San Francisco Chronicle. “There must be some mistake.” (Gilmour, 5/9)

“By the time she has her second surgery, she will have exhausted all of her accumulated sick leave days and will be using extended sick leave, which is the regular salary minus the cost of the substitute teacher. Her colleagues will be donating sick days, but they will not be available until the next school year,” the page read. The teacher has taught at Glen Park School for 17 years. In the San Francisco School District, a teacher is allotted 10 sick days at the beginning of the school year, and 100 days of extended sick leave if they need more time. The teacher’s salary for those extra days is reduced by the cost of a substitute teacher, which is generally between $167.94 and $203.16 per day in that district. (Shalby, 5/9)

A judge has ruled that a 3-year-old Florida boy must resume his cancer treatment, despite his parents’ wishes. The Tampa Bay Times reports that Hillsborough County Circuit Judge Caroline Tesche Arkin ruled Wednesday that Noah McAdams must immediately resume the first phase of chemotherapy to treat his leukemia. Joshua McAdams and Taylor Bland-Ball want to treat their son with natural remedies that include cannabidiol, fresh foods and alkaline water. Noah was diagnosed with acute lymphoblastic leukemia April 4. (5/9)

The revised state budget Gov. Gavin Newsom released this week includes more subsidies for Covered California enrollees but doesn’t expand Medi-Cal to all undocumented adults as some lawmakers have pressed him to do. On the campaign trail, Newsom came out in support of a single-payer system in which everyone receives the same government insurance. He says that’s still his goal, but he’s focusing on smaller steps toward providing all Californians health insurance they can afford. (Caiola, 5/9)

Calling it “a stain on the state of California,” Gov. Gavin Newsom on Thursday vowed to use part of a historic budget surplus to tackle homelessness in the nation’s most prosperous state. “This homeless issue is out of control,” Newsom told reporters on as he unveiled his revised state budget. “(People) are outraged by it, they are disgusted by it, they are wondering what the hell is going on in Sacramento, and they should.” (Beam, 5/9)

Gov. Gavin Newsom has said he wants to see Californians “harden” their homes to protect them from deadly wildfires, but he declined Thursday to endorse a proposed $1 billion fund to help homeowners pay for retrofits and did not include funding for home hardening in his latest budget proposal. Releasing his budget revisions at the Capitol, Newsom reiterated his support for fire-resistant roofs and other features that can protect homes during mega-fires. He cited reporting by McClatchy that showed half the homes built to stricter building codes survived the November 2018 Camp Fire that destroyed nearly 19,000 buildings, compared to the 18 percent survival rate for older homes built when less stringent codes were in effect. (Kasler, Bollag and Thompson, 5/9)

Iowa’s Medicaid director sought to reassure Iowans Wednesday that UnitedHealthcare’s exit from the giant health-care program would not cause major disruptions. “The first thing I want to emphasize is no one is losing benefits,” Mike Randol told more than 50 Medicaid members in the first of six town hall meetings he’s scheduled around the state. “…There are going to be bumps in the road, but we’re going to do everything we can to make it as seamless as possible.” (Leys, 5/8)

A program that helps victims of domestic violence is increasingly having trouble finding safe places for people to stay because of an energy boom that has filled all the housing options in the area. Converse Hope Center Director Lisa Thalken said recently, when a woman sought their help, they couldn't find anywhere to put her. "Our advocates literally called every hotel in the county and could not find a single hotel room," Thalken said. "Thankfully, we are good friends with the manager at the Higgins Hotel in Glenrock and she remembered that someone had reserved a night and hadn't checked in. So, we were able to get them in to Glenrock, but that was the only room in the entire county that evening." (Edwards, 5/8)

In their first major test, members of the Texas House’s LGBTQ Caucus helped muscle down a bill Thursday night that they characterized as an assault on gay rights and protections. The five female lawmakers in the first-of-its-kind caucus used a parliamentary maneuver to delay and ultimately defeat House Bill 3172 by Fort Worth Republican Matt Krause, a measure he said would protect religious individuals and organizations from attacks by the government, and authorize the Texas attorney general to bring lawsuits in their defense. (Platoff, 5/9)

New York's state Senate passed a bill this week requiring the informed consent of patients for any healthcare procedure or examination, including those performed in the course of medical education or training. The bill passed the Assembly March 14 and now heads to Gov. Andrew Cuomo. If signed into law, it would make it clear that patients who are unconscious after being anesthetized for a procedure must have explicitly consented to any unrelated procedure—such as a pelvic, rectal or prostate exam—before they were anesthetized. (Henderson, 5/9)

Connecticut’s largest health care employee union issued a new threat Thursday, setting a deadline of June 3 for more than 2,500 nursing home workers to strike if additional funding for pay raises isn’t added to the state budget. The union, New England Health Care Employees, District 1199 SEIU, has asked for a 4 percent increase in wages for all nursing home caregivers industrywide – including non-bargaining workers – in each of the next two fiscal years. This would cost $40 million annually, labor officials said. About half of that would be borne by the state and half would be covered by federal Medicaid payments to Connecticut. (Carlesso, 5/9)

On a street in downtown Athens, across from an arthouse movie theater and beside a craft brewery, sits an off-white building with a large statue of a bulldog near the entrance. This structure houses a local branch of Biotest Plasma Center, a national company that collects plasma from people’s blood. Plasma, when it’s separated from the rest of the blood, is a yellowish liquid. It is rich in protein and helps the body to fight infection. It is so valuable for pharmaceutical companies that it has sometimes been referred to as “liquid gold,” according to the National Institutes of Health. (Herbert, 5/9)

The penalty for disseminating intimate images without consent would be considerably more severe under a bill passed by the Senate Thursday. “It addresses a pernicious issue, thankfully not rampant but so serious that when it actually does occur, it has the potential to ruin individuals’ lives,” said Sen. John Kissel, R-Enfield, as he spoke in favor of the bill. “The dissemination of intimate images, especially regarding social media, has been gaining in traction over the years with the advent of more and more technology.” (Megan and Carlesso, 5/9)

A Cuyahoga County Jail officer sold drugs to an inmate as sheriff’s deputies watched him in real-time on surveillance videos, according to court records. Stephen Thomas’ arrest marks the latest in a growing number of investigations into issues at the jail following eight inmate deaths in 2018. Other investigations have focused on mismanagement of the jail, civil-rights abuses and officers attacking inmates. (Ferrise, 5/9)

Florida is an “outlier” in prison systems across the nation when it comes to the use of solitary confinement, according to a 90-page federal lawsuit filed Wednesday that alleges the state Department of Corrections is violating the constitutional rights of inmates.A view of a hallway from a jail cell. Attorneys with the Southern Poverty Law Center named the state agency and Secretary Mark Inch as defendants in the lawsuit, which contends state prison officials “discriminate against people with disabilities in its use of isolation” and are “deliberately indifferent to the substantial risk of harm caused” by isolation policies. (5/9)

Florida has improved its ranking in an annual report that rates states on how prepared they are for public health emergences. The Robert Wood Johnson Foundation analyzed which states are leaving themselves at risk to infectious disease, antibiotic resistance, terrorism, weather emergencies, or other threats in the "2019 National Health Security Preparedness Index" report. (Miller, 5/8)

In March 1997, an inmate at Arizona's Perryville Prison broke out of a cell with a faulty lock and stabbed a corrections officer to death. In November 2000, an inmate escaped his poorly secured cell at the state prison in Phoenix and assaulted a nurse, leaving her bloody and bruised. In June 2018, six inmates at Lewis Prison abandoned cells with broken locks and entered another inmate's quarters, beating him so badly he died of his injuries. (Polletta, 5/9)

Nearly 200 people have died in North Carolina from influenza or its complications so far this flu season — 199 to be precise. Each of those 199 people had a life, a family who loved them and a story to be told. Among them were infants, the elderly and everyone in between. Include Melissa Crady of Fayetteville in the group of 199. Melissa was born 36 years ago with chronic idiopathic neutropenia, a blood condition that causes a reduced number — or the complete absence — of neutrophils, a type of white blood cell that is responsible for much of the body’s protection against infection. (Barnes, 5/10)

A Cleveland-based study purports there is a gut-brain connection that may be an important step toward finding treatments for Parkinson’s disease. The local study’s findings, however, appear to contradict other previous research. An analysis of more than 62 million patient records from 26 health systems across the country showed that patients who had an appendectomy were more than three times as likely to develop Parkinson’s than those who had not. (Washington, 5/9)

A Minneapolis medical device maker that was supposed to challenge the existing business model for costly orthopedic implants for the lower body is instead being closed by Medtronic, which acquired the business in 2016 but could never make it work. Responsive Orthopedics, founded as a startup by entrepreneurs including Minneapolis med-tech veteran Doug Kohrs, designed a line of prosthetic knee and hip implants that were specifically engineered to have lower prices than the high-end implants that have long dominated the market. (Carlson, 5/9)

Rainy season in South Florida means it's also mosquito season. And now there's a new weapon being added to the arsenal against the insects in the Florida Keys. Wednesday morning, after heavy rains in Key West, residents woke up to a familiar sound — a mosquito control helicopter spraying larvicide aimed at the Aedes aegypti mosquito. That's the one that can carry diseases like zika and dengue fever. (5/9)

A rallying cry echoed across San Francisco’s City Hall steps Thursday afternoon as 60 homeless mothers, children and organizers called on the Board of Supervisors to allocate an additional $14 million in funding for homeless services and housing ahead of Mother’s Day. (Wu, 5/9)

When Stephany Angelacos was diagnosed with Stage 2 breast cancer in 2016, she immediately turned to the internet for support. Online, there are numerous groups and forums where people dealing with cancer can share their experiences. Angelacos researched her disease and its treatments, and then, inspired by how knowledgeable everyone was, decided to found her own invite-only breast-cancer Facebook group that same year. (Roisin Lanagan, 5/6)

Among a certain set, the Texas Legislature is known as the National Laboratory of Bad Ideas, a hothouse for legislative foolishness that often spreads across the country. But sometimes it works the other way around. Sometimes the bad ideas come here from elsewhere, and sometimes even Massachusetts. (Christopher Hooks, 5/4)

In the past year, I’ve had two significant surgeries: a C-section to deliver my son last June and an operation on my foot to remove a bunion in December. I had the first emergency room visit of my adult life (yes, I held onto my bills) and spent months in physical therapy teaching my foot how to walk again. That’s a lot of health care for a generally healthy 34-year-old. Along the way, I’ve changed the way I approach health care — and hopefully have learned a few things. (Sarah Kliff, 5/6)

Three years ago, my cousin tried to kill me. When people ask why, I don’t know what to say. Usually I mumble that he didn’t have a reason. I say that he didn’t even think he had a reason. We had no argument that day or any other in 40 years. I say that we didn’t think of each other merely as cousins. We were best friends. We spoke for hours every week, often late at night, squinting through the portal of a video chat to exchange complaints about our lives and show off household projects. I say that we had been planning for months to get together that weekend. We organized a family reunion at his house. (Wil S. Hylton, 5/8)

When it comes to abortion, Republicans are peeking out from behind their masks. To be clear, I don’t mean to say they aren’t still spreading lots of lies about abortion, about women’s health, and about their own supposedly deep concern for the welfare of children. There is no topic on which either party’s rhetoric is as consistently disingenuous, misleading, and outright false as when Republicans talk abortion. (Paul Waldman, 5/9)

The Trump administration is simultaneously working to end the Affordable Care Act (ACA) and advance a proposal that would help lower drug prices, which is like taking one step forward and eight steps back in terms of containing health-care costs. Unfortunately, the administration’s missteps would be particularly damaging to the millions of small businesses, their employees and self-employed individuals who depend on the ACA. (John Arensmeyer, 5/9)

Candidate Donald Trump’s biggest selling point was that he was supposedly a successful self-made entrepreneur who would use his private-sector know-how to “run government like a business.” Many of us scoffed. After all, even if you believed he was a successful businessman — one who hadn’t, ahem, lost a billion dollars — managing a private company is nothing like helming a government. ... This week, the administration proposed a change to how the government sets the official poverty line. That line, for those unfamiliar, is an income threshold that determines eligibility cut-offs for various safety-net programs, such as food stamps, housing assistance and Medicaid. (Catherine Rampell, 5/9)

President Trump recently spoke at the annual Prescription Drug Abuse and Heroin Summit in Atlanta, touting “pretty amazing” progress in combating the overdose crisis afflicting the country and expressing pride in government efforts to reduce the total number of opioids prescribed, claiming a 34 percent drop in total opioid prescriptions during his time in office. The number of opioid prescriptions might be coming down, but overdose deaths continue to mount, with the Centers for Disease Control and Prevention provisional report showing over 46,000 opioid-related deaths in the 12 months ending April 7, 2019, 60 percent of which involved illicit fentanyl. Thirty-two percent involved heroin. (Dr. Jeffrey A. Singer, 5/9)

The gold standard. A cornerstone. A bedrock. A true public health success story. These are all ways we describe the federal program that provides contraception, cancer screenings, STD treatment and other preventive health services to 4 million people every year. It’s also known as the Title X family planning program, created nearly 50 years ago to ensure access to modern methods of birth control for poor and low-income people. (Clare Coleman, 5/9)

You can determine the excesses of an era by its martyrs. Essential to the story of a martyr is that they did not wish to die but rather chose or accepted death over some unacceptable alternative. The alternative — the thing being selected against — contains the fervor of the age, and it signs its name in the blood of martyrs. On April 30, as college students at the University of North Carolina at Charlotte were gathering for an end-of-year concert, a gunman entered a university building and began firing. As campus police rushed to respond — any institution of any size trains its security for these occasions by now — Riley Howell, a 21-year-old student charged and tackled the shooter, bringing him down with such force that the killer reportedly complained of his injuries to first responders. (Elizabeth Bruenig, 5/9)

With the country in the throes of the opioid epidemic, the Food and Drug Administration started a risk evaluation and mitigation strategy (REMS) in 2012 to restrict prescribing of quick-absorbing fentanyl to appropriate patients. At the time, these were the most potent and riskiest opioid-based medications available. The program should have worked, but was undermined by one company, Insys, whose top executives were convicted last week of bribing doctors to prescribe this type of painkiller to people who weren’t supposed to get it. (William Fleischman and Joseph S. Ross, 5/10)

Last month, Joe Biden called me to talk about his conduct during Clarence Thomas’s Supreme Court confirmation hearings in 1991. There has been a lot of discussion recently about whether he has offered me the right words. Given the #MeToo movement and Mr. Biden’s bid for the presidency, it’s understandable why his role in the hearings is being debated anew. If the Senate Judiciary Committee, led then by Mr. Biden, had done its job and held a hearing that showed that its members understood the seriousness of sexual harassment and other forms of sexual violence, the cultural shift we saw in 2017 after #MeToo might have began in 1991 — with the support of the government. (Anita Hill, 5/9)

Last week President Donald Trump took another hostile action against LGBTQ people. But you wouldn’t know that from many of the headlines. “Trump Administration Strengthens ‘Conscience Rule’ for Health Care Workers,” read the headline in the New York Times about a bill that would allow doctors, nurses, physicians, pharmacists, nurses, teachers and others to discriminate based on their religious beliefs. National Public Radio’s web site went with “New Trump Rule Protects Health Care Workers Who Refuse Care For Religious Reasons.” (Michelangelo Signorile, 5/9)

If 18-year-olds are old enough to fight in a war for our country, why aren’t they old enough to drink alcohol legally? It’s a question that has been asked, mostly by 18-year-olds, for decades. To my mind, it has never received a wholly satisfactory answer. But keeping bartenders from serving teenagers legally at least kept third parties safer from drunk driving. There’s no such justification for raising the age to buy tobacco products. Yet a bipartisan coalition is gearing up to make it illegal to sell cigarettes and e-cigarettes to people under 21. (Ramesh Ponnuru, 5/9)

Anyone who is active on social media has come to expect a certain degree of tribalism around the issues of the day: guns, climate change, abortion, politics, and the like. We’ve been surprised to see it creep into the online conversation about nutrition science, especially the discussion about low-carbohydrate, high-fat diets. Even more surprising to us is that such advocacy sometimes comes from health professionals, scientists, and journalists, from whom we would normally expect a certain degree of objectivity. (Nicola Guess and Ethan J. Weiss, 5/9)

Concerns about Donald Trump’s fitness for the office of president arose during the campaign and continue to this day. But now, in the Mueller report, we have an abundance of new evidence that sheds light on these concerns. What makes this a unique opportunity is the quality and relevance of the data: They are derived from multiple sources both friendly and opposed to the president, were obtained under oath, and show us how the president conducted himself in the eyes of those who worked directly with him while in office. (Bandy X. Lee, Leonard L. Glass and Edwin B. Fisher, 5/9)

When McKenzie Regional Hospital closed last fall, it meant more than the loss of the only hospital in rural Carroll County. It meant the loss of one of the county’s largest employers. It meant babies born in McKenzie can no longer be delivered there. It meant nursing students at Bethel University could not graduate and work locally. It meant people with life-threatening injuries had to be transported an additional twenty minutes for care — and close to an hour if the road to the nearest hospital flooded. (Wendell Potter, 5/9)

If you were to rank all the ways humans can inflict harm on one another, ranked by severity, it might be a few pages before you got to “intentional inducement of FOMO.” Purposefully giving someone else FOMO — fear of missing out — is not a crime, or even a misdemeanor. But it is a big problem on Instagram, where millions of teenagers go every day to check on their peers. And it is one of the subtle slights that Instagram is focused on classifying as part of its new anti-bullying initiative, which will use a combination of artificial intelligence and human reviewers to try to protect its youngest users from harassment and pain. (Kevin Roose, 5/9)

I’m not a mother, and at 48 I’m unlikely to become one. My whole professional life, I’ve been leaning in. It wasn’t until things went badly wrong that I realized the human-capital value of a group of women modern society tends to ignore or dismiss—stay-at-home-moms. As a global management professional, I’ve lived and traveled all over the world. In 2015 my life exploded. On a dark April afternoon in Dubai, a perfect storm of issues with my job, my property investments, my health and an emotional entanglement forced me to recognize that something had to give. I resigned from my job and entered a period of physical, financial, emotional and spiritual hell. (Elizabeth Shine, 5/9)