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The House voted Wednesday to condemn the Trump administration for pushing a federal appeals court to obliterate the Affordable Care Act, and it urged the Justice Department to defend the law in court. The vote, 240-186, was nonbinding, but it documented the House’s support of the health law, which was passed nine years ago without the votes of any Republicans. With the resolution, Democrats sought to put Republicans on the record for failing to come to the defense of the health law’s most popular provisions, such as protecting people with pre-existing medical conditions and mandating coverage for “essential health benefits,” like mental health coverage, prescription drugs, emergency services and maternity care. (Pear, 4/3)

The resolution passed 240 to 186, with eight Republicans joining the chamber’s Democrats in rebuking Trump. One Democrat, Rep. Collin C. Peterson (Minn.), broke ranks and voted against the resolution. With Wednesday’s vote, Democrats were seeking to put Republicans on record as siding with Trump in his attempt to use the courts to overturn the ACA, known as Obamacare, including politically popular provisions that protect people with preexisting conditions and allow individuals to remain on their parents’ insurance plans until age 26. (Wagner, 4/3)

The non-binding resolution is one of is one of several steps Democrats are taking to try to link vulnerable Republicans with the administration's controversial legal strategy while touting their own work to shore up the law. The last time the GOP tried to get rid of Obamacare, it cost them control of the House and several state capitols, and Democrats are working to keep the spotlight on the issue going into the 2020 election cycle. (Ollstein, 4/3)

Many Republicans on Capitol Hill were ready to move on Wednesday from pursuing a politically risky health-care overhaul ahead of the 2020 election. But President Trump and the Democrats weren’t quite ready to change the subject. The Democratic-led House on Wednesday passed a resolution criticizing the Trump administration’s actions to undermine the Affordable Care Act. Eight House Republicans, largely from swing districts, defected to support the resolution, which was backed by all but one Democrat. “There’s no backup plan,” said Rep. Fred Upton (R., Mich.), who voted for the resolution. (Peterson and Armour, 4/3)

Trump’s rare reversal acknowledged dual political realities: One is that House Democrats are extremely unlikely to pass any Republican-backed health care bill. Perhaps more important, health care is a toxic issue for Republicans, who have repeatedly failed to unite behind an Obamacare alternative that would necessarily be hugely complex and filled with difficult compromises. Speaking at a GOP fundraiser in Washington on Tuesday night, Trump acknowledged that Democrats — who hammered Republicans on health care in the 2018 midterm elections — enjoy a political advantage on the issue: "They have healthcare right now," Trump said. "We have to take that away from them." Republican leaders said that the campaign for Trump to roll back his pledge stemmed from unrest in the rank-and-file of the Senate. (Johnson and Everett, 4/2)

Kaiser Health News: Listen: What’s Up With Trump’s Sudden Turnaround On Health Care?

Julie Rovner, the chief Washington correspondent for Kaiser Health News, joined Stephen Henderson on WDET’s “Detroit Today” show Tuesday to talk about the Trump administration’s recent decision calling for a federal appeals court to overturn the Affordable Care Act. The decision created so many concerns among Republican lawmakers that President Donald Trump has stepped back from comments suggesting the GOP would push through its own health plan this year.  Rovner also takes questions from listeners about the uncertain future of health care policies. Listen here for the conversation. (4/3)

The Obamacare wars have ignored what really drives American anxiety about health care: Medical costs are decimating family budgets and turning the U.S. health system into a runaway $3.7 trillion behemoth. Poll after poll shows that cost is the number one issue in health care for American voters, but to a large extent, both parties are still mired in partisan battles over other aspects of Obamacare – most notably how to protect people with pre-existing conditions and how to make insurance more affordable, particularly for people who buy coverage on their own. (Kenen, 4/3)

The Trump administration's health department is suspending contracts with several GOP-connected communications firms, according to four people with knowledge of the situation, days after a POLITICO report revealed the existence of the contracts. One of the contractors who was hired to boost Centers for Medicare and Medicaid Services Administrator Seema Verma's profile with the media has also abruptly cut ties with the agency, two people with knowledge of the situation said. (Diamond and Cancryn, 4/3)

Rep. Joe Kennedy first appeared on this podcast in early 2017, at House Democrats' lowest moment: The GOP had steamrolled the party, speeding an Affordable Care Act repeal bill that seemed inevitable. But the GOP's efforts ultimately failed; Democrats retook the House a year later; and Kennedy this week rejoined POLITICO's Dan Diamond to reflect on how House Democrats' health policy has changed as they've become the majority party, why he now supports a Medicare for All bill, how he approaches questioning Trump officials like HHS Secretary Alex Azar and more. (4/3)

Gov. Kim Reynolds said Wednesday she is confident Iowa will have two insurance companies ready to take on 425,000 poor and disabled Iowans after the state’s biggest Medicaid management company leaves. Reynolds said she has “every indication” that Amerigroup will stay in the state and that Iowa Total Care will start up July 1 as planned. Contracts for the next fiscal year have not yet been signed. (Sostaric, 4/3)

Six states and the District of Columbia sued the Department of Agriculture on Wednesday, saying it weakened nutritional standards in school breakfasts and lunches when it relaxed the requirements affecting salt and refined grains last year. The lawsuit in Manhattan federal court asked a judge to overturn the changes, saying they were carried out in an arbitrary and capricious manner. (4/3)

New York, California, Illinois, Minnesota, New Mexico, Vermont and the District of Columbia said Agriculture Secretary Sonny Perdue acted in an "arbitrary and capricious" manner, and asked a Manhattan federal judge to void the new sodium and whole grain standards. "The Trump administration has undermined key health benefits for our children . . . with deliberate disregard for science, expert opinion, and the law," New York Attorney General Letitia James said in a statement. (Stempel, 4/3)

The attorney general of New York, Letitia James, announced the lawsuit outside a Brooklyn elementary school, Public School 67, which serves residents of the Ingersoll Houses, a low-income apartment complex run by New York City. Ms. James said 99 percent of those students qualified for free or reduced-price meals before 2017, when the city made school lunches free for all students. With local officials, parents, a pediatrician and antihunger advocates at her side, Ms. James said the Trump administration, by rolling back nutritional requirements, was “attacking the health and the safety of our children,” particularly the poorest, including the two million across the state who live in poverty. (Green and Piccoli, 4/3)

In December, the Agriculture Department unveiled its final plans to loosen those standards, which mandated that carbohydrate-rich foods—like pizza, pasta or hamburger buns—be made with whole grains, and targeted an overall reduction in sodium content in elementary school lunches to 640 milligrams. The new standards require schools to serve whole grains in only half the items on their lunch menus, and maintain the overall sodium limit at 1,230 milligrams. The maximum recommended daily sodium intake is about 1,900 milligrams for that age group, according to government dietary guidelines. (Hackman, 4/3)

The Food and Drug Administration warned rogue stem-cell clinics on Wednesday to stop selling unproven treatments that could harm patients. The agency’s latest effort, like most of its previous ones, consisted only of letters to companies and clinics. One letter warned a company making products from umbilical-cord blood that it was violating federal law, and other letters told 20 clinics and stem-cell makers that they appeared to be subject to F.D.A. review for approval and that they should contact the agency about how to comply. (Grady, 4/3)

The letters are part of an ongoing attempt by the FDA to rein in the booming industry , which critics say has injured dozens of patients and cheated thousands more. In recent years, hundreds of clinics have have popped up selling stem cell procedures — not covered by insurance, unproven by science and unauthorized by the government — that purveyors claim can treat ailments ranging from creaky knees to Alzheimer’s, Crohn’s disease and multiple sclerosis. (Wan and McGinley, 4/3)

“Most forms of regenerative medicine are still in early stages of development, and adult stem cells and stem cells from birthing tissues have not been shown to be safe and effective for use” in treating patients, said FDA Commissioner Scott Gottlieb and Peter Marks, director of the FDA’s center on biologic therapies, in a statement. The FDA warning letter issued to Cord for Life Inc., of Altamonte Springs, Fla., said that the company’s products are intended for therapeutic uses such as orthopedic conditions. But they are, in the FDA’s view, subject to federal regulation as drugs and as human cells or cellular or tissue-based products. (Burton, 4/3)

In the summer of 2015, ophthalmologist Thomas Albini examined a patient who had suddenly lost vision in both eyes. The woman, 78, had macular degeneration and had visited a Miami clinic offering a new treatment: injections of stem cells made from fat in her belly. Instead of getting better, the woman’s vision deteriorated significantly. Peering into her eyes, Albini said, he saw clumps of blood floating inside. The next day, a second patient appeared in Albini’s emergency room at the University of Miami complaining of blindness and searing pain after receiving eye injections from the same company, U.S. Stem Cell. (McGinley and Wan, 4/3)

The National Institutes of Health is requiring all visitors — including patients — to disclose their citizenship as a condition of entry, a policy that has unnerved staff scientists and led to recent disputes with at least two Iranian scientists invited to make presentations, only to be blocked from campus. In one incident, a Georgetown University graduate student arriving for a job interview was held up at security, then allowed to proceed to one of the campus buildings. But as he prepared to make a presentation, NIH police arrived, removed him from a lab and escorted him off campus, according to a complaint Monday to a group that represents staff scientists. (Bernstein, Sun and Rein, 4/3)

U.S. health officials are investigating whether electronic cigarettes may trigger seizures in some people who use the nicotine-vaping devices. The Food and Drug Administration said Wednesday it has reviewed 35 reports of seizures among e-cigarettes users, mainly in young people. Regulators stressed it's not yet clear whether vaping is responsible. But they said they're concerned and encouraged the public to report information about the issue. (Perrone, 4/3)

The FDA has not established a pattern among reported cases: Seizures have been reported among first-time e-cigarette users and experienced users, and they have been reported as occurring immediately after inhalation and as much as a day after use. (Weixel, 4/3)

“While 35 cases may not seem like much compared to the total number of people using e-cigarettes, we are nonetheless concerned by these reported cases,” FDA Commissioner Scott Gottlieb and Principal Deputy Commissioner Amy Abernethy said in a statement. (Thielking, 4/3)

Seizures or convulsions are known potential side effects of nicotine poisoning and have been reported in relation to intentional or accidental swallowing of nicotine-containing e-liquids, according to the FDA statement. (4/3)

Gottlieb has been a vocal critic of electronic cigarette makers for not doing enough to keep the devices out of the hands of young people. E-cigarette use was up 78% among high school students and 48% among middle-school students from 2017 to 2018, according to federal data. (O'Donnell, 4/3)

As federal regulators and state legislators race to restrict electronic cigarettes – the most effective means to quit smoking – at least two other companies are introducing alternatives that involve nicotine without the need to inhale. Vaping, the most criticized smoking cessation option, will have a version of tobacco-free snuff to compete with starting this month. At the same time, the makers of Camel cigarettes are bringing back dissolvable nicotine lozenges. (O'Donnell, 4/3)

A Republican lawmaker will introduce legislation this week that would raise tobacco age of sale requirements from 18 to 21. Rep. Robert Aderholt (R-Ala.) said his intent is to keep tobacco products like e-cigarettes out of the hands of teenagers. ...Aderholt cited data from the Food and Drug Administration (FDA) that shows 15 to 17-year-olds are getting access to tobacco products from older friends who are legally allowed to purchase them. (Hellmann, 4/3)

On a rainy November afternoon last year, eight men held tight to a gray tarp, their bodies pressed against one another as they lay feet to head in the bed of a pickup truck. Most knew one another from Acatic, a Mexican town in the state of Jalisco, where the country’s most vicious cartel has caused the morgue to overflow. Rainwater pooled on the tarp, running in rivulets down the sides and soaking the men underneath. The closeness provided only some warmth, as the men lay shivering, feeling every bump of the rocky scrubland as they crossed into the United States. (Surana, Mejia and Queally, 4/4)

San Diego county’s Republican-dominated board of supervisors filed a federal lawsuit Wednesday against the Trump administration, claiming that policy changes in the way the federal government treats asylum seekers have strained the city’s finances and health services. The Trump administration ended the so-called “Safe Release” program in October, which gave asylum seekers who had crossed the border assistance in reaching final destinations with family members and friends, the lawsuit noted. (Rosenberg, 4/4)

Overwhelmed by an influx of migrant families, the federal government’s largest holding facility for people caught crossing the border illegally has run out of space and exhausted its budget. The Central Processing Center, located in McAllen, Texas, is known to migrants as la perrera, or “the kennel.” Designed for 1,500 people, it now houses 2,400, according to Border Patrol officials, who gave journalists a rare tour on Wednesday. (Hennessy-Fiske, 4/3)

An autopsy report confirmed that an 8-year-old Guatemalan boy who died while in custody of the U.S. Border Patrol on Christmas Eve succumbed to a flu infection — one of two deaths of Central American children in December that raised concerns about the government’s ability to care for minors at the southern border. The New Mexico Office of the Medical Examiner released its autopsy findings for Felipe Gomez Alonzo on Wednesday, two days after Guatemalan authorities said they had received a copy of the report disclosing the boy had a rapid, progressive infection that led to organ failure. (Hudetz, 4/4)

What Trump said about wind and cancer: "And they say the noise causes cancer. You tell me that one (makes whirring noise mimicking a turbine).” There's no evidence to suggest cancer and wind farms are linked. Critics have linked wind turbine operations to electromagnetic fields (EMF), shadow flicker, audible noise, low-frequency noise and infrasound, annoyances that could disrupt sleep, induce headaches or even cause mild nausea. (King, 4/3)

Count Chuck Grassley as among those displeased by President Donald Trump's attacks on wind energy. The longtime Iowa GOP senator told Iowa reporters on Wednesday afternoon that Trump's comments implying turbines cause cancer was "idiotic." Then he explained to Capitol Hill reporters that the president needs to stop railing against wind power. (Everett, 4/3)

"I’m told that the White House respects my views on a lot of issues," Grassley said Wednesday during the call. "[Trump's] comments on wind energy — not only as a president but when he was a candidate — were, first of all, idiotic, and it didn’t show much respect for Chuck Grassley as the grandfather of the wind energy tax credit." (Daugherty, 4/3)

One prisoner had been dead for so long that when he was discovered lying face down, his face was flattened. Another was tied up and tortured for two days while no one noticed. Bloody inmates screamed for help from cells whose doors did not lock. Those were some of the gruesome details in a 56-page report on the Alabama prison system that was issued by the Justice Department on Wednesday. The report, one of the first major civil rights investigations by the department to be released under President Trump, uncovered shocking conditions in the state’s massively overcrowded and understaffed facilities. (Benner and Dewan, 4/3)

"Our investigation revealed that an excessive amount of violence, sexual abuse, and prisoner deaths occur within Alabama's prisons on a regular basis," wrote Assistant Attorney General Eric S. Dreiband, and the three U.S. Attorneys in Alabama in a letter accompanying the report sent to Republican Governor Kay Ivey. (Elliott, 4/3)

The U.S. Justice Department says that in addition to long-term measures, the Alabama Department of Corrections should make immediate changes in response to constitutional violations in its prisons. Here is a brief summary. (4/3)

The Indian Treaty Room is a grand two-story meeting space in the Eisenhower Executive Office Building next to the White House, with French and Italian marble wall panels, a pattern of stars on the ceiling and the image of a compass worked into the tiled floor. Over the years, it has hosted signing ceremonies for historic foreign policy pacts such as the Bretton Woods agreement and the United Nations Charter. On Nov. 16, 2017, it hosted a different kind of gathering: an intimate meeting called by the White House to discuss the future of the Department of Veterans Affairs. ... Within months of leaving office, By the time the meeting in the Indian Treaty Room took place, [Jeff] Miller had three clients vying for access to veteran patients and VA dollars. He subsequently would lobby on behalf of seven other private interests seeking a piece of the agency’s budget. (Craven, 4/4)

At age 30, Stephen Hopkins was back in the Army for a second time. After serving as an enlisted soldier from 1991 to 1995, he returned as an officer in 2000. He was a man who routinely maxed fitness tests and endured physical hardship while deployed to rural locales in Afghanistan. Selected for Special Forces training, Hopkins tackled the demanding courses with gusto, later returning to combat for a total of seven deployments. He had a job he loved and excelled at, and his star was ascending. But in 2005, Hopkins began experiencing wild swings in blood pressure. (Kime, 4/3)

Each year, state lawmakers across the U.S. introduce thousands of bills dreamed up and written by corporations, industry groups and think tanks. Disguised as the work of lawmakers, these so-called “model” bills get copied in one state Capitol after another, quietly advancing the agenda of the people who write them. A two-year investigation by USA TODAY, The Arizona Republic  and the Center for Public Integrity reveals for the first time the extent to which special interests have infiltrated state legislatures using model legislation. (O'Dell and Penzenstadler, 4/4)

The measles outbreak that led to a state of emergency in New York’s Rockland County began far away: in an annual Hasidic pilgrimage from Israel to Ukraine. It is emblematic of a series of fierce, sometimes connected measles outbreaks — in places as diverse as Indonesia, the Philippines, Madagascar and Venezuela — that have shaken global health officials, revealing persistent shortcomings in the world’s vaccination efforts and threatening to tarnish what had been a signature public health achievement. (McNeil, 4/3)

Kaiser Health News: Even Amid Measles Outbreaks, Oregon Model Offers Easy Vaccine Exemptions

As measles outbreaks continue in the Northwest and across the nation, newly revealed health records from Oregon suggest it’s surprisingly easy to opt out of required vaccinations in that state — as in several others. In Oregon — which has the highest kindergarten vaccine exemption rate in the U.S. — about 95% of parents whose kids skip one or more vaccines use a print-your-own certificate to do so. That’s according to data from the Oregon Health Authority, which shows that of more than 31,500 non-medical vaccine exemptions submitted last year, nearly 30,000 were documented by parents who watched an online education video and then printed out a do-it-yourself form. (Aleccia, 4/4)

UC Davis Health said Wednesday they sent out roughly 200 letters to people who may have been exposed to the highly contagious measles virus March 17 in the emergency department at UCD Medical Center. A young girl taken care of there was diagnosed with the illness. (Anderson, 4/3)

Measles is infamously contagious. Symptoms usually begin a couple of weeks after exposure, ranging from 10 to 18 days afterward, and they tend to be non-specific at first, including a fever, runny nose and red, watery eyes. A rash usually breaks out two to four days later, beginning on the face. (Goldberg, 4/3)

Doctors can safely transplant hepatitis C-infected lungs and hearts into people desperate for a new organ, say researchers who may have found a way to protect those patients from getting the risky virus. The experiment, reported Wednesday, is the latest attempt to put a dent in the nation's long transplant waiting list by using organs that otherwise would be wasted, often ones from victims of the opioid epidemic. (4/3)

Typically, these organs have been discarded because of concerns about spreading the viral infection. But a study of heart and lung transplants published Wednesday by the New England Journal of Medicine finds that new antiviral drugs are so effective that the recipients can be protected from infection. And, as another sad result of the opioid epidemic, organs for donation increasingly carry the hepatitis C virus. People who use injected drugs and share needles are at high risk of hepatitis C infection. (Harris, 4/3)

The trial, published in the New England Journal of Medicine, is the largest to examine the safety of using infected lungs and hearts. The researchers, led by Dr. Ann Woolley of Brigham and Women’s Hospital, estimated that using organs from donors infected with hepatitis C could increase the supply of hearts and lungs by at least 25 percent. (Corley, 4/3)

Transplant surgeons hope that eventually, these early results will pave the way for thousands of additional organ transplants each year, provided that insurers agree to pay for the expensive drugs. The expected source for most of these additional organs is deaths from the opioid epidemic — a silver lining for a grim reality of 21st-century America. (Avril, 4/3)

In rolling out a first-of-its-kind program to prevent diabetes, Medicare officials dashed the hopes of many start-ups in 2017 by deciding to exclude online health companies from participation. Since the program’s launch, however, large cracks have formed in Medicare’s service network. The program, which offers classes to improve diet and exercise habits, has no providers in Alabama or Mississippi — states in the heart of the so-called diabetes belt — and only one in Georgia, according to a federal database of more than 460 participants. (Ross, 4/4)

In the world of scientific research, they are pernicious impostors. So-called predatory journals, online publications with official-sounding names, publish virtually anything, even gibberish, that an academic researcher submits — for a fee. Critics have long maintained that these journals are eroding scientific credibility and wasting grant money. But academics must publish research to further their careers, and the number of questionable outlets has exploded. (Kolata, 4/3)

Cancer Treatment Centers of America Global Inc. named Pat Basu, a former Obama administration adviser and Stanford University Medical Center doctor, as its chief executive officer. He is replacing Rajesh K. Garg, who stepped down in July. Basu, 40, brings a diverse background to the role of running the company’s network of hospitals and outpatient centers across the U.S. (Koons, 4/3)

A growing number of babies born in the U.S. are breastfed, and health officials are pushing to make it easier for even more new mothers to nurse their babies. But experts say there still isn’t enough research about one of the most common experiences among lactating women: taking medication. Scientific studies frequently exclude pregnant and lactating women, which means there’s little information about whether drugs are safe to use while pregnant or breastfeeding, how well they work, or the best doses to take. And in a new perspective paper published Wednesday in the New England Journal of Medicine, OB-GYNs say there is still a slew of unanswered questions about drug use while breastfeeding. (Thielking, 4/3)

You may not be thin-skinned, but your eyelids certainly are. The fragile tissue is the thinnest on the body, less than 1 millimeter thick. While crepe-thin skin is great for blinking, it makes the area especially vulnerable to the sun's UV rays. Five to 10 percent of skin cancers occur on the eyelid. Unfortunately, that same patch of sensitive skin is the area where we're most likely to skimp on sun protection, according to a study published Wednesday in PLOS One. (Ellis, 4/3)

Tom Smith hesitated to buy light bulbs guaranteed for up to 10 years, thinking they'd outlast him. Terry Langbaum debated filling a prescription for a $13,000-a-month drug that keeps cancer from worsening for three months on average and carries six pages of warnings. "There are so many of us living with cancers that can't be cured," Langbaum said. "We study the treatments but we don't study what it's like to be the person going through treatment." (4/3)

I can’t eat,” the 16-year-old boy announced sadly. He and his brother, along with their parents, were in London on vacation. The boy arrived a few days earlier, but he’d felt awful for the two weeks before that. Sitting at the restaurant, the boy looked sick — he was pale and clearly uncomfortable. “I have to go back to the room,” he said. His mother handed him the key, and he limped slowly to the elevators to go back to bed. That summer had started normally enough. The boy and his family spent two weeks in Hawaii, where they had a vacation home. Then they went back to their year-round home in Seattle to prepare for the rest of what was going to be a busy summer. (Sanders, 4/4)

Mom is right when she says to eat your peas. In one of the largest surveys of data on global dietary habits and longevity, researchers found that consuming vegetables, fruits, fish and whole grains was strongly associated with a longer life — and that people who skimped on such healthy foods were more likely to die before their time. (Jacobs, 4/3)

After securing a hefty financial settlement from Purdue Pharma last month, Oklahoma Attorney General Mike Hunter is training the state’s legal armaments on a much bigger pharmaceutical player: Johnson & Johnson. The company already has become a popular target. Many of the more than 1,600 opioid lawsuits in state and federal courts name Johnson & Johnson, even though its analgesic products account for less than 1% of the U.S. opioid market. (Vestal, 4/4)

On Friday, Bishop and two other veterans filed suit in Illinois’ Third Judicial Circuit, which includes Madison and Bond counties, against Purdue Pharma and more than a dozen other pharmaceutical companies, alleging they marketed dangerous painkilling drugs to vets. (Hundsdorfer, 4/3)

Fentanyl is killing black people in Connecticut at the same rate as whites for the first time since state officials began tracking the epidemic around 2012, a CT Mirror analysis has found. There is no clear consensus among experts in Connecticut as to what is driving up the death rate among African Americans. (Carlesso and Kara, 4/4)

More than 80 women are suing Sharp Grossmont Hospital and Sharp Healthcare for videotaping them without their consent as they underwent painful and emotional obstetric surgeries, including C-sections. According to the 15-page lawsuit, the operating room cameras in the La Mesa facility captured videos of about 1,800 women between July 17, 2012 and June 30, 2013. Plaintiffs’ attorneys said Sharp officials disclosed those numbers and dates during legal proceedings before the lawsuit was filed. (Clark, 4/2)

Allison Goddard, the lawyer representing the 81 plaintiffs, said one video shows a patient being wheeled into an operating room for an emergency caesarean section. Goddard said the video shows the woman being prepared for surgery with her gown tucked under her breasts. It shows her exposed stomach and thighs and, after the delivery of the baby, a nurse massaging the woman’s uterus to expel any blood clots. (Diaz, 4/3)

Sharp Grossmont Hospital’s parent company, Sharp HealthCare, said in a statement that from July 2012 to June 2013, computer monitors with motion-activated cameras were set up to record in three operating rooms in the women’s health center as part of an investigation into medications that had gone missing from drug carts. “Although the cameras were intended to record only individuals in front of the anesthesia carts removing drugs, others, including patients and medical personnel in the operating rooms, were at times visible to the cameras and recorded,” Sharp HealthCare said in the statement. (Bever, 4/4)

The Children’s Minnesota hospital and clinic system on Tuesday announced the creation of a pediatric gender health program to provide comprehensive care to kids who identify as transgender or gender-diverse. Among an array of other services, the multidisciplinary clinic will offer consultation with gender health experts, gender-affirming hormonal treatment and treatments that pause puberty and stop menstruation, according to a news release issued by Minnesota Children’s, which operates hospitals in Minneapolis and St. Paul as well as other pediatric care facilities. (Wolman, 4/3)

Highmark members will lose in-network access to University of Pittsburgh Medical Center hospitals and physicians on June 30, a Pennsylvania Commonwealth Court judge affirmed Wednesday. The ruling reinforced a state Supreme Court decision that will end the five-year consent decree between UPMC and Highmark this summer. While the court rejected Pennsylvania Attorney General Josh Shapiro's request to indefinitely extend the contract, the attorney general plans to appeal the ruling that also left other aspects of the case up for debate. (Kacik, 4/3)

About 50 Highland Hospital resident and intern physicians walked off the job briefly Wednesday afternoon to protest stalled labor negotiations between the Alameda Health System and their union, the Service Employees International Union. Hospital operations carried on as normal Wednesday during the 20-minute walkout, Alameda Health System spokesman Terry Lightfoot said. (Tadayon, 4/3)

The battles over hospital regulation and financial disclosure appeared to be finished last week at the Georgia Legislature. But on Tuesday, as the 2019 General Assembly session was wrapping up, these prickly issues proved they weren’t dead after all. (Miller, 4/3)

Go to the hospital or a clinic in a wealthy country, and you take it for granted that there's going to be enough clean water — for the doctor to wash her hands before she attends to you, for the staff to clean the floors and linens, and for you to drink when you get thirsty. But in 17 countries at least one in five health-care facilities has no clean water service on site. (Aizenman, 4/3)

In a countermeasure to a proposed Trump administration rule, Maryland would become the first state to stop participating in a federal family planning program known as Title X, under a bill that received final approval Wednesday in the Maryland General Assembly. The Maryland Senate voted 28-16 for the measure, sending the bill to Republican Gov. Larry Hogan, whose spokesman said the governor would review the bill before deciding whether to sign it. (4/3)

The U.S. Senate has launched an investigation into a national corporation’s homes for people with disabilities in response to a report in The Oregonian/OregonLive about substantiated abuse at one of the company’s Oregon facilities. The newsroom reported in January that Oregon regulators shuttered a Mentor Network home in Curry County following extensive evidence that a client had been severely neglected. State regulators found that managers repeatedly ignored caregivers’ concerns about the disabled person’s festering pressure wound, including that it smelled of “rotting flesh.” (Zarkhin, 4/3)

"Healthy Holly" is a polite African American girl with devoted parents and a curious little brother. She loves exercise. She craves fresh fruit and vegetables. And she's now the bane of Baltimore Mayor Catherine Pugh's existence. Since the state prosecutor's office began a criminal investigation into Pugh at the Maryland governor's request earlier this week, there's been a growing tide of examinations spurred by revelations that she was paid some $700,000 over roughly eight years for her self-published paperback series about the fictional "Healthy Holly." (4/3)

A doctor tapped by Gov. Ron DeSantis to become the state’s surgeon general has been embroiled in legal squabbles and investigations while working at the University of Florida. Scott Rivkees has been the subject of a university sexual harassment investigation, was found by a university auditor to have not properly filed financial-disclosure information and has sued a one-time colleague for libel and slander. (Sexton, 4/3)

California’s new surgeon general made Sacramento the first stop on her statewide listening tour, and after Tuesday’s event, Dr. Nadine Burke Harris told The Bee that capital residents are powerfully grappling with the long-term impact childhood trauma has on their families and neighborhoods. Burke Harris said many of the 100 Sacramento-area residents she met with asked her to find ways to bring training, resources and support to families, educators, nonprofits and other community-based organizations, so they can better deal with the toxic stress that affects physical and neuro-development starting in childhood. (Anderson, 4/3)

Who should get to decide what to do when a baby is born with atypical genitals? That’s the question lawmakers are grappling with as they consider a measure that would ban doctors from performing genital-altering surgeries on infants unless deemed medically necessary. (Sheeler, 4/4)

In Newtown — maybe more than anyplace else in the country — the persistence of traumatic grief is widely recognized, a reality woven into the fabric of everyday life. That reality engulfed the town again last week, with the devastating news that Dr. Jeremy Richman had died by suicide. (Russell, 4/3)

Annie Wang remembers the panic she felt being a freshman in a 500-person chemistry class at UC Davis when her period arrived and she didn’t have a tampon or pad. There was nowhere nearby to go, and leaving to find something meant missing the class. So she tried to focus on the lecture instead. “I stayed in my seat and prayed it would not be too bad. When I got up I had left a mark on UC Davis in a very bold way,” she said. “It was a very embarrassing moment for me.” (Aguilera, 4/3)

Health Quest and Western Connecticut Health Network have sealed their union to form what's now known as Nuvance Health. A little more than a year after first announcing the proposed deal, the two systems, based in LaGrangeville, N.Y., and Danbury, Conn., said they have received the necessary federal and state approvals and support from patients, donors and business and community leaders. (Bannow, 4/3)

A bill before the New Hampshire Legislature this session would require all school districts to provide suicide prevention training to faculty, staff, and volunteers. The bill has already passed the Senate and will move onto the House next week. (Cohen and Biello, 4/3)

Minnesota health officials are adjusting acceptable levels for two troublesome pollutants found in drinking water supplies in the east Twin Cities metro area, based on new scientific data. The chemicals are part of a family of compounds known as per- and polyfluoroalkyl substances, or PFAS, found in products ranging from nonstick cookware to firefighting foam. (Marohn, 4/3)

Clumps of dandelions have popped up in your yard, so you reach for a bottle of Roundup, the popular weed killer. It is known for being very effective, but its main ingredient, glyphosate, is getting a lot of attention because of lawsuits alleging links to cancer. Last week, a federal jury ordered Monsanto, the maker of Roundup, to pay $80 million to a 70-year-old man with cancer who had used it for three decades on his 56 acres in Sonoma County, Calif. The jury found that Roundup was a “substantial factor” in his illness. Bayer AG, which bought Monsanto last year, said it would appeal the decision. (Cone, 4/3)

It took Rogue Robotics to get Cillian Jackson his wheels. At an age when most children are careening across the living room, 2-year-old Cillian was stuck, held back by a genetic condition that delays his physical and cognitive development and a Catch-22 requirement from his family’s insurance provider. Then a tip from Cillian’s physical therapist led his parents, Krissy and Tyler Jackson, who live in Farmington, Minn., to a website that provided a model for retrofitting toy cars to give mobility to children with disabilities. (Malkin, 4/3)

A congressional committee launched an inquiry into a company named in multiple Iowa cases where abuse or neglect of people with intellectual and developmental disabilities is alleged. The MENTOR Network — specifically its subsidiaries REM Iowa and Mentor Oregon — were asked this week by the U.S. Senate Finance Committee for copies of previous or ongoing investigations in cases regarding suspected abuse. (Clayworth, 4/3)

Plans are underway to bring a successful “pay for performance” model called Pathways Community HUB to Cleveland to help combat infant mortality, according to the nonprofit healthcare improvement organization, Better Health Partnership. The organization is working with the city-county infant mortality coalition, First Year Cleveland, as well as other local public health agencies, to design a HUB for the city, Better Health Partnership said in its March newsletter. (Zeltner, 4/3)

She already has had to bury her 17-year-old daughter Claire. Gwen Hartley's mission now is to have Kansas lawmakers help save the life of her 12-year-old daughter Lola. Lola has up to 30 seizures a day due to spastic quadriplegic cerebral palsy, one of several conditions she suffers from. Hartley wants to try treating her with a cannabidiol (CBD) oil that contains tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana, which is not legal in the state of Kansas. (Ruiz, 3/4)

An analysis released Wednesday that looks at more than 100 statistics related to health outcomes and health-care spending ranks Ohio 46th, the same as two years ago. The 2019 Heath Value Dashboard from the Health Policy Institute of Ohio, which compares Ohio with the 49 other states and the District of Columbia, follows similar dashboards released in 2017 and in 2014, when the state ranked 47th. (Viviano, 4/3)

Spurred by a sharp rise in teen use of e-cigarettes, the Maryland legislature voted Wednesday to raise the legal age to buy tobacco from 18 to 21. Maryland Gov. Larry Hogan (R) has not said whether he will sign the bill, which exempts members of the military. The proposed law is one of several similar measures advancing across the country this year and comes as the Food and Drug Administration has taken steps to crack down on flavored cigars and vaping cartridges popular with young people. Outgoing FDA Commissioner Scott Gottlieb has said teen vaping use nationwide has become “an epidemic.” (Cox, 4/3)

New execution procedures signed Tuesday say that chaplains and ministers may "observe the execution only from the witness rooms." Currently, friends and family of the murder victims and prisoners, as well as media, are allowed to watch executions through a glass window in small rooms adjacent to the death chamber. (McCullough and Byrne, 4/3)

Husky Energy says it will invest more than $400 million to rebuild its oil refinery in Superior, Wisconsin, and continue its use of a highly toxic chemical that raised fears in the community of 27,000 after an explosion at the refinery last April. The blast injured 36 people and required the evacuation of much of Superior due in large part to the presence of hydrogen fluoride, which can be hazardous to human health. The tank containing the chemical was not damaged by the explosion. (4/3)

Although approximately one in five Medicare beneficiaries are discharged from hospital acute care to postacute care at skilled nursing facilities (SNFs), little is known about access to timely medical care for these patients after they are admitted to a SNF. Our analysis of 2,392,753 such discharges from hospitals under fee-for-service Medicare in the period January 2012–October 2014 indicated that first visits by a physician or advanced practitioner (a nurse practitioner or physician assistant) for initial medical assessment occurred within four days of SNF admission in 71.5 percent of the stays. (Ryskina et al, 4/1)

Most clinician-family conferences about prognosis and goals of care for critically ill patients appear to lack important elements of communication about values and preferences, with robust deliberation being particularly deficient. Interventions may be needed to better prepare surrogates for these conversations and improve clinicians’ communication skills for eliciting and incorporating patients’ values and preferences into treatment decisions. (Scheunemann et al, 4/1)

Visits to the emergency department (ED) for psychiatric purposes are an indicator of chronic and acute unmet mental health needs. In the current study, we examined if psychiatric ED visits among individuals 6 to 24 years of age are increasing nationwide. (Kalb, 4/1)

West Virginia is at the epicenter of a national opioid crisis, with a 2016 fatal opioid overdose rate of 43.4 per 100,000 population—more than triple the US average. We used claims data for 2014–16 to examine trends in treatment for opioid use disorder (OUD) among people enrolled in the West Virginia Medicaid expansion program under the Affordable Care Act. (Saloner et al, 4/1)

The rising cost of prescription drugs is currently a major focus for policymakers. One medication that has come under increasing scrutiny over its price increases is insulin, used by people with both Type 1 and Type 2 diabetes to control blood glucose levels. Among people with Medicare, one third (33%) had diabetes in 2016, up from 18% in 2000. The rate of diabetes is higher among certain groups, including more than 40% of black and Hispanic beneficiaries. Although not all people with diabetes take insulin, for many it is a life-saving medication and essential to maintaining good health. (Cubanski et al, 4/1)

The Trump administration is considering a proposed rule that would change long-standing policy in the Supplemental Nutrition Assistance Program (SNAP). The rule would tighten the criteria states use to obtain waivers of work-related time limits from the federal government for SNAP participants known as “able-bodied adults without dependents.” Able-bodied adults without dependents are required to meet stricter work requirements than other adults participating in SNAP. In order to receive SNAP benefits for longer than three months out of a three-year period, they must work 80 hours per month. (Joo and Waxman, 4/1)

By backing a flimsy, state-initiated lawsuit to throw out the entirety of the Affordable Care Act, President Trump has made himself and Republican candidates in 2020 vulnerable to attacks that they want to take health insurance away from millions of people. The president compounded the problem by saying Republicans are going to become the party of health care without having any plan, let alone a coherent proposal that would produce better results and could get through Congress. Republicans are now deeply divided on what should be done, and the president is no help in setting a course for the party. (Joseph Antos and James C. Capretta, 4/4)

The only way for Republicans to get into the health care debate is to broaden the discussion about subsidizing the care of those seriously or chronically ill. Insurance restrictions on medical underwriting and excluding pre-existing conditions aren’t the only way to do that. (Robert Robb, 4/3)

We are still months from the first votes being cast in Iowa, but the 2020 campaign is already well underway. The Democratic field is nearly set and the uncertain specter of the Mueller probe has mostly cleared the president and his team on the collusion narrative. So why would an administration — hot off one of the president’s critical victory laps — announce in a legal filing before the 5th circuit last week that it was backing a full invalidation of the Affordable Care Act? (Kevin Walling, 4/3)

When Donald Trump decided to encourage the courts to declare the ACA unconstitutional, Azar had one legitimate option if he disagreed — to resign. When Trump decided to undermine Medicaid by interfering with Congress’ vision of a program providing healthcare to low-income Americans, Azar had one option — to resign. But he didn’t. Trump has declared his intention to make the Republicans “the party of healthcare,” but he’s actually turning it into the party of death. And Alex Azar is standing shoulder to shoulder with him every step of the way. (Michael Hiltzik, 4/1)

The evolution of the American health-care system and interesting roots. Starting in the 19th century, to prevent wage loss due to illness, European nations developed national insurances similar to the current American Social Security. These systems evolved into national universal coverage. The United States, on the other hand, has a financially unsustainable and fractured system that fails to embrace health care as a human right as compared to other developed nations. American exceptionalism, the for-profit health-care industry, and physicians’ concerns over personal income are the three key elements that hinder progress toward universal health care. (Hagop Kantarjia, 4/3)

Budget scorekeepers tell us that taxpayers spent at least $600 billion in 2017 to pay for health care services for low-income Americans covered by Medicaid. This public health insurance program is a federal-state partnership that pays hospitals, nursing homes, and health care providers to care for more than 70 million people. That’s 1 out of 5 people living in the United States.Medicaid dollars are essential for safety net hospitals to stay in business. These hospitals provide charitable care for uninsured and low-income members of their community. For these providers, Medicaid bumps up payments to compensate them for their services. (U.S. Sen. Chuck Grassley, 4/3)

Because my AHP may not include coverage for certain conditions, it's likely that the premiums under this plan would be lower. So both the employee and me, the employer contributing to their health-care cost, would both pay less money if an employee chose the AHP. But again, they don't have to. They could stick what they have. No harm, no foul. To me, this sounds like a great idea. But I’m not going to offer this to my employees. Why? Because it’s just too risky. (Gene Marks, 4/3)

Imagine having to renew any of your insurance policies to keep your children covered — health, home, auto, and so on — not just once but potentially several times a year. Because of this paperwork burden, more than 4,000 Texas kids lose coverage each month. Not because they are no longer eligible, but because of the confusion and extra work these requirements cause families and our state agency. (Elena Marks and Earl Maxwell, 4/3)

Rep. Pramila Jayapal (D-Wash.) introduced a new Medicare-for-All bill in the U.S. House of Representatives on Feb. 26 that will finally mend our broken healthcare system. It would give all U.S. residents coverage for essential medical needs, including hospitalization, doctor visits, mental health, vision, dental and long-term care. (Elaine Silver, 4/4)

Last Wednesday at midnight, Rockland County, N.Y., did something no local government had ever done. It barred anyone under age 18 who has not received the measles vaccine from going to libraries, gyms, supermarkets — any public place where they could expose others to the virus. The state of emergency came as a desperate, final effort to stop the spread of the largest measles outbreak in America. Other communities might soon be taking similar measures: The number of measles cases across the country this year is at its second highest since the disease was eradicated in 2000 — and we’re only in April. (Bethany Mandel, 4/3)

The Multidisciplinary Association for Psychedelic Studies (MAPS) was established in 1986 to support research and education about psychedelics for therapeutic purposes as well as examine how best practices for mental health care may change. Mark Haden, the executive director of MAPS Canada, has written about the systems changes needed to support the mainstream use of psychedelics for medicinal purposes. “There’s a growing interest in psychedelics among the medical community since they seem to work for some hard-to-treat mental health disorders,” Haden told me. “But for psychedelics like ketamine we need supervised access because the experience [of patients on ketamine] can be challenging, unlike for other drugs used in mainstream psychiatric care, where a patient can simply self-administer at home.” (Amitha Kalaichandran, 4/3)

Buprenorphine could be transformative in the treatment of addiction. It reduces craving because it’s an opioid, but it acts differently than hydrocodone, heroin and the rest. Thanks to its “ceiling effect,” it poses a low risk of overdose. And when used to treat people who are addicted to other opioids, buprenorphine causes no euphoria. While other medications are available, buprenorphine offers particular promise. Methadone is effective, but it can be dispensed only in special clinics. A third drug treatment for opioid dependence, naltrexone, which blocks the effects of narcotics, can be given only to people who have been through at least seven days of opioid withdrawal. Not all patients manage to do that. (4/3)

Right now, our system is failing people with diabetes. We need systemic change, change that Congress can help make happen. A recent study from Yale found up to 25 percent of people with diabetes are actually taking less insulin than what they need, just to save on costs. No one should suffer or die because they cannot access insulin. (Aaron J. Kowalski, 4/3)

Can science tell us anything about the wisdom of ordering Burger King’s newly introduced “Impossible Whopper” burger, invented in Silicon Valley and made from vegetable matter and a lab-produced protein? Nutrition has recently changed course, reversing the late 20th century anti-fat dogma, and acknowledging that some kinds of fat found in animals can be good for you. If anything, the beef is the least unhealthy item in a fast food meal – compared with the bun, the pile of fries, and the soda. (Faye Flam, 4/3)