KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Can We Tax Away The Opioid Crisis?

Lawmakers in California, like their counterparts in Congress, are considering a tax that would pay for addiction prevention and treatment efforts. (Pauline Bartolone, 4/14)

Political Cartoon: 'Trick Shot?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Trick Shot?'" by Gary Varvel, The Indianapolis Star.

Here's today's health policy haiku:

FINAL RULE TO STABILIZE EXCHANGES ISSUED

Trump decrees both calm
And spook insurance markets.
Cognitive chaos.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law

HHS Issues Final Rule To Stabilize Marketplaces; Insurers Pleased But Want Even More Changes

The rule introduces several targeted changes aimed at curbing some of the losses insurers have faced in the law’s exchanges.

Reuters: Trump Administration Issues Final Rule On Stricter Obamacare Enrollment
The Trump administration on Thursday issued a final rule that will shorten the Obamacare enrollment period and give insurers more of what they say they need in the individual insurance market, likely making it harder for some consumers to purchase insurance, healthcare experts said. It could also raise out-of-pocket medical expenses, the experts said, because it gives insurers more flexibility in determining the value of their coverage. (Abutaleb, 4/13)

The Wall Street Journal: Trump Administration Takes Steps To Stabilize Health-Insurance Market
The Centers for Medicare and Medicaid Services, a division of the Department of Health and Human Services, published its final rule aimed at steadying the individual market, which has seen large premium increases and insurers retreating from unprofitable markets across the country. President Donald Trump’s administration is pitching the move as a temporary fix, while it continues to work with Congress to strike an elusive deal to dismantle large portions of the health law known as Obamacare. But after GOP leaders yanked their health plan off the House floor late last month, the administration’s moves to either bolster or undercut the existing health-care law have come under increased scrutiny. (Hackman, 4/13)

CQ Roll Call: Health Insurers Score Win On Enrollment Rule For Exchange Plans
The 2018 open enrollment period will be reduced to run from Nov. 1, 2017, to Dec. 15, 2017, a shift from an earlier cutoff date of Jan. 31, 2018, the Centers for Medicare and Medicaid Services said in its final published rule. The earlier deadline will limit the number of people who can purchase insurance after learning they have a health condition that requires medical care, blocking such signups in late December and January, CMS said. Thus, this move will help improve the so-called risk pool for insurers, or the balance of their healthier customers to those in need of costly medical services, the agency said. (Young, 4/13)

Bloomberg: Trump Sweetens Obamacare For Insurers After Repeal Failure 
“These actions are necessary to increase patient choices and to lower premiums,” said Seema Verma, administrator for the Centers for Medicare and Medicaid Services Administrator, which oversees the health insurance program. “While these steps will help stabilize the individual and small group markets, they are not a long-term cure for the problems that the Affordable Care Act has created in our health-care system.” (Tracer and Edney, 4/13)

Kaiser Health News: Repeal, Replace … Revise: Your Guide To How A Trump Proposal Might Change ACA Insurance
The controversial proposal by the Health and Human Services Department drew letters from nearly 4,000 organizations and individuals during an unusually short, 20-day public comment period that ended in early March. In their comments, consumer groups hated it, saying it would wreak havoc by making it harder to get coverage, while insurers were generally supportive. But such experts as Christopher Condeluci of CC Law & Policy in Washington, D.C., saw the initial proposal released in February by HHS as helpful for insurers, though he also thinks more adjustments are necessary. (Appleby, 4/13)

Modern Healthcare: White House Finalizes ACA Rule To Strengthen Individual Market
The rule, however, does not address the insurance industry's major concern regarding continued enforcement of the individual mandate. It does continue and even increase subsidies for people who buy coverage on the Affordable Care Act's individual coverage exchanges. Both requests were made in a letter sent Wednesday to President Donald Trump that was co-signed by the U.S. Chamber of Commerce, which previously supported a rollback of the ACA. Other signers included America's Health Insurance Plans, the American Academy of Family Physicians and the American Hospital Association. (Dickson, 4/13)

Morning Consult: Trump Administration Makes First Mark On Obamacare With Regulation
As it stands, Cara Kelly, a vice president at Avalere Health, warned the changes may not be enough to keep more insurers from dropping out of marketplaces next year. “These changes likely are not significant enough to sway health plan decisions for the upcoming plan year,” she said. “Losing health plans from the exchanges is still a risk for 2018.” (McIntire, 4/13)

The Associated Press: Insurers Say Trump Must Do More To Stabilize ‘Obamacare’
While calling the administration action a step in the right direction, the industry is looking for a guarantee that the government will also keep paying billions in “cost-sharing” subsidies that help consumers with high deductibles. President Donald Trump says he hasn’t made up his mind on that. (Alonso-Zaldivar and Murphy, 4/14)

The Hill: Trump Admin. Moves To Stabilize ObamaCare Markets 
Marilyn Tavenner, the president and CEO of America's Health Insurance Plans (AHIP) and the former Centers for Medicare and Medicaid Services administrator, praised the rule for adopting "important changes" to "improve the functioning of the individual market" but said insurers still need to hear about the cost-sharing reduction subsidies. (Hellmann, 4/13)

'I Think I Will Get It Done': Trump's Renewed Health Care Push Catches Republicans Off Guard

President Donald Trump's focus on health care has the potential of leading to a second embarrassing defeat that would raise more questions about the new administration’s ability to shepherd complicated legislation through Congress.

The Wall Street Journal: Trump Shifts Back To Health Care
After losing a fight to revamp the health-care system, President Donald Trump said last month he was prepared to put the setback behind him and move on to the next challenge, rewriting the tax code. Three weeks later, he said he is determined to resurrect the health-care bill even if it means delaying the tax overhaul, telling The Wall Street Journal in an interview: “I want to get health care done…I think I will get it done.” (Radnofsky, Nicholas and Rubin, 4/13)

In his efforts, the president is eyeing subsidies as a bargaining chip —

The New York Times: Trump Threatens Health Subsidies To Force Democrats To Bargain
In the weeks since President Trump’s attempts to replace the Affordable Care Act collapsed, the administration has debated what to do: Try again? Shore up the insurance marketplaces? Or let the whole system collapse? Mr. Trump has failed to get enough support from his own party, but he hopes to get the Democrats’ help by forcing them to the negotiating table with hints about the chaos he could cause. (Pear, 4/13)

Marketplace: President Trump Might Withhold ACA Subsidy Payments
Under current law, the federal government repays some money to insurance companies for covering people with very low income. President Trump said he was still considering what to do about those payments. Bob Atlas, president of healthcare consultancy EBG Advisors, said legally speaking, Trump can do that. (Uhler, 4/13)

Democrats Won't 'Negotiate With Hostage Takers,' Vow To Tie Insurer Subsidies To Spending Bill

The fight could lead to a government shutdown if neither side blinks.

The Wall Street Journal: Democrats Say They Won’t Be Bullied Into A Repeal Of Obamacare
Congressional Democrats said Thursday they won’t be coerced into negotiating a repeal of the Affordable Care Act by President Donald Trump’s threats to withhold federal payments critical to maintaining the stability of the insurance market. But the president’s comments could have a more immediate effect on Capitol Hill, thrusting the payments to insurers into negotiations over a spending bill needed to keep the government running beyond April 28, when its current funding expires. (Peterson and Hughes, 4/13)

The Hill: Dems Link ObamaCare Payments To Shutdown Fight 
“The President’s comments on stopping the Cost Sharing Reduction payments will increase costs, is a threat to the good health of the American people and a threat to keeping government open,” an aide to House Democratic Leader Nancy Pelosi (Calif.) said in a written statement. Democrats say Pelosi and Senate Democratic Leader Charles Schumer (N.Y.) are in agreement that the payments must be included in the spending bill being negotiated ahead of an April 28 deadline. Democrats want the funds to become mandatory spending, which would provide the certainty insurance companies have requested. (Sullivan, 4/13)

Politico: Democrats Say Spending Bill Must Fund Obamacare Payments
"Given the threat, we'll be pushing for a robust cost-sharing reduction appropriation," a Senate Democratic aide said. The aide declined to say how much funding Democrats would insist upon. Others have estimated that full funding for one year would require between $7 billion and $8 billion. Funding for the program "must be included" as "permanent mandatory spending," a Pelosi aide said. (Haberkorn and Ferris, 4/13)

The Washington Post: Trump Is Playing A Risky Game Of Chicken With Health Insurers
“This is a very potent threat, because the administration has the authority unilaterally to do this, and this is really a kill switch. This makes the program unprofitable for the majority of health plans operating in it today,” said Dan Mendelson, chief executive of Avalere Health, a consulting firm. “The timing of this threat is really curious, in the sense that now is the time that the plans have to be deciding whether to bid on 2018. If you’re on the bubble and the president is making a threat like this . . . this just puts more uncertainty on the program." (Johnson, 4/13)

The Hill: Dem Accuses Trump Of ‘Political Blackmail’
The head of the House Democratic Caucus is accusing President Trump of “political blackmail” for threatening to withhold ObamaCare funds that lower health costs for poor Americans. Rep. Joseph Crowley (D-N.Y.) said the recent suggestion that Trump may halt billions of dollars in insurance subsidies to force Democrats to negotiate a healthcare overhaul “is a blatant attempt to undermine the Affordable Care Act and manufacture a crisis.” (Illis, 4/13)

USA Today: Individual Insurance Plans At Risk In Some Areas With Trump Threats About Subsidies.
President Trump escalated fears this week by saying he may not authorize payment of the Affordable Care Act-required subsidies that up to 7 million people use to help pay their health care deductibles and co-payments. Trump said the move should prompt Democrats to negotiate on health care reform. But now, a bipartisan group including high-level former members of Congress and regulators is fighting back. (O'Donnell, Fletcher, Leys and Alltucker, 4/13)

GOP Not Willing To Pull Plug On Zombie Trumpcare When They Ran On Promises To Repeal Obamacare

The Republicans' bill may live in purgatory, even as the president renews his efforts to get something passed.

Politico: Obamacare Repeal Bill Is The Zombie GOP Can’t Kill — Or Bring Back To Life
Republicans in Congress for the first time are lowering expectations for how much of Obamacare they can repeal and how quickly they can do it. As they meet constituents back home, GOP lawmakers seem trapped between the reality of their failed repeal effort and President Donald Trump’s renewed promises this week to finish off Obamacare before taking on tax reform. Vice President Mike Pence is also still trying to keep the repeal dream alive, working with conservatives on new tweaks to the stalled House bill. But even if the ultra-conservatives come on board, there’s no sign that the moderate Republicans needed to pass a bill are ready to sign on. (Haberkorn and Cheney, 4/14)

Meanwhile, Rep. Greg Walden (R-Ore.) is the latest lawmaker to face the heat over health care at his town hall —

The Associated Press: House Chairman Skeptical Of Conservatives' Health Care Idea
A House committee chairman who's a leading author of the mired Republican health care bill said Thursday he's skeptical about proposals the Trump administration and conservative GOP lawmakers have discussed in hopes of breathing life into the legislation. Rep. Greg Walden, R-Ore., directed his skepticism at suggestions that states be allowed to sidestep the ban in President Barack Obama's health care law against insurers charging seriously ill people higher premiums than healthy customers. (Fram, 4/13)

The Washington Post: Republican House Leader Avoids Selling GOP Health-Care Plan At Home
“Why don’t you go back to Washington, [and] in the spirit of bipartisanship, grow a pair, sit down with [House Democratic leader] Nancy Pelosi and say, ‘Let’s fix Obamacare,’ ” said one middle-aged man at Columbia Gorge Community College, where about 500 people gathered. A few in the rowdy crowd at the next town hall seemed to know that Walden, as the chairman of the House Energy and Commerce Committee, played a pivotal role in crafting the GOP’s American Health Care Act, which would have rolled back Obamacare’s system of subsidies and phased out that law’s Medicaid expansion. (Winfield Cunningham, 4/13)

Administration News

Trump Rolls Back Obama Rule Barring States From Banning Funds To Planned Parenthood

The Health and Human Services Department regulation said that states and localities could not withhold money from a provider for any reason other than an inability to provide family planning services.

The Wall Street Journal: Trump Signs Legislation Allowing States To Deny Funding To Planned Parenthood
Thursday’s bill signing was quickly condemned by Planned Parenthood and other abortion-rights groups. Dawn Laguens, the organization’s executive vice president, said it would make it harder for Americans to access health care. “We should build on the tremendous progress made in this country with expanded access to birth control, instead of enacting policies that take us backward,” Ms. Laguens said in a statement. “Too many women still face barriers to health care, especially young women, women of color, those who live in rural areas, and women with low incomes.” (Andrews, 4/13)

NPR: Trump Signs Law Giving States Option To Deny Funding For Planned Parenthood
Anti-abortion activists cheered the move as a way to return some measure of discretion to states, which will now have the latitude they once did in deciding how to mete out Title X funds. "This is promise kept," said the Susan B. Anthony List's Marjorie Dannenfelser, who attended the signing which was conducted without media present. "This puts an end to the outgoing gift that Obama gave the Trump administration which was to disallow states from being in charge of its own family planning funds." (Dwyer, 4/13)

And a look at how it's playing out in the states —

Texas Tribune: With Trump's Signature, Texas Women's Health Clinics Could Lose More Funding 
Abortion providers in Texas that receive federal dollars to offer reproductive health services to low-income people are likely to lose that funding under a measure President Trump signed Thursday. The measure allows states to exclude Planned Parenthood and other women's health organizations that provide abortions at some of their clinics from receiving federal "Title X" money, which funds family planning services such as contraceptive counseling, pregnancy tests and STD testing. (Evans, 4/13)

FDA Warns Company About Slow Action On Recalling Faulty Defibrillators

St. Jude Medical did not recall the older devices or alert doctors or patients about the potential problem for years.

The New York Times: St. Jude Medical Played Down Defibrillator Failures For Years, F.D.A. Says
The medical device maker St. Jude Medical played down the failure of some batteries in its defibrillators, shipping them for years before recalling the devices last fall, according to a warning letter the Food and Drug Administration issued this week. The company, acquired by Abbott Laboratories in January, also failed to tell its own management and a medical advisory board that the battery problems had led to the death of a patient, the agency found. (Thomas, 4/13)

Chicago Tribune: FDA Warns Abbott On Heart Device Battery Woes, Cybersecurity Risks 
The devices, implanted in the chest, can provide pacing for hearts that beat too slowly and deliver shocks to stop dangerously fast rhythms. Normally the devices alert patients, through a series of vibrations in the chest, months before they need to be replaced. Batteries in some of the devices, however, ran out sooner than expected, giving patients, in some cases, as little as 24 hours' notice before the batteries died. (Schencker, 4/13)

In other news on Abbott —

Bloomberg: Abbott Said To Agree To Buy Alere At Lower Price, FT Reports 
Abbott Laboratories agreed to buy Alere Inc. at a lower price than previously offered, ending a legal battle over the merger between the two U.S.-based health-care companies. Abbott will buy Alere for $51 per share, the companies said Friday in a statement. The new transaction values Alere’s equity at $5.3 billion, or 8.6 percent less than its initial offer. The companies said they expect the deal to close by the end of third quarter, pending shareholder and regulatory approval. (Robinson, 4/14)

Medicaid

Maine Points To Results Linking Food Stamps To Work Requirements As A Path For Medicaid

The approach, however, is drawing criticism from advocates for the poor, who say jobs, volunteer positions and transportation can be hard to come by in rural areas ​with persistent unemployment.

The Wall Street Journal: After Linking Work To Food Stamps, Maine Seeks Same With Medicaid
Maine wants to do to Medicaid what it did to food stamps: link the health program for low-income people to work requirements in the hope of reducing enrollment, raising incomes and prioritizing resources for children, the elderly and disabled. The state is among several that plan to seek federal approval to apply work rules to able-bodied adults without dependents in its Medicaid program, which serves 270,000 people. To make the case, Maine officials say they will point to their record with food stamps. (Levitz, 4/14)

In other news on Medicaid —

Modern Healthcare: Low Rates Could Detract Medicaid Managed Care Plans
Several states soon may see an exodus of managed Medicaid plan insurers if they don't update their rate-setting processes and bake in additional funds [so] companies can pay administrative costs, according to a new report. More than 50 million Medicaid beneficiaries in 39 states receive healthcare through managed care programs, but many states aren't paying insurers enough money to generate an adequate margin on that business. Unless states increase Medicaid insurance companies' margins, they may have to rethink managed care altogether, according to a report from The Society of Actuaries. (Dickson, 4/13)

Forbes: States Moving More Medicaid Patients To Managed Care
Private health insurance companies stand to reap a bigger share of the Medicaid business as states deal with budget shortfalls and increased spending on medical care. Illinois, North Carolina and Oklahoma are among the larger states moving more of their states' Medicaid beneficiaries under the management of private insurers over the next two years. In addition, Florida and Mississippi are renewing Medicaid managed-care contracts with states, according to Medicaid Health Plans of America (MHPA). (Japsen, 4/13)

Capitol Hill Watch

Congressman Seeks More Regulations On Ads Warning Of Drugs' Side Effects

The advertisements are put out by attorneys soliciting clients for potential cases against drug companies.

The Wall Street Journal: Have You Or Your Loved Ones Been Hurt By This Ad? Congressman Wants To Know
Plaintiffs’ lawyers have long solicited clients through television advertisements that warn of a drug’s potentially harmful side effects. Now, a powerful congressman, backed by the leading doctors’ group and some drug companies, is pushing back, saying the ads are to blame for patients suffering harm or even dying after dropping treatment. Rep. Bob Goodlatte (R., Va.), chairman of the House Judiciary Committee, wants the ads to include a warning that patients should talk with their doctors before adjusting medication. (Randazzo and Rockoff, 4/14)

In other pharmaceutical news —

Health News Florida: First Drug To Treat Aggressive MS Hits The Market
The FDA approved the drug, sold as Ocrevus, two weeks ago. The approval comes after a series of clinical trials across the nation, including at the University of South Florida’s Multiple Sclerosis Center in Tampa. Health News Florida’s Stephanie Colombini talked with Dr. Janice Maldonado, Assistant Professor of Neurology at the center to learn more about Ocrevus and its development. (Colombini, 4/13)

Bipartisan Bill Would Limit Amount Of Opioids Doctors Can Prescribe

Under the legislation, introduced by Sens. John McCain (R-Ariz.) and Kirsten Gillibrand (D-N.Y.), doctors would be limited to prescribing no more than a week's worth of opioids to patients in acute pain.

Morning Consult: Bipartisan Senate Bill Takes Step Against Opioid Epidemic
A bipartisan Senate bill unveiled Thursday would impose strict limits on some opioid prescriptions, a small tweak to federal law that is part of an ongoing effort in Congress to curb overuse of the drugs. The legislation, introduced by Sens. John McCain (R-Ariz.) and Kirsten Gillibrand (D-N.Y.), would bar doctors from supplying more than a week’s supply of an opioid drug to patients suffering from acute pain. Refills for those patients would also be prohibited, but prescriptions to treat chronic illnesses and end-of-life care would not be subject to the rules. Several states, including New York and Arizona, have already enacted similar policies. (Reid, 4/13)

In other news on the crisis —

The Washington Post: Drug Overdose Deaths Top 1,400 In Virginia In 2016
Fatal drug overdoses increased 38 percent in Virginia between 2015 and 2016, an alarming jump that state health officials attribute to abuse of synthetic opioids, heroin and prescription fentanyl. A new report from the state medical examiner found an even bigger increase — 175 percent — in deaths from several varieties of fentanyl, a pain medication significantly more potent than morphine. (Sullivan, 4/13)

Marketplace

Massachusetts To Create Website To Help Consumers Navigate Tricky Health Care World

Part of the goal of the site is to get patients to shop around like they would with any other service.

Boston Globe: State Aims At Elusive Goal: An Online Guide To Health Care Prices 
After years of delay, Massachusetts is taking another crack at a job that has proven especially tough: creating a one-stop online shop to help consumers make educated choices about their health care. The state’s Center for Health Information and Analysis has hired a vendor to design and launch a user-friendly website that includes the average prices of dozens of common health care procedures, safety and quality measures for individual hospitals, and basic information about obtaining insurance and getting care. (Dayal McCluskey, 4/14)

In other news —

New Orleans Times-Picayune: How Much Will That Cost? Finding Out Medical Prices In Advance
If you're insured, ask your provider or check the company's website for pricing tools. Many insurers now offer them, though not all are extremely useful. Some states have terrific pricing tools, such as Minnesota and New Hampshire, but a lot of the state resources are not so great. In Ohio, for example, the prices are simply the list or "chargemaster" prices, which are the top-end rates, and thus not very useful. The National Conference of State Legislatures has a scorecard of those resources. (4/13)

Public Health And Education

Tech Giants Dream Big On Curing Diseases, But Realities Of Health Care May Drag Them Down

Stat looks at three diseases that technology companies are attacking -- and how they might fail. In other public health news: a gene-editing breakthrough, type 2 diabetes in teens and kids and homeopathic teething tablet dangers.

Stat: How Apple, Google, And Other Tech Titans Aim To Shake Up The Way We Treat Disease
Silicon Valley has audacious plans for shaking up the way we diagnose — and cure — disease. But the life sciences are far more challenging than the tech titans of this world might realize: There are countless regulatory hurdles, health care delivery obstacles, and — most of all — the challenge of untangling the extraordinarily complex biology of the human body. Still, giants like Apple, Google, IBM, Intel, and Microsoft are charging ahead. (Keshavaan, 4/13)

Los Angeles Times: Type 2 Diabetes, Once Considered A Disease For Adults, Is Increasingly Common In Tweens And Teens
For years, health experts have bemoaned the rise of childhood obesity in the United States. About 17% of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s, according to data from the Centers for Disease Control and Prevention. A report in this week’s edition of the New England Journal of Medicine lays out one of the consequences of all this excess weight: a corresponding increase in childhood cases of type 2 diabetes. (Kaplan, 4/14)

Stat: Homeopathic Teething Tablets Tied To Infant Seizures Recalled
One of the nation’s largest homeopathy companies announced Thursday that it was recalling all of its infant teething tablets at the request of US regulators, following reports that the tablets had caused seizures and other severe complications in hundreds of infants. The company, Standard Homeopathic, said it was recalling the tablets at the request of the Food and Drug Administration, which had concluded that they contained inconsistent amounts of belladonna, an herb known colloquially as “deadly nightshade.” (4/13)

State Watch

Kasich Celebrates Autism-Coverage Bill: 'We’re Not Coddling Anybody; We’re Giving People A Chance'

The legislation says Ohio health insurers “shall provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder." Outlets also report on news of state legislatures in Iowa and Florida as well.

Iowa Public Radio: Applause, Dismay, As Branstad Signs Gun Rights Bill 
Calling it an honor, Governor Branstad today signed into law what’s being called the most expansive gun  rights bill in Iowa history, to the applause of a roomful of supporters. The bill expands self-defense rights for gun owners, so-called Stand Your Ground. It also allows gun owners with permits to carry weapons into the statehouse. (Russell, 4/13)

Iowa Public Radio: Patty’s Law Approved To Combat Breast Cancer 
Breast cancer survivors and their supporters were at the capitol Thursday for a bill-signing of legislation known as Patty’s Law, named for a West Des Moines cancer patient. The new law directs mammogram providers to let a woman know if she has dense breast tissue, so she can get an ultrasound in addition to a mammogram. (Russell, 4/13)

Miami Herald: 5 Months After Medical Marijuana’s Big Win, Anti-Drug Group Helps Write Rules
An anti-drug group opposed to medical marijuana is helping craft Florida laws on pot’s expanded use — a cause its founders tried and failed to defeat during last year’s elections. The St. Petersburg-based Drug Free America Foundation is one of several anti-drug groups tied to conservative financiers Mel and Betty Sembler that opposed constitutional amendments legalizing medical marijuana in 2014 and 2016. (Auslen, 4/13)

State Highlights: Mich. Doctor Faces Genital Mutilation Charges; Judge Chastises New York Over Failure To Relocate Mentally Ill

Outlets report on news from Michigan, D.C., New York, Tennessee, Texas, California, Minnesota, Ohio, Louisiana, Pennsylvania and Massachusetts.

The New York Times: Michigan Doctor Is Accused Of Genital Cutting Of 2 Girls
A Michigan doctor has been accused of performing genital cutting on two 7-year-old girls at a medical clinic, in a case that federal officials believe to be the first prosecution under a law banning the brutal practice. The doctor, Jumana Nagarwala, 44, was arrested on Wednesday on charges that she performed the genital cutting at an unnamed medical clinic in Livonia, Mich.; transported minors with intent to engage in criminal sexual activity; and lied to federal agents. (Fortin, 4/13)

Pioneer Press: MI Doctor Charged With Genital Mutilation Of MN Girls, Age 7
A Detroit emergency room doctor is accused of performing genital mutilation on two 7-year-old girls from Minneapolis. Dr. Jumana Nagarwala is charged with performing the procedure out of a clinic in Livonia, Mich., in February, according to charges filed in U.S. District Court on Thursday. It’s believed to be the first case to be brought under the federal law criminalizing female genital mutilation of girls. The investigation suggests there are “multiple” other child victims of Nagarwala.  (Legge, 4/13)

The New York Times: New York Falls Short In Resettling Mentally Ill Adults, Angering Judge
Four years ago, after more than a decade of litigation and negotiation, New York State officials agreed that the system of often dismal and dangerous adult homes was no place for the mentally ill. They agreed to move as many as 4,000 mentally ill residents out of their apartments and into supportive housing, a hard-fought recognition that people with disabilities should have the opportunity to live independently and participate in all aspects of community life. (Santora, 4/14)

CQ Roll Call: VA's Shulkin Names New Leader At Troubled DC Medical Center
Secretary of Veterans Affairs David Shulkin personally intervened and appointed a member of his own staff to lead the VA Medical Center in the nation's capital Thursday, after a scathing interim report from federal investigators. “We will not put veterans at risk, and you will see in this administration when we believe there is unnecessary or unacceptable risk, we will take decisive action,” Shulkin said in a press call with reporters. A VA Office of Inspector General report publicized Wednesday revealed patients at the Washington hospital were being placed at risk because of the sloppy management of medical supplies and equipment. (Mejdrich, 4/13)

The Associated Press: AG Agrees Tennessee Will Stop Enforcing 2 Abortion Limits
Tennessee's attorney general has agreed that the state will drop two abortion limits similar to Texas laws struck down by the U.S. Supreme Court, according to federal court filings Thursday. One of the requirements mandated that abortion providers have hospital admitting privileges. The other forced abortion clinics to meet hospital-level surgical standards. (Mattise, 4/13)

Houston Chronicle: Local Couple Appear In Federal Court For $24 Million Medicare Fraud Scam
First, investigators contacted the couple's clients — all maintained they had never heard of them. Next, investigators talked to physicians who supposedly worked on Medicaid bills for the couple's home health care companies but they, too, had never heard of the Amoses. These discoveries were among the clearest signs to prosecutors that Oluyemisi Amos, 35, and her husband Felix Amos, 66, would represent the latest scam in a string of Houston health care fraud cases. The couple pled not guilty in Houston federal court Thursday following an indictment for multiple counts of health care fraud totaling more than $24 million. (Meyer, 4/13)

Minnesota Public Radio: 3 Measles Cases Confirmed In Minnesota
The Minnesota Department of Health is investigating three measles cases. All three patients are toddlers from Hennepin County. State health officials say they haven't figured out how the children contracted the disease and are trying to track down anyone who may have had contact with them. (Richert, 4/13)

Cleveland Plain Dealer: Hospitals Investing In Transit To Provide Access, Improve Health For Clevelanders 
With the announcement of MetroHealth System's decision to sponsor the Greater Cleveland Regional Transit Authority's newest Bus Rapid Transit (BRT) route, all three major health systems in the county soon will be on board with public transit. The new BRT line will start rolling in October. At that time, what is known as the No. 51 line will be rebranded as the MetroHealth Line - a new BRT line sponsored by the MetroHealth System for the same fare as existing routes. (Christ, 4/14)

New Orleans Times-Picayune: LSU Medical Schools Facing Another Budget Cut, This Time $3.6 Million 
LSU Health Sciences Center and medical school in New Orleans have lost research dollars and struggled to restore faculty to pre-Hurricane Katrina levels as a result of state budget cuts over the past decade, says Larry Hollier, the school's chancellor. Now they're facing another round of cuts unless the Legislature raises taxes or reduces other public services. Over the past eight years, Louisiana has trimmed funding for health sciences centers in New Orleans and Shreveport by $38 million. At the same time, state-mandated costs on the centers have increased by $22 million, causing more fiscal problems, Hollier said. (O'Donoghue, 4/13)

The Philadelphia Inquirer/Philly.com: Virtua Wins Health Planning Board OK To Build A $1 Billion Medical Campus In Westampton
Virtua Health can proceed with its plans to build a $1 billion hospital complex in Westampton,  Burlington County, as long as it meets 13 conditions, the New Jersey Health Planning Board decided Thursday after reviewing the proposal. The board voted unanimously to approve the plans but also adopted 12 recommendations made by the staffers of the Health Department who analyzed the proposal.  The board then added one additional stipulation – that Virtua obtain approval from the state Department of Environmental Protection prior to construction. (Hefler, 4/13)

WBUR: New WPI Center Aims To Accelerate Smart Medical Device Production
Worcester Polytechnic Institute is opening a new medical and technology development center it hopes will speed up the production of cutting edge medical devices and therapies for patients. PracticePoint at WPI, a public/private partnership announced Thursday, will include several testing suites to allow clinical researchers, engineers and manufacturers to more easily collaborate and commercialize robotic and other smart devices and systems. (Zimmerman, 4/13)

Cleveland Plain Dealer: Akron, Cleveland, Youngstown Air Pollution Still Is Among Ohio's Worst 
Three metropolitan areas in Northeast Ohio were among 72 areas in the U.S. that suffered through more than 100 days of unhealthy air pollution in 2015, according to a report released today by the Environment America Research & Policy Center. The Akron area paced Northeast Ohio with 188 days of moderate to unhealthy levels of soot particles in the air, followed by Cleveland-Elyria with 175, and Youngstown-Warren-Boardman with 142. (McCarty, 4/13)

The Philadelphia Inquirer: Philly Breast Cancer Survivor Helps Other Black Women Through The Challenge, Beautifully
Every time Traci Smith walked into chemotherapy at Lankenau Medical Center in 2013, she made sure she was looking her best. When Smith arrived, patients, nurses, and doctors complimented her, telling her she didn’t look sick, which, given that she had lost all her hair, fingernails, and appetite, felt good. “It was important to me,” says Smith, 48, who cofounded the nonprofit Traci’s B.I.O. (Beautiful Inside and Out) with business partner Phyllis Young in 2014. The organization works to support, educate, and pamper African American women with breast cancer. (Rush, 4/14)

Boston Globe: Partners To Use Wind Power To Cut Costs, Emissions 
Partners HealthCare, one of Massachusetts’ largest companies and biggest energy users, has signed an agreement with a New Hampshire wind farm to help power its hospitals and other facilities. Partners said the deal will reduce its greenhouse gas emissions by 110 million pounds per year. The agreement is with New York-based Walden Green Energy LLC, which is building a wind farm in Antrim, N.H. Construction is expected to be completed in 2019. (Dayal McCluskey, 4/13)

Editorials And Opinions

Viewpoints: Another Fight On Health Care Coming; Artificial Intelligence In The Hospital

A selection of opinions on health care from around the country.

Huffington Post: Democrats Say They Will Fight Trump Over Health Insurance Subsidies
Get ready for another big congressional fight over Obamacare. The flashpoint this time is a key funding stream for the program ― one that subsidizes insurers so they can offer low-income consumers plans with reduced out-of-pocket expenses. President Donald Trump suggested in a Wednesday Wall Street Journal interview that he and other Republicans might cut off the funds. Now Democrats are saying they’ll fight this by demanding that Congress include the money as part of a spending bill that is supposed to keep the government running past April. (Jonathan Cohn, 4/13)

The New York Times: Can Trump Take Health Care Hostage?
Three weeks have passed since the Trumpcare debacle. After eight years spent denouncing the Affordable Care Act, the G.O.P. finally found itself in a position to do what it had promised, and deliver something better. But it couldn’t. And Republicans, President Trump very much included, had nobody but themselves to blame. (Paul Krugman, 4/14)

Bloomberg: Trump's Obamacare Obsession Must Die
In an interview with Fox Business that aired on Wednesday, President Donald Trump said it's been "misreported" that his administration has failed in its efforts reform health care. He suggested that his party's reforms will result in $900 billion in government savings, and that an ACA repeal will come before an attempt at tax reform. Hospitals and Medicaid insurers, stocks that are most exposed to changes to the ACA, saw shares fall once again yesterday. A repeal is still unlikely, despite the President's continuing optimism. But continuing to tilt at that windmill doesn't enable tax reform, it renders it more distant and difficult to count on. That's a bigger issue than repeal for much of the health care sector. (Max Nisen, 4/13)

The Washington Post: Republicans Can’t Find A Way To Repeal Obamacare Because Too Many Of Them Secretly Love It
Republicans haven't been able to replace Obamacare, because they think the problem with it, metaphorically speaking, is that the food is terrible and the portions are too small. That, of course, is what Woody Allen had to say about life in “Annie Hall.” But the same kind of contradiction — you hate something, and want more of it — is why Republicans haven't been able to agree on anything other than that they want to be able to say that they repealed Obamacare. (Matt O'Brien, 4/14)

Los Angeles Times: Insurance CEOs Haven't Been Speaking Up For Obamacare — Except For One
President Trump and congressional Republicans finally goaded the health insurance industry into defending the Affordable Care Act this week — sort of. But the industry’s pusillanimous response to the GOP’s point-blank threat to Obamacare’s survival is a reminder that health insurance companies, which have made hundreds of millions of dollars from the law, have in many ways been its worst enemies. (Michael Hiltzik, 4/13)

The New England Journal of Medicine: Physicians, Firearms, And Free Speech — Overturning Florida’s Firearm-Safety Gag Rule
In February, the full U.S. Court of Appeals for the Eleventh Circuit issued its long-awaited ruling in Wollschlaeger v. Governor, State of Florida, invalidating parts of Florida’s Firearm Owners’ Privacy Act (FOPA) and affirming that the First Amendment applies to the speech between physicians and patients. The decision ensures that physicians may continue to make efforts to protect their patients from gun-related injuries, many of which are fatal and which in aggregate account for approximately as many deaths annually as do motor vehicle accidents. (Wendy E. Parmet, Jason A. Smith and Matthew Miller, 4/12)

Stat: 'Beautiful Babies' Will Die Without Global HIV Funding
President Trump was moved to launch an attack on an air base in Syria in part because of images he saw of the youngest victims of Syrian dictator Bashar al-Assad’s most recent chemical assault on civilians. “Even beautiful babies were cruelly murdered in this very barbaric attack. No child of God should ever suffer such horror,” Trump said while explaining the strike, as if he were learning of such atrocities being committed at the hands of the Assad regime for the first time. While I commend his rare public display of empathy, I hope he will give the same direct and forceful action to avert the deaths of hundreds of thousands of children a year from HIV/AIDS. (C. Nicholas Cuneo, 4/13)

Stat: Artificial Intelligence: Coming Soon To A Hospital Near You
Human intelligence has long powered hospitals and health care. We rely on doctors, nurses, and a variety of other clinicians to solve problems and create new solutions. Advances in artificial intelligence are now making it possible to apply this form of computer-based “thinking” to health care. As the chief technology officer for a new state-of-the-art advanced medical learning facility, I have been closely watching developments in artificial intelligence. Here are three areas — training, surgical robots, and data mining — in which I believe it will begin making a difference sooner rather than later. (Roger Smith, 4/13)

The Wall Street Journal: Why Hospitals Need To Stop Boarding Patients In Emergency Rooms
Just after World War II, there were 1.4 million hospital beds available in the U.S. The most recent estimates show fewer than 900,000 beds, even though the nation’s population has grown by 120% over the same period. Better care delivery, technology, and changing financial incentives have driven much of this decrease, with hospitals continuing to downsize their staff and operations, making for less-flexible bed management. Also shrinking in number are emergency rooms (ERs), even while demand increases. ... In the past few decades, an additional burden has been placed on the ER with major implications for patient care: boarding. (Howard Forman, 4/11)

The Wall Street Journal: What Being A Doctor Did–And Didn’t–Teach Me About Leadership
I spent 11 years after medical school training for my first career as a surgeon and scientist, and received little formal preparation for my eventual career as an institutional leader. Extensive training makes sense for a role in which you literally hold patients’ lives in your hands. But beyond the necessary technical skills, becoming a surgeon is a matter of absorbing deep and urgent responsibility for another’s life into a core part of yourself. In some ways, that training has helped me in my current administrative role. ... Other lessons don’t translate as readily. (Lloyd B. Minor, 4/11)

The New England Journal of Medicine: Lessons From Standing Rock — Of Water, Racism, And Solidarity
Having followed the events at Standing Rock, North Dakota, I was drawn to go there during Thanksgiving week — amazed by the unlikely fact that a tribe suffering from poverty and health disparities could take such a principled, powerful stand, galvanizing attention for environmental justice and the perfidy of continued carbon exploitation. I thought experiencing Standing Rock, and perhaps contributing, could teach me something about caring for the [traditional Navajo, or] Diné in Chinle. ... The Standing Rock movement is about both environmental justice and racism: it aims to protect Native American lands, reduce exploitation of carbon-based energy to slow climate change, and defend access to safe water for a vulnerable community. ... Medicine has a proud history of water protection. (David Goldberg, 4/13)