The New York Times: Justices Seem Split In Case On Birth Control Mandate
The Supreme Court weighed moral theology and parsed insurance terminology on Wednesday in an extended and animated argument that seemed to leave the justices sharply divided over what the government may do to require employers to provide free insurance coverage for contraception to female workers. A 4-to-4 tie appeared to be a real possibility, which would automatically affirm the four appeals court decisions under review. All four ruled that religious groups seeking to opt out of the requirement that they pay for the coverage must sign forms and provide information that would shift the cost to insurance companies and the government. (Liptak, 3/23)

Reuters: Supreme Court Faces 4-4 Split In Obamacare Contraception Case
Justice Anthony Kennedy, who often casts the deciding vote in close cases, appeared more aligned with the court's three other conservatives in favoring the challengers, which primarily were Roman Catholic including the archdiocese of Washington. The Christian employers call contraception immoral and argue that the government should not compel religious believers to choose between following their faith and following the law. They argue they should get the complete exemption from the mandate already given to places of worship such as churches, mosques and temples. (Hurley, 3/23)

The Wall Street Journal: Supreme Court Could Split In Contraceptive Case
The court’s four liberal members appeared convinced the government’s compromise met its legal obligation to accommodate religious objectors to the law. The more conservative justices sharply questioned why the government could relieve other employers of the contraceptive requirement—such as houses of worship, or companies using older, “grandfathered” plans—while denying identical treatment to the religious nonprofits. That appeared to leave the decision to Justice Anthony Kennedy, who early on in the argument recognized the practical difficulties of the challengers’ position, yet later suggested he strongly empathized with their moral imperatives. (Bravin and Radnofsky, 3/23)

Politico: Divided Supreme Court Hears Obamacare Birth Control Challenge
A sharply divided Supreme Court on Wednesday considered whether Obamacare's birth control coverage requirement violated the rights of religious institutions, with Justice Anthony Kennedy — the likely swing vote — voicing concern about how big a loophole the court might create if it rules for the challengers. Kennedy suggested that large institutions like Catholic universities shouldn't be able to get out of the employee coverage requirement in the same way that other challengers, such as the Little Sisters of the Poor order of Catholic nuns, perhaps should. (Haberkorn and Gerstein, 3/23)

Modern Healthcare: Supreme Court Appears Divided On ACA Contraception Case
Despite the questioning, Leila Abolfazli, senior counsel with the National Women's Law Center, which filed a brief in the case siding with the government, said she believes it still has a chance of winning the case. She pointed to Kennedy's writings in the previous Hobby Lobby case from 2014. ... Kennedy wrote a concurring opinion in that case agreeing that part of the reason to rule in favor of Hobby Lobby was because there were less restrictive ways to make sure its employees got birth control coverage than by forcing Hobby Lobby to provide it directly—such as the accommodation afforded to religious not-for-profits. (Schencker, 3/23)

Los Angeles Times: In Religious Liberty Vs. Obamacare Contraceptives, Supreme Court Appears Deadlocked
The court's liberals, led by its female justices, said the Obama administration had found a fair way to shield the employers from providing or paying for the contraceptives. “As in all things, it can’t be all my way,” Justice Ruth Bader Ginsburg said. “There has to be an accommodation, and that’s what the government tried to do.” Justice Elena Kagan said she could not understand how the Catholic charities could refuse to even notify the government they would not provide contraceptive coverage to their employees. You “object to objecting,” she said. (Savage, 3/23)

The Washington Post: Court Appears Divided On Contraceptive Coverage, With Kennedy Raising Concern
The hearing provided a vivid illustration of the difficulty the court — without Justice Antonin Scalia, who died last month — might have putting together the necessary five-member majority to decide its most important cases. In this case, it would mean the national law that has transformed health-care coverage would be implemented differently depending on where the organization and its employees are located. An inability to decide the case would mean the lower courts’ decisions would remain in place. The mandate has been upheld by eight of the nation’s regional appeals courts that have decided the issue and overturned in one. (Barnes, 3/23)

The Associated Press: Justices Divided Over New Challenge To Health Care Law
Contraception is among a range of preventive services that must be provided at no extra charge under the health care law. The administration pointed to research showing that the high cost of some methods of contraception discourages women from using them. A very effective means of birth control, the intrauterine device, can cost up to $1,000. Houses of worship and other religious institutions whose primary purpose is to spread the faith are exempt from the birth control requirement. Other faith-affiliated groups that oppose some or all contraception have to tell the government or their insurers that they object. (Sherman, 3/23)

Fox News: Supreme Court Divided On ObamaCare Contraception Mandate
Members of the Little Sisters of the Poor rallied along with their supporters in front of the court Wednesday, many carrying signs and buttons with "I'll Have Nun of It." Nearby were supporters of abortion rights and the Affordable Care Act. While the LSP leaders are nuns, the charity employs hundreds of lay workers who otherwise may be eligible for the insurance service. Similar non-profits would include certain hospitals, parochial schools, and private faith-based universities. (Mears, 3/23)

USA Today: Supreme Court Deeply Divided Over Religious Freedom, Reproductive Rights
This was the fourth time before the court for Obama's prized Affordable Care Act, and it came on the sixth anniversary of the law going into effect. While it suffered a setback in a 2014 case over the so-called "contraceptive mandate" as applied to certain for-profit businesses, it has survived two major challenges to its broader insurance requirements and subsidies. (Wolf, 3/23)

Kaiser Health News: Supreme Court Takes Up Birth Control Access — Again
A new poll by the Kaiser Family Foundation finds that more than a third of those surveyed (and 40 percent of women) said there is “a wide-scale effort to limit women’s reproductive health choices and services.” (Kaiser Health News is an editorially independent program of the foundation.) Not surprisingly, Democratic women were more likely to say there is a wide-scale effort than Republican women (56 percent v 25 percent) and far more likely to say that they are “personally concerned” about women’s reproductive health choices (52 percent v 18 percent). (Rovner, 3/23)

ProPublica: What's At Stake In The Latest Supreme Court Showdown Over Contraception And Religious Freedom
Legal analysts have called the case Hobby Lobby Part 2, and like that landmark 2014 ruling by the high court, Zubik has implications far beyond the realm of reproductive health care. ... A ruling in favor of the religious nonprofits would not only undermine key provisions of the ACA, but it could lead to challenges to laws meant to protect gays and lesbians from discrimination, [Gretchen Borchelt, vice president for reproductive rights and health at the National Women’s Law Center] said. (Smith and Martin, 3/23)

The Wall Street Journal: On Health Law’s Anniversary, Burwell Extols Successes And Acknowledges Frustrations
Health and Human Services Secretary Sylvia Mathews Burwell marked the sixth anniversary of the Affordable Care Act and a U.S. Supreme Court case contesting the law’s contraception workaround by extolling the ACA’s successes, and acknowledging frustrations some Americans have had with health costs. Ms. Burwell, speaking at an event on diabetes prevention, said the law has led to a drop in the number of uninsured Americans and health insurers that can no longer deny people coverage because of pre-existing conditions. “This progress has changed people’s lives,” she said. But in a nod to critics, she said many Americans are unhappy with their health care experience because of high costs. (Armour, 3/23)

Forbes: On Obamacare's 6th Birthday, Medicaid Expansion Creates Jobs, Saves Money
States that expanded Medicaid under the Affordable Care Act saw more job growth, lower health inflation and spent less on social and health services unneeded once more residents had medical coverage, a new analysis shows. A new report issued by the Robert Wood Johnson Foundation said states that opted to expand Medicaid coverage for poor Americans are saving “in many cases, tens of millions of dollars.” (Japsen, 3/23)

Columbus Dispatch: Obamacare In Ohio, 6 Years On
In Ohio, 1.3 million people were uninsured in 2013 before the rollout of the federally run insurance marketplace and the expansion of Medicaid under the law. Today, according Trey Daly, Ohio director for Enroll America: An estimated 402,000 Ohioans are uninsured. About 243,000 Ohioans have bought plans through the federal marketplace, up from 234,000 after the 2014-15 enrollment period and 155,000 after the first open-enrollment period in 2013-14. (Kurtzman, 3/24)

The Associated Press: Report: HealthCare.gov Logged 316 Cybersecurity Incidents
The web portal used by millions of consumers to get health insurance under President Barack Obama's law has logged more than 300 cybersecurity incidents and remains vulnerable to hackers, nonpartisan congressional investigators said Wednesday. The Government Accountability Office said none of the 316 security incidents appeared to have led to the release of sensitive data on HealthCare.gov, such as names, birth dates, addresses, Social Security numbers, financial information, or other personal information. (Alonso-Zaldivar, 3/23)

USA Today: Feds Mull Medicare Changes After Big Success In YMCA's Diabetes Program
People at high risk of developing diabetes lost about 5% of their body weight in a YMCA program that federal regulators said Wednesday was successful enough to expand. The Centers for Medicare and Medicaid Services (CMS) gave YMCAs nearly $12 million in 2011 to launch the program, which includes nutrition and fitness counseling and lifestyle coaching for Medicare recipients. The funding was provided by the Affordable Care Act, which also marked its 6th anniversary Wednesday. (O'Donnell, 3/23)

The Washington Post: Medicare Could Soon Pay For Services To Keep Diabetes From Developing
It is the first time an experimental prevention initiative has met the financial test to become part of the huge federal health insurance program for older Americans. ... Sylvia M. Burwell, secretary of the Department of Health and Human Services, said prevention programs of this kind “help people live longer, fuller lives and save money across the [health care] system.” (Bernstein, 3/23)

Kaiser Health News: Medicare Proposes Expansion Of Counseling Program For People At Risk Of Diabetes
Burwell said the intervention program could also save lives for people who aren’t covered by Medicare. Some insurers and employers already offer similar programs to their employees and customers, and others could do so to help the 86 million Americans who have a high risk of developing diabetes, Burwell said. This is the first preventive service program from the Center for Medicare & Medicaid Innovation that has become eligible for expansion within Medicare. The health law created the center to launch experiments that would change the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse. (Carey, 3/23)

NPR: HHS Says Diabetes Prevention Program Will Save Medicare Money
One of every three Medicare dollars is spent on patients with diabetes, according to HHS, and the prevention effort saved Medicare about $2,650 per participant over 15 months. That's more than the cost of the preventive program. (Kodjak, 3/23)

The Associated Press: Medicaid Expansion Fails In Idaho, Smaller Efforts Proposed
Idaho lawmakers have failed to finalize a proposal to expand Medicaid eligibility that would appease the Republican supermajority in the waning days of the legislative session. Instead, two minor proposals were approved Wednesday by the House to devote more resources to studying the so-called Medicaid gap population. (Kruesi, 3/22)

Kaiser Health News: In Conservative Indiana, Medicaid Expansion Makes Poorest Pay
Reginald Rogers owes his dentist a debt of gratitude for his new dentures, but no money. Indiana’s Medicaid program has them covered, a godsend for the almost toothless former steelworker who hasn’t held a steady job for years and lives in his daughter’s basement. “I just need to get my smile back,” Rogers, 59, told his dentist at a clinic here recently. “I can’t get a job unless I can smile.” Rogers is among the more than 240,000 low-income people who gained health coverage in the past year when Indiana expanded Medicaid as part of the Affordable Care Act. Rogers pays $1 a month -- a fee that is a hallmark of the state’s controversial plan. (Galewitz, 3/24)

The Wall Street Journal: Novartis Settles With SEC Over Accounting Failures
Novartis AG agreed to pay about $25 million in a settlement with the Securities and Exchange Commission over accounting and bookkeeping failures relating to illicit payments made in China. An SEC investigation found that employees of two China-based Novartis subsidiaries gave money, gifts and other things of value to health-care professionals, leading to several million dollars in sales of pharmaceutical products to Chinese state health institutions. Among the gifts, according to an administrative order filed by the SEC, was travel for the health-care professionals and their spouses to a conference in Chicago, along with walking-around money and coverage of strip-club charges on the side. (Rubenfeld, 3/23)

STAT: Novartis Agrees To $25M Settlement Over Bribery Charges In China
Novartis today agreed to pay $25 million to settle charges that it violated the Foreign Corrupt Practices Act by making illegal payments to health care providers in China. In doing so, the company becomes the latest drug maker to get punished for paying bribes in order to boost sales in a foreign country. (Silverman, 3/23)

The Wall Street Journal: Bristol-Myers to Buy Autoimmune Disease Treatment Developer Padlock
Bristol-Myers Squibb Co. said Wednesday that it would acquire privately-held Padlock Therapeutics Inc. in a deal potentially valued at up to $600 million, the latest attempt by a large pharmaceutical company to grab a chunk of the growing autoimmune disease market. Terms of the deal weren’t disclosed, and a spokesman declined to provide details. (Beilfuss, 3/23)

The Milwaukee Journal-Sentinel: Propeller Health Forges First-Of-Its Kind Partnership
Madison-based Propeller Health and global pharmaceutical company Boehringer Ingelheim Pharmaceuticals Inc. said Wednesday they have forged a first-of-its-kind partnership that will use digital health tools to help people living with chronic repiratory diseases. (Gallagher, 3/23)

The Wall Street Journal: AstraZeneca Says Its Blood Thinner No Better Than Aspirin In Stroke Trial
AstraZeneca PLC said its prescription blood thinner Brilinta was no more effective than aspirin at preventing major heart problems in stroke patients, denting the company’s growth ambitions for one of its key drugs. The U.K.-based drugmaker had hoped the large clinical trial would open up a new slice of the blood-thinner market for Brilinta, which is already approved for treating patients recovering from a heart attack. AstraZeneca said that while patients who took Brilinta in the 90 days after an initial stroke were slightly less likely to have a heart attack, a further stroke or to die, the trend wasn’t strong enough to show statistical significance. (Roland, 3/23)

Modern Healthcare: One Year After Zarxio Approval, Future Of Biosimilars Remains Unclear
A year ago, providers, plans and pharmacy benefit managers thought they were on the brink of a new era of competitive drug prices. The federal approval of the first biosimilar for sale in the U.S. was supposed to foster new products that offered big discounts on some of the most expensive treatments.But there's been no flood of new drugs and no lower prices since the Food and Drug Administration's approval of Sandoz's drug Zarxio. (Johnson, 3/23)

The Wall Street Journal: Potent Synthetic Drug Exacerbates Heroin Epidemic In New York City
Officials confronting New York City’s surge in heroin trafficking said the past year has brought a troubling trend—a large influx of fentanyl, a synthetic opioid 30 to 50 times more powerful than heroin. Fentanyl, which has long been prescribed for severe pain, has played a lethal role in the heroin epidemic sweeping the country. Scores of overdose deaths have been attributed to fentanyl, which is often combined with heroin to make the drug more potent, officials said. (O'Brien, 3/23)

North Carolina Health News: Potent Opioid Causing Overdose Deaths In NC
Word is spreading around the state about a deadly form of opioid that’s killed at least 19 people in North Carolina since the new year. The problems have been caused by a drug known as furanylfentanyl, a powerful form of the synthetic opiate fentanyl. (Hoban, 3/23)

The Cleveland Plain Dealer: Spike In Opioid Overdoses Straining Hospitals, Rehab Facilities; Fentanyl Linked To Spiraling Crisis
On a grim night in March, calls for opioid overdoses streamed into police stations across Cuyahoga County. One was for a 34-year-old man in North Royalton; another was for a 56-year-old woman in Parma; and still another was about a 28-year-old man found unresponsive in Cleveland Heights. All of them died, and not one stayed alive long enough to make it to the hospital. (Ross, 3/23)

WBUR: Mass. Hospitals Seeing Surge In Heroin-Related Visits
Opioid-related hospital visits are “skyrocketing” in Massachusetts, with heroin-related visits jumping by 201 percent between 2007 and 2014, according to Health Policy Commission figures discussed Wednesday. Opioid-related hospital visits have increased from around 30,000 in 2007 to more than 55,000 in 2014, with non-heroin opioids accounting for the bulk of the trips, an analysis by the commission found. (Lannan, 3/23)

USA Today/The (Nashville) Tennessean: Tennessee Law That Punishes Mothers Of Drug-Dependent Babies To End
A controversial law that criminalizes women who give birth to drug-dependent babies will sunset later this year after a bill in front of a House committee failed Tuesday. The legislation, sponsored by Rep. Terri Lynn Weaver, R-Lancaster, failed to receive the necessary approval from the Criminal Justice subcommittee, as a result of a tie vote on the six-member committee. (Ebert, 3/23)

NPR: Tennessee Lawmakers Discontinue Controversial Fetal Assault Law
A small but pivotal group of Tennessee representatives voted Tuesday to discontinue one of the state's most divisive criminal laws. Known as "fetal assault," the measure empowered prosecutors to arrest women who abuse heroin or pain pills during pregnancy, if their babies were born dependent. (Farmer, 3/23)

Meanwhile, a bill aimed at helping such babies is introduced in Congress —

Reuters: U.S. Bill Targets Babies Born Dependent On Opioids
A bill that aims to protect babies born to mothers who used heroin or other opioids during pregnancy was introduced on Wednesday in the House as part of the government’s response to a Reuters investigation. The bipartisan measure would require federal and state governments to do a better job of monitoring the health and safety of babies born drug-dependent. Last week – and also in response to the Reuters investigation – a similar bill moved to the Senate floor and the U.S. Health and Human Services Department pledged reforms. (3/23)

STAT: Congress Just Went On Spring Break Without Voting On Emergency Zika Measure
Lawmakers left town Wednesday for their spring recess without voting on an emergency funding request for the Zika virus, as the Obama administration and congressional Republicans failed to resolve their disagreement over whether federal health agencies need more money to support research and preparedness. (Nather, 3/23)

NPR: Parents Sleeping Badly? They May Think Their Children Are, Too
Funny how feelings about sleep change over the years. Many children fight bedtime and are still getting up once or more during the night well into childhood. Meantime, adults often feel they can never get enough sleep, and if they're anything like me, have vivid fantasies about napping. Now a study suggests that a parent's own sleep quality may bias how they perceive their child's sleep issues. (Hobson, 3/24)

The Washington Post: 4-Legged Healers Soothe Hospital’s Stressed-Out Docs, Nurses
Patients who delay getting treatment and insurers who balk at paying for it are among job stresses that Chicago nurse Ben Gerling faces on a semi-regular basis. So there was no tail-dragging when his employer offered a few four-legged workplace remedies. Gerling and dozens of other nurses, doctors, students and staffers flocked to a spacious entrance hall at Rush University Medical Center after learning about special animal therapy sessions the hospital has organized. Three huggable pups named Rocco, Minnie and Dallis greeted almost 100 white-coat and scrubs-clad visitors at a recent session, happily accepting cuddles, ear rubs and treats. Big grins on the human faces suggested the feelings were mutual. (Tanner, 3/23)

NPR: Probing The Complexities Of Transgender Mental Health
Experiencing the world as a different gender than the one assigned to you at birth can take a toll. Nearly all research into transgender individuals' mental health shows poorer outcomes. A new study looking specifically at transgender women, predominantly women of color, only further confirms that reality. What's less clear, however, is whether trans individuals experience more mental distress due to external factors, such as discrimination and lack of support, or internal factors, such as gender dysphoria, the tension resulting from having a gender identity that differs from the one assigned at birth. (Haelle, 3/23)

Los Angeles Times: Intensive Exercise May Keep The Aging Mind Sharp
Older Americans who engage in strenuous exercise are more mentally nimble, have better memory function and process information more speedily than do their more sedentary peers, new research suggests. And as they continued to age, participants who were very physically active at the start of a five-year study lost less ground cognitively than did couch potatoes, according to the study. The latest research, published Wednesday in the journal Neurology, is the most recent study to underscore the importance of moderate to intensive exercise in healthy aging. In addition to keeping diabetes, heart disease and osteoporosis at bay or in check, a welter of studies suggests a good workout is powerful medicine for the aging brain, preventing and treating depression and shoring up cognitive function. (Healy, 3/23)

Meanwhile, lobbyists hit the capitol in Iowa over dementia and Alzheimer's issues —

Iowa Public Radio: Alzheimer's Association Seeks Better Dementia Care Training
The organization that represents some 63,000 Iowans with Alzheimer’s disease had its annual lobby day at the capitol today. Officials with the Alzheimer's Association say they want more accountability for health care workers providing dementia care. (Russell, 3/23)

The Washington Post: Philanthropist Paul Allen Announces $100 Million Gift To Expand ‘Frontiers Of Bioscience’
Billionaire philanthropist Paul Allen has announced a $100 million commitment over 10 years to fund scientific endeavors at the “frontiers of bioscience" that he describes as having major implications for humankind. An initial set of grants, announced Wednesday, will go to Stanford and Tufts universities for the creation of new research centers and to individual scientists with unconventional approaches to projects in tissue regeneration, antibiotic resistance, gene editing and the development of brain circuitry. (Cha, 3/23)

Providence (R.I.) Journal: Was R.I. Slow To Act On Medicaid Overpayments?
Off-target assumptions on the cost of insuring 60,000 new Medicaid enrollees led to a temporary windfall for two health insurers, but state officials on Tuesday said they expect to collect most of the $133 million in remaining overpayments by June and all of it by the end of the year. However, questions remain about whether Rhode Island acted quickly enough to slow and recoup payments to United Healthcare and Neighborhood Health Plan from growing to $208 million last year, as identified in a report from Auditor General Dennis Hoyle on Monday. (Gregg and Anderson, 3/23)

Montgomery (Ala.) Advertiser: General Fund Goes To Bentley; Medicaid Issues Remain
The Alabama Legislature Wednesday gave final approval to a $1.8 billion General Fund budget, sending it to Gov. Robert Bentley. They’ll likely see it again. The Senate Tuesday voted 20 to 13 to concur in the House version of the budget, which level-funds most state agencies but gives the Alabama Medicaid Agency $85 million less than what the agency says it needs to maintain current services, which would allow it to begin implementation of a managed-care model for the program aimed at easing costs. ... Gov. Robert Bentley has said a budget with less than a $100 million boost for Medicaid would bring his veto and a special session. (Lyman, 3/23)

NPR: Independent Investigators: State Officials Mostly To Blame For Flint Water Crisis
"The Flint water crisis is a story of government failure, intransigence, unpreparedness, delay, inaction, and environmental injustice." That's how an independent task force opened its final report on the lead-tainted water crisis in Flint. It concluded that primary responsibility for the crisis in Flint, Mich., lies with a state environmental agency called the Michigan Department of Environmental Quality — though it said others are also to blame. (Kennedy, 3/23)

The Connecticut Mirror: Critics Urge More Transparency In Anthem-Cigna Merger Review
Saying that “all eyes will be on Connecticut,” critics of two pending mergers of major health insurers have asked the state’s insurance commissioner to take steps they say would increase transparency in the review of Anthem’s proposed acquisition of Cigna. (Levin Becker, 3/23)

North Carolina Health News: Legislators, Advocates Discuss Stemming The Flow Of Mentally Ill To Prison
North Carolina has about 36,900 people incarcerated in state prisons and, according to numbers from the state Department of Public Safety, at least 14 percent, or about 5,100, of those people have a severe mental illness. Compared to the number of psychiatric beds available in the state, about 2,700, it’s clear that North Carolina’s prison system houses more patients with mental health problems than the health care system, said David Guice, who manages adult corrections and juvenile justice for DPS. (Hoban, 3/23)

The Kansas Health Institute News Service: House Passes Bill Narrowing AG Abuse Investigations
The Kansas House on Wednesday passed a bill narrowing the scope of abuse claims the Attorney General’s Office investigates, with some revisions by a committee. Senate Bill 408 would move responsibility for investigating some cases involving children away from the Attorney General’s Abuse, Neglect and Exploitation Unit. Attorney General Derek Schmidt testified during a February hearing in favor of the bill, which he said would allow the unit to focus on abuse cases involving seniors and adults with disabilities. (Hart, 3/23)

The Providence Journal: R.I. Disability Law Center Opens Probe Into Abuse, Neglect Of Disabled
Exercising its federal authority to investigate suspected abuse or neglect of developmentally disabled people, the Rhode Island Disability Law Center has opened its own examination of the February death of a 70-year-resident of a state-run group home, College Park Apartments on Mt. Pleasant Avenue. The death is already under investigation by Attorney General Peter F. Kilmartin’s Medicaid Fraud and Patient Abuse Unit and the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH), which operates the home, scheduled to close by Friday after its 14 remaining residents have been transferred to other facilities. And on Wednesday, the state police confirmed they, too, are investigating. (Miller, 3/23)

The Associated Press: Alabama 'Personhood' Proposal Would Effectively Ban Abortion
A proposed Alabama constitutional amendment would legally define a fetus as a person from the moment of fertilization, effectively banning abortion in the state. The House Health Committee on Wednesday debated but did not vote on the amendment. The bill, sponsored by Rep. Ed Henry, R-Decatur, is similar to ballot measures voted down in Mississippi, Colorado and North Dakota in recent years. The Oklahoma Supreme Court in 2012 ruled a similar amendment unconstitutional. (3/23)

The Oregonian: Head Of Portland VA Medical Center Has Stepped Down
The director of Veterans Affairs in Portland has stepped down. Joanne Krumberger was named director of the VA Portland Health Care System in May 2014. On Friday, she was gone. (Terry, 3/23)

Georgia Health News: Kaiser Again Ranks Tops In Member Satisfaction
Kaiser Permanente of Georgia had the highest patient satisfaction rating in its region for the seventh consecutive year, as compiled by J.D. Power. Kaiser, which serves nearly 300,000 members in metro Atlanta and Athens, earned 765 of a possible 1,000 points in the survey of the South Atlantic region, which includes South Carolina and North Carolina. (Miller, 3/23)

The Associated Press: Indiana Court: IBM Breached Contract, Still Due $50M
IBM Corp. breached its state contract in the company's failed attempt to privatize Indiana's welfare services but is still entitled to nearly $50 million in state fees, the state Supreme Court said Tuesday in a ruling that also opens the door for Indiana to seek up to $175 million in damages. The high court's ruling in the long-running case upholds a February 2014 state Court of Appeals ruling and reverses a trial court judge's finding that Indiana had failed to prove IBM breached the $1.3 billion state contract it won in 2006. Under that contract, an IBM-led team of vendors had worked to process applications for food stamps, Medicaid and other public safety-net benefits through the call centers, the Internet and fax machines that residents could use to apply for those benefits. (Callahan, 3/22)

Vox: Elizabethkingia, The Rare And Deadly Bacteria That's Sickening People In The Midwest, Explained
Since last November, more than 50 people in Wisconsin have been sickened by mysterious bacteria called Elizabethkingia anophelis. This is the largest recorded outbreak caused by what's to date been a rare microbe — and the same bug was identified last week in a patient who died in Michigan. Public health officials in both states don't yet know what sparked the outbreaks or how people became infected, but they're worried. So far, 18 people have died from the infection, and researchers believe this particular strain is resistant to many of the antibiotics that could stop it. (Julia Belluz, 3/22)

STAT: One Man's Desperate Quest For A Brutal Surgery
The operation is so terrifying some call it MOAS: the Mother of All Surgeries. It can take 16 hours. The risk of complications is high. And after 30 years of research, doctors are still arguing about how well it works. But as Stephen Phillips shimmied himself onto the operating table one recent morning, he was almost relieved. He’d spent five months desperately trying to arrange this surgery in the hope that it would beat back his rare cancer of the appendix. (Eric Boodman, 3/24)

BuzzFeed: Addicts For Sale
One early evening last October, a group of young men and women were hanging out at the Starbucks on the main drag here, Atlantic Avenue, smoking cigarettes and bullshitting. They were sitting next to a pile of suitcases, the telltale sign of an addict looking for a place to stay. Some get kicked out of their old halfway house because they relapse; others because their insurance coverage has been used up. (Cat Ferguson, 3/19)

WBUR: Oral History: Bittersweet Memories Of A Cuban HIV Sanitarium
President Obama’s visit to Cuba this week has highlighted the fading of U.S.-Cuba alienation — but also the deep and lingering differences between the two countries, on issues from freedom of speech to free health care. Here, reporter Rebecca Sananes shares a chapter of medical history in which Cuba chose a policy diametrically opposite to America’s: Back in the 1990s, Cuba created a network of sanitariums, where people with HIV were confined indefinitely. It sounds barbaric, but as former patient Eduardo Martinez’s recollections reveal, it’s complicated. Life in the sanitariums was so much better than outside that some people purposely infected themselves with HIV. (Rebecca Sananes, 3/22)

Vox: The IUD Revolution
Birth control pills are currently the most popular contraceptive among American women, followed by condoms. These methods are especially susceptible to human error and have high failure rates. Of 100 women who rely on birth control pills, about six get pregnant every year. By contrast, long-acting reversible contraceptives (LARCs) like IUDs and implants are placed by health professionals and last for at least three years after insertion. They are 20 times more effective at preventing pregnancy than the pill, with failure rates between 0.2 and 0.8 percent. (Sarah Kliff, 3/23)

The Dallas Morning News: Danger In The Psych Ward
In Sherman, workers at a psychiatric ward dropped a suicidal patient off at a bus stop; a day later he was found dead after jumping from a Dallas bridge. In San Angelo, hospital employees created infection risks by leaving an observation room covered in vomit and a kitchen black with grease and dead bugs. And in Austin, male nurses stripped a teenage sex-abuse victim and shut her in solitary confinement, naked. (Miles Moffeit, 3/18)

The New York Times Magazine: Should Parents Of Children With Severe Disabilities Be Allowed To Stop Their Growth?
Physicians began prescribing estrogen to treat children with acromegaly, or excessive-growth disorder, in the 1940s. Later, in the 1950s through the 1970s, healthy preteen and teenage girls whose tall stature was merely deemed unattractive were given estrogen to reduce their predicted height by several inches. But as greater height in girls became increasingly acceptable, even desirable, growth attenuation fell into disfavor. By the turn of the century, the practice was all but obsolete. (Genevieve Field, 3/22)

The New Yorker: The Bugs That Live On Us And Around Us
New Yorkers received tainted water for decades, despite persistent protests over the foul taste. The city only bowed when a group of beer brewers began complaining that unpleasant water was undermining their product. An aqueduct was built that began to draw clean water from the Croton River, in 1842; eventually, cholera all but disappeared from New York. As Sonia Shah demonstrates in her new book, “Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond,” the vicissitudes of political will—along with other environmental factors—can tip the balance between pathogens and humans. (Amanda Schaffer, 3/18)

The New York Times: An Experimental Autism Treatment Cost Me My Marriage
What happens to your relationships when your emotional perception changes overnight? Because I’m autistic, I have always been oblivious to unspoken cues from other people. My wife, my son and my friends liked my unflappable demeanor and my predictable behavior. They told me I was great the way I was, but I never really agreed. (John Elder Robinson, 3/18)

Bloomberg: The Unfinished Work Of Obamacare
Unless Congress finds a way to repeal the Affordable Care Act over the next 10 months -- after more than 60 failed attempts -- President Barack Obama will leave office with his signature legislation intact, and running pretty smoothly. Obamacare, which turns six today, has reduced the share of Americans without health insurance by half, provided people without job-based coverage access to affordable high-quality options, and prevented people from being denied insurance because of preexisting health conditions. Meanwhile, health-care costs have grown more slowly than they did before the law was passed. (3/23)

The Wall Street Journal: The Affordable Care Act After Six Years
The Affordable Care Act generates so much partisan heat and draws so much media attention that many people may have lost perspective on where this law fits in the overall health system. The Affordable Care Act is the most important legislation in health care since the passage of Medicare and Medicaid. The law’s singular achievement is that 20 million people who were previously uninsured have health-care coverage. What sets the ACA apart is not only the progress made in covering the uninsured but also the role the law has played rewriting insurance rules to treat millions of sick people more fairly and its provisions reforming provider payment under Medicare. The latter is getting attention throughout the health system. (Drew Altman, 3/23)

Fox News: ObamaCare’s Unhappy 6th Birthday: The Brutal Facts About The Tottering Affordable Care Act
Happy birthday, ObamaCare. If only you were strong enough to blow out six candles. After a difficult gestation, an awkward birth and a few trips to the ER (aka the Supreme Court), the Affordable Care Act turns 6 years old on Wednesday. It made it through nursery school and kindergarten, but it’s still a very troubled child. (Sreedhar Potarazu, 3/23)

The New York Times: Will The Supreme Court Buy Faulty Logic On Religious Freedom?
What is a “substantial” burden on religious freedom? For four Supreme Court justices, the answer may be: whatever a religious objector says it is. That was the implication of a brief exchange during oral arguments on Wednesday morning, in one of the most significant cases of the court’s current term, involving a religious challenge to women’s access to free birth control. If the justices split 4-4, they would leave the issue unresolved until a new justice is confirmed, which could be a year or more from now. (Jesse Wegman, 3/23)

The New York Times' Upshot: How To Stop The Bouncing Between Insurance Plans Under Obamacare
Millions of Americans are finding Obamacare to be unstable ground. ... Because of fluctuations in income, millions of Americans move back and forth between Medicaid and the Affordable Care Act’s insurance marketplace, leading to significant health and financial costs for individuals, states and insurance companies. This cycling across different forms of insurance is called “churning.” (Dhruv Khullar, 3/23)

Los Angeles Times: Ending The Supreme Court Stalemate
On Wednesday, an eight-member Supreme Court heard a challenge to the requirement under Obamacare that employer health insurance plans cover birth control. The case was brought by nonprofit organizations with religious objections to contraception. But questions from the bench suggested that the justices might be evenly split on whether the complicated arrangement worked out by the Obama administration to balance religious freedom and women's health violates the nonprofits' rights under existing law. If so, two outcomes are possible: The justices could hand down a 4-4 ruling that would not establish a binding precedent around the country, leaving the law open for interpretation. Or they could decide to have the case reargued next term in the hope that a successor to the late Justice Antonin Scalia will have been confirmed by the Senate. (3/24)

USA Today: Religious Freedom Deserves Deference: Our View
If the Obama administration had thought long and hard about the meaning of religious freedom, one of the nation’s most fundamental rights, it would not have ended up in the Supreme Court on Wednesday doing battle over free birth control with Little Sisters of the Poor and other religious non-profits. (3/23)

USA Today: Don’t Harm Women’s Health: Opposing View
The Obama administration has gone out of its way to accommodate the religious beliefs of employers who don’t want to provide insurance coverage for birth control required by the Affordable Care Act. There is an outright exemption for churches and other houses of worship. Religiously affiliated non-profit organizations can opt out, too. They simply fill out a form stating their objection and send it to their insurance company or the government. Then, the insurance company must provide the non-profits’ employees with the coverage directly, without the employers’ involvement. These employers are exempted, but the women get the essential birth control coverage they need. (Gretchen Borchelt, 3/23)

The Baltimore Sun: Faster Approval Of Generic Drugs Could Cut High Prescription Costs
High prescription drug prices make most Americans' blood boil, with the same drugs costing up to six times more here than in Western Europe, where drug prices are regulated. However, one cause of high prices has received scant attention: the delays in bringing generic drugs to the market. This problem, costing consumers billions of dollars each year, should be a top priority for Dr. Robert M. Califf, who was just confirmed by the Senate as the new Commissioner of the Food and Drug Administration (FDA). (Andrew L. Yarrow, 3/23)

Bloomberg: Patent Law Holds Back Science
One of the biggest stories in science right now is the fight over the Crispr patents. Crispr is a gene editing technique that promises to allow previously unthinkable feats of bio-engineering. It was discovered in stages, like most scientific breakthroughs, by multiple teams working at various universities and research institutes around the world. The final, key advancements were made more-or-less simultaneously by two teams of researchers -- one based in California and led by Jennifer Doudna and Emmanuelle Charpentier, the other based at the Broad Institute in Massachusetts and headed by Feng Zhang. (Noah Smith, 3/23)

news@JAMA: Expanding Medicare Access To The Diabetes Prevention Program
Current efforts to enhance rewarding value rather than volume of health care focus principally on transitioning fee-for-service Medicare payments into alternative payment models, such as accountable care organizations or bundled payment arrangements. But to promote rewarding value, we also need to focus on long-term prevention that can improve outcomes over the long run. The Center for Medicare & Medicaid Innovation, under the Centers for Medicare & Medicaid (CMS), recently announced a model test for population-based reductions in projected 10-year cardiovascular risk. But many other opportunities for prevention-focused innovative payment models remain. One important opportunity is addressing chronic conditions such as type 2 diabetes. (Sameed Ahmed M. Khatana, Ann L. Albright and Darshak M. Sanghavi, 3/23)

The Dallas Morning News: Be Wary Of Minimum Wage, Medicare Price Controls
Senate Democrats recently ramped up their efforts to force businesses to pay managerial employees overtime. The reform is only the latest attempt by Democrats to tamper with — and ultimately ruin — our economy through wage and price controls. Both Hillary Clinton and Bernie Sanders, for instance, support a dramatic hike in the federal minimum wage, as well as Medicare overhauls that amount to government price controls on drugs. All of these proposals mistakenly assume that the federal government knows better than businesses and consumers what goods and labor are worth. (Michelle Ray, 3/23)

U.S. News & World Report: Make It A Mandate
The Centers for Disease Control and Prevention's new guidelines for doctors on responsibly prescribing painkillers such as Oxycontin and Vicodin bring important additional attention to the opioid crisis gripping our nation. The CDC's reason for issuing these guidelines is clear – almost 29,000 people fatally overdosed on prescription opiates or heroin in 2014 – and addiction continues to be a growing problem in communities across the United States. (Chuck Ingoglia and Becky Vaughn, 3/23)

The New York Times: U.S. Should Follow Canada’s Lead On Heroin Treatment
The crisis that led officials in Ithaca, N.Y., to consider opening a supervised-injection center for heroin users, part of what the United States Centers for Disease Control and Prevention has called a national epidemic of overdose deaths, is sadly familiar to us here. Overdose deaths and H.I.V. infection among injection drug users were so high nearly 20 years ago that Vancouver declared a public health emergency. With open drug use and needles discarded in the streets of downtown Vancouver, we responded in 2003 by opening North America’s first supervised-injection center for heroin and other injection drugs. (Patricia Daly, 3/23)

The Wall Street Journal: The One Doctor’s Appointment All Seniors Should Have–But Rarely Do
You think of yourself as proactive and prepared. You’ve thought through a smart retirement plan. Your car maintenance is up to date. Even your dog’s shots are up to date. But have you had your Medicare annual wellness visit? Probably not. According to Medicare, fewer than 20% of those who qualify for this free benefit take advantage of it. If you care about your health and long-term well-being, it’s a benefit you can’t afford to pass up. (Molly Mettler, 3/23)

STAT: Autopsies Are Vital To Medicine. Don’t Let Them Go Extinct
The newly dead have stories to tell and lessons to teach. But we aren’t listening. Autopsy, once a mainstay of medicine, is now often an afterthought. (Mary Fowkes, 3/23)

Forbes: Long-Run Demographic Effects Of The Zika Virus
While public health officials in the western hemisphere are trying to figure out how to stop the mosquito-borne Zika virus, few seem to have noticed that, even if eliminated in a year or two, the Zika virus could have profound long-term demographic effects in affected countries. (Robert Book, 3/23)

Miami Herald: New Laws Confront Unsolved Rapes, HIV
It’s a case of bad news and lousy publicity adding up to good, remedial legislation. On Wednesday, Gov. Rick Scott signed into law one bill that creates a needle-exchange program to battle and, it is hoped, slow the spread of HIV through intravenous drug use. The governor also put his signature on legislation that requires state crime labs to test rape kits within 120 days of receiving them. These two bills alone speak highly of lawmakers’ bipartisan effort to tackle head-on two unsustainable scourges. And we commend Gov. Scott for following through, acknowledging the challenges that the laws will now confront. (3/23)

Los Angeles Times: Has Robert De Niro's Tribeca Film Festival Sold Out To Anti-Vaccine Crackpots?
The festival, which was co-founded by Robert De Niro in 2002, has placed a film purporting to defend Wakefield and accusing the Centers for Disease Control and Prevention of a cover-up on its program this spring. The film is called "Vaxxed: From Cover-Up to Conspiracy." Its director: Andrew Wakefield. (Michael Hiltzik, 3/23)

Detroit Free Press: Time To Govern, Move Forward To Fix Flint
The abundant deficiencies of Gov. Rick Snyder's administration are laid bare in a scathing report issued Wednesday by the task force the governor himself appointed to postmortem the Flint water crisis. The appointment of this task force was the governor's response, in the days after he finally acknowledged that the water in Flint was not safe to drink, to critics demanding accountability from an administration that for too long seemed unmoved by the events unfolding in Flint. (3/23)