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Vaccine advisers to the Centers for Disease Control and Prevention meet Friday to make recommendations for use of the Johnson & Johnson Covid-19 vaccine after it was put on hold to investigate a potential link to serious blood clots. The CDC and US Food and Drug Administration recommended a pause on use of the J&J coronavirus vaccine last week following six reported US cases of a rare and severe type of blood clot. (Mascarenhas and Cohen, 4/20)

It was just about a year ago that doctors started noticing Covid-19 patients showing up in emergency rooms with strokes, and complained that blood clots were clogging up dialysis machines and other equipment being used to keep coronavirus patients alive. Frantic intensive care unit specialists reported "dramatic" blood clots in the heart, liver and other organs. Autopsies of coronavirus victims in New Orleans showed their lungs were jammed with clots. (Fox, 4/20)

An 18-year-old woman in Nevada who suffered seizures after receiving the Johnson & Johnson COVID-19 vaccine has received three brain surgeries related to blood clots, a spokesperson for her family said. Emma Burkey began feeling sick about a week after receiving the one-dose vaccine early this month, spokesman Bret Johnson said. She was one of six women in the U.S. and the only reported resident in Clark County, which includes Las Vegas, who experienced a serious clotting side effect. One person died. (4/20)

The federal “pause” in administering the Johnson & Johnson coronavirus vaccine doesn’t appear to have damaged public confidence in the vaccination process, one new survey suggests. Fifty-three percent of respondents polled in the wake of the pause agreed that it was a “good example of the rigorous safety monitoring of the COVID-19 vaccines that is in place to protect Americans.” In contrast, 29% said the pause was a case study on why the COVID-19 vaccines should be avoided. (Keshner, 4/20)

The European Union's drug regulator said Tuesday it had concluded there is a "possible link" between the Johnson & Johnson COVID-19 vaccine and several cases in the U.S. of a rare type of blood clot, but emphasized that the shot's benefits "in preventing COVID-19 outweigh the risks of side effects." (Neuman, 4/20)

The Czech Republic is rolling out the Johnson & Johnson coronavirus vaccines after examination by the European regulator. ... The Czech Health Ministry says the first 14,400 dozes will be sent to general practitioners across the country. Another 24,000 J&J vaccines are expected to be delivered next week. (4/21)

A pair of top House Democrats is investigating whether Emergent BioSolutions (EBS), which was responsible for contaminating millions of doses of the Johnson & Johnson (JNJ) Covid-19 vaccine, traded on its relationship with a key Trump administration official to win federal contracts. In a letter to the company, which is one of the biggest contract manufacturers in the pharmaceutical industry, the lawmakers noted they are reacting to reports that Emergent received a $628 million contract last June to create the main U.S. facility for making Covid-19 vaccines for both J&J and AstraZeneca (AZN), despite a history of inadequately trained staff and quality control problems. (Silverman, 4/20)

A year after a Connecticut company was awarded almost $1.3 billion in federal loans and contracts to supply an essential syringe for the Covid-19 vaccine rollout, no syringes have been made. The syringe hasn't received even the first of a series of approvals it needs from the federal government before it can be manufactured, and a factory promising 650 jobs remains unbuilt. ApiJect Systems Corp. positioned itself as the company that would make the difference between a stumbling rollout and delivery of lifesaving vaccines. But as the U.S. vaccine rollout hits full stride, with about half of adults in the U.S. having already received at least one injection, the need for ApiJect's device has waned, leaving the contracts and loans in question. (Lehren and Strickler, 4/21)

Arguing that Pfizer’s political spending conflicts with the company’s publicly stated values, a philanthropic organization is urging shareholders to support a proposal that would require the drug maker to publish an annual report analyzing its donations. The proposal, which is among those to be voted on at the Pfizer (PFE) annual meeting on Thursday, addresses political contributions that pose not only financial risks, but could also jeopardize its standing with the public at large, according to The Tara Health Foundation, which supports numerous organizations devoted to women’s health, the environment, and socially conscious investing. (Silverman, 4/20)

Johnson & Johnson’s Covid-19 vaccine contributed $100 million to the company’s sales growth in the latest quarter, though the outlook for future sales is uncertain due to pauses in vaccinations while health authorities in several countries probe safety concerns. The European drug regulator said Tuesday a safety committee recommended that a warning about a rare, serious blood-clot condition be added to the product information for J&J’s vaccine. The European Medicines Agency didn’t halt use of the vaccine and said its benefits continue to outweigh risks. It said the clot risk was very low but that people should be aware of symptoms so they can quickly get treated. (Loftus and Grossman, 4/20)

After a year of pandemic-related disruptions, the healthcare industry has nearly returned to business as usual. Wall Street doesn’t yet seem to have noticed. Take Johnson & Johnson for instance. Investors and the general public have focused lately on Johnson & Johnson’s Covid-19 vaccine, the rollout of which has been paused by regulators in the U.S. as adverse events related to blood clotting are reviewed. While European regulators declined to halt the vaccine on Tuesday, and shots could resume soon in the U.S., the vaccine itself isn’t material to the company’s finances. (Grant, 4/20)

The U.S. is set to meet President Joe Biden’s latest vaccine goal of administering 200 million COVID-19 shots in his first 100 days in office, as the White House steps up its efforts to inoculate the rest of the public. With more than 50% of adults at least partially vaccinated, Biden on Wednesday will reflect on his efforts to expand vaccine distribution and access in his first three months in the White House. But with all those 16 and older now eligible for shots, the president is expected to outline his administration’s plans to drive up the vaccination rate even further. (Miller, 4/21)

Distributing the coronavirus vaccine to community health centers has been "critical" to the Biden administration's goal of vaccinating Americans while maintaining racial equity, Cameron Webb, White House senior policy advisor for COVID-19 equity said at an Axios event on Tuesday. Webb said the administration was committed to getting everyone vaccinated but "there's also that long issue of making sure that racial justice is a priority, making sure that we're serving rural communities and a very real and meaningful way." (4/20)

As US health officials race to get more Covid-19 shots into arms to control the virus, experts now warn the country will run into another challenge in the next few weeks: vaccine supply will likely outstrip demand. "While timing may differ by state, we estimate that across the U.S. as a whole we will likely reach a tipping point on vaccine enthusiasm in the next 2 to 4 weeks," the Kaiser Family Foundation said in a new report published Tuesday. (Maxouris, 4/21)

North Dakota Gov. Doug Burgum and Manitoba Premier Brian Pallister unveiled a plan Tuesday to administer COVID-19 vaccinations to Manitoba-based truck drivers transporting goods to and from the United States. The Essential Worker Cross-Border Vaccination Initiative expects to vaccinate up to 4,000 Manitoba drivers in the next six to eight weeks, the two leaders said in a release. Burgum said North Dakota has adequate vaccine supplies and it benefits both countries to work together on giving shots. (4/20)

Louisiana’s vaccine supply is still able to keep up with demand, in part because shipments of the Pfizer and Moderna vaccines have ramped up. The Johnson & Johnson vaccine was already expected in smaller amounts because of earlier manufacturing issues. But the one-dose Johnson & Johnson vaccine, which does not require a freezer or dry ice for transportation, was popular among a wide range of people who could be challenging to reach for two separate doses: the homeless population, young people and those who lacked access to transportation or had trouble taking off work. (Woodruff and Rddad, 4/20)

Galveston County officials announced Tuesday that its mass COVID-19 vaccination site at Walter Hall Park will no longer be available for appointments beginning May 1, saying the site has largely accomplished its goals. Philip Keiser, the county’s local health authority, characterized the closing of the site as a milestone for the county’s relative success in getting as many as 4,000 doses of vaccine out per day. The site will continue to fill appointments for second doses through next week before shutting down for good. (Powell, 4/20)

The city of Los Angeles shut down Dodger Stadium and eight other COVID-19 vaccination sites Tuesday afternoon in anticipation of mass demonstrations with the verdict in the murder trial of former Minneapolis police officer Derek Chauvin imminent. The closures, which also apply to mobile vaccination clinics run by the city, are temporary and are a “simple precaution,” according to the office of Los Angeles Mayor Eric Garcetti. (Nelson, 4/20)

Some COVID-19 vaccine sites in rural Maine have recently closed as demand for shots appears to be slowing, presenting a new challenge for public health officials. Just over 50 percent of Mainers have had their first shot on Tuesday as Maine reached a public health milestone of 1 million doses. But while state officials say demand remains high in the state, signs are showing Maine may have reached a wide population of people eager to get vaccinated or able to do so within the current framework. (Andrews, 4/21)

Chris Reimer had never heard of Leopold, Mo., when he found himself rushing down a winding, two-lane road toward the rural, 65-person community in February. Reimer, a social media manager in St. Louis, had made a split-second decision when he saw a local television reporter tweet about a 2,000-dose COVID-19 vaccination clinic opening to anyone after 3 p.m. that day. "I jumped in the car and started driving south," Reimer says, though the clinic was two hours away in Leopold. "I definitely saw other cars [on the interstate highway] and thought to myself, 'I wonder if they're going the same place I am?' because we were all driving perhaps a little too quickly." (Fast, 4/20)

As the vaccine rollout continues behind bars, North Carolina state prisons are expanding opportunities for families to see incarcerated loved ones. All young children are now permitted to visit parents or family members in prison. (Critchfield, 4/21)

Three-quarters of Americans believe the U.S. government should start donating Covid-19 vaccines to other countries, but only after every person in the U.S. who wants a vaccine has received one, according to a new survey from STAT and The Harris Poll. At the same time, just over half of Americans said they agree with the idea that the Biden administration should immediately start donating vaccines to other countries in order to achieve global herd immunity, which reflects growing concern that the coronavirus cannot be contained until most of the world is vaccinated. (Silverman, 4/21)

Hawaii officials will allow state residents who have been fully vaccinated against the coronavirus to skip pre-travel testing and quarantine requirements for flights between islands. Hawaii becomes the second state in the nation after New York to implement a vaccination verification program, state officials said at a news conference Tuesday. (Jones, 4/21)

The world awaits pandemic weary travelers, who are vaccinated against COVID-19 and ready to hit the road. United Airlines (UAL) announced Monday, in its Q1 earnings report, that it will begin flying this July to Iceland, Greece, and Croatia "moving to capitalize on emerging pent-up demand for travel to countries where vaccinated travelers are welcome."  The key, of course, is for a passenger to prove they have been vaccinated. Countries like Israel and China are already using digital certificates to allow citizens to travel while New York state is using The Excelsior Pass. These digital documents allow people to "present digital proof of COVID-19 vaccination or negative test results." They are often called vaccine passports but Delta Air Lines (DAL) CEO Ed Bastian told Yahoo Finance Live, "We don't call it a vaccine passport. It carries too many connotations."  (Shapiro, 4/20)

A House committee Monday approved a proposal that would limit local emergency orders and make permanent Gov. Ron DeSantis’ executive order barring COVID-19 “passports” that would show people have been vaccinated. The Health & Human Services Committee voted 14-8 to support a revised proposal (HB 7047) intended to “minimize the negative effects of extended emergencies.” (Turner, 4/20)

COVID-19 vaccine interest among Generation Z, those born between 1997 and 2012, has dropped in recent months, according to new polls — a worrying trend as the country opens vaccine eligibility to everyone over age 16. In a NBCLX/Morning Consult poll conducted last month, 26% of Gen Z respondents said they will not get vaccinated, and 19% said that they do not yet know whether they will. In a similar poll conducted last year, only 5% of Gen Z said that they would not get vaccinated, demonstrating a sharp increase in vaccine hesitancy at a time when other groups are growing more accepting of the vaccine. A recent STAT-Harris Poll also found that 21% of Gen Z respondents said they would not get vaccinated against COVID-19, while 34% said that they would “wait a while and see” before getting vaccinated. (Ao, 4/19)

As the days grow longer, there’s a palpable feeling of hope in the air — at least in the more fortunate western countries. Thanks in part to vaccines, Covid-19 deaths are dropping in the U.K. and the U.S., enabling parts of normal life to resume. But, as we’re well aware, it’s not over yet. If we want to have a shot at halting transmission, everybody needs their jabs. Governments around the world desperately need to close the yawning vaccine gap between rich and poor nations. But as wealthy nations begin offering vaccinations to younger cohorts, they may hit a challenge closer to home. (Lara Williams, 4/21)

Doctors in Bradford County keep pleading with patients: Consider getting the coronavirus vaccine. But lately, patients keep saying they want to wait. The county, on the Pennsylvania-New York border, has seen COVID-19 cases and hospitalizations surge in recent days. While more than half of U.S. adults — and 43% of Pennsylvanians — have gotten at least one dose, barely a quarter of those in Bradford County have done so. And the state’s expansion last week of eligibility to all 16 and older didn’t bring a fresh rush to clinics. (McCarthy and McDaniel, 4/21)

Herpes infections may be a side effect of the COVID-19 vaccine, experts have revealed. Scientists in Israel identified six cases in a new study of patients developing a skin rash known as herpes zoster after receiving the Pfizer vaccine, according to a study in the Rheumatology journal. Herpes zoster starts off as a small, itchy skin rash, but if left untreated, it could cause nerve damage and pain, the Jerusalem Post reported. (Salo, 4/20)

On March 13, Lonnie Gaylor noticed he had a persistent cough that resisted over-the-counter medicine. Two days later, the 71-year-old met virtually with his primary care doctor who recommended he get tested for strep throat. A couple hours after driving through a hospital testing site in Waxahachie, Texas, just south of Dallas, Gaylor learned he was positive for both strep throat and COVID-19. It was a concerning diagnosis given Gaylor has Type 2 diabetes and a kidney disorder, and was 40 pounds overweight. Yet, he had been fully vaccinated against COVID-19 for a little over a month. (Camero, 4/20)

The recent rise in Covid-19 cases in the U.S. has largely been driven by a handful of states, many of them the same places that first emerged as hot spots a year ago. Through Monday, about 75% of the previous week’s new cases in the U.S. came from Michigan, Florida, New York, Pennsylvania and New Jersey. Covid-19 cases and the rate of new cases per 100,000 people are resurging in several states that, for long stretches, had kept the pathogen relatively at bay. Outside of the period from Thanksgiving to New Year’s, Michigan, Pennsylvania and New Jersey haven’t seen levels this high during the pandemic. And outside of that same holiday period, New York hasn’t had this many new cases since spring, and Florida not since the summer. (Umlauf and Ulick, 4/20)

A Nebraska study on asymptomatic COVID-19 cases in schools has found that infection rates may be higher than previously believed. OPS PROTECTS, an Omaha Public School district program in a partnership with the University of Nebraska Medical Center, found that infection rates in schools involved in the first phase of the pilot program were two-and-a-half times higher for staff and nearly six times higher for students than what was being reported through routine self-initiated tests and reporting. (Deliso, 4/20)

A deadlier coronavirus variant that had first ravaged Britain was now here — in metro Detroit, at the University of Michigan, a state prison in Ionia and rural counties in the Thumb region — with doctors, nurses and public health officials fully aware. And yet Michiganders — from state prison employees to small business owners and local officials to parents of high school athletes — ignored medical experts' repeated warnings about the highly infectious variant. They rebuffed stay-in-place recommendations, allowed crowded events to occur and turned a blind eye to defiant behavior, according to thousands of internal health department emails and contact tracing notes from across the state and interviews with those in charge. (Baldas, Chatterjee, Kravitz and Fortis, 4/20)

A number of hospitals in northwest and central Illinois are filling up — and at least one ran out of intensive care unit beds — amid the latest COVID-19 surge. Recent spikes in cases have been seen across the state, including in the Chicago area where ICU bed availability is also down, though not as severely. Even as some coronavirus metrics in Illinois have improved slightly this week, certain hospitals are continuing to feel squeezed. (Schencker, 4/20)

Single mom Aracely Nava said she was constantly afraid of virus contagion while she continued to work at a San Francisco fast-food restaurant during the pandemic. “All the time people were coming in from the street without masks,” she said in Spanish through an interpreter. “They never put anyone by the door counting the number of people who came in to maintain a certain number. A manager was allowed to work for over a week (while) really sick with flu symptoms.” (Said, 4/21)

The United States still lacks a comprehensive COVID-19 testing strategy more than a year into the pandemic, as the spread of variants and increasing case counts threaten to undermine the effects of the vaccine rollout. Some public health experts say the rise in new cases underscores the importance of a single, adaptable strategy as states lift restrictions amid spreading variants. (Clason, 4/20)

Orange County Mayor Jerry Demings has paused his planned loosening of coronavirus safety precautions. Demings says the decision is based on a combination of three concerning trends. He says Orange County continues to see an increase in its coronavirus test positivity. The 14-day average is 7.6 percent, the highest in more than two months. Then there’s the Johnson & Johnson vaccine pause and a slowdown in demand for vaccinations. Finally, Demings says hospitalizations are edging upward. (Byrnes, 4/20)

KHN: Censorship Or Misinformation? DeSantis And YouTube Spar Over Covid Roundtable Takedown.

In early April, YouTube took down a video featuring Florida Gov. Ron DeSantis and a group of controversial scientists at a March 18 coronavirus roundtable. The online video platform, owned by Google, cited as its rationale that the video contained false statements about the efficacy of children’s mask-wearing. The decision has drawn public blowback on social media and from DeSantis himself. (Knight, 4/21)

Ted Nugent has tested positive for COVID-19, after referring to the pandemic as a "hoax" on several occasions. The staunch Trump supporter, 72, took to Facebook Live on Monday to reveal he was diagnosed earlier that day, while perpetuating anti-vaccine conspiracy theories and racist language toward the AAPI community. ... He referred to his symptoms as a "clusterf—", detailing the "stuffed-up head" and "body aches" he's experienced. "My God, what a pain in the ass," Nugent continued. "I literally can hardly crawl out of bed the last few days. But I did, I crawled." (Garner, 4/20)

The U.S. poverty rate rose to 11.7% in March, the highest level yet during the pandemic following an increase in the latter part of last year as many government benefits expired, a study showed. The March 2021 estimates indicate that without additional aid many in the U.S. continued to suffer from the economic impacts from Covid-19, according to research released Tuesday by economists Jeehoon Han, from Zhejiang University, Bruce Meyer, from the University of Chicago, and James Sullivan of the University of Notre Dame. The projections didn’t capture benefits provided by the American Rescue Plan signed last month. (Tanzi, 4/20)

The United States Department of Agriculture announced Tuesday it would extend universal free lunch through the 2021-2022 school year, in an effort to reach more of the estimated 12 million youths experiencing food insecurity. In March, the USDA said these waivers, which made school meals more flexible to administer, would be extended only to Sept. 30, leaving schools and families uncertain about what next school year might look like. (Reiley, 4/20)

The pandemic exacerbated weaknesses and vulnerabilities in the economy, often harming minorities the most, and the recovery is taking on a similar “K shape” — with some groups improving while others stall or decline. The unemployment rate for white workers in Texas was 4.8% last month, continuing a steady improvement since late last year. But the jobless rate was 14% for Blacks and 9% for Hispanics, according to data cited by researchers at the Federal Reserve Bank of Dallas — and the minorities’ numbers have risen in recent months. (Schnurman, 4/20)

Los Angeles is poised to become the latest city to try universal basic income. Mayor Eric Garcetti included a $24-million Basic Income Guaranteed program in his city budget to be released Tuesday. L.A. would become the biggest city to try the concept, possibly joining Stockton, Compton and others. (Smith, 4/20)

The vaccine jobs boom is all about shipping boxes, delivering shots, opening doors and manning floors. Disrupted workers say that doesn’t match their skillset, and they’re hanging back or taking jobs with less pay. Truckers, nurses, sales associates and managers are some of the jobs in highest demand as America tries to reopen, according to an aggregate of all online job postings collected by jobs site ZipRecruiter. Truck driving is by far the most sought role, with over 1.3 million jobs open for different kinds of drivers, from semis to local delivery. (Popken, 4/19)

When Jonny Frostick realized he was having a heart attack this month, the first thing that occurred to the HSBC Holdings Plc contractor was: “I needed to meet with my manager tomorrow, this isn’t convenient.” Then he thought about funding for a project, his will, and finally, his wife. Frostick, who manages more than 20 employees working on regulatory data projects, chronicled his near-death experience in a viral LinkedIn post that had been viewed almost 7 million times as of Tuesday. The 45-year-old Briton is the latest financial employee to weigh in on the work-till-you-drop culture during a pandemic that’s obliterated the lines between office and home life for droves of workers. (Nguyen and Wilson, 4/21)

A top Senate Republican is holding up the confirmation of President Biden’s nominee to lead Medicare and Medicaid, he told STAT. In a brief interview, Sen. John Cornyn (Texas) said he had placed a hold on the confirmation of Chiquita Brooks-LaSure, the pending administrator of the Centers for Medicare and Medicaid Services, using a phrase that refers to a senators’ ability to temporarily block a nomination from advancing to a vote. His opposition, he said, stems from the Biden administration’s recent rejection of Texas’ request to extend its Medicaid waiver, which the Trump administration had previously approved. (Cohrs and Facher, 4/20)

[Cornyn] accused the Biden administration of playing “political chicken” by rescinding federal funds for Texas in a bid to pressure the state to expand Medicaid under the Affordable Care Act (ACA). ... The Biden administration moved last week to rescind a Medicaid waiver given to Texas in the final days of the Trump administration. That waiver extended federal funds that reimburse hospitals for providing care for uninsured people. (Sullivan, 4/20)

The Arkansas House voted Tuesday to keep the state's Medicaid expansion for another year, breaking a deadlock that left the program's future uncertain. The House voted 78-15 to approve the budget for Medicaid and the expansion program, sending the legislation to Gov. Asa Hutchinson's desk. The measure needed at least 75 votes to advance. (4/20)

While low-income residents rely on Medicaid for health care, state lawmakers working on the 2021-22 state budget are proposing some major cuts in dollars for the Medicaid program. The proposed reductions come at a time when many advocates have been pushing to expand Medicaid for low-income families. Florida is among a dozen or so states that haven’t expanded Medicaid, and Gov. Ron DeSantis has been against the expansion. (Morgan, 4/20)

Florida lawmakers met this past weekend to begin ironing out the differences between the House and Senate budgets. Budget leaders came closer on at least one remaining difference in the health care budget. House Speaker Chris Sprowls has thrown his weight behind a move to give new mothers Medicaid coverage for a year after they give birth. (McCarthy, 4/20)

During a floor session that ran late into Tuesday night, the Oklahoma House advanced a bill to halt privatization of the state’s Medicaid program.Senate Bill 131 would require the Oklahoma Health Care Authority to oversee the program and implement new elements like a prevention component assessing social health risks. Medicaid expansion in Oklahoma takes effect July 1. An estimated 200,000 residents will be newly eligible. (Trotter, 4/21)

Progressives in Congress, led by Sen. Bernie Sanders, have ramped up pressure on President Biden to honor his campaign pledge to lower the Medicare eligibility age to 60 — but their push is likely to hit a hospital industry-sized roadblock. The Biden White House hasn’t concretely committed to including a major health care initiative in its next legislative push, which is expected to be geared toward family-centered policies including paid leave and child care, but Sanders (I-Vt.) told STAT in a brief interview Tuesday he hasn’t lost hope. (Cohrs, 4/21)

The COVID-19 pandemic, which has left an estimated tens of thousands of Americans with long-term debilitating symptoms, has prompted a renewed push to provide full palliative care services to seriously ill patients in their homes. Palliative and hospice organizations are in talks with the Biden administration to create such a benefit as a demonstration project in Medicare, the health plan for older Americans. If successful, they hope it would become a permanent benefit in Medicare and then be offered under Medicaid, the federal/state program that covers lower-income Americans, and commercial insurance plans as well. (Ollove, 4/20)

Starting next month, Google will require health insurers to apply for certification for their ads to run on the search engine. The tech giant announced Tuesday that it will only allow insurance ads from certified government exchanges, first-party providers and licensed third-party brokers. “In order to run ads, advertisers will need to provide documentation showing they are permitted under state law to sell health insurance,” Google said in a blog post. (King, 4/20)

Tech-enabled insurance provider Oscar Health just launched its tech platform for payers and providers, called +Oscar, but the company still faces some steep hurdles. +Oscar is a standalone business that expands on previous partnerships. The company is selling it to everyone from other payers looking to improve their consumer experiences to medical groups looking to jump into value-based care arrangements. (Reed, 4/21)

Insurers spent record high totals on lobbying this year as congressional Democrats worked on multi-billion dollar legislation to subsidize commercial health plans and expand access to coverage. America's Health Insurance Plans, which represents insurers like Cigna and Centene, spent $3.9 million on lobbying in the first quarter of 2021, a 7% increase over the same time period last year. That's the most money AHIP has ever spent on lobbying in a first quarter, representing the changing political landscape in Washington that tends to favor expanding access to health coverage, which often means subsidizing commercial health plans. (Hellmann, 4/20)

Most uninsured Americans are already eligible for Medicaid or subsidized Affordable Care Act coverage. One path to universal health coverage would involve signing millions of Americans up for insurance that's already available to them, and some states are pursuing that goal. (Owens, 4/21)

Half of Americans take no prescription drugs. At the other end of the spectrum are people like Karen Milligan. She needs several drugs and pays a lot for them. She has dealt with multiple sclerosis for three decades. It’s a disease of the central nervous system with no cure. At 65, Karen is seeing her drug costs continue to increase, even for the same drug she has been taking for years. (Miller, 4/20)

A state appellate court on Monday gave Mayor Andre Sayegh’s administration a legal victory in a multimillion-dollar battle over the medical benefits the city provides its police officers and firefighters. The decision will affect the health care for more than 1,000 municipal public safety workers and retirees. At issue was the Sayegh administration’s 2018 decision to switch all municipal workers from a costly self-insurance program for employee health coverage to the state benefits plan, a move city officials said saved about $20 million per year. (Malinconico, 4/19)

Between the 2017-18 and 2020-21 fiscal years, Johnson City Schools expects to lose $7 million on its health insurance plan. As the cost of the system’s existing self-insured plan increases, staff will decide this week whether to switch to the Tennessee State Insurance Plan. In order to make the transition, employees must cast a simple majority vote (50% plus one) in favor of the switch. The voting will occur Monday through Wednesday this week. To have the state plan in place by the beginning of 2021-22 fiscal year, voting must occur before May 1. (Floyd, 4/19)

In a meeting on Friday afternoon the board of trustees at the hospital passed the "COVID safety" bonus program with unanimous support. Over $500,000 was allotted toward the program. The impending wave of tourism is one of the reasons hospital employees are being encouraged to get fully vaccinated by May 31. Workers to able to get fully vaccinated will receive a one time bonus of $600 prorated, based on hours worked, by June. Currently 74% of staff are vaccinated, twice the rate of the surrounding area of Teton County. (Gellman, 4/20)

Led by Cleveland Clinic and Mayo Clinic, a coalition of 60 healthcare systems launched a nationwide campaign Tuesday to promote COVID-19 vaccination. The "Get the Vaccine to Save Lives" campaign is designed to reassure people that vaccines are safe and effective, according to a news release. "We're asking people to talk to their healthcare providers if they have questions and then get vaccinated," Mayo Clinic President and CEO Dr. Gianrico Farrugia said in a statement. "The vaccine is our strongest asset to end the pandemic, and I urge everyone who is eligible to get whichever vaccine you're first offered to save lives." (Christ, 4/20)

After battling COVID for more than a year and weathering two surges of sick patients, Massachusetts hospitals are settling in to a new normal. They’ve shifted from managing a raging crisis to incorporating COVID into their daily work. For the foreseeable future, hospitals expect to continue treating COVID patients — though the number could rise as variants spread or fall as more people get vaccinated. Hospitals across the state are treating about 700 COVID patients, 23 percent in intensive care, even as the economy reopens and more than 2 million people in Massachusetts are fully vaccinated. (Dayal McCluskey, 4/20)

KHN: Listen: A Rookie Doctor Starts Her Career, Forged By The Pandemic

On this week’s episode of “America Dissected,” host Dr. Abdul El-Sayed spoke with Dr. Paloma Marin-Nevarez, an emergency medicine resident at UCSF Fresno, and KHN senior correspondent Jenny Gold about the challenges Marin-Nevarez faced as a new doctor learning the ropes during a devastating pandemic. Each July, thousands of new physicians begin their on-the-job training at hospitals across the U.S. Marin-Nevarez began caring for severely ill covid patients just a few months after the beginning of the pandemic. (4/21)

Patients who used telehealth for upper respiratory infections were more likely to receive more follow-up care than those who sought in-person care, a new study found. More than 10% of the telehealth users had an in-person visit the next week, compared with 5.9% of patients who went to a clinic, according to an analysis of around 86,000 Blue Cross and Blue Shield of Michigan claims from 2016 to 2019. While the study didn't quantify the value of the follow-up care, University of Michigan researchers found that the telemedicine cohort had fewer (0.5% versus 0.6%) emergency department visits but more subsequent office, urgent care and telemedicine visits. (Kacik, 4/20)

The N.H. Attorney’s General Office has approved Concord Hospital’s bid to purchase Lakes Region General Healthcare while stipulating certain protections for patients and medical staff. The parent company of hospitals in Laconia and Franklin declared Chapter 11 bankruptcy last year due largely to the costs associated with some $128 million in debt. After searching for a potential buyer for years, only Concord Hospital emerged with a bid to purchase LRGH for $30 million. (Rosenbluth, 4/20)

Research is underway to develop a twice-per-year vaccine that may help people overcome opioid addiction. The vaccine, which is being funded in part by a $25 million grant from the National Institutes of Health Helping to End Addiction Long-term Initiative (HEAL), targets fentanyl, a powerful synthetic opioid estimated to be 50 to 100 times more potent than morphine. "This could be a game changer for addiction," Therese Kosten, professor of psychology at the University of Houston, said, according to a news release posted on EurekAlert.org. (Hein, 4/20)

Syndax Pharmaceuticals said Tuesday that its genetically targeted cancer drug induced complete remissions in patients with advanced leukemia, although questions may linger about a heart-related side effect that limited dosing. The Syndax drug, a once-daily pill called SNDX-5613, belongs to an emerging class of so-called menin inhibitors that have the potential to become effective treatments for certain types of genetically defined leukemia that do not respond well to currently approved medicines. These drugs work by blocking the interaction of two proteins that prevents bone marrow cells from developing or differentiating into healthy cells. (Feuerstein, 4/20)

Fujifilm Holdings Corp said on Wednesday it started a new phase III trial in Japan of its Avigan drug for COVID-19, reviving hopes for a home-grown treatment for the virus. Domestic approval for the antiviral drug to treat the coronavirus was dealt a setback in December after a health ministry panel said that trial data was inconclusive. Fujifilm has over the years pivoted from its traditional camera and office solutions businesses to health care. (4/21)

Right now, trillions of donut-shaped red blood cells are whizzing through your arteries, ferrying oxygen from your lungs to the tips of your fingers and toes and everywhere in between. But if you’re one of the millions of people around the world who have sickle cell disease, this constant shuttle is constantly getting disrupted. (Molteni, 4/20)

Could getting too little sleep increase your chances of developing dementia? For years, researchers have pondered this and other questions about how sleep relates to cognitive decline. Answers have been elusive because it is hard to know if insufficient sleep is a symptom of the brain changes that underlie dementia — or if it can actually help cause those changes. (Belluck, 4/20)

Consistently getting a bad night's sleep may lead to an unsatisfactory sex life for many older women, a new study finds. In fact, women who slept poorly were nearly twice as likely to report issues such as lack of sexual interest or pleasure than women who got plenty of shut-eye, according to the study published Wednesday in Menopause: The Journal of The North American Menopause Society. (LaMotte, 4/21)

If you menstruate, you already know how costly tampons and pads can be — not to mention the Advil for your cramps and skincare for those pesky zits. This fall, the price tag is about to get even higher. Thanks COVID. The coronavirus pandemic has disrupted the global supply chain and driven up demand for many care products, including toilet paper and diapers, while others, including razors (looking at you with the overgrown beard), have dropped. Feminine care sales dropped in European markets last year, according to the P&G third quarter report, but were partially offset by "premium innovation growth in North America."  (Srikanth, 4/20)

Procter & Gamble is giving fair warning to consumers: Expect higher prices this fall for some of its products, ranging from baby supplies like Pampers to feminine hygiene products such as Tampax. That in itself wouldn't cause alarm, except that P&G follows several other consumer-goods companies that have told shoppers to brace for higher costs. Such announcements are fueling concerns that inflation may be set to rise, an issue that had already been on economists' minds given the trillions that have been pumped into the economy through several stimulus packages. (Picchi, 4/20)

After Navy veteran Jack Ray Hoaglan died from the coronavirus in December, his family tried to arrange a military funeral for the 73-year-old. They needed paper records from the National Personnel Records Center to prove the Ohio native’s service aboard the USS Enterprise decades ago. The phones at the St. Louis center, however, went unanswered. Since the beginning of the pandemic, the NPRC has sat empty, with employees working remotely. And records requests, most of which require someone to physically search for documents within the building, have been piling up. (Satter, 4/20)

Currently, 6 in 10 adults in the U.S. have at least one chronic disease, while 4 in 10 have two or more, according to the Centers for Disease Control and Prevention. The safety protocols instituted to slow the spread of COVID-19 also disrupted access to many non-emergency, routine care services for months. That's led to a reported rise in patients showing signs of more advanced preventable chronic diseases because they were not managed or controlled at earlier stages. (Ross Johnson, 4/20)

A far-reaching and ambitious new research initiative at Augusta University looking at chronic inflammation and age-related diseases could not only provide new insights but timely answers for a graying population in Georgia and across the country, officials said. AU President Brooks Keel announced the Inflamm-Aging and Brain Aging cross-disciplne project as a three-year, $15 million investment focused on recruiting researchers investigating the role of chronic inflammation pathways and common ailments such as bone loss and Alzheimer's disease. The 15-20 recruits would be not only for Medical College of Georgia but other schools such as Dental College of Georgia and the College of Science and Mathematics. (Corwin, 4/20)

Going to church is generally touted as good for the soul. But there is also evidence church attendance can be good for your health — unless, that is, you are a woman at a church that bars women from preaching or other leadership roles. A new study published in the American Sociological Review has found that women who attend churches with such restrictions report worse health than those who attend churches with women in leadership roles. The study suggests sexism can counter some of the health benefits associated with religion, said co-author Patricia Homan, an associate professor of sociology at Florida State University. (Smietana, 4/20)

KHN: Strides Against HIV/AIDS Falter, Especially In The South, As Nation Battles Covid

Facing a yearlong siege from the coronavirus, the defenses in another, older war are faltering. For the last two decades, HIV/AIDS has been held at bay by potent antiviral drugs, aggressive testing and inventive public education campaigns. But the COVID-19 pandemic has caused profound disruptions in almost every aspect of that battle, grounding outreach teams, sharply curtailing testing and diverting critical staff away from laboratories and medical centers. (Varney, 4/21)

KHN: Another Soda Tax Bill Dies. Another Win For Big Soda. 

A rogue industry. A gun to our head. Extortion. That’s how infuriated lawmakers described soft drink companies — and what they pulled off in 2018 when they scored a legislative deal that bars California’s cities and counties from imposing taxes on sugary drinks. (Young, 4/21)

A federal judge overseeing a sprawling lawsuit about homelessness in Los Angeles ordered the city and county Tuesday to offer some form of shelter or housing to the entire homeless population of skid row by October. Judge David O. Carter granted a preliminary injunction sought by the plaintiffs in the case last week and now is telling the city and county that they must offer single women and unaccompanied children on skid row a place to stay within 90 days, help families within 120 days and finally, by Oct. 18, offer every homeless person on skid row housing or shelter. (Oreskes, Alpert Reyes and Smith, 4/20)

Oklahoma urgently needs blood donations, officials with the Oklahoma Blood Institute said Tuesday. Donations have fallen to their lowest levels since the start of the COVID-19 pandemic, and the local blood supply is being "pushed to its limits" by increased blood usage from hospitals, the blood center said in a news release. (Branham, 4/20)

A Senate panel on Tuesday advanced a measure that would outlaw nearly all abortions in conservative Idaho by banning them once a fetal heartbeat can be detected. The legislation makes providing an abortion to a woman whose embryo has detectible cardiac activity punishable by up to five years in prison, and it would allow the woman who receives the abortion to sue the provider. (Ridler, 4/21)

Arizona Gov. Doug Ducey on Tuesday vetoed legislation that would have made the state’s sex education laws some of the strictest in the nation when it comes to teaching about LGBTQ issues. The governor called the legislation overly broad and vague and said it would lead to unintended consequences. He also said he was concerned a ban on sex education before 5th grade could put vulnerable children at risk by limiting sexual abuse prevention education. (Christie, 4/21)

The Montana Senate voted Tuesday to indefinitely postpone a bill that would have banned gender affirming surgery for transgender minors, effectively killing the proposal. The measure had faced significant opposition from medical experts, transgender people and human rights advocates, who testified earlier this year that gender affirming surgery is rarely undertaken by minors, but medical decisions should be left up to families. (Hanson and Samuels, 4/21)

Transgender youth, parents and advocates on Tuesday urged the Alabama House of Representatives, as well as the state’s governor, to reject legislation that would ban the use of puberty-blockers or hormones to treat transgender minors. Arkansas earlier this month became the first state to approve such legislation. Alabama could be the second if House members approve the Senate-passed bill. Parents, medical providers and a transgender teenager spoke out against the Alabama bill during a virtual press conference hosted by the Human Rights Campaign. (Chandler, 4/20)

The Republican-controlled Florida Senate appears to be abandoning a controversial transgender sports ban, a development that would hand LGBTQ activists and Democrats a huge victory. The bill, which specifies that K-12 and college sports teams must be designated based on “biological” sex while charging state agencies with crafting policies to hash out gender disputes, was condemned by the LGBTQ community and lawmakers who viewed the measure as discriminatory toward transgender students. (Atterbury, 4/20)

Tests are delayed. Medical oxygen is scarce. Hospitals are understaffed and overflowing. Intensive care units are full. Nearly all ventilators are in use, and the dead are piling up at crematoriums and graveyards. India recorded more than 250,000 new infections and 1,700 deaths in the past 24 hours alone, and the U.K. announced a travel ban on most visitors from the country this week. Overall, India has reported more than 15 million cases and 180,000 deaths – and experts say the numbers are likely undercounts. (Ghosal and Mehrotra, 4/20)

The Swedish Health Agency on Tuesday recommended that people under 65 years old who received the first shot of the AstraZeneca coronavirus vaccine should get a different vaccine for the second shot. There are no definitive studies regarding immune responses when initial and follow-up vaccine doses are different. The agency said that when results on mixing different doses are released they will evaluate whether the recommendation should be changed. (Gonzalez, 4/20)

When Ghana received 50,000 COVID-19 vaccine doses from India last month, it hit a frustrating roadblock: it had not trained enough staff to distribute them. The country was still rolling out shots received in late February from the global vaccine-sharing scheme COVAX, and didn't have the capacity to expand that operation, according to the head of Ghana's immunisation programme. (Mcallister, 4/21)

Mexican President Andrés Manuel López Obrador finally got a coronavirus vaccine Tuesday, after waffling on receiving the shot. Mexico is in a race to get its population vaccinated as case numbers have begun to rise again and the country’s estimated total death toll from COVID-19 surpassed 336,000. On Tuesday, Mexico expanded efforts to vaccinate teachers to five more states. (Marquez, 4/20)

New Zealand announced Wednesday it will consolidate its fragmented health care system into a national service similar to the one revered by many in Britain. New Zealand’s government-run system is currently divided into 20 district health boards, each with their own budget. Some describe the system as a “postcode lottery” of different treatment depending on where people live. (Perry, 4/21)

Doctors and medical ethicists in the UK are calling for terminally ill patients to have the option of using general anesthesia prior to their death as a way to relieve suffering. People with terminal illnesses like advanced cancer are often given treatments only meant to ease their pain and improve their quality of life before they die, in what doctors call palliative care. These can include potent painkillers and prolonged sedation. But in a new paper published Wednesday in the journal Anaesthesia, researchers at the University of Oxford say that general anesthesia—drugs used to send a person into full unconsciousness—should be made available to patients who want it. (Cara, 4/20)

The Nevada state Senate on Monday voted unanimously in favor of a proposal to allow pharmacists to provide patients birth control without authorization from a doctor or health care provider with a traditional prescription pad. Senate Bill 190 proposes expanding the scope of services that pharmacists can provide to ensure people who cannot access doctor’s appointments because of costs or the state’s physician shortage can obtain hormonal contraceptives including pills, patches or rings directly from a pharmacy. (Metz, 4/20)

A new contractor has been hired as part of a state effort to introduce “an unparalleled level of financial checks and balances” to the $3.5 billion prescription benefit program with Ohio Medicaid. This follows years of controversy over how private companies manage billions in drug spending on behalf of the state. (Schroeder, 4/15)

Those calling for sweeping action to reduce prescription-drug prices in North Dakota saw mixed results this legislative session. One proposal was a price transparency bill. When a planned price hike exceeds 10% over one year or 40% over five years, the drug manufacturer would be required to explain why. The bill has cleared hurdles in both chambers and is expected to go to the governor. (Moen, 4/16)

Under current law, Tennessee patients can be required to use certain pharmacies to fill their prescriptions, but a bill in the state legislature could change that. On March 30, the House Insurance Subcommittee approved a bill to ban so-called patient steering and increase transparency and regulation of drug pricing. Davidson County resident Eben Cathey said his wife, who has ALS, recently was told she almost certainly would need to change pharmacies and potentially switch providers after enrolling in Medicare. (Ramlagen, 4/17)

People go to outlet malls because they can often save anywhere from 25% to 65% (Consumer Reports, Dec. 9, 2018). The average discount, according to CR, is 38%. The appeal is brand name quality at a lower price. Most people don’t realize that they can get a similar value for their prescription medicines if they seek authorized generic (AG) drugs. This option is rarely mentioned by pharmacists, physicians or insurance companies, but it can represent huge savings for brand-name quality. (Graedon and Graedon, 4/18)

Mike Nielsen has worked his entire life serving his community ­– first in the military and when he came home helping raise over 20 foster children. When Mike’s wife, Jacqueline, was diagnosed with Hepatitis C, they didn’t have the money to pay the $433 per pill to treat it. It took a year to find funding for her life-saving medication. Jacqueline faced liver failure, daily exhaustion, and other severe symptoms that isolated her from her family while waiting for treatment. (State Rep. Rachel Prusak and State Sen. Deb Patterson, 4/14)

Every day, a Michigan family has less food on the table so they can afford necessary prescription drugs. Every day, a Michigan senior rations their insulin just to pay their electric bill. Every day, a Michigan child goes without potentially life-saving medication simply because a recent price increase put it out of their reach. No one should ever have to go hungry just to afford their prescriptions, but for so many throughout our state, that is the disheartening reality they are living in. (Rep. Angela Witwer, 4/14)

Many Coloradans struggle to pay for their prescription drugs. Sixty-six percent of all adults in the United State use prescription drugs; use is higher for older adults and patients with chronic conditions. While medications are vital to improving health, medications may be extremely costly. Advances in technology and new drug therapies have contributed to the increased cost of health care. As a pharmacist, I see the impact of drug costs on patients first-hand. While I applaud the Colorado legislature for taking on the issue of drug affordability, I have serious concerns about aspects of Senate Bill 175, which creates the Prescription Drug Affordability Review Board. This bill is intended to cap the price of certain high-cost drugs, but it may severely limit medication access for Coloradoans. (Emily Zadvorny, 4/17)

COVID-19 has exposed just how vulnerable so many communities are in the face of disease and just how critical access to necessary treatment is to protecting and maintaining patient health. The pandemic has also exposed how deep health inequities continue to leave many underserved communities behind. President Biden and lawmakers in New Jersey and states across the country have rightly made commitments to bridge these systemic disparities in our healthcare system and to improve treatment access and affordability. (Debbie Hart, 4/20)

The fear of Covid-19 catapulted symptom checkers from the periphery of public attention to the center. Wearables like the Apple Watch, Fitbit, and Oura Ring have shown promise as Covid-19 early-warning systems, while apps like MyCovidRisk let you enter your location and other factors for a quick estimate of your odds of infection. But the deserved praise for these devices shouldn’t obscure a troubling underside of health-related apps. Loose regulatory policies have allowed many thousands of consumer-facing apps to avoid oversight by claiming to be “low risk” and make it impossible to clearly assess the benefits and risks even for those approved by the Food and Drug Administration. (Michael L. Millenson, 4/21)

Fifty years ago, if you fell and broke your leg or had a heart attack, there likely weren’t ambulances around. Instead, someone called 911 and the police came to take you to the hospital. It wasn’t until the 1970s when national policy changes and grassroots advocacy led to the emergency medical services (EMS) model we rely on today. Assembly Bill 988 gives us the opportunity to similarly update our mental health emergency response with the same important premise: Mental health emergencies need trained professionals, not police. Last year, the federal government established a 988 calling code, requiring it to be available nationwide by July 2022. There are many goals for this new 988 number, foremost to serve as an alternative to 911 for mental health emergencies. To support this effort, the U.S. Substance Abuse and Mental Health Services Administration has created recommendations for implementing best practice crisis services. Congress has also appropriated millions of dollars for states to enact these life-saving measures. (Eric Rafla-Yuan , 4/19)

My mom died of stage 4 cancer in February 2008. Had the technology existed then to detect her cancer earlier, she might have met my three young daughters. Improving cancer prevention and treatment is an urgent priority for the United States. President Biden has repeatedly signaled as much through his work with the Biden Cancer Initiative and a previous administration’s Cancer Moonshot. (Joe Lonsdale, 4/20)

At the start of the Covid-19 pandemic, the Centers for Medicare and Medicaid Services and private insurers made the timely decision to rapidly expand coverage for telehealth visits, throwing a lifeline to millions of Americans who needed ongoing medical care despite nationwide stay-at-home orders. At the time, virtual visits done by video or by telephone were covered at the same rates as conventional, in-person office visits. (Sachin Shah, Lolita Alkureishi and Wei Wei Lee, 4/21)

Recent news coverage is fueling a pernicious narrative: What’s the point of getting a covid-19 vaccine if the vaccinated might still get infected, if protection doesn’t last that long and if the vaccine itself could lead to dangerous outcomes such as blood clots? Clinicians need to address each concern head-on, and we need the media’s help to do it. The science is squarely on our side. Last week, the Centers for Disease Control and Prevention released data on breakthrough coronavirus infections — meaning instances of fully vaccinated people testing positive. The data highlighted how effective vaccination is, but you might not have drawn that conclusion from news reports. (Leana S. Wen, 4/20)

When I was vaccinated against Covid-19, I felt a deep sense of relief: no more worries about personally catching the disease. So when I noticed mild, Covid-19-like symptoms two months later — stuffy nose, chest congestion, and an upset stomach — I thought they were due to seasonal allergies. I was shocked a few days later when a test for Covid-19 done in preparation for an unrelated medical procedure came back positive. (Stephen M. Tourjee, 4/20)

"You're a hero. "I can't count the number of times I've heard this from well-intentioned friends and family. They send messages of praise for the work I've done over the past decade, addressing rural health and infectious diseases in India (where I was born), Mozambique, Mexico, Dominican Republic, Honduras, Thailand, Nicaragua, Rwanda and Uganda. In many ways, this recognition felt and still feels misplaced. (Abraar Karan, 4/18)

This month, Johns Hopkins University made a decision on a question that many colleges and universities are thinking hard about: whether to mandate that students get COVID-19 vaccines, and provide proof of it, before returning to campus for classes in the fall. “Given the importance of mass vaccination in protecting our community, we will require all students coming or returning to our campuses this fall, and who do not require religious or health exemptions, to be vaccinated,” the leadership team, including President Ronald J. Daniels, wrote in a letter to the Johns Hopkins community April 9. “We strongly urge, and may soon require, all faculty and staff to be vaccinated as well.” (4/20)

As the days grow longer, there’s a palpable feeling of hope in the air — at least in the more fortunate western countries. Thanks in part to vaccines, Covid-19 deaths are dropping in the U.K. and the U.S., enabling parts of normal life to resume. But, as we’re well aware, it’s not over yet. If we want to have a shot at halting transmission, everybody needs their jabs. Governments around the world desperately need to close the yawning vaccine gap between rich and poor nations. But as wealthy nations begin offering vaccinations to younger cohorts, they may hit a challenge closer to home. (Lara Williams, 4/21)

As a form of identity politics, the coronavirus pandemic works in unusual, yet painfully familiar ways. For example, the widely reported divide between Blacks and whites in willingness to be vaccinated appears to pale next to differences between political partisans. While differences in access to vaccines continue to be a major challenge, the gap appears to be closing between Black and white Americans in their eagerness to get the shot, according to a recent NPR/PBS NewsHour/Marist survey. (Clarence Page, 4/20)

Happy maskers are all alike; every unhappy masker is unhappy in his own way. For some, the culprit is maskne. For others, it’s the fog of their breath on their glasses. For me, the irritant isn’t fabric per se but summer, which transforms the thick black cotton of my preferred mask from a convenient winter face warmer into a makeshift lip oven. Still, as temperatures climb, I know my discomfort is a small price to pay for keeping the people I encounter on my silly little walks safe. But what if keeping people safe isn’t actually what I’m doing? In recent days, a slew of essays — published in the center-leftish magazines Slate and The Atlantic, the more leftish magazine The New Republic and the libertarian magazine Reason — have sought to spark a reappraisal of our legal and cultural norms around outdoor masking. (Spencer Bokat-Lindell, 4/ 20)

Congress made the commitment to bring the U.S. health system into the modern computing age with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009. It then double downed on that commitment seven years later with the 21st Century Cures Act, putting the patient in the driver’s seat of where and when this new digital information travels from location to location. The next step Congress can take to realize a fully interoperable health system that captures and exchanges patient data across health systems with 100% confidence and minimal errors would be to remove the long-standing federal funding ban on a unique patient identifier (UPI) standard. (Cassie Leonard, 4/20)