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From Kaiser Health News:

Kaiser Health News Original Stories

1. Exodus By Puerto Rican Medical Students Deepens Island’s Doctor Drain

Interest in medical schools is high in Puerto Rico, but many students look to the U.S. mainland for residencies because of higher pay and the commonwealth's declining economy. The migration of young talent is both a symptom and an exacerbation of the island’s medical woes. (Carmen Heredia Rodriguez, 5/1)

4. Political Cartoon: 'Dead Men Tell No Tales?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Dead Men Tell No Tales?'" by Darrin Bell.

Here's today's health policy haiku:


Training is long and
Job prospects are slim. It leads
Some young docs to leave.

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

Summaries Of The News:

Spending And Fiscal Battles

5. Lawmakers Agree To Spending Bill That Includes Puerto Rico Medicaid Funds, Bump To NIH Budget

The $1 trillion-plus measure also retains funding for Planned Parenthood.

The Associated Press: Lawmakers Settle On Hard-Fought $1 Trillion Spending Bill
Congressional Republicans and Democrats have reached agreement on a huge $1 trillion-plus spending bill that would fund most government operations through September but denies President Donald Trump money for a border wall and rejects his proposed cuts to popular domestic programs. Aides to lawmakers involved in the talks disclosed the agreement Sunday night after weeks of negotiations. The bill was made public in the pre-dawn hours Monday. ... The measure funds the remainder of the 2017 budget year, through Sept. 30, rejecting cuts to popular domestic programs targeted by Trump such as medical research and infrastructure grants. (Taylor, 5/1)

The Washington Post: Congress Reaches Deal To Keep Government Open Through September
Democrats fought to include $295 million to help Puerto Rico continue making payments to Medicaid, $100 million to combat opioid addiction, and increases in energy and science funding that Trump had proposed cutting. If passed, the legislation will ensure that Planned Parenthood continues to receive federal funding through September. (Snell, 4/30)

Stat: NIH To Get A $2 Billion Funding Boost As Congress Rebuffs Trump
The National Institutes of Health will get a $2 billion funding boost over the next five months, under a bipartisan spending deal reached late Sunday night in Congress. The agreement marks a sharp rejection of President Trump’s proposal to cut $1.2 billion from the medical research agency in the current fiscal year. The deal does not address funding for 2018, when Trump has called for a slashing the NIH’s budget by about a fifth, or $5.8 billion. (Facher, 5/1)

CQ Roll Call: Spending Package Would Provide $2 Billion Bump For NIH
Senior Republican appropriators already had indicated that they were not swayed by White House proposals seeking to cut NIH in fiscal 2017, the budget year that began Oct. 1. An Office of Management and Budget spreadsheet that was circulating in Washington last month suggested a $1.2 billion reduction for the NIH. (Young, 4/30)

CQ Roll Call: Omnibus Averts Puerto Rico Medicaid Shortfall
Lawmakers agreed to funnel $295.9 million to Puerto Rico’s Medicaid program in a fiscal 2017 omnibus to avert a funding shortfall that lawmakers say could have put about 900,000 poor people at risk of losing health care coverage. But without legislative changes to the way Puerto Rico’s Medicaid program works, the funding boost is likely not the last chunk of money Congress will need to agree to send the island territory, which is crippled by a $72 billion debt crisis. The financial fallout is the subject of a 2016 law (PL 114-187) that established an oversight board to help deal with the problem, but the Medicaid issue was not addressed. (Mejdruch, 5/1)

Health Law

6. Trump Promises Protections For Preexisting Conditions That May Not Be Delivered By GOP Bill

The president spoke Sunday about the hot-button topic, saying he "mandated" that coverage for preexisting conditions will be in the Republican health care bill. But while the current version of the proposed legislation says "access" is guaranteed for people with preexisting conditions, it is silent on a key point: whether such access must be affordable.

The New York Times: Pushing For Vote On Health Care Bill, Trump Seems Unclear On Its Details
After two false starts on President Trump’s promise to repeal the Affordable Care Act, Trump administration officials are pressing the House to vote on a revised version of the Republican repeal bill this week, perhaps as soon as Wednesday, administration officials said. And on Sunday, Mr. Trump insisted that the Republican health legislation would not allow discrimination against people with pre-existing medical conditions, an assertion contradicted by numerous health policy experts as well as the American Medical Association. (Pear, 5/1)

USA Today: Trump Dominates The 101st Day With Tweets, Tough Talk About Health Care
Trump maintained there is yet another version of the American Health Care Act, House Republicans' plan to replace the Affordable Care Act, and blamed obstruction by Democrats for Congress' failure to pass the legislation before his 100th day in Congress, although Republicans control both chambers of Congress. Trump also maintained that "preexisting conditions are in the bill. I mandated it."  Coverage with people with existing medical conditions has to be included, he continued, because "Obamacare is dead." (O'Donnell, 4/30)

The Wall Street Journal: Trump Issues Health ‘Guarantee,’ Sidesteps Affordability Concerns
Interviewer John Dickerson repeatedly asked Mr. Trump if the Republican plan—being negotiated among GOP lawmakers in the House—would guarantee coverage to people in every state, regardless of their medical history. Mr. Trump said that it would, but he didn’t directly address the possibility that some states could opt to charge more to people with such pre-existing conditions, the current sticking point in negotiations between GOP centrists and conservatives. (Radnofsky, 4/30)

The Hill: Trump Says Coverage Of Pre-Existing Conditions Will Be In Healthcare Plan 
He said the GOP's new healthcare bill is "much different than it was a little while ago." "This bill has evolved. And we didn't have a failure on the bill," he said. "You know, it was reported like a failure. Now, the one thing I wouldn't have done again is put a timeline. That's why on the second iteration, I didn't put a timeline," he continued. (Savransky, 4/30)

The Associated Press: Fears Of Losing Pre-Existing Conditions Protection Under GOP
From cancer to addiction, doctors and patient groups are warning that the latest Republican health care bill would gut hard-won protections for people with pre-existing medical conditions. Some GOP moderates who may seal the legislation's fate are echoing those concerns. In a strongly worded statement this week, the American Medical Association said the Republican protections "may be illusory." The American Cancer Society Cancer Action Network said the plan could take the nation back to a "patchwork system" that pushes costs on people with life-threatening conditions. (Alonso-Zaldivar and Fram, 4/28)

The Hill: Trump: I Won't Touch 'Concept Of Medicare'
President Trump during an interview that aired Sunday said he will not touch the "concept of Medicare." "I'm not going to touch it, because I said it," the president said during an interview on CBS's "Face The Nation." "Now, waste, fraud and abuse, I'm going to touch. If there's something in Medicare that's been abused, I will touch that." (Savransky, 4/30)