THE PROGNOSIS

Health-care jobs are among the fastest-growing sectors in the historically low-unemployment economy President Trump loves to tout. It’s immigrants who fill a lot of them — something the president might consider as he seeks new limits on immigration.

Immigrants — both citizens and noncitizens — make up a disproportionate share of workers who care for the elderly and disabled and ensure their surroundings are safe, according to a study published this week in the health policy journal Health Affairs.

The study finds more than one-fourth of direct care workers and 30.3 percent of nursing home housekeeping and maintenance workers are immigrants, underscoring their key role as the U.S. population ages. They make up 18.2 percent of the total health-care workforce at more than 3 million people.

“This is a workforce responsible for everything from making sure the floors are clean and making sure our elderly and disabled don’t fall to washing linens and other things critical to wellness,” Leah Zallman, the study’s author and a physician at Cambridge Health Alliance, told me.

Health-care jobs — particularly those involving elder care — are expected to skyrocket in coming years as the baby boomers grow older. The Institute of Medicine has projected that 3.5 million more health-care workers will be needed by 2030. Immigrant health-care workers, who tend to be older and have more education than their nonimmigrant counterparts, are a key filler of these roles.

“Policies curtailing immigration will likely compromise the availability of care for elderly and disabled Americans,” Zallman wrote in her study.

It’s true that Trump isn’t exactly regarded as a pro-immigrant president. He’s currently seeking congressional support for cutting back on immigrant visas for relatives of U.S. citizens and replacing them with merit-based visas obtained through a points system. He has spent much of this year mired in battles with the Democrat-led House over funding for a border wall. House Democrats, however, passed a measure last night granting a pathway to citizenship for more than two million undocumented immigrants already in the country, including "dreamers," though its chanced in the Senate are poor.

Yet despite the president’s rhetoric, the number of people becoming U.S. citizens actually reached a five-year high last year, my Washington Post colleague Abigail Hauslohner reports.

Even as the administration pledged to tighten immigration protocols (Trump's new ICE chief says he'll increase family deportations), the government has maintained the same rate of approving citizenship applications. U.S. Citizenship and Immigration Services reported naturalizing 756,800 people in fiscal year 2018, a 16 percent increase from 2014. Approval rates for applications declined slightly, to just below 90 percent.

“In keeping with, and even exceeding, previous years’ totals for new citizens and green cards issued by USCIS, the report’s key statistics appear to suggest efforts to limit legal immigration have not taken root,” Abigail writes.

And a steady influx of immigrants bodes well for sectors such as the health-care industry, in which worker shortages could especially be felt as the country approaches what economists call full employment. Health care had the third-highest job gains in April, with 27,000 jobs added that month, after business services and construction, my Post colleague Heather Long reported.

“The U.S. economy added 263,000 jobs in April, notching a record 103 straight months of job gains and signaling the current economic expansion shows little sign of stalling,” Heather wrote.

Trump takes credit for the booming economy:

AHH, OOF and OUCH

AHH: Researchers at Pfizer discovered in 2015 the company’s rheumatoid arthritis drug Enbrel seemed to lower the risk of Alzheimer’s disease by 64 percent. But after researchers urged the company to do a clinical trial to confirm the findings, the drugmaker didn't do any further investigating, our Post colleague Christopher Rowland reports.

The company estimated a clinical trial would cost $80 million. Pfizer also told The Post it conducted three years of internal reviews but determined the anti-inflammatory drug did not in fact seem suitable for Alzheimer’s prevention because the drug does not reach brain tissue. A company spokesman said science was the only factor that determined that the company should not go ahead with a trial.

“Pfizer’s deliberations, which previously have not been disclosed, offer a rare window into the frustrating search for Alzheimer’s treatments inside one of the world’s largest drug companies,” Chris writes. “Despite billions spent on research, Alzheimer’s remains a stubbornly prevalent disease with no effective prevention or treatment.”

“Some outside scientists disagree with Pfizer’s assessment that studying Enbrel’s potential in Alzheimer’s prevention is a scientific dead end,” he adds. “Rather, they say, it could hold important clues to combating the disease and slowing cognitive decline in its earliest stages.”

OOF: Former Georgia gubernatorial candidate Stacey Abrams (D) is urging film and television studios that have threatened to boycott the state over its new abortion law to instead put financial support behind challenging the law.

The Democrat is working with abortion rights groups on a movement to “#StayAndFight” in the state, our Post colleague Hamza Shaban reports, calling on film executives and leaders in Hollywood to donate to candidates and groups that are challenging the state’s controversial law that bans abortion once a fetal heartbeat is detected.

Abrams says pulling work from the state will have a negative impact on the state’s workers, and some say the move won’t necessarily guarantee that the law would be reversed. An Abrams spokesman told Hamza she will meet with Hollywood leaders this month in Los Angeles on the issue.

OUCH: Gov. Ralph Northam (D) will convene a special session of the state legislature later this month to address gun policy in the wake of Friday's mass shooting in Virginia Beach.

At a news conference yesterday, Northam, Lt. Gov. Justin Fairfax, Attorney General Mark R. Herring and other Democratic leaders urged the Republican lawmakers in the state, who control the General Assembly, to act on a package of gun-control bills, as our Post colleague Gregory S. Schneider reports.

“We must do more than give our thoughts and prayers,” the governor said. “We must give Virginians the action they deserve … Let Virginia show the nation that we can respond to tragedy with decisive action.”

“Northam said he wants Republican leaders to bring gun-control bills to the full General Assembly so they can be voted up or down,” Gregory writes. “Bills sponsored by Democrats in past sessions were usually killed by a handful of Republican lawmakers in committees.”

Republican House speaker, Kirk Cox, called Northam’s action “hasty and suspect.” He said the Republican lawmakers would take up the issue but said Northam cannot “specify what the General Assembly chooses to consider or how we do our work.”

TRUMP TEMPERATURE

PARDON? President Trump suggested during a news conference in London that the U.K.'s health-care system could be “on the table” in a future U.S.-Britain trade deal.

“When you’re dealing on trade, everything is on the table — so NHS or anything else, and a lot more than that,” Trump said. “Everything will be on the table, absolutely.”

“Trump’s vague answer to the question may suggest he hadn’t given the idea much thought,” our Post colleague Adam Taylor writes, adding that British Prime Minister Theresa May, “keenly aware of how sensitive an issue the NHS is in Britain, stepped in quickly Tuesday, saying that ‘the point about making trade deals is that, of course, that both sides negotiate.’ ”

“The behemoth system is simultaneously one of the most lauded and derided parts of British life. Polls have shown that the NHS is more cherished than the monarchy or the British army but also that many Britons are dissatisfied with the service and worried about its future,” Adam writes. “Now there are fears that a trade deal with the United States could open up the NHS to profit-driven U.S. business interests — and, with it, the creeping possibility of privatization.”

HEALTH ON THE HILL

— Actress and talk show host Busy Philipps, Melissa Ohden -- who says she survived an abortion -- and other witnesses appeared yesterday before a House Judiciary subcommittee hearing on state abortion restrictions. In a particularly tense exchange with Rep. Louie Gohmert (R-Tex.), Phillipps dodged questions about what should happen if a baby is born alive after a botched abortion.

When Gohmert asked Philipps whether a baby who survived an abortion has a right to live, referring to Ohden's testimony, Philipps said “I don’t believe a politician’s place is to decide what’s best for a woman … it’s a choice between a woman and her doctor."

When Gohmert again asked about the “baby and the doctor,” Philipps responded that she was “not speaking about birth, I’m speaking about abortion.” 

— Sens. Bob Casey (D-Pa.) and Pat Toomey (R-Pa.) released a list this week of hundreds of the nursing homes across the nation with poor records of care. 

The list of about 400 homes put together by the Centers for Medicare and Medicaid Services was meant to name candidates for CMS's Special Focus Facility program, which monitors homes that have had a history of health or safety risks.

The senators explained that while the names of facilities chosen to participate in the agency’s initiative are made public “in order to provide greater transparency to individuals and families, Senators Casey and Toomey requested the names of these additional facilities be made publicly available by CMS. After CMS chose not to release this list, Senators Casey and Toomey are releasing this information alongside a report with additional background and context.

“Choosing a nursing home is a difficult, and often painful, decision to make. Individuals and families deserve to have all the information available to choose the facility that is right for them,” Toomey said in a statement. “I will continue to press the Administration to ensure every person has ready access to the information they need to make a fully informed choice.”

In a statement to Politico, an agency official said CMS “already clearly identifies poor performing nursing homes with an easy-to-understand star rating on the consumer-tested Nursing Home Compare website … The issue of nursing home quality is much bigger than the 440 candidate facilities for the available 88 SFF slots.”

STATE SCAN

— The state legislature in Illinois became the first in the nation to pass a bill legalizing the sale and possession of marijuana, but our Post colleague Amber Phillips explains the bill is also notable for how it incorporates criminal justice reform.

The measure will expunge criminal records for those that did what would now be legal, Amber writes. It also gives preference to marijuana vendor applications in high-poverty, high-conviction areas and will reinvest proceeds from taxes and revenue to communities most impacted by marijuana convictions.

In an interview, state Sen. Toi Hutchinson (D), a leading pro-legalization voice in Illinois's black caucus, also explained the hesitation some of her black colleagues had about the measure.  

“There are a lot of us who have a fair and honest amount of cynicism, considering what cannabis did to our communities in the criminal justice space,” she said. “It’s like: ‘Okay, so now you’re making money, you want to do this? Where was all this wonderful goodwill for criminal justice reform when we needed this the most?’”

But she said it’s important to note movement on legalization can’t be done without criminal justice reform. “There are still people in the country who are sitting in jail and sitting in prisons dealing with the lifetime impact of the war on drugs. So this is a start. We are really hoping this stance catches fire,” Hutchinson added.

— And here are a few more good reads: 

Gov. Gavin Newsom, who criticized parts of a bill to tighten immunization exemptions, was lauded on Monday by vaccine opponents including Robert F. Kennedy Jr.
Los Angeles Times
AGENCY ALERT
The former head of the Centers for Disease Control and Prevention pleaded guilty to disorderly conduct, resolving his arrest for alleged sexual misconduct.
Wall Street Journal
Politics
A whistleblower says internal and public records have different data about how many veterans are waiting for care.
Joe Davidson
MEDICAL MISSIVES
Education
The school apologized after the backlash, and said the teacher would face disciplinary action.
Liz Weber
INDUSTRY RX
CVS will open 1,500 HealthHUB stores by the end of 2021, the company announces ahead of its investor day. These stores are remodeled drugstores that focus more on health services and products and less on candy and greeting cards.
CNBC
REPRODUCTIVE WARS
National
Planned Parenthood hasn’t provided abortion services in Charlotte for about 30 years, but a new facility there will offer the procedure.
Jodie Valade
Trump administration’s ban on terminations is a crisis directed at women, warns Kate Gilmore
The Guardian
DAYBOOK

Today

  • The Senate Judiciary Subcommittee on Intellectual Property holds a hearing on patent eligibility.
  • The Senate Veterans Affairs Committee is scheduled to hold a meeting on pending nominations.
  • Axios hosts an event on health care and drug pricing with Sens. Chuck Grassley (R-Iowa) and Debbie Stabenow (D-Mich.) and former FDA commissioner Scott Gottlieb.
SUGAR RUSH

A clip of Duchess of Cornwall, Camilla Parker Bowles, went viral after she winked toward the cameras following a photo opportunity with President Trump and first lady Melania Trump: