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Paul Ryan leaves Congress with his entitlement reform goals unfulfilled. House Speaker Paul Ryan, R-Wis., announced on Wednesday that he was leaving Congress at the end of his term. Ryan will be giving up his job as speaker before fulfilling the central aim of his political life — the one that brought him to national stardom — overhauling our nation’s broken entitlement system that threatens to crush future generations with unsustainable debt. Ryan’s 20-year career in Congress is a story of a man constantly torn between his desire to advance ideological policy goals and his ambitions as a politician who knew when to play the role of a loyal party soldier. Throughout his time in Washington, he has tried to fuse the two impulses, with a mix of successes, failures, and some awkwardness. In 2016, Ryan’s conflict between being a party soldier and advancing his ideals faced its most difficult test when Donald Trump captured the Republican nomination. In a press conference touting the “big things” he accomplished as speaker and thanking Trump for being in a position to sign them, he touted as the two major achievements increasing military spending and the large tax cut passed last year — both of which added to deficits. Was embracing Trump ultimately worth it for the sugar high of tax cuts and increased military spending? While conservatives may want both policies, Ryan knows better than anybody that neither of these achievements will be sustainable without the passage of entitlement reform — which is much harder work. Ryan, on Wednesday, touted the fact that the House passed entitlement reform, and pointed the finger at the Senate for not acting. “More work needs to be done and it really is entitlements, that’s where the work needs to be done,” he said. “And I’m going to keep fighting for that.” But Ryan, who claimed he wanted to tackle entitlements this year, will leave his job unfulfilled.

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Alexander: U.S. will need more than a ‘moonshot’ to end opioid epidemic. The opioid epidemic will require more than a “moonshot,” said Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, R-Tenn., during a hearing on Senate opioid legislation this morning. “In January, [author] Sam Quinones testified before our committee that we need a ‘moonshot’ to solve this crisis,” Alexander said during a committee hearing on a big package of measures to fight the opioid epidemic. “I think it may require the effort and resources of a moonshot, but I also think it will be different and harder because this is not something that can be undertaken by a single agency in Washington, D.C. — it will require all-hands on deck work and solutions from states, communities, and local partners.” The opioid epidemic killed more than 64,000 Americans in 2016.

Warren implores Congress to ‘do better.’ Sen. Elizabeth Warren, D-Mass., said Congress needs to give localities many more resources to fight the epidemic. “Congress has nettled around the edge of this,” she said during the hearing. “This latest round of policy changes is no substitute for giving communities the resources and expertise they need to fight this fight on the ground.” She reiterated her call for Congress to take up legislation similar to an effort to combat the AIDS/HIV epidemic in the early 1990s. “Right now I don’t think we are doing what it takes,” she said. “We need to do better.”

Murkowski reminds of other debilitating addictions. Sen. Lisa Murkowski, R-Alaska, said during the hearing that it is important to remember that resources are needed to battle other types of addiction, too. “I am concerned that here in Congress we are so focused on opiates as the drug du jour, if you will, and that five years or so when this crisis ends or tapers off that we will have a bunch of programs specifically aimed at a problem that may not be as significant to dealing with other types of addictions,” Murkowski said. She also detailed the addiction problems in her own state. In Alaska, it’s alcohol, has been alcohol, will be alcohol.”

Push to combat opioid abuse doesn’t include restoring DEA powers. But missing from this massive effort is a bill to reverse a 2016 law that weakened the Drug Enforcement Administration’s power to go after suspicious drug distributors. Sen. Claire McCaskill, D-Mo., introduced a bill last year to restore DEA powers to fight suspicious drug wholesalers. The bill has been referred to the Senate Judiciary Committee, which means it will not be part of the Senate HELP package. McCaskill told the Washington Examiner that the bill has not received any Republican support. “I have tried, but so far I have not been able to find anybody who has been willing to co-sponsor it, and it is hard to get one across the finish line if you don’t have some Republicans that are willing to help,” McCaskill said.

Cummings calls on Trump to tackle price of overdose reversal drug. Rep. Elijah Cummings, D-Md., urged President Trump to take action to lower the price of the overdose antidote naloxone, a key recommendation from the president’s opioid panel. Cummings’ letter today comes a day after the U.S. Surgeon General Jerome Adams issued a public health advisory urging the public to stock up on the drug. A key hurdle has been price increases for the antidote, as some cities have had trouble paying for it.

Opioid memorial heads to White House. The memorial, “Prescribed to Death,” is an art installation that depicts the 22,000 deaths from prescription painkiller overdoses in 2015. The exhibit is a wall made up of carved pills, one for each person who died. It is hosted by the National Park Service and is carried out by the National Safety Council, an organization that partners with businesses and nonprofits to eliminate preventable deaths. Members of the administration, including Health and Human Services Secretary Alex Azar and Kellyanne Conway, senior counselor to the president, will appear at a press event unveiling the memorial at 12:30 p.m. It will be on the Ellipse April 12-18.

Boehner joins board at marijuana corporation. Former House Speaker John Boehner and former Massachusetts Gov. Bill Weld will join the board of advisers at one of the nation’s largest cannabis corporations. “I’m joining the board of #AcreageHoldings because my thinking on cannabis has evolved,” Boehner announced on Twitter Wednesday. “I’m convinced de-scheduling the drug is needed so we can do research, help our veterans, and reverse the opioid epidemic ravaging our communities.” He noted that descheduling the drugs would reduce conflict between state and federal laws, allow federally funded medical research and permit the VA to use marijuana as a treatment option.

Trump signs order pushing work requirements for safety net programs. Trump signed an executive order Tuesday promoting work requirements for safety-net programs, a change most likely to affect Medicaid, food stamps and housing benefits. “Welfare reform is necessary to prosperity and independence,” said Andrew Bremberg, the White House director of the Domestic Policy Council. The order would encourage agencies to strengthen work requirements for people who are able to work. As with previous broad orders signed by Trump, it calls for agencies to review all work requirements and report back, setting up possible changes in regulations.

Planned Parenthood launches ad campaign against judge nominee. The Senate Judiciary Committee is holding a hearing today on the nomination of Wendy Vitter for the U.S. District Court for the Eastern District of Louisiana, and Planned Parenthood is starting a five-figure opposition ad campaign on Facebook and Twitter. The organization is asking supporters to call their senators to oppose the lifetime appointment because Vitter advocated for abortion restrictions and appeared at anti-abortion events. “Wendy Vitter is dangerous, untrustworthy, and unfit for a lifetime appointment as a federal judge,” said Dana Singiser, vice president of public policy and government affairs for Planned Parenthood. “Vitter’s record of opposing women’s health and rights is far outside the mainstream. The bottom line is that Vitter can’t be trusted to be unbiased or fair-minded.”

CVS rolls out tool telling customers how to pay less for medicines. Pharmacists at CVS will be able to use the tool, CVS Pharmacy Rx Savings Finder, to see how customers can save money. The tool will show whether any discounts or cheaper alternatives are available and whether someone can save money by filling a 90-day prescription instead of a 30-day prescription.

New director named at CDC’s Division of Global HIV and TB. Rebecca Martin, director of Center for Global Health at the Centers for Disease Control and Prevention, named Dr. Hank Tomlinson director of the Division of Global HIV and TB. Tomlinson, a psychologist, has worked at similar programs at CDC since 2008 and came to the agency after directing a CDC-funded HIV prevention and health promotion program for LGBT youth at the American Psychological Association.

RUNDOWN

Bloomberg Are drug prices too low?

Washington Post With Medicaid expansion looking more likely, Va. legislature returns to Richmond

Axios Congress isn’t doing enough on opioid treatment, experts say

Los Angeles Times How single-payer healthcare has divided Democrats in California’s race for governor

The Hill VA privatization fight could erupt in confirmation hearings

STAT News Justice for Jane Doe: A New York attorney becomes the face of a crucial abortion rights case

Wall Street Journal How death strikes around the U.S.