 Welcome to Monday's Overnight Health Care. The number of confirmed COVID-19 cases in the U.S. is rapidly approaching 1 million. Still, some governors insist their states are ready to re-open, even without adequate testing capacity. To help, the Trump administration rolled out a new national testing strategy — one that largely puts the onus on states. Meanwhile, Congress is back in session next week. We'll start at the White House: Trump health official: U.S. will 'easily' perform 8 million tests in May A top Trump administration health official said Monday that the U.S. will “easily” perform eight million tests in the month of May as the White House rolled out some steps aimed at increasing testing. “According to the governors plans for next month, we will easily double that 4 million number,” Brett Giroir, an assistant secretary of Health and Human Services, said in a press conference at the White House. He said the administration would be sending out more of key testing supplies that have been in shortage, including 20 million swabs and 15 million tubes needed to transport test samples. However, 8 million tests per month would still be well short of the targets put forward by leading health experts for the level needed to safely reopen the economy. Harvard researchers said last week that at least 500,000 tests per day, or about 15 million per month, are needed. Dr. Anthony Fauci, the government’s top infectious disease expert, said last week the country needed “closer to” 3 million tests per week, or about 12 million per month. As pressure mounts on the administration to increase testing, the White House released a “blueprint” on testing strategy. The document largely summarized actions the administration has already taken and put the responsibility on states for key tasks. It did not include specific targets for increased numbers of tests. White House shifts messaging strategy on coronavirus The White House on Monday signaled it is changing the way it will handle messaging on its response to the coronavirus amid growing GOP fears that President Trump's daily briefings were hurting his party's electoral chances this fall. But in a sign that nothing is certain in the Trump White House, Monday's coronavirus task force briefing was initially cancelled, before being rescheduled two hours later as a press conference with Trump and Vice President Pence. Trump enjoyed an initial polling boost when he began participating in the daily press briefings. But the benefit has worn off, with recent surveys showing a dip in his approval rating and finding that most Americans trust their governors and other administration health officials more than the president. His performance may also be hurting vulnerable GOP senators up for reelection in November. Republican Sens. Martha McSally (Ariz.), Cory Gardner (Colo.) and Susan Collins (Maine) were all out-raised by their Democratic rivals in the first quarter of 2020. Read more here. Related: Trump asks why taxpayers should help bail out blue states Trump rips media after taking criticism over coronavirus briefings Louisiana extends shelter-in-place order while Iowa, Texas and Ohio plan to ease restrictions Louisiana Gov. John Bel Edwards (D) extended the state’s stay-at-home order through at least May 15, saying Monday that businesses could potentially begin reopening at a reduced capacity after that date. Edwards said the state doesn’t meet the White House’s criteria for phase one of reopening, which recommends a downward trajectory in new cases for two weeks. “While this is not the announcement I want to make, I am hopeful, and all of Louisiana should be hopeful, that we will enter into the next phase of reopening soon, in mid-May,” he said in a statement. “I am anxious to get all areas of our economy reopened, but if we accelerate too quickly, we may have to slam on the brakes. That will be bad for public health and for businesses, bad for our people and bad for our state.” What this means: Things stay essentially the same for Louisianans for the next few weeks. But Edwards said he hopes the state will be able to open businesses at a reduced capacity thereafter. Read more here. Meanwhile, governors in Texas, Iowa and Ohio announced they would ease restrictions. Iowa Gov. Kim Reynolds (R) said she will lift restrictions on businesses, including restaurants, gyms and retailers, in all but 22 of the state’s 99 counties. Businesses will be allowed to reopen at 50 percent capacity, with the exception of food courts and play areas, which must remain closed. Read more on those restrictions here. In Texas, Gov. Greg Abbott (R) said he will lift restrictions Friday on retailers, restaurants, movie theaters and malls, with occupancy limited to 25 percent. Barber shops, gyms and hair salons will remain closed. Read more here. Related: DC says supply shortfalls limiting tests to less than half capacity San Francisco counties extend shelter-in-place orders through the end of May Colorado and Nevada join western states cooperating on reopening Case fatality rates rise as coronavirus runs deadly course The percentage of people who die after testing positive for the coronavirus is rising even as thousands of new U.S. cases are identified each day, a troubling preview of the weeks and months that lie ahead. Epidemiologists and experts say increased case fatality rates are a natural function of a deadly virus running its course: The people who succumb today were probably infected as long as a month ago, when the number of cases began accelerating. "As the epidemic picks up and you see a sudden rise [in cases], deaths will be very low," said Michael Osterholm, director of the Center for Infectious Disease Research and Prevention at the University of Minnesota. "It's just new onsets. And then as they work through the process, becoming severely ill, becoming hospitalized, being in the ICU and then dying, it's a long-term process of three or up to four weeks." Read more here. McConnell: Senate will return on May 4 to start next coronavirus relief bill Congress is coming back to town. Senate Majority Leader Mitch McConnell (R-Ky.) said on Monday that the Senate will return to the Capitol next week — and he outlined GOP priorities for a fifth coronavirus relief bill. “Senators will return to Washington D.C. one week from today. We will modify routines in ways that are smart and safe, but we will honor our constitutional duty to the American people and conduct critical business in person," McConnell said in a statement. "If it is essential for doctors, nurses, healthcare workers, truck drivers, grocery-store workers, and many other brave Americans to keep carefully manning their own duty stations, then it is essential for Senators to carefully man ours and support them," he added. House is back too: Majority Leader Steny Hoyer (D-Md.) announced on a conference call with House Democrats that the chamber will also come back into session next Monday. That means despite worries about adhering to physical distancing requirements, both the Senate and House will return on Monday, May 4. Why it matters: Leadership in both chambers are already jockeying over the next coronavirus bill, which McConnell has vowed will not pass until all senators are back in Washington to discuss what should, or should not, be in it. Read more here. Related: Democratic House leaders plan vote next week on allowing proxy voting during pandemic Health experts call for $46.5 billion to expand contact tracing, isolation A group of leading health experts on Monday sent a letter to Congress calling for $46.5 billion to expand contact tracing and isolation of infected people in order to safely reopen the economy. “We are writing to propose Congress take swift action in upcoming legislation to give states the funding necessary to scale up our nation’s contact tracing ability and support voluntary self-isolation of infected and exposed individuals,” write the 16 health experts, who include former Food and Drug Administration (FDA) Commissioner Scott Gottlieb and former acting administrator of the Centers for Medicare and Medicaid Services (CMS) Andy Slavitt. “This is fundamental to our ability to begin to reopen our economy while continuing to safeguard American lives.” The letter asks for $12 billion to hire 180,000 new workers who would conduct contact tracing, meaning interviewing infected people to find out who they have been in contact with and then notifying those people so they can self-isolate for 14 days. The experts say this is important until a vaccine is developed. Read more here. In non-COVID-19 news: Supreme Court says Congress must pay insurers billions under ObamaCare Remember the risk corridor program? The Supreme Court says Congress owes insurance companies $12 billion. The 8-1 decision is a victory for insurers, but comes well after the funding could have had an impact on the ObamaCare law. Congressional Republicans assailed the program as an insurer "bailout" and passed measures preventing taxpayer dollars from funding it. The program could only pay out what it took in. According to experts, the decision destabilized the marketplace for years as insurers fled the exchanges or jacked up premiums. Insurers sued. The justices on Monday said Congress had an obligation to pay. So years later, long after the damage to the marketplace was done, insurers will get a windfall that was meant to help them stay in the marketplace. Key finding: “These holdings reflect a principle as old as the Nation itself: The Government should honor its obligations,” Justice Sonia Sotomayor wrote for the majority. Read more here. What we’re reading U.S. floats doubling up antibody tests to improve accuracy (Bloomberg) President’s intelligence briefing book repeatedly cited virus threat (The Washington Post) Top E.R. doctor who treated virus patients dies by suicide (The New York Times) State by state Florida Medicaid backers battle Senate on new law (Gainesville Sun) Inside Connecticut’s ‘ground war’ against coronavirus at nursing homes (Reuters) Op-eds in The Hill Supporting frontline women amid COVID-19 Learning from COVID-19 for the coming pandemics Don't waste the public's money bailing out private health insurers | 
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