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In February 2015, an unprecedented HIV outbreak fueled by intravenous drug use hit the small city of Austin, Indiana. Under pressure, then-Gov. Mike Pence reluctantly allowed a syringe exchange. Five years later, HIV is undetectable in most of the outbreak patients. Still, the lessons haven’t been learned nationwide. Fewer than a third of the 220 counties deemed by the federal government as vulnerable to similar outbreaks have active syringe-exchange programs.

Indiana was ground zero for shifting ideas about needle exchanges after a small town had an HIV outbreak in 2015 brought on by needle-sharing. But even as other parts of the country start to embrace needle exchanges amid the ongoing opioid epidemic, the sites remain controversial in Indiana. Only nine of the state’s 92 counties have them, after a series of closures and reopenings.

It’s November, do you know where your HHS spending bill is? Still stuck in Congress. Meanwhile, lawmakers move ahead on restricting tobacco products for youth while the administration’s proposal is MIA. Rebecca Adams of CQ Roll Call and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss this and more health news from the week. Also, Rovner interviews Dan Weissmann, host of the podcast “An Arm and a Leg.”