KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Scope Maker Olympus Hit With $6.6 Million Verdict In Superbug Outbreak Case

In the first case of its kind in the U.S., the company was ordered to pay damages to the hospital where a patient died of an infection linked to a contaminated scope. But jurors also found the hospital negligent, and it was ordered to pay the patients' family $1 million. (Chad Terhune and JoNel Aleccia, 7/25)

Jump-Starting Hard Conversations As The End Nears

An end-of life-planning website can encourage patients to tackle that difficult topic before they become too ill to communicate, according to a new study. But they may be more likely to make concrete plans with help from a doctor or social worker. (Kellen Browning, 7/25)

Summaries Of The News:

Health Law

McCain's Return For Health Vote Energizes GOP, Provides Tiny Bit Of Breathing Room

Sen. John McCain (R-Ariz.) was diagnosed with brain cancer last week. If he stayed home, the Republicans would have lost a precious vote, when they can only afford to sacrifice two in total.

The Associated Press: Trump Tweets, McCain Return Set Stage for Health Bill Vote
President Donald Trump urged Republicans to "step up to the plate" for Tuesday's crucial Senate vote on their bill eviscerating much of the Obama health care law. The stage was set for high drama, with Sen. John McCain returning to the Capitol to cast his first vote since being diagnosed with brain cancer. No stranger to heroic episodes, the Navy pilot who persevered through five years of captivity during the Vietnam War announced through his office that he would be back in Washington for the critical roll call on beginning debate on the legislation. (7/25)

The Hill: McCain Returning To Senate In Time For Health Vote 
Sen. John McCain (R-Ariz.) will return to the Senate on Tuesday after being diagnosed with brain cancer, giving the GOP push to repeal and replace ObamaCare a boost of momentum. “Senator McCain looks forward to returning to the United States Senate tomorrow to continue working on important legislation, including health care reform, the National Defense Authorization Act, and new sanctions on Russia, Iran and North Korea," McCain's office said on Monday evening. (Carney, 7/24)

The Washington Post: McCain’s Return To Senate Injects Momentum Into GOP Health-Care Battle
McCain, who was recently diagnosed with an aggressive form of brain cancer, could provide a critical vote to open debate on the GOP bill. The senator had been recuperating from surgery and exploring treatment options in Arizona. McCain’s announcement came as some Senate GOP leaders expressed confidence in a newly emerging strategy of trying to pass smaller-scale changes to the Affordable Care Act, with an eye toward continuing negotiations into the fall. (Sullivan, Snell, O'Keefe and Wagner, 7/24)

Politico: McCain To Make Dramatic Return For Obamacare Vote
McConnell spent the day cajoling his members and meeting with Vice President Mike Pence to plot strategy. The majority leader was still short of the votes to even open debate, and Republicans still don't know what they'd be voting to allow debate on if they agree to go along with McConnell on the procedural vote. (Everett, Kim and Haberkorn, 7/24)

The Hill: McConnell To Pin Down Colleagues On Healthcare
Senate Majority Leader Mitch McConnell (R-Ky.) appears to be blundering into a healthcare vote this week, despite not having a deal on a Senate healthcare bill. Public struggles aside, McConnell actually does have a plan: pin down fellow Republican senators on their seven-year-old promise to repeal ObamaCare. (Bolton, 7/25)

The Wall Street Journal: Trump Urges GOP Senators To Overturn Affordable Care Act
Lawmakers typically vote with party leaders at least to begin debate on legislation, and failure to pass the motion would be a rebuke for Senate Majority Leader Mitch McConnell (R., Ky.), who has argued that allowing debate to begin would give senators unhappy with the bill a chance to amend it. (Armour, Peterson and Radnofsky, 7/24)

Bloomberg: Senate GOP Set To Roll The Dice On Health Vote At Trump’s Urging 
Senate Republican leaders and President Donald Trump appear determined to begin a floor debate Tuesday on repealing Obamacare in a highly unorthodox way -- without lawmakers knowing what they’ll be voting on or where it might end up. It’s unclear whether they have the 50 votes needed to begin considering a version of Majority Leader Mitch McConnell’s replacement bill or a stripped-down bill that would repeal much of Obamacare with a two-year delay. (Litvan and Dennis, 7/25)

The Atlantic: What John McCain Can Learn From Clair Engle
None of us can choose how we are remembered. Most of us are not remembered at all. Senator John McCain knows that he will be remembered. He faces a choice about how his remarkable career will be noted in its autumnal phase. ... As he makes this decision, he should consider Clair Engle. (Fallows, 7/24)

The Hill: Cornyn Floats Conference Of House, Senate Healthcare Bills 
The Senate’s No. 2 Republican said the two chambers might conference their ObamaCare repeal-and-replace bills. “Initially there was some thought that maybe the House would take up the bill that we passed, but that may not be the case,” Senate Majority Whip John Cornyn (R-Texas) told reporters Monday. (Roubein, 7/24)

The Hill: Senate Dems Launch Talkathon Ahead Of ObamaCare Repeal Vote 
Senate Democrats held a talkathon from the Senate floor on Monday night, ahead of a key hurdle on the GOP effort to repeal and replace ObamaCare. "When the goal is big tax cuts, it's hard to come up with something that actually also improves people's healthcare. The Republican health bills have gone from bad to worse to embarrassing," said Sen. Elizabeth Warren (D-Mass.). (Carney, 7/24)

Trump Implores Republicans To Make Good On Their Years-Long Promise

President Donald Trump also lashed out at Democrats: “They run out. They say, ‘Death, death, death.’ Well, Obamacare is death. That’s the one that’s death.”

The New York Times: Senate Braces For Health Showdown With McCain On Hand But A Plan Unclear
President Trump spent Monday ratcheting up pressure on Republican senators to get onboard. Mr. Trump criticized their inaction and warned that they risked betraying seven years’ worth of promises to raze and revamp the health law if they did not.“Remember ‘repeal and replace,’ ‘repeal and replace’ — they kept saying it over and over again,” Mr. Trump said at the White House, flanked by people who he said suffered as “victims” of the “horrible disaster known as Obamacare.” (Kaplan and Davis, 7/24)

The Washington Post: ‘Obamacare Is Death’: Trump Urges Republicans To Move Ahead With Health-Care Overhaul
President Trump on Monday made a late-hour appeal to senators — targeting members of his own party — to move forward with debate over faltering Republican legislation to overhaul the Affordable Care Act. “Any senator who votes against starting debate is telling America that you are fine with the Obamacare nightmare, which is what it is,” Trump said in an afternoon address from the White House on the eve of an anticipated Senate vote that could spell defeat of the long-sought legislation. (Wagner and Johnson, 7/24)

The Associated Press: Trump Says Upcoming Health Vote Is GOP’s Chance To Keep Vow
At the White House, Trump lambasted Democrats who helped enact the 2010 health care law and uniformly oppose the GOP attempt to scrap and rewrite it. “They run out and say, ‘Death, death, death,’” Trump said, with a backdrop of families that he said have encountered problems getting affordable, reliable medical coverage because of Obama’s statute. “Well, Obamacare is death. That’s the one that’s death.” (Fram, 7/24)

Lawmaker Would Settle Health Debate With 'Aaron Burr-Style' Duel If Senators Blocking Bill Were Men

Rep. Blake Farenthold (R-Texas) says he blames "some female senators from the Northeast” for the party's failure to pass health care legislation. Though he didn't name them in particular, it may have been a reference to Sens. Susan Collins (R-Maine) and Shelley Moore Capito (R-W.Va.), who have both voiced objections to the proposal.

The Associated Press: Burr-Hamilton? Angry Lawmaker Singles Out 'Female Senators'
Passions are running high on Capitol Hill — but pistols at 10 paces over health care? GOP Rep. Blake Farenthold of Texas is angry with some fellow Republicans in the Senate who are balking at parts of legislation to overturn "Obamacare." After GOP promises to repeal the law, that "is just repugnant to me," he says. Who's to blame? (7/24)

Politico: Farenthold Blames 'Some Female Senators' For Obamacare Repeal Failure
Rep. Blake Farenthold on Monday blamed “some female senators from the Northeast” for hampering Republican efforts to repeal and replace Obamacare, telling a local radio station that he might challenge them to a duel if the allegedly obstructive lawmakers were men. The Texas Republican’s remark appeared to be a reference to Sens. Susan Collins (R-Maine) and Shelley Moore Capito (R-W.Va.), both of whom have expressed some degree of hesitancy toward Senate Republicans’ specific plans to repeal and replace former President Barack Obama’s signature health care legislation. (Nelson, 7/24)

A look at where other politicians stand —

New Hampshire Public Radio: Hassan Criticizes GOP Health Bill, And Trump Administration's 'Sabotage' Of Obamacare
Senator Maggie Hassan met with health care leaders in Exeter Monday to talk about the need for a bipartisan plan forward in Washington--and to criticize President Trump for his handling of the health care issue. Standing in the glass atrium of Exeter Hospital, the first-term Democrat did not mince words about what she sees as the flaws in the Republican approach to health policy. (Bookman, 7/24)

Atlanta Journal-Constitution: Pressure Mounts On Perdue, Isakson Ahead Of Health Care Vote
Majority Leader Mitch McConnell has yet to disclose whether he plans to immediately push a replacement for the 2010 health care law or simply a repeal-only plan, much like what the Senate voted on two years ago. ... But with the GOP in control of the White House and both chambers of Congress for the first time in a decade, the pressure is suddenly immense. (Hallerman, 7/25)

The Philadelphia Inquirer/Philly.com: Uncertainty Looms For Pat Toomey, GOP Ahead Of Key Health Care Vote
The Senate is planning a critical vote Tuesday on Republicans’ long-promised health-care overhaul, but on the eve of that decision, Sen. Pat Toomey (R., Pa.) was still unsure what exactly he would be voting on or whether the measure could pass. The cloud of uncertainty hovered even as Toomey spoke to business owners and executives at a suburban office park in West Chester. And with the potential for failure looming, the senator, who helped write the Republican health plan, already had one eye on another key GOP priority, tax reform. (Brennan and Tamari, 7/24)

Confused About What The Senate Is Actually Voting On? Here Are Some Explainers

Not even senators seem to know what they'll be voting on Tuesday afternoon, but these media outlets take a crack at explaining what's going on.

The Wall Street Journal: A Look At The Health-Care Provisions Senators May Vote On
Senate Republican leaders are pushing for a “motion to proceed” to debating their health-care legislation. But as of Monday, it remained unclear what that legislation would be. And if there is a debate, it’s likely to include a flurry of amendments that could reshape the bill. Here are some of the elements senators could vote on, either as part of the underlying bill or as amendments. (Armour, 7/24)

NPR: Trump Calls For A Senate Vote With Multiple Bills In Play
The Senate is expected to vote Tuesday on whether to advance health care legislation to the Senate floor. That would open up debate on an Obamacare repeal and/or replacement plan. ... But it's still not clear what the Senate will be voting on. There are multiple bills in play. (Grayson, 7/24)

Questions Raised About Whether GOP Steps To Moderate Medicaid Cuts Provide Enough Money

Administration and Senate officials pushing for a bill to replace the Affordable Care Act have said that a new $200 billion Medicaid "wraparound" fund would help cushion the changes for low-income people. But a new study suggests that money would last only about two years.

The Hill: Study: Adding $200 Billion To Health Bill Not Enough 
A new study says adding $200 billion to the Senate ObamaCare replacement bill would not be enough to fund private coverage for people who would lose insurance because of a halted Medicaid expansion. Centers for Medicare and Medicaid Services Administrator Seema Verma has been pitching undecided moderate Republican senators on a "Medicaid wraparound" that would provide funds to help people who were on Medicaid afford private coverage.  (Sullivan, 7/24)

The Hill: Thune: Progress Being Made On Medicaid 'Wraparound' 
Sen. John Thune (R-N.D.), a member of GOP leadership, said progress is being made on a change to the GOP health bill that could unlock the support of key moderates. The Medicaid "wraparound" would allow some states to use additional funds to help low-income people who are likely to lose Medicaid coverage afford the premiums and deductibles for private insurance. (Hellmann, 7/24)

Denver Post: Medicaid Funding In Colorado Would Drop $9 Billion Under Senate Plan
A new report finds that Colorado could lose out on more than $9 billion in federal funding for Medicaid over the first decade of a proposal the U.S. Senate is expected to bring up for a key vote Tuesday. Senate Majority Leader Mitch McConnell has vowed to hold a vote Tuesday on whether to begin debating a repeal of the Affordable Care Act — the health care measure that expanded Medicaid access to people slightly above the poverty line and that is also known as Obamacare. If that passes, the Senate would launch into debates on a variety of proposals for how to repeal the ACA, though it remains unclear exactly what they will be voting on. (Ingold, 7/24)

The Star Tribune: States That Expanded Medicaid Saw Drop In Medical Debt, U Study Finds
The federal health law's Medicaid expansion delivered a degree of economic stability to low-income Americans in states that adopted the program, according to a new report from University of Minnesota researchers. Low-income residents in states like Minnesota that expanded eligibility for Medicaid coverage saw a bigger decline in unpaid medical bills between 2012 and 2015 than people living in states that didn't expand coverage, according to the study published in a blog by the journal Health Affairs. (Snowbeck, 7/24)

In state Medicaid news —

Salt Lake Tribune: More Than 200 Utahns Weigh In On State’s Small-Scale Medicaid Expansion Plan
Utah is poised to ask the Trump administration's approval for its plan to extend Medicaid coverage to about 6,000 of the state's neediest childless adults, many of them chronically homeless or in need of mental health or drug addiction treatment. State health department officials say they are a week away from submitting the plan, after receiving more than 230 public comments on details of their Medicaid expansion proposal. (Stuckey, 7/25)

NPR: Centers That Counsel Women Against Abortion Help Them Enroll In Medicaid
When Taylor Merendo moved to Bloomington, Ind., nearly two years ago, fleeing an abusive marriage, she needed help. "I was six months pregnant and at that point in time, I really didn't have a stable place to live," Merendo says. That's where the Hannah Center in Bloomington stepped in. It's what's known as a crisis pregnancy center, where women are counseled against abortion and often get support after their babies are born. (McCammon, 7/24)

Lessons From 'Health Care Hell': Lawmaker Who Battled It Out In 2010 Offers Insights On Current Debate

Former Rep. Bart Stupak (D-Mich.) says lawmakers are too focused on politics over policy.

The Hill: Looking Back On ‘Healthcare Hell’
Bart Stupak didn’t seek out the role he played in the fight over ObamaCare more than seven years ago, but he has no regrets over how it all played out. Stupak, a Democrat who opposes abortion and represented Michigan’s 1st Congressional District for 18 years, became a thorn in his party’s side over demands in the debate on the Affordable Care Act (ACA) against funding for abortion. Now, he’s telling his side of the drama during former President Obama’s first term that resulted in the passage of the massive healthcare overhaul, just as Republicans struggle in their multi-year push to repeal it. (Chalfant, 7/25)

Meanwhile, another former lawmaker sounds the alarm over the Republicans' efforts —

CQ Roll Call: Former GOP Senator Warns There Are 'No Do-Overs' On Health Care
Former Minnesota Republican Sen. David Durenberger took aim Monday at current GOP senators for attempting to ram through a motion to proceed on their controversial bill to dismantle the 2010 health care law. In a USA Today op-ed, Durenberger laid out the normal procedures for deliberating on a bill with ramifications for millions of Americans of this magnitude: “You ask questions. You hold hearings. You understand what it would mean to your constituents. You listen to those who know the system. And when it doesn’t add up, you vote against it.” (Connolly, 7/24)

Administration News

Democrats Probe Whether HHS Videos Panning Health Law Veered Too Close To Advocacy

Administration officials are defending the posts saying they are pointing out problems with the current health law to the public.

The Wall Street Journal: Democrats Accuse HHS Of Using Improper Tactics In Health-Law Battle
Health and Human Services Secretary Tom Price and his department have been publicly panning the Affordable Care Act. Democrats call the campaign an improper use of federal resources to undermine the health law. The disagreement amounts to a low-profile skirmish on health care unfolding in the shadows of the attention-grabbing battle playing out on Capitol Hill. If Republicans in Congress fail to enact a sweeping health-care overhaul, Dr. Price’s battle with Democrats will take on far greater importance as the primary arena for the partisan back-and-forth on health care. (Armour and Hackman, 7/24)

The CT Mirror: Murphy Demands Answers From Price On Anti-Obamacare Videos
Sen. Chris Murphy and two of his Democratic colleagues in the Senate, are questioning whether Health and Human Services Secretary Tom Price misused taxpayer money through advertising and public relations efforts aimed at undermining the Affordable Care Act. In a letter that was also signed by Sens. Brian Schatz, D-Hawaii, and Cory Booker, D-N.J., Murphy asked Price to detail how much money HHS is spending to produce and distribute dozens of anti-Obamacare videos available on the department’s official social media accounts. (Radelat, 7/24)

Capitol Hill Watch

In Unexpected Turn, Democrats Block Once-Bipartisan Bill Funding VA Choice Program

Under the rules set for the bill, supporters needed support from two-thirds of members to pass the bill. Lawmakers voting against it cited opposition from a large group of veterans organizations that called on Congress to reject the bill because it pays for the choice program through cuts in the VA.

The New York Times: Future Unclear For Veterans Choice Program After House Bill Falters
Congressional lawmakers struggled on Monday to reach an agreement to prop up a popular multibillion-dollar health care program that allows veterans to see a private doctor at government expense. This was supposed to be a relatively easy task, meant to buy lawmakers time as they debated the future of the program. As recently as last week, Republican leaders were considering using a bill temporarily funding the Veterans Choice Program as a vehicle to raise the debt ceiling, a perennially bitter pill for Republicans. (Fandos, 7/25)

CQ Roll Call: Veterans' Health Care Funding Patch Blocked By House
The legislation would add roughly six months of funding to what’s known as the Veterans Choice Program, which provides a route to private care for certain veterans having difficulty getting medical care at traditional Department of Veterans Affairs facilities. (Mejdrich, 7/24)

Marketplace

Molina Healthcare To Lay Off About 1,400 Employees, Memo Says

The insurer says the upcoming cuts to 10 percent of its workforce is driven by losses to its Obamacare exchange business.

Reuters: Molina Healthcare To Cut About 1,400 Jobs: Memo
Molina Healthcare, a health insurer that specializes in the Obamacare and Medicaid healthcare programs for low-income and poor people, plans to cut about 1,400 jobs in the next few months, according to an internal company memo reviewed by Reuters. (Humer, 7/24)

Modern Healthcare: Molina To Lay Off 10% Of Its Workforce
Medicaid health plan Molina Healthcare intends to lay off 1,400 employees, or 10% of its workforce, over the coming months to try to offset losses from its Obamacare exchange business, the company said in an internal memo to employees Monday. The cuts will be across-the-board, including senior leadership, interim CEO and Chief Financial Officer Joe White said in the memo. (Barkholz, 7/24)

WebMD To Be Sold To California Online Media Company

Internet Brands, a company controlled by global investment firm Kohlberg Kravis Roberts, will take over the popular medical information website.

Los Angeles Times: KKR's Internet Brands Plans To Buy WebMD In A $2.8-Billion Deal
WebMD has found a remedy for its volatile business: A $2.8-billion sale to El Segundo online media company Internet Brands. The Internet’s leading destination for information about rashes, coughs and other ailments has gone through mergers and sales multiple times since its founding in the late 1990s. But investors made a fresh case for a deal earlier this year, contending that being at the cross-section of healthcare and the Internet should be more valuable than what traders were paying for WebMD shares on the stock market. (Dave, 7/24)

The Washington Post: WebMD Health To Be Sold To A KKR Company For $2.8 Billion
Stockholders of the New York-based health information provider would get $66.50 per each share in cash, a 20 percent premium of the Friday closing price of $55.19, before the deal was announced, and a 30 percent premium over the share price on Feb. 15, the day before the company said it would consider a buyout. The stock closed Monday at $66.10 a share. (Radu, 7/24)

Public Health And Education

Physicians, Often In Fear Of Losing License, Know How To Hide Signs Of Addiction To Escape Notice

“Somehow they believe their knowledge is going to be more powerful than addiction," said Dr. Marvin Seppala, an addiction expert. Meanwhile, Food and Drug Administration Commissioner Scott Gottlieb is looking to tap unlikely sources as allies in the battle against opioids: benefit payers and insurance administrators.

Los Angeles Times: Doctors And Drug Abuse: Why Addictions Can Be So Difficult
Allegations that Dr. Carmen A. Puliafito used methamphetamine and ecstasy while he was dean of USC’s medical school have opened a window into the pervasiveness of drug use and addiction among physicians and the challenges they face when confronting it. Experts say physicians become substance abusers at about the same rate as the general population. But they are often reluctant to seek treatment out of fear of losing their medical licenses and livelihoods. (Karlamangla, 7/24)

Bloomberg: Trump's FDA Chief Takes Wide Aim At Opioid Addiction Crisis 
The Food and Drug Administration, as part of a sweeping overhaul in how it regulates opioid painkillers, plans to look to some unusual allies to limit the flood of the addictive pills -- health insurers and companies that manage prescription drug benefits. Food and Drug Administration Commissioner Scott Gottlieb plans to meet in September with the benefit payers and insurance administrators, groups the FDA hasn’t typically worked with in its role as a drug regulator. The plan, Gottlieb said, is to stem the tide of addiction to the pills by limiting the number of people exposed to them in the first place. (Edney, 7/24)

And in other news on the epidemic —

The New York Times: Economy Needs Workers, But Drug Tests Take A Toll
Just a few miles from where President Trump will address his blue-collar base here Tuesday night, exactly the kind of middle-class factory jobs he has vowed to bring back from overseas are going begging. It’s not that local workers lack the skills for these positions, many of which do not even require a high school diploma but pay $15 to $25 an hour and offer full benefits. Rather, the problem is that too many applicants — nearly half, in some cases — fail a drug test. (Schwartz, 7/24)

Arizona Republic: Hepatitis C: The Public-Health Worry Lurking Behind The Opioid Crisis
Hepatitis C, a blood-borne virus that attacks the liver and causes inflammation, is so infectious it can spread through a few microscopic dots of blood. Intravenous drug users are among the most high-risk populations for infection because they share syringes, cookers, cotton, water, ties and alcohol swabs, according to the Centers for Disease Control and Prevention. (Stanford, 7/24)

Prominent Psychiatry Group Relaxes Stance On Speaking About Mental Health Of Public Figures

The rule against psychiatrists offering their analysis of behaviors, such as ones exhibited by the president, robs the public “of our professional judgment and prevents us from communicating our understanding” of the president’s mental state, one psychiatrist said. In other public health news: the next revolution in HIV treatment, Zika testing, ticks and disease, dental services, pollution and more.

Stat: Psychiatry Group Tells Members They Can Discuss Trump's Mental Health
A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures — even the president. The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior. (Begley, 7/25)

The Washington Post: Monthly Shot Could Be The ‘Next Revolution’ In HIV Therapy, Replacing Daily Pills
HIV/AIDS is no longer the death sentence it once was, but maintaining the strict regimen required to keep the virus at bay — one or more pills daily — still poses a major challenge to many people who are infected. Adherence is low among some populations, given the effort that is required to obtain, keep and store the medications. That may soon change. On Monday, scientists reported an important advance in the development of a long-acting antiretroviral shot. According to an international study involving 309 patients, an injection that combines two drugs, cabotegravir and rilpivirine, appears to be as safe and effective at suppressing HIV as the daily oral regimen. (Cha, 7/24)

The Washington Post: New Zika Testing Recommendation Issued For Pregnant Women
Federal health officials are changing their testing recommendations for pregnant women who may be exposed to the Zika virus through travel or sex or because of where they live. In updated guidance released Monday, the Centers for Disease Control and Prevention is no longer recommending routine testing for pregnant women without any Zika symptoms but who may have been put at risk because they have traveled to a region where Zika is circulating. (Sun, 7/24)

The Washington Post: A New Way To Fulfill The Single Biggest Need Of Poor Patients: Teeth
Larry Bays has seen his share of hard times, but on this day he was blessed. The 71-year-old goat farmer from Gate City, Va., had come to the annual free medical clinic held over the weekend here in coal country so his wife, Joyce, could have her asthma and arthritis checked. When her doctor realized she had no teeth, he sent the couple over to a trailer operated by the Mission of Mercy dental team. (Schneider, 7/24)

ProPublica: Has The Moment For Environmental Justice Been Lost?
Given how President Donald Trump has taken aim at the Environmental Protection Agency with regulatory rollbacks and deep proposed budget cuts, it may come as no surprise that the Office of Environmental Justice is on the chopping block. This tiny corner of the EPA was established 24 years ago to advocate for minorities and the poor, populations most likely to face the consequences of pollution and least able to advocate for themselves. (Buford, 7/24)

State Watch

State Highlights: In Special Session, Texas Senate Takes Up Abortion Bills; Ohio's Cost Transparency Law Stalls Amidt Strong Opposition

Media outlets report on news from Texas, Ohio, Pennsylvania, Minnesota, California, Tennessee, Florida, Maryland and Kansas.

Texas Tribune: Texas Senate Tackles Special Session Abortion Bills
Under state Sen. Donna Campbell’s Senate Bill 10, in procedures where complications occur, physicians would be required, within 72 hours, to submit reports to the state health commission that include detailed information like the patient’s year of birth, race, marital status, state and county of residence, the date of her last menstrual cycle, the number of previous abortions, and the number of previous live births. Physicians who failed to comply with the reporting requirements would face a $500 fine for each day of each violation. (Smith, 7/24)

Texas Tribune: Texas Senate OKs Maternal Mortality Task Force
State senators on Monday tentatively approved a bill that would give a state task force more time to study why an alarming number of Texas mothers are dying less than a year after childbirth. Under Senate Bill 17, the state’s Task Force on Maternal Mortality and Morbidity would be able to continue its work until 2023. (Evans, 7/24)

Kaiser Health News: Price Transparency In Medicine Faces Stiff Opposition — From Hospitals And Doctors
Two years after it passed unanimously in Ohio’s state Legislature, a law meant to inform patients what health care procedures will cost is in a state of suspended animation. One of the most stringent in a group of similar state laws being proposed across the country, Ohio’s Healthcare Price Transparency Law stipulated that providers had to give patients a “good faith” estimate of what non-emergency services would cost individuals after insurance before they commenced treatment. (Bluth, 7/25)

The Philadelphia Inquirer/Philly.com: New Five-Year Contract Between Independence And Jefferson
Independence Blue Cross is pushing for new contracts with area health systems that accelerate the hoped-for transition from paying for volume of services to paying for positive results. But it is not taking a one-size-fits-all approach. “We need to adapt to different providers” because they have “different states of readiness,” Anthony V. Coletta, president of Facilitated Health Networks at Independence, said Monday after the announcement of a contract with Jefferson Health that starts Sept. 1 and will last five years. (Brubaker, 7/24)

The Star Tribune: Minneapolis Proposal To Restrict Menthol Tobacco Sales Sparks Debate
While public health advocates pushed for the restrictions at a packed public hearing — arguing that tobacco companies target black smokers and young people with menthol products — Minneapolis store owners said it's the latest example of City Hall overreach and would devastate their livelihoods. ...The City Council heard from dozens of speakers Monday in crowded council chambers and is expected to vote on the policy in August. (Belz, 7/24)

San Francisco Chronicle: Jahi McMath’s Family Wins Backing For Argument That She’s Alive
It’s been more than three years since 13-year-old Jahi McMath was declared dead after something went terribly wrong following throat surgery at Children’s Hospital Oakland. Her family has never accepted the declaration and has kept her on life support ever since — and in a new twist, a prominent neurologist says recent videos of the girl show she is alive, with a partially functioning brain. (Johnson, 7/24)

The Philadelphia Inquirer/Philly.com: Horizon Blue Cross Ordered To Turn Over Omnia Documents
The New Jersey Supreme Court on Monday ordered Horizon Blue Cross Blue Shield, the state’s largest health insurer, to turn over a McKinsey & Co. report and other documents it used to establish two tiers of health systems for an insurance plan introduced in 2015. Providers in the second tier, including Capital Health System Inc. and St. Peter’s University Hospital Inc., sued, alleging that Horizon treated them unfairly and breached their contracts when it set up the tiers for its Omnia insurance plan. At the seven Tier One health systems in the Omnia Health Alliance consumers have lower out-of-pocket costs. (Brubaker, 7/24)

Texas Tribune: Texas To Lose Galveston And Hill Country Children's Therapy Providers
Children in the Galveston and Hill Country areas are going to be without state-funded speech, occupational and physical therapy services as two more providers prepare to leave the Early Childhood Intervention program. The Texas Health and Human Services Commission confirmed Monday that the University of Texas Medical Branch and Hill Country MHDD Centers are ending services through the program. (Evans, 7/24)

Nashville Tennessean: Children's ER At TriStar Centennial Opens
A new children's emergency room in Nashville — the city's second — is now seeing patients. The first patient at The Children's Hospital at TriStar Centennial arrived at 9:21 a.m. on July 24 to the new seven-bed, 6,000-square foot facility on the hospital's campus in Midtown Nashville. (Fletcher, 7/24)

Columbus Dispatch: Mount Carmel Adding 80 Beds For Mental-Health Treatment
Mount Carmel Health System and Acadia Healthcare announced on Monday that they are teaming up to open an 80-bed inpatient behavioral health hospital in Columbus to replace a 20-bed hospital at Mount Carmel West hospital in Franklinton. Officials say they are still finalizing a site for the $26 million, 64,300-square-foot freestanding facility that will have units for adult and geriatric patients as well as for dual-diagnosis patients — those who are suffering from both mental-health and drug-addiction illnesses. (Viviano, 7/25)

The Baltimore Sun: CVS Opens First Maryland Hearing Center
CVS Pharmacy opened its first Maryland hearing center in an Ellicott City store, as part of the drug store chain’s move to capture more health related business in its retail outlets. The store, which sells and services hearing aids, is staffed by audiologists and can provide hearing screenings and fittings. Insurance is accepted for some services. (Cohn, 7/24)

Cleveland Plain Dealer: Johnson Amends Cleveland 'Lead Safe' Law Proposal To Exclude Owner-Occupied Homes
Cleveland City Councilman Jeff Johnson, after hearing from a slew of residents said today he's changing the 'Lead Safe' ordinance he plans to propose next month so that it excludes mandatory compliance and fines for homeowners who live in their properties. The ordinance -- which proposes that all city homes built before 1978 be certified safe from lead hazards by 2021 -- would still apply to rentals and apartments, which comprise the majority of the city's homes, as well as child care centers and schools constructed prior to 1978, Johnson said. (Dissell and Zeltner, 7/24)

KCUR: Safety Net Clinic To Reopen Facility In Quindaro Neighborhood 
Southwest Boulevard Family Health Care, a safety net clinic in Kansas City, Kansas, will reopen its Quindaro facility after several years’ hiatus. The satellite clinic will be located in a church building owned by Family Health Care. Initially, it will be open a couple of half-days per week and, depending on demand, may increase its hours of operation. (Margolies, 7/24)

Editorials And Opinions

Tough Takes On The GOP's Health Legislation Strategy: A New Level Of Cynicism; 'A Tattered Band-Aid'

Opinion writers offer critiques of the GOP health plans, their strategies and how it could all play out for them in the next election.

The Washington Post: Senate Republicans Take Cynicism To A Horrifying New Level
We are hurtling toward a health-care disaster in the next 36 hours or so, for the worst possible reason. Cynicism is seldom completely absent from the operation of politics, but this is truly a unique situation. Republicans are set to remake one-sixth of the American economy, threaten the economic and health security of every one of us and deprive tens of millions of people of health-care coverage, all with a bill they haven’t seen, couldn’t explain and don’t even bother to defend on its merits. (Paul Waldman, 7/24)

The Wall Street Journal: Can Republicans Govern?
Mitch McConnell is scheduling another showdown vote in the Senate—the third attempt—as early as Tuesday on a motion to proceed to debate on health reform. Succeed or fail, the Republican Majority Leader is right to demand this moment of political accountability. (7/24)

The Wall Street Journal: If Mitch McConnell Fails To Repeal Obamacare, He Should Blame Himself First
Few people in America rode into 2017 higher than Senate Majority Leader Mitch McConnell (R-Ky.). After leading Republicans to the Senate majority in 2014 and blocking President Barack Obama from filling the late Justice Antonin Scalia’s Supreme Court seat, McConnell helped the GOP hold the Senate last fall to deliver the first unified Republican control of government in a decade. Just six months later, though, McConnell is staring at a dramatic reversal of fortunes, facing a full-blown rebellion among the Republican senators he leads and serious doubts about his leadership ability. (Adam Jentleson, 7/25)

The New York Times: How The Health Bill Could Cost Senators In The Next Election
One of the health care bills under consideration by Republican leaders would take health insurance away from 32 million people over the next decade, creating a cohort of Americans who could be motivated to vote against senators who approved the measure. The Senate could vote as early as Tuesday, but it is not yet clear which of the two bills in contention that the majority leader, Mitch McConnell, intends to bring up. The plan that would leave 32 million without coverage would repeal some of the most important parts of the Affordable Care Act without any replacement. (Vickas Bajaj and Stuart A. Thompson, 7/24)

Los Angeles Times: A Tattered Band-Aid: Senate GOP's $200-Billion Obamacare Cushion Would Run Out In Two Years
As Senate Republicans rush pell-mell toward a Tuesday vote on an Obamacare repeal bill that most, if not all, still haven’t seen, a new study examines one of the givebacks the GOP leadership has offered anti-repeal senators to bring them on board. The sweetener is a $200-billion fund for the 31 states that expanded Medicaid under the Affordable Care Act, to be paid out starting in 2022. Since the GOP bill would eliminate the Medicaid expansion, the ostensible idea is to help them cushion health insurance costs for those states and their Medicaid enrollees forced to transition to the ACA’s individual insurance exchanges. (Michael Hiltzik, 7/24)

The Washington Post: Every Republican Health-Care Plan So Far Would Cause Great Harm To The Nation
The Senate has been deadlocked on repealing and replacing Obamacare all month, but Majority Leader Mitch McConnell (R-Ky.) announced Monday afternoon that the chamber would vote Tuesday on . . . well, on something. The scrambling reflected a basic fact: Every major Republican proposal put forward so far would mean millions of Americans would lose access to health care. Each plan would theoretically fulfill a GOP campaign promise while inflicting serious harm on the nation. (7/24)

Los Angeles Times: Lessons From The GOP's Mostly Dead Healthcare Plan
Hill-watchers say the Republicans so badly need to pass something that they might just surprise everyone and pass … something today. Maybe. But whatever the Senate passes will not be an actual repeal of Obamacare, never mind an actual replacement. (It can’t be. Since Senate Majority Leader Mitch McConnell [R-Ky.] and company can’t or won’t work with Democrats — and vice versa — they are trying to pass their bill using the budget reconciliation process, which is rather limited in scope, but only requires a simple majority.) And even if the miracle happens, the immensely unpopular legislation must then go to conference, and after that go back to both chambers for more voting. It will look less like sausage getting made and more like an elaborate, rolling, mortuary makeover. (Jonah Goldberg, 7/25)

USA Today: GOP Health Bill Pits Freedom Of Choice Against Freedom From Fear
What is the health care debate all about? Freedom. Specifically two different conceptions of freedom. One is freedom to buy what you want. In this view, the country is a collection of 325 million individuals, and freedom is everyone pursuing their lives without interference. The other is freedom from worry. It views America as a community, and freedom is knowing you can get help when you are sick and in need. (Ezekiel J. Emanuel, 7/24)

The Kansas City Star: Pat Roberts, Nancy Pelosi And Passing A Health Care Bill To Find Out What’s In It
Kansas Sen. Jerry Moran has been lavished with attention lately. Which is what happens when you buck your party to save Obamacare one day and the very next time the sun comes up, announce that you support a doomed GOP plan to kill the Affordable Care Act and replace it with nothing but hearty best wishes for all Americans. If Moran now sticks with his party after all and green-lights legislation he has said would hurt his constituents, he’s going to wish he hadn’t distinguished himself in the first place. (Melinda Henneberger, 7/24)

Arizona Republic: John McCain Hands Gov. Doug Ducey His Health Care Vote
Until McCain’s tweet, [Doug] Ducey was nothing more than an observer in the health care debate going on in Washington. He could – if he chose to do so – complain about what senators might do in restructuring or abolishing the Affordable Care Act, but he would bear no measure of blame for their work. Now, he has a say. (EJ Montini, 7/24)

New Orleans Times-Picayune: Health Care Speech Might Be Donald Trump's Most Cynical One Yet
Trump, certainly the most prolific prevaricator who has ever rested his head at the White House, says that the Democrats' promises regarding the Affordable Care Act all amount to a "big, fat lie."If the Republicans had presented anything to make it easier for those families Trump trotted out, then maybe it would be fair to accuse the Democrats of overselling the Affordable Care Act.  But the Republicans aren't really offering much - if anything -- to help those who are struggling to pay their medical bills. (Jarvis DeBerry, 7/24)

Ideas About Issues: The Right Answers On Health Policy Are Beyond Politics; Could The Free Market Deliver A Solution?

Columnists offer thoughts on these issues as well as who has gained ground with Obamacare, how self-employed people are bracing for change and the future of single-payer concepts.

The Columbus Dispatch: Cast Aside Politics, Get Health Care Right
If you want to know what’s wrong with the never-ending political battle being fought in Washington to get rid of the Affordable Care Act, look no further than the lives, families, and communities that have been destroyed by opioid addiction all across America. Opioid addiction is a crisis ripping the heart out of our country. And every plan that’s been put forward by the Republican leadership in Congress takes a blow torch to the most important preventive care and treatment that’s currently covered by health insurance for those caught in the grip of addiction. If the Republicans get their way, that coverage goes away, and with it goes the best hope — and maybe the only real hope — that families and communities have to overcome the ravages of this terrible disease. (Joe Biden, 7/25)

Bloomberg: Obamacare's Big Win: It Helps Some People Be A Little Less Poor
There are some eternal debates that may never be settled. If there is a God, why does God allow evil in the world? Great taste, or less filling? And of course, does Medicaid make people healthier? I’m not going to rehash that last debate here, which I have covered many times. Suffice it to say that while liberals insist that the evidence is clear that health insurance expansions improve physical health, at least modestly, I do not see that the evidence warrants the confidence they exude. The intuitive sense that this ought to be correct seems to me to be doing a lot of heavy lifting in these evaluations. In health care, our intuitions are often wrong. (Megan McArdle, 7/24)

Modern Healthcare: Self-Employed People Weigh Returning To Corporate Jobs If Senate Passes ACA Repeal Bill
Steven DeMaio of New York City has been happily self-employed as a writer and editor since 2008. At that time, he felt comfortable leaving a corporate job with health benefits and going out on his own because the state where he then lived, Massachusetts, had established a system guaranteeing affordable individual-market coverage without regard to health status. But DeMaio, 46, recently decided to look for a corporate job with health benefits because of uncertainty over the future of his health insurance posed by Republican efforts to repeal and replace the Affordable Care Act. As of Aug. 1, he will begin working for a company that offers a group health plan. (Harris Meyer, 7/24)

RealClear Health: Single-Payer Health Care Looms As 2020 Campaign Issue
With 115 co-sponsors, a House bill that calls for single-payer health insurance now enjoys majority Democratic support in the lower chamber. Paired with Bernie Sanders’ presidential campaign, which helped bring national attention to the issue, some observers say that a single-payer push may become part of Democrats’ platform in 2020. (Ford Carson, 7/25)

Los Angeles Times: Single Payer Can't Happen In California. At Least, Not Right Away
Given the dismal state of healthcare reform in Washington, liberal Californians have rallied around the idea that the state should establish a single-payer program. Although in the future such a system would be workable and desirable, the reality is that at the moment a single-payer bill cannot pass. Fighting for one in the immediate term is a waste of time. Financing, first of all, is a heavy lift. In addition to higher state taxes, California would need to channel Medicare and other federal healthcare funding into the single-payer system. Before it can do that, Congress must pass a waiver and the president must sign it — which isn’t going to happen while Donald Trump is in office. (Steve Tarzynski, 7/25)

Viewpoints: Talking About Suicide; Military Life's Toll On Women; Listening To Patients

Here's a review of editorials and opinions on a range of public health issues.

The New York Times: Let’s Talk About Suicide
Chester Bennington, the lead singer of the band Linkin Park, was found dead on Thursday in his home near Los Angeles. The coroner’s office has confirmed that the 41-year-old died of suicide. That’s something I — and so many millions of other Americans suffering from mental illness — have considered. ... more often than not, we don’t talk about mental health. And shows like Netflix’s “13 Reasons Why” or artists like indie pop singer Lana Del Rey have sensationalized or glamorized mental illness and suicide rather than taking it seriously. Worldwide, 350 million people (that’s 5 percent of the population) suffer from depression every day. And they are suffering – and sometimes dying – in silence because we can’t seem to talk openly about mental health. (Robert Rigo, 7/24)

Stat: Protecting Interns And Other Physicians From Depression And Suicide
This month, more than 25,000 medical school graduates will begin working at hospitals and medical centers across the United States. By the end of September, nearly one-third of these new doctors could become depressed and 24 percent could have thoughts of suicide. First-year interns often move away from family and friends to start the next chapter of intensive training. It is an exciting time, but also a difficult time. A recent study in Academic Medicine confirms that their suicide risk is highest in the early months of training. (George Keepers and Mary Moffit, 7/24)

Los Angeles Times: What Military Recruiters Aren't Telling Women: You'll Face Disproportionate Health Risks
Recently, 18 brave women graduated from the U.S. Army Infantry School, pioneers headed for fully gender-integrated “ground close-combat” units. Women have long served valiantly and effectively in almost every military role, but now they are tackling extremely physical combat jobs that, until recently, were designated men-only. ... In this push for more female recruits, it’s not at all clear that young women — or the civilian population in general — understand the unique, disproportionate health risks women face in combat roles. The dangers, which have been known for decades, will undoubtedly be exacerbated as women serve in the most physically demanding units. (Julie Pulley and Hugh P. Scott, 7/25)

Bloomberg: Trump's Quiet Progress On Veterans Affairs
[I]n one area, Veterans Affairs, there actually has been progress. Since the Senate approved his appointment unanimously in February, Secretary David Shulkin has sought to improve accountability at hospitals by publicly posting wait times and care-quality data, and has extended much-needed mental health services to veterans with less-than-honorable discharges. Even Congress has made a contribution, passing a bill to streamline the agency’s hiring and firing processes -- legislation that Trump signed and tweeted about three times. (Mark Whitehouse, 7/24)

WBUR: Against Medical Advice: Sometimes, When Patients Defy Accepted Wisdom, So Must Doctors
Keeping the whole patient in view, including the social challenges they will return to after their short stint in a hospital, is as much a part of medical decision-making as the understanding of disease, or selection of the right medication. While this lesson is far from new — you'll hear it taught to every medical student across the country — it is much harder to apply it in practice than to learn in principle. (Abraar Karan, 7/24)

Cincinnati Enquirer: Heroin Epidemic Must Be A Priority
Currently, human services funding is allocated towards increasing gainful employment, reducing homelessness, and preventing violence, all in need of our attention. Heroin is often a component of these other issues but the acute nature of this crisis demands prioritized attention not secondary. (Amy Murray, 7/24)

RealClear Health: Ending The Opioid Epidemic: Only The US Can Stop China’s Counterfeit Pharmaceutical Trade
The United States is facing an explosion of counterfeit opioids from China. Illegal synthetic opioids like carfentanil and fentanyl are being packaged as legal prescription opioids (like oxycodone) and sold on the black market. The US has dealt with counterfeit drug scandals before, notably in 2008 when 149 Americans died from a counterfeit blood thinner found to have originated in China. Today, counterfeit opioid compounds with carfentanil and fentanyl are blamed for the sudden increase in overdose deaths in the United States, making drug overdoses the current leading cause of death for Americans under age 50. (Emily Foecke Munden, 7/25)

Sacramento Bee: Reparations For Drug War? Consider It California
The same people who went to prison in disproportionate numbers for selling marijuana are on the verge of being cut out of California’s multibillion-dollar legal marijuana industry – and, without help, could even become victims of it. ...Together, they are demanding that local governments adopt a reparations strategy that would begin to repair the damage done to communities of color. (Erika Smith, 7/24)

The Kansas City Star: Scrutiny Of Overland Park Pain Doctor Highlights Challenge Of Fighting Opioid Addiction
An Overland Park doctor is in the crosshairs of an expanding investigation into the business practices that are fueling American’s addiction to opioids. The records of Steven Simon of The Pain Management Institute have been seized by the FBI. He earns more than only a handful of other doctors in the U.S. from payments by drug manufacturers to promote both opioids and the medications that treat side effects of the drugs. It’s a revenue stream that can influence doctors to write more prescriptions. (7/23)

USA Today: Trump Budget Would Set Back Global AIDS Fight Just When We're On Track To Win It
When we started our HIV/AIDS Initiative at Saddleback Church 13 years ago, we reminded our congregation, “If you’re going to be like Jesus, you have to learn to be compassionate toward people when they’re sick.” Even in this time of tight budgets, America’s leaders should show precisely this kind of compassion for our brothers and sisters living with HIV and AIDS in Africa and around the world. (Rick and Kay Warren, 7/25)

The New York Times: Fixes: The Tasmanian Hep C Buyers’ Club
In 2014, when Greg Jefferys’s urine started smelling like dead meat, he knew there was something seriously wrong. For weeks, Jefferys, an Australian then 60 years old, had felt fatigued and noticed that just a slight bump would leave a dark purple bruise on his skin. Blood tests revealed to Jefferys that he had chronic hepatitis C – a disease he’d never heard of. (Sophie Cousins, 7/25)