KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Health Law

Trump Threatens Lawmakers' Own Insurance If They Don't Pass A Health Bill

President Donald Trump, following the defeat of the GOP health proposal, says Republicans looked "like fools" and should not give up on passing legislation.

The New York Times: Trump Tells G.O.P. Senators Not To Be ‘Total Quitters’ On Health Bill
President Trump on Saturday scolded Congress for looking “like fools” and urged Republican senators not to be “total quitters” as he insisted that his push to overhaul the nation’s health care law remained viable, the day after it was rejected by the Senate. To reinforce his demand, the president threatened to cut lawmakers’ own health insurance plans if Congress failed to revive the flagging seven-year effort to roll back the medical care program of former President Barack Obama. (Haberman, 7/29)

USA Today: After Big Staff Shake-Up, Trump Again Calls For New Health Care Plan
Trying to move forward after a big staff shake-up, facing issues ranging from North Korea to his own attorney general, President Trump said Sunday that Republicans should keep trying to repeal and replace Obamacare — while a top aide suggested Trump would pursue the same goal by cutting regulations. "Don't give up Republican Senators, the World is watching: Repeal & Replace," Trump tweeted early in the day. (Jackson, 7/30)

The Washington Post: Trump Insults And Threatens GOP Senators In Long Rant After Health Bill Failure
Trump's multi-chaptered and occasionally self-contradictory rant kicked off Friday morning, shortly after three Republican senators joined every Democrat to sink the GOP's last-ditch effort to overturn Obamacare, 51 to 49. At first, Trump seemed resigned to let the Affordable Care Act, also referred to as Obamacare, take its course, convinced that the program will fail and force Congress to replace it. (Selk, 7/29)

The Hill: Trump Threatens Health Insurance Benefits For Lawmakers
The second portion of the tweet referenced congressional health benefits. Members of Congress and many staffers were removed from Federal Employee Health Benefits structure and put into the new insurance exchanges set up by ObamaCare in 2010. The Office of Personnel Management under the Obama administration said members of Congress could obtain subsidized insurance through Washington, D.C.'s health insurance exchange. (Manchester, 7/31)

Politico: Mulvaney: No Other Votes Until Senate Votes Again On Health Care
The Senate should not vote on anything else until it’s voted again on repealing Obamacare, White House budget director Mick Mulvaney said Sunday. Mulvaney said that “yes,” it's official White House policy that the Senate shouldn’t hold a vote on another issue — not even an imminent crisis like raising the debt ceiling— until the Senate votes again on health care. (Klimas, 7/30)

Insurer Subsidies Once Again Taken Hostage In Health Debate After GOP Fails To Advance A Bill

President Donald Trump tweeted that unless Congress passes health care legislation, he'll end insurer subsidies, which would have a major impact on the individual marketplace. Meanwhile, that's just one action out of several that the Trump administration can take to undermine the Affordable Care Act.

The Wall Street Journal: Key Issue In Health-Care Battle: Insurance Subsidies
As health insurers weigh their commitments to the Affordable Care Act’s exchanges for 2018, they point to a key issue that will affect the rates they would charge and indeed whether they will participate at all: Federal subsidies known as cost-sharing reduction payments. Those payments are likely to be a major focus as the industry pushes Congress to pass legislation aimed at stabilizing the exchanges. (Mathews, 7/28)

The Wall Street Journal: Donald Trump Threatens To Cancel Some Health-Care Benefits For Lawmakers
For months, Mr. Trump has threatened to stop reimbursements to insurance companies—a part of the ACA—but his administration has always paid them in the end, including amid significant uncertainty in June and at a crucial moment in GOP negotiations just a week ago in July. The next set of payments, which total millions of dollars for insurers that have lowered deductibles and other out-of-pocket costs for the poorest enrollees in coverage under the law also known as Obamacare, is due in three weeks. (Radnosfky, 7/29)

Los Angeles Times: Stymied In Bid To Scrap Obamacare, Trump To Decide This Week Whether To Block Subsidies
A pair of prominent lawmakers urged President Trump on Sunday not to sabotage the Affordable Care Act, or Obamacare, in the wake of failed Republican efforts to scrap his predecessor’s signature legislative achievement. But Trump urged GOP senators to try again to push through some version of repealing and replacing the law, even though Senate Majority Leader Mitch McConnell (R-Ky.) said last week it was time to move on to other matters. (King, 7/30)

The Wall Street Journal: GOP Senator Says Trump’s Health-Payment Cuts Would Hurt Poor
Sen. Susan Collins, one of three Republican senators who blocked the GOP’s health-care bill last week, on Sunday said President Donald Trump’s threatened cuts in payments to insurers would be “detrimental” to America’s poor. The secretary of health and human services, meanwhile, was noncommittal about the payments and also declined to say whether the Trump administration would enforce the portion of the Affordable Care Act that generally requires individuals to carry health insurance. (Burton, 7/30)

The Hill: Collins: Trump's Threat To End ObamaCare Payments Won't Change My Vote
“It would not affect my vote on healthcare, but it’s an example of why we need to act: to make sure that those payments, which are not an insurance company bailout, but rather help people who are very low-income afford their out-of-pocket costs toward their deductibles and their co-pays,” Collins said. “It really would be detrimental to some of the most vulnerable citizens if those payments were cut off.” (Carter, 7/30)

Politico: Lawsuits Could Force Feds To Pay Obamacare Insurers
A pending court decision could force the Trump administration to pump billions of dollars into Obamacare insurers, even as the president threatens to let the health care law “implode.” Health insurers have filed nearly two dozen lawsuits claiming the government owes them payments from a program meant to blunt their losses in the Obamacare marketplaces. That raises the prospect that the Trump administration will have to bankroll a program the GOP has pilloried as an insurer bailout. (Demko, 7/30)

The Wall Street Journal: Health Bill’s Defeat Roils Republicans, Insurers
The abrupt collapse of Republicans’ bid to rework the U.S. health-care system opened a new chapter of uncertainty for insurers, medical providers and millions of Americans on Friday, as officials weighed divergent options for the road ahead. Insurers had been anxious about a fallback legislative plan crafted by Republicans that would strip a handful of elements from the 2010 Affordable Care Act they believed were integral—chiefly, the requirement that individuals buy coverage or pay a penalty. By Friday morning, that plan had fallen apart after a surprise defection of Republican senator John McCain. (Radnofsky, Mathews and Hackman, 7/28)

Reuters: Hundreds Of Counties At Risk For No Obamacare Insurer In 2018
With Republican efforts to dismantle Obamacare in disarray, hundreds of U.S. counties are at risk of losing access to private health coverage in 2018 as insurers consider pulling out of those markets in the coming months. Republican senators failed this week to repeal and replace Obamacare, former President Barack Obama's signature healthcare reform law, creating new uncertainty over how the program providing health benefits to 20 million Americans will be funded and managed in 2018. (Humer, 7/28)

The Star Tribune: Minnesota Health Insurance Shoppers Brace For New Rates
People who buy health insurance on their own are about to experience what’s become a dreary summer ritual — the first look at next year’s premiums. The state Commerce Department on Monday is scheduled to release preliminary rate requests from health insurers for the roughly 170,000 people who buy individual policies. (Snowbeck, 7/30)

Price: ACA Is Law Of Land, And It's Still HHS' Responsibility To Implement It

Health and Human Services Secretary Tom Price, however, also said that the law was failing the American people and the goal is to put a system in place that works for patients.

Politico: HHS Secretary Pledges To Implement 'Law-Of-The-Land' Obamacare
“Our job is to follow the law of the land, and we take that mission very, very seriously,” Price said. “The role of the Health and Human Services Department is to improve the health, the safety and the well-being of the American people. And what we understand, what the American people understand, is that their health and well-being is being harmed right now by the current law.” (Klimas, 7/30)

Lawmakers Turn Toward Fixes To Affordable Care Act That Have History Of Bipartisan Support

Among the provisions getting a look from a bipartisan working group are the employer mandate, creating a stability fund that states can tap to help deal with premiums and scrapping Obamacare’s medical-device tax.

Politico: Centrist Lawmakers Plot Bipartisan Health Care Stabilization Bill
A coalition of roughly 40 House Republicans and Democrats plan to unveil a slate of Obamacare fixes Monday they hope will gain traction after the Senate’s effort to repeal the law imploded. The Problem Solvers caucus, led by Tom Reed (R-N.Y.) and Josh Gottheimer (D-N.J.), is fronting the effort to stabilize the ACA markets, according to multiple sources. But other centrist members, including Rep. Kurt Schrader (D-Ore.), and several other lawmakers from the New Democrat Coalition and the GOP’s moderate Tuesday Group are also involved. (Caygle and Demko, 7/30)

The Hill: Dems Pivot To Offering ObamaCare Improvements
House Democrats are poised to advance a flood of proposals designed to address the problems dogging President Obama's signature healthcare law — a move that puts pressure on Republican and Democratic leaders alike. The strategy marks a pivot for the Democrats, as party leaders have throughout the year discouraged members from offering improvements to the Affordable Care Act (ACA), fearing they would highlight problems with the law and divert attention from the Republicans’ months-long struggle to repeal and replace it. (Lillis, 7/29)

The Washington Post: What’s Next For The Affordable Care Act Now That Repeal Has Failed?
The Affordable Care Act has reshaped the nation’s health-care landscape in a way the country has not seen since the passage of Great Society programs in the 1960s. For more than seven years, it has been the foundation for a slew of new regulations and a massive redistribution of funds within the medical system. And it has changed what Americans expect of their government — which is why Republicans, despite having used the ACA as a political rallying cry for seven years, have encountered such difficulty in peeling it back. (Eilperin, 7/28)

The New York Times: How To Repair The Health Law (It’s Tricky But Not Impossible)
Republicans have failed to repeal and replace the Affordable Care Act. Now, can it be repaired? The seven-year-old law has survived Supreme Court decisions and aggressive attempts to extinguish it by Republicans in Congress and the White House. But even people who rely on its coverage agree that it still has big problems. The question for the roughly 20 million Americans who buy their own health coverage — and for millions of others who remain uninsured — is what can realistically be done to address their main concerns: high prices and lack of choice in many parts of the country. (Abelson, Goodnough and Thomas, 7/29)

The CT Mirror: Blumenthal, Murphy Join Dem Chorus On Bipartisan ACA Fix, But That May Be Elusive
On Friday morning, Schumer. D-N.Y., spoke with House Speaker Paul Ryan about doing something insurers say will help stabilize the market for individual insurance policies that are at the center of Obamacare. Insurers want assurances the federal government will continue to pay cost-sharing reduction subsidies that lower the cost of co-pays and deductibles for lower-income Americans who purchase policies on state exchanges like Connecticut’s Access Health CT. (Radelat, 7/28)

Bloomberg: Republicans Face Tough Choice: Repeal Obamacare Or Cut Taxes
After the collapse of Obamacare repeal, Republicans may have to choose between pursuing another health bill or pushing through a tax overhaul this year, because there’s almost certainly not enough time to do both. And that’s not even their biggest problem -- which is, they can’t agree on either. (Dennis, 7/31)

The Death Knell Came With McCain's Thumbs Down, But The Path To Failure Was Quite Long

A ruling party that never expected to win. A conservative base long primed to accept nothing less than a full repeal. An overpromising and often disengaged president with no command of the policy itself and little apparent interest in selling its merits to the public. These are just a few of the reasons experts cite on why the Republicans failed. The New York Times and other media organizations take a deep dive on what went wrong. (And in the case of Democrats -- what went right).

The New York Times: Behind Legislative Collapse: An Angry Vow Fizzles For Lack Of A Viable Plan
The closing argument was a curious one: Vote yes, Republican leaders told the holdouts in their conference. We promise it will never become law. After seven years of railing against the evils of the Affordable Care Act, the party had winnowed its hopes of dismantling it down to a menu of options to appease recalcitrant lawmakers — with no more pretenses of lofty policy making, only a realpolitik plea to keep the legislation churning through the Capitol by voting to advance something, anything. They ended up with nothing. (Flegenheimer, Martin and Steinhauer, 7/28)

The New York Times: How Schumer Held Democrats Together Through A Health Care Maelstrom
Over the past week, as Senate Republicans feverishly cobbled together their doomed health care bill, Chuck Schumer, the Democratic leader, made several quiet visits to the private “hideaway” office of John McCain, Republican of Arizona, near the Senate chamber on the Capitol’s first floor. Senator McCain, who recently received a brain cancer diagnosis, was nervous about the bill, which he thought would harm people in his state, and elegiac about members of his storied family, reminiscing about them at some length. (Steinhauer, 7/29)

Politico: How Republicans Got Stuck On Repeal
Republicans openly speculated in November whether they could fast-track an Obamacare repeal bill to Donald Trump's desk by Inauguration Day or whether they might need just a few days longer. But Congress got stuck. Its last-ditch attempt to pass a "skinny" bill to kill a few pieces of the health law — many of which Trump could have abolished himself with an executive order — collapsed. (Haberkorn, 7/31)

The Associated Press: Leaders In McCain's Home State Frustrated By Repeal Failure
Sen. John McCain sent shockwaves through the Senate early Friday morning when he cast the deciding vote rejecting the GOP's heath care effort to repeal and replace the Affordable Care Act. While his dramatic thumbs-down rejection drew gasps and cheers in Washington, D.C., leaders in Arizona have responded with a mixture of disappointment and frustration — but little in the way of direct criticism in this Republican-heavy state. (7/28)

USA Today/Arizona Republic: What Ducey Told McCain Ahead Of His Big Vote To Kill GOP 'Repeal' Bill
Throughout U.S. Senate deliberations over a proposed repeal of the Affordable Care Act, Sen. John McCain repeatedly invoked the name of Gov. Doug Ducey, saying he wanted to ensure any new law didn't punish their home state of Arizona. "My position on this proposal will be largely guided by Governor Ducey's analysis of how it would impact the people of our state," McCain, R-Ariz., said Thursday during a news conference hours before the late night vote in which he would give a thumbs down to the Senate GOP's so-called "skinny repeal" bill. (Nowicki and Sanchez, 7/30)

Politico Pro: The New Rules Of Health Reform
The dark-of-night drama that abruptly halted Republicans' troubled Obamacare repeal for now was a fitting end to an irregular process that was surprising from the start. But veterans of previous health care reforms also acknowledge that the norm-shattering strategy was vanishingly close to success. (Diamond, 7/28)

Fall Out From Failure May Haunt GOP: 'I Don't Think This Is Something Voters Are Going To Forget'

Republicans have been promising their voters repeal and replace for seven years. They may have to face the political consequences of not delivering.

The Associated Press: GOP Fears Political Fallout After Health Care 'Epic Fail'
Weary Republicans in Washington may be ready to move on from health care, but conservatives across the United States are warning the GOP-led Congress not to abandon its pledge to repeal the Obama-era health law — or risk a political nightmare in next year's elections. The Senate's failure this past week to pass repeal legislation has outraged the Republican base and triggered a new wave of fear. The stunning collapse has exposed a party so paralyzed by ideological division that it could not deliver on its top campaign pledge. (Peoples and Beaumont, 7/29)

The Washington Post: Republicans’ Failure To ‘Repeal And Replace’ Obamacare May Cost Them At The Ballot Box
The Republican Party’s seven-year quest to undo the Affordable Care Act culminated Friday in a humiliating failure to pass an unpopular bill, sparking questions about how steep the costs will be for its congressional majorities. While lawmakers have not completely abandoned the effort, they are now confronting the consequences of their flop. Not only has it left the GOP in a precarious position heading into next year’s midterm elections, but it also has placed enormous pressure on the party to pass an ambitious and complex overhaul of federal taxes. (DeBonis and Phillips, 7/29)

McClatchy: Party In Peril As Republicans Reel After Obamacare Failure
Republicans have controlled Washington for seven months. They have virtually nothing to show for it. Returning home this week to face voters for the first time since the party failed to get an Obamacare repeal through a Senate where it had a majority, lawmakers are now struggling for a message that they can spin as a win. (Clark and Douglas, 7/30)

By Watching GOP's Efforts, Democrats Just Got A New Playbook On Passing Single-Payer

Democrats have been watching how Republicans used the reconciliation process to get their legislation close to the finish line. Under slightly different circumstances, Democrats are realizing they might be able to use it. “In 2009, what we consistently got from Democratic senators was: Hey, reconciliation was a procedural can of worms. We don’t want to go there,” said Adam Green, co-founder of the Progressive Change Campaign Committee. “Republicans have made very clear that you can go there and push your ideas into law."

The Washington Post: In GOP’s Repeal Failure, Democrats Find A Potential Game Plan
Outnumbered but emboldened, progressive Democrats who watched Republicans fail to unwind the Affordable Care Act are thinking harder about passing major expansions of health-care coverage. For many younger activists and legislators, the push to undo the ACA with just 51 Senate votes is less a cautionary tale than a model of how to bring about universal coverage. (Weigel, 7/30)

The Washington Post: Wary And Weary, Progressives Celebrate Victory Over ACA Repeal
Ben Wikler learned the Affordable Care Act’s fate from a text message. The Washington director of MoveOn.org, who had led nearly daily rallies outside the Capitol to stop repeal, was five hours into the final protest when a colleague passed him her phone, buzzing with texts. “Pence not in chair,” read one text. Wikler read it to the 300 protesters gathered around him, in a circle, who had been taking turns giving speeches. “Murkowski is a no. Let me confirm that. Murkowski is a no.” Then: “McCain is a no.”Wikler read the text out loud. “It was like fireworks going off,” he said in an interview. “Everyone started chanting U-S-A. Strangers were hugging.” (Weigel, 7/28)

The Hill: Sanders: Trump Should Stop His Tweeting Amid Healthcare Debate
Sen. Bernie Sanders (I-Vt.) said on Sunday that President Trump should lay off the Twitter messages amid the ongoing healthcare debate. "Maybe the president should ... stop his tweeting for a while, and understand that America today is the only country, only major country on Earth not to guarantee healthcare for all people," Sanders told host Jake Tapper on CNN's "State of the Union." (Beavers, 7/30)

Nearly Two-Thirds Of Americans Want To Keep Or Modify Obamacare

The Reuters/Ipsos poll also finds that voters want Congress to turn to other issues. Still, the results fall largely along party lines with just three out of 10 Republicans saying they wanted to keep or modify the law. Meanwhile, the most recent failure of Republicans to repeal the Affordable Care Act relieved some Americans.

Reuters: Majority Of Americans Want Congress To Move On From Healthcare Reform: Reuters/Ipsos Poll
A majority of Americans are ready to move on from healthcare reform at this point after the U.S. Senate's effort to dismantle Obamacare failed on Friday, according to an exclusive Reuters/Ipsos opinion poll released on Saturday. Nearly two-thirds of the country wants to either keep or modify the Affordable Care Act, popularly known as Obamacare, and a majority of Americans want Congress to turn its attention to other priorities, the survey found. (Erman, 7/30)

USA Today: Senate Obamacare Repeal Failure A Relief For Some Patients
Bill Rairigh had a high health insurance premium and a $20,000 hospital bill after he had a heart attack in 2007. Then he lost his insurance altogether because of his heart condition. The Affordable Care Act meant he could get insurance again, and at about half the price of his previous premium with only a $300 deductible. (O'Donnell, 7/28)

Californians Breathe Easier After Repeal Efforts Collapse

The state, which has fully embraced the Affordable Care Act, would have been particularly hard hit if the law had been rolled back. Media outlets report on reactions out of Ohio, Florida, Georgia and Connecticut, as well.

Columbus Dispatch: Kasich 'Glad' Health-Care Bill Failed; Calls For Bipartisan Revision Of Obamacare
Ohio Gov. John Kasich said he was “glad” Senate Republicans last week failed to dramatically scale back the 2010 health-care law, but insisted Congress needs to fix some of the flaws in the law known as Obamacare. ... But members of both political parties have acknowledged that revisions are needed to keep alive the state marketplaces created by Obamacare where middle-income families can rely on federal tax credits and subsidies to buy individual insurance policies. (Torry, 7/31)

Orlando Sentinel: Orlando Activists See Opportunity In Failed Health Care Vote
Supporters of the Affordable Care Act in Central Florida had one message to Congress following the Senate vote that struck down a repeal health care act without replacement on Thursday night: it’s not over yet. More than 30 health care activists from organizations including Organize Florida and Planned Parenthood affiliates rallied in downtown Orlando on Saturday for the National Day of Action to reiterate their support for Obamacare. (Padro Ocasio, 7/29)

WABE: Ga. Leaders Must Deal With Existing Health Care Law After Senate Vote
Georgia Gov. Nathan Deal's office says he had been waiting to see what Congress would do on health care, and after an early Friday vote, "we will have to re-evaluate where we are now," according to his spokeswoman Jen Ryan. ...The Georgia Hospital Association says it will work with state leaders and others to solve what it calls "the uninsured crisis." (Capelouto, 7/28)

The CT Mirror: Consternation Over Healthcare, The State Budget And The President’s Pronouncements
For many in Connecticut, it was hard to say which was the more confounding issue last week: federal health care legislation, the development of a state budget, or the behavior of the president of the United States. The healthcare debate was certainly as dramatic and unconventional as it was controversial and significant, since members of the U.S. Senate assembled to vote Tuesday without knowing which version of the healthcare bill — that would potentially affect one sixth of the U.S. economy — would be up for vote. (Stern, 7/30)

Veterans' Health Care

House Sends Bill Extending Veterans Choice Program To Senate

The bill would extend the program for six months and devote $1.8 billion to authorize 28 leases for new Department of Veterans Affairs medical facilities and establish programs to make it easier to hire health specialists.

The Associated Press: House Moves To Extend Choice Program, End VA Budget Crisis
The House overwhelmingly approved a $3.9 billion emergency spending package to address a budget shortfall at the Department of Veterans Affairs that threatens medical care for thousands of veterans. The bill provides $2.1 billion to continue funding the Veterans Choice program, which allows veterans to receive private medical care at government expense. Another $1.8 billion would go to core VA health programs, including 28 leases for new VA medical facilities. (Yen and Daly, 7/28)

The Wall Street Journal: Compromise Veterans Affairs Funding Measure Passes House
House members on Friday voted 414-0 to temporarily extend funding for the Veterans Choice program, which allows veterans to more easily get health-care services in the private sector if they aren’t readily available at Department of Veterans Affairs facilities. However, the bill is considered a stopgap measure, as the funding shortfall likely will arise again just after the new year. (Kesling, 7/28)

The Associated Press Fact Check: Trump Off Base On Vets, Health Payments
President Donald Trump bragged about a mission accomplished in veterans' health care that has not been achieved. He threatened to end health insurers' "bailouts" that actually help consumers. And he cited "tremendous" costs to taxpayers from providing health services to transgender troops without providing evidence of that expense. (7/31)

Administration News

FDA To Regulate Amount Of Nicotine In Cigarettes To Make Them Less Addictive

It will be the first time the government has gone beyond warning labels and taxes if the rule goes through.

Stat: The FDA Wants To Cut Cigarettes’ Nicotine Levels. Will That Help People Quit?
For the first time in history the Food and Drug Administration plans to regulate the level of nicotine in cigarettes, attempting to bring it down to “non-addictive” levels. The move, announced Friday, was praised by scientists — who also noted that there’s no consensus on what a “non-addictive” level of nicotine is. (Swetlitz, 7/31))

The Washington Post: FDA Aims To Lower Nicotine In Cigarettes To Get Smokers To Quit
The Food and Drug Administration said Friday it wants to reduce the nicotine in cigarettes to make them less addictive. The unexpected announcement sent shares of tobacco companies plummeting and sparked praise among some public health advocates. If successful, the effort would be the first time the government has tried to get the Americans to quit cigarettes by reaching beyond warning labels or taxes to attacking the actual addictive substance inside. (McGinley, 7/28)

Bloomberg: Trump’s FDA Chief Charts A Policy Shift Beyond Tobacco Products
Gottlieb, 45, has gained an early reputation for moving swiftly in an executive branch that has been bogged down by political drama and a relatively slow pace in filling key posts across many agencies. It’s not clear whether Gottlieb personally sought President Donald Trump’s counsel before making the bombshell nicotine-reduction announcement, which sent tobacco industry stocks tumbling, but the White House supported the move. (Edney, 7/31)

Public Health And Education

The Next 'Catastrophic' Superbug To Worry About Is Perfect Storm Of Scary Characteristics

Scientists are eyeing the invasive fungus warily. In other public health news: gonorrhea, autism, marijuana and DUIs, weight loss, contraception and more.

Stat: A ‘Perfect Storm’ Superbug: How An Invasive Fungus Got Health Officials’ Attention
try as they might, the infection control specialists at Royal Brompton Hospital could not eradicate the invasive fungus that was attacking already gravely ill patients in the intensive care unit. ... The lengths to which the Royal Brompton was forced to resort to rid the hospital of Candida auris — a member of a broader fungal family named Candida — raised red flags for the small community of scientists who study fungi that infect people. (Branswell, 7/31)

Stat: To Go After Drug-Resistant Gonorrhea, Partners Put A New Spin On Drug Development
That particular sexually transmitted infection is the target of a new drug being developed by Entasis, an antibiotics-focused spin-off from pharma giant AstraZeneca. But they’re getting help: their nonprofit partner, the Global Antibiotic Research and Development Partnership, will be funding the next round of trials and doing studies to ensure this drug keeps working for as long as possible. The partnership is GARDP’s first. (Sheridan, 7/31)

NPR: Autism Symptoms Are Less Obvious In Girls And May Lead To Underdiagnosis
Many more boys are diagnosed with autism every year than girls. According to the Centers for Disease Control and Prevention, the disorder is 4.5 times more common among boys than girls. Boys appear to be more vulnerable to the disorder, but there is some evidence that the gender gap may not be as wide as it appears. (Neighmond and Greenhalgh, 7/31)

NPR: Marijuana DUIs Are Still Too Subjective Say Cops. Why No BreathTest?
This spring, 16 state patrol officers from Colorado and Wyoming took a couple days off their usual work schedule to do something special. They assembled in a hotel conference room in Denver. As instructed, they wore street clothes for their first assignment: going shopping at nearby marijuana dispensaries."It's a brave new world," said instructor Chris Halsor, referring to the years since Colorado legalized recreational marijuana. (Bichell, 7/30)

Los Angeles Times: Maybe This Is Why You Can't Lose The Weight
After decades of pushing single plans and products that didn’t prove effective for a large chunk of the population, the health and wellness industry is finally zeroing in on more precise solutions tailored to the individual. Here’s a look at some of the latest programs, tools and products designed to take your overall health to the next level. (Fulmer, 7/30)

Reveal: Her Own Devices: Is A Contraceptive Implant Making Us Sick?
In Texas, women with limited access to abortions are traveling across the border to find a drug that will induce miscarriages. In Mississippi, anti-abortion groups are opening crisis pregnancy centers across from abortion clinics to persuade women to keep their babies. (7/29)

The New York Times: Charlie Gard Dies, Leaving A Legacy Of Thorny Ethics Questions
Charlie Gard, the incurably ill British infant who died on Friday, could not hear, see or even cry. But his case captured the attention of the pope and the United States president, and raised difficult ethical issues that reverberated around the world. He died with his parents by his side a day after the British High Court ruled that he could be moved to a hospice and that his life support could be withdrawn. His death was confirmed by a family spokesman. (Bilefsky, 7/28)

Los Angeles Times: NIH To Walk Away From $16 Million Of NFL Gift For Brain Research
Five years ago, four months after the suicide of legendary linebacker Junior Seau, the NFL donated $30 million to the National Institutes of Health for brain research. At the time, the league said its “unrestricted gift” was the largest donation in its history and would help fund a new Sports and Health Research Program to be conducted in collaboration with institutes and centers at the NIH. (Farmer, 7/28)

Baltimore Sun: University Of Maryland Scientists Research Gene Linked To Depression
Although medications exist to treat depression, many scientists aren’t sure why they’re effective and why they don’t work for everyone. Researchers at the University of Maryland School of Medicine believe they may have found a key to the puzzle of major depression that could lead to therapies for those who don’t respond to medications already on the market. (Wells, 7/29)

Tampa Bay Times: Advocates Push To Raise Awareness Of Mental Health In Minority Communities
According to the Health and Human Services Office of Minority Health, African Americans are 20 percent more likely to experience serious mental health problems than the general population. Homelessness and domestic violence can increase the group's risk for developing mental illnesses like depression, anxiety, and post-traumatic stress disorder, according to the National Alliance on Mental Illness. (Woodward, 7/28)

Refusal To Prescribe Opioids May Have Fueled Motive In Murder Of Indiana Doctor

A man shot a doctor who refused to write a prescription for his wife, who has chronic pain, before killing himself. Police are still investigating. In other news on the national drug epidemic, Chicago is handing out overdose antidotes to at-risk inmates upon release, Philadelphia aims to clean up and shut down a notorious heroin camp and Ohio doctors are working to cut down on painkiller prescriptions.

The Washington Post: A Doctor Was Killed For Refusing To Prescribe Opioids, Authorities Say
An Indiana man shot and killed himself shortly after gunning down a doctor who refused to prescribe opioid medication to his wife, authorities said this week. The shooting and the suicide unfolded within just hours of each other Wednesday in Mishawaka in northern Indiana, a state that's been gripped by problems with opioid addiction over the past several years. St. Joseph County Prosecutor Ken Cotter told reporters that Michael Jarvis confronted physician Todd Graham for not prescribing an opioid for his wife's chronic pain, but he cautioned that investigators are still determining whether drug addiction played a role in the killing. (Phillips, 7/29)

Philadelphia Inquirer: Lights, Camera, Cleanup For Heroin Camp … But Then What?
“There is this expectation that fences are going to go up and lights are going to go up and it’s problem solved,” said Jose Benitez, executive director of Prevention Point Philadelphia, the health-care provider and needle-exchange that has worked with the community for years. “That is not the way it is going to happen.” No one really knows where the residents of the encampment along the Conrail tracks are going. Most have already left, some into treatment, several dozen to city-funded housing, others joining small homeless clusters under I-95, more likely breaking into abandoned houses nearby. (Sapatkin, 7/30)

Columbus Dispatch: Ohio Doctors Cut Opioid Prescriptions, But Is It Enough?
The amount of opioid pain killers prescribed in Franklin County dropped by 41 percent from 2010 to 2015, but doctors still were prescribing the equivalent of a 14-day supply of the drugs for every person in the county, according to federal data. ... Across Ohio, prescriptions for opioids decreased by at least 10 percent in all but 13 of 88 counties. (Viviano, 7/30)

State Watch

State Highlights: In Ill., Requirements Put More Pressure On Anti-Vax Parents; Federal Judge Blocks Ark. From Enforcing New Abortion Restrictions

Media outlets report on news from Illinois, Arkansas, Massachusetts, California, Texas, Florida, Washington, Vermont, Maryland and Ohio.

Chicago Tribune: New Measures Add Pressure To Anti-Vaccine Parents In Illinois And Across U.S.
Parents with clear-cut religious objections can still opt to send their kids to school without vaccines, as long as they’re willing to meet with a health care provider and receive information about vaccine benefits. But parents who oppose vaccines as unnecessary or dangerous are on shaky ground under a 2015 law that does not recognize philosophical objections. (Schoenberg, 7/30)

Boston Globe: Maternal Deaths In Massachusetts Prompt State Probes
In 2015, the state public health department and the Board of Registration in Medicine, which licenses doctors, issued a statewide advisory on how to identify high-risk obstetrical patients and manage emergencies. They cited 20 deaths over the previous four years, including nine women who were low-risk. (Kowalczyk, 7/29)

Dallas Morning News: How Dallas Dealt Polio A Massive Blow By Vaccinating 900,000 People In Two Days
As temperatures soared into the mid-90s, a steady stream of young and old, rich and poor, families of every race and ethnicity joined the lines. It was probably the largest peacetime mobilization ever undertaken in North Texas, and one that required a mutual trust among government officials, the public and the medical community that seems unfathomable in today’s polarized environment. (Tarrant, 7/30)

Los Angeles Times: Despite Complaints, Judge Says Aliso Canyon Natural Gas Facility Can Reopen
A state appeals court judge ruled Saturday that Southern California Gas Co. can resume operations at its Aliso Canyon natural gas storage facility, the source of the biggest methane leak in the country’s history. On Friday, L.A. County had been granted a temporary restraining order that would have halted the reopening. But a judge ordered the stay lifted on Saturday after the gas company filed a motion opposing the stay. (Karlamangla, 7/29)

Seattle Times: UW Students Create Innovative Devices To Solve Vexing Medical Problems
Last year, there was a national outcry after the price skyrocketed for a medical-injection device that counteracts the life-threatening symptoms of a severe allergic reaction. But for a team of students at the University of Washington, the price jumps for the EpiPen signaled an opportunity — a chance to invent a cheaper device that could do the same thing, only better. (Long, 7/29)

The Washington Post: Medical School Without The ‘Sage On A Stage’
When the University of Vermont's medical school opens for the year in the summer of 2019, it will be missing something that all but one of its peer institutions have: lectures. The Larner College of Medicine is scheduled to become the first U.S. medical school to eliminate lectures from its curriculum two years from now, putting it at the leading edge of a trend that could change the way the next generation of physicians learn their profession. (The medical school at Case Western Reserve University also has a no-lecture curriculum, established when the school opened in 2004.) (Bernstein, 7/29)

Houston Chronicle: Physician Opens Pearland Clinic To Help Uninsured
On a recent Thursday night, a crowd gathered at the new Seva Clinic, a nonprofit facility in Pearland offering free medical care from physicians. "It was crowded," said Hita Dickson who, along with her husband, Jim, serves on the clinic's board. "They had people lined up all the way down the hall and around the corner and even waiting outside. "I think they had 30 people show up and they serviced them all," she said. (Lamkahouan, 7/30)

Cleveland Plain Dealer: Lake Erie An "Outstanding" Drinking Water Source, But Toxins Remain, Report Finds
The Environmental Working Group determined that, in 2015, virtually every large water system in Ohio produced tap water with detectable levels of the same seven or eight contaminants that exceeded health guidelines, but not federal standards. EWG obtained its health guidelines from the latest state and federal scientific research, as well as from health and environmental agencies and EWG's own research, said David Andrews, a senior scientist at EWG. (McCarthy, 7/29)

Los Angeles Times: Pasadena-Based Mental Health Agency To Provide More Direct On-Site Support For Magnolia Park Students
Pasadena-based mental health agency will provide more direct on-site educational support services for special-needs students enrolled at Magnolia Park School for the upcoming school year. The Burbank Unified School District contracted with Hathaway-Sycamores Child and Family Services during a board meeting last week to provide services at Magnolia Park, which offers enrollment for elementary through high school students with significant behavioral and emotional challenges. (Vega, 7/28)

Editorials And Opinions

Perspectives: Repeal, Replace And Monday-Morning Quarterbacking

Opinion writers offer their analysis on what happened last week to the Senate Republican's repeal-and-replace effort -- examining some of the key strategy moves that went awry and highlighting some lessons that could be learned from the process.

The Washington Post: The Single Biggest Lesson From Repeal-And-Replace
Congressional Republicans' misguided effort to reshape the U.S. health-care system, which appeared to collapse early Friday, had the virtue of clarifying where the country stands nearly two decades into the 21st century: Americans want universal health-care coverage, including for the poor and the sick, and they expect the government to ensure that it is provided. Republicans and Democrats can argue about how to meet this end — but if they are wise they will no longer dispute the goal. (7/28)

Los Angeles Times: Ding Dong. Repeal And Replace Is Dead. (For Now)
Early Friday morning, the U.S. Senate came within one thin vote of dropping a megaton legislative bomb on the health insurance markets serving roughly 1 in 10 Americans. Republican senators were so eager to keep their promise to repeal the 2010 Affordable Care Act, yet so unwilling to compromise on a coherent approach to unwinding the law, that 49 of them backed an eight-page, lowest-common-denominator proposal that seemingly every major healthcare trade association and patient-advocacy group had warned would be disastrous for all concerned. The measure even attracted the support of three senators who’d dubbed it a fraud and pledged to vote “yes” only if they were assured the House wouldn’t pass the thing into law. (7/28)

Bloomberg: RIP, Repeal And Replace
Though truthfully, the whole process reads less like a saga than a Christopher Buckley novel. You have a neophyte president who doesn’t know how Washington works, and doesn’t care to learn, and therefore provides none of the leadership that is normally necessary to get a major policy bill through Congress. You have a Republican caucus that spent six years promising to repeal Obamacare without bothering to make plans for, or get a consensus on, how they would actually do so. And thus we were repeatedly treated to the incredible sight of bills that literally no one in the legislature actually wanted, even as they were voting to move them forward. The only way people could bring themselves to cast that “Aye” was by nervously assuring each other that somewhere down the line, someone would come to their senses and stop this thing from actually becoming the law of the land -- the Senate, or the conference committee, or in the most desperate scenario, perhaps the president could … well, I’m sure the conference committee will come up with something we can actually like. (Megan McArdle, 7/28)

The Washington Post: The 7,150 Nuns Who Fought Against Trumpcare
The votes from Republican Sens. Susan Collins, John McCain and Lisa Murkowski to stop their party’s repeal-Obamacare juggernaut were demonstrations of genuine courage. The appearance of this virtue in a dark time is not necessarily miraculous, but I couldn’t help noticing the striking intervention in this debate by 7,150 American nuns who called the Senate GOP’s core proposal “the most harmful legislation for American families in our lifetimes.” (E.J. Dionne, 7/30)

Sacramento Bee: This Is What Should Happen Next On Health Care
Now that the Obamacare repeal has crashed and burned in the U.S. Senate, this is what would happen if we had a president who knew how to govern and a Congress that could work together:There would be a bipartisan summit to come up with ways to fix and strengthen the Affordable Care Act to slow rising premiums and create more competition in California and across the country. (7/28)

The New York Times: Susan Collins And Lisa Murkowski, The Health Vote Heroines
Were you expecting the Republican health care bill to go down with such a thud this week? Definitely a moment to remember. Unless, of course, you accept Donald Trump’s interesting theory that it all worked out exactly the way he wanted. “I said from the beginning — let Obamacare implode and then do it,” the president told a group of law enforcement officers on Friday. This was part of the White House celebration of “American Heroes Week,” which was highlighted by Trump’s surprise effort to discriminate against transgender volunteers in the military. (Gail Collins, 7/28)

Boston Globe: Murkowski And Collins Went Maverick Long Before McCain
Senators Susan Collins of Maine and Lisa Murkowski of Alaska went maverick long before [John] McCain. On Tuesday, the two women resisted enormous pressure from President Trump and party leaders when they voted “no” on a procedural measure to open debate on Obamacare repeal. (Joan Vennochi, 7/28)

Different Takes: Figuring Out A Path Forward; Whatever You Call It ... It's Now The Nation's Health System

Editorial pages examine possible next steps in the health care debate, the importance of issue expertise, spiraling costs and the president's state of mind.

The New York Times: Why Obamacare Is Still In Peril
In a dramatic last-minute spectacle, the latest Republican plan to destroy the Affordable Care Act was defeated early Friday because of the courageous votes of three senators: Susan Collins, John McCain and Lisa Murkowski. This will come as an immense relief to millions of Americans who stood to lose their health insurance, but it would be naïve to think that this is the end of the road for the repeal-Obamacare movement. (7/28)

The Washington Post: It’s Not Obamacare Anymore. It’s Our National Health-Care System.
Republicans failed to repeal and replace the Affordable Care Act early Friday because of divisions within their own ranks, and because they tried not only to repeal and replace the ACA but also to cut and cap the Medicaid program, generating opposition from many red-state governors and their senators. But most of all, they failed because they built their various plans on the false claim — busted by the Congressional Budget Office — that they could maintain the same coverage levels as the ACA and lower premiums and deductibles, while at the same time slashing about a trillion dollars from Medicaid and ACA subsidies and softening the ACA’s consumer protection regulations. Had they succeeded, they would have won a big short-term victory with their base, which strongly supports repeal, but suffered the consequences in subsequent elections as the same voters lost coverage or were hit with higher premiums and deductibles. (Drew Altman and Larry Levitt, 7/29)

RealClear Health: The Golden Ticket In Health Care Reform? Experts, Not Politicians.
Although nothing is ever truly dead in Washington, now that Senators Collins, McCain, and Murkowski have derailed a seven-year effort to undo the Affordable Care Act (ACA), we need to stop treating health care like a political football and face realities about what can work. It is not hyperbole to say that lives are literally at stake, and ideology won’t pay medical bills. (Craig Kleiger, 7/31)

Lexington Herald Leader: Health Costs Real Problem
Americans will always be at loggerheads about health-care reform until we stop acting like the blind men trying to describe an elephant by touching only one part of the animal. Look at the whole elephant and you’ll see the cost of health insurance is the tail end of a much bigger problem. Republicans promised to cut premiums for many by reducing the number insured and what has to be covered, which doesn’t address the real problem: the cancerous growth in health-care costs. (John Winn Miller, 7/30)

Boston Globe: Let Psychiatrists Talk About Trump’s Mental State
By attempting to exclude psychiatry as a profession from the public discourse, the APA is inescapably devaluing the relevance and importance of the very profession it imagines it is protecting. If their own national organization can’t trust them to exercise good judgement and speak in a self-aware, reflective, and circumspect fashion, what lesson should the public draw from that? (Leonard Glass, 7/28)

WBUR: Harvard Psychiatrist: How Trump's Speech Was Toxic For Boy Scouts Beyond 'Rhetoric'
The carefully worded statement suggests that the Scout leadership heard loud and clear the complaints from parents who were offended by a speech that sounded much like one of Trump's campaign rallies: slogans, promotion of a political agenda, cutting remarks about his opponents. But as a senior child and adolescent psychiatrist and advocate for healthy youth development, I'm concerned that the leadership may still not get just how bad this speech was for the tens of thousands of Scouts who heard it, cheered it, chanted "We love Trump!" (Gene Beresin, 7/28)

Viewpoints: The Opioid Epidemic Needs Presidential Focus; Drinking Water Shouldn't Be Dangerous

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

Salon: Despite All His Promises, Trump Has Done Nothing About The Devastating Opioid Epidemic
Lost in the morass of the Trump presidency is the country’s opioid epidemic. With the administration now fully embroiled in its mounting self-created crises, the public health calamity is unlikely to find space within the president’s tweets. Given the Republican plans to savage Obamacare — now at least temporarily defeated — the crisis only promises to fester. The numbers emerging from the epidemic are grim. According to the American Society of Addiction Medicine, drug overdose is the leading cause of accidental death in the United States, with opioid addiction contributing greatly to these figures. Further, drug overdoses are now the leading cause of death for Americans under 50. (Jalal Baig, 7/30)

The New York Times: If Americans Love Moms, Why Do We Let Them Die?
We love mothers, or at least we say we do, and we claim that motherhood is as American as apple pie. We’re lying. In fact, we’ve structured health care so that motherhood is far more deadly in the United States than in other advanced countries. An American woman is about five times as likely to die in pregnancy or childbirth as a British woman — partly because Britain makes a determined effort to save mothers’ lives, and we don’t. (Nicholas Kristof, 7/29)

Cleveland Plain Dealer: Social Factors Contribute To Infant Mortality
The release of a three-year strategic plan by First Year Cleveland, a city-county collaborative to reduce the high infant mortality rate in Cleveland, brings new focus to the issue. Although fewer infants died In Cuyahoga County in 2016 than in 2015, the infant mortality rate of 8.6 deaths per 1,000 births is still one-third higher than the national average. (Joseph Ahern, 7/30)

Boston Globe: When Babies Felt No Pain
Physicians have good reasons to suspect their patients’ self-reports of pain, especially in the midst of an opioid crisis fueled by rampant over-prescription of pain-killers. But more often, humans misunderstand others’ pain because of inaccurate preconceived ideas about what pain responses look like. (Linda Rodriguez McRobbie, 7/29)

St. Louis Post-Dispatch: Gov. Eric Greitens Sets Up Expensive Legal Showdown Over New Abortion Law
Asserting the absurd claim of protecting women’s health and safety, Gov. Eric Greitens approved a law last week tightening abortion regulations. An expensive legal showdown is almost certain to follow, all so the governor can burnish his political credentials at taxpayers’ expense. The Supreme Court has struck down similar laws in other states, saying abortions are medically safe and criticizing such laws as a ruse to chip away at access to legal abortions. (7/29)

Lexington Herald Leader: Shoddy Research, Deadly Results
China recently announced that research fraud may be considered a capital crime, punishable by death, when it leads to approval of dangerous drugs that result in the deaths of patients. This news was all but dismissed by journal editors on medical listserves as a sign of an oppressive totalitarian regime. But is it unethical for any government institution to recommend the death penalty for someone who knowingly, for profit or job advancement, promotes a gambit which needlessly results in fatalities, sometimes in the thousands? (Kevin Kavanagh, 7/29)

Chicago Sun-Times: As CTE Rocks Football, I’m Donating My Brain To Science
So it wasn’t a great leap to pledge even that ultimate thing that makes me human — my brain — to researchers at the Concussion Legacy Foundation in Boston. That is the organization that took the earliest data — some from independent pathologist Bennet Omalu, who examined deceased Hall of Fame center Mike Webster’s brain and found it terribly riddled with the disease now known as chronic traumatic encephalopathy — and has led the way in football-concussion research. (Rick Telander, 7/31)