KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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From Kaiser Health News - Latest Stories:

Kaiser Health News Original Stories

A 'Safe' Space To Shoot Up: Worth A Try?

A bill pending in the state legislature could make the Golden State the first in the U.S. to open establishments where intravenous drug users can shoot up under medical supervision. Proponents say that would save lives. (Stephanie O'Neill, 6/19)

Political Cartoon: 'I'm Stuffed?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'I'm Stuffed?'" by Hilary Price.

Here's today's health policy haiku:


Is the health care bill
"A great plan" or "mean, mean, mean"?
Depends when you ask.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law

GOP's Health Plan Threatens Coverage For Most Vulnerable, Bipartisan Group Of Governors Says

The governors are urging congressional leaders to concentrate on stabilizing the marketplace while searching for a bipartisan solution that will provide affordable health care to those who need it.

The Associated Press: GOP, Dem Governors Call For Changes In House Health Bill
A group of Republican and Democratic governors are echoing President Donald Trump's criticism of a House GOP health care bill, saying it threatens coverage for the most vulnerable. Instead, they're asking Senate leaders to work together on an overhaul of Democrat Barack Obama's health care law. In a letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer, seven governors, including three moderate Republicans, argue that "true and lasting reforms are best approached by finding common ground in a bipartisan fashion." (Beaumont, 6/16)

Denver Post: Colorado Gov. Hickenlooper Joins Kasich, Others, In Bipartisan Letter Opposing GOP Health Care Bill
Colorado Gov. John Hickenlooper and six other governors on Friday sent U.S. Senate leaders a letter urging Congress to scrap the GOP health care bill and work toward a bipartisan solution. The letter to Majority Leader Mitch McConnell and Minority Leader Chuck Schumer said that Congress should focus on health care reform that cuts costs while promoting market stability and giving states more flexibility. (Eason, 6/16)

Secrecy And 'Legislative Sleights-Of-Hand': McConnell's About-Face On Passing Health Bills

The Washington Post fact checks Senate Majority Leader Mitch McConnell's positions on the process of passing a health care bill in 2010 versus now. And other media outlets take a look at how Republicans are struggling with the fact that the legislation is being crafted behind closed doors.

The Washington Post Fact Checker: Mitch McConnell On The Health-Care Legislative Process, 2010 Vs. 2017
It has become a regular feature of the U.S. political system that the politicians in the minority accuse the politicians in power of cutting deals behind closed doors to advance controversial legislation — only to engage in similar tactics once they regain power. This has become increasingly clear as Republicans in the Senate struggle to craft a health-care deal that will gain at least 50 votes, the bare minimum necessary under the legislative path — known as reconciliation — chosen by the GOP. (Kessler, 6/19)

The Hill: Senators Wrestle With Transparency In Healthcare Debate 
Both Republican and Democratic senators are expressing concerns over the lack of open process in the Senate's work on a revised ObamaCare repeal-and-replace bill even as Republican leadership looks to move the bill to a vote as soon as possible. Many lawmakers have not yet laid eyes on the Senate version of the American Health Care Act, which was passed by the House in May, and have begun to raise concerns about potential issues with the bill. (Manchester, 6/18)

Kaiser Health News: Ear To The Door: 5 Things Being Weighed In Secret Health Bill Also Weigh It Down
Anyone following the debate over the “repeal and replace” of the Affordable Care Act knows the 13 Republican senators writing the bill are meeting behind closed doors. While Senate Majority Leader Mitch McConnell (R-Ky.) continues to push for a vote before the July 4 Senate recess, Washington’s favorite parlor game has become guessing what is, or will be, in the Senate bill. Spoiler: No one knows what the final Senate bill will look like — not even those writing it. (Rovner, 6/16)

The Associated Press: GOP Senator Warns Against Rushed Vote On Health Care Bill
A Republican senator on Sunday warned against rushing a vote on a GOP bill to repeal and replace the nation's health care law, saying both parties deserve a chance to fully debate the bill and propose changes after it was drafted in secret. "The Senate is not a place where you can just cook up something behind closed doors and rush it for a vote," said Sen. Marco Rubio, R-Fla. "So the first step in this may be crafted among a small group of people, but then everyone's going to get to weigh in." (Yen, 6/18)

Politico: Rubio Cautions Against Rushing Health Care In Senate
Sen. Marco Rubio on Sunday cautioned against fashioning health care legislation "behind closed doors" in the Senate and rushing it to the floor for a vote. “The Senate is not a place where you can just cook up something behind closed doors and rush it for a vote on the floor,” the Florida Republican said on CBS' “Face the Nation.” (Trudo, 6/18)

Meanwhile, in related news —

The Washington Post: New Ad Campaign To Pressure Five GOP Senators To Vote Against Health-Care Overhaul
An organization that opposes the Republican effort to repeal and replace key parts of the Affordable Care Act is pressuring five GOP senators not to vote for the emerging legislation in a new $1.5 million ad campaign that begins Monday, officials with the group told The Washington Post. Community Catalyst Action Fund, which bills itself as a consumer health organization, is targeting Sens. Lisa Murkowski (Alaska), Jeff Flake (Ariz.), Susan Collins (Maine), Dean Heller (Nev.) and Shelley Moore Capito (W.Va.) with television and radio ads urging them to vote no. (Sullivan, 6/18)

Nashville Tennessean: The American Health Care Act’s Winners And Losers In Tennessee
The Tennessee consumers who most stand to benefit from the AHCA are people who have individual health plans but make too much money to receive ACA subsidies.  Because of the double-digit premium increases over the last few years, the “sticker price” of ACA coverage can be hundreds or even thousands of dollars per month. More than 80 percent of ACA consumers receive subsidies to offset these costs, but some consumers do not. If you make more than 400 percent of the federal poverty line, you receive no assistance, and premiums have been unaffordable for many of these consumers. (Tolbert, 6/18)

With Self-Imposed Deadline Looming, Where Does Senate Stand On Health Plan?

Senate Majority Leader Mitch McConnell is "bound and determined" to hold a vote on the legislation soon, but there are still a lot of obstacles in the way.

The Hill: ObamaCare Repeal And The Senate: Where It Stands 
It's a key two weeks for Senate Republicans, who are edging closer to a vote as soon as the end of this month on legislation to repeal and replace ObamaCare. Lawmakers have yet to see text of a bill and are deeply divided over key questions, such as how quickly to phase out ObamaCare’s Medicaid expansion. They’re also under enormous pressure to move as the Trump White House seeks a legislative win and the clock ticks on other priorities, from tax reform to funding the government and lifting the debt ceiling. (Sullivan and Weixel, 6/18)

The Wall Street Journal: Where Health-Care Legislation Stands
Businesses are watching closely as Senate Republicans try to hash out a deal on a GOP version of health-care reform to replace the Affordable Care Act. Whether they can bridge their divisions, however, remains to be seen. Rep. Greg Walden of Oregon, who helped shepherd the party’s health-care overhaul bill through the House last month, sat down with Louise Radnofsky, The Wall Street Journal’s White House reporter, to offer his take on where the effort stands. (6/18)

The Hill: ObamaCare: Six Key Parts Of The Senate Bill 
While Senate Republicans are drafting their healthcare plan behind closed doors, they’ve given reporters a general idea of what might be in it. The bill is shaping up to have a similar structure as the House’s bill, while more reflecting the principles of centrist Republicans in both chambers. (Hellmann, 6/18)

For Democrats, Trump's 'Mean' Comments Could Be A Gift On A Silver Platter

The party hopes to use the sentiment as a unifying message against Republicans. Meanwhile, Sen. Bernie Sanders says he supports any tactic the Democrats take to "defeat that horrific piece of legislation."

Politico: Democrats Use Trump 'Mean' Comment To Tar GOP
Democrats are seeking to capitalize on President Donald Trump calling the Republican health care bill "mean" ahead of the Senate's vote to repeal Obamacare, seeing it as a pivotal moment in an issue that could drive the 2018 midterm elections. The comments from Trump, made privately to senators last week, were largely overshadowed by a mass shooting at a Congressional baseball practice and new developments in the special counsel's investigation into Trump and his associates. (Dawsey and Kim, 6/18)

Bloomberg: Sanders Signals Backing Of Senate Slowdown Over Health-Care Bill 
Senator Bernie Sanders signaled support for Democrats trying to shut down Senate business in response to Republicans’ closed-door work on legislation to replace Obamacare. ... CNN reported on Saturday, citing unnamed sources, that Democrats are considering steps to halt Senate business to protest Republicans working on their health bill in secret. (McLaughlin, 6/18)

And in other news from the Democrats' side of the aisle —

CQ Roll Call: Schumer Asks For Full Senate Conversation On Health Care
Senate Minority Leader Charles E. Schumer is making public his “dismay” at Republicans’ closed-door negotiations on the health care bill by inviting all senators to an open meeting on health care in the Old Senate Chamber next week. “We believe we all owe it to our constituents to meet to discuss your potential legislation that would profoundly impact so many American lives,” the New York Democrat said in a letter sent to Majority Leader Mitch McConnell of Kentucky on Friday. (Raman, 6/16)

CQ Roll Call: Democrats Plan Protest Of Advancing GOP Health Bill
Senate Democrats plan to speak on the floor late into the night Monday, amid speculation that Senate Majority Leader Mitch McConnell, R-Ky., is narrowing in on a plan for a potential GOP health bill. Patty Murray of Washington, the no. 3 Senate Democrat, is organizing the protest, said an aide. Senate Republicans have been working for weeks in closed-door meetings on revisions to a House-passed bill (HR 1628). McConnell has for weeks faced the decision of whether to tilt toward moderates or conservatives in his effort to write a bill that at least 50 of the chamber's 52 Republicans will support. (Young, 6/18)

The Hill: Blumenthal Plans ‘Emergency Health Care Hearing’ For Monday 
Sen. Richard Blumenthal (D-Conn.) said he will hold his own “emergency field hearing” on health care Monday.  The Connecticut lawmaker’s hearing is in response to what he says is a secret strategy Senate Republicans are using to push their version of the American Health Care Act. (Manchester, 6/17)

Did Alaska Actually Figure Out How To Fix The Health Law? Well, It's Complicated

The plan Alaska instituted to control spiking premiums is being touted as a great success, but is it really?

Roll Call: Obamacare In Alaska: Cost-Control Plan Is Challenging But Working
It’s hard to get excited about a health insurance premium spike. But for Lori Wing-Heier, Alaska’s blunt but friendly state insurance commissioner, the decision by the state’s Blue Cross Blue Shield plan to raise its rates by just 7 percent was a moment of joy. ... That 7 percent increase — finalized last August — was the first sign that her plan had worked. After a grueling slog with a state legislature of reluctant Republicans throughout the spring, Wing-Heier had put in place a program designed to prevent Alaska’s only remaining Obamacare insurer from raising its rates a whopping 42 percent, one of the highest projected hikes in the country. (Mershon, 7/19)

In other news —

Denver Post: Colorado Health Insurers Quiet About 2018 Participation In State Exchange 
Facing a Monday deadline to file proposed 2018 plans with the state, major Colorado health insurers won’t say whether they expect to raise premiums next year or even if they will participate in the state’s health insurance exchange. The answers — which might not be known publicly until July, when Colorado insurance regulators release the plans for public review — have major significance for the roughly 120,000 people who shop for health insurance in the individual market. And they will also add to the contentious debate over the stability of the Affordable Care Act and the impacts of its proposed Republican-backed successor plan. (Ingold, 6/18)


Where GOP's Plans For Medicaid Meet Reality: 'Around Here, There Ain’t No Jobs'

Republicans are embracing the idea of work requirements, but many of the places where the rules will go into effect are in deep Trump country. Media outlets report on other Medicaid news out of California, New Mexico, Texas, Kansas and Iowa.

Politico: Medicaid Overhaul Faces Tough Test In Trump Country
Kentucky Gov. Matt Bevin’s planned overhaul of Medicaid is running into the unforgiving reality of impoverished small towns like [Salyersville], which voted overwhelmingly for President Donald Trump. Making adults work as a condition for getting health benefits is popular with the conservatives running many state capitals and Washington, D.C. But here in Magoffin County, where one of the last coal mines shuttered two years ago, there is little work to be had. (Pradhan, 6/18)

Modern Healthcare: California ER Use Jumps Despite Medicaid Expansion
California is the latest state to report that emergency room usage is up despite expanding Medicaid eligibility. Emergency room visits by people on Medi-Cal, the state's Medicaid program, rose 75% over five years from 800,000 in the first quarter of 2012 to 1.4 million in the last quarter of 2016, according to California's Office of Statewide Health Planning and Development. (Dickson, 6/16)

Santa Fe New Mexican: New Mexico Has A Lot To Lose From Medicaid Rollback
While New Mexico is among states that will feel a major economic impact from changes in the federal health care law, New Mexico has no Republican senators involved in private meetings about the bill in Washington, D.C. ... “It’s very strange, taking something that affects one-sixth of the economy, and their doing the changes quickly without public hearings,” said Barbara Webber of Health Action New Mexico, a consumer advocacy organization. Any rollback in Medicaid coverage for low-income New Mexicans, she said, would be devastating for the state. “It would trigger a depression for New Mexico when you talk about the loss of that many jobs,” she said. “And then there is the moral and ethical concern for the many people who would lose their health care.” (Krasnow, 6/18)

Modern Healthcare: Texas Law Provides Medicaid Coverage Of Postpartum Depression Screening
Republican Texas Governor Greg Abbott signed a bill into law Thursday that would allow new mothers on Medicaid to obtain screening for postpartum depression. The law is part of a larger effort to address the high maternal mortality rate that plagues Texas. Two other bills are also going through the state Legislature that attempt to address the issue. (Castellucci, 6/16)

Kansas City Star: Children's Health Programs Expecting Kansas Medicaid Bump
Thousands of Kansas medical providers will see increased reimbursements for Kansas Medicaid, or KanCare, after Gov. Sam Brownback signed a bill Thursday to restore a 4 percent cut imposed in May 2016 amid persistent budget crises. The increase will begin July 1. Gordon Docking, who runs KidsTLC, a residential treatment facility in Olathe for kids with mental health problems, said he’s eager to have it. (Marso, 6/16)

Modern Healthcare: Iowa Accused Of Cutting Medicaid Funds For Disabled Beneficiaries
Iowa's privately run Medicaid program has been accused of cutting benefits that allow disabled beneficiaries to live independently in their communities. Six Iowa Medicaid beneficiaries with serious disabilities sued Gov. Kim Reynolds and the head of the state Human Services Department in a proposed class-action lawsuit in federal court on Monday, alleging the state's contracted managed-care organizations cut their monthly cost allowances for home- and community-based care, even though there has been no change in their care needs. (Teichert, 6/15)

Medicaid Funding Takes Center Stage At Opioid Commission's First Meeting

One after the other, experts highlighted the importance of maintaining and completing the expansion of Medicaid in the battle against the opioid crisis.

Stat: Health Advocates Plead For Medicaid Spending Before Opioid Commission
Health advocates on Friday used the first meeting of President Trump’s commission on the opioid crisis to criticize a bill that would slash future Medicaid spending and deregulate the health insurance market, arguing that the legislation would undermine whatever progress the panel could make. ... A pending bill in the Senate is expected to call for slashing federal Medicaid funding and rolling back expansions put into place in recent years by the Affordable Care Act. A version of the bill passed by the House would reduce planned Medicaid spending by $880 billion over the next decade. (Facher, 6/16)

CQ Roll Call: Addiction Experts Question GOP Plans To Cut Medicaid Growth
One commissioner, former Democratic Rep. Patrick J. Kennedy of Rhode Island, described the potential Medicaid cuts as “the elephant in the room.” The commission, he said, needs “to ensure we don’t step back at just the point we need to be stepping forward on this terrible epidemic.” (Siddons, 6/16)

Coverage And Access

Nev. Governor Vetoes Medicaid-For-All Bill, Saying It's Creative But Lacks 'Factual Foundation'

The legislation would have allowed all residents the option of buying into Medicaid coverage.

The Wall Street Journal: Nevada’s Governor Vetoes ‘Medicaid For All’ Insurance Plan
Nevada’s Republican governor vetoed a bill late Friday that would have created the nation’s first “Medicaid for all” insurance offering, a plan that drew widespread attention as states brace for changes in the federal Affordable Care Act. The bill would have allowed any state resident to buy into Medicaid, the federal-state program for people with low incomes or disabilities. The idea, which its Democratic sponsor said would have created a guaranteed health coverage option that was affordable, has drawn the interest of other liberal-leaning states as congress works to repeal major portions of the Affordable Care Act, including the law’s Medicaid expansion. (Hackman, 6/17)

Los Angeles Times: Nevada Governor Vetoes Medicaid-For-All Bill
In his three-page veto message released Friday night, Sandoval praised the sponsor of the bill for “creativity” in attempting to design a healthcare option for the state’s 2.9 million people, but he ultimately reasoned that there were too many unanswered questions about how the program would work. He wrote that the legislation was “an undeveloped remedy to an undefined problem” — and that it didn’t get proper scrutiny before it was passed in a short time frame.  (Montero, 6/17)

CNN: Nevada Governor Vetoes Medicaid-For-All Plan
Nevada's governor has vetoed a bill that would have made the state the first to open Medicaid to all residents. The Democratic-led state legislature passed a bill earlier this month that would have allowed anyone to purchase a Medicaid-like policy, regardless of their income. Governor Brian Sandoval, a Republican, on Friday vetoed the bill. The bill called for the state to create the Nevada Care Plan, which would have been separate from the state's Medicaid program but offered nearly all the same benefits. (Luhby, 6/18)


Trump's Working Group On Drug Prices Catering To Pharma's Wish List

Despite promising action to reel in an industry that he said was "getting away with murder," President Donald Trump and his administration's working group on high prescription drug costs is leaning toward policy recommendations backed by pharmaceutical companies.

Kaiser Health News: Exclusive: White House Task Force Echoes Pharma Proposals
President Donald Trump repeatedly talks tough about reining in the pharmaceutical industry, but his administration’s efforts to lower drug prices are shrouded in secrecy. Senior administrative officials met Friday to discuss an executive order on the cost of pharmaceuticals, a roundtable informed by Trump’s “Drug Pricing and Innovation Working Group.” Kaiser Health News examined documents that shed light on the workings of this working group. The documents reveal behind-the-scenes discussions influenced by the pharmaceutical industry. (Kopp, 6/16)

Politico: Trump's Drug Price 'Remedy' Expected To Be Industry Friendly
Candidate Donald Trump made rising drug costs a signature issue during his campaign and beefed up his criticisms after the election, saying in January that the drug industry was "getting away with murder." The comments unnerved drug executives, but six months later, the industry is no longer in a state of panic. (Karlin-Smith, 6/16)

Stat: The Drug Industry Is Coasting On Capitol Hill, Despite Pressure Over Prices
If Congress has its way, the ... president will soon sign into law a massive package that is at the top of the industry’s wish list: a reauthorization of drug makers’ funding agreements with the Food and Drug Administration. At least so far, the powerful pharmaceutical industry has managed to keep the package that is speeding toward Trump’s desk free of any controversial policy changes that could threaten the industry’s business model — as well as any partisan add-ons that could jeopardize its smooth, overwhelmingly bipartisan trip through the policymaking process. (Mershon, 6/19)


Marketing Sanctions Lifted Off Cigna

The federal sanctions barred the company from marketing and selling its Medicare Advantage policies to new beneficiaries.

The Wall Street Journal: Cigna Can Return To Medicare Advantage, Prescription-Drug Plans
Cigna Corp. can resume enrolling beneficiaries in Medicare Advantage and prescription-drug plans after the federal government lifted marketing sanctions in place since January 2016, the insurer said Friday in a securities filing. The Centers for Medicare and Medicaid Services had ordered the Connecticut-based firm to halt enrollment after finding a series of deficiencies following an audit. The government said beneficiaries had been inappropriately denied medical services that should have been covered, which raised issues with Cigna’s coverage-appeals process. (Armental, 6/16)

Modern Healthcare: CMS Lifts Medicare Advantage Sanctions On Cigna
"We are a better and stronger company as a result of collaborating with CMS and investing further in our processes and technology over the past year and half," Shawn Morris, interim president of Cigna's Medicare Advantage business, Cigna-HealthSpring, said in a statement. (Livingston, 6/16)

Feds To Collect More Than $53M From Genesis HealthCare To Settle False Medicare Claim Charges

The nursing home operator strikes a settlement with the Justice Department to end six federal lawsuits and investigations of allegations that the company submitted false claims to Medicare and Medicaid for medically unnecessary therapy, hospice service and substandard care.

The Associated Press: Genesis HealthCare To Pay $53.6M To Settle US Probes
Genesis HealthCare has agreed to pay $53.6 million to settle allegations that it submitted false claims to the federal government for unnecessary therapy and substandard nursing care, the Justice Department said Friday. The settlement resolves six federal lawsuits and investigations alleging Genesis HealthCare companies and facilities violated federal statutes by submitting false claims to Medicare and Medicaid for medically unnecessary therapy, hospice service and substandard nursing care. (Balsamo, 6/16)

The Philadelphia Inquirer/ Genesis Healthcare Finalizes $53.6M Federal Settlement
The U.S. Justice Department said Friday that Genesis Health Inc., a major nursing home operator based in Kennett Square, will pay $53.6 million to settle six federal lawsuits and investigations alleging that companies and facilities acquired by Genesis billed the government for “medically unnecessary therapy and hospice services, and grossly substandard nursing care.” The final settlement is slightly larger than the $52.7 million Genesis estimated last summer, when the company disclosed an agreement in principal to settle the allegations, some of which date back to 2003. (Brubaker, 6/16)

Health IT

Hospitals Only Have To Report Certain Cyberattacks, Leaving Rivals In The Dark And Vulnerable

Advocates are pushing for tighter reporting requirements for all electronic attacks.

The Wall Street Journal: Why Some Of The Worst Cyberattacks In Health Care Go Unreported
A cyberattack last year paralyzed MedStar Health computers, forcing the Maryland operator of 10 hospitals and more than 300 outpatient centers to shut down its entire electronic-record system. Doctors logged patient details with pen and paper. Laboratory staff faced delays delivering test results. “It was three weeks before we got most of everything that was important to us on a daily basis back and operational,” Craig DeAtley, director of the MedStar Institute for Public Health Emergency Readiness, said during a panel organized by federal health officials last year to address cyberthreats. (Evans, 6/18)

In other health IT news —

Stateline: Interactive Medical Drones: No Longer Science Fiction
Drone technology has been around for at least half a century, and for years people in health care have speculated about the medical use of drones, for example to transport medicines, organs for transplants, blood supplies and anti-venom serums. But to date, very few of those possibilities have been realized, in part because of the federal rules governing drones. By law, non-military drones can only be operated within the pilot’s line of sight, during the daytime, and at altitudes no higher than 400 feet. (Ollove, 6/16)

Public Health And Education

Stem Cell Scientists Worry Unregulated Clinics Undermine Actual Progress In Field

The researchers are optimistic about where stem cell therapy is headed but they fear horror stories stemming from some clinics will derail public support. In other public health news: Alzheimer's, a surgery gone wrong, brain injuries and depression, dog bites, transgender children, and more.

Stat: On The Cusp Of Payoffs For Patients, Stem Cell Therapy Faces Threat From Unregulated Clinics
Stem cells scientists have for some time been fighting back against the rise of these largely unregulated clinics, urging federal regulators to step in and lobbying on the state level against policies that they see as lending legitimacy to the clinics. But it was notable that the society devoted part of its messaging — Temple also raised the issue in her main address — to shoddy applications of stem cells at its annual conference celebrating the field and its new discoveries. (Joseph, 6/16)

NPR: Becoming A Grandparent With Alzheimer's Disease
"They're not gonna want me to play 'babies in space'," says Greg O'Brien. "You know, where I pick 'em up in my hands and I swirl them around over my head like a rocket ship. I always say 'Babies! In! Spaaaaace!'" It's October 2016, and he is musing about the latest O'Brien family news. His daughter, Colleen, is due to have a baby in November, and ever since he found out, Greg has been struggling with competing emotions. (Hersher, 6/17)

The Washington Post: He Underwent Surgery To Remove His Right Testicle. When He Woke Up, His Left One Was Missing.
In 2013, Steven Hanes visited his urologist, complaining of persistent pain in his right testicle. An ultrasound revealed that the testicle had atrophied, with scarring and damage from a previous injury, according to court documents. And so the doctor scheduled an orchiectomy — or surgical removal of the testicle — to help alleviate Hanes's pain. The good news? The orchiectomy was successful. The bad news? The doctor removed the wrong testicle during the surgery. (Wang, 6/18)

Stat: As She Operated On Babies' Birth Defects, A Doctor Hid Her Own Diagnosis
[Dr. Mary] Austin, a pediatric surgeon, helps counsel couples through that agonizing decision. She walks them through the potential risks and benefits. She describes each step in the hours-long surgery, from slicing open the uterus to closing the gap around the spinal cord with tiny stitches through developing fetal tissue so fragile, it’s almost “like tissue paper,” she said, vulnerable to tearing. What she doesn’t tell them: She herself has spina bifida. (Huff, 6/19)

The Washington Post: Childhood Brain Injury Tied To Adult Anxiety, Depression
Children who sustained traumatic brain injuries may experience such psychological effects as anxiety, phobias and depression more than a decade later, researchers say. “The study suggests that brain injury is in some way related to longer-term anxiety symptoms, while previously it was thought that brain injury only leads to short-term effects,” lead author Michelle Albicini said in an email. (Kennedy, 6/17)

The Washington Post: A Dog Bite Sent Him To The ER. A Cascade Of Missteps Nearly Killed Him.
Becky Krall hurried through the sliding-glass doors of the hospital emergency room around 8 a.m. on Sept. 25, 2015, expecting to see her feverish husband, David, sitting among the patients waiting to see a doctor. Instead Krall, who had left him for about 15 minutes while parking their car, was met by a nurse with an urgent message: Her 50-year-old husband had suddenly become unresponsive. Krall recalls with frightening clarity the words of a critical care specialist. “She put her hand on my knee and said, ‘Your husband is very, very sick. You need to be prepared for him not to make it through the day.’ ” (Boodman, 6/16)

San Francisco Chronicle: Transgender Child, Parents Sort Through New Reality
Today, as politicians fight over which bathroom transgender people are legally allowed to use, health care professionals find themselves having to develop what is essentially a new field for a growing number of transgender children. This is a difficult task because, while there is considerable evidence that transgender adolescents, when given the space to transition early, go on to have health outcomes similar to nontransgender peers, there’s little empirical data to help guide the way for very young transgender children. (Kost, 6/18)

The Washington Post: Why You Need To Know About Mice, Ticks, Warm Temperatures And Lyme Disease
Twice in the same week, Lois Wood woke to find ticks crawling over her bare leg in her New Hampshire home. A few nights later, she spotted a mouse running across her bed. A mother of seven, Wood tries to shrug off her tiny bedfellows. “It’s a common rural problem,” she says, although she admits that she has “never experienced anything like this in my own bed.” The recent appearance of vermin and pests in Wood’s bedroom coincides with the warming temperatures related to climate change. The past three years have been the planet’s hottest on record, and it is in this changing climate that many pests thrive, negatively affecting human health. (Banigan, 6/18)

Sacramento Bee: Extreme Heat Can Bring On Dehydration, Heat Exhaustion 
As scorching temperatures usher the Sacramento region into summer, local emergency room doctors expect to see plenty of patients walk in with the types of complaints that many don’t normally associate with dehydration or heat exposure. Generally, people will directly link their sunburn or high body temperature to the heat, doctors said, but they are less likely to make that same connection to symptoms such as fatigue, muscle cramps, dizziness, nausea, vomiting, constipation or headaches. In the worst cases, people are either unconscious or too confused to fully grasp the gravity of their condition. (Anderson, 6/18)

Atlanta Journal-Constitution: Sun Tan Drug Could Prevent Cancer, Study Says
A new kind of “tan in a bottle” could give you the sun-kissed skin you want while lowering your risk of skin cancer, the most commonly diagnosed cancer in the United States... The drug, which is in liquid form, mimics the effect of sunlight on the skin without the sun’s harmful UV rays, tricking the skin into producing a brownish pigmentation of melanin. (Pirani, 6/16)

The One-Paragraph Letter That Helped Shape The Opioid Epidemic

A letter, published in a 1980 edition of the New England Journal of Medicine, has been twisted and misrepresented by the makers of painkillers to prove their products are not addictive. In other news, researchers look at why treating opioid addiction can be complicated and the American Medical Association backs supervised injection sites.

NPR: Sloppy Citations Of 1980 Letter Led To Opioid Epidemic, Researchers Say
A one-paragraph letter, barely a hundred words long, unwittingly became a major contributor to today's opioid crisis, researchers say. "This has recently been a matter of a lot of angst for me," Dr. Hershel Jick, co-author of that letter, told Morning Edition host David Greene recently. "We have published nearly 400 papers on drug safety, but never before have we had one that got into such a bizarre and unhealthy situation." (Haney and Hsu, 6/16)

Stat: One Reason It's So Hard To Treat Opioid Addiction
Cases of hepatitis C have skyrocketed as the opioid epidemic has spread: There were an estimated 30,500 new cases in the U.S. in 2014, nearly double the number of new cases in 2011. Most of those new cases are among people who inject drugs such as heroin. Hepatitis C infections have increased particularly sharply among young people who live in rural areas of Appalachian states, according to the Centers for Disease Control and Prevention. (Thielking, 6/19)

WBUR: AMA Endorses Trying Supervised Injection Facilities 
The largest body of physicians in the U.S. is backing one of the most controversial proposals for curbing the country's opioid epidemic: supervised injection facilities. The American Medical Association (AMA) says these rooms, staffed by medical personnel who monitor drug users, lead to fewer overdose deaths, less transmission of infectious disease and promote treatment. (Bebinger, 6/16)

Kaiser Health News: A ‘Safe’ Space To Shoot Up: Worth A Try In California?
Tawny Biggs’ seemingly happy childhood in the northern Los Angeles County suburb of Santa Clarita, Calif., showed no outward sign that she would one day struggle with drug addiction. As Biggs tells it, she was raised with two siblings “in a very good family” by an assistant fire-chief dad and a stay-at-home mom. Her after-school hours were filled with hockey and soccer. (O'Neill, 6/19)

And in the states —

Los Angeles Times: California Atty. Gen. Xavier Becerra Announces Probe Of Drugmakers Over Epidemic Of Opioid Deaths
Citing an epidemic of opioid overdose deaths across the country, state Atty. Gen. Xavier Becerra said Friday that California is joining with more than 26 other states to investigate whether drugmakers have used illegal marketing and sales practices. Becerra said the probe would focus on whether drug manufacturers have played a role in creating or extending the opioid problem. (McGreevy, 6/16)

Los Angeles Times: L.A. Sheriff's Deputies To Carry Nasal Spray To Treat Opioid Overdose Victims
The Los Angeles County Sheriff’s Department will supply thousands of field deputies with the nasal anti-opioid spray naloxone to help prevent overdose-related deaths, officials announced Thursday. Next week, the department will begin issuing more than 1,200 single-dose spray dispensers — sold under the brand name Narcan — to field deputies in Santa Clarita, Crescenta Valley,and East Los Angeles, as well as to deputies patrolling community colleges and parks. (Bernhard, 6/15)

The Baltimore Sun: Baltimore City Running Low On Opioid Overdose Remedy
Baltimore health officials are running low on naloxone, the opioid overdose reversal drug used hundreds of times by bystanders in the last couple of years to save lives. Dr. Leana Wen, the city health commissioner, said demand has jumped significantly along with the drug epidemic and the health department needs funding for more supplies...The city has about 4,000 doses left to last until next May. The department will distribute them, two at a time, to residents, including IV drug users encountered by the city's needle exchange vans or by outreach workers in "hotspots," areas where a spate of overdoses recently occurred. (Cohn, 6/18)

The Washington Post: Mom’s Grief Spurs NY Bill Targeting Opioid Dealers In Deaths
Four years after Patty Farrell found her 18-year-old daughter lying cold and blue in bed from an overdose, the former police detective hopes to see heroin dealers charged with homicide when their product kills. “She was the love of my life, my only child,” says Farrell, whose home is like a shrine to her daughter with photos and keepsakes everywhere. “When I lost her, I lost my world.” (Esch and Klepper, 6/18)

Sleep Apnea, Called A 'Time Bomb' For Women, A Contributing Factor In Carrie Fisher's Death

Women, particularly older ones, have a greater chance of never being diagnosed with sleep apnea — and never being treated for it.

The Washington Post: Carrie Fisher’s Death Shines A Light On An Underrated Health Problem
Actress Carrie Fisher was unabashedly vocal about her lifelong battles with mental illness and drug abuse. She once defiantly told ABC News, “I am mentally ill. I can say that. I am not ashamed of that. I survived that, I’m still surviving it. But bring it on.” Her candor inspired a generation of women. If a cool and funny Hollywood icon could be so open about getting help for her struggles, then so could they. But a disorder that ultimately contributed to Fisher's death was something she hadn't publicly said much about: sleep apnea. (Wootson, 6/17)

Los Angeles Times: Carrie Fisher Died Of Sleep Apnea And 'Drug Use' Was Also A Factor, L.A. County Coroner Says
The report is vague about the role drugs played in Fisher’s death. But her daughter, Billie Lourd, issued a statement to People magazine Friday night linking her mother’s death to drug use. “My mom battled drug addiction and mental illness her entire life. She ultimately died of it. She was purposefully open in all of her work about the social stigmas surrounding these diseases,” Lourd told People. (Winton and Dolan, 6/16)

Reuters: Untreated Sleep Apnea May Worsen Markers Of Heart Health And Diabetes
Properly treating a common sleep-related breathing disorder may have benefits for the heart and for blood sugar, a new study suggests. If people with obstructive sleep apnea don’t use machines at night to help keep the airway open, measures of their heart health and blood sugar worsen, researchers found. (Seaman, 6/17)

State Watch

State Highlights: Calif. To Give $20M In Emergency Grants To Health Clinics; Legionnaires' Strikes Again In New York

Media outlets report on news from New York, Massachusetts, California, Georgia, Oklahoma, Maryland, Pennsylvania, Oregon, Ohio and Texas.

Reuters: California To Give Health Clinics $20 Million To Counter Possible Trump Cuts
California on Monday will announce plans to award $20 million in emergency grants to local health and Planned Parenthood clinics in anticipation of possible U.S. healthcare funding cuts, according to State Treasurer John Chiang's office. California and more than a dozen other Democratic-leaning states are fighting against regulatory changes and policies coming from Republican President Donald Trump and the Republican-controlled Congress. (Lambert, 6/16)

The New York Times: Legionnaires’ Outbreak On Upper East Side Kills One And Sickens Six
One person is dead and six other people have been sickened in an outbreak of Legionnaires’ disease on the Upper East Side of Manhattan, the city health department announced on Friday. The patients with the bacterial infection, which is typically contracted through contaminated water, fell ill within the past 11 days in the Lenox Hill neighborhood, said the agency, the Department of Health and Mental Hygiene. (Nir, 6/16)

Boston Globe: Water At State’s Largest Prison Raises Concerns  
A Globe review of state records found that 43 percent of all water samples collected at MCI-Norfolk since 2011 showed elevated levels of manganese, a prime component of the sediment from the wells. The naturally occurring mineral, found in many foods, can be dangerous when ingested at heightened levels for prolonged periods, potentially leading to tremors, slowed speech, and other neurological disorders that resemble Parkinson’s disease. (Abel, 6/17)

Los Angeles Times: L.A. County Health Officials Say 42 People Have Been Infected With Mumps
A mumps outbreak in Los Angeles County this year has infected 42 people, most of whom live on the Westside, health officials said this week. There have been several mumps outbreaks nationwide in recent years, including some that are ongoing in parts of Texas, Arkansas and Washington state. Last year there were 5,833 cases of mumps nationwide, the highest number in a decade, according to the U.S. Centers for Disease Control and Prevention. (Karlamangla, 6/17)

The Associated Press: Shooting Of Mentally Ill Man Raises Policing Questions
Joshua Barre's mental health was spiraling out of control before he grabbed two butcher knives and went outside. The 29-year-old black man with bipolar disorder had been off his medication and holed up at home, cycling through depression, anxiety and paranoia. His mother pleaded for an intervention from Oklahoma's first line of defense for mental health: law enforcement. And Tulsa County deputies responded: Officers with the agency's mental crisis unit, trained in de-escalation techniques, went to Barre's house three times in the days before their final encounter on June 9. (Juozapavicius, 6/17)

Sacramento Bee: California Assisted Death Battle Continues 
More than a year after California became the fifth state to allow assisted death, the controversial policy is still embroiled in court. But opponents, who have raised concerns about the devaluing of life and potential abuses against vulnerable Californians, are still seeking a way to overturn the policy. Though they previously failed to put a referendum on the ballot, a lawsuit filed last June shortly before the assisted death law took effect, alleging that it violates the civil rights of terminally ill patients, is ongoing in Riverside County. (Koseff and Svirnovskiy, 6/16)

Boston Globe: With Life-Sciences Center, Bayer Raises Its Profile In Mass. 
Bayer, which last week formally opened a life science center outside of Cambridge’s Kendall Square, trumpeted its arrival last year with a pair of outsize early-stage investments in biotech startups that are using cutting-edge technology. The company in August plowed $300 million into Casebia Therapeutics, a Cambridge joint venture with CRISPR Therapeutics that will use a gene-editing tool called Crispr-Cas9 to develop genetic-based treatments for heart disease, blindness, and blood disorders. (Weisman, 6/18)

The Baltimore Sun: Maryland's Children Fare Well In Well-Being 
Maryland children are thriving in most areas of life, but a recent spike in deaths unveiled in an annual report on the well-being of young people is raising concern among advocates. Maryland ranked 16th among states for the well-being of its children in the 2017 Kids Count Data Book, released each year by the nonprofit Annie E. Casey Foundation in Baltimore. The report determines how well kids are thriving by ranking states on 16 indicators across four key areas: health, education, economic well being and family and community. (McDaniels, 6/17)

The Philadelphia Inquirer/ Pa. Reviews Infant Heart Deaths; N. Philly Program To Reopen
Twenty percent of newborns who underwent surgery for heart defects died within a month of their procedures at St. Christopher’s Hospital for Children, the highest mortality rate among five hospitals analyzed in a new state of Pennsylvania report covering 2012 through 2015.At each of the four other institutions in the report, mortality rates following the delicate surgeries were below 10 percent during that four-year period, according to the Pennsylvania Health Care Cost Containment Council. (Avril, 6/16)

The Oregonian: Legacy Health Waives Medical Costs For MAX Stabbing Victim 
To honor his heroism during last month's horrific attack on a MAX train, Legacy Health has waived all medical costs for surviving stabbing victim Micah Fletcher. Fletcher, 21, visited Legacy's headquarters Friday to thank Legacy CEO and President Dr. George Brown.  Fletcher briefly choked up as he told Brown how much the waiver meant to him and his family. The men sat across from each other at a table in Brown's office, accompanied by representatives from the Muslim Educational Trust. (Matsumoto, 6/18)

Cleveland Plain Dealer: Processing Rape Kits Saves Heartache And Money, Cuyahoga Prosecutors Tell Congressional Task Force 
Anthony Sowell's horrific crime spree revealed systemic problems with how Cleveland-area law enforcement agencies handled rape cases, Cuyahoga County Prosecutor Michael C. O'Malley told a newly-formed congressional task force dedicated to fighting sexual violence. Though Sowell was jailed for rape before he committed 11 murders that imprisoned him for life, his DNA wasn't entered into criminal databases upon his initial prison release. (Eaton, 6/17)

Los Angeles Times: L.A. County Reports 2017's First Case Of West Nile Virus
San Gabriel Valley resident was hospitalized with West Nile virus in what health officials say is the first case in Los Angeles County this year. The patient ended up in the hospital in March and has since recovered, officials announced this week. West Nile virus is transmitted by mosquitoes, and officials say this winter’s heavy rains could breed more mosquitoes and lead to a higher chance of infection statewide. (Karlamangla, 6/16)

Houston Chronicle: Is Criminalizing Mental Illness In Texas The Best Means For Care? 
Texas in recent years ranked 49th in per capita mental health spending. While strapped systems exist for people thought to be a danger to themselves or to others, limited options are in place to help them remain stable in the periods in between. If parents do not want a volatile child with mental illness at home or on the streets, advocates note that scant affordable options exist where that person might live, receive treatment and find stability. (Foxhall, 6/16)

KQED: Refinery, Tanker Firm Cited For Fumes That Sickened Scores In Vallejo
Local air regulators have issued notices of violation to the Phillips 66 refinery in Rodeo and to the operator of an oil tanker for spilling crude oil they say caused an overpowering odor that sickened Vallejo residents last September. The Bay Area Air Quality Management District says it has concluded its investigation into the incident and now believes the spill near the refinery’s marine terminal is to blame for fumes that prompted more than 1,400 odor complaints. (Goldberg, 6/16)

WBUR: Mass. Senate Draft Bill Keeps 12 Percent Marijuana Tax 
The marijuana tax rate in Massachusetts would remain capped at 12 percent under a draft bill released Friday by the state Senate. It's in sharp contrast to the 28 percent tax rate in a House bill -- although that legislation is being revised. (Bebinger, 6/16)

Editorials And Opinions

Different Perspectives On Health Reform: Industry On The Sidelines; Alternative Options?

Opinion writers examine the secretive discussions in the Senate on the changes to the health law and the impact they could have around the country.

Modern Healthcare: A​ Perilous​ Moment​ For​ The​ Healthcare​ Industry
Senate Majority Leader Mitch McConnell is looking to cook up a compromise that can cobble together 50 votes before the July 4 recess. That's why he's having the bill written in secret without public hearings or a Congressional Budget Office score. Contrast that behavior with the dozens of hearings held by the Democratically controlled Senate in the year before the Affordable Care Act passed. Every major interest group -- hospitals, doctors, insurers, drug and device makers -- had their chance to weigh in, as did leading Republicans such as Chuck Grassley of Iowa and Orrin Hatch of Utah, who won amendments in committee before voting against the final package. (Merrill Goozner, 6/17)

Huffington Post: GOP Senators Still Frustrated With Obamacare Repeal Bill, Still Doing Nothing About It
When the House passed the American Health Care Act (AHCA), its version of the legislation, Republican senators were quick to decry both the bill and the debate that led to it. They said the House had acted brashly ― hatching legislation behind closed doors and then rushing to vote before the public could get a good look at it. Republican senators also said the proposal itself was too harsh ― breaking promises to protect people with pre-existing conditions and taking insurance away from 23 million people, according to Congressional Budget Office predictions. Now it’s clear that the Senate process won’t play out so differently after all. (Jonathan Cohn, 6/19)

Milwaukee Journal Sentinel: There's Plenty To Be Alarmed About With Senate Health Care Bill
If Trumpcare passes, the average health insurance premium in Wisconsin will increase by an estimated $910 in 2018. Total health insurance coverage losses would average $416,600. People with pre-existing conditions (such as diabetes, HIV/AIDS and women who've been pregnant) would again face discrimination in seeking coverage. The bill likely will reduce women's access to reproductive health care, defund Planned Parenthood (which is a crucial health care source especially for transgender people and folks of all genders with limited income), and even reduce coverage for kids. The House bill also used Medicaid and other cuts to give the extremely wealthy an enormous $836 billion tax cut. There are rumors the Senate measure would cut even more. (Emily Mills, 6/16)

The New York Times: How Did Health Care Get To Be Such A Mess?
The problem with American health care is not the care. It’s the insurance. Both parties have stumbled to enact comprehensive health care reform because they insist on patching up a rickety, malfunctioning model. The insurance company model drives up prices and fragments care. Rather than rejecting this jerry-built structure, the Democrats’ Obamacare legislation simply added a cracked support beam or two. The Republican bill will knock those out to focus on spackling other dilapidated parts of the system. An alternative structure can be found in the early decades of the 20th century, when the medical marketplace offered a variety of models. Unions, businesses, consumer cooperatives and ethnic and African-American mutual aid societies had diverse ways of organizing and paying for medical care. (Christy Ford Chapin, 6/19)

The Washington Post: Single-Payer Health Care Would Have An Astonishingly High Price Tag
Obamacare looks shaky, mostly because Republicans are sabotaging it. This, in turn, has rekindled calls on the left to create a European-style “single-payer” system, in which the government directly pays for every American’s health care. California lawmakers, for example, are considering such a plan for their state. The single-payer model has some strong advantages. ... But the government’s price tag would be astonishing. When Sen. Bernie Sanders (I-Vt.) proposed a “Medicare for all” health plan in his presidential campaign, the nonpartisan Urban Institute figured that it would raise government spending by $32 trillion over 10 years, requiring a tax increase so huge that even the democratic socialist Mr. Sanders did not propose anything close to it. (6/18)

Des Moines Register: We Need Medicare For All, Not A Heartless Health Care Bill
As a cardiac rehabilitation nurse in rural Iowa, I spent 10 years helping patients recover from procedures like valve replacements and heart bypasses. I saw patients survive against the odds, thanks to incredible health care provided in our state’s rural hospitals. Now all of us in rural Iowa — including our hospitals — face a grave threat with the health care repeal passed by the House. The only way we’ll survive is by making sure our senators stop it. (Barb Kalbach, 6/18)

Bloomberg: Health-Care Investors Are In Denial 
The U.S. health-care system is full of things that don't make much sense. A lot of them are extremely profitable. One of these, recently highlighted by legendary short-seller Jim Chanos, is dialysis, a market largely split in the U.S. between two large firms, DaVita Inc. and Fresenius Medical Care AG & Co KGaA. If the Senate passes a health-care bill similar to one the House of Representatives passed last month, then it may become easier for private insurance plans to stop covering dialysis, cutting off a big source of profit for these companies. (Max Nisen, 6/16)

WBUR: What My 90-Year-Old Mom Taught Me About The Future Of AI In Health Care
On the one side, organized medicine has to change its practice so that it can ingest the day-to-day or even minute-to-minute measurements made of our fast-growing chronically ill and aging population, and transduce these data into timely treatment. But without thoughtful and broad application of AI techniques into the process of health care, our already struggling and stressed health care workforce will simply be not able to meet this challenge. (Isaac Kohane, 6/16)

Viewpoints: Problems With Drug Labeling Rules; Fixing Genes; Mental Illness And Punishment

A selection of opinions on health care from around the country.

Morning Consult: Reform Prescription Drug Labeling To Benefit Patients And Their Doctors
These rules keep doctors from learning factual data about how medicines should be used, deprive insurance companies of understanding the value of new drugs, and make it harder to link drugs’ prescribed usage with recommended practice guidelines from medical experts. More importantly, the current system can keep patient’s experiences with using the drug from being included in the FDA-blessed package inserts. Why is this important? Because in an era of instantaneously available information about how and when to use everything from cars to drones, we can do better in talking about medicines. Yes, drugs are different, but not that different. (David Beier, 6/16)

The New York Times: The Upside Of Bad Genes
There’s a well-to-do couple thinking about having children. They order a battery of genetic tests to ensure that there’s nothing untoward lurking in their genomes. And they discover that they each carry one copy of the sickle cell gene. If their children inherit two copies of the gene, they could develop anemia, which can cause joint pain, weakness and even death. So what should the couple do? For the last two decades, they’ve had the option of artificially fertilizing embryos and selecting only those that lack the sickle cell trait. Now a new possibility is on the horizon: They may soon be able to edit the offending gene right out of their own sperm, eggs or embryos, erasing it from their bloodline forever. (Moises Velasquez-Manoff, 6/17)

The Washington Post: Executing A Severely Mentally Ill Man Would Be An Injustice
William Morva killed two people. This tragic reality is not disputed. But though Morva’s guilt is not in doubt, there is good reason to question Virginia’s plans to execute him. We now know what his sentencing jury didn’t know: Morva suffers from a serious mental illness. Justice cannot be served by executing him. (Nicholas Cote, 6/16)

San Antonio Press-Express: Addict Baby Statistics Disturbing 
The number of cases of neonatal abstinence syndrome — the problems experienced by babies born to addicted women — increased 75 percent in Texas between 2010 and 2015, state health records show. A closer examination of statistics indicates Bexar County has the dubious distinction of having 25 percent of the NAS cases in the state. (6/17)

Arizona Republic: Opioid Addiction Is Serious, But We're Fighting It With 3 Big Things
Seven-hundred and ninety. That’s how many people died from opioid overdoses in 2016. Not nationwide — that’s just in Arizona. ... Earlier this month, I declared a public health emergency in the state to address this epidemic. The issue is not unique to Arizona — all states are facing it. But in our state, we are taking serious and strategic action to save lives. A few days before I issued this declaration, the Arizona Department of Health Services released an alarming report. It concluded that an average of more than two Arizonans died every day as the result of an opioid overdose, a startling 74 percent increase in just four years. That is unacceptable. (Gov. Doug Ducey, 6/16)

WBUR: Let Mass. Be The First State To Tax Sugary Drinks 
Right now, Massachusetts has the opportunity to become the first state in the nation to pass a tax on sugar-sweetened beverages — sodas, “sports” drinks, fruit drinks and other drinks with added sugar — and get a two-fer: funds to help our struggling budget and a huge boon to public health. It’s estimated that in year one, over $350 million could be raised by the tax, funds that could be used to fix water fountains in schools, refurbish playgrounds and create the infrastructure every community needs to live healthy lives. (Louisa Kasdon and David Martin, 6/19)