KHN Morning Briefing

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Senators Grill Top Indian Health Officials About Trump Budget

The administration officials could not answer some basic questions from senators, including how much money the agency has gained from the health law’s Medicaid expansion and whether President Donald Trump’s proposed 2018 budget would help the agency hire more staff. (Phil Galewitz, 7/12)

In Texas, People With Mental Illness Find Work Helping Peers

Peer support, well-known in addiction treatment, is gaining ground for people with serious mental illness. Texas and 35 other states are training and paying peer support specialists to help bridge a gap in mental health treatment. (Lauren Silverman, KERA, 7/13)

Political Cartoon: 'Word On The Street?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Word On The Street?'" by Jen Sorensen.

Here's today's health policy haiku:


Naughty GOP,
You lost your health plan homework?
Stay in for recess!

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 Poised To Unveil New Plan In Hopes Of Securing 50 Votes And There's No Margin For Error

Sen. Rand Paul (R-Ky.) says he won't vote for the legislation, and Sen. Susan Collins (R-Maine) has also voiced strong opposition to the measure. That means Senate Majority Leader Mitch McConnell (R-Ky.) needs the vote of every single one of the rest of the 50 Republicans to pass the bill. The revised draft will be out today.

The New York Times: Senate Republicans, Preparing New Health Bill, Have No Votes To Spare
The likely defection of two Senate Republicans has left their leaders no margin for error as they move on Thursday to unveil another version of their bill to repeal much of the Affordable Care Act — without an assurance that they have the votes even to begin debate next week. Senator Rand Paul of Kentucky flatly declared on Wednesday that he would not vote to take up the bill, which he said left too much of President Barack Obama’s health law in place. Senator Susan Collins of Maine has gone almost as far, saying that the bill cuts too much and that only major revisions could win her over. (Pear and Kaplan, 7/12)

The Wall Street Journal: McConnell Faces Increasing Pressure Over Health Bill As Timetable Tightens
The revised bill is expected to include $45 billion more to combat the opioid epidemic, allow people to use funds from their health-savings accounts to pay insurance premiums, and retain the ACA’s two taxes on high-income households. Mr. McConnell responded Wednesday by warning Republicans about the perils of not coming together to pass a bill. “If we sit on our hands, families will continue to suffer,” he said on the Senate floor. (Armour, Peterson and Radnofsky, 7/12)

Politico: Senate Moderates Sidelined In New Obamacare Repeal Bill
In a closed-door meeting of Senate Republican chairmen Wednesday, Lisa Murkowski ripped GOP leaders’ attempt to scale back Medicaid spending in their Obamacare repeal bill. The two matters were unrelated, she argued, because the Affordable Care Act did not change Medicaid spending levels across the entire program. The independent-minded Alaska senator was backed up by Sen. John Hoeven of North Dakota, a Republican generally aligned with leadership, according to senators and people familiar with the conversations. (Everett and Pradhan, 7/12)

The Hill: Rand Paul: Senate Bill 'Does Not Repeal Obamacare' 
Sen. Rand Paul (R-Ky.) in a new op-ed blasts the Senate GOP's healthcare bill, saying it doesn't repeal ObamaCare. In the piece published Wednesday on Breitbart News, Paul criticized ObamaCare and targeted those in the GOP who he said are not upholding their commitment to repeal the former president's signature healthcare legislation. (Savransky, 7/12)

McClatchy: GOP Badly Needs Jerry Moran On Health Care. Will He Be There?
Senate Republicans are desperately trying to craft health care legislation that can win 50 votes, and to do that they badly need skeptics like Jerry Moran. But the Kansas senator skipped a high-level GOP caucus this week, and there’s little evidence he’s about to change his mind. (Wise, 7/12)

CQ Roll Call: Health Care Negotiations Continue As GOP Preps For Revised Bill
The Congressional Budget Office is analyzing versions of the revised bill that include and don’t include Cruz’s proposal. That analysis is still expected to be released early next week. “People who are really making a lot of the comments are fully invested in their point of view. There is an effort to get to compromise,” said Sen. David Perdue, R-Ga. “We really are down to one or two issues.” (McIntire, 7/12)

The Hill: White House Analysis Of Health Bill Seeks To Discredit CBO 
The White House on Wednesday released its own internal analysis of the Senate’s ObamaCare repeal and replace bill in an attempt to push back against the Congressional Budget Office’s (CBO) findings. In a statement, the White House said the CBO estimates about the Better Care Reconciliation Act’s (BCRA) Medicaid impact “should be discounted because of the large errors made by the agency in estimating the toll of the Affordable Care Act (ACA).” (Weixel, 7/12)

The Hill: McConnell Warns Senate: Don't Block ObamaCare Repeal Debate 
Senate Majority Leader Mitch McConnell (R-Ky.) is warning his colleagues to not block the chamber from taking up a bill to repeal and replace ObamaCare as leadership struggles to shore up support for the legislation. "I'm sure members will have other good ideas ... and I hope they will offer them. ... But if the Senate is prevented from even proceeding to the bill, none of us will have an opportunity — not Republicans, not Democrats, not anyone," McConnell said from the Senate floor Wednesday. (Carney, 7/12)

Roll Call: Senate Parliamentarian Backs Republicans On Health Law Question
After hearing arguments weeks ago from Democratic and Republican aides, Parliamentarian Elizabeth MacDonough issued her opinion that the House bill (HR 1628) complies with jurisdictional requirements within Senate reconciliation instructions. The development is significant because it means the hotly debated health care repeal written by the House can move more smoothly through the Senate without procedural problems. There still may be other challenges under the Senate's Byrd rule, which bars extraneous matter, once the bill is under debate. (Krawzak, 7/12)

Meanwhile, hospital employees, doctors and members of the public are pleading with Republicans to reject the legislation —

The Washington Post: From Hospitals, Doctors And Patients, A Last Gasp Of Opposition To The Senate Health-Care Bill
Just four days after Senate GOP leaders revealed their health-care bill this summer, Tucson Medical Center hosted a town hall thousands of miles away drawing roughly 700 people in person and 1,900 online. In its aftermath, hospital employees, doctors and members of the public sent nearly 2,900 emails to the state’s two senators, Republicans John ­McCain and Jeff Flake, urging them to reject any legislation that would jeopardize patient health care. The move was like nothing the hospital had done before, said Julia Strange, the center’s vice president for community benefit. (Eilperin and Cunningham, 7/12)

Juxtaposition Of Slashing Services For Poor, Deep Tax Cuts For Wealthy Hard To Sell To Constituents

Republicans say the taxes are killing jobs and strangling economic growth, but paired with their plans for rolling back Medicaid, the cuts may become politically toxic to Republicans.

The New York Times: A Risky Mix: Cutting Taxes For The Rich And Aid For The Poor
The tough lessons are piling up for Republicans as they struggle to repeal the Affordable Care Act, but one stands out as a harbinger of things to come: Tax cuts for the rich, paired with reduced services for the poor, are a politically unpalatable combination. Unable to get the first version of their health care bill off the ground, Senate Republicans are expected to release a revised bill on Thursday that would keep two of the taxes on the wealthy that were imposed by President Barack Obama’s health law: the 3.8 percent tax on investment income and the 0.9 percent surcharge on Medicare taxes, both imposed on high-income earners. (Rappeport, 7/12)

USA Today: Donald Trump Could Get Huge Tax Cut With Obamacare Tax Repeal
The elimination of an Affordable Care Act tax could result in a personal tax cut for President Trump of between $1.4 million and $2.8 million a year, according to a liberal advocacy group. Americans for Tax Fairness said the elimination of the 3.8% net investment income tax would, by its estimates, result in the big cut. The group based its estimates on Trump's financial disclosure form. (Estepa, 7/12)

Insurance Lobby Sounds Alarm Over Cruz Amendment To Senate Health Bill

America's Health Insurance Plans, an insurer trade group, warns that the conservative amendment to allow companies to sell skimpy plans would destabilize the market and harm coverage for people with pre-existing conditions.

Politico: Insurers Condemn Cruz-Lee Plan To Loosen Insurance Rules
Health insurers are blasting an effort by conservatives to modify the Senate Obamacare repeal bill and set up a two-tier market in which companies could sell plans that don’t meet Obamacare’s coverage requirements. Their big concern, according to documents obtained by POLITICO: The plan by Ted Cruz and Mike Lee would threaten access to coverage for individuals with costly medical conditions. (Demko, 7/12)

The Hill: Insurers Warn Cruz Amendment Would Hurt Coverage Of Pre-Existing Conditions 
The main health insurer trade group is warning Senate Republicans against including a controversial conservative amendment in their healthcare bill, saying the move would destabilize the market and harm coverage for people with pre-existing conditions. America's Health Insurance Plans (AHIP) warns in a position paper obtained by The Hill that the proposal from Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah) would cause people with pre-existing conditions to “potentially lose access to comprehensive coverage and/or have plans that were far more expensive, as premiums in the Exchange market would rise much faster than under existing market conditions.” (Sullivan, 7/12)

Roll Call: Insurance Lobby Warns Against Cruz Amendment
Health insurance lobbying groups are raising concerns about a proposed amendment to the Senate health care bill, warning that a proposal from Sen. Ted Cruz would destabilize and fracture the individual insurance market. The Texas Republican is pushing to allow insurers to sell policies on the federal exchanges that don’t meet the regulations laid out in the 2010 health care law (PL 111-148, PL 111-152), so long as an insurer offers one plan that does comply with the law. (McIntire, 7/12)

Morning Consult: AHIP Rejects Proposed Cruz Amendment To Senate’s Health Care Bill
AHIP’s cautious opposition was not enough to sink the House-passed version of the bill to repeal and replace the ACA, but the group’s skepticism may hold more weight with senators, who are awaiting the Congressional Budget Office’s cost estimate of the market impact of Cruz’s amendment. Senate GOP leaders are hoping to vote on revised legislation next week. (Reid, 7/12)

Senator Says Revised Health Bill Will Keep Republicans' Proposal To Reduce Medicaid Costs

Sen. Pat Toomey (R-Pa.), a proponent of the reductions, said he has been led to believe that the new draft bill will not change much on the question of Medicaid funding. If so, that could make it hard for some moderate senators to support the measure.

NBC News: Changes in Senate Health Care Bill Coming But Medicaid Cuts Remain
Senate Republicans are preparing to unveil a revised health care bill that aims to attract support from wary Republicans, but early indications suggest the proposed changes do little to address concerns about the current deep cuts to Medicaid, possibly putting the bill’s path to passage in peril. ... "My understanding is that remains the same," Sen. Pat Toomey, R-Penn., a proponent of the Medicaid cuts, of the Medicaid portion of the bill. (Caldwell, 7/12)

PolitiFact: Is Medicaid Driving The Budget Deficit, As Pat Toomey Said?
Sen. Pat Toomey, R-Penn., defended the Senate health care bill’s curbing of Medicaid spending by calling Medicaid the single-biggest driver of the federal budget deficit. ... Is Medicaid the primary culprit behind the federal budget deficit? We found Toomey is playing parlor games with budget figures. (Tobias, 7/12)

CNN: Medicaid Affects Millions Of Americans, Young And Old
Your tax dollars provide health care benefits for millions of people. Currently, 74 million people receive health coverage under Medicaid, a government program for low-income people, including adults with disabilities and children. Under the program, beneficiaries pay low out-of-pocket fees for health services that are paid for by federal dollars. ... Medicaid ranks as the single largest source of health coverage in the United States, according to the government website. (Scutti, 7/13)

Bipartisan Whispers Start Behind The Scenes As Republicans Publicly Push For A Vote

Discussions about what to do if the GOP's proposed legislation fails are under way, prompting senators to quietly reach across the aisle.

USA Today: Senate Health Care Troubles Spawn Bipartisan Talks
Senate Republican leaders are plowing ahead with their goal to pass a GOP-only bill to repeal and replace Obamacare next week, but behind the scenes a bipartisan group of senators is discussing how to move forward if the bill fails. “We’ve had great conversations — a lot of Democrats and Republicans,” Sen. Tom Carper, D-Del., told reporters Wednesday. Carper said he's been talking specifically with Sen. John McCain, R-Ariz., and they have agreed on the need to draft a bill in public with opportunities for amendments and a full debate. (Collins and Greene, 7/12)

Politico: Bipartisan Fixes Won't Come Easily If GOP's Repeal Effort Collapses
[M]any in the GOP privately say they might need a break between seven years of repeal attempts and a sudden repair effort. And some Democrats are already calling for single-payer health care — an automatic non-starter for Republicans. The sharp political divide underscores just how hard it would be for the parties to come together amid the ashes of a failed repeal. (Haberkorn and Cancryn, 7/12)

Meanwhile, these House Democrats have a proposal to stabilize the marketplace —

The Hill: Ten House Democrats Propose Plan To Fix ObamaCare 
Ten House Democrats are proposing a plan to stabilize the ObamaCare markets and reduce premiums. The plan, released Wednesday by the New Democrat Coalition's Affordable and Accessible Health Care Task Force, comes as Republicans pressure Democrats to come up with their own plan to "fix" the Affordable Care Act. (Hellmann, 7/12)

CQ Roll Call: House Democrats Push For Health Exchange Stabilization Plan
The five-part plan by the coalition, led by Democratic Reps. Kurt Schrader, Ore.; Ami Bera, Calif.; and Ann McLane Kuster, N.H., is designed to stabilize the individual marketplace, control costs, promote enrollment and increase options for consumers. During a news conference announcing the plan, Schrader emphasized there is room for bipartisan discussions to improve the marketplace. “I’ve had conversations with Republican and Democratic senators and there’s a group of folks willing and wanting to work, and I hope our leadership will give us that opportunity,” Schrader said. “Hopefully moderate Republican senators will be looking at this" and conclude that, "well, geez, there are Democrats that are willing to step up, maybe buck our leadership a little bit and work across the aisle and solve the problems in the individual marketplace.” (Raman, 7/12)

Trump Puts Pressure On McConnell: I'll Be 'Very Angry' If The Bill Doesn't Pass

The comments come as the majority leader is scrambling to garner support for his legislation.

The Washington Post: Trump: ‘I Will Be Very Angry’ If GOP Senators Don’t Pass A Health-Care Bill
The comments, coming in an interview at the White House with televangelist Pat Robertson of CBN News, intensified public pressure on Majority Leader Mitch McConnell (R-Ky.), who plans to release a revised version of his health-care legislation Thursday morning. “I am sitting in the Oval Office with a pen in hand, waiting for our senators to give it to me,” Trump said. “It has to get passed. They have to do it. They have to get together and get it done.” (Sullivan, Wagner and Snell, 7/12)

Politico: Trump: I'll Be 'Very Angry' If The GOP Health Care Bill Fails
Trump noted how often Republicans have touted repealing the landmark 2010 health care bill. “They’ve been promising it for years. They’ve been promising it ever since Obamacare which is failed,” Trump said. “It’s a failed experiment. It is totally gone. It’s out of business and we have to get this done.” (Tesfamichael, 7/12)

The Hill: Trump: I’ll Be ‘Very Angry’ If Senate Doesn’t Pass ObamaCare Repeal Bill 
President Trump said he’ll be “very angry” if Senate Republicans aren’t able to pass a bill to repeal and replace ObamaCare, as GOP leaders get ready to unveil their updated legislation. Trump said Republicans have been promising for years that they’d repeal ObamaCare, and now with Republicans controlling Congress and the White House, he said he’s “waiting” to sign a repeal bill. If Senate Republicans aren't able to pass their bill, known as the Better Care Reconciliation Act, he said that’d be “very bad.” (Hagen, 7/12)

ACA Repeal Would Jeopardize Coverage For More Than 300,000 Native Americans, Alaska Natives

The uninsured rate among Native Americans would climb by 27.4 percent in Kansas and 36.2 percent in Missouri.

KCUR: Report: ACA Repeal Would Send Native American Uninsured Rate Soaring 
The number of Native Americans without health insurance would increase sharply if Republicans in Congress succeed in repealing and replacing the Affordable Care Act, according to a new report. The report, from the left-leaning Center on Budget and Policy Priorities, says that proposed cuts to Medicaid and to the subsidies that reduce out-of-pockets costs for low-income individuals purchasing private insurance in the ACA marketplace would jeopardize the coverage of more than 300,000 Native Americans and Alaska Natives. (McLean, 7/12)

In other news on the effects of possible repeal —

The Washington Post: Republicans’ Obamacare Repeal Bill Would Bar Some Immigrants From Buying Insurance On The Exchanges
Hundreds of thousands of immigrants could be locked out of the health insurance marketplaces if the Senate’s new health-care bill becomes law. Buried among the bill’s provisions that roll back the Medicaid expansion and lower marketplace subsidies is a shift in eligibility requirements. Rather than all legal immigrants being able to receive tax credits and buy coverage in the marketplace like under the Affordable Care Act, the new bill — aside from a few, narrow exceptions — allows only permanent residents and people who immigrated for humanitarian reasons to participate. (Soffen, 7/12)

KQED: Rural Californians Want Price Relief From GOP Health Bill – But Most Won’t Get It
Aaron Albaugh peers out from under the brim of his cowboy hat, surveying the acres of hay fields in front of him. The fourth-generation rancher is raising about 450 cattle this year, in this remote corner of Lassen County. His closest neighbor lives a half mile away. “And that’s my brother,” Albaugh says. “If I want to go see a movie, it’s 70 miles round trip,” he adds. “If I want to go bowling, that’s 100 miles round trip.” Living a half day’s drive from civilization,  you learn to do without, he explains. (Dembosky, 7/12)

Health Care To Be Top Discussion Point At Governors Meeting

The ongoing opioid crisis is also expected to be a topic at the National Governors Association's three-day conference.

The Associated Press: Governors Gather To Discuss Challenges Facing Their States
More than half of U.S. governors are meeting this week to discuss the biggest challenges facing their states. Those include the possibility of major changes to Medicaid and states' health insurances marketplaces under the Republican health care plan in Congress, the ongoing opioid epidemic and the impact of climate change. (McDermott, 7/13)

Roll Call: A Friendly Face: Pence Deployed To Governors
Vice President Mike Pence on Friday will continue his quiet campaign as the Trump administration’s ultimate inside player when he tries to convince governors to view President Donald Trump as a partner on issues such as health care and infrastructure. With Trump in France participating in that country’s Bastille Day festivities, Pence is being deployed to the National Governors Association conference in Rhode Island. (Bennett, 7/13)


Obamacare Markets Showing Signs Of Profitability

Although Republicans often point to signs suggesting the individual insurance markets are collapsing, recent analysis suggests they are stabilizing, Politico reports. Other news outlets look at insurance issues including some companies' move to cover early chronic health problems to forestall bigger expenses later and efforts to keep beneficiaries out of emergency rooms.

Politico: Despite Doomsday Rhetoric, Obamacare Markets Are Stabilizing
“Obamacare is dead,” President Donald Trump frequently declares. But reports of its demise appear to be premature. For the first time ever this year, insurers selling plans in Obamacare’s markets appear to be on a path toward profitability. And despite the drumbeat of headlines about fleeing insurers, only about 25,000 Obamacare customers live in communities facing the prospect of having no insurer next year. (Demko, 7/12)

NPR: Health Insurers Pay More Up Front To Reduce Costs Later
Diabetes, high blood pressure and other chronic conditions account for the vast majority of health spending in the U.S., according to the Centers for Disease Control and Prevention. Almost half of American adults have one or more chronic physical or mental health conditions, and spending on them adds up to some $2.3 trillion a year. Some health plans are beginning to offer free maintenance care for people with chronic health problems, hoping that spending a little more early on will save a lot [of] money in the long run. (Zdechlik, 7/12)

And in other insurance news --

Bloomberg: Insurance Startup Expands In Medicare With Obamacare In Limbo
Startup Bright Health is betting it can compete in the lucrative market of covering U.S. seniors as congressional debate keeps the future of Obamacare’s insurance plans in limbo. Bright Health is preparing to offer Medicare Advantage plans in three markets next year in close collaboration with local health systems: Birmingham, Alabama; Phoenix, Arizona; and the Denver-Boulder area of Colorado. The company offered Obamacare plans in that area of Colorado this year, but is holding off on expanding amid doubts over the health law’s future. (Tracer, 7/12)

Capitol Hill Watch

'Horrified' Senators Question IHS Official Over Reports Of Unsafe, Poor Care At Hospitals

Acting Indian Health Service Director Rear Adm. Michael Weahkee says he visited the hospitals in question and "saw a committed caring workforce that is working hard.”

The Wall Street Journal: Lawmakers Grill Indian Health Service Leader On Failing Care
The Indian Health Service’s top official dodged frustrated lawmakers’ questions about unsafe care at the federal agency and whether proposed budget cuts would worsen the situation during a tense Senate committee hearing Wednesday. Members of the Senate Indian Affairs and Senate Appropriations committees repeatedly cited two articles published last week in The Wall Street Journal on the agency, which provides health care to 2.2 million tribal members. (Weaver and Frosch, 7/12)

Kaiser Health News: Senators Grill Top Indian Health Officials About Trump Budget
Leaders of the Indian Health Service struggled Wednesday at a Senate hearing to defend the Trump administration’s plans to slash funding to the agency, which is reeling from quality of care problems at several of its hospitals, a doctor shortage and facilities showing their age. The lack of answers infuriated both Democrats and Republicans on the Appropriations subcommittee. (Galewitz, 7/12)

CQ Roll Call: Senate Appropriators Tear Into Indian Health Leaders
Appropriators Wednesday fumed over the Trump administration’s budget request for the Indian Health Service, with one top lawmaker noting he was leaving the hearing with his “hair on fire” after the agency’s top official failed to give clear answers to basic budget questions. “If you guys don’t advocate for a budget, how the hell are we supposed to fix it?” Sen. Jon Tester said in a heated exchange, after acting Indian Health Service Director Rear Admiral Michael D. Weahkee would not answer yes or no when asked if the budget request cut funding for hiring staff at the agency. (Mejdrich, 7/12)

Coverage And Access

Lawsuit Against California Claims Medicaid Provides 'Unequal System Of Health Care'

Civil rights advocates file suit against California, alleging that care provided by Medi-Cal, the state’s health program for low-income people, is substandard and disproportionately hurts Latinos — by far the largest group of enrollees.

The Associated Press: Latino Plaintiffs Sue California Alleging Poor Health Care
California is harming medical care for more than 13 million lower-income residents, more than half of them Latinos, by failing to pay doctors enough to provide proper care, according to a lawsuit filed Wednesday. The lawsuit alleges the state violates Latinos' civil rights because poorly paid health care providers balk at providing treatment. (Thompson, 7/12)

California Healthline: California Sued For Allegedly Substandard Medi-Cal Care
The two groups that filed the case hope to get it certified as a class-action lawsuit on behalf of all Medi-Cal enrollees. The complaint claims that beneficiaries of Medi-Cal, the state’s version of the Medicaid program, often experience delays in care or are denied care altogether. And, it says, they may have to travel longer distances to find medical providers who are willing to see them. (Ibarra, 7/13)

Los Angeles Times: Medi-Cal Patients Sue State, Claiming Widespread Discrimination
Thomas A. Saenz, an attorney representing the plaintiffs and president and general counsel for the Mexican American Legal Defense and Educational Fund, said the state is required to provide coverage to low-income Californians through Medi-Cal that’s equivalent to the care other Californians receive through private insurance or Medicare. But Medi-Cal patients have a harder time finding doctors, wait longer for appointments, end up in the emergency room more often and have their diseases diagnosed later than those in other insurance programs, Saenz said. That’s in part because the state mismanages the health program and delays payments to doctors, making them unwilling to see Medi-Cal patients, he said. (Karlamangla, 7/12)

Administration News

NIH Gets $1.1B Funding Increase From House Appropriators

The funding boost for the National Institutes of Health, which was advanced by a House subcommittee, is counter to the White House plan to slash medical research spending and is offset with reductions to family planning and refugee services.

The Hill: Lawmakers Propose $1.1B Boost To NIH, Defying Trump Budget 
The House subcommittee controlling the purse strings of the National Institutes of Health (NIH) on Wednesday proposed a $1.1 billion boost for the agency, defying the Trump administration's push for cuts. The White House had proposed slashing the nation’s medical research agency by $5.8 billion. But it was clear from the get-go that Congress wouldn’t support cutting NIH’s budget, with members of both parties in opposition. (Roubein, 7/12)

CQ Roll Call: Family Planning Cuts Help Boost NIH In House Spending Bill
The House spending bill to fund the Department of Health and Human Services would decrease its fiscal 2017 allocation of $78 billion by $542 million for fiscal 2018, with cuts to family planning and refugee services going to offset a $1.1 billion increase to the National Institutes of Health. For the most part, the bill is a rejection of the Trump administration’s proposal to cut around $15 billion from HHS. The overall bill includes $156 billion in total funding, a $5 billion discretionary cut from fiscal 2017 levels. The Department of Education has the most significant cut of $2.5 billion, while the Department of Labor would face a $1 billion cut. HHS only faces around $500 million in cuts. (Siddons, 7/12)

New CDC Director's Track Record On Public Health Initiatives Worries Some Advocates

Brenda Fitzgerald chose to partner with Coke in an effort to fight obesity, a move that raises some eyebrows. “We hope Dr. Fitzgerald, as head of Centers for Disease Control and Prevention, avoids partnering with Coke on obesity for the same reason she would avoid partnering with the tobacco industry on lung cancer prevention,” said Jim O’Hara of the Center for Science in the Public Interest.

The Washington Post: New CDC Chief Partnered With Coke In State Obesity Program
As Georgia’s top public health official, Brenda Fitzgerald led the fight against childhood obesity in a state with one of the highest rates in the country. The program there, funded in part by the Coca-Cola Foundation, emphasizes exercise and makes little mention of the problems with sugary soft drinks — putting the effort at odds with research and the positions of many experts. (Sun, 7/12)

In other federal government news —

Nashville Tennessean: VA's Facility Planning An Obstacle To Modernize Its Care, Report Says
The Department of Veterans Affairs is using an outdated and shortsighted planning process for managing its facilities and it's an obstacle for the VA's effort to repurpose or rid itself of old buildings and plan for future of care. That is the finding of the Government Accountability Office, which issued an opinion Wednesday on the VA's two processes it uses to plan for managing facilities and how they are used to provide medical care for the nation's veterans. (Lowary, 7/12)


Despite Complaints About FDA's Right-To-Try Approach, Watchdog Says It's Mostly Doing A Good Job

The Government Accountability Office did say the agency could do better at providing clear and transparent information about potential side effects of the experimental drugs. In other pharmaceutical news: the House passed an Food and Drug Administration authorization bill, President Donald Trump considers scaling down a program that makes drugmakers give discounted products to hospitals, and a new method might help shave off development time for drugs.

Stat: FDA Gets Good Marks On Compassionate Use, Except For ...
Despite widespread criticism, a new report finds the Food and Drug Administration made useful changes to a controversial program that provides access to experimental medicines. However, the agency still needs to do a better job of explaining how patient side effect data can influence drug approval decisions, according to the U.S. Government Accountability Office analysis. Not surprisingly, the findings prompted the same sort of bickering sparked by the program, itself. (Silverman, 7/12)

Modern Healthcare: House Passes Bipartisan FDA User Fee Bill 
The House of Representatives passed bipartisan legislation Wednesday that reauthorizes the FDA's ability to collect user fees from drug and device makers, as policymakers look to avoid thousands of layoffs if the current agreement expires. The FDA user fee agreements, which are renegotiated every five years with the makers of prescription brand drugs, medical devices, generic drugs and biosimilars, fund much of the FDA's operations. (Kacik, 7/12)

CQ Roll Call: House Passes Key FDA User Fee Bill
The House on Wednesday passed by voice vote a key Food and Drug Administration authorization bill, setting up a Senate vote in the coming weeks that might not be quite so easy. The bill (HR 2430) would renew the FDA’s authority to collect fees from the prescription drug and medical device industries. Industry fees make up about $2 billion of the FDA’s nearly $5 billion budget. The bill would set new fee levels for fiscal years 2018-2022, and lawmakers have added other policy changes. It also would require the FDA to prioritize the approval of certain generic drugs and set up a system for the regulation of hearing aids that don’t require a prescription. (Siddons, 7/12)

Modern Healthcare: Trump May Be Backing Off From Plan To Scale Down 340B 
Hospital lobbying groups say they're hearing President Donald Trump may be backing off plans to scale back a federal program that requires drugmakers to give discounted products to hospitals that treat a high number of poor patients. A proposed executive order on drug pricing from the Trump administration leaked late last month contained language that directed the HHS Secretary to find ways to reduce the size of the 340B program. (Dickson, 7/12)

Stat: Bin Chen: Cutting To The Chase With Computational Biology
The in silico approach to drug development just got a taste of validation, thanks to some intriguing new research from University of San Francisco, California. A drug cherry-picked with algorithms has behaved as expected: It’s helped shrink tumors in animal models. The UCSF researchers have created a computational method to delve through enormous amounts of open-access data to find novel drugs — and also discover new ways to repurpose existing drugs. The work was just published in Nature Communications. (Keshavan, 7/13)


Medicare Analysis To Be Released Today Could Trigger Obamacare's Mandate To Cut Spending

Experts have warned that the report expected to be released today on the finances of Medicare could launch a process under the health law to make cuts. A panel expected to do that, called the Independent Payment Advisory Board, has not been named, however.

Stat: Board That Inspired 'Death Panel' May Have To Be Convened By Trump
Remember “death panels”? They may be back. As soon as Thursday, Trump administration officials may have to launch the process that inspired that phrase — and that is aimed at making cuts to Medicare. ...The panel, known as the Independent Payment Advisory Board, or IPAB, has never had to meet or make a decision about spending. But Medicare experts have warned that this year’s data, which is widely expected to be released as soon as Thursday, might trigger the panel — setting off a new political firestorm in the midst of congressional Republicans’ efforts to overhaul the rest of the health care system. (Mershon, 7/12)

Public Health And Education

'Most Exciting Thing I've Seen In My Lifetime': FDA Panel Approves Groundbreaking Cancer Treatment

Full approval from the agency is expected to follow.

The New York Times: F.D.A. Panel Recommends Approval For Gene-Altering Leukemia Treatment
A Food and Drug Administration panel opened a new era in medicine on Wednesday, unanimously recommending that the agency approve the first-ever treatment that genetically alters a patient’s own cells to fight cancer, transforming them into what scientists call “a living drug” that powerfully bolsters the immune system to shut down the disease. (Grady, 7/12)

The Washington Post: FDA Panel Recommends Approval Of CAR T-Cell Therapy
The unanimous recommendation from the Oncologic Drugs Advisory Committee means the treatment could be approved by the FDA by the end of September, forging a new path in the immunotherapy frontier. Timothy Cripe, a panel member who is an oncologist with Nationwide Children's Hospital in Columbus, Ohio, called the treatment the "most exciting thing I've seen in my lifetime." (McGinley, 7/12)

NPR: FDA Advisors Endorse Genetically Engineered Immunotherapy For Cancer
The treatment takes cells from a patient's body, modifies the genes, and then reinfuses those modified cells back into the person who has cancer. If the agency approves, it would mark the first time the FDA has approved anything considered to be a "gene therapy product." The treatment is part of one of the most important developments in cancer research in decades — finding ways to harness the body's own immune system to fight cancer. (Stein, 7/12)

The Fiscal Times: Groundbreaking New Leukemia Treatment Will Save Lives And Billions
An advisory panel of the FDA voted 10-0 to recommend the approval of tisagenlecleucel, a treatment developed by the pharmaceutical firm Novartis. The treatment requires the extraction of a patient’s own infection-fighting T-cells, which are then genetically engineered to recognize and fight the cancer cells affecting the patient, and infused back into the bloodstream. (Garver, 7/12)

Money, Recognition And Dark Chocolate: How To Sell Doctors On Prescribing Powerful Painkillers

Two former sales reps pleaded guilty to violating the federal anti-kickback law in bribing doctors to prescribe Subsys. A look at the case shows how companies can get doctors to do their bidding.

Stat: Former Insys Reps Plead Guilty To Bribing Docs For Opioid Prescribing; They Wanted 'Money' And 'Dark Chocolate'
Two former sales reps pleaded guilty on Tuesday to bribing doctors in exchange for prescribing the powerful Subsys painkiller sold by Insys Therapeutics, which is under numerous investigations by state and federal authorities for its role in the opioid epidemic. In both instances, the sales reps pleaded guilty to violating the federal anti-kickback law for participating in a speaker program that prosecutors say was used to reward doctors and other medical practitioners for prescribing Subsys, which contains fentanyl and carries a high risk of dependency. (Silverman, 7/12)

In other news on the opioid epidemic —

The Associated Press: Doctor Accused In Deaths Of At Least 7 In Oklahoma, Texas
A Texas doctor wrote unnecessary prescriptions for powerful drugs that contributed to the overdose deaths of at least seven people over a four-year period, according to a federal indictment unsealed Wednesday. Howard Gregg Diamond, 56, was arrested Tuesday on charges that include conspiracy to distribute controlled substances and health care fraud. (7/12)

The Philadelphia Inquirer/ Wolf Hails New Program In Opioid Treatment
Gov. Wolf on Wednesday joined Clarion University officials to announce the launch of an online certificate program in opioid treatment, which they said is the first of its kind in Pennsylvania. “Education is a powerful thing,” Wolf said at a news conference at the Capitol. “Armed with facts, health-care providers, drug counselors, EMTs, school counselors, therapists, anyone interested in learning more will be able to take this online course.” In 2015, 3,500 Pennsylvanians died of drug overdoses, Wolf said. He said it appears that the toll in 2016 was even higher. (Langley, 7/12)

The Associated Press: Palm Beach County Considers Suing Drug Companies
At the suggestion of a Palm Beach County Commissioner, the county is looking into suing drug companies whose products are at the heart of the opioid crisis. The Palm Beach Post reports the county attorney will have her staff examine the legal landscape to determine if pharmaceutical companies have been successfully sued, which jurisdictions have been involved and what law firms have taken on the work. (7/12)

Study May Provide Road Map For Scientists Searching For Genes Linked To Autism

Researchers found that the way children search out social experiences is connected to genetics. In other public health news: prostate cancer, Zika, food safety and diets, deadly infections and more.

Stat: 15 Percent Of Men Regret Prostate Cancer Treatment Choices Years Later
After years of introspection, about 15 percent of men with localized prostate cancer regretted the decisions they made regarding treatment, a survey of almost 1,000 patients showed. About twice as many men expressed regret after radical prostatectomy or radiation therapy as compared with active surveillance. The single biggest contributor to regret was treatment-associated sexual dysfunction, as reported in the Journal of Clinical Oncology. (Bankhead, 7/12)

Los Angeles Times: Surgery For Early-Stage Prostate Cancer Does Not Lead To Longer Lives, Study Finds
A long-term study of men diagnosed with early-stage prostate cancer has confirmed that patients who forgo immediate surgery have the same odds of living another decade or two as patients who have their tumors surgically removed. The results, published in Thursday’s edition of the New England Journal of Medicine, show that while each approach offers a different mix of benefits and risks, neither is likely to result in death due to prostate cancer. (Abed, 7/12)

USA Today: Why Zika Virus Infections Are Way Down In U.S. This Summer
Zika, the virus that sparked widespread concern last year? It’s on the wane, at least for now. The number of people infected with Zika is down substantially this year in the United States, reflecting a precipitous drop in mosquito-borne virus infections in Puerto Rico and other overseas locations. (Orr, 7/12)

Stat: Changing What You Eat Can Change How Soon You'll Die
A new study shows that such diet changes are better late than never — as long as those new healthy habits stick. That came from researchers at Harvard’s school of public health who tracked what over 70,000 people have eaten for decades. They found that long-term improvements in diet were associated with a significantly decreased risk of death. (Sheridan, 7/12)

The Baltimore Sun: Genetics Playing A Growing Role In Intersection Of Nutrition And Health 
Dieticians for years have used genetics on a limited basis, looking at mutations in one particular gene that may make patients prone to disease or more likely to have certain health conditions. For example, patients who are lactose intolerant can't break down the lactose found in dairy products because of a mutation in the lactose gene. So they suffer with gas and other uncomfortable digestive problems after drinking milk or eating cheese or ice cream. The sequencing of the human genome - or the mapping of every gene in the body - has enabled not just dieticians, but all doctors, to use genetics in a more comprehensive way. A doctor can look at a patient's entire genetic makeup to determine, for instance, if they have multiple gene mutations that would make them more prone to obesity or cardiovascular disease. (McDaniels, 7/13)

The New York Times: The Chemicals In Your Mac And Cheese
Potentially harmful chemicals that were banned from children’s teething rings and rubber duck toys a decade ago may still be present in high concentrations in your child’s favorite meal: macaroni and cheese mixes made with powdered cheese. (Rabin, 7/12)

Kaiser Health News: DNA Links Deadly Germs, Tainted Heart Surgery Devices To German Factory
Contamination at a German factory that makes crucial machines used during open-heart surgery is the likely source of a global outbreak of deadly infections tied to the devices, the largest analysis to date shows. Scientists using whole-genome sequencing matched the DNA fingerprints of samples taken from infected heart-surgery patients from several countries, including the U.S., to samples from the devices, called heater-cooler units, in multiple hospitals — and at the production site. (Aleccia, 7/12)

Stat: Movement Supports People Who Hear Voices, Yet Refuse Medication
Do patients who hear voices — and suffer other symptoms that psychiatrists would consider severe —  have the right to direct their treatment, even if that means rejecting conventional therapies, such as psychiatric medication? Some mainstream psychiatrists have concerns that people who are out of touch with reality and spurn treatment may pose a danger to themselves or others. But the movement, which began in the Netherlands, has spread rapidly in the past three decades; there are now “hearing voices” support groups on all five continents, and over 180 in the U.K., alone, anchored by the Hearing Voices Network. The idea has been slower to take hold in the U.S., which has a strong medical model for treating mental illness, but is gaining steam there, too. (Wang, 7/13)

NPR: Study Finds Mistakes With Medications On The Rise
When people take medicine at home, mistakes happen. Some people end up taking the wrong dose of a medication or the wrong pill. Sometimes, they don't wait long enough before taking a second dose. Other times, it's a health professional who's at fault. A pharmacist might have dispensed a medication at the wrong concentration, for example. (Columbus, 7/12)

The New York Times: Who Needs Hard Drives? Scientists Store Film Clip In DNA
It was one of the very first motion pictures ever made: a galloping mare filmed in 1878 by the British photographer Eadweard Muybridge, who was trying to learn whether horses in motion ever become truly airborne. More than a century later, that clip has rejoined the cutting edge. It is now the first movie ever to be encoded in the DNA of a living cell, where it can be retrieved at will and multiplied indefinitely as the host divides and grows. The advance, reported on Wednesday in the journal Nature by researchers at Harvard Medical School, is the latest and perhaps most astonishing example of the genome’s potential as a vast storage device. (Kolata, 7/12)

State Watch

About 1,200 Nurses Strike At Major Boston-Area Hospital

The nurses union at Tufts Medical Center held a one-day strike over a contract dispute centered on the administrators' plans to alter retirement benefits.

Boston Globe: ‘We Want To Work’: Nurses Strike At Tufts Medical Center Now A Lockout
More than 100 members of the striking Massachusetts Nurses Association made a symbolic effort to return to work at the Tufts Medical Center on Thursday, but they were rebuffed by security as the first nurses strike against a Boston hospital since 1986 turned into a lockout expected to last into Monday. The nurses union launched a one-day strike around 7 a.m. Wednesday, setting up a picket line that drew hundreds of union members along with political figures to the sidewalk outside the hospital on Washington Street in Boston’s Chinatown section. (Salinas and Sweeney, 7/12)

WBUR: Tufts Medical Center Nurses Go On Strike
Hundreds of nurses lined the sidewalks in front of Tufts Medical Center Wednesday in what the union says is the largest nursing strike in Massachusetts history. It is also the first nurses strike in Boston in 30 years. (Bebinger, 7/12)

The Wall Street Journal: Nurses At Major Boston Hospital Go On Strike
Nurses at a major Boston hospital went on strike Wednesday for the first time in three decades at a time of concerns nationally over labor costs at hospitals. Some 1,200 nurses at Tufts Medical Center staged a one-day strike over a contract dispute centered on the hospital’s efforts to alter retirement benefits by moving nurses who still have traditional pension plans into less costly 401 (k)-style accounts. (Levitz, 7/12)

Boston Globe: At Tufts Medical Center, Pressure To Cut Costs In A City Rich With Hospital Care
In many cities, for patients needing complex medical care, Tufts Medical Center would be the only destination in town. But in Boston, a city rich with big hospitals, Tufts has long been overshadowed by larger competitors with more prestigious names and deeper pockets. The disparities between Tufts and its competitors have been thrown into sharp relief by an ugly labor dispute. On Wednesday, more than 1,200 members of the Massachusetts Nurses Association went on strike after the union and the hospital failed to come to terms on staffing levels, wages, and retirement benefits. (McCluskey, 7/12)

State Highlights: San Diego Hepatitis A Breakout Claims 5 Lives; Colorado's 'Baby Box' Effort Aimed At Reducing Infant Mortality

Media outlets report on news from California, Colorado, Maryland, Illinois, Florida, Missouri, Wisconsin, New Hampshire and Ohio.

Los Angeles Times: Hepatitis A Outbreak In San Diego County Claims 5th Victim
A fifth person has died in San Diego County’s ongoing hepatitis A outbreak — the state’s largest in two decades, public health officials said Wednesday. The outbreak started in November and has grown among the region’s homeless population. There have been 228 confirmed infections, including 161 people who had to be hospitalized, according to the county’s Health and Human Services Agency. (Sisson, 7/12)

Denver Post: All New Mothers In Colorado Can Receive Baby Boxes, Thanks To New Program
New and expectant mothers across Colorado will soon be eligible to receive a free gift: a cardboard box that health workers hope will reduce infant mortality. The box comes courtesy of The Baby Box Co., a for-profit maker of the kinds of boxes that mothers in Finland have received for decades. The boxes include a basic foam mattress and can serve as a safe sleep space for infants up to about 6 months old. A smattering of other items — such as diapers, wipes and onesies — are also included with the boxes. (Ingold, 7/12)

Sacramento Bee: Single Payer Health Care Still On Wish-List In California
Toni Atkins grew up without health insurance in a “crossroads out in the middle of nowhere. ”The family lived in rural Virginia, where her father worked as a miner and her mother was a seamstress. Her mom broke an arm at one point, reducing the family to one income while medical bills stacked up. “We had to get food stamps. It was excruciating,” Atkins said. (Luna, 7/13)

The Baltimore Sun: University Of Maryland Medical System Board Approves Affiliation With Dimensions Health
The University of Maryland Medical System board of directors executive committee voted Wednesday to bring Dimensions Health Corporation under the UMMS banner. The vote authorizes, Robert A. Chrencik, UMMS president and chief executive officer, to enter into an affiliation agreement with Dimensions in Prince George's County.The Dimensions board voted last month to allow the merger to go through. (McDaniels, 7/12)

Chicago Tribune: Abbott, Silicon Valley Company Partner To Develop System For Diabetes Patients 
When Jeffrey Brewer's son was 15, the boy nearly lost his life because he took too much insulin. The diabetic teen took insulin to eat a large bag of chips late at night. But about 20 minutes later, he forgot about that first dose and took another. He spent two days in the hospital, his father said...Now, Bigfoot Biomedical and north suburban-based Abbott Laboratories hope to help prevent such problems — and make life easier for millions of people with diabetes — with a new partnership announced Thursday. The partnership aims to combine several technologies to make it easier for diabetics to monitor their glucose levels and figure out how much insulin to take throughout the day. (Schencker, 7/13)

Health News Florida: More Rain Means More Mosquitoes In Orange County
There’s a downside to the rainy season in Florida: Mosquitoes. Orange County Mosquito Control has seen a tenfold increase to about 100 calls for service every day. The calls are primarily for nuisance mosquitoes, not the mosquitoes that can transmit Zika virus and other diseases. The county urges residents to drain standing water to cut down on mosquito breeding areas. (Aboraya, 7/12)

Health News Florida: Newtown Celebrates New ‘One-Stop-Shop’ Clinic
A new adult-care clinic in Newtown opened this month.  A community-wide partnership aims to make the clinic a ‘one-stop-shop’ for a variety of needs for the community just north of the city of Sarasota, where access to medical care and other services has been a challenge. (Davis, 7/12)

KQED: Is The New Tobacco Tax Causing A Drop In Smoking? Big Time, Indicators Suggest
Last fall, California voters approved the biggest increase in cigarette taxes since the state first began levying tobacco in the 1950s. Advocates for Proposition 56, which passed with a fairly overwhelming 64 percent of the vote, argued that a $2-per-pack tax hike would hurt pocketbooks enough to nudge millions of California smokers to quit, or at least to light up less frequently. (Levin, 7/12)

Modern Healthcare: SSM Health To Acquire Wisconsin Hospitals From The Congregation Of Sisters Of St. Agnes
SSM Health will acquire two Wisconsin-based systems from the Congregation of Sisters of St. Agnes, the Catholic-sponsored providers announced Wednesday. The systems are Agnesian HealthCare and Monroe Clinic. St. Louis-based SSM Health owns St. Mary's Hospital in Madison, Dean Clinic and hospitals in Baraboo and Janesville. The facilities will likely carry the SSM Health brand. (Kacik, 7/12)

San Francisco Chronicle: Group Seeks Referendum On Flavored Tobacco Ban In S.F.
A San Rafael lawyer has filed a referendum measure to strike down the Board of Supervisors’ ban on flavored tobacco, which passed unanimously in June. ... The group represents tobacco manufacturers R.J. Reynolds and Altria, as well as several vaping advocacy groups and the Arab American Grocers Association, whose members opposed the supervisors’ ordinance, saying it hurt immigrant business owners. (Swan, 7/12)

Weekend Reading

Longer Looks: The Future Of Repeal; A New 'War On Drugs'; And IVF Innovations

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The Economist: The Republicans’ Chances Of Replacing Obamacare Are Receding
No Republican senator looms larger in the schemes of left-wing protesters than Susan Collins of Maine. One of the last New England moderates, a once-common Republican species, Ms Collins is considered the likeliest holdout against the draft Republican health-care reform that has overshadowed the week-long Independence Day recess. But on the evidence of her appearance at the Fourth of July parade held in Eastport, Maine, America’s easternmost city, liberals can relax. (7/6)

The New York Times: A Small-Town Police Officer's War On Drugs
Eric Adams is a handsome, clean-­shaven man, almost 41, with a booming voice and hair clipped short enough for the military, which once was an ambition of his. After high school, he tried to join the Marines but was turned away because of his asthma. He needed three different inhalers then, plus injections. Today he has outgrown the problem. He is 5-foot-10, weighs 215 pounds and can dead lift 350. (Benjamin Rachlin, 7/12)

The Atlantic: INVOcell: Growing Cheaper Embryos For IVF Inside The Vagina
As the number of U.S. babies born as a result of fertility treatment tops 1 million—an all-time high—clinics are under pressure to keep up to date with pricey lab equipment that can create, develop, and test embryos. But some fertility doctors have started to offer a new low-tech device that enables a woman to incubate them in her own body. The catch: She grows them inside her vagina. (Sarah Elizabeth Richards, 7/12)

FiveThirtyEight: The Trump Administration’s Own Data Says Obamacare Isn’t Imploding
President Trump and other Republicans have said repeatedly that one reason they have to repeal and replace the Affordable Care Act is that the law is failing: Healthy people are abandoning the insurance marketplaces set up by the law, driving up costs and leading yet more people to drop insurance — a so-called “death spiral.” Many health insurance experts, however, have argued that those fears are overblown, and they recently got support from an unlikely source: the Trump administration itself. (Anna Maria Barry-Jester, Michelle Cheng and Maggie Koerth-Baker, 7/7)

The New York Times: The Gentler Symptoms Of Dying
The patient’s hair was styled with curls so stiff, they held her head a few inches up from her hospital pillow. She had painted her lips a shade of bright pink that exuded the confidence of age. Just after her colon burst, she was still awake. She looked around, at me, at the monitors. She asked for pain medication. “Am I dying?” she asked. (Sara Manning Peskin, 7/11)

Editorials And Opinions

Viewpoints: Obamacare Options; Is It Really Exploding Or Imploding?; Reforming Medicaid

Opinion writers offer their analysis of the ongoing debate on Capitol Hill and across the country over health care reforms and other issues.

The Wall Street Journal: ObamaCare Freedom And Failure Options
Senate Republicans will roll out a revised health-care bill as soon as Thursday, and then begin a final drive to a vote this month. So this is a moment to take stock of some of the larger political dimensions of the ObamaCare debate. Legislative progress has been slower and more difficult than it might have been for a party that ran for seven years on a repeal-and-replace agenda. The benefit is that Senate Republicans are better educated about health-care substance and prepared to make hard governing choices—if they can persuade the remaining Bartlebys. (7/12)

The New York Times: Obamacare Is Not Collapsing, Imploding Or Exploding
The biggest lie that President Trump and other Republican leaders have been repeating about the Affordable Care Act for years is that it is collapsing, imploding or exploding. The truth is that the law is actually working reasonably well, and even the part that has shown the most weakness — the health insurance marketplaces — has been stabilizing. (7/13)

Los Angeles Times: Obamacare Is Only 'Exploding' In Red States
When he talks about his efforts to repeal the Affordable Care Act, President Trump almost always asserts that Obamacare is “exploding.” Republican members of Congress make similar claims, insisting that Obamacare is unsustainable—and that they therefore have no choice but to “repeal and replace” it. There is some basis for this argument. More than 1,300 counties only have one insurer in their exchanges, meaning there is no competition. But there is a nuance that Republicans willfully ignore: This is a problem of their own creation that is largely confined to red states. (Dean Baker, 7/13)

JAMA Forum: JAMA Forum: Reforming Medicaid
We are 2 former Administrators of the Medicare and Medicaid programs, under Presidents Barack Obama and George H. W. Bush. Although we represent different political parties, we take pride in the accomplishments of these 2 programs, which collectively help millions of US residents get the health care they need. ... we are calling for Congress to separate reforms to the Medicaid program from the most pressing task at hand—stabilizing and improving the nongroup market. Given the divergent views on appropriate Medicaid changes, we recommend initiating a 12-month bipartisan review process that focuses on long-term reforms to improve care and reduce costs. (Andy Slavitt and Gail Wilensky, 7/11)

Topeka Capital Journal: Medicaid Matters For Kansas Children
Over [the past 37 years], I have provided health care for thousands of children. A large number of those children have been Medicaid recipients. I have seen firsthand the importance of Medicaid to our community. I have seen firsthand the lives this program has saved. That is why I am so disheartened by the attempts of Congress to drastically cut funding to this program. (Dr. Dennis Cooley, 7/12)

The Washington Post: There’s No Way To Replace Planned Parenthood
Of all the magical thinking that has gone into Republican proposals to replace Obamacare, none has been more fanciful than the argument accompanying efforts to defund Planned Parenthood. The yarn that has been spun is that other health-care providers would easily absorb the patients left adrift if Planned Parenthood could no longer receive Medicaid reimbursements. In truth, there is no way community health-care centers cited by Republicans as an alternative could fill the gap. In truth, millions of women would lose access to critical health care. (7/12)

PBS Newshour: Why We Are All Insurance Companies
This odd dictum, from the famous American philosopher Charles Sanders Peirce, that likens us to insurance companies may serve us well as we struggle to find the best path forward in the health insurance debate. ... The usefulness of Peirce’s linkage between a financial concept and our humanity is also representative of how finance can be considerably more humane than usually assumed. (Mihir A. Desai, 7/13)

Bloomberg: States Have Good Reason To Investigate Opioid Makers
Frustrated by the ever-escalating opioid crisis, and short of effective strategies to tackle it, states are moving against drugmakers. More than half have joined a bipartisan investigation into whether the companies are to blame for the epidemic, because they marketed their prescription painkillers too aggressively, downplaying the risk of addiction. Some have already filed lawsuits seeking damages. (7/11)

Boston Globe: Mass. Can Propel Research On Gun Violence
There’s a story behind every firearm used in a crime. For example: How does a gun purchased legally out of state end up at a Lawrence shooting? Together, those stories can help uncover the drivers of gun violence. Do guns used for crimes in certain Boston neighborhoods, for instance, come more often from particular dealers? ... So far, the state has issued one annual report summarizing the data, but no detailed analysis has yet been performed to identify meaningful trends. (7/13)

The Wall Street Journal: Don’t Hold Fast To This Surgical Rule
Imagine you’re heading into surgery for a hip fracture. You might be anxious about how it will go and nervous about starting rehab. You also probably are hungry and thirsty. For decades, patients have been told to fast before surgery. Eight in 10 say their doctors instructed them to, according to a 2017 survey commissioned by my company, Abbott, and conducted by Clarus Research. (Hakim Bouzamondo, 7/12)