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

'Bureaucratic Ninjas' Slice Red-Tape To Battle Health Disparities

A person's ZIP code can be as important to her health as her genetic code. One large health system has begun to tackle the social challenges that influence a person's health by asking questions and giving extra help to people in need. (Kristian Foden-Vencil, Oregon Public Broadcasting, 8/7)

Political Cartoon: 'Happy Coincidence?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Happy Coincidence?'" by Mike Smith, Las Vegas Sun.

Here's today's health policy haiku:


Huge Aetna profits
Belie health care's "death spiral."
Fakest news of all!

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

As ACA Emerges From The Rubble Intact, Attention Shifts To Enrollment Season

Many questions remain about what exactly the enrollment period will look like, and if President Donald Trump and his administration will try to undermine sign-ups. Meanwhile, the damage may already be done to the individual marketplace following months of uncertainty.

The Washington Post: The First Affordable Care Act Enrollment Season Of The Trump Era Is Still A Mystery
As the fate of the Affordable Care Act dangled dramatically in the Senate last month, the Trump administration abruptly canceled contracts with two companies that have helped thousands of Americans in 18 cities find health plans under the law. The suspension of the $22 million contracts, which ends enrollment fairs and insurance sign-ups in public libraries, is one of the few public signs of how an administration eager to kill the law will run the ACA’s approaching fifth enrollment season. (Goldstein and Winfield Cunningham, 8/6)

The Associated Press: Trump's Role Shifts To Caretaker As Health Repeal Stalls
With Republicans unable to advance a health care bill in Congress, President Donald Trump's administration may find itself in an awkward role as caretaker of the Affordable Care Act, which he still promises to repeal and replace. The Constitution says presidents "shall take care that the laws be faithfully executed." So as long as former President Barack Obama's law is on the books, that doesn't seem to leave much choice for Trump, even if he considers the law to be "a disaster." (8/7)

Milwaukee Journal Sentinel: Move Threatened By Trump Could Create Turmoil In The Obamacare Market
President Donald Trump appears inclined to send rates soaring for at least some health plans sold directly to individuals and families next year, a move that could make health insurance far more expensive for millions of people who don’t get federal subsidies through the Affordable Care Act. Although congressmen from both parties are discussing ways to prevent such a shock in the marketplaces set up by the law, Trump tweeted last weekend that he wants to “let ObamaCare implode.” (Boulton, 8/4)

Politico: GOP Efforts To Stabilize Obamacare Markets Might Come Too Late
Republicans now say they want to stabilize the distressed Obamacare markets for 2018, but it may be too late. Insurers have warned for months that they need certainty from Washington in order to decide where they will sell Obamacare plans and how much to charge. But after months of fruitless repeal efforts and growing unease over White House threats about pulling funding and undermining the law, the damage may be done. Lawmakers can’t simply flip a bipartisan switch and pass a stabilization plan, particularly since they won’t return to Washington for a month. (Demko, 8/4)

Boston Globe: Mass. Health Insurers Uneasy Over Trump’s Threat To Cut Subsidies
Health insurance subsidies that help about 155,000 lower-income Massachusetts residents pay for their coverage are at risk if President Trump makes good on his threat to cut off the payments promised under the federal Affordable Care Act. ...An abrupt cutoff of the subsidies could further destabilize insurance markets by forcing insurers to raise their rates, which would make insurance less affordable for families on the lower end of the income scale. (Dayal McCluskey, 8/4)

And in other marketplace news —

Houston Chronicle: Insurer Lost $230 Million Last Quarter But Says Texas Market Remains Strong 
Molina Healthcare, one of three health insurers expected to remain on the Affordable Care Act's exchange in Houston next year, announced a $230 million loss in its second quarter. Molina Healthcare this week announced a $230 million loss in its second quarter and said it would stop offering plans on Affordable Care Act exchanges in Utah and Wisconsin. It's also looking at participation levels in other states. (8/4)

New Hampshire Union Leader: Member Medical Cuts Prices In Reaction To Obamacare Increase 
With rates expected to increase an average of 44 percent on the state’s Obamacare exchange, a New Hampshire company has decided to lower its membership prices.  “We want to make health care more accessible and more affordable,” said Nicole Lane, chief operating officer with Member Medical, which was founded by Nick Vailas, also the founder and CEO of Bedford Ambulatory Surgical Center in Bedford. (Houghton, 8/6)

McConnell Concedes GOP May Consider Bipartisan Solution To Stabilizing Marketplace

But Senate Majority Leader Mitch McConnell (R-Ky.) still hasn't entirely ruled out repeal efforts, either. Meanwhile, Republicans are facing a time crunch if they want to move to tax reform.

The Associated Press: McConnell To Consider Bipartisan Plan To Pay Health Insurers
A week after an attempt to repeal the Affordable Care Act failed, Senate Majority Leader Mitch McConnell says he'd consider a bipartisan effort to continue payments to insurers to avert a costly rattling of health insurance markets. McConnell told reporters Saturday there is "still a chance" the Senate could revive the measure to repeal and replace "Obamacare," but he acknowledged the window for that is rapidly closing. (8/5)

Bloomberg: Senate Republicans Nod At Bipartisan Push For Insurer Payments 
The Senate health committee will begin bipartisan hearings in early September on stabilizing and strengthening the Affordable Care Act’s individual insurance market, Republican Chairman Lamar Alexander of Tennessee and top Democrat Patty Murray of Washington said in a joint statement on Aug. 1. (Brody, 8/6)

San Francisco Chronicle: Senate Republicans Open To Bipartisan Talks On Health Care
Senate Republicans are willing to consider a bipartisan approach to strengthening the individual insurance market under Obamacare, even as President Trump is deciding whether to end payments for it. ...Trump has tweeted to his 35.2 million followers that senators, who are away from Washington for their summer recess, shouldn’t vote on anything else until they’ve completed the effort to revamp President Barack Obama’s signature health law. (Brody, 8/6)

The Hill: Five Tough Decisions For The GOP On Healthcare
While the GOP attempt at repealing ObamaCare has stalled for now, some in the party are not giving up. "This ain't over by a long shot … we won't rest until we end the ObamaCare nightmare once and for all,” Vice President Pence said at the Tennessee GOP 2017 Statesmen's Dinner Thursday, according to a pool report. (Roubein and Weixel, 8/6)

Politico: Tax Writers See Peril In Trump's Obamacare Persistence
Republicans acknowledge that the aggressive timeline they have set up for overhauling the tax code this fall leaves them little room for error. There could be one problem with that: Obamacare isn’t going away. ... That’s left key Senate tax writers frustrated that there’s potentially another issue to take precious time away from their tax reform efforts. (Becker and Lorenzo, 8/7)

Atlanta Journal-Constitution: With Health Care Bill In Limbo, GOP Shifts Into Push For Major Tax Reform
As a GOP plan to overhaul the Obama health law foundered in the U.S. Senate, Republicans in Congress quickly shifted their focus in recent days to a new goal, getting a major tax reform to the President’s desk, though many on Capitol Hill believe the undertaking could be more complicated – and includes more political pitfalls – than the derailed debate on Obamacare. ...What are the chances of that happening, and when will see the details on the GOP plan? (Dupree, 8/6)

And in other news —

The Wall Street Journal: Congressional Recess, Full Plate Keep The Heat On GOP Lawmakers
Congressional Republicans plan to use the next four weeks away from Washington making a public case for a sweeping rewrite of the tax code, an ambitious legislative undertaking they hope will heal divisions that opened when the party’s signature health-care bill collapsed. But at home in their districts, they face pressures that could make it hard to focus on taxes. Many of their constituents and party activists blame Congress, more than President Donald Trump, for the health-care stalemate and are pressing them to find a resolution. And before they can do anything, lawmakers face a load of time-sensitive fiscal business: hashing out a budget, funding the government and raising the federal debt limit. (Hughes and Hook, 8/6)

The Wall Street Journal: Susan Collins Talks Health Care At Camp Kotok
Health insurance reform isn’t dead yet, said U.S. Senator Susan Collins, the Maine Republican who cast one of the three pivotal GOP “no” votes that defeated her party’s efforts to repeal Obamacare. About a dozen Senators from both parties have met for three private dinners to talk about a potential compromise, Ms. Collins said Aug. 4 at Camp Kotok, an annual gathering in northern Maine of investors, asset managers and economists hosted by David Kotok. (Loder, 8/5)

The Associated Press: Gov. LePage Stands By Criticism Of Senators Over Health Vote
Gov. Paul LePage said on Friday he is standing by an op-ed he wrote that slammed his state's two U.S. senators despite criticism from former Senate Majority Leader George Mitchell. Mitchell, a Democrat who served as majority leader from 1989 to 1995, issued a rare public political statement Thursday in which he said Republican Sen. Susan Collins and independent Sen. Angus King were right to vote against a proposed repeal of the Affordable Care Act. (8/4)

The Hill: Collins, Murkowski Glad They Had Each Other For No Votes On Healthcare 
GOP Sens. Susan Collins (Maine) and Lisa Murkowski (Alaska) said they were glad that they had each other when they voted against moving forward on the Republican healthcare bill last week, the pair said Thursday on CNN. The two were the only Republicans who voted against the motion to proceed on the healthcare vote, leading the Senate to begin debating on their plans to repeal and replace ObamaCare. The Republicans eventually failed to pass even their watered-down "skinny" repeal plan after Sen. John McCain (R-Ariz.) joined them in voting against the measure. (Eberhardt, 8/4)

Administration News

Hospitals Nervous As Medicare Considers Paying For Joint Replacements At Surgical Centers

If the federal government begins covering hip and knee surgeries in outpatient facilities, hospitals could lose substantial business. Also in the news, consumer groups mobilize to fight the Trump administration's proposal to allow nursing homes to force residents to settle complaints through mediation and in support of a decision during the Obama administration to hold up Medicaid money for Texas because of anti-abortion laws there.

Modern Healthcare: Hospitals Leery Of CMS Proposal To Pay For Joint Replacements In ASCs 
Many orthopedic surgeons and ambulatory surgery center operators are delighted with the CMS' mid-July announcement that it's considering paying for total knee and hip replacement procedures in outpatient settings. But lots of hospital leaders are not. ...Hospital leaders are wary, however, for both financial and clinical reasons. They fear losing substantial inpatient revenue from total joint procedures—one of their bigger profit centers—to ambulatory surgery centers, as they've previously lost many other surgical procedures. In addition, they and doctors on staff aren't necessarily comfortable at this point doing the operations in either hospital outpatient departments or ambulatory surgery centers. (Meyer, 8/5)

The Hill: Fight Over Right To Sue Nursing Homes Heats Up
Consumer groups are making a last ditch effort to stop the Trump administration from stripping nursing home residents and their families of the right to take facilities to court over alleged abuse, neglect or sexual assault. The Centers for Medicare & Medicare Services (CMS) announced plans in June to do away with an Obama-era rule that prohibited nursing homes that accept Medicare or Medicaid funds from including language in their resident contracts requiring that disputes be settled by a third party rather than a court. (Wheeler, 8/6)

Texas Tribune: Feds Draw Thousands Of Comments On Texas' Request To Renew Women's Health Funding
Thousands of advocates have flooded the federal government with comments this week, weighing in on whether it should reverse an Obama-era decision to strip Texas of millions in federal funding for a health care program that excludes abortion providers and their affiliates. The number of comments to the Centers for Medicare & Medicaid Services on Texas' request has doubled in recent days, from 9,000 earlier this week to over 18,000 as of Friday afternoon, hours before the public comment period ends. (Platoff, 8/4)


Republican Lawmakers In Pa. Weigh Changes To Medicaid, Adding Work Requirement

The state Senate has passed the plan and it goes back to the House for a vote. Meanwhile, officials and Medicaid enrollees in Nevada are concerned about the future of the Medicaid expansion program there.

Pittsburgh Post-Gazette: Healthcare Advocacy Groups Oppose Effort To Add Medicaid Work Requirement
Democratic Gov. Tom Wolf scrapped his predecessor’s health plan in favor of a Medicaid expansion when he took over as Pennsylvania governor in 2015. But now a Medicaid plan with features of former Republican Gov. Tom Corbett’s Healthy PA — including a work requirement — could become law under Mr. Wolf. Legislation passed by the state Senate late last month could re-shape the commonwealth’s Medicaid program — potentially making benefit changes and requiring work from the pro­gram’s able-bodied recipients. (Giammarise, 8/7)

Las Vegas Review-Journal: High-Stakes Health-Care Debate Hits Nevada’s Medicaid Program
Nevada expanded its Medicaid program in 2014 as authorized by the ACA, adding some 210,000 residents to its rolls. As a result, hundreds of millions of additional federal dollars flow through the program into Nevada’s health care system annually. In total, 637,795 Nevadans were enrolled in the program as of June, an increase of 175 percent from the 231,923 who participated in 2010. While the political threat to the program has at least temporarily eased, with the Republican-led Congress turning to tax reform and other matters, it is far from over. (Botkin, 8/5)

In other Medicaid news —

Reuters: Illinois Fights Potential Hike In Disabled Care Funding
Illinois fought on Friday against a potential court order it contends could cost the state, which just ended an unprecedented budget impasse, as much as an additional $1 billion annually to care for developmentally disabled people. In arguments before U.S. District Court Judge Sharon Johnson Coleman, advocates for disabled people living outside of institutions said Illinois is violating a federal consent decree by failing to provide required services due to insufficient funding. (Pierog, 8/4)

Veterans' Health Care

Providers Failing To Follow Up With Troops At Risk For Suicide

The report also found that one third of troops with PTSD were prescribed with a medication harmful to their condition.

USA Today: Troops At Risk For Suicide Not Getting Needed Care, Report Finds
Pentagon health care providers failed to perform critical follow-up for many troops diagnosed with depression and post-traumatic stress syndrome who also were at high risk for suicide, according to a new study released Monday by the RAND Corp. Just 30% of troops with depression and 54% with PTSD received appropriate care after they were deemed at risk of harming themselves. The report, commissioned by the Pentagon, looked at the cases of 39,000 troops who had been diagnosed in 2013 with depression, PTSD or both conditions. USA TODAY received an advance copy of the report. (Brook, 8/7)

In other military health care news —

Modern Healthcare: House Committee To Explore Care For Veterans During Field Hearing 
The House Veterans Affairs Committee will be using the August recess to hear from the people. Committee Chairman Rep. Phil Roe (R-Tenn.) scheduled a field hearing for Aug. 10 in Duluth, Minn., to get a sense of how the Veterans Affairs Department can improve access to care, especially in rural areas. Among other things, the committee will look at how the VA can improve capacity at its medical centers and clinics. The committee will also delve into the Choice program, which allows veterans to seek care at non-VA facilities. (Weinstock, 8/5)


Shkreli Gave The Public A Face To Blame For Price Gouging. Now He's A Convicted Felon

Martin Shkreli was found guilty of three counts of fraud and faces a possible prison sentence. But how has his case affected the pharmaceutical industry?

Stat: The Shkreli Saga: What's Changed? What Hasn't? And What's Next?
Martin Shkreli, the hoodie-clad bete noire that pharma uses as a moral yardstick, is now a convicted felon. ... And in the years since the scandal surrounding Shkreli’s Turing Pharmaceuticals, the tone around drug pricing has gone from peripatetic frustration to ongoing outrage. Each new drug approval is met with “Yes, but how much will it cost?” Headlines that once heralded medical innovation are now sure to include words like “pricey,” “costly,” or “expensive.” Companies that withhold pricing information upon approval are only prolonging the inevitable. (Garde, 8/4)

Stat: Shkreli Is Convicted Of Fraud. Can Pharma Finally Slam The Door On Him?
Is this the end of the line for the “pharma bro” with the perpetual smirk? Martin Skhreli was found guilty on Friday of three counts of fraud after a five-week trial in federal court in Brooklyn, N.Y. He faces a prison sentence that could stretch years. ... The big question now: Can the pharma industry finally slam the door on Shkreli, after complaining for nearly two years that his price-hiking antics tainted the reputation of the entire field? (Keshavan, 8/4)

The Associated Press: Convicted ‘Pharma Bro’ Has An Image Problem, Lawyer Concedes
Martin Shkreli, the eccentric former pharmaceutical CEO notorious for a price-gouging scandal and for his snide “Pharma Bro” persona on social media, was convicted Friday on federal charges he deceived investors in a pair of failed hedge funds. A Brooklyn jury deliberated five days before finding Shkreli guilty on three of eight counts. He had been charged with securities fraud, conspiracy to commit securities fraud and conspiracy to commit wire fraud. (Hays and Neumeister, 8/4)

Public Health And Education

FDA Ramps Up Efforts To Stop Flood Of Synthetic Opioids Coming Into U.S. Through Postal Service

Members of Congress also are trying to address the mail issue. Sen. Rob Portman (R-Ohio) is pushing a bipartisan bill called the STOP Act, which would require foreign postal services to provide electronic security data on all packages shipped to the United States. Meanwhile, officials are worried that the surge in opioid-related deaths in Maryland signal a worsening of the crisis.

The Washington Post: FDA To Step Up Targeting Of Fentanyl, Other Synthetic Opioids At Postal Facilities
The Food and Drug Administration is strengthening efforts to detect opioids illegally entering the country through the mail, reflecting heightened concerns about the flood of synthetic fentanyl and similar drugs being shipped from China and elsewhere. Commissioner Scott Gottlieb, in internal remarks to a group of senior managers Thursday, said he was deploying about three dozen employees to international mail facilities run by the U.S. Postal Service to help detect and analyze suspicious packages, as well as to the FDA’s cybercrime and forensic-chemistry units. (McGinley, 8/4)

The Washington Post: Maryland Fentanyl Deaths Surge Again In First Quarter Of 2017
The number of Maryland deaths related to fentanyl, a powerful synthetic opioid, surged in the first quarter of 2017, more than doubling from the first quarter of 2016, and making up the majority of drug-related overdose deaths in the state. Maryland’s Department of Health and Mental Hygiene reported Friday that fentanyl-overdose­ fatalities jumped to 372 from January through March, up from 157 during the same period in 2016. Fentanyl and a related additive, carfentanil, which are increasingly common nationwide, can be 50 or 100 times more powerful than heroin. (Chason, 8/5)

The Baltimore Sun: Maryland Overdose Deaths Continued To Soar In The First Part Of The Year 
There were 550 overdose deaths, including 372 from fentanyl, a cheap and powerful drug coming into the U.S. from overseas that mixed in with heroin, typically without people knowing, according to data released Friday by the Maryland Department of Health. The number of deaths from fentanyl soared 137 percent from 157 deaths during the same period last year. The numbers were not surprising to public health officials who said they only expect the problem to get worse. (McDaniels, 8/4)

And in other news on the epidemic —

The Philadelphia Inquirer: After Cancer, Opioid Use Can Be A Lingering Side-Effect
Sandwiched between multiple reports and alarms about opioids being overprescribed and abused comes this: People who have survived cancer may get even more pain pills than the rest of the population. In this case, however, there may be good reasons. Although most people are well-aware that cancer can return years after it has been treated, oncologists say that there is an oversimplified belief that the disease, once banished from the body, has few lingering effects. (Sapatkin, 8/7)

New Hampshire Union Leader: New Drug Treatment Program At Valley Street Jail Gets Underway 
Members of the first group of eligible inmates to enroll in the new Substance Abuse Treatment Community for Offenders (SATCO) program at the Valley Street jail are scheduled to move into the second phase of their treatment later this week. Hillsborough County Board of Commissioners Chairman Toni Pappas said over the weekend the new SATCO program — in development for over a year and a half — launched June 12 at the Hillsborough County Department of Corrections with 20 participants: 12 in the female program, and eight in the male program. (Feely, 8/6)

San Francisco Chronicle: Lack Of ID Hinders Therapy For Homeless Heroin Addicts
As the nation’s heroin and painkiller epidemic rages, small but vulnerable populations of homeless people are sometimes turned away from the nation’s already-threadbare system of drug treatment centers because they do not have valid photo identification. Transient lifestyles are not conducive to keeping the identifying documents that are often necessary during the screening processes for drug treatment facilities (Izaguirre, 8/6)

Fears Of Entering Into A 'Designer Baby' Era Through Gene Editing Unfounded, Experts Say

For the first time, researchers were able to repair a gene mutation through editing, but that doesn't mean parents will be able to order a custom baby anytime soon, if ever.

The New York Times: Can Gene Editing Actually Do That?
This week, scientists reported that they had successfully edited harmful mutations out of genes in human embryos. It’s just the latest in a string of gene editing firsts facilitated by a system called Crispr-Cas9, which has enabled scientists, entrepreneurs -- even middle school students -- to snip, insert and delete genetic material with unprecedented precision and ease. (Murphy, 8/4)

The Way People Touch, Use Smartphones Could Predict And Preempt Mental Health Issues

A study has found a strong correlation between patients suffering from depression and anxiety and certain patterns in keyboard and other touchscreen actions on their smartphones. In other public health news: Alzheimer's tests, tobacco, sleep apnea, sexual assault and paralysis, kids with inexplicable pain, and more.

Stat: Mindstrong Wants To Predict Mental Illness From Smartphone Interactions
Dr. Thomas Insel is one of the most high-profile scientists who has departed Verily Life Sciences, the Google spinoff that has been plagued by turnover at the top and questions about its approach to science. Insel, a neuroscientist and longtime head of the National Institute of Mental Health, left for a venture that he says could use people’s behavior on smart phones — such as the speed and cadence of their typing and scrolling — to improve diagnosis and treatment of mental health. The idea, he said in an interview, is to apply the kind of precision approach used for cancer or heart disease to “predict and preempt” serious mental illness. (Piller, 8/7)

NPR: Better, Cheaper Alzheimer's Tests In The Works
Efforts to develop a treatment that stalls the memory-robbing devastation of Alzheimer's disease have so far been unsuccessful, but scientists are making strides in another important area: the development of better tests to tell who has the condition. Their aim is to develop more accurate, cheaper and less invasive tests to detect the biological markers of Alzheimer's-induced changes in the brain. (Wang, 8/4)

The Wall Street Journal: Big Tobacco’s Next Big Thing? Tobacco
Big Tobacco is working on its next act, as cigarette sales decline around the world and once-breakneck growth from the first wave of e-cigarettes fades. Three of the world’s biggest tobacco firms are rolling out new, electronic tobacco-heating devices they say are healthier alternatives to traditional smoking, but feel more like puffing on a real cigarette. That is a sensation many smokers complain is missing from the wide array of electronic cigarettes currently on the market. (Chaudhuri, 8/6)

Bloomberg: Trump Administration Halts Federal Effort To Combat Truckers' Sleep Disorder 
The Trump administration is halting a year-old effort to seek better ways to diagnose truckers and railroad workers who have sleep apnea, a health condition linked to deadly accidents. Two agencies in the Department of Transportation announced Friday that they will no longer pursue a regulation to combat obstructive sleep apnea, which prevents people from getting decent rest and has led to drivers nodding off behind the wheel. The federal government was considering screening truck drivers and train engineers for the disorder. (Levin, 8/4)

The Washington Post: How Talking To Yourself Can Help Scientists Understand The Brain
Do you talk to yourself? Don’t sweat it: Scientists say you’re not alone. And the ways in which you chatter to yourself, both in your head and out loud, are changing what neuroscientists know about the human brain. Writing in Scientific American, psychologist Charles Fernyhough reveals why we’re our best conversational partners. Scientists have only recently learned how to study self-talk — and it’s opening up exciting new avenues of research. (Blakemore, 8/5)

Stat: Track Authorities Move To Again Bar Women With Naturally High Testosterone
The limit dates back to 2011, when the International Association of Athletics Federation (IAAF), which oversees track and field events, first created the rule. Naturally produced high testosterone, the group ruled, provided female athletes with an unfair advantage akin to doping — and so, to compete, a woman over the limit would have to lower her testosterone, through medication or surgery, or prove that she was not sensitive to its effects. (Caruso, 8/7)

Chicago Tribune: Doctors May Be Over-Prescribing Seizure Drugs To Treat Pain
Doctors are prescribing the anti-seizure drugs gabapentin (Neurontin) and pregabalin (Lyrica) to treat pain more frequently, partly in response to the opioid epidemic in the United States, said Dr. Allan Brett. He's a professor of clinical internal medicine with the University of South Carolina School of Medicine in Columbia.However, the drugs might not be doing any good for many people suffering from chronic pain, Brett said. (Thompson, 8/4)

Stat: How Obama's Science Experts Are Still Operating In The Shadows
Nearly all of the Obama administration’s science staff has departed the White House since January, and the Trump administration has moved slowly to replace them. In the meantime, however, an unofficial shadow office, stocked with Obama loyalists, is quietly at work. The network, described to STAT by officials from the previous administration who are involved, is informal yet organized, allowing for a far-reaching if largely inconspicuous effort to continue advocating for the Obama science agenda. (Facher, 8/7)

Columbus Dispatch: Doctors Warn Of Deadly Risks Of Antibiotic Overuse
For decades, doctors and patients have overused, misused and abused antibiotics without much thought, but public health officials are warning that the practice is taking a dangerous, even deadly toll. ...Each year, at least 2 million people in the United States become infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result, according to the Centers for Disease Control and Prevention (CDC). (Pyle, 8/6)  

WBUR: 'Mozak' Lets Online Players Beat Brain Scientists At Their Own Game
Created by the Allen Institute for Brain Science and the Center for Game Science, the free online game has attracted around 2,500 players since its release last November. They're helping to fill a major scientific gap: We still don't really understand how neuron circuits in our brain are structured or how they work. (Choi, 8/4)

State Watch

State Highlights: Calif. Assembly Speaker Faces Recall After Sidelining Single-Payer Bill; Vermont Grapples With Funding Care For Those With Disabilities

Media outlets report on news from California, Vermont, Kansas, Wisconsin, Ohio, Texas, Michigan, Minnesota, Florida, Massachusetts, New York and Pennsylvania.

The Associated Press: California Speaker Recall Effort Reflects Democratic Tension
Democrats control every lever of power in California state government, and free from worrying about major losses to Republicans, they’re training fire instead on each other. The latest example is a recall effort against Assembly Speaker Anthony Rendon, a strong progressive now targeted by party activists upset that he derailed a bill seeking government-funded health care for all. (8/5)

WBUR: As Clients And Caregivers Age, Vermont Revamps Services To People With Disabilities
Vermont has long been a leader in supporting adults with developmental disabilities: It was one of the first states in the U.S. to shut down its institutional hospital and move adults with disabilities out into their communities. But the state is now grappling with how to fund quality services for those with disabilities as they — and their caregivers — age. (Weiss-Tisman, 8/4)

Milwaukee Journal Sentinel: Community Health Workers Offer A Bridge To Health In Low-Income Areas
Community health workers often are trusted members of the communities they work in and are able to connect residents to health and social services that are specific to their needs. ...Because these workers are familiar with the communities where they work, they have shared experiences and often understand their residents better than a health professional with multiple degrees would. (Guerra Luz, 8/4)

Columbus Dispatch: More Ohio Parents Don't Want Kids Vaccinated, But Numbers Still Small
This time of year, parents are checking the items off their child’s back-to-school list: pencils, pens, scissors, glue, notebooks, backpack. But there’s another back-to-school-list some parents forget: DTaP, chickenpox, MMR, hepatitis B, polio, and meningococcal — the six vaccinations Ohio law requires students receive before attending school. (Williams, 8/6)

NPR: South Texas Launches New Effort To Diagnose And Treat Tuberculosis
At San Antonio's largest homeless shelter, huge fans cool off the temporary residents. The courtyard can get crowded. One of the hundreds of nightly boarders is James Harrison. "I lost my apartment and had nowhere else to go," he explains. Like most people at Haven for Hope, Harrison, who is 55, doesn't plan on staying long. But while he's here, he's taking advantage of some free medical testing — a screening for dormant tuberculosis. (Rigby, 8/4)

Los Angeles Times: What We Know About California's Largest Toxic Cleanup: Thousands Of L.A. County Homes Tainted With Lead
By this fall, California’s Department of Toxic Substances Control plans to begin removing lead-tainted soil from 2,500 residential properties near the shuttered Exide Technologies battery recycling plant in Vernon. The cleanup — the largest of its kind in California history — spans seven southeast Los Angeles County neighborhoods, where plant operations have threatened the health of an estimated 100,000 people. (Barboza and Poston, 8/6)

Kansas City Star: Dangerous Chemicals In KC Area Water Listed In Database
It’s easy to check, using a database published last week by the national Environmental Working Group, which allows anyone to punch in their ZIP code and see a list of potentially harmful chemicals found in the local tap water. The database, which includes water utilities from all over the Kansas City area, shows test results collected from nearly 50,000 public water systems in all 50 states. (Cummings, 8/4)

Detroit Free Press: Thousands Expected To Seek Free Medical, Dental Care At At Cobo Center
Thousands of uninsured or underinsured metro Detroiters are expected to flood Cobo Center this week for free medical and dental care through a nonprofit that serves the needy population across the country and worldwide. The Motor City Medical Mission (MCMM), which could turn out to be the largest health care clinic ever in Detroit, will operate Thursday through Saturday in downtown Detroit. No identification, address or documentation of need is required. Nor are attendees being asked to register, just simply walk in. Attendees will be seen on a first-come, first-served basis. (Pais-Greenapple, 8/7)

Los Angeles Times: Rich And Powerful Figures Will Set USC Course In Wake Of Scandal, From Behind Closed Doors
How USC handles one of the biggest scandals in its history will be decided behind closed doors by a small group of wealthy and powerful people. Composed of 57 voting members, USC’s board of trustees includes noted philanthropists, accomplished alumni, Hollywood insiders and industrial tycoons. ... It is this elite group that is overseeing the investigation into how the university handled the case of former medical school dean Dr. Carmen A. Puliafito. The Times reported last month that Puliafito, while leading USC’s Keck School of Medicine, partied with a circle of addicts, prostitutes and other criminals who said he used drugs with them, including on campus. (Kohli, Parvini, Hamilton and Elmahrek, 8/6)

KCUR: KU Cancer Center To Persist In Quest For Prestigious ‘Comprehensive’ Designation 
The director of the University of Kansas Cancer Center says it will continue to pursue “comprehensive” status after the National Cancer Institute denied it that coveted designation this week. “We’re just going to be absolutely fearless in moving forward with this initiative,” says Dr. Roy Jensen, who has led the KU Cancer Center since 2004.Jensen says it typically takes 10 to 15 years to attain comprehensive status, a recognition that an institution has demonstrated a high level of excellence over an extended period of time. The KU Cancer Center only received National Cancer Institute (NCI) designation in 2012 – a status that was renewed for another five years this week – so the denial of comprehensive status was not entirely unexpected. (Margolies, 8/4)

Tampa Bay Times: How The 'No Wrong Door' Approach To Mental Health Treatment Is Playing Out In Hillsborough County
The facility, the only one of its kind in the Tampa Bay area, serves as a behavioral health emergency room with a coordinated web of services to ensure the person in crisis is getting the right level of care, said Gracepoint CEO Joe Rutherford. The concept has existed for years but gained steam statewide last year with the passage of a law that overhauled mental health and substance abuse treatment and mandated a "no wrong door" approach for people entering the system. (Varn, 8/4)

The Star Tribune: Minneapolis City Council Approves Menthol Tobacco Restriction
The City Council approved a restriction on menthol tobacco Friday, limiting sales to adult-only tobacco shops and liquor stores. The vote was the culmination of a community-led effort to reduce access to menthol tobacco, a product that historically has been marketed to black smokers and that anti-smoking activists say makes it easier for young people to start smoking. (Nelson, 8/4)

San Jose Mercury News: Santa Clara: Family Sues City After Police Killed Their Son
Underneath the red, purple and yellow poncho from Colombia bearing the name of her slain son, Amanda Sommers’ shoulders trembled. The mother of Jesús A. Geney, a 24-year-old man killed by Santa Clara police while suffering a mental breakdown, stood in front of Santa Clara City Hall on Saturday to announce her family is suing the city. (Giwargis, 8/5)

The Associated Press: Doctor Told To Stop Marketing 3-Person Baby Technique
U.S. regulators on Friday warned a New York fertility doctor to stop marketing an experimental procedure that uses DNA from three people — a mother, a father and an egg donor — to avoid certain genetic diseases. The doctor, John Zhang, used the technique to help a Jordanian couple have a baby boy last year. (Johnson, 8/4)

The Star Tribune: University Of Minnesota Bioethicist Takes On Clinics Touting Stem-Cell Studies
Listed on a government website, they present the opportunity to participate in clinical trials to test the potential of one of the most promising tools in medicine — the body’s own stem cells. ...Now, with a national debate raging over the future of one of the hottest frontiers in 21st-century medicine, a University of Minnesota bioethicist has taken center stage in questioning whether many of these services are legitimate. (Carlson, 8/5)

The Associated Press: Nurse Pleads Guilty To Secretly Filming Female Patients
Authorities say a Pennsylvania nurse has pleaded guilty to secretly filming unclothed female patients as they underwent medical procedures. Bucks County prosecutors say 45-year-old James Close admitted Friday that he videotaped the women, including a 17-year-old girl, during dermatology treatments at Penn Medicine in Yardley. (8/4)

Editorials And Opinions

Perspectives: 'Obamacare Sabatuers' Are Driving Costs Up; States, 'Bad Ideas' And Insurance Markets

Opinion writers offer thoughts on the current state of play regarding the Affordable Care Act, the repeal-and-replace effort and other ideas regarding health system reform.

Detroit Free Press: How Obamacare's Saboteurs Are Raising Your Health Care Cost
Donald Trump has been predicting Obamacare's collapse since he began his presidential campaign more than two years ago — and certainly, no one has done more than he has to make that prophecy come true. But Michigan's biggest health care providers and insurers still believe the health care framework the state put in place to comply with the stringent requirements established by the Affordable Care Act can be made to work for their patients and policyholders — if Congress takes steps to shore up the support beams President Trump seems determined to sabotage. (Brian Dickerson, 8/6)

Bloomberg: States Have Some Bad Ideas For Keeping Insurers
Insurers have been pulling out of Obamacare, and that’s a problem. How big a problem depends on where you live. In some counties, no insurers may be willing to offer coverage. In others, such as the metro New York City area, competition remains robust. But when you look at the maps of coverage, the pattern is clear: Every year, the areas with deep markets shrink, and those with monopolies, near-monopolies, or no coverage at all grow. And even in relatively healthy exchanges with a fair number of choices, exits mean disruption for customers who may lose access to their current doctors. (Megan McArdle, 8/4)

Chicago Tribune: Shamed For Having A Pre-Existing Condition: How Our Leaders Add Insult To The Health Care Debate
We've e heard an awful lot about pre-existing conditions lately. In an ideal world, this would suggest a greater awareness of illnesses and the infinite issues they raise. In our world, it has meant that millions of Americans have been terrified by the potential loss of literally crucial health care. But there's been another level to this conversation too — one that's less immediate in its practical dangers, but particularly insidious in its callousness. Right now, many of our leaders are behaving like the strangers every "sick person" encounters: the ones who boldly stare, or feel obliged to share their unkind thoughts, or otherwise make people with illnesses feel somehow shamed. (Elizabeth Weitzman, 8/4)

The Washington Post: The Next Tug Of War Between The Parties On Health Care
The fight over repealing the Affordable Care Act is over — for now — and the Democratic and Republican parties are moving into a new phase of our long argument over health care. It will play out in many different places and through many different proposals and initiatives, but what it comes down to is this: Democrats are going to try to expand the number of people who get health coverage through the government, while Republicans are going to try to minimize the number of people who get that coverage, even if it means kicking off those who are already covered. (Paul Waldman, 8/4)

The New York Times: What’s Next For Progressives?
For now, at least, the attempt to repeal the Affordable Care Act appears dead. Sabotage by a spiteful Trump administration is still a risk, but there is — gasp! — a bipartisan push to limit the damage, with Democrats who want to preserve recent gains allying with Republicans who fear that the public will blame them for declining coverage and rising premiums. (Paul Krugman, 8/7)

Lexington Herald Leader: Get Out And Protest For What Matters, And Bring The Young
A couple of weeks ago, a friend and I traveled to Lexington to be at the planned protest for Vice President Mike Pence’s visit. Pence had come to speak to a select invited group of businessmen to hear of their misfortunes with the Affordable Care Act. We wanted to remind the veep and his guests that quite a few people are expected to have trouble doing business without it — likely far more than those who have been inconvenienced. (Robert F. Moore, 8/4)

Viewpoints: Opioid Epidemic Demands Focus, Urgent Action And Big Spending; Paying For Organs?

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

St. Louis Post-Dispatch: A Well-Founded Call For Urgent Action, Big Spending, To Address The Opioid Crisis
Reports of presidential commissions tend to have the lifespan of a mayfly. They get attention for one day and then are quietly filed away. The nation must insist that that doesn’t happen to the work of President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. The commission, created by Trump’s executive order in March, issued its draft report last week. It called on Trump to “declare a national emergency” to force Congress to fund a multipronged, treatment-based attack on the problem and to “awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will.” (8/6)

The Washington Post: How To Reverse A Catastrophe
There is, alas, no shortage of ways to measure the damage done by the nationwide opioid epidemic, but perhaps the most dramatic is to consider how it has reversed four decades of progress against preventable deaths in the United States. Between 1975 and 2015, hard work by government, the private sector and individuals cut the motor vehicle accident death rate by nearly half, from 20.6 per 100,000 people to 10.9. A similar all-out effort cut the homicide rate from 9.6 per 100,000 to 4.9. These figures translate into hundreds of thousands of lives saved. Yet the opioid epidemic has driven the national death rate from overdoses of these drugs to 9.3 per 100,000 in 2015, up from 0.4 in 1975, according to data assembled in a stunning new report from the congressional Joint Economic Committee’s Social Capital Project. (8/3)

The New York Times: Should I Help My Patients Die?
I practice both critical and palliative care medicine at a public hospital in Oakland. In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness. ... California’s law permits physicians to prescribe a lethal cocktail to patients who request it and meet certain criteria: They must be adults expected to die within six months who are able to self-administer the drug and retain the mental capacity to make a decision like this. ut that is where the law leaves off. The details of patient selection and protocol, even the composition of the lethal compound, are left to the individual doctor or hospital policy. Our hospital, like many others at that time, was still in the early stages of creating a policy and procedure. To me and many of my colleagues in California, it felt as if the law had passed so quickly that we weren’t fully prepared to deal with it. (Dr. Jessica Nutik Zitter, 8/5)

Chicago Tribune: Football And CTE: The Dilemma For Parents
The e names of NFL players tormented by the degenerative brain disease CTE are well-known: Dave Duerson, Mike Webster, Junior Seau, to name a few. Parents would be smart to familiarize themselves with another name linked with chronic traumatic encephalopathy: Zac Easter. Zac began playing organized football when he was 8 and didn't stop until his senior year of high school in Indianola, Iowa. Concussions marred his days as a linebacker. After he stopped playing, Zac coped with depression, headaches and slurred speech. At 24, he took a shotgun from his father's truck, drove to a state park, and blasted a hole into his chest. A postmortem examination of Zac's brain confirmed what the young man had long suspected: He suffered from CTE. (8/6)

RealClear Health: A Solution To Surprise Medical Billing
Imagine two people, with the same health insurance companies, walk into an emergency room. The patients have identical symptoms and receive the same diagnoses and subsequent procedures and treatments. Both patients should get an identical bill, right? But in reality, one patient could receive a bill where nearly everything is covered by insurance, and the other could receive a bill where little or nothing is covered. For some patients, this can be the difference between an emergency room bill that cost several hundred dollars, versus one costing tens of thousands. (Ronnie Shows, 8/7)