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In the budding battle royale over the Supreme Court vacancy, what's the Democratic sweet spot between satisfying liberal activists' demands for an all-out fight against President Donald Trump's pick and protecting senators facing tight re-election races in deeply red states? So far, the party's formula is to cast itself as defending the right to abortion and the 2010 health care law against a president itching to use the court to snatch both away. Democrats want to make it as excruciating as possible for a pair of moderate, pivotal Republican senators to back the selection because without a GOP defection, it's game over. (Fram, 7/6)

The last time Senate Democrats stuck together through an all-consuming fight, the issue was Obamacare repeal — and they started off remarkably united against it. Now Senate Minority Leader Chuck Schumer is aiming to replicate that performance in the imminent battle over Donald Trump’s Supreme Court nominee, but his troops face a high risk of division right out of the gate. Under particular pressure to side with the president are the three red-state Democrats who voted for Justice Neil Gorsuch last year and face difficult reelection campaigns: Sens. Joe Manchin, Heidi Heitkamp, and Joe Donnelly. (Schor, 7/6)

Democratic Sen. Claire McCaskill is likely to oppose President Donald Trump’s Supreme Court nominee for being too conservative. And her Republican opponent for reelection, a constitutional lawyer who once clerked for Chief Justice John Roberts, is itching to make her pay. “She’s been wrong on every single court nominee since she has been running for the Senate or in the Senate. So I’m not surprised in the least,” Josh Hawley, Missouri’s attorney general, said in an interview, sitting in a pickup truck with the AC blasting after marching in a July 4 parade. (Everett, 7/6)

President Trump’s deliberations over a Supreme Court nominee now center on three candidates culled from his shortlist: federal judges Brett M. Kavanaugh, Raymond Kethledge and Amy Coney Barrett, according to White House officials and Trump advisers involved in the discussions. But Trump’s final decision on a replacement for Justice Anthony M. Kennedy remained fluid as he traveled Thursday to a political rally in Montana before heading to his golf course in New Jersey for the weekend, with the president pinballing between associates as he sought feedback and suggestions. (Costa and Kim, 7/5)

Speaking to reporters on Air Force One en route to Montana for a campaign appearance for a Senate candidate, Mr. Trump didn’t name the finalists. “I’ll say on the record that I am interviewing some extraordinarily talented and brilliant people and I’m very, very happy with them and we will pick somebody who will be outstanding, hopefully for many years to come,” he said. Mr. Trump is searching for a successor to Justice Anthony Kennedy, a swing vote on the court who announced last month he would be stepping down. The vacancy is the second Mr. Trump has had to fill since taking office, giving him a chance to nudge to the right a high court that has been split between conservative and liberal factions for years. (Nicholas, 7/5)

Judge Brett M. Kavanaugh, the front-runner to replace Justice Anthony M. Kennedy on the Supreme Court, once argued that President Bill Clinton could be impeached for lying to his staff and misleading the public, a broad definition of obstruction of justice that would be damaging if applied to President Trump in the Russia investigation. Judge Kavanaugh’s arguments — expressed in the report of the independent counsel, Kenneth W. Starr, which he co-wrote nearly 20 years ago — have been cited in recent days by Republicans with reservations about him and have raised concerns among some people close to Mr. Trump. But Judge Kavanaugh has reconsidered some of his views since then, and there is no evidence that they have derailed his candidacy. (Landler and Apuzzo, 7/5)

As Donald Trump moves to finalize his Supreme Court pick, Judge Raymond Kethledge is getting a behind-the-scenes push portraying him as the consensus choice of conservatives. Former aides and supporters of Kethledge, a Michigan resident who moves outside Washington circles and is considered the least known of the leading contenders, are quietly circulating positive information about the judge’s personal life, political profile and reassuring record on the U.S. Court of Appeals for the 6th Circuit. (Cadelago, Johnson and Gerstein, 7/5)

The Trump administration, in a race to comply with a court order to reunite up to 3,000 children with adult family members who crossed the border illegally, said Thursday it is encountering significant logistical hurdles. The federal government has until Tuesday to reunite children younger than 5 years old with their parents, under a court order issued last week by U.S. District Judge Dana Sabraw in San Diego. Older minors must be reconnected with their parents by July 26, the federal judge ruled. (Radnofsky and Campo-Flores, 7/5)

The complications could mount once HHS transfers the kids to their parents' detention centers and as the furor and litigation rage in the fallout of the Trump administration policy. In addition to the lawsuit that led to the recent court order—originally filed in February by the American Civil Liberties Union on behalf of a Congolese immigrant family—17 Democratic attorneys general have lodged a separate lawsuit that names Azar, HHS, ORR and other departments and administration officials as defendants. (Luthi, 7/5)

The Department of Health and Human Services (HHS) says it is reviewing the cases of “under 3,000” children who may have been separated from their parents or families at the U.S. border. HHS officials are trying to whittle that number down further to identify the children who were actually separated from their parents by the U.S. government — as opposed to other circumstances before they came to the U.S. — ahead of a court-imposed deadline to reunite children with their families. (Hellmann, 7/5)

About 100 children under the age of 5 will be reunited with their families next week after getting separated by authorities at the U.S. border, officials said Thursday. The Department of Health and Human Services (HHS) must reunite the children under 5 by Tuesday to comply with a court order handed down last month. (Hellmann, 7/5)

The Trump administration is conducting DNA tests to reunite children separated from their parents at the border. The Department of Health and Human Services (HHS) said Thursday that the agency is using the "faster" and more accurate method in order to comply with a court order to reunite children aged 4 and under with families by July 10, and children aged 5 to 17 by July 26. (Hellmann, 7/5)

The Trump administration is suppressing an Environmental Protection Agency report that warns that most Americans inhale enough formaldehyde vapor in the course of daily life to put them at risk of developing leukemia and other ailments, a current and a former agency official told POLITICO. The warnings are contained in a draft health assessment EPA scientists completed just before Donald Trump became president, according to the officials. They said top advisers to departing Administrator Scott Pruitt are delaying its release as part of a campaign to undermine the agency’s independent research into the health risks of toxic chemicals. (Snider, 7/6)

Nicholas Bade showed up at an Air Force recruiting office on an icy morning in January, determined to be one of the first transgender recruits to enlist in the military. He was in top shape, and had earned two martial arts black belts. He had already aced the military aptitude test, and organized the stack of medical records required to show he was stable and healthy enough to serve. So he expected to be called for basic training in a month, maybe two at the most. (Philipps, 7/5)

A newly unsealed lawsuit by Tennessee's attorney general says the maker of the world's top-selling painkiller directed its salesforce to target the highest prescribers, many with limited or no pain management background or training. Citing the public's right to know, Attorney General Herbert Slatery said Thursday that OxyContin maker Purdue Pharma has dropped its previous efforts to shield details of the 274-page lawsuit in state court. The Tennessee Coalition for Open Government and the Knoxville News Sentinel had also requested that the lawsuit's records become public. (7/5)

Illinois consumers who buy health insurance through the Obamacare exchange might get more coverage aimed at treating and preventing opioid addiction, starting in 2020, if the state has its way. The Illinois Department of Insurance has applied to the federal government to add a handful of requirements, mostly dealing with opioid addiction treatment and prevention, to the list of what insurers on Illinois’ exchange must cover. (Schencker, 7/5)

In an opioid epidemic that is killing tens of thousands of Americans a year, people like Kline and her doctor Michael Peck are unlikely pioneers in a drug-treatment experiment. Though there’s no clear scientific evidence that it will work, supporters say medical marijuana could some day change the way we deal with opioid addiction. (Giordano, 7/6)

Kaiser Health News: What A U.S.-China Trade War Could Mean For The Opioid Epidemic

The American struggle to curb opioid addiction could become collateral damage in President Donald Trump’s showdown on trade. Trade tensions with allies were heightened by the White House announcement in March of tariffs on steel and aluminum imports. Now, another round specifically targeting China is set to take effect Friday. And that China focus could interrupt other trade-related issues — specifically, those targeting the flow of dangerous drugs like fentanyl into the United States. (Garcia, 7/6)

On paper, Richard Strauss was a well-regarded Ohio State University physician who examined young athletes for decades as a team doctor and sports-medicine researcher. Some former athletes recall him differently: Locker-room voyeur. Serial groper. "Dr. Jelly Paws." In interviews with The Associated Press in recent weeks, seven former athletes and a former nursing student shared detailed allegations of sexual misconduct dating back to the 1970s against the doctor, who killed himself in 2005 at age 67 and is only now under investigation. (Franko, Welsh-Huggins and Seewer, 7/6)

Five former wrestlers, including former UFC world champion Mark Coleman, said this week that Rep. Jim Jordan was aware of, but didn’t respond to, allegations of sexual misconduct by an Ohio State University team doctor when the lawmaker was an assistant wrestling coach there in the 1990s. “There’s no way unless he’s got dementia or something that he’s got no recollection of what was going on at Ohio State,” Mr. Coleman, the mixed martial arts champion, said of Mr. Jordan in an interview Wednesday. Messrs. Coleman and Jordan roomed together on several wrestling trips, Mr. Coleman said. “I have nothing but respect for this man, I love this man, but he knew as far as I’m concerned.” (Kesling and Peterson, 7/5)

Imagine being a store owner who sells machines without knowing exactly what they do. Some of your products could help farmers grow more nutritious crops while a few others could spread disease among thousands of people. Part of your inventory would do nothing at all. This is the quandary facing many biotech companies that specialize in synthesizing or printing DNA. By selling genes, they have empowered synthetic biologists seeking to genetically engineer organisms capable of fighting disease or producing industrial materials. (Chen, 7/6)

A U.S. private citizen who visited China has reported symptoms like those of U.S. diplomats afflicted with a mysterious illness in Havana and Guangzhou, a U.S. State Department official said on Thursday. The person, who was not named by the department official, is the first non-official American known to have experienced the symptoms following a trip to China. Nineteen private U.S. citizens have reported similar symptoms after traveling to Cuba. (Mohammed, 7/5)

Preventive care experts have been divided for years on how to best counsel women on when to get breast cancer screenings. But a new study suggests that women might benefit from individualized approaches to mammograms rather than from universal guidelines. The study, published Thursday in JAMA Oncology, looks at personalized screening protocols tailored to each woman’s risk of developing breast cancer. The study showed that not offering mammograms to women at low risk for breast cancer might reduce the harms associated with screening, while still maintaining the benefits. And it might even be more cost-effective. (Farber, 7/5)

Mothers lead the way for their children. And new research finds that the paths that moms walk (or the couches they sit and smoke on) make a powerful difference in their children’s propensity to become obese. A study that tracked close to 17,000 female nurses and their 24,289 kids has found that women who practiced five healthy habits — maintaining a healthy weight, exercising regularly, eating a nutritious diet, consuming no more than moderate quantities of alcohol and not smoking cigarettes — had adolescents that were 75% less likely to be very overweight than the children of moms who practiced none of those healthy habits. (Healy, 7/5)

Vicki Bartholomew started a support group for wives who are caring for a husband with Alzheimer's Disease because she needed that sort of group herself. They meet every month in a conference room at a new memory care facility in Nashville called Abe's Garden, where Bartholomew's husband was one of the first residents — a Vietnam veteran and prominent attorney in Nashville. "My husband's still living, and now I'm in an even more difficult situation — I'm married, but I'm a widow," she says. (Farmer, 7/6)

Working as a flight attendant may increase the risk for cancer. Flight attendants are exposed to several factors known to increase cancer risk, including disrupted sleep patterns and exposure to the increased levels of cosmic ionizing radiation at high altitudes. (Bakalar, 7/5)

In Boston, some women are using parasols for shade. In New York City, children frolic in the spray of opened sidewalk fire hydrants. And in Lexington, Ky., people celebrating the Fourth of July clutched battery-operated hand-held fans. Americans expend as much effort improvising ways to escape the heat of summer as they do reveling in its rituals at pools, picnics and beaches, and in outdoor activities. (Hauser, 7/6)

New research published Monday in the journal BMJ Open Diabetes Research and Care suggests another diabetes risk factor for women: overworking. ...They found that women who worked an average of 45 hours or more had a 63 percent higher risk of developing diabetes compared to those working 35-40 hours per week. (Pirani, 7/5)

JScreen is a non-profit public health initiative dedicated to preventing Jewish genetic diseases. It is based at Emory University in Atlanta. For $149, the test will tell you if you are a carrier for more than 200 genetic diseases. (Haden, 7/5)

In London, there's a museum dedicated to Charles Dickens, housed in his old, lovingly preserved home near the King's Cross rail station. There are over 200 museums in London. This one wasn't anywhere near the top of my list. I hated the compulsory Dickens assignments in high school. To teenage me, slogging through the unremitting hopelessness of Great Expectations was absolutely agonizing. Bleak House? I couldn't get past the name. And as for the 743 pages of The Pickwick Papers? I was so traumatized by the other novels that I skipped the book and went straight to a study guide. (Silberner, 7/5)

Buildings at a Baltimore hospital were evacuated Thursday after employees were possibly exposed to tuberculosis, officials said. The Baltimore City Fire Department responded to Johns Hopkins Hospital to investigate after “a small sample of frozen tuberculosis” being used for research purposes was inadvertently released in an internal bridge between Cancer Research Building 1 and Cancer Research Building 2, Johns Hopkins Medicine spokeswoman Kim Hoppe said in a statement. (Moyer, 7/5)

The bacteria, which usually attacks the lungs and can require months of treatment, was released from a “small sample of frozen tuberculosis” in a walkway between two cancer-research buildings, said Ms. Hoppe. The sample was used for research. The release triggered a heavy emergency response outside the complex of Johns Hopkins hospital buildings, including the shutdown of the two used for cancer research. A “limited number” of workers who were in the area at the time of the release were isolated, according to Connor Scott, chief of staff in the health system’s security office. (Evans and McKay, 7/5)

In June 2016, Ernest “Chris” Keys received a heart transplant at Baylor St. Luke’s Medical Center in Houston, giving him and his family hope he would finally return home after months in the hospital battling chronic heart failure. ...After several follow-up surgeries, Keys, then 44, left St. Luke’s in August 2016 with a new heart — but also a severe brain injury that left him unable to speak or walk. (Hixenbaugh and Ornstein, 7/5)

Major health industry groups have spent more than $18 million on lobbying, according to an analysis by The Sacramento Bee, in an effort to kill or water down bills proposed to rein in rising health care costs and impose new regulatory requirements for insurers and health plans. The spending, similar to levels in the prior legislative session, foreshadows a costly and thorny political debate in the years ahead. (Hart, 7/6)

A health care network responding to lawsuits says it wasn't liable for a storage tank malfunction that destroyed more than 4,000 eggs and embryos at its fertility clinic near Cleveland. In court filings made public this week, attorneys for University Hospitals say patients were advised about risks involved with frozen specimens and signed related consent forms. The network says the problem wasn't caused by hospital negligence and suggests others might be responsible for what happened. (7/5)

New York's agency tasked with investigating accusations of abuse and neglect against disabled people in state care is promising to improve transparency following years of complaints about conducting nearly all of its work in secret. Denise Miranda took over last year as executive director of the Justice Center for the Protection of People with Special Needs. (7/5)

First came the rains. Now come the mosquitoes. Populations of the itch-inducing insects have multiplied across Maryland — in many areas up to three times their normal early summer numbers — because of recent storms and flooding that have given them an abundance of water to breed in. That means the ankle-biters are even more of a nuisance than normal and, potentially, a bigger public health threat, too. (Dance, 7/5)

Ohioans have been asked to vote on a slew of complicated – and sometimes oddly specific – ballot initiatives in recent years. This November could be no exception. One group submitted signatures Wednesday to limit the amount charged at kidney dialysis clinics and inspect them more frequently. (Balmert, 7/5)

The Dallas-based nonprofit American Heart Association is seeking to spin off a business that trains health care providers on best practices in cardiopulmonary resuscitation and other lifesaving techniques. The charity organization launched a project in 2015 called the Resuscitation Quality Improvement program, which goes into hospitals and gives medical professionals hands-on training at the site of care. (Rice, 7/6)

Now that Medicare has completed mailing its new card to people 65 or older in Pennsylvania and Delaware, folks who haven’t gotten one should call the agency to make sure one arrives. The federal program has set out to blanket the nation with the new cards by April 2019. (Arvedlund, 7/5)

A man suffering from severe mental illness was held for 92 days at the Hennepin County jail without access to proper medical treatment because of a severe and worsening shortage of beds in state psychiatric facilities. The prolonged detention of Raymond Traylor Jr., 28, has become the latest flash point in a long-running struggle between county and state officials over how to accommodate a growing number of jail inmates with serious mental illnesses. (Serres,7/5)

The growth story continues at Sanford Health with the Sioux Falls, S.D.-based hospital and clinic operator announcing plans last week to combine with Evangelical Lutheran Good Samaritan Society, a nonprofit group based in South Dakota that operates senior-care facilities in 24 states including Minnesota. Sanford Health, which is a nonprofit that already operates a number of hospitals in western Minnesota, said it might enter the Chicago market by way of the deal. (Snowbeck, 7/5)

Questions from residents about environmental contamination and childhood cancers have dogged this city of 14,000 in southeast Georgia since four children fell ill with rare sarcoma cancers within two months of each other in 2015. The cancers made local and national headlines. In March 2017, the well-known environmental activist Erin Brockovich announced that she was also looking into the situation. (Goodman and Miller, 7/5)

The Phoenix Police Department on Thursday got the OK to work with an expert in racial and cultural sensitivity to train each of the agency's nearly 3,000 officers about implicit bias in law enforcement. Police plan to partner with the National Training Institute on Race and Equity, a group that uses experts in psychology and sociology to work with police officers, educators, and health care workers. (Pohl, 7/5)

A group of raspberry pickers, sickened by several chemicals that drifted onto the Watsonville field where they were working close to a year ago, felt sick for longer than previously known, according to newly revealed investigative findings. Last month, Santa Cruz County Agricultural Commissioner Juan Hidalgo announced that he issued his largest fine ever, penalizing several companies tied to a pesticide drift near State Route 152 that made 15 agricultural employees sick the morning of June 29, 2017. (Goldberg, 7/5)

Milwaukee County agreed back in January to pay $1.4 million to settle a civil rights lawsuit over the death of a 25-year-old man at the Mental Health Complex in 2012. Now, the fight is over who gets the money: Brandon Johnson's mother, who raised him alone and sued over his mistreatment? Or must she share it with his father, whom she says raped her when she was 15 and had little to do with Brandon until his death? (Vielmetti, 7/6)

Here at Philly Health Costs, we see a lot of outrageous bills and get a lot of questions about infuriating insurance practices. ... Providers that aren’t part of an insurer’s network are sometimes allowed to “balance bill” patients for whatever their health plan doesn’t pay, a practice that results in surprise bills. Ambulances, especially those that respond in an emergency, are often not part of insurance networks. (Gantz, 7/5)

Proposals related to health care have grown in scope in both parties’ presidential platforms over the past century and affect both agendas and assessments of a president’s success. Continued controversy over the Affordable Care Act, potential reversals in gains in coverage and affordability, and voters’ concern suggest a central role for health policy in the 2020 election. Republicans will most likely continue to advance devolution, deregulation, and capped federal financing, while Democrats will likely overlay their support of the Affordable Care Act with some type of Medicare-based public plan option. The plans’ contours and specifics will be developed in the months ahead. (Lambrew, 6/26)

This study reveals that maternal depressive symptoms and IPV are associated with adverse child nutritional and developmental outcomes. Further research is needed to develop programs to address IPV and depression among women and enhance the growth and development of their children. (Neamah et al, 7/1)

A single-session ED BI revealed previously to show promise in reducing underage drinking also demonstrates promise in preventing dating violence perpetration and depression symptoms. These technology-enhanced BIs could be particularly helpful given the potential for more efficient resource usage and ease of future implementation. (Ngo et al, 7/1)

Despite intensive research, the causes of the obesity epidemic remain incompletely understood and conventional calorie-restricted diets continue to lack long-term efficacy. According to the carbohydrate-insulin model (CIM) of obesity, recent increases in the consumption of processed, high–glycemic-load carbohydrates produce hormonal changes that promote calorie deposition in adipose tissue, exacerbate hunger, and lower energy expenditure. Basic and genetic research provides mechanistic evidence in support of the CIM. (Ludwig and Ebbeling, 7/2)

With all the focus on Justice Anthony Kennedy’s retirement last week, it was easy to miss the court’s major decision on free speech and abortion that was announced the same day as the U.S. Supreme Court’s travel ban decision. Yet this case, National Institutes of Family and Life Advocates v. Becerra, is one of the most important of the court’s past term. It foreshadows what the court’s conservative jurisprudence is going to be like, no matter who President Donald Trump nominates Monday for Kennedy’s seat. Justice Clarence Thomas is on a libertarian mission to use the First Amendment to chip away at all kinds of ordinary legal regulations —  and the other conservatives seem to be on board. (Noah Feldman, 7/5)

Judge Amy Coney Barrett could be President Trump’s nominee to the Supreme Court—a prospect that thrills many conservatives. A former Antonin Scalia clerk and Notre Dame professor, Judge Barrett, 46, seems an ideal choice. Yet her religious beliefs could lead to a contentious confirmation process. Would it be a risk to pick her? Last year President Trump nominated Ms. Barrett for a seat on the Seventh U.S. Circuit Court of Appeals. Several Democratic senators pondered whether an “orthodox Catholic” would have dual loyalties. “The dogma lives loudly within you,” Sen. Dianne Feinstein said during Ms. Barrett’s hearing. “That’s of concern.” Video of Mrs. Feinstein’s religious test quickly spread, provoking outrage from thousands of Americans. Yet a New York Times news story suggested she and her colleagues hadn’t gone far enough: The nominee’s “membership in a small, tightly knit Christian group called People of Praise never came up at the hearing, and might have led to even more intense questioning.” (Adam O’Neal, 7/5)

Congressional opponents of the Affordable Care Act and reproductive health — with support from the White House — spent the majority of last year attempting to repeal the act and cut off people’s access to Planned Parenthood. Yet when members of Congress went home last year for the July 4 recess, women spoke out and rallied against the Obamacare repeal efforts. Through letters, calls, and rallies, they made it clear to their elected officials that the ACA was the greatest health advancement for women in a generation and Planned Parenthood is an essential source of care. Because of the incredible public backlash, attempts to roll back the act failed. Now, as we are once again in the midst of the July 4 break, the administration has been quietly issuing rules — and could even pick a Supreme Court justice — to sabotage the ACA in ways that will erode access to health coverage and reproductive health care, and the same congressional opponents from last year are supporting these efforts. (Jamille Fields and Stephanie Glover, 7/6)

“I’m like a dog chasing cars, I wouldn’t know what to do if I caught one.” That famous line  from the Joker in "The Dark Knight" could well be delivered by dozens of Republican senators this month. For decades, Republican politicians have run on pro-life platforms and promises to reverse Roe v. Wade with a pro-life majority on the Supreme Court. That mantra was picked up most recently by President Donald Trump, who pledged to supporters that overturning Roe v. Wade “will happen, automatically” because he would appoint only pro-life justices to the Supreme Court. The problem for the Republican Party is that Trump could actually succeed with the nominee he announces Monday to replace retiring Justice Anthony Kennedy. Many Republicans say privately it is the last thing they want to happen, given the potential for backlash in House and Senate elections that could turn on thin margins. Polls put public support for Roe v. Wade as high as 70 percent, with a majority opposing a nominee who wants to reverse it. (Jonathan Turley, 7/6)

Watch what you wish for, Republicans. The imagined implications of Justice Anthony Kennedy’s resignation for the future of legal abortion have brought visions of long-awaited sugar plums to anti-abortion politicians and activists. In 2016, candidate Trump pledged to appoint anti-abortion justices to the Supreme Court, saying that two or three such appointments would mean the end of Roe v. Wade. Next week, we get the name of President Trump’s second pick. Trump’s anti-abortion supporters — including his evangelical advisers, the National Right to Life Committee, Americans United for Life, the Susan B. Anthony List, and most significantly, the Republican Party — are now confident that it is just a matter of time until Roe is overturned. (Carol Sanger, 7/5)

The focus since Justice Anthony Kennedy’s retirement announcement has been on the prospect of a new justice joining with the Supreme Court’s current conservative bloc to overrule the court’s 1973 Roe v. Wade decision recognizing a woman’s constitutional right to terminate a pregnancy. Democratic Sen. Kirsten Gillibrand of New York, for example, already has declared her opposition on the grounds that “any one of President Trump's list of proposed SCOTUS justices would overturn Roe v. Wade and threaten our fundamental rights.” Sen. Susan Collins, one of two Republicans who supports Roe, told ABC News on Sunday that she would not support a nominee who would overturn it. (Harry Litman, July 5)

How will Susan Collins and Lisa Murkowski vote? The two U.S. senators, from Maine and Alaska, respectively, are the swing votes — moderate Republicans, women, and pro-choice — who will be under a spotlight as President Trump nominates someone to succeed Justice Anthony M. Kennedy on the Supreme Court. Liberal and conservative groups are mobilizing to lobby these and others who might stray from their party’s line. At stake is Roe v. Wade, the 1973 Supreme Court decision that protects a woman’s right to have an abortion. While campaigning for the presidency, Trump promised to nominate “pro-life” judges who would overturn or limit that ruling. Will Collins and Murkowski vote to confirm a nominee who would do that? (Michele L. Swers, 7/6)

In 2005, the FDA approved a new treatment for pain, administered through a patch on the patient’s skin. The drug’s approval coincided with a movement in the medical profession towards treating pain as the “fifth vital sign,” leading doctors to take more aggressive steps to deal with pain. By 2012, doctors were prescribing the drug, called fentanyl, over 255 million times a year throughout the U.S. For millions of Americans, these legal prescriptions intended to help their chronic pain had already pulled them into opioid dependency. The role of doctors in creating the current national crisis cannot be ignored.Fentanyl is now one of the most infamous drugs of America’s opioid epidemic, which claimed more than 30,000 lives by accidental overdose in 2016 alone. While about half of those deaths were from heroin and other illegally obtained opiates, most opiate-users started taking opiates prescribed by their doctors. Troublingly, many of these doctors — one in 12, according to Boston Medical Center researchers — received money from opioid manufacturing companies. (Albert Gustafson, 7/5)

History is repeating itself. Twenty years ago, a pain management crisis existed. As many as 70 percent of cancer patients in treatment at that time, or in end-of-life care, experienced unalleviated pain. Identified as a major medical problem, poor pain management became synonymous with poor medical care. In fact, prescribing adequate pain medication became mandatory for hospital accreditation. The medications used to treat moderate to severe pain among people with cancer are the same opioids helping fuel today’s opioid crisis. Though it has turned a much-needed spotlight on the overprescription of these medications, it is overshadowing their underprescription among people who really need them, especially those with cancer. (Sara Ray and Kathleen Hoffman, 7/6)

Gov. Matt Bevin’s decision to end dental and vision coverage for 460,000 Kentuckians is vindictive, probably illegal and also illogical because emergency-room visits for dental problems will increase. The administration’s excuse — that a federal judge’s rejection of Bevin’s Medicaid revamp necessitates the action — is ridiculous. The new payment mechanism for dental and vision coverage was to take effect July 1. The obvious answer is to keep the system that was in place June 30. (7/5)

On June 29, U.S. District Court Judge James Boasberg held that the federal Department for Health and Human Services lacked the authority to approve Kentucky’s request for a Section 1115 “demonstration waiver” to dramatically alter Kentucky’s Medicaid program. In essence, Judge Boasberg held that HHS failed to consider the impact of the probable loss of coverage for at least 95,000 Kentuckians under the waiver. Federal Medicaid law clearly obliges states to ensure that medical coverage is provided to all eligible individuals, and waiver proposals must be consistent with this objective. To approve Kentucky HEALTH, HHS must decide whether a waiver can eliminate coverage for tens of thousands of Kentuckians and still further the objective of Medicaid. That won’t be easy for Kentucky to demonstrate or HHS to approve. (Emily Whelan Parento and Nicole Huberfeld, 7/5)

Just a month has passed since the high-profile deaths of Kate Spade and Anthony Bourdain, yet suicide has already dropped off the public radar. That’s because it’s far too easy to personalize individual tragedies; far more difficult is confronting the public-health crisis at hand. Suicide claims the lives of more than 120 Americans each day. Each year, more Americans die from suicide than were killed in action during the entire Vietnam conflict. It’s time we confront this epidemic with the same determination that tamed HIV/AIDS. To do this, we must address the biology of suicide. (Jonathan Javitt, 7/5)

Beach season is officially in full swing, with Americans heading to the coast to swim, lounge, camp, party and generally cool off from the heat-drenched cities. And because we’ve been so well trained to avoid the harmful ultraviolet rays that cause skin cancer, most beachgoers will be mindful to slather on a generous coating of sunscreen. This is a sound and healthy practice for humans when they bake on the sands of California’s beaches, but it turns out it’s not so great for the health of the oceans when people covered in sunscreen take a cooling dip in the waves. A study conducted by an international team of scientists found that exposure to the two most common ingredients in sunscreen — oxybenzone, or BP-3, and octinoxate — is toxic to coral development in four ways. BP-3 in particular was correlated with bleaching, which is a sign of ill health, DNA damage and abnormal skeleton growth and deformities in baby corals (yes, there are baby corals). ...But let’s be clear: This is no call to skip the SPF 50. Skin cancer is a serious and all too common affliction; one-fifth of Americans will be diagnosed with skin cancer by the time they are 70, according to the Skin Cancer Foundation. (7/6)

Though surgery may seem a drastic step for someone who does not suffer a physical malady, such as cancer or trauma, the psychological distress caused by the transgender person’s physical state is no less lethal. Studies suggest that nearly 40 percent of the trans population have attempted suicide. This is likely underreported and much higher in at-risk populations, such as minorities and those living with HIV. (Jonathan Keith, 7/6)

Families across this country are struggling with rising prescription drug prices every day. Older Americans who rely on Medicare Part D — prescription drug coverage — take an average of 4.5 prescription medications and are hit particularly hard by these rising costs. Earlier this year, Congress took an important step to help reduce that financial burden on older Americans by passing the Bipartisan Budget Act of 2018 (BBA). The BBA closed the Medicare Part D coverage gap — known as the “doughnut hole” — in 2019, a year earlier than planned under the Affordable Care Act of 2010.It also requires brand name drug companies to pay more of the cost of their drugs for beneficiaries who are in the doughnut hole. This important change will help seniors move through the doughnut hole more quickly and into “catastrophic coverage” where they will pay less for their needed medications. (Nancy Leamond, 7/5)

Like many of my fellow Republicans, I welcome the re-examinations of policy the Trump administration is bringing to Washington. As a physician, I especially appreciate the vocal recognition by the president that for many Americans, the prices of prescription drugs are simply too high. As a former member of Congress, I agree with those who also say we must ensure pharmaceutical companies can and will continue to pioneer the development of new drugs to help improve the health and well-being of Americans with serious, life-threatening, chronic, and disabling conditions. As a conservative Republican, however, I have to call the administration’s position on the 340B Drug Pricing Program the equivalent of an own goal in soccer. (Former Rep. Phil Gingrey, 7/5)

Bipartisan legislation aimed at creating a national registry to collect data on the incidence of cancer among firefighters is awaiting the president’s signature. If signed into law, H.R. 931, the Firefighter Cancer Registry Act of 2018, could take effect in the next few weeks. This new law is expected to provide improved resources for research into the occupational hazards faced by approximately one million professional and volunteer firefighters in the United States. (Susan Olivo-Marston, 7/5)