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The Trump administration is giving health insurance companies more time to calculate price increases for 2018 because of uncertainty caused by the president’s threat to cut off crucial subsidies paid to insurers on behalf of millions of low-income people. Federal health officials said the deadline for insurers to file their rate requests would be extended by nearly three weeks, to Sept. 5. (Pear, 8/13)

The Trump administration is giving insurers more time to file their 2018 rate requests for ObamaCare plans. The Centers for Medicare and Medicaid Services said Thursday it would extend the deadline by three weeks, to Sept. 5, with a final deadline of Sept. 20. (Hellmann, 8/11)

Insurance companies struggling with uncertainty about the national health-care program have an extra three weeks to figure out how much to charge next year. The federal government said Friday it was extended its rate-filing deadline from Aug. 16 to Sept. 5 for insurance companies offering 2018 plans on state exchanges, including the exchange in New Hampshire. (Brooks, 8/11)

Insurers are grappling with a serious predicament in finalizing how much their health plans will cost, even after a three-week extension from the Trump administration. The new Sept. 5 deadline gives carriers more time to tweak their premiums for HealthCare.gov in a year where uncertainty surrounding the law has reached a new high. (Roubein, 8/13)

Senior officials have described the coming month as "brutal," “bad” or “really tough” because of the confluence of complicated issues — but they also say it’s pivotal to getting the presidency back on course. Aides hope to have a better blueprint for how the president wants to proceed on a series of thorny issues — the nation’s debt ceiling, the 2018 federal budget, tax reform, infrastructure spending and perhaps another stab at repealing Obamacare — after a series of meetings in New York this week. (Dawsey, 8/13)

Donald Trump’s attacks on Senate Majority Leader Mitch McConnell come at the worst possible time, if the president’s goal is actually to advance his agenda on health care, infrastructure and taxes that he’s goading his GOP ally to pass. ... McConnell’s allies say that Trump’s frustration over the failure on health care is shared by the majority leader. (Taylor, 8/12)

The long August congressional recess, which Republicans had hoped would begin a conversation about tax reform and must-pass budget measures, has so far seen another round of angry town halls focused on President Trump and the stalled effort to repeal the Affordable Care Act. Over just one day, in three small towns along Georgia’s Atlantic coastline, Rep. Earl L. “Buddy” Carter (R-Ga.) spent more than four hours answering 74 questions, many of them heated. Just three focused on tax reform; nearly half were about health care. (Weigel, 8/11)

A GOP senator says all Republicans are in trouble politically if they’re unable to scrap former President Barack Obama’s health care law and replace it with a better one. Sen. Lindsey Graham of South Carolina says he doesn’t mind that President Donald Trump is upset with Republicans for failing to fulfill their seven-year-old pledge on a health overhaul. (8/13)

Democrats used a bus emblazoned with the words “Drive for our Lives” to gin up opposition to vulnerable House Republicans who voted against “Obamacare” with the aim of upending the GOP’s majority in next year’s midterm elections. The vote to repeal and replace the Obama health care law looms large for 21 GOP lawmakers, including Iowa Reps. David Young and Rod Blum. They represent competitive congressional districts where Democrat Hillary Clinton won or came close in last year’s presidential election. (Beaumont, 8/12)

A policy decision by House Democratic campaign officials to in some cases support candidates who oppose abortion rights is dividing the Democratic Party as it tries to settle on a strategy for taking control of the House in the 2018 elections. (Andrews, 8/13)

Medicaid, a 1960s Great Society pillar long reviled by conservatives, seems to have emerged even stronger after the Republican failure to pass health overhaul legislation. The federal-state health insurance program for low-income Americans hasn’t achieved the status of Social Security and Medicare, considered practically untouchable by politicians, like an electrified “third rail.” But it has grown to cover about 1 in 5 U.S. residents, ranging from newborns to Alzheimer’s patients in nursing homes, and even young adults trying to shake addiction. ... Increased participation — and acceptance — means any new GOP attempt to address problems with the Affordable Care Act would be unlikely to achieve deep Medicaid cuts. (Alonso-Zaldivar, 8/14)

The Trump administration appears poised to roll back ObamaCare’s anti-discrimination protections for transgender patients, a move that has activist groups girding for a fight. A proposed rule from the Department of Health and Human Services is expected to be released in the coming weeks or months that opponents say would make it easier for doctors and hospitals to deny treatment to transgender patients and women who have had abortions. (Weixel, 8/12)

Reps. Mark Meadows (R-N.C.) and Tom MacArthur (R-N.J.) are in talks for a bill that would stabilize ObamaCare markets. The measure would fund key ObamaCare payments known as cost-sharing reductions, possibly in exchange for expanded flexibility favored by conservatives for states to waive ObamaCare regulations through broadening an existing provision known as 1332 waivers. (Sullivan, 8/11)

House Democrats want to use the looming battle over government spending and raising the debt limit as leverage to shore up ObamaCare. The minority party believes Republicans will need their votes on the critical fiscal issues, and they think they can secure concessions on healthcare. (Lillis, 8/13)

Members of the conservative House Freedom Caucus want to seize control of the health-care debate by petitioning Republicans to hold a vote on a version of a repeal bill that passed the House in 2015. Conservatives say they believe a repeal measure can pass without a replacement, despite warnings from Ryan and other leaders that the votes aren’t there. The long-shot effort gained momentum last week with support from influential outside groups. (Snell, 8/13)

Hard-line conservatives began an uphill fight Friday to force a fresh House vote this fall on erasing much of President Barack Obama's health care law without an immediate replacement, the latest instance of Republican rifts in what's been a fractious week for the GOP. The effort by the House Freedom Caucus seemed to have no chance of passing Congress. (Fram, 8/11)

Health insurers won a victory in 2015 when a tax that was part of the Affordable Care Act was suspended. Now as they fight to repeal or delay the tax again before it comes back into effect, the odds don’t seem to be in their favor.  Insurers, businesses and conservative groups are scrambling for ways to at least delay the health-insurance tax, or HIT, following the collapse of health-care legislation in July. They seemed poised for victory just a few months ago, when the health-insurance fee, and most of the other levies enacted to help fund Obamacare, were targeted in repeal bills passed by House Republicans and considered by Senate Republicans. (Brody, 8/11)

The industry that makes medical devices from artificial hips to miniature pumps for IV drips is looking for a fallback plan to repeal a widely reviled sales tax that almost met its end in GOP health care legislation. The 2.3 percent excise, one of several taxes and fees in the Affordable Care Act that pay for expanded insurance coverage, has been the subject of ferocious lobbying by manufacturers seeking its permanent death. Yet for now it's on track to be reinstated on Jan. 1 after a two-year hiatus, leaving industry leaders worried it will hurt employment and stifle development of innovative, even lifesaving products. (Salsberg, 8/13)

President Donald Trump has threatened to blow up Obamacare. But his own administration is separately dangling hundreds of millions of dollars before states to bail out their insurance markets. Alaska will get $323 million over the next five years to coax its lone Obamacare insurer to remain in the market and hold down premiums. At least four other states, including some that have vociferously opposed the Affordable Care Act, are seeking similar deals. ... The White House said Thursday it applauds the stabilization efforts even as Trump steps up the pressure on the Senate to resume efforts to try to pass legislation to repeal and replace Obamacare. (Pradhan, 8/13)

State officials are using every tool at their disposal to try to keep their insurance marketplaces stable in the face of uncertainty from the Trump administration over the future of ObamaCare. Insurance commissioners are working with providers, advocates and insurance companies to help keep the system running, but it’s an uphill climb. (Weixel, 8/13)

The Iowa Insurance Division is getting close to finalizing its "stopgap" plan to prop up the state’s individual health insurance market under the Affordable Care Act. An independent economic analysis shows more Iowans will be able to keep their individual ACA health insurance if the federal government approves the state’s stopgap plan. (Sostaric, 8/11)

Ohio insurers in the Affordable Care Act market are filing new, substantially higher premium requests -- with average hikes as high as 48 percent -- in case President Donald Trump pulls the plug on federal money promised by President Obama. It is still possible their earlier rate requests for 2018, with increases of 20 percent or more, will hold. Those were already considered steep. (Koff, 8/12)

A third insurance company said Friday that it will stop offering individual health insurance plans under the Affordable Care Act next year in Virginia, citing in part the uncertainty in Washington as lawmakers debate the future of the health care law. Anthem Blue Cross Blue Shield said in a statement that the decision was based on the shrinking individual market and “continual changes and uncertainty” in the operation, rules and guidance of the law. (Finley, 8/11)

As Republicans in Congress and the White House have an on-again, off-again debate about repealing Obamacare, a couple of developments on the ground are expected to affect this winter's open enrollment period for coverage. For one thing, Tampa is one of 18 cities nationwide affected by a Trump administration decision not to renew contracts with two companies that helped people sign up for health insurance through the Affordable Care Act. (Danielson, 8/14)

The Montana Health Co-op resumes accepting new enrollees on Sunday after withdrawing from the state’s health insurance exchange last year amid worries about its financial health. Chief Executive Officer Jerry Dworak asserts that the co-op is in position to absorb all 64, 000 Montanans who buy policies from the state’s health insurance exchange. (Calvan, 8/12)

The nonpartisan Congressional Budget Office (CBO) will release an analysis next week detailing the effects of ending key ObamaCare insurer payments. The CBO announced Friday the score would be released next week. President Trump has threatened to cancel the payments, known as cost-sharing reductions, which reimburse insurers for giving discounted deductibles and copays to low-income people. (Hellmann, 8/11)

A new healthcare must-read will hit everyone's summer list this week. That's when the Congressional Budget Office is set to release a report detailing what could happen to insurance markets if the federal government stops making cost-sharing reduction payments. The payments, part of the Affordable Care Act, reimburse insurers for limiting deductibles and copays to individual customers with incomes of less than $29,700, or 250% of the poverty level. Premiums for the plans those customers buy do not cover the cost of the generous benefits. (Lee, 8/12)

President Donald Trump has signed an emergency spending bill that will pump more than $2 billion into a program that allows veterans to receive private medical care at government expense. ... The bill, which addresses a budget shortfall at the Department of Veteran Affairs that threatened medical care for thousands of veterans, provides $2.1 billion to continue funding the Veterans Choice Program, which allows veterans to seek private care. (Lemire, 8/12)

In one of its last acts before leaving for the August recess, Congress injected $2.1 billion into a private medical care access program for veterans that was on life support. Meanwhile, federal watchdogs are raising red flags about how some parts of the current program are functioning — and the Department of Veterans Affairs' handling of Veterans Choice Program funds is prompting questions among lawmakers about how it will be revamped or widened. The Veterans Choice Program was created (PL 113-146) as a temporary relief valve to help reduce a spike in demand for medical care that left VA health centers struggling nationwide. While the new funds are designed to keep the program running for another six months, it’s clear that authorizers don’t want Choice to disappear. (Mejdrich, 8/14)

Poor oversight and mismanagement of the enrollment system resulted in delays to health care access for some veterans and likely denied access to others, according to a draft report that the VA’s Office of Inspector General wrote in May. The report highlights the depth of the problems in the VA’s enrollment process that is overseen by the Veterans Health Administration and its national Health Eligibility Center in Atlanta. (Schrade, 8/10)

The CMS has consistently penalized roughly 75% of hospitals for excessive readmissions since the Hospital Readmissions Reduction Program began in 2012. The stagnant numbers have policy experts and hospitals wondering if the CMS should move on from the effort. (Castellucci, 8/12)

Consumers are getting some relief on healthcare prices this summer. The increase in June was just 1.5% compared with the prior-year period at 1.9%, according to a new report by the Altarum Institute's Center for Sustainable Health Spending. Hospitals, whose privately insured patients paid just 1.8% more for services in June compared with the year before led the moderation. That's the smallest monthly increase in that category since Altarum started tracking the private-payer pricing data in June 2014. (Barkholz, 8/11)

According to [WebMD's] chief financial officer, Blake DeSimone, who was appointed to the position in September, WebMD is in the process of transforming its flagship site for consumers, WebMD.com, from a one-stop shop for information to a platform people can engage with and take action to improve their health. WebMD last month agreed to be acquired by private-equity firm KKR & Co. for $2.8 billion, after publicly putting itself in play early this year. (Stratton, 8/13)

President Trump threw the public for a loop again on Thursday when he announced his administration was moving to declare the opioid crisis a national emergency, just two days after administration officials said they weren’t going to take such a step. Emergency declarations can carry both symbolic weight and serious policy consequences. Here are four things STAT will be keeping an eye on. (Joseph, 8/11)

Public health officials and others concerned about the nation's opioid crisis are hailing President Trump's decision to declare it a national emergency. ... But while the Trump administration prepares the presidential order, governors in six states have already declared emergencies to deal with opioids. (Allen, 8/11)

The cost of treating opioid overdose victims in hospital intensive care units jumped 58 percent in a seven-year span, according to a new study that concludes increasingly sick patients are placing a greater strain on an overmatched health care system. Between 2009 and 2015, the average cost of care per opioid admission increased from $58,500 to $92,400 in the 162 academic hospitals included in the study, which was led by Beth Israel Deaconess Medical Center in Boston. That rapid escalation far outpaced the overall medical inflation rate in the U.S., which was about 19 percent during the period covered by the study. (Ross, 8/11)

As the nation’s opioid crisis has deepened, the number of drug treatment centers for pregnant women has grown. But experts and advocates say there aren’t enough services for pregnant women to meet the demand, and many don’t offer the drugs doctors would normally use to treat addiction because they are concerned about the effects they might have on a fetus. And some laws requiring that babies going through withdrawal be removed from their mother’s care can be a deterrent to seeking help, they said. (Ockerman, 8/13)

Arizona Gov. Doug Ducey this week extended an order requiring timely tracking of suspected opioid overdoses, a move that coincides with talk of declaring a state of national emergency. Ducey's initial June 13 order called for state health officials to collect opioid-related overdose information from first responders and health-care providers within 24 hours of a case, providing a nearly real-time picture of the issue. (Pohl, 8/11)

New Hampshire's Attorney General made waves earlier this week when it brought its first lawsuit against a pharmaceutical giant, Purdue, over its alleged role in the state’s opioid crisis. ...Logan and other legal experts say it’s a playbook that’s been tried lots of times before — with varying levels of success. (McDermott, 8/11)

Over the decades, the battle against addiction has been a constant on the Red Lake, Leech Lake, White Earth and Fond du Lac reservations in northern Minnesota. But recently, the demons afflicting many who call those communities home have escalated from alcohol to cocaine to deadly mixes of heroin. (Smith, 8/12)

Cases of chlamydia, gonorrhea and syphilis all hit record-high numbers in 2015. Tens of thousands contract HIV every year in the U.S., and oral cancers caused by human papillomavirus are increasing. So startups are popping up online to help serve what they see as unmet demand for STD testing. ... The question is whether those companies can survive — at least one left the market before its product even launched — and whether the services they offer get the right tests to the right people. (Haelle, 8/13)

Since Darren Daulton succumbed to brain cancer on Aug. 6, heartfelt tributes have honored the way he led a raucous Phillies team to the World Series in 1993. And unanswered questions have surfaced about the way he died. Daulton and several prominent contemporaries in baseball — including at least three other Phillies who played at Veterans Stadium, the team’s home from 1971 to 2003 — have died of glioblastoma, according to news media accounts. It is considered the most aggressive and frequently diagnosed form of malignant brain tumor. Researchers who have examined the baseball cases for years say there is insufficient evidence to determine whether they represent anything more than coincidence. Possible cancer clusters are notoriously hard to prove. (Longman, 8/14)

Scientists at Washington University in St. Louis are developing a test for the Zika virus that produces results quickly and don't require refrigeration. ...The test is a piece of paper coated with tiny gold particles that are covered with a protein that reacts to substances in an infected person's blood. (Chen, 8/11)

There are some hopeful signs of support for our fight against Lyme disease: The U.S. federal government has recently committed $40 million to create four regional centers of excellence for vector-borne diseases — which include Lyme — as part of its efforts to control the Zika virus. But most of that money is expected to go toward fighting Zika, so it will likely do little to help fill the public health funding gaps that are leaving us far behind France in the fight against Lyme. (Scales, 8/11)

As a renowned Stanford scientist, Ron Davis has a deep appreciation for the power of modern medicine. And yet an explanation for the disease afflicting his own beloved son eludes him. Son Whitney, 33, suffers from such severe Chronic Fatigue Syndrome that he is bedridden, unable to eat or speak. The handsome man was once a photographer and adventurer. He traveled through the United States, studied Buddhism in India and Nepal, lived in an Ecuadorian rainforest and ran a campaign office for former president Barack Obama. Now he’s returned home to Palo Alto for 24-hour care. (Krieger, 8/12)

In part because of their Alaska Native heritage, which puts a high value on spiritual health, the leaders of Southcentral recognized decades ago that behavioral health is tightly linked with bodily health. So they became one of the early adopters of integrated care. They embedded treatment for mental and emotional ills in their primary care practices, and found that patient satisfaction rates skyrocketed and usage of medical care went down, saving millions of dollars while improving patient outcomes. In the nearly 30 years since Southcentral hired its first psychologist, pretty much every study has shown that integrating mental health care into medical care results in better patient outcomes and lower costs. (Silberner, 8/9)

Just last week, scientists reported a new first in the journal Nature: They edited heritable cells in human embryos to treat an inherited form of heart disease. The day after the research was published, a group of genetics experts published a statement calling for further debate before applications of the technology are taken any further in humans. According to a new survey of 1,600 adults published in the journal Science today, much of the American public shares this desire for engagement in decision-making. (Abed, 8/11)

The medicine has had a powerful effect. Seizures that once struck multiple times an hour now come once every five or six days. But the drug came with a deadline: At the end of June, GlaxoSmithKline, the British drug company that sells Potiga, pulled it off the market because of declining sales, forcing families to stockpile supplies or wean their children off a drug that dramatically improved their quality of life. The dilemma faced by parents whose children benefited from Potiga — and future families who potentially may never have access to the drug — highlights the limitations of drug companies’ business model. (Johnson, 8/11)

The 90-year-old woman in the San Diego-area nursing home was quite clear, said Dr. Karl Steinberg. She didn’t want aggressive measures to prolong her life. If her heart stopped, she didn’t want CPR. But when Steinberg, a palliative care physician, relayed those wishes to the woman’s daughter, the younger woman would have none of it. ... Steinberg used an increasingly popular tool to resolve the impasse last month. He brought mother and daughter together for an advance-care planning session, an end-of-life consultation that’s now being paid for by Medicare. In 2016, the first year health care providers were allowed to bill for the service, nearly 575,000 Medicare beneficiaries took part in the conversations, new federal data obtained by Kaiser Health News show. (Aleccia, 8/14)

Rural hospitals across Ohio face a crisis in care and funding. Many feared that proposed cuts to health care funding in Washington would have pushed them to cut vital services, or go out of business entirely. But even with repeal and replace seemingly out of the equation, they still worry about their future in an increasingly difficult industry. (Christ, 8/14)

Since the start of the century, it has become more dangerous to have a baby in rural America. Pregnancy-related complications are rising across the U.S., and many require specialized care. For some women, the time and distance from hospitals with the resources and specialists to handle an obstetric emergency can be fatal. The rate at which women died of pregnancy-related complications was 64% higher in rural areas than in large U.S. cities in 2015. That is a switch from 2000, when the rate in the cities was higher, according to Centers for Disease Control and Prevention data analyzed by The Wall Street Journal. (McKay and Overberg, 8/11)

Texas women are on the verge of having to buy additional insurance to cover abortions if they want it under a bill that will likely land on the governor's desk early next week, dealing a win to conservative Republicans. The Senate passed the bill on a 20-10 vote Saturday evening, leaving it one perfunctory vote away from heading to Gov. Greg Abbott, who is expected to sign the legislation. It is one of 20 items he considered must-pass measures in the special session that ends Wednesday. (Wallace and Zelinski, 8/12)

The Republican-controlled Texas Senate backed a plan Saturday night to restrict insurance coverage for abortions, over the objections of opponents who expressed concern it could force some women to make heart-wrenching choices because no exceptions will be made in cases of rape and incest. The 20-10 party-line vote for preliminary approval requires women to purchase extra insurance to cover abortions except amid medical emergencies. (Weissert and Crary, 8/13)

Opponents of the bill argue that abortion is a safe procedure, with complication rates well below other procedures, making HB 13 another attempt to harass abortion providers and further stigmatize abortion. ...Under HB 13, doctors would have three business days to file an electronic report with the state if a complication arises during an abortion. (Lindell, 8/11)

Legislation that would extend the life of a state task force studying Texas’ high maternal morbidity rates was tentatively approved by the Texas House late Sunday night. The task force, launched by the Legislature in 2013, found that between 2011 and 2012, 189 Texas mothers died less than a year after their pregnancies ended, mostly from heart disease, drug overdoses and high blood pressure. (Samuels, 8/13)

More than half a million Illinois residents on Medicaid are about to see major changes in their coverage as the state slashes in half the number of insurers in its Medicaid managed care program. The Illinois Department of Healthcare and Family Services announced Friday that it has selected six insurers to be part of Gov. Bruce Rauner's planned overhaul of the program, down from the 12 now participating. In Medicaid managed care, private insurers administer Medicaid benefits, whereas the state administers benefits in traditional Medicaid. (Schencker, 8/11)

Thirty-two years ago, a vehicle accident left Todd Mouw a quadriplegic, unable to feed himself and needing a ventilator to breathe. Yet for decades he was able to live at home with the help of family, aided by medical staff who visited him daily to help provide 24-hour care. That care abruptly ended when a for-profit company that Iowa hired last year to manage the state's Medicaid program announced that some of the staffers who had attended to Mouw all those years weren't qualified, and it wouldn't pay for the cost. (Clayworth, 8/12)

A nonprofit organization supported by hospitals and another health care provider have filed complaints over Mississippi Medicaid's decision to award a major managed care contract to other companies. Mississippi True, a newly formed nonprofit backed by 65 hospitals, and Amerigroup have gone to court asking for damages and seeking a court order to bar the state from finalizing the Medicaid contract, which they contend was awarded improperly. (8/12)

As congressional efforts to change former President Barack Obama’s health law sputter, a push to expand Medicaid in Maine has opponents raising questions about the source of future federal funding. Maine voters are set to consider a Nov. 7 ballot question to require the state to apply for a Medicaid expansion for adults under 65 with incomes at or below 138 percent of the federal poverty line. (8/12)

Missouri Care Inc. has notified 1,223 Missourians enrolled in the state’s Medicaid program that some of their personal information was mailed to an incorrect address. No medical or financial information was shared in the letters, according to the Missouri Department of Social Services. (Liss, 8/11)

[A]n emboldened coalition of Democratic state attorneys general has unleashed a torrent of lower-profile litigation they argue is necessary to protect public health, the environment and consumers from a Republican White House. State attorneys from Massachusetts to New York to California, often working together, have brought more than 40 legal actions against the Trump administration over the last seven months. The pace, which both parties describe as unprecedented, has produced an average of one lawsuit or legal motion every five days since Trump’s inauguration, not including many more letters, legal threats and formal comments to federal agencies. (Peoples, 8/13)

Connie Ragonesi spent seven days in a hospital bed in Florida with a fractured ankle, and it set in motion years of heartache. The 88-year-old was cared for under “observation status,” a Medicare policy that became a nightmare and contributed to her having to sell her home in Wellington, on the state’s east coast, according to her daughter, Carol Taylor. ... The Washington, D.C.-based Center for Medicare Advocacy, which focuses on seniors’ rights, was recently granted class action status in a lawsuit against the federal government regarding the policy. The issue is whether patients should have the right to appeal to Medicare when they are placed by a hospital on the outpatient-based observation designation, as opposed to admitted. (Freeman, 8/12)

The new law enables clinics — particularly those such as community health centers that provide care primarily to people with low incomes — to hire dental hygienists to provide basic preventive care, such as cleanings, fluoride varnishes, sealants and education on oral health. ...Access to dental care for adults and children covered by Medicaid programs, such as BadgerCare Plus, is a longstanding problem throughout Wisconsin. (Boulton, 8/12)

Judy Dale died of cancer in her San Francisco home in September, in agony, after being denied the pain-relieving medication she might have received under the state’s aid-in-dying law that had taken effect three months earlier. A lawsuit by her children will determine whether UCSF Medical Center, where Dale first went for treatment, was responsible for her suffering by allegedly concealing its oncologists’ decision not to provide life-ending drugs to patients who ask for them. (Egelko, 8/12)

While Georgia’s state employees and teachers will see an average 3.7 percent hike in their health insurance premiums in 2018, the news is much worse for some retirees. About 46,000 retired teachers and state employees, and their dependents, currently get coverage from “premium” health insurance plans offered by Blue Cross Blue Shield and UnitedHealthcare through the State Health Benefit Plan. (Salzer, 8/11)

A U.S. judge on Friday ruled that Illinois was not providing sufficient resources for the care of developmentally disabled residents and ordered the state to come up with a plan to restore services. (Pierog, 8/11)

Even with a new law that has boosted kindergarten vaccination rates to record highs, hundreds of schools across California still have so many children lacking full immunization that they pose an increased risk of disease outbreaks, according to a Times analysis of state data. At nearly 750 schools, 90% or fewer kindergartners had been fully vaccinated last year, the analysis found. Experts say the rate should be at least 95% to prevent the spread of highly contagious diseases such as measles. (Karlamangla and Poindexter, 8/13)

The state of Texas ranks as the 11th worst state for health care, according to the personal-finance website WalletHub’s study of the year’s best and worst states for health care. ...The study compared each state and the District of Columbia 35 different measures of cost, accessibility and outcome to determine which state offered the best health care to citizens. (Hubby, 8/11)

Ironstone Real Estate Partners won Friday’s North Philadelphia Health System (NPHS) bankruptcy auction, agreeing to pay $8.5 million in cash with no contingencies, but with some twists to make the deal for the behavioral health operation work. Philadelphia-based Ironstone’s price is less than the baseline, or stalking-horse, bid of $10 million set by Meridian Behavioral Health Systems LLC, a Tennessee chain with facilities in four states, but Meridian’s offer was laden with conditions on the city and on unions that would have made it hard to complete the purchase. (Brubaker, 8/11)

When Sonoma County sheriff’s officials publicly revealed their plans last spring to build a $48 million jail wing for the mentally ill, a common question quickly emerged. Why not build a psychiatric hospital instead in Sonoma County? After all, the only local hospital beds for mental health patients are operated by a for-profit company, while many low-income residents suffering a psychiatric crisis often wait for hours in an emergency room, waiting for a bed to free up in a psychiatric hospital in another county. (Espinoza, 8/12)

The largest psychiatric facility in Sonoma County is not a hospital.It’s the jail.If not by design then by default, jail cells have essentially replaced psychiatric hospital beds for many of Sonoma County’s most severely mentally ill residents. It is a trend that began before the closure of Santa Rosa’s two secured mental health hospitals a decade ago, and has continued since. Now, nearly 40 percent of the 1,100 inmates held at the county’s main jail and its lower-security North County Detention Facility near the Charles M. Schulz-Sonoma County Airport have some form of mental health issue, from mild depression to bipolar schizoaffective disorder. (Espinoza, 8/12)

When someone loses the ability to swallow, these life-giving devices provide essential nourishment to the body. ...Now a startup company, working to advance research performed at the University of Wisconsin-Madison, may offer a way to alleviate these symptoms with plant extracts — or more specifically the tannins they contain. (Axelson, 8/12)

Seven people have been sickened by salmonella bacteria after eating fresh shelled (loose) peas purchased at three farmers markets in Wisconsin, state health officials said Friday. The announcement came as federal health officials reported that the number of cases from a fatal nationwide salmonella outbreak linked to imported papayas -- which includes one case in Wisconsin -- has risen to 141. (Garza, 8/11)

Emergency personnel from around the Seacoast responded to Exeter Hospital Friday, where employee complaints of nausea and dizziness resulted in a partial evacuation. At this time, the cause is unknown. (Bookman, 8/11)

Two sections of Exeter Hospital were evacuated Friday after 19 staff members reported flu-like symptoms in the inpatient operating room, a hospital official said. The cause of the staff members’ sickness at the New Hampshire hospital remained a mystery Friday, officials said. (Ellement and McDonald, 8/11)

[Chris] Cohn underwent treatment in San Francisco 10 years ago and has remained sober ever since. While in rehab, he realized a business calling of a different kind. He returned to Arizona to answer it and help those needing to get sober. (Yara, 8/12)

Much like many rural hospitals that are faced with impossible financial circumstances, air medical transport bases are being forced to close around the nation, leaving Americans without access to life-saving care. Already, 85 million of our fellow citizens (1 in 4) can only reach a Level 1 or 2 Trauma Care facility within an hour if they are brought there by a helicopter air ambulance. (LaRue, 8/13)

Things could go well for the Democrats in next year’s midterm elections — if they don’t Bern out. ... Bernie Sanders’s advisers are promoting a “litmus test” under which Democrats who don’t swear to implement single-payer health care would be booted from the party in primaries. Sanders pollster Ben Tulchin penned an op-ed with a colleague under the headline “Universal health care is the new litmus test for Democrats.” Nina Turner, head of the Sanders group Our Revolution, told Politico this week that “there’s something wrong with” Democrats who won’t “unequivocally” embrace “Medicare-for-all.” (Dana Milbank, 8/11)

If you’re a normal person who doesn’t have much time to burrow into the details of policy, you can be forgiven for thinking that the health care choice we face in this country is between the current improving but still inefficient and dissatisfying status quo and a single-payer system. After all, single payer, in which the federal government acts as every American’s insurance provider, is the only alternative that ever gets discussed. But that isn’t the case. Single payer is a policy choice, not a principle. The principle is universal coverage. Single payer is one way to get there. It’s how Britain and Canada do it. But there are other ways. (Michael Tomasky, 8/14)

Dreaming of a state-run single-payer healthcare system? Wake up and enter the real world. Want universal healthcare for all Americans? Medicare for all is the solution. Not this year or next, but possibly in the future — when Democrats recapture the presidency and Congress. That’s the clear-eyed, pragmatic fight to engage in, and one advocated by U.S. Rep. John Garamendi (D-Walnut Grove), a longtime healthcare warrior. “Medicare is far, far more efficient than private insurance companies,” he said. “Using the tax system to collect money for healthcare delivery is extremely efficient. No profits. No commissions. No advertising.” (George Skelton, 8/14)

The chaos that continues to engulf the health care debate in Washington, D.C.. reaffirms the assertion that states must forge their own paths to protect the most vulnerable people in their communities. But too many states have turned to an expansion of Medicaid through Obamacare as a solution — putting their truly needy at risk and leaving taxpayers with surging costs as a result. (Jason Spencer, 8/13)

Regardless of whether Congress enacts health care reform, the private sector isn’t waiting. Health care for our employees is too expensive, and the employer-based system must be reformed. ... The United States government defines health care as “affordable” if it costs less than 9.7 percent of a household’s income. By that standard, in less than 10 years more than half of employees who are heads of families are projected to be unable to afford their health care costs, creating a significant problem for everyone. (Robert Andrews, 8/11)

With flimsy justification, and in small type buried in routine documents, the Trump administration has informed 81 local governments and health groups that it will end grants they have received to run teen pregnancy prevention programs, two years before the grants are scheduled to end. The decision is unsettling even by the disquieting standards of this anti-science administration. (8/11)

Trump focused instead on stepping up law enforcement and border security, leading many to fear he is more interested in a taking an old-school “war on drugs” approach than treating the epidemic appropriately as a public health issue and addicts as people who are sick. ... The LA Times’ editorial board has some suggestions for the feds and states on how to do this: First and foremost, do not treat this as a law enforcement problem. The nation’s “war on drugs” was an expensive failure that didn’t stop drug abuse. It just filled up jails and ruined lives. Let’s not repeat that mistake. In that same vein, please don’t criminalize addicts. Help them. Especially if they are pregnant women. (Mariel Garza, 8/11)

With some apprehension, I agreed to join colleagues from the Maryland General Assembly on a tour of the Maryland Office of the Chief Medical Examiner to learn about forensic investigations, evidence collection and cause and manner of death, issues relevant to topics debated in the House Judiciary Committee. They also are relevant to the state’s opioid epidemic. (Del. Pamela E. Queen, 8/12)

Just as we don’t confuse toddlers with teenagers, or young adults with their middle-age parents, so, too, are we able to distinguish 70-year-olds from the nonagenarians a generation ahead of them. Those two groups — the “young old” and the “old old” — don’t just differ in how they look and spend their days; they also differ biologically. As a result, it’s likely that we are incorrectly vaccinating a significant number of the 47 million Americans over 65. (Louise Aronson, 8/11)

While much of the nation appears to be adjusting to the transgender rights movement, social conservatives in the Texas Legislature — prodded by Lt. Gov. Dan Patrick, a Republican — continue their obsessive campaign to restrict the bathroom rights of transgender citizens. They are fighting to the very end of the current special session, in the face of a storm of powerful opposition that ranges from the state’s Fortune 500 companies and business leaders to police chiefs, sports and tourism executives, concerned parents, and pastors in an evangelical community divided over the lack of basic charity underlying the anti-transgender legislation. (8/11)

The best laid plans of politicians often go awry, and then there’s Philadelphia’s soda tax. A new Tax Foundation report finds that the 1.5-cent-an-ounce levy that took effect in January is hurting low-income workers and producing less revenue than promised, but at least it’s helping beer sales. (8/13)

There may be some folks receiving disability benefits fraudulently, but I do know I got a good going over. A few weeks after my stroke, when I realized I wasn’t going to be able to work, my wife drove me to the Social Security office to apply for benefits. ... Months on, I still haven’t received a single check. Without help from family, I would be homeless, despite over forty years in the work force. To them, I am forever grateful, but also deeply ashamed. (Robert Fowler, 8/10)

The scourge of type 2 diabetes across the United States costs American taxpayers billions of dollars every single year. Diabetes and diabetes-related treatment is one of the biggest drivers of rising healthcare costs for every payer — with Medicare spending more on treating those with the disease every year. ... Last month, for the first time in the agency’s history, the Centers for Medicare and Medicaid Services laid out proposed rules to reimburse providers to proactively prevent chronic disease by paying for the evidence-based Diabetes Prevention Program for eligible beneficiaries. ... But unfortunately, the proposed rule missed a huge opportunity to extend access to this benefit to the area most in need: rural America. (Sean Duffy, 8/14)