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The Trump administration said Saturday that it was suspending a program that pays billions of dollars to insurers to stabilize health insurance markets under the Affordable Care Act, a freeze that could increase uncertainty in the markets and drive up premiums this fall. Many insurers that enroll large numbers of unhealthy people depend on the “risk adjustment” payments, which are intended to reduce the incentives for insurers to seek out healthy consumers and shun those with chronic illnesses and other pre-existing conditions. (Pear, 7/7)

In a weekend announcement, the Centers for Medicare and Medicaid Services said the administration is acting because of conflicting court ruling in lawsuits filed by some smaller insurers who question whether they are being fairly treated under the program. The so-called "risk adjustment" program takes payments from insurers with healthier customers and redistributes that money to companies with sicker enrollees. Payments for 2017 are $10.4 billion. No taxpayer subsidies are involved. (7/8)

CMS officials didn’t specify how long the suspension would last or what would trigger a resumption of payments in the program. CMS officials said they are looking for a quick resolution to the legal issues raised. “We’re now in the midst of the 2019 rate-filing process and it’s not clear how the risk-adjustment program will be operating,” said Cori Uccello, senior health fellow at the American Academy of Actuaries. (7/8)

America's Health Insurance Plans (AHIP), a trade group representing insurers offering plans via employers, through government programs and in the individual marketplace, said the CMS suspension would create a "new market disruption" at a "critical time" when insurers are setting premiums for next year. "It will create more market uncertainty and increase premiums for many health plans - putting a heavier burden on small businesses and consumers, and reducing coverage options. And costs for taxpayers will rise as the federal government spends more on premium subsidies," AHIP said in a statement. (7/8)

Blue Cross Blue Shield Association President and CEO Scott Serota said the administration has the legal justification needed to move forward with the payments regardless of the New Mexico ruling. “This action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices,” Serota said in a statement. “It will undermine Americans’ access to affordable coverage, particularly those who need medical care the most.” (7/8)

Risk adjustment is one of three methods built into the 2010 health-care law to help insulate insurance companies from the ACA requirement that they accept all customers for the first time — healthy and sick — without charging more to those who need substantial care. The other two methods were temporary, but risk adjustment is permanent. Federal health officials are required each year to calculate which insurers with relatively low-cost consumers must chip in to a fund, and which ones with more expensive customers are owed money. This idea of pooling risk has had significant practical effects: encouraging insurers to participate in the insurance marketplaces the ACA created for Americans who cannot get affordable health benefits through a job. (Goldstein, 7/7)

The effect of the cut-off will be complex. In the short-term, it will likely favor health insurers that have drawn healthier, less-costly customers. Under the risk-adjustment program, those insurers make payments into a pool is redistributed to plans with sicker, more costly patients. As a result, some plans that had already been doing better financially will benefit from not having to make the payments. (Tracer, Broderick and Kopit, 7/7)

The risk-adjustment program has been a source of frustration for small insurers and ACA co-ops that claim the formula makes their membership bases look healthier than they are. One reason could be that newer insurers have limited information on their members' health status and claims history. Legacy insurers that have a wealth of patient data may have a leg up on coding. Small health plans also have far less capital than more established insurers to comfortably make large risk-adjustment payments. (7/8)

It is unclear how many Americans are paying back some or all of the financial assistance they received to buy health insurance because their income turned out to be higher than they projected. The most recent analysis of the issue was done in 2015 by H&R Block, which found that 52 percent of people who enrolled in health insurance through Affordable Care Act marketplaces around the country ended up paying back some of the subsidies. (Ho, 7/8)

Premium increases of 2 percent to almost 15 percent would seem like bad news for Georgians needing health care coverage. But the rate hikes proposed by insurers for Georgia’s 2019 insurance exchange appear almost as a relief, compared with huge rate hikes a year ago — more than 50 percent. (Miller, 7/6)

President Trump sought to mine a last bit of drama from his decision on a Supreme Court nominee on Sunday, saying he might need to extend the process well into Monday, just hours before he is scheduled to announce the pick in a prime-time address. “I’m very close to making a decision,” Mr. Trump said on Sunday afternoon as he boarded Air Force One to return to Washington after a weekend spent golfing at his private club in Bedminster, N.J., and soliciting opinions from dozens of people about what he should do. (Haberman, Liptak and Schmidt, 7/8)

All four of President Trump’s candidates for the Supreme Court are white, middle-aged federal appeals court judges with reliably conservative legal records. One of them, Brett M. Kavanaugh, went to the same high school as Mr. Trump’s last nominee, Neil M. Gorsuch — Georgetown Preparatory School, outside Washington. Another, Raymond M. Kethledge of the Sixth Circuit, so resembles Justice Gorsuch in background, philosophy, hobbies — both are outdoorsmen who like fishing — and even physical appearance, that some conservatives have taken to calling him “Gorsuch 2.0.” (Landler and Haberman, 7/6)

Judge Kavanaugh had been a front-runner as late as Saturday, but the fact that Mr. Trump hadn’t settled on him suggested his front-runner status may have slipped by Sunday, several people familiar with the search said. (Nicholas and Radnofsky, 7/8)

One of the leading contenders for the Supreme Court, D.C. Circuit Judge Brett Kavanaugh, could see his chance at the nomination hinge on his handling of a legal battle last year over a 17-year-old immigrant's request for an abortion. To Kavanaugh's backers, his role in the legal showdown that played out over a couple of weeks last October exhibits the kind of judicial restraint conservatives have long called for from members of the bench. (Gerstein, 7/6)

Raymond Kethledge, one of President Trump’s finalists for the U.S. Supreme Court, has never explicitly stated his views on abortion or same-sex marriage. But he has spoken loudly on an issue that is just as important to conservative court-watchers. In April, Kethledge ruled in favor of Cathedral Buffet, a church-run Ohio restaurant being sued by the government because of claims that congregants were “spiritually coerced” by their pastor to work without pay. Kethledge went further than his fellow judges on the U.S. Court of Appeals for the 6th Circuit in arguing that the restaurant’s Christian affiliation shielded it from federal labor laws. (Goldstein, 7/7)

Senator Mitch McConnell, the Republican leader, told President Trump this past week that Judges Raymond M. Kethledge and Thomas M. Hardiman presented the fewest obvious obstacles to being confirmed to replace Justice Anthony M. Kennedy on the Supreme Court, according to Republican officials briefed on the conversation. While careful not to directly make the case for any would-be justice, Mr. McConnell made clear in multiple phone calls with Mr. Trump and the White House counsel, Donald F. McGahn II, that the lengthy paper trail of another top contender, Judge Brett M. Kavanaugh, would pose difficulties for his confirmation. (Haberman and Martin, 7/7)

The four judges believed to be in the running to be President Donald Trump’s next nominee to the Supreme Court “are all winners,” Sen. Lindsey Graham said Sunday, and will present a “nightmare” decision for red-state Democrats in the Senate. “Republicans are holding four lottery tickets and all of them are winners,” the South Carolina Republican, a member of the Senate Judiciary Committee, told “Fox News Sunday.” “If you’re a conservative Republican, the four people named — particularly Thomas Hardiman, I'm glad he’s on the list — are all winners and every Republicans should embrace these picks.” (Nelson, 7/8)

As the clock ticks on President Donald Trump’s choice for a Supreme Court vacancy, each of the four people under close consideration could move the court in a more conservative direction for decades. “Republicans are holding four lottery tickets, and all of them are winners,” Sen. Lindsey Graham (R., S.C.) said Sunday in a Fox News interview. Here’s a look at the top contenders. (Kendall and Bravin, 7/8)

Democratic senators running for re-election in Trump Country face an agonizing choice over President Trump’s coming Supreme Court nominee: Vote to confirm the pick and risk demoralizing Democratic voters ahead of the midterm elections, or stick with the party and possibly sacrifice their own seats — and any chance at a Democratic majority in 2019. The actions of a handful of Senate Democrats struggling to hold their seats in red states where Mr. Trump remains popular — notably Heidi Heitkamp of North Dakota, Joe Donnelly of Indiana and Joe Manchin III of West Virginia — will have broad implications for the party at a critical political juncture. (Hulse, 7/7)

In a sparsely decorated “war room” next to the West Wing on the White House grounds, Trump administration officials have been preparing for the president’s Supreme Court pick with an anything-can-happen approach to the historic task. With the knowledge that President Donald Trump could change his mind at the last minute — and with the president’s obsession to keep his final decision tightly held — Trump aides and Republicans familiar with the planning told POLITICO they initially were prepping for two possible nominees. (Cadelago, 7/8)

The coming battle over a Supreme Court nominee promises to be a bruising one. Republicans are eager for conservatives to gain a firm majority on the court. Democrats are voicing alarm about what the new justice could mean for charged issues such as abortion rights and gay rights. The stakes are enormous, and advocacy groups that don't have to unveil their donors are spending heavily to shape the fight. (7/9)

Sen. Richard Blumenthal (D-Conn.) said Sunday that he will ask President Trump’s Supreme Court nominee “really tough questions” on reproductive rights. Blumenthal told New York AM 970 radio host John Catsimatidis in an interview broadcast Sunday that he has “deep and serious concerns” about Trump’s top picks for the court. (Thomsen, 7/8)

A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly. Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes. (Jacobs, 7/8)

Now two new analyses of drinking water data and the science used to analyze it make clear the Environmental Protection Agency and the Department of Defense have downplayed the public threat posed by these chemicals. Far more people have likely been exposed to dangerous levels of them than has previously been reported because contamination from them is more widespread than has ever been officially acknowledged. (Lustgarten, 7/9)

The clock is ticking on a court-ordered Tuesday deadline for the federal government to reunite migrant parents with kids under 5 who were taken from them at the border. With a mere four days left, government attorneys have asked for more time — and some migrant parents say they have been given no information about how these court-ordered reunifications will take place. (Platoff and Parker, 7/6)

The 1-year-old boy in a green button-up shirt drank milk from a bottle, played with a small purple ball that lit up when it hit the ground and occasionally asked for “agua.” Then it was the child’s turn for his court appearance before a Phoenix immigration judge, who could hardly contain his unease with the situation during the portion of the hearing where he asks immigrant defendants whether they understand the proceedings. “I’m embarrassed to ask it, because I don’t know who you would explain it to, unless you think that a 1-year-old could learn immigration law,” Judge John W. Richardson told the lawyer representing the 1-year-old boy. (Galvan, 7/8)

A major U.S. defense contractor quietly detained dozens of immigrant children inside a vacant Phoenix office building with dark windows, no kitchen and only a few toilets during three weeks of the Trump administration’s family separation effort, Reveal from The Center for Investigative Reporting has learned. (Bogado, Branstetter and Swales,7/6)

South Carolina Gov. Henry McMaster removed $16 million for health care from the state budget, saying Friday he wanted to make sure no taxpayer money goes to abortion providers. The Republican governor said he was keeping a promise he made repeatedly as he campaigns for a full term, disagreeing with Democrats and some Republicans who said Planned Parenthood gets less than $100,000 of the money and all of it goes for family planning and not abortion. (7/6)

"Taxpayer dollars must not directly or indirectly subsidize abortion providers like Planned Parenthood," McMaster told The State. "There are a variety of agencies, clinics and medical entities in South Carolina that receive taxpayer funding [that] offer important women's health and family-planning services without performing abortions." (Wise, 7/6)

The number of abortions performed in Indiana increased last year for the first time since 2009, a state report shows. Nearly 7,800 women opted to terminate pregnancies in Indiana in 2017, almost 500 more than the previous year, according to an annual report released June 30 by the Indiana State Department of Health. The report looks at abortion trends over a five-year period. (7/6)

The Texas Attorney General has drawn on a network of pro-life advocates to defend the state’s abortion restrictions in federal court, spending half a million in taxpayer dollars for testimony that has done little or nothing to help the state make its case. The attorney general’s office has paid 21 expert witnesses to testify in legal challenges to a string of abortion laws and regulations enacted since 2013. Judges disregarded the testimony of six of the state’s experts and gave little or no weight to the others, according to their rulings and comments in court. (Matos, 7/7)

According to the Guttmacher Institute, nine other states have pre-Roe bans similar to Arizona's on the books: Alabama, Alaska, Massachusetts, Mississippi, New Mexico, Oklahoma, West Virginia and Wisconsin. Four states have post-Roe laws that would immediately ban abortion if Roe v. Wade was overturned: Louisiana, Mississippi, North Dakota and South Dakota. (Castle, 7/7)

Five years ago, Anthony, Drew and Raymond West were called into their supervisor’s office and let go from their jobs performing heavy-duty maintenance work at an oil refinery in Beaumont, Texas. “We kind of knew it was gonna happen, but then again we were all shocked,” said Raymond West, age 26, the youngest of the brothers. The Wests were employed for a contract-worker firm, Signature Industrial Services LLC, and were contracted to do work for Exxon Mobil Corp. Their Signature supervisor had been instructed to let them go because of their medical condition, hemophilia A, according to a lawsuit filed in February by the Equal Employment Opportunity Commission that charged Signature with violating the Americans with Disabilities Act. (Weber, 7/9)

Dr. Atul Gawande will step out of health care’s limelight on Monday to put himself under its microscope. Taking the helm of the new health venture funded by Amazon, JPMorgan Chase, and Berkshire Hathaway is the riskiest move of his career — one that will subject his acclaimed New Yorker narratives to a real-world stress test whose outcome is far from certain. In the balance will hang not just his reputation as a physician and writer, but perhaps the highest-profile effort to date to leverage the private sector to fix America’s fragmented and dysfunctional health care system. Gawande has made a name for himself by proposing novel solutions to the system’s many shortcomings — from surgical checklists to rooting out unnecessary care — and testing them in specific hospitals or markets around the world. (Ross, 7/9)

Stable cash flows and robust capital markets have kept the U.S. healthcare sector's 16-year default rate well below the overall market rate, according to a new report from Fitch Ratings. The sector that includes healthcare and pharmaceuticals saw an average high-yield default rate of 1% between 2002 and 2017, materially lower than the 4.1% rate for the market overall during that period. Given the short list of bonds Fitch is concerned about, the ratings agency wrote that it expects the sector's below-average default environment to stick around another year, absent unexpected regulatory changes or other external factors. (Bannow, 7/5)

People addicted to prescription opioids or heroin are far more likely to have run-ins with the law than those who don't use opioids, according to a study published Friday in JAMA Network Open. The study provides the first nationwide estimate for the number of people using opioids who end up in the American criminal justice system. The results suggest a need to engage law enforcement officials and corrections systems to tackle the opioid epidemic. (Chatterjee, 7/6)

Almost a year ago, the University of Tennessee Medical Center in Knoxville started requiring addicted patients admitted for medical treatment of drug-use associated infections to submit to tough new conduct rules. They must agree to a search by security, turn over their clothing and all personal property, hand over their cellphone, not leave the hospital floor, and receive no visitors. If they won't sign an agreement to follow those rules, they must leave. (Meyer, 7/7)

In Massachusetts, 26 advocacy and health care groups, including the Massachusetts Medical Society and Massachusetts Health and Hospital Association, have joined a coalition pushing the Legislature to require jails and prisons to provide the medications for opioid addiction to inmates. These medications ease cravings, prevent overdoses, and help people stay in treatment. (Freyer, 7/9)

In the good old days — way back in early 2012 — people who contracted gonorrhea were given a single pill to cure the infection. A newly published paper shows that a time is fast approaching when a far more onerous course of medical care may be required to get rid of a bacterium that seems hell-bent on becoming untreatable. Neisseria gonorrhoeae, the bug that causes gonorrhea, has relentlessly vanquished every antibiotic medical practice has used against it. The current recommended cure — an injection of a drug called ceftriaxone, given in combination with a second antibiotic, azithromycin — is the last good option to treat this infection, and there are already signs that its days may be numbered. (Branswell, 7/6)

Social egg freezing is a big topic of conversation in our office these days. My colleague Nicole Ellis has launched a video docuseries about her journey to figure out whether she should use the technology to save eggs that she could potentially use to fertilize later, when she feels the time is right. ("Social" differentiates this reason for egg storage from, say, freezing eggs before cancer treatment or for other medical reasons.) A number of other 20- and 30-something reporters, editors, producers and others are thinking about the procedure, too. (Cha, 7/6)

Close relationships with family and friends, we know, are important for our health and well-being. But what about the people who make up our broader social networks: the parents at school drop-off, the neighbor down the street or that colleague in another department who always makes you laugh? While research on the benefits of social connections has generally focused on the importance of “strong ties,” or the intimate relationships we have with family and close friends, a growing body of research is shedding light on the hidden benefits of casual acquaintances, too. Surprisingly, these “weak ties” (that funny colleague, for example) can serve important functions such as boosting physical and psychological health and buffering against stress and loneliness, researchers have found. (Wallace, 7/7)

Kaiser Health News: Feel Like The Last Friend Standing? Here’s How To Cultivate New Buds As You Age. 

Donn Trenner, 91, estimates that two-thirds of his friends are dead.“That’s a hard one for me,” he said. “I’ve lost a lot of people.” As baby boomers age, more and more folks will reach their 80s, 90s — and beyond. They will not only lose friends but face the daunting task of making new friends at an advanced age.Friendship in old age plays a critical role in health and well-being, according to recent findings from the Stanford Center on Longevity’s Sightlines Project. Socially isolated individuals face health risks comparable to those of smokers, and their mortality risk is twice that of obese individuals, the study notes. (Horovitz, 7/9)

When Americans hear about a health craze, they may turn to their physician for advice: Will that superfood really boost brain function? Is that supplement okay for me to take? Or they may be interested in food choices because of obesity, malnutrition or the role of diet in chronic disease. But a doctor may not be a reliable source. Experts say that while most physicians may recognize that diet is influential in health, they don’t learn enough about nutrition in medical school or the training programs that follow. (Cernansky, 7/8)

What if you wanted to speak but couldn’t string together recognizable words? What if someone spoke to you but you couldn’t understand what they were saying? These situations aren’t hypothetical for the more than 1 million Americans with aphasia, which affects the ability to understand and speak with others. Aphasia occurs in people who have had strokes, traumatic brain injuries or other brain damage. Some victims have a scrambled vocabulary or are unable to express themselves; others find it hard to make sense of the words they read or hear. (Blakemore, 7/7)

It happens fast: You crack open a bottle of your favorite drink and put it to your lips. The delicious flavor is nearly overwhelming. But a minute later, you’re barely noticing the taste as you drink it. Or you buy a new car and think it will make you smile every time you drive it for years. But a month later, that sensation is gone. Now it’s just a car. (Smith and O'Brien, 7/7)

Now that the weather is warm and mosquitoes are out, how much do we need to worry about Zika? Should we factor it into our summer travels? Here’s a guide to help you out. (Grennell, 7/6)

Alan Dambach was in his late 50s when he noticed how unsteady his hands had become. Over the next decade, his tremor got so bad he had difficulty eating with a spoon or fixing equipment at his family's tree farm in western Pennsylvania. "I couldn't get nuts and bolts to work," he says. (Hamilton, 7/9)

In 2016, as Kenneth MacLean was about to turn 90 and was looking to move to a retirement community, he had a question for Asbury Methodist Village in Gaithersburg, Md. “I asked, ‘Would there be many gays here? Would gays be welcomed?’ ” MacLean, a retired Unitarian minister, wanted to be sure his partner of 22 years, a man who lives in England and spends several months a year visiting him, would be welcomed by staff and other residents. (Bahrampour, 7/8)

There's new evidence to support a decades-old strategy for preventing the tick bites that lead to all sorts of nasty diseases, including Lyme disease and Rocky Mountain spotted fever. The remedy involves spraying your clothing with permethrin — a pesticide that's chemically similar to extracts of the flowering chrysanthemum plant. (Aubrey, 7/9)

Just weeks after their 6-year-old daughter started complaining about severe headaches, after numerous doctors' appointments and desperate trips to the emergency room — and after doctors discovered a brain tumor and took it out — it was happening all over again. Duncan and Nohea Avery had been tending to their daughter, Kalea, who was recovering last month from surgery to remove a medulloblastoma when they learned their 4-year-old son had one, too. (Bever, 7/7)

Behind tall brick walls and secure windows, hundreds of patients at Washington state's largest psychiatric hospital live in conditions that fail U.S. health and safety standards, while overworked nurses and psychiatrists say they are navigating a system that punishes employees who speak out despite critical staffing shortages. "They don't have enough staff to protect patients, or provide them with the bare minimum of care," said Lisa Bowser, whose mother spent two years at Western State Hospital and suffered dozens of falls and assaults. (7/6)

U.S. Sen. Bernie Sanders threw his support behind University of Vermont Medical Center nurses ahead of union negotiations Friday, saying hospital administrators need to increase wages and avert a scheduled strike. Sanders railed against the "exorbitant" salaries paid to hospital administrators, including over $2 million paid to hospital network's CEO John Brumsted. (7/6)

The family of a former Ohio State University team doctor accused by athletes of sexual misconduct says it is "shocked and saddened" by the allegations and is cooperating with the school's independent investigation. The Columbus Dispatch in a story published online Saturday said the statement was emailed by Scott Strauss. He's the son of the late Dr. Richard Strauss, who killed himself in 2005 at age 67. The statement said Strauss' family learned from news reports about the allegations that athletes were fondled by Strauss during medical examinations. The allegations date back to the 1970s. (7/7)

That idea is at the heart of the state’s effort over the past two decades to revamp its system for delivering health care to the neediest. The strategy has included a shift to managed care, meshing mental health services with physical care and creating programs specifically to coordinate an array of services so patients don’t have to hunt them down one at a time. (Gorn, 7/8)

The Harris County sheriff’s office doesn’t want its jail to be the largest mental health facility in Texas anymore — but first it needs to find somewhere else to accommodate patients before they get swept up in the criminal justice system. (Rayasam, 7/8)

Massachusetts is one of 22 states where cancer regularly beats out heart disease as the leading cause of death. In Boston, cancer actually causes more deaths than stroke and heart disease combined — a trend that holds across all races and ethnicities. (Kaplan, 7/6)

They were so motivated by money, the doctor and chiropractor were willing to make patients travel long distances from West Texas to a Dallas hospital for surgeries — a five-hour drive, federal court records say. Shawn Henry, a Fort Worth spine surgeon, was “aggressive” in recommending surgeries at Forest Park Medical Center, the court records said. But what the Midland patients didn’t know was that Henry was being paid by the hospital’s owners for referring them there, according to prosecutors. Those are the allegations in newly-released court records related to another plea deal in the $200 million federal bribery and kickback case against 21 people associated with the bankrupt Forest Park Medical Center. (Krause, 7/7)

Police, community leaders and mental health advocates agree that most patrol officers aren’t always the best suited to treat the nation’s mentally ill, despite often being the first ones responding to those in crisis. (Wilson, 7/6)

Ethics concerns over a Hennepin Healthcare clinical trial have raised public attention to a federal rule permitting research on patients in emergency situations without their initial consent. While little known, the rule has been commonly used in the Twin Cities for studies of everything from resuscitation equipment to breathing tubes to medications to slow bleeding at emergency scenes. U.S. Food and Drug Administration since 1996 has allowed “exceptions” from the usual process of gaining consent before performing experimental treatments on patients — but only in studies involving emergency treatments that couldn’t be accomplished any other way, and only if they propose to improve practices that are unproven or substandard. (Olson, 7/7)

Those dust storms can kick up dirt and soil that carry fungal spores called Coccidioides, or cocci. Found in Arizona desert soil, they can cause valley fever, a potentially serious lung infection. (Fish, 7/6)

Union representatives for more than 200 laboratory scientists and technologists at Dignity Health say they plan informational picketing Monday at their employer's facilities in Woodland, Stockton and Carmichael, having rejected the company's latest contract offer for wages and benefits. Michael Aidan, assistant executive director of Engineers and Scientists of California Local 20, said a mediator from the Federal Mediation and Conciliation Service will begin working with company and union contract negotiators on Monday to try and reach common ground. (Anderson, 7/9)

Money saved in the special accounts must be used for living expenses or costs relating a disability, such as education, housing, transportation and medical costs not covered by insurance. But that definition is broad. It can be used to pay rent, buy groceries, pay for college, purchase a wheelchair-accessible van and take a vacation -- as long as it "helps maintain or improve the health, independence, or quality of life of the person living with a disability," state guidelines say. Oregonians with disabilities can deposit up to $15,000 a year in such an account and accumulate up to $100,000 without affecting their benefits. They can deposit an extra $12,000 if they are employed and stay covered under Medicaid, although they may lose other benefits. Family members or friends can contribute too. (Voorhees, 7/6)

Colorado is one of at least nine states where teachers may arm themselves in the classroom if their districts or charter schools allow it. Thirty school districts or charter schools in the state have done so — though which districts do is less clear. There is no statewide training standard for school employees who carry guns, no standard use-of-force policy like the kinds intended to advise police officers and little guidance for school districts other than what their liability insurers provide. The result is that the arming of teachers in Colorado is a local issue not subject to debate, questioning or review by state regulators or lawmakers. That’s likely the way many rural districts prefer it, but even some ardent gun-rights supporters have sought a more uniform approach. (Hernandez, 7/8)

This spring, state legislators passed a law requiring sober living homes to secure licensing with the Arizona Department of Health Services. But that agency still has about 18 months of work left to get a licensing system up and running, according to Mesa Mayor John Giles. (Altavena, 7/7)

On Monday, President Trump is expected to announce his nominee to replace Justice Anthony M. Kennedy on the Supreme Court. Given the president’s promise to appoint justices who would overturn Roe v. Wade, it’s widely understood that his nominee will pose a clear danger to women’s reproductive rights. What most don’t realize is that everyone’s personal-liberty rights are on the line. The constitutional framework of Roe is about far more than abortion. It’s about rearing our children without unwarranted government interference. It’s about choosing whom we want to marry. It’s about deciding with whom we want to create a home. It’s about the right to use contraception. It’s about what the Supreme Court in Planned Parenthood v. Casey explained is the “promise of the Constitution that there is a realm of personal liberty which the government may not enter.” (Nancy Northup, 7/8)

Public opinion on abortion has been remarkably stable in recent decades, with significant but never overwhelming majorities supporting legal yet restricted abortion rights. Roe v. Wade, the Supreme Court decision that guarantees the right to abortion, with caveats based on the viability of the fetus and health of the mother, is an apt reflection of a national ambivalence that nonetheless decisively tips toward the rights of the woman over the rights of the fetus. The majority opinion in Roe is notably free of the triumphalism that has accompanied declarations of other rights. Still, the politics of abortion have been changing even as public opinion appears predictably settled. (Francis Wilkinson, 7/7)

In addition to so many other implications, it is essential that we consider the impact that the next Supreme Court Justice could have on women’s access to birth control. Believe it or not, it was just 46 years ago that single women gained the legal right to use birth control with the 1972 decision, Eisenstadt v. Baird, which followed the 1965 landmark Supreme Court case, Griswold v. Connecticut, that made birth control legal but only for married women. These Supreme Court decisions changed the game for women. Countless studies have pointed to the unparalleled impact of birth control in helping women build careers, achieve higher education, have healthier babies when they want to, and improve their overall quality of life. Birth control, for example, was directly tied to 30 percent of the wage gains realized by women between the 1960s and 1990s. (Ginny Ehrlich, 7/6)

As President Trump zeroes in on his nomination to replace Justice Anthony M. Kennedy on the Supreme Court, abortion has returned to the forefront of a national debate, and to a degree not seen since the 1980s. The topic never completely goes away, and Americans remain deeply divided on the subject. But abortion’s overall ranking as an issue of importance, compared with others, has risen and fallen over the years. It is resurrected now because Trump’s choice to replace Kennedy could conceivably tilt the court dramatically to the right, and progressives are making the prospect of overturning Roe v. Wade their rallying cry to oppose Trump’s pick. (Gary Abernathy, 7/8)

The 16 Kentuckians who recently won a lawsuit challenging the legality of Medicaid work requirements include a law student with a rare heart condition, a mortician with diabetes, a mother of four with congenital hip dysplasia and a housekeeper with rheumatoid arthritis. It’s a mixed bunch, united by two grim facts: They live at or below the federal poverty level, and they’re caught in the cross hairs of a debate over what society owes its neediest members. (7/7)

While the highly publicized deaths of celebrities frequently shock America, rural areas are suffering the most. Each year, thousands of Americans in small towns take their own lives after suffering — often for years — without adequate access to mental health professionals. (Jagdish Khubchandani, 7/9)

There is an approximately one in 10 chance that you or someone you know will attempt to end their life. Over 45,000 Americans kill themselves every year — more than all the annual deaths from terrorism across the world combined. In fact, there are twice as many suicides every year as there are homicides. And more than 500,000 people are treated in U.S. emergency rooms each year for injuries related to self-harm. Yet we rarely talk about suicide. Why? Because there is a strong sense of shame, guilt and stigma associated with mental health challenges and suicide. People are afraid to initiate conversations, as if talking about it will increase the incidence of suicide. Nothing can be further from truth. (Mansoor Malik, 7/8)

As physicians, we care for patients with acute and chronic diseases every day, doing whatever we can to help them achieve the best health outcomes possible and live long, productive lives. But as leaders of the two largest physician organizations dedicated to health advocacy for racial minority populations in the United States, we know that far too many of the patients our members treat will have less access to the care they need, and see poorer outcomes, than non-minorities. We see these disparities across all conditions, but one of our greatest challenges is in helping patients in minority communities live with serious mental illness. One in six U.S. adults has an illness like depression, bipolar disorder, or anxiety disorder, but African Americans are 10 percent more likely, and Latinos 40 percent more likely, to experience serious psychological distress than non-Hispanic whites. And those minority populations are only half as likely to receive needed treatment or counseling as non-Hispanic whites. Statistics are even worse for American Indians and Alaska Natives. (Elena Rios and Doris Browne, 7/7)

Obesity affects 40 percent of adults and 19 percent of children in the United States and accounts for more than $168 billion in health care spending each year. Sugary beverages are thought to be one of the major drivers of the obesity epidemic. These drinks (think soda and sports drinks) are the largest single source of added sugars for Americans and contribute, on average, 145 added calories a day to our diets. For these reasons, reducing sugary beverage consumption has been a significant focus of public health intervention. Most efforts have focused on sodas. But not juice. Juice, for some reason, gets a pass. It’s not clear why. (Erika R. Cheng, Lauren G. Fiechtner and Aaron E. Carroll, 7/7)

We’ve all heard of peanut allergies — a problem that was hardly existent when we were kids, but now is everywhere, with various warnings and awareness campaigns to make sure our kids stay safe. Because allergic reactions to peanuts may be life threatening, it garners massive attention from the medical community, parents, educators, lawmakers and the media. But there is another medical problem for our children, growing every year but getting much less attention: myopia, or nearsightedness. It is a condition that allows people to see things clearly close-up, but view objects at a distance as blurry. (Ed Towns, 7/6)

One of the more chilling things I’ve heard recently came from Jaron Lanier, the Silicon Valley founding father whose new book is “Ten Arguments for Deleting Your Social Media Accounts Right Now.” Lanier, who met Trump a couple of times back in the real estate developer’s New York heyday, thinks the president’s addiction to tweeting is rewiring his brain in a negative way. As Trump picks up speed on Twitter, the Oval Office is becoming a Skinner box. Like other “behavior modification empires,” as Lanier calls social media sites, Twitter offers positive reinforcement for negativity. (Maureen Dowd, 7/7)

The U.S. Food and Drug Administration (FDA) recently gave final approval for the first non-opioid drug shown to lessen the severity of opioid withdrawal symptoms. Meanwhile, President Trump signed into law groundbreaking “right to try” legislation allowing the terminally ill to explore unapproved medical treatments as a last resort. In light of these developments, researchers and advocates of the botanical Kratom were hopeful for increased support for the study of the herb as a new treatment for opioid withdrawal symptoms, acute and chronic pain, and a range of mood disorders.Instead the FDA has spoken out against Kratom, ignoring a history of safe use and existing research. By overstating safety concerns, the FDA has dismissed any possibility that Kratom might have benefits. (Paula N. Brown, 7/7)

When Jodie Ofosuhene learned she had breast cancer at age 29 in 2016, she got more than standard medical care. She was connected with Noel Peters, a former patient who serves as a mentor to new ones. “Noel helped me tremendously,” Ms. Ofosuhene said in an interview. “Every time I had a question about my response to treatment — whether it was normal — she had answers from her own experience.” In an ideal world, when we are faced with a new health problem, a clinician is available to sit down and address all our questions and anxieties about the condition and its treatment. This ideal is rarely met in the United States health system. More typically, we’re rushed through doctor visits that fly by too quickly for us to gather our thoughts. (Aaron E. Carroll and Austin Frakt, 7/9)

An important measure to expand access to mental health care services in California is going through the Legislature, but it would make it more difficult for counties to serve older adults. Senate Bill 1004, which was approved by the Assembly Health Committee on June 19, would amend Proposition 63, passed by voters in 2004 to provide funding for county mental health services with a 1 percent tax on annual incomes of more than $1 million. (Cheryl Brown, 7/6)