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Senators went into a recess skeptical over whether they could agree to legislation repealing and replacing ObamaCare. They will return on Monday more doubtful than ever. Sen. Richard Burr (R-N.C.), one of Senate Majority Leader Mitch McConnell’s (R-Ky.) most loyal allies, said Thursday it’s “unlikely” the GOP will get a healthcare deal. (Bolton, 6/5)

Republican senators return on Monday from a 10-day recess with immediate decisions to make on their quest to overhaul the 2010 health care law. ... Senate Majority Whip John Cornyn of Texas said in an interview with a local radio station last month that work on the effort would be done in the chamber by “July at the latest.” That aligns with the view of several GOP aides who say a vote on a bill would likely occur before the August recess, regardless of whether there are enough votes to pass it. Addressing the legislation in that time frame would allow the Senate to return from the August break and immediately tackle a number of impending deadlines. Aside from the Republicans’ ambitious legislative agenda, which includes an overhaul of the U.S. tax code, Congress must also soon turn to funding the government through fiscal 2018 and addressing the approaching debt ceiling deadline, among other funding cliffs. (Williams, 6/5)

A pair of Republican senators voiced considerable skepticism this week about the prospect of passing a bill to revamp the nation’s health-care laws in the coming months, injecting fresh uncertainty into the GOP effort to fulfill a signature campaign promise. Sen. Richard Burr (R-N.C.) sounded a deeply pessimistic note when he told a local television station he believes it’s “unlikely that we will get a health-care deal.” Earlier in the week, Sen. Jeff Flake (R-Ariz.) said he doubted a bill could pass before the August recess. (Sullivan, 6/2)

Sen. Richard Burr (R-N.C.) made the most direct prediction on Thursday, telling a news station in his home state that “I don’t see a comprehensive health care plan this year.” Earlier in the week, Sen. Ron Johnson (R-Wis.) suggested to home-state reporters that lawmakers might shift to a shorter-term plan that would keep insurance markets working, on the heels of negative comments from Iowa GOP Sens. Chuck Grassley and Joni Ernst. (Schor and Conway, 6/2)

Sen. Bill Cassidy got cheers on late-night television for calling for an Obamacare replacement plan that would pass what he calls "the Jimmy Kimmel test" — that is, cover children like the comedian's son recently born with a congenital heart defect. But the first-term senator and physician is not seeing that support from his GOP colleagues. (Haberkorn and Everett, 6/4)

Vice President Pence urged lawmakers on Saturday to pass a healthcare reform measure by the end of summer. Pence arrived at Sen. Joni Ernst's (R-Iowa) "Roast and Ride" fundraiser in Boone, Iowa riding a Harley-Davidson motorcycle before taking the stage and launching into a campaign-style speech reaffirming President Trump's key promises. "Iowa is facing a healthcare crisis under ObamaCare and it's high time we take action," Pence told a crowd at the Central Iowa Expo, about 40 miles north of Des Moines. (Greenwood, 6/3)

Olathe native Tim Gronniger served as a top official with the Centers for Medicare and Medicaid Services under the Obama administration. Currently a non-resident fellow at the Brookings Institution in Washington, he also was a senior adviser for health care policy at the White House Domestic Policy Council, a senior staff member for Rep. Henry Waxman, Democrat of California, and an analyst with the Congressional Budget Office. Gronniger was in Kansas City Thursday for a town hall-style meeting in Overland Park about national health care issues and the possible impact of the American Health Care Act, the Republican health care overhaul bill passed last month by the House, on local communities. (Margolies, 6/2)

Jason Westin is an oncologist and lymphoma researcher at MD Anderson Cancer Center in Houston. But now he wants a seat in Congress — the one held by longtime Republican congressman John Abney Culberson. Westin will have plenty of competition; several other Democrats say they'll run for the right to face off against Culberson in a district that Hillary Clinton narrowly won in November. Westin, 40, says he was bitten by the politics bug when, before medical school, he worked as an intern for former Florida senator Bob Graham (D). And now, he argues, with health-care science under assault in the nation's capital, it's important for scientists and physicians like him to get involved. (McGinley, 6/5)

The healthcare industry reported another month of strong job growth in May, outpacing the rest of the economy in hiring. The healthcare industry was among the nation's top generators of jobs last month, with 24,300 new hires in May, according to the most recent jobs report issued Friday by the Bureau of Labor Statistics. Payroll creation in healthcare was solid last month even as overall job growth fell below expectations. The economy added 138,000 non-farm jobs, which disappointed analysts who predicted about 185,000 jobs would be produced. (Castellucci, 6/2)

Hundreds of miles from the health care debate that will begin again this week in Congress, lobstermen here are out in force, bees are furiously pollinating the state’s famous blueberries and part-time workers are preparing for another summer tourist season. As a result of their short-term spike in income, many of Maine’s working class will likely lose some or all of their health insurance subsidy, a feature of the federal health care law, which has been a complicated blessing for the citizens of Maine. (Steinhauer, 6/4)

Craig Barnum, a school administrator, took the afternoon off recently and drove three hours to Sen. Chuck Grassley’s town-hall meeting to press the Republican senator on the GOP plan to overhaul health care. Mr. Barnum has health insurance through his work. But his family depends on Medicaid to help cover the medical costs of his 9-year-old son, Koan, whose delayed development means he needs expensive therapy and equipment including leg braces. (Peterson and Armour, 6/4)

Striking pre-emptively at an increasingly frequent foil, Gov. Andrew M. Cuomo plans to announce a series of steps on Monday to safeguard insurance coverage against a possible repeal of all or parts of the Affordable Care Act in Washington. The measures, taken via emergency regulations, will include requiring any private company doing business on the state’s insurance marketplace to guarantee the 10 “essential health benefits” required by President Barack Obama’s signature 2010 health care law. The governor will also direct the state’s health department to block any company that withdraws from the exchange from participating in Medicaid or its children’s health plan. (McKinley, 6/4)

No other state will see such a large drop in federal money flowing its way per person if the House-passed plan takes effect. The biggest change for the state will be the law’s tax credits. Under the 2010 health care law, tax credits for people who get insurance through their jobs vary by age, income and geography to help people who make less than 400 percent of the federal poverty level afford their insurance. Older people and those living in high-cost areas get more money to help buy insurance. Because Alaska has the highest costs in the nation, its insurance premiums are heavily subsidized. Premiums under the health care law in Alaska average about $927, compared to a national average of $361 per month for an individual. But people earning $30,000 a year pay roughly the same premium under Obamacare no matter the ZIP code. (Mershon, 6/5)

It seems like a simple solution based on the concept of reinsurance, transferring a portion of risk to another entity. The program really did reduce consumers’ expected premiums, which are at the center of so many complaints over the health law. The idea isn’t nakedly partisan, like so many other health proposals, and doesn’t alienate the hospitals, doctors or insurance companies that often fight changes to their business models.It comes with an even more attractive twist, too: the federal government might be persuaded to pick up some of the tab. But the real story is more complicated — and portends the arduous path the program would face in any other state weighing the idea. (Mershon, 6/5)

In Alaska, the Renners aren’t the only ones facing these costs. Many of the state’s smaller villages and towns are accessible only by air or boat. Only a handful of communities have their own nurse- or nurse-practitioner-run clinics, let alone hospitals. Much of the state relies on a lauded tribal health system — and pricey medevac rides — to access health care services.All of that feeds into the cost of health care in the Frontier State. Most insurance companies in Alaska cover the cost of at least one trip. Only some cover the cost of a return trip home, and only some cover a caregiver or family member’s travel, too. The state’s several medevac companies — including LifeMed, which transported John and Dawn Renner — offer their own insurance program. A small annual fee ($49 per year, in LifeMed’s case) will guarantee you don’t pay out of pocket for your ride. (Mershon, 6/5)

The once-powerful health insurance lobby — the same one that killed Hillarycare a generation ago and helped usher in Obamacare — can't pick a side in the latest battle over America's health care system. Some major members of the sprawling trillion-dollar industry, like Humana and Cigna, have little at stake in the fight. Other insurers heavily invested in the Obamacare markets, like the regional Blue Cross Blue Shield plans, are urging Congress to fix the 2010 health law instead of shredding it. And then there’s Anthem, a rare industry voice supporting repeal. (Demko, 6/3)

Insurance commissioners are pulling out all the stops to keep insurers from leaving their states amid uncertainty over ObamaCare's future. They are offering insurers new, previously unheard of flexibilities to try to keep them in the market. But the effort faces an uphill climb, given the Trump administration's wobbling over whether it will continue federal payments that compensate insurers for subsidizing out-of-pocket costs for lower-income households. There's also the question of whether Congress will repeal ObamaCare this year. (Roubein and Weixel, 6/4)

Tennessee’s individual insurance market has hit a rough patch over the last few years, as BlueCross BlueShield left the Nashville market and UnitedHealthcare and Humana pulled out of the Affordable Care Act exchanges altogether. But reports that a new carrier might enter the state could change this dynamic. The Tennessean recently reported that Tennessee’s insurance commissioner, Julie Mix McPeak, said that a Texas health insurer was considering entering a metro Tennessee market in 2018. This news could give health insurance consumers in Nashville, Memphis or Chattanooga more choices than initially expected. (Tolbert, 6/4)

When certain insurance companies have bailed on the Obamacare exchanges in the past — potentially leaving residents of entire counties without a single option for affordable health coverage — an insurer has always stepped up to fill the void. But it’s unclear if any insurer will extend marketplace coverage to the 25 Missouri counties that will be left with no carriers in 2018, potentially leaving 67,000 people in the western part of the state without coverage options. A series of actions undertaken by President Donald Trump’s administration over the last five months has made insurers wary of the government-run marketplaces that have already exposed some to significant financial losses. (Liss, 6/4)

For years, Republicans savaged Democrats for supporting the Affordable Care Act, branding the law — with some rhetorical license — as a government takeover of health care. Now, cast out of power in Washington and most state capitals, Democrats and activist leaders seeking political redemption have embraced an unlikely-seeming cause: an actual government takeover of health care. (Burns and Medina, 6/3)

Imagine if any California resident could walk into a hospital or clinic — penniless — to see a doctor about whatever health condition was bothering them. That’s the scenario state senators envisioned when they pushed through SB562 this week, a bill that proposes a universal health system in California that would ensure that every resident would have access to health care, regardless of wealth or employment status, age or pre-existing medical condition. (Ho, 6/3)

For four years, Jed Meltzer studied communication disorders at the National Institutes of Health, using brain-imaging technology to pinpoint the impact of strokes on speech. His postdoctoral training, he wrote on his blog, comprised “some of the most scientifically satisfying years of my life. “I got to collect amazing, irreplaceable data, and I got to learn from the best and work with unparalleled resources...." But now that data is useless for Meltzer and about a dozen other scientists caught in a dispute that is unusually fierce, even for the highly competitive world of elite biomedical research. (Bernstein, 6/4)

As President Donald Trump on Thursday pulled the U.S. out of the Paris climate accord, several healthcare executives vowed to continue their environmental stewardship efforts—with or without White House support. Under the climate agreement, the U.S. agreed to reduce its greenhouse gas emissions by as much as 28% below 2005 levels by 2025. But Trump withdrew the country's participation in the nonbinding agreement Thursday, saying it left the U.S. at an economic disadvantage because it and other wealthier nations would fund climate actions in developing countries. Health conditions related to climate change are estimated to have cost the healthcare system $14 billion a year between 2002 and 2009, according to a study published in Health Affairs. (Johnson, 6/2)

Change is hard. It is especially hard when the organization in question is among the top in its field. Doctors at the Mayo Clinic, the 153-year-old institution that pioneered the concept of patient-centered care, considered it an ideal place to practice, one that wasn’t in much need of fixing. It is renowned for diagnosing and treating medicine’s most complex patients. Dr. John Noseworthy, Mayo’s chief executive officer, had a different view about the need for change. He saw declining revenue, he says, from accelerating efforts by government health programs, private insurers and employers to rein in health-care costs as a looming threat to the clinic’s health. (Winslow, 6/2)

Heidi Karash has been working as a nurse in Erie, Pennsylvania, for nearly 13 years. And to her, opioid addiction isn’t just a crisis. It’s a weight to bear. “It's been an epidemic here in Erie,” she said. And Karash worries she played a role in that. In her first nursing job at Erie’s Hamot Hospital, she said she treated patients who had overdosed on painkillers. She also gave those very same opioids to people in pain. (Beras, 6/2)

Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times. The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Our estimate of 62,500 deaths would be a 19 percent increase over the 52,404 recorded in 2015. (Katz, 6/5)

Hate crimes, heroin and power plants pose disparate problems, but New York Gov. Andrew Cuomo has responded with the same idea: Start a task force. Mr. Cuomo, a Democrat, has increasingly relied on panels of mostly allies and appointees to navigate some of New York’s dilemmas and controversies. The governor’s office and some past panelists say the tactic allows Mr. Cuomo to delegate tricky issues to outside experts who can reach nonpartisan recommendations. And they point to panel ideas that became laws to indicate the panels were successful. (Vilensky, 6/4)

Americans' use of opioid painkillers has exploded since the mid-1990s, driven by changing philosophies on pain treatment, drug company marketing campaigns and unscrupulous "pill mill" operators. The result, many experts say, has been a surge in addiction, overdoses and death. Now, a reversal is underway. Opioid prescriptions have dropped sharply since 2012 as doctors have grown more conservative and the federal government has cracked down on what it deems "problematic prescribing." But some chronic pain patients say the turnabout has gone too far. (Keilman, 6/5)

More than two Arizonans died every day on average from opioid overdoses in 2016, according to a new Arizona Department of Health Services report. A total of 790 Arizonans died from overdoses of opioid prescription medications and heroin last year, a 74 percent surge since 2012. And state health officials cautioned that last year's death toll might be higher because of a lag in reporting these deaths. (Alltucker, 6/2)

The spread of new synthetic street drugs — fentanyl and carfentanil — has law enforcement officers across Michigan changing the way they conduct routine stops, raids and seizures, with agencies taking heightened measures to safeguard officers and agents from accidental overdoses while fighting the state's growing opiate epidemic. There has been a number of recent instances nationwide of officers overdosing after encountering narcotics during investigations, including one recent scare in Kent County in western Michigan, when a detective was sickened while a "white powdery substance" was being tested. (Dudar, 6/4)

Doctors often don't hear about the serious side effects of chemotherapy because patients are reluctant to complain or don't have enough time to talk about such problems during jam-packed office visits, experts say. But a new study points to a potential solution: using simple technology to encourage “real time” reporting of symptoms. Its findings show that patients with advanced cancer who reported side effects frequently via an online tool lived a median of five months longer than those who waited to mention problems during office visits. (McGinley, 6/4)

Women who breast-feed their babies for the recommended six months may be lowering their own risk of developing endometrial cancer, a new study suggests. In the analysis of data from 17 past studies, researchers found that women who had ever breast-fed their children were 11 percent less likely than women who had children but didn’t breast-feed to be diagnosed with endometrial cancer. (Crist, 6/3)

Women who have had early-stage breast cancer and become pregnant do not have a greater chance of recurrence and death than those who do not get pregnant, according to results released Saturday from the largest study to ever explore the issue. The study is the first to focus specifically on the safety of pregnancy for women whose cancers are fueled by estrogen. Researchers said their conclusions should allay concerns among some doctors and patients that pregnancy, which results in a surge in estrogen levels, could put these women at risk by encouraging the growth of any cancer cells that might remain in the body after treatment. (McGinley, 6/3)

Many colon cancer patients can cut their chemotherapy regimen in half, improving their quality of life and reducing their chances of having debilitating side effects, according to a major international study released Sunday. The goal of the research, eagerly awaited by oncologists, was to determine whether a three-month course of chemo was as effective as six months of treatment in staving off a recurrence in people with Stage 3 colon cancer. (McGinley, 6/4)

For years, the one thing standing between Candace Martinez and motherhood was her heart. She was born with a defect that a generation earlier would have led to death as an infant, but modern medicine — open-heart surgery at 5 weeks old to switch two misconnected arteries — had saved her. At age 18 she experienced heart failure: Her heart muscle couldn’t pump enough blood to oxygenate her body. At 19, she got a pacemaker. Martinez survived, but she always assumed that the life modern medicine had given her would not include having children. Pregnancy and childbirth long were thought to be too tough on women with congenital heart defects like hers. (Haelle, 6/4)

The sooner babies get their own rooms, the longer they'll sleep on average, according to a new study that breaks with the recommendations of the American Academy of Pediatrics. Analyzing surveys from 230 first-time mothers at Penn State, Dr. Ian Paul, a pediatrician, found that babies slept for longer stretches if they didn't sleep in the same bedroom as their parents. (Nedelman, 6/5)

Benjamin Stepp, an Iraq war veteran, sat in his graduate school course trying to focus on the lecture. Neither his classmates nor his professor knew he was silently seething. But his service dog, Arleigh, did. She sensed his agitation and “put herself in my lap,” said Mr. Stepp, 37, of Holly Springs, Miss. “I realized I needed to get out of class. We went outside, I calmed down. We breathed.” (Lucchesi, 6/4)

It is one thing to have a bucket list at any age. It is something else entirely to have a bucket list that sends you to college for the first time at 92 — or that sends you on your maiden flight at the controls of a single-engine airplane at 97. These are the bucket list accomplishments of Cecile Tegler (92) and Mildred “Milly” Reeves (97). And neither of them is done yet. (Horovitz, 6/5)

They sprouted up in abundance after heavy rains, poking up through California lawns and forests, appearing harmless to some of those who found them — as though they'd make a good meal. And so they do, at first. The “death cap” mushroom is said to be delicious. A new federal report detailed what came after consumption for 14 people who sampled the Bay Area's bloom of death cap — or amanita phalloides — last December: Violent nausea, in all cases. For some days later, organ damage as the death caps' potent toxins ravaged the liver. (Selk, 6/3)

Researchers and scientists still are trying to figure out how social media use affects young people. So far the evidence is mixed and there's no broad consensus on the long-term consequences of excessive social media use. Studies have shown the around-the-clock world of social media takes a mental and emotional toll on some young people. It has been linked to increased anxiety, depression and decreased relationship skills. One study found social media can be more addictive than cigarettes and alcohol for some people. Social media also can have a positive affect, however. Some research has found that social media can be a resource for teens to find social support when they are struggling with life issues, and that they can use the different online platforms as a way to express themselves. (McDaniels, 6/2)

Financial manipulation is a tactic abusers commonly use in domestic violence cases to torment and control their victims. "What we know is that economic security equals safety," said Sarah Gonzalez Bocinski, director of the Economic Security for Survivors Project at the Institute for Women's Policy Research. "Without those resources, options are very limited." As many as 74% of women surveyed at domestic violence shelters reported that they stayed with an abuser longer because of financial issues, she said, citing a 2012 Mary Kay Foundation report.  (Shamus, 6/3)

Bikes have transformed urban landscapes throughout America, from pavement markings on streets to our workday gear, and most of us agree it's a good thing. They've reduced the pollution we send into the ozone layer, helped us conserve gas and oil and kept us fitter than we might otherwise be. But there's also been a downside to all that cycling: more injuries. And those injuries are costing billions of dollars a year. (Cha, 6/3)

A controversial bill to lower costs of diabetes drugs was vetoed on Friday by the Nevada governor, the latest of many efforts by state legislators to fail to contain rising medicine prices. The bill would have required drug makers to report pricing histories, disclose costs, notify state officials and insurers in advance of price hikes above inflation, and report rebates paid to pharmacy benefit managers, the middlemen that negotiate favorable insurance coverage. (Silverman, 6/3)

Lawmakers in Texas largely failed to take any significant action to address the state’s skyrocketing rate of pregnancy-related deaths just months after researchers found it to be the highest in not only the U.S., but the developed world. Legislators introduced proposals to address the issue after a University of Maryland-led study found that the state’s maternal mortality rate doubled between 2010 and 2012. But several key measures didn’t even make it to a vote, falling victim to Republican infighting over other issues. (Hoffman, 6/4)

To understand why teen pregnancy rates are so high in Texas, meet Jessica Chester. When Chester was at in high school in Garland, she decided to attend the University of Texas at Dallas. She wanted to become a doctor. "I was top of the class," she says. "I had a GPA of 4.5, a full-tuition scholarship to UTD. I was not the stereotypical girl someone would look at and say, 'Oh, she's going to get pregnant and drop out of school.'" (Silverman, 6/5)

It’s been nearly a year since California began allowing terminally ill residents to end their lives with the help of a physician. And for Ray Perman, the right-to-die law worked exactly as lawmakers intended. On Feb. 4, as his family gathered around his bed, the 64-year-old Piedmont resident ingested a lethal dose of sedatives and passed away peacefully — in his own home, on his own terms — after years of battling cancer. Other terminal patients have been known to add a flourish to their final moments of life: a last cigarette, a shot of vodka, a favorite pet curled up with them in bed. (Seipel, 6/3)

More than a half-dozen people died at a state-run residential facility in Virginia from infections that typically are easy to treat with antibiotics. The state has acknowledged the deaths, which first were identified by a nonprofit watchdog organization that advocates for people with disabilities. Several of the residents who died, state officials also noted, had other medical issues. Six deaths connected to urinary tract infections occurred within a 14-month period, part of a pattern documented by the Richmond-based DisAbility Law Center of Virginia, which monitors state institutions. (Marimow, 6/2)

Illinois is conducting a broad review of how Blue Cross and Blue Shield of Illinois treats consumers — 27 years after regulators last released such a report on the state's dominant health insurer. Blue Cross and Blue Shield of Illinois confirmed the review this week, in response to questions from the Tribune about why it had been nearly three decades since the state publicly released a wide-ranging examination of the insurer's compliance with laws and regulations meant to protect consumers. Such reviews, conducted by states across the country, often look at how insurance companies advertise, enroll customers, pay medical claims and handle complaints. They're separate from rate reviews. (Schencker, 6/2)

The Florida Department of Corrections this week asked a federal judge to reject arguments that it violated the Americans with Disabilities Act by not providing “cutting edge” drugs to prisoners with hepatitis C. Three inmates filed a class-action lawsuit in May alleging that the department is failing to provide proper care to thousands of prisoners with liver-damaging hepatitis C. (6/2)

For five straight days this spring, Patty — who doesn't want her last name used to protect her son's privacy — sought refuge in the chapel at Heywood Hospital in Gardner. That's where her 28-year-old son Eric had been waiting for a psychiatric treatment bed. "The person that's having that breakdown is not the son that I know," Patty says. "I don't want him to see me crying over it, so sometimes I walk to the chapel and just be quiet in here." (6/5)

The State Senate has given unanimous approval to a bill that would ensure fertility coverage for those facing chemotherapy or some other medically necessary treatment that threatens their ability to have children. The measure, approved late Friday, was passed unanimously by the House on May 25 and now heads to Gov. Dannel P. Malloy’s desk. (Phaneuf, 6/3)

Ten years ago, Mary Thach unexpectedly needed throat surgery to improve her breathing and spent two weeks in the hospital. Her bill: $69,000.Her first reaction was panic, said Thach, speaking through a Vietnamese interpreter. Uninsured at the time, she had no idea how to come up with the money. Then she learned from the hospital staff that as a low-income legal resident, she qualified for Medicaid, which ultimately paid the bill. (Ibarra and Browning, 6/2)

A Jacksonville children's hospital is challenging a decision by the Florida Department of Health that prevented the hospital from opening a trauma center. Wolfson Children's Hospital wants an administrative law judge to back arguments that it should be allowed to open what is known as a “provisional” pediatric trauma center, according to documents posted Thursday on the state Division of Administrative Hearings website. (6/2)

Nail polish and hair dye. Cleaning products. Plants and flowers for the garden. California lawmakers have been considering new labels for them, triggering an annual conflict in the Capitol over how much to tell people about what they buy at the store or use at work. The bills reflect a recurring tension in the statehouse: Environmentalists and consumer advocates argue that people have a right to know what’s in everyday products, while industry lobbyists say putting too much information on a label could harm sales by creating unfounded fear. In most cases, industry wins. (Rosenhall, 6/5)

In defending the unpopular and flawed House bill to replace Obamacare, a common Republican refrain is that it fully protects health-insurance coverage for people with pre-existing medical conditions. "Under this bill, no matter what, you cannot be denied coverage if you have a pre-existing condition," insisted House Speaker Paul Ryan, a talking point echoed by President Donald Trump. ... Such duplicity! People with pre-existing conditions cannot be denied coverage outright but, as the Congressional Budget Office just reported, many of them would face huge increases in the cost. (Albert Hunt, 6/4)

Registering outrage over the high price of medicine is a national pastime, especially for politicians whose solution is always handing themselves more power. The latest examples come from Nevada and Maryland, where legislators are passing bills to punish drugmakers for no benefit to patients. (6/4)

Obama administration officials knew they were on shaky ground in spending billions of dollars on health insurance subsidies without clear authority. But they did not think a long-shot court challenge by House Republicans was cause for deep concern. For one thing, they would be out of office by the time a final ruling in the case, filed in 2014, was handed down. They also believed that a preliminary finding against the administration would ultimately be tossed out. Finally, they figured that President Hillary Clinton could take care of the problem, if necessary. (Carl Hulse, 6/3)

Republicans are trying to cut health care spending. But hacking away at Medicaid, weakening coverage requirements and replacing Obamacare’s subsidies with a convoluted tax credit will not deal with the real crisis in American health care. The Affordable Care Act was misnamed; it should have been called the Access to Unaffordable Care Act. In 2015 health care spending reached $3.2 trillion — $10,000 for every man, woman and child in America. While our health care system is the most expensive in the world by far, on many measures of performance it ranked last out of 11 developed countries, according to a 2014 Commonwealth Fund Report. (Jamie Koufman, 6/3)

Every new president tries to claim a mandate for his agenda, that because he won the election that means the public supports everything he wants to do. But ask yourself this: Is there anything — anything — on the agenda of the Trump administration and the Republicans in Congress that enjoys the support of the majority of the public? (Paul Waldman, 6/2)

Anthem is the nation’s second-largest health insurer, with thousands of medical professionals on its payroll. Yet its Blue Cross and Blue Shield of Georgia subsidiary has just informed its members that if they show up at the emergency room with a problem that later is deemed to have not been an emergency, their claim won’t be paid. It’s a new wrinkle in the age-old problem of how to keep patients from showing up at the ER for just anything. But medical experts say the Georgia insurer is playing with fire. By requiring patients to self-diagnose at the risk of being stuck with a big bill, it may discourage even those with genuine emergencies from seeking necessary care. And it’s asking them to take on a task that often confounds even experienced doctors and nurses. (Michael Hiltzik, 6/2)

Over the last three years, many Wellmark members with individual health plans governed by the Affordable Care Act (generally people who have purchased new individual health insurance plans since October 2013) have endured double-digit premium increases. Despite these increases, Wellmark has lost $90 million in Iowa over this same time frame on these ACA individual plans. Other health insurance carriers in Iowa and their customers have suffered a similar fate. This is simply not acceptable or sustainable. (John Forsyth, 6/4)

Health insurance does not equal health care. As Americans, we often conflate these two entities. But they are in fact separate. ... we’ve grown accustomed to a system in which health insurance covers everything, from flu shots to ICU. This may not be a terrible thing; we all need flu shots, and some of us may end up needing ICU care. The problem exists in how we pay for these services. If we continue to ask insurance companies like Blue Cross Blue Shield and government entities like Medicaid and Medicare to pay for all of our health care services, from blood pressure medications to cardiac bypass surgery, costs will continue to be inflated. (Paul Thomas, 6/4)

Asthma is complicated. The disease poses many challenges in the diagnosis, treatment and management of the condition. Children who live with asthma are particularly vulnerable; as their bodies develop and grow, their treatment regimen will need to adjust. In addition, there is an increased prevalence of asthma in children living below the poverty line, and disparity in their asthma outcomes. In Ohio, asthma is a leading cause of hospitalization and emergency department visits for children. (Benjamin Kopp, 6/4)

Like many people this fall, my family fell in love with NBC-TV's new show "This is Us." The adventures of this outrageous but still believable family touched our hearts. I enjoyed the cute relationships and unexpected plot twists, but the moment I truly fell in love with the show was not until further into the season. In an episode, the character Randall Pearson suffers from a stress-induced panic attack. (Annabeth Suchy, 6/4)

Perhaps taking a cue from the boss’s taste in food, the Trump administration has begun dismantling Obama-era regulations intended to help Americans eat healthier. The rationale isn’t quite clear for the reckless process now afoot. It might be argued that nutritional rules are a product of the nanny state. But America has an obesity epidemic, particularly with its children. This is a fact, like global warming, that the Trump administration prefers to ignore. (6/4)