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A congressional watchdog said the Trump administration needs to step up its management of sign-up seasons for former President Barack Obama's health care law after mixed results last year in the throes of a failed GOP effort to repeal it. The report due out Thursday from the Government Accountability Office is likely to add to Democrats' election-year narrative that the administration actively undermined "Obamacare" without regard for the consequences to consumers. (8/23)

Maryland officials on Wednesday announced federal approval of a waiver to create the nation’s largest health reinsurance program, a step designed to protect insurers from skyrocketing claims and hold down rates in the struggling individual market of the state’s health care exchange. The federal Centers for Medicare and Medicaid Services approved the waiver, Republican Gov. Larry Hogan and leading Democrats of the General Assembly announced at a news conference. (Witte, 8/22)

Maryland officials said the approval of the program will prevent increases of up to 30 percent in the state's individual insurance market. “With our innovative new reinsurance program, the health insurance market in Maryland will finally have the chance to be competitive and dynamic,” Gov. Larry Hogan (R) said Wednesday in a statement. (Hellmann, 8/22)

Tennesseans on who depend on federally assisted health insurance are likely to have more options and face cheaper prices next year, a reversal of a trend that has plagued the state since the enactment of the Affordable Care Act, known widely as Obamacare, four years ago. The most dramatic gains will be felt in the city of Memphis, which may have three new options for Obamacare health insurance. (Kelman, 8/22)

Democrats want to cast Brett Kavanaugh’s Supreme Court confirmation hearings as a referendum on Obamacare, and they’re getting inadvertent help from a Texas judge weighing a new legal threat to the health care law. Thanks to fortuitous timing, Kavanaugh will face a Capitol Hill grilling after Labor Day — the same week a federal judge in Texas holds oral arguments in a 20-state lawsuit seeking to wipe out the law. (Cancryn, 8/22)

Health care has emerged as a major issue in North Dakota's U.S. Senate race, with Democratic U.S. Sen. Heidi Heitkamp and Rep. Kevin Cramer, her Republican challenger, arguing over who will do more for people with medical problems. In a race seen as critical for control of the closely divided Senate, the candidates are struggling for an advantage and have turned to a component of former President Barack Obama's health care law that forbids health insurers from denying coverage to people with health problems. (8/22)

Rep. Kyrsten Sinema (D-Ariz.), the likely Democratic nominee for Senate in Arizona, says that she does not support Medicare for All. “I do not support Medicare for All,” Sinema told reporters in video posted by NBC reporter Vaughn Hillyard on Wednesday. “I'm really focused on solutions that are realistic and pragmatic and we can get done.” (Sullivan, 8/22)

Attorney General Jeff Sessions announced another crackdown on Wednesday on opioids, targeting doctors and drug dealers alike in cases that spanned physicians’ offices in Ohio, drugmakers in China and online black markets. ... His announcement came a week after President Trump asked Mr. Sessions during a cabinet meeting at the White House to sue companies that supplied opioids and to investigate opioid trafficking from China and Mexico, calling the flood of drugs from those countries “almost a form of warfare.” The president, who campaigned on targeting the opioid crisis, has also set a goal to reduce opioid prescriptions by one-third in three years. (Benner, 8/22)

Those actions included the country's first-ever civil injunction that has barred two Ohio doctors from prescribing drugs; the indictment of two Chinese nationals accused of shipping powerful synthetic opioids around the globe; and a recent operation to shut down the country's biggest "dark net" distributor of drugs. Sessions said the Centers for Disease Control and Prevention recently estimated there were 72,000 fatal drug overdoses in the country last year, adding that recent data show the number of deaths may be leveling off. (Gillispie, 8/22)

The Department of Justice is moving to block two Ohio doctors from writing prescriptions because it alleges they dispensed opioids without a legitimate medical purpose. ... The DOJ said the doctors had been served this week with temporary restraining orders preventing them from prescribing. “These injunctions – a temporary restraining order - will stop immediately these doctors from prescribing—without waiting for a criminal prosecution,” Sessions said. (Sullivan, 8/22)

Federal prosecutors allege that Matthew and Holly Roberts of San Antonio were two of the biggest drug dealers on the dark web, completing nearly 3,000 verified transactions on various underground marketplaces between 2011 and 2018 — including the largest number of verified fentanyl transactions on the dark web. Prosecutors said they operated under the name “MH4Life.” They could not be reached for comment Wednesday. In addition to the powerful synthetic opioid fentanyl, which has caused the number of overdose deaths nationwide to skyrocket, authorities allege the couple possessed and distributed fentanyl analogues, heroin, cocaine, methamphetamine, Xanax and other drugs. They allegedly bought postage with cryptocurrency to conceal their intent and used glow bracelets and other items to hide that they were mailing drugs, authorities said. Customers used digital currency to buy the drugs and conceal the deals, prosecutors said. (Zezima, 8/22)

The Justice Department has indicted two Chinese nationals for allegedly manufacturing and selling deadly drugs around the world that resulted in the deaths of two Americans. According to the indictment, Fujing Zheng, 35, and his father, Guanghua, 62, operated a global opioid and drug manufacturing conspiracy that involved shipping drugs to 25 countries and 37 states. (Hellmann, 8/22)

Faced with a soaring death toll from opioid-related overdoses, federal and state policymakers in recent years have enacted measures intended to keep doctors from prescribing too many opioid painkillers. But two studies published Wednesday in the journal JAMA Surgery suggest that such well-intentioned efforts sometimes don’t have the desired effect. (Freyer, 8/22)

The staff at the New Orleans Mission say the number of people addicted to opioids and in need of help is surging. The Mission is at maximum capacity nearly every night, filling the 232 beds at its New Orleans location, in addition to the 93 beds at its facilities in Lacombe and Hammond. The toll of the opioid crisis -- which resulted in the overdose deaths of 166 people in New Orleans last year -- is compounded by the limited resources the city has available to fight drug addiction. Now, New Orleans Mission and Bridge House/Grace House are joining a wave of treatment centers, local governments and others taking legal action against drug manufacturers. (Clark, 8/22)

A federal appeals court on Wednesday upheld a permanent injunction blocking Alabama from banning the most common method of second-trimester abortion. But two judges from the 11th U.S. Circuit Court of Appeals in Atlanta used the 3-0 decision to cast doubt on the Supreme Court's abortion jurisprudence, including that terminating a pregnancy is a constitutional right. (Stempel, 8/22)

A health official in the Trump administration compared abortion to the holocaust as a law school student, Mother Jones reports. Scott Lloyd, who has come under fire recently for blocking unaccompanied minors in government custody from getting abortions, wrote in an essay 15 years ago as a Catholic University law school student that the similarities between abortion and the Holocaust are "crystal clear."  (Hellmann, 8/22)

The Education Department is considering whether to allow states to use federal funding to purchase guns for educators, according to multiple people with knowledge of the plan. Such a move appears to be unprecedented, reversing a longstanding position taken by the federal government that it should not pay to outfit schools with weapons. And it would also undermine efforts by Congress to restrict the use of federal funding on guns. As recently as March, Congress passed a school safety bill that allocated $50 million a year to local school districts, but expressly prohibited the use of the money for firearms. (Green, 8/22)

Gov. Greg Abbott has announced additional funding for the Houston-area community where a teenage gunman in May fatally shot eight students and two substitute teachers. Abbott said in a statement Wednesday that $1.5 million will be given to Santa Fe for a "resiliency center" that will serve as a "focal point for the city's mental health response." Another $300,000 is earmarked for the school district to provide counseling services to students and others. (8/22)

A doctor accused of improperly looking up prescription records of the dead gunman in last October's mass shooting in Las Vegas will invoke his constitutional right against self-incrimination at an upcoming disciplinary hearing, his lawyer said Wednesday. Dr. Ivan Goldsmith is the focus of a "witch hunt" for the source of a newspaper report about Stephen Paddock's prescriptions in the days after the deadliest mass shooting in modern U.S. history, attorney E. Brent Bryson said. (Ritter, 8/22)

Microdosing involves taking roughly one-tenth the “trip” dose of a psychedelic drug, an amount too little to trigger hallucinations but enough, its proponents say, to sharpen the mind. Psilocybin microdosers (including hundreds on Reddit) report that the mushrooms can increase creativity, calm anxiety, decrease the need for caffeine, and reduce depression. There is enough evidence that trip doses might have the latter effect that, on Wednesday, London-based Compass Pathways received Food and Drug Administration approval for a Phase 2B clinical trial of psilocybin (in larger-than-microdoses) for treatment-resistant depression. But research into microdosing is minimal. (Begley, 8/23)

A new study offers a glint of hope to people in a desperate situation: Patients with melanoma, the most serious form of skin cancer, that has spread to the brain. A combination of two drugs that activate the immune system shrank brain tumors in many melanoma patients and prolonged life in a study of 94 people at 28 medical centers in the United States. The drugs were ipilimumab (brand name Yervoy) and nivolumab (Opdivo), and they belong to a class called checkpoint inhibitors. (Grady, 8/22)

Air pollution is shaving months — and in some cases more than a year — off your life expectancy, depending on where you live, according to a study published Wednesday. Worldwide, outdoor air pollution reduces the average life expectancy at birth by one year. The effect is much more pronounced in some countries: It cuts the average Egyptian’s life span by 1.9 years and the average Indian’s by 1.5 years. In Russia, it’s around nine months. (Sengupta, 8/22)

Think for a moment about your school gym classes. Did you just grin with fond reminiscence or reflexively shudder? A revealing new study suggests that these disparate responses to memories of physical education classes are both common and consequential. (Reynolds, 8/22)

New research in the journal Neuron converts that "somehow" into a very specific protein, called TMC1, a critical key for hearing. I spoke with Jeffrey Holt, a Harvard Medical School professor of otolaryngology and neurology and a senior author on the paper. (Goldberg, 8/22)

With high-school athletics starting up again for the academic year, Ellis on Friday joined his Barrow physician, Dr. Javier Cárdenas, to release the results of an annual Barrow survey that suggests more youths are reconsidering playing football because they fear concussions. Seventy-eight percent of the teenagers surveyed who had sustained a sport-related concussion said they have concerns about the long-term consequences of the concussion — a significant increase from the 58 percent of Arizona teen athletes who said they had concerns in 2017. (Innes, 8/22)

Anthropologists have just hit the genomic jackpot. Among the thousands of bone fragments excavated from an ancient cave in the Altai mountains in Siberia, scientists have identified an inch-long shard that belonged to a rare hominin hybrid: a female with a Denisovan dad and a Neanderthal mom. (Netburn, 8/22)

"We then have very direct evidence – almost caught in the act, so to say – of mixing with each other," says Svante Pääbo, a geneticist at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany, who led the research. He says the discovery of first generation offspring of these two groups was "almost too lucky to be true." (Wamsley, 8/22)

“We’re lost,” said Truus Ooms, 81, to her friend Annie Arendsen, 83, as they rode a city bus together. “As the driver, you should really know where we are,” Ms. Arendsen told Rudi ten Brink, 63, who sat at the wheel of the bus. But she was joking. (Schuetze, 8/22)

Medical researchers know the enemy that 12-year-old Jordan Lang and at least 66 other children are confronting. It’s a gene mutation that also has been linked to autism, Alzheimer’s disease and even cancer. What researchers lack is a treatment or cure and — until now — the funding for the work they must do to find one, said UC Davis researchers Kyle Fink and Jan Nolta. (Anderson, 8/22)

End of life care prompts a lot of difficult decisions; figuring out how to start a conversation about death shouldn't be one of them. A national survey found that about 46 percent of physicians feel uncertain about what to say. The Journal of the American Medical Association (JAMA) published an article urging doctors and hospitals to focus on providing high-quality end of life care that is in line with what the patient's desires. (Miller and Fornoff, 8/22)

Kaiser Health News: A Late-Life Surprise: Taking Care Of Frail, Aging Parents

“This won’t go on for very long,” Sharon Hall said to herself when she invited her elderly mother, who’d suffered several small strokes, to live with her. That was five years ago, just before Hall turned 65 and found herself crossing into older age. In the intervening years, Hall’s husband was diagnosed with frontotemporal dementia and forced to retire. Neither he nor Hall’s mother, whose memory had deteriorated, could be left alone in the house. Hall had her hands full taking care of both of them, seven days a week. (Graham, 8/23)

According to the Centers for Disease Control and Prevention, more than 1 in 20, or 2.6 million, U.S. children ages 6 to 17 had current anxiety or depression diagnosed by a health care provider in 2011-12. School nurses in Illinois say the increase is evident in the students from elementary to high school who enter their offices each day, requiring not only bandages and ice packs but also a quiet space to break from stress. Nurses now have to schedule meetings with parents about their child’s mental health histories and needs, then learn the side effects and potential complications associated with mood-altering medications. (Ortiz, 8/23)

Children whose families move homes frequently may be at increased risk for serious psychiatric illness. Researchers followed 1,440,383 children from birth to age 29, including data on residential moves. They found 4,537 cases of psychosis, symptoms of which can include hallucinations and delusions. (Bakalar, 8/22)

A mother’s depression may have long-term effects on her child’s immune system and psychological health. Israeli researchers followed 125 babies from birth through 10 years. About 43 percent of the mothers had a diagnosis of major depression, and the rest constituted a control group. The study is in Depression & Anxiety. (Bakalar, 8/22)

By now, many parents know kids are vaping sweet-smelling tobacco — often using devices that look deceptively like pens or flash drives. And most parents are hip to the prevalence of underage marijuana use. Now comes a combo of the two: vaping pot. Experts and educators say young people are — once again — one step ahead of the adults in their lives, experimenting with this new and more heady way to consume weed. (Ibarra, 8/22)

Gov. Bruce Rauner signed a bill Wednesday that strengthens insurance coverage for mental health conditions and addiction treatment – a measure that advocates say is one of the strongest of its kind in the nation. Federal and state laws already prohibit insurers from covering mental health and substance use disorders at lower levels than physical medical conditions, but advocacy and other groups have expressed concerns that insurance coverage for treatment was still getting short shrift. They considered the issue especially pertinent given the current epidemic of opioid addiction. (Schencker, 8/22)

A Duluth nursing home has been cited for neglect after state investigators found that four of its nurses failed to attempt resuscitation last May of a patient who was found unresponsive and died. The 170-bed nursing home, Chris Jensen Health and Rehabilitation Center, which has a history of regulatory violations, also lacked a system to ensure that patients’ medical wishes were followed when they are found without a pulse and not breathing, according to a Minnesota Department of Health investigation that was made public Wednesday. (Serres, 8/22)

Four nurses at a Duluth assisted living facility neglected a resident when they failed to perform CPR after the resident was found unresponsive, a state agency has found. The resident at Chris Jensen Health and Rehabilitation Center died, according to a report by the Minnesota Department of Health’s Office of Health Facility complaints. The date of death is not listed in the report by special investigator Peggy Boeck, which the agency posted online Tuesday. The investigation concluded July 31 after site visits on June 12-13. (Lundy, 8/22)

Louisiana and Mississippi are leading the nation in the number of people who have become the most seriously ill from West Nile virus this year. State health departments are warning residents to take precautions against mosquitoes, which spread the virus. "Not in my house, not on my skin, not in my yard," said Dr. Raoult Ratard, Louisiana's state epidemiologist, as he repeated the state slogan for fighting the disease Wednesday. Precautions include making sure door and window screens don't have holes; wearing long clothes and using mosquito repellent; and making sure the yard doesn't hold any standing water where mosquitoes might breed — even a bottle cap. (8/22)

Ten community health centers in New Hampshire are splitting over $835,000 in federal grants to improve health care delivery. The U.S. Department of Health and Human Services awarded the money last week after reviewing the performance of all 1,400 federally qualified health centers in the United States. (Gibson, 8/22)

Missouri’s incarceration rate for women is among the highest in the country. The majority of these women have children, yet little research has examined the effects of incarceration on mothers specifically. (Farzan, 8/23)

Previously, veterans who went to the Department of Veterans Affairs clinic in Austin but ended up needing hospitalization were sent to the VA hospital in Temple, the nearest option despite being about an hour away, said Christoper Sandles, who directs the Central Texas Veterans Health Care System. ...As of a new partnership unveiled Wednesday, the local VA clinic will now send veterans to Dell Seton Medical Center to receive covered care. (Goldenstein, 8/22)

A 37-year-old inmate suffered life-threatening symptoms for weeks without medical treatment at Pueblo County Detention Center after numerous staff members allegedly accused him of faking a serious illness and excruciating pain, a federal lawsuit says. Jeremy Laintz nearly died before he was taken to a Pueblo hospital and then sent by Flight for Life to St. Anthony Hospital in Denver on Nov. 1, 2016, according to the lawsuit filed Tuesday in Denver U.S. District Court by Denver attorney Anna Edwards. (Mitchell, 8/22)

Blue Cross and Blue Shield of Georgia is going to become Anthem Blue Cross and Blue Shield effective Jan. 1. Anthem, based in Indianapolis, is the parent company of the Georgia insurer. The name change will take effect Jan. 1, 2019, the company announced Wednesday. In addition, Greater Georgia Life, an affiliated Anthem plan, is changing its brand name to Anthem Life. (Miller, 8/22)

Thirteen Hillsborough County foster children slept for a total of 22 nights in offices this month because child welfare workers could not find them foster beds for the night, agency officials said. That is despite moves by Eckerd Connects to provide better care for traumatized teens who refuse to go to group homes, including the creation of a 24/7 mental-health crisis team. (O'Donnell, 8/22)

The state has agreed to pay $1.3 million to a former inmate who claimed correctional staff delayed identifying and properly treating his skin cancer, despite his rapidly deteriorating condition while incarcerated. The former inmate, Wayne World, sued in 2016. (Rigg, 8/22)

A nationally known youth drum corps based in the Milwaukee area has been suspended after reports of poor health care and other safety concerns. Pioneer Drum & Bugle Corps & Color Guard had a registered sex offender on its staff, which works with youth age 14 to 21, according to a statement issued this week from Drum Corps International, the Indiana-based organization and an organizer of such events nationwide. (Diedrich, 8/22)

A single mother fatally shot her severely disabled 7-year-old son and then attempted suicide after years spent caring for her child, authorities and family friends in Oregon said Wednesday. A relative found Tashina Aleine Jordan, 28, unconscious Monday at the Bend home she shared with her son and mother. Authorities found the boy, named Mason, and pronounced him dead. Notes at the scene indicated Jordan was the shooter, police spokesman Lt. Clint Burleigh told KTVZ-TV. (8/22)

The air quality around Minnesota is improving, and state officials are predicting good to moderate air quality for the rest of the week. But it's been a summer of many air quality alerts, and doctors and people who are active outdoors have noticed the effects. (Lebens, 8/22)

Pennsylvania’s state prison system is tightening security and revamping procedures after 18 staff members were treated at hospitals for exposure to a yet-unidentified substance at three prisons earlier this month. Corrections Department spokeswoman Amy Worden said Wednesday state police investigators are testing the substance, which she described as a “liquid synthetic drug that’s taking different forms.” (Scolforo, 8/23)

At their most recent meeting, the state’s top marijuana regulators debated whether they need to crack down on cities and towns that are seeking unlawfully large payments from companies in exchange for permission to open recreational cannabis businesses. ...But a Globe review found all 19 provisional licenses issued by the commission are tied to host community agreements that appear to violate the agency’s own guidance on how such deals should be structured. (Adams, 8/22)

There is a direct link between the prevalence of social networks — specifically Facebook and Twitter — and hate crime. That conclusion, from two recent papers by researchers at the University of Warwick, England, may not in itself require swift policy action. But the methods used to reach it could be used to answer other questions about the relationship between social media and the real world — such as how much Russia’s Facebook and Twitter trolling affects election results. (Leonid Bershidsky, 8/22)

Adolescents’ use of electronic cigarettes initially took the public health community by surprise. In 2011, less than 2% of U.S. high school students reported having used e-cigarettes in the previous month. But by 2015, the percentage had jumped to 16%. The following year, the U.S. Surgeon General issued a report concluding that e-cigarette use among young people was “a public health concern.” Ensuing public education campaigns and policies helped bring the prevalence of past-month e-cigarette use among U.S. high school students down to 11% in 2016. A recent evolution in technology and marketing may threaten this progress. A new product class called “pod mods” — small, rechargeable devices that aerosolize liquid solutions containing nicotine, flavoring, and other contents encapsulated in cartridges (see image) — appears to be gaining traction. Media stories about Juul, a popular pod mod brand, highlight anecdotal reports from students, parents, teachers, and school superintendents indicating that use of these products is rampant among young people. (Jessica L. Barrington-Trimis and Adam M. Leventhal, 8/22)

On June 1, 2018, the Department of Health and Human Services (HHS) proposed new regulations for the Title X Family Planning Program. If enacted, these regulations will radically alter the mix of health care providers and the range, quality, and effectiveness of services offered to support the reproductive health and childbearing decisions of low-income women, men, and adolescents in the United States. In addition, the new regulations will constrain the ability of clinicians within the system to follow professional recommendations for respecting patients’ autonomy and ability to make informed choices about childbearing and health care. The American Medical Association, the American College of Physicians, and eight specialty physician, nursing, and physician assistant organizations have issued statements opposing the proposed regulations. (Janet M. Bronstein, 8/23)

As a licensed pharmacist, I’m all too familiar with patients’ difficulties getting medications they need and their physician has prescribed. As baby boomers age, pharmacists see more patients at our counters unable to obtain needed treatments for heart disease, high blood pressure, diabetes, and other chronic illnesses. This issue is now being acknowledged and a healthy debate has begun over possible solutions. But one idea policymakers shouldn’t pursue is opening up our country’s secure drug supply to medicines coming from outside our borders. (Kenneth McCall, 8/23)

A new report on Ohio’s Medicaid expansion gives more support for what was a controversial move by Gov. John Kasich four years ago. More low-income Ohioans can see health-care providers regularly and more can get treatment for addiction or mental illness, helping thousands get jobs or promotions that pay enough money so that they no longer need Medicaid. (8/23)

Montana State Auditor Matt Rosendale wants the Affordable Care Act (ACA) gone. Rosendale doesn’t want to take responsibility for what his position means to the 425,900 Montanans who have pre-existing conditions, the 49,007 Montanans enrolled in the current ACA marketplace, or the 79,700 who would lose coverage if current attempts to dismantle the ACA succeed. Auditor Rosendale has claimed that the ACA is “causing tremendous pain for folks across the state.” In reality, the ACA opened the door for 58,100 Montanans to enroll in healthcare through Montana’s Medicaid. (Katie Mazurek and Amy Coseo, 8/22)

The ACA is stuck in purgatory, beyond comprehensive repeal but subject to a war of attrition that jeopardizes its gains. Such a campaign poses risks for Republicans. The politics of health care have fundamentally changed. Tens of millions of Americans are ACA beneficiaries; taking away their coverage and consumer protections is difficult. And as the party in power, Republicans are now responsible for Obamacare’s problems, which the Trump administration’s policies may worsen. Whereas resisting the ACA previously produced political benefits for the GOP, continued opposition could exact a price in coming years. The 2018 elections could further alter the political calculus, leading Republicans to either revive or retreat from repeal efforts. Yet the more the ACA is undermined, the further left U.S. health politics seem to shift. Threats to repeal Obamacare have increased Democrats’ support for single-payer health care and Medicare expansion. Thus, Republicans’ campaign against Obamacare could produce a transformation in U.S. health policy — just not the one that they envisioned. (Jonathan Oberlander, 8/23)

Jane did what thousands of young women were forced to do in the 1960s — she underwent a back-alley abortion. Though she had worried about going through with it, other young women she knew had used the same abortion doctor and had been fine. She went for the procedure with fear but determination. Unfortunately, afterward Jane was not fine at all: she developed sepsis and multiorgan failure. She survived after weeks of hospitalization and near-death episodes, along the way enduring a hysterectomy and severe acute kidney failure, with bilateral cortical necrosis. Acute dialysis saved her life. However, Jane’s kidney function thereafter was essentially nil, and she continued on thrice-weekly dialysis, donated as compassionate care by the hospital. Jane and her fiancé married while she was in the hospital, hoping that she would gradually improve, receive a transplant, and resume her studies. She told me she was sad that she would never have a biologic child, but she was full of plans for the future. A few weeks later, another complication developed — acute bleeding, with a hemothorax. I was the medical student on that dialysis shift, too. Jane was too ill to speak, though she was conscious and nodded hello, offering a weak smile. I chatted with her at the start of the dialysis run, but her status deteriorated, rapidly. There was a code. Though the team tried everything they could to resuscitate and stabilize her, she did not make it. We all cried. (Julie R. Ingelfinger, 8/23)

The burden of tickborne diseases seems likely to continue to grow substantially. Prevention and management are hampered by suboptimal diagnostics, lack of treatment options for emerging viruses, and a paucity of vaccines. If public health and biomedical research professionals accelerate their efforts to address this threat, we may be able to fill these gaps. Meanwhile, clinicians should advise patients to use insect repellent and wear long pants when walking in the woods or tending their gardens — and check themselves for ticks when they are done. (Catharine I. Paules, Hilary D. Marston, Marshall E. Bloom and Anthony S. Fauci, M.D., 8/23)

Dirtier air, hundreds more deaths, and a worsening of climate change. That’s what’s we as a nation can expect now that the Trump administration, ever dismissive of both scientific fact and environmental well-being, has proposed to scrap the Obama-era Clean Power Plan in favor of a free-for-all on restricting emissions from coal-burning power plants. So here’s the scorecard: coal plants and greenhouse gas emissions, 1; your right to breathe clean air, 0. (8/22)

Casting a lifeline to the sinking coal industry and its shrinking work force, the Trump administration announced on Tuesday a plan to weaken regulations of coal-fired power plants that President Barack Obama had put in place as part of an effort to reduce America’s emissions of planet-warming gases. The plan is wrongheaded on every level. It favors an old, dirty fuel and does nothing to accelerate the push toward the cleaner, renewable fuels on whose development the world is depending for real progress against global warming. ...For good measure, the proposal would also weaken provisions in the clean air laws designed to regulate pollutants like smog and soot and, in so doing, cause as many as 1,400 additional premature deaths annually by 2030, as well as many thousands of respiratory infections because of increases in fine particulate matter linked to heart and lung disease. (8/22)

Of the Obama Administration’s many power grabs, none was more audacious than its bid to regulate coal-fired electric power out of business. The Trump Administration is now proposing to rewrite the rule in a way that honors the law and still reduces carbon emissions, yet it is being portrayed as radical. (8/21)

Right on cue, predictions of widespread death and environmental ruin sprang from the Trump administration’s decision this week to replace the Obama-era Clean Power Plan. But the reality is that whether the rules stayed or went, coal power is on a downward spiral. The economics of burning coal to produce electricity no longer make sense. That’s why coal power production has been rapidly declining and was on the wane even before President Barack Obama unveiled his strategy in 2015 for making coal obsolete. (8/22)

The best that can be said for the Environmental Protection Agency’s new plan to loosen restrictions on coal-fired power plants is that it will probably never be put into practice. States are expected to sue, rightly, because the proposal fails to comply with the Supreme Court’s 2007 demand that the EPA responsibly regulate U.S. carbon emissions. The EPA itself acknowledges that its plan would not only increase carbon emissions but also lead to as many as 1,600 premature deaths annually. (8/21)

Besides trashing the Clean Power Plan, the president is pulling the United States out of a Paris climate accord that nearly 200 other nations signed, and he intends to roll back vehicle-efficiency standards aimed at reducing tailpipe emissions, the greatest domestic source of greenhouse gases. The new power plant rules and vehicle-efficiency rollbacks will likely be tied up in court challenges for years. That might stall Trump's great leap backward in the fight against climate change. But the nation needs to move forward, aggressively, in what is becoming an existential struggle. (8/22)