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Five governors will testify in front of the Senate Health Committee next month on ways to fix ObamaCare. Govs. Charlie Baker (R-Mass.), Steve Bullock (D-Mont.), Bill Haslam (R-Tenn.), Gary Herbert (R-Utah) and John Hickenlooper (D-Colo.) will testify at a hearing on Sept. 7. State insurance commissioners will testify Sept. 6. (Hellmann, 8/23)

The hearing is one of two that will focus on stabilizing premiums and helping people in the individual market in light of Congress’ failure to repeal and replace the Affordable Care Act, or Obamacare. (Collins, 8/23)

Kathleen Sebelius, the former HHS secretary who oversaw the rollout of Obamacare, is worried that HHS’s current leaders are steering the ACA the wrong direction. "They have done a lot to sabotage the health care law," Sebelius told POLITICO’s Dan Diamond. The former HHS secretary shares her thoughts on the current administration’s strategy, what she thinks HHS should be prioritizing and what’s been overlooked because of the intense focus on the ACA. (Diamond, 8/24)

Senate Majority Leader Mitch McConnell says he and President Donald Trump are in regular contact about "shared goals" and working together to advance them. He says people suggesting otherwise are "clearly not part of the conversation." ... Trump has criticized McConnell for the Senate's rejection of the GOP push to repeal President Barack Obama's health law. He suggested McConnell might need to step aside as leader if he can't push top bills through the chamber. (8/23)

Tricia Petrucci hasn’t quite reached the point where she regrets her vote for President Donald Trump. It would be understandable if she did, because Trump — and her senator, Senate Majority Leader Mitch McConnell (R-Ky.) — are trying to curb the medical services that sustain her 11-year-old stepson, who battles severe cerebral palsy. She is aware of the irony when she chats with her Louisville neighbor, Ann Pipes, a Democrat whose own son is 11 and struggles with a disability. (McAuliff and Gillespie, 8/24)

Does making health insurance premiums more affordable for healthier, wealthier people justify sharply increasing out-of-pocket costs for lower-income and sicker people? That's one of the key questions critics are raising about Iowa's sweeping new proposal to revamp its individual insurance market and abolish its federal exchange. The state submitted the plan—called the Iowa Stopgap Measure—to HHS and the U.S. Treasury Department Tuesday under Section 1332 of the Affordable Care Act. (Meyer, 8/23)

Iowa asked for federal permission to alter major provisions of the Affordable Care Act next year, a proposal that will be closely watched by officials in other states who hope to rewrite parts of the health law as Republican efforts to do so in Congress have stalled. Iowa’s plan, which state officials said they are already preparing to implement pending federal approval, would go further than proposals that other states have made so far to revamp the health law’s rules. The Iowa setup would offer just one type of insurance plan in the individual market and reshape the subsidies that help people buy coverage, among other changes. (Wilde Mathews, Hackman and Armour, 8/23)

The Connecticut Insurance Department on Wednesday asked Anthem and ConnectiCare to submit new rate filings for 2018 based on the possibility the federal government will stop “cost-sharing reduction” payments to the insurers that subsidize lower co-payment and deductibles for low-income Americans. (Radelat, 8/23)

Answering the question is complicated, but a new state report suggests that premiums under the old high-risk pool would be much higher today than what individuals are paying out-of-pocket for coverage in employer plans and for certain policies under the federal Affordable Care Act. (Snowbeck, 8/23)

The White House is expected to send guidance to the Pentagon in coming days on how to implement a new administration ban on transgender people in the military, issuing a policy that will allow Defense Secretary Jim Mattis to consider a service member’s ability to deploy in deciding whether to kick them out of the military. (Lubold, 8/23)

A White House memo that is expected to be sent to the Pentagon in coming days gives Jim Mattis, the secretary of defense, six months to enforce the transgender ban that Mr. Trump announced abruptly last month in a series of tweets. The directive was confirmed Wednesday by a person familiar with its contents but who was not authorized to discuss its details and spoke on the condition of anonymity. The authority has not yet been finalized. Once it is approved, it would allow Mr. Mattis to force out transgender service members by setting a legal standard of whether they would be able to deploy to war zones or for other lengthy military missions. (Hirschfeld Davis, 8/23)

The American Military Partner Association, a group that represents LGBT military spouses, called the the new proposal a “vicious assault on transgender service members.” “Despite the overwhelming bipartisan condemnation of his reckless tweets, President Trump is still pushing forward with his vicious assault on transgender service members,” said Ashley Broadway-Mack, the group’s president. “His foolhardy assertion that transgender service members are not able to deploy is simply not rooted in fact. Transgender service members are just as deployable as any other service member.” (Dawsey and Jackson, 8/23)

When Republican Sen. Bob Corker said last week  that President Trump hasn't "been able to demonstrate the stability" needed for success and recommended he "move way beyond himself," it was news mostly because Corker has been one of Trump's key supporters in Congress. Then James Clapper, who served in top intelligence jobs under former Presidents George W. Bush and Barack Obama, Wednesday morning questioned Trump's "fitness to be in this office" and said he was worried about the president's access to the nuclear codes. Clapper, who had a long military career, is a close friend and longtime colleague of Trump's Defense Secretary, Jim Mattis, a former Marine Corps general. (O'Donnell, 8/23)

Being the leader of the Free World is no doubt one of the most stressful jobs possible, but how much stress affects President Trump is open to debate. Still, psychiatrists including Bandy Lee, editor of the upcoming book The Dangerous Case of Donald Trump, worry about how Trump responds to what are likely stressful crises with fiery rhetoric that could provoke violence. (O'Donnell, 8/23)

California Democrats are stoking a debate over Donald Trump’s mental health and fitness for office, opening a new front in the resistance to the president but raising fears that the line of criticism could backfire. As early talk of impeachment wanes and questions about Trump’s stability have surfaced after his volatile responses to the violence in Charlottesville — most recently by GOP Sen. Bob Corker and former Director of National Intelligence James Clapper — California’s Democratic House delegation has seized on an issue that until recently was limited to the Internet fever swamps. (Marinucci, 8/23)

The contractions were coming eight minutes apart, and Billie Jo Yupanik was breathing into them, her gaze down, hands cradling her abdomen. Around her, other pregnant women padded around the open, airy rooms of the Yukon-Kuskokwim prematernal home, chatting on phones or grabbing coffee from the pot. They mostly smiled and nodded at Ms. Yupanik as they passed, but otherwise seemed to pay her little mind. Going into labor, after all, is hardly remarkable in this place. (Johnson, 8/24)

Abstaining from sexual activity is a surefire way to prevent pregnancy and avoid sexually transmitted diseases. But programs advocating abstinence often fail to prevent young people from having sex, researchers write in the September issue of the Journal of Adolescent Health. Such programs, sometimes referred to as "abstinence only until marriage" programs, typically advocate monogamous, heterosexual marriage as the only appropriate context for sexual intercourse and as the only certain way to avoid unwanted pregnancies and sexually transmitted diseases. (McCammon, 8/23)

Circuit Judge John Marshall said in a written decision Monday that a Richmond woman, Itzel A. Melendez, has legal standing to challenge the amended regulations as does Megan C. Getter, a Rockville resident who is a member of the Virginia State Board of Health. (Gorman, 8/23)

Jennifer Welch applied to be president and CEO of Planned Parenthood of Illinois before Donald Trump won the presidential election, a victory that has ushered in a new wave of challenges for the organization. But the turn of events didn't give Welch pause when it came to starting her new job in May. "I never swayed from wanting to return to Planned Parenthood," said Welch, 49, a lifelong Chicago-area resident who is also now head of Planned Parenthood Illinois Action, the organization's advocacy and political arm. (Schencker, 8/24)

A legal challenge to an Indiana law that criminalizes research using the remains of aborted fetuses could determine how much power states have to restrict scientific access to fetal tissue. The unusual case pits Indiana’s government against the state’s flagship research university, which is asking a federal court to declare Indiana’s fetal-tissue statute unconstitutional. (Gershman, 8/23)

For months, health officials in [Oklahoma City] ... have been staggered by a fast-spreading outbreak of a disease that, for nearly two decades, was considered all but extinguished. Syphilis, the deadly sexually transmitted infection that can lead to blindness, paralysis and dementia, is returning here and around the country, another consequence of the heroin and methamphetamine epidemics, as users trade sex for drugs. (Hoffman, 8/24)

In a study published Wednesday in the journal Science Translational Medicine, researchers reported that the exoskeletons helped most participants straighten their legs as they walked, alleviating the permanent knee bend that causes the crouching disorder known as “crouch gait.” The researchers also found that while the exoskeletons provided support when it was needed, participants were still in control of their own steps. (Joseph, 8/23)

In dental offices nationwide, children who need cavities filled or teeth pulled are sometimes sedated. Ideally, it makes them less anxious and more cooperative. They may swallow a liquid sedative or inhale laughing gas and once it kicks in, they will be conscious but calmer, so the dentist can do extensive work. (Saint Louis, 8/24)

The 25 million people who live among the Appalachian mountains have struggled to keep up with health gains of the rest of the nation, falling behind in most major public health indicators, according to a study released Thursday. (Beam, 8/24)

Taking oral contraceptives may reduce the risk for rheumatoid arthritis, a new study has found. The exact cause of rheumatoid arthritis is unclear, but since it is about three times more common in women than in men, some have suggested hormonal factors might be involved. (Bakalar, 8/23)

Pediatricians have been clear: Early bell times can spell sleep deprivation for teens and, in turn, a decline in academic performance, an increased risk of car accidents and physical and mental health issues. But according to a recent report by the National Center for Education Statistics, only a fraction of high schools are starting later than 8:30 a.m., which is what the American Academy of Pediatrics recommends. (Balingit, 8/23)

Cries of “Nazis, go home!” and “Shame! Shame!” filled the air as Angela King and Tony McAleer stood with other counterprotesters at the “free speech” rally in Boston last weekend. They didn’t join the shouting. Their sign spoke for them: “There is life after hate.” (Jayson, 8/24)

Taking too much vitamin B6 and B12 could dramatically increase lung cancer in men, according to a new study. By looking at more than 77,000 patients over 10 years, researchers found men who consumed high doses of B6 and B12 (often advertised as an energy-booster) doubled their risk of developing lung cancer. In men who smoked, the risk increased four times, according to results published in the Journal of Clinical Oncology Tuesday. Women who took the same amount of vitamin B didn't see an increased risk. (May, 8/23)

In the cooler section of any Whole Foods store or maybe the cup holder of your crunchy neighbor’s VW bus, you can find Kombucha, the yeast-fermented tea sold with some pretty over-the-top marketing claims. “The mission of Unity Vibration kombucha is to spread love, health and possibility in to the world and to better the lives of millions with our products,” touts one online kombucha commercial. But for all of kombucha’s peace and love image, research at the Stowers Institute in Kansas City shows some rather sinister activity when the yeast cell that’s found in it mates. (Smith, 8/24)

The Reflections treatment center looked like just the place for Michelle Holley's youngest daughter to kick heroin. Instead, as with dozens of other Florida substance abuse treatment facilities, the owner was more interested in defrauding insurance companies by keeping addicts hooked, her family says. "It looked fine. They were saying all the right things to me. I could not help my child so I trusted them to help my child," Holley said. (Anderson, 8/24)

A year ago, Maine was one of the first states to set limits on opioid prescriptions. The goal in capping the dose of prescription painkillers a patient could get was to stem the flow of opioids that are fueling a nationwide epidemic of abuse. Maine's law, considered the toughest in the U.S., is largely viewed as a success. But it has also been controversial — particularly among chronic pain patients who are reluctant to lose the medicine they say helps them function. (Wight, 8/23)

All told, at least eight people have overdosed from street drugs that were believed to be counterfeit versions of Percocet, a prescription painkiller. ... The GBI is testing the pill linked to the latest overdoses, agency spokeswoman Nelly Miles said Wednesday afternoon. (Miller, 8/23)

Truth Initiative, a leading tobacco-control nonprofit, has bought TV ads to run this Sunday during MTV’s Music Awards that accuse tobacco companies of purposely targeting mentally ill people and U.S. soldiers. The ads focus on this stark but little known fact: Roughly 40 percent of cigarettes sold in the U.S. are smoked by people with mental health issues, including depression, anxiety or substance-abuse problems. (Wan, 8/24)

When the price of a pack of cigarette increases by $1, there is a 20 percent increase in rates of quitting smoking. Researchers linked data on the smoking habits of 632 smokers, average age 58, to neighborhood cigarette prices in 896 chain grocery and drugstores in 19 states. They gathered data on local laws on indoor smoking in public places, and followed changes in prices, laws and smoking habits over 10 years. (Bakalar, 8/23)

Providence Health & Services began a series of layoffs last week as the giant health system attempts to bring its costs in line with revenue. Across the company's seven-state territory, 210 jobs were eliminated or soon will be. The cutbacks included 40 in Oregon, Providence spokesman Gary Walker said. That's a relatively tiny layoff, percentage-wise. Providence is one of the largest health systems in the country with more than 111,000 employees. The company is also choosing not to fill certain administrative positions. (Manning, 8/23)

Every so often, there comes a technology with benefits so indisputable that it becomes inevitable. Such is the case with telemedicine, or telehealth — care provided remotely using technology, from Skype to email to apps. (Haller, 8/23)

A task force to recommend changes at the Manchester VA Medical Center has yet to be formed, but members of the state’s congressional delegation want at least one of the medical center whistleblowers to serve on that committee. Doctors and nurses who went public with their concerns about conditions at the medical center were disappointed on Aug. 6 when Veterans Affairs Secretary Dr. David Shulkin announced the formation of the task force, with Dr. Michael Mayo-Smith as its chairman. (Solomon, 8/23)

With only a sprinkling of primary care medical practices in the community, Severna Park residents have often sought care elsewhere. But, recently, three urgent care clinics have popped up within a mile of each other to offer patients a range of medical services. They are: Priority Care Urgent Medical Care, 550 Ritchie Highway in Park Plaza; Choice One Urgent Care, 500-B Ritchie Highway at the corner of Robinson Road; and WiseCare Urgent Care in the Severna Park Market Center, 485 Ritchie Highway. (Tegler, 8/24)

Secondary teachers in the Glendale Unified School District must take part in mandatory training about suicide awareness this school year, specifically addressing youth with mental disabilities, those facing homelessness or those who are part of the LGBTQ community. The training comes after Assembly Bill 2246 put forth a mandate requiring school districts adopt a policy on suicide prevention for students in seventh through 12th grades, local school officials said last week. (Vega, 8/23)

Over the next two years, USF Tampa aims to invest about $1.5 million in mental health. ... students made 891 crisis visits to USF's center last year, more than double the year before. (McNeill, 8/24)

Nearly two years after Mercy Hospital closed its doors, the southeast Kansas town of Independence is still without a hospital. But it may have the next best thing: a new state-of-the-art clinic with an emergency room and a small cancer treatment center. The nearly $8 million Independence Healthcare Center operates as an extension of Labette Health, a regional hospital about 30 miles to the east in Parsons. (McLean, 8/23)

St. Agnes Healthcare will pay $122,928 to resolve claims that it overbilled Medicare for services performed by cardiologists of a specialty practice acquired by the health system, according to a settlement announced by the office of the U.S. Attorney for Maryland. According to the allegations, Baltimore-based St. Agnes billed Medicare for the evaluation and management of patients by 12 doctors at the practice formerly known as MidAtlantic Cardiovascular Associates, which was acquired by St. Agnes in 2011. The doctors became St. Agnes employees and continued to provide services to their patients through Maryland Cardiovascular Specialists, a practice affiliated with the health system. (Cohn, 8/23)

New York City-based AbleTo Inc., which makes a digital platform to connect individuals with licensed therapists and coaches, has closed $36.6 million in Series D funding led by Bain Capital Ventures. The company, which was founded in 2008, works with employers and health plans to offer support to employees who have medical conditions that may be associated with—or exacerbated by—underlying behavioral health issues. (Mack, 8/23)

Health and education leaders across California have joined forces with business and labor leaders to address workforce shortages in health care. The new group aims to create a blueprint for policymakers. The California Future Health Workforce Commission, unveiled Wednesday, includes two dozen representatives from businesses, organized labor, schools and hospitals. (Gorman, 8/23)

For the first time Californians would pay a tax on drinking water — 95 cents per month — under legislation aimed at fixing hundreds of public water systems with unsafe tap water. Senate Bill 623, backed by a strange-bedfellows coalition of the agricultural lobby and environmental groups but opposed by water districts, would generate $2 billion over the next 15 years to clean up contaminated groundwater and improve faulty water systems and wells. (Murphy, 8/23)

Smart Choice MRI, known for providing scans for $600 or less, has drawn its third investment from a health system and plans to expand to Colorado. The company, which has 17 imaging clinics in Wisconsin, Illinois and Minnesota, said Wednesday that UCHealth, a health system that includes University of Colorado Hospital in Denver, will invest in the company. (Boulton, 8/23)

While the topic of health insurance continues to be at the center of nationwide debate, Richmond Heights Fire Department Chief Marc Neumann said the effects of its uncertainty are being felt locally. The RHFD charges insurance companies and the uninsured for ambulance services. (Pirkowski, 8/23)

Locals embraced the CEO’s open style in leading the hospital, which has just 25 beds but is considered vital to the island. But in a move that stunned residents, the board of Martha’s Vineyard Hospital fired Woo-din this summer, just over a year into his tenure, without explaining why. (Dayal McCluskey, 8/23)

Last school year, with the help of the American Heart Association and the Menomonee Falls Fire Department, Dana went into five of the six schools in Menomonee Falls, and all of the teachers who did not already have CPR certification learned hands-only CPR. Making the change to certify at least 10 percent of teachers in CPR/AED training will earn the Menomonee Falls School District a Project ADAM heart safe designation. (Seemuth, 8/23)

State Sen. Scott Wiener criticized a San Francisco Board of Supervisors proposal to temporarily halt permits of new cannabis dispensaries, saying it would “send a terrible message statewide.” Wiener, a former supervisor who is among the city’s most prominent moderate politicians, generally avoids taking stances on city issues. (Swan and Fracassa, 8/23)

Sen. Jennifer Flanagan, a Leominster Democrat, will resign her seat at the end of the month to become one of five members of the new Cannabis Control Commission, tapped by Gov. Charlie Baker to help take on the responsibility of regulating the burgeoning recreational marijuana industry and licensing retail pot shops. Flanagan, who voted against the 2016 ballot question legalizing pot for adults and has made mental health and substance abuse issues her main focus in the Legislature, will assume her new duties on Sept. 1. (Murphy, 8/23)

The repeated inability of the GOP to move forward legislation repealing the ACA should be viewed by both sides as an opportunity to do what most Americans are clamoring for us to do: work together to fix the parts of the ACA that need to be fixed, while preserving the parts that need to be preserved. We should start by stabilizing the exchanges in all 50 states so that health insurers will reenter these markets, creating a competitive environment that will drive down premiums, co-pays, and deductibles. (Sen. Tom Carper (D-Del.), 8/22)

The Congressional Budget Office, whose estimates of the disastrous impact of various Republican health care bills did so much to sink them, reported this month on the potential impact of President Donald Trump’s Plan B for getting rid of the Affordable Care Act. The prognosis isn’t good, mainly because the goal has become simply to sabotage Obamacare without coming up with something better to replace it. (8/24)

Congress is nimble at evading responsibilities but cannot avoid deciding either to repudiate or to tolerate a residue of President Barack Obama’s lawlessness, one that most, perhaps all, congressional Democrats and many, perhaps most, Republicans want Obama’s successor to continue. ... The subsidy that Congress must confront in September is the ACA requirement that the secretary of health and human services devise a program to compensate insurers for the cost of selling discounted plans to some low-income purchasers. (George F. Will, 8/23)

You have to wonder how the consumer ratings company J.D. Power, which has now backed away from a report that originally said KanCare ranked dead last among 36 privatized state Medicaid programs, ever thought that interviewing just 10 of the 400,000 people on KanCare might provide a statistically significant picture of how well the program works. (8/23)

There’s no good explanation, no budgetary or scientific reason for ending a federal study into the possible health effects of living near surface coal mining in Appalachia. This study is well underway. The only reason the Trump administration would pull the plug now is to please the coal industry. And that reason is not good enough when so many people are waiting for answers. (8/23)

It’s a sad truth that Appalachia lags behind the rest of the country – dramatically by some measures – when it comes to health, but a new report shows that the gap between Appalachia and the rest of the United States is expanding. And the worst health disparities tend to be centered in Eastern Kentucky. Not coincidentally, the nation’s highest smoking rates are found in Kentucky, where 9,000 people a year die of smoking-related illnesses. (Ben Chandler, 8/24)

Solving the unrelenting opioid crisis has become a pressing national priority. As evidence, the President’s Commission on Combating Drug Addiction and the Opioid Crisis recently urged President Trump to declare “a national emergency under either the Public Health Service Act or the Stafford Act.” Critical to future progress will be leveraging the full resources of the community—in partnership with health professionals—to prevent misuse, addiction, and death. (Howard Koh, 8/22)

On August 10, 2017, President Trump announced his intention to declare a national emergency following the recommendation of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Opioid abuse is among the most consequential preventable public health threats facing the nation. More than 600 000 deaths have occurred to date, with 180 000 more predicted by 2020. Of the 20.5 million US residents 12 years or older with substance use disorders in 2015, 2 million were addicted to prescription pain relievers. A declaration of a national emergency authorizes public health powers, mobilizes resources, and facilitates innovative strategies to curb a rapidly escalating public health crisis. (Lawrence O. Gostin, James G. Hodge Jr. and Sarah A. Noe, 8/23)

A month ago, the federal government sent a “Dear John” letter to the Children’s Hospital Los Angeles. “Due to changes in program priorities,” the letter began, “it has been determined that it is in the best interest of the Federal government to no longer continue funding” the grant for one of our hospital’s teen pregnancy prevention programs. This one-page form letter, sent from the Department of Health and Human Services, arrived almost a year to the day that HHS initially approved our five-year project with glowing reviews about how the Children’s Hospital Los Angeles is “recognized for innovative service and training models, leadership in community collaboration, and research regarding adolescent issues” and has “over 50 years of experience in implementing programs in safe and supportive environments for youth and their families.” (Marvin E. Belzer and Arlene Schneir, 8/23)

Health care providers can influence vaccination rates with the right attitudes and message. However, providers do not always have accurate perceptions of parents’ views and concerns about vaccination. Some overestimate parents’ concerns, while others are unsure of how to approach conversations about possible vaccine side effects so that they are not misinterpreted. (Mary Politi, 8/22)

When low-income individuals get stable housing, their stress usually goes down and their health improves. It’s easier for people like Jane to go to follow-up appointments without worrying about where she will be sleeping that night. She has a place to store her medications and can now spend her time and effort making healthier food choices or exercising. Stable housing allows victims of domestic violence to find a safe haven and improve their mental health. It also reduces overall health care expenditures by contributing to an increase in the use of primary care services and a decrease in emergency department visits. (Ersilia M. DeFilippis, 8/23)

The last time I saw Margaret Worthen was in November 2012. She was in New York participating in a study of patients with severe brain injury. As soon as I walked into her room, I knew something had changed. She was still immobile, but she noticed my presence, was more attentive and engaged. And there was something else: She at times was able to use her left eye to answer simple yes or no questions. That morning, she seemed to relish her new found fluency. She responded with verve, as if the determined downward swoop of her eye could signal an exclamation point. (Joseph J. Fins, 8/24)

After World War II, America faced a severe shortage of primary care. Doctors struggled to meet the rising demand brought on by the baby boom, while the cost of care became increasingly unaffordable. In 1965, the first nurse practitioner training program launched at the University of Colorado. The result: a mid-level practitioner and increased access to care for the average American family. Today, history repeats itself in the form of a national dental crisis. (Jennifer Minjarez, 8/24)

A gender gap continues to exist in many subspecialties of surgery, often considered a profession more suitable to men because of physically demanding working conditions and long hours not always conducive to family life. Many studies cite this perceived conflict as the principal reason a career in surgery is avoided by female graduates. At a time when surgery is faced with recruitment challenges globally, addressing factors that make surgery less appealing is critical if surgery is to continue to attract the best physicians, irrespective of sex. (Ailín C. Rogers and Deborah A. McNamara, 8/23)