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There’s never been a major bipartisan Obamacare bill, and the path to passing one now — after the death of Senate Republicans' repeal effort — is steep. Senate HELP Chairman Lamar Alexander (R-Tenn.) and ranking Democrat Patty Murray of Washington are up against both time and history in their race to stabilize the shaky Obamacare markets and solidify their status as the chamber’s top dealmakers. (Haberkorn and Cancryn, 8/3)

A bipartisan Senate effort to continue federal payments to insurers and avert a costly rattling of health insurance markets faces a dicey future. The uncertainty shows that last week's wreck of the Republican drive to repeal the Affordable Care Act hasn't blunted the issue's sharp-edged politics. (Fram, 8/2)

Members of the Senate’s health committee welcomed a sharp change in the chamber’s approach to insurance legislation, while acknowledging the tight timeline the panel will be up against. Senate Health, Education, Labor and Pensions Chairman Lamar Alexander, R-Tenn., on Tuesday laid out a plan to hold hearings the week of Sept. 4 on ways to control costs for insurance plans sold on government-run exchanges, which serve about 11 million people. (McIntire, 8/2)

Tennessee Insurance Commissioner Julie Mix McPeak on Wednesday lauded Sen. Lamar Alexander’s decision to call for congressional hearings on stabilizing the individual health insurance market. But she stressed that President Donald Trump’s threat to pull the plug on federal subsidies to insurers remains a huge concern. Alexander’s announcement on Tuesday that the Senate committee he chairs will hold hearings next month on the individual market “is a positive step in the right direction,” McPeak said. (Collins, 8/2)

The health industry is heading into a pivotal few weeks that will determine whether the White House keeps making billions in payments to insurers or whether Congress will take over responsibility for them—decisions that rest on complex political calculations. President Donald Trump regularly decries the “cost-sharing reduction” payments as insurer bailouts, but he has so far kept making them. Republicans in Congress sued President Barack Obama to end them, but many now hope Mr. Trump will continue them. And congressional Democrats, who openly favor the payments, failed to lock them in when they could. (Radnofsky and Hackman, 8/2)

Democratic and Republican U.S. governors on Wednesday urged the Trump administration, as well as Congress, to continue funding payments to health insurance companies that make Obamacare plans affordable, calling it critical to stabilizing the insurance marketplace. (Cornwell, 8/2)

Governors from both parties are calling on the Trump administration to fully fund key subsidies to insurers under ObamaCare. President Trump is threatening to cancel the payments, known as cost-sharing reductions (CSRs), as he talks of how ObamaCare will “implode.” (Weixel, 8/2)

Republican Sen. Lamar Alexander of Tennessee is promising bipartisan hearings after Labor Day to see if Congress can't come to some kind of agreement on how to stabilize the individual health insurance market. That's the market most affected by the Affordable Care Act and, not coincidentally, it's caught in the political crosshairs of congressional Republicans who want to get rid of it. (Ryssdal, 8/2)

President Donald Trump’s bold threat to push “Obamacare” into collapse may get harder to carry out after a new court ruling. The procedural decision late Tuesday by a federal appeals panel in Washington has implications for millions of consumers. The judges said that a group of states can defend the legality of government “cost-sharing” subsidies for copays and deductibles under the Affordable Care Act if the Trump administration decides to stop paying the money. (Alonso-Zaldivar, 8/2)

A three-judge panel for the U.S. Court of Appeals for the District of Columbia Circuit held that 16 state attorneys general may intervene in House v. Price because they showed a "substantial risk" that terminating the cost-sharing reduction payments, or CSRs, would "directly and imminently" cause an insurance premium hike and lead to more people becoming uninsured. (Livingston, 8/2)

Now that California, 16 other states and the District of Columbia have been given legal standing in a critical court appeal, California Attorney General Xavier Becerra said Wednesday they will fight to preserve the federal funds that underpin their Obamacare health exchanges if the Trump administration bows out of the lawsuit. ...In this legal case, Republicans in the U.S. House of Representatives filed suit in 2014 against then-Secretary of Health and Human Services Sylvia Burwell, asserting that she had overstepped her authority by appropriating billions of dollars to cover discounts that insurers were mandated to give low-income consumers under the Patient Protection and Affordable Care Act, commonly called Obamacare. (Anderson, 8/2)

The District of Columbia Court of Appeals ruled Tuesday evening that 16 attorneys general — including Maura Healey of Massachusetts — could intervene in a lawsuit involving those subsidies, known as cost-sharing reductions. That means the coalition of 15 Democratic states and Washington, D.C., can appeal a ruling or block a settlement in the suit. (Freyer, 8/2)

The administration has slowed a decision to hear from lawyers, who are studying how the payments could be ended and what legal liabilities the administration could face if the payments stop, according to administration officials. Lawyers and some administration officials have raised questions about ending the payments but are expected to offer an analysis later in August, West Wing officials said. One official said the analysis could arrive as soon as next week. A different official said the White House was in no hurry and wanted to consider all factors before making a decision. Another payment is due approximately Aug. 22. (Dawsey and Haberkorn, 8/2)

Health insurers have won powerful allies in a fight over federal subsidies that President Donald Trump has threatened to cancel for millions of people who buy insurance through the Affordable Care Act. A federal appeals court ruled late Tuesday that Democratic state attorneys general favoring the subsidies can join a court case brought by the Republican-led House of Representatives. That three-year-old challenge could determine the fate of those subsidies. (Hancock, 8/2)

Republican Gov. Paul LePage is blasting Maine's U.S. senators as "dangerous" over their votes that helped sink a GOP proposal to repeal President Barack Obama's Affordable Care Act. The governor targeted Republican Susan Collins and independent Angus King in an op-ed published Wednesday in the Wall Street Journal, writing that they "are worse than out of touch — they are downright dangerous." (Sharp, 8/2)

Frustrated Republicans vented their displeasure at House Speaker Paul Ryan on Wednesday during a town hall meeting at a wire manufacturer in the Wisconsin congressman’s district. Ryan hasn’t held a town hall meeting open to the general public since October 2015, but he does frequently take questions from employees following business tours. It was at an event like that at Banker Wire on Wednesday when Ryan got challenged, something that’s rarely happened to him at other similar events. (Bauer, 8/3)

Cory Gardner faced several questions about health care — and his votes last week to unwind the Affordable Care Act — during a telephone town hall that drew about 6,000 people Wednesday night, including a woman who accused the GOP senator of “voting against your constituents” and a man who said he was disappointed in Republicans. Gardner defended himself by saying that Obamacare has worked for some and failed others and that he wants to ensure the parts that function remain while fixing aspects of the law that have left people facing high costs. (Paul, 8/2)

Sen. John McCain (R-Ariz.) explained Wednesday that he voted against a scaled-down ObamaCare repeal bill last week because people in his home state would be deeply hurt by the measure. "Arizona was about to get screwed, if I may, under this plan," McCain told Phoenix-based radio host Mike Broomhead. (Beavers, 8/2)

Arizona Sen. John McCain said in a radio interview Wednesday that he hates the healthy diet his wife and daughter are forcing on him as he fights an aggressive form of brain cancer but expects to return to the Senate next month. (Christie, 8/2)

One of the remarkable features of covering the congressional battle over health care this year has been the way reporters pieced together a picture of what was happening from snippets of information extracted from members of Congress dashing through the Capitol. At times, I felt as if I were in a time machine — reliving, in reverse, my previous reporting for The New York Times on the laborious legislative process that produced the Affordable Care Act in 2009 and 2010. Reporters roamed the halls like hunters and sprang into action with voice recorders in hand when a senator emerged from the Senate chamber, an elevator or a subway car, or an unmarked hideaway office. (Pear, 8/2)

Molina Healthcare Inc. said Wednesday it will exit the Affordable Care Act's insurance marketplaces in Utah and Wisconsin by the end of this year, citing costs that contributed to hefty losses for the health insurer in the second quarter. (Veiga, 8/2)

Molina said it will leave the insurance exchanges in Utah and Wisconsin and scale back its presence in Washington state, and may pull out of more state marketplaces. It also said it is increasing exchange premiums 55% on average, partly due to lack of clarity around key federal payments. Molina is one of the largest marketplace insurers currently, with 949,000 enrollees across nine states. “We’re prepared to make hard decisions” about exchange participation, said Joseph White, chief financial officer and interim CEO, during a call with analysts. (Wilde Mathews, 8/2)

The company said it’s eliminating about 1,500 jobs as part of a restructuring plan that it hopes will save $300 million to $400 million by late next year. In the meantime, Molina withdrew its 2017 earnings outlook. The company also said that it will exit money-losing Affordable Care Act markets in Utah and Wisconsin for next year and increase rates sharply elsewhere. (Tracer, 8/2)

Molina’s second-quarter financial results appear to show a company facing significant challenges, even with its premium revenue rising to $4.74 billion in the second quarter of this year, compared with $4.03 billion in the year-earlier one. But the company reported a net loss of $4.10 per diluted share in the second quarter, compared with income of 58 cents per share in the same period last year. Molina retracted its full-year financial guidance for 2017, citing uncertainty about federal health policy, a company-wide restructuring plan and uncertain plan performance in a number of states. And, the insurer is laying off 10 percent of its employees as part of the restructuring. The company earlier this year underwent a leadership shake-up when CEO J. Mario Molina and his brother, Chief Financial Officer John C. Molina, were unexpectedly ousted. (Clason, 8/2)

Molina doesn’t disclose how many people are enrolled in its various health plans, but it covered about 55,000 people through individual health plans in Wisconsin last year, according to the state Office of the Commissioner of Insurance. (Boulton, 8/2)

The Cleveland Clinic and Molina Healthcare inked a deal that will give Medicaid patients access to the Clinic's health system. Starting Aug. 1, Medicaid patients on Molina's plan will be able to use Clinic services. (Christ, 8/2)

Anthem, which this year attracted 19 percent of the exchange’s 1.4 million enrollees, will only offer 2018 plans in Santa Clara County, five counties in the Central Valley, and 22 Northern California counties.​ Anthem’s decision to withdraw its health plans in California affects only the individual insurance market — both on and off the health-insurance exchange. (Seipel, 8/2)

California Senator Dianne Feinstein said Wednesday that she was “deeply concerned” by Anthem Blue Cross’s decision to reduce individual health plan coverage for some 150,000 Californians. ...In an email to KQED, Anthem Blue Cross representatives said the shrinking individual market and changes in federal guidance were the reasons behind its decision to cover fewer Californians this year. (Klivans, 8/2)

Bill Daitchman got some bad news this week: His insurer is breaking up with him. Daitchman and his wife, who own a graphic design business in Santa Cruz County, Calif., each pay $350 a month for a health insurance plan from Anthem Blue Cross on the Covered California exchange. But Anthem announced Tuesday it’s pulling out of most of the state’s individual markets, citing the uncertainty swirling around the Affordable Care Act. (Batolone, Gorman and Terhune, 8/2)

The federal government on Tuesday confirmed what many in New Hampshire have feared for months — premiums for individual health insurance policies sold on the Obamacare exchange at healthcare.gov will rise by 44 percent or more for coverage in 2018. “Today’s news about rates is alarming, especially for the 94,000 New Hampshire residents who obtain their insurance through the individual market, but unfortunately, it does not come as a surprise,” Insurance Commissioner Roger Sevigny said. (Solomon, 8/2)

Blue Cross Blue Shield of Wyoming is proposing to raise health insurance rates by 48 percent in the coming year. That would mainly impact the 28,000 Wyomingites who get their coverage via the Federal Health Insurance Exchange. (Beck, 8/2)

Ohio insurers want big premium hikes next year for individual health care policies in the Affordable Care Act market, with typical average increases of 20 percent or more. Their rate requests have not yet been granted, but federal and state filings show the extent of the hikes insurers say they want -- and need -- because of expectations of costs for medical care, prescription drugs and the premiums necessary to cover these and other expenses. (Koff, 8/2)

State legislators approved a law last year to allow Missouri’s insurance regulator to review price increases for health insurance plans. But the state decided to postpone the deadline to share those rates with the public, citing “several significant developments impacting the individual health insurance market.” (Bouscaren, 8/2)

Facing a shortened enrollment period, Connecticut’s health insurance exchange announced Wednesday it plans to scale back its two existing storefronts and redeploy resources to broaden its reach. ... The exchange is anxiously awaiting a critical decision from the White House that will influence whether the individual marketplace’s two insurers will offer plans again next year. (Constable, 8/2)

Opponents of abortion have had reason for optimism this year. With Republicans in control of the U.S. Capitol and a president who embraces their cause, access to the procedure has appeared in greater jeopardy than it has in years. (Zavis, 8/2)

Leading progressive groups issued a "statement of principles" Wednesday urging the Democratic Party to embrace abortion rights and to reject "pro-life" Democratic candidates in 2018. The statement comes after Democratic Congressional Campaign Committee Chairman Rep. Ben Ray Luján (N.M.) told The Hill the party wouldn't withhold financial support from Democratic candidates that oppose abortion rights. (Hellmann, 8/2)

Planned Parenthood’s Virginia affiliate plans to spend $3 million to help elect Democrat Ralph Northam as the state’s next governor. The organization’s Virginia political action committee, working with Northam, plans to deploy canvassers to knock on 300,000 doors, send mailers to 400,000 homes and run digital and radio ads. (Nirappil, 8/2)

The Trump administration’s proposed reversal of a requirement that health insurers cover contraception relies on the work of religious researchers who dispute a fundamental public health tenet — that easier access to birth control reduces the rate of unintended pregnancies. The proposed change to the Obama-era mandate leans heavily on the philosophy that increasing access to contraception will encourage sexual activity, while discounting newer, highly reliable forms of long-acting contraception that have been credited for reducing teen pregnancy and abortion. (Ebbert, 8/2)

For two years, lobbyists for doctors and their insurers met regularly around a conference table a few blocks from the Capitol to draft an overhaul of the nation’s medical malpractice laws. The resulting legislation proposed strict limits on damages for some plaintiffs and sharply lower fees for their attorneys. Last month, with no public hearings and few modifications, the House voted to approve the measure — outraging victims’ rights advocates, who accused lawmakers of acting in secret to slam the courtroom door on people who have been grievously injured by doctors. (Kindy, 8/1)

Scientists for the first time have successfully edited genes in human embryos to repair a common and serious disease-causing mutation, producing apparently healthy embryos, according to a study published on Wednesday. The research marks a major milestone and, while a long way from clinical use, it raises the prospect that gene editing may one day protect babies from a variety of hereditary conditions. (Belluck, 8/2)

This is the first time gene editing on human embryos has been conducted in the United States. Researchers said in interviews this week that they consider their work very basic. The embryos were allowed to grow for only a few days, and there was never any intention to implant them to create a pregnancy. But they also acknowledged that they will continue to move forward with the science, with the ultimate goal of being able to “correct” disease-causing genes in embryos that will develop into babies. (Cha, 8/2)

Scientists’ ultimate goal is to fix gene mutations that lead to debilitating or fatal diseases, and to prevent the propagation of those mutations to future generations. Study leader Shoukhrat Mitalipov, a biologist at OHSU, said the new findings might correct genetic variants that can cause breast and ovarian cancer, cystic fibrosis and muscular dystrophy in those who inherit them. (Healy, 8/2)

"Potentially, we're talking about thousands of genes and thousands of patients," says Paula Amato, an associate professor of obstetrics and gynecology at Oregon Health & Science University in Portland. She was a member of the scientific team from the U.S., China and South Korea. (Stein, 8/2)

The study results raise ethical questions because they involve changes to the human germ-line, the genes of sperm, eggs or embryos. Scientists and bioethicists have called for caution in editing the germ-line because such changes would not only alter the individual but also be passed to future generations. (Marcus, 8/2)

Creating “designer babies” with a revolutionary new genome-editing technique would be extremely difficult, according to the first U.S. experiment that tried to replace a disease-causing gene in a viable human embryo. Partial results of the study had leaked out last week, ahead of its publication in Nature on Wednesday, stirring critics’ fears that genes for desired traits — from HIV resistance to strong muscles — might soon be easily slipped into embryos. In fact, the researchers found the opposite: They were unable to insert a lab-made gene. (Begley, 8/2)

For the first time in the U.S., a human embryo has been successfully edited to correct an inherited condition. ... But the milestone raises significant scientific and ethical questions. (Sreenivasen, 8/2)

The Justice Department will dispatch 12 federal prosecutors to cities ravaged by addiction who will focus exclusively on investigating health care fraud and opioid scams that are fueling the nation's drug abuse epidemic, Attorney General Jeff Sessions said Wednesday. He unveiled the pilot program during a speech in hard-hit Ohio, where eight people a day die of accidental overdoses. (Welsh-Huggins, 8/2)

The Justice Department said Wednesday it is forming a unit that will use health-care fraud data to combat the illicit distribution of prescription opioids. The new unit, in the department’s criminal division, will mine data in an effort to ferret out medical professionals who are contributing to what Attorney General Jeff Sessions described as a prescription opioid epidemic in a speech Wednesday. (Wilber, 8/2)

If you have a surgery, you are likely to wind up with more opioid painkillers than you need. And a new paper suggests this excess supply might contribute to abuse and misuse of these addictive drugs. A review of six published studies in which patients reported they were prescribed opioids after surgery found most of them used none or only some of the pills, sometimes due to side effects. Significantly, more than 90 percent of the patients failed to dispose of their leftover medicines in recommended ways, according to the review published in JAMA Surgery. (Silverman, 8/2)

America’s opioid crisis is fueled by prescription painkillers. Medications such as oxycodone, fentanyl and morphine were responsible for nearly half of the 33,000 overdose deaths recorded in 2015, according to the Centers for Disease Control and Prevention. How did Americans get their hands on so many opioid pills? A new study suggests that surgical patients have plenty go to around. (Kaplan, 8/2)

s the country reckons with an unfolding opioid crisis, and officials from both parties talk about improving access to care, jails and prisons remain treatment deserts. Few facilities provide any addiction treatment, and when prisoners are released, they return to the same environments — and the same triggers — that fostered their addiction in the first place. Here, at its campus of squat brick buildings, the Rhode Island Department of Corrections is trying something different. Over the past year, it has expanded its so-called medication-assisted treatment program, becoming the first state system to offer such a broad range of therapies — including all three drugs approved to treat addiction — to its entire prison population. (Joseph, 8/3)

Philip Kirby says he first used heroin during a stint in a halfway house a few years ago, when he was 21 years old. He quickly formed a habit."You can't really dabble in it," he says. Late last year, Kirby was driving with drugs and a syringe in his car when he got pulled over. He went to jail for a few months on a separate charge before entering a drug court program in Hamilton County, Ind., north of Indianapolis. But before Kirby started, he says the court pressured him to get a shot of a drug called Vivitrol. (Harper, 8/3)

Hospitals, medical organizations and maternal safety groups are introducing a host of initiatives aimed at educating expectant and new mothers and improving how providers respond to emergencies. But as [Marie] McCausland's experience illustrates, self-advocacy is also critically important. (Gallardo, Martin and Montagne, 8/3)

Each year, superbugs -- viral bacterial infections resistant to common antibiotics -- infect more than two million Americans, killing at least 38,000. As the list of antibiotic-resistant bacteria grows, so have the extraordinary efforts to prevent the spread of infection from patient to patient. (O'Brien and Solman, 8/2)

For years, headlines have promised an imminent breakthrough in male contraception. Time and again, these efforts have fallen short. Last October, for instance, researchers reported that a hormone cocktail they’d been testing curbed sperm production and prevented pregnancies. But they’d had to halt the study early because men were reporting troubling side effects, including mood changes and depression. ...Men have only two choices: condoms, which have a real-world failure rate of about 18 percent, and vasectomy, a surgical procedure that’s often permanent. A new contraceptive could give men more control over their reproductive futures, alleviate a burden that’s overwhelmingly borne by women, and reduce the rate of unintended pregnancies, which is about 40 percent worldwide, according to the nonprofit Guttmacher Institute. (Anthes, 8/3)

While President Donald Trump has thrust transgender people back into the conflict between conservative and liberal values in the United States, geneticists are quietly working on a major research effort to unlock the secrets of gender identity. (Trotta, 8/3)

Periodontal disease in older women is associated with an increased risk for cancer, a new study concludes. Previous studies have suggested a link, but this new analysis, in Cancer Epidemiology, Biomarkers & Prevention, offers additional evidence on specific cancers. (Bakalar, 8/2)

Allergy sufferers know the drill: Eyes that itch and water; sneezes that won’t stop; the fear that a hidden morsel of peanut will trigger a life-or-death crisis. Over-the-counter drugs and allergy shots deliver relief to some people, but not others. Now, a discovery by Seattle researchers holds out the hope of better diagnosis and treatment for allergies of all types — and may even lead to a cure someday. (Doughton, 8/2)

A hundred years ago, it was all the rage; in addition to the Institute of Ray Therapy, London also boasted a Municipal Sunlight Clinic. The concept seems to be coming back in vogue now; celebrities from Jennifer Aniston to Lady Gaga have been touting the benefits of sweating it out under infrared lights in a steamy sauna. A little digging through old medical journals (and, yes, modern search engines) turned up an array of therapies based on artificial light. Here, some of our favorites uses for the humble lamp. (Samuel, 8/3)

Maine will become the fourth state to raise the smoking age to 21 and will adopt stricter regulations on the sale of electronic cigarettes after lawmakers on Wednesday voted overwhelmingly to override the governor’s veto. Gov. Paul R. LePage, a Republican, had called the bill an attempt to “social engineer our lives,” saying that if 18-year-olds can join the military and fight in wars, they should be allowed to decide on their own whether to use tobacco. (Haag, 8/2)

Florida veterans will have more medical centers at which to receive mental health and outpatient services after the U.S. Senate late Tuesday unanimously approved legislation authorizing seven new major VA medical facilities in the state. The new Florida VA facilities will be in Daytona Beach, Jacksonville, Ocala, Tampa, Lakeland and two in Gainesville, according to a written statement from U.S. Sen. Bill Nelson, D-Florida, who co-sponsored legislation authorizing the new facilities. (Chang, 8/2)

From rehab centers to burger joints, more than 100 businesses, unions, trade groups and other entities weighed in on California’s universal healthcare legislation during the first half of 2017, according to new state lobbying disclosures. The filings, covering spending on lobbyists through June 30, underscore how Senate Bill 562 had the attention of special interests based in more than a dozen states as the measure advanced through the state Senate. (Miller, 8/2)

Rhode Island has enacted a law that requires insurers to cover "fertility preservation" for patients who undergo medical treatments that could leave them sterile. (8/2)

Victims’ rights groups estimate that hundreds of thousands of rape kits remain untested at police departments and crime lab storage facilities nationwide—thus far a partial inventory of California by the End the Backlog Initiative has identified some 9,000 untested kits. But the precise number remains a mystery because most states, including California, don’t inventory rape kits, and rape survivors sometimes struggle to get information about their own cases. (Young, 8/3)

Evergreen Health Inc. has been formally ordered into the state’s receivership program after its investors backed out last month, leaving the young health insurance company financially unstable. On Wednesday, Baltimore Circuit Judge Yolanda Tanner ordered Risk & Regulatory Consulting LLC, a professional services firm in Connecticut, to take control of Evergreen on behalf of the Maryland Insurance Administration and under supervision of the court. (Gantz, 8/2)

The once-anonymous patient at the center of a whistleblower action filed against KU Hospital by one of its own pathologists is now suing the hospital herself for fraud, negligence and civil conspiracy. Like the whistleblower case, the lawsuit by Wendy Ann Noon Berner accuses the hospital and the now-former chair of its pathology department of misdiagnosing her with pancreatic cancer and then covering up the misdiagnosis after parts of her pancreas and other body parts were surgically removed. (Margolies, 8/2)

The Governor and Executive Council approved an independent review of staffing levels at the New Hampshire Hospital on Wednesday as part of a settlement agreement with Dartmouth-Hitchcock over a contract dispute. The no-bid $85,000 contract with Joint Commission Resources will fund a review of the quality of care at the hospital from Nov. 1, 2016, to April 30, 2017. (Tuohy, 8/2)

San Mateo County Health officials have issued a reminder to parents to make sure that their children’s vaccines are current before the first day of school or child care. California law requires that students receive certain vaccines or they won’t be permitted to attend school or child care, unless they have a valid exemption, said Diana Rohini LaVigne, public information officer for the San Mateo County Health System. (Orr, 8/2)

The Texas Department of Agriculture administers a summer meals program providing federal reimbursement for school districts and nonprofits to give out meals to hungry children — but in recent years, the program has failed to draw students in, with July participation rates crashing by 20 percent in 2016. Experts and even the state have had trouble pinpointing exactly why, but they cite lack of transportation as the main reason rural Texas kids can't reach free summer meals available at hundreds of locations across the state. (Swaby, 8/3)

As an attorney specializing in elder law, Jerry Rothkoff sees many adult children at their wits’ ends about their parents’ driving. It’s “devastating” for a parent to lose the ability to drive, he said, but also terrifying to know your parent is a danger on the road. Here’s his advice: Make somebody else the bad guy. Rothkoff has geriatric social workers on his staff who can help, but the most effective third parties, he said, are doctors and specially trained occupational therapists who can evaluate drivers with disabilities. (Burling, 8/4)

Research shows that tackling tobacco use requires a four-pronged approach: Tax it. Restrict it. Prevent it. Help people quit it. Pennsylvania and New Jersey are strong on the taxation piece, but both states could do more on the other prongs, according to a new report by the American Cancer Society’s Cancer Action Network. “On tobacco control, I’d say we have a mixed bag. There is certainly room for improvement,” said Diane Phillips, who directs the network’s advocacy and lobbying efforts in the Keystone State. (McCullough, 8/3)

As of Tuesday afternoon, the House and the Senate had each voted out bills that would put $212 million into the Teacher Retirement System to make the TRS-CARE health insurance more affordable for retired teachers over the next two years, lowering their deductibles and premiums. The one-time influx of money would temporarily bolster a state-run program that has been faltering for years, with the state keeping base funding stagnant despite the rising costs of health care. (Swaby, 8/3)

Last week, officials with the Community Center of La Cañada Flintridge installed a device they hope they never have to use — an automated external defibrillator (AED), used in cases of cardiac arrest to assist CPR and help hearts find lost rhythms. The cabinet containing the unit is located next to the center’s office counter, high up on a wall where curious, young hands cannot likely reach. A blinking green light shows the battery is functioning, and an alarm sounds whenever the cabinet door is opened. (Cardine, 8/2)

The Senate GOP’s health failure is a political debacle that will compound for years, and the first predictable fallout is already here: Republicans in Congress are under pressure to bail out the Obama Care exchanges, even as Donald Trump threatens to let them collapse. The GOP needs to get at least some reform in return if it’s going to save Democrats and insurers from their own failed policies. At immediate issue are government payments that insurers receive to offset the costs of mandated benefits and other rules for Affordable Care Act customers. (8/2)

President Trump and other top Republicans are trotting out a new phrase in their rhetorical war on the Affordable Care Act: “insurer bailout.” That’s how they want you to think about a number of the steps Congress may need to take to stabilize the Obamacare insurance markets that are struggling in some states. ... But contrary to some critics’ rhetoric, reimbursing insurers is no more a “bailout” than it is when the Department of Transportation pays for the road and bridge repairs it orders. Insurers provide the subsidies because Congress ordered them to, with the promise that they would be repaid. (Jon Healey, 8/2)

Something unusual and important is happening in Congress: Republicans and Democrats are working together to improve the health care system. And they’re doing so in defiance of President Trump, who appears determined to sabotage the Affordable Care Act and the health insurance of millions of people. (8/2)

The president seems convinced that he can survive whatever comes his way as long as he keeps his much-celebrated political base with him. But this is not as easy as it sounds for either Trump or his party because his base is fundamentally divided. Nothing illustrated this more dramatically than the health-care showdown. Trump’s rhetoric about the Affordable Care Act during last year’s campaign should have been a tipoff to the dilemma both he and conservative politicians confront now. On the one hand, he roundly denounced Obamacare, which made right-wing ideologues happy. But he also regularly promised an alternative that would be more, not less, generous in helping Americans of modest means. (E.J. Dionne Jr. , 8/2)

Donald Trump wants you to pay more for your health insurance. And if you don’t let him get away with it, he’ll make you pay more for your health insurance. Higher premiums or higher premiums – Trump lets you have your pick. This pouty lust for vengeance on the American people’s wallets and health care may seem unique to the pouty president, but it has been the prime directive of the Republican Party since the Affordable Care Act became law. What’s different is Trump’s willingness to crow about the health care sabotage that has become his party’s trademark move. (Jason Sattler, 8/2)

Despite the resolve of Republicans in Congress and President Trump to destroy the Affordable Care Act, California — with 11 insurers in its state exchange — continues to have a stable health care market that is far superior to what the state would have today without Obamacare in place. The bipartisan work by moderates in Congress to repair the ACA makes far more sense than Republicans’ flailing attempts to repeal and replace it with an alternative system that covers fewer people at higher cost. (8/2)

For all the complexities of the health care debate, the root issue is remarkably simple: Either America is going to provide an infinite amount of medical care, or it is not. If it does not, then it is going to ration medical care one of two ways: through market forces (which mostly means prices), or through bureaucratic edicts. (8/2)

With the clock ticking on insurer decisions for plans and rates for 2018, Congress must find agreeable solutions to provide greater stability and relief. We cannot sit by and watch the individual market collapse. (Rep. Martha McSally (R-Ariz.), 8/2)

Members of Arizona’s congressional delegation – starting with Sen. John McCain – show a keen understanding of the lessons from the failed effort to repeal Obamacare. They know that what’s needed now is a bipartisan push to fix the law and impose some stability on the markets. (8/2)

Health care reform is one of the most difficult and thankless tasks policymakers can take on. But this week's preview of 2018 coverage costs on Minnesota's individual health insurance market shows that progress is possible when politicians set aside ideology and focus on pragmatic fixes that put consumers first. (8/2)

After seven years of futile bills to repeal Obamacare passing the House and Senate and being (expectedly) vetoed by President Barack Obama, the Republicans succumbed to the K Street lobbyists and others by relying on certain Republican senators to vote it down. Foremost among them was Sen. John McCain, who made a point of traveling back to D.C. after surgery and a diagnosis of aggressive brain cancer to figuratively raise his middle finger to President Donald Trump and cast the death blow vote. But most galling to me were the handful of Republican Senators who voted for the above-mentioned bills and then, when it really mattered and was not just an empty campaign promise, changed course and voted against the Senate bill last week. (Don Loucks, 8/3)

The health care issue is raging in the headlines and if you’re following the roller-coaster ride in Congress, regardless of party affiliation, you have to be shaking your head. There is a much better approach to all of this, and the Medicare model is a sensible place to begin. ... A “Medicare for All” or “Single Payer” program makes the most sense and is possible if people demand it. (John H. Clark, 8/1)

Democrats will fund anti-choice candidates in conservative districts, Representative Ben Ray Luján, chairman of the Democratic Congressional Campaign Committee, said in an interview this week, citing the party’s need to build “a broad coalition” to win control of Congress in 2018. ... I am prepared to make leviathan compromises to pull us back from that brink. But there is no recognizable version of the Democratic Party that does not fight unequivocally against half its constituents’ being stripped of ownership of their own bodies and lives. This issue represents everything Democrats purport to stand for. (Lindy West, 8/2)

[W]hen Democrats or others on the left bash the party for funding Democratic candidates with whom they disagree on abortion, they miss a key point: Democrats who oppose abortion aren’t like Republicans who oppose abortion. Not only are their priorities different, so are their policies. While Republicans who oppose abortion usually aim simply at banning the practice or making it difficult, Democrats who oppose abortion tend to take a whole-life approach, and to focus especially on reducing incentives to have abortions, rather than creating penalties. (Kristen Day, 8/3)

Most Democratic congressional candidates will happily declare themselves pro-choice (even if they hedge by adding that they are “personally pro-life”). But suppose a Democratic candidate is “pro-life” to the point of opposing legal abortion but agrees with the party’s other priorities? Should that candidate be denied funding — and the party a potential majority — for the sake of pro-choice purity? The party’s strategists seem to think not. It’s hard to disagree. (Michael McGough, 8/2)

The best ideas in the Democrats' proposal are investing in infrastructure and allowing Medicare to negotiate with drug makers over the prices it plays. But infrastructure spending is not strictly a Democratic idea, and the drug proposal is not new. It didn't help Democrats in 2014 and 2016, and it’s hard to see it having much impact in 2018. (8/2)

The news that researchers have carried out the first known attempt to create genetically modified human embryos is another signpost in an astounding revolution unfolding before our eyes. This is not the first breakthrough nor will it be the last, but it should serve as a reminder — an unmistakable one — that this realm of scientific inquiry, manipulating the tiny building blocks of life, demands caution as well as enthusiasm and encouragement. (8/2)

Two of the greatest sources of frustration for Medicare recipients and their families are hospital observation status and the government’s incredibly complex appeals process. On Monday, a federal judge in Hartford, CT certified a class action lawsuit aimed at addressing both. The judge’s eventual decision in the case (Alexander v. Price) could have far-reaching effects on both the burgeoning use of observation status in hospitals and the rights of people getting Medicare to dispute decisions about their care. (Howard Gleckman, 8/2)

West Virginia has the highest drug overdose rate in the country. According to the Centers for Disease Control and Prevention, opioid overdoses — both prescription and not — make up the majority of those deaths. ... On Monday, President Trump’s opioid commission made its first set of recommendations for how to get us out. It urged the president to declare the opioid epidemic a national emergency, and suggested a number of other common-sense measures that I hope will bring my state and so many others relief. But to this West Virginian, it was appallingly incomplete. (Cassady Rosenblum, 8/2)

Believers in the quest to make America great again should consider where there’s evidence things are going down the tubes. There’s hardly a more dismal example than the national decline in sperm production. Last week, scientists published a study confirming that sperm counts are half what they were in the early 1970s -- and not just in America, but in Europe, Australia and New Zealand, too. The more alarmist accounts warned that the human race is teetering on the brink of extinction. The good news is that our extinction is probably about as imminent as that of cockroaches. But the bad news is that something disturbing is going on. (Faye Flam, 8/1)

When my bulimia was at its worst, I used to see the ice cream I’d purged in the kitchen sink and think of all the money I’d vomited over the years. Now I realize it costs just as much to manage a mental illness as it does to be sick. Last year, Health Affairs reported mental disorders cost the United States more than any other medical condition: in 2013, $203 billion. That $203 billion accounts for psychologists, psychiatrists, inpatient and outpatient treatment, hypnosis, medication, but what about the staggering expenses the figure could never include, the private hacks people like me make to MacGyver life? Headphones. Noobie Soothie. One-thousand-dollar replacement tickets. (JoAnna Novak, 8/2)

Every school that takes part in federal school nutrition programs is required to update their wellness policy this year with comprehensive goals, including eliminating junk food from the school day. Today, 40 percent of Sacramento-area children suffer from childhood obesity and Type 2 diabetes, asthma and hypertension also are increasing. (Amber Stott and Debra Oto-Kent, 8/2)