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Robert Kingsland will have to pay hundreds of dollars if he goes without insurance next year, even though Congress recently repealed the Affordable Care Act’s penalty for not having coverage. That is because his home state of New Jersey just imposed a fine of its own for letting insurance lapse. In California, Aaron Brown’s small business association likely won’t be able to provide the cheaper health policies promoted by the Trump administration. California banned the creation of many associations that offer such policies. (Armour, 7/18)

President Donald Trump handed an influential business advocacy group what should have been a historic lobbying victory when he recently rolled out new rules encouraging small businesses to band together to offer health insurance. Trump, who’s touted the expansion of so-called association health plans as a key plank in his strategy to tear down Obamacare, even announced the rules at the 75th anniversary party of the National Federation of Independent Business last month, claiming the group’s members will save “massive amounts of money” and have better care if they join forces to offer coverage to workers. (Cancryn, 7/19)

A U.S. judge in San Francisco has thrown out a lawsuit over the Trump administration's decision to cut Affordable Care Act subsidies. The ruling by Judge Vince Chhabria on Wednesday came after California and other states that sued said a workaround was largely succeeding in protecting consumers from higher costs. (7/18)

Ahead of Robert Wilkie’s likely confirmation to lead the Department of Veterans Affairs, Trump loyalists at the agency are taking aggressive steps to purge or reassign staff members perceived to be disloyal to President Trump and his agenda for veterans, according to multiple people familiar with the moves. The transfers include more than a dozen career civil servants who have been moved from the leadership suite at VA headquarters and reassigned to lower-visibility roles. The employees served agency leaders, some dating back more than two decades, in crucial support roles that help a new secretary. (Rein, 7/18)

The department is currently run by Acting Secretary Peter O’Rourke and has been without a Senate-confirmed leader for months. Robert Wilkie, a former acting secretary who also served as the under secretary of defense for personnel and readiness, has been nominated for the top job by President Trump. If confirmed, Mr. Wilkie would take over the second-largest department in the federal government, overseeing a 360,000-person work force. (Fortin, 7/19)

Health and Human Services Secretary Alex Azar, whose department has recently become entangled in the fight over separating undocumented children from their families, is pushing to keep focus on his agenda. Mr. Azar took office in January with a set of explicit goals after his predecessor, Dr. Tom Price, resigned under an ethics cloud. Since HHS is charged with caring for underage illegal immigrants, the agency has been pulled into the immigration debate. Now Mr. Azar is trying to keep his agenda moving ahead by relying on a close-knit team of top policy advisers. (Armour, 7/18)

Kaiser Health News: From Crib To Court: Trump Administration Summons Immigrant Infants

The Trump administration has summoned at least 70 children under 1 year old to immigration court for their own deportation proceedings since Oct. 1, according to new Justice Department data provided exclusively to Kaiser Health News. These children, who may be staying with a sponsor or in a foster care arrangement, need frequent touching and bonding with a parent and naps every few hours, and some are of breastfeeding age, medical experts say. They’re unable to speak and still learning when it’s day versus night. (Jewett and Luthra, 7/18)

House Democrats are launching an official Medicare for All Caucus in an effort to promote a single-payer health-care bill. The caucus, which will officially be announced Thursday, comes as an increasingly larger number of Democrats warm to the idea. The idea, championed by Sen. Bernie Sanders (I-Vt.), is now favored by many potential 2020 Democratic presidential contenders. (Weixel, 7/18)

Dr. Atul Gawande is hitting the road. In one of his first actions as a CEO, Gawande is planning to travel across the country to meet with the employees he will serve through the health care venture being formed by Amazon, JPMorgan Chase, and Berkshire Hathaway. (Ross and Farber, 7/19)

UnitedHealth Group Inc. is among suitors exploring an acquisition of Tenet Healthcare Corp.’s health-care-management subsidiary, according to people familiar with the matter, as the industry giant pursues further expansion. Tenet, one of the largest U.S. hospital companies, has said it would weigh a sale of the unit, Conifer Health Solutions, which provides services to hospitals and physician groups. Tenet said it would make a decision in the first half of 2018 on Conifer, which accounted for about 8% of its revenue last year. (Mattioli and Evans, 7/18)

Massachusetts healthcare spending would increase by up to $251 million per year if regulators approve the planned merger between Beth Israel Deaconess Medical Center, Lahey Health and several other hospital systems to create the second-largest healthcare network in the state, according to a preliminary report from the Massachusetts Health Policy Commission. The deal involves Beth Israel in Boston and Lahey in Burlington, as well as Boston's New England Baptist Hospital, Mount Auburn Hospital in Cambridge and Anna Jaques Hospital in Newburyport. (Kacik, 7/18)

A state watchdog agency on Wednesday delivered a setback to the proposed union of Beth Israel Deaconess Medical Center and Lahey Health, warning that their sprawling merger could sharply raise health care costs statewide. The new hospital system could command substantially higher payments from insurance companies, boosting medical spending by as much as $191.3 million a year for inpatient, outpatient, and primary care services, the Massachusetts Health Policy Commission said. (Dayal McCluskey, 7/18)

Community Health Systems announced Wednesday it plans to sell two of its Arkansas hospitals and their associated operations to not-for-profit Baptist Health in Little Rock. The Franklin, Tenn.-based for-profit hospital chain has signed a definitive agreement to sell 492-bed Sparks Regional Medical Center in Fort Smith and 103-bed Sparks Medical Center in Van Buren, which together with their physician clinics and outpatient services comprise Sparks Health System. (Bannow, 7/18)

A new survey of hospital administrators shows their inpatient volumes continue to slump as patients flock to cheaper outpatient settings for services like heart surgeries, hip replacements and urological procedures. Leerink Partners, the investment bank that released the survey of nearly 50 mostly not-for-profit hospital administrators, wrote that its results are "modestly positive" for hospitals, whose executives reported inpatient utilization increased 0.7% in the second quarter of 2018, down from 1% in the second quarter of 2017. Meanwhile, the survey found ambulatory surgery center utilization was up 1.4% in the second quarter, down from 2.2% at the same time in 2017. Outpatient utilization growth fell to 1.1% from 2.5% in 2017. (Bannow, 7/16)

It’s not just for fine lines and wrinkles: Botox is showing promise as a treatment for chronic pain. Or, rather, the botulinum toxin that’s used commercially to erase signs of aging is also being studied as a potential alternative to opioid drugs. A new paper in Science shows that a single dose of botulinum toxin, injected into the spinal cavity, prompted several weeks of pain relief from chronic and neuropathic pain — in mice. (Keshavan, 7/18)

D.C. Fire and EMS medics have transported about 100 overdose patients in the past four days with symptoms that appear to be consistent with K2, or synthetic marijuana, officials said Wednesday. Medics evaluated and transported about 10 people to hospitals Wednesday, including four patients who were found unconscious and unresponsive at 3rd and E Streets NW, about two blocks from D.C. police headquarters, Chief Gregory Dean said in an interview. (Williams, 7/18)

It was a rare moment of optimism, amid all the bad news about the opioid epidemic, as leaders on the front line of the crisis gathered at Manchester Health Department Wednesday to talk about what’s going well. Dr. Joseph Pepe, president and CEO of CMC Healthcare System, said it will take a collaborative approach to address the issues that led to the epidemic. “This truly is a health crisis, and it belongs to all of us, and it’s going to take all of us to solve it,” he said. (Wickham, 7/18)

As the country struggles with an opioid epidemic that now kills tens of thousands of people each year, a new downtown St. Paul syringe exchange is a sign that some local governments are embracing once controversial measures in an effort to keep people who inject drugs as healthy as possible. (Collins, 7/18)

Families accepted into Amethyst Place get case managers and on-site therapy in a supervised, drug-free environment. The women get individual treatment plans and help getting an education or finding a job. ... Right now, the program takes in people from all over the metro, and the increasing demand has created a waiting list that Davis said stretches three to six months. (Marso, 7/19)

Deaths from cirrhosis and liver cancer are rising dramatically in the United States. From 1999 to 2016, annual cirrhosis deaths increased by 65 percent, to 34,174, according to a study published in the journal BMJ. The largest increases were related to alcoholic cirrhosis among people ages 25 to 34 years old. (Bakalar, 7/18)

Over the past decade, people ages 25 to 34 had the highest increase in cirrhosis deaths — an average of 10.5 percent per year — of the demographic groups examined, researchers reported. The study suggests that a new generation of Americans is being afflicted "by alcohol misuse and its complications,” said lead author Elliot Tapper, a liver specialist at the University of Michigan. Tapper said people are at risk of life-threatening cirrhosis if they drink several drinks a night or have multiple nights of binge drinking — more than four or five drinks per sitting — per week. Women tend to be less tolerant of alcohol and their livers more sensitive to damage. (Furby, 7/18)

Dr. Elliot Tapper has treated a lot of patients, but this one stood out. "His whole body was yellow," Tapper remembers. "He could hardly move. It was difficult for him to breathe, and he wasn't eating anything." The patient was suffering from chronic liver disease. After years of alcohol use, his liver had stopped filtering his blood. Bilirubin, a yellowish waste compound, was building up in his body and changing his skin color. Disturbing to Tapper, the man was only in his mid-30s – much younger than most liver disease patients. (Chisholm, 7/18)

Women who have given birth five or more times may be 70% more likely to develop Alzheimer's later in life than those who have fewer births, according to a new study of more than 3,500 women in South Korea and Greece. Even women without dementia who had given birth five or more times scored lower on a commonly used cognitive test than those with fewer children. (LaMotte, 7/18)

The kids aren’t kids anymore. And they’re still all right. The children of a first generation of lesbian women to take family-building into their own hands and conceive children through sperm donation are young adults now. And on Wednesday, the New England Journal of Medicine published new findings from the first study to comprehensively track those children’s mental health trajectories and compare them to those of kids in other U.S. households.y (Healy, 7/18)

Now it's a certain pasta salad that consumers shouldn't be eating. Consumers should avoid a spring pasta salad sold in 244 of Hy-Vee grocery stores in Iowa, Illinois, Missouri, Kansas, Nebraska, South Dakota, Minnesota and Wisconsin, according to federal health officials. Of the 21 people who have been sickened thus far by salmonella infections linked to the salad, five have been hospitalized. No deaths have been reported. (Sun, 7/18)

The incidence of heart failure has declined overall in both sexes in recent years and remains higher in men. But women are more likely to die from the disease. A study in the Canadian Medical Association Journal included 90,707 new diagnoses of heart failure among Ontario residents from 2009 to 2014. Almost 17 percent of women died within a year of follow-up, compared with just under 15 percent of men. Rates of hospitalization decreased over the study period in men and increased in women. (Bakalar, 7/18)

Growing up with a working mom may have some benefits for both daughters and sons later in life. A team of researchers from the United States and the United Kingdom analyzed data on more than 100,000 men and women across 29 countries to determine whether a mother's employment status has any link to her children's outcomes in adulthood. (Howard, 7/18)

A new study published in JAMA Internal Medicine has found urgent care centers are prescribing antibiotics to nearly half of patients with colds or the flu. Generally antibiotics are effective against bacterial infections like pneumonia. ... Medical researchers worry inappropriate prescribing of antibiotics can harm individual patients and contribute to the growing problem of bacterial resistance or what’s commonly called super bugs. (Gorenstein, 7/18)

A New Zealand firm that let its employees work four days a week while being paid for five says the experiment was so successful that it hoped to make the change permanent. The firm, Perpetual Guardian, which manages trusts, wills and estates, found the change actually boosted productivity among its 240 employees, who said they spent more time with their families, exercising, cooking, and working in their gardens. (Graham-McLay, 7/19)

In a sign that Representative Jim Jordan is unlikely to shake a sexual misconduct scandal anytime soon, five former wrestlers sued Ohio State University this week, accusing university officials of knowing that a team doctor was abusing student athletes and doing nothing to stop him. One of the lawsuits specifically mentions Mr. Jordan, Republican of Ohio, who served as the wrestling team’s assistant coach in the late 1980s and early 1990s, citing news reports that wrestlers had informed him of the abuse. Lawyers pursuing both cases say they expect to call the influential conservative as a witness. (Edmondson, 7/18)

U.S. Rep. Jim Jordan, who used to coach wrestling at Ohio State University, was interviewed by a law firm investigating allegations that a now-dead team doctor sexually abused male athletes there decades ago, his spokesman confirmed Wednesday. The Ohio Republican spoke Monday morning with the firm looking into allegations against Dr. Richard Strauss and how the school responded to any complaints about Strauss, said spokesman Ian Fury, who declined to discuss details of the conversation. (Franko, 7/18)

Retired Air Force Colonel David Antoon agreed to pay $100 to settle what were felony charges for emailing his former Cleveland Clinic surgeon articles the doctor found threatening and posting a list on Yelp of all the surgeries the urologist had scheduled at the same time as the one that left Antoon incontinent and impotent a decade ago. He faced up to a year in prison. Antoon's 10-year crusade against the Cleveland Clinic and his urologist is unusual for its length and intensity, as is the extent to which Cleveland Clinic urologist Jihad Kaouk was able to convince police and prosecutors to advocate on his behalf. (O'Donnell and Alltucker, 7/18)

Philadelphia's tax on soda and other sweetened drinks was upheld on Wednesday when the state's highest court rejected a challenge by merchants and the beverage industry. The Supreme Court ruled the 1.5-cent-per-ounce (per 28 grams) levy is aimed at distributors and dealers and does not illegally duplicate another tax. The four-justice majority said the state taxes sales at the retail level, a cost that falls directly on consumers, but the beverage tax applies to distributor and dealer-level transactions. (7/18)

Restaurants in Baltimore are now officially barred from including sodas and other sugary drinks on kids' menus, according to a city ordinance that went into effect Wednesday. Baltimore is now the biggest U.S. city and the first on the East Coast to pass this kind of measure, said Shawn McIntosh, director of the Sugar Free Kids Maryland advocacy group. Seven California cities and Lafayette, Colorado, have enacted similar ordinances, according to health officials. (7/18)

State lawmakers and advocates pushing to legalize marijuana this year aren’t just touting legalization as a way to raise tax revenue and regulate an underground pot market. They’re also talking about fixing a broken criminal justice system and reinvesting in poor and minority communities that have been battered by decades of the government’s war on drugs. The focus on justice and equity has sharpened over time, longtime pot advocates say, as it’s become clear that such issues should be addressed and that doing so won’t alienate voters — most of whom, polls consistently show, support legal marijuana. Civil rights groups also have raised their voices in legalization discussions. (Quinton, 7/19)

Oregon State University researchers found that Oregon college students, including those under 21, were much more likely to use marijuana after recreational use became legal, according to a study published this week. Most of the increase in the post-legalization period was among students who reported using marijuana one to five times a month, not among heavy users, the study found. (Voorhees, 7/18)

Massachusetts is one of 10 states that allow people to use marijuana recreationally. But with legalization comes, well, legislation — including standards for safety testing. Only one lab has completed the application for a license from the state government to test weed for microbial and other contaminants for recreational sales. The Massachusetts Cannabis Control Commission is expected to vote on that application later this month. (Sheridan, 7/19)

Oklahoma's Board of Health overstepped its authority with several of the emergency rules on medical marijuana it adopted last week, Oklahoma Attorney General Mike Hunter wrote Wednesday in a letter to the head of the agency. In the letter to Interim Commissioner of Health Tom Bates, Hunter specifically cites last-minute changes the nine-member board approved last week that prohibit the sale of smokable marijuana and require a pharmacist at every dispensary. (7/18)

Enquirer research suggests at least three out of 10 Ohioans endure one of the 21 medical conditions that under state law can be treated with medical marijuana. That could be 3.5 million Ohioans - about ten times as many as the state has estimated will use the program. (Saker, 7/18)

Surterra, one of the state’s largest medical marijuana treatment centers, has been forced to stop processing cannabis — halting its production of new items — after it failed to meet a food safety inspection deadline in a little-noticed provision of state law last week. The requirement, which mandates that medical marijuana treatment centers complete third-party inspections in the first year to ensure “good manufacturing practices,” caught several businesses by surprise earlier this month when the Department of Health indicated that it was enforcing the provision in letters sent out July 6. (Koh, 7/18)

Surterra, which was one of the first businesses in the state allowed to dispense medical marijuana, operates eight locations across in the state and the only physical dispensaries in Miami Beach, North Port, Largo and Deltona. Its reach is outpaced only by Trulieve, which has dispensaries in 15 cities. "Surterra will comply with all of the regulations set forth by the Department of Health in order to ensure that Floridians continue to receive the safest, most naturally derived treatments to enable health and well-being, as recommended by a doctor," said company spokeswoman Kim Hawkes in a statement. (Koh, 7/18)

For decades, some New York City workers in “physically taxing” jobs were eligible to retire at age 50, after 25 years of service, and start collecting full pensions. More than 380 job titles — from window cleaner to plumber to exterminator — qualified for the “physically taxing” designation before the city ended the program for new employees in 2012. The New York State Nurses Association felt that nurses deserved to be on the list of mostly male-dominated professions, created for city employees in strenuous jobs who might not be able to work until the usual retirement age, which ranges from 55 to 62. So starting in 2004, the group asked the city to include nurses at city hospitals. The city refused three times. (Pager, 7/18)

These “age-tech” pioneers are part of a Massachusetts cluster of entrepreneurs who are applying the state’s potent mix of brainpower and technology prowess to an ancient problem: easing the burdens of growing old. Government and business leaders believe the emerging industry could have huge potential for the state’s economy, and for aging populations around the world. (Weisman, 7/18)

Members of a special Texas Senate committee devoted to preventing school violence acknowledged in a hearing Wednesday the importance of school counseling and mental health care, but questioned whether it's financially feasible to expand those services statewide. In the third of its four scheduled meetings, the Select Committee on Violence in Schools and School Security looked at possible contributors to violence ranging from social media to video games to shortages of school counselors in the state. (Choi, 7/18)

Federal charges were filed Wednesday against 15 people allegedly involved in a drug-trafficking ring linked to three deaths and centered at the troubled Clinton-Peabody public housing complex just south of downtown. “I believe that the drug distribution organization operating at Clinton-Peabody has been dismantled this morning,” U.S. Attorney Jeff Jensen said in an emailed statement about the case. “The fentanyl dealt by this organization is literally poison.” (Patrick, 7/18)

A growing number of pediatric and primary care clinics in Minnesota are using children’s books to improve health care and enhance child development. The physicians believe they can have a positive and lasting impact on brain development during the critical first three years of a child’s life. That’s before many children go to day care or preschool — and a period when pediatricians have particular access. (Howatt, 7/18)

The state suspended the license of a private company operating a youth detention facility Monday after staff lost control of teen girls, according to state records reviewed by the Contact7 investigators. Rite of Passage, Inc. operated the Betty K. Marler Youth Service Center at West Hampden Avenue and South Wadsworth Boulevard until the state determined the youth detained there were no longer safe. (Larson, 7/18)

About 30 people living near the chemical plant south of Fayetteville will have their blood and urine tested for persistent industrial chemicals, state officials said Tuesday. The plant has been found to have released contaminants into the air and water. But the people to be tested are not downstream residents whose drinking water is drawn from the Cape Fear River, where DuPont spinoff Chemours has been releasing GenX and other suspect per- and polyfluoroalkyl substances for decades. (Hoban, 7/19)

Going through a slideshow of different graphs and charts, he told top health officials last month that the number of reported cases is going down. The city was seeing up to four new hep A infections per day in April whereas the latest statistics show a decrease of almost 50 percent in June. (Bailey, 7/18)

A coalition of religious and human rights groups called on the Virginia Board of Corrections to investigate the use of solitary confinement in jails, arguing the state needs facts rather than anecdotal evidence. ...There’s anecdotal evidence of people being held in solitary confinement in prisons and jails for long periods of time, [Charles Feinberg] he said, so facts are needed about how solitary confinement is used in jails, how many people with mental illness are put in solitary confinement and for how long, and how many people are released into the community from solitary confinement. (Wilson, 7/18)

Common Council President Ashanti Hamilton is urging Mayor Tom Barrett to delay naming a new leader for the troubled Milwaukee Health Department. Hamilton wrote to Barrett last week asking him to "temporarily withdraw" his nomination of Jeanette Kowalik, saying the interim commissioner needs more time to try to fix problems at the beleaguered agency. (Spicuzza, 7/18)

The Georgia Bureau of Investigation is rolling out a new public service announcement aimed at combating a rise in youth suicides. The video features parents and other family members of young people who either took their own lives or attempted to. (Burns, 7/18)

Rejecting the loud pleas of immigration advocates and liberal lawmakers, the Massachusetts Legislature enacted a $42 billion state budget on Wednesday after dropping provisions designed to protect undocumented immigrants from the ongoing federal crackdown. The Democratic-controlled House and Senate sent the compromise bill to Governor Charlie Baker hours after legislative leaders made the 331-page spending and policy proposal public. (Miller, 7/18)

A small survey of St. Louis-area physicians found doctors greatly overestimate the prevalence of Lyme disease and underestimate the prevalence of other tick-borne illnesses in Missouri. ...According to the results, published earlier this month in the journal Ticks and Tick-borne Diseases, 82 percent of respondents believed Lyme disease was among the most common tick-borne infections in the state. (Fentem, 7/19)

The county health department is warning anyone who stayed at USA Hostel in downtown San Diego between July 4 and July 14 that they may have been exposed to the bacteria that causes meningococcal disease, often called bacterial meningitis. A 24-year-old person — the county Health and Human Services Agency declined to release a gender — stayed at the Fifth Avenue hostel during the indicated dates and was hospitalized Saturday. The previously-healthy person was said to be recovering Tuesday, and health department personnel have already identified more than two dozen people who had close contact with the individual, offering each antibiotic treatments that can prevent infection. (Sisson, 7/17)

As a candidate, Gov. Rick Scott pitched the idea of having private companies provide health care to the state's prisoners in a plan to save taxpayers $1 billion over seven years. But in the first five years of privatization, the cost has climbed from $278 million to $375 million. (Ochoa, 7/19)

As public health officials prepare for a possible outbreak of whooping cough, the death of a baby in San Bernardino County from the disease has prompted warnings that pregnant women should be vaccinated. The death announced Tuesday marked the first time the disease had killed an infant in California in two years. State and county officials would not say when the child died or provide any further details. (Karlamangla, 7/17)

The Trump administration does not seem to care that the Affordable Care Act, aka Obamacare, has allowed tens of millions of Americans to purchase health coverage, or that its insurance markets have proved remarkably resilient, or that its popularity has soared since its namesake left office. Nor is it much impressed by the fact that the basic architecture of the ACA was originally a Republican idea, offered as an alternative to the unworkable plan spearheaded by former President Bill Clinton. No, the Trump administration is determined to kill the program. Having failed to persuade Congress to do the deed, the White House is doing everything in its power to sabotage the law through administrative actions. (7/18)

Faced with the mounting policy failures of Obamacare, liberals in Congress are desperate to shift the blame to President Donald Trump. Nonsense. Obamacare is responsible for the problems of Obamacare markets: rising costs, undesirable plans and declining choice. The problems have been evident since day one. In 2014, insurance premiums exploded by an average of 49 percent. From 2013 to 2017, they increased by 105 percent in the individual markets, while deductibles exploded. (Robert E. Moffit, 7/18)

Despite multiple attempts by the GOP-led Congress to repeal it, the Affordable Care Act has survived. A large part of the reason it survived was because regular citizens who had benefited from Obamacare’s provisions flooded their representatives’ phone lines and town hall meetings with demands to retain it. (7/18)

Three of the federal government’s largest means-tested safety-net programs are Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and housing assistance. To list these is to list the conditions against which Congress has decided to protect those who do not have enough money to protect themselves: sickness, hunger and homelessness. The Trump administration, with the support of the Republican Congress, seeks to make these protections more contingent than they are at present on the beneficiaries’ work effort. A new report by the White House Council of Economic Advisers argues for work requirements in noncash federal safety nets akin to those enacted for cash assistance in the 1990s, on the ground that “self-sufficiency has fallen in recent decades while material hardship has fallen.” (7/18)

At the end of June, a U.S. District Court judge blocked Kentucky Gov. Matt Bevin from imposing work requirements on Medicaid recipients. According to the ruling, Bevin’s reforms would have undermined Medicaid’s mission to help low-income Americans access medical care. Unfortunately, the judge’s decision will likely worsen health care access for Medicaid patients in the Bluegrass State. (Charlie Katebi, 7/18)

Florida is one of 17 states that has failed to take advantage of expanded health care funding under the ACA, although the number recently declined with Virginia’s decision to expand Medicaid. At a time when a growing number of Democrats are calling for major policy changes such as Medicare for all, former Florida Gov. and U.S. Sen. Bob Graham is a throwback. “I describe myself as being a raging incrementalist,” Graham told The Sun last week. Graham was visiting Gainesville to promote the candidacy of his daughter, former U.S. Rep. Gwen Graham, for the Democratic nomination for governor. Her recently released health-care plan includes support for Florida expanding Medicaid, providing coverage for about 500,000 Floridians who lack insurance but don’t qualify for subsidies under the Affordable Care Act. (7/18)

Florida’s residents deserve quality, affordable health care and currently nearly a million Floridians aren’t receiving it. Floridians have the power to change this.The Commonwealth Fund’s 2018 Scorecard on State Health System Performance ranked Florida 48th among the 50 states and the District of Columbia. The Commonwealth Fund is a well-known, independent think tank focused on assessing the efficacy of health care systems around the world. The criteria for the rankings include access to health care, quality of care, and affordability. I find it appalling that a state with the third largest population in the country has one of the lowest ranked health care systems. Many policy analysts attribute Florida’s poor national standing to our lack of Medicaid expansion. (Lori Berman, 7/18)

In the quest to reduce health spending without harming health outcomes, one area has always loomed large: end-of-life care. But it turns out that the share of total outlays that occurs near the end of life is small, and in any case it is difficult to predict when that stage is near, as a new analysis shows. (Peter R. Orszag, 7/18)

A couple of weeks ago I took an unusual selfie: it showed me and a colleague in the hot Texan desert, outside a U.S. Customs detention facility, wearing our white doctor's coats, surrounded by about 50 other health professionals. We were there protesting the separation and detention of nearly 3,000 asylum-seeking children, and the incarceration of a few dozen of them in the notorious “tent-city.” We joined a group of local doctors and nurses and silently walked in the extreme heat — it was 104 degrees — holding arms with complete strangers, to the gates of the detention center. It was somber. Moving. Emotional. A few speeches outside the gate. A few hugs. A few tears. And it was over. (Ranit Mishori, 7/18)

Brian Vastag was enjoying a life that many people would envy. At age 41, he had achieved professional success as an award-winning health and science reporter for the Washington Post, covering important stories from around the world. That came to an end in July 2012, when he found himself afflicted by a mysterious and poorly understood illness that ended up sweeping away almost every vestige of his vigorous and productive life. To add insult to injury, he also had to endure a four-year battle with his insurance company to cover his disability claim for the condition he eventually learned was chronic fatigue syndrome. (Steven Lubet and David Tuller, 7/19)

We can’t be sure what the substitution of Judge Brett Kavanaugh for Justice Anthony M. Kennedy means for the Supreme Court’s abortion jurisprudence. But we can take a page from history to make an educated guess. Two pages, actually. Let’s set two judicial opinions on the subject of abortion side by side to see what they tell us. One, less than a year old, is by the current Supreme Court nominee. The other was written by another appeals court judge, Samuel A. Alito Jr., 15 years before he became a Supreme Court justice. The Kavanaugh opinion may suggest what lies ahead if he is confirmed. Justice Alito’s opinion told us in no uncertain words. (Linda Greenhouse, 7/18)

The health insurer Anthem is coming under intense criticism for denying claims for emergency room visits it has deemed unwarranted. A new congressional report suggests Anthem has effectively reversed that policy, even as it is being hit with a new lawsuit about it from doctors. The insurer initially rolled out the policy in three states, sending letters to its members warning them that, if their emergency room visits were for minor ailments, they might not be covered. Last year, Anthem denied more than 12,000 claims on the grounds that the visits were “avoidable,” according to data the insurer provided to Senator Claire McCaskill, a Democrat from Missouri, one of the affected states. (Margot Sanger-Katz and Reed Abelson, 7/19)

Almost 1 in 5 adults in Massachusetts drinks excessively, according to the Centers for Disease Control and Prevention, one of the higher rates in the United States. Consumption comes with substantial costs. For instance, the Massachusetts economy lost more than $5.6 billion in 2010, according to a 2015 study, from lost productivity, health care expenses, and other costs, including those from accidents caused by drunken driving. (Gianmarco Raddi, 7/18)

You’re looking to adopt a pet, so you visit the local animal shelter with your son and granddaughter on a Sunday afternoon. While heading toward the cat area, another visitor accidentally fires the handgun in his pocket. The bullet ricochets off the floor and sends you to the hospital. Instead of going home with a new cat, you go home with shrapnel in your feet and the back of your leg. This is what happened to Denise Robinson during a recent visit to the Animal Rescue League in Des Moines. “As we were walking those two or three steps, some wild crash happened, and I thought somebody dropped something. In that nanosecond, I looked down, I was standing in a pool of blood,” she told a Register editorial writer. (7/18)

Despite the impact suicide has on families, communities and public health, methods for assessing suicide risk have been inconsistent and ineffective. But a new, effective, evidence-based tool is now available for use. Initially commissioned by the U.S. Food and Drug Administration, the Columbia-Suicide Severity Rating Scale was developed by Dr. Kelly Posner at Columbia University. It has been successfully deployed to screen millions of patients for suicide risk in a variety of health-care settings worldwide and, most importantly, has been shown to help prevent patient suicide. (Michael Burke, 7/19)

According to the American Red Cross, the annual summer slump in donations is worse than usual this year. Blood supplies across the country are at dire levels. Many blood centers are reporting a two-day supply of blood on hand — or less. (7/18)

Protecting our most vulnerable populations should be a top priority for not only every elected official but our community as a whole. Our seniors do not always receive the protections they deserve, and this issue will only grow in importance. North Carolina has a rapidly aging population. By 2025, 90 of the 100 counties in North Carolina are projected to have more people over the age of 60 than under 18. This type of shift requires policymakers to look closely at resources and care for our transforming population. (Scott Stone, 7/18)

Over the past few years, facial-recognition technology has rapidly become a feature of everyday life. It is used to tag people in Facebook pictures, unlock smartphones and even pay for purchases. But as this technology becomes more ubiquitous, so, too, have concerns that it could be misused. Last week, Microsoft added its voice to a growing movement calling for regulation of facial-recognition software. In a blog post, company president Brad Smith wrote that the technology has “broad societal ramifications and potential for abuse.” He proposed Congress create a bipartisan expert commission to identify the best way to regulate this software, adding that technology companies stand to benefit from guidance and clarity. In doing so, he drew attention to the fact there are few, if any, regulations in the United States governing the use of facial recognition. (7/18)