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The jockeying over who will be the next Food and Drug Administration commissioner intensified Tuesday when former agency heads and dozens of health groups urged the White House to nominate acting FDA chief Norman “Ned” Sharpless to become the agency’s permanent commissioner. Supporters of Sharpless sent two letters — one from four former FDA commissioners and the other from more than 50 cancer and other groups — to President Trump and Health and Human Services Secretary Alex Azar. The letters had the same message: The FDA needs a permanent commissioner, and Sharpless should be nominated and confirmed to lead the agency. (McGinley, 9/4)

Stephen M. Hahn, a senior executive and radiation oncologist at M.D. Anderson Cancer Center in Houston, has emerged as a leading candidate to be nominated by the Trump administration to become commissioner of the Food and Drug Administration, according to people familiar with the matter. Dr. Hahn, 59 years old, is chief of radiation oncology and chief medical executive at M.D. Anderson, a research and clinical hospital affiliated with the University of Texas. He didn’t respond to phone calls or an email seeking comment. (Burton, 9/4)

Less than two weeks after a gunman killed more than 50 people at two mosques in New Zealand, law-enforcement officials found a disturbing piece of graffiti outside a San Diego County mosque that had been set on fire. “For Brenton Tarrant -t./pol/,” it read. The cryptic message, which paid homage to the alleged New Zealand shooter and a dark corner of the internet where such shootings are celebrated, foreshadowed a string of violence. In April, one month after the graffiti appeared, John Earnest, the man who police say vandalized the mosque, allegedly attacked a nearby synagogue, leaving one person dead. Then, in August, a shooting in an El Paso Walmart killed 22. One week later, a Norwegian man allegedly opened fire at an Oslo mosque. (Wells and Lovett, 9/4)

Unsettled by recent mass shootings across the nation, the San Francisco Board of Supervisors unanimously approved a resolution this week declaring the National Rifle Association a domestic terrorist organization. The resolution was introduced by Supervisor Catherine Stefani on July 30, two days after a shooting at a garlic festival in Gilroy, Calif., in which three people were killed and more than a dozen others injured. (Padilla, 9/4)

President Donald Trump maintained Wednesday that he hopes to quickly see legislative action to address a spate of mass shootings, but he remained coy about what exactly he would support. Fielding questions from reporters following a White House event on the opioid crisis, the president said that any gun reform proposal would need to be bipartisan. (Oprysko, 9/4)

President Donald Trump declared Wednesday that he wanted to move quickly on gun violence legislation, but his new push came just days after posting an ad on his official Facebook page that defended the Second Amendment and warned that Democrats were looking to seize Americans' firearms. Under growing pressure to deliver some form of gun control package following mass shootings in Texas and Ohio, Trump told reporters in the White House, "I would like to see it happen soon." (Lemire, 9/4)

After the first day of school at Mark T. Sheehan High School in Wallingford, Conn., Mackenzie Bushey, a 15-year-old junior, came home upset that a teacher enforced a no-cellphones policy by confiscating students’ phones before class. She needed her cell, Mackenzie told her family last month, to notify police should a gunman attack her school. And also, she said, “to say my final goodbye to you.” Mackenzie’s mother, Brenda Bushey, blames her daughter’s fears on monthly active-shooter drills at Sheehan High. (Williamson, 9/4)

Law-enforcement officials said they have identified a person of interest they suspect of illegally manufacturing and selling the rifle used in Saturday’s mass shooting in West Texas. Authorities were in the process of investigating the Lubbock, Texas, man, whose identity they haven’t released, and were seeking to question him late Wednesday at his residence, officials said. The U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives has been trying to piece together how Seth Aaron Ator was able to purchase the AR-15-style rifle he used to kill seven people and wound 22 before police shot and killed him. (Frosch, Gurman and Elinson, 9/4)

Republican Gov. Greg Abbott on Wednesday rejected calls from Democrats for immediate votes on new gun safety measures in Texas following a violent August that began and ended with mass shootings that left 29 people dead and injured dozens more. The Texas Legislature doesn't meet again until 2021. That means any new Texas laws in response to two gunmen — both armed with assault-style rifles — opening fire at a Walmart in El Paso and an hour-long rampage in West Texas are at least two years away, unless the governor takes the rare step of ordering an emergency legislative session. (Silber and Weber, 9/4)

To open a meeting of local Republicans here last week, Butch Kuentzler had this message: “Red flag” laws, which allow families and law enforcement to remove guns from people deemed dangerous, are unconstitutional. Those laws are at the center of the current gun-policy debate, whose complicated politics are expected to dominate the legislative agenda when Congress returns to Washington next week from a recess scarred by a string of mass shootings. (Duehren, 9/5)

Catastrophic damage from Hurricane Dorian is putting natural disasters, and their potential connection to climate change, front and center in the U.S., but gun safety and a flood of Republican congressional retirements are also occupying public attention. Chris Buskirk of American Greatness and Colleen Nelson of the Kansas City Star join Judy Woodruff to discuss the politics of the three topics. (9/4)

This past Saturday brought yet another mass shooting in the United States, yet another push for aggressive gun control from presidential candidates and the public alike, and reminders from President Donald Trump and Sen. Ted Cruz (R-TX) that they will resist efforts to implement new background checks or gun limitations. Gun control supporters are getting more ambitious in their rhetoric; presidential candidate and former Texas Rep. Beto O’Rourke told a reporter that under his plan, if you own an AK-47 or AR-15, “you’ll have to sell them to the government.” That promises new debates about banning “assault weapons,” and with them discussions about what an “assault weapon” even is. (Matthews, 9/4)

Separated from his father at the U.S.-Mexico border last year, the little boy, about 7 or 8, was under the delusion that his dad had been killed. And he thought he was next. Other children believed their parents had abandoned them. And some suffered physical symptoms because of their mental trauma, clinicians reported to investigators with a government watchdog. (Long, Mendoza and Burke, 9/4)

Migrant children separated from their parents last year under the Trump administration’s “zero tolerance” immigration-enforcement policy didn’t receive adequate mental-health care in the government’s custody, according to a new report from the Department of Health and Human Services’ internal watchdog. The report offers a first glimpse at how shelter staff perceived conditions inside the facilities where thousands of children were detained. The Office of Refugee Resettlement, the federal agency charged with caring for unaccompanied migrant children, told investigators for HHS’s inspector general that it struggled to recruit enough mental-health counselors to meet the needs of the children in their care. (Hackman, 9/4)

The Department of Health and Human Services' Office of Inspector General visited 45 of about 90 facilities holding migrant children in August and September of 2018 and conducted interviews with operators, medical coordinators, mental health clinicians and other staff. In the resulting report, these officials and practitioners described significant challenges in meeting the mental health needs of children in their care, who had been traumatized long before coming to the United States, then were re-traumatized by policies at the border and further aggravated by being kept in government custody for long periods of time. (Misra, 9/4)

Shelter staff said that they were unprepared to address the problems because of a lack of resources and ongoing efforts to reunify children with their parents. The share of children under the age of 12 in ORR custody rose to 24 percent from 14 percent from April to May of last year. The shelter staff also said Trump administration policies requiring sponsors of children to undergo fingerprint background checks delayed unifications and led to overcrowding in shelters. (Rayasam, 9/4)

The children exhibited signs of fear and anxiety but were apprehensive about sharing that information since they viewed mental health experts as working with "the enemy," the report says. "Program directors and mental health clinicians reported that children who believed their parents had abandoned them were angry and confused," the report says. "Other children expressed feelings of fear and guilt and became concerned for their parents' welfare." (Gomez, 9/4)

A program director at an ORR facility is quoted in the report describing the situation of a 7- or 8-year-old boy who was separated from his father. "The child was under the delusion that his father had been killed and believed that he would also be killed. This child ultimately required emergency psychiatric care to address his mental health distress," the program director is quoted as saying. (Segers and Kates, 9/4)

The report made six recommendations, including telling HHS to assess whether there should be maximum caseloads for individual clinicians, as well as minimize the time that children remain in custody. (Weixel, 9/4)

In a separate report released Wednesday, the HHS inspector general reviewed whether required employee background checks were completed at ORR-funded facilities, looked at whether case managers and mental health clinicians met the minimum requirements, and assessed staffing challenges. The report found that generally, facilities met background checks and qualification requirements, but in some instances, facilities didn't have evidence of some checks or allowed staff to begin working before receiving the results of the FBI fingerprint check or the Child Protective Services check or both. (Alvarez, 9/4)

Migrant children who travel to the U.S. alone face significant trauma during their journeys — but the government-funded shelters tasked with their care are ill-equipped to address their mental health needs, according to a government watchdog report released Wednesday. The Department of Health and Human Services’ Office of Inspector General visited 45 facilities last year that house unaccompanied minors across 10 states, including three in California: BCFS in Fairfield, Southwest Key in Pleasant Hill and an unnamed facility in Yolo County. (Sanchez, 9/4)

Many mothers who were detained in border stations this summer reported that the health of their children worsened in custody. That's according to a questionnaire of 200 women by a nonprofit legal group that provides services to mothers detained in immigration custody at a family detention center in Dilley, Texas. (Long, 9/4)

A federal judge ordered the U.S. government Wednesday to allow the return of 11 parents who were deported without their children during the Trump administration's wide-scale separation of immigrant families. U.S. District Judge Dana Sabraw ruled that government agents unlawfully prevented those parents from pursuing asylum cases. In some cases, Sabraw found, agents coerced parents to drop their claims and accept deportation by having them sign documents they didn't understand or telling them that asylum laws had changed. (Merchant, 9/4)

A national provider of shelters for immigrant children has reopened one of two Arizona facilities it was forced to shutter last year because of issues with employee background checks. The Arizona Department of Health Services said Wednesday it approved an application by Southwest Key to reopen a Phoenix facility that can house up to 420 children. The shelters are for kids who traveled to the U.S. alone or were separated from a relative. (Galvan, 9/4)

The United States Navy has eliminated fried food and sugary drinks on its ships. It is keeping base gyms and fitness centers open all night. But its sailors keep getting fatter: A new Defense Department study found that 22 percent of them — roughly one in every five — now qualifies as obese. The Navy’s figure is the highest, but the study found striking rises in obesity rates in the other armed services as well, even though the Pentagon has rolled out one strategy after another in recent years to try to keep the troops trim. And the increases have military leaders worried. (Philipps, 9/4)

The Washington Post recently detailed how the former vice president told a moving but false story about an incident in Afghanistan. While watching a clip of the lengthy monologue that led to this tale, we were struck by his claim that there are more suicides per month of returning veterans than those killed in action in Iraq and Afghanistan — “by a long shot.” This seemed an interesting subject for a fact check, though it turned out the data is sketchy and not especially clear. There’s also an added wrinkle — what did Biden, who is not especially precise in his phrasing, mean with his comment? (Kessler, 9/5)

The Trump administration is awarding nearly $2 billion in grants to states and local governments to help fight the opioid crisis. Health and Human Services Secretary Alexander Azar says the grants come from money that President Donald Trump secured from Congress last year. Trump says "nothing is more important than defeating the opioid and addiction crisis." (9/4)

About $930 million in funding approved by Congress will go to states and some territories with a focus on prevention and treatment, Health and Human Services Secretary Alex Azar said in a press call. The programs are broad and include expanding rural telemedicine, support for obtaining the overdose reversal drug naloxone and prevention programs, he said. “We know we have more work to do,” Mr. Azar said. “More Americans still need treatment.” Another $900 million in grants over three years will go to the Centers for Disease Control and Prevention to help most states, localities and territories track overdose data and develop strategies on treatment. (Armour, 9/4)

The president, joined by Health and Human Services (HHS) Secretary Alex Azar, highlighted his administration’s efforts to combat the opioid epidemic, which include reducing the high cost of drug prescriptions, increasing illegal drug seizures, raising awareness through national anti-drug campaigns as well as improving reporting of opioid-related deaths. (Subramanian, 9/4)

Although state response grants by law have to focus on opioids, Azar added, they're meant to help states with the infrastructure they can use to manage treatment of other addictions. Azar estimated that opioid prescriptions have declined by 31% under the Trump administration. Medication-assisted treatment for Americans addicted to opioids is up by 38% and naloxone prescriptions are up 378% in the same time frame. (Luthi, 9/4)

Lawmakers on both sides of the aisle reacted positively to the announcement. The state opioid response grant program was created under the law known as 21st Century Cures (PL 114-255). "These new funds will help our efforts to combat the opioid epidemic that continues to grip our state," said Sen. Rob Portman, R-Ohio, who has been active in legislative efforts related to the epidemic. "My visits to treatment and recovery facilities around the state have again highlighted the need for additional resources to support education, treatment and recovery programs that work." Senate Majority Leader Mitch McConnell, R-Ky., whose state also has been hard hit, also praised the move. (Raman, 9/4)

Trump administration officials announced Wednesday morning that New Hampshire will receive more than $26 million in a new round of federal grants designed to combat the opioid crisis. The bulk of that money, about $22 million, comes in the second installment of a State Opioid Response grant that was originally approved by Congress and awarded to New Hampshire in 2018. (Moon, 9/4)

Dave Mara, Gov. Chris Sununu’s advisor on addiction and behavioral health, said the grant will help gather more data, and show a more complete understanding of the opioid epidemic. The funds will allow the state to study emergency department data, information from medical examiners’ reports and other data to find and understand patterns, and use that knowledge to better target prevention and treatment programs. (Albertson, 9/4)

U.S. Sens Todd Young and Mike Braun, both Indiana Republicans, issued a news release Wednesday saying Indiana will receive will receive $18,147,223 of that grant funding. “As I travel across Indiana, it is clear that no community has been spared from the harmful impacts of opioids,” Young said in a news release issued jointly by the Hoosier senators. “Today’s announcement is welcome news for Indiana as we fight to curb this devasting opioid epidemic. More funding will allow more access to prevention services and treatment options for countless Hoosiers struggling with opioid addiction across our state.” (9/4)

Kentucky will receive a $31.5 million grant from the U.S. Department of Health and Human Services to combat the state's opioid epidemic, part of a federal program created in 2016 to address the nationwide crisis. Sen. Mitch McConnell, R-Ky., announced the grant in a news release Wednesday, touting the 21st Century Cures (CURES) Act he advanced to create the State Opioid Response Grants Program. (Sonka, 9/4)

The U.S. Department of Health and Human Services on Wednesday announced that Ohio will get $55.8 million in grants to fight the drug epidemic - part of $1.8 billion that the Centers for Disease Control and the Substance Abuse Mental Health Services Administration awarded across the nation. The only two states that got more money were California, which got $69.8 million, and Pennsylvania - which got $55.9 million. U.S. Sen. Sherrod Brown said the Ohio Department of Health will distribute the money awarded to the state. (Eaton, 9/4)

In a boost to its fight against the opioid epidemic, Connecticut will receive a combined $17 million from two federal agencies to track overdoses and expand access to treatment. The state will get $11.1 million from the Substance Abuse and Mental Health Services Administration to broaden its availability of medication-assisted treatment, which combines behavioral therapy and medicine to treat addiction. (Lyons, 9/4)

Senator Patrick Leahy (D-Vermont), Vice Chairman of the Senate Appropriations Committee, on Wednesday announced that the Vermont Department of Health will soon receive its third State Opioid Response (SOR) grant of $4,020,896 from the Substance Abuse and Mental Health Services Administration. Vermont now has been awarded a total of $10,140,700 from SAMHSA through SOR grants since the inception of the grant program. (9/4)

The Trump administration is awarding nearly $2 billion in grants to states and local governments to help fight the opioid crisis, including $46.7 million for Tennessee, according to a statement from the U.S. Department of Health and Human Services. (Collins, 9/4)

Utah will receive nearly $24 million in federal funding to combat the state’s opioid crisis — where its number of opioid deaths ranks 21st in the nation — by expanding access to treatment and gathering data on the drug overdose crisis. (Bojorquez, 9/4)

The office of Sen. Deb Fischer, R-Neb., said Nebraska received over $4 million. In a statement, Fischer said the money "represents another important step in our ongoing fight to combat drug addiction, which continues to harm our families and communities.'' (9/4)

The union representing career HHS employees is accusing the agency spearheading the Trump administration’s response to the opioid crisis of engaging in a series of illegal labor practices, according to multiple sources and a notice obtained by POLITICO. The National Treasury Employees Union is in the process of filing “many grievances” against the Substance Abuse and Mental Health Services Administration, including a complaint over the sudden elimination in August of telework accommodations for disabled employees, the union’s national president told POLITICO. (Diamond, 9/4)

The coroner's sense of futility was clear, as he investigated the death of yet another Australian killed by prescription opioids. Coroners nationwide have long urged officials to address Australia's ballooning opioid addiction, and to create a tracking system to stop people from collecting multiple prescriptions from multiple doctors. Yet even as thousands died, the coroners' pleas were met largely with silence. (Gelineau, 9/5)

More than 70,000 Americans died from drug overdoses last year, and a growing number of those deaths are attributed to the powerful synthetic opioid fentanyl. Journalist Ben Westhoff says the drug, while an important painkiller and anesthesia medicine in hospitals, is now killing more Americans annually as a street drug than any other in U.S. history. "Fentanyl was originally formulated as a medical drug, something that was used in ... open heart surgery and in end-of-life care," Westhoff says. "It's an opioid that is 50 times stronger than heroin, 100 times stronger than morphine." (Davies, 9/4)

The Texas attorney general’s office is suing pharmaceutical company Johnson & Johnson for fraud, alleging it misrepresented the dangers of one of its opioid medications and helped fuel the state’s opioid crisis. The civil lawsuit filed Tuesday says that Johnson & Johnson’s sales representatives told doctors that the drug Duragesic, a pain patch that delivers the drug fentanyl through the skin, had fewer side effects, worked better and posed less of a risk for addiction than other opioids. (Huber, 9/4)

For the first time since the 1990s, federal officers with the Drug Enforcement Administration will be based in Duluth. The agency announced its plans this week to expand to Duluth to help combat the trafficking of opioids and methamphetamine in the region. It plans to hire two new federal agents, plus two additional local officers who will be federally deputized. (Kraker, 9/4)

For a long time, the address 1800 Chicago in Minneapolis has been synonymous with detox. As in, end-of-the-road, hit-rock-bottom detox. Now Hennepin County is turning the facility into a one-stop shop for services ranging from detox to mental health care to help signing up for low-income housing. It’s designed to keep people with mental health and substance use problems out of jail and hospitals. (Roth, 9/4)

Kaiser Health News: Americans More Likely Than Swedes To Fill Prescriptions For Opioids After Surgery

Americans and Canadians are seven times more likely to fill a prescription for opioid pain pills in the week after surgery than Swedes, says a study published Wednesday, one of the first to quantify international differences. More than 75% of patients in the U.S. and Canada filled a prescription for opioids following four common surgeries, compared with 11% of Swedes, researchers report in JAMA Network Open. Americans also received the highest doses of opioids. (Appleby, 9/4)

Kaiser Health News: School Districts Double Down On Drug Testing, Targeting Even Middle Schoolers

Thirteen-year-old Aura Brillhart and her 11-year-old sister, Morgan, will face a new sort of test in school this year: a drug test. The middle and high schools in their community of Fort Scott, Kan., are among the latest to require random drug testing of students who want to participate in sports, clubs, dances or any other extracurricular activities. “I hate that it’s even an issue for us to have to address,” said their mom, Jody Hoener. “But putting our heads in the sand isn’t going to make things any better.” (Ungar, 9/5)

The Trump administration gave new hope to marijuana researchers when the Drug Enforcement Administration (DEA) appeared to open the door for new applications for federally approved marijuana growers. While 33 states have legalized marijuana for medicinal purposes, federal research is extremely restricted. The administration’s announcement last week that it would expand the number of marijuana growers signaled a positive change after years of agency inaction and delay. (Weixel, 9/4)

The Internal Revenue Service on Tuesday published a notice asserting that health insurance companies face a $15.5 billion tax bill in 2020 if the ACA's health insurance tax resumes as planned. The ACA created the tax, known as the health insurance industry fee, to fund implementation of the ACA's marketplace exchanges. It's an annual fee on health insurance providers based on premiums and a payer's market share. (Brady, 9/4)

A Houston non-profit community group, Change Happens, has been awarded just over $400,000 in federal grant money to help assist in the upcoming enrollment for 2020 individual and family health coverage through the Affordable Care Act. Change Happens is only one of two organizations in the entire state to receive federal navigator grants which help pay for outreach and assistance for those wanting to sign-up for health insurance through the exchange. Advocates have said such assistance is crucial as the process of picking the best plan can be confusing. (Deam, 9/4)

Lawmakers, health care advocates and customers made a vociferous plea to Connecticut’s insurance commissioner and regulators Wednesday to block rate hikes, calling the years-long cycle of increases on the state’s health insurance exchange unsustainable. (Carlesso, 9/4)

Minnesotans who need to buy an individual insurance plan on the state’s MNsure exchange will have fewer days to sign up this year. MNsure announced Wednesday the 2020 open enrollment period when customers can sign up will run from Nov. 1 to Dec. 23, 2019. That’s about 20 fewer days than customers had during last year’s sign-up period. Minnesotans still have a week more than customers in other states who rely on the federal health insurance exchange and must sign up by Dec. 15. In past years, Minnesotans could pick in late December and early January, but their insurance coverage didn’t take effect until Feb. 1. (Magan, 9/4)

L.A. Care Health Plan and Blue Shield of California Promise Health Plan announced Wednesday they will jointly operate 14 new and existing community resource centers throughout Los Angeles county. The effort is part of a $146 million investment from both insurers over a five-year period with each group investing $73 million. Such a collaboration among two insurers, which are typically competitors, is unique. But John Baackes, CEO of L.A. Care, said there is an advantage to working with Blue Shield Promise because they share members. Blue Shield Promise contracts with L.A. Care to offer Medi-Cal, California's Medicaid program. (Castellucci, 9/4)

About 1 in 3 Ohioans with private health insurance was surprised by a medical bill in the past year, according to a new survey released Wednesday. More than half of that group said the bill was higher than they expected, and 40% of them said they received a doctor’s bill they didn’t know was coming. (Candisky, 9/4)

The National Association of Dental Plans estimates that about 74 million Americans have no dental coverage. That means about 23% of the population, or more than double the percentage of the population that lacks health insurance, could be unable to afford basic dental services like cleanings, fillings or extractions. The good news is that there are several great local resources, including some pop-up missions and some ongoing clinics, that will provide free or reduced-cost dental services and some medical services to people in need. (Hance, 9/5)

A federal judge reviewing a Justice Department decision to allow U.S. pharmacy chain and benefits manager CVS Health Corp to merge with health insurer Aetna said on Wednesday that the agreement was in fact legal under antitrust law. Judge Richard Leon of U.S. District Court for the District of Columbia had been examining a government plan announced in October to allow the merger on condition that Aetna sell its Medicare prescription drug plan business to WellCare Health Plans Inc. Both deals have already closed. (Bartz, 9/4)

The judge, in a first for a court review of a government merger settlement, convened hearings to consider live witness testimony from the deal’s critics who said the Justice Department’s deal with the companies was inadequate. Judge Leon on Wednesday said the critics’ testimony ultimately was unpersuasive. He said the health-care markets at issue in the case “are not only very competitive today, but are likely to remain so post-merger.” (Kendall, 9/4)

He further explained that despite critics' concerns that the merger would reduce competition, "CVS' and the government's witnesses, when combined with the existing record, persuasively support why the markets at issue are not only very competitive today, but are likely to remain so post-merger." (Livingston, 9/4)

That isn’t necessarily the landscape Patrice Harris, president of the AMA, sees. “We know from history that when health insurance and pharmaceutical benefit management markets are ruled by only a few massive companies, patients pay a steep price,” Harris said in a statement after the ruling. Referring to the “unprecedented judicial review” spurred by the opponents’ concerns, she said regulators “must vigilantly monitor the conduct of the merged firm to make sure that this colossal new entity does not hurt patients.”(Harris and McLaughlin, 9/4)

U.S. District Judge Richard J. Leon initially ordered hearings after he said the Justice Department and the companies acted like his approval was a mere “rubber stamp.” The companies had closed the deal just one month after reaching an agreement with federal regulators, which angered Leon. (Weixel, 9/4)

Health advocates in Missouri have launched an effort to put Medicaid expansion on the ballot in 2020. Medicaid expansion could mean coverage for more than 200,000 uninsured Missourians who earn less than $18,000 a year for an individual or $30,000 for a family of three, according to Healthcare for Missouri, the group spearheading the effort. (Weixel, 9/4)

Missouri hospitals on Wednesday helped launch a campaign put Medicaid expansion on the ballot in November 2020. Backers estimate that more than 200,000 uninsured Missourians could qualify for Medicaid if the state expands eligibility under the Affordable Care Act. And hospital leaders are citing rural hospital closures to try to rally support. (Luthi, 9/4)

Proponents of a Medicaid expansion in Missouri want to allow voters to override the state's Republican leaders, who have refused to extend coverage to more people. The Healthcare for Missouri coalition is collecting signatures on a petition that would place a Medicaid expansion on the November 2020 ballot. If approved by voters, Missouri would expand the health insurance program to those who earn up to $18,000 a year. (Fentem, 9/4)

Miami’s Jackson Memorial Hospital got hundreds of millions in Medicaid dollars that it shouldn’t have received between 2010 and 2014, auditors say, and now the federal government wants the money back. A new audit issued by the U.S. Department of Health and Human Services Office of Inspector General contends the public hospital erroneously claimed $686 million in Medicaid costs, of which $412 million was paid by the federal government. (Sexton, 9/4)

Planned Parenthood Federation of America will expand a telemedicine program to connect patients with birth-control and other services via smartphone, part of the organization’s effort to extend the reach of its health-care offerings that Republican policy makers have sought to weaken or destroy. Planned Parenthood’s telemedicine app will be available in all 50 states by next year, up from 27 states and Washington, D.C., currently, officials said Wednesday. (Armour, 9/4)

In a release, Planned Parenthood said that through the app, users can request for birth control pills to be delivered to their door, get a prescription for a UTI treatment sent to a nearby pharmacy, learn about different methods of birth control or make an appointment at a Planned Parenthood health center. "Planned Parenthood is continually looking for new ways to reach people with the care they need, and we're proud to be a leader in using technology and innovation to expand people's access to health care and information," Alexis McGill Johnson, acting president and CEO of Planned Parenthood Federation of America, said in a statement. "As politicians across the country try to restrict or block access to critical reproductive and sexual health care, the Planned Parenthood Direct app is just one part of the work we do to ensure that more people can get the care they need, no matter where they are." (Brown, 9/4)

The announcement comes less than a month after the healthcare clinic network removed itself from Title X, the marquee federal program dedicated to providing birth control to low-income women. A change to the program last year requires beneficiaries to comply with a so-called "gag order" on abortion services — something that Planned Parenthood said it wasn't willing to do. The clinic's exit will result in a loss of millions of federal dollars. (Smith, 9/4)

Planned Parenthood says it will expand its telemedicine app to all 50 states by the end of 2020, making it easier for women to access birth control and other prescription drugs without visiting a doctor's office. The announcement comes after the Trump administration effectively banned Planned Parenthood from the Title X family planning program, amounting to a funding loss of $60 million a year for the organization.  (Helllmann, 9/4)

A federal judge in Mississippi ruled Wednesday that the state had violated federal civil rights law by not providing mental health patients enough care in their communities, forcing them to essentially be segregated in state-run hospitals. In a 61-page opinion, Judge Carlton W. Reeves of United States District Court in Jackson, Miss., said that the state had run afoul of the Americans With Disabilities Act. He said he would appoint a special master to oversee changes to Mississippi’s mental health system. (Zaveri, 9/4)

Reeves wrote that he's "keenly aware of the judiciary's limitations" in cases like this. He ordered the state and federal government to each suggest three possible names to act as a special master, along with a proposal for that person's role. Until Reeves decides on the special master's role, the depth of federal intervention into the mental health system won't be clear. (Amy and Pettus, 9/4)

The judge, nominated by President Obama, wants a “special master” appointed to help craft and oversee changes in the state’s mental-health system. Both the state and the Justice Department will be able to name candidates for the job. In 2011, a Justice Department investigation found that Mississippi’s mental-health system “unnecessarily institutionalizing persons with mental illness.” Five years later, after negotiations with state officials failed, the Justice Department sued Mississippi, alleging that it failed to provide adequate services in the community for adults with mental illness. By confining the mentally ill in state-run hospitals and jails, Mississippi is violating the rights of individuals with disabilities, the lawsuit alleged. (Ansari, 9/4)

"Watching some of the trial and then seeing some of the documents, and having a chance to look at the documents that went with the trial, I think it's pretty clear that our system has not allowed people with mental illness who want to live in their community to be able to have that opportunity," Joy Hogge, who advocates for children's mental-health care as the executive director of Families as Allies, told the Jackson Free Press after the ruling came down Wednesday morning. "It's not good for people to be forced to live in an institution and be separated from everybody else." (Pittman, 9/4)

U.S. Sen. Ron Wyden on Wednesday said he will introduce legislation next week to tax e-cigarettes amid a multi-state outbreak of severe lung disease, including a recent death under investigation in Oregon of someone who used such vaping devices. Wyden, a ranking member of the Senate Finance Committee, made the announcement at Multnomah County’s Health Department, joined by county health Director Patricia Charles-Heathers, county Chairwoman Deborah Kafoury and Commissioner Sharon Meieran. (Bernstein, 9/4)

Adam Hergenreder started vaping about two years ago at age 16. The mint and mango flavors were his favorites. Now Hergenreder, of Gurnee, is hospitalized and unable to breathe without a steady flow of oxygen through tubes affixed to his nostrils. Doctors have told the 18-year-old that images of his lungs from a chest X-ray look like those of a man in his 70s. His lungs may never be the same again, and vaping is likely to blame. (Thayer, 9/4)

The Ohio Department of Health said Wednesday that three reported instances of severe lung illnesses in e-cigarette users are likely the result of vaping, and 11 other cases are being investigated. The department previously said it was investigating six cases and issued an alert Aug. 23, asking health-care providers in the state to report instances of severe pulmonary illnesses in which the cause is unclear and the patient has a history of vaping. (Viviano, 9/4)

Yet another person's life is in danger from a vaping-related lung injury. On Tuesday, the parents of 19-year-old Kevin Boclair told CBS 3 Philly that their son was put in a medically induced coma three weeks ago. They believe the teen's vaping habit caused him irreparable lung damage and put him on life support. (Naftulin, 9/5)

A life-threatening condition known simply as “vaping illness” has appeared across the U.S., with over 200 cases reported this summer. Louisiana has now joined the count: Nine people have reported cases of pulmonary illness after e-cigarette use, the state Department of Health confirmed on Wednesday. (Woodruff, 9/4)

About 7 in 10 young adults in Southwest Ohio, Northern Kentucky and Southeast Indiana have vaped at least once, a newly released survey shows. Nearly 4 in 10 of these 18- to 29-year-olds or 36% use vape products regularly. (DeMio, 9/4)

A 2008 study by WellShare International found peer pressure and other social factors drove tobacco use among Somali people in Minnesota. It also found that a lack of medical insurance made it difficult to quit. (Feshir, 9/4)

When she added Gabrielle's name to the chart in her kitchen, Judy Kennedy could picture the annual ritual. At birthdays she would ask her newest grandchild to stand up straight, heels against the door frame, so she could mark Gabrielle’s height beside that of her other granddaughter in the Maine house the family has lived in since the 1800s. But there are no lines for Gabrielle. In January, the 9-month-old was killed when a driver delivering Amazon.com packages crashed a 26-foot rented box truck into the back of her mother’s Jeep. The baby was strapped into a car seat in the back. (Callahan, 9/5)

In an effort to prevent child heatstroke deaths, an alliance of major car makers announced an agreement to include rear-seat alert systems in nearly all new cars and trucks—a move that a key child-safety group called inadequate. The agreement, which the auto industry had largely resisted in the past, pre-empts pending legislation in Congress that would mandate rear-seat monitoring features on U.S.-sold vehicles. The push, fueled with bipartisan support, comes after 53 children died in hot cars last year, marking a record, according to noheatstroke.org. So far this year, 38 children have died from vehicular heatstroke. (Byron and Foldy, 9/4)

Urban heat islands vividly illustrate the price humans will pay in the world’s growing climate crisis. With an abundance of concrete and little shade, they get hotter faster and stay hotter longer. And the people who live there are often sicker, poorer and less able to protect themselves. Rising temperatures in these neighborhoods will mean more trips to the hospital for heart, kidney and lung ailments. Drugs to treat mental illness and diabetes won’t work as well. Pregnant women will give birth to children with more medical problems. (9/3)

An analysis from policy firm Mathematica suggests 9 percent of households nationwide that currently receive food stamps, or Supplemental Nutrition Assistance Program benefits, would no longer qualify for those benefits under this proposed rule. But that percentage could be much higher in certain states. (Santhanam, 9/5)

The bullying started with some teasing and mean comments, but escalated significantly when Mallory Grossman, 12, a cheerleader and gymnast from New Jersey, began middle school. It spread to social media where a group of children tormented her. They took pictures of Mallory at school, without her knowledge, posted them online and taunted her with text messages containing screenshots of the vicious comments made about her. “They called her horrible names, told her you have no friends and said, when are you going to kill yourself,” said her mother, Dianna Grossman. (Valencia, 9/5)

When Deborah Huffman went for her annual physical a few years ago, she saw a new doctor who handed her a paper gown, instructing her to leave it open in the back. The doctor returned a few minutes later to find Ms. Huffman wearing the gown, sobbing. What was wrong? “I pick at my skin,” Ms. Huffman, who is now 65, remembers saying. The doctor peered at Ms. Huffman’s exposed back, which was dappled with scabs and open lesions. (Gellman, 9/5)

A district court judge ruled last year that a federal law banning female genital mutilation was unconstitutional. He said it’s up to the states to make laws about this cultural practice. While we don’t know how many people undergo the procedure in the Mountain West, many hope to amplify the conversation as some states pass laws and others don’t. (Beck, 9/4)

A Senate proposal to redesign the way Medicare pays for drugs could save seniors who rack up sky-high drug bills — more than $100,000 in a year — roughly $4,000 per year, according to a new paper published Monday in the New England Journal of Medicine. The plan wouldn’t actually change much for the average senior. But the paper’s lead author says that’s not necessarily a bad thing. (Florko, 9/5)

The Food and Drug Administration is bringing together a panel of outside experts to review a novel but controversial treatment that aims to protect people against severe peanut allergy. The convening of the FDA advisory panel, scheduled to meet — and vote — on Sept. 13, will be a pivotal moment for Aimmune Therapeutics (AIMT), the biopharma company that developed the new treatment, called AR101. If approved, AR101 will be the first protective therapy for peanut allergy and the start of what Aimmune hopes will be a family of products with blockbuster commercial potential — all designed to benefit the millions of people who suffer with life-threatening food allergies. (Feuerstein, 9/4)

The hardest part of curing tuberculosis, doctors say, is getting patients to take all their pills every day for at least six months. Even the easiest regimens of four antibiotics can cause nausea, fevers, rashes and stomach pain. Health officials have tried many ways to persuade patients to comply, from gentle encouragement to imprisonment in locked wards. Now researchers have come up with a new tactic: A program based on nagging cellphone texts succeeded in goading patients into taking their drugs in a preliminary test in Nairobi, Kenya, according to a study published on Wednesday in the New England Journal of Medicine. (McNeil, 9/4)

In the summer of 2016, Georgia’s Chatham County hired jail monitor Steven Rosenberg with a mission: scrutinize the county jail’s healthcare services after a string of deaths. In the previous 30 months, seven inmates had died at the Chatham County Detention Center, shaking public confidence. The last healthcare provider lost its contract in June 2016 after some of its own staff accused it of improper practices. Chatham County sought a fresh start, signing a multiyear contract worth $7 million annually with a small Atlanta company, CorrectHealth LLC. (9/4)

After watching his mother die slowly when he stopped her medication, Neil Mahoney knew he wanted the option of ending his own life peacefully when a doctor told him in July that he had months to live after being diagnosed with cancer. A physician was willing to help him do that under Colorado's medically assisted suicide law, but she was fired by Centura Health, a Christian-affiliated health system, for violating its guidelines on the issue. (9/4)

The Legislature's budget committee agreed Wednesday to put $100,000 toward mental health services to farmers grappling with low prices, bankruptcies and an international trade war. The unanimous vote came about a month after the Senate majority leader and state agriculture secretary traded barbs over the program. (Marley, 9/4)

Since childhood, Rachael Petersen had lived with an unexplainable sense of grief that no drug or talk therapy could entirely ease. So in 2017 she volunteered for a small clinical trial at Johns Hopkins University that was testing psilocybin, the active ingredient in magic mushrooms, for chronic depression. “I was so depressed,” Ms. Petersen, 29, said recently. “I felt that the world had abandoned me, that I’d lost the right to exist on this planet. Really, it was like my thoughts were so stuck, I felt isolated.” (Carey, 9/4)

Johns Hopkins Medicine is launching a new psychedelic research center where scientists will test the potential of so-called magic mushrooms and other drugs to treat some of the toughest mental health and addiction challenges. The center, announced Wednesday, is believed to be the first center in the United States and the largest in the world to focus on drugs still better known as symbols of 1960s counterculture than serious medicine. (9/4)

The Georgia agency that oversees child welfare, elder abuse prevention and food stamp programs would cut hundreds of jobs and spending on numerous services under a proposal to slash $46 million in order to meet Gov. Brian Kemp’s call for a leaner state government.Department of Human Services officials said none of its current 8,500 employees would lose their jobs, but more than 200 vacant positions or jobs now filled that will become vacant through normal attrition would remain open under the plan approved by its board Wednesday. (Salzer and Prabhu, 9/4)

Metro East residents will have more options for affordable dementia care. The Illinois Department of Healthcare and Family Services announced it is expanding its number of dementia care sites across the state. The department said it will add 1,600 apartments for dementia patients at 40 care sites over the next three years. Three of those sites are in the Metro East. The Cambridge House communities in Swansea, O’Fallon and Maryville will each get 50 new apartments. (Schmid, 9/4)

Boston is the biotech industry’s home base. But in digital health, the city hasn’t kept up with the competition. MassBio wants to change that. The state’s trade group is launching a series of new efforts to make the Bay State a leader in digital health. Earlier this year, the company released a report looking at how digital health could change the life sciences industry in Massachusetts. Next week, the group is hosting its first dedicated event centered around digital health. And next year, MassBio will add a digital health track to its mentoring program for budding entrepreneurs. (Thielking, 9/4)

Florida should repay the federal government $412 million improperly paid to Jackson Memorial Hospital, the country's largest public hospital, under a safety net health program, the HHS inspector general said in a report released this morning. The amount is slightly less than the $436 million the office was preparing to recommended Florida repay to the federal government, according to a draft report obtained exclusively by POLITICO in July. Federal auditors reduced the amount based on "additional information" provided by Florida, the inspector general said today. (Pradhan, 9/4)

The 18 physician shareholders at Beacon Orthopaedics in Cincinnati decided last year they needed an outside investor to help them grow and compete more effectively in the rapidly consolidating healthcare market. After interviewing about 15 private equity firms, the Beacon orthopedists selected Denver-based Revelstoke Capital Partners to help them launch a management services organization that takes over the business functions of the practice. That structure sidesteps rules in most states barring nonphysicians from formally owning medical practices. (Meyer, 8/31)

Despite clearing the Legislature on Wednesday, a bill to restrict vaccine medical exemptions for California schoolchildren faces one last hurdle: winning the support of a governor who has publicly wavered on the proposal. Although he said in June he would sign Senate Bill 276, Newsom has since reversed course and one of his top advisers now says his signature on the measure isn’t guaranteed. (Wiley and Bollag, 9/4)

Medical groups and a lawmaker behind California legislation to crack down on vaccine exemptions said Wednesday they were surprised by Gov. Gavin Newsom’s last-minute call for changes to the bill, a move that inserted fresh uncertainty into one of the year’s most contentious issues. It was the second time the Democratic governor sought to change the measure aimed at doctors who sell fraudulent medical exemptions for students, a proposal vehemently opposed by anti-vaccine activists. After expressing hesitancy with the bill and winning substantial changes to the measure in June, Newsom had committed to signing it. (Thompson and Ronayne, 9/4)

Ascension Wisconsin is partnering with a for-profit company to open a so-called micro-hospital in Menomonee Falls. The hospital — essentially an emergency department with eight inpatient beds — will be the third in the Milwaukee area. Froedtert Health also has partnered with a for-profit company to open micro-hospitals in Mequon and Oak Creek. (Boulton, 9/4)

Kaiser Health News: As Measles Outbreak Fades, N.Y. Sets In Motion New Rules On School Vaccinations

As children head to school this fall, the number of measles cases in New York has slowed to a trickle, and officials this week declared that the outbreak in New York City, which largely affected Orthodox Jewish families who avoided immunizations, is over. But even though the New York outbreak — which has sickened nearly 900 people in 2019 so far and accounted for three-quarters of all cases nationwide — may finally be fading, school vaccination requirements remain a contentious issue. (Andrews, 9/5)

Lisa Bari has left the CMS' Center for Medicare & Medicaid Innovation where she spent more than three years working on interagency health IT, interoperability and artificial intelligence issues. Bari will now work on health IT and value-based care issues as an independent consultant and said she hopes to still support primary care's adoption of technology. (Brady, 9/4)

Kansas child welfare officials say they received repeated reports about a Wichita toddler before he was found dead in a motel of a methadone overdose in the latest high-profile tragedy involving the agency responsible for overseeing young children. In response to a records request from The Associated Press, the Kansas Department of Children and Families released a summary Tuesday of its involvement with 2-year-old Zayden JayNesahkluah. (9/4)

A Lakeville eighth grader suffered a serious brain injury in April when she was sent back to gym class after an asthma attack, according to a lawsuit filed Tuesday in U.S. District Court. Aaliyah Bowen’s parents are seeking more than $10 million from the Lakeville school district and a McGuire Middle School nurse. According to the complaint, the nurse knew Bowen had a long history of asthma attacks sparked by even minimal physical exertion. They say the nurse administered an albuterol inhaler on April 16 but failed to test her breathing and told Bowen to return to gym class despite an elevated heart beat. (Verges, 9/4)

The Dartmouth Atlas of Neonatal Intensive Care released a report Wednesday that found the number of neonatal intensive care beds in the U.S. grew by 65% from 1995 to 2013 while the number of neonatologists grew 75% from 1996 to 2013. Babies born at normal birth weight accounted for 48% of all NICU admissions in 2017 while babies with very low birth weight—less than 3lbs, 5 ounces—made up just 12.7% of NICU admissions in 2017. But researchers found regions of the country with a high proportion of premature newborns, low levels of maternal education, and higher rates of cesarean sections that did not have more NICU beds or neonatologists. (Johnson, 9/4)

Kennesaw State University will team up with WellStar Health System to study bioethical issues faced by people experiencing social or economic barriers while trying to manage their care. The project will be funded by a one-year, $113,000 grant from the National Institutes of Health, the university said in a press release. Evelina Sterling, director of research development and strategic initiatives in KSU’s Office of Research, and Jason Lesandrini, assistant vice president of ethics, advance care planning, and spiritual health at WellStar, will conduct the study. (Dixon, 9/4)

Sacramento Mayor Darrell Steinberg and City Council members on Tuesday demanded their housing authority address harsh conditions in downtown’s Capitol Park Hotel “with great urgency” following a Sacramento Bee report that elderly and disabled residents of the historic hotel are living with bedbug infestations and broken elevators. Steinberg on Tuesday directed the Sacramento Housing and Redevelopment Agency to provide a public report by Friday on a myriad of issues that residents of the single-room occupancy hotel are experiencing, including broken elevators, bedbugs, cockroaches and water shutoffs. (Clift, 9/4)

Prosecutors are still weighing criminal charges against two Los Angeles men who are accused of intentionally setting fire to a homeless encampment late last month, a situation that sparked a brush fire and led to the evacuations of several homes in Eagle Rock and Glendale, authorities said Wednesday. The Los Angeles Police Department announced the arrests of Daniel Nogueira and Brian Araujo Cabrera, both 25, on suspicion of attempted murder late Tuesday afternoon. (Queally, 9/4)

As the number of Floridians allowed to use medical marijuana continues to grow, new data shows that a relative handful of doctors have been responsible for a majority of the patients approved for pot. Florida had 168,810 patient “certifications” for medical marijuana between Oct. 1 and March 31, and more than half of them came from 89 doctors, according to a new draft state report on medical marijuana. (Sexton, 9/4)

Electronic nicotine delivery systems (ENDS) have become the most popular tobacco products among young people, yet ENDS marketing remains unregulated, and its effects on ENDS use behavior across age groups is poorly understood. In this study, using a longitudinal design, we examined how recall of ENDS marketing through 5 different channels predicted subsequent ENDS initiation up to 2.5 years later among youth (ages 12–17 years) and young adults (ages 18–29 years). (Loukas et al, 9/1)

The high cost of fruit and vegetables can be a barrier to healthy eating, particularly among lower-income households with children. We examined the effects of a financial incentive on purchases at a single supermarket by primary shoppers from low-income households who had at least one child. Participation in an in-store Cooking Matters event was requested for incentivized subjects but optional for their nonincentivized controls. The sample included but was not limited to Supplemental Nutrition Assistance Program participants. Compared to the controls, incentivized shoppers—who were given an immediate 50 percent discount on qualifying fruit and vegetables—increased weekly spending on those items by 27 percent; this change was for fresh produce. (Moran et al, 9/1)

We can envision a future in which everyone has the same prospects for living a long and healthy life, no matter who they are or where they call home. All people live in safe and healthy environments. We all enjoy reliable access to health care, nutritious food, and stable housing. We have the knowledge and opportunity to make healthy choices about diet and exercise. And no one has to contend with the harms of persistent racial discrimination, violence, trauma, despair, and injustice. (9/4)

With a key source of federal funding set to expire in September, community health centers across the country are considering steps to reduce staffing, close some locations and eliminate or reduce services as they cope with uncertainty about their future financing, according to a new KFF/GWU survey and analysis. The Community Health Center Fund (CHCF), established by the Affordable Care Act, accounts for 72 percent of health center grant funding and is set to expire at the end of September unless Congress extends it. The fund provided $4 billion in federal money to health centers in fiscal 2019. The CHCF helps 1,362 health centers provide care to 28 million patients annually in medically underserved rural and urban areas in the U.S., including patients who lack health insurance. It also helps pay for services that typically are not covered by insurance, such as dental care. (9/4)

Cannabis concentrates, which are cannabis plant extracts that contain high concentrations of Δ-9-tetrahydrocannbinol (THC), have become increasingly popular among adults in the United States. However, no studies have reported on the prevalence or correlates of cannabis concentrate use in adolescents, who, as a group, are thought to be particularly vulnerable to the harms of THC. (Meier et al, 9/1)

By one count, there have been 30 mass shootings in America since President Donald Trump took office. During that time, the Republican-controlled government hasn’t lifted a finger to end the carnage. Walmart Inc., of all things, has stepped into the breach. (Mark Gongloff, 9/4)

So it was heartening to see Walmart’s announcement Tuesday that, in its view, enough is enough. Just four days before the carnage outside the retail giant’s El Paso store, a disgruntled employee allegedly shot and killed two managers at a Walmart in Southaven, Miss., and five days after the El Paso massacre a man wearing body armor and carrying a loaded rifle and 100 rounds of ammunition entered a Missouri Walmart. He allegedly told police that he was testing his 2nd Amendment right to be armed (Missouri allows open carry of firearms). Then came the massacres in Dayton, Ohio, and Odessa, and while neither involved a Walmart store, the corporation saw them as part of a whole. “It’s clear to us,” said Walmart CEO Doug McMillon, “that the status quo is unacceptable.” (9/5)

Another slaughter in Texas, this time in Odessa, four hours east of El Paso, where 22 people lost their lives just four weeks prior. Together, the two death tolls contributed to an overall count of 53 murdered in mass shooting incidents in the United States this August alone. When I lived in Texas, just 10 years ago, I spent much of my time in settings like those now marked by bloodshed: at Walmarts, with their endless parking lots glazed in late summer’s heat shimmer; in the hard, hardy grass of suburban front lawns; blinking through blazing white sunlight on stretches of interstate. Back then, I didn’t think of any of those common places as locations where people are murdered at random. Now, I do. (Elizabeth Bruenig, 9/4)

Beto O’Rourke has easily emerged as my favorite presidential candidate on the issue of gun control. He has done so because he is speaking openly, passionately and honestly about what he would like to do to stem our epidemic of gun violence, a stance that is surprisingly rare in my estimation. I long ago tired of hearing politicians who are supposed to be in favor of smarter gun laws and reducing American gun deaths and injuries pull their punches so as not to upset the gun lobby and gun lobbyists. (Charles M. Blow, 9/4)

A mysterious lung illness that appears to be associated with vaping has swept across the country over the past few months, according to the Centers for Disease Control and Prevention. Most of the victims are young people, who have been admitted to hospitals with symptoms that can include severe shortness of breath, fever, vomiting and diarrhea. One patient in Illinois died. NBC News reports that data from state health departments indicate at least 329 people have been affected. (Scott Gottlieb, 9/4)

Caretaking occupies a paradoxical place in the American mind. On the one hand, we cast caretaking for babies and children as a sacred duty of the private sphere. We lionize the bonds between parents and their children in movies, songs and storybooks. We romanticize the kinds of wisdom that are passed from an aging parent to a doting child in the dusk of life. At the end of our days, it is caring — love in action — that we feel matters most. (Courtney E. Martin, 9/4)

In an otherwise fractured Congress, Democrats and Republicans are coming together around newly proposed, bipartisan legislation to help states and communities manage costs and improve outcomes for Medicaid recipients. Called the Social Determinants Accelerator Act, the bill was introduced on July 25 by Reps. Cheri Bustos (D-Ill.), Tom Cole (R-Okla.), Jim McGovern (D-Mass.) and Cathy McMorris Rodgers (R-Wash.). The bill received support from health-care industry groups like the American Hospital Association and Aligning for Health. It proposes planning grants and technical assistance for states and communities to address individual patient non-medical needs that are closely tied to health, like food security, housing stability and employment. It also targets high-need Medicaid patients and improving the coordination of health and non-health services. (Brian c. Castrucci, Jonathan Fielding, and John Auerbach, 9/4)

As pediatricians, we are appalled by this latest cruel attack on the health of immigrant children, but sadly unsurprised. The Trump administration alleges that immigrant parents exploit their children to gain entry to the United States via legal loopholes, when in reality such parents take grave risks to save their children from violence, disease, and poverty, as any good parent would. Rather, it is the administration that exploits these children, recognizing their parents’ love as their greatest vulnerability and seizing upon it as a means to target and punish them. (Fiona Danaher, Ron Kleinman and Elsie Taveras, 9/5)

A new definition of pain is out for comment from the International Association for the Study of Pain, an influential global alliance of researchers. When I heard about it, my hair stood on end. Some people think a new definition could lead to new therapies. But as a 23-year veteran of serious pain from a progressive disorder, I dread losing the old therapy: opioids. Prescription opioids have lost favor since the national opioid crisis, when problem users fell victim to an increasingly unrelated supply. (Dawn Rae Downton, 9/4)

Essentially no one in the United States likes surprise medical bills. That’s why Democratic and Republican leaders in both the House and the Senate pulled together common-sense bills earlier this year to curtail the practice. So why isn’t such legislation a slam dunk? Because special interests — specifically hospitals and the private-equity-backed companies that have largely taken over their emergency rooms — are standing in the way. As lawmakers return to session next week, they should make it a priority to end this abusive tactic. (Ezekiel Emanuel, 9/4)

If you’ve needed emergency care in the last few years, you probably encountered this situation: Soon after entering the emergency department, you were asked to go to a triage area in the waiting room where a doctor, nurse practitioner, or physician assistant asked you a few questions and ordered some diagnostic tests while you waited.That’s a departure from the traditional form of triage, in which a nurse assesses the level of acuity of a patient’s illness or injury. ...The new “provider-in-triage” system ostensibly accelerates care. On the surface, ordering tests in the waiting room to get the ball rolling might seem like a good way to save time. A closer look reveals a system that sacrifices medical care for hospital profits. (Keith Corl, 9/5)

The California Legislature showed great courage on Wednesday by voting to close a loophole that vaccination skeptics have been using to get around mandatory immunizations for schoolkids — a vote that protects the public against the risk of serious harm from infectious diseases.Now we just have to hope that Gov. Gavin Newsom doesn’t undermine all this good work with last-minute meddling. For some reason, California’s otherwise rational governor is acting irrationally when it comes to SB 276, a bill written and supported by doctors to ensure that physicians grant medical exemptions only to people who really need them. (9/4)

It’s time for Gov. Gavin Newsom to pick a side in the debate over vaccines. Will he choose science and public health? Or will he side with conspiracy theories and the spread of dangerous yet preventable diseases? We think the choice is clear, but Newsom seems uncertain. After signaling his intention to sign Senate Bill 276 earlier this summer, the governor seems to be waffling at the last minute. (9/4)