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Top Senate Republicans think it's time to leave their derailed drive to scrap the Obama health care law behind them. And they're tired of the White House prodding them to keep voting until they succeed. Several GOP leaders said Monday that at least for now, they saw no clear route to the 50 votes they'd need to get something — anything — recasting President Barack Obama's health care statute through the Senate. (Fram, 8/1)

Senate Republicans have no plans to revive their party-line attempts to repeal Obamacare this summer, despite President Donald Trump’s increasing frustration over the chamber’s failed attempts last week to gut the law. "Until somebody shows us a way to get that elusive 50th vote, I think it's over,” said Sen. John Thune of South Dakota, the third-ranking Republican. “Maybe lightning will strike and something will come together but I'm not holding my breath." (Everett and Haberkorn, 7/31)

Trump administration officials continue to push the Senate to take another run at healthcare legislation, but on Monday senior Republican senators pushed back, making clear that they're done with the topic for now. "There's just too much animosity and we're too divided on healthcare," Sen. Orrin G. Hatch (R-Utah), the head of the Senate Finance Committee, said in an interview with Reuters. (Lauter, 7/31)

A top Senate Republican said he thinks congressional Republicans are too divided right now to continue trying to repeal ObamaCare.Sen. Orrin Hatch (R-Utah) said he and other senior Republicans will take that message to the Trump administration, in light of White House pressure to continue hammering out a repeal-and-replace plan that could pass both chambers. (Weixel, 7/31)

The White House is trying to rebuild momentum for Obamacare repeal after it stalled, yet again, in the GOP Senate last week. Sen. Bill Cassidy (R-La.) met Monday with top aides to President Donald Trump and Health and Human Services Secretary Tom Price about health care reform, said a Cassidy aide and Republican officials. (Everett and Dawsey, 7/31)

Sen. Bill Cassidy (R-La.) met with a top administration official on Monday as the White House tries to revive ObamaCare repeal after last week's setback in the Senate. The Louisiana Republican met at the White House with fellow physician Tom Price, President Trump's secretary of Health and Human Services, and governors to try to find a path forward on healthcare. (Carney, 7/31)

At the White House on Monday, Gov. Scott Walker talked with other governors and officials in Donald Trump’s administration about last week's Senate failure to repeal Obamacare and the way it has left states like Wisconsin at a continued disadvantage. Walker on Saturday issued a statement calling for the federal government to give states “the resources and responsibility for health care.” (Marley and Stein, 7/31)

As Senators returned to work on Capitol Hill for the first time since last week’s defeat of a bare bones GOP bill to overhaul the Obama health law, there was no indication of an immediate attempt by Republicans to rush a new proposal forward for a vote, as party leaders and rank and file GOP lawmakers started talking more about a major push on tax reform later this year. ... From Republicans of all stripes – that was a common theme – now is not the time to quit, even if the votes don’t seem to be there. (Dupree, 7/31)

President Trump took to Twitter this week to threaten insurance companies that he may withhold crucial government payments in an effort to undermine the Affordable Care Act. It's not the first time the president has threatened to cut off these payments to insurers, which he refers to as "BAILOUTS." But these payments aren't designed to compensate insurers for business failures. Rather they reimburse insurance companies for discounts the law requires them to give to low-income people who buy insurance through the Affordable Care Act exchanges. (Kodjak, 8/1)

President Donald Trump warned Monday that he could end federal payments to insurers, allowing them to be “hurt” by the Affordable Care Act, as a way to press members of Congress to revive efforts to repeal the Obama-era health law. “If ObamaCare is hurting people, & it is, why shouldn’t it hurt the insurance companies,” Mr. Trump wrote on Twitter. The president was alluding to the ACA’s “cost-sharing reduction” payments, which the government pays to insurers to help them cut deductibles and other costs for low-income consumers. (Hackman, Hughes and Wilde Mathews, 7/31)

President Donald Trump's threat to stop billions of dollars in government payments to insurers and force the collapse of "Obamacare" could put the government in a tricky legal situation. Legal experts say he'd be handing insurers a solid court case, while undermining his own leverage to compel Democrats to negotiate, especially if premiums jump by 20 percent as expected after such a move. (Alonso-Zaldivar, 8/1)

Lawmakers are facing off with President Trump over key ObamaCare payments that are in jeopardy after the collapse of efforts to repeal the healthcare law. Trump is threatening to cancel the payments, known as cost-sharing reductions (CSRs), as part of his effort to make ObamaCare “implode.” (Sullivan, 7/31)

President Donald Trump says Congress should be paying what the public pays when it comes to "Obamacare." But members of Congress already pretty much do. Here's a look at Trump's claim, and the reality. (7/31)

Top Senate Republicans on Monday offered support for continuing payment of a disputed subsidy created by Democrats’ 2010 health law, putting them at odds with the Trump administration. The White House renewed threats to cut off so-called cost-sharing reduction payments after the Senate last week was unable to advance GOP health care legislation. Insurers have appealed to Republicans to maintain these payments, which cover incidental costs of insurance for people with low incomes who purchase on government-run exchanges. The federal government is expected to spent about $48 billion on premium tax credits next year, and $10 billion on the CSRs, which cover costs such as deductibles, according to a Congressional Budget Office report. (McIntire and Clason, 7/31)

Reeling from the failure to repeal the Affordable Care Act, President Trump now threatens to block federal funding that lawmakers and their staff rely on to help buy health insurance. Trump's threats are not empty. The administration could simply stop the payments -- which are provided to Capitol Hill lawmakers and staff much the way many employers help pay employees' monthly insurance premiums -- by dashing off new federal regulation. (Mascaro, 7/31)

A warning by President Donald Trump that he might cut off congressional members’ health benefits in an effort to force them back to the bargaining table on health care has drawn a lot of attention—and some questions. We have answers. (Radnofsky, 7/31)

The recalcitrant senator kept crossing up the inexperienced new president on big-ticket legislation even though they represented the same party. Frustrated and angry, the White House fought back, threatening retaliation both petty and portentous, eyeing federal jobs and programs in the state of the rebellious lawmaker to force obedience. While this may sound like the current situation between President Trump and Senator Lisa Murkowski, Republican of Alaska, over her refusal to back the party line on health care, it was actually 1993. (Hulse, 8/1)

Interior Secretary Ryan Zinke said it is "laughable" to suggest he threatened Alaska's U.S. senators over a vote by one of them involving health care. Zinke said Sunday in Nevada that he often speaks with Republican Sens. Lisa Murkowski and Dan Sullivan and they get along well. "Ah, you know, the moon has been characterized as other things, too," Zinke said when asked by reporters about the calls and their characterization as threatening. "So, I think it's laughable." (7/31)

Dozens of House lawmakers from both parties unveiled a series of proposals on Monday designed to fix problems dogging the Affordable Care Act. “The last great hope for this country is that Republicans and Democrats prove they can work together,” Rep. Tom Reed (R-N.Y.), co-chairman of the Problem Solvers Caucus, said in a statement. (Lillis, 7/31)

The Problem Solvers Caucus, a bipartisan group of 43 House of Representative members, announced Monday that they have agreed on principles for improving Obamacare. "The Caucus hopes to restore some predictability as insurance companies make decisions about premium prices in 2018," the announcement said. The caucus is 21 Republicans and 22 Democrats, with another Republican expected to join soon. (Lee, 7/31)

After the collapse of the Obamacare repeal, Republicans may have to choose between pursuing another health bill or pushing through a tax overhaul this year, because there’s almost certainly not enough time to do both. And that’s not even their biggest problem -- which is, they can’t agree on either. The Senate debate last week laid bare how sharply divided the party remains over health care. And Thursday, the group in charge of developing a tax plan made clear that it’s agreed on very little. (Dennis, 7/31)

Senate Republicans couldn’t agree on a way to repeal and replace Obamacare. So now they’re contemplating a totally different approach: Blow it up and let the states sort it out. The latest attempt to resuscitate the GOP's repeal bid would reshape the nation’s health care system by sharply curtailing the federal government’s role and placing the future of Obamacare in the hands of governors. But Republican senators will have a hard time overcoming the internal divisions that doomed their three attempts last week to unravel the Affordable Care Act. (Cancryn, 7/31)

A proposal released Monday by the 43-member Problem Solvers Caucus would effectively guarantee insurance subsidies for the individual markets and exempt more businesses from mandated health coverage. U.S. Rep. Martha McSally helped craft the bipartisan plan for the Republicans as a way to help stabilize the individual markets, which face a deadline next month for setting premium levels even as President Donald Trump has suggested he may withhold subsidies to them. (Hansen, 7/31)

Sen. Rand Paul (R-Ky.) told President Trump on Monday that he believes administrative action can be taken to let organizations, such as trade groups, band together to buy insurance. ...Paul, for example, would like to let groups — such as AARP and the Chamber of Commerce — come together to buy health insurance and negotiate for lower costs. “Can you imagine the leverage you would get for drug prices and insurance prices if you were negotiating for 5 million people?” Paul said. (Roubein, 7/31)

Sen. Chuck Schumer said Monday he has heard from 10 of his Republican colleagues in response to his call for a bipartisan approach to health care legislation. “No one thought Obamacare was perfect — it needs a lot of improvements,” Schumer (D-N.Y.) said after an unrelated news conference at Albany Medical Center. “We’re willing to work in a bipartisan way to do it. What we objected to was just pulling the rug out from it and taking away the good things that it did: Medicaid coverage for people with parents in nursing homes, for opioid treatment, for kids with disabilities, pre-existing conditions.” (Vielkind, 7/31)

At a round table at the East Boston Neighborhood Health Center on Monday, Warren called her GOP colleagues’ failure to repeal the Affordable Care Act “a triumph for democracy” — and said it is time for senators to turn their attention to enhancing the existing health care system. ...The mood in the room Monday was celebratory, as health center patients and staff thanked Warren for her efforts to uphold the Affordable Care Act, and she touted the center as a model for low-cost, community health care in return. (Parker, 7/31)

Five health insurance companies in Ohio, including Molina Healthcare Inc, have stepped up to sell health plans in 19 counties that would have been without Obamacare individual coverage in 2018, the state's insurance regulator said on Monday. (Humer, 7/31)

Nearly every Ohioan will have an option on the Obamacare health care exchange even after Anthem leaves.The Ohio Department of Insurance has worked with five insurers to cover 19 counties — and about 11,000 Ohioans — that would have been left without an option on the state's health care exchange next year. Concerned about uncertainty over the future of Obamacare, health care heavy-hitter Anthem and Dayton-based Premier Health Plan announced they would leave the exchange in 2018, leaving a fifth of the state's counties in the lurch. (Balmert, 7/31)

“Ohio has long had a strong insurance system, and once again our insurers stepped up at an important time for thousands of Ohioans, taking unprecedented action to provide access to health insurance for Ohioans who otherwise were without options,” insurance director Jillian Froment said in a statement. A single Ohio county, Paulding County, still has no insurer expected to offer plans on the exchange. Froment said that regulators are searching for coverage options for that county. (Johnson, 7/31)

Insurers have until late September—when they sign federal contracts to offer exchange products—to make final calls on their participation, amid questions about steps that the Trump administration may take that insurers say could undercut marketplace offerings. “We recognize there is a lot of uncertainty at the federal level,” said Jillian Froment, director of the Ohio Department of Insurance. “Change at that level could affect coverage, not only in those 19 counties, but all 88 counties.” (Wilde Mathews, 7/31)

The prospect that 20 counties would lack a single carrier followed announcements that Anthem Blue Cross Blue Shield of Ohio, covering the entire state, and Premier Health Plan, a smaller insurer based in Dayton, decided to exit the ACA market in 2018. The insurers cited uncertainty in the market, including an ongoing question of whether the federal government will provide payments it was supposed to under the ACA. (Koff, 7/31)

[Chris Brock, the insurance department’s assistant director of public affairs] cautioned, however, that nothing is guaranteed until the companies sign contracts with the federal government at the end of September. Even then, coverage would be certain only through 2018. “This is not a commitment that they will be here in the next two years or five years or 10 years,” Brock said. (Schladen, 8/1)

California officials plan to release next year's monthly premiums Tuesday for people who buy individual insurance plans under former President Barack Obama's health care overhaul. The announcement comes at a time of extreme uncertainty about the future of the U.S. health care system. (Cooper, 8/1)

Minnesota’s insurers are proposing to lower or freeze premiums on many health plans — if the federal government approves a state program to subsidize some of the risk. The proposed rate reductions come one year after many plans saw premiums jump by more than 50 percent. In response, Minnesota lawmakers passed a program called “reinsurance” that spends $542 million over two years to pay some high-cost medical bills. The goal was that health insurers, freed from having to pay those costs, would transfer the savings on to their customers in the form of lower premiums. (Montgomery, 7/31)

Iowans who buy their own health insurance could face even bigger premium increases next year if President Donald Trump follows through with a threat to cut off a major stream of Obamacare assistance, the state's sole remaining carrier said Monday. Iowa’s health-insurance market is already teetering, with just one carrier planning to sell individual policies here next year. That carrier, Medica, has proposed raising Iowa premiums by 43 percent in order to keep up with fast-rising costs of caring for chronically ill Iowans. On Monday, Medica’s spokesman said the company would propose another 12 percent to 20 percent in increases on top of that 43 percent if Trump stops payments from a low-profile but important part of Obamacare. (Leys, 7/31)

Even though the U.S. Senate failed to repeal the Affordable Care Act, there will potentially be changes to Connecticut’s health care system that may affect tens of thousands of state residents. Depending on what the president and his administration decide in coming days, some people may lose subsidies that would help pay their premiums, co-pays and deductibles next year. (Radelat, 8/1)

President Donald Trump's drug commission has called on him to declare a national emergency to deal with the country's opioid drug epidemic. The commission sent an initial report to the Republican president on Monday saying the approximately 142 deaths each day from drug overdoses mean the death toll is "equal to September 11th every three weeks." (7/31)

The White House's opioid commission is recommending that President Trump declare a federal state of emergency over the epidemic, which has struck dozens of states. The commission, led by New Jersey Gov. Chris Christie (R), filed a long-awaited report on the crisis on Monday after missing its second deadline extension earlier this month. (Hellmann, 7/31)

The commission, led by New Jersey Gov. Chris Christie, states that the goals of such a declaration would be to “force Congress to focus on funding” and to “awaken every American to this simple fact: if this scourge has not found you or your family yet, without bold action by everyone, it soon will.” (Ingraham, 7/31)

"It would also awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will," the report reads. "You, Mr. president, are the only person who can bring this type of intensity to the emergency and we believe you have the will to do so and to do so immediately." (Estepa, 7/31)

The declaration would effectively nationalize a move that has already taken place in numerous states. Governors in Florida, Arizona, and Maryland have previously declared states of emergency, granting those governments access to millions of dollars and, in some cases, regulatory leeway in administering their responses. (Facher, 7/31)

In addition to seeking an emergency declaration, the commission proposed waiving a federal rule that sharply limits the number of Medicaid recipients who can receive residential addiction treatment. It also called for expanding access to medications that help treat opioid addiction, requiring “prescriber education initiatives” and providing model legislation for states to allow a standing order for anyone to receive naloxone, a drug used to reverse opioid overdoses. (Goodnough, 7/31)

The report recommends several steps for increasing access to medications such as buprenorphine and methadone that help treat opioid addiction. It advises the Justice Department to increase use of the medications in prisons, and the Centers for Medicare and Medicaid Services to require that all federally qualified health centers mandate that staff are licensed to prescribe buprenorphine. The report also recommends stronger enforcement of the Mental Health Parity and Addiction Equity Act, a 2008 law that prohibits health-insurance plans from covering mental-health services less generously than other medical services. (Whalen, 7/31)

Between 1999 and 2015, more than 560,000 people in the United States died of drug overdoses, a death toll larger than the population of Atlanta. In 2015, nearly two-thirds of drug overdoses were linked to opioids, including Percocet, OxyContin, heroin and fentanyl. There were more than 50,000 deaths from drug abuse and addiction in 2015, according to figures released by the White House when the commission was created. (Simmons, 7/31)

The recommendations published Monday were a draft. The commission is planning to finalize the report in the coming months. (Siddons, 7/31)

Nearly 92 million adults in the United States used prescription opioids in 2015 — and while the vast majority of those individuals used the medications according to their prescriptions, some groups are particularly vulnerable to opioid use disorders, a new study finds. The new report, published Monday in Annals of Internal Medicine, analyzed federal health data from more than 72,000 non-institutionalized, civilian adults in the U.S. The authors found that nearly 38 percent of those individuals used opioids in 2015. They then extrapolated their findings to the U.S. population as a whole. (Thielking, 7/31)

Express Scripts, the nation’s largest pharmacy benefits manager, will exclude an additional 64 medicines next year from its formulary – the list of drugs that get preferred insurance coverage. The company estimates that restricting access to the drugs will save health plans an extra $700 million. Combined with earlier exclusions, the PBM estimates overall savings will reach $2.5 billion in 2018, which would represent a 39 percent increase over projected savings this year. All in all, the PBM plans to exclude 159 medicines out of more than 3,700 that will be available next year. PBMs, you may recall, are crucial, behind-the-scenes middleman that negotiate drug prices on behalf of health plans, unions, and government agencies. (Silverman, 7/31)

As the Senate was barrelling toward one of its votes to repeal the Affordable Care Act earlier this summer, Tom Price was corralling a small group of doctors into a tiny, dimly lit conference room in a nondescript building in downtown Dallas. It was, on its surface, another of the health secretary’s many meetings with “victims” of Obamacare — this time with some of the conservative physicians who felt the law was hurting their patients and their own bottom lines. ... But that wasn’t Price’s only message to the doctors, according to two participants in the meeting. The health secretary also signaled he would protect the doctors from a raft of regulations that were put in motion by the Obama administration. (Mershon, 8/1)

For precision medicine to take root, diagnostics also have to be precise. But so far, there isn’t a ton of confidence about the reliability of next-generation sequencing tests. So the Food and Drug Administration is pressing ahead with an ambitious effort to bring order to the chaotic world of DNA sequencing. ... The FDA does not put most such diagnostic tests through the approval process; they’re largely exempt from regulatory oversight. Instead, the agency is pushing software developers to voluntarily put their algorithms through a review process. Through an initiative called precisionFDA, launched in 2015, the agency has, in a sense, gamified the effort, launching app-a-thons and community challenges designed to test how accurately — and how consistently — various tests analyze and interpret genetic data. (Keshavan, 8/1)

One of the whistleblowers at the Manchester Veterans Affairs Medical Center said he plans to propose his workplace as a “test case” for national reform of the veterans health care system when he meets with VA Secretary David Shulkin this week. Dr. Ed Kois, the head of the facility’s spinal cord clinic, said he hopes to peel away restrictive layers of bureaucracy at the state’s only veterans hospital and hold it up as a model for the rest of the country. (Reid, 7/31)

While almost every eye on Washington, D.C., last week focused on the Senate and its failed efforts to repeal and replace the Affordable Care Act, another health care battle continued on the other side of the Capitol. Less than three years into existence, the Department of Veterans Affairs' Veterans Choice health program is nearly broke and often criticized for not achieving what it said it would. Lawmakers scrambled to reach a deal that would fund the program for six additional months before the August recess when the program was projected to be broke and would force veterans using the program to return to VA facilities — some hundreds of miles from their homes — to get medical care. (Lowary, 7/31)

For context: In May, the United States Department of Defense requested $639.1 billion for its 2018 fiscal year budget. The proposal, which aims to help America’s armed forces “get bigger and more lethal,” offers an itemized accounting of proposed upgrades, many of which dramatically exceed the total cost of estimates for transgender health care. (Leonard, 7/31)

Suicide-related searches on Google jumped significantly after the release of the show 13 Reasons Why, according to a report published Monday in JAMA Internal Medicine. The show, which premiered in March on Netflix, follows the fictional story of Hannah Baker, a teenager who commits suicide and leaves behind 13 tapes detailing why she decided to end her life. (Toy, 7/31)

“Our analyses suggest 13 Reasons Why, in its present form, has both increased suicidal awareness while unintentionally increasing suicidal ideation,” the authors wrote. “The most rising queries focused on suicidal ideation. For instance, ‘how to commit suicide’, ‘commit suicide’ and ‘how to kill yourself’ were all significantly higher.” Overall, suicide queries were 19 percent higher in the 19 days following the series’ release, “reflecting 900,000 to 1.5 million more searches than expected,” the paper reported. (Murgia, 7/31)

In an effort to find the cause of chronic fatigue syndrome, researchers have identified 17 immune molecules whose concentrations in patients’ blood correlate with disease severity. ...Chronic fatigue syndrome (CFS) is poorly understood and notoriously difficult to diagnose or treat, and some medical professionals question whether it is psychological or biological in nature. One area of research has been cytokines — molecules the immune system uses to communicate while combating foreign invaders in the body. (Caruso, 7/31)

Imagine feeling horribly sick, day after day, yet doctors repeatedly tell you they can't find anything wrong. That typically happens to people with the mysterious illness commonly known as "chronic fatigue syndrome." Research findings from Stanford University released Monday could point the way to a long-sought diagnostic laboratory test for the condition, and possibly a first-ever treatment. (Tucker, 7/31)

The human throat houses billions of bacteria, most of them harmless. But one species is becoming more common, and it is anything but benign. Drug-resistant gonorrhea has been on the rise for years; the World Health Organization has reported an increase in more than 50 countries. Now scientists say the epidemic is being driven by a particular mode of transmission: oral sex. (Pattani, 7/31)

Of the world’s countries, only six — three rich ones and three poor ones — have taken the steps they should have to evaluate their ability to withstand a global pandemic, according to a recent report sponsored by the World Bank. Just three wealthy countries — Finland, Saudi Arabia and the United States — have gone through two external evaluations of their readiness to face pandemics, one for human diseases and one for animal outbreaks, the study found. (McNeil, 7/31)

There are trillions of microbial species in the world and thousands of them live in or on the human body. Bacteria, fungi, viruses and other microorganisms congregate in mini ecosystems called microbiomes, found almost anywhere you can imagine. (Pattani, 7/31)

By now, the connection between sleep and weight gain has been well established. Numerous studies have provided evidence that sleeping too little — less than five hours — messes with your hormones, slows down your metabolism and reprograms your body to eat more. But just how serious are the consequences in terms of numbers? (Cha, 7/31)

Studies show that about three-quarters of patients who see doctors for sinus complaints leave with prescriptions for antibiotics. Unfortunately, these often don’t meet the prescribing guidelines that are meant to curb unnecessary use of the germ-fighting drugs. (Hensley, 7/31)

Before being deployed overseas for the Iraq War in 2003, Army reservist Don Morrison filled out military forms that gave instructions about where to send his body and possessions if he were killed. “I thought, wow, this is mortality right in your face,” Morrison, now 70, recalled. (Andrews, 8/1)

House lawmakers tentatively approved a series of bills Monday aimed at helping Texas curb its unusually high rate of women dying less than a year after childbirth. The primary measure, House Bill 9, would direct the state’s Task Force on Maternal Mortality and Morbidity to continue studying pregnancy complications and maternal deaths until 2023. (Evans, 7/31)

A federal judge has struck down Alabama's one-of-a-kind law that enabled judges to put minors seeking abortions through a trial-like proceeding in which the fetus could get a lawyer and prosecutors could object to the pregnant girl's wishes. (Chandler, 7/31)

Not surprisingly, the six leading candidates to succeed the governor are split over how Georgia should proceed now that the Affordable Care Act seems destined to remain the law of the land. Democrats advocate a full expansion of the Medicaid program, while most of the Republicans are receptive to waivers that would grant Georgia more flexibility in spending federal dollars. (Bluestein, 8/1)

Westwood Lodge, a psychiatric hospital cited for repeated patient care problems, will be allowed to reopen Tuesday under increased oversight, the Baker administration has decided. State regulators had stopped admissions to the Westwood Lodge children’s unit on April 26 and then closed the unit entirely after discovering serious lapses, including the case of a 9-year-old boy who had been given the wrong medication for nine days. (Kowalczyk, 7/31)

The nursing program at MCPHS University in Boston was given a formal warning from the state after students’ sagging scores on the nursing licensure exam triggered a review that uncovered larger problems, documents show. State officials believe the school has run afoul of regulations regarding oversight, instructor qualifications, and student evaluations in the nursing program, according to a letter sent to the school by the state. (Krantz, 8/1)

The city health department has started a pilot program to train [Kendra] Nelson and four other city residents to become doulas — non-medical companions who provide emotional support and comfort to women during delivery. Doulas can also play a guiding role during pregnancy. They help moms develop birth plans, and can work in conjunction with physicians to make sure expectant mothers have the medical information they need to lead a healthy lifestyle during pregnancy. (McDaniels, 8/1)

A lawsuit alleging the Missouri Department of Corrections systematically denies medical treatment to prisoners with chronic hepatitis C has taken a big leap forward after a judge certified it as a class action. U.S. District Judge Nanette Laughrey last week ruled that the lawsuit, which was filed in December, meets all the requirements for class certification, including numerous plaintiffs and common issues of law and fact. (Margolies and Smith, 7/31)

The Executive Council on Wednesday will be asked to approve an $85,000 contract for an outside review of staffing and quality of care at New Hampshire Hospital, paid for by Dartmouth-Hitchcock. Medical staffing at the state-run psychiatric hospital has been a concern since the summer of 2016, when the state agreed to a $36 million contract with Dartmouth-Hitchcock health systems to provide psychiatrists, nurses and administrators. (Solomon, 7/31)

Recent advancements in robotic technology will help patients achieve better results during total knee replacement, says a surgeon who is training his peers on new methods. Dr. Akhil Sastry, of Atlantic Orthopaedics and Sports Medicine in Portsmouth, was one of the first surgeons to try the Mako Total Knee with Triathlon Knee System for Stryker, one of the largest developers and manufacturers of total knee replacement systems in the world. When the company began selling their newest technology for total knee replacements last year, Sastry started teaching surgeons in the United States and around the globe how to use it. (Haas, 7/31)

The proportion of first-baby C-sections at the U hospital — one of 18 hospitals nationwide involved in the Reducing Primary Cesareans project — dropped by 10 percent last year. This year, the researchers are aiming to slash C-section rates by another 10 percent among first-time moms. (Shah, 7/31)

The so-called “gray market” of marijuana in states that have legalized the drug’s use comes with various barriers from conflicts with federal laws. Banking is among those conflicts, with dispensary owners facing difficulties of being cash-only businesses unable to get business loans or offer workers payroll deductions for their federal income taxes. (Coltrain, 7/31)

Finally, some good news: It appears there are at least 40 grown-ups in the U.S. House of Representatives. And they're looking for colleagues in both parties who want to be grown-ups, too. After years of impotent congressional dithering, 43 House lawmakers -- 21 Republicans and 22 Democrats -- have coalesced around a plan to stabilize state health insurance exchanges roiled by uncertainty and advance some modest Obamacare reforms that have attracted support from both parties. (Brian Dickerson, 7/31)

Senate Republicans’ handling of the health insurance issue will go down among the most shameful episodes in the history of the world’s so-called “greatest deliberative body.” In the nearly 90 days since House Republicans passed and handed off the American Health Care Act, Senate Majority Leader Mitch McConnell, R-Ky., has turned the Senate into a Marx Brothers movie. (8/1)

Many Americans look back on the heroic political fights of the past — for suffrage, Social Security, civil rights, Medicare — and wonder why today’s politics never produce inspiring victories. Well, we just witnessed one. If one of the Senate or House health care bills had become law, millions of people would have lost their coverage. Ultimately, many would have been denied medical care. Birth defects, cancer, diabetes and other conditions would have gone untreated. (David Leonhardt, 8/1)

With Republican repeal-and-replace efforts temporarily sidelined, now is a good time to step back and take a big picture view of exactly how we got into the mess we are now in regarding health care.  What should be clear to people of all political persuasions is that Obamacare did not solve America's health care woes. (Chris Conover, 7/31)

One of the greatest bonuses of my years in the Senate was getting to know Sen. John McCain. John has consistently served causes larger than himself, beginning with our country. The speech he gave on the Senate floor last week, followed by his “no” vote after midnight Thursday on a health-care bill nobody wanted to become law, was one of his finest hours. (Joe Lieberman, 7/31)

With the collapse (for now) of the Republican effort to repeal the Affordable Care Act, the Trump administration faces a stark choice. Should it do whatever it can to make Obamacare work? Or should it sabotage the law in an effort to force Democrats to the bargaining table? Make no mistake about it: The choice is in President Trump’s hands. Contrary to Republican talking points, the Affordable Care Act is working. Millions have gained coverage, and the rate of the uninsured is at a historic low. (Nicholas Bagley, 8/1)

Opioid abuse ranks among the nation’s biggest public health challenges with drug overdoses now the leading cause of death among Americans under the age of 50. While the causes are complex and multiple, politicians and their trial lawyer friends aren’t letting the crisis go to waste. (7/31)

If 1,000 people in America were dying in plane crashes or terrorist attacks each week, the country would be horrified, demanding an end to the carnage. Well, 1,000 people are dying each week of drug overdoses, driven largely by addiction to opioids. (7/31)

To paraphrase President Reagan, in this present opioid crisis, "government is not the solution to our problem; government is the problem." The never-ending War on Drugs has led to a proliferation of counterfeit opioids widely available on the black market. Oftentimes, these drugs are laced with more dangerous and powerful opioids such as fentanyl and carfentanil that cause death by cessation of breathing. Many times, the actual strength of the dose of opioids purchased from illegal drug dealers is unknown or greater than expected. (Jeffrey A. Singer, 7/31)

For years, Iowa dentists have complained about the low rate of payment they receive from the Medicaid program. When treating a Medicaid patient, dentists can typically expect to collect just 30 percent of what they’d normally receive for providing the same care to a privately insured patient. As a result, many Iowa dentists have capped the number of Medicaid patients they’ll see — assuming they see any at all. (7/31)

Too many children in our community never see their first birthday. The release of a three-year strategic plan by First Year Cleveland, a city-county collaborative to reduce the high infant mortality rate in Cleveland, brings new focus to the issue. Although fewer infants died In Cuyahoga County in 2016 than in 2015, the infant mortality rate of 8.6 deaths per 1,000 births is still one-third higher than the national average. African-American infants have a mortality rate three times that for Whites. (Joseph Ahern, 7/30)

The explanation for this trending away from political neutrality seems clear: many of the most critical current threats to our health — including poverty, lack of access to affordable health care, gun violence, the opioid epidemic — cannot be eliminated by individuals, no matter how well-meaning. Many clinicians, frustrated by their inability to solve these problems for their own patients, have taken to writing op-ed pieces, marching, and lobbying Congress in hopes of effecting broader change. (Suzanne Koven, 7/31)