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Sen. Kamala Harris is introducing legislation designed to ensure all Americans, particularly those in at-risk communities, have access to safe, affordable drinking water, the latest response to burgeoning water crises across the country. The California Democrat and presidential candidate’s “Water Justice Act” would invest nearly $220 billion in clean and safe drinking water programs, with priority given to high-risk communities and schools. As part of that, Harris’ plan would declare a drinking water infrastructure emergency, devoting $50 billion toward communities and schools where water is contaminated to test for contaminants and to remediate toxic infrastructure. (Summers, 7/22)

2020 presidential candidate Andrew Yang on Monday unveiled a wide-ranging proposal to improve services for veterans, including updates to the education, employment and health care benefits troops receive after leaving the military. (Feldscher, 7/22)

A top Trump administration health official on Monday took aim at the idea of a “public option” health plan, which moderate Democrats have proposed as an alternative to “Medicare for All.” Centers for Medicare and Medicaid Services Administrator Seema Verma on Monday said a government-backed public option would promote unfair competition, and would drive private insurers out of the market. (Weixel, 7/22)

Deposed Planned Parenthood chief Leana Wen vowed in a memo before taking her post that she would treat abortion “as the fight of our time,” calling into question her claim that she was ousted as CEO last week for seeking to depoliticize Planned Parenthood’s signature issue. “We are facing [the] real probability that 1/3 of women of reproductive age—25 million—could be living in states that ban or criminalize abortion,” Wen wrote in an October 2018 internal memo where she laid out her agenda. “[W]e need to fight with everything we have.” (Diamond, 7/22)

Thousands of California women and teenagers seeking free or discounted reproductive health services through a federal program could find themselves in clinics that focus on abstinence and natural family planning as methods of birth control. Operated by the California-based Obria Group, the health centers appear to be modeled after faith-based crisis pregnancy centers, designed to persuade women to continue their pregnancies, but with a twist: Obria’s clinics encourage young clients to use online apps, developed with funding from religious conservatives, to “move them away from sexual risks as their only option in life, to an option of self-control.” (Cha, 7/22)

Texas’ fast-expanding, controversial Alternatives to Abortion program, which pays private counselors to discourage women from terminating their pregnancies, is on track to more than double its funding with a $41 million infusion — and one anti-abortion nonprofit is primed to win big on the state’s largesse. Eighty Republican state lawmakers took the unusual step last month of writing a letter to the Texas Health and Human Services Commission, which oversees the anti-abortion program, directing administrators to expand funding to a particular provider. The Texas Pregnancy Care Network has done such a good job connecting expectant and adoptive parents with counseling and other services, the lawmakers wrote, that the health commission should increase payments to the provider without considering offers from other potential contractors. (Walters, 7/23)

Depending on the outcome of a court decision this week, Arkansas could become the seventh state in the country to have only one abortion clinic. Women in the state could also lose access to any abortions after 10 weeks into their pregnancy. On Monday, Judge Kristine Baker, appointed by President Obama in 2012, heard challenges to three of Arkansas' recently-passed anti-abortion bills. If the laws are allowed to be implemented, it would force the closure of the state's last surgical abortion clinic, Little Rock Family Planning Services. (Smith, 7/22)

The U.S. Department of Agriculture proposed new rules Tuesday to limit access to food stamps for households with savings and other assets, a measure that officials said would cut benefits to about 3 million people. In a telephone call with reporters, U.S. Secretary of Agriculture Sonny Perdue and Acting Deputy Under Secretary Brandon Lipps said the proposed new rules for the Supplemental Nutritional Assistance Program (SNAP) were aimed at ending automatic eligibility for those who were already receiving federal and state assistance. (Reiley, 7/23)

The Agriculture Department issued a proposed rule Tuesday that curtails so-called broad-based categorical eligibility, which makes it easier for Americans with somewhat higher incomes and more savings to participate in the Supplemental Nutrition Assistance Program, or SNAP, the formal name for food stamps. It is the administration's latest step to clamp down on the food stamps program, which covers 38 million Americans, and other public assistance services. It wants to require more poor people to work for SNAP benefits, and it is looking to change the way the poverty threshold is calculated, a move that could strip many low-income residents of their federal benefits over time. (Luhby, 7/23)

“We are changing the rules, preventing abuse of a critical safety net system, so those who need food assistance the most are the only ones who receive it,” he added. Conservatives have long sought cuts in the federal food assistance program for the poor and disabled. House Republicans tried to impose similar restrictions on the food stamp program last year when Congress renewed it but were rebuffed in the Senate. The proposed change in rules for the Supplemental Nutrition Assistance Program -- often called by its former name, food stamps -- would deliver on the goal as the administration has agreed to a deal to lift caps on federal spending. (Dorning, 7/23)

Agriculture Secretary Sonny Perdue said the draft rule published in Tuesday’s Federal Register will end what he and congressional Republicans say is a loophole that allows people with gross incomes above 130 percent of the poverty level to become eligible for the Supplemental Nutrition Assistance Program and potentially qualify for food stamps through the program. They can do so by receiving nominal assistance from the nation’s federal welfare program such as a referral to services or a brochure from the Temporary Assistance for Needy Families, run by the Health and Human Services Department. The Government Accountability Office has raised questions about the use of TANF-financed referrals and brochures being used by states to trigger SNAP eligibility. (Ferguson, 7/23)

The U.S. spends trillions every year on a social safety net for people in all steps of life, from childhood to retirement. A new study from two Harvard University economists, Nathaniel Hendren and Ben Sprung-Keyser, examines 133 U.S. policy changes over the past half-century, including the creation of Medicare, Medicaid expansions, the introduction of food stamps, as well as dozens of state and local programs. (Oh and Adamy, 7/22)

Buyers of 23andMe Inc.’s genetic-testing kits will now have an easier time paying for the service with tax-advantaged health accounts after a favorable IRS ruling. The decision offers more clarity to consumers and reduces the cost of the company’s service. It also highlights differences between the tax law’s permissive definition of medical care and health regulators’ more restrictive approach to direct-to-consumer testing products. The Internal Revenue Service made the ruling in May and will release a redacted version next month. The Wall Street Journal reviewed the document before 23andMe disclosed it Monday. (Rubin and Marcus, 7/22)

The U.S. Food and Drug Administration has approved the first generic copies of a popular, pricey pill for nerve pain. The agency on Monday said it approved nine generic versions of Pfizer Inc.’s Lyrica. It is also used for seizures and fibromyalgia, a condition that causes chronic, widespread pain. Lyrica, approved in 2004, is Pfizer’s second bestseller, with sales last year of $4.6 billion. The heavily advertised drug costs about $460 to $720 per month without insurance, depending on the pharmacy. Prices can vary widely. (Johnson, 7/22)

Federal health officials will invest nearly $100 million to develop a new antibiotic that can treat drug-resistant "superbugs" for which there are currently few or no treatment options. HHS will collaborate with the Defense Department and Malvern, Pa.-based drugmaker VenatoRx Pharmaceuticals on the company's compound VNRX-5133. When combined with the intravenous antibiotic cefepime, the compound might combat bacteria that is resistant to currently available antibiotics, the agencies said Monday. (Johnson, 7/22)

CMS Administrator Seema Verma on Monday took swings at Medicare's "hospital-centric payment model," touting the Trump administration's recent site-neutral payment policy and decrying provider consolidation. Verma condemned Democratic proposals for a public insurance option at a policy summit for the Better Medicare Alliance, which represents Medicare Advantage plans. Medicare or Medicaid buy-in proposals are rapidly gaining momentum among leading Democratic presidential candidates and lawmakers as the next step to cover uninsured Americans or offer cheaper plans. (Luthi, 7/22)

Rural and mountain emergency medical services are trying just about anything to keep their money-losing ambulances running across Colorado’s rugged or remote terrain. High costs, low reimbursement rates and scarce job applicants are forcing ambulance services to consolidate with fire responders, take on new tasks between emergency runs, and outsource fast-growing transport runs to bigger metro hospitals. (Booth, 7/22)

Kaiser Health News: Retiring Abroad? Prepare To Possibly Mix And Match Health Insurance

When Karen Schirack, 67, slipped on her way into her house in January and broke her left femur in multiple places, she had a decision to make. Should she get surgery to repair the fractured thigh bone and replace her hip near Ajijic, Mexico, where she has lived for 20 years, or be airlifted back to her home state of Ohio for surgery and rehab? As the number of American retirees living overseas grows, more of them are confronting choices like Schirack’s about medical care. If they were living in the United States, Medicare would generally be their coverage option. But Medicare doesn’t pay for care outside the U.S., except in limited circumstances. (Andrews, 7/23)

Death rates are rising for young and middle-aged U.S. adults, and the outcomes for whites, blacks and Hispanics are diverging, according to a new government analysis. The report by the Centers for Disease Control and Prevention, to be published Tuesday, adds new detail to a grim picture of worsening health trends across the nation, as the opioid epidemic and stalled progress against heart disease have dragged down life expectancy. (McKay, 7/23)

Dr. Raeford Brown was uniquely positioned to help the U.S. government answer a critical question: Is a new version of the painkiller OxyContin helping fight the national opioid epidemic? An expert in pain treatment at the University of Kentucky, Brown led a panel of outside experts advising the Food and Drug Administration on opioids that have been reformulated to deter snorting and injecting. (7/22)

Drug distribution giants McKesson Corp. and AmerisourceBergen reiterated defenses of their respective businesses this week amidst the deadly opioid epidemic gripping the U.S., according to The Washington Post. The companies' statements, characterized as "broad defenses of their actions," came after The Post published previously secret Drug Enforcement Administration databases showing that five of the nation's largest drug companies distributed 35 billion doses of oxycodone and hydrocodone throughout the U.S. from 2006 through 2012. (DiFurio, 7/22)

A new report from the University of Michigan looks at how overprescribing can create new, persistent opioid users. The report — which analyzed data from a health insurance claims database for 592,000 patients — found that almost 12% of patients diagnosed with an ankle sprain filled an opioid prescription. (Young, 7/22)

Shot in the Dark has cut its monthly operating costs to $5,000 per month, but that doesn't come close to meeting the need, Saucedo said. A recent social media campaign has helped spread the word about the funding shortfall and monthly donors have increased, but more donations are needed to keep the program operating, she said. (Innes, 7/22)

San Francisco is one of the first counties in the state to roll out new updates to the Drug Medi-Cal program. Now the state gets more federal money to provide residential treatment for more people. But each county is responsible for running its own program. So while some bigger counties have gone all in, many rural counties, for financial or political reasons, have implemented the changes on a smaller scale; 18 opted out altogether. (Dembosky, 7/22)

A top aide to Speaker Nancy Pelosi (D-Calif.) said Monday that House Democrats will unveil their long-awaited bill to lower drug prices in September. Wendell Primus, Pelosi's top health care adviser, said House leadership is almost ready to release the proposal but is opting to wait and not leave drug companies the opportunity to attack the bill during the Congressional recess next month. (Sullivan, 7/22)

Speaking at an event on drug prices hosted by the USC-Brookings Schaeffer Initiative for Health Policy, Primus also confirmed some details of the Democrats’ plan to require the government to directly negotiate prices in Medicare. Under the current system, insurers conduct negotiations on drug prices. He said the plan would only apply to drugs without competition that Medicare is spending the most money on. While he didn’t specify a minimum number of drugs that would face negotiation, he noted that 250 drugs made up the majority of spending in Medicare Part B, which covers drugs administered by physicians, and Part D, which covers drugs that seniors pick up at the pharmacy. House members and aides have previously said that the proposal would require the administration to negotiate for a minimum of 250 drugs. (Siddons, 7/22)

Senate Finance Chairman Charles E. Grassley on Monday declined to commit to move a long-anticipated drug price bill forward this week, but Republicans leaving a meeting on the measure said a cost estimate predicted it would lower consumer and government costs. The bill is expected to contain provisions that would slow the growth of Medicare’s prescription drug spending, limit the cost-sharing for people receiving Medicare, and make it easier for state Medicaid programs to pay for expensive treatments. (Siddons, 7/22)

Dozens of coal miners are expected on Capitol Hill on Tuesday, where they'll press federal regulators and members of Congress to address the epidemic of deadly progressive massive fibrosis, the advanced stage of black lung disease. They'll ask lawmakers to fully restore a coal excise tax that pays for medical care and some living expenses for miners diagnosed with black lung, a crippling disease caused by the inhalation of coal and silica dust. The tax was cut more than 50% at the end of last year. It supports the federal Black Lung Disability Trust Fund, which is more than $4 billion in debt. (Berkes and Jingnan, 7/23)

Missouri Democrats are calling for legislative investigations to find out why 120,000 people have fallen off the state’s Medicaid rolls since January 2018. Republican Gov. Mike Parson’s administration has given several possible reasons, including an improving economy and the end of the federal mandate that people carry health insurance or face a tax penalty. (Marso, 7/23)

Upgrades for clients on Medicaid, restrictions on minors getting e-cigarettes and making it easier for nursing home residents to vote by absentee ballot were among a varied stack of bills Gov. Chris Sununu signed late last week. The two-term governor, a Republican from Newfields, signed 39 bills last week while vetoing eight. The total number of vetoes by Sununu in 2019, 38, is a modern-day record, according to veteran political observers. ... Sununu highlighted two measures that make improvements to the state’s Medicaid program, the federal- and state-financed health insurance plan for the state’s low-income, disabled and senior citizens. Sen. Jeb Bradley, R-Wolfeboro, authored a new mandate (SB 274) to allow those on Medicaid to get home visiting services for newborns and pregnant mothers. (Landrigan, 7/22)

Pregnancy care is poised for a 21st century upgrade. Algorithms promise to detect the difference between real labor and a false alarm. Wearables give women a way to track contractions. Apps relay home blood pressure readings directly to doctors, offering a possible way to cut down on prenatal visits — and catch certain pregnancy complications before they become full-blown crises. (Thielking, 7/23)

Health insurers are racing to roll out new digital tools that give them a deeper role in health care, aiming to reduce costs and improve convenience for consumers. The latest sign is a new app from Anthem Inc. that is set to be introduced next week in one state, but later reach the big insurer’s full geographic territory. The app will let consumers, including those who don’t have its insurance, schedule and pay for medical visits through their smartphones, as well as learn potential diagnoses and text with doctors. (Wilde Mathews, 7/22)

When a Mount Sinai Health System patient had to go to the emergency department for what turned out to be a stomach virus, Dr. Bruce Darrow followed up with him by video to ensure that it wasn't a heart issue. The patient, who had a history of heart problems, felt and looked great two days after he was discharged, the cardiologist and chief medical information officer at New York City-based Mount Sinai said. (Kacik, 7/22)

Seven young men sprinted down paths, darting behind houses and vaulting low walls. Each one carried a long-handled net. From yards, alleys and streets the din of canine outrage filled the air, announcing the invasion of the neighborhood. Some dogs hid, others retreated a bit before resuming their chorus of barking. The most wary fled long before the catchers got near. Too bad. Getting caught could be the best thing that ever happened to them. (Gorman, 7/22)

Rabies has been known since antiquity, and has been completely preventable since Pasteur developed a vaccine more than a century ago. But the World Health Organization still considers it “a neglected disease of poor and vulnerable populations.” Why? Rabies, one expert has written, “became a neglected disease when it was eliminated from Europe and North America.” The vast majority of the estimated 59,000 human deaths each year from rabies are in Africa and Asia, in countries with large populations of free-roaming dogs that provide a so-called reservoir for the virus. (Gorman, 7/22)

Nearly 60,000 people a year die from rabies around the world. The cause is almost always a bite by a rabid dog. Most of the deaths are in Africa and Asia. In Western Europe, the United States and other countries, the rabies variant that lives in populations of dogs has been eradicated, but people can still catch rabies from skunks, raccoons, bats and other animals. Bats are now the most common cause of rabies in the United States, but less than one percent of bats have rabies, and their contact with humans is infrequent. Only one to three people die each year from rabies in the United States. (Gorman, 7/22)

It's been seven years since passing boaters found Dawn Day's body floating in a lake on the high plains of Wyoming. Sitting next to each other on the couch, a warm breeze coming in through the screen door, her dad Gregory Day and her aunt Madeleine Day miss Dawn's laughter. "She was crazy," Madeleine Day says. "Crazy in a good way, huh?" Gregory Day says. "Make you laugh." (Edwards, 7/23)

Two new HHS Office of the Inspector General reports identified major deficiencies in Indian Health Service management and policies that led to severe quality and safety problems, risky opioid prescribing and dispensing practices, and vulnerable information technology systems. In one study, the OIG found that IHS made significant improvements at one troubled South Dakota hospital following a seven-month closure of the emergency department in 2015 and 2016 due to quality of care and safety issues. (Meyer, 7/22)

What’s known about the fungus Candida auris confounds the scientists who study it, the doctors who struggle to treat the persistent infections it causes, and the infection control teams that endeavor to clear it from hospital rooms after infected patients leave. But the list of what’s not known about this highly unusual fungus is longer still — and fascinating. Experts say there’s an urgent need for answers and for funding with which to generate them. (Branswell, 7/23)

Millions of people who take aspirin to prevent a heart attack may need to rethink the pill-popping, Harvard researchers reported Monday. A daily low-dose aspirin is recommended for people who have already had a heart attack or stroke and for those diagnosed with heart disease. But for the otherwise healthy, that advice has been overturned. Guidelines released this year ruled out routine aspirin use for many older adults who don't already have heart disease — and said it's only for certain younger people under doctor's orders. (7/22)

When it comes to lawsuits alleging discrimination, the wheels of justice sometimes turn even more slowly than usual. “It’s a difficult process, more difficult than it needs to be,” said Jeff Vardaro, a civil rights attorney in Columbus, Ohio. These cases can become complex and expensive, and defendants and their attorneys have incentives to drag them out. Over the past year or so, I have reported on several suits involving older adults’ complaints of discrimination based on age, sex and disability status, all of which are prohibited under federal law. (Span, 7/22)

Girls aren't alone in hitting puberty earlier -- boys are, too, according to a study published Monday in the medical journal JAMA Pediatrics. And boys' body mass index as children might play a role. Researchers looked through school health records and assessed trends in height and growth for 4,090 boys born in Sweden from 1947 to 1996. Boys born later in that 50-year time period hit puberty sooner. For every decade born later, boys reached peak height velocity, or PHV -- the study's marker for puberty -- 1.5 months earlier. (Nigam, 7/22)

Fashion and lifestyle blogger Maui Bigelow has always been curvy and built a social media presence by embracing every pound. Until the worst happened. At nearly 380 pounds, her health took a dive. She was diagnosed with a blood cancer and multiple uterine fibroids that couldn't be treated due to her weight. That's when she decided to have bariatric surgery, a weight loss procedure. (7/22)

Sticking to a plant-based diet could help lower your risk of type 2 diabetes, a new paper suggests. That link between plant-based eating habits and type 2 diabetes is even more beneficial when only healthy plant-based foods -- such as fruits, vegetables, whole grains, legumes and nuts -- are included in your daily diet, as opposed to refined grains, starches and sugars, according to the study, published in the journal JAMA Internal Medicine on Monday. (Howard, 7/22)

When the HPV vaccine first came on the market in 2006, the CDC recommended it for a relatively narrow slice of the population: just girls and young women, ages 11 to 26. Over the years, though, that recommendation has broadened dramatically, and for good reason. There’s more and more evidence that the shot protects against the human papillomavirus, and prevents cervical, anal, and other cancers. (Belluz, 7/22)

Children whining about being bored is an annoyance as old as time, but fewer parents these days are willing to push the kids out the door and yell, “Come back at dinner time!” The new parenting advice: Structure your child’s unstructured time. It’s a backlash against the advice that started bubbling up a decade ago to let children have unfettered downtime. The idea then was that boredom is a good thing, that it fosters in kids imaginative ways to fill the time. But that was before phones and “Fortnite” became ubiquitous. We all know now that when left to their own devices kids will, well, turn to their devices. (Jargon, 7/23)

Some welcome news at the height of summer swimming season: Children are far less likely to drown in California than they were in the 1980s — and child drowning rates have continued to fall even in the past decade, according to data from the Centers for Disease Control and Prevention. The nation as a whole has experienced a similar, though less dramatic, decline, with drowning rates for children age 14 and younger now about one-third of what they were in the early 1980s. (Reese, 7/22)

The Kentucky Board of Medical Licensure says a Mount Sterling doctor allowed his unlicensed wife to mishandle vaccines, causing an infection outbreak in patients across Kentucky, Indiana and Ohio. The Lexington Herald-Leader reports the board on Friday placed Dr. Paul E. McLaughlin on five years' probation. He also was ordered to pay $5,000 for delegating to someone without a medical license and contributing to a public health crisis. (7/22)

A Tennessee senator and other officials at a now-shuttered pain clinic company are facing a federal lawsuit that claims they defrauded Medicare and Medicaid of more than $25 million. The complaint filed Monday in Nashville by federal and state authorities alleges that Comprehensive Pain Specialists, Republican state Sen. Steve Dickerson and others submitted claims for a variety of unnecessary procedures and falsified documents. (7/22)

Democratic leaders in the Iowa Legislature called Monday for government oversight hearings on Gov. Kim Reynolds' refusal to discuss her reasons for asking the director of the Iowa Department of Human Services to resign. Senate and House Government Oversight Committee Democrats are calling for hearings on Jerry Foxhoven's sudden departure last month, and want him to explain what happened. (7/22)

A hospital failed to adequately monitor and treat a New Jersey high school principal as his oxygen level plummeted during a bone-marrow donation procedure in February, sending him into a coma and leading to his death several weeks later, a lawsuit filed Monday by his fiancee alleges. Westfield High School Principal Derrick Nelson died in April after lapsing into a coma during the procedure at Hackensack University Medical Center, which Sheronda Braker named in her suit. (7/22)

For Regina Brown, hope for a clean life is pink and comes at the bottom of a little plastic cup. Each weekday, Brown rises early to stop at the Man Alive Lane Treatment Center before work. She takes a number and waits her turn before approaching a staffer sitting behind a plexiglass window. A small dose of methadone is passed through a hatch, and she gulps down the bitter liquid. Before she can leave, Brown must open her mouth to say “thank you” to the clinic worker — a practice to ensure patients won’t spit out the medication later to sell on the street. (Bui and Demkovich, 7/22)

A compliance officer at the Minnesota Department of Human Services (DHS) said she was the victim of retaliation after she raised alarms about the legality of contracts at the social services agency. Faye K. Bernstein, a lead contract specialist at DHS, said she was verbally reprimanded and sidelined from her duties after she pointed out “serious non-compliance issues” with a group of contracts approved by leaders in the agency’s behavioral health division, which awards millions of dollars each year in contracts for mental health and substance use treatment and services. (Serres and Howatt, 7/23)

Lawmakers intent on wiping out Connecticut’s religious exemption to vaccines are courting a powerful ally they hope will help sell their case next year. But so far, the state’s new health commissioner is taking extraordinary pains to remain outside the political fray. (Carlesso, 7/23)

Less than 1,000 votes kept EvergreenHealth from passing a $345 million bond that the public hospital district said was needed to pay for needed upgrades. In the aftermath of April’s election, officials at EvergreenHealth Medical Center in Kirkland learned that Eastside voters, not surprisingly, were concerned about seeing their taxes increase. So they tried to figure out a way for the tax rate to remain the same without decreasing the amount of the bond measure. The result is a revised 20-year, $345 million bond measure on the Aug. 6 election ballot that would fund a new critical-care unit, an undated maternity center and work to retrofit the original hospital building. (Cornwell, 7/22)

Michael Thomas Barton, an inmate who suffered from mental illness and contracted the flu, died in custody because prison nurses and doctors failed to give him appropriate medical care, an advocacy group alleges in a new report released Monday. Barton begged to stay in the infirmary of the Oregon State Penitentiary, but medical staff disregarded his pleas as well as the pleas of other inmates and prison employees to get him help, Disability Rights Oregon claims. (Bernstein, 7/22)

[Don Thompson's] lifeline was being able to live independently at Friendship Palms, a government-subsidized apartment complex for people battling mental health issues. As well as cheap housing — Thompson pays about $280 per month — residents receive in-home mental health services. ...Project Return, the nonprofit that owns the complex, learned in February that it lost a federal grant that helped pay for the housing. Officials waited until June 6 to notify tenants of plans to sell the complex and that they must move out by the end of July. (O'Donnell and Kumar, 7/22)

The family of an inmate who died last month amid a mumps outbreak at the Harris County Jail believe he may have been exposed to the contagion at the facility. At a news conference outside the jail Monday, the prisoner’s wife, children and a granddaughter said they believed the jail had been negligent in protecting Ronald Washington after he was exposed to mumps. Randall Kallinen, a lawyer for the family, said mumps is “highly treatable” and said the family wants the Texas Rangers to investigate. (Banks, 7/22)

Kaiser Health News: Missouri Firm With Silicon Valley Ties Faces Medicare Billing Scrutiny

In many ways, Essence Group Holdings Corp. is a homegrown health care success story. Founded locally, it has grown into a broader company backed by a major Silicon Valley investor. Essence now boasts Medicare Advantage plans for seniors with some 60,000 members in Missouri and across the Mississippi River in Illinois. It ranks among the city’s top 35 privately held companies, according to the St. Louis Business Journal. And market research firm PitchBook Data values the company at over $1.64 billion. (Weber and Schulte, 7/23)

Gov. Chris Sununu is asking a legislative budget oversight group to take off the state budget firing line a popular program that provides services to adults with developmental disabilities. The two-term Newfields Republican is likely to get his wish from Democrats that dominate the Legislative Fiscal Committee but its leaders don’t agree with Sununu’s description of this dilemma as an “unintended consequence.” Sununu wrote the chairman of the Legislative Fiscal Committee Monday lobbing for support of an emergency spending item totaling $15.9 million for the so-called DD Wait List program. (Landrigan, 7/22)

An Eastern North Carolina hospital is planning to shut down its inpatient mental health unit next month. The impending closure of Vidant Beaufort Hospital’s 19-bed unit is the first time in recent memory that a mental health ward receiving state funds through a so-called “three-way contract” is closing, an N.C. Department of Health and Human Services spokeswoman said in an email. (Engel-Smith, 7/22)

Toxic blue-green algal blooms have been causing major problems on Kansas’ lakes since about 2010. Because the pond scum can make people sick, the lakes became out of bounds for swimmers and the like. Yet now the phenomenon is costing Kansans money. It’s infiltrating city water systems, triggering slightly more expensive treatments to keep drinking water safe. (Grimmett, 7/22)

Disability rights groups are accusing West Virginia’s largest school system of providing an inferior education for students with disabilities and segregating them, according to complaints lodged with state officials. The rights groups filed complaints with the West Virginia Department of Education on behalf of three students in June, accusing Kanawha County Schools of failing to provide the students academic and behavioral supports related to their disabilities. (Truong, 7/22)

In the pervasive gloom that has surrounded the results of L.A. County’s annual homeless count, officials have repeatedly pointed to one bit of bright news: A record number of people got off the streets and into housing last year. The 21,631 people who were housed last year using millions of new tax dollars was 23% higher than in 2017 and double the number housed in 2014. Still, the population living on the streets, in vehicles and in shelters climbed 12% in the past year, putting the number of homeless people at nearly 59,000 countywide. (Smith, 7/20)

Adversaries of Medicaid expansion have always pointed to the lack of evidence that enrollment in Medicaid improves health and saves lives, and therefore the expansion is a waste. A new study should put that argument to rest, permanently. The researchers found not only that the expansion of Medicaid under the Affordable Care Act brought appreciable improvements in health to enrollees, but also that full expansion nationwide would have averted 15,600 deaths among the vulnerable Medicaid-eligible population. (Michael Hiltzik, 7/22)

Health care was a key factor in Democrats’ victory in the 2018 midterm elections, and it should be a big plus in 2020 as well. The shared Democratic position — that every legal resident should have access to affordable care, regardless of income or health status — is immensely popular. The de facto Republican position — that we should go back to a situation in which those whose jobs don’t come with health benefits, or who suffer from pre-existing medical conditions, can’t get insurance — is so unpopular that G.O.P. candidates consistently lie about their own proposals. But right now, two of the major contenders for the Democratic presidential nomination, Joe Biden and Bernie Sanders, are having an ugly argument about health care that could hurt the party’s chances. (Paul Krugman, 7/22)

Republicans have nipped at the edges of the ACA but have fallen far short of repealing or replacing the controversial legislation. No GOP plans have garnered support, especially since Sen. John McCain was the deciding vote to keep Obamacare in place. But conservatives didn’t create the “unjust and inefficient” system being denounced by candidates today. You built that, Democrats. Obama and Biden’s promise that government can create a better health-care system than the free market has obviously been a disappointment. Taxpayers would be unwise to let them try again. (Jon Gabriel, 7/20)

The House voted last week to repeal a key piece of Obamacare. Hadn’t heard? That’s because hardly anyone in either party uttered a peep of concern; the repeal passed by a whopping 419-to-6 margin. The provision in question was the so-called Cadillac tax on overly generous health-care plans, designed to keep costs down even as more people got coverage, which was set to phase in three years from now. The repeal action moves to the Senate, where there is wide support. Repeal would cost the treasury $197 billion over a decade, according to the Congressional Budget Office. (7/22)

The rising cost of health care has become one of the largest sources of stress on American household budgets in the 21st century. More than one-quarter of Americans report problems paying medical bills in the past year, and many are sacrificing spending on basic necessities like food and clothing to pay medical bills. It’s no wonder that nearly 70% of Americans want lawmakers to make reducing health care costs a top priority. Congress has gotten the message and is finally starting to work on surprise medical bills and prescription drug costs. (Shannon Brownlee and Benjamin F. Miller, 7/23)

Universal coverage might increase costs for one big reason: When the uninsured get coverage (or the underinsured get better coverage), they’re likely to use more health care. For example, a study begun in the 1970s randomized thousands of people into different health care plans, and found that those with better coverage used more health care ...And yet, nations with universal coverage spend much less than the United States on health care. (Adam Gaffney, David Himmelstein and Steffie Woolhandler, 7/23)

“Medicare for All” advocates, such as Sen. Bernie Sanders (I-Vt.), argue that single-payer health care could help pay for a major expansion of coverage by greatly reducing the cost of purchasing medical services. They base their argument on two principal observations: that Medicare pays 40 percent less than private insurers for hospital services, and that medical costs are much lower in countries where prices are set by the government. What do we learn from comparing America’s health care costs with those of Sweden or Spain? (Chris Pope, 7/22)

Doctors are full of advice: Eat healthy. Exercise. Don’t miss your medications. Don’t get that unnecessary test. The premise behind this advice is simple: most people have little medical knowledge and doctors, by giving their patients more and better information about their health and available treatments, can help them make better decisions. But health education isn’t just the cornerstone of the patient-doctor relationship, it’s also the backbone of an enormous number of policies designed to improve public health. (Michael D. Frakes, Jonathan Gruber and Anupam B. Jena, 7/22)

Cancer physicians for more than a century have followed the simple dictum that more is better—more surgery, more radiation, more chemotherapy and, most recently, more immunotherapy. But how much is enough? Do we escalate doses to the point of lethality, as those engaged in bone-marrow transplantation are forced to do regularly? Is this struggle to eliminate every patient’s cancer achievable or even warranted? These questions have taken on a new urgency because oncology has lost sight of a basic principle: Every patient is a uniquely complex person with different medical needs requiring different treatments. (Robert Nagourney, 7/22)

Our bungalow was still dark when my cellphone rang at 5 a.m. My husband and I had escaped for a much needed yoga retreat on the remote island of Koh Phangan, Thailand, when I got the phone call no parent ever expects to get — a call that four years of medical school, three years of pediatric residency training and 15 years of practicing pediatrics hadn’t prepared me for. At the sound of the middle school principal’s voice, my heart started racing. “We know you are away and it is early, but we had to call you.” (Hassouri, 7/19)

What disease in the world today disables the most people? By many measures, it’s depression — and that holds nearly everywhere, whether you live in Zimbabwe or the United States. In poor countries, virtually no one gets treatment. But even rich countries run short. A survey in 2013 and 2014 found that about half a million residents of New York City had depression and that fewer than 40 percent of them got treatment. The city is taking this problem seriously, mainly through the efforts of ThriveNYC, a program founded by Mayor Bill de Blasio’s wife, Chirlane McCray. (Tina Rosenberg, 7/22)

Marijuana’s role in the health care universe has grown exponentially over the past few years. Currently, 33 U.S. states have legalized the use of medical marijuana, and more and more states are considering making it legal for recreational purposes as well. As cannabis becomes more accessible, many people are turning to tetrahydrocannabinol (THC) and cannabidiol (CBD) products to treat health issues like rheumatic and musculoskeletal disease (the aches and pains of arthritis). (Seth Ginsberg, 7/23)

As someone who has devoted his life to law enforcement, it pains me to see that some prominent voices in the law enforcement community are using their platforms to mislead and frighten the public. California, for example, is getting safer, even while a small group of fearmongers continues to insist that the sky is falling. (Downing, 7/22)

I’m glad that Planned Parenthood made this move, because it underscores something I have always known: that the organization doesn’t actually focus on women’s health. (Christine Flowers, 7/19)

Last month, three judges on an Army appeals court — two women and a man — overturned a 2017 rape conviction at West Point. They did so on the grounds that they did not believe there was sufficient evidence to show that the sex had not been consensual. One key piece of exculpating evidence, the judges found, was that Cadet Jacob D. Whisenhunt had made no effort to avoid being detected, or even to clean up his semen from the sleeping bag of the woman who had accused him of raping her — a sign that he thought he had nothing to hide. But why would he hide? He had nothing to fear. (Ryan Leigh Dostie, 7/22)

Putting politics aside, there is still a question looming on my mind: Why, if almost three decades of longevity have been tacked on to Americans’ lives since Social Security was implemented, haven’t we changed our ideas about the typical retirement age and what constitutes “old” age? It’s time for everyone to acknowledge that a new stage of life, between working age and being old, exists. And this stage of life can be just as rich as any other stage. (Wes Moss, 7/19)

Texas lawmakers made real progress on big-ticket issues like public school finance. However, on some key issues, like health care, much was left undone or completely ignored. Case in point: The Texas Legislature chose to sit on its hands in the face of a growing measles epidemic. (Rekha Lakshmanan, 7/19)

If older workers stayed on the job longer, they could do a lot for the labor shortage — and improve their financial prospects in the bargain. But 4 in 10 people retire earlier than expected, which often leads to a financial mistake: signing up for Social Security benefits before reaching full retirement age. (Mitchell Schnurman, 7/20)