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GOP leaders are planning to present to Senate Republicans options for the major policy decisions shaping their health-care bill during a closed-door lunch Tuesday, Senate GOP lawmakers and aides said Monday. The proposals are expected to include a prolonged phaseout of the Affordable Care Act’s Medicaid expansion. There is also growing interest in possible steps to shore up fragile individual insurance markets, according to people familiar with the discussions. (Armour and Peterson, 6/5)

"We've been talking about this for seven years, so now is the time to start coming up with some tangible alternatives and building consensus," GOP Sen. John Cornyn of Texas said Monday. (Werner, 6/5)

It’s a gut-check situation for Republicans, who are about to be confronted with tough choices that may result in millions fewer people with insurance coverage as a condition for cutting taxes and lowering some people’s premiums. “I don’t think this gets better over time,” said Sen. Roy Blunt (R-Mo.), a member of leadership. “So my personal view is we’ve got until now and the Fourth of July to decide if the votes are there or not. And I hope they are.” (Haberkorn and Everett, 6/5)

Thune acknowledged that members had varying perspectives on the likelihood of achieving the needed votes. (Lesniewski, 6/5)

Asked when the Senate would vote on a bill, Sen. John Cornyn (R-Texas) said, "July sometime." (Sullivan, 6/5)

President Donald Trump will meet with House and Senate leadership at the White House Tuesday afternoon to plot a path forward on health care and tax reform—two of the administration’s top legislative priorities that have been stalled in recent months amid a growing investigation into Trump associates’ ties to Russia. (Ballhaus, 6/5)

Senate Republicans may have too many cooks in the kitchen when it comes to healthcare, and it’s complicating efforts to draft an ObamaCare replacement bill. The main Senate group working on crafting healthcare legislation is the task force of 13 men backed by Senate leaders. It won negative attention early on for its lack of women, at which point GOP leaders opened it up to all members. (Weixel, 6/6)

Senate Majority Leader Mitch McConnell’s 13-member health care working group has gotten a lot of attention. But in the Senate, where a minority group of members can effectively stall any legislation from advancing, buy-in from the broader Republican Conference will be necessary for the GOP to succeed in overhauling President Barack Obama’s signature domestic policy achievement, the 2010 health care law. Given those dynamics, Roll Call has compiled its own roster of 13 lawmakers to watch as debate on the repeal bill continues. The list represents the various factions within the Republican Conference and the opposing views on key issues. (Williams and Kelly, 6/6)

Speaker Paul Ryan, eager to protect his House majority in what’s expected to be a politically volatile election cycle, is stepping up his fundraising following the chamber’s vote to repeal and replace Obamacare. The Wisconsin Republican’s political team on Tuesday morning will announce that Ryan has raised $22 million for House Republicans in the first five months of 2017, setting him on track to far outpace his 2016 fundraising haul. (Bade, 6/5)

Rep. David Valadao’s colleagues privately thought he’d vote against the House GOP bill to repeal and replace Obamacare. The California Republican’s Hispanic-populated swing district went for Hillary Clinton by a whopping 15 percent margin. And with more than half his impoverished constituency here in rural San Joaquin Valley on Medicaid, opposing a bill to cut $800 billion from the low-income health care program certainly would have been the politically prudent thing to do. (Bade, 6/5)

Emergency room doctor Rob Davidson announced he would challenge Michigan Republican Rep. Bill Huizenga after confronting him at a town hall event earlier this year. Huizenga and Davidson debated about health care during an event in February in Baldwin, Mich. (Garcia, 6/5)

New York Gov. Andrew Cuomo on Monday issued emergency regulations aimed at deterring insurers from leaving the state’s Affordable Care Act exchange market as Congress weighs repealing former President Barack Obama’s signature health-insurance law. The ACA, often dubbed “Obamacare,” set up marketplaces where consumers can buy coverage from different insurers and obtain federal subsidies to help with the cost. But the House of Representatives has passed legislation that would bring huge changes to the current exchange markets. The Senate is working on its own version of the bill. (Vilensky and Wilde Mathews, 6/5)

New York insurers have concerns about the plan, especially since the regulations to put it in place aren’t yet available, said Leslie Moran, senior vice president at the New York Health Plan Association. “We’re not sure that they can legally just say we won’t contract, because there are already contracts in place,” she said. “We just have some questions and concerns about where they’re trying to go with that.” (Tracer, 6/5)

Republican lawmakers and President Trump have criticized Obamacare, saying it took away people’s ability to choose their health plans and doctors, pointing to a recent exodus of insurers that could leave areas with a single insurer or none at all. Mr. Trump has insisted the markets are failing. Supporters of the Affordable Care Act hoped the law would spur more competition among insurers across the country. But so far, the law has not delivered on that promise, especially in states that never had much competition, but it didn’t create the lack of choice in those states, according to a Times analysis of insurer participation provided by the Robert Wood Johnson Foundation. (Abelson and Park, 6/6)

The immense uncertainty surrounding ObamaCare has some areas wondering whether they’ll soon be in a dead zone — a place without any insurance plans to buy on the healthcare exchanges. Insurance companies are in the midst of filing premium requests for the Affordable Care Act’s (ACA) marketplaces. But before seeking those premium hikes, they’ll have to decide whether to continue offering coverage at all. (Roubein, 6/6)

The second-largest insurer in the New Hampshire Obamacare market said his company has requested average rate hikes of 30 percent next year, blaming the increase on two provisions of the health care law — Medicaid expansion and federally imposed risk adjustments. Minuteman Health Chief Executive Officer Tom Policelli disclosed the preliminary proposal in a newspaper interview on Monday. He said Medicaid-expansion customers, who don’t pay any premiums or deductibles, won’t feel any impact, and subsidized Exchange customers will feel very little. (Hayward, 6/5)

Monday was the deadline for insurance companies in Ohio to propose their 2018 rates under the Affordable Care Act. That’s without knowing whether former President Barack Obama’s plan will be gutted or President Donald Trump will support government subsidies and other elements that were popular with consumer advocates. Eleven insurers had filed rates for the upcoming coverage year by 5 p.m. Monday. That’s the same number as this year, but six fewer than in 2016. The Ohio Department of Insurance would not yet identify the companies or release their rates. (Rinehart and Huson, 6/6)

The head of the Department of Veterans Affairs said Monday the agency will scrap its current electronic-records system and use the same system as the one now operating at the Defense Department. Dr. David Shulkin, the VA secretary, said the department will transition away from its antiquated electronic-records system and use a system interoperable with that used by the Defense Department, a yearslong goal for the two departments. (Kesling, 6/5)

Shulkin said the VA will adopt the same EHR system as the Defense Department, which is based on Cerner’s Millenium product. Until now, the two organizations have not adopted the same EHR system, instead spending hundreds of millions of dollars on “interoperability” – or ensuring the different IT and software systems can communicate with one another. (Margolies, 6/5)

Under the proposed change, the VA will work immediately to sign a contract with Cerner Corp., which designed the Pentagon's system, known as MHS Genesis. Shulkin said that because all the VA's patients originate in the Pentagon system, the VA would be better served if it could "trade information seamlessly." To expedite the process, Shulkin said he intended to bypass competitive bidding in favor of Cerner, noting that it took the Pentagon 26 months to finalize its contact. (6/5)

Shulkin said the exact VA contract value may not be known for three to six months, but industry observers suggested it will be worth hundreds of million of dollars. After 17 years of talking about melding the two health records systems, adoption of the same system “will ultimately result in all patient data residing in one common system,” the secretary said. (Stafford and Wise, 6/5)

“This is, essentially, the most cost-effective way to go,” Shulkin said when asked whether a cost benefit analysis had been conducted on the pick. He added that while there were "no guarantees" about how the rollout would go, DOD's previous experience implementing the upgrade would help. (Mejdrich, 6/5)

In a statement issued the same day, Cerner said the implementation "will lead to ongoing innovation, improved interoperability and the creating of a single longitudinal health record that can facilitate the efficient exchange of data among military care facilities and the thousands of civilian healthcare providers where current and former service members receive care." (Arndt, 6/5)

The U.S. Supreme Court on Monday ruled that church-affiliated hospital systems do not have to comply with a federal law governing employee pensions, overturning lower court decisions that could have cost the hospitals billions of dollars. The court ruled 8-0 that church-affiliated organizations are exempt from the Employee Retirement Income Security Act, a 1974 law that forces private employers to follow rules aimed at protecting pension plan participants. (Chung, 6/5)

The U.S. Supreme Court ruled Monday that Advocate Health Care and two other religiously affiliated hospital systems don't have to follow a federal law designed to protect employee pensions. The justices ruled unanimously in favor of Advocate, with the exception of new Justice Neil Gorsuch, who did not take part in the decision. The ruling, which reversed a lower court's decision, will save a number of religiously affiliated hospitals in Illinois and across the country from having to potentially pour more money into funding and supporting their pension systems. But it also means employees of those hospitals may not enjoy the same protections as employees of many other businesses when it comes to their pensions. (Schencker, 6/5)

The U.S. Supreme Court on Monday unanimously issued a decision that revives a decades-old practice exempting faith-based hospitals from federal pension regulations. The eight justices ruled that faith-based hospitals' pension plans qualify for the so-called "church plan" exemption from the Employee Retirement Income Security Act. Hospitals and health systems ranging from Dignity Health and Advocate Health Care down to one-hospital systems such as St. Peter's Healthcare System in New Brunswick, N.J., will not have to pay premiums to the Pension Benefit Guaranty Corp. or fully fund their pensions to meet ERISA requirements. (Teichert, 6/5)

Puerto Rico’s Zika epidemic has ended, officials said Monday, noting substantially fewer new cases this spring. Only 10 cases have been reported in each four-week period since April, a dramatic decrease from the more than 8,000 cases reported in a four-week period at the peak of the epidemic last August, according to a health ministry statement. (Sun, 6/5)

The announcement seemed to be an attempt by the government of the financially troubled territory to draw a line under an outbreak that has hit the island — in terms of both disease counts and economic fallout — harder than any other part of the United States. (Branswell, 6/5)

Hoping to get ahead of potential Zika outbreaks, Planned Parenthood of Collier County is launching a new education initiative aimed at prevention. While anyone is a target for a mosquito carrying the virus, the awareness program aims to help women protect their unborn children from the virus in underserved communities like Immokalee. (Smith, 6/4)

Three weeks after her last appointment, Sonja Mae Jonsson got a call from her doctor’s office in Waldport, telling her she needed to come in. Her urine drug screen had tested positive for a drug she hadn’t been prescribed. The doctor would no longer prescribe her any pain medication. Linda Jonsson, a registered nurse, had taken over her daughter’s care after a traumatic brain injury when she was 32, and carefully monitored her daughter’s medications. She pleaded with the clinic they had made a mistake. Without the pain medications, they would be condemning her daughter to a life of pain. But doctors had seen too many patients become addicted to painkillers and wind up overdosing. They were cutting her off. (Hawryluk, 6/2)

This town on the eastern border of Kentucky has 3,150 residents, one hotel, one gas station, one fire station — and about 50 opiate overdoses each month. On the first weekend of each month, when public benefits like disability get paid out, the local fire chief estimates the city sees about half a million dollars in drug sales. The area is poor — 29 percent of county residents live in poverty, and, amid the retreat of the coal industry, the unemployment rate was 12.2 percent when I visited last August— and those selling pills are not always who you’d expect. (Kliff, 6/5)

Going further than last week’s state lawsuit against drug makers, the cities of Dayton and Lorain also sued the companies and doctors Monday who spread opioids that made Ohio the drug overdose capital of America. “This case is about one thing: corporate greed. Defendants put their desire for profits above the health and well-being of the City of Dayton consumers,” says the opening line of the 233-page lawsuit for Dayton. (Johnson, 6/5)

With drug use among workers appearing to be on the rise, more employers across Maryland and the nation may face such decisions. Those who track workplace drug use say the problem is worsening because of the nationwide opioid epidemic, the loosening of marijuana laws in many states, including Maryland, and a resurgence of cocaine. An index maintained by Quest Diagnostics, one of the nation's largest workforce testing labs with 10 million samples annually, shows that positive results among workers last year hit a 12-year high, encompassing a spectrum of illicit drugs, including heroin, marijuana, cocaine and methamphetamines. (Cohn, 6/5)

A Manhattan family doctor was arrested Monday on accusations he wrote thousands of prescriptions for oxycodone without a legitimate medical purpose. Federal prosecutors in Brooklyn charged Martin Tesher, 81 years old, with illegally distributing a controlled substance. From June 2012 through January 2017, Dr. Tesher wrote more than 14,000 oxycodone prescriptions, totaling more than 2.2 million pills, prosecutors said. (Ramey, 6/5)

More than a third of all American adults have gone online to find a diagnosis, according to a 2013 Pew survey, and half of those people wound up discussing what they found with their health care provider. Looking for a digital diagnosis can either increase or alleviate concerns about a possible illness, according to Microsoft researchers. And there’s even a word that’s cropped up — “cyberchondria” — to describe what happens when searching for medical information starts to become a condition unto itself. (Sheridan, 6/6)

The divide between health outcomes for the richest and poorest Americans is among the largest in the world, according to a new study. Of people in households making less than $22,500 a year, 38 percent reported being in poor or fair health in a survey taken between 2011 and 2013. That's more than three times the rate of health troubles than faced by individuals in households making more than $47,700 a year, where only 12 percent of people reported being in poor to fair health, according to the findings published in Health Affairs. (Johnson, 6/5)

Heart disease is the leading cause of death for people with Type 2 diabetes. Surely, then, the way to dodge this bullet is to treat the disease and lower blood sugar. Well, maybe. Growing evidence suggests that the method by which blood sugar is lowered may make a big difference in heart risk. That has raised a medical dilemma affecting tens of millions of people with Type 2 diabetes — and for the doctors who treat them. (Kolata, 6/5)

Treatments for the [arthritis] afflicting about 1.5 million Americans can have terrifying side effects, so doctors and patients were excited when Actemra reached the U.S. market in 2010. Unlike competing drugs, it wasn’t associated with heart attacks, heart failure, or life-threatening lung complications. Yet hundreds of patients taking Actemra have died from such problems, and many more have suffered harm. STAT analyzed more than 500,000 side-effect reports on rheumatoid arthritis drugs, and found clear evidence that the risks of heart attacks, strokes, heart failure, and other conditions were as high or higher for Actemra patients than for patients taking some competing drugs. (Piller, 6/5)

Scientists are paying increasing attention to the “indoor microbiome,” the billions of bacteria, viruses and fungi that we share our homes and offices with. But not all those micro-organisms are bad for us, experts note. And exposure to a rich array of indoor germs may actually be salutary, helping stave off a variety of illnesses. (Schiffman, 6/6)

Women with metastatic breast cancer are living longer. In 1990, there were 105,354 women alive with the disease in the United States, according to a new analysis. Now that figure has risen to an estimated 154,794. (Bakalar, 6/5)

A major outbreak of botulism, a rare type of food poisoning, struck 10 people in Northern California over the last month, killing one Antioch man. Sacramento County health officials traced the illness to a gas station in Walnut Grove, where the victims were sickened after eating nacho cheese sauce from a dispenser. Botulism is caused by a dangerous nerve toxin created when a bacteria called clostridium botulinum multiplies in food. Symptoms begin with vomiting and blurred vision followed by a slow paralysis that can lead to respiratory failure if an antitoxin is not administered in time. (Caiola, 6/5)

A 31-year-old man who died earlier this year contracted flesh-eating bacteria while swimming in the Gulf of Mexico with a freshly inked tattoo, according to a new report. The gruesome details of the man's death are documented in a BMJ case report published May 27, 2017, which chronicles how the bacteria slowly ate away the flesh on the man's leg in the weeks preceding his death. (Bradshaw, 6/5)

America’s love affair with backyard chickens is a tad too intimate, and it’s making some of us sick. Just this year, the Centers for Disease Control and Prevention says, eight separate salmonella outbreaks linked to contact with pet poultry have taken place in the United States, sickening more than 370 people in 47 states and hospitalizing 71. (Brulliard, 6/5)

The Centers for Disease Control and Prevention Is investigating outbreaks of Salmonella in 47 states, including Ohio, connected to backyard flocks. As of May 25, 372 people had been infected since Jan. 4. In Ohio, 32 cases were reported to the Ohio Department of Health between Jan. 4 and June 2, said Melanie Amato, public information officer for the department. Ohio topped the list of states that reported illnesses, followed by Kentucky, Tennessee and California. (Washington, 6/5)

Salmonella can cause diarrhea, fever and abdominal cramps. Symptoms usually begin 12 to 72 hours after infection, health officials say. Most people recover within a week, but children, older adults and people with weakened immune systems are at highest risk for more serious health problems. Nationwide, 36 percent of the people infected in the outbreaks this year have been children younger than 5 years old. (Anderson, 6/5)

Emily Borghard has a computer inside her skull, but you wouldn’t know it to look at her. A small bump behind her left ear, the only external evidence of her implant, is partially covered by a tuft of hair that’s still growing in from the last time she had the batteries changed. Before Borghard received a brain implant, she was having as many as 400 “spikes” of seizure-like activity a day, along with multiple seizures. ... The field that gave Emily her life back is known as neurotechnology, or simply neurotech—a marriage of neurology, neuroscience, neurosurgery and the kind of hardware that goes into smartphones. Today, most neurotech companies are focused on medical applications, which they think could be a multibillion-dollar market. (Mims, 6/5)

A controversial Michigan Supreme Court decision has upended bill-collection practices for hospitals and clinics that treat people after auto accidents and could result in some patients getting surprise medical bills in the mail, although insurance companies say it may reduce costs for consumers. The state's highest court issued an opinion May 25 that says medical providers have no legal right to sue auto insurance companies for the unpaid bills of patients who received treatment through no-fault insurance benefits. (Reindl, 6/5)

Multiple Metro Council members are pushing changes to Mayor Megan Barry’s budget to increase funding for Nashville General Hospital, convinced a greater subsidy is needed given recent financial woes for the city’s safety-net hospital. Barry has proposed a $35 million subsidy for the Metro-operated hospital in her 2017-18 budget, which would be the same level as the last three years. Her proposal is $20.7 million less than the $55.7 million requested by General Hospital CEO Joseph Webb, who sought — and was granted — emergency funds that went on top of the hospital's last two budget allocations. The council approved both requests. (Garrison, 6/5)

The hospital announced Monday that John D. Couris, a hospital executive from Jupiter with a decade of high-level experience in Pinellas and Pasco counties, will become its new leader in September. (Puente, 6/5)

Crotched Mountain Foundation's board voted Monday to close its longtime specialty hospital in Greenfield, likely by the end of August. On a call with reporters Monday evening, Crotched Mountain officials cited a storm of factors — declining patient admissions, difficulty attracting qualified staff, state funding issues — as reasons for the closure, but said stagnant reimbursement rates were a significant factor. "We lose money on every patient — so even if we filled the hospital, we'd be filling the hospital with patients where we lose money," Crotched Mountain Foundation President Michael Coughlin said. (McDermott, 6/5)

Main Line Health has not lost its status as a financial juggernaut, but the system has felt financial pressure in recent years from rising expenses, inpatient volume swings, and weaker reimbursement, Fitch Ratings said even as it gave Main Line’s proposed $105.5 million bond offering a ‘AA’ rating, which is third from highest. The strengths of the nonprofit system, which owns four acute-care hospitals, include its trove of $1.47 billion of unrestricted cash and investments and an extremely low debt load of $285 million, including the new offering, which will be used to pay off old debt and pay for a portion of capital projects at Lankenau Medical Center and Bryn Mawr Hospital. (Brubaker, 6/6)

Every Friday, Christine Crawford has a counseling session at a clinic at New York City’s Mount Sinai Health System as she moves ahead with plans for gender transition surgery later this year. In addition to the many medical and psychosocial issues, there are practical ones as well. So, Crawford was thrilled when a Mount Sinai representative said they would assign a lawyer to help her legally change her name to Christine. (Andrews, 6/6)

The state House is poised to vote on a bill ensuring that abortion remains legal in Delaware if Roe v. Wade is ever overturned. The bill, which narrowly cleared the Senate last month, was scheduled for a House vote Tuesday. Delaware’s current law allows abortions only if the mother’s health is at risk, if there is a substantial risk the child would be born with serious disabilities, or if pregnancy results from rape or incest. It also prohibits abortions beyond 20 weeks of pregnancy. (6/6)

Health care and religious leaders are working in tandem to control Minnesota's measles outbreak, which has stricken the state's majority-Muslim Somali community. With another three weeks of Ramadan and its numerous gatherings and prayers yet to come, officials face the challenge of getting through the holy month without the highly contagious disease spreading further. (Zdechlik, 6/5)

The Seattle City Council on Monday approved a new tax on soda and other sugary beverages as way to raise millions for healthy food and education programs. The ordinance calls for a tax of 1.75 cents per ounce to be paid by distributors of beverages such as Pepsi and Coke, sports drinks, energy drinks and other sweetened drinks. The tax excludes diet drinks. (Le, 6/5)

A retired Falmouth doctor who has metastatic prostate cancer can continue pursuing a lawsuit seeking the right to obtain a lethal dose of medication from his doctor and choose when he dies, a Suffolk Superior Court judge ruled. The judge refused to dismiss a case brought against the state by Dr. Roger M. Kligler, a longtime advocate of expanding end-of-life options laws nationwide, who asked a judge to affirm his right to die in this way and to prevent prosecution of doctors who assist. Dr. Alan Steinbach, a physician who wants the option to provide such medication to patients with terminal illnesses like Kligler, is also a plaintiff, the Globe reported in October. (Finucane and Ellement, 6/5)

Matthew Clayton Robinson was off his medications and in the midst of a breakdown. In the back of a vehicle transporting him from a hospital in Chico to a mental facility in Redding on a July night in 2014, he began shouting that someone was following him. He bounced and flailed inside the van, equipped with a “cage” that separated him from the front seat. He broke an interior light fixture and used shards of plastic to shred the car’s upholstery. By the time the van arrived at Restpadd psychiatric facility, the driver had summoned police for help in removing Robinson. Within minutes, he was beaten and bloodied, pinned to the ground with a fabric “spit hood” pulled over his head. A Sacramento native and graduate of California State University, Chico, Robinson wound up in a coma and died seven days later. (Hubert, 6/5)

A Hennepin County district judge ordered Minnesota’s top mental-health official to testify Monday on why state psychiatric hospitals are refusing to admit three men who have diagnoses of severe mental illnesses, instead leaving them to languish in Hennepin County jail. The hearing also surfaced ongoing tension between the state Department of Human Services (DHS) and the Hennepin County Sheriff. (Mannix, 6/6)

A Virginia mosque has publicly condemned the words of its leading imam, highlighting lingering divisions among Muslim leaders over the controversial and widely rejected practice of female genital mutilation. The Board of Directors at the Dar al-Hijrah Islamic Center in Falls Church said Monday that Imam Shaker Elsayed’s seeming endorsement of the outlawed practice as “the honorable thing to do if needed” ran afoul of both U.S. and Islamic law. (Hauslohner, 6/5)

Javier Vivo helps carry passengers’ bags and pushes wheelchairs at Miami International airport’s J Terminal, welcoming international travelers to the area. When he was hired as a part time employee, he wasn’t given a choice whether to take his company’s health insurance or not. It was take it or leave the job. When Vivo tried to use his insurance at the emergency room to take care of a stomach issue, though, he found out the insurance card did not give him access to much of an insurance plan. (Sayre, 6/5)

Heart surgeons at St. Luke’s Hospital in Cedar Rapids are beginning to use a revolutionary device in one of the most common heart procedures. The new technology is known as the “world’s smallest pacemaker.” Previously, pacemakers were inserted in the shoulder and required a long incision and wires leading to the heart. This device is put into the leg and carried to the heart by a vein. The director of the Arrhythmic Center at St. Luke’s, Dr. Mohit Chawla, says it makes a huge difference in how fast patients recover. (Dillard, 6/5)

The family of a Florida autistic man has filed a federal civil rights lawsuit over a 2016 police shooting in which the man’s caretaker was wounded. The lawsuit was filed Monday in Miami on behalf of 27-year-old Arnaldo Rios against the city of North Miami and five officers. It says Rios was improperly handcuffed and detained after the incident and includes claims of false imprisonment and battery. (6/5)

The family of an inmate who died at Hampton Roads Regional Jail in 2016 filed a wrongful-death lawsuit Monday against the jail, its medical provider and nearly three dozen other defendants. Henry Clay Stewart, 60, died Aug. 6, 2016, of internal bleeding from a perforated ulcer in his intestines. He had lost 35 pounds between the time he was transferred to the jail on June 7, 2016, and the day his body was autopsied by the medical examiner, according to the lawsuit. (6/5)

A group of agencies that serve mental-health patients is considering opening a hub where they could work together to more quickly help people in crisis. Now, people who visit emergency departments with mental-health problems often have to wait hours until doctors can determine whether they should be admitted or sent home. (Viviano, 6/4)

A Miami doctor was arrested at his Miami Beach home Monday morning and charged with elder abuse involving two unlicensed assisted-living facilities in the Upper Keys. The doctor, Raul Arcadio Tamayo, 66, is charged with two counts of neglect of an elderly or disabled adult. Bond was set at $200,000. The caregiver who worked under his supervision, Amarylis Maristan, 47, is wanted on the same charges, Deputy Becky Herrin said. (6/5)

Parents of a Grand Terrace Elementary School third grader say that unaddressed bullying by another student led to their son attempting to commit suicide. “In kindergarten and first grade, he didn’t have a whole lot of problems,” said Kevin O’Rourke of his son’s classmate and alleged bully. “Most of the issues with this kid started in second grade.” (Yarbrough, 6/5)

Starting this fall, Duplin County students can visit the school nurse’s office to see a primary care doctor, a behavioral health specialist, a dentist or a dietician. East Carolina University is teaming up with the county school system on a grant project to bring telemedicine into the schools. Not only will the telemedicine service help kids see a doctor when they are sick, but ECU staff will use the technology to conduct screenings to prevent chronic problems such as obesity, diabetes and cardiovascular disease. ECU providers will also conduct mental health screenings for issues such as anxiety or depression. (Knopf, 6/6)

The legislature provided the latest example from a dysfunctional session Monday as a bipartisan effort to legalize recreational marijuana broke down minutes before its public announcement. Reps. Josh Elliott, D-Hamden, and Melissa Ziobron, R-East Haddam, engaged in an argument a few feet from the podium in the Legislative Office Building hearing room where a press conference was scheduled to make the announcement. After 10 minutes, Ziobron left and Elliott conceded the marijuana measure was stalled — but not dead. (Phaneuf, 6/5)

Next week's special legislative session focused on funding for education and economic development won't include medical marijuana, at least for now. House and Senate leaders remained hopeful that they could strike a deal on the framework for carrying out a voter-approved constitutional amendment that broadly legalizing medical marijuana. But if they don't reach agreement before the special session ends, the Legislature is unlikely to take up the issue later this summer, according to a top senator. (6/5)

As lawmakers fight over what conditions insurance companies should be required to cover, other areas of health-care reform remain painfully neglected. One major example: How much should insurance companies pay for what they cover? Consumers rarely care about health-care prices beyond what they personally pay for deductibles, co-payments and prescription drugs. But insurance payments are crucial to understanding why health-care prices have gotten so out of control in the United States. (Robert Gebelhoff, 6/5)

The Congressional Budget Office (CBO) has been criticized many times by both parties since it began issuing budget projections and cost estimates for legislation in the 1970’s. So it was not surprising to hear the Trump administration and many Republicans in Congress complain when the agency released an unflattering assessment of the House-passed American Health Care Act. What was different this time, though, was the attempt by OMB Director Mick Mulvaney to discredit CBO entirely. He said in an interview that the agency’s time “has probably come and gone,” and implied that policymaking in Congress would be better if the agency ceased to exist. This is absurd. (James C. Capretta, 6/6)

The AHCA’s proposed caps would limit the amount by which each state is able to automatically claim increases in funding per Medicaid enrollee from federal taxpayers in any particular year. Taken in context, these proposed caps are extraordinarily modest. Far from threatening “to end Medicaid as we know it,” the per-capita caps would do little to alter the program’s existing commitments, and serve mainly to increase the scrutiny applied to expansions of benefits that states may make in the future. (Chris Pope, 6/5)

The state’s governor, Andrew Cuomo, laid down the law Monday to health insurers thinking about abandoning the state’s Affordable Care Act exchanges. Any that take that step, he announced, will be banned from participating in other state health programs, including Medicaid, Child Health Plus, and the Essential Plan. Those all are programs that commercial insurers manage, generally at a profit. In fact, insurers clamor to service those programs even as they grouse about losses on the Obamacare exchanges. ... One of the enduring mysteries surrounding the withdrawal of insurers from individual exchanges across the nation is why more states haven’t taken similar steps. (Michael Hiltzik, 6/5)

The U.S. has one of the largest income-based health disparities in the world, according to a new paper out in the journal Health Affairs. Among the poorest third of Americans studied, 38.2 percent report being in “fair or poor” health, compared with 12.3 percent of the richest third. Only Chile and Portugal have a larger income-based gap in the health status of their citizens. (Olga Khazan, 6/5)

Put Sherrod Brown and Rob Portman in a room, and chances are the two senators would find a way to repair and keep the Affordable Care Act. The Cleveland Democrat and Cincinnati Republican offer widely different assessments of the act, the former highly favorable, the latter sharply critical. Yet they share an understanding of what it takes to govern effectively and recognition of the needs of those who cannot afford health insurance. (6/6)

The Trump administration is poised to undo what it believed it accomplished on behalf of conservative Christians when President Donald Trump appointed Neil Gorsuch to the Supreme Court. That appointment kept the court from taking a leftward turn and puts the political holy grail for conservative Christians – overturning or Roe v. Wade – within reach if another seat is vacated before the 2020 presidential election. But the administration’s assault on objective reality and its embrace of alternative facts is about to threaten decades worth of progress on the abortion front. A proposed revision of the contraception mandate in the Affordable Care Act would make it more difficult for hundreds of thousands of women to get protection. (6/5)

Perhaps not evident to many patients, there are two kinds of hospitals — teaching and nonteaching — and a raging debate about which is better. Teaching hospitals, affiliated with medical schools, are the training grounds for the next generation of physicians. They cost more. The debate is over whether their increased cost is accompanied by better patient outcomes. Teaching hospitals cost taxpayers more in part because Medicare pays them more, to compensate them for their educational mission. They also tend to command higher prices in the commercial market because the medical-school affiliation enhances their brand. Their higher prices could even cost patients more, if they are paying out of pocket. (Austin Frakt, 6/5)