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Health-care groups that vocally opposed the House Republicans’ health plan are now split on the best path forward in the Senate: Should they work with lawmakers to shape a measure or simply try to kill it? As House Republicans pushed through legislation toppling large portions of the Affordable Care Act, groups representing hospitals, doctors, consumers and some insurers made no secret of their displeasure. Largely shut out of the talks, they actively opposed the bill, firing off angry letters and in some cases airing ads aimed at vulnerable House Republicans. (Hackman, 5/28)

Senate Majority Leader Mitch McConnell faces a challenge in resolving the clashing demands of GOP senators on a health care replacement bill. Lawmakers have mixed feelings about Medicaid funding, with decisions that could throw millions into the ranks of the uninsured, and rising premium costs for some. Many conservatives are eager to cut costs, especially on Medicaid. (Fram, 5/30)

Sometime in the next few weeks, four Democratic lawyers and four Republican ones will file into the ornate Lyndon Baines Johnson Room just steps from the Senate chamber at the Capitol to consider a bill to overhaul the Affordable Care Act. They’ll sit at a long table before someone unknown to most Americans but with singular power to influence whether Republicans can follow through on their seven-year quest to remake President Barack Obama’s signature domestic achievement. That person is Elizabeth MacDonough — the Senate parliamentarian, who is charged with acting as Congress’s version of a referee in the contentious health-care debate. (Cunningham, 5/29)

Senate Majority Leader Mitch McConnell (R-Ky.) is tempering expectations that the Senate will pass an overhaul of the nation’s healthcare system, promising his colleagues a vote but not success. McConnell in his public comments and private conversations about the ObamaCare repeal and replace bill is painting a more sober picture than Speaker Paul Ryan (R-Wis.), who in March guaranteed passage through the House. (Bolton, 5/29)

About 500 of the roughly 18,000 people insured by Unity Health Insurance and Gundersen Health Plan last year accounted for half of their medical and pharmacy costs. The examples show why the most popular provision in the Affordable Care Act — requiring insurers to cover people with pre-existing conditions — also is the most vexing. (Boulton, 5/29)

Democrats are using the new Congressional Budget Office analysis of legislation repealing and replacing ObamaCare to go on the attack against Republicans over a critical one-week recess. A recess packet sent to House Democrats encourages lawmakers to hold events highlighting the “terrible consequences” of the House Republican bill to repeal and replace ObamaCare. (Roubein and Hellmann, 5/28)

Dawn Erin went nearly 20 years without health insurance before the Affordable Care Act, bouncing between free clinics for frequent and painful bladder infections. The liver-destroying disease hepatitis C made her ineligible for coverage until President Barack Obama's law barred insurers from denying people with a medical condition. She has since seen a specialist who helped get her bladder infections under control, and her insurance covered about $70,000 in prescription drugs to treat hepatitis C. "I don't want to go back to the old way of doing things, worrying if I'm going to have the money to get my bladder infection treated," said the 46-year-old self-employed massage therapist from Austin, Texas. (Murphy and Kennedy, 5/28)

Advocacy groups for older Tennesseans are joining forces to oppose the health care reform plan, which as currently written disproportionately impacts seniors. More than a dozen groups began talking in early December about how to band together to establish an amplified voice for the state's older residents. They planned to launch this summer but decided to fast track those plans because it felt like time was slipping by as federal lawmakers take up an Affordable Care Act repeal bill that threatens to hit the pocketbooks of seniors across the state. (Fletcher, 5/26)

Blue Cross and Blue Shield of Kansas City is leaving the Affordable Care Act, commonly called Obamacare, in 2018. So now what? Well, on the Kansas side of the metro, all eyes turn to Medica. On the Missouri side, the key player now is Cigna. (Marso, 5/26)

Signing up for coverage on the health insurance marketplace should be easier for some people this fall because new federal rules will allow brokers and insurers to handle the entire enrollment process online, from soup to nuts. Some consumer advocates are concerned, though, that customers going this route won’t get the comprehensive, impartial plan information they need to make the best decision due to the financial self-interest of insurers and brokers. (Andrews, 5/30)

Federal officials, following through on a pledge by President Trump, have drafted a rule to roll back a federal requirement that many religious employers provide birth control coverage in health insurance plans. The mandate for free contraceptive coverage was one of the most hotly contested Obama administration policies adopted under the Affordable Care Act, and it generated scores of lawsuits by employers that had religious objections to it. (Pear, 5/29)

Senate Democrats are warning the Trump administration not to roll back ObamaCare rules requiring free birth control for women. A Thursday letter, led by Sen. Patty Murray (D-Wash.), points to a forthcoming regulation currently under review at the White House that could change the ObamaCare requirements. Under ObamaCare, regulations currently require contraception to be offered at no cost to the patient, but the rules have drawn objections on religious grounds. (Sullivan, 5/26)

President Trump has promoted his first budget proposal as placing one mission above all else — keeping America safe. But the president has drawn a narrow definition of national security, and one aspect of defense would actually receive less money: protecting the nation from deadly pathogens, man-made or natural. To help offset a 10 percent increase in military spending, much of the government would take serious hits, including agencies tasked with biosecurity. (Baumgaertner, 5/28)

Despite some good aspects, President Trump's proposed 2018 budget includes cuts in biomedical programs that would cripple life science research and industry, experts say. "It's a horrendous proposal," said Dr. Eric Topol, a cardiologist-geneticist with Scripps Health in San Diego. "Every way you look at it, it spells trouble." The proposed cuts also would come at a time when biomedical research has become extraordinarily productive in finding new treatments and insights into human health, Topol said. (Fikes, 5/26)

Advocates for minority communities say the budget proposed by President Donald Trump will hit them hard if it's adopted. Trump's spending plan for the budget year beginning Oct. 1 generally makes deep cuts in safety-net programs. Those include Medicaid, the Children's Health Insurance Program and Social Security's disability program. The White House says its budget would put the country back on track for a healthy economy. (5/29)

President Trump urged spending more on health care, in a tweet Sunday night —  to “make it the best anywhere” — even as his administration’s budget proposal last week called for broad cuts to health programs, including Medicaid, public health, and medical research funding. It’s unclear what, if anything, Trump’s tweet means for his administration’s spending priorities. The White House declined to elaborate. The president also wrote that “Obamacare is dead — the Republicans will do much better!” (Gil, 5/29)

President Trump on Sunday evening called for more spending on health care and said his plan to overhaul the tax code “is actually ahead of schedule” — two statements that are at odds with the budget proposal he unveiled just last week. The statements came as part of a blizzard of Twitter posts the president made after he returned from his first foreign trip. (Paletta, 5/28)

Two former Theranos Inc. directors said they didn’t follow up on public allegations that the Silicon Valley blood-testing firm was relying on standard technology rather than its much-hyped proprietary device for most tests, according to newly released court documents. In depositions, the highly decorated former directors—former U.S. Navy Adm. Gary Roughead and former U.S. Secretary of State George Shultz —who were board members when concerns of employees and regulators became public—said they didn’t question Theranos founder Elizabeth Holmes about the matter. (Weaver, 5/30)

A case involving insider trading charges based on government information dispensed by a “political intelligence” operative raises interesting questions about how some of the tricky rules for proving the offense will be applied when information is leaked from a federal agency rather than a corporation. An indictment filed in United States District Court in Manhattan accuses David B. Blaszczak of exploiting his friendship with Christopher M. Worrall, who held a senior staff position at the Centers for Medicare and Medicaid Services, to learn about impending changes in Medicare reimbursement that would affect health care companies. Mr. Blaszczak then passed the information, the indictment says, to Deerfield Management, a hedge fund firm that was a client of his consulting firm. (Henning, 5/29)

In his prime, consultant David Blaszczak bragged that he made millions for his hedge-fund clients when he predicted important Medicare funding changes. “Warren Buffett can eat it,” Blaszczak wrote in one email in 2013, referencing the legendary stock trader. He boasted in that same year to a finance executive: “I am a beast that cannot be stopped.” (Jewett and Bailey, 5/30)

Federal authorities are investigating dozens of new cases of possible opioid and other drug theft by employees at Veterans Affairs hospitals, a sign the problem isn’t going away as more prescriptions disappear. Data obtained by The Associated Press show 36 criminal investigations opened by the VA inspector general’s office from Oct. 1 through May 19. It brings the total number of open criminal cases to 108 involving theft or unauthorized drug use. Most of those probes typically lead to criminal charges. (Yen, 5/29)

Government data obtained by The Associated Press show more cases of opioid drug theft or missing prescriptions at Veterans Affairs health facilities despite new prevention efforts. The VA inspector general’s office opened 36 new criminal investigations into possible drug theft from Oct. 1 to May 19. Doctors, nurses or pharmacy staff in the VA’s network of more than 160 medical centers and 1,000 clinics are suspected of siphoning away controlled substances for their own use or street sale — sometimes to the harm of patients. (5/29)

Federal authorities are looking into continued drug thefts at the Department of Veterans Affairs hospitals, The Associated Press reports. The VA inspector general has opened 36 investigations from Oct. 1 through May 19 into possible opioid and other drug theft by employees at the Department of Veterans Affairs hospitals, according to the AP. That brings the total number or open criminal investigations to 108. (Hellmann, 5/29)

It was Aubrey Reinhardt’s last year at Texas Tech University. So when things started getting serious with her boyfriend, she decided it was time to look into birth control. Reinhardt knew that abortion foes had been trying to strip Planned Parenthood of every penny it receives from government sources. But until that moment two years ago, Reinhardt recalled, she didn’t appreciate what that could mean for a person like her who just needed somewhere to go for affordable contraception — without feeling she was being judged. (Zavis, 5/30)

Texas senators voted Friday to send a bill banning the most common second-trimester abortion procedure and changing how health care facilities handle fetal remains to Gov. Greg Abbott’s desk. Under Senate Bill 8, which passed 22-9, health care facilities including hospitals and abortion clinics would be required to bury or cremate any fetal remains — whether from abortion, miscarriage or stillbirth. The bill would also ban facilities from donating aborted fetal tissue to medical researchers, and aims to outlaw "partial-birth abortions," which are already illegal under federal law. (Evans, 5/26)

Patient brokers can earn up to tens of thousands of dollars a year by wooing vulnerable addicts for treatment centers that often provide few services and sometimes are run by disreputable operators with no training or expertise in drug treatment, according to Florida law enforcement officials and two individuals who worked as brokers in Massachusetts...The facilities are tapping into a flood of dollars made available to combat the opioid epidemic and exploiting a shortage of treatment beds in many states. As center owners and brokers profit, many patients get substandard treatment and relapse. (Armstrong and Allen, 5/28)

[Carl] White enrolled in a pain management clinic that taught him some of his physical torment was in his head — and he could train his brain to control it. It’s a philosophy that dates back decades, to the 1970s or even earlier. It fell out of vogue when new generations of potent pain pills came on the market; they were cheaper, worked faster, felt more modern. But the opioid epidemic has soured many patients and doctors on the quick fix. And interest is again surging in a treatment method called biopsychosocial pain management, which trains patients to manage chronic pain with tools ranging from physical therapy to biofeedback to meditation. It helped Carl White, a 43-year-old social worker from Leroy, Minn. (Keshavan, 5/30)

As Cpl. Kevin Phillips pulled up to investigate a suspected opioid overdose, paramedics were already at the Maryland home giving a man a life-saving dose of the overdose reversal drug Narcan. Drugs were easy to find: a package of heroin on the railing leading to a basement; another batch on a shelf above a nightstand. The deputy already had put on gloves and grabbed evidence baggies, his usual routine for canvassing a house. He swept the first package from the railing into a bag and sealed it; then a torn Crayola crayon box went from the nightstand into a bag of its own. Inside that basement nightstand: even more bags, but nothing that looked like drugs. (Linderman, 5/27)

There's a narrative about the methamphetamine epidemic in Montana that says the state tackled it in the 2000s, yet now it's back with a vengeance because of super labs and drug cartels in Mexico. But here on the Fort Belknap Indian Reservation, it never really went away. "Getting high in your car in front of the store; that ain't a big deal," says Miranda Kirk. (Saks, 5/27)

A leading humanitarian organization known for providing medical aid to impoverished countries and disaster zones is now setting its sights on helping U.S. healthcare providers combat the opioid epidemic. California-based charitable medicine program Direct Relief has partnered with pharmaceutical giant Pfizer to donate up to 1 million doses of the drug overdose-reversal drug naloxone to free health clinics, community health centers, public health departments and other not-for-profit providers nationwide. Direct Relief began delivering the donated naloxone in March 2017 after a survey from the group revealed it was difficult for many providers to keep the drug in stock. (Johnson, 5/26)

Deaths from opioid overdoses increased again in Minnesota last year, despite heightened law enforcement and a massive decline in doctors prescribing opioid painkillers. A Star Tribune analysis of state death certificate data found 402 opioid-related deaths in 2016, up from 344 in 2015. (Olson, 5/28)

The scourge of opioid deaths has made its way to recreational cocaine users. That's because the highly toxic fentanyl, the synthetic opiate, and its analogs, are seeping into cocaine in the Cincinnati area and beyond. Just grains of fentanyl can kill. So far, incidents of the cocaine-fentanyl combination appear to be relatively spotty. (DeMio, 5/27)

Global warming caused by human emissions of greenhouse gases is having clear effects in the physical world: more heat waves, heavier rainstorms and higher sea levels, to cite a few. In recent years, though, social scientists have been wrestling with a murkier question: What will climate change mean for human welfare? (Gillis, 5/26)

The oncologist was blunt: Stefanie Joho’s colon cancer was raging out of control and there was nothing more she could do. Flanked by her parents and sister, the 23-year-old felt something wet on her shoulder. She looked up to see her father weeping. “I felt dead inside, utterly demoralized, ready to be done,” Joho remembers. (McGinley, 5/28)

An increasingly stressful environment and unfiltered access to information could be dramatically boosting the number of teens and children hospitalized for suicidal thoughts or actions. A recent study found that children’s hospital admissions of patients 5 to 17 years old for such thoughts or actions more than doubled from 2008-2015. The study looked at 32 hospitals using data from the Pediatric Health Information System (PHIS), which includes Cincinnati Children’s Hospital Medical Center. (Korte, 5/27)

Whether a painful strep throat turns into a fatal case of heart disease depends not just on prompt antibiotic treatment but also on the patient’s genetic makeup, according to a new study led by Oxford University scientists. The discovery could help the long fight to find a vaccine against Group A streptococcus bacteria, which cause strep throat, scarlet fever and rheumatic heart disease. (McNeil, 5/29)

People infected with HIV can now live long, healthy lives — so long as they don't have a heart attack. Cardiovascular problems among HIV patients are emerging as the latest threat they face and a major challenge for medical experts, whose success using antiretroviral drugs to prolong patients' lives has given rise to new risks...To test the idea, the National Institutes of Health has lined up about 100 hospitals, academic centers and health facilities around the globe — including the University of Maryland and Johns Hopkins Medicine in Baltimore — to take part in a long-term study that will provide a drug known as pitavastatin to HIV patients without signs of cardiovascular disease to see if it prevents heart problems. (Cohn, 5/28)

Do doctors need to know their patients’ sexual orientation and gender identity? A growing number of federal agencies has been pushing health care providers to ask. Federally funded community health centers, which treat millions of patients, have begun to collect the data. Electronic health software must be able to store it. And blueprints for national health goals recommend collecting the information from all patients. (Hoffman, 5/29)

Diagnosing attention deficit hyperactivity disorder can be difficult. The symptoms of the disorder, as defined by the Diagnostic and Statistical Manual, or DSM, have changed multiple times. Even if you know what to look for, many of the symptoms are pretty general, including things like trouble focusing and a tendency to interrupt people. Discerning the difference between people who have a problem and those who are just distracted requires real expertise. (Hersher, 5/29)

Let’s hear it for the written word. Learning to read can have profound effects on the wiring of the adult brain, even in regions that aren’t usually associated with reading and writing. That’s what researchers found when they taught a group of illiterate adults in rural India to read and write. Michael Skeide and colleagues at the Max Planck Institute for Human Cognitive and Brain Science in Leipzig, Germany, wanted to study how culture changes the brain, so they focused on reading and writing. These cultural inventions have appeared only recently in our evolutionary history, so we haven’t had a chance to evolve specific genes for such skills. (Ananthaswamy, 5/28)

Impulsive children become thoughtful adults only after years of improvements to the brain's information highways, a team reports in Current Biology. A study of nearly 900 young people ages 8 to 22 found that the ability to control impulses, stay on task and make good decisions increased steadily over that span as the brain remodeled its information pathways to become more efficient. (Hamilton, 5/26)

The most common cause of death in children under the age of 15 is unintentional injury, and the most common cause of unintentional injury is car accidents. Between 2010 and 2014, 2,885 children died in motor vehicle accidents nationwide — an average of 11 children a week. That number excludes pedestrians, those who died in motorcycle or bicycle accidents, and those who died riding in an unenclosed cargo area or trailer. (Bakalar, 5/29)

They thought it would be funny: During lunch, the boys threw peanuts at a fellow student with severe food allergies. The Los Angeles area fifth-grader was so sensitive to nuts that exposure might send him to the emergency room. He said: “No, stop. That could kill me.” When he turned away to talk to a friend, one of the boys stashed peanuts in the container that held his lunch. Seeing the nasty trick, the allergic boy’s friends quickly grabbed the container and threw it away, possibly saving their friend from a terrible incident. (Levingston, 5/28)

For their 11th annual sunscreen guide, researchers at the nonprofit Environmental Working Group evaluated the UV-ray protections, toxic ingredients and other health hazards in approximately 900 sunscreens, 500 SPF-labeled moisturizers and more than 100 lip products. The group found 73 percent of the 880 tested sunscreens either contained “worrisome” ingredients or didn’t work as well as advertised. Two toxic ingredients, oxybenzone (a hormone disruptor) and retinyl palmitate (a form of Vitamin D with the potential to increase skin cancer risk), were among the chemicals found. (Pirani, 5/26)

Though pioneered three decades ago as the first sickle cell cure, bone marrow stem cell transplants remain underused — especially for adult patients — because of the risks involved, a lack of public awareness and a shortage of bone marrow donors for African-Americans. Nationwide, fewer than 120 such transplants took place last year. Children’s Mercy Hospital, which currently has about 300 sickle cell patients, has done four or five transplants over a 14-year period. (McGuire, 5/29)

Most schools in the state of Massachusetts don't screen for dyslexia, even though experts say diagnosing the learning disability early is the key to successful interventions. Instead, many districts wait until a child shows obvious signs of trouble reading or writing. Some advocates say, by then, it's too late. (Mosley, 5/30)

To those steeped in the natural-food movement, the acronym GMO — for genetically modified organisms — has traditionally been almost as taboo as a plate of braised veal. However, that view could be changing as a new generation of Bay Area entrepreneurs upends the alternative meat and dairy industry, using biotechnology to create vegetarian foods that taste more like meat and promise ecological advantages to boot. (Duggan, 5/29)

Zika, the mosquito-borne virus that triggered public health alarm bells last summer, has receded from the spotlight. But, experts say, expect the virus to pose a renewed threat this year. How great of a threat? That’s where it gets tricky. (Luthra and Rodriguez, 5/30)

Mosquito fish are 2.5-inch long native, freshwater fish that love munching on mosquito hatchlings. On Saturday, March 27, Mosquito Control officials are giving out gambusia affinis to Hillsborough County residents for free. The giveaway, the second one so far this year, is an effort to fight mosquito-borne illnesses. (Miller, 5/26)

In March 2015, Apple promised to change the way medical research could be done. It launched ResearchKit, which could turn millions of iPhones around the world into a “powerful tool for medical research,” the company said at the time. Since then, ResearchKit — software that gives would-be app developers a library of coding to create health apps on the iPhone and Apple Watch — has spawned a number of studies: One team has used it to create an app to track Parkinson’s symptoms; another is trying out a screening protocol for autism. A third helps people inventory the moles on their skin and evaluate how they have changed over time. (Sheridan, 5/26)

Molina Healthcare, a major insurer in Medicaid and state exchanges across the country, has shut down its online patient portal as it investigates a potential data breach that may have exposed sensitive medical information. The company said Friday that it closed the online portal for medical claims and other customer information while it examined a “security vulnerability.” It’s not clear how many patient records might have been exposed and for how long. The company has more than 4.8 million customers in 12 states and Puerto Rico. (Terhune, 5/26)

Receiving a diagnosis in 2017 — at least one made at a medical center outfitted with the latest clinical gadgetry — might include a scan that divides your body into a bread loaf of high-resolution digital slices. Your DNA might be fed through a gene sequencer that spits out your mortal code in a matter of hours. Even your smartphone might soon be used to uncover health problems. Yet nearly 130 years since its inception — after decades of science has mapped out our neuronal pathways — a simple knob of rubber with a metal handle remains one of medicine's most essential tools. I'm referring to the cheap, portable, easy-to-use reflex hammer. (Stetka, 5/28)

The 11,000 year-round residents of this summer colony off Cape Cod are confronting an emotional question: whether the island is a place where they can grow old. Nantucket, a ritzy vacation destination whose permanent community is of more modest means, has one nursing home: Our Island Home, a 45-bed facility that is owned and run by the town and with a history that goes back to 1822. It sits on prime town-owned real-estate where its residents can watch boats on Nantucket Harbor. But it runs an annual deficit of about $3 million, needs major repairs and is pressuring the town’s coffers at a time when Nantucket needs other infrastructure to accommodate growth. (Levitz, 5/28)

People complain about nursing homes a lot: the food's no good or there's not enough staff, and so on. It's a long list. But the top complaint, according to the federal government, is eviction from a nursing home. Technically, it's known as involuntary discharge, and in 2015 it brought in more than 9,000 complaints. Now, a couple of states are looking for ways to hold nursing homes accountable for unnecessary evictions. (Jaffe, 5/26)

A sweeping proposal to replace private medical insurance in California with a single, government-run health care system has suddenly taken on sharp political edges for Democrats, threatening party unity even as it promises to mobilize voters on the left. Supporters say “single-payer” proposals like Senate Bill 562, which the state Senate could vote on this week, are becoming a hard-and-fast litmus test for Democrats in California, and perhaps nationally — despite the long odds of one state going it alone with a top-to-bottom health care overhaul. (Murphy, 5/27)

Gov. Scott Walker’s administration warned Friday that rejecting his insurance overhaul for state employees could lead to a 10% increase in workers’ premiums. In calculations released Friday, administration officials said they might have to make the double-digit increase to state worker coverage if the state doesn’t switch to a self-insurance model for its employees. (Price, 5/26)

Last year in Wisconsin, thousands of people visited an emergency room more than seven times each — a stream of bad outcomes for taxpayers, the health care industry and the patients themselves. To respond, lawmakers voted last week to give hospitals a powerful financial incentive to reduce emergency room costs within the state's Medicaid health programs for the needy. The pilot proposal: Work with diabetics and patients with asthma and heart disease to control the health conditions that are landing them in the emergency room. (Stein, 5/27)

Kansas legislators are facing a midsummer deadline to approve costly security upgrades for state hospitals and mental institutions in order to keep in place a four-year-old ban on concealed weapons inside the facilities. While the conservative state frequently embraces pro-gun policies, this debate is unique. Even Republican Gov. Sam Brownback and GOP lawmakers who are strong supporters of concealed carry don’t want the exemption for hospitals to disappear, fearing the prospect of guns around mental patients or in areas with specialized equipment. (Hanna, 5/27)

Texas legislators cast final votes Sunday evening on a pair of bills overhauling how the Texas Department of Family and Protective Services works with and finds homes for abused and neglected children. With just over 24 hours before the legislative session is set to end, both chambers voted to adopt final versions of Senate Bill 11. The bill, a top legislative priority for Gov. Greg Abbott, Lt. Gov. Dan Patrick and House Speaker Joe Straus, would have the Department of Family and Protective Services create a "community-based care" model, allowing contracted organizations to monitor children in foster care and adoptive homes and a relative's home. (Evans, 5/28)

Major bills to address the state’s troubled child welfare system are now headed for Gov. Greg Abbott’s desk. Both the House and the Senate on Sunday gave final approval on changes to Senate Bill 11 filed by Sen. Charles Schwertner, R-Georgetown, which would expand “community-based foster care” to at least two additional areas in the state over the next two years. The state would have to transfer foster care case management, including caseworker visits, court-related duties and decision-making on where children live, learn and receive services, to a nonprofit agency or a governmental entity such as a county or municipality. (Chang, 5/28)

A smartphone app that inexpensively checks eyes and renews prescriptions for contact lenses is cutting-edge, catnip for investors looking for the next big thing. But the political calculus of a bricks-and-mortar institution, the local optometrist, trying to ban the use of a disruptive web technology in Connecticut is decidedly old school. Startups offering online renewals are few and national, while the optometrists opposing them are numerous and local. (Pazniokas, 5/30)

The Bill of Rights in the New York State Constitution protects a number of essential liberties. Freedom of worship? Check. The right to assemble? Check. Freedom to divorce? That, too. The right to play bingo and gamble on horses? You bet. But environmental activists and some lawmakers say that one liberty that is conspicuously absent from the Constitution’s Bill of Rights is the right to a clean environment. Citing recent instances of contaminated water supplies and what they call an assault on the environment by the Trump administration, they are now determined to change that. (Foderaro, 5/26)

Nurx is like Uber for birth control. The new mobile health platform that launched earlier this month in Michigan is offering women access to birth control from state-licensed doctors and partner pharmacies. Through the Nurx app, women can get birth control delivered to their homes. The app offers easier access to birth control at a time when contraceptives are under fire, developers say. Six states permit pharmacists to refuse to dispense contraceptives, and eight states allow health care institutions to refuse to provide contraception-related services. (Zlatopolsky, 5/27)

Fannin High, with enrollment of roughly 1,000 students, is the only high school in mountainous, forested Fannin County, which borders Tennessee and has only about 25,000 residents. Burch’s class shows that the movement to get Georgia students eating healthier stretches much farther than big cities and suburbs. The idea of teaching about food in traditionally rural areas of Georgia such as Fannin County may seem paradoxical, but it’s necessary partly because times have changed. (Campbell, 5/29)

Hundreds of child care centers across Minnesota are not following state requirements that parents get their children vaccinated for the measles or provide written exemptions, according to state health data reviewed by the Star Tribune. The situation provides fertile ground for the highly contagious measles virus to continue to spread as the outbreak, which has sickened 68, continues into its eighth week. (Howatt, 5/28)

In recent years, some of Swedish’s top brain and spine surgeons routinely ran multiple operating rooms at the same time while keeping patients in the dark about the practice, according to internal surgery data obtained by The Seattle Times as well as interviews with patients and medical staffers. Four surgeons at the Swedish Neuroscience Institute — [Rod] Oskouian, David Newell, Johnny Delashaw and Jens Chapman — ran multiple operating rooms during more than half their cases over the past three years, according to the data. Oskouian did it 70 percent of the time. To manage two rooms, surgeons generally leave less-experienced doctors receiving specialized training to handle parts of the surgery. (Baker and Mayo, 5/28)

A chemical spill at Sacramento State last year has led to questions about whether the university is putting its lab workers at risk from exposure to hazardous substances. Some lab employees say they work in areas so poorly ventilated that acidic fumes corrode metal and rubber, and two workers claim that exposure to these substances and others may have led to their inability to have children. (Lambert, 5/28)

The approach, which Hopkins doctors call helistroke, is unusual in medicine. Normally stroke patients are transferred to other hospitals for advanced treatment. Johns Hopkins and Suburban are testing whether whisking the doctor to the ailing patient leads to better outcomes. It is one of the many ways that hospitals are trying to increase the use of catheters to treat certain kinds of severe strokes. Strokes occur when a blood flow is interrupted to part of the brain, either by a clot of a rupture of a blood vessel. They are the fifth leading cause of death in the United States, killing more than 130,000 each year, according to the U.S. Centers for Disease Control and Prevention. They afflict about 800,000 people each year and are a leading cause of disability. (McDaniels, 5/30)

Like many other acreages across Iowa, the symbiotic relationships between soil, weather, farmers, seeds and pollinators produce the foods that make up our dinners. Because on this particular acreage, most employees have autism spectrum disorder, which can severely impair communication and social skills, The Des Moines Register reported. So while the men of the Homestead and the specifically trained associates who work alongside them harvest veggies for a Community Supported Agriculture program, their mission is more than farming. (Crowder, 5/27)

California public school employees would be fully paid for at least six weeks during their maternity leave under a bill moving through the California Legislature. In a move that would apply to those working for school districts and community colleges, pregnant certificated, academic and classified employees would not need to spend their accrued leave to compensate for those days. The measure passed the state Assembly on Monday and will next be considered in the state Senate. (Ko, 5/26)

The Republican health care plan recently passed by the House would hollow out one of the most popular provisions of the Affordable Care Act: a prohibition on charging higher prices to people with pre-existing medical conditions. States, under the plan, could waive that rule, provided they offer publicly funded alternatives for coverage. The Republican plan raises questions, including about cost: Many experts believe the more than $100 billion earmarked for alternative programs, such as “high-risk pools,” would be inadequate. According to the Congressional Budget Office, many patients with pre-existing conditions would be priced out of the market. But the Republican proposal also raises a more basic issue: Who will decide what constitutes a pre-existing condition? (Elisabeth Rosenthal, 5/29)

Obamacare is wrecking individual and small group markets. This year, premium cost increases in the individual markets are averaging 25%, and the thousands of dollars in deductibles are breathtaking. Many middle-class folks in these markets are stuck paying the equivalent of a second mortgage. (Robert E. Moffit, 5/29)

Now we know why House Republicans were so quick to ram through an Obamacare repeal-and-replace bill last month, not waiting for an estimate of its impact or holding any public hearings. Now we also know why Senate staffers, who've been charged with coming up with a draft proposal for their chamber during last week's recess, plan to start from scratch. (5/24)

The new Congressional Budget Office score for the American Health Care Act showed who the winners and losers will be, and how quickly its negative consequences will take effect if the House bill is enacted into law without major changes. What it doesn't do is assess the politics. But the implications are clear: The negative effects of the AHCA, and the juicy news stories about them, will play out over each of the next two election cycles. It's the political equivalent of tearing off a bandage slowly. (Drew Altman, 5/30)

President Donald Trump and House Speaker Paul Ryan say their target is the Affordable Care Act. But what their American Health Care Act would do is take a machete not just to Medicaid expansion but to Medicaid generally - the Medicaid that cares for lots of people in Trump's Ohio counties. The real agenda: slashing health care to help the U.S. Treasury cover the cost of sweet tax cuts for the well-off. (Thomas Suddes, 5/27)

If any slim chance remained that the Senate would pass the House version of Obamacare repeal, the release of the Congressional Budget Office’s scoring of the bill surely squashed it. Democrats and the media pounced on predictions that the House bill would leave 23 million more people uninsured a decade from now than Obamacare would, and premiums for elderly Americans and some of those with pre-existing conditions could soar. (5/27)

Republicans have had seven years to figure out how they want to replace Obamacare, and this is what they’ve come up with: a plan that, according to the nonpartisan Congressional Budget Office, would lead to 23 million more people not having insurance and, in states that wanted to, sick people being burdened with much, much higher costs. Maybe they needed eight years? (Matt O'Brien, 5/27)

Trumpcare's chances of becoming law took a big hit this week. But the hospitals and Medicaid insurers directly in its path can't rest easy. Shares of such companies rose on Thursday, presumably cheering the Congressional Budget Office's score of the House-passed version of the American Health Care Act. The CBO score, released Wednesday evening, raised substantial new roadblocks to Trumpcare's passage in the Senate. It said the law would take health care from 23 million Americans, barely improving on the 24 million in the CBO's score of an earlier version of the AHCA. It also warned the law would destabilize the individual insurance market and gut pre-existing condition protections for one-sixth of Americans. (Max Nisen, 5/26)

The recently passed American Health Care Act in the House of Representatives would give billions to big drug and insurance companies while price gouging people over age 50 and those with pre-existing conditions. Under the AHCA, insurance companies can charge older adults five times what other consumers pay for the same health insurance policy. It’s an age tax. The bill also lets Nebraska lawmakers get a waiver that would give insurance companies the power to charge older adults even more. (Connie Benjamin, 5/28)

Twenty-three million people will lose health insurance coverage... As someone who has worked in health care for over 20 years, who has seen the amazing achievements under the Affordable Care Act, and heard the stories directly from the people whose lives are significantly better, I stand aghast at what our country is doing. And worse, what the Republicans in my own state voted for. (Carmela Castellano-Garcia, 5/28)

[R]ecent efforts by Congress to repeal and replace the Affordable Care Act could severely alter our public schools’ ability to foster all students’ development. In Montana, roughly $55 million in Medicaid funding flows into our schools, and more than $35 million of that is federal funding. State and federal Medicaid dollars fund critical in-school programs and services for our young students. While Medicaid spending on school-based health services is a small part of Medicaid spending, it plays a significant role in our schools. (Kirk Miller, 5/30)

It’s a harsh reality — the U.S. cannot afford to cover the current number of Medicaid recipients with the current level of benefits. ... But for those struggling families (and yes, some single childless, able-bodied adults under the Obamacare expansion), plans to gut the nation’s health insurance safety net will be devastating. ... But there is hope that Republicans in the Senate can find a middle ground if they are indeed dead-set on using their new-found majority to bring the federal budget more in line with reality on the back of health care for the neediest while increasing spending for the military. (5/29)

Dr. Juan Z. Montes recalls the surge of people who came calling, beginning about two years ago. “We couldn’t handle them all,” he said, referring to the new patients who visited his four Southern California clinics after they got health insurance under the Affordable Care Act. Montes, 67, who’s been doctoring in L.A. for four decades, estimated that his patient load increased about 20%. (Steve Lopez, 5/28)

President Donald Trump, I heartily agree with you when you told Australian Prime Minister Malcolm Turnbull, “You have better health care than we do.” You see, I have been both a patient and a doctor in the U.S. and Australia. After working and studying as a family physician in the U.S. for almost 20 years, I landed my dream job working in Australia in 2015. I love working within this excellent health care system where doctors and patients are supported by a program called Medicare. It is similar to American Medicare but covers every Australian of every age for most health care costs. (Marie Shieh, 5/27)

Anna, one of my patients with a progressive genetic illness, arrived in the emergency room one afternoon following many epileptic seizures. Her underlying diagnosis, abundantly documented in the hospital’s electronic medical record, was well-known to be associated with epilepsy. By the time I arrived in the emergency room, she had already been sent for an CT scan of the head. When I asked the emergency room physician the reason for the scan, in my view a clear waste of time and money, he explained that in “his clinical judgment,” the scan was necessary. (Steven Rothman, 5/30)

Senate Republicans appear to be solidly rejecting their House colleagues’ health-care plan. That shouldn’t be a close call, given the Congressional Budget Office’s findings that the American Health Care Act would increase the ranks of the uninsured by 23 million, while raising the cost of coverage for older and sicker people. Compared with current law — the Affordable Care Act — the out-of-pocket cost of coverage for an older, low-income person would rise by a factor of eight to nine under the AHCA. (Jared Bernstein, 5/30)

Now that our area’s top insurer, Blue Cross and Blue Shield of Kansas City, has announced that it is pulling out of the Affordable Care Act exchange next year, about 67,000 of its customers in Kansas and Missouri are vulnerable. Congressional Republicans insist that they don’t want insurance markets here or anywhere else to fail. But their party has done everything in its power to encourage that outcome. (5/26)

As California liberals go, the Democratic Party often follows. So it’s instructive, if not surprising, that Golden State Democrats are responding to the failure of ObamaCare by embracing single-payer health care. This proves the truism that the liberal solution to every government failure is always more government. (5/26)

Let’s start with what we can almost all agree on: single-payer healthcare is the most effective system for achieving universal health coverage in the U.S. Single-payer almost certainly would be cheaper and simpler than the ridiculous contraption we have now, a mishmash of employer, government and private plans all with different rules and standards. It’s favored by a clear majority of Americans in opinion polls, at least in theory, and it’s a linchpin of popular political movements like Sen. Bernie Sanders’. (Michael Hiltzik, 5/26)

Last month, Democratic House members were given polling data and a set of talking points on health care. The thrust: Hammer Republicans on their Obamacare repeal-and-replace plan, but do it with precision. More implicit, but just as clear, Democrats were advised to stay away from promoting the “Medicare for All” plan that has energized the party’s grass-roots activists and its rank and file in Congress. ... The documents help explain why and how Democratic leader Nancy Pelosi is trying to squash her own party’s desire to fight for a health care system in which the government is the single payer for necessary medical expenses and the health insurance industry is all but eliminated as a middle man. (Jonathan Allen, 5/30)

Critics are accusing President Trump’s 2018 budget of “gutting the safety net” with cuts to food stamps and disability insurance. In reality, the White House is proposing long-needed reforms that would fix a dysfunctional disability system that traps Americans in dependency. (5/29)

This Memorial Day, we honor Americans who made the ultimate sacrifice and gave their lives during service to their country. This recognition should include veterans who survived war but could not survive the peace that followed because of very real mental injuries suffered in combat. At least 20 veterans commit suicide every day in the United States. These are lives lost to war, and we must account for them today. (Nathan Fletcher, 5/29)

President Donald Trump is proposing more money for the Department of Veterans Affairs, but veterans groups and lawmakers are lining up against some of the administration’s priorities, especially cuts in payments to disabled veterans who are unable to work and increases for an outside care program that has yet to be formulated. Mr. Trump’s 2018 proposed budget would boost overall VA spending to $186.5 billion, an almost 6% increase. But as advocates and lawmakers of both parties have taken a closer look, they have grown concerned about the administration’s plans to reorder spending within the department. (Ben Kesling, 5/29)

On Monday, our nation will celebrate the annual observance of Memorial Day. As is our tradition, we will pause and reflect on the sacrifices of our country's veterans, especially those who gave their lives to protect our freedom. Such brave men and women selflessly paid the ultimate price for our priceless rights -- our right to free speech, our right to worship as we choose, our right to assemble when we need to come together. (Tony Milons, 528)

When the Korean War started in June of 1950, there was a shortage of doctors in the U.S. Army Medical Corps. To serve this need, the government instituted a "doctor draft" and by the beginning of 1951, the first drafted doctors began arriving in Korea. I was one of them, just a few years out of medical school with little surgical training and certainly no experience with "battlefield medicine." The thought of going to Korea scared me to death. It wasn't so much that I feared getting injured or even killed, but what really worried me was that I might not be a good enough doctor to provide the lifesaving skills that our soldiers would need. (Robert L. Emanuele, 5/26)

Proponents of the District’s Death With Dignity law breathed a sigh of relief when a Republican effort to block the law led by Rep. Jason Chaffetz failed. When Mr. Chaffetz later announced he would be resigning his Utah seat, there was guarded hope the matter would be quietly dropped. Then, a new low in federal meddling: President Trump included a rider in his proposed budget that would prevent D.C. officials from spending local tax dollars to give their residents a right that is exercised in six states. (5/27)

Facing worst-case scenarios in a safe environment can help people prepare themselves and practice how they might react. Consider the large body of scary children’s stories. Fairy tales and Disney movies are laden with wolves with large teeth, wicked witches, dragons breathing fire, even menacing adults. Yet far from harming children, exposure to such stories helps them build skills for dealing with frightening or threatening situations in real life. (Kathryn Kirkland, 5/29)

Today, the global marketplace has made it easier than ever to order deadly, synthetic drugs over the Internet with just the click of a button. Growing evidence shows that these drugs are increasingly coming to the U.S. from abroad — and they’re reaching Wisconsin. In recent weeks, Milwaukee County has reported Wisconsin’s first deaths linked to carfentanil, a deadly elephant tranquilizer 10,000 times more potent than morphine. (Tom Ridge, 5/26)

El l Salvador has one of the worst records on reproductive rights in the world. Since 1998, Article 133 of the Penal Code has made abortion illegal in all circumstances, without exception, punishable by up to eight years in prison. Sentences of up to 30 years have been handed down when a judge determined that “homicide” rather than abortion had occurred. The Alliance for Women’s Health and Life has reported that 147 El Salvadorian women were charged with crimes relating to abortion between 2000 and 2014. (Jeannette Urquilla, 5/30)

Planned Parenthood of the Heartland announced this month it will close clinics in Bettendorf, Burlington, Keokuk and Sioux City. So where will the Iowans served by those clinics go? On a mission to "defund" Planned Parenthood, Republican lawmakers insisted on forfeiting all federal family planning money to prevent any of it from compensating a health provider that also offered abortions. They repeatedly insisted Planned Parenthood closings would not harm the availability of health care. In one particularly memorable committee meeting exchange, Sen. Janet Petersen, D-Des Moines, asked Sen. Jeff Edler, R-State Center, what new providers would offer pregnancy-prevention services if Planned Parenthood did not. (5/27)

On Tuesday, the World Health Organization, under more democratic rules than in the past, elected its first African director general, Tedros Adhanom Ghebreyesus. Dr. Tedros, who goes by his first name, is a malaria expert who built his reputation by cutting through bureaucracy to bring transformative change to health services in his native Ethiopia. The W.H.O. will need him to do just that in his new job. (5/29)