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Republicans showed signs Tuesday of reaching out to Democrats for a joint if modest effort to buttress health insurance markets, four days after the GOP effort to unilaterally uproot and reshape the Obama health care law crumpled in the Senate. The Republican chairman of the Senate health committee, Tennessee's Lamar Alexander, said he'd seek bipartisan legislation extending for one year federal payments to insurers that help millions of low- and moderate-income Americans afford coverage. (Fram, 8/1)

In the House, two Republicans, Representatives Tom Reed of New York and Charlie Dent of Pennsylvania, teamed with Democrats to promote incremental health legislation that would also fund the cost-sharing subsidies. The moves were a remarkable response to the president’s repeated threats to send health insurance markets into a tailspin. They offered tangible indications of cooperation between the parties after Republican efforts to scrap the Affordable Care Act collapsed in the Senate last week, all but ending the seven-year Republican quest to overturn President Barack Obama’s signature domestic achievement. Lawmakers from both parties concede that the health law needs improvement, as consumers face sharp premium increases and a shrinking number of insurance options in many states. (Pear and Kaplan, 8/1)

The next cost-sharing payments are due to be paid in a few weeks and the president has said he'll announce this week whether he'll pay the money or keep it in the Treasury. "In the absence of the CSR, the rate increases could be astonishing," says Dr. Marc Harrison, CEO of Intermountain Healthcare, which operates nonprofit hospitals and clinics and insures more than 800,000 people across Utah. (Kodjak, 8/1)

Sen. Lamar Alexander, R-Tenn., said the Senate Health, Education, Labor and Pensions Committee, which he chairs, will hold hearings starting Sept. 4 “so that Americans will be able to buy affordable health insurance.” "If your house is on fire, you want to put out the fire, and the fire in this case is the individual health insurance market," Alexander said. (Gaudiano and Collins, 8/1)

Alexander, the chairman of the committee, emphasized that the work will be bipartisan and that the hearings will feature a range of health policy experts, including state insurance commissioners, patients and insurance industry representatives. He added that he’s urged President Donald Trump to continue paying for Obamacare’s cost-sharing subsidies through September, to give Congress time to craft a stabilization plan that would include one year of funding for the payments. (Cancryn, 8/1)

Sen. Patty Murray of Washington, the ranking Democrat on the HELP Committee, said she looked forward to bipartisan committee hearings, which will begin the week of Sept. 4. “I really appreciate your work with me on this and your commitment to getting a result for our constituents, particularly when it comes to making sure cost-sharing subsidies don’t get cut off and premiums don’t spike for patients and families,” Murray said. (McIntire, 8/1)

The hearings will give Democrats — particularly Sen. Patty Murray (Wash.), the committee’s ranking member — a seat at the negotiating table on healthcare for the first time, opening up a process that, to this point, has been tightly controlled by Senate Majority Leader Mitch McConnell (R-Ky.). (Roubein, 8//1)

Most patient advocates, physician groups, hospitals and even many health insurers have been saying for months that targeted fixes to insurance marketplaces make more sense than the kind of far-reaching overhaul of government health programs that Republicans had been pushing. The marketplaces, though a pillar of Obamacare, represent a small part of the U.S. healthcare system with just about 10 million people getting coverage there. But rate hikes and the decision by many insurers to exit markets amid the current political uncertainty in Washington has threatened consumers’ access to health plans. (Levey and Lauter, 8/1)

Top Senate Republicans are trying to move on from their partisan drive to replace Obamacare despite urging from President Donald Trump to keep seeking a broad alternative to President Barack Obama’s signature domestic achievement. The Senate health committee will begin bipartisan hearings in early September on stabilizing and strengthening the Affordable Care Act’s individual insurance market, Chairman Lamar Alexander of Tennessee and ranking Democrat Patty Murray of Washington said in a joint statement Tuesday. (Litvan and Edney, 8/1)

Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Sarah Kliff of Vox.com and Mary Agnes Carey of Kaiser Health News discuss what happens now, in the wake of the apparent demise of the Republican-only repeal and replace efforts for the Affordable Care Act. (8/1)

A U.S. appeals court on Tuesday allowed Democratic state attorneys general to defend subsidy payments to insurance companies under the Obamacare healthcare law, a critical part of funding for the statute that President Donald Trump has threatened to cut off. The U.S. Court of Appeals for the District of Columbia Circuit granted a motion filed by the 16 attorneys general, led by California's Xavier Becerra and New York's Eric Schneiderman. (Hurley, 8/1)

Led by the Democratic attorneys general of New York and California, the motion that the court granted is the most recent twist in the gnarled legal and political history of the subsidies. In practical terms, the ruling could make it more difficult for the Trump administration and House Republicans to abandon the payments without a court fight. (Goldstein, 8/1)

Insurers have threatened to leave the ObamaCare market exchanges if the payments are not continued, which could potentially leave millions without healthcare coverage options during the transition. "The states have shown a substantial risk that an injunction requiring termination of the payments at issue here ... would lead directly and imminently to an increase in insurance prices, which in turn will increase the number of uninsured individuals for whom the states will have to provide health care," the order stated. (Roubein and Seipel, 8/1)

In May, 16 state attorneys general from both Republican- and Democratic-led states, led by California and New York, asked the federal appeals court for permission to intervene in the case. The lawsuit was originally brought by House Republicans to block federal payment to insurers to fund the Affordable Care Act's cost-sharing reduction subsidies for low-income exchange plan members. (Livingston, 8/2)

“The court’s decision is good news for the hundreds of thousands of New York families that rely on these subsidies for their health care,” New York Attorney General Eric Schneiderman said in a statement reacting to the decision. “It’s disturbingly clear that President Trump and his administration are willing to treat them as political pawns; but this coalition of attorneys general stands ready to defend these vital subsidies and the quality, affordable health care they ensure for millions of families across the country.” (Harris, 8/1)

Even though Senate Republicans' push to repeal the Affordable Care Act fizzled out last week, health insurers are still grappling with uncertainty over whether the federal government will continue to fund crucial subsidies that help low-income Americans pay for health coverage. Insurers and lobbying groups have warned over the last few months that premiums will increase if the cost-sharing reduction subsidies go unfunded in 2018. Now the Trump administration could also face new litigation if it fails to make the subsidy payments, as President Donald Trump has repeatedly threatened to do. (Livingston, 8/1)

Insurance companies are bracing for the potential elimination of a federal health care subsidy with plans to boost premiums and file lawsuits. President Donald Trump is expected to announce as early as Tuesday whether he will continue to make the payments, with many experts counting on him to do so. Still, there are signs of nervousness among insurers.  America’s Health Insurance Plans joined the Blue Cross Blue Shield Association in recently calling on Congress to permanently appropriate the money and resolve a long-running dispute about a glitch in the 2010 health care law (PL 111-148, PL 111-152.) And, AHIP CEO Marilyn Tavenner was spotted in the Senate Tuesday afternoon. (Clason, 8/1)

Senate Republicans are not pretending to have missed the tweets anymore. They have abandoned well-worn phrases, like “growing pains” and “sea legs,” that sustained them through the endless winter and spring. And if a few months ago President Trump’s scattershot demands might have sent the chamber into a lather, compelling lawmakers to honor his megaphone, the collective shrugs at his rage over last week’s failed health care repeal vote have signaled a new phase in this shotgun marriage of unified Republican rule. (Flegenheimer and Kaplan, 8/1)

There wasn't a dramatic public break or an exact moment it happened. But step by step, Senate Republicans are turning their backs on President Donald Trump. They defeated an Obamacare repeal bill despite Trump's pleas. They're ignoring his Twitter demands that they get back to work on the repeal measure. They dissed the White House budget director, defended the attorney general against the president's attacks and passed veto-proof sanctions on Russia over his administration's objections. (Werner, 8/2)

The relationship between President Trump and Senate Republicans has deteriorated so sharply in recent days that some are openly defying his directives, bringing long-simmering tensions to a boil as the GOP labors to reorient its stalled legislative agenda. Sen. Lamar Alexander (R-Tenn.), head of the Senate Health, Education, Labor and Pensions Committee, announced Tuesday that he would work with his Democratic colleagues to “stabilize and strengthen” the individual insurance market under the Affordable Care Act, which the president has badgered the Senate to keep trying to repeal. Alexander also urged the White House to keep up payments to insurers that help low-income consumers afford plans, which Trump has threatened to cut off. (Sullivan, 8/1)

Senate Republicans made clear on Tuesday that they want to chart their own course to focus on a tax overhaul and critical fiscal legislation, bypassing requests from President Donald Trump and White House officials to keep health care their top legislative priority. (Hughes, Andrews and Hook, 8/1)

Senate Republicans don't appear to be too worried about President Trump's latest round of threats. "If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!" Trump said on Twitter over the weekend. He followed that tweet with a similar threat Monday, writing, "If ObamaCare if hurting people, & it is, why shouldn't it hurt the insurance companies & why should Congress not be paying what the public pays?" And yet, the Senate is clearly moving on from health care — at least for now. (Detrow, 8/1)

Senate Republicans appear poised to ignore President Trump's demands that they immediately resurrect ObamaCare repeal and abolish the legislative filibuster. Trump has waged a public pressure campaign against GOP senators since they failed to pass even a “skinny” bill repealing ObamaCare last week. (Carney, 8/1)

The White House and some Republicans who want to keep up efforts to repeal the Affordable Care Act have seized on a proposal aimed at giving states significant flexibility, though Senate leaders are suggesting they won’t revisit the health-care issue in the near future. The proposal, which Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) unveiled when the GOP’s primary legislation to overhaul the 2010 health-care law was faltering, is designed to let states craft their own health systems to some degree. (Hackman, 8/1)

Senate Majority Leader Mitch McConnell (R-Ky.) is leaving the door open for Republicans to take a second run at repealing ObamaCare after a GOP proposal failed last week. "We're continuing to score some of the options on healthcare," McConnell told reporters during a weekly press conference on Tuesday. "There's still an opportunity to do that." (Carney, 8/1)

Sen. John Cornyn (R-Texas) is urging Democrats to offer ideas on fixing the healthcare system, saying "fragile majorities" in the Senate force both parties to work together. "Democrats need to be more constructive rather than just continuing to bury their head in the sand about the fundamental problems with the Affordable Care Act," Cornyn, the No. 2 Republican, said from the Senate floor on Tuesday. (Carney, 8/1)

Dean Heller can’t win on Obamacare. He’s inflamed the left and right throughout the debate on repealing the law. And now the Nevada Republican is handing critics more ammunition by signing onto a new overhaul of Obamacare that has piqued the interest of the White House but nonetheless has little momentum. (Kim, 8/2)

Sen. Dean Heller’s vote to support a bill to repeal the 2010 health care law — while rejecting others — may make an already tough re-election campaign even harder. The Nevada Republican was already facing pressure from voters on the left and the right, his own party’s leadership and the White House going into last week’s Senate health care votes. That’s not all going away just because the votes are over. (Bowman, 8/1)

Even though Republican efforts to repeal the Affordable Care Act have died for the moment, it still was the biggest topic on the minds of several hundred people at a town hall hosted Tuesday by U.S. Rep. Justin Amash. The Cascade Township Republican heard from constituent after constituent that his support for a repeal was an injustice and that he should represent their interests. (8/1)

The apparent demise of the Republican drive to scrap the Affordable Care Act may open the door to bipartisan fixes to the law. If it does, some of the proposals being touted by a bipartisan group of governors may get a hearing on Capitol Hill. The seven Democrats and six Republican governors who crafted the proposals want federal money to stabilize the ACA’s health insurance marketplaces, and greater power to manage them. They argue it should be easier for states to customize Medicaid, the joint federal-state health insurance for the poor, and they want new tools to curb fast-rising drug prices. And they insist that states should continue to regulate the health policies sold within their borders. (Ollove, 8/1)

Major health insurers in some states are seeking increases as high as 30% or more for premiums on 2018 Affordable Care Act plans, according to new federal data that provide the broadest view so far of the turmoil across exchanges as companies try to anticipate Trump administration policies. Big insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are seeking to raise premiums by averages close to 30% or more, according to preliminary rate requests published Tuesday by the U.S. Department of Health and Human Services. Major marketplace players in New Mexico, Tennessee, North Dakota and Hawaii indicated they were looking for average increases of 20% or more. (Wilde Mathews and Radnosfky, 8/1)

Insurers in several states are pursuing premium increases nearing 30 percent or higher for ObamaCare health plans, according to a Tuesday report in The Wall Street Journal. Large insurers in West Virginia, Wyoming, Iowa, South Carolina, and Idaho are looking to up their premiums, records from the Department of Health and Human Services show. (Shelbourne, 8/1)

Monthly premiums for California health insurance plans sold under the Affordable Care Act will rise by an average of 12.5 percent next year, the second consecutive year of double-digit rate increases, officials said Tuesday. (Cooper, 8/1)

The expected 2018 rate increase is down from 2017’s average rise of 13.2 percent, and it includes a one-time increase averaging 2.8 percentage points because of the end of a “holiday” that gave health plans a break from the tax they are required to pay under the Affordable Care Act. (Bazar and Bartolone, 8/1)

Covered California Executive Director Peter Lee said that increases in the cost of providing care were responsible for about 7 percentage points of the state’s 12.5% average rate increase. Another 3 percentage points, he said, reflected a one-time tax adjustment. But another 3 points, he said, accounts for insurers’ overall unease with the ongoing debate over scrapping, or massively modifying, the Affordable Care Act. In negotiating with insurance companies this spring, Covered California put together a kind of hold-harmless agreement. That agreement, which Covered California will take to its board this month, essentially agrees to let health insurers make up losses from unexpected changes to the insurance market that may be caused this year or next by unexpected changes in the basic fundamentals of the Obamacare market. (Karlamangla, 8/1)

California is one of several states that have allowed insurers to file two different sets of premium requests: One for the continuation of ObamaCare, such as CSR payments and the enforcement of the individual mandate, and one in the event both are discontinued. (Weixel, 8/1)

Health insurers that sell Obamacare plans in California say they’ll double premium increases for some plans next year if President Donald Trump follows through on a threat to cut off subsidies under the law. Insurers requested a 12.5 percent rate increase on average for 2018 Obamacare plans, the state’s Covered California exchange said in a statement Tuesday. Trump, however, has threatened to stop paying what are known as cost-sharing-reduction subsidies -- which insurers get to help lower-income people afford to use their plans. If that happens, insurers would increase rates by another 12.4 percent on mid-level plans, the state said. (Tracer, 8/1)

Covered California's proposed 2018 health insurance rates — expected to rise an average 12.5 percent for the exchange's 11 plans — give the impression of stability during otherwise rocky times in state insurance markets. But exchange officials warn the price of some plans would double if the federal government stops funding critical Obamacare cost-sharing payments that defray the cost of covering low-income residents. (Colliver, 8/1)

U.S. health insurer Anthem Inc is pulling back from 16 of 19 pricing regions in California where it offered Obamacare options this year, state officials said on Tuesday. The move, which takes effect for 2018, means Anthem will offer Obamacare coverage in three pricing regions comprising 28 counties in California. (Erman and Berkrot, 8/1)

The lone insurer offering policies on Alaska's individual health insurance market has filed for an average rate decrease of about 22 percent next year. If approved, this would be the first time the average rate has decreased under the current federal health care law in Alaska, a remote state where high health care and premium costs have been an ongoing concern. (Bohrer, 8/1)

Insurers want to raise rates by up to 43 percent for Illinois customers who receive health care coverage under the Affordable Care Act. Among the companies seeking double-digit rate hikes on most of their plans starting next year are the three insurers that offered Obamacare coverage in Cook County this year, according to rate reviews released by the federal government on Tuesday. More than 351,000 Illinois residents are enrolled in Obamacare, with most of them — nearly 310,000 — covered by Blue Cross Blue Shield of Illinois. (Armentrout, 8/1)

Health insurers want to raise premiums next year for Illinois consumers who buy coverage through the Obamacare exchange — in many cases citing uncertainty surrounding the health care law as a reason for the proposed jumps. Average rate increases for individual plans in Illinois could range from 5 percent to 43 percent depending on a number of factors, including the type of coverage, a consumer's age and whether the person is a smoker. The proposed rate changes released Tuesday are the result of a complex series of calculations made by insurers and will likely be finalized in coming months. (Schencker, 8/1)

A commission established to explore Maryland’s options to respond to a possible repeal of Obamacare heard an accounting of the program’s accomplishments in the state Tuesday as well as warnings about the effects of President Donald J. Trump’s efforts to dismantle it. The Maryland Health Insurance Coverage Protection Commission, created by the General Assembly this year, launched its efforts to prepare for change in federal health programs less than a week after a Trump-backed effort to repeal the Affordable Care Act failed in the U.S. Senate. (Dresser, 8/1)

Most Americans will have from Nov. 1 to Dec. 15 this year to get 2018 health insurance on the individual market. Minnesotans will get an extra four weeks. The new Jan. 14 deadline was announced Tuesday by MNsure, Minnesota’s state-run health insurance exchange. Because Minnesota hasn’t turned its health insurance exchange over to the federal government, it has the ability to extend enrollment periods. “We heard loud and clear from stakeholders and consumers that Minnesotans needed more time to shop than the federal open enrollment period allowed,” MNsure CEO Allison O’Toole said in a statement. (Montgomery, 8/1)

The Affordable Care Act insurer in 13 of Arizona's 15 counties plans to raise average rates across all plans a moderate 7.2 percent next year. But Blue Cross Blue Shield of Arizona officials said the rate increases would be flat if President Donald Trump's administration did not plan to eliminate a key Affordable Care Act funding source. (Alltucker, 8/1)

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

Insurance Commissioner Roger Sevigny says he can’t remember another time when trying to map out New Hampshire insurance markets was quite as tricky as it is today. ...Now, Sevigny and Department of Health and Human Services Commissioner Jeff Meyers are tasked with figuring out how to ask the federal government for help stabilizing the state’s insurance markets in the face of projected double-digit rate increases next year without offering up any money from the state or its insurers, as Sevigny originally proposed. (McDermott, 8/1)

The Senate has approved a pair of bills taking aim at urgent problems at the Department of Veterans Affairs, clearing a $3.9 billion emergency spending package to fix a looming budget crisis and adopting new measures to pare down a rapidly growing backlog of veterans' disability claims. Both bills passed Tuesday by unanimous vote. (Yen, 8/1)

Senators cleared a $2.1 billion stopgap bill for President Donald Trump on Tuesday night that will keep a private medical care program for veterans running temporarily while authorizers work on a broader overhaul. The Veterans Choice Program was established in 2014 (PL 113-146) following a wait-time scandal in Phoenix that rocked the Department of Veterans Affairs and revealed a nationwide problem. Whistleblowers said that patients had died while waiting for care managed by VA employees who kept unofficial wait lists and were altering wait-time data in a way that obscured a massive appointment backlog. (Mejdrich, 8/1)

Veterans using a Department of Veterans Affairs program to seek care from doctors in the private sector instead of the VA face a greater danger of becoming entangled in the country’s opioid epidemic, the VA said Tuesday. Findings from the VA’s Office of Inspector General show that programs allowing veterans to get care from private doctors when appointments aren’t available in the VA system leave veterans vulnerable to overprescription of powerful opioids because of gaps in the process used by the VA to keep track of prescriptions. (Kesling, 8/1)

U.S. senators Cory Gardner and Michael Bennet want to know what the U.S. Department of Veterans Affairs is doing to solve the agency’s recurring problems in Colorado with scheduling speedy medical appointments, according to letters they sent Tuesday. Separate one-page letters from the Colorado Republican and Democrat to VA Sec. David Shulkin come five days after The Denver Post reported that waiting times in the Denver-based Eastern Colorado Health Care System are among the worst nationally, and are three times worse than in Phoenix, where the wait-list scandal erupted three years ago. (Migoya, 8/1)

Jerome Adams, Indiana’s state health commissioner, pledged Tuesday to put science ahead of politics if he becomes the next surgeon general. But while science is critical, Adams told senators at his confirmation hearing, it has to be applied in a “sympathetic and empathetic way.” (Groppe, 8/1)

At a hearing Tuesday for five of President Trump’s nominees at the Department of Health and Human Services, a long contentious issue briefly flared: the public health threat posed by gun violence. Sen. Chris Murphy (D-Conn.) asked Dr. Jerome Adams, Trump’s nominee for surgeon general, what the surgeon general can do to stem gun violence. It was a notable moment because Dr. Vivek Murthy, the former surgeon general, saw his confirmation delayed for a year because of his support for gun-control laws. (Joseph, 8/1)

The Senate will vote this week on a key legislative priority for the pharmaceutical industry and the Food and Drug Administration, according to three key senators. The package spells out how much drug and device makers pay the FDA to fund the agency’s oversight and approval processes, called user fees. The current contracts expire at the end of September, and the agency has said a new agreement is critical to its ability to continue to pay thousands of staffers. (Mershon, 8/1)

Republican leaders in the Senate seem to have struck a deal with a GOP holdout who had threatened to slow progress on a key Food and Drug Administration funding bill. Republicans hope to clear the measure for President Trump before departing for August recess, but they are still working out an agreement with Democrats to limit debate time. Sen. Ron Johnson, R-Wis., earlier indicated he would withhold consent to move the FDA bill quickly unless leaders gave him a vote on an amendment intended to increase people's access to experimental drugs. (Siddons, 8/1)

The Food and Drug Administration (FDA) is raising eyebrows with talk of cracking down on nicotine levels in cigarettes and flavored tobacco products, including menthol. The agency on Friday said it’s planning to look at reducing nicotine in cigarettes to nonaddictive levels, a policy change that would likely have huge repercussions for the tobacco industry. (Wheeler, 8/1)

Researchers are calling on the U.S. Food and Drug Administration to regulate caffeine-based energy products along with yohimbe, a botanical marketed for male sexual enhancement, after a recent study showed that children taking the supplements often had serious adverse reactions. The findings are part of a study that examined dietary supplements by reviewing 13 years of calls to poison-control centers in the U.S. and its territories. (Viviano, 8/2)

The Fertilome test hit the market at the start of this year and the company behind it, Celmatix, said more than 50 doctors have already ordered it for hundreds of women seeking scientific guidance on questions such as whether they should freeze their eggs for future use, or whether it’s worth it to try another round of in vitro fertilization. The Celmatix CEO, Piraye Yurttas Beim, said her team has heard of a small wave of “Fertilome babies” on the way. Some reproductive specialists are enthusiastic. But others caution that Fertilome is just the latest genetic test promising more than it can deliver — and, in this case, playing to the fears of women who are anxious about becoming a mother. (Robbins, 8/2)

States with more abortion restrictions tend to score worse when it comes to health outcomes for women and children and have fewer policies to support those populations, according to a new study from a research center and a legal advocacy organization that seek to improve abortion access. On average, the 26 states with more than 10 abortion restrictions had poorer health scores for women than the 24 other states, the report by Ibis Reproductive Health and the Center for Reproductive Rights found. (Choi, 8/1)

In the hope of finding an answer, and perhaps helping other women live longer, Mocarski is part of a University of Wisconsin-Madison study of "exceptional survivors" of metastatic breast cancer. These women continue to live while others die despite the same or better prognosis. (Herzog, 8/1)

Real men may wear pink, but at least 12 metro Denver guys will live, breathe and think pink for the next two months as they raise money to support breast cancer patients and the people who care for them. The first wave of competitors in the Real Men Wear Pink challenge made their formal debut Tuesday evening at the JW Marriott Cherry Creek to meet and strategize about how to raise the most money while vying for titles like “the pinkest man.” (Baumann, 8/1)

A clinical trial testing blood transfusion therapies for heart attack patients may place participants in danger of death or a repeat heart attack without fully disclosing those risks, a Washington, DC-based consumer advocacy group said Tuesday in a letter asking federal health officials to immediately suspend enrollment in the study, which is recruiting patients at dozens of hospitals, including Mount Sinai Medical Center in Miami Beach. The nonprofit consumer advocacy group, Public Citizen, claims the clinical trial, which is designed to compare two red blood cell transfusion strategies for heart attack patients with anemia, fails to inform participants of prior studies that strongly suggest one method is more likely to result in death or a repeat heart attack. (Chang, 8/1)

Even though most insurers cover Subutex, insurance plans require paperwork, called a prior authorization, before they’ll approve its use. Prior authorization requirements are especially onerous for pregnant women on Medicaid who may have to submit new paperwork multiple times during their pregnancy. (Forman, 8/2)

Attorney General Jeff Sessions plans to discuss the impact of the country’s opioid epidemic during a speech in hard-hit Ohio, where about eight people a day are dying of accidental overdoses. Sessions is scheduled to address law enforcement officers and families affected by the crisis Wednesday in Columbus. (8/1)

A commission organized by President Trump released its initial recommendations on Monday, saying it was time to declare a national health emergency, among other suggestions. Special correspondent Nick Schifrin talks with Gov. Roy Cooper, D-N.C., a member of the commission, about what would help ease the epidemic. (Schifrin, 8/1)

In the early 1800s, many Boston merchants became millionaires in part by selling opium illegally in China. ... The opium trade fueled an epidemic in China — and there are signs the merchants unwittingly fed addiction in Massachusetts. (Bebinger, 8/1)

Theranos Inc., the once highflying blood-testing firm, said Tuesday it settled a lawsuit filed against the company by the drugstore chain Walgreens and its parent, Walgreens Boots Alliance Inc. Terms of the settlement were not disclosed, but Theranos said there was “no finding or implication of liability” and Walgreens’ lawsuit will be dismissed. (Peltz, 8/1)

Rural medical clinics coordinate patient care better than Twin Cities clinics, on average, according to a new Minnesota survey that suggests small facilities and do-it-all small-town doctors still offer advantages in an era of modern medicine. The survey data published Wednesday by Minnesota Community Measurement, a nonprofit health care rating organization, showed below-average marks for Twin Cities clinics on care coordination — items such as whether doctors know their patients' histories before their appointments and call patients afterward about test results or prescription drugs. (Olsen, 8/1)

Between April 1 and the end of June, lawmakers in Sacramento passed a controversial gas tax, put the breaks on universal health care and began negotiations on a cap-and-trade deal to extend the state’s marquee climate change program. During the same period, business groups, unions, nonprofits and other interests shelled out $91.2 million to influence officials. (Luna and Miller, 8/1)

Florida health officials confirmed Tuesday the state’s first case of sexually transmitted Zika in 2017. ...The infected individual had no recent travel history but that person’s sexual partner had recently traveled to Cuba and was sick with symptoms consistent with Zika infection, health officials said. (Miller, 8/1)

Health officials on Tuesday reported Florida’s first sexually transmitted Zika infection of 2017, which occurred in Pinellas County and brings the statewide total to 90 cases this year. The person who acquired Zika through sex had not traveled outside of Florida, but the partner recently visited Cuba and fell ill with symptoms consistent with the virus. (Chang, 8/1)

he Cleveland Clinic has started a Center for Men's Health to offer specialty health services to men. Housed in the Glickman Urological & Kidney Institute on the main campus, the new center is designed to treat those who have been medically under-served, the Clinic said. (Christ, 8/1)

Arizona's largest health-care provider is partnering with Safeway grocery stores to open retail-based clinics at three different store locations — Chandler, Tempe and Tucson. The initiative is designed to make health care more accessible and affordable, said Corey Schubert, a Banner Health spokesman. (Na, 8/1)

It’s meant to boost your health but Minnesota doctors caution that this alternative health remedy can send you or a loved one to the emergency room. Six people have been treated at Hennepin County Medical Center this year for injuries sustained after accidentally drinking highly concentrated hydrogen peroxide. (Shah, 8/1)

A Milwaukee nonprofit group announced Tuesday it has received a $1.6 million federal grant to combat youth violence in the city. The four-year grant awarded to the Center for Self-Sufficiency will focus on working with Milwaukee high school students on violence prevention and staying on a path toward higher education and careers. (Oxenden, 8/1)

Hoping to minimize layoffs, Brigham and Women’s Hospital is considering asking more employees to volunteer to give up their jobs. The hospital already has a buyout offer on the table to some 1,600 employees, with the deadline to accept looming on Friday. (Conti, 8/1)

In an effort to shed some light on the least understood part of the underground sex trade, University of Minnesota researchers for the first time have studied the demand for commercial sex in Minnesota and who the typical client is. ...Researchers, who combed through court records and media reports and interviewed more than 150 experts statewide, found that most sex buyers in Minnesota seek quick and anonymous sex with young-looking girls or women. (Smith, 8/2)

Mayor Steve Adler and the mayors of Texas’ three largest cities sent a letter to Texas House of Representatives Speaker Joe Straus on Tuesday opposing bills that would prohibit local governments from partnering with Planned Parenthood. The Texas Senate has passed Senate Bill 4, which prevents any tax money from going to abortion providers and their affiliates, including Planned Parenthood. (Jankowski, 8/1)

The Texas House has approved taking money from a state emergency savings fund to pay to temporarily bolster the state-run health insurance program for retired teachers. The lower chamber voted 130-10 Tuesday to pass House Bill 20 authored by Rep. Trent Ashby, R-Lufkin, which would put a one-time influx of $212 million into TRS-CARE, the health plan that serves hundreds of thousands of retired teachers. (Swaby, 8/1)

The city of Minneapolis is weighing new restrictions on menthol tobacco sales that would limit sales to adult-only smoke shops. Public health advocates have pushed for the limits, claiming menthol products entice kids into smoking and make quitting more difficult. (Zdechlik, 8/2)

Symptoms of racial trauma can include depression and angry outbursts, but also a general reluctance to trust white people. Can the healing powers of yoga ease at least some of the symptoms of racial trauma? (Duan, 8/2)

A decade ago, physicians who treat epilepsy got what seemed like a piece of good news: Eight companies had received federal approval to sell a generic version of an injectable lifesaving drug. Doctors liked the brand-name drug Cerebyx because it was safer and easier to use than a previous medicine that stopped seizures but could cause terrible skin reactions. The only problem was that it was too expensive for many hospital pharmacy budgets. A widely available and cheaper generic version would remove those cost barriers — or so doctors thought. (Johnson, 8/1)

For the past seven months, the GOP push to replace the Affordable Care Act has consumed Washington. All the while, many consumers continue to be focused on the rising costs of prescription drugs. (Ying, Appleby and Stapleton, 8/2)

In response to a furor over medicines discovered with taxpayer dollars, Sen. Bernie Sanders (I-Vt.) is proposing a new rule to require drug makers to charge fair prices. The move would force federal agencies and federally funded nonprofit institutions, including universities, to negotiate a reasonable pricing agreement before granting exclusive rights to make prescription drugs. (Silverman, 7/31)

After several years in which drug makers have been pressured to release clinical trial data, a new analysis finds many companies are still doing an incomplete or inconsistent job of being transparent. Overall, 95 percent of the 42 companies reviewed – including the 25 largest drug makers, based on sales – had a publicly accessible policy. Otherwise, however, the specifics often varied wildly in terms of what is disclosed and even how to interpret some of the policies. (Silverman, 7/26)

Jana Gundy and Amanda Chaffin live within two hours of each other in Oklahoma. Each has a child with the same devastating disease, one that robs them of muscle strength, affecting their ability to sit, stand or even breathe. So both families were ecstatic when the Food and Drug Administration approved the first treatment for the genetic condition — known as spinal muscular atrophy (SMA) — two days before Christmas 2016. It seemed the gift they had been waiting for — a chance to slow the heartbreaking decline of their young sons. (Appleby, 8/2)

Tammi Bradley jumped on her computer the minute she heard the news about the Food and Drug Administration’s approval of a drug targeting spinal muscular atrophy (SMA), a progressive muscle-weakening condition she’s had since childhood. “That night, I wrote to all my neurology doctors and my personal physician, saying I was interested in obtaining this treatment,” recalled the 51-year-old Citrus Heights, Calif., resident. (Appleby, 8/2)

The internet has transformed the way consumers buy everything from clothes and cars to food and movie tickets. Can the power of technology also disrupt how Americans purchase prescription drugs? Certainly, it is an area crying out for innovation amid soaring cost increases that are straining the budgets of Americans who rely on medication to manage pain or chronic disease. Prescription drug costs for those under age 65, which shot up more than 11 percent in 2016, are are projected to jump nearly 12 percent this year, according to research firm Segal Consulting. And generic drugs, while cheaper, are no panacea given their own price increases and lack of availability for many medical conditions. (7/31)

Making a drug is a bit like baking — in the goopiest, messiest sense possible. Just ask Janet Woodcock, director of the Food and Drug Administration’s Center for Drug Evaluation and Research. “We take the [inactive] and active [ingredients] and put them into a giant pot. It looks like a gigantic cake mixer. And then we … take that mush and we squeeze it out into a string and put it into tablets,” said Woodcock. “It’s a mess, it gets all over the place.” (Wosen, 7/26)

Generic drug makers are turning to M&A to shield themselves against a concerted effort by U.S. regulators to crack down on steep drug prices. Impax Laboratories Inc (IPXL.O), Perrigo Company Plc (PRGO.N) and Alvogen Inc have been talking to advisers about strategic options for their generics businesses, ranging from acquisitions to increase scale to an outright sale of the units, people familiar with the matter said this week. The persons declined to speak for attribution because the discussions are private. (O'Donnell, 7/27)

An Ohio congresswoman unsuccessfully attempted to make it possible for the U.S. Department of Health and Human Services to conduct an end run around companies that price drugs —  developed with taxpayer dollars — higher than what is charged in seven other high-income countries. Last week, Rep. Marcy Kaptur (D-Ohio) introduced an amendment to a House appropriations bill that would have authorized HHS to exercise rights in a federal law which, under certain circumstances, would permit a company — other than the licensed patent holder — to make a lower-cost version of a drug. (Silverman, 7/25)

Opponents to a ballot measure that seeks to curb the money the state spends on pharmaceutical drugs has spent three times as much as supporters of Issue 2 and in less time. Ohioans Against the Deceptive Rx Ballot Issue spent $9.7 million of the $15.8 million it has raised from May 30 to June 21, according to campaign finance reports filed Monday with the Ohio secretary of state. (Hancock, 7/31)

The group backing a ballot measure that aims to lower the cost of prescription drugs raised $3.7 million from Feb. 14 through June 28. ... The proposed law would require drug companies to charge the state no more than the U.S. Veterans Administration for prescription drugs, which would affect Ohio programs such as Medicaid, state employees and retirees. (Hancock, 7/31)

Express Scripts, the nation’s largest pharmacy benefits manager, will exclude an additional 64 medicines next year from its formulary – the list of drugs that get preferred insurance coverage. The company estimates that restricting access to the drugs will save health plans an extra $700 million. (Silverman, 7/31)

Patient advocates have long complained that drug and device makers do not make enough experimental medicines available, but a new study finds that the industry funds most trials that aim to get such products to patients. Specifically, companies funded 61 percent of nearly 400 studies that make drugs or devices available to patients prior to regulatory approval, according to the analysis in BMS Research Notes. And the researchers suggest that, even without federal intervention, industry is “establishing programs to make experimental therapies available to terminally ill patients.” (Silverman, 7/31)

Only three types of drug-resistant bacteria make the Center for Disease Control and Prevention’s list of  “urgent” threats. One of them is gonorrhea. That particular sexually transmitted infection is the target of a new drug being developed by Entasis, an antibiotics-focused spin-off from pharma giant AstraZeneca. But they’re getting help: their nonprofit partner, the Global Antibiotic Research and Development Partnership, will be funding the next round of trials and doing studies to ensure this drug keeps working for as long as possible. The partnership is GARDP’s first. (Sheridan, 7/31)

Biogen Inc. said its interactions with health-care providers in Italy are under investigation by a prosecutor in Milan. The drugmaker learned of the investigation this month and is cooperating with the Italian government, according to a securities filing Tuesday. The company didn’t provide further details about the probe. Biogen spokesman Matt Fearer confirmed by email that the company’s Milan office was visited by officials acting on behalf of the prosecution Office of that city, adding it would be inappropriate to comment further. (Bloomfield, 7/25)

Hurdles ranging from existing commercial tie-ups to politics make drugmaker AstraZeneca a problematic takeover target in the wake of last week's big lung cancer setback that hammered the stock and rekindled takeover talk. Industry executives and bankers say Pfizer, which failed to buy it for $118 billion in 2014, is unlikely to return, while European rivals Novartis, Sanofi and GlaxoSmithKline are wary of large deals. (8/1)

Celgene Corp. agreed to pay $280 million to resolve a whistle-blower’s claims the drugmaker used illegal marketing tactics to turn its Thalomid and Revlimid cancer drugs into blockbuster sellers, the U.S. said. The settlement ends claims by a former company saleswoman that Celgene defrauded federal and state Medicare programs out of billions by luring doctors into prescribing the cancer drugs for unapproved uses, Acting U.S. Attorney Sandra Brown in Los Angeles said Tuesday in a statement. (Feeley and Bloomfield, 7/25)

Europe's drugs regulator is cutting back on lower-priority work as it prepares for disruption caused by Brexit and the need to relocate from London to another city inside the European Union. The European Medicines Agency (EMA) said on Tuesday its "business continuity plan" meant it would suspend work on a new web portal and an electronic submission project for drugs, as well as the development of a transparency roadmap. (Hirschler, 8/1)

The first substantive note from jurors in Martin Shkreli’s fraud trial asked on Tuesday about assets under management and what “fraudulent intent” meant. The jurors had been deliberating for more than a day and a half in Mr. Shkreli’s trial in the Federal District Court in Brooklyn. They had not asked any questions other than, on Monday, what time they were supposed to leave at night. (Clifford, 8/1)

Jurors weighing the fraud case against 'Pharmacy Bro' Martin Shkreli Tuesday asked for legal definitions of "fraudulent intent" and "assets under management. "In a note sent during the second day of deliberations, the seven women and five men also asked whether the Shkreli assets under management in the case referred to a particular financial fund or all assets handled by the portfolio manager or general partner. (McCoy, 8/1)

One of the FDA’s main jobs is to ensure that the drugs Americans take are safe and effective. Whether they’re affordable has always been someone else’s problem. Enter Scott Gottlieb, the new commissioner of the U.S. Food and Drug Administration, who wants to reduce drug prices significantly. It’s a worthy cause, and his strategy -- to enable greater competition from generic drugs -- makes sense. But the FDA can’t do it by itself. (7/31)

President Teddy Roosevelt famously said of foreign policy, “speak softly, and carry a big stick.” This advice can also apply to regulation. It is important for regulators to tread lightly, but they should also have the tools to punish bad actors who are clearly manipulating the market. Regulation can be a tool to strengthen competition and address important health and safety concerns, but it can also be abused to limit access to the market. Therefore, lawmakers and regulators must regulate wisely and be careful of unintended consequences. As then-Judge Robert Bork put it 30 years ago, “[p]redation by abuse of governmental procedures, including administrative and judicial processes, presents an increasingly dangerous threat to competition. (David Balto, 7/27)

After last year’s election, Donald Trump declared his determination “to bring down drug prices.” As president, he’s now reportedly cooking up an executive order aimed at cutting regulations for drug companies, which probably won’t do much to lower prices but should please industry execs. It’s worth asking, though: If Trump really wanted to bring down drug prices, could he? (David Lazarus, 8/1)

Across the board, drug prices are soaring. Even the cost of cancer medications are so high that some patients are delaying cancer treatments or skipping them altogether. But who is most responsible for higher drug prices: pharmaceutical companies or pharmacy benefit managers (PBMs)? That depends on whom you believe. (Lynn R. Webster, 7/27)

Canadians are used to paying more for identical products sold south of the border. Hockey equipment, perhaps paradoxically, can sometimes cost up to 18% more up north; and there are similar price differences for toiletries, books, and electronics. There are many reasons why goods cost more in Canada than in the United States, regardless of the value of the Canadian dollar, including higher costs of doing business (Canada has a higher minimum wage), lower purchasing power, and tariffs, among others. (Michael Fralick, Jerry Avorn and Aaron S. Kesselheim, 7/27)

Biopharma asset prices are "pretty high," according to Sanofi's CFO. He's not the only one who thinks so. His comments as Sanofi released its second quarter earnings echo those of a number of other large pharma executives. But those gripes don't always line up with market reality. A change in strategy and attitude might be needed for companies claiming sticker shock. (Max Nisen, 7/31)

Across the globe, people will mark World Hepatitis Day on July 28 to raise awareness about viral hepatitis, call for better access to prevention and treatment programs, and advocate for greater government action. Here in the United States that includes bringing to light the hundreds of thousands of people living with hepatitis C (HCV) who could be cured of their disease in as little as two months by a pill taken just once a day. However, most state Medicaid programs are refusing to pay for their treatment. Claiming high drug costs, these states are restricting access to only those with severe liver damage or who have abstained from substance use. This forces people to become sicker than necessary, violates current Medicaid law, and will cost state Medicaid programs more in the long run. This rationing of treatment needs to be stopped. (Michael Ruppal, 7/27)

When a failed drug trial moves the market caps of three different pharma companies by an aggregate $20 billion, you know it's important. AstraZeneca PLC's big effort to gain ground in the red-hot market for immune-boosting cancer drugs -- a combination of its already approved Imfinzi and a second immune-oncology (IO) drug tremelimumab -- was revealed as a flop in treating lung cancer Thursday morning. This trial -- code-named "Mystic" -- was always something of a Hail Mary. But it was one Astra desperately needed to work. (Max Nisen, 7/27)

What is a small business owner in the U.S. to do when an employee requires a prescription medication that costs more than their annual salary? Too many employees like that means you’ll be locking your doors soon. Richard Master, CEO of a family-owned factory, faced such a dilemma when his company’s health care costs were rising by the equivalent of $4 per hour each year. This meant that there wasn’t much room for increasing wages. (Ray Slavin, 7/27)

Several years ago, I learned the prescription drug I was taking cost three times more here than it did in Canada. I wondered if it was the same for all prescription medications. It was. And still is. I also learned why pharmaceutical companies charge so much more here than in other countries — because they can. (Pat Nash, 7/29)

Last week, a gravely ill senator flew across the country to give the speech of his life. John McCain invoked the spirit of the Senate in better times to highlight our current ills. “Our deliberations today,” he said, are “more partisan, more tribal more of the time than at any other time I remember.” The polarization of political discourse has practical—negative—consequences, he added: It is not producing much for the American people. (William A. Galston, 8/1)

If the failure of health care reform taught us anything last week, it’s that somebody somewhere in Washington is going to have to start compromising if anything is ever going to get done. But if you’re thinking a successful compromise is going to come from moderates like Sen. Susan Collins, R-Maine, or Sen. Joe Manchin, D-W.Va., think again. Although those senators’ roles will be important, all of the moderates from both parties together still don’t have enough votes to pass legislation. Instead, the movement, and the concessions, are going to have to come from the true believers of both parties — the hardcore liberals and conservatives who are least likely to give up on their principles and are thus most likely to bring a critical mass of their party along with them. (Patricia Murphy, 8/2)

The failure of Senate Republicans to pass even their “skinny” repeal bill is a serious disappointment to critics of the Affordable Care Act. Despite campaign rhetoric suggesting otherwise, “repeal and replace” of the ACA is something Republicans are apparently unable and likely unwilling to do. The only silver lining for conservatives is that the failure has demonstrated what the political market will bear when it comes to changes to the law. (Lanhee J. Chen and Tevi Troy, 8/1)

Say what you will about Congress's failure to repeal Obamacare -- and there was a lot to be said about its reckless efforts -- at least the process acknowledged one basic fact of America's constitutional system: If Congress doesn't like a law, it can change it. If the president does not like a law, he cannot be allowed to sabotage it. (8/1)

President Trump likes to govern by Twitter threat, which often backfires, to put it mildly. But he’s onto something with his recent suggestion that Members of Congress should have to live under the health-care law they imposed on Americans. Over the weekend Mr. Trump tweeted that “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” He later added: “If ObamaCare is hurting people, & it is, why shouldn’t it hurt the insurance companies & why should Congress not be paying what public pays?” (8/1)

If the American people wanted more Obamacare, they would have re-elected Democrats to their majorities in the House in 2010 and Senate in 2014, and given them back the White House in 2016. The American people want a different approach. They want affordable health insurance. They want quality care. They want to be able to keep their doctors, and they want to make health care decisions with their doctors, not the government. Republicans have put forward two reform plans that, though not full repeal, are first steps at fixing the failures of Obamacare. Both of these Republican plans protect Americans with pre-existing conditions while offering lower-cost insurance options for millions of Americans who are hurt by Obamacare. (Rep. Jim Jordan, 8/1)

When it comes to providing affordable health care to the people of Maine, Sens. Susan Collins and Angus King are worse than out of touch—they are downright dangerous. After Maine expanded Medicaid to childless adults in 2002 under then-Gov. King, the program nearly bankrupted our state. But now Ms. Collins and Mr. King are pushing to do it again by refusing to reform ObamaCare and prevent the future expansion of Medicaid. (Maine Gov. Paul R. LePage, 8/1)

It was a nice nod in the direction of bipartisanship. But it also perpetuates a deceptive narrative, repeated often by Republicans, that they were completely excluded from the process that resulted in Obamacare. While it is true that no Republican voted for the final bill, it is blatantly untrue that it contains no GOP DNA. In fact, to make such an assertion is like researching your ancestry and going no further back than your mother and father. Not only were Republican senators deeply involved in the process up until its conclusion, but it's a cinch that the ACA might have become law months earlier if the Democrats, hoping for a bipartisan bill, hadn't spent enormous time and effort wooing GOP senators — only to find themselves gulled by false promises of cooperation. And unlike Majority Leader Mitch McConnell's semi-secret proceedings that involved only a handful of trusted colleagues, Obamacare, until the very end of the process, was open to public scrutiny. (Ross K. Baker, 8/1)

As a medical researcher, I am astounded that politicians can callously ignore rigorous scientific research that points to the extraordinarily high human cost of losing access to health care. That research definitively shows how the Affordable Care Act is making a difference for millions of Americans. (Lyndsay Ammon Avalos, 8/1)

U.S. . Senate Republicans belly-flopped recently in an attempt to overhaul Obamacare. Many Democrats, meanwhile, have remained steadfastly opposed to significant fixes to the law because, well, it's a success in their estimation. On Tuesday, federal officials released the Obamacare rates for Illinois in 2018. Insurers propose to hike health insurance prices by as much as 43 percent next year for those who buy coverage through Obamacare exchanges. That's on top of nosebleed-section rate increases of more than 40 percent for 2017. (8/1)

The governor keeps telling us that the Obamacare expansion is saving money and that these savings will continue. He wants this to be true, since last year he promised taxpayers the expansion would save $1 billion over the next decade. Many at the time, including local hospitals, rightly warned these projections were overly optimistic. Especially considering that to pay for itself, the governor's expansion plan relies on a budget gimmick that even former Vice President Joe Biden called a "scam." It's a scheme wherein the state collects a provider tax from hospitals and then returns the funds to the hospitals in the form of higher Medicaid payments. (John Kay, 8/2)

The 52nd anniversary of Medicare was Sunday and the program is more relevant than ever no matter your age. If you’re younger than 50 or even 40, you may benefit from a brief description of Medicare. “Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease” (Medicare website). Congress created it in 1965 to aid older citizens who had no insurance coverage following retirement. (John H. Clark, 8/1)

While the early advocates for the liberal prescription of opioids are no longer vocal, there continue to be insidious incentives to prescribe opioids. For instance, physician reimbursement is now closely linked to patient satisfaction surveys. There is deep concern in the medical community that overprescribing may be occurring as a function of the desire to optimize patient satisfaction. How do we start to make things better? (Brian D. Sites and Matthew A. Davis, 8/1)

The opioid crisis in Missouri has reached epidemic portions. It is the No. 1 public health crisis that we face. In 2016, there were 908 opioid- or heroin-related deaths in the state, a 35 percent increase over 2015. Every day, two babies are born in Missouri addicted to opioids. And the numbers are rising. Gov. Eric Greitens is leading the Missouri government in the fight against this modern-day plague. Two recent actions stand out as being innovative in our efforts to save live. (Randall W. Williams, 8/1)

Digging Ohio out from under the opioid-addiction scourge that is killing eight people in the state every day won’t be nearly as easy as falling victim to it was. But it’s good to see the state and local communities working steadily, one idea at a time, to fix the damage and change the culture. (8/2)

Preventing infections in the first place will also reduce the need for antibiotics. That’s where vaccines come in as an important part of the solution. Vaccines are an icon of prevention, well-regarded as one of the best buys in health. With immunization averting up to 3 million deaths annually, no health intervention better embodies the old adage that an ounce of prevention is worth a pound of cure. But in the context of the global trend in antibiotic resistance, we have been undervaluing all that vaccines offer to both individuals and communities. (Bruce Gellin, 8/1)

Thousands of 7th- and 12th-grade Iowa students are not supposed to attend school this fall if they are not vaccinated against meningitis. Though classes start in a few weeks, about 4,000 students in Polk County have not been immunized, according to local health officials. And Iowa has 98 more counties. (8/1)

Believers in the quest to make America great again should consider where there’s evidence things are going down the tubes. There’s hardly a more dismal example than the national decline in sperm production. Last week, scientists published a study confirming that sperm counts are half what they were in the early 1970s -- and not just in America, but in Europe, Australia and New Zealand, too. The more alarmist accounts warned that the human race is teetering on the brink of extinction. (Faye Flam, 8/1)

Democrats will fund anti-choice candidates in conservative districts, Representative Ben Ray Luján, chairman of the Democratic Congressional Campaign Committee, said in an interview this week, citing the party’s need to build “a broad coalition” to win control of Congress in 2018. “There is not a litmus test for Democratic candidates,” Luján told The Hill. “As we look at candidates across the country, you need to make sure you have candidates that fit the district, that can win in these districts across America.” (Lindy West, 8/2)

Encouraged by President Trump’s abysmal approval ratings and dysfunction in the Republican-controlled Congress, Democrats are entertaining scenarios of recapturing control of Capitol Hill in 2018 — and key to that scenario is coaxing back voters who supported Trump in 2016. Part of that strategy is a message heavy on economics and light on identity politics, but it also involves recruiting candidates in swing districts who might depart from liberal orthodoxy on social issues. (Michael McGough, 8/1)

Yet, based on recent testing data, San Jose Unified appears to only take the presence of lead in drinking water seriously if there’s at least 15 times the pediatricians’ standard, and then only if the taps test high for lead at least twice. This is a problem because a 15 parts per billion threshold for action is not a safety standard for kids. (Jason Pfeifle, 8/1)

SB 349 by Sen. Ricardo Lara would establish the strictest-in-the-nation staffing minimums for nurses and technicians in dialysis clinics, where patients in kidney failure have their blood cleansed several times a week. It may sound humanitarian, but it’s a craven play for union support in the senator’s run for Insurance Commissioner next year. (8/1)

Public health advocates should be jumping for joy at the U.S. Food and Drug Administration’s announcement that it would explore ways to reduce nicotine levels in conventional cigarettes to non-addictive levels. Such a policy could save millions of lives if it caused the estimated 36.5 million Americans who smoke regularly to lose interest in lighting up. Smoking may be on the wane, but it is still the leading cause of preventable death in the United States, according to the Centers for Disease Control and Prevention. (8/1)