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Senate Democrats tore into President Trump’s Supreme Court nominee on Tuesday, painting Judge Brett M. Kavanaugh as a narrow-minded partisan as the opening day of his confirmation hearings verged on pandemonium. Dozens of screaming protesters were hauled out of the hearing room in handcuffs. The verbal brawl began moments after the hearings began. Democrats, furious at being denied access to records related to Judge Kavanaugh, immediately interrupted the chairman of the Senate Judiciary Committee, Charles E. Grassley of Iowa, demanding time to consider tens of thousands of pages of documents released late Monday — the night before the hearing. (Stolberg and Liptak, 9/4)

But GOP senators mostly calmly defended Kavanaugh from what Sen. Ted Cruz (R-Tex.) called the Shakespearean nature of the hearing — “sound and fury, signifying nothing” — confident that there were no defections from the solid Republican support Kavanaugh needs to be confirmed as the Supreme Court’s 114th justice. The 53-year-old judge, who serves on the U.S. Court of Appeals for the D.C. Circuit, sat impassively for nearly seven hours of senators’ statements before speaking for less than 20 minutes. Senators plan to begin questioning him Wednesday morning. (Barnes, Kim, Marimow and Wagner, 9/4)

Given the brutal odds they face in beating a nominee they can’t stop unilaterally, Democrats went as far as they could go without splintering. Even Senate Judiciary Chairman Chuck Grassley (R-Iowa) admitted the display had caught on, remarking that “either you run the committee, or it runs you” and telling Democrats that “you guys have been very successful today in running the committee.” (Everett and Schor, 9/4)

Republicans rushed to Kavanaugh’s defense and accused Democrats of playing politics with the nomination. "If you want to pick judges for your way of thinking, then you better win an election,” Sen. Lindsey Graham (R-S.C.) told Democrats. (Savage, Haberkorn and Wire, 9/4)

Judge Kavanaugh, who spoke at day’s end, made no reference to the seven hours of partisan debate. He touted his judicial impartiality at a session in which Democrats painted him as a servant of social conservatives and business interests. “I don’t decide cases based on personal or policy preferences. I am not a pro-plaintiff or pro-defendant judge. I am not a pro-prosecution or pro-defense judge. I am a pro-law judge,” he said. “If confirmed to the court, I would be part of a team of nine, committed to deciding cases according to the Constitution and laws of the United States.” (Bravin and Tau, 9/4)

Democrats have at least two days — and 50 minutes each — to ask Kavanaugh about abortion, gun rights, presidential power, healthcare or whatever else they choose. Republicans will have the same time to draw out Kavanaugh’s credentials and strengths. Here’s a look at what we’ll be watching for Wednesday. (Wire and Haberkorn, 9/4)

Kavanaugh is also likely to be questioned about his thoughts on presidential power and immunity. Although he worked on the Starr report, he later wrote that a sitting president should not have to face the distraction of civil or criminal investigations — a position that worries Democrats in light of the ongoing Department of Justice probe of Russian interference in the 2016 election and possible ties to the Trump campaign. "We have to confront an uncomfortable but important question about whether President Trump may have selected you, Judge Kavanaugh, with an eye towards protecting himself," said Sen. Chris Coons, D-Del. (Horsley, 9/5)

Abortion is expected to figure prominently at the Senate confirmation hearings for Supreme Court nominee Brett Kavanaugh. Since Republican President Trump announced his pick to replace Justice Anthony Kennedy, Democrats and abortion-rights activists have expressed alarm about the fate of Roe v. Wade, the 45-year-old ruling that first established abortion as a fundamental right under the Constitution. As a guide, here are some questions and answers about the abortion legal landscape, how it could change, and what to expect at the hearings. (Gershman, 9/4)

Once opening statements launched [on Tuesday], Democrats homed in on core issues starting with Roe v. Wade and gun control, noting Trump's promise to conservatives that he would appoint a "pro-life and pro-gun" judge. "We cannot find the documents that absolve from that conclusion" that Kavanaugh is such a judge, Sen. Diane Feinstein (D-Calif.) said in her opening statement. Feinstein said she feared that his nomination put "what women have won through Roe and a host of privacy cases" at stake. On abortion, Feinstein referenced Kavanaugh's opinion in the well-publicized Garza v. Hargan lawsuit; in that case an undocumented minor sued HHS after the department blocked her from obtaining an abortion while she was in its custody. (Luthi, 9/4)

There were frequent disruptions by demonstrators inside the hearing room, often interrupting the Democrats' interruptions. Many expressed concerns over the fate of Roe v. Wade, the 1973 Supreme Court decision that legalized abortion. At one point, a protester could be heard shouting "more women are going to be subject to back-alley abortions." And outside the hearing room a group of women dressed in bonnets and red robes from The Handmaid's Tale stood silently. U.S. Capitol Police say they arrested a total of 70 demonstrators Tuesday. (Naylor, 9/4)

The TV ads will air in Washington, D.C., and Alaska, home of Sen. Lisa Murkowski (R), a key vote in the confirmation process. The ads in D.C. will air through this week on MSNBC's "Morning Joe" and NBC's "Meet the Press" Sunday. Ads in Alaska will air on TV and radio. The ads highlight the "risk" Kavanaugh's nomination poses to abortion access in the U.S. and urges senators to vote against his confirmation. (Hellmann, 9/4)

If the Senate confirms Brett Kavanaugh, President Trump’s Supreme Court nominee, the high court will have a consistently conservative majority. As a result, Roe vs. Wade, which legalized abortion nationwide, would be vulnerable. The most dramatic possibility would be that it is overturned outright. That would return the decision to the states about whether to ban or limit abortion. Though Trump campaigned on a promise to appoint judges who would overturn Roe vs. Wade, a more likely scenario is that a conservative Supreme Court would approve restrictions that eliminate certain protections for abortion rights without making the practice illegal. To understand what could happen, it’s crucial to look at the reality of abortion across the country today. (Shalby and Krishnakumar, 9/4)

Spoiling for a fight, a trio of Democratic senators weighing 2020 presidential campaigns seized upon the opening moments of Supreme Court nominee Brett Kavanaugh’s Senate confirmation hearings Tuesday in a show of force aimed at countering President Donald Trump. One by one, Democrats on the Senate Judiciary Committee, including Kamala Harris of California, Amy Klobuchar of Minnesota and Cory Booker of New Jersey, demanded that Republicans delay Kavanaugh’s hearing after a last-minute release of more than 40,000 pages of documents and the withholding of more than 100,000 others. (Thomas, 9/4)

There was also about an hour of straight-out campaign speeches, given that there are at least four future and former presidential candidates on the committee. This led to the curious moment in which Sen. Cory Booker (D-N.J.), proud son of Newark, channeled the concerns of those who toil the land, telling Kavanaugh that “farm country is being threatened by the consolidation of huge corporations” and recalling the farmer who told the senator about the soaring suicide rate in the American heartland. (Fisher, 9/4)

The Republican National Committee deployed a rapid-response effort spotlighting Harris and Booker’s status as White House contenders, accusing them of capitalizing on the moment to boost their own profiles. Senate Majority Whip Sen. John Cornyn on Tuesday night tweeted “All about 2020 presidential politics” with a link to an Associated Press story highlighting the roles of Booker, Harris and Sen. Amy Klobuchar (D-Minn) in the hearings. Booker already had riled Republicans for suggesting that backers of President Donald Trump’s nominee are “complicit in the evil” his ideology represents, July comments that Cornyn (R-Texas) and Sen. Thom Tillis (R-N.C.) referenced anew on Tuesday. (Schor, 9/4)

The Affordable Care Act has survived numerous court battles and repeal efforts, but a new case is threatening the law’s future once again. A federal judge in Fort Worth, Texas, will hear arguments Wednesday on whether to grant a preliminary injunction that would suspend the health law until the case is decided. He has also indicated that he might go straight to ruling on the merits of the case. It focuses on whether the law’s requirement that most Americans have health insurance is unconstitutional, but has much broader implications. (Goodnough and Hoffman, 9/4)

The Trump Justice Department is asking the court to invalidate certain planks of the ACA, rather than tossing out the entire law. Among those provisions is a prohibition on insurers denying coverage to people with pre-existing medical conditions. About 130 million non-elderly people in the U.S. have pre-existing conditions, and before the ACA, insurers could deny coverage to people for conditions including high cholesterol, cancer, and asthma. Democrats say a return to that arrangement would leave many patients without resources, while Republicans contend that over-regulating insurers makes coverage more expensive for many people. (Armour, 9/5)

Attorneys general from mostly conservative states will try to pick up where the GOP-led Congress left off, seeking a permanent injunction halting enforcement of the law. They argue that because Congress gutted the individual mandate — zeroing out the penalty for not having coverage starting next year — the rest of the law needs to go as well. Numerous legal experts have deemed the argument a stretch, but Attorney General Jeff Sessions has thrown the Trump administration’s weight behind key parts of the assault — with Sessions notably opposing the law’s popular protection for people with pre-existing conditions. (Demko, 9/5)

Democrats have made the case an issue in the midterm elections, blasting Republicans over the lawsuit and warning that it threatens to abolish popular protections for pre-existing conditions. (Sullivan, 9/4)

“The fact that this lawsuit is taking place in September means that the GOP’s health-care agenda -- the way they’re trying to increase premiums and cut coverage for preexisting conditions -- will be front and center for voters minds," said David Bergstein, a spokesman for the Democratic Senatorial Campaign Committee. (Kapur, 9/5)

More than 25 patient groups on Tuesday released a statement saying a recent GOP bill aimed at protecting people with pre-existing conditions is insufficient. The legislation, introduced by 10 GOP senators last month, aims to clarify that Republicans want to maintain ObamaCare’s protections for people with pre-existing conditions in case a GOP-backed lawsuit against the 2010 health law succeeds. (Sullivan, 9/4)

A majority in a new poll want ObamaCare’s protections for pre-existing conditions to remain the law. According to the Kaiser Family Foundation’s latest tracking poll, 72 percent of those surveyed said it is “very important” to them that insurance companies remain prohibited from charging sick people more. (Weixel, 9/5)

Sen. Dean Heller (R-Nev.) is hitting back on criticisms his opponent, Rep. Jacky Rosen (D-Nev.), has made on his health-care record, trying to blunt a major line of attack against him ahead of November's midterms. Heller launched a new ad on Tuesday that seeks to counter an ad from Rosen last month that called him "Senator Spineless" and featured an inflatable figure waving in the wind. (Sullivan, 9/4)

Iowa employers, who provide health insurance to more than half of all Iowans, aren't dropping the benefit, despite facing a series of steep premium increases, a new study shows. On average, Iowa employers faced premium increases of 8.4 percent for 2018, according to the new survey by consultant David P. Lind. (Leys, 9/4)

California lawmakers this year played offense and defense on health care, adopting bills to give patients more access to care and medications, while defending Californians against Trump administration attacks on the Affordable Care Act. As they raced toward their Friday deadline to pass bills, legislators voted to make the abortion pill available to students on public college campuses, and to stop hospitals from discharging homeless patients onto the streets. (Young, 9/4)

Theranos Inc., the blood-testing company accused of perpetrating Silicon Valley’s biggest fraud, will soon cease to exist. In the wake of a high-profile scandal, the company will formally dissolve, according to an email to shareholders. Theranos will seek to pay unsecured creditors its remaining cash in coming months, the email said. The move comes after federal prosecutors filed criminal charges against Theranos founder Elizabeth Holmes and the blood-testing company’s former No. 2 executive, alleging that they defrauded investors out of hundreds of millions of dollars and defrauded doctors and patients. (Carreyrou, 9/5)

Elizabeth Holmes, founder of the embattled blood-testing company, was charged with fraud alongside Ramesh “Sunny” Balwani, the former chief operating officer of Theranos. Holmes and Balwani are also accused of lying to investors about the company's technological abilities. (Anapol, 9/4)

Theranos, which owes at least $60 million to unsecured creditors, will turn over its assets and intellectual property to credit and investment firm Fortress, says the e-mailed letter, first reported by The Wall Street Journal. This move, rather than a bankruptcy, will leave $5 million to distribute to creditors, it says. The action is the final act in Theranos' dramatic downfall. Founded in 2003 by then teen-age Stanford dropout Elizabeth Holmes, Theranos grew into a $9 billion firm based on its promise of a blood test requiring only a finger prick, rather than a vial of blood. (Snider, 9/5)

Ms Holmes sold that vision to a roster of well known investors, including Walgreens, the drugstore group, media mogul Rupert Murdoch, and Oracle co-founder Larry Ellison. Theranos raised $700M, giving it valuation of roughly $9B at its zenith. She also assembled a board of directors that included the elite of political and corporate America, including Jim Mattis, the current US defence secretary, two former secretaries of state — Henry Kissinger and George Shultz — and David Boies, the high-profile lawyer. (Crow, 9/5)

Jack Stoddard, a longtime health-care executive, has been named as chief operating officer of the new health venture being launched by Amazon.com Inc., JPMorgan Chase & Co. and Berkshire Hathaway Inc. Stoddard started Tuesday, according to a statement from the still-nameless health venture. He’ll work with Atul Gawande, the Harvard surgeon and writer who was named in June to run the initiative. (Tracer, 9/4)

His hiring adds another influential executive to the team being assembled by Amazon and its partners to take on the U.S. health care system. For the past year, Stoddard has infused digital services into health benefits provided by Comcast, which is credited with crafting one of the nation’s most innovative approaches to employee health. (Ross, 9/4)

Not long after Beau Braden moved to southwest Florida to open a medical clinic, injured strangers started showing up at his house. A boy who had split open his head at the pool. People with gashes and broken bones. There was nowhere else to go after hours, they told him, so Dr. Braden stitched them up on his dining room table. They were 40 miles inland from the coral-white condos and beach villas of Naples, but Dr. Braden said that this rural stretch of Collier County, with tomato farms and fast-growing exurbs, had fewer hospital beds per person than Afghanistan. (Healy, 9/5)

Insurance premiums and outpatient prices spiked as California health systems have snatched up physician groups, new research shows. In 41 highly concentrated California counties, the percentage of hospital-employed physicians increased from about 25% in 2010 to more than 40% in 2016, according to a new Health Affairs study. (Kacik, 9/4)

There are several reasons a doctors’ practice owned by a hospital or hospital chain can charge higher prices. A hospital can tack on what’s called a facility fee, which pays for overhead costs like building maintenance. And a doctors’ practice acquired by a larger, well-known health system like Stanford or UCSF could seek to charge higher prices because of its parent’s name. (Ho, 9/4)

HCA Houston Healthcare has completed the acquisition of North Cypress Medical Center, a 139-bed hospital at 21214 Northwest Freeway near Huffmeister in the northwest Houston area. The hospital, founded by physicians in 2006, expands HCA's Gulf Coast network to 18 hospitals in the Gulf Coast division. The deal includes four freestanding emergency centers in Barker Cypress, Spring Cypress, Fairfield and Texas 249. (Feser, 9/4)

Portland's imperiled psychiatric center has seven more weeks before it could lose a crucial federal certification. The Oregon Health Authority confirmed Tuesday that Unity Center for Behavioral Health has until Oct. 31 to fix significant safety issues. The federal Centers for Medicare and Medicaid Services last month gave Unity officials a second list of problems to fix and extended the time Unity has to make improvements. It previously faced a deadline of Sept. 11. (Harbarger, 9/4)

Cities seeking to open sites where illegal drug users are monitored to prevent overdoses responded defiantly Tuesday to a Justice Department threat to take “swift and aggressive action” against that approach to the nationwide opioid epidemic. Plans for those “supervised injection sites” — under consideration in San Francisco, Philadelphia, New York City, Seattle and elsewhere — collided with a stern Justice Department warning issued last week, threatening to create a standoff between federal and local authorities like the confrontation over “sanctuary cities.” (Bernstein and Zezima, 9/4)

San Francisco officials, as well as health care and substance abuse service professionals, are urging California Gov. Jerry Brown to sign a bill allowing the city to open the country's first supervised injection site for drug users. State Sen. Scott Wiener, co-author of Assembly Bill 186 --"controlled substances: overdose prevention program" -- said he's hopeful that the governor will sign it, because Brown believes in progressive alternatives to incarceration. (Veltman, 9/4)

California appears poised to become the first state in the nation to adopt a take-back law that addresses prescription drugs and needles, a contentious issue that is slowly spreading across the country as local governments grapple with budget constraints caused by unwanted or unused medicines and the opioid crisis. And as in other states, manufacturers would have to underwrite the costs.In a vote last week, the California senate unanimously endorsed a bill that would require companies to finance the cost of collecting and disposing of medicines and sharps, as needles are sometimes called. The measure was sent to California Gov. Jerry Brown, who has until Sept. 30 to sign the bill. A spokesperson declined to say whether Brown will do so. (Silverman, 9/4)

Pressure is on the Senate to finalize and vote soon on a package that both parties are prioritizing to combat opioids addiction. But differences between the House and Senate versions could delay enactment. Majority Leader Mitch McConnell, R-Ky., has hinted at a possible vote as early as this week, saying that Republicans agree on the bill. (Raman, 9/5)

Kaiser Health News: Rudy Giuliani’s Consulting Firm Had Hand In Halting Florida’s Opioid Investigation

Six months after hiring former New York City mayor Rudy Giuliani’s consulting firm, Purdue Pharma settled a Florida state investigation that had threatened to expose early illegal marketing of its blockbuster drug OxyContin, company and state records show. The November 2002 deal was a coup for the drugmaker, which at the time faced growing criticism about overdose deaths and addiction linked to the painkiller. Purdue agreed to pay the state $2 million to help fund a computer database to track narcotics prescriptions and up to $150,000 to sponsor five one-day conferences to educate law enforcement about drug abuse. (Schulte, 9/5)

For four years, Mary Tabar said, her 19-year-old daughter Brette was a regular at three Pinellas County bars serving kratom tea. ... Now, Mary Tabar has filed a lawsuit in Pinellas County as her daughter’s guardian, alleging Brette Taber suffered frontal lobe damage to her brain after drinking the Southeast Asian herbal remedy. (Figueroa IV, 9/4)

Adam and Whitney Hayden waited for the doctor, both sitting with their right legs crossed over their left. They fidgeted their feet. They flicked them, bounced them, circled them. Whitney, 38, twisted a ring on her right hand. Adam, 36, locked his fingers around his cane. Every so often, he ran a hand over the scar on his head, where the baseball-sized tumor was pulled out two years ago. They waited to find out if today was the day they would learn that the cancer had started growing again.“It’s a slow-motion freight train coming toward me,” Adam said as Whitney drove them to the appointment. (Joseph, 9/5)

New children's concussion guidelines from the U.S. government recommend against routine X-rays and blood tests for diagnosis and reassure parents that most kids' symptoms clear up within one to three months. Signs of potentially more serious injuries that may warrant CT imaging scans include vomiting, unconsciousness and severe, worsening headaches, according to the guidelines released Tuesday. (Tanner, 9/4)

As deaths of new and expectant moms multiplied in the United States, the picture in California and the rest of the developed world has veered in the opposite direction. ...A study out Tuesday in the journal Health Affairs, by the Stanford University medical team that started the initiative, seeks to explain why. (Veklerov, 9/4)

A few months ago, my biggest sources of anxiety were politics, my finances, and whether I’d make my next work deadline. Then one afternoon my mother called to tell me she had leukemia. Suddenly, my fear went beyond the kind that’s inevitable when you have aging parents, to a more urgent worry about her current state of health and well-being. (Yuko, 9/4)

Playing tennis and other sports that are social might add years to your life, according to a new epidemiological study of Danish men and women. The study found that adults who reported frequently participating in tennis or other racket and team sports lived longer than people who were sedentary. But they also lived longer than people who took part in reliably healthy but often solitary activities such as jogging, swimming and cycling. (Reynolds, 9/5)

More than a quarter of the world's adults - or 1.4 billion people - take too little exercise, putting them at higher risk of cardiovascular disease, type 2 diabetes, dementia and cancers, according to a World Health Organization-led study. In 2016, around one in three women and one in four men worldwide were not reaching the recommended levels of physical activity to stay healthy – at least 150 minutes of moderate, or 75 minutes of vigorous exercise a week. (Kelland, 9/4)

Most U.S. and Canadian fraternities have one year to ban vodka, tequila and other hard alcohol under a rule adopted during the recent annual meeting of their trade association, the group announced Tuesday. In "a near-unanimous vote" on Aug. 27, the 66 international and national men's fraternities of the North-American Interfraternity Conference adopted the rule prohibiting hard alcohol with more than 15 percent alcohol by volume from fraternity chapters and events unless served by licensed third-party vendors, the group said. The member fraternities have until Sept. 1, 2019, to implement the rule across their more than 6,100 chapters on 800 campuses. (9/4)

About 30 more people have been sickened by a salmonella outbreak that forced Kellogg Co. (K) to recall more than 11 million boxes of Honey Smacks cereal, health officials said Tuesday. That brings the total to 130 people believed to have been infected in 36 states since March, according to the Centers for Disease Control and Prevention and the Food and Drug Administration. (Armental, 9/5)

Nearly 30 years after California became the first state to ban the sale of assault weapons and embarked on a path toward the strictest firearm laws in the nation, legislators have sent Gov. Jerry Brown nine new gun-control bills in response to a surge in mass shootings. The action by the Legislature was applauded more than 3,000 miles away in Parkland, Fla., where a 19-year-old gunman killed 17 students and employees at a high school in February. Among the legislation waiting approval by Brown are proposals to lift the age for buying rifles and shotguns from 18 to 21, and to prohibit the purchase of more than one long gun a month. (McGreevy, 9/5)

The Florida commission investigating February's high school massacre will discuss the role of campus police officers and changes to the state's mental health laws. The Marjory Stoneman Douglas High School Public Safety Commission is scheduled to make recommendations Wednesday on how many school resource officers each campus should have based on enrollment and what the officers' duties should be. (9/5)

Throughout the summer of 1991, anti-abortion protesters went to all kinds of lengths to stop abortions at Wichita’s three clinics — blocking doors, standing and lying in front of cars, bringing out their children, filling parking lots and sidewalks outside Wichita clinics. An anti-abortion group called Operation Rescue, which gained prominence after the 1988 Democratic National Convention, chose Wichita as its target for the summer of 1991 mostly because it was the home of George Tiller, one of a few physicians in the country performing abortions terminating third-trimester pregnancies. (Fox, 9/4)

The author of a high-profile measure to curb paid “conversion therapy,” which purports to change a person’s sexual orientation, said he is shelving his bill Friday in hopes of finding consensus with religious communities that vigorously opposed the proposal. The bill by Assemblyman Evan Low (D-Campbell), which would have designated paid “conversion therapy” services as a fraudulent business practice under the state’s consumer protection law, easily cleared prior legislative hurdles thanks to large Democratic majorities in both chambers, as well as a handful of Republican votes. (Mason, 8/31)

Thousands of Detroit public schools students were told Tuesday to drink from district-supplied water coolers or bottled water on the first day of classes, after the drinking fountains were shut off because of contaminants in some water fixtures. Superintendent Nikolai Vitti said last week that elevated levels of lead or copper were found in fixtures at 34 schools. Test results are pending for other schools. (9/4)

The American Civil Liberties Union of Pennsylvania said Tuesday that the state prison system should reinstate inmate mail and visitation privileges that have been suspended because about 50 guards and other employees have fallen sick in recent weeks. Pennsylvania ACLU Executive Director Reggie Shuford called the lockdown in place over the past week "gravely serious," arguing that state officials should provide more information to the public. (9/4)

Senior medical student Giselle Lynch has plenty of accomplishments to list when she applies for a coveted spot in an ophthalmology residency program this fall. But one box she won't be able to check when she submits her application? One of the highest academic awards medical students can receive, election to the honor society Alpha Omega Alpha (AOA). (Gordon, 9/5)

Iowa’s early-summer clouds of mosquitoes have faded, but don’t put away the bug spray just yet. The relatively few mosquitoes buzzing around now include the most dangerous kinds, experts warn. Late summer and early fall are prime time for Culexbreeds of mosquito, which are most likely to carry West Nile virus. The virus has killed at least two Iowans so far this year, and seriously sickened 16 others, the Iowa Department of Public Health said. There were 12 cases all of last year. (Leys, 9/4)

WellCare Health Plans has closed on its biggest acquisition ever, a $2.5 billion purchase of three Midwestern health plans and, along the way, has become the Tampa Bay area’s biggest company by market value. WellCare, a Fortune 200 company that focuses on providing government-sponsored managed care services, has seen its market capitalization rise from less than $10 billion when the purchase of Meridian Health Plans was announced in May to $15.2 billion by the close of markets Tuesday. (Danielson, 9/4)

More than 38,000 Medicare beneficiaries with health plans from Blue Cross and Blue Shield of Minnesota are wrongly receiving termination notices, prompting the Eagan-based insurer to begin calling subscribers to explain the mistake. The letters are related to the elimination of Medicare Cost health plans at the end of the year, which will prompt true health plan terminations for an estimated 320,000 seniors across much of Minnesota. (Snowbeck, 9/4)

In the Central Valley, in particular, excess amounts of arsenic, nitrates and other substances that can cause cancers and birth defects have tainted drinking water. In Compton, residents have been living with foul-smelling brown water because the cost of fixing the pipes is high, and many can’t afford to buy a constant supply of bottled water. (Gorn, 9/4)

An eighth defendant, a Colleyville surgeon, has agreed to plead guilty to accepting kickbacks in exchange for referring his patients to Forest Park Medical Center, federal court records show. Dr. David Daesung Kim, 55, will plead guilty to soliciting or receiving illegal remuneration, court records show. A judge has to accept his plea before it becomes official. (Krause, 9/4)

Another of Virginia’s institutions established decades ago for housing developmentally and intellectually disabled people has closed under an agreement with the federal government to move the residents into community settings. The last resident moved out of the Southwestern Virginia Training Center in Carroll County on Aug. 21, said Maria Reppas, a spokeswoman for the Virginia Department of Behavioral Health and Developmental Services. The closure marks another milestone in complying with a deal reached with the Department of Justice in 2012. (Rankin, 9/4)

To help meet a need for English/Spanish interpreters within the city's vast medical infrastructure, the University of Texas Extended Campus will begin a three-month program for translators, the school announced. The Medical Interpreter Certificate program, launched by the university's Center for Professional Education, will start Oct. 3. It is being expanded to Houston and modeled after a similar program in Austin, a spokesman said. (Deam, 9/5)

More than 70 Houston-area children were screened for vision issues Friday, Aug. 24, at a back-to-school event, and those that needed it will receive follow-up care and a free pair of glasses. The vision screening event at BakerRipley Leonel Castillo Community Center was funded by a $5,000 grant provided by UnitedHealthcare to Prevent Blindness Texas, an organization that works to fight blindness and save people’s sight through screening, educating, training and advocating, said Heather Shirk Patrick, Prevent Blindness Texas president and CEO. (Maness, 9/4)

[Kerri Evelyn] Harris’s go-to campaign topics include drug pricing, special interests, the opioid crisis — and what she views as the throughline joining all three: the pharmaceutical industry. The race, broadly, is emblematic of the Democratic Party’s struggle to become more inclusive — Harris is a queer biracial woman in her 30s, Carper a straight white man in his 70s. But Harris, an Air Force veteran and community organizer, is among a select few candidates engaged in a different fight for the party’s identity: the desire to rid it of pharmaceutical industry influence. (Facher, 9/4)

Diabetic ketoacidosis is a terrible way to die. It's what happens when you don't have enough insulin. Your blood sugar gets so high that your blood becomes highly acidic, your cells dehydrate, and your body stops functioning. Diabetic ketoacidosis is how Nicole Smith-Holt lost her son. Three days before his payday. Because he couldn't afford his insulin. "It shouldn't have happened," Smith-Holt says looking at her son's death certificate on her dining room table in Richfield, Minn. "That cause of death of diabetic ketoacidosis should have never happened." (Sable-Smith, 9/1)

The Senate recently endorsed a Trump administration proposal to require pricing information in drug advertisements, and Congress could soon build on this with other modest measures. One thing lawmakers seem to agree on is that pharmacists should have the right to tell customers when a lower-cost option is available. (Siddons, 9/4)

Shareholders voted in August to approve health insurer Cigna’s $67 billion acquisition of Express Scripts, the country’s largest pharmacy benefit manager. The deal still needs the go-ahead from government antitrust regulators. But what does Express Scripts do, what even is a pharmacy benefits manager ... and why should you care? (McKinley, 9/1)

Jacqualyn “Jackie” Fouse was one of the top executives at Celgene, beloved by Wall Street and credited with helping to oversee a period of strong revenue growth and stock performance for the biotech company. Then, last year, she “retired,” after reportedly being passed over for the top job. Now Fouse has a shot to run her own show. On Tuesday, Cambridge-based Agios Pharmaceuticals said it had hired Fouse, already a board member, as its chief executive, effective Feb. 1. Current Agios CEO David Schenkein is retiring up to become the biotech’s executive chairman. (Feuerstein, 9/4)

In a setback to the pharmaceutical industry, the health minister in the new Chilean government has endorsed the idea of allowing the government to grant compulsory licenses for hepatitis C treatments, despite a vigorous campaign by drug makers to abandon the notion. (Silverman, 8/30)

Swiss pharmaceutical company Novartis AG wants to increase its operating margins by making production and other processes more efficient as it positions for possible further declines in U.S. drug prices, its chairman said in an interview. Joerg Reinhardt told the newspaper NZZ am Sonntag that his company is taking steps to increase its operating profit margin towards 35 percent in no more than five years, from 32 percent, and is closely watching developments in the U.S. (Bosley, 9/1)

In a boost to Novartis (NVS), the National Health Service in England has agreed to provide some coverage for its CAR-T gene therapy for combating leukemia in children and young people, a move that may give the drug maker an edge in a closely watched showdown with Gilead Sciences (GILD). (Silverman, 9/4)

A growing herd of former Wall Street bankers and drug industry veterans from the West are rushing to cash in on China’s embrace of biotechnology. For years, China has been seen as a backwater in the pharmaceutical business. Despite its vast potential market, cumbersome regulations kept brand-name treatments from reaching patients for years after they became available elsewhere. Facing a bureaucratic gauntlet, many drugmakers either waited or didn’t bother to seek approval for blockbuster therapies in China at all. (Spalding, 8/29)

Seven scientists in the United States and Britain who have come up with a revolutionary gene therapy cure for a rare genetic form of childhood blindness won a 1 million euro ($1.15 million)prize on Tuesday, Portugal's Champalimaud Foundation said. Established in 2006, the annual award for work related to vision is one of the world's largest science prizes, more than the latest 9 million Swedish crown Nobel Prize in Physiology or Medicine. (Khalip, 9/4)

As a way to rein in the staggering amount of money that Americans spend on the complex drugs known as biologics each year, creating biosimilars as less-expensive alternatives makes sense. Europe has already approved 43 biosimilars; the U.S. just 11 of them. The U.S. will continue to lag behind in the development and use of biosimilars if Congress and the FDA require the “interchangeability” label for pharmacy substitution of reference biologics. (Vijay Ramakrishnan and Edwin P. Ching, 9/4)

The lives of more than 10 million Americans — those with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, ulcerative colitis and Crohn’s disease — depend on safe and effective biological medicines called tumor necrosis factor (TNF) inhibitors. These are highly effective but can cost as much $48,000 annually for a single patient. (Angus B. Worthing, 9/3)

It’s not quite the big short, but the latest outsized bet by hedge funds suggests the highly paid managers are worried that the economy’s good health may falter soon. Hedge funds, which until recently have been overweight technology stocks, particularly the popular FANG members, in addition to the consumer discretionary sector, have shifted their assets into health care. It’s typically a sector that’s less sensitive to moves in the economy than, say, tech or consumer discretionary, and it’s a place investors turn to for protection when they are worried the market might head south. (Stephen Gandel and Max Nisen, 8/30)

Big Pharma is in a rut. The industry keeps spending more and yet making fewer scientific breakthroughs. But help is on the way. (Jon Markman, 8/30)

Brett M. Kavanaugh’s confirmation hearing is a triumphant moment for both the Republican Party and its social movement allies, especially antiabortion organizations. For years, these groups have built a strategic alliance with the GOP. This partnership centers on activists’ hope that Republican presidents would nominate Supreme Court justices who would overturn Roe v. Wade. After the first day of Kavanaugh’s hearings, the marriage between the Republican Party and the antiabortion movement seems closer than ever.But if a post-Kavanaugh court overturns Roe, this alliance could fracture, costing the GOP the loyalty of antiabortion voters. (Mary Ziegler, 9/4)

At Judge Kavanaugh’s confirmation hearing, which gets underway today, you’ll hear buzzwords like “settled law,” the importance of “precedent,” and stare decisis — a Latin term meaning “to stand by things decided.” These terms are meant to sound reassuring — a commitment that a nominee won’t upend the status quo. But these phrases contain more lawyerly wiggle room than you might think. (Nancy Northup, 9/4)

President Donald Trump’s nomination of Judge Brett Kavanaugh to the U.S. Supreme Court gives cause for concern — not least because of the nominee’s views on the Second Amendment. Senators should use this week’s confirmation hearings to question him closely on the weight he attaches to public safety when it comes to regulating guns. ...More than one-quarter of the U.S. population, for example, lives in places where “assault weapons” are banned. Kavanaugh appears committed to ending such local control, thereby forcing the NRA agenda on everyone, everywhere, in the U.S. (9/4)

Important new research published in the Journal of the American Medical Association on Tuesday showed that a promising experiment aimed at reducing health care costs through changes to the payment system delivered underwhelming early results. But there’s more to the story, and the research is exactly what should be happening as we transition away from fee-for-service payments. (Peter R. Orszag, 9/4)

As overdose deaths from opioids and other drugs continue to rise — they are up almost 7 percent from the previous year — the U.S. Senate has a choice to make. It can change the course of this crisis or let the country continue to lag behind in addressing this public health emergency. (Devin Oller, 9/5)

Multiple studies have found that play builds social skills and creativity and develops the ability to solve problems and to collaborate. What is new is that a clinical report published in August by the American Academy of Pediatrics specifically calls on pediatricians and family doctors to start taking play, well, seriously – in fact to prescribe it for their small patients. (Karin Klein, 9/4)

The search for the so-called Golden State Killer — who allegedly raped dozens of women and killed at least 12 people in the 1970s and 1980s — had hit a dead end when investigators decided to test DNA evidence from a crime scene against genetic data on GEDmatch, a website of volunteered samples. Eventually, this technique helped investigators close one of the most notorious cold cases in recent history — but it also raised important questions about the privacy rights of customers. How and when should genetic testing companies share data with third parties such as researchers, websites or law enforcement officials? And do companies have an obligation to inform users that their information has been shared? (9/4)

For less than $100 and a sample of spit, you can learn about your genes, your disease susceptibility, and your ethnic heritage. Wearable sensors report on your sleep patterns, your heart rate, and what air pollutants are nearby. With Detox Me Action Kit, a crowdsourced project my team recently launched, you can find out what common hormone-disrupting chemicals are in your body, including ingredients that manufacturers don’t have to disclose. Then there’s all the data in your medical record that you can now get hold of, thanks to changes in health laws. ...Yet for participants in most research studies, outdated ethical standards prevent them from learning anything at all about what was found in their blood, urine, or any other tissue they donated for research. (Julia G. Brody, 9/5)

Modern American history can be measured at intervals by the historic deals that presidents have made with the American people. The Square Deal. The New Deal. And most important for us today, the Affordable Care Act, which promised and delivered on its guarantee that all Americans deserve the dignity and security of having access to affordable healthcare.Two weeks ago was the anniversary of the ACA's rescue. A steadfast coalition of Senate Democrats and a handful of Republicans successfully defended our health care from those who would repeal the ACA without a sufficient plan for replacement. That’s very good news for residents of the Sunshine State who have taken advantage of improved access to healthcare. During the 2018 open enrollment period, 1.7 million Floridians enrolled in plans through the Florida exchange – more than any other state in the union. (Fla. State Rep. Shevrin D. Jones, 9/4)

While you might think that your mental health is known only to you, your health practitioner or those closest to you, you might be unwittingly revealing it to strangers online. A series of emojis, words, actions or even inactions can communicate how you feel at a given moment and when collected over time, comprise your “socionome” — a digital catalogue of your mental health that is similar to how your genome can provide a picture of your physical health. (Adam Hofmann, 9/4)

You can add the name Jordan McNair to the list of college, high school and middle school players who might have needlessly died for the love of football.A simple, well-known procedure — immersing McNair, 19, in a tub of ice water — when he collapsed at an off-season University of Maryland workout in May could well have saved his life. But it didn't happen. This failure drew national attention to how unprepared many football programs are to keep their players safe. (9/4)

For the third year in a row, the Cleveland Clinic has been named the nation's No. 2 hospital in U.S. News & World Report rankings. Its numerical score -- based on 16 specialties and nine procedures and conditions -- considers such measures as patient safety and survival, the medical complexity of those treated, nursing staffing and, in certain specialties, reputational measures. ...The rankings underscore Cleveland's pre-eminence in medical care statewide, with University Hospitals Cleveland Medical Center -- home to Ohio's only women's hospital -- ranked the second best hospital in Ohio overall, and No. 6 nationally in neonatology. UH received the survey's highest ranking in eight of nine nationally rated procedures and conditions. (The Clinic got the highest ranking in all nine, including heart bypass surgery.) Why does this matter? There are nearly 12 billion local reasons, all with dollars attached. (9/4)