The New York Times: Projected Drop In Medicaid Spending Heightens Hurdle For G.O.P. Health Bill
Projected Medicaid spending under a Senate Republican bill to repeal the Affordable Care Act would be 35 percent lower after two decades, the Congressional Budget Office said on Thursday in a new report, which detailed how Medicaid changes would cut more deeply as they go fully into force. The budget office analysis created a fresh challenge for Republican leaders as they tried to muster support for their bill, even as senators scattered to their home states for a 10-day July 4 recess. (Pear and Kaplan, 6/29)

Reuters: Senate Republican Bill Would Slash Medicaid By 2036, Complicating Talks
The Congressional Budget Office report, requested by Senate Democrats, provides a longer-term look at how the Republican plan would affect Medicaid spending as Senate Majority Leader Mitch McConnell searches for a formula to win over the conservative and moderate elements of his Republican caucus. ( Cornwell and Abutaleb, 6/29)

CQ Roll Call: CBO: Impact Of Senate Bill's Medicaid Cuts Would Grow Over Time
The analysis, which considers the effects of spending over 20 years under the Senate GOP discussion draft that was first released last week, says that federal spending would be reduced by $160 billion in 2026 compared to under current law. The proposal is meant to roll back the 2010 health care law and change the Medicaid program, and is somewhat similar to a bill (HR 1628) passed by the House in May. (McIntire, 6/29)

The Washington Post: Senate Democrats Shine Light On Health Bill’s Longer-Term Effect On Medicaid
The Better Care Reconciliation Act relies on the time-honored political strategy of pressing a bill’s most profound effects years into the future — in this case, in severely constricting the main source of public health insurance for poor and vulnerable Americans. Until Thursday, that scenario had been cloaked in arcane legislative language about per-capita caps and varying inflation adjustments. What Congress’s nonpartisan budget scorekeepers did, at the prodding of the Senate Finance Committee’s senior Democrat, is make clear that the GOP legislation would squeeze federal Medicaid spending by 35 percent by the end of two decades, compared with current law. (Goldstein, 6/29)

Bloomberg: GOP Bill Would Slash Medicaid Over Next Two Decades, CBO Finds 
“A large gap would grow between Medicaid spending under current law and under this bill,” CBO said in the new analysis. “States would continue to need to arrive at more efficient methods for delivering services and to decide whether to commit more of their own resources, cut payments to health-care providers and health plans, eliminate optional services, restrict eligibility for enrollment, or adopt some combination of those approaches.” (Edney and Tracer, 6/29)

Politico: CBO: Medicaid Spending Falls 35 Percent In 20 Years Under Senate Health Bill
The drop-off stems from stricter limits Republicans want to enact beginning in 2025 to control the entitlement's growth. Under the Senate bill, federal Medicaid outlays would be 26 percent less in 2026 compared to current law. The gap widens to 35 percent in 2036. (Pradhan, 6/29)

The Washington Post Fact Checker: President Trump’s Claim Medicaid Spending In Senate Health Bill ‘Actually Goes Up'
The White House is defending changes to Medicaid financing in the Senate health-care overhaul bill by saying that the Better Care Reconciliation Act (BCRA) actually increases Medicaid spending. In the tweet, Trump included a graph that showed the spending increases from 2017 to 2026. ... But that’s quite misleading. (Lee, 6/30)

Modern Healthcare: Federal Medicaid Spending To Fall 35% In Two Decades Under Senate Healthcare Bill 
The CBO report may make it more difficult for GOP leadership to line up moderate votes to pass the bill, and they may have to scrap the bill's proposed change to a lower inflation rate in 2025 to ensure passage. (Lee, 6/29)

The Hill: CBO: GOP Healthcare Bill Would Cut Medicaid By 35 Percent Over Next 20 Years 
Senate Democrats immediately used the findings to blast the Republican legislation. Senate Minority Leader Charles Schumer (D-N.Y.) said the bill is “even worse than we thought.” (Weixel, 6/29)

The Washington Post: Why The Senate Health Care Bill Is Even Harsher Than It Looks, In One Chart
The Congressional Budget Office laid out a stark picture of what would happen over the next decade if the Senate health-care bill were implemented as written: 22 million fewer Americans would have insurance than under current law in 2026, driven largely by cuts to federal spending on Medicaid. But by focusing only on the next decade, the report fails to capture how rapidly Medicaid funding would continue to erode, according to a new analysis by the consulting firm, Avalere Health. (Johnson, 6/29)

Meanwhile, experts react to the Medicaid provisions in the GOP's bill —

Modern Healthcare: Would Senate Bill's Extra Payments To Non-Expansion States Offset Overall Medicaid Cuts? Hospital Groups Say No Way
The Senate Republican bill to repeal and replace the Affordable Care Act offers billions in additional funding to states that didn't expand Medicaid or that spend less on Medicaid, for the intended benefit of providers in those states. Hospital leaders in those states say they would welcome the additional dollars. But they, along with Medicaid policy experts, say the Senate provisions would not come close to offsetting the large cuts providers and patients would suffer under the bill's other provisions. (Meyer, 6/29)

The Wall Street Journal: Republicans Clash Again Over Senate Health-Care Bill
New divisions opened among Senate Republicans on Thursday over their proposed health-care legislation even as they edged closer to hammering out some agreements to shore up support for the bill. The bill’s status appeared shaky as lawmakers left Washington for a week-long break, its fate likely vulnerable to home-state pressures they may face and any deals they can make over the vacation. (Peterson, Rubin and Hughes, 6/29)

The Washington Post: If These Two Republicans Can’t Agree, The Senate Can’t Pass Its Health-Care Bill
They came to the Senate together amid less fanfare than some of their 2010 classmates, with lower profiles that didn’t lead to presidential bids. But Sens. Rob Portman (Ohio) and Patrick J. Toomey (Pa.) were intellectual forces inside the Republican caucus from the moment they took the oath in January 2011. (Kane, 6/29)

Los Angeles Times: Healthcare Issue Delivers Nothing But Pain For Nevada's Embattled Sen. Dean Heller
Dean Heller is Stephanie Diaz-Gonzalez’s problem now. She’s never met Nevada’s Republican senator and hadn’t had much time to familiarize herself. How could she? The 25-year-old is holding down a full-time job and raising a 7-year-old son, who keeps her busy with soccer games, math homework and those too-often terrifying moments when he can’t breathe. (Montero and Barabak, 6/30)

Los Angeles Times: Hopes Fade For Friday Revise Of Senate Republican Health Bill With No Quick Fix In Sight
Senate Republicans appeared unlikely to hit a self-imposed Friday deadline for revising their healthcare bill, as negotiators considered scaling back promised tax cuts for the wealthy in order to provide more insurance assistance to the poor. Vice President Mike Pence led a White House push by meeting Thursday with divided Republican senators, but conservatives and centrists have been unable to resolve their differences. “We’re working,” Pence said as he dashed through the halls, followed by reporters shouting questions. (Mascaro, 6/29)

Politico: Dazed GOP Bolts Washington In Health Care Disarray
Senate Republicans skipped town on Thursday afternoon facing stiff internal opposition to their health care proposal and a Fourth of July recess in which critics will pummel their effort to repeal Obamacare. Though the Senate whirred to life with deal-making between Senate Majority Leader Mitch McConnell and his members, senators were dazed by the up-and-down week and nowhere near a plan that could get 50 votes. The GOP is planning to write new language to be analyzed by Friday, but were far from reaching a broad agreement as senators had hoped. (Everett, Kim and Karlin-Smith, 6/29)

Roll Call: GOP Wheeling And Dealing Takes Center Stage In Senate
Deal-making was the name of the game Thursday as Senate Republican leaders met with skeptical lawmakers in an attempt to bridge deep policy divides among the GOP conference on their legislation to overhaul the U.S. health care system. Vice President Mike Pence and Centers for Medicare and Medicaid Services Administrator Seema Verma were also on Capitol Hill, joining in the effort to rework a bill that would tighten the cap on federal funding for Medicaid over several years and alter the 2010 health care law’s subsidies that help individuals afford insurance. (Williams, 6/29)

The Hill: GOP Scrambles To Win Centrist Votes On ObamaCare Repeal 
Senate Republican leaders are focused on winning over centrists as they try to revive their legislation repealing and replacing ObamaCare. Their strategy is to win over moderates who balked at their earlier bill, and then hope that the pressure to take action on the GOP’s promise to repeal former President Obama’s signature legislation will be enough to get conservative senators to back the bill. GOP leaders can only afford to lose two votes, giving them little room for error. (Bolton and Sullivan, 6/29)

The Hill: GOP Adds $45 Billion In Opioid Money To Healthcare Bill 
Senate Republicans are adding $45 billion to their ObamaCare replacement bill to fight opioid abuse, according to sources familiar with the discussions. The move was widely expected as an attempt to win over moderate Republicans like Sens. Rob Portman (Ohio) and Shelley Moore Capito (W.Va.), who have both made the opioid epidemic a priority. (Sullivan, 6/29)

Roll Call: What Portman And Capito Want In Obamacare Repeal Debate
Sens. Rob Portman of Ohio and Shelley Moore Capito of West Virginia were known to want $45 billion in dedicated funding for drug abuse treatment for the population currently served through Medicaid expansion, and those dollars needed to be outside the current Medicaid structure so that treatment could continue during any eventual wind-down of the expansion under the 2010 health care law. But, as Capito made clear in her statement announcing opposition to the most recent draft, there also came to be questions about Medicaid cuts itself. (Lesniewski, 6/29)

Texas Tribune: Ted Cruz Proposes Amendment With Aim To Salvage Senate Health Care Plan
Cruz, a Texas Republican, is now proposing an amendment that would allow any health plan to offer "non-Obamacare compliant" plans in a state if it was already offering at least one plan that does comply with the 2010 health care law in that state, according to a Vox.com report. That measure, combined with reducing the bill's tax cuts, could be enough to win over a conservative bloc of senators who are withholding support for the bill, while also freeing up funds to boost Medicaid funding, which might bring along some moderate Republicans opposed to the bill, per Vox. (Livingston, 6/29)

Bloomberg: Cruz Pitches GOP Leaders To Allow Cheap Insurance In Health Bill 
Senate Republican leaders are considering a proposal by Senator Ted Cruz that would allow insurers to sell cheaper, less robust plans as long as they also sell policies that meet coverage standards imposed by Obamacare. The Texan’s idea is aimed at breaking the health-care logjam and winning conservative holdouts -- but the proposal faces opposition from the moderate wing, underscoring the delicate balance facing party leaders trying to secure the votes for a bill to unwind the Affordable Care Act. (Kapur, 6/29)

The Hill: GOP Leaders Prepared To Make Big Boost To Healthcare Innovation Fund 
Top Senate Republicans are signaling that they are willing to dramatically increase funding for a special state innovation fund in order to persuade wavering moderates to support their floundering healthcare reform bill, according to sources involved in negotiations. One Republican senator said leaders could double the amount of money in the bill’s long-term state innovation fund. (Bolton, 6/29)

McClatchy: Abortion, Planned Parenthood Could Derail Senate Health Bill
The health care provider uses federal funding to treat Medicaid patients and subsidize other health services, and by law cannot use those funds to provide abortions. But House Republicans still want to deny Planned Parenthood funding for a year because it performs abortions. (Clark, 6/29)

Kaiser Health News: This Woman Can Make Or Break McConnell’s Health Bill
As Majority Leader Mitch McConnell (R-Ky.) tries to negotiate his way to a health bill that can win at least 50 Republican votes, there is one woman in the Senate who could stop the bill cold. She isn’t even a senator. (Rovner, 6/30)

The Associated Press: GOP May Keep Some Obama Tax Increases To Save Health Bill
Senate Republican leaders considered keeping one of former President Barack Obama's big tax increases on wealthier Americans and using the money to fatten proposed subsidies for the poor in a bid Thursday to placate moderate GOP lawmakers and salvage their struggling health care bill. (Fram, 6/29)

The Washington Post: GOP Health-Care Talks Center On Stark Question: Help Vulnerable Americans Or Help The Rich?
Republican negotiations over how to overhaul the Affordable Care Act centered sharply Thursday on a divisive and ideological question: How much money should the Senate health-care bill spend on protecting vulnerable Americans, and how much on providing tax relief to the wealthy? Senate Majority Leader Mitch McConnell (R-Ky.), in an effort to strike a balance between centrists and conservatives, is now making concessions to both factions of his caucus, according to lawmakers and aides. (Snell, Eilperin and Sullivan, 6/29)

The Washington Post: Why Republicans Are Thinking Of Keeping An Obamacare Tax On The Rich
The details of which taxes would be scaled back and by how much haven't been officially released, but The Washington Post reported that Sen. Majority Leader Mitch McConnell (R-Ky.) was rewriting the bill to preserve a tax on investment income for families that made more than $250,000 a year or individuals who made more than $200,000. Over a decade, that tax is projected to add up to $172 billion by the Congressional Budget Office and Joint Committee on Taxation. (Johnson, 6/29)

The Wall Street Journal: Some Senators In Health Talks Would Keep Tax On Investment Income 
Leaving the tax in place would give Republicans two potential benefits as they try to put together a health-care bill that can attract 50 of their 52 members. First, it provides up to $172 billion Republicans can use to make health insurance more affordable to low-income households. Second, it could blunt attacks from Democrats that their bill undermines health care for the many in exchange for tax cuts for a few. (Rubin and Hughes, 6/29)

The Hill: GOP Considers Keeping ObamaCare Tax In Revised Health Bill 
Senate Republicans are considering dropping a tax break for the wealthy from their ObamaCare repeal bill as they seek to secure 50 votes for the legislation. Sen. Bob Corker (R-Tenn.) on Thursday said the bill would be changed to increase the subsidies that help lower-income people afford health insurance. The most likely way for that to happen is by keeping a 3.8 percent tax on investment income for high earners, Corker said. (Weixel, 6/29)

Politico: Trump On Health Care Impasse: Repeal Obamacare Now, Replace Later
President Donald Trump, who has previously said that he would prefer Obamacare be repealed and replaced at the same time, reversed course Friday morning, suggesting instead that the process of undoing the health care law could be broken up. “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” Trump wrote on Twitter Friday morning. (Nelson, 6/30)

Roll Call: Trump: If Senate Fails, Repeal Obamacare Now, Replace Later
His tweet seemed to mirror a way ahead laid out by Sen. Ben Sasse, R-Neb., in a letter sent to the president Friday morning, and in an appearance on “Fox and Friends” minutes earlier. In his letter, Sasse wrote Trump, “If we don’t get to agreement on a combined, comprehensive ObamaCare repeal and replace plan by that day (July 10), I humbly suggest that you publicly call on the Congress to do two things.” (Bennett, 6/20)

The Hill: Schumer To Trump On Healthcare: 'Try Me' 
Senate Minority Leader Charles Schumer (D-N.Y.) is doubling down on his push to get President Trump to meet with Senate Democrats to discuss a bipartisan healthcare deal. "I repeat the offer I made to President Trump and my Republican friends yesterday: Let's start over. Drop this fundamentally flawed approach ... and we can discuss the problems that our Americans are actually concerned about: the cost, the quality, and availability on healthcare," Schumer said from the Senate floor. (Carney, 6/29)

The Hill: Sanders: Throwing 23 Million Off Healthcare Is 'Beyond Obscene' 
Sen. Bernie Sanders (I-Vt.) ripped Republicans on Thursday for not holding public hearings on their efforts to repeal and replace ObamaCare, saying the GOP needs to find the "courage" to listen to Americans." They haven't had the courage to hold one hearing in the United States Senate to hear from doctors, to hear from hospitals, to hear from insurance companies," Sanders said on MSNBC. "Put it out on the table. Have hearings. Let's see how we can go forward together to improve the Affordable Care Act, not throw 22, 23 million people off of health insurance." (Bowden, 6/29)

In other news from the Democrats' side of the aisle —

NPR: Senate Democrats Don't Have The Votes To Block The GOP Health Care Bill, So What Can They Do?
When Senate Republican leaders delayed the vote on their bill to repeal and replace the Affordable Care Act, also known as Obamacare, Minority Leader Chuck Schumer, D-N.Y., was quick to not declare victory. "We're not resting on any laurels, nor do we feel any sense yet of accomplishment," Schumer said at his weekly press conference, shortly after the surprise GOP decision to punt on a vote. "Other than we are making progress, because the American people are listening to our arguments." (Detrow, 6/30)

CQ Roll Call: Democrats Push For More Generous Medicare Benefits
The top Democrat on the House Ways and Means Health Subcommittee hopes to draw a contrast between the two parties by pushing to expand Medicare coverage while Republicans are discussing scaling back benefits under the Democrats' health care law. Rep. Sander Levin, D-Mich., will reintroduce a bill Thursday, which CQ Roll Call obtained first, that would increase Medicare coverage for dental, hearing and vision care, which are not included in Medicare benefits. Medicare recipients either have to pay out of pocket for things like vision tests or glasses or often forgo them if they prove to be too costly. (Raman, 6/29)

WBUR: With The Senate's Health Care Vote Delayed, What's Next For Democrats?
Do Democrats want to work with Republicans to make the health bill better? Rachel Martin talks to Tom Perez, chairman of the Democratic National Committee. (Martin, 6/29)

The Washington Post: Americans Watch A Health-Care Bill That Could Upend Many Lives Again
Millions of Americans of all ages and needs would be affected if Republicans in Congress succeed in overhauling major parts of the Affordable Care Act. And the latest maneuvering is only intensifying concerns. But with Senate GOP leaders trying to retool parts of their bill — which was pulled back this week after support for a fast vote eroded — it isn’t easy sussing out exactly how an individual might benefit or lose. Would an uninsured home-care worker in Ohio get a tax credit that would make private health coverage affordable? Would the big changes envisioned for Medicaid funding cut out a New Mexico house painter with emphysema? What about the medical services a young West Virginia boy might require for the rest of his life? (Somashekhar, McGinley, Sun and Bernstein, 6/29)

The Wall Street Journal: How The Proposed Health-Care Bill Would Affect Your Taxes
There is no question your taxes will change if Republicans pass a new health-care bill. Earlier this week, Senate leaders delayed a vote on the Better Care Reconciliation Act of 2017 until after July 4. The bill seeks to repeal or replace large swaths of the Affordable Care Act (ACA), also known as Obamacare. (Saunders, 6/30)

The Wall Street Journal: Senate Health Bill Could Hit Employer-Sponsored Plans
Little-noticed provisions in the Senate Republican health bill could have a significant impact on employer-provided health plans, removing four million more people from such coverage in 2018, compared with current law, according to one projection. These provisions could pave the way for higher out-of-pocket costs for many workers. (Armour and Hughes, 6/29)

The Washington Post: Republicans’ Health-Care Efforts Would Set Black Women Back, Report Says
Black women were one of the biggest beneficiaries of the Affordable Care Act, but a new report argues that the Republican efforts to dismantle parts of the law threaten to undo many of the gains made, putting low-income women and women with chronic health conditions most at risk. Under the ACA, the report found more black women were able to access to health care, including preventive screenings and treatment for chronic illnesses such as diabetes, HIV and hypertension. (Lewis, 6/29)

Los Angeles Times: Less Coverage, More Uninsured: Here's What The Latest Republican Healthcare Plan Could Mean For Women
Women’s health advocates have assailed the plans put forward by congressional Republicans to replace the Affordable Care Act, saying they would cause disproportionate harm to half the adult population. “Both bills are nothing short of an all-out attack on women’s health,” said Janel George, director of federal reproductive rights and health at the National Women’s Law Center. (Zavis, 6/29)

NPR: How The Senate GOP Health Care Bill Could Affect The Midterms And Beyond
One provision of the Senate's health care bill stands to be quite popular: the Better Care Reconciliation Act would eliminate the Affordable Care Act's individual mandate. That would be repealed immediately. Another would likely please the Republican base: defunding Planned Parenthood for a year. Those funds would disappear right away, too. (Kurtzleben, 6/29)

Arizona Republic: Uproar Over Senate Health Bill Puts Flake's Re-Election In Focus
U.S. Sen. Jeff Flake has not signaled how he would vote on the now-struggling Better Care Reconciliation Act, although he supports repealing former President Barack Obama's signature health-care law, which he and other Republicans dubbed "Obamacare." The political turmoil of the Trump presidency has the left fired up, which could make for unpredictable midterm elections — even in a usually Republican-friendly state such as Arizona. (Nowicki, 6/29)

San Jose Mercury News: What Senate Health Care Delay Means For House Republicans
The Republican health care bill would have a dramatic effect in California because of its steep cuts to Medicaid – particularly in the Central Valley... All of the state’s 14 Republican members of Congress voted for the House’s version of the bill, in part due to pressure from House leaders and a desire to keep their promises on the campaign trail to repeal “Obamacare.” (Tolan, 6/29)

Meanwhile, protesters are out in force against the bill —

The Washington Post: 40 Arrested As Health-Care Bill Protesters Swarm Capitol Hill This Week
It seems everyone at the various health-care protests in Washington this week brought a story. The Pennsylvania man who relied on the Affordable Care Act for his dialysis and was willing to get arrested so his senator understood the legislation was life and death. The D.C. woman who feared that her 27-year-old, nonverbal, autistic brother would be forced into an institution without Medicaid. And the Arlington father, Rick Hodges, who wondered if the Republican-proposed health-care bill would afford his teenage daughter with Down syndrome the opportunity to live a semi-independent life as an adult. (Stein, 6/29)

Denver Post: Cory Gardner Office Protest: Disabled Advocates Arrested
Ten protesters — most with disabilities — were arrested in U.S. Sen. Cory Gardner’s Denver office Thursday, two days after they began a sit-in to demand that the Republican senator pledge to oppose the GOP’s plan to repeal and replace Obamacare. “Rather go to jail than to die without Medicaid!” protesters, some in wheelchairs or lying on the floor, chanted while Denver police stood in the doorway of Gardner’s downtown office and ordered them to leave. The demonstrators live-streamed their own arrests on Facebook while the chanting continued. Police also used video cameras to record the arrests. (Worthington, 6/29)

Cincinnati Enquirer: Another Insurer Leaves Ohio Health Care Exchange
A Dayton-based insurer is the latest to leave Ohio's health care exchange, leaving people in nine Southwest Ohio counties with one fewer option. The Premier Health Plan said Thursday that uncertainty surrounding the future of the Affordable Care Act, better known as Obamacare, fueled its decision to leave the Ohio exchange as of Jan. 1, 2018. (Balmert, 6/29)

Houston Chronicle: Memorial Hermann Quits Individual Insurance Business 
After wading into the individual health insurance business the past three  years, Memorial Hermann Health System confirmed this week it is abandoning the effort at the end of the year. No health maintenance organization (HMO) or preferred provider organization (PPO) individual plans will be sold for 2018, officials with the health system said. (Deam, 6/29)

And in news on Aetna —

The Wall Street Journal: Aetna To Move Corporate Headquarters To New York City
Aetna Inc. will move its corporate headquarters along with 250 jobs to Manhattan by late 2018, from Hartford, Conn., the latest company to abandon a smaller city for a major urban center.The company said it chose New York as its new location to tap a more robust pool of talent at a time when Aetna is repositioning itself as a consumer-oriented health company. (De Avila and Morris, 6/29)

The New York Times: Trump Nominates Indiana Health Commissioner As Surgeon General
President Trump has nominated Dr. Jerome M. Adams, the health commissioner for Indiana and a strong advocate of needle exchanges to avoid the spread of disease, to be the surgeon general of the United States. Dr. Adams, 42, was first appointed to the Indiana post in October 2014 when Vice President Mike Pence was governor. Shortly after Dr. Adams took office, there was an unusual H.I.V. outbreak in Scott County, a rural Indiana community near the Kentucky border. (Kaplan, 6/29)

USA Today: Trump Nominates Indiana Doctor For Surgeon General
During his time in office, Adams presided over a major health crisis — an HIV outbreak in Scott County associated with intravenous drug use that eventually stretched to more than 200 cases. Although Pence had first expressed reservations about needle exchange programs, the state's response eventually included such a program among other measures. People who have worked in Indiana with Adams praised him for his tireless energy as well as his finely honed people skills and ability to listen. (Rudavsky, 6/30)

The Washington Post: Trump Picks Indiana Health Commissioner For Surgeon General
If confirmed by the Senate, which is controlled by Republicans, Adams would become another prominent health official from Vice President Pence’s home state to take a high-profile post in the Trump administration. Seema Verma, a former health policy consultant who crafted Indiana’s unusual Medicaid expansion rules, now heads the federal Centers for Medicaid and Medicare Services. (Bernstein, 6/29)

Politico: Trump Nominates Indiana Health Official For Surgeon General
Trump abruptly fired the previous surgeon general Vivek Murthy without explanation. Murthy had been a supporter of Obamacare, an advocate for comprehensive treatment of addiction and had argued for treating gun violence as a public health problem. (6/29)

The Hill: Trump Nominates Indiana Health Official For Surgeon General 
President Trump is nominating Jerome M. Adams to be the surgeon general of the Public Health Service. Adams is currently Indiana's state health commissioner and was appointed to the post by Vice President Mike Pence, during his time as the state's governor. If confirmed, Adams would replace Rear Adm. Sylvia Trent-Adams, the current acting surgeon general. Trent-Adams took over the post in April after President Trump dismissed the previous surgeon general, Dr. Vivek Murthy, an Obama appointee. Murthy had served in the post since 2014. (Delk, 6/29)

In other administration news —

The Fiscal Times: Why Trump’s Rollback Of Clean Air Rules Could Cost Taxpayers Billions
The grim reality is that even under Obama’s aggressive efforts to combat air pollution, tens of thousands of mostly older Americans are dying unnecessarily every year because carbon emission levels are still way [too] high. Air pollution causes an estimated 200,000 early deaths in the U.S. annually, according to a 2013 national study by the Massachusetts Institute of Technology (MIT) Laboratory for Aviation and the Environment. (Pianin, 6/29)

The Wall Street Journal: Walgreens, Rite Aid End $9.4 Billion Merger
Walgreens Boots Alliance Inc. and Rite Aid Corp. scrapped their $9.4 billion merger agreement, the latest in a series of high-profile deals to be derailed by antitrust enforcers. Instead, Walgreens said it would seek to buy half of Rite RAD -26.46% Aid’s stores for $5.18 billion in cash. Executives said they had crafted the smaller deal to address regulatory issues, but antitrust experts said it doesn’t eliminate competition concerns. (Terlep and Kendall, 6/29)

Bloomberg: Walgreens Gives Up On Rite Aid Deal, Will Buy Stores Instead 
The new agreement ends a saga that dragged on for more than a year and a half as the companies struggled to get approval from regulators. On Thursday, they said they would scrap the $7.37 billion takeover, and instead Walgreens will pay $5.18 billion to buy 2,186 stores, leaving Rite Aid as a regional chain. “This deal is much simpler,” Walgreens Chief Executive Officer Stefano Pessina said on a conference call. “It is an asset deal so it is less controversial.” (Langreth, 6/29)

The Washington Post: The U.S. Fertility Rate Just Hit A Historic Low. Why Some Demographers Are Freaking Out.
The United States is in the midst of what some worry is a baby crisis. The number of women giving birth has been declining for years and just hit a historic low. If the trend continues — and experts disagree on whether it will — the country could face economic and cultural turmoil. (Cha, 6/30)

Columbus Dispatch: Birth Rate Among Teenage Girls Reaches Historic Low, CDC Says
Births to American teens ages 15 to 19 fell 9 percent between 2015 and 2016, according to the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. The birth rate in 2016 — 20.3 babies per 1,000 females — marks a decrease of 51 percent from 2007 and 67 percent from 1991. (Gilchrist, 6/30)

NPR: Breast Cancer Test May Identify Low-Risk Tumors That Don't Require Treatment
For years, doctors have focused on detecting breast cancer at the earliest possible moment after a tumor develops so treatment can start right away. But more and more studies are showing many small, early tumors don't present a danger. So, when is it safe to remove a tumor but skip additional treatments like tamoxifen, chemotherapy and radiation? (Neel and Neighmond, 6/29)

Stat: Where A Doctor Saw A Treatable Cancer, A Patient Saw An Evil Spirit
Thousands of Hmong emigrated from Southeast Asia after the Vietnam War, when the CIA recruited them to fight or spy on the United States’s behalf, only to face harsh repercussions after U.S. forces withdrew. Many Hmong understand physical illness in mystical terms: an evil spirit, or “dab,” can enter the body if a person is badly startled, for instance, or if a baby’s placenta is not properly buried. A dab might depart only if a person takes specific actions, like drinking an herbal remedy while also leaving a cup of the remedy for the dab to drink. The Hmong’s beliefs about medicine and illness, combined with hard-earned suspicions about American institutions, can mix poorly. (Tedeschi, 6/30)

Stat: Freeze-Dried Placenta Pills Likely Caused This Newborn's Dangerous Bacterial Infection
In a certain corner of the alternative health movement, fueled by celebrity buzz, it’s become en vogue for new mothers to consume their placentas after giving birth. Companies have sprouted up offering to turn placentas into smoothies, truffles, and freeze-dried pills, claiming that placental eating — practiced by many mammal species — can give recovering moms a boost of vitamins and nutrients, and help prevent postpartum depression. Evidence, however, is lacking that it has any health benefit for human moms or babies. And a new case report reveals that it can be incredibly dangerous. (Caruso, 6/29)

NPR: After Decades On The Rise, C. Diff Infections Are Finally Falling
The risk of getting a deadly, treatment-resistant infection in a hospital or nursing home is dropping for the first time in decades, thanks to new guidelines on antibiotic use and stricter cleaning standards in care facilities. (Chen, 6/29)

Stat: Has Salvador Dalí's DNA Melted Away?
Even if you didn’t take art history classes in school, you probably know Salvador Dalí’s work. One of the surrealist’s most famous paintings, “The Persistence of Memory,” is the one with the melting clocks. But memory is not the only thing that persists — a woman who has claimed to be Dalí’s daughter for over a decade has not given up. To support her contention, Pilar Abel has had two previous paternity tests performed — one with inconclusive results, another that allegedly never sent her results. Now a Spanish court has granted her request to have Dalí’s body exhumed from a crypt in Catalonia so a third test can be conducted. But Dalí has been dead for nearly 30 years. Can a sample of his DNA still give Abel a definitive answer? (Sheridan, 6/29)

Kansas City Star: Opioid Panel In Olathe Says County Not In Crisis But Problems Growing
Willey said nationwide deaths from prescription opioids are leveling off, suggesting physicians are tightening their prescribing practices. But at the same time deaths from illegal opiates are on the rise, suggesting people who are addicted are moving to cheap street drugs as an alternative. (Marso, 6/29)

Kansas City Star: Overland Park Doctor Among Top-Paid Speakers For Opiate Maker Facing Federal Charges
An Arizona company paid an Overland Park pain doctor more than $200,000 over three years to promote its new opiate in presentations to medical practitioners. Now, federal prosecutors have accused six former leaders of the company of handing out speaking gigs to doctors for prescribing Subsys, a concentrated fentanyl spray approved for cancer patients in severe pain. (Marso, 6/29)

New Hampshire Public Radio: State Regulators Seek To Advise Hope For N.H. Recovery On Managing Rapid Growth
An investigation by the attorney general’s office into New Hampshire’s largest provider of drug recovery centers has ended with no criminal activity found. But attorneys from the state’s justice department will be meeting with leadership at Hope for New Hampshire Recovery soon to offer assistance and guidance in the management of the organization. (Sutherland, 6/29)

The Wall Street Journal: Cyberattack Forces West Virginia Hospital To Scrap Computers
Princeton Community Hospital in rural West Virginia will scrap and replace its entire computer network after being struck by the cyberattack paralyzing computers globally. The cyberattack, known as Petya, froze the hospital’s electronic medical record system early Tuesday, leaving doctors unable to review patients’ medical history or transmit laboratory and pharmacy orders, said Rose Morgan, the hospital’s vice president of patient care services. (Evans, 6/29)

The Baltimore Sun: Maryland To Become First State With Law To Protect Planned Parenthood 
Maryland on Saturday will become the first state in the nation with a law to protect funding for Planned Parenthood from a possible federal cutoff. Legislation ensuring that the state will cover the cost of the group's health care services in Maryland if Congress blocks it from receiving federal funding is among the more than 250 bills passed by the General Assembly that will become law July 1. (Dresser, 6/29)

The Associated Press: South Dakota Sued For Using Catheter In Toddler Drug Screen
The American Civil Liberties Union sued South Dakota on Thursday over the forced use of a catheter to take a urine sample from a 3-year-old boy who was being tested for exposure to drugs as part of a child-neglect investigation. (6/29)

Boston Globe: Nonprofit Sues Maine Governor Over Anticipated Government Shutdown
Ahead of an imminent government shutdown, a nonprofit legal-aid group filed a federal lawsuit Thursday against Maine Governor Paul LePage, seeking to force the state to continue operating welfare programs... If state government shuts down, nearly 450,000 people who rely on public assistance programs — including MaineCare, food stamps, and Temporary Assistance for Needy Families — would be affected, argued Maine Equal Justice Partners, the organization suing the state. (Edmondson, 6/29)

Reuters: Judge Halts Indiana Abortion Law Targeting Minors
Indiana may appeal a U.S. court ruling that blocked parts of the state's latest abortion law that critics said would deter girls under 18 from getting an abortion without parental approval, the state attorney general's office said on Thursday. U.S. District Court Judge Sarah Evans Barker issued a preliminary injunction late on Wednesday against portions of measure signed in April by Indiana Governor Eric Holcomb. (Kenning, 6/30)

State House News Service: House, Baker, And Now Senate On Record For Pregnant Workers Bill
The Massachusetts Senate unanimously passed legislation Thursday mandating protections for pregnant workers, an effort that came up short on Beacon Hill last session but now appears poised to become law... Lovely said three-quarters of women in America will become pregnant at some point during their working lives, and in Massachusetts, more than half of all pregnant women and new mothers are in the workforce. (Young, 6/29)

Orlando Sentinel: Orlando Health Partnering With Orlando Area CareSpot Urgent Cares
Orlando Health is boosting its presence in Central Florida’s urgent care market by partnering with the Florida-based CareSpot Urgent Care chain... The company has more than 30 locations in Florida, and similar partnerships with hospitals in Gainesville and Jacksonville. (Miller, 6/29)

The Philadelphia Inquirer/Philly.com: Troubled Mount Laurel Nursing Home Has Buyer, Will Stay Open
A troubled Mount Laurel nursing home whose Medicare agreement was canceled June 16 will remain open while a new owner seeks certification under the health programs for the elderly and the poor. The buyer, Marquis Health Services, based in Brick, N.J., said it learned Monday that patients will be allowed to stay in the 220-bed facility if they choose, though when Marquis takes over it will not be paid by Medicare and Medicaid until the facility is certified again. (Brubaker, 6/29)

St. Louis Public Radio: Siteman Cancer Center Expands To North St. Louis County
Siteman Cancer Center is expanding its reach to north St. Louis County, a move aimed at better serving the region’s African-American population. Doctors will begin seeing patients at Christian Hospital during the first week of July, where Siteman will replace the hospital’s existing Cancer Care Center. (Bouscaren, 6/30)

Des Moines Register: UI Health Care To Go 'Cashless' On July 1
Starting Saturday, most patients won't be able to cover their co-pays or other medical expenses with cash or checks at University of Iowa Health Care clinic services. The health care enterprise is going "cashless" July 1. "We are always looking at how to reduce expenses in ways that do not affect patient care quality and safety," Tom Moore, a spokesman for UIHC, said via email Tuesday. "Reducing an administrative cost like cash handling is one of the methods that help us reach that goal." (Charis-Carlson, 6/29)

Boston Globe: Adjunct Professors Push Legislators For Better Pay, Benefits
In higher education, they’re the equivalent of gig workers: part-time professors who power many of the area’s colleges, cobbling together teaching assignments each semester at one or two universities at a time. Now, many are demanding that state legislators ensure they are paid adequately for their work and receive similar health care and retirement benefits as full-time professors. (Fernandes, 6/29)

The Philadelphia Inquirer/Philly.com: Buy Your Medical Cannabis Here; Pa. Announces Dispensary Sites
The Pennsylvania Department of Health on Thursday announced the names of 27 companies that will be permitted to sell medical marijuana across the state next year, reaching another milestone in a program that could lead to cannabis being available by 2018. The announcement also set off another round of consternation about whether the cannabis dispensaries were being distributed fairly and put in places where they would serve the most patients. (Wood, 6/29)

Boston Globe: Questions Remain On Changes To Pot Law
Massachusetts legislators, toiling in secret to finalize a rewrite of the voter-passed marijuana legalization law, hit an impasse Thursday as they tried to iron out differences between a House version that would alter major parts of the ballot measure and a Senate bill with more modest changes... Supporters fear that a significant delay could thwart the expected opening of retail stores, aimed for July 2018. (Miller, 6/29)

Kaiser Health News: California Joins States That Protect Patients Against Nasty Surprise Bills
Before Kevin Powers underwent lung cancer surgery last October, his girlfriend, Agi Orsi, meticulously checked and double-checked to be sure his Santa Monica, Calif., hospital and surgeon were in his health plan’s network. They were.Even in the hospital, Orsi dutifully wrote “No out-of-network doctors” across the top of Powers’ admission paperwork. Her diligence was for naught. (Bazar, 6/30)

The Commonwealth Fund: High-Need, High-Cost Patients: Who Are They And How Do They Use Health Care? 
High-need adults differed notably from adults with multiple chronic diseases but no functional limitations. They had annual health care expenditures that were nearly three times higher—and which were more likely to remain high over two years of observation—and out-of-pocket expenses that were more than a third higher, despite their lower incomes. On average, rates of hospital use for high-need adults were more than twice those for adults with multiple chronic conditions only; high-need adults also visited the doctor more frequently and used more home health care...Wide variation in costs and use of services within the high-need group suggests that interventions should be targeted and tailored to those individuals most likely to benefit. (Hayes et. al, 8/29)

The Commonwealth Fund: AHCA Economic And Employment Consequences For States 
The AHCA would raise employment and economic activity at first, but lower them in the long run. It initially raises the federal deficit when taxes are repealed, leading to 864,000 more jobs in 2018. In later years, reductions in support for health insurance cause negative economic effects. By 2026, 924,000 jobs would be lost, gross state products would be $93 billion lower, and business output would be $148 billion less. About three-quarters of jobs lost (725,000) would be in the health care sector. States which expanded Medicaid would experience faster and deeper economic losses. (Ku et al, 6/14)

JAMA: Quality Of Care After Health Plan Exit From Medicaid Managed Care
State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences...Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. (Ndumele et. al, 6/27)

New England Journal of Medicine: Implementation Of Medical Homes In Federally Qualified Health Centers
We examined the achievement of medical-home recognition and used Medicare claims and beneficiary surveys to measure utilization of services, quality of care, patients’ experiences, and Medicare expenditures in demonstration sites versus comparison sites. Using difference-in-differences analyses, we compared changes in outcomes in the two groups of sites during a 3-year period...Level 3 medical-home recognition was awarded to 70% of demonstration sites and to 11% of comparison sites. Although the number of visits to federally qualified health centers decreased in the two groups, smaller reductions among demonstration sites than among comparison sites led to a relative increase of 83 visits per 1000 beneficiaries per year at demonstration sites. (Timbie et. al, 6/21)

Urban Institute: Rapid Growth In Medicaid Spending On Medications To Treat Opioid Use Disorder And Overdose 
Between 2011 and 2016, spending on Medicaid-covered prescriptions used to treat opioid addiction and overdoses increased from $394 million to $930 million, an average annual increase of 19 percent. Spending grew faster in later years, with a 30 percent increase between 2015 and 2016. Certain states—including Kentucky, Maine, and Ohio—have seen particularly fast growth. These same states, and others, could be particularly hard hit by reductions in Medicaid spending growth under consideration in Congress because of their fast growth and high rates of fatal overdoses. (Clemans-Cope, Epstein and Kenney, 6/28)

The Washington Post: Why Is It So Hard For Republicans To Pass A Health-Care Bill?
Almost every Republican in Congress can agree with what House Speaker Paul D. Ryan (R-Wis.) said earlier this week: It's really, really important they pass a health-care bill as soon as possible.“I think it's probably the most, it's the biggest signature issue we have,” Ryan told “Fox & Friends.” “And it's the biggest promise we've ever made in the modern era. We said if we get elected, we will repeal and replace Obamacare.” (Amber Phillips, 6/29)

The New England Journal Of Medicine: Health, Wealth, And The U.S. Senate
The Better Care Reconciliation Act (BCRA), as the U.S. Senate calls the health care bill released by a small working group of Republican senators last week, is not designed to lead to better care for Americans. Like the House bill that was passed in early May, the American Health Care Act (AHCA), it would actually do the opposite: reduce the number of people with health insurance by about 22 million, raise insurance costs for millions more, and give states the option to allow insurers to omit coverage for many critical health care services so that patients with costly illnesses, preexisting or otherwise, would be substantially underinsured and saddled with choking out-of-pocket payments — all with predictably devastating effects on the health and lives of Americans. What would get “better” under the BCRA is the tax bill faced by wealthy individuals, which would be reduced by hundreds of billions of dollars over the next decade — about $5,000 per year for families making over $200,000 per year and $50,000 or more for those making over $1 million, according to analysis of the AHCA, which included a similar set of tax provisions.1 We believe that that trade-off is not one to which we — physicians, patients, or American society — should be reconciled. (Debra Malina, Stephen Morrissey, Mary Beth Hamel, Caren G. Solomon, Arnold M. Epstein, Edward W. Campion and Jeffrey M. Drazen, 6/27)

The New York Times: Understanding Republican Cruelty
The basics of Republican health legislation, which haven’t changed much in different iterations of Trumpcare, are easy to describe: Take health insurance away from tens of millions, make it much worse and far more expensive for millions more, and use the money thus saved to cut taxes on the wealthy. (Paul Krugman, 6/30)

The Wall Street Journal: On Health Care, A Promise, Not A Threat
We are coming up on a great American holiday. There will be fireworks and children frolicking in pools; there will be baseball games, cookouts and flags. America will be looking and acting like America. So this is no time for gloom. This moment in fact may be, perversely, promising. The failure so far of Senate Republicans to agree on a health-care bill provides an opening. Whatever happens the next few days, moderates and centrists on both sides can and should rise, name themselves, and start storming through. (Peggy Noonan, 6/29)

The New York Times: There’s Only One Grocery Store In Most Rural Areas. Should We Expect Two Health Insurers?
Republicans say a big reason the Affordable Care Act needs to go is that it fosters weak competition and limited choice in insurance marketplaces. But their replacement bill could actually make the problem worse in the rural counties that are struggling the most. (Reed Abelson and Margot Sanger-Katz, 6/29)

Cleveland Plain Dealer: The Fine Line Between The Health-Insured - And The Uninsured In America
In the reckless rush to repeal the Affordable Care Act, leaving 22 million more Americans uninsured, Washington must remember that we are all just one bad boss or health crisis away from needing help to obtain health insurance. (Betsy Rader, 6/30)

Bloomberg: Bipartisanship Dies On The Hill Of Obamacare
With the Republicans' health-care bill in crisis, some have suggested they try a bipartisan approach. To understand the prospects of such a thing, recall the most important political distinction about health care: Republicans hate Obamacare, but they are mostly indifferent about the Affordable Care Act. (Jonathan Bernstein, 6/29)

The Washington Post: This Remarkable Moment Perfectly Captures Trumpcare In All Its Cruel Absurdity
With the GOP’s repeal-and-replace bill hanging in the balance, Politico reports that Republican Senate leaders are trying to entice moderate GOP holdouts with the promise of an additional $45 billion in spending to counter the opioid crisis. One administration source tells Axios that the game plan is to try to “bribe” moderates with this extra spending, while trying to win over conservatives with longer-term reforms. (Greg Sargent, 6/29)

Richmond Times-Dispatch: 'Repeal And Replace'? Try 'Tweak And Move On'
Perhaps for policy reasons, and certainly for political reasons, it is impossible to unwind reliance on employer-provided insurance. But this fact, combined with the “pre-existing conditions” consensus, means that henceforth the health care debate will be about not whether there will be a thick fabric of government subsidies, mandates and regulations, but about which party will weave the fabric. (George Will, 6/29)

The New York Times: The Blood On A Tax Cut
Pretend you are that most improbable of combinations — a lovable billionaire. In other words, you’re Warren Buffett. The politicians who worship guys like you have another treat in store: They will cut your most recent tax bill by $679,999, making you even wealthier. (Timothy Egan, 6/30)

St. Louis Post-Dispatch: Don't Fall For The Distractions: Nation's Health And Welfare At Stake
It is important to note that this is an extremely unpopular bill throughout the country. Recent national polls suggest that fewer than 30 percent of U.S. citizens support the House bill. Furthermore, credible and mainstream institutions such as the AARP, American Medical Association, American Hospital Association and American Cancer Society, among others, oppose the bill. This fact is not lost on Senate Republicans who formulated their bill behind closed doors without any plans for a public hearing to discuss its merits. They understand the deep unpopularity of their proposal and have gone to great lengths to essentially bury their heads in the sand. (Jon Mizrahi, 6/29)

San Antonio Press-Express: What’s Really Ailing Health Care
The Senate health care bill, which was scuttled Tuesday until after July 4, was doomed by two narratives: Republicans are mean, and poor people would be dropping like flies. Assisting the opposition was none other than President Donald Trump, who called the earlier version passed by the House “mean.” (Kathleen Parker, 6/29)

Los Angeles Times: As Depression, Anxiety And Suicide Skyrocket, The GOP Wants To Gut Our Mental Health Coverage
Since the Senate healthcare reform bill was released late last week, there’s been tons of conversation around what’s in the darn thing. Among the rotten provisions in the current iteration of Trumpcare — and there are many — arguably the least discussed are those affecting individuals with mental illness. Mental illness is an extraordinarily broad category, by the way; it includes everything from anxiety, depression, bipolar disorder, eating disorders, ADHD, schizophrenia and more. To escape the bill’s clinical, impersonal language and get to the point: Folks living with mental illness are about to get completely screwed. (Melissa Batchelor Warnke, 6/29)

WBUR: A Mother's Response To The Health Care Debate
Notwithstanding their seven year crusade to eliminate the Affordable Care Act, Mitch McConnell and Paul Ryan are failing yet again because they refuse to address the fundamental barrier to achieving their goal... Even as the House and Senate proposals are particularly cruel to the poor, the bills do not spare many from their ravages. (Lauren Stiller Rikleen, 6/30)

The Wall Street Journal: The ObamaCare Waiver Breakthrough
Senate conservatives wish the health-care bill was more ambitious on deregulation, and so do we, though the benefits of its state waiver feature are underappreciated and worth more explanation. This booster shot of federalism could become the greatest devolution of federal power to the states in the modern era. (6/29)

Milwaukee Journal Sentinel: Ron Johnson Should Vote 'Yes' On Senate Health Care Plan
Repealing Obamacare shouldn’t be a partisan issue. The law has failed in its central promise, which is to make health care affordable. (Bill Smith, 6/29)

Bloomberg: Republican Plans For Medicaid Are On The Right Track
Republican efforts to pass health-care legislation are in jeopardy again, in part because of controversy over its potential impact on Medicaid. But the Republican reforms are more moderate, and more worthwhile, than they are getting credit for. (Ramesh Ponnuru, 6/29)

The Washington Post: There’s No Sugarcoating It: Republicans Are Taking A Sledgehammer To Medicaid
In a Post commentary this week, Medicaid administrator Seema Verma espoused a troubling philosophy about the program she oversees. She spoke of transforming Medicaid under the Republican plans to repeal and replace the Affordable Care Act. Taking a fiscal sledgehammer to the program is more like it. (Irwin Redlener, 6/29)

USA Today: Senate Health Bill: Reports Of Medicaid's Demise Greatly Exaggerated
Clearly the use of numbers is the easiest way to quantify the effort made to help the less needy, or, conversely, to criticize the absence of such aid. This week, the non-partisan Congressional Budget Office estimated that the new Senate Republican health care bill would leave 22 million more people without health insurance in 2026 than under current law, triggering Democratic predictions of death and destruction throughout the nation. (Christian Schneider, 6/29)

RealClear Health: The Fixes The Senate Bill Needs
Senate Majority Leader Mitch McConnell is struggling to find the votes to pass an updated version of the draft health-care bill he first released last week. The Congressional Budget Office (CBO) estimate of the bill did not make his job any easier. CBO projects the Senate plan would increase the number of Americans going without health insurance by 22 million in 2026. (James C. Capretta, 6/30)

CBS News: Should People On Medicaid Be Required To Work?
[Kellyanne] Conway's comment that Medicaid recipients should seek new jobs with health care coverage seemingly ignores that many Americans on Medicaid are working for employers who can't or won't pay for health care coverage. Walmart (WMT), for instance, by one estimate is said to cost taxpayers $6.2 billion in subsidies from programs such as Medicaid and food stamps, since many of its low-wage workers must rely on government programs to make ends meet. While Walmart is often singled out for this phenomenon, it's far from alone. (Aimee Picchi, 6/26)

Cleveland Plain Dealer: Gov. John Kasich Must Veto Medicaid Freeze In Ohio Budget
There is little doubt -- nor should there be -- that Gov. John Kasich will line-item veto Ohio lawmakers' ill-considered, destructive, inhumane freeze of Ohio's Medicaid expansion in the state budget bill. The freeze from his fellow Republicans demands a veto from Kasich, who sought and supports the expansion, which now covers about 700,000 Ohioans, 98,000 of them in Cuyahoga County. (6/29)

Chicago Tribune: When A Patient Is A Bigot, What Can A Doctor Do?
The video is appalling in its brazenness: a woman in the Canadian city of Mississauga demanding, loudly and repeatedly, that her son receive medical treatment only from a white pediatrician. "Can I see a doctor, please, that's white?" she says in the now-viral video. "That doesn't have brown teeth, that speaks English?" (Brit Trogen and Arthur Caplan, 6/29)

RealClear Health: The Digital Health Hope: Your Health And Big Data: Holy Grail Or Orwellian Nightmare?
The intersection of digital technology and health care has led to a new world of potential in the medical industry. And while other industries have focused for years on big data, health care is just now beginning to take advantage of its potential. Large data sets are now providing us with the ability to generate new questions and, more importantly, answer old ones. However, the sheer amount of data is not the most important issue—it is what is done with the data that will revolutionize health care and likely change the way disease is approached in the coming decades. (Kevin Campbell, 6/30)

RealClear Health: Why Market Competition Has Not Brought Down Health Care Costs
It is easier than ever to buy stuff. You can purchase almost anything on Amazon with a click, and it is only slightly harder to find a place to stay in a foreign city on Airbnb. So why can’t we pay for health care the same way? (Gerald Friedman, 6/30)

Roll Call: The Politics Of Drug Policy
It’s an intractable issue in the news daily, so the proposed, much-debated and now-delayed Senate Republican health care bill had to do something to answer the opioid addiction crisis in America. Add to that the basic political realization that in many of the states that supported Donald Trump and Republicans, a high percentage of people are hurting — to turn a blind eye would be a problem for America and for the GOP on many levels. Many fear the Senate bill is not enough to meet a challenge that is intertwined with unemployment, the economy and more. Though, at least — and some would label it the very least — the uncertain yet compassionate reaction contrasts with the harsh strategy the Justice Department has laid out for other low-level drug offenders. (Mary C. Curtis, 6/29)

Sacramento Bee: Sacramento's Teen 'Killing Zone' Is A Call To Action
The number is hard to wrap your mind around – 114 teenagers killed by violence in Sacramento County since 2007... A big hurdle is that many deaths are linked to gangs, which makes it even more important that in the next few weeks the City Council decides on the best anti-gang strategy to target the relatively few criminals responsible for a lot of violence. (6/29)

Lexington Herald Leader: Ky. Opioid Limits Will Save Lives
Gov. Matt Bevin is correct that one way to combat the overdose crisis is to stop creating addicts, which is the goal of a new state law that limits opioid prescriptions for acute pain to three days. No one needs a month’s supply of addictive drugs for a sprained ankle or tooth extraction. Research shows that even small quantities of opioids prescribed for minor injuries increase the risk of long-term use. (6/29)

Fortune: How We Can Win The War On Cancer
We are proud to join Vice President Joe Biden and Dr. Jill Biden in their commitment to end cancer as we know it through the work of a new nonprofit, the Biden Cancer Initiative. The Biden Cancer Initiative will convene experts from around the world to work alongside the vice president and Dr. Biden to gather and analyze the best ideas about how to address some of the biggest barriers to progress in the fight against cancer. Those barriers include lack of data standards in treating cancer, lack of data sharing in the research and development enterprise, lack of patient input and participation in clinical trials, and research and disparities in the access to care and treatment based on cost, socioeconomic status, and geographic disadvantages. (David Agus, Elizabeth Jaffee, Greg Simon, Kim Thiboldeaux and Jeff Zients, 6/29)

The New England Journal Of Medicine: Recognizing Sepsis As A Global Health Priority — A WHO Resolution
“Some very important clinical issues, some of them affecting life and death, stay largely in a backwater which is inhabited by academics and professionals and enthusiasts, dealt with very well at the clinical and scientific level but not visible to the public, political leaders, leaders of healthcare systems. . . . The public and political space is the space in which [sepsis] needs to be in order for things to change.” So said Sir Liam Donaldson, the former chief medical officer for England and the current World Health Organization (WHO) envoy for patient safety, on May 24, 2017. Two days later, the World Health Assembly (WHA), the WHO’s decision-making body, adopted a resolution on improving the prevention, diagnosis, and management of sepsis. (Konrad Reinhart, Ron Daniels, Niranjan Kissoon, Flavia R. Machado, Raymond D. Schachter and Simon Finfer, 6/28)