The New York Times: Another Case Is Threatening Obamacare. Democrats Hope It Will Help Them.
More than 1,000 miles from the caustic Supreme Court confirmation hearing of Brett M. Kavanaugh, a federal judge in Texas on Wednesday listened to arguments about whether to find part or all of the Affordable Care Act unconstitutional, in a case that may end up before a newly right-leaning set of justices. The case has become not simply a threat to the landmark legislation. Democrats have sought to make it both a flash point in the battle over whether to confirm Judge Kavanaugh and a crucial prong in their strategy to retake control of the House and Senate in the midterm elections. (Goodnough, 9/5)

The Associated Press: No Immediate Ruling In GOP's Latest 'Obamacare' Lawsuit
The latest push to scrap the Affordable Care Act once and for all pressed ahead Wednesday as Republican-controlled states asked a federal judge to finish what Congress started last year and bring the law that insures 20 million Americans to a halt. A small group of protesters, some holding signs reading "Save the ACA," shouted across the street from a Fort Worth, Texas, courthouse where former President Barack Obama's health care law is again under attack. At issue are core principles of the law, including protections for people with pre-existing medical conditions and limits on how much older customers can be charged. (Weber, 9/5)

The Washington Post: The Affordable Care Act Is Under Fire Again In Federal Court
The nearly four hours of legal sparring at Wednesday’s hearing shone a light on the partisan acrimony surrounding the statute that, several years after it extended health coverage to millions of Americans, remains a favorite Republican whipping post and is serving as a convenient rallying cry for Democratic candidates in this year’s midterm elections. In an abnormal arrangement, attorneys for the federal government — the defendant in the case — sat on the same side of the courtroom as the plaintiff’s lawyers during Wednesday’s hearing. The odd seating pattern stems from the fact that the Trump administration is largely agreeing with the plaintiffs who are suing. In June, the Justice Department saying in a court filing it would not defend the law. (Goldstein and Reaves, 9/5)

Texas Tribune: Texas Asks A Federal Judge To Block Obamacare Nationwide
At the hearing Wednesday, Texas aimed to convince U.S. District Judge Reed O’Connor to block the law across the country as it continues to fight a months- or years-long legal case that could land before the U.S. Supreme Court. Citing rising health care premiums, Texas says such an injunction is necessary to preserve state sovereignty and to relieve the burden on residents forced to purchase expensive insurance coverage. California counters that temporarily blocking or ending the law would cause more harm to the millions of people insured under it, particularly the 133 million people the state says enjoy the law’s protections for pre-existing conditions. The U.S. Department of Justice, which has taken up many of Texas’ positions in the case, nonetheless sided with California, arguing that an immediate injunction would throw the health care system into chaos. (Platoff, 9/5)

The CT Mirror: Dems Warn Insurers May Deny Coverage To Sick People As Texas Court Takes Up ACA Case
Democrats warned that a popular provision in the ACA requiring insurers to cover people with pre-existing health conditions –which includes a wide range of ailments, from sleep apnea to cancer – is in danger of disappearing. (Radelat, 9/5)

Modern Healthcare: Judge Skeptical Of ACA's Standing Without Effective Individual Mandate Penalty
O'Connor, in his questions from the bench, cut straight to the so-called severability in the case—whether Congress, when it zeroed out the tax penalty in the 2017 tax overhaul, intended to keep the popular consumer protections in place. "It does seem for the majority of cases, the Supreme Court says to look at the original legislation as enacted," O'Connor said. "Why would I not? Let's assume I don't buy the argument it is still a tax and believe the mandate should fall and I get to severability, why wouldn't I look at those cases?" (Luthi, 9/5)

The Wall Street Journal: Judge Grills Democrats On Health Law’s Constitutionality
Judge O’Connor, who was appointed by former President George W. Bush, said he would issue a decision as quickly as he can. If he strikes down the ACA or parts of it, the 16 Democratic attorneys general who intervened in the case would likely seek a stay of the decision as they file an appeal. The case could wind up in the Supreme Court. Attorneys representing the Democrats said millions of people with pre-existing conditions could be harmed if the ACA is tossed. “The harm of striking down the ACA…would be devastating,” said Nimrod Elias, a California deputy attorney general. (Hobbs and Armour, 9/5)

The Hill: Judge Presses ObamaCare Supporters During Arguments On Future Of Health Law
“If necessary we're ready to go to the appellate court,” a spokesperson for the California Department of Justice, which defended the health law in court, told The Hill on Wednesday. (Sullivan, 9/5)

CQ: Texas Judge To Rule Soon On Injunction Of Health Care Law
Democrats have pointed to the administration’s decision not to defend the law in court, attacking Republicans for seeking to overturn the protections, which are some of the most popular parts of the law. “All we really need is about another two months because I believe that the best way to guarantee that we strengthen the health care law and protect pre-existing conditions — to change the law you change the lawmakers,” said Rep. Lloyd Doggett, D-Texas, at a press conference Wednesday.  (McIntire, 9/5)

Bloomberg: Trump Administration Fears `Chaos' If Obamacare Blocked Too Soon 
The Trump administration isn’t defending Obamacare from a legal attack that could finally slay the embattled health-care law, but the federal government cautioned Wednesday that an immediate and nationwide halt may trigger “chaos.” Unlike the state of Texas, which urged a federal judge to block the Affordable Care Act right away, the Justice Department wants a court order not to take effect before Jan. 1, when the provision requiring people to pay a tax if they don’t have insurance is phased out. (Korosec, 9/5)

Kaiser Health News: LISTEN: The GOP Case Against ACA’s Preexisting Condition Protections Begins 
Ashley Lopez of member station KUT in Austin reports on the first day in court, and KHN’s Senior Washington Correspondent Julie Rovner discusses what it all means on NPR’s All Things Considered. (9/6)

The Hill: McConnell: No Plan To Try Again On ObamaCare Repeal Soon 
Senate Majority Leader Mitch McConnell (R-Ky.) signaled to reporters on Wednesday that he doesn’t have any plans to move again this year to repeal ObamaCare, even though Republicans might now have a better chance of success after Sen. Jon Kyl (R-Ariz.) was sworn in. Senate Republicans view Kyl as someone more likely to vote with GOP leaders on health care reform legislation than was late Sen. John McCain (R-Ariz.), the maverick whom Kyl replaced after his death. (Bolton, 9/5)

And in health law news from the states —

Modern Healthcare: Montana Insurer Wins Lawsuit Against Feds Over Unpaid Cost-Sharing Reduction Payments 
Several health insurers have sued the U.S. government over its failure to make cost-sharing reduction payments that help lower healthcare costs for certain consumers. One just scored the first victory. The U.S. Court of Federal Claims ruled in favor of Montana Health Co-op, which sued the federal government for $5.3 million in unpaid cost-sharing reduction payments, finding that the government violated its obligation under the Affordable Care Act when it stopped paying the CSRs in October 2017. (Livingston, 9/5)

The CT Mirror: CT Insurance Customers, Advocates Urge Regulators To Reject Rate Hikes
Connecticut insurance customers and health care advocates on Wednesday urged state regulators to reject proposals to raise rates next year. Those calls surfaced during a Connecticut Insurance Department hearing focused onAnthem Blue Cross and Blue Shield and ConnectiCare Benefits Inc.’s proposed increases for individual plans. (Silber, 9/5)

Columbus Dispatch: Ohio Democratic Candidate Criticizes GOP Over Affordable Care Act
Democratic attorney general candidate Steve Dettelbach on Wednesday called out two Republican candidates for statewide office over their past opposition to the Affordable Care Act. After several legal challenges and scores of unsuccessful votes in Congress, arguments began in Texas Wednesday in a suit brought by 20 Republican attorneys general seeking to gut the ACA for good. (Schladen, 9/5)

The Washington Post: Kavanaugh Debates And Dodges On Day 2 Of His Supreme Court Confirmation Hearing
Supreme Court nominee Brett M. Kavanaugh presented himself to the Senate and the American public Wednesday as an independent judge with an open mind, refusing to be pinned down on legal questions involving investigations of President Trump and how his presence on the court might shift its ideology to the right. Kavanaugh, 53, a judge on the U.S. Court of Appeals for the D.C. Circuit, proved to be an amiable and collected witness during a 12½ -hour day of questioning and dozens of interruptions from screaming protesters, who were quickly escorted outside the committee room by Capitol Police. (Barnes, Marimow, Kim and Viebeck, 9/5)

The New York Times: What Kavanaugh’s Hearings Reveal About His Beliefs On Abortion, Guns And Presidential Power
Asked about the constitutional right to abortion, Judge Brett M. Kavanaugh talked instead about precedent. He described the Supreme Court’s two key decisions: Roe v. Wade, the 1973 ruling that established a constitutional right to abortion, and Planned Parenthood v. Casey, the 1992 decision that reaffirmed the core of that right. Collectively, he said, the two decisions held that “a woman has a constitutional right to obtain an abortion before viability subject to reasonable regulation by the state up to the point where that regulation constitutes an undue burden on the woman’s right to obtain an abortion.” (Liptak, 9/5)

Los Angeles Times: Kavanaugh Sticks To His Position On Guns, Dodges Questions About Abortion And Presidential Power
Most legal experts predict that Kavanaugh, if confirmed, will provide the fifth conservative vote on the court to at least restrict abortion rights, if not overturn Roe. During his campaign, Trump promised to appoint only judges who would vote to overturn the abortion ruling. But Kavanaugh seemed eager to raise some doubts about those predictions. “I understand the significance on the issue,” he said Wednesday. “I don’t live in a bubble. I live in the real world.” (Savage, Haberkorn and Wire, 9/5)

The New York Times: Kavanaugh Ducks Questions On Presidential Powers And Subpoenas
Judge Brett M. Kavanaugh, President Trump’s nominee to the Supreme Court, on Wednesday dodged direct questions about whether the Constitution would allow Mr. Trump to use the powers of the presidency to thwart the Russia collusion and obstruction investigations that are swirling around his administration. (Shear, Liptak and Stolberg, 9/5)

The Wall Street Journal: Kavanaugh Pledges Fairness As Supreme Court Justice
Democrats—and some Republicans—pushed Judge Kavanaugh on “the elephant in the room,” as Sen. Richard Blumenthal (D., Conn.) put it: President Trump, whose 2016 election campaign and subsequent administration face legal probes that have brought the conviction of his former campaign chairman and guilty pleas by his former lawyer. Clearly anticipating such questions, Judge Kavanaugh at the outset praised Supreme Court cases in which justices voted against the interests of the president who appointed them. U.S. v. Nixon—in which the court unanimously ordered then-President Richard Nixon to turn over potentially incriminating audiotapes in the Watergate scandal—is “one of the four greatest moments in Supreme Court history,” he said. (Bravin and Tau, 9/5)

Politico: Kavanaugh Dodges Debates That Could Touch Trump
Kavanaugh kept his cool amid frequent demonstrator disruptions throughout the long day and rarely appeared rattled by Democratic questioners, although Coons appeared to carve a chink in the nominee’s armor by pressing him on his views about whether a sitting president can be indicted. (Schor, 9/5)

The Washington Post: Kavanaugh Hearing: Supreme Court Nominee Won’t Commit To Removing Himself From Cases Directly Affecting Trump
Earlier in the evening, Senate Majority Leader Mitch McConnell (R-Ky.) dismissed Democratic objections to Kavanaugh’s nomination and predicted the judge would be seated on the Supreme Court before its session begins in October. (Kim, Marimow, Barnes and Viebeck, 9/5)

The Associated Press: Trump Taking Supreme Court Fight To Montana, North Dakota
President Donald Trump is taking the Washington debate over his Supreme Court nominee to the home of two red-state Senate Democrats this week, elevating Judge Brett Kavanaugh's confirmation as a political litmus test for voters. Trump's strategy aims to turn the screws on the lawmakers, Jon Tester of Montana and Heidi Heitkamp of North Dakota, who find themselves caught between Senate leaders and progressive donors who are fighting Kavanaugh's confirmation, and their states' more conservative electorate, which is more broadly supportive of Trump's pick. (Miller and Thomas, 9/6)

The Wall Street Journal: Justice Department Nearing Antitrust Approval Of Health Mergers Combining CVS-Aetna, Cigna-Express Scripts
Justice Department antitrust enforcers are preparing to give the green light to two deals in the health-care industry, CVS Health Corp.’s planned acquisition of health insurer Aetna Inc. and Cigna Corp.’s planned purchase of Express Scripts Holding Co., according to people familiar with the matter. Both deals could receive formal antitrust approval as soon as the next few weeks, these people said. (Kendall, Wilde Mathews and Terlep, 9/5)

Bloomberg: Major Health-Industry Deals Are Said To Move Closer To Approval 
CVS and Aetna are in talks with the Justice Department about divesting Medicare prescription drug plans to resolve the government’s concerns the deal will otherwise harm competition. The Cigna-Express Scripts deal may not require any divestitures, said the person. “We continue to constructively work with the Department of Justice and remain confident the deal will close by the end of the year,” said Brian Henry, a spokesman for Express Scripts. Representatives for the Justice Department, CVS and Aetna declined to comment. A Cigna spokesman didn’t return requests for comment. (McLaughlin, Tracer and Langreth, 9/5)

In other health industry news —

Bloomberg: Athenahealth Ex-CEO Bush To Get $4.83 Million If Firm Is Sold 
Athenahealth Inc. will pay former Chief Executive Officer Jonathan Bush $4.83 million if the company is sold with his help in coming months. Bush, who stepped down in June after being accused of sexual misconduct, will receive an additional $2 million in early 2020 if he upholds a non-compete agreement with the health-technology firm, according to a regulatory filing Wednesday. (Melin and Ritcey, 9/5)

The Hill: Democrats Hold Up Senate Opioids Bill Over 'Earmark' For PhRMA-Backed Group 
Democrats are objecting to a bill in the Senate aimed at curbing the opioid crisis because of a GOP provision they say is an earmark for one PhRMA-funded advocacy group. The provision, added by Senate Majority Whip John Cornyn (R-Texas), has sparked concern among Democrats, who say it would only benefit the Addiction Policy Forum, an advocacy group funded by PhRMA, according to a source familiar. (Hellmann, 9/5)

CQ: Senate Opioid Package Encounters Hiccup
The Cornyn provision was added to a bill (S 2789) that the Senate Judiciary Committee had approved. That bill was tucked into the broader opioids legislation. The language was carefully written to benefit only the industry-backed center. The provision would authorize $10 million for each of the fiscal years from 2018 to 2022. The language would require the expansion of call center services to help individuals and their families impacted by a substance use disorder. It also calls for the development of health information technology systems that aid in prevention, drug intervention, and the operation of treatment and recovery resources. (Raman, 9/5)

Kaiser Health News: States Looking To Tax Opioids Pin Hopes On November Elections
After almost slapping a tax on makers of opioid pills earlier this year, Minnesota lawmakers are set to try again when they meet in January. The drug manufacturers that helped create the opioid addiction crisis should help fix it, said state Sen. Chris Eaton, whose daughter died of an overdose. “I’m definitely going to pursue it” in the next legislative session, said Eaton, a Democrat. “Whether it has a chance or not kind of depends on the election.” (Hancock and Luthra, 9/6)

The Associated Press: Report: Fentanyl Deaths In Alaska Quadrupled In 2017
Overdose deaths in Alaska involving the synthetic opioid fentanyl more than quadrupled last year, according to a new report. Alaska State Troopers released its latest annual drug report Wednesday, saying the state's overall illegal drug problem continues to worsen. With it has come associated crimes including thefts, burglaries and violence. (D'Oro, 9/5)

NPR: A Researcher Takes Lessons From Cancer To Develop New Pain Treatment
The explosion of deaths related to opioid misuse has underscored a pressing need for better ways of treating pain, especially chronic pain. Duquesne University pharmacology associate professor Jelena Janjic thinks she's on to one. It involves using a patient's own immune system to deliver non-opioid pain medication to places in the body where there's pain. (Palca, 9/5)

Nashville Tennessean: Blue Cross To Stop Covering OxyContin In Tennessee Next Year
The largest health insurance company in Tennessee will stop covering OxyContin prescriptions next year as part of sweeping policy changes intended to combat opioid addiction and make pain pills less valuable on the black market. The shift is a major blow to one of the drugs that ignited the nationwide opioid epidemic. In place of OxyContin, BlueCross BlueShield of Tennessee will instead encourage doctors to prescribe two other painkillers that are engineered to be more difficult to abuse. (Kelman, 9/6)

New Orleans Times-Picayune: Orleans Jail Staff Failed To Take Vital Signs Of Man Who Died Detoxing From Opioids, Lawsuit Says
The protocol for caring for people coming down from heroin at the Orleans Parish jail includes taking their vital signs at least every eight hours, according to a wrongful death lawsuit filed this week. The family of a detoxing man who died last November after going into cardiac arrest while seated in the jail's medical clinic claims in the suit the staff at the jail failed to take Narada Mealey's vital signs for two days before he collapsed in the chair. The lawsuit, filed Tuesday in federal court, also claims staff mostly ignored Mealey's repeated complaints of severe abdominal pain and nausea, even as he vomited in the cell where he was being held -- a cell in the booking area that did not have a bed. (Lane, 9/5)

Medpage Today: How Calif. Medical Board's Opioid Accusations Went Down
If one had to identify a physician to symbolize its "Death Certificate Project," an aggressive effort by the Medical Board of California to nab doctors who overprescribe opioids, a likely candidate would be Harold S. Budhram, MD, of Shasta Lake. (All cities named in this article are in California.) Triggered by deaths of two of his patients attributed to opioid overdoses, the board investigated his practice and, in April, filed a 39-page complaint listing 16 separate accusations. (Clark, 9/5)

USA Today: I Lost My Son To The Opioid Crisis And Nothing Can Bring Him Back
Whenever I meet someone new at a social gathering, the question typically comes up within a few minutes of casual conversation: How many children do you have? Until nine months ago, this innocent question had a simple answer. Now it triggers a rapid and painful mental calculation. I could say two. My daughter is in New York and my son is in Philadelphia. That’s the easy answer, I suppose. But it doesn’t feel right. No, that doesn’t feel right at all. (Sternberg, 9/5)

USA Today: Social Isolation And Loneliness Epidemic Harm Mental, Physical Health
Rushing to get to work, I almost didn’t stop. But my friend and neighbor, Carol Bell, was right by the driver’s side window so I lowered it to say hello. “Did you hear the man up the street died two weeks ago?” she asked. I hadn’t. And it was the 65-year-old husband of a woman I was close to when our kids, now 18, were toddler friends. We still loved to chat when we bumped into each other. (O'Donnell, 9/5)

Reuters: U.S. Judge Blocks Texas Fetal Tissue Burial Laws
A federal judge blocked Texas laws requiring the burial or cremation of aborted fetal tissue, saying in a decision on Wednesday the measures placed substantial and unconstitutional obstacles in the path of a woman's right to choose an abortion. U.S. District Judge David Ezra in Austin, Texas, issued a permanent injunction preventing the measures from going into effect. (Herskovitz, 9/5)

The New York Times: Texas Fetal Burial Law Struck Down In Another Blow To Abortion Restrictions
The Texas Legislature passed the law in 2017. It would have required hospitals, abortion clinics and other providers to arrange for the burial or cremation of fetal remains, regardless of a patient’s personal wishes or religious beliefs, and regardless of whether the remains were from an abortion or miscarriage. David A. Ezra, a senior judge with the Federal District Court in Austin, issued a permanent injunction that blocks enforcement of the law, which had been set to go into effect in February. Texas abortion providers had won a temporary injunction earlier; Judge Ezra issued his final ruling on Wednesday following a five-day trial in Austin in July. (Fernandez, 9/5)

The Hill: Federal Judge Permanently Blocks Texas Fetal Burial Law 
The judge ruled that the law would create "substantial obstacles" for women, doctors and abortion facilities while offering absolutely no health benefits. Ezra had previously issued a temporary injunction in January, blocking the law from going into effect on Feb. 1. (Hellman, 9/5)

Dallas Morning News: Judge: Texas' Fetal Burial Law Restricts Abortion Rights, Would Be 'Catastrophic' To Health Care System 
“The facts as I have found them, and it was not even a close call, show that this law would cause a violation of a woman’s right to obtain a legal abortion,” Ezra said. “If the law were to go into effect now, it would cause significant, if not catastrophic, disruptions to the health care system.” (Stone, 9/5)

Houston Chronicle: Even Ophthalmologists Could Have To Bury Fetal Tissue If Texas Law Stood, Judge Says 
When U.S. District Judge David Ezra explained why he was striking down Texas’ fetal burial law, he offered a hypothetical: As the law was written, if a pregnant woman visits an ophthalmologist’s office and miscarries while there due to a medical emergency, that eye doctor would be responsible for arranging the burial or cremation of the embryonic or fetal remains. ... That was just one of several issues Ezra found in the Texas law passed in 2017 requiring doctors, hospitals and abortion clinics to ensure internment for the remains of failed or aborted pregnancies. The judge said the law would cause a “significant if not catastrophic failure” of the health care system for women terminating a pregnancy or seeking medical care for miscarriages or complications. He ruled the law violated constitutional amendments guaranteeing due process clause and equal protection under the law. (Zelinski, 9/6)

Stateline: Counting Kicks To Prevent Stillbirths
Campaigns based on the Iowa model have been launched in Nebraska, Illinois, Kansas and Missouri, the last two just this year and both with state financing. Emily Price, executive director of Count the Kicks, the nonprofit behind the campaign, said there are plans for launches by the end of the year in Alabama and Ohio. Many doctors have long urged pregnant women to pay attention to fetal kicks. But too many physicians still rely on what they glean from routine office visits, even though waiting for the next scheduled appointment may be too late, according to Jason Collins, a Louisiana obstetrician who has practiced for 30 years and has studied stillbirths. (Ollove, 9/6)

In other news —

The New York Times: Diet And Exercise May Stem Weight Gain Of Pregnancy, But Should Begin Early
For years, maternal health experts have worried about a troubling statistic: More than half of all pregnant women in America are overweight or obese when they conceive, putting them and their children at a higher risk of developing diabetes and other health problems. So about a decade ago, the federal government launched a multimillion-dollar trial to see whether diet and exercise could help overweight women maintain a healthy weight during their pregnancies and potentially reduce their rate of complications. (O'Connor, 9/6)

The New York Times: Assisted Reproductive Technologies May Pose Heart Risks For Babies
Children born by assisted reproductive technologies may be at risk for high blood pressure in adolescence, Swiss researchers report. Previous studies in both animals and humans have suggested that conception by assisted technology is associated with premature aging of the vascular system. One result of this may be hypertension. (Bakalar, 9/5)

ProPublica: As Months Pass In Chicago Shelters, Immigrant Children Contemplate Escape, Even Suicide
ProPublica Illinois has obtained thousands of confidential records about the nine federally funded shelters in the Chicago area for immigrant youth operated by the nonprofit Heartland Human Care Services — some dating back years, others from as recently as last week. ...The documents provide a sweeping overview of the inner workings and life inside one of the country’s largest shelter networks for unaccompanied minors, including children separated from their parents under the Trump administration’s zero-tolerance policy. (Sanchez, Eldeib and Cohen, 9/6)

In other news —

Columbus Dispatch: Migrant Mom Recounts Anguish Of Being Separated From Son
The mother and son came to the U.S. in May, during the roughly two months that the Trump administration separated migrant children from their parents at the border, as part of an aggressive effort to deter illegal immigration. The boy was taken from her on their third day in the country, and they were sheltered in separate detention facilities in Arizona for about two months. (King, 9/5)

The New York Times: These Firms Say They Can Help Prevent School Shootings And Suicides. Do They?
Hours after the deadly school shooting in Parkland, Fla., companies that market their services to schools began to speak up. “Governor, take pride that a Vermont-based company is helping schools identify the violence before it happens,” one company wrote on Twitter to Gov. Phil Scott of Vermont. The chief executive of another company appeared on the news to boast of a “home run”: Its algorithms, he said, had helped prevent two student suicides. (Leibowitz, 9/6)

Stat: Patients In Landmark Genome-Editing Trial Show Improvement — But Questions Linger
Two patients with a rare inherited disease are showing early signs of improvement after being injected with a groundbreaking genome-editing fix from Sangamo Therapeutics. That’s the encouraging news emphasized by the biotech on Wednesday from its latest clinical trial, the first in which gene-editing is being used in patients to try to repair disease-causing DNA. But Sangamo is simultaneously downplaying other results from the study that are more confounding and may give outsiders reason to be concerned. (Feuerstein, 9/5)

Stat: Researchers To Release First-Ever Genetically Engineered Mosquitoes In Africa 
The government of Burkina Faso granted scientists permission to release genetically engineered mosquitoes anytime this year or next, researchers announced Wednesday. It’s a key step in the broader efforts to use bioengineering to eliminate malaria in the region. The release, which scientists are hoping to execute this month, will be the first time that any genetically engineered animal is released into the wild in Africa. While these particular mosquitoes won’t have any mutations related to malaria transmission, researchers are hoping their release, and the work that led up to it, will help improve the perception of the research and trust in the science among regulators and locals alike. It will also inform future releases. (Swetlitz, 9/5)

The Wall Street Journal: Schools Across The U.S. Find Elevated Lead Levels In Drinking Water
Schools in multiple states are tearing out water fountains and old faucets after finding elevated levels of lead in their drinking water. Indiana tested 915 schools in recent months and found that 61% had one or more fixtures with elevated lead levels. Schools in Colorado and Florida, among others, are taking steps to address lead in drinking water. (Maher, 9/5)

The Wall Street Journal: Bayer Says More Americans Are Alleging Monsanto Weedkillers Cause Cancer
Bayer AG said the number of American plaintiffs alleging its recently acquired weedkillers cause cancer has risen sharply, adding to concerns about potentially lengthy and costly litigation stemming from its acquisition of Monsanto. The German chemicals company on Wednesday also lowered its full-year earnings outlook because of delays in closing its $63 billion purchase of Monsanto, which included a portfolio of herbicides that contain glyphosate, notably flagship product Roundup. (Bender, 9/5)

Kaiser Health News: Avoidable Sepsis Infections Send Thousands Of Seniors To Gruesome Deaths 
Shana Dorsey first caught sight of the purplish wound on her father’s lower back as he lay in a suburban Chicago hospital bed a few weeks before his death. Her father, Willie Jackson, had grimaced as nursing aides turned his frail body, exposing the deep skin ulcer, also known as a pressure sore or bedsore. “That was truly the first time I saw how much pain my dad was in,” Dorsey said. (Schulte, Lucas and Mahr, 9/5)

WBUR: What Kills 5 Million People A Year? It's Not Just Disease
A new report published in The Lancet on Wednesday finds that when it comes to health, quality — not quantity — seems to be more important. The study estimates that 5 million people die every year because of poor-quality health care in low- and middle-income countries. That's significantly more than the 3.6 million people in those countries who die from not having access to care. (Schreiber, 9/5)

The New York Times: Airport Security Trays Carry More Cold Germs Than Toilets, Study Finds
Airport security is there to protect you, but it may also give you the sniffles — or worse. To all the places and surfaces we’ve been warned are teeming with germs or bacteria — your pets, the subway seat, airplane cabins, the A.T.M. — add the airport security tray. (Karasz, 9/5)

NPR: Germ-Eating Microbes Might Be Another Way To Fight Antibiotic Resistance
Here's a bold idea to fight back against bacteria that can't be stopped by antibiotics: Go after them with germ-eating microbes. That reasoning lies behind an intriguing line of research that might also be put to use in the event of a germ-warfare attack. It might seem strange to think of microbe-eating microbes, but "actually they're found in almost every ecosystem on Earth," says Brad Ringeisen, deputy director of the Biological Technologies Office at the Defense Advanced Research Projects Agency (DARPA). (Harris, 9/6)

Politico: Pulse Check At Work: Home Health Aides
Home health aide is one of the fastest-growing jobs in America – and the first job the Pulse Check podcast explores in a month-long series that will explain how different health care workers fit into the broader health policy picture. The show will visit with a home health aide, a health coach, and others as we explain how the big trends in the field feel on the front lines. (Diamond, 9/5)

Kaiser Health News: Assisted Living Kicks Out The Frail ’Cause ‘We Can’t Take Care Of You Any Longer’
The phone call came as a shock. Your aunt can’t transfer into memory care; we have to discharge her from this facility, a nurse told Jeff Regan. You have 30 days to move her out. The next day, a legal notice was delivered. Marilou Jones, 94, who has dementia, was being evicted from Atria at Foster Square, an assisted living facility in Foster City, Calif. The reason: “You are non-weight bearing and require the assistance of two staff members for all transfers,” the notice said. (Graham, 9/6)

The New York Times: Goop Agrees To Pay $145,000 For ‘Unsubstantiated’ Claims About Vaginal Eggs
Gwyneth Paltrow’s lifestyle brand, Goop, has agreed to pay $145,000 in civil penalties in a settlement in California after an investigation found its claims about some of the products it sells were not backed by scientific evidence, the Orange County district attorney’s office said. The settlement involved three products that Goop had promised would deliver medical benefits. Two items were “eggs” for vaginal wellness — one made of jade and another made of quartz — that the company said would balance hormones, increase bladder control and regulate menstrual cycles. Goop said the third item, Inner Judge Flower Essence Blend, “could help prevent depression,” according to the district attorney’s office. (Garcia, 9/5)

The Washington Post: Gwyneth Paltrow’s Goop Touted The ‘Benefits’ Of Putting A Jade Egg In Your Vagina. Now It Must Pay.
Specifically, the suit called out Goop's jade egg, its rose quartz egg and its “Inner Judge Flower Essence Blend” as products “whose advertised medical claims were not supported by competent and reliable science,” according to the Santa Clara County district attorney's office. For example, the flower essence blend had been marketed as a blend of essential oils that could ward off depression. And the jade eggs? They had developed a reputation — and a backlash — of their own. Last year, the Goop website published a Q&A with “beauty guru/healer/inspiration/friend Shiva Rose” touting the products under the headline “Jade Eggs for Your Yoni.” Rose described the use of the eggs as “an incredible, secret practice” by concubines in ancient Chinese temples. (Wang, 9/5)

The Associated Press: Judge Orders Quick Action On Graphic Cigarette Warnings
A federal judge is ordering the Food and Drug Administration to quickly finish writing a rule requiring graphic warnings on cigarette packages and advertisements. Judge Indira Talwani in Boston said Wednesday the FDA hasn't worked fast enough to issue new requirements after previous graphic warnings were struck down in 2012 when challenged by tobacco companies. (9/5)

Boston Globe: Mass. Judge Rules That FDA ‘Unlawfully Withheld’ Action To Require Graphic Cigarette Warnings
Her decision came in a lawsuit filed in October 2016 in Boston by eight groups representing pediatricians, cancer and heart specialists, and antitobacco activists, along with three Massachusetts pediatricians. The suit asked the court to order the FDA to comply with the 2009 law. ... In 2011, the FDA proposed a series of dramatic photos, including images of rotting teeth, curdled and blackened lungs, and a man exhaling cigarette smoke through a tracheotomy hole in his neck. But the agency was barred from using those images after legal challenges from the tobacco industry. (McDonald, 9/5)

PBS NewsHour: What’s Happened Since California Let Fewer Families Reject Vaccines
A California law that aims to limit the number of people who can refuse vaccines has led to a slight improvement in kindergartners’ vaccination rate in recent years, according to a new study in Health Affairs. But the law was not as effective in private schools, and did little to break up localized clusters of children who opted out of vaccines. (Santhanam, 9/5)

Stat: Plane Quarantined At Kennedy Airport Amid Reports Of Ill Passengers
An Emirates Airline flight was held in quarantine for a period Wednesday at New York’s John F. Kennedy International Airport after a large number of passengers and crew members reported feeling ill during the flight. Estimates of how many people were sick varied throughout the day, with an initial count of 106 people, New York City’s Acting Health Commissioner Dr. Oxiris Barbot said during a late afternoon press conference. (Branswell, 9/5)

Georgia Health News: Medicaid, ACA, Rural Crisis, Regulations: Gubernatorial Candidates Talk Health Care
The race between Secretary of State Brian Kemp, a Republican, and Stacey Abrams, a Democrat and former House minority leader, has already featured debate between them over the future of health care in the state. Georgia Health News recently asked the candidates about their views on several major health care issues. (Miller, 9/5)

Texas Tribune: Despite Cost Savings, Retired Teachers Health Care Program Still Underwater
After Texas dramatically changed the health care program for retired teachers last year, unexpectedly sending deductibles and out-of-pocket costs sky-high, thousands of retired teachers jumped ship. ...That's the chaotic scene that Tim Lee, executive director of the Texas Retired Teachers Association, described for the House Appropriations subcommittee Wednesday, during a discussion about how to provide long-term funding for TRS-CARE, the beleaguered health care program for retired teachers. (Swaby, 9/5)

Austin American-Statesman: Texas Lawmakers To Discuss Rising Retired Teacher Health Costs
Texas House lawmakers are expected to discuss Wednesday funding problems within the state health insurance program for retired teachers. Among the issues that the House Appropriations Subcommittee could discuss include a proposal by the Teacher Retirement System board to increase premiums by $600 a year for retired teachers under the age of 65. (Chang, 9/5)

The Star Tribune: Bloomington Schools Will Test 'Smart' Thermometers For Early Alerts On Sickness 
Ten Bloomington elementary schools will offer free “smart” thermometers to families this fall in the hope that online reporting of fevers will provide early warnings of illnesses and infections circulating among students. The program is one of the latest to use crowdsourcing — the tracking of consumer input on search engines, social media or mobile apps — to improve public health. (Olson, 9/5)

Arizona Republic: Mayo Clinic To Nearly Double Size Of Phoenix Campus With New Project
Citing increased patient need, Mayo Clinic in Arizona will nearly double the size of its Phoenix campus with a five-year building project set to cost $648 million. The construction project, which officials say will add 2,000 jobs by 2029, is the largest expansion in not-for-profit Mayo Clinic's 30-year history in Arizona. (Innes, 9/5)

Cincinnati Enquirer: Vaccine Shortage: New Double-Dose Shingles Vaccine Called 'Effective'
A national shortage of the new shingles vaccine and the small amounts available are affecting residents in Greater Cincinnati. ... Shingles, which is triggered by a dormant chickenpox virus, causes a painful blistering rash along with possible complications including searing nerve pain and pneumonia. It can be prevented by vaccination. (Reinert, 9/5)

The Oregonian: Unity Center Confirms 2 Deaths, Wants To Be Free Of Investigation In September
The president of Unity Center for Behavioral Health said Wednesday he expects the metro area's troubled mental health hospital to remain open and fix serious safety problems this month. ... The center, a 24-7 clinic for people in mental health crisis, opened at the end of January 2017 as a collective answer to long waits at regular hospital ERs. It's supported by four major health groups – Legacy Health, Oregon Health & Science University, Adventist Health and Kaiser Permanente -- and run by Legacy. (Harbarger, 9/5)

St. Louis Public Radio: SLU Opens First Food Pantry To Help Feed Hungry Students
Next week, SLU will open a food bank for hungry students. It joins the University of Missouri - St. Louis and St. Louis Community College, which already have food pantries in place. (Fentem, 9/5)

USA Today: I Lost My Son To The Opioid Crisis And Nothing Can Bring Him Back
Picture an NFL stadium holding a capacity crowd of 72,000. That number, according to a preliminary estimate by the Centers for Disease Control and Prevention, is about how many Americans died last year from drug overdoses. An entire stadium full of people. Our son Scott was one of those people. After a lengthy battle with opioid addiction, he suffered a fatal overdose Nov. 30. It was a Thursday night. My wife, Ellen, and I were watching the Redskins-Cowboys game from our home in the suburbs of Washington, D.C. (Bill Sternberg, 9/5)

The New York Times: Here’s A Cheap Way To Fight Drug Misuse: Send Doctors A Sharp Letter
The letters doctors received from the county medical examiner included a shocking fact: A patient you once prescribed an opioid medication has died in the last year from a drug overdose. Faced with this statistic and others on annual county prescription drug deaths from the medical examiner, doctors reduced their prescribing of opioids by just under 10 percent, compared with doctors who didn’t get a letter. (Margot Sanger-Katz, 9/5)

News Herald: Opioid Crisis Grew Unchecked
If officials and authorities would have followed the money, it should have been easy to spot the tidal wave of opioid use. Congressional committees recently brought the top executives of opioid manufacturers to Washington to explain their role in America’s opioid epidemic. Sadly, the executives largely shifted the blame elsewhere. At its peak in 2012, physicians wrote 282 million opioid prescriptions — enough for eight in 10 Americans, Politico reported. Fortunately, the latest statistics suggest the prescription surge has slowed dramatically. But the surge drove home a somber reality in this country: Opioids have been America’s national pill. The fact is that other developed nations have not experienced the spikes in opioid use, opioid abuse and opioid-related overdoses that we have in this country. That’s led hundreds of cities and localities to sue opioid manufacturers — in part to obtain funding to treat opioid abuse victims. If officials and authorities would have followed the money, it should have been easy to spot the tidal wave of opioid use. (9/4)

Detroit News: Prisons Are Overlooked In Opioid Crisis
According to the Centers for Disease Control and Prevention around 66 percent of the 63,600 drug overdose deaths in 2016 involved an opioid. In prisons and jails, dependency on opioids and use of synthetic drugs such as fentanyl, hydrocodone, and carfentanil have become increasingly common, putting the safety of staff, inmates and visitors at risk. From mail-rooms to drones in the yard, these drugs have consistently found their way into correctional institutions, leaving officers exposed and inmate consumers susceptible to the dangers of the opioid epidemic. Despite increased awareness and focus on prevention, the volume and availability of these drugs remains steady and continues to wreak havoc on the corrections system. (Andy Potter, 9/5)

The Washington Post: Republicans Keep Trying To Strip Protections For Preexisting Conditions
In a federal courtroom in Texas on Wednesday, oral arguments begin in an extraordinary lawsuit that seeks to remove the Affordable Care Act’s protections for the tens of millions of Americans with preexisting conditions, allowing insurance companies to once again deny them coverage or jack up their premiums to unaffordable rates. Who’s behind this lawsuit? Some fringe group of libertarian extremists? A bunch of socialists hoping to get the ACA struck down so that a single-payer system will rise from the ashes of the ensuing conflagration? Nope. With an exception here and there, it’s pretty much the entire Republican Party. The suit was brought by 20 Republican-run states and is being supported by the Trump administration. (Paul Waldman, 9/5)

The New York Times: Blame Emergency Rooms For The Out-Of-Control Cost Of Health Care
There are many reasons Americans pay more for health care than citizens of any other country. But one of the most powerful forces driving cost increases is buried in a little-known set of regulations concerning emergency room care.These regulations have granted hospitals what is essentially a monopoly over emergency room patients, allowing them to charge basically whatever they want. (Glenn Melnick, 9/5)

The Hill: HHS Should Look Into Azar's Close Ties To The Drug Industry
Over the next several weeks, it is anticipated that the White House will roll out its recommendations for reducing drug prices. For the millions of Americans struggling with medical costs, this proposal could determine whether or not they will be able to afford life saving drugs. The Department of Health and Human Services (HHS) is responsible for developing the administration’s drug price policy. Given the significance of this issue, it is critical that the American people have confidence that the proposed changes are based on sound policy. This is why my organization, Campaign for Accountability a nonprofit, nonpartisan watchdog group focused on public accountability, called on ethics officials at HHS to open an investigation into HHS Secretary Alex Azar and his relationship with his former employer, the pharmaceutical manufacturing giant Eli Lilly. (Daniel Stevens, 9/5)

San Antonio Press-Express: Protect Children By Vaccinating Them
The ever-increasing number of children not receiving the recommended immunizations presents a clear risk to public health. Parents, pediatricians, and all who care for children must continue to advocate for sound leadership and public policy that promotes the importance of routine immunization. (Ryan Van Ramshorst, 9/5)

New England Journal of Medicine: Protecting Mothers And Babies — A Delicate Balancing Act
More than 50 years ago, an epidemic of serious birth defects caused by prenatal exposure to thalidomide shattered the prevailing notion that the placenta served as a barrier against damaging influences and led to recognition that exposures during pregnancy can result in harm to a developing fetus. Since that time, ensuring that a pregnant woman has access to potentially lifesaving treatments while safeguarding her fetus has become a delicate balancing act, one that requires a careful evaluation of risks and benefits to both the mother and her fetus. Recent findings from Zash et al. now published in the Journal have again highlighted the need to carefully weigh both risks and benefits in developing recommendations for the treatment of pregnant women. In May of this year, the World Health Organization, the Food and Drug Administration (FDA), and other organizations released statements about a safety signal that suggested a possible link between periconceptional use of the antiretroviral medication dolutegravir and neural tube defects. (Sonja A. Rasmussen, Wanda Barfield and Margaret A. Honein, 9/6)

New England Journal of Medicine: A New Threat To Immigrants’ Health — The Public-Charge Rule
The United States is making major changes to its immigration policies that are spilling over into health policy. In one such change, the Trump administration is drafting a rule on “public charges” that could have important consequences for access to medical care and the health of millions of immigrants and their families. ...Research on federal welfare reform, local immigration-enforcement efforts, and state-level policies excluding immigrants from access to public services and benefits suggests that the new rule could have negative health consequences. It would probably result in lower rates of health insurance coverage not only for immigrants but also for their U.S.-born children and other dependents. An estimated 19% of noncitizen adults and 38% of noncitizen children were enrolled in Medicaid or CHIP in 2016.5 In addition, 5.8 million citizen children with a noncitizen parent received Medicaid or CHIP that year. (Krista M. Perreira, Hirokazu Yoshikawavand Jonathan Oberlander, 9/6)

New England Journal of Medicine: The Violence Of Uncertainty — Undermining Immigrant And Refugee Health 
Immigrants and refugees in the United States have long faced structural violence due to unequal health care access. Now they’re being subjected to “the violence of uncertainty,” enacted through systematic instability that exacerbates inequality and generates fear. (Breanne L. Grace, Rajeev Bais and Benjamin J. Roth, 9/6)

New England Journal of Medicine: Voluntary Euthanasia — Implications For Organ Donation
Canada now permits physicians to hasten the death of a patient by means of physician-assisted suicide or voluntary euthanasia. This development creates a new pathway for organ donation — and with it, some challenges. (Ian M. Ball, Robert Sibbald and Robert D. Truog, 9/6)

Kansas City Star: Are Missouri Prison Inmates Subjected To Inhumane Conditions? 
Missouri statute allows members of the General Assembly to visit state-run prisons at any time. The law overrides a directive issued by Missouri Department of Corrections Director Anne Precythe to Ronda Pash, warden at Crossroads Correctional Center, to deny entry to the prison. But the recent refusal to allow state Rep. Brandon Ellington, a Kansas City Democrat, to check on prisoners housed at the correctional facility in Cameron could be the least of the state’s concerns if a class-action lawsuit determines prison officials are subjecting inmates to inhumane conditions. (9/4)

Detroit News: Michigan Can't Let Kids Buy E-Cigs
The FDA enacted a regulation on e-cigarettes in 2016 that banned the sale of e-cigarettes with nicotine to those younger than 18. Yet, because Michigan has no state law affirming that regulation, law enforcement can’t keep kids from purchasing the nicotine-delivery devices. Though e-cigarettes for adult use should not be regulated the same as tobacco products, they should be regulated and policed like other substances that pose health risks to children. The sole purpose of an e-cigarette is to deliver nicotine to the bloodstream. Nicotine is highly addictive and can harm brain development. In addition, some of the liquids contain flavor agent like diacetyl, a compound known to cause extensive lung scarring (called popcorn lung) and cancer, according to the surgeon general. (9/5)