The New York Times: Appeals Court Seems Skeptical About Constitutionality Of Obamacare Mandate
A panel of federal appeals court judges on Tuesday sounded likely to uphold a lower-court ruling that a central provision of the Affordable Care Act — the requirement that most people have health insurance — is unconstitutional. But it was harder to discern how the court might come down on a much bigger question: whether the rest of the sprawling health law must fall if the insurance mandate does. In 90 minutes of oral arguments on whether a federal district judge in Texas was correct in striking down the Affordable Care Act in December, two appellate judges appointed by Republican presidents peppered lawyers with blunt questions while the third judge, appointed by President Jimmy Carter, remained silent. (Goodnough, 7/9)

The Washington Post: Appeals Judges Question Whether The ACA Can Stand Without Insurance Penalty
During oral arguments in a case with momentous stakes for consumers and politicians ahead of the 2020 elections, two members of a three-judge panel of the U.S. Court of Appeals for the 5th Circuit grilled lawyers representing Democratic-led states and the U.S. House to explain why the Affordable Care Act remains valid. “If you no longer have the tax, why isn’t it unconstitutional?” asked Judge Jennifer Walker Elrod, who was appointed by President George W. Bush. She and the other GOP appointee, Judge Kurt Engelhardt, named by President Trump last year, repeatedly noted that the law was written without an explicit feature guaranteeing that if one part were ever removed by Congress or the courts, the rest would remain in place. (Goldstein, 7/9)

The Wall Street Journal: Appeals Court Signals Peril For Affordable Care Act
California, leading 20 states defending the health law, argued the insurance mandate raised no constitutional problems because it is no longer enforceable without a penalty, making it more of a wish by Congress that people purchase coverage, not a command. “The individual mandate no longer requires anyone to do anything,” said California Deputy Solicitor General Samuel Siegel. Judges Elrod and Kurt Engelhardt, a Trump appointee, voiced doubts about that argument, saying the ACA still included language that requires people to carry coverage, penalty or not. Congress “left in place the mandatory nature of the mandate,” Judge Elrod said. (Kendall, 7/9)

Modern Healthcare: Appeals Court Shows Signs It Will Invalidate ACA Individual Mandate
Douglas Letter, general counsel for the House Democrats, made an impassioned argument that the Supreme Court in that 2012 case, known as NFIB v. Sebelius, which upheld the individual mandate as a tax, said "unequivocally" that the mandate is a choice, not a command. That choice remains even though the penalty was reduced to $0, he said. Still, he said the Republicans states need to show that Congress would have wanted the rest of the ACA struck down along with the mandate. Douglas insisted that under severability doctrine, the court must do what it can to save the statute. (Livingston, 7/9)

The Associated Press: Validity Of Obama Health Care Law At Issue In Appeal Hearing
It was less clear after the arguments whether the judges also would invalidate the entire health care law, as the Trump administration favors. The hearing marked the latest development in a 2018 lawsuit by 18 Republican-leaning states claiming that the absence of a tax converts the law into an unconstitutional directive to U.S. citizens to buy a product. A lower court judge ruled in December that it did, and that the entire law must fall as a result. That includes popular provisions such as protection for pre-existing conditions. (McGill and Santana, 7/9)

Politico: Appeals Court Skeptical Obamacare Can Survive
Judge Kurt Engelhardt, a Trump appointee, pointed out that Congress could settle the dispute over the health law’s future by immediately stripping out the individual mandate entirely, eliminating the basis for the lawsuit. He also questioned why the Republican-controlled Senate hasn’t weighed in on the lawsuit.“They’re sort of the 800-pound gorilla who’s not in the room,” Engelhardt said. (Demko, 7/9)

CQ: Federal Appeals Court Questions Legality Of Insurance Mandate
Justice Department attorney August Flentje faced questions about the administration’s approach to the law. He said the government would keep enforcing it until a final decision comes. Elrod asked about the possibility of striking down the law only in the states where officials joined the lawsuit. “That raises complicated issues and we are appreciative of the existence of the stay until there’s a final ruling,” Flentje said. (McIntire, 7/9)

Texas Tribune: Texas Asks Federal Appeals Court To Declare Obamacare Unconstitutional
Most of the unusually large courtroom audience of journalists and interested but unaffiliated attorneys focused on Elrod at the center. By far the most vocal judge of the three, Elrod probed both sides on the issue of standing — whether they have the right to participate in the lawsuit at all. And she appeared highly focused on her court’s options for ordering a remedy, seeming to weigh options for sending the case back to a lower court for further consideration. Engelhardt, who is among the newest appointees to the court, was harsh and occasionally sarcastic, asking more questions of the blue state coalition than he did of the Texas-led team. He seemed skeptical of the standing of both the California-led coalition and the Democratic-majority U.S. House of Representatives, which intervened in the case although the Republican-majority U.S. Senate did not. (Platoff, 7/9)

Bloomberg: Obamacare Mess Irks Judges. It’s Complicated, U.S. Lawyer Admits
“Why does Congress want the judiciary to be a taxidermist for every big-game legislative accomplishment it achieves?” the rookie on the panel, Kurt Engelhardt, an appointee of President Donald Trump, asked the lawyer representing the U.S. House of Representatives during a lively hearing in New Orleans. (Calkins, 7/9)

ABC News: Judges Grill Obamacare Defenders Over Individual Mandate
Legal analysts see three possible outcomes in the appeals case: the court could affirm the lower court ruling, striking down the individual mandate and the entire ACA as unconstitutional; it could invalidate the mandate alone and sever it from the rest of the law, leaving much of the ACA in place; or it could leave the law functioning as-is. "As it stands today, the Affordable Care Act presents a stand-alone command to buy an insurance product that the federal government deems suitable and it does so without raising even a dime of revenue," argued Texas solicitor general Kyle Hawkins. "The text of the ACA declares that mandate essential to the law and the goals that Congress wanted to achieve. " (Dwyer, 7/9)

CNN: Republican-Appointed Judges Appear To Side With Texas Challenge To Obamacare
If the challenge to the Affordable Care Act ... is upheld, it would do what Trump and a GOP-led Congress failed to accomplish in 2017: take down Obamacare. And while Trump has repeatedly said that people with pre-existing conditions, such as cancer and diabetes, would be covered even if the law is struck down, he has not issued any specific plans to do so. (Luhby, Berman and Biskupic, 7/9)

Los Angeles Times: Federal Appeals Court Appears Skeptical Of Obamacare, Putting Future Of Law In Doubt
That would set the stage for another showdown before the Supreme Court, which has twice in the last decade been called upon to rule on the landmark law, often called Obamacare. Such a ruling could also prolong uncertainty over the fate of health coverage for tens of millions of Americans who depend on the law for health insurance and other protections, including the ban on insurers denying coverage to people with preexisting medical conditions. (Levey, 7/9)

CNBC: Health Stocks Fall Before Arguments On Constitutionality Of Obamacare
U.S. District Judge Reed O’Connor of the Northern District of Texas ruled in December that the entire health law was unconstitutional because of the move by Congress in 2017 to eliminate the so-called individual mandate penalty. The mandate imposed a tax penalty on uninsured taxpayers and was considered a cornerstone of the ACA legislation. A coalition of Democratic state attorneys general, led by California’s Xavier Becerra, appealed the lower court ruling. The Justice Department later said it supported the federal judge’s ruling but has changed its position, slightly. (Lovelace, 7/9)

The Hill: Appeals Court Seems Unsure On Whether ObamaCare Mandate Is Constitutional
Robert Henneke, who represents a set of private business owners who are on the case as plaintiffs alongside the GOP states, said he was optimistic about the outcome. “Today’s arguments seem to have gone very, very well,” Henneke said in a phone call with reporters. (Weixel, 7/9)

CNN: How John Roberts's Signature Opinion Saving Obamacare Can Still Doom It
Chief Justice John Roberts saved Obamacare in 2012 by calling it a tax. Now, his core argument is helping power a Republican-led legal challenge that threatens to sweep away the entire law. ... Roberts, a 2005 appointee of Republican George W. Bush, forged a compromise in 2012 with the four Supreme Court liberal justices to uphold the signature domestic achievement of Obama. In dramatic moves behind the scenes, Roberts shifted multiple times in that landmark Obamacare challenge. After the 2012 case was argued, Roberts was part of a five-justice majority that wanted to strike down the individual insurance mandate. But he became wary of voiding a significant part of the law that was years in the making and reconsidered. (Biskupic, 7/10)

The New York Times: So You Want To Overturn Obamacare. Here Are Some Things That Would Be Headaches.
It’s not just that 21 million people would probably lose health insurance, or that 133 million Americans with pre-existing conditions would lose their protection. Those effects would be the major focus of attention if the Affordable Care Act were to be struck down. But the law was much, much broader, affecting a wide range of health programs, even some areas you might not think of as related to health. Overturning the entire law would mean all of its parts, in theory, would go away at once. (Sanger-Katz, 7/10)

PBS NewsHour: Why Current Court Battle Represents Existential Threat To Obamacare
John Yang talks to Axios' Sam Baker about the legal test and how the law's provisions extend beyond individual health insurance. (7/9)

The CT Mirror: Dems Aim To Turn Legal Attack On The ACA Into A Political Weapon
Democrats’ political embrace of the ACA with its protections for people with pre-existing conditions and its expansion of Medicaid — known as HUSKY in Connecticut — has been a long time coming. Controversy over the ACA, fueled by Tea Party opposition, cost Democrats politically in the years right after the law was passed in December of 2009. (Radelat, 7/9)

New Hampshire Public Radio: Sununu To Sign Bill To Protect Health Coverage For Those With Pre-Existing Conditions
A key portion of the federal Affordable Care Act that gives protection to people with pre-existing conditions will soon be enshrined in New Hampshire state law. Republican Governor Chris Sununu said Tuesday he intends to the sign the bill authored by Senate Democrats. (Moon, 7/9)

In other health law news —

The Star Tribune: Minnesota Health Insurers Seek Small Rate Increases 
Three of Minnesota's primary health insurers in the individual market are seeking relatively modest rate increases for 2020, while a fourth carrier is seeking an average rate decrease. The proposed rates released by the state Commerce Department on Tuesday apply to the state's individual market, where about 141,000 people were buying coverage last year. It is a market that has been highly volatile over the past five years with changes driven by the federal ­Affordable Care Act (ACA), but the numbers released Tuesday are yet another sign of relative stability. (Snowbeck, 7/9)

California Healthline: With ACA’s Future In Peril, California Reins In Rising Health Insurance Premiums
Premiums on California’s health insurance exchange will rise by an average of 0.8% next year, the lowest increase in the agency’s history, state officials announced Tuesday. Covered California Executive Director Peter Lee credited two new statewide initiatives for keeping the proposed rate hikes low: Next year, California will be the first state in the country to offer state-funded tax credits to middle-class enrollees, which will be paid for in part by a new tax penalty on Californians who don’t have health insurance. (Feder Ostrov and Ibarra, 7/9)

Stat: Top Trump Advisers Hint At Support For Progressive Drug Pricing Idea
A trio of key White House advisors on Tuesday hinted for the first time that they could support a progressive proposal to cap price increases for certain medicines, speaking at a closed-door Capitol Hill briefing of Republican senators. Health secretary Alex Azar joined Joe Grogan, the president’s top policy adviser, to encourage senators to pursue bipartisan legislation on drug pricing and potentially to include one idea from Sen. Ron Wyden (D-Ore.) that would cap some drug price hikes at the rate of inflation, according to senators who attended. (Facher and Florko, 7/10)

The Hill: GOP Senators Raise Concerns Over Potential Deal To Lower Drug Prices
Republican Senators and Trump administration officials met Tuesday morning to debate a potential deal to lower drug prices, with some attendees raising concerns about a possible agreement with Democrats. Senate Finance Committee Chairman Chuck Grassley (R-Iowa) held the meeting with GOP committee members to discuss a possible agreement that he has been negotiating for months with Sen. Ron Wyden (Ore.), the top Democrat on the panel. (Sullivan, 7/9)

The Hill: Trump Officials Seek Plan B On Drug Pricing Rule
The Trump administration suffered a blow when a federal judge blocked a key rule about drug price disclosures just hours before it was scheduled to take effect. U.S. District Judge Amit P. Mehta in Washington, D.C., on Monday sided with a coalition of drug companies and blocked the Trump administration from implementing a policy that would require prescription drug manufacturers to disclose list prices in TV ads. (Weixel, 7/9)

In other pharmaceutical news —

Stat: 23andMe’s Chief Scientific Officer, A Star In Drug Development, Is Leaving Role
The chief scientific officer at 23andMe is leaving his role at the consumer genetics company, four years after his arrival helped energize its move toward drug discovery. Richard Scheller, a Genentech veteran, has joined the Palo Alto, Calif.-based BridgeBio (BBIO) as chairman of research and development, according to Securities and Exchange Commission filings. Scheller remains on 23andMe’s board of directors. (Sheridan, 7/9)

The Associated Press: Trump Revamps Kidney Care To Spur Transplants, Home Dialysis
President Donald Trump is directing the government to revamp the nation's care for kidney disease to give more people with failing kidneys a chance at early transplants and home dialysis. Trump is set to sign an executive order Wednesday aimed at saving lives and millions of Medicare dollars. Senior administration officials tell The Associated Press that the order also is designed to ease financial hardship for living donors and help organizations collecting deceased donations do a better job. (7/10)

The Washington Post: Trump To Order Overhaul Of Organ Transplant And Kidney Dialysis Systems
“These are all good ideas. I’m impressed, very impressed,” said Tommy Thompson, who worked to boost organ donation when he was secretary of health and human services under President George W. Bush. “They are finally modernizing organ procurement.” The executive order the president is expected to unveil Wednesday, first reported by Politico, is one of a series of health- care initiatives Trump is announcing in the run-up to the 2020 presidential election. Several of the Department of Health and Human Services rules have been held up by court fights or budgetary concerns. (Bernstein and Kindy, 7/9)

Bloomberg: Trump Targets Dialysis, Kidney Transplants In Care Overhaul
President Donald Trump will announce an overhaul of the U.S. approach to care for people with kidney disease on Wednesday, an effort intended to move more patients out of costly dialysis centers and increase transplants. Trump will direct Medicare to adjust payments for treatment of kidney disease to encourage patients to undergo dialysis at home, a person familiar with the plan said. Administration officials hope his proposal will also produce an additional 17,000 kidney transplants a year, the person said. (Darie and Jacobs, 7/9)

The Wall Street Journal: Rifts Emerge Over Congressional Move To Curb Surprise Medical Bills
A Congressional plan to tackle surprise medical bills is spurring a furious lobbying campaign and disagreements among Republican lawmakers that could make it difficult to pass the legislation this month. Measures protecting patients from high hospital bills from out-of-network doctors and other health providers has the backing of President Trump, who in May urged lawmakers to take action. Senate Health Committee Chairman Lamar Alexander (R., Tenn.) is hoping the full Senate will vote this month on a plan that would address surprise bills, after his committee approved it in late June. (Armour and Peterson, 7/10)

Politico Pro: House E&C Subcommittee To Mark Up Bipartisan Surprise Medical Bill lLegislation
House Energy and Commerce leaders late today released revised legislation addressing "surprise" medical bills ahead of a Thursday markup in the panel's health subcommittee. The revised bill doesn’t include major policy differences from an earlier draft. The plan from Chairman Frank Pallone (D-N.J) and ranking member Greg Walden (R-Ore.) would resolve payment disputes between providers and health plans by establishing a federal benchmark rate, an approach doctors and hospitals oppose. (Roubein, 7/9)

Meanwhile, in California —

The Associated Press: California Takes On Surprise Bills, Over Hospital Objections
Lawmakers in Congress and state legislatures across the country have proposed bills to fix problems like this, especially in emergency situations where patients often cannot choose what hospital treats them. While most people agree patients should not have to pay in these situations, there's little agreement on who should. It's a debate now playing out in the California Legislature that's pitting insurance companies and hospitals against each other. A bill by Assemblyman David Chiu, a San Francisco Democrat, would make sure emergency patients never pay more than their copays or deductibles, even if they are treated at an out-of-network hospital. But the bill would cap what hospitals can charge insurance companies, because advocates and some lawmakers view hospitals as a monopoly with too much power over prices. Chiu said his goal is to keep insurance rates from skyrocketing. (Beam, 7/9)

The New York Times: Why Women Getting Abortions Now Are More Likely To Be Poor
Abortion access in America is narrowing. There are fewer clinics, longer drives and more restrictions earlier in pregnancy. But something else is different: The women themselves. Women getting abortions today are far more likely to be poor than those who had the procedure done 20 years ago. Half of all women who got an abortion in 2014 lived in poverty, double the share from 1994, when only about a quarter of the women who had abortions were low-income, according to the Guttmacher Institute, a research group that supports abortion rights and conducts a national survey of abortion patients every six years. (Tavernise, 7/9)

Boston Globe: Who Gets Abortions In Massachusetts? Here’s What The Data Show
There were 18,256 abortions in Massachusetts last year, according to the Massachusetts Registry of Vital Records and Statistics, which tracks the data. The annual number has dropped dramatically over time, after peaking at 44,044 in 1979. Here’s a look at who is getting abortions, at what ages, and in what circumstances, based on newly released 2018 data from the registry. (Ebbert, 7/9)

In other news on abortion —

Vox: A Boom In At-Home Abortions Is Coming
After Marie decided to take medication to end her pregnancy, it took several days for the pills to work. When the uterine contractions started, Marie recalled, she experienced “a lot of bleeding, a lot of pain, a lot of cramps. Just like a bad cycle.” (Marie asked that her last name not be used because of legal concerns.) She used a sock filled with rice, heated in the microwave, as a heating pad to relieve the cramps, and put on soothing music to help her calm down. One thing she didn’t do was call her doctor. (North, 7/9)

The Associated Press: Abortions Halted At Arkansas Clinic While New Site Sought
Planned Parenthood says it's stopped providing medication-induced abortions at its facility in northwest Arkansas while it seeks a new location, leaving the state for now with two abortion providers. Planned Parenthood Great Plains Chief Executive Officer Brandon Hill said in a court filing over the weekend that the organization stopped providing abortions at its health center in Fayetteville, located 140 miles northwest of Little Rock, while it looks for a new site. (DeMillo, 7/9)

The Associated Press: Number Of Abortions In South Dakota Continues To Decline
The number of abortions performed in South Dakota declined 23% in 2018 compared to the previous year, according to the state Department of Health's annual report on the procedure. It was the sharpest one-year decline in a decade. The report shows 382 induced abortions were performed in the state in 2018, compared to 497 in 2017. Following the decrease, Gov. Kristi Noem signed a package of bills aimed at further reducing abortions in South Dakota. Noem said after signing the bills last March that they would "crack down on abortion providers in South Dakota" by requiring providers to use a state form women must sign before they can end a pregnancy. (7/9)

The Associated Press: California OKs Benefits To Immigrants In Country Illegally
California has become the first state to offer taxpayer-funded health benefits to young adults living in the country illegally. Democratic Gov. Gavin Newsom signed a bill into law on Tuesday that makes low-income adults age 25 and younger eligible for the state's Medicaid program regardless of their immigration status. (7/9)

NPR: California Approves Law Giving Health Benefits To Undocumented Adults
On Tuesday, Newsom said the state law draws a sharp contrast with Trump's immigration policies. "If you believe in universal health care, you believe in universal health care," Newsom said. "We are the most un-Trump state in America when it comes to health policy." In California, extending health benefits to undocumented immigrants is widely popular. A March survey conducted by the nonpartisan Public Policy Institute of California found that almost two-thirds of state residents support providing coverage to young adults who are not legally authorized to live in the country. (Allyn, 7/10)

Los Angeles Times: Are Democrats Helping Trump By Promising Healthcare To Undocumented Migrants?
With a sharp left turn, Democrats are risking a backlash on an issue of raw emotional and political sensitivity: providing government healthcare to millions of people in the country illegally. Ten of the party’s nearly two dozen presidential candidates stood on a debate stage last month and, without hesitation, raised their hands pledging themselves to the policy shift. Most others in the field have also expressed their support. “This is not about a handout,” said South Bend., Ind., Mayor Pete Buttigieg. “This is an insurance program. We do ourselves no favors by having 11 million undocumented people in our country be unable to access healthcare.” (Barabak and Levey, 7/9)

Marketplace: Here's How It Works If You're Undocumented And Need Health Care
People in the country illegally are, for the most part, barred from enrolling in Medicaid or Medicare. They can’t buy insurance through the Affordable Care Act marketplace because that would be publicly subsidized. But if an undocumented person can afford it, they can purchase their own, unsubsidized insurance. (Uhler, 7/9)

The New York Times: Border Arrests Drop By 28% In June In First Decline Of The Year
Arrests at the southwestern border dropped by 28 percent in June, according to the Department of Homeland Security, signaling the first time this year that the number of border crossings declined. The department said that 104,344 arrests occurred in June, down from 144,278 in May — the highest monthly total in 13 years. It credited the drop to the security forces Mexico deployed to prevent migrants from reaching the United States border and the expansion of a program that forces migrants to wait in Mexico as their immigration cases are processed. (Kanno-Youngs, 7/9)

The Associated Press: Border Numbers Drop Amid Heat, Mexico Crackdown
The decline comes amid renewed outcry over squalid conditions for migrant children crammed into facilities not meant to hold them longer than 72 hours. Some are kept for weeks because of delays in the system. The monthly border apprehension numbers have become a yardstick by which President Donald Trump measures the success of his administration’s efforts to reduce immigration, his signature issue. The number of families from Central America has risen dramatically under his term despite his hardline policies. (Long, 7/9)

NPR: Drop In Migrant Flow Across U.S.-Mexico Border In June
Still, the number of migrants DHS reported taking into custody remains high. DHS noted that that the total number of apprehensions in the first six months of this year is 140% higher than the same period last year. "We are still in an ongoing border security and humanitarian crisis," the department said in a statement. "We are past the breaking point and in a full-blown emergency. This situation should not be acceptable to any of us." (Burnett and Rose, 7/9)

The Associated Press: Most Attackers Made Threats Before Incident, Report Finds
One-third of the attackers who terrorized schools, houses of worship or businesses nationwide last year had a history of serious domestic violence, two-thirds had mental health issues, and nearly all had made threatening or concerning communications that worried others before they struck, according to a U.S. Secret Service report on mass attacks. (Long, 7/9)

Reuters: Most Perpetrators In 2018 Mass Attacks Made Threats: U.S. Secret Service
Two-thirds of the attackers also had a history of mental health issues and half were motivated by workplace or personal grievances, the agency said in a report published by its National Threat Assessment Center. "The violence described in this report is not the result of a single cause or motive," it added. "The findings emphasize, however, that we can identify warning signs prior to an act of violence." (O'Brien, 7/9)

CBS News: Secret Service Report On Mass Violence Emphasizes Prevention
In its yearlong study, researchers from the Secret Service's National Threat Assessment Center examined 27 violent attacks in public spaces like offices, schools, and places of worship across 18 states to identify "key information that will enhance efforts to prevent" future incidents of mass violence. The incidents examined included the Parkland school shooting, the killing of five journalists at the office of a Maryland newspaper and a deadly shooting at a bar in Thousand Oaks, California. Between January and December 2018, 91 people were killed and 107 more were injured as a result of the incidents outlined in the report. According to its findings, 24 of the 27 attacks were carried out using firearms and 93% of the attackers were male. Three of the attackers used vehicles to inflict harm. (Legare, 7/9)

CNN: A New Report On Mass Attacks In The US Shows Common Traits Among Assailants
The findings emphasize the need for anyone who hears a threat to speak up, said acting Homeland Security Secretary Kevin McAleenan. He said prevention is a "community effort." "While not every act of violence can be prevented, the MAPS report indicates we can do much more to prevent targeted violence together when appropriate systems are in place," he said. (Yan and Shortell, 7/9)

NBC News: Secret Service Report Finds Mass Attackers Leave Warning Signs Before Violence
Among the other findings: 24 of the 27 attacks were carried out with firearms, mostly at places of business, and more than half ended within five minutes. The average attacker was a 37-year-old man, and some kind of grievance was the motivating factor, rather than ideology. In 11 of the cases, the attackers appeared to have selected their targets in advance, such as the man who killed 11 people at a Pittsburgh synagogue in October. This was the second analysis by the Secret Service of mass attacks. Its report from a year ago found that most attacks in 2017 were motivated by workplace or domestic issues, and that more than three-fourths of them had made threatening or concerning communications. (Williams, 7/9)

USA Today: Mental Illness And Threatening Messages Often Come Before Mass-Casualty Attacks, Secret Service Finds
Social workers, mental health counselors, school administrators and law enforcement all had been warned about Nikolas Cruz's deteriorating mental state and risk of violence before he launched the attack that killed 17 and injured 17 others. About a month before the attack, the FBI received a tip about Cruz and his "desire to kill people," but the information was never forwarded for investigation, the bureau later confirmed. (Johnson, 7/9)

The New York Times: A Gun-Focused Special Session In Virginia Ends Abruptly
In the grim aftermath of the mass shooting in Virginia Beach in May, Gov. Ralph Northam insisted it was time for action. Thoughts and prayers were not enough, he said, as he called for a special session of the Virginia General Assembly to consider a raft of gun control proposals. That special session began on Tuesday around noon. An hour and a half later, it was over. The House and Senate voted along party lines to adjourn until November. (Robertson, 7/9)

The Washington Post: Gun Debate Ends Abruptly In Virginia As GOP-Controlled Legislature Adjourns After 90 Minutes
Gov. Ralph Northam (D) ordered the session in the wake of the May 31 mass shooting at a Virginia Beach municipal building in which 12 people were killed. Lawmakers had filed some 30 bills aimed at restricting gun use or lethality or stiffening penalties for gun law violations. Republican leaders in the state House and Senate said they would refer all bills to the bipartisan Virginia State Crime Commission for study and recommendation, and then reconvene Nov. 18 — after a high-stakes state election in which all 140 legislative seats are on the ballot. (Schneider, Vozzella and Olivo, 7/9)

CNN: Virginia Session To Debate Gun Control Adjourns Without Action
"It is shameful and disappointing that Republicans in the General Assembly refuse to do their jobs, and take immediate action to save lives," Northam said in a statement Tuesday. "I expected better of them. Virginians expect better of them." (Stracqualursi, 7/9)

The Roanoke Times: General Assembly Adjourns With No Action On Gun Bills, Election 4 Months Away
House Speaker Kirk Cox, R-Colonial Heights, called Northam’s decision to call a special session an “election-year stunt.” Senate Majority Leader Thomas Norment, R-James City, said Northam chose “politics over policy.” Sen. Mark Obenshain, R-Rockingham, called it a “gut reaction.” “We owe more to the people of Virginia,” Obenshain said at a news conference after the legislature adjourned. (Friedenberger, 7/9)

USA Today: Gun Laws: Virginia Considers Plan To Ban Assault Weapons
Gun control supporters had hoped the special session would energize their efforts nationwide to turn the tide against the "corrosive influence" of the gun lobby. Kris Brown, president of the Washington-based Brady gun control group, described the state's GOP leadership as "nothing short of cowards" who could have set an example for the nation. "If these 'leaders' won't enact solutions that their own constituents are demanding, then we're going to fight tooth and nail for representatives who will," Brown said. (Bacon, 7/9)

The Virginia Pilot: Republican Lawmakers Vote To Adjourn Special Session On Guns Without Debating Legislation
The votes to adjourn came after hundreds of people gathered near the Capitol to urge new gun control laws they hoped would prevent future mass shootings. Hundreds more asked lawmakers not to restrict Second Amendment rights, with some saying none of the bills proposed would have prevented a gunman from killing 12 people in Virginia Beach on May 31. (Albiges and Coutu, 7/9)

The Washington Post: Amid Bitter Divisions On Gun Control In Virginia, Moments Of Understanding
One man held an AR-15 semiautomatic rifle and wore a black “Make America Great Again” hat. The other man held a sign with a picture of two arms in an embrace and the caption “The only arms we need” and wore a blue hat that said “Make America Obama Again.” They were caught Tuesday morning outside the Virginia State Capitol between hundreds of anti-gun protesters on one side and a long line of gun rights activists on the other. And they began to talk. (Schneider and Vozzella, 7/9)

The New York Times: C.D.C. Investigates Rare Type Of Paralysis In Children
Last year, health officials confronted a record number of cases of a rare, mysterious neurological condition that caused limb weakness and paralysis in more than 200 children across the country. Officials with the Centers for Disease Control and Prevention said on Tuesday that they were still trying to understand the condition, called acute flaccid myelitis, or A.F.M. And though there have been very few cases so far this year, they urged doctors to be on the lookout because the illness has tended to emerge in late summer and early fall. (Belluck, 7/9)

Stat: With A Surge In Cases Of Mystery Condition, CDC Seeks Help To Crack Case
The Centers for Disease Control and Prevention on Tuesday appealed to doctors to rapidly report suspected cases of a mysterious ailment that afflicts young children, saying delays in identifying possible cases of acute flaccid myelitis, or AFM, are hindering the search for the condition’s cause. Every two years since 2014, a surge of the polio-like illnesses has struck a number of young children across the country, leaving them with weakened limbs. Efforts to find the cause of the phenomenon have pointed to viral infections as a possible culprit, but to date no one virus has been clearly implicated. (Branswell, 7/9)

CNN: Polio-Like Illness AFM: 11 Confirmed Cases In Eight States So Far In 2019
"AFM is a devastating illness for patients and their families," Dr. Anne Schuchat, CDC's principal deputy director, told reporters Tuesday. "We know families are facing uncertainties when it comes to their child's recovery from AFM, and we want parents to know that we are keeping their children front and center and working with our partners to better understand this illness, its risk factors and ways to treat and prevent it." (Nedelman, 7/9)

Bloomberg: Mystery Child Virus Stirs Fresh U.S. Concern On Possible Return 
The first sign of what scientists are calling acute flaccid myelitis, or AFM, occurred in 2014, amid an outbreak of a severe respiratory infection caused by the EV-D68 virus. Most of the affected children were healthy until an infection caused fever or cold symptoms about a week before they started losing muscle strength, said officials with the U.S. Centers for Disease Control and Prevention. There have been about 570 cases to date. (Cortez and Ward, 7/9)

Stat: CDC Made A Synthetic Ebola Virus To Test Treatments. It Worked
Scientists at the Centers from Disease Control and Prevention have created a synthetic version of the Ebola virus circulating in the Democratic Republic of the Congo, part of an effort to determine whether diagnostic tests and experimental treatments being used in the field are effective. The research, conducted in the agency’s most secure laboratories — BSL4 — showed that even though the tests and two of the treatments being used in the field were developed based on earlier variation of Ebola viruses, they continue to be effective against the virus causing the current outbreak, the second largest on record. (Branswell, 7/9)

The Associated Press: In US Baby Is Born From Dead Donor’s Transplanted Womb
The Cleveland Clinic says it has delivered the first baby in North America after a womb transplant from a dead donor. Uterine transplants have enabled more than a dozen women to give birth, usually with wombs donated from a living donor such as a friend or relative. In December, doctors in Brazil reported the world’s first birth using a deceased donor’s womb. These transplants were pioneered by a Swedish doctor who did the first successful one five years ago. (7/9)

The New York Times: How Music Can Rev Up A High-Intensity Workout
Cuing up some Calvin Harris or Macklemore during short, intense workouts might change how we feel about the exercise, according to a useful new study of how listening to jaunty music can encourage us to push ourselves harder. The study also found, though, that other types of distractions, such as podcasts, may not have the same effect. High-intensity interval workouts are quite popular at the moment, touted by trainers, coaches, scientists and this column as a way to exercise effectively without investing much time. (Reynolds, 7/10)

NPR: Beat Bedbugs With Heat And Hotel Vigilance
Summer is a time of travel and fun. But with every bed an exhausted traveler falls into after a day of sightseeing, the chances of bringing home an unwanted bug increase. Bedbugs don't fly or jump or come in from your garden. They crawl very quickly and are great at hiding in your luggage when you travel and hitching a ride into your home — or hotel room. (Quiros, 7/9)

KCUR: ‘Get Your Peanut Dust’: Kansas City Doc Prescribes Tiny Doses Over Months To Treat Peanut Allergies 
When Porter Hall of Raymore, Missouri, was a year old, he broke out in hives after eating a spoonful of peanut butter. It led to a scary night in the emergency room and a diagnosis of peanut allergy. But today, Porter, who’s now five, is giving peanuts another shot with the help of Kansas City doctors, who have been giving him tiny doses of peanuts over the course of months. This oral immunotherapy treatment isn’t a cure, but doctors say these tiny exposures may help to reduce or prevent severe reactions – although some critics are warning families to consider the risks. (Smith, 7/10)

KCUR: If You Thought Vaping Was Safe, Kansas Researchers Have Bad News 
Many people figure vaping spares their health because it lets them inhale nicotine in aerosols instead of sucking in smoke from burning cigarettes. New research from the University of Kansas casts doubt on that, raising the specter that vaping nicotine may cause some of the same respiratory problems that plague and even kill smokers today. (Llopis-Jepsen, 7/9)

St. Louis Public Radio: Kansas City Activist Says 'I'm Ready To Be More Of Who I Am' About Her Transition
For many in the transgender community, use of their birth name to refer to them after they have transitioned is a no-no, a sign of disrespect. But Merrique Jenson, a transgender woman working in the LGBTQ community, knows she is in a unique situation. She started her transition in October, but she is best known, both in Kansas City and nationally, as Randall Jenson. A recent study estimated that there are approximately 1.4 million transgender adults in America. (Johnson, 7/9)

The Associated Press: A Peek Into Opioid Users' Brains As They Try To Quit
Lying inside a scanner, the patient watched as pictures appeared one by one: A bicycle. A cupcake. Heroin. Outside, researchers tracked her brain's reactions to the surprise sight of the drug she'd fought to kick. Government scientists are starting to peek into the brains of people caught in the nation's opioid epidemic, to see if medicines proven to treat addiction, like methadone, do more than ease the cravings and withdrawal. Do they also heal a brain damaged by addiction? And which one works best for which patient? (7/9)

Reuters: Trump Administration Drug Officials Clash Over How To Combat Fentanyl Copycats
Trump administration officials are divided over part of a proposal to crack down on illicit versions of fentanyl, the deadly synthetic painkiller that U.S. President Donald Trump targeted in declaring a national opioid abuse emergency. In an inter-agency dispute that highlights the challenges of curbing opioid abuse, the U.S. Drug Enforcement Administration (DEA) is publicly backing tighter rules for fentanyl analogues, which are slightly altered copycat versions of the powerful drug fueling an explosion in overdoses. (7/9)

Modern Healthcare: CMS Policy Change Improved Addiction Treatment Access
The CMS' push for Medicare plans to reduce preauthorization barriers to medication-assisted treatment for patients with opioid use disorders has worked very well, according to a new study. Now the agency should apply similar pressure on Medicaid and private health plans, which cover a far larger number of Americans with addiction treatment needs, the researchers recommend in a study published in JAMA. (Meyer, 7/9)

Pioneer Press: Minnesota Opioid Deaths Decreased In 2018. Has State Turned The Corner In Drug Battle?
The number of Minnesotans who died of an opioid overdose decreased in 2018, putting an end to a streak of increases that spanned close to a decade. There were 331 opioid overdose deaths last year, down from 422 in 2017, according to preliminary data released Tuesday by the state Health Department. The decline was driven by decreases in deaths that involved prescription opioid painkillers and heroin. ...The overall number of drug overdose deaths in the state declined from 733 in 2017 to 607 in 2018. Deaths from methamphetamine leveled out while overdoses from cocaine and benzodiazepines decreased. (Faircloth, 7/9)

MPR: Numbers Suggest Progress On Opioid Fight
State health officials say new data suggest progress is being made in the opioid epidemic with preliminary numbers released Tuesday showing a significant drop in opioid overdose deaths from 2017 to 2018. Minnesota Commissioner of Health Jan Malcolm stressed that last year's numbers are still preliminary. (Zdechlik, 7/9)

Boston Globe: Stop Sending Men To Prison For Addiction Treatment, Group Recommends
A state advisory commission has recommended that the Legislature put an end to the practice of incarcerating men who are civilly committed for addiction treatment. The nonbinding recommendation by the Section 35 Commission, released this week, may bolster proposed legislation requiring that those ordered into treatment receive care at a licensed facility. (Freyer, 7/9)

Bloomberg: DNA-Testing Service Exposed Thousands Of Customer Records Online 
DNA-testing service Vitagene Inc. left thousands of client health reports exposed online for years, the kind of incident that privacy advocates have warned about as gene testing has become increasingly popular. More than 3,000 user files remained accessible to the public on Amazon Web Services cloud-computer servers until July 1, when Vitagene was notified of the issue and shut down external access to the sensitive personal information, according to documents obtained by Bloomberg. The genealogy reports included customers’ full names alongside dates of birth and gene-based health information, such as their likelihood of developing certain medical conditions, a review of the documents showed. (Grant, 7/9)

Stat: 5 Questions About Deploying Voice Recognition Technology In Health Care
Voice assistant technologies like Amazon Alexa and Google Assistant are increasingly popular  — today, nearly 25% of U.S. households own a smart speaker — and health care providers are taking notice. A host of health care companies and researchers are hoping the same technology can help make doctors’ jobs easier and better — particularly when it comes to filling out electronic health records, which was found to take up more than half of a physician’s average 11-hour workday. (Hailu, 7/10)

Modern Healthcare: Advocate Aurora, One Medical To Expand Membership-Based Care
Advocate Aurora Health is partnering with One Medical to expand membership-based primary care in the Chicago area. Under the deal, the terms of which are confidential, 28-hospital Advocate Aurora will be the preferred chain for One Medical's three existing Chicago clinics, as well as future locations the organizations open together. San Francisco-based One Medical operates a membership model, in which local patients pay $199 annually for access to primary care doctors. (Goldberg, 7/9)

Modern Healthcare: Beaumont Makes Deal To Acquire Ohio's Summa Health
Southfield, Mich.-based Beaumont Health has signed a letter of intent to acquire Akron, Ohio-based Summa Health, a deal that would add four hospitals and a health insurance operation to Beaumont as a wholly owned subsidiary, officials for the health systems told Crain's. It would be the first purchase of a healthcare company outside of Southeast Michigan for Beaumont and one of only a few outside of the state by a Michigan-based healthcare company. Early last year, Grand Blanc-based McLaren Healthcare completed the acquisition of MDWise, an Indiana-based HMO. (Greene, 7/9)

Modern Healthcare: Berkeley Research Group Closes On Prism Healthcare Partners Purchase
Berkeley Research Group announced Tuesday it has closed on its acquisition of fellow healthcare consultancy Prism Healthcare Partners, just two months after the deal was first announced. The combined company, BRG | Prism Healthcare, will retain BRG's Emeryville, Calif., headquarters and will have annual revenue exceeding $225 million. (Bannow, 7/9)

Chicago Tribune: ’A Lack Of Mental Health Services Has Plagued Chicago For Decades’: Holy Cross Hospital Expanding To Fill That Void On The Southwest Side 
Now, Holy Cross Hospital on the city’s Southwest Side seeks to address the issue with the opening of a $6.5 million unit this week to treat patients experiencing mental health crises. The 12,000-square-foot unit, housed mostly in new construction on the east side of the hospital, can treat up to 32 patients at a time. It will accept patients brought by ambulances and police as well as walk-ins and people sent from the hospital’s emergency room. Patients will be able to get treatment in the unit for up to a day before being connected with other services or admitted to the hospital, if necessary. (Schencker, 7/10)

The Wall Street Journal: Rhode Island Looks To Lift Providence’s Failing School District
Brown tap water. Student brawls. Chronically absent teachers. Test scores that rank among the worst in the country. The public school district here is full of deplorable conditions, according to a recent scathing report by the Johns Hopkins Institute for Education Policy. Now the capital city, proud of its downtown renaissance, restaurants and arts scene, faces a painful reckoning as it debates what to do with a failing school system that serves 24,000 children, who are mostly poor and Hispanic. (Brody, 7/10)

North Carolina Health News: As Legislators Debate Medicaid Expansion, Josh Stein Defends The Law That Makes It Possible 
As North Carolina lawmakers focused on health care policy on the home-front for much of Tuesday, Josh Stein, the state attorney general, honed in on what’s happening on the national stage. Oral arguments began earlier that day in a federal courtroom in New Orleans over a Texas-based lawsuit that could ultimately bring an end the Affordable Care Act and cause mass upheaval in the health care industry. (Blythe, 7/10)

Seattle Times: Parents Of Seattle Children’s Patient Look For Reassurances As It Restarts Surgeries After Clearing Mold That Killed 1 
It wasn’t the first time the mold had appeared at Children’s: The hospital detected it last summer as well. When The Seattle Times inquired about the more recent operating-room closures, Children’s disclosed that since 2018, six surgical patients had been infected, one of whom died. Aspergillus is a common mold found outdoors and indoors, and people breathe it daily without getting sick, according to the CDC. But people with lung disease or weakened immune systems, and especially organ- or stem-cell-transplant patients, are at higher risk of developing aspergillosis, a disease caused by the mold. (Blethen, 7/9)

Reuters: Air Quality Plummets As Wildfire Smoke Hits Alaska's Most Populous Cities
Smoke and soot from central Alaska wildfires have afflicted the subarctic city of Fairbanks with some of the world's worst air pollution in recent days, forcing many residents indoors and prompting one hospital to set up a "clean air shelter." Fine particulate matter carried by smoke into the Fairbanks North Star Borough over the past two weeks has been measured at concentrations as high as more than double the minimum level deemed hazardous to human health, borough air quality manager Nick Czarnecki said. (7/9)

Los Angeles Times: Ex-USC Gynecologist Sold Sex Videos He Recorded In Foreign Hotel Rooms, Prosecutor Says
A former USC gynecologist charged with sexual abuse of patients also sold photographs and sex videos he took of young women he lured to his hotel rooms while traveling outside the U.S., a prosecutor said Tuesday. The allegation was raised at a downtown Los Angeles court hearing, during which the prosecutor tried to persuade a judge to keep George Tyndall’s bail at nearly $2.1 million, arguing that the doctor charged with sexual misconduct toward 16 former patients was a danger to the public and a flight risk. (Tchekmedyian, 7/9)

The Associated Press: Former USC Gynecologist's Bail Lowered In Sex Assaults Case
A Los Angeles judge reduced bail Tuesday for a former University of Southern California gynecologist accused of sexually assaulting 16 women. Superior Court Judge Teresa Sullivan lowered Dr. George Tyndall's bail from nearly $2.1 million to $1.6 million, which he may be able to post using his condominium as collateral. If he posts bail, he will be confined to house arrest with GPS monitoring. (7/9)

CALmatters: New CA Rules For Deadly Police Force Go To Governor's Desk
Aiming to reduce police shootings in a state that has more than 100 of them each year, the California legislature passed a bill Monday setting a tougher standard for police to use deadly force, allowing officers to fire their guns only “when necessary in defense of human life.” Gov. Gavin Newsom said he intends to sign Assembly Bill 392, likely putting an end to more than a year of emotional debate in the Capitol that began after Sacramento police killed an unarmed black man in his grandparents’ backyard. The heated testimony revealed the anguish of Californians whose relatives have been killed by police, as well as the energy of a national civil rights movement drawing attention to the disproportionate impact of police shootings in communities of color. (Rosenhall, 7/8)

MPR: Health Department Investigating Illness For Lake Minnetonka Visitors
Hennepin County Public Health is investigating an illness outbreak among people who were on Lake Minnetonka over the Fourth of July holiday. Public Health Epidemiology Manager Dave Johnson says more than 100 people have called to report vomiting or diarrhea after being on the lake in recent days, especially in the Big Island area. The department has confirmed about 30 cases of illness. (Gunderson, 7/9)

WBUR: Section 35 Panel Recommends Mass. End Civil Commitments To Prisons, Jails
How Massachusetts involuntarily commits people to addiction treatment is likely to change after much debate about one of the most visible intersections of the public health and criminal justice systems. A state commission has released its final recommendations about the civil commitment process under the state law known as Section 35. (Becker, 7/9)

Detroit Free Press: Beaumont Health To Acquire Ohio's Summa Health System
Michigan's largest health care system is about to get bigger. Beaumont Health announced Tuesday that it has signed a letter of intent to acquire  Summa Health, an Akron, Ohio-based nonprofit hospital system that employs 7,000 people at four hospitals and community health centers in northeastern Ohio. Under the deal, Summa Health would become a subsidiary of Beaumont and would maintain local leadership and a local board. (Shamus, 7/9)

Arizona Republic: First Death In Maricopa County Recorded From Hepatitis A Outbreak
Maricopa County has recorded its first death attributed to a statewide hepatitis A outbreak that began late last year, officials said Tuesday. The death marked the third in Arizona since the outbreak began, according to the Maricopa County Public Health Department. (Rafford, 7/9)

Milwaukee Journal Sentinel: Murder In Milwaukee: Segregation Shapes Racial Disparities In Crime
Violent crime in Milwaukee is unequal, victimizing African American residents more often than their white counterparts.Criminologists and other academics have long focused on individual choices and risk factors, such as illegally carrying a gun or selling drugs, when it came to explaining who gets shot and why — but a growing body of research is showing systemic factors may matter more. When public health experts wanted to figure out how violent crime is linked with structural racism, they looked at decades-old housing maps. (Luthern, 7/10)

Los Angeles Times: UCLA Employee May Have Spread Measles At Campus Food Court
A UCLA employee who contracted measles may have exposed students and others to the highly contagious disease, according to campus officials. A university employee was diagnosed with measles on Monday. But health officials say he may have infected students when he ate lunch at the Court of Sciences Student Center food court between 9 and 11:30 a.m. on July 2 and 3, according to health officials. (Karlamangla, 7/9)

Los Angeles Times: San Francisco Homeless Count Goes From Bad To Worse, Jumping 30% From 2017
Over the last several months, cities and counties across California have been releasing homeless counts. The results have been grim. San Francisco was no exception. In May, the city released data that showed homelessness had jumped 17%. That was bad enough. Last week, a more complete accounting, known as a point-in-time count, showed the problem was even worse. The count revealed that homelessness in a city that’s become a caricature of wealth inequality in the U.S. had actually increased by about 30% from 2017, when the last count took place. (Oreskes, 7/9)

PBS NewsHour: What Has Changed In States That Have Legalized Marijuana — And What Hasn’t
Across the country, more state laws are aligning with voter attitudes about recreational use of marijuana. The wave of cannabis legalization has had a significant influence on individuals, communities and governments, and driven the development of a burgeoning commercial industry. William Brangham begins our series on marijuana with a look at what has changed in states that have legalized it. (Brangham, 7/9)

Miami Herald: FL Law Limiting Medical Pot Companies Is Unconstitutional
A 1st District Court of Appeal decision in Tallahassee called the current, vertically integrated system unconstitutional for the way it caps licenses and charges companies with essentially being one-man bands — they must grow, process, package and sell medical marijuana without bringing in businesses to handle different parts of the process. Critics say licensees may not have the technical or business skills to be effective in all areas, making it an inefficient model for a burgeoning industry. (Gross, 7/9)

Boston Globe: As Mass. Debates Marijuana Cafes, Colorado’s Burgeoning Scene Offers Insights
The 11 states with legal recreational pot are grappling with how to handle public and social consumption. As in Massachusetts, people in Colorado are barred from smoking, vaping, or eating pot products anywhere besides private homes. That can pose a challenge for tourists, renters, and public housing residents who have nowhere to legally consume a legal substance. (Martin, 7/9)

NPR: Drug Prices Can Take A Surprising Turn When A Poor Country Gets Richer
A new report, published by the Center for Global Development in June, finds that as countries move up the ladder of economic development, it becomes harder for government agencies, hospitals and health care companies to buy drugs at reasonable prices. The report compares the range of prices that seven low- and middle-income countries pay for 25 medicines, including acetaminophen for pain relief, bisoprolol to treat high blood pressure, insulin to treat diabetes and omeprazole to treat heartburn. (Lu, 7/8)

Stat: What We Know — And What We Don’t — About Trump’s ‘Most Favored Nation’ Drug Pricing Policy
President Trump’s surprise promise to pen an executive order ensuring the U.S. gets the best deal around the world for drugs has left more questions than answers for the nation’s top drug pricing experts. Trump made it sound easy ....But in the United States’s complex drug pricing system, minute details matter. Those details could mean the difference between Trump dismantling the nation’s existing drug pricing system in favor of a central price-setting scheme more akin to those employed in European nations, or making much smaller — albeit still significant changes — within the existing system, experts said. (Florko, 7/9)

The Hill: Trump Misleadingly Says Prescription Drug Prices Have Gone Down
President Trump on Sunday wrongly claimed drug prices declined in 2018, saying bipartisan cooperation on the issue would “get big results.” “Last year was the first in 51 years where prescription drug prices actually went down, but things have been, and are being, put in place that will drive them down substantially,” Trump tweeted Sunday. “If Dems would work with us in a bipartisan fashion, we would get big results very fast!” (Budryk, 7/7)

The Wall Street Journal: Drugmakers Rise After Trump Pricing Rule Is Blocked
Shares of drugmakers are rallying on hopes of greater pricing flexibility. The blocking of a Trump administration rule that would have required drugmakers to disclose their products’ pricing in television ads is expected to help pharmaceutical and biotech companies avoid some of the near-term pricing pressures that had weighed on those stocks in recent months. (Wursthorn, 7/9)

CQ: More States Eye Importing Canadian Drugs
In June, Florida became the third state, after Colorado and Vermont, to enact a law permitting drug imports from Canada, but the first with both a Republican-controlled legislature and a GOP governor. (On June 24, Maine, which has a Democratic governor, also opened the door to Canadian drugs.) Though the imports are conditional on approval of the Health and Human Services Department, the law’s enactment puts further pressure on President Donald Trump to follow through on his campaign pledge to reduce drug prices. (Cunningham, 7/8)

Pioneer Press: Diabetics From Minnesota Make Trek To Canada In Search Of Affordable Insulin 
The weary travelers on the bus, most of them diabetics from Minnesota, erupted into cheers at the GPS announcement: “Welcome to Canada.” They had just spent 15 hours on a chartered bus traveling from the Twin Cities to buy insulin in London, Ontario. There they can buy the life-saving drug for a tenth of the price it is being sold for in Minnesota. (Pross, 77)

Kaiser Health News: Watch: High Cost Of Insulin Sends Americans To Canada To Stock Up
Insulin is a vital drug that some 7.4 million Americans must take daily to manage their diabetes. But its price nearly doubled from 2012 to 2016, leaving some patients with no choice but to turn to black-market drugs or traveling to Canada, where insulin can be 90% cheaper. KHN senior correspondent Sarah Varney reports in collaboration with PBS NewsHour about the skyrocketing cost of insulin — and the trend’s deadly consequences. (Varney, 7/10)

Kaiser Health News: How To Get A Cheaper Prescription Before Leaving The Doctor’s Office
When Mary Kay Gilbert saw her doctor in May for a skin infection on her leg, she wasn’t surprised to receive a prescription for an antibiotic cream.But Gilbert, 54, a nurse and health consultant, was shocked when her physician clicked on the desktop computer and told Gilbert the medicine would cost $30 on her Blue Cross and Blue Shield plan. “I was like, ‘Wow — that’s pretty cool that you know that information,’” she recalled telling the doctor in Edina, Minn. (Galewitz, 7/10)

Columbus Dispatch: Dispute Over Reining In Drug Middlemen Key In Ohio Budget Impasse
A key holdup in Ohio’s state budget stalemate centers on how to deal with pharmacy benefit managers.The middlemen in the Medicaid drug supply chain were targeted by both branches of the legislature. But House and Senate members remain far apart on what they see as a solution. (Rowland, 7/8)

Columbus Dispatch: Pharmacy 'Deserts' Appear In Ohio As Stores Close Amid Drug Pricing Debate
In an era of low reimbursements for drugs they dispense — especially under the Ohio Medicaid program — hundreds of Ohio pharmacies have closed, creating more than a dozen areas with no easy access to medicine and a pharmacist’s care. Scores of other places across the state are one closure away from joining them, according to a Dispatch analysis of state pharmacy data. (Caruso and Schladen, 7/7)

The Star Tribune: Minnesota Is Aiming For More Transparency On Drug Prices 
At a time of worrisome increases in drug prices, Minnesota is joining a growing number of states that regulate a set of powerful but little-known companies that critics say are contributing to the problem. Known as pharmacy benefit managers, or PBMs, these companies are hired by health insurers to manage their drug benefits, and they influence what drugs are available, where consumers can buy them, and ultimately the price consumers pay at the drugstore counter. (Howatt, 7/6)

Austin American-Statesman: Merck Walks Away From $7M In Incentives For Austin Tech Hub
Merck & Co. is walking away from nearly $7 million in taxpayer-funded state and local incentives aimed at luring to Austin a major technology innovation center operated by the pharmaceutical giant, a project once heralded as the private-sector anchor of a developing medical district around the University of Texas Dell Medical School. Merck spokeswoman Pamela Eisele on Tuesday attributed the move to “internal priorities and events” that have slowed the New Jersey-based company’s hiring in Austin since the incentive deals were announced in July 2017. (Sechler, 7/2)

Kaiser Health News: ‘An Arm And A Leg’: The Full Story Of Insulin And Its Cost ― No Sugarcoating It
One out of every 4 people with Type 1 and 2 diabetes rations insulin. Adeline Umubyeyi is among them. She’s a college grad with a professional job and health insurance who still sometimes goes to bed without dinner — because skipping a meal allows her to skip a dose of her costly insulin. On Episode 5 of “An Arm and a Leg,” meet Umubyeyi and take a 98-year journey with host Dan Weissmann as he traces insulin’s origins. (Weissmann, 7/10)

The New York Times: Sound, Fury And Prescription Drugs
Nothing typifies the failures of health care in the United States like prescription drugs. Americans pay more for their medications — including those developed in America, with taxpayer dollars — than residents of any other country in the world. So many patients are rationing or outright skipping essential medications that stories of people dying for want of basic drugs — or fleeing the country to avoid that fate — have become commonplace. And despite years in the spotlight, the issue is no closer to being resolved: Prescription drug prices rose four times faster than inflation in the past six months alone. (7/6)

The Wall Street Journal: Rebuking Trump On Drug Prices
One abuse of the Trump years has been federal judges who exceed their power to strike down directives they don’t like on policy grounds, from association health plans to the travel ban. But on Monday the Trump Administration received a deserved rebuke on an extralegal rule on drug pricing.Federal Judge Amit Mehta blocked a Health and Human Services rule that would require many drug manufacturers to disclose the list price of drugs in television advertisements. Such transparency sounds innocuous, though in practice consumers learn nothing about their out-of-pocket costs after insurance. With side-effect warnings, a 30-second ad would tell viewers: Don’t buy this; it’s expensive and may kill you. (7/9)

Bloomberg: Trump Health-Care Reform: He's Everywhere And Nowhere
A hodgepodge of news this week is telling the confusing and contradictory story of President Donald Trump’s efforts to change American health care. On Monday, a federal judge blocked the administration’s efforts to force drugmakers to disclose the often astronomical list prices of medicines in their TV ads. It was intended to shame pharma into lowering prices, and would have been the first of the Trump administration’s major drug-cost initiatives to actually take effect. On Tuesday, oral arguments were set for a Department of Justice-backed case that could wipe out the Affordable Care Act. Wednesday will reportedly see the president reveal an ambitious set of initiatives intended to rein in spending on kidney costs. (Max Nisen, 7/9)

Stat: Pharmaceutical Mergers And Megamergers Stifle Innovation
It isn’t lost on the public that the pharmaceutical industry is putting profits over people. Over 80% of Americans across party lines believe that lowering drug costs should be a “top priority” for lawmakers. Policymakers across the political spectrum have put the industry on notice, holding hearings with pharmaceutical company CEOs and introducing a flurry of policies to rein in high-cost medicines. President Trump also made lowering drug costs a priority, and went as far as accusing drugmakers of “getting away with murder” on the campaign trail. Yet the industry continues to operate as if it’s business as usual, putting profits over people’s health. Case in point: the second-largest pharmaceutical merger this year made headlines in late June with a $63 billion deal between AbbVie and Botox maker Allergan. (Katy Milani, 7/10)

The Hill: Speaker Pelosi, Seize The Moment To Make History On Drug Pricing
House Speaker Nancy Pelosi has spent her entire life immersed in the Democratic Party, so she knows well the history of its leaders’ most momentous legislative accomplishments. Minor tweaks to a broken status quo are not on that list. President Franklin Roosevelt’s New Deal is on the list. So is the Medicare program secured by President Lyndon Johnson. Those landmark achievements carry with them a lesson for the Speaker and her congressional colleagues as they consider how to respond to the American public’s deep frustration with prescription drug prices. (Fran Quigley, 7/8)

The Advocate: Louisiana Sets Good Example With 'Netflix' Approach To Drug Costs
When a deadly disease is treatable, but the price is out of reach for many people, that’s an obvious problem in our health care system. When the disease is highly infectious, like hepatitis C, the threat is larger and requires a response from the system before more people get it and deaths rise. Costs do, too, at $24,000 per patient.Louisiana is doing something right in health care, trying out a better way to get access to hep C treatments for poor people. (7/8)

Potts Mercury: Guest Column: U.S. Dependence On China For Medicine A Major Problem
As tensions between the U.S. and China escalate, Washington is waking up to the threat posed by Beijing’s longstanding espionage and cyber hacking. But there’s another looming problem — and one that’s been overlooked for too long: America’s growing dependence on China for prescription drugs. Right now, millions of Americans are taking medicines made in China — medications sold in big box and grocery store pharmacies, administered in hospitals, and used by the VA and military facilities around the world. This is different from illegal fentanyl, or the counterfeit drugs sold on the internet. (Rosemary Gibson, 7/9)

USA Today: Obamacare: Republicans Try To Kill It In Court, Avoid Blame And Backlash
Republicans have never found a convincing argument to kill off the Affordable Care Act. But now they may have found the court that may murder it anyway.And this may be the finest example yet of the success of a conservative legal movement that figured that the real unacknowledged legislators of our time are our courts. They can find a partisan means to justify any end — from partisan gerrymandering to ending health coverage for a population the size of New York State. (Jason Sattler, 7/10)

Bloomberg: Trump Health-Care Reform: He's Everywhere And Nowhere
A hodgepodge of news this week is telling the confusing and contradictory story of President Donald Trump’s efforts to change American health care.  On Monday, a federal judge blocked the administration’s efforts to force drugmakers to disclose the often astronomical list prices of medicines in their TV ads. It was intended to shame pharma into lowering prices, and would have been the first of the Trump administration’s major drug-cost initiatives to actually take effect. On Tuesday, oral arguments were set for a Department of Justice-backed case that could wipe out the Affordable Care Act. Wednesday will reportedly see the president reveal an ambitious set of initiatives intended to rein in spending on kidney costs. (Max Nisen, 7/9)

Arizona Republic: Meantime, People You Elected Would Like To Kill Your Health Care
Republican attorneys general (supported by President Donald Trump) filed a lawsuit to kill the Affordable Care Act, a case heard this week by an federal appeals court in New Orleans. Arizona Attorney General Mark long ago joined that effort.If the lawsuit succeeds (it may well end up at the Supreme Court) the state of Arizona, represented by Brnovich and supported by Gov. Doug Ducey and the Republican-controlled Legislature, will have put the screws to the roughly 2.8 million Arizonans with pre-existing medical conditions. (EJ Montini, 7/10)

Salon: Trump's Attack On Obamacare Goes Critical: Surprisingly, It's Built On Enormous Lies
Hang on tight. On Tuesday, the process of immolating the Affordable Care Act will have its first day in court following a controversial ruling last year by a federal judge in Texas. Back in December we learned that Donald Trump has decided to allow the courts to kill the Affordable Care Act, primarily because cruel whimsy is the official agenda of this president’s administration. Obviously. In case you’re just joining us, this particular series of unfortunate events began with the aforementioned controversial ruling handed down by Judge Reed O’Connor, ludicrously striking down the entire Affordable Care Act as unconstitutional. (Bob Cesca, 7/9)

The Advocate: Overturning Obamacare Wouldn't Give Louisianans Better Health Coverage
The eyes of the health care world will be on a New Orleans courtroom Tuesday, as a panel from the Fifth Circuit Court of Appeals considers whether the Affordable Care Act should live or die. On one side are 18 states, led by Texas, seeking to invalidate the law often referred to as Obamacare. On the other are 20 states and the District of Columbia, which are asking the court to uphold it. And while Louisiana is among the plaintiffs, its residents should be hoping the state’s side loses. (7/9)

Cincinnati Enquirer: Bipartisan Immigration Bill Could Help Solve Health Care Crisis
The Fairness for High-Skilled Immigrants Act is one way policy makers can address this worker shortage now. It’s encouraging to see bipartisan support among the bill’s list of cosponsors, which includes Ohio’s own representatives Joyce Beatty, Bob Gibbs, Bill Johnson, Steve Stivers, Tim Ryan, Anthony Gonzalez, Troy Balderson and Brad Wenstrup. By voting in favor of this bill, our nation’s leaders would help employers like hospitals hire medical professionals and address the pressing needs of our most vulnerable communities. (Vijaya Reddy, 7/9)

Bloomberg: Vape ‘Epidemic’: FDA Should Act Fast On Youth E-Cigarette Use
Teen vaping has skyrocketed in just a few years: Between 2017 and 2018, the share of high-school students using e-cigarettes rose by 78%, to one in five. Unlike other tobacco products, e-cigarettes have not been subject to a government health and safety review because of multiple decisions by FDA delaying that review. At long last, the FDA now says it wants to end this regulatory limbo, and move up a deadline for manufacturers to show that their products meet basic standards by two years — requiring action in 10 months, rather than by 2022. Even that is too long to wait. (7/9)

Stat: Take Aim At Implicit Bias To Reduce Pregnancy-Related Deaths
Pregnancy-related deaths occur 3.3 times more often among black women, and 2.5 times more often among Native Americans and Alaska Native women, than they do among white women. To right this wrong, we need to do three things: prioritize women’s health throughout their lives; take concrete steps to address racism and implicit bias in health care; and spread information about what we know works to keep all women safe and healthy. What does it mean to make women’s health a lifelong priority? For starters, women need health insurance coverage and access to primary and behavioral health care from the cradle to the grave. (Laurie Zephyrin, 7/10)

The Washington Post: We Need Answers On The Border Patrol’s Inhumane Treatment Of Migrants
The crush of migrants that overwhelmed U.S. border facilities in the spring, producing appalling conditions for migrant children at Customs and Border Protection stations, has eased with summer’s arrival as scorching temperatures and deterrent measures adopted by Mexican authorities drove down border-crossing arrests by nearly a third between May and June. Together with the $4.6 billion in supplemental funding enacted by Congress and signed by President Trump, that is taking pressure off the government’s capacity to manage the flow of migrants, especially the families and minors that have transformed the immigration landscape. (7/9)

WBUR: How The Opioid Settlement Could Truly Help The Addicted
The proposed settlement seeks to treat these cases like a class action settlement where the class members would consist of the current plaintiffs and grow substantially to include other local government-related and tribal victims. All would then receive the settlement payments by defendants. This may be the fairest and most effective way for everyone to resolve the tens of thousands of pending and potential claims. (Mark A. Gottlieb, 7/9)

USA Today: People Who Use Drugs Need Compassion, Not Judgment
As a researcher at the Johns Hopkins Berman Institute of Bioethics, I didn’t start thinking about America’s problems with pain and drugs through dispassionate research. I got there thanks to a motorcycle accident, after which I was given lots of prescription opioids and then left to my own devices. The result was that I formed a profound dependence on the drug, and then went through the agony of withdrawal as I tried — with no help from my doctors — to get off the meds. That experience gave me a new perspective on the risks and benefits of prescription opioids, as well as a deep desire to help the millions of Americans who are suffering from addiction (and to prevent some of the tens of thousands of overdose deaths each year). (Travis Rieder, 7/9)

Stat: We Need Trustworthy Data From Consumer Health Devices
Americans collectively spend more on pregnancy and childbirth than any other nation yet have the worst maternal and infant mortality rates in the developed world. The U.S. is the only developed country in which maternal mortality is rising. And as the Centers for Disease Control and Prevention reported recently, the U.S. has seen increases in preterm births for four consecutive years as well as alarming rates of pregnancy-related deaths among black and Native American women. It’s a complex problem made worse by a lack of maternal health data, scant research funding, and fear that commercial and public investments in anything pregnancy-related are too risky. ...Data sourced from consumer health devices can accelerate clinical research and help fill this gap in medical knowledge faster than traditional methods. But this consumer-generated data must be held to standards used in medical research. (Eric Dy, 7/9)

The Washington Post: Why Don’t Americans Talk About Child Care?
The Democrats recently held two nights of debate, each two hours long, and in both sessions the two words that most American families talk about, worry about and sweat about behind closed doors were barely mentioned. Those two words are “child care.” Finding it is a challenge; paying for it can be crippling; it’s an issue that resonates with voters regardless of party, race or geography; and, as of yet, we aren’t talking about it in a serious way. (Michele L. Norris, 7/9)

The Hill: It's Time To End The Senseless And Cruel Policy Of Cannabis Criminalization
For the first time in a generation, there will be a candid conversation in the Judiciary Committe about the failures of marijuana prohibition in the United States and how Americans have been impacted under the blanket policy of criminalization. Specifically, the House Judiciary Subcommittee on Crime, Terrorism, and Homeland Security will hold a hearing this Wednesday entitled “Marijuana Laws in America: Racial Justice and the Need for Reform” to discuss pathways forward as Congress prepares for a substantial shift in public policy. (Justin Strekal, 7/9)

The Washington Post: After The Virginia Beach Shooting, Let’s Replace ‘Thoughts And Prayers’ With ‘Votes And Laws’
“The victims are in our thoughts and prayers.” We’ve all read and even offered our own variations of this condolence after every tragic shooting that makes the headlines. All too often Virginians have felt the pain of senseless death — 12 people murdered by a co-worker in Virginia Beach; 32 students and faculty gunned down at Virginia Tech; a little girl fatally shot at a Memorial Day picnic in Richmond. (Eileen Filler-Corn and Dick Saslaw, 7/9)

St. Louis Post Dispatch: A Court Sees Through Missouri's Abortion 'Emergency.' Now It's Up To The Voters.
An appellate court ruling allowing abortion-rights advocates to launch a ballot challenge of Missouri’s draconian new anti-abortion-rights law is a major victory for women’s control over their own bodies. The clock is now ticking; those advocates will have a little over a month to gather the more than 100,000 signatures needed to prevent the law from going into effect in late August and putting the issue on the statewide ballot next year. With the Legislature’s Republican supermajority radicalized and relentless on this issue, it’s crucial that organizers not drop the ball on this one. Missourians need to be rallied to sign those petitions as soon as possible, and to follow up at the ballot box next year. (7/10)