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With the nomination of Judge Brett Kavanaugh to the Supreme Court, President Donald Trump has now engaged all three branches of government in his fight to get rid of the Affordable Care Act and protections for people with pre-existing health conditions. Kavanaugh made clear last year in a speech at the Heritage Foundation that he thinks the court was wrong to uphold the ACA's insurance mandate as constitutional. He has also said a president should be allowed to not enforce components of a law if he personally deems it unconstitutional (encouragement this president doesn’t need). There couldn’t be a more in-your-face threat to the ACA than from a Justice Kavanaugh. (Andy Slavitt, 7/13)

As ThinkProgress’s Ian Millhiser explains, last year Kavanaugh gave a speech to the American Enterprise Institute praising William Rehnquist’s dissent in Roe v. Wade and Rehnquist’s insistence that the Constitution does not imply a right to abortion. This is hardly an unusual view — Roe relied on an earlier case finding that the Constitution contains an implied though not explicit right to privacy — but it does remove a good measure of doubt about Kavanaugh’s beliefs. And in the one case concerning abortion he dealt with as an appeals court judge, he charted a path that would have adhered to the letter of Roe (as he had no choice but to do) but would also have circumvented its protections for the plaintiff and likely allowed the government to prevent her from getting the abortion she needed. But this is all a kind of game. We all know that one way or another, Kavanaugh is going to be a vote to take away women’s right to choose. To pretend otherwise is to be willfully obtuse. (Paul Waldman, 7/12)

If Atul Gawande’s first week as CEO of a health care startup was anything like mine, I hope he is able to get away from it all and enjoy a completely relaxing weekend. He will have earned it. After Gawande was named to head the joint venture between Amazon, Berkshire Hathaway, and JPMorgan, some critics said that choosing a physician was a mistake. I disagree — a physician is exactly what this new company needs. Health care in America is at a crossroads. Our success in navigating the many challenges ahead will depend heavily on who is leading the charge. (Alexi Nazem, 7/13)

The federal court decision on Kentucky's Medicaid waiver may be more sweeping than has been recognized — because it shows how any state proposal to impose work requirements, or make other changes that reduce coverage, could be immediately vulnerable to legal challenges. The bottom line: The DC District Court shot down the Kentucky waiver, including its work requirements, because the Health and Human Services secretary did not address the likelihood that it would cause people to lose their health coverage. And whether you are for them or against them, all work requirement programs will cause some coverage losses. (Drew Altman, 7/13)

The text messages that begin arriving on June 28 end my ordinary life. “Where does your husband work?” “What’s happening in Annapolis?” “Have you seen the news?” My husband, John McNamara, is a reporter for the Capital Gazette. I am at my office, a government agency just outside Washington.I Google. Then I close my laptop and run toward the parking lot. (Andrea Chamblee, 7/13)

With all of these different approaches available, why focus on naloxone? Critics note that a number of the people treated with the drug will still die within a year, because the underlying problem isn’t addressed. This is true — but ignores the obvious fact that saving some is better than saving none. (Brenden Layte, 7/13)

When my grandfather was a private practice pediatrician in Queens, making house calls in exchange for eggs and hand-knitted hats, medical communications were often between one doctor and his or her patient (or parent). As a primary care provider to adults with opioid use disorder, I need to communicate with many other clinicians. Privacy rules can thwart me from doing that. (Melissa Stein, 7/13)

Marijuana has since risen into prominence as the new cigarette of choice, as folks refuse to believe that weed is harmful. Sound familiar? Too many people were serving time in prisons who were otherwise not criminals — sad but true. We began seeing casual scenes in motion pictures where kids and adults used pot routinely, much like cigarettes of yore. More and more, celebrities promoted pot as not only harmless; it was useful in the treatment of numerous diseases. (Marshall Frank, 7/12)

On June 8, we lost a rare, great man. Anthony Bourdain was a lightning rod of cultural connectivity. He brought disparate, marginalized people together and made the unknown accessible — some of the many gifts that made Anthony such a valuable presence in our collective lives, whether we knew him or not. An unwavering supporter of women and the #MeToo movement, Bourdain’s loss was a tragedy on so many levels, to so many people who saw him as a beacon of a new way of being. We share that grief and deepest sadness for his family and those closest to him whose pain must be unimaginable. One of the most vocal and unwavering figures in the #MeToo movement has been Asia Argento. At the center of our community, Asia has stood, her fist in the air, fighting daily not just for justice for those of us she has come to know, but for abused people the world over. Asia has now found herself on the receiving end of vicious cyberbullying and repulsive slander at the hands of internet trolls who hold her responsible for Anthony’s death. She has been accused of everything from causing her boyfriend’s suicide to trying to use her “survivor status” and the #MeToo movement to advance her career. (7/12)

The so-called Goldwater rule, an ethical guideline that prohibits diagnosing public figures without a personal examination, started with an unremarkable history. Based on one lawsuit and already considered outdated by the time it entered the books in 1973, scholars largely ignored it. Many psychiatrists had not even heard of it, and those who pondered it considered changing it to simple etiquette. Then came the turbulent presidency of Donald Trump. We have a president with questionable decisional capacity who attended a summit with North Korea, a hostile nuclear power, unprepared and unaware of his deficiencies. He woke up one morning and decided to launch a trade war. He just threatened to quit NATO. Now he's about to meet with Russian President Vladimir Putin, who attacked our 2016 elections. Nominating a Supreme Court justice, or deciding to hold summits with rivals and enemies, are political decisions that presuppose certain basic mental capacities. Are we certain Trump possesses them? Some of the most renowned psychiatrists in the country have their doubts. (Bandy X. Lee, 7/13)

A thistle to UnitedHealthcare, one of Iowa’s private Medicaid insurers, for its dedication to slashing in-home care for a disabled man — again. (And a jab to Gov. Kim Reynolds for continuing to support the disastrous privatization of this state’s health insurance program for 600,000 low-income and vulnerable Iowans). Jamie Campbell, who is paralyzed after breaking his neck in a high school wrestling accident 29 years ago, lives at home with daily assistance from aides paid by Medicaid. After United tried last year to drastically reduce the amount of in-home care he could receive, Campbell appealed to an administrative law judge who ruled in his favor and ordered the insurer to continue covering the amount of care he had received before. (7/12)

Reasonable Texans can disagree on abortion policy. But generally, we agree that government should be free of waste, incompetence and anything smelling of financial shenanigans.So, the revelation that a statewide elected official helped dole out hundreds of thousands of taxpayer dollars to unqualified consultants is cause for concern. The fact that the elected official is already under indictment for security’s fraud is cause for alarm. (7/12)