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Most federal insurance cooperatives created under the Affordable Care Act are losing money and could have difficulty repaying millions of dollars in federal loans, an internal government audit has found, prompting the Obama administration to step up supervision of the carriers. Daniel R. Levinson, the inspector general at the Department of Health and Human Services, said that most of the insurance co-ops enrolled fewer people than they had predicted, and that 22 of the 23 co-ops lost money last year. (Pear, 8/14)

Rep. Brett Guthrie (R-Ky.) on Saturday said GOP lawmakers remain completely invested in repealing ObamaCare. Guthrie added that rolling back President Obama’s signature healthcare law is essential before its latest set of regulations takes effect next year. ... “If ObamaCare’s next round of regulations takes effect on Jan. 1, mere months from now, small businesses will be forced into larger group insurance markets that have dramatically higher rates,” Guthrie added. (Hensch, 8/15)

The exact figure is not known, but a reasonable estimate has 158,000 people in Wisconsin gaining health insurance since January 2014 when coverage was expanded through the Affordable Care Act. That's based on a recent analysis by the University of Wisconsin Population Health Institute. The analysis shows the state's progress in expanding coverage, said Donna Friedsam, director of health policy programs at the agency. ... An estimated 450,000 adults in the state were uninsured in 2013. (Boulton, 8/15)

The complexity of health insurance and lagging levels of insurance literacy have long been a concern. But many experts say the problem is particularly urgent now that the federal health law has expanded coverage to millions more people, including many who have limited experience with insurance and some with limited English proficiency. (Levin Becker, 8/17)

These labor talks are the first in a generation to be held during a down market. During the past two negotiating sessions—in 2008 and 2012—prices were strong. Workers had bargaining leverage, and they negotiated solid blue-collar paychecks including health-care benefits and wages well over $50,000 a year. (Miller, 8/16)

Beginning on Jan. 1, most Boeing employees here will be able to choose a new health insurance provider: Mercy Health. St. Louis will become the second region, along with Charleston, S.C., in which Boeing has contracted directly with a health care system to offer some employees what they say will be less-expensive care coupled with a better experience. Around 12,000 mostly nonunion employees in the St. Louis area will be eligible for this option. (Liss, 8/14)

With a rise nationally in fatal heroin overdoses, the White House on Monday will announce a plan pairing law enforcement officials with public health workers in an effort to emphasize treatment rather than prosecution of addicts, the Washington Post said. (8/16)

As heroin overdoses and deaths soar in many parts of the nation, the White House plans to announce Monday an initiative that will for the first time pair public health and law enforcement in an effort to shift the emphasis from punishment to the treatment of addicts. (Fisher, 8/16)

The latest numbers show that deaths from heroin-related overdose more than tripled nationally between 2002 and 2013. Opiate addiction touches every demographic: white, black, Hispanic, rural, suburban and urban. Proposed solutions nationally include more government funding for treatment, tougher penalties for dealers, and proactive interventions to stop people before they start. (Allen, 8/16)

State health officials say Massachusetts has received a federal grant to treat pregnant women who are addicted to opioids. Gov. Charlie Baker says the funding will help save the lives of women and their children. The state Department of Public Health was awarded the funding as part of the Moms Do Care project, which also includes other state agencies, hospitals and nonprofit organizations. (8/16)

The Obama administration says there are no known violations of the country’s fetal tissue laws among government researchers or the companies that supply the tissue. “Currently, we know of no violation of these laws in connection with the research done at our agencies,” Jim Esquea, assistant secretary for legislation at HHS, wrote in a letter to Sens. Joni Ernst and Roy Blunt, obtained by POLITICO. ... Very little federal research is done with fetal tissue, but it has come under scrutiny since an anti-abortion group earlier this summer began releasing undercover videos alleging that Planned Parenthood was trafficking in fetal tissue and organs. Planned Parenthood has denied that, saying it facilitates legal tissue donation at a few of its locations. (Haberkorn, 8/16)

A company that helped with Planned Parenthood's fetal tissue donation program is ending its relationship with the health provider. Stem Express, a small company based in northern California, has come under intense scrutiny in the last few weeks after it was caught up in an anti-abortion group’s campaign against Planned Parenthood. ... Anti-abortion activists with the Center for Medical Progress have used secretly recorded footage of Stem Express employees, as well as video from former employees, to raise questions about the legality of Planned Parenthood’s fetal tissue program. (Ferris, 8/14)

StemExpress, one of the tissue companies that works with Planned Parenthood, is cutting its ties with the women’s health organization after a series of sting videos that have prompted congressional inquiries. (Haberkorn, 8/14)

Ben Carson alleged in an interview with Fox News Wednesday that Planned Parenthood puts most of its clinics in black neighborhoods to "control the population" and that its founder, Margaret Sanger, "was not particularly enamored with black people." ... It's not the first time Planned Parenthood has faced criticism about its founder and the placement of its clinics — former presidential candidate Herman Cain made a similar statement in 2011. ... Did Margaret Sanger believe in eugenics? Yes, but not in the way Carson implied. (Kelly, 8/14)

Ohio Gov. John Kasich, whose GOP presidential campaign has been focused heavily on New Hampshire, is making a swing down south Monday to pick up an endorsement from Alabama Gov. Robert J. Bentley, according to a Kasich campaign source. ... Mr. Kasich’s Alabama endorsement comes from a governor who took a very different path than the one followed by Mr. Kasich as governor of Ohio in his approach to carrying out President Barack Obama‘s health-care law, the Affordable Care Act. Under Mr. Bentley, a dermatologist, Alabama refused to accept federal funds for Medicaid expansion, which the law provides to expand health coverage. Mr. Kasich, by contrast, broke ranks with his party and expanded his state’s Medicaid program under the ACA—a move that has drawn criticism from conservative Republicans and some of his presidential rivals. (Hook, 8/17)

Ohio Gov. John Kasich, who is campaigning for the Republican presidential nomination with a unique message of compassionate conservatism and cultural inclusion, will pick up a head-turning endorsement Monday in the Bible Belt. (Rucker, 8/17)

John Kasich likes Obamacare’s expansion of Medicaid to more low-income Americans. He wants to ensure insurance coverage for people who have pre-existing conditions. He likes insurance exchanges. And he thinks everyone should have health insurance – even young, healthy people who need an incentive to sign up. (Thompson, 8/15)

Republican Governor John Kasich says it’s a moral imperative to expand the federal-state insurance program for the poor .... He says it reaps savings from better public health and less prison time. Yet the state spent $1.4 billion more than projected with about 152,000 unexpected enrollees for the first 18 months of expansion. ... The Kasich administration said that even with the increase, spending was $1.9 billion under budget in 2015. With expansion expenses projected to increase to $5.09 billion in 2017, including a $133 million state share, critics question whether it’s sustainable and wonder why Ohio didn’t pursue a state-based plan to lessen dependency on Medicaid. (Niquette, 8/17)

Donald Trump, calling women’s health issues “very important,” is making it clear he now supports a woman’s right to chose an abortion in the case of rape, incest or if her life is at risk. (Shutt, 8/16)

Former Hewlett-Packard CEO Carly Fiorina said Thursday that vaccinations should be left up to parents — a view that puts her in sharp contrast with at least one other Republican presidential candidate. (Collins, 8/14)

If you're trying to figure out Hillary Clinton's position on a key issue, often there's an easy way to know: it's usually the same as President Barack Obama's. From community college (make it free) to ending the U.S. embargo with Cuba (a good idea) to going around Republicans in Congress and using executive power to change U.S. policy on immigration (yes) to creating a Medicare-for-all style health system (no) to raising the minimum wage (yes, but not to $15 an hour), Clinton's stances have closely mirrored those of Obama. (Bacon, Jr., 8/15)

[T]hey'd spent years torturing themselves over acts that tortured their conscience. "Souls in anguish" is how some experts describe this psychological scar of war now being identified as "moral injury." Unlike post-traumatic stress disorder, which is based on fear from feeling one's life threatened, moral injury produces extreme guilt and shame from something done or witnessed that goes against one's values or may even be a crime. ... While the idea of warriors feeling remorse over battlefield horrors is not new, moral injury has gained more attention following the wars in Iraq and Afghanistan as mental health providers point to it as a reason why veterans aren't improving with PTSD treatments. More than 390,000 veterans of those conflicts have sought help through the VA for PTSD. (Watson, 8/15)

A psychological wound known as moral injury is gaining attention in the aftermath of the wars in Iraq and Afghanistan, with veterans now being treated for these injuries to the soul — even as medical experts debate whether moral injury is a condition unto itself or a subset of post-traumatic stress disorder. Some questions and answers about moral injury, and how it compares with and differs from PTSD. (8/15)

Arkansas Governor Asa Hutchinson on Friday canceled the state's contracts with Planned Parenthood, making his the third Southern state to do so since anti-abortion activists released a series of videos that they say suggests the organization sells fetal tissue. (Barnes, 8/14)

Arkansas is ending its Medicaid payments to Planned Parenthood, Republican Gov. Asa Hutchinson said Friday, despite warnings federal officials have given other states that such a move could violate the law. Hutchinson ordered the Arkansas Department of Human Services to terminate its Medicaid provider contract with the organization in 30 days. The move came in response to secretly recorded videos released by an anti-abortion group showing Planned Parenthood officials describing how they provide fetal tissue from abortions for medical research. (Demillo, 8/14)

Arkansas and Utah are the latest states to target funding for Planned Parenthood, making five states in total trying to restrict money from the women's health group. Arkansas Gov. Asa Hutchinson is moving ahead with plans to strip state funding from Planned Parenthood, defying a federal warning earlier this week that doing so could be against the law. ... Utah Gov. Gary Herbert also announced Friday that he has instructed the Utah Department of Health to stop acting as an intermediary for pass-through federal funds to the women’s health group. “The allegations against Planned Parenthood are deeply troubling,” Herbert said in a statement. (Ferris, 8/14)

Planned Parenthood said the move is part of a bigger, dangerous political agenda and that Mr. Hutchinson has signed new abortion restrictions into law this year. ... Planned Parenthood said earlier that it is weighing all options following the steps to cut off Medicaid funding. The organization said it is also watching for potential defunding measures in Pennsylvania and Wisconsin. (Armour, 8/14)

The Obama administration this month warned two states that by ending Medicaid funding of Planned Parenthood, they may be out of compliance with federal law—step one in a process that could end in a complete termination of federal Medicaid funding for those states. But if precedent holds, things need not get that far for Planned Parenthood in Louisiana and Alabama to keep receiving Medicaid money. (Friday, Arkansas Gov. Asa Hutchinson directed the state Human Services Department to end its agreement with Planned Parenthood.) States have made similar defunding attempts before, and when Planned Parenthood sued, they lost in court. (Owens, 8/17)

Arizona’s 1.6 million residents who get health insurance through Medicaid will hear more details this week on Gov. Doug Ducey’s plan to overhaul the public program for the poor and disabled. The Ducey administration is holding six community forums to answer questions about the governor’s plan to modernize the Arizona Health Care Cost Containment System, known as AHCCCS. ... The Republican governor earlier this month described his plan as a path off government assistance for about 350,000 low-income, able-bodied adults. They would be required to pay a larger share of their health-care costs, establish health-savings accounts, search for employment and face a five-year Medicaid eligibility limit. (Alltucker, 8/16)

A multimillion-dollar IT project for the state’s largest agency is on track to be completed this fall after being delayed for years and costs rising from $62.5 million to more than $97.9 million. Department of Human Services officials said the state’s new Medicaid Management Information System project had experienced a series of delays and changes in its budget, missing a federal deadline of Oct. 1 last year to go live. The tentative go-live date for the new system is Oct. 5. (Smith, 8/17)

Poor, obese South Carolinians covered by Medicaid can get help slimming down through nutritional counseling sessions aimed at stemming chronic and costly health problems. The Department of Health and Human Services added the weight-loss services this month for the estimated 184,000 Medicaid-covered adults with a body mass index of 30 or more, which is the definition of obese. That roughly translates to a 5-foot-8 adult weighing more than 200 pounds. (Adcox, 8/15)

Two CareFirst BlueCross BlueShield customers have filed a proposed class action suit against the Maryland health insurer after a cyberattack exposed about 1.1 million current and former members' personal information. The suit alleges that CareFirst, the region's largest health insurer, failed to protect their data after the company became aware of security weaknesses during an attempted hack last year. The attackers, who left behind hidden back doors that let them later re-enter undetected, gained access to names, birth dates, email addresses and insurance identification numbers during a breach in June 2014 CareFirst officials said when they disclosed the hack in May. (Sherman, 8/15)

With efforts to legalize doctor-assisted suicide stalled in the California Legislature, the contentious issue of providing end of life treatment to the terminally ill is now headed back to the courts. A San Francisco judge on Friday is expected to hear one of the leading legal challenges to California laws forbidding physicians from providing medical treatment that helps the dying end their lives. (Mintz, 8/14)

States are shifting dollars they once spent on children’s health into roadways and tax cuts, raising fears for advocates that important healthcare programs could lose their funding. Kansas, Indiana and California are among the states looking to relocate money away from their Children’s Health Insurance Programs (CHIP) as the federal government begins picking up more of the tab this year. (Ferris, 8/15)

For school nurses, preparing for the start of a new year begins months before classes start. The nurses must make sure each student is up to date on vaccinations, unless that child has an exemption. Often, tables are set up during school registration to check if students have all the necessary shots. Nursing departments call, email or send letters to parents about six months ahead of the upcoming school year. (Armbruster, 8/14)

After seven years of increases, the level of charity care provided by area hospitals dipped slightly in 2013, according to a new report by the St. Louis Area Business Health Coalition. While the reason for the slight decline remains unclear, it came at a time when hospital profits were on the rise and when the state had yet to expand Medicaid to cover more uninsured individuals throughout the state, the report found. Overall, in the St. Louis area charity care as a percentage of revenue slipped to 2.93 percent in 2013 from 3.02 the year prior. (Liss, 8/14)

When the bacteria that cause Legionnaires’ disease were discovered last week in a cooling tower above a South Bronx deli, New York City officials decided the cleanup could not wait. At their request, Rich Parker rushed his best cleaning crew over to the two-story building at 903 Sheridan Avenue on Tuesday night, arming them with respirators, power washers and an arsenal of chemicals for an emergency disinfection. The Fire Department’s Ladder Company 44 was summoned to lift the crew to the roof using a fire truck ladder. (Hu, 8/16)

When Kausha King’s son Christian was born with cerebral palsy, along with a seizure disorder and lung disease, doctors told her he would not live past the age of three. Today, Christian is 18, and although he cannot walk or speak, he is happy and thriving, King says. King credits much of her son’s progress to a little-known state program known as California Children’s Services (CCS), which pays for specialized medical care for children with severe illnesses or birth defects. (Ostrov and Gorman, 8/17)

Gov. Jerry Brown and lawmakers will start tackling some of the state's toughest challenges this week, and the solution to many of them may be new taxes and fees for Californians. The Capitol's ruling Democrats want to hit up residents and businesses for billions of dollars as they seek new ways to fund public healthcare, subsidize construction of affordable housing and pay for road repairs. (Megerian and McGreevy, 8/15)

As lawmakers grappled with and ultimately decided to shutter Montana's center for people with developmental disabilities, the voices of those closest to the decision say they largely went unheard. But those living and working at the Montana Developmental Center in Boulder are well aware of what happened and hold unique insight into a center most Montanans will never see. The center's clients also include people with mental health issues and personality disorders. (Baumann, 8/16)

To anyone who’s been around Yadkinville for a while (and most folks up here have), it was “Hoots,” and forever would remain so. Sure, the name – Hoots Memorial Hospital – was changed about five years back, but, as Yadkin County Manager Lisa Hughes sees it, when Yadkin Valley Community Hospital has been long forgotten, “this will still be Hoots.” In fact though, Hughes and many of her fellow Yadkin County residents would prefer that Yadkin Valley Community Hospital, which today sits shuttered, not soon be forgotten. Rather, they’d like for it to be reopened and revitalized in the spirit of the community institution that Hoots was. (Sisk, 8/17)

Dallas-area taxpayers picked up the tab for more than $825,000 in costs related to the Ebola outbreak last fall, ranging from cleanup and overtime expenses to barbecue dinners and special T-shirts. Most of the costs — more than $600,000 — were paid by Dallas County, which led the multi-agency response last October. (Hunt, 8/14)

More than 100 patients were duped by a “dangerous scam artist” who posed as a clinical psychologist, met with patients in his basement and prescribed antidepressants, prosecutors said Friday in announcing his arrest. Donald Lee-Edwards, 43, pleaded not guilty Thursday to criminal impersonation, drug sale, scheme to defraud and other charges. (Balsamo, 8/14)

New York on Friday became the most populous U.S. state to ban the sale of powdered alcohol, a controversial just-add-water beverage that opponents say will lead to a rise in underage drinking and abuses. The new drink that comes in freeze-dried liquors like rum and vodka has gotten a swell of political pushback, with more than 20 states banning the beverage since federal regulators approved it in March. (Kearney, 8/14)

A federal judge has blocked an Alabama abortion regulation that could have permanently closed the state's busiest abortion clinic, saying Thursday that the rule was unnecessary to protect women. U.S. District Myron Thompson issued a temporary restraining order blocking the regulation last week, saying that the closure of the West Alabama Women's Center in Tuscaloosa could prevent women from obtaining abortions. He followed up the order with an 81-page opinion issued Thursday. (Chandler, 8/14)

When the tornado sirens go off, people know to seek shelter in a basement and away from windows, but that option isn't always available inside a hospital. The windows are large, patients can't move themselves, elevators aren't an option for those on top floors and visitors don't know where to go. During tornado season, Decatur's two hospitals are especially at risk when storms hit the area, so staff constantly monitor local weather and regularly revisit and practice their emergency plans. (Steele, 8/16)

A federal agency threatened to halt Medicare payments to Norwood Health Center after inspectors discovered serious problems there earlier this year, newly released records show. The U.S. Department of Health and Human Services found 32 deficiencies at the center, including dangerously low staffing levels, insufficient information in medical records and failure to use the least-restrictive methods of restraining patients, according to more than 120 pages of documents obtained by News-Herald Media under the state’s open records law. (Anderson, 8/14)

Disavowing remarks made by the state's chief housing official, Lt. Gov. Boyd Rutherford said Saturday that the Hogan administration will not propose any easing of liability for landlords whose tenants' children are harmed by lead paint in rental homes. Rutherford, who took the governor's traditional place as closing speaker at the summer convention of the Maryland Association of Counties, said Secretary of Housing and Community Development Kenneth C. Holt's call for such limits does not represent administration policy. (Dresser, 8/16)

When the Americans With Disabilities Act was passed 25 years ago, many people may have assumed that the law was written only to protect the rights of people with physical disabilities. But that’s never been the case, said Cindy Held Tarshish, ADA Minnesota program manager for the Metropolitan Center for Independent Living. The ADA is an inclusive piece of legislation, she pointed out, that also provides legal protections for Americans with hidden disabilities, including mental illness and addiction disorders. (Steiner, 8/14)

Amazingly, yet another lawsuit challenging a significant provision of the Affordable Care Act remains pending in court. This time, however, what is at stake is not a disagreement about Obamacare, but a question about the role of the judiciary: Should the House be able to bring a lawsuit simply because it disagrees with how the president is interpreting the statutes that the full Congress has enacted? The answer is no. Allowing interpretive disagreements between the legislature and the executive to be resolved in federal court would constitute the single most radical expansion of the authority of federal judges in more than 200 years. (Walter Dellinger, 8/16)

The New York Times reported last week on the Obama administration, in an effort “to avoid another political uproar over the Affordable Care Act,” urging state insurance commissioners to hold down premium increases for 2016. ... But trends in many states appear likely to force premiums higher. Continued low enrollment after the 2015 open-enrollment season means that some insurers still face a group of enrollees who are older and sicker than their initial projections. (Chris Jacobs, 8/14)

Donald Trump may be the “post-policy candidate,” but when you strip away the bluster and the outrageous commentary that have defined his campaign to find his occasional, substantive statements about public policy, a surprising fact emerges: Mr. Trump is a moderate Republican. ... Instead of promoting his ideological purity, he notes that policy choices are circumstance-specific. For example, he’s not a priori opposed to single-payer health care. “It works in Canada,” he said at the first Republican presidential debate on Aug. 6. “It works incredibly well in Scotland.” Even in the United States, “it could have worked in a different age,” but it wouldn’t work very well right now, he said. So instead, he’d replace Obamacare with “something terrific,” which would take care of people who can’t afford health insurance. (Josh Barro, 8/14)

The Food and Drug Administration thinks its powers are so total that it can even prohibit drug companies from making true claims about their products. Not so fast. A federal judge in an important and closely watched test case in New York has called this political control a violation of the First Amendment. At issue are off-label prescriptions. ... [The FDA] said drug makers could engage in off-label marketing in limited ways if the FDA edited and signed off on the materials first. The word for this is censorship, which a small company called Amarin Pharma is now challenging, at considerable risk of FDA retaliation. (8/14)

If the Food and Drug Administration can't regulate how pharmaceutical companies market their drugs to doctors, its ability to protect the public will be severely diminished. A federal court ruling last week makes this scenario possible, and it will take a concerted effort by the FDA to continue setting limits on eager pharmaceutical salespeople. (8/14)

About 27,000 people in West Africa have been infected with the Ebola virus and more than 11,000 of them have died since the outbreak began last year. Many could have been saved if an effective vaccine had been available. But the world relies on drug companies to create new vaccines and medications, and they have no financial incentive to do so for diseases that mostly affect poor countries. Clearly, the world needs a better mechanism for vaccine development. ... Last month, the New England Journal of Medicine published a bold proposal by three doctors for an international vaccine fund with an initial capitalization of $2 billion. (8/14)

On Aug. 7, the American Psychological Association overwhelmingly approved a sweeping ban on any involvement by psychologists in national security interrogations conducted by the U.S. government. This ban includes even non-coercive interrogations. ... For me the APA ban is simply sidestepping responsibility for what the organization failed to do, and still has not done, in regard to the psychologists who took part in harsh interrogations or witnessed and abetted “soft” torture or so-called enhanced interrogation techniques for the U.S. military, other countries’ militaries and police, the CIA and so forth. Those psychologists should have been, and should still be, called up on ethics charges and have their APA memberships revoked. (Anne Speckhard, 8/16)

Of the almost 22 million veterans in the United States today, more than two million are women, and of those, over 635,000 are enrolled in the Department of Veterans Affairs system, double the number before 9/11. Women are the fastest growing group of veterans treated by the V.A., and projections show that women will make up over 16 percent of the country’s veterans by midcentury. Like Ms. Brooks, many female veterans are returning home with PTSD — the No. 1 complaint among women seeking treatment at V.A. health facilities. Hypertension and depression are the next two largest diagnostic categories for women. And one in five female veterans treated by the V.A. reported having experienced military sexual trauma. Unfortunately, these veterans aren’t always getting the care they require from a system originally designed to serve mostly men. (Helen Thorpe, 8/15)

Last month, my husband and I signed forms donating an embryo we had conceived to medical research. Meanwhile, conservative Republicans are vowing to defund Planned Parenthood for allowing women who have abortions to make the same choice. (Margo Kaplan, 8/14)

Hidden-camera videos showing Planned Parenthood staffers discussing fetal tissue donations have led not just to efforts to defund the organization, but to calls for an end to the use of fetal tissue in research. In an article in The New England Journal of Medicine, the law and bioethics professor R. Alta Charo explains why these calls are misguided. Fetal tissue is not only being used in potentially life-saving medical research, it has already saved countless lives. (Anna North, 8/14)

The Coca-Cola Company, which has suffered a large decline in consumption of sugary sodas as consumers worry about obesity, has formed a new organization to emphasize exercise as the best way to control obesity and to play down the importance of cutting calories. Coke and other beverage makers have long funneled money to industry-leaning scientists and formed innocent-sounding front groups to spread the message that sugary sodas have no deleterious effect on health and should not be taxed or regulated. The new organization, the nonprofit Global Energy Balance Network, is the latest effort to put a “science based” gloss on industry positions. (8/14)

The Maryland region is one of the richest sources of health care knowledge and research innovation in the world. Here you can find more than 800 life sciences companies, 70 federal labs, regulatory agencies such as the U.S. Food and Drug Administration (FDA), and elite academic, medical and research institutions. ... Our goal is to place our region among the top three biotech hubs in the U.S. by 2023. To achieve this objective, we intend to develop a comprehensive strategic plan and a branding strategy that clearly portrays the benefits of the Maryland region as the heart of the biotech industry. (Reg Seet, Rich Bendis, Phil Schiff, 8/16)