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Gov. John R. Kasich, a blunt-spoken and unorthodox Republican who bucked his party by expanding Medicaid under President Obama’s health care law and says politicians must “reach out and help those who live in the shadows,” is expected to announce Tuesday that he is joining his party’s long list of candidates for president. Mr. Kasich, 63, would become the 16th prominent Republican to enter the 2016 field. As a two-term governor in a critical swing state — no candidate since John F. Kennedy in 1960 has won the White House without winning Ohio — he will be a credible candidate, though his late entry means he has catch-up work to do. (Stolberg, 7/21)

Budget and the Economy: Mr. Kasich broke with other conservative governors by accepting funds for the expansion of Medicaid under Mr. Obama’s Affordable Care Act, though he said he opposed the law. The expansion made 275,000 Ohioans eligible for Medicaid. Mr. Kasich has in recent years defended the social safety net, taking issue with fellow Republicans who slash poverty programs. “I’m concerned about the fact there seems to be a war on the poor,” he said in 2013. He has pointed to his experience as a fiscal hawk as chairman of the House Budget Committee during the Clinton administration, when he proposed alternative budgets that cut federal spending, including military appropriations and entitlements like Medicaid. As Ohio governor, though, Mr. Kasich has emphasized his record of balancing budgets, cutting taxes and, most important, creating jobs — though critics have said he partly benefited from an improving national economy. (Mullany, 7/21)

In a large and varied Republican field, there may be no more confounding presidential candidate than John Kasich. In the 1990s, he was part of the conservative revolution on Capitol Hill. As Ohio governor, he has cut income taxes and government regulation, battled organized labor and approved new restrictions on abortion and voting rights. He also spared several inmates facing execution, supported higher taxes on cigarettes and fracking and horrified conservatives by expanding healthcare access under the Affordable Care Act, throwing in a lecture on what it means to be a good Christian. (Barabak, 7/21)

The two-term Republican governor’s bid will test whether a candidate who has bucked the right flank of his party on issues ranging from Medicaid expansion to immigration can gain traction in a primary. Mr. Kasich, 63 years old, is counting on his mix of executive and Capitol Hill experience to catapult him to contender status. He’ll also tout his work on national security and budget issues during his tenure as a congressman from 1983 until 2001, as well as the economic turnaround in Ohio. (McCain Nelson, 7/20)

The two-term governor will announce his bid during a Tuesday appearance at The Ohio State University, his alma mater, where he will highlight his long career in public office and his success in turning around his state’s troubled economy. ... Nationally, his decision to embrace a key component of Obamacare — the expansion of Medicaid to low-income adults — could hurt him with conservative voters, who despise the president’s health-care law, and puts him at odds with his primary opponents. Kasich, though, has a more immediate concern: qualifying for the first Republican primary debate, slated for Aug. 6 in Cleveland. (Isenstadt, 7/21)

Kasich served in the House for 18 years and was chairman of the Budget Committee at a time when Washington balanced the federal budget for the first time in a generation. He spent another decade in the business world before winning the governorship in 2010. He won reelection in a landslide last November after his Democratic opponent imploded a few months before the general election. ... In Ohio, he engineered an expansion of Medicaid under the Affordable Care Act, in contrast to many Republican governors. He has championed spending more money on such things as treatment for drug and alcohol addiction. He cites his religious faith as motivating him to help those in need. (Balz, 7/21)

Ohio Gov. John Kasich is set to round out the Republican presidential field Tuesday when he formally announces his White House bid. ... He has accepted Medicaid expansion under the Affordable Care Act, supports Common Core education standards and has allowed for the possibility of a pathway to citizenship for undocumented immigrants. (Burlij and LoBianco, 7/21)

Mr. Trump’s attacks were all the more misguided, veterans’ advocates said, because Mr. McCain has an extensive record of being helpful and involved. ... In just the last year, Mr. McCain was a key player in negotiations with Senator Bernie Sanders, a Vermont independent who was then chairman of the Veterans Affairs Committee, to pass a broad-based overhaul of the Department of Veterans Affairs after the disclosure that staff members had been manipulating wait times to make it appear that patients were receiving care faster than they were. Mr. McCain was also a lead sponsor of the Clay Hunt Suicide Prevention for American Veterans Act — one of the first pieces of legislation that became law after Republicans took over Congress this year. (Peters, 7/20)

TRUMP: "I'm very disappointed in John McCain because the vets are horribly treated in this country. I'm fighting for the vets. I've done a lot for the vets ... He's done nothing to help the vets. And I will tell you, they are living in hell." ... THE FACTS: McCain ... was instrumental in a landmark law approved last year to overhaul the scandal-plagued Department of Veterans Affairs. McCain worked with the chairman of the Senate Veterans Affairs Committee, independent Bernie Sanders of Vermont, as well as Rep. Jeff Miller, R-Fla., chairman of the House veterans panel, to help win passage of the law, which aims to alleviate long delays veterans faced in getting medical care. The VA says it has completed 7 million more appointments for care in the past year, compared with the previous year, but veterans still face increased wait times in Phoenix, Las Vegas and other places. ... McCain pushed for a provision in the law allowing veterans who live more than 40 miles away from a VA health care site to get government-paid care from a local doctor. (7/21)

Businessman Donald Trump surged into the lead for the 2016 Republican presidential nomination, with almost twice the support of his closest rival, just as he ignited a new controversy after making disparaging remarks about Sen. John McCain’s Vietnam War service, according to a new Washington Post-ABC News poll. ... The rankings are more important than early national surveys in previous campaigns because only the top 10 candidates, based on an average of the most recent national polls, will qualify for the first Republican debates. The first debate will be held Aug. 6 in Cleveland. Fox News Channel is the sponsor of that event and established the rules for eligibility. (Balz and Craighill, 7/20)

The speech drew a sharp contrast in tone and content with Hillary Rodham Clinton, the Democratic front-runner, who has begun rolling out a series of policy proposals, many of which would involve expanding government’s role. ... Jeb Bush’s pledge to “turn off the automatic switch on discretionary spending increases” also struck an odd note. That category of spending, which covers federal spending governed by annual appropriations bills, has been shrinking as a share of the budget. Bush said that he would propose ideas later for the entitlement programs, such as Social Security and Medicare, that account for most of the long-term growth in federal spending. (Lauter, 7/20)

In Cedar Rapids, when a voter asked him Friday during a town hall about what he would do to keep jobs in Iowa, Walker took that as an opportunity to dive into his five-point economic plan, making a few connections between Obamacare and her question, but generally sticking to a script that he used everywhere else. (Glueck, 7/20)

To these activists, it was the Democrats’ failure to prosecute Wall Street after the 2008 crash that enabled the tea party movement and the Republican Party’s comeback in Congress. It was the kludged, mandate-driven design of the Affordable Care Act that prevented it from being a boon to Democrats, as Medicare for all might have been. (Weigel, 7/20)

Republican Wisconsin Gov. Scott Walker, one week after launching his bid for the 2016 presidential nomination, signed a bill Monday that outlaws non-emergency abortions at or beyond 20 weeks of pregnancy. Abortion is a core issue for the conservative Republican base whose support Walker will seek as he tries to stand out in a crowded presidential field that also includes former Florida Gov. Jeb Bush, Florida Sen. Marco Rubio and billionaire Donald Trump. (Richmond, 6/20)

The legislation makes performing an abortion a felony punishable by up to three and a half years in prison and $10,000 in fines. The only way abortions after 20 weeks are allowed is if the mother is likely to die or be severely injured. Anti-abortion activists have coalesced around 20 weeks because, they say, that’s when fetuses begin to feel pain. The American Congress of Obstetricians and Gynecologists, however, says that pain doesn’t occur until 27 weeks. (Collins, 7/20)

The Democratic National Committee (DNC) on Monday denounced Walker for signing the bill. “This legislation is nothing more than a timely favor that will rally the GOP base just days after Scott Walker’s presidential campaign kickoff,” said Kaylie Hanson, DNC director of women’s media. “But the harsh reality is that this law will hurt women, as it puts up barriers to care for rape and incest survivors — no exceptions — and threatens the health of the mother." (Sullivan, 7/20)

Planned Parenthood Federation of America on Monday accused an activist group of editing out, in an undercover video, an executive’s repeated assertions that the group does not sell fetal tissue and makes no money off of tissue donations. (Collins, 7/20)

While at least a dozen states that have expanded Medicaid are dealing with unexpectedly high enrollment and budget concerns, Utah lawmakers are hopeful their plan to insure thousands of low-income Utahns will be secure and sustainable. ... Some lawmakers in other states worry the health care expansion programs could mean less money for other state services, such as education. At least 22 states were dealing with budget shortfalls for the 2016 fiscal year, according to an Associated Press review earlier this year. Utah Republican leaders say the state is moving forward on expansion because they believe their plan could address those very concerns and mitigate the risks. (McKellar, 7/20)

Under President Barack Obama’s signature Affordable Care Act, states can choose to expand the Medicaid program to cover people whose incomes fall below 133 percent of the federal poverty level but are not currently eligible for the program. Estimates put the number of people in North Carolina that would apply at between 318,000 and 500,000. (Hoban, 7/20)

[A]s he lay in the hospital hooked to a ventilator, Mr. Bird’s insurance company declined to cover his medical bills. The reason? His injuries resulted from “illegal activity.” Yet Mr. Bird was not convicted of any crime in connection with the incident. He was not even charged. ... Insurers have long relied on allegations of illegal activity to deny coverage to patients injured in a variety of contexts, from traffic infractions to gun accidents. (Rabin,7/20)

Earlier this month a guy named Todd Fassler was bitten by a rattlesnake in San Diego, KGTV San Diego reports. In itself this isn't terribly unusual—the CDC estimates that roughly 7,000 to 8,000 people a year get bit by a venomous snake in the U.S. And somewhere between five and six people die from these bites each year. What raised eyebrows, though, was Fassler's hospital bill—all $153,000 of it. KGTV reporter Dan Haggerty shared it on Twitter. ... The bulk of his hospital bill—$83,000 of it— is due to pharmacy charges. Specifically, charges for the antivenin used to treat the bite. ... There's currently only one commercially-available antivenin for treating venomous snakebites in the U.S. -- CroFab, manufactured by U.K.-based BTG plc. And with a stable market of 7,000 to 8,000 snakebite victims per year and no competitors, business is pretty good. (Ingraham, 7/20)

The insurance department published comments on three companies’ proposed rate hikes in advance of next Monday’s public hearing on the proposals. Anthem is seeking to raise rates by an average of 4.7 percent on plans that cover 55,000 people, while ConnectiCare is seeking a 9.8 percent rate hike for plans that cover 34,400 people. Golden Rule, which covers 3,414 people, has proposed an 18.5 percent rate increase. (Levin Becker, 7/20)

Until recently, John Henry Foster, an equipment distribution firm based in Eagan, Minn., offered its employees only a couple of health plans to choose from. That’s common in companies across America. “They just presented what we got,” says Steve Heller, a forklift operator who has worked at John Henry Foster for 15 years. But these days the company’s employees have dozens of choices. And something else is new: Each worker now receives money from the company (from $350 to $1,000 a month, depending on whether Heller and his co-workers are buying insurance for a single person, a couple or a family) to buy a health plan. (Zdechlik, 7/21)

Health care was one of the few industries that saw job creation in the month of June because of a revolution going on in the industry. We are living longer, getting in front of disease and monitoring everything from our fluids and heart rate to our digital records. All of this as premiums are going up and the Supreme Court rules the Affordable Care Act will stay the law of the land. I caught up with one of the leaders in this new marriage between health care and technology: AthenaHealth CEO Jonathan Bush who is providing cloud-based services for electronic health records, revenue management, and other point-of-care apps that are changing the way we approach health care. I also asked him about his first cousin who is hoping to occupy the White House in 2017. (Bartiromo, 7/20)

A manager at a Veterans Affairs medical center in Georgia is on leave with pay following his indictment on 50 counts of ordering his staff to falsify medical records of veterans waiting for outside medical care. The case against Cathedral Henderson appears to be the first round of criminal charges stemming from a wait-times scandal that came to light last year and led to the resignation of VA Secretary Eric Shinseki. (Rein, 7/20)

The Charlie Norwood Veterans Affairs Medical Center in Augusta, Ga., was a hospital with systemic failures. Its gastrointestinal clinic was so overwhelmed and mismanaged that close to 5,000 referrals for endoscopies were delayed, auditors found, resulting in the deaths of three cancer patients in 2011 and 2012, hospital officials acknowledged in published reports. (Rein, 7/20)

Putnam County Memorial was ailing from the same conditions squeezing the finances of many of the nation's rural hospitals. At least 55 have closed since 2010 across the U.S., with another 1 in 10 at risk of going under, by one talley. Only about 5,000 people live in Putnam County, and they tend to be older, poorer, sicker and less insured than the rest of the state. Health care analysts says Medicare and Medicaid's relatively low reimbursements, combined with dwindling populations in rural regions, are forcing many hospitals like Putnam to operate with tighter profit margins than suburban institutions — and sometimes even at a loss. (Sable-Smith, 7/21)

A year ago there were almost 3,500 Kansans with physical disabilities awaiting Medicaid coverage for services to help them live in their homes and communities. Much has changed in 12 months. The physical disability (PD) waiting list is down to fewer than 1,500 people, and Kari Bruffett, secretary of the Kansas Department for Aging and Disability Services, told members of the National Council on Disability who visited Topeka earlier this month that more reductions are coming. [But] even as the number of Kansans waiting for PD services shrinks, the number of Kansans enrolled and actually receiving the services is also dropping. (Marso, 7/20)

Just 12 percent of Georgia home health agencies received a superior 4-star or 5-star rating in a new Medicare quality ranking system for that industry. The only states worse than Georgia in percentage of top-rated home health agencies were Alaska, with 0 percent, Washington state, with 3 percent, Wyoming, with 4 percent, and Oregon, with 9 percent. (Miller, 7/20)

California may be in the vanguard of a movement of parents who resist vaccinating their children against measles and other communicable diseases, but they’re going to have a tougher time avoiding the immunizations starting next summer. On June 30, California Gov. Jerry Brown signed a bill that will eliminate both personal and religious exemptions for the inoculations starting on July 1, 2016. The state joined West Virginia and Mississippi as the only ones not allowing religious or personal exemptions for the vaccine. (Evans, 6/20)

Baltimore County plans to begin charging fees for ambulance rides — reversing a policy that for years has set the county apart from nearly every other jurisdiction in Maryland and many across the country. The fees, $700 or $750, depending on the type of care provided, plus $10 per mile, will be charged to a patient's health insurance company, Medicaid or Medicare. The plan, announced Monday, is expected to add up to $26 million annually to county coffers. (Wood, 7/20)

Parents of children insured by Medicaid, the U.S. health program for the poor, are more likely to incorrectly assume antibiotics can treat colds and flu and seek these drugs when kids don’t actually need them, a study suggests. Parents surveyed in Massachusetts reported using antibiotics for their kids on average less than once a year, the study found. But when asked if antibiotics should be used for colds or flu, only 44 percent of the Medicaid parents correctly said “no,” compared with 78 percent of parents with private coverage. (Rapaport, 6/20)

Indiana's Labor of Love public health initiative to reduce the state's infant mortality rate appears to be working, according to a new report. With 7.6 deaths for every 1,000 live births in Indiana in 2012 — one of the country's worst rates, according to the KIDS Count Data Book report from the Annie E. Casey Foundation — the number of babies with low birth weight is decreasing significantly statewide and locally. Short gestation and low birth weight — less than 5.5 pounds — is the leading cause of death for infants under 1 year old among all races. (Lazerus, 6/20)

After Ashley Anderson gave birth to her daughter, Jade Marie, the nurses placed the little girl on her mom’s chest. She says she remembers her newborn looking serene, with delicate lashes, her eyes gently closed. The heartbreaking truth — as Anderson had learned during the delivery — was that Jade had died in the womb. Jade would have been a year old in May, but Anderson is far from the only mom in Wyandotte County who must celebrate filial milestones with only their memories. Wyandotte is one of just three Kansas counties where infant deaths reached triple digits combined between the years 2009 and 2013, according to statistics from the Kansas Department of Health and Environment. (Sherry, 6/20)

But for years state government here has been dominated by Republicans. Most of them are white, and deeply skeptical about the power of government to solve South Carolina’s problems. In the midst of the recession, the state’s previous governor, Mark Sanford, refused to take $700 million in federal stimulus money to help the state’s struggling schools, and did so only after the State Supreme Court forced his hand in 2009. And Mr. Sanford’s successor, Nikki R. Haley, is among a number of Republican governors who have declined to use the Affordable Care Act to expand Medicaid eligibility to the working poor in their states. Some Democrats here interpret such stands in the context of the state’s troubled racial history. (Blinder and Fausset, 7/20)

The N.C. Ethics Commission has dismissed a complaint filed against Rep. Donny Lambeth by a whistleblower who contends the lawmaker betrayed his trust. Joe Vincoli, a former hospital official who spurred a federal investigation into Carolinas HealthCare System, says that he sent emails to Lambeth in confidence in 2013 and 2014. But later, Vincoli said, he was troubled to learn that Lambeth had forwarded those emails to officials with CHS and MedCost, a for-profit health benefits company that the Charlotte-based hospital system co-owns. (Alexander, 7/20)

The expansion of Medicaid is one of key components of the Affordable Care Act. It’s a critical tool for the Indian Health System because it opens up a revenue channel for clinics and hospitals to bill Medicaid, a third-party insurance, for services. That boosts budgets at the local level, in a political climate where Congress is unlikely to spend more money on Indian health. ... Medicaid is an odd program for Indian country. Most of us understand the IHS to be the government’s fulfillment of its treaty obligations. However the agency has never been fully funded. Medicaid, however, is an unlimited check. If a person is eligible, then the money is there. Yet states, not tribes nor the federal government, determine the rules for Medicaid. (Mark Trahant, 7/20)

Every day, American scientists explore the root causes of the most devastating, debilitating and costly diseases. Their search is what leads to the development of new cures and therapies for cancer, heart disease and other life-threatening illnesses. Meanwhile, in Washington, Congress is debating legislation intended to address abusive practices by patent trolls, the financial predators that exploit loopholes in patent law to fatten their wallets at the expense of great American science. These two events are on a collision course. To protect the integrity of the critically important patent system and the innovation that flourishes within it, Congress must get this legislation right. (Jim Greenwood and John Castellani, 7/20)

Last month, the CMS announced that the 17 physician practices participating in its Independence at Home Demonstration Project saved Medicare more than $3,000 per beneficiary in its first performance year. The agency saved $25 million. The program targeted seniors with at least two chronic conditions or disabilities who had at least one hospital admission in the past year. The physician practices created teams that delivered in-home care, starting with monthly visits by a nurse to ensure that minor changes in a person's condition were treated before they led to an event that required hospitalization. It sounds expensive. But the demonstration is proving that coordinated in-home care delivery can be cheaper in the long run. (Merrill Goozner, 7/18)

Washington’s notorious revolving door was in full swing again last week as the health insurance industry snagged another top federal official to help it get what it wants out of lawmakers and regulators. America’s Health Insurance Plans, the industry’s biggest lobbying and PR group, announced Wednesday that its new president, starting next month, will be none other than Marilyn Tavenner, who served as the chief administrator of the Centers for Medicare and Medicare Services from 2013 until she stepped down in February. Tavenner’s appointment comes just a few months after the industry recruited former Congresswoman Allyson Schwartz, a Pennsylvania Democrat, to head its newest front group, the Better Medicare Alliance. (Wendell Potter, 7/20)