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It took only one question — the very first — in Tuesday night’s Democratic presidential primary debate to make it clear that the issue that united the party in last year’s congressional elections in many ways now divides it. When Jake Tapper of CNN asked Senator Bernie Sanders whether his Medicare for All health care plan was “bad policy” and “political suicide,” it set off a half-hour brawl that drew in almost every one of the 10 candidates on the stage. Suddenly, members of the party that had been all about protecting and expanding health care coverage were leveling accusations before a national audience at some of their own — in particular, that they wanted to take it away. “It used to be Republicans that wanted to repeal and replace,” Gov. Steve Bullock of Montana said in one of the more jolting statements on the subject. “Now many Democrats do as well.” (Goodnough, 7/30)

The targets Tuesday were two of the most liberal and leading candidates in the field, Sens. Elizabeth Warren (Mass.) and Bernie Sanders (Vt.), who were accused of embracing “free-everything . . . fairy tale” policies and making “impossible promises” that could compromise the party’s chances of winning back voters they lost in 2016 — a loss that cost them the White House. Warren and Sanders more than stood their ground during two spirited hours of sharp and passionate exchanges. (Balz, 7/31)

The most protracted exchanges of the night, and by far the most substantive ones, concerned Mr. Sanders’s signature proposal to replace private health insurance with a single-payer system of the kind employed in Canada and a number of European countries. Mr. Delaney and the other moderates attacked the proposal from the first minutes of the debate, calling it a politically toxic idea that would void the health care plans of union members and of employees of private businesses. “We don’t have to go around and be the party of subtraction, and telling half the country, who has private health insurance, that their health insurance is illegal,” Mr. Delaney said. (Burns and Martin, 7/30)

Warren added that Democrats aren’t trying to take away health care from Americans. “That’s what the Republicans are trying to do,” she said. “And we should stop using Republican talking points in order to talk with each other about how to best provide that health care.” (McCaskill, 7/30)

The battle lines were drawn in the first half-hour of the debate, as an impassioned and prolonged exchange broke out over whether to abolish private health insurance in favor of a single-payer system favored by Sanders and Warren. When Sanders was asked how he would respond to Delaney, who described Medicare-for-all as bad policy, the senator offered a blunt retort: “You’re wrong!” “Why do we got to be the party of taking something away from people?” Delaney asked him in return. “We don’t have to do that. We can give everyone health care and allow people to have choice.” Warren quickly jumped in, saying candidates who favor Medicare-for-all are not trying to take anything away from the American people. (Olorunnipa, Viser and Wang, 7/31)

Traditionally a noncombatant debater, Hickenlooper on Tuesday warned that Sanders’s policies would be a “disaster at the ballot box.” He continued: “You might as well FedEx the election to Donald Trump.” He added that he is more pragmatic about health care: “It comes down to that question of Americans being used to being able to make choices, to have the right to make a decision.” (Fuchs et al, 7/30)

Warren took a more measured, reasoned approach, while Sanders showed more outrage, throwing his hands up in disgust during one exchange with Hickenlooper. But the two never went after each other. At one point, when Sanders accidentally interrupted Warren, he stopped himself and apologized — a courtesy he didn't afford other opponents. (Taylor, 7/31)

“I don’t understand why anybody goes to all the trouble of running for president of the United States to talk about what we really can’t do and shouldn’t fight for,” Warren said after several candidates argued that she and Sanders would doom the party. Several of their opponents argued that there was too much at stake to risk giving any advantage to Trump and that a more pragmatic approach would sway a wider swath. (Bierman, Mehta and Halper, 7/30)

South Bend, Ind., Mayor Pete Buttigieg (D) said during the 2020 Democratic debate on Tuesday that Democrats should “stop worrying about what the Republicans will say” and stand up for “the right policy.” “It is time to stop worrying about what the Republicans will say,” Buttigieg said. “It's true that if we embrace a far-left agenda, they're gonna say we're a bunch of crazy socialists. If we embrace a conservative agenda, you know what they're gonna do?” “They're gonna say we're a bunch of crazy socialists. So let's just stand up for the right policy, go out there and defend it,” he continued. (Folley, 7/30)

Former Rep. Beto O'Rourke (D-Texas) said on Tuesday that it will take more than just expanding the Affordable Care Act to get Americans health insurance. "The middle class will not pay more in taxes to ensure that every American is guaranteed world-class health care. I think we're being offered a false choice," O'Rourke said at the Democratic primary debate in Detroit. (Manchester, 7/30)

Sanders has said that his single-payer plan would raise taxes on the middle class but that amount would be more than offset because people would no longer pay deductibles, co-payments or premiums for health insurance. Sanders has said one option to fund Medicare-for-all would be from a 4 percent tax on employees, exempting families earning less than $29,000. Warren appeared to join Sanders in making that argument under pressure from CNN’s Jake Tapper to answer whether she supports raising middle-class taxes to pay for the plan. ... But other candidates have sought to embrace proposals that are less expensive. (Stein, 7/31)

Moderate Rep. Tim Ryan (D., Ohio) said that Mr. Sanders didn’t know that benefits under Medicare for All would be as good as or better than private insurance. “I do know that. I wrote the damn bill,” Mr. Sanders responded. (McCormick and Parti, 7/30)

Estimates for Sanders’s Medicare for All plan project it would cost at least $30 trillion over a decade. To pay for those programs, candidates have focused on taxing corporations and the wealthy. But many of the plans they’ve put on the table would require across-the-board tax increases that would hit middle-earners as well as the wealthy. Some of the less ambitious plans that would preserve employer-based insurance -- like those Buttigieg and O’Rourke have said they support -- would likely cost less than Sanders’s proposal, but could still require middle-class tax increases, depending on their size. (Davison, 7/30)

“Tonight in America as we speak, 87 million Americans are uninsured or underinsured but the health-care industry made $100 billion in profits last year," said Sen. Bernie Sanders (I-Vt.). In the first part of his statement, Sanders is quoting from a 2019 report from the Commonwealth Fund. The report said that the number of people who are uninsured — 24 million — had declined since the passage of the Affordable Care Act in 2010, but that more people are “underinsured.” That term refers to out-of-pocket costs that exceed 10 percent of income (or 5 percent of income if low-income, as well as deductible that were more than 5 percent of income. It also covers people who may have had a gap in insurance coverage. The report said that 43.8 million people had insurance but were underinsured, while 19.3 million people had a coverage gap. (Kessler, Rizzo and Kelly, 7/30)

“Giant corporations and billionaires are going to pay more [under Sanders’s Medicare-for-all plan]. Middle class families are going to pay less out of pocket for their health care," said Sen. Elizabeth Warren (D-Mass.). This isn’t as straightforward as Warren makes it sound. Sanders has put out a menu of possible options for how to fund Medicare-for-all, though many experts says that he still falls short. One option would require a 7.5 percent payroll tax that employers would pay to help fund the program. Virtually every economist will tell you that a payroll tax paid by an employer largely comes out of the pay earned by the employee, but Sanders argues that the savings on the premiums currently paid by the employer should result in an overall reduction in costs for the employer. (Kelly, 7/30)

Kaiser Health News: In A Messy Democratic Presidential Debate, Facts About Medicare For All Get Tossed About 

Delaney: “It’s been well documented that if all the bills were paid at Medicare rate, which is specifically — I think it’s in section 1,200 of their bill — then many hospitals in this country would close. I’ve been going around rural America and I ask rural hospital administrators one question: ‘If all your bills were paid at the Medicare rate last year, what would happen?’ And they all look at me and say, ‘We would close.’” Delaney made this argument to attack Sanders’ Medicare for All plan, which he referred to as “bad” policy in his opening statement. He made this claim about rural hospitals during last month’s debates, too. We rated it False. (Huetteman, 7/31)

Lower-polling candidates did have their moments, though none outshone the top two. The self-help author Marianne Williamson got applause, and a huge surge of attention online, for her comments on racism and reparations. Mayor Pete Buttigieg of South Bend, Ind., drew a forceful contrast with President Trump. Gov. Steve Bullock of Montana, on the debate stage for the first time, made a case for himself as a voice of moderation. (Astor, 7/31)

Montana Gov. Steve Bullock, a centrist who was on the debate stage for the first time on Tuesday, was quick to mention that he was the only candidate in the race who had won a statewide election in a state that Trump won by 20 points in 2016. It was that record, he argued, that would propel him to victory in 2020. “I’m a pro-choice, pro-union populist Democrat that won three elections in a red state, not by compromising our values but by getting stuff done,” Bullock said. (Greenwood, 7/31)

Democratic presidential candidates took the stage for the first night of their second set of debates on Tuesday in Detroit. [Here] is a transcript that will be updated throughout the evening. (7/30)

A coalition of hospitals, insurance companies and drugmakers that oppose "Medicare for All" will air national television ads blasting the proposal during this week's Democratic primary debates. Partnership for America's Health Care Future, which is funded by influential health care groups like PhRMA, the American Hospital Association and the American Medical Association, will air the ads Tuesday and Wednesday nights as part of a six-figure television and digital campaign targeting the proposal and other expansions of Medicare. (Hellmann, 7/30)

Mayor Pete Buttigieg and Gov. Steve Bullock on Tuesday night both spoke in stark terms about how the epidemic of gun violence had personally affected them. During the Democratic presidential debate, Mr. Buttigieg, the 37-year-old mayor of South Bend, Ind., recalled being in high school when two students killed 12 classmates and a teacher at Columbine High School in Colorado in 1999. “I was part of the first generation that saw routine school shootings,” Mr. Buttigieg said. “We have now produced the second school shooting generation in this country. We dare not allow there to be a third.” (Corasaniti, 7/30)

Sen. Bernie Sanders, who, along with Sen. Elizabeth Warren, was the top-polling candidate on the stage, touted his poor ratings from the NRA as proof of his ability to effect major change. “Nobody up here is going to tell you that we have a magical solution to the crisis,” Sanders said. “I have a ‘D-’ voting record from the NRA. And as president, I suspect it will be an ‘F’ record.” (McDonald, 7/30)

A candidate debating gun control at Tuesday’s Democratic presidential primary debate invoked the youngest victim of the mass shooting Sunday at a garlic festival in Gilroy, California. “When that little 6-year-old boy died, Stephen Romero, when his dad said, ‘he’s only 6 years old’ — all I can say is: He’s 6 years old. We have to remember that,” said Sen. Amy Klobuchar, D-Minn., as she called for gun control measures such as universal background checks. (Gilmour, 7/30)

Over the last decade, an unrelenting stream of mass shootings with increasing body counts has horrified the public, fanned liberal activism and emboldened Democrats to embrace gun control policies that would dramatically increase the federal government’s restrictions on gun purchases. Almost every candidate in the field supports universal background checks, implementing “red flag” laws to take away guns from high-risk individuals, and bringing back a ban on the sale of “assault” weapons similar to the one the nation had between 1994 and 2004. And they have not been apologetic about it. (Pearce, Finnegan and Hook, 7/30)

Gun control had already become a rising issue in Virginia after 12 people were killed in a mass shooting in Virginia Beach on May 31. A recent legislative breakdown over gun laws demonstrates how it could be a centerpiece of the state’s upcoming elections. Virginia has a Democratic governor, Ralph Northam, but both houses of its legislature are narrowly controlled by Republicans, who have a 51-48 majority in the lower house and a one-seat advantage in the Senate. (Kim, 7/30)

Montana Gov. Steve Bullock (D) on Tuesday accused Sen. Elizabeth Warren (D-Mass.) of playing into President Trump’s hands on immigration by calling to decriminalize illegal border crossings. In a heated exchange during Tuesday night's Democratic presidential debate, Warren argued that the law criminalizing border crossings allowed Trump to separate families and jail children. “We need to fix the crisis at the border, and a big part of how we do that is we do not play into Donald Trump’s hands, but he wants to stir up the crisis at the border, because that’s his overall message,” Warren said. (Elis, 7/30)

Pledges to repeal Section 1325 of Title 8 of the U.S. code — which makes "improper entry" into the U.S. a federal misdemeanor crime — have gained traction among some of the more progressive candidates in the large Democratic primary field after Obama-era Housing Secretary Julián Castro pressed fellow Texan Beto O'Rourke on his opposition to repealing the law during the debate last month. Under the widely criticized and now discontinued "zero tolerance" policy, the Trump administration employed Section 1325 to prosecute thousands of migrant parents who crossed the southern border illegally and forcibly separate them from their children.  (7/30)

Sanders agreed and defended his proposals to provide undocumented immigrants health care coverage and free college tuition. “When I talk about health care as a human right, that applies to everyone in this country,” he said. Their comments come after 10 of the Democratic contenders were asked in the first debates if they would decriminalize border crossings, and all present raised their hands. (Pager, Kinery and Egkolfopoulou, 7/31)

Sen. Ted Cruz was confronted at Los Angeles International Airport on Sunday by protesters who decried the detention of migrants at the U.S.-Mexico border. A video shared on social media showed people in the airport chanting, "Free the children!" as a smiling Cruz stood uncomfortably in the terminal. "Americans will not be silenced!" at least one protester shouted. At one point, the Texas Republican took time to pose for a photograph with a woman even as the chants continued.  (Cummings, 7/30)

President Trump's campaign will air an ad during the Democratic debates this week highlighting the candidates' support for providing health care to immigrants without legal status. Democrats are "putting illegal immigrants before hardworking Americans," says a narrator in the ad, which will air on CNN, MSNBC and Fox during the debates Tuesday and Wednesday. (Hellmann, 7/30)

President Trump’s 2020 campaign manager accused Democrats of fighting to increase taxes for the middle class and make patients wait in long lines for health care in the midst of the second 2020 Democratic debate. “Democrats are fighting to take away private insurance, tax you for it, and then convince you that the Government will give you better coverage,” Brad Parscale tweeted Tuesday night. (Pitofsky, 7/30)

The Tuesday debate will tee up an an even starker contrast on health care on Wednesday, when former Vice President Joe Biden is again likely to advocate for a more incremental health plan that pulls the party back from its leftward lurch and Sen. Kamala Harris promotes her new twist on Medicare for All. Harris' new plan, which she released on Monday, could upend the dynamics of an issue that's energized Democratic voters — but one that more moderate Democrats worry will hurt the party’s shot at defeating President Donald Trump. (Pradhan and Cancryn, 7/30)

Expect health care to be a big issue, as it was on Night 1. Sen. Kamala Harris of California unveiled her "Medicare for All" plan on Monday, presenting a middle ground between more progressive candidates' stances looking to replace private health insurance and that of Biden, who wants a public option. (Montanaro, 7/31)

The Trump administration says it will set up a system allowing Americans to legally access lower-cost prescription drugs from Canada. Health and Human Services Secretary Alex Azar made the announcement Wednesday morning. Azar, a former drug industry executive, says U.S. patients will be able to import medications safely and effectively, with oversight from the Food and Drug Administration. States, drug wholesalers and pharmacists would act as intermediaries for consumers. (7/31)

Lawyers for the American Civil Liberties Union told a federal judge Tuesday that the Trump administration has taken nearly 1,000 migrant children from their parents at the U.S.-Mexico border since the judge ordered the United States government to curtail the practice more than a year ago. In a lengthy court filing in U.S. District Court in San Diego, lawyers wrote that one migrant lost his daughter because a U.S. Border Patrol agent claimed that he had failed to change the girl’s diaper. (Sacchetti, 7/30)

Family breakups have been imposed with even greater frequency in recent months under the Trump administration’s most widely debated immigration policy, ostensibly to protect the welfare of the children, but in many cases because of relatively minor criminal offenses in a parent’s past, such as shoplifting or public intoxication, according to tallies the Justice Department provided to the American Civil Liberties Union, which is challenging the separations. Earlier this month, the acting Homeland Security secretary, Kevin McAleenan, said in testimony before the House Oversight and Reform Committee that separations were “rare” and made only “in the interest of the child.” (Jordan, 7/30)

"It is shocking that the Trump administration continues to take babies from their parents," said Lee Gelernt, deputy director of the ACLU's Immigrants' Rights Project. "The administration must not be allowed to circumvent the court order over infractions like minor traffic violations." (Gonzales, 7/30)

Tuesday's filing marks yet another development in the family separation lawsuit that began in 2018. Earlier this year, a federal judge ruled that potentially thousands more parents and children the US government split up at the southern border would now be included in the lawsuit over family separations. (Alvarez, 7/30)

The ACLU has been receiving monthly updates from the government on new separations over the past year. Of the 911, 678 were based on criminal conduct, 71 on gang affiliation, 20 for allegations of unfitness or safety concerns, 46 for unverified familial relationship and 24 for parental illness.The government’s explanations don’t get more specific than that in many cases, although the ACLU has been rounding out the record with sworn declarations from the network of attorneys who have been representing separated families. One father was separated with his three young daughters because he has HIV, according to one attorney. Another mother who broke her leg at the border did not immediately have her 5-year-old child returned once she was released. (Davis, 7/30)

The policy created a massive outcry, and the backlash forced the administration to walk it back just three months later. In his executive order ending the policy, President Trump said it is the "policy of this Administration to maintain family unity" unless detaining a child with its parents "would pose a risk to the child’s welfare." (Weixel, 7/30)

The attorneys asked the court to provide additional guidance on the criteria for separating families and “to reaffirm the basic premise of this Court’s preliminary injunction: that children should not be taken from their parents absent a determination that the parent is genuinely unfit or presents a true danger based on objective facts.” (Silva, 7/30)

The Trump administration is scouting sites in central Florida, Virginia and Los Angeles for future facilities to hold unaccompanied minors who have crossed the U.S.-Mexico border. The U.S. Department of Health and Human Services sent letters to Florida lawmakers Monday saying it is looking for vacant properties in those locations to build permanent licensed facilities for children under age 18 who have entered the United State illegally without a parent or guardian. (Schneider, 7/30)

The federal government is considering Central Florida as a site for future permanent shelters to hold unaccompanied migrant children, according to a letter emailed late Monday to several Orlando-area state lawmakers. The content of the letter was confirmed by U.S. Health and Human Services to the Times/Herald. (Madan and Mahoney, 7/30)

Planned Parenthood and the American Civil Liberties Union are suing the state of Missouri to stop a law that bans abortions beyond the eighth week of pregnancy from taking effect Aug. 28. The organizations allege in the federal lawsuit filed Tuesday that the abortion bill signed in May by Missouri Gov. Mike Parson that does not include exceptions in cases of rape or incest is part of an "unrelenting campaign to deny patients the health care they seek and to which they are entitled." (7/30)

“Extreme legislators are really pushing to find any way possible to outlaw abortion in the state,” said Colleen McNicholas, chief medical officer of Planned Parenthood of the St. Louis Region and Southwest Missouri. Among the defendants named in the lawsuit are Republican Gov. Mike Parson, Attorney General Eric Schmitt and Randall Williams, director of the state Department of Health and Senior Services. The Republican-controlled Legislature passed HB 126 in May. Parson signed it over objections from abortion-rights activists, Democratic lawmakers and Republican megadonor David Humphreys. (Fentem, 7/30)

"By imposing a ban on abortion prior to viability, the 8-Week Ban violates Plaintiffs' patients' rights to privacy and liberty guaranteed by the Fourteenth Amendment to the United States Constitution," the groups wrote. The challenge joins several others by abortion rights supporters in response to laws passed this year restricting abortion in Alabama, Arkansas, Georgia, Indiana and Ohio. (Kelly, 7/30)

Planned Parenthood's new president said Tuesday that the organization has been “politicized” by abortion opponents and that it is first and foremost a health group. “We are primarily a health care provider. We provide access to sexual and reproductive health, in some cases primary care,” Alexis McGill Johnson told CBS News in her first interview since becoming head of Planned Parenthood. (Pitofsky, 7/30)

The head of Planned Parenthood in Southern New England said employees across the region’s 17 clinics are undaunted by threats to the nonprofit’s federal funding, and she pledged not to let attacks from government leaders interfere with the group’s mission. Amanda Skinner’s remarks on Tuesday came days after the Trump administration began enforcing new regulations that prohibit Title X grant recipients from counseling patients about abortion. (Carlesso, 7/30)

While Georgia’s population has ballooned in recent decades, the number of abortions dropped more than 18% in 23 years, according to state records, much of it due to increased access to birth control, experts say. Anti-abortion activists and lawmakers motivated by the desire to stop even one abortion from occurring in the state passed legislation earlier this year that all but outlaws the procedure as early as six weeks into pregnancy. (Prabhu, 7/30)

The Trump administration hasn't given up on its 340B hospital reimbursement cuts, but officials have also come up with a smaller, alternative pay cut in case the CMS loses its ongoing court battle over the original plan. In the CMS' newly proposed outpatient payment rule released late Monday, the administration walked a careful line. The steep Medicare Part B cuts to 340B hospitals will continue for now, even though a federal judge has blocked them and demanded a government remedy to providers that saw the cuts. (Luthi, 7/30)

The CMS on Monday issued several proposed rules that, among other changes, would require hospitals to publish payer-negotiated prices for various services alongside standard gross charges. The goal is to make it easier for patients to understand the cost of a hospital service before accessing care, according to agency leadership. Starting in January 2019, the CMS began requiring hospitals to publish their list of retail charges for healthcare services—a move that's been roundly criticized since patients rarely pay those rates. (Cohen, 7/30)

Kaiser Health News: Trump Administration Moves To Make Health Care Costs More Transparent

Shopping around for the best deal on a medical X-ray or a new knee? The Trump administration has a plan for that. On Monday, it proposed new rules that would provide consumers far more detail about the actual prices hospitals charge insurers. It comes amid growing calls from consumer advocates, who argue transparency can help tackle rising health care costs. But the plan also has the potential to overwhelm patients with data. (Appleby, 7/31)

The CMS is asking stakeholders if hospitals should report quality information on their websites alongside retail charges. Tucked within its 819-page Medicare Outpatient Prospective Payment System proposed rule this week, the CMS requested feedback on ways patients can have better access to quality data including the value of providers displaying information related to the volume and complication rates of procedures that would be listed alongside the retail charges hospitals are already required to show. (Castellucci, 7/30)

The CMS hinted at some of the ways it plans to use technology to get patients more timely access to healthcare services and data as part of its latest set of proposed payment rules. The agency on Monday issued several proposed updates to its payment rules for 2020, including changes to the Medicare physician fee schedule and quality payment program. As part of its proposed changes to the Medicare physician fee schedule for next year, the CMS said it wants to add new codes for telehealth treatment for opioid use disorders. (Cohen, 7/30)

The CMS is eying a potentially massive regulatory overhaul for the two big players in organ transplants: the regional contractors that procure and distribute organs for transplant and the transplant centers themselves. The agency's announcement was embedded in an 800-page hospital regulatory proposal released on Monday night. It came as a sign that the Trump administration will continue working on the highly political and contentious policy issue that is the nation's organ allocation system. (Luthi, 7/30)

The Centers for Medicare and Medicaid Services on Tuesday unveiled a new initiative that aims to connect the dots between a patient’s health records held by different providers. The Data at the Point of Care, or DPC, demonstration seeks to bridge the data gap by connecting Medicare’s Blue Button — a tool that allows Medicare patients to download their health records and save them in computer files or apps — directly to a patient’s doctor. A doctor could then see claims data from a patient’s other providers that might not be accessible otherwise. (Clason, 7/30)

Medicaid expansion advocates are eyeing 2020 wins in red states by taking the issue straight to voters, a strategy that yielded success last year in other Republican-led states. Proponents are petitioning Florida, Missouri and Oklahoma to include ballot measures asking residents if they want to broaden out the federal health care program to cover more low-income adults, many of whom are uninsured. (Hellmann, 7/30)

Ohio’s Medicaid enrollment has declined more than 8% in the past two years, raising questions about whether the more than 250,000 former beneficiaries have become uninsured or found other health coverage. According to the Ohio Office of Budget and Management, Medicaid enrollment has fallen in 23 of the past 24 months. More than three fourths of those leaving the rolls were adults while the rest, some 60,000, were children. (Candisky, 7/30)

A deputy commissioner at New York City’s social-services agency was fired after a judge in a disciplinary trial ruled he inaccurately designated 30 employees as performing Medicaid work, forcing the city to repay more than $7 million to the state. In a decision last month, a city administrative judge found that Thomas Colon, 49 years old, wrongly designated employees as performing only Medicaid-related work, which is eligible for a state reimbursement. (Honan, 7/30)

The youngest senator in Congress, and one of its toughest crusaders against Big Tech, proposed a bill Tuesday meant to curb social media addiction by regulating the techniques that prolong engagement on the platforms. Freshman Sen. Josh Hawley’s bill, the Social Media Addiction Reduction Technology (SMART) Act, would make it illegal for social media companies such as Instagram, Twitter and Snapchat to use infinite scroll, autoplay video or techniques like Snapchat’s “streaks,” which reward a user with badges for repeated use. (Mettler, 7/30)

Artificial intelligence is poised to alter care in many medical specialties over the next several years. But few doctors are likely to see as much change as cardiologists, whose practices are already shifting with the use of algorithms to monitor patients’ hearts and produce reams of personalized data. These data can be used not only to detect troublesome heart rhythms, but also to predict future life-threatening heart problems and inform treatment decisions that may head off those episodes. (Ross, 7/31)

Methodist Le Bonheur Healthcare will raise the minimum wage it pays employees, dramatically expand its financial assistance policy for hospital care and stop suing its own employees for unpaid medical debts, hospital officials announced Tuesday. The broad reforms were prompted by a MLK50-ProPublica investigation that detailed how the nonprofit hospital system used aggressive collections tactics, including the courts, to pursue unpaid medical bills from poor patients, including its own employees. “We were humbled to learn that while there’s so much good happening across our health system each day, we can and must do more,” Methodist CEO and president Michael Ugwueke said on a call with reporters Tuesday. (Thomas and Douglas, 7/30)

As the region’s largest hospital system wraps up a 30-day review of its collection and charity care policies, consumer advocates encouraged officials to make fundamental changes that will lift the threat of lawsuits or even wage garnishments for low-income patients who cannot afford their hospital debts. “They could immediately decide to stop suing patients,” Jenifer Bosco, a staff attorney at the National Consumer Law Center, said in a commentary piece for MLK50 this month. “They could decide to stop garnishing wages. It’s not that they have to do those things.” (Thomas, 7/30)

Biologist Jennifer Erwin of the Lieber Institute for Brain Development, however, has no intention of babying her organoids: the world’s first human placentas in a dish that were made from stem cells. Challenging as the half-millimeter-across organoids were to create, she intends to starve them of oxygen and douse them with stress hormones, among other assaults. It’s all for a good cause: to mimic pregnancy complications that raise the risk of brain development going off the rails, resulting in conditions including schizophrenia, autism, attention deficit hyperactivity disorder, and intellectual disability. (Begley, 7/31)

Several years ago I found myself lost one night near Big Sur, Calif. Fog encircled me, erasing the full moon that would have helped me find the path to my friend’s house. I stopped and waited, anxiety building, when suddenly I took several steps into a gap in the fog. The moon, uncovered again, revealed the way forward. A few tiny steps and my entire perspective had changed. I understood the metaphor: Change your perspective to change your life. (Petrow, 7/31)

The Los Angeles County coroner’s office says Disney actor Cameron Boyce died unexpectedly from epilepsy. An autopsy report released Tuesday states the “Descendants” star was found unresponsive at home on July 6, and later pronounced dead at the scene. Boyce’s family said previously that the 20-year-old died due to an ongoing medical condition for which he was being treated, but did not reveal specifics. (Campione, 7/30)

Clinics offering ketamine infusions tout it as “the path to happiness,” the “future of healing and hope,” and a way to “feel good again” and a way to “get back your life” and “feel again.” As use of the medication grows, so has the hype around it. One particularly eyebrow-raising example: A recent press release from Kalypso Wellness Centers boasts a 90% success rate for its infusions, personalized treatment plans based on a patient’s DNA, and success in treating multiple sclerosis, lupus, Lyme disease, and ALS with ketamine. (Thielking, 7/31)

Diapers promising to soften babies’ behinds and digitally track their sleep are hitting the market. Billed as parental aids, the new products also are helping the biggest diaper makers lift prices.Demand for diapers has declined in the U.S. and is set to fall further as Americans have fewer babies, a dilemma for Procter & Gamble Co. , maker of Pampers and Luvs, and Huggies maker Kimberly-Clark Corp. The number of babies born in the U.S. last year fell to a 32-year low, dropping 2% from 2017 to 3.79 million births. (Terlep, 7/31)

When heartburn or ulcer pain strikes, drugs can target stomach acid to calm bellies and offer relief. But a new study suggests the medications may come with a hive-inducing side effect: allergies. After analyzing health insurance data from more than 8 million people in Austria, researchers found that prescriptions of anti-allergy medications surged in those who were prescribed stomach acid inhibitors, a class of drugs that includes proton-pump inhibitors and H2 blockers. (Azad, 7/30)

[Dr. Jeffrey] Wang and transplant specialists at HCMC in Minneapolis said they hope the development can reduce waiting times that have sometimes amounted to a death sentence for patients with kidney failure. In Minnesota alone, 2,160 people are awaiting kidney transplants, and 704 have been waiting at least three years. Last year, 93 people on Minnesota’s list died awaiting transplant, and another 74 were removed from the list because they had become too sick. (Olson, 7/30)

People who exercise in the morning seem to lose more weight than people completing the same workouts later in the day, according to a new study of workouts and waistlines. The findings help shed light on the vexing issue of why some people shed considerable weight with exercise and others almost none, and the study adds to the growing body of science suggesting that the timing of various activities, including exercise, could affect how those activities affect us. (Reynolds, 7/31)

Childhood cancer’s toll amounts to a total of more than 11 million lost healthy years each year — a sum that could be lower if kids got adequate care around the globe. According to a study published Monday in the journal Lancet, underdiagnosis of cancer and lack of access to treatment facilities contributed to death and disability, wiping out those millions of healthy years when children and their families could have instead been spending their resources, time and energies in other ways. And that’s not just bad for them — it’s bad for their communities and beyond. (Santhanam, 7/30)

A new study recently published in the journal Brain Injury points out that 72% of TBI-related emergency department visits among children and adolescents are attributable to specific consumer products and activities. Using 2010-2013 data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), researchers found that between those years, children aged 1-19 years accounted for 4.1 million non-fatal TBI-related emergency department visits. (Pirani, 7/31)

Despite improvements in teen birth rates and child health insurance rates, more Connecticut children are living in single parent families and households that pay more than 30% of their income for housing, according to the 2019 Kids Count Data Book, an annual report on children’s wellbeing throughout the country. (Lyons, 7/30)

Living near oil and gas wells may increase a woman’s risk of having a baby with a congenital heart defect. Researchers writing in Environment International reported on 3,324 infants born in Colorado from 2005 to 2011, comparing 536 babies with heart defects to 2,860 controls matched for sex, maternal smoking, race and ethnicity. (Bakalar, 7/30)

State lawmakers this year passed a bill making Colorado one of the first states in the country to create such a plan. It would guarantee consumers have at least one comprehensive health insurance option across the state, even if private carriers pull out. It would offer coverage at prices competitive to or below current rates. Access and affordability were its buzzwords. But lawmakers left the rest of the details blank. It would be up to [Insurance Commissioner Michael] Conway and Kim Bimestefer, the head of the state’s Medicaid department, to make it all work, a task no state official anywhere in the country has ever actually done. (Ingold, 7/30)

Hygienists in North Carolina have been lobbying for years to be able to clean teeth, take X-rays, check gum health and apply sealants when a dentist is not on-site with them. At long last, they seem to be one step closer to being able to do just that in certain schools, elder care facilities and special-needs centers in some parts of the state. The N.C. Board of Dental Examiners recently endorsed a rule change that could give hygienists a slightly broader scope of practice in one of the most restrictive states in the country. (Blythe, 7/31)

The Manchester VA announced Monday that it has expanded its network of walk-in and urgent care providers across the state, including a couple in the capital area. Eligible veterans enrolled in the VA health care system can visit a provider in the network without prior authorization from the VA, as long as they have received care from the VA or a community provider in the previous two years. (7/30)

Authorities have charged a woman with impersonating a pharmacist and illegally filling more than 745,000 prescriptions in the San Francisco Bay Area. Charges against Kim Thien Le were announced Tuesday. Prosecutors say that from late 2006 through 2017, Le — who didn’t have a pharmacist license — used the license numbers of registered pharmacists in order to impersonate them and dispense prescriptions at Walgreens pharmacies in Santa Clara and Alameda counties. (7/30)

UnitedHealthcare is giving $1.1 million in grants to four Northeast Ohio nonprofits to improve access to health care, according to a news release. The grants are part of UnitedHealthcare’s Empowering Health initiative, which aims to address the social determinants of health, things like access to healthy food, transportation and housing. (Christ, 7/30)

Kaiser Health News: This Indiana Clinic Has Patient-Care Stats Worth Bragging About

When I visited Dr. James Gingerich, he launched into some of the nerdiest bragging I’ve ever heard. We were chatting in front of his stand-up desk at Maple City Health Care Center, the clinic he founded and runs in Goshen, Ind. “Here’s our data,” he said, and started clicking through a set of preventive care benchmarks. (Weissmann, 7/31)

The city is looking for partner communities willing to join it in a lawsuit against the state’s new rules on PFAS chemicals in water, City Manager Shaun Mulholland said Tuesday. “We are considering possibly filing an injunction against the process in which the rules were implemented,” Mulholland said. The state is changing the limits on PFAS, a group of man-made chemicals that includes PFOA, PFOS, GenX, and many others that are used in manufacturing. The state had set the limit of PFAS in drinking water at 70 parts per trillion, identical to the United States Environmental Protection Agency’s limit, but the outcry after the chemicals were found in water in several communities is prompting action in Concord. (Fisher, 7/30)

Calling on Congress to reduce toxic chemicals in drinking water, Attorney General Maura Healey joined her counterparts in 21 states Tuesday in urging federal lawmakers to pass legislation to help states address their threat to public health. The manmade chemicals, known as PFAS, are widespread and have been used for decades in products such as flame retardants, pans, pizza boxes, clothing, and furniture. (Abel, 7/30)

A top Florida health official on Monday disagreed with the findings of a draft federal audit that contends the state overpaid hundreds of millions of dollars to one of Florida’s biggest public hospitals and that $436 million should be returned to the federal government. Agency for Health Care Administration Secretary Mary Mayhew said in a statement that the agency “disagrees with the findings” of the draft audit and that returning the money would impair Jackson Memorial Hospital’s ability to serve uninsured and poor patients in Miami-Dade County. (Sexton, 7/30)

Gov. Gavin Newsom signed legislation on Tuesday that prohibits condoms as evidence of prostitution when prosecuting someone for sex work crimes. Sex workers are also protected under the new law from arrest when they report rape and other serious felonies. (Wiley, 7/30)

Two healthcare giants are expanding a pilot program in the Kansas City area aimed at using their drug stores to provide primary care and other services to Medicare beneficiaries. Humana and Walgreens announced on Tuesday that they plan to open two primary care centers in area Walgreens stores in addition to the two they opened last year. (Margolies, 7/30)

However, the rates of vaccinations for Texas students have been dropping as more and more parents are seeking waivers to the required vaccinations. According to the Texas Department of State Health Services, kindergartners are required to have 10 immunizations to be enrolled in Texas schools. They are not required to have the meningococcal vaccination. However, parents of kindergartners have been seeking more and more exemptions. Since the state first reported exemption rates in 2006, the rate for kindergartners has risen from 0.3 percent in the 2005-06 school year to 2.15 percent for the 2018-19 school year. (Kent, 7/31)

Students in the New Orleans area will get more than just a free backpack at the back-to-school event held by Inspire NOLA this year. Eye, ear and teeth check-ups will be offered, along with access to mental health care at the event on Saturday, August 3. Doctors will also be on hand to sign off on the required physical for student athletes. Inspire NOLA, which operates seven charter schools in New Orleans, started Passport to Student Success, in 2017, but moved to offer health screenings along with backpacks and school supplies this year. (Woodruff, 7/30)

A spiritual retreat center in Western Massachusetts, home to 19 acres of bucolic fields and forested trails, may become a residential treatment facility for young men who need to detach from technology and overcome their debilitating addiction to video games. Odyssey Behavioral Healthcare is awaiting a special permit approval from the town of Leyden, near the Vermont border, to launch the Greenfield Recovery Center, intended for people with “gaming disorder.” (Kuznitz, 7/30)

Braving the weather, nearly 200 residents and hospital employees joined state and local officials to break ground for the new $11.2 million expansion and renovation at St. Martin Hospital in Breaux Bridge. The project, which is funded through a bond approved by Hospital Service District No. 2 voters in March of 2018, will see the hospital more than double in size with an additional 30,000 square feet that will include a new nursing unit with 25 new patient rooms, a new, state-of-the-art MRI suite and a new surgical suite that will allow the hospital to offer surgical services for the first time. (Boudreaux, 7/30)

The University of Maryland School of Medicine appointed the first woman in its history to head the department of surgery, after Dr. Stephen Bartlett left the position in 2017 to take another job within the university. Dr. Christine Lau also was named chief of surgery at the University of Maryland Medical Center. Currently a professor of surgery and chief of the division of thoracic surgery at the University of Virginia, Lau will start at the University of Maryland in December. (Bowie, 7/30)

A transgender woman in Oregon has filed a $375,000 lawsuit against her insurance companies and her employer, saying they’ve discriminated against her by refusing to pay for facial surgery that would make it more likely that strangers would perceive her as female. Christina Ketcham, a 59-year-old Clatsop County employee, has already undergone sex reassignment surgery, hormone replacement therapy, worked with a voice coach and changed her name, clothes and hairstyle to reflect her gender identity, but her doctors also recommend that she undergo “facial feminization surgery” to continue on that path. (Green, 7/30)

President Trump suggested Tuesday that Baltimore is “worse than Honduras” in terms of violent crime, escalating his criticism of the district of House Oversight Committee Chairman Elijah E. Cummings (D-Md.). Trump made the remarks in an interview with The Washington Post. (Kranish and Sonmez, 7/30)

The Cannabis Control Commission has been wrestling with host community agreement (HCA) policy for nearly a year while activists and business owners have pointed to the required agreements as one reason for the slower-than-anticipated rollout of the retail marijuana market and as a barrier that’s keeping small businesses from establishing themselves in the new industry. (Young, 7/30)

FBI agents in black vehicles pulled up at the suburban Pittsburgh headquarters of generic drug giant Mylan NV. Wearing windbreakers with block-yellow FBI logos and carrying a warrant, they headed for the fifth-floor executive offices. The September 2016 raid was meant to surface what a multiyear Justice Department investigation hadn’t found up to that point: evidence that Mylan’s top executives played a role in what authorities have described as widespread price fixing in the generic-drug industry—potentially one of the biggest corporate collusion cases in U.S. history. Mylan, which on Monday announced a deal to be absorbed into Pfizer Inc.’s older drugs unit next year, has denied any wrongdoing. (Griffin, McLaughlin and Elgin, 7/30)

The conservative health policy minds asked to gather at the White House on July 12 were not there to celebrate a legislative victory or to strategize. Instead, the who’s-who list of Republican-leaning advocates received a head-turning admonishment from a key White House aide who told them, in no uncertain terms, to get in line with President Trump. “The president will not be outflanked on the left on drug prices,” said Joe Grogan, the White House’s top policy aide, according to four sources familiar with his remarks, two of whom were present. (Facher, 7/29)

Eli Lilly CEO David Ricks told CNBC on Tuesday that prescription drug costs would still soar even if Democrats managed to cap the prices that pharmaceutical companies are allowed to charge. “There’s a lot of rhetoric in the air, and most of it non-productive,” Ricks told with “Squawk Box. ” “We could cap that forever. And what we get is less innovation and still have growing health-care costs.” Democratic proposals aimed at lowering health-care costs target Big Pharma directly. (Lovelace, 7/30)

Democratic presidential candidates are making bigger promises than ever before on reforming the pharmaceutical industry. But the candidates have not formulated the policies on their own. Instead, to workshop the bold and occasionally far-fetched ideas, Democrats have turned to a familiar cast of outside advisers, according to drug pricing advocates, Capitol Hill aides, and the campaigns themselves. (Facher, 7/30)

Mylan NV has reached a tentative agreement to pay $30 million to resolve a probe by the U.S. Securities and Exchange Commission related to its emergency allergy shot EpiPen, which became the center of a firestorm over price increases. The drugmaker in a regulatory filing on Monday disclosed that it had reached an agreement-in-principle with the SEC's enforcement staff to resolve the investigation that dated back to 2016. Mylan said it will neither admit nor deny wrongdoing as part of the accord. (7/30)

Unusually high numbers of U.S. lymphoma patients are choosing experimental treatments over expensive cell therapies sold by Gilead Sciences Inc and Novartis AG, new data shows, helping explain why sales of the two products have not met rosy expectations. Both Gilead's Yescarta and Novartis's Kymriah - which are part of a class of therapies known in the medical field as “CAR-T” - were approved in 2017. (7/30)

Cancer treatment has never been cheap. But the cost of oncology drugs in the U.S. has become jaw-dropping, and where there are big dollars, business interests compete. And in the world of oncology, that “battle ground” is between cancer doctors and pharmacy benefit managers. (Farmer, 7/29)

Lawmakers working for months on a way to help Minnesotans struggling with runaway insulin prices say they’ve agreed on a plan to get emergency insulin to those who need it. However, there’s no deal yet on how to pay for it, and Capitol leaders haven’t signed off on it. (Bierschbach, 7/29)

ICER's conclusion has patients with Duchenne muscular dystrophy and their families worried, and it led to a tense meeting with ICER's review panel this week in Cambridge. Their concern is that if a treatment is seen as having both little evidence that it works and a high cost, health insurers may choose not to cover it. (Chen, 7/26)

Vertex Pharmaceuticals will promote Reshma Kewalramani, its chief medical officer, to president and CEO on April 1, the company announced Thursday morning. She will succeed Jeffrey Leiden, who said he would step down as president and CEO after seven years in those roles. Leiden, who has also served as chairman, will become executive chairman, a position he will hold through the first quarter of 2023. (Herper, 7/25)

A pair of consumer advocacy groups wants antitrust authorities in Italy and Belgium to investigate Biogen (BIIB) for allegedly abusing its “position in the marketplace” by imposing an “unfair price” for Spinraza, a pricey therapy for treating a rare and fatal childhood disease called spinal muscular atrophy. In arguing their case, the advocacy groups maintain that there is an “excessive” and “disproportionate” difference between the development costs for the medicine and what the Italian and Belgian health systems are paying. And they want authorities to take action in order to strike a balance between innovation and access. (Silverman, 7/25)

Medicaid provides roughly 65 million Americans with health care coverage paid for by taxpayers. This federal-state health insurance program provides a safety net for low-income adults, children, the elderly, and people with disabilities. I worry that it could unravel because of unsustainable spending for unchecked drug pricing. Medicaid spending is growing and it is fast contributing a larger share to federal health spending. States contributed roughly one-third of the half-trillion Medicaid dollars spent last year. (Sen. Chuck Grassley, 7/29)

Sen. Bernie Sanders, I-Vt., again defended his “Medicare-for all” plan Sunday, as he headed from Detroit to the nearby Canadian city of Windsor with a group of diabetics to dramatize the lower cost of insulin in Canada. Sanders is bound to mention his Canadian trip when he debates nine other presidential contenders Tuesday night to make his frequently stated point that Americans pay too much for prescription drugs and that pharmaceutical companies' “greed” to blame. (Sally Pipes, 7/29)

Pfizer on Monday announced a deal to combine its off-patent drugs with Mylan, one of the world’s largest generic manufacturers. This Big Pharma cocktail could help both manufacturers cope with increased competition, but maybe it should come with a black box warning for investors: High risk of political intervention. (7/29)

When I was 13 years old, my doctor told me I had Crohn’s disease, a painful gastrointestinal condition that swells the intestines and threatens the digestive tract. Breakthrough treatments like Remicade, Enbrel, and Humira were still decades away, so the diagnosis cost me my colon. My surgeries and the lifelong challenges — and triumphs — that came with them inform my vantage point in the simmering drug pricing debate. I believe in the social contract that drug companies, mine included, have a duty to responsibly set list prices so patients can access needed medicines. And I think it’s time for industry leaders to exert more pressure on colleagues who violate that contract. (Paul Hastings, 7/30)

Merck & Co. has a problem, but it’s the kind of problem the rest of the pharmaceutical world  wish they had.  The drugmaker released second-quarter earnings and revenue figures Tuesday that smashed Wall Street expectations and prompted a significant boost to full-year guidance. The driver – as always for Merck – was blockbuster immune-boosting cancer treatment Keytruda. Sales of the medicine, which is approved to treat a wide variety of cancers, were $2.6 billion in the latest quarter, 58% higher than a year earlier. Keytruda’s performance was so good, its year-over-year growth exceeded the second-quarter sales of all but one other Merck franchise.  (Max Nisen, 7/30)

Health care is the number one issue on the minds of Democratic voters: Nearly 9 in 10 of them saying they want the topic discussed during the presidential candidate debates. Indeed, all candidates vying for the Democratic nomination seem to agree that everyone should have health care coverage, marking a huge step forward. After all, not long ago advocating for “universal” coverage was highly sensitive political territory. But many candidates have been vague and noncommittal about how, exactly, they want to reform our health care system. Voters deserve the opportunity to understand the real, significant differences between each candidate’s approach to this critical issue. As voters watch the debates this week, they should pay close attention to the candidates’ answers (and non-answers) to these three key questions. (Arthur ''Tim'' Garson, Jr. and Ryan Holeywell, 7/30)

It was the Detroit Donnybrook. Tuesday’s Democratic debate was choppy but passionate, opening up wide philosophical divisions within the party’s presidential field and providing sound bites critical of progressive ideas and candidates that Republicans are certain to use in 2020. Moderate candidates trailing in the polls went in determined to upend Sens. Elizabeth Warren (Mass.) and Bernie Sanders (Vt.), the two strongest candidates on the stage and leaders of the party’s left. Warren and Sanders were still standing at the end. Warren was consistently crisp, displaying the mastery-on-the-run that has lifted her in the polls. (E.J. Dionne Jr. 7/31)

It wasn’t the debate result many in the media wanted. Author Marianne Williamson was the surprise star of a debate where she had very little time compared to her opponents – less than half that of the big-name candidates. Williamson’s debate strategy was to push for “radical truth-telling.” This included a call for up to $500 billion in reparations for African-Americans and some tough talk about the Flint, Michigan, water crisis that won her loud support in the Detroit audience. New York Times reporter Katie Benner pointed out how Williamson used Flint “to tackle the issue of racism head on.” (Dan Gainor, 7/30)

I’m no good at sartorial stuff, so I can’t describe how Bernie Sanders and Elizabeth Warren were actually dressed. But I can tell you what they were effectively wearing: targets. They came into the debate in Detroit on Tuesday night not just as the highest-polling candidates among the 10 on the stage, but also as the most ardent progressives, with plans more expansive and expensive than their rivals’. That gave those rivals both the motivation and the means to attack. (Frank Bruni, 7/31)

Just in time for her second Democratic presidential debate appearance, on Wednesday night, Sen. Kamala D. Harris (Calif.) has unveiled a Medicare-for-all plan. The timing of Harris’s release is excellent news for health-care wonks; now CNN’s Dana Bash, Don Lemon and Jake Tapper will have an opportunity to ask her to fill in the plan’s somewhat scanty details. Here are some questions about Harris’s Medicare-for-all plan the debate moderators might want to consider. (Megan McArdle, 7/30)

When did so many of our elected leaders become so uncompromising on health care? Was it the moment when many in the Democratic field raised their hands in support of providing subsidized health insurance to all undocumented immigrants? That’s a position that even our peer countries with better coverage rates have yet to embrace. (Vin Gupta, 7/30)

After months of confusing statements on the campaign trail, Sen. Kamala D. Harris (D-Calif.) has finally released her proposal to offer comprehensive, universal health-care coverage under the Medicare-for-all brand. Harris’s rollout Monday was met with swift criticism from both the Biden camp, which called it “A Bernie Sanders-lite Medicare for All,” and the Sanders camp, which insists Harris “can’t call [her] plan Medicare for All.” (Charles Gaba, 7/30)

Opponents have accused the Trump administration of taking a fragmented, inconsistent approach toward the health-care system. They are wrong. There is a definite overriding strategy which favors deregulation and the re-introduction of market forces to provide more choices for patients, while at the same time protecting the essential pieces of the existing system — namely, employer-based insurance, Medicare and Medicaid. (Marc Siegel, 7/30)

There may come a day when we here in America have settled our major arguments about what sort of health-care system we should have and all that remains is making minor adjustments to something whose basic structure is no longer a point of contention. This is not that day. But this day is the anniversary of the day 54 years ago when President Lyndon B. Johnson signed the bill that created Medicare and Medicaid. (Paul Waldman, 7/30)

‘If I’m elected president,” Joe Biden says, “we’re going to cure cancer.” Mr. Biden has a personal interest in the disease, which killed his son Beau in 2015. But the Obama-Biden administration had a bad record on screening, the best way to save patients from cancer. When Barack Obama was president, the U.S. Preventive Services Task Force—a panel of experts in the Health and Human Services Department, whose advice guides coverage decisions for both private and government insurance—argued that screening should be limited to prevent false positives, which the panel claimed cause distress and unnecessary further testing. (Betsy McCaughey, 7/30)

Recently-released preliminary data from the federal Centers for Disease Control and Prevention shows that opiate overdoses in Ohio fell by four times the national average in 2018 — a decline of 22%. At a time when we often struggle to find good news and wonder if government can do anything but fail, we can take comfort in these facts because they were so very hard to achieve. The plan we developed in Ohio to start turning the tide on the opiate epidemic is a model for other states to follow and I want to share it as far and wide as possible so more lives can be saved. (Former Ohio Governor John Kasich, 7/31)

Last month, the Centers for Disease Control and Prevention announced that, after decades of relentless increases, there is finally evidence that the number of fatal drug overdoses is declining. Averaged across all states, in 2018, there were 4% fewer deaths. Experts from around the country expressed cautious optimism that the money and effort spent to rein in the opioid crisis — the worst drug epidemic in modern history — is finally yielding results.The story is less hopeful here in Missouri where, despite receiving some $65 million in aid from the federal government since 2015 to address the epidemic, preliminary data shows that we defied the national trend, and our death rate actually increased by about 17%. (David Patterson Silver Wolf, 7/30)

Cannabidiol — better known as CBD — is everywhere, from small specialty shops to large national retail chains. It can be found in foods, supplements, drugs, oils, creams, pet foods and more, and sellers purport that the compound treats everything from cancer to depression. Analysts say the market could surpass $20 billion by 2024. But many of the compound’s expansive benefits are fanciful, and in fact, the sale of much of the product is illegal under current law. The Food and Drug Administration must act to make sure commercial interests don’t strip away any legitimate value that the compound might have. (Scott Gottlieb, 7/30)

Boise, Idaho – a bit shy of a quarter-million people – would rank as only the third most populous city in Los Angeles County. But it’s big enough to take up a federal court case that could radically change how Los Angeles and virtually every other city and county in nine Western states – including Hawaii and Alaska – deal with the homeless people in their midst. A year ago, the 9th U.S. Circuit Court of Appeals told Boise that it’s unconstitutional to stop the homeless from sleeping in public spaces if there’s not enough shelter available for them. Now Boise wants the U.S. Supreme Court to have a look at that decision. (Patt Morrison, 7/31)

Nearly 100 years ago, a team of archaeologists working in Greenland stumbled onto something strange: careful arrangements of brightly colored stones nestled into the frozen landscape. There was no mistaking they were intentional, the ovals of red and white pebbles, but what were they? (Dorsa Amir, 7/30)

Although the victim may need to leave the perpetrator for safety, separation may not be enough to eliminate the risk of harm by the violent partner, and at times, it may increase danger to the victim. Therefore, it is important that victims develop an action plan to relocate to a victims’ shelter or to another secure, supportive environment. (Spencer Eth and Sharon Kasanoff, 7/31)

As a mom of two kids, air quality is particularly important to me. I’ve had to rush my infant child to the emergency room as he struggled to breathe. Too many parents are now sharing that terrifying experience because our air quality has deteriorated so badly. No one should have to check air pollution reports before letting their kids play outside or go for a hike. (Stacy Jayawardene, 7/29)