The Wall Street Journal: Affordable Care Act Battle Returns To Court And Capitol Hill
The battle between congressional Republicans and the White House over the Affordable Care Act is again escalating—in court and on Capitol Hill. The administration on Wednesday appealed a federal trial judge’s ruling that the government is improperly reimbursing insurers under a program to cover discounts for low-income consumers. And House Republicans on Thursday began two days of hearings to hammer away at the issue. They released a report that said the administration distributed the funds even though it was aware it needed Congress’s approval. (Armour, 7/7)

Bloomberg: Next Generation Of ACA Challenges Meeting Mixed Reception
Ever since the Supreme Court slapped away a direct challenge to the Affordable Care Act, opponents of the law have turned to collateral attacks on it’s implementation by the HHS as a possible way to paralyze and eventually kill the law. Two of these attacks recently reached the federal appeals court in Washington D.C. (Loughran, 7/7)

Morning Consult: Did The White House Overstep Appropriations Law To Pay Insurers?
House Republicans on Thursday released an investigative report and held the first of two hearings questioning the legality of Obamacare’s cost-sharing reduction program. That program is also the subject of a House lawsuit against the administration. ... The cost-sharing reduction program was included in the Affordable Care Act as one of two ways to relieve the cost burden for low-income enrollees on the individual market. The other method is premium tax credits for those falling between 100 percent and 400 percent of the federal poverty level. (Owens, 7/7)

The Hill: GOP Report Calls ObamaCare Payments Unconstitutional
An investigation by House Republicans argues that the Obama administration is illegally making certain payments under ObamaCare and that officials initially recognized they did not have authority to do so before reversing course. House Republicans argue that the administration is unconstitutionally making ObamaCare’s “cost sharing reduction” payments to insurers — which help lower out-of-pocket healthcare costs for low-income ObamaCare enrollees — without a congressional appropriation. (Sullivan, 7/7)

In other health law news --

The Associated Press: Study: Trump Health Care Plan Would Make 18M Uninsured
Donald Trump's health care plan would make 18 million people uninsured, but also lower premiums significantly for policies purchased directly by consumers, according to an independent study released Thursday. The new policies would be stingier than what's sold now. Trump's plan would have little effect on people covered by employers and those on Medicare. But millions of low-income adults covered by the Medicaid expansion under President Barack Obama's health care law would lose newly gained benefits. Separately, taxpayers might save money because the government no longer would have to subsidize insurance for millions of citizens. (Alonso-Zaldivar, 7/7)

Stateline: Under Affordable Care Act, Growing Use Of ‘Community Health Workers’
Thanks in part to federal grants awarded under the Affordable Care Act, the number of community health workers is growing. In 2015, there were 48,000 of them working in the U.S., up from 38,000 three years earlier, a 27 percent increase, according to the U.S. Department of Labor. But many insurers still don’t cover their services, limiting their potential impact. (Ollove, 7/8)

The CT Mirror: Access Health CT Faces Growing Challenges As Insurers Drop Out
In the wake of a state order halting new enrollment in Connecticut's co-op health insurer, HealthyCT, the state's health insurance exchange faces growing challenges as it prepares to lose two of its four carriers. The exchange, Access Health CT, has been widely heralded as one of the strongest state health insurance exchanges in the country, but loss of the two insurers will limit the options available to customers in search of health insurance. Officials at the exchange remain optimistic, although they concede the next two years will be volatile. (Constable, 7/8)

Reuters: U.S. Democrats Pressure Republicans For Bipartisan Zika Funding
The White House and congressional Democrats pressured Republicans on Thursday for bipartisan Zika-funding legislation, saying the public health battle against the mosquito-borne virus is being undercut by efforts to ram through a bill with less funding. But there was no sign that Republicans would abandon their $1.1 billion measure, raising the chance that Congress will leave the growing health crisis unattended until September. (Morgan, 7/7)

Morning Consult: Obama Involved In White House Urging Of Zika Funding
Obama has personally spoken with Senate Majority Leader Mitch McConnell and top Senate democrats about Zika funding in the past few days, according to a White House advisor. The White House again called on Congress to pass a bipartisan deal that would provide funding for the Zika virus before adjourning next week in a call with reporters Thursday, saying more consequences will be evident if legislators leave town for the rest of summer without providing new funding. (McIntire, 7/7)

The Hill: Obama Gets Involved In Last-Ditch Push For Zika Funding
President Obama this week has personally lobbied leaders in Congress over funding for the fight against the Zika virus. Obama has spoken with Senate Majority Leader Mitch McConnell (R-Ky.) as well as top Senate Democrats over the “past few days,” White House homeland security adviser Amy Pope told reporters Thursday. (Ferris, 7/7)

The Hill: Dem Senator To McConnell: Bring Back Senate Zika Deal
Sen. Bill Nelson is asking Majority Leader Mitch McConnell (R-Ky.) to bring up a Senate-passed bill to combat the Zika virus ahead of Congress's seven-week recess. The Florida Democrat sent a letter to McConnell Thursday noting that a $1.1 billion deal passed the Senate in May with bipartisan support. (Carney, 7/7)

In other news, a survey shows that women are willing to accept advisories from the Centers for Disease Control and Prevention to avoid pregnancy during the Zika outbreak —

Politico Pro: Most Americans OK With Advice Against Pregnancies During Zika Outbreak
The majority of Americans would accept federal advice to women to avoid pregnancy during a Zika outbreak, according to a survey released Thursday. So far, officials have stopped short of such advice but warned about the risks Zika poses to pregnant women and their babies. The survey by PSB Research found the stark advice was acceptable to about 62 percent of Americans, of whom 21 percent said it would “absolutely” be appropriate for the government to issue it. About 9 percent said such advice was completely inappropriate. (Ehley, 7/7)

The New York Times: U.S. Bans Theranos Founder From Running Lab For Two Years
United States regulators have banned Elizabeth Holmes, the chief executive of Theranos, from owning or operating a medical laboratory for at least two years, in a major setback for the embattled blood-testing firm and its once widely lauded founder. In a statement late Thursday, Theranos said the regulators also yanked the operating license of its Newark, Calif., laboratory and forbade the laboratory from taking Medicare and Medicaid payments for its services. Regulators will also levy a monetary penalty that Theranos did not specify. (Tejada, 7/8)

The Wall Street Journal: U.S. Regulator Bans Theranos CEO Elizabeth Holmes From Operating Labs For Two Years
The sanctions, which include an unspecified monetary penalty, cap eight months of public scrutiny that began in October when The Wall Street Journal raised questions about the company’s ability to perform a wide variety of blood tests with just a few drops of blood. Theranos once was a leading light in the technology boom, with the private company valued at $9 billion in 2014. (Siconolfi, 7/8)

Stat: Theranos CEO Elizabeth Holmes Banned From Operating A Lab For Two Years
Along with the ban on Holmes, CMS has pulled the operating license of the company’s Newark laboratory and will also levy a fine, Theranos announced in a statement. It’s not clear yet how much the company, once valued at $9 billion, will have to shell out. “While we are disappointed by CMS’ decision, we take these matters very seriously and are committed to fully resolving all outstanding issues with CMS and to demonstrating our dedication to the highest standards of quality and compliance,” Holmes said in the statement, adding that the company accepts “full responsibility for the issues” at the lab. (Thielking, 7/8)

Reuters: Justice Dept. Has Concerns Over Aetna-Humana Deal: Source
The U.S. Department of Justice has significant concerns about Aetna Inc's proposed acquisition of health insurer Humana Inc, a source familiar with the situation said on Thursday, sending shares of Humana down as much as 11 percent. Aetna's purchase of Humana would combine two of the largest providers of Medicare Advantage plans for elderly people, and investors have long been concerned the deal might pose a competition issue for antitrust regulators. (7/7)

Bloomberg: Aetna Said To Meet With DOJ On Friday About Humana Deal
Aetna Inc. is preparing to meet with top U.S. Justice Department officials on Friday as it seeks to win antitrust approval for its $37 billion takeover of rival Humana Inc., people familiar with the matter said. The insurer plans to meet with antitrust officials, including the department’s No. 3, Bill Baer, one of the people said, a top-level gathering that signals the review is entering a final, make-or-break stage. (Tracer, McLaughlin and Hammond, 7/7)

The CT Mirror: Jepsen Concerned About Anthem-Cigna Deal, May Move To Block It
Connecticut Attorney General George Jepsen said he is concerned an Anthem-Cigna merger would result in decreased competition and higher premiums and will make a decision in as soon as two weeks whether to try to block it in court. “Our state's health insurance market is already concentrated,” Jepsen said in a statement. “Further concentration could lead to an unacceptable accumulation of market power, which arguably could lead to higher prices and negative effects on quality of care through reduced products, service and innovation.” (Radelat, 7/7)

Concord Monitor: State: Anthem Is Slow To Provide Information About Proposed Health Insurance Merger With Cigna
The state review of a proposed merger between health insurance giants Anthem and Cigna is being delayed because Anthem has thus far provided “incomplete” information to state requests...Because of the inadequate level of information from Anthem, the review process has been halted, and no public hearing for the $48 billion merger scheduled. (Brooks, 7/8)

Modern Healthcare: CMS Proposes Expanding Diabetes-Prevention Model
In addition to a slew of changes to Medicare's physician payment policies, the CMS on Thursday proposed expanding a program aimed at helping people avoid diabetes. The CMS suggests starting the program in 2018 and is seeking comment whether to launch the effort nationally or in additional select markets. (Dickson, 7/7)

Kaiser Health News: House Panel Extends Funding For Medicare Program To Help Consumers
A House subcommittee voted on Thursday to continue $52 million in funding for a program that helps seniors understand the complexities of their Medicare coverage. Two weeks ago, a Senate committee voted to eliminate it. The measure preserving the State Health Insurance Assistance Program, known as SHIP, is part of a massive spending bill for federal health, education and labor programs. (Jaffe, 7/7)

The Tennessean: Republican Leader Sees Benefits, Problems With Health Care Plan
One of the House Republicans who will be a vital part of selling a health care expansion plan to Tennessee lawmakers sees the first part of a two-phase plan as a good step forward but remains skeptical about a key part that would provide coverage to all Tennesseans. Rep. Glen Casada, R-Franklin, told The Tennessean this week that he is trying to remain open-minded about the recently released plan from the 3-Star Healthy Task Force, which was created by House Speaker Beth Harwell, R-Nashville, in an effort to increase access to health care coverage to uninsured Tennesseans. (Ebert, 7/7)

The Tennessean: TennCare Expansion Plan Raises Mental Health Issues
The TennCare expansion proposal to offer access to coverage to those who suffer from mental health or substance abuse disorders tackles a historically underserved population — but it also confronts serious challenges that come with providing behavioral health care in Tennessee. (Fletcher, 7/7)

The Columbus Dispatch: Lower Medicaid Spending Helped Ohio’s Budget Amid Revenue Shortfall
The cash didn’t flow as expected for last year’s state budget, but Ohio still landed on solid ground thanks to spending that finished $1.2 billion below estimates, due in large part to Medicaid. ... [Medicaid] came in $926 million below projections, $428 million of which was state dollars. The rest was federal. Medicaid has held steady at about 3 million enrollees for 18 months. However, enrollment for the aged, blind and disabled population, the most expensive group covered under the program, has been lower than projected. (Siegel, 7/7)

The Philadelphia Inquirer: Pa. Medicaid Plans Get Hepatitis C Help
The insurer Health Partners Plans had 32 percent of the Medicaid market in Southeastern Pennsylvania last year, but accounted for 70 percent of regional spending on hepatitis C drugs. That meant the Philadelphia company spent $32 million on expensive new drugs to treat the disease that damages the liver - and had to absorb 60 percent of that outlay as a loss .... But this year, Pennsylvania regulators launched a risk-sharing plan to help its Medicaid contractors withstand the crippling costs of hepatitis C drugs. (Brubaker, 7/8)

Morning Consult: Barton, Castor Eye Vote On Children’s Medicaid Bill By Year’s End
A veteran GOP lawmaker is eyeing a September subcommittee markup of a bill that would give states the option to use health homes to provide care the most sickly children enrolled in Medicaid. Rep. Joe Barton (R-Texas) said he hoped the Advancing Care for Exceptional Kids Act would be marked up in subcommittee in September and could be passed before the end of the year. The bill has bipartisan support in both chambers (Florida Democratic Rep. Cathy Kastor is an original co-sponsor on the House side where there are 212 co-sponsors) and should be sent to the White House this year, he said. (McIntire, 7/7)

The Washington Post: Justice Department To Make $40 Million Available For Victims Of Deadly Meningitis Outbreak
The Justice Department plans to make as much as $40 million available for victims of a 2012 fungal meningitis outbreak that federal investigators traced to a batch of contaminated steroid injections after a dispute over whether those affected by the outbreak qualified for such financial assistance was finally resolved, officials said. While some of the details still need to be worked out, the Office for Victims of Crime has decided to make the money available from its Crime Victims Fund, which is financed by fines and penalties paid by those convicted of crimes, the officials said. (Zapotosky, 7/7)

In other news, public health officials are concerned about an outbreak of meningitis currently sweeping through Los Angeles —

Los Angeles Times: Meningitis Outbreak In L.A. Gay Community Prompts Plea For Vaccinations
Los Angeles County public health officials and LGBT advocates are urging gay and bisexual men to get meningitis vaccinations, citing a recent outbreak of potentially deadly meningococcal disease that is disproportionately affecting men who have sex with men. There have been 17 confirmed cases of invasive meningococcal disease confirmed in the county so far this year, including 12 in the last two months, Jeffrey Gunzenhauser, the interim director of the L.A. County Department of Public Health, said Thursday. Eight have been among gay or bisexual men, including seven within the last two months, he said. (Branson-Potts, 7/7)

Stat: Sanders, Other Lawmakers Urge FDA Approval Of Generic Crestor
In a pointed letter, US Senator Bernie Sanders and several other lawmakers urged the US Food and Drug Administration on Thursday to approve generic versions of the best-selling Crestor cholesterol pill. And they maintained that a successful legal challenge by AstraZeneca, which last week sued the agency to thwart lower-cost competition, would be “disastrous” for consumers. (Silverman, 7/7)

The Wall Street Journal: KaloBios Takes Measures To Limit Martin Shkreli’s Shareholder Rights
KaloBios Pharmaceuticals on Thursday said it had reached an agreement with ousted Chief Executive Martin Shkreli to limit his shareholder rights, a week after the rare disease drugmaker said it had emerged from bankruptcy. Mr. Shkreli, who now holds less than 14% of the South San Francisco-based biotech firm’s shares according to the company, was arrested in December on securities-fraud charges unrelated to KaloBios. Soon after, the company filed for bankruptcy protection, fearing the turmoil surrounding Mr. Shkreli created an “imminent threat” to its liquidity. (Steele, 7/7)

Bloomberg: KaloBios In Agreement To Buy Former CEO Shkreli’s Shares
KaloBios Pharmaceuticals Inc. said it has an agreement with Martin Shkreli, the company’s former chief executive officer who came under fire for raising drug prices, to buy back his shares and restrict his shareholder actions, in a move to cut ties with the controversial investor. (Bloomfield, 7/7)

The New York Times: Suicide Rate Among Veterans Has Risen Sharply Since 2001
The suicide rate among veterans has surged 35 percent since 2001, driven in part by sharp increases among those who have served since 2001, according to the largest study of such suicides. Of particular concern is the suicide rate among women, which has increased 85 percent in that time. The Department of Veterans Affairs released key findings Thursday of a recently completed study examining the death records of more than 55 million veterans from 1979 to 2014 from every state. (Philipps, 7/7)

In other news, veterans are the center of attention in the 2016 election, but many aren't sure who the right candidate is —

The Boston Globe: Veterans Who Favor GOP Grapple With 2016 Choice
Traditionally, veterans vote Republican — they did overwhelmingly in 2004, 2008, and 2012 — but little has been traditional about this presidential contest. Now, under the enlarged spotlight of a presidential campaign, local veterans are trying to figure out who will get their vote in a contest in which polls show neither candidate is well liked or thought of as a good commander in chief. ... Still, a recent Morning Consult poll showed veterans and their families largely back Trump, with 47 percent saying they support the likely Republican nominee, compared with 38 percent who favor Clinton. About 14 percent of the 1,668 military voters polled remain undecided, according to the May survey. (Johnson, 7/8)

NBC News: HPV-Related Cancers An 'Epidemic' In Men, Report Finds
The number of cancers related to HPV has dramatically increased, a new government report finds. But too few people are receiving the best protection against the preventable and potentially deadly diseases of the cervix, head and neck: a vaccine given to pre-teens which could protect them later in life. (Gussone, 7/7)

The New York Times: Why Do More Black Women Die Of Breast Cancer? A Study Aims To Find Out
Black women are at a greater risk of dying of breast cancer and of suffering from aggressive subtypes of the disease. Recent advances in survival rates among women of other races haven’t applied to them, and scientists aim to better understand why through a large study. A $12 million grant will finance a study of more than 20,000 black women with breast cancer, comparing them with thousands of black women who do not have the disease and white women who do. (Victor, 7/7)

Stat: Juno Halts Its Immunotherapy Trial For Cancer After Three Patient Deaths
Juno Therapeutics, a pioneer in the sizzling field of treating cancer by revving up the immune system, on Thursday said it had halted development of its lead treatment after three patient deaths, dealing a blow to a promising but still unproven approach to oncology called CAR-T immunotherapy. The treatment, dubbed JCAR015, is created by harvesting a patient’s own immune cells and rewiring them to home in on cancer in the blood. Three patients — all younger than 25 — died after excess fluids accumulated in their brains, Juno said. (Garde and Keshavan, 7/7)

KQED: In Fresno, Cancer Screening Advocates Reach Out To Hmong Community
Older members of the Hmong community, in particular, often resist undergoing screening tests that could save their lives because of cultural beliefs, say health professionals and advocates. Studies show the Hmong community has a higher cancer mortality rate when compared to other Asian Americans, in part because the disease is diagnosed at a later stage, which greatly reduces chances of survival. Part of the issue — low utilization of cancer screenings — is rooted in a distrust of invasive medical procedures, says Kay Vu Lee, chair of the Hmong Cancer Coalition and one of the event’s organizers. (Romero, 7/7)

Meanwhile, a study shows that doctors swiftly adjusted to new research when it comes to treating breast cancer, and a professor of oncology forms a unique partnership —

Kaiser Health News: Study Finds Doctors Quick To Change Practice For Breast Cancer Patients
Doctors cling to comfortable, widely used medical practices, even if they’re no longer particularly effective, right? A new study disputes that popular perception. In the case of a particular breast cancer treatment at least, many physicians quickly abandoned it after a clinical trial showed it was ineffective. The study, published in the July issue of the journal Health Affairs, tracked treatment patterns before and after the results of a major clinical trial that examined the effectiveness of removing lymph nodes near the breast to prevent the spread of cancer. (Andrews, 7/8)

Kaiser Health News: Report: ‘Convergence Science’ Has Potential To Accelerate The Research-To-Product Pipeline
A few years ago, Elizabeth Jaffee, a professor of oncology in the Johns Hopkins School of Medicine, probably wouldn’t have imagined that she would team up with an aerospace engineer to advance her research on cancer therapies. Advancements in mapping out genetic sequences had already given biomedical researchers a wealth of information to study tumors and cells — but they didn’t have existing tools to handle that data. So Jaffee reached out to a professor in the department of physics, thinking that the computer system used to analyze complex data from outer space might be able to accommodate the huge trove of information she had on her hands." (Tan, 7/8)

Stat: Drug Maker Is Warned Over Missing Study About Child Opioids Use
As the nation grapples with opioid abuse and misuse, one drug maker has failed to provide the Food and Drug Administration with a required study about the effect its powerful painkiller might have on teenagers. At issue is Xartemis XR, which Mallinckrodt Pharmaceuticals received regulatory approval to sell two years ago. At the time, the company was also required to conduct a so-called postmarketing study to determine its safety in youngsters between 12 and 17 years old, according to FDA documents .... But as of June 24, the company blew past a March 31 deadline for submitting its pediatric assessment. (Silverman, 7/7)

The CT Mirror: CT Dems Take Stand On Opioid Funding – And Lose
Democrats drew a line in the sand this week on federal funding to battle opioid addiction and their Republican colleagues blithely walked across it. Despite protests and high drama over the level of money the federal government will spend fighting heroin addiction and prescription pain pill abuse, Democrats lost their battle this week to increase federal funds by nearly $1 billion to pay for additional treatment for addicts. The White House estimated the boost in funding would have provided Connecticut with about $9 million over two years to battle opioid addiction in the state. (Radelat, 7/7)

The Boston Globe: When Calories Consume You
As with substance abuse, the science on how best to treat eating disorders can be murky. Talk therapy and peer support groups have long been thought of as effective options. But unlike with alcoholism or narcotics addiction, there is no consensus that addictive overeating is a true medical condition. That can often leave those who struggle with it especially isolated. (Kasulis, 7/8)

Meanwhile, a new study shows that using cartoon characters can actually persuade children to eat their vegetables —

Wyoming Public Radio: Want Kids To Eat More Veggies? Market Them With Cartoons
Be it SpongeBob SquarePants or Tony the Tiger, food companies have long used cartoon characters to market their products to children. But that tactic can also sway younger kids to eat fresh vegetables, according to a new study. Sammy Spinach, Oliver Onion, Colby Carrot, Suzy Sweet Pea and a slew of cartoon vegetable characters with superpowers were developed as puppets by a nonprofit organization called Super Sprowtz. (Chatterjee, 7/7)

The Washington Post: Brain Changes Persist In Student Athletes Six Months After A Concussion, Study Suggests
Despite all the recent attention to cases of long-term traumatic brain injury in National Football League players, concussions in daily sports among the rest of us are still often treated as temporary. There's a lot of evidence to back up this way of thinking. Numerous studies have shown that although players may experience headaches, difficulty balancing and memory or thinking problems immediately following an impact to the head, these symptoms usually disappear in a week or two. According to the current medical criteria for treating concussions, the athletes should then be considered fully recovered and allowed to return to their previous level of activity. (Cha, 7/7)

Stat: Scientists Discover New Threat To Antibiotic Of Last Resort
European scientists have discovered another gene that makes bacteria resistant to the antibiotic of last resort, one that could spread more easily among other kinds of bacteria. The gene, called mcr-2, was found in E. coli bacteria from pigs in Belgium, the scientists reported Thursday in the journal Eurosurveillance. It is similar to the gene mcr-1, which was first identified in China last fall and has now been seen in 30 countries across five continents, including the United States. (Joseph, 7/7)

Stat: First He Pioneered A New Way Of Making Life. Now He Wants To Try It In People
The next great advance in fertility treatments may rest with five young monkeys in a lab outside of town. Each of the five carries genes from three parents instead of two, because they were conceived using a novel — and controversial — gene therapy. ... If so, the three-parent fertilization technique will likely be tried in humans, potentially helping women with certain genetic glitches give birth to healthy children. The same approach might also someday provide older women a chance to extend their fertility by freshening up their eggs with contributions from another woman. (Weintraub, 7/8)

NPR: Synthetic Stingray May Lead To A Better Artificial Heart
Scientists have created a synthetic stingray that's propelled by living muscle cells and controlled by light, a team reports Thursday in the journal Science. And it should be possible to build an artificial heart using some of the same techniques, the researchers say. "I want to build an artificial heart, but you're not going to go from zero to a whole heart overnight," says Kit Parker, a bioengineer and physicist at Harvard University's Wyss Institute. "This is a training exercise." (Hamilton, 7/7)

Milwaukee Journal Sentinel: Woman Calls Attention To Rare Neurological Disorder
According to the National Organization for Rare Disorders, stiff person syndrome, or SPS, is characterized by muscular rigidity and repeated episodes of painful muscle spasms. It can seriously impact a person's ability to perform even routine daily tasks, and it can impair breathing and swallowing. "My husband likens it to the worst charley horse you've ever had, over your entire body. I often have to wake him up at 2 or 3 in the morning to try to get the muscles to stop being so tight. Eventually, it will freeze that way," Nadine said. (Stingl, 7/7)

And in news concerning women's health —

The Columbus Dispatch: More Pregnant Women Might Be Exposed To Nicotine Than Previously Thought, Study Suggests
More women might smoke and be exposed to nicotine while pregnant than previously thought, according to a new study. The study, conducted by researchers at Cincinnati Children's Hospital Medical Center and published Thursday in the Journal of Perinatology, reports that as many as 24 percent of pregnant women at a southwest Ohio maternity hospital smoked or were exposed to nicotine. (Fochesato, 7/7)

California Healthline: ‘Don’t Cut Me!’: Discouraged By Experts, Episiotomies Still Common In Some Hospitals
Episiotomy, a once-common childbirth procedure that involves cutting tissue between the vagina and anus to enlarge the vaginal opening, has been officially discouraged in most cases for a decade. Yet it is still being performed at much higher than recommended rates in certain hospitals and by certain doctors. In 2006, the American College of Obstetricians and Gynecologists released a recommendation against routine use of episiotomy, finding that it benefited neither mothers nor babies. In 2008, the National Quality Forum also endorsed limiting the routine use of episiotomies. The procedure is still supported for use in certain emergency situations. (Wiener, 7/8)

Kansas Health Institute: Budget Cuts ‘Devastating’ Kansas Mental Health System, Providers Say
Kansas community mental health centers are sending a distress signal to state policymakers. The association that represents the state’s 26 community mental health centers issued a statement Wednesday expressing “strong concerns” about the $30 million in funding cuts that it says its members have suffered in the past 12 months. (McLean, 7/7)

The Associated Press: Indiana Sued Over Ultrasound 18 Hours Before Abortion Rule
A new Indiana mandate that women undergo an ultrasound at least 18 hours before they have an abortion is unconstitutional and will prevent some women from getting abortions, a federal lawsuit filed Thursday contends. The American Civil Liberties Union of Indiana and Planned Parenthood of Indiana and Kentucky argue in the suit filed in U.S. District Court in Indianapolis that the provision which took effect July 1 as part of a new law places "an undue burden" on women's constitutional right to seek an abortion. (7/7)

Modern Healthcare: Doctor Alleges University Of Kansas Hospital Misled Patient After Unnecessary Organ Removal
A Kansas doctor has filed a lawsuit against the University of Kansas Hospital Authority, saying a patient was misdiagnosed with cancer, wrongly had an “essential” organ removed and was never told about the mistakes. University of Kansas Hospital Authority pathologist Dr. Lowell Tilzer accused the head of pathology at the University of Kansas Medical Center/University of Kansas Hospital of misdiagnosing a patient with cancer in the lawsuit (PDF) filed in state court last week. ... Tilzer then, in September 2015, urged hospital administrators to conduct a “root cause analysis” to investigate the underlying cause of the mistake. The hospital, however, did not investigate, Tilzer said in the complaint. (Schencker, 7/6)

The Associated Press: US House Probes Response To Toxic Chemical In Drinking Water
A congressional committee is asking state officials and federal environmental regulators for information about their responses to drinking water contaminated with the toxic chemical PFOA in an upstate New York village. The House Committee on Oversight and Government Reform said in letters Wednesday to Gov. Andrew Cuomo and U.S. Environmental Protection Agency Administrator Gina McCarthy it is concerned about the time it took New York officials to take action on the findings in Hoosick Falls and a possible communication breakdown at EPA. (7/7)

Georgia Health News: Atlanta Childbirth Prices Low By National Standards, Study Says
Prices for a regular baby delivery in the Atlanta area range from $5,831 to $10,700, with an average price of $8,497, a report says. That average figure for vaginal deliveries places Atlanta 18th among 30 U.S. cities studied in the Castlight Health report, released last week. For routine Cesarean deliveries, Atlanta’s average price is $9,424, ranking the city 26th. (Miller, 7/7)

The Philadelphia Inquirer: Report: Pa. Hospital Mixups Meant Babies Got Wrong Breast Milk, Treatments
A new study by the Pennsylvania Patient Safety Authority found 1,234 misidentification "events" involving babies born at hospitals and birthing centers in the state in 2014 and 2015, averaging about two a day. In almost all cases, there was no harm to the baby, generally because providers caught the mistake before it led to any incorrect treatment. But in five cases, a newborn experienced harm, according to the study by the state agency. (Avril, 7/8)

Macon Telegraph: Macon-Bibb Exploring New Ways To Curb Teen Pregnancy
Melinda Robinson-Moffett noticed the teens’ expressions change drastically as she shared her story. The teens were all smiles when talking about their favorite pastimes, but morphed into somber faces considering how their fun would be curtailed if they were raising babies. Robinson-Moffett imagined the Mentors Project students thinking, “That is not the life I want,” when she recently counseled them on the pitfalls of teen pregnancy. (Fabian, 7/6)

The Columbus Dispatch: Home News Trade Organization To Serve As Voice For Marijuana Entrepreneurs Amid Regulatory Uncertainty
With medical marijuana slated to become legal in Ohio on Sept. 8, potential cannabis entrepreneurs are faced with two major challenges: growing an entire pot industry from the ground up, and avoiding being choked out by state bureaucrats. Those challenges comprised the major theme of the Ohio Cannabis Association's public forum Wednesday night. The group serves as the first marijuana trade association in the state. (Perkins, 7/8)

Miami Herald: Cannabis Catalyst: Medical Marijuana May Boost Businesses In Florida
By 2018, medical marijuana users will spend nearly $200 million in Florida, according to estimates by New Frontier, a financial analyst that focuses entirely on cannabis. It says that by 2020 the state will make up 14 percent of the nation’s legal marijuana use. (Auslen, 7/8)

Health Affairs: Population Of US Practicing Psychiatrists Declined, 2003–13, Which May Help Explain Poor Access To Mental Health Care
We studied changes in the supply of psychiatrists from 2003 to 2013, compared to changes in the supply of primary care physicians and neurologists. During this period the number of practicing psychiatrists declined from 37,968 to 37,889, which represented a 10.2 percent reduction in the median number of psychiatrists per 100,000 residents in hospital referral regions. In contrast, the numbers of primary care physicians and neurologists grew during the study period. These findings may help explain why patients report poor access to mental health care. (Bishop et al., 7/6)

Health Affairs: Early Efforts By Medicare Accountable Care Organizations Have Limited Effect On Mental Illness Care And Management
People with mental illness use more health care and have worse outcomes than those without such illnesses. In response to incentives to reduce spending, accountable care organizations (ACOs) may therefore attempt to improve their management of mental illness. We examined changes in mental health spending, utilization, and quality measures associated with ACO contracts in the Medicare Shared Savings Program and Pioneer model for beneficiaries with mental illness, using Medicare claims for the period 2008–13 and difference-in-differences comparisons with local non-ACO providers. Pioneer contracts were associated with lower spending on mental health admissions in the first year of the contract, an effect that was attenuated in the second year. Otherwise, ACO contracts were associated with no changes in mental health spending or readmissions, outpatient follow-up after mental health admissions, rates of depression diagnosis, or mental health status. (Busch et al., 7/6)

Pediatrics: Practice Patterns In Medicaid And Non-Medicaid Asthma Admissions
With American children experiencing increased Medicaid coverage, it has become especially important to determine if practice patterns differ between Medicaid and non-Medicaid patients. ... [Researchers studied] 17 739 matched pairs of children (Medicaid to non-Medicaid) admitted for asthma in the same hospital between April 1, 2011 and March 31, 2014 in 40 Children’s Hospital Association hospitals .... Medicaid patient median cost was $4263 versus $4160 for non-Medicaid patients .... Additionally, the median cost difference (Medicaid minus non-Medicaid) between individual pairs was only $84 ... and the mean cost difference was only $49 .... Length of stay (LOS) was also very similar; both groups had a median stay of 1 day. (Silber et al., 7/6)

JAMA: Effect Of Palliative Care–Led Meetings For Families Of Patients With Chronic Critical Illness
[Researchers sought to] determine whether family informational and emotional support meetings led by palliative care clinicians improve family anxiety and depression .... [in a] randomized clinical trial conducted from October 2010 through November 2014 in 4 medical intensive care units. ... At 3 months, there was no significant difference in anxiety and depression symptoms between surrogate decision makers in the intervention group and the control group. ... Posttraumatic stress disorder symptoms were higher in the intervention group .... These findings do not support routine or mandatory palliative care–led discussion of goals of care for all families of patients with chronic critical illness. (Carson et al., 7/5)

American Journal of Managed Care: Primary Care Appointment Availability And Nonphysician Providers One Year After Medicaid Expansion
We examined primary care appointment availability and wait times for new Medicaid and privately insured patients before and after Medicaid expansion in Michigan. ... During the study period, approximately 600,000 adults enrolled in Michigan’s Medicaid expansion program .... One year after expansion, we found that appointment availability remained increased by 6 percentage points for new Medicaid patients ... and decreased by 2 percentage points for new privately insured patients .... Over the same period, the proportion of appointments scheduled with nonphysician providers (nurse practitioners or physician assistants) increased from 8% to 21% of Medicaid appointments ... and from 11% to 19% of private-insurance appointments .... Median wait times remained stable for new Medicaid patients and increased slightly for new privately insured patients, both remaining within 2 weeks. (Tipirneni et al., 6/17)

The Kaiser Family Foundation: Overview Of Medicaid Per Capita Cap Proposals
The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). ... Proponents of per capita cap proposals argue that this structure could reduce federal spending and promote flexibility for states. However, such policies may be difficult to implement and may result in cost shifts .... Pre-set growth rates cannot account for changes in medical costs or health care epidemics or emergencies. With limited federal financing states may turn to restrictions in provider rates and benefits, and with changes to federal requirements states could impose eligibility restrictions or policies to shift costs to beneficiaries. (Rudowitz, Garfield and Young, 6/22)

The Kaiser Family Foundation: Children’s Health Coverage: The Role Of Medicaid And CHIP And Issues For The Future
This brief summarizes the role Medicaid and CHIP play in providing coverage to children ... and raises issues impacting the future of children’s coverage. It shows: Medicaid and CHIP are central sources of coverage for the nation’s children, covering nearly four in ten children nationwide. ... Despite consistent coverage gains for children, which have reduced their uninsured rate to a record low of 6%, an estimated 5 million children remain uninsured. ... Going forward, sustaining and advancing coverage gains for children will hinge in part on the future of CHIP as well as outreach and enrollment efforts and state adoption of policy options. (Cornachione, Rudowitz and Artiga, 6/27)

Urban Institute: Sales Of Insurance Across State Lines: ACA Protections And The Substantial Risks Of Eliminating Them
This analysis delineates the reasons why proposals to sell nongroup health insurance coverage across state lines, outside the consumer protections provided by the Affordable Care Act, cannot solve problems with the health care system. Like other policies that would increase segmentation of health care risks, such sales would reduce premiums for those who are healthy at a given time but would increase premiums and reduce access to coverage for those with health problems. Such an approach would also reduce the likelihood that insurers would continue to sell comprehensive benefits and moderate cost-sharing options to any nongroup consumers. (Blumberg, 6/29)

Fortune: Americans Are Skipping Obamacare So They Can Smoke
Obamacare enrollment has a smoking problem. A new study from the Yale School of Public Health finds that an anti-smoking provision in the health law is discouraging people from signing up for insurance while simultaneously failing to get them to kick the habit. (Sy Mukherjee, 7/7)

The Wall Street Journal: Boys, Not Statistics
Last week we asked the Food and Drug Administration what’s holding up a first-in-class treatment for boys with a rare and lethal form of muscular dystrophy. Still no answer on that. But we understated the promising clinical results from the drug maker, Sarepta Therapeutics, and our error is a chance to note that the statistic captures only part of the therapy’s efficacy. Ten out of 12 boys with Duchenne muscular dystrophy walk after four years of treatment on eteplirsen, which produces a protein called dystrophin. (We mistakenly said it was eight of 10.) A trial with more than 83% of patients walking longer than the disease’s progression would predict is more than marginal progress. It’s a breakthrough. (7/7)

JAMA: Health Insurance Stores And Health Hubs
Although brick and mortar stores are a ubiquitous feature of the US consumer landscape, health insurance for individuals is typically sold via phone, mail, computers, brokers, or, newly, “exchanges.” However, Blue Cross Blue Shield of Florida, now known as Florida Blue, broke this mold with 18 retail stores in a do good/do well innovation to reach patients without insurance with health insurance products. The stores also functioned as health care hubs. (Regina E. Herzlinger, 7/5)

Stat: Here’s An Idea That Shouldn’t Be Radical: There Can Be Joy In Practicing Medicine
It was the talk of joy that surprised me most during my first week of training as a resident physician. Most of orientation was devoted to priming me and my fellow residents for the dual responsibility of being both learners and employees of the Cambridge Health Alliance. Then one of the senior physicians started talking about finding joy in medicine. (Jennifer Adaeze Okwerkwu, 7/8)

Stat: Medical School Hasn't Changed Much In A Century. Here Are 5 Ways To Fix That
ike many aspects of health care, medical education evolves slowly. The modern curriculum is based on the Flexner Report — a review published in 1910. It hasn’t changed much since then. It needs to. As a medical student at Stanford, I’ve seen firsthand the limitations of today’s physician training. We can do better. Here are five reforms that I think would prepare doctors for medicine in the 21st century. (Akhilesh Pathipati, 7/7)

JAMA: Better Palliative Care for All
The recent announcement by Vice President Joseph Biden of a cancer cures “moonshot” has brought renewed attention to the goals of 21st-century cancer care. Not since the late President Nixon’s declaration of War on Cancer has so much focus been directed toward the experiences of the 1.66 million persons diagnosed with cancer annually in the United States.1 The framing of this initiative is focused on accelerating scientific progress against cancer as a disease, with little attention to equity2 or to the experience of those living with cancer and its consequences. As billions of dollars are invested in seeking the cure for cancer, attention to the quality of life of people living with cancer and the effect of cancer treatment are at least as important to address and far more achievable in the near term. (Arif H. Kamal, Thomas W. LeBlanc and Diane E. Meier, 7/5)

JAMA: Why Population Health And Palliative Care Need Each Other
Two evolving disciplines in medicine have brought new ways of thinking about health and disease. One is palliative care, which focuses on improving the quality of life of patients with serious illnesses and their families. A second is population health, which focuses on improving the health of populations, with a special emphasis on reducing disparities in health outcomes and improving the value of health care. Although palliative care and population health are related, there has been limited discussion about how these 2 disciplines can support and complement each other. This synergy is key to improving the quality of care of frail older persons with chronic, life-limiting illnesses. In this Viewpoint, we describe the potential synergies between these 2 disciplines and propose next steps to foster collaboration. (David Casarett and Joan Teno, 7/5)

WBUR: Why Mass. 'Death With Dignity' Ballot Initiative Isn't Back This Year
It was a squeaker, and a dramatic reversal. Poll after poll had found that a majority of Massachusetts voters would support the 2012 "Death with Dignity" ballot measure allowing terminally ill patients to get doctor-prescribed medications to end their own lives. But in the final days, amid a well-funded opposition TV ad campaign, the picture changed. (Carey Goldberg, 7/7)

The New England Journal Of Medicine: Biomarker Tests For Molecularly Targeted Therapies — The Key To Unlocking Precision Medicine
As the promise and the pitfalls of precision medicine gain increasing attention,1,2 enthusiasm about the field has been heightened by a rapid reduction in the cost of high-throughput genomic sequencing and a dramatic increase in the identification of potential molecular targets for therapy. Biomarker tests for molecularly targeted therapies can help physicians to select the most effective therapy for a patient's condition and avoid treatments that could be ineffective or harmful. If precision medicine is to reach its potential, such biomarker tests will have to be developed in a timely fashion. (Gary H. Lyman and Harold L. Moses, 7/7)

Health Affairs: Beating A Cancer Death Sentence
Several months ago, my wife, Françoise, and I attended something novel for melanoma patients: a survivors’ dinner. People said they wanted to make it an annual gathering. Planning anything that far in advance had been pointless for me. Two years ago, I was about to accept hospice care. When I was first diagnosed in 1996, early surgery was the only reliably successful treatment. Anything more advanced was essentially a death sentence. Over the past five years, a series of revolutionary drugs have given me and many other people a surprisingly hopeful prospect. Nevertheless, the drugs’ development process has often been excruciating for clinical trial participants, and their remarkably high costs limit their value. (Jonathan Friedlaender, 7/2016)

Milwaukee Journal Sentinel: Planned Parenthood Asks To Repeal Law Struck Down By Supreme Court
Democrats and officials with Planned Parenthood called Thursday for repealing an abortion law struck down by the U.S. Supreme Court last week. A Republican leader said the effort was a publicity stunt because the law has already been invalidated. ...The ruling makes the law invalid, but abortion supporters told reporters on a conference call that the state should also formally repeal it so it’s off the books. (Patrick Marley, 7/7)

The Des Moines Register: Access To Abortion Trumps Women's Health
“Safe but legal” abortions are so yesterday. The U.S. Supreme Court has made “unsafe and legal” the new standard in the abortion industry. Last week, the Supreme Court issued a ruling that will put women’s health at risk. The Supreme Court justices reversed the Fifth Circuit Court of Appeals on Whole Woman’s Health v. Hellerstedt in a 5-3 decision. The two main components of this bill: a requirement that abortionist’s have admitting privileges at a hospital within 30 miles of the clinic, and that their facilities meet the same basic health standards as ambulatory surgical centers. (Maggie DeWitte, 7/7)

The New England Journal Of Medicine: Zika And The Risk Of Microcephaly
Zika virus (ZIKV) infection during pregnancy has been linked to birth defects, yet the magnitude of risk remains uncertain. Investigators studying the 2013–2014 Zika outbreak in French Polynesia estimated that the risk of microcephaly due to ZIKV infection in the first trimester of pregnancy was 0.95% (95% confidence interval, 0.34 to 1.91), on the basis of eight microcephaly cases identified retrospectively in a population of approximately 270,000 people with an estimated rate of ZIKV infection of 66%. (Michael A. Johansson, Luis Mier-y-Teran-Romero, Jennita Reefhuis, Suzanne M. Gilboa and Susan L. Hills, 7/7)

JAMA Forum: Place Matters For Tobacco Control
For too long, tobacco industry strategies to normalize and glamorize use of their product have perpetuated a preventable epidemic. Although US adult smoking rates declined to 15.1% in 2015, nearly half a million people die annually just from cigarette use in the United States. Projections are that 5.6 million US children alive today will die prematurely from tobacco-related disease. For every tobacco-related death, approximately 30 more individuals live with chronic tobacco-induced disease and disability. (Howard Koh, 7/6)

The Conversation: Public Health Research Reduced Smoking Deaths -- It Could Do The Same For Gun Violence
So what does it mean to view firearm violence as a public health problem? And how does that change the debate Americans are having about gun violence? First, and most importantly, viewing firearms violence as a public health problem means declaring that the current situation is unacceptable, and preventable. (Sandro Galea and Michael Siegel, 7/7)