First Edition: July 5, 2018

Today's early morning highlights from the major news organizations.

Kaiser Health News: Texas Clinics Busting Traditional Silos Of Mental And Physical Health Care

Kerstin Taylor fought alcohol and substance abuse problems for two decades. She periodically sought help through addiction and psychiatric treatments to stay sober, but she continued to relapse. That unrelenting roller coaster, and the emotional and mental fallout, left her with little energy or resources to take charge of her overall health. Taylor, 53, has asthma and doctors told her she was at risk of developing diabetes.“I wasn’t doing anything to help myself,” she said about her physical health. (Covington, 7/5)

California Healthline: The Other Victims: First Responders To Horrific Disasters Often Suffer In Solitude

The day a gunman fired into a crowd of 22,000 people at the country music festival in Las Vegas, hospital nursing supervisor Antoinette Mullan was focused on one thing: saving lives. She recalls dead bodies on gurneys across the triage floor, a trauma bay full of victims. But “in that moment, we’re not aware of anything else but taking care of what’s in front of us,” Mullan said. Proud as she was of the work her team did, she calls it “the most horrific evening of my life” — the culmination of years of searing experiences she has tried to work through, mostly on her own. (de Marco, 7/5)

Kaiser Health News: Tennessee-Based Pain Management Group To Close Clinics Amid Financial Turmoil

One of the largest pain management groups in the Southeast is closing multiple clinics amid worsening financial troubles and a federal criminal investigation that targeted its former chief executive. This week, Tennessee-based Comprehensive Pain Specialists advised patients and employees about clinic closures, leaving patients scrambling to find new doctors willing to prescribe them opioids, according to a report on WSMV television. (Shulte, 7/3)

The New York Times: Obamacare Is Proving Hard To Kill

As health insurers across the country begin filing their proposed rates for 2019, one thing is clear: The market created by the Affordable Care Act shows no signs of imminent collapse in spite of the continuing threats by Republicans to destroy it. In fact, while President Trump may insist that the law has been “essentially gutted,” the A.C.A. market appears to be more robust than ever, according to insurance executives and analysts. A few states are likely to see a steep spike in prices next year, but many are reporting much more modest increases. Insurers don’t appear to be abandoning markets altogether. In contrast to last year, regulators are not grappling with the prospect of so-called “bare” counties, where no carrier is willing to sell A.C.A. policies in a given area. (Abelson, 7/3)

The Wall Street Journal: Trump Winnows Down Supreme Court Picks, Focusing On Three

President Donald Trump’s search for a Supreme Court justice to succeed Anthony Kennedy is focusing on a trio of federal judges, with a decision expected this week in anticipation of an announcement on Monday, people familiar with the search said. Following a brisk round of interviews Monday and Tuesday, the three front-runners at this late stage in the president’s search are all U.S. appeals court judges: Brett Kavanaugh of Maryland, of the D.C. Circuit; Raymond Kethledge of Michigan, of the Sixth Circuit; and Amy Coney Barrett of Indiana, of the Seventh Circuit. (Nicholas and Radnofsky, 7/4)

Politico: Trump Touts Upcoming Supreme Court Pick

President Donald Trump on Tuesday promised that his supporters would love his nominee for the Supreme Court and knocked liberals for calling to abolish U.S. Immigration and Customs Enforcement. “I think you’re going to be very impressed,” Trump said during a dinner for U.S. troops at The Greenbrier resort here. (Restuccia, 7/3)

The Associated Press: AP Source: Pence Has Met With Supreme Court Contenders

Vice President Mike Pence has met with some of the contenders for the Supreme Court vacancy created by Justice Anthony Kennedy's retirement, The Associated Press has learned. The meetings took place in recent days, according to a person familiar with the search process. The person did not specify which candidates Pence met with and spoke on condition of anonymity Wednesday to describe the private search process. (7/5)

Politico: New Supreme Court Justice Could Weigh In On Abortion Quickly

President Donald Trump’s pick for the Supreme Court won’t have to wait long to make a potentially historic decision on abortion rights. A slew of abortion-related cases are working their way through lower courts, dealing with questions about when abortions should be allowed, or which procedures doctors can perform to terminate a pregnancy. Any of these could become opportunities for the justices to address fundamental questions about the legal right to abortion in the United States, putting Roe v. Wade in the Supreme Court’s sights. (Haberkorn, 7/3)

The Hill: Abortion Rights Group Targets Susan Collins In First Supreme Court Ad Buy

An abortion rights group leading the fight on the left against President Trump's next Supreme Court nominee announced its first ad buy Tuesday targeting Sen. Susan Collins (R-Maine), who is expected to be a key vote in the confirmation battle. NARAL Pro-Choice America announced full page print ads and "homepage takeovers" of four Maine newspapers and websites: the Portland Press Herald, Kennebec Journal/Morning Sentinel, Bangor Daily News and Lewiston Sun Journal. The ads begin Wednesday. (Hellmann, 7/3)

The Associated Press: Court Vacancy Makes Abortion Politics A Midterm Priority

Democrats and Republicans once largely agreed that the upcoming midterm elections would hinge on the economy, health care and President Donald Trump's popularity. Not anymore. A Supreme Court vacancy has pushed abortion to the forefront of election year politics, with both supporters and opponents suggesting that the emotional issue could drive more voters to the polls. That's especially true in states like Iowa, where Republicans have enacted restrictive measures on abortion in the past two years. (Beaumont and Rodriguez, 7/5)

Politico: Trump’s Supreme Court Search Unleashes Fierce Politicking

President Donald Trump’s commitment to select from a widely publicized list of Supreme Court candidates may have helped win him the White House — but it has also injected unprecedented politicking into the selection process for the next justice. Much of the jockeying has centered on D.C. Circuit Court Judge Brett Kavanaugh, who is the preferred choice of White House counsel Don McGahn, according to two Republicans close to the White House. McGahn’s backing helped Kavanaugh secure a spot on Trump’s existing Supreme Court list last November, when the president added five names. (Johnson, 7/4)

The Washington Post: Liberal Democrats Mount Campaign Against Trump’s Supreme Court Nominee By Targeting Two Republican Senators

Liberal political strategists hope to block President Trump’s next Supreme Court nominee by replaying a strategy they used to help defeat the Republican effort to repeal the Affordable Care Act last year. The multimillion-dollar plan of advertising and grass-roots activism will focus heavily on convincing two Republican defenders of the ACA, Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine), to buck the president again by denying his first choice to replace retiring Justice Anthony M. Kennedy. Trump plans to reveal his selection Monday. (Scherer, 7/4)

The Associated Press: Judge's Ruling Slows Plans For Medicaid Work Requirement

The Trump administration's drive to wean poor people from government benefits by making them work has been slowed down by a federal judge. U.S. District Judge James E. Boasberg framed a fundamental question: Are poverty programs meant to show tough love or to help the needy? Boasberg last week halted Kentucky's first-in-the-nation experiment with Medicaid work requirements, ruling that the Trump administration glossed over potential coverage losses. (Alonso-Zaldivar, 7/4)

The Associated Press: Medicaid Becomes Latest Sparring Issue In Congressional Race

U.S. Rep. Andy Barr said Tuesday that Kentucky's efforts to put work requirements on many Medicaid recipients would be in their best interests, leading them toward self-sufficiency and away from reliance on the government health insurance program. That stance could elevate health care as a flashpoint in a congressional race that Democrats think gives them their best chance to gain a seat this year in a state that has trended heavily toward Republicans. It puts the GOP incumbent at odds with his opponent in Kentucky's 6th District, Democrat Amy McGrath, who says she values encouraging people to work but cautions that a work requirement shouldn't be used punitively. (Schreiner, 7/3)

The Hill: Kentucky Dentists Say Kids Wrongly Denied Care Over Medicaid Cuts

Kentucky Gov. Matt Bevin’s (R) decision to cut Medicaid benefits for thousands of adults in the state has created confusion, in some cases reportedly resulting in dentists wrongly denying care to patients. Dentists told Kentucky’s Courier-Journal that they have had to deny care to some patients, including children, who incorrectly appeared in the state’s computer system as having lost coverage, even though they are supposed to be exempt from the cuts. (Chalfant, 7/4)

The Hill: HHS Enters Damage-Control Mode Over Family Separations

President Trump's “zero tolerance” immigration policy has left the Department of Health and Human Services (HHS) scrambling to contain what’s quickly becoming a public relations nightmare. While HHS didn't write the policy, the agency is responsible for implementing the most controversial aspect: housing the children separated from their parents at the U.S.-Mexico border. (Weixel, 7/3)

The Hill: HHS Tries To Clamp Down On Unannounced Lawmaker Visits To Child Detention Centers

The Department of Health and Human Services is urging lawmakers to schedule visits to detention centers housing migrant children instead of showing up at the facilities unannounced. In a letter sent Tuesday to Senate Judiciary Committee Chairman Chuck Grassley (R-Iowa) and House Judiciary Committee Chairman Bob Goodlatte (R-Va.), the agency asked the lawmakers to help coordinate congressional visits to HHS-funded detention facilities. (Weixel, 7/3)

The New York Times: Instead Of A Ban, Transgender Military Recruits Hit Endless Red Tape

Nicholas Bade showed up at an Air Force recruiting office on an icy morning in January, determined to be one of the first transgender recruits to enlist in the military. He was in top shape, and had earned two martial arts black belts. He had already aced the military aptitude test, and organized the stack of medical records required to show he was stable and healthy enough to serve. So he expected to be called for basic training in a month, maybe two at the most. (Philipps, 7/5)

Stat: Trump Promised Drug Makers Would Lower Their Prices, But Not All Did

On May 30, President Trump promised that “some” of the big drug makers would announce “voluntary, massive drops in prices” in two weeks. But not everyone in the pharmaceutical industry got the memo. Since last Friday, two large purveyors — Pfizer (PFE) and Teva Pharmaceuticals (TEVA) — both took hefty price hikes on numerous medicines, as did several other companies. (Silverman, 7/3)

Stat: Biotech's New Big Idea For Making Cancer Immunotherapy Work Better

The drug industry has made a mint on immunotherapies for cancer, but those game-changing treatments don’t work for most people’s tumors. That has set in motion a scientific gold rush, as biotech companies search for molecules they can add to those drugs to turn them into universal therapies. The latest promising candidate is TGF-beta, a thorny collection of proteins that regulates a host of bodily functions. Among them is the process by which the immune system decides to either attack cancerous growths or let them pass idly by. (Garde, 7/5)

The Hill: CVS Health CEO 'Surprised' By Azar's Comments On Drug Prices

CVS Health says it is not standing in the way of lower drug prices, pushing back on comments Health and Human Services Secretary Alex Azar made last week. Larry Merlo, president and CEO of CVS Health, wrote in a letter to Azar that he was "surprised" to hear him say pharmacy benefit managers (PBMs) — companies that manage insurance plans for employers and insurers — are standing in the way of lower drug prices in order to protect their bottom lines. (Hellmann, 7/3)

The Washington Post: HPV Test Is Better Than Pap Smear At Detecting Precancerous Cervical Changes, Study Says

A test for HPV detects precancerous changes of the cervix earlier and more accurately than the Pap smear, according to a large clinical trial published Tuesday. The randomized, controlled study — the kind of trial considered the “gold standard” of research — showed that the human papillomavirus test is more sensitive than the Pap smear, a widely used test that has been a standard part of women's preventive health care for decades but has drawbacks. (McGinley, 7/3)

NPR: Study: HPV Tests Outperform Pap Smears In Testing For Cervical Cancer

The FDA in 2014 approved the first HPV test, which tests vaginal and cervical secretions (which can be gathered with a swab) for the presence of HPV. The new study, called the HPV FOCAL trial, compared the HPV test with traditional Pap smear screening among 19,000 Canadian women over four years. It adds to a body of research suggesting that HPV testing might be more accurate. "In our world this study is going to be a pretty big deal, in a good way," says Dr. Kathleen Schmeler, a gynecologic oncologist at the University of Texas MD Anderson Cancer Center. (Watson, 7/3)

Stat: As Drug Resistance Grows, Combining Antibiotics Could Yield New Treatments

Combining certain antibiotics could help them pack a one-two punch against harmful bacteria, according to a new study published Wednesday in Nature. Nassos Typas and his colleagues at the European Molecular Biology Laboratory in Germany tested 3,000 different combinations of antibiotics with each other or with drugs, food additives, and other compounds on three common types of bacteria that infect humans. (Thielking, 7/4)

Stat: Did Pandemic Flu Vaccine Trigger An Increase In Narcolepsy Cases?

Nearly a decade on from the 2009 influenza pandemic, scientists are still trying to solve what is proving to be an intractable medical mystery: Did some of the vaccines used to protect against the new flu virus trigger an increase in narcolepsy cases? A major attempt to unravel the mystery — a study that’s still in the publication pipeline — did not find evidence that vaccines containing a boosting compound called an adjuvant sparked a rise in cases of narcolepsy, a serious but rare sleep disorder. (Branswell, 7/5)

Los Angeles Times: An Extra Dose Of Testosterone Increases Men's Preference For High-Status Luxury Goods, Study Says

An extra shot of testosterone, it seems, makes a man act like an animal. You know the type: one of those male birds who unfurls some of his most spectacular feathers when the ladies are around, or the buck who uses his crown of antlers to advertise his virility. In short, an animal prone to making showy displays of his power, beauty or wealth to win mates, gain allies and intimidate competitors. (Healy, 7/4)

The New York Times: Lots Of Successful Women Are Freezing Their Eggs. But It May Not Be About Their Careers.

“Freeze Your Eggs, Free Your Career,” announced the headline of a Bloomberg Businessweek cover story in 2014. It was the year that Facebook and then Apple began offering egg freezing as a benefit to employees. Hundreds of think pieces followed, debating the costs and benefits of “postponing procreation” in the name of professional advancement. In the years since, many more women across the world have frozen their eggs. Many are highly educated. But the decision may have very little to do with work, at least according to a new study. In interviews with 150 American and Israeli women who had undergone one cycle, career planning came up as the primary factor exactly two times. Instead, most women focused on another reason: they still hadn’t found a man to build a family with. (Murphy, 7/3)

The New York Times: Exercise May Aid In Weight Loss. Provided You Do Enough.

Can working out help us to drop pounds after all? A provocative new study involving overweight men and women suggests that it probably can, undercutting a widespread notion that exercise, by itself, is worthless for weight loss. But the findings also indicate that, to benefit, we may need to exercise quite a bit. (Reynolds, 7/4)

The New York Times: Probiotics May Be Good For Your Bones

A probiotic supplement could be good for your bones, a new study suggests. Researchers studied 90 women, 75 to 80 years old, all generally healthy but with low bone mineral density. They measured their bone density at the start of the study, and then randomly assigned them to a placebo or to two daily doses of freeze-dried Lactobacillus reuteri, an intestinal tract microbe that occurs naturally in many, but not all, people. (Bakalar, 7/3)

NPR: Carbon Dioxide Increase Could Lead To Nutritional Deficiencies And Disease

The rising level of carbon dioxide in the atmosphere means that crops are becoming less nutritious, and that change could lead to higher rates of malnutrition that predispose people to various diseases. That conclusion comes from an analysis published Tuesday in the journal PLOS Medicine, which also examined how the risk could be alleviated. In the end, cutting emissions, and not public health initiatives, may be the best response, according to the paper's authors. (Chisholm, 7/3)

The New York Times: It’s Time For A Chemistry Lesson. Put On Your Virtual Reality Goggles.

There was a time when biochemists had a lot in common with sculptors. Scientists who had devoted their lives to studying a molecule would building a model, using metal and a forest of rods to hold up the structure of thousands of atoms. “Slow work, but at the end you really know the molecule,” said Michael Levitt, who shared the Nobel Prize in Chemistry in 2013. These days simulations on screens have replaced such models, sacrificing some of their tactile value while gaining the ability to show movement. But what if you could enter a virtual reality environment where the molecules lie before you, obeying all the laws of molecular physics as calculated by supercomputers, and move them around in three dimensions? (Greenwood, 7/3)

NPR: A Promise To Bail Out Rural Hospitals May Be Risky

The only hospital serving the community of rural Callaway County, Mo. — Fulton Medical Center — was set to shut down last September. When staff arrived one afternoon for a potluck goodbye party, they were met with an unexpected guest, Jorge Perez, a management consultant from Florida. He announced he'd just bought the hospital, and planned to keep it open. When Perez spoke about the takeover four days later to a packed city council chambers in Fulton, Mo., he got a standing ovation. (Margolies and Sable-Smith, 7/3)

CNN/Center for Investigative Journalism: Records Suggest Puerto Rico Saw A Leptospirosis 'Outbreak' After Hurricane Maria -- But Officials Won't Call It That

Puerto Rico's own records list so many cases of the bacterial disease leptospirosis that officials should have declared an "epidemic" or an "outbreak" after Hurricane Maria instead of denying that one occurred, according to seven medical experts who reviewed previously unreleased data for CNN and the Centro de Periodismo Investigativo (CPI).A Puerto Rico mortality database -- which CNN and CPI sued the island's Demographic Registry to obtain -- lists 26 deaths in the six months after Hurricane Maria that were labeled by clinicians as "caused" by leptospirosis, a bacterial illness known to spread through water and soil, especially in the aftermath of storms. That's more than twice the number of deaths as were listed in Puerto Rico the previous year, according to an analysis of federal records. (Sutter and Pascual, 7/3)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription