�������ýҕ�l

The Senate on Thursday passed legislation aimed at stanching acts of mass gun violence, with 15 Republicans joining Democrats to advance a bill combining modest new firearms restrictions with $15 billion in mental health and school security funding. The 65-to-33 vote represented an unlikely breakthrough on the emotional and polarizing question of U.S. gun laws, which have gone largely unchanged for more than 25 years, even as the nation has been repeatedly scarred by mass shootings whose names have become etched in history — from Columbine and Virginia Tech to Sandy Hook and Parkland. (DeBonis, 6/23)

"This bill is a compromise," said Sen. Chris Murphy, D-Conn., who led the negotiations, right before the vote began. "It doesn't do everything I want. But what we are doing will save thousands of lives without violating anyone's Second Amendment rights." The legislation would incentivize states to pass red flag laws and expand background checks for 18- to 21-year-olds, among other measures. House leaders are expected to quickly begin consideration of the bill. In a statement shortly after the Senate vote, President Biden urged the House to act quickly on the bill. The House and Senate begin their two-week July 4 recess after Friday. (6/23)

Speaker Nancy Pelosi (D-Calif.) announced on Thursday that the House will take up the Senate-passed gun safety bill “first thing” Friday morning, after the legislation cleared the upper chamber in a bipartisan vote. “First thing tomorrow morning, the Rules Committee will meet to advance this life-saving legislation to the Floor. When the Rules Committee finishes its business, we will head immediately to the Floor,” Pelosi wrote in a statement minutes after the Senate approved the measure. (Schnell, 6/23)

The Bipartisan Safer Communities Act, written by a small group of Republicans and Democrats in the aftermath of back-to-back mass shootings, would enhance background checks for gun buyers between 18 and 21 years old, incentivize states to enact “red flag” laws that enable firearms to be temporarily confiscated from people deemed dangerous, and provide hundreds of millions of dollars for mental health and school safety. It would also extend to dating partners a federal law that prohibits domestic abusers from purchasing guns. (Lai and Cochrane, 6/23)

The sudden voice from the intercom in the University of Louisville Hospital's emergency department is brief. "Room 9." The message may not mean much to visitors, but the surgeons, nurses and hospital staff for the Louisville region's main trauma center know exactly what it portends. Another person seriously wounded or dying — very possibly from a bullet, or two or three, ripping through their body. Last year, more than 800 people were shot in Louisville, or roughly two shootings per day. This year, nearly 200 people have been injured in nonfatal shootings in addition to over 80 killed in homicides through mid-June. (Kobin, 6/24)

The Supreme Court ruled on Thursday that Americans have a broad right to arm themselves in public, striking down a New York law that placed strict limits on carrying guns outside the home and setting off a scramble in other states that have similar restrictions. The decision is expected to spur a wave of lawsuits seeking to loosen existing state and federal restrictions and will force five states — California, Hawaii, Maryland, Massachusetts and New Jersey, home to a quarter of all Americans — to rewrite their laws. (Liptak, 6/23)

The American Medical Association has called the ruling a “harmful and deeply disturbing decision.” “Firearm violence is a public health crisis, and easier access to weapons and fewer restrictions on who can carry them — and where they can be carried — are dangerous steps in the wrong direction,” Dr. Jack Resneck, the AMA’s president, said in a written statement. “Overturning decades of reasonable firearm regulations will cost more lives.” (6/23)

New York and a half a dozen other states with similar laws now must decide their next steps. As with New York, California, Hawaii, Maryland, Massachusetts, New Jersey and Rhode Island all have legislatures controlled by Democrats who could propose measures to ensure that guns will not be allowed in certain places. Gun rights groups in those states have vowed to continue pushing back against what they view as restrictive gun control laws. (6/24)

Within hours of the court’s decision to strike down New York’s rules, California Democratic Attorney General Rob Bonta and state lawmakers announced legislation that would bar concealed firearms in places like courthouses and schools and require applicants to undergo assessments for whether they are dangerous to others, which could include checking for criminal records and restraining orders. Lawmakers said they hoped to move the bill through the Legislature and to Gov. Gavin Newsom’s desk as quickly as possible. (White, 6/23)

“It will not take long at all” until the gun licensing law is challenged here, said Kent Greenfield, a Boston College law professor. “The next person denied a permit under the Massachusetts law can go immediately into federal court and get an injunction requiring their permit be issued based on this ruling. We’re not talking months, we’re talking days.” Currently, Massachusetts law gives local police chiefs, who serve as the state’s licensing authority, the discretion to determine whether someone is suitable to have a license. Policymakers say that provision is a key part of the gun safety system in Massachusetts, which had the second-lowest firearm mortality rate in the country in 2020, trailing only Hawaii. (Stout, 6/23)

The Food and Drug Administration on Thursday ordered vaping giant JUUL to remove its remaining products from the market, after roughly two years of reviewing the company’s applications. The agency cited “insufficient and conflicting data” about the potential for leaking chemicals from JUUL e-liquid pods, which it said precluded its ability to complete a proper risk assessment. (Clason, 6/23)

“We respectfully disagree with the FDA’s findings and decision and continue to believe we have provided sufficient information and data based on high-quality research to address all issues raised by the agency,” said Joe Murillo, the chief regulatory officer at Juul Labs, in a statement. “We believe that we appropriately characterized the toxicological profile of Juul products, including comparisons to combustible cigarettes and other vapor products, and believe this data, along with the totality of the evidence, meets the statutory standard of being ‘appropriate for the protection of the public health.’” Juul must immediately discontinue sales of its products. If it doesn’t, it risks enforcement actions from the FDA. (Foley, 6/23)

The FDA's decision to order Juul e-cigarette products off the U.S. market opens a new and grinding battle in the push to revamp the government’s rules for smoking and vaping. With parallel efforts to cap nicotine in cigarettes and ban menthol cigarettes and flavored cigars, the Biden administration is pursuing a broad tobacco agenda not seen since the Clinton administration. It could be a drawn-out and costly fight. Hours after the FDA issued its marketing denial order on Thursday, Juul said it would seek a stay and was exploring a possible appeal. (Bettelheim, 6/24)

Online search interest in "How to stop vaping" is up amid news that impacts people who use vaping products nationwide, Google Trends data indicates. The Food and Drug Administration on Thursday announced it will order Juul to remove its e-cigarettes out of the U.S. market, taking away an e-cigarette option for millions of smokers. The FDA has been working to cap nicotine in cigarettes, while the Biden administration has been working to limit tobacco in the U.S. (Scribner, 6/23)

KHN: KHN’s ‘What The Health?’: The FDA Goes After Nicotine 

The FDA this week launched a crackdown on smoking and vaping — ordering the vaping device Juul to be taken off the market and announcing its intention to require makers of cigarettes and other tobacco products to reduce the amount of nicotine in them. (6/23)

Nearly 20 million lives were saved by COVID-19 vaccines during their first year, but even more deaths could have been prevented if international targets for the shots had been reached, researchers reported Thursday. On Dec. 8, 2020, a retired shop clerk in England received the first shot in what would become a global vaccination campaign. Over the next 12 months, more than 4.3 billion people around the world lined up for the vaccines. (Johnson, 6/23)

However, millions more deaths could have been prevented. The team found that one in five of the deaths that occurred due to Covid-19 in low-income countries could have been prevented if the World Health Organization’s global vaccine targets were met. (Muthukumar, 6/23)

Late-stage data on an experimental COVID-19 vaccine from Sanofi and GSK has showed the shot confers protection against the Omicron variant of the virus, the companies said on Friday. The so-called bivalent vaccine targets the Beta variant - first identified in South Africa - as well as the original Wuhan strain of the virus. (Grover, 6/24)

An expert panel backed a second COVID-19 vaccine option for kids ages 6 to 17 Thursday. Advisers to the U.S. Centers for Disease Control and Prevention voted unanimously to recommend Moderna shots as an option for school-age kids and adolescents. This group has been able to get shots shots made by Pfizer since last year. The panel’s recommendations usually are adopted by the CDC, and become the government’s guidance for U.S. doctors and their patients. (Stobbe, 6/23)

Since COVID-19 vaccines first became available, Publix has played a major role in tackling the public health emergency in Florida by offering vaccines to adults and, later, children as young as 5. But the Lakeland grocery company says it will not offer the vaccine approved for children ages 4 and under “at this time.” Spokesperson Hannah Herring said Tuesday that Publix will not release a statement explaining its decision. The company’s website indicates that it is still accepting COVID-19 vaccine appointments for children ages 5 and up. (O'Donnell and Hodgson, 6/23)

Maternal COVID vaccination during pregnancy provides 52% protection against COVID-19 hospitalization in infants but only 38% protection against Omicron hospitalization, according to a study yesterday in the New England Journal of Medicine. Protection against an intensive care unit (ICU) stay, however, was 70%. (6/23)

Dr. Anthony Fauci, the nation’s top infectious disease expert, says his COVID-19 recovery is an “example” for the nation on the protection offered by vaccines and boosters. Speaking during a White House briefing, Fauci, 81, said he began experiencing virus symptoms on June 14 and tested positive a day later. He was prescribed the anti-viral drug Paxlovid, which has proven to be highly effective at preventing serious illness and death from COVID-19, on June 15. (6/23)

New York City hasn’t been enforcing the rule mandating that private businesses require employees to be vaccinated against Covid-19, and a spokesman for Mayor Eric Adams said the administration has no plans to start doing so. Newsday reported on Wednesday that the city hasn’t been inspecting businesses to check for compliance since Adams took office in January. The rule, one of the strictest in the US, was implemented during the final month of the administration of former Mayor Bill de Blasio. Businesses said the mandate would be difficult to enforce and could lead to worker shortages. (Sheinerman, 6/23)

A former nursing director pleaded guilty Thursday to lying to federal agents in South Carolina about providing fake COVID-19 vaccination cards. Tammy Hudson McDonald, who worked at a PruittHealth skilled nursing facility last summer, filled out cards for people she knew had not received the vaccine, according to an investigation by the U.S. Department of Health and Human Services, FBI and South Carolina Law Enforcement Division. (Pollard, 6/23)

Dr. Deborah L. Birx, President Donald J. Trump’s coronavirus response coordinator, told a congressional committee investigating the federal pandemic response that Trump White House officials asked her to change or delete parts of the weekly guidance she sent state and local health officials, in what she described as a consistent effort to stifle information as virus cases surged in the second half of 2020. Dr. Birx, who publicly testified to the panel Thursday morning, also told the committee that Trump White House officials withheld the reports from states during a winter outbreak and refused to publicly release the documents, which featured data on the virus’s spread and recommendations for how to contain it. (Weiland, 6/23)

A lack of clear, concise and consistent messaging about the seriousness of the novel coronavirus in the earliest months of its spread created a false sense of security among Americans that the pandemic would not be serious and resulted in inaction early on across the federal government. That was the assessment of Dr. Deborah Birx, who served as the COVID response coordinator under former President Donald Trump and testified for the first time Thursday before a House panel about her time in the Trump administration. (Freking, 6/23)

“People were communicating with the president dangerous ideas … on a daily basis,” such as encouraging former president Donald Trump to advocate for unproven treatments, including hydroxychloroquine, or providing him with misleading data about the virus, Birx told the House select subcommittee on the coronavirus crisis. Asked about Trump’s repeated claims in 2020 that the virus would simply disappear, Birx implied that the president wrongly believed that if enough Americans were infected, the pandemic would go away. (Diamond, 6/23)

"It wasn't just the president — many of our leaders, were using words like 'we could contain,' and you cannot contain a virus that cannot be seen," Birx told the House select subcommittee on the coronavirus crisis. "And it wasn't being seen because we weren't testing." (Falconer, 6/24)

Former COVID-19 coordinator Dr. Deborah Birx appeared before a Select Subcommittee on the Coronavirus Crisis Thursday morning to testify on former President Donald Trump's response to the pandemic. (6/23)

The Biden administration on Thursday rolled out free at-home Covid-19 tests that are designed to be more accessible for people who are blind or visually impaired. White House Covid-19 response coordinator Dr. Ashish Jha said the administration will provide more accessible, rapid self-tests to Americans across the country for free through Covidtests.gov, which ships tests through the US Postal Service. (Judd and Vazquez, 6/23)

Christy Smith has never been tested for the coronavirus. As a blind person, she can’t drive to testing sites near her home in St. Louis, and they are too far away for her to walk. Alternative options — public transportation, ride share apps or having a friend drive her to a test site — would put others at risk for exposure. The rapid tests that millions of other people are taking at home, which require precisely plunking liquid drops into tiny spaces and have no Braille guides, are also inaccessible to Ms. Smith. Many people who are blind or have limited vision are not being tested as often as they would like — and some are staying isolated because testing is too difficult. (Morris, 1/12)

There are workarounds. Apps like Be My Eyes, which is free, and Aira virtually connect blind or low-vision people with a sighted person to assist with life tasks, such as interpreting coronavirus test results. The National Federation of the Blind is now offering blind people free access to Aira to help with at-home testing. There are also some tests, like the kit from Cue Health Inc., that can send results to a smartphone using Bluetooth technology, which could then be read with a screen reader audibly. Those apps and tests, however, can be costly or raise privacy concerns with sharing medical information to third parties. A pack of three tests from Cue Health costs $474. Another at-home coronavirus test, made by Ellume, can be used with a free app that includes video and audio instructions, and can send results to an email address. Its retail price is around $38 for a single test. (Smith, 2/2)

President Biden’s coronavirus response coordinator said Thursday that he remained optimistic that Congress would approve billions of dollars in new emergency aid to fight Covid, even as Republicans on Capitol Hill have made clear the aid package is all but dead. “I’m an eternal optimist,” the coordinator, Dr. Ashish K. Jha, told reporters during a White House briefing. “I remain convinced that Congress is not going to walk away at this point in the pandemic, when we have made so much progress.” (Stolberg, 6/24)

What unites many of these numbers is the tendency, especially in the United States, to pick thresholds and view them as binaries: above this, mask; below this, don’t; after this, exposed, before this, safe. But some of the COVID numbers that have stuck most stubbornly in our brains these past 20-odd months are now disastrously out of date. The virus has changed; we, its hosts, have as well. So, too, then, must the playbook that governs our pandemic strategies. With black-and-white, yes-or-no thinking, “we do ourselves a disservice,” Saskia Popescu, an epidemiologist at George Mason University, told me. Binary communication “has been one of the biggest failures of how we’ve managed the pandemic,” Mónica Feliú-Mójer, of the nonprofit Ciencia Puerto Rico, told me. Here, then, are five of the most memorable numerical shorthands we’ve cooked up for COVID, most of them old, some a bit newer. It’s long past time that we forget them all. (Wu, 6/23)

In January, Sonali Patel, an emergency department doctor at a big Houston hospital, became ill while on duty. After testing positive for Covid, she said she told her boss she had the coronavirus and was going home. “He insisted I stay and finish the shift,” she recalled in an interview with NBC News and in a recent lawsuit. “I told him it’s not the safe thing to do. We have a ton of immunocompromised patients and we were putting them at risk.” By requesting time off from work while sick with Covid, Patel breached an unofficial policy promoted by officials at the hospital staffing company she works for — American Physician Partners — according to the lawsuit filed against the company by her and seven physician colleagues. (Morgenson, 6/24)

Vermont’s state-run COVID-19 testing sites are closing for good by Saturday. The state first opened sites in the spring of 2020 to help slow the spread of the virus. The Health Department said at-home tests are available at pharmacies and online and meet most testing needs. The tests are covered by many insurance providers and Vermonters are encouraged to have some at home in case they develop symptoms, the department said. (6/23)

More than 330,000 Americans could have been saved during COVID-19 pandemic if the United States operated under a universal health care system – nearly one-third of the total COVID-related deaths – according to a recent study. The study, published in Proceedings of the National Academy of Sciences USA last week found that universal health care would have helped address underlying and pre-existing conditions that contributed to the COVID-related deaths, ultimately saving over 338,000 lives between the start of the pandemic and mid-March 2022. (Elbeshbishi, 6/23)

Disparate health outcomes could cost the American healthcare system $1 trillion annually by 2040, nearly tripling in size over the next 20 years and accounting for nearly 12.5% of healthcare spending, a new report warns. The analysis, published by Deloitte Wednesday, found the cost of excess health services delivered due to disparities is $320 billion annually, and the rate of increase outpaces overall cost trends. Total healthcare spending is expected to rise by 5.3% annually to 2040 while spending tied to disparities is expected to increase by 6.2% per year. (Hartnett, 6/23)

A Supreme Court decision that greenlighted a private health plan's limited dialysis coverage may set the stage for other insurers to cut pay for kidney care and other treatments Medicare covers. The high court rejected a challenge to an employer health plan's low reimbursements for dialysis, which the plaintiff argued discourage providers from joining its network and effectively nudge policyholders to enroll in Medicare instead. This legal decision offers a playbook that other group health plans could follow by designing benefit packages in a way that encourages people with end-stage renal disease to forgo private coverage in favor of Medicare, which is available to anyone with chronic kidney failure regardless of age. And the ramifications may extend beyond dialysis patients. (Tepper, 6/23)

Once again, California’s largest healthcare workers union is campaigning for dialysis reform — but they face powerful opponents. It’s deja-vu for the California political scene, where such a battle transpires repeatedly. This time around, SEIU-United Healthcare Workers West is advocating for a ballot initiative that would require a physician assistant, physician or nurse practitioner to monitor patient dialysis treatments. (Tucker-Smith, 6/22)

The Supreme Court will hear a case on whether the federal government has the authority to dismiss a False Claims Act case after declining to take action. In August 2019, the Department of Justice dismissed a whistleblower case filed in 2012 by Dr. Jesse Polansky, a former employee of UnitedHealth Group subsidiary Executive Health Resources, that alleged hospital billing fraud. Polansky claimed his employer was billing the Centers for Medicare and Medicaid for inpatient admissions that were outpatient visits to receive higher reimbursements. (Christ, 6/23)

Mayo Clinic and UnitedHealthcare have come to terms on an agreement that adds the provider to the insurer's network, the health system announced Thursday. The Mayo Clinic stopped accepting appointments from out-of-network patients to preserve hospital capacity during the COVID-19 pandemic early this year. The deal that takes effect Jan. 1 will give UnitedHealthcare's Medicare Advantage members nationwide access the Mayo Clinic in Rochester, Minnesota, and its other Midwest locations. (Abrams, 6/23)

KHN: Health Care Startups Turn To ‘Coaches’ To Help Patients Cope And Monitor Treatment 

In 2011, Sean Duffy and Adrian James were sitting in San Francisco’s Dolores Park debating what to call some workers at the company they founded, Omada Health. Omada, which launched that year, provides virtual treatment for chronic conditions. The company addresses the conditions through a team of employees — some traditional clinicians and others meant to give encouragement to patients as they manage the day to day of hypertension, prediabetes, and other conditions. This second group was crucial, they thought. The founders ended up asking patients what title to use. (Tahir, 6/24)

Colorado is reviving an old progressive health care goal with a new twist, creating a public health insurance option that could be a model for other states trying to expand affordable coverage as they move past the pandemic. Using flexibilities the Biden administration granted on Thursday, the state is trying to prove a government-run health plan can attract more consumers and save money while avoiding the political pitfalls associated with single-payer systems. (Dreher, 6/24)

The plan will be sold on the ACA’s exchanges and is expected to lower premiums by an average of 22%, or approximately $132 per person a month. Colorado’s plan must cover all essential health benefits required by the ACA and establish premium reduction targets. Any county that has an ACA insurer offering a plan on the individual or small group market must also offer the Colorado Option plan. (King, 6/23)

The Colorado Option will be available to residents who enroll in health plans on the individual market and small employers with fewer than 100 employees. Insurers must offer Colorado Option plans in every county they operate and meet premium reduction targets by 2025. If carriers fail to cut premium costs during that time frame, the state's insurance commissioner can order healthcare providers to join Colorado Option plans at set rates, following a public hearing. (Goldman and Tepper, 6/23)

The federal waiver approval also extended another of Polis’ signature health care initiatives — a reinsurance program that helps insurance companies pay their highest-cost claims, thus allowing them to reduce premium prices for everyone. The Polis administration estimates reinsurance reduces insurance prices for people in the individual market by 20% a year. Polis has made his efforts to save Coloradans money into the centerpiece of his reelection campaign, and he capitalized on Thursday’s announcement to promote that work. (Ingold, 6/23)

California lawmakers on Thursday passed a bill that aims to protect abortion providers and patients seeking abortion care in the state from civil action started in another state. Assembly Bill 1666 next heads to the desk of Democratic Gov. Gavin Newsom, who is supportive of abortion rights. It would take effect immediately with his signature. The measure would make it so that "another state's law authorizing a civil action against a person or entity that receives or seeks, performs or induces, or aids or abets the performance of an abortion, or who attempts or intends to engage in those actions" is contrary to California public policy, and is unenforceable by California courts. (Stracqualursi, 6/23)

A group of elected officials in St. Louis wants to use some of the city’s remaining money from the American Rescue Plan to boost access to reproductive health care, including abortions. The measure set to be introduced Friday by 8th Ward Alderwoman Annie Rice and others sets up a Reproductive Equity Fund and uses $1.75 million in federal coronavirus relief funds as seed money. Because ARPA is a one-time infusion that must be allocated by 2024, supporters hope the fund will become part of the city’s regular budget in the future. ARPA permits local governments to use the funds to support the health of communities, and that’s exactly what the reproductive equity fund would do, said Mallory Schwarz, the executive director of Pro Choice Missouri. (Lippmann, 6/23)

Doctors worried about getting sued under Texas’ restrictive abortion law have delayed treating pregnancy complications until patients’ lives were in danger, according to a paper from the Texas Policy Evaluation Project. The law, which empowers private citizens to file suit against anyone who “aids or abets” in an abortion after about six weeks of pregnancy, has caused confusion among providers and complicated treatment for patients facing pregnancy complications, the study found. (Klibanoff, 6/23)

When G. found out she was pregnant for the fourth time, she decided it was time for her to die. She refused to bring another child into the home she shared with her husband, who frequently raped her and beat her and her two sons. She’d already lost one pregnancy after he kicked her in the stomach during a brutal beating. “I just thought, I can’t have one more baby with this man,” she told The Texas Tribune. “I’m going to kill myself and I can’t wait any longer.” It was 2003, and G., identified in this story by the first initial of her nickname because she fears retaliation from her ex-husband, had been trying unsuccessfully to leave her marriage for more than six years. (Klibanoff, 6/24)

A Republican U.S. representative says he believes abortion rights activists may be behind vandalism at the building his campaign office shares with an anti-abortion group in southern Michigan. Attackers smashed windows and a front door of the building in Jackson, Michigan, early Wednesday, U.S. Rep. Tim Walberg’s campaign said. Jackson is about 80 miles (130 kilometers) west of Detroit. (6/23)

When she came across a training opportunity for mifepristone, a drug used in early pregnancy loss and abortions, Jessica Warner put a mention of it in the May edition of the newsletter she compiled as a coordinator at the Ohio Department of Health. An hour after she hit send, her supervisor called. It was the start of an ordeal that culminated in Warner, a sexually transmitted infections and viral hepatitis training coordinator, being fired and two other employees disciplined. An investigative report prepared by human resources described abortion topics as “off limits,” adding that “the mifepristone item in the newsletter is in direct conflict with the agency’s mission and is an embarrassment to ODH.” It also said the topic was “contrary” to the state’s mission. (Shammas, 6/23)

As the Supreme Court considers potentially overturning Roe v. Wade, abortion rights activists are heralding abortion pills as a potential option in places where clinics may have to close — but several red states are already cracking down on the pills. Almost half of U.S. states have banned or tightly restricted abortion pills — two medicines named mifepristone and misoprostol — and more could soon follow suit. Prior to the pandemic, the FDA said patients seeking abortion pills had to get the drug from hospitals or medical facilities in person. (Gonzalez, Gold and Schrag, 6/23)

A pill used to terminate early pregnancies is unlikely to become available without a prescription for years, if ever, experts say, as the conservative-leaning U.S. Supreme Court is expected to dramatically curb abortion rights in the coming weeks. (Aboulenein, 6/23)

A pregnant American woman who suffered an incomplete miscarriage while vacationing in Malta will be airlifted to a Spanish island on Thursday for a procedure to prevent infection because Maltese law prohibits abortion under any circumstances, the woman’s partner said. Jay Weeldreyer told The Associated Press by phone from a hospital in the island nation that his partner, Andrea Prudente, is at risk of a life-threatening infection if the fetal tissue isn’t promptly removed. ... He indicated she was 16 weeks pregnant when the bleeding began. (D'Emilio, 6/23)

A Supreme Court decision overturning Roe v. Wade would have a ripple effect on health care for women who aren’t trying to seek an abortion, experts say. Doctors providing abortion care use skills and drugs similar to those used to treat miscarriages and stillbirths. Medical residents who sign up for abortion training learn skills they use in non-abortion care, such as how to work with patients experiencing emergencies and how to clear the uterine lining to prevent dangerous complications after a miscarriage — also a method used in surgical abortions. (Gutierrez, 6/24)

For a Mississippi doctor, it was a glimpse of a fetal arm. For a police officer, it was the treatment of anti-abortion protesters outside a clinic. A Catholic leader was galvanized by the civil rights movement. These and other experiences shaped prominent abortion opponents in their decades-long effort to see the U.S. Supreme Court reverse the 1973 Roe v. Wade ruling that established the constitutional right to abortion. (Bernstein, Borter and Brooks, 6/23)

Genetic analysis suggests that although the monkeypox virus is rapidly spreading in the open, it has been silently circulating in people for years. Health officials have already identified two versions of monkeypox among American patients, suggesting at least two separate chains of transmission. Researchers in several countries have found cases with no known source of infection, indicating undetected community spread. And one research team argued last month that monkeypox had already crossed a threshold into sustainable person-to-person transmission. (Mandavilli, 6/23)

Public health experts, including within the Biden administration, are increasingly concerned that the federal government’s handling of the largest-ever U.S. monkeypox outbreak is mirroring its cumbersome response to the coronavirus pandemic 2½ years ago, with potentially dire consequences. As a result, they said, community transmission is occurring largely undetected, and the critical window in which to control the outbreak is closing quickly. (Sun, Diamond and Nirappil, 6/23)

Facing a growing outbreak of the monkeypox virus, New York City health officials expanded access to a monkeypox vaccine on Thursday, offering it to a new group of people who may be at higher risk: men who have had multiple or anonymous male sexual partners over the last two weeks. New York City is the first American jurisdiction to broaden access to the vaccine beyond close contacts of people infected, following similar moves in the United Kingdom and Canada. (Otterman, 6/23)

US health officials are looking to expand use of the monkeypox vaccine for children as the outbreak continues to spread across the US and in countries around the world, with more than 3,300 cases reported globally. The US Centers for Disease Control and Prevention is developing a protocol aimed at allowing use of Bavarian Nordic A/S’s Jynneos vaccine in children, if needed, according to documents prepared for a meeting of agency advisers that took place this week. The vaccine is currently cleared for use in adults and is considered safer than Emergent BioSolutions Inc.’s ACAM2000 smallpox vaccine, which can also be used against monkeypox. (Muller and Griffin, 6/23)

Six more men in Massachusetts have been diagnosed with monkeypox in the past week, bringing the total to 13 since the state’s first case was announced May 18, officials said Thursday, as international public health officials considered labeling the expanding outbreak a global emergency. The six men were found to be positive for the virus between June 16 and Wednesday after initial testing at the State Public Health Laboratory in Jamaica Plain, which will be confirmed by further tests at the US Centers for Disease Control and Prevention, according to a statement from the Department of Public Health. (Fox, 6/23)

With monkeypox cases ticking up in California, public health officials in Riverside and Santa Clara counties reported their first probable cases this week. Health officials in Riverside County received positive test results from a man in the eastern portion of the county on Tuesday, said Jose Arballo Jr., spokesperson for Riverside University Health System-Public Health. The man, who is under 60 years old, showed up at a clinic with symptoms and was tested, Arballo said. He did not require hospitalization and was well enough to recover at home. (Valdez, 6/23)

The U.S. Centers for Disease Control and Prevention (CDC) said there was evidence of local transmission of monkeypox, in addition to reports of cases where people had traveled abroad. The cases are mainly occurring in men who have sex with men, but women are also getting infected, CDC staff member Dr. Agam Rao said at a panel meeting on Thursday. (6/23)

The American Academy of Pediatrics (AAP) is advising depression and suicide risk screenings for all adolescents age 12 and older, according to their updated schedule for preventative care released online this week. The screening for suicide risk was added to the existing depression screening recommendation consistent with the AAP's Guidelines for Adolescent Depression in Primary Care, which were released in 2018. (Brown, 6/23)

More than 1 in 4 adults ages 18 to 24 experience insomnia every night; it's the highest rate of insomnia out of any age group in the U.S., according to a recent survey from Norwegian health and wellness publication Helsestart. The company conducted a Google survey among 2,000 U.S. adults age 18 and up, asking respondents how often they struggle to fall asleep, as well as their genders and their ages. Half of respondents said they experienced insomnia at least once a month, while nearly a quarter said they struggle to fall asleep every night. (Martin, 6/23)

New HIV diagnoses dropped 17% during the first year of the pandemic, according to a new report from the Centers for Disease Control and Prevention, but researchers warn disruptions brought by the pandemic’s early lockdowns mean that far fewer people got tested. (Salzman, 6/23)

In Rochester, N.Y., Diane Coleman has relied on a machine to help her stay alive, but she worries that it might be slowly undermining her health. Her ventilator was among millions of breathing devices that Philips Respironics recalled last summer over safety concerns about numerous models of its ventilators, BiPAP and CPAP machines. (Reyes, 6/23)

Houston scientists are beginning to understand the underlying cause of congenital heart disease, according to a study published Wednesday that sheds new light on the illness. Physician-scientists from the Texas Heart Institute, Texas Children’s Hospital and Baylor College of Medicine together documented the first reported evidence of unique differences in the heart muscle cells and immune systems of patients who suffer from congenital heart disease — one of the leading causes of death in children and adults. The findings create a kind of genetic road map that could lead to targeted therapies for the tens of thousands of children born with the disease each year. (Gill, 6/23)

Since late May, at least 470 consumers of Daily Harvest’s lentil and leek crumbles, a recalled accompaniment included in some of its meal kits, have gotten sick, the company said Thursday in a press release. Daily Harvest — a direct-to-consumer provider of vegan-friendly smoothies, bowls and other foods that are typically shipped through the mail — has stopped production and distribution of the product and is conducting “a root cause investigation” in conjunction with the U.S. Food and Drug Administration. (D'Zurilla, 6/23)

KHN: Seniors With Prediabetes Should Eat Better, Get Moving, But Not Fret Too Much About Diabetes 

Almost half of older adults — more than 26 million people 65 and older — have prediabetes, according to the Centers for Disease Control and Prevention. How concerned should they be? Not very, say some experts. Prediabetes — a term that refers to above-normal but not extremely high blood sugar levels — isn’t a disease, and it doesn’t imply that older adults who have it will inevitably develop Type 2 diabetes, they note. (Graham, 6/24)

KHN: Readers And Tweeters Weigh In On America’s Medical Debt, Obesity Epidemic, And Opioid Battles

KHN gives readers a chance to comment on a recent batch of stories. (6/24)

The latest report notifying federal health regulators that a baby died after it had consumed Abbott Laboratories’ baby formula mentions the cronobacter bacteria, the Food and Drug Administration said. Cronobacter is the same bacteria that previously sickened at least four other infants, including two who died, between September 2021 and February after they had consumed Abbott formula. The bacteria occurs naturally in the environment and can live in dry, powdered foods. It can be fatal in infants, causing sepsis or meningitis. (Newman and Loftus, 6/23)

Sarepta Therapeutics said Thursday that it has temporarily stopped a clinical trial of its second-generation medicine for patients with a certain type of Duchenne muscular dystrophy due to a serious safety incident reported by a patient. The Food and Drug Administration placed a clinical hold on the Sarepta drug, called SRP-5051, after a patient in the study experienced a “serious” decrease in blood-based magnesium, a condition known as hypomagnesemia. (Feuerstein, 6/23)

Three years ago, a former CVS Health executive told a U.S. Senate committee hearing that the company — which has deep tentacles into the Byzantine system for making prescription drugs available — ensures that its customers receive the lowest-cost medicines. “When those lower list prices result in the lowest net cost for the patient as well as for the plan, then absolutely, that is the preferred drug on formulary,” said Derica Rice, who was an executive vice president at the time. He was responding to questions about the ways in which CVS places medicines on its formularies, or list of medicines covered by health insurance, created by its pharmacy benefits unit. But a recently unsealed whistleblower lawsuit argued that, in fact, CVS and its various subsidiaries — the CVS Caremark pharmacy benefits manager, the SilverScript Medicare Part D plan and the CVS chain of pharmacies — conspired to do exactly the opposite. (Silverman, 6/23)

Merck & Co. is pushing forward with a potential deal for biotech Seagen Inc., according to people familiar with the matter, in what would be one of the largest takeovers of the year. The Wall Street Journal reported last week that Merck was in talks to buy Seagen, which would beef up the pharmaceutical giant’s cancer-drug portfolio, but that no agreement was imminent. The talks have picked up pace and the two companies are scheduled to meet this week, some of the people said Thursday. (Cimilluca, Lombardo and Rockoff, 6/23)

Bausch Health Cos. has named hedge fund billionaire John Paulson as its new chairman, replacing Joseph Papa, who resigned on Thursday. The pharmaceutical and device company, which focuses on eye care, gastroenterology and dermatology products, said Papa’s resignation wasn’t the result of “any dispute or disagreement.” Paulson, who is also the company’s second-largest shareholder, starts immediately. Shares of Bausch jumped in late trading, gaining about 3% to $7.49 a share at 6:30 p.m. in New York. The Canadian company was once known as Valeant Pharmaceuticals. It rebranded in 2018 in the wake of public outcry over drug price hikes and the conviction of a former executive for accepting a bribe. (Swetlitz, 6/24)

One of the biggest names in breast cancer research funding is rolling out a $21.7 million funding round to combat the biggest challenges around the disease, which is diagnosed more than 250,000 times a year. Dallas-based Susan G. Komen for the Cure will back 48 new research projects at 26 U.S. medical institutions. That’s in addition to the $93.3 million in active projects the nonprofit is currently funding across 104 research teams. (Wright, 6/23)

The state of Michigan has agreed to destroy more than 3 million dried blood spots taken from babies and kept in storage, a partial settlement in an ongoing lawsuit over consent and privacy in the digital age. At the state’s direction, hospitals have routinely pricked the heels of newborns to draw blood to check for more than 50 rare diseases. That practice, which is widespread across the U.S., isn’t being challenged. Rather, the dispute is over leftover samples. (White, 6/23)

Prisoners on death row in Mississippi will no longer have to be mentally competent in order for their post-conviction review process to go forward, after a state supreme court decision Tuesday. The court's ruling, which overturned 26 years of precedent in the state, involved Stephen Elliott Powers, who was convicted of murder and attempted rape in 2000 and sentenced to death. On June 13, 1998, Powers killed 27-year-old Elizabeth "Beth" Lafferty in Hattiesburg. Evidence pointed to attempted rape, a charge that elevated the crime to capital murder. Powers admitted to shooting Lafferty five times but denied that he ever tried to rape her. (Perlis, 6/24)

Virginia Board of Health members on Thursday told Health Commissioner Colin Greene that his comments dismissing evidence of structural racism in health outcomes and calling gun violence a political talking point damaged the health department, its employees and marginalized communities. After questioning Greene for nearly an hour, the board passed a resolution expressing members’ “embarrassment” over his views and advised him not to publicly question “basic scientific facts regarding disparities.” (Portnoy, 6/23)

At his State of the Union speech in March, President Joe Biden urged Congress to fund a new federal agency that would “supercharge” breakthrough medical research and “end cancer as we know it.” Congress responded two weeks later by approving $1 billion for the Advanced Research Projects Agency for Health, or ARPA-H, which will tackle projects that are seen as too costly, risky or time-intensive for the private sector and traditional public research. In Maryland, research institutions, labs, pharmaceutical companies and biotech startups have long had a close, symbiotic relationship with the numerous federal health agencies already located here, but federal leaders and lawmakers think it might be time now for some distance. (Bologna and Cohn, 6/24)

California’s record wildfire season two years ago dished up some of the worst and most memorable air pollution in modern times - the smoke, the dark skies, the eerie orange glow of the sun. But just how bad it was, and what the toll of the unhealthy air will be on people and communities, is a matter that’s still coming to light. A new report finds that California was home to 19 of the 20 worst counties in the nation for particulate pollution in 2020. If sustained, these pollution levels could shave months, if not years, off the lives of residents, according to the Air Quality Life Index, published this month by the Energy Policy Institute at the University of Chicago. (Alexander, 6/23)

Baltimore’s water system, which serves 1.8 million homes and businesses in the city and Baltimore County, contains measurable levels of so-called “forever chemicals” that the EPA said last week pose health risks even at minute levels. The chemicals known as PFAS, used in firefighting foams and in consumer products for their nonstick and stain-resistant properties, were found in the system at a concentration of 4.93 parts per trillion, according to a city Department of Public Works report. (Dance, 6/23)

The Museum at the Bighorns in Sheridan is hosting a temporary exhibit that tells the story of healthcare and healing practices on the Crow and Northern Cheyenne reservations in Montana. It’s from the collection from of the Western Heritage Center in Billings, Mont. “Baá Hawassiio & Ènomóhtåhéseh: Healthcare on the Crow & Northern Cheyenne Reservations” has been on display at other museums and will continue to make the rounds after it leaves Sheridan. “One of the reasons why we wanted to get this exhibit was because it’s a topic that people don’t know anything about,” said Jessica Salzman, Collections Manager for the Museum at the Bighorns. “Yes, the Crow and Northern Cheyenne reservations are technically across the Montana border [but] the people that live there came to Sheridan to shop, they were part of the community here, and they still are.” (Cook, 6/23)

The number of Utahns experiencing homelessness for the first time rose last year, and state officials believe pandemic-fueled turmoil and surging housing prices may be to blame. The Utah Office of Homeless Services’ annual report, released Wednesday, found the number of first-time homeless Utahns jumped by 14% from fiscal 2020 to 2021, representing the first time in five years that metric has spiked. (The federal fiscal year runs from Oct. 1 to Sept. 30.) Joseph Jensen, data manager of the state office, said officials are studying the extent to which the pandemic and housing costs are affecting homelessness. Utah, he said, is still seeing more people access assistance programs — even if they aren’t experiencing homelessness. (Apgar, 6/22)

Top Biden administration officials told senators Thursday that the government will soon release its plan to issue payments to U.S. diplomats and intelligence officers who suffered mysterious injuries abroad known as “Havana Syndrome,” four people with knowledge of the matter told NBC News. In a classified briefing, Deputy CIA Director David Cohen and Assistant FBI Director Alan Kohler updated a group of senators on the latest on the yearslong investigation into the injuries, which the administration calls “anomalous health incidents.” (Lederman, 6/23)

The State Department is preparing to compensate victims of mysterious brain injuries colloquially known as “Havana Syndrome” with six-figure payments, according to officials and a congressional aide. Current and former State Department staff and their families who suffered from “qualifying injuries” since cases were first reported among U.S. embassy personnel in Cuba in 2016 will receive payments of between roughly $100,000 and $200,000 each, the officials and aide said. (Lee and Merchant, 6/23)

A new study by an international team of scientists reveals a new understanding of how antibiotic-resistant strains of typhoid fever have quickly emerged and spread from South Asia to other parts of the world. The authors of the study, published this week in The Lancet Microbe, say the findings highlight the need to consider drug-resistant typhoid fever as a global—rather than a local—problem, and to rapidly expand prevention measures. (Dall, 6/23)

Burundi has the lowest income per capita of any country measured by the World Bank. But according to a rights measurement tracker, it’s doing its best to meet its population’s health needs. Burundi scored 100% in ensuring its people’s right to health in the Human Rights Measurement Initiative’s latest update to its Rights Tracker, launched Wednesday. It’s the only country out of 144 to achieve this perfect score, despite having one of the lowest per capita incomes globally. Its 2020 per capita income was $731, measured in 2017 dollars with adjustments for inflation and purchasing power. (Ravelo, 6/23)

Emberly McLean-Bernard, born six weeks premature in rural Mississippi, weighed less than five pounds when doctors sent her home. She did not cry and barely ate, her mother said, and not two days elapsed before she began to gasp for breath. Jocelyn McLean rushed her daughter to the nearest emergency room, but the baby was already turning blue. The medical team went straight to code blue, pumping air into the baby’s lungs, trying to force an IV line into Emberly’s neck and scalp, prodding her with a rectal thermometer — but her vital signs kept failing. After four hours, they gave up. (Dewan, 6/20)

Maria Contreras and Monica Davis share many things — including a vital organ. The two Ohio women, who refer to themselves as “split-liver sisters,” received a liver transplant on July 1, 2020. But it wasn’t an ordinary transplant surgery: They had a split-liver transplantation, in which a donor’s liver was divided into two distinct portions, which were then implanted into each patient. (Page, 6/22)

Doctors can’t fully explain the death of the first recipient of a genetically modified pig heart, but they offered several theories in a new study—and said clinical trials of pig-to-human organ transplantation should begin despite the continuing mystery. (Marcus, 6/22)

Everleigh Victoria McCarthy was born three months premature at Brigham and Women’s Hospital in Boston and weighed a little over two pounds. Soon after her birth on July 25, 2020, she developed massive bleeding in her brain. ... But on Aug. 6, when Everleigh was less than 2 weeks old, doctors told the couple that she would not survive. The baby was taken off the ventilator. ... When the funeral home tried to retrieve Everleigh’s body four days later, hospital employees said that they could not find her remains, according to a police report. The Boston police determined that the baby’s body “was probably mistaken as soiled linen” and discarded, officers wrote in the report. (Cramer, 6/23)

Researchers have made great strides toward eventually providing the more than 5 million people with paralysis in the U.S. more mobility and independence with the development of an experimental device called a brain-computer interface (BCI). In recent years, BCIs have successfully enabled dozens of study participants who lost the use of their limbs after strokes, accidents or diseases such as multiple sclerosis, to control a mouse cursor, keyboard, mobile device, wheelchair and even a robotic arm that provides sensory feedback to the patient, simply by using their own mind. The technology could be a gamechanger to help those with paralysis return to work and communicate more quickly and effectively. (Guzman, 6/21)

“There are some health risks associated with public bathrooms,” said Erica Donner, a professor of environmental science at the University of South Australia. The size of the risk depends on many things, including how often the restroom is cleaned and how well ventilated it is, she said. But you can also take simple steps to protect yourself, said Dr. Donner, a co-author of a recent review of studies on infectious disease transmission in public restrooms. (Callahan, 6/21)

Japan's notable coronavirus pandemic resilience has generated scores of possible explanations, from the country's preference for going shoeless indoors, to the purportedly low-aerosol-generating nature of Japan's quiet conversation, to its citizens' beneficial gut bacteria. Even irreligiousness — said to have spared the Japanese from exposure to crowded houses of worship — has been touted as a virtue in the age of COVID-19. Despite having the world's oldest population, with almost one in three residents 65 or older, Japan has had fewer COVID fatalities per capita than almost any other developed nation. (Craft, 6/23)

Rite Aid President and CEO Heyward Donigan has a vision for the future of the pharmaceutical industry: People should be able to consult their local pharmacists via video or text from their smartphones. Donigan, who took on the leading role just months before the coronavirus pandemic, has been working to modernize the 60-year-old company that’s currently under restructuring. (Abril, 6/15)

Strolling into your local Rite Aid, there’s not much that separates the store from those of its biggest competitors, CVS and Walgreens. All the standard chain-pharmacy building blocks are there: rows of shampoo and painkillers, a snack aisle filled with brightly colored bags of potato chips, the “seasonal” section, stocked with plastic pumpkins or maybe pastel Easter baskets, and, of course, the pharmacy counter, usually tucked away near the back. But broaden the picture and that facade of similarity crumbles. Rite Aid, which was once the largest pharmacy chain in the country, is now just a minnow in the Big Pharmacy pond. (Wahba, 6/14)

Long Covid is making it hard for millions of Americans to return to normal life, pushing some out of the workforce altogether, sometimes permanently. Yet medical efforts to figure out how best to help these patients are proceeding only slowly. (Lisa Jarvis, 6/23)

Yesterday, a CDC panel discussed whether smallpox vaccines should be offered more widely as a preventive measure against monkeypox. The panel made no decision. But getting those shots into patients’ arms—and particularly gay and bisexual men’s arms—is an urgent matter. Since May 13, more than 3,300 cases of monkeypox have been reported in 58 countries, including the United States, where the disease was not previously thought to be endemic. (Monica Gandhi, 6/24)

Monkeypox is spreading: there have been more than 3,000 confirmed cases of this virus in over 40 countries, and the actual number is likely much higher. Although the monkeypox virus is not normally as contagious or transmissible as coronavirus, this peculiar spread of cases worldwide is worrisome, because there are still so many unknowns. (Muhammad Jawad Noon, 6/23)

Before Roe v. Wade was decided in 1973, millions of Americans found ways around state laws so that they could get abortions. Too many were forced to rely on unsafe methods — whether that was a “back alley” provider or a knitting needle at home — resulting in injury, infertility and even death. (Greer Donley, Rachel Rebouche and David S. Cohen, 6/23)

As the leaked Supreme Court draft opinion overturning Roe v. Wade continues to cause alarm across the country, religious minority groups are gearing up for a legal battle to protect their religious freedoms. On June 10, a Florida synagogue filed a lawsuit challenging the state’s ban on abortions after 15 weeks saying it prevents Jews from having a procedure that, in some cases, Jewish law would require them to have. They’re not alone. (Asifa Quraishi-Landes, 6/23)

For most of his life, Harris Marquesano struggled to live inside his own skin. He was a sweet boy — affectionate with his parents, protective of his little sister and devoted to his friends. But he had more energy than he knew what to do with, and he worried almost constantly. In preschool, when his teacher had to have surgery, he was so distressed by her absence that he tried to take over his classroom, presiding over each playgroup like a tiny, anxious general. By junior high, he was acting out in earnest. Some of Harris’s teachers suggested to his mother, Stephanie Marquesano, that he was just testing limits. But she knew it was more than that. “He was crawling out of his own skin half the time,” she said. “Running around and acting out was the only way for him to manage that feeling.” (Jeneen Interlandi, 6/24)

When asked the question “Why do health insurance companies exist?” A reasonable person would likely respond that the role of health insurance companies is to use their influence to negotiate and keep healthcare costs low for members. This same person might then be infuriated to find out that as a single person with effectively no negotiating power, oftentimes, they could potentially end up paying less out of pocket for medical services than what insurance companies negotiate on their behalf. (Ross Klosterman, 6/23)

For years, racism mandated that Black people and other people of color in the United States use back doors to enter restaurants, movie theaters, and other public places. While these practices have ended, digital back doors may once again make them and others second-class citizens when it comes to health. Digital back doors are technological processes and tools used in health care, such as racially biased algorithms, infrastructural limitations, and dirty data. These unwittingly exacerbate existing health inequities, which the World Health Organization defines as “systematic differences in the health status of different population groups.” (Kim Gallon, 6/24)

In 2021, BlueCross BlueShield of Tennessee paid out a record-high of $16.76 billion in claims costs to meet the health care needs of our members. Unfortunately, rising costs are predicted to continue: the Centers for Medicare & Medicaid Services reports that health care costs are expected to rise another 3.6% in 2022. This is especially relevant now as the Wall Street Journal has reported that hospitals want to continue raising treatment costs, even as consumers face the daily effects of inflation. (Robin Young, 6/24)