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The Department of Veterans Affairs has experienced five months of tumult. Its previous secretary got into a political brawl with his staff and was fired by Twitter message. His first proposed replacement was scuttled by allegations of drunkenness. Then the acting secretary who took charge was accused of making false statements to Congress. In the department’s headquarters a block from the White House, political appointees who worked in the Trump campaign forced career officials out of key positions; inexperienced newcomers published an erroneous report about thousands of military suicides that never happened; and the department’s top technology official fended off calls from Congress to resign over his ties to Cambridge Analytica, the voter-profiling company. (Philipps, 7/30)

President Donald Trump said Monday during an Oval Office ceremony that Wilkie will work day and night “to protect those who protect us.” He also told Wilkie that hundreds of thousands of people are counting on him. The former Pentagon official was selected to replace Secretary David Shulkin, who was fired amid ethics charges and internal rebellion at the department over the role of private care for veterans. Wilkie was confirmed by an 86-9 vote in the Senate last week. He secured the backing of many Democrats after insisting he would not privatize the government’s second-largest department. (Ebbs, 7/30)

"I want to congratulate you and congratulate you strongly,” Trump told Robert Wilkie, previously an undersecretary at the Pentagon, who was joined by family members in the Oval Office ceremony. "Since day one, my administration has been focused on serving the men and women who make freedom possible – our great veterans," the president said. "These American heroes deserve only the best and they will have it under Robert Wilkie – I have no doubt about it." (Slack, 7/30)

A longtime Washington insider, Mr. Wilkie has worked for decades at the Pentagon and in the defense contracting industry. He brings to the VA the expectation he can manage the complex bureaucracy of the second-largest department in the federal government, after the Department of Defense. He is President Trump’s second permanent VA secretary, taking over after the departure of David Shulkin, who was fired by the president earlier this year. While Mr. Wilkie awaited confirmation, the department was helmed by Peter O’Rourke, whose new role has yet to be defined by the department. A VA spokesman declined to comment further and said the VA had no announcements to make regarding personnel changes. (Kesling, 7/30)

Before they were separated at the southwest border, Ana Carolina Fernandes’s 5-year-old son loved playing with the yellow, impish Minion characters from the “Despicable Me” movies. Now his favorite game is patting down and shackling “migrants” with plastic cuffs. After being separated from his mother for 50 days, Thiago isn’t the same boy who was taken away from her by Border Patrol agents when they arrived in the United States from Brazil, Ms. Fernandes said last week. (Jordan, 7/31)

The Senate Judiciary Committee is demanding answers from federal immigration officials about the Trump administration's separation of migrant children from their families and its struggle to reunite them, a fraught effort that's drawn election-year criticism from both parties. But a hearing scheduled for Tuesday on the topic may have a wider focus after the committee's bipartisan leaders asked federal investigators to probe reports of sexual and other abuse of immigrants at government detention facilities. (Fram, 7/31)

A federal judge on Monday ordered the Trump administration to transfer all undocumented immigrant minors out of a detention facility in Texas due to allegations of abuse and over-medication against the children. U.S. District Judge Dolly Gee ruled that conditions at the Shiloh Residential Treatment Center in Manvel, Texas, violate a 1997 court settlement that dictates how the government must care for minors who entered the country illegally on their own or were separated from their parents. (Gomez, 7/30)

When 17-year-old Destani Williams ran away from an upstate New York residential treatment program in May 2017 and was found dead a week later, it was but the latest in a string of troubling incidents at Cayuga Centers, a 166-year-old child-welfare agency. In the year leading up to her death, three workers were arrested on charges of abuse, and the agency was sued for negligence as a result. The local police in Auburn, N.Y., complained about hundreds of emergency calls to deal with runaway residents and violent incidents on the campus, which included residents injuring police officers, throwing chairs through windows and wielding shards of glass to cut staff members. (Robbins, 7/31)

Senator Joe Manchin III of West Virginia broke with his party on Monday to become the first Democrat to meet with Judge Brett M. Kavanaugh, President Trump’s Supreme Court pick, as the two parties escalated their feud over access to documents relating to the nominee. Mr. Manchin, who faces a tough fight for re-election in a state that Mr. Trump won handily in 2016, is central to the Democrats’ uphill battle to defeat Judge Kavanaugh’s nomination, and is under intense pressure at home from both sides. If he votes to confirm Judge Kavanaugh, he will infuriate Democratic voters. But if he votes against confirmation, he risks his own Senate seat. (Stolberg and Shear, 7/30)

The first Democratic senator to sit down with Supreme Court nominee Brett Kavanaugh said Monday he’s not ready to say how he’ll vote, but Kavanaugh did pick up the backing of Kentucky’s Rand Paul, the only Republican in the narrowly divided Senate to have outwardly wavered in possible support. Paul said he will back Kavanaugh despite misgivings about the judge’s views on surveillance and privacy issues. Few had expected Paul would oppose President Donald Trump’s choice in the end. (Freking, 7/30)

A libertarian think tank on Monday alleged that the Medicare for All plan backed by Sen. Bernie Sanders would put the brunt of the proposal's costs on provider pay cuts. In a white paper released Monday by the Mercatus Center of George Mason University, senior research strategist Charles Blahous claimed healthcare spending constraints laid out in the plan from the Vermont independent senator fall almost totally on providers. The plan could save the United States more than $2 trillion over 10 years in national healthcare spending, but could increase the federal government's costs to nearly $33 trillion above current levels, according to Blahous' calculations. (Luthi, 7/30)

Sen. Bernie Sanders’ “Medicare for all” proposal would increase federal spending by $32.6 trillion over 10 years, according to a new analysis of the proposed legislation by a libertarian think tank. The analysis by Charles Blahous of the Mercatus Center at George Mason University says that federal spending under a universal, single-payer system would equal roughly 10.7 percent of GDP in 2022, rising to 12.7 percent by 2031. (Rainey, 7/30)

A "Medicare for All" health care proposal by Sen. Bernie Sanders would cost $32.6 trillion over 10 years to implement, a study released Monday from the libertarian Mercatus Center estimates. All Americans would be covered by an expanded Medicare program under the bill (S 1804) that the Vermont independent introduced last year. Under the plan, patients would not pay for cost-sharing, such as co-pays or deductibles. Health care providers, including hospitals and physicians, would be reimbursed for care at Medicare payment rates, and the program would expand to cover areas like vision, dental and hearing coverage. (McIntire, 7/30)

The Food and Drug Administration on Monday announced that it had warned several companies to stop marketing laser devices for procedures billed as “vaginal rejuvenation,” saying they were dangerous and deceptive treatments. The agency originally permitted the lasers and related energy-based devices onto the market for treatment of serious conditions, like cancer, genital warts, or surgery including hysterectomies. (Kaplan, 7/30)

The agency said that it has approved such devices, which commonly use laser beams or radiofrequencies, for specific gynecologic uses, including the destruction of precancerous cervical or vaginal tissue and the removal of genital warts. But the agency has not cleared the devices for symptoms related to menopause, urinary incontinence or sexual function. The FDA noted in a safety alert issued Monday that vaginal "rejuvenation" often is used to describe nonsurgical procedures intended to treat symptoms such as vaginal laxity, atrophy or dryness, and pain during intercourse or urination. During menopause, levels of estrogen decline, which may lead to symptoms such as pain during sexual intercourse. (McGinley, 7/30)

The FDA said it had reviewed adverse event reports and medical literature and catalogued “numerous cases” in which use of the devices resulted in vaginal burns, scarring, pain during intercourse, and chronic pain. In some cases, the FDA said, the devices are being marketed specifically to women who have gone through treatment for breast cancer and are experiencing early menopause. “The deceptive marketing of a dangerous procedure with no proven benefit, including to women who’ve been treated for cancer, is egregious,” Gottlieb said. And, he added, the misleading marketing of unproven treatments might keep some women from receiving appropriate, evidence-based care for their conditions. (Thielking, 7/30)

We all hope for a little peace at the end of life, for ourselves and for our loved ones. Hospice services can play a big role, relieving pain and providing spiritual and emotional support. But a federal report published Tuesday synthesized patient and Medicare payment data going back to 2005 and found that, as the hospice industry expands, some hospice providers are bilking Medicare and neglecting patients. The report calls for the Centers for Medicare and Medicaid Services, which is a key player in the funding of hospice services, to increase its level of scrutiny to improve the detection of these problems. (Jaffe, 7/31)

Kaiser Health News: Missed Visits, Uncontrolled Pain And Fraud: Report Says Hospice Lacks Oversight

The report from the Office of Inspector General (OIG) at the Department of Health and Human Services sums up over 10 years of research into inadequate care, inappropriate billing and outright fraud by hospices, which took in $16.7 billion in Medicare payments in 2016. The Medicare hospice benefit aims to help patients live out their final days in peace and comfort: It pays for agencies to send nurses, aides, social workers and chaplains to visit patients who are likely to die within six months and who agree to forgo curative treatment for their terminal illness. Most of the time, this care takes place where the patient already lives — their home, nursing home or assisted living facility. (Bailey, 7/31)

An injectable drug that the manufacturer says is too dangerous to use along the spine is growing in popularity for back pain as doctors turn away from opioids. The anti-inflammatory drug, called Depo-Medrol and made by Pfizer, is approved for injection into muscles and joints. Once a drug is approved, however, doctors may legally prescribe it however they see fit. And doctors have long given Depo-Medrol shots, or the generic equivalent, close to the spinal cord for painful backs, necks and conditions like spinal stenosis. (Kaplan, 7/31)

The St. Louis County program consists of a database used by doctors and pharmacists to check a patient’s prescription history. Though it covers 80 percent of Missouri’s population, many rural — and often more vulnerable — counties do not participate. Prescription drug monitoring programs have been an important tactic used by states and municipalities across the U.S. to try to prevent doctor-shopping — the practice of visiting multiple providers to fill prescriptions for drugs intended for illegal sale or use. National public health agencies, like the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services, say state monitoring programs play a vital role in fighting the opioid crisis. (Black, Lin and McGrath, 7/30)

The nation’s five largest cities have been excluded from millions in federal funding to address the nation’s opioid crisis — and lawmakers from the affected areas say the Trump administration has no right to exclude the metropolitan areas. Forty-eight House members and seven senators representing the cities — Los Angeles, Chicago, Houston, New York and Philadelphia — are objecting to the administration’s decision last month to withhold opioid funding to their local governments. (Haberkorn, 7/30)

Eight states are filing suit against the Trump administration over its decision to allow a Texas company to publish downloadable blueprints for a 3D-printed gun, contending the hard-to-trace plastic weapons are a boon to terrorists and criminals and threaten public safety. The suit, filed Monday in Seattle, asks a judge to block the federal government’s late-June settlement with Defense Distributed, which allowed the company to make the plans available online. Officials say that 1,000 people have already downloaded blueprints for AR-15 rifles. (Rubinkam, 7/30)

“These downloadable guns are unregistered and very difficult to detect, even with metal detectors, and will be available to anyone regardless of age, mental health or criminal history,” said Bob Ferguson, Washington state’s attorney general who filed the suit on behalf of the other states. (Elinson, 7/30)

Aftab Pureval, a Democrat seeking to unseat a Republican congressman in Ohio, knows the political risks in calling for gun restrictions – and taking on the powerful National Rifle Association, which has spent more than $115,000 supporting his opponent over the years. But after a spate of school shootings, including February's massacre at a high school in Parkland, Florida, Pureval believes voters in the Republican-leaning district have had enough of congressional inaction. (7/30)

Public school families across Florida have a different first day of school ahead compared to previous years. The 2018-19 school year brings new school safety mandates created by the Legislature after former student Nikolas Cruz killed 17 and wounded 17 more at Marjory Stoneman Douglas High in Parkland: An armed guard on every campus, increased security technology and stricter rules. (Wright, 7/31)

Toward the end, the pain had practically driven Elizabeth Martin mad. By then, the cancer had spread everywhere, from her colon to her spine, her liver, her adrenal glands and one of her lungs. Eventually, it penetrated her brain. No medication made the pain bearable. A woman who had been generous and good-humored turned into someone hardly recognizable to her family: paranoid, snarling, violent. (Ollove, 7/30)

Sanofi is one of the world’s leaders in influenza vaccine production, through its vaccine arm Sanofi Pasteur. And if anyone at Sanofi knows vaccines, it’s Dr. Gary Nabel, the company’s chief scientific officer, who happens to be a former head of the National Institutes of Health’s Vaccine Research Center. When Nabel dropped by STAT for a visit, we thought we’d explore some flu vaccine-related issues. (Branswell, 7/31)

When a San Diego-based mother posted an emergency alert on Nextdoor, a community discussion app, she hoped a Good Samaritan could help, according to court filings. Her son was hysterical after losing a flash drive with his homework near the local McDonald’s, she wrote, uploading a photo along with the message. A neighbor quickly replied, explaining that the chewing-gum-sized object in the picture was not a flash drive: It was a Juul vaping device. (Paul, 7/30)

It is vital to transgender women to find the feminine voice that matches their gender identity, gives them confidence and helps prevent harassment. ... The problem for transgender women is that finding a feminine voice is no easy task. As The Washington Post reported, testosterone, which transgender men take to build up their muscles and grow facial hair, also increases the size of their vocal folds, making their voices deeper. Estrogen, however, which most transgender women take, can’t shrink the vocal cords. (Nutt, 7/30)

Gene and cell therapy companies collectively raised $2.3 billion in equity financing in the first 4 1/2 months of this year, putting them on pace to exceed their $4.5 billion haul last year, according to a database maintained by the news organization BioCentury. For cancer alone, there are 753 cell therapies being developed worldwide, according to the Cancer Research Institute, a nonprofit group. Half of them have reached human testing. That’s the point at which it becomes essential for a company to have an experienced professional who knows how to oversee a manufacturing operation of far greater complexity than the kind traditionally used by pharma to make synthetic compounds. (Robbins, 7/31)

Scientists in China now have hard evidence that eating raw centipedes is a really bad idea. That might go without saying in most parts of the world. But centipedes are an established remedy in traditional medicine in China. (McNeil, 7/30)

One of the hottest fields in health care investing is digital health. Companies in the space collectively raised $3.4 billion in venture capital in the first half of this year, spread across 193 deals, according to a count from the venture firm Rock Health. If that pace continues, the sector will set a new record this year — both in terms of number of deals and VC money invested overall. But is all that cash being invested wisely? To tease out that question, STAT sat down to chat with veteran health care VC Lisa Suennen, who works as the lead health care investor for General Electric’s corporate venture arm. (Robbins and Feuerstein, 7/30)

In Minnesota alone, the rate increased 40.6 percent between 1999 and 2016, according to the latest figures from the Centers for Disease Control and Prevention. So what are medical professionals doing to prevent suicides? (Wurzer, 7/30)

Nobody wants a deadly Ebola outbreak, but for the world health chief, the latest episode has been invaluable. The World Health Organization’s Tedros Adhanom Ghebreyesus this month declared an end to an Ebola outbreak that started in May in the Democratic Republic of the Congo, four years after the agency’s high-profile failure to contain the spread of the virus throughout West Africa. (Jennings, 7/29)

Kaiser Health News: For Many College Students, Hunger Can ‘Make It Hard To Focus In Class’

As students enter college this fall, many will hunger for more than knowledge. Up to half of college students report that they were either not getting enough to eat or were worried about it, according to published studies. “Food insecurity,” as it’s called, is most prevalent at community colleges, but it’s common at public and private four-year schools as well. Student activists and advocates in the education community have drawn attention to the problem in recent years, and the food pantries that have sprung up at hundreds of schools are perhaps the most visible sign. (Andrews, 7/31)

Washington's Democratic governor pledged Monday that if the Trump administration sticks with its proposed Title X family planning rules that include a ban on Planned Parenthood, the state will forgo its share of the nearly $290 billion that the federal government pays out. The statement by Gov. Jay Inslee could mean a loss of nearly $4 million each year in grants to family planning clinics should HHS finalize its proposed Title X rule without changes, and other Democratic governors plan to make similar pledges over the next few days. (Luthi, 7/30)

Concerns about the medical care provided to inmates in Connecticut’s prisons emerged during a six-hour hearing Monday as family members of inmates testified about substandard care and the system’s former medical director told lawmakers that requests for specialized treatment were routinely denied. (Rigg, 7/30)

Tobacco retailers have mixed reviews for a new law that raises the legal age for purchasing tobacco in Massachusetts to 21. The law standardizes the minimum age across the state, where more than 170 municipalities, including Boston and Worcester, had already raised the age above 18. (Halper, 7/31)

A former Mississippi jail nurse has been convicted of manslaughter in the death of a diabetic inmate who went a week without insulin. The Sun Herald reports a Warren County judge sentenced Carmon Sue Brannan on Monday to 15 years in prison. Brannon testified she thought 28-year-old William Joel Dixon of Lucedale was undergoing drug withdrawal the week before his death in 2014 in the George County jail. (7/30)

Elliot Hospital is spending $1.5 million to offer more beds and a better setting for emergency room patients in need of psychiatric care. Elliot on Monday unveiled a new psychiatric evaluation program unit in the emergency room that will provide six beds — two more than in the existing unit. It opens Aug. 6. (Cousineau, 7/30)

The Endowment for Health, the state’s largest health foundation, recently awarded nearly $1 million in grants to support a wide range of projects. The $996,964 in funds is “aimed at strengthening the voices of families and youth, as well as greater access to community-service information,” according to a news release. The Endowment’s focus includes work on health equity, children’s behavioral health, early childhood, elder health and health policy. (Feely, 7/30)

The executive director of Iowa’s medical regulatory board has abruptly retired, saying he was treated unfairly by state officials. The Iowa Board of Medicine put executive director Mark Bowden on administrative leave about a month ago, and voted to reinstate him Friday. (Sostaric, 7/30)

A class-action lawsuit has been filed against Cupertino Healthcare & Wellness Center and more than a dozen other skilled nursing homes accused of deliberately running an understaffed business to make a bigger profit. The 24-hour skilled nursing home and rehab facility on Voss Avenue is one of four Bay Area businesses named in the suit; the other three are in Hayward, Novato and San Rafael. (Sarwari, 7/30)

The Unity Center for Behavioral Health, Portland's 1 ½-year-old psychiatric emergency room, is no longer accepting most new patients while it works to address problems raised by a state investigation into employee and patient safety. In a move that could cause backups at hospital emergency rooms, the 100-bed center has told ambulances and area hospitals to no longer bring or refer patients to Unity. The facility will still accept walk-in patients only for now, said Legacy Health spokesman Brian Terrett. (Harbarger, 7/30)

All public housing in Missouri is now smoke-free. The U.S. Department of Housing and Urban Development announced the policy change in November 2016, mandating the facilities prohibit smoking by July 30 of this year. (Lewis-Thompson, 7/30)

Clinics buy subscriptions to the software service from Praestan Health, which draws on more than 20 behavior change models to create a personalized "change path" for individual patients. When crafting plans for individuals, the software is designed to pull data from electronic health record systems in clinics as well as detailed online screening tools that patients fill out online, said Dr. L. Read Sulik, the company's founder and chief medical officer. (Snowbeck, 7/30)

Homeless people living on the street in Boston had a death rate nearly three times higher than those living in shelters and almost 10 times higher than the general Massachusetts population, a new study has found. The study, published Monday online in the journal JAMA Internal Medicine, looked at 445 unsheltered homeless adults who were “sleeping rough” in 2000 and followed what happened to them over 10 years. One hundred and thirty-four of them died. (Finucane, 7/30)

Many U.S. states have been making progress against gun violence, passing laws that make it harder for the most dangerous people to get hold of firearms. Those gains are in jeopardy thanks to new technology and Washington’s failure to grapple with its implications. Last month the State Department quietly settled a lawsuit brought by a gun entrepreneur who promotes the private manufacture of untraceable firearms. Cody Wilson, the founder of Defense Distributed, had been barred from publishing online computer files that can be used with a 3-D printer to create firearms. The State Department had imposed the ban using its export-control powers. The settlement allows Wilson to go ahead. (7/30)

The administration’s apparent bias toward Medicare Advantage is not merely a Washington insiders’ issue. It directly impacts the health care of seniors. Part of the problem is that Medicare Advantage attracts younger and healthier enrollees, leaving older and sicker patients in traditional Medicare. If left unchecked, this trend will drive up the costs of traditional Medicare and further strain the system’s finances. Indeed, the new “goodies” that Medicare Advantage can now offer tend to intensify this disparity — as they are more enticing to younger seniors and less important for older ones. (Max Richtman, 7/30)

In recent elections, Republicans have effectively used health care and anti-Affordable Care Act sentiment to rally their base. Now, the repeal effort has made the ACA more popular and given Democrats a weapon to use to motivate their base and reach out to independents. Between the lines: The importance of health care as a national priority is sometimes overstated — but our recent polling shows it really could be a decisive issue in the midterms. That's because it has been surging as an issue for Democrats, and in an election many see as a referendum on President Trump, it may now be as important a factor as Trump is. By the numbers: The surprising number from our tracking polls: 33% of Democrats pick health care as the top factor in their vote in the upcoming elections, while 30% pick Trump. For the general public, 25% pick health care, about the same percentage as pick Trump (26%). (Drew Altman, 7/31)

An aide to Mahatma Gandhi once famously observed, “It costs a lot of money to keep this man in poverty.” Likewise, it would take a lot of cash to pay for all of Bernie Sanders’ “free” stuff. On Monday, the Mercatus Center at George Washington University released a study concluding the Vermont socialist’s “Medicare for all” proposal — a government takeover of the nation’s health care system — would cost $32.6 trillion over 10 years, requiring astronomical tax hikes. To put this into perspective, the entire federal budget for fiscal 2019 will be $4.407 trillion. Sen. Sanders responded typically for those who don’t have the facts on their side: He shot the messenger. In particular, he attacked the Mercatus Center because it receives some money from … trigger warning! … the nefarious Koch brothers, those dastardly, rich libertarians who promote dangerous ideas such as the value of free markets. (7/30)

When the head of U.S. Customs and Border Protection appeared at a Washington forum the other day to discuss his agency — which was instrumental in the Trump administration’s family separation debacle — the toughest moments he faced came from hecklers, one of whom shouted, “You’re orphaning children! You’re kidnapping children!” Setting aside those interruptions, Commissioner Kevin K. McAleenan fielded one gentle question after another, never challenged to explain CBP’s role in what a federal judge has characterized as a breakdown in coordination among government agencies that has left hundreds of migrant children stripped from their parents. (7/30)

“Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving the safety of patient care is possible during mergers and affiliations, but requires intentional efforts. What happens after a merger or acquisition matters keenly to patients, and tens of millions of them are affected by such deals each year. There have been more than 100 hospital or health system mergers and acquisitions each year since 2014, with a high of 115 in 2017, and that pace is likely to continue. No part of the country has been spared. (Susan Haas, William Berry and Mark Reynolds, 7/31)

After a seven-year struggle, Navy veterans are on the cusp of getting exposure for those who served in the bays, harbors and estuarine waters of the Republic of Vietnam. Despite a unanimous vote in the House of Representatives, some naysayers have come forward to launch a last ditch attack this bill. First a real estate agent in Phoenix objected to the small increase in veterans home loan guarantee fees used to offset the new benefits. Then Anthony Principi, the former VA Secretary, who implemented the decision to strip the Navy veterans of their benefits, published an op-ed claiming that the bill was not supported by science.Under the Pay as You Go Act, any new benefit must be scored by the Congressional Budget Office (CBO) and offset by a reduction elsewhere in the budget. CBO has scored the Blue Water Navy bill at $894 million over ten years. The House agreed to a small increase in loan guarantee fees to pay for the benefits. (John B. Wells, 7/30)

Democrats have been casting about for a winning theme this November. Here’s one suggestion: Kids. After all, despite once declaring themselves the party of family values, Republican politicians have more recently ceded this territory. The GOP is now the party of state-sanctioned child abuse, of taking health care away from poor children, of leaving young immigrant “dreamers” in legal limbo. It is GOP policy, and GOP policy alone, that has ripped thousands of immigrant children from their parents and locked them in cages, where they cannot be held or comforted when they cry. (Catherine Rampell, 7/30)

Events in Washington can seem remote. But the devastating impact of last year’s Trump-GOP tax cuts — supported by our Republican Congressman, Rod Blum — can be felt just a few miles north of downtown Waterloo, at the Country View nursing home. After 150 years of direct service to the community by Black Hawk County, Country View is being sold to a Chicago-area private company, an unsettling prospect for both residents and staff. A big reason for the sale is insufficient funding from Medicaid, the federal-state public health program for low-income and disabled people. This problem has been further exacerbated by Republican actions to privatize the management of Medicaid in Iowa, a move that has been an absolute disaster for both patients and providers. Medicaid and its sister program, Medicare — which primarily serves the elderly — both turn 53 years old this week. But thanks to the Trump-GOP tax cuts, the only birthday presents they can look forward to this year are severe budget cuts. (Chris Schwartz, 7/30)