Tagged Courts

From Crib To Court: Trump Administration Summons Immigrant Infants

The Trump administration has summoned at least 70 infants to immigration court for their own deportation proceedings since Oct. 1, according to Justice Department data provided to Kaiser Health News.

These are children who need frequent touching and bonding with a parent and naps every few hours, and some were of breastfeeding age, medical experts say. They’re unable to speak and still learning when it’s day versus night.

“For babies, the basics are really important. It’s the holding, the proper feeding, proper nurturing,” said Shadi Houshyar, who directs early childhood and child welfare initiatives at advocacy group Families USA.

The number of infants under age 1 involved has been rising — up threefold from 24 infants in the fiscal year that ended last Sept. 30, and 46 infants the year before.

The Justice Department data show that a total of 1,500 “unaccompanied” children, from newborns to age 3, have been called in to immigration court since Oct. 1, 2015.

Roughly three-fourths of the children involved are represented by a lawyer and they have to make their case that they should stay in the United States.

Officials who review such deportation cases say most children under 1 cross the border with a parent and their deportation cases proceed together.

But some of the infants were deemed “unaccompanied” only after law enforcement separated them from their parents during the Trump administration’s “zero-tolerance” immigration policy. The children were sent to facilities across the U.S. under the supervision of the Department of Health and Human Services.

“This is to some extent a … crisis of the creation of the government,” said Robert Carey, who previously headed the Office of Refugee Resettlement, which takes custody of unaccompanied minors. “It’s a tragic and ironic turn of events.”

Younger children are also considered unaccompanied if they enter the U.S. with an older family member who is not yet 18. The data do not clarify which children arrived that way or which were separated from their parents.

The Justice Department did not respond to a request for further data about where the children are housed. They could be in a foster care home, at a group home, with a relative or sponsor or reunited with a parent. HHS, which operates the refugee resettlement office, did not provide comment by publication  time.

In previous statements, the government has argued that separation — and its consequences — are unfortunate but unavoidable under the law.

“There is a surefire way to avoid separation from your children. Present yourself legally … or stay back at your home country, and go through the process others do,” HHS Secretary Alex Azar said on a media call earlier this month. “None of us want children separated from their parents. I want no children in our care and custody.”

The number of unaccompanied children called in to court since Oct. 1, 2015, swells to 2,900 if kids up to 5 are included. The total will rise between now and Sept. 30, when the fiscal year ends, noted Susan Long, a statistician at Syracuse University and director of TRAC, a repository of immigration and federal court data. There’s also an ongoing backlog in entering the data.

In June, a district judge in San Diego ordered the government to reunify families within a month, specifically directing them to unite children younger than 5 with parents by July 10.

HHS reunited about half of those children by July 12 — 57 out of 103. Others, the government said, could not be placed with a parent, citing in some cases “serious criminal history” or parents currently being in jail.

In 12 cases, those children’s parents had already been deported. In another, the government had failed to figure out where the child’s parent was located, and in another, the parent had a “communicable disease,” HHS said.

The Department of Homeland Security, which issues the court orders, also did not respond to a request for comment.

In the removal cases, children have no right to an appointed lawyer, but rather to a list of legal aid attorneys that the child’s current caregiver can contact.

And young children rarely know the details of why they fled their home country, especially without a parent present, noted Eileen Blessinger, a Virginia-based immigration lawyer who has been aiding parents.

“Think about it as a parent. You’re not going to tell your child they might be killed, right?” she said. “A lot of the kids don’t know.”

Immigration court, which is an administrative unit of the Department of Justice, is different from typical courts. It handles “respondents” who may be too young to speak, but has no social workers or legal remedies focused on the best interest of a child, said Lenni Benson, a New York Law School professor and founder of the Safe Passage  Project, which provides legal services to migrant youth.

“An immigration judge has no discretion,” Benson said. “There’s no ‘I’m hearing the mom wants the kid, I’m going to decide what’s best,’” she said. Instead, “it’s ‘the government has charged you with being removable from the U.S. Do you have evidence to show you have a right to be here?’”

Benson recounted being in immigration court in 2014 when a judge asked for a crying baby to be removed from the courtroom. She said she paused to inform the judge that the baby was the next respondent on the docket — and asked that the child’s grandmother stand in.

The stakes for the babies, and any migrant fleeing violence, are high, said Paul Wickham Schmidt, a former immigration judge who retired in 2016 after 13 years on the bench in Arlington, Va.

“Final orders of deportation have consequences,” he said. “For something that has a very serious result, this system has been described as death penalty cases in traffic court.”

Ashley Tabaddor, president of the National Association of Immigration Judges and a judge specializing in juvenile cases in Los Angeles, acknowledged that the administration narrowed a directive on how much judges can assist juveniles in court. Still, she said, judges do their best to ensure that young children get a fair hearing.

Justice Department data show that asylum denials are at a nearly 10-year high at 42 percent, and the Associated Press reported that the administration has raised the bar for making a successful case.

At the same time, children can be strapped for resources, Blessinger said.

She described one client whose 7-year-old daughter received legal support from a New York-based charity. Even in that case, she said, the organization acted simply as a “friend of the court” — rather than a full-fledged attorney — requesting delays in proceedings until the child and mother could be reunited. That finally happened Tuesday night, she said.

“It’s the saddest experience. These people are not going to be recovering anytime soon,” she said. “The parents are crying even after they’re reunited.”


KHN’s coverage of children’s health care issues is supported in part by the Heising-Simons Foundation.

If Defendants With Substance Abuse Disorders Relapse They Can Be Sent To Jail, Court Unanimously Rules

The case was closely watched because it pitted the traditional method of punishment versus the new thinking that treatment is best for drug addiction. Justice David A. Lowy wrote that a judge has the power and discretion to determine probation requirements tailored to an individual and that further probation’s twin goals: rehabilitation and public safety. Judges, he said, “stand on the front lines of the opioid epidemic” and are “faced with difficult decisions that are especially unpalatable.”

States Attacking ACA Would Hurt Most If Shield On Preexisting Conditions Were Axed

If the Affordable Care Act’s protections for people with preexisting medical conditions are struck down in court, residents of the Republican-led states that are challenging the law have the most to lose.

“These states have been opposed to the ACA from the beginning,” said Gerald Kominski, a senior fellow at the UCLA Center for Health Policy Research. “They’re hurting their most vulnerable citizens.”

Twenty Republican state attorneys general and governors challenged the constitutionality of the ACA in federal court in February. Last month, U.S. Attorney General Jeff Sessions and the Department of Justice made the unusual decision not to defend key portions of the law against this legal challenge.

The states’ lawsuit argues that because Congress eliminated the Obamacare tax penalty for not having insurance coverage, effective next year, the entire law is unconstitutional. By extension, the suit calls on federal courts to find the health law’s protections for people with preexisting conditions unconstitutional — and Sessions agrees.

Nine of the 11 states with the highest rates of preexisting conditions among adults under 65 have signed onto the lawsuit to strike down the ACA, according to data from insurance companies and the U.S. Centers for Disease Control and Prevention. The 2015 data, the most recent available, were analyzed by the Kaiser Family Foundation in 2016. (Kaiser Health News, which produces California Healthline, is an editorially independent program of the foundation.)

Those who support the lawsuit contend that there are other means of protecting people with preexisting conditions.

“If a court strikes down the constitutionality of the ACA, there are ways to repeal and replace without Arizonans with preexisting conditions losing their coverage,” said Katie Conner, a spokeswoman for Arizona Attorney General Mark Brnovich.

Conner said her boss, who is party to the lawsuit, believes preexisting conditions should “always be covered.” In Arizona, more than 1 in 4 adult adults under 65 have a preexisting condition, according to the data.

The state with the highest rate of adults with preexisting conditions is West Virginia — 36 percent of those under age 65. That means that about 1 in 3 of them could have a hard time buying insurance through the individual marketplace without the ACA protections.

The office of West Virginia Attorney General Patrick Morrisey, who joined the legal challenge against the ACA, declined to comment. But a spokesman for Morrisey’s re-election campaign told PolitiFact last month that “help should be provided to those who need it most, including those with preexisting conditions.”

Plaintiffs in the lawsuit “are paying lip service to these critical protections for people, but they are in fact engaged in a strategy that would get rid of those protections,” said Justin Giovannelli, an associate research professor at Georgetown University’s Center on Health Insurance Reforms. “Frankly, it’s hard to square what they’re saying on the one hand and what they’re arguing in the courts on the other.”

According to a poll released in June, also by the Kaiser Family Foundation, three-quarters of Americans say that maintaining protections for people with preexisting conditions is “very important.” This includes majorities of Democratic, Republican and independent voters.

Before the health law was adopted, insurance companies routinely denied coverage to millions of people with preexisting conditions who purchased insurance through the individual marketplace. If they didn’t deny coverage outright, some health plans charged consumers exorbitant premiums, or offered policies that excluded coverage for pricey conditions. (Although many people got insurance through their employers or public plans that covered preexisting conditions, they could have been left vulnerable if their employment status or other circumstances changed.)

The ACA ended those practices.

Common conditions that led insurance companies to deny coverage included high blood pressure, cancer, obesity, diabetes and depression, among many others. Some people were denied for having acne, asthma or for being pregnant.

The KFF analysis estimated that at least 27 percent of adults under 65 — more than 50 million Americans — had at least one preexisting condition that would have jeopardized their coverage pre-ACA. The foundation said its estimates were an undercount because some diseases that insurers cited when declining coverage are not in the survey data. Also, each insurance company set its own rules and conditions for denials, making accurate counts of those who could be affected hard to nail down.

Less precise estimates by other researchers and the Department of Health and Human Services show that up to half of all adults under age 65 have at least one preexisting condition.


This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.

California Clinic Screens Asylum Seekers For Honesty

OAKLAND, Calif. — Dr. Nick Nelson walks through busy Highland Hospital to a sixth-floor exam room, where he sees patients from around the world who say they have fled torture and violence.

Nelson, who practices internal medicine, is the medical director of the Highland Human Rights Clinic, part of the Alameda Health System. A few times each week, he and his team conduct medical evaluations of people who are seeking asylum in the United States. The doctors listen to the patients’ stories. They search for signs of trauma. They scrutinize injuries, including electrocution scars, bullet wounds and unset broken bones.

As the Trump administration looks to reduce the number of asylum applicants, citing loopholes and fraudulent claims, this clinic — and others like it in San Diego, Los Angeles, New York and Chicago — seeks evidence that can help determine whether someone should gain asylum in the U.S.

The Highland clinic opened in 2001 as a place for asylum seekers and refugees to get care. Five years later, the staff started offering forensic exams that aim to discern whether there is evidence of torture or abuse. Nelson, who took over as director in 2012, says his team does between 80 and 120 evaluations each year.

Nelson and his colleagues diagnose physical and psychological ailments and, in many cases, substantiate these patients’ claims about how they were hurt. Sometimes the asylum seekers have health coverage that pays for the exams, but the county covers the cost for those who don’t.

“Our job is to make sure that the asylum office understands all the medical and psychological facts about a person’s case so that they can make a decision,” Nelson said.

Nelson bases his findings on an internationally recognized protocol for torture documentation.

For example, he may be called on to judge whether a scar or injury could have occurred as the patient describes. Sometimes, Nelson said, attorneys ask him to answer specific questions, such as, “Is this burn scar consistent with a cigarette burn?” or “Are these marks on his back consistent with being beaten with PVC pipe?”

Nelson has had some medical training on what to expect to see in cases of torture. He also applies his general expertise as a doctor in knowing how to interview and examine patients, and has learned something about the countries these asylum seekers are fleeing and the injuries they may have endured.

For example, when someone is hit with a long, stiff object, it produces a pair of parallel bruises like railroad tracks, he said.

“That’s a specific thing that I didn’t learn in medical school or residency,” he said, “but that I have learned through taking care of a lot of people who have been tortured.”

In most cases, Nelson said, he finds evidence to support the stories his patients tell him. But there are also exams that don’t yield definitive evidence.

Nelson also addresses the asylum seekers’ health needs, sometimes diagnosing cases of tuberculosis or HIV that were previously undiagnosed. Nearly all of the patients he sees need mental health referrals, he said, because of years of torture or abuse in their native countries.

Juan Lopez Aguilar, who fled Guatemala three years ago, meets with Nelson at the Highland Hospital in Oakland, Calif., in June 2018. (Heidi de Marco/KHN)

One of the patients Nelson recently treated is 60-year-old Juan Lopez Aguilar, an indigenous Maya who fled Guatemala three years ago. He said he was beaten and threatened off and on for nearly four decades because of his ethnicity and feared for his life back home. Lopez Aguilar’s son also was murdered in 2005 and his daughter fled because of threats, his attorney said.

“I’m worried,” Lopez Aguilar told the doctor through a translator, as he sat in the exam room. “There are a lot of gangs. They want to kill people in my community.”

Nelson first examined and interviewed Lopez Aguilar earlier this spring and wrote a report corroborating the man’s account for his asylum case, formally filed last year.

Lopez Aguilar, who grew up in a family of peasant farmers, told Nelson that his community was attacked by soldiers when he was in his 20s and that his father was killed during that attack. Lopez Aguilar moved to another part of Guatemala, where he continued to be the victim of “race-based harassment, extortion and threats,” Nelson said.

The man’s story echoes those of other clinic patients, Nelson said, and violence and discrimination against indigenous Mayan-speaking Guatemalans is common.

Lopez Aguilar, who has worked as a dishwasher, has now returned to the clinic for a regular medical visit. He tells the doctor in his native language that he has been having severe headaches and dizziness since soon after he arrived in the U.S.

His wife and some of his children are back in Guatemala, he explained, and he can’t petition to bring his wife to the States unless and until he is granted asylum. That won’t be before 2020, when his court date is scheduled.

Men like Lopez Aguilar have faced increasingly tough odds since early June, when U.S. Attorney General Jeff Sessions announced that gang violence and domestic abuse would no longer be considered grounds for granting asylum.

Lopez Aguilar had spent decades being persecuted as an indigenous Maya. “I’m worried,” he says through a translator while sitting in the exam room. “There are a lot of gangs. They want to kill people in my community.” (Heidi de Marco/KHN)

To be eligible for asylum, applicants must prove they face physical violence, or fear it, based on factors such as race, ethnicity or religion.

Even before the Trump administration’s recent crackdown, getting asylum was a difficult and time-consuming proposition. In 2017, only about 38 percent of asylum seekers in the U.S. were granted that status by the immigration court, according to data from the nonpartisan Transactional Records Access Clearinghouse at Syracuse University.

The harsher federal policies, including detentions at the border, have generated anxiety and uncertainty among those seeking asylum and their advocates and immigration lawyers.

“Every day is a roller coaster,” said Oakland attorney Haregu Gaime, who frequently refers her clients to the Highland clinic.

Niloufar Khonsari, executive director of Pangea Legal Services, a Bay Area legal advocacy group, said the obstacles won’t deter people from seeking a safe place to live or from seeking judicial help to stay in the U.S.

When applicants are examined at the Highland clinic, Khonsari said, it “definitely makes a difference for judges.”

Gaime said the clinic’s reports frequently help corroborate her clients’ experiences in a way that their testimony alone cannot.

“Sometimes a traumatized person is not able to relay what happened to them in a way that tells the full story,” she said.

Ira Mehlman, spokesman for the Federation for American Immigration Reform, which favors stricter controls on immigration, noted that there are limits to a doctor’s ability to interpret these cases. Doctors may be able to determine if somebody suffered an injury, he said, but not necessarily the circumstances that led to it. “And they can’t determine if it was because of political persecution,” he said.

Mehlman said there is no question that there is violence in Central America and that gangs are rampant, but the U.S. can’t accept everyone who is danger.

Nelson searches Tefamicael for signs of trauma and examines injuries and wounds. (Heidi de Marco/KHN)

On the same morning that Nelson saw Lopez Aguilar at Highland clinic, he also examined Gebremeskl Tefamicael, an asylum seeker from Eritrea. Nelson took notes as he listened to Tefamicael’s story of being conscripted into the military, then imprisoned and tortured.

Nelson asked Tefamicael exactly what his tormentors used to tie him up.

It was a rope made from tree bark, the patient responded, as Nelson wrote in his notebook a description of the scars on Tefamicael’s wrists.

Afterward, Nelson’s report for the court stated that Tefamicael’s physical scars and psychological state are consistent with the man’s description of what happened to him.

Nelson said he got involved with the clinic because he wanted to treat people who were underserved. People fleeing their countries and seeking asylum here are “definitely one of the more … underserved and generally marginalized” communities, he said.

Often, Nelson doesn’t hear until months or years later whether his patients have been granted asylum. But when the request is approved, he said, he sees a tremendous change in them.

Getting asylum doesn’t take away the trauma, but it relieves these people of the fear of returning to a country where they are not safe, Nelson said.

“When someone who has got a real basis for an asylum claim gets granted, and you were part of demonstrating why that should be the case,” he said, “that feels really good.”


KHN’s coverage in California is supported in part by Blue Shield of California Foundation.

Must-Reads Of The Week From Brianna Labuskes

On this Friday the 13th, we’re wrapping up another week dominated by the upcoming battle over the next Supreme Court justice and the administration’s scramble to reunite separated families — not to mention new efforts to chip away at the health law.

Don’t feel overwhelmed. Here are some of the best stories on all that news and more.

The battle brewing over Supreme Court nominee Brett Kavanaugh highlights the political complexities of the upcoming midterms. In the Senate, where the battleground favors conservatives, the vote is an albatross around vulnerable red-state Democrats’ necks. But in the lower chamber, the fights are being waged in swing suburban districts around the country, giving Democrats the chance to appeal to independents and moderate Republicans.

The New York Times: Who Might the Court Fight Help in the Midterms? Democrats. and Republicans.

However, Democrats — in what even they say is a classic problem with the party — can’t seem to focus their message. Yes, they’re talking health care (threats to not only abortion but the health law itself). But they’re also focusing on presidential power and unions and LGBTQ rights and … the list goes on.

Politico: Dems Pitch Mixed Messages in Supreme Court Fight

(On that note, my favorite quote of the week comes from Politico’s coverage of Senate Minority Leader Chuck Schumer trying to get his people in line: “I’ll be 71 years old in August, you’re going to whip me? Kiss my you know what,” said Sen. Joe Manchin (D-W.Va.) when asked if Schumer can influence his vote.)

States are also scrambling to make sure they don’t have any centuries-old laws on the books banning abortions … just in case.

The Associated Press: States Brace for Abortion Fights After Kavanaugh Nomination

Even though the government missed the court-ordered deadline, officials have announced that all “eligible” children under age 5 have been reunited with their families. That still leaves 46 “ineligible” kids, plus thousands of older ones still in custody.

The New York Times: U.S. Says It Has Reunited Half of All Migrants Under 5, With Rest ‘Ineligible’

And somehow Health and Human Services Secretary Alex Azar has become the public face (and punching bag) of this crisis.

Politico: How the New Face of the Migrant Crisis Got Stuck With the Job

The health law absorbed a one-two blow this week. Not only did the administration slash funding for navigators (counselors who help people sign up for coverage), but it also froze a program that provides billions of dollars to insurers to help stabilize the marketplace. The reaction to both was fairly tempered, though. (Which might be a sign that upheaval and uncertainty has become the new norm.)

Politico: Latest Obamacare Shake-Up Could Fuel Rate Hikes

Modern Healthcare: CMS Risk-Adjustment Payment Freeze to Hit High-Cost Insurers Hardest

Pfizer’s agreement to roll back its price hikes earned the company flashy headlines. Looking more closely, the move doesn’t really translate to savings for consumers.

Stat: What Pfizer, Trump, and Consumers Got Out of a Surprising Deal

Be sure to check out this deep dive on the CEO who, while having a knack for turning a profit, is described as tone-deaf to the current outrage on drug prices.

Stat: How Pfizer’s CEO Kept on Raising Prices — Until Trump’s Tweet

If all that wasn’t enough news for you, here’s my miscellaneous file for the week: A startling report finds that drug distributors shipped the equivalent of about 260 opioid pills for every person in Missouri in a six-year period; despite New York’s abundance of world-class hospitals and surgeons, thousands of patients needing transplants are languishing on lists because New Yorkers donate organs at a lower rate than anywhere else in the country; and the administration tried to water down a global resolution on breastfeeding, resorting to trade threats and backing off only when Russia stepped in to introduce the measure.

The Washington Post: Companies Shipped 1.6 Billion Opioids to Missouri From 2012 to 2017, Report Says

The New York Times: New York Has World-Class Hospitals. Why Is It So Bad for People in Need of Transplants?

The New York Times: U.S. Opposition to Breast-Feeding Resolution Stuns World Health Officials

And just when we were getting over the romaine lettuce outbreak, we have not one but two more food-related illnesses popping up.

Have a great weekend!

Initiative Targeting Synthetic Opioids Will Hyper-Focus On Counties To Try To Eradicate Every Instance Of Drugs

Attorney General Jeff Sessions announced the project, which is based on a successful model in Manatee County, Florida. The program will provide a new assistant U.S. attorney to districts in New Hampshire, California, Kentucky, Maine, Ohio, Pennsylvania, Tennessee and West Virginia.

Podcast: KHN’s ‘What The Health?’ ACA Under Fire. Again.

Democrats in the Senate are gearing up to fight President Donald Trump’s nominee to the Supreme Court, U.S. Circuit Judge Brett Kavanaugh. They argue he is not only a potential threat to abortion rights, but also to the Affordable Care Act.

Meanwhile, the Trump administration continues its efforts to undermine the workings of the Affordable Care Act. This week, officials announced a freeze on payments to insurers who enroll large numbers of sicker patients, and another cut to the budget for “navigators” who help people understand their insurance options and enroll for coverage.

This week’s panelists for KHN’s “What the Health?” are:

Julie Rovner of Kaiser Health News

Margot Sanger-Katz of The New York Times

Anna Edney of Bloomberg News

Julie Appleby of Kaiser Health News

Among the takeaways from this week’s podcast:

  • One reason Democrats are rallying around the health issue rather than the abortion issue is that there is more unity in their caucus over health than abortion. Also, the two key Republican senators who support abortion rights — Sen. Susan Collins (R-Maine) and Sen. Lisa Murkowski (R-Alaska) — also voted against GOP efforts to repeal the Affordable Care Act last year.
  • The Trump administration’s action on risk-adjustment payments sent yet another signal to insurers that the federal government does not necessarily have their backs and is willing to change the rules along the way.
  • The Trump administration says it wants to cut to payments for navigators because they are not cost-effective. But the navigator money does not come from taxpayers or government sources. It is paid from insurance industry user fees. These funds also go to support ACA advertising — which has also been cut. However, the user fees have not been reduced. In theory, reducing these fees could provide savings that could be passed on to consumers.
  • After being called out on Twitter by Trump, drugmaker Pfizer this week announced it would delay some already-announced price increases on about 100 of its drugs. It is worth noting that the president used his bully pulpit and gained some success. The six-month delay will mean that consumers will not experience an increase in cost at the pharmacy for at least that time period. But it still raises questions.
  • The Trump administration worked to block a World Health Organization resolution to promote breastfeeding. But while this seemed a clear case of promoting the interests of infant formula companies over public health experts, there was pushback from some women who say they are unable to breastfeed and feel stigma when they opt for formula instead. On the other hand, formula can be dangerous in developing countries without easy access to clean water.

Plus, for “extra credit,” the panelists recommend their favorite health stories of the week they think you should read, too:

Julie Rovner: Politico Agenda’s “The One Big Winner of the Obamacare Wars,” by Joanne Kenen

Julie Appleby: The New York Times’ “Doctor, Your Patient Is Waiting. It’s a Red Panda,” by Karen Weintraub.

Anna Edney: Politico’s “CMS Quit Test of Pricey Cancer Treatment Amid Concerns Over Industry Role,” by Sarah Karlin-Smith and David Pittman

Margot Sanger-Katz: HuffPost’s “Trump Administration May Be Preparing A New Obamacare Sabotage Effort,” by Jonathan Cohn

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher or Google Play.

Podcast: KHN’s ‘What The Health?’ ACA Under Fire. Again.

Democrats in the Senate are gearing up to fight President Donald Trump’s nominee to the Supreme Court, U.S. Circuit Judge Brett Kavanaugh. They argue he is not only a potential threat to abortion rights, but also to the Affordable Care Act.

Meanwhile, the Trump administration continues its efforts to undermine the workings of the Affordable Care Act. This week, officials announced a freeze on payments to insurers who enroll large numbers of sicker patients, and another cut to the budget for “navigators” who help people understand their insurance options and enroll for coverage.

This week’s panelists for KHN’s “What the Health?” are:

Julie Rovner of Kaiser Health News

Margot Sanger-Katz of The New York Times

Anna Edney of Bloomberg News

Julie Appleby of Kaiser Health News

Among the takeaways from this week’s podcast:

  • One reason Democrats are rallying around the health issue rather than the abortion issue is that there is more unity in their caucus over health than abortion. Also, the two key Republican senators who support abortion rights — Sen. Susan Collins (R-Maine) and Sen. Lisa Murkowski (R-Alaska) — also voted against GOP efforts to repeal the Affordable Care Act last year.
  • The Trump administration’s action on risk-adjustment payments sent yet another signal to insurers that the federal government does not necessarily have their backs and is willing to change the rules along the way.
  • The Trump administration says it wants to cut to payments for navigators because they are not cost-effective. But the navigator money does not come from taxpayers or government sources. It is paid from insurance industry user fees. These funds also go to support ACA advertising — which has also been cut. However, the user fees have not been reduced. In theory, reducing these fees could provide savings that could be passed on to consumers.
  • After being called out on Twitter by Trump, drugmaker Pfizer this week announced it would delay some already-announced price increases on about 100 of its drugs. It is worth noting that the president used his bully pulpit and gained some success. The six-month delay will mean that consumers will not experience an increase in cost at the pharmacy for at least that time period. But it still raises questions.
  • The Trump administration worked to block a World Health Organization resolution to promote breastfeeding. But while this seemed a clear case of promoting the interests of infant formula companies over public health experts, there was pushback from some women who say they are unable to breastfeed and feel stigma when they opt for formula instead. On the other hand, formula can be dangerous in developing countries without easy access to clean water.

Plus, for “extra credit,” the panelists recommend their favorite health stories of the week they think you should read, too:

Julie Rovner: Politico Agenda’s “The One Big Winner of the Obamacare Wars,” by Joanne Kenen

Julie Appleby: The New York Times’ “Doctor, Your Patient Is Waiting. It’s a Red Panda,” by Karen Weintraub.

Anna Edney: Politico’s “CMS Quit Test of Pricey Cancer Treatment Amid Concerns Over Industry Role,” by Sarah Karlin-Smith and David Pittman

Margot Sanger-Katz: HuffPost’s “Trump Administration May Be Preparing A New Obamacare Sabotage Effort,” by Jonathan Cohn

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher or Google Play.

Kavanaugh’s Impact On Elections Highlights The Two Very Different Fights Happening For House And Senate

In states where the upcoming battle over Brett Kavanaugh’s nomination to the Supreme Court could help Senate Republican candidates, it could also hurt the party’s chances in the House. Unlike in the upper chamber, where the vulnerable seats are mostly Democrats in red-state districts, the fight for control of the House is taking place in swing-districts across the country.

Beyond Abortion: Democrats’ Focus On Kavanaugh’s Threat To Health Law To Protect Red-State Candidates

Ten Democrats face re-election this year in states that President Donald Trump won in 2016, and four of those battlegrounds lean against abortion rights. So instead of making abortion their key issue in the Supreme Court nomination fight, Democratic leadership is focusing on the broader threat to health care access in general. Meanwhile, outlets take a look at where Brett Kavanaugh stands on various other health care issues.

Democrats Rally Against Threats To The ACA To Block Trump’s Supreme Court Nominee

Senate Democrats, who are divided on abortion policy, are instead turning to health care as a rallying cry for opposition to President Donald Trump’s Supreme Court nominee.

Specifically, they are sounding the alarm that confirming conservative District Court Judge Brett Kavanaugh could jeopardize one of the Affordable Care Act’s most popular provisions — its protections for people with preexisting health conditions.

“Democrats believe the No. 1 issue in America is health care, and the ability of people to get good health care at prices they can afford,” said Senate Minority Leader Chuck Schumer (D-N.Y.).

The Kavanaugh nomination, he added, “would put a dagger” through the heart of that belief.

Democratic senators spent Tuesday trying to connect the dots between potential threats to health care and Trump’s high court pick.

“President Trump as a candidate made it very clear that his priority was to put justices on the court who would correct for the fatal flaw of John Roberts,” said Sen. Chris Murphy (D-Conn.) on the Senate floor Tuesday. Chief Justice Roberts was the decisive fifth vote to uphold the ACA in a key case in 2012. “[Republicans’] new strategy is to use the court system to invalidate the protections in the law for people with preexisting conditions,” Murphy said.

Murphy — and many of his Democratic colleagues — are referring to a case filed in Texas in February by 20 Republican state attorneys general. The AGs charge that because the tax bill passed by Congress last year eliminated the tax penalty for not having health insurance, it rendered the entire health law void.

Their reasoning was that Roberts based his opinion upholding the ACA on Congress’ taxing power. Without the tax, the AGs argue, the law should be held unconstitutional.

The Trump administration, which would typically defend the ACA because defending federal law is part of what the Justice Department is tasked to do, opted to follow a different course of action.

In a response filed in June, political appointees in the department said eliminating the penalty should not invalidate the entire law. But it should nullify provisions that prevent insurers from refusing to sell insurance to people with preexisting conditions or charging them higher premiums.

If this argument were to be upheld by a newly reconstituted Supreme Court, the health law would be dealt a serious blow.

The lawsuit, however, is only in its earliest stages. And many legal scholars on both sides doubt it will get very far.

In an amicus brief filed with the court in June, five liberal and conservative legal experts who disagreed on previous ACA cases argued that both the Republican attorneys general and the Justice Department are wrong — that eliminating the mandate penalty should have no impact on the rest of the law.

Their position is rooted in something called “congressional intent.” When a court wants to invalidate a portion of a law, it usually also has to determine whether Congress would have considered other aspects of the law unworkable without it.

But that is not a problem in this case, the legal experts argued in their brief. “Here, Congress itself has essentially eliminated the provision in question and left the rest of a statute standing,” they wrote. “In such cases, congressional intent is clear.”

The merits of the lawsuit notwithstanding, the issue works well for Democrats.

For one thing, the health law’s preexisting condition protections are among its most popular parts, according to public opinion polls.

And unlike abortion, defending the health law is something on which all Senate Democrats agree. That includes some vulnerable senators in states that voted for Trump in 2016, including Sens. Joe Manchin (D-W.Va.), Heidi Heitkamp (D-N.D.) and Joe Donnelly (D-Ind.). None are strong supporters of abortion rights. But all have stood firm against GOP efforts to take apart the Affordable Care Act.

Manchin, for example, said in a statement about the nomination, “The Supreme Court will ultimately decide if nearly 800,000 West Virginians with preexisting conditions will lose their health care.”

Manchin’s opponent in November is Republican Attorney General Patrick Morrisey. He is one of the officials who filed the suit against the health law.

Democrats Rally Against Threats To The ACA To Block Trump’s Supreme Court Nominee

Senate Democrats, who are divided on abortion policy, are instead turning to health care as a rallying cry for opposition to President Donald Trump’s Supreme Court nominee.

Specifically, they are sounding the alarm that confirming conservative District Court Judge Brett Kavanaugh could jeopardize one of the Affordable Care Act’s most popular provisions — its protections for people with preexisting health conditions.

“Democrats believe the No. 1 issue in America is health care, and the ability of people to get good health care at prices they can afford,” said Senate Minority Leader Chuck Schumer (D-N.Y.).

The Kavanaugh nomination, he added, “would put a dagger” through the heart of that belief.

Democratic senators spent Tuesday trying to connect the dots between potential threats to health care and Trump’s high court pick.

“President Trump as a candidate made it very clear that his priority was to put justices on the court who would correct for the fatal flaw of John Roberts,” said Sen. Chris Murphy (D-Conn.) on the Senate floor Tuesday. Chief Justice Roberts was the decisive fifth vote to uphold the ACA in a key case in 2012. “[Republicans’] new strategy is to use the court system to invalidate the protections in the law for people with preexisting conditions,” Murphy said.

Murphy — and many of his Democratic colleagues — are referring to a case filed in Texas in February by 20 Republican state attorneys general. The AGs charge that because the tax bill passed by Congress last year eliminated the tax penalty for not having health insurance, it rendered the entire health law void.

Their reasoning was that Roberts based his opinion upholding the ACA on Congress’ taxing power. Without the tax, the AGs argue, the law should be held unconstitutional.

The Trump administration, which would typically defend the ACA because defending federal law is part of what the Justice Department is tasked to do, opted to follow a different course of action.

In a response filed in June, political appointees in the department said eliminating the penalty should not invalidate the entire law. But it should nullify provisions that prevent insurers from refusing to sell insurance to people with preexisting conditions or charging them higher premiums.

If this argument were to be upheld by a newly reconstituted Supreme Court, the health law would be dealt a serious blow.

The lawsuit, however, is only in its earliest stages. And many legal scholars on both sides doubt it will get very far.

In an amicus brief filed with the court in June, five liberal and conservative legal experts who disagreed on previous ACA cases argued that both the Republican attorneys general and the Justice Department are wrong — that eliminating the mandate penalty should have no impact on the rest of the law.

Their position is rooted in something called “congressional intent.” When a court wants to invalidate a portion of a law, it usually also has to determine whether Congress would have considered other aspects of the law unworkable without it.

But that is not a problem in this case, the legal experts argued in their brief. “Here, Congress itself has essentially eliminated the provision in question and left the rest of a statute standing,” they wrote. “In such cases, congressional intent is clear.”

The merits of the lawsuit notwithstanding, the issue works well for Democrats.

For one thing, the health law’s preexisting condition protections are among its most popular parts, according to public opinion polls.

And unlike abortion, defending the health law is something on which all Senate Democrats agree. That includes some vulnerable senators in states that voted for Trump in 2016, including Sens. Joe Manchin (D-W.Va.), Heidi Heitkamp (D-N.D.) and Joe Donnelly (D-Ind.). None are strong supporters of abortion rights. But all have stood firm against GOP efforts to take apart the Affordable Care Act.

Manchin, for example, said in a statement about the nomination, “The Supreme Court will ultimately decide if nearly 800,000 West Virginians with preexisting conditions will lose their health care.”

Manchin’s opponent in November is Republican Attorney General Patrick Morrisey. He is one of the officials who filed the suit against the health law.

If High Court Reverses Roe V. Wade, 22 States Poised To Ban Abortion

What would the U.S. look like without Roe v. Wade, the 1973 case that legalized abortion nationwide?

That’s the question now that President Donald Trump has chosen conservative Judge Brett Kavanaugh as his nominee to replace retiring Supreme Court Justice Anthony Kennedy.

Reversing the landmark case would not automatically make abortion illegal across the country. Instead, it would return the decision about abortion legality to the states, where a patchwork of laws are already in place that render abortion more or less available, largely depending on individual states’ political leanings.

“We think there are 22 states likely to ban abortion without Roe,” due to a combination of factors including existing laws and regulation on the books and the positions of the governor and state legislature, said Amy Myrick, staff attorney at the Center for Reproductive Rights, which represents abortion-rights advocates in court.

“The threat level is very high now,” Myrick said.

Kavanaugh never opined on Roe v. Wade directly during his tenure on the U.S. District Court in Washington, D.C. In his 2006 confirmation hearing for that position, though, he said he would follow Roe v. Wade as a “binding precedent” of the Supreme Court — which lower-court judges are required to do.

Abortion opponents are buoyed by the pick.

“Judge Kavanaugh is an experienced, principled jurist with a strong record of protecting life and constitutional rights,” said a statement from Susan B. Anthony List President Marjorie Dannenfelser. She spearheaded support for Trump in his presidential campaign after he promised to appoint to the Supreme Court only justices who would overturn Roe v. Wade.

Kennedy, by contrast, was a swing vote on abortion issues. He frequently sided with conservatives to uphold abortion restrictions. However, in key cases in 1992 and 2016, he sided with liberals to uphold Roe’s core finding that the right to abortion is part of a right to privacy that is embedded within the U.S. Constitution.

Even now, with Roe v. Wade’s protections in place, a woman’s ability to access abortion is heavily dependent on where she lives.

According to an analysis by the Guttmacher Institute, a reproductive-rights think tank, 19 states adopted 63 new restrictions on abortion rights and access.

At the same time, 21 states adopted 58 measures last year intended to expand access to women’s reproductive health.

Since 2011, states have enacted nearly 1,200 separate abortion restrictions, according to Guttmacher, making these types of laws far more common.

As of now, four states — Louisiana, Mississippi and North and South Dakota — have what are known as abortion “trigger laws.” Those laws — passed long after Roe was handed down — would make abortion illegal if and when the Supreme Court were to say Roe is no more.

“They are designed to make abortion illegal immediately,” said Myrick.

Another dozen or so states still have pre-Roe abortion bans on the books.

Some have been formally blocked by the courts, but not repealed. Those bans could, at least in theory, be reinstated, although “someone would have to go into court and ask to lift that injunction,” said Myrick.

States could simply begin enforcing other bans that were never formally blocked, like one in Alabama that makes abortion providers subject to fines and up to a year in jail.

At the same time, Myrick said, “there are 20 states where abortion would probably remain safe and legal.”

The Path To The High Court

Several major challenges to state abortion laws are already in the judicial pipeline. One of these will have to get to the Supreme Court to enable a majority to overturn Roe v. Wade.

“It’s not a question of if, it’s a question of what or when,” said Sarah Lipton-Lubet, vice president for reproductive health and rights at the National Partnership for Women and Families.

The cases fall into three major categories.

The first — and most likely type to result in the court taking a broad look at Roe v. Wade — are “gestational” bans that seek to restrict abortion at a certain point in pregnancy, said Lipton-Lubet.

Mississippi has a 15-week ban, currently being challenged in federal court. Louisiana enacted a similar ban, but it would take effect only if Mississippi’s law is upheld. Iowa earlier this spring passed a six-week ban, although that is being challenged in state court, not federal, under the Iowa Constitution.

The second category involves regulations on abortion providers.

One pending case, for instance, involves an Arkansas law that would effectively ban medication abortions. Finally, there are bans on specific procedures, including several in Texas, Arkansas and Alabama that would outlaw “dilation and evacuation” abortions, which are the most common type used in the second trimester of pregnancy.

Myrick and Lipton-Lubet agree that there is no way to predict which abortion case is likely to reach the high court first.

The case that’s actually closest to the Supreme Court, noted Myrick, is a challenge to an Indiana law that would outlaw abortion if the woman is seeking it for sex selection or because the fetus could be disabled. A federal appeals court found that law unconstitutional in April.

Many analysts also agree that even with the court’s likely philosophical shift, Roe v. Wade might not actually be overturned at all.

Instead, said Lipton-Lubet, a more conservative court could “just hollow it out” by allowing restrictive state laws to stand.

“The court cares about things like its own legitimacy,” said Myrick, “and how often a precedent has been upheld in the past.” Given that Roe’s central finding — that the decision to have an abortion falls under the constitutional right to privacy — has been upheld three times, even an anti-abortion court might be loath to overrule it in its entirety.


KHN’s coverage of women’s health care issues is supported in part by The David and Lucile Packard Foundation.

If High Court Reverses Roe V. Wade, 22 States Are Likely To Ban Abortion

What would the U.S. would look like without Roe v. Wade, the 1973 case that legalized abortion nationwide?

That’s the question now that President Donald Trump has chosen conservative Judge Brett Kavanaugh as his nominee to replace retiring Supreme Court Justice Anthony Kennedy.

Reversing the landmark case would not automatically make abortion illegal across the country. Instead, it would return the decision about abortion legality to the states, where a patchwork of laws are already in place that render abortion more or less available, largely depending on individual states’ political leanings.

“We think there are 22 states likely to ban abortion without Roe,” due to a combination of factors including existing laws and regulation on the books and the positions of the governor and state legislature, said Amy Myrick, staff attorney at the Center for Reproductive Rights, which represents abortion-rights advocates in court.

“The threat level is very high now,” Myrick said.

Kavanaugh never opined on Roe v. Wade directly during his tenure on the U.S. District Court in Washington, D.C. In his 2006 confirmation hearing for that position, though, he said he would follow Roe v. Wade as a “binding precedent” of the Supreme Court — which lower-court judges are required to do.

Abortion opponents are buoyed by the pick.

“Judge Kavanaugh is an experienced, principled jurist with a strong record of protecting life and constitutional rights,” said a statement from Susan B. Anthony List President Marjorie Dannenfelser. She spearheaded support for Trump in his presidential campaign after he promised to appoint to the Supreme Court only justices who would overturn Roe v. Wade.

Kennedy, by contrast, was a swing vote on abortion issues. He frequently sided with conservatives to uphold abortion restrictions. However, in key cases in 1992 and 2016, he sided with liberals to uphold Roe’s core finding that the right to abortion is part of a right to privacy that is embedded within the U.S. Constitution.

Even now, with Roe v. Wade’s protections in place, a woman’s ability to access abortion is heavily dependent on where she lives.

According to an analysis by the Guttmacher Institute, a reproductive-rights think tank, 19 states adopted 63 new restrictions on abortion rights and access.

At the same time, 21 states adopted 58 measures last year intended to expand access to women’s reproductive health.

Since 2011, states have enacted nearly 1,200 separate abortion restrictions, according to Guttmacher, making these types of laws far more common.

As of now, four states — Louisiana, Mississippi and North and South Dakota — have what are known as abortion “trigger laws.” Those laws — passed long after Roe was handed down — would make abortion illegal if and when the Supreme Court were to say Roe is no more.

“They are designed to make abortion illegal immediately,” said Myrick.

Another dozen or so states still have pre-Roe abortion bans on the books.

Some have been formally blocked by the courts, but not repealed. Those bans could, at least in theory, be reinstated, although “someone would have to go into court and ask to lift that injunction,” said Myrick.

States could simply begin enforcing other bans that were never formally blocked, like one in Alabama that makes abortion providers subject to fines and up to a year in jail.

At the same time, Myrick said, “there are 20 states where abortion would probably remain safe and legal.”

The Path To The High Court

Several major challenges to state abortion laws are already in the judicial pipeline. One of these will have to get to the Supreme Court to enable a majority to overturn Roe v. Wade.

“It’s not a question of if, it’s a question of what or when,” said Sarah Lipton-Lubet, vice president for reproductive health and rights at the National Partnership for Women and Families.

The cases fall into three major categories.

The first — and most likely type to result in the court taking a broad look at Roe v. Wade — are “gestational” bans that seek to restrict abortion at a certain point in pregnancy, said Lipton-Lubet.

Mississippi has a 15-week ban, currently being challenged in federal court. Louisiana enacted a similar ban, but it would take effect only if Mississippi’s law is upheld. Iowa earlier this spring passed a six-week ban, although that is being challenged in state court, not federal, under the Iowa Constitution.

The second category involves regulations on abortion providers.

One pending case, for instance, involves an Arkansas law that would effectively ban medication abortions. Finally, there are bans on specific procedures, including several in Texas, Arkansas and Alabama that would outlaw “dilation and evacuation” abortions, which are the most common type used in the second trimester of pregnancy.

Myrick and Lipton-Lubet agree that there is no way to predict which abortion case is likely to reach the high court first.

The case that’s actually closest to the Supreme Court, noted Myrick, is a challenge to an Indiana law that would outlaw abortion if the woman is seeking it for sex selection or because the fetus could be disabled. A federal appeals court found that law unconstitutional in April.

Many analysts also agree that even with the court’s likely philosophical shift, Roe v. Wade might not actually be overturned at all.

Instead, said Lipton-Lubet, a more conservative court could “just hollow it out” by allowing restrictive state laws to stand.

“The court cares about things like its own legitimacy,” said Myrick, “and how often a precedent has been upheld in the past.” Given that Roe’s central finding — that the decision to have an abortion falls under the constitutional right to privacy — has been upheld three times, even an anti-abortion court might be loath to overrule it in its entirety.


KHN’s coverage of women’s health care issues is supported in part by The David and Lucile Packard Foundation.

Must-Reads Of The Week From Brianna Labuskes

It’s been a week since a tweet went viral about an injured woman begging fellow train passengers not to call an ambulance for fear of the expense — and the story is still resonating. It was a snapshot of our reality, a shocking but relatable moment, where we all wondered: When is a $3,000 ride to the hospital worth it?

Here are some other stories — and yes, much longer than 140 or so characters — that will make you think as well.

Democrats are walking a tightrope as they strategize for the upcoming Supreme Court nominee battle. They have a base that’s raring for a knock-down, drag-out brawl on one side, and vulnerable red-state candidates that need protection on the other. Help might come from an unlikely source: the health law.

The Associated Press: Dems Want to Focus High Court Fight on Abortion, Health Care

As lawmakers gird for the fight even before a nominee is picked, President Donald Trump mulls over his short list. But we can expect a choice as early as Monday.

The Washington Post: Trump Narrows List for Supreme Court Pick, With Focus on Kavanaugh and Kethledge

“Death spiral” and “doomsday” predictions were thick on the ground last year when it came to the health law marketplaces, but the exchanges are proving to be surprisingly resilient to any attempts to kill them.

The New York Times: Obamacare Is Proving Hard to Kill

The Washington Post: More Americans Pay for ACA Health Plans, Despite Trump Administration Moves to Undercut Law

True to his word, Kentucky Gov. Matt Bevin announced the state is cutting benefits for Medicaid recipients as “an unfortunate consequence” of a judge’s ruling on Kentucky’s work requirements waiver. But, it might be a little more complicated than that: Some say the announcement is actually misleading and people will continue receiving limited coverage.

Modern Healthcare: Questions Arise Over Kentucky’s Medicaid Cuts Following Work Requirement Rejection

Is the convenience of getting prescription pills at your door worth handing over a ton of your personal health care information to Amazon? The company is in a league of its own when it comes to analyzing consumers’ shopping behaviors and preferences — and critics wonder what will happen when it is handed sensitive health care data.

The Wall Street Journal: Amazon’s PillPack Deal Gives It Access to Sensitive Health Data

In the miscellaneous file this week: the heartbreaking story of the unclaimed AIDS victims buried during the height of the crisis on a small island in New York; revelations about a persistent weakness in the nation’s food-safety system — with a lot of fingers pointing at the Food and Drug Administration; in an experiment right out of pulp fiction, scientists have shown that zapping the front part of someone’s brain can actually curb aggressive tendencies; and people are rushing to get their genes checked for dangerous mutations — but are failing to read the small print where it says those results could be completely and totally wrong.

The New York Times: Dead of AIDS and Forgotten in Potter’s Field

Politico: Victims Blame FDA for Food-Recall Failures

Stat: Can Zapping Brains Reduce Violence? Controversial Study Sees Potential

The New York Times: The Online Gene Test Finds a Dangerous Mutation. It May Well Be Wrong.

In news that cheered many a journalist in this newsroom (though not me, because I don’t drink coffee), a new study finds that you should indulge in that cup of joe in the morning: You might live longer for it.

Must-Reads Of The Week From Brianna Labuskes

It’s been a week since a tweet went viral about an injured woman begging fellow train passengers not to call an ambulance for fear of the expense — and the story is still resonating. It was a snapshot of our reality, a shocking but relatable moment, where we all wondered: When is a $3,000 ride to the hospital worth it?

Here are some other stories — and yes, much longer than 140 or so characters — that will make you think as well.

Democrats are walking a tightrope as they strategize for the upcoming Supreme Court nominee battle. They have a base that’s raring for a knock-down, drag-out brawl on one side, and vulnerable red-state candidates that need protection on the other. Help might come from an unlikely source: the health law.

The Associated Press: Dems Want to Focus High Court Fight on Abortion, Health Care

As lawmakers gird for the fight even before a nominee is picked, President Donald Trump mulls over his short list. But we can expect a choice as early as Monday.

The Washington Post: Trump Narrows List for Supreme Court Pick, With Focus on Kavanaugh and Kethledge

“Death spiral” and “doomsday” predictions were thick on the ground last year when it came to the health law marketplaces, but the exchanges are proving to be surprisingly resilient to any attempts to kill them.

The New York Times: Obamacare Is Proving Hard to Kill

The Washington Post: More Americans Pay for ACA Health Plans, Despite Trump Administration Moves to Undercut Law

True to his word, Kentucky Gov. Matt Bevin announced the state is cutting benefits for Medicaid recipients as “an unfortunate consequence” of a judge’s ruling on Kentucky’s work requirements waiver. But, it might be a little more complicated than that: Some say the announcement is actually misleading and people will continue receiving limited coverage.

Modern Healthcare: Questions Arise Over Kentucky’s Medicaid Cuts Following Work Requirement Rejection

Is the convenience of getting prescription pills at your door worth handing over a ton of your personal health care information to Amazon? The company is in a league of its own when it comes to analyzing consumers’ shopping behaviors and preferences — and critics wonder what will happen when it is handed sensitive health care data.

The Wall Street Journal: Amazon’s PillPack Deal Gives It Access to Sensitive Health Data

In the miscellaneous file this week: the heartbreaking story of the unclaimed AIDS victims buried during the height of the crisis on a small island in New York; revelations about a persistent weakness in the nation’s food-safety system — with a lot of fingers pointing at the Food and Drug Administration; in an experiment right out of pulp fiction, scientists have shown that zapping the front part of someone’s brain can actually curb aggressive tendencies; and people are rushing to get their genes checked for dangerous mutations — but are failing to read the small print where it says those results could be completely and totally wrong.

The New York Times: Dead of AIDS and Forgotten in Potter’s Field

Politico: Victims Blame FDA for Food-Recall Failures

Stat: Can Zapping Brains Reduce Violence? Controversial Study Sees Potential

The New York Times: The Online Gene Test Finds a Dangerous Mutation. It May Well Be Wrong.

In news that cheered many a journalist in this newsroom (though not me, because I don’t drink coffee), a new study finds that you should indulge in that cup of joe in the morning: You might live longer for it.

Podcast: KHN’s ‘What The Health?’ Whither Work Requirements?

A federal District Court judge in Washington, D.C., has — for now — blocked Kentucky’s proposal to add a work requirement for much of its adult Medicaid population. The decision, while far from final, is likely to prompt lawsuits from advocates in other states where the Department of Health and Human Services has approved similar proposals.

Also this week, HHS released updated enrollment information about those purchasing health insurance in the individual market. Despite efforts by the Trump administration and Republicans in Congress to depress enrollment by cutting outreach and canceling federal payments to insurers, the number of people who actually paid their first month’s premium was up slightly in 2018, compared with 2017.

This week’s panelists for KHN’s “What the Health?” are: Julie Rovner of Kaiser Health News, Stephanie Armour of The Wall Street Journal, Anna Edney of Bloomberg News and Joanne Kenen of Politico.

Among the takeaways from this week’s podcast:

  • While the overall number of people buying coverage in the health law’s exchanges rose, the number of people not getting help with their premiums fell for the third-straight year. While some consumers may have found other coverage (through Medicare or jobs), rising premiums have been a problem.
  • The court decision blocking Kentucky’s Medicaid work requirement does not necessarily preclude other states’ work requirements from going forward. But the decision is likely to spark lawsuits in those states that have already had their work programs approved by HHS.
  • The window for bipartisan action on health care costs on Capitol Hill has closed. The Justice Department’s decision to join the state attorneys general lawsuit on preexisting conditions was likely the last straw. Issues surrounding coverage of preexisting conditions will now likely dominate the political discussion leading up to the midterm elections this fall.
  • Two things worth noting from the month of June. First, the recent court decision on risk-corridor payments to insurers seems to be a significant blow to the industry. Also, the Trump administration announced a major reorganization of Cabinet-level agencies. Although this is a common step for an administration, and something that rarely moves beyond “pie-in-the-sky” discussions, this one seems to be encapsulating the debate about the safety-net and social welfare programs.

Read the latest on the Bill of the Month series:

“Father’s And Son’s Injuries Lead To The Mother Of All Therapy Bills,” By Stephanie O’Neill.

If you have a medical bill you’d like NPR and KHN to investigate, you can submit it here.

Plus, for “extra credit,” the panelists recommend their favorite health stories of the week they think you should read, too:

Julie Rovner: Kaiser Health News’ “Unlocked And Loaded: Families Confront Dementia And Guns,” by JoNel Aleccia and Melissa Bailey

Stephanie Armour: NPR’s “Rising Cost of PrEP to Prevent HIV Infection Pushes It Out of Reach for Many,” by Shefali Luthra and Anna Gorman

Anna Edney: The New York Times’ “Emergency Rooms Run Out of Vital Drugs, and Patients Are Feeling It,” by Katie Thomas

Joanne Kenen: The Washington Post’s “College Students Are Forming Mental-Health Clubs — and They’re Making a Difference,” By Amy Ellis Nutt

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher or Google Play.