The Desert Sun: A Small Hospital In The California Desert Fears The Worst From Obamacare Repeal
Palo Verde Hospital in Blythe offers some local care. Its 51 beds are more than enough for this city of about 20,000 people, a number bolstered by inmates in two state prisons. But the emergency department sees heavy use for such a small hospital — a rate of about one new patient every hour around the clock. A baby is born here every two or three days, on average, but high-risk deliveries are usually moved to another hospital two hours away. Now hospital officials fear Palo Verde, like other small, rural hospitals, won't be able to survive after a repeal of Obamacare, which offered them financial support in addition to giving more patients health insurance. (Newkirk, 7/20)

In other news —

KQED: Sighs Of Relief From Health Safety-Net Providers In California After Senate Bill Collapses
Health care workers at California hospitals and clinics that serve low-income patients are relieved but still wary after the collapse of the Senate Republican health care bill earlier this week. The bill proposed deep funding cuts to Medicaid, which is called Medi-Cal in California and covers one out of three state residents. (Klivans, 7/20)

Los Angeles Times: About One-Third Of Dementia Cases Could Be Prevented By Actions That Begin In Childhood, Experts Say
More than 1 in 3 cases of Alzheimer’s disease and other forms of dementia can be traced to factors — such as inadequate education, obesity, hearing loss and smoking — that simply don’t need to be, according to a new report. These challenges first present themselves in childhood, and they continue to make their presence felt all the way through one’s senior years. (Healy, 7/20)

KPCC: Eating Better And Getting More Exercise Could Stave Off Dementia, Study Suggests
Up to 35 percent of dementia cases could be prevented if people ate better and got regular exercise in mid-life and didn't smoke or cut themselves off from others later in life. ...Interventions could include ensuring children are motivated to stay in school and taxing sugar-sweetened beverages, says Dr. Lon Schneider, director of the USC California Alzheimer's Disease Center and one of the authors of the report. (Plevin, 7/20)

Previous California Healthline coverage: These Preventive Measures Might Help Delay Dementia Or Cognitive Decline

Los Angeles Times: Sen. John McCain Has A Glioblastoma Tumor. Here's How Doctors Treat This Aggressive Form Of Brain Cancer
Being told you have cancer is never welcome, but being told you have a glioblastoma tumor is especially scary. This is the news that longtime Arizona Sen. John McCain got after he had a blood clot removed above his left eye on Friday. A glioblastoma is the same type of tumor that killed Sen. Edward M. Kennedy in 2009. It also was responsible for the death of Beau Biden, son of then[-Vice President Joe Biden, in 2015. (Netburn, 7/20)

Los Angeles Times: Cancer Diagnosis Spotlights Sen. John McCain's Rare Ability To Bring Partisans Together
John McCain, with his short fuse and lashing tongue, is not always an easy man to like, or to get along with. The Arizona senator acknowledged as much in a wry tweet he dispatched Thursday morning — candor and self-deprecation always being two of his strongest, most appealing suits. “I greatly appreciate the outpouring of support,” McCain wrote hours after revealing he had been diagnosed with an aggressive form of brain cancer. “Unfortunately for my sparring partners in Congress, I'll be back soon, so stand-by!” At a time of bone-deep political division, the two-time Republican presidential hopeful is a rare unifier. (Barabak, 7/20)

The Mercury News: Valley Fever Cases Increase In California
California public health officials on Thursday announced a large hike in the number of reported Valley Fever cases in the state, with illness onset in 2016 — but they don’t know what’s behind the increase. From January through December 2016, 5,372 new cases of Valley Fever were reported to California Department of Public Health corresponding to an incidence rate of 13.7 cases per 100,000 people. (Seipel, 7/20)

In other news from across the state —

Modesto Bee: Modesto Moves To Condemn Building That Is Home To About 80 Poor People
Rather than make the repairs required by the city, owner Steve Arakelian had eviction notices given to tenants Saturday. ...The evictions come as Stanislaus County is experiencing a rental housing crisis for low-income tenants, said Mark Galvan, landlord tenant case manager with Project Sentinel’s Stanislaus County Mediation Center. (Valine, 7/20)

The New York Times: Senate Leaders Press For Health Care Vote, But On Which Bill?
Senate Republicans ended a demoralizing week on Thursday with their leaders determined to press ahead with a vote to begin debating health care next week, but with little progress on securing the votes and no agreement even on which bill to take up. With President Trump urging them to move forward on their seven-year quest to erase the Affordable Care Act, Republican senators on Thursday still had not decided whether to revive a proposal to replace former President Barack Obama’s health care law with one of their own, or to simply repeal it and work on a replacement later. (Kaplan and Pear, 7/20)

The Associated Press: GOP Leaders Plan Tuesday Health Vote, It's An Uphill Climb
Republican leaders pushed toward a Senate vote next Tuesday on resurrecting their nearly flat-lined health care bill. Their uphill drive was further complicated by the ailing GOP Sen. John McCain's potential absence and a dreary report envisioning that the number of uninsured Americans would soar. (7/20)

USA Today: McCain Absence Won't Stop Senate From Voting On Health Care
Senate Majority Leader Mitch McConnell, R-Ky., is still expected to hold a vote to proceed on some form of legislation to repeal Obamacare next week, despite the fact that Sen. John McCain likely won’t be back in Washington to cast his vote. The Arizona Republican senator's absence, in addition to the GOP members who have announced their opposition to the bill, makes it even harder for McConnell to round up the votes to pass a bill. (Collins, 7/20)

NPR: With 4 Bills In Play To Repeal Obamacare In The Senate, Confusion Reigns
On Thursday, the Senate unleashed yet another iteration of its effort to repeal and replace the Affordable Care Act, also known as Obamacare, and with it came another analysis from the nonpartisan Congressional Budget Office. If your head is spinning, you've got plenty of company, us here at Shots included. Here are the key versions of repeal and/or replace legislation so far this year. (Grayson, 7/20)

The Wall Street Journal: GOP Floats Proposal To Ease Medicaid Cuts
Senate Republicans, scrambling to win support for their health-care bill, pushed a measure Thursday that they said could ease the impact of the bill’s Medicaid cuts on low-income people. Advocating for the new direction is a little-known health official who is now at the center of the health-care fight: Seema Verma, head of the Centers for Medicare and Medicaid Services, which oversees the two federal medical programs. (Radnofsky and Peterson, 7/20)

The Washington Post: Cloud Of Confusion Hangs Over Health-Care Bill
Senate Republican leaders’ latest attempt to salvage support for a GOP health-care bill floundered Thursday as leaders struggled to explain to rank-and-file members what exactly they would be voting on next week. Senators left town for the weekend under a cloud of confusion after Senate Majority Leader Mitch McConnell (R-Ky.) reopened talks on a discarded plan to repeal and replace the Affordable Care Act under heavy pressure from President Trump. The White House intervention sparked a flurry of meetings and activity, but the rush produced no new evidence that the bill can pass. (Snell and Goldstein, 7/20)

Reuters: Senate Republicans Complain Of Chaos In Healthcare Effort
U.S. Senate Republicans, scolded by President Donald Trump for failing to overturn Obamacare, tried to salvage their seven-year effort for a new healthcare law on Thursday, but leading senators indicated frustration over shifting goal posts. Trump on Wednesday told the Senate's fractured Republican majority to revive a bill to repeal and replace Obamacare that collapsed on Monday after Republicans from both moderate and conservative factions pulled their support. (Cornwell and Becker, 7/20)

Reuters: Latest Senate Healthcare Bill Would Leave 22 Million Without Insurance: CBO
The latest version of Senate Republicans' legislation to repeal and replace the Affordable Care Act would leave 22 million Americans without health insurance coverage by 2026, the U.S. Congressional Budget office said on Thursday. (Alexander, 7/20)

The Associated Press: Budget Office: GOP Health Bill Adds 22 Million Uninsured
The reworked bill would increase average premiums over the next two years, but reduce them starting in 2020 by 30 percent, the report estimated. But the policies would typically offer less coverage. And because the GOP measure would also eliminate federal subsidies that let insurers lower out-of-pocket costs for low-earners, the changes “would contribute significantly to a decrease in the number of lower-income people with coverage,” the budget office said. (Fram and Werner, 7/20)

Bloomberg: CBO Says Senate Health Bill Would Boost Uninsured By 22 Million 
The Senate Republican health bill promises lower premiums for consumers. To get there, it would require patients in standard plans to spend as much as about $13,000 upfront on their own care. The deductibles would be so high, in fact, that they’d violate maximums set in U.S. law, an analysis by the nonpartisan Congressional Budget Office said Thursday. Under Obamacare, by comparison, an individual in a standard plan would have a deductible of roughly $5,000. (Tracer and Edney, 7/20)

Los Angeles Times: Revised GOP Healthcare Bill Would Still Leave Millions Without Insurance, New Report Concludes
And it would increase costs for millions of sick and elderly Americans, the budget office estimates. Those costs could soar even further under another provision of the bill that would allow insurers to offer slimmed-down health plans that don’t offer the basic set of health benefits — including prescription drugs, maternity care and mental health services — currently mandated by the Affordable Care Act, also known as Obamacare. (Levey, 7/20)

The Washington Post: Revised Version Of Withdrawn Health-Care Bill Would Still Leave 22 Million More Americans Uninsured, CBO Says
Compared with earlier versions, it would give more money to states to help pay for insurance for high-cost patients and would preserve some Affordable Care Act taxes. It would still eliminate the law’s requirement that most Americans carry health insurance, phase out the law’s expansion of Medicaid and transform the rest of Medicaid funding. According to Congress’s nonpartisan budget scorekeepers, this version would have a greater impact on lowering the federal deficit — a $420 billion reduction between next year and 2026, compared with $321 billion under the previous form of the bill. The change is largely because the new plan would keep more Affordable Care Act taxes. (Goldstein, 7/20)

The Wall Street Journal: CBO Says Revised Senate Plan Would Increase Uninsured By 22 Million
The impact of the new report is uncertain, however, as the CBO didn’t include a full analysis of an amendment from Sen. Ted Cruz (R., Texas) that would allow for cheaper but more bare-bones insurance plans because that analysis requires more time. (Armour, 7/20)

Politico: Trump's War Of Attrition Against Obamacare
Obamacare may escape another GOP repeal effort, but surviving a hostile administration could be a much tougher challenge. If a last-ditch repeal effort fails in Congress next week, all indications are the Trump administration will continue chipping away at the Affordable Care Act — if not torching it outright. (Demko and Pradhan, 7/21)

The Associated Press: Trump Administration Pulls Health Law Help In 18 Cities
President Donald Trump's administration has ended Affordable Care Act contracts that brought assistance into libraries, businesses and urban neighborhoods in 18 cities, meaning shoppers on the insurance exchanges will have fewer places to turn for help signing up for coverage. Community groups say the move, announced to them by contractors last week, will make it even more difficult to enroll the uninsured and help people already covered re-enroll or shop for a new policy. (Johnson, 7/20)

The Daily Beast: Team Trump Used Obamacare Money To Run PR Effort Against It
The Trump administration has spent taxpayer money meant to encourage enrollment in the Affordable Care Act on a public relations campaign aimed at methodically strangling it. The effort, which involves a multi-pronged social media push as well as video testimonials designed at damaging public opinion of President Obama’s health care law, is far more robust and sustained than has been publicly revealed or realized. (Stein, 7/20)

San Francisco Chronicle: Health Care Fight Shows Washington At Its Worst
I like partisan fights when those fights are about something real. The Medicaid fight was at least about something real. But most of this nonsense is a battle of liars trying to protect past lies in the hope of being able to make new lies seem just plausible enough for the liars to keep repeating them. (Jonah Goldberg, 7/21)

East Bay Times: D.C. Should Look To Alameda County On Health Care
As both sides of the aisle in Washington debate the many facets of health care, our representatives would be wise to look at Alameda County as an example of how the Affordable Care Act (ACA) has improved lives while saving health care costs. Since the ACA expansion of Medi-Cal, community health centers in Alameda County have worked to ensure that residents have access to health care — many for the first time in their lives.  Thanks to the ACA, more than 42,000 new patients have enrolled at Community Health Centers in Alameda County.  Lives have changed – previously ill persons are now able to work; those with chronic illnesses are making fewer trips to the ER for complications; and many who previously used the ER for care have a medical home and enjoy better health. (Ralph Silber and Sue Compton, 7/17)

Los Angeles Times: As The Healthcare Bill Goes Down, It's Another Bad Week For Male Separatists
It’s been a bad week for male separatists. In Washington, D.C., the all-male Republican Senate leadership, which chose not to invite any female senators to their working-group meetings on repealing the Affordable Care Act, watched in frustration as their bill fizzled after those women declined to support it. Sen. Majority Leader Mitch McConnell, demonstrating that overconfidence and sexism often go hand-in-hand, had insisted the bill could succeed without women senators’ input. “Nobody’s being excluded based upon gender,” he said. “Everybody’s at the table.” Sure, if your definition of everybody is “13 middle-aged guys in ill-fitting suits.” (Ann Friedman, 7/20)

Los Angeles Times: With Obamacare Repeal Off The Table, Will Republicans Start Trying To Actually Improve Healthcare?
Miillions of Americans whose healthcare coverage was imperiled can breathe a sigh of relief now that congressional Republicans’ reckless efforts to dismantle the Affordable Care Act have foundered. They can thank a handful of courageous moderates in the Senate Republican Caucus for being unwilling to repeal the ACA without having a replacement ready that wouldn’t make matters worse for their constituents. (7/19)

Los Angeles Times: Uh-Oh, The GOP Has No Choice But To Work With Democrats On Healthcare Reform
The sudden collapse of Kentucky Sen. Mitch McConnell’s healthcare bill on Monday was much more than a tactical setback for the Senate Republican leader once considered an unbeatable legislative wizard. It was a catastrophic failure for the GOP’s attempt to make one-party government work. It’s one thing to produce gridlock when control of Congress is divided. When one party manages to produce gridlock all by itself, something is seriously wrong. The setback means that Obamacare will almost certainly survive for the foreseeable future, despite seven years of GOP promises to repeal it. (Doyle McManus, 7/19)

The Mercury News: The Game Is Not Over For Mitch McConnell
McConnell’s biggest challenge was getting 50 Republican senators to agree to vote for a “motion to proceed” on a bill that they disagreed with — knowing that it was unlikely to be amended in ways that would make a difference to their final votes given the split between Republican conservatives and moderates and given the Democrats’ refusal to cooperate. Instead of cooperation, Republicans would have to endure an onslaught of politically toxic Democratic amendments, as Senate Democrats forced them to cast one vote after another designed to make them look like monsters come Election Day. (Marc Thiessen, 7/18)

Los Angeles Times: The Trump Administration Is Using Obamacare Marketing Dollars To Attack Obamacare
President Trump keeps saying Obamacare will fail on its own. So why is his administration trying so hard to kill it? The latest effort was uncovered by the Daily Beast website, which reported Thursday that Trump’s Department of Health and Human Services was dipping into its “consumer information and outreach” budget — money Congress provided to encourage people to obtain insurance through Obamacare — to produce nearly two dozen YouTube videos blasting the law as burdensome and harmful. (7/21)

Los Angeles Times: Is Rand Paul's Opposition To The GOP Health Bill Principled, Or Cynical?
The greatest trick any politician can pull off is to get his self-interest and his principles in perfect alignment. As Thomas More observed in Robert Bolt’s “A Man for All Seasons,” “If we lived in a State where virtue was profitable, common sense would make us good, and greed would make us saintly.” (Jonah Goldberg, 7/18)

Los Angeles Times: How I Got Caught In The Crossfire Between V.P. Pence And Ohio Gov. Kasich Over Medicaid
At the National Governors Conference on Friday, Vice President Mike Pence took Ohio Gov. John Kasich to task in a speech attacking the Affordable Care Act’s Medicaid expansion. Pence presumably had two goals. The first was to silence Kasich, the loudest voice among GOP governors opposed to congressional Republicans’ efforts to drastically roll back Medicaid as part of their ACA repeal plans. The second was to justify that rollback by claiming that the Medicaid expansion eroded services for the program’s traditional beneficiaries, including the disabled. (Michael Hiltzik, 7/17)

Los Angeles Times: USC’s Silence On Its Medical School Dean’s Double Life Is Deafening
Dr. Carmen A. Puliafito, the former dean of the USC Keck School of Medicine, led quite a rollicking double life. According to a Times investigation, he was a highly respected doctor, administrator and prolific fundraiser for the university — but at the same time, according to explicit videos and interviews, he found time to party with a circle of criminals and drug users who said he used methamphetamine and other drugs with them. (7/19)

Los Angeles Times: USC Bosses Flunk The Leadership Test Amid Shocking Allegations About Former Medical School Dean
By now you probably know the details.Dr. Carmen Puliafito, a $1.1-million-a-year professor, doctor, dean and big-bucks rainmaker for the University of Southern California, left plenty of time in his busy schedule for extracurricular activities. They included drug-fueled parties with a prostitute, convicted criminals and drug addicts. Los Angeles Times sleuths dug up photos of Puliafito’s exploits in hotel rooms, apartments and even the dean’s office at USC, including a shot of him using a butane torch to light a glass pipe while a female companion smoked heroin. (Steve Lopez, 7/20)

Los Angeles Times: Dear Media: When You Cover Death By Suicide, Do It Thoughtfully
When a family member died by suicide, my parents chose not to tell me his method. They wanted me to remember him as he lived, for both of our sakes. While I didn’t understand their decision at the time, I now see it as one borne out of deep care. I was especially thankful for my parents’ thoughtfulness after reading the media coverage of Linkin Park singer Chester Bennington’s death by suicide this week. (Melissa Batchelor Warnke, 7/21)

Sacramento Bee: Laura's Law Helps Severely Mentally Ill People 
Passed in 2002, the law allows participating counties to obtain court orders to provide assisted outpatient treatment for seriously mentally ill people... Since we adopted Laura’s Law, Yolo County has experienced a 50 percent reduction in police calls and transportation to psychiatric hospitals involving the individuals being cared for under the law. (Matt Rexroad, 7/15)

Orange County Register: ‘Urgent … Alarming’ – But Rehab Investigator Won’t Be In Thick Of SoCal Action Any Time Soon – Orange County Register
AB 572, by Assemblywoman Sharon Quirk-Silva, D-Fullerton, would shatter the California Department of Health Care Services’s regulatory model by stationing a single inspector in or near Costa Mesa – home to the densest concentration of licensed addiction treatment facilities in California outside of Malibu – rather than having all inspectors based in far-off Sacramento, as they are currently. It can take up to a 18 months for a Sacramento analyst to respond to a local complaint, and that’s only when the people complaining can tease out precisely who to complain to, and how to contact them, Quirk-Silva said. (Teri Sforza, 7/20)

Los Angeles Times: Domestic Violence Victims Shouldn't Have To Choose Between Deportation And Medical Care
When Elena attempted to break up with her abusive boyfriend, he beat her horribly, saying he would leave her with scars by which to remember him. Although badly injured, she did not contact the police to report the domestic violence. Nor did she seek medical care for her open wounds or the ringing in her ear. She had heard news of President Trump’s expanded immigration enforcement policies and stories of immigration agents arresting domestic violence and human trafficking victims inside courthouses. She had also learned that her state, California, requires medical professionals to report domestic violence and sexual assault to the police, and she feared deportation more than she desired medical care. (Jane K. Stoever, 7/17)

East Bay Times: Geronimo! 71-Year-Old Woman Who Hates Flying Will Skydive To Support Cancer-Stricken Grandson
Rebecca Byrom freely admits that she hates to fly. Also known as Grandma Bee, Byrom has passed on trips to exciting locales because she didn’t want to deal with the anxiety of getting on an airplane.On Saturday, Grandma Bee, 71, will jump out of one. (Gary Peterson, 7/19)

Sacramento Bee: Why California Must Step In For EPA On Pesticides
More than a million pounds of Dow’s brain-damaging pesticide chlorpyrifos are dumped on California crops every year, accounting for a fifth of all U.S. use.So when Environmental Protection Agency chief Scott Pruitt announced this spring he was stopping plans to ban the dangerous pesticide, he knew he was laying a disproportionate share of well-documented health risks squarely on Californians, especially farm workers and their children. (Sarah Aird and Jonathan Evans, 7/12)