Hawaii Tribune Herald | King tides return to islands this weekend Hawaii Tribune Herald Another round of king tides will roll in this weekend, which could bring flooding to all shores statewide, particularly south-facing shores. A high tide of 3.1 feet is forecast for 4:07 p.m. today in Hilo and a high tide of 3 feet is expected at 4:51 p ... |
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King tides return to islands this weekend - Hawaii Tribune Herald
By Associated Press By Associated Press June 23
To small island nations where the land juts just above the rising seas, the U.S. pulling out of the Paris climate change pact makes the future seem as fragile and built on hope as a sand castle.
Top scientists say it was already likely that Earths temperatures and the worlds seas will keep rising to a point where some island states may not survive the next 100 years. That likelihood increases, they say, if the United States doesnt follow through on promised cuts in heat-trapping carbon dioxide emissions. President Trump this month said he plans to withdraw the United States from the climate deal, prompting leaders of vulnerable islands to talk about their future with a mixture of defiance, hope and resignation.
If we really push into action, we can save some [small islands], but we may not be able save all of them, said Hans-Otto Poertner, a German scientist who chairs the climate impacts study group for the United Nations Intergovernmental Panel on Climate Change. The chances are even less with the U.S. pulling out of the climate agreement in Paris.
Hilda Heine, president of the Marshall Islands (a chain of islands in the Pacific), called Trumps announcement deeply disappointing.
I cannot give up on my people and my country and my culture, she said. Its very important for us to be optimistic.
Heine and other island leaders are putting their hope in strong pollution curbs by China, other nations, individual American states and cities, as well as improved technology. While visiting Europe, she said, its all the more important that Europe takes the lead on climate change.
The State Department said it considers engagement with other counties on climate change important and it will continue, including with small island states. Secretary of State Rex Tillerson said after Trump pulled out of the agreement that the United States has cut its carbon dioxide emissions dramatically even before the Paris pact was reached.
When the Paris pact was being negotiated in 2015, small island nations successfully campaigned for a stricter but secondary target for limiting global heat-trapping emissions.
In 2009, world leaders adopted a goal to prevent 2 degrees Celsius (or 3.6 degrees Fahrenheit) of warming since 1850 to 1900, saying 2 degrees is a dangerous level of warming. The islands tougher goal would try to limit warming to 1.5 degrees Celsius (2.7 degrees Fahrenheit) since that time period.
The world has already warmed about 1 degree Celsius since then, so the islands are really trying to prevent an additional half-degree of warming Celsius (0.9 degrees Fahrenheit).
When Trump announced he would pull the United States out of the Paris treaty, scientists said that made the 2-degree goal close to unachievable and the 1.5 degree goal even more out of reach. Promised American pollution cuts were about one-fifth of the pledged global reductions hoped for in the accord.
We are pushing the 1.5 [as a goal], but realistically I think we have passed the point that it can be achieved, said Kenrick Leslie of the Caribbean Community Climate Change Centre.
Ahmed Sareer, the Maldives ambassador to the United Nations and chairman of the Alliance of Small Island States, said the 1.5 goal is harder to achieve without the United States but not yet impossible.
The island spirit is to never give up, Sareer said. We are always a resilient people.
Originally posted here:
Climate change threatens to wipe some islands off the map - Washington Post
Love Island 's power couple could be about to lose their villa virginities after spending their first night in the Hideaway.
Marcel Somerville and Gabby Allen have gone from strength to strength after sparking a romance on the ITV2 show.
But their relationship may have been taken to the next stage after the couple get some precious alone time in the villa.
Rather than being sent a text to give them a night's sleep in a separate room - it is in fact Marcel who requests to have the Hideaway for the evening.
The gentleman even admits that it's not necessarily about having sex, he just wants some alone time with his flame.
Speaking in the Beach Hut, he asks: Obviously me and Gabs, were getting along really well. Im not trying to force nothing or anything like that, but is it possible for me to get the Hideaway tonight?
"Just so we can have a nice, intimate, personal night. Not saying that theres going to be any sex going on as obviously I dont want to rush nothing.
Someone is smiling down on Marcel as his wish is granted, but the big question is whether Gabby will accept the proposal.
Revealing his plans to her, he says: I thought to myself, you know what, I want to have a nice little moment with us where theres not so many people around.
"So I asked if we could have the Hideaway, not for anything too much. Just so we could be together without you being embarrassed and stuff like that.
"So would you like to go to the Hideaway with me tonight? Promise you, Im a gentleman forever.
Thankfully Gabby accepts his offer - setting up a night of pure passion away from the other islanders.
She says: Im really excited. Im nervous. You cant just do that to me. We have to prepare.
The dancer goes upstairs to get some advice from the other girls, even borrowing a pair of Olivia Attwood's saucy knickers to get into the mood.
Olivia asks: Do you feel like youre losing your virginity all over again, its like youre 18?
Embarrassed, Gabby replies: No because Im not going to be losing anything apart from
Montana cheeky interjects with your knickers.
The couple escape to the Hideaway for the evening, but things don't go to plan thanks to an unwelcome intruder.
Spotting a bumble bee that seemed intent on jeopardising his night of passion, Marcel moans: Oh my god this is the worst night of my life. Gabs, this is the worst night of our lives.
"Theres another one over there. How do I open the door? This is my worst nightmare. Theres got to be a way to get this out.
Gabby then squeals as she spots it on the bed, the place where the pair want to end up in together.
With their surprise visitors finally taken care of, the pair jump between the sheets and lock lips in a passionate embrace beneath the cobers.
Did they follow in Jess and Dom's footsteps and give the Hideaway it's second night to remember?
The next morning, the islanders speculated on what had really happened between Garcel' as they rush to find out if they did or didn't have sex.
Montana was convinced that they had indeed done the deed, insisting to Dom: I think like, surely you would if you had the hideaway but then Im not sure.
"You should have seen Gabs before she left. You should have seen the underwear Gabs had on.
Dom later told the Beach Hut: Marcel and Gabb - absolute mint couple. They are probably now the power couple in the villa.
"They spent the night in the Hideaway last night so I will get the down low on that later on.
* Love Island continues on Sunday night at 9.00pm on ITV2
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Exiled Chagos islanders protesting in London, 2016, over the long bar on their living in the archipelago. Photograph: Fiona Hanson/PA
The UK has suffered a humiliating defeat at the United Nations general assembly in a vote over decolonisation and its residual hold over disputed territory in the Indian Ocean.
By a margin of 94 to 15 countries, delegates supported a Mauritian-backed resolution to seek an advisory opinion from the international court of justice (ICJ) in The Hague on the legal status of the Chagos Islands.
A further 65 countries abstained on Thursday, including many EU states who might have been expected to vote in support of another bloc member.
Among EU members who abstained were France, Germany, Spain, Denmark, Belgium, the Netherlands, Estonia, Latvia, Greece and Finland. Canada and Switzerland also abstained.
Speaking after the vote Jagdish Koonjul, the Mauritian representative at the UN, said: Im elated. The results are beyond my expectations. Its interesting that the EU didnt support the UK. Even some of the countries that supported the UK agreed that this was an issue of decolonisation. Now we wait to see what the UK will do as a result of the vote. We have given the US full comfort of a long-term lease [for the Diego Garcia base] that would be renewable [if sovereignty passed to Mauritius].
The resolution, though only in favour of obtaining a non-binding legal opinion, is a blow to the UKs international prestige and demonstrates the limited diplomatic influence wielded by the British foreign secretary, Boris Johnson, at the UN.
The row between Mauritius and the UK over what Britain terms BIOT, or British Indian Ocean Territory has become increasingly acrimonious in recent years.
In 1965, three years before Mauritius was granted independence, the UK decided to separate the Chagos Islands, an archipelago, from the rest of its Indian Ocean colony. The Mauritian government claims this was in breach of UN resolution 1514, passed in 1960, which specifically banned the breakup of colonies before independence.
Most of the 1,500 islanders were deported so that the largest island, Diego Garcia, could be leased to the US for a strategic airbase in 1971. The US was one of the few countries that publicly backed the UK over the islands fate. The islanders have never been allowed to return home.
The UK has promised to return the Chagos Islands to Mauritius when they are no longer needed for defence purposes, but has refused to give a date.
Two years ago Mauritius won a ruling at the permanent court of arbitration at The Hague saying Britain had acted illegally in the way it had exercised territorial control over the Chagos Islands. The court criticised the UK for failing to consult over establishing a marine protection zone around what is now the British Indian Ocean Territory.
The fact that Diego Garcia was used by the CIA after 9/11 in rendition and interrogation operations may have alienated many states from the UKs cause.
Urging delegates at the UN general assembly to oppose the resolution, the UK permanent representative, Matthew Rycroft, warned: This could set a precedent that many of you in this hall could come to regret. He added that the resolution for an advisory opinion is an attempt by the government of Mauritius to circumvent the principle referring to the principle that a state could only be involved at the ICJ through its own consent.
The UK, Rycroft added, would not consent to the Chagos Islands being taken to the court. The dispute, he said, should be left as a bilateral issue for the UK and Mauritius to deal with through direct negotiations, and that the Chagos Islands were still needed for security purposes.
Philipe Sands QC, who attended the UN debate, and is acting as legal counsel for Mauritius, said: The vote, passed with an overwhelming majority, sends a strong signal about the UNs attachment to decolonisation. That Britain was able to obtain the support of barely a dozen countries, including just four EU members and no permanent member of the security council apart from the US, will, hopefully, give it pause for thought about its position on Chagos.
Its arguments that Chagos is about security and a bilateral matter between it and Mauritius were given short shrift. The message is clear: the UN wants the world court to rule on Chagos, and seeks the courts advice and assistance in bringing colonialism to an end.
Advisory opinions at the ICJ are normally triggered by a formal request from the UN secretary general. The court can request submissions from member states and those involved in a dispute.
Although its findings are normally non binding, the ICJs advisory opinions carry some legal influence and moral authority.
The Foreign Office labelled the outcome disappointing.
Sovereignty of the British Indian Ocean Territory is clearly a matter for the UK and Mauritius to resolve ourselves. Taking this dispute to the international court of justice is an inappropriate use of the ICJ mechanism. This is reflected in the fact that over half of General Assembly members did not vote for the resolution, a Foreign Office spokesperson said.
While we do not recognise Mauritiuss claim to sovereignty over the islands, we have committed to cede them to Mauritius when the territory is no longer required for defence purposes. We will be robustly defending our position at the ICJ.
David Snoxell, coordinator of the all party parliamentary group on the Chagos Islands and a former British diplomat, welcomed the UN vote.
This was a brilliant result for Mauritius and the Chagossians. Apart from the sovereignty issue, now referred to the ICJ, the resolution was a means of bringing to the attention of the UN general assembly the travesty of the UKs treatment of the Chagossian people since 1965 when the [general assembly] last considered the Chagos Islands, Snoxell said.
174 states took part in the debate but only 15 sided with the UK. That sends a clear message to the British government that the UN expects the UK to bring this relic of the cold war to an end.
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EU members abstain as Britain defeated in UN vote on Chagos Islands - The Guardian
When the race to sequence the human genome was reaching a fever pitch in the early 2000s, when I was in high school, I couldnt help but wonder, What comes next? Once we had full access to our genetic blueprint, what more was there to do?
As it turned out, the understanding of human genetics is much more complicated than Id imagined as a teen. And understanding how human health hinges upon the strings of molecular letters within our DNA isnt always easy, either.
Researchers at Stanford, in collaboration with the biotechnology company Pacific Biosciences, are working to push past some of the limitations of current sequencing technology. Their goal is to make full-genome sequencing accessible for clinical use. The team has used a new sequencing technology called long-read sequencing in a patient for the first time. I described their work in a press release:
Current sequencing technologies cut DNA into words that are about 100 base-pairs, or letters, long, according to the studys senior author, Euan Ashley, DPhil, FRCP, professor of cardiovascular medicine, of genetics and of biomedical data science at Stanford. Long-read sequencing, by comparison, cuts DNA into words that are thousands of letters long.
This allows us to illuminate dark corners of the genome like never before, Ashley said. Technology is such a powerful force in medicine, he added. Its mind-blowing that we are able to routinely sequence patients genomes when just a few years ago this was unthinkable.
In this study, which appears in Genetics in Medicine, the team used long-read sequencing to examinea part of Ricky Ramons genes that hadnt been successfully sequenced with current technology. Ramon, who is 26, has had benign tumors throughout his body since he was about 7 years old, but doctors couldnt pinpoint a diagnosis. Especially problematic were the tumors in Ramons heart, which required open-heart surgery to remove.
The team thought Ramons symptoms were indicative of Carney complex, an extremely rare genetic condition, but the sequencing method they used initially did not identify any changes to the gene responsible.
Carney complex arises from mutations in the PRKAR1A gene, and is characterized by increased risk for several tumor types, particularly in the heart and hormone-producing glands, such as ovaries, testes, adrenal glands, pituitary gland and thyroid. According to the National Institutes of Health, fewer than 750 individuals with this condition have been identified.
The most common symptom is benign heart tumors, or myxomas. Open heart surgery is required to remove cardiac myxomas; by the time Ramon was 18 years old, hed had three such surgeries.
The long-read sequencing gave Ramons team of doctors at Stanford a confirmed diagnosis of Carney complex, which allows them to make better-informed recommendations about his treatment.
Though having confirmation of a permanent genetic condition can be disheartening at times, Ramon told me: Im in good hands Im glad to be here.
Previously: Clinical guidance on genetic testing: A Q&A, New tool to ID disease-causing genetic changes developed at Stanfordand Mystery solved: Researchers use genetic tools to diagnose young girls rare heart condition Photo by MIKI Yoshihito
Excerpt from:
New genome sequencing method helps diagnose a rare genetic condition - Scope (blog)
Researchers from the University of Tuebingen and the Max Planck Institute for the Science of Human History in Jena, both in Germany, have decoded the genome of ancient Egyptians for the first time, with unexpected results.
Modern Egyptians, by comparison, share much more DNA with sub-Saharan populations.
The findings have turned years of theory on its head, causing Egyptologists to re-evaluate the region's history while unlocking new tools for scientists working in the field.
Extracting genome data is a new frontier for Egyptologists, however.
Scientists took 166 bone samples from 151 mummies, dating from approximately 1400 B.C. to A.D. 400, extracting DNA from 90 individuals and mapping the full genome in three cases.
Previous DNA analysis of mummies has been treated with a necessary dose of skepticism, explains professor Johannes Krause of the Max Planck Institute.
"When you touch a bone, you probably leave more DNA on the bone than is inside (it)," he argued. "Contamination is a big issue. ... Only in the last five or six years has it become possible to actually study DNA from ancient humans, because we can now show whether DNA is ancient or not by (its) chemical properties."
Heat and high humidity in tombs, paired with some of the chemicals involved in mummification, all contribute to DNA degradation, the paper adds, but it describes its findings as "the first reliable data set obtained from ancient Egyptians."
Analyzing samples spanning over a millennium, researchers looked for genetic differences compared with Egyptians today. They found that the sample set showed a strong connection with a cluster of ancient non-African populations based east of the Mediterranean Sea.
Krause describes the far-reaching data set gained from looking at mitochondrial genomes: "This is not just the DNA of one person. It's the DNA of the parents, grandparents, grandparents' parents, grand-grand-grandparents' parents and so forth.
"So if we don't find sub-Saharan African ancestry in those people, that is pretty representative, at least for Middle Egypt."
Krause hypothesizes that ancient Northern Egypt would be much the same, if not more, linked to the Near East. Ancient Southern Egypt might be a different matter, however, where populations lived closer to Nubia, home of the "Black Pharaohs" in what is now Sudan.
"The genetics of the Abusir el-Meleq community did not undergo any major shifts during the 1,300-year timespan we studied," said Wolfgang Haak, group leader at the Max Planck Institute.
This period covered the rule of Alexander the Great (332-323 B.C.), the Ptolemaic dynasty (323-30 B.C.) and part of Roman rule (30 B.C.-A.D. 641). Strict social structures and legal incentives to marry along ethnic lines within these communities may have played a part in the Egyptians' genetic stasis, the paper speculates.
"A lot of people has assumed foreign invaders ... brought a lot of genetic ancestry into the region," Krause said. "People expected that through time, Egypt would become more European, but we see the exact opposite."
Modern Egyptians were found to "inherit 8% more ancestry from African ancestors" than the mummies studied. The paper cites increased mobility along the Nile, increased long-distance commerce and the era of the trans-Saharan slave trade as potential reasons why.
The team's findings do come with one obvious caveat: "All our genetic data (was) obtained from a single site in Middle Egypt and may not be representative for all of ancient Egypt," the paper concedes.
While the study might be limited in scope, the team believes it has made some technical breakthroughs.
"I expect there will be a ton of ancient Egyptian mummy genomes (mapped) in the next couple of years," Krause said, adding that "multiple groups" are following his team's lead.
"There's always more research we can do. This is not the end. It's just the beginning."
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DNA discovery reveals genetic history of ancient Egyptians - CNN
Another Republican senator came out against the GOP health care plan on Friday, making it nearly impossible for the package to pass the chamber in its current form.
Sen. Dean Heller, R-Nev., said on Friday that the bill is "simply not the answer," joining Republican Sens. Rand Paul, R-Ky., Ted Cruz, R-Texas, Mike Lee, R-Utah, and Ron Johnson, R-Wis., in opposition.
"My point is this bill currently in front of the United States Senate is not the answer--it is simply not the answer," Heller said at a press conference in Nevada on Friday. "I am announcing today that in this form I will not support it."
Heller and Cruz are both up for re-election in 2018.
Senate Majority Leader Mitch McConnell, R-Ky., who rolled out the legislation on Thursday, needs 50 votes to pass the bill to the House, with Vice President Mike Pence serving as the tie-breaking vote. But without the support of Paul, Cruz, Lee, Johnson, and now Heller, passage of the bill in its current form will be nearly impossible, unless Republicans can manage to draw Democratic votes, which is highly unlikely.
AP (Sen. Dean Heller, R-Nev., in his office on Capitol Hill in 2011)
"Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor," the joint statement from Cruz, Paul, Johnson and Lee said on Thursday. "There are provisions in this draft that represent an improvement to our current health care system but it does not appear this draft, as written, will accomplish the most important promise that we made to Americans: to repeal ObamaCare and lower their health care costs."
Reuters (Sen. Rand Paul, R-K.Y., on Capitol Hill on March 7, 2017)
Paul told reporters on Capitol Hill Thursday that if members who support the bill know they don't have the votes needed, discussion would begin earlier.
AP (Sen. Ron Johnson, R-Wis., on Capitol Hill )
"I didn't run on ObamaCare lite," Paul said. "I think we can do better than this --my hope is not to defeat the bill, but to make the bill better."
Paul added: "Now the discussions begin -- I think it could take longer than a week."
AP (Sen. Ted Cruz, R-Texas, in Washington, D.C.)
Cruz acknowledged that he had not yet had "the opportunity" to fully review the bill in its entirity, but said "there are components that give me encouragement and there are also components that are a cause for deep concern."
I have been clear from day one that I want to get to yes, Cruz told reporters on Capitol Hill Thursday. Nobody has fought harder against ObamaCare in the Senate than I have, but we have to actually have legislation that fixes the underlying problem.
Cruz said the current draft doesnt do nearly enough, and would be a disaster politically. Cruz said that key components to get everyone to yes are lowering premiums, and giving the states flexibility.
Reuters (Sen. Mike Lee, R-Utah, in Washington, D.C. on March 29, 2017)
Senate Republicans released the 142-page draft of their version of a "repeal and replace" health care plan on Thursday titled, Better Care Reconciliation Act of 2017, which eliminates a majority of ObamaCare provisions, already drawing backlash from Senate Democrats, and even some congressional Republicans.
The bill could go to a vote as early as next week, after the Congressional Budget Office reviews and gives a score to the new plan, but McConnell did not announce a specific timeline for consideration. The Congressional Budget Office expects to have a score for the draft early next week.
The bill repeals key components of ObamaCare, and manages to maintain some"crucial"conservative items congressional Republicans were looking for, like a cut to Planned Parenthood funding.
GOP SENATORS UNVEIL OBAMACARE OVERHAUL
But despite the early GOP-opposition, Sen. Chuck Grassley, R-Iowa, said hes glad the process is moving forward.
The Senate discussion draft is available for everyone to review, Grassley said. There will be a full debate before the Senate, with the ability for senators of both parties to offer amendments.
But Democrats, as expected, are slamming the billand most are hanging on comments made by President Trump earlier this week, suggesting the House bill, called the American Health Care Act, was mean.
The President said the Senate bill needs heart, the President says the House bill was mean, Senate Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor Thursday after the bill was rolled out. The Senate version is meanerthe House bill is a wolf, but this bill is a wolf with sharper teeth -- its a wolf in sheeps clothing.
At the White House, the president remained consistent in his comment from earlier in the week, and said he hoped to get something done with heart.
Wed love to have some Democratic support, but theyre obstructionist, Trump said. Hopefully well get something done and itll be something with heart and very meaningful.
Sen. Bernie Sanders, I-Vt., said the bill is even worse than expected and called it by far the most harmful piece of legislation I have seen in my lifetime.
Our job now is to rally millions of Americans against this disastrous bill to make sure it does not pass the Senate, Sanders said.
Despite Sanders, and other Democrats criticisms, Sen. Lamar Alexander, R-Tenn., said the bill makes no change in current law when it comes to protecting people with pre-existing conditions.
McConnell said on the Senate floor Thursday that Democrats made it clear early on that they did not want to work with us, but Sen. Ron Wyden, D-Ore., said he had never been asked.
It is not just a fiction, it is a gross fiction, Wyden said.
Still, many members have yet to read the 142-page legislation in its entirety, with some Republicans hesitant to forecast votes, prior to reading the bill in full.
WHAT'S IN THE SENATE PROPOSAL: KEY PROVISIONS OF BETTER CARE RECONCILIATION ACT OF 2017
I dont know, Sen. Luther Strange, R-Ala., told Fox News. Weve got a lot of work to do.
Sen. Susan Collins, R-Maine, already has a number of concerns, according to her spokesperson, and plans to read the bill in full.
She has a number of concerns and will be particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program, Collins spokeswoman Annie Clark said.
McConnell said that when legislation comes to the floor, it will present Senate Democrats another opportunity to do whats right for the American people.
Fox News' Peter Doocy,Chad Pergram, Mike Emanuel, Jason Donner contributed to this report.
Brooke Singman is a Reporter for Fox News. Follow her on Twitter at @brookefoxnews.
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Senate health care bill: 5th Republican senator comes out ...
The Senate health care bill released Thursday would cut Medicaid for low-income Americans, roll back tax hikes passed under the Affordable Care Act and allow states to waive standards on insurance coverage.
Named the Better Care Reconciliation Act to distinguish it from the House version of the bill, a "discussion draft" was released publicly Thursday after a working group of Republicans put it together behind closed doors.
Senate Majority Leader Mitch McConnell said the legislation would allow Congress to repeal the Affordable Care Act.
"The Senate will soon have a chance to turn the page on this failed law," Senate Majority Leader Mitch McConnell said on Tuesday . "We have to act, and we are."
Senate Democrats, meantime, cited President Trump's remark that the House version of the bill was "mean."
"The way this bill cuts health care is heartless," said Senate Democratic Leader Chuck Schumer. "The president said the House bill was mean. The Senate bill may be meaner. The Senate Republicans health care bill is a wolf in sheep's clothing, only this wolf has even sharper teeth than the House bill."
Heres what we know about the details of the bill and its differences between the Affordable Care Act and the the House bill, known as the American Health Care Act:
Under the Affordable Care Act, insurance companies are barred from refusing customers with pre-existing conditions and all coverage must include 10 essential health benefits , including maternity care and mental health coverage. Seniors cannot be charged more than three times the premiums of younger adults, and people with pre-existing conditions cannot be charged more than healthier people in their area. Insurers must also spend a certain amount of their revenue from premiums on claims and provide plans that cover a certain percentage of an individual's overall health care cost.
Under the House bill, states would be able to apply for waivers to bypass these five major parts of Obamacare and establish their own guidelines for insurers.
Under the Senate bill , according to CNN , states would be allowed to apply for waivers for all but one of these five regulations: the community rating provision that prevents people with pre-existing conditions from being charged more . However, there is some doubt that this measure will survive to the final bill because of parliamentary rules on budget reconciliation bills.
Under the Affordable Care Act, Medicaid was expanded to include more than 10 million more lower-income Americans . After the Supreme Court ruled on the law, the expansion was made voluntary, which led some states to choose not to expand.
Under the House bill, government spending on Medicaid would decrease by about $840 billion over 10 years . The bill would also eliminate funding provided to states for Medicaid expansion by 2020, meaning no new people would be able to enroll. It would also institute a per capita cap that placed restrictions on how much money the federal government spends on each recipient and allow states to choose to receive a block grant instead.
Under the Senate bill , there will be steeper cuts to the Medicaid program. The bill would grant states a fixed amount of money each year depending on the enrollment (per capita cap) or in the form of a block grant. But Medicaid's annual growth rate would be based on standard inflation by 2025 , instead of medical inflation, causing a further slash in funds over time. In a concession to Senate moderates, the bill would instead phase out the Medicaid expansion by 2021 , instead of 2020.
Under the Affordable Care Act, individuals receive subsidies to help pay for insurance plans based on their income, age, where they live , and the cost of their coverage . Overall, 85 percent of enrollees qualify for financial assistance.
Under the House bill , individuals would receive subsidies based on their age , not income, health care plan, or where they live. The House also included $138 billion over ten years for high-risk pools to help states pay for people who require more expensive care, though critics say that would not be enough. According to a recent study conducted by the AARP , premiums could surpass $25,000 per year for these high-risk patients. Also, overall, Americans would receive significantly less money under the AHCA program than they do under the current Affordable Care Act subsidies system.
Under the Senate bill, the Obamacare subsidies program will remain largely intact. However, by 2020 , fewer people would receive coverage . Only individuals earning up to 350 percent of the poverty level would qualify, instead of 400 percent, as it was under Obamacare. There will also likely be more money added to the state stability fund . Though, this remains a point of contention among Republican senators.
Under the Affordable Care Act, patients could use Medicaid funds to get care at Planned Parenthood, which offers people a wide range of reproductive health care services. According to estimates, half of the 2.5 million people that go to Planned Parenthood clinics each year pay for their services with Medicaid.
Under the House bill, Planned Parenthood would lose 30 percent of its funding it gets through Medicaid reimbursements, unless the clinics stop offering abortions.
Under the Senate bill, the provisions would be the same . Planned Parenthood would be stripped of a large portion of its funding for one year.
Under the Affordable Care Act, the amount of uninsured Americans has dropped around 13.3 percent since 2013, or around 12.8 million people, according to the Census Bureau .
Under the House bill, 16 million people would lose health care by next year, and by 2026, 23 million people would be without insurance, according to CBO estimates .
Under the Senate bill, many Americans would still lose coverage , though Senators are hoping the CBO will project a smaller number of uninsured than the House bill. No one will know for sure until the CBO releases its score.
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A small group of moderate Republican senators, worried that their leaders health-care bill could damage the nations social safety net, may pose at least as significant an obstacle to the measures passage as their colleagues on the right.
The vast changes the legislation would make to Medicaid, the countrys broadest source of public health insurance, would represent the largest single step the government has ever taken toward conservatives long-held goal of reining in federal spending on health-care entitlement programs in favor of a free-market system.
That dramatic shift and the bills bold redistribution of wealth the billions of dollars taken from coverage for the poor would help fund tax cuts for the wealthy is creating substantial anxiety for several Republican moderates whose states have especially benefited from the expansion of Medicaid that the Affordable Care Act has allowed since 2014.
Their concerns that the legislation would harm the nations most vulnerable and cause many Americans to become uninsured have thrust into stark relief the ideological fault lines within the GOP. Though Senate conservatives were the first to threaten to torpedo the bill, contending that it is too generous, the potential loss of nearly half a dozen moderate lawmakers votes may be the main hurdle. Since the bill will get no support from Democrats, Senate Majority Leader Mitch McConnell can afford defections from no more than two Republicans as he tries to bring it to a vote this week.
His odds worsened Friday when Sen. Dean Heller (R-Nev.), who is up for reelection next year, said he could not support the bill in its current form. Heller specifically cited its cuts to Medicaid, not just by ending its expansion in Nevada and 30 other states but by restricting government spending for the program starting in 2025.
(Peter Stevenson/The Washington Post)
This bill is simply not the answer, he declared, describing some of the 200,000 Nevadans who have gained health coverage through the expansion. He rhetorically asked whether the Republican plan will ensure that they have insurance in the future. Im telling you, right now it doesnt do that, he said.
Though three of the other four wavering GOP centrists also come from Medicaid-expansion states, not all were as explicit as Heller in their reactions after the Better Care Reconciliation Act was finally unveiled late last week. Both Sens. Shelley Moore Capito (W.Va.) and Lisa Murkowski (Alaska) said that they would evaluate it with an eye toward its effect on low-income residents.
It needs to be done right, Murkowski said in a tweet. I remain committed to ensuring that all Alaskans have access to affordable, quality health care.
Part of the pressure the moderates now face is that Medicaid consistently draws widespread support in surveys. A poll released Friday by the Kaiser Family Foundation found that three-fourths of the public, including 6 in 10 Republicans, said they have a positive view of the program. Just a third of those polled said they supported the idea of reducing federal funding for the expansion or limiting how much money a state receives for all beneficiaries.
Even among Republicans, the foundation found, only about half favor reversing the federal money for Medicaid expansion.
Congressional budget analysts plan to issue their projections as early as Monday on the legislations impact on the federal deficit and the number of Americans with insurance coverage. Already, proponents and critics alike are predicting that the Senate proposal would lead to greater reductions through the Medicaid changes than the estimated $834 billion estimated for a similar bill passed by House Republicans last month.
The focus of Republican efforts largely has been on costs, said Lanhee Chen, a research fellow at Stanford Universitys Hoover Institution. You do have a different set of issues that the two sides have been focused on, which partly explains why this has been such an intractable and difficult debate to find common ground on.
Under the Senate GOP version, 2021 is when Medicaids transformation would begin. The expansion, which has provided coverage to roughly 11 million people, would be phased out. What is now an open-ended entitlement, with federal funding available for a specific share of whatever each state spends, would be converted to per capita payments or block grants.
Then, four years later, the federal government would apply an inflation factor to spending increases that would be equal to the urban consumer price index rather than the higher medical inflation rate used in the House bill.
There has never been a rollback of basic services to Americans like this ever in U.S. history, said Bruce Siegel, president of Americas Essential Hospitals, a coalition of about 300 hospitals that treat a large share of low-income patients. Lets not mince words. This bill will close hospitals. It will hammer rural hospitals, it will close nursing homes. It will lead to disabled children not getting services. ... People will die.
To some extent, the division within the GOPs ranks reflects geography. Some of the most reticent senators come from states where health-care systems stand to lose the most financially if the bill passed.
According to an analysis by the Commonwealth Fund, hospitals in Nevada would be saddled over the next decade with at least double the costs in uncompensated care bills for which neither an insurer nor a patient paid. It examined the House legislation but noted that the Senate bill would doubtless hit harder because of its deeper reductions in federal Medicaid payments.
Hospitals in West Virginia would suffer an even greater spike in uncompensated care, about 122 percent during the decade. But the analysis showed that the greatest damage would come in McConnells own state: Kentucky, which has had the nations largest Medicaid expansion under the ACA, would see a 165 percent jump in unpaid hospital bills.
Yet conservative Sen. Patrick J. Toomey (R-Pa.), one of the bills champions, said it would establish a very, very gradual and gentle transition to a normal inflation rate for a program in which he said costs were spiraling out of control. Beyond Medicaid, it would permit private health plans to cover fewer services and would allow individuals and employers to eschew coverage without penalty elements that its authors say could lower how much consumers pay for their insurance.
The idea that theres a sector of our economy that has to permanently have a higher inflation rate than the rest of our economy is ridiculous, Toomey said Thursday. I think that its absolutely essential to putting [Medicaid] on a sustainable path so that it will be there for future generations.
Avik Roy, a conservative health expert who serves as president of the Foundation for Research on Equal Opportunity, said the legislations proponents need to show that competitive insurance markets can work for the poor and the vulnerable and the sick.
People too often equate federal spending with establishing a safety net, when greater competition and a free market could produce better results at a lower cost, in Roys view. The Senate bill would extend quite robust tax credits to many people, he said, even to those living in poverty who were not eligible for Medicaid: Republicans have a different view of what a safety net should look like.
Pressure is coming from outside groups on the right. Though the four conservatives who have voiced opposition to the bill might be pushed hard Sens. Rand Paul (Ky.), Mike Lee (Utah), Ted Cruz (Tex.) and Ron Johnson (Wis.) Heller will be a special target. A super PAC, America First Policies, reportedly is planning a seven-figure ad buy just in Nevada.
But patient-advocacy organizations that focus on an array of diseases are intensifying their own lobbying on the bill, including running print and online ads in several key states. If one health issue has emerged as a flash point, however, it is the nations opioid epidemic.
Shatterproof, a national nonprofit organization focused on addressing addiction, estimates that 2.8 million people have gained access to substance-abuse treatment under Medicaid expansion. In Ohio alone, total federal funding provided 70 percent of the $939 million that the state spent to combat the epidemic last year.
Capito and Sen. Rob Portman (Ohio) have asked the chambers Republican leaders to provide in the bill $45 billion over 10 years to address opioids; the measure currently provides $2 billion. But that amount, Shatterproof chief executive Gary Mendell said Friday, is less than a tenth of what experts predict will be needed over the next decade. And providing a designated fund while leaving millions uninsured makes little sense, he added.
Shatterproof just launched a six-figure advertising buy in Ohio, West Virginia and Maine which is represented by another undecided Republican, Sen. Susan Collins to urge the states senators to vote against the bill. Mendell noted that Portman has been a champion on substance-use treatment for years, and it was difficult to run ads targeting him.
His people need to understand that this has to be a no vote, Mendell said.
Specific constituencies aside, some policy experts regard the Senates plan as a wholesale reversal of the governments path to offer health insurance to ever-wider groups of Americans, piece by piece. That started with the creation of Medicaid and Medicare as part of President Lyndon B. Johnsons Great Society and could be ending with the ACA.
This is bringing us back to where we were before 1965, said Paul Starr, a Princeton University professor of sociology and public affairs who has written extensively about the history of U.S. health-care policy. There is no longer the federal commitment to back up the states in terms of health care for the poor.
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Senate health-care bill faces serious resistance from GOP moderates - Washington Post
Chief lieutenants in the Koch brothers' political network lashed out at the Senate Republican health care bill on Saturday as not conservative enough, becoming a powerful outside critic as GOP leaders try to rally support for their plan among rank-and-file Republicans.
Tim Phillips, who leads Americans For Prosperity, the Koch network's political arm, called the Senate's plans for Medicaid "a slight nip and tuck" of President Barack Obama's health care law, a modest change he described as "immoral."
"This Senate bill needs to get better," Phillips said. "It has to get better."
Some Republican senators have raised concern about cuts to Medicaid, which provides health care coverage to millions of poor and middle-income Americans. Several more conservative senators have voiced opposition because they feel it does not go far enough in dismantling what they call "Obamacare."
The comments came on the first day of a three-day private donor retreat at a luxury resort in the Rocky Mountains. Invitations were extended only to donors who promise to give at least $100,000 each year to the various groups backed by the Koch brothers' Freedom Partners a network of education, policy and political entities that aim to promote small government.
"When I look at where we are at the size and effectiveness of this network, I'm blown away," billionaire industrialist Charles Koch told hundreds of donors during an outdoor evening reception. His brother, David Koch, looked on from the crowd along with Sens. Mike Lee of Utah and Jeff Flake of Arizona.
"We've got to keep doing it at an accelerated pace," Charles Koch said.
No outside group has been move aggressive over the yearslong push to repeal Obama's health care law than the Kochs', who vowed on Saturday to spend another 10 years fighting to change the health care system if necessary. The Koch network has often displayed a willingness to take on Republicans including President Donald Trump when their policies aren't deemed conservative enough.
Network spokesman James Davis said the organization would continue to push for changes to the Senate health care bill over the coming week.
"At the end of the day, this bill is not going to fix health care," Davis declared.
The network's wishes are backed by a massive political budget that will be used to take on Republican lawmakers, if necessary, Phillips said.
He described the organization's budget for policy and politics heading into the 2018 midterm elections as between $300 million and $400 million. "We believe we're headed to the high end of that range," he said.
On Friday, Nevada Republican Dean Heller became the fifth GOP senator to declare his opposition to the Senate health care proposal. Echoing the other four, Heller said he opposes the measure "in this form" but does not rule out backing a version that is changed to his liking.
Heller, facing a competitive re-election battle next year, said he was opposing the legislation because of the cuts it would make in Medicaid.
Senate Majority Leader Mitch McConnell, R-Ky., has said he's willing to alter the measure to attract support, and promised plenty of back-room bargaining as he tries pushing a final package through his chamber next week.
Republican leaders have scant margin for error. Facing unanimous Democratic opposition, McConnell can afford to lose just two of the 52 GOP senators and still prevail.
At least two of the current opponents, Lee and Texas Sen. Ted Cruz, were among 18 elected officials scheduled to attend the Koch retreat. Two more undecideds were also on the guest list: Flake and Nebraska Sen. Ben Sasse.
President Donald Trump continued to push for replacing Obama's health care law, tweeting Saturday: "I cannot imagine that these very fine Republican Senators would allow the American people to suffer a broken ObamaCare any longer!"
The Senate measure resembles legislation the House approved last month that the nonpartisan Congressional Budget Office said would mean 23 million additional uninsured people within a decade and that recent polling shows is viewed favorably by only around 1 in 4 Americans.
Charles Koch and his chief lieutenants met privately with Vice President Mike Pence for nearly an hour Friday. Pence, a longtime Koch ally, was in Colorado Springs to address a gathering of religious conservatives.
Phillips said it was "a cordial discussion" about policy, but that neither side asked the other for anything specific.
Also Saturday, retired football star Deion Sanders announced plans to partner with the Kochs to help fight poverty in Dallas.
The unlikely partnership aims to raise $21 million over the next three years to fund anti-poverty programs in the city where Sanders once played football. The outspoken athlete also defended Koch, who is often demonized by Democrats, as someone simply "trying to make the world a better place."
"I'm happy where I am and who I'm with because we share a lot of the same values and goals," Sanders said when asked if he'd be willing to partner with organizations on the left.
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Koch chief says health care bill insufficiently conservative - ABC News
Sen. Bernie Sanders is headlining a "don't take our health care" rally tonight in Pittsburgh as a first stop on a three-state tour to mobilize opposition to the Senate health care bill, which the Vermont senator has called "by far the most harmful piece of legislation I have seen in my lifetime."
Sanders teamed up with progressive advocacy organization MoveOn.org to hold rallies this weekend in Pittsburgh; Columbus, Ohio; and Charleston, West Virginia, with the goal of pressuring Republican senators in each of the states to oppose the legislation released Thursday.
Republican Sens. Pat Toomey in Pennsylvania, Rob Portman in Ohio and Shelley Moore Capito in West Virginia have said theyre reviewing the legislation and have not made a final decision.
Toomey issued the most supportive statement of the three, calling the Senate bill, an important and constructive first step in repealing Obamacare and replacing it.
Five GOP senators have so far announced their opposition to the bill drafted by some of their Republican colleagues. Republicans can afford only two defections from the 52 senators in their ranks to pass the bill.
The nonpartisan Congressional Budget Office is expected to release its assessment of the bill early next week.
Sanders has slammed the legislation as "disastrous," saying in a statement Thursday that it "has nothing to do with health care. It has everything to do with an enormous transfer of wealth from working people to the richest Americans."
Sanders spokesperson Josh Miller-Lewis told ABC News, Were at a pivotal moment in the fight to save health care and the goal this weekend is to elevate that fight.
All three of the states where the senator and MoveOn are holding rallies were won by President Trump in the 2016 election.
The first rally is tonight at 7 p.m. in Pittsburgh, followed by events Sunday in Ohio and West Virginia.
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Bernie Sanders headlining 'don't take our health care' rallies in three states - ABC News
The Cost Sharing Reduction (CSR) payments, which have been paid on a monthly basis to insurers for the past three years, are an integral part of the Affordable Care Act (ACA). Whether to continue with the payments is a central issue in the ongoing health care reform debate in Washington.
The CSR program is critical to our ability to provide comprehensive and affordable care to patients across the country but it is caught in an unresolved legal quagmire.
Assuming the payments are made, a question remains: For how long?
Regardless, the outcome would likely be millions either losing or dropping coverage with the consequence that they would no longer seek medical care until it was an emergency -- a return to the old days. If this market disruption happens, I believe individual and community health will decline because patients will be shut out of the health care system because it's no longer affordable.
Hospitals will certainly be negatively impacted if the subsidies are eliminated. If millions of Americans lose or drop their coverage, we will see a jump in bad debt and uncompensated care -- that is care for which we receive no payments. In this scenario, everyone else will face higher premiums, higher deductibles and higher out-of-pocket costs to help cover those who no longer have coverage.
Eliminating CSR payments would have an immediate, negative impact on patients -- their health and their finances will take a huge hit. These payments give patients who need the most help the stability they need to ensure they receive the high-quality care they deserve.
Our elected officials, in the name of individual and community health, must continue to fund CSR payments until a better solution is developed for the people who need care the most.
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Why Washington should continue billions in health care subsidies - CNN
"That's not true, and that is not fair. That is so not fair," said Conway, the senior counselor to President Trump, during a back-and-forth with CNN anchor Alisyn Camerota.
She added, "It actually helps no one to peddle the false rumor that this health care bill does 'nothing' to help."
"If there's anything in the new health care bill that will help the opioid crisis, I haven't seen it," said Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University.
"I would say the health care bill is more likely to make the opioid crisis worse, rather than better," he added. "If people right now who have opioid-addiction treatment paid for, and the health care bill results in their loss of coverage, it means people could lose their lives."
Conway told CNN that the administration has launched a "multi-Cabinet assault on this."
Kolodny noted that those grants are "money that came from a bill that President Obama signed on his way out." While praising the administration for talking about the issue and forming an opioid commission to look into the problem, Kolodny said it's time for the Trump team to act.
"I don't really see anything the Trump administration has done, other than just talk about the problem," he said. "What I'd like to see from the Trump administration is a large investment in building up an opioid addiction treatment system that doesn't yet exist."
Those struggling with addiction, Kolodny said, need easy access to maintenance therapy drugs like buprenorphine. He also said the government must do more to regulate opioid manufacturers to prevent new cases of people becoming addicted to opioids.
"If heroin, fentanyl and painkillers remain easier to get, then we're really not going to be able to see deaths come down."
Other experts agree,
Arthur Evans, CEO of the American Psychological Association, said the new bill will weaken Medicaid and allow states to waive essential health benefits, including for those seeking treatment of their opioid addictions.
"At a time that we are trying to get more people access to treatment, we're essentially taking away access," Evans said. "I think this really undermines any efforts that we might have in trying to curb the opioid epidemic."
The nation has not seen a reduction in the numbers of people overdosing and becoming addicted, he said, adding that "the timing of reducing the numbers of people covered by health insurance is very unfortunate."
"The thing we know about addiction is that having coverage does make a difference in terms of people's access and ultimate recovery," Evans said.
What would he tell Conway if he were to meet with her?
"The net effect is, the bill is going to make it worse," Evans said. "I don't think there's any doubt about that."
The National Alliance on Mental Illness also sharply criticized the bill, urging its supporters to call senators to voice their opposition, especially to the billions of dollars in cuts to Medicaid.
Ohio Gov. John Kasich, a Republican whose state is at the epicenter of the opioid crisis, said he was deeply concerned about the bill and the way it was handled behind closed doors.
"I have deep concerns with details in the US Senate's plan to fix America's health care system and the resources needed to help our most vulnerable, including those who are dealing with drug addiction, mental illness and chronic health problems and have nowhere else to turn," Kasich tweeted.
Pennsylvania Gov. Tom Wolf slammed the bill: "#BCRA makes care worse for everyone."
"The Republicans that wrote this bill don't want you to understand the damage it will cause before they vote on it," said Wolf, a Democrat.
Kasich and Wolf were among a bipartisan group of governors who wrote a pointed letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer ahead of the bill's release this week.
"It calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states," said the letter, signed by seven governors: three Republicans and four Democrats. "Medicaid provisions included in this bill are particularly problematic."
For states hit hard by the opioid epidemic, addiction specialists say the loss of funding could have a devastating impact on treatment and recovery programs.
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Could Senate health care bill make opioid crisis 'worse'? - CNN
Ms. Handels victory showed she was able to bridge the divide in her own party between admirers of President Trump and those made uneasy by his administration.
Seen as a referendum on Mr. Trump, the race in the heavily conservative and affluent district outside Atlanta was the latest in a string of demoralizing losses for Democrats.
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The death of Otto Warmbier, the American student who was returned from North Korea in a coma, drove a new wedge between Washington and Pyongyang.
President Trump condemned the North for its brutality, but he and Secretary of State Rex Tillerson stopped short of announcing fresh sanctions.
Mr. Trump said that China had not succeeded in getting Pyongyang to curb its nuclear and ballistic missile programs. He now faces a range of unattractive options in dealing with what he has called Americas most urgent foreign threat.
Speaking in Iowa on Wednesday, President Trump commended Gary D. Cohn, his top economic adviser and a former executive at Goldman Sachs, saying he would keep the world from taking advantage of the United States.
President Trump said on Wednesday that he was crafting legislation to bar new immigrants from receiving welfare for at least five years. He announced the proposal in a conquering-hero-returns speech in Iowa, his first trip back to the political battleground state since he won it in the 2016 general election.
His mood buoyant after twin Republican wins in congressional special elections the night before, the president also revealed his anticipated plan for putting solar panels on a proposed wall on the Mexican border an idea he boasted he had come up with himself.
Our fact-check of the rally found the president made 12 inaccurate claims about the economy, health care and his own accomplishments.
Senate Republicans, who have promised a repeal of the Affordable Care Act for seven years, took a major step on Thursday toward that goal, unveiling a bill to cut Medicaid deeply and end the health laws mandate that most Americans have health insurance.
The 142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment.
The legislation would shift money from the poor to the rich, making deep cuts to Medicaid and creating a system of tax credits to help people buy health insurance. Despite being described as a revamp, its similar to a measure passed by the House last month.
Mitch McConnell, the Senate majority leader, wants a vote next week, but four Republican senators said they wouldnt support it without changes.
We tracked where Republican senators stand, and compared the proposal to current law.
During an interview with Fox News on Friday morning, President Trump indicated that his tweet hinting at taped conversations with James Comey had been intended to influence the fired F.B.I. directors testimony before Congress. On Thursday, the president acknowledged that he had not recorded the conversations.
_____
The Supreme Court unanimously rejected the governments position that it could revoke the citizenship of Americans who made even trivial misstatements in naturalization proceedings.
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Federal investigators are examining financial transactions involving Paul Manafort, President Trumps former campaign manager, and his son-in-law, who embarked on a series of real estate deals in recent years fueled by millions of dollars from Mr. Manafort, The Times reported.
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Trump's Washington News of the Week: Health Care Bill, Karen ... - New York Times
Sacramento Bee | Bernie Sanders 'extremely disappointed' by stalling of California's single-payer health care bill Sacramento Bee I am extremely disappointed that the speaker of the California Assembly is refusing to allow S.B 562, the single-payer health care bill passed by the state Senate, to come to the Assembly floor for a vote, Sanders said in a statement issued Saturday. California Assembly Speaker Anthony Rendon shelves single-payer healthcare bill, calling it 'woefully incomplete' Single payer health care put on hold in California - The Mercury News |
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To illustrate why she believes everyone should have access to comprehensive health care, Rep. Maxine Waters said she and her 12 siblings never saw a physician or a dentist their entire childhood.
I was born at home in St. Louis back in the day when it was hard for minorities to get into hospitals, she said.
To soothe cavities, Waters said her family relied on turpentine and cotton. If it was really bad, the tooth was yanked out using string and a slammed door.
The California Democrat, who spoke Saturday at a packed town hall meeting in Gardena, said she worries some Americans will be forced to do what her family did if the Republican health care bill passes. Senate Republicans have pledged to pass a bill before the July Fourth holiday.
Some GOP senators have said they want to review the analysis of the bill from the Congressional Budget Office before making up their minds. The budget office has said it will release that assessment early next week.
Waters said the existing bill would deny access to people with preexisting conditions, cause millions to lose their healthcare and penalize millennials.
We can do better than this, she said.
Supporter Gwen Bailey, 59, who works doing admissions at a hospital, said she worries especially about the people who could lose their insurance and the strain it would put on hospitals.
Its a lot that people would be losing, she said.
Inside, chants of USA! USA! could be heard from around 80 protesters who paced back and forth outside the venue.
Waters opponents were dressed in pro-Trump garb and called her Dirty Waters.
Chanell Temple said she lost her job a few years ago and hasnt been able to find a new one because she doesnt speak Spanish. She said Waters has destroyed the black community by supporting immigrants.
Waters criticized key members of President Trumps cabinet, including Education Secretary Betsy DeVos, Attorney General Jeff Sessions, and Secretary of State Rex Tillerson. She said Housing Secretary Ben Carson should go back to being a surgeon and that shell take him apart when he goes before the House Committee on Financial Services, of which she is the ranking Democrat.
Waters said some Republicans might vote against the health care bill.
She told the crowd that they deserve a president who will represent everyone. A woman in the audience stood up with a sign that said Impeach Mad Max and began walking through the rows and up to the foot of the stage, yelling that Waters needs to go.
Waters didnt skip a beat. She led her supporters in a chant to Impeach 45, repeating it over and over as her supporters turned to face the woman and narrowed in on her, clapping to the beat. The chant lasted more than four minutes.
A short while later, Waters closed by repeating a phrase that millennials, who call her Auntie Maxine, taught her: Stay woke.
An earlier version of this article said Rep. Maxine Waters had 13 siblings. She had 12.
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After decades of research and theoretical debates, it seems precision oncology is finally falling into place.
At the end of May, FDA triggered a seismic shift in the field with its decision to approve a therapy based on a genetic signature,not a tissue of origin. The ruling solidified the fields move towards the use of biomarkers to precisely target each persons cancer, rather than blindly administering toxic agents.
On Thursday, another big milestone was reached with FDAs premarket approval (PMA) of the first companion diagnostic for multiple drugs, the Oncomine Dx Target Test. A PMA is the most stringent type of device marketing application required by FDA.
Developed by Thermo Fisher Scientific, the assay uses next-generation sequencing (NGS) to simultaneously screen for 23 cancer genes. Three of those genes are tied to three different FDA-approved therapies for non-small cell lung cancer (NSCLC).
And thats just the beginning.
Via phone, Thermo Fishers President of Clinical NGSJoydeep Goswami noted that the regulatory work has already been done for further indications.
While we presented evidence of analytical validation of all the different genes, given the initial companion drugs were all non-small cell lung cancer-related, the FDA chose to initially limit this approval to that patient group, he said.
After all, its all new territory for the agency as well.
Its the first-ever multi-biomarker NGS, IVD [in vitro diagnostic], companion diagnostic that was ever approved. And also, I think for the FDA, for multiple drugs being approved for a companion diagnostic at the same time.
The company intends to work with the FDA to get more genes added to the panel, more companion therapies matched, and more indications for use in different tissues.At least one other company,Foundation Medicine, is working on a multi-biomarker, multi-drug companion test.
Lung cancer is a good starting point for a number of reasons: The genes are actionable, the samples are hard to collect, and time is of the essence.
With this NGS test, the sample requirement is very small and it delivers results in a matter of days, Goswami said. That compares to the single biomarker, sequential testing techniques using PCR or IHC, which take weeks and use a large amountof sample with each test. Oncologists dont want to go back for more.
The cost of a lung biopsy, at the best of times, is somewhere in the $5,000-$20,000 range, Goswami explained. But if there are complications, which is often the case with compromised patients, it can go up to $40,000 or more.
Perhaps more importantly, the procedure is an immense burden on already sick patients, he stated.
The companion therapies are made by Pfizer, AstraZeneca, and Novartis. The latter also received approval for its combination therapy on Thursday, in concert with the approval of the Oncomine Dx Target Test. FDA noted both in its announcement.
For Goswami, the greatest advantage of a companion diagnostic tied to multiple drugs is its ability to democratize access to precision medicine.
When FDA announced its approval of Keytruda for a biomarker, it incited a lot of debate about the number of patients that were getting their tumors sequenced. As it stands, an NSCLC patient at a top academic institution, such as Mayo Clinic, will likely get the tests required to confirm their eligibility for all the approved therapies or clinical trials. Yet these are laboratory-developed tests (LDTs), which are tied to a single clinical location.
The Oncomine Dx Target Test will be available nationwide;LabCorps Diagnostics and Covance Businesses, NeoGenomics Laboratories, and Cancer Genetics have all signed up as early adopters.
I dont see why any patient should not have access to this technology, Goswami said.
Thermo will start discussions with payers and the Centers for Medicare and Medicaid Services now that the approval is finalized.
If the trend continues, biomarkers will become an increasingly important part of cancer treatment. But its not always a one-to-one equation.These mutations are often actionable in unexpected ways.
Take, for example, Mercks flagship immunotherapy Keytruda. In an early June interview, Mercks SVP, Head of Global Clinical Development, and CMO Roy Baynes said the company is currently taking a four-pronged approach to its diagnostics. The first is testing for PDL-1, the biomarker that the drug targets and binds. The next is testing for inflammatory signals more broadly. The third is looking for tumors that are MSI-high, the mutation tied to the landmark FDA approval. And finally, there is evidence to suggest that a broadly high tumor mutational burden correlates with a response to checkpoint inhibitors such as Keytruda.
If physicians only tested for PDL-1, they wouldnt be maximizing the drugs potential.
Its a reminder that we need to cast the net as wide as possible for potential mutations, in all patients.
Photo: Nataniil, Getty Images
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Another win for precision medicine: FDA approves companion diagnostic panel - MedCity News
In his lab in Lake Nona, Dr. Peter Crawford has been studying nonalcoholic fatty liver disease, a condition thats closely linked to obesity and type 2 diabetes.
He is using cutting edge metabolic and genetic tools to try to figure out how and why nonalcoholic fatty liver disease, or fatty liver, progresses into a more severe form, putting the patients at a higher risk of developing cirrhosis and liver cancer.
Its a real scare, and its directly linked to the obesity epidemic, said Crawford, a physician and research scientist at Sanford Burnham Prebys Medical Discovery Institute.
In nonalcoholic fatty liver disease, liver cells retain fat. The condition has a strong association with developing cardiovascular disease. In a small portion of individuals it can progress to the point that they need a transplant or get cancer.
The disease began making its mark on medical charts not long after obesity became an epidemic in the 1980s.
Its cause is not exactly known, but it is strongly linked to diabetes, obesity and high cholesterol, making it the most common liver disorder in Western industrialized countries. By 2030 the condition will be the most common reason for liver transplants in the United States, according to a 2014 study by researchers at the Cleveland Clinic.
Meanwhile, most patients who have fatty liver arent aware of it, and the condition can evade primary care providers too, because it usually doesnt affect the results of routine blood work. For those who are eventually diagnosed usually after the disease progresses to its more severe form there are no drugs available.
When you combine the fact that the natural history of the disease is unclear; its difficulty to diagnose, treat and stage it; and theres no FDA-approved medicine, it becomes a huge issue, said Dr. Jaideep Behari, associate professor of medicine at the University of Pittsburgh and director of the Fatty Liver Clinic.
The issue is more pronounced in states like Florida, where more than a quarter of the population is obese, and as a result, more likely to have type 2 diabetes.
For local doctors, who continue to see liver disease cases related to hepatitis infections and alcohol abuse, fatty liver is a rapidly growing third category.
Its becoming an epidemic, said Dr. Nasim Ahmed, a gastroenterologist at Gastroenterology Consultants CFL in Orlando.
At Digestive and Liver Center of Florida, one of the large local independent practices, the proportion of patients who have liver disease because of alcohol, hepatitis and obesity is almost equal these days, said Dr. Srinivas Seela, one of the practices founding partners.
Its frustrating that these patients have no medical treatment, said Dr. Harinath Sheela, Seelas partner and brother.
Scientists learn more about Zika virus
About 10 percent to 15 percent of the patients develop the more severe condition called nonalcoholic steatohepatitis, or NASH, but its not yet known which patients are more likely to fall in this category, adding to doctors frustration.
For now, the standard treatment is lifestyle change. Patients are advised to lose weight and get their diabetes under control, although not all patients follow the advice.
But theres hope, because fatty liver has become an active area of research.
At least 200 drugs targeting the conditions are in clinical trials and a handful are in the advanced stages of research. The National Institute of Diabetes and Digestive and Kidney Disease has created a nationwide clinical research network to conduct studies for preventing and treating the disease.
So its possible that there will be a therapies within the next three to five years that will decrease the rates [of the disease], said Behari of University of Pittsburgh.
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He was also encouraged by Crawfords research.
Crawfords recent findings from animal studies has amplified the silent dialogue between liver cells and their neighboring immune cells, showing that when certain fuels produced by the liver cells are off balance, the immune cells in the liver go rogue and cause scarring and worsening of fatty liver disease.
Thats a very exciting finding, said Behari, whos not involved in the research. Anything that helps us open up that black box and understand the disease at the molecular level is a big deal.
Crawford, whos working to publish the results of his most recent study, hopes the findings will pave the way toward developing a drug and help identify patients who are at a higher risk of developing severe forms of nonalcoholic fatty liver disease.
He added that the findings also reiterate another important point.
One way to look at it is that even in one strict cell type, having a balanced nutrition is important, Crawford said.
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Fatty liver disease target of cutting-edge genetic research - Orlando Sentinel
Added on June 23, 2017 The News Wheel algae , biofuel , corn , Exxon , Green driving , renewable energy source , soybeans
So far the biofuel game has belonged to two cropscorn and soybeans. But, a third organism is ready to play. Kind of.
According to Bloomberg writer Jennifer A Dlouhy, after eight years of painstaking work, researches from J. Craig Venters Synthetic Genomics in collaboration with Exxon (a relationship which started in 2009) may have finally found a way to turn algae into a viable biofuel source.
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Algae, which has been on scientists radars for a long time now as a biofuel candidate traditionally lack enough oils and fats that a viable biofuel source requires; corn and soybeans have whats needed, but algae is a more sustainable option because it can grow in salt water and thrive under harsh environmental conditions.And the oil contained in algae potentially could be processed in conventional refineries, according to Dlouhy.
Through advanced cell engineering, the team from J. Craig Venters Synthetic Genomics has reported that they were able to more than double the fatty lipids insidea strain of algae, reports Dlouhy.
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After depriving algae of nitrogen, the scientists were able to pinpoint the single gene tasked with monitoring the amount of oil the algae produces.
Using the CRISPR-Cas9 gene-editing technique, the researchers were able to winnow a list of about 20 candidates to a single regulator they call it ZnCys and then to modulate its expression, according to Dlouhy.
The advanced cell engineering increased the typical oil production of algae10 to 15 percentto over 40 percent, reports Dlouhy.
Although this is a critical breakthrough and a much needed step in the evolution of algae into a viable biofuel source, commercialization of this kind of modified algae is decades away, according to Dlouhy.
News Source: Bloomberg
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Around the age of 15, I began experiencing periodic bolts of searing pain shooting down the outer sides of my legs and up through my shoulder blades. The pain would occasionally grow so debilitating that I was forced to walk with a cane and could barely manage a flight of stairs. For sleepless months at a time, I would limp and grimace through my day. The worst part was that doctor after doctor was not able to diagnose the problem, and I resigned myself to a life of making the best of it.
Once I hit my mid-30s, I couldn't take it anymore and decided I had to do something about it. I tasked myself to keep seeing doctors untilsomebodycould tell me what the problem was. After plowing through a series of specialists, I eventually found my way to a rheumatologist who diagnosed me with an inflammatory condition, which isn't exactly fully understood by science, calledAnkylosing spondylitis(spells just like it sounds).
Now, this condition can be treated somewhat with a special diet (please don't send me any info on the subject -- I know), but the food restrictions are pretty harsh and results in my case weren't always consistent. But as it turns out, modern science has another fix.
My rheumatologist recommended that I begin a regimen of a type of medicine known as a biologic (or sometimes a "biopharmaceutical"), which is seeped directly from living organisms. I put a lot of trust in science and technology's ability to make the world a better place, so I was open to seeing what this cutting-edge treatment could do for me.
And I am happy to say that after a month or so, the treatments worked -- in fact, they worked far better than I could have possibly imagined. I've been almost totally pain-free for the past two years and even taken up running. (I should note that the medication I was on came with some serious potential side effects -- most notably, they decrease your body's immune system, including the ability to fight certain cancers. Just speaking for me, the trade-off was worth it.)
Now, this medication was unlike any other I had taken -- I had to inject it. Most second-generation biologics used to fight inflammatory conditions have to be introduced directly into the body through a syringe or via an IV. I had to learn to use a disposable epi-pen like contraption, which I keep stored in my refrigerator. There was a learning curve, but not a sharp one (and it certainly helped that I am not at all squeamish when it comes to needles).
So, what is this magic goop I inject into my body? It comes from natural sources, but at the same time -- there's really anything natural about it.
Scientists have been deriving medicines from living organisms since forever -- just about every vaccine you've taken can be considered a biologic. However, the scope of these medicines have boomed in recent years with the advent of genetic-manipulation techniques.
While the exact definition of "biologic" varies from regulatory body to regulatory body, the term is often used today to refer to newer classes of drugs resulting from techniques that tweak cells at their fundamental genetic level to turn them into living factories.
According to the FDA'sown description, "In contrast to most drugs that are chemically synthesized and their structure is known, most biologics are complex mixtures that are not easily identified or characterized." Many of these second-generation biologics (ones that have popped up in the past 15 years or so, as opposed the first-gen ones like vaccines) are not recreatable -- by humans. We just don't know how. However, scientists can use modern genetic-manipulation techniques to cajole living cell cultures to do it for them. Therein lies a wrinkle to the biologic story -- they can be insanely expensive.
The manufacturing of these medicines is a complex undertaking -- particularly on an industrial scale. Not only is there gene manipulation, but the cellular cultures are particularly susceptible to contamination and must be maintained under very aseptic and strictly temperature-controlled environments -- all of which must take place under the supervision of a highly trained workforce. When you consider that the patient pools are relatively small, prices inevitably rise.
I can only speak for myself and say that these drugs have been a godsend and truly improved my quality of life. But I'm also fascinated (and even humbled) to consider how this treatment would not be possible without decades of scientific inquiry that took place before it.
The line of scientific history -- down through Darwin, Mendeland the team of Watson & Crick -- had no idea it would one day help a middle-aged tech blogger not have to limp in pain for months at a time. They all just wanted to know the answers to weird and impractical questions.
This is why I get annoyed when I hear politicians wanting to balance budgetson the backs of scientific research. While there are ways to best use research dollars, their benefit is invaluable -- just not always immediately (quantum physics took decades to find a use in the function of smartphones, as it took years for Einstein's theories to be used insatellite configuration).
There is no way we can predict how the impractical research of today will affect some major breakthrough years down the line. That's why we should all want our tax dollars to fund inquiry into weird, unnecessary questions like "Do gravitons exist?," "What does Pluto look like?," or "Is the whole universe a hologram?" Answering those questions might not necessarily bring us a new breakthrough today -- in fact, they probably won't. But they leave us with the promise that they will someday.
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