Away here in iowa, and half a century ago. Woodruff all that and more on tonights pbs newshour. Major funding for the pbs newshour has been provided by moving our economy for 160 years. Bnsf, the engine that connects us. And the william and flora hewlett foundation, helping people build immeasurably better lives. And with the ongoing support of these institutions and individuals. This program was made possible by the corporation for public broadcasting. And by contributions to your pbs station from viewers like you. Thank you. Woodruff spending fights in states across the country are heating up over this long fourth of july holiday period, and none hotter than in new jersey. This was day three of a State Government shutdown with republican governor Chris Christie and democratic lawmakers at odds over a budget. Christie drew fire sunday for using the governors official residence at one of new jerseys public beaches that are now closed to the public. He has a place to go, so as long as he can go and his family can have a good holiday, i guess thats more important than the people of new jersey. Its very sad. Woodruff christie dismissed the criticism today in a phone call to a morning tv show. Asked about people being upset, he said, well, im sorry theyre not the governor. Meanwhile, maines State Government is also partially shut down, over a budget fight. And lawmakers in illinois are back in session, trying to resolve a budget standoff thats now in its third year. President trump shows no signs of backing off his public feud with the news media. In a new tweet today, he said at some point the fake news the president drew new criticism on sunday, after he tweeted mock video of him tackling a man with the cnn logo over his face. Chinese president xi jinping warned President Trump today that u. S. china relations are being harmed by a series of problems initiated by the United States. They include a new u. S. Arms deal with taiwan, and sanctions against a chinese bank for its dealings with north korea. Chinese state tv gave beijings assessment of the call. translated xi jinping stressed to mr. President trump that since our meeting at the maralago resort, u. S. China relations achieved important results. At the same time, the relationship between both countries has been impacted by some negative factors. We hope the u. S. Can act earnestly in accordance with the one china principle. Woodruff the phone call also came hours after the destroyer u. S. S. Stethem, seen here last summer, again sailed near a disputed island in the south china sea. Iraqi army units in mosul closed in today on the last sliver of the city still held by a few hundred Islamic State fighters. The Government Troops were backed by heavy air strikes by the u. S. Coalition. Isis fought back with female suicide bombers in mosul and elsewhere. They killed at least 15 people in the last 24 hours. One of bombers was just 15 years old. In germany, 18 people were killed when a bus full of Senior Citizens crashed this morning. Police say the bus rearended a semitruck in bavaria, then burst into flames. Nearly 200 emergency workers joined the response and tried to recover bodies from the charred wreckage. Authorities say the heat from the fire was so intense, only the buss twisted frame was left. Back in this country, automakers posted another poor showing for june, with Sales Numbers tumbling for the sixth straight month. Fiat chrysler fell more than 7 , while ford and g. M. Were down roughly 5 . Meanwhile, korean automaker hyundai posted a 19 loss. Analysts say a downturn was expected after last years record Sales Numbers. Wall street cut short its trading day, ahead of the fourth of july, but banks and Energy Companies made the most of it. They led the Dow Jones Industrial average higher, adding 129 points to close at 21,479. The nasdaq fell 30 points, and the s p 500 gained five. And, on the eve of the fourth of july, theres new evidence that americans need to brush up on their history. In a newshour npr marist poll, only 77 correctly said the United States won independence from britain. The rest were unsure or named another country, including russia and afghanistan. Even fewer, only 69 , knew the american colonies declared their independence in the year 1776. Still to come on the newshour the march of dimes president on replacing obamacare. A new report highlighting the broad reach of the opioid epidemic. Are americans less civil since President Trump took office . A newshour poll offers clues. And much more. Woodruff weve heard from a number of interested parties in recent weeks and months as republicans on capitol hill have been working to repeal and replace the Affordable Care act. Theyve included hospitals, the pharmaceutical industry, advocates for the homeless and the disabled, as well as lawmakers from both parties. Tonight we turn to stacey stewart, president of the march of dimes, a nonprofit that focuses on the health needs of mothers and babies, especially when it comes to preventing premature birth, birth defects and infant mortality. Stacey stewart, thank you very much for being here. So what is your main concern with the Senate Version of this healthcare reform plan . Well, the march of dimes, as you mentioned, what we care about is the health of pregnant women and their babies, and our main concern with the senate bill as proposed is it would put at risk the health of many of those women and their babies. Medicaid covers about half of all pregnancies in the United States and about 30 million children are covered by medicaid. Under what the senate proposed, about 6. 5 lowincome women of child bearing age would lose their coverage under medicaid, and we think that that pughts at risk those women in terms of them being able to access prenatal care to have a healthy baby and pregnancy. Woodruff about half pregnant women in this country depend on government help to cover a pregnancy . Medicaid covers lowincome pregnant women with prenatal care and delivery. If the waib baby is born too soon, low birth wait or has defects, medicaid covers those babies as well. So it ends up covering a lot of the babies and providing the need to make sure they have the support they need if there are complications. Woodruff there hasnt been a great deal of talk about prevention, but prevention is a big part of this. One of the big conversations is how do we stabilize the Health Market and medicaid and healthcare in general, and i think one of the conversations we need to have as a country is how do we do more, to put more emphasis on prevention and care earlier on versus having a system that really is fund ago lot of chronic disease and illness. One of the reasons we focus on maternity coverage and prenatal care is because thats what happens to enable those women to have healthy babies if they get the help they need and certainly if they before they get pregnant, if they are healthy, that creates the best outcome for the baby. Healthy women equals healthy babies. The more we can put emphasis on early prevention efforts and fund a system that actually focuses on that, we think will improve Health Outcomes, reduce cost and premiums, which is what everybody wants. Woodruff isnt it the case, though, stacey stewart, under traditional medicaid states are required to cover pregnancy, to cover prenatal care and babies, so even if medicaid is scaled back, which looks like would be the case under the Senate Republican plan, they would still be required to cover women in these circumstances, wouldnt they . The problem is, with reductions as proposed, were not sure how much of the need would be covered. With women coming off medicaid coverage as a result of the pullback of the expansion of medicaid, i think there is a concern we have. And the concern isnt just in the medicaid market, its also in the private market. Before the Affordable Care act, private Healthcare Plans did not necessarily include maternity coverage as a requirement as did employbased plans and medicaid. We need to make sure all women have accesses to the resources they need, whether private plan or medicaid, and we believe much of the support women need could be at risk and thats our primary concern. Woodruff how do you answer the argument from conservatives that something has to be done, that maibd has grown at a rate thats out of control, cannot be sustained, and unless some methods are found to scale that back, medicaid wont be there in the lon long term for people who need it. We share the concern. The costs of medicaid are exorbitant and growing. But lets look at whats going on in the medicaid market. You have a lot of lowincome women, women of color, and we see Health Outcomes not improving. One of the big issues with the march of dimes, the government issued statistics showing preterm birth rates increased for the second time in the past two years after some decline over the past seven years. Health outcomes are not improving for pregnant mothers and babies. Its actually going down. So one of the things that we can do to control the costs of medicaid and healthcare in general, again, is to focus on what all the interventions could be put in place, what prevention methods could be put in place, to educate and perform and provide the support and healthcare coverage women need so both kind of Health Outcomes can be avoided. If we can avoid those outcomes we can keep costs under control and have a much more manageable system over time. Woodruff weve heard the argument among republicans, why should single men be required to buy coverage at the includes maternity and cover births and costs. We all buy insurance for thaingts may never happen to us, including Health Insurance for Health Outcomes we may never suffer from. The fact that women are responsible for child bearing, does that mean theyre responsible for creating the baby in the first place by themselves . It takes men and women together to create babies and, so, we believe its very important that the Insurance Market cover those thingsthat are risks that each one of us individually may not experience but they are risks and they are costs that are in the system that are important to make sure get covered. So i think its really important to say, look, when we buy insurance, we buy for a lot of things we personally may not experience or be impacted by, but thats the point of having insurance and a larger pool of risk included in insurance so that it reduces the cost for everyone to participate. Woodruff stacey stewart, president of the march of dimes, and the debate goes on. Thank you. Thank you so much, judy. Woodruff now, a new study by one of the nations biggest Health Insurance companies gives a startling look at the toll that prescription opioids are taking on its policyholders. William brangham has that. Brangham the insurance giant Blue Cross Blue Shield analyzed medical records for 30 million customers and found striking results. In 2015, roughly 20 of customers, one in five, filled at least one prescription for opioid painkillers, almost half of those patients were prescribed high doses of the drugs which are more likely to cause dependence. Between 2010 and 2016 the rate of abuse or addiction to those painkillers shot up dramatically by almost 500 , this while the rate of medically assisted treatment considered the most successful way to curb the addictions grew by 65 in the same time frame. The report detailed abuse of opioids between men and women and different parts of the country. Im joined by dr. Trent haywood, chief medical officer for the Blue Cross Blue Shield association. Welcome to the newshour. This is an interesting set of data produced from your patients records. Weve said one in five have had a prescription for these painkillers, obviously most of them for legitimate pain suppression needs, but weve also discovered the rate of addiction shot up. Why do you think that has been happening . The reason why we wanted to focus on this particular issue is just what you just alluded to, the escalation in the opioid addiction from physicians prescribing these particular opioids, in the 90s, we were aggressive as physicians making sure we address pain. Unfortunately, it was found out later, as we see unfold now, we underestimated the risk of the high doses prescribed in the particular ownoids and are suffering the consequences of that. Brangham some of the data you guys have put together is not necessarily new news. Why hasnt the message seemingly gotten out to the medical Community Just how serious these drugs really are . One of the things we know when it comes to medicine and the practice of medicine sit really requires a substantial amount of time for it to change. Were headed into the independence holiday, so people are moving off to make sure they enjoy time with friends and family, but, as this report highlights, all of us want to be independent this day, because whether it be your family or someone elses, were all struggling with opioid addiction. Over 2 millionmines americans a year are suffering from opioid addiction. Its not one specific demographic. Brangham the bestknown streams for the addictions have barely kept up with the pace. Why do you think that is . Were talking about someone moving from an acute situation to a chronic condition. The opioid addiction is chronic con diction and we need to treat it that way and make sure people have the necessary support they need to have. Brangham if i am a Blue Cross Blue Shield policy holder and i recognize i have a problem and try to get treatment, will my policy cover that Addiction Treatment . Yeah, one of the reasons were highlighting this is you need to make certain you follow up at your local plan level to get that treatment this is something that is actually covered in most members policies so you should be following up to get that treatment. Brangham one of the things i was struck by in the report is the gender differences. When men and women are younger, men seem to be more have you cial. As we age, women seem to become more vol herbal to addiction. Do you have a sense of why that is . One of the reasons we think women are being imacted into an Older Age Group is the fact that theyre appropriately following up with their physicians. The more you follow up, the more likely youre prescribed an opioid. Women in Older Age Groups are more predescribed to getting the prescribed opioid. Brangham the senate is debating a healthcare bill that could eliminate hundreds of millions of dollars from medicaid. Medicaid itself pays for much of adduction treatment around the country. Do you share concern of many that if this bill were to become law the doubts medicaid could only worsen an already awful epidemic . From every indication, this particular issue is not partisan. Whether on the right or left, as relates to the opioid epidemic, both sides of the aisle are to address that particular concern. While there may be broader implications relating to the medicaid reform, we ought to stand together as americans. Brangham dr. Trent haywood, chief medical officer Blue Cross Blue Shield, thank you so much. Thank you. Woodruff stay with us, coming up on the newshour bringing hope to children with a birth defect in india. How one undocumented family in wisconsin chose to come out of the shadows. And from our newshour bookshelf, a retelling of a greek tragedy. But first, we break down the latest results from our pbs newshour npr marist poll, the president s continued attacks against the media, and the battle over healthcare on capitol hill. Its time for politics monday with tamara keith of npr and stu rothenberg, Senior Editor at inside elections. And welcome to you both on this day before the fourth of july. Thank you for wearing red, white and blue. , so tam so, tam, the white house is saying they fully respect some version of the Healthcare Plan the republicans like is going to pass the senate and congress. What is your reporting telling you . Its possible, though at the moment Mitch Mcconnell described the effort to find a healthcare bill 50 republicans can support in the senate is like working with a rubrics cube you move one piece, and then some other piece moves out of the way. Its a very delicate negotiation thats happening right now. Its not clear that theyll get there. Some of the medicaid tests discussed in the last segment are a hangup. There are other hangups for more conservative republicans, but they are highly motivated to get to a win, so you cant discount the motivation that exists to find a way. Stu, i think ive asked this question before, what is the cal clues, if youre a Senate Republican, what are you thinking . I think the choice is not passing anything, or passing something thats going to be broadly unpopular but going to find a lot of support within republican and conservative circles. Thats the choice. For most republicans, i think for most republicans campaign strategists, passing something is a strong imperative. You have to do something for the base, even if you risk alienating a larger electorate. For individual members, that has different equations for someone like Lisa Murkowski in alaska, susan collins, rand paul, portman, they have their own ideas. Woodruff it looks like its hard to circle the circle or the square. At this point, it does look that way, but it kind of looked that way in the house, too. It looked like it was a dead bill so we were calling it a zombie bill and the next thing you knew they passed it. They came up with a compromise