What we know about the virus that's spreading across the globe.

Coronavirus

What's ahead in a post-Roe v. Wade world.

Axios Explains: Abortion

The developments that matter in how Americans are paying for drugs, treatment, insurance and more.

Health care costs

Opioids

The developments that matter in the fight over Obama's landmark health care law.

Affordable Care Act

The latest in the debate over whether the U.S. should shift to government-funded health care.

Medicare for All

The developments that matter in the fight over e-cigarette use.

Vaping

The developments that matter on issues that affect our immediate safety and health.

Public health

The U.S. faces a range of health care flashpoints — unaffordable drugs, opioids, vaping — as we debate whether to adopt universal care. For now, the Affordable Care Act is the law of the land, but Republicans want to issue it a final death blow.

Health

National

Axios Finish Line

This originally appeared in Axios Finish Line, our evening newsletter focusing on life lessons, leadership, and health and fitness. Sign up here. 

In America, we value family and work — but friendship often falls behind. Many of us have few or no close confidants, the data shows.

Why it matters: Friends help us get through the tough times and sweeten the good times. And a thriving society is filled with strong friendships.

Studies have shown friendship lengthens our lives, improves our performance at work, makes us better parents and broadens our minds.

But 27% of millennials say they have no close friends, and 22% say they have no friends at all, according to a recent YouGov survey.

Americans also lost touch with many of their friends when COVID hit, an American Enterprise Institute study found.

Friendship is a huge investment, says Jeffrey Hall, a professor at the University of Kansas. It takes around 50 hours of time spent together to go from being acquainted to being casual friends, per his research.

It takes about 90 hours to advance from casual pals to good friends.

And it takes more than 200 hours to become confidants.

Spending that time together became even harder when the pandemic isolated us and remote work and school kept us at home.

So if you're looking for friendship, here are some tips — gleaned from sociologists and psychologists — on how to make those connections.

Put in the hours. Cultivating a close friend takes time — and pays off.

Put in the face time. It can feel forced to try to build friendships virtually, Hall says. If you're looking for a friend, go to the office a few times a week if you're remote, or try an in-person workout class instead of a YouTube video.

Remember old friends. It can be easier to revive dormant ties than forge new ones. Many of us saw the value of reconnecting with old friends during the pandemic. Don't be afraid to reach back out to a buddy you've lost touch with.

Diversify. The ideal number of close friends to have is between three and five. Don't underestimate the value of casual friends or work buddies. Those in our larger circle can bring fresh perspectives, says Hall.

The bottom line: Life's short. Let's lean on friends! 

Axios Finish Line: Making friends

We value family and work — but friendship often falls behind.

Animated illustration of two halves of a sad face pendant on necklace chains gravitating towards each other and turning into a united smiley face

Mental health

Economy & Business

Health: NYC to offer COVID medication Paxlovid at mobile testing sites.

Vaccines: More kids got COVID shots in counties with active vaccinators, CDC says — Pfizer to begin testing universal coronavirus vaccines — FDA: Updated COVID boosters will roll out in the fall.

Politics: Clarence Thomas suggests COVID vaccines are created with cells from "aborted children" — Biden administration orders $3.2 billion in new COVID shots.

Economy: COVID disproportionately hurt renters of color, study says.

Global: Total confirmed cases as of 10 p.m. ET on Friday: 548,245,885 — Total deaths: 6,337,563 — Total vaccine doses administered: 11,748,944,336. 

U.S.: Total confirmed cases as of 10 p.m. ET on Friday: 87,778,434 — Total deaths: 1,017,819.

What should I do? Axios asked the experts:

When you can be around others after contracting the coronavirus

Traveling, asthma, dishes, disinfectants and being contagious

Answers about the virus from Axios experts

Download our app and follow the Coronavirus channel to get the latest news.

Editor's note: Johns Hopkins University stopped reporting U.S. COVID-19 recoveries on its dashboard on Dec. 15, citing a Coronavirus Tracking Project post that explained the national data is incomplete since several states do not keep records of recovered patients. It stopped reporting global recoveries and began reporting doses administered in May. 

COVID-19 dashboard

The latest headlines that you need to know.

Illustration of a covid particle reflected in a rearview mirror

Health Care

World

Politics

President Biden has made the COVID-19 crisis and a post-Trump return to national unity and traditional democratic ideals his top priorities. From vaccinations to stimulus to schools, Biden is seeking bipartisan compromise while showing a willingness to use executive authority and bare Democratic majorities in the U.S. House and Senate to implement his policies. Republican leaders are navigating deep party divisions over if and how to move beyond former President Trump.

Politics & Policy

China is becoming the most formidable rival America has faced, and the risk of confrontation with Russia, North Korea or Iran still looms. Authoritarians are rising, the chaotic Afghanistan exit revealed the limits of U.S. power, and the pandemic, climate change and other critical challenges continue to pose grave threats.

New York lawmakers advanced an amendment on Friday to enshrine the right to get an abortion in the state's constitution, a week after the Supreme Court overturned Roe v. Wade.

The big picture: The amendment passed in the state Senate and Assembly during an extraordinary session that Gov. Kathy Hochul (D) called. The process to change the New York Constitution requires that lawmakers pass the change during the next regular legislative session, as well. Advocates hope voters will be able to decide on the amendment in 2024.

In general, New Yorkers will not get to vote on the bill during this year's upcoming election.

Don't forget: Access to abortion before viability is already protected in New York under state law.

Earlier this month, Hochul also signed into law a series of bills to protect abortion providers in the state, as well as patients coming from out-of-state to access the procedure, from bans in red states.

Details: The Equal Rights Amendment says that "[n]o person shall be denied equal rights under the laws of this state or any subdivision thereof based on that person's race, color, ethnicity, national origin, disability, or sex including pregnancy and pregnancy outcomes, sexual orientation, gender identity, and gender expression."

New York State Senator Liz Krueger said in the bill's summary that it is important to include discrimination based on pregnancy (which includes abortion) because "a lack of clarity on whether pregnancy discrimination transgresses the federal constitution still exists."

Zoom out: New York joins California and Vermont as a state taking steps to make abortion access a state constitutional right.

Voters in California and Vermont will get to choose in November whether they wish to amend their respective state constitutions in support of abortion rights.

Go deeper: Where abortion access is guaranteed without Roe v. Wade

New York advances constitutional amendment to protect abortion access

Advocates hope voters will be able to decide on the amendment in 2024.

New York

Democrats hauled in $80 million within one week of the Supreme Court decision overturning Roe v. Wade, AP reports.

Why it matters: The numbers indicate that the issue has struck a nerve and is galvanizing voters to funnel money into the party ahead of November's elections.

By the numbers: ActBlue, the Democratic Party's online fundraising platform, raked in over $20 million in the first 24 hours after the Supreme Court struck down Roe.

That number rose to over $51 million by Tuesday and surpassed $80 million by Friday.

Yes, but: Party officials tell the AP most of that money is going to national campaigns instead of state and local races, which will now shape abortion policy.

What they're saying: In the aftermath of the Supreme Court ruling, many are calling on Democrats to invest more heavily in down-ballot campaigns.

"We are entering a new chapter in American democracy where state officials must be prepared to step into a stronger leadership role for the nation, and serve as the last line of defense against these regressive trends on our freedoms," New York state Sen. Andrea Stewart-Cousins (D), chair of the Democratic Legislative Campaign Committee, wrote in a recent post on the progressive media platform Democracy Docket.

The big picture: Abortion rights advocates are already bringing the next legal battle to the states as many move to ban abortion access.

Go deeper: Abortion rights activists plot next legal steps

Democrats raised $80M in a week after Supreme Court overturned Roe

The Democratic Party's online fundraising platform raked in over $20 million in the first 24 hours after the decision.

Photo of Nancy Pelosi speaking from a podium with a sign that says "#ProtectRoe" as other Congress members stand behind her

House Speaker Nancy Pelosi, joined by House Democrats and abortion rights advocates, speaks during a press conference at the U.S. Capitol in Washington, D.C. on May 13, 2022. Photo: Stefani Reynolds/AFP via Getty Images

Democrats

What will happen immediately in each state now that Roe v. Wade has been overturned

Data: Axios research; Cartogram: Sara Wise and Oriana Gonzalez/Axios

Abortion will become illegal in at least 13 states after the Supreme Court's decision to overturn Roe v. Wade, and more will quickly follow suit.

Why it matters: The Supreme Court's Friday ruling grants states the legal authority to ban the procedure at any point in pregnancy — including at fertilization. 

Where it stands: With the court's ruling to ultimately overturn the precedents that established the constitutional right to an abortion, a patchwork of state laws will now govern the procedure.

In the U.S. 13 states have what are known as "trigger" laws — abortion bans that take effect shortly after the court overturns its precedents.

In the wake of the Supreme Court decision, abortion has already become illegal in Arkansas, Missouri, Oklahoma and South Dakota.

The "trigger" laws of Louisiana, Utah and Kentucky took effect immediately after the Supreme Court's decision, but they have been temporarily blocked.

The "trigger" laws in Idaho, Tennessee and Texas say that they take effect a month the Supreme Court's judgment overturning Roe is issued. In Mississippi, the law is set to take effect 10 days after being certified by the state's attorney general, who did so on June 27.

Abortion providers have filed lawsuits challenging abortion bans in Idaho, Texas and Mississippi.

The laws in Wyoming and North Dakota require some sort of state action in order for them to take effect. As of June 27, officials in those states have yet to take steps to activate the bans.

The big picture: Four states — Alabama, Louisiana, Tennessee and West Virginia — have amended their state constitutions to prohibit any protections for abortion rights.

Oklahoma enacted a bill in late April that would modify the language of the trigger law to ban abortions if the court “overrules in whole or in part” Roe and Planned Parenthood v. Casey. 

Several other states don't have trigger laws in place but will likely move quickly to ban or tightly restrict the procedure now that the court has cleared the way:  Florida, Indiana, Montana and Nebraska would be prime candidates, according to analysis from the Guttmacher Institute, a reproductive rights research organization.

Alabama, Georgia, Iowa, Ohio and South Carolina have all enacted restrictive laws that were then blocked by federal courts, and some of them have already been brought back.

States with trigger bans following SCOTUS overturning of Roe v. Wade

Data: Guttmacher Institute, Axios research; Table: Simran Parwani/Axios

At least nine states have pre-Roe abortion bans still on the books, but many of those would not immediately take effect in the disappearance of Roe, Elizabeth Nash, a lead state policy analyst for the Guttmacher Institute, told Axios back in October.

"It would take some kind of action," Nash said, such as an attorney general issuing an opinion, a state filing a court case, etc.

For some states, it "might" even be easier to pass a new law prohibiting abortion instead of starting the process to make a pre-Roe ban take effect, Nash noted.

Yes, but: At least 16 states and Washington, D.C., have enacted laws that automatically keep abortion legal even with Roe overturned.

Colorado in March became the latest state to codify the right to have an abortion. Abortion-rights advocates in the state are considering pursuing a ballot measure in 2024 to enshrine abortion access in the state's constitution. 

In Vermont, where abortion access is already guaranteed, lawmakers have advanced an amendment, which voters will decide on in November, that would protect the right to get an abortion under the state's constitution — which could make it the first state to do so. 

Zoom in: In states like New Mexico, Kansas, Montana, Alaska, Florida and Minnesota, the right to an abortion is protected by a state Supreme Court precedent, according to the Center for Reproductive Rights.

However, lawsuits could be brought in the more conservative states where there is an anti-abortion majority of lawmakers and politicians that could challenge these decisions.

Red states race to enact new abortion restrictions

Abortions could require 200-mile trip if Roe is overturned

The Supreme Court's abortion showdown arrives

The abortion trigger laws that have gone into effect now that Roe v. Wade is overturned

A patchwork of state laws will now govern the procedure.

Abortion

Map showing what states have "trigger" laws and what states have laws protecting abortion.

Abortion providers on Friday filed a lawsuit directly with the Oklahoma Supreme Court to challenge two abortion bans in the state.

Driving the news: Nearly all abortions have been unavailable in Oklahoma since late May, when Gov. Kevin Stitt (R) signed into law a bill banning abortion that is enforced by lawsuits from private citizens.

In early May, the governor signed a bill that bans abortion past the sixth week of pregnancy and is also enforced by private civil action. Both lawsuit-enforced bans are being challenged in court.

Oklahoma also has a "trigger" law that took effect shortly after Roe's fall.

Details: The lawsuit challenges a 1910 pre-Roe total abortion ban that was reinstated by the state's attorney general after the Supreme Court overturned Roe v. Wade, and a law enacted earlier this year that makes performing an abortion a felony punishable by up to 10 years in prison.

The plaintiffs in the case argue that both bans violate "the strong protection for individual liberty in the Oklahoma Constitution."

They also say that the 1910 law was declared unconstitutional in 1973, when Roe was first decided.

What they're saying: "For over a month, Oklahomans have been completely deprived of abortion access, and they cannot wait one moment more," said Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America, which filed the lawsuit.

"Today, we are asking this court not only to quickly block the state’s cruel abortion bans, but to do its job and protect the people of Oklahoma. Already, thousands of Oklahomans have been forced to either find a way to get out of state for essential care or carry a pregnancy to term — bearing the serious risks that come with it."

Go deeper: Nearly all abortions are illegal in 9 states but more bans are coming

Editor's note: This post has been corrected to reflect that the bill that is enforced by lawsuits from private citizens was signed in May (not April). (edited) 

Abortion providers sue Oklahoma to challenge bans

Nearly all abortions have been unavailable in the state since late April, when a near-total ban was enacted.

Picture of the Supreme Court building with abortion rights activists marching in front of it

Abortion-rights activists protest outside the U.S. Supreme Court on the last day of their term on June 30. Photo: Kevin Dietsch/Getty Images

Children aged 5 to 11 who lived in counties with an active COVID-19 vaccine provider had significantly higher vaccine coverage in the six months after pediatric shots became available, the CDC reported on Thursday.

Why it matters: Experts say younger kids remain at risk of severe illness from the virus, noting about half of U.S. counties lack an active pediatric clinic, family medicine clinic or federally qualified health center.

Findings: As of early June, 36% of children aged 5 to 11 received one or more doses of COVID-19 vaccine, the CDC said.

Vaccine coverage was 1.66 times higher in counties with at least one pharmacy or other active COVID-19 vaccine providers than in counties with no active providers from November through April after the CDC recommended shots for that age group.

Active providers were primarily concentrated in the Northeast, Midwest and several counties in the West.

Between the lines: Previous studies have shown how pharmacies filled a critical role in expanding access to COVID-19 shots.

But some parents remain concerned about vaccine safety and effectiveness or perceive the risk for serious COVID-19–associated illness to be low in kids.

Public health experts say one key to boosting uptake is the presence of pediatricians, who are among the most trusted sources of reliable information about vaccines. The CDC said the availability of pediatric clinics was associated with the largest difference in vaccination coverage.

More kids got COVID shots in counties with active vaccinators: CDC

Kids 5 to 11 likelier to get COVID shots in counties with active vaccination centers.

Photo: Michael Nagle/Bloomberg via Getty Images

COVID-19 vaccines

McKinsey & Company found opportunities to boost opioid manufacturers' sales amid the addiction crisis from 2004 to 2019, new documents published by the University of California at San Francisco and Johns Hopkins University show.

Why it matters: When one opioid fell out of favor with federal regulators, drugmakers created and marketed another, further stoking the crisis. 

The more than 114,000 pages of documents show how McKinsey had a much broader role advising the companies than was previously documented, providing growth and turnaround plans to combat the loss of revenue from opioid lawsuits, advice on how to deal with regulators and strategies to boost sales while concern about the addictive properties of the painkillers grew. 

Flashback: Nearly half a million people died from an opioid-related overdose from 1999 to 2019, according to the CDC, and the proliferation of prescription opioid addiction gave way to heroin then synthetic opioid use, which continued the upward trajectory of opioid deaths through 2019.

Despite lawsuits, regulation and backlash during the height of the opioid epidemic, McKinsey continued to consult with leading opioid drugmakers Purdue Pharma, Endo Pharmaceuticals, Johnson & Johnson and Mallinckrodt, the new documents show.

The new documents reveal "a sweeping and detailed depiction of a firm that became a trusted adviser to companies at the core of an epidemic that has claimed half a million American lives," the New York Times reported.

The other side: In 2019, McKinsey cut ties with opioid manufacturers, and in early 2021, the company reached a $573 million settlement agreement with 47 states, five territories and the District of Columbia, which called for the release of the internal documents.

"As we have said before, we recognize the terrible consequences of the opioid epidemic and have acknowledged our role in serving opioid manufacturers," a McKinsey spokesperson said in a statement in response to the documents being published on Thursday. 

Documents reveal McKinsey's role increasing opioid sales until 2019

More than 114,000 documents reveal the role McKinsey played in consulting with drug companies at the height of the opioid epidemic.

Illustration of the score line on a pill in the shape of an upward arrow instead of straight across.

Opioid epidemic

Axios Vitals

Patients will soon have a clearer picture of what insurers and employers pay for health care thanks to a federal rule that kicks in today — if a collection of health tech companies can make the trove of data understandable.

Why it matters: Patients often have no idea what a procedure or service costs — and have little ability to comparison shop — until they're left holding the bag with a higher bill than they expected.

Driving the news: Starting today, insurers will have to list their negotiated rates with in-network providers, as well as out-of-network allowed amounts and billed charges for certain items and services. 

It's part of a Trump-era price transparency rule that also required hospitals to start posting negotiated rates in 2021 (although many hospitals have been slow to comply.) 

Enforcement of the payer version of the rule was delayed until July 1, 2022. Insurers who don't release the info will face a penalty of $100 per person per day per violation. 

What they are saying: "It's like the biggest milestone in U.S. health since the ACA was rolled out. It's massive what's about to happen," said Chris Severn, co-founder and CEO of Turquoise Health, a San Diego-based tech start-up that works with price transparency data.

"On all these insurance company websites, in all of these files, the real price of health care is coming out. Not just for hospitals, but for all types of services," Severn told Axios.

Behind the scenes: There are a number of tech companies, like New York-based Ribbon Health — which just launched a partnership with Turquoise — eager to get their hands on this massive trove of machine-readable files to translate it for use by consumers.

"This is a huge moment for the industry," Nate Maslak, co-founder and CEO of Ribbon Health told Axios. "We've finally hit this moment in time where this can be accessible."

While some consumer price comparison tools exist, including on some insurer and provider websites, the numbers don't always match, and some tools only offer potential ranges of prices or are based on historical claims data which can be outdated.

"I think for a long time we just kind of said: This is just impossible. I guess we'll just have to live with it," Maslak said. "In no other industry would we do that. Ever. I can't imagine going to a restaurant and saying: 'Well, this chicken might be $30 or $400 and we'll just have to find out.'"

Be smart: This push for price transparency has been years in the making, it'll probably take a while to impact the average consumer.

The idea of shopping for a CT scan online has obvious appeal, but health care is filled with unfulfilled, tech-driven promises. 

Some researchers like Harvard's Amitabh Chandra also assert that consumers just aren't as inclined to shop for health care the way they would for a car or cell phone. 

Tech tools will likely start by offering more directional information such as offering an idea of where patients might save the most money on their care,  "We're at the very first inning," Maslak said.

Reality check: While tech companies will have access to a lot of data, the law didn't require payers and providers to work together to define what a total episode of care means, said Seth Cohen, president at Cedar, a New York-based tech company that syncs payer and provider billing.

"You look up a hip replacement. Does it include anesthesiology? Does it not? Do we have any post-care or follow-up? Or no post-op? Even if [the payer and provider] both display hip replacement, they can display wildly different prices."

And while the idea of price transparency is aimed at driving down costs by allowing consumers to shop, it could actually drive up prices.

"I don't know about you, but I don't like shopping for the cheapest doctor," Cohen said. "It's like buying a bottle of wine. I don't want to be the guy who chooses the cheapest bottle of wine on the menu."

But Cynthia Fisher, founder and chairwoman of PatientRightsAdvocate.org said the price transparency shifts the power not only to patients, but to employers.

"It's the empowered consumer and the empowered employer and union that are going to drive these costs down because they aren't going to tolerate any longer being overcharged once they see the data and are able to easily parse it," she said. 

What to watch: The next step is the AI-driven tech tools getting better at predicting bundles of care that often occur together, Severn said.

Ultimately, the goal is total accuracy, he said. "Pre-packaged, upfront prices that do not waver at all in your encounter," he said. "You pay upfront and you're done. You'll never see another bill."

"I can't wait in the next couple of years when the patient is spoiled and that's what they expect."

Consumers will soon get access to huge amounts of health care price data

Patients will soon have easier access to more accurate price estimates before getting a health care service, thanks to a federal law — and a collection of health tech companies racing to take advantage of it.

Illustration of a caduceus with a price tag

Health tech

Representatives for some Indigenous tribes tell Axios they have no plans to set up abortion clinics on their lands and would take offense at any non-Native Americans, including progressives, telling them what to do. 

The big picture: The Biden administration has made clear it has no plans to pursue such moves, telling progressives who leaned on them to set up abortion clinics on federal land in red states that they're underestimating the legal risks and other complications. 

Vice President Kamala Harris told CNN,  "It's not, right now, what we are discussing." White House press secretary Karine Jean-Pierre told reporters there are "dangerous ramifications" to providing abortions on federal lands. 

But tribal leaders and legal experts are speaking out as well to ensure their position is clear.

What they're saying: "It's an overreach for people to assume, or presume that a tribe would want to do this in the first place," Stacy Leeds, a professor of law and leadership at Arizona State University Law who previously served as a Cherokee Nation Supreme Court justice, told Axios.

"We have an arc of historic oppression that's really undermined a tribal ability to respond," Lauren van Schilfgaarde, the director of UCLA Law School's tribal legal development clinic and a member of the Cochiti Pueblo, told Axios. "And so the idea that tribes have some magic balm, it's just frustrating."

Even if tribes did want to set up private abortion clinics, Leeds noted, "It would have to not have any federal money because it would be restricted with the Hyde Amendment. And it would need to involve tribal citizens only."

It's also unfair for non-Natives to make safe harbor demands given the U.S.'s history of exploitation, van Schilfgaarde said.

Principal Chief Chuck Hoskin Jr. of the Cherokee Nation of Oklahoma said in a statement to Native News Online that "Cherokee citizens hold a range of views on this subject. Now is not the time for politicians or candidates for office to use the issue to demonize Tribes and drive a wedge between citizens..."

Driving the news: Following the Supreme Court decision overturning Roe v. Wade, U.S. Rep. Alexandra Ocasio Cortez (D-N.Y.) and Sen. Elizabeth Warren (D-Mass.) demanded the Biden administration consider building abortion facilities on federal lands located in red states. 

Warren, Murray (D-Wash.), and 23 other Senate Democrats also signed a letter asking Biden to take executive action.

Indigenous tribes push back on calls to open abortion clinics on federal lands

Some tribal leaders are speaking out to ensure their position is clear.

Sections

Axios Local

Axios gets you smarter, faster with news & information that matters.

About

Subscribe