Axios

An investor uprising is starting to bubble over at Mylan, which has been under fire for hiking the prices of EpiPens and other drugs. Mylan released the vote tallies from its June 22 shareholder meeting, and the picture wasn't pretty.

Why it matters: It's a prime example of the megaphone that activist investors have today, and of the tone deafness that some in the pharmaceutical industry have toward their business operations.

A Republican Senator told the New York Times on Tuesday that President Trump gave the impression that he "did not have a grasp of some basic elements of the Senate plan" and that he was "especially confused" by the idea of opponents calling the bill "a massive tax break for the wealthy." More aides described Trump as uninterested in the particulars of health care.

"There would be times when he would describe what was clearly Medicare...but say Medicaid, and when we pointed that out, he would say, 'That's what I said, Medicare and Medicaid."

President Trump's rallying behind the Senate GOP's health care bill continued this afternoon as he tweeted that the bill actually increases Medicaid spending rather than cutting it:

Our thought bubble: The Senate bill would cut Medicaid spending by $772 billion over a decade from its levels under the Affordable Care Act. Some Republicans argue, as the the New York Times summed up yesterday, that health care spending under the ACA is dangerously out of control, so the Senate bill doesn't include "cuts," it simply increases Medicaid funding at a more reasonable rate.

Anthem will only sell health plans on Nevada's Affordable Care Act exchange in three counties next year: Clark (where Las Vegas is located), Nye and Washoe. The 14 counties Anthem is leaving could potentially have no ACA options in 2018 — making a total of 61 counties throughout the country that may have no insurers selling ACA coverage, per the Kaiser Family Foundation.

Why it matters: Anthem, one of the largest ACA insurers and a well-known Blue Cross Blue Shield brand, has already exited the exchanges in Indiana, Ohio and Wisconsin.

Yes, but: Kaiser Family Foundation data show that even though Anthem is exiting 14 total counties, the insurer will offer plans in Nevada's most populated areas that cover 90% of people in the individual market, raising questions about why Anthem chose to exit the state's more rural counties. (An aside: Anthem supports the Senate's health care bill, but Republican Dean Heller of Nevada currently does not.)

President Trump touched on health care during an energy roundtable Wednesday, saying he'd had a "tremendous meeting" yesterday with Republican senators, and that although the Senate bill will be "very tough" to get approved, he thinks the GOP will "get at least very close" to passing it, and will ultimately get it over the line. More from Trump:

• "Obamacare is dying, it's essentially dead... It's been a headache for everybody, it's been a nightmare for many and we're looking at a health-care that will be a fantastic tribute to your country."
• "It will be far better than Obamacare and much less expensive for the people and also much less expensive for the country."
• From the WH pool: "Healthcare is working along very well...we're gonna have a big surprise. We have a great Healthcare package. ... we're going to have a great, great surprise."

NPR and PBS NewsHour are out this morning with a Marist poll showing 17% approval of the Senate's healthcare plan, and 21% approval of the GOP's handling of health care. That may partly reflect how the question was asked.

• But it's a disgrace when your party controls the whole federal apparatus. And it shows the foreboding feat Senate Majority Leader Mitch McConnell faces in trying to revive repeal-and-replace after his stunning gamble to punt the vote until after the July 4 break.
• The announcement was followed by a swarm of defections — opposition was suddenly cost-free.
• The lull gives more time for negotiation but, more likely, more time for opposition to metastasize and spook senators when they're home for the holiday.