Axios

Mayor Nan Whaley of Dayton, Ohio, which is host to the county that tops the U.S. for overdose deaths, told fellow mayors Friday that people don't understand how expensive and time-consuming fixing the opioid epidemic in America will be: "Number one, it's going to be incredibly expensive…it will take around 5 years. Some people thing this can be fixed in thirty days. That's a fallacy and you're setting people up to die."

Other highlights from the panel:

• "Substance abusers" are more stigmatized than "people with substance abuse disorders," Joyce Linehan, the chief of policy for the City of Boston, said.
• Dr. Josh Sharfstein, Director of the Bloomberg American Health Initiative pointed out that if people start addiction treatment in emergency departments, as opposed to getting referred out, success rates in treatment more than double. Rhode Island serves as an example of how this works.

Update: "We need to make sure the national government really does more than just talk on this issue…We cannot have another failed policy coming from national government…my city and other cities across the country simply cannot afford it," Whaley said at the press conference.

Investors have filed a class-action lawsuit against Envision Healthcare, alleging the company and its emergency room outsourcing business EmCare did not disclose that EmCare overcharged patients and sent out surprise medical bills. The company's "revenues were likely to be unsustainable after the foregoing conduct came to light," according to the complaint.

Surprise billing occurs when patients go to a hospital in their insurance network but are treated by doctors who are out-of-network. The lawsuit cites a July New York Times story that featured a study showing out-of-network emergency room bills and use of high-paying medical codes increased after hospitals hired Envision and EmCare. An Envision spokeswoman said the company does not comment on pending litigation.

Why it matters: The lawsuit is a direct response to research and newspaper coverage about billing practices that have plagued the health care system for years — practices that lawmakers and policy experts agree should be fixed.

The White House has so far failed to coordinate with a coalition of national and local Latino organizations to develop community outreach campaigns ahead of the ACA's open enrollment deadline, according to a report from Talking Points Memo.

• By the numbers: Latinos have benefitted the most of any ethnic group from the ACA with the greatest drop in their uninsured rate and expanded coverage for 4 million adults.
• What's missing: The Obama administration leveraged Latino community resources to educate and prep local groups ahead of the open enrollment deadline. Now, these Latino groups are doing it themselves, which they acknowledge is much more difficult without the federal government's help.
• Why it matters: It's only August, so it's possible that the Trump administration will just begin the outreach efforts later. But it also could be an early sign that the administration just isn't interested in promoting a law it tried to repeal.

The big questions about the stability of the Affordable Care Act marketplaces have focused on how fast premiums will rise, and how many plans will participate. But an equally important question, and the heart of the matter politically, is: How many people will be affected by the sharp premium increases?

Data: Kaiser Family Foundation analysis of data from Mark Farrah Associates, Healthcare.gov, and KFF Survey of Nongroup Health Insurance Enrollees; Chart: Andrew Witherspoon / Axios