Almost daily headlines about insect-borne diseases menacing the U.S. highlight the expanding threat posed by mosquitoes and ticks.

Why it matters: Longer, hotter, summers and changes in land use can spread diseases to new places, or compound the misery where they already exist.

• Global warming is "changing where mosquitoes and ticks live, and thus what diseases are moving around in different regions," CDC director Mandy Cohen said Wednesday.

Driving the news: The death of a New Hampshire resident from eastern equine encephalitis, or EEE, brought the risk home this week.

• The CDC has also warned this summer about an increased risk of dengue fever, which is spread by the same type of mosquitoes that carry the Zika virus and chikungunya.
• West Nile Virus — recently blamed for the hospitalization of Anthony Fauci — has become a perennial threat throughout much of the continental U.S. The same goes for Lyme disease, which was once viewed as a summertime nuisance and now is the most common vector-borne illness in the Northern Hemisphere.

Zoom in: In the U.S. in particular, experts say the environment for insects has become far more hospitable with temperatures rising further north.

• "We're seeing diseases that used to be "tropical." Well, now parts of the U.S. can count," Megan Ranney, dean of the Yale School of Public Health, told Axios.
• "Ticks are not dying over the winter because it's not getting cold enough, so it's making Lyme disease spread. And then we're seeing other tick-borne diseases, like Powassan virus, start to spread. It is a predictable but potentially deadly consequence of climate change."

Changes in land use are another factor. Lyme disease is thought to be spreading in large part because of the suppression of wildfires, which has allowed for the maturation of forests and animals that allow ticks to thrive.

• Then there's travel and globalization, key elements behind Oropouche fever, which is transmitted by mosquitoes and midges and entered the U.S. and Europe via travelers who had been to Cuba and South America.

Read more

Growing numbers of Americans are buying into misinformation about COVID-19 vaccines, according to a new national survey, with more than one in five believing it's safer to get the virus than to get a shot.

Why it matters: Belief in misconceptions is stoking vaccine hesitancy with the nation facing a summer surge of infections, more COVID-related hospitalizations, and updated shots now reaching pharmacy shelves.

The big picture: The findings from the University of Pennsylvania's Annenberg Public Policy Center are further evidence of how intense backlash to the government's at times muddled COVID response eroded trust in public health.

What they found: 28% of respondents incorrectly believe that COVID-19 vaccines have been responsible for thousands of deaths, up from 22% in June 2021. The percent of those who know this is false declined to 55% from 66%.

• 22% believe the false idea that it's safer to get a COVID infection than to get the vaccine, up from 10% in April 2021, months after the shots were rolled out.
• The percent incorrectly believing that the Covid-19 vaccine changes people's DNA nearly doubled to 15% from 8% in April 2021.

Between the lines: Previous polling has shown sizable numbers of Americans who believe COVID vaccine misinformation know they're at odds with scientists and medical experts, suggesting that educating people on the science behind vaccines won't change many minds.

More here

The Biden administration and Johnson & Johnson are sparring over a company plan to change how safety net hospitals get discounts on two popular drugs under a federal program, Axios' Adriel Bettelheim wrote first in Pro.

Why it matters: J&J struck agreements to lower the list prices on the drugs — the blood-thinner Xarelto and the anti-inflammatory Stelara — as part of the first round of Medicare price negotiations.

Driving the news: The company last week told hospitals in the federal 340B drug discount program that it will require them to buy the drugs at full price starting in mid-October, then submit claims data to receive a rebate once they're verified.

• The program requires drugmakers to give large discounts on outpatient drugs to providers serving low-income patients. Savings typically come at the time of purchase.
• The Health Resources and Services Administration, which administers the program, told J&J its rebate plan doesn't comply with federal law and requires the Health and Human Services secretary's sign-off, an agency spokesperson confirmed to Axios.
• HRSA "will take appropriate actions as warranted," the spokesperson said.
• A J&J spokesperson said the 340B program isn't meeting its goal of allowing safety net providers to obtain discounted medicines for vulnerable patients and that the company "is implementing reasonable, standard business practices used across other government programs and contracts."
• The rebate model is consistent with the 340B statute, which specifically references rebates as a payment mechanism, the spokesperson said.

340B Health, which represents providers in the program, is urging HRSA to move quickly and warn other drugmakers against similar rebate plans, saying they impose new costs and administrative burdens.

• The American Hospital Association similarly said HRSA should take steps, including assessing civil monetary penalties against J&J for overcharging hospitals.

If you need smart, quick intel on health care policy for your job, get Axios Pro.

Sanford Health is leaving Humana's Medicare Advantage plan network, saying the health insurer delays patient care and denies coverage, the Minnesota Star Tribune reports.

Why it matters: It's the latest instance of friction between providers and insurers as Medicare Advantage coverage swells and MA plans tighten control of how health services are used.

• The Sioux Falls, S.D.-based Sanford Sanford operates 48 medical centers and more than 200 clinics.

Driving the news: Pre-treatment approvals and payment delays are at the root of many of the disputes.

• Houston-based Memorial Hermann Health System and Newark, Del.-based ChristianaCare have also dropped out of Humana's MA network this year, per a roundup from Becker's Hospital Review.

What they're saying: In a statement to Axios, Sanford said the pullout was "the right thing to do for our patients."

• "We have attempted to work with Humana for several years, but unfortunately, we have continued to experience delays in patient care, barriers to scheduling, and denials of coverage causing financial burden and undue stress to our patients," the health system said.
• Humana told Axios the termination was surprising, saying, "We remain open to working with them on a fair and equitable agreement that keeps health care coverage affordable for our members and avoids the significant disruption that this decision will cause."

💰 UnitedHealth pledged to be a hands-off owner after buying a Connecticut medical group. Then it upended how doctors practice. (STAT)

🏥 Former patients of a Yale Fertility Center accused of neglect say troubling signs were there all along. (USA Today)

🫸 Using subtle social cues, or nudges, to guide people's decision-making is making inroads in health care, with mixed results. (Undark)