TIME Healthcare

Nonprofit Hospitals Seize Low-Income Patients’ Wages

An investigation reveals the ongoing struggles of people too poor to afford health insurance but no poor enough to qualify for Medicaid

Many hospitals in the U.S. receive tax breaks in exchange for the community service of providing care to those who cannot afford to pay. But hospitals in at least five states employ aggressive debt collectors to garnish the wages of low-income patients with unpaid debts, a ProPublica/NPR investigation revealed Friday.

Hospitals in Kansas, Oklahoma, Nebraska, Alabama and Missouri pass debts along to for-profit collection agencies. People affected tend to be those who earn too much to qualify for assistance in states that rejected the Medicaid expansion in President Barack Obama’s health care law, but not enough to purchase health care on their own. The cost of health care services for the uninsured tend to be significantly higher than for people with health insurance.

Read more at ProPublica

TIME health

Changing the Face of Medical Education in the U.S.

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Zocalo Public Square is a not-for-profit Ideas Exchange that blends live events and humanities journalism.

We have a focus on wellness, prevention, chronic disease management, and finding ways to deliver health care in the most cost-effective setting

The United States spends more money on health care than any other country in the world. So how does Costa Rica outperform the United States in every measure of health of its population?

Costa Rica is healthier because its government spends more money than ours does on prevention and wellness.

In our country, we have left vast segments of the population without affordable care and we do not focus on wellness or chronic disease management. We don’t consistently control the glucose levels in diabetics and, consequently, too many go blind or lose a limb. Too often, hypertension goes untreated until the patient has a stroke or kidney disease. Then, all too often, these individuals go on medical disability with far more societal expense than the cost of the original health management.

Sadly, it has become the American way to leave many chronic diseases untreated until they become emergency situations at exorbitant cost to the U.S. healthcare system. For many patients, this care is too late to prevent life-changing disabilities and an early death.

When people ask me why we started the UC Riverside School of Medicine last year – the first new public medical school on the West Coast in more than four decades – I talk about the need for well-trained doctors here in inland Southern California. But we also wanted to demonstrate that a health care system that rewards keeping people healthy is better than one which rewards not treating people until they become terribly ill.

As we build this school, we have a focus on wellness, prevention, chronic disease management, and finding ways to deliver health care in the most cost-effective setting, which is what American health care needs.

We also teach a team approach to medicine—another necessary direction for our health care system. If you have a relatively minor problem, your doctor might refer you to a nurse practitioner or physician’s assistant for follow-up. This kind of team care makes financial and clinical sense, particularly since we have such a national shortage of primary care doctors. The good news: Even among physicians, the team approach, or medical home model, is gaining ground, with the Affordable Care Act accelerating change.

For all the talk about the lack of health insurance in this country, we don’t often discuss the other side of the problem – the fact that many Americans get more care than they need. You may have heard advertisements that you should have your wife or mother get a total body scan for Mother’s Day, because it will find cancer or heart disease. There is no evidence that this screening is a good idea. But in the U.S., we often encourage people to do things that have no proven benefit, and our churches or community centers sponsor these activities.

For all these reasons, we must shift the focus of health care to prevention. Two of the most profitable prescription drugs in the U.S., according to some sources, are those that reduce blood cholesterol and prevent blood clots—both symptoms of coronary heart disease, a largely preventable condition. Shouldn’t we be spending at least as much on prevention as we do on prescriptions? Closely connected to prevention is wellness. So many of our health problems in the United States are self-inflicted, because we smoke, eat too much, and don’t exercise. Doctors need to “prescribe” effective smoking cessation programs, proper diets and exercise as an integral part of care.

One way to accomplish this shift is to teach it to future doctors. At UC Riverside, we are supplementing the traditional medical school curriculum with training in the delivery of preventive care and in outpatient settings. Our approach is three-pronged..

First, we work with local schools and students to increase access to medical school through programs that stimulate an interest in medicine and help disadvantaged students become competitive applicants for admission to medical school or other professional health education programs. These activities start with students at even younger than middle school age, because that is when students begin to formulate ideas about what they want to be when they grow up. We focus on students from Inland Southern California because students who live here now will be among those best equipped to provide medical care to our increasingly diverse patient population. Doctors who share their patients’ cultural and economic backgrounds are better at influencing their health behaviors.

Second, we recruit our medical students specifically with a focus on increasing the number of physicians in Inland Southern California in primary care and short-supply specialties. Our region has just 40 primary care physicians per 100,000 people—far below the 60 to 80 recommended—and a shortage in nearly every kind of medical specialty. Students who have been heavily involved in service such as the Peace Corps, or who are engaged in community-based causes, are more likely to go into primary care specialties and practice in their hometowns.

Then, we teach our medical students an innovative curriculum. For instance, the Longitudinal Ambulatory Care Experience, called LACE for short, replaces the traditional “shadowing” preceptorship, where students follow around different physicians. Instead, our students participate in an a three-year continuity-of-care primary care experience that includes a sustained mentor-mentee relationship with a single community-based primary care physician. In this experience, they “follow” a panel of patients and gain an in-depth understanding of the importance of primary care, prevention and wellness. Our approach also includes community-based research that grounds medical students in public health issues such as the social determinants of health, smoking cessation, early identification of pre-diabetic patients, weight loss management and the use of mammograms to detect breast cancer.

We try to remove the powerful financial incentive for medical students to choose the highest paying specialties in order to pay off educational loans. We do this with “mission” scholarships that cover tuition in all four years of our medical school. This type of scholarship provides an incentive for students to go into primary care and the shortest-supply specialties and to remain in Inland Southern California for at least five years following medical school education and residency training. If the recipients practice outside of the region or go into another field of practice before the end of those five years, the scholarships become repayable loans.

Third, we are creating new residency training opportunities in our region to capitalize on the strong propensity for physicians to practice in the geographic location where they finish their post-M.D. training. Responding to our region’s most critical shortages, we are concentrating the programs on primary care specialties like family medicine, general internal medicine, and general pediatrics, as well as the short-supply specialties of general surgery, psychiatry, and OB/GYN. We are also developing a loan-repayment program for residents linked to practice in our region.

Ultimately, we hope our ideas for how to change health care will succeed and be adopted by others. It might take 30 years, but we believe what we are doing at the UC Riverside School of Medicine will change the face of medical education in the U.S.

G. Richard Olds is vice chancellor of health affairs and the founding dean of the UC Riverside School of Medicine. He wrote this for Zocalo Public Square. Zocalo Public Square is a not-for-profit Ideas Exchange that blends live events and humanities journalism.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Health Care

Number of Uninsured Americans Near Historic Low

Marketplace guide Jim Prim works on the Healthcare.gov federal enrollment website as he helps a resident sign up for a health insurance plan under the Affordable Care Act at an enrollment event in Milford, Delaware on March 27, 2014.
Marketplace guide Jim Prim works on the Healthcare.gov federal enrollment website as he helps a resident sign up for a health insurance plan under the Affordable Care Act at an enrollment event in Milford, Del. on March 27, 2014. Andrew Harrer—Bloomberg/Getty Images

Just 11.3 percent of Americans were uninsured in the second quarter

New federal government data shows the percentage of Americans without health insurance was at or near historic lows this year following the roll-out of the Affordable Care Act, and appears certain to fall to record levels next year.

The data released Thursday from the National Center for Health Statistics’ National Health Interview Survey found that 11.3 percent of Americans were without coverage in the second quarter of 2014, down from 13.1 percent in the first quarter and 14.4 percent throughout 2013. An analysis by the White House Council of Economic Advisers finds the drop in the uninsured to be the largest in four decades, amounting to roughly 9.7 million Americans getting insurance, consistent with other Affordable Care Act estimates.

“As this week’s data confirm, 2014 has seen dramatic coverage gains, gains matched or exceeded only by those seen in the decade of rapid progress that followed the creation of Medicare and Medicaid,” wrote Council of Economic Advisers Chairman Jason Furman and CEA Senior Economist Matt Fiedler in a blog post on the White House website. “Following this year’s gains, we estimate that the Nation’s uninsured rate is now at or near the lowest levels ever recorded across the 50 years for which we have data.”

Council of Economic Advisers

The new data does not include the nearly 2.5 million who have newly selected or re-enrolled for coverage in the latest round of open enrollment which began last month. Nor does it include those who’ve gained coverage in Medicaid or the Children’s Health Insurance Program since the second quarter—including 400,000 from September to October, according to new data from the Centers for Medicare & Medicaid Services—as more states expand access to the program with federal money under the law.

“These data imply that the uninsured rate will continue to fall in the year ahead, reaching low levels unprecedented in the Nation¹s history,” the economists wrote.

TIME health

How Obamacare Has Changed My Hospital

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Getty Images

So far in 2014, we have brought almost 7,500 new patients into primary care facilitating better preventative health and chronic disease management

The holidays are a convenient time to take stock of our blessings and opportunities, and to consider the challenges we have overcome in the previous year. As I reflect back, I have many things to be thankful for: good health, a supportive, healthy family, colleagues I enjoy and respect, and a job that I love.

This year, the Affordable Care Act (ACA) had a profound and rapid change on my professional life as a physician who works in an institution that forms part of California’s safety net for those in need. I’m the chief medical officer for San Mateo Medical Center, the county hospital and affiliated clinics in San Mateo County. I also provide primary care in one of our outpatient clinics.

As a result of the ACA, many patients we serve in our county became newly eligible for Medi-Cal, California’s Medicaid program. With this transition, they were offered far more choices: They had access to services that were previously unavailable, such as dental services and expanded mental health services. And, instead of having to travel to our specialty clinic in the middle of the county, they could be referred to “private” specialists in their own communities. Far from luxuries, these new choices will help promote preventative care and early disease intervention; patients who in the past might have delayed a gallbladder or hernia surgery (and ended up in the emergency department with pain) can get prompt treatment with their new Medi-Cal coverage.

Before the ACA, most of our patients were either uninsured or were enrolled in a county program that only covered services at our institution; they could not seek care elsewhere. So more choice for patients means more pressure on us; as patients become eligible for Medi-Cal, they may now choose to leave our organization to seek care elsewhere. I will try to avoid clichés as I write this, but there is one that is especially appropriate here: “pressure makes diamonds.” I am seeing a spectacular gem being built around me here in San Mateo, far from flawless but beautiful nonetheless.

Competition has forced us to confront some difficult questions, such as: What is the role of the safety net in this new era when many more people are insured? Why should we, as an institution, continue to exist? Thankfully the answers to these questions came fairly easily.

As an integrated health system, we offer a range of services from outpatient to emergency services to inpatient to long-term care; we offer a distinct advantage over the traditional fragmented health care system. Embedded in the San Mateo County Health System, we can work with our colleagues in Adult and Aging Services, Family Health Services, and Public Health to better meet all the psychosocial needs of our patients. For example, our partnership with the county’s Behavioral Health and Recovery Services has allowed us to embed behavioral health experts in our primary care clinics so that they can better address the mental health needs of our patients; this partnership also expands our ability to refer patients with drug and alcohol problems.

As our patients have moved to Medi-Cal, the ACA has brought our institution some new funding. But we realize that this will be short-lived; many of the new programs of the ACA are funded by reductions to other parts of the safety net. Such pressure is not new; safety net programs are often short of resources, forcing adjustments and redesigns. But the ACA ramps up this pressure on us to innovate, to find ways to do things cheaper and more efficiently.

Fortunately, we had a head start. We began almost a decade ago by redesigning our primary care services and establishing team based care. The county implemented an electronic health record in our clinics long before there was a mandate to do so. The ACA, through its resetting of priorities and funding mechanisms, offers us an opportunity to build on this foundation. We have repurposed some staff roles and brought in new staff members with new skill sets. For example, we have staffers who are specially trained to extract information from electronic records to better manage chronic disease, and pharmacists have been added to some primary care teams to assist with medication management.

The ACA has facilitated new partnerships with other community provider, allowing us to focus on those services that we provide well while partnering to provide services that are best delivered by others. This is a transition from the past, when we were the provider of last resort, forced to provide as much as we could and living without the services we could not provide by ourselves.

One of our biggest investments has been in what we call our Lean transformation. Lean, based on the Toyota Production System, is a proven performance improvement methodology. Lean healthcare principles focus on increasing value by constantly improving quality and reducing defects and other wastes. Within the San Mateo County Health System, this transformation is being organized through our LEAP Institute. LEAP stands for Learn, Engage, Aspire, and Perfect (as a verb). As part of LEAP, we bring together teams that include line staff to observe and analyze our core processes – and then design new improved approaches that reduce waste and improve outcomes.

There is much work ahead, but much has already been accomplished. So far in 2014, we have brought almost 7,500 new patients into primary care facilitating better preventative health and chronic disease management. The majority of these patients are newly eligible for Medi-Cal. We have also seen a reduction of more than 20 percent in the number of patients leaving our Emergency Department without being seen due to long waits. We have seen an improvement in our performance on patient satisfaction surveys in a variety of areas including the Emergency and Inpatient Departments. And our pharmacy has reduced the time patients must wait for their prescriptions by about 75 percent. These are just a few of the gains. We look forward to many more.

Dr. Chester Kunnappilly is chief medical officer for San Mateo Medical Center, the county hospital and affiliated clinics in San Mateo County. He is board certified in Internal Medicine and also serves the organization as a primary care physician. He is a graduate of Dartmouth College and the University of Pennsylvania Perelman School of Medicine. He wrote this for Zocalo Public Square. Zocalo Public Square is a not-for-profit Ideas Exchange that blends live events and humanities journalism.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

MONEY Health Care

5 Things You Need to Know for Today’s Health Care Coverage Deadline

Today is the deadline to buy individual health insurance if you want to have coverage on Jan. 1.

Since open enrollment began on Nov. 15, almost 1.4 million people have signed up for health coverage through the federal insurance exchange, and another 183,000 through state exchanges. With nearly 7 million people already participating, signups are on pace to meet the government’s projection of 9 million enrollees in 2015, according to the Kaiser Family Foundation.

If you’re one of the many who still need to enroll for 2015 coverage, here are five keys things you need to know before you visit your state’s health exchange website.

1. If you want health insurance on Jan. 1, you must enroll today. You still have until Feb. 15 to buy a 2015 plan, but you will have a gap in coverage if you enroll after today’s deadline. Coverage begins on Feb. 1 for people who enroll between Jan. 1 and Jan. 15. Sign up between Jan. 16 and the end of the month, and coverage won’t begin until March 1.

2. Some states are giving you more time and extending the deadline to get coverage by Jan. 1. For example, New York and Idaho’s exchanges will allow users to sign up until Dec. 20. To find out whether you’re eligible for an extension, visit your state’s marketplace exchange website through healthcare.gov.

3. You’ll be automatically re-enrolled if you bought on an exchange last year and do not renew coverage by today. If the health plan you signed up for is no longer offered, insurers can automatically enroll you in another policy similar to the one you have now. But you can opt out of any plan you’re automatically enrolled in and choose another up until Feb. 15.

4. Skip automatic enrollment and shop again, even if you liked your 2014 policy. The Department of Health and Human Services found that more than 70% of people who currently have insurance through the health law’s federal online marketplace could pay less for comparable coverage if they are willing to switch plans.

5. Costs have changed. Many plans will have out-of-pocket spending limits that are lower than the maximums allowed under the health law, according to an analysis by Avalere Health. But the tradeoff for those lower maximums may be a higher deductible, so be sure to pay attention to both figures when choosing your plan. You can also expect to see your premium change. Depending on where you live, that may be a good or bad thing. The premium for the second-lowest-cost silver plan in Nashville jumped 8.7%, while it dropped 15.6% in Denver, according to a study by the Kaiser Family Foundation.

MONEY Debt

The Unknown Debt That’s Dragging Down Your Credit Score

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Science Picture Co—Getty Images

A new report from the Consumer Financial Protection Bureau finds that 52% of all debt on credit reports is medical debt.

Even if you carry no debt on your credit card and pay your mortgage every month, another kind of debt might be ruining your credit: medical debt.

Almost 43 million Americans have overdue medical debt dragging down their credit, according to a new report from the Consumer Financial Protection Bureau. But 15 million of those people, by CFPB estimates, have no other dings on their credit. And debt collection agencies pursue fairly small medical debts: The average medical debt on a credit report is $579, and the median is just $207.

The scariest part? You may not know that you have a problem. “Many, many people don’t even know they have a bill—much less that it’s affecting their credit score,” says Christina LaMontagne of NerdWallet.

The CFPB attributes part of the problem to a debt collection practice called “parking.” The federal agency says some debt collectors will ding the consumer’s credit before even notifying the consumer that there’s an outstanding medical bill. “Parking” the debt where it can do the most damage motivates the person to pay it off quickly. Sometimes insurers ultimately pay the costs—after a consumer’s credit may have already suffered.

“This is viewed by some collectors as a way to minimize costs, but it is not how the system is supposed to work,” CFPB director Richard Cordray explained in a statement announcing the report. “And the collection process should not depend on harming consumers by adverse reporting before a consumer even learns she owes a medical debt. If it takes a drop in her credit score or an adverse action notice to make the point, then even more damage has been done to her financial standing.”

Even if debt collectors haven’t “parked” medical debt on your credit report, medical bills can be a vexing problem. Patients often struggle to learn the cost of their health care beforehand and understand their bills after the fact, LaMontagne says. A NerdWallet study found that 63% of Americans say they’ve received unexpectedly high medical bills. And bills are often wrong: In an audit of Medicare claims, NerdWallet found that 49% contained errors, resulting in an average 23% overcharge.

As a result, one in five Americans may be contacted by a collection agency about medical debt this year, by NerdWallet’s estimate. That’s why all consumers should be on guard. Here’s what to do to keep it from happening to you.

Control costs

Of course, the best way to avoid debt is to keep expenses low at the outset. But with medical costs, that’s easier said than done. The most important thing? Stay in network.

“Most of the very high charges I see are for people who inadvertently saw out-of-network providers,” LaMontagne says. “Print out the statement that says this doctor is in network and have that to protect yourself down the line.”

Also, if you know you’ll need a procedure like an MRI, shop around first. “Leverage price transparency tools whenever possible,” LaMontagne says. “People do see huge variations in prices.”

Save for high deductibles

While the Affordable Care Act has provided health insurance to an additional 10 million people, most Americans still get health coverage from their employers, and employers have been steadily raising deductibles, LaMontagne says. That means many consumers have to pay much more out of pocket before insurance covers the bulk of their costs. So more Americans may be hit with unexpectedly high bills.

But that doesn’t mean high-deductible plans are bad, LaMontagne is quick to add. It just means people with these plans need to shop around for procedures and budget for health care expenses by setting aside money in tax-advantaged savings accounts like a health savings account (HSA).

Ask for an itemized bill

“It’s really hard to read a straight bill as they usually come in the mail,” LaMontagne says. Luckily, you’re entitled to an itemized one.

When you get it, look for doctors and procedures you don’t recognize. Compare the bill against your explanation of benefits from your insurer to see if your insurance has been applied correctly.

If you think there’s a serious billing error, “call the doctor or call the insurance as your first line of defense,” LaMontagne says. But when all else fails, you can seek help from a professional medical bill advocate.

Check your credit report

Once a year, you’re entitled to a free credit report from each of the three credit bureaus: Experian, Trans­Union, and Equifax. So check every four months. Go to annualcreditreport.com to request your report. If you find an error, submit a dispute with the credit bureau.

Pay it off quickly

The good news: Fair Isaac, the company that creates FICO credit scores, announced earlier this year that medical debt will no longer drag down your credit score after it’s been paid off. Consumers with median credit scores and no other debt can expect to see their FICO score increase 25 points after paying off an overdue medical bill that’s been sent to collections.

So tackle medical debt quickly—it can make a big difference.

Read more:

TIME Healthcare

Abortion Complication Rates Are ‘Lower Than That For Wisdom Tooth Extraction’, Study Says

People who get abortions are less likely to have complications than people who have their wisdom teeth removed, finds a new study published in the journal Obstetrics & Gynecology.

Researchers at University of California San Francisco wanted to understand, from a medical standpoint, the safety of abortions, so they analyzed 54,911 of them performed from 2009-2010 on women, as well as the health care services the women received in the six weeks following the abortion.

Of those abortions, only 2.1% resulted in a complication—considerably lower than the 7% complication rate for wisdom tooth removal and 9% rate for tonsillectomy, the authors point out. Major complications that required hospitalization, surgery or a blood transfusion occurred in only 0.23% of the women in the study—126 cases. That’s lower than the rate of major complications for colonoscopy, says study author Ushma Upadhyay, PhD, an assistant professor in the department of obstetrics, gynecology and reproductive sciences at UCSF.

Fewer than 2% of abortions resulted in a minor complication. Medication abortions—a sequence often called the “abortion pill“—had the highest rate of complications at 5.2%, “the vast majority of which were minor and expected,” the study authors write. Those minor complications often mean they come back for another dose to complete the abortion.

According to the study, 23 states now have regulations that an abortion clinic must meet standards for ambulatory surgical centers. 8 states have hospital transfer agreement requirements, and 13 require hospital admitting privileges. The typical explanation for these regulations has been that safety is a factor, but the researchers hope to remove that as an issue. “Across the country, there are a record number of restrictions against abortions,” Upadhyay says. “I think basically that they’re supported by the public because they seem like they are needed”—but abortion providers sometimes can’t get admitting privileges, so abortion clinics often end up being shuttered, she says. “I hope [the data] clarifies that abortion is a safe procedure, and that it’s not this scary procedure it can be made out to be in the media or public policy,”

TIME Healthcare

Obamacare Economist Apologizes to Congress for ‘Glib’ Comments

The MIT economist had come under fire for controversial statements on the Affordable Care Act

Jonathan Gruber, the healthcare economist whose controversial comments about Obamacare have drawn fierce criticism in recent weeks, apologized Tuesday while under harsh interrogation by House Republicans.

“I’m a professor of economics at MIT. I’m not a politician or a political adviser,” Gruber said in his opening statement before the House Oversight and Government Reform Committee. He apologized for statements he called “glib, thoughtless and sometimes downright insulting.”

Gruber, and supporters of the Affordable Care Act in general, came under fire last month after video clips surfaced of the economist suggesting the ACA was passed in a way intended to confuse the public. “Lack of transparency is a huge political advantage. Call it the stupidity of the American voter, or whatever,” he said.

“I knew better, I know better, I’m embarrassed and I’m sorry,” Gruber said Tuesday. He insisted his comments were taken out of context and reflect a personal failing that should not reflect on the substance of the healthcare reform measure. “I behaved badly and I’ll have to live with that but my own inexcusable arrogance is not a flaw in the Affordable Care Act,” he said.

Committee Republicans leveled a harsh and sometimes insulting interrogation against Gruber.

“Are you stupid?” Committee Chairman Darrel Issa asked Gruber in his opening remarks. Issa questioned whether Gruber’s comments reflect substantive problems with the ACA and closed with a call for an independent audit of Gruber’s complex simulation model on the effect Obamacare would have on the cost of obtaining insurance, which was widely cited in debate over the ACA.

TIME

Morning Must Reads: December 9

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The early morning sun rises behind the US Capitol Building in Washington, DC. Mark Wilson—Getty Images

Exclusive: Putin Cut Ukraine Criticism From Speech Ahead of Peace Talks

Russia’s President apparently cut out a blistering critique of Ukrainian authorities from a Dec. 5 speech just moments before delivery, TIME’s Simon Shuster reports, as his position on the conflict with his country’s neighbor softens ahead of the next round of peace talks

How Sharing Your Health Data Could Change Medical Research

A slew of companies and organizations promise to tear down barriers to data collection and sharing by encouraging patients to give away their information

Senate to Release Torture Report

The report, expected on Tuesday, will shed light on the CIA’s use of so-called “Enhanced Interrogation Techniques” in the years after 9/11

President Obama Gets Personal With Stephen Colbert

Obama took his first and final turn on the Colbert Report Monday night, fending off verbal assaults from the faux-conservative comedian. The appearance on the satirical show was partly meant to highlight the ongoing open enrollment for health insurance in 2015

Second Nor’easter Is Coming

A second nor’easter in two weeks will slug the Interstate 95 corridor starting Tuesday, prompting winter storm watches and warnings in six states. The storm is expected to arrive with strong winds and 2 in. of rain from Maine to New Jersey

Prince William and Kate Just Met Beyoncé and Jay Z

The momentous encounter took place Monday night at the Barclays Center in Brooklyn, where both couples watched the Brooklyn Nets play the Cleveland Cavaliers, which meant LeBron James was also in the same room. The royal couples had courtside seats, and sat across from each other

New Batch of Ferguson Grand Jury Documents Released

Bob McCulloch, the prosecutor who oversaw the Ferguson police shooting inquiry, has released additional grand jury documents after not including a law-enforcement interview with a key witness in the initial public release of evidence

Portland Tells Uber to Stop Operating

The City of Portland filed a lawsuit against Uber on Monday, alleging that the ride-sharing service broke local codes. Officials said Uber was “in violation of the City of Portland’s Private for Hire Transportation Regulations,” in a suit just three days after Uber’s Portland launch

RNC Chairman Reince Priebus Set for Re-Election Bid

Republican National Committee chairman Reince Priebus formally declared his bid for a third two-year term on Monday evening in an email to members. “With such support it is impossible for me to say no,” Priebus wrote to members of the committee

Sierra Leone Has Highest Number of Ebola Cases

Sierra Leone has surpassed Liberia as the country with the highest number of Ebola cases, according to the most recent World Health Organization statistics. The WHO said transmission of the virus was “intense” in Sierra Leone

Malaria Deaths Nearly Halved Since 2000

According to the World Health Organization’s World Malaria Report 2014, the mortality rate decreased by 47% worldwide since 2000, and the number of infections went from 173 million the same year to 128 million in 2013

Actor Who Played The Addams Family Son Has Died

Ken Weatherwax, who played the Addams Family’s pudgy, cake-loving son, Pugsley, on the 1960s television hit, died of a heart attack on Sunday. He was 59. The actor was best known for his memorable role in the cult series, but later said the part stymied his acting career

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