There’s a clinic that’s right in Kelsey’s town of Sioux Falls, S.D., that performs abortions, but she still drove hours away to get one.

Back in 2015, she was going through a difficult time — recently laid off, had to move suddenly, helping a close family member through some personal struggles — when she found out she was also pregnant.

“I kind of knew right away that this was just not the time or place to have a child. I mentally wasn’t ready, financially wasn’t ready,” she says. “The whole situation really wasn’t very good.”

When Kelsey decided to end her pregnancy, she found herself navigating a maze of legal restrictions, in a part of the country where providers are few and far between. NPR is not using her last name to protect her privacy.

South Dakota has a 72-hour waiting period for abortions and requires women to meet with their doctor in advance of the procedure. Kelsey, a nurse, had recently started a new job and couldn’t take the time off to go to two appointments at the clinic in her city.

She was just a few weeks along, and it was important to her to end the pregnancy early.

“I just knew that I didn’t want to wait on this too long,” she says. “Everybody has their own feelings about what is appropriate for them to have an abortion … how far they want to wait and things like that. I just knew I just wanted to do it.”

She called several providers throughout the region, some hundreds of miles away, before she finally found an appointment in Minneapolis, about a four-hour drive away, on a day she happened to have off work.

Kelsey’s story is similar to that of many women across the country, according to a report released Tuesday by the Guttmacher Institute, a reproductive health research organization that supports abortion rights.

The report, published in The Lancet Public Health, includes an analysis by Guttmacher researchers of the distances women must travel to obtain abortions in the United States. For 1 in 5 women, the report finds, the trip is more than 40 miles one way.

The trip is often longest for women in rural areas, with some in South Dakota driving more than 330 miles, according to Jonathan Bearak, a senior research scientist with Guttmacher and lead author of the report.

“I think there’s an unfortunate extent to which access to abortion is a bit contingent on your ZIP code, and that doesn’t need to be the case but it is,” he says.

Bearak says that increasing the use of options like telemedicine to provide medication abortion and reducing legal barriers to the procedure, like cumbersome health regulations on clinics and providers, could help improve access.

Social pressure is another factor that deters some doctors, midwives and nurse practitioners from providing those services, Bearak says.

“I think right now the issue is that it’s hard to do that because there are so many barriers in place to providing that care — not just the patients, but the doctors are affected by stigma,” Bearak says.

In South Dakota, where patients like Kelsey struggle with limited access to abortion services, Planned Parenthood has had to find creative ways to staff its local clinic. There’s no full-time abortion provider there, so Planned Parenthood flies a doctor from Minneapolis to Sioux Falls and back twice each week — first to consult with patients, as required by law, and then to perform the abortions.

Dr. Carol Ball has been making that trip for about a decade. She said local doctors are unwilling or unable to provide abortion services.

“I’ve been told by a supportive physician here that basically providing abortions for a South Dakota physician in Sioux Falls would be — quote unquote — ‘career suicide,’ ” Ball says. “Because I believe that the feeling is that there would be consequences to their practice.”

Ball says many of her patients travel hundreds of miles, some from out of state, to obtain an abortion at the clinic in Sioux Falls.

“It means that they have to find time away from their jobs and find child care for their children and all of the other sort of logistical things that it takes for us to stop and go to a doctor’s appointment,” Ball says. “They have to do that twice.”

Planned Parenthood’s Upper Midwest region has been flying abortion providers in and out of Sioux Falls for more than 25 years. Communications director Jen Aulwes says women there have limited options for abortion services.

“They’re very few and far between. They’re very spread out.” Aulwes says. “There’s, over the years, fewer and fewer clinics that that are providing abortion.”

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Hospitals across the Las Vegas area were inundated Sunday evening when hundreds of people injured in the mass shooting at a country music festival on the Strip arrived at their doors by ambulances and private car.

And hundreds of doctors, nurses, and support personnel were called into work to help handle the patients that were lined up in ambulance bays and hallways, officials say.

Following the shooting, Clark County Sheriff Joseph Lombardo said at least 58 people had died and 515 were injured after a gunman opened fire on thousands of people at a crowded outdoor concert.

While the numbers still may be in flux, they are enormous by any standard.

The University Medical Center of Southern Nevada, the state’s only comprehensive trauma center, received 104 patients, according to spokeswoman Danita Cohen. Four people died and 12 remained in critical condition Monday, Cohen says.

Sunrise Hospital and Medical Center saw 180 people who were injured in the shooting, including 124 people with gunshot wounds, according to Dr. Jeffrey Murawsky, the hospital’s chief medical officer. It’s the closest hospital to the site of the shooting and is a Level 2 trauma center, which means it can provide definitive care for all injured patients.

St. Rose Dominican hospital in nearby Henderson treated another 58 patients, five of whom are in critical condition, according to spokeswoman Jennifer Cooper.

The victims need blood donations, local officials say, and people are lining up to give.

“No one can say they’ve seen anything like this,” Sunrise’s Murawsky told All Things Considered on Monday. “We’ve seen events that have brought us 30 patients at once.”

He said 100 extra doctors were called in to work Sunday night, along with another 100 people including nurses, technicians, and support staff.

“We have a relatively large emergency department. We were able to triage within our emergency department,” he says. “We used the hallway space to see patients, so it’s a lot fuller than it normally would be and it feels a lot more chaotic.”

At University Medical Center, patients were being triaged in the ambulance bays, Cohen told CNN. The hospital has an 11-bay trauma center, with three operating bays, as well as regular surgery suites, which they likely used in this situation.

“We can get patients from an ambulance into the OR [operating room] in one minute,” Cohen says.

As reports of the gunfire emerged shortly after 10:30 p.m. PST Sunday, the city’s trauma centers began calling in extra personnel.

People working in trauma centers train for such emergencies and would know they’re likely to have to report to work as soon as they heard about the shooting on the news or social media. But still, the scale of this incident may have been surprising. “When you think of more than one hundred shooting victims, ballistic injuries, that is an absolute giant number,” says Bruno Petinaux, the chief medical officer and co-chair of emergency management at the George Washington University Hospital in Washington, D.C.

“When you’re talking about a mass casualty incident like this, this is where you call in the backup, and you call in the backup to the backup, and you may have to message the rest of your medical staff that you may need their help,” he says.

Petinaux says trauma centers have incident command structures in place to determine what kinds of people they need. A mass shooting is very different than a chemical incident or a fire.

In Las Vegas on Sunday, calls were likely going out to surgeons first, but not just surgeons. “Surgeons don’t work in a vacuum,” Petinaux says. “We’re now talking anesthesiologists, we’re talking about nurses, we’re talking about even pharmacists coming in. You may need to bring in more cleaners to help clean the OR and turn it around quickly.”

The Southern Nevada Health District, which includes Las Vegas and Clark County, has a 65-page trauma system plan that lays out how emergency responders and hospitals should communicate, work together, and divide responsibilities in a mass casualty situation.

Most major cities have such a plan, says Ian Weston, executive director of the American Trauma Society, which advocates for victims of trauma and the trauma care system.

“Hospitals are prepared to build capacity,” he says. “They’ll get the most critical patients into surgery quickly, they’ll stabilize more in the ER and some will even be treated in the lobby.”

He says hospitals determine exactly how many people they can care for in such a situation, even taking into account how many people they can fit into hallways, at least temporarily.

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Updated at 7:25 p.m. ET

Health and Human Services Secretary Tom Price resigned Friday in the face of multiple investigations into his use of private charter and military jets to travel around the country at taxpayer expense. Later, the White House placed new requirements on officials’ air travel plans.

A statement released by the White House Friday afternoon said that Price had “offered his resignation earlier today and the president accepted.”

President Trump had said multiple times this week that he was “not happy” about the optics of Price’s travel.

Friday afternoon, federal agencies were told that “all travel on Government-owned, rented, leased, or chartered aircraft, except space-­available travel and travel to meet mission requirements … shall require prior approval from the White House Chief of Staff.”

In his resignation letter, Price said, “I regret that the recent events have created a distraction” from his work at HHS.

The White House said that Trump intends to designate Don Wright, currently deputy assistant director for health and director of the Office of Disease Prevention and Health Promotion at HHS, as acting secretary.

The work-related travel, which was first reported Sept. 19 by Politico, cost taxpayers nearly $1 million, or about $400,000 for private charters and $500,000 in military airplane costs. Most of the trips were between cities where inexpensive commercial flights were also available.

The revelations had sparked a flurry of criticism from government ethics watchdogs.

Sen. Patty Murray, the ranking Democrat on the Health, Education, Labor and Pensions Committee, which oversees some parts of Price’s agency, wrote an angry letter to the secretary on Thursday about his travel habits.

“The decision is particularly shocking as you serve in an administration that routinely calls for draconian spending cuts and a reduction in government waste, and you yourself have repeatedly advocated for fiscal restraint,” Murray wrote.

HHS Inspector General Daniel Levinson launched an investigation of Price’s travel spending on Sept. 22, and the House Committee on Oversight and Government Reform has requested information on the flights.

Price tried to contain the damage on Thursday by promising to pay back the costs for his own seats on those flights chartered on his behalf, or about $52,000. But that offer didn’t approach the total costs of the trips, which included his staff and sometimes his wife.

“I regret the concerns this has raised regarding the use of taxpayer dollars,” he said in a statement.

But that wasn’t enough. On Friday, rumors mounted that Price’s tenure was in peril, fueled by Trump’s own afternoon statement that an announcement would be coming soon.

Price, a former Republican congressman from Georgia, was confirmed in February to lead HHS, the trillion-dollar agency that runs Medicaid, Medicare and the National Institutes of Health. It also administers the federal health care exchange created by the Affordable Care Act.

He had a reputation as a budget hawk who would fight government waste and rein in spending.

A former orthopedic surgeon, Price was a fierce opponent of the ACA, also known as Obamacare. While serving as head of HHS, he cut the agency’s spending for outreach and advertising in support of the insurance exchanges created by the law and issued news releases and created videos critical of the law’s effects on the individual insurance markets.

Price was often criticized for what appeared to be efforts to undermine a law he was charged with implementing.

The travel scandal wasn’t Price’s first brush with ethics problems.

During his confirmation hearing he faced tough questioning from Democrats over a series of stock trades in which he made money selling shares in companies over which his committees or the House held sway.

Price, 62, who had been chairman of the powerful House Budget Committee and a member of the tax-writing Ways and Means Committee, says he followed all congressional ethics rules, but his well-timed trades made it appear that he could have used his position to influence the price of stocks he owned or that he had received special treatment from companies in which he invested.

In one case he got access to special discounted shares of an Australia-based biotech company called Innate Immunotherapeutics. The price of the shares then quadrupled.

In another case, Price bought shares in Zimmer Biomet, an Indiana-based manufacturer of replacement knees and hips, and then introduced a bill that would have affected the price of such joint replacement surgery.

Seema Verma, a protege of Vice President Pence’s, has been mentioned as a possible successor to Price, The Associated Press reports. Verma leads the Centers for Medicare & Medicaid Services, which runs health insurance programs that cover more than 130 million Americans.

Scott Gottlieb, the commissioner of the Food and Drug Administration, has also been mentioned frequently. He is a physician with health policy expertise, including prior stints as the FDA’s deputy commissioner for medical and scientific affairs and before that as a senior adviser to the FDA commissioner.

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Nearly a decade ago, Maureen Sweeney worked at a Cleveland-area hospital during nursing school, completing her labor and delivery rotations. She helped hundreds of women deliver their children, many of whom were minors in their early teens.

That’s because, in Ohio, the rate of teenage pregnancy is slightly higher than the national average. This year, about 23 in 1,000 teenage girls will become pregnant.

One patient in particular from those nursing school days sticks out in Sweeney’s mind.

“It was a 15-year-old woman who was coming in, in labor, to the emergency room,” Sweeney remembers.

The teen was scared. She didn’t talk much and didn’t trust any of the doctors. She told Sweeney she had no family and that she was a runaway.

“She was by herself and she was living on the streets or between friends’ houses,” Sweeney says.

In that moment, Sweeney became the young woman’s only support system to help her through the delivery of her baby.

“So as it progressed and it got more and more painful, she did request an epidural,” Sweeney says.

An epidural is a common type of regional anesthesia that eases the pain of labor. As she had done many times before, Sweeney followed hospital protocol and called the anesthesia department. But to her shock, they told her they could not help her young patient.

“They said that without parental consent, … she would not be able to sign for her own epidural,” Sweeney says.

In Ohio, people under 18 who are in labor cannot consent to their own health care. They can receive emergency services, but nothing considered to be elective. For the many Ohio minors who become pregnant, it’s a painful gap in coverage.

It’s also complicated by the fact that in Ohio, there is no legal process for emancipation: A minor’s parents must be deceased, or the minor must be married or enlisted in the armed forces to be granted independent legal status.

When the hospital wouldn’t authorize an epidural, Sweeney called the office of Cuyahoga County Children and Family Services; oftentimes an agent from children’s services can sign for medical consent in these cases. But it was 3 a.m. The young woman was in active labor and an agent couldn’t make it to the hospital until 9 a.m.

Sweeney remembers how hard to was to tell her patient the news.

“I had to go in, sit down with her and talk about the fact that she wasn’t going to be able to get an epidural, and she was going to have to do this naturally,” Sweeney says.

That’s when the young woman broke down, Sweeney says, and folded in on herself in tears.

Throughout the U.S., minors are generally required to have permission from their parents or legal guardian before they can receive most medical treatment. However, each state has established a number of exceptions.

According to the Guttmacher Institute, 26 states allow minors 12 and older to get prescription methods of contraception without a parent’s or guardian’s consent, and just two allow minors to consent, on their own, to an abortion. Ohio is one of 13 states that has no explicit policy allowing a minor to consent to prenatal and pregnancy-related care.

Diana Thu-Thao Rhodes directs public policy for Advocates for Youth, an advocacy organization that focuses on, among other things, the rights of minors to get access to health care. She says in the last few years, minor-consent laws in some places around the country have become increasingly restrictive.

“We can legislate minors’ decision-making much easier because of the fact that they are minors,” says Thu-Thao Rhodes.

Dr. Michael Cackovic, an obstetrician at The Ohio State University Wexner Medical Center, says every couple of months he sees a teenage mom who, under Ohio law, is unable to receive elective treatment, like an epidural. He says it’s frustrating to see patients in unnecessary pain.

“First of all, from a labor and delivery standpoint, you don’t like to see anybody uncomfortable,” Cackovic says.

Both Cackovic and Sweeney report that, just as frequently, they’ve had cases where the mothers intentionally denied their teenage daughters an epidural – as a sort of punishment for getting pregnant.

All Cackovic can do is try to talk them out of it.

“To take the mom aside,” he says, “and say, ‘You know, this isn’t some life lesson here. This is basically pain — and there’s no reason for somebody to go through that.’ “

This gap in Ohio law bars a young mother from choosing a C-section. And she can’t consent for a procedure to test for chromosomal abnormalities in the fetus.

Cackovic says he thinks that’s pretty backward: After she gives birth, the teenage mother can consent to the care of her baby, but she can’t consent to the prenatal procedure that would help pinpoint a diagnosis.

There is no way to know for sure how many teens across the country are denied these elective procedures. Thu-Thao Rhodes says in states like Ohio these young patients have been overlooked by lawmakers because they’re not in a position to advocate for themselves.

“The priority for a lot of these young people is to just get the basic health care and services they need,” Thu-Thao Rhodes says, “not spending unnecessary, and often unavailable, time and resources navigating complicated healthcare and legal systems.”

Two Ohio lawmakers, Reps. Nickie Antonio and Kristin Boggs, are currently working to fix this oversight with a state bill, HB 302, that’s progressing through the Ohio House and would allow pregnant minors to consent to health care from the prenatal stage through delivery.

This story was produced in partnership with WOSU and Side Effects Public Media, a reporting collaborative focused on public health.

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Tightening the screws on pricey imaging exams, health insurer Anthem will no longer allow many patients to get MRI or CT scans at hospital-owned outpatient facilities, requiring them to use independent imaging centers instead. The insurer began phasing in these changes in July and expects to finish by March.

Anthem says the change is aimed at providing high-quality, safe care while reducing medical costs.

But critics say that imposing a blanket rule that gives preference to freestanding imaging centers is at odds with promoting quality and will lead to fragmented care for patients.

“To achieve true value, you have to have high-quality care at a good price,” says Leah Binder, president and CEO of the Leapfrog Group, a nonprofit organization that advocates for improved safety and quality at hospitals.

“Anthem would be better off judging the quality of these [imaging] diagnoses,” regardless of where they’re provided, and setting payment accordingly, she says.

Imaging tests are generally subject to preapproval by Anthem to confirm that they’re medically necessary. Under the new policy, AIM Specialty Health, an Anthem subsidiary, will also evaluate where they should be performed. Doctors who request nonemergency outpatient MRI or CT scans that can be done at an independent imaging center rather than one owned by the hospital will be given a list of centers eligible for patient referrals.

The policy doesn’t apply to mammograms or X-rays.

In rural areas that lack at least two imaging centers that aren’t owned by hospitals, outpatient scans from hospitals will still be approved.

The new policy could save Anthem enrollees hundreds of dollars, says Lori McLaughlin, Anthem’s communications director.

“There are huge cost disparities for imaging services, depending on where members receive their diagnostic tests,” she says. “Members can save close to $1,000 out-of-pocket for some imaging services for those who haven’t met their deductible, and up to $200 for those whose plans require only a copay.”

Hospital imaging is indeed pricier than imaging at freestanding centers. Average prices for MRI and CT scans ranged from 70 percent to 149 percent higher at hospitals, according to an analysis published by the Healthcare Financial Management Association, a membership group for health care finance professionals.

But price isn’t the only important variable, and the perception that all imaging studies conducted by qualified providers generally yield comparable results is wrong, Binder says. A study published last year in The Spine Journal, for example, found that when a “secret shopper” patient with low back pain received MRI at 10 imaging centers over a period of three weeks, each center reported different findings. Some missed a problem they should have found, while others detected nonexistent problems.

The Anthem policy applies to 4.5 million enrollees in individual and group plans in 13 of the 14 states in which Anthem operates, according to McLaughlin. (Self-funded employers that pay their employees’ claims directly are exempted from the policy, but can incorporate it if they wish.) New Hampshire is the only state on that list without an implementation date, McLaughlin says.

This is the second change in coverage from Anthem this year that’s attracted attention. The company has also come under fire for a new policy under which it will no longer pay for emergency department visits that it determines after the fact weren’t emergencies. Some physicians and others worry that policy could discourage people who might need emergency treatment from seeking care.

Patient advocates and health care providers have also expressed concerns about the new imaging rule’s potential impact on patients.

Cancer patients, who often are being treated at cancer centers within hospitals, would feel the effect, notes Dr. J. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society.

“They have to go to a new outpatient facility, get the film, get it read and transmitted back to the cancer center,” Lichtenfeld says. If, as often happens, the hospital and the imaging center’s computer systems don’t talk to each other, the patient may have to bring the results back to the doctor on a CD. “For that patient who’s in a lot of stress to begin with, it adds another level of stress,” he says.

Dr. Vijay Rao, chair of the department of radiology at Thomas Jefferson University in Philadelphia, says the Anthem policy will create extra effort for hospital radiologists on a patient’s care team, if they need to review and possibly redo the imaging center’s work. Further, relying on a patient to transport the scan so that it can be put into the hospital’s electronic medical record system “leaves lots of room for error,” she says.

Anthem isn’t the only insurer trying to find a way around hospitals’ steeper costs for outpatient imaging, says Lea Halim, a senior consultant at the Advisory Board, a health care research and consulting company. The Medicare program is taking steps as well, although its approach doesn’t directly influence patient care in the same way.

In recent years, hospitals have been snapping up independent physician practices and outpatient imaging and testing facilities, and then charging Medicare higher hospital outpatient fees for their services. In a bid to equalize payments, in January the Medicare program reduced by 50 percent the amount it pays some hospital-owned outpatient facilities — including imaging centers — that are located away from a hospital’s campus.

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Republicans officially pulled the plug on their last-ditch effort to repeal and replace the Affordable Care Act on Tuesday.

“We don’t have the votes,” said Sen. Bill Cassidy, R-La., after a closed-door meeting of Senate Republicans. “And since we don’t have the votes, we’ve made the decision to postpone the vote.” Cassidy, along with Sen. Lindsey Graham, R-S.C., put together the proposal they hoped could pass the Senate.

As of Sunday, though, the Senate will no longer be able to pass a health law overhaul bill with only a simple majority. That means the bill is effectively dead, for now.

That message was underscored by Senate Majority Leader Mitch McConnell, R-Ky., who said, “Where we go from here is tax reform.”

But that does not mean all is smooth sailing for the ACA. Here are five ongoing challenges the law faces.

1. Insurers still face tremendous uncertainty.

Wednesday is the deadline for health insurers to finalize rates for the 2018 individual market open enrollment season, which starts Nov. 1. Yet there has been no resolution to the question of whether the federal government will continue to reimburse insurers for subsidies known as cost-sharing reductions. Those are payments insurers are required to provide to moderate-income enrollees to help them afford deductibles and out-of-pocket costs. The law says the federal government is supposed to make those payments, but a lawsuit has left that an open question, and the Trump administration has repeatedly threatened to stop making the payments.

Without reimbursement of those subsidies, Pennsylvania Health and Human Services Secretary Teresa Miller told the Senate Finance Committee Monday, insurers in her state “reported they would need to request a statewide average increase of 20.3 percent” in the cost of health plan premiums. Those increases are similar nationwide.

A bipartisan effort led by Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., to advance legislation to affirmatively fund the payments was reportedly progressing until Republican leaders stopped them to concentrate on efforts to pass the Graham-Cassidy legislation.

But Alexander and Murray now appear back at it.

Murray said Tuesday she is “ready to keep working on the bipartisan path that could lead to results.”

Alexander similarly released a statement that he would “consult” with Murray and others “on a limited bipartisan plan that could be enacted into law to help lower premiums and make insurance available to the 18 million Americans in the individual market in 2018 and 2019.”

2. The Trump administration has cut funding for efforts to sign people up for insurance.

Administration officials announced earlier this month major cuts to the “navigator” program, which provides funding to community groups that guide people through the complex task of signing up for health insurance through the online marketplaces. Some groups are losing more than 90 percent of their budgets.

The cuts have forced many groups to lay off workers just before open enrollment begins and to limit the areas they serve.

3. The 2018 enrollment period is half the length of 2017’s, and now it will be shorter still.

Trump officials are also slashing by 90 percent the advertising budget that reminds people about open enrollment and how to sign up — from $100 million to $10 million.

Those cuts are even more significant this year because for the first time since the law’s implementation, open enrollment starts in November, rather than December, and lasts only 45 days.

“Most people don’t know the open enrollment dates, and they don’t know that the deadline this year is Dec. 15, not Jan. 31, like last year,” wrote Lori Lodes, who ran outreach for the ACA in the Obama administration, in a recent op-ed for Vox.

Trump administration officials said they don’t think advertising is cost-effective, but Lodes wrote that “my office produced reams of data that proved the overall effectiveness of outreach advertising.”

Additionally, HHS announced late last week that it will shut down HealthCare.gov for maintenance from 12 a.m. to 12 p.m. every Sunday during open enrollment, except for Dec. 10 – a step critics say could further undermine enrollment efforts.

4. The Trump administration is dragging its feet on giving states flexibility to stabilize their markets.

Back in March, Health and Human Services Secretary Tom Price and Centers for Medicare & Medicaid Services chief Seema Verma, who oversees the ACA, sent a letter to states encouraging them to use the law’s waiver process to improve the functioning of their individual insurance markets. In particular, they suggested states could create “reinsurance” programs that would help lower premiums by providing a payment mechanism for the most expensive patients.

But when Minnesota took up that invitation, the administration delayed its response. When it finally did grant permission last week, HHS also informed the state that it will lose significant funding for a program that provides insurance to the state’s low-income residents.

Gov. Mark Dayton, a former Democratic senator, said in a letter to Price that “we have now been informed that Minnesota would lose more federal Basic Health Plan funding than we would receive in federal support for reinsurance,” and described the entire waiver process as “nightmarish.”

5. Republicans could take another shot at a full overhaul next year — or even this year.

While the acknowledgment that the GOP lacks the votes to overhaul the health law means an immediate vote will not happen, the Republicans have potentially two more shots to try to pass a bill with a simple majority vote.

What triggers the ability to pass a bill in the Senate without threat of filibuster is a formal budget resolution. Republicans have still not passed a budget resolution for fiscal 2018, which begins Oct. 1. The upcoming resolution is expected to call for a major tax cut bill. Some Republicans, notably Graham himself, have suggested adding health language to that resolution, which would be allowed.

But that would complicate efforts for both bills.

More likely is that Republicans could try again for a health overhaul via its fiscal 2019 budget resolution, which is due next April. That would leave them only a few months before the 2018 elections. Still, it’s possible, particularly if they can use the time to reach consensus.

That is clearly what sponsors of the latest GOP bill have in mind.

“We’re on a path to pass” his bill, Graham told reporters. “It’s just a matter of when. It will be in this Congress, under a better process.”

Kaiser Health News, a nonprofit health newsroom, is an editorially independent part of the Kaiser Family Foundation.

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