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While the nation was focused on migrant caravans, mail bombs and President Trump’s disgusting tweets last week, his administration was making another big change to the Affordable Care Act, also known as Obamacare. The new plan would give states far more flexibility in regulating health-insurance markets within their borders. That sounds like a good thing. It is not. Obamacare reorganized the market for individual insurance plans — that is, coverage people do not get from their employers or directly from the government. The law recognized that there are only so many ways to get people with preexisting conditions onto the comprehensive plans they need. The government could insure them directly, at high taxpayer expense, or it could mandate that everyone carry decent, private health-care coverage. With many people, healthy and sick, in the system, premiums overall would be contained and everyone would have quality health insurance that would cover expected and unexpected medical costs. (10/30)

Republicans have been very busy lying about health care: lying about their policy agenda, lying about Democrats calling them liars and lying about who said who was really lying about all this. Amid those lies, however, GOP officials and candidates have occasionally lapsed and told the truth: The party, like it always has, wants to cut federal health care programs. They want to repeal the Affordable Care Act, still without having any idea how to replace it, and they’re working hard to make the law worse in the meantime. They want to slash Medicaid. They want to shrink Medicare. (Jeffrey Young, 10/30)

Despite their almost comically dishonest insistence that they have suddenly discovered a passion for protecting people with preexisting conditions, Republicans will continue their assault on the Affordable Care Act, including, yes, its protections for people with preexisting conditions. If the lawsuit filed by a group of Republican-controlled states is successful, one supported by the Trump administration and pretty much every Republican everywhere, the ACA will be nullified. Even if that doesn’t happen, the administration will continue its effort to sabotage the ACA in every way it can imagine, making health care less secure and more expensive. Republicans have already made clear that they will take another shot at repealing the ACA in Congress, and will probably attempt to cut Medicaid as well. (Paul Waldman, 10/30)

HPREP’s message was simple yet enormously powerful: You belong here and don’t let anyone sell you short.The program, which celebrates its 30th anniversary in 2019, was started by medical students at Weill Cornell Medicine with the aim of drawing more underrepresented minority students into the medical field. Now a national program under the auspices of the Student National Medical Association, more than 7,000 high school students have participated in the HPREP program. (Jessica M. Pena, 10/31)

E-cigarettes or “vapes” are known as the wildly popular “safe” alternative to cigarettes and tobacco products. Though many see them as harmless, little is known about the direct health effects of the products. This is especially concerning considering that a 2016 survey found more than 2 million U.S. middle and high school students reported using e-cigs within the last 30 days. Because e-cigs and vapes contain highly addictive nicotine and other potentially harmful agents, I believe they should be included in the, Great American Smokeout in an effort to avoid having users become the cigarette patients of tomorrow. (Peter Shields, 10/30)

We do not know whether herpes viruses, with or without host genetic susceptibility, can cause AD (Alzheimer's disease) or not. But scientists have been investigating this possibility for as long as the polio vaccine has existed. And as with the polio vaccine, the best way to find out if a virus can cause an illness, is to perform a clinical trial where half the patients receive a safe and effective agent against the implicated herpes virus(es), and half receive a placebo (sugar pill), then see if the drug-treated patients have a better outcome than the placebo-treated patients in terms of thinking ability and ability to function in daily life.Researchers believe that based on these recent studies of human herpes viruses and AD, we may be approaching a major paradigm shift in our approach to the disease, instead of continuing on our current path of spending billions on failing AD studies. (Fred G. Volinsky, Pascal J. Goldschmidt-Clermont and Steven P. Larosa, 10/30)

How about “rat explosion”? As the climate warms, rats in New York, Philadelphia and Boston are breeding faster — and experts warn of a population explosion. Like rats, humans are hardy animals, and we’ve adapted to all kinds of climates. So it can be tempting to brush off the prospect of 2 degrees of warming. Especially for Americans, who mostly use Fahrenheit. That 2 degree warming is Celsius. Think of 3.6 degrees Fahrenheit. Still not scared? Fine. (Faye Flam, 10/30)

California struck a blow for intelligent public health policy in 2015, when the state abolished all “personal belief exemptions” from child vaccine mandates. The new rules were designed to put a stop to the stupid and irresponsible behavior of parents whose casual approach to getting their children vaccinated against a host of communicable diseases — chiefly measles, mumps and rubella — places their neighbors’ children and their entire communities at risk. (Michael Hiltzik, 10/30)

(Janet) Mills has promised to move quickly to expand Medicaid, suggesting that the state use, as a down payment, $35 million from a tobacco settlement she negotiated. She would push hard for broadband for rural areas, for a transition to cleaner energy, for a better-funded school system, and for red-flag gun legislation. (10/30)