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Republican candidates are trying to have it both ways on Obamacare. On one hand, Republicans are still campaigning against the law, arguing a strong election result will allow them one more shot at repealing the Affordable Care Act with GOP majorities in both chambers. And many high-profile Senate GOP candidates support a lawsuit that would scuttle Obamacare if successful in the nation’s courts, a case that will be heard by a federal judge in September. Yet at the same time Republicans are still touting the law’s most popular provisions, arguing that after it is struck down they will be able to preserve protections for pre-existing conditions by passing a new bill. (Everett, 8/17)

Despite Republican efforts to undermine the Affordable Care Act, insurance premiums will go up only slightly in most states where carriers have submitted proposed prices for next year. And insurance carriers are entering markets rather than fleeing them. The improvements stem from less political uncertainty over health policy, steeper than necessary increases this year, better understanding of the markets, improvements in care and a host of actions taken by individual states. (Ollove, 8/16)

Health insurance rates will rise an average of 4.2 percent next year for individuals and small businesses buying coverage in Massachusetts, state officials said Thursday. The price increase is relatively modest compared with the beginning of 2018, when rates climbed an average of 16.8 percent after the White House followed through on a threat to pull federal payments that subsidize insurance coverage. (Dayal McCluskey, 8/16)

The Trump administration is preparing to let conservative-led states impose additional restrictions on the nation’s health program for the poor that could push tens of thousands of people off coverage, POLITICO has learned. The high-stakes changes, involving work requirements and questions about illegal drug use, have been the subject of intense behind-the-scenes lobbying in recent months by federal and state lawmakers in the latest chapter of the GOP’s long-running efforts to reshape Medicaid — a policy priority extending back to the Reagan era. (Diamond, 8/16)

Thousands of unaccompanied minors who crossed the border illegally aren’t being tracked after being placed with sponsors by the Health and Human Services Department, according to a bipartisan Senate investigation that faulted the HHS and Homeland Security departments for the lapse. Representatives from HHS and the Justice Department pushed back in a Senate subcommittee hearing Thursday, with an HHS representative saying the agency has started doing background checks on adults that volunteered to take care of the children and that the department wasn’t responsible for children once they are placed with sponsors. (Andrews, 8/16)

A Health and Human Services official insisted that the agency is not responsible for ensuring the safety of unaccompanied migrant children once they leave its care -- and pleaded with senators on Thursday not to force it to take on the responsibility. “Please don’t make us a law enforcement agency,” said Jonathan White, testifying on behalf of HHS at a hearing held by the Senate Homeland Security and Government Affairs subcommittee on investigations. "I think it’s very important that HHS remain the agency tasked with the best interests of the child rather than to assign it enforcement duties. (Itkowitz, 8/16)

Trump administration officials acknowledged Thursday that they have no system for tracking the tens of thousands of migrant children who are released from federal custody each year after traveling to the United States alone. Facing heated questions from a Senate subcommittee, officials from the Health and Human Services Department, Customs and Border Protection, Immigration and Customs Enforcement and the federal immigration courts each said they were not responsible for following up after the children are handed over to sponsors, most of whom are undocumented relatives or family friends. (Dickerson, 8/16)

The federal government spends much less on children than it does the elderly, with the latter claiming roughly 35 percent of the annual budget. The disparity is driven in part by the government’s budget process, which places younger citizens at a disadvantage, according to a new report from the Committee for a Responsible Federal Budget. (Rainey, 8/16)

In a cabinet meeting Thursday at the White House, Mr. Trump asked Attorney General Jeff Sessions to bring federal lawsuits against certain companies supplying opioids to hospitals, rather than joining state lawsuits. He also charged Mr. Sessions with investigating fentanyl coming from China and Mexico, countries he said were “sending their garbage and killing our people.” “It’s almost a form of warfare,” Mr. Trump said. Mr. Sessions said he would follow Mr. Trump’s request. (Ballhaus, 8/16)

President Donald Trump said Thursday he wants the U.S. government to sue pharmaceutical companies that manufacture opioids as part of his efforts to halt an epidemic of drug addiction. Trump said he’d like to bring a federal lawsuit, rather than just join existing litigation against the drugmakers. (Sink and Edney, 8/16)

President Donald Trump is asking Attorney General Jeff Sessions to file a federal lawsuit against certain companies that supply and manufacture opioids. Speaking during a Cabinet meeting Thursday, Trump said he’s directing Sessions to file a separate lawsuit, rather than joining existing lawsuits filed by states affected by the spread of the often-lethal, highly-addictive drugs. (Superville, 8/16)

President Trump on Thursday urged Attorney General Jeff Sessions to bring a federal lawsuit against drug companies that produce opioids.  Speaking during a Cabinet meeting, the president also asked his embattled attorney general to look at opioid drugs coming into the country from China and Mexico, saying those countries were “sending their garbage and killing our people.” (Fabian and Weixel, 8/16)

OxyContin maker Purdue Pharma LP has tapped law firm Davis Polk & Wardwell LLP for financial restructuring advice, as its potential liabilities swell with a wave of lawsuits over the opioid addiction epidemic sweeping the United States, people familiar with the matter said on Thursday. (DiNapoli and Raymond, 8/16)

The Trump administration is using new powers to propose a significant decrease in how many opioids drug companies can manufacture in the U.S. in 2019. The Justice Department and Drug Enforcement Administration (DEA) are proposing an average 10 percent decrease next year in the manufacturing quotas for six frequently misused opioids. (Hellmann, 8/16)

2016 was the worst year for drug overdose deaths in America — at least, until 2017 came along. According to preliminary data from the Centers for Disease Control and Prevention, more than 72,000 people in the US are predicted to have died from drug overdoses in 2017 — nearly 200 a day. That’s up from 2016, which was already a record year in which roughly 64,000 people in the US died from overdoses. At least two-thirds of drug overdose deaths in 2016 and 2017 were linked to opioids. (Lopez, 8/16)

The ever-rising death toll from the synthetic opioid fentanyl showed graphically this week how vulnerable the United States has become to powerful drugs concocted in laboratories. On the same day that more than two dozen people were raced from a New Haven, Conn., park to emergency rooms after violent reactions to synthetic marijuana, federal authorities announced that more than 72,000 people had died of drug overdoses nationwide in 2017. Leading the death toll is the increasing number of fatalities from fentanyl. (Zezima, Bernstein and Schmidt, 8/16)

Kaiser Health News: Purdue Pharma’s Sales Pitch Downplayed Risks Of Opioid Addiction

Two decades ago, Purdue Pharma produced thousands of brochures and videos that urged patients with chronic pain to ask their physicians for opioids such as OxyContin, arguing that concerns over addiction and other dangers from the drugs were overblown, company records reveal. Kaiser Health News earlier this year posted a cache of Purdue marketing documents that show how the pharmaceutical company sought to boost sales of the prescription painkiller, starting in the mid-1990s. ... This week, the New York attorney general’s office filed another suit that accuses Purdue of operating a “public nuisance” in it sales tactics and marketing of opioids. (Schulte, 8/17)

The US Food and Drug Administration has raised alarm about one way people might access opioids to misuse and abuse: their pets. As America's opioid epidemic rages, some pet owners could be stealing pain medications intended for their furry friends, according to a statement from FDA Commissioner Dr. Scott Gottlieb. (Howard, 8/16)

The United States Food and Drug Administration Commissioner Scott Gottlieb issued a statement Wednesday, warning veterinarians that some pet owners may be using their animals to get prescriptions for opioid drugs. (Pirani, 8/16)

Over the past five years, 219 people have gone through the Dane County Jail opiate treatment program. Of them, 43 percent have accomplished their treatment goals, according to Todd Campbell, the county’s adult community services administrator. (Luthern, 8/16)

HHS Secretary Alex Azar has called the shift to value-based care a top priority, signaling for months that the Trump administration will take steps like cracking down on free riders in Medicare's Shared Savings Program. The question is whether a new rule aimed at redesigning that program will spur a health system resistant to quick and sweeping change or undermine that priority. (Roubein, 8/15)

Kaiser Health News: Hospitals Battle For Control Over Fast-Growing Heart-Valve Procedure

When Medicare in 2011 agreed to pay for a revolutionary procedure to replace leaky heart valves by snaking a synthetic replacement up through blood vessels, the goal was to offer relief to the tens of thousands of patients too frail to endure open-heart surgery, the gold standard. To help ensure good results, federal officials limited Medicare payment only to hospitals that serve large numbers of cardiac patients. The strategy worked. In the past seven years, more than 135,000 mostly elderly patients have undergone transcatheter aortic valve replacement, known as TAVR. And TAVR’s in-hospital mortality rate has dropped by two-thirds, to 1.5 percent. (Galewitz, 8/17)

The healthcare industry experienced fewer commercial bankruptcies in the second quarter of 2018 relative to the first quarter, after the sector suffered record or near-record highs in each of the past eight quarters, according to a new report. The law firm Polsinelli tracks Chapter 11 bankruptcy filings among companies with assets of at least $1 million and releases a quarterly stress index. In the second quarter, the overall index was 49.26, down 5 points since the first quarter, despite having increased in three of the past four quarters. (Bannow, 8/16)

In recent years, “disruption” and “innovation” have become buzzwords as the health-care industry aims to remake America’s complex health system by using technology to curb high costs and boost outcomes. But as industry members gathered at Catalyst HTI in Denver’s River North district Thursday, the discussion centered around the collaboration the new health-tech campus will foster by placing so many different players — from providers to startups — in one building. (Seaman, 8/16)

New York University said Thursday that it will cover tuition for all its medical students regardless of their financial situation, a first among the nation’s major medical schools and an attempt to expand career options for graduates who won’t be saddled with six-figure debt. School officials worry that rising tuition and soaring loan balances are pushing new doctors into high-paying fields and contributing to a shortage of researchers and primary care physicians. Medical schools nationwide have been conducting aggressive fundraising campaigns to compete for top prospects, alleviate the debt burden and give graduates more career choices. (Korn, 8/16)

N.Y.U.’s plan, which was announced Thursday morning in an unexpected ending to the annual “White Coat Ceremony” for new students and their families, goes beyond that, and may spur other top medical schools to follow suit. In a statement, N.Y.U. said that it would be the only top-ranked medical school in the nation to offer full-tuition scholarships to all students. (Chen, 8/16)

Three out of four medical school graduates in 2017 graduated in debt, according to the Association of American Medical Colleges. Of those in debt, the median amount was $192,000, the group says. NYU also says medical school debt is "reshaping the medical profession," as graduates choose more lucrative specialized fields in medicine rather than primary care. (Doubek, 8/17)

Students will still be responsible for books, fees, housing and other costs. The school estimates those education and living-related expenses will total about $27,000 for a 10-month term. "No more tuition ... The day they get their diploma, they owe nobody nothing," said Kenneth G. Langone, board of trustees chairman for NYU Langone Medical Center. The center is named for Langone and his wife, Elaine. (Shannon, 8/16)

It took 11 years for NYU to raise enough funding to make the effort possible. To date, the school has raised over $450 million .... Ultimately, NYU hopes to have an endowment of $600 million to support the effort. The school already allowed students the option to shave off their fourth year of training — typically spent doing additional specialty rotations and applying for residences — saving students a year’s tuition. (Nadell Farber, 8/16)

"This gives our students choice in two ways: First it will enable students who couldn't afford medical school to afford it and the second thing it does is enable students enrolled in medical school to think with a clear eye (about their future specialty)," said Dr. Robert Grossman, the dean of NYU School of Medicine and CEO of NYU Langone Health. NYU leaders also hope the fund will enable the school to attract more diverse candidates who won't be deterred from pursuing a career in medicine because of debt. (Castellucci, 8/16)

A liberal veterans group is suing to block the influence of three outside advisers who have been secretly influencing the Department of Veterans Affairs from Mar-a-Lago, President Donald Trump’s private club in Palm Beach, Florida. ProPublica reported last week that the advisers — Marvel Entertainment chairman Ike Perlmutter, West Palm Beach doctor Bruce Moskowitz and Washington lawyer Marc Sherman — have been shaping VA personnel and policy decisions despite having no official role or relevant expertise. (Arnsdorf, 8/16)

Family caregivers seeking help from the Department of Veterans Affairs encountered extended wait times and spotty aid from the agency, according to a new report from the VA’s Office of Inspector General. The OIG investigation found that 65 percent of the more than 1,800 applicants between January and September 2017 were forced to wait longer than the required 45-day timeframe to be approved for the program.  Fifty-five percent of the applicants waited between three and six months for approval, while 14 percent waited even longer, according to thereport released Thursday. (Clason, 8/17)

Legendary soul singer Aretha Franklin died of a rare form of pancreatic cancer, a disease that is difficult to discover early and among the most deadly forms of cancer. ... Franklin's family said in a statement that she died from advanced "pancreatic cancer of the neuroendocrine type," a diagnosis confirmed by Franklin's oncologist, Dr. Philip Phillips of Karmanos Cancer Institute in Detroit. The disease begins in the pancreas but quickly spreads to nearby organs. It is rarely detected in the early stages, experts said. (Alltucker, 8/16)

Aretha Franklin’s death from pancreatic cancer highlights the viciousness with which the disease attacks, killing tens of thousands of Americans a year. It’s not clear when the Queen of Soul was diagnosed. She had what she called a health scare in 2010, then finally stopped performing in November, and by last week celebrities were coming to pay their last respects. Pancreatic cancer is among the nation’s deadliest diseases. Here’s why. (Basu, 8/16)

Pancreatic cancer is the third-leading cause of death from cancer in the United States, after lung and colorectal cancers. The lifetime risk of developing it is about 1 in 63 for men, and 1 in 65 for women. This year, about 55,440 people will be diagnosed with pancreatic cancer, and the disease will kill about 44,330 people, according to the American Cancer Society. (Landau, 8/16)

Californians are living longer with most types of cancer, due to earlier detection and more effective treatments, according to new research from the University of California-Davis. But racial, ethnic and socioeconomic disparities persist, the report found. ... They found improved survival rates for patients with all but five types of cancer. (Gorman, 8/17)

UnitedHealthcare denied [Kate] Weissman coverage for proton beam therapy after multiple appeals, saying "there is not enough medical evidence to show proton beam therapy is effective for your particular condition." One of the insurance medical directors who twice reviewed Weissman's appeals wasn't board-certified in "gynecologic oncology," according to the American Board of Obstetrics and Gynecology, raising troubling questions about why she was involved in a cancer case. The denials put Weissman in a terrible predicament: pay $95,000 out of pocket for what her doctors said was the best chance at a cure or continue with fully covered standard radiation, which could lead to lifelong complications. (Drash, 8/16)

Federal health officials are investigating a outbreak of measles this year that has spread to 21 states and the District of Columbia. From Jan. 1 to July 14, 107 people had contracted the disease, federal Centers for Disease Control officials said Wednesday. Measles cases have been reported in Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland,  Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Washington. (8/16)

Health officials are urging parents to make sure their children are vaccinated against measles after three cases of the disease were reported in a Florida county, among more than 100 cases throughout the U.S. this year. Federal officials declared the contagious virus had been eliminated in the U.S. in 2000; however, infections periodically occur nationwide, as the virus is still common in many other parts of the world. Travelers can bring measles into the country, where it can spread among people who are not vaccinated. (Kay, 8/16)

Health officials have determined that a type of bacteria found in food left at unsafe temperatures is the cause of an outbreak of gastrointestinal illness that struck 647 people who ate last month at a Chipotle Mexican Grill restaurant in Ohio. Between July 26 and July 30, customers of a Chipotle restaurant in Powell, Ohio, just north of Columbus, complained of food poisoning and diarrhea after eating tacos and burrito bowls there. (Neuman, 8/17)

A new analysis of packaged foods made for babies and toddlers found "worrisome" levels of heavy metals in two-thirds of the tested products. Consumer Reports analyzed 50 nationally distributed baby foods checking for cadmium, lead, mercury and inorganic arsenic, the type most harmful to health. (8/16)

Some people suffering from high blood pressure who take valsartan-containing medications have been frantically calling their pharmacies and doctors to find out whether they should stop taking their heart pills in the wake of the FDA’s recent recall. ...Consumers should start by comparing their prescription bottle to the FDA’s list to determine if their drugs have been recalled. (D'Souza, 8/15)

A hundred thousand Americans are on a waiting list for a kidney from a deceased donor. But another option is the paired-organ exchange, which allows living kidney donors who are not a match with their intended recipient to network with others who are. (Solman, 8/16)

Today, more than 47,000 mobile apps help patients track and record their health profiles. The volume of recordable health data has seen a massive uptick. Yet a recent survey found that 63 percent of Americans don’t know where their medical data is stored or who has access to it. (Chang and Okafor, 8/16)

The possibility of another Trump nominee ascending to the Supreme Court bench has created a sense of urgency among abortion supporters in the states, where activists are pushing to safeguard access to the procedure. Supporters of abortion rights worry that Judge Brett Kavanaugh’s confirmation could lead to the weakening of Roe v. Wade, the landmark Supreme Court decision that cemented a woman’s right to abortion. (Hellmann, 8/16)

Benedict Liao is one of 73 doctors around the country with active medical licenses who got FDA warning letters over a five-year period alleging serious problems. ... The warning letters, which get scant public attention, are sent after FDA officials conduct inspections at offices, clinics and medical facilities to determine if federal rules designed to protect patients are being violated. (Fauber and Wynn, 8/16)

As a pediatrician, Dr. Emily Andriessen is used to fielding phone calls from worried parents inquiring about a rash or a sudden fever their child has developed. Now some of those calls come through a video conferencing application Andriessen works with at the Children's Pediatrics after-hours clinic in River Ridge. This summer the clinic began offering a telemedicine option for parents needing to consult with a pediatrician after regular business hours. When a call comes in, the parent speaks with a nurse who will determine whether their child's medical situation requires an in-person consultation or whether the conversation can be held through the video conferencing system with the doctor. (Clark, 8/16)

For the first time in its 19-year history, Mercy Community Healthcare will expand its services outside of Williamson County. The faith-based clinic in Franklin saw 9,000 patients in 2017. Those in need of health care — particularly those without insurance — came from 23 different counties. In an effort to better service patients, the clinic will expand into Marshall County, chief medical officer Dr. Alexander Brunner said. (West, 8/16)

One year before University of Maryland football player Jordan McNair died after collapsing at a team workout, the school’s athletic department submitted a proposal that would have fundamentally changed how health care was delivered to athletes, a drastic overhaul aimed at better aligning the school with NCAA recommendations. But the plan was never implemented, its recommendations nixed by Maryland President Wallace D. Loh, according to three people with knowledge of the situation. (Stubbs, 8/16)

The U.S. Department of Education is investigating Ohio State University’s response to allegations of sexual abuse against former athletic doctor Richard Strauss. The probe by the department’s Office for Civil Rights will examine whether Ohio State responded “promptly and equitably” to allegations by former students that Strauss touched athletes inappropriately during appointments and ogled them in a campus locker room, as well as claims that school officials knew or should have known about the alleged abuse, the school said. (Vieback, 8/16)

As New Haven grappled Thursday for the second straight day with a drug overdose crisis, new data from the Centers for Disease Control and Prevention shows that Connecticut’s rise in overdose deaths in 2017 was much higher than all but one other New England state. According toearly estimatesfrom the CDC, Connecticut saw an increase of around 10 percent, which is on par with the U.S. as a whole but higher than all other New England states except Maine, which saw an increase of around 14 percent. (Kara and Silber, 8/16)

State-mandated testing in Maryland has detected elevated lead levels in drinking fountains and taps in schools in Montgomery County, Anne Arundel County and Harford County. A bill passed last year by the state legislature and signed by Gov. Larry Hogan (R) requires that public and private schools test for lead in drinking water outlets. That testing, the first phase of which had to be completed by July 1, yielded levels of lead above the Environmental Protection Agency guideline of 20 parts per billion (ppb) in water fixtures in several school districts. (Barrios and Svrluga, 8/16)

D.C. Water and Sewer Authority officials pledged Thursday to revamp their systems for communicating with the public after an internal report identified multiple shortcomings in the way it handled a potential contamination of the city’s water supply last month. The report — which includes recommendations for improving the agency’s oversight of the water system and protocols for alerting D.C. residents of emergencies — offers the most thorough accounting to date of events that led to tens of thousands of people being warned against drinking their tap water over two days in mid-July. (Jamison, Thebault and Nirappil, 8/16)

Florida is living through an unprecedented environmental crisis that’s devastating tourism, recreation and wildlife along the state's southwest coast. Two kinds of toxic algae are blooming, one in freshwater, one in salt, creating a red tide along the Gulf of Mexico and blanketing rivers and canals inland with goo. ... Red tide’s effects are not subtle – along the lines of mild pepper spray. Coughing, sneezing, watery eyes, shortness of breath and wheezing are all common in those exposed to it. (Bennett Williams, 8/16)

The Browns’ story and others, told publicly for the first time here, reveal a toxic scourge inside homes on military bases. Previously undisclosed military and state health records, and testing by Reuters for lead in soldiers’ homes, show problems at some of America’s largest military installations. Federal law defines lead-based paint as containing 0.5 percent or more lead by weight. Sales have been banned since 1978. But many older homes still contain lead paint, which is particularly dangerous when it peels, chips or turns to dust – easy for kids to swallow or breathe in. (Schneyer and Januta, 8/16)

Open enrollment season for health insurance is just around the corner. Starting November 1, Americans who don’t get coverage through work or the government will be able to sign up for health plans that take effect in 2019. Fewer will do so this year than last, according to a recent report from the Congressional Budget Office. Last open enrollment, 11.8 million people signed up through the exchanges; roughly 5 million purchased plans “off-exchange” through agents or directly from insurers. This time, the CBO projects that just 12 million people in total will purchase individual-market plans — whether on or off the exchanges. Progressives claim this drop is the product of sabotage by the Trump administration. But fewer people will sign up because Obamacare has made coverage too expensive. Fortunately, the administration has teed up several executive actions that could make insurance more affordable for those who shop in the individual market. (Sally C. Pipes, 8/16)

This month, Monsanto was ordered to pay $289 million to a former school grounds keeper in San Francisco who used its weed killer Roundup, and now is dying of non-Hodgkins lymphoma. It’s the first ruling in more than 800 cases alleging that using Roundup gave its handlers cancer. The jury verdict is significant for Iowa farmers, whether or not they sued, because glyphosate, the key ingredient in Roundup, is widely used on Iowa farms: more than 88 pounds of it per square mile, to be precise. Glyphosate use has "sharply" increased since the development of genetically modified crops, according to a 2015 World Health Organization report that said it was probably carcinogenic to humans. But Monsanto continues to maintain it isn't. (Rekha Basu, 8/16)

We live in a world of risk and risk assessment. The trouble is that if you or your child happens to experience a one-in-a-million event, a remote possibility becomes a certainty. That’s good when it’s the lottery, bad when it’s a disease. Many people also increasingly distrust the “experts” who are judging risk, especially when it comes to a child’s well-being. It’s one of the reasons why some educated and well-intentioned parents are opting out of vaccination programs, despite clear scientific and epidemiological evidence against doing so. (William F. Bynum, 8/16)

I graduated high school in 2010. In the fast-paced world of technological advancement, those eight years create a vast difference between my high school experiences and those of the students I am teaching now. I'll admit: I texted during class sometimes, staring at my teacher, my thumbs working furiously on the buttons of my flip phone inside my desk. Quick glance down to make sure the words had come out correctly, send the message, get back to work. Now, my students don't only want to use their phones when someone is texting them. They have games they want to play, social media they need to update, and clever apps that can scan their math problems and give them the answers. The availability of smartphones and all the services they offer have created students today who have a complete inability to accept the state of boredom. (Rosemary Curts, 8/16)

As we accrue more data on the benefits and harms from cancer screening, it is clear that the benefits do not always exceed the harms. This imbalance is particularly at issue in lung cancer screening by low-dose computed tomography (LDCT), for which 1 randomized clinical trial found a mortality benefit in high-risk smokers and ex-smokers, but 3 other randomized clinical trials found no benefit. In addition, data from the National Health Interview Survey show that most people undergoing screening for lung cancer do not fall in the recommended groups, and thus their harms of LDCT, including radiation exposure, will likely exceed the benefits. (Rita F. Redberg, 8/13)

At the Massachusetts Biotechnology Council (MassBio), we have been following the proposed merger among the Beth Israel Deaconess Medical Center system, Lahey Health, New England Baptist Hospital, Mount Auburn Hospital and Anna Jaques Hospital with great interest. While hospital mergers may seem outside the realm of biotech, after much consideration and review we had to strongly support this proposal. (Robert Coughlin, 8/16)

Earlier this year, the Massachusetts Health Policy Commission (HPC) determined that the proposed merger between Partners HealthCare and Massachusetts Eye and Ear is likely to increase Massachusetts commercial health care spending by $20 million to a total of $60 million a year. ...Now up for review is what would be the second largest merger in Massachusetts health care to date: a proposed merger between the Beth Israel Deaconess Medical Center system, Lahey Health and a few other hospitals. (Rev. Burns Stanfield and Bonny Gilbert, 8/16)

The simple fact that Andrew was living at home is somewhat miraculous. Heroin and fentanyl caused him to stop breathing, but he learned to breathe on his own again. His kidneys failed and then recovered. But Andrew’s brain, starved of oxygen too long, was left severely damaged. More than four years have passed since the overdose. For Andrew’s parents, the fear that their son will die has now been replaced by a new set of realities and unanswerable questions: Is this a good life? Is he happy? What will happen to him when they grow old? (Daniela J. Lamas, 8/16)

The Oregon Health Authority is contemplating a radical plan to end opioid coverage for many chronic-pain patients enrolled in the state’s Medicaid program. Beginning in 2020, physicians would have one year to fully taper off doses of medications such as Percocet, Vicodin and OxyContin. OHA’s chief medical officer says the agency believes “pain patients have been put at higher risk with regard to overprescribing.” Oregon’s proposal is a more extreme version of increasingly common policies that position dose reductions as the key to patient safety. But the available evidence does not show a safety benefit from mandatory, across-the-board opioid tapers. Instead of targeting those most at risk of overdose, the mandate would needlessly exacerbate suffering for thousands of patients. (Sally Satel and Stefan Kertesz, 8/16)

In an attempt to combat one of the worst public health crises in the nation’s history, U.S. Senate committees are now debating a varied and wide range of  legislation to fight the opioid epidemic. This follows the approval by the House of dozens of such bills. At first blush, it might seem like reason for optimism. But the legislation, while well intended, leaves a gaping hole in federal drug policy. It does not even mention, much less engage, with the most severely disordered drug abusers. I am talking about those who are often ignored and neglected — the hundreds of thousands who are so sick they can no longer function normally in society, have lost their family and employment ties, and have few resources to get the treatment they so desperately need. They are the ones most likely to be among the nearly 200 Americans who die every day from drug overdoses. (Mitchell S. Rosenthal, 8/16)