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President Donald Trump's administration says it is trying to accommodate consumers as hold times grow for those seeking to enroll in insurance under the federal health care law. The Centers for Medicare and Medicaid Services said Thursday that some callers to HealthCare.gov are being asked to leave their contact information. A spokeswoman says operators will call them back and they'll be able to get coverage effective Jan. 1. (12/14)

Fewer people are expected to sign up for ObamaCare coverage ahead of Friday’s deadline to enroll in the exchanges. The Trump administration’s abbreviated enrollment period has left advocates acknowledging the numbers are almost surely going to be lower than the 9.2 million who signed up on HealthCare.gov at the end of the last open enrollment season. (Roubein and Hellmann, 12/14)

Don’t be fooled, Californians. Despite what you may be seeing or hearing about a Dec. 15 enrollment deadline, you still have more than six weeks to choose or switch your Affordable Care Act health plans. It’s true that Americans who live in the 39 states that rely on the federal health insurance marketplace, healthcare.gov, face a final deadline Friday to sign up for plans. But Californians who buy their own insurance via the private market or the state health insurance exchange, Covered California, have a three-month open enrollment period that ends Jan. 31, 2018. (Ibarra, 12/15)

Responding to a strong surge in demand, Covered California on Thursday announced that anyone who still hasn’t enrolled in a 2018 health insurance plan on the individual market now has until Dec. 22 to sign up for coverage that begins Jan. 1. ... While open enrollment ends for most states on Friday, Californians have until Jan. 31, 2018, to sign up. (Seipel, 12/14)

In Colorado, people shopping for health insurance on the individual market use Connectforhealthco.com to pick a plan that comes with tax credits provided under the Affordable Care Act. While Friday is the deadline to buy a plan that starts Jan. 1, open enrollment in Colorado lasts until Jan. 12. That’s because Colorado gained greater autonomy when it chose to set up its own health insurance exchange, rather that going with the federal Healthcare.gov. (Ingold, 12/14)

The numbers paint a contrast. By late December 2016, the end of the enrollment period, New Hampshire had seen 35,000 people choose individual marketplace plans, according to figures by the Center for Medicare and Medicaid Services. As of Dec. 9 this year, a week before the deadline, that number hovered around 25,000.Now, with the new midnight Dec. 15 deadline approaching, officials assisting with signup efforts say enthusiasm can only take the numbers so far. (DeWitt, 12/15)

The deadline to enroll in an Affordable Care Act plan is Friday, but most Florida residents will qualify for an extension until Dec. 31 to sign up for coverage through the healthcare.gov insurance exchange because of damage caused by Hurricane Irma. A special enrollment period for Floridians kicked in after the Federal Emergency Management Agency declared all of the state’s 67 counties eligible for assistance as a result of Irma, which made landfall in South Florida on Sept. 10. (Chang, 12/14)

Florida is leading the nation with more than 1 million people signing up for health insurance in the federal marketplace since open enrollment began Nov. 1, according to numbers released by the Trump administration this week. Nationwide, almost 4.7 million people have signed up for a plan this year, which is 17 percent more than the same time last year. (Miller, 12/14)

With a deadline looming next week, officials at the state’s health insurance exchange are urging residents to enroll in coverage for 2018 as uncertainty around federal health care policy continues to swirl. So far, more than 260,000 people have selected plans or have been auto-enrolled in coverage through the Massachusetts Health Connector. (Dayal McCluskey, 12/14)

The deadline to shop for a health insurance plan on the federal marketplace is here, and so far more than 579,000 Texans have purchased insurance on healthcare.gov. While that’s nearly 30 percent higher than the sign-up rate this time last year, one reason the pace might be accelerated is because the period to enroll in 2018 plans is 45 days shorter this year. Most Texans have until Friday to shop on the federal marketplaces established by the Affordable Care Act. Indeed, despite a tumultuous year of back-and-forth debate and various failed attempts by Republicans to repeal or replace the Obama-era health law, it remains in effect. (Rice, 12/14)

The seemingly imminent repeal of the Affordable Care Act’s insurance requirement, which could happen next week as part of the final passage of Republicans’ broad tax overhaul, has focused attention on Congress’ potential next moves on health care, including a bipartisan plan to shore up the insurance markets. But that plan, sponsored by Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.), is losing support as more health analysts say it could raise costs for many consumers. The bill would restore payments to insurers, allowing them to cut premiums, but in doing so it would reduce the tax credits that are pegged in part to the premium costs of certain plans. (Armour, 12/14)

Speaker Paul Ryan (R-Wis.) said Thursday that lawmakers need to "revisit" ObamaCare, but also pointed to welfare reform as the focus of next year. "ObamaCare is collapsing and failing, so we won’t be able to ignore that problem," Ryan said at a news conference. "So we’re going to have to revisit the problem of a health-care marketplace that is collapsing and that is something that we’re just going to have to get on to." (Sullivan, 12/14)

Health-care groups are urging states to override changes made under an executive order from President Trump, warning the moves threaten to undermine insurance markets. A coalition of leading health-care groups, including America’s Health Insurance Plans and the American Cancer Society Cancer Action Network, wrote a letter Thursday to state insurance commissioners urging them to take action to counteract an order signed by Trump in October. That order aimed to ease ObamaCare rules and opened up cheaper insurance plans that do not have to meet all of the ObamaCare requirements. (Sullivan, 12/14)

As House and Senate negotiators put the finishing touches on their tax plan, one thing is clear: the legislation will likely have a big impact on health care. The tax bill could repeal the individual mandate — a centerpiece of the Affordable Care Act — and could also trigger cuts in Medicaid and Medicare funding down the line. (Bush, 12/14)

President Donald Trump's drive to win passage of a sweeping Republican tax bill in the U.S. Congress hit potential obstacles on Thursday as two more Republican senators insisted on changes, joining a list of lawmakers whose support is uncertain. (12/14)

Senate Republicans rushed toward votes next week on their sweeping $1.5 trillion tax package, hopeful ailing Sens. John McCain and Thad Cochran will be back and well enough to cast their votes. The 81-year-old McCain, of Arizona, is at a Washington-area military hospital being treated for the side effects of brain cancer treatment. Cochran, 80, of Mississippi, had a non-melanoma lesion removed from his nose earlier this week. (Lardner and Daly, 12/14)

Kaiser Health News: Listen: Collins Plays Let’s Make A Deal On ACA Mandate Repeal

Sen. Susan Collins (R-Maine) was a deciding vote that kept the Affordable Care Act standing last summer, and she has had a lot of leverage in negotiations on the GOP tax bill this fall. Collins says she will vote for the bill even though it repeals the ACA’s mandate that most people buy insurance or pay a penalty. In exchange for that vote, she has assurances that payments for low-income consumers called cost-sharing subsidies will be restored and that a bill to stabilize the markets will move forward. (Wight, 12/15)

The failure of Republicans in Congress this year to repeal the Affordable Care Act means that a controversial tax on medical device sales will return in 2018 unless legislators intervene in the next couple weeks, putting a major Bay State industry on edge. The tax, which was included in the 2010 health care reform law as a way to help pay for an expansion of Medicaid, puts a levy of 2.3 percent on devices like X-ray and MRI machines, surgical instruments and pacemakers. (Murphy, 12/14)

Everyone in Congress claims to be a champion of children’s health.But funding for the Children’s Health Insurance Program ran out Sept. 30. And some lawmakers worry it might not be replenished until early next year. It’s a mess that can happen only in Washington: Even a bipartisan program that covers 9 million poor and middle-class children is caught up in partisan squabbling, with Republicans and Democrats split over how to pay for renewed funding and placing blame on the other party. (Haberkorn, 12/15)

Lawmakers have yet to renew federal funding for the Children’s Health Insurance Program, also known as CHIP, which insures nearly nine million children in low-income families. Most states will run out of money in the next few months if Congress does not act. (Park, 12/14)

For Nancy Minoui of Portland, Oregon, and Crystal Lett of Dublin, Ohio, Congress' failure to fund the Children's Health Insurance Program is not some distant tale of political wrangling. For Minoui, it's about how to provide care for her daughter, Marion Burgess, born last Valentine's Day with a hole in her heart. For Lett it's about providing care for her 6-year-old son, Noble, who was born with a complex genetic disorder. (Mincer and Abutaleb, 12/14)

The Children's Health Insurance Program funding fight shows no sign of ending as next week's spending deadline looms, and states and hospitals are mounting increasingly urgent pleas for action. States now have sent out letters to parents of CHIP-enrolled children warning them the program may not continue. One-third of states project they will run out of CHIP funding by the end of January. (Luthi, 12/14)

Democrats are unhappy about the House GOP’s Children’s Health Insurance Program provisions in the continuing resolution, although they are pushing for a renewal for the funding with different offsets. The CR, which would continue government funding through Jan. 19, includes a House-passed CHIP renewal bill (HR 3922) that funds CHIP for five years and other safety net programs such as community health centers for two years. (Raman, 12/14)

University of Chicago medical students had a message for Chicagoans on Thursday: Congress is putting children’s health at risk by not renewing a children’s health insurance program. More than 50 medical students and others gathered at Federal Plaza on Thursday to decry Congress’ failure to reauthorize funding for the Children’s Health Insurance Program before it expired in late September. About 255,000 children in Illinois receive coverage through the program, which is meant to help kids whose families make too much to qualify for Medicaid but still can't afford private insurance. (Schencker, 12/14)

Massachusetts’ top health official said Thursday that the state would maintain health coverage for thousands of children through the middle of 2018, even if Congress fails to approve new funding for the popular program on which they rely. About 172,000 children in Massachusetts from low- and moderate-income families are covered by the Children’s Health Insurance Program, or CHIP, whose cost is paid mostly by the federal government (the rest is covered by the state). (Dayal McCluskey, 12/14)

The Federal Communications Commission voted 3-2 Thursday to repeal net neutrality rules, ending Obama-era regulations that prohibited internet providers from blocking or slowing web content. Whereas all internet traffic previously shared the same "lane," it can now be split among different lanes with different speeds. Those differing speeds could hurt telemedicine since it requires a "pretty robust connection," said Mei Kwong, interim executive director and policy adviser for the Center for Connected Health Policy. (Arndt, 12/14)

The Department of Veterans Affairs' contract for a new electronic health record system from Kansas City-based Cerner isn't finished due to lingering questions from VA Secretary David Shulkin about whether it will provide the benefits of full interoperability, Shulkin said Tuesday at a POLITICO Outside, In event. Shulkin said it would be easy to simply replicate the Department of Defense's version of Cerner. But, he added, "I'm not convinced we can do it with the rest of the system." The Choice program allowing veterans to seek care from outside the department necessitates a system that provides interoperability between the VA and its private-sector partners. (Tahir, 12/12)

The VA turned to Cerner for a new health records system largely because it would match up with the system Cerner and other companies are building for the U.S. Defense Department. The VA even sidestepped its normal bidding process to award Cerner the contract. (Davis, 12/14)

As the first babies born with brain damage from the Zika epidemic become 2-year-olds, the most severely affected are falling further behind in their development and will require a lifetime of care, according to a study published Thursday by the Centers for Disease Control and Prevention. The study, the first to comprehensively assess some of the oldest Zika babies in Brazil, focused on 15 of the most disabled children born with abnormally small heads, a condition called microcephaly. (Belluck, 12/14)

A new report paints a bleak picture, one that suggests Brazilian children who were born with severe microcephaly and whose blood showed signs of prior Zika infection are at increased risk of cerebral palsy, seizures, vision problems, and many other conditions. Those findings — published Thursday in Morbidity and Mortality Weekly Report, a journal published by the Centers for Disease Control and Prevention — come from a small study of the health status of 19 babies born with Zika-related microcephaly. (Branswell, 12/14)

The investigation focused on Brazil, where thousands of children born during 2015 and 2016 were affected by the virus. It studied the health and development of 19 children with microcephaly and evidence of congenital Zika virus through clinical assessments, medical record reviews and caregiver interviews. (Rios, 12/14)

When the Oxitec mosquitoes interbreed with wild ones, the genetic engineering causes birth defects in the offspring, killing off successive generations. Oxitec’s mosquitoes were approved in October by the Food and Drug Administration as a pesticide, but they cannot be released without approval from state authorities and the Environmental Protection Agency. (Tourial, 12/18)

Like much of the rest of the nation, West Virginia has a severe shortage of behavioral health professionals who can help people beat their addictions to drugs and alcohol. And with hundreds of people outside of the criminal justice system on waiting lists for treatment, county mental health officials are hesitant to make room for drug users when not enough beds and treatment services are available for existing clients, according to Jim Johnson, West Virginia’s recently appointed drug czar. (Vestal, 12/14)

White House press secretary Sarah Sanders on Thursday told reporters she was unsure when Congress would fund new initiatives specific to addressing the opioid crisis. Sanders declined to guarantee that additional spending would be included in either a stopgap spending bill Congress is expected to approve in the coming week or a longer-term budget agreement many expect lawmakers to reach in January. (Facher, 12/14)

Sen. Ed Markey (D-Mass.) is raising concerns about a campaign in his home state aimed at combating the opioid epidemic and questioning the Department of Justice’s role in it. In a letter to Attorney General Jeff Sessions sent Thursday, Markey asked what the department's role was in “designing, funding or supporting” the campaign in Massachusetts.  (Roubein, 12/14)

When, in early 2016, Dr. Reshma Jagsi published her survey on sexual harassment in biomedical research labs, it prompted an outpouring of emails from women in the field. The study was the first of its kind in two decades, and its findings were startling: Among a sample of 1,000 biomedical researchers, both men and women, the number of women reporting workplace sexual harassment had declined since 1995, but still amounted to 1 in 3 women. Now, in the wake of high-profile sexual assault allegations sweeping through popular culture, Jagsi — who heads the Center for Bioethics and Social Sciences in Medicine at the University of Michigan — has found that her research has gotten a second life. The biggest change, she said, is that she is hearing from more men. (Samuel, 12/15)

Women with high glucose readings early in pregnancy are at increased risk of having a baby with heart defects, even if they do not have full-blown diabetes, a new study found. Diabetes during pregnancy is a known risk factor for heart problems in babies. Researchers studied data on 19,107 mothers, members of two large health care systems, of whom 811 gave birth to babies with congenital heart disease. The data included blood glucose measurements done between four weeks before conception and the 14th week of gestation. (Bakalar, 12/15)

Eleanor Thomas and her sister have reorganized their schedules and finances to take care of their 93-year-old mother, Elising Roxas, who needs round-the-clock care. “A lot of women, especially single women, need to work,” said Ms. Thomas, 63, who lives in Mililani, Hawaii. “But at the same time they have all these responsibilities, to pay the bills, and to caregive. How can they possibly do all of that the same time?” (Towey, 12/15)

A new study suggests that vigorous physical activity may increase the risk for vision loss, a finding that has surprised and puzzled researchers. Using questionnaires, Korean researchers evaluated physical activity among 211,960 men and women ages 45 to 79 in 2002 and 2003. Then they tracked diagnoses of age-related macular degeneration, from 2009 to 2013. Macular degeneration, the progressive deterioration of the central area of the retina, is the leading cause of vision loss in the elderly. (Bakalar, 12/14)

On average, there's nearly one school shooting a week in the United States, according to Everytown Research, a non-profit organization which advocates for gun control. ...There are various schools of thought as to how to approach active shooters on a school's campus. (Banlamudi, 12/14)

More than 76,000 Arizonans who purchased a Theranos blood test will get a refund check in the mail starting Friday under a $4.6 million settlement Arizona Attorney General Mark Brnovich negotiated with the embattled blood-testing company. The average refund per customer will be $60.92, but customers who ordered several tests or more expensive tests will get a larger check. (Alltucker, 12/14)

In Oregon, with a population of 4 million, about 600 people are required to receive treatment for mental illness against their will each year. That is a low rate compared with that of other states. A workgroup of judges, mental health advocates, police and state lawmakers is trying to revise those rules to allow officials the latitude to ensure that fewer people like Karen Batts die on the streets. (Harbarger, 12/14)

Fenway Community Health Center’s board of directors said it is “eager for change,” in its first public communication addressing the nonprofit’s future since its chief executive and chairman resigned this week over the handling of harassment and bullying complaints against a former doctor. (Healy, 12/15)

Dr. Peter Provonost, one of the nation’s top patient safety experts and advocates, is leaving Johns Hopkins Health System for a job at insurance giant UnitedHealthcare, he announced Thursday on Twitter. “A great opportunity to help improve care for millions,” tweeted Pronovost, currently Hopkins’ senior vice president for patient safety and quality and director of the Armstrong Institute for Patient Safety and Quality. (Cohn, 12/14)

Two couples that gave birth to children with a genetic defect later traced to donated eggs won a lawsuit against a New York fertility doctor and his clinic in the state’s highest court Thursday. The two children, both born in 2009, have Fragile X syndrome, a genetic condition that can lead to intellectual and developmental impairments. The parents, identified by initials and last names in legal papers, were told the egg donors were screened for genetic conditions. (Klepper, 12/14)

The American Medical Association is partnering up with MedChi, the Maryland State Medical Society, as part of a multi-state effort to reduce Type 2 diabetes. The association has started to work on preventing new cases of Type 2 diabetes in California, Michigan and South Carolina and will now be paired with Maryland as well eight additional medical societies — in Maine, Mississippi, New York, Ohio, Oregon, Pennsylvania and Rhode Island — to develop models to prevent the disease, according to a recent statement. (Slater, 12/14)

Minnesota Health Department researchers say efforts to better coordinate care for diabetes likely fueled a sharp 22 percent drop in hospitalizations for the condition. They traced the decline between 2006 and 2014 to fewer hospital admissions for diabetes-related health problems other than extremely high or low blood sugar levels. (Zdechlik, 12/14)

A recent Star Tribune series exposed abuse and neglect in Minnesota nursing homes. The newspaper found that in the last year, across state-licensed homes for the elderly, there have been 25,226 allegations of neglect, physical abuse, unexplained injuries and thefts. To make matters worse, 97 percent of these incidents were never investigated. As we and our loved ones get older, how do we prevent abuse and exploitation? (Curtis and Pekow, 12/14)

Activists are blaming the Republicans they help put in power — as well as Democrats — for the lack of action on the gun lobby’s number one legislative priority. (Drusch, 12/14)

As a new mother, D.C. Council member Brianne K. Nadeau (D-Ward 1) often pauses during long workdays to go into her office, shut the door and pump milk for her 3-month-old daughter. But on Thursday during a public hearing about homelessness that spanned nearly six hours, Nadeau announced that instead of excusing herself, she would be pumping from the dais. (Chandler and Nirappil, 12/14)

Maryland has received federal approval to expand services for people with developmental disabilities. The state health department said Thursday said the Centers for Medicare and Medicaid Services approved expanding services through the Maryland Developmental Disabilities Administration’s Community Supports Waiver. (12/14)

A pharmacy services unit of the Denver-based dialysis provider DaVita Inc. will pay $63.7 million to resolve allegations it improperly billed federal health care programs and paid illegal financial inducements to patients, the U.S. Department of Justice reported Thursday. The settlement resolves an investigation by the U.S. Department of Justice into the practices by DaVita Rx LLC, a pharmacy services unit that specializes in serving patients with severe kidney disease. (Osher, 12/14)

After months of tense negotiations and weeks of political impasse, the City Council on Thursday derailed a proposal that would have changed the ownership structure of the city’s largest hospital, Bayfront Health St. Petersburg. The 5-3 vote scuttled a deal that would have allowed the Foundation for a Healthy St. Petersburg, a nonprofit that owns 20 percent of the hospital, to sell its share, separate from Bayfront and expand its charitable mission. (Frago and Griffin, 12/14)

Penn Medicine and Virtua plan to build a $35 million proton cancer therapy center on Virtua’s campus in Voorhees, the two nonprofit health systems said Thursday. Penn already has a proton therapy center on its University City campus. Since the Roberts Proton Therapy Center opened in 2010, at a cost of  $144 million, Penn oncologists have treated almost 4,500 patients there, Penn said. The South Jersey center is expected to open in 2020. (Brubaker, 12/14)

University of Maryland Upper Chesapeake Health is moving forward with the first phase of its planned Havre de Grace Medical Campus. The Harford County based hospital and outpatient services operator has applied for approval to build a 40-bed, “special psychiatric hospital” on 32 acres off Barker Lane, according to legal notices published recently by the Maryland Health Care Commission. (Anderson, 12/14)

While it’s common for hospitals to have close relationships with their top benefactors, prominent experts in nonprofit and health-care law say the Swedish-Sabey alliance has developed an unusual interdependence, setting up potential conflicts and pitfalls that some organizations work to avoid. ...Along the way, Sabey’s company has collected millions of dollars in annual rent from Swedish and embarked on a for-profit venture with its parent organization. He has helped connect device companies with surgeons and propelled a contentious plan for taller buildings in the campus neighborhood where his business now owns $150 million in real estate. (Baker, 12/14)

Between 2013 and 2016, the uninsured rate for adults ages 19 to 64 declined in all states and the District of Columbia, and fell by at least 5 percentage points in 47 states. Among children, uninsured rates declined by at least 2 percentage points in 33 states. There were reductions of at least 2 percentage points in the share of adults age 18 and older who reported skipping care because of costs in the past year in 36 states and D.C., with greater declines, on average, in Medicaid expansion states. (Hayes et al., 12/14)

The news is filled with stories of celebrities who have engaged in egregious sexual misconduct. A recent poll suggested that more than half of U.S. women have experienced “unwanted and inappropriate sexual advances” at some point in their lives. Because I led a study of workplace sexual harassment in medicine, I was not surprised when reporters contacted me for comments on the recent disclosures. When a secretary filling in for my usual assistant relayed one reporter’s request, she told me she presumed the story was about my personal experience of sexual harassment. Disturbed, I leapt to correct her misapprehension: I was being sought out as a scholarly expert, not a victim. Then I wondered why it seemed so urgent to make that distinction. (Jagsi, 12/13)

In this cohort study of 5760 women with ductal carcinoma in situ who underwent mastectomy, women treated at hospitals under high financial distress and medium financial distress were significantly less likely to receive breast reconstruction surgery than women treated at hospitals with low to no financial distress. ...Hospital financial distress (HFD) is a state in which a hospital is at risk of closure because of its financial condition. Hospital financial distress may reduce the services a hospital can offer, particularly unprofitable ones. Few studies have assessed the association of HFD with quality of care. (Richards, Rundle, Wright et al., 12/6)

Health policies and clinical programs that encourage an individualized approach to glycemic control for U.S. adults with type 2 diabetes reduce costs and increase quality of life compared with uniform intensive control. Additional research is needed to confirm the risks and benefits of this strategy. (Laiteerapong et al., 12/12)

MenB-FHbp elicited bactericidal responses against diverse meningococcal B strains after doses 2 and 3 and was associated with more reactions at the injection site than the hepatitis A virus vaccine and saline. (Ostergaard et al., 12/14)

Findings: In this population-based cohort study of patients with hip fracture and hip arthritis, there were 960 and 1560 overlapping procedures, respectively. For patients undergoing overlapping procedures, there was an approximately 90% increase in the risk for surgical complications at 1 year, although the association was weaker in elective hip replacements than in hip fractures. Meaning: Overlapping surgery is associated with an increased risk for complications in hip surgery, particularly for nonelective procedures. ... Overlapping surgery, also known as double-booking, refers to a controversial practice in which a single attending surgeon supervises 2 or more operations, in different operating rooms, at the same time. (Ravi et al., 12/4)

There is mixed evidence that blood pressure (BP) stabilizes or decreases in later life. It is also unclear whether BP trajectories reflect advancing age, proximity to end of life, or selective survival of persons free from hypertension. ...  In 46 634 participants (51.7% female; mean [SD] age at death, 82.4 [9.0] years), SBPs and DBPs peaked 18 to 14 years before death and then decreased progressively. (Delgado, Bowman and Ble, 12/4)

Another reason experts expect an enrollment decline is the Trump administration’s management of the program, which has included neglect and outright sabotage. Over the past year, the administration has reduced spending on “navigators,” the official counselors who help people enroll, by 40 percent. And it has cut spending on advertising by 90 percent, despite evidence that such efforts boosted enrollment and encouraged people to shop around for better deals. (Jonathan Cohn, 12/13)

Even before his grand giveaway to corporations and the wealthiest Americans has passed, Republicans are sharpening their knives to carve up programs that assist the middle class and the poor to pay for it. ...Senate Republicans already inserted a sneaky way in their bill to lower Social Security payments by changing the way they’re calculated. (Joni Ashbrook, 12/14)

Soon, Congress will once again consider a short-term spending bill designed to keep the government running while procrastinating lawmakers figure out how to run the country. Once again, Congress is expected to put off a decision on fully funding the Children’s Health Insurance Program, known as CHIP. The delay is unnecessary. (12/14)

While health policy attention in recent months has focused on Washington, D.C., several proposals from individual states have garnered less publicity despite their potentially far-reaching implications. One such proposal comes from Massachusetts, which has applied for a waiver from federal rules in order to shift 140,000 near-poor adults — those with incomes between 100% and 138% of the federal poverty level — from Medicaid into private plans on the state’s health insurance marketplace and, perhaps more important, to create a closed drug formulary for Medicaid, which would be a first for the program. (Benjamin D. Sommers and Aaron S. Kesselheim, 12/13)

Uncontrolled asthma keeps many kids from low-income communities out of school and their parents out of work, and in the worst cases puts them in the hospital — or the morgue. But it is among the most manageable diseases if patients are diagnosed, given medication (and education on how to use it), and empowered to live in environmentally-friendly homes. Yet two academic medical pillars in Baltimore — Johns Hopkins and the University of Maryland Medical Center — have chosen profit over public health in the city’s poorer neighborhoods. (John Fairhall, 12/13)

As the U.S. Congress debates the future of the Affordable Care Act (ACA), the public has increasingly called for bipartisan solutions on health care reform. An immediate challenge is stabilizing the ACA marketplace, where 10.3 million people enroll in coverage. Given that certain areas of the country have few insurers participating in the marketplace — because of high enrollee costs, uncertainty over cost-sharing–reduction payments from the federal government, and the expiration of protections for insurers such as reinsurance and risk corridors (which limit how much they can gain or lose through risk sharing) — policies that encourage insurers to enter and stay in the marketplace are needed. (Zirui Song, 12/14)

Congress gave veterans the freedom to receive medical care from providers in their local communities through the Veterans Choice Program. The program was intended to make certain that veterans would never again be forced to wait in long lines or drive hundreds of miles to access care they deserve. ... From the program’s inception, however, we emphasized that Choice was only the first step toward broader reform of veterans’ health care. That’s why we have introduced legislation that incorporates lessons learned from Choice to transform the VA into a modern, high-performing and integrated health care system that will improve veterans’ access to timely and quality care — within the VA and in the community. (Sens. John McCain (R-Ariz.) and Jerry Moran, (R-Kan.) 12/15)

The opioid epidemic has claimed more than 300,000 lives in the United States since 2000 and could claim another half million over the next decade. Although heroin and illicitly manufactured fentanyl account for an increasing proportion of opioid-involved overdoses, the majority of persons with opioid addiction started with prescribed painkillers. The search for solutions has spread in many directions, and one tentacle is probing the legal accountability of companies that supply opioids to the prescription market. Even as the federal government, among others, pursues civil and criminal actions against physicians and pharmacies to address inappropriate prescribing and dispensing of opioids, a variety of lawsuits have been filed and continue to be filed against opioid manufacturers and distributors. (Rebecca L. Haffajee and Michelle M. Mello, 12/14)

An in-depth study commissioned by the California Endowment’s Building Healthy Communities found that in some rural counties, death rates for whites ages 25 to 34 have more than doubled because of premature deaths. Drug overdoses account for only about a third of these excess deaths, while suicide and alcoholic liver disease each cause almost as many. (Anthony Iton, 12/14)

The gravity of the opioid epidemic in the United States barely needs introduction. The numbers speak for themselves: in 2015, more than 33,000 Americans died from an opioid overdose, according to the Centers for Disease Control and Prevention — similar to the 35,000 and 36,000 deaths attributable to motor vehicle accidents and firearms, respectively, in the same year. The dramatic rise in opioid prescribing in the United States since the 1990s is frequently blamed as a driver of this epidemic, and policymakers have focused substantial energy on curbing prescribing rates. (Michael L. Barnett, Josh Gray, Anna Zink and Anupam B. Jena, 12/14)

My best Route 88 AC transit friend has cancer. He’s waiting until the end of the holidays to “turn himself in” to the hospital, where they’ll “poke him all over,” but he knows in any case he has to do this soon because there’s a big lump on his stomach. I didn’t know how much I’d begun to care for him, my fellow in-a-wheelchair bus rider, until I felt my sadness become a different kind of lump in my throat. (Katie Savin, 12/15)

Question: With the US Congress apparently unable to advance federal policies, except for a tax reform bill, how do we move forward the policies needed for improving health and health care, while reducing costs? Answer: One state at a time and with a committed constituency. (Diana Mason, 12/13)

On December 13th the Campaign for Tobacco-Free Kids released its annual report “Broken Promises to Our Kids,” which evaluates how states address the “enormous health problems caused by tobacco use in the United States.”  One of the key metrics is funding, and I’m proud to report that – after many years of stagnant or declining funding – Tennessee has risen in the rankings, spending $6.2 million on tobacco prevention and cessation for 2018.  (Bill Frist, 12/13)