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Warren released a plan Friday detailing how she would seek to pay for "Medicare for All" without raising taxes on the middle class "by one penny." The highly anticipated plan arrives amid a weeks-long onslaught from Warren's Democratic primary rivals, who accused the Massachusetts senator of misleading voters of hiding from the fiscal realities of financing a program that some experts have calculated could cost up to $34 trillion over a decade. (Luhby, Krieg, Lee and Santiago, 11/1)

So how would she pay for it? Among other proposals, Warren calls for bringing in nearly $9 trillion in new Medicare taxes on employers over the next 10 years, arguing this would essentially replace what they’re already paying for employee health insurance. Further, Warren’s campaign says if they are at risk of falling short of the revenue target, they could impose a “Supplemental Employer Medicare Contribution” for big companies with “extremely high executive compensation and stock buyback rates.” (Singman and Berger, 11/1)

Under Ms. Warren’s plan, employer-sponsored health insurance — which more than half of Americans now receive — would be eliminated and replaced by free government health coverage for all Americans, a fundamental shift from a market-driven system that has defined health care in the United States for decades but produced vast inequities in quality, service and cost. Ms. Warren would pay for the $20.5 trillion in new federal spending through a mix of sources, including by requiring employers to pay trillions of dollars to the government, replacing much of what they currently spend to provide health coverage to workers. (Kaplan, Goodnough and Sanger-Katz, 11/1)

Her plan is built on transferring to the government 98% of the $8.8 trillion she estimates that employers will spend on private insurance for their employees. “We can generate almost half of what we need to cover Medicare for All just by asking employers to pay slightly less than what they are projected to pay today, and through existing taxes,” Warren wrote in a 20-page online post detailing her program. Companies with fewer than 50 employees would be exempted and — in a nod to unions whose support will be key in the Democratic primary — Warren said that employers already offering health benefits reached under collective bargaining agreements will be allowed to reduce how much they send to federal coffers — provided that they pass those savings on to employees. (Weissert, 11/1)

Warren places most of the revenue burden on businesses and the wealthy. She plans to carry over almost all existing health funding from employers and state governments, while also levying a variety of new taxes on the rich, corporations and high-earning investors — including doubling her signature wealth tax on billionaires. Warren backs up her revenue and cost estimates with 44 pages of analysis from experts, including former IMF chief economist Simon Johnson, former Obama economic adviser Betsey Stevenson, Moody’s chief economist Mark Zandi, and former Obama-appointed Medicare and Medicaid administrator Dr. Donald Berwick. (Sarlin and Vitali, 11/1)

Warren acknowledged that a “key step in winning the public debate over Medicare for All will be explaining what this plan costs – and how to pay for it”, and said health insurance and drug companies would push back to protect their profits. “Serious candidates for president should speak plainly about these issues and set out their plans for cost control – especially those who are skeptical of Medicare for All.” (Becker and Ax, 11/1)

As she saw her support swell in both national and early state polls in recent weeks, the 2020 presidential candidate faced more pressure about how she would fund a single-payer, government run health care system. (Pramuk, 11/1)

Warren had promised at a recent debate that she would not sign a bill that raises healthcare costs for the middle class. Under a plan released Friday morning, the Massachusetts senator and 2020 Democratic presidential candidate goes further: Middle class Americans would no longer pay health premiums or copays, and would also not pay any taxes to replace those costs. However, she will boost what had been a 3 percent wealth tax on people with over a billion dollars to 6 percent. (Kurtzleben, 11/1)

With her proposal, Warren becomes the first of the Democratic candidates to fully describe how a Medicare for All plan would be paid for. Her chief rival on the party’s left, Sen. Bernie Sanders of Vermont, who has campaigned in favor of a government-run medical plan for years, has outlined various options for financing, but has not committed to one. Warren argues in her plan that America could do away with private insurance — entirely eliminating premiums, deductibles and co-payments — and move everyone into a single-payer system without sacrificing care and without hiking taxes on the middle class. (Halper, 11/1)

Warren’s new health-care financing blueprint comes at a pivotal moment in the Democratic presidential primary, as the Massachusetts senator’s steady rise in the polls has prompted sustained attacks by competitors about how she would pay for her plans. As someone known to come up with politically savvy ways to sell dense policy ideas, communicating the gist of this 20-page proposal will be a major test of her candidacy. (Linskey and Stein, 11/1)

When ObamaCare’s open enrollment period begins Friday, many people can expect to find lower premiums and more plan options on healthcare.gov. But experts and advocates are projecting the number of enrollees for 2020 will decrease for a fourth consecutive year, in large part because of actions taken by the Trump administration. (Hellmann, 10/31)

Open enrollment for 2020 health plans on Connecticut’s insurance exchange is now underway. It’s the seventh enrollment period for the state’s marketplace, and despite a recent drop in the number of uninsured people, health officials are still trying to reach the nearly 187,000 residents who lack coverage. (Carlesso, 11/1)

Islara Souto, the navigation program director at Epilepsy Florida, said federal budget cuts have left her organization with only about half as many ACA outreach workers as she had last year. She now has seven navigators instead of 12 serving the South Florida region of Palm Beach, Broward, Miami-Dade and Monroe counties during the six-week enrollment period for 2020 that starts Friday and ends Dec. 15. (Conarck, 11/1)

The number and rate of uninsured children continued to increase in Florida and across the nation in 2018, according to a report released today by Georgetown University’s Center for Children and Families. The report finds that the number of uninsured children is now at the highest levels since major provisions of the Affordable Care Act took effect. (Miller, 10/31)

With more than 40,000 New Hampshire residents expected to sign up for federally subsidized health care through the Affordable Care Act next year, state and health care officials are reminding people that open enrollment for 2020 coverage begins Friday and lasts for six weeks. Health insurance premiums are expected to drop about 6% compared to double-digit increases in recent years, according to state officials. The Affordable Care Act — commonly referred to as Obamacare — was signed into law by President Barack Obama on March 23, 2010. (Phelps, 10/31)

Kaiser Health News: Obamacare’s Star Ratings Offer A Glimmer Of Insight ― But Not For All

As millions of Americans start shopping Friday for individual health insurance for 2020, they will see federal ratings comparing the quality of health plans on the Affordable Care Act’s insurance marketplaces. But Christina Rinehart of Moberly, Mo., who has bought coverage on the federal insurance exchange for several years, won’t be swayed by the new five-star rating system. (Weber and Galewitz, 11/1)

Georgia Gov. Brian Kemp unveiled a much-anticipated plan Thursday that aims to reduce premiums for residents who buy health insurance under the Affordable Care Act and give the state control of billions of dollars in federal health care funds. The proposal could eventually lead to subsidies for cheaper coverage that doesn't include all the benefits required by the ACA. The plan does not address Medicaid coverage. The Kemp administration is expected to release its Medicaid plans next week. (Thanawala and Nadler, 10/31)

Kemp announced the plan in his office, surrounded by lawmakers and government officials. He said Thursday that the waiver plan “is a Georgia-centric approach that will lower health care costs and insurance premiums for Georgia families, enhance access to top-notch doctors and state-of-the-art services, and ultimately improve health outcomes for every Georgian.” (Miller, 10/31)

"Through these new, innovative measures Georgians will have access to more insurance options like association health plans that cover our friends and neighbors with pre-existing conditions," Kemp said Thursday at an event announcing the plan. The Trump administration has already indicated it would approve state programs that would allow subsidies to pay for plans that don't comply with the law's coverage requirements. (Hellmann, 10/31)

As a part of the overhaul, Georgians could no longer access the federal website at healthcare.gov to enroll in ACA programs. The website would guide residents to private web brokers or encourage them to register directly with insurance companies, which is something they can’t do now. “No one has done this yet,” said Katie Keith, a professor of health law at Georgetown University. “This is exactly what the Trump administration encouraged states to do, and no one yet has taken them up on it. So this is going to be a really big deal.” (Hart and Bluestein, 10/31)

Georgia Access would let business owners help their employees pay for coverage purchased through the Obamacare marketplaces. It would also encourage more people to buy association health plans that cover preexisting conditions. The state is seeking a 1332 waiver from the CMS to move forward. Under the ACA, the CMS can grant waivers to states that allow them to change Obamacare requirements related to the individual and small group insurance markets. States can use them to tackle weak insurance markets, fix state-specific insurance issues or test different ways to provide coverage. (Brady, 10/31)

Most people on Medicare report that they are very satisfied with their health care coverage — but the program is complicated. Medicare features an alphabet soup of plans, coverage choices, premium levels and enrollment rules. The New York Times recently invited readers to submit their questions about Medicare. Today, we’re responding to some of the most frequent ones. (Miller, 11/1)

About 60 million Medicare recipients have the chance to change their coverage during the health care service’s annual open enrollment season, which opened on October 15 and closes on December 7. But research indicates fewer than 4 in 10 seniors review their Medicare plan each year to find the best deal. That means millions of Medicare recipients may be making a costly mistake: The program’s open enrollment period represents the only time of the year when seniors can tweak their drug coverage, says Diane Omdahl, the chief executive and founder of 65 Inc., which provides fee-based Medicare advice to seniors. Skipping the process, or rushing through it, can mean losing out on savings or choosing a plan that doesn’t cover your prescriptions, she adds. (Picchi, 10/31)

The tobacco giant Altria Group said Thursday that it had devalued its investment in the vaping company Juul Labs by $4.5 billion, a move that reflects deepening turmoil in the e-cigarette industry. Altria, one of the world’s largest tobacco companies, invested $12.8 billion in Juul in December 2018, acquiring a 35 percent stake in the Silicon Valley start-up. (Robertson, 10/31)

Juul appointed a longtime Altria executive as its CEO last month in a bid to rebuild its image. The company has also cut jobs, suspended advertising in the United States and revamped its management. "While we had a range of scenarios when we made the investment, we did not anticipate this dramatic a change in the e-vapor category," Altria Chief Executive Officer Howard Willard said on a conference call with analysts. (Mishra, 10/31)

Altria for years had a predictable cigarette business and steady profit growth. Acknowledging its shifting fortunes, the company on Thursday lowered its profit forecast for the next three years for growth in a range of 5% to 8%, instead of 7% to 9%. “The industry is becoming increasingly dynamic and complex,” Altria Chief Executive Howard Willard said on a conference call. “Of course, we’re not pleased to have to take an impairment charge on the Juul investment. We did not anticipate this dramatic a change in the e-vapor category.” (Maloney, 10/31)

U.S. antitrust enforcers are probing Altria Group Inc for potentially exerting influence over electronic-cigarette maker Juul Labs Inc before winning approval for a big share buy, Altria said in a government filing on Thursday. Marlboro maker Altria purchased a 35% stake in Juul in December 2018 for $12.8 billion, but the shares are non-voting and the companies have not yet received antitrust approval for the transaction. (10/31)

Juul CEO Kevin Burns stepped down last month and was replaced by Altria executive K.C. Crosthwaite. Since then, Juul said that it will end the sale of its flavored products in the US. And the company announced another management shakeup earlier this week. The problems at Juul have taken a toll on Altria. The stock is down more than 5% this year and the company abandoned talks about a possible reunification with Philip Morris (PM), which sells Marlboro and other cigarettes internationally, last month. Altria had spun off Philip Morris in 2008. (La Monica, 10/31)

Juul on Sept. 25 announced it was replacing its CEO Kevin Burns with longtime Altria executive K.C. Crosthwaite. Altria made a “special recognition” payment of $2.5 million upon his departure, according to a separate filing with the SEC that detailed Crosthwaite’s severance package. Within days, Crosthwaite hired Altria colleague Joe Murillo as Juul’s chief regulatory officer. The companies have said the decision was Juul’s. Crosthwaite served as an observer on Juul’s board of directors after Altria’s investment in Juul. (LaVito, 10/31)

Juul spokesman Josh Raffel declined to comment. Steve Callahan, the director of communications for Altria, said he had nothing to add beyond the filing “other than Juul is an independent company which makes its own decisions and the decision to hire K.C. Crosthwaite was Juul’s decision.” That echoes Callahan’s response last month. (Moore, McLaughlin and Huet, 10/31)

The number of U.S. vaping illnesses has jumped again, reaching more than 1,800 cases. The Centers for Disease Control and Prevention said 1,888 confirmed and probable cases have been reported in 49 states. An Illinois report brings the toll to 38 deaths in 24 states. (Johnson, 10/31)

Investigators still don’t know the specific cause of the illness, which include symptoms such as coughing, shortness of breath, gastrointestinal symptoms, fever and abdominal pain. Public-health authorities attribute most of the cases to products containing THC, the psychoactive ingredient in cannabis, and in particular to products obtained from unregulated or illicit sources such as friends, family, dealers or online. (Abbott, 10/31)

Another person in Illinois has died from an injury linked to vaping, the Illinois Department of Public Health announced Thursday, the third such case confirmed in the state. “The unfortunate death of a third Illinois resident underscores the seriousness of these lung injuries,” Illinois state health director Ngozi Ezike said in a statement. (Frazin, 10/31)

Social conservatives are urging President Trump’s administration to not back away from plans to include mint and menthol flavors in a ban on flavored vaping products. The leaders of Eagle Forum and the Republican National Committee’s (RNC) former director of faith engagement, along with others, sent Trump a letter Wednesday expressing concern over a recent report that the Trump administration was reconsidering banning mint and menthol products amid pressure from e-cigarette advocates. (Chalfant, 10/31)

About 1,400 New Hampshire residents will have to find new health insurance plans after state regulators said they had been sold illegal policies. The state insurance commissioner on Wednesday ordered Aliera Healthcare and Trinity Healthcare to stop selling or renewing insurance in New Hampshire. Officials say Aliera has been marketing and administering health coverage on behalf of Trinity, which calls itself a healthcare sharing ministry. (10/31)

Roger Sevigny, who was commissioner of the state Insurance Department for 15 years before retiring in the summer of 2018, is defending his role as a member of the board of Aliera Healthcare, which was ordered Wednesday to stop selling illegal insurance policies in New Hampshire. Sevigny joined Aliera's board in September. At that time, the company was already facing scrutiny in New Hampshire from Sevigny’s successor, as well as cease and desist orders in multiple states for questionable business practices. (Bookman, 10/31)

The company that runs Blue Cross and Blue Shield plans in five states is unlawfully denying behavioral health benefits to members in violation of generally accepted medical standards, according to a federal lawsuit seeking class action status. The complaint filed Thursday accuses Chicago-based Health Care Service Corporation of denying coverage last year to a young Chicago-area woman suffering from depression, substance use disorder, and borderline personality based on faulty guidelines issued by MCG Health in Seattle. (Meyer, 10/31)

Cigna Corp reported a 75% rise in quarterly profit on Thursday, benefiting from its acquisition of Express Scripts pharmacy benefits business last year. The health insurer, which in December closed its $52 billion acquisition of pharmacy benefits manager Express Scripts, said shareholders' net income rose to $1.35 billion, or $3.57 per share, in the third quarter ended Sept. 30, from $772 million, or $3.14 per share, a year earlier. (10/31)

Indiana has become the second state in two weeks to retreat from compelling some poor people to work or prepare for a job to qualify for Medicaid, pulling back from a central goal of the Trump administration for redesigning the health insurance safety-net. In an announcement Thursday, Indiana’s Medicaid agency joined Arizona in postponing plans to cut off benefits to people who do not meet new requirements. In publicizing their turnabouts, both states cite federal lawsuits challenging what supporters call “community engagement” rules but what critics say violate the program’s basic purpose. (Goldstein, 10/31)

“The Indiana Family and Social Services Administration announced today that it will temporarily suspend the reporting requirements of the Gateway to Work program due to a pending legal challenge,” the state agency said in a statement. A federal district judge has already struck down Medicaid work requirements in Arkansas, Kentucky and New Hampshire. Those cases are now being appealed. (Sullivan, 10/31)

Last month, two legal advocacy groups sued to block Indiana's Medicaid work requirement waiver. The lawsuit also seeks to remove Indiana waiver provisions that require beneficiaries to pay premiums, establish lock-out penalties, get rid of retroactive coverage and stop coverage for non-emergency medical transportation. Indiana estimated that 24,000 people would lose Medicaid coverage after the work requirement was fully implemented. CMS Administrator Seema Verma previously worked on Indiana's Medicaid program before taking the helm at the federal agency. (Brady, 10/31)

Other states are similarly reviewing such work requirements. Pennsylvania will ask beneficiaries if they want job training rather than basing Medicaid benefits on work. Ohio wants to have a caseworker to first connect with beneficiaries before terminating their coverage if they aren’t working. Arizona, which has federal approval to implement work requirements, has opted to delay the program. (Armour, 10/31)

In early August, Elizabeth Petersen was home-schooling her children in the kitchen of their northern Idaho home when she got a call from Providence Sacred Heart Medical Center, where her 4-year-old son, Paul, was set to have surgery a few weeks later. Since having a stroke around his first birthday, Paul had been under treatment to restore use of the right side of his body. He had recently graduated from a feeding tube and needed surgery to close a hole in his stomach. (Churchill, 10/31)

North Carolina is one of 15 states that saw a statistically significant jump over the past two years in the number of children without health insurance, according to a Georgetown University report released this week. The number of uninsured children grew in North Carolina between 2016 and 2018, pushing the total number of children not covered from 115,000 to 130,000, researchers at Georgetown’s Center for Children and Families found. (Blythe, 11/1)

A furor over patient privacy shadowed a four-day hearing this week that will help determine the fate of the last remaining abortion clinic in Missouri. The hearing, which concluded Thursday, follows months of legal wrangling that threatens to close the clinic, which is in St. Louis and run by Planned Parenthood. A ruling is expected to take weeks or even months. (Tavernise, 10/31)

An administrative hearing to decide whether Missouri can revoke the license for the state's only abortion clinic concluded Thursday with emotional testimony from a clinic official. The hearing in St. Louis before a commissioner with the Missouri Administrative Hearing Commission was expected to last five days but wrapped up a day early. A ruling isn't expected until February at the earliest. (Salter, 10/31)

An administrator at Planned Parenthood’s St. Louis clinic testified Thursday that recent Missouri inspections became much more combative after the involvement of the inspectors’ supervisor, who eventually opened an investigation into the clinic of his own volition. “The dynamic completely changed,” Kawanna Shannon, director of surgical services, said. Shannon’s testimony, which at times became emotional, came on the fourth and final day of a state administrative commission hearing that will help decide whether the clinic can retain its license to perform abortions. (Thomas, 10/31)

Nearly a decade after receiving U.S. citizenship, Guatemalan-born Mayra Lopez thought she had cleared all the hurdles for her parents to join her in the United States. Then on Oct. 4 U.S. President Donald Trump changed the rules she and others had been complying with: Trump signed a proclamation requiring all prospective immigrants to prove they will have U.S. health insurance within 30 days of their arrival or enough money to pay for "reasonably foreseeable medical costs." (10/31)

The two men haven't met, but their stories are strikingly similar. They grew up in Cuba, studied to become doctors and swore an oath to do no harm. Then, years later, they ended up somewhere they never expected: a privately-run US immigrant detention center in rural Louisiana. Held behind bars as they pleaded for asylum, these men say they watched people around them receiving poor medical care, but -- despite their years of training -- felt powerless to help. (Shoichet, 11/1)

U.S. Immigration and Customs Enforcement has transferred detainees out of a West Texas detention center after a water shortage forced the facility to use portable toilets and bottled water. The shortage has forced the West Texas Detention Facility, operated by Louisiana-based LaSalle Corrections, to turn off its water every night and outsource its laundry services since the shortage began Oct. 21. (Aguilar, 10/31)

The White House plans to name Homeland Security official Chad Wolf acting secretary, according to three people familiar with the situation. Wolf will replace acting DHS Secretary Kevin McAleenan, whose last day in the job was supposed to be Thursday. McAleenan will now stay until Nov. 7, according to one of the people with knowledge of the matter. (Lippman, Kullgren and Kumar, 10/31)

A pair of new studies report “impressive” benefits from a drug therapy for cystic fibrosis, a deadly and devastating disease that affects tens of thousands of people worldwide, the director of the National Institutes of Health wrote in an editorial published in The New England Journal of Medicine on Thursday. “These findings indicate that it may soon be possible to offer safe and effective molecularly targeted therapies to 90 percent of persons with cystic fibrosis,” wrote the director, Dr. Francis S. Collins, who led the team that in 1989 identified the gene that causes the genetic disease affecting the lungs and digestive system. (Chokshi, 10/31)

A new cystic fibrosis therapy dramatically improved patients’ lung function and showed clear signs of targeting the genetic root of the disease, instead of just alleviating symptoms — a breakthrough so long-sought that many doctors and patients are moved to tears when talking about it. The data, being unveiled Thursday at a national conference in Tennessee and simultaneously published in two leading medical journals, was so persuasive that the Food and Drug Administration last week approved the three-drug combination, called Trikafta — five months ahead of the agency’s deadline. (Johnson, 10/31)

One approach federal lawmakers have used to jumpstart certain types of drug development has been to offer vouchers to companies that can later be redeemed when seeking approval for yet another medicine. But a new analysis suggests the notion may not be worth the cost if it were used to entice drug makers to develop much-needed antibiotics. Citing a bill proposed last year to offer vouchers for new antibiotics, the researchers calculated the idea would have cost an extra $4.5 billion in spending on medicines over a 10-year period, had the legislation taken effect in 2007. (Silverman, 10/31)

Amgen is acquiring a premium stake in BeiGene (BGNE), one of the largest cancer-focused drug companies in China, for $2.7 billion as part of a broad commercial and drug development partnership, both companies announced Thursday. The California-based biotech joins a long list of American firms seeking to tap the pharmaceutical market in China, which is said to have as many cancer patients as the U.S. and Europe combined. (Feuerstein, 10/31)

Erika Haas calls it “the pull.” When Haas was 24, her doctor prescribed OxyContin for back pain. She quickly progressed to heroin — and then to methamphetamines. Now 30 and in recovery, she described the grip that meth had over her for more than five years. “It’s like God tells you that if you take another breath, your children will die,” she said, shaking her head and trying to hold back tears. “You do everything you can not to take a breath. But eventually you do. That’s what it’s like. Your brain just screams at you.” (Vestal, 11/1)

Kaiser Health News: Meth Trip Or Mental Illness? Police Who Need To Know Often Can’t Tell

The dispatch call from the Concord, N.H., police department was brief. A woman returning to her truck spotted a man underneath. She confronted him. The man fled. Now the woman wanted a police officer to make sure her truck was OK. “Here we go,” muttered Officer Brian Cregg as he stepped on the gas. In less than three minutes, he was driving across the back of a Walmart parking lot, looking for a man on the run. (Bebinger, 11/1)

Measles has a stealth side effect: New research shows it erases much of the immune system's memory of how to fight other germs, so children recover only to be left more vulnerable to bugs like flu or strep. Scientists dubbed the startling findings "immune amnesia." The body can rebuild those defenses — but it could take years. And with measles on the rise, "it should be a scary phenomenon," said Dr. Michael Mina of Harvard's school of public health, lead author of research published Thursday in the journal Science. (Neergaard, 10/31)

The weakened immunity leaves a child vulnerable for several years to other dangerous infections like flu and pneumonia. The damage occurs because the virus kills cells that make antibodies, which are crucial to fighting off infections. Scientists call the effect “immune amnesia.” During childhood, as colds, flu, stomach bugs and other illnesses come and go, the immune system forms something akin to a memory that it uses to attack those germs if they try to invade again. The measles virus erases that memory, leaving the patient prone to catching the diseases all over again. (Grady, 10/31)

The discoveries have enormous and immediate public health implications, researchers and clinicians said, and underscore more than ever the importance of measles vaccination. In recent years, anti-vaccine misinformation has been one reason vaccination rates have plummeted and global measles cases have surged. This year, the United States has had 1,250 cases of measles, the most since 1992. (Sun, 10/31)

Dr. Michael Mina, first author of the Harvard paper, said the phenomenon bears some similarities to the one that takes place after HIV infection. HIV also infects immune system cells. “If you took the first 10 years of somebody having HIV and you squished that into a few weeks, that’s the kind of memory damage and immune damage you get from measles,” Mina, an assistant professor of epidemiology at Harvard’s T.H. Chan School of Public Health, told STAT. (Branswell, 10/31)

“The measles virus is like a car accident for your immune system,” said Harvard University geneticist Stephen Elledge,the senior author of the Science study. An unvaccinated child who weathers the measles may emerge only slightly the worse from such a crash. Or he might sustain an injury from which it takes months or years to recover. (Healy, 10/31)

Previous evidence for immune amnesia has been based on mathematical models and population-level studies according to Dr. Michael Mina, assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health and the primary author of the study released this week in Science. The new studies are the first to show "any of the real biology that helps explain the population-level effects," he says. (Vaughn, 10/31)

This year has seen measles outbreaks all over the world, even in places that had previously eliminated the virus. Just a few months ago, the United States experienced its largest outbreak since 2000, which was so severe experts feared the country would lose its measles elimination status. In August, four European countries lost their measles-free status when the disease made a comeback after being eradicated years ago. (Yeung, 11/1)

In a related study published Thursday in the journal Science Immunology, researchers using the same study population of children from the Netherlands as in the Science study reported on how the measles virus affects immune cells called B cells. "This study is a direct demonstration in humans of immunological amnesia, where the immune system forgets how to respond to infections encountered before,” study author Velislava Petrova, a researcher at the Wellcome Sanger Institute in the United Kingdom, said in a statement. “We show that measles directly causes the loss of protection to other infectious diseases." (Stenson, 10/31)

Office workers bemoan driving home in the dark. Night owls relish the chance to sleep in. As clocks tick toward the end of daylight saving time, many sleep scientists and circadian biologists are pushing for a permanent ban because of potential ill effects on human health. Losing an hour of afternoon daylight sounds like a gloomy preview for the dark winter months, and at least one study found an increase in people seeking help for depression after turning the clocks back to standard time in November — in Scandinavia. (10/31)

Someone already drowsy or irritable during the day shouldn’t take this weekend’s time change as a license to sleep in or go to bed later, he said, because they’re only shifting their poor sleep habits. Such an abrupt change — even just an hour — can wreak havoc on our circadian rhythms, the 24-hour cycles of living beings that determine sleeping and feeding patterns, and can be affected by stimuli including sunlight and temperature. (Carney, 10/31)

Will you enjoy an extra hour of sleep when daylight saving time ends Sunday? Many sleep-deprived seniors, after dutifully setting back their clocks Saturday night, will mark the occasion doing what they’re often doing in the wee hours: tossing and turning, nudging snoring spouses, and fretting about being awake. (Weisman, 10/31)

The brain waves generated during deep sleep appear to trigger a cleaning system in the brain that protects it against Alzheimer's and other neurodegenerative diseases. Electrical signals known as slow waves appear just before a pulse of fluid washes through the brain, presumably removing toxins associated with Alzheimer's, researchers reported Thursday in the journal Science. (Hamilton, 10/31)

Laura Lewis and her team of researchers have been putting in late nights in their Boston University lab. Lewis ran tests until around 3:00 in the morning, then ended up sleeping in the next day. It was like she had jet lag, she says, without changing time zones. It’s not that Lewis doesn’t appreciate the merits of a good night’s sleep. She does. But when you’re trying to map what’s happening in a slumbering human’s brain, you end up making some sacrifices. “It’s this great irony of sleep research,” she says. “You’re constrained by when people sleep.” (Harrison, 10/31)

As fires spread across Northern California last year, Capt. Matt Alba and Strike Team 2253A found themselves wading through a smoldering jungle of plastic and metal in search of bodies. As they worked through charred auto shops and trailers, Mr. Alba kept thinking about the poisons they were kicking up, and that they did not have a single mask or hazmat suit among them. Wildfire fighting had changed. (Turkewitz, 10/31)

For tens of thousands of children in California, the biggest monsters this Halloween are wildfires that have thrown trick-or-treating into disarray. Nancy Metzger-Carter and her family have been in a San Francisco hotel since Saturday when a blaze in Sonoma County wine country forced them to evacuate their home in the small community of Graton. (Tang, 10/31)

The winds subsided in virtually all parts of the state Thursday and forecasters anticipated at least a week of calm weather, though there was no rain in the forecast that would reduce the threat of fall fires. However, winds lingered in some mountainous areas and they were blamed for driving a new wildfire that threatened homes Thursday night north of Los Angeles. (Melley and Chea, 10/31)

A brush fire exploded in Ventura County Thursday night, quickly consuming more than 7,400 acres and burning structures. The blaze, which has been dubbed the Maria fire, broke out atop South Mountain, just south of Santa Paula, and was moving toward the small agricultural towns of Somis and Saticoy. At least two stuctures have been lost, and 1,800 are threatened. (Wigglesworth and Lin, 11/1)

Fern Brown, 81, sat in the rear of a tent on the windswept fairgrounds of this historic Gold Rush town, drawing deep breaths through the mouthpiece of a nebulizer plugged into a power strip atop a plastic folding table. Afflicted for years with asthma and chronic obstructive pulmonary disease, Brown uses the nebulizer twice a day to avoid flare-ups that can be life-threatening. It turns her medicine into a fine mist that she can inhale. (Kreidler, 11/1)

“Is this seat taken?” I heard a student ask another student, who was holding a seat in the front row of a class I was about to teach. “Yep — that one’s taken!” He laughingly gestured to his lap. “Want to sit here instead?” he asked softly. She paused and looked at him silently for a split second before walking away and taking a seat at the back of the class. Not wanting to start the first day of the course on a negative note, I said nothing. I should have. (Periyakoil, 10/31)

A former top aide to WeWork co-founder Adam Neumann has filed a federal discrimination complaint against him, saying she was demoted for becoming pregnant, subjected to derisive comments and ultimately fired for raising concerns. The complaint seeks class action status against WeWork, alleging a pattern of discrimination against women at the office-sharing company. (Olson, 10/31)

A federal judge ruled this week that Oregon no longer needs extra oversight to ensure criminal defendants in need of mental health treatment get to the Oregon State Hospital within seven days. The development means the Oregon Health Authority is back in compliance with a 2002 court order that set the deadline. (Zarkhin, 10/31)

A bill in the Ohio House aims to eliminate “surprise” medical billing – unanticipated charges to patients receiving care in an in-network facility by out-of-network specialists. But the bill’s sponsor, Rep. Adam Holmes, a Muskingum County Republican, will need to talk Gov. Mike DeWine into his proposal, since the fellow Republican vetoed the most recent legislative attempt to rein in surprise billing. (Hancock, 10/31)

A New York City Council committee on Thursday reviewed whether the city is doing enough to provide primary care through its public hospital system. The City Council held the oversight hearing because it is pushing legislation that would create a health-access program that includes a “medical home” for primary-care services in every community district. The medical home could be one of the public NYC Health + Hospitals facilities, or a Federally Qualified Health Center, or FQHC. (West, 10/31)

According to the U.S. Environmental Protection Agency’s annual Toxics Release Inventory, plants in Ascension Parish emit greater quantities of toxic chemicals from industrial stacks than anywhere else in the country. While this method of measuring releases doesn’t factor in the toxicity of each pollutant, it signals relative levels of total chemical activity across regions.Unlike most industrial parishes, Ascension is among Louisiana’s whitest and most affluent. (Meiners, 11/1)

Advocates across Wisconsin are working with native women to help them recognize the signs of abuse and get help. And a researcher in Milwaukee, meantime, has plans to interview women in the state to see what barriers kept them from seeking help. (Zettel-Vandenhouten, 10/31)

California regulators have rejected a proposed merger between Adventist Health System/West and St. Joseph Health System that would have created a joint operating company to manage 10 hospitals in six largely rural counties in northern California. The California Department of Justice issued a denial letter Thursday citing concerns that the transaction is not in the public interest, has the potential to increase healthcare costs, and could limit access and availability of healthcare services. (Meyer, 10/31)

County and health officials in Asheboro will likely breathe a sigh of relief this weekend as a long-desired bill to help the county hospital, which has been in financial trouble in recent years, passed both chambers of the General Assembly and is headed to Gov. Roy Cooper for his signature. Language from the Rural Health Care Stabilization Act, which was introduced earlier this year by Senate leader Phil Berger (R-Eden) and Randolph County Sen. Jerry Tillman (R-Archdale), had been added to multiple bills this legislative session, looking for a vehicle for passage. (Hoban, 11/1)

A husband and wife in Louisiana have each been sentenced to 28 years in federal prison for horrific abuses of a young autistic woman who at times was forced to live in an outdoor cage. The sentences for Terry Knope II and Raylaine Knope had been expected since their guilty pleas to federal charges in May. They had received similar state court sentences in Tangipahoa Parish. (10/31)

On most weekends, Dave Fraser leaves his house at 6 a.m. to begin his marathon training. Starting from his home in Canarsie, Brooklyn, the 52-year-old pushes himself in a wheelchair across the borough, then across the Brooklyn Bridge and through Manhattan, where he culminates his workout with a couple of laps of Central Park. Afterward, he hops on an express bus back home. (Blint-Welsh, 10/31)

As Gov. Greg Abbott and Austin Mayor Steve Adler have waged a social media war about how to deal with homeless people in the state's capital, Texans who don't have shelter have gone about their daily lives in tents and under highway overpasses. The Texas Tribune spoke to several homeless residents in recent weeks to hear about life without a home. Here, they share their stories in their own words. (Espejo, Tatum and Gaspar, 11/1)

It is a common occurrence: an undocumented immigrant gets pulled over for a traffic violation, ends up in detention and swiftly is removed from the United States. In the case of Tania Romero, a Honduran mother of four who was arrested recently in Georgia, a deportation could happen within days. But her case is not so common. Ms. Romero has been receiving treatment for Stage 4 oral cancer that needs continual attention. And she has a son, a doctoral student at Yale University who is himself undocumented, who was not about to stand idly by. (Jordan, 10/31)

Portland State University chemistry professor David Peyton had never been attacked with such intensity. Peyton and a group of other chemists discovered almost five years ago that e-cigarettes could sometimes produce more cancer-causing formaldehyde than regular cigarettes. Formaldehyde is produced by a chemical reaction when a regular cigarette is lit, and finding it at such high levels in e-cigarette vapor, which has been held out as a safer smoking alternative, was a surprise. The study made headlines when the New England Journal of Medicine published it in January 2015. But along with the publicity came a swift backlash. (Langreth, 10/31)

Before there were vapes, there was sulfanilamide. One of the first great medicines of the antibiotic era, sulfanilamide was a miracle drug at a time when curing pneumonia with a quick trip to the pharmacy seemed akin to walking on water. When a sweet, raspberry-flavored liquid version appeared in stores in early September of 1937, it was a no-brainer prescription for doctors whose sick young patients were still picky enough they might reject even Jesus himself if he returned in the form of a bitter-tasting pill. (Koerth-Baker, 9/25)

Enas was contemplating suicide. She was only 17. For three years she’d been living in Mamrashan, a remote mountain camp for displaced people in the Kurdish region of northern Iraq. Mamrashan was just one of 16 camps scattered around Duhok, a province smaller than Connecticut. At its peak, Duhok was home to nearly half a million people displaced by the Islamic State, also known as ISIS. Many have yet to return home. Two weeks earlier, her 16-year-old cousin lit herself on fire in a camp bathroom, next door to Enas’s tent. She was too scared to go to the hospital and see her cousin’s melted skin. “I saw the smoke,” Enas told me. “I could smell the body.” (Percy, 10/31)

The greatest fear of many distance runners is a devastating fate known as hitting the wall. In marathon running, that often happens about two hours into a race. The body says, Okay, we’re done here. It is no longer capable of motion. You want to collapse on the ground and weep, but instead you fall sideways and lie rigid in the road like a horrible work of taxidermy. Other runners step over you until someone can drag you off the course. (Hamblin, 10/31)

Health care is a human right, and we need a system that reflects our values. That system is Medicare for All. Let’s be clear: America’s medical professionals are among the best in the world. Health care in America is world-class. Medicare for All isn’t about changing any of that.It’s about fixing what is broken — how we pay for that care. And when it comes to health care, what’s broken is obvious. A fractured system that allows private interests to profiteer off the health crises of the American people. A system that crushes our families with costs they can’t possibly bear, forcing tens of millions to go without coverage or to choose between basic necessities like food, rent, and health — or bankruptcy. (Sen. Elizabeth Warren, 11/1)

Here’s bad news for Bernie Sanders (I-Vt.): Turns out that to pay for “Medicare for All,” we’ll need a whole lot more rich people. Today’s crop just won’t come close to providing the vast sums needed for his single-payer plan. That would appeal to the crusty Vermont senator, who has said billionaires shouldn’t exist, about as much as force-feeding foie gras to an animal-rights activist. (Liz Peek, 10/31)

In recent years, chronic-pain patients on long-term opioid therapy have been living in fear. They fear being abruptly cut off from their medication by doctors who no longer feel comfortable prescribing opioids. They fear the prospect of withdrawal and a life of pain. We now have evidence that these fears are eminently reasonable. Across the country, clinicians have changed their prescribing practices, requiring that patients taper abruptly to a lower dose or discontinue their opioid medication altogether, sometimes under threat of being “fired” from their clinic if they don’t comply. (Travis N. Rieder, 10/31)

As an Australian living in California and doing research on health policy, I’ve taken an interest in the ongoing debate among Californians about the benefits of moving to a single-payer health care system.In my home country, the government’s Medicare policy covers health care costs for its citizens. There’s a set fee for physician consultations, and most medicines and procedures are subsidized. While it was perhaps a blessing to grow up with this system, it didn’t prepare me for health care coverage in the United States. (David Boettiger, 11/1)

Since our nation’s founding, Americans have valued hard work and self-sufficiency. With near record-low unemployment and seven million open jobs, the American Dream has never been more attainable. So why is the government fast-tracking its citizens on to welfare instead of connecting people with opportunities? Across the country, state officials are using auto-enrollment to funnel people already on food stamps into Medicaid, a massive government-provided healthcare program intended to serve low-income folks and the disabled. They’re also using automatic renewals for existing Medicaid enrollees to keep them in dependency. (Robin Walker, 10/30)

If you want to track your period, there’s lots of ways to do it besides taking notes on your own personal calendar. There’s Period Tracker and Clue and Flo and Eve and Cycles and Bellabeat Period Diary and so on. In fact, there are at least 200 apps that will do the job for you. And apparently, the state of Missouri briefly joined that crowded market, at least if you terminated a pregnancy at the state’s one remaining abortion clinic, a Planned Parenthood facility in St. Louis. (Helaine Olen, 10/31)

Hey Missouri, Margaret Atwood can’t keep up with you. In the totalitarian Gilead of her novel, “The Handmaid’s Tale,” the Commanders would appreciate the ingenuity of creating a whole spreadsheet of women’s menstrual cycles. So as to better protect them, of course. As you’ve probably heard, the Missouri state health director, Dr. Randall Williams, testified this week at a hearing on revoking the license of the state’s last Planned Parenthood clinic that his department kept a spreadsheet on the menstrual periods of women who were patients there. This was to help the health department identify those who’d had complicated abortions. Put another way, it was to help them find something, anything, to justify closing the St. Louis facility. (10/31)

Memo is a minimalist, so we’ll keep this short. In the Video Op-Ed above, we trail Guillermo Piñeda Morales, a.k.a. Memo. He clocked a 2:28:42 at this year’s Boston Marathon, placing him in the top 10 marathon runners for his age group globally. That’s very fast. The American fitness industry is worth $30 billion, but Memo’s not in on the trend. He won’t pop up in your Instagram #fitspo feed and you won’t get a glimpse of him at your gym. But if you have a resolution to run a marathon sometime, Memo will likely be whizzing past you. This Sunday, he’ll be running the New York City Marathon, bib #477. What’s Memo’s trick? Well, you can find that in the video. But it’s far simpler and cheaper than anything else out there. (Lindsay Crouse, Nayeema Raza, Taige Jensen and Max Cantor, 11/1)

Starting today, health insurance open enrollment begins in Connecticut. That means people across our state and around our country can choose a health care plan that works for them and their families. This includes signing up through Access Health CT—our state-run online insurance marketplace created by the Affordable Care Act (ACA). (Chris Murphy, 11/1)

The Michigan Marijuana Regulatory Agency today starts to take applications for recreational marijuana business licenses, nearly a year after voters passed a ballot initiative legalizing pot for pleasure .The state has had a year to prepare for this day, and we hope it's ready. Given the state's poor record of handling medical marijuana licensing of both businesses and testing facilities, the pot regulatory agency has a lot to prove. (11/1)