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Even as embattled Republican candidates across the country pledge to protect Americans with preexisting medical conditions, nearly all continue to resist extending health protections to their poorest constituents. Republicans running for governor in states that have not expanded Medicaid to low-income adults through the Affordable Care Act almost universally oppose any coverage expansion through the government safety net program. (Levey, 11/1)

In campaign speeches, advertisements and interviews, Republican politicians are showing a zeal for protecting Americans with pre-existing health conditions. President Trump has gone the furthest, saying not only that he will ensure protections for the previously ill, but also pledging that his party will do so more effectively than Democrats. There are many reasons to doubt these words. (Sanger-Katz, 11/2)

Kaiser Health News: The Election’s Impact On Health Care: Some Bellwether Races To Watch

Voters this year have told pollsters in no uncertain terms that health care is important to them. In particular, maintaining insurance protections for preexisting conditions is the top issue to many. But the results of the midterm elections are likely to have a major impact on a broad array of other health issues that touch every single American. And how those issues are addressed will depend in large part on which party controls the U.S. House and Senate, governors’ mansions and state legislatures around the country. (Rovner, 11/2)

Democrats are pinning their hopes on health care as a winning message in the final days of the midterm campaign, saying they will not be distracted by President Trump's attempts to make the election about immigration. When Trump this week proposed ending birthright citizenship, House Democratic Leader Nancy Pelosi (Calif.) responded by hammering Republicans on health care. Meanwhile, the House Democrats' campaign arm recently launched another wave of ads targeting GOP lawmakers for their ObamaCare repeal votes. (Sullivan, 11/1)

While President Trump has been talking about the Supreme Court, immigration and the “liberal mob,” Betsy Dirksen Londrigan has just kept talking about health care. Londrigan, a Democratic House candidate hoping for an upset victory over Rep. Rodney Davis, the Republican incumbent in this central Illinois district, says health care is the issue that motivated her to enter the race. (Werner and Weigel, 11/1)

Florida’s U.S. Senate race could come down to what polls show is the No. 1 issue for Hispanic and independent voters: health care. Gov. Rick Scott, the GOP nominee, appears to be hyperaware of that statistic. Since early voting began, he’s run at least 1,333 ads in Orlando and Tampa media markets — crucial for reaching Hispanic and independents voters — wherein he promises to protect patients with pre-existing health conditions. The political group supporting his opponent, Democratic incumbent Bill Nelson, has run at least 541 TV hits in those same media markets, trying to convince voters of the opposite. (Glorioso, 11/1)

In the past year alone, President Trump has bellyached about drug makers charging “rip-off” prices, numerous Democrats have accused the pharmaceutical industry of pure greed, and polls have shown that voters believe lowering the cost of prescription medicines should be among government’s top priorities. But if Republicans prevail in just two nailbiter races on Tuesday, the Senate’s ranks would suddenly include two former drug industry lobbyists and even a pharma CEO. The prospect isn’t so far-fetched. (Facher, 11/2)

Perhaps no sector will be in the election spotlight as much as healthcare, which has been one of the top-performing S&P 500 sectors this year. Policy efforts to lower prescription drug prices that have started under Trump could get more attention should Democrats gain control in Congress. Democratic gains in particular could lead investors to anticipate expanded coverage or other changes related to the Affordable Care Act, possibly benefiting some insurer company and hospital shares. (Krauskopf, 11/1)

Montana legislators expanded Medicaid by a very close vote in 2015. The measure passed with the condition that the expansion of Medicaid eligibility in the state would expire in 2019 unless lawmakers voted to reapprove it. And once it expired, people who got Medicaid under the expansion would lose it. Fearing legislators might not renew funding for Medicaid's expanded rolls, Montana's hospitals and other health advocacy groups have come up with a ballot measure to keep it going — and to pay for it with a tobacco tax. (Whitney, 11/2)

A few months before the accident, President Barack Obama had signed the Affordable Care Act. Under the new law, [Stacy] Stanford would qualify for Medicaid. ... In 2012, however, the Supreme Court ruled that it was up to the states to decide whether they would accept federal dollars to expand their Medicaid programs under the A.C.A.; in 2013, the Utah state legislature, dominated by Republicans, rejected Medicaid expansion (and also passed a law prohibiting the governor from expanding Medicaid without the legislature’s approval). The vote affected approximately a hundred and thirty thousand Utah adults. Stanford was devastated. (Schaffer, 11/1)

Among the most significant are referendums that would expand Medicaid in Idaho, Nebraska and Utah. If voters in all three states approve, an estimated 340,000 additional low-income adults would be eligible for free health coverage through the government program, as the health law allows, starting next year. But the ballot questions also cover a wide range of other issues: whether to ease penalties for low-level drug offenders in Ohio; consider a ban on vaping in indoor work spaces in Florida; and whether to remove abortion protections from state constitutions in Alabama and West Virginia. (Goodnough and Hoffman, 11/1)

Legalization of medical marijuana has won widespread public support in the United States, driven at least in part by enthusiastic health claims made by its advocates. ... But many physicians are far more cautious about medical marijuana, and a number of Missouri medical associations are opposing all of the legalization measures on the Missouri ballot on Nov. 6. (Smith, 11/1)

As they cast their vote in this year’s midterms elections, Nevada voters will also get to weigh in on a number of ballot initiatives. Among them is the proposal to eliminate the so-called “tampon tax” by making feminine hygiene products exempt from sales tax. (Kasperkevic, 11/1)

California voters are being bombarded with ads in what is the most expensive ballot measure campaign this year. They are being asked to decide Tuesday whether the state should limit the profit of kidney dialysis centers to 15 percent over the cost of patient care, with revenue above that rebated primarily to insurers. What exactly would happen if voters approve Proposition 8 is still vague, and the $127 million raised to persuade voters hasn’t made it any clearer. (Rowan, 11/2)

Open enrollment for health care under the Affordable Care Act began today. Though long-held promises to repeal Obamacare have not happened, President Donald Trump and Republican lawmakers have taken actions many fear will weaken the exchanges where people buy health insurance. (Kim, 11/1)

But what you pay will still vary greatly based on your income, location and plan level. Premiums for a benchmark “silver” plan are expected to dip 1.5 percent on average after rising sharply for two years. The variation is so wide, though, that people in Tennessee could see double-digit declines while those in North Dakota may see steep increases. That’s why simply renewing an existing policy could cost you plenty, and spending time comparison-shopping and digging into plan details will most likely yield more savings. (Bernard, 11/1)

The federal website where consumers can get health insurance under the Affordable Care Act was up and running Thursday after a slow start as sign-up season for 2019 opened days before the midterm elections. ... With health care a major issue in Tuesday’s elections, this sign-up season under the Trump administration is getting close scrutiny. In earlier years, technical problems with the site created major headaches for the Obama administration. (Alonso-Zaldivar, 11/1)

[Chad] Bertanzetti and other consumers will have more choices when shopping for insurance when the six-week open enrollment period for health plans under the Affordable Care Act begins Thursday. Millions of consumers buy coverage through the Obamacare marketplace. New rules created by the Trump administration allow more options, including less-expensive, bare-bones plans that lack the consumer protections found in Obamacare insurance. (Alltucker, 11/1)

The state’s MNsure health insurance exchange said open enrollment got off to a smooth start Thursday, with more than 27,000 visits to the government-run website as of midafternoon. Callers seeking help by phone waited an average of 1 second, MNsure said. (Snowbeck, 11/1)

Insurers are feeling more bullish about the Obamacare markets than they have in years as enrollment opens Thursday. The Trump administration claims credit for fixing the individual markets, arguing its policies are bringing relief to consumers bludgeoned by skyrocketing premiums and eroding competition. (Demko and Goldberg, 11/1)

“Perverse” incentives in the insulin supply chain lead to artificially high prices, as well as limited competition in the markets, according to a bipartisan report released Thursday by two lawmakers. The report from Reps. Diana DeGette (D-Colo.) and Tom Reed (R-N.Y.), co-chairs of the Congressional Diabetes Caucus, took more than a year to complete and concluded that several factors drive insulin prices up, while forces that would typically drive prices down are “blunted.” (Hellmann, 11/1)

A bipartisan group of more than 290 lawmakers is throwing its support behind some of the drug industry’s least favorite proposals for bringing down the cost of insulin. Parts of the report — released Thursday by the Congressional Diabetes Caucus — read like a laundry list of the drug industry’s worst fears: It pitches everything from legislation requiring drug companies to disclose how they set their prices to legislation that dings drug makers who can’t prove that a new version of insulin is more effective than an older one. (Florko, 11/1)

Congress is on the verge of renewing one of the most successful and popular federal efforts on HIV/AIDS ever launched, but some say lawmakers are missing an opportunity to improve a program whose funding has been flat in the face of an evolving epidemic. While funding for global HIV/AIDS programs could see an increase for the first time since 2014, some advocates question whether the U.S. is approaching the fight against the disease in the right way. (Siddons, 11/2)

After years of bickering, thousands of so-called safety-net hospitals and clinics won a significant battle over the Trump administration, which agreed to implement a rule that would penalize drug makers for overcharging for their medicines. The rule is supposed to go into effect on Jan. 1. The rule, which had been delayed several times by the Trump administration, would fine drug makers up to $5,000 for each instance in which they “knowingly and intentionally” overcharge for their medicines. The companies must also reimburse providers for medicines that were purchased. The rule would also require drug makers to post ceiling prices on a government web site. (Silverman, 11/1)

A group of large employers plans to use a new online prescription-savings tool as they confront high drug costs and try to steer patients to the most cost-effective medicines. The Health Transformation Alliance, a coalition of more than 40 big companies that includes IBM Corp., Verizon Communications Inc. and American Express Co., has agreed to use a new online tool from startup Rx Savings Solutions to help the millions of people who work for the group’s members get better deals on their medications. (Langreth, 11/1)

Daniel Best, a senior adviser to Health and Human Services Secretary Alex Azar, has died. “It is with tremendous sadness that I learned of the passing of our friend and colleague," Azar said in a statement Thursday. ...Best worked at CVS Health before joining HHS in March. He lead the agency's efforts on drug pricing reform. Best received his bachelor's degree from the University of Dayton in 1991. (Hellmann, 11/1)

Dan Best, the government’s top drug pricing adviser, has died, the Department of Health and Human Services announced Thursday afternoon. “It is with tremendous sadness that I learned of the passing of our friend and colleague,” HHS Secretary Alex Azar said in a statement. “I had the great privilege to know Dan Best for the past decade. He joined me here at HHS out of a desire to serve the American people by making healthcare more affordable.” (Swetlitz, 11/1)

U.S. health insurer Cigna Corp, which is in the process of acquiring Express Scripts Holding Co, significantly bumped up its 2018 adjusted profit forecast, and its shares rose more than 3 percent on Thursday. ... “The guidance raise in excess of the magnitude of the earnings beat this quarter signals Cigna’s confidence in its industry-leading medical cost performance,” Leerink analyst Ana Gupte said. (Mishra and Mathias, 11/1)

The turnaround at Teva Pharmaceutical Industries remains on schedule. The generic drug giant reported third-quarter sales of $4.5 billion and adjusted earnings of 68 cents a share. While both figures were down significantly from a year earlier, the earnings figure topped expectations thanks to deeper cost cuts than analysts had anticipated. Teva also increased its full-year guidance for profit and free cash flow. (Grant, 11/1)

Pfizer Inc. is reviewing options including a sale of its women’s health portfolio as the U.S. pharmaceutical giant seeks to focus on developing treatments with higher growth potential, according to people with knowledge of the matter. The drugmaker is working with financial advisers to gauge the interest of potential buyers, the people said, asking not to be identified because the deliberations are private. A sale of the division, which has annual sales of roughly $1.2 billion, could fetch about $2 billion and draw bids from both private equity firms and rival pharmaceutical companies, they said. (Baigorri, 11/1)

In a controversial move, Merck is rolling back its commitment to provide a life-saving rotavirus vaccine to parts of West Africa at the same time the drug maker is ramping up supplies to China, where the product would reportedly be sold for a much higher price. The company supplies its RotaTeq vaccine through an arrangement with GAVI, the Vaccine Alliance, a public-private partnership that helps provide medicines and vaccines to low-income countries. However, Merck is reducing shipments by one-third this year and next, according to GAVI. After that, supplies are not expected. About 4.7 million doses will be delivered this year and 4 million next year. (Silverman, 11/1)

McKesson Corp. said its longtime Chairman and Chief Executive John H. Hammergren will retire next year, capping a 17-year reign in which he helped build one of the country’s largest pharmaceutical wholesalers despite weathering shareholder criticism over his compensation and handling of the opioid crisis. (Walker, 11/1)

Less than two months after the FDA approved the first-ever drug that uses a Nobel-winning technique to mute disease-causing genes, the pharmaceutical industry is already looking for a piece of the next one. Within the last month, Eli Lilly, Alexion and Janssen have all announced licensing and collaboration deals — each potentially worth billions — with companies developing treatments with the technique known as RNAi. (Sheridan, 11/2)

Kaiser Health News: New Heart Drug Spotlights Troubling Trends In Drug Marketing

At the end of September, Amarin Corp. teased some early findings for Vascepa, its preventive medicine for people at risk of heart disease. The claim was astounding: a 25 percent relative risk reduction for deaths related to heart attacks, strokes and other conditions. Headlines proclaimed a potential game changer in treating cardiovascular disease. And company shares quickly soared, from $3 a share to about $20. Vascepa is Amarin’s only product. The company wants to turn its pill made of purified fish oil into a cash cow, allowing it to staff up both in the United States and abroad so it can sell doctors and millions of consumers on its medical benefits. ... Except there is one problem. The particulars of the scientific study on which this claim was based remain a mystery. (Luthra, 11/2)

When the Department of Veterans Affairs released the annual ratings of its hospitals this fall, the facility in Atlanta dropped to the bottom, while the one in West Haven, Conn., shot to the top. It was something of a mystery as to why. The Atlanta hospital was downgraded to one star from three on the agency’s five-star scale, even though there had been only a “trivial change” in its quality data from the year before, according to the department. The Connecticut hospital climbed to five stars from three, even though numerous operations had to be performed elsewhere or canceled at the last minute because of problems with sterilization of surgical tools, according to an internal assessment and other accounts cited by Senator Richard Blumenthal in a letter to the agency. (Philipps, 11/1)

When senators asked Veterans Affairs Secretary Robert Wilkie in September about the three Trump supporters who’ve been quietly shaping the agency’s agenda from the president’s Mar-a-Lago resort, he minimized his interactions with the trio, saying they’d had a single meeting on a seemingly dry subject: electronic medical records. As unexciting as that might seem, it is a subject that will shape the agency for decades to come. The VA gave a software company a $10 billion no-bid contract to replace the agency’s records system. The new system is supposed to synchronize with data from other providers, as the VA increasingly sends veterans to private doctors instead of treating them in-house. While Wilkie’s comments to the Senate made it sound like the so-called Mar-a-Lago Crowd — a doctor, a lawyer and an entertainment executive with no U.S. military or government backgrounds — opposed the records transition, they actually championed it, highlighting the issue to the incoming Trump White House and making it their top focus, four former officials said. (Arnsdorf, 11/1)

The Department of Veterans Affairs is pushing forward with invasive and ultimately fatal experiments on dogs as part of the VA's medical research program, according to documents obtained by USA TODAY. The controversial procedures previously sparked outrage and opposition from some veterans’ advocates and prompted strict restrictions from Congress. The VA says the studies could produce discoveries that may help veterans suffering from spinal cord or breathing problems. (Slack, 11/1)

On Thursday, an international team of researchers offered a glimpse at something better than the seasonal flu shot. With a sophisticated combination of immunotherapy and gene therapy, they created an artificial antibody that protected mice against dozens of flu strains. It’s an important step toward a type of flu shot that scientists have long sought: a shield against whatever flu strain people happen to pick up. (Zimmer, 11/1)

Along with soulful eyes, endearingly long necks and and warm fuzzy coats, llamas have a far less appreciated feature: They make an array of immune system antibodies so tiny they can fit into crevices on the surface of an invading virus. That feat could one day protect humans from entire families of flu viruses that bedevil scientists with their unpredictable and shape-shifting ways. All, potentially, with a once-a-year puff up the nose. (Healy, 11/2)

Their final reports, for example, concluded that there is “clear evidence” that male rats exposed to high levels of cellphone radiation developed cancerous heart tumors, after initially saying there was just “some evidence”—a less certain classification. They also said there was “some evidence” of brain and adrenal gland tumors in male rats that were exposed to cellphone radiation after characterizing that evidence as “equivocal” earlier this year. (Krouse, 11/1)

Two U.S. government agencies are giving conflicting interpretations of a safety study on cellphone radiation: One says it causes cancer in rats. The other says there’s no reason for people to worry. No new research was issued Thursday. Instead, the National Toxicology Program dialed up its concerns about a link to heart and brain cancer from a study of male rats that was made public last winter. The Food and Drug Administration, which oversees cellphone safety, disagreed with the upgraded warning. And “these findings should not be applied to human cellphone usage,” said Dr. Jeffrey Shuren, FDA’s chief of radiological health. (Neergaard and Borenstein, 11/1)

For decades, health experts have struggled to determine whether or not cellphones can cause cancer. On Thursday, a federal agency released the final results of what experts call the world’s largest and most costly experiment to look into the question. The study originated in the Clinton administration, cost $30 million and involved some 3,000 rodents. The experiment, by the National Toxicology Program, found positive but relatively modest evidence that radio waves from some types of cellphones could raise the risk that male rats develop brain cancer. (Broad, 11/1)

The first cannabis-derived medication approved by the Food and Drug Administration is now available by prescription in every state, according to its manufacturer. Epidiolex, manufactured by GW Pharmaceuticals, is intended to treat seizures associated with two rare and severe forms of epilepsy that begin in childhood. The drug is made of cannabidiol (CBD), a component of marijuana that doesn’t give users a high. (Weixel, 11/1)

The Food and Drug Administration has labeled the drug a potential “breakthrough” for post-traumatic stress disorder and cleared late-stage studies of up to 300 patients. The studies are to be conducted by [Rick] Doblin’s nonprofit group dedicated to promoting mind-altering drugs, the Multidisciplinary Association for Psychedelic Studies, or MAPS. Researchers will begin screening patients this month. The goal is to win FDA approval by 2021. MDMA would become the first psychedelic drug — currently in the same ultra-restrictive category as heroin and cocaine — to make the leap to prescription medicine. (Perrone, 11/1)

John Tavolacci, Odyssey House’s chief operating officer, said he has run 22 marathons. He started the running group in 2001 as a supplement to treatment, based on a strong belief that running can be effective in helping overcome addiction. He has watched the Odyssey House team build self-esteem among participants, create a cooperative environment, and fill time for runners that otherwise might have been spent on negative pursuits. New York City saw a nearly fivefold increase in heroin overdose deaths per 100,000 residents between 2010 and 2015. Similarly, opioids were linked to more than 42,000 deaths nationwide in 2016, five times the 1999 rate, according to the Centers for Disease Control and Prevention. (Shannon, 11/1)

For a nonprofit in an impoverished town, the day had all the makings of a success. Every family went home with food that would help them get through the next month: tuna mac and cheese, boxes of cereal, long-grain rice, potatoes, peaches, corn on the cob, a large watermelon, chicken legs and loaves of bread. But [Margaret] Sheskey and [Larry] Lafferty were already focused on a question that has increasingly come to shape the work they do: Could they find enough food before the pantry reopened? Finding food has always been a challenge, but the task is getting even tougher — a consequence of an ongoing shift in how states distribute federal grants to help the poor. (Samuels, 11/1)

Four years ago, Harold Hempstead stunned the Florida prison system — and unleashed a major scandal — when he described to the Miami Herald how officers at Dade Correctional Institution had locked an inmate in a small, rigged shower room, turned the water on full hot and left him, screaming for mercy, for nearly two hours, until he collapsed and died, the skin peeling off his body. Hempstead called it torture. A lot of people agreed. (Mansoor, 11/1)

California’s chief prison psychiatrist has issued a scathing report on management of mental health care in the prisons, saying officials are misrepresenting the care given to thousands of prisoners and are jeopardizing the health of inmates — including a woman who, in a horrifying 2017 incident, pulled out her own eye and swallowed it. (Egelko, 11/1)

State health officials are seeking $2.7 million to add beds at the state’s psychiatric hospital in Junction City to house a burgeoning number of mentally ill inmates from county jails. The money, sought from the legislative Emergency Board, would pay for 25 beds and staff for six months. The request comes as state lawmakers renew their focus on diverting mentally ill Oregonians from the criminal justice system to mental health treatment and resources. (Achen, 11/1)

A federal lawsuit accuses New York City of failing to ensure that students with diabetes can attend public school safely and with equal access to educational opportunities as their peers. The proposed class-action suit, filed Thursday in federal court in Brooklyn, claims that the New York City Department of Education and others violate students’ rights by denying them adequate diabetes-related care, including services for school field trips, before-and-after school activities and bus transportation. Diabetes, a lifelong condition, is considered a disability under federal and local laws. (West, 11/1)

The American Civil Liberties Union demanded Thursday that a Hawaii retirement home stop discriminating against non-Catholic residents and allow them to take advantage of the state’s new medically assisted suicide law if they wish. The ACLU of Hawaii sent a letter to the executive director of the Kahala Nui home after receiving an anonymous tip that the home had notified residents they would not be permitted to exercise the provisions of the law, which takes effect in January. (McAvoy, 11/2)

In a high-stakes election campaign with statewide implications, a health care union is spending millions to sway voters in two Bay Area cities to cap how much hospitals can charge patients. The hospitals, led by Stanford Health Care, are fighting back with their own millions to deliver the message that the union is more interested in signing up new members than containing patient costs. (Ruggiero, 11/1)

Only 16 states have laws concerning insurance coverage for infertility treatments and five states have fertility preservation laws, which require insurance companies to help women undergoing chemotherapy freeze their eggs before starting treatment. In states without these laws, many insurance companies refuse to cover treatments that can help families conceive children. (Castle, 11/1)

Gov. John Kasich proposed modest gun reforms in the wake of the school shooting in Parkland, Fla., earlier this year and the legislature has been mulling over numerous bills, including Republican-introduced legislation that calls for a means to flag people with mental health issues who should not own guns. As it stands, Ohio has some of the loosest gun laws in America, but not for a lack of trying by some urban communities. (Krouse, 11/1)

In light of the continued onslaught of gun violence in Cleveland and communities across the country (but before the recent slayings at a synagogue in Pittsburgh), cleveland.com asked several legislators who voted for HB 347, and for the override of Gov. Bob Taft's veto of that bill, why they supported legislation that Cleveland leaders believed would help reduce gun violence. We also asked them if their views had changed since then and to discuss their views on other commonly debated gun reforms.One of the legislators is no longer in the General Assembly but is running for office this year. (Krouse, 11/1)

In the next few years, publicly traded life sciences companies headquartered in California could collectively need to add hundreds of women to their boards in order to comply with a new state gender-parity law. That’s going to mean finding women to fill 126 board seats in the sector by the end of 2019. And by the end of 2021, 456 women may need to be recruited to join these boards. All told, across every category of the life sciences sector, at least 85 percent of public California companies will need to add at least one woman to their board by the end of 2021. (Robbins, 11/1)

Georgia’s preterm birth rate rose from 11.2 percent to 11.4 percent in 2017, keeping the state at a “D’’ grade in the annual Premature Birth Report Card from the March of Dimes. The state’s rate of babies born too soon (before 37 weeks of pregnancy) continued to reflect large racial disparities, with black women at 13.7 percent – 46 percent higher than the rate among all other women. (Miller, 11/1)

The Phoenix-based Translational Genomics Research Institute is planning to build a cell therapy manufacturing facility to improve cancer treatment. The California-based City of Hope cancer research center, along with TGen, announced Thursday the intent to develop the facility in Phoenix. (Innes, 11/1)

Moving to the U.S. can seriously mess with immigrants' microbiomes, according to a new study that tracked the digestive health of refugees coming to Minnesota from Southeast Asia. ...Knights and his colleagues arrived at these insights by analyzing the intestinal bacteria of about 500 ethnically Hmong and Karen women living in Thailand and in the U.S., including first- and second-generation immigrants. (Singh, 11/1)

Family members of Chris Cornell on Thursday sued a doctor they say overprescribed drugs to the rock singer, leading to his death. Cornell’s widow, Vicky Cornell, and their children, Toni and Christopher, are plaintiffs in the lawsuit filed in Los Angeles Superior Court alleging that prescription drugs, especially the anti-anxiety drug lorazepam, led to erratic behavior from the Soundgarden frontman before his death in Detroit in 2017 at age 52. (Dalton, 11/1)

One percent of children with the highest expenditures accounted for 20% of Medicaid expenditures in children with NC-CDs; mental health conditions account for a large proportion of aggregate Medicaid spending in children with NC-CDs. (Bettenhausen, Richardson, Shah et. al., 11/1)

Our analysis of information from a large commercial insurance database indicated that comprehensive use mandates implemented during 2011–15 were associated with a 6–9 percent reduction in opioid prescriptions with high risk for misuse and overdose. We also found delegate laws to be associated with reductions of a similar magnitude for selected outcomes. In general, the effects of all three policies strengthened over time, especially beginning in the second year after implementation. (Bao, Wen, Johnson et. al., 10/1)

Compounded with the fact that housing is the biggest monthly expense for many households, those who find themselves struggling to keep a roof overhead may be faced with the difficult choice of foregoing other basic needs such as food and health care. This brief looks closely at financial insecurity and material hardship among homeowners and renters, controlling for demographic and economic differences and income. (Scally and Gonzalez, 11/1)

Intimate partner violence (IPV), elder abuse, and abuse of vulnerable adults are common and result in adverse health outcomes. ...Although available screening tools may reasonably identify women experiencing IPV, trials of IPV screening in adult women did not show a reduction in IPV or improvement in quality of life over 3 to 18 months. (Feltner, Wallace, Berkman et. al., 10/23)

Imagine buying a plane ticket, but the fare only covers your seat, the fuel, the gate attendant, and the peanuts. You have to pay the pilot separately. You are sitting on the plane and, unbeknownst to you, the pilot scheduled to fly your plane is delayed and a pilot from another airline takes over. Because that pilot costs more than the regular pilot, you now have to pay an extra $500. And you only find out weeks later when you get the bill.It sounds like a preposterous scenario. Yet this is the absurd reality in health care and the epidemic of surprise medical bills. (Ateev Mehrotra and Vivian Ho, 11/2)

Medicaid is a vital program that enables millions of Americans to live healthy lives. It is also an important economic driver, particularly in states that have chosen to expand Medicaid under the Affordable Care Act.Take Montana, one of the states in which the health care system I run operates hospitals and clinics. Before Medicaid expansion started in 2016, 15 percent of Montanans lacked health insurance. Today, after expansion, less than 8 percent of them don’t have health insurance. Moreover, the expansion has created 5,000 new jobs and generated nearly $300 million in new personal income for Montana residents. That is an unequivocal success we should all get behind. (Rod Hochman, 11/2)

The federal government announced new rules that would allow states to apply for waivers so they could permit insurers to sell limited health insurance plans that offer bare-bones coverage through Affordable Care Act (ACA) marketplaces. This comes on the heels of rules released this year allowing insurers to sell short-term and association health plans on the individual market.Some argue this makes sense and that consumers want more affordable insurance options. The problem is that these plans are cheap but, in exchange for low premiums, they cover very little and can leave consumers who need health care with huge unexpected medical bills that they cannot afford to pay. (David Blumenthal, 11/1)

If you’re equally perplexed by whether your vote can influence healthcare prices, here are some things to consider. ... There’s no magic pill to fix these systemic problems or flatten healthcare’s rate of inflation. Political candidates nevertheless vow to cure our healthcare woes (painlessly). The truth is, campaign promises are like babies: easy to make, hard to deliver. Democrats promising “Medicare for all” can’t deliver “free” healthcare because it’ll be too expensive and overtax the middle class. Republicans are promising affordable “short-term” insurance plans that sidestep the Affordable Care Act requirements, but these plans are thin on coverage and big on risk. (Robert Pearl, 11/2)

It was last Saturday when it hit me that my entire life has been framed by violence. I don’t remember being born on Jan. 28, 2000, and I don’t remember being a year and a half old when 9/11 happened. I don’t remember the panic of my mother as she stepped outside our house in Washington and smelled the smoke of the burning Pentagon. I don’t remember her knowing I would grow up in a changed world.But I remember other things. I remember being 7 years old and seeing adults who were sad, angry, shocked after something terrible happened at Virginia Tech. (Julia Savoca Gibson, 11/1)

About two-thirds of gun deaths in the U.S. each year are suicides, traumatic and desperate acts that often lie at the nexus of mental illness and ready access to a firearm. Yet a new study published in the Annals of Internal Medicine finds that only 13% of people know that gun suicides far outpace homicides, a likely function of regular news coverage of violent crimes and a tendency to not cover suicides. (Scott Martelle, 11/1)

In this most indecent time of political rage and politically weaponized tragedy, America desperately needed to see decent people do the decent thing: Like Dr. Jeffrey Cohen and other Jewish doctors and nurses who treated the wounded, raving and murderous anti-Semite who’d just slaughtered 11 people at the Tree of Life synagogue in Pittsburgh. (John Kass, 11/1)

Basic human rights and protection from discrimination should not be a topic for debate. Whether or not the life experience of a least 1.4 million American transgender adults and thousands of youth is valid and true should not be an academic conversation about legal precedent.But the memo related to Title IX currently circulating in the Department of Health and Human Services does exactly that. The department is seeking to define gender “on a biological basis that is clear, grounded in science, objective and administrable,” and if the topic is ever unclear, should be settled with genetic testing. (Chris Davis, 11/1)

We’ve gotten used to a president who tells lies so habitually, so routinely, that even the fact-checkers have grown blasé. We can become so numb, so exhausted by the everyday spectacle of lie after lie, that it’s easier to just go with the flow of believing the politicians, rather than consulting our own hearts or minds about what they tell us .On abortion, for example. You may have heard that some Democrats currently running for office are “pro-abortion.” In fact, that some are so “pro-abortion” that they are for it “right up to the moment of birth.” (Susan Bordo, 10/30)

As nutrition experts, we will leave the spiritual nature of veganism to others and focus on the onslaught of conflicting health claims regarding the beneficial effects of veganism on blood pressure, weight, longevity and just about every other system in our bodies. Unfortunately, most Americans get this information from our least reliable medical news source, the morning talk shows. Spoiler alert. The answer is going to be, “We’re not sure.” Don’t keep reading if you don’t like an honest response. (Michael Rosenbaum and David Seres, 11/1)