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The average price tag for the most popular level of insurance sold in the Affordable Care Act’s federal marketplaces is dropping slightly, the first time the rates have stopped going up since the health plans were created a half-dozen years ago. In the 39 states that rely on HealthCare.gov, the monthly premium is dipping by 1.5 percent for 2019 in a tier of coverage that forms the basis for the ACA’s federal insurance subsidies, according to federal figures released Tuesday. (Goldstein, 10/11)

“Though the average decrease is small, it is a dramatic and very positive change from the double-digit increases experienced over the past two years,” said Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, which runs the online marketplace serving 39 states. From 2017 to 2018, the benchmark rose 37 percent, officials said, and in the prior year it rose 25 percent. (Pear, 10/11)

Kaiser Health News: Obamacare Premiums Dip For First Time. Some Call It A Correction.

The analysis by federal officials looked at the price of the second-lowest silver plan for a 27-year-old nonsmoker on the marketplaces. Those silver plans are used by the ACA to set subsidies. Open enrollment for 2019 runs from Nov. 1 through Dec. 15. (Galewitz and Appleby, 10/11)

Tennessee will see the sharpest premium decline, as average monthly premiums for silver plans fell more than 26% from more than $600 last year to $449. North Dakota had the greatest increase, with average premiums rising more than 20% from $312 per month to $375. Sixteen of the 39 states using the federal exchange will see declines, two states will have no change, and the majority of the remaining states will face marginal, single-digit increases. (Luthi, 10/11)

The new dynamic could muddle both parties’ political messages. The pattern of more moderate rate increases could hold in future years if the markets remain stable, but it’s uncertain how the spread of plans that don’t comply with the ACA, and the legal challenges to the health law itself, will affect insurer pricing in years to come. The data also confirm that insurers are expanding their presence in the ACA markets, after previous industry pullbacks. (Armour and Wilde Mathews, 10/11)

“The rhetoric on the exchanges has not matched the facts,” Verma said, and despite predictions that the insurance market would destabilize, the opposite has happened. “We were told if the individual mandate were repealed, premiums would skyrocket. We were told if we shifted focus away from navigators, no one would sign up,” Verma said. (Weixel, 10/11)

Consumers who buy health insurance on Illinois’ Obamacare exchange for next year will see slightly lower prices, on average, for the most popular plans — but it’s unclear whether the decline in premiums will be enough to keep people buying them. Starting next year, consumers no longer will face penalties for not buying insurance. They also will have new options, including the ability to use short-term plans, purchased outside the exchange, for a longer period of time. Short-term plans are often cheaper than exchange plans though they may not offer as much coverage. (Schencker, 10/11)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Falling Premiums And Rising Political Tensions

The Trump administration announced that, for the first time, the average premium for a key plan sold on the federal health law’s insurance marketplaces will fall slightly next year. Federal officials said that changes they have made helped facilitate the reduction, but others argue that it was because more plans are moving back into those federal exchanges and making money. (10/11)

Bay Medical Center, a 300-bed hospital in the center of town, was a tumultuous mess. Staff members were frantically working on Thursday to evacuate patients just as new ones showed up at the door. Hurricane Michael had strafed the place, blowing out windows and stripping some of the buildings in the sprawling complex down to their metal girders. Signage was strewn in the streets. Doctors, nurses and workers wandered outside, some crying, some looking for cell service. (Fausset, Fink and Haag, 10/11)

Gov. Nathan Deal said Thursday morning that all hospitals and nursing homes in the state had power in the aftermath of Hurricane Michael, though many were having to use backup generators. ... A trade group representing Georgia’s nursing home industry said at noon Thursday that 11 nursing homes were still without regular electricity and were operating on generator power. (Miller and Dyer, 10/11)

In this election season, lawmakers are taking on drug distributors with abandon, and many seem to relish the role. “I just want you to feel shame,” one member of Congress said in May to five executives of major drug wholesalers, which are accused of worsening the opioid crisis by dumping thousands of addictive painkillers into small towns. ... In the run-up to next month’s midterm elections, the country’s three largest distributors alone have given nearly $3 million to congressional campaigns. Key lawmakers from both parties — including many of the ones who publicly shamed the companies for their role in the crisis — have accepted the contributions eagerly. (Facher, 10/12)

U.S. Rep. David Young and his Democratic challenger, Cindy Axne, sharply disagreed on a range of key issues, from health care to federal tax policy to addressing the federal debt, Thursday night in a televised debate. ... Health care was one of the most contentious issues as the candidates were quizzed by journalists before a studio audience. Young described himself as a supporter of Iowans who have pre-existing medical conditions and need to obtain health insurance, while Axne repeatedly contended his record in Congress is to the contrary. (Petroski, 10/11)

Williams is one of nearly 68,000 Californians on dialysis. That number is expected to grow 5 percent each year as diabetes and obesity, two common risk factors for kidney failure, become more prevalent. It is also a big business — one that major dialysis providers are spending tens of millions of dollars to preserve with their opposition to Proposition 8, a ballot initiative that would cap revenue for California’s dialysis centers. (Ho, 10/11)

Gov. Charlie Baker weighed in Wednesday on one of this year's most contentious election issues, indicating that he planned to vote against a ballot question that would set minimum nurse to patient staffing ratios. The governor had been waiting to see the results of a report produced last week by the Health Policy Commission, which he said he read over the weekend. (Murphy, 10/11)

Fear and anger over the GOP’s health policies are driving a majority of Democratic voters to the polls in an effort to flip control of the House and put the brakes on the Trump administration’s agenda, according to POLITICO-Harvard polling gauging voter attitudes before the midterm elections. More than half of Democrats likely to vote in House races rank health care as “extremely important” in determining their vote, the new survey found. (Cancryn, 10/11)

Kaiser Health News: Fact-Check: Who’s Right On Protections For Preexisting Conditions? It’s Complicated 

Ensuring that people with preexisting health conditions can get and keep health insurance is the most popular part of the Affordable Care Act. It has also become a flashpoint in this fall’s campaigns across the country. And not only is the ACA, which mostly protects people who buy their own coverage, at risk. Also potentially in the crosshairs are preexisting conditions protections that predate the federal health law. (Rovner, 10/11)

It was not hard to tell when the doctor was in at the Staten Island office of Carl Anderson. Noisy crowds of people, some with visible signs of drug addiction, stood in long lines at all hours of the night, seeking prescriptions for oxycodone pills, the authorities said Thursday. Sometimes, the noise outside Dr. Anderson’s office got so loud that it prompted neighbors to call the police, and more than once ambulances were called to treat pill-seeking patients, a series of new indictments show. Several patients, including two of his employees, overdosed and died, the authorities said. (Weiser, 10/11)

One of the doctors, Dante Cubangbang, 50 years old of Nassau County, is accused of selling more than 6 million oxycodone pills from a Queens medical center since January 2012, the most prescriptions of the narcotic in the state, Mr. Berman said.  Dr. Cubangbang, as well as one of his nurses and clinic employees, received more than $5 million dollars in cash for their dealings, Mr. Berman said. “Instead of caring for their patients, these doctors were drug dealers in white coats,” he said. “They hid behind their medical licenses to sell addictive, dangerous narcotics.” (Kanno-Youngs, 10/11)

The Tennessee Department of Health is attempting to revoke the nursing license of Christina Collins, a nurse practitioner who was once one of the top opioid prescribers in the state. State officials have said Collins’ prescriptions were so "colossal" that their only reasonable purpose was suicide or drug trafficking. She wrote these prescriptions in 2011 and 2012 while working for Bearden Health Associates, a pain clinic in the Knoxville suburbs. (Kelman, 10/11)

This massive prescription — 51 pills a day with an opioid dosage more than 31 times the current recommendation of the government — was issued eight years ago by Christina Collins, a Knoxville-area nurse practitioner who was once one of the top opioid prescribers in Tennessee. This prescription would have almost certainly killed anyone who actually tried to consume it, state officials say, but Collins regularly issued prescriptions like this one in 2011 and 2012, sending hundreds of thousands of pills into the communities of eastern Tennessee, where the opioid crisis hit hard. In state records, the Department of Health has said that Collins' contributions to the epidemic are "obvious and appalling" and that her prescriptions were “so colossal” that their only reasonable use would be drug trafficking or suicide. (Kelman, 10/12)

Orange County firefighters will now pass out the opioid reversal drug naloxone to the family members of people suspected of an overdose. The executive order allowing naloxone to be given to family members went into effect more than two years ago. (Prieur, 10/11)

Planned Parenthood on Wednesday launched a campaign to protect access to abortion as widely as possible even if the Supreme Court, with the addition of conservative Justice Brett Kavanaugh, moves to curtail a woman's right to undergo the procedure. "We know that we'll need an ironclad network of states and providers across the country where abortion will still be legal and accessible, no matter what happens at the Supreme Court," said Dawn Laguens, Planned Parenthood's executive vice president. (Crary, 10/10)

Women are in for the fight of their lives in the next few years, says Dr. Leana Wen, Baltimore’s departing health commissioner. And starting next month Wen will be on the front lines of that battle over women’s health when the 35-year-old becomes executive director of Planned Parenthood of America. ...As health commissioner, she sometimes held back some of her opinions. For example, she wishes she had challenged Gov. Larry Hogan on the way he doled out money for key health programs. Baltimore should have received a greater portion in some cases, including funds for opioid use prevention, because the city bears the brunt of the overdoses, she said. (McDaniels, 10/12)

Kentucky’s only abortion clinic and two groups are asking for almost $1.5 million in legal costs from the state after winning a federal case over the clinic’s existence. The Courier Journal reports that lawyers for EMW Women’s Surgical Center of Louisville, Planned Parenthood of Indiana and Kentucky and the American Civil Liberties Union filed motions Thursday seeking legal expenses. (10/11)

Oregon, Alabama and West Virginia voters will face separate ballot initiatives next month aimed at restricting abortion access in those states. These ballot initiatives fit into a larger fight over abortion that continues to heat up. Anti-abortion advocates hope that changes at the state level can be used as test cases and later implemented more broadly, while abortion-rights advocates hope to defeat them. A particularly contentious ballot initiative can be used as a messaging move to drive voters to the polls in tight elections such as this fall's West Virginia Senate race. (Raman, 10/12)

Rates of caesarean section births almost doubled between 2000 and 2015 – from 12 to 21 percent worldwide - new research has found, with the life-saving surgery unavailable to many women in poor countries while often over-used in richer ones. The research, published in The Lancet medical journal on Thursday, found that 60 percent of countries overuse C-sections and 25 percent under-use them, suggesting that recommendations for their use in cases of medical need are widely ignored. (Kelland, 10/11)

The House Ways & Means Committee will investigate rising maternal mortality rates in the U.S. "With this investigation, we are committed to finding out why these deaths are happening and where Congress can take action to not only prevent these deaths, but also reverse this trend," Republicans on the committee led by Chairman Kevin Brady (R-Texas), said in a statement. While rates of maternal mortality have declined in other industrialized countries, they have dramatically increased in the U.S. since 2000. (Hellmann, 10/11)

University of Michigan researchers published a new study that will appear in the November issue of the Journal Obstetrics & Gynecology that reveals just how much a woman's risk of developing a life-threatening condition while she's in the hospital for delivery depends on her racial and ethnic background and that patient's underlying health problems. Although a life-threatening complication during childbirth occurred in 1.6 percent of all deliveries included in the study, non-Hispanic black women had a 70-percent higher rate of having a severe birth-related health problem than non-Hispanic white women. (Shamus, 10/11)

Obesity is linked to an increased risk for colorectal cancer in younger women, new research has found. Colorectal cancer rates have been increasing in people under 50 while declining in older people. No one knows why. In an observational study published in JAMA Oncology, researchers prospectively tracked the health of more than 85,000 women for 22 years, beginning when they were 25 to 42 years old. They found 114 cases of colorectal cancer in women under 45. (Bakalar, 10/11)

For a breastfeeding mom just returning to work, Sarah Madden has what would be considered the best-case scenario. Her employer, the nonprofit Guidestar, has a brand-new Oakland office with a lactation room that the 36-year-old can duck into whenever she has to pump. The ability to video chat limits her need to travel. And, she describes her co-workers as generally accepting. Yet, just a couple months back from maternity leave, Madden can already see the “longer-term consequences” breastfeeding can have on her career. (Greenfield, 10/12)

The genetic genealogy industry is booming. In recent years, more than 15 million people have offered up their DNA — a cheek swab, some saliva in a test-tube — to services such as 23andMe and Ancestry.com in pursuit of answers about their heritage. In exchange for a genetic fingerprint, individuals may find a birth parent, long-lost cousins, perhaps even a link to Oprah or Alexander the Great. But as these registries of genetic identity grow, it’s becoming harder for individuals to retain any anonymity. (Murphy, 10/11)

About 60 percent of the U.S. population with European heritage may be identifiable from their DNA by searching consumer websites, even if they've never made their own genetic information available, a study estimates. And that number will grow as more and more people upload their DNA profiles to websites that use genetic analysis to find relatives, said the authors of the study released Thursday by the journal Science. (Ritter, 10/11)

“Genetic privacy is becoming compromised over time,” said Eric Topol, a professor at the Scripps Research Institute in La Jolla, Calif., who is familiar with the researchers’ findings but wasn’t involved in the studies published Thursday. Genetic data can reveal private information that people don’t always want to share. DNA can be used to identify someone’s risk of a future medical condition, opening individuals and their children to possible discrimination or receiving information they don’t want to know. (Marcus, 10/11)

This new reality represents the convergence of two long-standing trends.One of them is the rise of direct-to-consumer genetic testing. Companies such as Ancestry.com and 23andMe can sequence anyone’s DNA for about $100. All you have to do is provide a sample of saliva and drop it in the mail. The other essential element is the proliferation of publicly searchable genealogy databases like GEDmatch. Anyone can upload a full genome to these sites and powerful computers will crunch through it, looking for stretches of matching DNA sequences that can be used to build out a family tree. (Netburn, 10/12)

"It's kind of like each person in this database is a beacon that illuminates hundreds of distant relatives," Erlich says. "So it's enough to have your third cousin or your second cousin once-removed in these databases to actually identify you." And when the researchers combined their strategy with other information, such a specific geographic area or the approximate age of a person, they could quickly reduce a list of possibilities to just a few people. (Stein, 10/11)

The idea that people who voluntarily spit into a tube and share their genetic data online to search for relatives could unwittingly aid law enforcement was thrust into the spotlight recently. This spring, genetic genealogy helped California police identify a suspected serial killer and rapist in a grisly, decades-old cold case. But the new study, published in the journal Science, drives home the reality that that instance was not an outlier; a majority of Americans of European descent could be matched to a third cousin or closer using an open-access genetic genealogy database. (Johnson, 10/11)

To crack that case, the California investigators used GEDmatch, an online database that allows people who got their DNA analyzed by companies like 23andMe and Ancestry to upload their raw genetic data so that they can track down distant relatives. MyHeritage’s database — which contains data from 1.75 million people, mostly Americans who’ve gotten their DNA analyzed by MyHeritage’s genetic testing business — works similarly, although it explicitly prohibits forensic searches. (23andMe warns users about the privacy risks of uploading their genetic data to such third party sites.) (Robbins, 10/11)

Skyway pedestrians in Minneapolis can earn $100 for samples of their blood, urine and saliva in the latest type of mass genetic testing, this time to help develop life insurance products. Scientific Testing Partners, which set up in the second floor of the U.S. Bank building at the start of October, is seeking 1,000 participants in a project that illustrates the rapid expanse in genetic know-how and in its collection of data for business, public health, genealogy and academic research. (Olson, 10/11)

A small but increasing number of children in the United States are not getting some or all of their recommended vaccinations. The percentage of children under 2 years old who haven’t received any vaccinations has quadrupled in the last 17 years, according to federal health data released Thursday. Overall, immunization rates remain high and haven’t changed much at the national level. But a pair of reports from the Centers for Disease Control and Prevention about immunizations for preschoolers and kindergartners highlights a growing concern among health officials and clinicians about children who aren’t getting the necessary protection against vaccine-preventable diseases, such as measles, whooping cough and other pediatric infectious diseases. (Sun, 10/11)

"This is pretty concerning. It's something we need to understand better — and reduce," said the CDC's Dr. Amanda Cohn. Most young children — 70 percent — have had all their shots. The new estimate is based on finding that, in 2017, 1.3 percent of the children born in 2015 were completely unvaccinated. That's up from the 0.9 percent seen in an earlier similar assessment of the kids born in 2011. A 2001 survey with a different methodology suggested the proportion was in the neighborhood of 0.3 percent. (Stobbe, 10/11)

Overall, the CDC reported child vaccination rates have been steadily increasing since 2001. The agency’s survey encompasses millions of children across 49 states* and the District of Columbia by pulling data from health care providers and schools. Their findings show that vaccine coverage remains high for 19- to 35-month-olds and kindergarteners. But the median percentage of kindergarteners with an exemption rose from 2 percent in 2016 to 2.2 percent in 2017. (Leventhal, 10/11)

The latest wearable technology can reliably track heart beats and notify users of any irregularities. Up next? Reliably tracking your brain and mental health. A team of researchers at the Center on Depression and Resilience at the University of Illinois at Chicago is working on technology that could monitor users’ mood and cognition—important indicators of mental-health stress—by tracking their typing patterns with an iPhone app called BiAffect. Initial research has found it is possible to predict episodes of mania and depression among users with bipolar and major depressive disorder based on changes in their typing habits. (Higgins, 10/11)

An Environmental Protection Agency panel that advises the agency’s leadership on the latest scientific information about soot in the atmosphere is not listed as continuing its work next year, an E.P.A. official said. The 20-person Particulate Matter Review Panel, made up of experts in microscopic airborne pollutants known to cause respiratory disease, is responsible for helping the agency decide what levels of pollutants are safe to breathe. Agency officials declined to say why the E.P.A. intends to stop convening the panel next year, particularly as the agency considers whether to revise air quality standards. (Friedman, 10/11)

For the first time, scientists said Thursday that they had bred mice with two genetic fathers, steering around biological hurdles that would otherwise prevent same-sex parents from having offspring. The researchers also bred mouse pups with two genetic mothers. Those pups matured into adults and had pups of their own, outpacing previous efforts to create so-called bimaternal mice. (Joseph, 10/11)

Whatever the cluster of second-year students at Weill Cornell Medicine in New York expected to hear from an 82-year-old woman — this probably wasn’t it. At first, Elizabeth Shepherd, one of several seniors invited to meet with future doctors in an anti-ageism program called “Introduction to the Geriatric Patient,” largely followed the script. (Span, 10/12)

Kiara Eldred sometimes compares her nine-month-long scientific experiments, growing tiny human retinas in a laboratory dish, to raising children. Eldred, a graduate student at Johns Hopkins University, starts by growing thousands of stem cells and feeding them nutrients and chemicals that will steer them to develop into the retina, the part of the eye that translates light into the signals that lead to vision. After two weeks of painstaking cultivation, those cells typically generate 20 to 60 tiny balls of cells, called retinal organoids. As they mature, these nascent retinas get dirty and slough off lots of cells, so they also need to be washed off when they’re fed every other day — at least for the first month and a half. (Johnson, 10/11)

The discovery, published Thursday in the journal Science, could help accelerate current efforts to cure colorblindness. It could also lead to new treatments for diseases including macular degeneration, the leading cause of vision loss. "It's important that we understand how nature controls the development of the retina so we can understand better why things go wrong in disease and how we can treat them," says Steven Becker, a scientist at the National Eye Institute. The newly published findings are a step in that direction, says Becker, who has no connection to the research. (Hamilton, 10/11)

Kaiser Health News: Dementia And Guns: When Should Doctors Broach The Topic?

Some patients refuse to answer. Many doctors don’t ask. As the number of Americans with dementia rises, health professionals are grappling with when and how to pose the question: “Do you have guns at home?” While gun violence data is scarce, a Kaiser Health News investigation with PBS NewsHour published in June uncovered over 100 cases across the U.S. since 2012  in which people with dementia used guns to kill themselves or others.  The shooters often acted during bouts of confusion, paranoia, delusion or aggression — common symptoms of dementia.  Tragically they shot spouses, children and caregivers. (Bailey, 10/12)

Omega-3 supplements may help reduce anxiety symptoms, a review of studies has concluded. The analysis, in JAMA Network Open, concluded that people with clinically diagnosed anxiety disorders who took large doses of the supplement — up to 2,000 milligrams a day — benefited most. (Bakalar, 10/11)

Cervical cancer is at a crossroads: If no action is taken, the number of women dying from the disease is expected to increase substantially by 2030. But the cancer is caused by the human papillomavirus and highly treatable if the warning signs are caught early. (Wheaton, 10/11)

ProPublica and the Houston Chronicle reported in May that some St. Luke’s doctors complained internally in 2015 and 2016 about problems that led to poor outcomes in the hospital’s heart transplant program. ... Rios’ case also opens a window into St. Luke’s use of peer review, a confidential process intended to assess and discipline doctors accused of negligence or wrongdoing, but one that legal and health care experts say is sometimes manipulated by hospitals in order to punish outspoken physicians. (Hixenbaugh and Ornstein, 10/11)

In an unusual enforcement action against an insurer for out-of-network billing, Humana will pay Texas a $700,000 fine for failing to maintain an adequate number of in-network anesthesiologists at its contracted hospitals in four counties. It's the latest development in a running national battle over surprise out-of-network bills, which a bipartisan group of U.S. senators recently targeted with draft legislation. The problem is particularly pronounced in Texas, which lacks a comprehensive system for shielding patients from contract disputes between insurers and providers, unlike California and other large states. (Meyer, 10/11)

The Washington Supreme Court has struck down the state's death penalty, saying that it is imposed arbitrarily and with racial bias. ... Thursday's ruling makes Washington the 20th state to abolish capital punishment. (Kennedy, 10/11)

Texas leads the nation in the number of nursing homes penalized with payment suspensions. Over the past three years, Texas nursing homes were hit 260 times with this extreme sanction. That’s 21 percent of all Texas facilities. (Doroshow, 10/11)

A senior Michigan medical executive who is charged in the death of a man due to a Legionnaires' outbreak linked to Flint's lead-tainted water crisis has been recognized for her eminent career in health care. The Flint Journal reports that Dr. Eden Wells has been awarded the Roy R. Manty Distinguished Service Award. (10/11)

At least seven children and one adult in Texas have been diagnosed this year with a rare condition that threatens lifetime paralysis, and the Centers for Disease Control and Prevention is working to confirm additional cases. The condition, acute flaccid myelitis (AFM), affects the nervous system, primarily through the spinal cord. It weakens a person's muscles and nerves, according to the CDC. (Smith, 10/11)

A man hospitalized for dehydration a few months ago at Los Angeles County-USC Medical Center started suffering a severe fever, and doctors weren’t sure why. The patient was homeless, a clue to doctors that he might have typhus. Every year people contract flea-borne typhus in Southern California, mostly in Los Angeles County. Doctors did a blood test. (Karlamangla, 10/11)

Kaiser Health News: ‘Grossly Unfair’? Widower Takes Ban On Military Injury Claims To Supreme Court

More than four years after Navy Lt. Rebekah Daniel bled to death within hours of childbirth at a Washington state military hospital, her husband still doesn’t know exactly how — or why — it happened. Walter Daniel, a former Coast Guard officer, demanded explanations from officials at the Naval Hospital Bremerton, where his wife, known as “Moani,” died on March 9, 2014. He says he got none. No results from a formal review of the incident, no details about how the low-risk pregnancy of a healthy 33-year-old woman — a labor and delivery nurse herself — ended in tragedy, leaving their newborn daughter, Victoria, now 4, without a mom. (Aleccia, 10/11)

A federal judge has ruled the state of Maryland can’t force state retirees onto a federal prescription drug plan until a lawsuit is decided. U.S. District Judge Peter Messitte issued the ruling this week. Four Maryland state retirees filed the lawsuit last month. They contend Maryland can’t force them to enroll in Medicare Part D when open enrollment begins Oct. 15. (10/11)

AFSCME Local 3299 announced Thursday morning that the 15,000 patient-care technical workers in its ranks voted to authorize a strike against the University of California after reaching a deadlock in labor contract negotiations. The strike vote received approval from 96 percent of AFSCME 3299 members, AFSCME leaders said, and the patient-care workers will be joined on the picket line by 9,000 employees in AFSCME’s service unit and 15,000 members of the UPTE-CWA union, who voted to join in solidarity. (Anderson, 10/11)

For many cancer patients, getting to and from treatment can be one of the biggest barriers to successfully fighting the disease. The ACS conducted a national survey of hospital social workers who reported that about 125,000 cancer patients require transportation services each year to keep up to date with their treatment appointments. To address the need, the organization launched the Road to Recovery Volunteer Program to recruit drivers able to provide rides to and from patients' cancer-related medical appointments. They have recruited 24 volunteer drivers so far in the New Orleans area, including Sandra Waguespack, a retired nurse who took Boatner to his radiation appointment on Tuesday (Oct. 9). (Clark, 10/11)

A Grand Junction hospital is looking to join Centura Health’s system, saying Thursday that it has signed a letter-of-intent to pursue exclusive negotiations with the Centennial-based provider. Community Hospital said in a statement that the decision to enter talks with Centura Health “reflects its long-term commitment to preserve and expand options for compassionate, high quality health care in the Grand Valley.” (Seaman, 10/11)

A federal jury in Madison has awarded $780,000 to two transgender state employees who were wrongfully denied insurance coverage of transition surgeries. A judge last month ordered that care is covered, and the trial this week was only to determine the damages due to the plaintiffs, University of Wisconsin-Madison graduate student, Alina Boyden, and Shannon Andrews, a researcher at UW School of Medicine. (Vielmetti, 10/11)

The number of Connecticut high school students who used vaping products, such as e-cigarettes, doubled from 2015 to 2017, according to a new study released by the state Department of Public Health. Overall, 14.7 percent of high school students reported “currently” vaping in 2017, compared to 7.2 percent in 2015. (Rigg, 10/11)

The owner of a West Miami-Dade pharmacy became the latest South Florida healthcare fraudster to plead guilty Tuesday in Miami federal court, admitting to running an $8.4 million Medicare fraud. Miami Beach resident Antonio Perez, Jr., 48, will be sentenced Dec. 18 on his one count of conspiracy to commit healthcare fraud. (Powell, 10/11)

More than a dozen camper vans flanked the University Mound Reservoir in San Francisco’s Portola neighborhood Tuesday, spreading along University Street, past the antebellum senior center and alongside a row of abandoned greenhouses around the block. To residents who flocked to a neighborhood meeting that night, the vehicles are a source of frustration and a vexing symbol of the city’s inability to solve its homeless crisis. (Swan, 10/11)

The Dartmouth Atlas of Health Care sheds light on wide variations in spending for Medicare beneficiaries in the 6 months before their death. That report has led to several efforts to better standardize patient care. High-value care has been defined as the seventh competency, with national efforts to educate physicians and physicians in training about how to deliver higher-quality care, while decreasing the cost of that care. Medical students and residents are particular targets for this effort because of the known “imprinting,” or sustained influence, that the training environment has on practice habits during a physician’s career. Kahneman and colleagues found that professionals express a much greater-than-expected degree of variability in the outcomes of their work, even when given the same data with which to base their conclusions. We are aware of 2 previous studies that showed a large degree of variability in resident patterns of test ordering. One study analyzed outpatient test ordering in 1987, and another, “practice intensity” in 2015. (Geleris, 10/8)

The State of Maryland implemented the Health Enterprise Zone Initiative in 2013 to improve access to health care and health outcomes in underserved communities and reduce health care costs and avoidable hospital admissions and readmissions. In each community the Health Enterprise Zone Initiative was a collaboration between the local health department or hospital and community-based organizations. (Gaskin, 10/1)

Six-in-ten Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage, including 31% who support a “single payer” approach to health insurance, according to a new national survey by Pew Research Center. These views are little changed from last year, but the share saying health care coverage is a government responsibility remains significantly higher than it was from 2008 through 2016 (51% said this in 2016, compared with 60% today). (Kiley, 10/3)

With this nationally representative study, we present results on new measures of transition planning among YSHCN as well as youth without special health care needs. The relationship between transition planning and various health system characteristics among YSHCN is also examined. (Lebrun-Harris, 10/1)

There is strong evidence that housing conditions affect population health, but evidence is limited on the extent to which housing with supportive social services can maintain population health and reduce the use of expensive hospital services. We examined a nonprofit, community-based program in Queens, New York, that supplied affordable housing with supportive social services to elderly Medicare beneficiaries. We evaluated whether this program reduced hospital use, including hospital discharges for ambulatory care–sensitive conditions (ACSCs). (Gusmano, 10/1)

Among a retrospective cohort of more than 2.4 million musculoskeletal-related primary care visits by 814 049 older adult patients with hypertension, heart failure, or chronic kidney disease, 9.3% of visits resulted in prescription NSAID use within the following 7 days. Prescription NSAID use was not associated with increased risk of safety-related outcomes at 37 days. (Bouck, 10/8)

The implementation of Medicaid work requirements in Arkansas has been complex, with many Medicaid enrollees still not aware of program changes despite substantial outreach.  In addition, an online reporting requirement is proving difficult for many enrollees due to limited knowledge of the requirements as well as lack of computer literacy and internet access, according to a new analysis from KFF (the Kaiser Family Foundation). (10/9)

The American people have a very clear choice in the upcoming elections. On one side is Donald Trump and the Republican leadership in Congress, who made throwing 32 million Americans off of health insurance their number one priority in Washington. On the other side is my "Medicare for All" plan supported by 16 senators and 122 House members. It would guarantee everyone could get the health care they need without going into debt at far lower cost than the current dysfunctional system. And Americans are very clear about which side they are on. In a poll last summer, 70 percent said they support expanding and improving Medicare to cover everyone in our country. They understand that there is something profoundly wrong when our current dysfunctional health care system is designed not to provide quality care to all, but to enable the private health insurance industry and drug companies to make billions in profits. (Sen. Bernie Sanders, 10/11)

As Democrats have increasingly advocated for some kind of universal, government-guaranteed health insurance program (though there are multiple plans floating around with different features), Republicans have struggled to settle on the most effective rhetorical counter to the idea. “Big government takeover!” has gotten a little old. “Bureaucrats making decisions for you instead of your doctor!” rings false to anyone who has had to deal with the nightmare of insurance company bureaucracy. “It’ll cost trillions!” is less persuasive when they’re running up trillions in debt themselves for things like corporate tax cuts. So what’s the alternative? (Paul Waldman, 10/10)

Do you remember political spin? Politicians used to deceive voters by describing their policies in misleading ways. For example, the Bush administration was prone to things like claiming that tax breaks for the wealthy were really all about helping seniors — because extremely rich Americans tend to be quite old. But Republicans no longer bother with deceptive presentations of facts. Instead, they just flat-out lie. (Paul Krugman, 10/11)

Last week, the Trump administration reached out to the USA TODAY Opinion team to publish an opinion from the president, criticizing the Democrats’ proposal for a government-funded, single-payer health care system known as "Medicare for All.” David Mastio, the deputy editorial page editor, said it is not unusual for U.S. presidents to submit opinions to USA TODAY, especially ahead of key races such as the midterm elections. Presidents Barack Obama and George W. Bush submitted op-eds and opposing views during their years in office as well as in their campaigns. (Manny Garcia, 10/11)

President Trump chose this paper to make his case that Republicans are the party to be trusted and the Democrats are to be feared when it comes to your health care. Polls suggest Americans don’t see it that way. If they’re smart, they will pay attention to votes, not quotes (or op-eds) from politicians and look at what’s likely to happen in health care after next month’s election. So let’s take a look at what is likely to happen based on who carries the midterms. (Andy Slavitt, 10/12)

In November of every even-numbered year since at least 1970, the biggest lie in American politics has been Democrats claiming that Republicans are going to take away your Social Security. Republicans learned to live in a defensive crouch and to try to avoid mentioning the words “Social Security.” Now the new lie is about health care, mostly that Republicans are going to take away coverage for preexisting conditions. As usual, the truth is very different. The Senate Republican Policy Committee explained in a May 2017 paper that under the Republican-backed alternative to Obamacare, the American Health Care Act, “no one will be denied coverage because of a pre-existing condition.” Even if you are skeptical of Republican talking points, you don’t have to look very far to find objective confirmation. According to FactCheck.org, “Sen. [Charles E.] Schumer [D-N.Y.] … was wrong to say, as he did on the Senate floor April 28, that the bill goes ‘back to the day when insurance companies could deny coverage to those with preexisting conditions.’ ” (Ed Rogers, 10/11)

Iowans have now received what the Republican-controlled state Legislature and Gov. Kim Reynolds ordered: the option to buy unregulated health plans that can deny coverage, suddenly cancel plans, not pay medical bills and face no repercussions. The Iowa Farm Bureau last week unveiled details about its new health plans, which are supposed to offer an alternative to policies that must comply with requirements in the Affordable Care Act. These "health benefit plans" are not health insurance, not subject to basic coverage requirements and not regulated by any state or federal entity. (Des Moines Register, 10/10)

In baseball, the winning pitcher is the one who was on the mound just before his team took the lead for good — regardless of how well he pitched. So a reliever who gets hammered, turning a three-run lead into a two-run deficit, nevertheless will get credit for the win if his teammates retake the lead the next time they’re at bat. Keep that in mind whenever President Trump talks (or writes) about health insurance premiums for Obamacare policies, which are sold to people not covered by a large employer’s group plan. (Jon Healey, 10/11)

There's been a lot of discussion of narrow provider networks and how they reduce costs by limiting access to the highest priced providers. They're commonplace in the Affordable Care Act marketplaces where about 10 million people are enrolled, and in the individual market generally — but they are actually quite rare in the group market, where about 152 million Americans get coverage through their employers. (Drew Altman, 10/12)

By the narrowest of margins, the U.S. Senate rejected legislation Wednesday that would have subjected patients with expensive illnesses to soaring premiums, canceled coverage and medical bankruptcy. You might expect such legislation to have been introduced by Republicans and defeated by Democrats, but you’d be wrong. Democrats sought to deny care to the sick. Republicans stopped them. (Michael F. Cannon, 10/11)

In Boston’s Jamaica Plain neighborhood, investments spurred by federal tax credits are turning into windows and walls. Soon will come stoves, pots and pans; then lunches and dinners; then healthier people, fewer hospital visits, lower health-care costs and jobs. But for federal New Markets Tax Credits (NMTCs), this trailblazing “food as medicine” project — and many other important projects nationwide — may never happen. (Antony Bugg-Levine and Daniel Nissenbaum, 10/11)

The most audacious play in the 2018 election cycle is that the party that destroyed the American health insurance market is positioning itself as the savior of health care.And the most mind boggling piece is that the pitch seems to be selling. Democrats are managing to dump the mess they made of Obamacare fully in the laps of Republicans. Nearly all Democratic candidates are accusing their GOP opponents of stripping vulnerable Americans of health insurance, and setting themselves up as the defenders of the very system they ravaged. (Nolan Finley, 10/10)

ince the Affordable Care Act was signed into law in 2010, the percentage of uninsured Americans has dropped. Today, more than 20 million of us have access to health care thanks to the ACA and Medicaid expansion. That’s the good news. Unfortunately, millions of Americans are still uninsured. Last year alone, more than 2.6 million Floridians did not have the safety net of health insurance at one time or another. That’s nearly 13 percent of our population, a rate that tops the national average and ranks as the fifth highest in the country. (Dick Batchelor, 10/9)

Bernie Sanders, move over. Josh Hawley would like to get to your left on health care. Hawley, Missouri’s attorney general and Republican U.S. Senate candidate, would surely dispute that characterization. Yet Hawley’s latest explanation of how he would eliminate Obamacare while still covering people with pre-existing conditions sounds more like government-run health care than even what the socialist senator from Vermont has proposed. Hawley proposes to have the government collect people’s insurance premiums and pay their major medical costs once they’ve reached a certain threshold. (10/8)

On Jan. 8, my husband, Josiah “Si” Lewis went to Kaiser Oakland for a routine colonoscopy. During the procedure, the team lacerated his spleen without perforating his colon (it’s so rare for it to happen that it’s not listed on their Consent for Treatment form). They were unaware of the injury and sent him home with standard post-procedure instructions. By 5 p.m. Si was in such severe pain that I drove him to Kaiser’s emergency room. After several other tests, a CT scan showed bleeding from the spleen. (Alice Lewis, 10/11)

At the Department of Health and Human Services, we are deeply concerned about the risks that e-cigarettes pose for children, given how quickly teenage use of these products has accelerated. Using a small battery to heat a liquid that contains nicotine, e-cigarettes turn the liquid into an inhalable vapor. Since 2014, they have been the most popular nicotine product among American teenagers. And e-cigarettes' popularity is accelerating: From 2017 to 2018, according to new preliminary data from the National Youth Tobacco Survey, the number of high-school-age children reporting use of e-cigarettes rose by more than 75 percent. Use among middle-schoolers also increased nearly 50 percent. That is an epidemic. (HHS Secretary Alex M. Azar and FDA Commissioner Scott Gottlieb, 10/11)

After enduring another scorching summer — the fourth-hottest on record for the contiguous United States — it may be hard to imagine conditions getting much worse. But as a new report from the United Nations’ panel on climate change warns, we are locked in to additional warming and other changes like sea level rise. And we are running out of time to avert potentially catastrophic outcomes. One critically important and underreported fact is that as temperatures rise, absolute humidity, the total amount of moisture in the air, will also increase. That may create combinations of heat and humidity so extreme that the evaporation of human sweat won’t sufficiently cool our bodies, leaving even healthy adults at risk of death from overheating. (Ethan Coffel, Radley Horton and Colin Raymond, 10/11)

President Trump’s new National Biodefense Strategy contains welcome tactics for protecting the health of Americans when “biological incidents” such as the 2001 anthrax attacks or the 2014 Ebola epidemic in West Africa occur. Some of the plans, however, are at odds with the administration’s policies on health insurance and immigration. Reconciling the two is essential for the strategy to match its promise. (David Beier and Devabhaktuni Srikrishna, 10/11)

Are my breast cancer and I on the wrong side of statistics, or just caught in the confusing and potentially devastating conflict between medical societies about when women should start breast-cancer screening? One morning more than a year ago, it didn’t seem like either. As both of my kids cuddled in bed with my husband and me, I started the conversation I’d been dreading. (Leda Dederich, 10/12)

Today is World Mental Health Day. The day’s objective, as stated by the World Health Organization, is to raise “awareness of mental health issues around the world and mobiliz[e] efforts in support of mental health.” Although mental health is an important topic for all citizens, it is of particular importance for our nation’s veterans, many of whom struggle with mental health issues that stem from combat, deployment, declining physical health, and readjusting to civilian life. (Rory E. Riley-Toppings, 10/10)

In several states there are reports of children developing cases of a mysterious polio-like syndrome known as Acute Flaccid Myelitis (AFM).A cluster of six cases in Minnesota has prompted Sen. Amy Klobuchar (D-Minn.) to request an investigation by the Centers for Disease Control and Prevention (CDC). In total 16 states are reporting cases. While it is understandable that the news of a polio-like illness appearing, seemingly, in clustered outbreaks across the United States is concerning, it is important to emphasize how rare such cases are and how they occur. (Amesh Adalja, 10/11)

Eight years ago, an organization called the Council for Education and Research on Toxics commenced a lawsuit against coffee vendors in California, maintaining that to comply with Proposition 65, cancer warnings must be placed on lattes, cold brews and plain old cups of joe they sell in the state. Hundreds of millions dollars in damages have been sought from companies such as Starbucks for not including such warnings previously. New warnings are sought advising potential purchasers that coffee contains a chemical called acrylamide that can cause cancer. (Floyd Abrams, 10/11)

When the White House mentioned that hip-hop artist Kanye West would be meeting with President Trump on Thursday, it was presented as a plan to discuss issues that are of great significance to many voters — jobs, prison reform and gun violence in Chicago, the hometown of the multi-platinum artist. But in trying to draw attention to these issues, West, using profanity while discussing a broad range of subjects with little clarity, appeared to mainly draw attention to himself — and perhaps, specifically, how ill-equipped he is to discuss the issues he longed to address most. (Eugene Scott, 10/11)