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A bipartisan proposal to calm churning health insurance markets gained momentum Thursday when enough lawmakers rallied behind it to give it potentially unstoppable Senate support. But its fate remained unclear as some Republicans sought changes that could threaten Democratic backing. (Werner and Fram, 10/19)

The bipartisan deal to stabilize ObamaCare’s markets has 24 co-sponsors, Senate Health Committee Chairman Lamar Alexander (R-Tenn.) announced Thursday. Twelve Republicans and 12 Democrats signed on to the bill, which would continue ObamaCare's insurer subsidies for two years and give states more flexibility to waive ObamaCare rules. (Hellmann, 10/19)

Among those backing the bill, Sen. Lisa Murkowski (R-Alaska), said she not only supports the policy, but the opportunity it provides for Congress to show, "at a time when things are a little tense ... that we can come together. We can demonstrate the ability to govern." (Mascaro, 10/19)

Senate Health Committee Chairman Lamar Alexander (R-Tenn.) on Thursday told GOP colleagues bluntly that their efforts to repeal ObamaCare have failed and urged them to change course. Alexander said Republicans need to come up with a new path on health care after holding dozens of votes over the years to repeal ObamaCare and always ending in failure. (Bolton, 10/19)

Mitch McConnell and Lamar Alexander go way back. The two Southern Republicans met in Washington in 1969 when Mr. Alexander was a promising young aide at the Nixon White House and Mr. McConnell an up-and-coming legislative assistant to Senator Marlow W. Cook of Kentucky. The story goes that Senator Howard H. Baker Jr. suggested to Mr. Alexander, his fellow Tennessean, that he should look up Mr. McConnell, that he was a “smart young man and I think you’d like him.” A nearly 50-year friendship and political alliance was born. (Hulse, 10/19)

Republican U.S. Senators Lindsey Graham and Bill Cassidy said on Thursday they were working with Republican Senator Ron Johnson and members of the House of Representatives to add more "flexibility provisions" to a proposed bipartisan bill to stabilize the healthcare insurance market in the short term. (10/19)

Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) say they are working to make changes to a bipartisan health-care deal to make it more likely to win favor in the House. Graham and Cassidy, authors of a failed bill to repeal and replace ObamaCare earlier this year, are supporting a bipartisan measure aimed at stabilizing ObamaCare, but they are also looking for changes to move the proposal to the right. (Sullivan, 10/19)

Sen. Ron Johnson is trying to write a bill to fund Obamacare’s cost-sharing payments that he hopes will appeal to conservatives skeptical of the Senate's bipartisan stabilization effort. (Haberkorn, 10/19)

Ohio U.S. Sen. Rob Portman said Thursday he doesn't yet support efforts to restore money to insurance companies under the Affordable Care Act, saying the legislation still doesn't do enough to reduce insurance premiums and help Ohioans. Even if the money was restored, he said, premiums for ACA policies would rise by an average of 23 percent next year in Ohio. (Koff, 10/19)

A bipartisan coalition of 24 senators — 12 Republicans and 12 Democrats — has signed on to health care legislation to prop up the individual insurance market and keep premiums down. ...But questions remain over when it might actually get a vote, as well as whether President Trump and House Republicans would bring the bill over the finish line. (Davis, 10/19)

Healthcare leaders gathered [in Arizona] for Modern Healthcare's second annual Leadership Symposium have grown pessimistic about the prospect for passing legislation that would stabilize the insurance exchanges for next year's open enrollment season—now just two weeks away. President Donald Trump's sudden reversal on support for the compromise legislation crafted by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) cast a pall over a meeting where the nearly 100 top officials are discussing leadership challenges during a time of "disruption, complexity and uncertainty." (Goozner, 10/19)

The bipartisan health care bill formally proposed Thursday in Congress would help stabilize insurance markets up-ended by the fierce partisan battle over "Obamacare." For consumers, it offers a potential respite from the spiral of rising premiums and dwindling choice. (10/19)

Kaiser Health News: Podcast: ‘What The Health?’ Whiplash

The bipartisan leaders of the Senate Health, Education, Labor and Pensions Committee this week agreed on a bill they say could help stabilize the struggling health insurance exchanges. But despite compromises made by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), it’s still unclear whether Congress can pass the measure, particularly in time for the Affordable Care Act’s 2018 open enrollment season, which begins Nov. 1. (10/19)

A senior White House aide said on Thursday that U.S. President Donald Trump would demand steps toward repealing Obamacare in any healthcare legislation, comments that cast doubt on the prospects for a short-term bill to shore up insurance markets. Marc Short, the White House's top liaison to Congress, said on CNN that Obamacare's mandates and taxes would have to be rolled back and consumers be allowed to more heavily invest in health-savings accounts for Trump to sign off on any congressional deal. (Cowan and Abutaleb, 10/19)

“We are certain that it can be improved,” Mr. Alexander said on the Senate floor Thursday. But the White House made clear Thursday that Mr. Trump was seeking more than minor tweaks to the legislation, which would shore up the ACA’s individual insurance markets by extending for two years federal payments known as “cost-sharing reductions” that help insurers offset subsidies they provide to some low-income consumers, while giving states greater say in how the law is implemented. In order for Mr. Trump to support such legislation, it must provide relief from the ACA’s requirement that most people have health coverage or pay a penalty, the spokesman said Thursday. (Armour and Peterson, 10/19)

A package "must provide immediate benefits to American families," a White House aide said, such as relief from the 2010 health care law's individual and employer mandates, a request pushed by the conservative group Freedom Partners. In addition, the White House is pushing for state regulators to be able to approve more types of coverage options, such as the short-term, limited duration insurance plans encouraged in the executive order signed by President Donald Trump last week. (McIntire, 10/19)

“I respect very much the two senators your talking about, I love that they’re working on it,” Trump said at the White House Thursday when asked about his position on the bill. Shortly after Trump’s comments, Tennessee Republican Lamar Alexander and Washington Democrat Patty Murray introduced their stabilization bill with 22 senators, half of whom are Republicans. That broad backing could give the package momentum in the Senate. (Edney and Sink, 10/19)

The requested changes emphasize that the White House could be a long way off from supporting the deal. Republican lawmakers say White House support is crucial for the passage of health-care legislation. (Sullivan, 10/18)

Key Senate Republicans are urgently trying to get President Donald Trump to reconsider his apparent opposition to a bipartisan deal shoring up health insurance markets, several senators said Thursday morning. Sens. Lindsey Graham of South Carolina and Lamar Alexander of Tennessee, who negotiated the deal with Democratic Sen. Patty Murray of Washington, both spoke to the president about it on Wednesday evening. (Everett and Haberkorn, 10/19)

President Donald Trump overrode his own advisers when he promised to deliver an emergency declaration next week to combat the nation’s worsening opioid crisis. “That is a very, very big statement,” he said Monday. “It's a very important step. ... We're going to be doing it in the next week.” (Ehley and Dawsey and Karlin-Smith, 10/20)

There is little that resembles a current and all-encompassing drug policy in the United States. A national drug control plan issued by the Obama administration last year was written immediately prior to a White House transition, and many hoping for a newer framework are waiting for next month’s reveal of a new presidential commission’s final report on the opioid epidemic.  A new analysis by the Kaiser Family Foundation, however, shows that many of the elements that could soon be codified as federal guidance are already creeping toward national standards in a patchwork fashion, apparent in the regulations imposed by a number of states for implementing Medicaid. (Facher, 10/19)

Health insurers heading into the 2018 Affordable Care Act enrollment season say they’re staying laser focused on maximizing sign-ups, even as Republicans remain in disarray and even denial over the seven-year-old health-care law. A big funding infusion that could help lower Obamacare premiums is in flux just 12 days before enrollment starts. President Trump sent mixed signals this week about whether he’d support legislation funding subsidies for lower-income Americans to get coverage. (Winfield Cunningham, 10/19)

Tom Westerman voted for Donald Trump in last year's election but says he might not do so again after the president cut off billions of dollars in Obamacare subsidies to health insurance companies. "It really upset me," said Westerman, 63, a self-described "middle-class guy" with an annual household income of about $60,000 in the western Pennsylvania city of Arnold. (Reid and Abutaleb, 10/19)

In less than two weeks, the first Trump-era open enrollment season for health insurance will commence. Whether consumers look to renew insurance plans or join the individual market for the first time, here are some ways the experience may be different this year compared to years prior, according to a presentation to reporters Wednesday by the nonpartisan Kaiser Family Foundation. (Jamerson, 10/19)

As President Trump and his allies in Congress keep pushing to get rid of Obamacare, new research shows that the contentious law has succeeded in expanding health insurance coverage for Americans with cancer. But not everywhere. This upside of Obamacare — known formally as the Patient Protection and Affordable Care Act, or ACA — was seen primarily in states that participated in the Medicaid expansion that the law made possible. (Kaplan, 10/19)

The number of U.S. adults without health insurance is up nearly 3.5 million this year, as rising premiums and political turmoil over "Obamacare" undermine coverage gains that drove the nation's uninsured rate to a historic low. (10/20)

A sudden burst of bipartisanship this week on health care just as quickly appeared to lose steam in Washington. Two key senators, Republican Lamar Alexander and Democrat Patty Murray, announced a bill Tuesday aimed at stabilizing the health insurance marketplaces under the Affordable Care Act. It would guarantee payment of “cost-sharing reduction” subsidies that help lower-income consumers with their deductibles and copays for 2018 and 2019. President Donald Trump had halted those payments last week. (Other federal subsidies that help people pay for their premiums weren’t affected and remain intact.) (10/19)

The Massachusetts Health Connector announced last week it would use the lower of two rate sets for some of its plans, but President Trump's decision hours later to end certain federal insurance subsidies means the Connector will use the higher rates after all. ...With uncertainty still prevalent about the federal health care landscape, the Health Connector and Division of Insurance had prepared two sets of rates for its 2018 plans, including one featuring bigger rate increases that accounted for the possibility the federal government would stop making monthly payments to insurers known as cost-sharing reduction (CSR) payments. (Lannan, 10/19)

Nineteen Senate Democrats have signed on to a bill that would reverse the Trump administration's new exemption for ObamaCare's birth control mandate. The administration recently announced it will allow most employers to stop providing birth control coverage in their insurance plans if they have moral or religious objections. (Hellmann, 10/19)

Democratic Sens. Patty Murray of Washington and Bob Casey of Pennsylvania introduced a bill Thursday to overturn the rule issued by the U.S. Health and Human Services Department last week allowing more employers to opt out of providing no-cost contraceptives by claiming religious or moral objections. The bill, which is co-sponsored by Sen. Maria Cantwell, D-Wash., and others, says the rule would not take effect and would be treated as if it never happened. (Blethen, 10/19)

Lawmakers and advocates continue to argue about the scope of two rules creating moral and religious exemptions for employers who do not want to cover birth control, two weeks after the Trump administration revealed the policies. The rules significantly expanded the types of organizations that can apply for exemptions to a mandate established under the 2010 health care law (PL 111-148, PL 111-152), which requires most private plans to cover birth control without a copay. Under the rules, any employer is able to qualify for an exemption, provided they have a religious or moral objection to contraception. (Raman, 10/19)

Another program that lost funding helps seniors navigate the complexities of Medicare, still another gives payments aimed at keeping smaller, often rural hospitals financially afloat. Others offer grants to providers and other businesses working to address childhood obesity or improving abstinence education efforts. In the past, Congress has reauthorized this slate of extenders with bipartisan support. Already this year, two House committees have approved tweaks or reauthorizations of many of the programs, teeing them up for further consideration from the full legislative body. The Senate also approved several of the programs, including a broad expansion of the Independence at Home program, as part of a bill aimed at improving care for individuals with chronic conditions. (Mershon, 10/19)

An appeals court on Thursday temporarily stayed a judge's ruling that would have allowed a pregnant 17-year-old being held in a Texas facility for unaccompanied immigrant children to obtain an abortion. The U.S. Court of Appeals for the District of Columbia issued a short ruling that still allowed the teenager to be taken to a counseling meeting with the doctor who would perform the abortion. Texas state law requires women to receive counseling 24 hours before an abortion. (Merchant, 10/19)

In a rare move Thursday, a federal appeals court hastily scheduled an oral argument for Friday morning after U.S. District Judge Tanya Chutkan in Washington, D.C., sharply criticized the administration’s position and ordered it to release the teen to travel to the nearest abortion clinic this week. The government appealed the decision immediately. The appeals court put the court order on hold temporarily so it could consider the case, which raises questions about whether undocumented immigrants in custody have the same constitutional right to an abortion that is accorded to U.S. citizens. (Kendall and Meckler, 10/19)

Federal officials say the 17-year-old, who entered this country in September, could solve the problem herself by voluntarily leaving or finding a sponsor in the United States to take custody of her. “The Administration stands ready to expedite her return to her home country,” the White House said in a statement. But the American Civil Liberties Union, which is representing the teenager, says she is entitled to have an abortion, which she would pay for, under the 1973 Supreme Court ruling in Roe v. Wade. (Sacchetti and Marimow, 10/19)

The ACLU, which is representing the girl, has produced internal emails from the Department of Health and Human Services Office of Refugee Resettlement suggesting the agency has quietly implemented a new policy banning abortion for immigrant minors in its care. The office’s new director under President Trump, Scott Lloyd, has told his staff to refer pregnant girls to pro-life religious pregnancy counseling instead of abortion clinics. In at least one case, he has personally met with a girl considering abortion. (Michels, 10/19)

The U.S. abortion rate has fallen dramatically, by 25 percent, in recent years. The procedure continues to be common: One in  four women will have an abortion by 45, according to a report published in the American Journal of Public Health on Thursday. Researchers used data from three surveys, two conducted by the federal government and the third by the Guttmacher Institute, to estimate abortion rates. They found that in 2008, there were 19.4 abortions per 1,000 women ages 15 to 44. By 2014, the number had dropped to 14.6 per 1,000. (Cha, 10/19)

The CMS may have overcorrected when it honored some hospitals' request to cancel mandatory cardiac pay models. The move means hospitals that were ready to embrace the models could be out millions of dollars. Those hospitals are also missing out on millions in bonus payments they would have received had they improved care. The CMS wants to cancel models for acute myocardial infarction, coronary artery bypass and as well as the Cardiac Rehabilitation Incentive Payment Model, all of which were scheduled to begin on Jan. 1, 2018. Comments on the termination were due Oct. 16. (Dickson, 10/19)

The CMS is taking its first steps to evaluate whether MACRA will lead to reduced Medicare spending with a new pilot test. The test will evaluate eight new measures to determine if physicians in the Merit-based Incentive Payment System, known as MIPS, are actually reducing the cost of care. The CMS unveiled the initiative just two weeks after the Medicare Payment Advisory Commission suggested repealing MIPS over concerns it wouldn't lead to better quality of care for patients or lower costs. (Dickson, 10/19)

Environmental pollution — from filthy air to contaminated water — is killing more people every year than all war and violence in the world. More than smoking, hunger or natural disasters. More than AIDS, tuberculosis and malaria combined. One out of every six premature deaths in the world in 2015 — about 9 million — could be attributed to disease from toxic exposure, according to a major study released Thursday in the Lancet medical journal. The financial cost from pollution-related death, sickness and welfare is equally massive, the report says, costing some $4.6 trillion in annual losses — or about 6.2 percent of the global economy. (Daigle, 10/20)

Hypertension is dangerous. High blood pressure damages the inner lining of the arteries, limits the ability of the heart to pump blood and strains the organ in a way that can lead to heart failure. The condition increases the risk for stroke and vascular dementia, and hypertension is one of the most common causes of kidney failure. It impairs vision by damaging the blood vessels in the eyes. (Bakalar, 10/19)

As the U.S. obesity rate has galloped toward 40%, doctors, drug designers and dispirited dieters have all wondered the same thing: What if a pill could deliver the benefits of weight-loss surgery, but without the knife? New research brings that hope a notch closer. Scientists from the biotechnology company Amgen Inc. report they have identified and improved upon a naturally occurring protein that brought about significant changes in obese mice and monkeys, including weight loss and rapid improvements on measures of metabolic and heart health. (Healy, 10/19)

Reducing nicotine levels in cigarettes to nonaddictive levels could prevent as many as 8 million tobacco-related deaths and keep 30 million people from becoming regular smokers this century, according to new estimates from the Food and Drug Administration. FDA Commissioner Scott Gottlieb revealed the initial estimates on Thursday during a tobacco discussion at the Johns Hopkins Bloomberg School of Public Health. (Edney and Kaplan, 10/19)

In just the past few years, researchers have identified what they believe is an adult version of attention deficit disorder: a restless inability to concentrate that develops spontaneously after high school, years after the syndrome typically shows itself, and without any early signs. The proposed diagnosis — called adult-onset A.D.H.D. and potentially applicable to millions of people in their late teens or older — is distinct from the usual adult variety, in which symptoms linger from childhood. (Carey, 10/20)

Joanie Simpson woke early one morning with a terrible backache. Her chest started hurting when she turned over. Within 20 minutes, she was at a local emergency room. Soon she was being airlifted to a hospital in Houston, where physicians were preparing to receive a patient exhibiting the classic signs of a heart attack. But tests at Memorial Hermann Heart & Vascular Institute -Texas Medical Center revealed something very different. Doctors instead diagnosed Simpson with Takotsubo cardiomyopathy, a condition with symptoms that mimic heart attacks. It usually occurs following an emotional event such as the loss of a spouse or child. That link has given the illness its more colloquial name: broken-heart syndrome. (Brulliard, 10/19)

A lot has changed in the past 10 years when it comes to sports concussions. As evidence has grown of the devastating effects of traumatic brain injuries, athletes and parents have become increasingly alarmed and demanded preventive steps. Some of the most tangible results of that concern are new laws passed in all 50 states and the District of Columbia that try in some form to address head injuries among young athletes. (Wan, 10/19)

A study of more than 8,000 concussions sustained by U.S. high-school athletes indicates that traumatic brain injury laws aimed at protecting children in the aftermath of such injuries are having their intended effect. In the 11-year study of nine sports, researchers found that the rate of repeat concussions significantly declined beginning a little more than 2 1/2 years after the laws went into effect, said senior author Ginger Yang, a principal investigator in the Center for Injury Research and Policy at Nationwide Children’s Hospital. (Viviano, 10/19)

Medica Health Plans transferred the money this month to shore up the finances of its for-profit and Wisconsin insurance businesses, using reserves from its nonprofit HMO. The move is also reigniting a debate about the role of Minnesota’s nonprofit health plans. (Howatt, 10/19)

Attorneys are preparing to make their closing arguments in the case of a Massachusetts pharmacist charged with second-degree murder in a deadly meningitis outbreak. Closing arguments in Glenn Chin’s trial are expected Friday in Boston’s federal courthouse. Chin faces second-degree murder, mail fraud and other charges under federal racketeering law. (Richer, 10/20)

Two North Texas free-standing emergency room operators want tech giant Google to give up the identities of nearly two dozen reviewers who rated them poorly online. Highland Park Emergency Center on Lemmon Avenue and Preston Hollow Emergency Room on Walnut Hill Lane filed a joint petition Tuesday in Dallas County District Court. The 30-page pre-suit deposition lists the screen names used by 22 individuals, who the facilities claim never were treated in their emergency centers. (Rice, 10/19)

The state’s attempt to overhaul its childcare rules has been stalled yet again, after childcare providers across the state mobilized against the proposed changes. The Joint Legislative Committee on Administrative Rules sent the Department of Health and Human Services back to the drawing board after a hearing on the issue Thursday morning. (McDermott, 10/19)

Marques Davis was in the infirmary at Hutchinson Correctional Facility on Dec. 27, 2016, back with the same symptoms he’d been complaining of for months, including numbness and weakness in his legs. But on that day there was something new. “It feels like something is eating my brain,” Davis told Corizon Health employees who staff the prison infirmary. According to a lawsuit filed in federal court Monday, something was infecting his brain: a fungus that slowly killed the 27-year-old over the next four months, as he pleaded for help. (Marso, 10/17)

The study, from the Pew Charitable Trusts, finds that more than 14 percent of Massachusetts inmates are over the age of 55. And the state spends more than $8,900 per inmate per year on health care. (Becker, 10/19)

States like Massachusetts, which have some of the tightest laws regulating who can carry a concealed handgun, have significantly lower rates of handgun homicides than states with more lax handgun permitting laws. That's according to a new study from Boston University, released Thursday in the American Journal of Public Health. (Brooks, 10/19)

Out of all the people who died of heat-associated causes in Maricopa County in 2016, around 15 percent had a history of mental illness, according to an Arizona Republic analysis of autopsy reports. ...Some medications, including certain types of antidepressants and antipsychotics, block the body’s ability to regulate its temperature, said Dr. David Eisenman, a professor of medicine at the University of California, Los Angeles. (Altavena, 10/19)

The Pennsylvania Department of Health revoked the regular license of St. Francis Center for Rehabilitation & Healthcare last month and installed a temporary manager at the Darby nursing home after an August inspection found that a patient had developed “wounds that went down to the bone with exposed tendon.” The 273-bed facility, one of five sold in 2014 by the Archdiocese of Philadelphia to Center Management Group of New York, appealed the decision and remains open under a temporary manager installed by the health department. The revocation was the first in Pennsylvania since at least the beginning of 2014. (Brubaker, 10/20)

Cleveland HeartLab, a cardiovascular diagnostic testing company, has proprietary tests that use biomarkers to predict cardiovascular disease. With the deal, Quest, a New Jersey-based medical testing laboratory with locations around the world, will be able to add those diagnostic tests, and others, to its offerings. (Christ, 10/19)

Bobby Cagle, who as DFCS director is credited with stabilizing the long-troubled state agency, is departing for a child welfare position in Los Angeles. He is being replaced by the agency’s chief of staff, Virginia Pryor, who will be interim DFCS director, the governor’s office announced this week. (Miller, 10/19)

Throughout last summer, 25-year-old quadriplegic Louis Facenda Jr. spent as much as half of each day in a dirty diaper after his caregiver services provided through Iowa's Medicaid program were dramatically cut. ...The cuts ended payments for at least 16 visits each week for an in-home care program that helped the family dress, feed and change the diapers of Facenda Jr. two to three times each day. (Clayworth, 10/19)

The Hospital Readmissions Reduction Program penalizes hospitals that have high 30-day readmission rates across specific conditions. There is support for changing to a hospital-wide readmission measure to broaden hospital eligibility and provide incentives for improvement across more conditions. ... We used Medicare claims from 2011 through 2013 to evaluate the number of hospitals that were eligible for penalties, in that they met a volume threshold of 25 admissions over a 3-year period for a specific condition or 25 admissions over a 1-year period for the cohorts included in the hospital-wide measure. ... Changing to the hospital-wide measure would result in 76 more hospitals being eligible to receive penalties. (Zuckerman et al., 10/19)

The burden of human papillomavirus (HPV)–positive oropharyngeal squamous cell carcinoma (OPSCC) is disproportionately high among men, yet empirical evidence regarding the difference in prevalence of oral HPV infection between men and women is limited. ... The overall prevalence of oral HPV infection was 11.5% ... in men and 3.2% ... in women (equating to 11 million men and 3.2 million women nationwide). (Sonawane et. al, 10/17)

The human papilloma virus (HPV) vaccine is the first and only vaccination that helps protect women and men from getting many different types of cancer that are associated with different HPV strains. The vaccine protects young people against infection from certain strains of the HPV, the most common sexually transmitted infection (STI) in the United States.1 Since HPV vaccines were first introduced in the U.S. in 2006 there have been changes in the range of protection they offer and the dosing regimen. Furthermore, the vaccines were originally recommended only for girls and young women and were subsequently broadened to include boys and young men. This factsheet discusses HPV and related cancers, use of the HPV vaccines for both females and males, and insurance coverage and access to the vaccines. (10/19)

Interest in the intersection between health and housing is rising within both sectors as they work together to prevent asthma attacks and reduce related emergency room (ER) and hospital use. Initiatives to reduce asthma triggers in the home—including mold, pests, and tobacco smoke—are under way across the country, from home remediation to new regulations (e.g., a public housing smoking ban). Understanding the relationship between asthma, ER and urgent care visits, and housing-related triggers is difficult, but the 2015 American Housing Survey includes a special module with questions on asthma and triggers in the home. (Ganesh, Scally, Skopec and Zhu, 10/16)

A large share of Medicare spending is generated by a relatively small group of patients with expensive medical needs. These patients, many of whom are frail and elderly, account for the vast majority of potentially preventable Medicare spending. Interventions targeting the health conditions of these patients could significantly reduce avoidable expenditures in Medicare. (Jha et. al, 10/17)

In this cohort study, with follow-up of nearly 90 000 US women older than 26 years, women with a history of gestational diabetes had 43% greater risk of CVD (myocardial infarction or stroke) compared with women without prior gestational diabetes , although absolute rates in this cohort were low. Adhering to healthy lifestyle factors over follow-up mitigated this modestly elevated risk. (Tobias et al., 10/16)

Senators Alexander and Murray may well have tried and tried to devise a deal that gave both sides a real win. In health care, though, it is extremely hard to find one, because there is little overlap between liberal and conservative policy objectives. If you allow catastrophic plans, a lot of young and healthy people will choose them, and the comprehensive plans liberals prefer will have high premiums. So liberals see almost any step conservatives want to take as a way of undermining or unraveling Obamacare. (Ramesh Ponnuru, 10/19)

Republicans may have unified control of government, but they seem curiously incapable of getting major agenda items through. Maybe it’s because Republicans have insisted on cutting out Democrats and doing things unilaterally. Or at least they had been until Thursday, when a bipartisan coalition of 24 senators signed onto a bill to patch up Obamacare. While President Trump and congressional Republican leadership remain skeptical about working with the enemy, this could be the start of a turnaround for the GOP. To be clear, “bipartisan” ideas are not necessarily “good” ideas. Sometimes a policy that both parties support turns out to be a huge mistake. As a political matter, though, it can be extremely useful for the majority party to get buy-in from the other side, for three reasons. (Catherine Rampell, 10/19)

At the end of the 2017 Obamacare repeal-and-replace legislative battle (and before the next one begins), it is worth taking stock of why — defying the odds — the Affordable Care Act (ACA) still stands. From my perspective as an Obama administration veteran of every near-death experience of the law to date, this one is notable for its unlikely heroes. (Jeanne M. Lambrew, 10/18)

For seven years, congressional Republicans and Democrats battling over Obamacare have agreed on only one thing: They couldn’t agree on anything. As more Americans dropped or skipped coverage because of soaring premiums, lawmakers of the two parties couldn’t — wouldn’t — agree on how to fix the 2010 law. (10/20)

Give President Trump an A for effort with his latest executive order, which tries to expand health-insurance options for individuals battered by exploding premiums and fleeing insurers. At least somebody is trying to do something after congressional Republicans failed to repeal and replace ObamaCare. While the executive order represents progress, Congress still needs to act. (Merrill Matthews, 10/19)

Most complaints about the Affordable Care Act (ACA) (e.g., high and rising insurance premiums, large deductibles, and insurer exits) relate to nongroup insurance markets. These markets, the ones that were the most dysfunctional before the ACA, provide coverage to just 7% of the nonelderly population (under 65 years of age) and 6% of the full U.S. population. The ACA’s changes to employer-sponsored insurance plans, Medicare, and Medicaid were more limited, and enrollees are generally satisfied with those coverage options. The problems with the nongroup market, though significant, are fixable, and correcting them does not necessitate disruption of coverage for the remaining 94% of the population. (Linda J. Blumberg and John Holahan, 10/18)

As the U.S. Congress debates the future of the Affordable Care Act (ACA), the public has increasingly called for bipartisan solutions on health care reform. An immediate challenge is stabilizing the ACA marketplace, where 10.3 million people enroll in coverage. Given that certain areas of the country have few insurers participating in the marketplace — because of high enrollee costs, uncertainty over cost-sharing–reduction payments from the federal government, and the expiration of protections for insurers such as reinsurance and risk corridors (which limit how much they can gain or lose through risk sharing) — policies that encourage insurers to enter and stay in the marketplace are needed. (Zirui Song, 10/18)

Patients refuse care based on health-care providers’ ethnicity and religion so often that this phenomenon has been dubbed “medicine’s open secret.” A new poll shows that a majority of health-care professionals say they have faced prejudice from patients. In 2013, a nurse in Flint, Mich., sued a pediatric intensive care unit after it granted a request from a father to enter “no African American nurses” on his infant’s care plan. Damon Tweedy, an African American psychiatrist, describes similar experiences in bruising detail throughout his memoir, “Black Man in a White Coat.” And when Esther Choo, an Asian American emergency department physician, tweeted last month that white nationalists refused her care, she set off a Twitter storm of health-care providers responding with similar stories. (Dorothy R. Novick, 10/19)

Drug overdoses are now the leading cause of death for Americans under age 50, killing roughly 64,000 people in the United States last year. An increase in fatalities is largely fueled by opioids, including fentanyl, a powerful synthetic substance considered up to 50 times more potent than heroin. Although Iowa has not been hit as hard as some other states by the opioid epidemic, we have not been spared. (10/19)

Many addicted people try to bind their future selves to a commitment to stop using drugs. Some move across the country to a place where they don’t know any dealers or fellow users. Others throw away all their drugs and injection equipment. ... Such tactics are often thwarted by the future self of the addicted person who adopted them. Like other drugs to which people become addicted, opioids cause enduring adaptations in the brain that weaken self-control and increase the urge to use these drugs. In addition, many people with drug addictions inhabit social networks that provide repeated stimuli and opportunities to use drugs. (Keith Humphreys, 10/19)

In early September, a 17-year-old girl from Central America was apprehended trying cross the border between the United States and Mexico. After being taken to a shelter for unaccompanied minors in South Texas to await immigration proceedings, she learned she was pregnant. The girl, referred to as Jane Doe in court filings, was adamant that she wanted an abortion. ... For almost a month, some of these Trump appointees have been waging a crusade to force the young woman, whose future in this country is extremely uncertain, to carry her pregnancy to term. Their standoff shows us the real-world consequences of this administration’s radical disregard for women’s autonomy. (Michelle Goldberg, 10/20)

It is unconscionable that the federal government would so flagrantly undermine the rights of a person in its custody. The girl, known in court papers simply as Jane Doe, may not be here legally, but, while she is here, she has a constitutional right — like every other pregnant girl or woman in the United States — to a legal abortion. Even U.S. District Judge Tanya Chutkan, who ruled Wednesday that Doe could get the abortion, shook her head in disbelief when a U.S. Department of Justice lawyer at the hearing would not concede that Doe has constitutional rights. (10/20)

In the annals of cynical corporate subterfuges, it would be hard to top the effort by the drugmaker Allergan to fend off a patent challenge by selling its drug rights to a rural New York Indian tribe. ... [Judge William] Bryson didn’t invalidate the tribal deal because that wasn’t at issue in the case before him, but he expressed “serious reservations” about whether the deal should be treated as valid. That could function as a guidepost for the U.S. Patent Office, which will have to rule on the transaction’s validity. Legal authorities say Bryson’s opinion should be taken as a red light by other companies thinking about using the same maneuver. (Michael Hiltzik, 10/19)