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It has not been a market for the faint of heart. Supporters of the Affordable Care Act achieved a major victory this past week when, thanks to cajoling and arm-twisting by state regulators, the last “bare” county in America — in rural Ohio — found an insurer willing to sell health coverage through the law’s marketplace there. So despite earlier indications that insurance companies would stop offering coverage under the law in large parts of the country, insurers have now agreed to sell policies everywhere. (Abelson, 8/26)

Iowans who buy their own health insurance pleaded with the state’s insurance commissioner Saturday to rein in the largest proposed premium increase in state history, but he warned them his powers are limited. (Leys, 8/26)

Congress and the Trump administration could boost insurance coverage by a couple of million people and lower premiums by taking a few actions to stabilize the Affordable Care Act insurance markets, according to a new analysis by the consulting firm Oliver Wyman. The paper, which lays out a simple blueprint for making insurance more affordable for more people while working within the current health law's structure, comes just days before the Senate Health, Education, Labor and Pensions Committee begins hearings on ways to stabilize markets in the short term. (Kodjak, 8/25)

Christine Sabas had just left her job and was preparing to attend seminary when the symptoms began: Dizziness, burning nerve pain, numbness in her arms and legs. With the private health insurance she had through work set to expire, the 43-year-old Salisbury woman turned to the Affordable Care Act, qualified for Medicaid and has been undergoing a battery of otherwise unaffordable tests in search of a diagnosis. (Fritze and Cohn, 8/28)

It looked just like a campaign launch, from the line winding around the Fellowship Chapel Church, to the tailgaters giving away hot dogs, to the 2,000 voters who eventually packed inside. But when Sen. Bernie Sanders (I-Vt) and Rep. John Conyers Jr. (D-Mich.) arrived, there were no waving signs. They were there to kick off the push for universal health care, with legislation queued up for September, and no expectation that the Republican-controlled Congress would pass it. “Every major country in the world, they’ve already got it,” said Conyers. (Weigel, 8/26)

Sen. Dean Heller is trying to walk a fine line on ObamaCare ahead of his tough reelection race next year. (Sullivan, 8/27)

Tensions between President Donald Trump and Senate Republicans are rising, as lawmakers are being blamed by the president, House colleagues and many voters for the party’s failure to pass a major legislative initiative. “I’m sick of them,” said Matthew Walters, a 58-year-old construction worker who lives in Shelbyville, Ky., and has been eager for the GOP to repeal the Affordable Care Act as his wife’s insurance premiums jump. “They’ve said for six years if we get a Republican in the White House we’re going to get this repealed. What is the problem? What are the excuses? I’m sick of it. We elected Donald Trump for change.” (Hughes and Peterson, 8/27)

President Donald Trump on Friday directed the Pentagon to extend indefinitely a ban on transgender individuals joining the military, but he appeared to leave open the possibility of allowing some already in uniform to remain. Trump gave Defense Secretary Jim Mattis authority to decide the matter of openly transgender individuals already serving, and he said that until the Pentagon chief makes that decision, "no action may be taken against" them. (Burns, 8/26)

The new policy, outlined in a call from senior administration officials late Friday, makes exceptions for those receiving medical care in some cases “to protect the health of the individual who has already begun treatment. ”The policy pertains not only to the Defense Department, but also to the Department of Homeland Security, which oversees the U.S. Coast Guard. (Lubold, 8/25)

Friday, President Donald Trump signed an official memo implementing a new policy on "military service for transgender individuals." The memo indicates a reversal of an Obama-era policy implemented in 2016, which allowed active-duty service members who are transgender to serve openly and transition while enlisted. (Hanson, 8/26)

VA Secretary David Shulkin has proven to be something unique in President Donald Trump's Washington: an Obama appointee nominated by Trump who is beloved by almost everyone and getting stuff done. By tweaking regulations, he has managed to fire hundreds of allegedly incompetent employees, publicized waiting times at VA clinics, gotten money to expand vets’ treatment by private doctors, and expanded care for isolated vets through telemedicine and mobile phones, while promising to close 430 vacant VA buildings and speed up benefit awards. Shulkin also made a bold — and risky — decision to bypass contracting rules to buy a $16 billion digital health record system. (Allen, 8/28)

For Jon Lubecky, the scars on his wrists are a reminder of the years he spent in mental purgatory. He returned from an Army deployment in Iraq a broken man. He heard mortar shells and helicopters where there were none. He couldn’t sleep and drank until he passed out. He got every treatment offered by Veterans Affairs for post-traumatic stress disorder. But they didn’t stop him from trying to kill himself — five times. (Wan, 8/26)

More than 1 in 4 cases of possible sexual and physical abuse against nursing home patients apparently went unreported to police, says a government audit that faults Medicare for failing to enforce a federal law requiring immediate notification. The Health and Human Services inspector general’s office was issuing an “early alert” Monday on its findings from a large sampling of cases in 33 states. Investigators say Medicare needs to take corrective action right away. (Alonso-Zaldivar, 8/28)

Government investigators are conducting an ongoing review into nursing home abuse and neglect but say they are releasing the alert now because they want immediate fixes. These are cases of abuse severe enough to send someone to the emergency room. One example cited in the alert is a woman who was left deeply bruised after being sexually assaulted at her nursing home. Federal law says that incident should have been reported to the police within two hours. But the nursing home didn't do that, says Curtis Roy, an assistant regional inspector general in the Department of Health and Human Services. (Jaffe, 8/28)

Abuse often leads to depression and medical problems in older patients — even death within a year of an abusive incident. Yet, those subjected to emotional, physical or financial abuse too often remain silent. Identifying victims and intervening poses challenges for doctors and nurses. (Sadick, 8/28)

One of Donald Trump's earliest backers is taking advantage of a law signed by the president to further restrict funding to abortion providers, signing an executive order directing state agencies not to allocate state and federal money to health care providers affiliated in any way with abortion clinics. In the order signed Thursday, South Carolina Gov. Henry McMaster also directed the state's Medicaid agency to seek federal permission to exclude abortion clinics from its Medicaid provider network. (8/25)

The order directs state agencies to cease providing funds, whether via grant, contract, state-administered federal funds or "any other form," to any abortion clinic. McMaster also directed the state's Department of Health and Human Services to seek waivers from the federal government allowing it to exclude abortion clinics from the state's Medicaid provider network. (Hellmann, 8/25)

A Maryland abortion clinic, one of only a few that provides late-term abortions to women in the United States, plans to close its doors and is under contract to be purchased by an antiabortion group that has worked for many years to shut it down, according to an official with the coalition that has plans to buy it. If the sale goes through this fall, the new owners of the Germantown clinic will soon be owned by the Maryland Coalition for Life, a grass-roots organization that has staged regular protests at the clinic and, in 2011, opened up a crisis pregnancy center across the parking lot to counsel women against choosing abortion. (Chandler and Hendrix, 8/25)

The District’s landmark 2014 law that says employers cannot discriminate against workers based on their reproductive health decisions is being targeted for the third straight year by a House Republican. Rep. Gary Palmer (R-Ala.) late Thursday filed an amendment to a House appropriations bill to block the District from using funds to carry out the Reproductive Health Non-Discrimination Amendment Act. (Portnoy, 8/25)

Losing a pregnancy because of a miscarriage can be a difficult and painful experience, one that people often don't talk about even among friends and family. Women who suffer miscarriages can feel shame and isolation. Some even blame themselves. (Nsoesie and Cesare, 8/27)

For those who survived Hurricane Katrina 12 years ago or last August's flood in Louisiana, Tropical Storm Harvey could threaten their mental health more than their physical well-being, experts said Saturday. Hurricanes and other natural disasters are common in Texas and Louisiana, but that can make people more resilient or more likely to experience symptoms associated with post-traumatic stress disorder. Unnerving news reports can exacerbate this. (O'Donnell, 8/26)

Hurricane Harvey, which killed two people and devastated parts of Texas this weekend was causing some hospitals to close or evacuate because of flooding and still-dangerous weather. Baylor College of Medicine and its clinics closed on Sunday, as did all Texas Children's Pediatrics practices and Texas Children's Urgent Care locations. MD Anderson's Houston locations would be closed Monday. (8/27)

With more than a foot of rain falling outside and hurricane-force winds blowing on the hospital windows, Irma Rodriguez had all the problems that other residents of Corpus Christi, Tex., had on Friday night, plus two more: She hadn’t chosen a name for her baby. And it was growing clear he was not going to let something as trivial as a hurricane delay his grand entrance. (Wootson, 8/27)

In an unrelenting opioid epidemic, hepatitis C is infecting tens of thousands of mostly young, white injection drug users, with the highest prevalence in the same Appalachian, Midwestern and New England states that are seeing the steepest overdose death rates. (Vestal, 8/28)

The state shut down admissions at Recovery Centers of America’s inpatient addiction treatment center in Danvers on Friday, citing “concerns regarding patient care and safety.” The Department of Public Health took the step after the death a week earlier of a patient who was being treated at the facility. (Allen and Armstrong, 8/25)

Mexican authorities seized their largest haul ever of fentanyl — some 140 pounds of powder and nearly 30,000 pills — that officials say was headed to Tijuana and most likely across the border to the United States. “All I can say is that this not a surprise, Tijuana is the main corridor for Mexican drug traffickers to smuggle fentanyl into the United States,” said Mark Conover, deputy U.S. attorney in San Diego and head of an inter-agency fentanyl working group. “All the indicators are that this load of fentanyl was destined for the city streets of the United States.” (Dibble, 8/26)

New York City on Friday agreed to postpone enforcement of a rule requiring restaurants, convenience stores and other establishments to post calorie counts for prepared food. The move came in response to an industry lawsuit that was supported by the federal government. The city said that it would wait to enforce the calorie posting rules until May, when the Food and Drug Administration is scheduled to put its own rules on calorie labeling into effect. (Neuman, 8/25)

The new regulations were an update to a 2008 city law that orders restaurant chains with 15 or more locations to post calorie counts for their products and other nutritional information. Under the new regulations, chains of convenience and grocery stores would have to post nutritional information for prepared foods, such as hot dogs and salads. The regulation would also allow the city to fine food establishments for not alerting customers about the recommended daily calorie intake. (Alfaro, 8/25)

As a court fight simmers over New York City's pioneering requirement for calorie counts on chain restaurant menus, scientists say the jury's still out on whether giving people the numbers spurs them to eat healthier. The city says that by requiring eateries to tell people that their $4 cheeseburger will also cost them about 540 calories, it's helping diners make informed choices in an era of rising obesity. (8/26)

When a local government leader passed the deciding vote on a penny-per-ounce soda tax, she said it would generate enough money to balance the county budget while making people in Chicago and the surrounding suburbs healthier. But so far, the tax seems mostly to have created problems for Cook County Board President Toni Preckwinkle, who until recently was so popular many considered her the only possible candidate who could unseat Chicago Mayor Rahm Emanuel. (Burnett, 8/26)

Revenue from Boulder’s recently enacted sugary-drink tax should be distributed among 16 different community groups and agencies, the city Health Equity Advisory Committee recommends. But the pot of money those 16 will share may be considerably smaller than originally expected, as the city has revised projected revenue for the tax down to about $1.5 million a year — roughly half of what was expected. (Burness, 8/25)

Does talcum powder cause ovarian cancer? A Los Angeles jury thinks so. This week it ordered Johnson & Johnson to pay $417 million to 63-year-old Eva Echeverria. She blamed her terminal illness on Johnson's Baby Powder, which she used for decades starting at age 11. The company should have warned consumers about the risk, she argued. (McGinley, 8/25)

Samantha Peters is trading in her foundation and concealer for an IV. For years, she’s had a daily makeup routine to cover dark blotches on her face and the discoloration and scarring on her arms that won’t go away — a common problem for those with darker skin tones. Now she’s hoping a new treatment, intravenous glutathione, will accomplish what makeup and skin bleaching creams could not: an even, lighter skin tone. (Pattani, 8/28)

Money can't buy happiness, right? Well, some researchers beg to differ. They say it depends on how you spend it. A recent study published in the Proceedings of the National Academy of Sciences suggests that when people spend money on time-saving services such as a house cleaner, lawn care or grocery-delivery, it can make them feel a little happier. By comparison, money spent on material purchases – aka things – does not boost positive emotions the way we might expect. (Aubrey, 8/28)

Dr. Colin Zhu thought about starting a family practice. But the 33-year osteopathic physician realized all the management, paperwork, and financial overheard might distract him from what he enjoyed most: seeing patients. So Zhu went freelance. (Blau, 8/28)

Health-sharing ministries predate the Affordable Care Act, or Obamacare, by decades but have burgeoned in popularity since the law passed in 2010. The ministries are exempt from Obamacare’s coverage requirements, and their members are exempt from the law’s penalties for not carrying insurance. (Marso, 8/25)

In June, CareSource sent the Clinic a termination notice, which would have left thousands on the state's largest Medicaid managed care plan without access to care from the Clinic. During that time, affected Northeast Ohioans have had to make tough choices: stay with the Clinic and switch to a new insurance provider; stay with CareSource and find new doctors; or wait to see if there was a resolution between the two at the final hour and risk losing health coverage if there wasn't. (Christ, 8/27)

The boards that run schools, universities and the public health system have, combined, spoken for about $750 million of increased spending for the upcoming year. The money will go to pay for increased enrollment in K12 schools and universities, and the rising cost of Medicaid, the state-federal health care program for the poor and disabled. (Salzer, 8/25)

The [Betsy and David] Winklers represent the intersection of two Gem State demographic trends. Idaho’s population is graying faster than the nation as a whole. And more than a third of the state’s households have difficulty making ends meet each month, left behind by a booming  economy with its help-wanted signs and soaring construction cranes. (La Ganga, 8/27)

A new state law designed to battle bedbugs requires California landlords to provide tenants with written information about these blood-sucking, tenacious pests and how to report suspected infestations to the landlord. The disclosure requirement took effect for new tenants July 1 and will apply to existing tenants Jan. 1. (Pender, 8/26)

With no measles cases in 42 days, state officials on Friday declared the outbreak over after the highly contagious virus sickened 79 Minnesotans this year. The vast majority of cases were in unvaccinated Somali-American children living in Hennepin County. (Zdecklik, 8/25)

California faces a shortfall of primary care doctors and other health care providers, and the gap is expected to widen over time. A new commission unveiled this week will spend the next year investigating the problem and drafting potential solutions. The 24-member California Future Health Workforce Commission will focus on primary care, aging and mental health. Its members include politicians, doctors, educators, labor leaders and others. (8/28)

It was the latest spate of violence in a city hurtling toward a grim milestone far quicker than it has in years past. If the two incidents recorded Friday both prove to be homicides, they will be No. 99 and No. 100 for 2017. (Marso, 8/25)

An arm of the White House’s antidrug office has asked Massachusetts and several other states where medical marijuana is legal to turn over information about registered patients, triggering a debate over privacy rights and whether state officials should cooperate with a federal administration that appears hostile to the drug. (Adams, 8/25)

As Baltimore prepares for the opening of 11 medical marijuana dispensaries in the city, some residents say it’s been difficult to get information about where they’re opening or how the sites were selected. (Broadwater, 8/28)

What should you expect now that the drive to repeal and replace the Affordable Care Act appears dead — at least for the moment? Given how legislation gets made in Washington, I wouldn't be surprised to see some elements of the repeal and replace bill surface again, possibly tacked onto what's known as must-have legislation. (Trudy Lieberman, 8/25)

More broadly, a Republican Congress truly concerned with making the health insurance exchanges work better could restore the now-expired reinsurance program that helped offset costs for the most expensive cases, thereby keeping those costs from pushing up premiums for others. If the administration and the Republican-led Congress instead tries to sabotage the law’s functioning or undermine it through malign neglect, the Republican Party will bear the political responsibility for the consequences. (8/27)

Now that Republicans in Congress appear to have at least temporarily abandoned their crusade against the Affordable Care Act, it seems like a good time for lawmakers to come up with plans to fulfill their promises to increase access to health care and to lower costs. Let’s stipulate up front that congressional leaders and President Trump are unlikely to lead that effort, given that they narrowly failed to take health insurance away from millions of people. (8/26)

In recent days, Democrats have stepped into the health policy vacuum created by the Republicans’ failure to repeal and replace the Affordable Care Act. Proposals making the rounds include allowing Americans to buy into Medicare at age 55 or to buy into Medicaid. Both Medicare and Medicaid pay lower prices to health care providers compared with private market plans offered by employers and in the Affordable Care Act marketplaces. On that basis, you might think these public programs are more cost-efficient. Are they? (Austin Frakt, 8/28)

The collapse of the seven-year Republican campaign to repeal the Affordable Care Act (ACA) was caused in large part because a majority of the American public has come to view a government guarantee of universal access to healthcare as an entitlement that cannot be taken away. The effect is to bolster American support for the principle that healthcare is a human right, a norm accepted by most countries and especially by other advanced democracies, but long ignored in mainstream American political discourse despite its origins in the work of [President Franklin Delano Roosevelt and First Lady Eleanor Roosevelt.] (Lawrence Moss, 8/22)

Health is a very unsynchronized system. The failure to collaborate and share information is slowing down our ability to find new cures and achieve the goals that we have for patients. It also disrupts the creation of business models to support the health care challenges for our aging population and the coming generations. The health care system needs to be healthy, and right now it’s not. (Pamela Buffalone, 8/28)

One reason health care is so expensive is that government rules often distort the price of care. Consider the market for hearing aids, which after decades of regulation will soon be open to competition and innovation that lowers prices for patients. President Trump recently signed a Food and Drug Administration funding bill that includes a directive for the agency to develop standards for over-the-counter hearing aids. (8/26)

New Hampshire’s bipartisan Medicaid expansion plan is boosting our economy and providing access to life-saving services, including substance use disorder treatment and recovery programs, to more than 50,000 Granite Staters. That is why it is so troubling that Washington Republicans keep trying to sabotage it – if they can’t eliminate it altogether. (Democratic State Sen. Donna Soucy and Rep. Cindy Rosenwald, 8/28)

The stated goal of Senate Bill 17 is to increase transparency by requiring drug companies to give advance notice of price increases. I am concerned that the bill will have unintended consequences that could harm patients in the long run, while doing nothing to address prices that consumers actually pay for medicine. (Deborah Goldberg, 8/25)

Since becoming active in Oregon politics, I've seen some serious campaign whoppers. But this summer's propaganda coming from Our Oregon, the front group for the public employee and nurses' unions, wins hands down for its doomsday scare tactics and false messaging about the health care tax referendum. (Julie Parrish, 8/27)

At the close of this summer’s special session, Texas Gov. Greg Abbott signed into law a ban on private insurance coverage of abortion in Texas. ... Of course, a huge problem with this bill is that we rarely anticipate our exact health care needs — that’s why we have insurance in the first place. (Nan Little Kirkpatrick, 8/25)

There are about four million citizens living in the U.S. territories, yet they’re seldom considered in the calculus of national policy decisions. That blind spot is especially prominent in health-policy decisions, as the territories are uniquely dependent on federal programs and don’t have the same kind of latitude or flexibility as states to respond to the needs of citizens—who tend to be both poorer and sicker than their mainland counterparts. (Vann R. Newkirk II, 8/26)

On an overcast Tuesday morning last October in Northford, Conn., I sat in a second-row pew in a quiet church and watched my father tell a heartwarming story about his older sister, Martha. He recalled an incident from his childhood when, as he recovered from a bike accident that injured his jaw, Martha had baked him a chocolate cake and lovingly cut it into tiny pieces so he could eat it through his stitched mouth. My father told the story that morning as part of his eulogy for Martha, the fourth and final one he delivered for his nuclear family. His father, his mother and his two older sisters all succumbed to the ravages of Alzheimer’s disease. (Jeremy Abbate, 8/25)

In 2013, Dr. Phillip K. Chang had what he calls an “eye-opening moment.” Chang had used his prowess as a trauma surgeon at the University of Kentucky to repair a young man’s injuries from a vehicle crash, only to have the pain medicine he prescribed leave his patient addicted to opioids. ... Chang and his team began thinking about less risky ways to treat acute pain, and this weekend he will tell the Kentucky Medical Association how they were able to halve the amount of opiates given to trauma patients without increasing their pain levels. (8/25)

The advice President Trump received from his commission on the nation’s opioid crisis wasn’t what he wanted to hear. So he seems to be ignoring it. Which denigrates not only commission members he appointed but also the addicted and their loved ones whom he promised during the campaign to help. (8/25)

When we think of innovation in modern biomedical research, what likely comes to mind is development of new high-tech drugs, biologics, surgical techniques and devices. Far less often do we include public health research and policy. We have it wrong. For proof, we need look no further than the extraordinary success of taking a simple vitamin supplement, folic acid, to prevent disease. (John Barnard, 8/27)

Treating mental illness is expensive. But the cost of not treating it is enormous. It affects our population’s health in ways that range from obesity to homelessness and addiction. Treating mental illness has traditionally been separate from treating physical illnesses. But that doesn’t really make sense, given what we know about both today. (Marc Harrison, 8/25)

President Obama’s call for the scientific community to embrace a precision medicine revolution gave me hope for some forward motion on two disorders I’ve quietly struggled with since my adolescence: trichotillomania and dermatillomania. Taking a precision medicine approach to these two conditions, which run under the radar of the medical establishment, could answer some longstanding clinical questions and potentially identify the first-ever effective treatments for them. (Kimi Vesel, 8/28)

Kentucky is one of seven states that, as a result of medically unnecessary restrictive laws and administrative actions intended to shut down clinics, have a single abortion clinic to serve the entire population. Not only is my home state facing the possible closure of our only clinic, but our community has, for many years, been subject to extreme and sometimes violent demonstrations by both local and national anti-abortion activists. (Caitlin Willenbrink, 8/25)

Plaintiff attorneys are naturally opportunistic, so it’s not surprising that they’re responding to tort reforms by searching for new vulnerabilities in the legal system. See the spread of talcum powder torts to California and other friendly forums. A Los Angeles jury this week awarded a 63-year-old woman with advanced ovarian cancer a $417 million verdict against Johnson & Johnson . The plaintiff claimed that the company’s Baby Powder, which she had been using for more than 50 years, caused her terrible cancer. Her attorneys compared the company to the tobacco industry, which failed to warn consumers of cigarettes’ carcinogenic risk. (8/25)

Fortunately, my daughter attends a college that doesn’t allow tanning beds on campus. Other students aren’t as fortunate — almost half of U.S. colleges have tanning beds available in school facilities, and 14 percent let students pay for tanning beds with campus cash cards. The International Agency for Research on Cancer, part of the World Health Organization, has labeled indoor tanning devices to be “carcinogenic to humans.” So why do so many college campuses have them? (Beth Allgaier, 8/25)

There is much to celebrate in the D.C. auditor’s recent report on child fatalities. The District, for years ranked among the worst major U.S. cities for child mortality, saw significant improvement in its child fatality rates between 2008 and 2015. The number of child fatalities per year dropped by 32 percent, from 182 deaths to 124. This was largely fueled by a 53 percent decline in the deaths of 15- to 19-year olds, though infant mortality rates also improved substantially. Given the city’s long and troubled history with child safety, these figures are a heartening sign of progress. (8/27)