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The California union that provided major funding for successful ballot campaigns to expand Medicaid in three red states this year is already looking for where to strike next to expand Obamacare coverage in the Donald Trump era. Leaders of SEIU-United Healthcare Workers West declined to identify which states they might target in 2020. But the six remaining states where Medicaid could be expanded through the ballot are on the group's radar: Florida, Mississippi, Missouri, Oklahoma, South Dakota and Wyoming. (Ollstein, 11/16)

Democrats believe that replicating these wins in the Sunbelt region in 2020 could help offset Midwest states that appear to be slipping further from Democrats. Both [Sen.- elect Kyrsten] Sinema and Sen.-elect Jacky Rosen (D-Nev.) relentlessly focused their messaging on health care and protections for pre-existing conditions coverage, drawing sharp contrasts with Republican opponents who had backed GOP efforts to repeal the Affordable Care Act, also known as ObamaCare. (Hagen, 11/18)

The search for remains of victims of the devastating Northern California wildfire has taken on new urgency as rain in the forecast could complicate those efforts while also bringing relief to firefighters on the front lines. Up to 400 people fanned out Sunday to search the ash and rubble where homes once stood before flames roared through the Sierra foothills town of Paradise and surrounding communities, killing at least 77 people in the deadliest U.S. wildfire in a century. (Thanawala, 11/19)

As victims from the devastating Camp Fire in Butte County are recovered by search teams, the remains are loaded into body bags, then taken by hearse to refrigerated trucks. Then, they are driven 90 miles south to Sacramento, where Coroner Kim Gin’s staff is facing the biggest challenge she has seen in her time in the office. “This is not normal,” Gin said Thursday as her staff worked alongside coroner’s officials who have streamed in from other offices around the state. “I’ve been here 19 years, and we haven’t had anything even close to this. (Stanton and Yoon-Hendricks, 11/15)

At Creative Care’s serene hilltop campus in Malibu, Calif., patients typically pay more than $35,000 a month to be treated for addiction and mental health problems against the backdrop of a spectacular Pacific Ocean view. On Friday, just a few hours after an early-morning evacuation order from the city, all anyone could see were flames. ... Malibu has one of the largest concentrations of addiction treatment centers and sober living homes in the United States, with at least one per square mile, according to data from the federal Substance Abuse and Mental Health Services Administration. Luxury properties in the area, part of a coastal strip known as Rehab Riviera, often attract paparazzi hoping for a glimpse of wealthy clients like Ben Affleck and Britney Spears. (Hsu, 11/16)

By Sunday morning, the blaze was 60% contained. But forecasters expect gusty winds will bring in critical fire weather conditions across portions of the western slopes of the northern Sierra. Officials said smoke from the blaze would continue to bring poor air quality across the region through Tuesday. In Southern California, the Woolsey fire has charred 96,949 acres and destroyed about 1,452 structures. By Sunday night, it was 91% contained and Cal Fire said it expects full containment by Thursday. (Tchekmedyian, Alpert Reyes and Reyes-Velarde, 11/18)

While there’s a strong chance shifting winds and rain will help clear out smoke in the Bay Area just in time for Thanksgiving Day, air quality here could get worse before it gets better. Residents of the area should continue to monitor air quality and take steps to protect their health, especially by staying indoors, officials say. “We’re expecting winds to bring more smoke into the Bay Area on top of what’s already here,” Kristine Roselius, a spokeswoman for the Bay Area Air Quality District, said Sunday. “Basically right now we’re seeing unhealthy air quality throughout most of the Bay Area.” (Geha, 11/18)

The wildfires that have laid waste to vast parts of California are presenting residents with a new danger: air so thick with smoke it ranks among the dirtiest in the world. On Friday, residents of smog-choked Northern California woke to learn that their pollution levels now exceed those in cities in China and India that regularly rank among the worst. (Turkewitz and Richtel, 11/16)

The sky goes dark in the middle of the day in Sacramento, California. Thick smoke smothers downtown, and the dome of the statehouse is barely visible. Schools are closed. Some colleges and hospitals have told all but essential employees to stay home. Many of the people who still brave the streets are wearing bandannas, masks and even respirators. Decades after leading the U.S. war against smog and after years of federal and state clean-air legislation, California is once again being crippled by poor air quality -- this time from the deadly wildfires scorching the state. (Eckhouse, Marois and Sullivan, 11/16)

The devastating wildfires that have ravaged parts of California brought with them plumes of smoke, shrouding some communities in a soupy black fog. Air pollution like that is full of tiny particles that can cause health problems, ranging from temporary discomfort to long-term heart and lung diseases. (Fortin, 11/17)

Brad Weldon lost his home to fire when he was a kid, so when a deadly wildland blaze came roaring toward his ranch house in the pines where he lives with his 89-year-old blind mother, he wasn’t going to let disaster strike twice. Weldon and his mother’s caregiver, armed only with a garden hose and buckets, successfully fought the flames for 24 hours. At times, they had to lie down in the dirt to “avoid burning up” as 60 mph (97 kph) winds drove flames through the forest. (11/18)

Some found devastation, some found miracles. Authorities on Sunday afternoon began allowing some residents to return for the first time to the destruction zone of the Camp Fire, and though many had already seen pictures taken by emergency workers and knew whether their homes had made it or not, the scenes that greeted them came as a shock. (Baron, 11/18)

Ron Zimmer, pastor of East Ave Church in Chico, explains the norovirus outbreak in his shelter. He details the evacuation site staff's attempts in mitigating the spread of the virus. (Kim, 11/16)

This was going to be easy, I thought foolishly. Ask some legislators and experts for their ideas on how to control California’s deadly wildfire epidemic. What should state government do about it? But they basically didn’t have a clue. And who could fault them? It’s like asking how you stop hurricanes or tornadoes or earthquakes. It’s all part of nature. You try to prepare. (Skeoton, 11/19)

Apartment complexes subsidized by HUD collectively house more than 2 million low-income families around the country. Some are run by public housing authorities and others are owned by private for-profit or nonprofit landlords. By law, the owners of such complexes must pass inspections demonstrating they are decent, safe and sanitary in exchange for millions of dollars in federal money each year. But as thousands of renters across the country have discovered, passing scores on HUD inspections often don’t match the reality of renters’ living conditions. The two-decade-old inspection system — the federal housing agency’s primary oversight tool — is failing low-income families, seniors and people with disabilities and undermining the agency’s oversight of billions of dollars in taxpayer-funded rental subsidies, an investigation by The Southern Illinoisan and ProPublica has found.(Parker, 11/16)

Mikaila Bonaparte has spent her entire life under the roof of the New York City Housing Authority, the oldest and largest public housing system in the country, where as a toddler she nibbled on paint chips that flaked to the floor. In the summer of 2016, when she was not quite 3 years old, a test by her doctor showed she had lead in her blood at levels rarely seen in modern New York. A retest two days later revealed an even higher level, one more commonly found in factory or construction workers and, in some cases, enough to cause irreversible brain damage. (Goodman, Baker and Glanz, 11/18)

Health experts are urging people living near a Chattanooga Superfund site to have their children tested for lead contamination. The Chattanooga Times Free Press reports the Environmental Protection Agency discussed its remediation plans at a Thursday community meeting after the Southside Chattanooga Lead Site was put on the Superfund National Priorities list in September. The EPA says full remediation could take five years and cost $26 million. (11/16)

Drug companies jacking up the price of life-saving medications can seem arbitrary, cruel, and even scandalous. The infamous CEO Martin Shkreli hiked the price of Daraprim, a drug used by AIDS patients to fend off infections, from $13.50 To $750 for one pill. The company Mylan raised the cost of the Epipen that reverses anaphylactic shock caused by allergies 500%, from $100 to $600. And now there's the case of Evzio. It's a talking auto-injector with naloxone, the antidote to reverse opioid overdoses. It's easy to use for people with no medical training. The actual drug naloxone can cost as little as a nickel a dose, according to industry insiders. But Evzio costs a lot more: its price tag is over $4,000. (Stahl, 11/18)

"The fact that one company dramatically raised the price of its naloxone drug and cost taxpayers tens of millions of dollars in increased drug costs, all during a national opioid crisis, no less, is simply outrageous," [Sen. Rob] Portman continued, pledging his subcommittee will "continue its efforts to protect taxpayers from drug manufacturers that are exploiting loopholes in the Medicare and Medicaid system in order to profit from a national opioid crisis." (Eaton, 11/18)

Opioid makers and distributors are fighting a novel New York state law that aims to collect hundreds of millions of dollars from the industry to help defray costs of the opioid crisis, with some companies re-engineering their supply chain to avoid the new tax. Companies and trade groups have argued in three legal challenges filed in recent months that the law, which seeks $600 million over six years, is unconstitutional. They point to a lawsuit New York’s attorney general has already filed against major opioid industry players to recoup money for the state, and say the tax is an improper end-run around resolution of that case. (Randazzo, 11/19)

A county in Southwest Virginia plans to open the state’s third needle exchange. The Roanoke Times reports that the state has given Smyth County permission to open an exchange in Marion. State health department HIV prevention planner Bruce Taylor said an opening date hasn’t been set yet and local funding hasn’t yet been secured. (11/18)

Six national veterans groups are calling on the Department of Veterans Affairs to improve the quality of care at its nursing homes following a report by The Boston Globe and USA Today detailing the agency’s own findings of “blatant disregard for veteran safety” at the VA nursing home in Brockton. “Anybody who respects veterans should be angered by this,” American Legion National Commander Brett Reistad said. “America’s veterans deserve better.” The groups, who together represent nearly 5 million members, said veterans who risked their lives for their country shouldn’t have to risk their lives in VA nursing homes. (Estes and Slack, 11/19)

Thousands of Navy and Marine Corps veterans of Iraq and Afghanistan who developed post-traumatic stress disorder but were denied Veterans Affairs health benefits have been given a green light to sue the military, under a ruling by a federal judge in Connecticut. Senior U.S. District Judge Charles Haight Jr. in New Haven on Thursday certified a class-action lawsuit against Navy Secretary Richard Spencer by veterans who say they were unfairly given less-than-honorable discharges for minor infractions linked to their untreated mental health problems. (Collins, 11/16)

One in five Army generals could not deploy in 2016 for medical reasons, according to data obtained by USA TODAY, a troubling trend in the military's readiness to fight that Defense Secretary Jim Mattis has vowed to fix. Overdue medical and dental exams were the primary reasons for what the Army refers to as medical readiness in 2016. The deployment rate has improved to nearly 85 percent, according to Brig. Gen. Omar Jones, the Army's top spokesman. (Vanden Brook, 11/19)

The Trump administration is under fire from GOP lawmakers and conservative groups over its proposed crackdown on e-cigarettes and menthol tobacco products. The Food and Drug Administration (FDA) on Thursday proposed sweeping new restrictions on the sale of e-cigarettes in an effort to cut down on teenage vaping. The agency also said it would seek to ban menthol-flavored traditional cigarettes and flavored cigars. (Weixel, 11/17)

New Hampshire stores that sell e-cigarettes are reacting to the Food and Drug Administration’s sweeping proposals to limit teen vaping. The crackdown comes after a national report revealed a nearly 80 percent increase in the number of high-schoolers who vape. (Gibson, 11/16)

The Food & Drug Administration this week announced new initiatives aimed at stemming the increase in young Americans’ use of tobacco and its primary psychoactive agent, nicotine. The object of FDA Commissioner Scott Gottlieb’s ire was flavorings — those minty, sweet, nutty or even salty flavors that cigarette and e-cigarette manufacturers add to their products to make them more enticing. (Healy, 11/17)

Michael Saiger doesn’t smoke e-cigarettes, but many of his friends like Juul, so he began to tinker with designs to make it feel more elegant. “Back in the day, people used to have a beautiful Cartier lighter, or a really cool monogrammed lighter,” said Mr. Saiger, the founder and creative director of Miansai, a jewelry company known for men’s bracelets. “I wanted something that feels nostalgic paired to something that’s new and modern.” (Kurutz, 11/16)

There is a growing number of baby boomers who find themselves caring for both their elderly parents and their adult children, rather than kicking back at retirement age. They face the strain of constant caregiving and derailed dreams, as well as added expenses. It’s one more reason why many Americans are entering their retirement years as unprepared financially as any generation in years. A 2014 study by the Pew Research Center found 52% of U.S. residents in their 60s—17.4 million people—are financially supporting either a parent or an adult child, up from 45% in 2005. Among them, about 1.2 million support both a parent and a child, more than double the number a decade earlier, according to an analysis of the Pew findings and census data. (Phillips and Gillers, 11/16)

When Kathy Klute-Nelson heads out a on neighborhood walk she often takes her two dogs — Kona, a boxer, and Max, a small white dog of questionable pedigree who barrels out the front door with barks of enthusiasm. The 64-year-old resident of Costa Mesa, Calif., says she was never one to engage in regular exercise – especially after a long day of work. But about three years ago, her employer, the Auto Club of Southern California, made her and her colleagues an offer she couldn't refuse: Wear a Fitbit, walk every day and get up to $300 off her yearly health insurance premiums. (O'Neill, 11/19)

The Wyoming legislature has a long history of exploring ways to get quality and affordable insurance to more citizens, but for a variety of reasons, nothing has really ever worked. The legislature has long opposed accepting federal dollars to expand Medicaid due to fears that the money would eventually dry up and the state would have a program it could no longer afford. But there is not an available state solution either. (Beck, 11/6)

Kaiser Health News: Hospitals Follow Big Pharma Into Direct-To-Consumer Advertising

The scene is shadowy, and the background music foreboding. On the TV screen, a stream of beleaguered humans stand in an unending line. “If you’re waiting patiently for a liver transplant, it could cost you your life,” warns the narrator.One man pulls another out of the queue, signaling an escape. Both smile. (Luthra, 11/19)

There's no reason to skip Thanksgiving dinner because of a salmonella outbreak linked to raw turkey. That's according to health officials who've been monitoring the year-old outbreak. But they say it's a reminder to properly prepare your holiday bird. Cooking kills salmonella. (11/18)

Health officials say the investigation has been complex because the strain has been identified in a wide range of products, and investigators have been interviewing sick people to trace it back to a single source. Without a source or supplier of the product or products that are making people sick, officials say the best advice for consumers is to handle raw turkey carefully — including washing their hands, cutting boards and other utensils after touching raw turkey — and to cook it thoroughly to prevent illness. (Sun, 11/16)

Kaiser Health News: In Throes Of Turkey Salmonella Outbreak, Don’t Invite Illness To Your Table

Many who fell ill reported preparing or eating such products as ground turkey, turkey parts and whole birds. Some had pets who ate raw turkey pet food; others worked at turkey processing plants or lived with someone who did. Late Thursday, Jennie-O Turkey Store Sales LLC of Barron, Wis., recalled more than 91,000 pounds of raw ground turkey products that may be connected to the illnesses. (Aleccia, 11/19)

An experimental drug derived from peanuts protected some children and adolescents with life-threatening peanut allergies, according to a study, allowing the subjects to eat small amounts of peanuts without suffering a serious reaction. The drug, from a small California company, Aimmune Therapeutics, didn’t work for everyone, has some side effects and hasn’t been approved by regulators for sale. Yet the findings from the late-stage trial promise a potential new solution for peanut allergies, a growing concern. (Loftus, 11/18)

Aimmune is trying to standardize a peanut allergy protection method already used on an ad hoc basis. AR101 is a capsule filled with a precise, measured quantity of peanut flour. The capsules are opened and mixed into food. The idea is simple: Expose people to small, escalating doses of ingestible peanut protein over time with the goal of desensitizing them enough to prevent severe reactions. (Feuerstein, 11/18)

The World Health Organization has evacuated 16 people working to contain the Ebola outbreak in the Democratic Republic of the Congo following a rebel attack near the area where they were staying, Director General Tedros Adhanom Ghebreyesus said Saturday. The decision marks another violence-related setback for the response to the outbreak, but Tedros said in an interview with STAT that he hoped containment operations could resume as normal soon. (Branswell, 11/17)

The first treatment for sleeping sickness that relies on pills alone was approved on Friday by Europe’s drug regulatory agency, paving the way for use in Africa, the last bastion of the horrific disease. With treatment radically simplified, sleeping sickness could become a candidate for elimination, experts said, because there are usually fewer than 2,000 cases in the world each year. (McNeil, 11/16)

Violence from patients is a big problem in U.S. health care. According to the Occupational Safety and Health Administration, health-care and social assistance workers experience violent injuries that require days away from work at four times the rate of workers in the broader private sector. Assaults from patients can be particularly prevalent in high-risk settings, such as psychiatric units and emergency departments. The Bureau of Labor Statistics reports that psychiatric aides and technicians endure workplace violence at a rate 69 times greater than the national average. In a 2018 poll of more than 3,500 emergency physicians, 47 percent reported having been physically assaulted at work and 71 percent said they had witnessed another assault. After an assault from a patient, health-care workers face a complicated question: Should they press charges? (Morris, 11/18)

For nearly a month, the two sisters — then ages 17 and 12 — traveled by road from their home in El Salvador to the southern border of the United States. They had no parent or relatives with them on that difficult journey in the fall of 2016 — just a group of strangers and their smugglers. Ericka and her younger sister Angeles started out in multiple cars, Ericka remembers. "In Mexico, it was buses. And we changed buses very often." (Chatterjee, 11/17)

Verily, the life sciences-focused Google offshoot, has shelved the ambitious project to develop a glucose-sensing contact lens that inspired its founding. In a blog post on Friday, Verily said it will put “on hold” its work on the contacts, which had been envisioned as a way to relieve people with diabetes of the need for needle sticks to test their blood sugar. The project was begun almost five years ago by Google — before the launch of Verily. Verily began a collaboration in 2014 with partner Alcon, a division of Novartis, to develop the lens. (Robbins, 11/16)

We know that physical activity is good for us, and that being sedentary is not. Some have extrapolated this to mean that sitting, in general, is something to be avoided, even at work. Perhaps as a result, standing desks have become trendy and are promoted by some health officials as well as some countries. Research, however, suggests that warnings about sitting at work are overblown, and that standing desks are overrated as a way to improve health. (Carroll, 11/19)

Pity the poor appendix, a 2- to 4-inch-long wormlike pouch dangling from the head of the cecum, where the large and small intestines meet. For most of its medical history — anatomists have known about it for well over five centuries — it was maligned as a mysterious, vestigial and seemingly useless organ that could only cause trouble if left to its own devices. (Brody, 11/19)

The night the nosebleed started, Zina Martinez, seven months pregnant with her second child, was sitting in the living room of her Las Vegas home, eating a bowl of ice cream. Martinez, 22, was used to nosebleeds. She’d had them nearly every day since she was 10, an annoying occurrence doctors had repeatedly dismissed as insignificant — a probable result of the bone-dry desert air. (Boodman, 11/17)

It’s that time again. The Department of Health and Human Services has released a new edition of the Physical Activity Guidelines for Americans. That sound you hear is Americans collectively sighing. Let’s be honest: Physical activity guidelines can be tough. As behavioral scientists with expertise in exercise motivation, we will be the first to admit that maintaining a physically active lifestyle isn’t easy. This is what we do, and we don’t even always hit the goal. Life is messy and often gets in the way of even the best intentions. Let’s take a deep breath, unwrap these new guidelines and talk strategy. (Conroy and Pagoto, 11/17)

Kaiser Health News: Gun Control Vs. Mental Health Care: Debate After Mass Shootings Obscures Murky Reality

After the recent mass shooting in Thousand Oaks, Calif., in which 11 people were killed at a country music bar, President Donald Trump struck a familiar refrain: “It’s a mental health problem,” he said of the gunman, Ian David Long. “He was a very sick puppy.” Similarly, after a school shooting in Parkland, Fla., that killed 17 students and staff members in February, Trump tweeted that there were “so many signs that the shooter was mentally disturbed.” (Waters, 11/19)

Chickenpox has taken hold of a school in North Carolina where many families claim religious exemption from vaccines. Cases of chickenpox have been multiplying at the Asheville Waldorf School, which serves children from nursery school to sixth grade in Asheville, N.C. About a dozen infections grew to 28 at the beginning of the month. By Friday, there were 36, the Asheville Citizen-Times reported. (Stanley-Becker, 11/19)

An 11th child has died in less than four weeks at a New Jersey rehabilitation center, one of 34 young patients with compromised immune systems to have been infected by a viral outbreak, state health officials said on Friday. The child, who died late Thursday, and the others at the Wanaque Center for Nursing and Rehabilitation in the town of Haskell, became ill with adenovirus between Sept. 26 and Nov. 12, the state's Department of Health said in a statement. (11/16)

Iowa children would be routinely screened for mental health issues, under a proposal delivered to the governor and top legislators Thursday. The plan also would expand and organize services for children showing signs of mental struggles. The recommendations came from Gov. Kim Reynolds' children mental health board. The governor has emphasized the need to bolster Iowa's spotty system for helping children with mental illnesses, such as depression or anxiety. (Leys, 11/16)

An 18-member state board tasked with outlining a children’s mental health system for Iowa gave its final plan Thursday to the governor and lawmakers, who will have to work out legislation and funding to implement it. The plan calls for mental health screenings for all kids, a statewide crisis hotline, and several types of youth mental health services to be rolled out over the next few years. (Sostaric, 11/15)

The state is warning parents and caregivers to avoid giving infants honey-filled pacifiers after four babies — including one from North Texas — contracted botulism over the last few months. In each case, the infant had been given a pacifier bought in Mexico, according to KENS-TV, San Antonio's CBS affiliate. The cases were reported between mid-August and the end of October and required hospitalization and life-saving treatment for the potentially deadly illness, which can impede breathing and cause paralysis. Babies were also sickened in South and West Texas. (Ramirez, 11/18)

Connecticut’s Affordable Care Act exchange, Access Health CT, is protesting a Trump administration plan that would require the nation’s insurers to send a separate bill to consumers who purchase plans with abortion coverage. The Trump administration proposed changes earlier this month to how abortion coverage is billed. The Centers for Medicare & Medicaid, which has authority over the ACA, said it wanted to ensure that people who purchase health care coverage in ACA exchanges and receive federal subsidies to pay for their premiums and other expenses are not violating the Hyde Amendment, a federal law that bars the use of federal dollars to provide abortion services. (Radelat, 11/16)

The goal of Tennessee’s public psychiatric hospitals is to serve as a last-resort safety net to stabilize patients in crisis and then link them to ongoing treatment in their communities. Yet, nearly one in three adults admitted to Tennessee’s public psychiatric hospitals will return within six months, according to federal data. Thousands more are turned away each year because they do not meet Tennessee's strict involuntary admission law. They then face limited access to ongoing mental health care even if they have insurance. Few have insurance. Tennessee's mental illness care system as a whole is overburdened. (Bliss and Wadhwani, 11/17)

The day after Thanksgiving in 1998, Rita Hester was murdered in Allston — just two days before her 35th birthday. Hester was — by all accounts — glamorous, brilliant, and driven. She was also a transgender woman. Her murder has yet to be solved. Twenty years later, roughly 300 people gathered inside the Cathedral Church of St. Paul in Downtown Crossing for the annual Transgender Day of Remembrance. The event started in Boston after Hester’s death, spread to San Francisco, and is now observed around the world. (Kilgannon, 11/18)

The Ohio House of Representatives this week passed one of the most restrictive abortion bills in the country — one that would penalize doctors for performing an abortion when a fetal heartbeat can be detected and pose a potential challenge to Roe v. Wade. A fetal heartbeat can be detected by an ultrasound as early as six weeks into a pregnancy, a time during which most women are unaware they are pregnant. (Caren, 11/16)

If all goes as planned, the merger of Memorial Hermann Health System of Houston and Baylor Scott & White Health in Dallas would create a $14 billion health care behemoth, with increased muscle to negotiate better deals and the flexibility to innovate in challenging times. The hospitals’ leaders insist bigger is better, and patients will be the winners, benefiting from easier access to medical services, greater efficiency and lower costs after merger closes next year. The nation’s health economists are less certain. (Deam, 11/16)

A Texas corporation that runs behavioral health hospitals is accused of illegally holding four patients, two of whom were voluntary patients who were allegedly prohibited from leaving. SAS Healthcare Inc. was indicted Wednesday on nine counts of violating the Texas Mental Health Code, the Fort Worth Star-Telegram reported. (11/16)

LifePoint Health is officially merged with RCCH HealthCare Partners, the companies announced Friday. Affiliates of private equity firm Apollo Global Management, which owns RCCH, are purchasing LifePoint, a Brentwood, Tenn.-based rural hospital operator. They're paying LifePoint shareholders $65 per share in cash, representing a premium of about 36% to LifePoint's closing share price on July 20, the last trading day prior to the merger's announcement. (Bannow, 11/16)

A California judge on Thursday granted an expedited trial in the case of a California couple suffering from cancer who sued Bayer AG's Monsanto unit, alleging the company's glyphosate-containing weed killer Roundup caused their disease. The order by Superior Court Judge Ioana Petrou in Oakland, California, comes on the heels of a $289 million verdict in the first glyphosate trial in San Francisco, in which a jury found Monsanto liable for causing a school groundskeeper's cancer. (11/16)

A federal judge has thrown out two lawsuit filed by more than 50 survivors and victims’ families in the Pulse nightclub shooting. The civil lawsuit alleged the city of Orlando, police officers and an off-duty officer didn’t do enough to stop the shooter, and that the city failed to provide adequate training for its officers. (Byrne, 11/16)

The marketing director for a shuttered hospice company has reached a plea agreement with federal prosecutors over his role in recruiting patients as part of a $60 million health-care fraud scheme. Slade C. Brown, 49, of Plano has agreed to plead guilty to one count of conspiracy to commit health-care fraud. His is the sixth such plea agreement in the criminal investigation into Frisco-based Novus, which operated one of the largest hospice companies in North Texas before it closed in late 2015. (Wigglesworth, 11/17)

The Washington Department of Social and Health Services (DSHS) has requested $800 million from the state to build a new psychiatric facility on Western State Hospital’s existing campus for patients coming from the criminal-justice system. The request is one of many ideas being floated over how to improve the state’s troubled mental-health system, which has suffered from staffing shortages, safety issues and a lack of available beds for people. (O'Sullivan, 11/16)

Florida teachers are eager to teach kids about sea-level rise, rising heat and other impacts of climate change, but many say it can be hard to find engaging and in-depth information in their textbooks or the state curriculum. A workshop on Wednesday offered about 30 Florida educators ideas and resources for climate education. (Stein, 11/16)

A pair of veterans will stand at the center of history-making moments scheduled for this week: the first legal marijuana sales in Massachusetts in more than a century. At 8 a.m. on Tuesday, Iraq veteran and medical marijuana advocate Stephen Mandile will walk into Cultivate, a hybrid medical-recreational cannabis shop in Leicester, and buy a quarter-ounce of pot — preferably a sativa — plus some edibles. (Adams, 11/19)

Many Iowa doctors have qualms about helping patients qualify for the state's new medical marijuana program, which is set launch Dec. 1. The program’s rules ask doctors to certify that patients have specific medical conditions allowing them to participate. Doctors will have no role in prescribing the products, which five dispensaries will sell to Iowans who have obtained special state cards. So far, only about 325 of Iowa’s 7,000 actively practicing physicians have certified people for the program, confirming that the patients have conditions such as intractable pain, cancer or epilepsy. (Leys, 11/16)

Police in South Florida say a 66-year-old doctor is accused of giving patients medical marijuana cards without meeting them in person, conducting physical exams or requiring a debilitating medical condition. The SunSentinel reports Tommy Louisville used closed-circuit television to evaluate patients who came to Miracle Leaf Health Center in Pembroke Pines. Louisville was arrested Thursday and had his medical license restricted. Prosecutors say he appears to be the first Florida doctor charged with illegally prescribing marijuana since voters legalized the drug in 2016. (11/16)

In May New Jersey imposed a health-insurance mandate requiring all residents to buy insurance or pay a penalty. More states will feel pressure to follow suit in the coming year as the federal mandate’s penalty disappears Jan. 1 and state legislatures reconvene, some with new Democratic majorities intent on “protecting” ObamaCare. But conflicts with federal law will make state-level health-insurance mandates ineffective or unduly onerous, and governors and legislatures would do well to steer clear. (Chris Jacobs, 11/18)

In nearly 800 days, a Democratic president and Congress may take office. This is not as far away as it sounds. If Democrats want the chance to pass health reforms that will build on the Affordable Care Act and fix its defects, they need to start planning now. The Democrats’ House victories in the midterms are an important step in that direction. Medicaid will expand in Idaho, Nebraska and Utah, thanks to ballot initiatives, and could expand in Kansas, Maine and Wisconsin, thanks to those states’ new Democratic governors-elect. (Harold Pollack, 11/17)

Voters in Idaho, Nebraska and Utah tend to skew conservative politically, and the last time they supported a Democratic president was in 1964. Yet on Nov. 6, voters in all three states passed Medicaid expansion referendums after their governments failed to act. To succeed, these referendums needed a key voting bloc to look past its self-interest: college graduates with bachelor’s degrees. (David Matsa, 11/19)

Sticking with health care, the extent to which Republicans pretended to be the defenders of preexisting coverage suggests we’ve won that part of the argument. Yet one thing that’s clear in today’s non-representative politics is that you can win a policy argument and lose the policy. Republicans are actively pursuing a legal strategy to repeal the Affordable Care Act, and I urge you to pay close attention to the Trump administration’s sabotage efforts, including skimpy coverage that exempts people from key consumer protections, along with attempts to destabilize the individual insurance market. (Jared Bernstein, 11/15)

At a time when Americans are looking for help to lower health-care costs, a tax on Medicare and Medicaid beneficiaries enrolled in Medicare Advantage plans called the Health Insurance Tax (HIT) would be detrimental for millions of disabled and older adults who do not have the resources to absorb an increase in out of pocket costs.Currently, the scheduled $16 billion tax will impact over 20 million seniors and disabled individuals enrolled in Medicare Advantage. Congress recognized the negative consequences of this tax and wisely delayed the HIT in 2019. Without Congressional action in the lame-duck session, the tax will return in 2020 creating instability, raising costs for beneficiaries, and reducing access to the coverage beneficiaries value its affordability, simplicity, supplemental benefits and care management. (Former Rep. Allyson Y. Schwartz (D-Pa.), 11/16)

The commissioner of the Food and Drug Administration insists that he is determined to keep electronic cigarettes away from children. “We won’t let this pool of kids, a pool of future potential smokers, of future disease and death, to continue to build,” Scott Gottlieb said this week, in response to news that the number of high-school and middle-school kids who vape is up 1.5 million since last year. “We’ll take whatever action is necessary to stop these trends from continuing.”Yet the steps the FDA is taking are not enough. (11/16)

The Food and Drug Administration’s sweeping new tobacco rules did not quite satisfy public-health activists seeking more stringent rules, nor industry-sympathetic conservatives who see them as a “heavy-handed regulatory plan.” In fact, the rules represent an extraordinary step in the fight against nicotine addiction, one that, if successful, would become one of the nation’s greatest public-health victories. (11/17)

The problem is that anti-smoking zealots want to go further and remove e-cigarettes from the market altogether while leaving most tobacco products untouched. That would snuff out the most impactful public health development in decades. The FDA’s action is designed to reduce e-cigarette use among high school and middle school students “because there is also evidence that a large percentage of these children will become addicted to nicotine and ultimately take up smoking." Yet plummeting and all-time low smoking rates – especially among young adults – would suggest otherwise. In contrast, the FDA recognizes that use of e-cigarettes can help adults stop smoking. (Peter J. Pitts and Robert Goldberg, 11/16)

The changes don’t go far enough and must still clear regulatory hurdles that could take two years or more. In the meantime, Alachua County should proceed with its own plan to prevent e-cigarette and tobacco use among young people.Last month, county commissioners voted to draft an ordinance that would ban the sale of e-cigarette and tobacco products in the county to anyone under 21 years old. Six states and at least 350 cities and counties across the country have already raised the legal age for such purchases to 21 from 18. (11/16)

One of public health’s greatest successes has been the steady decline in use of combustible tobacco (e.g., cigarettes, cigars), however the rising use of electronic cigarettes (also a tobacco product) among youth could reverse this trend. The 2018 Charlotte-Mecklenburg Youth Drug Survey, with 10,000 youth participating, shows high school youth smoking cigarettes at an all-time low of 5.1 percent, however one in five (19.6 percent) high school youth are currently using e-cigs with white teens using at the highest rates (34 percent). The 2017 North Carolina Youth Tobacco Survey shows that 39.6 percent of our 12th graders statewide are vaping. (Gibbie Harris, 11/19)

Rejecting Dsuvia should have been a no-brainer. An FDA-approved intravenous version of sufentanil has been used by clinicians only in hospital settings for general anesthesia and for epidurals during labor and delivery for more than 20 years. But research shows that, along with fentanyl, it is one of the two most diverted and abused drugs by anesthesiologists. One of us (Brown) has witnessed the drug’s potency firsthand, attempting to resuscitate doctors and other health-care providers — some successfully but others not. (Raeford Brown and Sidney Wolfe, 11/16)

While the new law is a positive step in the right direction, it fails to address several root causes of the epidemic. As a physician who cares for patients with chronic pain every day, as well as those with substance use disorders, I urge policymakers and the new Congress to maintain their focus on the opioid crisis by instituting policies and investing in the following three key areas. (Jeffrey Gudin, 11/19)

The package, Support for Patients and Communities Act directs much-needed resources to research and public health programs that aim to prevent and treat opioid use disorder. This includes funding for grants created to combat drug addiction at the state level, the creation of comprehensive opioid recovery centers, and desperately needed regulatory guidelines for recovery housing. The opioid package, which passed the House 393-8 and the Senate 98-1, recognizes that these drugs have an important medical application for the treatment and management of pain. This acknowledges a crucial concern that many in the pain management field have raised: that some approaches to combating the opioid epidemic may actually be exacerbating the problem. (Carrie Wade and Cory Goracke Postle, 11/15)

What is it like to face dying during childbirth in the richest country in the world in Thea was 35 years old and 40 weeks pregnant when she went to her doctor for her final prenatal appointment. She was in good shape, didn’t smoke and had received regular prenatal care, though she wasn’t thrilled with the obstetrics practice she’d chosen in Chicago. The doctors were “more interested in protocols than people,” she said. 21st century? (Kim Brooks, 11/16)

Last month, a team of scientists led by Maria Gloria Dominguez-Bello, a Venezuelan now at Rutgers University, suggested a source of new cures: Create a global microbe vault or system of vaults, perhaps where the climate is easy on refrigeration, to collect and preserve such beneficial microbes, particularly from countries least affected by modernization. Who knows the magic that surviving ancestral biotics might hold for understanding and curbing today’s diseases? (Sarah Schenck, 11/18)

Federal law prohibits medical marijuana users from possessing or buying firearms and ammunition — even if state law allows the drug’s use. That likely will come as a surprise to many Missourians who supported the legalization of medical marijuana in the state. And there are no exceptions, according to the Bureau of Alcohol, Tobacco, Firearms and Explosives, which means Missouri residents won’t legally be able to have a license for medical marijuana and possess a firearm at the same time. (11/18)

Michigan House Bill 4461: The Death with Dignity Act was introduced in March of 2017, and has been referred to the House Committee on Health Policy where it was never acted upon. In the meantime, people suffer needlessly while no movement has been made on a bill that could allow people to make own informed decisions to request prescribed medication to end their lives in a humane and dignified manner. Part of that informed decision is the availability of feasible alternatives, including, but not limited to, comfort care, hospice care and pain control. (Robin Piach, 11/18)