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Senator Claire McCaskill isn’t subtle in reminding voters what her campaign is all about. She’s rechristened it the “Your Health Care, Your Vote” tour. The turnaround could not be more startling. After years of running as far as they could from President Barack Obama’s health care law, Ms. McCaskill and vulnerable Senate Democrats in Florida, West Virginia and other political battlegrounds have increasingly focused their closing argument on a single issue: saving the Affordable Care Act. Now, with Republicans desperate to reposition themselves and come up with their own health care pitch, and with the elections roiled by gale-force winds on immigration and Justice Brett M. Kavanaugh’s confirmation hearings, the question is whether health care will be enough to save her and Democrats in other key Senate races. (Gabriel, 10/28)

As President Trump pushes ahead with efforts to chip away at the Affordable Care Act, Democrats are seizing on his moves to attack Republicans’ claims that they will protect people with pre-existing medical conditions. Republicans are hitting back, saying Mr. Trump’s actions will increase consumer choice and that they strongly favor covering pre-existing conditions. In either case, the back-and-forth shows the continuing potency of health care as an issue less than two weeks before the midterm elections. (Armour, 10/28)

Somewhere, somehow, a memo must have gone out to Republican lawmakers who voted for the American Health Care Act (AHCA), the Republican bill to repeal and replace Obamacare: If you are attacked for undermining protections for people with existing health problems, jab back by saying the claim got Four Pinocchios from The Washington Post. That’s not true. Republicans are twisting an unrelated fact check and are misleading voters. We have found at least seven politicians who have done this. (Kessler, 10/29)

With the federal deficit growing and President Trump suddenly talking about another tax cut, the conversation in Washington has turned to the inevitable question of how — or whether — Congress will engage in any type of fiscal discipline. Senator Mitch McConnell, the majority leader and Kentucky Republican, got people in Washington talking — and generated some new campaign ads from Democrats — when he suggested this month that changes to Medicare, Social Security and Medicaid were needed to tame the deficit. So what does that presage should Republicans maintain control of Congress? (Steinhauer, 10/26)

After weeks of criticism over his lack of a health-care plan, [Republican gubernatorial nominee Ron] DeSantis posted the proposal online Wednesday shortly before his final debate with Democratic candidate Andrew Gillum. The plan calls for people to have the right to buy the health care they want; use price-transparency tools to shop for care; and get rebates from insurers when patient choices save money. (Sexton, 10/26)

Forget Donald Trump or whatever is on cable news on a given day — health care is the dominant issue in Texas’ most competitive congressional races. With early voting underway, Democratic challengers are relentlessly pushing the issue on the air, on the campaign trail and on debate stages. And Republican incumbents, many facing their first real races in a long time, are moving to defend their records after years of GOP orthodoxy against the Affordable Care Act, while also seeking to paint their opponents’ health care views as too extreme. (Svitek and Livingston, 10/27)

Two years after Ohio swooned over Donald Trump’s law-and-order presidential campaign, the state is weighing a decidedly un-Trumplike solution to its spiraling opioid epidemic: Stop locking up drug users, and instead use the money to treat them. Democratic gubernatorial candidate Richard Cordray is embracing a proposal on the ballot that would downgrade all drug possession crimes to misdemeanors and prohibit jail time for all but the most frequent offenders, a move that has put him out of step with key state officials and even some in his own party — and sets up a test of how far leftward Ohio’s frustrated voters will go to escape a deepening drug crisis. (Cancryn, 10/27)

A former top Drug Enforcement Administration official says he told staffers who work with Tennessee Rep. Marsha Blackburn exactly what to expect from a 2016 law she co-sponsored during the nation's opioid crisis. He ripped into her later suggestion the law may have had "unintended consequences." Joe Rannazzisi, former head of DEA's Office of Diversion Control, said in an interview with The Associated Press that he told the congressional staffers during a July 2014 conference call that the bill would hamper the DEA's ability to go after companies illicitly distributing opioids. (Mattise, 10/26)

Kaiser Health News: In California, Novel Initiatives Test Cities’ Power — And Will — To Tame Health Costs

At a time of mounting national anger about rising health care prices, the country’s largest union of health workers has sponsored ballot measures in two San Francisco Bay Area cities that would limit how much hospitals and doctors can charge for patient care. The twin measures in Palo Alto and Livermore, sponsored by the Service Employees International Union-United Healthcare Workers West, take aim primarily at Stanford Health Care, which operates Stanford Hospital and Clinics, the facility with the third-highest profits in the country from patient care services, according to a 2016 study. (Waters, 10/29)

Dialysis companies have contributed an extraordinary $111 million and counting to defeat a California ballot initiative that would cap their profits, the most any one side has spent on a U.S. ballot issue since at least 2002. A $5 million donation from this week from dialysis provider Fresenius Medical Care pushed the anti-Proposition 8 campaign's total past the $109 million pharmaceutical companies spent two years ago to defeat a measure limiting prescription drug costs. More than $70 million has been spent on television and radio ads as well as consulting services in the last two months. (Bollag, 10/26)

The Trump administration faces a lengthy battle to make its plan to lower Medicare drug costs a reality, with resistance coming from its own party, Democrats and large segments of the health care industry. Conservatives and the drug industry say it’s tantamount to government price controls and socialized medicine. Democrats are beating up the president for not going far enough and doctors are worried their patients could lose access to critical medicines. (Karlin-Smith, 10/26)

The Trump administration’s drug-pricing plan puts the U.S. on a path toward policies like those in Europe, where governments use tight cost controls. Under the new proposal unveiled at an event at the Department of Health and Human Services on Thursday, President Donald Trump and health secretary Alex Azar said that the administration would create a reference price for high-cost medicines paid for by Medicare, based on comparable prices from other countries. (Lauerman and Edney, 10/26)

Kaiser Health News: Trump Adds A Global Pricing Plan To Wide Attack On Drug Prices, But Doubts Persist

President Donald Trump’s new pledge to crack down on “the global freeloading” in prescription drugs had a sense of déjà vu. Five months ago, Trump unveiled a blueprint to address prohibitive drug prices, and his administration has been feverishly rolling out ideas ranging from posting drug prices on television ads to changing the rebates that flow between drugmakers and industry middlemen. Last week, Trump proposed having Medicare base what it pays for some expensive drugs on the average prices in other industrialized countries, such as France and Germany, where prices are much lower. (Tribble, 10/26)

President Trump is trying to do what President Obama failed to accomplish: stand up to the pharmaceutical industry and doctors to change the way that the government pays for drugs. In a sweeping proposal Thursday that lacked critical details, his Department of Health and Human Services detailed a plan to change the way that Medicare pays for doctor-administered drugs in the Part B program, with one goal of removing the current incentive for doctors to prescribe high-cost drugs. The end goal: to bring down costs for the government and ultimately, for patients. (Swetlitz, 10/26)

Meanwhile, physician and patient advocacy groups, which helped kill a somewhat similar Obama administration proposal two years ago, were guarded in their reactions pending release of further details about President Donald Trump's plan. “Pharma is one of the smartest, most sophisticated, wealthiest industries represented in Washington,” said Lawrence Jacobs, a health policy and politics professor at the University of Minnesota. “Does the White House really want to make this a fight they give blood on?” (Meyer, 10/27)

President Trump is proposing a major shift in how the government pays for high-cost drugs for seniors, saying it could lower prices as much as 30 percent. The timing — two weeks before an election where health care remains a prominent issue — may be political. (Bradford, 10/26)

President Trump’s newly unveiled test plan to lower Medicare Part B drug costs may have limited resonance in the days before the midterm elections — and could face a difficult, if not impossible, road over the longer-term as well, given resistance from the pharmaceutical industry and doctors as well as some conservatives worried that the plan runs counter to their free-market principles and some Democrats who say the plan doesn’t go far enough. (Rosenberg, 10/26)

States and employers are getting a lot more leeway in the types of health insurance they can offer residents and workers, ensuring the likelihood that differences in access and affordability of coverage will continue to widen in the name of expanding consumer choice and reducing regulatory burden. But observers are divided over whether the Trump administration's moves last week to allow states to sidestep certain aspects of the Affordable Care Act through new 1332 waiver guidance and allowing employers to pay for workers' individual market premiums through health reimbursement arrangements will ultimately harm the marketplace and its enrollees. (Livingston, 10/27)

A federal judge in a Friday hearing appeared skeptical of a push by advocacy groups to stop the implementation of short-term insurance plans as designed by the Trump administration. U.S. District Court Judge Richard Leon of the D.C. Circuit didn't seem impressed by the groups' arguments that Trump administration actions were undermining the individual insurance markets. He indicated he would not rule for several weeks on their request for a preliminary injunction to stop the plans, which only last up to 12 months and cover less than the full plans under the Affordable Care Act. (McIntire, 10/26)

A federal judge on Friday slammed a request to halt the Trump administration’s expansion of short-term health insurance plans during oral arguments in Washington, D.C. District Judge Richard Leon, a George W. Bush appointee, appeared sympathetic to the administration’s argument that the expanded plans would not affect Obamacare marketplaces since they will largely appeal to young and healthy people who now can't afford coverage. (Cancryn, 10/26)

When the annual open enrollment period begins in a few days, consumers across the country will have more choices under the Affordable Care Act, but fewer sources of unbiased advice and assistance to guide them through the labyrinth of health insurance. The Trump administration has opened the door to aggressive marketing of short-term insurance plans, which are not required to cover pre-existing medical conditions. Insurers are entering or returning to the Affordable Care Act marketplace, expanding their service areas and offering new products. But the budget for the insurance counselors known as navigators has been cut more than 80 percent, and in nearly one-third of the 2,400 counties served by HealthCare.gov, no navigators have been funded by the federal government. (Pear, 10/27)

Insurance shoppers likely will have several choices for individual health coverage this fall. The bad news? There’s no guarantee they will cover certain doctors or prescriptions. Health insurers have stopped fleeing the Affordable Care Act’s marketplaces and they’ve toned down premium hikes that gouged consumers in recent years. Some are even dropping prices for 2019. But the market will still be far from ideal for many customers when open enrollment starts Thursday. (Murphy, 10/28)

Every fall, open enrollment season means complicated forms to read and big decisions to make about insurance and other benefits offered at your job. You may find the process a headache, but taking the time to evaluate your choices could save you thousands of dollars. Three out of five (60 percent) workers say their employer offers an open enrollment period for benefits, according to a recent Nationwide Financial consumer survey. Workers typically can switch health care plans, add disability or life insurance, or sign up for other benefits. (Herron, 10/29)

But stability doesn't equate to affordability. Consumers continue to feel the sting of higher costs, whether they get their coverage through the individual market or an employer. It's not just rising premiums; deductibles, co-pays and maximum-out-of-pocket expenses (the dreaded MOOPs in insurance parlance) are high and getting higher. All this adds up to some eye-popping sums, particularly for the approximately 150,000 Oregonians who buy insurance on the individual market. One Portland-area woman just got word from Providence Health Plan that the monthly premium for her and her spouse and two grown sons will jump 24 percent, from $1,270 to $1,577 a month. Their deductible will go from $7,350 to $7,900, a 7.5 percent increase. (Manning, 10/28)

The first three years of the Affordable Care Act were a roller coaster — not just for customers but also for insurance carriers. No local carrier has traveled as turbulent a road as Moda Health, the Portland company that jumped headlong into the new market created by Obamacare and almost didn't live to tell the tale. ...The Moda saga offers a glimpse of both the promise and the chaos wrought by the 2010 passage of the Affordable Care Act. Company officials contend Moda was a victim of its own idealism. Eager to make the Affordable Care Act work, Moda officials moved aggressively into the new markets the legislation created. It expanded its presence in Alaska and Washington. (Manning, 10/28)

Kaiser Health News and NPR: That’s A Lot Of Scratch: The $48,329 Allergy Test

Janet Winston had a rash that wouldn’t go away. The English professor from Eureka, Calif., always had been sensitive to ingredients in skin creams and cosmetics. This time, however, the antifungal cream she was prescribed to treat her persistent rash seemed to make things worse. Was she allergic to that, too? ... Her Stanford-affiliated doctor had warned her that the extensive allergy skin-patch testing she needed might be expensive, Winston said, but she wasn’t too worried. After all, Stanford was an in-network provider for her insurer — and her insurance, one of her benefits as an employee of the state of California, always had been reliable. Then the bill came. (Feder Ostrov, 10/29)

Early this month, a respected medical journal published a research paper on its website that analyzed the effects of a business trend roiling the field of dermatology: the rapid entrance of private equity firms into the specialty by buying and running practices around the country. Eight days later, after an outcry from private equity executives and dermatologists associated with private equity firms, the editor of the publication removed the paper from the site. No reason was given. Furor over the publication and subsequent removal of the article has deepened a rift in the field over what some see as the “corporatization” of dermatology and other areas of medicine. (Hafner, 10/26)

Kaiser Health News: Dialysis Giant DaVita Defends Itself In Court And At The Polls

It’s been a year of playing defense for DaVita Inc., one of the country’s largest dialysis providers. A federal jury in Colorado this summer awarded $383.5 million to the families of three of its dialysis patients in wrongful death lawsuits. Then this month, the Denver-based company announced it would pay $270 million  to settle a whistleblower’s allegation that one of its subsidiaries cheated the government on Medicare payments. But its biggest financial threat is a ballot initiative in California that one Wall Street firm says could cost DaVita $450 million a year in business if the measure succeeds. (Young, 10/29)

With other states watching to see how New Hampshire combats the opioid crisis using the Safe Stations approach, organizers of the program say there is still a lot to be done to make it more successful here at home. Manchester began the program in May 2016, with all 10 of the city’s fire stations becoming access points for drug users seeking addiction treatment. Nashua launched its Safe Stations program in November 2016, and has seen its fatal drug overdoses decline by about 21 percent in the past two years. (Houghton, 10/26)

For Zachary Dezman, an emergency physician in heroin-plagued Baltimore, there is no question that offering addiction medicine to emergency room patients is the right thing to do. People with a drug addiction are generally in poorer health than the rest of the population, he said. “These patients are marginalized from the health-care system. We see people every day who have nowhere else to go. “If they need addiction medicine — and many do — why wouldn’t we give it to them in the ER? We give them medicine for every other life-threatening disease.” But elsewhere in the country, all but a few emergency doctors and hospital administrators see things differently. (Vestal, 10/28)

But heroin addiction and abuse are not just a big city problem, as [Ty] Trenary had thought. While the bulk of fatal overdoses still happen in urban areas, the rural overdose rate has increased to slightly surpass that of cities. Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years. (Boiko-Weyrauch, 10/28)

Influenza viruses cause about 200,000 hospitalizations every year in the United States. Annual seasonal vaccination is our best line of defense, but in recent years, mismatches in the vaccine can clearly limit its effectiveness. We study how the flu virus spreads between people. While we strongly encourage everyone to get the flu vaccine, the findings from our study on the stability of flu viruses in the air can provide useful information for parents, teachers and health-care officials to limit the spread of the flu in the community. By employing simple strategies to reduce the amount of the flu virus in our environment, we can decrease the number of infections every year. (Lakdawala and Marr, 10/27)

Confused about what to eat and drink to protect your health? I’m not surprised. For example, after decades of research-supported dietary advice to reduce saturated fats to minimize the risk of heart disease and stroke, along comes a new observational study of 136,384 people in 21 countries linking consumption of full-fat (read saturated) dairy foods to a lower risk of death from cardiovascular disease. ... Caution is in order, especially since another new study, this one a randomly assigned clinical trial, found that three weeks on a diet rich in saturated fat caused liver fat and insulin resistance to rise far higher than diets high in sugar or unsaturated fat. (Brody, 10/29)

Dating to the 1980s, the amyloid hypothesis holds that the disease is caused by sticky agglomerations, or plaques, of the peptide beta-amyloid, which destroy synapses and trigger the formation of neuron-killing “tau tangles.” Eliminating plaques was supposed to reverse the disease, or at least keep it from getting inexorably worse. It hasn’t. The reason, more and more scientists suspect, is that “a lot of the old paradigms, from the most cited papers in the field going back decades, are wrong,” said MGH’s Rudolph Tanzi, a leading expert on the genetics of Alzheimer’s. (Begley, 10/29)

Epithelioid sarcoma is exceedingly rare — estimates vary but at most, no more than around 100 cases per year. Of those, 10 percent occur in children and adolescents. For this and many other rare cancers that kids get, it takes a long time to find enough patients to test new therapies. Even worse, small patient numbers mean there's less motivation to allocate resources to study the diseases and develop potential drugs. Dozens of childhood cancers fall in this category, some so rare that few pediatric oncologists hear about them. (Landhuis, 10/26)

Gov. Jerry Brown, flanked by his attorney general and air quality chief, issued another demand on Friday that the Trump administration abandon its plan to freeze auto emission standards and revoke California's right to set its own rules. ...State officials, along with attorneys general from 20 other states, also released their 415 pages of comments on the proposal, which Trump appointees have dubbed the SAFE Rule, for Safer Affordable Fuel-Efficient Vehicles, calling it "riddled with errors and based on faulty assumptions, incorrect modeling, cherry-picked data and a fundamental misunderstanding of consumer behavior." (Miller, 10/26)

Across Wisconsin, universities are banning plastic straws, nonrecyclable takeout containers and plastic bags in campus dining halls. They are composting food scraps and collecting uneaten food for food pantries. And they are supporting local food growers or tending campus gardens to reduce the distance food travels. (Herzog, 10/26)

For decades, Los Alamos had been criticized for sacrificing workers’ health and safety in the name of atomic progress. ...Before his death, Chad [Walde] filed a claim for federal benefits, joining more than 1,400 people who said they became sick from radiation exposure for work done within the last 20 years at the lab, according to data obtained by the Santa Fe New Mexican under the Freedom of Information Act. (Moss, 10/26)

Hospitals are often thought of as the hubs of our health care system. But hospital closings are rising, particularly in some communities. “Options are dwindling for many rural families, and remote communities are hardest hit,” said Katy Kozhimannil, an associate professor and health researcher at the University of Minnesota. Beyond the potential health consequences for the people living nearby, hospital closings can exact an economic toll, and are associated with some states’ decisions not to expand Medicaid as part of the Affordable Care Act. (Frakt, 10/29)

Roughly 39,000 unionized employees wrapped up a three-day strike Thursday at five University of California teaching hospitals, including UC Davis Medical Center, a job action that UC leaders said moved them no closer to a contract agreement. ...Union leaders, however, said that they received reports from colleagues working on the UCD hospital floor, saying that the hospital had to postpone services for patients in the gastrointestinal clinic, physical therapy and elective surgery. (Anderson, 10/26)

Until recently, mental health screenings were not standard for pregnant women and new mothers even though at least 20 percent will experience depression or anxiety that can be exacerbated by hormonal surges, lack of sleep and the demands of an infant. The screenings can be lifesaving — as many as one in five deaths of women in the postpartum period is caused by suicide. ...At Barnes-Jewish Hospital, postpartum nurses will alert the mental health team if they notice that a new mother doesn’t want to hold her baby or makes comments about feeling inadequate or overwhelmed. (Bernhard, 10/28)

Demand for these workers, who provide the majority of hands-on non-medical care to older adults, is strong now and for the foreseeable future because of the aging baby-boom generation, longer life expectancies and growing rates of chronic conditions. In the next decade, home-care work is expected to add more jobs than any other occupation, with an additional 1.2 million needed by 2026, according to the Bureau of Labor Statistics. ... Yet even with high demand and tight supply, wages remain stubbornly low. Between 2007 and 2017, inflation-adjusted median hourly wages for direct-care workers—including home-health aides, personal-care aides and nursing assistants—fell 2% to $11.83 from $12.08, according to PHI, an organization that works with the direct-care industry. A 40-hour work week at that rate yields an annual income of around $24,600. (Ansberry, 10/27)

The state of Maryland on Thursday announced a $2.2 million settlement in its suit against the owners of Neiswanger Management Services, a nursing home company that routinely discharged patients when their Medicare coverage ran out and they had no income for further care. Capital News Service ran a series in September 2016, called “Discharging Trouble ,” that shared the stories of several patients who, at the end of their coverage, had been left at the doorstep of unlicensed assisted living homes where they alleged they were assaulted and robbed. (Williams and Dubose, 10/26)

But a deficit of trained and available staff, especially licensed nursing assistants who provide most of the direct care to patients, is increasingly becoming a problem for New Hampshire’s nursing homes — not just Bedford Hills Center, where the dining room was closed four nights a week during the summer because of a lack of staff. Statewide, nursing homes struggle to maintain enough workers to provide sufficient care while earning enough to stay solvent, according to health care advocates. (Baker, 10/29)

Patients at La Clinica de la Raza have caught wind of a recent Trump administration proposal that could make it harder for legal immigrants to get a green card if federal immigration officials think they’re likely to use Medicaid or other public benefits in the future. And they’ve been asking Plasencia if they should drop their Medicaid coverage, or not apply, for fear that receiving the benefit could imperil their chances at permanent residency. (Ho, 10/28)

Luz said she left her six other children in the care of her mother and other relatives in Honduras; her lawyer said she hoped to gain asylum and bring them to the United States to join her. Then, within a week of arriving at Port Isabel, Luz said her umbilical hernia and Cesarean section scar — the aftermath of delivering her seventh child in March 2017 — ripped open. (Wiley, 10/26)

By the end of this month, San Francisco officials had hoped to have at least 2,000 homeless people enrolled in the city’s new system to monitor and document their interactions with city aid agencies, with the goal of improving the care they receive. On Friday, with six days to go before the end of October, the Department of Homelessness and Supportive Housing said it had already reached its goal — and then some. (Fracassa, 10/26)

A ninth child has died of respiratory illness at the Wanaque Center for Nursing and Rehabilitation in the Haskell section of Wanaque, New Jersey, the state’s Department of Health announced Sunday morning. The latest victim was someone who  had a confirmed case of adenovirus and fell ill before Oct. 22. There have been 25 pediatric cases associated with the outbreak. A staff member also was ill but has recovered, according to the health department. (Sobko, 10/28)

Public libraries have long been a refuge, not just for readers, but also for people with nowhere else to go during the day — people who sometimes sleep in chairs, use the bathroom sinks to wash themselves or inject themselves with drugs in bathroom stalls. Sometimes they have been kicked out. At best they’ve been left alone. But now a growing number of libraries in Illinois and across the nation are facing the issue head-on, hiring social workers to help connect people with housing, health care and food. The Chicago Public Library has a social worker who splits time between two of its Uptown branches, paid for by local hospital system Amita Health. (Schencker, 10/27)

Even as a young man, Cesar Sayoc showed signs that he struggled with mental health problems, but his family could not persuade him to seek help. Sayoc, now facing federal charges in connection with mailing bomb-like devices across the country to top Democrats and media personalities, would get angry when his relatives asked him to seek help, said Ronald Lowy, a Miami lawyer who has represented Sayoc and the family for years. (Marino and Mills, 10/28)

As part of a multi-year effort to modernize behavioral health in Ohio’s Medicaid system, the Kasich administration in January expanded the way services could be coded, adding more than 100 new codes to the system. ...But providers, like the center, say the transition is full of processing and reimbursement delays and is putting a financial strain on a field already overwhelmed by the opioid epidemic. (Christ, 10/26)

Doctors in Puerto Rico are outraged at the government’s unexpected decision to declare the Zika crisis over in the aftermath of Hurricane Maria. Plus, communities in Houston and North Carolina struggle to put their homes and lives back together. (Murphy, Satija and Walters, 10/27)

The Sacramento County Board of Supervisors recently approved a $25,000 grant to pay for a nurse to work twice a week at the health centers at Cosumnes River College and Sacramento City College to offer free screenings and treatments for sexually transmitted infections, including chlamydia, syphilis, gonorrhea and HIV.The contract will start Nov. 1 and run through June of next year, said Sacramento County spokeswoman Brenda Bongiorno. (Yoon-Hendricks, 10/28)

As investigators search for answers as to why dozens of fetuses were hidden inside cardboard boxes at two Detroit funeral homes, Detroit’s high infant mortality rate could yield clues. The infant death rate recorded for the city of Detroit is about 12.7 per 1,000 live births in 2016, according to the most recent data from the Michigan Department of Health and Human Services (MDHHS). That's more than double the national rate of 5.9 per 1,000 live births and one of the highest in the state of Michigan after Saginaw, Muskegon and Flint. (Siacon, 10/22)

Health authorities in California have more power to insist that a dog is vaccinated against rabies than to ensure that a child enrolled in public school is vaccinated against measles. That’s just one of the frustrations faced by health officials in the first year after California did away with “personal belief exemptions” that allowed parents to send their kids to school unvaccinated, according to a study published Monday in the journal Pediatrics. In the 2014-15 school year, when parents could still opt out of vaccinations for any reason they chose, only 90.4% of kindergartners in California public schools were fully immunized. That’s below the 94% threshold needed to establish community immunity for measles, according to experts. (Kaplan, 10/29)

The Missouri health department is mailing letters to about 10,000 people whose personal information — including in some cases Social Security numbers — may have been exposed in a security breach. The Missouri Department of Health and Senior Services said in a statement that an information technology contractor improperly stored the information in an electronic file that was not password-protected. (Marso, 10/26)

After Matthew Shepard's murder, his autopsy was filed away and never released to the public. Julie Heggie was the coroner at the time and said, she decided, along with law enforcement and the county attorney's office, that was the best thing to protect the report from mass distribution. (Edwards, 10/26)

A report for a marijuana trade group says pot production, processing and sales could reap more than $1 billion in tax revenue for Nevada over seven years. ... The analysis by Las Vegas-based RCG Economics didn't look at public safety, health, human services, schools or criminal justice costs associated with legalization. (10/26)

Backers of legalizing marijuana in North Dakota have high hopes that voters will approve the drug's use for anyone old enough to drink alcohol. But they could be in for a bummer because opponents have spent far more money against the proposal. Critics say it would mean big problems for law enforcement and society. It comes as North Dakota still is setting up a medical marijuana system that voters approved by a wide margin two years ago. (MacPherson, 10/28)

With Election Day looming, Republicans around the country, at every ballot level, are engaged in a party-wide effort to pull the proverbial wool over voters’ eyes on health care. It’s best summed up in a recent tweet from President Donald Trump, which is, even by his mendacious standards, astonishing: “Republicans will totally protect people with Pre-Existing Conditions, Democrats will not!” This isn’t just an attempt by Republicans to jump on a popular train; it’s an attempt to jump on a train they have been trying to derail for years, and will finally dynamite if they maintain control of Congress. They would destroy it despite the fact that, whatever they claim, they have no realistic plan with which to replace it. Americans everywhere need to understand that as they enter the voting booths. (10/28)

A woman with cancer experiences complications related to her treatment and is hospitalized at a facility that accepts her insurance. During a four-day stay there, she is cared for by a team of physicians and nurses and undergoes a battery of tests and procedures. Once she is stable, she’s sent home. She continues seeing her oncologist for cancer treatments covered by her insurance, but a few weeks later, out-of-network bills from providers at the hospital begin to trickle in. Those bills aren’t mistakes. They are actually an all-too-common occurrence, one that health plans often fail to mention — or do anything about. As a result, patients pay higher out-of-network costs that are partially covered, if at all, by their health insurance. (R. Bruce Williams and Geraldine B. McGinty, 10/29)

Allowing employers to provide tax-free reimbursement for health-care expenditures, as a new proposed rule from the Department of Labor promises to do, could go a long way to improving access to affordable health insurance for people employed in small businesses.However, it will not save the U.S. individual health insurance market or revolutionize consumer-driven health care. Just as money in your pocket won’t help you prepare for a hurricane if the store shelves are empty, this savings scheme will be dependent on supplier actions. (Deborah Gordon and Anna Ford, 10/28)

Rarely have current events — and the fiery opinions they generate — seemed so exhausting as they have in the last few months. It’s not uncommon nowadays to think, “Last Friday was the longest year of my life.”Are there any helpful coping skills for those of us who are looking to weather outrage fatigue without abusing the consolations of talk therapy or heavy drinking? (Henry Alford, 10/28)

Retired Supreme Court justice Sandra Day O’Connor recently disclosed that she has now been diagnosed with probable Alzheimer’s disease. At 65, she had a 1 in 10 chance of developing dementia. At 85, her odds increased to 1 in 3. Now we acknowledge with great sadness that the 88-year-old’s keen mind will fade away and that she, too, will succumb to the disease, just as her husband did. How does this affect those of us who are reaching that magical Medicare age of 65? Should we pretend that dementia can’t happen to us and hope we beat the odds? Knowing our risk for developing a disease gives us the opportunity to plan for our future and to advocate for programs that will enhance services for those affected by this devastating disease. (Ann Norwich, 10/26)

It’s bad enough that, as the old saying goes, a lie gets halfway around the world before the truth gets its boots on. It’s even worse when the truth then drags its feet. A journal has finally retracted a long-debunked article about the spurious link between vaccines and autism, a full eight years after the bogus research on which the paper was based was pulled from the scientific literature. (Adam Marcus, 10/26)

Homelessness is not one problem and requires subtle approaches. Some suffer from mental-health issues, while others are from families that have fallen behind on rent or lost a job. Many are lost to drugs and some are children who somehow still manage to attend school. Homelessness is also closely associated with other local problems—especially housing and zoning policy and the lack of high-speed regional transit systems. San Francisco has limited the supply of homes and apartments. This raises rents, which drives people onto the streets. Every soul who has encountered the cruel hardship of homelessness requires a different and specialized form of assistance. (Michael Moritz, 10/28)

Trump wants to distract voters from the biggest lie being told by him and other Republicans, including Martha McSally. He phrased it this way during a rally in Nevada: “Republicans will always protect people with pre-existing conditions.” (EJ Montini, 10/27)

The new syringe exchange law passed in 2017 only grants legal immunity to health care workers and staff distributing syringes as part of these programs, not to participants themselves. While many states have similar paraphernalia laws, some have added exceptions for syringe exchange participants to ensure the legal focus is on the illicit sale of equipment, not public health interventions. (Sanjay Kishore and Beth Macy, 10/27)

Just as it is foolish to think that gun control will end all mass killings or that armed guards would prevent them all, it is foolish to pretend that there is not a national spiritual crisis. To end the killings we must admit that. Yes, there is a mental health and mental health institutionalization crisis as well. But Pittsburgh’s alleged domestic terrorist was consumed by a disease called hate. We need a reassertion of religious and humanist values. We need to learn benevolence and implant care and mercy in our hearts. We all need to get and give more mercy. (10/28)

In the Nov. 6 election, Missouri could become the 32nd state in the nation to legalize medical marijuana. But first, voters must unravel a confusing tangle of three different medical marijuana questions on the ballot.The triad of proposals likely will leave voters wondering: Should I vote to approve each of the three? Reject them all? Or come up with a combination of yes and no?Here’s the short answer: Voters should approve Amendment 2 and reject Amendment 3 and Proposition C. (10/26)

Thousands of Michiganians are benefiting from Medicaid expansion due to the ACA. The political reckoning taking place in Michigan as it relates to health care is happening all over the nation. Politicians who were vehemently opposed to coverage of pre-existing conditions are now forced to explain themselves to their constituents. Some of the candidates are engaging in outright lies about their earlier stances to deceive voters, and others are simply been called out by angry voters at town halls. (Bankole Thompson, 10/28)

For years, patient advocates, led by a courageous group of Virginia parents, made the case for legal access to cannabidiol (CBD) and THC-A oils for those suffering from intractable epilepsy. These are heavily regulated cannabis compounds that have significant positive medical benefits, but don’t make people feel “stoned.” (Glenn Davis, 10/28)

With Election Day rapidly approaching, we’ve found ourselves asking: Which candidates will fight for gun safety in Florida? We are lifelong Republicans. But, as this past year in the state legislature shows, gun violence prevention doesn’t have to be a right or left issue or red or blue issue. It’s a life or death issue. We’re fortunate to see a number of Florida candidates embracing gun safety this year. Sean Shaw, who’s running to be Florida attorney general, released an ad compiling clips of him discussing taking on the NRA in court, fighting to prohibit assault weapons and strengthening background checks. And just this past weekend, during the Florida gubernatorial debate, Andrew Gillum stressed his commitment to taking on the gun lobby, and conversely, Ron DeSantis wants to strengthen his ties to the NRA. (Fred and Maria Wright, 10/27)

I believe our system needs more staffing, especially for the more vulnerable patients, but I would prefer to see that staffing include community-based nursing, social services, community health workers, physician assistants and nurse practitioners, home services for frail elders, and recovery and treatment support for people with addiction. The future of care for those populations is in the community, not the hospital. (Karen Donelan, 10/26)

Protecting the most vulnerable children in our community begins with ensuring that every child receives the care they need, including those with the most complex conditions. To ensure that happens, we, the voters, must make a stand this November by voting “yes” on Proposition 4, the children’s hospital bond. (Alexandria Felton, 10/26)