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From coast to coast, the fifth annual season for Americans to buy insurance under the Affordable Care Act opened on Wednesday with scattered reports of crowds, some technical difficulties and a public confused as never before by the political turmoil surrounding the law. The federal website HealthCare.gov said “2018 Open Enrollment is here,” as both it and state insurance marketplaces attracted the year’s first customers. They came despite a 90-percent reduction in federal advertising about the sign-up window and a decision by the Trump administration to send advance emails about enrollment to millions fewer Americans than in past years. (Goldstein, Eilperin and Itkowitz, 11/1)

Former President Barack Obama sought to boost his namesake health law Wednesday by appearing in a video urging people to sign up for coverage on the first day of the 2018 enrollment season. Obama’s call comes as the Trump administration has taken numerous actions to undermine the law while doing almost nothing to publicize the start of the six-week enrollment season that wraps up on Dec. 15. (Cancryn and Pradhan, 11/1)

Former President Barack Obama released a video urging people to sign up for ObamaCare as a new enrollment period — the first under a new president — begins on Wednesday. In the video, Obama said today is the first day to "get covered for 2018." (Savransky, 11/1)

Obama's tweet to his more than 95 million followers includes a short video, set to jaunty music, where the former president urges people to log on to the federal insurance exchange, HealthCare.gov, and sign up for coverage for next year. "It's November 1, which means today is the first day to get covered for 2018," Obama says. It's not clear where he's standing, but the ocean is in the background. (Kodjak, 11/1)

Having dodged multiple failed repeal-and-replace attempts this year, the Affordable Care Act, commonly known as Obamacare, will enter its fifth open enrollment period this week for individuals and families looking to buy health insurance plans for 2018. But consumers should be aware of several big changes: this year's shortest-ever enrollment period, planned outages to the Healthcare.gov website, and big premium price hikes that will be felt most acutely by those whose incomes disqualify them from receiving the health care law's government subsidies. (Reindl, 11/1)

According to the Kaiser Family Foundation, 93 percent of Illinois residents were insured in 2016, up by 3 percent from 2013. More than 350,000 Illinois residents enrolled through the marketplace in 2017, according to the The Illinois Department of Insurance. The department expects enrollment numbers for 2018 to remain consistent, hovering between 350,000 to 380,000, as they have for three years. ...The Department of Insurance hosted a press conference on Wednesday, announcing a partnership with GoHealth that will allow consumers to receive over the phone support from licensed insurance agents while shopping for coverage on Get Covered Illinois, the state’s online marketplace. The Get Covered website provides the all the marketplace options available on Healthcare.gov. (Hartz and Sweet, 11/1)

Minnesotans who buy insurance on the individual market could start signing up for plans Wednesday as politicians continued to debate the role government should play in providing citizens health insurance. Open enrollment for MNsure, the state’s Affordable Care Act marketplace, began Wednesday and runs through Jan. 14 for the roughly 4 percent of the state population that purchases individual or small group insurance plans. Many other Minnesotans who get their insurance through work will also be making health care plan decisions as the end of the year approaches. (Magan, 11/1)

Open enrollment begins today for health insurance under the Affordable Care Act, and officials are urging those in need of coverage to shop around. Two insurers are offering plans for 2018, but average premium prices are soaring by double digits for most plans to reflect costs as well as the Trump administration’s policy changes to the federal health law known as Obamacare. (Cohn, 11/1)

About 72,000 Iowans who buy their own coverage have just one carrier choice, Medica, for individual insurance policies next year. Two other carriers, Aetna and Wellmark Blue Cross & Blue Shield will no longer sell such policies here, because they said they lost too much money. Medica only agreed to stay in Iowa if it could raise premiums by an average of more than 57 percent. But more than 50,000 of the affected consumers, including Hanson, have incomes low enough to qualify them for subsidies that help pay premiums. The income limit for a single person is about $48,000. For a couple, it’s about $65,000. (Leys, 11/1)

The Health Connector website goes live Wednesday for hundreds of thousands of Massachusetts residents expected to shop for health insurance for the coming year. But after a year packed with pledges to repeal the Affordable Care Act and recent funding cuts, what’s left for many people is a lot of confusion. (Bebinger, 11/1)

Obamacare health insurance enrollment kicks off on Wednesday, and in the wake of President Donald Trump draining almost all funding to promote sign-ups, two Democrats and a Republican are stepping up to fill that void. Democratic governor candidate JB Pritzker is paying about $1 million to run radio and digital ads to run all across Illinois. (Sweet, 11/1)

The open enrollment period for Affordable Care Act exchange plans begins today and will bring with it a slew of changes for the roughly 207,000 Ohioans who get insurance on the exchange. A shorter enrollment period, less outreach and significant price changes will make ACA marketplace shopping a different experience than in years past. (Christ, 11/1)

In preparation for the Affordable Care Act’s latest enrollment season, the Trump administration sent notices about the sign-up options to millions fewer Americans than in past years and deleted themes known to be most effective in motivating consumers to sign up. Emails went in advance only to people with current health-care plans through marketplaces created under the law, leaving out most of the names in a database of about 20 million consumers who once had such coverage or at some point explored the federal website HealthCare.gov. (Goldstein, 11/1)

President Trump's acting health chief said Wednesday that the administration wants to make the ObamaCare sign-up season "as consumer friendly as possible." Eric Hargan, the acting secretary of Health and Human Services (HHS), said in a speech that Trump is committed to repealing and replacing the law, but the administration still wants this enrollment period, which began Wednesday, to go smoothly. (Sullivan, 11/1)

When consumers shop for Affordable Care Act plans starting Nov. 1, what they find will depend on their individual circumstances. Call it a tale of two open enrollments. For those who get federal subsidies to help with their premiums, it could be the best of times, with many able to access health insurance that won’t require them to pay any premiums. But on the other side, folks who aren’t eligible for those subsidies—which go to people making 400% of the federal poverty level, around $48,000, or less—will see a far less appealing situation, where they bear the full brunt of rising rates. (Wilde Mathews, 11/1)

The Trump administration’s actions to scale back Obamacare have made it harder and more complicated to find the best health plan. But the pricing chaos has also created great deals for some consumers, who can sign up during open enrollment beginning today. Here’s our advice on how to shop — the best strategy depends on how much you earn. (Sanger-Katz and Park, 11/1)

Here's what's new, what's the same, and some important points to consider when searching for 2018 coverage. (Murphy, 11/1)

Open enrollment for ObamaCare begins on Wednesday, opening a new chapter in what has been a tumultuous year for the health-care law.  The frenzy over health care this year has stoked public confusion about ObamaCare, with some people erroneously stating in polls that the law has been repealed or that they no longer have to pay a fine for not having insurance. (Hellmann, 11/1)

Republicans may seek to repeal the Affordable Care Act requirement that most Americans must have insurance coverage or pay a fine as part of their tax overhaul package, part of a push to undo or delay parts of the health law in the aftermath of the failure of a broader repeal effort. President Donald Trump, in posts on his Twitter account Wednesday, threw his support behind the proposal. (Armour and Peterson, 11/1)

President Trump on Wednesday suggested using the GOP tax bill to repeal ObamaCare’s individual mandate. “Wouldn't it be great to Repeal the very unfair and unpopular Individual Mandate in ObamaCare and use those savings for further Tax Cuts,” Trump tweeted. (Weixel, 11/1)

The president’s position represents a bit of a reversal from the White House. Asked about the individual mandate at Tuesday’s press briefing, White House press secretary Sarah Huckabee Sanders told reporters, “I don’t believe it has to be part of tax reform, but the child care tax credit is something he’d certainly like to see.” (McCaskill, 11/1)

A "skinny" repeal of Obamacare that scrapped the individual mandate failed in July to pass the Senate after three GOP senators defected. Scrapping the mandate’s tax penalty on most Americans who don’t purchase insurance would raise $416 billion over a decade, and increase the number of uninsured by 15 million, according to a December 2016 estimate by the Congressional Budget Office. (Kapur, 11/1)

President Donald Trump threw congressional Republican tax-writers a curveball Wednesday, suddenly voicing support for using a coming overhaul measure to repeal the 2010 health care law’s individual insurance mandate. Trump endorsed a provision being pushed by Sen. Tom Cotton, R-Ark., with whom he has met several times in recent weeks. Cotton has been working with the Senate Finance and House Ways and Means committees to include the repeal of the health care law’s individual mandate in a tax overhaul bill. He said if he is unable to convince the leaders of those panels to include it in their tax bills, he will try to attach it as an amendment. (Bennett, 11/1)

Sen. Lamar Alexander said Wednesday that bipartisan legislation to stabilize the Affordable Care Act health insurance markets in the short term could pass the Senate next month as part of a broader bill. The Tennessee Republican, who chairs the Senate Health, Education, Labor and Pensions Committee, predicted the legislation has a good chance of passing because more GOP lawmakers are coming to realize that something must be done to provide certainty to the Obamacare health insurance markets. (Collins, 11/1)

More than 200 health and business groups have endorsed a bipartisan bill to shore up ObamaCare's insurance markets. Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and ranking member Patty Murray (D-Wash.) announced the support Wednesday as part of their latest push to get the bill passed. (Hellmann, 11/1)

President Trump’s bipartisan commission on the opioid crisis made dozens of final recommendations on Wednesday to combat a deadly addiction epidemic, ranging from creating more drug courts to vastly expanding access to medications that treat addiction, including in jails. The commissioners did not specify how much money should be spent to carry out their suggestions, but they pressed Congress to “appropriate sufficient funds” in response to Mr. Trump’s declaration last week of a public health emergency. (Goodnough and Hoffman, 11/1)

The panel's final report stopped short, however, of calling for new dollars to address the worst drug crisis in U.S. history. Instead, the commission asked Congress for "sufficient funds" and suggested giving the White House drug czar's office the ability to review federal spending on the problem. "If we are to invest in combating this epidemic, we must invest in only those programs that achieve quantifiable goals and metrics," the report said. The drug czar's office "must establish a system of tracking and accountability." (Johnson, 11/1)

The commission, headed by New Jersey Gov. Chris Christie (R), called for expanding drug courts — an alternative system that tries to channel substance abusers accused of crimes into treatment — into all 94 federal court jurisdictions. Currently they are in fewer than half. The more than 50 recommendations in the draft report also include requiring doctors and others who prescribe opioids to show they have received training in the safe provision of those drugs before they can renew their licenses to handle controlled substances with the Drug Enforcement Administration. The panel also wants to mandate that providers check prescription-drug-monitoring databases to ensure that users aren't “doctor shopping” for prescription drugs. In some states, use of that technology is voluntary. (Bernstein, 11/1)

The report includes 56 distinct recommendations, many of which now fall to Congress, a number of federal departments, and local governments to fund and implement. (Facher, 11/1)

The group also got an assist from the CMS, which said it would approve state demonstrations that waive federal Medicaid rules limiting coverage for inpatient substance abuse treatment in facilities with more than 16 beds to 15 days. "This new demonstration policy comes as a direct result of the president's commitment to address the opioid crisis and ensure states have immediate relief and flexibility," said CMS Administrator Seema Verma in a written statement. "Previous policies ignored the growing urgency of the national opioid epidemic and instead put onerous requirements on states that ultimately prevented individuals from accessing these needed services. The Trump administration's approach reflects the pressing nature of the issues states are facing on the ground." (Johnson, 11/1)

Advocacy groups argue a robust infusion of federal dollars is needed to combat the epidemic of prescription painkiller and heroin overdose deaths plaguing the nation. Without more money, they say, the emergency declaration won’t make a significant dent in the crisis. The public health emergency fund doesn’t have much left — about $57,000. New Jersey Gov. Chris Christie (R), who helms the commission, predicted Trump will initially ask “for billions of dollars to deal with this.” (Roubein, 11/1)

A presidential commission created to address the nation’s devastating opioid crisis released a sweeping set of recommendations Wednesday that included the creation of a nationwide system of drug courts, the development of non-addictive painkillers and a national campaign aimed at educating the public about the dangers of drug use. (Wehrman, 11/2)

The Trump administration approved Medicaid waivers in Utah and New Jersey to help improve access to treatment for opioid addiction, according to the states’ governors. The waivers were the first to be approved under a new policy from the Centers for Medicare and Medicaid Services (CMS) that will allow states to design demonstration projects to let Medicaid to pay for opioid use disorder treatments. (Weixel, 11/1)

Missouri Attorney General Josh Hawley has issued subpoenas to three companies that distribute opioids throughout the United States. The subpoenas were issued to AmerisourceBergen, Cardinal Health, and McKesson Corporation. As opioid overdoses rise across the country, Hawley is accusing those companies of putting profits ahead of patient health. (Griffin, 11/1)

John Kapoor has stepped down as chairman of Lake Forest-based Akorn Pharmaceuticals less than a week after he was charged with leading a nationwide conspiracy, as the founder of a different company, to bribe doctors and pharmacists to overprescribe an opioid pain medication. Kapoor resigned as Akorn chairman Monday, according to a Tuesday filing by the company with the U.S. Securities and Exchange Commission. (Schencker, 11/1)

Everyday Advanced Hemp Oil, Bosom Lotion and CBD Edibles Gummie Men may have their fans, but the Food and Drug Administration is not among them. Four companies selling those and dozens of other marijuana-derived dietary supplements have been warned by the F.D.A. to stop pitching their products as cures for cancer, a common but unproven claim in the industry. (Kaplan, 11/1)

U.S. officials sent a warning to the marijuana industry, alerting online sellers they cannot market their products as a treatment for cancer. The Food and Drug Administration sent letters to four companies on Tuesday, warning them about unsubstantiated claims that their marijuana-derived products can combat tumors and kill cancer cells. The firms sell products including oils and capsules made from cannabidiol, also known as CBD, a component of the marijuana plant that doesn’t cause the mind-altering effects of the other main component, tetrahydrocannabinol, or THC. (Edney and Kaplan, 11/1)

The American Civil Liberties Union sued the Trump administration on Tuesday over its detention of a 10-year-old girl with cerebral palsy who was stopped by Border Patrol agents in Texas last week on her way to surgery. The girl, Rosa Maria Hernandez, had been living in Laredo, Tex., with her parents, where she was brought illegally from Mexico when she was 3 months old. (Ugwu, 11/1)

A House committee on Wednesday considered a bill that would make it illegal for doctors to perform abortions after a heartbeat is detected. The "Heartbeat Protection Act," authored by Rep. Steve King (R-Iowa), would make it a crime for a doctor to perform an abortion if the fetus has a "detectable" heart beat.  (Hellmann, 11/1)

Iowa's Steve King, who introduced the bill, H.R. 490 (115), made clear that he wants to bring fetal heartbeat legislation to the Supreme Court to challenge the Roe decision. President Donald Trump is reshaping the courts “with strong conservative nominees who would hear arguments about this bill while it is being challenged on the way to the Supreme Court,” King said at House Judiciary subcommittee hearing on his bill. “President Trump will hopefully appoint one or two more justices to the Supreme Court, making this a profound moment in the Pro-Life movement.” (Haberkorn, 11/1)

Northwest women seeking financial help for an abortion now have one number to call. The Network for Reproductive Options in Oregon and The CAIR Project in Washington state are merged Thursday to form one abortion fund. The new Northwest Abortion Access Fund will have a budget of nearly $315,000 and will serve women in Oregon, Washington State, Idaho and Alaska. The organization is expected to serve at about 1,000 people a year, with an average grant of $180 to help pay for the procedure or expenses, such as travel. The average cost of an abortion in the first trimester costs $650 in the Northwest, the organization said in a release. (Terry, 11/1)

Women's health groups are going to court Thursday morning over Texas' new ban on a common type of second-trimester abortion. Whole Woman's Health and other abortion rights groups sued in July after Gov. Greg Abbott signed the bill banning "dilation and evacuation" abortions. The law would make performing such abortions a crime, and doctors could face fines or jail time. In August, U.S. District Court Judge Lee Yeakel granted the groups a temporary restraining order against the law until Nov. 22. (Wang, 11/2)

Texas abortion providers are set to be in to court Thursday to try to block part of a new state law restricting the most common second-trimester abortion procedure. ..At issue is part of Senate Bill 8, a state law passed earlier this year, that bans dilation and evacuation abortions — deemed the safest way to terminate a second-trimester abortion by medical professionals — unless the fetus is deceased. (Najmabadi, 11/2)

After a lengthy, emotional debate, the Ohio House approved a controversial bill Wednesday that would ban abortions in cases in which the fetus might have Down syndrome.The vote was 63-30. The measure, Ohio Right to Life’s top legislative priority this year, now goes to the Senate, where an identical bill is pending. (Henry, 11/2)

Aspirin may help alleviate your headache or stomach pains, but it may also reduce your risk of cancer, according to a new report. ...After analyzing the results, they found that aspirin users were 47 percent less likely to have liver and esophageal cancer. (Parker, 11/1)

Chronic inflammation in middle age may be associated with an increased risk for brain shrinkage and Alzheimer’s disease later in life. A new study, published in Neurology, looked at 1,633 people whose average age was 53 in 1987-89, measuring white blood cell count and various blood proteins that indicate inflammation. (Bakalar, 11/1)

Sure, space travel makes bones and muscles atrophy and alters the distribution of blood and other bodily fluids, among other physiological consequences of microgravity, but what does it do to the brain? Since astronauts on a mission to Mars will need their wits about them, NASA and outside scientists have been keen to assess the effects of prolonged weightlessness on the 3 pounds of protoplasm inside the skull. In a NASA-funded study published on Wednesday, Dr. Donna Roberts of the Medical University of South Carolina and her colleagues therefore compared before- and after-mission MRIs of 34 astronauts, 18 who spent months on the International Space Station (average voyage: 165 days) and 16 who had shorter jaunts (14 days, on average, on the space shuttle). (Begley, 11/1)

The elderly dementia patient in the next room was unresponsive and in a foul mood, the head nurse warned. Dapper Dan and Beatrice took that information into account and proceeded anyway. The patient was lying in bed with her eyes wide open and didn’t say a word when the pair launched into a medley of 50s tunes. By the time they got to their third song, “Under the Boardwalk,” they noticed the patient’s toes were moving to the rhythm under the bedsheet and that she was gently tapping her fingers to the music. (Hollow, 11/1)

Kaiser Health News: Learning To Advance The Positives Of Aging

What can be done about negative stereotypes that portray older adults as out-of-touch, useless, feeble, incompetent, pitiful and irrelevant? From late-night TV comedy shows where supposedly clueless older people are the butt of jokes to ads for anti-aging creams equating youth with beauty and wrinkles with decay, harsh and unflattering images shape assumptions about aging. Although people may hope for good health and happiness, in practice they tend to believe that growing older involves deterioration and decline, according to reports from the Reframing Aging Initiative. (Graham, 11/2)

Diana Feliz Oliva, a 45-year-old transgender woman who grew up outside Fresno, Calif., remembers being bullied when she was younger and feeling confused about her gender identity. She was depressed and fearful about being found out, and she prayed every night for God to take her while she slept. “I was living in turmoil,” said Oliva, who now works as health program manager in a clinic for transgender people at St. John’s Well Child & Family Center in Los Angeles. “Every morning, I would wake up and I knew I would have to endure another day.” (Gorman, 11/2)

It’s a common problem: Many breast cancer patients find themselves facing expenses they never contemplated. The medical field has a name for it: financial toxicity. Some patients fall into heavy debt, or bankruptcy. Some skip treatments to cut costs, and drain their savings and retirement accounts to keep up with medical bills. Some lose their jobs, because they’re too sick to work or because they miss too many work days. The depletion of funds can affect patients from all walks of life, including those who have insurance. (McDaniels, 11/1)

Computers and smart phones are wearing out people’s eyes. Dry eye, a condition that causes strain and fatigue of the eye, is just one of the conditions caused by looking at screens all day. Dr. Richard A. Adler, a surgeon and ophthalmology specialist with Belcara Health in Baltimore, said that eye drops used to be the main treatment for the disease. But now doctors are using many other medical tools to offer relief to patients, he said. (McDaniels, 11/2)

Dr. Jerry Mendell refers to a boy and a tricycle to explain how effective a new gene-replacement therapy has been in rescuing babies at Nationwide Children’s Hospital from a debilitating and deadly neuromuscular disease. ...Perhaps an ordinary milestone for most children, this is remarkable for a child who was born with type-1 spinal muscular atrophy (SMA), which attacks nerve cells and can cause severe physical limitations — including the inability to breathe, swallow, talk or sit up. (Viviano, 11/2)

Rural hospitals such as Fulton Medical serve as a lifeline for health care and jobs in small towns but face dwindling revenues. Had it closed, Fulton Medical Center would have been the 20th rural hospital in the country to shutter in just the past two years. Nearly 700 of the nation's rural hospitals, about one-third of the facilities, are at risk of closing. Yet despite their notoriously slim operating margins, [management consultant named Jorge] Perez has purchased close to 20 rural hospitals in recent years in Missouri, Kansas, Oklahoma, Florida and elsewhere. By next year, he said he wants to own 50 of them. (Margolies and Sable-Smith, 11/1)

In August, the department declared an end to the state's largest measles outbreak in 30 years. ...Despite a push to increase vaccination rates in the Somali-American community during the summer outbreak, Ehresmann said vaccination rates remain extremely low in the Somali community. (Pugmire, 11/1)

Darby Borough police and agents from the Pennsylvania Attorney General’s Office on Wednesday raided St. Francis Center for Rehabilitation and Healthcare, whose regular license was revoked by state regulators Sept. 1 after an August inspection found serious problems with care. The facility was allowed to continue operating during an appeal of the revocation. (Brubaker, 11/1)

Survivors of a woman who claimed that Johnson & Johnson’s talcum powder contributed to her ovarian cancer are challenging a Missouri appeals court ruling that threw out a $72 million award. The estate of Jacqueline Fox, of Birmingham, Alabama, was awarded the money in 2016 in the first of several cases in St. Louis claiming talc powder contributed to cancer. Fox died in 2015 at age 62. (11/1)

A mental health and substance abuse treatment center for children in Pueblo has had its license revoked following complaints that children were abused and underfed. El Pueblo Boys & Girls Ranch was shut down in September and has now had its license revoked, Colorado Department of Human Services spokeswoman Nourie Boraie said. (Nicholson, 11/1)

There’s been a severe shortage of inpatient psychiatric care facilities for troubled teens and youth for decades in Santa Clara County, and on Tuesday supervisors will hear a pitch to build a new specialty center on the Valley Medical Center campus to address that need. For years, kids who need short-term psychiatric hospitalization — usually because they’ve been deemed a hazard to themselves or others — have been shuttled to facilities in Alameda, Contra Costa, Solano and even Sacramento counties. (Kurhi, 11/1)

Premature birth is the leading cause of infant death, and preterm birth rates are on the rise in California, reflecting a nationwide trend, according to the 2017 Premature Birth Report Card released Wednesday by March of Dimes, a foundation focused on preventing birth defects and infant mortality. In 2016, California’s preterm birth rate was 8.6 percent, an increase from 2015 and a six-year high. (Sullivan, 11/1)

A new March of Dimes report card gives Georgia a “D’’ grade for its preterm birth rate, which rose last year to 11.2 percent from 10.8 percent. ...The nation’s rate of preterm birth also rose in 2016, to an average of 9.8 percent. (Miller, 11/1)

fter several years of steady decline, premature birth rates are increasing again, in Florida and across the nation, according to the March of Dimes’ annual report released on Wednesday. In Orange County, the rate of premature births increased from 9.6 percent to 10.5 percent between 2015 and 2016, lowering the county’s letter grade from a C to a D. (Miller, 11/1)

UnitedHealthcare will eliminate 381 jobs in metro Phoenix on Jan. 2 after losing a lucrative federal contract to provide health care to military families. The Minnesota-based health insurer this week informed employees their positions would be eliminated within 60 days, a notice required by the federal Worker Adjustment and Retraining Notification Act. (Alltucker, 11/1)

Circle Health Services, formerly the Free Medical Clinic of Greater Cleveland, and The Centers for Families and Children announced their affiliation this afternoon. The boards for the two organizations each voted unanimously last week to team resources. (Higgs, 11/1)

Partners HealthCare’s expansion plans suffered a setback Wednesday after a state watchdog agency warned that health care costs for consumers would rise significantly if Partners is allowed to acquire the specialty hospital Massachusetts Eye and Ear. The Health Policy Commission said Partners, the state’s largest health care network, is likely to seek higher reimbursements for care by Mass. Eye and Ear and its doctors if the deal goes through. (Dayal McCluskey, 11/1)

The proposed merger of Massachusetts Eye and Ear and Partners HealthCare would increases costs for consumers and businesses in the state by $20.8 to $61.2 million a year, according to a preliminary report from the Massachusetts Health Policy Commission. The lower estimate, $20.8 million, assumes Mass. Eye and Ear rates would rise to those paid Partners' community hospitals. (Bebinger, 11/1)

Owens & Minor Inc. announced the largest acquisition in the company’s history on Wednesday — a $710 million cash deal to buy the surgical and infection prevention business of Georgia-based Halyard Health Inc. ...The acquisition comes as Owens & Minor has been looking for ways to offset pricing and margin pressures in the health care supply industry that have hurt its financial results and weighed on its stock price, along with the loss in 2016 of a large contract with managed care provider Kaiser Permanente. (Reid Blackwell, 11/1)

The sale of Girard Medical Center, part of the bankrupt North Philadelphia Health System, is now expected to be completed by Nov. 30, a month later than the original closing deadline, attorneys told U.S. Bankruptcy Judge Magdeline D. Coleman Wednesday. Terms of the August sale agreement called for the buyer, Iron Stone Real Estate Partners, to reach an agreement to lease the property to the city, which in turn is expected to hire a unit of NHS Human Services to run drug-treatment and behavioral-health operations at the 801 W. Girard Ave. facility. Iron Stone agreed to pay $8.5 million. (Brubaker, 11/1)

The University of Kansas Health System and Nashville-based Ardent Health Services announced Wednesday that they have completed the purchase of St. Francis Health in Topeka. St. Francis Health became a focal point of the Medicaid expansion debate in Kansas earlier this year, as sources said the state’s decision not to expand eligibility for the program complicated negotiations with potential buyers. The 378-bed Topeka hospital and medical clinics were near closure before KU Health System and Ardent partnered for the purchase. (Fox, 11/1)

Officials in Imperial Beach said Wednesday that sewage flowing up the coast from Tijuana fouled miles of shoreline over the weekend, severely sickening surfers and other beachgoers. Mayor Serge Dedina, who also fell ill, said he received no advance notice from officials in Mexico about the pollution. (Smith, 11/1)

It’s time to select a health insurance plan for 2018! Whether we get covered through an employer or the Affordable Care Act exchanges, we’ll be told to carefully review our options to find a plan that will give us the best coverage for the least amount of money. We will be told we need to shop. (Helaine Olen, 11/2)

Republican lawmakers have shown us that they don’t really care about helping people get quality, affordable health care, or even helping them keep it for that matter. ...A month ago, the GOP leadership allowed the Children’s Health Insurance Program (CHIP) to expire. (Joni Ashbrook, 11/2)

Americans have opposed the Trump administration in many ways, from taking to the streets to leaving Congress. Here’s a more practical form of protest: obtaining health insurance. (11/1)

Thanks to careful planning, the vast majority of the 1.4 million enrolled in Covered California plans will be able to find affordable health insurance plans for 2018. Covered California Executive Director Peter Lee says 78 percent of the program’s enrollees can expect to see their costs actually decrease next year. (11/1)

It is generally assumed that the biggest obstacle to a national health plan like Medicare for All will be the large tax increase needed to pay for it. But new polling shows another challenge: Almost half of the American people don't know that they would have to change their current health insurance arrangements if there was a single-payer plan. (Drew Altman, 11/2)

As he tells it, Senator Bernie Sanders of Vermont fell in love with the Canadian health system 20 years ago when he brought a busload of his constituents across the border to buy cheaper prescription drugs. Now he wants to make Americans fall in love with his proposal to make the United States system a lot more like Canada’s. (Margot Sanger-Katz, 11/1)

The big news in health care last week was the disclosure that CVS Health — owner of a vast network of drugstores — is considering buying Aetna, one of the nation’s largest health insurers, for roughly $66 billion. It’s undeniably important, but why? (Robert J. Samuelson, 11/1)

Sen. Matt McCoy and Rep. John Forbes are exactly right. Iowans who cannot find affordable, private health insurance should be able to buy into Medicaid coverage. The proposal, unveiled last week by the two Democratic state lawmakers, is especially welcome now, as the state’s individual private insurance market is faltering. (11/1)

Albert Lasker, considered the “father of modern advertising,” transformed product marketing from an endeavor based on the simple presentation of facts to one finely tuned to consumer psychology, particularly as it pertained to women. At a time when discussion of menstruation was taboo, for example, Lasker helped launch the Kotex brand by convincing popular magazines that women were eager to receive information about menstrual products. ... he joined the board of what was then called the American Birth Control League and suggested that the organization would garner broader public acceptance if it called itself “Planned Parenthood” instead. It seems fitting that some 75 years later, the Lasker Foundation, started by Albert and his wife to honor outstanding achievements in health, gave Planned Parenthood the Lasker–Bloomberg Public Service Award for a century’s worth of essential contributions to women’s health. (Lisa Rosenbaum, 11/1)

Recently, the media have devoted increasing attention to maternal mortality in the United States, as in a ProPublica and National Public Radio article describing the devastating death of a nurse shortly after her first child was born. These reports have heightened public awareness of grim realities that have been on obstetricians’ minds for years: that the rate of maternal death in the United States is higher than rates in most other high-income countries; that this rate has been rising over the past two decades; and that there are profound racial, ethnic, and socioeconomic inequities in women’s risk of dying during or soon after pregnancy. Despite this increased awareness, issues surrounding maternal mortality have been notably absent from most health care policy debates. (Rose L. Molina and Lydia E. Pace, 11/2)

A pregnant girl or woman who shows up at a pregnancy counseling center, often in crisis, needs to know the full range of her options. But before the Reproductive FACT Act became law in 2015, most were getting an antiabortion polemic, and nothing else. The FACT Act required state-licensed pregnancy counseling centers to do one more, relative minor thing: post or provide a specifically worded notice to patients informing them about public programs that provide free or low-cost access to family planning services, including prenatal care and abortion. (11/2)

The University of Notre Dame, which once reigned as a beacon of liberal Catholic thought, has announced that it will cancel all birth-control coverage for students and employees next year. That includes contraception provided to those recipients for free, under government auspices and at government expense. Notre Dame thus becomes the first and most important employer publicly to take advantage of the Trump administration’s Oct. 6 rollback of contraceptive coverage under the Affordable Care Act. (Michael Hiltzik, 11/1)

The ravages of advanced HIV infection, the nearly-forgotten news items of the 1980s like PCP — Pneumocystis pneumonia -- and Kaposi Sarcoma, are still afflicting those diagnosed late, even if this fact is no longer news. In the last few years we have learned that taking HIV medications early in infection decreases not only these advanced-HIV-related illnesses, but also the risk of some cancers, cardiovascular disease, and renal and liver problems. (Shiva Saboori, 11/2)

I asked my friend, Mary Neubauer, to send me some thoughts this week in connection with the announcement of a gubernatorial candidate forum on mental health. It was the story of her 18-year-old son, Sergei, that inspired this effort to elevate mental health as a priority for our state. (Kathie Obradovich , 11/1)