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Presidential hopeful Sen. Bernie Sanders (I-Vt.) pledged to undo all of President Trump's executive actions on immigration on day one of his presidency, as part of his detailed immigration policy plan released Thursday. Sanders, currently polling among the top three candidates vying for the Democratic nomination, vowed to move quickly on changes that don't require congressional action, starting with a moratorium on all deportations until an audit of U.S. immigration enforcement policies is conducted. (Bernal, 11/7)

Like other contenders for the party’s 2020 nomination, Sanders would decriminalize border crossings and provide a pathway to citizenship for roughly 11 million people without legal residency in the country. But he also went further, pledging to temporarily halt all deportations, end federal immigration raids and break up two federal agencies, Immigration and Customs Enforcement and Customs and Border Protection, that have been at the forefront of President Trump’s family separation policy. (Ulloa, 11/7)

Sanders’ plan calls for broadening President Barack Obama’s clemency program to shield the estimated millions of immigrants who have lived undocumented in the United States for more than five years from the threat of deportation. Sanders would pause all deportations until the federal government audits its immigration practices. (Newshauser, 11/7)

Under his "A Welcoming and Safe America for All" plan, the Vermont independent indicated for the first time that he will reverse guidance from the Trump administration's Department of Justice and permit asylum claims from those fleeing domestic or gang violence. Sanders would also overturn Trump's so-called "public charge" rule and ensure that immigrants are not discriminated against based on income or disability, while extending temporary protected status until more permanent resolutions are in place, invalidating Trump's efforts to end those designations. (Grayer, 11/7)

Sanders also says his signature universal health-care plan, “Medicare for All,” would “provide comprehensive care to everyone in America,” regardless of immigration status. (Pramuk, 11/7)

Sanders says he would end detention for essentially every migrant without a violent criminal conviction. The Vermont senator would fund “community-based alternatives to detention” that would give migrants access to legal resources and health care. Sanders says he would break apart the Homeland Security Department entirely — including Immigration and Customs Enforcement and Customs and Border Protection — and distribute the responsibilities among the Justice, Treasury and State departments. He says he would extend DOJ anti-profiling guidance to border areas and eliminate the use of DNA testing and facial recognition for enforcement. (Kullgren, 11/7)

“If you open the borders, my God, there’s a lot of poverty in this world, and you’re going to have people from all over the world,” Sanders said at an April town hall in Iowa. “And I don’t think that’s something that we can do at this point. Can’t do it.” (Narea and Golshan, 11/7)

Trump has made cracking down on illegal immigration a centerpiece of his presidency and accuses Democrats of supporting "open borders." ICE has stepped up its activities, arresting more than 2,300 people in the 2018 fiscal year, compared with just over 300 the year before. (Lewis, 11/7)

Voters in Virginia and Kentucky sent a clear message on health care Tuesday night: Medicaid expansion and preexisting conditions are winning issues for Democrats, even as President Donald Trump and his allies try to undercut Obamacare. And strident GOP attacks on abortion weren’t enough to stave off Republican losses. Democrat Andy Beshear, who claimed victory in Kentucky’s tight gubernatorial race, and Virginia Democrats who took back control of the state legislature promised to defend Obamacare’s popular insurance protections for preexisting conditions, and they railed against Republican plans to contract the law’s expansion of Medicaid to millions of poor adults. (Pradhan, 11/6)

Democratic victories in Tuesday’s elections marked a significant setback for the Trump administration’s efforts to impose Medicaid work requirements at the state level. By flipping the legislature in Virginia, coupled with an apparent win in Kentucky’s gubernatorial race, Democrats can now block GOP plans to tie Medicaid benefits to employment. (Hellmann, 11/6)

If Tuesday’s elections served as a referendum on health care — Medicaid expansions and work requirements were on the line in Virginia, Kentucky and Mississippi  — then a number of voters sent a clear message: They want expanded access to health care in their states. In Kentucky, incumbent Republican Gov. Matt Bevin appears to have narrowly lost to his Democratic challenger, Attorney General Andy Beshear. Bevin has not conceded the race. (Henney, 11/6)

Throughout the 2019 election season, three issues kept surfacing in debates, ads and speeches — expanding Medicaid, increasing the gas tax, and raising teacher pay. Now that the elections are over, which of these issues can Mississippians expect their newly elected leaders to tackle? (Bologna, 11/7)

The outcomes of state races in Kentucky and Virginia could have implications for Medicaid and abortion policy. Democrats declared victory in the Kentucky governor's race and both Virginia state houses flipped to that party's control, delighting abortion-rights groups and opponents of Medicaid restrictions. In a close gubernatorial race, Kentucky Attorney General Andy Beshear, a Democrat, appeared to edge out current Republican Gov. Matt Bevin. Bevin did not concede, though, and called for a recount. (Raman, 11/6)

Gun control in the home state of the National Rifle Association. Passage of the Equal Rights Amendment in a legislature that used to run like an old boys’ club. Climate legislation, in a state once defined by coal. A day after winning control of the General Assembly for the first time in a generation, Virginia Democrats were making big plans to use the new power they will consolidate with Gov. Ralph Northam (D). (Schneider and Vozzella, 11/6)

Sen. Elizabeth Warren’s colleagues aren’t exactly jumping to voice support for her plan to finance "Medicare for All." The hesitation from rank-and-file Democrats across the political spectrum on backing the Massachusetts Democrat’s plan shows how fraught the issue is within the party – and how challenging it would be for a Democratic White House to shepherd a plan through Congress. Just 14 senators, including Warren, have co-sponsored Medicare for All legislation (S 1129) from Sen. Bernie Sanders, I-Vt., another White House hopeful, while half of House Democrats back a similar measure (HR 1384). (McIntire, 11/7)

More than 177,000 people signed up for ObamaCare plans during the first two days of open enrollment, according to numbers released Wednesday by the Trump administration. Nov. 1 marked the first day of open enrollment on healthcare.gov, the federal government’s enrollment platform used by 38 states. Of the 177,082 people who selected plans on healthcare.gov Friday and Saturday, nearly 49,000 were new customers. (Hellmann, 11/6)

You might know by now that Medicare’s annual open enrollment is underway and ends Dec. 7. So do scammers. Every fall, when the program’s 60 million or so beneficiaries can make coverage changes for the next year, criminals tend to step up their game, experts say. It could involve a person pretending to be a Medicare representative, a fraudulent provider trying to prescribe you medical equipment or services, or any other undertaking with the goal of stealing your personal information or your money. (O'Brien, 11/4)

A federal judge on Wednesday voided the Trump administration’s “conscience rule,” which would have made it easier for health care workers to avoid assisting with abortion or other medical procedures on religious or moral grounds. Hospitals, insurance companies or local governments that violated their employees’ rights under the rule could have faced a loss of federal funds. (Weiser and Sanger-Katz, 11/6)

U.S. District Judge Paul Engelmayer in Manhattan said the "conscience" rule was unconstitutionally coercive because it would let the U.S. Department of Health and Human Services (HHS) withhold billions of dollars of funding from hospitals, clinics, universities and other healthcare providers that did not comply. "Wherever the outermost line where persuasion gives way to coercion lies, the threat to pull all HHS funding here crosses it," Engelmayer wrote in a 147-page decision. (Stempel, 11/6)

“The court’s finding that the rule was promulgated arbitrarily and capriciously calls into question the validity and integrity of the rulemaking venture itself,” U.S. District Judge Paul Engelmayer wrote in his decision. “Indeed, the Court has found that HHS’s stated justification for undertaking rulemaking in the first place—a purported ’significant increase’ in civilian complaints relating to the conscience provisions—was factually untrue.” (Armour, 11/6)

Two sets of arguments underpinned the plaintiffs' case. One was procedural: that the "Conscience Provisions" to which Engelmayer referred -- stipulations in several existing laws that aimed to protect against religious discrimination on the job, which HHS claimed as its statutory authority -- don't give HHS the authority "to promulgate regulations with the force of law, or to withhold all federal funds for violating such laws," as the judge put it in summarizing the plaintiffs' arguments. Additionally, the administration's process for developing the rule failed to follow established procedures and violated a number of other statutes, including the Affordable Care Act. The other set was constitutional. One of these was grounded in the First Amendment, in that the rule requires employers "to conform their business practices to the religious practices of their employees." (Gever, 11/6)

The National Family Planning & Reproductive Health Association and Public Health Solutions, the plaintiffs in the suit, said the rule would force providers to employ individuals who refuse to perform essential job functions, without regard for the well-being of patients or public safety. For instance, they argued, a hospital receptionist could refuse to schedule an appointment for a patient seeking gender dysphoria treatment, or an orderly could refuse to transfer a patient to the operating room for an emergency abortion. (Meyer, 11/6)

Many physician and health advocacy groups contended that the rule would have disproportionately harmed certain groups of patients, including LGBTQ patients. “We are heartened by today’s ruling, and we will not stop fighting to prioritize patients’ need for standard medical care over health-care personnels’ personal religious or moral beliefs,” the National Family Planning and Reproductive Health Association said in a statement. (Abutaleb, 11/6)

The ruling is part of an ongoing series of legal battles as administration officials boost socially conservative policies in federally funded health programs. The most high-profile example is the Title X family planning program, where Planned Parenthood is fiercely fighting new restrictions that have prompted the clinics to withdraw from the program. HHS spokesperson Caitlin Oakley said the agency along with the Justice Department is reviewing the court's opinion, "so will not comment on the pending litigation at this time." Backers of the rule say it protects health care workers from having to violate their personal beliefs. (Luthi, 11/6)

Complaints of such violations are relatively rare — for a decade, the office would receive an average of one complaint like this each year. Severino frequently pointed to a jump in those complaints to 343 last year as proving the need for this rule. He attributed that increase to a strong message from his office that they were "open for business" when it came to issues of religious freedom. However, that increase in the number of complaints is "demonstrably false," according to Engelmayer's ruling. Nearly 80% of all the complaints given to the court were about vaccinations — unrelated to health care workers and their religious beliefs in providing care. (Simmons-Duffin and Dwyer, 11/6)

The so-called conscience rule, which was slated to go into effect on November 22, has drawn eight challenges across four different federal district courts filed by a slew of states and reproductive health groups. Reproductive rights advocates argue that the rule would hurt those seeking reproductive care and in the LGBTQ community, with the idea of religious liberty used to justify endangering patients. (Kelly, 11/6)

The Trump administration had touted the rule as important protection for people’s religious beliefs, specifically citing abortion. “This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life,” Department of Health and Human Services official Roger Severino said when the rule was proposed in May. (Sullivan, 11/6)

Lawmakers and legal groups were quick to respond to the ruling Wednesday. “This decision is absurd mush. The point of the First Amendment — especially the free exercise of religion — is to protect the conscience rights of Americans,” said Sen. Ben Sasse, R-Neb., a Senate Judiciary Committee member. “The Trump Administration ought to defend basic conscience rights all the way to the Supreme Court.” First Liberty Institute, a religious liberty legal organization, similarly slammed the ruling. (Raman, 11/6)

A federal judge has ruled that the government must provide mental health services to thousands of migrant parents and children who experienced psychological harm as a result of the Trump administration’s practice of separating families. The decision, issued late Tuesday, marks a rare instance of the government being held legally accountable for mental trauma brought about by its policies — in this case, border security measures that locked thousands of migrant parents in detention while their children were placed in government shelters or foster homes. (Jordan, 11/6)

Federal regulators are expected to announce a ban on electronic cigarette flavors other than tobacco and menthol within days, although it's unclear if mint flavors will be allowed or reformulated as menthol. Another possible exemption could be vaping products sold in vape stores rather than convenience stores, which is where the under-aged youth who are the focus of the ban often shop. (O'Donnell, 11/6)

The Trump administration may exempt vape shops when it unveils expected restrictions on e-cigarette flavors, White House adviser Kellyanne Conway said. Speaking at the White House on Wednesday, Conway drew a line between two groups of flavors -- tobacco and menthol on one side, and mint, fruit and all other flavors on the other. The latter group appeals to kids and the White House must address use by minors, she said. (Wingrove and Porter, 11/6)

Legislators from both parties are seeking to set the age to buy tobacco and vaping products at 21. Now, people have to be 18 to buy tobacco and nicotine products. There is no minimum age to buy vaping products that don't have nicotine. (Marley, 11/6)

For decades a chemical used to sterilize medical devices and surgery tools has been the only option to ensure safe devices for billions of critical health care procedures. But the chemical, ethylene oxide, has been shown to cause cancer, and growing panic among people living near plants that sterilize medical devices has led to a major crackdown and the shutdown of the factories in several states. (Karlin-Smith, Snider and Owermohle, 11/7)

New data released by EPA Wednesday indicate that Americans across the country have been exposed to levels of a cancer-causing gas that, over a lifetime, would put their risk of cancer far higher than what EPA deems acceptable. In effect, residents of communities from Phoenix to Seattle to rural Kentucky may be experiencing a 1 in 1,000 risk of developing breast cancer, leukemia and other cancers, according to new data that measured concentrations of the gas ethylene oxide at 18 sites across the country. (Snider, 11/6)

Nakiya Wakes could not understand how her wiry, toothy-grinned 6-year-old had gone from hyperactive one school year to what teachers described as hysterical the next. Then, in 2015, the state of Michigan delivered a diagnosis of sorts: Ms. Wakes’s neighborhood’s water — which her son, Jaylon, had been drinking and bathing in for more than a year — was saturated with lead, at some of the highest levels in the city. Jaylon would cycle through two schools, receive 30 suspensions and rack up 70 unexcused absences. (Green, 11/6)

Some District residents qualify for financial assistance from the city to cover part or all of the cost of replacing their lead water pipes under a new program aimed at completing lead service line replacements in about 12,000 homes. The program covers homes where D.C. Water already has replaced the part of the lead service line, which connects homes to the water main, on public property. Those residents may apply for financial aid to replace the rest of the lead line between the property line and their home with safer copper pipe, D.C. Water officials said Wednesday. (Shaver, 11/6)

A health program for veterans that President Trump heralds as a triumphant success is struggling to make its network of doctors as large as required to meet an aggressive expansion of care outside the Department of Veterans Affairs health facilities, officials said. The company managing the new program in a majority of the states said it would probably need millions of dollars more to meet the plan’s coverage goals. Under a new law, known as the Mission Act, veterans who need to drive for at least 30 minutes to a government-operated veterans hospital — rather than 40 miles under old standards — can receive primary care and mental health services outside the department’s traditional system. (Steinhauer, 11/6)

Apple Inc on Wednesday said that U.S. military veterans who use its iOS devices and get medical care from the Veterans Health Administration will be able to access their health records on the devices. The Department of Veterans Affairs runs the largest integrated healthcare system in the United States, with 9 million veterans enrolled and more than 1,200 facilities. Apple began working with the department this summer to allow access to health records from the system on iPhones and other Apple mobile devices running its iOS operating system. (11/6)

More than a year after performing the world's most extensive penis transplant, doctors say their patient has recovered and reports "feeling whole" again. The U.S. veteran lost both legs and his genitals from a blast in Afghanistan. Last year, Johns Hopkins University surgeons rebuilt the man's pelvic region, transplanting a penis, scrotum and part of the abdominal wall from a deceased donor. (11/6)

For the rest of his life, the man will almost certainly take anti-rejection medication, making him more vulnerable to infections, kidney problems and certain cancers. And he cannot father biological children: ethical considerations forbade the transfer of testes, which would have generated semen bearing the DNA of his deceased donor. Still, for a young man whose injuries were too extensive for conventional reconstructive surgery, having an external appendage that feels and works like the one he had “is a big deal,” said Dr. Richard Redett, the transplant surgeon who led a team of roughly 35 medical professionals in a 14-hour operation. (Healy, 11/6)

Connecticut prison inmate Daniel Elliot says he didn't feel comfortable talking about his problems until he met Hank and Sparky — who happen to be horses. Elliot suffered a traumatic brain injury during an accident while serving on an attack submarine in the Navy. He is serving time for a 2017 arson, which he says he committed in an effort to kill himself inside his Norwich apartment. (11/6)

Results from a new clinical trial of active-duty service members have shown that an injection in the neck called stellate ganglion block, or SGB, is an effective treatment for post-traumatic stress disorder. The Army-funded trial shows that SGB injections reduced PTSD symptoms at a rate about twice that of a placebo. JAMA Psychiatry published the results Wednesday. "Finally, we have the definitive randomized controlled trial to demonstrate that stellate ganglion block not only works, but works well enough to be incorporated across the board into PTSD treatment plans," said U.S. Army physician Colonel Jim Lynch. (Abbott and Polevoy, 11/6)

The Trump administration on Wednesday sued Gilead Sciences, a pharmaceutical company that sells H.I.V.-prevention drugs that can cost patients up to $20,000 a year, accusing the company of earning billions from research funded by taxpayers without paying taxpayers back. The government said the company infringed upon patents owned by the Department of Health and Human Services, and had refused attempts by the department to license its patents and collect royalties. The company sells two drugs, Truvada and Descovy, that can be taken once daily to prevent H.I.V. infection, a strategy called pre-exposure prophylaxis, or PrEP. (Victor, 11/7)

In a news release Wednesday night, HHS said Gilead had ``willfully and deliberatively induced infringement of the HHS patents.’’ The department said as a result, ``Gilead has profited from research funded by hundreds of millions of taxpayer dollars and reeped billions from PrEP’’ through the sale of Truvada and a newer Gilead drug, Descovy. Despite efforts by the government to reach an agreement, the department said, ``Gilead has repeatedly refused to obtain licenses for the use of the HHS patents.’’ (Rowland, 11/6)

A new version of the Senate Finance Committee’s sweeping drug pricing bill may include some tweaks, but will not back off on a provision limiting prices to inflation rates, Chairman Charles E. Grassley said Wednesday. The Iowa Republican did not say when the new bill would be released, but it will likely include sweeteners for reluctant GOP members as Grassley works to build support within the party. (Clason and McIntire, 11/6)

To the average observer, the Alzheimer’s Drug Discovery Foundation couldn’t be further from achieving its mission of finding a treatment or cure for Alzheimer’s. But the group’s executive director, Dr. Howard Fillit, tells a different story. (Florko, 11/7)

Regeneron Pharmaceuticals yesterday announced it would spend $1 billion buying its own stock, a move that was both unremarkable and remarkable at the same time. Stock buybacks, like patent thickets and price increases, are pretty de rigueur in the drug industry, after all. But not so for Regeneron. As Piper Jaffray analyst Christopher Raymond described the move: “Not as dramatic as hell freezing over, but it’s close.” (Garde, 11/6)

In the wake of controversy over a Sanofi (SNY) dengue vaccine, Takeda (TAK) Pharmaceuticals is betting its own effort will meet a largely unmet medical need and, in the process, become a best-selling product. But preliminary results released on Wednesday suggest the company has more work to do to ensure its vaccine does not encounter the same problems that have hobbled its rival. A key hurdle Takeda must clear is to demonstrate that its own vaccine is not hindered by an issue that has clouded Sanofi’s Dengvaxia vaccine, which can actually make future cases of the mosquito-borne virus more severe in people who were not previously infected. (Silverman, 11/6)

Massachusetts Senate leaders on Thursday will propose new legislation they say targets the high cost of prescription drugs, giving state officials the power to study and propose what they consider fair values for expensive medicines. The bill — the Senate’s first major foray into a broader debate on Beacon Hill over health care — also would cap out-of-pocket costs for insulin, the lifesaving drug used by many patients with diabetes. (Dayal McCluskey and Stout, 11/7)

Pharmacy giant CVS Health on Wednesday touted the strong performance of its first HealthHUBs, the stores it launched earlier this year to help patients better manage their health in between doctor appointments. The three pilot hubs it opened in Houston in February have so far "outperformed their control group," delivering higher prescription volumes and MinuteClinic visits, as well as higher front-of-store sales, traffic and margins, CVS CEO Larry Merlo told investment analysts during the company's third-quarter earnings call on Wednesday. (Livingston, 11/6)

CVS Health revenue surged in the third quarter as the drugstore chain and pharmacy benefits manager added health insurance and pushed ahead with a plan to change how many of its stores operate. The company said Wednesday its roughly $69 billion acquisition of the insurer Aetna helped its top line climb 36% in the quarter while earnings rose 10%. (11/6)

CVS Health Corp reported higher-than-expected third-quarter profit on Wednesday as medical costs in its Aetna health insurance business came in below forecasts, and the company said its new strategy of using in-pharmacy clinics would contain healthcare spending going forward. Shares of CVS, which runs a national drugstore chain, rose more than 5%, as its pharmacy benefits business also posted better-than-expected operating profit. (11/6)

CVS said its pharmacy-services business, which offers pharmacy benefit services to employers, health plans and employee groups, recorded revenue of $36.02 billion in the quarter, up about 6% versus a year ago. Its retail business, filling prescription medications and selling a range of merchandise, saw revenue increase 3% to $21.47 billion. Prescription volumes grew 6.4% from a year earlier. (Thomas, 11/6)

A surgeon has implanted electrodes in the brain of a patient suffering from severe opioid use disorder, hoping to cure the man’s in­trac­table craving for drugs in the first such procedure performed in the United States. The device, known as a deep brain stimulator, is designed to alter the function of circuits in the man’s brain. It has been used with varying degrees of success in the treatment of Parkinson’s disease, dystonia, epilepsy, obsessive-compulsive disorder and even depression. It is seen as a last-resort therapy after the failure of standard care, such as medication that reduces the craving for drugs. (Bernstein, 11/6)

Bankruptcy scholars on Tuesday called for an independent probe of the Sackler family’s dealings with OxyContin maker Purdue Pharma LP, which sought court protection from an avalanche of lawsuits over the opioid epidemic. “The extraordinary public interest in these cases warrants a targeted bankruptcy examination,” law professors Jonathan Lipson, Adam J. Levitin and Stephen J. Lubben wrote in a letter to federal watchdogs overseeing the drugmaker’s bankruptcy. (Brickley, 11/6)

Chinese authorities on Thursday handed severe sentences to members of a fentanyl production ring in an overt show of commitment toward tackling an issue at the heart of President Trump’s criticisms of China. Central government officials invited foreign media to a court in northern Hebei Province where officials announced the arrest of 20 people and the closure of two online shops selling the synthetic opioid, which U.S. public health officials say is responsible for killing more Americans in overdoses than any other drug. (Shih, 11/7)

First lady Melania Trump visited a Boston hospital Wednesday that uses cuddling to help infants born dependent on drugs or alcohol. The first lady met with caregivers and administrators at Boston Medical Center and told them she's "very focused" on their pioneering work with babies born with neonatal abstinence syndrome. (LeBlanc, 11/6)

More people waiting for a permanent place in the state’s substance use disorder (SUD) treatment system will have access to respite care services as the state on Wednesday approved contracts to double the number of respite beds. Gov. Chris Sununu said the contracts the Executive Council approved should help lessen the demand for services in Manchester that until this point had been the only place to have these beds, 15 of them that the Farnum Center operates. (Landrigan, 11/6)

Behind Google’s $2.1 billion deal for wearables maker Fitbit Inc. FIT -0.42% is the search giant’s dream to become a major player in health data after a failed attempt to establish a foothold in it years ago. Big technology companies have long been tantalized by the promise of devices like smartwatches and wireless earbuds to collect a wealth of real-time user data on heart rates, body temperature and the like. Makers of these wearable products sometimes share that data, though they aren’t particularly transparent with whom. Fitbit’s privacy policy says it works with unnamed “partners who provide us with analytics and advertising services” as well as third-party apps. (Needleman and Copeland, 11/6)

The DNA-testing firm Veritas Genetics experienced a security breach that included customer information, the startup said. Veritas, which sells whole-genome sequencing for $599, said it became aware that a customer-facing portal had been “recently” accessed by an unauthorized user. The company said that the portal didn’t contain genetic data, DNA-test results or health records. (Brown, 11/6)

Doctors have for the first time in the United States tested a powerful gene-editing technique in people with cancer. The test, meant to assess only safety, was a step toward the ultimate goal of editing genes to help a patient’s own immune system to attack cancer. The editing was done by the DNA-snipping tool Crispr. (Grady, 11/6)

The treatment deletes three genes that might have been hindering these cells' ability to attack the disease, and adds a new, fourth feature to help them do the job. "It's the most complicated genetic, cellular engineering that's been attempted so far," said the study leader, Dr. Edward Stadtmauer of the University of Pennsylvania in Philadelphia. "This is proof that we can safely do gene editing of these cells." (11/6)

Stadtmauer stresses that the trial was not designed to determine whether the approach actually works — only whether it is safe and feasible. "This treatment is not ready for prime time," he says. "But it is definitely very promising."Other researchers agree. "I'm just so excited about this," says Jennifer Doudna of the University of California, Berkeley, who contributed to the discovery and development of CRISPR techniques. (Stein, 11/6)

The disparities are staggering: A growing body of research suggests that transgender teens experience suicidal thoughts and attempt to take their own lives far more often than their cisgender peers. But in many studies and surveys on adolescent mental health, transgender teens are lumped together in one big group. A transgender teen boy is treated the same, in terms of the research, as a non-binary teen who was assigned male sex at birth, or as a transgender girl. Many other studies and surveys don’t ask about gender identity at all. (Thielking, 11/7)

Despite an uptick in the number of child psychiatrists nationwide, one out of five U.S. children live in a county with no such provider, according to a study published this week in the journal Pediatrics, which also found that those specialists are largely concentrated in certain pockets of the country. Meanwhile, for various reasons, only half of U.S. children with a mental health condition are receiving treatment. (Santhanam, 11/6)

The health of millennials is deteriorating more rapidly than older generations’ did, and that could have a devastating effect on the economy, according to a new report by Moody’s Analytics and the Blue Cross Blue Shield Association. The report, released Wednesday, paints a dismal picture of how the 2009 economic recession affected millennials’ health. ...Now ages 23 to 38, millennials suffer from higher rates of physical ailments, such as hypertension and high cholesterol, as well as behavioral health problems such as depression when compared with the generation before them. (Gantz, 11/7)

According to the World Health Organization, burnout is a workplace issue. But just because burnout can happen at work or because of work, doesn’t mean how you use your time outside of work can’t help prevent it. As a time management coach, I’ve seen that at the core, burnout prevention is about living out what is true about your body, your personality and your reality. You don’t need a dream job. But in your overall life, you do need to find time to take care of your health, do things you find refreshing and have a sense of purpose. The closer you are to living your truth, the less likely you are to burnout. (Saunders, 11/6)

At 66, Bob Karger was losing language. It was not the tip-of-the-tongue feeling that melts when you recall a sought-after word. He had lost the connection between sounds and meaning — the way ba-na-na recalls a soft, yellow fruit or ea-gle calls to mind a large bird of prey. In a recent conversation, he had thought acorns grew on pine trees. Mr. Karger did not know how to use items around the house, either. When he picked up a can opener, he would not realize it could remove the top from a tin. If he held a hammer, he might grasp it by the head, turning it around in his palm, not knowing he could swing it into a nail. His world was filled with incomprehensible items. (Peskin, 11/7)

Scientists using advanced DNA sequencing technology have documented a previously unidentified strain of HIV under the group that is responsible for the vast majority of human infections. The previous strain in that group was documented in 2000. The latest strain was found in just three people, but the findings by Abbott Laboratories ABT 0.95% —a maker of HIV tests—are expected to strike up a broader conversation about how to classify new viral strains that could surface. The company described its findings on Wednesday in an academic journal. (Rana, 11/6)

Do you suffer from insomnia? You may be more likely to suffer a heart attack or stroke or develop heart disease, according to a new study published Wednesday. "This is probably one of the larger studies that have been published so far on the connection between insomnia and cardiovascular risk," said Harvard professor and neurologist Dr. Natalia Rost, chief of the stroke division at Massachusetts General Hospital in Boston. (LaMotte, 11/6)

Known for years as the annual Femicide Report, it started in 1989 as a way to fill in a gap in reporting gender-bias violence against women and girls. There was no other state or national group collecting this kind of data at the time, and to this day no state agency collects comparable data. (Bierschback, 11/7)

Everything was going really well for the men of Tennessee Street. Women wanted to talk to them, investors wanted to invest, their new site got traffic, phones were buzzing, their Magic: The Gathering cards were appreciating. This all was exactly the problem. They tried to tamp the pleasure. They would not eat for days (intermittent fasting). They would eschew screens (digital detox). It was not enough. Life was still so good and pleasurable. (Bowles, 11/7)

Native Americans are more likely than any other group to have diabetes, and Sharon Day wants to start addressing the problem early — really early. Day is executive director of the Indigenous Peoples Task Force in Minneapolis, which is preparing to release a baby food next year under the brand name Indigi-Baby. It will be made from traditional Native American ingredients like wild rice, Gete-Okosomin squash and rutabaga. (Nesterak, 11/6)

Kaiser Health News: When Caring For A Sick Spouse Shakes A Marriage To The Core

For a dozen years, Larry Bocchiere, 68, didn’t find it especially difficult to care for his wife, Deborah, who struggled with breathing problems. But as her illness took a downward turn, he became overwhelmed by stress. “I was constantly on guard for any change in her breathing. If she moved during the night, I’d jump up and see if something was wrong,” he said recently in a phone conversation.  “It’s the kind of alertness to threat that a combat soldier feels. I don’t think I got a good night’s sleep for five years. I gained 150 pounds.” (Graham, 11/7)

Many antibacterial cleaning solutions and sanitizers specifically target bacteria, which could clear space for other kinds of microbes to flourish. Fungi also have thick cell walls, which may make them harder to kill. (Huang, 11/6)

A mile from Apple’s headquarters in Cupertino lies the sun-faded carcass of the Vallco Shopping Mall. At the moment it consists of empty, buff-colored buildings, acres of black asphalt and a pile of rubble where the parking garage used to be. About a year ago, a developer submitted a proposal to build 2,400 apartments on the site, half of them subsidized to put rents below the market rate. The city approved the plan reluctantly, and afterward a community group sued. The project is stuck in court. (Dougherty, 11/6)

TennCare officials want to dramatically expand postpartum health insurance for thousands of low-income women in response to a slew of "preventable" deaths of new mothers who timed out of existing coverage. Currently, low-income women are eligible for TennCare coverage for two months after giving birth. TennCare Deputy Director Stephen Smith revealed during a budget hearing on Wednesday that the agency hopes to expand this coverage to one year. (Kelman, 11/6)

Ohio lawmakers already passed one of the most restrictive abortion bans in the nation this year. But they're not done regulating the procedure. While courts decide whether Ohio can ban abortions after a fetal heartbeat is detected or following a Down syndrome diagnosis, abortion opponents have found new ways to penalize doctors who perform the procedure. (Balmert, 11/6)

The news came in September: Long Beach Residential, a 49-bed home for adults who are mentally ill, was being sold. The residents of the converted apartment building, some of whom had lived there for decades, would have 60 days to move. It’s a scenario that is becoming increasingly common across California, brought on by a combination of an inadequate state funding system and California’s red hot real estate market. (Smith, 11/6)

After a tumultuous year in which a self-dealing scandal prompted the resignation of the University of Maryland Medical System’s leadership, the hospital network said Wednesday it has promoted Dr. Mohan Suntha to become its chief executive officer. Suntha ― known for helping St. Joseph Medical Center recover after its star cardiologist was accused of placing unnecessary stents in patients and for facing the media after one of the system’s Baltimore hospitals was condemned for “patient dumping” ― will now try to right the overall organization after the board of directors scandal that resulted in the resignation of Baltimore’s mayor. (Broadwater, 11/6)

Alethea Brown learned she took a $10,700 genetic test when the charges appeared in a statement from her insurer, she said.Brown was never told that her psychiatrist needed her DNA and no one from his office counseled her on the test results, she said. She thought the mouth swab she received Jan. 9 was to check how much medication remained in her body.What’s more, a consent form Brown was supposed to sign lacks her signature. And whoever wrote in her name in looping script misspelled it. (Mariano, 11/6)

The CMS on Wednesday approved Washington, D.C.'s request to essentially waive a longstanding federal rule that prohibited reimbursing behavioral healthcare and substance use disorder services performed in large residential psychiatric institutions and treatment centers. D.C. becomes the first Medicaid program in the country to score approval for a demonstration that will use federal Medicaid money to pay for treatment of patients with severe mental illness in "Institutions for Mental Diseases", which Medicaid currently prohibits under its exclusion payment rule. (Johnson, 11/6)

Spending on health care surged 5.9% in Minnesota last year, largely due to a rise in the cost and use of prescription drugs and outpatient surgeries and clinics. Total spending per patient per month was $596 in 2018, compared to $563 in 2017 and $475 in 2013, according to an analysis released Thursday by Minnesota Community Measurement, a nonprofit agency that monitors’ clinics based on their quality and costs. (Olson, 11/7)

A jury awarded $101 million to the mother of a severely brain-damaged boy who sued a Chicago-area hospital for medical malpractice, but an agreement between the parties cut the amount to $50 million, a lawyer said Tuesday. Attorneys told a Cook County jury that medical staff at West Suburban Medical Center in Oak Park ignored ultrasound results that indicated the unborn baby didn't move for six hours during labor in 2014. (11/6)

Miami-Dade and Monroe counties could lose about $11.5 million in funding for their child welfare system in the next few years, under changes that are being weighed by the state Department of Children and Families. But a plan to keep the existing funding in place could involve sending some of the state’s most troubled children from other regions to a facility in South Florida for more involved care, DCF Secretary Chad Poppell said, without additional funds to support them. (Koh, 11/7)

Geisinger Commonwealth School of Medicine plans to provide free tuition to students who agree to practice primary care after residency at its affiliate health system Geisinger Health, it announced Wednesday. The Danville, Pa.-based integrated delivery system hopes the offering, which will cost Geisinger an estimated $10 million per year, will help address the primary care shortage it faces, which is similar to the national trend. (Castellucci, 11/6)

In three years, First Year Cleveland has dramatically reduced the Cuyahoga County infant mortality rate – dropping deaths by 18 percent. But African-American babies are four times as likely as white babies to die in their first year of life. The rate is one of the worst in the country. And it’s largely due to structural racism, says First Year Cleveland, a partnership of Cleveland, Cuyahoga County and Case Western Reserve University. (Kilpatrick, 11/7)

Therapists who attempt to change the sexual orientation or gender identity of LGBTQ minors through conversion therapy could be fined up to $500 dollars and spend as much as six months in jail, if the Kansas City council approves an ordinance passed by a committee today. The proposed ban calls conversion therapy ‘ineffective’ and ‘harmful.’ It’s also been debunked by the American Psychological Association. But, opponents say outlawing it would infringe on the rights of people who want the therapy. (Gott, 11/7)

Kaiser Health News: The Air Ambulance Billed More Than His Surgeon Did For A Lung Transplant

Before his double lung transplant, Tom Saputo thought he had anticipated every possible outcome. But after the surgery, he wasn’t prepared for the price of the 27-mile air ambulance flight to UCLA Medical Center — which cost more than the lifesaving operation itself. (Almendrala, 11/6)

Miami-Dade and Monroe counties could lose about $11.5 million in funding for their child welfare system in the next few years, under changes that are being weighed by the state Department of Children and Families. But a potential plan to keep the existing funding in place could involve sending some of the state’s most troubled children from other regions to a facility in South Florida for more involved care, DCF Secretary Chad Poppell said, without additional funds to support them. (Koh, 11/6)

Among the nearly 1 million Northern California households and businesses that went dark during the outage that began Oct. 26 — just one of several PG&E shutoffs in October — more than 35,000 were registered medical baseline customers with health conditions requiring special energy needs, the utility said. In addition to providing discounted rates, the utility is also required by law to individually notify those customers in advance of shutoffs.In the Bay Area, where about 447,000 customers went dark for at least one night, there were more than 11,500 medical baseline households. (Green, 11/6)

[Amanda Jackson] and many other residents at Southwest Crossing, a 328-unit complex at 7851 Bandero Drive, are on edge this week. Trash is piled up. There’s fear that the water will be shut off soon. The front office is closed. Management and maintenance workers were either recently laid off or on strike for alleged nonpayment by T.E.H. Realty. ...Still, she stays. Even though Marquise, 1, is allergic to mold, which is a trigger for his asthma. He gets multiple breathing treatments a day. She’s rushed him to the hospital lots of times. (Bogan, 11/6)

A wide-ranging legislative package reforming sexual assault laws passed both chambers of the NC General Assembly unanimously last week, with two elements closing decades-old legal loopholes on the definition of rape that set North Carolina apart. The Senate passed SB 199 49-0 Thursday morning. The House voted 108-0 Thursday afternoon. The package was hammered out in conference committee in recent weeks and had wide bipartisan support, despite related measures failing in committee in previous sessions of the legislature. (Martin, 11/7)

Recreational cannabis will be legal in Illinois in less than two months, and some employers are scrambling to understand what legalization will mean for their drug-free policies. Specifically, the new law pits an employee’s right to use marijuana recreationally on their own time against an employer’s ability to enforce drug-free policies under Illinois’ Cannabis Regulation and Tax Act. (Schmid, 11/6)

A new law that allows companies to grow and sell medical marijuana in Georgia for the first time has been stalled since it was signed six months ago. But that’s about to change. House Speaker David Ralston said Wednesday on GPB’s “Political Rewind” that he’ll soon begin to appoint members of the Georgia Access to Medical Cannabis Commission. Gov. Brian Kemp and Lt. Gov. Geoff Duncan could also follow suit. (Bluestein, 11/6)

In a cross-sectional study of more than 15 million emergency department visits from 2009 to 2016 among Medicare beneficiaries, there was a significant decline in mortality rates during or after an emergency department visit. This decline was greatest for patients with a high severity of illness compared with those with a medium severity or low severity of illness. (Burke et al, 11/4

Electronic cigarette (e-cigarette) use has become increasingly prevalent among US youth and young adults in recent years. Exposure to e-cigarette marketing may stimulate e-cigarette use. In this study, we estimated the longitudinal association between e-cigarette marketing exposure and e-cigarette experimentation among US youth and young adult never tobacco users. (Chen Sankey, 11/1)

Emerging evidence indicates transgender adolescents (TGAs) exhibit elevated rates of suicidal ideation and attempt compared with cisgender adolescents (CGAs). Less is known about risk among subgroups of TGAs because of limited measures of gender identity in previous studies. We examined disparities in suicidality across the full spectrum of suicidality between TGAs and CGAs and examined risk for suicidality within TGA subgroups. (Thoma et al, 11/1)

Since Medicaid’s inception, federal law has generally prohibited states from using Medicaid funds for services provided to nonelderly adults in “institutions for mental disease” (IMDs). The IMD payment exclusion was intended to leave states with the primary responsibility for financing inpatient behavioral health services. However, the lack of federal funding may limit access to needed inpatient services and contribute to high levels of unmet need. In recent years, the federal government has provided new mechanisms for states to finance IMD services for nonelderly adults through Medicaid in certain situations. There are now four options for states to cover these services: Section 1115 demonstration waivers, managed care “in lieu of” authority, disproportionate share hospital payments, and the SUPPORT Act state plan option. (Musumeci, Chidambaram and Orgera, 11/6)

Statins, commonly taken to reduce cholesterol, may increase the risk for skin infections. Statins are known to increase the risk for diabetes, and diabetes increases the risk for staphylococcus infections of the skin and underlying soft tissue. But a new study in the British Journal of Clinical Pharmacology suggests that the effect of statins on infection may also be independent of diabetes. (Bakalar, 11/4)

Single-payer health care can work. Government-run systems operate in other industrialized countries and often achieve comparable or better overall results, for less money, than the health-care patchwork in the United States. So why aren’t Sen. Bernie Sanders (I-Vt.) and Sen. Elizabeth Warren (D-Mass.) proposing something that resembles those systems? The two presidential candidates promise far more generous benefits than other countries offer. They pretend that the United States wouldn’t have to make any of the trade-offs other nations have had to make. They promise fantastically generous benefits, no premiums, co-payments or other cost-sharing, and a miraculously low price tag. It’s fiction. (11/6)

Until now, Medicare for All proposals have been pleasantly vague. They plausibly allowed voters to imagine that more medical services would be covered, without premiums, out-of-pocket costs or the inconvenience of networks or claims reviews by insurers. But now Sen. Elizabeth Warren has sought to specify exactly how her overhaul of American health care would be paid for. The most remarkable feature of her proposal is the extent to which she proposes to rein in health-care spending simply by restricting the resources available to providers. (Chris Pope, 11/6)

Public support for Medicare for All might have peaked, but it’s still a powerful idea among many Democrats. By the numbers: Support for the national health plan rose from around 40% in 2000 to a high of 59% in March of 2018, but had slipped back to 51% by October of this year.That's still a majority, but it’s narrow and headed in the wrong direction. And polling shows that support drops much further, and opposition rises, when people hear some of the most common arguments against Medicare for All. Between the lines: Critics, debate moderators and the media have focused largely on two unpopular tradeoffs in a Medicare for All plan: the large number of Americans who would have to give up their private coverage; and the likelihood of a middle class tax hike to finance the plan. (Drew Altman, 11/6)

A new study by the prestigious National Academy of Sciences may expose “Medicare for All” as the fraud it is.The study found that between one-third and one-half of all American physicians experience burnout in their work and learning (residency/training) environments, because of inadequate capacity (supply of doctors), health financing and reporting chaos, and overbearing administrative systems. Medicare for All would exacerbate all of that and crater the system. Today, most doctors are massively over-worked, comparatively underpaid, and experience extreme stress. (Grady Means, 11/6)

The Pennsylvania General Assembly is considering how to address the issue of balance billing — the amount patients have to cover when their insurance company does not pay the full cost of their care. This is a common issue when, say, Pennsylvanians experience a medical emergency, have to go to a hospital out of their insurance network to address it, and end up staring down a huge medical bill.Emergency physicians applaud the legislature for tackling this issue, as no Pennsylvanian should worry about insurance at a time of crisis. (Richard Hamilton and Arvind Venkat, 11/7)

In a statement issued Tuesday night, Gov. Ralph Northam promised: “Since I took office two years ago, we have made historic progress as a commonwealth. Tonight, Virginians made it clear they want us to continue building on that progress. They want us to defend the rights of women, LGBTQ Virginians, immigrant communities and communities of color. They want us to increase access to a world-class education for every child, and make sure no one is forced to go bankrupt because they or a family member gets sick. They want us to invest in clean energy and take bold action to combat climate change. And they want us to finally pass commonsense gun safety legislation, so no one has to fear being hurt or killed while at school, at work or at their place of worship.” (11/7)

Struggling with mental demons, Kayla Williams went to her bathroom and held a gun in her hand, contemplating suicide. It was 2004, and she’d been home for only a few months after serving as an Army sergeant and Arab linguist in the Iraq war.But hers is one story that doesn’t end in tragedy: Ms. Williams held those demons at bay long enough to get help and learn to manage the challenges of marriage to a combat-wounded veteran while writing two books about her experiences. “I’m doing well,” she told me. She is now the director of the Military, Veterans and Society program at the Center for a New American Security. (Carol Giacomo, 11/1)

The success of 9-1-1, our nation’s emergency service hotline, is undeniable. In an instant, Americans can   reach police, fire and emergency services from anywhere in the country. It’s hard to fathom that before the adoption of 9-1-1, Americans had to dial the individual numbers to their local police station, fire department or EMT services in an emergency. Yet, for millions of Americans, this remains the reality during a mental health crisis. Crucial services, which can save lives, can be difficult to access because our nation does not have an easy-to-remember number to call for a mental health or suicide emergency. (David Guth, 11/6)

An unspoken truth about the journey of a thousand miles is that the first and most significant steps often happen in one’s own backyard. A “historic” gift of $150 million from the Huntsman family to the University of Utah to establish a mental health institute is another move in changing the direction of mental health trends in Utah and beyond. The new institute has the potential to do for mental health what the Huntsman Cancer Center did for cancer research — save lives through unprecedented study and medical prowess. And it could be a game changer for a mental health crisis gripping the country. The National Alliance on Mental Illness estimates that 1 in 5 Americans experience mental illness each year. In Utah, suicide is the leading cause of death for youths ages 10 to 24. (11/6)

The members of the team that discovered insulin sold the patent to the University of Toronto for $1 each because they felt that the drug belonged to the public. Nearly 100 years later, insulin is inaccessible to thousands of Americans because of its high cost. (Michael Fralick, M.D., and Aaron S. Kesselheim, 11/7)

She’s probably sleeping. Terrina Riley remembers a hospital nurse offering her that reassurance after she noticed the normally active baby in her belly had stopped moving. As Riley tells it, she was seven months pregnant and had already spent a few days in a Washington, D.C., hospital bed, worried about the amniotic fluid she was losing each hour. (Theresa Vargas, 11/6)

New standards to address the maternal mortality crisis will go into effect July 2020 and aim to improve how hospitals prevent, identify, and treat maternal hemorrhage and severe pre-eclampsia. Journalists from USA Today and ProPublica have documented this crisis and its impact on every day women. Even famous women like Beyonce and Serena Williams survived serious complications with their recent pregnancies, preeclampsia and a pulmonary embolism respectively. (Bryna Koch, 11/6)

When we celebrate World AIDS Day less than a month from now, Americans will have something to celebrate. Innovative treatments have transformed a disease that a few decades ago would have been a death sentence into a diagnosis that, with support, is manageable. While lawmakers should acknowledge this progress, they should not consider this crisis solved. (Sharon R. Browne, 11/6)