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President Trump on Wednesday backed away from his endorsement of a bipartisan Senate proposal to stabilize health insurance markets, throwing the legislative effort into doubt even as the chief architect of the deal predicted that it would become law before the end of the year. The latest actions by the White House confused Republicans on Capitol Hill and irked Democrats — but in the end, their effect was not clear. (Kaplan and Pear, 10/18)

The authors of a bipartisan plan to calm health insurance markets said Wednesday they’ll push the proposal forward, even as President Donald Trump’s stance ricocheted from supportive to disdainful to arm’s-length and the plan’s fate teetered. “If something can happen, that’s fine,” Trump told reporters at the White House. “But I won’t do anything to enrich the insurance companies because right now the insurance companies are being enriched. They’ve been enriched by Obamacare like nothing anybody has ever seen before.” (Fram, 10/18)

Mr. Trump touched off confusion on Capitol Hill Wednesday morning, tweeting he “can never support bailing out ins co’s who have made fortune w/O’Care,” echoing criticism from conservatives that the deal is a bailout for insurers, a characterization the sponsors dispute. ... Mr. Trump’s comments on Wednesday cheered conservatives, troubled some Republicans who support the bill and left many Democratic lawmakers frustrated. Some Capitol Hill aides said they thought Mr. Trump’s remarks might be a negotiating tactic to get more concessions from Democrats, and GOP lawmakers began looking at potential changes that might ultimately get the president’s backing. (Armour and Peterson, 10/18)

President Trump became the subject of an unusual public lobbying campaign over the fate of the Affordable Care Act on Wednesday as Senate Democrats and a key Republican sought to salvage a bipartisan health deal while conservatives pressured the president to disavow the agreement. ... The convoluted campaign, in which Senate Minority Leader Charles E. Schumer (D-N.Y.) insisted that a deal remained in reach even as he blasted the president’s “zigging and zagging,” underscored the unpredictable nature of dealmaking in Trump’s Washington. With constantly shifting alliances, the city’s key political players are jockeying to win the president’s support one issue at a time. (Eilperin and Sullivan, 10/18)

Trump swung wildly on whether he'd support the bipartisan Alexander-Murray Obamacare deal. The deal aims to stabilize Obamacare insurance markets by restoring subsidies Trump cut off less than a week ago. Here he is in his own words. (Mihalik, 10/18)

A Senate healthcare deal to extend critical ObamaCare payments to insurers appears all but completely dead just 24 hours after it was announced. President Trump reversed course Wednesday and said he opposed the deal, while Speaker Paul Ryan’s (R-Wis.) office said the Senate should keep its focus on repealing and replacing President Obama’s signature law. (Sullivan and Roubein, 10/18)

By then, John Thune of South Dakota, the Senate’s No. 3 Republican leader, had told reporters the pact had “stalled” as Senator Orrin Hatch of Utah, the chairman of the Finance Committee, said he opposed the deal. In the House, Speaker Paul Ryan also had signaled his opposition. (Litvan and Wasson, 10/18)

A spokesman for Speaker Paul Ryan (R-Wis.) on Wednesday indicated Ryan won’t support a bipartisan deal to stabilize the ObamaCare insurance markets as opposition to the proposal mounts. "The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare,” Doug Andres wrote in an emailed statement. (Roubein, 10/18)

Senate Minority Leader Charles Schumer (D-N.Y.) ripped President Trump's comments on a bipartisan deal to extend key ObamaCare payments to insurers, arguing he doesn't understand the agreement.  "Frankly the president doesn't know what he's talking about in the compromise. ... The president ought to know what he's talking about when he tweets about bills. Because on this one he had no understanding of what it's about," Schumer said from the Senate floor. (Carney, 10/18)

Sen. Ron Johnson (R-Wis.) is floating changes to a bipartisan deal to stabilize insurance markets that would pull the measure to the right. Johnson said he’s discussed the changes with Sen. Lamar Alexander (R-Tenn.) — the Senate Health Committee chairman who brokered the deal with Sen. Patty Murray (D-Wash.) — and Johnson contends they’re crucial to shoring up support for the bill in the House. (Roubein, 10/18)

Senate Health Committee Chairman Lamar Alexander (R-Tenn.) said President Trump called him Wednesday morning expressing optimism about the bipartisan health plan. "He called me to say that, number one, he wanted to be encouraging about the bipartisan agreement that Sen. [Patty] Murray and I announced yesterday," Alexander said at an Axios event Wednesday. (Hellmann, 10/18)

Alexander still expects the legislation to pass by the end of the year. "From my experience here, most of the ideas fail for lack of the idea, and whenever you put a well-formed idea out before this Congress, sooner or later it has a pretty good chance of being adopted," he said. (McIntire, 10/18)

GOP lawmakers acknowledged they’ll eventually have to contend with shaky insurance markets and an estimated $1 billion hole Trump carved into the health care law last week when he eliminated remaining payments due this year. The money to fund a key insurance subsidy program could be resurrected as part of a year-end spending agreement. Even if the deal struck by Sens. Lamar Alexander and Patty Murray goes nowhere, Republican sources say it's only a matter of time before Congress must find some way of addressing the reeling insurance markets — a vote the GOP sources know will infuriate lawmakers and their base. (Haberkorn and Bade, 10/18)

Most Americans disapprove of President Donald Trump’s decision to end Obama-era federal subsidies to insurers that lower costs for low- and middle-income families, a new poll found. Fifty-three percent of respondents to an Economist/YouGov poll conducted Oct. 15 and 16 said they disapproved of the executive move, compared to 31 percent who were in favor. Sixteen percent declined to give an opinion. (Connolly, 10/18)

Top government lawyers representing 19 U.S. states on Wednesday asked a federal judge in California to force the administration of President Donald Trump to make health care subsidy payments that Trump abruptly cut off last week. The monthly payments would normally be scheduled to go out Friday. The states, led by California Attorney General Xavier Becerra, asked a judge in San Francisco for an emergency court order by 4 p.m. Thursday requiring they be paid on time. (Cooper, 10/18)

California Atty. Gen. Xavier Becerra asked a federal court Wednesday to issue an emergency temporary restraining order to block the Trump administration from cutting off cost-sharing subsidies that help reduce the price of healthcare for millions of Americans. A week after California and 17 other states filed a lawsuit challenging the decision on its merits, the same attorneys general requested a restraining order to avoid immediate harm to millions of people who get subsidized healthcare through the Affordable Care Act, Becerra said. (McGreevy, 10/18)

[New York Attorney General Eric] Schneiderman, Becerra and the other attorneys general contend the ACA requires those payments be made, even though a U.S. judge in Washington disagreed in a 2016 decision that is currently under appeal. Immediate elimination of the payments would inflict multimillion-dollar losses on carriers and force them to raise premiums, forcing people to go without coverage, according to the AGs. The latest round of payments are to be made this week. (Harris, 10/18)

“Donald Trump doesn’t get to pick and choose which laws to follow,” California Attorney General Xavier Becerra (D) said in a statement. “For nearly a year, Trump has submitted those payments. So the question now has to be: is Donald Trump correct today or was he breaking the law?” (Weixel, 10/18)

A bipartisan group of 10 governors is calling on Congress to vote on a deal to stabilize ObamaCare’s insurance markets. “We urge Congress to quickly pass legislation to stabilize our private health insurance markets and make quality health insurance more available and affordable,” the governors wrote Wednesday in a letter to House and Senate leaders from both parties. (Roubein, 10/18)

Most people think of the term “bailout,” as a political pejorative, often involving hundreds of billions of taxpayer dollars being funneled to failing companies. It’s now become one of President Trump’s oft-repeated rhetorical cudgels against the Affordable Care Act and federal payments to insurance companies. (Qiu, 10/18)

President Donald Trump says health insurers have been "enriched" by President Barack Obama's Affordable Care Act. So why are companies pulling back from the law's insurance marketplaces? (10/18)

President Trump has defended his decision to end cost-sharing reduction (CSR) subsidies — an element of the Affordable Care Act that helped lower the cost of deductibles and co-pays for people making less than 250 percent of the federal poverty level — by pointing to the gain in stock prices for health-insurance companies. (Kessler, 10/19)

If President Donald Trump prevails in shutting down a major "Obamacare" health insurance subsidy, it would have the unintended consequence of making free basic coverage available to more people, and making upper-tier plans more affordable. The unexpected assessment comes from consultants, policy experts, and state officials trying to discern the potential fallout from a Washington health care debate that's becoming harder to follow. (Alonso-Zaldivar, 10/19)

Even before President Donald Trump announced plans last week to nix Obamacare subsidies, the Illinois Department of Insurance raced over the summer to get insurers on board with a strategy to minimize the financial pain of such a move. The action in essence allows Illinois—as well as more than two dozen other states adopting the maneuver—to sidestep Trump's recent moves to undo major portions of his predecessor's signature health insurance law. Trump on Oct. 12 ordered the federal government to stop paying the cost-sharing subsidies provided to insurers to defray the cost of covering low-income people. (Schorsch, 10/18)

ObamaCare supporters are worried that President Trump’s attacks on the law will depress enrollment and confuse consumers, inflicting damage that can’t be fixed even if Congress comes up with a bipartisan health-care deal. Open enrollment begins in less than two weeks, and advocates are bracing for a drop in the number of people signing up amid the Trump administration’s months-long campaign against ObamaCare. (Hellmann, 10/19)

Jason Sanford has heard so many rumors about the changing health care landscape that every few weeks he dials a local information desk, seeking just a rough estimate of what his diabetes medication will soon cost him. The answer is the same every time: It's too early to say, even with the next open enrollment period under the Affordable Care Act beginning in two weeks. (10/18)

It’s less than two weeks until people have to start signing up for next year’s health insurance plans, and Iowans who buy their own insurance through the Affordable Care Act don’t know what to expect. They don’t know what system they will use to buy insurance, what plans will be available to them, or how much they will have to pay. (Sostaraic, 10/19)

Open enrollment in the Obamacare marketplace begins in less than two weeks but this year some consumers think the law is already dead. From threats to repeal the Affordable Care Act, to news about rising premiums and President Donald Trump's recent decision to do away with some subsidies, people who don't closely follow the issue are getting lost in the headlines and sound bites. (Ochoa, 10/19)

It was the Friday before a Monday deadline, and federal health officials in Washington, D.C. were working feverishly with their counterparts in Oklahoma to finalize the details of a new state reinsurance program. Emails flew between the Centers for Medicare and Medicaid Services in Washington and Oklahoma's Department of Health. Blue Cross Blue Shield of Oklahoma, the only ACA insurer in the state, was on board. Everything had to be done by Monday, Sept. 25, so the insurance company could set new, presumably lower, health insurance rates for 2018. (Kodjak, 10/19)

A report released Wednesday indicates that more Americans with health insurance are not able to keep up with those out-of-pocket costs. The Commonwealth Fund report said that last year, 28 percent of U.S. adults who were insured all year were “underinsured” — an estimated 41 million people. (Miller, 10/18)

A federal judge on Wednesday ordered the government to allow a pregnant 17-year-old immigrant, who was detained after entering the country illegally, to undergo an abortion. After a brief hearing that included a testy exchange with government lawyers, Judge Tanya Chutkan ordered the government to move "promptly and without delay" to transport the teenager or allow her to be transported by others to the nearest abortion provider. (10/18)

Lawyers for the American Civil Liberties Union, which represents the pregnant teen, cheered the judge’s ruling as a major victory for abortion and immigrant rights. “We never should have had to fight this in the first place,” said Brigitte Amiri, a senior ACLU staff attorney who argued the case on Wednesday. “It should never have been something that we needed to go to court over.” (Sacchetti, 10/18)

At a hearing Wednesday, a lawyer for Atty. Gen. Jeff Sessions had suggested that because the woman was not legally a U.S. resident, she was not covered by the constitutional right to end her pregnancy. U.S. District Judge Tanya S. Chutkan rebuked the government lawyers at the hearing. Her order directs officials to transport Jane Doe to the clinic of her choice and allow her to obtain an abortion by Saturday. (Lauter, 10/18)

"Janes everywhere are rejoicing that their dignity and humanity have been recognized and respected by the federal court," Susan Hays, legal director of Jane's Due Process — a legal referral source for teens facing unintended pregnancies in Texas — said in a prepared statement. (Wang, 10/18)

In late September, a Texas court granted her request to get an abortion without her parents’ approval, according to the state’s “judicial bypass” provision. But officials at the Department of Health and Human Services Office of Refugee Resettlement blocked Doe from leaving the South Texas shelter where she’s being held, sending her instead to a religious crisis pregnancy center. The government is required to provide healthcare for immigrant minors in its custody, and has paid to help girls end pregnancies that resulted from incest or rape, an ever-present risk for those crossing north from Central America. (Michels, 10/18)

The Trump administration is appealing a judge's order requiring that the government allow an undocumented pregnant minor in a federally funded Texas shelter receive an abortion. (Rayasam, 10/18)

A Jackson County judge on Wednesday took under advisement Planned Parenthood’s request to block a Missouri law requiring that abortion physicians meet with their patients three days before they undergo the procedure. The law, enacted this summer during a special session of the Missouri Legislature called by Gov. Eric Greitens, is set to take effect Oct. 24. The two Planned Parenthood affiliates in Missouri and two obstetrician-gynecologists at the Washington University School of Medicine in St. Louis sued last week to have the law declared unconstitutional under the Missouri Constitution and sought a temporary restraining order blocking it. (Margolies, 10/18)

The Trump administration has gone nine months without a permanent drug czar. But within hours of the announcement that Rep. Tom Marino (R-Pa.) had withdrawn his name from consideration on Tuesday, the D.C. rumor mill was up and running. Potential candidates, according to administration officials, Capitol Hill staffers, and others in the world of drug and addiction treatment policy, include a who’s-who of players in the current battle against the opioid crisis. (Facher, 10/18)

President Donald Trump’s former nominee to be the nation’s drug czar is defending his role in writing a law that critics say weakened the government’s authority to stop companies from distributing opioids. Rep. Tom Marino, R-Pa., said he’s proud of his work on the 2016 law, which passed without opposition in the House and Senate and was signed by President Barack Obama. (10/18)

The state of California wants to revoke the wholesale license for a facility run by Cardinal Health, one of the nation’s largest pharmaceutical distributors, for failing to note a series of unusual sales of an opioid painkiller and three other tightly regulated medicines to a pharmacy. Between 2013 and 2015, the Cardinal Health outpost in Valencia, Calif., sold increasingly large quantities of the controlled substances — including Norco, which is a mixture of acetaminophen and hydrocodone — to the pharmacy, which state officials called “red flags.” Another medicine was the Xanax anxiety pill. (Silverman, 10/18)

Aonce-a-month shot to treat opioid addiction was as effective in maintaining short-term abstinence from heroin and similar drugs as a more commonly prescribed daily treatment, according to a Norwegian study released Wednesday. The study is believed to be the first to directly compare Vivitrol — administered as a monthly shot — with a combination drug treatment sold under the brand name Suboxone. In the U.S. and many other countries, Suboxone or methadone have been the standard medical treatment for people with an opioid use disorder. (Armstrong, 10/18)

Federal, county and city court officials are looking hard at Buffalo, N.Y.’s new opioid crisis intervention court as one potential model solution to the epidemic of heroin and opioid overdoses that continue to devastate families and communities across America, taxing local governments, first responders and the nation’s criminal justice system. (Westervelt, 10/18)

Rep. John Delaney, D-Potomac, announced Tuesday that he is co-sponsoring legislation to make it easier for the Drug Enforcement Administration to combat the opioid epidemic. The bill, called the “Opioid Immediate Suspension Order Act of 2017,” was introduced Monday by Rep. Gerry Connolly, D-Virginia. Four Democratic representatives, including Delaney, have co-sponsored the legislation, but no Republicans, according to Connolly’s office. (Jacob, 10/18)

More than 200 millennia of human civilization and two centuries of modern medicine have brought us to this recent heavy-handed admonition by scientific researchers: It’s probably a bad idea to eat your placenta. (Wootson, 10/18)

Lack of sleep may raise the risk for gestational diabetes. Gestational diabetes — abnormally high blood sugar that develops during pregnancy — can lead to excessive birth weight, preterm birth or respiratory distress in the baby, among other problems. It can also increase the mother’s risk for Type 2 diabetes later in life. (Bakalar, 10/18)

Most people probably know by now that flu can make fall and winter dangerous for older adults. But another virus that circulates at the same time and causes similar symptoms is now getting more attention as a killer of older people, especially those who are frail, or have chronic health problems or weakened immune systems. ...Long thought to be a threat mostly to infants, respiratory syncytial virus (RSV) is increasingly recognized for its impact on adults. (Burling, 10/18)

Here’s yet another reason to protect young athletes from head trauma: A large-scale new study found that concussions in adolescents can increase the risk of later developing multiple sclerosis. The risk of multiple sclerosis, or M.S., an autoimmune nervous system disorder with an unknown cause, was especially high if there were more than one head injury. (Reynolds, 10/18)

Veteran biotechnology executive George Scangos has been busy since leaving Biogen Inc. and setting up an infectious-disease startup: After founding Vir Biotechnology Inc. in January, he’s done seven deals and raised more than $500 million. That’s one of biggest fundraising rounds for any biotechnology startup this year, particularly for one focused on infectious diseases, an arena that traditionally hasn’t made a lot of money. Vir, which won’t start human trials for about 18 months, is setting its sights on treatments for tricky ailments that have long thwarted researchers, such as drug-resistant tuberculosis, Zika, hepatitis B and HIV. (Chen, 10/18)

Massachusetts General Hospital researchers are offering a new free app to help new mothers determine whether they have run-of-the-mill "baby blues" or something more serious: postpartum depression. (Fernandez, 10/18)

The Maryland Health Care Commission, the state’s independent regulatory agency, is unveiling a website on which people scheduling a hip replacement, knee replacement, hysterectomy or vaginal delivery can see price differences among different providers for the same procedure. The site is launching amid rising health-care costs and as some consumers turn to insurance plans with high deductibles. (Itkowitz, 10/18)

A new website — wearthecost.org — being launched Thursday by the Maryland Health Care Commission will help consumers compare these types of costs among hospitals and bring more transparency to hospital pricing practices. While patients can request all or some of this data from other agencies and the hospitals themselves, the commission said the website compiles the information all in one place and in an easy-to-navigate, consumer-friendly way. The commission hopes the website will arm users with more information to help them make more informed decisions when choosing a hospital. (McDaniels, 10/19)

The head of New York City’s public hospital system said New York Gov. Andrew Cuomo’s administration has agreed to disperse hundreds of millions in aid to the agency, ending a funding dispute that left the hospitals dangerously low on cash. Stanley Brezenoff, interim president and chief executive of NYC Health + Hospitals, said in a letter to agency employees Wednesday that the state had agreed to distribute some $380 million in federal and city funds under the state’s control to the system over the coming months. (Gay, 10/18)

Colorado is spending more per inmate on health care as the state’s prison population ages, according to a national report released Wednesday. The report, from the Pew Charitable Trusts, found that Colorado spent $6,641 per inmate on health care in the 2015 fiscal year. That placed the state in the middle of the pack nationally: 21st  for the highest spending and about $900 per inmate more than the national median. (Ingold, 10/18)

utraged by a Chicago Tribune report, state Rep. Mary Flowers, D-Chicago, is asking officials from the Illinois Department of Public Health to explain at a legislative hearing next week why they never implemented a 2007 law that mandated screening Illinois babies for a deadly genetic condition. Flowers, chair of the Illinois House Health Care Availability and Access Committee, was a co-sponsor of the law that added Krabbe disease to the state's newborn screening program a decade ago. (Callahan, 10/18)

Moody’s Investor Service downgraded Einstein Healthcare Network’s credit rating by one notch, to just above junk bond status, citing the nonprofit system’s large and unexpected loss of $23 million on an operating basis in the year ended June 30, a decline in liquidity, and uncertain state funding. Einstein said in a statement that it “remains committed to providing high-quality care while balancing the demands of today’s challenging health-care environment. There are initiatives already underway which we believe will put the organization in a stronger financial position moving forward while increasing access to care.” (Brubaker, 10/18)

A federal grant of almost $7.5 million to the Maryland Department of Health will go to helping teach parenting skills and provide other resources to pregnant women and parents of young children, health department officials said Wednesday. The department will use the funds from the U.S. Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, to support local agencies that make home visits to women and parents through the state’s Maternal, Infant and Early Childhood Home Visiting Program. The goal of the program is to help the families raise children who are physically, socially and emotionally healthy and ready to learn. (Cohn, 10/18)

Summa Health's Barberton campus introduced a new cancer-fighting tool, the Elekta Versa HD, this month. The radiotherapy treatment device is designed to provide speed and precision for cancer-management professionals to more accurately target tumors. (Nader, 10/18)

The resident was fine when Sunrise Assisted Living staff checked in around 9 p.m. When staff returned around 12:30 a.m., the resident’s neck was wedged between a bed and a transfer pole, and the resident was no longer breathing, according to a report by the Minnesota Health Department. The department determined earlier this month that the Roseville facility was at fault for neglect, having placed the pole too close to the bed. (Chavey, 10/18)

The federal government has filed a lawsuit accusing a south suburban couple of defrauding Medicare out of millions of dollars through false claims by their medical companies. The suit, filed Tuesday in U.S. District Court, accuses Gateway Health Systems Inc. and its owners – 58-year-old Ajibola Ayeni and his wife, Joy H. Turner-Ayeni – of violating the federal False Claims Act by seeking and accepting Medicare payments for fraudulent services, according to a statement from the U.S. attorney’s office. (10/18)

The new bipartisan health proposal is far from a cure-all for Obamacare’s problems, but if it passed it would send health insurers a message they have sought all year: that it’s safe to stay in the marketplaces. Insurers have already signed contracts and are making final arrangements to sell their products in time for next year’s enrollment period, which begins on Nov. 1. (Reed Abelson and Margot Sanger-Katz, 10/19)

Time for another test of whether this Congress can do the easy things -- on health care this time. Republican Senator Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington have reached a deal to "fix" the Affordable Care Act -- a seemingly reasonable agreement designed, in very general terms, to help the insurance markets work better while giving states more flexibility to administer things. Both parties have incentives to approve something like this. Democrats care about preserving their big policy win in the original Affordable Care Act; Republicans don't want chaos in health insurance while they control the White House and have majorities in both chambers of Congress. Sure, Republicans in theory would rather repeal and replace Obamacare, but if they didn't realize earlier that they don't actually have any realistic plan for doing so, most of them surely know it now. (Jonathan Bernstein, 10/18)

A bipartisan proposal to shore up the Affordable Care Act and guarantee the U.S. government keeps helping insurers cover low-income patients would have been something like a best-case scenario for the companies participating in the market -- if it happened several months ago. As it stands, the bill, spearheaded by Senators Patty Murray and Lamar Alexander, has only a small chance of passing. And even if it does pass, it is unlikely to entirely mitigate the Trump administration's active sabotage of the ACA. (Max Nisen, 10/18)

Bipartisan negotiators announced Tuesday that they had struck a deal to temporarily stabilize Obamacare markets. Republican Sen. Lamar Alexander (Tenn.) agreed to continue paying “cost-sharing reduction” payments that the government promised insurance companies, and Democratic Sen. Patty Murray (Wash.) agreed to relax health-market regulations a bit. Both sides of this deal contain good policy. (10/18)

While there is plenty of blame to go around for Republicans’ inability to repeal and replace Obama Care, the effort was all but doomed as soon as the GOP chose to fight on the wrong battlefield. Trying to pass a replacement through the budget process known as reconciliation was powerfully attractive, since it would have permitted the Senate to act on ObamaCare with only 51 votes. (Phil Gramm, 10/18)

For seven years, congressional Republicans and Democrats battling over Obamacare have agreed on only one thing: They couldn’t agree on anything. As more Americans dropped or skipped coverage because of soaring premiums, lawmakers of the two parties couldn’t — wouldn’t — agree on how to fix the 2010 law. (10/18)

That’s the question to ask about this week’s deal between Republican Lamar Alexander and Democrat Patty Murray to appropriate two years of funding for Obama Care’s “cost-sharing” reductions that flow to insurers. The Trump Administration last week cut off these subsidies, which the Obama Administration paid without an appropriation from Congress. A federal judge ruled last year that those payments are illegal. Democrats would also get about $100 million for advertising ObamaCare. (10/18)

President Trump and Republicans in Congress have brought chaos to the American health care system by trying to destroy the Affordable Care Act and failing to reauthorize the Children’s Health Insurance Program, which, with bipartisan support for the past 20 years, has provided care for millions of children. Over the next few weeks they can choose to set things right or to destroy them. (10/18)

The recent, strong growth of Medicare Advantage—private plan alternatives to traditional Medicare—makes understanding the program a priority for policy makers. Of the 57 million Medicare beneficiaries, approximately 33% are now enrolled in Medicare Advantage, an increase from 13% in 2004. Although we know a great deal about Medicare Advantage, there’s one thing we know almost nothing about: the extent and value of plans’ networks of physicians and hospitals at which enrollees can obtain covered care. This is important, because establishment and oversight of networks is a principal way Medicare Advantage plans manage cost and quality, and there has been a trend toward more narrow networks in insurance markets, raising concerns about access and patient cost. (Austin Frakt, 10/18)

Medical devices increasingly include capabilities for wireless communication and remote monitoring systems that relay clinical information from patients to clinicians. For example, many cardiac implantable electrical devices can transmit data regarding arrhythmia burden and heart failure metrics with minimal patient effort. This technology can improve patient care, but also introduces possible risks to data security and patient safety. (Daniel B. Kramer and Kevin Fu, 10/18)

Big Pharma should be writhing in embarrassment this week after The Washington Post and “60 Minutes” reported that pharmaceutical lobbyists had manipulated Congress to hamstring the Drug Enforcement Administration. But the abuse goes far beyond that: The industry systematically manipulated the entire country for 25 years, and its executives are responsible for many of the 64,000 deaths of Americans last year from drugs — more than the number of Americans who died in the Vietnam and Iraq wars combined. The opioid crisis unfolded because greedy people — Latin drug lords and American pharma executives alike — lost their humanity when they saw the astounding profits that could be made. (Nicholas Kristof, 10/18)

What would America’s abortion policy be if the number of months in the gestation of a human infant were a prime number — say, seven or eleven? This thought experiment is germane to why the abortion issue has been politically toxic, and points to a path toward a less bitter debate. The House has for a third time stepped onto this path. Senate Democrats will, for a third time, block this path when Majority Leader Mitch McConnell (R-Ky.) brings the House bill to the floor, allowing Democrats to demonstrate their extremism and aversion to bipartisan compromise. (George F. Will, 10/18)

Although describing a “good death” is an existentially challenging exercise, most people, if asked to do so, would note the importance of the presence of friends and family, relief from distressing symptoms, time at home, completing life goals, and other values. Although these goals are likely shared quite widely, how they are prioritized, and how they relate to other goals, may vary among individuals and across cultures. (Michael O. Harhay and Scott D. Halpern, 10/17)

The availability of large databases of blood donors and transfusion recipients has facilitated investigation of associations of donor characteristics with recipient outcomes. These databases are available in Sweden-Denmark, Canada, and the Netherlands, using government health data, and in the United States, using a donor-recipient database funded by the National Heart, Lung, and Blood Institute. (Ritchard G. Cable and Gustaf Edgren, 10/17)

Can we all agree that prison inmates with health problems should never be refused treatment? Or assumed to be faking symptoms even as they’re dying? Nor should they receive medical care from a private company with a financial incentive for doing just that. It isn’t as though inmates can shop around for a doctor, or even seek a second opinion. (10/18)

I was in my first year of medicine residency, still losing my way to radiology, still forgetting the codes I needed to access one room or another, still desperately trying to learn how to keep track of my multiple patients and their multiple problems when I assumed his care. As the intern, it fell to me to examine Mr Jones and write admission orders. As the intern, I’d also been up all night. My new white coat was stained with coffee spilled while sprinting to accomplish one forgotten task or other. My pager was chirping regularly, a constant reminder of the calls I’d yet to return. Tired, anxious, and painfully aware of his nurse’s brisk competence as she quieted a beeping alarm and tugged the bed sheet, I introduced myself. (Jessica Gregg, 10/17)