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Nearly three years into President Trump’s aggressive efforts to undermine the Affordable Care Act, prices for the most popular type of health insurance plan offered through the health law’s federal marketplace will actually drop next year, and the number of insurers offering plans will go up. Administration officials credited Mr. Trump with the resiliency of the law even as they echoed his contempt for it. (Goodnough, 10/22)

For now, the Department of Health and Human Services is touting a second consecutive year of positive-sounding numbers. An additional 20 insurers will participate for 2020, expanding consumer choice in many states, officials said. Nearly 70 percent of customers will have three or more insurers from which to pick a plan. (Alonso-Zaldivar, 10/22)

Average rates for the most popular, middle-priced plan will fall 4% in 2020 for a 27-year-old buying health insurance on the federal exchange, although premiums will vary widely by location, federal health officials said Tuesday. Rates had also declined 1.5% in 2019, after years of double-digit-percentage premium increases. (Armour, 10/22)

States that run their own exchanges are also seeing improvements for 2020. In California, for instance, rates are rising by a record low 0.8%. The Golden State restored the individual mandate, requiring residents to have insurance or pay a penalty, and expanded subsidies to middle-income Californians. Washington will see two new health insurers enter the market and rates will drop an average of 3.25%. "Despite the Trump administration's effort over the last two years to sabotage the Affordable Care Act, the record average rate decrease and interest by insurers is evidence that our market is stabilizing," said Insurance Commissioner Mike Kreidler. (Luhby, 10/22)

Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma persisted in tarring the system of individual insurance created under the health-care law as unwieldy, unaffordable for too many and in need of replacement. They also praised President Trump’s guidance for making the law’s insurance exchanges work better. “The president who was supposedly trying to sabotage the law has been better at running it than the guy who wrote the law,” Azar said during a phone briefing for reporters, alluding first to Trump and then to his predecessor, President Barack Obama, who regarded the ACA as one of his main domestic accomplishments. (Goldstein, 10/22)

Obamacare supporters have said the improving marketplaces are largely a sign of the law's maturing, and that the Trump administration has taken steps to undermine the law. The administration "deserves zero credit" for the law's success, said Protect Our Care, a Democratic-aligned group formed to defend Obamacare. Premiums rose sharply in the first years of Obamacare as insurers adjusted to new rules. Insurers also hiked their rates in Trump's first year amid congressional Republicans’ failed effort to repeal the law and numerous steps taken by the administration seen as undermining the marketplaces. (Goldberg, 10/22)

Health insurance rates are going up an average 10% in the individual marketplace in Louisiana in 2020, reversing a drop in premium costs that policyholders experienced this year. On average, rates are going down 4% in 2020 among states served by the federal healthcare.gov website. About a dozen states run their own sign-up websites, but most like Louisiana rely on the healthcare.gov market, the web portal created by the Obama-era Affordable Care Act. Annual enrollment in the program starts Nov. 1 for 2020 coverage. The program offers income-based, taxpayer-subsidized private health insurance plans for people who aren't covered on the job. (Mosbrucker, 10/23)

Maryland’s individual health insurance market, which will begin open enrollment next week, stands to gain from a second straight year of premium rate declines. Last year, premiums on the Maryland Health Benefit Exchange fell by about 11%, the first premium decrease in years, while enrollment rose 2% despite a projected decrease. (Curtis, 10/23)

Premiums for health insurers’ individual policies in Pennsylvania for 2020 will reflect an aggregate statewide increase of 4 percent, with an increase of 10 percent in the small group market. (10/20)

Health insurance costs have climbed so high, there's insurance for it. More employers are offering their workers supplemental coverage for expenses that crop up when an unexpected illness or injury hits. These additional policies can help make up for lost wages due to disability leave and pay bills that regular health insurance doesn't cover. (Murphy, 10/23)

CMS Administrator Seema Verma on Wednesday defended the Trump administration's actions on healthcare, telling the U.S. House of Representatives' Energy and Commerce Committee that her agency is trying to provide greater access to care in the face of rising healthcare costs. Verma touted the CMS' efforts on a range of healthcare issues from health IT interoperability to opioid abuse throughout her testimony, but the committee's Democratic members met her with fierce criticism. They said that under the Trump administration, the healthcare system is heading in the wrong direction and that the Affordable Care Act is succeeding "despite" the administration's best efforts to undermine it. (Brady, 10/23)

Democrats argued that premiums would have gone down more if the Trump administration had not taken certain actions, such as expanding the sale of short-term insurance plans that do not have to comply with all of the law's requirements. "In reality, it is you and the Trump administration who have done everything you can to sabotage the ACA and reverse the lost historic gains in health coverage," said Rep. Jan Schakowsky, D-Ill. "Imagine how much more money Americans could have saved if you were uplifting the ACA and helping them to get coverage." (McIntire, 10/23)

At Wednesday's hearing, Verma refused to answer how many people would lose insurance if the ACA is struck down. Representative Diana DeGette, the subcommittee's Democratic chairwoman, placed the number at 21 million. DeGette also asked Verma if the Trump administration has a contingency plan to protect people with preexisting conditions, considering Obamacare required insurers to cover them. Verma refused to answer, telling DeGette she was "not going to get into any specifics of the plan." Degette was just one of many members to press or criticize Verma about the existence of a contingency plan. (Cournoyer, 10/23)

Rep. Frank Pallone Jr. (D-N.J.), the chairman of the full committee, also pressed Verma for details about what the administration would do in a post-ObamaCare environment. “Does the president have a plan and what is the plan? It sounds like he has a secret plan he doesn’t want to reveal,” Pallone said. “Could you just tell us some information … in the event that he is successful in this awful lawsuit?” “I’m not going to get into specifics about the plan,” Verma said. “We have planned for a number of different scenarios, but we need to hear from the courts." (Weixel, 10/23)

Rep. Joe Kennedy III (D-Mass.) in a tense exchange Wednesday pressed the head of the Medicare and Medicaid programs to explain why she has allowed states to impose work requirements on Medicaid beneficiaries. Kennedy asked Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, to point to any study that backs up the administration’s argument that work requirements make people healthier. (Weixel, 10/23)

Verma contends that the drop stems from more people gaining jobs that carry employer health coverage — not new rules in Republican-led states that require recipients to work to receive the aid. “When we look at the Medicaid program it’s natural to see fluctuations in enrollment,” Verma explained during a House Energy and Commerce Committee hearing, adding “because we’re in a booming economy, less people in poverty, we’re going to see that in the Medicaid program.” (Coombs, 10/23)

The hearing was a rare opportunity for congressional Democrats who have been eager to publicly question Trump administration health officials on White House efforts to roll back the ACA, part of a messaging battle ahead of the 2020 election. Democrats, many of whom will seek re-election by promising to preserve the ACA, say the administration has adopted policies it knew would raise health-care costs and leave more people without coverage. They point to work requirements in Medicaid, the end of billions in payments to insurers that drove up premiums, and the Trump administration’s backing of a GOP-led lawsuit to strike down the ACA. (Armour, 10/23)

A federal appeals court decision that could strike down the Affordable Care Act as soon as this month has rattled officials in several states who are pursuing legislation to preserve some coverage in the absence of any Trump administration contingency plan. Lawmakers in states including Louisiana, Nevada, New Mexico and California have passed bills or are reviewing action aimed at dealing with the fallout if the ACA is overturned. Many of these lawmakers are also facing re-election campaigns this fall in some of the very states that brought the lawsuit. (Armour, 10/21)

Attorney General Eric Schmitt on Wednesday defended his decision to keep Missouri on the list of states challenging the Affordable Care Act — a day after his possible Democratic opponent in next year’s general election blasted the move as “pure politics.” ... Schmitt said Wednesday he had always “fought to make health care more available, more affordable and more portable, including fighting for our most vulnerable as it relates to insurance.” (Suntrup, 10/23)

Sen. Elizabeth Warren’s pledge to reveal how she'd pay for her "Medicare for All" plan carries big risks, no matter which path she takes. Taxing the wealthy won’t cover the trillions in cost. Raising taxes on the middle class is a political third rail. Other options, like reducing health care benefits or raising payroll taxes are also politically dicey. Small wonder then that the top-tier Democrat — whose motto is that she has a plan for everything — doesn’t have one yet for how to pay for universal health care. (Ollstein, 10/21)

One explanation, according to sources close to Warren’s campaign, is that the U.S. senator from Massachusetts is still considering financing options and at least one under review does not include a middle-class tax hike. “I’ve been working for a long time on this question about what the costs will be and how to pay for it and I’m getting close. It’s just got a little more work that it needs on it before it’s ready,” Warren told reporters in Indianola, Iowa, on Sunday, adding that she will be “ready to put out a plan soon on exactly what the costs will be.” (Becker, 10/21)

Gov. Charlie Baker's new health care bill focuses on primary care, behavioral health and prescription drug prices. On the national stage, Sen. Elizabeth Warren's Medicare for All proposal is facing deeper scrutiny over its potential cost. A WBUR poll released today found that while Warren is currently the top choice for Massachusetts voters in the 2020 Democratic presidential primary, her health care proposal is not. (Dearing and Citorik, 10/23)

The South Bend, Indiana, mayor is betting other Iowans are also scrutinizing Medicare for All, the policy idea that's dominated the health care conversation this election cycle. He's used television appearances and ads in recent weeks to proclaim that Medicare for All will take away choice for Americans. "Iowans, by nature, are practical," [Mayor Pete] Buttigieg told the Des Moines Register. "I think this is a state where people are strong in progressive values, and also looking for a way to deliver on those values that's not polarizing." (Rodriguez, 10/23)

Two top Obamacare officials spent years in their Washington offices, right next door for a time, thinking about how to fix health care. Then both came to North Carolina, determined to put their ideas to the test in the real world. One runs the state Health and Human Services Department, including Medicaid. The other led the state’s dominant private insurer. Combined, they cover well over 6 million people, more than half the state. Together, they made North Carolina arguably the most innovative state in the country when it comes to improving how health care is delivered and addressing the underlying social and economic drivers, like homelessness, of poor health and high costs. (Kenen, 10/24)

North Carolina has embarked on an ambitious attempt to shift health care payments so they reward the value of care, not the volume. Working largely through Medicaid and North Carolina’s dominant private health insurer, the state is also addressing social and economic drivers of poor health, like homelessness. Here’s how that’s working in practice for three providers: an urban safety net hospital, a small-town family doctor and a community clinic. (Kenen, 10/24)

Anthem's third-quarter profit jumped 23%, and the Blue Cross-Blue Shield insurer raised its 2019 forecast after pulling in more people covered by Medicare Advantage and Medicaid. Anthem also gave investors an initial glimpse into next year's profit expectations. (Murphy, 10/23)

Anthem said on Wednesday medical costs in its Medicaid business, which manages health plans for low-income Americans, improved in the quarter even as overall costs rose and came in higher than Wall Street targets. "We're very positive about the overall Medicaid environment business going forward," Boudreaux said. The insurer reported third-quarter profit ahead of estimates and raised its full-year earnings forecast, riding on higher sales of its government-backed health plans. (Mathias and Humer, 10/23)

The health insurer also gave some initial projections for 2020, suggesting that adjusted earnings per share growth will be around the low end of its 12% to 15% targeted rate. Anthem also said it still expects its new pharmacy-benefit manager, IngenioRx, to produce gains of at least $800 million, or around $2.30 per share, next year. (Wilde Mathews and Sebastian, 10/23)

Amazon.com Inc said on Wednesday it bought healthcare start-up Health Navigator, its second purchase in the healthcare services industry. The deal comes after the company acquired online pharmacy PillPack last year, pitting itself against drugstore chains, drug distributors and pharmacy benefit managers. (10/24)

The company’s ambitions in health care have been the subject of fevered speculation in the industry and among investors well versed in Amazon’s record of disrupting established industries. Amazon has partnered with Berkshire Hathaway Inc. and JPMorgan Chase & Co. to launch Haven, a nonprofit working on ways to halt the rise in employee health-care costs. (Day, 10/23)

The baby’s lips were turning blue from lack of oxygen in the blood when his mother, Kristin Johnson, rushed him to an emergency room here last month. Only after he was admitted to intensive care with a respiratory virus did Ms. Johnson learn that he had been dropped from Medicaid coverage. The 9-month-old, Elijah, had joined a growing number of children around the country with no health insurance, a trend that new Census Bureau data suggests is most pronounced in Texas and a handful of other states. Two of Elijah’s older siblings lost Medicaid coverage two years ago for reasons Ms. Johnson never understood, and she got so stymied trying to prove their eligibility that she gave up. (Goodnough and Sanger-Katz, 10/22)

Arizona quietly suspended plans to require about 120,000 people to work, volunteer or go to school to receive Medicaid benefits, as courts have taken a dim view of similar mandates in other states. The decision is another setback to efforts by President Donald Trump and his allies in many Republican-led states to put conditions on low-income people seeking taxpayer funded benefits. (Cooper, 10/21)

Three governors’ races next month could affect the medical coverage of hundreds of thousands of people and offer test cases of how voters might view health care issues — particularly Medicaid for lower-income people. In Mississippi, the Democratic candidate vows to expand Medicaid under the health care law (PL 111-148, PL 111-152), while the Republican opposes that. The Kentucky GOP governor wants to scale back coverage that his Democratic opponent’s father, a former governor, expanded. And in Louisiana, the incumbent Democratic governor touts his expansion of Medicaid while his GOP challenger would freeze enrollment. (McIntire, 10/24)

In late August, the Minnesota Department of Human Services (DHS) began requiring that people on Medical Assistance, Minnesota's version of Medicaid, fill out a two-page form that enables the state to verify that their assets do not exceed eligibility limits. However, people were given just a 10-day grace period if they failed to return the form by mid-September. Many were unable to meet the tight deadline and were "disenrolled" from Medicaid, creating turmoil for those with urgent or life-threatening medical needs. (Serres, 10/23)

No one said it would be easy to move 1.6 million Medicaid recipients away from the existing fee-for-service system that’s been in place for decades, to a new system with a different management and payment model. And that message – it’s not easy — is what state lawmakers heard Wednesday as top officials from the N.C. Department of Health and Human Services, including Sec. Mandy Cohen, updated lawmakers on the switch to managed care, which is supposed to go into effect Feb. 1. (Ovaska-Few, 10/24)

After years spent opposing past efforts to expand Medicaid, Kansas Senate Republican Leader Jim Denning now has a plan of his own. But the Johnson County lawmaker’s proposal drew tough reviews from both Democrats and members of his own party. (Shorman, 10/23)

President Trump plans to nominate Stephen M. Hahn, a radiation oncologist and chief medical executive at M.D. Anderson Cancer Center in Houston, as the next Food and Drug Administration commissioner, according to people familiar with the situation. Dr. Hahn, 59, would replace acting FDA commissioner Norman “Ned” Sharpless, whose acting term expires on Nov. 1. He took the acting position after the departure in April of previous commissioner Scott Gottlieb. The appointment requires confirmation by the Senate. (Burton, 10/23)

President Donald Trump personally directed administration officials to report to one of his largest donors, Marvel Entertainment chairman Ike Perlmutter, according to a new book by former Secretary of Veterans Affairs David Shulkin. Starting with Shulkin’s interview for the cabinet post, Trump routinely dialed Perlmutter into meetings and asked if the secretary was keeping Perlmutter informed and happy, Shulkin wrote. Perlmutter would call Shulkin as often as multiple times a day, and White House officials such as Stephen Miller would scold Shulkin for not being in close enough contact with Perlmutter and two of his associates at Mar-a-Lago, Trump’s private club in Florida. (Arnsdorg, 10/22)

Women considering surgery to receive breast implants should be warned in advance of the risk of serious complications, including fatigue, joint pain and the possibility of a rare type of cancer, the Food and Drug Administration said on Wednesday. Agency officials are urging manufacturers to print a boxed warning on the packaging of the implants, and to provide a checklist spelling out the risks for prospective patients to review before making a decision and putting down a deposit on the surgery. It will be left to doctors to review those risks with women seeking breast implants. (Rabin, 10/23)

The agency is also recommending patients complete a checklist to make sure they understand all the possible side effects of the implants, such as scarring, pain, rupture and even a rare form of cancer. "We have heard from many women that they are not fully informed of the risks when considering breast implants," the agency said in a statement detailing the recommendations. (Perrone, 10/23)

The FDA’s steps are the latest effort to deal with reports of complications involving devices that have been at the center of sometimes angry debate and legal actions for decades. The devices are used in about 400,000 surgeries in the United States every year, with 75 percent of the women involved getting implants for cosmetic reasons. Most of the rest get them as part of reconstruction after surgery for breast cancer. Over the past few years, patients who say they were harmed by the devices have become increasingly active on social media sites that have enabled tens of thousands of patients to exchange information. (McGinley, 10/23)

Kaiser Health News: A Million-Dollar Marketing Juggernaut Pushes 3D Mammograms

When Dr. Worta McCaskill-Stevens made an appointment for a mammogram last year, she expected a simple breast cancer screening ― not a heavy-handed sales pitch. A receptionist asked if she wanted a free upgrade to a “3D mammogram,” or tomosynthesis. “She said there’s a new approach and it’s much better, and it finds all cancer,” said McCaskill-Stevens, who declined the offer. (Szabo, 10/22)

A flagship Medicare program that HHS expected to engage up to 110,000 people annually each year in measures to help them avert Type 2 diabetes only managed to enroll about 200 people last year, according to an analysis of CMS data. People familiar with the program said a heavy regulatory burden had kept many providers from offering the diabetes prevention service. CMS’s rollout of the program, these sources said, could presage difficulties for any future programs aimed at paying providers of so-called social determinants of health, ranging from housing payments to job training or mold abatement. (Tahir, 10/22)

The only type 1 diabetes-focused venture firm has a new dealmaker. Dr. Steven St. Peter will join the JDRF T1D Fund as a managing director, the fund announced Wednesday morning. ...As managing director, St. Peter will help decide the fund’s next wave of investments — which could define which early-stage diabetes therapeutics companies get attention and funding. (Sheridan, 10/23)

Brain scientists are offering a new reason to control blood sugar levels: It might help lower your risk of developing Alzheimer's disease. "There's many reasons to get [blood sugar] under control," says David Holtzman, chairman of neurology at Washington University in St. Louis. "But this is certainly one." Holtzman moderated a panel Sunday at the Society for Neuroscience meeting in Chicago that featured new research exploring the links between Alzheimer's and diabetes. (Hamilton, 10/21)

Biogen, the drug company, said on Tuesday that it would ask the Food and Drug Administration to approve an experimental drug, aducanumab, to treat people with mild cognitive impairment and the earliest signs of Alzheimer’s disease. About 10 million Americans might qualify for treatment if the drug were approved, according to Michel Vounatsos, the company’s chief executive. Even so, it is not quite time for these patients to celebrate. (Kolata, 10/22)

Biogen’s aducanumab was the last great hope for treating Alzheimer’s disease through an approach that the leading lights in the field have believed in for 30 years: siccing a lab-made monoclonal antibody on amyloid plaques in the brain. Now that aducanumab is back from the dead, with the company announcing on Tuesday that additional data overturned its earlier conclusion that the drug had no chance of working, the “amyloid hypothesis” also has a new lease on life — and Biogen has a potentially zillion-dollar moneymaker, should the Food and Drug Administration be persuaded. (Begley, 10/23)

Beyond the grabby headlines, punchy tweets, and stock market bounces, Biogen’s surprise resuscitation of a once-doomed treatment for Alzheimer’s disease drew a hefty dose of caution — and even some skepticism. The basis for Biogen’s decision was a re-analysis of data from late-stage studies of its drug, aducanumab. Those data, the company said, showed the treatment reduced the rate of patients’ cognitive decline. (Begley and Garde, 10/23)

With a data picture this cloudy, it isn’t hard to imagine the FDA asking for another late-stage efficacy study before any approval. That would likely push any possible approval back by years, quelling today’s optimism. What’s more, even if regulators sign off, insurance companies will likely need to be persuaded that the drug can slow disease progression before they pay for it. (Grant, 10/22)

In this week’s $260 million settlement between drug companies and two Ohio counties hit hard by the opioid crisis, $25 million worth of the addiction medication known as Suboxone is a big part of the deal. Suboxone would make up a much larger share of a proposed national settlement announced shortly afterward by a bipartisan group of state attorneys general: an estimated $26 billion over 10 years out of a $48 billion overall settlement. (Vestal, 10/23)

Teva Pharmaceutical Industries Ltd's proposed $23 billion drug giveaway to settle thousands of U.S. opioid lawsuits will likely cost the company a fraction of that figure due to how it has valued those medicines, according to a Reuters review of pricing data and industry analysts. When Teva announced the value of the donated medicine - a generic version of opioid addiction treatment Suboxone - it based the figure on the drug's list price, which does not account for significant discounts routinely provided by the drugmaker. (Erman and Raymond, 10/23)

Johnson & Johnson on Wednesday lowered its previously reported third-quarter profit by $3 billion to account for a proposed opioid settlement payment. A framework settlement, announced on Monday, was hammered out by some drugmakers and distributors and attorneys general in North Carolina, Pennsylvania, Tennessee and Texas. The proposed deal will need broad support among all the state attorneys general and local governments that have sued the companies over the opioid crisis. (10/23)

The state of Ohio will receive $39.4 million from a $700 million settlement between the federal government and states with a U.K.-based drug manufacturer over the marketing of an opioid addiction treatment medication. Reckitt Benckiser Group agreed in July to pay $1.4 billion to resolve criminal and civil investigations into its marketing of the medication Suboxone. (Heisig, 10/23)

New York and other states have reached a $700 million settlement deal with Reckitt Benckiser over allegations that the drug distributor improperly marketed a drug to treat opioid addiction, New York Attorney General Letitia James said on Wednesday. The deal is a part of an up to $1.4 billion settlement agreed to in July to resolve U.S. state and federal claims that Reckitt Benckiser's former pharmaceuticals business Indivior, before it was spun out, carried out an illegal scheme to boost sales of opioid addiction treatment Suboxone. (10/23)

A new policy from the Drug Enforcement Administration (DEA) aims to improve the agency’s quotas of controlled substances, with the intent of preventing manufacturers from overproducing opioids. A proposed rule published Wednesday would further limit excess quantities of medications that might be vulnerable to diversion for illicit distribution and use, the agency said in a statement. (Weixel, 10/23)

Thousands of people have received brain scans, as well as cognitive and genetic tests, while participating in research studies. Though the data may be widely distributed among scientists, most participants assume their privacy is protected because researchers remove their names and other identifying information from their records. But could a curious family member identify one of them just from a brain scan? Could a company mining medical records to sell targeted ads do so, or someone who wants to embarrass a study participant? (Kolata, 10/23)

Researchers at the Mayo Clinic used commercially available facial-recognition software to match photographs of about 80 volunteers to unidentified MRI images that show outlines of the head in addition to the brain itself. The software correctly matched 83% of the images, they reported in the New England Journal of Medicine. Results are the latest to find technology has outflanked privacy protections in health care, where an aggressive push is under way to amass and mine medical data from patient medical records, research, medical devices and consumer technology such as smartwatches. (Evans, 10/23)

Byran Dai was 24 when he promised his mother, who passed away less than two months later, that he would look out for his younger brother Brandon, who is autistic. Brandon, 15 at the time, was receiving special education and social services, but Mr. Dai knew that by 22, his brother would phase out of the services and education provided by the state. “In the autism community, we call that ‘falling off the cliff,’” Mr. Dai said. “It’s what a lot of families are worried about.” (Rosen, 10/24)

Rep. Bill Posey (R-Fla.) on Wednesday pressed Facebook CEO Mark Zuckerberg over the social media platform's efforts to reduce the spread of anti-vaccine material. Posey used his five minutes during Zuckerberg's appearance before the House Financial Services Committee to ask the CEO why Facebook cracks down on anti-vaccine content if believes in freedom of expression. (Birnbaum, 10/23)

Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis. It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, artificial intelligence and smartphone apps instead of doctors' ears to help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs. (10/23)

Today's teens have a lot on their plate. They strive for perfect grades, college-essay worthy volunteer gigs, trophies in multiple sports — and many of them still find hours a day to spend on social media. "This is an incredibly stressful time to be a teenager," says pediatrician Megan Moreno, a researcher at the University of Wisconsin-Madison. (Vaugh, 10/22)

A phishing scam targeting employees at Kalispell Regional Healthcare may have compromised health information of nearly 130,000 patients, the Montana health system confirmed. Kalispell discovered the phishing incident, in which several employees unknowingly provided login credentials to hackers in response to a "well-designed email," this summer, according to a notification the system posted online Tuesday. Those hackers may have gained unauthorized access to Kalispell's IT systems as early as May 24. (Cohen, 10/23)

When it opens just across the river from St. Louis this week, the new Planned Parenthood clinic in Illinois will be one of the largest abortion clinics in the Midwest, set up to serve around 11,000 women a year with various health services, double the capacity of the clinic it is replacing. Its size says as much about the future as the present: With the Supreme Court’s shift to the right, activists on both sides of the abortion divide are adjusting their strategy, anticipating that Roe v. Wade, the 1973 Supreme Court decision that extended federal protections to abortion, might eventually be overturned and that some states would jump at the chance to ban abortions. (Tavernise, 10/22)

An Oklahoma judge on Wednesday temporarily blocked a new law that would allow doctors who perform medication abortions to face felony charges for not informing women about the possibility of reversing the process. Oklahoma County District Judge Don Andrews issued a temporary injunction that prevents the law from taking effect Nov. 1. The injunction will remain in place while the case is fully litigated before the judge. (10/23)

The Centers for Disease Control and Prevention has linked vaping to 1,479 cases of a mysterious lung disease over the last six months. At least 33 people have died since the outbreak began. The illness is marked by chest pain, shortness of breath and vomiting, and it has largely affected young people. The vast majority of cases, almost 80%, involve e-cigarette users younger than 35, and another 15% are younger than 18. (Baumgaertner, Greene and Mukherjee, 10/23)

Dr. Mangala Narasimhan carefully inserted the long, thin probe down Gregory Rodriguez's throat, snaking it past his vocal cords and deep into his damaged lungs. A ventilator breathed for the 22-year-old college student as Narasimhan began sucking out the yellow, jelly-like clots that had nearly killed him. "It really was gross," said Narasimhan, a lung specialist and director of critical care medicine at Northwell Health in New Hyde Park, New York. (Hughes and O'Donnnell, 10/23)

Kaiser Health News: As Vaping Devices Evolve, New Potential Hazards Scrutinized

The smokeless tobacco industry that began with low-voltage cigarette look-alikes has evolved to include customizable, high-wattage machines capable of generating enormous clouds of vapor ― and potentially toxic substances. As the technology continues to change, researchers are finding more evidence that the way vaping devices and e-liquids interact could harm consumers. High-powered devices may overheat vaping liquids to produce toxic chemicals, tobacco experts warn, and the aerosol that is inhaled may be contaminated with dangerous metals from the device. (Heredia Rodriguez, 10/24)

For years, a divisive debate has raged in the United States over the health consequences of nicotine e-cigarettes. During the same time, vaping of a more contentious substance has been swiftly growing, with scant notice from public health officials. Millions of people now inhale marijuana not from joints or pipes filled with burning leaves but through sleek devices and cartridges filled with flavored cannabis oils. People in the legalized marijuana industry say vaping products now account for 30 percent or more of their business. (Richtel, 10/21)

Numerous U.S. states have put bans on some types of the products, and federal regulators have also signaled that tighter curbs on vaping are coming soon. If the crackdown endures, tobacco companies will find themselves in an unusual situation in 2020: While the vaping controversy may cloud the future of different cigarette alternatives that they’ve spent billions of dollars to develop, it may also mean their staple products—the cigarettes that made them into globe-spanning behemoths but also left them on the hook for hundreds of billions for smoking-related illnesses—stage a bit of a comeback. (Kary, 10/23)

For the first time, U.S. health regulators have judged a type of smokeless tobacco to be less harmful than cigarettes, a decision that could open the door to other less risky options for smokers. The milestone announcement on Tuesday makes Swedish Match tobacco pouches the first so-called reduced-risk tobacco product ever sanctioned by the Food and Drug Administration. (Perrone, 10/22)

The powerful Ways and Means Committee advanced, 24-15, a bill that would tax nicotine used in e-cigarettes to the House floor Wednesday. The legislation (HR 4742), sponsored by New York Democrat Tom Suozzi, would establish a $27.81 tax per gram of nicotine used in vaping devices. Traditional cigars and cigarettes, which already face a similar tax, are exempt. Smoking cessation therapies are also excluded. (Clason, 10/23)

A five-block section of downtown Los Angeles that used to be part of the city’s Toy District has become ground zero for the nation’s counterfeit cannabis trade. While a few remaining stores sell fidget spinners and stuffed animals, the majority are hawking vape cartridges, e-juice flavors, vaporizers and other wholesale smoking and vaping supplies — including knockoffs that originated in China. (De Marco, 10/18)

It all started at the mall when a friend offered her a puff from a JUUL e-cigarette. "It was kind of peer pressure," says Beth, a Denver-area 15-year-old who started vaping in middle school. "Then I started inhaling it," she says. "I suddenly was, like, wow, I really think that I need this — even though I don't." (Daley, 10/23)

Kaiser Health News: For Generation Juul, Nicotine Addiction Happens Fast And Is Hard To Shake

When Will tried his first vape during his sophomore year, he didn’t know what to expect. It was just something he had vaguely heard about at his high school. “I just sort of remember using it a bunch of times, like in a row,” he said. “And there’s this huge buzz-sensation-like head rush. And I just … didn’t really stop.”Will kept vaping nicotine addictively for the next year and a half. He was part of a trend. (Yu, 10/21)

Governor Charlie Baker faced questions Wednesday on Boston Public Radio about the merits of his four-month ban on all vaping products that has come under fire by consumers, regulators, industry experts, and much of the wider community. The ban, which Baker implemented late last month, is on shaky ground this week after a state judge ruled Monday that the governor’s administration has until next week to properly re-file the ban as an emergency regulation, or nicotine vape sales will resume. (Gans, 10/23)

The plaintiffs in the case challenging Governor Charlie Baker’s four-month ban on the sale of nicotine and marijuana vaping products have also filed an appeal of a Superior Court judge’s ruling that partially sided with the vaping industry. The Vapor Technology Association on Tuesday asked the Appeals Court to impose an immediate injunction based on Superior Court Judge Douglas Wilkins’s conclusion that the plaintiffs were likely to prevail in their lawsuit seeking to overturn the ban. (Murphy, 10/23)

Despite the spread of vaping-related illnesses, Florida’s top health official told legislators the state isn’t taking dramatic steps at this time to address the issue. Florida Surgeon General Scott Rivkees said Tuesday the state has had 68 cases of vaping-related illnesses in 21 counties and one confirmed death. (Sexton, 10/23)

A vote could come within the next month on legislation aimed at curbing youth tobacco and e-cigarette use, House Speaker Robert DeLeo suggested Tuesday as advocates met with lawmakers to make their case for quick action to ban flavored tobacco. A day after a Superior Court judge allowed the Baker administration’s temporary ban on vaping product sales to stay in place for at least another week, DeLeo said that vaping is an “evolving issue” and that he hopes lawmakers use the coming weeks to “take a more comprehensive look beyond just a plain vaping ban.” (Lannan, 10/23)

Climate change is making it harder to eradicate deadly epidemics, with rising temperatures helping mosquitoes spread malaria in higher places in Africa, the head of a global health fund said on Tuesday. Other potential deadly consequences of climate change include more intense cyclones which leave an increased risk of infections in their wake, said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. (Farge, 10/22)

Albert Einstein. Benjamin Franklin. Thomas Edison. Steve Jobs. Picture a brilliant person and odds are a white man will come to mind. That idea gets into kids’ heads as early as the age of 6, a new study finds. Researchers who polled more than 200 New York kindergartners and first-graders found that they had already begun to believe that white men are more “brilliant” than white women. (Khan, 10/23)

More pedestrians and cyclists were killed last year in the United States than in any year since 1990, according to a report released on Tuesday by the National Highway Traffic Safety Administration. Most of the news about traffic safety has been good in recent decades, as vehicle manufacturers have added safety features, drunken driving deaths have fallen and seatbelt use has climbed to nearly 90 percent. But in recent years, pedestrian and cyclist deaths have been a disturbing outlier. (Bogel-Burroughs, 10/22)

A semi-viral Facebook post from a Pennsylvania police department has become the latest example of an exhausting Halloween tradition: the spread of super-scary — but largely unfounded — warnings about poisoned Halloween candy. This time, the police in Johnstown, Pa., warned people that “drug laced edibles are package [sic] like regular candy and may be hard to distinguish from the real candy” and urged parents to check their kid’s hauls for edibles containing THC. (Ohlheiser, 10/23)

Scientific research ideally is colorblind, with merit the only factor in hiring, publishing or the awarding of research grants. But the reality often falls short. Eight years ago, a study published in Science found that black researchers were 10 percentage points less likely than white ones to receive funding from the National Institutes of Health, even after controlling for factors like educational background, previous research awards and publication record. Its authors theorized that the difference might reflect an accumulation of slight advantages over the course of white scientists’ careers. (Goldberg, 10/23)

In another milestone on the long, expensive and sometimes discouraging road to wiping out polio, global health officials announced Wednesday that two of the three strains of wild polio virus have officially been eliminated. Although that brings the world another step closer to eradication, the effort has taken far longer than was ever anticipated. When the campaign began in 1988, most public health officials and donors expected the battle to be over by 2000. (McNeil, 10/23)

Doctors are criticizing a recent recommendation from medical experts to give blood-thinning drugs to nearly all women who give birth by caesarean section, saying the advice may be unsafe and tainted by potential conflicts of interest. Hospitals across the U.S. have been adopting the recommendation—aimed at preventing fatal blood clots—since it was published in the medical journal Obstetrics & Gynecology in 2016. But many doctors say there isn’t any evidence to support such widespread blood thinner use and it could harm some women. (Hopkins, 10/23)

In 1991, Karestan Koenen was a recent college graduate and Peace Corps volunteer who arrived in a village in Niger eager to help local women start small businesses. When her sister came to visit during Christmas, the two decided to travel north to Agadez, a city in the Sahara. There, on the morning of Dec. 27, two male traders stopped by, trying to sell them jewelry. Koenen’s sister went to the market with one of men to have a look. While she was gone, the second man grabbed Koenen, held her down and raped her. (Cimons, 10/19)

The shortage of a crucial drug that fights childhood cancers has left both families and hospitals in a desperate search for treatment. In July, Teva Pharmaceuticals discontinued the production of vincristine, an injection vital to the treatment of children suffering from a number of different cancers. (Bakst, 10/23)

Blood pressure medicines may work better if they are taken at night. Spanish researchers randomized 19,084 men and women with diagnoses of high blood pressure, half to take their medicine at bedtime and the other half when they awoke. Over a six-year follow-up, there were 3,246 coronary events — stroke, heart attack, heart failure, angina and others — and 310 deaths from cardiovascular disease. (Bakalar, 10/23)

In a nod to transgender and nonbinary customers, Procter & Gamble said this week that it was removing the Venus symbol, which has historically been associated with womanhood and the female sex, from the wrappers of Always brand sanitary pads. “For over 35 years Always has championed girls and women, and we will continue to do so,” the company said in a statement. “We’re also committed to diversity and inclusion and are on a continual journey to understand the needs of all of our consumers.” (Murphy, 10/22)

It was a challenge unlike any other the chef-turned-graduate student had faced: Vayu Maini Rekdal had to create a menu where every ingredient could be eaten either raw or cooked. No pickling was allowed, nor fermented toppings like soy sauce or miso. Nothing could be processed in any way, so things like tofu were out. And the more sweet potatoes he could serve up, the better. “It was extremely challenging,” said Mr. Rekdal, a chemistry graduate student at Harvard. (Greenwood, 10/23)

Slave to your sweet tooth? Researchers say the predilection for sweetened drinks — a major driver of the nation’s obesity crisis — begins in childhood. That’s one reason health experts recommend children under 2 never be given fruit juice. When it comes to children 2 to 18, the American Academy of Pediatrics recommends a daily limit of 25 grams of sugar, or six teaspoons. Nice try. (Jacobs, 10/22)

Each of us appears to have a unique way of moving, a physical “signature” that is ours alone, like our face or fingerprints, according to a remarkable new study of people and their muscles. The study, which used machine learning to find one-of-a-kind patterns in people’s muscular contractions, could have implications for our understanding of health, physical performance, personalized medicine and whether and why people can respond so differently to the same exercise. (Reynolds, 10/23)

Diagnostic errors are the most frequent adverse safety event patients can experience in outpatient care, according to a new ECRI Institute report. The analysis, published Wednesday, found that diagnostic testing errors represented 47% of all patient safety events reported in an outpatient setting over a one-year period. The second-most common safety event was medication errors, accounting for 27% of total events. (Castellucci, 10/23)

Imagine a health-care system in which doctors and nurses are so exhausted and beaten down that many of them work like zombies — error-prone, apathetic toward patients and at times trying to blunt their own pain with alcohol or even suicide attempts. That is what America’s broken health care system is doing to its health workers, according to a 312-page report released Tuesday by the National Academy of Medicine, one of the country’s most prestigious medical institutions. (Wan, 10/23)

If there's one thing you do want to catch from a trip to your doctor, it's her optimism. A new study, published Monday in the journal Nature Human Behavior, finds that patients can pick up on subtle facial cues from doctors that reveal the doctor's belief in how effective a treatment will be. And that can have a real impact on the patient's treatment outcome. (Vaughn, 10/21)

In the face of rising rates of depression, anxiety and suicide among young people, some states and school systems have started allowing students to take mental sick days off from school. Last year, Utah changed its definition of valid excuses for absences to include mental health issues. This summer, Oregon enacted a law — driven by a group of high school student activists — that allows students to take days off for mental health. (Wan, 10/22)

The dispatch call from the Concord, N.H., police department is brief. A woman returning to her truck spotted a man underneath. She confronted him. The man fled. Now the woman wants a police officer to make sure her truck is OK. "Here we go," mutters Officer Brian Cregg as he steps on the gas. In less than three minutes, he's driving across the back of a Walmart parking lot, looking for a man on the run. (Bebinger, 10/22)

New data reveals that damaging air pollution has increased nationally since 2016, reversing a decades-long trend toward cleaner air. An analysis of Environmental Protection Agency data published this week by researchers at Carnegie Mellon University found that fine particulate pollution increased 5.5 percent on average across the country between 2016 and 2018, after decreasing nearly 25 percent over the previous seven years. (Popovich, 10/24)

Trans fatty acids, known to increase the risk for heart disease, stroke and diabetes, have now been linked to an increased risk for dementia. Researchers measured blood levels of elaidic acid, the most common trans fats, in 1,628 men and women 60 and older and free of dementia. Over the following 10 years, 377 developed some type of dementia. (Bakalar, 10/23)

Nestlé SA, one of the world's largest food processors, believes population growth will require human diets to adapt, reducing consumption of sugar, salt and meat products, an executive said on Wednesday. "We have 7.5 billion people and the population continues to grow, so there is a need to eat more vegetables, cereals, and less sugar, meat products," said Laurent Freixe, Executive Vice President and head of operations in the Americas. (10/23)

Kaiser Health News: Compression Garments Can Ease Lymphedema. Covering Costs? Not So Easy.

Every morning, Britta Vander Linden dons compression stockings, a cumbersome process she calls “putting on my legs.” She relies on the garments to stand and walk without intense leg pain and swelling. That’s because Vander Linden, 44, was born with lymphedema. The condition affects the lymphatic system, a network of lymph nodes and vessels that move infection-fighting liquid through the body. (Heredia Rodriguez, 10/23)

Kaiser Health News: For Boomers Reframing Aging, Age-Proofing A Home Won’t Come Cheap

Dennis and Chris Cavner, in their early 70s, are preparing to move less than two blocks away into a 2,720-square-foot, ranch-style house they bought this year. But first a renovation is underway, taking the 45-year-old property all the way back to its studs. When the work is finished, these baby boomers are confident the move will land them in their forever home. “We wanted to find a house that we could live in literally for the rest of our lives,” Dennis Cavner said. “We were looking specifically for a one-story house and one that had a flat lot, to age in place.” (Jayson, 10/21)

The same tactics that law-enforcement officials developed to stop terrorists should be adopted to prevent mass shootings, Attorney General William Barr said in a memo released Wednesday directing the FBI to find ways to better identify and thwart such attacks. Authorities should include psychologists, community groups and “intervention teams” when trying to gauge whether someone is gearing up for mass violence, in much the same way the FBI’s terrorism squads seek to identify people as they radicalize, Mr. Barr wrote in the memo to the nation’s federal prosecutors. (Gurman, 10/23)

Repeated school shootings have yet to force action on gun control in Washington, but safety advocates are trying to build support for another strategy to keep children safe: smart school design. Two bills pending in Congress would provide school districts with more information about safe school design, as well as money to pay for design services. As districts focus more intently on safety, some architects are pushing back against a rush to load up schools with security equipment by promoting community over technology. (Prevost, 10/22)

A rapidly spreading wildfire driven by strong winds exploded in Sonoma County late Wednesday, prompting evacuation orders for residents east of Geyserville. The Kincade fire is an estimated 7,000 acres and has no containment, according to the California Department of Forestry and Fire Protection and local officials. It is being driven by strong north winds and is moving south, a Cal Fire spokeswoman said Wednesday night. It started in a mountainous area near Kincade Road and Burned Mountain Road, according to preliminary information. (Cosgrove and Lin, 10/24)

Strong offshore winds and extremely dry conditions will result in widespread critical fire weather conditions throughout California on Thursday, according to the National Weather Service. Strong surface high pressure in the Great Basin will promote strong northeasterly Santa Ana winds. (Duginski, 10/23)

PG&E Corp. on Wednesday began shutting off power to 179,000 customers in 17 California counties, its second major intentional blackout this month meant to head off potential wildfires. The shut-offs began at 2 p.m. local time in the Sierra Nevada foothills and 3 p.m. in some counties north of San Francisco. More were planned for 1 a.m. Thursday in parts of San Mateo County, between San Francisco and San Jose, and Kern County, in the southern part of the state’s Central Valley. (Carlton, 10/24)

More than half a million utility customers could lose power this week as California braces for hot weather, strong winds and the heightened potential for fast-moving wildfires. Southern California Edison said more than 308,000 customers in seven counties — Ventura, Los Angeles, San Bernardino, Riverside, Orange, Kern and Santa Barbara — could face blackouts starting Wednesday night and rolling into midday Thursday. (Fry and Cosgrove, 10/23)

Public schools Supt. Michelle John greeted a gym full of teachers for a kickoff breakfast a day before the start of the 2019-20 school year. She spoke of loss, perseverance and duty. Ms. John expected about a third of the students from last year. Many would be ferried into Paradise by families living outside of town. “It’s been, of course, the toughest summer of my life and we just have to keep going,” she said, her voice wavering. “We have kids coming.” (Ailworth, 10/21)

After the Make-a-Wish Foundation was told that Olivia Gant, who was 6, had a terminal illness, it made one of her dreams come true. In 2017, the girl was transformed into a superhero Bat Princess for a day so she could save other princesses from evil villains. A local CBS station in Denver captured a heartwarming scene as Olivia, dressed in a blue Batman mask, shiny purple cape and custom logo, walked through a cheering crowd holding swords above her head and battled with a volunteer dressed as Ursula, Disney’s sea witch from “The Little Mermaid.” Olivia later sang “Part of Your World” with Ariel. (Rueb and Padilla, 10/23)

The number of Connecticut schools with vaccination rates that don’t meet federal health guidelines has grown, according to newly released data. There were 134 schools in the state with immunization rates for measles, mumps and rubella vaccinations of kindergartners that dipped below 95% during the 2018-19 school year, up from 102 from the previous year, according to data released Monday by the state Department of Public Health. (De Avila, 10/21)

Measles, which was declared eliminated from the United States in 2000, has returned with a vengeance this year, with 1,250 individual cases confirmed in 31 states so far in 2019. Though no other measles cases have yet been linked to last week’s visit, places that have a high volume of visitors, like Disneyland, strike a special fear among public health officials. (Hassan, 10/23)

Los Angeles County health officials say a visitor to Disneyland this month may have exposed others to measles. The Department of Public Health says a county resident with a confirmed case of measles visited the theme park on Oct. 16 from 9:15 a.m. to 8:35 p.m. (10/23)

Insults like “financial parasites” and “bums” have been directed at them, not to mention rocks and pepper spray. Fences, potted plants and other barriers have been erected to keep them off sidewalks. Citizen patrols have been organized, vigilante style, to walk the streets and push them out. California may pride itself on its commitment to tolerance and liberal values, but across the state, record levels of homelessness have spurred a backlash against those who live on the streets. (Fuller, Arango and Keene, 10/21)

Nearly 4,000 Kaiser mental health workers in California represented by the National Union of Healthcare Workers voted to strike the week of Nov. 11, the union announced Wednesday. The union described Kaiser's mental health employees as the "proverbial stepchild," citing fragmented care amid an otherwise integrated system, overwhelming caseloads, excessive wait times for appointments and inadequate pay and benefits. (Kacik, 10/23)

This year, the nurses at St. Christopher’s Hospital for Children celebrated a major victory. They had won powerful staffing guidelines in their new union contract, the first in the state with enforceable standards for how many patients one nurse could be required to care for at a time. ... But now, the fate of the contract is in question. As St. Christopher’s is purchased for $50 million by Tower Health and Drexel University as part of a bankruptcy sale, Tower says it will not honor a contract it didn’t negotiate — a standard move for a buyer — and nurses are readying for a fight to get its new owners to do so. (Reyes, 10/23)

Kaiser Health News: Washington State Law On Behavioral Care Balances Parental Rights, Teens’ Autonomy

When Ben Packard met with the 16-year-old girl a little over a year ago, she was a patient at Seattle Children’s Hospital, where she’d been admitted after trying to kill herself. Her parents were distraught. “They wanted to know what was going on, and why their kid wanted to die,” said Packard, a mental health therapist on the psychiatric unit who worked with her and her family. But Washington is one of many states that carved out exceptions to the rights of parents to know about or consent to certain types of care their minor children receive, including mental health and drug and alcohol treatment as well as reproductive health services such as birth control and abortion. (Andrews, 10/24)

California and New York City sued the U.S. Postal Service on Tuesday to stop tens of thousands of cigarette packages from being mailed from foreign countries to U.S. residents, saying the smugglers are engaging in tax evasion while postal workers look the other way. The lawsuit in Brooklyn federal court blames the Postal Service for deliveries from Vietnam, China, Israel and other countries, saying the failure to enforce a federal law aimed at banning cigarette mail deliveries costs California an average of $19 million annually in tax revenues and New York City and state over $21 million each year. (10/22)

The number of Maryland children who tested positive for lead poisoning fell 11% in 2018, state health and environmental officials said Wednesday. The number of children with at least 5 micrograms of lead per deciliter of blood, the standard benchmark for determining lead poisoning, fell from 2,049 in 2017 to 1,825 last year. But the number of children found with the highest levels of lead contamination was virtually unchanged, at nearly 400 cases. (Dance, 10/23)

New Hanover Regional Medical Center serves six counties. At 647 beds, as of the state’s last count, it’s also the largest county-owned hospital in North Carolina. But last month, the county signaled that may soon change. The New Hanover County commissioners, by a vote of 3-2, passed an “intent to sell” resolution at a Sept. 16 meeting. County and hospital officials stressed that the resolution is about exploring a range of options for the medical institution’s future. Those options include remaining a nonprofit in county ownership or affiliating with a larger health care system. But they also haven’t ruled out an outright sale either. (Engel-Smith, 10/23)

Former Cuyahoga County Jail director Kenneth Mills was charged Wednesday and accused of making the jail unsafe during a period of time when seven inmates died. A Cuyahoga County grand jury handed up an indictment charging Mills with two second-degree misdemeanor counts of dereliction of duty. (Ferrise, 10/23)

Two young children in Boston were diagnosed with meningococcal disease, which is infectious and can lead to meningitis, a bacterial infection of the brain and spinal cord, officials announced Wednesday.“ Both cases have been associated with day care centers specializing in serving children who have experienced homelessness, however it is not currently known if the two cases are connected,” Mayor Martin J. Walsh and the Boston Public Health Commission said in a statement. (Lovato, 10/23)

An executive of one of Iowa’s most influential medical associations was fired after he criticized Gov. Kim Reynolds for the state's Medicaid “mess” in what he said was a satirical a Facebook post, records obtained by the Des Moines Register this week show. Thomas “Scott” McIntyre's 18-year career with the Iowa Hospital Association ended after his response in March to a coworker’s post that he said also was critical of Reynolds' handling of Medicaid. (Clayworth, 10/23)

Many liberal arts colleges in a demographic and financial trap have sought escape by seeking applicants elsewhere — traveling the country, accepting more international students or adjusting their programming or their pitch. But Regis College, based in Weston, has thrived over the past 15 years, in part by becoming more than a college. (Larkin, 10/24)

Jennifer Gunter said she nearly fell off her chair when she saw the headline on the University of Utah’s medical center website. Getting ready for your wedding night with a premarital exam. Gunter, an OB/GYN and the author of “The Vagina Bible,” says she had never heard of a premarital exam. And, she said, some of the medical advice it seemed to offer was concerning. (Iati, 10/23)

A debate over hiking the salary of Phoenix-based Valleywise Health CEO Steve Purves raises the question of what a nonprofit Arizona health system leader is paid these days. Generally, it's a lot. Leading the earnings for executives leading nonprofit health systems in Arizona is Peter Fine, the CEO of Phoenix-based Banner Health. Fine's most recent salary data available, listed on Schedule J of the company's IRS Form 990, shows he earned a total of $25.5 million in gross pay in 2017. That's a significant leap from his prior year earnings of $8.7 million.The increase was driven by a one-time executive retirement plan payment of $17 million, Banner officials said. (Innes, 10/23)

Toxic blooms of red tide are the scourge of Southwest Florida’s sea turtles, who often find themselves stranded onshore or killed after ingesting too many of their deadly brevitoxins. But researchers and wildlife veterinarians around the state are finding that what treats toxicity in humans – namely, a treatment used for drug overdoses – also works on the four-legged flippers. (Fox, 10/23)

It was an alluring pitch. Patidegib was chemically similar to Erivedge but supposedly safer: By rubbing the stuff on to skin, the thinking went, you could avoid the taste loss, hair loss, and muscle cramps that came when you swallowed it — reactions that kept some from taking the pills. ...To scientists, it’s still an exuberant story of discovery against the odds. To patients like [Kaylene] Sheran, it’s a story tempered with worry: Every side effect, it seems, has been prepared for except financial toxicity. (Boodman, 10/23)

It all began with a hypothesis: That the biology behind Gorlin might hold the secret to other cancers. After tracing this rare disorder to a mutation in one of the hedgehog genes, which help shape bodies during development, researchers began to look for the same clue elsewhere. They found it in the tumors of patients who didn’t have the syndrome but who grew the same sorts of cancers: A molecular lock was missing, allowing hedgehog proteins to proliferate unchecked. In many other cancers, the signs they found were subtler. There were traces of hedgehog proteins but no telltale mutations, a whiff of smoke but no gun. Still, smoke was smoke, and the news wafted from conference to conference, lab to lab. (Boodman, 10/24)

As the Marine Band warmed up and White House aides scurried to set up chairs in a sun-soaked Rose Garden for perhaps the most consequential health care address of the Trump presidency, a brazen mid-level budget aide was battling to jettison the entire event. President Trump was set to take the stage in barely an hour to unveil a “blueprint” to lower prescription drug prices. But on that afternoon in May 2018, Joe Grogan refused to sign off on either the remarks or the policy rollout. (Facher, 10/22)

The House Ways and Means Committee late Tuesday approved Speaker Nancy Pelosi’s drug pricing bill, sending the legislation to the full House floor for a vote expected before the end of this month. The legislation, which passed three committees along partisan lines, has a high chance of approval in the House, where Democrats control the chamber with 234 seats versus 197 held by Republicans. The Education and Labor Committee and the Energy and Commerce Committee made few changes to the bill last week, despite Republican members expressing concerns that the legislation was rushed and dead on arrival in the Senate. (Lovelace, 10/22)

Prescription drug companies and trade groups shelled out millions of dollars to lobby Congress as it considered legislation aimed at reining in skyrocketing drug prices, according to new lobbying disclosure reports. The Pharmaceutical Research and Manufacturers of America (PhRMA) — the trade group representing branded drug companies — spent $6.2 million on lobbying in the third quarter of 2019, which ran from July through the end of September. (Hellmann, 10/22)

The Association for Accessible Medicines wants generic medicines excluded from new Medicare rebates the bill mandates if companies raise their prices above the rate of inflation, the trade group's leader Chip Davis said during a press briefing today. The Senate Finance Committee's drug pricing package, S. 2543 (116), excluded generics from a similar provision. (Karlin-Smith, 10/23)

As debate grows over the role that taxpayer dollars play in drug discovery, an analysis finds one in four new medicines approved by regulators over the past decade benefited from publicly supported late-stage research or spinoff companies that were created by public sector research institutions. Moreover, drugs that were approved following major public financing were more likely to have won speedier approvals by the Food and Drug Administration. These medicines were also more likely to be so-called first-in-class treatments, suggesting they offered novel approaches to therapeutic care and therefore were potentially more clinically important. (Silverman, 10/23)

Eli Lilly Co. posted lower-than-expected revenue as the pharmaceutical company provided more funding for Medicare participants according to a change in federal requirements this year. The Indianapolis-based drugmaker on Wednesday reported third-quarter revenue of $5.48 billion, up 3.2% from a year earlier but below the $5.5 billion analysts polled by FactSet had expected. Lilly said an 8% volume increase drove revenue. (Sebastian and Loftus, 10/23)

Eli Lilly and Co third-quarter sales missed Wall Street estimates on Wednesday as rebates limited revenue from its top-selling diabetes drug Trulicity, and its shares fell about 4%. The Indianapolis-based drugmaker has been banking on newer drugs such as Trulicity and psoriasis therapy Taltz as it faces competition from cheap generic versions of erectile dysfunction treatment Cialis and other older medicines. (10/23)

Humana is suing a slew of pharmaceutical companies for allegedly fixing the prices of widely used generic drugs to boost their profits at the expense of insurers. The Louisville, Ky.-based health insurer alleged in the lawsuit that the drug companies violated antitrust laws by conspiring to obstruct competition among generic manufacturers that would normally lead to reduced prices for those drugs. (Livingston, 10/21)

Novartis reported a strong launch for its new gene therapy Zolgensma—the world’s most expensive drug—overcoming concerns about whether insurers would cover the treatment and a data-manipulation scandal at the unit that makes it. Zolgensma, which costs $2.1 million per patient, brought in $160 million in the three months to Sept. 30, its first full quarter of sales. That was well above analyst expectations of around $98 million. (Roland and Martuscelli, 10/22)

Novartis sales data on Tuesday suggested the Swiss drugmaker is reaping less than the $2.1 million U.S. list price for its gene therapy Zolgensma, as insurers may be getting breaks on the world's most-expensive one-time treatment. The spinal muscular atrophy (SMA) treatment, approved by the U.S. Food and Drug Administration in May, has reaped $175 million in revenue this year, including $160 million in the third quarter. (10/22)

On Monday, Vertex (VRTX) Pharmaceuticals secured approval of a new cystic fibrosis drug. Margot Cleveland bought steaks. She was in the mood to celebrate. Cleveland’s son, 10, was born with cystic fibrosis. He recently started taking an older Vertex medicine, but hopes to switch soon to the newly approved drug, called Trikafta. Life with cystic fibrosis was about to get a lot less stressful. (Feuerstein and Herper, 10/23)

Silicon Valley billionaire Sean Parker, founder of Napster and an early investor in Facebook (FB), has more recently recast himself as a scientifically minded philanthropist, spending much of his vast fortune to fund academic scientists working on new treatments that harness the immune system to attack cancer. Now, Parker is taking on a new role: creating biotech companies. His Parker Institute for Cancer Immunotherapy played a key role in the creation of ArsenalBio, a new biotech startup debuting Thursday that aims to use CRISPR genome editing tools, synthetic biology, and other technologies to engineer immune cell therapies that can better find and kill cancer cells. (Feuerstein, 10/17)

The National Institutes of Health and the Bill and Melinda Gates Foundation will together invest at least $200 million over the next four years to develop gene-based cures for sickle cell disease and HIV with an attribute even rarer in the world of genetic medicine than efficacy, the groups announced on Wednesday: The cures, they vowed, will be affordable and available in the resource-poor countries hit hardest by the two diseases, particularly in Africa. The effort reflects growing concerns that scientific advances in genetic medicine, both traditional gene therapies and genome-editing approaches such as CRISPR, are and will continue to be prohibitively expensive and therefore beyond the reach of the vast majority of patients. (Begley, 10/23)

Do you have expired or unused prescription medicine at home? Get rid of it on Saturday during National Prescription Drug Take Back Day. The nationwide event, sponsored by the Drug Enforcement Administration and law enforcement agencies nationwide, helps people dispose of drugs safely. (Blakemore, 10/22)

Canada's Liberal government is more likely to pass a universal prescription drug plan after losing its majority in Monday's election, setting the stage for what would be the biggest shakeup of the country's public healthcare system since it was created in the 1960s. The Liberals won the most seats in the election but fell short of a majority, which means Prime Minister Justin Trudeau will need the support of rivals like the left-leaning New Democratic Party (NDP) to govern. Both the Liberals and NDP have promised a new national drug plan. (10/22)

The future of medical innovation in America is at a crossroads.Biopharmaceutical science is accelerating at a record pace, leading to new discoveries that are radically reshaping our ability to fight disease. At the same time, politicians in Washington, D.C., are considering legislation to lower drug costs this week that threatens this progress and would put us on a path to government-run health care. (Stephen J. Ublo, 10/17)

A measure being pushed by House Speaker Nancy Pelosi (D-San Francisco) is challenging the Washington assumption that bringing down drug prices is an impossible task — and its approach has been validated by nonpartisan legislative analysts. The bill is H.R. 3, which was advanced Thursday by two House committees on party line votes. The bill would require Medicare authorities to negotiate lower drug prices directly with manufacturers, using a benchmark based on prices for the target drugs in six developed countries, which generally have lower prices than the United States. (Michael Hiltzik, 10/18)

Matt Hiznay was diagnosed with stage IV lung cancer. He was a non-smoker and just 24 years old.Unfortunately for Matt, the cancer was an aggressive form caused by a gene mutation. Thankfully, the U.S. Food and Drug Administration had approved a new chemotherapy drug on the day he was diagnosed. (Scott Walker, 10/22)

Washington is consumed with wall-to-wall coverage of impeachment, Ukraine, and transcripts. Every question we receive from the D.C. press corps is about that. But do you know who isn’t obsessed with this? Our constituents. Every day, we hear from people across North Dakota and Iowa. Most of them are not talking to us about impeachment. They are coming to us because they worry about being able to afford the medications they need to live. They face heartbreaking calculations, trying to figure out if they can pick up their prescriptions and still afford to put food on the table or pay for their housing. (Sens. Chuck Grassley and Kevin Cramer, 10/21)

The headlines were bold, trumpeting House Speaker Nancy Pelosi’s new legislation to lower drug prices, H.R. 3. Many mainstream media outlets said the drug plan would save Medicare $345 billion. Wow. However, each breathless story included the phrase “according to the Congressional Budget Office.” Well, that’s a horse of a different color. (Jason Chaffetz, 10/23)

Even with all of the political chatter in Washington, D.C., talk about controlling prescription drug prices is still rising above the din. Of all the proposals being batted around, one that bases prices on an international average of prices in mostly European countries has bipartisan support. This strategy, known as the international pricing index, is particularly worrisome. (Susan Peschin and Duane Schulthess, 10/21)

One of the many things I’ve learned during four decades of doing research on Alzheimer’s disease is that the work always brings surprises. Biogen’s announcement on Tuesday about its experimental Alzheimer’s drug, aducanumab, was a big one. ...Not long after Biogen’s decision to stop the trials, I wrote in Nature Reviews Neurology that when Biogen had a chance to look more closely at the data, it would likely observe some participants who benefited from aducanumab. At the time, I didn’t think the later analyses would be as good as what I heard Tuesday morning, which is that one of the two trials fully achieved its primary and secondary endpoints. (Dennis J. Selko, 10/23)

Biogen’s rescue mission is in part a different spin on the story; the company says its new data means that one of its trials should never have been labeled a failure in the first place. The attempt to put a positive spin on the second badly failed trial is the same sort of cherry-picking that gets drugmakers in trouble. The world badly needs an Alzheimer’s drug, and the company’s engagement with the FDA may mean the agency is inclined to be open-minded. Biogen still has an uphill battle to prove that it actually has one. (Max Nisen, 10/22)

Despite many promising leads, more than 120 drug treatments for Alzheimer’s disease have failed. But Cambridge-based biotech company Biogen revived hope on Tuesday with its announcement that it would seek Food and Drug Administration approval for a drug it abandoned earlier this year. Biogen’s experimental Alzheimer’s drug aducanumab targets beta-amyloid proteins that form plaque in the brain, which many scientists believe contributes to the debilitating disease. Investors and doctors considered Biogen’s drug the best hope in years for patients with early-stage Alzheimer’s, and the FDA in 2016 granted it fast-track designation for approval. But Biogen in March abruptly suspended its drug trials after a “futility analysis” based on data from December indicated patients were unlikely to show meaningful improvement. That judgment may have been premature. (10/23)

Emily Walden’s son T.J. was 11 when he was first prescribed painkillers after breaking his arm. One prescription led to another, and by the time he was 18 he had become addicted to OxyContin. In an interview with The Courier-Journal of Louisville, Ky., Ms. Walden recalls him saying, “Mom, I don’t want to die from this.” In 2012, he did, at the age of 21. (Spencer Bokat-Lindell, 10/22)

Our failure to prioritize sexual health in the United States is making people sick, and for some of us it will be deadly. The Centers for Disease Control and Prevention (CDC) released new data showing that STDs have reached record highs, after five straight years of increases. Most STDs can be treated, and many are curable, but if they go undetected, they can have life-changing and life-threatening consequences, including cancer, infertility, ectopic pregnancy, and increased risk for HIV. Thousands of Americans die every year as a result of STDs, even though every single one could be prevented.  (David C. Harvey, 10/22)

With costs rising painfully, insurance companies denying care and nearly 30 million people still uninsured, America desperately needs an honest health policy discussion. That’s why it has been so disappointing over the past several weeks to watch multiple candidates parrot right-wing attacks on "Medicare for All," like claiming that it will greatly increase spending on health care or ringing alarms about raising taxes on the middle class. The truth is the opposite: Medicare for All would sharply reduce overall spending on health care. (Donald M. Berwick, 10/22)

A great divide has appeared in the Democratic presidential primary between traditional candidates and populists who have latched onto proposals that sound great — at least to anyone who doesn’t do the math. The current frontrunner, Elizabeth Warren (D-Mass.), is among the candidates trading on the proposed policy of “Medicare for All” plan. Make no mistake: Medicare for All makes for a great soundbite but probably would never be approved even by a Democratic House, let alone a Republican Senate. (David Grazzo, 10/21)

This past week the U.S. District Court in D.C. refused to modify its September decision that found CMS’ 2019 expansion of its Medicare site neutral payment policy illegal. Instead of appealing the decision, CMS should rethink how the Medicare program can become a prudent purchaser of health-care services.  The Medicare site-neutral payments were based on a 2012 MedPAC recommendation that CMS made payments the same between higher paid hospital outpatient departments (HOPDs) and lesser-paid freestanding physician offices. (David Introcaso, 10/23)

I became an obstetrician-gynecologist 20 years ago because I wanted to be a source of compassion and expertise for patients and their families as they navigate a wide range of reproductive experiences, including when they seek abortion care. I wanted to be someone my patients could turn to when others might abandon or judge them. (Lisa H. Harris, 10/22)

California Atty. Gen. Xavier Becerra’s many lawsuits against the Trump administration are policy fights, at the simplest level — legal battles by a blue state to impede a Republican president’s deregulatory and socially conservative agenda.But a more interesting subtext is the work by California and its allies to limit the power of the federal government, and in particular the executive branch of the federal government. (John Healey, 10/22)