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Health insurers are finding success in ObamaCare this year and are planning to expand their offerings in many states, defying expert’s predictions. Insurance startup Oscar Health filed to sell ObamaCare plans in Florida, Arizona and Michigan for the first time, and will enter new markets in Ohio, Tennessee and Texas. (Weixel, 6/26)

Illinois residents who buy health insurance on the state’s Obamacare exchange are unlikely to find out until later this summer how much more they might pay in 2019, but consumers in some other states are facing double-digit increases. Premiums are set to increase by an average of 15 percent for silver-level plans in 10 states and the District of Columbia where proposed rates have been publicly released, according to consulting firm Avalere. (Schencker, 6/25)

Kaiser Health News: Thinking About An Association Health Plan? Read The Fine Print

If you own a restaurant, plumbing company or other small business, you may be intrigued by the expected expansion of association health plans under a new rule that got a stamp of approval from the Trump administration last week. Will they meet your needs? Save you money? Those are important questions for small businesses and self-employed people who struggle to buy affordable insurance for themselves and their workers. (Andrews, 6/26)

One child stopped eating and fell into a depression. Another who could previously walk on his own now asks his mother to carry him everywhere. A third child started biting other children. These are the experiences of children who have spent just three weeks at a temporary family immigration detention at the South Texas Family Detention Center in Dilley, Texas, attorneys and volunteers who work at the center told Reuters. (Levinson, Torbati and Cooke, 6/25)

Dr. Peter Hotez, dean of the National School of Tropical Medicine and a Baylor College of Medicine professor of pediatrics and molecular virology and microbiology, said he would expect the same types and abundance of illnesses in the detention centers as surfaced in evacuation shelters after hurricanes or other disasters, where infections spread quickly. The biggest concerns are viral respiratory diseases, noroviruses, which cause severe vomiting and diarrhea, and enteroviruses, which can cause meningitis, Hotez said. (Gross, 6/25)

The Trump administration has scaled back a key element of its zero-tolerance immigration policy amid a global uproar over the separation of more than 2,300 migrant families, halting the practice of turning over parents to prosecutors for charges of illegally entering the country. Customs and Border Protection Commissioner Kevin McAleenan said Monday that President Donald Trump’s order last week to stop splitting immigrant families at the border required a temporary halt to prosecuting parents and guardians, unless they had criminal history or the child’s welfare was in question. He insisted the White House’s zero tolerance policy toward illegal entry remained intact. (Spagat and Lee, 6/26)

Republicans pressed ahead Monday with a narrow fix to the migrant crisis created by President Trump, all but abandoning efforts for a far-reaching immigration overhaul that would fund a border wall and deal with the fate of young undocumented immigrants. With Trump proving to be an unpredictable ally, deeply divided Republicans say they have little hope of rallying support for a broad package of reforms. However, GOP leaders are eager to adopt legislation that would make sure migrant children can remain with their parents at the border. (DeBonis and Sullivan, 6/25)

Children who allege they’re being detained for crossing the U.S. border without any court oversight and forcibly medicated will have to wait another month for a judge to consider whether the government’s practices violate a 1997 agreement. A federal judge in Los Angeles on Monday postponed to July 27 a hearing that had been scheduled for this week. U.S. District Judge Dolly Gee gave human rights’ lawyers representing immigrant children two days to respond to a separate U.S. Justice Department request to modify the 1997 settlement that restricts the use of detainment so that children caught crossing the border illegally can be held together with their families. (Pettersson, 6/25)

The psychiatrist who has been prescribing powerful psychotropic medications to immigrant children at a federally funded residential treatment center in Texas has practiced without board certification to treat children and adolescents for nearly a decade, records show. (Bogado, 6/25)

Foster care advocates say the government won't likely be able to reunite thousands of children separated from parents who crossed the border illegally, and some will end up in an American foster care system that is stacked against Latinos and other minorities. With few Spanish-speaking caseworkers, it's a challenge tracking down family members of the children who live south of the U.S.-Mexico border, and other relatives living in the states might be afraid to step forward to claim them because of fears of being detained or deported themselves. (6/26)

Two weeks ago, Dalila Pojoy stopped breastfeeding her baby girl. The 33-year-old Guatemalan immigrant decided it was the sensible thing to do in case the U.S. government took custody of her 6-month-old. Little Bernardethe wailed for three days and clawed at her mother’s breast. (Carcamo, 6/25)

The 4-month-old Honduran had just entered the United States illegally with a man who first claimed to be her father, then said he was her uncle, and presented what appeared to be a false birth certificate. The girl, wrapped in white bedding, was placed in a white crib under close watch of U.S. investigators, who waited for a Honduran consular official to arrive Monday. She was among about 1,100 people in a former warehouse that tripled in size last year, largely to accommodate people — many from Central America — traveling as families, and children traveling alone. (6/25)

An analysis of internal documents shows residents at more than two-thirds of Department of Veterans Affairs nursing homes last year were more likely to have serious bedsores, as well as suffer serious pain, than their counterparts in private nursing homes across the country. The analysis suggests large numbers of veterans suffered potential neglect or medication mismanagement and provides a fuller picture of the state of care in the 133 VA nursing homes that serve 46,000 sick and infirm military veterans each year. (Slack and Estes, 6/25)

Today, 39 percent of large employers offer only high-deductible plans, up from 7 percent in 2009, according to a survey by the National Business Group on Health. Half of all workers now have health insurance with a deductible of at least $1,000 for an individual, up from 22 percent in 2009, according to data from the Kaiser Family Foundation. About 41 percent say they can’t pay a $400 emergency expense without borrowing or selling something, according to the Federal Reserve. The bottom line: People like the Jordans simply can’t afford to get sick. (Tozzi and Tracer, 6/26)

A new study reveals that the number of competitors in a given market may be less important than the type of competitors when analyzing healthcare costs. Sufficient competition, even between only two health systems, generally translated to lower healthcare costs, according to a report from the Healthcare Financial Management Association, Leavitt Partners and McManis Consulting, with support from the Commonwealth Fund. The reseach examnined cost indicators using commercial data from 2012 to 2014, and Medicare data from 2007 to 2015. (Kacik, 6/25)

General Electric Co. plans to spin off its health-care business and unload its ownership in oil-services company Baker Hughes, people familiar with the matter said, betting that the once-sprawling conglomerate can reverse a painful slump by further shrinking. The moves are the conclusion of a yearlong strategic review by CEO John Flannery that has been tumultuous for GE employees and investors. The onetime industrial bellwether has slashed its dividend and has already set plans to shed numerous businesses. Its shares have tumbled by half in the past year, erasing more than $100 billion in wealth. (Gryta, 6/26)

Instead Gawande, a best-selling author and surgeon, frets over processes and systems that others might find tedious, but that can make the difference between life and death. His signature innovation is a drab slip of paper called the surgical checklist, 19 steps intended to prevent mistakes by having the operating-room staff pause and check at critical junctures. (Freyer, 6/25)

Kaiser Health News: Gawande’s Goal Is Providing The ‘Right’ Health Care In New Venture By 3 Firms

Dr. Atul Gawande, the famed surgeon-writer-researcher chosen to lead a joint health venture by three prominent employers to bring down health costs, said his biggest goal is to help professionals “make it simpler to do the right thing” in delivering care to patients. His comments at the Aspen Ideas Festival came just days after being named chief executive of a health care partnership unveiled earlier this year by Amazon, Berkshire Hathaway and JP Morgan Chase & Co. The new enterprise will oversee health coverage for about 1.2 million employees of the companies and their families. Gawande said he will focus on the same behaviors by doctors and hospitals that he studies at his Boston-based think tank Ariadne Labs. (Rovner, 6/26)

Leaders at El Camino Hospital, located in California's Silicon Valley, wanted to make it easy for tech-savvy consumers to shop online for personalized, reliable price estimates for its medical services. The independent not-for-profit hospital launched a consumer self-service tool in May 2017, after about a year of development work with Experian Health, which previously helped El Camino set up an internal price-estimator tool for its billing staff. Since then, more than 3,000 people have visited the hospital's website, selected one or more of about 90 medical or surgical services they were interested in, entered their insurance information, and received an instant out-of-pocket cost estimate the hospital claims is 95% to 99% accurate. (Meyer, 6/23)

A federal court has received the American Hospital Association's ideas on reducing the huge backlog of denied Medicare claims. A federal judge may mandate HHS to follow some or all of the ideas in order to curb the ever-growing number of appeals. The ideas were filed Friday in response to a request from U.S. District Judge James Boasberg. He asked the AHA to submit ideas after he was reportedly frustrated with HHS' inability to process appeals. As of June 2017, 607,402 pending appeals would not be reviewed for another three years, the agency predicts. At this rate, the backlog will reach 950,520 appeals by the end of fiscal 2021. (Dickson, 6/25)

Mayo and other major hospitals across the country have responded with new clinics and consolidated mental and physical health services to meet the needs of trans people. But as they work to meet that rising demand, doctors are also navigating some difficult medical and ethical questions. (Richert, 6/25)

Washington state's largest psychiatric hospital has lost its federal certification and $53 million in annual federal funds after a recent unannounced inspection discovered a list of health and safety violations. The Centers for Medicare and Medicaid Services notified the state on Monday that Western State Hospital is out of compliance, and the federal government will not make payments for patients admitted after July 8. They'll cover current patients for up to 30 days. (6/25)

The hospital, which has been at risk of losing federal funding since a 2015 inspection, holds about 850 beds for patients who are involuntarily committed due to psychiatric disorders as well as criminal defendants whose competency is in question. Washington officials say the funding loss — which comprises less than 20 percent of Western State’s annual budget — won’t disrupt its operations. (O'Sullivan, 6/25)

Today, science has made possible what [Victor] Hugo could not have fathomed in his day: water-sampling robots placed at strategic points in a sewer system and capable of delivering ever-more precise information about a community’s health. As the country confronts an opioid crisis that kills more than 60,000 American each year, one Cambridge, Mass.-based company is hoping that it can use that kind of technology to measure traces of the drugs in sewers. Doing so, according to the firm, Biobot Analytics, could help to reveal remarkably detailed patterns of drug use — and give communities a powerful tool to detect emerging public health threats. (Chen, 6/26)

When Jessica Ney stopped by his office one morning in March, Joe Quinn thought she looked happier than he’d ever seen her. She’d just gotten out of rehab for her heroin addiction and couldn’t wait to get her life restarted, she told Quinn and other outreach workers at Pathways to Housing, the innovative Philadelphia program that helped her get a place to live even before she got sober. (Whelan, 6/25)

The number of people choosing to treat chronic pain with acupuncture instead of opioids is growing. [Ryan] Gauthier — a doctor of acupuncture and Oriental medicine at the Henry Ford Health System's Center for Integrative Medicine in Northville —  is eager to help them avoid the highly addictive pain killers. It's his job, of course. But it's also his passion. ...As more people learn more about the drugs' incredible power to destroy and as more doctors cut back on prescriptions (in Michigan the number of opioid prescriptions dispensed decreased by 10.7 percent since 2015), acupuncture is becoming an increasingly attractive alternative. Research shows it is effective in managing some types of pain. (Kovanis, 6/25)

Lawsuits against the opioid manufacturers, including one brought by Missouri Attorney General Josh Hawley, are piling up and drawing scrutiny to the industry's marketing practices. With new federal and state guidelines on opioid use taking hold, prescriptions are down about 20 percent in Kansas and Missouri since 2013. Missouri still doesn't have a comprehensive statewide monitoring system, but Gilmore said her daughter is now "red-flagged" in a system Jackson County set up in 2016. (Marso, 6/26)

The Arizona State Board of Pharmacy will investigate the complaint of a woman who says a Walgreens pharmacist refused to give her medication necessary to end her pregnancy after her baby stopped developing. The woman, who the Arizona Republic identified as Nicole Arteaga, described in a viral Facebook post how she was publicly humiliated when attempting to fill the prescription to end her pregnancy — a pregnancy she wanted, but needed to terminate because she would ultimately miscarry. She says the pharmacist refused to fill the prescription with other customers within earshot and she left the location in tears with her 7-year-old child by her side. (6/25)

Walgreens Boots Alliance Inc. will revamp its training after an Arizona woman said she was humiliated when a pharmacist, citing personal objections, refused to fill a prescription to treat her miscarriage. In an incident that sparked heated commentary on social media, a pharmacist at a Walgreens store in the Phoenix suburb of Peoria wouldn’t dispense a miscarriage drug for Nicole Mone Arteaga, who had just found out that her baby’s development had stopped. (Langreth and Kasumov, 6/25)

Nicole Arteaga described in a viral Facebook post how she unsuccessfully tried to pick up a medication that would terminate a wanted pregnancy after her doctor determined the baby had no heartbeat. The pharmacist refused to fill the prescription, citing his ethics. He did not relent even after both she and her husband attempted to explain the situation. “I stood at the mercy of this pharmacist explaining my situation in front of my 7-year-old, and five customers behind only to be denied because of his ethic(al) beliefs,” she wrote in a Facebook post Friday that has been shared nearly 37,000 times. (Burkitt, 6/25)

For some USC students who visited campus gynecologist George Tyndall, it was obvious right away that something was wrong. They said he touched them in inappropriate ways, made bizarre comments and acted unprofessionally. Others said they left feeling uneasy but weren’t sure what to make of Tyndall’s behavior. It wasn’t until the Los Angeles Times revealed years of misconduct allegations against the doctor that these patients said they began to come to terms with those exams. (Karlamangla, 6/25)

The nation’s rapidly rising suicide rate is a tragedy, and the Centers for Disease Control and Prevention is doing more to address two of the most common ways people take their lives: substance abuse and firearms, the agency’s new director said in his first interview in the role. “It should bring people to have pause,” Robert Redfield said of the suicide rate, in an interview that also touched on his goals for ending the HIV/AIDS epidemic in the U.S., improving immunization rates and strengthening public-health systems in countries where epidemics are a risk. (McKay, 6/25)

Here’s a psychological challenge for anyone over 30 who thinks “kids these days” can’t delay their personal gratification: Before you judge, wait a minute. It turns out that a generation of Americans now working their way through middle school, high school and college are quite able to resist the prospect of an immediate reward in order to get a bigger one later. Not only that, they can wait a minute longer than their parents’ generation, and two minutes longer than their grandparents’ generation could. (Healy, 6/26)

Several dozen African clinics and hospitals are the latest front in the battle to decipher the genetic roots of the little-understood diseases schizophrenia and bipolar disorder. Scientists currently search for hints in genetic databases largely extracted from European and North American populations. That means they may be missing genetic variants in other populations that could help explain how the diseases develop—and how to treat them. (Whalen, 6/25)

Kaiser Health News: Dementia And Gun Safety: When Should Aging Americans Retire Their Weapons?

With a bullet in her gut, her voice choked with pain, Dee Hill pleaded with the 911 dispatcher for help. “My husband accidentally shot me,” Hill, 75, of The Dalles, Ore., groaned on the May 16, 2015, call. “In the stomach, and he can’t talk, please …” Less than four feet away, Hill’s husband, Darrell Hill, a former local police chief and two-term county sheriff, sat in his wheelchair with a discharged Glock handgun on the table in front of him, unaware that he’d nearly killed his wife of almost 57 years. (Aleccia and Bailey, 6/26)

A lawyer representing the eldest son and two grandsons of Henrietta Lacks, whose “immortal cells” have been the subject of a best-selling book, a TV movie, a family feud, cutting-edge medical research and a multibillion-dollar biotech industry, announced last week that she plans to file a petition seeking “guardianship” of the cells. “The question we are dealing with is ‘Can the cells sue for mistreatment, misappropriation, theft and for the profits earned without their consent?’ ” said Christina J. Bostick, who is representing Lawrence Lacks, the eldest son of Lacks, and grandsons Lawrence Lacks Jr. and Ron Lacks. (Brown, 6/25)

What do you want in bed? Sexual fantasies are among the most taboo of topics—awkward to talk about, even (or perhaps especially) with a partner we know well. They can sometimes feel embarrassing or shameful, even if we tell no one. We wonder: Where did this come from? Is it normal? (Bernstein, 6/25)

You might know Headspace as a meditation app. What if it were also a prescription medication? The California-based company recently launched Headspace Health, a subsidiary whose executives’ goal is to apply to the U.S. Food and Drug Administration as a prescription meditation app by 2020. The company will soon launch a series of clinical trials to support an application. (Reddy, 6/25)

Provided along with curative treatments, palliative care emphasizes pain and symptom management, care management and coordination, assistance with treatment decisions, and 24-hour-a-day access to the palliative team's nurses and doctors. (Anderson, 6/25)

These wound treatments are often costly, especially when there’s an effort to prevent infection or scarring. However, new wound dressings are being developed in Georgia that could mimic the body’s natural healing process and may not only prevent infection but also reduce the cost of treatment. (Boss, 6/22)

In August 2015, Dr. Mona Hanna-Attisha was having a glass of wine in her kitchen with two friends, when one friend, a water expert, asked if she was aware of what was happening to the water in Flint, Mich. Hanna-Attisha, a pediatrician in Flint, knew that the city had changed its water source the previous year. Instead of channeling water from the Great Lakes, residents were now drinking water from the nearby Flint River. She had been aware of some problems with bacteria after the switch, but she thought everything had been cleared up. (Gross, 6/25)

Four Mississippi residents are accused of defrauding insurers of more than $200 million, the latest indictments in a still-unfolding investigation into pharmacies that prosecutors say bribed health care providers to prescribe handcrafted high-dollar medications that were in many cases unnecessary. Indictments against Hope Thomley and Randy Thomley of Hattiesburg, Glenn Beach Jr. of Sumrall, and Gregory Parker of Laurel were unsealed Monday in Hattiesburg. (6/25)

Since 2009, a state mediation program managed by the Texas Department of Insurance has allowed patients with certain health insurance plans to remain off the hook for large and unexpected medical bills while their insurer and health care provider agree on a payment. ... Mediation requests do not qualify if the health insurance plan is not eligible or the amount of the bill is too small. The Texas Department of Insurance says it has intervened in over $15 million in medical bills since it began to track the payout amounts in 2015. (Rice and Hogue, 6/25)

Advocates of state-funded efforts to expand health insurance coverage for immigrants and some middle-class Californians will have to wait for the next governor before they can have any realistic hope of advancing that goal. Several proposals to make coverage more accessible and affordable for millions of Californians were left out of the state’s 2018-19 budget, dealing a sharp setback to Democratic lawmakers who fashion themselves as leaders of the resistance against federal retrenchment on health care. (Ibarra, 6/25)

Financial services company MetLife Inc. was charged with fraud Monday by Secretary of State William F. Galvin’s office for allegedly failing to make pension payments to hundreds of Massachusetts retirees the company had wrongly presumed to be dead. More than 400 Massachusetts pensioners with an average age of 72 were deemed to be deceased by MetLife after they failed to respond to notices from the company that their pension plans had been transferred to MetLife, according to Galvin. (Conti, 6/25)

Palliative Connect was designed to identify patients at Penn Medicine who have a high risk of dying within six months so they have time to prepare. ...But the data scientists behind Palliative Connect set out with a very different goal in mind: saving lives by predicting which patients were likely to develop one particular life-threatening condition. (Haydon, 6/26)

President Trump’s administration was not shy about its health-care scheme: If it couldn’t repeal the Affordable Care Act outright, it would sabotage it, meaning the White House would create uncertainty and move to end the cost-sharing reduction payments that helped keep premium costs down and keep insurers in the market. Republicans repealed the individual mandate, and the administration cut down on ACA advertising intended to remind the public about open enrollment. Trump’s theory, which he never hid, was that the public would blame President Barack Obama and Democrats would have to agree to one of the GOP plans they unsuccessfully tried to implement in 2017. Let Obamacare “implode,” he declared. As child separation was to immigration (the intentional infliction of pain on innocents to get his way), Trump’s approach of strangling Obamacare (make it more expensive, the exchanges more unstable for consumers) was to health care. (Jennifer Rubin, 6/25)

Polls continue to show that the health care issue, despite being crowded out of the news by immigration, tariffs, North Korea and Trump administration scandals, remains near the top of voters’ concerns. Republican candidates would be wise not to underestimate the power of this issue to sway votes this fall. Among major items of concern:• Two weeks ago, the Trump administration’s Justice Department told a federal court that it would no longer enforce key parts of the Affordable Care Act that require insurance companies selling plans on the Healthcare.gov marketplace to cover consumers with pre-existing conditions. This decision also could affect the 160 million Americans covered by employer-sponsored health care plans, who could be free to resume charging higher premiums or imposing waiting periods for coverage of pre-existing conditions. The administration is rolling out new ”association health plans” for individuals and small businesses. These policies would be cheaper and offer less comprehensive than current plans and might eliminate coverage for things like maternity services, emergency care or mental health treatment. (6/25)

When Sens. Cory Gardner (R-Colo.) and Elizabeth Warren (D-Mass.) introduced legislation this month to restrain the federal government from interfering with state-legal cannabis consumption and commerce, they galvanized an all-too-rare level of bipartisan, bicameral support. Notably missing from the voices of support for their bill are America’s veterans. While the States Act would provide vital protection from federal criminal prosecution under the Controlled Substances Act, it would do nothing to provide legal protection or access to medical cannabis for the nine million veterans who rely on the Veterans Health Administration (VHA). (Nick Etten, 6/26)

Pharmaceutical giants forming venture capital groups is an interesting twist in drug development. We need innovative approaches like that to help create new medications. But they shouldn’t come just from the pharma industry. Personal sacrifice, political will, and a shared commitment to the public good must also play roles. (Allan Hugh Cole Jr., 6/26)

June is Pride Month, a ripe time to reflect on one of the most startling facts about our sexual culture today: Condom use is all but disappearing among large numbers of gay men. Many rightly attribute the condom’s decline to the rise of PrEP — an acronym for pre-exposure prophylaxis, a two-drug cocktail that inoculates a person from contracting H.I.V. But another crucial component is the fading memory of the AIDS crisis that once defined what it meant to be gay. After tracking the sexual practices of 17,000 gay and bisexual Australian men from 2014 to 2017, a team of researchers this month unveiled the most convincing evidence to date. While the number of H.I.V.-negative men who are on PrEP increased to 24 percent from 2 percent, the rate of condom use decreased to 31 percent from 46 percent. More troubling, condom use among non-gay men is also down significantly. (Patrick William Kelly, 6/26)

In my more exasperated moments of residency, I must admit I was envious not only of what my supervising doctors knew, but also who they treated. Residents in our clinic, doctors in training just out of medical school, generally picked up patients they cared for in the hospital — with lots of medical problems, little medical care and often without a place to stay. The attending physicians who supervised us, it seemed, built their patient panels handing out business cards in luxury suites at Patriots games. Over time, as we transferred patients from one graduating resident to the next, our panels came to embody the city’s deepest and most recalcitrant social challenges. (Dhruv Khullar, 6/26)

The FDA’s approval of Epidiolex, a medication derived from cannabis, could be life changing for Americans suffering from certain types of epilepsy. It may also have far-reaching implications for U.S. marijuana policy. Epidiolex, made by GW Pharmaceuticals, is the first medication derived from the cannabis plant ever approved by the FDA. It has in the past approved synthetic formulations of tetrahydrocannabinol (THC) the active ingredient in marijuana. The FDA’s decision directly contradicts the decision by the Drug Enforcement Administration (DEA) to keep the newly approved compound, cannabidiol, under the umbrella of marijuana as a Schedule I substance, since by definition drugs in that class have no medicinal benefit. (John Cooper, 6/26)

As research-validated, evidence-based treatments for addiction disorders continue to emerge, the pendulum has begun to swing from the traditional emphasis on a 30-day inpatient treatment model to a primarily outpatient chronic disease management approach. This shift has many advantages for patients, but it also poses some challenges. Outpatient treatment allows individuals to live their lives and fulfill family and work obligations while receiving the medical care and behavioral therapy necessary for a successful recovery. However, patient retention, compliance, and long-term, consistent follow up with treating clinicians may be more of a concern for outpatient treatment models than for inpatient approaches. It seems now is the perfect time for the emergence of digital technology as a potential solution for some of these challenges. (Brent Boyett and Stephen Taylor, 6/26)

The bigger issue here is whether the city will use the construction of a modest number of housing units as an excuse to start rousting homeless people off streets across Los Angeles at night. That’s the last thing the city should be doing right now. Whether the city has reached what amounts to an arbitrary number of housing units set 11 years ago, there are still — and this should not come as a news flash to city officials — thousands more homeless people than there are available housing units or beds in decent shelters. And until we can solve that problem, police should not be breaking up homeless encampments wholesale at night. (6/26)

Rather than look for innovative, people-first solutions that could include working with local, public hospitals and universities, ADC chooses more of the same: providing inadequate care to some of our state’s most vulnerable. Judge Duncan’s sanctions are themselves an urgent call for change, but apathy is proving to be ADC’s only response. (Tiera Rainey, 6/25)