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U.S. President Donald Trump on Monday declared Obamacare "dead" and "gone," but urged Republicans and Democrats in Congress to craft a short-term fix of healthcare markets under the 7-year-old law that critics say he has effectively sabotaged. "It’s dead. It’s gone. It’s no longer - you shouldn’t even mention. It’s gone," Trump said of former Democratic President Barack Obama's signature 2010 healthcare law that Republicans have repeatedly tried and failed to repeal. (Rampton and Cowan, 10/16)

President Trump threw his weight Monday behind a measure to fix parts of Obamacare, the first time he has voiced approval of a specific legislative approach to do so and an abrupt turnaround on a bipartisan effort to preserve key elements of the healthcare system that he has sought to repeal. Trump’s backing of what he repeatedly referred to as a “short-term fix” to ensure “good healthcare” came during freewheeling remarks in which he sought to mend relations with GOP leaders, even as he kicks a growing list of complicated issues to Congress, including immigration and the Iran nuclear deal. (Mascaro and Bierman, 10/16)

President Donald Trump urged Republican Sen. Lamar Alexander to seek out an Obamacare deal with Democrats — encouragement that might help sway Republicans who are skeptical of a bipartisan agreement. Alexander said Trump told him by phone Oct. 14 he’d like to see a bill that funds the Obamacare cost-sharing subsidies that he abruptly cut off last week. In return, he wants to see “meaningful flexibility for the states in providing more choices,” Alexander (R-Tenn.) said. (Haberkorn, 10/16)

“He called me a week ago and he called me on Saturday,” Alexander said of the effort, which he’s working on with Democratic Senator Patty Murray . “We had a good conversation each time, and he encouraged me to get a result with Senator Murray. He said, ‘I don’t want people to suffer.’ That’s his words.” Trump said Monday that creating a crisis was a necessary step to getting legislation moving. “Republicans are meeting with Democrats because of what I did with the CSRs,” Trump said on Monday at a Cabinet meeting, referring to subsidies to insurers the administration said on Thursday it was cutting off. “If I didn’t cut the CSRs they wouldn’t be meeting, they’d be having lunch and enjoying themselves, all right. They’re right now having emergency meetings to have a short-term fix of health care.” (Tracer, Sink and Litvan, 10/16)

Congressional Democrats have to decide how badly they want an ObamaCare deal. Senate Republicans are open to renewing the insurer payments that President Trump canceled last week, but, in return, they want to expand a program that allows states to waive Affordable Care Act regulations. That asking price could be hard for Democrats to swallow. (Sullivan, 10/17)

U.S. House Speaker Paul Ryan signaled Monday he does not want to restore Obamacare subsidies that President Donald Trump is cutting. Instead, Ryan said, Congress should take a more comprehensive approach and repeal and replace the Affordable Care Act — something the U.S. Senate has failed to do despite multiple attempts this year. (Marley, 10/16)

A pair of swing-state Democrats are offering new legislation that would create Medicare-style options for non-elderly workers, with a heavy focus on rural areas that have few insurers offering coverage under the Affordable Care Act. The proposal, from Sens. Michael F. Bennet (Colo.) and Tim Kaine (Va.), is politically significant because it tries to build on the existing law rather than the tear-it-all-down proposal of a national health-care system that is being offered by Sen. Bernie Sanders (I-Vt.). (Kane, 10/16)

The Trump administration is allowing some insurance companies to change health exchange premiums following the president’s decision to end crucial consumer cost-sharing subsidies. President Donald Trump announced Friday he would end the subsidies, which aid families up to 250 percent of the federal poverty level with copays and deductibles. The subsidies had been at the center of a legal fight between House Republicans and the Obama administration that Trump inherited. (Clason, 10/16)

The short-term medical plans promoted in President Donald Trump’s new executive order on health care have a long history of customer disputes over pre-existing conditions and denied claims -- just the sort of scenarios that were being weeded out by Obamacare. The Affordable Care Act pushes Americans to buy comprehensive long-term coverage; the Obama administration limited short-term plans to three months and prevented them from being extended. The temporary plans are geared toward people who are between jobs or considering retirement. (Larson and Tracer, 10/16)

President Trump’s decision to end payments to insurers that help make health coverage affordable for millions of lower-income Americans under the Affordable Care Act blew up what would have been a year of relatively low rate increases in Pennsylvania. The Pennsylvania Department of Insurance on Monday announced that it had approved average rate increases of 30.6 percent for individual plans to be sold next year both on and off the ACA health insurance exchange. (Brubaker, 10/16)

Insurance premiums for plans sold on Pennsylvania’s ObamaCare exchange will increase by an average of 30.6 percent for 2018, primarily because of President Trump’s decision to stop paying key subsidies, the state’s insurance department said. If Trump had decided to continue making the cost-sharing reduction payments, projections showed a much more modest premium increase of 7.6 percent. (Weixel, 10/16)

Major last-minute changes at the federal level to the Affordable Care Act and additional rate increases at the state level threaten to undermine enrollment in health insurance this year, but Maryland health exchange officials are sticking to a goal of signing up at least as many people as last year. The exchange, where people who do not get insurance through work can buy coverage, enrolled more than 140,000 people in private plans and about 280,000 in the expanded Medicaid program during the last year’s enrollment period for 2017 insurance coverage. (Cohn, 10/16)

Four days after President Donald Trump ended a key Affordable Care Act subsidy, pitching the individual market into further chaos, Republican Gov. Chris Sununu pressed Congress to authorize the payments themselves. In a joint letter sent to Congressional leaders Tuesday, Sununu and New Hampshire Insurance Commissioner Roger Sevigny asked U.S. House and Senate leaders to restore the funding, known as cost-sharing reduction payments, or CSRs, which reimburse insurers for discounts they are legally required give certain low-income individuals. (DeWitt, 10/17)

Gov. Chris Sununu and Insurance Commissioner Roger Sevigny on Monday waded into the national health care debate in a letter to leaders in Congress, urging them to restore cost-sharing reduction payments and pass “the Lower Premiums Through Reinsurance Act of 2017,” a bipartisan measure sponsored by Sen. Susan Collins, R-Maine, and Senator Bill Nelson, D-Fla. The reinsurance program proposed in the legislation would help offset the loss of cost-sharing reduction payments by the federal government, announced last week by President Trump. (10/16)

Gov. Mark Dayton signed off on a federal waiver Monday allowing for Minnesota's new health care reinsurance program. ...Because of the program, non-group, individual-market health insurance rates for next year will be about 20 percent lower than they otherwise would have been, insurers say. (Zdechlik, 10/16)

Under attack from President Donald Trump, the nation’s insurers hit back Monday with a report aimed at showing the industry’s impact on the U.S. economy and the economies of every state, including Connecticut where it said health insurers are a $1.15 billion business. The study, released by America’s Health Insurance Plans, or AHIP, said the health insurance industry employs 9,544 people in Connecticut and their average annual salary is $120,366, much higher than in all other states. (Radelat, 10/16)

Marjorie Swanson was the first in the family to get a job at Baxter Regional Medical Center after moving to this rural Ozark town from Chicago’s South Side in 1995. A year later, her husband was hired by the maintenance department. Six months ago, their daughter snagged a job as a pharmacy technician and shares the night shift with her fiancé, who works in housekeeping. Their son started in 2013 as a biomedical technician, repairing medical equipment. He was introduced to his wife by two nurses there: one who is now his mother-in-law and Beverly Green, an aunt through marriage. (Cohen, 10/16)

President Donald Trump on Tuesday announced that Rep. Tom Marino has withdrawn his name from consideration to become the administration's next drug czar, after CBS' "60 Minutes" and The Washington Post reported that the lawmaker championed a law that hobbled federal efforts to combat the abuse of opioids." Rep.Tom Marino has informed me that he is withdrawing his name from consideration as drug czar. Tom is a fine man and a great Congressman!" Trump tweeted on Tuesday morning. (10/17)

The announcement came following a joint investigation by CBS' "60 Minutes" and The Washington Post on the opioid crisis. The report found that Congress helped disarm the Drug Enforcement Administration during the height of the crisis. Marino, R-Pennsylvania, was the chief advocate for the bill at the center of the investigation. (10/17)

The congressman's withdrawal comes after a joint CBS "60 Minutes" and Washington Post report revealed that Marino took nearly $100,000 from the pharmaceutical lobby while sponsoring a bill that made it easier for drug companies to distribute opioids across American communities and thwart the Drug Enforcement Agency. (10/17)

Sen. Claire McCaskill (D-Mo.) on Monday said she would introduce legislation to repeal a 2016 law that hampered the Drug Enforcement Administration’s ability to regulate opioid distributors it suspects of misconduct. The new bill would rescind a little-noticed law championed last year by Rep. Tom Marino (R-Pa.), who President Trump has since nominated to serve as “drug czar” and director of the Office of National Drug Control Policy. (Facher, 10/16)

The Trump administration is preventing an undocumented, pregnant teenager detained in a Brownsville refugee shelter from getting an abortion in a policy shift with big implications for hundreds of other pregnant, unaccompanied minors held in such shelters. She is not the first to be stopped, according to advocates who work with undocumented teenagers. (Rayasam, 10/16)

Senate Majority Leader Mitch McConnell (R-Ky.) said on Monday that the Senate will vote on a 20-week abortion ban, though he didn't specify when the legislation will come up. "It's supported by virtually all of my members, and we expect to have a vote on it at some point," McConnell told reporters during a press conference in the Rose Garden with President Trump. (Carney, 10/16)

Kaiser Health News: Want An IUD? Take Note Of Trump’s New Birth Control Policy.

The Trump administration’s recently announced changes to health insurance rules have raised concerns among people wondering how they’ll be affected. This week, I address some of the questions likely on people’s minds. (Andrews, 10/17)

Over the next two years, with a dozen sessions, these students will act out roles focused on how to say no to sex, how to talk to their parents about problems and how to keep healthy and safe. But in July, the U.S. Department of Health and Human Services suddenly pulled the plug on this project and 80 others funded by the government’s Teen Pregnancy Prevention Program, as first reported by Reveal from The Center for Investigative Reporting. (Kay, 10/16)

As guardians of health and gatekeepers to the world of medicine, primary care doctors are expected to plunge dauntlessly into the most delicate topics with their patients. Now, in the wake of the worst mass shooting in recent U.S. history, a new campaign is challenging these physicians to talk to their patients about guns. As doctor questions go, it’s right up there with inquiring about risky sexual behavior and a notch stickier than drug or excess alcohol use and obesity. Asking about a patient’s guns strays into prickly political territory. It risks backlash from hard-line gun rights advocates. And in small or rural communities, where guns are often plentiful and medical care is scarce, it may scare a few patients off. (Healy, 10/16)

State waiting periods for handgun purchases prevent about 750 gun deaths each year in the United States, new research has found. An estimated 910 gun deaths could also be avoided if those policies were adopted nationwide, according to the study, published Monday in the Proceedings of the National Academy of Sciences. (Chokshi, 10/16)

Brain imaging studies have a diversity problem. That's what researchers concluded after they re-analyzed data from a large study that used MRI to measure brain development in children from 3 to 18. Like most brain imaging studies of children, this one included a disproportionate number of kids who have highly educated parents with relatively high household incomes, the team reported Thursday in the journal Nature Communications. (Hamilton, 10/16)

The incidence of mouth and throat cancers caused by the human papilloma virus in men has now surpassed the incidence of HPV-related cervical cancers in women, researchers report. The study, in the Annals of Internal Medicine, found that 11 million men and 3.2 million women in the United States had oral HPV infections. Among them, 7 million men and 1.4 million women had strains that can cause cancers of the throat, tongue and other areas of the head and neck. (Bakalar, 10/16)

Michele K. Bourquin, an account executive from Atlanta, was 36 and divorced when she first looked into freezing her eggs. “I knew I wasn’t getting any younger, and my eggs were aging,” Ms. Bourquin said. So she visited a doctor who gave her a blood test that’s often used to check a woman’s egg supply. It works by looking for anti-Müllerian hormone, or AMH, which is secreted by growing follicles, the sacs that house each egg. (Caron, 10/16)

The National Sleep Foundation recommends an average of eight hours of sleep per night for adults, but sleep scientist Matthew Walker says that too many people are falling short of the mark. "Human beings are the only species that deliberately deprive themselves of sleep for no apparent gain," Walker says. "Many people walk through their lives in an underslept state, not realizing it." (Gross, 10/16)

Wielding his pen, Gov. Jerry Brown has reinforced the Affordable Care Act, stood up to pharmaceutical companies and boosted testing for childhood lead poisoning. Facing a Sunday deadline to approve or reject measures passed by the legislature this year, Brown weighed in on some key health care bills, including measures to protect Californians who buy insurance for themselves. (Bartolone and Ibarra, 10/16)

The state Department of Labor has issued an emergency update to its minimum-wage regulations that reinforces its longstanding guidance to home health care employers to pay workers for just 13 hours of a 24-hour shift. The policy, known as the '13-hour rule,' helps control state spending on home care, which accounts for about 11% of the Medicaid budget. But it conflicts with three New York appellate court decisions issued in April and September that threw the home care industry into a panic. The rulings said home health aides who don't live full time with their elderly or disabled clients should be paid for every hour of a 24-hour shift. (Lewis, 10/16)

An effort to overturn part of Oregon's $550 million health care tax plan qualified for the ballot on Monday, which means voters will decide whether to keep the taxes in a Jan. 23 special election. State lawmakers passed the taxes earlier this year to raise money so they could balance the state's Medicaid budget and stabilize the individual insurance market. Oregon's health agency faced a budget gap due to reasons including the long-planned ramp down of federal support for states that expanded Medicaid under the Affordable Care Act. (Borrud, 10/16)

Texas Education Commissioner Mike Morath on Oct. 11 announced the establishment of the Hurricane Harvey Task Force on School Mental Health Supports to deliver needed attention to schools and higher education institutions impacted by the storm. (Sterling, 10/16)

Four years ago, Bill de Blasio, then the city’s public advocate and a mere mayoral hopeful, took part in a rally in Midtown Manhattan to protest the imminent closing of Long Island College Hospital. Surrounded by dozens of singing and cheering hospital workers, he chanted “No Hospital, No Peace,” and helped block the entrance to the offices of the chancellor of the State University of New York. The police arrested Mr. de Blasio and charged him with disorderly conduct. (Santora, 10/16)

A father in Georgia who had prepared to donate a kidney to his 2-year-old son said last week that he is being forced to wait after a recent stint in county jail. Anthony Dickerson's son, A.J., was born without kidneys, and Dickerson, who is a perfect match, was ready to donate one of his, he told NBC affiliate WXIA in Atlanta. He was arrested days before the planned transplant but released from Gwinnett County Jail this month to undergo surgery. Now, he said, the transplant center at Emory University Hospital has put it on hold — in a case that one expert called befuddling. (Bever, 10/16)

In a bid to end Connecticut’s budget stalemate and persuade legislators to abandon a legally questionable deferral of contributions to the state’s underfunded pension system, Gov. Dannel P. Malloy unveiled his fourth budget proposal for the new biennium Monday. It asks lawmakers to reduce tax increases by accepting deeper cuts to town aid, education and social services. (Phaneuf, Pazniokas and Rabe Thomas, 10/16)

Georgia’s preterm birth rate rose in 2016 after years of decrease, a disturbing trend that is mirrored by national data, state officials said Monday. Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. It’s also called premature birth. (Miller, 10/16)

Every 10 minutes or so, a truck or a van pulled up to the exposed spigot of an overgrown well, known as Maguayo #4, that sits not far from a bustling expressway and around the corner from a Krispy Kreme doughnut shop. Fencing around the area had been torn open, and a red and white “Peligro” sign, warning of danger, lay hidden beneath debris and dense vegetation. One after another, people attached a hose to draw water for bathing, washing dishes and, in some cases, drinking. They filled buckets, jugs, soda bottles. (Hernandez and Dennis, 10/16)

Kaiser Health News: On Back Roads Of Appalachia’s Coal Country, Mental Health Services Are As Rare As Jobs

Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions. But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day. Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end. (Connor, 10/17)

BioEnterprise, which promotes and nutures healthcare companies and bioscience technologies, will oversee marketing, promotion and tenants at the struggling Global Center for Health Innovation. The nonprofit company was retained Monday by the Cuyahoga County Convention Facilities Development Corp., the nonprofit organization that oversees the Huntington Convention Center and Global Center. (Farkas, 10/16)

The fate of one of the largest U.S. nursing home operators, HCR ManorCare, will reach a critical court deadline on Thursday in a battle over months of unpaid rent, a growing problem in an industry where eviction would put thousands of elderly out on the street. Many nursing home chains spun off their properties to real estate companies over the last decade to unlock value. Now those landlords need to deal with operators behind on their rent without harming thousands of elderly residents. (Rucinski, 10/16)

wo Democratic state lawmakers on Monday unveiled bills they say would save the lives of children by requiring alarms in vehicles used by day-care centers and large family child-care homes. (Harris, 10/16)

President Trump isn't afraid to use his bully pulpit, or become an outright bully, to let us know what's important to him. We don’t see moral leadership – quite the contrary. Instead he revels in mocking senators, NFL football players, public officials in disaster zones, morning TV hosts, and news outlets that bring him bad publicity. (Andy Slavitt, 10/16)

Since Obamacare became law, it’s been subject to one challenge after another. Some challenges have truly been existential, like the 2012 Supreme Court case and this year’s repeal effort in Congress. Others have had the potential to do damage without undermining the entire law. President Trump’s actions last week are in the second category. (David Leonhardt, 10/16)

By scrawling his name a couple of times on Thursday, President Donald Trump added $194 billion to the deficit projection. He increased health care premiums for 12 million working poor and middle-class families by 20 percent and made health insurance unaffordable for 1 million of them. He further undermined the health care marketplaces and legalized cheap, bare-bones insurance sold across state lines. With two executive orders, Trump made the private insurance side of the Affordable Care Act — the part designed for working people — more likely to collapse. Trump would have been smart to recall the Pottery Barn Rule that then-Secretary of State Colin Powell applied to the 2003 Iraq invasion: “You break it, you own it.” (10/16)

Trump’s lack of understanding of America’s healthcare system appears to be almost infinite, so it’s hardly surprising that he doesn’t grasp the complexities of the cost-sharing reduction payments. But the misunderstandings extend to congressional Republicans, and even Democrats.The truth is that Trump’s action could lead to more Americans receiving subsidized health coverage. It could also produce a windfall for states including California. (Michael Hiltzik, 10/16)

During the 2016 presidential campaign, Donald Trump repeatedly vowed to “make America great again" if elected. Many voters were never clear on what exactly that meant. After a Republican-controlled Congress failed to repeal the Affordable Care Act this year, the frustrated president said he would work with Democrats to create “great” health care for Americans. When he took steps on Thursday to undermine Obamacare, he again pledged to deliver a “great” plan. (10/16)

Unable to persuade Congress to kill the Affordable Care Act, President Donald Trump appears determined to do the dirty work himself. The president's unilateral actions are aimed at driving up premiums, steering healthy people away from the federal marketplace and ensuring his inaccurate description of the law as a nightmare comes true. Reducing Americans' access to health care as a political maneuver is a cynical, callous act by a president who once promised better coverage that would be available and affordable to all. (10/16)

While the president’s decision appears to have been designed to disrupt the Affordable Care Act exchanges, states now have an opportunity to restore order to their insurance markets.Specifically, states can step in to make the subsidy payments themselves — and then turn around and sue the federal government for reimbursement. The law is on their side, and while it might take months or years, the states are highly likely to be repaid in full, plus interest. In the meantime, the backstop provided by the states will encourage insurers to stay on the exchanges rather than rushing to the exits. (Daniel Hemel, 10/16)

For the past seven months, Americans have watched and weighed in as Congress considered the continued existence of the Affordable Care Act (ACA). Last Thursday, the Trump administration announced that the government would stop subsidizing insurers for making premiums and deductibles more affordable for low-income customers. Most of the discussion to date has been about whether these plans are good for families, and if so, which ones. But what if insurance had another value, beyond protecting individuals from financial and health risks? What if it was good for democracy? (Emily Nacol, 10/16)

President Donald Trump's two-step gutting of the Affordable Care Act, ending cost-sharing for insurance companies, and allowing them to cover fewer medical conditions should be a political nightmare for Republicans. That’s because the White House has miscalculated, apparently falling for the fantasy that it can sabotage Obamacare and then successfully pin the political blame for lost coverage on President Barack Obama and the Democratic Party. Trump and some other Republicans have developed “Obamacare is imploding” as a talking point, trying to persuade Americans that the Affordable Care Act is collapsing under its own weight. (Albert R. Hunt, 10/16)

The subsidies offered to low-income individuals to purchase insurance on the individual market and to insurance companies to support this benefit under the ACA, provide the necessary hand up needed to help pull individuals up our prosperity ladder continually. Without this hand, the ladder becomes splintered and broken, forcing those affected to take an inadequate path—after all other options have been exhausted. ... Without the subsidies, Medicaid will remain the best and often only realistic option for many Americans. The recently eliminated ACA subsidies supported working Americans and their families to move up the income ladder with a helping hand. Cutting off the subsidies cuts off the hand. (Jim Rickards, 10/17)

[N]ow looms another quiet threat to these hospitals and our neediest citizens. The Medicaid disproportionate share hospital (DSH) program provides crucial support to hospitals that treat patients whose care is not fully covered by third-parties like Medicaid, and it is essential to keeping hospitals that treat low-income patients open and running. Congress failed to act to renew the DSH program before October 1 allowing massive cuts. Missouri will be hit particularly hard, facing a devastating $2.2 billion in cuts through 2025 after having already passed on nearly $2 billion per year in Medicaid funds for working low-income families. (Judy Baker, 10/16)

Multiple, glaring government breakdowns are documented in the revealing investigation of the opioid-overdose epidemic by The Post and CBS’s “60 Minutes.” The report exposed weakening federal enforcement of drug distribution; corrosive industry lobbying that crippled that enforcement; and a dysfunctional Congress and White House at a time when a debilitating scourge swept the country. (10/16)

As the nation’s opioid-addiction problem mushroomed into a full-blown epidemic, major drug manufacturers and distributors anticipated that a regulatory crackdown was coming. So they boosted campaign donations to key lawmakers and spent $106 million successfully lobbying Congress to limit enforcement powers that might have stemmed the epidemic. (10/16)

The drug epidemic of the 1980s and ’90s was horrific. It led to draconian laws that helped break already vulnerable families, killed thousands of people, devastated communities and created an image of zombie-like addicts and unrepentant pushers that made it harder for Americans not directly affected by the scourge to empathize with those suffering. (10/16)

This view of post-human medicine may seem repulsive to those who see medicine as uniquely human. Some of that view is grounded in arrogance — surely nothing could ever do what we do as well as us. But as medicine confronts its limitations, modern providers are faced with a paradox: We want the precision and specificity of the machine yet we want to believe that we can still do it all with our hands and eyes and ears. We probably can’t. So we need to start redefining what the human doctor of the 21st century will do. (Bryan Vartabedian, 10/16)

After a long history of public debate about women’s access to contraception, a University of Texas/Texas Tribune Poll conducted just last year found the right to use contraception essentially a settled issue. Now the Trump administration’s high-profile action in the name of religious liberty has introduced conflict into an area where before there had been consensus. (Jim Henson and Joshua Blank, 10/16)

There are nearly 30 million people with diabetes in the United States. About 90,000 of them were just thrown a curve ball. Johnson & Johnson announced that it’s closing its Animas subsidiary and getting out of the insulin-pump business, leaving the field primarily to a single large competitor, Medtronic, which will control roughly 85% of the market. (David Lazarus, 10/17)

The health of a nation’s economy and the health of its people are connected, but in some surprising ways. At times like these, when the economy is strong and unemployment is low, research has found that death rates rise. At least, in the short term. In the long term, economic growth is good for health. What’s going on? (Austin Frakt, 10/16)