�Թϲ�����

A U.S. judge on Monday appeared skeptical toward a request from several states that want him to order the administration of Republican President Donald Trump to continue payments to health insurers under Obamacare. At a hearing in San Francisco federal court, U.S. District Judge Vince Chhabria said he aimed to issue a ruling on Tuesday. (Levine, 10/23)

Earlier this month, Trump announced that the administration would stop payments that compensate insurers for discounts given to low-income consumers to help cover their out-of-pocket expenses under policies sold on the Affordable Care Act’s insurance marketplaces. These subsidies are different from the tax credits many consumers get, depending on their income, to pay Obamacare premiums. (Nguyen, 10/24)

California Atty. Gen. Xavier Becerra, joined by Democratic counterparts from 17 other states and the District of Columbia asked the court to put Trump’s order on hold. They argue Trump’s action would spark “chaos and uncertainty,” raise the cost of health insurance and the number of uninsured Americans and saddle states and local governments with higher expenses. But U.S. District Judge Vince Chhabria, an Obama appointee, expressed considerable skepticism during a hearing Monday. (Dolan and Lauter, 10/23)

Chhabria peppered an attorney for California with questions about why he should force the administration to resume payments when the states had devised a workaround that would benefit many consumers. "The state of California is standing on the courthouse steps denouncing the president for taking away people's health care, when the truth is that California has come up with a solution to that issue that is going to result in better health care for a lot of people," Chhabria said. (Thanawala, 10/24)

The judge highlighted the decision by Covered California, the state's Obamacare exchange, to load the impact of the lost CSRs on to the silver-tier plans, which allows for consumers' tax-credit subsidies to rise accordingly. He noted that the contingency plan, which most states have adopted in some form, would cost the taxpayers more money and protect consumers, who may even benefit in 2018. Brown contended that not all states have taken such steps and he feared insurers could flee some markets. (Colliver, 10/23)

Republicans returning to Washington will decide in coming days whether to embrace or set aside a bipartisan health bill that has gained traction in Congress, a decision potentially made harder by President Donald Trump’s statements praising the effort but opposing the bill itself. Senate Minority Leader Chuck Schumer (D., N.Y.) said on Sunday the bipartisan bill’s support includes all 48 Senate Democrats as well as the 12 publicly committed Republicans, enough to overcome any filibuster. Senate Majority Leader Mitch McConnell (R., Ky.) said he would bring the bill to a vote if it is clear Mr. Trump will sign it. But that remains far from certain, given Mr. Trump’s recent comments on the plan from Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.). (Armour and Lazo, 10/23)

Republicans on Capitol Hill can’t seem to tell if the White House wants an Obamacare stabilization bill, leaving their path forward murky. Conflicting statements from President Donald Trump and a list of White House-requested changes circulated over the weekend have given GOP leaders no clarity on whether they should force a controversial vote on the proposed bipartisan Obamacare fix, or set it aside for now and then try to roll it into a far-reaching year-end spending bill. (Haberkorn and Cancryn, 10/23)

Senate Republicans say it’s up to the White House to decide whether a bipartisan ObamaCare deal can move forward. President Trump has repeatedly expressed support for the bipartisan negotiations led by Sen. Lamar Alexander (R-Tenn.), but has sent mixed signals on whether he supports the agreement that the senator reached with Democrats. Without Trump’s support, it’s unlikely the bill can pass. (Sullivan, 10/23)

The Trump administration's funding cuts to ObamaCare's advertising budget could result in at least 1.1 million fewer people signing up for coverage this year, according to an analysis released Monday. "The threat to Open Enrollment this year is very real," wrote Josh Peck, the author of the analysis, who served as healthcare.gov's chief marketing officer during the Obama administration.  (Hellmann, 10/23)

Kaiser Health News: Enrollment News To Bank On: Obamacare Is Still Here So It’s Time For Coverage Checkup

The open enrollment period begins in one week for 2018 marketplace coverage, but many consumers are confused about what to expect. No wonder! The Trump administration has slashed advertising and outreach about open enrollment, so concrete consumer information is sparse. But there’s more than enough political rhetoric to make up for it, with regular partisan pronouncements that the marketplaces have collapsed and Obamacare is dead. (Andrews, 10/24)

Maryland insurance regulators said Monday they were working to minimize the pain from last-minute rate increases for those buying plans sold under the Affordable Care Act by limiting the increases to certain consumers. The proposed rate hikes became necessary last week when the Trump administration announced it would no longer pay a subsidy that insurers rely on to offset the out-of-pocket costs for some low-income consumers. The decision set off a scramble to figure out how to shore up insurance companies, which had already reported millions in losses on so-called Obamacare plans sold to individuals. (Cohn, 10/23)

As California health care officials brace themselves for changes to the Affordable Care Act by President Donald Trump and the Republican-controlled Congress, state lawmakers today and Tuesday will hold a hearing examining the gaps in coverage and financing of California’s current system. (Seipel, 10/23)

Open enrollment for health care coverage next year begins next week amid uncertainty over the future of the Affordable Care Act and big increases in premiums for individuals and businesses that do not qualify for subsidies. Nevertheless, the health care law is still in effect and those required to enroll in a plan will face increasing penalties by the Internal Revenue Service if they fail to do so. (Radelat, 10/24)

Iowa officials withdrew a proposal Monday that sought to pull out of the Affordable Care Act and redirect federal money toward lowering premiums for younger participants under a separate program. If the Trump administration had approved Iowa's waiver request, it would have been the first to create a state-run alternative to the health exchanges required under the law championed by President Barack Obama. (Pitt, 10/23)

Iowa leaders pulled the plug Monday on their “stopgap” proposal to try to shore up the state’s rickety market for individual health insurance policies. With open enrollment set to start in less than two weeks, the state could no longer wait to hear if federal officials would approve the plan, which would have rewritten significant Affordable Care Act rules on how federal subsidy money is used. (Leys, 10/23)

"Obamacare is an unworkable law," Doug Ommen, Iowa's Republican-appointed insurance commissioner, said in a written statement. "The Stopgap Measure was an innovative solution to help thousands of Iowans. Unfortunately, Obamacare's waiver rules are so inflexible that the stopgap cannot be approved under terms that would be workable for Iowa." In addition, the plan may have fallen victim to Trump's recent decision to halt cost-sharing reduction payments to insurers. The state originally was counting on those funds to help finance its alternative coverage system, said Keith Mueller, interim dean of the University of Iowa College of Public Health. (Meyer, 10/23)

The waiver request had been closely watched by health policy experts as the most far-reaching effort by a state to sidestep requirements of Obamacare. Governor Reynolds, a Republican, said the Trump administration had tried hard to approve it, but had found it impossible to do so without violating the terms of the law. “Unfortunately, it now appears Obamacare’s waiver rules are as inflexible as the law itself,” Ms. Reynolds said at a news conference in Des Moines. “I’m extremely disappointed.” (Goodnough, 10/23)

The state’s withdrawal comes two months after President Trump telephoned a top federal health official with instructions to reject Iowa’s proposal. In announcing the withdrawal of what the state has called a crucial “stopgap” plan to prevent its marketplace from collapsing, Iowa Gov. Kim Reynolds (R) on Monday did not mention the president’s intervention, instead thanking Trump for trying to repeal the ACA and blaming the law itself for what she called its inflexibility. (Goldstein and Eilperin, 10/23)

The Iowa setup would have offered just one type of insurance plan in the individual market and reshaped the subsidies that help people buy coverage, among other big alterations to the infrastructure of the ACA. Iowa’s largest insurer, Wellmark Blue Cross and Blue Shield, had said it would reverse its plans to exit from the state’s individual market and would instead sell plans in every county next year if the state won approval for its proposal. On Monday, after Iowa’s decision, Wellmark said it “will continue to work on a long-term solution with state and federal officials.” (Wilde Mathews, 10/23)

Oklahoma also recently withdrew a waiver request to the federal government that would have stabilized its health insurance markets. The Oklahoma health commissioner said that approving the waiver would have helped more than 130,000 Oklahoma residents and reduced premiums by 30 percent. (Hellmann, 10/23)

Nick Podhajsky plans to get married this year for an unusual reason: health insurance coverage. The 44-year-old farmer had expected to tie the knot next year. But because Iowa’s individual health insurance market is in chaos—with competition disappearing and prices skyrocketing—his fiancee was potentially going to be left with no affordable coverage options for next year. So they’ve decided to hold the ceremony before the end of the year, allowing his bride-to-be to get coverage through his plan. (Demko, 10/23)

The words "concierge medicine" can easily conjure an image of a private practice doctor in a swanky downtown office, providing care to only the most well-heeled patients able to afford an annual co-pay of tens of thousands of dollars. .... Less frequently is concierge medicine associated with the nation's hospitals, which are more known for their care for the poor and uninsured. But major not-for-profit health systems are opening primary-care practices to cater to wealthy patients. Acclaimed systems such as the Mayo Clinic, Rochester, Minn.; Stanford Health Care, Palo Alto, Calif.; Duke Health, Durham, N.C.; and Boston's Massachusetts General Hospital, part of Partners HealthCare, are a few examples of the small but growing number of hospitals with concierge practices. (Livingston, 10/21)

Dignity Health and Select Medical will combine their urgent-care businesses to better align care delivery, executives said in a news release Monday. Dignity will merge its urgent-care and occupational medicine subsidiary U.S. HealthWorks with Select Medical's Concentra Group Holdings. Dignity will own a 20% equity interest in the combined entity, valued at $238 million, and receive the remainder of the undisclosed purchase price in cash when the deal is expected to close in the first quarter of next year, pending the customary regulatory reviews. (Kacik, 10/23)

Tenet Healthcare Corp. CEO Trevor Fetter has resigned amid the company's financial troubles and planned reorganization, the health system announced late Monday. Executive Chairman Ronald Rittenmeyer will fill in while the company continues its search for a permanent CEO. Fetter announced in late August that he would step down in March or when a successor was appointed and that the investor-owned chain would shake up its board. "I want to sincerely thank Trevor for his leadership of the company over the past 14 years, and particularly for his support in making this transition a success," Rittenmeyer said in a release. (Kacik, 10/23)

As Florida’s lawmakers grapple with the opioid crisis, one U.S. representative says there’s a correlation between states that expanded Medicaid through Obamacare and states affected the worst by the epidemic. Republican U.S. Rep. Matt Gaetz shared this factoid on Twitter on Oct. 17: "Opioid crisis the worst in ObamaCare expansion states!" ... Information supplied by Gaetz’s office rests on the notion that patients in states that expanded Medicaid through Obamacare have more access to legal prescriptions that fuel the opioid epidemic. Experts said the theory ignores critical facts and does not take into account the other factors that have led to an increase in opioid deaths. "It is important to avoid confusing association with causation," said David A. Fiellin, a professor of medicine at Yale School of Medicine. (Grave, 10/23)

The White House will hold an event on the opioid epidemic Thursday afternoon, according to an email obtained by The Hill that suggests President Trump will make his announcement about a national emergency this week. The email, from the White House Office of National Drug Control Policy, is an invitation and a call to RSVP to an event at the White House on the “nationwide opioid crisis” at 2 p.m. Thursday. (Roubein, 10/23)

A woman has been indicted on involuntary manslaughter and child-endangering charges in the death of a 12-year-old boy who authorities say died from a fentanyl overdose during a sleepover at her Ohio apartment. The Franklin County prosecutor says the boy, Kanye Champelle, got the drug from atop a refrigerator and ingested it while the baby sitter was gone. The prosecutor says the woman, 60-year-old Sheila Hutchins, ran errands and left several children she was baby-sitting. (10/23)

Indeed, for the last decade, the U.S. hasn’t had an official annual count of pregnancy-related fatalities, or an official maternal mortality rate — a damning reflection of health officials’ lack of confidence in the available numbers. (Fields and Sexton, 10/23)

The patient, still inside his mother’s womb, came into focus on flat screens in a darkened operating room. Fingers, toes, the soles of his feet — all exquisite, all perfectly formed. But not so his lower back. Smooth skin gave way to an opening that should not have been there, a bare oval exposing a white rim of bone and the nerves of the spinal cord. (Grady, 10/23)

Majorities in many ethnic, identity and racial groups in America believe that discrimination exists against their own group, across many areas of people's daily lives, according to a poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. The poll asked a wide range of questions about where Americans experience discrimination — from the workplace to the doctor's office — and people's experiences with discrimination and perceptions of it. The groups polled include whites, blacks, Latinos, Asian-Americans, Native Americans and LGBTQ adults. (Neel, 10/24)

It’s a telemedicine app that seems rather innocuous — enter your info, have it reviewed by a physician, and get a prescription. The California-based company behind it has raised millions to support its mission of expanding access to the pill, ring, or morning-after pill with minimal hurdles. But that last option is now starting to attract pushback from anti-abortion activists, who consider the morning-after pill equivalent to abortion — and who say lax telemedicine laws are enabling access to this drug with insufficient oversight. (Blau, 10/24)

Undiagnosed diabetes may not be as big of a public health problem as thought. That's the takeaway from a study published Monday in the Annals of Internal Medicine that says that some previous efforts have likely overestimated the number of people with undiagnosed diabetes because they relied on a single positive test result. (Hobson, 10/23)

Until recently, the National Fire Protection Association, which sets standards for departments such as Columbus, had no guidelines on cancer prevention. The agency released standards aimed at cancer prevention for the first time this summer. (Wagner and Sullivan, 10/24)

As Boston heads into cold weather and flu season, the American Academy of Pediatrics is out with new guidelines on what pediatricians' offices should do to prevent and control infections. The new guidelines, out Monday, include items like diligent hand washing, and asking anyone who treats your kids if they've washed their hands too. (Becker, Sundt and Goldberg, 10/23)

Abby Delaney can roll onto her stomach, hold up her head and turn pages in her favorite books. Her sister, Erin, can now sit up on her own, and she is starting to think about crawling — learning to hold herself up on her small hands and knees. More than four months after the formerly conjoined twins were separated in a rare surgery at Children’s Hospital of Philadelphia, their mother said there have been rewarding but “terrifying” moments as the 15-month-olds recover. (Bever, 10/23)

Gun shows in a state with weak gun restrictions increase the short-term risk for firearm-related injuries, a new analysis has found. Researchers studied deaths, emergency department visits and hospitalizations related to firearms before and after 915 gun shows in California and Nevada from 2005 to 2013. California has laws requiring background checks, waiting periods, documentation and Department of Justice surveillance at gun shows. Nevada has no regulations pertaining explicitly to gun shows. (Bakalar, 10/23)

In the two weeks after a gun show is held in Nevada, injuries and deaths involving firearms jump by 69% — in neighboring areas of California. However, when gun shows occur in California, the state does not experience an increase in firearm-related trauma over the next fortnight. (Kaplan, 10/23)

A proposal to create a single-payer health care system in New Hampshire drew mixed reactions in the House on Monday, with some denouncing it as a wayward fantasy and others heralding an opportunity for a conversation on broader reform. The legislative service request, sponsored by Rep. Peter Schmidt, D-Dover, is titled “establishing a New Hampshire single payor (sic) health care system.” (DeWitt, 10/23)

A Jackson County judge on Monday declined to block a Missouri law requiring abortion physicians to meet with their patients three days before the procedure. In rejecting a challenge to the law by Missouri’s two Planned Parenthood affiliates, Jackson County Circuit Judge S. Margene Burnett found that the requirement did not impose an “undue burden” on women seeking an abortion. (Margolies, 10/23)

Leaders of the state’s two largest hospitals made a rare appearance Monday on Beacon Hill to warn state senators against approving any policies that would slash their revenues in order to rein in health care spending. (Dayal McCluskey, 10/23)

Electronic cigarettes, the popular vapor substitute to traditional tobacco cigarettes, will soon be banned from public indoor spaces in New York State — just like the real thing. Gov. Andrew M. Cuomo on Monday signed a bill to ban vaping anywhere cigarettes are already prohibited, like workplaces, restaurants and bars. The ban goes into effect in 30 days. (Nir, 10/23)

New York volunteer firefighters who have been diagnosed with certain cancers will be eligible for health care benefits under a new state law. Democratic Gov. Andrew Cuomo announced Sunday that he had signed legislation that will provide the benefit to the nearly 100,000 New Yorkers who serve as volunteers with fire companies across the state. (10/23)

Massachusetts is facing an epidemic of people slipping into the shadows of dementia, and lawmakers want to make sure the state is prepared. The number of people in Massachusetts who have Alzheimer’s and other dementias will increase by 25 percent in just eight years, rising from 120,000 in 2017 to 150,000 in 2025, according to the Alzheimer’s Association. (Finucane, 10/23)

Since exposure to lead at a young age can cause permanent neurological problems, it’s important to spot exposure early so something can be done to remove the source of the lead – usually old lead paint, which remains a serious problem in a state where 60 percent of housing units were built before 1978, when lead paint was banned. And that’s why health officials want to get more quick-testing units into pediatricians’ offices around the country. ...State officials hope to get more doctors and private practices to buy and use the devices, which cost about $2,500 to install and about $8 to run a test. The system is designed to provide quick information to the state so it can track outbreaks of lead poisoning more quickly than with current methods. (Brooks, 10/23)

The University of Kansas Health System has received a major boost in achieving its goal of raising $100 million to complete a new hospital tower. Hospital officials announced Monday morning it was receiving a gift of $10 million from Cheryl Lockton Williams. The gift is to support the construction of Cambridge Tower A, a new hospital building on the northwest corner of Stateline Road and 39th Street in Kansas City, Kansas. (Smith, 10/23)

In the days since fires ravaged towns here, people have pulled together. Strangers at coffee shops share their trauma, talking of homes destroyed and loved ones lost. Almost everyone seems to know a neighbor who knocked on a door or lifted someone into a car, and saved a life. The phrase “The love in the air is thicker than the smoke” is on signs in shop windows, in Facebook posts and on people’s lips. (Karlamangla, 10/23)

The Department of Children and Families still doesn’t have a specific timeline for when people will see post-hurricane food stamps. And the agency isn’t answering some key questions that have been raised recently. (Madan and Teproff, 10/23)

A 36-year-old Oregon woman has filed a $1.8 million lawsuit against medical professionals who she says mistakenly suggested she undergo a double mastectomy and a hysterectomy. The Oregonian/OregonLive reported Monday that Elisha Cooke-Moore’s lawsuit says she underwent the life-altering surgeries after her gynecologist, Dr. William Fitts, determined that genetic blood tests indicated she had a 50 percent chance of getting breast cancer and up to an 80 percent chance of getting uterine cancer. (10/24)

Eagle Crest in suburban Sacramento was among the chain’s worst-performing facilities nationwide, teetering toward decertification while federal regulators kept it on a consumer-beware list for three years. Now, with many of the former Eagle Crest residents shepherded off to other Genesis homes, The Bee’s analysis found that the troubles at Eagle Crest were not isolated at all. (Lundstrom and Reese, 10/23)

Despite making progress in health care access and parental employment, Florida has not improved its poverty rate for children over the past five years, a newly released national report shows. And that indicator, along with several others, bodes particularly poorly for children of ethnic minorities and immigrant families, who are disproportionately affected by poverty, the Annie E. Casey Foundation states in its 2017 "Race for Results" index. (Solochek, 10/24)

Neglect by caregivers at a troubled north-central Minnesota assisted living facility led to the death of an 86-year-old man, the state Department of Health has reported. An investigation of the Heritage House in Pequot Lakes that was completed by the agency substantiated charges of neglect, described as improper catheter care and an unclean environment leading to death by a complex urinary tract infection. (Perkins, 10/23)

Vegetable supplier Mann Packing has issued a voluntary recall for a number of bagged vegetables, salads and other vegetable products sold in the U.S. and Canada due to a potential risk of listeria contamination. The Salinas, Calif., firm said last week it issued the recall “out of an abundance of caution” after a “single positive result” for the germ, Listeria monocytogenes, was found on one of its products during a random test by the Canadian Food Inspection Agency. (Masunaga, 10/23)

Cesar Tavera, the former executive director of a community health center in Camden, was sentenced Monday to more than five years in prison for stealing money from the nonprofit, which was created to provide mental health services for the city’s underserved residents. In addition to 70 months in prison, three years of supervised release was ordered by U.S. District Judge Noel L. Hillman in Camden. The judge also issued a $2.5 million restitution order. (Moran and Boyer, 10/23)

Repeal-and-replace may be done for now, but for Senator Bernie Sanders, the war is just beginning — and it has already become a fracas that is dividing the Democratic Party, to its detriment. Mr. Sanders — who, of course, isn’t even a registered Democrat — is banging on about what he calls “Medicare for All,” a government-run plan that would provide health care coverage for every American. But now the crusty Vermont independent wants to be a senatorial pied piper for Democrats. He has made his proposal into a kind of litmus test for who is a “good Democrat,” inveigling 16 of his colleagues — more than a third of Senate Democrats — into endorsing it. (Steven Rattner, 10/24)

“If you like your doctor, you can keep your doctor. If you like your plan, you can keep your plan.” For years, Republicans used that exaggerated pledge to thrash the Affordable Care Act (ACA) and President Obama for not keeping his promise. Politifact labeled it as “lie of the year” in 2013. Politifact will have a lot of lies to choose from this year, given the hurricane of falsehoods and broken promises on healthcare made by President Trump. Who can forget Trump’s oft-repeated promise that “We will repeal and replace ObamaCare, and we will do it very, very quickly”? (Juan Williams, 10/23)

As Congress decides the fates of Americans who cannot afford health insurance, our new data shows that this is a larger group than previously thought. In a new survey of 9,200 people across 15 states by my organization, the Texas Medical Center Health Policy Institute, 49% of respondents said they must cut other expenses to pay for health care. And they aren’t cutting back on frivolities like expensive electronics. Most often, they said, they had to cut back on their savings, as well as spending on food and clothing, to pay for health care. (Arthur “Tim” Garson Jr., 10/23)

The Affordable Care Act is not the cause of rising health-care costs. If it were, simple repeal would fix the problem. The cause is the massive mergers of health-care providers creating an economic and political behemoth. ... In Kentucky, antitrust laws have apparently been largely overlooked. Now all of Northern Kentucky has a single hospital system, which also employs the majority of doctors. ... The answer to health-care reform is simple. We must lower health-care costs. Either instill true provider competition or give more power to the purchasers with a variation of a single-payer system. (Kevin Kavanagh, 10/20)

If you own a vehicle, you’ve likely received a recall notice about a potentially defective part. You can schedule an appointment with a mechanic who will replace everything from an airbag to a sun visor at no cost to you. Nearly 900 vehicle recalls affected 51 million vehicles in 2015. Contrast this with a recall on a medical device implanted in your chest. You may not be notified of a problem. The medical costs associated with replacing it are not covered by the manufacturer. And you'll need to do more than spend a half hour sipping coffee in a car dealership waiting room. (10/23)

Under the directorship of E. Scott Lloyd, an antiabortion activist appointed by President Trump to lead the Department of Health and Human Services’ Office of Refugee Resettlement, ORR began preventing federally funded shelters from “facilitat[ing]” access to abortion services unless Mr. Lloyd approved. Instead, shelters for undocumented minors may support only “pregnancy services and life-affirming options counseling.” Mr. Lloyd has personally reached out to several pregnant teenagers to counsel them against seeking abortions, reportedly viewing himself as a “foster father.” ... Mr. Lloyd’s behavior toward J.D. is not just unconstitutional. It is also a grotesque abuse of government power over a vulnerable young woman far from her home. The government should not need a court order to do what is obviously right. (10/24)

All the Trump administration/“Handmaid’s Tale” comparisons seemed overwrought. Then came J.D. She is a 17-year-old detained by federal authorities after illegally crossing the border in Texas without her parents, who she claims abused her. She is also pregnant — 15 weeks and counting — and wants an abortion. In fact, she’s been seeking one for nearly a month. (Ruth Marcus, 10/23)

Opioids — whether it’s Vicodin or oxycodone or many others — have transformed dental and other pain into a moral and clinical cage fight. This struggle is lost in the headlines that blame physicians for the opioid crisis. It ignores the on-the-ground experiences of many of us who strive to do the right thing when the “right thing” is the very thing in question. Will the opioid pills Sonny is asking for treat his pain, feed an addiction, or both? (Jay Baruch, 10/23)

Court-ordered opioid treatment, known as civil commitment, gives judges the authority to hospitalize people against their will. Commitment is not a criminal charge, only a decree that has the force of law, obliging a person to receive medical treatment. In Massachusetts, which has one of the highest rates of opioid deaths nationally, addiction-related civil commitments have doubled in the past decade, to more than 6,000 last year, largely in response to the opioid crisis. More than 30 states now have commitment laws for substance users on the books. But while policymakers and families might be desperate for tools to address the opioid crisis, we need to recognize that we don’t yet know know the impact of commitment laws. We need to carefully and empirically review these laws as we consider sequestering and treating more opioid users against their will. (Michael Stein and Paul Christopher, 10/23)

When we encounter someone eating out of a garbage can that believes they are on the planet Pluto, this is the person we must help, and not necessarily someone who claims trauma due to political events. Our county government has expanded to include programs and services that were never intended, taking away funds from core services such as mental health. (Pierluigi Oliverio, 10/23)