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Health insurers are aggressively increasing prices next year for individual policies sold under the federal health care law, with some raising premiums by more than 50 percent. By approving such steep increases for 2018 in recent weeks, regulators in many states appeared to be coaxing companies to hang in there, despite turmoil in the market and continuing uncertainty in Congress about the future of the law, the Affordable Care Act. (Abelson, 10/3)

Republicans are willing to provide insurers with two years of ObamaCare subsidies under a bipartisan market stabilization bill, according to the Senate Health Committee chairman. Sen. Lamar Alexander (R-Tenn.) said continuing cost-sharing reduction subsidies for two years is a key part of the stabilization package he is trying to negotiate with Sen. Patty Murray (D-Wash.). (Weixel, 10/3)

The Council for Affordable Health Coverage (CAHC) is urging Congress to take several bipartisan steps to help stabilize the individual insurance markets. In a letter to Democratic and Republican leaders in both chambers, the coalition of drugmakers, insurers and others in the health sector is seeking a federal reinsurance program or a grant program to provide money for state-led reinsurance programs. (Roubein, 10/3)

Former Obama administration officials are launching an effort to sign people up for ObamaCare, saying they need to fill the gap left by the Trump administration’s cutbacks. Lori Lodes and Joshua Peck, who oversaw enrollment efforts in the Department of Health and Human Services under President Barack Obama, are launching the group called Get America Covered. (Sullivan, 10/4)

A top CMS official on Tuesday told staff that the agency is “really proud” that there are no counties lacking an Obamacare insurer, saying it was the Trump administration’s goal to make sure every area had at least one company offering plans in the law's exchanges. The comments came from Randy Pate, who was appointed by the administration to helm the office at CMS that oversees Obamacare implementation, on Tuesday afternoon during a meeting of agency staff in which top officials discussed agency priorities, according to a video obtained by POLITICO. (Pradhan, 10/3)

Gov. Mark Dayton renewed efforts Tuesday to reverse a decision by federal health officials that could cost the state $369 million a year in connection with its MinnesotaCare health insurance program. In a letter to top health regulators in Washington, D.C., Dayton urged them to reconsider a recent decision that would sharply cut the federal funding stream that helps pay for MinnesotaCare. (Howatt, 10/3)

Louisiana Sen. Bill Cassidy said there will be changes to a proposal he wrote to overhaul the 2010 health law as he and fellow Republican Sen. Lindsey Graham of South Carolina try to win more support for the measure while other lawmakers focus on tax legislation. ... Cassidy said he and other sponsors need to promote the plan in the coming months so people can learn about the changes the bill would make and better understand it. He said that time could also be used to address concerns of lawmakers such as Arizona GOP Sen. John McCain, who had concerns with the abbreviated process. Neither the Senate Finance Committee nor the Health Education, Labor and Pensions Committee has indicated they have plans to hold more hearings on the bill. (McIntire, 10/3)

The Congressional Budget Office will still release a full analysis of a proposal from four Republican senators that would overhaul the health care system, according to one of the bill’s main sponsors. During an interview for Tuesday’s CQ Roll Call Big Story Podcast, Sen. Bill Cassidy of Louisiana said a full score from the nonpartisan budget office is still expected. He believes that report could help dispel some of the opposition to the legislation. (Williams, 10/2)

When President Trump nominated Scott Gottlieb as the head of the Food and Drug Administration, he was quickly pegged by many as a conservative businessman who was cozy with the pharmaceutical industry. Seven months later, he is attracting praise from some of President Trump’s staunchest critics — including former Obama administration officials. He may also be in line to succeed his old boss, Tom Price, as secretary of health and human services. (Swetlitz, 10/4)

Speaker Paul Ryan last week urged the White House to reconsider ousting Health and Human Services Secretary Tom Price, his longtime friend who had come under fire for often using taxpayer-funded private jets for travel, according to two people with knowledge of the call. John Kelly, the White House chief of staff, called the Wisconsin Republican minutes before the departure was announced Friday afternoon. It was a heads-up call, one White House official said. (Dawsey and Bade, 10/3)

A top Democratic senator is demanding to know if former Health and Human Services (HHS) Secretary Tom Price has reimbursed taxpayers for his use of charter flights on official government business. In a letter obtained by The Hill, Sen. Patty Murray (D-Wash.) on Tuesday asked Treasury Secretary Steven Mnuchin to confirm whether Price has in fact sent a check to the U.S. Treasury, and for how much. (Weixel, 10/3)

House lawmakers have made a move to postpone a multibillion-dollar cut to federal funds to offset hospitals' uncompensated-care costs. The House Energy and Commerce Committee added language that would delay the disproportionate-share hospital funding cuts to its Children's Health Insurance Program reauthorization bill. The Affordable Care Act required the CMS to cut Medicaid DSH funds by $43 billion between fiscal 2018 and 2025. The cuts build year over year, starting at $2 billion in fiscal 2018 and ending at $8 billion in fiscal 2025. (Dickson, 10/3)

The Memorial Hospital of Salem County, which has been struggling for years, remains on life support and desperately needs an infusion of cash from a trust fund to keep its doors open, state lawmakers said Tuesday. A trio of lawmakers led by State Senate President Steve Sweeney (D., Gloucester) called for the return of the $51 million trust fund to Salem County to help facilitate the sale of the hospital. The money was set aside for the Salem Health and Wellness Foundation when the hospital was sold earlier, in 2002. (Burney, 10/3)

A new $17 million rehabilitation hospital with a special unit designed to treat patients who have suffered traumatic brain injuries and strokes is slated for completion in mid-2019. (Garcia, 10/3)

Lahey Health System on Tuesday became the latest local hospital system to slash expenses by cutting jobs. ... The cuts come as Lahey is pursuing a big merger with Beth Israel Deaconess Medical Center and several other hospitals. (Dayal McCluskey, 10/3)

Most late-term abortions would be outlawed under legislation Republicans pushed through the House on Tuesday, a major priority of the GOP and conservative groups that won't reach an eager President Donald Trump because it faces certain Senate defeat. The House approved the measure by a near party-line 237-189 vote. Though the bill's fate is sealed, the push for abortion restrictions remains a touchstone issue for most Republicans, even as the party splinters between traditionalist conservatives and anti-establishment voters looking to roil Washington. (10/3)

The bill, known as the Pain-Capable Unborn Child Protection Act, is not expected to emerge from the Senate, where most Democrats and a handful of moderate Republicans can block its consideration. But antiabortion activists are calling President Trump’s endorsement of the bill a significant advance for their movement. The White House said in a statement released Monday that the administration “strongly supports” the legislation “and applauds the House of Representatives for continuing its efforts to secure critical pro-life protections.” (DeBonis and Johnson, 10/3)

The co-chairs of the House Pro-Choice Caucus, Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), along with Rep. Barbara Lee (D-Calif.), said in a statement the ban “endangers women, interferes with their private health care decisions, and marginalizes sexual assault victims while also being blatantly unconstitutional.” Ninety-nine percent of abortions already take place before 21 weeks, according to Planned Parenthood. (Facher, 10/3)

The bill, sponsored by Rep. Trent Franks (R-Ariz.), would make it a crime to perform or attempt an abortion after 20 weeks of pregnancy, with the possibility of a fine, up to five years in prison or both. (Hellmann, 10/3)

There's a clinic that's right in Kelsey's town of Sioux Falls, S.D., that performs abortions, but she still drove hours away to get one. Back in 2015, she was going through a difficult time — recently laid off, had to move suddenly, helping a close family member through some personal struggles — when she found out she was also pregnant. (McCammon, 10/3)

Planned Parenthood asked a federal appeals court Tuesday to prevent Arkansas from enforcing restrictions on how the abortion pill is administered while the organization asks the nation's highest court to review a ruling in favor of the new limits. Planned Parenthood Great Plains asked the 8th U.S. Circuit Court of Appeals to not allow its ruling in favor of the restrictions to take effect yet. (10/3)

The American Civil Liberties Union sued Tuesday in a challenge to federal restrictions that limit many women's access to the so-called abortion pill. The lawsuit, filed in U.S. District Court in Hawaii, targets long-standing restrictions imposed by the Food and Drug Administration that say the pill, marketed in the U.S. as Mifeprex, can be dispensed only in clinics, hospitals and doctors' offices. The lawsuit contends the drug — used for abortions up to 10 weeks of pregnancy — should be made available by prescription in pharmacies across the U.S. (10/3)

The American Civil Liberties Union (ACLU) filed a lawsuit Tuesday against the Food and Drug Administration (FDA), challenging federal restrictions they argue "significantly" limit access to abortion pills. Currently, a prescription for the abortion pill Mifeprex cannot be filled at a retail pharmacy. (Hellmann, 10/3)

A federal appeals court ruling has opened the door for Planned Parenthood to pursue abortion licenses in more areas of Missouri. The 8th U.S. Circuit Court of Appeals on Monday lifted a temporary stay that had allowed the state to continue enforcing certain abortion requirements while appealing a lower court's ruling that the requirements infringed on women's abortion rights. The appeals court didn't explain its decision. (10/3)

The same day a federal appeals court overruled itself and voted to block two Missouri abortion restrictions, the state advised Missouri abortion providers that they will have to abide by a new restriction. A memo dated Oct. 2 from the Missouri Department of Health and Human Services (DHSS) says the agency will file emergency rules on Oct. 24 establishing standards for “complication plans” for medication-induced abortions. (Margolies, 10/3)

Representative Tim Murphy of Pennsylvania, a strong and frequent critic of abortion, asked a woman with whom he was having an affair to undergo an abortion, according to a report published on Tuesday by The Pittsburgh Post-Gazette. Mr. Murphy, 65, who is married with an adult daughter, confirmed last month that he “became involved in an affair with a personal friend,” according to a statement previously provided to The Post-Gazette. (Stevens, 10/3)

As trauma nurse Renae Huening rushed into Sunrise Hospital and Medical Center on Sunday night, she “followed a trail of blood indoors. ”Dozens of patients already were crammed into the waiting area, hallways and rooms of the hospital’s emergency department. Some were “red-tagged,” meaning they needed attention immediately. Names were being assigned randomly because there was no time to register people or find IDs. Huening could smell the blood. (Craig, Mello and Sun, 10/3)

The call went out Monday from the Mandalay Bay Resort and Casino. Less than 24 hours earlier, from a suite on the 32nd floor, Stephen Paddock had squeezed off enough rounds from an AK-47-type rifle to kill at least 59 people and injure more than 500. And now, again, the hotel sought urgent help. “We are in need of certified trauma counselors,” it tweeted. And then these details: “If you can volunteer your time, please go to Circus Circus — Ballroom D where you will be given an assignment. . . . We are grateful for the support of our community.” (Nutt, 10/3)

Blood centers across California are seeing increased donations in the wake of the shooting in Las Vegas on Sunday night that killed 59 people and injured more than 520. (Klivans, 8/3)

In the wake of Sunday’s mass slaughter of 59 people here at the hands of a man who perched himself in a hotel suite above a country music concert with a high-powered arsenal — and apparently one that was fully legal — many Nevadans are loath to link the bloodshed to a gun-friendly culture. (Sernoffsky and Fagan, 10/3)

Orlando Health officials have done six presentations in Las Vegas in the last year about how to respond to a mass shooting — including an emergency room doctor giving an educational presentation to University Medical Center Las Vegas.Physicians and emergency preparedness officials shared lessons learned from the Pulse nightclub shooting. (Aboraya, 10/3)

Across the country, judges increasingly are sending defendants to rehab instead of prison or jail. ...But in the rush to spare people from prison, some judges are steering defendants into rehabs that are little more than lucrative work camps for private industry, an investigation by Reveal from The Center for Investigative Reporting has found. (Harris and Walter, 10/4)

For years, Jody Christ, 62, struggled to control her high cholesterol. Her doctors encouraged her to exercise, change her diet and lose weight, but none of that ever seemed to lower her numbers. When her health plan, the Geisinger Health System of Pennsylvania, offered a genetic test that screens for dozens of hereditary diseases, she submitted a saliva sample and awaited the results. (O'Connor, 10/3)

Fresh evidence that the body's immune system interacts directly with the brain could lead to a new understanding of diseases from multiple sclerosis to Alzheimer's. A study of human and monkey brains found lymphatic vessels — a key part of the body's immune system — in a membrane that surrounds the brain and nervous system, a team reported Tuesday in the online journal eLife. (Hamilton, 10/3)

When two of John Crowley’s children were diagnosed with the rare and debilitating Pompe disease, he founded a company that helped develop a successful treatment. Now, he’s running another biotech — and clinical trial data presented Wednesday suggest that it’s on the way to developing a more effective drug for the same disease. The new drug from Amicus Therapeutics (FOLD) appears to deliver greater improvements in muscle and lung function for people with Pompe, according to interim data from a small, mid-stage study. (Feuerstein, 10/4)

This field of comparative medicine — using animals to better understand and treat human disease — is not new; creatures such as mice, rats, and actual guinea pigs have long been the mainstay of medical research and studies of experimental drugs. What’s different is that veterinarians are now conducting rigorous clinical trials of new treatments with the hope they might eventually benefit humans as well as the family pet. Increasingly, they’re using dogs and cats and other companion animals in these experiments, as medical researchers recognize the limitations of traditional lab animals. (McFarling, 10/4)

People who don’t get vaccinated are the most likely reason for the steady increase in the rate of measles and major outbreaks in the United States, according to an analysis released Tuesday. The findings, published in JAMA, add to the body of evidence linking failure to vaccinate with the spread of the highly infectious and potentially fatal disease. Once common in the United States, measles was eliminated nationally in 2000 but has made a return in recent years largely because of people who reject vaccinating their children, experts say. (Sun, 10/3)

A poor sense of smell may indicate an increased risk for dementia, a new study has found. Researchers recruited 2,906 men and women ages 57 to 85, testing their ability to identify five odors — orange, leather, peppermint, rose and fish. (Bakalar, 10/3)

Our ancestors have been catching herpes since before we were human. The infection is quite common today; the World Health Organization estimates that two-thirds of adults under 50 are infected with the herpes virus that causes oral cold sores. One in six have genital herpes. Yet humans might have dodged herpes' below-the-belt blow if it weren't for an ancient encounter between early members of our genus and a more distant primate relative. (Guarino, 10/2)

Here’s a lingering public health mystery: Heterosexual black women in Philadelphia are at higher risk of contracting HIV than their white counterparts. But no one can yet say exactly why — or how to fix the problem. It’s probably not behavior: Studies indicate that African American women have fewer sexual partners and are more likely to use condoms than white women from similar economic backgrounds. And they are not members of the highest-risk demographic: gay and bisexual men. (Sapatkin, 10/3)

Breast cancer death rates declined almost 40 percent between 1989 and 2015, averting 322,600 deaths, the American Cancer Society reported Tuesday. Breast cancer death rates increased by 0.4 percent per year from 1975 to 1989, according to the study. After that, mortality rates decreased rapidly, for a 39 percent drop overall through 2015.  The report, the latest to document a long-term reduction in breast-cancer mortality, attributed the declines to both improvements in treatments and to early detection by mammography. (McGinley, 10/3)

Survival rates among breast cancer patients have increased, in part due to improvements in breast cancer screenings, treatment and new technologies. "People are living longer with breast cancer," said Dr. Uzma Iqbal, medical director and medical oncologist at the Cypress Fairbanks Medical Center's Cancer Center. At northwest Houston hospitals, 3D mammograms are now regular practice, providing a more accurate x-ray detection tool. Many private insurance providers are now paying for 3D mammograms, which are proven to be significantly more effective. (Santana, 10/3)

After years of grousing about the tax code, drug makers stand to benefit substantially from the changes the Trump administration is seeking. In fact, to a great extent, the plan that the White House is proposing appears to check off a few key items on an industry wish list, according to one tax expert. ... For one, the corporate tax rate would drop from 35 percent to 20 percent. This is not the 15 percent that Trump promised previously, but it is still a big difference. To compensate for the uptick, companies would be able to immediately write off capital spending for the next five years. (Silverman, 10/2)

Brian Kursonis, who was diagnosed last year with early-onset Alzheimer’s at age 55, is a star of the drug industry’s “Go Boldly” campaign — a sophisticated PR push, costing tens of millions a year, to highlight pharma’s commitment to develop cures for dreaded diseases. ...Kursonis hopes he can find a way to earn a living as an advocate, but if money doesn’t come in soon, he won’t be able to make the December rent on his spartan apartment in a suburb outside Charlotte, N.C. He fears he will soon be homeless, his best option the men’s shelter in downtown Charlotte. Kursonis’s story highlights the complicated, often heartbreaking realities that compound the challenges of living with a disease like Alzheimer’s. (Robbins, 10/3)

Exorbitant drug costs are one of the American health system’s most vexing problems. Today’s case-in-point is a hormone called 17-P, which prevents many preterm births. A new analysis by Harvard researchers looks at 535 women at high risk of giving birth prematurely who got a generic form of 17-P, and 3,350 others who got a brand-name version. (Knox, 10/3)

Kaiser Health News: Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment

Valerie Green is still waiting to be cured.The Delaware resident was diagnosed with hepatitis C more than two years ago, but she doesn’t qualify yet for the Medicaid program’s criteria for treatment with a new class of highly effective but pricey drugs. The recent approval of a less expensive drug that generally cures hepatitis C in just eight weeks may make it easier for more insurers and correctional facilities to expand treatment. (Andrews, 10/3)

Pfizer (PFE) lost a round in the larger fight over pharmaceutical pricing when a federal judge ruled that Texas lawmakers should be able to obtain state Medicaid rebate data about its medicines. The drug maker last year filed a lawsuit against the Texas Health and Human Services Commission for releasing the data to a pair of state lawmakers, who sought the information in order to assess drug costs for the state Medicaid program. But Pfizer argued that releasing the data would violate federal and state laws that protect its confidential information. (Silverman, 10/3)

Texas legislators are entitled to details about how pharmaceutical giant Pfizer priced drugs offered through the state's expansive Medicaid program, according to a judge's ruling in a year-old case. The case hits at the core of a drug cost debate that has been frustrating policymakers nationwide. (Rice, 10/2)

The controversial patent deal between Allergan (AGN) and a Native American tribe is now engulfing the pharmaceutical industry trade group. In a pointed letter, U.S. Sen. Claire McCaskill (D-Mo.) told the Pharmaceutical Research & Manufacturers of America that it should review whether Allergan’s sales of lucrative patents is in keeping with the organization’s boastful mission to “promote innovation and discourage predatory pricing practices and anticompetitive conduct.” (Silverman, 10/3)

Americans spent $457 billion on prescription drugs in 2015, according to a recent issue of the AARP Bulletin. The most popular brand-name drugs rose 208 percent between 2008 and 2016—bad news for retirees living on a fixed income, and according to one senior citizens lobbying group, because Medicare doesn’t have the authority to negotiate drug prices, millions of older Americans are at risk of price gouging for their prescription drugs. (Dowd, 10/1)

Kaiser Health News: Do Pharma’s Claims On Drug Prices Pass The Smell Test? We Found 5 Stinkers.

Drug companies launched an ad and publicity extravaganza this year right after President-elect Donald Trump said they “are getting away with murder” on sky-high pill prices. More than it has in years, the pharmaceutical industry fears major legislation that would curb prices and shrink profits. TV spots lauding drug companies, quoting poet Dylan Thomas and showing heroic scientists have been hard to escape. (Hancock, 10/2)

Taxpayers are bailing out drug makers the same way they did big banks back in 2008 and 2009, former U.S. Rep. and presidential candidate Dennis Kucinich said Monday. Kucinich, a Democrat, was in Columbus to announce that he was joining the campaign in support of Issue 2 to end those alleged subsidies, which he said cost the Ohio taxpayer more than $400 million a year. (Schladen, 10/2)

The Ohio Drug Price Relief Act — Issue 2 on the November ballot — has caused plenty of debate. It would require that the state, including the Ohio Department of Medicaid, pay the same or lower prices for prescription drugs as the U.S. Department of Veterans Affairs — which currently negotiates drug prices at least 24 percent less than other agencies.Here are views from both sides of the issue. (Wedell, 10/3)

In the absence of national action to control the high price of prescription drugs, California is considering a small state rule that could make a big difference. It targets a game that pharmaceutical companies play to keep people spending more than they need to on medicines. The rule, contained in legislation now on the governor's desk, would bar the use of coupons to help consumers cover the cost of co-payments for any brand-name drugs for which there is a generic alternative that works as well. (9/28)

American consumers have been inundated over the past few years by marketing campaigns for a growing range of anti-viral, biologic “cures” for Hepatitis C. The disease affects between 2.7 million and 3.9 million Americans, and between 75 and 85 percent of those who are infected with Hepatitis C are afflicted with the chronic variant. For an estimated 1 to 5 percent of Hepatitis C patients, it is the major cause of death from liver cancer and cirrhosis. (Thomas Hemphill, 10/2)

Johnson & Johnson's one of the largest drugmakers in the world, and according to a lawsuit Pfizer has filed, it's leveraging its size to negotiate contracts that prevent insurers from paying for cheaper biosimilars to Remicade, its best-selling drug. Pfizer's suit reveals the lengths to which drugmakers are going to keep sales flowing in from drugs even after patents expire, so let's take a closer look to see what's at stake. (Todd Campbell, 10/2)

When Novartis announced that the price of its new personalized gene therapy for cancer, Kymriah, would be $475,000, Wall Street analysts thought that was a relative bargain, but some health payers didn’t agree. Among the naysayers was Steve Miller, the outspoken chief medical officer of pharmacy benefits manager (PBM) Express Scripts. “We need a new payment model,” declared Miller in a blog post last week. He pointed out that $475,000 is much more than the price of the average specialty drug, and with at least 1,500 experimental gene therapies in the pipeline, the potential for the health care system to be overwhelmed by high-priced, one-time cures is great. That’s why, he said, new payment models should include “tracking [patients’] health outcomes over time to ensure payments aren’t being made if the treatment stops being effective.” (Arlene Weintraub, 9/29)

There are very few things biotech and pharma investors are inclined to under-value. But the stunning longevity of the world's best-selling drug -- AbbVie Inc.'s Humira -- might be one of them. Amgen Inc. on Thursday agreed to delay the launch of an Humira copycat until late 2018 in Europe and 2023 in the U.S. I've been skeptical of AbbVie's claims that it could keep Humira competition-free in the U.S. and grow the drug's sales through 2020. But now it seems it just might manage it.  (Max Nisen, 10/29)

The price of an Epipen injector has risen from around $100 for a two-pack in 2009 to more than $600 in 2016. Epipen is a life-saving emergency injector for people violently allergic to certain foods, such as peanuts: it will keep a person’s throat from closing up during anaphylactic shock. A year ago, as news spread about this enormous hike in prices, Congress summoned Heather Bresch, the CEO of Mylan, Epipen’s manufacturer, to find out why. She told them that, with rebates and insurance coverage, 85% of patients were actually paying less than $100 for the absurdly-priced medication. But that meant the insurance industry was paying the balance of those higher prices for those with coverage. And it would raise premiums accordingly. In other words, we would all be paying for those unreasonable profits. (Peter Georgescu, 9/27)

Valeant Pharmaceuticals International Inc. has made some not-terrible business moves in the past few months. The troubled pharma firm has divested assets, raising cash to pay down debt. It has avoided big, public scandals over its accounting. It hasn't filed for bankruptcy. (Max Nisen and Lisa Abramowicz, 10/2)

Californians and others around the country following the California legislature’s multiyear debate on prescription drug pricing may have stood up and taken notice on September 13 when the state Senate followed the Assembly in passing SB-17 to facilitate greater transparency in brand-name and generic drug pricing. While sponsors often make grandiose claims about the potential impact of their legislation, California senator Ed Hernandez may have set a new standard when he declared that the passage of SB-17 was “a monumental achievement for the entire nation” and “one of the most transformative pieces of health legislation in the country.” (Ian Spatz, 10/2)

During his short stint as health and human services secretary, Tom Price didn’t spend all his time on chartered airplanes billed to taxpayers. He was also busy making funding cuts to state programs, endangering disabled seniors, ignoring Medicaid waiver requests and sabotaging the Affordable Care Act. His resignation is welcome. So is his personal check to repay the public for his travels. Congress should ensure that money is delivered. And then lawmakers need to get their act together. (10/3)

Health and Human Services Secretary Tom Price is gone, ushered out of office last week after being caught causing $1 million in unnecessary taxpayer expense by chartering private planes and taking military aircraft around the country and the world instead of flying commercial, like normal people. This looks like a case in which the right thing has happened for the wrong reason — or at least for an incomplete reason. The grounds for Price’s ouster should have been his atrocious management of the most important program under his jurisdiction, the Affordable Care Act. Instead of acting to make Obamacare work better for all Americans, Price took every step within his power to undermine the law in ways that will cost American families millions of dollars. (Michael Hiltzik, 10/3)

Republicans have now failed twice to repeal and replace ObamaCare. But their whole focus has been wrong. The debate centered, like ObamaCare, on the number of people with health insurance. A more direct path to broadening access would be to reduce the cost of care. This means creating market conditions long proven to bring down prices while improving quality — empowering consumers to seek value, increasing the supply of care, and stimulating competition. (Scott Atlas, 10/3)

Since its creation in the Affordable Care Act, the Center for Medicare and Medicaid Innovation has led efforts at CMS to advance alternatives to fee-for-service. ... But most payment reforms are still at relatively early stages, and private-sector innovators cannot make the shift without the government’s commitment to shift from volume- to value-based payments. With so much at stake, the actions of the Department of Health and Human Services are closely watched. The recent revisions in a set of mandatory payment reform pilots caused some to worry about continued HHS commitment to payment reform. (Mark McClellan and Mike Leavitt, 10/3)

My wife and are small-business owners. We teach music to small children and their families in our community. It’s work we love and care deeply about. But it makes it hard to get health insurance on our own. That’s why CHIP is so important: Because of the program, which provides health care to children of low- and moderate-income families, we could follow the advice of our doctors and Luna could get the care she needed. Luna could see new specialists and go to follow-up appointments without us risking bankruptcy — just the first few days of testing and evaluation cost up to $40,000. Thanks to CHIP, my wife and I could focus on growing our business and taking care of our family. (David Berzonsky, 10/4)

At least at the cellular level, cancer doesn’t discriminate by income. It strikes rich people and poor people and those in between, forcing new reckonings and leaving emotional and physical scars. October is Breast Cancer Awareness Month, but beneath all the pink-themed marketing is a new normal: Insurance coverage can dictate a woman's recovery. ... If your coverage is through Iowa’s Medicaid program for low-income people, you may find yourself unable to get a post-mastectomy breast prosthesis. That is, unless you can shell out up to $1,000 in cash. (Rekha Basu, 10/3)

There are no simple solutions to drastically reduce America’s gun violence. Much needs to be done on many fronts, ranging from expanded mental health access to addressing the adverse socioeconomic circumstances that engender street crime and day-to-day violence in the first place. Nevertheless, much will be said about gun control in coming days. Many proposals will be offered, and realistically nothing will be accomplished — at least in the short term. As political circumstances change, however, some good may be able to be done. When that happens, insofar as we want to do anything about the types of guns people can buy, we should aim for an across-the-board semiautomatic firearms ban. (Adam Gaffney, 10/4)

Stop. Right. There. Pending in the Ohio House is a bill to strip from Ohio cities their power over lead abatement. House Bill 299 is sponsored by suburban Toledo Republican Derek Merrin. Last spring, he got the House to add the measure to Ohio's then-pending budget bill, but it was deleted before passage. (10/4)

At every level of training beyond medical school, there is a strong assumption that these periods of transition are limited to big new beginnings, and that the trainees will rapidly settle in. Orientations tend to focus on the logistics of starting a new job, pivoting from a deluge of information about electronic medical records and human resources packets to ice breakers and password setups. After a few weeks, programs designed to aid in transitions taper off, aside from a few individual review meetings with the program director. Trainees are expected to take flight relatively independently. (Jason J. Han and Neha Vapiwala, 10/3)

Will addicts in the throes of opioid cravings really click through a smartphone app for help? As central Ohio communities remain overwhelmed by the still-skyrocketing numbers of overdose deaths, the idea is well worth pursuing. The Alcohol, Drug and Mental Health Board of Franklin County will make such an addiction-support app available to 200 drug users within the next few weeks, thanks to a $108,000 donation by The Columbus Foundation for a pilot program. (10/4)

In the months leading to the March 20 Illinois primary, when incumbents will need majority support in their party, Gov. Bruce Rauner finds himself jilted by much of his 2014 base. His Sept. 28 signature on a controversial abortion bill has undercut his support among former loyalists who hoped that in 2018 he would elevate the GOP from its longstanding minority status in Springfield. (10/3)

St. Louis health care advocates had something to celebrate recently when the city was toppled for the first time in a decade from its reigning position as the nation’s capital of sexually transmitted diseases. But coming in second place to Etowah County, Ala., still means there’s much work to be done locally to impress upon sexually active people that condoms are the best method to prevent the spread of infection. (10/3)