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On the March 23 anniversary of the Affordable Care Act becoming law, Democrats attacked Republicans for trying to sabotage the health law and praised the embattled legislation. So did Russian trolls. “8 years ago today, President Obama signed the Affordable Care Act into law. Millions of Americans have gained access to health care. Thank you, Mr. President!” said a tweet linked to the Internet Research Agency, a Russian company engaged in an online influence campaign that typically seeks to pit one side against the other on controversial issues. (Armour and Overberg, 9/12)

House GOP legislation that would delay or repeal certain parts of ObamaCare will cost $51.6 billion over the next decade, according to a new government analysis. The report from the nonpartisan Congressional Budget Office (CBO) released Tuesday comes as the House plans to vote on the legislation later this week. (Weixel, 9/11)

Former President Barack Obama's recent denunciation of President Donald Trump's treatment of the press overlooks the aggressive steps the Justice Department took to keep information from the public during his administration. Obama also made a problematic claim that Republican "sabotage" has cost 3 million people their health insurance. With his return to the political donnybrook on behalf of Democrats in the November elections, Obama has brought a once-familiar style back into the discourse. It's measured, nuanced and distinct from the torrent of misstatements from Trump. That doesn't mean Obama always tells the story straight. (Woodward and Rugaber, 9/12)

Democrats believe they have their best chance in years to flip as many as five state attorneys general seats by capitalizing on the blue wave forecast for the midterms, as well as the mounting backlash to the latest lawsuit seeking to abolish Obamacare brought by 20 Republican state attorney generals. With the national landscape looking increasingly favorable for Democratic candidates for governor, Congress and state legislatures, the lawsuit against the Affordable Care Act has injected unexpected energy and cash into many of the 30-plus races across the country for state attorneys general. (Ollstein, 9/11)

After several years of double- and triple-digit increases in health insurance premiums, Arizona could see premiums fall more than 4 percent in 2019, one of only 11 states looking at a drop, according to a new analysis. It’s a sharp turnaround for Arizona, a state where a premium increase of 116 percent in 2017 was cited by President Donald Trump as proof that the Affordable Care Act needed to be repealed. (Egeland, 9/11)

A Democratic-leaning group has launched an ad campaign against Republican candidate for governor Jeff Johnson, accusing him of pushing policies that would take health care away from people who need it. In a statement, Johnson called the ads “blatant lies intended to cover up the fact that the DFL candidate for governor wants to eliminate private health insurance and force all Minnesotans onto one government program.” It’s in reference to U.S. Rep. Tim Walz’s stated aim to provide a government health plan to all Minnesotans, like seniors currently use under Medicare. (Coolican, 9/11)

Pressure is intensifying on undecided senators before a vote to confirm President Trump’s Supreme Court nominee, with one senator — Susan Collins, Republican of Maine — reporting that she and her staff have been targeted with a barrage of calls, including some using vulgar language and threats to push her to vote against Judge Brett M. Kavanaugh. With last week’s confirmation hearings behind them, interest groups and advocates are spending hundreds of thousands of dollars on advertising to target both Ms. Collins and another undecided Republican who supports abortion rights: Senator Lisa Murkowski of Alaska. Also in the cross hairs are three vulnerable Democrats running for re-election in states won by President Trump. (Stolberg, Fandos and Edmondson, 9/11)

Brett Kavanaugh avoided glaring missteps — and most tough Democratic questions — at his confirmation hearings. But that’s not stopping the Supreme Court nominee’s liberal critics from unleashing new ads and grass-roots campaigns in one last shot at derailing him. (Schor and Everett, 9/11)

The Senate will vote this week on a bill to prevent illicit fentanyl trafficking, account for drug diversion in opioid manufacturing quotas, and improve access to addiction treatments via telemedicine. Many senators, soon to campaign for re-election in states hard-hit by the epidemic, say the bill is enough. Many advocates for better addiction treatment beg to differ. (Facher, 9/12)

The company that created OxyContin is offering free doses of an opioid-abuse treatment as part of its offer to resolve more than 1,000 lawsuits accusing the drugmaker of helping fuel the opioid crisis, according to people familiar with the negotiations. Purdue Pharma has repeatedly said it will give away doses of a new version of buprenorphine -- which helps wean people addicted to opioids off the drugs -- as part of any settlement, according to four people familiar with the talks sponsored by state attorneys general and a federal judge. They asked not to be cited by name as the negotiations are confidential. (Hopkins and Feeley, 9/11)

Cristina Rivell has been struggling with an opioid addiction since she was a teenager — going in and out of rehab for five years. The most recent time, her doctor prescribed her a low dose of buprenorphine (often known by its brand name, Suboxone), a drug that helps curb cravings for stronger opioids and prevents the symptoms of withdrawal. (Feldman, 9/12)

Private insurers across the country and in Texas have entered the very public fight against opioid addiction, with some now outright denying coverage of OxyContin, the most notorious of drugs linked to the crisis. But the move has unleashed a clash of opinion over its wisdom, with the insurance industry defending the crackdown as an important deterrent while some in Houston’s drug abuse treatment and pain management communities call it an over-reaction and question the effectiveness of taking a stand against one drug. (Deam, 9/11)

Delaware public health officials are reporting a record number of deaths from suspected drug overdoses in August. Officials said Tuesday that the 39 deaths reported last month is the highest since they began tracking deaths from suspected overdoses in late 2013. The previous monthly high was 27 deaths in April. Officials suspect many of the overdoses involved fentanyl, a highly toxic synthetic opioid far more potent than heroin. (9/11)

Plymouth State University has received a grant from the federal government to train its clinical mental health students in treating substance abuse. The $400,000 will go towards two things: paying students a $10,000 stipend when they intern at a partner health center, and providing training and conference funding for students and faculty. (Allee, 9/11)

Since Bernie Sanders made “Medicare-for-all” a central plank of his wildfire presidential campaign, support for a once-fringe idea has exploded. Democratic senators with eyes on the 2020 presidential contest – including Cory Booker, Kirsten Gillibrand and Kamala Harris – have conspicuously lined up as co-sponsors of the “Medicare-for-all” legislation that Sanders introduced last year; a similar proposal in the House has 123 co-sponsors. All of those politicians are Democrats, but among voters, support appears to cross the aisle: A recent Reuters/Ipsos poll showed that “Medicare-for-all” was supported by 70 percent of American adults, including a slight majority of Republicans. (Demko, 9/12)

The U.S. government will expand its tent shelter for immigrant minors crossing the southwest border to 3,800 beds and keep it open through the end of this year, an agency spokesman said Tuesday. The facility at Tornillo, Texas, which originally opened with a 360-bed capacity for 30 days, is being expanded based on how many children are in the care of the U.S. Department of Health and Human Services, agency spokesman Kenneth Wolfe said in a statement. (9/11)

The decision marks the third time the facility's operations have been extended since it opened in June. It's necessary because of the ongoing arrival of unaccompanied immigrant minors in the United States, a spokesperson for the U.S. Department of Health and Human Services said in an email. The extension is not in response to President Donald Trump’s former “zero tolerance” policy that separated children from their parents or guardians, which has been placed on hold after a national uproar. The facility will also expand to 3,800 beds, spokesperson Kenneth Wolfe said. Earlier this summer, the facility reportedly had around 400 beds. (Aguilar, 9/11)

A youth care worker at an Arizona shelter for migrant children has been convicted of sexually abusing teenagers who were under his supervision, federal prosecutors said on Monday. After a seven-day trial, the worker, Levian D. Pacheco, 25, of Phoenix, was convicted on Friday by a jury in United States District Court of seven counts of abusive sexual contact and three counts of sexual abuse of minors, the prosecutors said in a statement. He will be sentenced on Dec. 3. (Hauser, 9/11)

Hospitals in South Carolina and North Carolina are testing generators, stockpiling supplies and evacuating patients as they prepare for Hurricane Florence to batter the coast later this week. With Category 4 Florence still gaining strength and aiming for Wilmington, N.C., both states have declared states of emergency. The National Hurricane Center said Florence, which was upgraded from a Category 3 to 4 hurricane on Monday, will carry winds near 130 miles per hour that are expected to extend up to 40 miles from the center of the hurricane. It's expected to make Thursday night or Friday morning. Late Tuesday night, HHS Secretary Alex Azar declared that both states were facing public health emergencies. (Livingston, 9/11)

Hospitals, nursing homes and assisted living facilities in Georgia are receiving patients evacuating from the Carolinas as Hurricane Florence approaches the Southeastern coast, state officials said Tuesday. Georgia appears likely to escape the brunt of the Category 4 storm as it spins toward landfall. But state health care officials are preparing for an influx of evacuees from states hard hit by the storm. (Miller, 9/11)

Although the bullseye for Hurricane Florence has shifted, our area may still see up to 10 inches of rain. Health care centers are regulated under the state of Virginia. By law, they have to provide quarterly emergency preparedness plans, though most HCCs, including The Legacy review emergency action plans on an ongoing basis. (Calello, 9/11)

Nearly two decades ago, in a Manhattan subway station, a mentally ill man shoved Kendra Webdale, a promising young writer, to her death in front of an oncoming N train. It was a horrific crime that shocked the city and the nation, highlighting deep flaws in the care of seriously mentally ill people and spurring a wave of state laws that use court orders to move them into outpatient treatment. Last week, the man who killed Ms. Webdale, Andrew Goldstein, now 49, who has had schizophrenia since his youth, walked out of prison and into a mental health system that has been heavily influenced by his crime. (Watkins, 9/11)

A new alliance of mental health advocacy groups wants a seat at the table in the court's review of the city of Portland's four-year old settlement agreement with the U.S. Department of Justice stemming from police use of excessive force against people with mental illness. The alliance was formed in July and is made up of Disability Rights Oregon, the Mental Health Association of Portland and Cascadia Behavioral Healthcare. The groups cite their experience and expertise as direct service providers to people with mental illness. (Bernstein, 9/11)

A nine-year-old boy in Colorado took his own life on the first week of school this year. The tragedy highlighted a pervasive problem in the state and in the Mountain West region as a whole -- the high suicide rate -- especially among youth. (Budner, 9/11)

Active shooters with semi-automatic rifles wound and kill twice as many people as those using weapons that don't self-load, although chances of dying if hit in either type of assault are the same, a new analysis shows. Researchers examined FBI data on nearly 250 active shooter incidents in the United States since 2000. Almost 900 people were wounded and 718 were killed. (Tanner, 9/11)

In the United States, shootings that involved a semiautomatic rifle resulted in nearly twice as many deaths compared with shootings carried out with only handguns, shotguns or non-semiautomatic rifles, according to a report published Tuesday in the Journal of the American Medical Assn. Nonfatal injuries were significantly higher as well. In other words, the study authors noted, the weapons work exactly as intended. “Semiautomatic rifles are designed for easy use, can accept large magazines, and fire high-velocity bullets, enabling active shooters to wound and kill more people per incident,” they wrote. (Kaplan, 9/11)

Federal and state laws on gun sales are complicated. So are mental health issues. No one wants a dangerous person to have a gun, but no one wants to take away guns from people because of a mental health stigma. The Enquirer answers 11 key questions about guns and mental health laws. (Balmert, 9/11)

Violence, bitter partisanship, an uncertain future. These are dark times. In fact, humanity just had its gloomiest year in more than a decade, according to a new survey of the emotional lives of more than 154,000 people around the world. More people reported negative experiences, defined as worry, stress, physical pain, anger or sadness, than at any point since 2005, when Gallup, the analytics and consulting company, introduced the survey. (Chokshi, 9/12)

British American Tobacco Plc hasn’t produced adequate data to show its Camel smokeless tobacco pouches are a less risky alternative to cigarettes, according to U.S. regulators, a sign the company may face hurdles as it attempts to develop less-harmful products. Although Camel Snus have lower levels of some potentially harmful chemicals compared with cigarettes, they contain higher amounts of arsenic, cadmium and nicotine, said Food and Drug Administration staff in a briefing document posted online on Tuesday. Those levels “may result in increased user exposures to carcinogens and other toxicants that may subsequently increase the risk for cancer, heart disease and reproductive or developmental effects,” FDA staff said. (Edney, 9/11)

Rapid advances in technology have been a boon to the medical device industry. They’ve also sparked growing concern that those devices can be hacked. Devices from hospital-room infusion pumps to pacemakers use wireless internet and network connectivity. Researchers and hackers have shown that networked devices — including some approved by the Food and Drug Administration — can be vulnerable to threats. Just last month, two cybersecurity experts made headlines when they said they had found security weaknesses in Medtronic pacemakers that made them hackable. (Thielking, 9/11)

For Griselda Cruz, the long drive from her home in Indiana to Alivio Medical Center in Chicago is well worth it. Cruz, 25, likes that she can speak with the Alivio providers in Spanish, her first language. She also feels they take good care of her and her three young children. Cruz visits Alivio for pediatric and women's healthcare appointments. “If my children are sick, they can see them on the same day,” she said in the waiting room of one of Alivio's clinics in the city's Little Village neighborhood, which has a predominantly Latino population. (Castellucci, 9/8)

A large new study links whole-fat dairy food consumption to a reduced risk for cardiovascular disease. The findings raise questions about current dietary guidelines, which suggest substituting fat-free or low-fat dairy for full-fat products. The study, published in Lancet, included 136,384 people in 21 countries followed for an average of nine years. (Bakalar, 9/11)

New research has found that obstructive sleep apnea — a disorder in which breathing stops and starts during sleep — is associated with an increased risk for gout, a common cause of painful arthritis. Scientists studied 15,879 patients with apnea and 63,296 matched controls without, following them for an average of almost six years. Over that time, 4.9 percent of people with apnea developed gout, compared with 2.6 percent of those without the disorder. (Bakalar, 9/11)

Health officials are urging everyone over six months old to get their flu vaccine as soon as possible to help avoid another nasty season. And to encourage needle-phobic kids to get immunized, a leading pediatric group is softening its insistence that they get it in a shot rather than a painless nose spray. (Woolfolk, 9/11)

Kids with ADHD are easily distracted. Barn owls are not.So a team at Johns Hopkins University in Baltimore is studying these highly focused predatory birds in an effort to understand the brain circuits that control attention. The team's long-term goal is to figure out what goes wrong in the brains of people with attention problems, including attention deficit hyperactivity disorder. (Hamilton, 9/11)

An intriguing study published this week suggests that bonobos, among the closest relatives to humans, are surprisingly willing to hand over food to a pal. But they didn't share tools. The discovery adds a new wrinkle to scientists' efforts to understand the evolutionary origins of people's unusual propensity to help others. (Greenfieldboyce, 9/11)

Members of the generation that came of age in the era of marijuana are reaching for weed in their golden years. A study published in the journal Drug and Alcohol Dependence this month suggests that increasing numbers of middle aged and older adults are using marijuana — and using it a lot. The analysis comes from data gathered in the National Survey on Drug Use and Health from 2015 and 2016. About 9 percent of U.S. adults between ages 50 and 64 used marijuana in the the previous year, according to survey results. About 3 percent of people over 65 used the drug in that time period. (Gordon, 9/12)

Kaiser Health News: Doctor To The Stars Disciplined Over Use Of Controversial Menopause Therapy 

A Santa Monica doctor who touted a controversial menopause therapy on the Oprah Winfrey Network and received testimonials for her work from such celebrity patients as model Cindy Crawford and actress-author Suzanne Somers has been disciplined by California’s medical board for gross negligence. In a settlement approved late last month, the Medical Board of California put Dr. Prudence Hall on probation for four years, faulting her for being “unaware” of potential risks posed by the plant-based hormones — including cancer — and failing to monitor her patients properly. (Feder Ostrov, 9/12)

As climate change makes wildfires more intense, U.S. deaths from chronic inhalation of smoke could climb to 40,000 per year -- that's more than double the current number of 15,000 deaths per year, according to a recent study. While the study's co-author Jeff Pierce cautioned that more research must be done, he said the model shows "smoke concentrations will roughly double and this will counteract a lot of improvements gained from a reduction in emissions from human sources, such as power plants." (Fiore, 9/11)

For weeks, smoky, unhealthy air from large wildfires has plagued much of the West Coast and beyond. What's the public health impact of an increase of urban wildfires, in which homes and other structures burn? (Wise, 9/11)

The Environmental Protection Agency issued new rules making it easier for oil and gas companies to release methane, a potent greenhouse gas. It's the Trump administration's third major step to roll back regulations aimed at combating global warming and climate change. (Brangham, 9/11)

The Environmental Protection Agency has proposed adding the former site of a refrigerator-valve manufacturing facility in Washington, Missouri, to its National Priorities List. ...Harmful contaminants such as benzene and trichloroethylene — or TCE — remained in the soil and groundwater over several decades. Exposure to such chemicals can cause cancer and damage to multiple organs. (Chen, 9/11)

Lead contamination has been an ongoing crisis in New York City’s public housing, and the Education Department said on Tuesday that it continues to be an issue in schools as well. In a report, the department said that while it has made progress in eliminating lead in schools over the last year, more than 1,100 water fixtures in city school buildings still have lead levels above the 15 parts per billion threshold that the Environmental Protection Agency allows. (Shapiro, 9/11)

The city has replaced many fixtures and pipes leading to them as well as taken other steps such as a weekly flushing protocol to prevent a buildup of lead in standing water. The city’s results stem from tests conducted in the 2016-17 school year, and retests in 2017-18, after repair efforts were made, of fixtures that initially showed elevated lead levels. City Department of Education officials said 99% of the roughly 142,000 potential drinking water fixtures in the city’s public schools tested at or below the state action level of 15 parts per billion. (Brody, 9/11)

A Chicago business that buys and resells diabetic testing supplies has drawn attention to a hazy “gray market” of online buyers and sellers. Surplus Diabetic Supplies LLC, which operates online as CashNowOffer.com, is the subject of 355 complaints to the Better Business Bureau of Chicago, most of them in the past few months. Consumers say they were never paid for their testing strips and couldn’t get answers when they complained. (Zimmerman, 9/11)

A finance panel will consider a recommendation that Baltimore pay more than $1 million in attorney's fees to a Christian-based health organization that successfully challenged an ordinance requiring pregnancy centers to notify patients if they don't offer abortion or birth control services. The Daily Record reports the city's Board of Estimates will consider the Baltimore Law Department's recommendation Wednesday. (9/11)

A lawsuit is challenging the state of Maryland’s decision to move Medicare eligible retirees to Medicare Part D. Lawmakers say Maryland Attorney General Brian Frosh notified them this week about the lawsuit. It was filed in Baltimore City Circuit Court by attorneys for former state employees. Lawmakers had planned a briefing on the transition Thursday, but that has been pulled from the schedule. (9/11)

Henry Ford Hospital has a new CEO. Richard "Chip" Davis, Ph.D., an Ann Arbor native who has spent 25 years in leadership roles at Johns Hopkins Medicine in Maryland, will replace Dr. John Popovich Jr., who retired earlier this year, Henry Ford Health System announced Monday in a news release. Davis will be responsible for strategic leadership and will direct "the entire clinical and financial operations" including "new clinical, academic and commercial partnerships," the news release said. (Burton, 9/11)

UCare is now offering its 30,000 non-group health plan members access to hundreds of dollars of healthy food discounts. The insurer said the Healthy Savings program will help its members save up to $200 a month on healthy foods such as lean meats, whole grains, fresh fruit and vegetables. (Zdechlik, 9/11)

The death of a woman living at a Minneapolis homeless camp is raising fresh concerns about the health of the rapidly growing number of people staying there. Alissa Rose Skipintheday, 26, was found unconscious and not breathing last week near the camp, which is known by locals as the Wall of Forgotten Natives because it is close to a highway sound wall and is made up primarily of Native Americans. Skipintheday died Saturday at Hennepin County Medical Center, the Star Tribune reported. The Hennepin County Medical Examiner's office said Tuesday that her death remains under investigation. (9/11)

With an estimated 100 million Americans not going to the dentist because they can't afford it, I'm happy to report on some popup dental clinics that are offering free services this month. Some of these clinics offer an array of medical services in addition to the dental options, and most are are set up where patients can just show up and be treated on a first-come, first-served basis. (Hance, 9/11)

Michael Grunstein, a longtime professor of biological chemistry at UCLA who uncovered the key role that DNA’s “packing material” plays in turning genes on and off, has won the Albert Lasker award for basic medical research. He shares the prize with Rockefeller University biochemist C. David Allis, who extended Grunstein’s findings on how certain proteins modify gene expression and identified how one such route can lead to childhood cancers. (Healy, 9/11)

Connecticut is suing a Florida-based compounding pharmacy and more than a dozen former and current state employees for their alleged involvement in a kickback pyramid scheme that cost the state nearly $11 million, state Attorney General George Jepsen announced Tuesday. ...The state alleges that Assured Rx paid the Mauluccis kickbacks for their own compound drug prescriptions and those of other Pharmacy Benefit Plan members they recruited into the scheme. (Rigg, 9/11)

A suspect is in custody after police responded to reports of an active shooter at Kaiser Permanente Medical Center in Downey, authorities said Tuesday. Downey police received a call about 11:34 a.m. reporting a disturbance at the medical center at 9333 Imperial Highway. As officers were en route, the report was updated to shots fired, according to police Chief Carl Charles. (Mejia, Fry and Reyes-Velarde, 9/11)

Middle and high school students do better when they get an extra hour or so of sleep, according to research and, many parents would say, common sense. But many school districts resist a mandate on start times because it can inconvenience working parents and disrupt bus schedules. (McBride, 9/11)

Loyalty and devotion held a homeless couple together for nine years, but the relentless struggle for survival on the streets has left them with an uncertain future. (McConahey, 9/10)

A Columbus pharmacist convicted of stealing and reselling more than $1 million worth of prescription drugs was sentenced Tuesday in federal court to two years in prison. Maria Mascio, 62, also will have to repay $1.1 million from a decade of fraudulent activity under the sentence handed down by U.S. District Judge Michael H. Watson. (Kovac, 9/11)

Not everybody reads the legal notices inside the Ottumwa Courier. But in January, Iowa pharmacist Mark Frahm noticed something unusual in the paper. For years, Frahm’s South Side Drug bought pills from distributors, and dispensed prescriptions to the Wapello County jail. In turn, the pharmacy got reimbursed for the drugs by CVS Health Corp., which managed the county’s drug benefits plan. As he compared the newspaper notice with his own records, and then with the county’s, Frahm saw that for a bottle of generic antipsychotic pills, CVS had billed Wapello County $198.22. But South Side Drug was reimbursed just $5.73. So why was CVS charging almost $200 for a bottle of pills that it told the pharmacy was worth less than $6? And what was the company doing with the other $192.49? (Langreth, Ingold and Gu, 9/11)

The rising cost of prescription drugs is an issue in midterm races across the country, but nowhere more so than in New Jersey, where one candidate is the recently retired CEO of an actual drug company. So we decided to take a look at the rhetoric in that race, pitting incumbent Sen. Bob Menendez against former Celgene boss Bob Hugin. In TV ads blanketing New Jersey (and Philadelphia and New York City), Menendez paints his opponent as a craven profiteer, raising prices on patients with no other options. But Hugin argues that Celgene has saved thousands of lives by giving away doses of its banner cancer drug for free to patients who can’t afford it. (Garde, 9/11)

A decade ago, when their son Bertrand was still an infant, Matthew Might and his wife, Cristina, realized that there was something terribly wrong. When he cried, his eyes stayed dry; the lack of tears damaged his corneas and threatened blindness. Eventually, he suffered seizures, a movement disorder and a severe developmental delay. It took four years to discover the problem: Bertrand had inherited two mutations of the NGLY1 gene, which plays a key role in recycling cellular waste. That meant the child’s cells were choking on their own trash. (Weintraub, 9/10)

Angered by rising prices and persistent shortages of generic drugs, seven of the nation’s largest hospital systems have launched a new, not-for-profit manufacturer. The company, which was first discussed publicly earlier this year, starts with a $100 million in capital and loans, some of which will come from three philanthropic organizations, including the Laura and John Arnold Foundation. Civica Rx will contract with other companies to make more than a dozen generics and some sales will start in mid-2019. We spoke with Dan Liljenquist, a vice president at Intermountain Healthcare who initiated the project, about the possibilities and challenges. This is an edited version of our conversation. (Silverman, 9/6)

For the CEO of a biotech startup, there may be no bigger asset than a compelling sales pitch. Frank Reynolds had a great one. He hadn’t planned a career in biotechnology, the head of Cambridge-based InVivo Therapeutics would tell investors. His calling found him. (Saltzman, 9/8)

It was a great summer for big pharma stocks. Investors shouldn’t expect that trend to reverse this fall. As has become routine, biotechnology stocks had a strong summer. A broad index of those stocks is up about 15% this year and is near a record. This time, however, major pharmaceutical companies are joining in the rally. (Grant, 9/5)

File this under “If at first you don’t succeed, …” AmerisourceBergen (ABC), which is one of the nation’s largest pharmaceutical wholesalers, has conceded that its compounding business needs to be fixed, so the company has hired manufacturing experts to review procedures at a key facility in Memphis and postponed plans to resume shipments. (Silverman, 9/7)

Just months after Pfizer slashed hundreds of jobs in  its own neuroscience R&D program, the pharmaceutical giant is making notable investments in two Boston-based neuroscience startups. The company announced Wednesday that Tevard Biosciences and QurAlis will each receive one of Pfizer’s coveted “Golden Tickets”— a valuable voucher for the fees associated with renting a spot for one scientist for one year at LabCentral, a biotech incubator in Cambridge, Mass. For companies based elsewhere, the ticket also allows a start-up to set up shop at the noted space in Kendall Square. (Sheridan, 9/12)

Drug distributor AmerisourceBergen Corp. ABC -0.35% said its finance chief Tim Guttman will retire in November and will be succeeded by Executive Vice President James Cleary. Mr. Guttman has served as the company’s chief financial officer since May 2012, and was previously vice president and corporate controller since joining the company in 2002. He will continue to serve as an adviser further into fiscal 2019 to ensure a smooth transition, the company said. (Shumsky, 9/10)

Private-equity firm General Atlantic has agreed to invest $200 million in a startup that aims to manage independent cancer-treatment clinics, the latest sign investors see opportunity in the health-services sector. The investment makes General Atlantic the majority owner of OneOncology, a startup that launched this month. Its founders, three cancer-treatment practices in Tennessee and New York, are the other owners and its first customers. (Evans, 9/12)

Kaiser Health News: Unwitting Patients, Copycat Comments Play Hidden Role In Federal Rule-Making

A proposal to sharply cut a drug discount program that many hospitals rely on drew some 1,400 comments when the Trump administration announced its plan last year. Hundreds appeared to come from patients across the country — pleas from average Americans whose treatments for diseases such as cancer depend on costly medicines. But a review of the responses found that some individuals were not aware they apparently had become part of an organized campaign to oppose what’s known as the “340B” program. (Tribble, 9/11)

Among the 30,000 attendees of the Rutherford Street Fair, sweating it out on the street between the zeppoles and deep-fried Oreos, was the pharmaceutical millionaire who wants to be their next senator. Bob Hugin, the former CEO of Celgene, spent Labor Day walking through the crowd with a phalanx of staff and volunteers, each with a sign and a T-shirt bearing his name. They chanted, cheered, and sloganeered as Hugin’s would-be constituents looked on, varyingly bemused or befuddled at the merry little militia demonstrating in their town. Hugin shook hands, posed for photos, and remembered to say “good to see you” but never “nice to meet you.” (Garde, 9/6)

Philip Frost, a longtime biotech billionaire, was accused Friday of taking part in a pump-and-dump stock scheme that bilked investors out of $27 million. The Securities and Exchange Commission charged Frost and nine others in connection with what it described as a scheme to buy up shares in penny-stock biotechs, illegally promote the companies online, and then sell their shares before the bottom fell out. (Garde, 9/7)

In the category of saying the quiet parts out loud, consider this statement by Nirmal Mulye, the chief executive of drug company Nostrum Laboratories: “I think it is a moral requirement to make money when you can ... to sell the product for the highest price.” Mulye was responding to questions posed by the Financial Times about his quadrupling the price of an essential antibiotic to $2,392 per bottle. The drug, nitrofurantoin, is used to treat urinary tract infections. It has been on the market since 1953 and is listed by the World Health Organization as an essential medicine for “basic healthcare systems.” (Michael Hiltzik, 9/11)

n health care circles, 21 words have rarely caused as much speculation as “Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection,” the title of proposed regulations currently under review at the Office of Management and Budget. Much of the buzz about the document’s content has centered on Department of Health and Human Services Secretary Alex Azar’s oft-mentioned complaint that rebates for prescription drugs contribute to high drug prices. Health plans, and their intermediaries known as pharmaceutical benefit managers (PBMs), negotiate with drug companies for rebate payments in return for covering their drugs. (Ian D. Spatz, 9/7)

Recently, The Centers for Medicare & Medicaid Services (CMS) issued a guidance allowing step therapy under Part B in Medicare Advantage Plans. Step therapy, appropriately labeled “Fail First,” is an approach that too many health-care providers and companies impose on patients in an attempt to save money on costs. However, it can also be harmful to patients, potentially leading to extended periods of illness, significant unnecessary follow-up visits and time waiting for this and all too often more complicated downstream medical issues. (Salvatore Giorgianni, 9/11)

Over the next several weeks, it is anticipated that the White House will roll out its recommendations for reducing drug prices. For the millions of Americans struggling with medical costs, this proposal could determine whether or not they will be able to afford life saving drugs. The Department of Health and Human Services (HHS) is responsible for developing the administration’s drug price policy. (Daniel Stevens, 9/5)

After the undignified theatrics at Brett Kavanaugh’s confirmation hearings last week, it was hard to imagine that the opposition to this competent Supreme Court nominee could get any more embarrassing. Well, how about a campaign to trade a Senator’s vote for political donations? A crowdfunding website is trying to strong-arm Senator Susan Collins, the Republican from Maine, by giving more than $1 million to her 2020 opponent—unless she opposes Judge Kavanaugh. Donors are asked to make a financial pledge and then enter their credit-card information. As of Tuesday afternoon, 37,425 people had put down $1,041,878. (9/11)

This month, Minority Leader Nancy Pelosi (R-Calif.) released a letter to the Democratic Caucus preparing them to become the Majority. A shift in party control would not only reinstate the pro-abortion Californian as Speaker of the House of Representatives. It means Pelosi’s liberal colleagues would gain control of the various committees. While pro-lifers should worry about a potential Speaker Pelosi, the Democrats most likely to chair committees have built their careers on being hostile to protections for women and the unborn. (Tom McClusky, 9/11)

The greatest fear of many opposing Brett Kavanaugh’s appointment to the U.S. Supreme Court is that he would help overturn Roe v. Wade, the landmark case that legalized abortion. But this assumes that Republican strategists actually want to overturn Roe. Why would the far-right really want to toss out a ruling that’s been so fruitful to the GOP? If abortion foes really wanted to reduce abortion rates even further past the all-time lows we’re seeing today, there are sure ways to do it. Start by providing low-income women access to birth control that can help them prevent unwanted pregnancies and, thus, the need for abortion. (9/10)

Those who fear that Brett Kavanaugh’s ascension to the Supreme Court would start the erosion of abortion rights across America are mistaken: Kavanaugh hasn’t even been confirmed yet, and the erosion has already begun, right here in Missouri. In a Monday ruling based on linguistic smoke and mirrors, a three-judge panel of the 8th U.S. Court of Appeals in St. Louis upheld a Missouri law that restricts access to abortion by imposing gratuitous physical standards on abortion clinics. The U.S. Supreme Court struck down a nearly identical Texas law just two years ago. (9/11)

The real potential for change this year comes instead from the Affordable Care Act’s quieter half, its expansion of Medicaid to cover a larger subset of low-income Americans. If things go well for Democrats in November as many expect — with congressional wins providing momentum down ticket and on statewide ballots — that will set the stage for Medicaid expansion to, well, expand. The chance that more states will embrace the program offers a much more concrete and likely way toward greater health coverage than a near-term exchange resurgence, let alone Medicare For All, which won’t be a serious policy possibility until at least 2020. (Max Nisen, 9/11)

Under a government-controlled health care system the government is the only payer. As a result the political party in power would be able to set the prices they are willing to pay and limit the services they are willing to reimburse and dictate the bureaucratic rules for payment. Most importantly what is missing is choice. Health care is not one size fits all and the insurance options that work for a family of four will not be the same as for a young entrepreneur or a couple nearing retirement. The role of the health insurance agent is to help individuals, families, and businesses chose the insurance that is the best for them. However, in order to do this there needs to be a robust and competitive health insurance market that allows for innovation and customization. (Keith Wright, 9/11)

Have we forgotten that pollution kills? Apparently the Trump administration has or never actually believed that pollution is a serious threat to our health and well-being. Let’s be reminded that pollution through toxic chemicals, fine particulate matter, and indirectly through greenhouse gasses contributes to cancers, respiratory conditions including asthma and COPD exacerbations, heart disease, birth defects, developmental problems in children, brain and nervous system damage, and ultimately premature death. The Trump administration has rolled back or proposed reversal of more than 60 Environmental Protection Agency regulations benefiting industry at the expense of human health. What is good for business sometimes is really bad for health. We might as well rename the EPA as the Industrial Protection Agency. (Richard Feldman, 9/11)

The concept of free innovation has entered the technology lexicon, particularly when it comes to health care. The term refers to innovations developed in creators’ personal time and unprotected by patent or copyright. Hundreds of examples are visible on platforms like Arduino and Hackaday.Free innovation is a variation on the decentralized supply and demand found in traditional markets. As in some other unconventional markets, it’s driven by motives besides the immediate monetary rewards directly attributable to product distribution. (Some indirect monetary rewards, like advertisements on a development site, sale of user data, or payoffs from resume-building, might be part of the equation.) Why is free innovation gaining traction now in the health space? At least five features of the contemporary economy contribute to the trend. (Robert Graboyes and Sara Rogers, 9/11)

Less than 5 percent of OB-GYNs practicing in Sacramento, Calif., are under age 40. West Texas can’t recruit enough psychiatrists to meet the region’s needs. All but two of Alabama’s rural counties need more primary care physicians.For most Americans, the physician shortage feels familiar: months to get an appointment, hours in the waiting room, and a visit so quick you barely scratch the surface. But it’s only going to get worse. (Elsa Pearson and Austin Frakt, 9/11)

The U.S. government’s nutrition advice since 1980 has mainly been to increase consumption of carbohydrates and avoid fats. Despite following this advice for nearly four decades, Americans are sicker and fatter than ever. Such a record of failure should have discredited the nutrition establishment. Yet defenders of the nutrition status quo continue to mislead the public and put Americans’ health at risk. A widely reported study last month purported to show that carbohydrates are essential to longevity and that low-carb diets are “linked to early death,” as a USA Today headline put it. The study, published in the Lancet Public Health journal, is the nutrition elite’s response to the challenge coming from a fast-growing body of evidence demonstrating the health benefits of low-carb eating. (Nina Teicholz, 9/11)

The CRISPR patent dispute between the University of California, Berkeley, and the Broad Institute is finally over. As almost everyone following the case predicted, the U.S. Court of Appeals for the Federal Circuit affirmed Monday the U.S. patent office’s decision that there was “no interference-in-fact” between UC Berkeley’s patent application and more than a dozen Broad patents. In plain English: Broad researcher Feng Zhang’s CRISPR patents were sufficiently inventive over the UC Berkeley’s patent applications with Jennifer Doudna and Emmanuelle Charpentier. Many scientists disagree with the decision, believing that it fails to comport with how molecular biology is actually practiced. I agree with them. But that doesn’t make the Federal Circuit’s decision wrong. In fact, I think its decision is absolutely correct. (Jacob S. Sherkow, 9/11)

Sept. 12 marks two years since the funeral of my 15-month-old son, Liam. He had been in a stroller, being pushed through a pedestrian crosswalk in suburban Los Angeles by my sister-in-law, who was 15 years old at the time. She had done everything right: pressed the button, waited for the lights to change and then started walking. Other cars stopped, but one didn’t. Police later estimated that the car was going 35 to 40 mph as it smashed into Liam and my sister-in-law. The car was driven by a 72-year-old woman. She was drunk and behind the wheel at 3:30 in the afternoon. (Marcus Kowal, 9/11)

With the White House declaring the opioid epidemic a national public health emergency earlier this year, the discussion rages on across the country about how exactly to solve this growing problem. Much of that discussion is now shifting to the specialized drug treatment facilities that help those battling this deadly disease. (Salvatore G. Rotella, 9/11)

About 72,000 Americans died from drug overdoses in 2017. That’s nearly 200 people per day — more than the number of people killed in car accidents. Fatal overdoses have been on the rise in recent years, due in large part to the proliferation of tremendously dangerous synthetic opioids such as fentanyl, and it’s a safe bet that the daily death rate will be higher again by the end of this year. ...Last month, the Legislature gave its blessing to a proposal under which San Francisco would be allowed to open one safe injection facility on a three-year trial basis. It was a scaled-back version of a controversial bill that gave the same permission to seven other counties, including Los Angeles. That bill stalled a year earlier after a contentious legislative battle. The narrower bill is now on the desk of Gov. Jerry Brown. He should sign it, despite the threat leveled by Deputy U.S. Atty. Gen. Rod Rosenstein in an op-ed in the New York Times in August, the day after the Legislature approved the bill. (9/12)

Kentucky is on an avoidable pathway to bankruptcy. There are at least two reasons for conservatives to support eliminating Medicaid expansion to help fix this problem. The first is simple arithmetic. Since just after the implementation of the Great Society, government entities have explored incalculable theories on how to restrain growing health care costs. They have all failed. In the last 50 years, health care spending has outpaced GDP growth by nearly 2.5 percent annually, making a massive difference over time. In 1960, health spending as a share of GDP was approximately 5 percent. By 2013, the year before Kentucky adopted Medicaid expansion, health care spending had grown to 17.4 percent of GDP. By 2025, health care spending will rise to nearly 20 percent of GDP. (Jordan Harris, 9/11)