First Edition: Oct. 31, 2023

KFF Health News: Start Shopping: Enrollment Begins Nov. 1 For Most Obamacare Insurance Plans 
For millions of Americans who buy their own health insurance through the Affordable Care Act marketplace, the end of the year brings a day of reckoning: It’s time to compare benefits and prices and change to a new plan or enroll for the first time. Open enrollment starts Nov. 1 for the ACA’s federal and state exchanges. Consumers can go online, call, or seek help from a broker or other assister to learn their 2024 coverage options, calculate their potential subsidies, or change plans. (Appleby, 10/31)

KFF Health News: Medical Debt And Nurse Shortages Haunt Winning Halloween Haikus 
Readers, beware! There’s a bitter chill in the air and bloodcurdling screams coming from our newsroom. We received more than five dozen spooky submissions to KFF Health News’ fifth annual Halloween haiku contest. Here’s the winner and the top runners-up, illustrated by Oona Tempest. The judges’ favorites were inspired by school nurse shortages and the nation’s gut-wrenching medical debt crisis. Keep an eye on KFF Health News’ social media accounts (X, formerly known as Twitter; Instagram; and Facebook) for more of our favorites. Enjoy! (10/31)

KFF Health News: An Arm And A Leg: John Green Vs. Johnson & Johnson (Part 2)
The final episode of this two-part series about YouTube star John Green and his fight to make tuberculosis drugs more affordable takes listeners halfway around the world to India. For nearly two decades, activists there have been organizing for patent reform. Host Dan Weissmann and producer Emily Pisacreta speak with one of them, drug patent expert Tahir Amin, about how legal victories in India (and some extra pressure from John Green’s online community of fans) have set the stage for generic manufacturing and lower-priced TB drugs.   (10/31)

USA Today: Pharmageddon Walkout Hits As Workers Protest At Some Chain Pharmacies
Pharmacists protesting deteriorating working conditions inside the nation’s largest retail chains launched their third and largest walkout of the season on Monday with a three-day movement they've dubbed "Pharmageddon." Organizers estimated the effort has drawn as many as 4,500 pharmacists and pharmacy technicians from multiple chains, including CVS, Rite Aid and Walgreens. It also drew support from the American Pharmacists Association, the industry’s largest professional organization, which said in a statement it stands with every participant of the movement. (Le Coz, 10/30)

The Boston Globe: Pharmacy Workers Stage 3-Day Walkout, Pressuring Companies To Recruit
Amy Thibault, a spokeswoman for Woonsocket-based CVS Health, told the Globe the pharmacy chain was “not seeing any unusual activity” regarding unplanned pharmacy closures or pharmacist walkouts. “We’re making targeted investments to address their key concerns, including enabling teams to schedule additional support as needed, enhancing pharmacist and technician recruitment and hiring, and strengthening pharmacy technician training,” said Thibault. (Gagosz, 10/30)

The Wall Street Journal: Army Reserve Commander, Family Warned Police About Maine Gunman 
Deputies were unable to locate Card and issued a missing persons report, the sheriff said, adding that deputies made contact with Card’s brother, who told him he would work to secure Robert Card’s firearms. (Vielkind and Palazzolo, 10/30)

The Trace: Will Maine’s Permissive Gun Laws Change After Lewiston Shooting?
In Maine, which suffered the deadliest mass shooting in its history on October 25, guns are a fact of life. Nearly half of all households own one, mostly for hunting and recreation, sometimes for self-defense. The state’s gun access laws are permissive — there are no background checks on private sales, and residents don’t need a permit or training to carry a concealed gun in public. Its gun homicide rate is so low that it’s been hard to justify the need for tighter regulation. And with no history of public mass shootings to point to, this arrangement seemed to be working. (Mascia and Brownlee, 10/30)

The Washington Post: The Loophole In Efforts To Block Gun Sales To The Mentally Ill 
In early August, Robert Card went to a gun store in Auburn, Maine, to finalize a purchase he had made online. According to reporting from ABC News, Card was hoping to take possession of a firearm suppressor — known more commonly as a silencer — he had bought, a purchase that necessitated completing the paperwork mandated for such a purchase by federal law. One of the forms Card filled out included yes/no questions he had to complete. One asked if he was an unlawful drug user. The next asked if he had ever been “adjudicated as a mental defective OR … ever been committed to a mental institution?” Card indicated that he had; over the summer he had spent two weeks in a facility after claiming to hear voices. (Bump, 10/30)

The Wall Street Journal: Fingers Crossed: Flu Season Might Not Be So Bad This Year
There’s some good news about flu season this year. Doctors and scientists don’t expect the worst. The flu season in the Southern Hemisphere, where the cold-weather illness period wraps up as we head into ours, often serves as a harbinger of what’s to come for us. There, cases picked up a little earlier than usual in some countries but didn’t result in an especially large number of hospitalizations and deaths, say public health experts and doctors. Also encouraging: The components in this year’s flu vaccine are a good match to the predominant strain so far. (Reddy, 10/30)

The Hill: Biden Administration Looks To Avoid Vaccine Hiccups As COVID-19 Treatment Coverage Goes Commercial 
Administration officials have acknowledged the problems when the vaccines moved to commercial payers but said ample supply plus a relatively long transition period for antivirals should make it so those same issues — delayed insurance coverage and lack of supply — don’t happen again. “The federal product will continue to be available for days to weeks. And that gives a chance for the insurers, the [pharmacy benefit managers], the pharmacies, providers, all to work through the system changes needed to distribute the product commercially and effectively,” a senior Health and Human Services (HHS) official told reporters during a recent briefing. (Weixel, 10/30)

CIDRAP: Study: Regardless Of Variant, Half Of Long-COVID Patients Fail To Improve After 18 Months
More than 50% of long-COVID patients failed to improve 1.5 years after their initial diagnosis, according to a new study based on cases seen at a Danish post-COVID clinic, both before and after the Omicron variant period. The study was published yesterday in the International Journal of Infectious Diseases. The analysis included 806 patients who were infected with the wild-type strain, Alpha, Delta, or Omicron strain. All case-patients had been referred to a long COVID clinic with symptoms persisting at least 12 weeks from onset of COVID-19. Seventy percent of participants were female, with a median age of 48. (Soucheray, 10/30)

Reuters: Providers Can Sue Over Arizona Ban On Abortion For Genetic Anomalies -Court 
A U.S. appeals court on Monday revived a challenge to an Arizona law banning abortions from being performed solely because the fetus has a genetic abnormality. A three-judge panel of the 9th U.S. Circuit Court of Appeals unanimously ruled that a group of healthcare providers can sue the state over the law because they are harmed by it, reversing a lower court ruling. (Pierson, 10/30)

Modern Healthcare: Opill Should Be Fully Covered By Insurance, Democratic Senators Say 
Senate Democrats are urging federal regulators to require health insurance companies and government health programs to cover over-the-counter birth control pills at no cost as the first nonprescription contraceptive medication is poised to hit the market next year. Under the Affordable Care Act, insurers must cover all Food and Drug Administration-approved contraceptives without cost-sharing. But the Health and Human Services, Labor, and Treasury departments' standing guidance refers only to prescription products. (McAuliff, 10/30)

Axios: Trump Calls For The Return Of Mental Institutions
Former President Trump has called for the return of "mental institutions" as part of his plan "to get the homeless off our streets" should he be elected to a second term in office. The state-run psychiatric hospitals that largely disappeared in the mid-1900s are often associated with inhumane mistreatment. (Owens, 10/31)

PolitiFact: Fact Check: Do 95% Of U.S. Over-The-Counter Drugs Come From China?
The claim: Republican presidential candidate Vivek Ramaswamy ... urged the U.S. to declare “pharmaceutical independence,” saying that “95% of over-the-counter pharmaceuticals are coming from our enemy in China.” PolitiFact ruling: False. The 95% figure is greatly exaggerated. Available data puts the share at no bigger than 20%, and possibly even lower. (Jacobson and Putterman, 10/30)

USA Today: Gene Therapy Might Cure Sickle Cell, But At A Steep Cost For Patients, Society
Several companies are pursuing gene therapies to treat sickle cell. A federal advisory panel will review the first of those proposals in an all-day meeting on Tuesday. Dr. Jeffrey Glassberg, who has had several patients go through gene therapy trials, said the results were impressive. "These people simply don't have sickle cell anymore," said Glassberg, a hematologist at the Icahn Sinai School of Medicine at Mount Sinai in New York. (Weintraub, 10/31)

Stat: The FDA Weighs The Risks Of Candy-Like Nonprescription Drugs
M&Ms, Reese’s, gummy bears, and even cotton candy made an appearance at the Food and Drug Administration on the day before Halloween. Commissioner Robert Califf was not throwing a costume party. Regulators were debating the potential benefits and pitfalls of “candy-like” nonprescription drug products such as gummies, particularly for children who often cannot, or do not want to, swallow actual pills. (Florko, 10/30)

Stat: Biden's Order Seeks To Regulate AI Risk Without Stifling Innovation
President Biden ordered the nation’s leading health agencies on Monday to develop a plan for regulating artificial intelligence tools already widely in use within hospitals, insurance companies, and other health-related businesses. (Ross, 10/30)

Modern Healthcare: How Biden's AI Executive Order Applies To Healthcare
President Joe Biden signed a sweeping executive order and invoked the Defense Production Act on Monday to establish the first set of standards on the use of artificial intelligence in healthcare and other industries. As the hype, promise and usage of AI has grown in healthcare, health system leaders and developers have sought more concrete guardrails on its usage, particularly for clinical purposes. Biden signed the order at an afternoon AI-focused event at the White House. (Perna and Turner, 10/30)

The New York Times: Doctors Wrestle With A.I. in Patient Care, Citing Lax Oversight
In medicine, the cautionary tales about the unintended effects of artificial intelligence are already legendary. There was the program meant to predict when patients would develop sepsis, a deadly bloodstream infection, that triggered a litany of false alarms. Another, intended to improve follow-up care for the sickest patients, appeared to deepen troubling health disparities. (Jewett, 10/30)

Bloomberg: 23andMe Will Give GSK Access To Consumer DNA Data
GSK Plc will pay 23andMe Holding Co. $20 million for access to the genetic-testing company’s vast trove of consumer DNA data, extending a five-year collaboration that’s allowed the drugmaker to mine genetic data as it researches new medications. Under the new agreement, 23andMe will provide GSK with one year of access to anonymized DNA data from the approximately 80% of gene-testing customers who have agreed to share their information for research, 23andMe said in a statement Monday. The genetic-testing company will also provide data-analysis services to GSK. (Brown, 10/30)

Modern Healthcare: Information Blocking Rule From HHS Would Penalize Providers
Healthcare providers that engage in so-called information blocking to impede appropriate access to patient information in electronic health records would be subject to significant penalties under a proposed rule published Monday. ... “HHS is committed to developing and implementing policies that discourage information blocking to help people and the health providers they allow to have access to their electronic health information,” HHS Secretary Xavier Becerra said in a news release. (Bennett, 10/30)

Modern Healthcare: MIPS Penalties On The Horizon In 2024 As AMA, Others Lobby CMS
Physician groups are pressuring the Centers for Medicare and Medicaid Services to forestall looming penalties associated with the Merit-based Incentive Payment System, citing systemic challenges facing doctors and the ongoing effects of the COVID-19 pandemic. MIPS, as the Medicare reimbursement program for physician services is known, makes doctors eligible for bonus payments or penalties based on factors such as quality, cost and electronic health record use. (Bennett, 10/30)

Modern Healthcare: How 340B Drug Pricing Program Policy Reversal Will Affect Hospitals
Changes to registration requirements for the offsite clinics of 340B-eligible hospitals represent the latest clash between providers, regulators and drugmakers amid the program’s exponential growth. The federal government on Thursday reversed a policy that streamlined 340B certification during the COVID-19 pandemic. ... “The [policy] reversal is a gut punch to hospitals hoping for more permanent flexibility,” said Susan Banks, a healthcare attorney at the law firm Holland & Knight. (Kacik 10/30)

Reuters: Healthpeak To Merge With Physicians Realty To Create $21 Bln Firm 
Healthpeak Properties and Physicians Realty Trust DOC.N have agreed to combine in an all-stock deal to create a $21 billion healthcare properties operator that would manage clinics, hospitals and surgery centers. The deal values Physicians at about $2.64 billion, based on 238.45 million shares outstanding, according to Reuters calculations. (10/30)

Axios: U.S. Health Plan Rates Can Vary Sharply By County, Study Shows
One of the first studies of publicly available insurer price data found generally higher rates for office visits and medical procedures in the Upper Midwest and Southeast, and the lowest costs in the Central U.S. and Florida. The findings published in JAMA Health Forum could help shine a light on regional price variations and whether higher costs translate to more value in markets. (Goldman, 10/30)

Axios: The High Cost Of Unnecessary Stents
Hospitals place an unnecessary coronary stent in a Medicare beneficiary every seven minutes, costing taxpayers $800 million annually, according to a new analysis of claims data. Overuse of stents comes with hefty costs for patients and the federal government, and it can sometimes pose serious health risks. (Goldman, 10/31)

Politico: ‘People Just Can’t Pay Their Bills’: Oklahoma’s Wild Marijuana Market Is About To Shrivel
Tokelahoma’s days are numbered. The world’s wildest weed market — which at its peak had nearly 14,000 licensed medical marijuana businesses — has been steadily shrinking since Oklahoma voters overwhelmingly rejected a recreational legalization referendum in March. Heightened enforcement by state regulators and law enforcement is pushing some businesses to shut down. Others are simply realizing that Oklahoma is producing so much weed — a staggering 64 times the volume needed to serve the state’s medical patients, according to a recent study — that it’s impossible to make any money. (Demko, 10/30)

Bloomberg: Illegal Weed In NYC Is Dangerous, Says State Senator
New York’s illicit marijuana market has become a public health threat, state Senator Brad Hoylman-Sigal said at a public hearing, citing sales to minors and shootings outside dispensaries. “This is a public health issue, particularly for young people. Does it not deserve a more expedited process for addressing the illegal shops?” Hoylman-Sigal said during a joint hearing of the New York State Senate. (Kary, 10/30)

CNN: Loss Of Slow-Wave Sleep Raises Dementia Risk, Study Finds
Loss of slow-wave sleep as you age may increase your risk of developing dementia, according to a new study. “We found that aging was associated with a decline in the amount of the deepest stages of sleep, known as slow wave sleep,” said Matthew P. Pase, senior author of the study published Monday in the journal JAMA Neurology, via email. (Rogers, 10/30)

The Washington Post: How To Get In To See Primary Care Physicians And Specialists — Quickly
Need to see a doctor right away? Today, that can be challenging. The average wait for an appointment with a physician for new patients is 26 days, according to a 2022 survey of 15 metropolitan areas by the physician recruiting firm Merritt Hawkins. That’s the longest it has been since the company began doing the survey in 2004. In addition, 22 percent of adults 65 or older waited six days or more for a doctor’s appointment when they were sick, according to a 2021 survey of 11 high-income countries by the Commonwealth Fund, a nonprofit group. Only Canada had a higher percentage of long waits. (Levine, 10/30)

The New York Times: Hearing Aids Are More Affordable, And Perhaps More Needed, Than Ever
A year ago, the Food and Drug Administration announced new regulations allowing the sale of over-the-counter hearing aids and setting standards for their safety and effectiveness. That step — which was supposed to take three years but required five — portended cheaper, high-quality hearing aids that people with mild to moderate hearing loss could buy online or at local pharmacies and big stores. So how’s it going? It’s a mixed picture. (Span, 10/30)

The Washington Post: Why Are People Afraid Of Clowns? A New Study Explains The Fear
Clowns can be unpredictable, inscrutable and a little weird. Those are just a few of the reasons why some people develop coulrophobia, or fear of clowns. (Amenabar, 10/30)