The Associated Press: Study Finds 20M Would Lose Health Coverage Under Trump Plan
A new study that examines some major health care proposals from the presidential candidates finds that Donald Trump would cause about 20 million to lose coverage while Hillary Clinton would provide coverage for an additional 9 million people. The 2016 presidential campaign has brought voters to a crossroads on health care yet again. The U.S. uninsured rate stands at a historically low 8.6 percent, mainly because of President Barack Obama's health care law, which expanded government and private coverage. Yet it's uncertain if the nation's newest social program will survive the election. (Alonso-Zaldivar, 9/23)

Bloomberg: The Numbers Behind Trump Versus Clinton Health-Reform Proposals 
If Democrats keep the White House come November, millions of Americans could gain health-care coverage. If Republicans take it back, millions could become uninsured. A new study ran the numbers under the proposals of both U.S. presidential candidates. Donald Trump’s pledge to repeal the Affordable Care Act, President Barack Obama’s signature health-care law, would result in 19.7 million more people without insurance and widen the federal deficit by $33.1 billion in 2018, according to an analysis conducted by research group Rand Corp. and funded by the Commonwealth Fund, a nonprofit foundation. The Republican nominee’s proposed tax credits would largely benefit higher-income people, the study also found. (Tracer and Kapur, 9/23)

Dallas Morning News: Clinton Vs. Trump: Health Care Policy Could Radically Change With Election
In terms of health care, Hillary Clinton and Donald Trump have their eyes set on the high cost of prescription drugs, the Affordable Care Act and the health of U.S. veterans. The soaring cost of pharmaceuticals has drawn national attention as a major threat to the nation’s economy. The latter two issues are also of particular interest to Texas, a state that has not expanded Medicaid and is home to the second-highest population of the nation’s veterans. (Rice, 9/22)

Meanwhile, in Arizona the health law's reverberations are felt on the campaign trail —

Kaiser Health News: In Arizona, Health Law’s Gains And Losses Play In Presidential Race
Just weeks before the presidential election, Josephine has spent nearly every morning worrying as she drives to her breast cancer treatments, waits for her doctor and comes back home. At 61, Josephine, who asked that her last name not be used because she has been under the protection of a restraining order, has much riding on this election. Once uninsured after being laid off from her job, she was recently diagnosed with breast cancer and has been able to get subsidized health coverage through the Affordable Care Act. The pro-Hillary Clinton signs on her parched lawn show which candidate she trusts to keep her covered. (Varney, 9/23)

The Wall Street Journal: House Republicans Warn Against Settling Suits With Insurers Over Health-Care Payments
Congressional Republicans are warning the Obama administration not to settle with insurers that have sued the government over an Affordable Care Act program to compensate them for losses under the law, saying such a move would bypass spending limits set by Congress. Forty-six House Republicans signed a letter sent Thursday to Health and Human Services Secretary Sylvia Mathews Burwell saying they oppose any settlements and could sue the administration to block them. (Armour, 9/22)

In other news, Democrats are trying to get Republicans to work with them to fix the health law, fears of a death spiral are flamed by the failure of co-ops, and more out of the states —

The Hill: Dems To GOP: Help Us Fix ObamaCare 
Democrats are beginning to talk about changing ObamaCare to fix what they acknowledge are growing problems in the law’s insurance marketplaces. Insurers have been dropping out of ObamaCare or hiking their premiums this year due to financial losses, fueling Republican criticism of the law ahead of the November elections. (Sullivan, 9/22)

Bloomberg: Failing Obamacare Nonprofit Co-Ops Add To ‘Death Spiral’ Fears
As concerns about the survival of the Affordable Care Act’s markets intensify, the role of nonprofit “co-op” health insurers -- meant to broaden choices under the law -- has gained prominence. Most of the original 23 co-ops have failed, dumping more than 800,000 members back onto the ACA markets over the last two years. Many of those thousands of people were sicker and more expensive than the remaining insurers expected -- and they’re hurting results.  ... “These co-ops have attracted, we think, disproportionately high health-care utilizers,” Gary Taylor, an analyst with JPMorgan who follows the industry, said in a telephone interview. Their former members “are now enrolled in these for-profit health plans. That’s been a factor driving the deterioration in their profitability.” (Darie, 9/23)

Morning Consult: Blue Cross Blue Shield Of North Carolina To Offer Marketplace Plans Across State
Blue Cross Blue Shield of North Carolina will marketplace plans in every county in the state next year, the insurer said Thursday. The insurer will be the only one to offer plans in every county next year. BCBSNC had previously suggested it could withdraw from the marketplace before 2017, citing financial losses, which would have left most counties in the state without an insurer offering exchange plans. (McIntire, 9/22)

California Healthline: Remember The ‘Public Option’? Insurance Commissioner Wants To Try It In California
With major insurers retreating from the federal health law’s marketplaces, California’s insurance commissioner said he supports a public option at the state level that could bolster competition and potentially serve as a test for the controversial idea nationwide. “I think we should strongly consider a public option in California,” Insurance Commissioner Dave Jones said in a recent interview with California Healthline. “It will require a lot of careful thought and work, but I think it’s something that ought to be on the table because we continue to see this consolidation in an already consolidated health insurance market.” (Terhune, 9/22)

The Wall Street Journal: Senate Moves Closer On Budget Bill Despite Divisions
Republicans and Democrats in the Senate have agreed on $1.1 billion in funding to combat the Zika virus as part of a stopgap spending bill needed to keep the government running beyond next Friday, but they remain divided over whether to include assistance for Flint, Mich., as part of that deal. Senate Majority Leader Mitch McConnell (R., Ky.) introduced legislation Thursday that would keep the government funded through Dec. 9, but Democrats said they weren’t ready to sign on to a bill that included flood relief for certain states but doesn’t address the drinking water crisis in Flint. (Peterson, 9/22)

The Associated Press: McConnell Unveils Stopgap Spending Bill, Anti-Zika Funds
Majority Leader Mitch McConnell said the stopgap measure was "clean" of controversies and he left out internet-related language demanded by Texas GOP Sen. Ted Cruz and Republican presidential nominee Donald Trump. But Democrats immediately blasted the proposal for failing to fund one of their top priorities: money to help Flint, Michigan, repair its lead-tainted water system. (9/22)

Reuters: Senate Splits Over Bill To Avoid Government Shutdown
"We Democrats cannot vote for that," said Senator Barbara Mikulski, top Democrat on the Senate Appropriations Committee. (9/22)

Morning Consult: Senate GOP CR Includes $1.1B For Zika, $37M For Opioids
The spending stopgap measure Senate Majority Leader Mitch McConnell filed Thursday includes $1.1 billion in emergency funding for the government’s response to the Zika virus, as well as new funding through Dec. 9 to begin implementation of a law meant to curb the nation’s opioid crisis. ... The $1.1 billion for the Zika virus would provide $933 million to the Department of Health and Human Services, including $394 million to the Centers for Disease Control and Prevention for mosquito control and surveillance and $397 million to the National Institutes of Health for vaccine and diagnostic development. The measure would also provide $175.1 million for state and foreign operations and related programs. (McIntire, 9/22)

The Hill: Funding Bill Includes $37 Million For Opioid Crisis
The short-term funding bill that Senate Republicans released Thursday includes $37 million in new funding to fight the crisis of opioid addiction. Republicans said that the new money would give a head start to setting up programs in the recently passed Comprehensive Addiction and Recovery Act (CARA), preventing the need to wait until the longer-term spending bill is considered in December. (Sullivan, 9/22)

Meanwhile, in Florida —

Orlando Sentinel: Gov. Scott Pledges $25 Million For Zika Research 
Still steaming over the lack of action by the federal government to combat the Zika virus, Gov. Rick Scott announced Thursday he’ll authorize $25 million in state funds to be spent on research for a vaccine... Scott traveled to Washington D.C. last week to press Congressional leaders to pass a Zika funding measure. (Rohrer, 9/22)

Tampa Bay Times: Rick Scott Directs $25M Toward Zika Vaccine Research 
In an unusual move, Gov. Rick Scott announced Thursday he'll use his emergency powers to direct $25 million from the state for Zika research. The Florida Department of Health will dole out the money through a competitive grant for speeding up the development of a Zika vaccine and "innovative, cost-effective" methods to test for the virus. (Auslen, 9/22)

ProPublica: Doctor Confesses: I Lied To Protect Colleague In Malpractice Suit
Almost two decades ago Dr. Lars Aanning sat on the witness stand in a medical malpractice trial and faced a dilemma. The South Dakota surgeon had been called to vouch for the expertise of one of his partners whose patient had suffered a stroke and permanent disability after an operation. The problem was that Aanning had, in his own mind, questioned his colleague's skill. His partner's patients had suffered injuries related to his procedures. But Aanning understood why his partner's attorney had called him as a witness: Doctors don't squeal on doctors. (Allen, 9/23)

Columbus Dispatch: Addicted Moms Often Torn Between Treatment, Kids 
Fighting heroin is daunting for the hundreds of thousands of Americans hooked by this opiate addiction, but for women with children, seeking help can force nearly impossible choices. Like many who find that it takes multiple trips to rehab centers to beat their addictions, Duggan, 26, relapsed in her recovery program, and the state took her son into foster care. Child-welfare agents are considering putting Giovanni up for adoption if Duggan doesn’t agree to enter a residential treatment facility. But that would mean being away from her son for at least seven months, and probably longer. (McNamara, 9/23)

Boston Globe: These Grim Maps Show How Discarded Needles Litter ‘Methadone Mile’
No area of Boston is plagued by discarded drug needles like the so-called “Methadone Mile,” a stretch of blighted blocks along Massachusetts Avenue in the South End, Roxbury, and Dorchester where the use of heroin and other opioids is rampant. City data on recent constituent reports of discarded needles spotted in public places — on streets, sidewalks, alleys, and parks — demonstrates how the toll of drug use and the opioid epidemic has been widespread, leaving virtually no sections of the city unscathed. But records also show Methadone Mile, an area recently chronicled by the Globe, has been particularly troublesome. (Rocheleau, 9/22)

The Washington Post: As Overdoses Surge, Two Accused Of Selling Deadly Heroin Laced With Elephant Tranquilizer
A man and a woman from Cincinnati, were indicted Wednesday on charges of dealing heroin laced with carfentinal — the deadly animal tranquilizer officials blame for an unprecedented surge in overdoses in the U.S. — marking what may be the first carfentanil-related criminal case brought in the federal court. A grand jury charged Phillip Watkins, 31, and Jeannetta Crawford, 26, with distributing heroin cut with fentanyl and carfentanil, a heroin analogue that is 10,000 times stronger than the drug itself. (Hawkins, 9/23)

The Washington Post: The Pill Mill Doctor Who Prescribed Thousands Of Opioids And Billed Dead Patients
A former Michigan doctor who ran a pill mill for 16 months, distributing tens of thousands of narcotics and controlled substances to people who didn't need them for medical purposes, has agreed to pay $200,000 to settle a federal lawsuit that accused him of, among other things, falsifying records to charge dead patients, subjecting patients to unnecessary tests and billing for office visits that never happened. The settlement was announced Wednesday, amid National Heroin and Opioid Awareness Week, and came nearly four years after Hussein Awada, 46, was accused of defrauding Medicare, Medicaid and Blue Cross Blue Shield of about $2.3 million. (Guerra, 9/22)

The Baltimore Sun: Users Of Kratom Defend Herbal Supplement Ahead Of Federal Ban 
The Southeast Asian plant derivative, which has been used for generations by people overseas for pain, and mood disorders, and to boost energy, is gaining a following in the United States. It can also help wean someone off addictive opioids, some say. But imports of capsules, teas and other kratom products will be cut off at the end of September, when a U.S. Drug Enforcement Administration ban of the plant's active compounds goes into effect. The DEA says the goal of the ban is avoiding "an imminent hazard to public safety," as agency officials figure out how to regulate what they consider an increasingly popular recreational drug. (Cohn, 9/22)

NPR: Are We Reaching The End Of The Trend For Longer, Healthier Lives?
American lives have been getting steadily longer, and since the 1960s that trend has been driven mostly by a remarkable reduction in heart disease. But those improvements have slowed dramatically. Scientists are now wondering whether we're approaching the end of the trend of longer, healthier lives. That's because the steady decline in heart disease is fading. Most people alive today don't remember the days when many people in their 40s and 50s would simply drop dead of a heart attack. (Harris, 9/23)

Stat: Food That Is 'Generally Recognized As Safe' Is Not Good Enough
Most of the chemicals added to food and beverages — from cheese to chips to chicken soup — are never reviewed by the Food and Drug Administration (FDA) before those products are sold in grocery stores. Sometimes the FDA may not know such chemical ingredients exist unless a company chooses to voluntarily disclose that information. In fact, the FDA may never have even heard of an estimated 1,000 or more chemicals that have been added to foods and beverages, let alone reviewed them for safety. (Markey, 9/23)

WBUR: Good Gut Microbes: Studies Explore How 'E. Faecium' Fights Off Infection
Two papers just out in Science journals dig in to the virtues of what sounds like a helpful microbe: E. faecium, a bacterium that can actively protect our guts from infection. The research pinpointed a key enzyme in cultures of the microbe, called SagA, and found it boosted resistance to a nasty Typhoid-like pathogen in mice and worms. (Goldberg, 9/22)

Miami Herald: Breast Cancer And Pregnancy: How To Treat Mom Without Harming Baby
Little is known about breast cancer in pregnant women. One out of every 3,000 pregnant women is diagnosed with breast cancer either during pregnancy or within the first year of delivery, according to the American Cancer Society. It’s a diagnosis that’s often delayed because the symptoms of pregnancy can mask the symptoms of breast cancer. (Cochrane, 9/22)

The Star Tribune: Hopkins Outbreak Is Part Of A Rising Tide Of Legionnaires' Cases In U.S.
The ongoing outbreak of Legionnaires’ disease in Hopkins, which rose to 17 cases Thursday, is part of a dramatic national increase that so far has baffled doctors and epidemiologists. The three new cases reported Thursday involved patients over 50 — an age group most likely to be susceptible to the pneumonia-like infection, the Minnesota Department of Health said... Health officials said more cases could emerge in the coming week because the infection has an incubation period of 10 days, and it could take a few more days for patients to see a doctor and have their cases reported. (Marcotty, 9/22)

Stat: Taking The Long View With Facebook Founder's $3 Billion
The Facebook founder and his physician-wife’s $3 billion commitment for research to cure and prevent disease, announced Wednesday by the Chan Zuckerberg Initiative, will stand out from other medical philanthropies by cross-pollinating diverse fields and taking a long view — aiming to solve tough medical problems over generations — the project’s scientific leader said in an interview. “What’s unique here is the combination of engineering and biology” to solve long-range problems, said Cori Bargmann, the Rockefeller University neuroscientist who heads the scientific projects underwritten by Facebook CEO Mark Zuckerberg and his wife, Dr. Priscilla Chan. (Piller, 9/22)

Modern Healthcare: Supreme Court Pauses Dignity Health Pension Decision 
The U.S. Supreme Court made its first move toward weighing in on whether Dignity Health and faith-based companies have to comply with federal regulations for costly worker pension plans. Associate Justice Anthony Kennedy granted Dignity Health a temporary reprieve from complying with the federal Employee Retirement Income Security Act until the eight justices decide whether or not to take up their appeal. In July, the Ninth Circuit determined that Dignity Health didn't qualify for a religious exemption from ERISA and its employee pension system couldn't be considered a church plan. (Teichert, 9/22)

Boston Globe: Tufts-Hallmark Deal OK’d By State Watchdog Agency 
The proposed merger of Medford’s Hallmark Health System and the parent company of Tufts Medical Center took a step closer to completion on Thursday after a state watchdog blessed the deal, saying it would not put upward pressure on health care costs. In fact, the state Health Policy Commission said the merger is likely to decrease hospital market concentration and may reduce costs by directing more patients away from higher-priced Boston hospitals. (Dayal McCluskey, 9/22)

Modern Healthcare: Quality Of Care Doesn't Improve At Hospitals That Employ Physicians
The trend of hospitals nationwide employing physicians and buying medical practices does not benefit patients any more than other employment models, according to a recent study. About 42% of hospitals in 2012 directly employed clinicians, up from 29% in 2003. The moves are primarily aimed at increasing productivity and leveraging the local market, but it's often touted as a way to coordinate care and improve quality. (Castellucci, 9/21)

The Philadelphia Inquirer: CHOP, Comcast Founders Announce $50 Million Genetics Initiative
Children’s Hospital of Philadelphia on Friday announced that the founding family of Comcast Corp. has given $25 million toward a new $50 million initiative designed to put CHOP at the forefront of pediatric genetics research and development. The Roberts Collaborative for Genetics and Individualized Medicine will unite and accelerate the cutting-edge research already going on at CHOP in fields including inherited disorders, mitochondrial disease, cancer, and autism. (McCullough, 9/22)

Texas Tribune: Lawmaker Unveils Vision For Austin State Hospital 
State Sen. Kirk Watson, D-Austin, on Thursday proposed creating an "MD Anderson of the brain" on the site of the troubled Austin State Hospital, a psychiatric facility that has been plagued with staff shortages, crumbling facilities and a failure to meet federal health standards. ... A 2015 study from the Texas Department of State Health Services, which oversees state hospitals, identified the Austin campus as one of five facilities that were beyond repair and should be replaced. Last year, Medicare and Medicaid inspectors cited the Austin State Hospital twice in one month for nursing shortages and restraint violations, according to the Austin American-Stateman. (Cobler, 9/22)

Stat: Colorado Is Latest State To Be Sued For Restricting Access To Hepatitis C Drugs
You can add Colorado to the list of states being sued for refusing to widen access to the hepatitis C medications in its state Medicaid program. The lawsuit, which is seeking class action status, was filed on behalf of two Colorado citizens on Monday in response to a longstanding policy by the state Medicaid program to restrict coverage only to people with the most advanced stages of liver disease, such as cirrhosis. The state “illegally restricts” access to medically necessary treatment “that can be provided only by” the available hepatitis C drugs, the lawsuit states. (Silverman, 9/22)

AL.com: Alabama Medicaid Agency Restores Payment Rates For Doctors
Gov. Robert Bentley announced today that the Alabama Medicaid Agency would restore payments to doctors to levels they were before cuts were made effective Aug. 1. The payments were reduced because of an $85 million shortfall in Medicaid's budget for the year that starts Oct. 1. The reduced payments to doctors were expected to save about $14.7 million .... But two weeks ago, the Legislature passed a bill to close the 2017 budget gap and provide additional funding for Medicaid in 2018. (Cason, 9/22)

Montgomery (Ala.) Advertiser: Alabama Medicaid Restores Physicians' Funding
Gov. Robert Bentley and Medicaid Commissioner Stephanie Azar Thursday announced that the agency would restore a primary care bump for doctors, cut in August amid a shortfall in state funding for the program. The restoration will begin Oct. 1. “Our primary care physicians are the ones most affected by Medicaid,” Bentley said at a press conference Thursday. “Almost all our primary care docs take Medicaid. A large percentage of people they see, especially children, a large percentage of those take Medicaid.” (Lyman, 9/22)

Arkansas Times Record: Official: More Than 317,000 Arkansans Eligible For Expanded Medicaid
The number of people who have been deemed eligible for Arkansas’ expanded Medicaid program has reached 317,289, state Department of Human Services Director Cindy Gillespie said Thursday. In a letter to Gov. Asa Hutchinson, Gillespie said that at the end of August, 265,608 Arkansans were enrolled in private health insurance plans under the program known as the private option, 23,043 who applied for the program were enrolled in traditional Medicaid because they were deemed medically frail, and 28,638 people who had been deemed eligible for the program were in the process of enrolling. (Lyon, 9/23)

Texas Tribune: Texas Not Budging On Rule Requiring Burial Or Cremation Of Fetal Remains
Despite intense outcry from the medical community, reproductive rights advocates and funeral directors, Texas isn't budging on a proposed rule to require the cremation or burial of fetal remains. Following an initial public comment period that sparked medical concerns and a legal threat, Texas health officials have re-submitted for public consideration a proposed rule change that prohibits hospitals, abortion clinics and other health care facilities from disposing of fetal remains in sanitary landfills, instead allowing only cremation or interment of all remains regardless of the period of gestation — even in instances of miscarriages. (Ura, 9/22)

Modern Healthcare: SEIU Urges N.J. Attorney General To Force The Sale Of Five Prime Hospitals
The powerful Service Employees International Union is urging the attorney general of New Jersey to force the sale of five Prime Healthcare Services' hospitals in response to a federal lawsuit against the hospital chain alleging it fraudulently billed Medicare beneficiaries. SEIU-United Healthcare Workers West sent a letter Thursday to New Jersey Attorney General Christopher Porrino calling on him to use his authority to force the resale of Prime's five hospitals in the state in order to protect “their charitable assets and protect the quality and accessibility” of services as the system faces a lawsuit that could potentially affect its Medicare participation, according to a news release. (Castellucci, 9/22)

The Wall Street Journal: Health Diagnostic Laboratory Executives Accused Of Fraud
Executives who ran Health Diagnostic Laboratory Inc., a bankrupt Virginia blood-testing lab that health regulators accused of paying kickbacks to doctors, have been sued for allegedly carrying out illegal business practices that plaintiffs say caused the company more than $600 million in damages. Health Diagnostic Laboratory’s top leaders “continuously violated the law” and paid themselves millions through “self-dealing and improper transactions” that prompted the company to file for bankruptcy in June 2015, according to the lawsuit filed in U.S. Bankruptcy Court in Richmond, Va. (Stech, 9/22)

Dallas Morning News: Is Key Critic's Flip-Flop A Sign That Telehealth Can Now Take Off In Texas? 
The executive director of a Texas organization that has been leading the fight to limit telemedicine services in the state will be leaving next month to direct the telehealth program at an academic medical school. Mari Robinson will be departing the Texas Medical Board to join the University of Texas Medical Branch in Galveston, the Texas Tribune reported Wednesday.  Her role will be temporarily filled by Scott Freshour, the board's general counsel. Telehealth, also referred to as telemedicine, is a service that allows patients to connect with doctors and other health care providers through smartphones, computers and other devices. Patients can sometimes provide photos or videos to supplement their descriptions. (Rice, 9/22)

The Philadelphia Inquirer: UnitedHealthcare Adds Nemours To Network
UnitedHealthcare has added Nemours Children's Health Network to its insurance network for families in individual and employer-sponsored plans, but not for those in Medicaid plans, the two organizations said Thursday. The new contract, covering Nemours facilities and physicians in Delaware, Pennsylvania, New Jersey and Maryland, takes effect Oct. 1. UnitedHealthcare, the nation's largest health insurer, said it covers 240,000 people in Delaware and southeastern Pennsylvania through employer-sponsored and individual plans. Its network has 12 hospitals and more than 5,000 physicians and other care providers, United said. (Brubaker, 9/22)

The Star Tribune: Mental Illness In Hennepin Jail Far Higher Than Previous Estimates, New Study Finds 
More than half of all inmates in the Hennepin County jail suffer from a mental illness of some kind — far more than previously thought — and they are more likely to reoffend than other inmates, according to a detailed new jail study. The findings, based on a one-day survey of 680 inmates, are likely to buttress ambitious new efforts by the county to break the pattern of offenders with mental health problems cycling in and out of courts and jails without receiving adequate treatment. (Serres, 9/22)

Miami Herald: FIU Mobile Mammogram Unit Offers Free Screenings To Needy Women
Launched in November 2014 by the Herbert Wertheim College of Medicine at Florida International University, the mobile mammogram unit is funded by the Braman Family Foundation. It’s named after Norman Braman’s sister-in-law, Linda Fenner, who died of breast cancer in 2005 at age 54. Since its inception, the center has served nearly 1,400 women and diagnosed 12 breast cancer cases. Eight of these cases were detected in the early stages. (Horton, 9/22)

Health News Florida: State Wins Lawsuit In Placement Of Kids In Nursing Homes
U.S. District Judge William Zloch  issued a 28-page ruling that said the Justice Department did not have legal standing to file the lawsuit under part of the Americans with Disabilities Act. Under that part of the law, Zloch wrote, such cases can only be filed by a “person alleging discrimination,” which doesn't apply to the Justice Department. The Justice Department filed the lawsuit in 2013 amid a controversy about whether the state Medicaid program had improperly placed medically fragile children in nursing homes instead of providing community-based services. (9/22)

Columbus Dispatch: Advocates For Disabled Sue To Gain Access To Juvenile Detention Facility
Disability Rights Ohio filed a federal lawsuit today charging that the Multi-County Juvenile Detention Center in Lancaster violated state and federal law by repeatedly refusing advocates access to incarcerated juveniles.The agency, which provides protection and advocacy services for people with disabilities, said its employees were refused access to inmates by the juvenile facility, which serves Fairfield, Hocking, Licking and Perry counties. The lawsuit was filed in U.S. District Court in Columbus against the detention center and Dana C. Moore, the superintendent. (Johnson, 9/22)

The CT Mirror: Connecticut Has Baby Bust, Slow Growth And Aging Population
Connecticut women are having fewer children than those in most other states, its population continues to age, and growth is lagging. Those are some of the findings in the U.S. Census Bureau’s latest American Community Survey, which provides demographic estimates between the decennial counts of the nation’s population. The census bureau said that in 2015 Connecticut women ranked 49th in fertility among the states and the District of Columbia. (Albert, 9/23)

Houston Chronicle: Houston Randalls Store Works With Quest To Provide Medical Tests 
Through a partnership between national medical firm Quest Diagnostics and Albertsons Cos. -- Randalls' parent company -- Quest has built a patient service center near the grocery store's pharmacy at 3131 W. Holcombe Blvd. The service center is one of 12 such centers opened nationwide as part of a pilot that Quest is testing in four markets in the U.S., including Houston, said Chris Grant, director of national patient services for Quest. The centers have been running since Sept. 1 and Grant said that feedback has been positive. (Smith, 9/22)

The Philadelphia Inquirer: Pa. Court Overturns Gov. Wolf's Home Care Order
In a 4 to 1 decision, Commonwealth Court of Pennsylvania said Gov. Wolf exceeded his authority with a Feb. 2015 executive order that allowed  the establishment of an intermediary between certain home aids paid under a Medicaid waiver and the Pennsylvania Department of Human Services. ... Critics of the order said the move amounted to forced unionization. The selected intermediary, United Home Care Workers of Pennsylvania, is a joint venture of two union,  Service Employees International Union and American Federation of State, County and Municipal Employees. (Brubaker, 9/22)

Columbus Dispatch: Diarrheal Disease Outbreak Grows To Nearly 800 Cases
After grueling months of skyrocketing numbers, a highly contagious diarrheal disease outbreak in central Ohio could soon taper off, health officials say. The number of diagnosed cryptosporidiosis cases in Franklin and Delaware counties reached 792 as of Thursday, based on recent figures from public health officials. That number, which increased by about one-third over the past two weeks, has continued to climb since the outbreak was first detected in late July. (Widman Neese, 9/22)

Cleveland Plain-Dealer: Teens Take Aim At Lead Poisoning Crisis With 'Forgotten Homes' Track
"Forgotten Homes" is one track from a soon-to-be released CD called "Drop the Lead" created by student interns with Fresh Camp, a non-profit that teaches youth to create music and socially-messaged shirts that amplify their voices and ideas. The effort explores the roots and intersections of two persistent Cleveland problems – lead poisoning and gun violence. (Dissell, 9/22)

Milwaukee Journal Sentinel: Cell Therapy Brings Hope For Quadriplegics
Today, [Lucas] Lindner is one of a small group of recent quadriplegics who have shown improvement in the weeks after receiving the treatment. He regained movement in his fingers and arms. Then, his big toes. "Things started changing,” he said. Whether the progress continues, whether it can definitively be attributed to the treatment and whether it becomes a breakthrough therapy remains to be seen. (Fauber, 9/22)

Health News Florida: The Money Behind Medical Marijuana Looks Like 2014 – Dejà Vu
United for Care has gotten more than 3,000 contributions from individuals and corporations this year, but the vast majority – about 2,800 – are $100 or less. Drug Free Florida, on the other hand, has only gotten 21 donations in 2016 – but the average donation is more than $136,000. And while John Morgan may be the public face of the medical marijuana campaign, Barbara Steifel has given the campaign $50,000 dollars more than John Morgan this year. (Aboraya, 9/22)

Nashville Tennessean: New Freed-Hardeman Dickson Health Wing Helps Future Nurses
The first-ever nursing class at Dickson Freed-Hardeman started this fall. Greeting those 12 students on the lower floor of the Renaissance Center — now 17 years old but still strikingly contemporary — is the newly created Health Sciences Wing of the university. The wing will officially be unveiled to the public 2 p.m. Thursday next week. The classrooms, labs and offices comprise nearly 7,000 square feet with hospital equipment and simulation mannequins for training. (Gadd, 9/22)

Annals of Internal Medicine: Changes In Hospital–Physician Affiliations In U.S. Hospitals And Their Effect On Quality Of Care
[Researchers used a] retrospective cohort study of U.S. acute care hospitals between 2003 and 2012 [to examine employment relationships with their physicians]. ... In 2003, approximately 29% of hospitals employed members of their physician workforce, a number that rose to 42% by 2012. Relative to regionally matched controls, switching hospitals were more likely to be large (11.6% vs. 7.1%) or major teaching hospitals (7.5% vs. 4.5%) and less likely to be for-profit institutions (8.8% vs. 19.9%) .... Up to 2 years after conversion, no association was found between switching to an employment model and improvement in any of 4 primary composite quality metrics. (Scott et al., 9/20)

Pediatrics: Federally Qualified Health Center Access And Emergency Department Use Among Children
[Researchers sought to] determine whether increasing access to federally qualified health centers (FQHCs) in California was associated with decreased rates of emergency department (ED) use by children without insurance or insured by Medicaid. ... [They found] Increased geographic density of FQHC sites was associated with ≤18% lower rates of ED visits among Medicaid-insured children and ≤40% lower ED utilization among uninsured children .... However, the percentage of Medicaid-insured and uninsured children seen at FQHCs was not associated with any significant change in ED visit rates among Medicaid-insured or uninsured children. (Nath et al., 9/22)

JAMA Internal Medicine: Effects Of Subsidies And Prohibitions On Nutrition In A Food Benefit Program
[Researchers sought to] evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants’ diets. ... A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions. (Harnack, 9/19)

Morbidity and Mortality Weekly Report/CDC: Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014
In 2014, 28.7% of older adults reported falling at least once in the preceding 12 months, resulting in an estimated 29.0 million falls. Of those who fell, 37.5% reported at least one fall that required medical treatment or restricted their activity for at least 1 day, resulting in an estimated 7.0 million fall injuries. ... Although falls are common, approximately half of older adults who fall do not discuss it with their health care provider. However, older adult falls are largely preventable. Health care providers can play an important role in fall prevention by 1) screening older adults for fall risk, 2) reviewing and managing medications linked to falls, and 3) recommending vitamin D where appropriate for improved bone, muscle, and nerve health. (Bergen, Stevens and Burns, 9/23)

The Kaiser Family Foundation: Medicare Advantage Plan Switching: Exception Or Norm?
This analysis focuses on enrollees in Medicare Advantage plans with prescription drug coverage (MA-PDs) who change plans when given the opportunity. ... Relatively few Medicare Advantage enrollees, roughly one in ten, voluntarily switch from one MA-PD to another MA-PD each year, suggesting that plan switching among seniors is more the exception than norm. The takeaway from this analysis for beneficiaries is not entirely clear. On the one hand, our analysis shows some price sensitivity among Medicare Advantage enrollees: switching rates were higher among the minority of enrollees with relatively big premium increases. On the other hand, the findings confirm that the vast majority of enrollees do not change plans, and that plan “stickiness” may come at a cost, in terms of higher premiums and higher out-of-pocket spending limits. (Jacobson, Neuman and Damico, 9/20)

Here is a selection of news coverage of other recent research:

Reuters: Disease-Related Malnutrition Costs U.S. $15.5 Billion Annually: Study
The United States could save at least $15.5 billion in annual healthcare spending if malnutrition caused by chronic diseases is better addressed, according to a study. The study, conducted by Abbott Laboratories' nutrition division and the University of Illinois, noted one in three patients who arrive at a U.S.-hospital suffer from malnutrition. A further one-third become malnourished during their stay. (Grover, 9/21)

The New York Times: Stress May Counteract Effects Of A Healthful Diet
Stress may counteract the beneficial effects of a healthful diet, a study in Molecular Psychiatry suggests. ... Among women who had low levels of stress, markers of inflammation tended to be higher after eating the meal containing high levels of saturated fat than after the low saturated fat meal. But for women who had high levels of stress, those differences disappeared — they had high levels of inflammation even after the meal that was low in saturated fats. (Bakalar, 9/22)

Reuters: Yes, Virginia, There Is A Weight Gain Over Christmas
A new study has confirmed what your waistband has told you all along -- you gain weight during the holidays. It also concluded that people who weigh themselves frequently seem to lose those extra pounds faster. ... Within 10 days of Christmas, the average weight increased 0.4 percent among Americans and 0.6 percent among the Germans. For the Japanese, a 0.3 percent increase came during Golden Week in May, which includes an aggregation of four holidays. For a 150-pound person, that's less than a pound. But one of the authors of the study published in the New England Journal of Medicine, Dr. Brian Wansink, told Reuters Health in a telephone interview that the increase was so low because the people using the scales were unusual. (Emery, 9/21)

Medscape: Conflicting Interpretation Of Cancer Genetic Test Results Common
The results of multiplex genetic cancer tests are being interpreted in different ways at different laboratories, even when they are Clinical Laboratory Improvement Amendments (CLIA)–approved commercial laboratories. A new study has found considerable variation: In some cases, genetic mutations were interpreted as pathogenic or likely pathogenic by some labs but were considered to be of unknown significance by others. These variations could have implications for medical management decisions, the authors comment. (Brooks, 9/22)

Forbes: A Health Care Legacy Moonshot For Obama
President Obama has an opportunity to win a positive legacy in health care. Although his attempt at payment reform, Obamacare, has failed in public opinion, he is also encouraging important initiatives in medical innovation. The Cancer Moonshot and Precision Medicine Initiative represent investments in innovation that can bring big payoffs. However, they will not succeed fully unless the Food and Drug Administration allows patients access to new therapies. Legislation modernizing the FDA, the 21st Century Cures Act, is being fumbled inches away from the Congressional end zone. Presidential leadership is needed. (John Graham, 9/22)

Los Angeles Times: Recipe For Ripoffs: Pricing Drugs By Their 'Value' To Sick People
It’s easy to assume that greed is solely to blame for runaway drug prices — and companies like Mylan do nothing to challenge that perception. The reality, however, is more complicated. When [Mylan Chief Executive Healther] Bresch talked about drug prices and access existing “in a balance,” she was referring to what the pharmaceutical industry calls value-based pricing. This is what you get when you price a drug not just commensurate with its research and development, production and marketing, but also reflecting the drug’s importance to patients. And that’s a very slippery concept. (David Lazarus, 9/23)

Morning Consult: Spurring Drug Development For Life-Threatening, Rare Pediatric Conditions
Hope is a necessity, especially when you have a rare disease in your family. My family lives with one of the 7,000 rare diseases without a cure, so our one true hope is for a treatment that increases the quality of life of our children. That hope relies on a strong government/industry partnership. This partnership began in earnest in 1984 with the passage of the Orphan Drug Act, and must be strengthened by the Rare Pediatric Disease Priority Review Voucher Program, an incentive for drug development that is set to expire on Sept. 30. (Brett Kopelan, 9/22)

Bloomberg: Drugs Can't Cure Alzheimer's. Could They Prevent It?
Even if the experimental drug isn’t a cure, there’s reason to believe something like it might ward off Alzheimer’s disease in healthy people, sort of the way statins are thought to prevent heart attacks. And preventive therapy for the brain could help avert what many experts see as an impending disaster: By 2050, there will be 32 million people over the age of 80 in the U.S., and unless something big changes, about 16 million will have Alzheimer’s disease. (Faye Flam, 9/22)

Stat: It's Time To Call The Opioid Epidemic A Public Health Emergency
Last month, the Obama administration declared a public health emergency in Puerto Rico to cope with the spread of the Zika virus. There’s no question that Zika poses a threat to public health, but its magnitude is uncertain. In contrast, we know that the opioid epidemic is killing more than 500 Americans a week and harming thousands more. Why isn’t that a public health emergency, too? (Benjamin Bearnot and Mark Eisenberg, 9/22)

The Baltimore Sun: Drug Overdoses Deadlier Than Car Crashes 
In Maryland, heroin-related deaths tripled from 2011 to 2015, rising from 247 to 748. There has also been an alarming spike in deaths from the synthetic opioid fentanyl, rising 105 percent during the first quarter of 2016 as compared to 2015. Increases in overdose deaths have been reported throughout the state, including western and central Maryland and the Eastern Shore. It is essential to alert people about the dangers of opiate use, whether obtained through prescriptions or on the street. Everyone is at risk if they are not informed. (Rod J. Rosenstein, U.S. attorney in Maryland, and Brian E. Frosh, Maryland's attorney general, 9/22)

Chicago Tribune: We Need To Start Over On Obamacare
[Hillary] Clinton actually wants to double down on Obamacare, even after seeing public support for the health law tumble. She wants to create another big government "public option" health insurance plan. The "option" would have unlimited calls on taxpayer dollars and government force and would quickly drive remaining private insurers out of the market, leaving people with only the "choice" of a government-run health plan. The idea might have more traction were it not for the experience of a similar experiment the nonprofit, citizen-run health insurance cooperatives concocted by Obamacare. The co-op program cost taxpayers $2.4 billion, but 17 of the 23 state co-ops have failed, forcing hundreds of thousands of people to scramble to find new policies. (Grace-Marie Turner, 9/22)

The Wall Street Journal: The Terminally Ill Deserve Right-To-Try Laws
In 2014 I met a young mother of three from Waukesha, Wis. Her name was Trickett Wendler, and she had the degenerative nerve disease amyotrophic lateral sclerosis (ALS). Before her diagnosis, Trickett was living a normal life and looking forward to a bright future. ALS robbed her of her dreams and took away her body’s ability to function. She died on March 18, 2015. Like their mother and grandfather, Trickett’s children are genetically predisposed to ALS. Trickett was prescribed the same medications her father was given in the 1990s. Her husband Tim prays that better treatments will be developed if, God forbid, one of his children must fight this horrible disease. (Sen. Ron Johnson, R-Wis., 9/22)

Sacramento Bee: ‘Right To Try’ Bill Offers False Hope To The Desperately Ill 
The Medical Oncology Association of Southern California and the California Nurses Association oppose Assembly Bill 1668, by Ian Calderon, D-Whittier. We agree that it is in the best interest of terminally ill Californians and their loved ones that the governor veto this bill again. The misleadingly named bill would not give patients a real right to try experimental drugs. Rather, it would give them a “right” to request access to drugs in development at pharmaceutical companies. But there is no obligation for a company to grant a patient’s request. (Alison Bateman-House, Arthur Caplan and Lisa Kearns, 9/22)

The New York Times: Restrictions On The Type Of Food Stamp Purchases Can Help Fight Obesity
Often, when I discuss the obesity crisis in the United States, especially when I’m pointing out another failed effort to help people change their eating habits, it’s as if there’s nothing we can do. But sometimes it’s actually more that there’s nothing we will do. ... The Supplemental Nutrition Assistance Program (SNAP), colloquially known as food stamps, provides aid to poor families in the United States so that they can buy food. ... In studies, people who receive SNAP tend to be more obese than those who don’t. This has led some to call for a reduction in benefits, arguing that the program is causing obesity. It’s more likely that we need to change the behavioral economics of food, not the aid we supply. (Aaron E. Carroll, 9/22)

The Washington Post: The Origin Of House Of Representatives V. Burwell
In House of Representatives v. Burwell, the House challenged the legality of subsidies the Obama administration paid to insurers. Judge Rosemary M. Collyer ruled that the House as an institution had standing and that the payments were made without an appropriation. Currently, the case is on appeal to the U.S. Court of Appeals for the D.C. Circuit. Though the litigation has had unexpected success in the courts, its origin was rocky. As I discuss in Chapter 23 of “Unraveled,” one of the most difficult aspects the case was finding an attorney to take it — or, more precisely, an attorney whose law firm would allow him keep the case. (Josh Blackman, 9/22)