The New York Times: A Last Push For Obamacare Sign-Ups — And Worries About Who Got Hurt
Denise English was one of just two employees working six days a week to handle the crowd of people signing up for health insurance under the Affordable Care Act at a neighborhood health clinic here, as the Friday deadline for open enrollment loomed. Most of the people who sat waiting wanted to speak to her co-worker, who speaks Spanish. But Ms. English — she speaks only “un poquito” — was doing her best, her phone open to Google Translate, as she tried to help clients like Ana Gonzalez and Celso Morales, who moved here from Puerto Rico in April, sign up for a subsidized health plan. (Zernike and Pear, 12/15)

The Washington Post: Americans Sprint To Get Affordable Care Act Coverage In Last Hours Before Deadline
Consumers jammed call centers and enrollment offices in the final sprint toward the Friday deadline in most of the country to get Affordable Care Act health plans for 2018, defying months of naysaying by President Trump about the law’s insurance marketplaces. In several states, enrollment helpers reported a crush of interest in recent days. Some navigator organizations, which help people sign up, received more requests for appointments than they could accommodate — a consequence of an enrollment season that is half as long as the past three years’ time frame and large cuts by federal officials in grants to those groups. (Goldstein, 12/15)

The Wall Street Journal: Affordable Care Act Sign-Ups Bump Up, But Still Fewer Expected This Year
The end of open enrollment under the Affordable Care Act Friday saw an uptick in people selecting health plans, but with a shorter window this year’s sign-ups are still expected to fall short of last year’s, an outcome that could further imperil the fragile individual insurance market. Less robust sign-ups on the federal health exchange are likely to lead to higher premiums and bolster critics who say that the law is failing. Supporters say the enrollment pace has defied expectations, given that the Trump administration shortened the sign-up window and cut millions of dollars in outreach funding. (Armour, 12/15)

The Associated Press: Sign-Ups Show Health Law's Staying Power In Trump Era
A deadline burst of sign-ups after a tumultuous year for the Obama health law has revealed continued demand for the program's subsidized individual health plans. But the Affordable Care Act's troubles aren't over. On the plus side for the overhaul, official numbers showed a sizable share of first-time customers, 36 percent, were among those rushing to finish HealthCare.gov applications in the run-up to Friday's enrollment deadline. One new challenge comes from the GOP tax bill, which repeals the law's requirement that people have health insurance or risk fines. (12/18)

CQ: State Outreach Efforts Pay Off In Health Coverage Enrollment
States and insurance companies ramped up outreach for health coverage enrollment this year to fill the gap left by a drastic funding cut by the Trump administration. In many places, the hard work is showing. A recent study by the Wesleyan Media Project showed an overall spike in advertising this open enrollment season, a surprise given the Department of Health and Human Services’ decision to slash federal funds for marketing by 90 percent and in-person outreach by 41 percent. (Clason, 12/15)

The Hill: Trump Officials Decline To Extend ObamaCare Sign-Up Deadline
The Trump administration declined to extend the ObamaCare sign-up period amid the last-minute surge of enrollees, a break with the precedent set under the Obama administration. The enrollment period ended Friday at midnight. The Obama administration in previous years consistently extended the deadline for a few days to accommodate the high number of enrollees who wait until the last minute to enroll. (Sullivan, 12/16)

The Associated Press: Health Law Sign-Up Deadline Extended For Some People
After a rush of last-minute sign-ups, the Trump administration says it's extending the deadline for some people to finish health insurance applications for next year under the Affordable Care Act. Callers to the HealthCare.gov service center on Saturday morning got a recorded message saying "don't worry" — if they'd called and left their phone number before the deadline, they'll get a call back and still can enroll for 2018. (12/16)

Houston Chronicle: Harvey Victims Get 2 Weeks More To Buy Obamacare Plans 
Enrollment for 2018 health insurance through the Affordable Care Act ended Friday for most people, but Texans affected by Hurricane Harvey will get two extra weeks to sign up. People in Houston and a wide swath of storm-affected areas will be able to enroll for plans on the federally mandated exchange through Dec. 31. But advocates caution that applying after Friday can be cumbersome. (Deam, 12/15)

Politico: How Blue States Might Save Obamacare's Markets
The looming demise of Obamacare’s individual mandate is spurring talks in a handful of blue states about enacting their own coverage requirements, as state officials and health care advocates fear repeal will roil their insurance markets. Republicans in Congress are poised to kill off the individual mandate in their sweeping tax overhaul, knocking out one of Obamacare's most unpopular features — but one that health experts have said is essential to making the law's insurance marketplaces function. (Pradhan, 12/17)

In other news on the health law —

The Hill: Medical Device Companies Press To Lift ObamaCare Tax This Month 
The medical device industry is pressing Congress to act before the end of the year to lift ObamaCare’s medical device tax. In a letter to lawmakers, Scott Whitaker, CEO of AdvaMed, the medical device trade group, warned against waiting until January to pass a delay of the tax, instead urging them to pass the measure this month. (Sullivan, 12/15)

The Hill: Anti-Abortion Groups Push For Stronger 'Pro-Life' Restrictions In ObamaCare Funding Bill 
Anti-abortion groups are sounding the alarm over an ObamaCare funding bill, urging lawmakers to vote against it because they say it doesn't contain "pro-life" protections. A bill sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) would fund the key ObamaCare insurer payments called cost-sharing reductions (CSRs), which reimburse insurers for giving discounted deductibles and copays to low-income patients. (Hellmann, 12/15)

CQ: House Nears Settlement In Obamacare Spending Lawsuit
The House, White House and a number of states reached a tentative settlement Friday in a lawsuit over appropriations for the 2010 health care law, which would appear to end the legal showdown between the two political branches by essentially pretending it never happened. A federal judge’s May 2016 ruling in the case set up a showdown at the U.S. Court of Appeals for the D.C. Circuit that promised to test the boundaries of separation of powers and influence when the courts can step into disputes between the branches of government. (Ruger, 12/15)

The Associated Press: Judge Temporarily Blocks New Trump Rules On Birth Control
A federal judge in Philadelphia on Friday ordered the Trump administration not to enforce new rules that could significantly reduce women's access to free birth control. Judge Wendy Beetlestone issued the injunction, temporarily stopping the government from enforcing the policy change to former President Barack Obama's health care law. (Cornfield and Thanawala, 12/15)

The New York Times: Court Temporarily Blocks Trump Order Against Contraceptive Coverage
In the lawsuit, filed by the State of Pennsylvania, the judge said the rules would cause irreparable harm because tens of thousands of women would lose contraceptive coverage. The Affordable Care Act contains no statutory language allowing federal agencies to create such “sweeping exemptions” to the law’s requirements to cover preventive services, Judge Beetlestone declared. (Pear, 12/15)

The Wall Street Journal: Judge Temporarily Blocks Trump Administration’s Birth-Control Rule
The judge, appointed by former President Barack Obama, said the exemptions the administration created to the contraceptive mandate were likely unlawful because they were too broad and had been implemented using improper procedures. Trump administration health officials hadn’t provided a compelling reason why the rules should take effect immediately rather than going through a more typical public comment period, she said. Judge Beetlestone’s ruling is likely to be an early step in a long court battle that could reach the U.S. Supreme Court. (Hackman, 12/15)

Politico: Judge Blocks Trump Rollback Of Obamacare Contraception Mandate
“The Commonwealth’s concern is absent available cost-effective contraception, women will either forgo contraception entirely or choose cheaper but less effective methods — individual choices which will result in an increase in unintended pregnancies,” Beetlestone wrote in her 44-page opinion. “That in turn will inflict economic harm on the Commonwealth because unintended pregnancies are more likely to impose additional costs on Pennsylvania’s state-funded health programs.” (Colliver, 12/15)

The Hill: Federal Judge Blocks Trump Rollback Of ObamaCare Birth Control Mandate
ObamaCare requires that most companies cover birth control as preventive care for women at no additional cost. The Trump administration rolled back the requirement earlier this year, arguing that it infringed on the religious and moral rights of some businesses. Other Democrat-led states have also sued the administration, including California. (Hellmann and Anapol, 12/15)

The Associated Press: Tax Bill Guts Unpopular 'Obamacare' Insurance Mandate
Republicans didn't get their wish to repeal former President Barack Obama's health care law, but the tax bill barreling toward a final vote in Congress guts its most unpopular provision, the requirement that virtually all Americans carry health insurance. Politically, the move is a winner for Republicans, who otherwise would have little to show for all their rhetoric about "Obamacare." (Alonso-Zaldivar, 12/16)

The Associated Press: Huge Tax Bill Heads For Passage As GOP Senators Fall In Line
After weeks of quarrels, qualms and then eleventh-hour horse-trading, Republicans revealed the details of their huge national tax rewrite late Friday — along with announcements of support that all but guarantee approval to give President Donald Trump the Christmas legislative triumph he's been aching for. (Ohlemacher and Gordon, 12/16)

The Washington Post: GOP Faces 5-Day Scramble To Pass Tax Bill, Avoid Government Shutdown
Republicans return to Congress on Monday facing a packed agenda with little time to enact it, as party leaders aim to quickly pass their massive tax plan and then cut a budget deal with Democrats before the end of Friday to avert a government shutdown. Republicans’ tight timing on taxes is self-imposed. (Stein, DeBonis and Reis, 12/17)

The Washington Post: Sen. Susan Collins Takes Huge Leap Of Faith With Tax Bill. Critics Say She’s Getting Played.
As GOP tax legislation nears final passage on Capitol Hill, Sen. Susan Collins is approaching the moment for a mighty leap of faith. The Maine Republican extracted key concessions in exchange for her support for the bill, including commitments from the Trump administration and Senate leaders to back two pieces of legislation pumping money into the health-care system. The problem is, House Republicans largely oppose the health-care bills. (Werner, 12/15)

The New York Times: The Winners And Losers In The Tax Bill
With the bill finally headed to a vote this coming week, taxpayers are scrambling to determine whether the legislation renders them winners or losers. ... With the repeal of the individual mandate, some people who currently buy health insurance because they are required by law to do so are expected to go without coverage. According to the Congressional Budget Office, healthier people are more likely to drop their insurance, leaving insurers stuck with more people who are older and ailing. This is expected to make average insurance premiums on the individual market go up by about 10 percent. All told, 13 million fewer Americans are projected to have health coverage, according to the Congressional Budget Office. (Drucker and Rappeport, 12/16)

The Hill: Final GOP Tax Bill Repeals ObamaCare Mandate
The final Republican tax-reform bill unveiled Friday repeals ObamaCare’s individual insurance mandate, leaving the GOP poised to blow a significant hole in the health-care law next week. The change, which takes effect in 2019, removes one of the least popular parts of ObamaCare, but one that many experts warn is necessary to make the law function smoothly. (Sullivan, 12/15)

Stat: Final Tax Bill Holds Much To Please Biopharma
The tax overhaul that Republicans hope to send to President Trump’s desk next week is expected to lighten the tax burden on the pharmaceutical industry and provide a number of other benefits that could help drug makers boost their bottom lines. The final version of the bill, released late Friday, retains a key tax credit aimed at incentivizing research into rare disease treatments — an improvement over an early draft that repealed it for the industry. The package will also lower the tax rate companies have to pay on earnings they stockpiled overseas, though the final rate is higher than in earlier drafts. (Mershon, 12/15)

The New York Times: How The Republican Tax Bill Could Affect You
The $1.5 trillion Republican tax bill would make major changes to the tax code. But what do they mean for you? This is how the agreement’s changes to some common deductions and taxes could affect Americans. (Andrews, Buchanan, Davis and Watkins, 12/15)

The New York Times: John McCain, Fighting Brain Cancer, Likely To Miss Vote On Tax Overhaul
Senator John McCain, who is battling brain cancer, has returned home to Arizona and is likely to miss the Senate’s vote this week to approve a sweeping tax overhaul, though President Trump said on Sunday that the senator would return if his vote was needed. Mr. McCain’s office said in a statement on Sunday night that the senator, who had been hospitalized recently in the Washington area, would undergo physical therapy and rehabilitation at the Mayo Clinic in Arizona and “looks forward to returning to Washington in January.” (Kaplan, 12/17)

Kaiser Health News: Podcast: ‘What The Health?’ Farewell, Individual Mandate
The compromise tax bill emerging from Republican efforts in Congress appears to have jettisoned a number of contentious health-related changes. Still, it seems likely lawmakers will repeal the penalties for not having health insurance. That so-called individual mandate was considered a linchpin of the Affordable Care Act, but now it seems possible the rest of the health law could survive without it. (12/15)

Modern Healthcare: Healthcare Issues Loom Large As Congress Tackles Spending Bills, Tax Reform
Steep divisions remain, not just along party lines but between the House and Senate. House conservatives support the defense bill and don't want extra spending provisions beyond the reauthorization of the Children's Health Insurance Program and federally qualified health centers. But the plan they've laid out to pay for CHIP and health centers is meeting stiff opposition from Democrats. House Republicans want to fund the five-year CHIP reauthorization with money from the Affordable Care Act Prevention and Public Health Fund and higher Medicare Advantage premiums for wealthy people. This bitter fight over the so-called pay-fors has kept CHIP in limbo for months. Funding for Medicare programs that are crucial for rural hospitals and money to help battle the opioid crisis also hang in the balance. And, at deadline, it still wasn't clear what was going to happen with ACA cost-sharing reduction payments for insurers. (Meyer, Weinstock and Luthi, 12/16)

Dallas Morning News: No Bah Humbug? Texas Won't Mail Notices Canceling Poor Kids' Health Coverage Before Christmas
Federal officials have given a health insurance program for low-income Texas children a short-term funding boost to extend the kids’ coverage through February, the Texas Health and Human Services commission said Friday. The Children’s Health Insurance Program will receive nearly $136 million from the federal Centers of Medicare and Medicaid Services, executive commissioner Charles Smith said in a letter to Gov. Greg Abbott. (Wang, 12/16)

Houston Chronicle: Texas Will Get Funding To Keep CHIP Alive One More Month
Texas law bars officials from using state funds to pay for the program if there are no federal dollars in place. If the state runs out of money, it will send all CHIP recipients to the federal government’s health care marketplace. ... In response to a news article about the one-month extension, Texas Sen. John Cornyn said in a tweet that funding was imminent.“Congress will pass a long term CHIP bill next week,” Cornyn said in a tweet. (Matos, 12/15)

Texas Tribune: Texas To Receive $135M To Keep Children's Health Insurance Program Alive Through February
Republican Texas House Speaker Joe Straus said in a statement that “the children who benefit from this program should never have been put in a position where they might lose care.” “The written assurances from the administration will provide some short-term certainty for the program, and that’s important,” Straus said. “But the need for Congress to act quickly has not diminished, and I hope Congress will reauthorize the program soon in order to provide the longer-term certainty that working families in Texas need.” (Evans, 12/15)

The Philadelphia Inquirer/Philly.com: Wolf Signs State CHIP Bill, But Still No Federal Action
Gov. Wolf signed a bill Friday reauthorizing Pennsylvania’s participation in the Children’s Health Insurance Program (CHIP). The bigger worry, however, remains with Congress, which has yet to renew this largely federally funded program that provides health care for nearly 9 million low-income and special-needs children, as well as more than 370,000 pregnant women nationwide.  Pennsylvania’s CHIP program is projected to run out of money by the end of January if federal lawmakers fail to act soon. “Congress needs to do its part and reauthorize CHIP at the federal level,” said Wolf. “Without federal funding, more than 180,000 children in Pennsylvania could be without health care in early 2018.” (Giordano, 12/15)

Richmond Times-Dispatch: Virginia Letters Meant To Warn, Not Scare Or Confuse, CHIP Families
With the holiday season in full swing and a million other things likely on their minds, 68,000 Virginia families will receive, or have already received, a letter warning them that by the end of January, their children might not have health insurance. That is because, for nearly three months, an effort to reauthorize a 20-year-old bill that has always been supported by both sides of the aisle has been neglected. (O'Connor, 12/17)

The CT Mirror: Families Of 17,000 CT Children Being Told Health Coverage May End
Letters are going out this weekend telling families that 17,000 children and teenagers across the state will lose their health coverage on Jan. 31 unless Congress acts. Federal funding for the Children’s Health Insurance Program, known as CHIP, ended on Sept. 30 because Congress didn’t authorize continuation of the program by the fall deadline. (Rigg, 12/15)

The Washington Post: Words Banned At Multiple HHS Agencies Include ‘Diversity’ And ‘Vulnerable’
The Trump administration has informed multiple divisions within the Department of Health and Human Services that they should avoid using certain words or phrases in official documents being drafted for next year’s budget. Officials at the Centers for Disease Control and Prevention, which is part of HHS, were given a list of seven prohibited words or phrases during a meeting Thursday with senior CDC officials who oversee the budget. The words to avoid: “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.” (Sun and Eilperin, 12/16)

The New York Times: Uproar Over Purported Ban At C.D.C. Of Words Like ‘Fetus’
The Department of Health and Human Services tried to play down on Saturday a report that officials at the Centers for Disease Control and Prevention had been barred from using seven words or phrases, including “science-based,” “fetus,” “transgender” and “vulnerable,” in agency budget documents. “The assertion that H.H.S. has ‘banned words’ is a complete mischaracterization of discussions regarding the budget formulation process,” an agency spokesman, Matt Lloyd, said in an email. “H.H.S. will continue to use the best scientific evidence available to improve the health of all Americans. H.H.S. also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.” (Kaplan and McNeil, 12/16)

The Hill: HHS Pushes Back On Report It's Blocking CDC From Using Certain Words 
The Department of Health and Human Services (HHS) is pushing back on a report saying the agency was not allowing the personnel at the Centers for Disease Control and Prevention (CDC) to use words like "diversity," "transgender" and "fetus" in official documents. "The assertion that HHS has 'banned words' is a complete mischaracterization of discussions regarding the budget formulation process," HHS spokesman Matt Lloyd told The Hill on Saturday. (Manchester, 12/16)

Stat: After Report On CDC's Forbidden Words Draws Outrage, HHS Pushes Back
A spokesman for the Health and Human Services Department said Saturday the agency remains committed to the use of outcomes data and scientific evidence in its decisions, pushing back on the characterization of a Washington Post report that the Centers for Disease Control and Prevention is now banned from using words like “science-based” and “transgender” in budget documents. The spokesman, Matt Lloyd, didn’t respond to follow-up questions about whether the policy might apply more broadly, now or in the future, to other HHS agencies such as the Food and Drug Administration or the National Institutes of Health. (Mershon, 12/16)

Stat: CDC Chief To Staff 'No Banned Words,' Does Not Refute Report
The new director of the Centers for Disease Control and Prevention reached out to alarmed agency staff over the weekend to tamp down fears incited by a report that the Trump administration has banned the CDC from using words like “fetus,” “evidence-based,” and “diversity” in its budget submissions. Dr. Brenda Fitzgerald, who has led the agency since July, sent an all-hands email to the agency’s staff assuring them that the CDC is committed to its mission as a science- and evidence-based institution. She later posted it on Twitter. (Branswell, 12/17)

The Hill: Words Banned At CDC Were Also Banned At Other HHS Agencies: Report 
Multiple agencies in the Department of Health and Human Services (HHS) have reportedly been told by the Trump administration that they cannot use certain phrases in official documents.  Officials from two HHS agencies, who asked that their names and agencies remain anonymous, told The Washington Post that they had been given a list of "forbidden" words similar to the one given to the Centers for Disease Control and Prevention (CDC) (Seipel, 12/16).

The Associated Press: Lawsuit: 2 Immigrant Teens In US Custody Can’t Get Abortions
President Donald Trump’s administration is blocking two pregnant teens in the country illegally and being held in federal custody from obtaining abortions, the American Civil Liberties Union said Friday, a repeat of the situation that led to a high-profile court fight earlier this year. Both girls arrived in the country as unaccompanied minors and are being held in federal shelters, the ACLU said, though it didn’t say where. The ACLU earlier this year represented a pregnant teen in the same circumstances in Texas, helping her obtain an abortion following a lawsuit. (Gresko, 12/15)

The Hill: ACLU Fighting Trump Over Abortion Access For Two Undocumented Immigrants 
The Trump administration defended the move, with the Department of Health and Human Services's (HHS) Administration for Children and Families saying the minors could leave the country or "find a suitable sponsor." “The minors in this case—who entered the country illegally—have the option to voluntarily depart to their home country or find a suitable sponsor. If they choose not to exercise these options, HHS does not believe we are required to facilitate the abortion," it said in a statement. (Greenwood, 12/15)

The Washington Post: ‘We Feel Like Our System Was Hijacked’: DEA Agents Say A Huge Opioid Case Ended In A Whimper
After two years of painstaking investigation, David Schiller and the rest of the Drug Enforcement Administration team he supervised were ready to move on the biggest opioid distribution case in U.S. history. The team, based out of the DEA’s Denver field division, had been examining the operations of the nation’s largest drug company, McKesson Corp. By 2014, investigators said they could show that the company had failed to report suspicious orders involving millions of highly addictive painkillers sent to drugstores from Sacramento, Calif., to Lakeland, Fla. Some of those went to corrupt pharmacies that supplied drug rings. (Bernstein and Higham, 12/17)

The Washington Post: New Drug Law Makes It ‘Harder For Us To Do Our Jobs,’ Former DEA Officials Say
A new law supported by opioid distributors and manufacturers is making it increasingly difficult to hold companies accountable when they run afoul of the nation’s drug laws, according to recently retired Drug Enforcement Administration investigators on the front lines of the war against opioids. They join a chorus of voices — including Attorney General Jeff Sessions, 44 state attorneys general and the head of the DEA office that regulates pharmaceuticals — who are calling for changes to the law. (Higham and Bernstein, 12/15)

In other news —

Stat: Pressure Builds On The DEA To Stem The Supply Of Prescription Drugs
The process was started nearly five decades ago to ensure that drug makers produced enough medicines to avoid shortages. But in the midst of a national opioid epidemic, fresh scrutiny of the quota system has spread to Capitol Hill, where Democratic lawmakers are pressing the DEA to use it for another reason — to help stem supply. ...Rarely, however, has the quota system been used to eliminate or constrain supply for a class of drugs similar to opioids — created to fill a medical need but with consequences that, in at least some cases, have outweighed the medical benefits. (Facher, 12/18)

The New York Times: In Opioid Battle, Cherokee Want Their Day In Tribal Court
Cherokee children were disappearing. At weekly staff meetings, Todd Hembree, the attorney general of the Cherokee Nation, kept hearing about babies in opioid withdrawal and youngsters with addicted parents, all being removed from families. The crush on the foster care system was so great that the unthinkable had become inevitable: 70 percent of the Cherokee foster children in Oklahoma had to be placed in the homes of non-Indians. (Hoffman, 12/17)

The Wall Street Journal: Prosecutors Treat Opioid Overdoses As Homicides, Snagging Friends, Relatives
After Daniel Eckhardt’s corpse was found on the side of a road in Hamilton County, Ohio, last year, police determined he died of a heroin overdose. Not long ago, law enforcement’s involvement would have ended there. But amid a national opioid-addiction crisis fueling an unprecedented wave of overdose deaths, the investigation was just beginning. Detectives interrogated witnesses and obtained search warrants in an effort to hold someone accountable for Mr. Eckhardt’s death. The prosecutor for Hamilton County, which includes Cincinnati and its suburbs, charged three of Mr. Eckhardt’s companions, including his ex-wife and her boyfriend, with crimes including involuntary manslaughter, an offense carrying a maximum prison sentence of 11 years. (Walker, 12/17)

Dallas Morning News: Unresponsive
As a record number of women go to jail in Texas, sheriffs are increasingly coping with a special class of inmates: women with minor criminal records but major mental-health and addiction problems. A recent federal survey found that almost a third of women in jails showed symptoms of serious psychological distress, even higher than the rate for men. And when inmates die in jail, drugs are more commonly the cause for women than for men, according to an analysis of state data by The Dallas Morning News. At least 10 of the 86 female jail fatalities since 2011 were attributed to overdoses. (Aspinwall and Lamm, 12/17)

The Hill: Bipartisan Senators Urge Congress To Fund Fight To Curb Opioid Crisis
A bipartisan group of senators is calling on Congress to provide significant funding to battle the opioid epidemic — and quickly. The nine senators hail from areas the epidemic has hit particularly hard, and are arguing there’s an “urgent need for Congress to provide our states with the resources they need to deal with this public health emergency” in a letter sent Friday to Senate Majority Leader Mitch McConnell (R-Ky.) and Minority Leader Charles Schumer (D-N.Y.). (Roubein, 12/15)

The Associated Press: Lifesaver Or Distraction? Police Split On Anti-Overdose Drug
The sheriff of Clermont County firmly believes it's a call of duty for his deputies to carry a nasal spray that brings people back from the brink of death by drug overdose. Less than 50 miles away, his counterpart in Butler County is dead set against it, saying it subjects deputies to danger while making no lasting impact on the death toll. The divide over naloxone, the popular overdose antidote, between nearby sheriffs in two hard-hit counties in one of the hardest-hit states for drug deaths shows just how elusive solutions are on the front lines of the U.S. opioid crisis. (12/18)

Denver Post: Colorado’s Largest Treatment Provider For Drug And Alcohol Addiction Is Closing 
Amid an ongoing epidemic of opioid and heroin overdoses, Colorado’s largest provider of treatment for drug and alcohol abuse will close its doors early next year, the victim of long-running financial losses and low government payments. Arapahoe House announced Friday that its last day at all of its locations will be Jan. 2. As of Friday, it will no longer accept new patients. It currently serves 5,000 people a year, all of whom will have to find a new treatment provider. (Ingold, 12/15)

The Washington Post: The Link Between Autism And Parental Age
Older men and women are more likely than young ones to have a child with autism, according to multiple studies published in the past decade. Especially regarding fathers, this effect is one of the most consistent findings in the epidemiology of autism. The link between a mother’s age and autism is more complex: Women seem to be at an increased risk both when they are much older and much younger than average, according to some studies. Nailing down why either parent’s age influences autism risk has proved difficult, however. (DeWeerdt, 12/16)

The Washington Post: Stress During Holidays Hits Many People But There Are Ways To Cop
Every holiday season, families and friends convene to share affection, kindness and experience. In the ideal holiday atmosphere, one often depicted in commercials and media, such get-togethers are events of warmth, appreciation and general happiness. If you find yourself in such a family, count yourself lucky and blessed. (Joyce, 12/17)

The Wall Street Journal: Replacement Parts: Organs On Demand
Twenty Americans die every day waiting for transplants. Now researcher Harald C. Ott thinks he’s found a way to save lives and meet the demand for replacement organs. WSJ's Jason Bellini takes a look, in this latest episode of Moving Upstream. (Bellini, 12/18)

Stat: Study: Antibiotics Could Dramatically Reduce Sexually Transmitted Infections
The spread of some sexually transmitted infections could potentially be dramatically reduced by instructing people who have had unprotected sex to take antibiotics within 24 hours after the intercourse, a new study suggests. But such a strategy, which was tested in a population of men who had frequent unprotected sex with a number of male sex partners, could spark a controversy over the use of antibiotics and the general threat of growing antibiotic resistance. (Branswell, 12/18)

The Washington Post: Cancer Clinical Trials Exclude Many Desperate Patients. Should That Change?
When 29-year-old Carly Bastiansen was diagnosed in January 2016 with advanced pancreatic cancer, doctors told her a clinical trial was her best shot at slowing the notoriously quick-killing and hard-to-treat disease. She found one that appeared promising and went through the screening process. But the trial would not accept her. “Participating in a clinical trial is really my only chance at living longer,” Bastiansen, a children’s librarian in Baltimore, said this fall as she was growing weaker. “To have had that option taken off the table was devastating.” (Swartz, 12/17)

NPR: Older Adults' Forgetfulness Tied To Faulty Brain Rhythms In Sleep
Older brains may forget more because they lose their rhythm at night. During deep sleep, older people have less coordination between two brain waves that are important to saving new memories, a team reports in the journal Neuron. "It's like a drummer that's perhaps just one beat off the rhythm," says Matt Walker, one of the paper's authors and a professor of neuroscience and psychology at the University of California, Berkeley. "The aging brain just doesn't seem to be able to synchronize its brain waves effectively." (Hamilton, 12/18)

The Washington Post: Sugar Is 'Powerfully Negative' For Your Health.
Who hasn’t been in a relationship we know is bad for us, but one we just can’t quit? For many people, it’s like that with sugar. Breaking up is hard to do. “People generally know that sugar isn’t good, but they don’t appreciate how powerfully negative it really is,” says Donald Hensrud, medical director of the Mayo Clinic Healthy Living Program. “If you look at all the things in our diet we can change, pulling away from refined or added sugar will do more good than anything else.” (Cimons, 12/16)

The Washington Post: A 13-Year-Old's Violent, Unexplained Seizures Were The Key To A Frightening Medical Mystery
Amy C. Hughes was looking forward to a rare luxury: a leisurely weekday lunch with a friend at a restaurant near her suburban Philadelphia home. Hughes, an engineer at Merck, had taken off the week after Christmas 2015 to spend time with her husband, Kevin, and their two children. The couple’s son, Rion, then 13, had come down with a cold on Christmas Day and complained of a headache. A few days later, his pediatrician suspected a sinus infection and prescribed a three-day course of antibiotics. (Boodman, 12/16)

The Star Tribune: Why Use Words? Emojis Convey Health Just Fine, Mayo Finds
Mayo researchers gave Apple watches and mobile phone apps to 300 cancer patients and asked them to report how they were feeling on a standard zero-to-10 scale but also on a new five-face emoji scale — from really smiley to a big frown. Early results for the first 115 participants suggest that emojis are just as reliable in providing doctors with meaningful health information. (Olson, 12/16)

KQED: California Issues Guidelines To Reduce Potential Harm From Cellphones
The California Department of Public Health Wednesday released a new set of guidelines concerning  the use of cellphones and radiation risk. Some studies have suggested that long-term use could be linked to brain or salivary gland cancer, lower sperm count, and headaches, the department said. (Venton and Brooks, 12/15)

San Jose Mercury News: California Activists Applaud New Cell Phone Safety Advisory
California’s new cell-phone safety guidelines for adults and children are being welcomed by the public health, environmental and First Amendment advocates who successfully sued the state to release guidelines that had been languishing since 2009. In fact, the lawsuit’s plaintiff, Joel Moskowitz, said the new advisory goes “well beyond what any federal health agency has published on this issue.’’ (Seipel and Lochner, 12/15)

San Francisco Chronicle: Radiation Typical Of Cell Phones And Wi-Fi Linked To High Rate Of Miscarriages
A study of hundreds of pregnant women in the Bay Area found that those who were more exposed to the type of radiation produced by cell phones, wireless networks and power lines — radiation that grows more and more common — were nearly three times as likely to miscarry. The Kaiser Permanente study, published last week in the journal Scientific Reports, did not show definitively what was causing the higher rate of pregnancy loss, nor did it isolate the potential impact of cell phones or other producers of electromagnetic fields, or EMFs. (Haigney, 12/17)

The Associated Press: Virginia Governor Proposes Boost In Mental Health Spending
Virginia’s governor is proposing a multi-million-dollar effort to move dozens of people out of state mental hospitals. The Daily Press reported Wednesday that Gov. Terry McAuliffe’s final budget proposes boosting funding for discharge planning by $6.9 million for 80 to 90 people who are on state hospitals’ extraordinary barriers lists. Another $4.8 million would go to community mental health services intended to help people leave the hospitals. (12/15)

New Orleans Times-Picayune: Louisiana Experiencing Some Of The Worst Flu Outbreaks In The U.S. 
The Centers for Disease Control and Prevention is reporting that Louisiana, Mississippi and South Carolina had the highest levels of flu activity in the nation for the week ending Dec. 2. ...Puerto Rico and three states experienced moderate ILI [influenza-like illness] activity (Georgia, Hawaii, and Texas), the CDC reports. The District of Columbia and six states experienced low ILI activity (Alabama, Alaska, Arkansas, Oklahoma, South Dakota and Virginia), the CDC reports. The rest experienced minimal ILI activity. (Morris, 12/15)

Georgia Health News: House Panel Urges Big Changes To Stop Decline Of Rural Health Care
The recommendations from the House Rural Development Council include expanding insurance coverage through a Medicaid “waiver’’ project and making a fundamental change in the state’s licensing laws known as Certificate of Need (CON). The report’s proposals, approved Wednesday, also include streamlined billing for health care services; requiring nursing homes to have telemedicine capability; and allowing expanded responsibility for health care providers who are not physicians. (Miller, 12/15)

The New York Times: In Bronx, Obstetricians May Find Work Inspiring, And Careers Hindered
Dr. Mark Rosing, the chairman of obstetrics and gynecology at St. Barnabas Hospital in the Bronx, is clear with every job candidate he interviews: Once they join his department, they may have trouble leaving. That’s partly because, he tells them, it is an inspiring place to work. The staff is passionate, the benefit to patients in the city’s poorest borough visible. But it’s also because they may not be able to get hired anywhere else. (Wang, 12/15)

Nashville Tennessean: Questions Swirl Over Nashville General's Fate
A month into the seven-month proposal to shutter inpatient services at Nashville General Hospital, questions are piling up about how Mayor Megan Barry's final plan will remake Nashville’s health care landscape. Closing the inpatient portion of the facility that serves many of Nashville's low-income and uninsured residents would send people to other hospitals, which in aggregate can absorb the patients. But just how the city will work with hospitals to take on new patients remains unclear. (Fletcher, 12/15)

Georgia Health News: Are State’s HIV Laws Unfair? Activists Say It’s Time For Change
A movement to change HIV laws has been under way for some time. Martinez is one of the steering members of the Georgia Coalition to End HIV Criminalization, an advocacy group. The coalition would like to see several changes to Georgia’s current code. One of those changes would be a requirement that a person be prosecuted only if there’s proof of intent to transmit HIV. (Knight, 12/16)

Milwaukee Journal Sentinel: Veterans In Milwaukee Participate In Groundbreaking Genetic Study
Scientists are hoping to use the genetic information from Brewer and 1 million other American military veterans to study diabetes, cancer and other illnesses and understand how genes affect health. ... Aside from gender, though, the program is one of the most diverse genetic collections in the world — 17% African-American, 7% Hispanic and 2% American Indian. (Jones, 12/15)

Cleveland Plain Dealer: Wait For A Social Security Disability Decision Drags On Months - And Years - For Many Ohioans
For tens of thousands of Ohioans applying for Social Security disability benefits, an underfunded and inadequately staffed federal system means months, and even years, of waiting to get in front of a judge and receive a decision on a claim. More than 1 million people across the country are waiting on average more than 600 days--about 19 months-- for these hearings. (Zeltner, 12/17)

Cleveland Plain Dealer: Summa Health Enters Agreement With Dayton Home Health Care Company
Summa Health has entered into a joint venture with Alternate Solutions Health Care Network of Dayton to increase efficiency and streamline patient care outside of the hospital. The move allows Akron-based Summa Health to reorganize its Summa Health at Home and Summa Hospice departments. (Washington, 12/15)

Nashville Tennessean: Future Uncertain For Nashville General CEO Amid Mayor's Plans To End Inpatient Care
Three years ago, Joseph Webb was hired to stabilize Nashville General, the city’s safety net hospital for uninsured and indigent patients that has long struggled to pay its bills. He began with ambitious transformation plans: upgrade the emergency room; remodel the maternity ward; hire new administrators; and create a healthcare model intended to cut costs by focusing on managing diabetes, hypertension and other chronic illnesses affecting the north Nashville community’s residents who use the hospital the most. Today, Webb’s future designs for the 125-year-old hospital are in question after Mayor Megan Barry announced plans to end all inpatient admissions, making the facility an outpatient-only clinic. Webb wasn’t consulted about Barry's proposal, he said. (Wadhwani, 12/17)

Los Angeles Times: California Officials Say Housing Next To Freeways Is A Health Risk — But They Fund It Anyway
It’s the type of project Los Angeles desperately needs in a housing crisis: low-cost apartments for seniors, all of them veterans, many of them homeless. There’s just one downside. Wedged next to an offramp, the four-story building will stand 200 feet from the 5 Freeway. State officials have for years warned against building homes within 500 feet of freeways, where people suffer higher rates of asthma, heart disease, cancer and other health problems linked to car and truck pollution. Yet they’re helping build the 96-unit complex, providing $11.1 million in climate change funds from California’s cap-and-trade program. (Barboza and Zahniser, 12/17)

Los Angeles Times: Santa Ana Winds Help Clear The Smoke From The Thomas Fire, But Health Risks Remain
Raging Santa Ana winds helped clear smoke from the massive Thomas fire out of Ventura County on Sunday, but health officials cautioned residents that "non-smoky" conditions don't mean the air is safe to breathe. The winds "will cause dust particulate to stir up, resulting in air quality that is at times unhealthy," according to an advisory from the Ventura County Air Pollution Control District. (Poston, 12/17)

Columbus Dispatch: Ohio Ranks 30th In Protecting Kids From Tobacco Use In National Study
Ohio ranks 30th among the states when it comes to money budgeted for programs aimed at preventing tobacco use and helping users quit, according to a new report from several advocacy groups. It shows that for fiscal year 2018, the state has budgeted $12.5 million for tobacco prevention and cessation programs. (Viviano, 12/17)

Kansas City Star: Healthy Transitions To Give Former Inmates Returning To KC 90-Day Prescription Supplies
People coming back to Kansas City after being discharged from prison will get a 90-day supply of prescription medications instead of a 30-day supply under a grant-funded program announced Friday. The program is called “Healthy Transitions” and it started in St. Louis last year. (Marso, 12/15)

Columbus Dispatch: Area's Air Quality Continues To Improve
Today, after two decades of air-quality improvements and education, central Ohio’s air is in good shape, an 11-page report released last week shows. ...MORPC produced the report, which covered air quality from November 2016 through October 2017 and focused only on particle pollution — pollutants from diesel trucks, wood-burning fireplaces, buses and power plants — and ground-level ozone pollution, the main ingredient in smog. (Perry, 12/17)  

The New York Times: Trump, The C.D.C. And The Peek-A-Boo Doctrine
In case you were keeping score at home: In Donald Trump’s America, you’re allowed to refuse to make me a cake, because pastry is free speech. But if you’re a researcher studying medicine at the leading national public health institute of the United States, you can’t say “science-based” in a budget request. Because science, apparently, is a less protected form of communication than buttercream frosting. (Jennifer Finney Boylan, 12/18)

Los Angeles Times: With Apologies To George Carlin, Here Are Seven Words They Can't Say At The CDC
Comedian George Carlin famously crafted a routine around “Seven Words You Can Never Say on Television,” a piece so far over the line for a newspaper that you’re just going to have to look it up yourselves. But the Trump administration has gone one better and has listed seven words and phrases the Centers for Disease Control and Prevention is now banned from using in budget documents. (Scott Martelle, 12/16)

USA Today: When Hospitals Merge, You Pay The Bill
Health insurers are not the most beloved companies. They deny claims, bury people in paperwork, and generally make life more difficult. But a good case can be made that America’s health care woes lie more with its providers than its insurers. Some communities are served by a single hospital or group of specialists. Some patients are reliant on a single drug. That gives these businesses enormous leverage to hike prices. (12/17)

The Columbus Dispatch: CVS Merger May Change Health Care
American consumers aren’t the only ones struggling with higher health-care costs. CVS Health’s proposed $69 billion purchase of health insurer Aetna is driven in part by the companies’ efforts to get control over more of the costs they face, and to make their operations more efficient. The question for regulators, though, is whether the combination results in a company that uses its clout to help consumers or squeeze more dollars out of them. (12/17)

Bloomberg: The Individual Mandate Would Be A Big Loss
In its failure to repeal Obamacare this fall, Congress should have learned a simple lesson: Americans want the government to see that everyone has health insurance. Instead, the Republican majority tirelessly insists on moving in the opposite direction. Thus, their shambles of a tax bill repeals Obamacare's requirement that everyone have health insurance. (12/15)

USA Today: We're Reversing Opioid Overdoses, But We'd Rather Help People Change
I’ve worked at Preble Street in Portland, Maine, for 26 years and never thought I’d see the day when our social workers are reversing opioid overdoses on a regular basis. In my first 22 years here, we had no overdoses. Zero. Now every eight days we find someone on a bathroom floor, lips blue, not breathing. (Mark R. Swann, 12/16)

Los Angeles Times: The Terrible Toll Of The Opioid Crisis Is Even Worse For Women
The opioid epidemic’s disproportionate impact on women is the latest, and most destructive, symptom of wider gender-based disparities that leave millions of American women in worse health than men. Data show that deaths among women from opioid overdose have increased at a much faster rate than for men, 400% compared with 265%. And states where doctors write the most opioid prescriptions per 100 residents are also the states with the widest overall disparities between men’s and women’s health. (Ken Sagynbekov, 12/18)

Sacramento Bee: Universal Health Care Is Doable For Far Less Cost – But At A Political Price
Making California the first state to guarantee health care for every resident has become a touchstone issue – and a divisive one – for the state’s dominant Democrats. ...It’s not necessary for the state to seize control of California’s entire medical care system if the real bottom line goal is covering those undocumented immigrants. It could be done for about $10 billion a year, which is a lot less than $100 billion. However, advocates would have to publicly acknowledge that covering them is what this conflict is all about and take whatever political heat it generates. (Dan Walters, 12/17)    

Detroit Free Press: The Kill Switch Built In To Michigan's Medicaid Expansion Law
The Patient Protection and Affordable Care Act (ACA) has polarized policymakers since its initial stirrings in the Obama administration’s first term. In Michigan, state lawmakers embraced one of its most significant elements – the expansion of Medicaid we now know as Healthy Michigan – but inserted language that makes Healthy Michigan’s future contingent on an unorthodox cost-vs-savings mechanism that now threatens its survival. (Eric Lupher,12/17)

Chicago Tribune: Illinois' Home Health Care Hustle
For those who are ailing but hope to stay out of nursing homes or hospitals — and who wouldn’t? — there’s an increasingly popular alternative: home health care providers. These are doctors, nurses and other medical staffers who visit patients at home, with the goal of treating chronic conditions and keeping people healthy enough to avoid costly long-term stays in more intensive facilities. That saves patients, and the health care system, money. (12/15)

Kansas City Star: Missouri, Kansas Should Spend Tobacco Settlement Money On Helping Smokers Kick The Habit
Missouri’s sad history of ignoring the dangers of tobacco use was reinforced this week when a coalition of health groups released a new study of state spending on the problem. ...Missouri will spend $48,500 on smoking cessation efforts this fiscal year, the report says. That’s 49th out of 50 states and the District of Columbia. (12/17)