First Edition: October 31, 2018

Kaiser Health News: People With Disabilities Face Health Care Hurdles With Trump Rollback Of Accommodation Rules
Going to the doctor’s office can feel so routine. You sit in the waiting room, fill out the paperwork, get measured and hop onto the exam table. But medical appointments for patients with disabilities require navigating a tricky obstacle course, full of impediments that leave them feeling awkward and could result in substandard care. (Bluth, 10/31)

Kaiser Health News: In Swing Districts, Republicans May Pay For Having Tried To Reverse The Health Law
Not long ago many voters knew little about Tom MacArthur. A low-key moderate Republican congressman in a district that twice went for Barack Obama, he burnished his reputation as the guy who worked with Democrats to help rebuild in the years after Hurricane Sandy. Now, as he wages a bitter fight for re-election to a seat he won by 20 percentage points just two years ago, even some of his supporters have turned virulently against him. The reason? His new reputation as the turncoat whose legislation almost repealed the Affordable Care Act. (Huetteman, 10/31)

California Healthline: From A Negative To A Positive: Dems Use Health Care To Hammer GOP In Ads
In 2014, Republican congressman Jeff Denham was all about axing the Affordable Care Act. He vowed in a campaign ad that aired before that year’s midterm election to “repeal and replace Obamacare so families aren’t forced to pay higher premiums for reduced care.” Four years later, Denham isn’t talking about the ACA. But his Democratic opponent is — quite a bit. (Ibarra, 10/31)

Politico: Obamacare Enrollment Opens Facing Pressure From New Trump Attacks
No deeply conservative state has done more than Idaho to make Obamacare work. But no other state is doing more to untangle itself from the health care law. On the eve of the 2019 open enrollment season, at least three insurers are selling plans in every corner of the sprawling state. It’s got one of the best enrollment rates in the country. The outgoing Republican governor is supporting a ballot initiative to expand Medicaid, which could improve the health of the Obamacare market. But Idaho officials are backing a radical plan to offer skimpier coverage options, sounding the alarm over their insurance marketplace. (Demko, 10/31)

The Washington Post: Republican Governor Of Idaho Backs Ballot Measure Expanding Medicaid
The Republican governor of Idaho gave advocates of expanding Medicaid a significant lift Tuesday, coming out in favor of the Obamacare policy just a week before voters in the state decide on its fate. The question of whether to grow the low-income health-care program to cover more people is on ballots in three deep-red states — Idaho, Utah and Nebraska — where conservative legislatures didn’t choose expansion. Outgoing Gov. C.L. “Butch” Otter, a conservative with an independent streak, announced his support and cut an ad for Idahoans for Healthcare, an organization advocating for expansion. (Itkowitz, 10/30)

Politico: Red State Governor Races Could Bring Medicaid Expansion To Millions
Georgia’s neck-and-neck governor’s race is one of at least half a dozen where a Democratic supporter of Medicaid expansion has a fighting chance of replacing a Republican who opposes it. Competitive races in Florida, Wisconsin, Kansas, Oklahoma and South Dakota could also flip the status of those holdout states that have so far refused Obamacare's Medicaid expansion — though Republican legislatures are not likely to make it easy. (Ollstein, 10/29)

The Washington Post: Why Are Red States About To Adopt Obamacare?
The battle to expand Medicaid in Utah is being waged from a small, three-desk office in a downtown high-rise, by three women in their 20s and 50 or so volunteers. If they succeed and Utah's Proposition 3 passes, one of the reddest states will embrace the Affordable Care Act. Last week, the “Yes on 3" team was signing off on its final handouts and informational fliers, their measure cruising close to 60 percent in the polls. An electorate that's expected to elect Republican Mitt Romney to the Senate is also, increasingly, expected to approve a small tax to fund health-care coverage. (Weigel, 10/30)

The Associated Press: Family History Leads Kentucky Candidates To Different Places
Now [Andy] Barr and [Amy] McGrath are running for Congress against each other in Kentucky in one of the most competitive and expensive races in the country. But their families' struggles with insurance companies has led them to different places. Whoever wins could help determine which party controls Congress for the final two years of President Donald Trump's term and shape health policy for millions of Americans. "It's the No. 1 issue," said McGrath, a Democrat and retired Marine fighter pilot. "People are worried." (Beam, 10/30)

The Associated Press: Indiana Senate Candidates Spar Over Abortion Stances
Sen. Joe Donnelly, Indiana’s lone statewide Democrat, was propelled into office six years ago after his opponent’s incendiary comments about abortion and rape during a disastrous debate appearance tanked his candidacy. On a similar stage Tuesday night, Donnelly’s Republican challenger Mike Braun appeared determined to avoid the same fate, despite a full-throated attack from the Democrat, who tried to force the issue. (Slodysko, 10/31)

The Associated Press: In Tight Race, Ohio Governor Rivals Hedging Bets On Trump
Locked in a tight race for governor in the perennial swing state of Ohio, Republican Mike DeWine and Democrat Richard Cordray are using the final stretch to hedge their bets on Donald Trump. ... Cordray, the Obama-era consumer protection chief, has continually hit DeWine for opposing insurance protections for those with pre-existing conditions, a top issue this year among voters. He points to DeWine's decision to join Republicans' lawsuit seeking to do away with the federal Affordable Care Act that includes such protections. (Carr Smyth, 10/30)

The Washington Post: Florida’s Senate Race Was Rick Scott’s To Lose, But He Is Haunted By His Environmental Record
In a race that many thought was [Gov. Rick] Scott’s to lose, polls show his opponent, [Sen. Bill] Nelson could retain his seat. The governor is being taunted as “Red Tide Rick,” and some Floridians have made him the butt of jokes on social media, contrasting the state’s beautiful beaches with the dead fish littering its shores. Scott is haunted by a perception among many voters, conservative and liberal, that his environmental policies made a natural disaster worse. In his first term, the state cut hundreds of millions of dollars from agencies that manage fresh water, laid off hundreds of workers in the environmental protection department, squashed a deal to buy land from sugar farms that pollute water and killed an attempt to increase inspections of septic tanks that soil water and contribute to the algae problem. (Fears and Rozsa, 10/30)

Stat: In New Document, Trump Officials Labor To Defend His Drug Pricing Proposal
The Trump administration is ready to defend its sweeping new drug pricing proposals. In a new Q&A, obtained by STAT, its authors parry several key criticisms — some already aired, some expected — from drug makers and other groups. The document, which is expected to be published later Tuesday according to a senior administration official, represents a quick response from the administration, which only unveiled the policy in an address on Thursday. (Florko, 10/30)

The New York Times: Trump Administration To Revise Birth Control Exemptions In Hopes Of Saving Them
Having lost in two federal courts and fearing more setbacks, the Trump administration is revising rules that allow employers to deny women insurance coverage for contraceptives based on religious or moral objections. Administration officials hope that the changes, the details of which remain unclear, will overcome the judges’ objections without fundamentally altering the purpose or the effects of the rules. ... It is unclear whether the administration intends to issue the final rules before the midterm elections next week. Opinion polls suggest that the birth control benefit, mandated by the Obama administration under the Affordable Care Act, is popular. (Pear, 10/30)

Los Angeles Times: California Spent $4 Billion On Medi-Cal For People Who May Not Have Been Eligible, Audit Finds
California spent $4 billion on Medi-Cal coverage between 2014 and 2017 for people who may not have been eligible for the government-funded health plan, according to a state audit released Tuesday. Medi-Cal provides health coverage to 13.1 million Californians, approximately one-third of the state’s population. To qualify, a single adult must make less than $16,754 annually. County workers typically determine whether someone is eligible for health coverage under Medi-Cal, then send that information to the state. But the records don’t always match up. (Karlamangla, 10/30)

The New York Times: In Echo Of Flint, Mich., Water Crisis Now Hits Newark
For nearly a year and a half, top officials in Newark denied that their water system had a widespread lead problem, despite ample evidence that the city was facing a public health crisis that had echoes of the one in Flint, Mich. ... But this month, facing results from a new study, the officials abruptly changed course, beginning an urgent giveaway of 40,000 water filters across the city of 285,000 people, targeting tens of thousands of residences. (Leyden, 10/30)

The Hill: Pfizer CEO: 'Business As Normal' On Drug Prices Next Year Despite Trump Pressure
Pfizer CEO Ian Read said the company will return to “business as normal” on its drug pricing in January, after agreeing to hold off on price increases earlier this year following pressure from President Trump. Read noted on an earnings call that the agreement to hold off on price increases would end at the end of the year, at which point the company will return to pricing based on the market. “We price to the marketplace, we price competitively,” Read said. (Sullivan, 10/30)

The Associated Press: Pfizer's 3Q Profit, Up Due To Tax Cut, Beats Expectations
Pfizer posted a 45 percent jump in third-quarter profit, as the biggest U.S.-based drugmaker benefited from sharply lower taxes due to this year’s federal tax cut. The maker of Viagra and nerve pain treatment Lyrica on Tuesday reported net income of $4.11 billion, or 69 cents per share. (Johnson, 10/30)

The Associated Press: High Hopes & Hype For Experimental Depression Drug Ketamine
It was launched decades ago as an anesthetic for animals and people, became a potent battlefield pain reliever in Vietnam and morphed into the trippy club drug Special K. Now the chameleon drug ketamine is finding new life as an unapproved treatment for depression and suicidal behavior. Clinics have opened around the United States promising instant relief with their “unique” doses of ketamine in IVs, sprays or pills. And desperate patients are shelling out thousands of dollars for treatment often not covered by health insurance, with scant evidence on long-term benefits and risks. (Tanner, 10/31)

Stat: Medical Marijuana Push Washes Over One Of The Nation's Most Conservative States
At first, the debate over medical marijuana in Utah played out as you might expect: The Republican governor declared the issue shouldn’t be on the ballot. Once it was, the state medical association steered the opposition. By August, a senior official in the Church of Jesus Christ of Latter-day Saints was warning that residents of some states that had legalized marijuana were seeing serious “health and safety consequences.” But, then, something curious happened: Key opponents negotiated an agreement with the measure’s backers and other state leaders. Now, no matter what happens on Election Day, state lawmakers will be called into a special legislative session and plan to enact an alternate medical marijuana program. (Joseph, 10/31)

NPR: When Adolescents Give Up Pot, Their Cognition Quickly Improves
Marijuana, it seems, is not a performance-enhancing drug. That is, at least, not among young people, and not when the activity is learning. A study published Tuesday in the Journal of Clinical Psychiatry finds that when adolescents stop using marijuana – even for just one week – their verbal learning and memory improves. The study contributes to growing evidence that marijuana use in adolescents is associated with reduced neurocognitive functioning. (Cohen, 10/30)

Stateline: Long Stigmatized, Methadone Clinics Multiply In Some States 
While Congress and the Trump administration were promoting greater use of the addiction medication buprenorphine to quell the opioid epidemic, a handful of states were licensing new methadone clinics in dozens of the nation’s hardest-hit communities. In fact, the methadone treatment industry, which began in the late 1960s, grew more in the past four years than it has in the past two decades, said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence Inc., which represents methadone treatment providers. (Vestal, 10/31)

San Diego Union-Tribune: Two Years After It Started, San Diego Declares End To Deadly Hepatitis A Outbreak
Two years in, San Diego’s hepatitis A outbreak is finally over. Dr. Wilma Wooten, the county’s public health officer, said Monday that enough time has now passed to formally declare a curtain call for the contagion that killed 20, sickened nearly 600 and spurred a complete re-think of how the region handles homelessness.“ Last Thursday, it was officially 100 days since the most-recent case, and, for hepatitis A, that’s the threshold we use that allows us to say it no longer meets the definition of an outbreak,” Wooten said. (Sisson, 10/30)

The Associated Press: San Diego Hepatitis A Outbreak Ends After 2 Years
Local health authorities detected the infectious disease in February 2017. Investigators determined the first likely case occurred during the week of Nov. 22, 2016. The outbreak led to a focus on unsanitary living conditions among San Diego’s homeless population. City and county governments promoted vaccination, washed streets, installed portable toilets and hand-washing stations, and put up temporary shelters capable of housing 700 people at a time. (10/30)

The New York Times: A Novel Solution For The Homeless: House Them In Backyards
Now, as part of an unusual arrangement, Ms. Chavarria may soon be welcoming some of those homeless people into her backyard. Ms. Chavarria is one of several Los Angeles residents who are building additions to their homes that would be used by people emerging from homelessness. Faced with a major housing crisis, Los Angeles is trying out an idea that some hope is so wild that it just might work: helping homeowners build small homes in their backyards and rent them to people who have spent months living in their cars, in shelters or on the streets. (Medina, 10/29)

The Associated Press: Why Is It So Hard To Text 911?
People can livestream their every move on Facebook and chatter endlessly in group chats. But in most parts of the U.S., they still can’t reach 911 by texting — an especially important service during mass shootings and other catastrophes when a phone call could place someone in danger. Although text-to-911 service is slowly expanding, the emphasis there is on “slow.” Limited funds, piecemeal adoption and outdated call-center technology have all helped stymie growth. (Anderson, 10/31)

The Washington Post: Weather Data Show Cold Temperatures Raise Risk Of Heart Attacks, Report Suggests
Heart attacks occur more often when temperatures plummet, a large new study suggests. Based on 16 years of medical and weather data, researchers linked an increased incidence of heart attacks to lower air temperatures, lower atmospheric pressure, higher wind velocity and shorter durations of sunshine, according to the report in JAMA Cardiology. (Carroll, 10/30)

The New York Times: How Emotions Can Affect The Heart
A century ago, the scientist Karl Pearson was studying cemetery headstones when he noticed something peculiar: Husbands and wives often died within a year of one another. Though not widely appreciated at the time, studies now show that stress and despair can significantly influence health, especially that of the heart. One of the most striking examples is a condition known as Takotsubo cardiomyopathy, or broken-heart syndrome, in which the death of a spouse, financial worries or some other emotional event severely weakens the heart, causing symptoms that mimic a heart attack. (O'Connor, 10/30)

The Associated Press: Gum, Bottled Water, Pizza Bagels Want To Be Called 'Healthy'
The U.S. Food and Drug Administration is revamping its definition of healthy to reflect our changing understanding of nutrition science. The push is fueling debate about eating habits and what the new standard should say. Frozen food-makers are seeking special rules for “mini meals,” citing little pizza bagels and dumplings as examples that might qualify. Chewing gum and bottled water companies say they should no longer be shut out from using the term just because their products don’t provide nutrients. Advocacy groups and health professionals are also weighing in, raising concerns about ingredients like sugar. (Choi, 10/30)

The Associated Press: US Steps Up Scrutiny Of Funds For Asbestos Exposure Victims
The Trump administration has stepped up scrutiny of asbestos trust funds, concerned that the pots of money intended to help people exposed to the hazardous substance are being depleted by fraudulent claims, harming victims, businesses and the government. The Justice Department in the last two months has demanded trust documents as part of a civil investigation, opposed the creation of another trust it said lacked sufficient safeguards, and argued against the appointment of a lawyer it said was too conflicted to represent victims. (Tucker, 10/31)