First Edition: November 10, 2017

Kaiser Health News: Obamacare Shopping Is Trickier Than Ever. Here’s A Cheat Sheet.
Health care is complicated. Shopping for an individual health plan just got even more so, with President Donald Trump’s decision last month to block $7 billion in Affordable Care Act subsidies. Known as cost-sharing reduction payments (CSRs), these federal funds had helped insurers offset the costs of the discounts they are required to offer to some lower-earning customers to help them pay for deductibles and copays. (Hancock, 11/10)

Kaiser Health News: Pressure Builds To Cut Medicare Patients In On Prescription Deals
Medicare enrollees, who have watched their out-of-pocket spending on prescription drugs climb in recent years, might be in for a break. Federal officials are exploring how beneficiaries could get a share of certain behind-the-scenes fees and discounts negotiated by insurers and pharmacy benefit managers, or PBMs, who together administer Medicare’s Part D drug program. Supporters say this could help enrollees by reducing the price tag of their prescription drugs and slow their approach to the coverage gap in the Part D program. (Tribble, 11/10)

Kaiser Health News: Experts Explain Why Lead Found In Fidget Spinners Is No Idle Threat
That fidget spinner your kid can’t put down? It turns out it may be putting children at risk for lead exposure. That’s according to a report out Thursday from a consumer advocacy group, the U.S. Public Interest Research Group Education Fund. The organization tested the toys — which represent the latest iteration of a long line of skill-based amusements that include yo-yos and spinning tops — for lead. (Luthra, 11/10)

California Healthline: Teaching Teens The Perils Of Pot As Marketplace Grows
After Yarly Raygoza attended the drug prevention program at the Boys & Girls Club here last year, she used what she learned to talk a few friends out of using marijuana. The 14-year-old took the class again this year but worries that counseling her friends will become more difficult. (Gorman, 11/10)

The New York Times: Pace Of Sign-Ups Under Affordable Care Act Blows Past Prior Years
More than 600,000 people signed up last week for health insurance under the Affordable Care Act, significantly beating the pace of prior years as consumers defied President Trump’s assertion that the marketplace was collapsing. (Pear, 11/9)

The Associated Press: Despite Trump's Scorn, Early 'Obamacare' Sign-Ups Top 600k
With only four days of data, experts said it's hard to discern a trend. But definitely the Affordable Care Act doesn't seem to be collapsing. If anything sign-ups for 2018 are on track with previous years. Figures from the Centers for Medicare and Medicaid Services showed that 601,462 people signed up Nov. 1-4 in the 39 states served by the federal HealthCare.gov website. Of those consumers, about 77 percent were renewing their coverage, and about 23 percent were new customers, a split that mirrors previous years. (Alonso-Zaldivar, 11/9)

USA Today: Feds' Obamacare Site Does Biggest Business Yet, While About Half Of People Can Pay $0
Consumers are flocking to the Affordable Care Act (ACA) exchanges to buy insurance, setting a record in the first few days of open enrollment, federal numbers out Thursday show. Total daily sign-ups were up 79% for the first few days Healthcare.gov was open, compared to the equivalent period last year. Open enrollment started Nov. 1 and runs through Dec. 15. (O'Donnell, 11/9)

The Washington Post: More Than 600,000 Consumers Select ACA Plans At Start Of Enrollment, CMS Says
While CMS officials did not provide a direct comparison with any of the four previous enrollment periods, administration officials said that more than 200,000 consumers selected plans on the first day, more than double the number last year. The officials spoke about the first-day figure on the condition of anonymity because they were not authorized to disclose it. The overall total for the initial four days compares with just over 1 million Americans who signed up on the federal exchange during the first 12 days of open enrollment in 2016. (Eilperin and Goldstein, 11/9)

The Wall Street Journal: Insurers See Jump in Sign-Ups for Affordable Care Act
Insurers suggested the early influx was partly sparked by the spotlight on the ACA amid Republican efforts to repeal or change it. “You couldn’t have paid for that kind of advertising,” said Steve Ringel, president of the Ohio market for CareSource, which sells ACA plans in four states. “It doesn’t matter what the story line is, it’s drawing attention to the marketplace.” (Wilde Mathews, 11/9)

Los Angeles Times: Signups For Obamacare Insurance Coverage Surge, Despite Trump Administration Attacks
The pace of signups cheered supporters of the healthcare law, many of whom feared that President Trump’s criticism of the law, coupled with major cuts in federal funding for advertising and outreach efforts, would depress enrollment. At six weeks, the enrollment period is also only half as long this year, running until Dec. 15. (Levey, 11/9)

Reuters: Amid Trump Cuts, Uber Kicks Off Campaign To Enroll Drivers In Obamacare
Uber Technologies Inc and some smaller technology companies are launching campaigns to publicize Obamacare enrollment among their contract workers after the Trump administration slashed government marketing for the health program by 90 percent. Freelance and contract workers are an important part of the workforce for many Silicon Valley companies, including drivers at Uber and rival Lyft Inc, and technology companies also have been among the most vocal in confronting Trump administration policies - particularly immigration - that they perceive as hurting their workforce. (Rodriguez, 11/9)

The Wall Street Journal: Elections Results Suggest GOP Lost Edge on Health Care
The Republicans are losing their seven-year political advantage on health care, this week’s election results suggest, a shift that affects everything from candidates’ campaign messages to lawmakers’ policy choices to the level of enrollment for the Affordable Care Act. Republicans have won national and state elections for seven years by attacking the ACA. But this week, Virginia voters cited health care in exit polls as a major reason for delivering the governorship to Democrat Ralph Northam and Maine residents voted decisively to expand Medicaid. (Armour, 11/9)

The Wall Street Journal: Trump Official Says Medicaid Expansion Not Sustainable Without Changes
Medicaid, the federal-state health-insurance program, was never designed for low-income but able-bodied adults and is unsustainable without major changes, a top Trump administration health official said Thursday. “One of the major fundamental flaws in the Affordable Care Act was putting in able-bodied adults into a program that was designed for disabled people,” said Seema Verma, the Centers for Medicare and Medicaid Services administrator, who oversees Medicaid as well as implementation of the ACA, popularly known as Obamacare. “It stretched the safety net and it jeopardizes care for the individuals that the program was originally intended for.” (Radnofsky, 11/9)

The Associated Press: Virginia's Electoral Changes Boost Medicaid Expansion Odds
This week's groundswell of political change in Virginia has improved the odds of Medicaid expansion becoming law there. The long-stalled liberal priority gained new life after Democrats nearly wiped out Republicans' overwhelming majority in the House of Delegates. For years Medicaid expansion, a key part of former President Barack Obama's health care law, has been a non-starter in the Old Dominion. (11/9)

CQ: West Virginia Could Close Children's Health Program
West Virginia could close its Children’s Health Insurance Program as early as February if Congress does not act soon to renew federal funds for the program. The state’s CHIP board of directors voted Wednesday to close enrollment on Feb. 28, 2018, if funds are not provided before then. If needed, notifications with additional information will be sent to families and providers in early January, but benefits would continue as usual until the end of February. (Raman, 11/9)

The Hill: Initial Senate Tax Bill Does Not Repeal ObamaCare Mandate
The tax-reform bill that Senate Republicans are releasing Thursday does not repeal ObamaCare's individual insurance mandate, though the provision could be added down the line, GOP senators said. Senators leaving a briefing about the legislation said repealing the mandate is not in the initial text of the legislation, but cautioned that the issue is still under discussion. (Sullivan, 11/9)

The Hill: Senate Keeps Medical Expenses Deduction In Break With House
The Senate GOP tax bill will retain a key deduction for qualified medical expenses that was excluded from the House version, according to a Republican senator on the Senate Finance Committee. Sen. Bill Cassidy (R-La.) told reporters that the deduction will remain in the initial version of legislation the Senate is set to unveil today. (Weixel, 11/9)

The New York Times: With Obamacare Fight Lost, Conservatives Turn To Veterans’ Care
With their hopes of repealing the Affordable Care Act dashed for now, deep-pocketed conservative activists have turned their attention to a smaller but still potent new effort: allowing private health care to compete with Veterans Affairs hospitals for the patronage of the nation’s veterans. Concerned Veterans for America, a little-known advocacy group backed by the conservative billionaire industrialists Charles G. and David H. Koch, is pressing Republicans to make it easier for veterans to see private doctors at government expense. The group’s voice had been lonely until recently, when a raft of Koch-connected advocacy organizations and other conservative allies joined the effort. (Fandos, 11/9)

The Washington Post: Controversy Erupts Over Plan To Let Pentagon Authorize Unapproved Drugs For Battlefield Use
Should the Pentagon be allowed to authorize the use of unapproved drugs and medical devices on an emergency basis for combat soldiers? That question has sparked a furious battle this week among some of Washington's biggest power players, with the Defense Department and its congressional advocates on one side and the Food and Drug Administration and the health committees on the other. (McGinley, 11/9)

The Associated Press Fact Check: Trump Falls Short On Promises To Veterans
President Donald Trump is pointing to big achievements in advance of Veterans Day on his campaign promise to fix the Department of Veterans Affairs, just 10 months into his administration. But several of the initiatives are far from bold or as immediate as claimed. In a two-page fact sheet this week, the White House declares that "tremendous progress has been made in a short period of time." (11/10)

The Associated Press: DEA Cracking Down On Fake Fentanyl Traffickers
The U.S. Drug Enforcement Administration wants to make it easier for federal prosecutors to go after people who peddle illicit versions of the deadly opioid fentanyl that are fueling the nation’s drug abuse crisis. The agency said Thursday it intends to classify drugs that are chemically similar to fentanyl as illegal controlled substances, letting prosecutors avoid the hurdles they often face in bringing charges in such cases. (Gurman, 11/9)

The Hill: Feds Move To Crack Down On Opioid Trafficking
The Drug Enforcement Administration (DEA) intends to temporarily schedule all fentanyl-related substances on an emergency basis, the Justice Department announced Thursday. That classification will let prosecutors charge people trafficking substances similar to fentanyl with the same charges as fentanyl, which is up to 50 times more potent than heroin. (Roubein, 11/9)

Stat: The White House Punted To Congress On Opioids Funding. Congress Doesn’t Have A Plan
The Trump administration declared the opioid crisis a public health emergency two weeks ago. Six days later, a White House-appointed panel proposed a national drug court system, a dramatic increase in addiction treatment beds, and what President Trump called “really tough, really big, really great advertising” to warn of the perils of drug use. Neither the White House nor Congress has suggested how to pay for those measures. (Facher and Mershon, 11/9)

USA Today: It's Far More Than Overdoses: IV Opioid Users' Diseases Overwhelm Hospitals
Sarah Bolin's heart infection got so bad last month, the longtime heroin user was passing out by the time she got to Cincinnati's Christ Hospital. She was relieved the infection — called endocarditis — didn't require her to get a pacemaker or replacement heart valve like so many other "girls on the streets." It did require surgery to remove lesions from infected valves, a 10-day hospital stay and weeks of IV antibiotics and nursing home care. (O'Donnell and DeMio, 11/8)

Politico: Hospitals And PhRMA Face Off Over Drug Prices And 340B Program
President Donald Trump promised to crack down on drug companies “getting away with murder,” but it turns out that it’s hospitals taking it on the chin over the cost of medicine. There’s a big, expensive fight brewing between the two powerful lobbies around a somewhat obscure drug discount program called 340B. (Pittman, 11/9)

Stat: Vermont Probes Whether Drug Makers Violated Its Gift Ban
The Vermont attorney general is investigating the extent to which drug and device makers may have violated state law by giving gifts or payments for other items to health care providers, according to a source familiar with the matter. The state banned industry gift giving to health care providers eight years ago over concerns such payments may influence medical practice, a contentious issue that later led the federal government to create a database to which drug and device makers must report any payments to physicians and teaching hospitals. (Silverman, 11/9)

Stat: Sage Therapeutics Drug Reduces Postpartum Depression In Two Late-Stage Clinical Trials
Sage Therapeutics (SAGE) reported positive results Thursday from two late-stage clinical trials of its lead drug brexanolone in women suffering from postpartum depression. Both brexanolone trials achieved their primary endpoints, but the results are not without question marks. An infusion of brexanolone reduced depressive symptoms compared to placebo after 60 hours of treatment in women with both severe and moderate postpartum depression. However, the antidepressive effect of brexanolone was modest and didn’t last long in women with moderate postpartum depression. (Feuerstein, 11/9)

The New York Times: Violence Against Transgender People Is On The Rise, Advocates Say
On Oct. 21, a body was found off a county road west of Corpus Christi, Tex., with bullet wounds to the chest, abdomen and shoulders. The victim was Stephanie Montez, a transgender woman. But because the police misidentified her as a man, it was not until last week that Ms. Montez, 47, was known to be among the more than two dozen transgender Americans killed this year. (Astor, 11/9)

Reuters: 1 In 5 U.S. Adults Used Tobacco In 2015: Government Study
One in five adults in the United States was using some form of tobacco in 2015, according to national survey data released on Thursday by the U.S. Centers for Disease Control and Prevention. The report, conducted in conjunction with the Food and Drug Administration, found 21 percent of U.S. adults, or 49 million people, were tobacco users. Of them, about 87 percent reported smoking cigarettes, cigars or some form of pipe. (Steenhuysen, 11/9)

Los Angeles Times: Fidget Spinners Sold At Target Contain Dangerous Levels Of Lead, Advocacy Group Says
Fidget spinners — the multipronged, whirling gadgets that became so popular this year that some schools banned them as a distraction — have been marketed as playful diversions meant to help people calm down and focus. But now a consumer advocacy group says that two types of fidget spinners being sold at Target could be dangerous. The items — Fidget Wild Premium Spinner Brass and Fidget Wild Premium Spinner Metal — were found to contain as much as 330 times the federal legal limit for lead in children's products, according to lab tests conducted for the U.S. Public Interest Research Group, or U.S. PIRG, Education Fund. (Bhattarai, 11/9)

NPR: Algae Toxins In Drinking Water Sickened People In 2 Outbreaks
The city of Toledo and nearby communities have earned the dubious distinction of being the first to report outbreaks of human illness due to algae toxins in municipal drinking water, according to a report published Thursday by the Centers for Disease Control and Prevention. Both areas take their drinking water from Lake Erie. Blue-green algae are common there and in many other in freshwater lakes, were they can multiply in the heat of summer and produce toxins, according to the Environmental Protection Agency. (Jochem, 11/9)

Los Angeles Times: San Diego's Big Hospitals Plan A Push Into Medical Tourism
Planning a visit to San Diego? Hit the beaches. Check. Spend a day at the zoo or a theme park. Check. Sample craft beer. Check. Book a stay at a local hospital for cutting-edge cardiac or cancer treatment? For decades, San Diego has traded on its reputation for year-round sun, a captivating coastline and family-friendly attractions to woo tourists. But enticing visitors with the promise of lifesaving treatments by acclaimed physicians and hospitals has never been offered up as a selling point. Until now. (Weisberg, 11/9)

The Wall Street Journal: Outcome Health’s Investors Receive Subpoenas From Justice Department
Investors in Outcome Health on Thursday said in a court filing that they were receiving subpoenas from the Justice Department as part of a fraud investigation into the prominent Chicago advertising startup. The filing, submitted to the New York State Supreme Court in New York County, said Goldman Sachs Group Inc. and other investors, which are suing Outcome for allegedly defrauding them, were receiving the subpoenas on Thursday. The investors also said “additional inquiries” were expected from the Securities and Exchange Commission, without elaborating. (Winkler, 11/9)

The Associated Press: Feds Backing Out Of Lawsuit Against Nursing Chain
The federal government is moving to dismiss a lawsuit it brought two years ago against a national nursing-care provider after a judge tossed out the government’s key witness over issues of credibility. The Justice Department joined in on a whistleblower lawsuit against Toledo, Ohio-based HCR ManorCare, which operates more than 250 skilled nursing facilities nationwide. Authorities say the chain fraudulently overbilled Medicare for millions of dollars. (Barakat, 11/9)