First Edition: November 17, 2016

California Healthline: Electing To ‘Opt Out’ Of Obamacare
Steven Lopez has gone without health insurance for 15 years, and the Affordable Care Act hasn’t changed his mind. Once again this year he will forgo coverage, he said, even though it means another tax penalty. Last tax season, the 51-year-old information technology professional and his family paid a mandatory penalty of nearly $1,000, he said. That’s because they found it preferable to the $400 to $500 monthly cost of an Obamacare health plan. (Ibarra, 11/17)

The New York Times: HealthCare.Gov Sees Early Rise In Enrollment Amid Worries On Law’s Future
More than a million people have signed up for 2017 health insurance coverage on HealthCare.gov, and more than 300,000 of them selected plans in the three days after Donald J. Trump won the presidential election, the Obama administration said on Wednesday. About one-fourth of those using the online exchange to sign up — 246,400 people — were new to the federal marketplace, and the other 761,800 were renewing coverage they had this year. (Pear, 11/16)

The Associated Press: Early Sign-Ups For Health Care Law Are Steady, But No Surge
A little more than 1 million people renewed health coverage or signed up for the first time through HealthCare.gov around the start of open enrollment, which coincided with a GOP election sweep likely to scramble President Barack Obama's signature law. The figures released Wednesday by the Obama administration represent steady sign-ups but no enrollment surge so far. (Alonso-Zaldivar, 11/16)

The Wall Street Journal: Sign-Ups Under Affordable Care Act So Far Seem Not Hurt By Donald Trump’s Win
The government says that more than a million people selected plans on the federal exchange during the first two weeks of open enrollment under the Affordable Care Act, indicating sign-ups so far haven’t been hurt by President-elect Donald Trump’s plan to repeal or amend the health law. (Armour, 11/16)

Los Angeles Times: More Than 300,000 Signed Up For Obamacare After Trump Was Elected
There were 53,000 more signups during the first 12 days of open enrollment this year than last, according to the health agency. The outpouring over the first two weeks of the enrollment period comes amid rising uncertainty about the fate of the insurance system set up by the 2010 health law. (Levey, 11/16)

San Diego Union-Tribune: Covered California Director Urges Enrollees To Ignore Trump-Caused Uncertainty
Covered California, the state’s health insurance exchange, is at a crossroads brought about by President-elect Donald Trump’s vow to repeal at least parts of the Affordable Care Act. Obamacare pays income-based subsidies to 87% of the 1.3 million Californians currently covered by plans sold through the exchange. Elimination of those payments could very well lead to mass cancellations by people no longer able to afford their insurance policies. (Sisson, 11/16)

Politico: Republicans Aim To Start Obamacare Repeal In January
Republicans on Capitol Hill are growing confident that they can begin to repeal Obamacare once President-elect Donald Trump is sworn in, along with a pledge to replace it later. “We have an Obamacare emergency right now,” said Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate HELP Committee. “I think we could move forward in January on some aspects of repeal but we need to make sure that we are helping people and that we do no harm.” (Haberkorn, 11/16)

The Washington Post: The One Thing Missing From The Debate Over Obamacare, According To A Top Doctor
President-elect Donald Trump's promise to repeal the Affordable Care Act while preserving some key elements has triggered rampant speculation about the future of American health care — and plunged millions of patients who benefit from the law into deep uncertainty about the future of their coverage. Little is known about the replacement plan that will ultimately emerge. But one voice angling to shape future policy is the leader of the Mayo Clinic, neurologist John Noseworthy. The issue he thinks has been strangely missing from the years-long debate over malfunctioning websites, politics and soaring premiums is this: the patient's health. (Johnson, 11/16)

The Wall Street Journal: Trump’s Biotech Rally Based On False Hopes
There have been a lot of big, somewhat dubious assumptions behind the rise in stocks since the election. Drug stocks offer a prime example. Biotechnology emerged as a major winner. The Nasdaq Biotechnology Index has risen 17% since Nov. 8. Yet the NYSE Arca Pharmaceutical Index with biotech’s bigger brothers in it is up less than 5% over the same period. (Grant, 11/16)

USA Today: Can President Trump Undermine Abortion Rights? Not So Fast
President-elect Donald Trump opposes abortion, but even he admits that overturning the Supreme Court's 43-year-old decision in Roe v. Wade "has a long, long way to go." After Trump nominates a justice to replace the late Antonin Scalia, the Supreme Court will remain one or two votes short of a majority to send abortion decisions back to the states, experts on both sides of the issue agree. (Wolf, 11/16)

The Associated Press: Surprise Doctor Bills From ER Care Can Add Angst To Injury
A trip to the emergency room can be traumatic enough, but researchers warn that many insured patients may be in for another shock when the medical bills arrive. Even if patients go to a hospital included in their health insurance network, the emergency room physicians might not be. That could mean an unexpected expense. (Murphy, 11/16)

The Wall Street Journal: Patients May Still Get A ‘Surprise’ Bill After An In-Network ER Visit, Study Finds
Patients who get emergency care at a hospital in their insurance network have nearly a 1 in 4 chance of being treated by an out-of-network ER physician who may send a “surprise” bill, according to an analysis in the New England Journal of Medicine. The study, by two Yale University economists, is one of the first to quantify the surprise-bill issue that has caused patient uproar and stoked friction between ER doctors and insurers. (Beck, 11/16)

ProPublica: High-Dollar Prescribers Proliferate In Medicare’s Drug Program
The number of doctors who each prescribe millions of dollars of medications annually in Medicare’s drug program has soared, driven by expensive hepatitis C treatments and rising drug prices overall, federal data obtained by ProPublica shows. The number of providers who topped the $5 million mark for prescriptions increased more than tenfold, from 41 in 2011 to 514 in 2015. The number of prescribers—mostly physicians but also nurse practitioners–exceeding $10 million in drug costs jumped from two to 70 over the same time period, according to the data. (Ornstein and Jones, 11/17)

Reuters: Surgeon General Calls For Action To Fight Drug, Alcohol Abuse
The U.S. Surgeon General issued a call to action on Thursday to end what he said was a public health crisis of drug and alcohol addiction that is both underappreciated and undertreated. Dr. Vivek Murthy issued the first-ever Surgeon General's report on substance abuse and said he hopes it will galvanize work on the issue the way a similar report 50 years ago sparked decades of effort to combat smoking. (Clarke, 11/16)

The Washington Post: Landmark Report By Surgeon General Calls Drug Crisis ‘A Moral Test For America’
“The reason I’m issuing this report is I want to call our country to action around what has become a pressing public health issue,” Murthy said in an interview. “I want our country to understand the magnitude of this crisis. I’m not sure everyone does.” The report, “Facing Addiction,” pulls together the latest information on the health impacts of drug and alcohol misuse, as well as on the issues surrounding treatment and prevention. It offers reasons for optimism despite a still-increasing overdose epidemic that has killed more than 500,000 Americans since 2000, and it presents evidence that addiction is a treatable brain disease, with new therapies under development. (Bernstein, 11/16)

Politico: Surgeon General Ramps Up Addiction Battle
The report itself has three basic themes. Addiction is a chronic neurological disease, not a moral failing or lack of will power. That means it’s time to stop the “shame and misunderstanding,” the report says. Prevention is key. Keeping teens in particular from trying drugs and alcohol vastly lowers the likelihood of addiction later on. And treatment works. Not perfectly, but it works. (Kenen, 11/17)

The Washington Post: Teamsters Demand McKesson CEO Return Millions Of Dollars For Role In Opioid Crisis
The Teamsters union called Tuesday for health-care giant McKesson to take back millions of dollars in incentive pay from chief executive John H. Hammergren, citing damage to the company's reputation caused by its role in the opioid crisis. In a letter, Ken Hall, general secretary and treasurer of the International Brotherhood of Teamsters, urged the company's board of directors to use its “executive clawback policy to recover all or a significant portion of CEO Hammergren's incentive pay” over the past year and suspend future payouts until it restructures its compensation system. (Bernstein and Higham, 11/15)

Los Angeles Times: There's Another Type Of Rural/Urban Divide In America: Teens Having Babies
The teen birth rate in America’s small towns is 63% higher than in its biggest cities, a new government report reveals. In 2015, there were 18.9 births for every 1,000 women between the ages of 15 and 19 living in counties with large urban areas, according to a report published Wednesday by the Centers for Disease Control and Prevention. That compares with 30.9 births per 1,000 women in the same age group who lived in rural counties, the report said. (Kaplan, 11/16)

The Wall Street Journal: Theranos Whistleblower Shook The Company—And His Family
After working at Theranos Inc. for eight months, Tyler Shultz decided he had seen enough. On April 11, 2014, he emailed company founder Elizabeth Holmes to complain that Theranos had doctored research and ignored failed quality-control checks. The reply was withering. Ms. Holmes forwarded the email to Theranos President Sunny Balwani, who belittled Mr. Shultz’s grasp of basic mathematics and his knowledge of laboratory science, and then took a swipe at his relationship with George Shultz, the former secretary of state and a Theranos director. (Carreyrou, 11/16)

The Associated Press: Drug Prices Don’t Budge Even After Pressure From Congress
Congress’s routine of publicly shaming drug company executives over high prices works no better than a placebo: It may make some people feel better, but it doesn’t treat the problem. In the last two years, House and Senate committees issued more than a dozen subpoenas to price-hiking drugmakers, collecting hundreds of thousands of documents and berating executives for more than 16 hours of public hearings. (Perrone, 11/16)

The Associated Press: Veterans Affairs Whistleblower Resigns, Citing Retaliation
A Department of Veterans Affairs employee who told Congress the agency was using unauthorized wait lists for mental health care in Colorado has resigned, saying he was subjected to retaliation for speaking out. Brian Smothers told The Associated Press Wednesday the VA had opened two separate inquiries into his actions and tried to get him to sign a statement saying he had broken VA rules. He said he refused. (11/17)

NPR: The Wait To Get Medicaid Help Can Be 7 Years In Kansas
For 22 years, Nick Fugate washed dishes at a local hotel near his home in Olathe, Kan. "There was nothing easy," he says, and chuckles. "I just constantly had to scrape the dishes off to get them clean." ... But things got tough last year when Nick lost his job and his health insurance. For the first time, he enrolled in Medicaid. He got his basic medical care covered right away, but in Kansas, there's now a long waitlist — a 7-year wait — for people with intellectual disabilities to get the services they need. Decades ago, Fugate might have been institutionalized, but Medicaid now provides services to help people remain independent — including job coaching, help buying groceries, food preparation and transportation. These are the services Nick is eligible for but must wait to receive through Medicaid. (Smith, 11/16)

Los Angeles Times: Star-Shaped Drug Dispenser Stays In Gut To Deliver Medication For Weeks
Wrought in metal and wielded by a ninja, one star-shaped device can deliver swift, silent death. Now, researchers have unveiled a star-shaped device designed to deliver health for weeks at a time. A team of Boston-based engineers and physicians on Wednesday demonstrated a first: a multi-pronged drug-delivery mechanism capable of withstanding the tumultuous and corrosive forces that prevail in the human gut for as long as two weeks. (Healy, 11/16)

NPR: Immune Boosting Supplements And Juices Don't Really Help
Flu season is upon us, which means it's time for the wave of advertisements promoting $8 juices or even more expensive supplements to "boost your immunity" or "support immune function." But those are marketing terms, not scientific ones. And there's no proof that those products are going to keep you from getting sick. (Hobson, 11/16)

The Associated Press: Missouri Appeals Court: Frozen Embryos Property, Not People
A divorced man and woman must mutually consent to using embryos that were frozen and stored while married, a Missouri appellate court has ruled in declaring the embryos marital property, not humans with constitutional rights. The Missouri Court of Appeals’ 2-1 ruling Tuesday upheld a St. Louis County judge’s 2015 finding that Jalesia “Jasha” McQueen and Justin Gadberry maintain joint custody of the embryos, which have been frozen since 2007. The couple separated in 2010 and divorced last year; dissolution proceedings were drawn out by their dispute over the embryos. (Suhr, 11/16)