First Edition: November 2, 2017

Kaiser Health News: Learning To Advance The Positives Of Aging
What can be done about negative stereotypes that portray older adults as out-of-touch, useless, feeble, incompetent, pitiful and irrelevant? From late-night TV comedy shows where supposedly clueless older people are the butt of jokes to ads for anti-aging creams equating youth with beauty and wrinkles with decay, harsh and unflattering images shape assumptions about aging. Although people may hope for good health and happiness, in practice they tend to believe that growing older involves deterioration and decline, according to reports from the Reframing Aging Initiative. (Graham, 11/2)

California Healthline: Mental Health Of Transgender People Is Under Stress, Study Finds
Diana Feliz Oliva, a 45-year-old transgender woman who grew up outside Fresno, Calif., remembers being bullied when she was younger and feeling confused about her gender identity. She was depressed and fearful about being found out, and she prayed every night for God to take her while she slept. “I was living in turmoil,” said Oliva, who now works as health program manager in a clinic for transgender people at St. John’s Well Child & Family Center in Los Angeles. “Every morning, I would wake up and I knew I would have to endure another day.” (Gorman, 11/2)

The Washington Post: ACA Enrollment Opens After GOP Fails To Kill Off Obamacare
From coast to coast, the fifth annual season for Americans to buy insurance under the Affordable Care Act opened on Wednesday with scattered reports of crowds, some technical difficulties and a public confused as never before by the political turmoil surrounding the law. The federal website HealthCare.gov said “2018 Open Enrollment is here,” as both it and state insurance marketplaces attracted the year’s first customers. They came despite a 90-percent reduction in federal advertising about the sign-up window and a decision by the Trump administration to send advance emails about enrollment to millions fewer Americans than in past years. (Goldstein, Eilperin and Itkowitz, 11/1)

Politico: First Day Of Obamacare Enrollment Stays Drama-Free
Former President Barack Obama sought to boost his namesake health law Wednesday by appearing in a video urging people to sign up for coverage on the first day of the 2018 enrollment season. Obama’s call comes as the Trump administration has taken numerous actions to undermine the law while doing almost nothing to publicize the start of the six-week enrollment season that wraps up on Dec. 15. (Cancryn and Pradhan, 11/1)

The Hill: Obama Releases Video Urging People To Sign Up For ObamaCare
Former President Barack Obama released a video urging people to sign up for ObamaCare as a new enrollment period — the first under a new president — begins on Wednesday. In the video, Obama said today is the first day to "get covered for 2018." (Savransky, 11/1)

NPR: Obama Takes To Twitter To Promote Obamacare Enrollment
Obama's tweet to his more than 95 million followers includes a short video, set to jaunty music, where the former president urges people to log on to the federal insurance exchange, HealthCare.gov, and sign up for coverage for next year. "It's November 1, which means today is the first day to get covered for 2018," Obama says. It's not clear where he's standing, but the ocean is in the background. (Kodjak, 11/1)

The Washington Post: Federal Notices About ACA Enrollment Season Get Cut In Number And Messaging
In preparation for the Affordable Care Act’s latest enrollment season, the Trump administration sent notices about the sign-up options to millions fewer Americans than in past years and deleted themes known to be most effective in motivating consumers to sign up. Emails went in advance only to people with current health-care plans through marketplaces created under the law, leaving out most of the names in a database of about 20 million consumers who once had such coverage or at some point explored the federal website HealthCare.gov. (Goldstein, 11/1)

The Hill: Trump Health Chief Wants 'Consumer Friendly' ObamaCare Signups 
President Trump's acting health chief said Wednesday that the administration wants to make the ObamaCare sign-up season "as consumer friendly as possible." Eric Hargan, the acting secretary of Health and Human Services (HHS), said in a speech that Trump is committed to repealing and replacing the law, but the administration still wants this enrollment period, which began Wednesday, to go smoothly. (Sullivan, 11/1)

The Wall Street Journal: Shopping For Affordable Care Act Plans? Read This
When consumers shop for Affordable Care Act plans starting Nov. 1, what they find will depend on their individual circumstances. Call it a tale of two open enrollments. For those who get federal subsidies to help with their premiums, it could be the best of times, with many able to access health insurance that won’t require them to pay any premiums. But on the other side, folks who aren’t eligible for those subsidies—which go to people making 400% of the federal poverty level, around $48,000, or less—will see a far less appealing situation, where they bear the full brunt of rising rates. (Wilde Mathews, 11/1)

The New York Times: How To Be A Smart Obamacare Shopper
The Trump administration’s actions to scale back Obamacare have made it harder and more complicated to find the best health plan. But the pricing chaos has also created great deals for some consumers, who can sign up during open enrollment beginning today. Here’s our advice on how to shop — the best strategy depends on how much you earn. (Sanger-Katz and Park, 11/1)

The Associated Press: What To Look For As 'Obamacare' 2018 Enrollment Opens
Here's what's new, what's the same, and some important points to consider when searching for 2018 coverage. (Murphy, 11/1)

The Hill: Five Things To Know As ObamaCare Enrollment Begins 
Open enrollment for ObamaCare begins on Wednesday, opening a new chapter in what has been a tumultuous year for the health-care law.  The frenzy over health care this year has stoked public confusion about ObamaCare, with some people erroneously stating in polls that the law has been repealed or that they no longer have to pay a fine for not having insurance. (Hellmann, 11/1)

The Wall Street Journal: Repeal Of ACA’s Individual Mandate Could Be Part Of Tax Overhaul
Republicans may seek to repeal the Affordable Care Act requirement that most Americans must have insurance coverage or pay a fine as part of their tax overhaul package, part of a push to undo or delay parts of the health law in the aftermath of the failure of a broader repeal effort. President Donald Trump, in posts on his Twitter account Wednesday, threw his support behind the proposal. (Armour and Peterson, 11/1)

The Hill: Trump Suggests Repealing ObamaCare Mandate In Tax Bill 
President Trump on Wednesday suggested using the GOP tax bill to repeal ObamaCare’s individual mandate. “Wouldn't it be great to Repeal the very unfair and unpopular Individual Mandate in ObamaCare and use those savings for further Tax Cuts,” Trump tweeted. (Weixel, 11/1)

Politico: Trump Tries To Tie Obamacare Repeal To Tax Cuts
The president’s position represents a bit of a reversal from the White House. Asked about the individual mandate at Tuesday’s press briefing, White House press secretary Sarah Huckabee Sanders told reporters, “I don’t believe it has to be part of tax reform, but the child care tax credit is something he’d certainly like to see.” (McCaskill, 11/1)

The New York Times: Panel Recommends Opioid Solutions But Puts No Price Tag On Them
President Trump’s bipartisan commission on the opioid crisis made dozens of final recommendations on Wednesday to combat a deadly addiction epidemic, ranging from creating more drug courts to vastly expanding access to medications that treat addiction, including in jails. The commissioners did not specify how much money should be spent to carry out their suggestions, but they pressed Congress to “appropriate sufficient funds” in response to Mr. Trump’s declaration last week of a public health emergency. (Goodnough and Hoffman, 11/1)

The Associated Press: Trump Opioid Panel Wants Drug Courts, Training For Doctors
The panel's final report stopped short, however, of calling for new dollars to address the worst drug crisis in U.S. history. Instead, the commission asked Congress for "sufficient funds" and suggested giving the White House drug czar's office the ability to review federal spending on the problem. "If we are to invest in combating this epidemic, we must invest in only those programs that achieve quantifiable goals and metrics," the report said. The drug czar's office "must establish a system of tracking and accountability." (Johnson, 11/1)

The Washington Post: White House Opioid Commission Calls For Wide-Ranging Changes To Anti-Drug Policies
The commission, headed by New Jersey Gov. Chris Christie (R), called for expanding drug courts — an alternative system that tries to channel substance abusers accused of crimes into treatment — into all 94 federal court jurisdictions. Currently they are in fewer than half. The more than 50 recommendations in the draft report also include requiring doctors and others who prescribe opioids to show they have received training in the safe provision of those drugs before they can renew their licenses to handle controlled substances with the Drug Enforcement Administration. The panel also wants to mandate that providers check prescription-drug-monitoring databases to ensure that users aren't “doctor shopping” for prescription drugs. In some states, use of that technology is voluntary. (Bernstein, 11/1)

Stat: Here Are The Final Recommendations Of The White House Opioid Commission
The report includes 56 distinct recommendations, many of which now fall to Congress, a number of federal departments, and local governments to fund and implement. (Facher, 11/1)

The Hill: Trump Officials Approve Medicaid Waivers For Opioid Treatment 
The Trump administration approved Medicaid waivers in Utah and New Jersey to help improve access to treatment for opioid addiction, according to the states’ governors. The waivers were the first to be approved under a new policy from the Centers for Medicare and Medicaid Services (CMS) that will allow states to design demonstration projects to let Medicaid to pay for opioid use disorder treatments. (Weixel, 11/1)

Reuters: Puerto Rico Seeks Help As Medicaid Crisis Deepens After Maria
Puerto Rico, still reeling from Hurricane Maria, is asking the Trump administration and U.S. lawmakers for help in staving off a Medicaid crisis that has put a quarter of the island’s residents at risk of losing medical care. The territory, which has grappled for years with shortfalls in funding of its Medicaid healthcare program, is on track to run out of money to pay doctors and hospitals by early next year, leaving as many as 900,000 low-income Puerto Ricans without care. (Rampton and Respaut, 11/1)

Stat: Waste Not, Want Not: Bill Tries To Cut Drug Makers' Waste
The move follows various reports that large quantities of different types of medicines — from expensive cancer treatments to pricey eye drops — are wasted each year because of packaging. An analysis published last year, for instance, estimated that $2.8 billion is wasted each year by government and private insurers on cancer meds, which are typically injected or infused in doctor’s offices and hospitals based on a patient’s weight. However, the drugs are packaged in uniform-sized vials, which often generate leftover medicine that must be discarded due to safety standards. (Silverman, 11/1)

The Wall Street Journal: Hospitals Vow Fight To Keep Medicare Drug Subsidies
The Trump administration said it is slashing a lucrative pharmaceutical subsidy Medicare pays some hospitals, prompting the American Hospital Association and other powerful hospital groups to threaten legal action to block the move. In a rule released Wednesday evening, the federal agency that runs Medicare said it would sharply lower what Medicare pays for certain drugs that certain hospitals buy and administer to patients through the subsidy program. (Evans, 11/1)

The Wall Street Journal: Ballot Measure To Cap Ohio Drug Prices Unleashes Expensive Ad Battle
One of the fiercest battles yet over high drug prices is playing out in Ohio, where an approaching ballot referendum on price caps has unleashed tens of millions of dollars of television advertising and sharp rhetoric on both sides of the issue. The Nov. 7 ballot measure would require state government entities, including the Medicaid health-insurance program for low-income people, to pay no more for prescription drugs than what the U.S. Department of Veterans Affairs pays for veterans. Under federal law, the VA buys drugs at a mandatory 24% discount to regular prices, and negotiates additional discounts with manufacturers. (Loftus, 11/1)

The New York Times: A.C.L.U. Sues Trump Administration Over Detention Of 10-Year-Old Immigrant
The American Civil Liberties Union sued the Trump administration on Tuesday over its detention of a 10-year-old girl with cerebral palsy who was stopped by Border Patrol agents in Texas last week on her way to surgery. The girl, Rosa Maria Hernandez, had been living in Laredo, Tex., with her parents, where she was brought illegally from Mexico when she was 3 months old. (Ugwu, 11/1)

The New York Times: F.D.A. Warns Companies Against Claims That Marijuana Cures Diseases
Everyday Advanced Hemp Oil, Bosom Lotion and CBD Edibles Gummie Men may have their fans, but the Food and Drug Administration is not among them. Four companies selling those and dozens of other marijuana-derived dietary supplements have been warned by the F.D.A. to stop pitching their products as cures for cancer, a common but unproven claim in the industry. (Kaplan, 11/1)

Politico: Atul Gawande On Washington, Writing And What Really Matters By Politico's Pulse Check
Atul Gawande doesn't really need an introduction — but if PULSE CHECK were to provide one, it would highlight his work as a New Yorker writer, researcher, best-selling author, surgeon and founder of two non-profits. (Among other responsibilities) Atul sat down with POLITICO's Dan Diamond to discuss how he manages his schedule, his book "Being Mortal" and how he thinks its lessons have resonated, his perspective on politics and public health, his early career as a Hill staffer and Clinton-era appointee at HHS, whether he'd ever take a job in D.C. again and his writing process. (Diamond, 11/2)

The New York Times: Inflammation In Midlife Tied To Brain Shrinkage Later In Life
Chronic inflammation in middle age may be associated with an increased risk for brain shrinkage and Alzheimer’s disease later in life. A new study, published in Neurology, looked at 1,633 people whose average age was 53 in 1987-89, measuring white blood cell count and various blood proteins that indicate inflammation. (Bakalar, 11/1)

Stat: Squashed In Space: Study Identifies Changes In Astronauts' Brains
Sure, space travel makes bones and muscles atrophy and alters the distribution of blood and other bodily fluids, among other physiological consequences of microgravity, but what does it do to the brain? Since astronauts on a mission to Mars will need their wits about them, NASA and outside scientists have been keen to assess the effects of prolonged weightlessness on the 3 pounds of protoplasm inside the skull. In a NASA-funded study published on Wednesday, Dr. Donna Roberts of the Medical University of South Carolina and her colleagues therefore compared before- and after-mission MRIs of 34 astronauts, 18 who spent months on the International Space Station (average voyage: 165 days) and 16 who had shorter jaunts (14 days, on average, on the space shuttle). (Begley, 11/1)

The New York Times: Tapping Into Dementia Patients’ Memories Through Vaudeville
The elderly dementia patient in the next room was unresponsive and in a foul mood, the head nurse warned. Dapper Dan and Beatrice took that information into account and proceeded anyway. The patient was lying in bed with her eyes wide open and didn’t say a word when the pair launched into a medley of 50s tunes. By the time they got to their third song, “Under the Boardwalk,” they noticed the patient’s toes were moving to the rhythm under the bedsheet and that she was gently tapping her fingers to the music. (Hollow, 11/1)

The Associated Press: Family Of Cancer Victim Want Another Review In Talc Case
Survivors of a woman who claimed that Johnson & Johnson’s talcum powder contributed to her ovarian cancer are challenging a Missouri appeals court ruling that threw out a $72 million award. The estate of Jacqueline Fox, of Birmingham, Alabama, was awarded the money in 2016 in the first of several cases in St. Louis claiming talc powder contributed to cancer. Fox died in 2015 at age 62. (11/1)