First Edition: November 7, 2017

Kaiser Health News: Ohio’s Drug-Pricing Ballot Question Triggers Voter Confusion
Lawmakers in the nation’s capital have yet to grapple with rising drug costs, but Ohio voters are being asked — in a single ballot-box question next week — to figure out how best to lower the tab the state pays for prescriptions. The Drug Price Relief Act, better known as Ohio Issue 2, has been promoted and pilloried in a dizzying crush of robocalls, TV and radio ads, and direct mailings. (Luthra, 11/7)

Kaiser Health News: Beyond Stigma And Bias, Many Transgender People Struggle With Mental Health
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, 11/7)

California Healthline: Breathing Fire: Health Is A Casualty Of Climate-Fueled Blazes
As the deadliest fires in California history swept through leafy neighborhoods here, Kathleen Sarmento fled her home in the dark, drove to an evacuation center and began setting up a medical triage unit. Patients with burns and other severe injuries were dispatched to hospitals. She set about treating many people whose symptoms resulted from exposure to polluted air and heavy smoke. (Upton and Feder Ostrov, 11/7)

The Washington Post: ACA Sign-Ups Spike At Open Enrollment’s Start
More than 200,000 Americans chose a plan on Nov. 1, the day open enrollment began, according to one administration official. That’s more than double the number of consumers who signed up on the first day of enrollment last year. More than 1 million people visited HeathCare.gov, the official federal website, the official said, which amounts to roughly a 33 percent increase in traffic compared with 2016. These figures capture only a portion of the nation’s overall ACA enrollment, because they encompass states that either use the federal health-care marketplace or rely on its website for their consumers to sign up for coverage. More than a dozen states and the District of Columbia run their own programs and do not use HealthCare.gov. (Eilperin, 11/6)

The Hill: ObamaCare Signups Surge In Early Days To Set New Record
A record number of people signed up for ObamaCare in the first few days of open enrollment this year compared to the same period in previous years, several sources close to the process told The Hill. The surge in sign-ups, which was confirmed by an administration official, comes despite fears from Democrats that enrollment would fall off due to the Trump administration's cutbacks in outreach and advertising. (Sullivan, 11/6)

Reuters: Insurers Step Up Pitch For Obamacare As Government Slashes Its Effort
President Donald Trump's 90 percent cut to Obamacare advertising has U.S. health insurers in many states digging deeper into their pockets to get the word out about 2018 enrollment, which opened last week. Independence Blue Cross, a health insurer in Pennsylvania, has commissioned a tractor trailer truck to bring insurance consultants out to shopping centers and other neighborhood spots around Philadelphia. (Humer, 11/6)

The New York Times: Why So Many People Choose The Wrong Health Plans
If you get health insurance from your employer, you have to make decision every year about which coverage to choose. So here is a warning: If you are simply sticking with an old plan with a low deductible, that may well be a wrong and costly choice. ... Because of human quirks, lack of understanding and overly complicated plans, many people are paying more without getting anything extra in return. (Thaler, 11/4)

The New York Times: Which Health Plan Is Cheaper?
Doing a thorough comparison of health care plans is difficult. But there is an imperfect, yet fairly, simple way to check whether a high-deductible plan might qualify for “no-brainer” status, meaning, it enables you to save on health care no matter how often you go to the doctor. Here’s how to do it. (Thaler, 11/4)

The Washington Post: White House Seeks To Weaken ACA’s Individual Mandate, With Executive Order As Backup Plan
White House officials have prepared an executive order that would weaken the Affordable Care Act’s requirement that taxpayers demonstrate proof of insurance, according to people briefed on the matter, suggesting they will issue it if congressional Republicans cannot achieve the same goal through the tax reform process. President Trump supports abolishing the insurance requirement, called the individual mandate, but he cannot eliminate it unilaterally because it is enshrined in law. Given that several Republican bills aimed at unraveling the ACA have failed, Trump and his deputies are now seeking other ways to scale back the requirement for health-care coverage. (Eilperin and Sullivan, 11/6)

The Hill: GOP Unlikely To Repeal ObamaCare Mandate In Tax Measure
The House is unlikely to repeal the mandate to buy insurance under ObamaCare as part of its tax-reform bill, GOP sources say, though the issue could return down the road. President Trump and conservative lawmakers are pushing for the individual mandate to be repealed in the bill, but House Ways and Means Committee Chairman Kevin Brady (R-Texas) has expressed worry that the controversial measure would jeopardize the broader tax-reform bill, given the Senate’s failure on health care earlier this year. (Wong and Sullivan, 11/6)

CQ: Republicans Could Target HSAs In Bipartisan Health Tax Deal
Ways and Means Committee Chairman Kevin Brady told reporters Monday night that an emerging bipartisan agreement to delay some medical care taxes could include changes to health savings accounts. “We are working with our Democrats on a bipartisan agreement on the medical device tax and health insurance tax, and perhaps HSAs as well,” the Texas Republican said Monday night. “And we expect that to be part of the discussion on CHIP and teaching health centers and all that." (McIntire, 11/6)

The Associated Press: Mainers Set To Vote On Whether To Expand Medicaid
Voters in Maine are headed to the polls Tuesday to decide if they want to join 31 other states and expand Medicaid under former President Barack Obama's Affordable Care Act. It's the first time since the law took effect that the expansion question has been put before voters. (11/7)

NPR: Maine Voters Will Decide If They Want More Access To Medicaid
Question 2 asks Maine voters if they want to provide roughly 70,000 Mainers with health care coverage by expanding eligibility of Medicaid, known as MaineCare. It provides health coverage for people living at or near the poverty line. The national battle over Medicaid expansion began with a 2012 U.S. Supreme Court decision that conservatives originally hoped would hobble the Affordable Care Act, President Obama's signature legislative achievement. (Mistler, 11/7)

NPR: In Texas And Beyond, Mass Shootings Have Roots In Domestic Violence
In the wake of the massacre at a small-town Texas church on Sunday, many people are asking why. We know that a large portion of the mass shootings in the U.S. in recent years have roots in domestic violence against partners and family members. Depending on how you count, it could be upwards of 50 percent. (Fulton, 11/7)

The Associated Press: Trump Calls Attackers ‘Deranged’ But Mental Health Link Weak
President Donald Trump called the Texas church shootings gunman “deranged,” the New York bike path attacker “a very sick and deranged person,” and the Las Vegas massacre shooter “a sick, demented man.” It’s a common reaction to mass violence — who in their right mind would commit these senseless crimes? The truth is more nuanced. (Tanner, 11/6)

Los Angeles Times: Gun Injuries In The U.S. Have Become More Severe Since The 1990s, Study Says
If the purpose of a gun is to inflict serious damage to a body, then these weapons have become increasingly effective, new research shows. An analysis of U.S. hospital records shows that gun injuries bad enough to land a victim in the hospital grew more severe over the course of two decades. Wounds involving "serious open fractures" — trauma that pairs a break in the skin with a broken bone — increased by 0.61% per year between 1993 and 2013. Meanwhile, gun injuries classified as "minor" fell by 0.74% per year during the study period. (Kaplan, 11/6)

Politico: Lawmakers Defend 'Unprecedented' Pentagon Health Panel, Which Could Undermine FDA
The Defense Department — and not FDA — would have the power to approve drugs and medical devices under the defense policy bill that's being hammered out by a conference committee, alarming congressional health staff and HHS who say it would undermine medical safety and potentially put soldiers at risk. But the lawmakers backing the bill, including House Armed Services Chairman Mac Thornberry (R-Texas), say the measure is necessary and even overdue. (Diamond, 11/6)

Stateline: For Addicted Doctors, Confidential Treatment That Works
They are among hundreds of physicians from across the country who come to this quiet, pine-shaded retreat 25 miles north of Birmingham, where they can get mental health and addiction treatment without jeopardizing their medical licenses. Bradford [Health Services] addiction treatment regimen isn’t unique — more than a dozen other addiction centers across the country offer similar programs — but when combined with other services offered by state organizations known as physician health programs, it is extraordinarily effective. (Vestal, 11/6)

Stat: Harris Calls For Probe Into Alkermes And Its Vivitrol Promotion For Opioid Treatment
A mid a worsening opioid crisis, a U.S. senator has opened a probe into Alkermes and its controversial promotion of the Vivitrol monthly shot for combating opioid addiction. The move comes as Alkermes is scrutinized for aggressive lobbying and marketing. The company has spent heavily on contributions to lawmakers who are trying to mitigate opioid abuse. In state legislatures across the country, the drug maker has pushed bills that favor its treatment over rival medicines. And Alkermes has provided thousands of free doses to encourage usage in jails and prisons. (Silverman and Facher, 11/6)

The Hill: Trump’s Anti-Opioid Advertising Campaign Needs Millions
President Trump’s plan to use a blizzard of advertising to help stem the opioid crisis faces a serious funding challenge. Similar initiatives have been backed by hundreds of millions in federal funding, but it's not clear if — or how soon — the money for Trump’s initiative could come. (Roubein, 11/5)

Stat: Bipartisan Bill Pushes For The ‘Next Step’ In Solving Alzheimer's
A bipartisan group of four senators on Monday introduced a bill they say would better align Alzheimer’s treatment and prevention strategies with public health approaches for other chronic health conditions, allowing the Centers for Disease Control and Prevention to “create a modern infrastructure for the prevention, treatment, and care of Alzheimer’s and related dementias.” The legislation, authored by Sens. Susan Collins (R-Maine), Catherine Cortez Masto (D-Nev.), Shelley Moore Capito (R-W.Va.), and Tim Kaine (D-Va.), focuses on improving early detection mechanisms, local health program coordination, and data-gathering operations. (Facher, 11/6)

The New York Times: For Patients With Heart Failure, Little Guidance As Death Nears
Ricky Hurst’s doctors told him last year that there was nothing more they could do. His heart was failing and he should get his affairs in order. The end was coming. His family gathered. He spoke to his pastor and resigned himself to death. “If it was meant to be, it was meant to be,” he said. (Kolata, 11/6)

NPR: A Quest: Insulin-Releasing Implant For Type-1 Diabetes
Scientists in California think they may have found a way to transplant insulin-producing cells into diabetic patients who lack those cells — and protect the little insulin-producers from immune rejection. Their system, one of several promising approaches under development, hasn't yet been tested in people. But if it works, it could make living with diabetes much less of a burden. For now, patients with Type-1 diabetes have to regularly test their blood sugar levels, and inject themselves with insulin when it's needed. (Palca, 11/6)

NPR: Sleepless Night Leaves Some Brain Cells As Sluggish As You Feel
When people don't get enough sleep, certain brain cells literally slow down. A study that recorded directly from neurons in the brains of 12 people found that sleep deprivation causes the bursts of electrical activity that brain cells use to communicate to become slower and weaker, a team reports online Monday in Nature Medicine. (Hamilton, 11/6)

Los Angeles Times: Why Hasn't California Cracked Down On Anti-Vaccination Doctors?
A year ago, California officials appeared to be coming down hard on doctors and parents who were reluctant to vaccinate children. The state had just implemented one of the strictest vaccination laws in the nation. The medical board was threatening to pull the license of Dr. Robert Sears, a celebrity in the anti-vaccine community. One vaccine skeptic called the case against Sears “a shot across all the doctors’ bows.” (Karlamangla, 11/6)

The Washington Post: Two More Former UMC Employees Criticize Consultants As Contract Vote Looms
Two more high-ranking former employees of the District’s only public hospital stepped forward Monday to criticize the firm running the facility, even as the company’s owner fought back on the eve of a high-stakes D.C. Council vote on whether it should continue to manage United Medical Center. Pamela Lee, the hospital’s former chief operating officer, and Stanley Pierre, its former quality director, said the consulting firm, Veritas of Washington, had taken steps to remove critical safeguards for patients — particularly by understaffing the department that ensures quality of care and compliance with state and federal laws. (Jamison, 11/6)

Los Angeles Times: San Diego's Hepatitis A Outbreak Continues To Grow, But More Slowly
Though the case count in San Diego's ongoing hepatitis A outbreak increased again Monday, officials said that the number of new infections continues to slow. In a presentation to the San Diego County Board of Supervisors, Dr. Wilma Wooten, the county's public health officer, showed a chart that indicated there were 31 cases in October, significantly fewer than the 81 reported in September and 94 in August — the largest total of the outbreak so far. (Sisson, 11/6)