First Edition: October 13, 2017

Kaiser Health News: Trump’s Order Advances GOP Go-To Ideas To Broaden Insurance Choices, Curb Costs
The executive order directs many agencies, including the Department of Labor, to consider proposing rules or new guidance to loosen current restrictions on what are called “association health plans” and on selling low-cost, short-term insurance. ... Associations are generally membership groups based on a profession or business. Proponents say allowing consumers to buy insurance through these organizations gives them more clout with insurers than they’d have buying their own plan on the individual market — and results in lower premiums. But the real savings in premiums is likely to come because the policies could offer fewer benefits than more regulated ACA plans, and the associations would have more leeway to set premiums based on the health of the group. (Appleby, 10/12)

Kaiser Health News: Facebook Live: Things To Know About Trump’s Directive On Health Insurance
The executive order that President Donald Trump signed Thursday touches on a range of GOP policy approaches — such as association health plans and short-term health insurance policies, among other things. This live chat features KHN senior correspondent Julie Appleby answering questions about how implementing these ideas could alter the current health insurance marketplace. (10/12)

California Healthline: Anthem Eases Up On Premium Hikes After State Scrutiny
Insurance giant Anthem Blue Cross agreed to reduce two planned premium increases for 2018 after California regulators questioned the company’s rationale for raising rates by as much as it had initially proposed. The scaled-back rate hikes, in the individual and small-employer markets, will reduce premiums by $114 million, state officials said. (Terhune, 10/12)

California Healthline: Fires Prey On Frail Residents Living On Their Own
They were asleep when the fire reached their home. Charles Rippey, 100, and his wife, Sara, 98, had been married 75 years. They died together, after a caregiver struggled to save them but couldn’t get them out in time. A 27-year-old woman had spina bifida and used a wheelchair. In the hours after the fires broke out, her relatives frantically sought information about her whereabouts. When a fire inspector visited her home, he found her body. (Feder Ostrov, 10/13)

The New York Times: Trump To Scrap Critical Health Care Subsidies, Hitting Obamacare Again
President Trump will scrap subsidies to health insurance companies that help pay out-of-pocket costs of low-income people, the White House said late Thursday. His plans were disclosed hours after the president ordered potentially sweeping changes in the nation’s insurance system, including sales of cheaper policies with fewer benefits and fewer protections for consumers. The twin hits to the Affordable Care Act could unravel President Barack Obama’s signature domestic achievement, sending insurance premiums soaring and insurance companies fleeing from the health law’s online marketplaces. (Pear, Haberman and Abelson, 10/12)

The Associated Press: Trump To Issue Stop-Payment Order On Health Care Subsidies
The Department of Health and Human Services made the announcement in a statement late Thursday. "We will discontinue these payments immediately," said acting HHS Secretary Eric Hargan and Medicare administrator Seema Verma. In a separate statement, the White House said the government cannot legally continue to pay the so-called cost-sharing subsidies because they lack a formal authorization by Congress. However, the administration had been making the payments from month to month, even as Trump threated to cut them off to force Democrats to negotiate over health care. (10/13)

The Wall Street Journal: Trump To End Subsidies To Health Insurers
“We believe that the last Administration overstepped the legal boundaries drawn by our Constitution,” acting HHS Secretary Eric Hargan and Seema Verma, administrator of the Centers for Medicare & Medicaid Services, said in a joint statement. “Congress has not appropriated money for [the payments], and we will discontinue these payments immediately.” (Armour, 10/13)

Politico: Trump Will Scrap Critical Obamacare Subsidy
The subsidies, which are worth an estimated $7 billion this year and are paid out in monthly installments, may stop almost immediately since Congress hasn’t appropriated funding for the program. (Dawsey and Demko, 10/12)

NPR: Trump Administration To End Obamacare Subsidies For The Poor
The decision ends speculation about whether the Trump administration would continue making the monthly payments to insurers. That money particularly helps people earning between 100 percent and 250 percent of the poverty level pay for the insurance and health care they get through the exchanges set up by the Affordable Care Act, also known as Obamacare. (Kurtzleben and Neuman, 10/12)

Reuters: Trump Nails Obamacare With Decision To Cut Off Billions In Subsidies
The decision is the most dramatic action Trump has taken yet to weaken the Affordable Care Act, President Barack Obama's signature healthcare law, which extended insurance to 20 million Americans. The move drew swift condemnation from Democrats and threats from state attorneys general in New York and California to file lawsuits. (10/13)

The Washington Post: Trump To End Key ACA Subsidies, A Move That Will Threaten The Law’s Marketplaces
Trump has threatened for months to stop the payments, which go to insurers that are required by the law to help eligible consumers afford their deductibles and other out-of-pocket expenses. But he held off while other administration officials warned him such a move would cause an implosion of the ACA marketplaces that could be blamed on Republicans, according to two individuals briefed on the decision. (Goldstein and Eilperin, 10/13)

The Hill: Dems Rip Trump's 'Spiteful' Decision To End Key ObamaCare Payments  
Democratic leaders blasted the administration on Thursday night over President Trump's decision to end key payments to insurers offering ObamaCare coverage, calling the move "spiteful." “Sadly, instead of working to lower health costs for Americans, it seems President Trump will singlehandedly hike Americans’ health premiums," Senate Minority Leader Charles Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) said in a joint statement. (Byrnes, 10/12)

The Hill: New York, California Threaten To Sue Over Health-Care Subsidies 
Attorneys general from California and New York say they are prepared to sue the Trump administration to protect health-care subsides that the White House said would be cut off. New York Attorney General Eric Schneiderman (D) said in a statement that hundreds of thousands of New York families rely on ObamaCare's subsidies for their health care. (Savransky, 10/12)

Los Angeles Times: Trump Plans To Halt Subsidies To Health Insurers, Further Undermining Obamacare
“This shocking action is several steps beyond the sabotage of our health system, but more the equivalent of Trump swinging a baseball bat wildly in a china shop,” said Anthony Wright, head of Health Access California. “This decision is deliberately destructive and destabilizing for the coverage of millions of Americans.” (Levey, 10/12)

The Hill: Trump Administration Hints At Enforcing ObamaCare Mandate 
The Trump administration is hinting that it will continue to enforce the ObamaCare mandate requiring Americans to have health insurance coverage. An administration document obtained by The Hill that accompanies an executive order signed by President Trump Thursday states that "only Congress can change the law" when it comes to the mandate. (Sullivan, 10/12)

Politico: Trump’s Salvo On Obamacare Unlikely To Result In Quick Changes
President Donald Trump may be eager to dismantle the Affordable Care Act after months of failed GOP repeal efforts, but his promise to provide millions of Americans "with Obamacare relief" with the executive order he signed Thursday is sure to collide with the slow grind of the federal bureaucracy. Trump’s order directs a trio of federal agencies to rewrite regulations to encourage the rise of a raft of cheap, loosely regulated health insurance plans that don't have to comply with certain Obamacare consumer protections and benefit rules. They're expected to attract younger and healthier people — leaving older and sicker ones in the Obamacare markets facing higher and higher costs. (Cancryn, 10/12)

NPR: Trump Order Aims To Promote Insurance Options
"The competition will be staggering," Trump said. "Insurance companies will be fighting to get every single person signed up. And you will be, hopefully, negotiating, negotiating, negotiating. And you will get such low prices for such great care." (Horsley, 10/12)

The New York Times: What Did Trump’s Health Care Executive Order Do?
President Trump signed an executive order on Thursday that he said would begin “saving the American people from the nightmare of Obamacare.” There’s a lot that’s still uncertain about how the order will change the health law. Here’s what we know so far. (Sanger-Katz, 10/12)

Los Angeles Times: Trump Issues Order To Deregulate Health Insurance, Promising Relief From Obamacare
The broadly worded order leaves many key elements of the new plans uncertain, however, subject to a lengthy administrative process, which means the order’s impact will remain unclear, and the new plans unavailable to consumers, for this year’s open enrollment season and many months to come. Trump avoided that point as he formally released the order at the White House, declaring that it would “provide millions of Americans with Obamacare relief” and would “increase competition, increase choice and increase access to lower-priced, high-quality healthcare options.” (Levey, 10/12)

The Wall Street Journal: Trump Signs Order Paving Way For Health-Care Changes
Thursday’s executive order paves the way for a proliferation of less-expensive insurance plans with fewer benefits for those who buy their insurance individually, rather than getting it through an employer. A range of next steps are on the table, but White House officials said no final decisions have been made. (Armour, 10/13)

The Wall Street Journal: Trump Health Order Could Hurt Many Insurers, Help Others
The executive order on the health-care system signed Thursday by President Donald Trump  will likely have a split effect on the health-insurance industry, creating new challenges for many companies but opportunities for others. The impact of the order will take months to become clear, as federal agencies move the changes through the regulatory process. But actuaries and industry officials said the shift could create problems for insurers that offer plans under the Affordable Care Act, both to individuals and small businesses. (Wilde Mathews, 10/12)

The Hill: Hospital Group Warns Trump's Executive Order Could Weaken Insurance Markets 
The largest hospital association warned that an executive order signed by President Trump on Thursday could destabilize insurance markets and make coverage unaffordable for people with pre-existing conditions. "Today’s Executive Order will allow health insurance plans that cover fewer benefits and offer fewer consumer protections," said Tom Nickels, executive vice president of the American Hospital Association, in a statement. (Hellmann, 10/12)

Bloomberg: Trump's Health Care Executive Order: Few Silver Linings
President Donald Trump on Thursday signed an executive order aiming to make it easier for Americans to buy skimpier and cheaper health insurance. The order isn't as aggressive as it might have been in undermining the ACA, but that's scant reassurance for insurers, who face an administration that seems actively hostile to a law it's supposed to enforce. The order aims to let association health plans -- groups of small employers banding together to buy insurance -- offer coverage throughout the U.S. Insurers consistently oppose selling health insurance across state lines because of varying regulations. (Nisen, 10/12)

Reuters: Trump Healthcare Order Could Run Afoul Of Retirement Plan Law
President Donald Trump's plan to make it easier for small businesses to band together and buy stripped-down health insurance plans could violate a federal law governing employee benefit plans and will almost certainly be challenged in court, legal experts said. (Pierson and Raymond, 10/12)

The Hill: Health Groups Warn Trump's Executive Order Could Hurt Patients
Nearly 20 health organizations warn that an executive order signed by President Trump on Thursday could weaken patient protections and destabilize the individual market. ...Trump’s order seeks to expand the ability of small businesses and other groups to band together to buy health insurance through what are known as association health plans. It also lifts limits on short-term health insurance plans. (Hellmann, 10/12)

The New York Times: We’re Tracking The Ways Trump Is Scaling Back Obamacare. Here Are 12.
The Trump administration continues to take action that could weaken the Affordable Care Act and curtail enrollment in coverage under the law. (Park, 10/12)

Politico: How Trump Is Undercutting Obamacare
Here are all the ways the president is trying to dismantle the law without help from Congress. (Millman, 10/12)

The New York Times: House Ethics Office Says New York Congressman May Have Violated Rules
Representative Chris Collins of New York may have violated federal law by sharing nonpublic information about a company on whose board he served, according to a report released Thursday by the Office of Congressional Ethics. The report also said Mr. Collins may have broken House ethics rules by meeting with the National Institutes of Health and asking for help with the design of a clinical trial being set up by the company, Innate Immunotherapeutics. Mr. Collins, a Republican whose district encompasses much of western New York, is also the company’s largest shareholder, reporting for the year 2016 that he held between $25 million and $50 million in the company. (Thomas and Kaplan, 10/12)

The Wall Street Journal: Congressional Ethics Office Says New York Republican May Have Violated Law
The Office of Congressional Ethics also said Rep. Chris Collins may have shared nonpublic information about Innate Immunotherapeutics Ltd. with other investors. In a report released Thursday, the ethics office said it found “substantial reason” to believe both allegations and voted unanimously to send the case to the House Ethics Committee for further investigation. The office said the conduct may have violated federal law. (Tau, 10/12)

The Washington Post: Rep. Chris Collins’s Advocacy For Biotech Company Broke Rules, House Ethics Watchdog Finds
Collins’s attorneys have denied the allegations of wrongdoing in the report. “Rep. Collins has done nothing improper, and his cooperation and candor during the OCE review process confirm he has nothing to hide,” they wrote in an Aug. 14 letter released Thursday by the Ethics Committee. “There is nothing in the record to suggest, let alone support, the conclusion that Rep. Collins violated House rules, standards of conduct, or federal law.” (DeBonis, 10/12)

Politico: Ethics Panel Continues Probe Into Rep. Collins’ Stock Trades
Collins — who has repeatedly denied any improper or unethical behavior — is on the board of Innate and is its biggest stockholder, having invested at least $6 million in the firm. His children own a block of Innate shares too. Collins has pushed the company's stock to former HHS Secretary and one-time House colleague Tom Price, other lawmakers and officials in Buffalo, N.Y. Collins was once overheard bragging on the phone in the House Speaker's Lobby about “how many millionaires I’ve made in Buffalo the past few months." Price made more than $225,000 in his Innate stock trades, according to public records. (Bresnahan and Cheney, 10/12)

The Hill: Watchdog Recommends Price Subpoena In Stock Sales Probe
A congressional watchdog is recommending the subpoena of former Health and Human Services Secretary Tom Price after he refused to cooperate in its probe of Rep. Chris Collins (R-N.Y.) related to stock sales of an Australian biotechnology firm. The Office of Congressional Ethics (OCE) on Thursday said Price was one of 10 individuals or entities that refused to cooperate with the investigation into whether Collins improperly shared nonpublic information in the purchase of Innate Immunotherapeutics Limited stocks. (Weixel, 10/12)

The Associated Press: Florida Nursing Home Where 14 Died Cut From Medicare Program
The state previously banned the center from the Medicaid program. Company officials later announced they were closing permanently. A spokeswoman for the home says they'll appeal and look forward to showing evidence that their actions were consistent with all state and federal rules. (10/12)

The Washington Post: Virginia Lawmakers Say Late VA Payments Jeopardize Veterans’ Care
Members of Congress from Virginia say chronic late payments from the Department of Veterans Affairs to doctors are jeopardizing care for the state’s aging veteran population. The state’s two senators and 11 House members urged VA administrators to fix a system that can leave health-care providers waiting more than four months for payments they should have received within 30 days. The delays can damage credit, they said. (Portnoy, 10/12)

The Washington Post: ‘This Is Frightening’: Noxious Gas Has Sickened VA Workers For Two Years, With Few Solutions
Staff and patients at a D.C. medical facility for homeless military veterans have endured noxious gas exposure for nearly two years as top hospital administrators, though aware of the problem, have failed to remedy it, according to interviews with staff and documents obtained by The Washington Post. At least eight clinical workers at the Department of Veterans Affairs Community Resource and Referral Center have tested positive for elevated levels of carbon monoxide, a March internal email said, describing a potentially dangerous condition that restricts oxygen circulation. As many as 30 employees, desperate to avoid further exposure, have sought reassignment or permission to work remotely. (Horton, 10/12)

Stat: A 'Holy Cow' Moment: The FDA Approved A Record Number Of Generics
As the Food and Drug Administration attempts to foster more competition in the prescription drug market, the agency appears to be making good on one key effort — approving more generics. In fiscal year 2017, which ended Sept. 30, the agency approved a record number of applications — 763 in all. That beat the previous high of 651 in fiscal year 2016, and worked out to a monthly average of 63 approvals. (Silverman, 10/12)

The Hill: NIH, Drug Companies Launch Cancer Moonshot Partnership 
A new public-private research collaboration launched Thursday in an effort to increase the number of therapies aimed at attacking cancer. The National Institutes of Health (NIH) is partnering with 11 biopharmaceutical companies to form the Partnership for Accelerating Cancer Therapies (PACT), a five-year, $215 million initiative. It’s part of the Cancer Moonshot, an effort pushed by former Vice President Joe Biden after he lost his son to brain cancer in 2015. (Roubein, 10/12)

The Hill: New Campaign Launched For Low Cost Generics
Patients for Affordable Drugs is launching a new campaign to pass a bill aimed at easing hurdles to bringing lower cost generic drugs to the market. The group wants the CREATES Act passed, viewing it as a measure for decreasing the costs of prescription drugs. (Roubein, 10/13)

The Washington Post: FDA Advisers Urge Approval For First Gene Therapy For Inherited Disease
A Food and Drug Administration advisory committee unanimously endorsed an experimental gene therapy Thursday for patients with a rare kind of hereditary blindness, setting the stage for a historic approval. If the agency agrees with the recommendation, the one-time treatment would be the first gene therapy cleared in the United States for an inherited disorder. (McGinley, 10/12)

NPR: First Gene Therapy For An Inherited Disorder Gets Expert Endorsement
Gene therapy, which has had a roller-coaster history of high hopes and devastating disappointments, took an important step forward Thursday. A Food and Drug Administration advisory committee endorsed the first gene therapy for an inherited disorder — a rare condition that causes a progressive form of blindness that usually starts in childhood. (Stein, 10/12)

The Washington Post: Steps The U.S. Government Should Take Right Now Against The Opioid Epidemic
The Food and Drug Administration should consider banning “ultra-high-dosage” painkillers from the market, and law enforcement must step up efforts to curb the flow of heroin and fentanyl into the United States if the nation hopes to come to grips with the opioid epidemic, two authorities on the crisis said Thursday. (Bernstein, 10/12)

The Associated Press: Hospital Revives Toddler Who Tested Positive For Opioids
Police in Ohio say hospital workers used three doses of the overdose drug naloxone to revive a 1½-year-old boy who tested positive for opioids. The child’s mother tells police in Toledo that her older son saw the toddler put a bag in his mouth that he found at a neighborhood park. (10/12)

The Associated Press: Judge OK Denying Parole To Pregnant Addict For Baby’s Sake
An appeals court says a Pennsylvania judge was justified in denying parole to a pregnant addict to safeguard her unborn child from her drug abuse. A Superior Court panel on Tuesday agreed Lehigh County Judge James Anthony was right to deny parole to Britnee Becker last year. (10/12)

Los Angeles Times: Nearly 4 In 10 U.S. Adults Are Now Obese, CDC Says
Americans’ obesity rates have reached a new high-water mark. Again. In 2015 and 2016, just short of 4 in 10 American adults had a body mass index that put them in obese territory. In addition, just under 2 in 10 American children — those between 2 and 19 years of age — are now considered obese as well. (Healy, 10/12)

The New York Times: A Condom-Maker’s Discovery: Size Matters
Condoms get a bad rap for being a bad wrap. Men often complain of discomfort, diminished sensation and poor fit. A recent federal study found only a third of American men use them. Now, changes by the Food and Drug Administration and industry-standards groups have opened the door to the condom equivalent of bespoke suits. A Boston-based company has begun selling custom-fit condoms in 60 sizes, in combinations of 10 lengths and nine circumferences. (Belluck, 10/12)

Los Angeles Times: When It Comes To Cancer, Here's What You Should Sweat And Here's What You Shouldn't
We all want to avoid cancer. That’s a given. But when cancer risk seems to lurk everywhere, it’s hard to know what you really need to do to protect yourself. The stakes are high. As many as 40% of cancer cases, and about half of all cancer deaths, could be prevented with a healthy lifestyle, according to a study by Harvard researchers published in the journal JAMA Oncology. (Woolston, 10/12)

Los Angeles Times: Life After Cancer: “The Real Battle Happened After Treatment”
Bin McLaurin was lucky. Doctors detected his prostate cancer early, and he successfully completed the surgery, radiation and hormone therapy he needed to keep the disease at bay. But two years out from his 2014 diagnosis, McLaurin didn't feel so great. He had gained 60 pounds during treatment, and the hormones he was taking sapped his energy and drive. (Brown, 10/12)

Los Angeles Times: Your Guide To The Latest In Cancer Screening Tests: Which Do You Need, Which Can You Skip?
Cancer screening could save your life. Then again, it could give you a false alarm or lull you into a false sense of security. Screening is a science, but it’s not an exact science. “Sometimes people think it’s better than it actually is,” says Dr. Otis Brawley, chief medical officer for the American Cancer Society. (Ravn, 10/12)

Los Angeles Times: Curing Cancer Isn't Always The Goal. Sometimes You Just Want It To Be A Manageable Chronic Disease
If you can’t beat ’em, manage ’em. Millions of patients live by that rule every day — patients with chronic conditions that can’t be cured but can be kept under control with the right combination of medication, diet and lifestyle choices. (Ravn, 10/12)

Los Angeles Times: Northern California Firestorm Brings Illness, Strains Healthcare System
The deadly Northern California fires — by forcing the evacuation of several hospitals and clinics and destroying the homes of many doctors and nurses — have put a strain on available medical services. The Petaluma Health Center canceled all scheduled appointments this week to make time for people requiring urgent care. They’ve treated asthmatics struggling to breathe amid some of the most unhealthy air in Bay Area history, as well as people who sprained their ankles or forgot to grab their medications as they raced from burning homes in nearby Santa Rosa, clinic chief administrative officer Pedro Toledo said. (Karlamangla, 10/12)

NPR: Wildfire Smoke Has Made Bay Area Air Quality Its Worst On Record
Air pollution in counties of the San Francisco Bay Area this week has been the worst since 1999 when officials began collecting data. "The pollution is so high it's comparable to high pollution days in China," says Lisa Fasano at the Bay Area Air Quality Management District. (McClurg, 10/12)

The Washington Post: A Mother Was Jailed For Refusing To Vaccinate Her Son. Now She’s Outraged He’s Been Immunized.
A Michigan mother said she's had a “rough few days” after serving nearly a week in jail for defying a court order to have her 9-year-old son vaccinated and then learning that he received several immunizations after she was locked up behind bars. Rebecca Bredow, from the Detroit area, was sentenced last week for contempt of court nearly a year after an Oakland County judge ordered her to have her son vaccinated. (Bever and Phillips, 10/12)

The Washington Post: A Doctor Shouted At A Sick Mother To ‘Get The Hell Out.’ Now He’s Under Criminal Investigation.
A doctor in northern Florida is under criminal investigation after he was seen on video shouting at a patient to “get the hell out” of an urgent-care clinic, then apparently grabbing her daughter's cellphone, which was recording the incident. Peter Gallogly, a physician at Gainesville After-Hours Clinic, was captured on video Monday arguing with a patient who was scolding him for a long wait time. (Bever, 10/12)