The Wall Street Journal: Election Shifts Health-Care Landscape Across The U.S.
The midterm elections abruptly shifted the health-care landscape across the country, strengthening the position of the Affordable Care Act while resulting in a divided Congress that could mean most changes unfold on the state level. Health care was the No. 1 issue among voters this election, according to an AP survey of about 90,000 people. The voting results suggested a rebuke to repeated Republican efforts to roll back the health law, and that many Americans care deeply about issues such as coverage for pre-existing medical conditions. (Armour, 11/8)

Modern Healthcare: Medicaid Expansion In Alaska, Montana Threatened By Midterm Results
Medicaid expansion in Alaska and Montana potentially could be rolled back or repealed as a result of Tuesday's midterm election results. If that happens, it would be the first time the extension of coverage to low-income adults under the Affordable Care Act was ever reversed. (Meyer, 11/8)

Kaiser Health News: Montana’s Legislature Could Decide Medicaid Expansion’s Fate
A ballot initiative that would have continued funding Montana’s Medicaid expansion beyond June 2019 has failed. But advocates say they’ll continue to push for money to keep the expansion going after that financial sunset. “We now turn our attention to the legislature to maintain Montana’s bipartisan Medicaid expansion and protect those enrolled from harmful restrictions that would take away health insurance coverage,” said a concession statement Wednesday from Chris Laslovich, campaign manager with the advocacy group Healthy Montana, which supported the measure. (Whitney, 11/9)

Billings Gazette: Medicaid Decisions Move To Montana Legislature
The initiative to raise tobacco taxes to fund health care appeared to be going down to defeat Wednesday as ballots were still being counted around Montana. (11/8)

And in other election news —

The New York Times: Gretchen Whitmer Of Michigan Was Overlooked. Not Any Longer.
There is a tendency for people to define Gretchen Whitmer by who she is not. Ms. Whitmer was not one of the surprising, insurgent Democratic nominees for governor this cycle, as her campaign for Michigan’s governorship was flush with money and key endorsements from the outset. She did not have the up-from-nothing background story of some other Democratic candidates; after all, a building in downtown Detroit is named for her father, the former chief executive of Blue Cross Blue Shield. She was not Abdul El-Sayed, the fiery leftist whose campaign for governor captured national attention, but who lost badly to Ms. Whitmer in the primary. ... Mr. El-Sayed consistently chided Ms. Whitmer on health care. Though Ms. Whitmer was integral in helping Michigan expand Medicaid in 2013, she refused to back the Medicare-for-all proposal that Mr. El-Sayed and other progressive stalwarts attributed to her close connection with the health care industry and companies like Blue Cross Blue Shield. (Herndon, 11/8)

The Associated Press: Health Insurers Riding Postelection Wave
Health insurers are extending their postelection streak before the opening bell thanks to several ballot initiatives and the increased chance that a divided Congress that may not repeal the Affordable Care Act. Shares of Centene Corp., WellCare Health Plans Inc. and Humana Inc., up between 7 percent and 9 percent this week, all edged higher in premarket trading, defying the broader markets which are retreating Thursday. The hospital chain HCA Healthcare Inc., up 5 percent for the week, is rising again. (11/8)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Split Decision On Health Care
Voters on Election Day gave control of the U.S. House to the Democrats but kept the U.S. Senate Republican. That will mean Republicans will no longer be able to pursue partisan changes to the Affordable Care Act or Medicare. But it also may mean that not much else will get done that does not have broad bipartisan support. (Rovner, 11/8)

The Hill: House Dems Plan Key Vote On Pre-Existing Conditions 
House Democrats are planning to hold a vote to protect people with pre-existing conditions, a key issue that powered their victory on Tuesday, quickly after taking the majority next year. A House Democratic aide said the vote would be on a measure to have the House of Representatives formally intervene in an anti-ObamaCare lawsuit to defend the health law. (Sullivan, 11/8)

Politico: House Democrats Weigh Joining Obamacare Suit
The move would come soon after the next Congress is sworn in and marks an early attempt to make good on campaign pledges to protect the Affordable Care Act, House sources told POLITICO. Bringing up a resolution to intervene in the case also would force an early vote that puts chamber's Republicans on record about protecting the law and its popular preexisting condition protections.(Ollstein and Cancryn, 11/8)

WBUR: Rep. Neal, Poised To Chair Ways And Means, Will Prioritize Health Care And Trump's Tax Returns
With Democrats now poised to seize control of the U.S. House from Republicans, Congressman Richard Neal of Springfield is ready to take on a more powerful role. The 69-year-old said Wednesday that his plans include protecting Social Security and the Affordable Care Act, and requesting President Trump's tax returns. (DeFeudis, 11/8)

And in health law news from the states —

Sacramento Bee: Covered California Kicks Off Open Enrollment Campaign At Sacramento Event
Covered California, the Golden State’s health insurance marketplace, leaped into its open enrollment period at its headquarters in Sacramento on Thursday morning, commissioning a choreographer and dancers to depict how unexpected life events can leave people thankful they have medical coverage. (Anderson, 11/8)

Seattle Times: Washington State Obamacare Signups Increase; 190,000 So Far This Month 
Despite changes to the Affordable Care Act during the past couple of years, local health-insurance officials are optimistic that the state’s health-insurance exchange will flourish in 2019. Since enrollment for 2019 began Nov. 1, about 190,000 people have signed up for health insurance through the Washington Health Benefit Exchange, which is about 5 percent more than the same period last year. (Blethen, 11/8)

MPR: MNsure Says Open Enrollment Off To Smooth Start
MNsure officials say they consumers are showing strong interest in buying non-group health plans for next year, despite the end of the federal mandate to have coverage. MNsure CEO Nate Clark said through Wednesday, the agency's website had nearly 190,000 visits and that its comparison shopping tool has logged more than 3,300 sessions since open enrollment began November first. (Zdechlik, 11/8)

Stat: Elijah Cummings Sparred With Martin Shkreli And Mylan’s CEO. Now He’s Got A Gavel To Take On Pharma
He accused Valeant Pharmaceuticals of obstructing a congressional investigation into its pricing practices. He called out Biogen for charging so much for a multiple sclerosis drug that the government holds a patent on. And he famously scolded a smirking Martin Shkreli during a hearing, saying, “It’s not funny, Mr. Shkreli. People are dying.” For years, Elijah Cummings has been a persistent, if forceless, thorn in the pharmaceutical industry’s side. Now, though, Congress’ pharma critic-in-chief will be armed with the authority of a powerful committee chairmanship at a time when lawmakers in both parties are squeezing drug companies more than ever before. (Joseph, 11/9)

The Hill: Dem Overtures To Trump On Drug Pricing Worry Pharma 
The Democratic takeover of the House is giving new life to efforts to fight high drug prices with bipartisan action, a worrying prospect for the pharmaceutical industry. It’s a top priority for House Democrats, who now have powers to press the issue and put the drug industry on the hot seat. It’s also an issue where Democrats believe there is potential to reach a deal with President Trump. (Sullivan, 11/8)

The New York Times: F.D.A. Plans To Ban Most Flavored E-Cigarette Sales In Stores
The Food and Drug Administration plans to ban sales of most flavored e-cigarettes in retail stores and gas stations around the country, in an effort to reduce the popularity of vaping among young people. The agency also plans to require age-verification measures for online sales to try to ensure that minors are not able to buy the flavor pods. (Kaplan, 11/8)

Reuters: U.S. To Restrict E-Cigarette Flavors To Fight Teenage Vaping 'Epidemic'
The ban means only tobacco, mint and menthol flavors can be sold at these outlets, the agency official said, potentially dealing a major blow to Juul Labs Inc, the San Francisco-based market leader in vape devices. The FDA also will introduce stricter age-verification requirements for online sales of e-cigarettes. The FDA’s planned restrictions, first reported by The Washington Post and confirmed to Reuters by the official, do not apply to vape shops or other specialty retail stores. (Reuters, 11/9)

The Washington Post: FDA Plans Curbs On E-Cigarette Sales Over Concerns About Surge In Teen Vaping
The FDA’s initiatives on vaping are spurred by preliminary government data that show ­e-cigarette use rose 77 percent among high schoolers and nearly 50 percent among middle schoolers in 2018. That means 3.5 million children were vaping in early 2018, up 1 million from 2017. Gottlieb, who once served on the board of a North Carolina vaping company, was at one time viewed as an ally of the e-cigarette industry, and he delayed some critical e-cigarette rules shortly after becoming commissioner in 2017. He has also said his first priority is protecting children from tobacco-related disease. Most vaping products are flavored, and studies show teenagers are attracted to the flavors. (McGinley, 11/8)

Bloomberg: FDA Is Said To Prepare Strict New Limits On E-Cigarette Sales 
The FDA has talked for months about ways to reduce youth use, citing rising concern that e-cigarettes are creating a new class of nicotine users, rather than primarily helping people transition off regular cigarettes. The FDA has called youth use of the devices “an epidemic” and said it would consider significant action to stop it. Vaping surged 77 percent among high school-age children and about 50 percent among middle-schoolers in 2018, according to preliminary government data. (Armstrong, Edney and Zaleski, 11/8)

The Wall Street Journal: New York Eyes Ban Of Flavored E-Cigarettes
The Cuomo administration is planning to ban the sale of flavored e-cigarettes as soon as next year—putting New York at the forefront of growing efforts around the country to rein in the products. The state Department of Health posted regulations on Wednesday banning the sale or possession of flavored e-cigarettes, citing an “alarming increase of e-cigarette use among New York’s youth” and a desire to “protect our youth from a lifetime addiction to nicotine.” (Vielkind, 11/8)

Politico's Pulse Check: FDA Commissioner Scott Gottlieb
The FDA commissioner explains why he's cracking down on e-cigarettes, how he views science in the Trump administration and the reaction to his infamous "almonds don't lactate" line, and much more. (11/8)

In other news from the agency —

The Associated Press: FDA Approves Return Of Popular Primatene Mist Asthma Inhaler
A new version of the once-popular asthma inhaler Primatene Mist will soon return to U.S. stores. The Food and Drug Administration approved the over-the-counter aerosol inhaler late Wednesday. It's for temporary relief of mild, intermittent asthma symptoms in people ages 12 and up. (11/8)

The Washington Post: Ventura Shooting: Guard, Officer Killed, Stoking Debate About Active-Shooter Defenses
The gunman began his rampage by shooting an unarmed security guard outside a country-music bar in California, police said. After the attacker began firing on patrons inside, a sergeant with the sheriff’s office charged into the building to confront him and was cut down by gunfire. The Ventura County mass shooting that left 12 dead Wednesday became a grim test case in a persistent debate about how places such as schools, nightclubs and houses of worship should steel themselves against shooters and how police should respond to them. (Jouvenal and Horton, 11/8)

The New York Times: A Look At California Gun Laws, Among The Toughest In The Nation
California, where a gunman killed 12 people in a bar in Thousand Oaks on Wednesday night, has some of the strictest gun laws in the country. It was the first state to ban assault weapons in 1989 after a shooting at a Stockton elementary school left five students dead. In the wake of several recent mass shootings — including one in February in Parkland, Fla., where a gunman killed 17 students and employees at a high school — state legislators put forward at least nine new gun control bills in response. Here’s a look at the state of gun regulations in California. (Urbina, 11/8)

CNN: Doctors Share Gun Stories, Demand Action After NRA Tells Them To 'Stay In Their Lane'
Two signs of the times: another mass shooting and more Twitter outrage. This time, though, the barbs over social media came from the medical community in response to a tweet from the National Rifle Association. The piling-on began after the NRA tweeted on Wednesday a link to an article from its Institute of Legislative Action. The article, titled "Surprise: Physician Group Rehashes Same Tired Gun Control Policies," was promoted with these words: "Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves." (Ravitz, 11/8)

The Associated Press: California Gunman Was Volatile But Passed Mental Assessment
Neighbors of Ian David Long described the man who shot and killed 12 people at a country music bar as distant in public but combative with his mother inside the suburban Los Angeles home the two shared. One ruckus in April was so extreme that they called law enforcement. Authorities brought in a mental health specialist who concluded that Long could not be involuntarily committed for psychiatric observation but worried the 28-year-old Marine veteran might have post-traumatic stress disorder. (Ronayne and Pritchard, 11/9)

The Wall Street Journal: Police Probe Motive In Southern California Bar Massacre
From Las Vegas to Parkland, Fla., Pittsburgh to Santa Fe, Texas, the nation has been shaken by the frequency of mass shootings over the past two years. The Federal Bureau of Investigation says 30 active-shooter incidents in 2017 left in 138 people dead—both the highest totals since the FBI began keeping track in 2000. The FBI defines an active shooter as someone actively engaged in killing or attempting to kill people in a populated area. (Lovett, Frosch and Elinson, 11/8)

The Wall Street Journal: California Bar Shooter Had Domestic-Disturbance History After Serving In Afghanistan
Ian David Long, identified as the gunman in a mass shooting here, was a high-school baseball player remembered as a perfectionist who dropped the sport his senior year in part to focus on joining the military. When Long’s baseball coach sat down to write about him in a yearbook, one word came to mind: “Intensity!” (Berzon and Randazzo, 11/8)

KQED: Thousand Oaks Shooter's Health Frayed In College, Roommate Says
Research on links between mental health disorders associated with military service and violent acts leaves an incomplete picture. Impulsive aggression, like getting into fistfights, has been tied to PTSD. But there was no higher likelihood for premeditated aggression in veterans suffering from PTSD. (Suulvado, Jamali, Gilbertson and Denkmann, 11/8)

The Washington Post: ‘A Surreal Shock’: Las Vegas Shooting Survivors Live Through California Massacre
When the first shots were fired at Borderline Bar & Grill, David Anderson immediately knew he was in the middle of a mass shooting. He had lived through one last year. Anderson survived the attack at a country music festival in Las Vegas in October 2017 that left 58 people dead. On Wednesday, he again survived a gunman indiscriminately firing at people enjoying country music, this time at college night at a well-loved bar. Twelve people were killed. (Zezima and Mettler, 11/9)

The Washington Post: Thousand Oaks Parents: ‘I Don’t Want Prayers. I Don’t Want Thoughts. I Want Gun Control.’
Marc and Susan Orfanos awoke at 2 a.m. on Thursday in Thousand Oaks, Calif., to a call from a relative in New York. The groggy-eyed couple stumbled into a ritual that is familiar to parents in Columbine, Blacksburg, Aurora, Newtown, Orlando, Parkland — and, as of this week, also in the quiet outpost of Los Angeles. They waited to find out if their child, who had survived the deadliest gun massacre in modern American history last year in Las Vegas, had perished in another mass-casualty shooting. (Stanley-Becker, 11/9)

Los Angeles Times: 'We Have Been Drawn Into This Terror': At Vigils, Thousand Oaks Grieves For 12 Victims Of Mass Shooting
The wind that roared through Thousand Oaks on Thursday night threatened to drown out their voices, but the mourners still sang, channeling their grief, shock and anger into a familiar melody. More than 100 people fell silent as the strains of “Amazing Grace” wafted through the crowd and the light-wrapped trees on the lawn outside the Thousand Oaks Civic Arts Plaza. (Gerber, Karlamangla, Newberry and Greene, 11/8)

Kaiser Health News: Deadly Shootings Are Rising In U.S. After Steady Declines
After steadily declining for more than two decades, deadly shootings are rising across the country, according to a new government report. The researchers also said that the number of suicides involving a firearm grew 21 percent between 2006 and 2016. The report, published Thursday by the Centers for Disease Control and Prevention, looked at gun deaths around the country and in 50 major metropolitan areas. The researchers found a rise in gun homicides in 2015 and 2016, reversing a downward trend and bringing them to a level comparable to a decade ago. (Heredia Rodriguez, 11/9)

CNN: Gun Deaths Increasing After Years Of Decline
During 2015-16, 27,394 people were killed by someone with a gun in the United States, and 44,955 used a gun to kill themselves, according to a report published Thursday in the agency's Morbidity and Mortality Weekly Report. Researchers looked at firearm homicides and suicides from 2012-13 to 2015-16 in the 50 most populous US metropolitan areas, including Los Angeles, not far from Wednesday's mass shooting at a bar in Thousand Oaks that left 13 dead, including the suspect. (Christensen, 11/8)

And in other news —

The Associated Press: Mother On A Mission: Gun Control Advocate Wins US House Race
In a campaign ad pierced by the sound of gunfire, Lucy McBath earlier this year laid out the story of her 17-year-old son's shooting death and how his loss propelled her to activism. The story resonated with voters, who elected her Tuesday to fill a long-red House seat that Georgia Republicans held onto just last year. (Martin and Santana, 11/8)

Politico: How An All-Woman, Pro-Gun Control Ad Crew Is Flipping Republican Seats
When Sen. Chris Murphy of Connecticut gave his now-famous filibuster in the aftermath of the 2016 Pulse nightclub shooting, his impassioned plea for increased gun control galvanized liberals across the country. One of them, all the way on the other coast in Los Angeles, was Sarah Ullman. The 30-year-old had once interned for Murphy and relocated to pursue a career as a filmmaker, but she was moved deeply enough that she launched a special undertaking, separate from but related to her primary career. She began to make political ads for progressive, pro-gun control candidates across the country with her super PAC, One Vote at a Time. (Flores and Robertson, 11/9)

MPR: Twin Cities Researchers To Discuss Preliminary Results Of Mass Shooting Study
Two Twin Cities professors have been working on a study of mass shootings. They're trying to find ways to identify people who might turn into mass shooters, and strategies to prevent attacks like the one in California this week and the many before it. They recently received a $300,000 federal grant to further that research. (Roth, 11/8)

ProPublica: The Strange Case Of American Diplomats In Cuba: As The Mystery Deepens, So Do Divisions in Washington
Yet more than a year after the CIA secretly shut down its Havana station and the State Department withdrew most of its diplomats from Cuba in response to the incidents there, escalating a bitter new cold war between the two countries, U.S. investigators still have no clear idea who or what made the Americans sick. A sprawling investigation has enlisted law enforcement agents, intelligence officers and defense experts, as well as scientists and medical specialists from within and outside government. (Golden and Rotella, 11/9)

The New York Times: Under 40 With High Blood Pressure? Be Wary Of Heart Risks
Adults under 40 with high blood pressure are at increased risk for cardiovascular disease later in life, researchers have found. A prospective study published in JAMA included 4,851 American adults whose average age was 36. They had their blood pressure measured on two occasions at the start and were followed for an average of 19 years. Over the period, there were 228 instances of coronary heart disease, stroke, heart failure or peripheral artery disease. (Bakalar, 11/8)

The New York Times: The Ecosystem In Immigrants’ Guts Is Shaped By The Place They Call Home
Bodies that migrate across borders undergo tremendous change. Immediately, feet alight on alien terrain, ears channel novel sounds and noses breathe in unfamiliar scents. More gradually, daily routines fall into new rhythms, cultural norms hybridize and dreams evolve. Another transformation occurs deep within the body, two recent studies from the Netherlands and United States find, as the trillions of microbes that live in the human digestive system shift in composition. (Yin, 11/8)

Miami Herald: Taxes On Red Meat Save Lives, Cut Health Care Costs: Study
A team of researchers led by Oxford population health scientist Marco Springmann have published a study that says there’s a relatively simple way to save 220,000 lives per year, and to cut about $41 billion in global annual health care costs. ...If authorities imposed a meat tax, for public health reasons, of 34 percent on unprocessed meats — meats that have not been smoked, cured, salted or preserved with chemicals like nitrates — and a whopping 163 percent on processed meats — like bacon, sausage, pastrami or hotdogs — enough people would shy away from meat to prevent 220,000 people from dying each year. (Martinez, 11/8)

The New York Times: Crossing From Asia, The First Americans Rushed Into The Unknown
Nearly 11,000 years ago, a man died in what is now Nevada. Wrapped in a rabbit-skin blanket and reed mats, he was buried in a place called Spirit Cave. Now scientists have recovered and analyzed his DNA, along with that of 70 other ancient people whose remains were discovered throughout the Americas. The findings lend astonishing detail to a story once lost to prehistory: how and when humans spread across the Western Hemisphere. (Zimmer, 11/8)

Stat: Animal Rights Group To Drug Makers: End Test That 'Traumatizes' Rodents
A leading animal rights group wants four big drug makers to abandon a decades-old test that has been used for antidepressant research, over concerns the testing may traumatize rodents while failing to yield any reliable outcomes for drug development. At issue is the so-called forced swim test in which mice, rats, guinea pigs, and gerbils are placed in beakers filled with water and forced to swim in order to keep from drowning. The test has been used to gauge the effectiveness of antidepressants on the theory that an animal will swim or struggle longer, and spend less time floating, after being given one of these pills. (Silverman, 11/8)

Boston Globe: Millions Of Older People Fall Each Year. Sometimes The Effects Can Be Dire
Not much information has been released about Supreme Court Justice Ruth Bader Ginsburg’s falling and breaking her ribs. The Supreme Court has issued a terse statement saying that the 85-year-old justice fell in her office, went home, but then went to the hospital for observation and treatment for fractures to three ribs on her left side. But one thing is clear: Falls are a problem for older people. The risk of falling rises as people get older and, once falls happen, they can cause broken bones — and even more serious problems, including disability and death. (Finucane, 11/8)

NPR: Sadness Circuit Found In Human Brain
Scientists may have caught a glimpse of what sadness looks like in the brain. A study of 21 people found that for most, feeling down was associated with greater communication between brain areas involved in emotion and memory, a team from the University of California, San Francisco reported Thursday in the journal Cell. "There was one network that over and over would tell us whether they were feeling happy or sad," says Vikaas Sohal, an associate professor of psychiatry at UCSF. (Hamilton, 11/8)

The Wall Street Journal: Google Picks Geisinger CEO To Oversee Health-Care Initiatives
Google is expected to name a prominent hospital-system chief executive to a newly created role overseeing the technology company’s health-care efforts. David Feinberg is moving to the new Google health-care post after leading the Geisinger health system, which includes a health plan and hospital system operating in Pennsylvania and New Jersey. (Hopkins and Wilde Mathews and MacMillan, 11/8)

CNBC: Google Hires Geisinger CEO David Feinberg To Oversee Health
The search has been underway for months, according to several people familiar with the search process. Artificial intelligence head Jeff Dean has been deeply involved in the process and personally interviewing candidates, the people said. Some of the candidates have included leaders in health consulting, hospital management and insurance. The position would report to Dean, but would also work closely with Google CEO Sundar Pichai. Feinberg's job will be figuring out how to organize Google's fragmented health initiatives, which overlap among many different business groups. (Farr, 11/8)

Business Insider: Google Hires Geisinger CEO David Feinberg 
Feinberg has been at Geisinger, a health system in Pennsylvania that provides health insurance as well as care through its medical centers, since 2015. Prior to that he served as CEO of UCLA's health system. Ryu is an emergency medicine physician, who previously worked as an executive at the health insurer Humana. He joined Geisinger in 2016. (Ramsey, 11/9)

Modern Healthcare: Google Hires Geisinger CEO Dr. David Feinberg
Google has been snapping up healthcare executives recently. In July, Google parent company Alphabet hired former Cleveland Clinic CEO Dr. Toby Cosgrove to be an executive adviser to the Google Cloud healthcare and life sciences team. Earlier, the company brought on Dr. Michael Howell, former director of the Center for Healthcare Delivery Science and Innovation at University of Chicago Medicine, as Google Research's chief clinical strategist. The company also brought on Dr. Vivian Lee, former CEO of University of Utah Health Care, as president of health platforms for Alphabet's Verily Life Sciences. (Arndt, 11/8)

Stat: HHS Recommended That The DEA Ban Kratom, Documents Show 
The Department of Health and Human Services has recommended a ban on the chemicals in kratom that would make the popular herbal supplement as illegal as heroin or LSD, according to documents obtained by STAT. HHS asserted in a letter to the Drug Enforcement Administration that two chemicals in kratom should be classified as Schedule I substances, meaning that the chemicals have “a high potential for abuse” and that there is “no currently accepted medical use” for them. The letter was accompanied by a supporting analysis. (Swetlitz, 11/9)

Milwaukee Journal Sentinel: Do Needle Exchanges Work? Advocates Say Yes But The Research Is Mixed
One tool to combat infection is giving users clean needles in exchange for used ones, says Gina Allende, health promotions manager at UMOS, a nonprofit group on the city’s south side. But there is heated debate — some of it politicized — over whether these programs work, and research in the U.S., at least, is mixed. (Mendez, 11/8)

Boston Globe: From Canada, Ideas On Keeping People Safe From ‘Poisoned’ Illicit Drugs
The state’s Harm Reduction Commission recently held its first meeting to study the controversial proposal to open a place or places where people could inject illicit drugs under medical supervision. The commission, created by the opioid legislation signed into law in August, has until February to report to the Legislature on the risks and benefits of establishing “supervised injection facilities” or “safe injection sites.” (Freyer, 11/7)

The Baltimore Sun: Some Maryland Workers Turn Heavily To Opioids When Injured, Study Finds 
Close to a third of Maryland workers who filed injury compensation claims in recent years continued to rely on highly addictive opioid painkillers three months after they were hurt, according to a recent study by University of Maryland School of Medicine researchers. Excessive use of painkillers such as OxyContin and Vicodin, along with use of the illegal opioids herion and fenantyl, has been cited in the opioid overdose crisis around the nation that has led to tens of thousands of deaths a year. (Cohn, 11/8)

Reuters: U.S. Regulators Snip Red Tape For Medical Devices To Curb Opioid Crisis
Laura Perryman expected her medical company, Stimwave Technologies Inc, would have to wait several years for its painkilling device to win U.S. approval as a treatment for chronic migraines. She now thinks it could be done in months, thanks to a new initiative by the U.S. Food and Drug Administration to use medical device-based treatments, diagnostic tests and mobile medical apps to address the country's opioid crisis. (11/9)

Medpage: Calif.'s 'Death Certificate Project' Nabs 11 More Physicians
Another 11 physicians now face new "Death Certificate Project" accusations from the Medical Board of California, filed over the last month, because a patient for whom they had prescribed narcotics fatally overdosed years ago. That brings the total to 23 physicians who face new disciplinary actions. (Clark, 11/6)

The Associated Press: Group Challenges Kansas Ban On Telemedicine Abortions
A group that supports abortion rights on Thursday filed a lawsuit challenging a Kansas ban on telemedicine abortions, a practice that allows women in rural areas to get abortion pills without an in-office consultation in a city clinic. The Center for Reproductive Rights contends the anti-abortion section in the Kansas Telemedicine Act is unconstitutional because it treats women seeking abortions differently from other patients seeking medical care through telemedicine. (11/8)

The Associated Press: Kentucky Abortion Battle Shifts To Second-Trimester Ban
Kentucky’s protracted legal fight over abortion is entering a new round involving the same combatants, but this time they’ll be arguing over a second-trimester procedure to end pregnancies. Lawyers for Kentucky’s only abortion clinic will argue in federal court next week that a new state law amounts to an unconstitutional ban on a procedure they term the “safest and most common method” of second-trimester abortions. Critics called the procedure a form of dismemberment of a live fetus. (Schreiner, 11/8)

The Associated Press: Lawyers: Cops Didn't Have Key As Women Drowned In Police Van
Two women drowned in the back of a locked cage while being taken for involuntary commitment to a mental hospital because the police van they were in took an unsafe route and rolled over, and deputies lacked a key or bolt cutters to get them out, a lawyer for one of the women's families told South Carolina lawmakers Thursday. The deputies, who drove around barricades and a manned checkpoint and ignored the safer route they had been given to avoid floodwaters from Hurricane Florence, bear plenty of responsibility for the deaths of Wendy Newton and Nicolette Green, said Tommy Brittain, a lawyer for Newton's family. (Collins, 11/8)

The Associated Press: Harvard Medical School Receives 'Transformational' Gift
Harvard has received a $200 million gift that officials say is the largest in its medical school's 236-year history. The gift announced Thursday is from Len Blavatnik and the Blavatnik Family Foundation. Officials say the gift will allow the medical school to accelerate research and develop new tools to diagnose, prevent and treat disease. (11/8)

The Oregonian: Portland Mental Health Center Cleared Of Federal, State Investigation 
Portland's main psychiatric center is in the clear from federal and state scrutiny as of this week. The U.S. Centers for Medicare and Medicaid Services notified Unity Center for Behavioral Health on Wednesday night that it had made all the necessary improvements after nearly a year of oversight for severe and persistent safety problems. The Oregon Health Authority, on behalf of the federal government, had issued two damning reports with findings that included at least two preventable patient deaths and patient-on-patient sexual assaults. Other issues included patients harming themselves and escaping the center. (Harbarger, 11/8)

Nashville Tennessean: Nashville Is Getting A New 76-Bed Mental Health Hospital
As Nashville continues to struggle with an overwhelming need for mental health care, state officials have approved plans for a new behavioral health facility in the city’s Metro Center area. The 76-bed hospital, a joint venture from Saint Thomas Health and Acadia Healthcare, is expected to open in 2020, according to a new release issued on Thursday. The facility will include 40 adult psychiatric beds, providing inpatient care and substance abuse services, and 36 geriatric psychiatric beds, the release said. (Kelman, 11/8)

Milwaukee Journal Sentinel: Health Care Prices In Milwaukee, Green Bay Well Above National Average
Different studies over the years have shown that health care prices in the Milwaukee area are higher than those in other markets. The Health Care Cost Institute now has an estimate on just how much higher. Its estimate: Milwaukee's prices are 17 percent above the national average. (Boulton, 11/8)

The Associated Press: 1 Death Linked To Ongoing Turkey Salmonella Outbreak
Federal health officials on Thursday reported the first death in an ongoing salmonella outbreak linked to raw turkey. The Centers for Disease Control and Prevention said the death was in California but didn't have any immediate details. Since last November, the agency said 164 people have fallen ill in 35 states, with the most recent case being reported on Oct. 20. (11/8)

Cincinnati Enquirer: WalletHub: Ohioans Have 12th Worst Weight Problem In U.S.
Ohio – you can stand to lose a few poundsThat's the message WalletHub relayed as it ranked the state as the 12th highest obesity and overweight problem in the U.S. And the findings from WalletHub analyst Jill Gonzalez are grim. (Pugh, 11/8)

East Oregonian: Boardman Health Clinic Seeks To Open Center In Pendleton 
The empty office building at the former site of St. Anthony Hospital could become home to a new Pendleton health clinic. Columbia River Community Health Services, Boardman, is looking to buy and renovate the three-story building with the help of a Community Development Block Grant from Business Oregon. The county board of commissioners voted 3-0 at its meeting Wednesday in Pendleton for the county to serve as the grant applicant. Columbia River Health also runs Umatilla County’s school-based health center. (Wright, 11/8)

Houston Chronicle: Texas Tech Child Psychiatry Hub Opens In Midland 
The children’s and adolescent psychiatry hub in Midland is open for business. Officials from Texas Tech University Health Sciences Center, the Midland Development Corp., Midland Health and the city of Midland cut the ribbon Thursday on a new facility in central Midland. The ceremony also served as an acknowledgment of a partnership that could impact as many as 9,000 children and adolescents in West Texas every year. (Doreen, 11/8)

KCUR: Most Kansas City Area Hospitals Do Well In A New Patient Safety Report 
Seven of 20 Kansas City area hospitals got A’s in patient safety, according to a new report, while nine got B’s and four got C’s. The grades were assigned by The Leapfrog Group, a nonprofit that twice a year rates 2,600 general acute-care hospitals across the country on patient safety measures. The 28 performance measures include handwashing practices, blood infections and patient falls. Leapfrog uses the measures to come up with a single letter grade ranging from A to F, meant to show how effective a hospital is in keeping patients safe from preventable harm and medical errors. (Margolies, 11/9)

Cincinnati Enquirer: Future Cloudy For Shriners Hospital Cincinnati As Funding, Cases Slide
Local hospital officials declined to discuss the future of the 30-bed hospital, one of 22 in the national Shriners network. But the push to lower-cost outpatient facilities is forcing Shriners to re-evaluate how to deliver care, national Shriners spokesman Mel Bower said In a statement Thursday. Bower did not have any details on what happens next. (Saker, 11/9)

Nashville Tennessean: Nashville Health Director Bill Paul Is Stepping Down — Six Months Early
Nashville’s longtime director of health announced Thursday that he will be stepping down next month — six months earlier than previously expected. Dr. Bill Paul, who has lead the Metro Public Health Department since 2007, was expected to leave the position when his current contract expired in July of next year. A news release issued Thursday said Paul will instead leave the job on Dec. 14. No explanation for Paul’s departure was provided in the statement. Paul did not immediately respond to a request for comment sent to a department spokesman. (Kelman, 11/8)

Austin American-Statesman: Austin-Based Medici Acquires Health Care Messaging Company
Five months ago, Austin-based tech company Medici raised $22 million for expansion. Now the company is putting some of that investment to work by acquiring fellow medical communication company DocbookMD, which is also based in Austin. Financial terms of the deal weren’t disclosed. (Hawkins, 11/8)

Pediatrics: A Tool To Identify Adolescents At Risk Of Cigarette Smoking Initiation
Cigarette smoking typically begins during adolescence, and the younger the age of initiation, the greater the risk of daily smoking, heavy cigarette consumption, nicotine dependence (ND), and difficulty quitting. The prevalence of “tried smoking” has declined markedly in North American youth (from 20% of US middle school students in 20136 to 7% in 20167 and from 45% of sixth- through ninth-grade Canadian students in 1994 to 8% in 2014–2015). However, 25% to 30% of never-smokers lack firm commitment to never smoke and are classified as “susceptible to smoking.” These individuals represent a key target group for prevention because the transition from never to ever smoking can lead to rapidly increasing cigarette use. (Sylvestre et al, 11/1)

JAMA Internal Medicine: Reduced Salt Intake For Heart Failure: A Systematic Review
Recent estimates suggest that more than 26 million people worldwide have heart failure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heart failure. Current management also often includes advice to reduce dietary salt intake, although the benefits are uncertain. (Mahtani et al, 11/5)

The Henry J. Kaiser Family Foundation: What Does The Outcome Of The Midterm Elections Mean For Medicaid Expansion?
While not typically an election issue, Medicaid — particularly the Medicaid expansion created under the Affordable Care Act (ACA) — was an important issue in the 2018 midterm elections in a number of campaigns throughout the country. Following the election, 37 states including the District of Columbia have adopted the ACA’s Medicaid expansion. States may implement the expansion at any time, and while they can no longer receive 100% federal financing for three years, they remain eligible for enhanced federal financing of 93% in 2019 and 90% in 2020 and beyond. Many studies on the effects of the ACA Medicaid expansion point to positive effects on coverage, access to care, service utilization, and state budgets and economies. This fact sheet highlights key states in which the results of the 2018 midterm elections have implications for Medicaid expansion adoption or implementation. States examined include those that had Medicaid expansion ballot initiatives and states in which governor races have potential implications for Medicaid expansion. In states that had governor races with implications for Medicaid expansion, changes in the composition of state legislatures are also important as governors in most states will need to work with their legislatures in order to adopt the expansion. (11/7)

Urban Institute: New Evidence Shows The Safety Net Reduces Americans’ Material Hardship By 48 Percent 
The American economy has seen strong growth and low unemployment, but many families continue to struggle. A recent Urban Institute study (based on data from the Well-Being and Basic Needs Survey) found that 4 in 10 nonelderly Americans had trouble playing for housing, food, utilities, or health care in 2017. Our study released today found that the social safety net is one tool to help Americans cope with these challenges. (McKernan and Ratcliffe, 11/5)

Health Affairs: Does Nursing Home Compare Reflect Patient Safety In Nursing Homes?
[W]e compared nursing homes’ performance on several composite quality measures from Nursing Home Compare, the most prominent recent example of a national policy aimed at improving the quality of nursing home care, to their performance on measures of patient safety in nursing homes such as pressure sores, infections, falls, and medication errors. Although Nursing Home Compare captures some aspects of patient safety, we found the relationship to be weak and somewhat inconsistent, leaving consumers who care about patient safety with little guidance. We recommend that Nursing Home Compare be refined to provide a clearer picture of patient safety and quality of life, allowing consumers to weight these domains according to their preferences and priorities. (Brauner et al., 11/05)

The New York Times: Trump Said He Wants Tougher Gun Laws. Can A New Congress Help Get Them?
This is what it’s come to — there are now Americans who have lived through two gun massacres. Many of the people who were able to flee a California bar where a man shot dozens of people late Wednesday night had also survived an attack last year in which a gunman in a Las Vegas hotel fired down on a music festival, killing 58 people. But at least one of the Las Vegas survivors was among the dead at the bar. (11/8)

The Washington Post: Voters Sent A Message In The Midterms: Enough Is Enough On Guns
Americans woke Thursday morning to the sickening news of yet another mass shooting. The crime offered a kind of tragic punctuation to a message that midterm voters sent their government on Tuesday. That message: It is time to do more than lower flags and send thoughts and prayers. This time the carnage was at a country-western dance hall in Thousand Oaks, in Southern California. This time, 12 people, including an unflinching first responder, were gunned down. “The young kids, they were just having a good time. . . . Enjoying themselves. None of them deserved this at all,” one shellshocked witness told CNN. (11/8)

The Washington Post: The NRA Wants Us To Talk About Mental Health Over Guns. Here’s Why It’s Wrong.
In the wake of almost every mass shooting — a term which, by now, has become so familiar as to feel almost disconnected from the vicious slaughter of random people in ordinary places — the National Rifle Association and its fellow travelers make the same point: There are many more guns in circulation in the United States than murders, so the problem isn’t guns, per se, but the people who turn them on innocents. The problem, they say, is mental health. (Elizabeth Bruenig, 11/8)

USA Today: The Sacrifice Of Ventura County Sheriff's Sgt. Ron Helus
Politicians, particularly at the federal level, could respond to these killings with common-sense gun laws that establish universal background checks and ban assault-style rifles and high-capacity magazines. (California outlaws both, but both are readily available in neighboring states like Nevada.) But Congress remains paralyzed when it comes to sensibly limiting the nation's growing arsenal of firearms and mass-killing accessories.  So the rampages continue, and selfless police officers like Sgt. Ron Helus elect to move toward the gunfire to limit the dying, even if it means they might die themselves. (11/8)

Los Angeles Times: Alabama's Amendment 2 Provides A View Of A Post-Roe World
In Alabama on Tuesday, 59% of voters ratified Amendment 2, adding the State Abortion Policy Amendment to the state constitution. It would be easy to dismiss Amendment 2 as an empty political gambit aimed at increasing Republican voter turnout, but that would be a mistake. Instead, it represents clear and troubling evidence of what a post-Roe vs. Wade world would look like — and the U.S. Supreme Court should take note now. (Ronald J. Krotoszynski Jr., 11/9)

The Hill: Pro-Choice Voters Won, Now Let's Get To Work
Tuesday was the first chance for the entire American electorate to cast their vote on the Trump-Pence agenda. And in historic, overwhelming numbers they showed up to cast their ballots and emphatically rejected two years of the Trump-Pence administration’s destructive agenda. President Donald Trump and his allies tried to ban abortion; they tried to defund Planned Parenthood; they tried to erase the transgender community; they embraced racist and discriminatory policies and the American people firmly said no. (Dana Singiser, 11/8)

The Hill: Marijuana Was A Big Winner On Election Day
On Tuesday, marijuana was favorable among voters. In Michigan, voters approved Proposal 1, legalizing the adult use, cultivation, and retail marketing of marijuana. Michigan is the first Midwest state to legalize adult marijuana use and sales, and it is the tenth state to do so overall. An estimated 25 percent of the U.S. population now resides in a jurisdiction where the adult use and possession of cannabis is legal. Marijuana also won big in Missouri and Utah. In both states, voters approved ballot initiatives legalizing medical cannabis access. They are the 32nd and 33rd states to do so. They will not be the last. (Paul Armentano, 11/8)

The Washington Post: VA, Skirting Court Order, Kills ‘Official Time’ For Medical Professionals
Further poisoning the Trump administration’s already noxious relationship with federal labor organizations, the Department of Veterans Affairs has rejected parts of collective-bargaining agreements with four unions. The heading on a memorandum sent to union leaders is blunt: “Notice of Repudiation.” (Joe Davidson, 11/8)

Stat: People With Serious Mental Illness Tend To Die Prematurely. We Can Fix That 
Media reports of suicides of high-profile individuals make it easy to believe that suicide is a leading killer of people with serious mental illness. It’s not even close, falling behind largely preventable conditions such as heart disease (10 times higher than suicide), cancer, diabetes, and other chronic diseases. Although these diseases can affect anyone, they make for a particularly lethal combination among people with serious mental illness. In fact, people with serious mental illness die 10 to 25 years earlier than the general population. (Shekhar Saxena and Ralph Aquila, 11/8)

New England Journal of Medicine: Politics And Pandemics
This year marks the 100th anniversary of the deadliest event in U.S. history: the Spanish influenza epidemic of 1918, which killed more Americans than World Wars I and II combined. Although science and technology have advanced tremendously over the past century, the pandemic peril remains: a recent exercise at the Johns Hopkins Center for Health Security showed that an epidemic of an influenza-like virus could kill 15 million Americans in a single year. (Ron Klain, 11/7)

Sun Sentinel: A Triumph For Voting Rights. Next Up, Medicaid?
The Robert Wood Johnson Foundation has estimated that Florida’s refusal will cost the state $66.1 billion in Medicaid money by 2023, more than any other state. That translates to thousands of jobs turned away — and many lives lost.If Ron DeSantis clings to his narrow lead, Florida’s next governor will be hostile to Medicaid expansion. So will the Legislature. But Florida’s people aren’t.The time is right — and so, we think, is the public’s mood — for another voter initiative. If Andrew Gillum is looking for a good cause to lead, that would be it. (11/8)

Detroit News: Voters Have Spoken: They Want Pot
Nearly 60 percent of Michigan voters came out in support of recreational marijuana Tuesday. Yet now that Proposal 1 has passed, many local communities are already working to preempt its influence, just as they did with medical marijuana a decade ago. We're pretty sure that’s not what most voters intended. (11/8)