The Associated Press: 'Obamacare' Sign-Ups 45 Percent Ahead Of Last Year's Pace
Sign-ups for Affordable Care Act health plans are running more than 45 percent ahead of last year's pace, according to government data released Wednesday. The numbers from the Centers for Medicare and Medicaid Services come as Republican senators are pushing to pay for tax cuts by repealing the "Obamacare" requirement to carry coverage. (Alonso-Zaldivar, 11/15)

Reuters: Nearly 1.5 Million People Signed Up For Obamacare Plans So Far: Officials
More than 800,000 people signed up for Obamacare individual health insurance plans in the second week of open enrollment, U.S. government health officials said on Wednesday, bringing the total number of sign-ups to nearly 1.5 million so far. (Abutaleb, 11/15)

The Washington Post: ACA Federal Enrollment Surges By At Least 47 Percent This Year, CMS Says
The portion of new consumers enrolling in ACA plans is slightly down this year, according to the latest federal report. Those Americans accounted for 23 percent of enrollees between Nov. 1 and Nov. 11, as opposed to 24 percent in the early days of 2016. (Eilperin, 11/15)

The Hill: Nearly 1.5 Million Sign Up For ObamaCare In First 11 Days
There are also more new consumers signing up for plans this year, the data show. In the first two weeks of open enrollment, 345,719 new consumers have signed up for plans, compared to 246,433 during the same time period last year. (Hellmann, 11/15)

Modern Healthcare: Sign-Ups Hit 1.5 Million In First Two Weeks Of ACA Open Enrollment
Prior to the start of open enrollment, many experts feared sign-ups would lag this year because of deep cuts in federal funding for Obamacare marketing and outreach, and enrollment assistance through certified navigators. The first two weeks of the enrollment period suggest those concerns may have been overblown. (Livingston, 11/15)

Politico: Defying Gloomy Predictions, Obamacare Enrollment Surges
In other words, there might be no such thing as bad news for Obamacare. “As P.T. Barnum would say, as long as my name is in the papers and it’s spelled correctly, it’s all good,” said Michael Marchand, chief marketing officer for Washington state’s Obamacare marketplace, which saw its website traffic increase by 24 percent during the first week of enrollment. “I think there’s some truth to that.” The conventional wisdom was that enrollment would dip significantly as a hostile administration gutted outreach and marketing. (Demko, 11/15)

Bloomberg: Obamacare Signups Are Up 47% From Last Year So Far
It’s hard to gauge what the acceleration means for the Obamacare marketplaces overall, because consumers have only half the time to enroll in plans on healthcare.gov this year. Even a stronger-than-expected start could end with fewer people signing up by the time the window closes Dec. 15. (Tozzi, 11/15)

Pioneer Press: MNsure Sign-Ups ‘Off To A Good Start,’ On Pace For At Least 5 Percent Growth
Health insurance sign-ups through MNsure, the state’s individual insurance marketplace, are off to a strong start in the first two weeks of open enrollment. As of Tuesday, 91,623 people had signed up through Minnesota’s exchange for the federal Affordable Care Act, or Obamacare. Most of those sign-ups were from existing customers who renewed plans or who chose different coverage. (Magan, 11/15)

The Associated Press: 'Obamacare' Mandate Repeal Would Remake Market For Consumers
Millions are expected to forgo coverage if Congress repeals the unpopular requirement that Americans get health insurance, gambling that they won't get sick and boosting premiums for others. The drive by Senate Republicans to undo the coverage requirement under former President Barack Obama's health care law is a sharp break from the idea that everyone should contribute to health care. (Alonso-Zaldivar, 11/15)

The New York Times: Obamacare, Reliant On Insurance Requirement, Would Crumble Under Senate Tax Bill
Senate Republicans want to eliminate the Affordable Care Act’s requirement that most people buy health insurance as part of their overhaul of the tax code. Repealing the rule, known as the individual mandate, is a longstanding Republican goal and would allow lawmakers to save hundreds of billions of dollars to help pay for broad tax cuts. (Park, 11/15)

The Washington Post: The GOP Plan To Kill Obamacare’s Least Popular Provision Could Backfire On Some In The Middle Class
The Republican proposal to strike the Affordable Care Act's least popular provision, the requirement that people maintain health coverage or pay a fine, could bring an immediate political victory — but would backfire on upper-middle-class people who buy individual insurance and pay full price for their plans, health policy specialists said. “The market is stable, but you need to define 'stable.' 'Stable' is the insurance companies ramming the rates to holy hell,” said Robert Laszewski, president of Health Policy and Strategy Associates. “That's a catastrophically terrible market. This is a screwed-up market, to the 16th power. But it can continue this way, indefinitely. So, therefore, it's stable." (Johnson, 11/15)

Modern Healthcare: Senate Republicans Likely To Repeal ACA Mandate As Part Of Tax Bill
Senate Republicans have a good chance of passing a repeal of the Affordable Care Act's individual mandate as part of their tax cut legislation, even though healthcare industry groups are lobbying hard against it, political observers say. That's because the three GOP senators who scuttled the last repeal-and-replace effort — Maine's Susan Collins, Alaska's Lisa Murkowski, and Arizona's John McCain — are unlikely to balk at erasing the ACA's least popular feature, especially when the bill would not cut federal Medicaid funding to their states. (Meyer, 11/15)

Politico: How Cotton Brought Obamacare Repeal Back From The Dead
Sen. Tom Cotton was about to enter the White House early this month to discuss immigration policy when he got an unexpected call from President Donald Trump to talk about a different topic. For days, the Arkansas senator had been working behind the scenes to convince Republicans that reigniting a battle over repealing Obamacare in the tax fight wasn’t as crazy as it seemed. But Trump, still smarting from GOP’s failures to dismantle the law whom Cotton had first pitched on the idea four days prior, needed little persuading. (Kim and Haberkorn, 11/15)

Politico: Dems Seize On GOP’s Obamacare Attack To Awaken The Left On Taxes
Senate Republicans’ decision to strike at Obamacare in their tax legislation may be just what Democrats and progressive organizers need to rally an otherwise distracted base. The liberal activists who besieged the GOP’s health bill have yet to rise up as fiercely against the tax plan. They haven’t been helped with headlines dominated by the Roy Moore scandal and a Russia probe drawing closer to President Donald Trump. (Schor, 11/15)

The Washington Post Fact Checker: Schumer’s Claim That The GOP Is ‘Kicking 13 Million People Off Health Insurance’
In a last-minute switch to the Senate version of the GOP tax plan, lawmakers added a repeal of the individual mandate embedded in the Affordable Care Act. Schumer’s comment equates the health-care move with accusations that the tax bill is tilted toward the wealthy. The requirement that Americans maintain health coverage or pay a fine is one of the least popular provisions of Obamacare. But it is a key element of the law — one of three legs of the “stool” holding up the law. The two other legs are tax subsidies that make insurance affordable and a prohibition on insurance companies from denying coverage or raising premiums based on a preexisting condition. (Kessler, 11/16)

The Hill: Mandate Repeal Sparks Fears Of Premium Hikes
The move by Senate Republicans to repeal ObamaCare’s individual mandate could plunge insurance markets into uncertainty, leading to premium hikes or insurers dropping out of the market, experts say. The mandate requires most people to either have health insurance or pay a fine. It was designed to ensure that people don’t wait until they are sick to buy health insurance, since ObamaCare also bars insurers from denying coverage based on pre-existing conditions. (Sullivan, 11/16)

The Hill: GOP Senator: ObamaCare Mandate A 'Tax On The Poor And Working Class'
Sen. Tim Scott (R-S.C.) called the ObamaCare individual mandate a "tax on the poor and working class" during an interview on Wednesday, one day after Senate Republicans announced they would include a repeal of the mandate in their tax-reform legislation. "The fact of the matter is that the individual mandate is a tax on the poor and working class," Scott said on "The Hugh Hewitt Show." (Manchester, 11/15)

The Tennessean: Sen. Lamar Alexander Backs GOP Plan To Repeal Obamacare Mandate As Part Of Tax Reform
Sen. Lamar Alexander said Wednesday he supports the Senate GOP’s tax-reform bill and has no problem with it including a provision to repeal the Affordable Care Act’s mandate that everyone buy health insurance. Tying repeal of the so-called individual mandate to the tax-reform measure could cost Alexander Democratic support for a separate bipartisan bill that he negotiated with Democratic Sen. Patty Murray to stabilize Obamacare’s individual health insurance markets in the short term. (Collins, 11/15)

Bloomberg: Health Care For Millions At Risk As Tax Writers Look For Revenue
The Republican tax plans are suddenly looking a lot more like health-care bills, with provisions that may affect coverage and increase medical expenses for millions of families. The House version of the tax bill, which President Donald Trump endorsed on Tuesday, would end a deduction that allows families of disabled children and elderly people to write off large medical expenses. The Senate plan would repeal the Obamacare requirement that most Americans carry insurance, a move that insurers promise would raise premiums in the nationwide individual insurance market. (Olorunnipa and Edney, 11/16)

The New York Times: Tax Bill Thrown Into Uncertainty As First G.O.P. Senator Comes Out Against It
Uncertainty gripped the Senate on Wednesday over efforts to pass a sweeping $1.5 trillion tax cut after a Wisconsin Republican became the first senator in his party to declare that he could not vote for the tax bill as written, and other senators expressed serious misgivings over the cost and effect on the middle class. The House is set on Thursday to pass its own version of the tax bill, which would cut taxes by more than $1.4 trillion over 10 years and broadly rewrite the business tax code. But as with the health care debate earlier this year, the Senate emerged as the inconstant ally in President Trump’s pursuit of a major legislative accomplishment in his first year. (Rappeport and Kaplan, 11/15)

The Associated Press: 1st GOP Senator Opposes Tax Bill In Early Sign Of Problems
Democrats said the measures would bestow the bulk of their benefits on higher earners and corporations. In the Senate Finance Committee, they focused their attacks on two provisions designed by Republicans to save money. One would repeal President Barack Obama's health law requirement that people buy coverage or pay a fine, a move the nonpartisan Congressional Budget Office projects would result in 13 million more uninsured people by 2027. The other would end the personal income tax cuts in 2026 while keeping the corporate reductions permanent. (11/15)

CQ: Discord Over Individual Mandate Repeal Grows In The Senate
A surprise move by Senate leaders to repeal the individual health insurance mandate in their tax overhaul is endangering support from key Republicans. Sen. Susan Collins of Maine told reporters Wednesday her concerns have increased over the provision after receiving statistics showing it would lead to more expensive premiums for middle class families that make slightly too much to qualify for subsidies — outweighing the benefits from the proposed tax cuts. (Clason, 11/15)

Bloomberg: Wall Street Ponders If Obamacare Axing Helps Or Hurts Tax Bill
The Senate’s latest plan to fund one of the largest tax cuts in history has dragged the health-care debate back into the limelight -- and that’s got Wall Street’s attention. Ending the requirement would save the government $338 billion over 10 years, but leave around 13 million Americans uninsured and raise premiums by about 10 percent, the Congressional Budget Office estimated. Analysts are divided on the chances of passage and the impact across the health-care sector varies. The removal of Obamacare’s individual mandate may increase the chances of tax cuts that could bolster growth, a win for the broader market, while numerous other provisions may hurt select companies. (Flanagan and Maranz, 11/15)

The Wall Street Journal: Bipartisan Plan Would Boost Health-Insurance Markets
Republican lawmakers looking to repeal a rule requiring most people to have health insurance said Wednesday they were now more open to a bipartisan plan to bolster the insurance markets, since they would likely face political responsibility for the health-care system. The measure, reversing President Donald Trump’s halting of payments to health insurers, is now more likely to be in a year-end spending package, Republican aides said. Repealing the Affordable Care Act’s so-called individual mandate is expected to raise insurance premiums, health experts say, adding pressure on GOP lawmakers to take offsetting measures. (Armour and Peterson, 11/15)

The Hill: Key GOP Senator: ObamaCare Payments Likely To Be Included In Funding Bill
Sen. John Cornyn (R-Texas) said Wednesday that the Senate will likely include key ObamaCare payments in an end-of-year spending bill. "I think that's likely to happen," Cornyn, the second-ranking Senate Republican, told reporters when asked if the cost-sharing reduction payments would be included in the December funding bill. (Carney, 11/15)

The Hill: Schumer: Dems Won't Back ObamaCare Deal If It Is Tied To Tax Bill
Senate Minority Leader Charles Schumer (D-N.Y.) warned on Wednesday that Democrats won't help pass a bipartisan deal on key ObamaCare payments if Republicans use their tax plan to repeal the individual mandate. "The Republicans cannot expect to pass their own separate ideological health-care provision and then turn around and ask Democrats to vote to pass Alexander-Murray," Schumer said from the Senate floor, referring to a bill by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.). (Carney, 11/15)

The New York Times: I.R.S. Starts To Enforce Health Law’s Rule That Employers Offer Insurance
As Republicans and the Trump administration continue trying to chip away at the Affordable Care Act, the Internal Revenue Service has begun, for the first time, to enforce one of the law’s most polarizing provisions: the employer mandate. Thousands of businesses — many of them small or midsize — will soon receive a letter saying that they owe the government money because they failed to offer their workers qualifying health insurance. (Cowley, 11/16)

In other news on employers and health care —

The New York Times: Tech Companies Get High Marks For Covering Infertility Treatments
A relatively small number of companies offer generous benefits for infertility treatment to employees, while most have minimal or no coverage, a new report found. It’s a case of “haves and have-nots,” said Jake Anderson, a founder of FertilityIQ, the start-up that wrote the report. (Carrns, 11/15)

Kaiser Health News: For Millions of Insured Americans, State Health Laws Don’t Apply
Let’s say you have health insurance through your employer and live in one of 21 states with laws protecting consumers against surprise medical bills from out-of-network providers. Should one of those unwanted bills land in your mailbox, you can turn to your state law and regulators for help, right? Not necessarily. (Bazar, 11/16)

The Washington Post: Parents Of 4-Year-Old With Cancer Can’t Buy ACA Plan To Cover Her Hospital Care
Four-year-old Colette Briggs bounded into the dining room where her parents sat in the midst of another distressing conversation. Oblivious to their anxiety, she cheerily asked her mom to retie one of the loose pigtails atop her head. Ever since her brown locks regrew long enough for a ponytail, hair has been a big deal around here, her father, Christopher Briggs, said as Colette skipped off to rejoin her older sisters. (Itkowitz, 11/15)

In other marketplace news —

Richmond Times-Dispatch: VCU Health To Be In-Network Provider On Individual Market In Richmond Area Next Year
After reaching an agreement with the health insurer Cigna, VCU Health has secured its spot as an in-network option next year on the individual market in the Richmond area. Before that agreement was reached last week, HCA Virginia was the sole in-network choice for anyone who bought a plan on the individual market in Henrico and Chesterfield counties, as well as Richmond. (O'Connor, 11/15)

KCUR: Health Insurer Centene To Cover KU Health System Patients
Centene Corp. has agreed to offer individual marketplace coverage under the Affordable Care Act to patients who receive care at The University of Kansas Health System. Until now, the KU Health System, which includes the University of Kansas Hospital, was not covered in-network under any of the individual marketplace plans offered in 2018 in the Kansas City area. (Margolies, 11/15)

The New York Times: Uwe Reinhardt, 80, Dies; A Listened-To Voice On Health Care Policy
Uwe Reinhardt, an economist whose keen, caustic and unconventional insights cast him as what colleagues called a national conscience in policy debates about health care, died on Monday in Princeton, N.J. He was 80. ... Professor Reinhardt helped shape health care deliberations for decades as a prolific contributor to numerous publications, an adviser to White House and congressional policymakers, a member of federal and professional commissions and a consultant and board member, paid and unpaid, for private industry. (Roberts, 11/15)

Modern Healthcare: Famed Health Economist Uwe Reinhardt Dies
A tall man with movie-star looks and a melodious baritone voice, he used a combination of ironic humor, rigorous grasp of health economics, and lucid speaking and writing style to become perhaps the nation's foremost popularizer of healthcare policy issues. NPR and other news media frequently turned to him to explain complicated issues to the public. "He was part of that first wave of Ph.D-trained economists working in healthcare," said Gail Wilensky, a senior fellow at Project Hope who headed the Medicare program under President George H.W. Bush. "But nobody could approach him in terms of his wit and ability to communicate serious issues in a way that was so entertaining." (Meyer, 11/14)

Medscape: Health Economist Uwe Reinhardt Dies After Illness
Uwe Reinhardt, PhD, famed health economist and the James Madison professor of political economy and of economics at Princeton University in New Jersey, died Tuesday after an as yet undisclosed illness. ... Dr Reinhardt, born in Germany, taught health economics, comparative health systems, general microeconomics, and financial management at Princeton. He was also the codirector of the Griswold Center for Economic Policy Studies at Princeton. (Frellick, 11/14)

The New York Times: How To Lower Your Blood Pressure
The American Heart Association and the American College of Cardiology have released new treatment guidelines that sharply lower the threshold for high blood pressure, also called hypertension. As a result, tens of millions of Americans now qualify for the diagnosis. The new guidelines have raised a number of questions for patients. Here are a few answers. (Kolata, 11/15)

Stat: FDA Urged To Ban A Blood Pressure Medication With Troubling Side Effects
A consumer advocacy group is asking the Food and Drug Administration to ban the sale of a widely prescribed blood pressure medication — as well as several generic versions — over concerns the drug can cause a gastrointestinal disorder that leads to severe and chronic diarrhea, vomiting, abdominal pain, and weight loss. In a petition filed on Wednesday with the agency, Public Citizen argued that olmesartan medoxomil, which is marketed under the brand names Azor, Benicar, Benicar HCT, and Tribenzor, ought to be removed from the market. The group cited “overwhelming evidence” that the treatment causes severe sprue-like enteropathy, which is similar to celiac disease but does not improve with a gluten-free diet. (Silverman, 11/15)

WBUR: Don't Let New Guidelines Raise Your Blood Pressure, But Do Take Them Seriously. Here's How
The American Heart Association's new guidelines on blood pressure move the goalposts for healthy levels. The short version: "Hypertension" now begins above 130 over 80, instead of 140 over 90. (Goldberg, 11/15)

Health News Florida: New High Blood Pressure Guidelines Mean Nearly Half Will Qualify
Nearly one half of the U.S. population will meet the diagnosis of high blood pressure under new guidelines revised this week. The new guidelines – the first change in 14 years – recommend lifestyle changes before medication. (Aboraya, 11/15)

And in other heart health news —

The New York Times: Heart Attack Survivors At Risk Of Later Dementia
Heart attack survivors have an increased risk for developing dementia, a new study has found. Danish researchers studied 314,911 heart attack patients and compared them with 1,573,193 controls who had not had a heart attack. They excluded anyone who had already been diagnosed with dementia or other memory disorders. The study, in Circulation, adjusted for heart failure, pulmonary disease, head trauma, kidney disease and many other variables. (Bakalar, 11/15)

The Washington Post: American Heart Association President Has Heart Attack
American Heart Association President John Warner suffered a heart attack during the organization's annual conference in Southern California, where he spoke about his family's history with heart disease. Warner, vice president and chief executive of UT Southwestern University Hospitals in Dallas, was recovering after what the American Heart Association called a “minor” episode Monday morning at the organization's Scientific Sessions, a five-day conference on cardiovascular science in Anaheim. He was in stable condition after doctors inserted a stent to open an artery, the association said in a statement. (Bever, 11/15)

The New York Times: Amish Mutation Protects Against Diabetes And May Extend Life
Amish people living in a rural part of Indiana have a rare genetic mutation that protects them from Type 2 diabetes and appears to significantly extend their life spans, according to a new study. The findings, published on Wednesday in the journal Science Advances, shed light on the processes underlying cellular aging and could lead to new therapies for chronic diseases, some experts say. The researchers are planning at least one follow-up trial that will recreate the effects of the mutation so they can study its impact on obese people with insulin resistance, a precursor to diabetes. (O'Connor, 11/15)

NPR: What If We Treated Gun Violence Like A Public Health Crisis?
When U.S. officials feared an outbreak of the Zika virus last year, the Department of Health and Human Services and state officials kicked into high gear. They tested mosquitoes neighborhood by neighborhood in Miami and other hot Gulf Coast communities where the virus was likely to flourish. They launched outreach campaigns to encourage people to use bug spray. And they pushed the development of a vaccine. (Kodjak, 11/15)

NPR: A Baby Exposed To Zika Virus Is Doing Well, One Year Later
Two years ago, when the Zika virus was first identified as the cause of microcephaly in babies, women were scared. Expectant mothers who got infected had no idea what the chances were of having a healthy baby. Researchers have since learned that while Zika infection is dangerous, about 94 percent of babies born to women infected with Zika appear to be normal at birth. (Simmons-Duffin, 11/15)

The Washington Post: New Robotic Hand Named After Luke Skywalker Helps Amputee Touch And Feel Again
Keven Walgamott wasn’t sure what to expect when scientists first hooked up what was left of his arm to a computer. Last year — 14 years after he lost his hand and part of his arm in an electrical accident — he heard about a team at the University of Utah working on an experimental robotic arm. The prosthetic hand and fingers would be controlled by an amputee’s own nerves. Even more challenging, researchers were trying to restore the sense of touch to amputees through that robotic hand. (Wan, 11/15)

KCUR: Young, Healthy And Planning For Death
Most people want to live and die on their own terms. But having the death one wants requires having a conversation about wishes and putting them in writing: how much medical intervention you want, whom you want visiting you, where you want to be cared for. It’s called advance care planning. A lot of Americans are putting it off till they’re older ... or not doing it at all. About two-thirds of adults in the U.S don’t have an advance care plan, according to a report published in July, even though Medicare and some private insurers will pay doctors to have these conversations and fill out advanced directives documenting end-of-life wishes with patients. In 2015, only 7 percent of people ages 18 to 29 had an advance directive. (Horton, 11/15)

NPR: Pop-Ow! 'Popeye' Deformity Can Be A Painful Armful
A 79-year-old man picked up an object with his left hand and suddenly felt a sharp pain in his shoulder. Something moved in his upper arm. And with that, he was Popeye. His right arm looked the same as it always had: lean and sagging a little with age. But his left biceps now sported a baseball-size bulge that looked like it could land a powerful punch. The brand-new muscle mound looked even bigger when the man flexed his biceps. The only thing was, it hurt. A lot. (Bichell, 11/15)

Stat: FDA Clears Electronic Earpiece To Block Opioid Withdrawal Symptoms
A wearable device claiming to block the pain of opioid withdrawal has been cleared by the Food and Drug Administration under an expedited review process for medical devices. However, patient safety advocates note that the device has limited evidence for its effectiveness. The NSS-2 Bridge is a device that attaches to the ear and transmits small electrical pulses through four cranial nerves. It’s marketed by Indiana-based Innovative Health Solutions, and was cleared to treat chronic and acute pain in 2014. IHS can now market the device as one that reduces symptoms of opioid withdrawal including nausea, anxiety, and aches. (Blau, 11/15)

Milwaukee Journal Sentinel: Tammy Baldwin Introduces Bipartisan Bill To Strengthen Opioid Safety In VA Choice Program
Democratic U.S. Sen. Tammy Baldwin and five others introduced bipartisan legislation Wednesday to strengthen opioid safety in the Department of Veterans Affairs. The legislation got a boost from Marvin and Linda Simcakoski, who traveled from Stevens Point to Washington, D.C., to support the effort. (Glauber, 11/15)

In other news on the crisis —

Arizona Republic: Phoenix To Sue Prescription Drug Makers Over Costs Of Opioid Crisis
Phoenix will join several other cities, such as Chicago and Indianapolis, in taking massive drug companies to court over the national opioid-addiction crisis. The City Council voted 8-0 Wednesday to take legal action against drug manufacturers and distributors to recoup some of the money the city has spent fighting the opioid epidemic. (Boehm, 11/15)

The Associated Press: Drug Firm Founder Indicted In Opioid Conspiracy Due In Court
The founder of a pharmaceutical company charged with leading a conspiracy to bribe doctors to prescribe a powerful opioid pain medication for people who didn’t need it is due in court in Massachusetts. John Kapoor of Insys Therapeutics Inc. was arrested in Arizona last month and is expected to make his first appearance in Boston’s federal courthouse on Thursday. (11/16)

NPR: Getting Doctors To Stop Prescribing Codeine To Kids Has Taken Years
For years the Food and Drug Administration has been trying to get doctors to quit prescribing codeine, an opioid painkiller, to children after getting their tonsils or adenoids out. But it can be hard to get clinicians to change their prescribing habits, even when children have died and other less risky medications are available. (Jochem, 11/16)

Columbus Dispatch: Cardinal Health Announced Program To Address Opioid Crisis
As Cardinal Health continues to face lawsuits over its alleged role in stoking the national opioid crisis, the company on Thursday is scheduled to announce a sweeping program in Appalachia aimed at combating drug abuse. Its Opioid Action Program, in cooperation with local partners in Ohio, Kentucky, Tennessee and West Virginia, is being called a pilot program that could be expanded over time. (Rose, 11/16)

WBUR: American Medical Association Takes Stance Against ICE Patrolling Inside Hospitals
The American Medical Association (AMA) is opposing the presence of federal immigration agents in hospitals and clinics. A new resolution declaring this stance was passed Wednesday by the AMA's House of Delegates, the policy-making body for the association. (Dooling, 11/15)

The Baltimore Sun: Hospital Presidents Talk About Health Issues With Business Owners
Leading a major hospital in an era where health care is a political hot button means having to deal with constant change and uncertainty, the presidents of Baltimore’s two major medical centers told business leaders Wednesday. Dr. Mohan Suntha, speaking to members of the Greater Baltimore Committee, said that just that morning, he awoke to texts asking what he thought about tax reform efforts moving through Congress. Senate Republicans now want to include an amendment in their tax bill that would repeal the so-called individual mandate, the Affordable Care Act’s requirement that most people have health insurance. (McDaniels, 11/15)

Politico: Tax-Exempt Mayo Clinic Grows, But Rural Patients Pay A Price
The Mayo Clinic, which sprawls across this Midwestern city, is the nation's top-ranked hospital, according to U.S. News & World Report. But that might undersell its prominence: The clinic is arguably the best-regarded health care system on the entire planet. Patients from nearly 150 countries travel to Mayo Clinic sites in Minnesota, Arizona, Florida and beyond. Famed filmmaker Ken Burns is making a documentary about Mayo and the story of its founders — Will and Charlie Mayo, a pair of brothers and doctors who have assumed near-mythic status in the health care field. (Diamond, 11/16)

The Denver Post: Despite Political Turmoil, Colorado Hospitals And Insurers Turned Profits In 2016
Colorado hospitals and health insurers both turned overall profits in 2016, a sign of the state health care system’s general stability despite ongoing political debate around health care funding. Denver-area hospitals last year reported combined pre-tax net income of more than $1.3 billion — about 15 percent of net patient revenue — according to a new report by a nationally recognized health care business consultant. Many of the larger hospitals outside the metro area also reported profits. (Ingold, 11/15)

CT Mirror: House Gives Final Approval To CT Budget Fix
The House of Representatives overwhelmingly gave final approval Wednesday to a measure fixing technical flaws with the hospital tax, a renters’ rebate program and other aspects of the new state budget. ...The hospital tax is a complex legal and fiscal maneuver designed to increase federal Medicaid reimbursements. (Phaneuf, 11/15)

Georgia Health News: State OKs New Hospital For Lee County
In the biggest state health care licensing decision in years, Georgia regulators have approved Lee County’s bid to build a 60-bed, $123 million hospital. The certificate-of-need (CON) decision, announced Wednesday by the Department of Community Health, is being celebrated as a triumph for the southwest Georgia county and a significant setback to Phoebe Putney Health System, based in nearby Albany. (Miller, 11/15)

The Associated Press: 17 Escapes From Hawaii Hospital Since 2010
More than a dozen escapes have occurred over the past eight years at a Hawaii psychiatric hospital where a patient described as dangerous walked off the grounds and made it to California before he was captured this week. Many of the 17 escapes between 2010 and this year happened when a patient broke "curfew" and didn't return from the Hawaii State Hospital after being allowed to leave for a period of time, according to information obtained by The Associated Press from police and the state Department of Health. (11/16)

California Healthline: California Fines Anthem $5 Million For Failing to Address Consumer Grievances
California’s managed-care regulator announced Wednesday it has fined insurance giant Anthem Blue Cross $5 million for repeatedly failing to resolve consumer grievances in a timely manner. The state Department of Managed Health Care criticized Anthem, the nation’s second-largest health insurer, for systemic violations and a long history of flouting the law in regard to consumer complaints. (Terhune, 11/15)

Dallas Morning News: Plano-Based Nursing Home Chain Files For Bankruptcy Due To ‘Overwhelming Amount’ Of Lawsuits
The Plano-based operator of one of the nation’s largest nursing home chains filed for bankruptcy Monday, citing an “overwhelming amount” of lawsuits and huge legal payouts. Preferred Care Partners, headquartered on 5420 W. Plano Parkway, noted a $28 million verdict in October for a personal injury claim. But the company also has more than 160 other pending lawsuits, mainly in Kentucky and New Mexico, the court documents said. (Rice, 11/15)

Los Angeles Times: Anaheim Legionnaires' Outbreak Grows; 11 Cases Linked To Disneyland Visits
The number of people diagnosed with Legionnaires’ disease after spending time in Anaheim or Disneyland increased to 15, Orange County health officials said Wednesday. The victims were infected between late August and October, officials said. Two patients have died, though neither of them visited Disneyland. (Karlamangla, 11/15)

Boston Globe: Caught In A Financial Crisis, UMass Boston Begins To Cut Jobs
University of Massachusetts Boston officials began a first round of layoffs Wednesday, the latest step in the university’s effort to help solve its major financial problems. ...In all, administrators plan to lay off 36 people this week and reduce the hours of seven more, all of them staff who clean the school, help run academic programs, work in the student health office, or in other ways support the daily operations of the university. (Krantz, 11/15)

Star Tribune: A Model To Protect Seniors
In many states, a violent assault like this one would vanish in a bureaucratic haze. In Minnesota, thousands of allegations of abuse in senior care homes, including beatings and sexual assaults, go uninvestigated each year, records show. (Serres, 11/16)

Bloomberg: California's Famed Cancer Warnings Imperiled By Federal Push
Seizing on the Trump administration’s deregulation drive, corporate lobbyists are pushing to override state laws on ingredient-disclosure rules and warning labels, including landmark California legislation on potential cancer risks. The goal is to set a single federal law that could replace a barrage of state label requirements, making it easier for industries ranging from chemical manufacturing to food production. (Coleman-Lochner, 11/15)

The Associated Press: Couples Sue Fertility Clinic Over Eggs With Genetic Defect
Two couples are suing a New York fertility doctor and his clinic after giving birth to children with a genetic abnormality later traced back to donated eggs. The two children, both born in 2009, have Fragile X syndrome, a genetic condition that can lead to intellectual and developmental impairments. The parents, identified by initials and last names in legal papers, argue the doctor and the clinic failed to test the women who donated the eggs to determine whether they were carriers for Fragile X. They’re seeking damages for the added expenses of raising a disabled child. (Klepper, 11/15)

The Baltimore Sun: Cord Blood Bank Program Struggling Amid Costs And Declining Usage
Similar to bone marrow, stem cells extracted from the blood of an umbilical cord can be used to treat and cure more than 80 life-threatening diseases by helping to rebuild the immune system. Cord blood is often preferable to bone marrow because it is easier to match and has a significantly lower risk of the cells being rejected. But it is often thrown out as medical waste after a baby’s birth. To increase access to stem cells and their use, the federal government in 2005 created public banks like the one at Mercy that [Laura] Brinkley donated to. The 19 banks still open have seen success in the units of blood collected but have struggled financially. Some others closed. (McDaniels, 11/16)

Columbus Dispatch: Firefighters Have To Accept Some Responsibility For Dealing With Carcinogens, State Rep Tells Forum
The 80 new firefighters Columbus plans to hire next year could be among the first to really understand the risk of cancer they face on the job. For the 50 city firefighters who are expected to retire in 2018 and thousands of others, it could be too late. (Rouan, 11/16)

California Healthline: California Firm Running Physician Practices Is Closing Down As Scrutiny Ramps Up
SynerMed, a company that manages physician practices serving hundreds of thousands of Medicaid and Medicare patients across California, is planning to shut down amid scrutiny from state regulators and health insurers. The company’s chief executive, James Mason, notified employees in an internal email Nov. 6, obtained by Kaiser Health News, that audits by health plans found “several system and control failures within medical management and other departments.” (Terhune, 11/15)

KCUR: Shawnee Mission Health Now A Member Of MD Anderson Cancer Network
Shawnee Mission Health has become the 17th member nationwide of the MD Anderson Cancer Network, joining forces with one of the top cancer centers in the United States. The affiliation follows a year-long certification process by MD Anderson and is a big leap forward for Shawnee Mission Health’s cancer center, which opened not quite four years ago. (Margolies, 11/15)

San Francisco Chronicle: California Judge Says Companies Must Remove Pre-1951 Lead Paint In Homes
Paint companies must pay the state for the cost of removing lead paint from the interior surfaces of homes in San Francisco, Alameda, San Mateo and seven other counties, a state appeals court ruled Tuesday. The Sixth District Court of Appeal in San Jose upheld a judge’s ruling that the three companies — Conagra, NL Industries and Sherwin-Williams — had marketed lead paint for decades while knowing of its health dangers to children. But the court narrowed the judge’s ruling, which previously had applied to homes built before the government outlawed lead paint in 1978. Instead, the ruling would cover only homes built before 1951, when the companies stopped advertising the product. (Egelko, 11/14)

The New York Times: Why We’re Still Fighting Over The Health Care Mandate
Seven and a half years after the passage of the Affordable Care Act, and five years after the Supreme Court gave its central provision a stamp of legal approval, America is still fighting over the individual mandate. The debate over the requirement to maintain health coverage or pay a penalty has become a permanent feature of American political life — a debate from which we seemingly cannot escape. (Peter Suderman, 11/15)

Los Angeles Times: Suddenly, The GOP Tax Bill Has Morphed Into An Attack On Your Healthcare
The line going around Washington these days is that the Republicans previously tried to hide a tax cut for the rich in their Obamacare repeal measures; and now they’re hiding an Obamacare repeal inside their tax cut bill. That’s correct. The Senate Finance Committee on Tuesday slipped a provision into its tax cut bill that would effectively repeal the Affordable Care Act’s individual mandate. On the surface, this is a fiscal measure—it would theoretically reduce the federal deficit by $338 billion over 10 years, according to the Congressional Budget Office. (Michael Hiltzik, 11/15)

The Washington Post: The GOP Is Trading 13 Million People’s Health Care For Corporate Tax Cuts
To finesse the tricky politics and brutal math of tax reform, Senate Republicans say that they want to repeal the Affordable Care Act’s individual mandate. For Republicans, repeal would be a trifecta: a blow to Obamacare, a money-saver for the federal government and a way to finance a permanent cut to the corporate tax rate. (Nicholas Bagley, 11/15)

The Wall Street Journal: The Appeal Of Mandate Repeal
The House is poised to pass tax reform on Thursday, while Senate Republicans have fortified their draft to include a repeal of ObamaCare’s individual mandate. The latter is being denounced as an attempt to deny Americans health insurance, but Republicans can rebut this falsehood and achieve two policy goals with one reform if they don’t flinch from the debate. (11/15)

Bloomberg: The GOP's Obamacare Threat Is Doubly Painful For Insurers
That's ugly news for insurers and hospitals in at least two ways: Passing such a measure will hurt the individual insurance market. But failure may drag the tax-cut effort down with it, possibly hurting the stock market and leaving companies with higher tax bills. The ACA's mandate is unpopular but necessary. It generates revenue for the federal government via penalty payments. Repeal would only save money and enable larger tax cuts because millions of people would stop buying insurance, reducing government spending on subsidies. (Max Nisen, 11/15)

The Washington Post: Republicans Turn Their Irresponsible Tax Bill Into Monumentally Unwise Social Policy
Republican senators remade their tax bill into an Obamacare repeal bill, announcing Tuesday that they inserted an Obamacare sabotage device into the text. In a stroke, they turned a fiscally irresponsible tax plan into a monumentally unwise piece of social policy that would do much more than widen the deficit. If passed, it would be the most significant health-care shift since the 2010 Affordable Care Act — and in a decidedly negative direction. (11/15)

JAMA Forum: Undermining Health Care Through Tax Reform
One of President Trump’s regular refrains is that Obamacare is failing. Many have taken issue with this assessment of the Affordable Care Act (ACA), but what seems clear in the wake of a failed attempt to use the legislative process to repeal the ACA is that the Trump administration is doing all it can to sabotage the law. (Andrew B. Bindman, 11/15)

Sacramento Bee: This Is How Health Care Costs Are Stealing Your Raises
How do rising health costs reduce wages? Most full-time workers are paid a combination of wages and benefits. If the cost of benefits goes up, employers have less to pay wages – and the cost of health benefits to employers has been increasing rapidly for many years. (Glenn Melnick, 11/15)

Fox News: We Can't Let Unions Hold Medicaid Funding For Home Health Care Hostage
The state-run program paid for by Medicaid to fund home health-care is a win-win for patients, their families and the taxpayer. The program keeps patients at home, where they are more comfortable and surrounded by loved ones, rather than putting them in nursing homes or other expensive institutions that would cost Medicaid far more. But unfortunately, some states are diverting millions of these Medicaid dollars from home health-care to labor unions. (Andy Puzder, 11/16)

JAMA: Global Budgets For Safety-Net Hospitals
Investing in outpatient and community-based services can improve health and lower cost in the United States. Opportunities include enhancing primary care, expanding evidence-based behavioral health services, improving the coordination of care for patients with complex health needs, and linking patients to critical social resources. Yet because there is limited direct reimbursement for such efforts, major expansions depend on capturing savings. As a committee of the National Academy of Medicine recently noted: “In terms of sustainability, interventions that improve health and quality of care or reduce utilization and cost are only feasible to maintain if the provider is paid in such a way that profits (revenues minus costs) are higher with the intervention than without. (Joshua M. Sharfstein, Sule Gerovich and David Chin, 11/14)

USA Today: Supreme Court Abortion Case Could Promote Free Speech By Both Sides
As a supporter of both free speech and free contraception, I may have two dogs inthe fight that the Supreme Court recently agreed to settle. But I think one side is going to make the other wish he’d never gotten into the quarrel. The case, National Institute of Family and Life Advocates v. Becerra, is a challenge to California’s Reproductive FACT Act. The law forces the state’s 200 or so pro-life crisis pregnancy centers to post notices about free or low-cost abortion and contraceptive services available elsewhere. (Melinda Henneberger, 11/16)

JAMA: Prepregnancy Obesity And Severe Maternal Morbidity
There is an obesity pandemic in the United States. In 1991, approximately 12% of the US population was obese, and no single state had an obesity rate greater than 15%. In 2014, the obesity rate was 38%, and no single state had an obesity rate less than 20%. ... In 2014, approximately 50% of all pregnant women in the United States were overweight or obese. Obese pregnant women are at increased risk of pregnancy complications. Maternal-related pregnancy complications (diabetes, preeclampsia, and cesarean delivery) and fetal or neonatal complications (preterm birth, macrosomia, fetal growth restriction, and stillbirth) are more common in obese pregnant women. Further, some evidence suggests that the recent increase in maternal mortality in the United States is related to maternal obesity. (Aaron B. Caughey, 11/14)

Los Angeles Times: In Landmark Ruling, Court Orders Paint Companies To Pay To Clean Lead Paint Out Of California Homes
In a ruling that could set a precedent for lawsuits over the effects of climate change, a panel of appeals judges on Tuesday found three paint manufacturers responsible for the health hazards of lead paint in California homes and upheld an order that they pay to abate the dangers. The companies — ConAgra, NL Industries and Sherwin-Williams — had been ordered by a trial court in 2014 to pay a combined $1.15 billion for a lead paint abatement program in 10 counties and cities covering homes built before 1978, when lead paint in homes was outlawed. (Michael Hiltzik, 11/15)

JAMA: The Greatest Gift: How A Patient’s Death Taught Me To Be A Physician
The package was in plain brown paper wrapping. The note enclosed read, “Thanks for everything you did for my father. It meant more than you can ever imagine.” I teared up, remembering the day I helped the father of a colleague die peacefully. When I opened the wrapping and saw the picture of two saplings planted side by side and a certificate saying that the family planted one in my honor next to the one in their father’s, the single tear turned to a river. Although I never thought that a patient’s death would be one of the best clinical experiences of my then young career, that day increased my love for practicing medicine significantly. (Lawrence I. Kaplan, 11/14)

JAMA: The Las Vegas Shootings—Underscoring Key Features Of The Firearm Epidemic
Mass shootings draw widespread media attention. The Las Vegas shooting has been followed, as are most such events, by survivor interviews and video clips, commentators discussing the political challenges of gun legislation in the country, and the range of potential actions that could be taken to mitigate the human cost of firearms in the United States. Yet beyond the focus on fatalities, the Las Vegas event also highlights several issues that mandate attention in public and academic conversations around this issue. We summarize them here. (James M. Shultz, Siri Thoresen and Sandro Galea, 11/14)