Bloomberg: Trump Pick To Lead HHS Faces Senate Questions On Drug Prices
Senators grilled President Donald Trump’s selection to lead the U.S. Department of Health and Human Services about his close ties to the pharmaceutical industry and plans tackling high drug prices. Nominee Alex Azar was an executive at drugmaker Eli Lilly & Co. until January, a role that Democrats say raises concerns about whether he will take on rising drug costs. Azar took questions on his views before the Senate Committee on Health, Education, Labor and Pensions, one of two committees he’ll face as part of the nomination process, on Wednesday. (Edney, 11/29)

The New York Times: Health Nominee Grilled On Commitment To Lower Drug Prices
Mr. Azar sailed through the first of two hearings on his nomination without making major missteps. But he did not appear to dispel the doubts of Democrats who distrust him because of his experience as a top executive at a major drug maker, Eli Lilly and Company, for 10 years. (Pear, 11/29)

The Washington Post: HHS Nominee Alex Azar Testifies On Government Role In Lowering Drug Costs
“I think there are constructive things we can do” to bring down the price of medicines, Azar said, sitting alone at the broad witness table in a paneled Senate hearing room. He said he favors fostering competition between brand-name drugs and generic equivalents — an issue he worked on in the early 2000s while he was the HHS general counsel during the George W. Bush administration. “We have to fight gaming in the system by patents and exclusivity agreements.” (Goldstein and Eilperin, 11/29)

USA Today: Senators Question Commitment Of HHS Secretary Nominee To Lower Drug Prices
“First, drug prices are too high,” Azar told the Senate Health, Education, Labor and Pensions Committee. “The president has made this clear. So have I.” But Azar faced questions from both Democrats — and even some Republicans — about Lilly’s pricing practices and his commitment to lowering costs. (Groppe, 11/29)

The Associated Press: Trump Health Pick Parries Questions On Drug Cost, Health Law
That was insufficient for Sen. Rand Paul, R-Ky. “You’ve got some convincing to make me believe you’re going to represent the American people, not big pharma,” said Paul. Paul demanded a written explanation from Azar on why it wouldn’t be safe for U.S. patients to import lower-cost prescription drugs from other advanced countries. (Alonso-Zaldivar, 11/29)

Roll Call: HHS Pick Grilled On Drug Prices
The nominee to lead the Health and Human Services Department, Alex M. Azar, told a Senate panel that his top priority would be addressing the high price of prescription drugs. But there was skepticism from both sides of the dais at Wednesday’s Health, Education, Labor and Pensions Committee hearing that Azar, a former pharmaceutical company executive, would live up to that promise. While it was mostly Democrats who took aim at Azar’s tenure working for and running the U.S. affiliate of Eli Lilly & Co., Sen. Rand Paul said he would also need to be convinced. (Siddons, 11/29)

The Hill: Five Takeaways From Trump Health Nominee’s Hearing
Alex Azar, President Trump’s nominee to lead the Health and Human Services Department (HHS) took his first step forward Wednesday at a relatively quiet confirmation hearing by the Senate Health Committee. If confirmed, the former HHS general counsel and deputy secretary would replace former Rep. Tom Price (R-Ga.), who resigned after reports that he’d repeatedly used private jets to fly around the country at taxpayer expense. (Roubein, 11/29)

Stat: In A Shift, Debate Over Drug Prices Overshadows Obamacare
After years in which the debate over Obamacare has dominated all health policymaking discussion on Capitol Hill, U.S. lawmakers are increasingly turning their attention to the prices that everyday Americans pay for their prescription drugs. Less than one year ago, when the Senate health committee spent four hours grilling Tom Price, President Trump’s nominee as secretary of health and human services, Democrats focused their most aggressive attention on his support for repealing Obamacare and for making major changes to the Medicare and Medicaid programs, as well as his investments in an Australian biotech company. (Mershon, 11/29)

Bloomberg: Stabilization Bill Couldn’t Fix The Damage Of Repealing Obamacare’s Mandate
Passing a bipartisan Obamacare stabilization bill wouldn’t do much to cushion the blow from repealing the health law’s requirement that all individuals buy health insurance, the Congressional Budget Office said. The CBO has estimated that scrapping the mandate would result in 4 million people losing health coverage in 2019 and premiums in the individual market to increase by 10 percent. On Wednesday, the nonpartisan Congressional agency said a stabilization proposal backed by some Republican Senators would have no impact on its calculations. (Tracer, 11/29)

The Hill: CBO: ObamaCare Fix Would Not Make Up For Mandate Repeal
The Congressional Budget Office (CBO) says that a bipartisan ObamaCare fix would not do much to make up for the premium increases or coverage losses from repealing the health-care law’s individual mandate. In a letter to Sen. Patty Murray (D-Wash.) on Wednesday, CBO Director Keith Hall wrote that the estimate of premiums rising 10 percent and 13 million fewer people with coverage over 10 years would remain roughly the same even if the bipartisan fix from Murray and Sen. Lamar Alexander (R-Tenn.) were added in. (Sullivan, 11/29)

Roll Call: CBO: Insurance Market Stabilization Impact Null If Mandate Repealed
Legislation from the duo at the helm of the Senate health panel would do little to improve the number of uninsured individuals if the mandate created by the 2010 health law is repealed, according to the Congressional Budget Office. A repeal of the mandate — which requires individuals to purchase insurance or pay a yearly fine — is currently included in the GOP bill to overhaul the U.S. tax code. Some Republican senators, like Sen. Susan Collins of Maine, have cited the legislation from Senate Health, Education, Labor and Pensions Chairman Lamar Alexander and Sen. Patty Murray of Washington, the panel’s top Democrat, as a necessary measure should the mandate be repealed. (Williams, 11/29)

CQ: CBO: Bipartisan Health Deal Would Not Mitigate Mandate Repeal
A bipartisan Senate bill aimed at stabilizing the individual insurance market would not have a significant effect on the projected impact of scrapping the current penalty for not having health insurance, the Congressional Budget Office said on Wednesday. Senate Republicans have included a repeal of the requirement for most Americans to purchase health insurance or pay a fine in tax legislation they hope to pass by the end of the week. The nonpartisan analysts projected that would result in an additional 13 million uninsured people after a decade and that average premiums would increase 10 percent. (McIntire, 11/29)

The Fiscal Times: CBO Says Alexander-Murray Obamacare Fix Isn’t Much Of A Fix
The Congressional Budget Office says that the bipartisan bill by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) meant to stabilize the insurance market would do little to counteract the premium increases and coverage losses caused by repealing Obamacare’s mandate requiring individuals to buy insurance or pay a penalty. (Rosenberg, 11/29)

POLITICO Pro: Alexander Says His ACA Subsidy Bill Would Prevent Premium Price Spike
Senate HELP Chairman Lamar Alexander said his bipartisan health bill would prevent a health insurance premium spike of 25 percent, disputing a CBO report issued today that said enacting his bill while repealing the individual mandate would result in a net 10 percent increase in premiums. (Haberkorn, 11/29)

The New York Times: The Tax Bill’s Automatic Spending Cuts
If Congress passes its tax bill and then takes no other action, the funding for dozens of federal spending programs could be cut — in many cases to nothing — beginning next year. The cuts would be automatic, the consequence of a 2010 law that Congress passed to keep itself from increasing the deficit too much. The biggest program affected would be Medicare, the health insurance program for older people and the disabled. But the law allows Medicare to take only a relatively small cut: 4 percent. (Sanger-Katz, 11/29)

The Hill: Insurance Officials Worry Mandate Repeal Will Damage Markets
Many state insurance officials, even some in red states, are warning that repealing ObamaCare's individual mandate in the GOP tax-reform bill would cause damage to their markets. Insurance commissioners warn that premiums would rise, insurers could drop out of the market and more people would go without coverage if the mandate is repealed, as Senate Republicans are poised to do as part of their tax bill this week. (Sullivan, 11/30)

Reuters: U.S. Healthcare Shares Climb As Investors See Upside From Republican Tax Bill
Shares of U.S. healthcare companies mostly climbed on Wednesday, as investors saw some potential upside for the stocks from a Republican-led bill to cut taxes. ... “We see tax reform as providing a durable benefit to healthcare services companies,” Bernstein analysts wrote in a research note. “Healthcare services companies generally pay the full 35 percent corporate tax, as domestic companies with limited adjustments.” Possible changes to the Affordable Care Act and fees paid by health insurers could also benefit healthcare companies, they said. (Valetkevitch, 11/29)

The orphan drug tax credit also remains in play -

Stat: How The Orphan Drug Tax Credit May Change. What You Need To Know
As congressional Republicans race toward a vote on their tax code overhaul, a key tax credit for biotech and pharmaceutical companies — the so-called orphan drug tax credit — is on the line. The House passed a tax reform package earlier this month that would entirely repeal the credit, which is aimed at incentivizing research into treatments for especially rare diseases. The Senate version, up for a vote this week, lessens the amount companies can claim under the credit but keeps the idea in place. If it clears the Senate, the two chambers would have to reconcile their different versions before it could head to President Trump’s desk. (Mershon, 11/29)

Kaiser Health News: Patients With Rare Diseases And Congress Square Off Over Orphan Drug Tax Credits
As President Donald Trump talked tax reform on Capitol Hill Tuesday, Arkansas patient advocate Andrea Taylor was also meeting with lawmakers and asking them to save a corporate tax credit for rare disease drug companies. Taking the credit away, Taylor said, "eliminates the possibility for my child to have a bright and happy future." (Tribble, 11/30)

And in an attempt to secure the vote of Sen. Susan Collins (R-Maine), the GOP leadership is negotiating possibilities for advancing legislation to stabilize the Obamacare insurance markets -

The Hill: Collins Gets Promise To Pass ObamaCare Funding This Year
Sen. Susan Collins (R-Maine) said Wednesday she has received a commitment from Senate GOP leadership to include ObamaCare funding in a must-pass bill. Collins said she got a promise from Majority Leader Mitch McConnell (R-Ky.) that the deal crafted by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) would be included in legislation this year. (Carney, 11/29)

The Hill: Freedom Caucus Chair Opposes ObamaCare Funding Pushed By GOP Senator
House Freedom Caucus Chairman Mark Meadows (R-N.C.) said Wednesday that he opposes ObamaCare funding known as "reinsurance" that was part of a commitment given to Sen. Susan Collins (R-Maine) to help gain her vote for tax reform. "That's a totally different thing because that actually puts more money into a failing system where the money will not actually lower premiums and reduce costs in a substantial way," Meadows told The Hill. "I think that's a bigger problem." (Sullivan, 11/29)

Reuters: Sign-Up Pace Much Slower In Week 4 Of 2018 Obamacare Enrollment
The pace of people signing up for individual insurance under Obamacare slowed significantly during the fourth week of 2018 enrollment, as nearly 37 percent fewer people signed up for the healthcare plans than in the previous week, a U.S. government agency reported on Wednesday. The U.S. Department of Health and Human Services said that 504,181 people signed up for 2018 Obamacare individual insurance in the 39 states that use the federal government website HealthCare.gov for the week ended Nov. 25, down from 798,829 people in the previous week. New consumer sign-ups fell to 152,243 from 220,323 in the previous week. (11/29)

The Hill: ObamaCare Enrollment Slows In Fourth Week
Nearly 2.8 million people signed up for ObamaCare plans during the first 25 days of open enrollment, but the rate of sign-ups has slowed, the Trump administration announced. ... While more people are signing up for ObamaCare in the initial weeks, the final numbers could fall short of previous years because the enrollment period ends Dec. 15, meaning people only have about half as much time to sign up as last year. (Weixel, 11/29)

Columbus Dispatch: About 60,000 Ohioans Have Signed Up For 'Obamacare'
Nearly 2.8 million people have signed up for health insurance through Affordable Care Act since enrollment opened Nov. 1, including more than 60,000 in Ohio, but the the rate of sign-ups continues to slow. ... Last year, about 12.2 million nationwide signed up for health care on HealthCare.gov including about 240,000 in Ohio. (Candisky, 11/29)

Georgia Health News: Holiday Week Not A Bustling Time For Insurance Exchanges
Enrollment on the health insurance exchanges appeared to slow during Thanksgiving week in Georgia and nationally, federal figures show. After 119,968 Georgians enrolled for 2018 coverage in the first three weeks of sign-ups, just 26,931 picked a health plan last week. (Miller, 11/29)

Chicago Sun Times: Over 95,000 In Illinois Sign Up For Obamacare Plans
Although some would agree the website is confusing, that hasn’t stopped over 95,000 Illinois residents from enrolling in an Obamacare health insurance plan this year according to the Centers for Medicare and Medicaid Services. That’s a roughly 40 percent increase from 2016. By this point in time last year, a little over 68,000 people had signed up. (Hinton, 11/29)

St. Louis Public Radio: Shortened Enrollment Period For Affordable Care Act Gets A Healthy Start In Missouri
Once again, people who don’t get health insurance through their job are logging into online market places set up by the Affordable Care Act to buy it on their own. This year, the enrollment season is shorter — six weeks — but business is brisk. In the first four weeks of this year’s enrollment season, 78,676 Missourians enrolled in a plan, according to numbers released Wednesday by the Centers for Medicare and Medicaid Services. That’s about 17,000 more people than were signed up during the same period last year. (Bouscaren, 11/29)

Politico: HHS Winds Down Health Reform Office, Sources Say
HHS has quietly pared back its Office of Health Reform, a small office originally created to implement Obamacare that faced an uncertain future under a Republican administration hostile to the health law. Sources inside and outside of HHS say office staffers have left or taken on new roles in the administration in recent weeks. (Pradhan and Demko, 11/29)

KCUR: Trump Administration Rule Scales Back Program Keeping Rural Hospitals Afloat
The drug discount program has become a financial lifeline for rural hospitals like Pemiscot County [in Missouri], nearly a third of which are struggling to keep their doors open. Now, a pending rule change may scale it back dramatically. It’s yet another hurdle for rural communities fighting to keep their healthcare local. In 2016, the first full year the Pemiscot County hospital participated, the 340B program netted the hospital $1.6 million. That revenue played a big role in turning the hospital around after it lost over $3 million in 2013 and nearly shuttered. (Sable-Smith, 11/29)

Meanwhile, Roll Call takes a big-picture look at how the Trump administration has flexed its executive muscle regarding health policy and other agenda items -

Roll Call: Trump Executive Actions A ‘Disruptive’ Lot
From touting national security via the three versions of his travel ban, to greenlighting two pipelines his predecessor blocked, to ending an immigration program that affects millions, to targeting federal regulations to altering the 2010 health care law and beyond, the 45th president and his team have been unapologetic about his use of executive powers. ... Hill lawmakers from both parties have expressed concerns not about the number of actions Trump has signed but about the substance. ... In a sign that many congressional Republicans are standing beside the president, scores among their ranks — especially in the House — have fully embraced Trump’s orders, actions and memoranda. (Bennett, 11/30)

The Hill: Justice Department Announces New Steps To Combat Opioid Epidemic
Attorney General Jeff Sessions announced Wednesday that the Justice Department will award $12 million in grants to help law enforcement agencies combat the opioid crisis and create a new office in the Appalachian region to crack down on illicit drug trafficking. Sessions is also ordering all U.S. attorneys' offices to designate an opioid coordinator to work with prosecutors and other federal, state, tribal and local law enforcement officials to coordinate opioid prosecutions. (Hellman, 11/29)

The Hill: GOP Bill Would Limit Opioid Prescriptions For First-Time Users
Two Republican lawmakers are proposing to restrict the prescriptions of opioids for first-time users, calling it a necessary step to combat abuse. A new bill introduced Wednesday by Reps. Mark Meadows (R-N.C.) and Jim Renacci (R-Ohio) would limit a patient's first opioid prescription for acute pain to seven days, except in cases of traumatic injury, chronic conditions, cancer care, end-of-life care, palliative care, or based on a physician’s recommendation. (Hellmann, 11/29)

Bloomberg: Opioid Crisis Affects Farmers Harder Than Their Rural Neighbors
The U.S. opioid crisis that’s sweeping through America’s heartland has hit farmers harder than the wider rural population. Almost three-quarters of U.S. farmers and farm workers say they have been directly affected by opioid dependence, either from taking an illegal dose or dealing with a habit themselves, or by knowing someone who has used. That compares with about 45 percent for the rural population as a whole, according to a poll commissioned by the American Farm Bureau Federation and the National Farmers Union, the two biggest U.S. farmer groups. (Bjerga, 11/30)

Milwaukee Journal Sentinel: Two-Thirds Of Wisconsin Counties Have Now Sued Opioid-Makers In Federal Court
Two-thirds of all Wisconsin counties — 48 of 72 — have now filed lawsuits in federal district court in Milwaukee against the makers of prescription opioid painkillers. (Behm, 11/29)

Los Angeles Times: Australia's Flu Season Has U.S. Health Officials Bracing For A Bad Winter — And Wishing For A New Vaccine
The flu season is just getting underway in North America, but if Australia’s experience with influenza is any guide, we’re in for a miserable winter. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, warned Wednesday that the United States could experience a “relatively severe influenza season.” If so, it would extend a run of bad luck that began in 2014, when the available flu vaccines proved to be a poor match for the most common viruses in circulation. (Healy, 11/29)

The Baltimore Sun: Johns Hopkins Researchers Discover Mutation That May Be Key To Return Of Popular Nasal Spray Version Of Flu Vaccine
Johns Hopkins researchers believe they’ve figured out how to fix a popular nasal spray vaccine that federal authorities told people to stop using last year because it offered little protection from the flu. That would be welcome news for needle-averse children and adults who dread getting a shot even if it protects them against the respiratory virus that infects millions of Americans every year and can be dangerous for the elderly, chronically ill and very young. (Cohn, 11/29)

In other vaccine news -

Health News Florida: Rapid Zika Test Possible For 2018
Hospitals and health departments could have a new tool in 2018 to detect Zika – a test that is cheap, portable and fast. The test involves a drop of blood, can get results in 20 minutes and doesn’t require blood be sent out to a lab. (Aboraya, 11/29)

Reuters: New Vaccine, Long-Acting Drug Trials Buoy Hopes In HIV Fight
Researchers announced the launch of two big studies in Africa on Thursday to test a new HIV vaccine and a long-acting injectable drug, fueling hopes for better ways to protect against the virus that causes AIDS. (Hirschler, 11/30)

USA Today: 'Scary' Prediction For U.S. Kids: 57% Could Be Obese By Age 35
A whopping 57% of the nation’s children and teens will be obese by age 35 if current trends continue, according to a sobering new study out Wednesday. The research, published in the New England Journal of Medicine, goes beyond previous studies suggesting unhealthy childhood weights often lead to adult obesity. It suggests that while heavy children face the highest risk, even those who make it to age 20 in good shape face substantial peril in a world where obesity could soon be the new normal. (Painter, 11/29)

WBUR: More Than Half Of Today's American Kids Will Be Obese By Age 35, Harvard Study Projects
A new Harvard T.H. Chan School of Public Health study projects that if current tends continue, more than 57 percent of today's youth will be obese at age 35. Currently, about one in five schoolchildren is considered obese. (Goldberg, 11/29)

And more news on childhood nutrition —

USA Today: Hey Kids! You Can Soon Have Low-Fat, Chocolate Milk With Your School Lunch
Lunchroom bosses across the nation are getting a bit more flexibility in what they serve under a new federal rule unveiled Wednesday amid criticism that easing restrictions means less healthy young Americans. Agriculture Secretary Sonny Perdue cited President Trump's February executive order to alleviate unnecessary regulatory burdens in announcing the interim rule, effective for the 2018-2019 school year. (Bacon, 11/29)

The New York Times: Air Pollution May Weaken The Bones
Air pollution increases the risk for osteoporosis and bone fractures, researchers report. (Bakalar, 11/29)

NPR: Gene Therapy Shows Promise For A Growing List Of Diseases
So far, gene therapy has only been tested on a relatively small number of patients who have been followed for relatively short periods of time. Many more patients will have to be studied for longer periods before anyone really knows how well the therapies work, how long the benefits last, and whether the therapies are safe. But doctors and families of those helped so far are elated at the progress. (Stein, 11/29)

The Associated Press: Health Groups Urge Congress Not To Allow AIDS Fight To Wane
A coalition of nearly 40 advocacy groups said Wednesday they’re concerned about the Trump administration’s commitment to the global fight against AIDS so they’re urging senior members of Congress to make sure money for key prevention programs isn’t cut back. (Lardner, 11/29)

The Associated Press: US Troops Get Freeze-Dried Plasma For Battlefield Bloodshed
All of the U.S. military’s special operations fighters sent off to warzones and raids now have an essential addition to their first-aid kits: freeze-dried blood plasma. Last month, the Marines Corps’ special ops units became the last of the military branches to begin carrying freeze-dried plasma. The plasma helps clot blood and can prevent badly wounded troops from bleeding to death on the battlefield. (Dalesio, 11/30)

The Washington Post: Quitting Smoking Is Hard. FDA Wants New Nicotine-Replacement Therapies To Help.
The Food and Drug Administration said Wednesday it is taking new steps to encourage the development of innovative nicotine-replacement therapies to wean smokers off conventional cigarettes. In a blog post on the agency's website, three top officials said they want to ensure the FDA has the right policies to advance new products to help smokers. ... The post said a new Nicotine Steering Committee made up of senior FDA officials will explore the agency's handling of smoking-cessation products. (McGinley, 11/29)

Modern Healthcare: End-Of-Year Funding Fight Threatens CHIP, Extenders; Insurers Hopeful For ACA Tax Delays
Earlier this week, Colorado health officials delivered some dire news to tens of thousands of households: funding for Child Health Plan Plus is about to dry up, and with it coverage for children and pregnant women. CHP+ operates under the federal Children's Health Insurance Program and the state relies heavily on federal matching funds to keep operations going. More than 70,000 children and 800 pregnant women are covered by the program. Congress failed to reauthorize CHIP by the Sept. 30 deadline and that's left states like Colorado scrambling. (Luthi, 11/29)

Boston Globe: State Braces For Possible Loss Of Federal Funding For Children’s Health Program
Massachusetts is on track to run out of money in January for a federal program that provides health coverage for 172,000 children in the state unless Congress moves quickly to approve new funding. Without congressional action, Massachusetts is slated to lose $295 million in annual funding, according to state health officials. (Dayal McCluskey, 11/30)

Los Angeles Times: What Happens If Congress Doesn't Fund The Health Insurance Used By Almost 2 Million Kids And Pregnant Women In California?
Unless Congress comes to an agreement fast, federal funding for a program that provides health insurance to 2 million California children and pregnant women will run out around the end of the year. After that, California could be on the hook for hundreds of millions of dollars because the state is required to offer the insurance even if the federal funds don’t show up. (Wire, 11/29)

Columbus Dispatch: Two Months Expired, Children's Health Insurance Awaits Approval In A Congress Mired In Fighting
The federal program that provides health insurance to nearly 9 million low income children — including 219,000 in Ohio — expired two months ago, and states are beginning to panic that they’ll have to cut services to vulnerable families beginning early next year. Nearly half of all states — including Ohio — will have run out of their 2017 federal allotment for the nearly $15 billion Children’s Health Insurance Program by the end of December, according to the Medicaid and CHIP Payment and Access Commission, a nonpartisan legislative agency that provides information and analyses on Medicaid and the federal Children’s Health Insurance Program. (Wehrman, 11/29)  

Dallas Morning News: Texas Confident In Additional Federal Funding To Extend CHIP Through February
Texas officials got good news Wednesday: They may not have to send out health insurance cancellation letters to nearly half a million kids three days before Christmas. The federal Centers for Medicare and Medicaid Services on Wednesday signaled it’s very likely to give Texas enough additional money to keep its Children’s Health Insurance Program running through February, according to a spokeswoman for the state’s CHIP program. (Wang, 11/29)

The Oregonian: Auditors Pin Medicaid Mess On Oregon Bungling
Oregon's Medicaid program has missed opportunities to prevent or recover millions of dollars in overpayments, according to an audit released by the Secretary of State's office Wednesday morning. Auditors looked into how the Oregon Health Authority could avert, detect and recover improper payments of state and federal funds in the low-income health insurance plan. Problems they were looking for include paying for care that wasn't medically necessary, duplicate payments and covering patients who had other insurance. Auditors also examined what the health department did to catch such problems.  (Borrud, 11/29)

Eugene (Ore.) Register Guard: Audit: OHA Should Bolster Its Efforts To Detect Improper Medicaid Payments
The Oregon Health ­Authority should improve its efforts to detect and stop ­improper payouts for Medicaid ­recipients, an audit released Wednesday by the Secretary of State’s ­Office said. OHA lacks “well-defined, consistent and agency-wide processes” to ­verify that claims submitted by ­providers for health care services to low-income ­Oregonians are accurate, the much-­anticipated audit said. (Hubbard, 11/30)

Kansas City Star: Fines Against Kansas Nursing Homes Up Nearly 9,000 Percent Since 2012
Residents in nearly a third of Kansas nursing homes face possible harm or are in immediate jeopardy, according to citations issued this year — the fourth highest percentage among all states. Nationwide, 13.4 percent of nursing homes have had such citations this year, according to data compiled by the state of Wisconsin. (Shorman, 11/29)

Houston Chronicle: Report: State Cuts Led To Drop In Therapy For Young Children On Gulf Coast
The number of young children enrolled in early intervention to cope with conditions like autism, speech delays and Down syndrome has dropped by 21 percent in the Texas Gulf Coast region as state funding for the program waned, according to a new report out Wednesday. Hardest hit over the last six years was the number of black children receiving services, according to Texans Care for Children, a non-profit advocacy and research group studying enrollment statistics in the Early Intervention Program. (Zelinski, 11/29)

Denver Post: Colorado Grapples With 80 Percent Jump In Newborns Going Through Opioid Withdrawal
The rise in Colorado newborns addicted to opioids has alarmed physicians and child advocates, jumping 83 percent from 2010 to 2015. The state’s rate, according to the Colorado health department, climbed from 2 births out of 1,000 to 3.6 births in that five-year period. In some parts of Colorado, the rate is much higher. At Parkview Medical Center in Pueblo, the city’s safety-net hospital that sees many Medicaid patients, the rate of newborns addicted to opioids skyrocketed from 0.7 per 1,000 in 2010 to 20.8 in 2012. The rate at Parkview now hovers around 10, and doctors have noted a shift from prescription drugs such as Oxycontin to street drugs, mainly heroin, in recent years. (Brown, 11/29)

State House News Service: Meningitis Outbreak Declared At UMass Amherst
With its Amherst campus filled with students who just returned from Thanksgiving break, University of Massachusetts officials on Tuesday said they are treating two cases of meningitis as an outbreak. (Norton, 11/29)

Arizona Republic: Phoenix Wants To Regulate Sober-Living Homes, But Can It?
There are hundreds of group homes across Phoenix, set up in single-family dwellings, that house anywhere from two to 10 people recovering from drug abuse. There are no licensing requirements to operate these facilities and virtually no government oversight. (Boehm, 11/29)

Milwaukee Journal Sentinel: EPA Finds Wisconsin Barrel Plants Violating Environmental Laws
The EPA determined the plants in St. Francis, Oak Creek and Milwaukee were breaking the law by transporting, storing and treating hazardous waste without required licenses, among other violations. ... The inspections were initiated following a Milwaukee Journal Sentinel investigation, published in February, which uncovered a host of problems that endangered workers and residents living near the company's plants in the Milwaukee area and three other states — Tennessee, Indiana and Arkansas. (Diedrich, 11/29)

The Star Tribune: Cannabis Interruption Alarms Minnesota Patients
A distribution glitch at one of Minnesota's two medical marijuana providers has left some patients with little or no supply left for treatment of conditions such as chronic pain, epileptic seizures and Tourette syndrome. (Olson, 11/29)

KCUR: Concussions Don’t Discriminate, As Central Missouri’s Women’s Soccer Team Found Out
The undefeated Central Missouri Jennies women’s soccer team is hoping to earn its first NCAA Division II national championship. But this season, which continues Thursday with a semifinal matchup against Mercy College of New York, wasn’t without challenges: The team has been affected by an increasing national trend from high school athletics to the pros — concussions. (Echlin, 11/30)

Georgia Health News: Art For The Blind: A Serious Concept That’s Also A Lot Of Fun 
The American Foundation for the Blind says there are 2,424 children under age 5 with some vision loss in Georgia. And there are 16,675 children from 5 through 17 years in the same situation. Hundreds of the parents of these young Georgians have turned to the Center for the Visually Impaired, an Atlanta nonprofit that helps children and adults adjust to — or improve — a life with limited or no sight. (Kanne, 11/29)

Modern Healthcare: Tax Reform Should Mean Improving The Economy, But Not At The Expense Of Our Healthcare System
When congressional leaders set their sights on comprehensive tax reform, the aims were to improve our tax system and create a tax code that suited our country's economic needs. This should have meant finding a way to improve the health of our economy—not harm our healthcare. Instead of bipartisan progress, the current tax reform debate has devolved into an eerie case of déjà vu—echoing this summer's failed healthcare repeal efforts. Between the Senate's individual mandate repeal—yet another iteration of "repeal without replace"—and cuts to Medicare and Medicaid, the tax bill, as it stands today, is set to do more harm than good to America's health. (John Rother, 11/29)

The Washington Post: No Serious Lawmaker Should Support This Tax Bill
Similarly, the federal “pay-as-you-go” law requires that tax cuts and entitlement increases be paid for in the year they’re enacted; it that doesn’t happen, automatic cuts in Medicare and other important programs are supposed to be triggered automatically. But GOP leaders are now publicly stating that once their tax bill is approved, they will follow quickly with legislation to exempt the just-passed tax cuts from this trigger. Why would anybody think they won’t end up doing the same with the trigger, if the need arises? (Robert E. Rubin, 11/29)

The New York Times: The Senate Is Rushing To Pass Its Tax Bill Because It Stinks
This rush to the Senate floor has been orchestrated by Mr. McConnell, following the same playbook he used in the failed effort to repeal the Affordable Care Act. The longer people have to study the details, the less likely the bill is to pass. People should know by now about the big stuff: the giant permanent corporate tax-rate cut, the small and temporary tax cuts for the middle class, the repeal of the A.C.A.’s individual mandate and the $1.4 trillion added to the federal deficit over 10 years. But other provisions are not as well understood and deserve to be called out. Here are three. (11/29)

The Wall Street Journal: The Rubio-Schumer Amendment
On Wednesday Mr. Rubio and his political sidecar, Mike Lee of Utah, announced that they’ll file an amendment to the tax bill to change the $2,000 child tax credit. They want to make the credit refundable up to a person’s payroll tax liability, among other expensive tweaks. To pay for the changes, Messrs. Rubio and Lee would increase the corporate tax rate to 22% from the bill’s 20%. If Mr. Rubio thinks payroll taxes are too high, he can propose a payroll tax cut. But then he’d have to weather the political fight of going after funding for Medicare and Social Security. So instead his back-door plan is to expand a refundable credit, which delivers checks to folks who owe no federal income tax. This is a disincentive to work and we would have thought antithetical to conservative principles. (11/29)

Arizona Republic: John McCain Can Lead (Again) With His Vote On Senate Tax Bill
Once again, the nation waits for Sen. John McCain to show us who he is. Will he be that reliable party guy who does the politically expedient thing and votes yes on the Senate tax cut bill? (Laurie Roberts, 11/29)

The New York Times: Lambs Of The Senate
The Republican senators who aren’t yet committed to voting for the tax bill have a huge amount of leverage. They are not using it. Instead, they mostly seem to be folding — accepting vague promises from President Trump (who doesn’t exactly have a good record of keeping his word) and Mitch McConnell. That was Tuesday’s theme on Capitol Hill. Susan Collins, who has said she is worried about the damage the bill will do to health care, no longer seems to be insisting on any legislation to reduce the damage. (David Leonhardt, 11/29)

Huffington Post: Even With ‘Fixes,’ The GOP Tax Cut Plan Would Likely Damage Health Care
The tax cut bill would eliminate the mandate. If that happens, experts warn, both health insurance premiums and the number of people without coverage will go up. Insurers would be more likely to exit markets altogether. Now some Republicans are talking about passing yet another piece of legislation, in order to make sure insurance markets don’t deteriorate. It’s not a crazy idea. But the new legislation would have only a modest impact ― and, even then, only on a temporary basis. (Jonathan Cohn, 11/29)

Los Angeles Times: Time Is Running Out On Children's Health Insurance Program
The Republicans who control Congress allowed the [Children's Health Insurance Program's] authorization to lapse in September, shutting off the spigot of federal dollars. The main issue holding up reauthorization has been a fight over how to cover the program’s price tag. Let’s be clear: any sign of fiscal responsibility in Washington is welcome. Nevertheless, the hand-wringing over children’s health insurance, which costs $8 billion a year, stands in sharp contrast to the GOP’s eagerness to pass a package of tax cuts that would cost an estimated $1.4 trillion over the coming decade. (11/30)

Bloomberg: Trump's HHS Pick May Not Be Totally Pharma-Friendly
Congressional hearings are frequently exercises in grandstanding, and high drug prices are near-universally unpopular. So it was no surprise, then, that drug pricing featured prominently in a Senate confirmation hearing Wednesday for Alex Azar, President Donald Trump's nominee to run the Department of Health and Human Services. The pharma industry likely took heart when Azar, a former Eli Lilly & Co. executive, blamed the whole health-care system, rather than drugmakers alone, for high prices. But Azar also went off the standard pharma script when he said he planned to target industry efforts to unnaturally extend drug monopolies by "gaming" the patent system. (Max Nisen, 11/29)

The Washington Post: Trump Says Pharma Gets Away With Murder. Alex Azar Is The Guy With The Hatchet.
President Trump could not have been more clear. “The drug companies, frankly, are getting away with murder,” he said in mid-October. He had used the same “getting away with murder” line previously, adding that “pharma has a lot of lobbies and a lot of lobbyists and a lot of power.” Yet just four weeks later, Trump nominated the former president of Eli Lilly’s U.S. business to run the Department of Health and Human Services. If drug companies are murderers, Alex Azar is the guy with the rusty hatchet. (Dana Milbank, 11/29)

Des Moines Register: Welcome To Iowa, The Care Less State
Many might not view the cuts of positions in state government as bad news. But this IS bad news, and Iowans should be disturbed by it. Iowans should also be disturbed by this – the budget proposal submitted by the Office of the Long-Term Care Ombudsman for the next fiscal year doesn’t seek funding to reinstate the travel or the positions that have been eliminated. And why doesn’t it? Because the independence that the office is supposed to have, independence that is called for in federal law and regulations, doesn’t exist. (John Hale, 11/29)

JAMA: Is It Time For A New Medical Specialty?
Medicine has seen a proliferation of specialties over the last 50 years, as scientific discovery and care delivery advanced. Diagnoses and treatments have become more complex, so the need for formal training for specialty competence in cognitive and surgical disciplines has become clear. ... We propose the concept of a new specialty representing the medical virtualist. This term could be used to describe physicians who will spend the majority or all of their time caring for patients using a virtual medium. A professional consensus will be needed on a set of core competencies to be further developed over time. (Michael Nochomovitz and Rahul Sharma, 11/27)