Reuters: Repeal Of Individual Mandate Would Increase Uninsured, Premiums: CBO
The Congressional Budget Office said on Wednesday that repealing the Obamacare individual mandate would increase the number of uninsured by 13 million by 2027 and reduce the federal budget deficit less than initially forecast. The CBO, the nonpartisan budget-scoring agency, said that eliminating the Obamacare mandate that all Americans purchase health insurance or else pay a fine would lower the deficit by $338 billion over the next decade, not $416 billion as it estimated in December. (Brice and Abutaleb, 11/8)

The Hill: Repealing ObamaCare Mandate Means Millions Fewer Insured: CBO
Getting rid of the individual mandate means fewer people with health insurance. That means fewer subsidies the government will pay to help people afford their ObamaCare health plans, and thus, savings. Premiums in the individual insurance market would increase by about 10 percent in most years of the decade, CBO concluded, because repealing the mandate means less healthy people will buy insurance. That would leave sicker, older people to share the costs in the market, resulting in higher premiums. (Roubein and Hellmann, 11/8)

Politico: CBO: Obamacare Mandate Repeal Would Cut Deficit By $338 Billion
The new analysis finds that repealing the mandate would not have as big of an impact as the estimates CBO made nearly a year ago. A December 2016 CBO analysis found that undoing the mandate would reduce the budget deficit by $416 billion over nearly a decade and result in 15 million more uninsured Americans in 2026 than under current law. (Haberkorn, 11/8)

NPR: CBO: Repealing Health Coverage Mandate Would Save $338 Billion
House Republicans are toying with the idea of repealing the so-called individual mandate — a key part of the Affordable Care Act — as part of their plan to overhaul the tax code. Including the provision could be a win-win for Republicans. The move would allow them to offset more of the tax cuts they want in their tax plan and give them the chance to claim they repealed one of the most hated parts of the Affordable Care Act, also known as Obamacare. (Kodjak, 11/8)

Modern Healthcare: CBO: Axing ACA Mandate Would Give GOP $338 Billion More For Tax Cuts
If Republicans repeal the Affordable Care Act's individual mandate as part of their tax cut bill, that would give them $338 billion in cost savings over 10 years to soften the bill's rollback of popular tax breaks like the mortgage interest deduction, according to a Congressional Budget Office report released Wednesday. There would be 13 million fewer people with health insurance in 2027 due to repealing the mandate, and average premiums in the individual market would be 10% higher than if the mandate were preserved. (Meyer, 11/8)

Bloomberg: Repealing Obamacare Mandate Would Save $338 Billion, CBO Says
Rolling back Obamacare’s requirement that all Americans have health insurance would save the U.S. $338 billion over 10 years, according to the Congressional Budget Office, a smaller benefit than previously projected for a plan favored by the White House. Republicans are considering repealing the coverage rule in the Affordable Care Act as a way to pay for far-reaching changes in the tax code. The savings would come from the government spending less to subsidize Obamacare plans as more people opt to forgo health coverage. (Edney, 11/8)

CQ: CBO Projects Fewer Savings From Repealing Health Law's Mandate
Repealing the requirement that most Americans purchase health insurance coverage would reduce the federal deficit by $338 billion over a decade, an analysis by nonpartisan analysts expected later Wednesday will show. The Congressional Budget Office is set to publish an updated estimate of the effects of repealing the individual mandate included in the 2010 health care law (PL 111-148, PL 111-152). Republicans are considering including a repeal in tax legislation (HR 1) they hope to clear by the end of the year. (McIntire, 11/8)

The Associated Press: In Election Glow, Dems See Health Care As A Winning Issue
Democrats are starting to see a political edge in health care — particularly the idea of widening Medicaid access for more low-income people — after big election victories Tuesday night. In Virginia, Democrat Ralph Northam promised a vigorous push as governor to expand Medicaid. Voters who said health care was important went decisively for Northam. (Alonso-Zaldivar, 11/9)

The Wall Street Journal: Democratic Wins Dent Efforts To Roll Back Health Law’s Individual Mandate
Democratic wins in Tuesday’s elections make it less likely that Republicans, as part of their tax package, will seek to repeal the Affordable Care Act’s requirement that most people have health coverage, according to congressional aides. Voters in Maine this week decisively backed a referendum to expand Medicaid under the ACA, and exit polls showed health care was a central issue for Virginians who elected Democrat Ralph Northam as their state’s governor. (Armour and Peterson, 11/8)

Politico: Battered By Trump, Obamacare Triumphs At The Polls
As Democrats now look to the 2018 midterms that will decide control of the House, Senate and key governorships across the country, they can begin to more confidently embrace the law that’s covering 20 million Americans and that emerged politically stronger after surviving months of concentrated Republican repeal attacks. (Pradhan, 11/8)

Los Angeles Times: Healthcare, For Years A Political Winner For GOP, Now Powers Democratic Wins
Tuesday's elections don't ensure healthcare will remain a winning issue for Democrats in 2018, when party leaders hope they can retake the majority in at least one chamber of Congress. But the emergence of healthcare as a political liability for Republicans marks a dramatic turnabout for the GOP, which for years reaped huge electoral gains by playing on the unpopularity of the 2010 law. (Levey, 11/8)

Kaiser Health News: Election Night Surprise: Health Care Galvanizes Voters
Health care appears to have played an unexpectedly robust role in Tuesday’s off-year elections, as Democrats swept statewide races in Virginia and New Jersey and voters told pollsters it was a top concern. The health headline of the night came in Maine, where voters by a large margin rebuked Republican Gov. Paul LePage and approved a referendum expanding Medicaid under the Affordable Care Act. Maine is one of 19 states that has not expanded the program to people with incomes up to 138 percent of the federal poverty line, or about $16,600 for an individual. An estimated 70,000 to 90,000 Mainers could gain insurance under the expansion. (Rovner, 11/8)

Meanwhile, a look at what went wrong for advocates in Ohio's drug prices ballot initiative —

Cleveland Plain Dealer: What We Learned From Issue 2's Failed Campaign
Issue 2, the drug price ballot initiative, failed by a historic margin on Tuesday night. ... this is the worst loss ever for an initiated statute, with a 58.5-point defeat. (Richardson, 11/8)

Roll Call: Governors’ Obamacare Waiver Power Would Broaden Under GOP Proposal
Legislation from two Republican senators would allow governors to implement a waiver under the 2010 health care law without approval from state legislatures, a departure from current law, according to a discussion draft obtained by Roll Call. The bill from Senate Finance Chairman Orrin G. Hatch and Idaho Sen. Michael D. Crapo would end the requirement for states to pass legislation to implement a so-called 1332 waiver. It would also let governors unilaterally end the program and would mandate that the Department of Health and Human Services secretary make a determination on a waiver application within 100 days. (Williams, 11/8)

In other health law news —

The Baltimore Sun: Enrollments In The Maryland Health Exchange Up In First Week
Enrollments in Maryland’s health exchange are well ahead of last year in the first week of the sign-up period, exchange officials said. Those buying policies for the first time are up 15 percent to about 4,020. And total enrollments, which includes new and returning consumers, are double the number at this time last year, at 10,420. (Cohn, 11/8)

The New York Times: Congress Weighs Repeal Of Tax Credit For Rare Disease Drugs
A decades-old tax credit designed to spur cures for rare diseases has been so successful that it’s now become a target in the House Republican tax plan. The proposal under consideration would end the tax breaks for development of what are called orphan drugs. Ending the credit used by big and small drug companies could save the government an estimated $54 billion over the next decade, an effort to help offset some of the anticipated losses in revenue if other Republican tax cut provisions become law. (Thomas and Kaplan, 11/8)

Stat: Trump Wants To Cut Big Pharma’s Tax Bill, But What Are Drug Makers Actually Paying?
Pharma has had a rocky relationship with President Trump since inauguration, but the two agree on at least one thing: Corporate taxes are too high. And yet the nation’s biggest drug makers aren’t paying anywhere near the top corporate tax rate Trump, and congressional Republicans, hope to slash. (Garde, 11/8)

In other news on the GOP tax overhaul —

The New York Times: Ending Medical Tax Break Could Be A ‘Gut Punch’ To The Middle Class
Suzanne Hollack tried to care for her husband at home after he was diagnosed with frontotemporal dementia at age 69. But it got to the point where she couldn’t take a shower for fear he would stray out of the house. So 18 months ago, she moved him to a memory care community near their home in Scottsdale, Az., which like most long-term care, is not covered by Medicare. That, plus his other medical expenses, cost the couple $90,000 last year. (Zernike and Goodnough, 11/8)

Politico Pro: NDAA Moves Forward As Lawmakers Discuss Separate Fix For Drug Approval Provision
Must-pass defense policy legislation will move forward unchanged despite protests from health committees over a provision that would shift some approvals for drugs and medical products from the FDA to the Pentagon. Instead of delaying a vote on the National Defense Authorization Act, H.R. 2810, to make changes, the House Armed Services and Energy and Commerce committees will continue talks on a potential fix, an Armed Services aide told POLITICO. (O'Brien, 11/8)

The Hill: GOP Chairmen Seek Hold On Giving Defense New FDA Powers
Three GOP chairmen are asking for a delay in moving the defense policy bill’s conference report over concerns the measure would let military personnel receive devices and drugs that haven’t won Food and Drug Administration (FDA) approval. At issue is a provision in the Senate’s National Defense Authorization Act that would let the Pentagon sign off on unapproved medical products for emergency use on the battlefield. Currently, the FDA is responsible for such approvals, and its commissioner, Scott Gottlieb, believes that shouldn’t change. (Roubein, 11/8)

In other FDA news --

Politico Pro: FDA Moves To Prevent Brand-Name Drugmakers From Slowing Competition
FDA today released guidance to help make it easier for makers of brand-name drugs and generics to collaborate on mandated safety programs known as REMS — a move that should make it harder for brand drug companies to use REMS to prevent competition. (Karlin-Smith, 11/8)

Reuters: Ex-Pharma Exec Azar Is Top Choice to Run U.S. Health Agency: Sources
Alex Azar, a former pharmaceutical company executive, is U.S. President Donald Trump's top pick to run the Department of Health and Human Services, two sources with knowledge of the confidential process said on condition of anonymity on Wednesday. Azar served at Eli Lilly for a decade, including five years as president of its U.S. Lilly USA, LLC unit. (Abutaleb, 11/8)

Bloomberg: Trump Expected To Name Ex-Lilly Executive Azar HHS Secretary
Azar, who worked at Eli Lilly & Co., would be the administration’s point person on running -- or dismantling -- Obamacare, the health program enacted by Trump’s predecessor that insures millions of Americans. He will also oversee Medicare and Medicaid, along with dozens of public health programs and sub-agencies. Trump is in Asia for an extended trip and could still change his mind before a replacement is officially named. At Lilly, Azar ran U.S. operations. Trump has been highly critical of the drug industry, saying that companies are “getting away with murder” and threatening to use the federal government’s buying power to bring down prices. However, he’s taken no concrete action yet to do so. (Edney, 11/8)

The Hill: Anti-Abortion Lawmakers Push ‘Conscience Protection’ Bill
Anti-abortion lawmakers in the House and Senate are pushing for language in the end-of-year spending bill that they say would protect health-care professionals who don’t want to take part in abortions because of their personal objections. The Conscience Protection Act would allow health-care providers like nurses and doctors to sue if they’re coerced into participating in abortions or if they face discrimination at work for refusing to do so. (Hellmann, 11/8)

Boston Globe: Mass. House Approves Bill That Ensures Free Birth Control
House lawmakers Wednesday overwhelmingly approved a bill that would ensure access to free birth control in the state and shield state residents from changes to federal law regarding contraceptive coverage requirements. The bill is headed to the Senate after the 138-16 vote. (McDonald, 11/9)

Texas Tribune: Benefits, Burdens Of Texas Abortion Procedure Ban Debated In 5-day Trial
In a five-day trial that concluded Wednesday, lawyers for the state defended part of a Texas law that bans the most common second-trimester abortion procedure unless the fetus is deceased. Abortion rights groups sued the state in July, arguing the provision restricting the dilation and evacuation procedure imposes an undue burden on Texas women seeking second-trimester abortions. (Najmabadi, 11/8)

Boston Globe: Midwives Debate Bill That Could Regulate Home Births Around The State
Dozens of midwives and mothers with babies in slings and toddlers in strollers gathered at the State House this week to offer their take on a bill that, if passed, would require home-birth midwives to be licensed by the state. Out-of-hospital midwives currently have no state oversight in Massachusetts, according to proponents of the legislation. (Guerra, 11/8)

Reuters: Trump Says He And China's Xi To Try To End Opioid Crisis
U.S. President Donald Trump said on Thursday that he and Chinese President Xi Jinping would be focusing "very strongly" on the U.S opioid crisis, which he has declared a public health emergency. Trump said shortly before arriving in Beijing he would discuss as a "top priority" stopping the "flood of cheap and deadly" fentanyl "manufactured in China" when he meets Xi. (Holland and Wen, 11/9)

In other news on the crisis —

Modern Healthcare: Pharmacies, PBMs, Insurers Call For Opioid Prescription Policy Changes
Drug prescribers throughout the country should establish a seven-day supply limit for initial opioid prescriptions, and they should be written electronically to slow the abuse of the addictive painkillers, a group of pharmacies, pharmacy benefit managers and health plans wrote in a letter to President Donald Trump Wednesday. The group pledged to support the federal government and states in clamping down on behaviors that have allowed opioid abuse to swell into a national epidemic.

The New York Times: Alternatives To Opioids For Pain Relief
A combination of Tylenol and Advil worked just as well as opioids for relief of pain in the emergency room, a randomized trial has found. Researchers studied 416 men and women who arrived in the E.R. with moderate to severe pain in their arms or legs from sprains, strains, fractures or other injuries. (Bakalar, 11/8)

The Washington Post: Genetically Modified Skin Grown From Stem Cells Saved A 7-Year-Old Boy’s Life
Scientists reported Wednesday that they genetically modified stem cells to grow skin that they successfully grafted over nearly all of a child's body — a remarkable achievement that could revolutionize treatment of burn victims and people with skin diseases. The research, published in the journal Nature, involved a 7-year-old boy who suffers from a genetic disease known as junctional epidermolysis bullosa (JEB) that makes skin so fragile that minor friction such as rubbing causes the skin to blister or come apart. (Cha, 11/8)

Stat: ‘Extraordinary’ Tale: Stem Cells Heal A Young Boy’s Lethal Skin Disease
The doctors were ultimately able to reconstruct fully functional skin for 80 percent of the boy’s body by grafting on genetically modified cells taken from the boy’s healthy skin. The researchers say the results of this single-person clinical trial, published on Wednesday in Nature, show that transgenic stem cells can regenerate an entire tissue. De Luca told reporters the procedure not only offers hope to the 500,000 epidermolysis bullosa patients worldwide — but also could offer a blueprint for using genetically modified stem cells to treat a variety of other diseases. (Blau, 11/8)

The Wall Street Journal: New Skin for 7-Year-Old Boy Marks Advance In Gene Therapy
The new skin remains functional after 21 months, and doesn’t blister or require ointment or medication, according to the team of scientists and doctors from Austria, Germany and Italy who described the case in a paper in the journal Nature. The child in the study has Junctional Epidermolysis Bullosa (JEB), part of a family of rare, often lethal, skin-blistering diseases. Epidermolysis Bullosa affects only around 1 in every 20,000 births in the U.S.; JEB is a severe form of the disease, often leading to death in early childhood. (Dockser Marcus, 11/8)

Los Angeles Times: 9-Year-Old Boy With Rare Disease Now Has Engineered Skin Covering 80% Of His Body
Over a five-month period in the fall and winter of 2015, they harvested some of the boy's few remaining healthy skin cells. Using a virus to invade the cells, they introduced a corrected version of the mutated gene that had caused the catastrophic failure of his epidermis, the body's largest organ. They cultured the corrected cells and, on sheets backed with plastic and a naturally-occurring adhesive, used them to build many square meters of healthy new epidermis. Then, ever so delicately, they clothed his small body in a new set of skin. (Healy, 11/8)

NPR: Genetically Altered Skin Saves A Boy Dying Of A Rare Disease
After eight months in the intensive care unit, the boy was well enough to go home. And, two years later, he is in school, even playing soccer. "The kid is doing quite well," Rothoeft said. "The skin is of good quality, it doesn't need any ointments or stuff like that. It's perfectly smooth and it is quite stable. And if he gets any bruises, they just heal like bruises in every other kid." (Harris, 11/8)

The New York Times: Are Mass Murderers Insane? Usually Not, Researchers Say
If what people do is any reflection of who they are, then Devin P. Kelley, who slaughtered 26 churchgoers on Sunday in Texas, surely was a madman. Before the atrocity, he had attempted to sneak weapons onto an Air Force base after making death threats to his superiors, according to a local police report. In 2012, he had escaped from a mental hospital in New Mexico to which he had been sent after assaulting his wife and fracturing his stepson’s skull. (Carey, 11/8)

Stat: Risky Stimulants Turn Up — Again — In Weight Loss And Workout Supplements
Dr. Pieter Cohen, the Harvard internist and noted supplement detective, took the case. He and his collaborators purchased and analyzed six supplements marked as containing one of the mystery ingredients. They expected that, however they were listed, all the ingredients would turn out to be a stimulant known as octodrine, which the Food and Drug Administration approved decades ago, in inhaled form, as a treatment for bronchitis, laryngitis, and other conditions. (Robbins,11/8)

The New York Times: Pesticides Tied To Problems In Assisted Pregnancies
Eating fruits and vegetables high in pesticides may lower the chance of successful birth with assisted reproductive technology, according to a new report. Researchers studied 325 women undergoing fertility treatment in Boston. They collected data on medical and lifestyle factors and had the women fill out food frequency questionnaires. (Bakalar, 11/8)

Stat: New Brain Technologies Pose Threats To Privacy And Autonomy That Are All Too Real, Experts Warn
With Elon Musk aiming to build brain implants so people can communicate telepathically, fMRIs already (approximately) reading minds, under-the-radar companies working on computer chips to control brain activity that generates intentions, and technologies promising to boost brain performance like Bradley Cooper’s in “Limitless,” it might seem like neuroscience has become neurofiction. But the advances, and the threats they pose, are all too real, experts warned on Wednesday. In an essay in Nature, 27 neuroscientists, physicians, ethicists, and artificial intelligence experts argue that these and other powerful “neurotechnologies,” originally conceived to help people who are paralyzed or have other neurological disorders, could “exacerbate social inequalities and offer corporations, hackers, governments or anyone else new ways to exploit and manipulate people.” (Begley, 11/8)

Boston Globe: More Researchers Weigh In On Double-Booked Surgeries
Neurosurgeons can safely run two operations at once without endangering patients, a study from Emory University in Atlanta concluded, part of a growing body of research in response to a Globe Spotlight Team report that found surgeons sometimes do simultaneous surgeries without telling patients. (Saltzman, 11/8)

Modern Healthcare: Overlapping Neurosurgeries Don't Hurt Patient Outcomes
Overlapping surgery, a well-established practice in which a surgeon performs critical parts of a procedure and then departs to perform another procedure just beginning, has received intense scrutiny in recent years by critics who argue the practice is unsafe. But a new JAMA study found outcomes for neurosurgery patients who received overlapping surgery were the same as those of patients who didn't receive such treatment. (Castellucci, 11/8)

Pioneer Press: Sudden Infant Deaths Attributed To Unsafe Sleep Practices, Health Officials Say
For a few days this week, commuters driving past the Lowry Avenue Bridge in Minneapolis will see its lights colored blue, light blue and pink in honor of Infant Safe Sleep Week, an initiative to encourage safe sleep practices for infants. ... According to data released Wednesday from the Minnesota Department of Health, unsafe sleeping environments contribute to almost all sudden infant deaths. According to a page on Mayo Clinic’s website, SIDS is commonly thought to have no explanation, but data from 2015 found that 53 of the 54 sudden infant deaths in Minnesota involved unsafe sleeping conditions. (Johnson, 11/8)

Star Tribune: Infant Deaths Linked To Sleep Positions
Minnesota recorded 54 unexplained infant deaths in 2015 — about the same as prior years — and all but one involved a child in an unsafe sleeping environment, according to an analysis from the Minnesota Department of Health. State health officials used the findings to renew their warnings to parents to place their babies to sleep on their backs and in uncluttered cribs. (Olson, 11/8)

Concord Monitor: Former N.H. Chief Justice Urges Kids To REACT To Mental Illness
John Broderick, a former chief justice on the Supreme Court, has crisscrossed the state for nearly two years, giving speeches and meeting students in an effort to destigmatize mental illness as part of the national Change Direction campaign. He’s given approximately 160 talks and spoken to some 20,000 people. But now there’s a new twist in his now familiar story. Broderick is now asking kids to REACT. The acronym stands for “Recognize” the signs of emotional suffering, “Express” concern and offer support, “Act now” and tell someone you trust, “Care enough” to follow up, and “Text” or call a number for extra support. (Duffort, 11/8)

Kaiser Health News: KHN Discussion On Advance Care Planning: What You Need To Know Now
Planning for end-of-life medical care can be daunting and uncomfortable, which is why so many people put it off — or don’t do it at all. On Wednesday, Nov. 8, Kaiser Health News senior correspondent JoNel Aleccia moderated a discussion of the pressing issues surrounding end-of-life advance care planning. (11/8)

Pioneer Press: Nurses Union Hits Duluth Health Care System Over Requiring Flu Shots
As Essentia Health was in court with one union over its new mandatory flu shot policy on Tuesday, another was challenging the Duluth-based health system over the same policy. The Minnesota Nurses Association, which represents 2,000 Essentia nurses, charged in a statement on Monday that the health system hadn’t made good on a promise to hold off on enforcing the policy until negotiations took place. Instead, the MNA said, Essentia was ignoring that process and threatening to fire nurses who did not comply. (Lundy, 11/8)

Chicago Tribune: Feds Allege Illinois Company, Others, Failed To Pay $26 Million In Medical Bills
A federal court has ordered several companies to stop administering health plans for small businesses in Illinois and across the country after they allegedly failed to pay $26 million in members’ medical bills while keeping large amounts of money for themselves. Illinois-based Black Wolf Consulting, along with Texas-headquartered AEU Holdings and one of its subsidiaries, allegedly failed to pay medical bills for many of the 14,000 members of health plans administered by the companies for small businesses in Illinois and across the country, according to the U.S. Department of Labor, which investigated after complaints from members. Black Wolf is based in Monee, according to court documents. (Schencker, 11/8)

The Wall Street Journal: Outcome Health Fires Back Against Fraud Claims By Investors
Outcome Health on Wednesday fired back at investors suing the prominent Chicago advertising startup, saying that their accusations of fraud are baseless and that their effort to freeze $225 million in funds controlled by the founders was unfair and could financially damage the company. (Winkler, 11/8)

WBUR: Whistleblower Lawsuit Says Mass. Mental Health Center Defrauded The Government By Using 'Unqualified' Employees
A whistleblower lawsuit accuses South Bay Mental Health Center Inc. of defrauding the federal and state government of $130 million through fraudulent billing practices. ...The suit states that more than 30,000 patients a year were treated by unqualified clinicians and calls that a clear violation of regulations and requirements of the state's Medicaid program. (Boeri, 11/8)

Houston Chronicle: TMC Venture Fund Launches With $25M For Med Startups
The Texas Medical Center is launching a $25 million venture fund to support early-stage companies developing technologies in the health-care field. "The TMC Venture Fund is a quintessential example of the Texas Medical Center's ongoing commitment to driving collaboration across our medical city and further establishing Texas as the 'third coast of life sciences' in the United States," said Bill McKeon, TMC president and CEO in a statement Wednesday. (Najarro, 11/8)

Philadelphia Inquirer: Genesis Healthcare Takes $532 Million Write-Down, Warns Of Possible Bankruptcy
Genesis Health Inc., one of the nation’s largest nursing home operators, warned Wednesday that without relief from creditors it may have to file for bankruptcy protection. “As currently structured, it is unlikely that the company will be able to generate sufficient cash flow to cover required financial obligations, including its rent obligations, its debt-service obligations and other obligations due to third parties,” the Kennett Square company said in its quarterly report to the Securities and Exchange Commission. (Brubaker, 11/8)

Kaiser Health News: Breathing Fire: Health Is A Casualty Of Climate-Fueled Blazes
As the deadliest fires in California history swept through leafy neighborhoods here, Kathleen Sarmento fled her home in the dark, drove to an evacuation center and began setting up a medical triage unit. Patients with burns and other severe injuries were dispatched to hospitals. She set about treating many people whose symptoms resulted from exposure to polluted air and heavy smoke. “People were coming in with headaches. I had one. My eyes were burning,” said Sarmento, the director of nursing at Santa Rosa Community Health, which provides health care for those who cannot afford it. But respiratory problems — coughs and shortness of breath — were among the biggest risks. “We made sure everyone had a mask.” (Upton and Feder Ostrov, 11/9)

Cleveland Plain Dealer: Cuyahoga County Churches Mobilize To Reduce Infant Mortality
Ministers in Cleveland and inner-ring suburbs are preaching the gospel about prenatal care and safe sleep in an initiative to reduce infant mortality. ...The city-county collaborative was formed in December 2015 by a coalition of elected officials and health leaders to address the region's abysmal infant mortality rate, which is among the highest in the nation. (Farkas, 11/8)

Cleveland Plain Dealer: Cleveland Clinic, CareSource Sign Long-Term Contract
The Cleveland Clinic and CareSource signed a long-term Medicaid contract, after months of negotiations. ...An estimated 61,000 people with CareSource receive primary care through the Clinic. (Christ, 11/8)

Kaiser Health News: Grass-Roots Network Of Doctors Delivers Supplies To Puerto Rico
After Hurricane Harvey flooded her city of Houston in August, Dr. Jennifer McQuade planned to donate socks to those affected. Instead, surprised by the lack of medical care at a nearby shelter, McQuade, an oncologist, became the unofficial leader of a group of physicians and mothers providing emergency aid at the George R. Brown Convention Center in Houston. She triaged patients, solicited donations and recruited more doctors to join. (Martyn, 11/9)

San Francisco Chronicle: California’s New Birth Certificate Heralds Third-Gender Intersex Rights
The Gender Recognition Act, which Gov. Jerry Brown signed into law on Oct. 15, puts California in the lead nationally in legal recognition for nonbinary genders. ...The new law allows the designation of a third gender on birth certificates. (Knight and Tamar-Harris, 11/8)

The Washington Post: Chuck Norris Claims His Wife Was Poisoned During MRI Scans, Sues For $10 Million
Actor and martial artist Chuck Norris is suing several health-care companies, claiming his wife was poisoned by a chemical used during magnetic resonance imaging scans. In a lawsuit filed last week in San Francisco Superior Court, Chuck and Gena Norris argued that gadolinium, a metal used as a contrast agent in MRI scans, caused Gena to sustain gadolinium deposition disease, experiencing “multiple, debilitating bouts of pain and burning throughout her body” and suffering long-term damage. (Bever, 11/8)

The Washington Post: Voters Just Sent A Message: Republicans Are Way Out Of Step On Health Care
There's a long list of issues on which the Trump administration, and Republicans generally, are out of step with most Americans, yet on few of them is the chasm so broad or so deep as on health care. On Tuesday, voters made that clear in a pair of purple states, Virginia and Maine, while for the past week Americans across the country have been surging to sign up for health-care coverage under the Affordable Care Act, which the White House and congressional Republicans have tried to repeal and, failing that, sabotage. (11/8)

The Washington Post: Maine’s Governor Wants To Ignore The Will Of Voters. He’s Not Alone.
Less than a day after voters in Maine voted to expand Medicaid in their state, Gov. Paul LePage (R) moved quickly to subvert their democratic will, announcing Wednesday that he will not implement the expansion until it is “fully funded by the Legislature.” (Josh Silver, 11/8)

The Washington Post: Americans Love Medicaid. Republicans Hate It. Here’s Where The Fight Is Going Next.
Democrats won pretty much everywhere in Tuesday’s election, but there is a reason beyond the effect President Trump has on their fortunes for Republicans to be unnerved by the results. It has to do with both politics and policy, and it could mean trouble for them in 2018. I’m talking about Medicaid. As you might have seen, voters in Maine approved a ballot initiative Tuesday to accept the Affordable Care Act’s expansion of Medicaid by a margin of 59 percent to 41 percent. The expansion has been resisted by Paul LePage (R), to whom I fondly refer as America’s Worst Governor™. (Paul Waldman, 11/8)

Los Angeles Times: Trump's Medicaid Chief Attacks Her Own Program, On The Very Day It Scored A Huge Win At The Polls
Republicans who think the American public is clamoring to repeal or roll back the Affordable Care Act have another think coming. Voters in Maine overwhelmingly enacted Medicaid expansion for their state Tuesday, overturning a string of five successive vetoes by their right-wing governor, Paul LePage. The vote was roughly 60%-40%. Maine thus becomes the 33rd state (including the District of Columbia) to expand Medicaid under the Affordable Care Act, the first to do so during the Trump administration, and the first to do so by ballot initiative. (Michael Hiltzik, 11/8)

Kansas City Star: Expand Medicaid In Missouri? There’s A Petition For That
On Tuesday, the state’s voters approved Medicaid expansion by an enormous 18-point margin. The proposal was placed before the state’s voters by a petition drive, bypassing recalcitrant GOP legislators and controversial Gov. Paul LePage. Regrettably, Page said Wednesday he would not implement the expansion if it is not funded. (11/8)

JAMA: Factors Associated With Increased US Health Care Spending
In this issue of JAMA, Dieleman and colleagues1 report findings from their study in which they examined trends in US health care spending from 1996 to 2013. The authors evaluated the association between 5 factors—population growth, population aging, disease prevalence or incidence, service utilization, and service price and intensity of services—and health care spending over time and also analyzed trends overall and across major conditions. This report is a significant contribution to the literature because trends in health care spending over time, by major categories of spending, accounting for prevalence of disease, and across conditions have not been previously reported. (Patrick H. Conway, 11/7)

JAMA Forum: Five Ethical Values To Guide Health System Reform
The US health system is so mired in politics, with positions hardened by rigid ideologies, that we can’t even seem to talk with one another civilly about difficult tradeoffs. If the polity could agree on core ethical values to guide discourse, we would make hard health system choices based on which values we prefer and why. Herein, I offer 5 critical values for health system reform—universal access, equitable access, affordable access (cost), quality, and choice—explain the tradeoffs, and provide reasons why certain values should take priority. There will be disagreement across the political spectrum, but alternative visions should be justified by reasoned argument. (Lawrence Gostin, 11/8)

The Wall Street Journal: Koskinen’s Parting Gift From The IRS
IRS Commissioner John Koskinen has made no secret of his contempt for Republicans who tried to hold his agency to account for Tea Party targeting. His payback as he walks out the door is a major hit on employers. The IRS confirmed Tuesday that it is now for the first time beginning to enforce the Obama Care employer mandate, issuing thousands of penalty letters to noncompliant companies. The letters are on the way to firms with more than 50 employees that have failed to provide what ObamaCare defines as qualifying coverage to its workers. The letters reach back to 2015, setting up companies for years of penalties. (11/7)

St. Louis Post-Dispatch: If Gov. Greitens Is So Committed To Fighting Opioid Abuse, Where's His Program?
Is Missouri operating a new stealth prescription drug monitoring program, or has Gov. Eric Greitens simply failed to get his promised program up and running? After saying in July that the program could be operational within weeks, the state Department of Health and Senior Services and the state Office of Administration wouldn’t say Tuesday whether it is. (11/8)

JAMA: Opioid Vs Nonopioid Acute Pain Management In The Emergency Department
The United States is experiencing a serious epidemic of opioid-related drug addiction that includes a 200% increase in the number of opioid-related overdose deaths from 2000 to 2014. In 2015, there were 52 404 drug overdose deaths in the United States with 33 091 (63.1%) involving an opioid. An important contributor to this epidemic is semisynthetic prescription opioid pain medications (eg, oxycodone and hydrocodone) that are frequently used for nonmedical purposes and are implicated in many opioid overdose deaths. (Demetrios N. Kyriacou, 11/7)

Los Angeles Times: Notre Dame, Reentering 21st Century, Restores Employees' Access To Birth Control
The University of Notre Dame, in an abrupt reversal, says it will continue to allow its employees access to contraception under their insurance policies. Only a week ago, the university said it would cancel all birth control coverage for students and employees next year. That includes contraception provided to those recipients for free, under government auspices and at government expense. (Michael Hiltzik, 11/8)

The New York Times: The Worrisome Future Of Abortion Rights
Sheriff Joe Arpaio used to require pregnant inmates in the Arizona jails he controlled to get a court order before being allowed out of their cells to obtain a desired abortion. Needless to say, he was sued, and needless to say, he lost. (The sheriff appealed to the Supreme Court, which refused to hear the case.) So he switched tactics to require any inmate who wanted an abortion to prepay the transportation and security costs, something not required for any other off-site medical procedure. The American Civil Liberties Union took the sheriff back to court and won again. (Linda Greenhouse, 11/9)

USA Today: To Be Really Pro-Choice, You Must Protect Each Doctor's Choice To Not Perform Abortions
In a society where many issues divide Americans from each other, abortion is often called one of the most divisive and intractable. For many years, about half of Americans who hold a definite view have identified themselves as “pro-life” and half as “pro-choice.” While there are variations by age, race and so on, the most important factor influencing Americans’ views on abortion is religion — not denomination, but religious commitment. (Timothy Dolan and Russell Moore, 11/8)

Los Angeles Times: Anti-Vaxxers Have Found A Way Around California's Strict New Immunization Law. They Need To Be Stopped
Two years ago the state Legislature passed a law banning so-called personal belief exemptions that many parents were using to keep their children from being vaccinated because they believed — wrongly — that vaccines were linked to autism and other serious health problems. But even as the number of personal belief exemptions fell to zero, the number of medical exemptions has skyrocketed. That's fishy. (11/8)

The Washington Post: Rural America’s Disappearing Maternity Care
Life in rural America can be tough, with challenges starting right from birth. Increasingly, rural women lack access to maternity services, jeopardizing their health and that of their newborns at a time when U.S. maternal mortality is rising. Giving birth is hard enough, but racing 100 miles to the nearest hospital down winding country roads is a particularly harrowing way to experience labor. Evidence confirms what common sense suggests: Drive time affects outcomes. A Canadian study shows that the babies of mothers who travel more than an hour to give birth are more likely to require intensive care or to die within their first year of life. (Katy B. Kozhimannil and Austin Frakt, 11/8)

Miami Herald/Florida Times-Union: Make Plan For Florida Nursing Homes Realistic
Florida Gov. Rick Scott acted decisively with his administration’s rules to protect nursing home residents from power outages. The tragic deaths of 14 residents at the Rehabilitation Center at Hollywood Hills nursing home in during Hurricane Irma shocked the nation — and rightfully so. ... Scott was right to make sure that nursing homes have enough backup power in hurricanes. But his rules were unrealistic, according to a Florida court. ... Moving away from the initial, but understandable, knee jerk reaction, the nursing home industry ought to be consulted in order to come up with a workable solution. Cost is a factor, as well. Many nursing homes operate on a slim profit margin. (11/9)

JAMA: Evidence Supports Action To Prevent Injurious Falls In Older Adults
With the aging of the population, the occurrence of falls among older adults is increasing in the United States and worldwide. In 2014, the incidence of falls among people older than 65 years was 672 per 1000 population in the United States, and the incidence increases with age. Among people older than 85 years, the fastest growing segment of the US population, fall incidence was 820 per 1000 population in 2014. In addition, the risk of falls increases substantially among individuals as they develop dementia. (Eric B. Larson, 11/7)

San Francisco Chronicle: Battle Over Veterans’ Health Care Comes Down To VA Choice
To address problems of long wait times at Veterans Health Administration hospitals, in 2014 Congress established the Veterans Choice Program, which provides private health care options for eligible veterans at government expense. ... Advocates, however, had long warned that private-sector options increase the cost of veterans’ health care. Now this has proven true. (Michael Blecker, 11/8)

Arizona Republic: House Passed 24 VA Reform Bills, But There's More Work To Do
We promise our veterans health care and additional services through the Veterans Administration. Many who work at the VA do an excellent job and are committed to providing quality care. Unfortunately, a lack of accountability and oversight has led to a plague of poor care for our veterans. (Rep. Andy Biggs, 11/8)