The New York Times: Workers Pay More For Health Care As Companies Shift Burden, Survey Finds
State health insurance exchanges created under the new health care law are in turmoil. By contrast, the employer market — where the majority of Americans still get their coverage — seems like a bastion of stability. An analysis by the Kaiser Family Foundation released on Wednesday shows that the share of employers offering coverage remained steady this year, and that the cost of premiums for health plans remained largely unchanged. (Abelson, 9/14)

The Washington Post: How Companies Are Quietly Changing Your Health Plan To Make You Pay More
While politicians have been embroiled in a fiery debate over President Obama's signature health-care law, a quiet but profound shift is fundamentally reshaping how health insurance works for the roughly 155 million Americans who receive coverage through their employers. A national survey of employer health benefits released Wednesday shows how much deductibles — the health-care costs that people must pay out of their own pockets before insurance kicks in — have shot up. In 2016, 4 in 5 workers had a deductible as part of their individual coverage, averaging $1,478. During the past five years, deductibles have grown 10 times as fast as inflation and nearly six times as fast as wages, according to the new report. (Johnson, 9/14)

The Wall Street Journal: Average Cost Of Employer Health Coverage Tops $18,000 For Family In 2016
The average cost of health coverage offered by employers pushed above $18,000 for a family plan this year, though the growth was slowed by the accelerating shift into high-deductible plans, according to a major survey. Annual premium cost rose 3% to $18,142 for an employer family plan in 2016, from $17,545 last year, according to the annual poll of employers performed by the nonprofit Kaiser Family Foundation along with the Health Research & Educational Trust, a nonprofit affiliated with the American Hospital Association. (Wilde Mathews, 9/14)

Bloomberg: Workers’ Up-Front Health Costs Keep Rising, Study Says
Rising deductibles have entered the spotlight recently because they push more of the costs and responsibilities of getting treatment onto consumers. Mylan NV’s prices for EpiPen allergy shots gained public attention as mounting deductibles forced increasing numbers of patients to pay the device’s full cost, more than $600 for a pair. (Tracer, 9/14)

The Philadelphia Inquirer: Employers Continue Health Cost Shift To Workers
The relatively modest increase in employer-sponsored insurance, which covers 150 million people nationwide, stands in sharp contrast to the volatility in premiums for plans being offered for next year on Affordable Care Act exchanges. The key difference is that premiums for employee-sponsored insurance are for a stable market, said Gary Claxton, a Kaiser vice president and director of the Health Care Marketplace Project. (Brubaker, 9/14)

Kaiser Health News: Studies: Employer Costs Slow As Consumers Use Less Care, Deductibles Soar
The study of more than 1,900 small and large companies showed little evidence that high costs are prompting employers to dump health coverage or cut workers’ hours to make them ineligible for insurance. The Affordable Care Act requires companies with at least 50 employees to offer coverage to most full-time workers but not part-timers. Seven percent of companies falling under the requirement reported they were shifting employees from part time to full time to make them eligible for health insurance. Only 2 percent said they were switching full-timers to part time to make them ineligible. (Hancock and Luthra, 9/14)

NPR: Workers' Health-Care Deductibles Are Going Up Again
High deductible health plans are the new normal. Just over half of employees this year have a health insurance policy with a deductible of at least $1,000, according to a survey of employers from the Kaiser Family Foundation. It's the continuation of a multiyear trend of companies passing more of the costs of employee health care back onto workers. (Kodjak, 9/14)

Modern Healthcare: The Ongoing Cost Shift In Employer Health Benefits 
More than 150 million Americans get their health coverage through their employer, compared to the roughly 20 million people who buy their coverage on and off the Affordable Care Act's troubled insurance exchanges. ... Employers and some analysts argue that high deductibles, copays and coinsurance rates—all cost-sharing mechanisms that give consumers more “skin in the game”—spur people to think more about costs and reduce unnecessary healthcare services. But many people feel their employer-sponsored coverage has become less of a benefit and more like a way to shift out-of-pocket costs onto the backs of workers. (Herman, 9/14)

The Star Tribune: Kaiser Survey Finds 'Modest' Increase In Worker Health Insurance Premiums 
“What we’re really seeing this year, but we’ve seen it develop gradually, is a shift in what insurance is for most Americans — from more comprehensive to skimpier coverage,” said Drew Altman, president of the California-based Kaiser Family Foundation. “I think it’s the biggest change in health care in America that we are not really debating.” There’s been much more political focus, Altman noted, on the federal Affordable Care Act, which continues to transform the market where individuals purchase coverage outside of employer groups. (Snowbeck, 9/14)

Houston Chronicle: Insurance Premiums Stable, But Out-Of-Pocket Health Costs Rising
This year, 83 percent of workers have some kind of deductible as part of their employer-sponsored health plan. Over the past five years the average amount of a single deductible rose to $1,478, up from $991 in 2011, the Kaiser study showed. (Deam, 9/14)

Richmond Times Dispatch: Studies Find Greater Health Care Access In Va. 
Two new sets of data released this week by the U.S. Department of Health and Human Services, the Kaiser Family Foundation and the Health Research and Education Trust illustrate a promising trend in health care costs and outcomes in Virginia. (Demeria, 9/14)

Morning Consult: Employer Health Deductibles Have Grown, Study Finds
Premium growth in the employer market is far lower than the growth in the individual market. Insurers on the ACA exchanges have requested double-digit rate increases for 2017 across the country. Insurers say this is a result of sicker than expected enrollees, the abuse of special enrollment periods, and the end of two Obamacare programs designed to reduce risk. (Owens, 9/14)

The Baltimore Sun: Insurance More Affordable, Accessible Under Affordable Care Act, Federal Health Officials Say
Several new reports prove that the Affordable Care Act has made health insurance more affordable and accessible to Marylanders, federal health officials said Wednesday. The Department of Health and Human Services touted the achievements of the federal health care law saying that premiums are growing slower than before it went into affect and that more people than ever now have insurance. (McDaniels, 9/14)

Morning Consult: House Republicans Pounce On Rising Premiums, Closing Co-Ops
House Republicans on Wednesday jumped on rising premium rates and co-op closures to slam the Affordable Care Act, while Democrats lamented another hearing not focused on fixes to the Affordable Care Act. At a joint Energy and Commerce subcommittee hearing, Republicans raised concerns about how rising premiums have affected their constituents, as well as the potential for fraud under the Obamacare exchanges. The subcommittee released a slate of reports earlier this week that slammed the future sustainability of the federal and state-based exchanges. (McIntire, 9/14)

Modern Healthcare: Slavitt Says High Premium Increases Are Result Of One-Time Effects 
Lawmakers cited contrasting headlines to assess the performance of the Affordable Care Act during a hearing Wednesday where acting CMS Administrator Andy Slavitt once again defended the law under harsh questioning. Republicans on the two House Energy and Commerce subcommittees hosting the hearing brought up recent news of major insurers dropping out of the ACA exchanges, several reports of large premium increases and more co-ops failing. (Muchmore, 9/14)

St. Louis Post Dispatch: Centene Seeks To Sell 2017 Marketplace Plans In Arizona 
Centene Corp. said Wednesday that it's seeking regulatory approval to sell individual health insurance plans for 2017 on the exchange in two Arizona counties. Centene said it has filed applications with both the Arizona Department of Insurance and the Centers for Medicare and Medicaid Services (CMS) to sell plans in Pima and Maricopa counties for coverage beginning Jan. 1, 2017. Some major health insurance carriers have decided to stop selling plans on the health insurance marketplaces, also known as the exchanges, a key part of President Barack Obama's landmark health reform bill. Many issuers said they were losing too much money on the exchange business that attracted an older and sicker population. (Liss, 9/15)

Morning Consult: Alexander Bill Would Extend Subsidies To Off-Exchange Plans
Sen. Lamar Alexander is introducing a bill Wednesday that would extend Affordable Care Act subsidies to plans off of the exchanges for some eligible consumers. The Tennessee Republican is proposing that states could opt to expand the Obamacare subsidies to plans sold off of the exchanges. For states without enough competition on the exchanges, governors could choose to have the subsidies to plans offered off the exchanges so consumers have more choice, he said. (McIntire, 9/14)

The Hill: Official Hints At Settlement Talks With ObamaCare Insurers 
A top Obama administration health official indicated Wednesday that there are discussions underway about a possible settlement with insurance companies over ObamaCare payments. The possibility of settlements has drawn alarm from Republican lawmakers, who warn that the administration is seeking to get around limitations set by Congress. (Sullivan, 9/14)

Lexingon (Ky.) Herald-Leader: Ky. Shouldn’t Go ‘Backward’ On Medicaid Expansion, Federal Official Says
The U.S. Department of Health and Human Services is unlikely to approve changes to Kentucky’s Medicaid program that would interfere with its “extremely successful” progress at helping more people get health insurance, a top official said Wednesday. HHS is currently considering a Medicaid waiver proposal, submitted last month by Gov. Matt Bevin, that would reshape the program that provides health insurance for 1.32 million Kentuckians. ... However, as it weighs Bevin’s proposal, HHS will keep its eyes on the sharp drop in the size of Kentucky’s uninsured population since former Gov. Steve Beshear expanded Medicaid coverage to working-poor adults in 2013, Aviva Aron-Dine, senior counselor to HHS Secretary Sylvia Mathews Burwell, told the Herald-Leader. (Cheves, 9/14)

Sioux Falls (S.D.) Argus Leader: Feds Fault State For Medicaid Fraud Efforts
A federal report on Wednesday criticized South Dakota’s commitment to fighting Medicaid fraud, finding the state is understaffed in a key area for rooting out fraud and abuse. The report from the United States Health and Human Service’s Office of Inspector General was ostensibly a review of the state’s Medicaid Fraud Control Unit, or MFCU, within the attorney general’s office. Nationally, MFCUs are responsible for prosecuting Medicaid fraud cases, levying civil fines or prosecuting abuse and neglect cases. (Ellis, 9/14)

Cronkite News/Arizona PBS: Court: Medicaid Patients Who Sued Over State Plan Can Get Lawyers’ Fees
A federal appeals court ruled Wednesday that a group of Arizona Medicaid recipients who sued the government after it approved higher copayments for their care should still be able to recover attorneys’ fees in the case. The ruling by a three-judge panel of the 9th U.S. Circuit Court of Appeals overturned a lower court that said the patients could not collect because they did not ultimately win their case – even though the lower court judge agreed that the higher fees had been improperly approved. (Chavez, 9/14)

The Wall Street Journal: EpiPen Maker Executive To Testify At House Hearing
Lawmakers have summoned the top executive from EpiPen maker Mylan NV to Washington for a hearing next week to explain substantial price increases for the emergency allergy treatment that have generated widespread consumer outrage. The company confirmed Wednesday that Chief Executive Heather Bresch will come to Capitol Hill Sept. 21 to testify before the House Oversight and Government Reform Committee in a hearing likely to feature intense questioning about Mylan’s pricing strategy. (Radnofsky, 9/14)

The Hill: House Oversight Panel To Grill EpiPen CEO Next Week 
The House Oversight will hold a hearing next Wednesday to grill the CEO of Mylan, the maker of EpiPens. The more-than-400 percent increase in the price of EpiPens in recent years has drawn outrage from both sides of the aisle. Mylan CEO Heather Bresch, who is also the daughter of Sen. Joe Manchin (D-W.Va.), will now face questions from lawmakers next week. (Sullivan, 9/14)

USA Today: Senators Move To Force Drug Makers To Justify Big Price Hikes
A bipartisan group of Senate and House members plan to introduce a bill Thursday that would force drugmakers to tell the Department of Health and Human Services why any price hike of more than 10% is justified at least a month before the increase. Companies would have to disclose spending on research and development, manufacturing, marketing and advertising spending on the drug, as well as profit information. (O'Donnell, 9/14)

USA Today: Progressives Push For 'Public Option' Health Plan
Progressive senators and activists will launch a campaign Thursday calling for every American to have the choice of a public health insurance option. They aim to build on Democratic presidential candidate Hillary Clinton’s support for a public option with what they hope will be the biggest health care push by Democrats since the passage of the Affordable Care Act in 2010. (Gaudiano, 9/15)

Related KHN coverage: Obama Renews Call For A Public Option In Health Law (Rovner, 7/11)

Meanwhile, Clinton moves to cut dies with the Clinton Health Access Initiative, and Republicans aren't rushing to support Donald Trump's maternity-leave plan —

The Wall Street Journal: Clinton Health Access Initiative Sets Plan To Sever Ties To Family
The Clinton Health Access Initiative, the largest project of the Clinton Foundation, announced Wednesday the steps it would take to sever ties to Democratic nominee Hillary Clinton and her family if she is elected president. Among CHAI’s proposed changes, according to a spokeswoman: The five board members appointed by the Clinton Foundation would step down, including former president Bill Clinton, daughter Chelsea Clinton and Clinton Foundation board chairman Bruce Lindsey. The Clinton Foundation would lose its power to appoint members of the board, and CHAI would no longer include “Clinton” in its name, though it would continue to go by the same acronym. (Ballhaus, 9/14)

Politico: Clintons' Health Initiative Pledges Changes If Hillary Wins
Both former President Bill Clinton and his daughter Chelsea Clinton will step down from the board of the Clinton Health Access Initiative if Hillary Clinton is elected president in November, the initiative announced in a statement Wednesday. (Nelson, 9/14)

The Wall Street Journal: Republicans Are Slow To Back Donald Trump’s Paid Maternity-Leave Plan
Donald Trump’s proposal to create a new federal program offering six weeks of partially paid maternity leave is winning few Republican supporters in Congress. The mixed reaction to Mr. Trump’s proposal, put forward in a speech Tuesday night, leaves him squeezed between Democrats who dismiss it as insufficient and Republicans reluctant to embrace ideas they have spent years criticizing. (Rubin, 9/14)

The New York Times: Hillary Clinton And Donald Trump Give More Details On Their Health
With less than eight weeks until Election Day and pressure mounting for the candidates to give details about their health and medical histories, Donald J. Trump acknowledged on Wednesday that he was overweight and taking a cholesterol-fighting drug, and Hillary Clinton elaborated on the circumstances that led to her contracting pneumonia and the medicine she was taking to recover. (Chozick and Haberman, 9/14)

Politico: Trump And Clinton Offer Peek Into Medical Files
While the Republican filmed an appearance on the Dr. Oz show — a safe environment — to discuss select details of his health, his opponent's campaign released updated letters from both Clinton's and running mate Tim Kaine's physicians depicting a relatively healthy pair. Not to be outdone, it took less than an hour before Trump's campaign said his running mate Mike Pence would soon release health information of his own. (Debenedetti, 9/14)

The New York Times: Donald Trump Reveals Checkup Has Him Weighing 267 Pounds
After a whiplash-inducing morning of mixed messages, Donald J. Trump on Wednesday gave a small window into some of the results from his most recent physical examination, revealing his weight to be 267 pounds and that he takes a statin. Mr. Trump gave the quick synopsis on Dr. Mehmet Oz’s television show after the Republican presidential nominee’s aides had said that he would, then that he would not, broach the topic with the doctor on the show. (Haberman, 9/14)

POLITICO Pro: Trump's Favorite TV Doctor Has A Basketful Of Critics
"The Dr. Oz Show" said, in a press release, that Oz took Trump through a "full review of [his] systems" including his cardiovascular and respiratory health. And, according to a preview clip released by the show, the only "medical records" that Trump released on-air were two one-page letters from his a New York City hospital and his doctor, the colorful gastroenterologist Harold Bornstein. [Bornstein's] earlier missive on Trump was widely ridiculed for its hyperbolic prediction that Trump would be “the healthiest individual ever elected to the presidency. (Cook, 9/14)

USA Today: Clinton Campaign Releases Additional Medical Info
Hillary Clinton released more detailed medical information Wednesday that describes the form of pneumonia she's been diagnosed with as a mild, non-contagious bacterial infection. The campaign also released more details about the results of routine lab tests given to the Democratic presidential nominee, such as blood cholesterol levels and her annual mammogram. (Przybyla, 9/14)

The Washington Post: Clinton Campaign Releases Doctor’s Letter Describing ‘Mild’ Pneumonia
Hillary Clinton’s campaign released a letter from her doctor Wednesday describing her treatment for “mild” bacterial pneumonia and painting an overall picture of good health in an attempt to put to rest concerns about her medical condition following her illness over the weekend. The letter, from Clinton’s doctor, Lisa Bardack, noted that she received a CT scan confirming the pneumonia diagnosis and is now about halfway through a regimen on the antibiotic Levaquin. (Phillip and Gearan, 9/14)

Politico: Clinton's Doctor Declares Her 'Fit To Serve' As President
Hillary Clinton’s campaign on Wednesday released more information about her health that depicted her as a healthy 68-year-old woman with low cholesterol (without taking a statin) and seasonal allergies. She also takes a thyroid medication, and as the campaign has previously disclosed, she takes a blood thinner, Coumadin. (Debenedetti, 9/14)

Stat: Hillary Clinton Remains 'Healthy And Fit To Serve,' Her Doctor Says
Aside from an ongoing bout of pneumonia, Hillary Clinton is in good physical and mental condition, her doctor said in a new letter released Wednesday. Clinton has a mild case of non-contagious bacterial pneumonia, Dr. Lisa Bardack said, and she is taking a 10-day regimen of Levaquin to address it. (Scott, 9/14)

Politico: Kaine Releases Health Records
Democratic vice presidential candidate Tim Kaine is in "excellent health," according to his physician, a disclosure that comes as the medical history of Hillary Clinton and Donald Trump take center stage in the presidential campaign. (Everett, 9/14)

Bloomberg: America Tries To Fight Zika With Next To No Money 
While there are many paths to conquering the growing threat, one thing experts agree on is a need for more public education on how to avoid infection. What people will learn is that the seemingly mundane task of making sure your backyard doesn’t have standing water is the most critical component of this strategy. (Shanker, 9/15)

POLITICO Pro: Debate Over Planned Parenthood Could Derail Zika Funding — And More
Although the issue of Planned Parenthood funding simmered in the background among conservative Republicans for years, it was really sparked by the release last year of sting videos accusing the group of trafficking body parts — allegations that the organization vehemently denied and which have not led to criminal charges against it. Last year, Republicans flirted with a government shutdown over defunding Planned Parenthood. Now, the fight is threatening to stall approval of funding to combat the Zika virus. The GOP doesn’t want anything to do with giving the group government funding. (Haberkorn, 9/14)

The Hill: Poll: Swing-State Voters Support Abortion Access For Zika-Infected Women
The risks of the Zika virus to pregnant women are softening some Americans’ opposition to late-term abortion, potentially sending a ripple effect into crucial state races this year, according to a new poll. A total of 62 percent of voters living in 10 battleground states say they support abortions after 24 weeks if a doctor believes there is a “serious possibility” that a woman’s fetus could have severe birth defects from the Zika virus, according to polling by NARAL Pro-Choice America. (Ferris, 9/14)

In other news on Zika —

The New York Times: Florida Gets Help To Deal With Backlog Of Zika Tests
Gov. Rick Scott of Florida announced on Wednesday that the state was getting help to speed up the results of Zika tests, a move that should reduce the inordinately long waits — sometimes up to five weeks — experienced by hundreds of pregnant women who took the state-offered tests at no cost. In a statement, Mr. Scott said the Centers for Disease Control and Prevention was sending seven laboratory technicians to help process Zika tests — noting that he had made this request in August. The governor added, however, that in light of the long waits, the seven technicians are not enough and he has requested additional help. (Alvarez, 9/14)

USA Today/Naples News: No Spraying For Zika Planned In Everglades
Although hordes of mosquitoes populate swampy Everglades National Park, no spraying against the dreaded Zika virus is being done there, the park’s supervisor said Wednesday. (Fletcher, 9/14)

NPR: Doctors Studied 42 Infants In Brazil With Microcephaly And The News Isn't Good
"These babies do not catch up as they grow," says Dr. Antonia Augusto Moura da Silva of the Federal University of Maranhao, Sao Luis, Brazil. He's describing the findings from a study of 48 babies whose mothers were believed to have been infected with the Zika virus. Forty-two of the children were diagnosed with microcephaly. The study, on the early neurological growth pattern of the infants, will be published in the journal Emerging Infectious Diseases in November but was released early online. (Brink, 9/14)

The New York Times: Prostate Cancer Study Details Value Of Treatments
A new study offers important information to men who are facing difficult decisions about how to treat prostate cancer in its early stages, or whether to treat it at all. Researchers followed patients for 10 years and found no difference in death rates between men who were picked at random to have surgery or radiation, or to rely on “active monitoring” of the cancer, with treatment only if it progressed. (Grady, 9/14)

The Washington Post: Almost All Men With Early Prostate Cancer Survive 10 Years, Regardless Of Treatment
The survival rate for early-stage prostate cancer is 99 percent after 10 years, regardless of whether men undergo surgery, radiation or are "actively monitored," according to studies published Wednesday. Researchers hailed the results as good news, saying they had been expecting a survival rate of 90 percent. The two new studies, published in the New England Journal of Medicine, also illustrated the complicated treatment equations facing men with early-stage prostate cancer, and they immediately set off a debate among physicians about how to interpret the results. (McGinley, 9/14)

Stat: Men With Early Prostate Cancer Can Safely Opt Out Of Treatment
Men diagnosed with early prostate cancer can safely choose active monitoring rather than surgery or radiation without cutting their lives short, according to an eagerly awaited landmark study published on Wednesday. Although research dating back to the 1970s has hinted that many prostate cancers are too slow-growing to threaten a man’s life, the new study is the most definitive ever to test that premise. (Begley, 9/14)

And a separate study reports on disparities in stroke treatment -

Los Angeles Times: Women And Minorities Are Less Likely To Get Key Stroke Treatment, Even When They're Eligible, Study Says
If you’re having an ischemic stroke, it’s crucial that you get to a hospital fast so you can be treated with a clot-busting medicine. And to improve your odds of getting that medicine, it helps to be a white man. A new analysis of more than 60,000 stroke patients from around the country found that women were less likely than men to receive an infusion of tissue plasminogen activator, the drug that’s considered the gold standard in stroke treatment. The analysis also showed that racial minorities were less likely to get the drug than whites. (Kaplan, 9/14)

Kaiser Health News: Geographic, Racial Disparities In Stroke Treatment Tracked In New Study
In the United States, one out of every 20 deaths is caused by stroke. And yet, based on new research, race and geography prevent some of the most vulnerable from obtaining effective treatments.The findings come from a report published Wednesday in the journal Neurology. Researchers found stroke patients living in the Northeast states had more than twice the odds of receiving tPA — a powerful anti-coagulant that can break up the clot causing the stroke — than those living in the Midwest and the South. (Heredia Rodriguez, 9/14)

The Wall Street Journal: Greater Share Of U.S. Workers Testing Positive For Illicit Drugs
The share of U.S. workers testing positive for illicit drug use reached its highest level in a decade, according to data from millions of workplace drug tests administered by Quest Diagnostics Inc., one of the nation’s largest medical-screening laboratories. Detection of illicit drugs—from marijuana to heroin to methamphetamine—increased slightly both for the general workforce and the “safety-sensitive” workforce, which includes millions of truck drivers, pilots, ship captains, subway engineers, and other transportation workers. (Weber, 9/14)

The Washington Post: Opioid Epidemic’s Hidden Hazard: SWAT Officers Treated For Fentanyl Exposure During Drug Raid
Amid the nation’s deadly and unrelenting opioid epidemic, U.S. law enforcement officers are shouldering an increasingly heavy burden — battling a booming drug market and responding to an endless string of narcotics-related calls while attempting to protect themselves from exposure to the lethal substances. Of particular concern is the potent synthetic opioid fentanyl, the subject of numerous alerts and advisories from the Drug Enforcement Administration, which has warned the nation’s policing community “to exercise extreme caution.” (Bever and du Lac, 9/14)

Los Angeles Times: California Democrats Urge President Obama To OK Expanding Covered California To People In Country Illegally
California will soon be the first state in the nation to ask the federal government to allow immigrants in the country illegally to purchase health insurance through a state exchange. Democrats from the Golden State gathered outside the U.S. Capitol on Wednesday to urge President Obama to approve the request quickly. (Wire, 9/14)

The New York Times: California Moves To Allow Undocumented Immigrants To Buy Insurance
In a move that is sure to draw the ire of Republicans, California officials are asking the Obama administration this week to approve a plan that would allow undocumented immigrants to buy health insurance on the state’s public exchange. Officials say that up to 30 percent of the state’s two million undocumented adults could be eligible for the program, and that roughly 17,000 people are expected to participate in the first year, if the plan is approved. But the proposal faces serious hurdles in Washington, where it must be approved by both the Treasury and the Health and Human Services Departments. (Medina, 9/14)

Morning Consult: California Democrats Urge Administration To Grant Coverage To Undocumented Immigrants
California Democrats on Wednesday urged the Obama administration to approve a waiver that would allow undocumented immigrants to access unsubsidized health care under the state’s insurance marketplace. California Gov. Jerry Brown, a Democrat, signed a bill in June that obligated the state to ask the federal government to allow undocumented immigrants to purchase insurance on the state’s marketplace set up under the Affordable Care Act. Under the health care law, undocumented immigrants are not eligible to purchase insurance on the exchanges. (McIntire, 9/14)

Pioneer Press: 1,500 RNs Fill In During Allina Hospitals Nurses Strike
As thousands of Twin Cities hospital nurses represented by the Minnesota Nurses Association went on an open-ended strike last week, their employer, Allina Health, brought in 1,500 traveling nurses — recruited and paid through staffing agencies — to operate its four metro-area hospitals and a clinic. The replacement nurses traveled from across the country to fill in at United Hospital in St. Paul, Abbott Northwestern in Minneapolis, Unity in Fridley and Mercy in Coon Rapids, plus the Phillips Eye Institute in Minneapolis. (Cooney, 9/14)

The Star Tribune: Nurses Fault Allina On Borrowing Strategy That Has Lost Millions
In a new tactic to pressure Allina Health, striking nurses are seizing on an advocacy group’s report that says the hospital system lost millions of dollars borrowing in capital markets — wasting money that otherwise could improve pay, benefits and patient care. At a news conference Wednesday, the Minnesota Nurses Association (MNA) highlighted the report, “Time to Pay the Piper,” produced by the Chicago-based ReFund America Project. (Olson, 9/14)

Houston Chronicle: Hospital Readmissions In Texas Are Going Down 
The revolving door of avoidable hospital re-admissions is slowing across the nation, including in Texas. The state posted a 5.8 percent decline in recent years, the federal Centers for Medicare and Medicaid Services reports. Nationally, the average decline was 8 percent between 2010 and 2015, with every state except Vermont reporting reductions, a CMS blog post said. In Vermont the increase was statistically negligible. (Deam, 9/14)

KQED State of Health: California Hospital Considers Allowing Patients To Use Medical Marijuana
On Tuesday evening, the Marin Healthcare District Board took a step in that direction by voting to ask its staff to investigate clinical and legal issues related to patient use of the drug on-site. Medical marijuana is legal in the state, but hospitals haven’t yet allowed patients to use it. (Fine, 9/14)

Chicago Tribune: University Of Chicago Medicine To Break Ground On New Emergency Department 
A ceremonial groundbreaking Thursday will mark the start of a $43 million project to convert part of a parking garage into a new emergency department at University of Chicago Medicine, bringing back trauma services to the South Side after a 25-year absence. The new emergency department is expected to open in January 2018, and trauma services will likely be offered in early spring 2018. (Schencker, 9/15)

Seattle Times: Ice Machine, Sinks Linked To Legionnaires’ Cases At UW Medical Center 
The bacteria that cause Legionnaires’ disease have been detected in part of the water supply at the University of Washington Medical Center, where officials said a second person linked to an outbreak has died. An ice machine and two sinks in cardiac units of the hospital’s Cascade Tower were found to be contaminated with the germs that can cause the potentially deadly form of pneumonia, officials said Wednesday. (Aleccia, 9/14)

The Washington Post: How Tens Of Thousands Of Patients Who Weren’t Actually Dying Wound Up On Hospice Care
Hospice patients are expected to die. The service, after all, is intended for the terminally ill. But over the past decade, as a 2014 Washington Post investigation found, the number of patients who outlived hospice care in the United States has risen dramatically, in part because hospice companies earn more by recruiting patients who aren’t actually dying. Now government inspectors have turned up information about how that happens. (Whoriskey, 9/14)

Kaiser Health News: Key Steps Can Help Patients Recover From A Stay In The ICU
As many as 1.4 million seniors survive a stay in the ICU every year. And most go home, with varying degrees of disability. ICUs are responding to older patients’ needs by helping them try to regain functioning — something that families need to pay attention to as well. “There’s a growing recognition that preparing patients and families for recovery needs to start in the ICU,” said Dr. Meghan Brooks Lane-Fall, assistant professor of critical care at the Hospital of the University of Pennsylvania. (Graham, 9/15)

Pioneer Press: Public Board That Owns Unity Hospital Votes To Disband
The North Suburban Hospital District Board, which owns the Allina-run Unity Hospital in Fridley, (Minn.), voted Wednesday night to begin the process of dissolution. The unanimous vote was the result of months of discussion, beginning formally in the spring, when Allina announced its plan to turn Unity and its Coon Rapids-based Mercy Hospital into a single hospital with two campuses, according to the board’s attorney, Scott Lepak. (Cooney, 9/14)

Des Moines Register: High Court Asked To Overturn Branstad's Closures Of Mental Health Institutes
The Iowa Supreme Court was asked Wednesday to decide if Gov. Terry Branstad violated state law last year by using his line-item veto authority to close two state mental health institutes. "We feel the governor did not exercise his veto correctly," plaintiffs' attorney Mark Hedberg told the justices. He noted that existing Iowa law requires the operation of mental health facilities in Mount Pleasant and Clarinda, and argued Branstad should have asked the Iowa Legislature to modify the statute. (Petroski, 9/14)

Boston Globe: $10M Initiative To Bolster Child Mental Health Services At BMC, 3 Community Health Centers
A new initiative will provide $10 million to three community health centers and Boston Medical Center to give children in the region better access to mental health services. Organizers said the funding, provided by the Richard and Susan Smith Family Foundation, will allow the Dimock Center in Roxbury, the Codman Square Health Center in Dorchester, and the Lowell Community Health Center to create a model that combines mental health care with primary care for children. (Quintana, 9/14)

Cincinnati Enquirer: West Chester Wrestles With Drug Treatment Rules
Should a mental health and drug addiction facility be a permitted or conditional use in West Chester Township? That’s one of several questions that will be addressed over the next several weeks as township officials wrestle with proposed changes in the township's zoning law. A moratorium on issuing permits for such facilities was initiated last April, much to the chagrin of Dr. Mohamed Aziz, who wants to open a mental health and addiction treatment center along U.S. 42 in the former West Chester Nursing and Rehabilitation Center. (Kiesewetter, 9/14)

The Associated Press: Report Cites Lax Security At Mental Hospital
Corrections officials who investigated the April escape of two violent patients from Washington state's largest psychiatric hospital say they discovered a list of mistakes, blunders and deceptions at what should be a secure facility. Investigators tasked with assessing security at Western State Hospital determined there were no routine inspections; 25,000 master keys were missing; thousands of tools used to open patient windows had been misplaced; and management was unwilling to recognize that failing to focus on security puts patients and the public at risk, according to a report obtained by The Associated Press in response to a public records request. (Bellisle, 9/14)

Stateline: Why States Are Taking A Fresh Look At Drug-Free Zones
The idea behind the “drug-free school zones” was to deter dealers at the height of a national crack cocaine epidemic from peddling drugs to children where they could be found most days. Now those laws are undergoing new scrutiny, as states revisit long sentences for drug crimes that have led to mass incarceration and as they face a new drug epidemic, this time opioid addiction. (Wiltz, 9/15)

Nashville Tennessean: 'Turf War' Pits Tennessee Doctors Against Nurse Practitioners
The dispute centers on exactly what types of treatment can be provided by advanced practice registered nurses (APRN), and under what level of oversight. Tennessee is among the dozen states with the most restrictive scope of practice laws — and the reform debate is a recurring flashpoint in legislative sessions. The nurses contend they are equipped to administer many of the same primary care and preventative treatments as doctors. Further, they point to a growing primary care physician shortage across the region. (Fletcher, 9/14)

The Baltimore Sun: Students In Baltimore Region Without Required Immunizations Will Be Barred From Schools
Baltimore school officials are warning parents that their children will be prohibited from attending school starting next week if they have not received immunizations for certain diseases. The policy could mean that thousands of students will be barred from classes. Neighboring Baltimore County barred hundreds of children from school this week after failing to meet a Tuesday deadline for required vaccinations. (Green, 9/14)

Boston Globe: State Moves To Make It Easier For Patients To Get Medical Marijuana
State regulators moved Wednesday toward making it significantly easier for patients to gain access to medical marijuana, proposing an overhaul of a program hobbled by missteps when it dawned three years ago. The rules would allow nurse practitioners to certify patients for marijuana use, similar to the way such nurses already write prescriptions for other medicines. Now, only physicians can certify patients for medical marijuana use. (Lazar, 9/15)

Chicago Tribune: Cook County To Start Program To Help Uninsured Get Health Care
The program will allow uninsured Cook County residents earning up to twice the federal poverty level — in other words, $48,600 a year for a family of four — to get primary care physicians within the Cook County Health and Hospitals System who could also refer them to specialists within the system. The program is expected to help nearly 40,000 people in 2017. Patients will have access to the system's two acute care hospitals, Stroger Hospital and Provident Hospital, and more than a dozen clinics where they will be able to present a special membership card to receive services. (Schencker, 9/14)

Atlanta Journal Constitution: How To Get Health Care In Atlanta Without Leaving Your Home
Whether you're sick or just need a checkup, it can be inconvenient to go to the doctor. Especially if you're not feeling well, you may not want to navigate traffic and flip through old magazines in the waiting room while surrounded by other sick people. And if you have mobility issues, getting out could be difficult. A few options are available that will let you get health care in Atlanta without leaving your home. (Caldwell, 9/14)

Los Angeles Times: Majority Of Californians Support Initiative To Require Actors In Adult Films To Use Condoms
A majority of Californians support an initiative on the November ballot to require performers in adult films to use condoms during sex scenes, according to a new USC Dornsife/Los Angeles Times poll of registered voters conducted by SurveyMonkey. Fifty-five percent said they would back Proposition 60 if the election were held today, the survey found. (Panzar, 9/15)

The Wall Street Journal: Beverage Industry Sues To Block Philadelphia’s Sweetened-Drink Tax
Beverage companies and retailers on Wednesday sued to try to halt Philadelphia’s special tax on sweetened drinks slated to go into effect in January. Philadelphia become the first large U.S. city to pass such a measure in June, when the city council approved a levy of 1.5 cents per ounce on non-alcoholic beverages with added sweeteners ranging from soda to sports drinks and energy drinks. (Esterl, 9/14)

ABC News: Official Didn't Publicly Report Flint-Area Disease Outbreak
Michigan's former state epidemiologist acknowledged in a plea deal Wednesday that she was aware of dozens of cases of Legionnaires' disease in the Flint area around the same time the city changed its water source, but that she didn't report it to the general public. (Karoub, 9/14)

Chicago Tribune: Home Health Care Boss Admits To Kickbacks 
The owner of one of the state's largest home health care companies admitted in federal court Wednesday that he paid nearly $790,000 in bribes to doctors in exchange for patient referrals. His Lemont-based firm, Home Bound Healthcare Inc., has also agreed to pay $6.8 million to the government related to Medicare reimbursements the company received, the U.S. Attorney's Office said in a news release. (Nolan, 9/14)

Cincinnati Enquirer: Miami Township Bans Smoking In Parks
Miami Township has become the first the first local government in Clermont County to outlaw all tobacco products and electronic cigarettes — which contain nicotine but no tobacco – on its property. The prohibition extends to the 277 acres of the five township parks. (Houck, 9/14)

Los Angeles Times: Oral Infection Outbreak Appears Linked To An Anaheim Dental Office, Officials Say
As if visiting the dentist wasn’t scary enough, Orange County health officials are alerting parents to an outbreak of oral infections that appear linked to a children’s dental office in Anaheim. At least one case of a Mycobacterial abscessus infection has been confirmed in a patient who visited the Children’s Dental Group, in the 2100 block of East Lincoln Avenue in Anaheim, according to the OC Health Care Agency. The infection was detected after the child underwent a pulpotomy procedure to remove or treat an infected tooth, health officials said. (Rocha, 9/14)

Columbus Dispatch: Sharing Health Data In Franklin County Is Focus Of National Challenge 
Franklin County is one of 50 U.S. communities chosen to participate in the 2016 Healthiest Cities and Counties Challenge. The county has been awarded $10,000 to develop ideas to contribute to improving residents’ health; areas include income, poverty, nutrition, violence, education and decreasing stress. (Perry, 9/15)

JAMA Forum: Action on the ACA Next Year? Maybe.
What are the prospects for action on the Affordable Care Act (ACA) during the next Congress and presidential administration? There is no easy answer to that question in this unusual election year .... At the risk of being proven wrong, it also seems reasonable to assume that there will continue to be a political standoff in practice next year, with neither party able to push through its preferred solutions for health care. And the Republican “Repeal Obamacare” mantra seems to leave little space for compromise. But a standoff could also lead to interesting prospects for some agreement, assuming that repeal of the ACA remains a nonstarter. (Stuart Butler, 9/14)

The New England Journal of Medicine: From Obamacare to Hillarycare — Democrats’ Health Care Reform Agenda
What happens to Obamacare after its namesake leaves the White House? ... If Donald Trump becomes president and Republicans maintain congressional majorities, the GOP could seek to repeal major ACA provisions, though Trump’s health care agenda is uncertain. If Hillary Clinton wins the presidency, however, Democrats can advance the ACA. For decades, reformers sought to enact universal health insurance. Now that they’ve taken a major step toward that goal, what happens next? Victory in the 2016 elections could allow Democrats to shift their focus from preserving the reforms to strengthening and improving them. (Jonathan Oberlander, 9/14)

The New England Journal of Medicine: What Would A Republican Win Mean For Health Policy?
Republicans may be willing to provide support for strategies to help stabilize the ACA insurance exchanges — such as continued use of risk corridors (which limit the amounts that insurers can gain or lose through risk sharing) after 2016, perhaps with some increased funding from existing appropriations in exchange for increased flexibility using innovation waivers (1332 waivers), such as allowing budget neutrality to be measured over 3 years rather than 1 and allowing states to pool savings from Medicaid with those from exchanges. Agreement that states that have not previously expanded Medicaid should be given 100% federal funding for Medicaid for 3 years after 2016 might be attractive to both Republicans and Democrats. The government could also smooth transitions between Medicaid and exchange coverage by letting people use their Medicaid subsidies to buy insurance in the exchanges and their exchange subsidies to buy Medicaid coverage. (Gail R. Wilensky, 9/14)

National Review: Repeal Without Replace?
It cannot be ruled out entirely that Donald Trump will be elected president on November 8. It is therefore only prudent to begin thinking about what might happen if that actually were to occur. One thing that is fairly certain is that, on November 9, we’d hear loud calls from some quarters for the incoming administration and Congress to move quickly in 2017 on a “clean” repeal of the Affordable Care Act — a.k.a. Obamacare. What people mean by “clean” is that the bill would go as far as possible (within legislative constraints) to repeal the ACA without being encumbered politically by new provisions to replace it. ... Regardless of Trump’s inclinations, however, it would be a terrible idea — for substantive and political reasons — for Republicans in Congress to pursue repeal without replace in 2017. (James Capretta, 9/14)

The New York Times: Hillary And Me: A Tale Of Two Pneumonias
I’m a big believer in empathy on the medical beat, but this is ridiculous. On Monday, my editors asked me to write about Hillary Clinton’s pneumonia, partially because I am, after all, a health writer (though my beat is global, not presidential), and partially because I too have pneumonia. I’m about two weeks ahead of her. ... I called a friend, a recently retired workaholic who’s had pneumonia twice. “Do not try to power through this,” he said immediately. “I did that the first time and I ended up in the hospital on oxygen.” (Donald G. McNeil Jr., 9/14)

Miami Herald: Hillary Clinton Was Doing What Women Do — Work While Ill
Hillary Clinton revealed a disconcerting flaw when she fell ill at a 9/11 event Sunday. She showed us that she is human. Not the superhuman we have demanded she be, only human. That’s something a woman can’t afford to disclose when she’s competing in a race that always has been dominated by men. One of the lessons women learn early in life is that they’ve got to be tough in order to succeed. Fragility can be a fatal flaw that has brought an end to many a promising career. And whatever you do, we’re told, never let them see you cry. (Dahleen Glanton, 9/14)

Reuters: How The 'Sub-News' Drives The Clinton Health Rumors
Here’s what you know about Democratic presidential nominee Hillary Clinton’s health because you saw it, or read about it, in the news: She is suffering from a case of walking pneumonia that caused her to wilt in the heat on Sunday. But, wait, here’s what you may not know but others are sure of: Clinton has a severe neurological disorder. She’s suffering from a brain tumor. She has dementia. She is such a sick woman that she isn’t likely to have the mental capability to fulfill her duties as president — should she be elected. The reason you may not know these things is that they, of course, aren’t true. (Neal Gabler, 9/13)

The Washington Post: Should We Care If Trump Is Obese?
We noted Tuesday that Donald Trump eats poorly, does not exercise and is badly overweight. Today we learned more about what now appears to be a very unhealthy lifestyle for a 70-year-old. Depending on what news report you choose, Trump is either nearly obese (236 pounds) or quite obese (267 pounds), meaning a body-mass index of more than 30. Trump, just like he did on taxes, promised to reveal his health records and now has reneged. (Jennifer Rubin, 9/14)

The New York Times: Birth Control Continues To Bedevil The Supreme Court
Remember the debate over the Obama administration’s contraception mandate, the requirement for employer-provided health benefit plans to include free birth control coverage? ... A short-handed court threw up its hands and put the best minimalist face it could on a dispute evidently beyond its institutional capacity to resolve. Although the outcome was ambiguous to say the least, the religious organizations that had sued for an exemption from the mandate were quick to declare victory. ... Not quite so fast — maybe. It’s just possible that the Supreme Court’s post-Scalia deadlock has given the administration the opportunity it needs to lift the verbal fog. (Linda Greenhouse, 9/14)

The Washington Post: Memo To Congress: Bickering Won’t Cure Zika
Back at the start of this year, Republican leaders were full of promises that Congress could overcome inaction and partisan stalemate. Senate Majority Leader Mitch McConnell (Ky.) said, “Some thought the Senate could never be cured of its dysfunction and its gridlock. . . . We believed the Senate could be restored to a place of high purpose again.” House Speaker Paul D. Ryan (Wis.) declared, “We need to raise our gaze.” Well, gentlemen, it is now September, a dangerous virus has hit U.S. shores, and all Congress has contributed so far is bickering. Definitely time to raise your gaze — and do something constructive. (9/14)

Columbus Dispatch: Zika Is A Crisis Except In Congress
In Michael Fielding’s line of work, you have to think and act fast. Fielding works in the population health section of the Columbus Public Health department. By the time central Ohioans hear about a health crisis like the Zika virus, he and his colleagues already are hustling to get out in front of it. ... But if local health departments are, by necessity, 11-speed road bikes in the race to beat Zika, Congress lazes at the back of the pack, clunking along in a single gear on under-inflated tires while dreaming of other races, most likely the kind that always end in November. (Theodore Decker, 9/15)

Bloomberg: Trump's New Middle-Class Entitlement
The details left many left-of-center think tanks, women's groups and child-care advocates cold. They complained, for example, that Trump's plan would only allow mothers paid leave from work, not fathers, possibly widening the gender-pay gap and signaling that women are solely responsible for staying home to care for newborns (read: forgoing salaries and career advancement). They also criticized Trump for not doing enough for low-income families and for failing to say how he'd pay for it all. They're right on all scores. But the bigger picture is of a Republican presidential nominee proposing a new entitlement program for working mothers, a new tax deduction for middle-class parents and decent improvements on an existing tax credit for the working poor. (Paula Dwyer, 9/14)

Los Angeles Times: Trump’s Maternity Leave Plan Is A Halfhearted Bid For The Female Vote – But It's Better Than Nothing
Donald Trump’s daughter Ivanka promised during the Republican National Convention that her father would offer more help to working families, and this week the elder Trump laid out more of the specifics: six weeks of paid maternity leave for new mothers and a new approach to tax breaks for child-care expenses. Perhaps the best that can be said is that it’s refreshing to see a Republican presidential candidate advocate for federal paid family leave policies and financial assistance to help working parents afford the tremendous costs of raising children. The plan itself? Like so much of what Trump has said during the campaign, the proposal falls short on details, including how to pay for these new benefits, and it’s woefully out of touch with the needs of many families. (9/15)

Morning Consult: Thinking Outside The Box For Health Care Cost Savings
It’s no secret that our health care system is undergoing transformational change. We are proving that the traditional mode of thinking — that lowering costs would adversely impact health — is simply wrong. Driven by policy and technology, our government, the private sector, and everyday citizens are upending an outdated, inefficient system that performs poorly and deprives millions of Americans access to the care they need, yet costs more than that of other developed nations. Amid all the gridlock in Washington, there’s one thing everyone can agree on: We need new ways of delivering health care that are high performance, high value and provide quality care for all. (Tom Daschle, 9/15)

The New England Journal of Medicine: Rethinking The Primary Care Workforce — An Expanded Role For Nurses
The adult population of the United States will soon have a different primary care experience than we’ve been used to. In the primary care practice of the future, the physician’s role will increasingly be played by nurse practitioners (NPs). In addition, the 150 million adults with one or more chronic conditions will receive some of their care from registered nurses (RNs) functioning as care managers. (Thomas Bodenheimer and Laurie Bauer, 9/15)

Huffington Post: This Is What Happens When Your State Government Blocks The Medicaid Expansion
Among the seven states where the Census Bureau found that more than 12 percent of people still didn’t have coverage last year, six were states that rejected the Medicaid expansion. The three biggest holdouts are Florida, Georgia and Texas. Two of the others are also in the South, in which Republicans dominate. ... The result is a disparity in how many people have insurance, from state to state. And although that disparity existed even before Obamacare, for a variety of reasons, now the disparity is getting wider, as analysts at the Center on Budget and Policy Priorities noted on Tuesday. (Jonathan Cohn, 9/13)

Fortune: This Vote Could Finally Make A Difference In Crazy Drug Prices
On November 8, most eyes will be on the historic presidential contest between Hillary Clinton and Donald Trump. But the pharmaceutical industry will be focusing on another vote: Proposition 61, a California public referendum that could become the first initiative to truly draw blood from drug makers, which have largely refused to change their pricing habits despite an ongoing political firestorm over the issue. (Sy Mukherjee, 9/14)

Los Angeles Times: Gross But True: Tampons And Diapers Are Not Essential To Human Survival
Sorry ladies and new parents, but California Gov. Jerry Brown vetoed bills that would exempt diapers and tampons from sales tax. Those bills were among seven bills that got the gubernatorial ax because they gave tax breaks that Brown said would have collectively sucked about $300 million out of the state’s budget. I’m not going to be popular with my female friends or family for saying this (especially my sisters who have four boys in diapers among them), but it was the right thing to do. (Mariel Garza, 9/13)