Axios: Biden's Last Effort To Boost ACA Enrollment
President Biden is making a final push to build on the Affordable Care Act, extending the enrollment period for marketplace coverage that kicks in Jan. 1 as sign-ups lag. ACA enrollment has hit new record highs each year of the Biden administration. But those gains are on shaky ground as the Trump administration prepares to take over in January. (Goldman, 12/17)

The Hill: Fewer Than Half Of Latinos In The U.S. Have Adequate Health Insurance Coverage
Latinos in the United States are less likely to have adequate health insurance than Americans overall, according to a new survey from health research nonprofit The Commonwealth Fund.  The nonprofit found that 46 percent of Latinos in the U.S. of working age have health insurance for the whole year and are not underinsured, according to the survey published Tuesday. (O'Connell-Domenech, 12/17)

Modern Healthcare: No Surprises Act Update Would Boost Noncompliant Insurer Fees
Sens. Dr. Roger Marshall (R-Kan.) and Michael Bennet (D-Colo.) are expected to unveil legislation Monday that would set the stage for an effort to strengthen penalties against health insurance companies that violate the No Surprises Act. The No Surprises Act, enacted in 2020, is meant to protect patients against unexpected out-of-network medical bills. But providers and patient advocates complain that health insurance companies have not been following the law's requirements to remunerate those providers. (McAuliff, 12/16)

In health industry news —

The Washington Post: Resident Doctors At George Washington Hospital Call Off Strike After Labor Deal 
Resident physicians at George Washington University Hospital called off a strike Monday evening after doctors said they reached a tentative labor deal with the medical school that includes higher wages, more vacation and money for mental health care. They reached the deal after a seven-hour bargaining session Monday and less than 12 hours before hundreds of residents were expected to walk off the job for three days. (Portnoy, 12/16)

Modern Healthcare: Updated Antitrust Guidelines Could Deter Hospital Partnerships
Federal regulators' decision to remove longstanding antitrust guidance could deter some provider-led joint ventures. The Federal Trade Commission voted 3-2 Wednesday to withdraw guidelines issued in 2000 that helped hospitals and other providers gauge whether regulators would investigate affiliations between competitors. (Kacik, 12/16)

Modern Healthcare: GoodRx Hires Wendy Barnes As CEO
More than a year after its co-founders left the company, GoodRx will have a new president and CEO. On Monday, the consumer drug pricing and digital health company announced Wendy Barnes will take over Jan. 1. Barnes most recently worked served as CEO of pharmacy benefits optimization company RxBenefits, and previously was president of pharmacy benefit manager Express Scripts. She also held roles at pharmacy chain Rite Aid and drugmaker Pfizer. (Turner, 12/16)

The New York Times: Drugmakers Paid PBMs Not To Restrict Opioid Prescriptions 
In 2017, the drug industry middleman Express Scripts announced that it was taking decisive steps to curb abuse of the prescription painkillers that had fueled America’s overdose crisis. The company said it was “putting the brakes on the opioid epidemic” by making it harder to get potentially dangerous amounts of the drugs. The announcement, which came after pressure from federal health regulators, was followed by similar declarations from the other two companies that control access to prescription drugs for most Americans. (Hamby, 12/17)

ProPublica: How Opioid Giant Endo Escaped A $7 Billion Federal Penalty 
This spring, the Justice Department announced a major victory against a drug firm that manufactured billions of opioid painkillers. Endo Health Solutions, the agency said, would face $1.5 billion in fines and forfeitures and plead guilty to a corporate criminal charge. Prosecutors said the massive fine would hold accountable a suburban Philadelphia company that profited by “misrepresenting the safety of their opioid products and using reckless marketing tactics to increase sales.” (Fernandez and McCoy, 12/17)

In related PBM news —

Stat: PBM Reform, Telehealth Extension, Doctor Pay In Federal Spending Deal 
After two years of haggling, Congress has nearly reached a deal to rein in the drug-industry middlemen known as pharmacy benefit managers. Lawmakers agreed to extend telehealth flexibilities, fund public health programs, and enact these major PBM changes as part of a government funding package they are planning to pass before the end of the year, according to four health care industry sources and two congressional aides. The language of the government funding package has not been publicly released, and could still change. (Zhang, 12/16)

St. Louis Post-Dispatch: To Save Small Drugstores, Missouri’s Hawley Again Joins Forces With A Massachusetts Liberal
If this keeps up, people are going to talk. Once again, the unlikely coupling of U.S. Sens. Josh Hawley and Elizabeth Warren appears atop yet another piece of legislation. Hawley, a Missouri conservative Republican, and Warren, a liberal Democrat from Massachusetts, introduced legislation that aims to prevent pharmacy benefit managers (PBM) from owning pharmacies and driving up prescription drug costs for their own benefit. (Holleman, 12/16)

Bloomberg: CVS, Cigna, UnitedHealth Shares Drop On Trump 'Middleman' Comment
Shares of pharmacy benefit managers fell Monday after President-elect Donald Trump said he plans to “knock out” drug-industry middlemen, a sign the sector isn’t likely to see relief from political scrutiny during his administration. CVS Health Corp. shares fell as much as 4.3%, UnitedHealth Group Inc. dropped as much as 3.9%, and Cigna Group shares dropped as much as 2.6% after the comments. The companies own the largest prescription drug middlemen, businesses that have been blamed by both Republicans and Democrats for driving up the cost of medicine. (Tozzi, 12/16)

Modern Healthcare: Where Incoming FTC Chair Andrew Ferguson Stands On PBMs, Big Tech
President-elect Donald Trump's selection last week of Andrew Ferguson to head the Federal Trade Commission could set the stage for a more hands-off approach to regulation and consumer protection, while maintaining the agency’s opposition to Big Tech's consolidation. Ferguson, who has served as an FTC commissioner since March, has been vocal on a number of issues, advocating for stronger enforcement actions against pharmacy benefit managers, citing their impact on drug prices, while opposing a ban on noncompete agreements. (Dubinsky, 12/16)

CNN: Kennedy Says He’s ‘All For’ Polio Vaccine As GOP Senators Raise Questions About His Views
Robert F. Kennedy Jr. is trying to tamp down concerns about his history of vaccine skepticism as he meets with GOP senators who will vote on whether to confirm him as President-elect Donald Trump’s pick to lead the US Department of Health and Human Services. Kennedy on Monday told reporters on Capitol Hill that he is “all for” the polio vaccine — comments that came hours after Trump said at a news conference that Americans are “not going to lose the polio vaccine.” (Bradner, 12/16)

AP: RFK Jr. Meets With Senators As Questions Swirl About Trump's Pick To Lead Health Agency
Robert F. Kennedy Jr. swept onto Capitol Hill late Monday as the anti-vaccine health guru from the famous political family reintroduced himself to senators, this time as President-elect Donald Trump’s pick to lead the nation’s Health and Human Services Department. It was a soft-opening debut for Kennedy, whose wide-ranging views — yes to raw milk, no to fluoride, Ozempic and America’s favorite processed foods — are raising alarms in the scientific community and beyond. In the Senate he’s facing a mix of support, curiosity, skepticism and downright rejection among the senators who will be asked to confirm him to Trump’s Cabinet. (Mascaro and Jalonick, 12/16)

Politico: RFK Jr. Has Public Health Leaders Quietly Hopeful — And Scared As Hell
Nearly a dozen researchers and public health officials who spoke with POLITICO see in Kennedy a chance to improve Americans’ poor diet and exercise habits and reduce their exposure to harmful chemicals. But they also see a purveyor of dangerous misinformation about vaccinations who could do irreparable harm to the public’s health. They’re coming to different conclusions about whether they should seek to direct Kennedy’s energies or oppose him entirely. (Payne, 12/17)

The Hill: Trump Seeks To Smooth Over Concerns Over RFK Jr
President-elect Trump tried to downplay concerns about Robert F. Kennedy Jr. on Monday, telling reporters that his nominee for Health and Human Services secretary won’t be “radical.”  “I think he’s going to be much less radical than you would think,” Trump said during a wide-ranging news conference at Mar-a-Lago. “He’s going to have an open mind, or I wouldn’t have put him there.” (Weixel, 12/16)

The Hill: Trump Says There Are ‘Problems’ With Vaccines, Rejects Mandates
President-elect Trump said he thinks there are “problems” with vaccines and again drew a false connection between vaccines and autism rates on Monday.  “There are problems. We don’t do as well as a lot of other nations, and those nations use nothing,” Trump said during a wide-ranging press conference at Mar-a-Lago. During the press conference, Trump again hinted that vaccines are driving up autism rates and that his administration would investigate it. (Weixel, 12/16)

KFF Health News: Trump’s Picks For Top Health Jobs Not Just Team Of Rivals But ‘Team Of Opponents’
Many of President-elect Donald Trump’s candidates for federal health agencies have promoted policies and goals that put them at odds with one another or with Trump’s choice to run the Department of Health and Human Services, Robert F. Kennedy Jr., setting the stage for internal friction over public health initiatives. The picks hold different views on matters such as limits on abortion, the safety of childhood vaccines, the covid-19 response, and the use of weight-loss medications. (Armour and Rovner, 12/17)

In Trump administration news —

San Francisco Chronicle: Private Prison CEOs Are Thrilled About Donald Trump — And Prop 36
The California measure to increase punishments for theft and drug crimes will not only grow prison and jail populations, but will also likely result in more people accused of crimes being referred to federal authorities for potential deportation. Along with President-elect Donald Trump’s promise to usher in a wave of mass deportations, industry leaders say the anti-crime crackdown embraced by voters is good for their business. (Burke and Bollag, 12/16)

Stat: Marty Makary: What To Know About Trump's Pick To Run FDA 
Marty Makary knows how to captivate an audience. President-elect Trump’s nominee for Food and Drug Administration commissioner has spent his medical career crusading against injustice in the health care system, attracting constant media and political attention along the way. Recently, he’s used his skills to help vault chronic disease into a hot-button political issue and to amplify distrust of the government’s handling of the Covid-19 pandemic. But Makary, a pancreatic surgeon, got his start raising awareness about an important and hard-to-grasp issue: the impact of hospital workplace culture on patient care. (Lawrence, 12/17)

KFF Health News: Trump Threat To Immigrant Health Care Tempered By Economic Hopes
President-elect Donald Trump’s promise of mass deportations and tougher immigration restrictions is deepening mistrust of the health care system among California’s immigrants and clouding the future for providers serving the state’s most impoverished residents. At the same time, immigrants living illegally in Southern California told KFF Health News they thought the economy would improve and their incomes might increase under Trump, and for some that outweighed concerns about health care. (Sánchez, 12/17)

Military Times: Congress Finalizes Sweeping Bill To Help Veteran Caregivers
House lawmakers on Monday finalized a sweeping veterans bill to expand caregiver benefits for elderly and infirm veterans and update medical options for veterans outside the department’s health care system, sending the legislative package to the White House to become law. The legislation was originally passed by the chamber last month but had to be reapproved this week after technical changes were added by the Senate last week. The measure now heads to the White House, where President Joe Biden is expected to sign it into law in the coming days. (Shane III, 12/16)

NBC News: Democratic Senators Seek To Ax Transgender Care Ban From Defense Bill
Fourteen Democratic senators will introduce an amendment Monday evening to remove language from Congress’ massive defense spending bill that seeks to ban coverage of gender-affirming care for transgender children of service members, the office of Sen. Tammy Baldwin, D-Wis., told NBC News. ... The $895 billion bill authorizes the annual budget for the Defense Department and sets defense policies for the upcoming year. (Lavietes, 12/16)

The Washington Post: Bill To Avert Government Shutdown Appears To Hit Snags Ahead Of Deadline 
A bipartisan framework to put off a government shutdown appeared to hit snags over the weekend, and lawmakers continued bickering Monday over a federal funding bill that will lay the groundwork for the early days of the incoming Trump administration. Without new legislation, government agencies will shutter just after midnight Saturday. Lawmakers are on the cusp of approving a stopgap bill to extend federal funds into mid-March, but new disputes over farm aid and disaster recovery spending have stalled progress near the final stages. (Bogage, 12/16)

The Boston Globe: Post-Steward, Lawmakers Struggle To Curb Private Equity In Health Care
Lawmakers spent much of 2024 bemoaning the role of financial giants in health care as hospital chain Steward Health Care, long bankrolled by a private equity firm, collapsed into bankruptcy, putting thousands of jobs and the care of tens of thousands of patients in jeopardy. ... Yet as the grim Steward saga ended this fall, those bills bogged down both in Congress and on Beacon Hill, while regulators approved the sale of Steward’s national physicians group — which includes about 2,500 doctors in Massachusetts — to another private equity firm. (Weisman, 12/16)

The New York Times: 15-Year-Old Girl Identified as the Shooter in a Wisconsin School
The shooter who killed at least two people on Monday at a Christian school in Madison, Wis., was identified as Natalie Rupnow, a 15-year-old student who later died from what appeared to be a self-inflicted gunshot wound, the police said. The shooter, who went by “Samantha,” opened fire in a study hall classroom with students from several grades at Abundant Life Christian School, said Shon F. Barnes, the Madison police chief. A teacher and a teenage student were killed, and five students and another teacher were injured, the authorities said. (Karlamangla and Taft, 12/16)

CBS News: After Shooting At Christian School In Madison, Wisconsin, Here's What We Know So Far 
A law enforcement source said the weapon used in the shooting appears to have been a 9mm pistol. Authorities could not say how the shooter obtained a gun. (Chasen, 12/16)

Newsweek: Are Female Mass Shooters On The Rise? What Data Shows 
An overwhelming majority of assailants in major mass shootings are male, with only a handful of female shooters having ever been identified, making Monday's gunfire an anomaly. Crime data shows little evidence to support the notion there has been a spike in mass shootings committed by women or girls in recent years, although there may have been an increase over the decades. (Slisco, 12/16)

Axios: Gen Z Teachers Lead School Shooter Drills Amid Rising Gunfire
This year was the most active for gunfire on school grounds since 2013, when Everytown for Gun Safety started tracking data. As the threat of gun violence has persistently grown, students often learn to prepare for an active shooter from teachers who had the same hide, fight and run mentality drilled into them as children. (Lotz, 12/17)

UnitedHealthcare shooting updates —

The Wall Street Journal: Luigi Mangione’s Best Defense In Case Over UnitedHealth Shooting In New York Might Be To Try Reducing Punishment 
Accused killer Luigi Mangione's potential arguments could revolve around attributing his actions to his mental state at the time of the killing. Two defenses in New York state—a plea of not guilty by reason of insanity and claiming extreme emotional disturbance—might be relevant. Former Manhattan prosecutor Karen Friedman Agnifilo, hired last week to defend Mangione on the murder charge, previously speculated that such a plea could be a possibility. (Ramey and Fanelli, 12/16)

The Washington Post: Deny And Delay: The Practices Fueling Anger At U.S. Health Insurers
Most frustrating, according to patient advocates, is that insurance companies often act without explanation, sending denial letters that offer only sparse justifications. The patient “gets a cryptic message saying ‘it’s not medically necessary,’ but without any other explanation,” said Elisabeth Benjamin, a vice president at the Community Service Society in New York, which runs a program that helps consumers appeal denials. “People are mad because it’s all a big secret,” Benjamin said. “It’s unfair for us as a society, on something that’s so visceral, to trust giant corporations that make money when they deny care. This is why people are so, so very angry.” (Whoriskey, 12/16)

In related news —

The Washington Post: Start-Up Putting Ammo Vending Machines In Grocery Stores Plans To Grow
Dallas-based start-up American Rounds rolled its first automated retail ammo machine into a Fresh Value grocery store in Pell City, Alabama, late in 2023, selling various brands of rifle, shotgun and handgun ammo. The company advertises its machines as a safer and more convenient way to buy ammo than at a large retail store or online. But public health experts have questioned whether the company’s suicide prevention efforts are sufficient, and elected officials in areas where machines were set up have worried that the easy availability of ammunition could lead to impulsive purchases by people who seek to do harm. (Barton, 12/15)

Newsweek: US Poised To Reach Executions Milestone 
The U.S. has two executions scheduled this week—if both go ahead, it will bring the number of inmates put to death across the country in 2024 to 25. If both are put to death, it would mean the U.S. has carried out the highest number of executions in a year since 2018. That's despite the public's waning support for capital punishment and a rise in the number of Americans who believe the death penalty is being administered unfairly. (Rahman, 12/17)

Wyoming Public Radio: In-The-Works “Community-Led” Hospital In Riverton Promises Delivery And Labor Unit 
Riverton Medical District started construction on a new community-led hospital on Dec. 12. The locally-based nonprofit spent the last six and a half years getting the project off the ground. Once complete, the two-story, 71,000-square-foot facility will have an Emergency Department, 24/7 surgery and 13 in-patient beds. Two of those beds will be for labor and delivery. Corte McGuffey is the nonprofit’s board chair and said their mission is to “ restore” hospital services to Riverton and the surrounding communities. (Habermann, 12/16)

The Boston Globe: After Cyberattack, Rhode Islanders File Class-Action Lawsuit RIBridges Vendor Deloitte
Rhode Islanders whose personal information was exposed in a major cyberattack on the state’s public benefits system have filed class-action lawsuits against the system’s New York-based vendor. The lawsuits were filed Sunday against Deloitte Consulting in US District Court in Rhode Island and in the Southern District of New York, just days after Governor Daniel J. McKee announced that the data breach of the RIBridges benefits system had put at risk the personal data of hundreds of thousands of people. (Milkovits and Machado, 12/16)

The CT Mirror: CT Cancels $30M In Medical Debt For Thousands Of Residents
In the coming weeks, 23,000 residents will see part or all of their medical debt cancelled, Connecticut officials announced on Monday morning at the state Capitol. The measure will erase $30 million in medical debt, providing relief for thousands at a time when the frustration over health care costs has dominated the national conversation. (Golvala, 12/16)

From California —

CBS News: Los Angeles County Announces $2 Billion Medical Debt Relief Program
Los Angeles County announced its $2 billion Medical Debt Relief Program aimed at helping low-income residents settle past-due bills. "The launch of this program is a critical step forward in ensuring that those receiving critical medical services do not find themselves experiencing financial harm associated with not being able to afford care," said Dr. Barbara Ferrer, Director of LA County Department of Public Health. (Rodriguez, 12/16)

San Francisco Chronicle: S.F. Plans To Add Locked Psychiatric Beds To Help Most Desperately Ill
San Francisco has asked state officials for $144 million to create 175 more beds for people experiencing mental illness and addiction. The Department of Public Health submitted an application to the state this month in hopes of securing a portion of the $6.4 billion mental health bond passed by California voters in March. (Angst, 12/16)

Los Angeles Times: Southern California Doctor Sentenced In Hospice Fraud Scheme
A Southern California doctor accused of bilking Medicare out of millions by billing for unnecessary hospice services has been sentenced to 24 months in federal prison, federal prosecutors said. Dr. Victor Contreras, 69, of Santa Paula was charged with falsifying medical claims for hospice care between July 2016 and February 2019 — billing the federal insurance program nearly $4 million during that time, according to the U.S. attorney’s office. (Mendez, 12/16)

NPR: Surgeons Transplant A Genetically Modified Pig Kidney Into A Human
Towana Looney can hardly contain her anticipation as she waits to get wheeled to an operating room at the NYU Langone Health hospital in New York City for an historic procedure. ... She volunteered to become the first living person in the world to get a kidney from a new kind of genetically modified pig. Scientists hope this kind of pig will someday provide an unlimited supply of kidneys, livers, hearts and other organs that could alleviate the chronic shortage of organs for transplantation and save thousands of patients every year. (Stein, 12/17)

Stat: FDA Authorizes Many AI Devices For Use In Kids. Are They Validated In A Pediatric Population?
Children aren’t just little adults, goes the saying in pediatrics. But with little financial incentive for companies to develop kid-specific treatments, pediatricians are often left to use adult medicines and medical devices off-label for their patients — or none at all. (Palmer, 12/16)

Crain's Chicago Business: Northwestern, Penn State Collaborate On AI Screening Of Placentas
Scientists at Northwestern Medicine and Penn State are developing a tool to train computer vision and artificial intelligence to evaluate placentas at birth for abnormalities. A computer program, PlacentaVision, can analyze a photograph of a placenta after birth to detect signs of infection and neonatal sepsis, which can be life-threatening and affects millions of newborns globally, Northwestern Medicine said in a press release. (Asplund, 12/16)

Stat: Heart Failure Risk Becomes Easier To Estimate With New Model 
Just over a year ago the PREVENT calculator to predict cardiovascular risk was released by the American Heart Association. It was acclaimed for improving on a 2013 model that didn’t take into account companion conditions such as kidney disease or type 2 diabetes, or include people from more diverse backgrounds. (Cooney, 12/16)

Axios: Scientists Call For Ban On Creating "Mirror Life"
Scientists are sounding new alarms about man-made organisms whose constituent molecules are mirror images of what's found in nature and could pose unprecedented risks to humans, animals and the environment. While the ability to create "mirror life" is probably at least a decade away, researchers already have synthesized mirror-image biological systems that could be used in the development of new drugs. (Reed, 12/17)

Regarding Alzheimer’s —

Side Effects Public Media: Recent Alzheimer's Advancements Leave Black And Latino Patients Behind
Althea Jordan sits in her white recliner while her physical therapist, Danielle Heltzel, kneels on the floor in front of her to go through a series of exercises to help move her legs. “Did I ask if your knees hurt? Are they sore? They ache?” Heltzel asked. Jordan mumbles quietly affirming some leg pain. She’s in the late stages of Alzheimer’s Disease, but the 73-year-old is also recovering from a recent virus, making her quieter than usual. (Krebs, 12/16)

MedPage Today: Alzheimer's Mortality Lowest For Taxi, Ambulance Drivers 
Taxi drivers and ambulance drivers -- two groups of people with jobs that require frequent spatial and navigational processing -- had the lowest proportions of deaths attributed to Alzheimer's disease, an analysis of U.S. death certificates showed. Of nearly 9 million people who had died with occupational information, 3.88% had Alzheimer's disease listed as a cause of death. However, only 1.03% of taxi drivers and 0.74% of ambulance drivers died from Alzheimer's disease, according to research led by Anupam Jena, MD, PhD, of Harvard Medical School and Massachusetts General Hospital in Boston. (George, 12/16)

Stat: Will Donald Trump Be The One To Slay PBMs? 
Public awareness is rapidly intensifying about the harmful role pharmacy benefit managers (PBMs) play in driving up prescription drug costs and denying consumers access to vitally needed medications. These powerful middlemen have come under increasing scrutiny from policymakers and regulators, with the Federal Trade Commission (FTC) taking decisive action this year by filing a complaint against the largest PBMs for anticompetitive and unfair practices and issuing a groundbreaking interim report about their anticompetitive practices. These practices are not just unfair; they’re forcing consumers to pay unnecessarily high prices for the medications they rely on. (David Balto, 12/17)

The Atlantic: The Push For Puberty Blockers Got Ahead Of The Research 
Are medical treatments for minors with gender dysphoria even scientifically justified? In the late 1990s, doctors in the Netherlands touted a new treatment for teenagers with severe gender dysphoria who found puberty distressing: chemically blocking their sex hormones and then giving them the hormones of the opposite sex. (Helen Lewis, 12/16)

The New York Times: Why Ultraprocessed Foods Aren't Always Bad
The way we eat desperately needs to change. Experts estimate diet is a bigger contributor globally to early death than smoking. In America, nearly half the adult population has Type 2 diabetes or pre-diabetes. (Nicola Guess, 12/16)

Stat: A Deadly Kidney Disease’s Possible Connection To The Slave Trade 
In the summer of 2008, with only two weeks left before returning home from a visiting Fulbright professorship in Japan, I made a doctor’s appointment for a checkup to take advantage of that nation’s inexpensive health care system. My only complaint was arthritic joint pain. But the physician I saw focused on a laboratory test that came back with an unexpected and grim diagnosis: advanced kidney disease. (Constance B. Hillard, 12/17)

Stat: Medicaid Has A Data Coordination Problem. AI Can Help 
When I worked as a social worker at a community clinic in Detroit, I often saw James (not his real name), a patient receiving Medicaid benefits who was grappling with chronic substance use. Every appointment revealed a deeper, more disturbing layer of systemic disarray impacting James’ life and care: fragmented health records, conflicting medication lists, incomplete therapy session notes, and scattered commentary on detox treatments. This disorganized care record frequently delayed his treatment, given how long it took me to piece together his medical history and, as a result, how little time was left to address his immediate care needs. (Sadiq Y. Patel, 12/16)