The Wall Street Journal: Inside The Affordable Care Act’s Arizona Meltdown
When Affordable Care Act insurance marketplaces launched in fall 2013, Arizona seemed like a success. Eight insurers competed to sign up consumers, offering a wide variety of plans and some of the lowest premiums in the country. Today, with ACA enrollment starting Nov. 1, Arizonans will find in most counties only one insurer selling exchange plans for 2017. (Wilde Mathews, 10/31)

Arizona Republic: 'Obamacare' Enrollment Opens This Week In Arizona With Higher Costs, Fewer Choices
Thousands of Arizona residents who begin shopping for an Affordable Care Act health-insurance plan on Tuesday will find fewer options and higher costs compared with one year ago. Residents of every county in Arizona except Pima County will have one marketplace insurer offering plans, each with different coverage tiers. ... Despite less choice and higher costs that have been a talking point in political campaigns, experts encourage consumers to visit the marketplace's website, healthcare.gov, or reach out to an enrollment "assister" for more information during the three-month enrollment period that begins Tuesday. (Alltucker, 10/31)

Texas Tribune: Texas Residents Could Receive More Federal Aid To Pay For Costly Health Plans 
As Texas consumers prepare for the fourth open enrollment to sign-up for or renew health insurance coverage under the federal Affordable Care Act, they face rising costs but could also receive more financial assistance. Beginning Nov. 1, Texas residents can go to Healthcare.gov, the federal health exchange website, to sign up for health plans available in their area. But the sign-up period comes after several health insurers — including Aetna, UnitedHealthcare, Scott and White and insurance start-up Oscar — have called it quits on the federal website. Texas consumers’ monthly health insurance bills could rise an average 25 percent, according to a federal Department of Health and Human Services report. (Evans, 11/1)

San Antonio Press Express: S.A. Help For Enrolling In Obamacare Starts Tuesday
Those seeking health insurance through the federal exchange can begin to sign up Tuesday, and Bexar County health organizations are hosting events throughout November to help residents enroll. The Affordable Care Act requires all Americans and legal residents to have health insurance. Enrollment for 2017 is open from Nov. 1 to Jan. 31, 2017. Enroll by Dec. 15 to secure coverage starting Jan. 1. (Martin, 10/31)

The Philadelphia Inquirer: Obamacare Signups Begin, With Fewer Choices And Higher Prices
In Southeastern Pennsylvania,  the average Obamacare premium for a 50-year-old nonsmoker buying the most common benchmark plan is rising more than 50 percent, according to an analysis by Avalere Health. But in New Jersey, where coverage was much more expensive in past years, that average plan’s cost is rising just 5 percent. Unsubsidized premiums there will cost $111 a month less than across the river. (Sapatkin, 10/31)

Kansas City Star: KC Consumers Using The Affordable Care Act Insurance Will Be Paying More 
Tuesday is the day tens of thousands of Kansas City-area consumers can begin signing up for 2017 health insurance coverage through the Affordable Care Act. ... But while almost all insurance customers — on the ACA marketplace and in the open market — will see cost increases or tighter benefits for 2017, “the person who gets subsidies won’t feel as bad as those who don’t,” predicted Ron Rowe, Blue KC’s senior vice president of sales and marketing. In fact, up to 90 percent of those nationally who do get subsidies, the Department of Health and Human Services points out, will see little or no increase in out-of-pocket costs for their coverage and will still be able to find insurance for less than $100 a month. However, that means taxpayers in general will make up for the higher subsidies needed to limit the premium increases. (Stafford, 10/31)

Kansas Health Institute: Marketplace Shoppers Likely To Find Higher Premiums, Deductibles For 2017 
Kansas families who buy health insurance through the online marketplace for 2017 could pay $20,000 or more if they have serious medical problems, according to federal data. Most families likely won’t pay that much because they qualify for subsidies, but the information shows that even low-premium plans can become costly. KHI News Service used data from healthcare.gov to calculate the total costs for a family of four with two 40-year-old adults and two children in seven Kansas counties. Premiums would be different for other families based on age, number of family members and geography. Information isn’t available yet on plans offered by Medica, the newest insurer on the exchange in Kansas. (Wingerter, 10/31)

Pioneer Press: MNsure Open Enrollment Starting: What You Need To Know
Tuesday is the first day of Minnesota’s open enrollment period for the individual health care market. It’s a very unusual time, with the market in crisis. Even people accustomed to buying individual health insurance in recent years will find plenty of differences this time around. Minnesota’s individual market covers about 5 percent of Minnesotans — those who don’t have coverage from an employer or a government program. It includes those who buy coverage directly from an insurance carrier and those who go through the state-run MNsure exchange. (Montgomery, 10/31)

Pioneer Press: Abolish MNsure? Mark Dayton Says, ‘We’ll See How It Performs’ 
Minnesota’s state-run health insurance exchange could be eliminated if it doesn’t perform well in the upcoming open enrollment period, Gov. Mark Dayton said Monday. Dayton, who championed MNsure, told Minnesota Public Radio’s Tom Weber that eliminating MNsure, as Republicans want to do, is one of several “legitimate ideas” for improving Minnesota’s broken individual health insurance market. Asked specifically whether he supports eliminating it, Dayton laid down a challenge. “MNsure certainly has problems,” Dayton said. “We’ll see how it performs in the next couple months, in the open enrollment period. That will be real evidence of whether MNsure has gotten its footing and is providing the service that’s needed.” (Montgomery, 10/31)

Milwaukee Journal Sentinel: Rates For Obamacare Plans Jump In Wisconsin
When the fourth open-enrollment period begins Tuesday, most people who buy health insurance on the marketplaces set up through the Affordable Care Act will see little, if any, change in their monthly costs. But the tens of thousands of people throughout the state who don’t qualify for federal subsidies — most of whom have already seen the cost of their health insurance jump in recent years — will be in for additional pain. They will pay the full cost of double-digit premium increases. Several insurers, including at least four in the Milwaukee area, are raising premiums by more than 20%. (Boulton, 10/31)

Kansas Health Institute: Missouri Takes Step To Hold Down Health Insurance Rates, But Will It Be Enough? 
When individual health insurance plans go on sale on healthcare.gov Tuesday, many Missourians will probably be more than a little shocked to see some rate increases as high as 40 percent. Similar increases are popping up nationwide, but different states have different powers to address them. Take Oregon, for example. Each year around late April, insurance companies send the state their proposed rates, starting a conversation about what’s fair based on the cost of health care and the health of customers. (Smith, 10/31)

Health News Florida: Subsidies Soften Obamacare Premium Increases In Florida
Open enrollment in the Affordable Care Act Marketplaces begins Tuesday and the state says the average premium increase in Florida is 19 percent. But the news is not be as bad as it sounds for most consumers. More than 90 percent of Floridians who enroll in the marketplace receive government subsidies to cover monthly premiums. (Ochoa, 10/31)

Sacramento Bee: Covered California Executive Director Peter Lee Talks About Obamacare, Millennials And Premium Increases 
Starting Tuesday, Nov. 1, through Jan. 31, Californians who don’t have employer-based health insurance or Medicare can sign up for health insurance through the state’s marketplace, Covered California. That’s the easy news.As Covered California launches its fourth annual sign-up season under the federal Affordable Care Act, health care coverage is as contentious as ever, both in presidential debates and in national headlines. Covered California has already posted average premium increases of 13.2 percent, compared with a nationwide average of 25 percent. (Buck, 10/31)

Kaiser Health News: 7 Tips To Help Avoid Costly Health Plan Enrollment Headaches
With the annual sign-up period for plans on the health law’s marketplaces starting Nov. 1, many consumers are worried about rising premiums, shrinking provider networks and the departure of major insurers such as UnitedHealthcare, Aetna and Humana from many exchanges.The impact on coverage will vary, but the shifting landscape means that it’s more important than ever for consumers to carefully evaluate the plans that are available in their area and choose the best one for their needs. There are several elements to factor into that decision. (Andrews, 11/1)

The Hill: House Dems Push Back Against GOP ObamaCare Lawsuit 
House Democrats on Monday accused Republicans of an “end-run around the law” as they pushed back on a GOP lawsuit against ObamaCare. House Democrats filed a brief in federal court defending the Obama administration in a lawsuit, House v. Burwell, brought by House Republicans. The GOP argues that certain ObamaCare payments are being made unconstitutionally because Congress has not appropriated the money.  (Sullivan, 10/31)

Morning Consult: House Democrats File Amicus Brief In GOP Obamacare Lawsuit
House Democrats argue in an amicus brief filed Monday that a lawsuit brought by House Republicans against the Obama administration over the Affordable Care Act should not have standing in court. Led by House Minority Leader Nancy Pelosi, 11 top Democrats filed the brief arguing the dispute should not be settled in court, but that even if the case has standing, the Obama administration acted lawfully by reimbursing insurers for cost-sharing reductions under the Affordable Care Act. (McIntire, 10/31)

In related news —

The Hill: Popular ObamaCare Provision Hampering Push For Millennials
One of the most popular pieces of ObamaCare could be hurting the administration’s push to attract more young people into the wobbly marketplace, according to several people who helped shape the law. ... Because of the healthcare law, the White House says nearly 3 million young people under the age of 26 have been able to stay on their parents’ insurance plans and don’t have to shop for coverage on HealthCare.gov. That’s about double the number of young people between the ages of 18 and 25 who are currently covered through the exchanges. (Ferris, 11/1)

Kaiser Health News: As Insurers Cut Brokers’ Commissions, Consumers May Have One Less Tool For Enrollment
With open enrollment set to begin, some health insurance brokers are already fielding questions about coverage and whether existing plans will still be available next year. For an increasing number of brokers, there’s also another question: Will they get paid? (Appleby, 11/1)

California Healthline: Blue Shield Again Owes Californians Millions In Health Care Rebates
Blue Shield of California, already under scrutiny from the Department of Managed Health Care, is on the hook for almost $25 million this year to enrollees and the employers that cover them and their dependents. A rule in the Affordable Care Act requires insurance companies to pay customers back when the insurers don’t spend enough money on medical care. (Bartolone, 11/1)

St. Louis Post-Dispatch: DaVita Changes Policy On Helping Patients Secure Financial Assistance
DaVita Healthcare Partners Inc. will no longer help certain patients obtain financial aid to pay for health insurance they don’t necessarily need. The Denver-based company, one of the nation’s largest dialysis providers, announced Monday that it will “suspend support” for applications to the American Kidney Fund that allowed some dialysis patients, also enrolled in Medicaid, to gain access to private health insurance plans. The American Kidney Fund, a charitable organization, provided the funds that allowed some Medicaid patients to obtain the additional insurance coverage. The private plans allowed DaVita to be reimbursed at higher rates for the same services. Medicaid and Medicare, government-run insurance programs, pay significantly less for dialysis services than private insurance. (Liss, 10/31)

CNBC: DaVita Shares Jump On Change For Medicaid Patients Seeking ACA Coverage
The company said the change would affect about 2,000 patients, or one percent of DaVita's patient population. "While our analysis indicates that dialysis patients account for less than 2 percent of the overall medical costs in ACA Plans, we understand the financial pressures in the risk pool," Chairman and CEO Kent Thiry said in a statement. "We stand ready to work with all stakeholders to preserve the intent of the ACA within a sustainable rate and regulatory structure." (Lovelace, 10/31)

Related KHN coverage: Insurers, Hospitals Clash Over Help Paying Obamacare Premiums (Galewitz, 10/31)

The New York Times: Is High-Deductible Health Insurance Worth The Risk?
As companies push workers to pay more for their medical care, millions of employees are facing a tough decision, choosing between high premiums and high deductibles. The choice is this: Pay more every month for peace of mind later, or pay less and run the risk of having higher out-of-pocket costs down the line. (Abelson, 10/31)

Chicago Tribune: What's Worse? Visiting The Dentist Or Picking A Health Insurance Plan? 
About one-fourth of consumers would rather file their taxes than go through the ordeal of selecting a health insurance plan, according to a recent UnitedHealthcare survey. About 28 percent would rather get a teeth cleaning. But this month, many Americans will have no choice but to begin the often-reviled exercise of choosing insurance for next year — a task made particularly painful by rising prices and, in some cases, fewer choices. According to several recent surveys, yet another reason may be behind consumers' anxiety when it comes to choosing coverage: They don't understand it. (Schencker, 11/1)

Chicago Tribune: Appeals Court Rules Against Advocate, NorthShore Hospital Merger 
A federal appeals court has ruled against Advocate Health Care and NorthShore University HealthSystem in a case over their quest to merge, reversing a lower court's decision. The case will now go back to a lower court — if the hospitals decide to continue to fight. A three-judge panel of the 7th U.S. Circuit Court of Appeals sided Monday with the Federal Trade Commission and the state of Illinois, which sought a preliminary injunction to temporarily halt a merger of the two hospital systems. (Schencker, 10/31)

The Wall Street Journal: Appeals Court Gives Boost To Government Opposition To Chicago-Area Hospital Merger
The ruling, by the Seventh U.S. Circuit Court of Appeals in Chicago, sided with the Federal Trade Commission, reversing a June trial judge’s ruling that said the government hadn’t shown the planned combination of Advocate Health Care and NorthShore University HealthSystem was likely anticompetitive. Among other things, the appeals court said the trial judge made errors in how he analyzed competition in the geographic area, including how patients choose hospital services and how insurers market health plans. (Kendall, 10/31)

And in another takeover --

Modern Healthcare: Merger Decisions Sealed Fate Of Troubled TeamHealth 
It took more than a year, but two merger decisions – one completed and one rebuffed – ultimately led to the sale of TeamHealth. The Knoxville, Tenn.-based physician staffing giant Monday announced it will be taken private and bought for $6.1 billion by the Blackstone Group. ... TeamHealth is the nation's largest physician staffing company with about 19,000 employed physicians and annual revenue of more than $4 billion. Leading up to the Blackstone announcement, TeamHealth management and its board spent more than a year trying to dig themselves out from under a pair of fateful merger decisions. (Barkholz, 10/31)

Los Angeles Times: The Tobacco Tax Campaign Has Reached $100 Million. But This Time Something's Different
Never before have tobacco companies spent so much trying to defeat a cigarette tax hike in California. The $71 million raised by opponents of this year’s Proposition 56, which would add a $2 per pack tax on cigarettes, to date tops the industry’s totals in 2006 and 2012, when R.J. Reynolds and Philip Morris successfully knocked down previous tobacco tax hikes at the ballot. But unlike those previous failed campaigns, proponents of this tobacco tax hike have done a lot more to match the industry’s dollars. (Dillon, 11/1)

In other news, a study finds that nearly one-third of all cancer deaths can be attributed to smoking —

The New York Times: A New Death Toll For Smoking
A new study has found that 28.6 percent of all cancer deaths in the United States are attributable to cigarette smoking. Researchers calculated the number using the relative risks for 12 smoking-related cancers, including acute myeloid leukemia, mouth cancers, and those of the esophagus, stomach and colon. (Bakalar, 10/31)

Reveal: Disabled And Disenfranchised: Families Fight To Restore Voting Rights 
Across the country, thousands of people with appointed guardians routinely lose the right to vote. More than 7,300 lost the right to vote due to “mental incompetence” between 2012 and 2014 alone, according to federal survey data collected from 33 states by the Election Assistance Commision. Ten states automatically ban anyone declared mentally incompetent from voting. Among them is Missouri, which restricted more voters than any other state, rescinding the rights of close to 2,000 people for mental incompetence in those election years. (Walter, 10/31)

The Baltimore Sun: Telemedicine Is Becoming More Widespread
Last year, more than 15 million Americans received some kind of virtual medical care, according to the American Telemedicine Association. The trade group expects the number to jump by 30 percent this year. Nearly three-quarters of large companies will offer telemedicine doctor visits as part of their health packages this year, an increase from 48 percent last year. In a nod to the large role telemedicine soon may play in health care, Johns Hopkins Medicine this summer created the first administrative position and office dedicated to the practice. Among the tasks of the new office is developing policies and guidelines around the use of telemedicine. (McDaniels, 10/31)

The Fiscal Times: Medical Identity Theft Is On The Rise: 7 Steps To Protect Yourself
One in five Americans says that they’ve been a victim of identity theft or attempted identity theft in the past year, and most of us are familiar by now with the steps to take if your identity has been compromised. The process is a hassle, but it typically takes just a few days and involves minimal financial losses, according to the Bureau of Justice Statistics. The consequences for one form of identity theft can be much more severe, though. Cases where thieves steal your Social Security number and health insurance info to fraudulently obtain medical services or treatment can be much more difficult to detect or resolve. (Braverman, 10/31)

The New York Times: Colombia Is Hit Hard By Zika, But Not By Microcephaly
This tropical city on the Caribbean coast may hold the answer to one of the deeper mysteries of the Zika epidemic: Why has the world’s second-largest outbreak, after Brazil’s, produced so few birth defects? In Brazil, more than 2,000 babies have been born with microcephaly, abnormally small heads and brain damage caused by the Zika virus. In Colombia, officials had predicted there might be as many as 700 such babies by the end of this year. There have been merely 47. (McNeil and Symmes Cobb, 10/31)

In other news on the virus —

Stat: In Mouse Study, Zika Damages Cells In Testes, Impedes Fertility
The Zika virus attacks cells in mouse testes crucial for sperm and sex hormone generation and hampers reproduction, according to new research that raises the possibility that the virus could affect fertility in men. There are major caveats to the research, which was published Monday in the journal Nature. The study was conducted in mice, and many findings from mouse studies do not hold up in people. The researchers also used a very powerful dose of Zika when infecting the mice. (Joseph, 10/31)

Stat: Raising 'Good' Cholesterol Doesn't Reduce Heart Attack Risk
“Good” cholesterol might be in for a name change. Raising HDL, widely known as good cholesterol, for years has been thought to protect against heart attack and stroke. But a big new study published Monday found little evidence it does. The finding upends the advice doctors have been giving millions of patients — and helps explain why the drug industry has failed time and again, despite billions in investment, to develop a drug that cuts deaths from heart disease by boosting HDL levels. (Garde, 10/31)

The New York Times: Americans Blame Obesity On Willpower, Despite Evidence It’s Genetic
Americans believe that obesity is the biggest health threat in the nation today — bigger even than cancer. But though scientific research shows that diet and exercise are insufficient solutions, a large majority say fat people should be able to summon the willpower to lose weight on their own. (Kolata, 11/1)

And, in other public health news —

The New York Times: Medical Charities Once Advised On Coping With A Disease. Now They Try To Cure It.
Like every mother who has a sick child, Katie Clapp remembers with painful clarity the moment 24 years ago when her doctor called to say that her young son, Andy, had Fragile X, an inherited disease that causes intellectual disability. Ms. Clapp did not give up on Andy, and within two years she helped establish a foundation that has spent decades and millions of dollars on research for a cure. At the time, that kind of response was rare. (Harris, 10/31)

The Washington Post: Feel Ashamed? Good For You!
In the past, many psychologists theorized that shame was maladaptive and served no useful function. Earlier this year, however, anthropologists from California, Israel and the Netherlands put a positive spin on the much-maligned emotion in a study published in the Proceedings of the National Academy of Sciences. Shame is a product of self-critique — we cannot feel shame without feeling guilty — and a consciousness of how others perceive our transgressions. For this reason, the anthropologists said, shame developed as a way of maintaining social order. (Ellis Nutt, 10/31)

Los Angeles Times: A Neuropsychiatrist Explains Why We Crave Fear
Each Halloween, we are reminded that we are a nation divided. Some of us think going to an amusement park and being chased by people dressed as zombies is a really fun way to spend a Saturday night. Others think that sounds like torture. So why do some people love to be scared, while others find it so frightening? (Netburn, 10/31)

Miami Herald: Another Reason To Put Down Your Phone — Especially When You’re Outside 
In addition to damage caused by direct and indirect sun, UV reflectance poses yet another serious threat to our skin—and most people are unaware of it. UV exposure is increased when rays are reflected off water, sand and even concrete (runners, take note). Any shiny surface can reflect UV rays, and this study in the Journal of the American Academy of Dermatology identifies yet another source of UV reflectance: Your cell phone. (Leslie Baumann, 10/31)

The Wall Street Journal: Heart Attacks Are Linked To Patients’ Activity Level, Emotional State
A large global study of more than 12,000 first-time heart-attack patients found a strong link between the attack and what the patients were doing and feeling in the hour preceding the event. The study, published in the journal Circulation, found that being angry or emotionally upset more than doubled the risk of suffering a heart attack. (Lukits, 10/31)

The New York Times: Facebook Could Be Associated With A Longer Life, Study Finds
As our social lives have moved onto social media sites like Facebook over the past decade, there’s been a lot of hand-wringing over what all that screen time might be doing to our health. But according to a new paper, time spent on social media could be associated with a longer life. (Bromwich, 10/31)

Los Angeles Times: Accepting More Facebook Friend Requests Is Linked To Lower Mortality, Study Says
Think online social networks have no bearing on your real life? Think again. Scientists who studied Facebook activity and mortality rates of registered California voters found that people who received many friend requests were far less likely to die over a two-year period than those who did not. Initiating friend requests, however, seemed to have no effect on death rates whatsoever. (Khan, 10/31)

The New York Times: Studies Linked To Soda Industry Mask Health Risks
Do studies show that soft drinks promote obesity and Type 2 diabetes? It depends on who paid for the study. Researchers from the University of California, San Francisco, looked at studies of soft drink consumption and its relationship to obesity and diabetes published between 2001 and 2016. They found about 60 studies that were fairly rigorous in their methodology. (O'Connor, 10/31)

Los Angeles Times: Does The Soda Industry Manipulate Research On Sugary Drinks' Health Effects?
One hundred percent. That is the probability that a published study that finds no link between sugar-sweetened beverage consumption and poorer metabolic health was underwritten by the makers of sugar-sweetened beverages, or authored by researchers with financial ties to that industry. (Healy, 10/31)

The Washington Post: Children’s Sleeplessness May Be Linked To Bedtime Use Of Electronic Gadgets
If you shrugged off the new screentime guidelines issued by the American Academy of Pediatrics earlier this month, you may want to grab your kid's tablet back for a second and reevaluate your position. An analysis published Monday in JAMA Pediatrics of data from 26,000 children provides the strongest evidence yet of a link between bedtime use of electronic devices and poor sleep, inadequate sleep and excessive daytime sleepiness. (Cha, 10/31)

Los Angeles Times: Mobile Devices In The Bedroom Rob Kids Of Sleep, Study Says
Good night, sleep tight, and don’t look into that tablet light. Dads and moms who are concerned about the quantity and quality of their children’s sleep should keep mobile devices like phones, tablets and laptops out of kids’ bedrooms, according to a new study published Monday in JAMA Pediatrics. (Netburn, 10/31)

Kaiser Health News: Premature Births Rise Slightly, First Uptick In 8 Years, March Of Dimes Reports
The number of preterm births in the United States rose in 2015 for the first time in eight years, according to data presented Tuesday by the March of Dimes. The organization also reported that racial minorities continue to experience early labor at higher rates. Preterm births increased from 9.57 to 9.63 percent in 2015, which represents an additional 2,000 babies born prematurely in the U.S., the report found. (Heredia Rodriguez, 11/1)

Reuters: Cancer Survivors Take More Psych Meds Than Other People
People who live through a bout with cancer are more likely than others to use drugs for anxiety and depression, a study suggests. About 19 percent of adult cancer survivors take drugs for depression, anxiety or both, compared with roughly 10 percent of other adults, the study found. (10/31)

The Washington Post: Opioid Pills ‘Are Like Guns': More Than 13,000 Children Were Poisoned During Six-Year Period
Graphic images of a mom and dad passed out, mouths agape, in a car with their 4-year-old still strapped into the back seat. A video of a woman lying in a grocery store aisle as a toddler in pink pajamas cries and shakes her. The police report of a 7-year-old who told her bus driver on the way back from school that she couldn’t wake her parents. Such stories, circulated on social media in recent months, have highlighted the toll of the epidemic of opioid abuse on the youngest Americans. They have become a rallying cry for pediatricians calling for better psychological counseling and other supports to better protect the children of addicts. (Cha, 10/31)

Kaiser Health News: Study: ‘Ubiquitous’ Nature Of Painkillers Lands Kids — Even Toddlers — In The ER
As the nation continues to confront an epidemic of opioid and prescription painkiller addiction and overdoses, its victims seem to flood emergency rooms. But a study out Monday highlights a surprising group of patients suffering from opioid poisoning at rates that have also marked a dramatic increase: adolescents, children and even toddlers. (Luthra, 11/1)

Stat: Toddlers' Hospitalizations For Opioid Poisoning Triple In Recent Decades
Easy access to opioids has harmed even society’s youngest members: The number of children and teenagers hospitalized for painkiller poisoning has doubled in recent decades, according to a study published Monday. ... Researchers examined a database of hospitalization data on children, aptly named KID — Kids’ Inpatient Database — that now covers 44 different states. Using ICD-9 codes, which describe the reason the patient is in the hospital, researchers were able to identify the number of opioid poisonings. They split the data up into age groups and calculated how the hospitalization rates changed over time. (Swetlitz, 10/31)

The CT Mirror: Study: Opioid Hospitalizations For Kids Nearly Doubled In 15 Years 
Hospitalization for prescription opioid poisoning among U.S. children and teens nearly doubled during a recent 15-year period, and grew especially dramatically among children under 4, according to a study published Monday in the journal JAMA Pediatrics. Using a database of millions of hospital discharges, the researchers estimated that 2,918 patients aged 1 to 19 were hospitalized for prescription opioid poisonings in 2012, up from 1,049 in 1997. Most hospitalizations occurred among teens 15 to 19. (Levin Becker, 10/31)

In other news on the crisis —

Stateline: States Move To Encourage More Addiction Counseling
To encourage the centers to offer more counseling when patients need it, Maryland’s Medicaid agency is changing the way it reimburses them. Rather than paying a flat rate for all patients, the federal-state health care program for the poor in March will begin to pay providers for as much counseling and related medical services as are needed for individual patients. At the same time, the state will lower its traditional per-person weekly reimbursement rate for opioid treatment centers. The new fee structure is similar to schemes developed in New York and California. New Jersey is moving in the same direction. The shift reflects a growing consensus among medical researchers that patients who receive a combination of addiction medication and counseling fare better than those who receive only one or the other. (Vestal, 11/1)

Stat: Opioid Users Flock To A Safe Place Where They Are Monitored
One of those new ways [to help addicts] is SPOT, which opened in Boston earlier this year to give drug users a safe place to go when they’re high. A nurse monitors users for signs of an overdose, and the facility also connects people to rehab programs. In less than six months, SPOT has been visited more than 1,500 times by 275 different people, including several friends [Tommy] Blais brought in because they seemed overly sedated. Not a single user has fatally overdosed, and many have come back repeatedly. (Bond, 11/1)

Los Angeles Times: Women In California Can Legally Get Birth Control Without A Prescription. But For Many, It's A Struggle
For many women in California, a new law that was supposed to make getting birth control easier has been a little disappointing. Under the law, women should be able to go to a pharmacy without a doctor’s prescription and pick up hormonal contraception, including pills and patches. Although the legislation was passed in 2013, women still struggle to find pharmacists who will dole out the medicines. (Karlamangla, 10/31)

Tampa Bay Times: Florida Supreme Court To Hear Arguments Over Abortion Waiting Period Law
Justices on the Florida Supreme Court will this morning hear arguments about whether a state law requiring women to see a doctor 24 hours before having an abortion should continue to be blocked by court order -- as it has for most of the last year and a half -- or should go into effect. The law, signed by Gov. Rick Scott in June 2015, was challenged in a lawsuit by abortion-rights activists and a Gainesville clinic, who argue that it creates an undue burden on abortion access and violates the state Constitution. (Auslen, 11/1)

The New York Times: For Melinda Gates, Birth Control Is Women’s Way Out Of Poverty
Melinda Gates has made providing poor women in developing countries access to contraception a mission. The Bill & Melinda Gates Foundation, which she leads with her husband, has donated more than $1 billion for family planning efforts and will spend about $180 million more this year. Since 2012, she has helped lead an international campaign to get birth control to 120 million more women by 2020. (Dugger, 11/1)

Iowa Public Radio: Iowa Paying An Additional $33 Million For Medicaid Management
The State of Iowa is increasing the amount of money it pays to the three private companies managing Iowa’s Medicaid system by $33.2 million. Gov. Terry Branstad says the increase is largely due to pharmaceutical costs, which are higher than anticipated since April when the state privatized its Medicaid system. ... Despite the additional payments, the governor insists Iowa will still reap the $110 million in savings projected by state actuaries. Branstad says that’s because the money Iowa is saving by privatizing Medicaid is also higher than expected, so the state can afford to increase contract rates to the Managed Care Organizations. (Boden, 10/31)

Des Moines Register: Branstad Pumps $33 Million More Into Medicaid Privatization
Senate Democrats, who strongly opposed the shift of government-managed Medicaid health care to a privately managed program, were sharply critical of the Republican governor. Medicaid is one of the state's most expensive government programs, serving about 560,000 low-income and disabled people at an annual cost of more than $4 billion. “Many correctly predicted Governor Branstad’s hasty handover of the state’s Medicaid health care system to for-profit, out-of-state companies would not be in the best interests of Iowans,” state Sen. Amanda Ragan, D-Mason City, co-chair of the the Iowa Legislature's health care policy oversight committee, said in a statement. “So far, Medicaid privatization has been a nightmare for hundreds of thousands of elderly and disabled Iowans and their families, as well as for thousands of local health care providers." (Petroski and Leys, 10/31)

Providence Journal: Medicaid Enrollment Surging In R.I.
Public spending on medical benefits in Rhode Island is on track to run $72 million higher than budget writers predicted earlier this year as Ocean State Medicaid enrollment continues to surge, according to projections released Monday by the Executive Office of Health and Human Services. The majority of the spending is covered by the federal government, with the state's share now estimated to come in at $9.5 million more than the budget approved by lawmakers in June, according to figures presented to the twice-annual state Revenue and Caseload Estimating Conference. (Anderson, 10/31)

Nashville Tennessean: Primary Care Doctors Sue CMS Over Medicaid Recoupments
A group of physicians from around the state is suing federal health officials over a regulation that requires the doctors to repay some Medicaid reimbursements. Twenty-one primary care doctors are challenging how the U.S. Centers for Medicare and Medicaid Services interprets a federal law, the Medicaid Enhanced Payment Statute, in a lawsuit filed today in the U.S. District Court of the Middle District of Tennessee. (Fletcher, 10/31)

Austin Statesman: Fewer Children With Disabilities Received Services Amid Funding Cuts
Fewer babies and toddlers born with disabilities are receiving critical services after the state slashed $18 million in funding for such programs since 2011, according to a new report by child advocacy group Texans Care for Children. Over four years, the number of disabled children under 3 years old who receive early childhood intervention services dropped by 14 percent to 50,634 children in 2015, the Austin-based group said in the report released Tuesday. The drop has occurred even though the state’s population of children under the age of 3 has grown by 2 percent during the same period. (Chang, 11/1)

Georgia Health News: ‘Health Literacy’ Can Be A Life-Or-Death Matter
According to Georgia’s Task Force on Adult Literacy, one out of three adult Georgians is functionally illiterate.  In the Augusta area alone, there are more than 65,000 adults whose basic educational levels may be less than those of the average eighth-grader, according to Augusta University’s Literacy Center. Without a clear understanding of their health condition, these adults are more likely to skip necessary medical tests and have a harder time with diabetes management or high blood pressure numbers. (Kanne 10/31)

Boston Globe: Southcoast To Pull Physicians From Tufts Network 
Southcoast Health System is planning to cut its ties with Tufts Medical Center’s physician network and launch its own independent doctors group. The New Bedford-based health system filed plans with the state to leave the Tufts network at the end of the year. The change, which applies to about 425 doctors, comes after Southcoast abandoned merger talks with Care New England Health System of Providence. (Dayal McCluskey, 10/31)

Chicago Tribune: Zombies Would Rule Chicago In 60 Days, A Real Disease-Tracking Computer Says 
Chicago would be overtaken by a zombie invasion in 60 days. That’s according to a team of scientists at Argonne National Laboratory, who came to the conclusion using a high-powered computer model that’s normally used for much more serious work on infectious diseases. “The people of Chicago could suffer dire consequences at the hands of a zombie invasion,” said Chick Macal, a senior systems engineer in Argonne’s Global Security Sciences Division. “No part of the city would be spared.” While the scenario is obviously fictional, Macal and his colleagues on the Argonne Infectious Disease Modeling Team calculated the timeline by running the numbers through an intricately designed system that was originally created to analyze the spread of real diseases. (Meyerson, 10/31)

San Jose Mercury News: Safeway Teams Up With Weight Loss Clinic Inside 5 Bay Area Stores
Could a trip to the grocery store help you lose weight? A unique partnership between five Bay Area Safeway stores and a longtime Southern California medical weight loss firm is giving it a try. The Pleasanton-based supermarket chain is doing what some weight-challenged consumers might call the unthinkable: leasing space to Lean for Life by Lindora Clinic adjacent to in-store pharmacies at Safeways in San Jose, Menlo Park, Danville, Dublin and Livermore. (Seipel, 10/31)

Orlando Sentinel/Tampa Bay Tribune: State To Sanford Burnham: Give $77.6 Million Back
State officials are demanding that Sanford Burnham Prebys return $77.6 million in state taxpayer money it received as part of a 2006 deal, the latest development in the downward spiral of a project meant to bring high-paying biotech jobs to Orlando. Sanford Burnham is in breach of its contract with the state and must return the funds within two weeks or face legal action, state officials wrote in a letter sent Friday. (Rohrer, Miller and Shanklin, 10/31)

WSBTV: Testing Underway After Schools' Water Tests Positive For Lead 
Additional testing is underway after 4 out of 5 DeKalb County schools tested positive for the presence of lead in its drinking water... The schools are taking action to keep kids safe by shutting off the water to the fountains where the water tested positive for lead. (Washington, 10/31)

Georgia Health News: Medical School Seeking To Expand Ga. Footprint To Underserved Area 
The Philadelphia College of Osteopathic Medicine, which already has a campus in suburban Atlanta, is moving to develop another med school location in Georgia. PCOM has signed an agreement with Colquitt Regional Medical Center in Moultrie, in southwest Georgia, to produce a feasibility plan and present it to an accreditation committee for osteopathic colleges. The agreement was announced Monday. (Miller, 10/31)

Denver Post: Howard Dental Center Provides Life-Changing Dental Work To Patients With HIV Or AIDS 
Staff from the center say the stigma still exists and patients often arrive at the center after being turned away from other dental offices. Some patients travel up to four hours to reach Howard Dental Center on Cherry Creek Drive. Others haven’t had dental care in two years. One side effect of HIV/AIDS medication is dry mouth, which can lead to cavities and periodontal disease. Dental ailments can exacerbate pre-existing medical problems or create new ones, so the center aims to address health issues by working with other clinics. (Siegelbaum, 10/31)

Boston Globe: Protesters Demonstrate At Controversial Canton Center For Troubled Youth
More than 100 demonstrators gathered Monday afternoon in front of a controversial school to demand that it stop administering skin shock treatments to special needs students. The protesters converged on the Judge Rotenberg Educational Center shortly after 3:30 p.m., organizers said. (Anderson, 10/31)

San Jose Mercury News: Hayward Man Who Blew Himself Up At Oakland Clinic Identified 
A wheelchair-bound man who blew himself up with a pipe bomb two weeks ago at an East Oakland health clinic was identified by authorities Monday as Ralph Mark Harris, 60, of Hayward. The Alameda County Coroner’s Office said they had no occupation listed for Harris. The case is being investigated as a suicide but has not yet been officially classified, officials said. (Harris, 10/31)

Miami Herald: Teaching Children Why Grandma Can’t Recall Their Name 
Being 10 minutes late to work saved Kent Karosen’s life 16 years ago [on Sept. 11, 2001]. Since then, [he] has dedicated a good part of his life to helping the families of his co-workers and other groups, including an Alzheimer’s research center. Karosen, 51, who now lives in Miami Beach, co-wrote a children’s book, “Why Can’t Grandma Remember My Name?” that explores the heartbreak that can happen to a family when confronted with Alzheimer’s, a neurological condition that affects 5.4 million Americans, a number that is expected to nearly triple by 2050, according to the Alzheimer’s Association. He co-wrote the book with children’s book writer Chana Stiefel. (Figueroa, 10/31)

RealClear Health: Why Are We In So Much Pain?
There are more than 100 million people in chronic pain in the United States. The rate of providing healing is hardly successful. Microglia, the ever-vigilant guardian cells of the central nervous system (CNS), are now providing a clue as to why some of us stay sick and fail to recover. Microglia are thin, thread-like immune cells responsible for collecting debris and pathogens in the brain. They become active in response to any number of stressors on the body, and when properly regulated, secrete inflammatory chemicals that allow for harmful bacteria to be killed, and for healing to occur. (Gary Kaplan, 10/31)

Stat: In Defense Of Data Sharing, But Done In The Right Way
Someday, researchers doing a cardiovascular trial could easily share their data with others conducting trials on cancer, kidney disease, or even schizophrenia and learn something that hadn’t been known before. These insights may help us design clinically informative trials that are not being misled by false relationships among the data. The problem is that we are in the early stage of the data-sharing process and there are not many examples of insights that have evolved from it. (Jeffrey Drazen and Isaac Kohane, 10/31)

The Columbus Dispatch: EMS Mergers Make Sense
Local governments — that is to say, local taxpayers — need to stretch every dollar these days, yet redundant services and duplicate costs continue to burden central Ohioans through overlapping city, county and township fire and emergency medical services. Until now, it’s been hard to pin down the cost of multiple emergency-medical services. But this past week, a Delaware County commissioner released an analysis that showed merging the region’s six independent EMS operations — five operated by townships and one by the city — with the existing county-run EMS would save taxpayers at least $17 million. (11/1)

Kansas City Star: Medical Theater: The NFL Hopes You Trust Its Inadequate Concussion Test 
The NFL, in its own protocol, says that athletes with concussions can pass the tests partly because, by definition, the in-game testing is brief. To put it as plainly as possible: Doctors using this test to determine whether a man has a concussion cannot know whether that man has a concussion. But off he goes anyway, back into the violent chaos of an NFL game, his potentially damaged brain made more vulnerable to what has been scientifically shown to be exponentially worse damage. (Sam Mellinger, 10/31)

WBUR: British Vs. American Health Care, Through One Trainee Doctor's Eyes 
I spent my school years and college in Massachusetts and attended medical school in Poland, the country of my parents. But I trained as a doctor in England. I completed the British equivalent of medical residency in internal medicine in London, and lived there until I came to Boston in August. I returned home to view the provision of health care in the United States through Earl Grey-tinted glasses that make some aspects of our system particularly shocking and others particularly impressive. (Martin Kaminski, 10/31)

Arizona Republic: Colorado Officials Politely Ask Arizona's Anti-Marijuana Group To Stop Lying
According to the Campaign to Regulate Marijuana Like Alcohol, a group of elected officials from Colorado has sent a letter to the leaders of the anti-Proposition 205 group disputing the information (or misinformation) touted in the anti-marijuana campaign of Arizonans for Responsible Drug Policy. The letter was sent to Seth Leibsohn and Sheila Polk, leaders of Arizonans for Responsible Drug Policy, by Colorado Sen. Pat Steadman and Reps. Millie Hamner and Jonathan Singer. I'll let you read it and decide. (EJ Montini, 10/31)

The New York Times: The Impact Of Obamacare, In Four Maps
Three years into the Affordable Care Act, there remain places where many people still lack health insurance. But their share keeps shrinking. (Margot Sanger-Katz and Quoctrung Bui, 10/31)

Los Angeles Times: Inside Those Big Obamacare Rate Increases: State Hostility To The Law Costs Residents Plenty
In all the knee-jerk hand-wringing over the announced rate increases for Affordable Care Act exchange insurance (sorry for the mixed metaphor, but it’s apt), one factor in the increases has been consistently overlooked. On average, states that have been hostile to Obamacare are facing the largest premium increases for 2017. Residents in states that have embraced the law will do much better. (Michael Hiltzik, 10/31)

Chicago Tribune: Will Americans Vexed By Obamacare's Broken Promises Sign Up Or Stay Away? 
Whatever the outcome of the election, at minimum, Obamacare requires major surgery. Insurers won't stick around to lose hundreds of millions of dollars. Customers won't renew if prices soar even more. This is a crisis moment. Democrats and Republicans will either overhaul the law or watch millions of Americans lose coverage. Pols who fail will be betting — hoping — that voters blame ... the other party. That's shortsighted and dangerous. ... But our concern transcends the political repercussions. Remember all those hopeful millions of Americans who applauded Obamacare? They — and their children — still need excellent coverage at affordable prices. They don't need any more empty promises from Washington. (10/31)

(Raleigh, N.C.) News & Observer: ACA Increases Are Deceptive And Not The End
[T]he gleeful gloating of people such as Republican presidential nominee Donald Trump, that this is the end of “Obamacare,” that it is a failure, is simply wrong. Most of the people who’ll see the premium increases won’t feel them much, because they get government subsidies to help them get their insurance. And is the ACA a failure for people whose lives may have been saved because they’ve had health insurance for the first time in their lives and can now afford to see a doctor regularly rather than rely on care in hospital emergency rooms? Is it a failure for those who have insurance even though they have medical problems that would have caused them to be denied at private companies? Is it a failure for those young people who were able, under the ACA, to stay on their parents’ policies until the age of 26? The ACA is not a failure, no matter how badly Republicans want it to fail. (10/31)

Sacramento Bee: Where You Live Matters More Than Obamacare To Your Health 
The recent announcement that insurance premiums will be going up for people who buy their health coverage through Obamacare has put the program back in the news, with Republicans from Donald Trump on down calling for its repeal and Democrats saying its problems can be easily fixed. But the issue that neither side ever wants to talk about is that the Affordable Care Act, whether it survives or not, will have little effect on the health of most Americans. (Daniel Weintraub, 10/31)

Kansas Health Institute: Analysis: Selzer Put People Before Politics To Help ACA Insurance Purchasers 
Some Kansans will face the sticker shock of big premium hikes, but their premium increases will be lower than those for some nearby states. And, thanks to Kansas Insurance Commissioner Ken Selzer, they will have choices that they otherwise would not have. Like every candidate in the five-way Republican primary race for insurance commissioner in 2014, Selzer made opposition to the ACA, commonly called “Obamacare,” part of his campaign. But once elected to work on behalf of Kansas insurance consumers within the confines of the federal system, Selzer put practicality ahead of politics by recruiting a new insurer, Medica, into the Kansas ACA marketplace for 2017. Selzer worked for months to get Medica and another insurer, Coventry Health and Life (a subsidiary of Aetna), to join the exchange. (Andy Marso, 10/31)