The Hill: President Trump Advocates For Direct Health Care Payments, Slams Insurance Companies
President Trump on Tuesday said amid rising health care premiums he would only consider approving legislation that provides a pathway for direct health care payments. “THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH,” Trump wrote in a statement on Truth Social. (Fields, 11/18)

Politico: Who Is The Democrat Talking With Trump On Health Policy? 
President Donald Trump said he’s talking to Democrats on health care. No Democrat will cop to it. POLITICO reached out to two dozen House and Senate offices and none would acknowledge they are in contact with the White House on health care. “Lol no,” replied one Senate Democratic spokesperson, when asked if the president had reached out. (Gangitano, 11/19)

Politico: House GOP Leaders Pitch Members On Addressing ‘Unaffordable Care Act’
House Republican leaders delivered a presentation to members Tuesday morning slamming the enhanced tax credits for the Affordable Care Act that are due to expire at the end of the year. It comes as members of both parties and chambers are rushing to develop, and pass, legislation to lower health care costs by Dec. 31, when the Obamacare subsidies will expire and premiums are set to go through the roof. (Lee Hill and Guggenheim, 11/18)

Modern Healthcare: Why ACA Subsidy Extension Hopes Are Dimming After The Shutdown
The government shutdown is gone, and so is much of the leverage Democrats had to pressure Republicans to extend enhanced subsidies for health insurance exchange plans. While the seven Democrats and one allied independent who sided with the Republican majority to fund the government through Jan. 30 secured a promise from Senate Majority Leader John Thune (R-S.D.) to vote on the subsidies before year-end, too few GOP lawmakers have publicly come on board for a straight extension to pass. (McAuliff, 11/18)

More on the high cost of health care —

Fierce Healthcare: Employers Brace For 6.7% Health Benefits Cost Increase: Mercer
Employers expect to see health benefits rise by 6.7% in 2026, reaching more than $18,500 per employee on average, according to a new report. Analysts at Mercer estimate that health costs in 2025 reached an average of $17,496 for each employee, growth of 6%. That's a rate that outpaced inflation and wage growth, according to the report. (Minemyer, 11/18)

Axios: Nearly Half Of Americans Worry They Can't Afford Health Care: Survey
Almost half U.S. adults are worried they won't be able to afford needed health care in the coming year, according to a West Health-Gallup survey — the highest level recorded since the organizations began tracking the measure in 2021. (Bettelheim, 11/18)

KFF Health News: Listen To The Latest 'KFF Health News Minute'
Jackie Fortiér reads the week’s news: You have until Jan. 15 to pick an Affordable Care Act health plan for next year, and the Trump administration is taking aim at state laws that protect consumers’ credit scores from medical debt. (Cook, 11/18)

The Washington Post: Trump’s HIV Drug Plan Shuts Out South Africa, The Nation Most Affected 
Amid steep cuts to U.S. foreign assistance, the Trump administration is touting a new plan to provide a powerful HIV prevention drug to countries most affected by the disease in an ambitious push to end the spread of the virus that causes AIDS. But the program, which saw the first donated doses of lenacapavir delivered to Eswatini and Zambia last week, is already facing criticism from patient advocacy groups because the Trump administration refuses to provide the lifesaving antiretroviral medication free to South Africa, the country with the world’s largest HIV-positive population. Critics say the move appears politically motivated. (Taylor, 11/17)

More health news from the federal government —

The New York Times: ICE Frees Blind Migrant Who Was Detained For Days In Isolation 
Carlos Anibal Chalco Chango, 40, was released on Monday from an upstate New York jail where he had been held without his cane. It was a surprising move by an agency that rarely frees detainees. (Weiser and Ferre-Sadurni, 11/18)

Disability Scoop: Ed Department Sheds Several Offices, But Spares Special Education 
The Education Department said this week that it is entering into six so-called “interagency agreements” with four other federal agencies to “co-manage” programs related to K-12 education, postsecondary education and more. Notably, however, the Office of Special Education and Rehabilitative Services, or OSERS — which houses offices overseeing implementation of the Individuals with Disabilities Education Act and vocational rehabilitation — is not included. Neither is the Education Department’s Office for Civil Rights, or OCR, which handles disability discrimination complaints. (Diament, 11/19)

The Washington Post: Trump Officials Give $1 Billion Loan To Restart Three Mile Island
Amid rising energy demands, the taxpayer-backed loan will go toward the unprecedented effort to reopen a mothballed U.S. nuclear plant that suffered a partial meltdown decades ago. (Halper, 11/17)

AP: SNAP Benefits Are Flowing, But Work Requirements Are About To Begin
After a disruptive U.S. government shutdown, federal SNAP food assistance is again flowing to low-income households. But in the months ahead, many participants will have to abide by new work requirements. The Supplemental Nutrition Assistance Program provides monthly benefits — averaging around $190 per person — to about 42 million people nationwide. During the first couple weeks of November, many of those recipients missed their regular allotments as President Donald Trump’s administration battled in court over whether tap into reserves to fund the program while the government was shut down. (Lieb and Mulvihill, 11/19)

Military.com: Bill Would Force VA To Reveal Secret List Of Toxic Exposure Illnesses 
Lawmakers want the Department of Veterans Affairs (VA) to stop keeping veterans in the dark about which toxic exposure illnesses the federal agency is quietly studying behind closed doors. U.S. Senate Veterans’ Affairs Committee Ranking Member Richard Blumenthal (D-CT) introduced the Presumptive Clear Legal Assessment and Review of Illnesses from Toxic Exposure Yields (CLARITY) Act in early November. If passed it would require the VA to establish a public website to educate veterans exposed to toxins on processes the agency uses to determine which conditions are correlated with military toxic exposures. (Radzius, 11/17)

USA Today: RFK, Jr. Links Peanut Allergies To Aluminum In Vaccines, Pesticides
The Health Secretary pointed to his own experience with food allergies and why he thinks early exposure in childhood isn't the answer. (Rodriguez, 11/18)

Stat: RFK Jr.'s Thimerosal Warning Sparks Global Vaccine Concerns 
Earlier this month, health secretary Robert F. Kennedy Jr., a longtime vaccine critic, urged countries around the world to follow the lead of the United States and disallow the use of the preservative thimerosal in vaccines. (Branswell, 11/19) 

The Wall Street Journal: RFK Jr. Adviser To Rejoin Administration, Bridging MAHA-MAGA Divide
Calley Means, a confidant to Health Secretary Robert F. Kennedy Jr., is taking a permanent post in the Trump administration, where he is expected to serve as a bridge between the Make America Healthy Again movement and President Trump’s broader MAGA coalition. Means, who earlier this year served in a temporary role at the White House, has been tapped to be a senior adviser in the Department of Health and Human Services, charged with helping to ensure the success of the MAHA movement’s policy goals, according to people familiar with the matter. (Essley Whyte, 11/18)

In related news about covid and flu vaccines —

Stat: After Vaccine Skeptics Took Control, Covid Lawsuits Quickly Followed 
A wave of Covid pandemic-era lawsuits that previously faced steep odds of success are gaining momentum under the Trump administration. (Cueto, 11/19)

Military.com: Military Veterans Who Refused COVID Vaccine Now Eligible For GI Bill Benefits
Approximately 900 veterans who were discharged from service during the previous Biden administration for refusal to take the COVID vaccine are now eligible for GI Bill education benefits, with potentially thousands more getting the same opportunity. In January, President Donald Trump signed Executive Order 14184, "Reinstating Service Members Discharged Under the Military’s COVID-19 Vaccination Mandate," which called for a reversal of pandemic-era mandates put into effect Aug. 24, 2021, by former Secretary of State Lloyd Austin. (Mordowanec, 11/18)

KFF Health News: A Small Texas Think Tank Cultivated Covid Dissidents. Now They’re Running US Health Policy
Martin Kulldorff, chair of the Trump administration’s reconstituted CDC vaccine panel, made a shocking — and misleading — statement as the group met in September. Referring to a clinical trial, Kulldorff, a biostatistician and former professor at Harvard Medical School, said eight babies born to women who received Pfizer’s covid vaccine while pregnant had birth defects, compared with two born to unvaccinated women. “It is very concerning to have a fourfold excess risk of birth defects in these pregnant women,” Kulldorff then said. (Pradhan, 11/19)

The 19th: Most Americans Have High Confidence In Childhood Vaccines, But There's A Catch
Although a majority of Americans are confident that childhood vaccines are highly effective against serious illness, Republicans’ trust in vaccine safety and support of school requirements is dropping, according to new polling from Pew Research Center. (Rodriguez, 11/18)

CNN: A New Flu Virus Variant And Lagging Vaccinations May Mean The US Is In For A Severe Season 
The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan. (Goodman, 11/18)

AP: South Carolina Bill To Jail Women For Abortions Stalls In Subcommittee
A South Carolina bill that would allow judges to sentence women who get abortions to decades in prison and could restrict the use of IUDs and in vitro fertilization has stalled after failing to get out a legislative subcommittee Tuesday. Four of the six Republicans on the subcommittee refused to vote on the bill, which would ban all abortions unless the woman’s life is threatened. The three Democrats were then able to vote against sending the bill forward. The proposal is not dead, but the effort did reveal a lack of support for the most extreme positions among groups opposing abortions. (Collins, 11/18)

ProPublica: “Ticking Time Bomb”: A Pregnant Mother Kept Getting Sicker. She Died After She Couldn’t Get an Abortion in Texas.
ProPublica has found multiple cases of women with underlying health conditions who died when they couldn’t access abortions. Tierra Walker, a 37-year-old mother, was told by doctors there was no emergency before preeclampsia killed her. (Surana and Presser, 11/19)

Post-Tribune: Dolton Woman Turned Away By Crown Point Hospital While In Labor Speaks Out
As she was told to leave Franciscan Health Crown Point and had to give birth in her car, Mercedes Wells said she felt less than human. Now, she wants the hospital staff to be held accountable for their actions. (Wilkins, 11/18)

More health news from across the U.S. —

New Hampshire Bulletin: Despite Safety And Liability Concerns, Lawmakers Push To Deregulate NH Meat Processing
A proposal to deregulate New Hampshire’s meat market could defy federal food safety laws and carry risks for farmers and consumers, lawmakers acknowledge. But members of the House Environment and Agriculture Committee voted to support it anyway, saying those risks are acceptable if the move helps alleviate a statewide slaughterhouse bottleneck taking a toll on smaller farms. (Rains, 11/18)

AP: Florida Takes Early Steps To Advance Recreational Marijuana Question To 2026 Ballot
Florida elections officials have taken early steps under pressure from activists to advance a proposed initiative to legalize recreational marijuana to next year’s ballot, legal filings show. The procedural move comes after the campaign behind the issue, Smart & Safe Florida, filed a complaint with the Florida Supreme Court, alleging that officials in Republican Gov. Ron DeSantis’ administration were trying to improperly block the measure from getting on the ballot in 2026. (Payne, 11/18)

The New York Times: Hochul Urged To Ban Horseshoe Crab Fishing
Conservationists are pressing Gov. Kathy Hochul of New York to approve a ban on the harvesting of horseshoe crabs in state waters after she vetoed the same measure a year ago. ... New York’s version would also prevent the state’s fishing industry from taking the creatures for their blood, which is used by the pharmaceutical industry in testing for toxins in medical products including vaccines. Although New York does not issue permits for the so-called biomedical catch, the bill’s supporters say that some in the fishing industry illegally “rent out” captured crabs for bleeding and then kill them for bait. (Hurdle, 11/15)

North Carolina Health News: Psych Commitment Process Under Scrutiny After Iryna’s Law 
North Carolina lawmakers are now taking a closer look at how people with mental health issues can be involuntarily committed for treatment in the wake of a new law they passed — in September. (Knopf, 11/18)

North Carolina Health News: Police Embrace Social Workers To Help Field Rising Calls Tied To Social Issues
Chris Hatton oversees a 15-officer police force in a small western North Carolina town in Jackson County — a place where he says many calls to 911 aren’t really police matters at all. A “suspicious” person loitering. Someone yelling in the street. A person rummaging through a dumpster. Someone in a mental health crisis threatening self-harm. (Crumpler, 11/19)

KFF Health News: A Hidden Health Crisis Following Natural Disasters: Mold Growth In Homes
After returning from what felt like the best internship of her life, Danae Daniels was excited to unwind and settle into a new semester at Florida Agricultural and Mechanical University. But when she opened the door to her off-campus apartment, she was met with an overwhelming smell — and a devastating reality. “There was mold in my bedroom, on my bed, mold in my expensive purse,” Daniels said. “Mold in my closet, my bathroom — literally everywhere.” (Charles, 11/19)

Seeking Alpha: UnitedHealth Adds Ex-FDA Chief Scott Gottlieb To Board  
UnitedHealth Group announced on Tuesday that Scott Gottlieb, a former commissioner of the U.S. Food and Drug Administration, is joining its board of directors effective immediately, marking CEO Stephen Hemsley’s latest effort to turn around the managed care giant. (Lokuwithana, 11/18)

Modern Healthcare: Humana, Epic Expand Collaboration For Medicare Advantage Members
Epic Systems is expanding a collaboration with Humana as it looks to deepen its relationship with large insurers. The electronic health record company and the insurer said Tuesday they have made a feature that makes automatic verification for Humana’s Medicare Advantage members more widely available. When Humana’s Medicare Advantage members check in to see a doctor, their coverage details and digital insurance cards are automatically uploaded into the electronic health record system. (Perna, 11/18)

Chicago Tribune: Chicago-Based Oak Street Health To Lay Off 219 Workers
Chicago-based Oak Street Health is laying off 219 people early next year as its owner, CVS Health, restructures parts of the business and closes health centers across the country. (Schencker, 11/18)

Minnesota Public Radio: UCare Closing, Moving Health Insurance Plans To Medica 
One of Minnesota’s largest health insurers is shutting down at the start of next year. Minnesota-based UCare announced the move in a statement issued Monday. According to officials with the nonprofit, its health insurance plans for more than 300,000 members across Minnesota and western Wisconsin will be transferred to Medica, another large nonprofit health insurer based in Minnesota. (Timar-Wilcox, 11/18)

St. Louis Post-Dispatch: St. Louis Children's Hospital Eyes Wentzville For New Center
BJC Health, the region's largest medical group, has announced plans for a new outpatient pediatric specialty care center in Wentzville. The move makes BJC Health the latest health care provider to announce a major investment in Wentzville, a growing city of about 49,000 people on the western edge of the region. (Suntrup, 11/18)

Becker's Hospital Review: 4 Notes On Where Hospital Supply Costs Stand Heading Into 2026
As 2026 approaches, healthcare tariffs are pushing costs higher, with providers and premiums feeling the squeeze, and little sign of relief in sight. Here are four notes on where hospital supply costs stand: 1. A Vizient report from July found medical supply chain costs are expected to increase 2.41% in 2026, up from the predicted 2.3% in January. IT services, capital equipment and surgical supply costs were pointed to as change drivers. (Ashley, 11/18)

MedPage Today: The Residency Match -- Reimagined
The residency match has long been a source of stress for newly minted doctors and medical schools alike, but the American Academy of Family Physicians (AAFP) is launching a new initiative that its leaders hope will change all that. "What we really aim to do is increase the primary care workforce to improve the health of the U.S.," Karen Mitchell, MD, vice president of national residency and academic partnerships at AAFP, said in a phone interview at which a public relations person was present. (Frieden, 11/18)

Also —

AP: Michael Jordan Donates $10M To Honor His Mother At NC Medical Center
Michael Jordan is giving $10 million to a North Carolina regional medical center in honor of his mother. The six-time NBA champ and now businessman announced the gift to Novant Health New Hanover Regional Medical Center in Wilmington on Tuesday. With the donation, the medical center will name its neuroscience institute after Deloris Jordan. (11/18)

CIDRAP: New Test Promises Faster, More Accurate Lyme Disease Diagnosis, Researchers Say
Researchers at Dartmouth Hitchcock Medical Center have developed a way to detect Lyme disease more rapidly and reliably than current testing methods. The team presented the new molecular test late last week at the Association for Molecular Pathology 2025 Annual Meeting & Expo. The project originated with a patient whose antibody tests showed evidence of previous, but not current, Lyme infection (existing serologic tests cannot distinguish between active and past infection). (Bergeson, 11/18)

In other pharma and tech developments —

Stat: Novo Nordisk Testing Its Blockbuster GLP-1 Drugs In Alzheimer's
Within the next two weeks, Novo Nordisk is expected to announce the results of perhaps the most ambitious studies yet of its blockbuster GLP-1 drug semaglutide — whether the medicine can help slow the progression of Alzheimer’s disease. (Chen, 11/19)

Bloomberg: Pfizer Raises $6 Billion In Bond Sale For Metsera Deal
Pfizer Inc. sold $6 billion of US dollar bonds on Tuesday to help fund its acquisition of Metsera Inc. The pharmaceutical company priced the bond offering across seven parts, according to a person with knowledge of the matter, who asked not to be identified discussing private details. The longest portion of the deal, a 40-year bond, yields 1 percentage point more than Treasuries, compared with initial price talk of about 1.25 percentage point, the person added. (Gambale, Smith and Mutua, 11/18)

CIDRAP: New Online Hub For Antimicrobial Resistance Data Launches
The European Molecular Biology Laboratory's European Bioinformatics Institute (EMBL-EBI) today announced the launch of a new online hub for global antimicrobial resistance (AMR) data. Launched with the aim of making global AMR data more accessible and usable for researchers, the AMR portal will collect and present data on resistance phenotypes, AMR genes, and genome sequences, along with sample metadata, including information about the included bacteria, experimental methods, and the provenance of the dataset. The first release is based on a dataset from Imperial College London. (Dall, 11/18)

Becker's Hospital Review: How Accurate Are Smartwatches For Detecting Afib?
Several smartwatches claim to be able to detect atrial fibrillation in wearers. But how accurate are they? That was the focus of an October meta-analysis in JACC: Advances that reviewed 28 studies spanning 17,349 patients. (Bruce, 11/18)

On smoking and alcohol use —

ABC News: As Few As 2 Cigarettes Per Day Linked To 50% Increased Risk Of Heart Disease: Study
Just 100 cigarettes over the course of someone's life may be enough to raise their risk of heart disease and death, a new study suggests. Researchers at Johns Hopkins University, who looked at the smoking habits of more than 300,000 adults for almost 20 years, found that men and women who smoked as few as two cigarettes daily had a 60% increased risk of death from any cause compared to those who never smoked. (Malhotra, 11/18)

The New York Times: Smoking Weed Could Lead To Less Drinking, New Study Suggests
In a makeshift bar on a college campus, researchers studied how smoking cannabis affected alcohol consumption. (Blum, 11/19)

Stat: Innovative Program Gives Medical Students A Fuller View Of The Health Care System’s Failings
When I first met Maria during her primary care visit, I, a medical student, was struck by her independence at 90 years old. Her frosty hair was brushed into neat curls. Her glasses rested on the tip of her nose. Her reusable grocery bag was frayed at the corners from carrying years of paperwork from doctor’s appointments. (Serena Wang, 11/19)

Bloomberg: The World Is Failing Women And Children 
In too many countries, maternal and child deaths are rising, conflicts are eroding health systems, and climate and economic shocks are widening inequalities. (Cyril Ramaphosa and Helen Clark, 11/19)

The Washington Post: The FDA Finally Corrects Its Error On Menopause Hormone Therapy
At long last, the Food and Drug Administration will remove a “black box warning” label required on the packaging of most types of menopause hormone therapies. The decision, announced last week, will finally bring regulation in line with science. (Leana S. Wen, 11/18)

Stat: Medical AI Has A ‘Human In The Loop’ Problem 
In 1912, on the banks of the Seine in Paris, Lawrence Sperry, an aviation pioneer, debuted his invention of the autopilot, as he and his assistant climbed onto opposite wings of a biplane flying itself along the river. The stunt shocked onlookers and paved the way for modern aviation. This year, I think medicine reached its autopilot moment. As a physician, the AI hype cycle in health care has long felt to me to be detached from the hard realities of practicing medicine. (Vishal Khetpal, 11/19)

The Colorado Sun: Colorado Caregivers Fight For Basic Rights As Billionaires Lobby For AI
I have spent the last seven months learning to be a volunteer lobbyist — registering with the Colorado General Assembly, showing up with research, hoping someone will listen. I became a lobbyist because I became a caregiver. In Colorado, you can be fired or denied workplace flexibility simply because you’re caring for an aging parent, a child with disabilities or a seriously ill spouse. There’s no law protecting you. (Mark Fukae, 11/18)