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3. Political Cartoon: 'Big Ask?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Big Ask?'" by Chip Bok.

Here's today's health policy haiku:

America's Lack Of Maternal Data 'Embarrassing'

How many mothers
Die in childbirth in U.S.?
We don’t really know.

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Summaries Of The News:

Health Law

4. Judge In Insurer Subsidies Case Points To Steps States Have Taken In Anticipation Of Payment Cut Off

Attorneys general from 18 states and D.C. asked the court for an immediate order halting President Donald Trump's decision to cut off federal payments to health insurers. The judge seemed skeptical of their arguments, but aims to issue a ruling Tuesday.

Reuters: U.S. Judge Questions States Seeking To Restore Obamacare Payments
A U.S. judge on Monday appeared skeptical toward a request from several states that want him to order the administration of Republican President Donald Trump to continue payments to health insurers under Obamacare. At a hearing in San Francisco federal court, U.S. District Judge Vince Chhabria said he aimed to issue a ruling on Tuesday. (Levine, 10/23)

California Healthline: Judge Questions Claims That Ceasing Obamacare Insurance Subsidies Hurts Consumers
Earlier this month, Trump announced that the administration would stop payments that compensate insurers for discounts given to low-income consumers to help cover their out-of-pocket expenses under policies sold on the Affordable Care Act’s insurance marketplaces. These subsidies are different from the tax credits many consumers get, depending on their income, to pay Obamacare premiums. (Nguyen, 10/24)

Los Angeles Times: Federal Judge Appears Unlikely To Block Trump's Action On Obamacare
California Atty. Gen. Xavier Becerra, joined by Democratic counterparts from 17 other states and the District of Columbia asked the court to put Trump’s order on hold. They argue Trump’s action would spark “chaos and uncertainty,” raise the cost of health insurance and the number of uninsured Americans and saddle states and local governments with higher expenses. But U.S. District Judge Vince Chhabria, an Obama appointee, expressed considerable skepticism during a hearing Monday. (Dolan and Lauter, 10/23)

The Associated Press: Judge Skeptical Of Need To Reinstate Trump Health Care Cuts
Chhabria peppered an attorney for California with questions about why he should force the administration to resume payments when the states had devised a workaround that would benefit many consumers. "The state of California is standing on the courthouse steps denouncing the president for taking away people's health care, when the truth is that California has come up with a solution to that issue that is going to result in better health care for a lot of people," Chhabria said. (Thanawala, 10/24)

Politico Pro: Federal Judge To Issue Ruling On CSR Emergency Order Tuesday
The judge highlighted the decision by Covered California, the state's Obamacare exchange, to load the impact of the lost CSRs on to the silver-tier plans, which allows for consumers' tax-credit subsidies to rise accordingly. He noted that the contingency plan, which most states have adopted in some form, would cost the taxpayers more money and protect consumers, who may even benefit in 2018. Brown contended that not all states have taken such steps and he feared insurers could flee some markets. (Colliver, 10/23)

5. Senate Republicans On Bipartisan Health Plan: The Ball Is In President's Court

Conflicting statements from President Donald Trump have made it hard for lawmakers to know exactly where he stands on the measure proposed by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) to shore up the Obamacare marketplaces.

The Wall Street Journal: Republicans Face Tough Decision On Bipartisan Health Bill
Republicans returning to Washington will decide in coming days whether to embrace or set aside a bipartisan health bill that has gained traction in Congress, a decision potentially made harder by President Donald Trump’s statements praising the effort but opposing the bill itself. Senate Minority Leader Chuck Schumer (D., N.Y.) said on Sunday the bipartisan bill’s support includes all 48 Senate Democrats as well as the 12 publicly committed Republicans, enough to overcome any filibuster. Senate Majority Leader Mitch McConnell (R., Ky.) said he would bring the bill to a vote if it is clear Mr. Trump will sign it. But that remains far from certain, given Mr. Trump’s recent comments on the plan from Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.). (Armour and Lazo, 10/23)

Politico: Senate Seeking Clarity From Trump On Obamacare Deal
Republicans on Capitol Hill can’t seem to tell if the White House wants an Obamacare stabilization bill, leaving their path forward murky. Conflicting statements from President Donald Trump and a list of White House-requested changes circulated over the weekend have given GOP leaders no clarity on whether they should force a controversial vote on the proposed bipartisan Obamacare fix, or set it aside for now and then try to roll it into a far-reaching year-end spending bill. (Haberkorn and Cancryn, 10/23)

The Hill: Senate Republicans Push Trump To Join ObamaCare Talks 
Senate Republicans say it’s up to the White House to decide whether a bipartisan ObamaCare deal can move forward. President Trump has repeatedly expressed support for the bipartisan negotiations led by Sen. Lamar Alexander (R-Tenn.), but has sent mixed signals on whether he supports the agreement that the senator reached with Democrats. Without Trump’s support, it’s unlikely the bill can pass. (Sullivan, 10/23)

6. Trump's Move To Slash Outreach Budget May Have Drastic Effect On Enrollment, Analysts Project

Josh Peck, the author of the analysis, estimates that 1.1 million fewer people will sign up for coverage in 2018. Peck calls the findings a "best case scenario" because he didn't take into account any of the administration's other actions.

The Hill: 1.1 Million Fewer People Could Sign Up For ObamaCare This Year Due To Trump Funding Cuts
The Trump administration's funding cuts to ObamaCare's advertising budget could result in at least 1.1 million fewer people signing up for coverage this year, according to an analysis released Monday. "The threat to Open Enrollment this year is very real," wrote Josh Peck, the author of the analysis, who served as's chief marketing officer during the Obama administration.  (Hellmann, 10/23)

Kaiser Health News: Enrollment News To Bank On: Obamacare Is Still Here So It’s Time For Coverage Checkup
The open enrollment period begins in one week for 2018 marketplace coverage, but many consumers are confused about what to expect. No wonder! The Trump administration has slashed advertising and outreach about open enrollment, so concrete consumer information is sparse. But there’s more than enough political rhetoric to make up for it, with regular partisan pronouncements that the marketplaces have collapsed and Obamacare is dead. (Andrews, 10/24)

Meanwhile, in the states —

The Baltimore Sun: Maryland Officials Consider Higher Obamacare Rates After Federal Subsidies Cut
Maryland insurance regulators said Monday they were working to minimize the pain from last-minute rate increases for those buying plans sold under the Affordable Care Act by limiting the increases to certain consumers. The proposed rate hikes became necessary last week when the Trump administration announced it would no longer pay a subsidy that insurers rely on to offset the out-of-pocket costs for some low-income consumers. The decision set off a scramble to figure out how to shore up insurance companies, which had already reported millions in losses on so-called Obamacare plans sold to individuals. (Cohn, 10/23)

San Jose Mercury News: California Lawmakers Kick Off Healthcare Hearings
As California health care officials brace themselves for changes to the Affordable Care Act by President Donald Trump and the Republican-controlled Congress, state lawmakers today and Tuesday will hold a hearing examining the gaps in coverage and financing of California’s current system. (Seipel, 10/23)

The CT Mirror: Obamacare Open Enrollment To Begin Amid Shaky Insurance Market
Open enrollment for health care coverage next year begins next week amid uncertainty over the future of the Affordable Care Act and big increases in premiums for individuals and businesses that do not qualify for subsidies. Nevertheless, the health care law is still in effect and those required to enroll in a plan will face increasing penalties by the Internal Revenue Service if they fail to do so. (Radelat, 10/24)

7. Iowa Yanks Far-Reaching 'Stop Gap' Proposal That Would Have Eroded ACA's Protections

With enrollment season only a little more than a week away, state officials made the decision to withdraw their waiver request to opt out of the Affordable Care Act exchanges.

The Associated Press: Iowa Withdraws Proposal To Opt Out Of Affordable Care Act
Iowa officials withdrew a proposal Monday that sought to pull out of the Affordable Care Act and redirect federal money toward lowering premiums for younger participants under a separate program. If the Trump administration had approved Iowa's waiver request, it would have been the first to create a state-run alternative to the health exchanges required under the law championed by President Barack Obama. (Pitt, 10/23)

Des Moines Register: Iowa Stopgap Health Insurance Proposal Dropped As Deadline Looms.
Iowa leaders pulled the plug Monday on their “stopgap” proposal to try to shore up the state’s rickety market for individual health insurance policies. With open enrollment set to start in less than two weeks, the state could no longer wait to hear if federal officials would approve the plan, which would have rewritten significant Affordable Care Act rules on how federal subsidy money is used. (Leys, 10/23)

Modern Healthcare: Iowa Withdraws Request To Establish Alternative Insurance Model
"Obamacare is an unworkable law," Doug Ommen, Iowa's Republican-appointed insurance commissioner, said in a written statement. "The Stopgap Measure was an innovative solution to help thousands of Iowans. Unfortunately, Obamacare's waiver rules are so inflexible that the stopgap cannot be approved under terms that would be workable for Iowa." In addition, the plan may have fallen victim to Trump's recent decision to halt cost-sharing reduction payments to insurers. The state originally was counting on those funds to help finance its alternative coverage system, said Keith Mueller, interim dean of the University of Iowa College of Public Health. (Meyer, 10/23)

The New York Times: Iowa Withdraws Request To Leave Obamacare Market
The waiver request had been closely watched by health policy experts as the most far-reaching effort by a state to sidestep requirements of Obamacare. Governor Reynolds, a Republican, said the Trump administration had tried hard to approve it, but had found it impossible to do so without violating the terms of the law. “Unfortunately, it now appears Obamacare’s waiver rules are as inflexible as the law itself,” Ms. Reynolds said at a news conference in Des Moines. “I’m extremely disappointed.” (Goodnough, 10/23)

The Washington Post: Iowa Abandons Bold Attempt To Jettison ACA Rules
The state’s withdrawal comes two months after President Trump telephoned a top federal health official with instructions to reject Iowa’s proposal. In announcing the withdrawal of what the state has called a crucial “stopgap” plan to prevent its marketplace from collapsing, Iowa Gov. Kim Reynolds (R) on Monday did not mention the president’s intervention, instead thanking Trump for trying to repeal the ACA and blaming the law itself for what she called its inflexibility. (Goldstein and Eilperin, 10/23)

The Wall Street Journal: Iowa Halts Effort To Overhaul Affordable Care Act
The Iowa setup would have offered just one type of insurance plan in the individual market and reshaped the subsidies that help people buy coverage, among other big alterations to the infrastructure of the ACA. Iowa’s largest insurer, Wellmark Blue Cross and Blue Shield, had said it would reverse its plans to exit from the state’s individual market and would instead sell plans in every county next year if the state won approval for its proposal. On Monday, after Iowa’s decision, Wellmark said it “will continue to work on a long-term solution with state and federal officials.” (Wilde Mathews, 10/23)

Politico Magazine: How Iowa Became An Obamacare Horror Story
Nick Podhajsky plans to get married this year for an unusual reason: health insurance coverage. The 44-year-old farmer had expected to tie the knot next year. But because Iowa’s individual health insurance market is in chaos—with competition disappearing and prices skyrocketing—his fiancee was potentially going to be left with no affordable coverage options for next year. So they’ve decided to hold the ceremony before the end of the year, allowing his bride-to-be to get coverage through his plan. (Demko, 10/23)


8. CHIP Funding Bill Could Get House Vote This Week, But Democrats Object To How It's Paid For

Democrats say the five-year renewal would cut the Affordable Care Act's public health prevention fund and raise Medicare rates for wealthy seniors.

The Hill: Dem Pushes Back On CHIP Extension Proposal 
Disagreements over how to pay for an extension of the Children’s Health Insurance Program (CHIP) could result in a partisan bill reaching the House floor as soon as this week, a top House Democrat said Monday. Rep. Frank Pallone Jr. (D-N.J.), the ranking member on the House Energy and Commerce Committee, said Republicans are insisting that the extension is paid for by cutting other health programs, adding that the bill could get a floor vote in the House on Thursday. (Weixel, 10/23)

In other news on Medicaid —

The Associated Press: Audit: More Oversight Needed of Medicaid Managed-Care Firms
Louisiana's health department doesn't properly monitor managed-care organizations that provide services for most state Medicaid patients to ensure they have enough specialists to treat mental health problems and drug addiction, according to an audit released Monday. The report from Legislative Auditor Daryl Purpera's office comes as the health department is asking lawmakers to extend the contracts with the managed-care companies for another two years, deals carrying an estimated price tag of $15.4 billion in federal and state dollars. (Deslatte, 10/23)

The Associated Press: Advocates File Idaho Medicaid Expansion Ballot Initiative
Idaho is joining a handful of states where health advocates are hoping to bypass lawmakers who have refused to expand Medicaid and take the issue directly to voters through a ballot initiative. "It seemed like a time for change," Luke Mayville, co-founder of Reclaim Idaho, a group leading the ballot initiative effort, said Monday. ... Idaho lawmakers have long refused to consider the idea while also failing to come up with a solution to provide health coverage to the estimated 78,000 Idahoans who currently don't qualify for Medicaid or make too much for a subsidy. (Kruesi, 10/23)


9. Hospitals Are Feeling The Pinch From Hurricane's Devastating Effect On Puerto Rico

Hospital pharmacists across the country are racing to find an alternative to a product called a Mini-Bag, which dilutes intravenous drugs for patients. But that's just the first of what providers and officials fear will be many shortages of drugs and devices following in the wake of the hurricane.

The New York Times: U.S. Hospitals Wrestle With Shortages Of Drug Supplies Made In Puerto Rico
One of the workhorses of Clarke County Hospital, a 25-bed facility in rural Osceola, Iowa, is an unassuming product known as a Mini-Bag. It is a small, fluid-filled bag used by nurses to dilute drugs, like antibiotics, so that they can be dripped slowly into patients’ veins. The bag’s ease of use has made it popular in small facilities like Clarke County, where the pharmacy is closed on nights and weekends, as well as at nationally known hospitals like the Cleveland Clinic, which uses 34,000 of the bags every month. (Thomas, 10/23)

Stat: FDA: Drug And Device Companies In Puerto Rico Still Operating Far Below Capacity After Storm
Drug and device companies with manufacturing operations in Puerto Rico have told the American public that their plants are getting up and running again, but that does “not reveal the true scope of the challenge that we are facing,” Food and Drug Administration Commissioner Scott Gottlieb said in prepared congressional testimony made available Monday. ... Gottlieb will appear before the subcommittee on oversight and investigations of the House Committee on Energy and Commerce Tuesday morning for a hearing on the Department of Health and Human Services’s response to hurricanes this summer and fall, including Hurricanes Harvey, Irma, and Maria. Officials from the Center for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and the main HHS office will also testify. (Swetlitz, 10/23)

10. J&J Scores Back-To-Back Victories As Courts Overturn Massive Awards For Consumers In Talcum Cases

The science on the potential link between talcum powder and ovarian cancer is still being fiercely debated.

CNN: Record Verdict Overturned In Johnson & Johnson Talcum Powder Trial
Judges in two separate cases have ruled in favor of pharma giant Johnson & Johnson, overturning large financial judgments awarded to plaintiffs who believe the company's Baby Powder and Shower to Shower powder products caused their ovarian cancer. One award was to a California woman for $417 million, and another was to an Alabama woman for $72 million. In the California case, which was decided by a jury in August, Eva Echeverria testified that she had been using talcum powder as a regular part of her feminine hygiene routine for more than 50 years, since she was 11. She developed ovarian cancer and stopped using the powder in 2016, after she read a news story about another woman who used it and had ovarian cancer. (Christensen, 10/23)


11. Hospitals Tapping Into Lucrative Concierge Medicine Trend

While they're not providing the kind of services patients could get at high-end independent practices, they are offering options such as same-day appointments or access to doctors via text for those who can afford it.

Modern Healthcare: Concierge Care Taking Hold At Some Large, Urban Hospitals
The words "concierge medicine" can easily conjure an image of a private practice doctor in a swanky downtown office, providing care to only the most well-heeled patients able to afford an annual co-pay of tens of thousands of dollars. .... Less frequently is concierge medicine associated with the nation's hospitals, which are more known for their care for the poor and uninsured. But major not-for-profit health systems are opening primary-care practices to cater to wealthy patients. Acclaimed systems such as the Mayo Clinic, Rochester, Minn.; Stanford Health Care, Palo Alto, Calif.; Duke Health, Durham, N.C.; and Boston's Massachusetts General Hospital, part of Partners HealthCare, are a few examples of the small but growing number of hospitals with concierge practices. (Livingston, 10/21)

In other health industry news —

Modern Healthcare: Dignity Health, Select Medical To Combine Urgent-Care Businesses
Dignity Health and Select Medical will combine their urgent-care businesses to better align care delivery, executives said in a news release Monday. Dignity will merge its urgent-care and occupational medicine subsidiary U.S. HealthWorks with Select Medical's Concentra Group Holdings. Dignity will own a 20% equity interest in the combined entity, valued at $238 million, and receive the remainder of the undisclosed purchase price in cash when the deal is expected to close in the first quarter of next year, pending the customary regulatory reviews. (Kacik, 10/23)

Modern Healthcare: Tenet CEO Trevor Fetter Steps Down 
Tenet Healthcare Corp. CEO Trevor Fetter has resigned amid the company's financial troubles and planned reorganization, the health system announced late Monday. Executive Chairman Ronald Rittenmeyer will fill in while the company continues its search for a permanent CEO. Fetter announced in late August that he would step down in March or when a successor was appointed and that the investor-owned chain would shake up its board. "I want to sincerely thank Trevor for his leadership of the company over the past 14 years, and particularly for his support in making this transition a success," Rittenmeyer said in a release. (Kacik, 10/23)

Public Health And Education

12. Experts: Saying Medicaid Expansion Worsened Opioid Crisis Is Confusing Association With Causation

"Just because one event [Medicaid expansion] occurred during a period of increasing opioid deaths, many from illicit sources doesn't mean that it caused the increase in deaths," says David A. Fiellin, a professor of medicine at Yale School of Medicine.

PoliticoFact/Florida: No Evidence To Prove Medicaid Expansion Is Fueling The Opioid Crisis
As Florida’s lawmakers grapple with the opioid crisis, one U.S. representative says there’s a correlation between states that expanded Medicaid through Obamacare and states affected the worst by the epidemic. Republican U.S. Rep. Matt Gaetz shared this factoid on Twitter on Oct. 17: "Opioid crisis the worst in ObamaCare expansion states!" ... Information supplied by Gaetz’s office rests on the notion that patients in states that expanded Medicaid through Obamacare have more access to legal prescriptions that fuel the opioid epidemic. Experts said the theory ignores critical facts and does not take into account the other factors that have led to an increase in opioid deaths. "It is important to avoid confusing association with causation," said David A. Fiellin, a professor of medicine at Yale School of Medicine. (Grave, 10/23)

In other news on the epidemic —

The Hill: White House To Host Opioid 'Event' Thursday
The White House will hold an event on the opioid epidemic Thursday afternoon, according to an email obtained by The Hill that suggests President Trump will make his announcement about a national emergency this week. The email, from the White House Office of National Drug Control Policy, is an invitation and a call to RSVP to an event at the White House on the “nationwide opioid crisis” at 2 p.m. Thursday. (Roubein, 10/23)

The Associated Press: Woman Indicted In Boy’s Fatal Drug Overdose At Sleepover
A woman has been indicted on involuntary manslaughter and child-endangering charges in the death of a 12-year-old boy who authorities say died from a fentanyl overdose during a sleepover at her Ohio apartment. The Franklin County prosecutor says the boy, Kanye Champelle, got the drug from atop a refrigerator and ingested it while the baby sitter was gone. The prosecutor says the woman, 60-year-old Sheila Hutchins, ran errands and left several children she was baby-sitting. (10/23)

13. Tracking Of Maternal Deaths So Riddled With Flaws, U.S. Doesn't Even Publish An Official Rate

ProPublica offers a look at the "embarrassing" state of data collection on maternal deaths in the country. In other public health news: fixing birth defects in the womb; discrimination; Uber for birth control; diabetes; firefighters and cancer; germs; and more.

NPR: Poll: Most Americans Say They Are Discriminated Against, Regardless Of Race
Majorities in many ethnic, identity and racial groups in America believe that discrimination exists against their own group, across many areas of people's daily lives, according to a poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. The poll asked a wide range of questions about where Americans experience discrimination — from the workplace to the doctor's office — and people's experiences with discrimination and perceptions of it. The groups polled include whites, blacks, Latinos, Asian-Americans, Native Americans and LGBTQ adults. (Neel, 10/24)

Stat: App Known As The ‘Uber For Birth Control’ Sparks Ire In Conservative States
It’s a telemedicine app that seems rather innocuous — enter your info, have it reviewed by a physician, and get a prescription. The California-based company behind it has raised millions to support its mission of expanding access to the pill, ring, or morning-after pill with minimal hurdles. But that last option is now starting to attract pushback from anti-abortion activists, who consider the morning-after pill equivalent to abortion — and who say lax telemedicine laws are enabling access to this drug with insufficient oversight. (Blau, 10/24)

NPR: Screening For Diabetes Is Working Better Than We Thought
Undiagnosed diabetes may not be as big of a public health problem as thought. That's the takeaway from a study published Monday in the Annals of Internal Medicine that says that some previous efforts have likely overestimated the number of people with undiagnosed diabetes because they relied on a single positive test result. (Hobson, 10/23)

Columbus Dispatch: Unmasked: Firefighters And Cancer
Until recently, the National Fire Protection Association, which sets standards for departments such as Columbus, had no guidelines on cancer prevention. The agency released standards aimed at cancer prevention for the first time this summer. (Wagner and Sullivan, 10/24)

WBUR: New Pediatrician Guidelines On Kids, Germs And How To Prevent Illness
As Boston heads into cold weather and flu season, the American Academy of Pediatrics is out with new guidelines on what pediatricians' offices should do to prevent and control infections. The new guidelines, out Monday, include items like diligent hand washing, and asking anyone who treats your kids if they've washed their hands too. (Becker, Sundt and Goldberg, 10/23)

The Washington Post: Conjoined Twins Survived One Of The World’s Rarest Surgeries. Now They’re Preparing To Go Home.
Abby Delaney can roll onto her stomach, hold up her head and turn pages in her favorite books. Her sister, Erin, can now sit up on her own, and she is starting to think about crawling — learning to hold herself up on her small hands and knees. More than four months after the formerly conjoined twins were separated in a rare surgery at Children’s Hospital of Philadelphia, their mother said there have been rewarding but “terrifying” moments as the 15-month-olds recover. (Bever, 10/23)

14. California's Strict Gun Show Laws Paying Off In Terms Of Public Safety, Study Suggests

When a gun show is held in California, the state sees no measurable increase in injuries and deaths in the following two weeks. However, when one is held in Nevada, which doesn't have the same regulations as its neighbor, such incidents jump by nearly 70 percent in California region's within two hours.

The New York Times: Stricter Gun Laws Tied To Fewer Firearm Injuries After Gun Shows
Gun shows in a state with weak gun restrictions increase the short-term risk for firearm-related injuries, a new analysis has found. Researchers studied deaths, emergency department visits and hospitalizations related to firearms before and after 915 gun shows in California and Nevada from 2005 to 2013. California has laws requiring background checks, waiting periods, documentation and Department of Justice surveillance at gun shows. Nevada has no regulations pertaining explicitly to gun shows. (Bakalar, 10/23)

State Watch

15. State Highlights: Single-Payer Proposal In N.H. Draws Mixed Reactions; Judge Won't Block Mo. Abortion Rule

Media outlets report on news from New Hampshire, Missouri, Massachusetts, New York, California, Florida, Kansas, Oregon, Minnesota and New Jersey.

Concord (N.H.) Monitor: N.H. Rep Proposes Statewide Single-Payer Health Care
A proposal to create a single-payer health care system in New Hampshire drew mixed reactions in the House on Monday, with some denouncing it as a wayward fantasy and others heralding an opportunity for a conversation on broader reform. The legislative service request, sponsored by Rep. Schmidt, D-Dover, is titled “establishing a New Hampshire single payor (sic) health care system.” (DeWitt, 10/23)

KCUR: Judge Says New Missouri Requirement Does Not Impose ‘Undue Burden’ On Abortion Patients 
A Jackson County judge on Monday declined to block a Missouri law requiring abortion physicians to meet with their patients three days before the procedure. In rejecting a challenge to the law by Missouri’s two Planned Parenthood affiliates, Jackson County Circuit Judge S. Margene Burnett found that the requirement did not impose an “undue burden” on women seeking an abortion. (Margolies, 10/23)

The New York Times: New York State Bans Vaping Anywhere Cigarettes Are Prohibited
Electronic cigarettes, the popular vapor substitute to traditional tobacco cigarettes, will soon be banned from public indoor spaces in New York State — just like the real thing. Gov. Andrew M. Cuomo on Monday signed a bill to ban vaping anywhere cigarettes are already prohibited, like workplaces, restaurants and bars. The ban goes into effect in 30 days. (Nir, 10/23)

The Associated Press: Law Provides Health Benefits To Volunteer NY Firefighters
New York volunteer firefighters who have been diagnosed with certain cancers will be eligible for health care benefits under a new state law. Democratic Gov. Andrew Cuomo announced Sunday that he had signed legislation that will provide the benefit to the nearly 100,000 New Yorkers who serve as volunteers with fire companies across the state. (10/23)

Boston Globe: Growing Number Of Alzheimer’s Cases Seen As Challenge To Massachusetts
Massachusetts is facing an epidemic of people slipping into the shadows of dementia, and lawmakers want to make sure the state is prepared. The number of people in Massachusetts who have Alzheimer’s and other dementias will increase by 25 percent in just eight years, rising from 120,000 in 2017 to 150,000 in 2025, according to the Alzheimer’s Association. (Finucane, 10/23)

Concord (N.H.) Monitor: Faster Testing For Lead In Children’s Blood May Help Concord’s Very Low Testing Rate
Since exposure to lead at a young age can cause permanent neurological problems, it’s important to spot exposure early so something can be done to remove the source of the lead – usually old lead paint, which remains a serious problem in a state where 60 percent of housing units were built before 1978, when lead paint was banned. And that’s why health officials want to get more quick-testing units into pediatricians’ offices around the country. ...State officials hope to get more doctors and private practices to buy and use the devices, which cost about $2,500 to install and about $8 to run a test. The system is designed to provide quick information to the state so it can track outbreaks of lead poisoning more quickly than with current methods. (Brooks, 10/23)

KCUR: KU Hospital Receives $10 Million Donation For New Medical Tower
The University of Kansas Health System has received a major boost in achieving its goal of raising $100 million to complete a new hospital tower. Hospital officials announced Monday morning it was receiving a gift of $10 million from Cheryl Lockton Williams. The gift is to support the construction of Cambridge Tower A, a new hospital building on the northwest corner of Stateline Road and 39th Street in Kansas City, Kansas. (Smith, 10/23)

Los Angeles Times: As Flames Fade, Wine Country Grapples With Emotional Scars Of Devastating Fires
In the days since fires ravaged towns here, people have pulled together. Strangers at coffee shops share their trauma, talking of homes destroyed and loved ones lost. Almost everyone seems to know a neighbor who knocked on a door or lifted someone into a car, and saved a life. The phrase “The love in the air is thicker than the smoke” is on signs in shop windows, in Facebook posts and on people’s lips. (Karlamangla, 10/23)

The Associated Press: Woman Says She Was Misled Into Mastectomy, Hysterectomy
A 36-year-old Oregon woman has filed a $1.8 million lawsuit against medical professionals who she says mistakenly suggested she undergo a double mastectomy and a hysterectomy. The Oregonian/OregonLive reported Monday that Elisha Cooke-Moore’s lawsuit says she underwent the life-altering surgeries after her gynecologist, Dr. William Fitts, determined that genetic blood tests indicated she had a 50 percent chance of getting breast cancer and up to an 80 percent chance of getting uterine cancer. (10/24)

Sacramento Bee: Carmichael Patients Shipped From One Troubled Nursing Home To Another
Eagle Crest in suburban Sacramento was among the chain’s worst-performing facilities nationwide, teetering toward decertification while federal regulators kept it on a consumer-beware list for three years. Now, with many of the former Eagle Crest residents shepherded off to other Genesis homes, The Bee’s analysis found that the troubles at Eagle Crest were not isolated at all. (Lundstrom and Reese, 10/23)

Tampa Bay Times: Report: Well-Being Of Black And Hispanic Children Continues To Lag In Florida
Despite making progress in health care access and parental employment, Florida has not improved its poverty rate for children over the past five years, a newly released national report shows. And that indicator, along with several others, bodes particularly poorly for children of ethnic minorities and immigrant families, who are disproportionately affected by poverty, the Annie E. Casey Foundation states in its 2017 "Race for Results" index. (Solochek, 10/24)

Pioneer Press: State Alleges Neglect In Death Of 86-Year-Old Man At Troubled Minnesota Care Center
Neglect by caregivers at a troubled north-central Minnesota assisted living facility led to the death of an 86-year-old man, the state Department of Health has reported. An investigation of the Heritage House in Pequot Lakes that was completed by the agency substantiated charges of neglect, described as improper catheter care and an unclean environment leading to death by a complex urinary tract infection. (Perkins, 10/23)

Los Angeles Times: Mann Packing Recalls Some Bagged Vegetables And Salads Because Of Listeria Concerns
Vegetable supplier Mann Packing has issued a voluntary recall for a number of bagged vegetables, salads and other vegetable products sold in the U.S. and Canada due to a potential risk of listeria contamination. The Salinas, Calif., firm said last week it issued the recall “out of an abundance of caution” after a “single positive result” for the germ, Listeria monocytogenes, was found on one of its products during a random test by the Canadian Food Inspection Agency. (Masunaga, 10/23)

The Philadelphia Inquirer/ Cherry Hill Man Gets 70 Months In Prison For $2.5M Medicaid Fraud
Cesar Tavera, the former executive director of a community health center in Camden, was sentenced Monday to more than five years in prison for stealing money from the nonprofit, which was created to provide mental health services for the city’s underserved residents. In addition to 70 months in prison, three years of supervised release was ordered by U.S. District Judge Noel L. Hillman in Camden. The judge also issued a $2.5 million restitution order. (Moran and Boyer, 10/23)

Editorials And Opinions

16. Perspectives On Health Law: Sanders' Plan Could Upend Democrats; New Lies About Obamacare

Opinion writers offer thoughts about the health care debate in the country.

The New York Times: Why ‘Medicare For All’ Will Sink The Democrats
Repeal-and-replace may be done for now, but for Senator Bernie Sanders, the war is just beginning — and it has already become a fracas that is dividing the Democratic Party, to its detriment. Mr. Sanders — who, of course, isn’t even a registered Democrat — is banging on about what he calls “Medicare for All,” a government-run plan that would provide health care coverage for every American. But now the crusty Vermont independent wants to be a senatorial pied piper for Democrats. He has made his proposal into a kind of litmus test for who is a “good Democrat,” inveigling 16 of his colleagues — more than a third of Senate Democrats — into endorsing it. (Steven Rattner, 10/24)

The Hill: Trump's Cynical Sabotage Of ObamaCare
“If you like your doctor, you can keep your doctor. If you like your plan, you can keep your plan.” For years, Republicans used that exaggerated pledge to thrash the Affordable Care Act (ACA) and President Obama for not keeping his promise. Politifact labeled it as “lie of the year” in 2013. Politifact will have a lot of lies to choose from this year, given the hurricane of falsehoods and broken promises on healthcare made by President Trump. Who can forget Trump’s oft-repeated promise that “We will repeal and replace ObamaCare, and we will do it very, very quickly”? (Juan Williams, 10/23)

USA Today: Half Of America Skimps To Pay For Health Care. The Only Fix Is To Cut Waste.
As Congress decides the fates of Americans who cannot afford health insurance, our new data shows that this is a larger group than previously thought. In a new survey of 9,200 people across 15 states by my organization, the Texas Medical Center Health Policy Institute, 49% of respondents said they must cut other expenses to pay for health care. And they aren’t cutting back on frivolities like expensive electronics. Most often, they said, they had to cut back on their savings, as well as spending on food and clothing, to pay for health care. (Arthur “Tim” Garson Jr., 10/23)

Lexington (Ky.) Herald: Kentucky Doctor Says Medicare-Style Plan Could Curb Costs, Empower Consumers
The Affordable Care Act is not the cause of rising health-care costs. If it were, simple repeal would fix the problem. The cause is the massive mergers of health-care providers creating an economic and political behemoth. ... In Kentucky, antitrust laws have apparently been largely overlooked. Now all of Northern Kentucky has a single hospital system, which also employs the majority of doctors. ... The answer to health-care reform is simple. We must lower health-care costs. Either instill true provider competition or give more power to the purchasers with a variation of a single-payer system. (Kevin Kavanagh, 10/20)

17. Viewpoints: The Costs Of Defective Medical Devices; Holding A Teenager Hostage

A selection of opinions on health care from around the country.

The Des Moines Register: When A Pacemaker Gets Recalled: Defective Heart Devices Cost Medicare A Fortune
If you own a vehicle, you’ve likely received a recall notice about a potentially defective part. You can schedule an appointment with a mechanic who will replace everything from an airbag to a sun visor at no cost to you. Nearly 900 vehicle recalls affected 51 million vehicles in 2015. Contrast this with a recall on a medical device implanted in your chest. You may not be notified of a problem. The medical costs associated with replacing it are not covered by the manufacturer. And you'll need to do more than spend a half hour sipping coffee in a car dealership waiting room. (10/23)

The Washington Post: The Government’s Grotesque Abuse Of Power Over A 17-Year-Old Seeking An Abortion
Under the directorship of E. Scott Lloyd, an antiabortion activist appointed by President Trump to lead the Department of Health and Human Services’ Office of Refugee Resettlement, ORR began preventing federally funded shelters from “facilitat[ing]” access to abortion services unless Mr. Lloyd approved. Instead, shelters for undocumented minors may support only “pregnancy services and life-affirming options counseling.” Mr. Lloyd has personally reached out to several pregnant teenagers to counsel them against seeking abortions, reportedly viewing himself as a “foster father.” ... Mr. Lloyd’s behavior toward J.D. is not just unconstitutional. It is also a grotesque abuse of government power over a vulnerable young woman far from her home. The government should not need a court order to do what is obviously right. (10/24)

The Washington Post: The Trump Administration Is Holding A Teenager Hostage Over Abortion
All the Trump administration/“Handmaid’s Tale” comparisons seemed overwrought. Then came J.D. She is a 17-year-old detained by federal authorities after illegally crossing the border in Texas without her parents, who she claims abused her. She is also pregnant — 15 weeks and counting — and wants an abortion. In fact, she’s been seeking one for nearly a month. (Ruth Marcus, 10/23)

Stat: As A Doctor, Did I Just Feed An Addiction? Or Ease A Man's Pain?
Opioids — whether it’s Vicodin or oxycodone or many others — have transformed dental and other pain into a moral and clinical cage fight. This struggle is lost in the headlines that blame physicians for the opioid crisis. It ignores the on-the-ground experiences of many of us who strive to do the right thing when the “right thing” is the very thing in question. Will the opioid pills Sonny is asking for treat his pain, feed an addiction, or both? (Jay Baruch, 10/23)

The Washington Post: The Problem With Hospitalizing Opioid Addicts Against Their Will
Court-ordered opioid treatment, known as civil commitment, gives judges the authority to hospitalize people against their will. Commitment is not a criminal charge, only a decree that has the force of law, obliging a person to receive medical treatment. In Massachusetts, which has one of the highest rates of opioid deaths nationally, addiction-related civil commitments have doubled in the past decade, to more than 6,000 last year, largely in response to the opioid crisis. More than 30 states now have commitment laws for substance users on the books. But while policymakers and families might be desperate for tools to address the opioid crisis, we need to recognize that we don’t yet know know the impact of commitment laws. We need to carefully and empirically review these laws as we consider sequestering and treating more opioid users against their will. (Michael Stein and Paul Christopher, 10/23)

San Jose Mercury News: Opinion: Santa Clara County Can Do More For Mental Health
When we encounter someone eating out of a garbage can that believes they are on the planet Pluto, this is the person we must help, and not necessarily someone who claims trauma due to political events. Our county government has expanded to include programs and services that were never intended, taking away funds from core services such as mental health. (Pierluigi Oliverio, 10/23)