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Podcast: 'What The Health?' Welcome Back, Congress. Now Get To Work.

In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Margot Sanger-Katz of The New York Times and Mary Agnes Carey of Kaiser Health News discuss the return of Congress and bipartisan efforts to shore up the individual health insurance market for 2018, as well as renew the Children’s Health Insurance Program. (9/8)

Quiz: How Well Are You Paying Attention?

To strengthen your core knowledge of health care policy, it helps to be a regular reader of Kaiser Health News. Here's a pop quiz to gauge what you have learned. (9/11)

Political Cartoon: 'Thrill Ride?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Thrill Ride?'" by Nick Anderson.

Here's today's health policy haiku:


Vaccine’s price tag — high.
But MenB can be deadly.
Which matters the most?

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law

Democrats Worry Compromising For Short-Term Wins Will Lead To Long-Term Evisceration Of Law

Democratic lawmakers want the insurer subsidies to be paid. But to get that, they have to give up on something important to them -- state waivers. Meanwhile, the clock is ticking for them to reach a deal.

The Hill: Dem, GOP Demands Could Sink Bipartisan ObamaCare Fix 
Democrats fear that GOP demands for concessions on a bill meant to stabilize insurance markets could lead to the end of key protections for consumers under ObamaCare. Republicans say that in exchange for funding for insurers that would help prevent an ObamaCare premium spike, Democrats should agree to expanding waivers that could allow states to opt out of certain requirements under ObamaCare. (Sullivan, 9/8)

The Hill: Week Ahead: Senate Panel Looks To Quickly Strike Deal On ObamaCare Fix 
Democrats want the bill to include multiple years of funding for key insurer payments, known as cost-sharing reduction (CSR) subsidies, while Republicans only want one year. Insurers have threatened to leave the market or hike premiums if they don't get more certainty on these payments. But a bigger sticking point is the changes Republicans want to make to ObamaCare's 1332 waivers. (Hellmann, 9/11)

The Hill: Kasich: ObamaCare Insurers 'Have To Make A Profit Like Anyone Else' 
Ohio Gov. John Kasich (R) on Friday voiced support for more state flexibility under ObamaCare, while also advocating for the Trump administration to fund subsidy payments to insurers. Kasich pushed back on the notion among some conservatives that the payments, known as cost-sharing reductions, are a bailout of insurers. (Weixel, 9/8)

Kaiser Health News: Podcast: ‘What The Health?’ Welcome Back, Congress. Now Get To Work.
The Senate this week launched hearings on both the fate of the individual insurance market and the future of the Children’s Health Insurance Program (CHIP), which is set to expire at the end of September. Still in the mix on Capitol Hill is one possible last-ditch effort to “repeal and replace” the Affordable Care Act. But with Congress quickly wrapping up much of its “must-do” legislation, it’s not clear how or when these issues will be tackled, says a panel of experienced health care journalists in this week’s episode of “What the Health?” (9/8)

Freedom Caucus Leader Offers Tepid Support For Graham And Cassidy's Obamacare Replacement

Rep. Mark Meadows (R-N.C.), who leads the conservative caucus of lawmakers, said the bill being promoted by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) is the "most promising" option for replacing the federal health law. But the effort faces uphill odds.

The Hill: Freedom Caucus Chair Calls New ObamaCare Repeal Bill 'Promising' 
House Freedom Caucus Chairman Mark Meadows (R-N.C.) said Friday that a new ObamaCare replacement bill in the Senate is the "most promising" option for repealing the law. Meadows spoke favorably of the bill from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), which would replace ObamaCare with block grants to states instead of the law's current spending on subsidies and Medicaid expansion. (Sullivan, 9/8)

Politico Pro: Graham-Cassidy Plan Would Include $1.2T In Block Grants, Overhaul Medicaid
A long-shot Obamacare repeal bill from a pair of Republican senators would set aside $1.2 trillion in state block grants by 2026 and create two formulas to determine funding, according to details shared with GOP governors and obtained by POLITICO. Forthcoming legislation from Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) would replace Obamacare funding for Medicaid expansion and private insurance subsidies with block grants. (Pradhan, 9/8)

Trump Looking Ready To Put Repeal And Replace Efforts Behind Him To Focus On Tax Reform

President Donald Trump tweets: “Republicans, sorry, but I’ve been hearing about Repeal & Replace for 7 years, didn’t happen!” Meanwhile, a closer look at the deteriorating relationship between the president and House Speaker Paul Ryan (R-Wis.).

Bloomberg: Trump's ‘Republicans, Sorry’ Tweet Casts Doubt On GOP's Obamacare Repeal Plan 
Lindsey Graham and Bill Cassidy are still pushing their plan to repeal Obamacare. It appears the president has moved on to tax cuts. “Republicans, sorry, but I’ve been hearing about Repeal & Replace for 7 years, didn’t happen!,” President Donald Trump said in the first of a series of tweets on Friday. Graham and Cassidy, Republican senators from South Carolina and Louisiana, respectively, said on Thursday they’re planning to introduce a new version of their proposal to replace Obamacare. They’re aiming for a vote this month, and have said that the president backs their plan. Tennessee Republican Lamar Alexander, meanwhile, is pushing for a more limited bipartisan plan to stabilize the health law’s markets. (Tracer, 9/8)

The Associated Press: For Trump And Ryan, A Tortured Relationship Grows More So
It started out cold as ice, and then turned warm and friendly. Now the tortured relationship between President Donald Trump and House Speaker Paul Ryan has gone cool again, with the Republican president making clear he has no qualms about bucking the GOP leader to cut deals with his Democratic foes. The two men dined at the White House Thursday night and discussed legislative challenges ahead for the fall, a get-together that was scheduled over Congress’ August recess, long before the head-spinning events of this week. In a moment that stunned Washington, Trump cut a debt and disaster aid deal Wednesday with Congress’ Democratic leaders as Ryan and Senate Majority Leader Mitch McConnell watched on helplessly, after lobbying unsuccessfully for much different terms. (9/8)

The Hill: Trump Regrets Putting ObamaCare Repeal On Top Of Agenda, Blames Ryan: Report
President Trump reportedly regrets putting repealing and replacing ObamaCare at the top of his legislative agenda and blames Speaker Paul Ryan (R-Wis.) for assuring him that a health-care overhaul was sure to pass in the GOP-controlled Congress. Trump has privately fumed that Republican congressional leaders, including Ryan and Senate Majority Leader Mitch McConnell (Ky.), misled him on health care, among other issues, The Associated Press reported Friday. (Greenwood, 9/8)

And the president's former adviser talks about health care —

Politico: Bannon: Hill Republicans Said Obamacare Would Be Replaced By Easter
Former White House chief strategist Steve Bannon said Republicans in Congress assured President Donald Trump that repealing and replacing Obamacare would be a quick process. In an interview on Sunday's edition of "60 Minutes" on CBS, Bannon said congressional Republicans pledged to Trump they would be able to eliminate the Affordable Care Act by Easter — a timetable the Trump administration agreed to so it could move on to other matters. (Cohen, 9/10)

The Long Months Of Uncertainty Are Wearing On Insurers

And insurance providers aren't banking on a lifeline being tossed from Congress anytime soon.

Modern Healthcare: Left In The Lurch: Ongoing Uncertainty Is Taking A Toll On Health Insurers 
For nearly a year, health insurers have operated under a cloud of political and regulatory uncertainty that has taken a toll on finances, and for some, their day-to-day operations. Even though Congress shifted its focus from bulldozing the Affordable Care Act to stabilizing the troubled individual market in the short term, big questions remain, particularly around future funding for cost-sharing reduction subsidies that insurers say are crucial to steadying that business line. (Lee and Livingston, 9/9)

The Hill: Groups Fear Trump Funding Cuts Will Lower ObamaCare Enrollment 
Groups that for years have helped people sign up for ObamaCare say the White House's cuts to their funding will almost certainly lower enrollment in the insurance exchanges this year. Some of the groups, known as navigators, say they’re worried they’ll have to permanently cut back on staff, as well as education and outreach about the health-care law ahead of an open enrollment period beginning Nov. 1. (Roubein, 9/8)

Capitol Hill Watch

As Single-Payer Gains Momentum, Sanders To Release 'Medicare For All' Plan

The move may force Democrats on Capitol Hill to take a stance on the issue, which is becoming a test for 2020.

The Hill: Sanders To Unveil 'Medicare For All' Bill On Wednesday
Sen. Bernie Sanders (I-Vt.) will unveil his “Medicare for all” bill on Wednesday, his office announced Friday. The announcement comes as single-payer health care is gaining as a force within the Democratic Party, and Sanders’s formal announcement will move the issue further into the spotlight. (Sullivan, 9/8)

The Hill: Warren Dismisses Dem Divisions As Lawmakers Rally Around Single-Payer
Massachusetts Sen. Elizabeth Warren (D) dismissed conflict inside the Democratic Party on Friday in a new interview, noting that Democrats are rallying around health care and other issues. Warren told the editorial board of The Republican on Friday that the Democratic Party has found agreement on the idea that health care should be a guaranteed right for all citizens. (Bowden, 9/9)

The Hill: ObamaCare Architect Supports Single-Payer System
Former Sen. Max Baucus, one of the chief architects of ObamaCare, says the U.S. should consider a single-payer health-care system. "My personal view is we've got to start looking at single-payer," the Montanan Democrat said Thursday, according to the Bozeman Daily Chronicle. (Hellmann, 9/8)

Public Health And Education

Many Florida Hospitals Show 'Tremendous Spirit' In Face Of Hurricane And Remain Open

At least 35 hospitals in the states that are or have been affected by the storm had to be closed or partially evacuated though. Meanwhile, clinicians evaluate the theory that hurricanes induce labor, Georgia faces Irma, and mental health professionals prepare for the strain a natural disaster puts on children.

Stat: Irma Forces At Least 35 Hospitals To Evacuate Patients. Here's A Rundown
At least 35 hospitals in Florida, Georgia, and South Carolina have either closed entirely or ordered partial evacuations in advance of Hurricane Irma. The decisions come as officials have ordered nearly 7 million people to leave their homes, causing a mass exodus north before the storm begins to lash the Florida coast. (Blau, 9/9)

Health News Florida: Public Health Emergency Declared For Florida
A public health emergency was declared for Florida on Thursday ahead of Hurricane Irma. Health and Human Services Secretary Tom Price made the declaration and took action that gives HHS’ Centers for Medicare & Medicaid Services’ (CMS) greater flexibility in meeting emergency health needs. (Ochoa, 9/8)

Stat: Can A Hurricane Induce Labor? Women In The Path Of Irma Are Worried
Many of Florida’s hospitals are built to withstand hurricane winds in order to protect patients. While most don’t act as emergency shelters, some make exceptions for expectant mothers facing high-risk pregnancies. They allow them to inflate mattress inside their walls, provided they bring their own sheets and snacks, in case they enter labor. The reason is rooted in the idea that low barometric pressure induces labor. The debate has fascinated local reporters for years: Back in 1992 the Sun Sentinel reported that at least 1,500 women were hospitalized during Hurricane Andrew. A handful of studies — including a 2007 retrospective study published in the Archives of Gynecology and Obstetrics — further suggests there’s a connection between low barometric pressure and the likelihood that fetal membranes will rupture. (Blau, 9/8)

The New York Times: Life After The Storm: Children Who Survived Katrina Offer Lessons
The children upended by Hurricane Katrina have no psychological playbook for the youngsters displaced by Harvey, or those in the path of Irma, the hurricane spinning toward Florida. In the aftermath of Harvey, more than 160 public school districts and 30 charter schools have closed in the sprawling Houston metropolitan area. Families have scrambled to higher ground, some to other cities like Dallas or San Antonio, others into shelters. Thousands of children will have to adjust on the fly, bussed for hours to new schools from makeshift housing. Texas officials are scrambling to coordinate mental health support; the state’s psychology board is issuing temporary licenses for out-of-state therapists. (Carey, 9/8)

Texas Tribune: Harvey Deals A Blow To Texas' Already Struggling Child Welfare System
Texas' child welfare system was already in crisis before Hurricane Harvey. Now, perhaps hundreds of foster families in Houston and along the Gulf Coast have been displaced by the storm and hundreds of child welfare workers have been unable to return to work, said the state official who oversees Child Protective Services on Friday. (Evans, 9/8)

Elsewhere —

NPR: Smoke From Western Wildfires Can Make It Hard To Breathe
It's an unusually bad wild fire season in the West, and for weeks people across the region have been breathing air thick with smoke. "There's smoke from Canada, smoke from Idaho, smoke from California and Montana. There's smoke everywhere," says Greg Svelund, a spokesman for Oregon's Department of Environmental Quality. (Greenhalgh, 9/11)

Urgent Talk On Opioid Epidemic Runs Into Reality Of Getting Things Done In Washington

It's been a month since President Donald Trump declared the crisis a national emergency. That hasn't even been made official yet. Meanwhile, Purdue Pharma says Ohio's lawsuit against the company should be tossed, dental schools are teaching students ways to combat the crisis, a look at the president's claim that a wall will stop the flood of drugs into the country and more.

The New York Times: A Month Has Passed Since Trump Declared An Opioid Emergency. What Next?
When President Trump announced in early August, following a presidential commission’s recommendations, that the opioid crisis was a “national emergency,” he called it “a serious problem the likes of which we have never had.” A month has now passed, and that urgent talk has yet to translate into urgent action. While the president’s aides say they are pursuing an expedited process, it remains to be seen how and by what mechanism Mr. Trump plans to direct government resources. (Haberman, 9/10)

Bloomberg: Ohio's Opioid Suit Should Be Thrown Out, Purdue Pharma Argues 
The state of Ohio’s lawsuit against opioid maker Purdue Pharma should be thrown out because it runs afoul of federal drug regulations and doesn’t show the company’s Oxycontin painkiller marketing caused specific harm, according to a court filing. Stamford, Connecticut-based Purdue filed its response late Friday in state court in Ohio to Attorney General Mike DeWine’s May suit, accusing the pharmaceutical firm and four other opioid makers of using misleading marketing to dupe doctors into over-prescribing opioids. (Feeley and Hopkins, 9/9)

NPR: Teaching Dental Students That Opioids Aren't The Best Way To Treat Pain
The opioid epidemic has been fueled by soaring numbers of prescriptions written for pain medication. And often, those prescriptions are written by dentists. "We're in the pain business," says Paul Moore, a dentist and pharmacologist at University of Pittsburgh School of Dental Medicine. "People come to see us when they're in pain. Or after we've treated them, they leave in pain." (Siegel and Cheung, 9/8)

The Washington Post: President Trump’s Claim That A Wall Will ‘Stop Much Of The Drugs From Pouring Into This Country’
One of President Trump’s signature campaign promises was building a wall along the U.S.-Mexico border to stem illegal immigration. He also insisted that somehow Mexico would reimburse the United States for the cost, but in the meantime he has pushed for start-up funding despite skepticism in Congress. Increasingly, the president has argued that the wall will not only block illegal immigrants but also will stem the flow of drugs coming into the United States from Mexico. Trump repeats this idea often. During rallies. At news conferences. On Twitter. (Lewis, 9/11)

Sacramento Bee: California Opioid Use Shows Regional Differences
There were 1,925 opioid-linked overdose deaths in California last year, according to recently updated state data, and thousands of emergency room visits. ... In rural and semi-rural parts of the state, where the demographics resemble Appalachia more than Anaheim, prescription drug use and death rates vastly exceed the state average, state data show. (Miller, 9/8)

In Search Of Genetic Marker For Suicide: Scientists Envision Medication That Could Save Lives

It will be a long and complicated path even if it's successful, but researchers think searching DNA for links to suicide will eventually lead to them being able to create a pill to stop it. In other public health news: melanoma, doctors and Yelp, breast milk, chemotherapy, tick saliva and more.

Stat: Could A Pill Prevent Suicide? A New Genetics Study In Utah Seeks The Answer
The project, unveiled Friday, seeks to advance existing genetic research on suicide by potentially developing new medications that could help prevent patients from ending their lives. Utah’s famously expansive DNA database makes it an ideal setting for the research. The state also has one of the highest suicide rates in the country — more than 22 per 100,000 people — and suicide is the leading cause of death among youths between the ages of 10 and 17. (Ross, 9/11)

The Washington Post: New Clinical Trial Might Change The Standard Treatment For Melanoma
In a head-to-head comparison of two immunotherapy drugs used to prevent relapse in certain patients with advanced melanoma, one treatment was the clear winner — and it's not the one that most people get. The international study, released Sunday, involved 900 patients whose tumors were removed by surgery but who remained at high risk of recurrence of melanoma, an often aggressive form of skin cancer. (McGinley, 9/10)

Bloomberg: Don't Yelp Your Doctor. Study Finds Ratings Are All Wrong. 
If you’re looking for the best doctor, online ratings are unlikely to be much help. That’s the determination of researchers at Cedars-Sinai Medical Center in Los Angeles, who compared reviews of 78 of the medical center’s specialists on five popular ratings sites with a set of internal quality measures and found there was essentially no correlation. The results suggest that in a world awash in online feedback for seemingly every consumer choice, reliable, easy-to-interpret information on how good doctors are at their jobs remains scarce. (Tracer, 9/8)

The Washington Post: Neonatal Facilities Increasingly Use Donated Breast Milk To Save Premature Babies
The weekly shipment arrived at noon Thursday — 300 ounces of breast milk donated by women across the country and pasteurized at a milk bank in Austin. It was packed with dry ice and shipped via FedEx to feed the most medically fragile premature infants in the neonatal intensive care unit at Children’s National Health System. “Liquid gold,” said Victoria Catalano, a NICU dietitian at the children’s hospital in Washington, holding up a plastic bottle containing three ounces of frozen milk. Then she corrected herself. “Well, that’s liquid gold,” she said, pointing to two large deep freezers stocked with milk the infants’ mothers had produced. “This is the next best thing,” she said. (Chandler, 9/10)

The Washington Post: She Rejected Chemotherapy And Chose To Die Of Cancer — So She Could Give Birth To Her Child
The headaches began sometime in March. They didn’t think much of them, other than that they were possible migraines — until she started vomiting.An initial scan showed a mass in Carrie DeKlyen’s brain. More tests showed that it was a form of cancer, possibly lymphoma, but treatable. But a pathology exam revealed a more grim diagnosis. The 37-year-old mother of five from Wyoming, Mich., had glioblastoma, an aggressive form of brain cancer. If lucky, she could live for five more years. (Phillips, 9/10)

Pittsburgh Post-Gazette: Tick Saliva May Be A Secret Ingredient To Help HIV Patients
The blacklegged tick — the one that carries Lyme disease — may have some value: its spit. The insect’s saliva — which helps it feed on hosts by blocking blood coagulation — is now part of experiments examining ways to reduce heart disease in people living with HIV. Their risk of heart attack and stroke is nearly double that of the general population, according to a study last year. That risk was found even in people whose virus was undetectable in their blood because of antiretroviral drugs. (Daly, 9/9)

The Oregonian: Genetic Test Bumps Breast Cancer Patients Down A Stage Or 2 
For decades, tumor size has been crucial to the treatment and prognosis of breast cancer. Bigger usually meant the cancer was more advanced and at a higher stage, required more treatment and brought a worse outlook. But now physicians have biological tests that help them determine how aggressive the cancer is likely to be and the best course of treatment. (Terry, 9/10)

The Washington Post: E Cyclists’ Recovery From Brain Injuries Can Be Slow, But Death Rate Has Dropped
On the day that would change his life forever, Ryan Brown went on his regular morning run. He rode his bicycle the quick mile to work at the U.S. Trademark and Patent Office in Alexandria, Va., where he was an examiner for plant molecular biology patents. Late in the afternoon, he headed home to take his two sons to dinner while his wife finished teaching a piano lesson. He never made it. (Arcement, 9/9)


Despite Serious Safety Issues, Hospital Watchdog Didn't Change Its Rating Of Facility

An investigation by The Wall Street Journal finds that the Joint Commission, which is the accrediting organization for almost 80 percent of U.S. hospitals, typically takes no action to revoke or modify accreditation when state inspectors find serious safety violations. Meanwhile, an expert talks to Politico about hospitals and health care spending.

The Wall Street Journal: Hospital Watchdog Gives Seal Of Approval, Even After Problems Emerge
Patient-safety problems were so serious at Cooley Dickinson Hospital in Northampton, Mass., that the federal Medicare agency threatened to cut it off. Most patients never knew. Two babies died within six weeks in late 2013 and early 2014. That was just a couple of months after a pregnant woman died when the hospital didn’t ensure she was treated for high blood pressure from a condition called pre-eclampsia, according to a federal inspection report. (Armour, 9/8)

And in news from the states —

Boston Globe: Humane Treatment Comes At Last To Bridgewater State Hospital, Where Prisoners Have Become ‘Persons Served’
In April, a private firm hired by the Baker administration replaced almost all the guards at Bridgewater State Hospital with a specially trained security force, along with psychiatrists and other clinicians equipped to provide more humane methods of handling distressed patients. ... Five months in, the results are remarkable, beyond the imagining of mental health advocates. (Rezendes, 9/8)

KCUR: KU Hospital Denies Patient's Allegations Of Cancer Misdiagnosis And Cover-Up 
The University of Kansas Hospital is denying allegations by a patient that it wrongly diagnosed her with pancreatic cancer and then covered it up. In an answer filed this week, the hospital says that many of the allegations made by Wendy Ann Noon Berner “reference undisputable hearsay and speculation, and many would arguably constitute defamation” if they were not part of a lawsuit. (Margolies, 9/8)

Boston Globe: Former Medical Center Site Said To Have No Takers
Boston-area health care providers have not shown interest in locating their operations at the former Quincy Medical Center site, according to its owner, who had hoped to have a reuse plan for the property before the end of the year. FoxRock Properties, a Quincy commercial real estate firm that bought the former hospital in December 2016, has been marketing the property to health care providers, but they have told FoxRock that the complex is too old and outdated, company representative Chet Clem told more than 50 people at a recent neighborhood meeting. (Terreri Ramos, 9/8)


Rural Mental Health Crisis Center Threatened By Glitch In Iowa's Medicaid Payments

State officials say some of the services provided by the center in rural Appanoose County should qualify for Medicaid reimbursement, but they haven't written rules to make such payments. The center, which opened three years ago, could close next month. Also in Maine, advocates hope that voters can push through a referendum to force the state to accept the health law's Medicaid expansion.

Des Moines Register: Iowa Medicaid Not Set Up To Pay For Lauded Rural Mental Health Facility
An innovative program that provides mental-health help in a rural area desperate for such services is on the cusp of closure, partly because state officials haven't arranged a way for it to bill Medicaid. Numerous southern Iowans who've used the Oak Place center are stepping forward to explain why they want it to stay open, pushing aside fears about being identified publicly as people who were hamstrung by depression or anxiety — and who sought help. (Leys, 9/8)

Modern Healthcare: Maine Residents Hope Ballot Box Will Do What Legislators Couldn't: Expand Medicaid To More Low-Income Adults
A coalition of Democratic and moderate Republican state lawmakers passed bills five times that would have had Maine apply for federal Medicaid expansion money to cover low-income able-bodied adults without children at home. Gov. Paul LePage vetoed them each time. Both Florida and Montana had previously tried to expand Medicaid through a ballot initiative, and neither effort gathered enough signatures. By contrast, Maine collected the 67,000 signatures on a single day — election day, last year. (Lee, 9/8)

State Watch

State Highlights: The Hotly Contested Drug Price Transparency Bill In Calif.; Assisted Suicide Advocates Gear Up For Fight In N.Y.

Media outlets report on news from California, New York, Ohio, Kansas, Virginia and Alaska.

San Jose Mercury News: Fate Of Controversial California Drug Price Transparency Bill Up In Air
Senate Bill 17’s goal of moving toward “transparency” in drug prices would enable health insurers to negotiate lower prices for drugs or, in many cases, replace those drugs with cheaper alternatives, its supporters say. They argue that the measure could make a huge difference because when California has required cost transparency in other areas of the health care industry, prices have stabilized or even decreased. (Seipel, 9/8)

The Associated Press: Groups Aim To Renew Doctor-Assisted Suicide Debate In NY
Groups fighting to give terminally ill people the right to physician-assisted suicide in New York state are gearing up for another fight in the Legislature. The state’s highest court on Thursday ruled against terminally ill patients who argued they should be allowed to seek a doctor’s help in ending their lives rather than suffer needlessly.The decision could send the debate back to the Legislature, where bills to permit and regulate physician-assisted suicide have so far failed. (9/9)

The Associated Press: Abortion Clinic Dispute To Be Argued In Ohio Supreme Court
A dispute over whether to shut down Toledo's last abortion clinic is headed to the Ohio Supreme Court Tuesday, in a case both sides view as pivotal. At issue in oral arguments will be the state health department's 2014 order shutting down Capital Care of Toledo for lack of a patient-transfer agreement, which would formally authorize the transfer of patients from the clinic to a local hospital. (9/10)

San Jose Mercury News: Two Cases Of Hepatitis A Linked To Santa Clara County Jails
As other parts of the state contend with a surge in cases of Hepatitis A, Santa Clara County officials are investigating how a jail inmate and staff member contracted the disease. ... The case involving the inmate was reported to the county Public Health Department at the end of August, and on Tuesday the agency received word that a jail staff member also had contracted the disease. (Green, 9/8)

Richmond Times-Dispatch: Initiatives Underway To Combat Richmond's Food Deserts
In 25 corner stores in Richmond neighborhoods, primarily low-income areas with limited availability of supermarkets, Tricycle Gardens’ Corner Farm initiative brings fresh produce to the people. In a few weeks, for instance, locally grown kale and collard greens will be in season and among the fresh produce on the shelves at the Clay Street Market at North 30th and East Clay streets in Richmond’s Church Hill neighborhood. (Smith, 9/10)

Sacramento Bee: California Dialysis Center Bill Shelved For The Year
Sen. Ricardo Lara, D-Bell Gardens, introduced Senate Bill 349 earlier this year at the behest of the Service Employees International Union-United Healthcare Workers West. ... The measure would have required dialysis centers to provide one nurse for every eight patients and one technician for every three patients, among other new standards. (Luna, 9/8)

The Associated Press: Alaska Gold Rush Town Struggles With Hard-Drinking Legacy
The old Gold Rush town of Nome on Alaska's western coast is trying again to address hard drinking that's deeply entrenched there — this time with a proposed law prohibiting intoxication in public places like the city's main street, where people can be seen stumbling along or passed out near tourist shops. The measure would for the first time outlaw intoxication in public rights of way, such as Nome's Front Street and its sea wall. It targets those with a blood-alcohol content of at least 0.08 percent — the same threshold for driving while intoxicated. (9/10)

Editorials And Opinions

Perspectives: On Obamacare, Is Trump 'Throwing In The Towel' Or Using 'Bureaucratic Sabotage'?

Editorial writers take on a variety of health policy issues, ranging from what's next for the Affordable Care Act, to whether bipartisan reforms are possible and even who is really to blame.

The Washington Post: Are Trump And Republicans Finally Throwing In The Towel On Obamacare?
The single biggest win that President Trump has scored for his economically struggling supporters thus far is his failure to repeal Obamacare. This fact is sitting right at the center of one of the biggest and most-discussed stories in Washington right now — the possibility that Trump may be in the midst of rethinking his approach, and pivoting toward a more sustained effort to make bipartisan deals with Democrats — yet the centrality of it is largely passing unnoticed. (Greg Sargent, 9/8)

USA Today: Trump Shows GOP How It's Done: Scrap Absolutism, Deal With Reality
Turns out as well that repealing the Affordable Care Act, aka Obamacare, is not popular either — especially when the Congressional Budget Office has found that every variation on a replacement would cost people more, take away consumer protections, and insure far fewer — up to 24 million fewer in one case. Those protesting repeal at town meetings included conservatives and Trump voters as well as liberal Democrats. Those seeking a bipartisan compromise to stabilize markets and improve the law include more than a few Republican senators and governors. Those trying to get Congress to abandon repeal and move on include … Trump. At least as of Friday. (Jill Lawrence, 9/10)

The Washington Post: Obamacare Doesn’t Deserve A Bailout
Those who cheered for Senate Republicans to fail have been celebrating ever since, and we’re now hearing calls for bipartisan solutions. While most reasonable people would welcome a bipartisan outcome to this mess, the solutions proffered thus far would do little more than shore up the bad policies already in place with another slate of bad policies. We need legitimate, long-term reforms. (Sen. Orrin Hatch, 9/8)

Sacramento Bee: Is Bipartisan Health Reform Possible?
As a doctor, I know many Americans are concerned about the future of health care. Nobody should have to worry that an unexpected medical bill could threaten their family’s financial security. ... As Congress returns from summer recess, we have a clear decision to make: Can we work together to fix health care? ... But in order for Congress to make improvements, both sides need to honestly discuss the law’s shortcomings. (Rep. Ami Bera, 9/8)

St. Louis Post-Dispatch: Trump Administration Tries Bureaucratic Sabotage To Kill Obamacare
While attention was focused last week on President Donald Trump’s move to end the Deferred Action for Childhood Arrivals program, his administration was moving to sabotage another, much-larger Obama-era achievement: the Affordable Care Act. The Department of Health and Human Services is cutting the budget for outreach programs intended to help Americans sign up for health insurance coverage in 2018. In addition, HHS has cut the sign-up period that begins Nov. 1 from 90 to 45 days. (9/10)

The Washington Post: The ‘Progressives’ Are To Blame, Too, For Mismanaging Our Government
As I have written countless times, the semi-automatic expansion of programs for the elderly (mainly Social Security, Medicare and long-term care under Medicaid) is slowly crowding out many other government programs, from defense to the Centers for Disease Control and Prevention. The paradoxical result is that government spending will grow larger even while it grows less effective. The conventional wisdom in Washington is that the Republicans are responsible for this mess. Their fixation with sizable tax cuts leaves government perpetually dependent on massive borrowing. There is much truth to this. ... The other half is the refusal of Democrats — “liberals” and “progressives” — to cut almost any Social Security and Medicare benefits. They’re essentially off-limits, even though life expectancy has increased and many elderly are well-off. (Robert J. Samuelson, 9/10)

Viewpoints: Coal Country Health Study Is 'No Waste Of Time'; The Fight Against The Opioid Epidemic Continues

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

The Washington Post: Trump Says He Cares About People In Coal Country. So Why Halt A Study On Their Health?
One would imagine that the Trump administration, which swept into power claiming to support the people who live in coal country, would prioritize federal spending on those very people’s health. Instead, the Interior Department has halted a study on how so-called mountaintop-removal coal mining affects people who live around these landscape-stripping operations. Ostensibly, the halt is part of a broad budgetary review. If so, Interior should restart the study quickly. It is a worthwhile use of government research money, and it should proceed no matter which constituency the president had promised to support. (9/10)

The New York Times: A Helpful Tool To Combat The Opioid Crisis
The opioid crisis is so complex and so large — drug-related deaths now exceed those caused by cars, H.I.V. or guns — that there is no single solution. Among the partial ones: prescription drug monitoring programs, an approach highlighted in the draft report from President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. (Austin Frakt, 9/11)

Chicago Tribune: Illinois Vs. The Opioid Epidemic
The epidemic of opioid overdose deaths has been geographically lopsided. West Virginia has the highest rate, followed by New Hampshire, Ohio and Kentucky. Illinois’ rate is one-third of West Virginia’s, but that’s only modest comfort. Last year, 1,889 people died from opioid overdoses in Illinois. ... In recent days, a report put together by a group of state agencies mapped out a comprehensive strategy to eliminate one-third of opioid overdose deaths by 2020. And Gov. Bruce Rauner appointed a task force to look for ways to implement the strategy. ... A big need is greater access to “medication-assisted treatment” (MAT), which offers methadone and buprenorphine , drugs proven useful helping those with “opioid use disorder” (addiction, in common parlance) beat the habit. (9/11)

Kansas City Star: Medicaid Is Not To Blame For The Opioid Crisis
Saying that Medicaid expansion is fueling the opioid epidemic is kind of like saying that a sump pump can cause flooding in your basement. The iffy underpinning for this argument is the fact that many of the states that expanded Medicaid coverage under the Affordable Care Act do have higher overdose death rates. (9/10)

Topeka Capital Journal: Time To Debate Medicaid Expansion
Considering its significance for 150,000 Kansans — as well as hospitals and businesses around the state — Medicaid should be a major issue during this campaign. We should demand robust debate, and we can’t allow candidates to obscure the facts (for example, those who oppose expansion often cite its costs and ignore the economic benefits mentioned above). Kansans support Medicaid expansion, and we need to remind our future governor of this fact. (9/9)

Stat: How Good Is A Doctor At The End Of A 28-Hour Shift?
It isn’t terribly reassuring to know that doctors who might need to make life or death decisions about your health could be doing so after having been awake for so long. Would they be on top of their game at hour 16? What about hour 22? In medicine, the devil can be in the details — what if the doctor was too tired to notice something small that might not actually be that small? But according to the organization that sets the rules on how long resident physicians like me are allowed to work, the Accreditation Council for Graduate Medical Education (ACGME), this is OK. (Christopher Bennett, 9/8)

The Columbus Dispatch: Better Care For The Vulnerable
When it comes to caring for the most vulnerable elderly and mentally ill, Franklin County can take pride in the Guardianship Service Board. It has helped remake a system that once permitted shameful exploitation of wards into one of the state’s best. A new agreement between the board and Ohio State University’s Wexner Medical Center demonstrates how its impact can grow even more. (9/11)

Los Angeles Times: Trump And Sessions Are Ignoring Voters' Overwhelming Support For Medical Marijuana. Will Congress Listen?
Never mind what President Trump said on the campaign trail. His administration and GOP leaders appear determined to eliminate protections for medical marijuana growers, sellers and users. Every year since 2014, Rep. Dana Rohrabacher (R-Costa Mesa) has inserted an amendment into a federal spending bill to prevent the Justice Department from prosecuting medical marijuana businesses that comply with their state’s laws. It’s been a temporary but necessary fix to address a fundamental contradiction: that even though 26 states have legalized medical marijuana, the drug is still prohibited under federal law. ... But last week, the House Rules Committee killed the amendment at the urging of Atty. Gen. Jeff Sessions, a hard-line marijuana prohibitionist. (9/9)