KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Video: Health After A Hurricane

In this Kaiser Health News video conversation, senior correspondent Julie Appleby and Georges Benjamin, the executive director of the American Public Health Association, hold a wide-ranging discussion about the continuing public and environmental health issues resulting from Hurricanes Harvey, Irma and Maria, as well as other natural disasters such as the wildfires ravaging California. (10/11)

Political Cartoon: 'Concussion Protocol?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Concussion Protocol?'" by Gary Varvel, The Indianapolis Star.

Here's today's health policy haiku:

PAY NOW OR PAY LATER

Less contraception
Means more insurance payouts
For maternity.

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

Trump To Sign Executive Order Today To Further Chip Away At Health Law

The order is supposed to ease rules on small businesses banding together to buy health insurance and lift limits on the sale of short-term insurance.

The New York Times: Foiled In Congress, Trump Moves On His Own To Undermine Obamacare
President Trump, after failing to repeal the Affordable Care Act in Congress, will act on his own to relax health care standards on small businesses that band together to buy health insurance and may take steps to allow the sale of other health plans that skirt the health law’s requirements. The president plans to sign an executive order “to promote health care choice and competition” on Thursday at a White House event attended by small-business owners and others. (Pear and Abelson, 10/11)

The Wall Street Journal: In Start To Unwinding The Health Law, Trump To Ease Insurance Rules
President Donald Trump is planning to sign an executive order Thursday to initiate the unwinding of the Affordable Care Act, paving the way for sweeping changes to health-insurance regulations by instructing agencies to allow the sale of less-comprehensive health plans to expand. Mr. Trump, using his authority to accomplish some of what Republicans failed to achieve with their stalled congressional health-care overhaul, will direct federal agencies to take actions aimed at providing lower-cost options and fostering competition in the individual insurance markets, according to a Wall Street Journal interview with two senior White House officials. (Radnofsky, Armour and Wilde Mathews, 10/11)

The Hill: Officials Detail Trump Executive Order On Healthcare Coming Thursday
The order will ease rules on small businesses banding together to buy health insurance, through what are known as association health plans, and lift Obama administration limits on short-term health insurance plans, according to a source on a call with administration officials Wednesday night. The order will direct the Department of Labor to "modernize" rules to allow small employers to create association health plans, the source said. Small businesses will be able to band together if they are within the same state, in the same "line of business," or are in the same trade association. (Sullivan, 10/11)

Politico: Fed Up With Congress, Trump Whacks Obamacare With His Pen
It's not yet clear how far the administration will go, or how quickly it can implement the president's order. But if successful, the new rules could upend the way businesses and individuals buy coverage — lowering premiums for the healthiest Americans at the expense of key consumer protections and potentially tipping the Obamacare markets into a tailspin. "Within a year, this would kill the market," said Karen Pollitz, a senior fellow at the Kaiser Family Foundation who previously worked at former President Barack Obama’s HHS Department. (Cancryn, 10/12)

Reuters: Trump Healthcare Order Could Face Strong Legal Objections
U.S. President Donald Trump's expected plan to let Americans buy insurance across state lines could violate federal law governing employee benefit plans and will almost certainly be challenged in court, several legal experts said. Trump said on Tuesday he would likely sign an executive order this week allowing people to cross state lines to obtain "great, competitive healthcare" that would cost the United States "nothing." (Pierson and Raymond, 10/12)

Iowa Residents Wait To Hear If State's Unique Plan For Insurance Markets Will Be Approved

The state is seeking a federal waiver to set up its own insurance marketplace, which officials said could offer better prices to consumers. But the change would also mean that customers could not get federal subsidies to help them defray costs. Also, news outlets report on marketplace news in Tennessee and California.

Des Moines Register: Iowa Health Insurance Market Is In Flux, Three Weeks Before Sign-Ups
[Glen] Gardner and tens of thousands of other Iowans are anxiously awaiting the outcome of last-minute negotiations over state regulators’ “stopgap” proposal to shore up Iowa’s health-insurance market. Iowans heard last week that President Donald Trump allegedly demanded his administrators reject the proposal, which would rewrite key rules of the Affordable Care Act. The president wants to repeal the law, also known as Obamacare. He has said Republican politicians should let Obamacare collapse in order to build support for the repeal effort. Just one carrier, Medica, plans to sell individual health-insurance policies in Iowa under current rules, which will remain in place if the state’s stopgap plan is rejected. Medica plans to raise its premiums by an average of nearly 58 percent. (Leys, 10/11)

Politico Pro: Iowa Democrats Request Trump Administration Records On Stalled Obamacare Waiver
The state Democratic Party filed a Freedom of Information Act request days after The Washington Post reported that Trump in August personally asked top health officials to turn down the plan after reading about it in The Wall Street Journal. Iowa officials have said their plan, which would rewrite major parts of Obamacare, is needed to prevent its individual insurance market from collapsing. (Pradhan, 10/11)

Nashville Tennessean: Vanderbilt Health Inks Deal To Be On 2018 ACA Exchange
Vanderbilt University Medical Center has worked out a contract with Cigna to be covered under individual health insurance plans in 2018. The contract means people in Davidson and eight surrounding counties will be able to see VUMC doctors in-network via the Cigna Connect plans. And, unlike in 2017, the plans covering the health system are eligible for tax credits for those who financially qualify. (Fletcher, 10/11)

California Healthline: California Slaps Surcharge On ACA Plans As Trump Remains Coy On Subsidies
California’s health exchange said Wednesday it has ordered insurers to add a surcharge to certain policies next year because the Trump administration has yet to commit to paying a key set of consumer subsidies under the Affordable Care Act. The decision to impose a 12.4 percent surcharge on silver-level health plans in 2018 means the total premium increase for them will average nearly 25 percent, according to Covered California. Taxpayers, not consumers, will bear the brunt of the extra rate hike because federal premium assistance for policyholders, which is pegged to the cost of coverage, will also increase. (Terhune, 10/11)

Women’s Health

Liberal Groups See Political Advantage In Rollback Of Contraception Mandate

“As millions of women watch this administration take away fundamental health care like birth control, they’re also paying attention to all those members of Congress who are not standing up to fight for them,” says Erica Sackin, political communications director for the Planned Parenthood Action Fund.

The Washington Post: Liberal Groups Plan To Hammer Vulnerable Republicans On Birth Control
Liberal groups are seizing on Republican attempts to roll back health coverage and limit access to birth control, as they seek to galvanize women voters ahead of next year’s midterm elections. Organizations such as Planned Parenthood Action Fund and Emily’s List believe the Trump administration handed them a potent political issue Friday when it carved out wide exceptions to the Affordable Care Act’s promise of no-cost contraception. Activists plan to link this action to congressional Republicans’ repeated attempts to undercut the ACA in ways that could have caused millions to lose health insurance, as part of a broader strategy focused on defeating moderate GOP members and buttressing vulnerable Democrats. (Viebeck, 10/11)

The Associated Press: Women's Health Docs Say Trump Ignores Birth Control Science
The Trump administration's new birth control rule is raising questions among some women's health experts, who say it overlooks known benefits of contraception while selectively citing data that raise doubts about effectiveness and safety. "This rule is listing things that are not scientifically validated, and in some cases things that are wrong, to try to justify a decision that is not in the best interests of women and society," said Dr. Hal Lawrence, CEO of the American Congress of Obstetricians and Gynecologists, which represents women's health specialists. (Alonso-Zaldivar, 10/11)

The Philadelphia Inquirer/Philly.com: Pennsylvania Sues Trump Administration Over Birth Control Rollback
Pennsylvania Attorney General Josh Shapiro on Wednesday became the latest official to sue the Trump administration over its move to roll back the Affordable Care Act’s birth control coverage mandate. ... On Friday, the Department of Health and Human Services issued a directive that would let many more employers, including colleges, universities, and health insurance companies, deny birth control coverage on moral grounds. (McCullough, 10/11)

In other women's health news —

The Hill: ACLU, Planned Parenthood Sue Missouri Over New Abortion Law 
Planned Parenthood and the American Civil Liberties Union (ACLU) of Missouri sued the state of Missouri on Tuesday over new abortion regulations. The groups argue a recently passed law "severely restricts access to safe, legal abortion" by requiring the same physician performing an abortion to be the one giving state-mandated information to a patient 72 hours before the procedure. (Hellmann, 10/11)

Capitol Hill Watch

New York Facing Dire Consequences If Congress Doesn't Act On CHIP, State Official Warns

The state would have to address a nearly $1 billion shortfall if Congress doesn't renew funding for the popular program.

The Hill: New York Warns HHS Over Children's Health Care Funding Delay 
New York will have to convene a special legislative session to address a nearly $1 billion shortfall if Congress doesn’t quickly renew funding for the Children’s Health Insurance Program (CHIP), the state’s health department said Wednesday. In a letter to Acting Health and Human Services Secretary Eric Hargan, the state’s health commissioner warned about the consequences if CHIP funding is not renewed “in the next few weeks.” (Weixel, 10/11)

In other news from Capitol Hill —

The Hill: Senate Dems Urge NIH To Renew Gun Research Grants 
Senate Democrats are calling on the National Institutes of Health to renew recently-lapsed funding for gun violence research following the Las Vegas concert shooting. In a letter to NIH Director Dr. Francis Collins, Democratic Sens. Elizabeth Warren (Mass.), Chris Murphy (Conn.), and 21 others joined Sen. Bernie Sanders (I-Vt.) in saying that continuing the program is urgent. (Weixel, 10/11)

Medicare

Medicare Advantage Plans' Star Ratings Shows Little Change In Quality Over Past Year

Although the number of these plans earning four stars or better have fallen slightly, more beneficiaries are signing up for the higher performing plans.

Modern Healthcare: Medicare Advantage Star Ratings Show Insurers' Performance Hasn't Improved 
The CMS' release of its Medicare star ratings reveals that performance among insurers overall in Medicare Advantage remains largely unchanged year-over-year. ... The CMS said about 44% of the 384 active Medicare Advantage contracts in 2018 that also have Part D prescription drug coverage earned 4 stars or higher for their overall rating. This is a drop from 2017 when about 49% of the 363 active Medicare Advantage plans earned 4 stars or higher. Although the overall number of 4-star or high plans dropped slightly, more beneficiaries will be covered by the highest performing Medicare Advantage plans in 2018, the CMS said. Nearly 73% of Medicare Advantage enrollees are in contracts with 4 or more stars, compared to about 69% of enrollees in such plans last year. (Castellucci, 10/11)

The Philadelphia Inquirer: Ten Questions To Ask During Medicare Open Enrollment
It’s time for one of the more confusing rituals of the retirement years: Medicare open enrollment. If you like your current plan, it might be tempting to leave things alone for another year, but experts say that’s not a good idea. Insurers tweak Medicare Advantage plans all the time, and depending on your needs, these changes can cost you money or leave you unable to see your favorite doctors. Even in traditional Medicare, it’s a good idea to reevaluate your drug plan because insurers may change which drugs they cover or the co-pays they charge. (Burling, 10/12)

Pharmaceuticals

To Bring Down Big Pharma, This BioHacker Wants To Teach Patients To Make Own Medications

Michael Laufer's latest plan involves developing a desktop lab and a recipe book meant to equip patients to cook up a range of medicines, including a homemade version of the expensive hepatitis C drug Sovaldi, on their kitchen counters. In other news: an old FDA program is responsible for higher drug prices and lawmakers want more oversight over the 340B program, which allows hospitals to purchase drugs at a discounted rate.

Stat: An Anarchist Takes On Big Pharma — By Promoting DIY Prescription Drugs
Swaggering, charismatic, and complex, Michael Laufer has become a fixture in the growing biohacker movement ever since he published plans last year for a do-it-yourself EpiPencil — a $35 alternative to the pricey EpiPen. It’s not clear whether anyone has actually ever used a homemade EpiPencil to prevent anaphylactic shock. But that seems almost an afterthought to Laufer’s bigger goal — trying to build a DIY movement to attack high pharma pricing and empower patients. (Piller, 10/12)

Stat: An FDA Program To Approve Old Drugs Causes Higher Prices And Shortages
In 2006, the Food and Drug Administration launched a program to require drug makers to win approval of medicines that — believe it or not — were being sold without the agency’s imprimatur or remove them from the market. At the time, hundreds of treatments were readily available because some companies failed to comply with a 1962 law mandating companies prove drugs were effective. ...More medicines may have received needed regulatory approval, but often enough, shortages ensued, prices rose, and there was no new clinical evidence to support the vast majority of the medicines that were approved, according to a new study published in the Journal of Managed Care & Specialty Pharmacy. (Silverman, 10/11)

Stat: D.C. Pharmacist Has Something To Say About That Alzheimer’s Remark
The pharmacist who prepares prescription drugs for Congress would like you to know that he does not know of any members with Alzheimer’s. And if he did, he wouldn’t tell you. “I am not aware of any member that actually has Alzheimer’s and would certainly not disclose any such information if I did know,” Mike Kim said, adding that “patient privacy is a very serious matter that I am committed to upholding.” (Mershon, 10/11)

Modern Healthcare: Lawmakers Worry Providers Are Abusing The 340B Program
Federal lawmakers said Wednesday that the 340B program that allows hospitals to purchase drugs at discounted rates does not have enough oversight, leaving it susceptible to misuse. Approximately 45% of all acute-care hospitals participate in the 340B program, which has grown significantly. The Medicare Payment Advisory Commission estimates that 2,140 hospitals participated in the program in 2014, up from 583 in 2005. Program spending during that period jumped from $2.4 billion to $14 billion, according to federal data. (Dickson, 11/11)

Morning Consult: House Republicans Ramp Up Scrutiny Of Providers In Drug Discount Program
House Republicans are intensifying scrutiny of a federal program that gives thousands of safety-net providers hefty discounts on prescription drugs but that they say doesn’t have effective tools to track where the savings are going. The 340B Drug Pricing Program makes some providers, such as children’s hospitals, federal health centers and specialty clinics, eligible for discounts of between 25 to 50 percent on outpatient drugs. Providers are supposed to use the generated savings to ensure low-income patients have access to essential health services and treatments. ... At a hearing on Wednesday, the [Energy and Commerce] committee’s chairman, Greg Walden, (R-Ore.) said some providers recently interviewed by the committee don’t have policies in place to ensure all their eligible patients directly benefit from the program or track their 340B savings on a regular basis. (Reid, 10/11)

Public Health And Education

The Opioid Epidemic's Deadly Grip On The Bronx

Perhaps nowhere in New York City has the trajectory of opioid addiction been as complex as in the Bronx, which lost more residents to drug overdoses last year than any other New York City borough.

The New York Times: The Bronx’s Quiet, Brutal War With Opioids
The bodies turn up in public restrooms, in parks and under bridges, skin tone ashen or shades of blue. The deceased can go undiscovered, sometimes for hours, or days if they were alone when they injected heroin and overdosed. Terrell Jones, a longtime resident of the Bronx, was pointing to the locations where overdoses occurred as he drove through the East Tremont neighborhood, the car passing small convenience stores, rowhouses and schools. (DelReal, 10/12)

CQ: Lawmakers Urge More Action On Opioids
More than 50 lawmakers testified Wednesday at a House committee hearing on the nation’s opioid epidemic, describing how the crisis has devastated their communities and proposing solutions. While many applauded bipartisan legislation passed last year that included hundreds of millions of dollars targeting opioid abuse, they emphasized that more needs to be done. More than 90 Americans die from opioid overdoses each day, said House Energy and Commerce Committee Chairman Greg Walden, R-Ore. (Williams, 10/11)

How Hurricanes Hammer Already Struggling Mental Health Systems

Officials say the long-term psychological injuries after a hurricane outpace more immediate issues and swamp the health care system long after emergency workers go home and shelters shut down. Meanwhile, health care providers are flocking to Puerto Rico to offer their help, and a study finds that evacuating residents from a nursing home before a storm actually increases the chances of death or injury.

Politico/Stateline: 'Katrina Brain': The Invisible Long-Term Toll Of Megastorms
Brandi Wagner thought she had survived Hurricane Katrina. She hung tough while the storm’s 170-mph winds pummeled her home, and powered through two months of sleeping in a sweltering camper outside the city with her boyfriend’s mother. It was later, after the storm waters had receded and Wagner went back to New Orleans to rebuild her home and her life that she fell apart. “I didn’t think it was the storm at first. I didn’t really know what was happening to me,” Wagner, now 48, recalls. “We could see the waterline on houses, and rooftop signs with ‘please help us,’ and that big X where dead bodies were found. I started sobbing and couldn’t stop. I was crying all the time, just really losing it.” (Vestal, 10/12)

Modern Healthcare: Healthcare Providers Answer The Call To Lead Relief Efforts In Puerto Rico
Many have criticized the federal government for being slow in its response to Puerto Rico compared to its efforts in Texas after Hurricane Harvey or Florida after Hurricane Irma. The immediacy of the need for relief has prompted healthcare providers to take a lead role in providing support. ... Along with Florida Hospital, providers based in New York have been among the leaders in the relief effort. New York City has the largest Puerto Rican population in the mainland U.S. (Johnson, 10/10)

Kaiser Health News: Video: Health After A Hurricane
If a hurricane strikes where you live, how does it affect your health and well-being? In this Kaiser Health News video, senior correspondent Julie Appleby and Georges Benjamin, the executive director of the American Public Health Association, discuss the ongoing public and environmental health concerns resulting from Hurricanes Harvey, Irma and Maria — and the latest natural disaster of wildfires in California. (10/11)

Texas Tribune: Texas Creates Task Force To Address Students' Post-Harvey Trauma
When the clouds darken and rain starts pouring down, many Houston-area elementary school students get nervous and start to sob — a sign of the long-lasting effects of watching the water levels rise during and after Hurricane Harvey. ...To address such challenges, the Texas Education Agency on Wednesday announced a task force — in conjunction with the Texas Higher Education Coordinating Board and the Texas Health and Human Services Commission — that will connect Harvey-affected schools, universities and their communities with counselors, training, and funding opportunities as they continue to deal with the after-effects of the destructive storm. (Swaby, 10/11)

Miami Herald: Ophelia Becomes 10th Consecutive Hurricane This Year
Ophelia became a hurricane late Wednesday, the tenth in a row and tying a record set more than a century ago. Located in the central Atlantic about 760 miles southwest of the Azores, the hurricane poses no threat to land and would probably be unremarkable if not for its place in the record books. (Staletovich, 10/11)

Hot New Cancer Treatment Comes With Sometimes Toxic Side Effects, And Scientists Want To Know Why

The therapy uses patients' own immune system to help fight the disease, but it can lead to dangerous complications. In other public health news: cervical cancer, the evolution of cells, stroke risks, high blood pressure, vaccines and more.

The Washington Post: Cancer Researchers Learn More About Toxic Side Effects Of New Treatments
One of the most promising new cancer treatments involves altering patients' own immune cells to attack blood cancers. But it comes with a big downside: It can cause serious side effects, including high fevers and sharp drops in blood pressure as well as potentially fatal brain swelling. Now researchers at two major cancer centers — Fred Hutchinson Cancer Research Center in Seattle and MD Anderson Cancer Center in Houston — are homing in on these toxic complications to better understand why they occur, which patients are most vulnerable to the side effects and how to prevent them. (McGinley, 10/12)

NPR: Do Women Still Need 2 Tests For Cervical Cancer?
A proposal to simplify cervical cancer screening could end up missing some cancers, researchers and patient advocates say. And that could be especially true for minority women. Latina and black women already have the highest rates of cervical cancer in the U.S., and more than half of women with the disease were not screened in the five years before their diagnosis, according to the Centers for Disease Control and Prevention. (Haelle, 10/11)

Boston Globe: Scientists Aim To Address Racial And Ethnic Disparities In Cancer Research
It is a medical puzzle: Why are death rates for black men with prostate cancer almost 2.5 times the rate of white men in the United States? ... Understanding those biological differences is difficult, however, because many ethnic and racial groups are underrepresented in genomic studies and in the cell lines and clinical trials used to test new drugs, said Franklin Huang, an oncologist at Dana-Farber Cancer Institute. (Levenson, 10/11)

Stat: Meet The MacArthur 'Genius' Tracking The Evolution Of Our Cells
This year’s crop of MacArthur “geniuses” included artists, writers, computer scientists — and one biomedical researcher: Gabriel Victora, an immunologist who’s studying how our bodies respond to foreign invaders. Victora — who runs an immunology research lab at Rockefeller University in New York City — didn’t pick up the phone the first time the folks at MacArthur tried to call to notify him he’d won the award. Nor did he pick up the second time his phone rang, or the third. He was sitting in on a seminar. (Thielking, 10/12)

NPR: Modifiable Stroke Risks Still Rising Across All Ages, Races
For years, doctors have been warning us that high cholesterol, cigarette smoking, illegal drug use and diabetes increase our chances of having a potentially fatal stroke. And yet, most of the stroke patients showing up at hospitals from 2004 to 2014 had one or more of these risk factors. And the numbers of people at risk in this way tended to grow among all age groups and ethnicities in that time period. (Fulton, 10/11)

The New York Times: High Blood Pressure In Midlife Tied To Later Dementia
Women with high blood pressure in their 40s are at increased risk for dementia in later years, researchers report. But the finding does not hold for men. Beginning in 1964, investigators collected health and lifestyle information on 5,646 men and women when they were 30 to 35 years old, and again when they were in their 40s. From 1996 to 2015, 532 of them were found to have Alzheimer’s or other forms of dementia. The study is in Neurology. (Bakalar, 10/11)

NPR: Why Does Sex Exist? This 18-Million-Year-Old Worm Left It All Behind
Abstinence may have found its most impressive poster child yet: Diploscapter pachys. The tiny worm is transparent, smaller than a poppy seed and hasn't had sex in 18 million years. It's basically just been cloning itself this whole time. Usually, that's a solid strategy for going extinct, fast. What's its secret? (Bichell, 10/12)

Stat: Century-Old Vial Sheds Light On One Of Medicine's Enduring Mysteries
A115-year-old vaccine vial has provided an important clue in the search for an answer to one of medicine’s enduring mysteries: What went into the world’s first vaccine?  Medical legend has it that Edward Jenner — the father of vaccination — used cowpox virus to protect against the dreaded smallpox. But a new report, published Wednesday, shows a virus closely related to the horsepox virus was used in a 1902 smallpox vaccine, providing fresh ammunition to those who believe the history books have it wrong. (Branswell, 10/11)

The Wall Street Journal: Ebola Vaccines Show Promise In New Study
The first placebo-controlled study of two vaccines against the Ebola virus found they both successfully created a powerful antibody response for a year, suggesting they both could be tools to save lives in a future epidemic of the deadly disease. The research, by doctors from the U.S. and Liberian governments and elsewhere, was published Wednesday in the New England Journal of Medicine. The study looked at 1,500 patients in Liberia, and took place amid and after the outbreak of Ebola in Liberia from 2014 into 2015. (Burton, 10/11)

WBUR: Obesity In Children And Teens Rose Sharply Worldwide Over Past 4 Decades
In just over four decades, obesity levels in children and teenagers have risen dramatically worldwide, though that rise has been far from uniform. In a new study published online Tuesday, British researchers and the World Health Organization say those levels have plateaued lately in high-income countries, "albeit at high levels," while the rise in obesity rates has only accelerated in regions such as East Asia and Latin America. (Dwyer, 10/11)

Denver Post: Aurora Mental Health Agencies And Kaiser Permanente Expand Access, End Stigma
Kaiser Permanente timed the kickoff of some efforts to broaden its reach to coincide with National Suicide Prevention Awareness Month in September. Its new campaign, “Find Your Words,” encourages people to discuss their mental illness and treatment and help remove the stigma. One of Kaiser’s public service announcements features a young black teenager walking alone around his neighborhood. He doesn’t speak, but the lyrics to rapper and songwriter Kendrick Lamar’s confessional “i” are recited. It is vastly different from the typical pharmaceutical industry commercial related to mental health. (Scoville, 10/11)

State Watch

After Deal With Loyola, Tenet Has Its Foot Out The Door In Chicago

Loyola Medicine will buy MacNeal Hospital, and Tenet is looking to sell its other three hospitals in the city, as well.

Modern Healthcare: Tenet Eyes Chicago Exit, Sells MacNeal Hospital To Loyola 
Loyola Medicine has a deal to acquire MacNeal Hospital in Berwyn, Ill., a community facility owned by for-profit giant Tenet Healthcare Corp. And Dallas-based Tenet is looking to sell its other three hospitals here and exit the Chicago market entirely, just four years after it arrived, a source close to the company said. Tenet, with nearly 80 hospitals nationwide, also owns Weiss Memorial Hospital in the Uptown neighborhood, Westlake Hospital in Melrose Park and West Suburban Medical Center in Oak Park. Dallas-based Tenet has been busy shopping around its hospitals nationwide. (Schorsch, 10/11)

Chicago Tribune: Loyola Medicine To Acquire MacNeal; Tenet Seeks To Sell 3 Other Chicago-Area Hospitals 
Loyola Medicine plans to buy MacNeal Hospital in Berwyn, further expanding its reach while adding another name to the list of suburban hospitals snapped up by Chicago-area health systems. It also marks the beginning of the end of Tenet Healthcare Corp. in Chicago. The for-profit hospital chain, which owns MacNeal, has three other Chicago-area hospitals it plans to sell: Weiss Memorial Hospital in Chicago, Westlake Hospital in Melrose Park and West Suburban Medical Center in Oak Park. Dallas-based Tenet is in discussions with potential buyers for those hospitals. (Schencker, 10/11)

In hospital news elsewhere —

Denver Post: Welltok Acquires Georgia's Tea Leaves, Gains Access To 400 Hospital Partners And Consumer Data
Denver’s Welltok expanded big time into hospitals on Wednesday with its purchase of Tea Leaves Health, a Georgia digital-health company that uses data to help hospitals connect with patients and doctors. The acquisition gives the Denver firm access to Tea Leaves’ more than 400 hospitals, plus customers in 30 percent of the nation’s top health systems, according to Welltok. The company said it paid $83 million for Tea Leaves. By comparison, Ziff Davis paid $30 million when it purchased of Tea Leaves in 2015. Ziff Davis is now owned by j2 Global. (Chuang, 10/11)

The Oregonian: Nurse Who Objected To 'Rushing Patients' Settles Case 
A Portland nurse who successfully argued that she was fired for raising an alarm about hospital cutbacks that she believed jeopardized patient care has agreed to settle her case two years after a jury awarded her $3.1 million. Linda Boly had not received any of the jury award since the September 2015 verdict in Multnomah County Circuit Court because Legacy Good Samaritan Medical Center appealed the verdict to the Oregon Court of Appeals. (Green, 10/11)

State Highlights: In Minn., Nurses File Complaint About Allina Staffing; Mich. Gov.'s Testimony On Legionnaire's Disease Outbreak Draws Scrutiny

Media outlets report on news from Minnesota, Michigan, Tennessee, California, Massachusetts, Ohio, Georgia and Oregon.

The Star Tribune: Nurses File Complaint Over Allina Staffing
The union representing Allina Health hospital nurses filed a complaint Wednesday — one year to the day after ending a 37-day strike — over the continued assigning of patients to supervisory charge nurses. Allina leaders haven't lived up to a key provision in the contract that ended the strike, said Emily Sippola, a nurse at United Hospital in St. Paul: a commitment to meet and discuss how to prevent charge nurses from being overworked by being assigned patients. (Olson, 10/11)

The Washington Post: Michigan Governor Sticking To Story About Legionnaires’
Michigan Gov. Rick Snyder is sticking by his congressional testimony about when he learned about a fatal outbreak of Legionnaires’ disease during the Flint water crisis, despite a senior aide’s new disclosure that he informed the Republican governor weeks earlier. Some Democrats in Congress are pouncing on the conflict and urging the U.S. House Oversight and Government Reform Committee to investigate. (White, 10/11)

Nashville Tennessean: Nashville's Emergency Rooms Prep For Mass Shootings, Stock 'Go Bags,' Tourniquets And Revise Plans
The frequency of mass shootings has changed how Nashville's top trauma medicine experts think about whether it could happen here: It's no longer a theoretical scenario of "if." It's when. And with each event — the Pulse Nightclub shooting in 2016, the Las Vegas shooting, the 2011 massacre that killed 77 in Norway, the 2015 attack at the Bataclan in Paris, to name just a few — the trauma teams review what happened and modify their plans. (Fletcher, 10/11)

Detroit Free Press: Beaumont, U-M-Dearborn Collaborate On A New Autism Center In Dearborn
The newly expanded 33,000-square-foot center is a collaboration between the Beaumont Center for Exceptional Families and the University of Michigan-Dearborn's Early Childhood Education Center, and includes a preschool program where children with autism can be included with typically developing children and experience what it's like to be in a mainstreamed classroom before they start kindergarten. The demand for a center like this is huge. About 50,000 people in Michigan are on the autism spectrum. It is the fastest-growing developmental disability in the U.S., according to the Centers for Disease Control and Prevention, now affecting as many as 1 in every 68 children. (Shamus, 10/11)

Sacramento Bee: Smoke From Northern California Wildfires Blankets Sacramento With Unhealthy Smoke
Sacramento Valley and foothills residents awoke Wednesday to the heavy smell of smoke, hazy brown skies and ashes on car windshields – the result of nearly two dozen Northern California wildfires, including the Atlas Fire, which exploded overnight in the hills west of Fairfield. ...Air meters throughout the region registered unhealthy levels of particulate matter from Vacaville and Davis in the west valley to higher foothill elevations in Grass Valley and Colfax early Wednesday. (Bizjak, Anderson and Glover, 10/11)

California Healthline: Giving Birth Is Hard Enough. Try It In The Middle Of A Wildfire.
Days before there was any sign of fire, Nicole and Ben Veum of Santa Rosa, Calif., had been waiting and waiting for their baby to arrive. Nicole’s due date came and went. Her doctor called her into the hospital — Sutter Santa Rosa Regional Hospital — to induce labor. That was Friday. “So we were very excited at that point,” she said. “And then, day after day after day with not a whole lot of progress.” (Dembosky, 10/11)

Columbus Dispatch: Local Vietnam Veterans Share Struggles With Late-Onset PTSD
About 8 percent of people who serve in the military go on to develop PTSD, said Heather Axtell, who oversees trauma recovery in the behavioral-health service at the Department of Veterans Affairs’ Chalmers P. Wylie Ambulatory Care Center on the Northeast Side. That means that about 700,000 veterans of the Vietnam War, which ended more than 40 years ago, have struggled with the disorder. (Viviano, 10/12)

Georgia Health News: Parents, Advocates Sue State, Claim Inequities In GNETS Schools
Parents of children with disabilities and advocacy groups filed a lawsuit in federal court Wednesday alleging the state of Georgia has discriminated against students placed in “unequal and separate’’ schools for kids with behavioral disorders and problems. The Georgia Network for Educational and Therapeutic Support (GNETS) schools are “segregated programs,’’ housed in separate buildings or in separate wings of regular schools, the lawsuit says. (Miller, 10/11)

Atlanta Journal-Constitution: Georgia Disabled Students Segregated In Inferior Schools, Suit Alleges
Georgia uses its unique network of psychoeducational schools as a “dumping ground” for unwanted students with disabilities, a new class-action lawsuit claims. The suit, filed Wednesday by several advocacy groups on behalf of three parents, accuses state officials of violating federal law and the U.S. Constitution by placing disabled children in segregated schools and classrooms operated by the Georgia Network for Educational and Therapeutic Support, or GNETS. (Judd, 10/11)

Cincinnati Enquirer: What's Top Concern For Cincinnati Parents? Their Kids' Mental Health
In a first-of-its-kind survey this year by Beech Acres Parenting Center, nearly half of Greater Cincinnati parents, 44 percent, said “understanding kids’ mental health issues” is “very or extremely concerning” to them. More than half of respondents, or 55 percent, were “very or extremely interested” in getting training or guidance to address childhood mental-health issues. (Saker, 10/11)

Kaiser Health News: Dementia Patient At Center Of Spoon-Feeding Controversy Dies
An Oregon woman with Alzheimer’s disease, whose husband claimed she was kept alive with spoon-feeding against her written wishes, has died. Nora Harris, 64, died early Wednesday at the Fern Gardens senior care center in Medford, Ore. Her husband, Bill Harris, said the death marks the end of an eight-year battle with the progressive, debilitating disease, which included an unsuccessful court fight to withdraw all food and liquid. (Aleccia, 10/12)

Editorials And Opinions

Viewpoints: Trump's Order Won't Improve Health Care; Why Is Congress Delaying CHIP Funds

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

Bloomberg: Trump's Cure for Obamacare Is Worse Than the Disease
On Twitter, President Donald Trump said he would be “using the power of the pen to give great HealthCare to many people — FAST.” He isn’t bluffing. His White House has been working on a series of executive actions on health insurance. But his tweet is misleading. The most far-reaching action under consideration would not give anyone health care. Rather, it would dramatically reduce enforcement of Obamacare’s fines on people without insurance. (Ramesh Ponnuru, 10/11)

Huffington Post: Trump Plans To Sign Order That Would Undermine Obamacare Insurance Rules
President Donald Trump on Thursday plans to sign an order that could rattle the Affordable Care Act’s private insurance markets by allowing a proliferation of cheaper, less comprehensive plans that would undermine rules about who and what insurers must cover. The changes represent a step toward repeal of Obamacare, something Trump and Republicans have unsuccessfully attempted to do through legislation. And the ultimate impact on small businesses and people who buy private coverage on their own ― the two groups Thursday’s order would affect directly ― is likely to resemble some of the effects that experts predicted GOP repeal bills would have if they become law. (Jonathan Cohn, 11/11)

Los Angeles Times: The High Price Of The Trump Administration's Waffling On Healthcare
Covered California made it official Thursday: The Trump administration’s waffling will raise health insurance premiums an additional 12.4% for many Californians not covered by large employer plans. In some cases, the Trump-induced surcharge will be 27%. Those increases are on top of an average premium increase of 12.5% due to other factors. In other words, premium increases will be twice as high next year for many Californians, simply because the Trump administration (and Congress) won’t commit to reimbursing insurers for the payments the government requires them to make. (Jon Healey, 10/11)

Los Angeles Times: 11 Days And Counting: Why Hasn't Congress Renewed Health Insurance Program For 9 Million Children?
We know that Congress is just unimaginably busy right now, so perhaps it’s understandable that 11 days after funding for a crucial children’s healthcare program expired, the lawmakers still haven’t gotten around to restoring it. We’re talking about the Children’s Health Insurance Program, a state-federal program serving 9 million children and their mothers. (Michael Hiltzik, 10/11)

The Washington Post: Trump Does Nothing To Stop 175 American Deaths A Day
Americans are dying at the rate of 175 a day from opioid overdoses, but President Trump has yet to deliver his promised strategy to end the crisis. And so the people’s representatives, in the absence of presidential leadership, did about the only thing they could do. They had a day of opioid karaoke. There wasn’t actual music. But it was open-mic day Wednesday before the House Energy and Commerce Committee. The panel invited members of Congress to take the witness seat and, in three minutes or less, sing a sad song about how the opioid crisis is ruining the lives of their constituents. (Dana Milbank, 10/11)

The New York Times: On Contraception, It’s Church Over State
Saudi women are gaining the right to drive. American women are losing the right to employer-provided birth control. The first development signifies a theocratic kingdom’s bow to the inexorable onslaught of modernity. The second is a cynical bow to the forces of reaction against modernity. (Linda Greenhouse, 10/11)

Forbes: What Are Adult Day Centers -- Besides The Basis For Political Insults?
Adult day centers seem to have made it into the political debate in Washington, though not in a good way. In his nasty weekend back-and-forth with President Trump, Senator Bob Corker (R-TN) suggested the White House has become an “adult care center” and wondered if the staff had “missed a shift” when Trump launched his Sunday Twitter storm. ... Leaving aside this mature level of political discourse, the name-calling does raise an important question: What are adult day centers and how do they work? Adult day centers can be an important service to frail seniors and other people with disabilities who are living at home. (Howard Gleckman, 10/11)

San Jose Mercury News: David Chui Bill Will Save Money By Housing Homeless
Gov. Jerry Brown can take an important step in recognizing housing is health care by signing Assembly Bill 74 by Assemblyman David Chiu, D-San Francisco. Our emergency department staff at Santa Clara Valley Medical Center can do little to prevent a homeless patient from returning again and again to the hospital for preventable and manageable conditions. (Rene Santiago, 10/11)

Weekend Reading

Longer Looks: Puerto Rico's Health Care; Cancer Drugs In Africa & Undermining Obamacare

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

FiveThirtyEight: If Puerto Rico Were A State, Its Health Care System Would Recover Faster From Maria
Nearly three weeks after Hurricane Maria landed in Puerto Rico as a Category 4 hurricane, health care providers are still struggling. Almost all of the community health centers — which are a lifeline for the poorest people — on the western half of the island were still closed Friday or operating at partial capacity. There are serious concerns about how they and other health service providers will begin even basic recovery in many places where diesel is still scarce and communication almost nonexistent. (Anna Maria Barry-Jester, 10/9)

The New York Times: As Cancer Tears Through Africa, Drug Makers Draw Up A Battle Plan
In a remarkable initiative modeled on the campaign against AIDS in Africa, two major pharmaceutical companies, working with the American Cancer Society, will steeply discount the prices of cancer medicines in Africa. Under the new agreement, the companies — Pfizer, based in New York, and Cipla, based in Mumbai — have promised to charge rock-bottom prices for 16 common chemotherapy drugs. The deal, initially offered to a half-dozen countries, is expected to bring lifesaving treatment to tens of thousands who would otherwise die. (Donald G. McNeil, 10/7)

WIRED: The Speculum Finally Gets A Modern Redesign
That the speculum is old is not, on its face, a problem. It's that the design is neither optimal for patients nor physicians. Doctors have to stretch the speculum's bills wide in order to see as far back as the cervix, and even then, it's not always possible to get a good look inside. (Some specula come with built-in lights, but the problem has more to do with tissue falling in than the darkness of the vaginal canal.) All of that pressure causes discomfort; one review of the medical literature found that some women even avoid the gynecologist because of the dreaded device. (Arielle Pardes, 10/5)

Vox: I’m An OB-GYN Who Had A 2nd-Trimester Abortion. The 20-Week Ban Bill Is Dangerous.
For women who choose to end a pregnancy in the second trimester — medically defined as between the 13th and the 27th week of gestation — the reasons often involve medical complications. As an obstetrician and a woman who has had a second-trimester abortion, I must emphasize the damaging effects of this bill. Without my procedure, I would have been condemned to carry to term a baby doomed to suffer and die — even as I continued to see patients and delivered other people’s healthy babies. (Cheryl Axelrod, 10/9)

The New York Times: Why Are More American Teenagers Than Ever Suffering From Severe Anxiety?
The disintegration of Jake’s life took him by surprise. It happened early in his junior year of high school, while he was taking three Advanced Placement classes, running on his school’s cross-country team and traveling to Model United Nations conferences. It was a lot to handle, but Jake — the likable, hard-working oldest sibling in a suburban North Carolina family — was the kind of teenager who handled things. Though he was not prone to boastfulness, the fact was he had never really failed at anything. Not coincidentally, failure was one of Jake’s biggest fears. He worried about it privately; maybe he couldn’t keep up with his peers, maybe he wouldn’t succeed in life. The relentless drive to avoid such a fate seemed to come from deep inside him. He considered it a strength. (Benoit Denizet-Lewis, 10/11)

Huffington Post: Trump Has A New Plan To Undermine Obamacare And It Doesn't Need Congress 
President Donald Trump has already done a lot to sabotage the Affordable Care Act, whether it’s slashing the program’s advertising budget or threatening to cut off some payments that insurers need to cover their costs.Now Trump is thinking about using his executive authority to do something that could be even more damaging to the law ― and, arguably, more threatening to people who depend on it for coverage. (Jonathan Cohn, 10/9)