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Political Cartoon: 'Push Over?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Push Over?'" by Bob Englehart, CagleCartoons.com.

Here's today's health policy haiku:

Fiscal Revenue Needs Now and in the Future

Tax cuts all the rage!
But we love entitlements
Deficits and debt!?

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Summaries Of The News:

Health Law

Trump's Health Care Executive Order Expected This Week, But What Will It Really Do?

Media outlets examine what's expected in the administration's proposal to allow for association plans, which may give small employers and individuals the ability to secure the same kind of benefits and lower prices that large employers have been able to get.

NPR: Will Trump's Order Really Expand Health Care Choices?
President Trump is poised to sign an executive order that he says will make it easier for people to join together as a group and buy health insurance from any state. The president tweeted about his plans on Tuesday morning. "Since Congress can't get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people — FAST," he wrote. (Kodjak, 10/10)

The Hill: Trump Says Health Executive Order 'Probably This Week' 
President Trump said Tuesday that he will be signing an executive order on health care "probably this week" that will provide "great, great health care." Trump's executive order, which has been expected for several weeks, is aimed at allowing small businesses and other groups to join together to buy health insurance through what are known as association health plans. (Sullivan, 10/10)

Los Angeles Times: Obamacare 101: How Trump Might 'Use The Power Of The Pen' To Overhaul Healthcare
President Trump, who has been unable to get Republicans in Congress to roll back the Affordable Care Act, is promising to issue an executive order this week that he says will offer relief to consumers facing rising insurance premiums. Administration officials are reportedly looking specifically at ways to loosen health insurance regulations and promote wider use of a form of insurance known as association health plans. (Levey, 10/10)

Bloomberg: A Trump Order On Obamacare Could Further Destabilize Fragile Markets 
An executive order from President Donald Trump to allow new health plans outside of Obamacare could further destabilize the law’s fragile markets, health-care experts say. In the last week, Trump has talked about taking action to create more health-care options for people. Insurance experts say one option Trump’s likely considering would create what are known as association health plans. The plans would loosen regulations to let people band together and buy cheaper, unsubsidized coverage outside of the Affordable Care Act. (Rausch, 10/10)

The Associated Press: Trump Health Coverage Alternatives May Pose Risk To The Sick
The White House is working on a plan that could bring more health insurance choices and cheaper options to people buying individual and small business coverage. But the bill for this might be paid by the sick. Senior administration officials have said President Donald Trump is expected sign an executive order this week to expand the use of health plans offered through associations. These groups already allow individuals or businesses to band together to buy coverage, and Trump's order could increase their use by making it easier to sell this coverage across state lines. (10/10)

Washington Examiner: Trump's Executive Order Would Mean Cheaper Insurance Premiums For Healthy Obamacare Customers
President Trump is expected to sign an executive order on Obamacare this week that would allow people to buy cheaper health insurance with fewer regulations, targeting healthcare goals that eluded congressional Republicans all year. The full details of the executive order have not been released, but enough information has been reported to reveal its overall framework. Trump would direct the Departments of Labor, Treasury and Health and Human Services to make changes to regulations so more people could band together to buy "association health plans" which would allow individuals or small businesses to band together, such as members of a Chamber of Commerce, to buy plans sold across state lines. The order also would allow people to buy short-term health insurance plans for longer than the Obama administration allowed and would encourage the use of health savings accounts. (Leonard, 10/11)

Bloomberg: This Is What Trump Could Do To Obamacare With An Executive Order 
President Donald Trump on Tuesday hinted on Twitter that he’s getting closer to signing an executive order that could erode Obamacare, after Republicans in Congress failed to pass a repeal bill. The Wall Street Journal reported on Saturday, citing an administration official, that an executive order regarding association health plans would be signed this week. The official echoed the president’s Sept. 27 comments to reporters, when he said he would “be signing a very major executive order where people can go out, cross state lines, do lots of things and buy their own health care.” (Rausch, 10/10)

Federal Officials Weigh Iowa's Request To Revamp Insurance Enrollment System

Iowa is seeking to move out of the federal marketplace system and set up a state-run exchange instead. State officials say that would help lower premiums, but that could come with higher out-of-pocket costs for consumers. News outlets also report on enrollment issues in Florida and Kansas.

The New York Times: In New Test For Obamacare, Iowa Seeks To Abandon Marketplace
With efforts to repeal the Affordable Care Act dead in Congress for now, a critical test for the law’s future is playing out in one small, conservative-leaning state. Iowa is anxiously waiting for the Trump administration to rule on a request that is loaded with implications for the law’s survival. If approved by the federal Centers for Medicare and Medicaid Services, it would allow the state to jettison some of Obamacare’s main features next year — its federally run insurance marketplace, its system for providing subsidies, its focus on helping poorer people afford insurance and medical care — and could open the door for other states to do the same. (Goodnough, 10/10)

Des Moines Register: Reynolds Seeks Conversation With Trump On Iowa's Stopgap Insurance Proposal
Iowa Gov. Kim Reynolds said Tuesday she has requested a conversation with President Donald Trump following a news report that he instructed his top human services administrator to deny Iowa's proposal to stabilize its individual insurance market. "I haven’t spoken directly to the president," Reynolds told reporters at her weekly news conference. "I’ve asked for a conversation." The Washington Post reported last week that Trump, upon hearing of Iowa's waiver request, called the administrator overseeing the proposal and told her to reject it. (Pfannenstiel, 10/10)

Kansas City Star: Trump's Obamacare Cuts Lead Kansas City Health Organizations To Buy TV Ads
The Community Health Council of Wyandotte County has run ads online and on radio in past years urging uninsured people to sign up for coverage through the Affordable Care Act, often called Obamacare. But after President Donald Trump’s administration announced in August that it was slashing 90 percent of the funding for the federal government’s ACA ads this year, the group decided to start placing TV ads as well. (Marso, 10/10)

And in other news about the health law —

Stateline: Mobile Clinics Assume Greater Role In Preventive Care
Encouraged by incentives in the Affordable Care Act, health care providers and insurers are trying to treat health care problems before they turn into costly health crises. Mobile clinics are an effective way to reach patients who may forgo preventive care because they can’t afford it or can’t get to a doctor’s office. ... Studies have shown the success of mobile clinics in identifying and improving previously undiagnosed conditions. A 2014 study published in The American Journal of Managed Care found that Family Van patients who were diagnosed with high blood pressure had significantly lower blood pressure on follow-up visits. That led to fewer health crises, including a 32 percent reduction in the relative risk for heart attack and a 45 percent reduction in the relative risk of stroke. (Rodd, 10/11)

Modern Healthcare: Delivery System Reform Hampers ACO Progress On Risk-Based Contracts 
Accountable-care organizations are participating more and more in risk-based contracts, but that progress has been stalled by sluggish care-delivery changes, a new survey suggests. Roughly 50% of ACOs are involved in at least one downside risk contract, such as shared savings and capitation contracts, according to a Leavitt Partners and National Association of ACOs report recently published in Health Affairs. About 47% of ACOs plan to participate in shared-savings risk-based contracts in the next year or so. (Castellucci, 10/10)

Administration News

Gottlieb Says He Can Be Most Effective At FDA, But Dodges Question On Nomination Talks

"I feel like I want to continue to follow through on the policies we've put out and it's where I think I can be most effective," said Food and Drug Administration Commissioner Scott Gottlieb, whose name has been floated as a replacement for former Health and Human Services Secretary Tom Price. Meanwhile, President Donald Trump names an acting secretary for the agency.

Reuters: Food And Drug Chief Gottlieb Skirts Health Secretary Talk, Says Most Effective At FDA
U.S. Food and Drug Administration Commissioner Scott Gottlieb, considered a potential successor to recently departed Health and Human Services Secretary Tom Price, said on Tuesday he believed he could best serve the Trump administration in his current role. "I feel like I want to continue to follow through on the policies we've put out and it's where I think I can be most effective," Gottlieb told Reuters in an interview in New York. (Clarke, 10/10)

The Hill: FDA Chief Plays Down Talk Of Succeeding Price At HHS 
But Gottlieb did not rule out moving up to the Health and Human Services (HHS) secretary position, declining to say whether he has been in talks about the job. “I‘m not going to get into private discussions I might have had around that,” he said. (Sullivan, 10/10)

CQ: FDA Chief's Fans Hopes He Gets Passed Over For Promotion
Food and Drug Administration Commissioner Scott Gottlieb is considered to be a leading contender to succeed Tom Price as Health and Human Services secretary. While many, including Republicans in Congress, think he is qualified for the promotion, many of his fans and allies would lament his departure from FDA. In the five months since he was confirmed to lead FDA, Gottlieb has steered clear of controversy or drama, made overtures to Democrats who opposed him and tried to strike a balance between consumer concerns and industry demands. While those things help make a case for him as HHS secretary, there is also a fear that Gottlieb’s departure from FDA would have negative implications. (Siddons, 10/11)

The Hill: Trump Announces Hargan As New Acting HHS Secretary
President Trump announced a new acting secretary for the Department of Health and Human Services: Eric Hargan, who the Senate confirmed last week to fill the No. 2 position within HHS. Hargan will fill the post vacated by Tom Price, who came under fire and resigned late last month as HHS secretary after a series of Politico articles reported his use of private and government planes for travel cost taxpayers more than $1 million. (Roubein, 10/10)

Bloomberg: Trump Names Hargan As Acting Health And Human Services Secretary 
President Donald Trump has formally designated Eric Hargan as acting secretary of the U.S. Department of Health and Human Services, taking over for a deputy who’s held the job since Tom Price resigned from the post late last month over his use of taxpayer dollars to travel in private jets. Hargan, a former corporate lawyer who served on Trump’s transition team, takes over for Don Wright, the deputy Health and Human Services secretary, who had been acting secretary since Price was forced to step down after just seven months on the job. (Marois, 10/10)

Trump's Birth Control Mandate Not Scientifically Sound, Researchers And Doctors Say

The rules provide moral and religious exemptions to a requirement that employers provide coverage plans that include contraception.

The Associated Press: Critics Say Trump Birth Control Rule Ignores Science
The Trump administration's new birth control rule is raising questions among some doctors and researchers. They 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, a professional society representing women's health specialists. (Alonso-Zaldivar, 10/11)

The Oregonian: After Trump Rollback, Most Oregon Women Will Still Have No-Cost Birth Control
Last week, President Donald Trump loosened an Affordable Care Act requirement that required insurance plans to offer no-cost contraception for women, allowing more employers to opt out for moral or religious reasons. But most Oregon women won't be impacted by the move, the Oregon Department of Consumer and Business Services reported Tuesday. ... That's because in August, Oregon Governor Kate Brown signed House Bill 3391 into law. The bill, also called the Reproductive Health Equity Act, requires, among other things, all insurance plans to cover no-cost birth control beginning Jan. 1, 2019. (Acker, 10/10)

Capitol Hill Watch

Rep. Walden Delays House Vote On Children's Insurance To Seek Compromise With Democrats

Funding for the Children's Health Insurance Program expired last month. Although both parties support the program, they are divided about how to pay for it in this bill.

The Hill: House GOP Delays Vote On Children's Health Care Funding To Negotiate With Dems 
Republicans on the House Energy and Commerce subcommittee on health have agreed to return to negotiations with Democrats on a bill to continue funding for the popular Children's Health Insurance Program (CHIP). House Energy and Commerce Chairman Greg Walden (R-Ore.) said Monday he would delay floor consideration of the bill passed by the committee last week "in hopes of reaching a bipartisan agreement on offsets." (Hellmann, 10/10)

The Hill: Clinton Urges Congress To Reauthorize Children's Health Care Program 
Hillary Clinton issued her strong support for the Children’s Health Insurance Program in a series of tweets Monday night, urging Congress to re-authorize the program, which expired last month. “This hasn't gotten enough [attention]: For the first time, Congress missed the deadline to reauthorize the Children's Health Insurance Program,” Clinton said. (Carter, 10/9)

Pharmaceuticals

What Do Lawmakers Do When They Need Prescriptions Filled? They Don't Walk Into The Nearest CVS

It's a little-known perk, but lawmakers have their pills delivered directly to the Capitol, so they can just walk down and pick them up. That also means the pharmacist in charge of filling the prescriptions knows a lot more about the leaders of the country than most pharmacists know about their customers.

Stat: Pharmacy Hand-Delivers Drugs To Congress, A Perk For The Powerful
If House Speaker Paul Ryan comes down with the flu this winter, he and his security detail won’t be screeching off toward the closest CVS for his Tamiflu. Instead, he can just walk downstairs and pick up the pills, part of a little-known perk open to every member of Congress, from Ryan and Majority Leader Mitch McConnell down to the newest freshman Democrat. Nearly every day for at least two decades pharmaceutical drugs have been brought by the carload to the Capitol — an arrangement so under the radar that even pharmacy lobbyists who regularly pitch Congress on their industry aren’t aware of it. (Mershon, 10/11)

In other pharmaceutical news —

Stat: FDA Permits Importation Of Saline Bags To Address Shortages
To address a shortage of intravenous solution bags exacerbated by Hurricane Maria, the Food and Drug Administration has granted permission for a health supply company to import certain products to the United States from Australia and Ireland. In letters dated Monday, the company, Baxter International, informed its customers that they could now order bags of saline solution that are manufactured abroad even though they are not FDA-approved because they are not marketed in the United States. Saline solution, given intravenously, is used for hydration and to dilute drugs. (Swetlitz, 10/10)

Arizona Republic: Goldwater Institute Seeks Ebola Drug Records FDA Refuses To Provide
The federal agency that oversees drug safety made a quick decision in 2014 to allow two health-care workers to take a yet-to-be-tested drug after they contracted the Ebola virus while volunteering in Liberia. The two health workers, Dr. Kent Brantly and Nancy Writebol, became the first humans to ever get the experimental drug, called ZMapp, and both recovered from their illness. (Alltucker, 10/10)

Public Health And Education

For Leading Doctors' Group There's No Gray Area: Guns Kill People And Are A Public Health Threat

“Guns do not make individuals, their families, or homes safer and they result in far more deaths to loved ones than to an intruder intending to cause harm," Dr. Howard Bauchner, editor in chief of the influential Journal of the American Medical Association wrote. In other public health news: obesity rates in children, epidurals, social media and young people, fertility and more.

Los Angeles Times: 'Guns Kill People,' And Leading Doctors Want To Treat Them Like Any Other Threat To Public Health
The doctors who lead the medical profession’s debates on how best to preserve and restore our health are done with moments of silence in the face of gun-related violence. In the wake of a mass shooting that killed 59 people and wounded hundreds more in Las Vegas, they neither minced words nor observed political niceties in describing the threat that firearms pose to Americans’ health. (Healy, 10/10)

The Washington Post: New Maps Show Big Divide Between The World’s Overweight And Underweight Children
The weight problems that preoccupy Americans typically are about how to lose weight, not gain it. But a study published in the Lancet on Tuesday night provides a sobering look at how much the relationship children globally have with food and weight depends on where they are growing up. The study reports that the number of obese children has increased more than tenfold in the past four decades — from 5 million girls in 1975 to 50 million in 2016, and from 6 million boys in 1975 to 74 million in 2016. (Cha, 10/10)

The New York Times: Epidurals Do Not Prolong Labor
Many obstetricians resist giving epidural anesthesia during the late stage of delivery because they believe it lengthens the duration of labor. But a clinical trial by Chinese researchers has found that it does not. The study, in Obstetrics & Gynecology, randomized 400 women in labor to receive either a standard epidural anesthetic or a saline solution in an identical container. Neither the patients nor the health care providers knew who was receiving which. (Bakalar, 10/10)

Kaiser Health News: Social Media Is Harming The Minds Of Our Youth, Right? Maybe Not.
It was 1:30 a.m., and Anna was trying to keep her mind off her ex-boyfriend, with whom she had ended a painful relationship hours earlier. It was too late to call the therapist she was seeing to cope with low self-esteem and homesickness, and too late to stop by a friend’s house. So, she turned to social media. “I’m having a really hard time right now,” Anna — who asked to be identified by a pseudonym — posted on Facebook. “Is there anyone I can call and talk to until I feel better?” (Jacewicz, 10/11)

Stat: Ovarian Reserve Tests Aren't A Good Predictor Of Fertility, Study Finds
Tests that measure a woman’s “ovarian reserve” to estimate how many more years of fertility she has have grown increasingly popular. But a new study finds that levels of the hormones commonly tested aren’t tied to lower chances of getting pregnant. The new research, published in the Journal of the American Medical Association, looked at three markers: anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B. (Thielking, 10/10)

Stat: Why Are There So Few Medical Geneticists?
Research grounded in genetics is booming: Therapies are in the works to treat a number of rare, inherited disorders, from blindness to nerve disease. But there’s a shortage of doctors trained to diagnose and treat such illnesses. During match season for medical trainees this year, just 30 of the 55 spots for medical genetics residencies in the U.S. were filled. (Thielking, 10/11)

First Lady Wants To Help Battle Opioid Crisis, But What Those On The Front Line Say They Need Is Money

Melania Trump met with staff members and former clients of a clinic that helps children born with addiction. It's unclear how the first lady will be able to help those on the ground fighting the epidemic, though. Meanwhile, Democrats push for a rule to require testing for transportation workers.

The New York Times: Melania Trump Says She Aims To ‘Give A Voice’ To The Victims Of Opioids
Melania Trump, a once-reluctant first lady who has lately been ramping up her travels as well as directing her aides to lash out at rivals, allowed the public a glimpse at her nascent platform on Tuesday at a clinic that treats infants born with addiction. Mrs. Trump flew about 400 miles to this western edge of the state. Her visit is a signal that her interests — so far stated broadly as helping children and combating cyberbullying — have narrowed, at least for now, to focus on learning more about the opioid epidemic. (Rogers, 10/10)

The Hill: Dems Press Trump To Require Opioid Testing For Transportation Workers
Democrats are pressing the Trump administration to move ahead with a stalled rule that would require opioid testing for certain transportation workers. Currently, the Department of Transportation (DOT) only administers a five-panel drug test for safety-sensitive transportation workers, which includes marijuana, cocaine and PCP. (Zanoma, 10/10)

And in news from the states —

Concord (N.H.) Monitor: $3 Million Anonymous Donation To Help Babies Affected By Drug Abuse
New Hampshire babies born to drug-addicted mothers received a leg up Tuesday. The New Hampshire Charitable Foundation announced a new fund created with an anonymous $3 million donation to assist mothers with substance use disorders and their children. Nearly 470 New Hampshire babies were born exposed to drugs last year, compared with 367 in 2014, according to the state’s Division for Children, Youth and Families. Concord Hospital alone recorded 70 substance-exposed births in 2016. (Willingham, 10/10)

Medicaid

Federal Officials Approve W.Va.'s Plan To Expand Medicaid Coverage For Drug Treatment

West Virginia officials say Medicaid will begin paying for about a 30-day stay at a residential drug treatment center, as well as methadone treatment and the overdose reversal drug naloxone.

The Hill: West Virginia Gets Approval To Expand Substance Abuse Treatment Coverage
The Trump administration has approved a request by West Virginia to expand Medicaid coverage for treatment of substance abuse disorders, state officials announced Tuesday. West Virginia has the highest rate of drug overdose deaths in the country, and officials said the waiver will contribute to a “comprehensive statewide strategy” to combat prescription drug abuse and opioid use disorders. (Weixel, 10/10)

The Associated Press: West Virginia Gets OK To Expand Medicaid Drug Treatment
The waiver from the U.S. Centers for Medicare and Medicaid Services was requested to improve care and outcomes by expanding services for those diagnosed with a substance use disorder. ... The waiver is more than 80 percent funded by the federal government. West Virginia led the nation with 41.5 overdose deaths per 100,000 people in 2015. State officials say they rose nearly 18 percent last year, killing 864 people. (10/10)

Charleston (W.Va.) Gazette-Mail: Medicaid To Begin Paying For 30-Day Drug Treatment And Naloxone
In about nine months, Medicaid is scheduled to begin paying for about a 30-day stay at a residential drug treatment center, according to state officials. The state Department of Health and Human Resources anticipates Medicaid will also begin paying for methadone and the overdose reversal drug naloxone, including referrals to treatment that first responders would make after responding to an overdose, in January. Medicaid billing for peer recovery support services would begin in July. (Beck, 10/10)

Women’s Health

Missouri Abortion Restrictions Challenged In Court By Planned Parenthood And ACLU

The groups argue that the requirements of the new state law are medically unnecessary and limit access to safe and legal reproductive services. Meanwhile, another American Civil Liberties Union lawsuit centers around a legal dispute over whether unaccompanied immigrant minors have the right to an abortion in the U.S.

The Associated Press: Planned Parenthood, ACLU Sue Over Missouri Abortion Law
Planned Parenthood and the American Civil Liberties Union filed a lawsuit Tuesday seeking a temporary injunction against a portion of a new law passed this summer that tightens abortion regulations in Missouri. During a special session called this summer by Gov. Eric Greitens, lawmakers approved a bill that gave the attorney general new powers to prosecute people who violate abortion laws and enacted several new requirements, such as annual state health department inspections of clinics and approval of clinics' plans for handling complications during medication-induced abortions. (Stafford, 10/10)

KCUR: Planned Parenthood Challenges New Missouri Abortion Restrictions In Court 
Just two weeks before new regulations on Missouri abortion providers would take effect, the state’s Planned Parenthood affiliates are challenging the provisions in state court. The General Assembly approved several new rules by a wide margin in a lengthy special legislative session called by Governor Eric Greitens this summer. Greitens, a Republican, signed the law, which among other things requires the physician who will be performing an abortion to explain the risks to the patient no less than 72 hours before the procedure. (Ellison and Margolies, 10/10)

Texas Tribune: Undocumented Teenager In Texas Seeks Court Authorization For Abortion
In a news release, the ACLU stated that Doe "is currently being prevented from accessing abortion care because the Trump administration has adopted a new policy that directly prevents unaccompanied immigrant minors from obtaining abortions." In addition, Doe was forced to go to a religious clinic for counseling and a pregnancy test, according to Jane's Due Process, a nonprofit that provides legal representation for pregnant minors in Texas and is also involved in the case. (Afiune, 10/10)

State Watch

State Highlights: The Demise Of Chicago's Soda Tax; N.H. Foundation Aims To Aid Expectant Mothers Struggling With Addiction

Media outlets report on news from Illinois, New Hampshire, Oregon, California, Louisiana, Ohio, Wisconsin and Georgia.

The Washington Post: Why Chicago’s Soda Tax Fizzled After Two Months — And What It Means For The Anti-Soda Movement
About two months after the country’s largest soda tax went into effect, embattled lawmakers in Cook County, Ill. — the home of Chicago — have decided to repeal it. The tax has been plagued, in its very short life, by legal challenges, implementation glitches and a screeching, multimillion-dollar media battle between the soda industry and public health groups. On Tuesday, in recognition of growing public pressure, the Cook County Board of Commissioners voted 15-1 to roll back the tax, effective as soon as Dec. 1. (Dewey, 10/10)

New Hampshire Public Radio: Charitable Foundation Launches $3 Million Effort To Support Mothers And Babies Impacted By Opioids
The message from the New Hampshire Charitable Foundation to expecting and new mothers struggling with addiction is simple: help is available, and more is coming. The Foundation on Tuesday announced a new three-year $3 million grant program, courtesy of an anonymous donor, that will help fund both residential and outpatient programs in the state that support mothers and their babies affected by substance misuse. (Bookman, 10/10)

Stat: STAT List: These 10 Cities Had The Biggest Jumps In Hospital Jobs
The health care industry has been a main driver of employment gains since the Great Recession, with hospitals in particular fueling job creation around the country. The jobs have been a boon to communities, and the competition is so fierce to fill open spots that hospitals have had to get creative. But there’s a risk, too: If the country ever actually tries to control health care costs, it won’t be able to support as many jobs in the industry. (Joseph, 10/11)

The Oregonian: Oregon Fines Zoom+Care Parent $285,000 As Part Of Lawsuit Settlement 
State insurance regulators have settled their lawsuit against the founders of Zoom Management, reaching a deal that includes $285,000 in civil penalties. The department said Zoom Management and an affiliate, Zoom Health Plan, also agreed to pay $2.1 million in cash to cover member claims and liabilities. The settlement allows Zoom Management to concentrate on running and growing its popular chain of health clinics, the company said. Those clinics, located in Portland and Seattle, see about 20,000 patients a month, generating about $50 million in annual revenue. (Manning, 10/10)

New Orleans Times-Picayune: East Jefferson General Hospital Finds Lease Partner, Same One It Always Preferred
East Jefferson General Hospital, five years after it began seeking a corporate operator, has finally found one. It's the same company that the Metairie hospital's leaders favored during the early phases of the tortuous political process of putting East Jefferson General under control of a private company. The publicly owned hospital's governing board said Tuesday (Oct. 10) it is has accepted a letter of intent to lease the property to University Healthcare System, a partnership between HCA Healthcare and Tulane University. The Nashville, Tenn.-based HCA is one of the largest health care companies in the country, with 174 hospitals and 119 free-standing surgery centers in 20 U.S. states and in the United Kingdom. Its network includes Tulane Medical Center in New Orleans, Tulane Lakeside Hospital in Metairie and Lakeview Regional Medical Center near Covington. (Broach, 10/10)

Milwaukee Journal Sentinel: Wisconsin Pharmacal Co. Donates Water Purification Products
Jackson-based Wisconsin Pharmacal Co., a manufacturer of Potable Aqua water purification products, said Tuesday it has donated enough water purification tablets to purify 15,000 liters of water for those affected by Hurricanes Harvey, Irma and Maria. The company also said it is working to get its Potable Aqua PURE Water Purification Devices, each capable of purifying more than 60,000 liters of water, to Puerto Rico. (Taschler, 10/10)

Georgia Health News: Want Medical Wishes Carried Out? You May Need A POLST
Today, Georgia has what is known as a POLST form (Physician Orders for Life-Sustaining Treatment). Many nurses and physicians are hopeful that use of POLSTs will better serve patients who may be near death. But many medical personnel and hospitals are still not familiar with the POLST document or its latest legal revision. (Kanne, 10/10)

Prescription Drug Watch

Author Of New Drug Transparency Law Hopes Rest Of Country Will Follow In California's Footsteps

News outlets report on stories related to pharmaceutical pricing.

Stat: Q&A: Can California's New Drug Price Transparency Law Make A Difference?
On Monday, California adopted a law that requires drug makers to explain and justify price hikes, making it only the third state in the country to demand some transparency in response to rising medicine prices. Although the law does not actually allow the state to control pricing, the pharmaceutical industry fought the effort over concerns other states will now pursue similar legislation, since California is often seen as a bellwether. We spoke with state Sen. Ed Hernandez, the Democratic legislator who shepherded the bill — and who believes it can force a change in the national conversation about drug pricing. (Silverman, 10/10)

Stat: Biotech Execs Are Fretting A Bit Less These Days About Lowering Drug Prices
Biotech executives appear slightly less concerned about drug pricing than in the recent past, according to a new analysis, but the continued pressure from payers and lawmakers to bring down costs does still weigh on them. A review of risk factors cited by the 100 largest companies listed in the Nasdaq Biotechnology Index found 84 percent cited worries over pricing pressures, according to the BDO advisory and consulting firm, which examined the most recent crop of annual filings with the US Securities and Exchange Commission. (Silverman, 10/5)

Bloomberg: Trump’s Fastest Moving Agency Is Approving Drugs And Pleasing Wall Street 
Gridlock under the Trump administration, particularly the repeated failures to repeal and replace Obamacare, is riveting the nation’s attention. Yet at least one government agency is running smoothly -- and even accelerating its operations. The U.S Food and Drug Administration, under Commissioner Scott Gottlieb, is taking advantage of policy groundwork laid in past years to speed drug approvals. Thirty-four new drugs -- treating everything from cancer to rare genetic diseases -- have been approved so far this year. That’s on pace to nearly double last year’s approvals. So far, at least nine decisions came more then 20 days ahead of the FDA’s scheduled action date. (Chen and Paton, 10/6)

Stat: California Bans Drug Coupons When Cheaper Alternatives Are Available
Call it a one-two punch. At the same time California Governor Jerry Brown signed a law requiring drug makers explain and justify price hikes, he also signed another law prohibiting the use of prescription drug coupons when a lower-priced medicine is available. The law reflects controversy over the role that coupons play in the debate over rising health care costs, and also arrives as state and federal authorities examine other forms of financial assistance that the pharmaceutical industry provides patients. (Silverman, 10/10)

Healthline: Drug Price Gouging Laws May Become A New Trend
Maryland has permission to go after prescription drug price gouging.A federal judge gave the go-ahead last week. Drug makers had attempted to block the state’s first-in-the-nation law targeting extreme increases in generic drug prices. The ruling adds Maryland to a growing number of states taking action against high drug prices, as Congress lags behind with similar proposed legislation. (Radcliffe, 10/10)

The New York Times: Price Matters, In Patients’ Minds
When people believe a medicine is expensive, they may show a greater response to it. Researchers told 49 volunteers that they were testing two anti-itch creams — one that was costly, and one cheap — that contained the same ingredient known to reduce itch, but that the ingredient sometimes increased sensitivity to heat. (Bakalar, 10/5)

Bloomberg: Amazon Is Headed For The Prescription-Drug Market, Analysts Say
Amazon.com Inc. is almost certain to enter the business of selling prescription drugs by 2019, said two analysts at Leerink Partners, posing a direct threat to the U.S.’s biggest brick-and-mortar drugstore chains. “It’s a matter of when, not if,” Leerink Partners analyst David Larsen said in a report to clients late Thursday. “We expect an announcement within the next 1-2 years.” (Langreth and Soper, 10/6)

Forbes: One Of Biotech's Hottest Names Embraces Pharma's Bygone Era
Susan Waite, 48, still remembers hearing her disease's name, myelofibrosis, for the first time five years ago. "You Google," she says. "I know you're not supposed to, but everybody does. And at the time the average life expectancy was two and a half years." This rare cancer was turning her bone marrow, which produces blood cells, into scar tissue, leaving her anemic. She had one child in high school and two more in college, and was so tired she'd gone from being a social butterfly to a person who goes to bed right after dinner. Her spleen was so enlarged with blood cells that it hurt and prevented her from eating. (Herper, 10/10)

Stat: Spark's Gene Therapy For Blindness Is Racing To A Historic Date With The FDA
The $1 million medicine is coming. On Thursday, a committee of experts invited by the FDA will meet outside Washington D.C. to review an experimental gene therapy from Spark Therapeutics (ONCE). Barring unexpected surprises, the experts will advise the FDA to approve the one-time shot, which will be used to treat a rare, inherited form of childhood blindness. (Feuerstein, 10/9)

CBS News: Time To Review Your Medicare Rx Coverage
With Medicare's open-enrollment period approaching -- Oct. 15 to Dec. 7 -- you should be getting ready to review your Medicare prescription drug coverage. Your goal is to minimize your total out-of-pocket spending for prescription drugs, including your premiums, co-payments and deductibles. Let's first look at some basic information about prescription drug coverage under Medicare. (Vernon, 10/10)

Bloomberg: Big Pharma Gets Boost As China Speeds Up New Drug Approvals
For decades, Chinese patients have struggled to gain access to cutting-edge medicines thanks to bureaucratic delays that have hamstrung drug development. Now a sweeping government overhaul of drug approvals is poised to change that.  Beijing on Sunday announced new rules that will speed up approvals of medicines and medical devices, easing bottlenecks in introducing new treatments. The move is also a growth opportunity for international and local drugmakers in the world’s second biggest pharmaceutical market. It also parallels the acceleration of approvals by the U.S. Food and Drug Administration. (10/8)

Stat: A Drug With The Power To Mute Defective Genes Raises Hopes — Cautiously
The experimental drug has startling powers: It can turn down a mutant gene in a patient’s body, stopping the production of proteins that cause a terribly painful rare disease. A crucial, late-stage clinical trial showed that the drug works — and that it’s safe. And now the biotech company behind it, Alnylam, is poised to bring this first-of-its-kind therapy to market. (Keshavan, 10/5)

Nashville Tennessean: How United Way Helped Families Save Millions On Rx
Pricey prescriptions can easily sink family budgets but United Way of Metropolitan Nashville has helped connect more than 52,000 people to a discount program that's saved them millions of dollars in prescription costs. Families around Nashville have saved about $7 million at the pharmacy through United Way's decade-long partnership with FamilyWize, a for-profit company that offers prescription discount cards. People using the program in Rutherford and Cannon counties have saved an additional $836,146, according to an estimate from United Way officials. (Fletcher, 10/4)

Perspectives: Expensive Cancer Drugs May Finally Be In For A Little Competition

Read recent commentaries about drug-cost issues.

Bloomberg: Cancer-Drug Prices Are At A Tipping Point
Cancer drugs generate a great deal of outrage with their six-figure price tags for vulnerable patients. Until now, they've faced little in the way of price competition. That finally might be set to change with a recent wave of FDA approvals. (Max Nisen, 10/10)

Bloomberg: The Hepatitis Drug Market Is Worse Than Wall Street Realizes
And then there were three.Johnson & Johnson and Merck & Co. Inc. have both recently halted development of drugs to treat hepatitis C (HCV), with no plans to work on any others. This capitulation leaves the market largely split between Gilead Sciences Inc., AbbVie Inc., and a drug Merck already has on the market. (Max Nisen, 10/4)

Forbes: Reforming The 340B Program Will Lower The Price Of Prescription Drugs
The U.S. health care system needs systemic reforms that comprehensively address the problems of declining quality and rising costs. Alas, beneficial systemic reforms will not be implemented any time soon. There are still opportunities for Congress to implement tailored reforms that can help address these problems in the near term. One such opportunity is reforming the out-of-control 340B drug pricing program (the federal drug discount program created under the Veterans Health Care Act of 1992). (Wayne Winegarden, 10/10)

Detroit News: Drug Prices Need State Review
Back-to-school season can be an exciting and hectic time of year for many of us. As a former teacher, I know our educators are busy making final preparations to ensure our classrooms are safe and productive learning spaces. Parents are working to check off every last item on the school supply list to set their student up for success. But for many Michigan families, this back-to-school list can have some expensive additions. In particular, many families across the state stare wide-eyed at their checking accounts as they prepare to purchase another critical item for their student: the year’s supply of EpiPens. (Darrin Camilleri, 10/10)

The Baltimore Sun: Pharma Balked When Maryland Tried To Regulate Prescription Drug Costs; Now They Have To Contend With California
Generic drug manufacturers suffered a setback in court late last month when a federal judge dismissed one half of their argument against a new Maryland law regulating price gouging and cast doubt on the other. They suffered an even bigger one Monday when California Gov. Jerry Brown signed a prescription drug price law that is in some ways even more sweeping than Maryland’s. (10/10)

Bloomberg: Express Scripts' Deal Helps Answer Amazon Threat
Amazon.com Inc. is seemingly on the brink of entering the prescription-drugs market. Express Scripts Holding Co. shareholders should be pleased that the pharmacy-benefits manager isn't taking this development lying down. On Tuesday, Express Scripts said it's buying medical-benefits manager EviCore Healthcare for $3.6 billion, its biggest deal since the nearly $30 billion acquisition of Medco Health Solutions in 2012. While few details have been released, the purchase is expected to be accretive to Express Scripts' adjusted diluted earnings per share in its first full year. (Gillian Tan, 10/10)

Los Angeles Times: Shining A Narrow But Necessary Beam Of Light On Drug Price Hikes
Pharmaceutical companies have so much power over their customers, it’s practically an abusive relationship. Maybe that’s why consumer advocates are heralding what might otherwise seem like a minor legislative win over Big Pharma. SB 17, which Gov. Jerry Brown signed Monday morning, would not stop drug companies from making a brand new drug costlier than a college education, or from driving the price of an existing drug up faster than a hot tech stock. It wouldn’t place anything that even vaguely resembles a price control on pharmaceutical companies. Instead, it tries to discourage big price hikes by shining a light on which drug companies are imposing big price hikes and why. In short, it’s naming and shaming. (Jon Healey, 10/9)

The Wall Street Journal: A Flawed Study Depicts Drug Companies As Profiteers
Are drug companies ripping off cancer patients? Of course they are, suggests a much-hyped study published last month in the journal JAMA Internal Medicine. The truth is more complicated. Drug companies receive a staggering return on investment “not seen in other sectors of the economy,” write Vinay Prasad of Oregon Health and Science University and Sham Mailankody of Memorial Sloan Kettering Cancer Center. They estimate that pharmaceutical firms spend $720 million on average to develop a single cancer drug, while the average cancer therapy generates sales of $6.7 billion. The editors at JAMA are brilliant physicians, but they could use a refresher on the economics of drug development. (Peter J. Pitts, 10/9)

US News: Switch And Save On Medicare Part D
In just less than a week, 41 million seniors will have the opportunity to make a choice that might save them hundreds, perhaps thousands, of dollars in health care costs. Too many of them, however, will fail to take advantage, leaving billions on the table, all to the benefit of insurance and pharmaceutical companies. (Daniel McFadden and Joachim Winter, 10/10)

The Wall Street Journal: Reverse Patent Trolls Are Harming Drug Innovation—and Patients
Allergan ’s agreement with the Saint Regis Mohawk Tribe has inspired a lot of commentary. Under the deal, my company transferred the patents for Restasis, a prescription eyedrop, to the Native American tribe as a way of protecting the intellectual property from unfair challenges. The agreement was intended to address the disadvantage that “inter partes review” creates for biopharma innovators and the patients they serve. (Brent Saunders, 10/8)

Editorials And Opinions

Viewpoints: Health Care Costs Are About More Than Economics; Did The Danger Of Painkillers Go Unnoticed By The FDA?

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

RealClear Health: Health Care Costs Aren't Just About Economics
Reimbursement incentives are crucial in health care. The bottom line is, well, the bottom line. But one reason we still have haven’t got a tight handle on health care costs is that they are too often treated only as an issue of economics, rather than medicine. The limits of this approach are clear. Health care costs in the United States have been rising much faster than inflation for a long time. When Medicare was created in 1965, for example, the United States was spending about 6 percent of GOP on health care. Today the number is about 18 percent, or $3.4 trillion in 2016. (Marschall S. Runge, 10/9)

St. Louis Post-Dispatch: GOP Is Failing Children Of All Ages On Health Care
In their abortive last-ditch effort to get rid of the Affordable Care Act (and gut Medicaid in the process) before the Sept. 30 end of the fiscal year, Senate Republicans didn’t get around to reauthorizing the Children’s Health Insurance Program. For 20 years, CHIP has enjoyed broad bipartisan support, and still might if GOP lawmakers can stop turning every health care issue into an argument about Obamacare. (10/9)

JAMA Forum: Building Blocks For Addressing Social Determinants Of Health
Our health care system is waking up to the fact that the health of individuals and families does not depend solely on good coverage and good medical care; it also requires us to address social and other factors that are major contributors to a person’s physical and mental well-being. That’s why more and more clinics are screening incoming patients for challenges in areas ranging from housing conditions, nutrition, access to transportation, and even their ability to afford utilities. It’s why the American Academy of Pediatrics urged its members not only to screen all patients for food insecurity but to refer parents to appropriate agencies. It is also why some hospitals, to reduce readmissions, have brought organizations like Health Leads into their discharge planning to connect patients with social services. (Stuart Butler, 10/5)

The Wichita Eagle: The Interminable Race Against Depression
I know that there are many places and people out there, right now, who are trying their best to reach out and help those who are struggling with depression. And it seems simple enough to those on the outside. Reach out, get help and you can beat depression. But like I said, depression is relentless and doesn’t give up so easily. Just like with alcoholism and drug addiction. Depression keeps pounding at you, whispering in your ear, trying to bring you back in to its fold. So even those people who are fortunate enough to have all the resources in the world can still end up bowing down to its will. (Becky Galloway, 10/10)

The Kansas City Star: Kansas Isn’t ‘The Religious Police’ In Vaccine Case
A Kansas couple trying to keep their 2-year-old grandson from being vaccinated sees themselves as fighting “the religious police.” Which makes it sound like they’re comparing the State of Kansas to Saudi Arabia’s Committee for the Promotion of Virtue and the Prevention of Vice, who until not that long ago went around beating Islamic dress code violators with canes. (Melinda Henneberger, 10/9)