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President Trump blasted his potential Democratic presidential rivals in a highly political speech here Thursday, telling a group of senior citizens that “maniac” Democrats would rip away their health care, decimate their retirement accounts and prioritize undocumented immigrants over U.S. citizens. (Olorunnipa and Goldstein, 10/3)

President Donald Trump on Thursday accused Democrats of an all-out attempt to “totally obliterate Medicare” and portrayed himself as the program’s defender as he signed a directive to expand the program’s private insurance options. Trump skipped past his own proposals for Medicare budget cuts, and he ignored the fact that no Democrat is proposing to take coverage or benefits away from seniors. (Freking and Alonso-Zaldivar, 10/3)

While the Medicare for All Act proposed by Senator Bernie Sanders of Vermont would indeed cover all Americans under a single national health insurance program, most of the other Democratic presidential candidates want to give people the option of buying into Medicare, or a similar “public option,” but do not require it. That did not stop Mr. Trump from pitching himself in a critical swing state as the bulwark against a raid on health care benefits that members of his audience rely on. (Karni and Goodnough, 10/3)

Mr. Trump’s pivot to health care comes as he seeks to shift attention away from the Democrats’ impeachment efforts over his July call with the president of Ukraine. The White House schedule called the Thursday event an “executive order protecting Medicare from socialist destruction.” Mr. Trump also suggested, without offering evidence, that the pharmaceutical industry might have a role in the impeachment effort. (Armour, 10/3)

"They want to raid Medicare to fund a thing called socialism," Trump said, standing in front of backdrop with the words "Great Healthcare For You." The speech is a part of the White House's efforts to put Trump's health care agenda at the forefront of his reelection campaign, hoping to attract swing voters uncomfortable with his attacks on the Affordable Care Act or a fully government-run health care system championed by two of his chief 2020 Democratic rivals, Sens. Bernie Sanders and Elizabeth Warren. Trump has recently rolled out a series of health care initiatives, including an overhaul of kidney care and proposed new price transparency measures, and plans to issue more in the coming months. (Roubein, 10/3)

Kaiser Health News and Politifact: Trump Speech Offers Dizzying Preview Of His Health Care Campaign Strategy
President Donald Trump offered a preview of what his 2020 health agenda might look like in a speech Thursday — blasting Democratic proposals for reform and saying he would tackle issues such as prescription drug prices and affordability. He outlined the pillars of his health care vision, which included protecting vulnerable patients; delivering affordable care and prescription drugs; providing choices and control; and improving care for veterans. (Luthra, 10/3)

President Trump on Thursday attacked "Medicare for All" and called his Democratic presidential rivals “maniacs” as he tried to make his case on health care ahead of next year’s election. Trump, speaking at The Villages, a sprawling retirement community in the key swing state of Florida, sought to portray himself as a protector of Medicare for seniors, in contrast to Democratic plans to expand the program to everyone through Medicare for All. (Sullivan, 10/3)

President Donald Trump focused his campaign on health care Thursday, contrasting his positions with Democratic presidential candidates as he criticized government-run coverage and signed an executive order to strengthen private Medicare plans. “As long as I am president, no one will lay a hand on your Medicare benefits,” Trump said in a speech at The Villages, a retirement community in the politically important state of Florida, which Trump won by a single percentage point in 2016. (Clason, 10/3)

The speech was pegged to Trump's signing of an executive order -

The executive order he signed had previously been titled "Protecting Medicare From Socialist Destruction" on the White House schedule but has since been renamed "Protecting and Improving Medicare for Our Nation's Seniors." (Simmons-Duffin, 10/3)

Trump outlined proposed changes to provide more plan choices for Medicare, the government's flagship fee-for-service program for Americans who are 65 and older. The order aims to lower premiums in Medicare Advantage, the plan offered by private insurers that covers nearly a third of Medicare's 60 million beneficiaries. (Subramanian, Jackson and Fritze, 10/3)

Under Medicare Advantage, the federal government still foots the bill, but it is a starkly different model than the universal, Medicare-for-all plans some Democratic presidential candidates are pushing. Medicare Advantage has come under scrutiny recently from everyone from health care advocates to the U.S. Department of Justice. Insurers in the program have been criticized for cherry-picking customers by moving into the healthiest communities that offer the best chance of profit and for overbilling the government for unjustified services. (Johnson, 10/3)

The executive order follows measures his administration rolled out in recent months designed to curtail drug prices and correct other perceived problems with the U.S. healthcare system. Policy experts say the efforts are unlikely to slow the tide of rising drug prices in a meaningful way. (Mason, 10/3)

President Donald Trump signed an executive order on Thursday that aims to improve Medicare by giving seniors access to more innovative, affordable plan options. The order, titled Protecting and Improving Medicare for our Nation's Seniors, directs HHS to propose regulations and implement administrative actions that encourage Medicare Advantage plans, in particular, to offer innovative plan designs and benefits including telehealth services and supplemental benefits not available in the traditional fee-for-service Medicare program. (Livingston, 10/3)

Also during the speech, Trump boasted that prescription drug prices have fallen during his administration, a point that triggers debate. He also criticized the pharmaceutical industry, charging that drug makers are behind the push for impeachment  -

In a bid to seize the narrative on prescription drug pricing, the White House issued a report that criticized a steady stream of news stories for saying prices are rising and, instead, argued that an economic index shows prices have actually fallen recently. However, the effort was quickly denounced because the index does not account for all medicines, including some newer and pricier drugs. (Silverman, 10/3)

Read this earlier, related KHN/PolitiFact check on the issue: Mulvaney: Trump Brought Down Drug Prices For The First Time In 50 Years (Luthra, 4/15).

President Donald Trump charged Thursday without evidence that the pharmaceutical industry was behind House Democrats' impeachment proceedings, suggesting it was payback for his administration's effort to lower drug costs. "Lowering the cost of prescription drugs, taking on the pharmaceutical companies, you think that’s easy, it’s not easy. It’s not easy. ... I wouldn’t be surprised if the hoax didn’t come a little bit from some of the people that we’re taking on." Trump said. (Karlin-Smith and Owermohle, 10/3)

President Trump is back in attack mode — and drug companies are again a clear target. In a rowdy, hourlong speech at a sprawling Florida retirement home, Trump renewed his pointed criticisms of the pharmaceutical industry, even implying they may have been behind the recent push to open a formal impeachment investigation. ...The impromptu rally remarks included some of Trump’s most vicious attacks against drug makers since his first speech as president-elect in 2017, when he claimed the industry was “getting away with murder.” (Florko, 10/3)

Bernie Sanders remained hospitalized in Nevada on Thursday because of a blocked artery in his heart but will participate in the next Democratic presidential debate, according to his campaign. ... Sanders’ wife, Jane O’Meara Sanders, said in a statement released by the campaign Thursday that her husband was expected to be discharged and fly back to Vermont before the end of the weekend. “Bernie is up and about. Yesterday, he spent much of the day talking with staff about policies, cracking jokes with the nurses and doctors, and speaking with his family on the phone. His doctors are pleased with his progress, and there has been no need for any additional procedures,” she said. (Price, 10/3)

Mr. Sanders’s campaign has declined to say whether he had suffered a heart attack, and his wife’s statement did not address that. On Wednesday, Mr. Sanders’s campaign said he experienced “some chest discomfort” during an event on Tuesday evening; a medical evaluation found blockage in one artery, and two stents were inserted. He has canceled a two-day college tour this week in California, and his aides have not said when he would return to the campaign trail. (Ember, 10/3)

The fraught debate over whether someone is too old to manage the rigors of the presidency has largely been overlooked during a Democratic primary that has put more emphasis on issues such as health care, immigration and gun control. That changed this week. The hospitalization of 78-year-old Bernie Sanders to treat a blocked artery in his heart ensures that the question of how old is too old to be president moves to the forefront of the Democratic contest. (Barrow, 10/4)

“Building on the same American spirit that gave us Social Security, Medicare, nutrition assistance and so much more, we must come together to ensure that every child has a fair shot to participate in and benefit from our collective promise,” Mr. Booker said in a statement. “I know that we can do this, and as president, I will act.” A central tenet of Mr. Booker’s plan is to provide a $300 monthly cash allowance to families for each child under 5 years old through a vast expansion of the child tax credit. The proposal would also eliminate a loophole that leaves out the poorest American families, whose tax credit under the current system is limited to 15 percent of their earned income over $2,500. (Corasaniti, 10/3)

If you’re enrolled in Medicare but worry about the cost of health care, your chance to do something about it is right around the corner. Most people enroll in Medicare when they become eligible at age 65. But every fall, they have the opportunity to change their coverage during an enrollment season that runs from Oct. 15 through Dec. 7. This is the time of year when you can switch between original fee-for-service Medicare and Medicare Advantage, the all-in-one managed care alternative to the traditional program. You also can re-evaluate your prescription drug coverage — whether that is a stand-alone Part D plan, or wrapped into an Advantage plan. (Miller, 10/4)

Patients' access to care hasn't been hurt by a decline in the number of primary-care physicians practicing, but a continued drop-off in the rate of new physicians could create problems down the line, according to new research presented Thursday. The Medicare Payment Advisory Commission found that about 1 in 5 physicians that it previously considered primary-care physicians are actually hospitalists—physicians whose focus is providing medical care to hospitalized patients. (Brady, 10/3)

The number of vaping-related illnesses has surpassed 1,000, and there’s no sign the outbreak is fading, U.S. health officials said Thursday. Doctors say the illnesses, which first appeared in March, resemble an inhalation injury. Symptoms include severe, shortness of breath, fatigue, and chest pain. Most who got sick said they vaped products containing THC, the marijuana ingredient that causes a high, but some said they vaped only nicotine. (Stobbe, 10/3)

The Centers for Disease Control and Prevention said that cases had occurred in 48 states and the United States Virgin Islands. This week, Nebraska, Alabama, Delaware, Connecticut, Virginia and New Jersey reported deaths, which brought the total to 19 in 16 states. (Grady, 10/3)

The CDC recommends that people stay away from vaping altogether while the investigation is continuing, singling out THC-containing products specifically, as 78% of patients who self-reported their vaping products to officials reported use of THC. THC is the psychoactive ingredient in cannabis. (Abbott, 10/3)

“The increasing number of lung injury cases we see associated with e-cigarette use, or vaping, is deeply concerning,” Robert Redfield, director of the CDC, said in a statement. “Unfortunately, this may be the tip of the iceberg when it comes to the escalating health threat this outbreak poses to the American public, particularly youth and young adults.” (Langreth, 10/3)

The latest survey found that 70% of the lung injury cases involved males and 37% were from users under 21 years of age. The median age of those who died was 49.5, but even young vapers might face long-term injuries, Schuchat said. (Stanglin, 10/3)

[T]he CDC says it still doesn't know the cause of the illnesses, and no brand or substance has been linked to all cases. It might not be THC or nicotine that is making people sick, but any number of the chemicals or additives that are found in vaping liquids, particularly those bought off the street. (Hellmann, 10/3)

"We're worried that there are plenty of risky products still out there," the CDC's principal deputy director, Dr. Anne Schuchat, said during a briefing with reporters. "That's one of the reasons we've intensified our warnings." The agency is now warning people to avoid use of all vaping products, especially products containing THC. "It is pretty much impossible for you to know what is in the e-cigarette or vaping product that you're getting, particularly THC-containing products bought off the street or bought from social sources," said Schuchat. (Aubrey and Wroth, 10/3)

The CDC is working with the Food and Drug Administration and the Drug Enforcement Administration to find the sources and causes of the outbreak and remove them from circulation. But Schuchat said that is likely to be difficult and time-consuming. “I’m not optimistic that tomorrow, we’ll be able to pull all the risky stuff off the market,” she said. (Sun, 10/3)

It’s a widely known vape cartridge in the marijuana economy, but it’s not a licensed brand. And it’s got the kind of market buzz no legitimate company would want. The vape cartridges that go by the catchy, one-syllable name “Dank” -- a slang word for highly potent cannabis -- are figuring prominently in the federal investigation to determine what has caused a rash of mysterious and sometimes fatal lung illnesses apparently linked to vaping. Most of the cases have involved products that contain the marijuana compound THC, often obtained from illegal sources. (Blood, 10/4)

Health officials, lawmakers and parents have been raising alarms about vaping for a couple of years, warning that products touted as healthier alternatives for smokers are instead drawing in young people with fun flavors and slick marketing — concerns the Trump administration cited this month while announcing plans to ban most flavored e-cigarettes. The caution has taken on new urgency in recent weeks as authorities scramble to understand a rash of mysterious vaping-linked illnesses that have put healthy people in the hospital with serious lung diseases. (Knowles and Sun, 10/3)

Health officials across the nation are are telling people to refrain entirely from vaping, whether marijuana or nicotine. Politicians have been passing laws banning e-cigarettes and other tobacco-related products. The messaging has gotten a little messy. Here’s some information to help sort it out. (Karlamangla, 10/3)

Doctors at the WakeMed Raleigh campus saw three relatively young adults come in within a week of each other this summer, all struggling to breathe and with no other obvious signs of what could be causing their distress, said Kevin Davidson, one of the critical care pulmonologists at WakeMed, in an interview with N.C. Health News. All three patients told doctors they recently vaped some form of Tetrahydrocannabinol (THC), the active compound in marijuana that leads to the characteristic high. Davidson and his colleagues quickly realized there may be a danger that stretched far beyond the treatment rooms of the Raleigh hospital. (Ovaska-Few, 10/4)

The Federal Trade Commission wants to know how e-cigarette manufactures are selling, advertising, and promoting their products, which are already facing scrutiny elsewhere in the executive branch and in Congress. Juul Labs Inc., R.J. Reynolds Vapor Company, Fontem US, Logic Technology Development, Nu Mark, and NJOY are being compelled by the commission to provide it with data on their advertising and marketing; websites and social media used to advertise or sell their products; any affiliate or influencer marketing; and promotion on college campuses from 2015 through 2018. (Stein, 10/3)

The information sought by the commission includes annual sales, product giveaways, characteristics of e-cigarette items, such as product flavors, advertising expenses and college-campus programs. “The goal is to assist the commission, policy makers, and the public to better understand the rapidly growing e-cigarette market,” the FTC said Thursday. (Sebastian, 10/3)

Altria Group Inc, which owns Nu Mark and has a 35% stake in Juul, will comply with the FTC request for information on Nu Mark, a company spokesman said. A Juul spokesman said the company will fully cooperate with the FTC. A Fontem Ventures spokeswoman said the company has been working with the FTC and will meet the request’s deadline. Reynolds American said it is reviewing the request, while Japan Tobacco said it is looking forward to continuing its dialogue with the FTC. (Pietsch, 10/3)

The orders are different from a separate probe into whether Juul deliberately targeted its advertising efforts, including the use of paid “influencers,” to appeal to minors. That probe was first reported by the Wall Street Journal, but the agency has not confirmed its existence. (Weixel, 10/3)

Federal law prohibits traditional tobacco companies from numerous sales tactics, including giving away cigarettes, sponsoring sports events and advertising on television, radio, public transportation and billboards. But those laws don’t apply to e-cigarettes, which first launched in the U.S. in 2007. (Perrone, 10/3)

Meanwhile, some influential conservatives are calling for the Trump administration to hold back on its plans to ban flavored tobacco. They argue such a move would hurt small vape business owners and people trying to quit smoking.

A coalition of conservative groups led by Americans for Tax Reform is urging the Trump administration to abandon its plan to ban flavored e-cigarette sales. The Food and Drug Administration (FDA) is expected to issued guidance on the prohibition soon, arguing the flavors are appealing to children and leading to rising youth vaping rates. (Hellmann, 10/3)

Several outlets also take a look at the history behind regulation of cigarettes and vaping products and also how the growing anxiety about the outbreak of respiratory problems might be dangerous.

The recent controversy around the health risks of vaping is but a small piece in a long history of the tobacco industry in the United States. The history of regulatory fights over tobacco products goes back to the earliest days of the U.S., University of Virginia assistant professor Sarah Milov writes in her new book "The Cigarette: A Political History." Like traditional cigarettes, electronic cigarettes weren’t regulated when they hit the market. Plus, vaping is much more inconspicuous than smoking. (Hobson and Hagan, 10/3)

There appears to be a unanimous consensus that something should be done to better understand and prevent this vaping-related harm. The message from many in the public-health community simply has been to avoid vaping. Last week the CDC told Americans as much. But as bans are actually being implemented, some experts are realizing the potentially dangerous effects of misplacing collective anxiety. (Hamblin, 10/1)

With multiple cities and states cracking down on vaping in recent weeks, spurred by a wave of mysterious illnesses and deaths, some public health advocates say they are energized by the sudden movement to reduce access to nicotine. On a single day in Los Angeles County this week, at least four cities advanced laws that would greatly restrict the sales of tobacco. Massachusetts also recently instated a four-month ban on e-cigarettes, while Michigan and New York outlawed flavored e-cigarette products. But, increasingly, other public health experts are warning of the unintended consequences of this political momentum. (Karlamangla, 10/3)

A New York state regulation banning the sale of flavored e-cigarettes and vaping products has been put on hold by a state appellate court. Judges granted a temporary restraining order Thursday that stops the state from enforcing a ban set to begin Oct. 4. They are expected to rule on a preliminary injunction at an Oct. 18 court date. (West, 10/3)

A New York court on Thursday temporarily halted a state ban on the sale of flavored e-cigarettes, giving the embattled vaping industry a breather just a day before the state’s prohibition was due to take effect. (Singh, 10/4)

[New Jersey] Gov. Phil Murphy on Thursday called on state lawmakers to pass legislation that would severely restrict the sale of e-cigarette and vaping products and rein in an industry that’s at the center of a national public health crisis. A task force appointed by the Democratic governor three weeks ago presented a report Thursday recommending legislation that would prohibit the sale of flavored vape cartridges, including menthols, in addition to a bill that would restrict the sale of e-cigarette products to face-to-face transactions. (Sutton, 10/3)

A Utah public school system said Thursday that vaping devices used by students have tested positive for methamphetamine in “more than one incident.” “At this time, it is unclear as to how the methamphetamine was acquired or who was responsible for the vaping devices containing the drugs,” Grand County School District officials in Moab, Utah, said in a news release. (Gilmour, 10/3)

Maryland health officials are now requiring doctors and others to report information about cases of vaping-relating lung injuries to get a better handle on the mysterious illnesses. The state has now recorded 23 cases, but reporting had been voluntary, according to the Maryland Department of Health. (Cohn, 10/3)

Federal health authorities expect the U.S. will retain its coveted status as a nation that has eliminated domestic transmission of measles, dodging a bullet after outbreaks in New York state threatened the designation. It came down to the wire for U.S. officials to be able to determine, at the last minute, that the elimination status had likely not been lost. It would have been if outbreaks in New York state were continuing. (McKay and West, 10/3)

Thousands of individual schools in the U.S. don’t have high enough immunization levels to meet the threshold considered adequate to protect a population from measles, a Wall Street Journal examination found. While the majority of schools have relatively high measles-mumps-rubella vaccination rates of 90% or above, many schools have rates in the 70% to 80% range, and some small, private schools have rates hovering around 50%. While the U.S. overall had a fairly high and stable MMR immunization rate of 94.3% of kindergartners during the 2017-2018 school year, according to the Centers for Disease Control and Prevention, these pockets of low vaccination leave local communities vulnerable to outbreaks. (Abbott, Umlauf and Moriarty, 10/3)

Use the drop-down feature to choose your state to look up local kindergarten immunization rates, how the state collects its data, and the number of measles cases so far this year. If your state only has county-level data available, you can see the county-level rates here. The separate county-level article also contains more information about our methodology and results. (Moriarty, Umlauf and Abbott, 10/3)

Two Ohio counties have asked a court to deny their state attorney general’s request to delay a major trial over the toll of opioids. In their filing Wednesday with the 6th U.S. Circuit Court of Appeals, Cuyahoga and Summit counties argued the state doesn’t have a say in the matter because it’s not part of the federal case set for trial Oct. 21 in Cleveland. (Mulvihill, 10/3)

OxyContin maker Purdue Pharma should be prohibited from giving $38 million in employee payouts as it goes through bankruptcy, attorneys general from 24 states said in a court filing Thursday. Purdue has said it needs to make bonus payments to keep employees and maintain operations at a time of high turnover, which also is requiring the company to provide severance packages for employees heading to the exits. (10/3)

Two dozen drug companies, distributors, retail pharmacies and others blamed for the opioid crisis gripping the nation may follow Purdue Pharma’s lead and try to settle claims before an Oct. 21 trial in a federal court in Cleveland. Dozens of Connecticut cities and towns that have sued these defendants could benefit from a rash of settlements. And although the state has not sued them, it also hopes to gain. (Radelat, 10/3)

Acknowledging a worsening opioid epidemic taking hold in the city, Mayor Martin J. Walsh’s administration is set Friday to launch Mass and Cass 2.0, a plan that would double-down on efforts to remove needles from city streets, and pair police officers with additional outreach workers, putting more “boots on the ground” to ease tensions in a neighborhood hardest hit by drug addiction.In a briefing with reporters, city officials said the plan will boost resources for an array of services in the area around the intersection of Massachusetts Avenue and Melnea Cass Boulevard, where a close concentration of treatment providers has oversaturated the neighborhood with drug addicts seeking services and drug dealers coming to prey on them. (Valencia, 10/4)

One case involved pharmacists and clinic employees who conspired to illegally distribute the opioid drugs that have killed millions, prosecutors say. In another, the owner of a mental health clinic stole doctors’ identities to rip off more than $1 million from Medicaid. (Sullivan, 10/3)

The recordings show that the transplant team was fixated on keeping him alive, rather than his quality of life or his family’s wishes, because of worries about the transplant program’s survival rate, the proportion of people undergoing transplants who are still alive a year after their operations. Federal regulators rely on this statistic to evaluate — and sometimes penalize — transplant programs, giving hospitals across the country a reputational and financial incentive to game it. (Chen, 10/3)

MyKayla McCann was shocked by what she discovered at her first day of work. Using confidential medical records, her new co-workers at St. Mary’s Regional Medical Center in Lewiston, Maine, had created an ersatz collage that was hidden on the inside of a cabinet door and labeled it the “Wall of Shame.” The records belonged to the hospital’s physically and mentally disabled patients, and described their “sexual activity, genital dysfunction, bowel movements, bodily odors and other personal maladies,” according to a 2018 report from Maine’s Human Rights Commission, which labeled the collage “objectively offensive.” (Noori Farzan, 10/4)

In a less than a week, Sutter Health, a sprawling system of 24 hospitals and 5,500 doctors, will face a court trial over accusations that it used its dominance in Northern California to stifle competition and force patients to pay higher medical bills. Sutter, the nonprofit hospital group in Sacramento, with operating revenues of $13 billion, has long been viewed as the classic example of a hospital system that got way too big. Its network of hospitals and services enabled it to essentially corner much of the market, corralling insurers and patients so that they couldn’t go elsewhere for less expensive or better treatment, according to a lawsuit filed by Xavier Becerra, the California state attorney general. (Abelson, 10/3)

Kaiser Permanente said Thursday that a data breach had left personal information on 990 Sacramento-area patients exposed to an unknown and unauthorized individual for about 13 hours. ...In a letter to Kaiser members, issued Sept. 27, Anderson explained that the unauthorized individual had access to a Sacramento-area provider’s email account, and data in that email account included a combination or some of the following: date or dates of service, age, date of birth, gender, provider name, provider comments, payer name, diagnosis, medical history, benefit information, insurance coverage status, treatment procedure and service provided. (Anderson, 10/3)

The state Legislature required nonprofit hospitals to begin posting a raft of financial information on their websites this week, and some of it is eye-opening at a time when some facilities say they are struggling to get by. Northside Hospital CEO Bob Quattrocchi makes $4.9 million including salary and other benefits. Children’s Healthcare of Atlanta CEO Donna Hyland made $1.9 million last year. (Hart, 10/3)

Kaiser Health News: Why Hospitals Are Getting Into The Housing Business
Legally and morally, hospitals cannot discharge patients if they have no safe place to go. So patients who are homeless, frail or live alone, or have unstable housing, can occupy hospital beds for weeks or months — long after their acute medical problem is resolved. For hospitals, it means losing money because a patient lingering in a bed without medical problems doesn’t generate much, if any, income. Meanwhile, acutely ill patients may wait days in the ER to be moved to a floor because a hospital’s beds are full. ... To address the problem, hospitals from Baltimore to St. Louis to Sacramento, Calif., are exploring ways to help patients find a home. With recent federal policy changes that encourage hospitals to allocate charity dollars for housing, many hospitals realize it’s cheaper to provide a month of housing than to keep patients for a single night. (Hawryluk, 10/4)

A CVS Health Corp health plan that uses an outside drug pricing group to help it decide whether to cover certain new medicines has gained little traction with customers, according to its top medical executive, and has drawn fierce criticism from patient advocacy groups. The company has held back on marketing the pharmacy benefit plan while it talks to these groups, CVS said. (Humer, 10/3)

Jim Swanson, formerly a technology executive at Bayer AG ’s crop-science division, has joined Johnson & Johnson as chief information officer. He succeeds Stuart McGuigan, who was CIO at J&J for seven years and now runs information technology at the State Department. (Castellanos, 10/3)

Epinephrine, or adrenaline, is one of a handful of lifesaving drugs that are supposed to be “no-go” items for commercial passenger planes. According to federal regulations, flights are not supposed to take off without these medicines. Citing chronic drug shortages, however, the Federal Aviation Administration has granted airlines exemptions that permit passenger planes to fly without a complete medical kit if the airlines say they cannot replenish the drugs. The exemptions apply to international as well as domestic flights. (Caryn Rabin, 10/3)

This is the first abortion case that will be argued since Justice Brett Kavanaugh and Neil Gorsuch joined the bench, solidifying a conservative majority. While the case does not directly challenge Roe v Wade, supporters of abortion rights are fearful that this is the first of what could be a growing number of opportunities for the new conservative majority to chip away at abortion rights. (de Vogue, 10/4)

The Supreme Court on Friday announced it will review Louisiana abortion restrictions that could leave the state with just one abortion provider, in a case that gives the high court's new conservative majority a chance to redefine abortion rights. (Ollstein, 10/4)

The United States Supreme Court has agreed to hear arguments over a Louisiana law that would require abortion providers have admitting privileges at a nearby hospital. Abortion rights advocates challenging the law had argued that the Supreme Court should reach a decision without hearing oral arguments because they believe the court already ruled on the matter when it struck down an identical Texas law three years ago. (Crisp, 10/4)

Planned Parenthood attorneys took great pains today to convince jurors that its lawsuit against anti-abortion activists who secretly filmed employees discussing aborted fetal tissue isn't about abortion. "This is about the defendants’ plans to use any means, including illegal means, to try to destroy Planned Parenthood,” Rhonda Trotter, one of the organization's lawyers, said during opening arguments in the federal civil suit. (Colliver, 10/3)

Kansas lawmakers spent years imposing ever tougher restrictions on abortion and then saw the state Supreme Court declare that women hold a right to the procedure. Now Republicans and abortion opponents appear determined to amend the Kansas Constitution to reverse that ruling. They’re looking to protect years of wins on the contentious issue, efforts that peaked during the term of Republican then-Gov. Sam Brownback. (Koranda, 10/3)

Noisy conflict is common outside Mississippi’s only abortion clinic, with protesters sometimes using bullhorns to amplify their voices and the clinic itself blaring music to keep patients from hearing the protesters. ... In response, the Jackson City Council voted 3-1 Tuesday to enact a local law limiting amplified sound outside health care facilities and creating buffer zones to move protesters further from the entrances. The law is set to take effect in about a month, and opponents say it unconstitutionally limits their right to free speech. A court challenge is likely. (Wagster Pettus, 10/3)

The unanimous resolution, signed by four Republicans and one Democrat, throws local support behind House Bill 655, which recently passed through the General Assembly’s House Health Committee and awaits a vote on the House floor. The bill would use the Affordable Care Act to extend the Medicaid program to provide health insurance coverage to many low-income workers who currently don’t qualify for the program. (Hoban, 10/3)

Gov. Bill Lee on Thursday downplayed recent pushback on his administration’s effort to change Tennessee’s Medicaid program into a block grant system, countering that the opposition is likely due to misinformation. “I do think that a lot of the folks who are concerned about this have been either misinformed or have not taken the time to really understand it. And there’s legitimate concern about that. We want people to understand this,” Lee, a Republican, told reporters. (Kruesi, 10/3)

Alaska's hospitals and other providers will get back Medicaid dollars they lost due to the state's emergency Medicaid cuts earlier this year, under a settlement announced Wednesday. The settlement will allow Medicaid providers to recover the difference between current reimbursement and what they would have been paid if Republican Gov. Mike Dunleavy's administration hadn't rushed through the emergency cuts in late June. (Meyer, 10/3)

Dozens of primarily elderly or disabled Kansans lost their Medicaid coverage because of errors made by Aetna. Staff at the state health department discovered the problem, restored their insurance and stopped further cancellations. Months later, state workers are still double-checking the work of Aetna Better Health — one of the three companies that helps run the state’s privatized Medicaid system — while Aetna puts together a permanent fix. (Llopis-Jepsen, 10/4)

For the first time since requiring drug makers to report pricing data about their diabetes medicines, Nevada officials plan to impose fines totaling more than $17 million on 21 companies for failing to supply information required by a controversial state law. Earlier this week, the state Department of Health and Human Services wrote each of the drug makers that they face hundreds of thousands of dollars in penalties for not submitting required information, while several others will be fined for failing to meet a deadline. Each drug maker is entitled to an informal dispute resolution before the cases are referred to the state attorney general. (Silverman, 10/3)

Since 2014, Flint, Michigan, has been synonymous with tainted water. Five years on, not all of the city's residents have access to safe water. Some wait for hours in line to obtain bottled water, while others deal with the physical and emotional fallout of exposure to high lead levels from corrosion of city pipes. (Yang, 10/3)

Gov. Gavin Newsom said Thursday the drug revenue model that some safety-net hospitals and other health organizations rely upon is "rather perverse," making clear his dissatisfaction with the federal 340B program that his Medi-Cal drug overhaul would undercut in California. Newsom has ordered a systemwide shift to fee-for-service Medi-Cal drug purchasing by 2021, a move that would save the state money but effectively gut the federal 340B drug discounting program that generates $150 million for community health centers alone, they said last week. (Hart, 10/3)

Two years after closing an office in Garden City, the federal Drug Enforcement Administration announced this week it’s coming back to town. The agency’s new setup comes at a time when methamphetamine seizures are on the rise in Finney County and the area’s seen some drug-related shootings. Plus, states are grappling with the fallout of billions of opioids distributed throughout the U.S., and western Kansas has few drug rehabilitation options. (Boyer, 10/3)

Attorney General William Tong announced Thursday he is investigating whether the manufacturers of do-it-yourself rape kits have falsely represented that evidence collected with the kits is admissible in court. Tong said he is seeking information from two manufacturers of these kits — the MeToo Kit Company based in Brooklyn and PRESERVEkit in New Jersey — about “representations and implications” that their kits will yield evidence that would be admissible in criminal prosecution. (Megan, 10/3)

A 37-year-old man from Cameroon died Tuesday in U.S. Immigration and Customs Enforcement custody, after undergoing treatment for a brain hemorrhage since Sept. 26 at Sharp Chula Vista Medical Center. Nebane Abienwi was being detained at the Otay Mesa Detention Center in San Diego, according to an ICE news release. He was rushed to the emergency room a week ago after experiencing a hypertensive event in the middle of the night, according to the news release. (Fry, 10/3)

A 34-year-old man who has a life-threatening allergy to nuts filed a $10,000 lawsuit against Starbucks this week, saying he had to rush to a Portland emergency room after he ordered a coffee with soy milk but was given almond milk instead. Max Scher said he’s a regular Starbucks customer and when he orders coffee with soy milk, he regularly tells the staff, “Hey, I have an allergy. Please be careful.” (Green, 10/3)

The heads of the state legislative committees that oversee much of California's oil and gas industry are questioning whether a fine issued by state regulators against Chevron this week, for a massive uncontrolled release of crude petroleum in a Kern County oil field, will be effective.California's Division of Oil, Gas and Geothermal Resources on Wednesday announced that it slapped the San Ramon-based oil giant with a $2.7 million fine for illegally allowing releases of large amounts of oil at one of the company's well sites in the Cymric Oil Field between May and July. (Goldberg, 10/3)

A medical supply sterilizing facility east of Atlanta that is under scrutiny for toxic emissions had an eight-day leak last month of ethylene oxide, a cancer-causing substance. The City of Covington on Wednesday released a report on the September ethylene oxide leak at the BD facility, which the company said was about 7 pounds per day, or 54 pounds in all. (Goodman and Miller, 10/3)

Faced with tuition escalation and fast-rising rents – particularly in Sacramento – higher-education students find themselves struggling to get a decent night’s sleep, find permanent shelter and put food in their stomach so they can focus enough in class to make it to graduation. Nearly 40 percent of Sacramento-area college students struggle to find affordable housing. (Bizjack and Morrar, 10/3)

Though the federal courts have yet to determine the fundamental legality of Medicaid work requirements, key informants and focus group participants identified several lessons learned and potential strategies to address the challenges surrounding Arkansas’s Medicaid work requirements—strategies that could help reduce coverage losses and promote individuals’ ability to work—including expanding the scope, depth, and intensity of community-based outreach and education efforts; expanding and simplifying the means and methods available for reporting work and community engagement activities; and increasing funding for work support agencies and infrastructure so they have the expanded capacity to help Medicaid enrollees gain employment. However, many stakeholders we spoke with believed that beneficiaries would face barriers to compliance even if these strategies were implemented. (Hill and Burroughs, 10/3)

Nearly half (46%) of Kentuckians enrolled in Medicaid said they had not heard anything about the state’s plans for a new work requirement. Minorities and those with less education were less likely to have heard about the policy. Eighty percent of low-income Kentuckians reported they were unsure whether the requirement was in effect, and only 8 percent knew the policy was not in effect. Nearly all adults in Kentucky Medicaid surveyed were already working or otherwise meeting the state’s proposed work requirements. The survey found similar results in Arkansas, which implemented work requirements in 2018 and experienced higher uninsured rates, no increase in employment, and substantial confusion. (Madubuonwu, Chen and Sommers, 9/27)

This year is the first in which Americans no longer face a tax penalty for not having health insurance: Congress repealed the penalty, effective 2019. At the time of the survey, three states — Massachusetts New Jersey, and Vermont — as well as the District of Columbia had passed legislation establishing an individual mandate. Among survey respondents living outside these states, 54 percent were aware of the change in federal law, including 55 percent of insured adults and 48 percent of uninsured adults. Among uninsured adults who were aware the penalty was no longer in effect, 24 percent said they chose not to get health insurance this year because of the change. This translates into about 11 percent of all uninsured adults. (Collins and Gunja, 9/26)

Nearly 1 in 10 Medicare enrollees 65 years and older and 4 in 10 enrollees younger than 65 years experience food insecurity, suggesting both poor eating patterns that threaten health and inadequate access to other basic needs. Our estimates for older Americans are consistent with earlier reporting. Long-term disabled enrollees are far less studied. The pervasive food insecurity across segments within the disabled group is striking. We found disabled status, lower incomes, Medicaid dual enrollment, chronic condition burden, depression, and anxiety to be distinct factors. However, our cross-sectional analyses cannot establish causality. These findings highlight the appropriateness of the Centers for Medicare & Medicaid Services intensifying focus on social determinants of health, exemplified by the Accountable Heath Communities model,6 which targets dual enrollees, and the recent expansion of allowable supplemental benefits in Medicare Advantage plans. (Madden, Shetty, Zhang et al, 9/30)

Justice Department Inspector General Michael E. Horowitz issued a grim account this week of the Drug Enforcement Administration’s slow response to the opioid crisis and failure to use all the tools at its disposal to address the overdose epidemic. His tale is an important acknowledgement of troubling problems at the agency, including bureaucratic infighting and stunning incompetency. But there’s an essential element of self-examination missing from this report: The opioid scandal was not just a failure of an agency; it is the consequence of an industry clawing its way into our political system and hijacking the policymaking process. (Robert Gebelhoff, 10/3)

Sen. Bernie Sanders’ once-quixotic campaign to abolish private health insurance in the U.S. — most of it employer-sponsored — in the name of “Medicare for all” has now become the leading progressive litmus test for anyone seeking the Democratic Party’s presidential nomination. Twelve of the remaining candidates subscribe to it, in various versions. Unfortunately, the progressives’ eagerness to upend the entire $3.5-trillion U.S. healthcare system while canceling the current health insurance of 217 million Americans is based on some serious misconceptions. (Peter D. Salins, 10/4)

Mayor Pete Buttigieg describes his health care proposal as a “better way to do ‘Medicare for All.’” It’s not. The proposal, which extends traditional Medicare to all who prefer it, is touted by the mayor as enhancing choice. But more choice can undermine competition in information-sensitive markets. Indeed, when buyers’ and sellers’ information differ, markets can collapse. (Laurence Kotlikoff, 10/3)

As politicians talk about how to reduce medical costs, Walmart and CVS are doing something about it. This month Walmart opened its first Health Center, in Dallas, Ga. It offers “primary care, labs, X-ray and EKG, counseling, dental, optical, hearing and community health education,” all under one roof, a company press release announces. The health center follows Walmart’s business model of “everyday low prices.” A dental cleaning costs $25, a doctor’s visit $40. A test for a urinary-tract infection is $10; a pap smear $50, a vitamin B-12 injection $18. Immunizations range from $39.84 for a flu shot to $223.88 for an inoculation against the human papillomavirus. Although Walmart Health Centers take insurance, most patients have deductibles high enough that they must pay out of pocket, so low prices benefit them directly. (Charles Silver and David A. Hyman, 10/3)

“Why would I ask 72-year-old Mrs. Smith her pronouns?” That’s a question many practicing health-care providers already overwhelmed by long days taking care of patients may ask. This one simple act, however, can open the door to a more accepting and inclusive health-care culture for a long neglected population. (Ravi Iyengar, 10/3)

Some days I see the #MeToo movement as akin to climate change. Both are making valuable resources dwindle: Climate change is shrinking glaciers and sea ice, while #MeToo is shrinking the pool of mentors for the next generation of physicians. Women need to step up to fill the gap. (Lara Ronan, 10/4)

President Trump has called for ways to allow U.S. residents to buy cheaper prescription drugs from Canada. Many drugs are cheaper in Canada, thanks to government price controls in that country.I teach a course in medication economics and have written and spoken about drug pricing at the national and state level. My assessment is that buying prescription drugs from our northern neighbor can be risky in terms of quality and safety. And, it isn’t likely to reduce your drug prices. (Michael White, 9/30)

In July, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule to implement President Trump’s executive order aimed at creating meaningful medical price transparency. The public comment period on the CMS rule ended in September.  Unlike the disclosure requirement that took effect on Jan. 1, 2019, this new requirement promises to be useful to consumers because it requires hospitals to disclose their negotiated (real) prices for bundled procedure-based services with plain English descriptions. (George A. Nation III, 10/3)

President Donald Trump is accusing House Speaker Nancy Pelosi of trying to distract voters from the Democratic impeachment inquiry with promises to work with the White House on lowering drug prices and other initiatives. “Nancy Pelosi just said that she is interested in lowering prescription drug prices & working on the desperately needed USMCA. She is incapable of working on either,” Trump said in a tweet Wednesday. (Berkeley Lovelace Jr., 10/2)

Eliminating medical deferred action for immigrant children with highly complex conditions or the immigrant parents of U.S.-citizen children with such conditions would be a death sentence. How can physicians stand up to an administration that threatens patients’ lives? (Lakshmi Ganapathi, Adolfo Caldas, Jacqueline Miranda, Julia R. Köhler, Gary Visner, and Gregory Sawicki, 10/2)

This city has been conducting a three-decade experiment in what happens when society stops enforcing bourgeois norms of behavior. It has done so in the name of compassion for the homeless. The result: Street squalor and misery have increased, while government expenditures have ballooned. Yet the principles guiding city policy remain inviolate: Homelessness is a housing problem, it is involuntary, and it persists because of inadequate public spending. These propositions are readily disproved by talking to people living on the streets. (Heather Mac Donald, 10/3)

Homelessness has been a humanitarian crisis in the state of California for some time now, as the number of homeless people keeps growing along with their visibility on sidewalks, in riverbeds, in parks. Casting about for solutions, some officials in L.A. County — including Supervisor Mark Ridley-Thomas, who co-chairs a state task force on homelessness, and L.A. City Councilman Joe Buscaino — are calling on California Gov. Gavin Newsom to declare a state of emergency on homelessness. But that’s not a solution. It’s a press release. (10/4)