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Even as turmoil in insurance markets nationwide fuels renewed election-year attacks on the Affordable Care Act, California is emerging as a clear illustration of what the law can achieve. The state has recorded some of the nation’s most dramatic gains in health coverage since 2013 while building a competitive insurance marketplace that offers consumers enhanced protections from high medical bills. (Levey, 10/7)

When Elizabeth Wolfe switched her insurance to Molina Healthcare Inc. earlier this year, her coverage changed dramatically. She had to stop going to her old doctors because they didn’t accept Molina. Her new health-maintenance-organization plan didn’t include some of the highest-profile hospitals in the Los Angeles area, where she lives. Losing her old doctors and switching to a no-frills clinic “was a big concern, but when we had to make the first premium payment, we got over that quickly,” she says. (Wilde Mathews, 10/6)

In a letter sent to HHS Secretary Sylvia Burwell on Thursday, 153 patient groups said they were encouraged by the department’s plans to extend standardized options plans into 2018, with the assumption that patients will be able to more easily compare plans across insurers. The groups encouraged HHS to go a step further and require issuers to offer the standardized plans in 2018. (McIntire, 10/6)

Delawareans are again facing steep price increases for health insurance next year under the Affordable Care Act. Insurance Commissioner Karen Weldin Stewart has approved an average rate increase of 32.5 percent in the individual market for Highmark Blue Cross Blue Shield of Delaware, which has the vast majority of the individual market share in Delaware. That follows an average premium increase of 22.4 percent for individual Highmark plans this year. (Chase, 10/6)

Republican presidential nominee Donald Trump’s updated health care proposals narrow what the Republican presidential nominee had previously proposed regarding health care, but his campaign still has not offered details about how such reforms would work. Trump’s health care proposals ... say he would replace the Affordable Care Act with health savings accounts if elected to the presidency. He’s previously said people should be allowed to use health savings accounts that are tax-free and can accumulate .... Trump’s updated proposals also say he would work with Congress to create a patient-center system focused on choice, quality and affordability, and would work with states to establish high-risk pools to ensure continued coverage for individuals, a new idea for the campaign. (McIntire, 10/6)

The result of the presidential election, more than gubernatorial elections, will decide whether more states expand their Medicaid programs, an adviser on Republican nominee Donald Trump’s presidential transition team said Oct. 5. Hillary Clinton, if elected president, would push more states to expand Medicaid, Mike Leavitt, who served as secretary of the Department of Health and Human Services under George W. Bush and was named a key adviser to the Trump campaign’s transition team, said. ... Under a Clinton administration, governors and lawmakers in states that haven’t expanded their Medicaid programs are likely to take advantage of a little-known ACA provision set to begin in 2017 that allows states to waive many of the law’s requirements—such as individual and employer mandate—if they provide similar coverage, Leavitt said. (Ruoff, 10/6)

Republicans have been vowing for six years now to repeal the Affordable Care Act. They have voted to do so dozens of times, despite knowing any measures would be vetoed by President Barack Obama. But if elected, a President Donald Trump wouldn’t have to wait for lawmakers to once again pass repeal legislation to stop the health law from functioning. Indeed, he could do much of it with a stroke of a pen. (Rovner, 10/7)

Last week, lawmakers raced to find a funding deal to avert a government shutdown, and they’ll be back in a few weeks to do it all over again. ... Spending fights will likely take up much of the time before the 114th Congress wraps up. But the GOP leaders in both chambers also expressed interest in passing a 21st Century Cures Act during the lame-duck. The measure is aimed at promoting medical research and developing innovative medical solutions. The bill “could end up being the most significant piece of legislation we pass in the whole Congress,” [Senate Majority Leader Mitch] McConnell said. (Bowman, 10/6)

The leaders of nearly two dozen healthcare industry organizations want Congress to continue to push for lifting an 18-year-old ban that prevents HHS from developing a national patient identifier. ... Providers and other users of electronic health records now often use a technique called probabilistic matching. It matches patients to their electronic records using mathematical algorithms that take basic demographic data in those records, such as first and last names, date of birth and sex, and calculates the probability the patient's records being queried belong to the patient seeking care. (Conn, 10/6)

Federal lawmakers will continue to rail against the high cost of prescription drugs in the next few years, but their most likely actions will be limited to relatively small steps such as the enactment of measures intended to approve more generics. “There is not going to be a magic bullet," said Douglas Holtz-Eakin, a former director of the Congressional Budget Office who now leads the conservative American Action Forum. “There are a bunch of little levers they can pull.” (Dooley Young, 10/6)

House Democrats on Thursday wrote to the National Hockey League to press the organization to take steps to reduce head injuries in the sport. The lawmakers pointed to studies showing the danger of head injuries due to physical contact in the normal course of a hockey game and that such hits to the head can have long-term effects like chronic traumatic encephalopathy, a brain disease more commonly known as CTE. (Sullivan, 10/6)

Iowa employers continue to face rising health-insurance premiums, but they’re not dropping coverage of their workers, a new survey shows. “We’re not seeing an exodus at all,” said David P. Lind, a Clive health care analyst who oversees the annual survey. In fact, he said, slightly more employers are offering coverage this year than last. An estimated 1.6 million Iowans, who make up more than half the state’s population, receive health insurance via an employer. Most of the rest buy their own policies or obtain coverage from a government program, such as Medicare or Medicaid. (Leys, 10/6)

It can be well worth the effort to go up against your health plan if it denies you treatment you think you need. That’s just one of the many lessons consumers can glean by using a new online tool unveiled today by the Department of Managed Health Care. It shows that last year, nearly two-thirds of Anthem Blue Cross enrollees who filed an appeal with the department to challenge a denial of-care ended up getting the medical services they requested. (Ibarra, 10/6)

The Department of Veterans Affairs will begin covering costs for in vitro fertilization and adoptions for combat-wounded veterans struggling with infertility because of their injuries, giving thousands of young veteran families fresh hope at starting a family, advocates say. President Obama signed a bill last week that allows the agency to pay the costs for the next two years from existing VA health-care funds. The provision was authored by U.S. Sen. Patty Murray (D-Wash.), who said she is also pushing to fund the services permanently. (Wax-Thibodeaux, 10/6)

Members of the U.S. House of Representatives’ Committee on Veterans’ Affairs and some of the Peninsula’s top political leaders have questioned why VA Palo Alto spent $6.3 million on artwork and related consulting in the past 10 years at a time when medical care languished at other VA hospitals. The artwork debacle followed revelations that many veterans across the country had to wait exceedingly long periods for treatment and some died before ever seeing a doctor. Long patient wait times have not been an issue at the Palo Alto system’s facilities, however. (Lee, 10/6)

With 1-in-5 working-age Americans reporting they had trouble paying their medical bills in the past year, according to a Kaiser/Times survey released in January, it’s no wonder some entrepreneurs want to offer solutions. Among them, a Bay Area startup called Remedy launched its website last week in hopes of helping consumers fight medical billing errors and overcharges. In some cases, said chief executive and co-founder Victor Echevarria, the company will even negotiate down balances. (Krasny, 10/7)

The Stop A Suicide Today site is intended to give people a sense of urgency — to know they can and should intervene when they're concerned a friend or family member might be suicidal, and treat it as a medical emergency — just as if the loved one were having a heart attack. In 70 percent of cases, a suicidal person makes actual statements indicating what he or she is thinking — sometimes obvious, sometimes more subtle, according to Jacobs. (Jolicoeur, 10/6)

Central Ohio Urology Group put a number to the size of its data breach August — 300,000. The Gahanna-based health-care provider submitted a report to the U.S. Department of Health and Human Services, which tracks such breaches and has an online database dating to 2009. The urology group's breach is the eighth-largest in the country this year among healthcare providers and is the biggest among Ohio-based providers in the federal database. (Malone, 10/6)

Governors in Florida, South Carolina, North Carolina and Georgia declared states of emergency, ordered mass evacuations of coastal areas and called in thousands of National Guard members. President Barack Obama declared a federal state of emergency in both Florida and South Carolina on Thursday, directing aid to those states. Eight hospitals in Florida evacuated this week because of their coastal locations, while inland hospitals prepared to face the storm, stocking up on supplies and coordinating staff to quickly respond once the Category 4 hurricane hits. (Rubenfire and Livingston, 10/6)

Florida hospitals prepared Thursday to get hit by the monster storm Matthew, with many facilities altering their normal operations, and a number of facilities closing and evacuating patients. Jackson Health System, a major hospital operator in the Miami area, said it "will continue normal operators at all Jackson facilities, with the exception of its primary care clinics, the ambulatory care centers and rehab outpatient clinic, which will all be closed Thursday and Friday." (Mangan, 10/6)

The White House is reviewing a proposal from the Food and Drug Administration (FDA) that apparently would require lower levels of a well-known carcinogen in chewing tobacco. While it has not yet been made public, the proposed rule under review by the White House's Office of Management and Budget is listed as a tobacco product standard for N-nitrosonornicotine levels in finished smokeless tobacco products. The Campaign for Tobacco-Free Kids said the chemical has long been known as one of the most troublesome cancer-causing agents in smokeless tobacco as well as in cigarette smoke. (Wheeler, 10/6)

Mammography can prevent deaths from breast cancer, but it's not a perfect test. It misses some cancers, especially in women with dense breast tissue, and flags abnormalities for follow-up tests that turn out to be benign, among other issues. So there's a lot of interest in additional tests that might make screening more accurate in women who have dense breasts. (Hobson, 10/7)

California will tighten rules on how much farmers can use a common pesticide listed by the nation's most productive agricultural state as a chemical known to cause cancer, regulators said Thursday. The change doesn't ban the pesticide Telone but creates a uniform rule for its application each year. The rule is drawing criticism from farmers who call it a key way to fight pests and fear the crackdown could lead to rising food prices. (Smith, 10/6)

Officials from the U.S. government's health research agency are to be questioned by a congressional committee about why taxpayers are funding a World Health Organization cancer agency facing criticism over how it classifies carcinogens. An aide to the U.S. House Committee on Oversight and Government Reform told Reuters that National Institutes of Health officials have agreed to give an in-person briefing to the committee after questions were raised by lawmakers over its grants to the International Agency for Research on Cancer (IARC), a semi-autonomous part of the WHO based in Lyon, France. (Kelland, 10/6)

UCSF gastrointestinal oncologist Dr. Margaret Tempero is among colleagues at 200 other medical centers around the world participating in the clinical trial called HALO-301. As part of the 420-patient Phase 3 clinical study, Tempero is evaluating the efficacy of an investigational therapeutic called PEGPH20. Tempero is looking for patients with untreated Stage IV pancreatic cancer, and patients whose cancers have high levels of a sugar called HA (hyaluronic acid), which impacts 35 percent to 40 percent of Stage IV pancreatic cancer patients. (Seipel, 10/6)

As part of an ambitious $100 million-plus expansion plan, Olathe Medical Center broke ground Thursday on a new $25 million cancer center. The 25,000-square-foot facility, expected to be completed next year, will consolidate the hospital’s currently fragmented cancer outpatient services in one place. It’s the latest project in a frenzy of construction at the hospital’s 250-acre medical campus near 151st Street and Interstate 35. The last year has also seen the opening of a new hospice house and the start of construction on a neonatal intensive care unit. (Margolies, 10/6)

The rate at which American women are dying from causes related to pregnancy or childbirth is on par with Iran, China, and some nations that made up the Soviet bloc. The difference is that in those countries, the prognosis is for improvement. In America, it’s not. The disturbing trend is a counterpoint to global progress on healthy childbirth, according to a comprehensive new study. More than 275,000 women died worldwide last year in pregnancy, childbirth, or complications from it, most of the deaths preventable. In the U.S. these deaths have increased about 2.7 percent a year since 2000, to 26.4 deaths for every 100,000 live births, or 1,063 total, last year. (Roston, 10/6)

Houston-based Legacy Community Health Services, a federally qualified health center, is trying hard to fight the Zika virus. It’s screening pregnant women and following federal guidelines to test people at risk. But despite best efforts, there’s a problem, says Legacy’s chief medical officer, Dr. Ann Barnes. Women who could be infected usually have to wait as long as a month to know if their pregnancy is at risk. That’s the turnaround time from the state public health lab, where blood samples are sent for testing. (Luthra, 10/7)

A federal appeals court has ruled in favor of three former Valencia College students who alleged their constitutional rights were violated in a training program that included students performing invasive ultrasound procedures on each other. A three-judge panel of the 11th U.S. Circuit Court of Appeals on Tuesday overturned a lower-court judge's decision to dismiss the case. The panel's ruling sent the case back to the lower court, with the dispute focused on whether the former students' First Amendment rights were violated and whether two of them were subjected to unconstitutional searches. (10/7)

Anti-abortion protesters through the nationwide 40 Days for Life campaign made a stop at the Planned Parenthood in Mount Auburn Thursday evening. The 40 Days for Life vigil, prayer and rally campaign bus tour moving through 50 states – with stops at 125 cities in 40 days – desires to put an end to the "abortion crisis," according to a news release. Steve Karlen, the director of the North American campaigns, said on a podium by the bus that this is the largest mobilization of anti-abortion demonstrators in history. (Milam, 10/6)

Sixteen years ago, two teams of scientists announced they had assembled the first rough draft of the entire human genome. If you wanted, you could read the whole thing — 3.2 billion units, known as base pairs. Today, hundreds of thousands of people have had their genomes sequenced, and millions more will be completed in the next few years. But as the numbers skyrocket, it’s becoming painfully clear that the original method that scientists used to compare genomes to each other — and to develop a better understanding of how our DNA influences our lives — is rapidly becoming obsolete. (Zimmer, 10/7)

[Wayne] Eskridge felt fine, and he didn’t drink alcohol or have hepatitis C like many people with liver disease. Instead, the cause was non-alcoholic steatohepatitis, or NASH, which is what leads to cirrhosis in one-quarter of people with the condition. It is increasingly common, for reasons that are unclear, and there is no known cure. Eskridge isn’t alone — people with NASH usually have no symptoms. It’s estimated that roughly 2 percent to 5 percent of adults in the United States have the disease, and that another 10 percent to 20 percent may have its milder cousin, non-alcoholic fatty liver disease, or NAFLD, according to the National Institute for Diabetes and Digestive and Kidney Diseases. NASH is expected to become the most frequent reason for liver transplants by 2020. (Bond, 10/6)

The teenage brain has been characterized as a risk-taking machine, looking for quick rewards and thrills instead of acting responsibly. But these behaviors could actually make teens better than adults at certain kinds of learning. "In neuroscience, we tend to think that if healthy brains act in a certain way, there should be a reason for it," says Juliet Davidow, a postdoctoral researcher at Harvard University in the Affective Neuroscience and Development Lab and the lead author of the study, which was published Wednesday in the journal Neuron. (Ross, 10/6)

A month’s stay is typical for people who go to an inpatient facility to treat drug or alcohol addiction. But why? “As far as I know, there’s nothing magical about 28 days,” said Kimberly Johnson, director of the Center for Substance Abuse Treatment at SAMHSA, the federal agency that studies treatment services. (Allen, 10/7)

Turns out health care spending in Massachusetts was actually worse than we thought last year. The state’s Center for Health Information and Analysis, or CHIA, said Thursday that statewide medical spending increased 4.1 percent last year, up from the 3.9 percent rate the agency previously reported. CHIA said Harvard Pilgrim Health Care, one of the state’s largest insurers, noticed an error in the figures it submitted to the agency. After Harvard Pilgrim turned in new data, CHIA ran the numbers again. (Dayal McCluskey, 10/6)

Though the parties reached an eleventh-hour settlement, the Florida Supreme Court on Wednesday plunged into a dispute that could have implications for medical-malpractice cases across the state. Justices heard more than 45 minutes of arguments about an issue rooted in a 2004 constitutional amendment that was aimed at expanding access to records in malpractice cases. Plaintiffs' attorneys heavily backed the voter-approved amendment, as records held by hospitals and other medical providers can play a key role in pursuing malpractice claims. (10/7)

Los Angeles County plans to require hospitals to begin reporting when patients are infected with a certain superbug so lethal that it can kill half its victims, health officials said Thursday. Unlike two dozen other states, California has not required hospitals to report when patients are sickened with the lethal bacteria, which federal officials warn is one of the nation’s most urgent health threats. (Petersen, 10/6)

U.C. Irvine Health began laying off 175 employees this week as part of a plan to ensure efficiency of its medical center's clinical and educational operations, the university-based care provider said. Those being let go — many of whom are in management or administrative and support positions — are being notified individually, according to UC Irvine Health spokesman John Murray. The layoffs will not include faculty, which includes doctors, he said. (Chan, 10/6)

Western Reserve Hospital has partnered with Collide: Cuyahoga Falls and ArtsNow of Summit County to introduce artwork from the local creative community to patients at their Cuyahoga Falls facility. The partnership's goal is to enhance the environment for oncology patients. (Jackson, 10/6)

By mixing artificial intelligence and machine learning with custom health plans and financial rewards, Welltok figured out a way to help people get healthier — and attract even more investors. The Denver digital-health company will announce Thursday that it added $33.7 million from new and existing investors. That brings Welltok’s funding to $163 million to date. (Chuang, 10/6)

This week, as part of the 10-day DesignPhiladelphia event series, a 20-foot-tall monument occupies the plaza at 10th and Locust Streets on the Thomas Jefferson University campus. Called the Beacon, it's made of laser-cut steel and light-emitting yarn, with an outer skin to be woven by a pair of drones performing a nightly 30-minute ballet choreographed based on how visitors respond online to questions about urban regeneration. This futuristic totem is, on one level, a symbol of an idea that's recently become trendy among medical school administrators: bringing creativity and, with it, empathy back into medical education. (Melamed, 10/6)

After reviewing clients’ medical records, state officials believe a resident ran out of lithium, a prescribed anti-psychotic medication, and went without it for eight days. Another boy spent five days without trazodone, a prescribed anti-depressant. The treatment plan for a boy admitted in mid-March called for a mental health referral. By early May, there was still no evidence he had received one. On Monday, [the Department of Human Services] ordered the Vintage Place and Vintage Place North to close, citing more than 30 state licensing violations. If they hope to stay open, the group home administrators have 10 days to file an appeal with the department. (Melo, 10/6)

The city has received $75,000 to buy water filters for low-income Milwaukee families with young children. Mayor Tom Barrett announced the grant Thursday, one month after he urged owners and residents of Milwaukee homes built before 1951 to install faucet filters capable of removing lead from drinking water. The money was donated by the United Way of Milwaukee and Waukesha County and a group that includes Aurora Health Care, Children's Hospital of Wisconsin, Ascension Wisconsin, and Froedtert and the Medical College of Wisconsin. (Spicuzza, 10/6)

Ohio's new medical marijuana law required Gov. John Kasich and legislative leaders from both parties to appoint 14 members to the Ohio Medical Marijuana Advisory Committee within a month of the law taking effect Sept. 8. The panel will make recommendations to the three state agencies writing the rules for the program: The Ohio Department of Commerce, Ohio State Medical Board and Ohio State Board of Pharmacy. (Borchardt, 10/6)

Changes in insurance coverage over time, or “churning,” may have adverse consequences, but there has been little evidence on churning since implementation of the major coverage expansions in the Affordable Care Act (ACA) in 2014. We [surveyed] 3,011 low-income adults in Kentucky, which used a traditional expansion of Medicaid; Arkansas, which chose a “private option” expansion that enrolled beneficiaries in private Marketplace plans; and Texas, which opted not to expand. We also compared 2015 churning rates in these states to survey data from 2013, before the coverage expansions. Nearly 25 percent of respondents in 2015 changed coverage during the previous twelve months—a rate lower than some previous predictions. We did not find significantly different churning rates in the three states over time. (Sommers et al., 10/4)

We examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient. Similar patterns were seen across states and diagnoses. The rapid decay in the quality signal suggests that most readmissions after the seventh day postdischarge were explained by community- and household-level factors beyond hospitals’ control. (Chin et al., 10/4)

Despite national recommendations for adolescent human papillomavirus (HPV) vaccination, rates have lagged behind those of other adolescent vaccines. ... Denver Health is an integrated urban safety net health system serving >17 000 adolescents annually. The process for achieving high vaccination rates in our health system includes “bundling” of vaccines, offering vaccines at every visit, and standard orders. ... In 2013, HPV coverage of ≥1 dose was 89.8% (female subjects) and 89.3% (male subjects), compared with national rates of 57.3% and 34.6%. Rates of HPV coverage (≥3 doses) were 66.0% for female subjects and 52.5% for male subjects, versus 37.6% and 13.9% nationally. ... Female subjects, Hispanic subjects, non-English speakers, and teenagers <200% below the federal poverty level were more likely to have received 3 doses of HPV. (Farmer et al., 10/5)

It is clear that the use of e-cigarettes has biologic effects and possibly health-related effects on persons who do not smoke conventional tobacco products. Although some studies suggest that smoking e-cigarettes may be less dangerous than smoking conventional cigarettes, more needs to be learned. A particular challenge in this regard is the striking diversity of the flavorings in e-cigarette liquids, since the effects on health of the aerosol constituents produced by these flavorings are unknown. At present, it is impossible to reach a consensus on the safety of e-cigarettes except perhaps to say that they may be safer than conventional cigarettes but are also likely to pose risks to health that are not present when neither product is used. ... e-cigarette use is growing among minors and young adults and may promote nicotine addiction in these age groups. (Dinakar and O’Connor, 10/6)

The unadjusted prevalence of stage 3 and 4 [chronic kidney disease] CKD increased from the late 1990s to the early 2000s. Since 2003 to 2004, however, the overall prevalence has largely stabilized (for example, 6.9% prevalence in 2003 to 2004 and in 2011 to 2012). There was little difference in adjusted prevalence of stage 3 and 4 CKD overall in 2003 to 2004 versus 2011 to 2012 after age, sex, race/ethnicity, and diabetes mellitus status were controlled for (P = 0.26). Lack of increase in CKD prevalence since the early 2000s was observed in most subgroups and with an expanded definition of CKD. (Murphy et al., 10/4)

Presidential candidate Hillary Clinton has indicated interest in a Medicare buy-in option for those ages 55 to 64 and a public plan option for the Affordable Care Act’s Marketplaces as mechanisms for increasing the affordability of insurance outside employer-sponsored insurance. Medicare is an attractive basis for developing insurance alternatives (either a direct buy-in or a public option based in Medicare rates) since the program generally has lower provider payment rates and lower administrative costs than private insurers. This paper explores the design issues raised by these proposals and their implications for costs and benefits to different age groups. (Blumberg and Holahan, 9/29)

Medicare provides coverage for a wide array of medical and drug benefits, but, with its deductibles, cost-sharing requirements, and lack of an annual out-of-pocket spending limit, many people on Medicare purchase Medigap supplemental insurance to help cover their out-of-pocket costs. ... Thanks to a 1990 federal law, people age 65 and older are able to buy a Medigap policy when they sign up for Medicare, but younger Medicare beneficiaries with disabilities are not granted the same right unless they live in a state that requires it. Today, Medicare covers 9 million people under 65 with disabilities. ... a much smaller share of beneficiaries under 65 with disabilities than seniors have a Medigap policy (2% versus 17%, respectively), and a much higher share have no supplemental coverage whatsoever (21% versus 12%). (Neuman and Cubanski, 9/27)

People who gained ObamaCare coverage in 2014 were more likely to have a regular doctor and an annual checkup than people who remained uninsured, a new study finds. The study, published in Health Affairs, finds that 27 percent of people who were uninsured in 2013 and gained coverage through ObamaCare’s marketplaces in 2014 went from not having a usual source of care to having one. That is significantly higher than the 11 percent of people who remained uninsured who gained a regular doctor. (Sullivan, 10/5)

All presidential campaigns are unique, and the current one, as George Orwell might have said, seems more unique than most. When it comes to health care, however, there is continuity between the 2016 presidential contest and past elections, reflecting deep underlying political forces and historical experiences with health care politics and policy. (David Blumenthal and James Morone, 10/6)

When Bill Clinton emerges as an ObamaCare critic and even President Obama admits in a recent interview that his entitlement has “got real problems,” the discipline of the law’s apologists must be fading. The question now is whether Republicans can capitalize to improve U.S. health care from its ObamaCare bottom. For years liberals have depicted the law as an end-of-history achievement, dismissing genuine problems as partisan inventions. ObamaCare remains as unpopular today as when Democrats rammed it through Congress in 2010, but they claimed it could never be repealed or changed. (10/6)

There is such a thing as a political goof. It should not be confused with a cosmic political error, mind-boggling in its inanity, inexplicable on any level, the electoral equivalent of stuffing your opponent’s ballot box. An example of the latter is Donald Trump’s failure to jump on ObamaCare as an excellent path to the White House. (Kimberley A. Strassel, 10/6)

Now, as I turn 85 Friday, with my life closer to its end than its beginning, I wish to help give people dignity in dying. Just as I have argued firmly for compassion and fairness in life, I believe that terminally ill people should be treated with the same compassion and fairness when it comes to their deaths. Dying people should have the right to choose how and when they leave Mother Earth. I believe that, alongside the wonderful palliative care that exists, their choices should include a dignified assisted death. (Desmond Tutu, 10/6)

We know that Americans are increasingly sorting themselves by political affiliation into friendships, even into neighborhoods. Something similar seems to be happening with doctors and their various specialties. New data show that, in certain medical fields, large majorities of physicians tend to share the political leanings of their colleagues, and a study suggests ideology could affect some treatment recommendations. (Margot Sanger-Katz, 10/6)

For the sake of competition in Maryland's Obamacare marketplace — particularly for those who buy insurance as individuals, not through their employers — Evergreen Health needs to survive. CareFirst BlueCross BlueShield had 80 percent of Maryland's individual insurance market in 2014, according to the Kaiser Family Foundation, up from 74 percent three years before. Evergreen, with nearly 40,000 members and growing fast, is expanding in the state at a time when other carriers are pulling back. (10/6)

Nowhere is there greater evidence of the depths of petty partisan politics than in North Carolina’s stubborn refusal to expand Medicaid. Voters must elect legislators who WILL EXPAND Medicaid. Any legislator seeking re-election, who opposed expansion in the past and won’t publically promise to back it now, should not be re-elected. (10/6)

I recently noticed some billboards pushing Medicaid expansion which, like the (Un)Affordable Care Act (a.k.a. Obamacare), is basically another form of socialized medicine. Like Obamacare, the goal of Medicaid expansion and its proponents is not to provide care, but to create an ever increasing dependence upon government. Socialized medicine does not, and never has, benefited the patient. (Marianne Gasiecki, 10/6)

Women’s health care advocates in Missouri are bracing for potentially severe reproductive care consequences as the state patches together plans to fund the Women’s Health Services Program. Some other states that rejected federal money in an effort to punish Planned Parenthood saw a rise in maternal mortality rates, unintended pregnancies and HIV transmission. (10/7)

A trio of new reports shows the fundraising landscape for new digital health ventures remains promising. New York’s Startup Health, an investor and accelerator, has released its report on the digital health venture market for the third quarter. Startup Health estimates $6.5 billion has been invested in digital health deals in the first three quarters of 2016, more than the $6.1 billion invested in all of 2015. (John Graham, 10/6)

This fall, as Americans make their choices in a host of local, state and national elections, including 2016 presidential, gubernatorial and congressional races, seniors and those eligible for Medicare in the New Orleans area must pay special attention to the decisions they face during another important election— the Medicare Annual Election Period (AEP). During this year's Medicare AEP, which lasts from Oct. 15 to Dec. 7, it's important for people with Medicare to understand that the choice they make can affect their health throughout 2017. As with any major decision, thoughtful research will go a long way toward making the best care coverage choice that maximizes value based on your individual health needs. (Laura Trunk, 10/6)

I finished reading a remarkable book on the subject called “When Breath Becomes Air,” written by Dr. Paul Kalanithi and completed by his wife, Lucy. ... It is a vivid picture of a driven and accomplished professional — a neurosurgeon — on the verge of a brilliant career, facing a disease that humbles and then kills him. It is a situation we sometimes see from a distance. It is a gift to be given an honest account from inside. (Michael Gerson, 10/6)

One in 5 Americans believe that immunizations cause autism and that vaccines fall into the category of a medical conspiracy contrived by physicians and governmental officials whose motives are purely suspect. That was the conclusion of a study in JAMA Internal Medicine two years ago. These individuals share a distrust of science, not unlike those who are convinced the FDA is hiding homeopathic cures for cancer to protect drug company profits or that health officials know cellphones cause cancer but are doing nothing to stop it. (Bryan Alsip, 10/6)

Drug overdoses have surpassed car crashes as the number one cause for accidental death in America, with a staggering 47,000 lives lost to addiction in 2014 alone. However, the systems largely responsible for combatting the disease of opioid addiction – public policy, insurance and criminal justice - are just beginning to publicly address the problem, and in some cases, even hinder the pursuit of safe and effective treatments. (Newt Gingrich, Patrick J. Kennedy and Van Jones, 10/6)