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Addressing concerns about rising premiums and dwindling competition, Health and Human Services Secretary Sylvia Burwell asserted Thursday that the federal health law's insurance markets clearly are sustainable. Willingness by Congress to help smooth out problems would definitely help, Burwell told reporters, but it is not absolutely essential. Congressional Republicans committed to repealing "Obamacare" are unlikely to assist. (9/1)

Burwell also mentioned HHS is seeking to increase enrollment by working with the Internal Revenue Service to contact people who paid a penalty for not having coverage and providing information about how to enroll on the exchanges. HHS and other federal agencies have also worked to reduce “data matching” errors that may have prevented eligible people from signing up for coverage. (Carey, 9/1)

The question of whether Congress would need to step in to fix ObamaCare has risen in prominence since announcements by Aetna, UnitedHealthcare and other large insurers saying they will pull out of ObamaCare exchanges next year because of financial losses. But Congress remains deadlocked in political fighting over the law, raising the stakes for changes the administration is taking on its own. “Stability exists even using the administrative tools that we have,” Burwell said. (Sullivan, 9/1)

Many of next year's premium rate increases on the Affordable Care Act exchanges threaten to surpass the high and wildly fluctuating rates that characterized the individual insurance market before the health law took effect, interviews with insurance regulators and records show. With dramatic drops in insurance company participation on the exchanges for some states, decreased competition and other factors are leading to often jarring rate hikes. Some of the states that are facing what are likely among the biggest increases this year — Tennessee, Arizona and North Carolina — were among those the Urban Institute reported in May had the biggest increases last year. (O'Donnell and Leys, 9/1)

Minnesota health insurers are proposing hefty average premium hikes next year for plans sold to individuals and families. Blue Cross Blue Shield of Minnesota's HMO, Blue Plus, is seeking hikes ranging from 36 percent to 67 percent. HealthPartners proposes average increases of 43 percent and 51 percent. UCare's average is 66 percent.Medica is seeking 59 percent, and PreferredOne wants an average of 63 percent more for an individual plan with children's dental coverage. (Catlin and Sepic, 9/1)

Insurers are asking to raise premiums by an average of more than 50 percent for customers on Minnesota’s individual insurance market. Massive proposed premium increases weren’t a surprise, coming on the heels of national market turmoil, the end of a federal subsidy for insurance companies and the withdrawal of a major insurer from Minnesota’s market. These new proposed rates would affect only people who buy individual insurance plans. About 300,000 Minnesotans are in that category, of whom 70,000 buy their plan through the state-run MNsure exchange and 230,000 directly from insurers. (Montgomery, 9/1)

One of the state's newest health insurance companies, Community Health Options, is pulling out of New Hampshire. Community Health Options is the exact type of business that was supposed to make the individual insurance market more competitive under the Affordable Care Act. In 2014, the first year it was in operation, Community Health Options dominated the individual market in Maine. In 2015, it expanded into New Hampshire with a federal loan. (Rodolico, 9/1)

Despite much hand-wringing about health insurers exiting the marketplaces where people buy individual coverage, in many areas consumers will likely still have a choice of plans when the 2017 open enrollment starts in November. Aiming to make picking a plan easier, the federal government, which runs the marketplaces in roughly two-thirds of states, is encouraging insurers to offer “simple choice plans” as an option this fall. The six new standardized plan designs will eliminate many of the moving parts that have bedeviled consumers trying to make apples-to-apples comparisons between plans. (Andrews, 9/2)

Florida announced on Thursday that, for the first time, mosquitoes in Miami Beach had tested positive for the Zika virus, a disappointing confirmation that the virus is still active in the area. The Aedes aegypti mosquito that spreads Zika is famously difficult to fight, and experts often say that testing the bugs to find the virus is like looking for a needle in a haystack. The three samples that tested positive all came from a 1.5-square-mile area in Miami Beach where locally acquired cases of Zika had been confirmed. (Tavernise, 9/1)

Authorities in Florida have found the Zika virus in mosquitoes in Miami Beach, confirming what they had suspected: The virus that can cause devastating birth defects is being spread by the insects. The three mosquitoes that tested positive for Zika were trapped in a 1.5-square-mile area that had already been identified as a source of infection, the Florida Department of Agriculture and Consumer Services said Thursday. (Zavis, 9/1)

“The message here remains the same: We need to drain and cover,” said Miami-Dade County Mayor Carlos Gimenez at a press conference about the findings. He reiterated that pregnant women should cover up and people should use protection to keep from spreading the virus sexually. (Mack, 9/1)

While this is the first time mosquitoes have tested positive for Zika, health authorities had already confirmed through epidemiological investigations that the virus was spreading via insects. The outbreak in Florida is the first outbreak of locally transmitted Zika virus in the continental U.S. (Mohney, 9/1)

Florida health officials said Thursday they found the Zika virus in mosquitoes trapped in the Miami Beach area, and blamed popular tropical plants known as bromeliads. Florida also announced two more cases of locally acquired Zika, presumably spread by mosquitoes there.That makes for 49 home-grown cases in Florida. (Fox, 9/1)

Despite the prospect of a potentially devastating viral outbreak, gridlock has hobbled the federal response and left the burden of fighting Zika almost entirely on the back of state and local governments. In February the White House asked Congress for $1.9 billion to fund the development of a vaccine and fight mosquitoes. House and Senate Republicans crafted a $1.1 billion plan that also limited funding for Planned Parenthood and eased pesticide regulations. Senate Democrats balked. Then Congress went on recess for August, right when Miami had to deal with the specter of a Zika epidemic. (Chen and Smith, 9/1)

Local outbreaks of Zika virus have sent demand for tests jumping in Florida and sparked interest in new diagnostics for the disease that threatens the health of newborns. At least 47 people in the state have been infected with Zika via mosquitoes, most of them in two areas of Miami where the virus is known to be spreading. Health officials have warned pregnant women to avoid those neighborhoods and seek testing if there’s a possibility of infection because the virus can cause brain damage in fetuses. (Darie, 9/1)

The U.S. government has pledged $19.8 million to help Takeda Pharmaceutical Co. pay for initial development of a Zika vaccine under a contract that could go up to $312 million. Takeda said the Japanese government, with which it is working on fighting pandemic influenza, could join the Zika virus project. Several companies, including Sanofi SA, are trying to develop a vaccine to help fight the virus, normally transmitted by mosquitoes, that has been tied to severe birth defects, including brain malformations. (Armental, 9/1)

Takeda Pharmaceutical Co. is joining the campaign to develop a Zika vaccine with nearly $20 million in US funding for a Cambridge-based research program. The company, which last year said it will move its global vaccines business to Cambridge from Deerfield, Ill., disclosed Thursday that it was tapped by the Biomedical Advanced Research and Development Authority to produce a vaccine to treat the virus in the United States and abroad. The initial contract of $19.8 million will fund the program into early-stage clinical trials. If it moves through late-stage trials, funding could grow up to $312 million. (Weisman, 9/2)

The pictures are heartbreaking: Millions of honeybees lie dead after being sprayed with an insecticide targeting Zika-carrying mosquitoes. ... (Juanita) Stanley, co-owner of Flowertown Bee Farm and Supply in Summerville, South Carolina, said she lost 46 beehives -- more than 3 million bees -- in mere minutes after the spraying began Sunday morning. (LaMotte, 9/1)

The worsening Zika outbreak in Singapore and its potential to spread elsewhere in Asia and beyond is rapidly raising alarms among health experts. Singapore has at least 151 confirmed cases, authorities reported Thursday, with two involving pregnant women. Neighboring Malaysia also confirmed that a 58-year-old woman who recently visited her Zika-infected daughter in Singapore had been diagnosed with the disease. The developments came as a new study released Thursday identified eight countries in Asia and Africa that researchers say are at the greatest risk of Zika virus transmission. (Sun, 9/1)

A powerful drug that's normally used to tranquilize elephants is being blamed for a record spike in drug overdoses in the Midwest. Officials in Ohio have declared a public health emergency and the U.S. Drug Enforcement Administration says communities everywhere should be on alert for carfentanil. The synthetic opioid is 100 times more potent than fentanyl, the prescription painkiller that led to the death earlier this year of the pop star Prince. Fentanyl itself can be up to 50 times more deadly than heroin. (Ludden, 9/2)

You can add Suffolk County, N.Y., to the list of local and state governments that are filing lawsuits against the drug makers that market opioid painkillers. The Long Island county on Wednesday accused several companies — Purdue Pharma, Johnson & Johnson, and Endo International, among others — of using deceptive marketing to downplay the risks of their painkillers, and of improperly encouraging physicians to prescribe the medicines in a way that caused some patients to become addicts. In the process, the county alleged it paid for prescriptions for its employee health plan inappropriately. (Silverman, 9/1)

A group of state attorneys general nationwide are discussing new ways they can pursue legal action against opioid manufacturers like Purdue Pharma, according to two sources with knowledge of the conversations. Purdue Pharma’s drug Oxycontin has been blamed for kickstarting the opioid epidemic. The drug generated over $3 billion for the company in 2010.The latest entity to sue Purdue Pharma for the epidemic is Suffolk County, New York, which filed their lawsuit Wednesday claiming Purdue Pharma and other manufacturers are misleading the public and doctors about the dangers of painkillers. (Strickler, 9/1)

The rising cost of naloxone—a 40-year-old drug capable of reversing drug overdoses—is prompting questions about the wisdom of allowing market-forces to determine the price of a vital tool in the public health response to the nation’s opioid crisis. Some say the federal government should purchase the drug and distribute it to state and local health agencies at a more affordable price. (Johnson, 9/1)

Physicians across the country are learning to administer a new opioid treatment. It's an implant — four little sticks that get inserted in a patient's arm, delivering a constant low dose of medication. Experts say it could be a real game changer for people dependent on opioid addiction medication. But physicians are encountering some challenges in adopting it. (Shakerdge, 9/1)

Pharmacists working in the 350 CVS drug stores in Massachusetts will have to consult a database of prescriptions before dispensing powerful painkillers under a first-in-the-nation agreement designed to help stem the opioid crisis. The pact, the result of an investigation by Attorney General Maura Healey into CVS stores improperly dispensing drugs to high-risk patients, emerges as opioids have left thousands dead across New England. (Freyer, 9/2)

As part of a settlement with the state, CVS Pharmacy will require its pharmacy staff in Massachusetts to check the state’s Prescription Monitoring Program (PMP) before filling prescriptions for "commonly misused opioids," Attorney General Maura Healey announced Thursday. The PMP collects dispensing data on certain drugs and allows doctors and pharmacists to monitor patient prescription history. In a statement, Healey's office called it a "first-in-the-nation settlement with the largest pharmacy chain in the country." (WBUR, 9/1)

From the DEA’s perspective, kratom is a dangerous, life-threatening drug that is creating a “public health crisis.” But to daily kratom users like (Margo) Burton, the drug is a lifeline. “A whole lot of people are going to go into a deep depression and commit suicide, or start back on dangerous drugs that cause them to OD,” Burton said. It’s easy to dismiss kratom users as herbal remedy enthusiasts, intent on using psychoactive plants however they like. But the DEA’s decision has revealed, instead, a hidden nationwide network of advocates, educators, and devotees who talk about discovering kratom the way some Christians talk of being born again. (Boodman, 9/2)

Some "natural" techniques can help ease pain, including acupuncture, yoga, tai chi and massage, government researchers said Thursday. A review of high-quality studies shows these approaches rarely cause any harm and can help people with lower back pain, headaches and arthritic knees, the team at the National Center for Complementary and Integrative Health found. (Fox, 9/1)

The idea is tantalizing: Reengineer a patient’s own immune cells to attack the cancer that’s killing her. Scientists have proven it can be done, curing patients of otherwise terminal blood cancers. But faith in this approach, dubbed CAR-T immunotherapy, has been shaken in recent months. First, Juno Therapeutics, a leader in the field, announced that four patients in its clinical trials had died. Then, just this week, Novartis — one of the prime contenders in the race to commercialize CAR-T therapy — shuttered its cell and gene therapy unit and announced plans to lay off 120 employees. (Keshavan, 9/2)

Bald but beaming, 5-year-old Eden Oyelola yanked the long rope to ring the “victory bell” at Children’s National Medical Center last September. She was finally done with her treatment for brain cancer — surgery followed by months of radiation and chemotherapy that made her terribly ill. At a “bell party” at her home in Upper Marlboro, Md., later that week, she gobbled down ice cream with friends and rode a pony around the back yard. Her parents exhaled in relief. “We thought she was in the clear,” her father said. The relief was short-lived. (McGinley, 9/1)

The sharp decline in American teenage pregnancy and birthrates in recent years was driven exclusively by the increased use of contraceptives, a new study concludes. Researchers interviewed a nationally representative sample of more than 3,000 women ages 15 to 19 at three different time periods: in 2007, 2009 and 2012. They then combined data on sexual activity, contraceptive use and contraceptive failure rates to calculate a Pregnancy Risk Index at these times. This risk index declined steadily at an annual rate of 5.6 percent. (Bakalar, 9/1)

Teen pregnancy is way down. And a study suggests that the reason is increased, and increasingly effective, use of contraceptives. From 2007 to 2013, births to teens age 15 to 19 dropped by 36 percent; pregnancies fell by 25 percent from 2007 to 2011, according to federal data.But that wasn’t because teens were shunning sex. ... Rather, the researchers from the Guttmacher Institute and Columbia University found that “improvement in contraceptive use” accounted for the entire reduced risk of pregnancy over the five-year period. (Rovner, 9/2)

The e-cigarette and cigar industries have enlisted high-profile lobbyists and influential congressional allies in an attempt to stop the Food and Drug Administration from retroactively examining their products for public health risks or banning them from the market. The campaign targets a broad new rule that extends F.D.A. jurisdiction to include cigars, e-cigarettes and pipe and hookah tobacco. (Lipton, 9/2)

The American Heart Association is pressuring pharmacies to follow the lead of CVS and stop selling tobacco. “The public wants this absurd contradiction to come to an end,” CEO Nancy Brown said. “If you promote health, you should not be in the business of selling products that can lead to addiction and death,” she added. This comes as the Centers for Disease Control and Prevention published a study Thursday that shows 66 percent of Americans do not want pharmacies selling tobacco, including roughly half of the smokers surveyed. (Devaney, 9/1)

President Barack Obama says he supports a congressional panel's recommendation to create a veterans' health care system that coordinates government and private care. The recommendation is among a total of 18 issued in July by the Commission on Care. Congress created the panel following a scandal over long wait times for veterans who sought care through the Department of Veterans Affairs. (9/1)

The Freedom Hills Therapeutic Riding Program is one of 50 equine healing programs in Maryland that work with patients with diagnoses ranging from Down syndrome to multiple sclerosis to Alzheimer's disease. Ten of these programs in Maryland — including Freedom Hills — have groups designated specifically for members of the military, according to Ross Peddicord, executive director of the Maryland Horse Industry Board. (McCauley, 9/2)

New data ranking state-by-state obesity rates is out today, and despite some modest improvements, the statistics are still pretty grim. According to the report conducted by the Trust for America’s Health and the Robert Wood Johnson Foundation, adult obesity rates now exceed 35 percent in four states and 30 percent in 25 states. What’s more, obesity rates are above 20 percent in every single state across the country. To put that in perspective, the authors point out that in 1991, no state had a rate above 20 percent. (Welch, 9/1)

There's some good news about obesity in the U.S. for a change. Rates of obesity fell in four states last year: Minnesota, Montana, New York and Ohio, according to a report released Thursday. Colorado is the slimmest state, with just 20 percent of the population in the obese category, while Louisiana weighs in as the heaviest state with 36 percent of the population being obese. (Fox, 9/1)

Nearly one third of adults in Pennsylvania and a quarter of those in New Jersey are considered obese and at increased risk of diabetes and heart disease, according to The State of Obesity, a report released this morning by the Robert Wood Johnson Foundation. The annual report was previously titled "F As in Fat." In the Keystone State, the percentage of adults burdened with worrisome weight has nearly doubled in the last two decades. Since 1995, it has risen from almost 16 percent to 30 percent. In the Garden State during the same period, the proportion rose from 12 percent to 26 percent. (Wood, 9/1)

Minnesota's adult obesity rate saw a statistically significant drop between 2014 and 2015 and it was the only state in the Upper Midwest to keep those rates below 30 percent, state health officials said Thursday. The percentage of adults considered obese improved from 27.6 percent in 2014 to 26.1 percent in 2015, the Minnesota Department of Health said, citing data from the national Centers for Disease Control and Prevention. The figures "confirm that Minnesota has returned to its historically lower obesity rate that remains steady on a year-to-year basis even as other states and the U.S. as a whole continues on an upward trend," the department said in a statement. (9/1)

The percentage of Minnesotans who are obese has dropped, and the obesity rate is lower here than in other Upper Midwestern states, data released on Thursday show. State health officials aren’t above some not-so-humble bragging about that. “Minnesota was the only state in the region, including North Dakota, South Dakota, Wisconsin and Iowa, to succeed in keeping its obesity rates firmly below 30 percent,” the Minnesota Department of Health reported, citing newly released data from the U.S. Centers for Disease Control and Prevention. From 2014 to 2015, the percentage of Minnesotans who meet the definition of obese dropped from 27.6 percent to 26.1 percent, the data show. (Lundy, 9/1)

When Dr. Jonathan Lewin arrived in Atlanta in February as CEO of Emory Healthcare, it quickly became apparent to him that the system could not expect to grow in the region's rapidly consolidating hospital market by merging with community hospitals. Integrating acquired hospitals would be expensive and time-consuming, Lewin said in an interview this week. And given the data compiled by an Emory needs assessment study group, available community hospitals were unlikely to produce enough of the very hard cases — the complex brain surgeries, stem cell transplants and cancer trials that Emory tackles daily — for the system to grow its clinical, teaching and research missions. (Barkholz, 9/1)

Two months after a violent patient killed a doctor at Timberlawn  — and nine months after Texas officials moved to close the hospital over unsafe conditions — the facility remains open. And its Pennsylvania owners haven’t paid a cent of the $1 million fine the state levied in December. The state’s failure to act against the 99-year-old psychiatric hospital, despite all its safety problems, has mental-health experts questioning whether regulations are strong enough to protect patients and staff. (Moffeit, 9/1)

Long hours. High stress. Not enough time to stop and regroup. These are the causes of burnout, and according to a 2014 survey by Mayo Clinic and the American Medical Association,  more than half of responding doctors reported feeling its effects. Given the links between provider burnout, patient outcomes, and higher health care costs, hospitals across the country are deploying new techniques to reduce stress and help nurses and physicians strike a better balance. (Ross, 9/2)

The nurses of Boston City Hospital weren’t in the habit of stopping by the bar on their way into work. But that was where they began finding themselves every morning, starting in the mid-1980s. They would show up as early as 8 a.m. at now shuttered bars in South Boston. They got to know the neighborhood’s bartenders, but not because they were ordering drinks: The nurses were using the bars to see their patients. The tuberculosis outbreak then raging among Boston’s homeless population had started in early 1984. By July of 1985, the US Centers for Disease Control and Prevention was calling it the most severe outbreak ever documented among America’s homeless population, according to Boston Globe reporting from the time. (Seervai, 9/1)

California medical consumers will enjoy strong new protection against surprise out-of-network medical bills starting next July, under a hard-fought bill overwhelmingly approved by the state legislature this week. It's widely expected that Democratic Gov. Jerry Brown will sign it. Under the bipartisan bill, AB 72, authored by Democratic Assemblyman Rob Bonta, patients who received care in in-network facilities would have to pay only in-network cost sharing. (Meyer, 9/1)

Kentucky's attorney general is accusing a medical company of Medicaid fraud for allegedly promoting a kidney dialysis product it knew was harmful to patients. Attorney General Andy Beshear is suing Fresenius Medical Care Holdings Inc. His lawsuit, filed in Franklin County Circuit Court, says Fresenius is the nation's largest provider of kidney dialysis and renal care products, treatment and services. (9/1)

A massive $175 million fraud involving specialty prescription creams used to treat pain and other ailments was headquartered in South Florida, according to criminal charges filed Thursday by federal prosecutors.The suspects include about a dozen residents of Palm Beach and Broward counties, as well as at least three doctors and other medical workers from around the U.S. Court records suggest they are all cooperating and are expected to surrender in court in the next week or so. (McMahon, 9/1)

Delaware prison officials have reached a tentative settlement in a federal lawsuit alleging that mentally ill prisoners have been subjected to solitary confinement without proper evaluation, monitoring and treatment. As part of the settlement, the Department of Correction has agreed to undertake steps to better classify, track and care for prisoners with mental health issues and in restrictive housing. Prison officials also have agreed to create a special needs unit at the women’s prison in New Castle. (Chase, 9/1)

The California legislature is near final approval of a bill that would make it a crime, punishable by a jail sentence, to carry out and distribute undercover video or audio stings against Planned Parenthood and other health-care groups. The measure was inspired by two California antiabortion activists who made undercover videos of themselves trying to buy fetal tissue from Planned Parenthood. The project prompted multiple investigations by Congress and states. (Barbash, 9/1)

A now-closed Reynoldsburg home health care provider was overpaid $4.9 million in Medicaid funds — the largest such finding ever made by the office of Ohio Auditor Dave Yost. Great Nursing Care Inc. improperly claimed payments by using unqualified health-care aides and billing for services before they were authorized, Yost's office announced this morning. With interest, Great Nursing Care owes the Ohio Department of Medicaid a total of $5.2 million for services billed between mid-2011 and mid-2014, a compliance audit concluded. (Ludlow, 9/1)

The center, located inside Merrillville High School, will celebrate its 35th year in operation this month. It's a spacious center, with plenty of parking and loaded with activities, tables of informational brochures, and a flea market with clothing and other items. Bingo, bunco, card games, low-impact exercise and other activities are also offered. Before the center lost its funding, Gass also arranged for guests to speak to seniors about relevant topics such as health care, nutrition, home mortgages and Medicare. (Davich, 9/1)

The Detroit Medical Center says it is making contingency plans with other physician groups in case it doesn't resolve a contract negotiations impasse with Wayne State University medical school doctors who have practiced at the DMC for years. The talks broke down this week after DMC officials walked out of a Tuesday meeting with representatives from the Wayne State University Physician Group, which employs the doctors who teach and do research at the university while practicing at DMC hospitals and clinics. (Reindl, 9/1)

This report describes national trends for selected marijuana use and related indicators [based on data from the National Survey on Drug Use and Health (NSDUH)] .... In 2014, a total of 2.5 million persons aged ≥12 years had used marijuana for the first time during the preceding 12 months, an average of approximately 7,000 new users each day. During 2002–2014, the prevalence of marijuana use during the past month, past year, and daily or almost daily increased among persons aged ≥18 years, but not among those aged 12–17 years. ... A decrease in the perception of great risk from smoking marijuana combined with increases in the perception of availability (i.e., fairly easy or very easy to obtain marijuana) and fewer punitive legal penalties (e.g., no penalty) for the possession of marijuana for personal use might play a role in increased use among adults. (Azofeifa et al., 9/2)

This study examines whether there is variation by worker income on how an HSA [health savings account] eligible health plan affects health care services use and spending. ... HSA-eligible health plan was associated with a decline in (non-preventive) outpatient office visits for workers at all income levels, but the decline was over twice as large for workers and their dependents with incomes less than $50,000 as compared with those with incomes of at least $100,000. ... There was an across-the-board decline in prescription drug fills regardless of worker income. ... The HSA-eligible health plan was associated with a reduction in various preventive services by worker income. For example, lower-income workers reduced their use of influenza vaccinations more than higher-income workers. (Fronstin and Roebuck, 8/30)

[Researchers sought to] examine demographics and health care spending and use of services among adults with high needs, defined as people who have three or more chronic diseases and a functional limitation in their ability to care for themselves or perform routine daily tasks. ... [They used] data from the 2009–2011 Medical Expenditure Panel Survey. ... High-need adults differed notably from adults with multiple chronic diseases but no functional limitations. They had annual health care expenditures that were nearly three times higher ... and out-of-pocket expenses that were more than a third higher .... On average, rates of hospital use for high-need adults were more than twice those for adults with multiple chronic conditions only; high-need adults also visited the doctor more frequently and used more home health care. (Hayes et al., 8/29)

Medicare is most commonly known as a health insurance program for people ages 65 and older, but, since 1973, the program has also provided coverage to millions of people with permanent disabilities who are younger than age 65. ... Contrary to what might be expected based on health status differences between Medicare beneficiaries under age 65 with disabilities and older beneficiaries, average Medicare per capita spending on services covered under Part A and Part B was only moderately higher among those under age 65 than over age 65 in 2014, and was in fact somewhat lower among younger beneficiaries between 2000 and 2011. Total per capita spending began to diverge more widely beginning in 2006 when the Part D prescription drug benefit took effect, with much higher average Part D spending among beneficiaries under age 65. These findings suggest that curtailing rising drug costs would have the effect of reducing the Medicare spending gap between beneficiaries under and over age 65. (Cubanski, Neuman and Damico, 8/16)

We analyzed 2006–2012 adult ICU CLABSI and hospital annual survey data from the National Healthcare Safety Network. The final analytic sample included 244 hospitals, 947 hospital years, 475 ICUs, 1,902 ICU years, and 16,996 ICU months. ... Controlling for the overall time trend, ICUs in states with laws had lower CLABSI rates beginning approximately 6 months prior to the law's effective date ...; this effect persisted for more than 6 1/2 years after the law's effective date. These findings were robust in secondary models and are likely to be attributed to changes in central line usage and/or resources dedicated to infection control. ... Our results provide valuable evidence that state reporting requirements for HAIs improved care. Additional studies are needed to further explore why and how mandatory HAI reporting laws decreased CLABSI rates. (Liu, 7/24)

Paying smokers to quit and giving them more money the longer they avoid cigarettes might help get more people to kick the habit than cessation advice on its own, a recent study suggests. (Rapaport, 8/25)

Mobile apps and web-based programs do help people reach health goals like exercising more, losing weight and quitting smoking, but studies need to follow-up longer to see how sustainable these interventions are, according to a recent review of existing research. (Kennedy, 8/31)

“You bet I voted for that bill. I’m proud I did it!” yelled Russ Feingold at a Wisconsin campaign stop in 2010. That pride—in ObamaCare—lost the three-term Democratic senator his job. Now his party’s ownership of the health-care law may once again decide the Senate. ObamaCare is roaring back as a political liability to Democrats in a way not seen since that 2010 wave election. Right in time for this fall’s presidential contest, insurers are bailing out of the government system, leaving millions of voters with dwindling options and skyrocketing premiums. ObamaCare was always destined to crack up, but there is something notable that it comes precisely as so much control of Washington is up for grabs. (Kimberley A. Strassel, 9/1)

With insurers pulling out of the Obamacare exchanges, and the remaining plans contracting towards inexpensive Medicaid-style offerings with limited choices of doctors and hospitals, it was a safe bet that regulators would be scrambling to figure out how to stabilize the exchanges. They’ve now stepped in with a sort of early holiday present, releasing their proposed rulemaking for the 2018 marketplaces on Monday, instead of in November. These rules suggest meaningful changes to how the insurance market would operate, especially in its risk-adjustment program. (Megan McArdle, 9/1)

The Obama administration proposed this week new rules for its Risk Adjustment program — a critical component of the Affordable Care Act. There are actually some better-late-than-never parts of the proposal. Most notably the new rules will try to compensate for the extra expense insurers incur when people exploit ACA regulatory and enforcement weaknesses to time their insurance purchases to cover only expensive medical emergencies. Unfortunately, the better parts of the new Risk Adjustment proposal are contaminated by an illegal component : one that would transfer money among insurers in different states. (Seth Chandler, 9/1)

Today, insurers can no longer deny coverage to sick people and cannot place a cap on benefits paid to treat their illnesses. For many patients, this access to insurance and treatment is crucial to their wellbeing and, often, their lives. But now insurers are engaging in a different kind of effort to avoid covering people with expensive illnesses by refusing to accept premium payments from third-party charities that help low-income patients pay their premiums.  In other words, charitable assistance is insurers’ new “pre-existing condition.” (LaVarne A. Burton, 9/1)

Drug makers are entitled to make a profit. But public investment and simple human decency argue that there is a clear public interest to control the price of drugs. The EpiPen isn't the only example of price gouging. A year ago, Turing Pharmaceuticals raised the price of daraprim, used in the treatment of HIV and malaria, from $13.50 a pill to $750. Following public outrage, it lowered the cost to about $375...Sovaldi, a relatively new treatment for hepatitis C, costs $1,000 a pill. That was enough for the Senate Finance Committee to find the cost was unjustified. But little has happened to lower the price. (8/31)

The immediate outrage centered on the clear appearance of price gouging by generic pharmaceutical firm Mylan, the manufacturer of EpiPens. In less than a decade, the price of a dual-pack of EpiPens has increased from just under $100 to over $600. The bulk of that price increase, as the New York Times reported, has come in the last three years. Further fuel was added to the fire when it was discovered that Mylan's CEO, Heather Bresch and other top Mylan executives each received salary increases of approximately 700 percent over the last eight years, as was reported by the Washington Post. (Jesse Heitz, 9/1)

The launch of President Obama’s Precision Medicine Initiative is putting a cutting-edge approach to research and patient care on the map.  Academic medical centers have been pioneering the development of precision medicine for more than a decade—and now it’s time for the biopharmaceutical industry to get deeper in the game. The goal of precision medicine is simple: to offer individual patients exactly the right medical care at the right time, by taking their genes, lifestyle, and environment into account.  However, making that vision a reality will require a significant investment of brainpower, technology, and capital. (Jessica M. Bibliowicz, 9/1)

Since 2000, over a million American women have been able to terminate pregnancies safely using drugs instead of surgery. Over the years, doctors have found ways to make these sorts of abortions even safer and more convenient, but anti-choice politicians in many states have pushed restrictions that make the process more onerous and that could even harm women’s health. (9/2)

Close to 20 million Americans have gained health insurance since the Affordable Care Act (ACA) — also known as Obamacare — was implemented, resulting in about 90 percent of the population now being covered. That’s no small achievement for a country that still hasn’t fully embraced the notion that healthcare is a right of citizenship. With the law’s success, you’d think the nation’s public hospitals would finally have a chance to come out from under the decades-long charity care burden they have been carrying for the $3 trillion-a-year U.S. healthcare system. (Mike King, 9/1)

Freestanding emergency rooms are expanding fast in North Texas. You can hardly drive down any major street in Dallas without seeing one. But are they good for patients? Park Cities, Allen and Plano are the newest locations for these slick and efficient facilities that claim the capabilities and services of full-service emergency rooms, guaranteeing treatment without the wait of a hospital-based emergency room. In a sense, patients receive the convenience of an urgent care center, but they anticipate receiving the same quality of a hospital emergency service. (Britt Berrett, 9/1)

The heroin epidemic rages around us. Can Iowa act quickly enough as the threat spreads here? This summer's headlines chronicle the tragic toll: Milwaukee records 20 overdose deaths in two weeks. Doctors see a surge in newborns addicted to opiates. Emergency responders treat increasing numbers of overdose victims in Des Moines and Cedar Rapids. (9/2)

It turns out trying to remake yourself into a "healthy" snack-food company is harder than it looks. Shares in Campbell Soup dropped 6 percent on Thursday after the company reported quarterly earnings that missed expectations and warned next year's results would disappoint, too. It's well-known by now that sales of Campbell's salty soups have slowed. But what's unnerving is that its so-called "fresh business" -- its supposed saving grace -- is shaky, too. (Shelly Banjo, 9/1)

Easily the oddest measure on the California ballot is a proposal to require porn actors to use condoms while at work. It attempts to address a worthy subject of concern, but Prop. 60 underscores what’s wrong with trying to impose workplace health and safety regulations through the ballot box. The measure is promoted by Los Angeles’ AIDS Healthcare Foundation, which has long pushed for better health coverage, including condom use to stem the spread of HIV. In this case, it’s pushed the crusade too far with a mandate designed to curb the spread of sex-linked diseases in the porn world. (9/1)

The role of women at home and work remains highly politicized and steeped in stereotypes. This tension plays out in a unique way in academic medicine, particularly pediatrics, where women comprise more than 57 percent of pediatricians and 70 percent of pediatric residents. Despite their numbers, women hold a minority of leadership positions. Across all academic fields, 14 percent of department chairs are female. In pediatrics, with a higher percentage of female physicians, only 25 percent are female. Access to medical school isn’t the problem. Women now comprise 48 percent of medical school students in the United States. (Angira Parel and Sarah C. Bauer, 9/1)

A Sacramento chiropractor, James Joseph Martin, was arrested in July on felony charges of practicing medicine without a license and grand theft after authorities said he claimed to be a “thyroid and diabetic specialist” who practiced “functional neurology and metabolic medicine.” According to the California Board of Chiropractic Examiners, Martin presented himself as a “doctor of pastoral science,” licensed by the Pastoral Medical Assn. The Medical Board of California ruled that “doctor of pastoral science is not recognized in California and does not authorize anyone to practice medicine or any of the healing arts in the state.” What’s noteworthy about the case isn’t that a chiropractor was passing himself off as a diabetes authority. Rather, it’s that so many other chiropractors do it as well — yet manage to stay within the law. (David Lazarus, 9/2)