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For thousands of consumers, proving they are legal U.S. residents so they can keep their Obamacare plans can be a bigger health care challenge than affording them. Documentation issues over immigration or citizenship status ensnared more than a half million people who bought plans on HealthCare.gov last year. Health and Human Services Secretary Sylvia Burwell noted 85% fewer people had their plans terminated for these "data matching" issues for the first three months of 2016 — the most recent information available — than the first quarter of 2015. (O'Donnell, 9/8)

The cost of health insurance plans offered under the Affordable Care Act will jump 20 percent or more next year under rates to be announced Friday by Maryland regulators. The CEO of Maryland's largest insurer defended the hefty rate increases and said the federal law that expanded health insurance to most Americans needs to be changed if it is to remain sustainable. (McDaniels, 9/9)

Thousands of people who buy subsidized health insurance will face substantial premium increases — an average of 21 percent — if they want to keep the only plan that gives them access to certain prestigious Boston hospitals. That insurer, Neighborhood Health Plan, has raised its rates dramatically for customers of the Massachusetts Health Connector, the state agency that serves people who don’t get insurance from an employer. (Freyer, 9/9)

The federal government told the Bevin administration Thursday that its Medicaid waiver proposal has “sufficient information to evaluate” and it now wants to hear from Kentuckians what they think about the proposal. U.S. Department of Health and Human Services Press Secretary Marjorie Connolly said the agency has certified the completeness of Kentucky’s application for a Medicaid waiver, one of the first hurdles the proposal must clear. She said the next step is a 30-day federal comment period. (Brammer, 9/8)

"Application completeness is an early step in the waiver review process, and simply means that the waiver contains sufficient information to evaluate it," said Marjorie Connolly, press secretary for HHS. Connolly added, "We now begin the federal comment period, during which we look forward to the people of Kentucky sharing their views and questions with HHS." She said following the comment period the waiver process normally involves "significant additional dialogue" between HHS and a state seeking a waiver. (Loftus, 9/9)

Two weeks after a State House stalemate killed any chance of an Alabama lottery, lawmakers passed a plan to provide a short-term boost for the budget and pay off $400 million in debt. The plan uses most of a $1 billion oil spill settlement that BP is due to pay over 18 years. Gov. Robert Bentley, who had proposed the lottery as a way to help pay for state programs, especially Medicaid, said the bill was a big win for the state and said he expects to sign it into law after a review. (Cason, 9/8)

The compromise settlement will take the state’s settlement share as a single $639 million lump sum. $400 million of that will go to pay outstanding debts which, combined with money from Gov. Robert Bentley and $15 million given directly to the [Medicaid] program from settlement, should leave the agency with the extra $85 million it says it needs to maintain services in 2017. The bill also allocates $105 million to the program in 2018. (Lyman, 9/7)

Shortly after state lawmakers officially reconvene for a special legislative session on Monday, a small group of officials will continue their discussions with health care experts as they work on a Medicaid expansion plan. Members of the the 3-Star Healthy Task Force, which formed in June, will meet with officials from Vanderbilt University School of Medicine on Monday, Rep. Steve McManus, R-Cordova, told members of a legislative committee meeting on Wednesday. (Ebert, 9/8)

Glaring differences in insurance coverage persist for amputees, children with autism and others in need of certain expensive treatments even after the Affordable Care Act set new standards as part of its push to expand and improve coverage, and despite efforts by states to mandate coverage for some treatments. These differences don't develop simply because some people pay more for better coverage. Instead, they stem from random factors like what state someone lives in or who happens to provide their coverage — and often people can do nothing about it. The federal health care law largely leaves decisions on what actually gets covered up to states or employers who provide insurance for their workers. (9/8)

The American Medical Association and several consumer groups called on a New York regulator to reject Anthem and Cigna's proposed $53 billion merger over concerns it will stifle insurance competition and lead to more costly, lower quality healthcare across the state. The majority of speakers at a two-hour New York Department of Financial Services hearing Thursday told the state agency that regulation and concessions from the insurers would not ameliorate the anticompetitive impact the massive insurer consolidation would have on consumers, businesses or providers. (Teichert, 9/8)

Walgreens believes that it will probably have to unload more stores than expected to ease antitrust concerns over its pending, $9.41 billion acquisition of Rite Aid, a deal that would make the nation's largest drugstore chain even larger. While it still expects to complete the acquisition this year, the Deerfield, Illinois, company said Thursday that it will probably have to divest more than 500 stores. The company previously said that it expected to divest 500 or fewer. (9/8)

Leading progressive senators are demanding an explanation from the insurance giant Aetna about its abrupt decision to pull out of most ObamaCare exchanges this year, which they said appeared to be politically motivated. Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) announced Thursday they are launching a probe into Aetna, which bailed on ObamaCare just weeks after the Justice Department moved to block its multi-billion merger with another top-five insurer.  (Ferris, 9/8)

In a strongly worded letter to Aetna CEO Mark Bertolini, Sen. Elizabeth Warren and several other Democrats, including Sen. Bernie Sanders, have asked the company to explain why it entered into a “risky” merger deal with Humana that now makes it financially unable to sell policies in 11 state health insurance exchanges. (Radelat, 9/8)

Lawmakers are making progress toward a bipartisan deal on mental health legislation in the Senate, though there is a rapidly closing window of time to finish the deal.  Mental health groups met with top senators Thursday and discussed a way past one of the major holdups for a deal in the Senate: a dispute over gun-related language being offered by Sen. John Cornyn (R-Texas) as part of his larger mental health bill.  (Sullivan, 9/8)

Senate leaders may be nearing a truce in the ideological battle over Planned Parenthood that's crippled Congress’ response to the Zika virus. Senior senators and aides said Thursday that the main impediment to a $1.1 billion bill to combat the virus — a fight over which health centers in Puerto Rico can use Zika funding — is likely to be dropped from the debate. That would allow the Zika money to more easily be tucked into a government funding bill that must pass by the end of the month to avoid a government shutdown. The House would remain a major hurdle, however: Republicans in that chamber are warning that they have a harder line against any funding that includes Planned Parenthood. (Everett, Kim and Haberkorn, 9/8)

Vice President Biden stormed Capitol Hill on Thursday to amplify the Democrats' long-held charge that Republican "dysfunction" has paralyzed Congress at the expense of the country. Appearing on the steps of the Capitol on a sweltering day in Washington, the vice president accused the Republicans of undermining the judiciary system by blocking President Obama's Supreme Court nominee; threatening public health by stonewalling legislation to address the spread of the Zika virus; and endangering public safety by ignoring proposals to rein in gun violence. (Lillis, 9/8)

House Speaker Paul Ryan (R-Wis.) on Thursday again dismissed concerns that the GOP’s funding bill to fight the Zika virus intentionally targets Planned Parenthood, even as members of his party call for the controversial language to be removed. “First of all, there’s no Planned Parenthood [provision] in this bill, and to put an earmark for Planned Parenthood is something that we won’t do,” Ryan said at his weekly briefing. Ryan’s strong stance against changing the language to appease Democrats comes as Senate Republican leaders inch toward a deal that would likely take the Planned Parenthood fight out of the bill to fund Zika relief altogether. (Ferris, 9/8)

Senators are optimistic that Zika funding will be easily attached and approved by the chamer in a continuing spending resolution, which could put House Speaker Paul Ryan (R-Wis.) in an uncomfortable position. ... Senate negotiations are centered around $1.1 billion in funding to fund the federal government’s response to the virus, the amount included in the Senate’s original bill to respond to the virus and the conference report negotiated by top appropriators in both the House and the Senate. (McIntire, 9/8)

Governor Rick Scott says he’s disappointed by the failure of Congress to pass a Zika funding bill, and he’s not alone. (Cordner, 9/8)

Brazil’s attorney general is urging the nation’s Supreme Court to permit abortions for pregnant women infected with the Zika virus. Although there is no timeline yet for the high court to take up the matter, the proposal by Attorney General Rodrigo Janot has sparked objections from religious leaders and some legal authorities in socially conservative Brazil. Under current law, abortion is permitted under limited circumstances, such as when a woman has been raped or if her health is threatened by carrying her baby to term. (Jelmayer and Johnson, 9/8)

With the number of locally transmitted Zika cases continuing to climb, 61 members of the Florida House have signed a letter urging federal officials to allow the use of genetically engineered mosquitoes to help combat the virus. (9/8)

After a heated emergency workshop that included protests from neighbors against the use of a pesticide forbidden in Europe and exchanges between the Miami-Dade County Mayor Carlos Gimenez and Miami Beach Mayor Philip Levine, the aerial spraying of adulticide against mosquitoes in Miami Beach was postponed 24 hours until Friday morning. (Frontado, 9/8)

The Healthy Start Coalition of Hillsborough County will hold a Zika forum Friday in Tampa to address concerns about pregnancy. Zika infection is linked to microcephaly, a birth defect that causes infants to be born with small heads. (Miller, 9/8)

The U.S. Marine Corps has completed three internal investigations into the death of a Muslim recruit that recommend criminal charges or administrative action against as many as 20 Marines, officials said. Investigators found that a drill instructor allegedly physically abused Raheel Siddiqui and referred to him as a terrorist, said the Marine officials, who described details of the completed probes to The Wall Street Journal. ... Mr. Siddiqui fell three stories to his death in what the military classified as a suicide. New details emerging from the investigations indicate Mr. Siddiqui leapt from the balcony of a barracks building after he was slapped in the face by the drill instructor, according to Marine officials. (Lubold and Sonne, 9/8)

The Marine Corps is considering possible punishments and potential courts-martial for up to 20 officers and enlisted leaders in the wake of investigations into the suicide of a 20-year-old recruit at its Parris Island training facility in South Carolina. The results of three investigations released Thursday found trainees — and even some drill instructors — were subjected to repeated incidents of verbal and physical abuse at the storied training site. It also faulted commanders for not paying enough attention to what was going on. (9/9)

Almost half of all Americans take prescription painkillers, tranquilizers, stimulants or sedatives, according to results of a federal survey released Thursday. The prevalent use of these drugs could help explain why millions of Americans end up misusing or abusing them. Last year, for the first time, the government's National Survey on Drug Use decided to ask the people it interviewed about all uses of prescription medicines, not just inappropriate use. The survey found that 119 million Americans over the age of 12 took prescription psychotherapeutic drugs. That's 45 percent of the population. (Harris, 9/8)

Federal dollars for the prevention of overdose deaths caused by opioids such as heroin and prescription painkillers are being sent to St. Louis area counties in both Missouri and Illinois. Each state also received one additional federal grant aimed at fighting the national opioid crisis. One will help the Missouri Department of Health better track opioid overdoses. The other will increase access to medication-assisted addiction treatment in Illinois, but the Metro East won’t benefit from that grant. (Phillips, 9/8)

A former pain doctor facing manslaughter charges over the 2013 overdose deaths of two Palm Beach County patients reached a plea deal Thursday. John Christensen — who had offices in West Palm Beach, Port St. Lucie and Daytona Beach — pleaded guilty to two counts of manslaughter and one count of conspiracy to traffic oxycodone. He faces up to five years in prison, under the terms of the plea, according to the State Attorney's Office. Christensen also agreed to never practice medicine again. (Reid, 9/8)

Smoking and drinking among teenagers fell to new lows in 2015, new federal data show, as young Americans continued to shift away from the habits of their parents. Just 9.6 percent of adolescents, ages 12 to 17, reported using alcohol in 2015, down from 17.6 percent in 2002, according to the data. Far fewer adolescents smoke every day: about 20 percent in 2015, down from 32 percent in 2002. (Tavernise, 9/8)

Technology analysts have been calling Apple’s decision to eliminate the earphone jack on its new iPhone 7 a risky business move. But some potential users of the new smartphone wonder whether the company is asking them to take on some health risk as well. Unless iPhone 7 users adopt a workaround that would let them plug their earphones into the device’s charging jack, they will need to don wireless headphones or earpieces. But is it safe to put a radiation-emitting earphone device directly in contact with one’s head? (Healy, 9/8)

Between 2 percent and 5 percent of women say they use marijuana while pregnant, according to the American College of Obstetrics and Gynecology. And while harm to the fetus is certainly plausible since the drug crosses the placenta, the evidence has been spotty. Now a review and analysis of 31 previously published studies has found no independent connection between a mother's pot use and adverse birth events. But the doctors say that doesn't mean it's OK to partake. (Hobson, 9/8)

Forget getting carded for alcohol — if you want to order gluten-free food at the White Moose Cafe in Dublin, you’ll have to provide a doctor’s note. After a customer inquired about gluten-free pancakes without knowing what “celiac” meant, owner Paul Stenson posted the following on the restaurant’s Facebook page Saturday morning: “From now on, guests who demand gluten-free food are required to produce a doctor’s note which states that you suffer from coeliac [the spelling used in Ireland] disease. Guests following a gluten-free fad, who don’t even know what gluten is, can cop the [expletive] on and eat regular food like everybody else.” (Rao, 9/8)

Eight years ago, Jeff Ammon, now 55, began noticing a feeling of pressure in his ears every day after work. Over the next months, when his symptoms progressed into a slight loss of hearing and sensitivity to noise, he became worried. Ammon, a construction worker for 32 years, eventually started wearing ear protection hoping this would address these complaints — but it was too late. (Tan, 9/9)

A lack of psychiatric care beds and rising homelessness are fueling a dramatic increase in mental competency cases in Los Angeles County, a new study has found. The county launched a review after The Times reported on a surge in the number of competency cases in Los Angeles’ mental health court over the last five years. The number of cases referred to the mental health court’s Department 95 to determine defendants' competency had swelled from 944 in 2010 to 3,528 in 2015. (Sewell, 9/8)

Allina Health says the number of nurses crossing the picket line "continues to climb by the hour," with more than 413 now signed up to work just four days into an open-ended strike. The company said Thursday that 20 percent of its union nurses at Unity Hospital in Fridley have agreed to work. At Mercy Hospital in Coon Rapids 13 percent of nurses have signed up for shifts, according to a company spokesman. (9/8)

Reynolds American Inc., Altria Group Inc. and other tobacco companies are steering millions of dollars to defeating a $2 cigarette-tax increase in California, a high-stakes effort and the third such fight in a decade in the most populous U.S. state. The tobacco industry’s outlay of $35.6 million so far means that it has outspent supporters 2-to-1 in donations to defeat the measure, which starting in April would boost the levy to $2.87 a pack. The initiative would generate from $1 billion to $1.4 billion in revenue in fiscal 2018 for cancer treatment and smoking prevention. (Vekshin, 9/9)

Health regulators have sued nursing-home chain Vanguard Healthcare LLC, accusing it of providing poor patient care at some of its 13 locations, costing government insurance programs tens of millions of dollars. In their lawsuit, officials from the U.S. Department of Health and Human Services said the Brentwood, Tenn., company provided a level of patient care “that caused serious physical and emotional harm to highly vulnerable elderly, disabled and low-income residents at [its] facilities.” (Stech, 9/8)

As many as 80 percent of donor lungs are damaged by lifestyle or as a result of the manner of death, such as drowning or asphyxiation, which typically would make them bad candidates for transplant.But now, surgeons at Ohio State University’s Wexner Medical Center are using a procedure called ex-vivo lung perfusion to expand the pool by restoring lungs that would have been rejected in the past. (Ferenchik, 9/9)

Dr. Bob Sears, an Orange County pediatrician and nationally known critic of vaccination laws, faces the loss of his medical license after the state medical board accused him of improperly excusing a toddler from immunization and endangering both the child and the public. The Medical Board of California contends in legal documents released Thursday that Sears committed “gross negligence” and deviated from standard practice when he issued a letter in 2014 prescribing no more vaccines for the child. (Hamilton, 9/8)

About 2,500 OhioHealth employees — some new hires and others working in offices across central Ohio — can look forward to working in new digs near Riverside Methodist Hospital in a couple of years. (Rose, 9/9)

Over the objections of unions opposed to a further consolidation of the hospital industry, state health regulators Thursday approved an affiliation agreement that makes Yale New Haven Health Services Corporation the owner of the struggling Lawrence + Memorial Hospital in New London. (Pazniokas, 9/8)

A federal appeals court on Thursday rejected a woman's appeal in a lawsuit that alleged a Roman Catholic hospital in Michigan denied her adequate treatment during a painful miscarriage because of a policy banning even the discussion of abortion as an option. Tamesha Means said she went to a Mercy Health Partners facility in Muskegon, Michigan, the only hospital within 30 minutes of her home, when her water broke after only 18 weeks of pregnancy, according to the lawsuit filed against the U.S. Conference of Catholic Bishops in 2013. (Skinner, 9/8)

A state administrative judge has recommended permanently revoking the license of a Houston dentist whose care culminated in a 4-year-old girl sustaining brain damage. In a strongly worded opinion, Holly Vandrovec ruled that Dr. Bethaniel Jefferson failed to meet a minimum standard of care in her treatment of Navaeh Hall, including not "recognizing and responding to the emergency situation," when the girl had a seizure and went into shock. (Ackerman, 9/8)

The Affordable Care Act (ACA) includes provisions to reduce Medicare beneficiaries’ out-of-pocket spending for prescription drugs by gradually closing the coverage gap between the initial coverage limit and the catastrophic coverage threshold (known as the doughnut hole) .... However, Medicare beneficiaries who take specialty pharmaceuticals could still face a large out-of-pocket burden because of uncapped cost sharing in the catastrophic coverage phase. ... we analyzed trends in total and out-of-pocket spending among Medicare beneficiaries who take at least one high-cost specialty drug .... Annual total drug spending per specialty drug user studied increased considerably ... from $18,335 to $33,301, and the proportion of expenditures incurred while in the catastrophic coverage phase increased from 70 percent to 80 percent. (Trish, Xu and Joyce, 9/7)

Spending on anticancer drugs has risen rapidly over the past two decades. A key policy question is whether new anticancer drugs offer value, given their high cost. Using data from the Surveillance, Epidemiology, and End Results (SEER)–Medicare database, we assessed the value of new cancer treatments in routine clinical practice for patients with metastatic breast, lung, or kidney cancer or chronic myeloid leukemia in the periods 1996–2000 and 2007–11. We found that there were large increases in medical costs, but also large gains in life expectancy. (Howard et al., 9/7)

[This was a] direct observational time and motion study ... [of] 57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics who were observed for 430 hours, 21 of whom also completed after-hours diaries. ... During the office day, physicians spent 27.0% of their total time on direct clinical face time with patients and 49.2% of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9% of the time on direct clinical face time and 37.0% on EHR and desk work. The 21 physicians who completed after-hours diaries reported 1 to 2 hours of after-hours work each night, devoted mostly to EHR tasks. ... For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. (Sinsky et al., 9/6)

Social determinants of health shape both children’s immediate health and their lifetime risk for disease. Increasingly, pediatric health care organizations are intervening to address family social adversity. However, little evidence is available on the effectiveness of related interventions. ... Patients were randomized to intervention or active control conditions by the day of the week. Primary outcomes observed at 4 months after enrollment included caregivers’ reports of social needs and child health status. ... The reported number of social needs at baseline ranged from 0 to 11 of 14 total possible items .... At 4 months after enrollment, the number of social needs reported by the intervention arm decreased more than that reported by the control arm .... In addition, caregivers in the intervention arm reported significantly greater improvement in their child’s health. (Gottlieb et al., 9/6)

As they did in Q1, several companies reported losses on their individual market business, both on and off the marketplaces. Not surprisingly, United, which announced its departure from most ACA marketplaces earlier this year, reported continued losses. ... Centene and Molina attributed their financial success in this market in part to their strategy of targeting the lowest-income marketplace enrollees, some of whom may experience fluctuations in income that move them above or below the income threshold for Medicaid eligibility. Both companies have considerable experience in the Medicaid markets. ... Further, their targeted enrollees are the most heavily subsidized, making them more likely to enroll and less likely to drop their plans than those who must pay a higher proportion of the premium and cost-sharing. (Corlette, Lucia and Curran, 9/6)

As Congress returns from recess this September and is expected to once again consider funding for Zika, this brief compares funding in the President’s emergency Zika request to the Congressional bills that have been proposed thus far. Specifically, it looks at the President’s February 22nd request compared to House and Senate bills that passed each chamber in May and a Conference Agreement that was approved by the House in June but blocked in the Senate and opposed by the Administration. (Wexler, Oum and Kates, 9/6)

More people in the U.S. are on gluten-free diets even though the proportion of Americans with celiac disease held steady from 2009 to 2014, according to a new study. Despite the fact that gluten-free diets are not known to provide any health benefits for the general population, some people believe they benefit from going gluten-free, said lead author Dr. Hyunseok Kim, of Rutgers New Jersey Medical School in Newark. (Seaman, 9/6)

Trainee doctors are finding a more supportive attitude from superiors and colleagues toward their pregnancies, a small study suggests. In the U.S., women entering medicine face many barriers to childbearing, including a persistent negative stigma surrounding pregnancy during years-long training programs, said senior author Dr. Marissa Tenenbaum of Washington University School of Medicine in St. Louis, Missouri. (Doyle, 9/5)

A new study adds to evidence that hospice care during the last six months of life is associated with better overall experiences for patients and a lower likelihood of dying in a hospital. “Consistent with other studies demonstrating benefit, the use of hospice care is associated with better quality-of-care outcomes, including patient-centered care metrics,” study leader Ruth Kleinpell and colleagues write in the journal BMJ Supportive and Palliative Care, online August 16. (Thrasybule, 9/2)

Conservatives should acknowledge that the coverage expansion is real, it is large (though not as large as we were led to expect), and that while it is not necessarily going to make people much healthier, it is probably going to reduce financial hardship among at least some of the people who have gained coverage...Liberals, however, should also acknowledge uncomfortable facts. The first is that most of the decrease in the uninsured population came in 2014 and 2015, and is now leveling off. (Megan McArdle, 9/8)

Even though the Affordable Care Act has stumbled lately, with large national insurers drastically reducing their footprints in the marketplaces, it's difficult to ignore how the law has greatly decreased the number of people who don't have health insurance. (Bob Herman, 9/9)

A key domestic policy directive presidential aspirant Donald Trump made to Congress as a way to reform the healthcare system is to “block-grant Medicaid to the states.” ... But a new analysis from the Urban Institute takes issue with Medicaid proposals like the Republican presidential nominee’s, saying block grants would create huge disparities in spending from state to state. Not only would one Medicaid patient be valued at a higher level just because they lived in a certain state, taxpayers would end up paying more money if states expanded Medicaid coverage by broadening eligibility. (Bruce Japsen, 9/8)

One of Donald J. Trump’s recent attack lines against Hillary Clinton focuses on her health: If she has nothing to hide, he asks in a tweet, why doesn’t she release her medical records to the public? For the moment, put aside Mr. Trump’s own revelations about his medical history, which consist of a hyperbolic, undated letter with little detail from his gastroenterologist. And put aside Mrs. Clinton’s own recent disclosures, which include a somewhat more detailed accounting of her health and medication history from the internist who has overseen her care in recent years. Put aside, finally, the question of whether complete medical records would allay the conspiracy theories of some of Mrs. Clinton’s critics, who say a recent cough is a sign of disqualifying illness or believe she experienced a seizure during a recent news conference. (Margot Sanger-Katz, 9/8)

Improving the performance of America’s health system will require improving care for the patients who use it most: people with multiple chronic conditions that are often complicated by patients’ limited ability to care for themselves independently and by their complex social needs. Focusing on this population makes sense for humanitarian, demographic, and financial reasons. (David Blumenthal, Bruce Chernof, Terry Fulmer, John Lumpkin and Jeffrey Selberg, 9/8).

So it’s come to this: The chief executive of a major drug company is a hero because he won’t rip off customers any more. Brent Saunders, CEO of Allergan, the company best known for making Botox, made headlines this week after posting an announcement on his company’s website that future price hikes will be limited to single digits and he’ll no longer jack up prices to crazy levels right before a patent expires. “While we have participated in this industry practice in the past, we will stop this practice going forward,” Saunders said. (David Lazarus, 9/8)

Maybe Democrats aren’t so confident anymore about retaking the Senate in a romp. This would explain why they’d rather reserve the Zika crisis as political ammunition for the campaign than pass the bipartisan $1.1 billion bill to wipe out the mosquito-borne virus that can cause birth defects. On Tuesday Senate Democrats for the third time this year filibustered the Zika rescue legislation, which failed 52-46. They have claimed for months that more money is urgently needed for prevention, research and health services. Mosquitos are now carrying Zika in the continental U.S. and some 16,800 and rising Americans are infected, mostly in Puerto Rico with more than 700 in Florida. (9/8)

On Nov 8, the residents of a suburb of Key West will vote on whether to allow scientists to release genetically-modified mosquitoes into their backyards. Inserted into the mosquito's genetic makeup would be an artificial stretch of DNA that renders them unable to reproduce. As the “transgenic” mosquitoes mate with wild ones, the plan goes, their offspring would die, bringing the local population of skeeters down significantly — by as much as 90 percent, according to Oxitec, the for-profit firm that wants to release the modified mosquitoes. That would potentially reduce the risk to local residents of catching mosquito-borne diseases such as dengue and Zika. (Fred Guterl, 9/8)

Few topics stir more controversy in this country than guns. Mass shootings and urban gun violence inflame public passions. Gun control measures divide our political leaders, and elections often hinge on candidates' views of guns. I struggle with issues related to firearms every day, but in a different way. To me, it's not about politics or elections. It's part of my daily job. As a mental health provider, I have to ask all my patients about guns. (Nathaniel P. Morris, 9/8)

As thousands of union coal miners rallied at the U.S. Capitol urging Congress to approve a bipartisan plan to protect their retirement and health-care benefits, Sen. Rand Paul tweeted that the Clinton Foundation should “shore up miner’s pensions” because “ her agenda ... bankrupted the coal industry.” Paul’s flip response to the serious problem facing many of his constituents evaded the question of whether he supports the Miners Protection Act. (9/8)

Despite the development of two vaccines against Borrelia burgdorferi, the bacterium that causes Lyme disease, there is no such vaccine currently on the market. But the problem of Lyme disease is large and growing. Fortunately, the future seems reasonably bright for new vaccines. (Stanley A. Plotkin, 9/8)

A recent explosion in the number of fentanyl-related drug overdoses in Milwaukee County has gone largely unnoticed — the exception being the few who are closely following the trajectory and body count associated with the opioid epidemic sweeping the country. Fentanyl is a synthetic opiate that is 50 to 100 times more powerful than heroin. Fentanyl-laced heroin has flooded the illicit user market in many cities. The tragedy is compounded because many users, enslaved by heroin addiction, are clueless as to the potency of this mixture, and succumb to a fatal overdose. (Michael Murphy, 9/8)

Cuyahoga County Medical Examiner Dr. Thomas Gilson calls it a "clear and present danger." The Washington Post, casting Ohio as ground zero for the drug in the United States, says a tiny dose a fraction of the weight of a paper clip could send 500 people to the morgue. It's been showing up in Columbus, Cincinnati and maybe Akron. And unlike heroin, it is so lethal -- 10,000 times more potent than morphine -- that the naloxone antidotes used to save lives in heroin overdoses may not work. (9/8)

Ohioans have faced an onslaught of unconscionable restrictions designed to limit access to abortion for the women of our state, many passed by politicians in recent years. One of the oldest and harshest of these restrictions is the federal Hyde Amendment, which has been used to ban Medicaid coverage for low-income women. So while women enrolled in Medicaid have coverage for other reproductive services, one procedure is barred from being covered: abortion. (Angel Rucker, 9/9)

A few weeks ago, the monthly purchasing managers index — a broad measure of the economy that takes into account things like wages and product orders — sent a warning signal about health care. The industry that had buoyed Houston through the oil bust might be losing steam, the numbers showed, as the once-breakneck pace of hiring looks to be slowing down. That impression appears to have been born out by a new report from Colliers, showing that only about 2 million square feet of medical office space were under construction in the second quarter of 2016, compared to more than 2.7 million at the same time last year. Net absorption, or the rate at which new buildings are leased or purchased, declined by more than 60 percent.  (Lydia DePillis, 9/8)

Imagine if we could reduce by half the number of teens who use tobacco, and prevent a lifetime habit that leads to high risks for cancer, heart disease and stroke. In other communities, one simple policy change has been shown to dramatically lower the rates of teen tobacco use: raising the age at which people can legally buy the product. Almost 200 cities, including Chicago, Kansas City and Columbia, Mo., have followed suit. The young people of the St. Louis region deserve no less. (Dr. Timothy J. Eberlein, 9/9)