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The Supreme Court on Friday once again entered the conflict between religious freedom and access to contraception, taking up a case about whether some religious employers must provide free insurance coverage for birth control. The new case concerns religious objections to a requirement under the Affordable Care Act that employers provide coverage for contraception to their female workers or face fines. Houses of worship, including churches, temples and mosques, are automatically exempt from the requirement and do not have to file any paperwork. But the new case concerns a second category of institutions — nonprofit groups like schools and hospitals that are affiliated with religious organizations. (Liptak, 11/6)

In taking up a series of lawsuits on the issue, the justices brought the 2010 health-care overhaul back before the justices for the fourth time since its passage. The court will review whether the contraception rules are at odds with a federal law on religious freedom, thrusting a contentious social issue further into the limelight in an election year and raising the prospect of further changes to the health law. (Kendall and Radnofsky, 11/6)

The Obama administration says it has provided the organizations with an easy way to opt out of the legal requirement that employers include contraceptives as part of health insurance coverage. Employers who object must make clear their religious objections and let insurance companies and the government take over from there. But the groups say even that step would implicate them in what they believe to be a sin, adding that they face ruinous fines if they refuse to comply. They want to be included under the blanket exemption from providing the coverage that the government has extended to churches and solely religious groups. (Barnes, 11/6)

The Obama administration has stood fast on the so-called contraceptive mandate, insisting that women employees and students must have access to birth control through their insurance. Providing contraceptives free of charge will greatly reduce unwanted pregnancies and abortions, they say. And, they argue, it's one thing for the religious institutions to say they should not be required to pay for contraceptive coverage. It's quite another for them to refuse even to notify the government so that other arrangements can be made. (Savage, 11/6)

The justices combined seven similar cases from groups that include the Little Sisters of the Poor, an order of Roman Catholic nuns that runs nursing homes. Their lawsuit has received the most media attention of any of the birth control cases. By accepting so many of the challenges, the court is giving a significant amount of attention to the case. The challenge is very similar to the Hobby Lobby case the Supreme Court heard in 2014. The justices ruled last year that the law’s contraception coverage requirement violated for-profit businesses’ rights under the Religious Freedom Restoration Act. This suit, however, deals with how groups with some religious ties — such as Catholic service groups or evangelical colleges — have to comply with the birth control rule. (Haberkorn, 11/6)

Among the challengers are the Little Sisters of the Poor, nuns who run more than two dozen nursing homes for impoverished seniors. The administration has argued that the accommodation it came up with does not violate the nonprofits’ religious rights. Even if the Supreme Court rejects that argument, the administration has said in court papers, the justices should determine that the system for getting contraceptives to women covered by the groups’ insurance plans is the most effective and efficient way to do so. (Sherman, 11/6)

The Little Sisters object to playing any role in the process of making birth control pills and devices available to their employees or students, even the limited one under the government's accommodation. They want the same kind of total exemption given to churches. Joined by other religiously affiliated groups, the nuns say even under the accommodation, they must still take steps to ensure that the employees covered by their insurance plans get contraceptive coverage. (Williams, 11/6)

Seven of eight federal appeals courts have agreed with the administration that requiring the faith-based groups to make their objection known and identify their insurer or insurance administrator does not violate a federal religious freedom law. Only the appeals court in St. Louis ruled for the groups, saying they probably have a right to refuse to comply with the administration rules. (11/6)

The Affordable Care Act, or the ACA, requires employers with 50 or more full-time employees to offer health plans with “minimum essential coverage,” including access to federally approved contraception for women, without copayments or deductibles. Under federal religious freedom laws, religious nonprofits can seek “accommodations” to be exempted from the contraceptive mandate by submitting a form or notification certifying the organization’s objection to paying for contraception coverage on religious grounds. (Ura and Walters, 11/6)

President Obama wants YOU to help get more people signed up for Obamacare. Beginning the third year of open enrollment on the public health insurance exchanges created under the Affordable Care Act, the White House is rolling out a new strategy to boost participation above the elusive 10 million mark. (Korte, 11/7)

As open enrollment season on HealthCare.gov begins, President Obama is introducing a contest meant to motivate Americans to sign up for health insurance coverage through federal and state exchanges. (Flores, 11/7)

The nation’s insurance commissioners are recommending sweeping new standards to address complaints from consumers about limited access to doctors and hospitals in health plans sold under the Affordable Care Act. Limited networks of health care providers are a feature of many insurance policies offered in the public marketplaces, or exchanges, where people with low incomes can often obtain subsidies that reduce their monthly premiums to $100 or less. Such “narrow networks,” consumers say, often do not include the doctors they need for specialized care for themselves or their children. (Pear, 11/8)

Health care systems are competing in the market around both price and quality. Nonprofit health co-ops are struggling to provide affordable insurance coverage, while for-profits are also trying to keep business afloat under new federal laws. In Oregon, health insurers will be raising premiums next year. But one for-profit company, recently launched in Portland, is going lower. Zoom Performance Health Insurance offers what it calls “a full stack” of care in neighborhood clinics. ... Zoom doesn’t accept Medicare or Medicaid. It’s too early to say if it’s cherry-picking young, healthy consumers to cut costs, said David Rosenfeld of the Oregon consumer watchdog group OSPIRG. “I think it’s very reasonable to argue that Zoom’s model of care would more naturally appeal to younger people,” Rosenfeld said. (Sevcenko, 11/6)

Health Republic and the 11 other co-ops set to close this year make up more than half of the total plans established under the Affordable Care Act. The 23 organizations — nonprofit start-ups with consumer-led boards — were set up as alternatives to government-run plans and were intended to create competition with companies like Aetna and Anthem. The plans took off but soon encountered financial and political difficulties. ... Congress also made deep cuts to the funds meant to boost struggling co-ops, reducing that budget by 60 percent. Health Republic has now become a cautionary tale and a warning to other struggling insurers. The company has also become a source of anxiety, from Albany to Long Island, as some New Yorkers try to determine what insurance plan to sign up for next. (Casey, 11/6)

Those eligible for the lowest subsidies to buy health insurance were the least likely to sign up for 2015 plans, studies show, another indication of the challenge of boosting enrollment for President Obama's signature health care law in 2016. The percentage of those choosing health plans dropped from about 75% for those earning $23,540 to about 14% for those earning about $47,000, new research from the Urban Institute and the Robert Wood Johnson Foundation (RWJF) shows. Premium tax credits available on the federal and state insurance exchanges decrease as consumers earn closer to 400% of the federal poverty limit, which is about $47,000 for an individual. (O'Donnell, 11/6)

With the health insurance markets open for next year’s enrollment, Eve Campeau says she’s planning to look carefully at the fine print. Last time she shopped, she switched to a plan with a lower monthly premium, but found herself paying far more out-of-pocket for medications and doctor visits. While she might be saving money on the premium, she is reluctant to go to seek medical care because of the up-front cost. (Appleby, 11/9)

Recording and mixing music is Vernon Thomas’ passion, but being CEO and producer of Mantree Records is not his day job. He’s an HIV outreach worker for a local county health department outside Newark, N.J. He took what was to be a full-time job in May because the gig came with health insurance – and he himself has HIV, the virus that causes AIDS. But then the county made it a part-time job – and Thomas lost that coverage before it started. (Mogul, 11/9)

Imagine what you could do with $2,000. If you’re between 18 and 34, you might travel somewhere fun. Maybe buy a big TV. But would you buy health insurance? Take it from another millennial: Think about insurance if you don’t have any. (Gillespie, 11/9)

Republican-led states that expanded Medicaid are sticking with the change, despite qualms and intense political pressure within the GOP about embracing a key part of President Obama’s health-care law. GOP governors and legislators have balked at repealing expansion partly because of the benefit of providing federally funded health insurance to large numbers of constituents, analysts say. They also wish to keep the billions of dollars of federal funds that the Affordable Care Act (ACA) — also called Obamacare — gives states that broaden Medicaid. (McCartney, 11/6)

The U.S. Attorney’s Office for the Eastern District of Pennsylvania and the Justice Department’s civil division are seeking information from Valeant Pharmaceuticals International Inc. and Eli Lilly & Co. about how they calculate and report drug prices for the Medicaid rebate program, the companies disclosed in filings to the Securities and Exchange Commission in recent weeks. (Loftus, 11/6)

Merck and Eli Lilly are both being investigated by the Justice Department for their drug-pricing practices. The pharmaceutical giants both disclosed the probes by the U.S. Attorney's office in Philadephia in SEC documents. (Isidore, 11/6)

Federal prosecutors in at least four states are mounting investigations into what they describe as widespread fraud by compounding pharmacies in claims to the health-insurance program that covers 9.5 million U.S. military members and their families. In the latest move, four Florida pharmacies last month agreed to pay $12.8 million combined to settle civil allegations that they falsely billed the insurance program Tricare for expensive pharmaceutical creams and gels to treat pain, scars and other ailments, according to A. Lee Bentley III, the U.S. attorney for the Middle District of Florida. (Walker, 11/8)

Brenton Saunders, the whiz-kid pharmaceutical executive with a reputation for being wary of the costs of early-stage drug development, says he's open to new ideas from outside and is now warming up to investing in drug discovery if it makes sense for his company. While sources close to the ongoing negotiations stress that no decision on Saunders' role has been taken yet, the possibility of Pfizer being led or influenced by an executive who has not overseen the full development, from discovery to approval, of a single drug raises concerns among many industry insiders. (Pierson and Berkrot, 11/6)

Health insurer Cigna Corp (CI.N) reported a better-than-expected quarterly profit, helped by higher enrollments in its government plans and favorable medical costs. However, Cigna said it expected revenue growth in 2016 could be offset by reduction in customers in its individual plans, which are sold on exchanges created under the U.S. Affordable Care Act. (Penumudi, 11/6)

Humana Inc., which in July agreed to be acquired by rival Aetna Inc., on Friday said Medicare membership growth lifted third-quarter profit. Strength in health care services, driven by Medicare, offset a soft commercial segment. Chief Financial Officer Brian Kane said the insurer expects “marked improvement” in the Medicare and individual commercial businesses next year, but added that Humana remains cautious about 2016 earnings growth expectations due to challenges in those segments. (Beilfuss, 11/6)

Health insurer Humana Inc, which agreed to be bought by Aetna Inc for $37 billion in July, reported a better-than-expected quarterly profit as it added more members to its individual Medicare Advantage business. Humana, which manages large Medicare Advantage health plans for the elderly and disabled, said individual Medicare Advantage membership rose 14 percent to 2.74 million at the end of the quarter. (Banerjee, 11/6)

Senate Minority Leader Harry Reid (D-Nev.) and House Minority Leader Nancy Pelosi (D-Calif.) are working behind the scenes to repeal one of the most controversial taxes in ObamaCare, multiple sources tell The Hill. Reid and Pelosi have been talking since the spring with President Obama about repealing the “Cadillac tax” on employer healthcare benefits, a senior Democratic aide confirmed on Friday. (Ferris, 11/7)

Rep. Joe Pitts (R-Pa.) announced Friday he will not seek re-election, marking an end to his nearly 20-year career in the House. Pitts, who will have spent five years as chairman of the key health panel of the House Energy and Commerce Committee, was first elected in 1997. Deeply religious and strongly anti-abortion, Pitts was the founding leader of the Republican Study Committee’s Values Action Team. The group formed the first year he served in Congress and has been a key liaison to the Christian right. (Ferris, 11/6)

Pennsylvania Republican Rep. Joe Pitts announced Friday he will not seek re-election and will retire at the end of his 10th term. Pitts, 76, is one of the House's most ardent conservatives on social issues such as abortion. As chairman of a key health panel on the powerful Energy and Commerce Committee, Pitts helped pass legislation earlier this year to fix a broken Medicare reimbursement system for physicians and is a co-author of bipartisan legislation boosting medical research. (11/6)

[Rep. Kevin] Brady, from a solidly Republican district north of Houston, headed the trade subcommittee until 2013. That's when he took over the health subcommittee and helped lead many of the House's GOP's repeated, unsuccessful efforts to roll back President Barack Obama's health care law. As chairman, Brady's portfolio is much wider. (11/8)

Republicans and Democrats have stacked a new select committee on Planned Parenthood with their fiercest fighters on abortion rights, setting the stage for a major election-year battle. Unlike every other committee in Congress, the overwhelming majority of lawmakers on the panel are women, with Rep. Marsha Blackburn (R-Tenn.) serving as chairwoman and Rep. Jan Schakowsky (Ill.) serving as the ranking Democrat. (Marcos and Ferris, 11/7)

The nonprofit, member-run health insurance plans created by the Affordable Care Act are in a world of trouble. Twelve of the nation’s 23 Consumer Operated and Oriented Plans, known as co-ops, won’t provide coverage in 2016 after collapsing under the weight of low enrollment, financial problems and a host of technical and operational issues. (Pugh, 11/5)

Hopes are rising for an increase in funding for the National Institutes of Health after a budget deal, even as negotiators haggle over a longer-term increase in a separate bill. The push for increased funding for medical research at NIH is a rare area of bipartisan consensus, but the budget caps put in place in 2011 had posed an obstacle. The agreement sealed late last month, which lifted the cap for domestic spending by $40 billion over the next two years, is providing a new ray of hope. (Sullivan, 11/8)

One Duke University surgeon called it a “new frontier” in cancer treatment. Another said it could save “10,000 lives a year” or more. A researcher at Mass General Hospital called it “a very, very exciting tool” in the fight against lung cancer. As news spread in 2006 and 2007 of the work of Anil Potti, a star cancer researcher at Duke, the excitement grew. What he had claimed to achieve, in leading medical journals, was a genomic technology that could predict with up to 90% accuracy which early stage lung cancer patients were likely to have a recurrence and therefore benefit from chemotherapy. (Barbash, 11/9)

The last time Ben Carson stepped onto a debate stage, he was asked about something he had never really questioned. Why had he endorsed the nutritional products of Mannatech, a Texas-based company that was forced to settle a 2009 wrongful marketing lawsuit? What did that endorsement say about his “judgment”? ... Yet, in defiance of the facts, Carson professed ignorance on the debate stage about any “relationship” with the company. He spent two days following the debate denouncing the questions about Mannatech as “propaganda.” And his most ardent supporters don’t care. (Weigel, 11/7)

Does Ben Carson have a “death panels” problem? Before he was a 2016 presidential candidate, Carson, a retired neurosurgeon, frequently raised questions about the high cost of end-of-life medical care — and asked whether patients should be able to pursue every available treatment. The statements touched on many of the most sensitive questions about care for the elderly. (Nather and Swetlitz, 11/8)

Hillary Rodham Clinton has long declined to endorse legalized medical or recreational marijuana at the federal level, but on Saturday, she added more specifics to her proposal to increase research into medical marijuana. Clinton said that she supports removing marijuana from a list of schedule 1 drugs, a classification that prevents federally-sponsored research into its effects. As a schedule 1 drug, marijuana is classified among the most dangerous drugs that the federal Drug Enforcement Agency regulates. (Phillip, 11/7)

Dr. Roberta Miller hits the road at 8 a.m. to see her patients. Many are too old or sick to go to the doctor. So the doctor comes to them. ... Although Miller's practice may harken back to the country doctor of decades past, it could be the future of medicine. In 2013, about 2.6 million Medicare claims were filed for patient home visits and house calls. That's up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics. The trend is expected to accelerate as baby boomers grow older. One in 20 people over the age of 65 is homebound in the U.S., according to a study published in July in JAMA Internal Medicine. (Friedman, 11/8)

Within five weeks, [Dr. Rene] Dua's entrepreneur husband had developed an Uber-like app that would allow a doctor to be sent to someone's home or office at an hour's notice. The service — Heal — launched in February and thus far has raised $6.5 million from investors who include Qualcomm Executive Chairman Paul Jacobs, United Talent Agency Managing Director Jay Sures and entertainer Lionel Richie. It has a network of 100 doctors in Los Angeles County, Orange County, San Francisco and Silicon Valley who offer house calls at a flat rate of $99 per patient. (Daswani, 11/7)

Every time JoAnna James took her husband, Lawrence, to the doctor, she left the hospital without understanding what was wrong with him. ... Frustrated, the couple signed up two years ago for an experimental program at the University of Chicago Medicine. The James’ new primary care doctor explained Lawrence’s prostate cancer diagnosis and every procedure that followed until they understood each of them. “She speaks your language,” JoAnna James said. The Comprehensive Care Program, funded with a $6.1 million federal grant, is an example of a new model of care aimed at changing the culture of America’s health care system to one where doctors treat people rather than symptoms. (Cacino, 11/9)

Veterans' hospitals and clinics are beefing up staff and seeing more patients, but the number of appointments not completed within 30 days continues to grow, Department of Veterans Affairs Robert McDonald said Friday. Speaking at the National Press Club in advance of Veterans Day, McDonald described a VA that is doing much to address problems that investigators say caused chronic delays for veterans seeking care. (Freking, 11/6)

So some folks were startled to learn that the new “self plus one” option in the Federal Employees Health Benefits (FEHB) program can be more expensive than family coverage, depending on the company. This option allows enrolled federal workers and retirees to purchase health insurance for themselves and one eligible family member. Open season, when health plans can be chosen, begins Monday and runs through Dec. 14. With health insurance costs for FEHB participants rising by an average of 7.4 percent next year, the most since 2011, enrollees are looking for any break they can get. Unfortunately for older people, health-care expenses rise with age and they are more likely to want self-plus-one policies. (Davidson, 11/8)

On Friday, Mr. Bevin, a wealthy businessman who ran with support from the Tea Party movement, repeated his intent to reverse two pillars of Mr. Beshear’s efforts, under the Affordable Care Act, to insure more people. He said he would phase out the state’s health insurance exchange, pushing consumers onto the federal exchange, by the end of 2016. He also said he would phase out the expansion of Medicaid coverage to larger numbers of low-income people — plans that were among the central issues in the campaign. On Medicaid, Mr. Bevin said he wanted a federal waiver to “customize something for Kentucky.” He did not offer details. (Pérez-Peña, 11/6)

Bevin also said Friday he would dismantle kynect, Kentucky's state-run health insurance exchange, by the end of 2016. More than 100,000 people have used kynect to purchase private health insurance plans with the help of federal subsidies. Instead, Bevin wants those people to buy health insurance from an exchange run by the federal government. "(Kynect) adds nothing of value," Bevin said. "It is a redundancy that we as taxpayers in this state are paying for twice." State health officials disagree, arguing kynect was designed specifically for Kentucky and has helped slash the share of uninsured state residents from about 20 percent in 2013 to 9 percent by 2015. But most of that reduction came because more people qualified for the state's expanded Medicaid program. (Beam, 11/6)

Gov. Terry McAuliffe intends to make another push for Medicaid expansion despite intense opposition from Republicans, who retained full control of the General Assembly in elections last week. McAuliffe (D) said he will pursue a new strategy that he thinks will be more palatable to conservatives — one that he said would allow Virginia to extend health-care benefits to 400,000 uninsured citizens at no cost to the state. (Vozzella, 11/7)

Last week, Gov. Pat McCrory put his pen to paper and signed into law Senate Bill 698, a bill that will help several struggling hospitals in their attempts to reopen. Tucked into the bill, is a single line repealing two laws written in the 1990s, when Asheville’s Mission Hospital asked for permission to merge with St. Joseph’s Hospital. That 1995 merger would have created a virtual health care monopoly in Asheville, and so the state approved a “certificate of public advantage.” The COPA allowed the merger to proceed while protecting Mission from anti-trust litigation that may have come because of its new size. (Hoban, 11/6)

Hospital industry officials say Georgia’s decision not to expand Medicaid under the Affordable Care Act has hurt rural health care. Hospitals in rural areas tend to treat many uninsured people, incurring heavy losses. If more low-income residents were covered by Medicaid, these hospitals would be guaranteed more revenue. (Miller, 11/6)

The last time a hospital closed in Maryland, Bill Clinton was president, Celine Dion was at the top of the music charts and Michael Jordan announced his retirement from basketball. It was 1999 and Liberty Medical Center, New Children's Hospital and Church Hospital in Baltimore all shuttered their doors, blaming low occupancy, steep revenue declines and the challenge of competing as a small hospital. Sixteen years later, Laurel Regional Hospital is ending its status as a full-service hospital — a move that has triggered outrage and protest from politicians, union leaders and residents. (McDaniels, 11/7)

The Anne Arundel County Medical Center is planning to expand its teaching capabilities by offering residencies to medical school graduates. Starting in June 2017, the Annapolis hospital will train future doctors through a Graduate Medical Education program, President and CEO Victoria Bayless told the Capital Gazette editorial board Thursday. (Rahman, 11/9)

About 75 people in need of the most extensive mental health care — those who are a danger to themselves or others — are admitted monthly to Baltimore Washington Medical Center. The Glen Burnie hospital has the only inpatient psychiatric ward in Anne Arundel County. It has 14 beds. Even with 75 admitted, another 65 are transferred to hospitals outside the county for treatment, said Dwight Holmes, who oversees psychiatric services at the hospital. (Weathers, 11/7)

Hartford Hospital and one of its contractors have agreed to pay the state $90,000 and undertake training and security measures to resolve an investigation into the theft of a laptop containing unencrypted patient information in June 2012, according to Attorney General George Jepsen’s office. The laptop contained protected health information for 8,883 Connecticut residents when it was stolen from the home of an employee of a Hartford Hospital contractor, EMC Corporation. The hospital had hired the company as part of a project aimed at reducing readmissions. (Levin Becker, 11/6)

Glendale Adventist Medical Center earned an A grade from a hospital watchdog group for patient safety while three other local hospitals collectively earned a B and two Cs. Leapfrog Group, which releases semi-annual report cards based on criteria such as reducing infections and patient falls, announced last week Glendale Adventist earned its second A of 2015. (Mikailian, 11/7)

A senior federal official expressed “significant concerns” Friday that Iowa’s plans to shift its Medicaid health insurance program to private management could put the quality of health care for 560,000 low-income and older Iowans at risk. Questions are also being raised about the extent to which so-called managed care organizations, health care providers and people receiving Medicaid services are prepared for the transition, which is scheduled to begin Jan. 1, said Timothy Hill, deputy director of the Centers for Medicare and Medicaid Services, a unit of the U.S. Department of Health and Human Services. (Petroski, 11/6)

Some of the claims made by the for-profit corporations chosen to manage Iowa’s $4.2 billion annual Medicaid program contain unverifiable data, misleading statements or half-truths, a Des Moines Register investigation has found. The questionable information was provided to Iowa officials in public bid documents used to help the companies edge out competitors to win the lucrative contracts. (Clayworth, 11/7)

A little more than a year from now, Nebraska Medicaid recipients will have their physical and mental health care -- and medications -- managed under a new program called Heritage Health. State Department of Health and Human Services officials recently announced they are sending out requests for proposals for two to three companies to make up the program. Now, Medicaid recipients get their care through different programs. (Young, 11/8)

Sen. John McCollister of Omaha will hit the road this month to share with Nebraskans a new legislative proposal to access available federal Medicaid expansion dollars and use them to purchase private health care insurance for the working poor. McCollister, who is teaming up with Sens. Kathy Campbell of Lincoln and Heath Mello of Omaha to push for a new private market-centered plan modeled after legislation in Arkansas, has scheduled meetings in 10 communities spreading from Omaha to Alliance. (Walton, 11/8)

Cancer patients insured by California’s health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers. While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC-Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer. (Feder Ostrov, 11/6)

What Michigan's low-income seniors and disabled people don't know could their make health care a whole lot easier. It also could help them tap into care, such as dental services, that they've long been unable to get. "Right now, there is the fear of the unknown," said Jo Murphy, executive director of the Michigan Medicare/Medicaid Assistance Program (MMAP), which helps consumers sort through their coverage choices. ... The state's experimental program, MI Health Link, is an effort to coordinate care for more than 230,000 Michiganders whose health care is paid by both Medicare and Medicaid, a confusing tangle of fee-for-service coverage. (Erb, 11/8)

The state of Alaska is appealing a judge's decision that found a state law and regulation further defining what constitutes a medically necessary abortion for purposes of Medicaid funding to be unconstitutional. Jonathan Woodman, a senior assistant attorney general, said by email that the appeal will argue that the state can establish standards to distinguish between elective and medically necessary abortions so that Medicaid pays only for those medically necessary. (Bohrer, 11/7)

The state’s four medical schools have agreed to incorporate into their curriculum instruction in the prevention and treatment of prescription drug misuse, as part of Governor Charlie Baker’s effort to combat opioid addiction. Under the agreement, expected to be announced Monday, the 3,000 students enrolled in the medical schools at the University of Massachusetts and Boston, Harvard, and Tufts universities will be taught skills designed to prevent painkillers from being misused. (Freyer, 11/9)

For the past 10 months, Adriana Parrales has been confined to her bed, breathing through a ventilator and fighting her insurance company for her life. Her days are spent with nurses monitoring vital signs that can be stable one minute and swing out of control the next, because of a genetic condition that causes debilitating tumors on Parrales’ brain and spine. (Koh and Miller, 11/6)

Do you take your teeth for granted? The fact that you still have them, and they don’t cause you pain? Then you are among the fortunate. Hundreds of the region’s less fortunate streamed into the Walter E. Washington Convention Center in downtown Washington on Sunday for a free one-day clinic sponsored by the American Dental Association. (Brown, 11/8)

On a recent afternoon at Hanson Elementary School in Commerce City, Mariana Martinez-Guzman walked into a small room bearing a brave face. The second-grader was there to get an anti-cavity sealant put on her six-year molars, and she was comporting herself with an alacrity many adults don't share in a dental chair. Amy Whitehorn, a registered dental hygienist, fitted her with a bib and sunglasses, the latter to protect her eyes from UV rays from one of her instruments. (Porter, 11/7)

The number of fentanyl-related overdose deaths is up sharply in Massachusetts. State police, which conducts toxicology tests for the state medical examiner, say that fentanyl was present in 336 people who died of overdoses in a 12-month period that ended on Oct. 6. That’s up more than 50 percent from the previous 12-month period. (Bebinger, 11/6)

Despite major improvements in eliminating newborn screening delays throughout the country, some states still won't publicly disclose how quickly hospitals submit tests to detect deadly genetic disorders in newborns. State officials have until Monday to apply for a new federal grant designed to improve the timeliness of newborn screening programs and to track performance of individual states. Although summary data will be made public through the federally funded program, the performance of specific states will not, even though public knowledge of poor performance has sparked huge improvements across the country. (Gabler, 11/7)

When Aaron Harvey was born with a very rare disorder 21 years ago, doctors gave him a year to live. So you could infer the severely disabled young man’s survival this long has been a miracle. Perhaps. But two extraordinary circumstances have benefited him greatly: an at-home nurse for a mother; and a place like ChildServe in Johnston, where he has been cared for since he was 12. In January, though, Aaron turns 22 and will “age out” of the place he considers home. (Rood, 11/6)

Anthony Barsotti looks on the verge of death. His skin is ashen, his face gaunt. His mouth gapes as he stares at the ceiling, sporadically sucking in breaths. Three hours earlier, Anthony was a physically healthy 23-year-old living in the state’s care at a Gainesville mental hospital. Then he took a swing at another mental patient and a hospital orderly launched him head-first into a concrete wall. Workers at North Florida Evaluation and Treatment Center have a good chance to save his life this night in July 2010. Instead, as hospital security cameras roll, they make one mistake after another. (Anton, Braga and Cormier, 11/8)

The University of Colorado School of Medicine is returning a $1 million contribution from Coca-Cola to start a group that says it's dedicated to ending obesity. The money was provided to establish the Global Energy Balance Network, which says it is working on an "evidence-based approach to ending obesity." Since a New York Times story noted its funding from Coke in August, the group has been criticized for trying to play down the role sugary drinks play in fueling weight gain and instead playing up the importance for physical activity. (11/6)

Indiana's first statewide program that pays for addiction and mental health treatment for convicted felons sent to community corrections instead of jail or prison is now underway in a push that's targeting uninsured offenders. Courts, probation and parole officers and community correction managers on could begin referring eligible felons on Nov. 1 to designated drug and mental health treatment centers instead of to jail or prison. Family and Social Services Administration spokeswoman Marni Lemons said it's too early to know how many were referred since the initiative began or how many will eventually take part, but it's expected to number in the thousands. (Callahan, 11/8)

Now that the Supreme Court has agreed to hear the latest challenge to the Affordable Care Act’s guarantee of insurance coverage for birth control, it is worth reiterating what the conflict at the core of these cases is really about. The plaintiff employers — including several religious schools and an order of Catholic nuns that provides services to the elderly poor — refuse to provide coverage for certain contraceptives, which they believe (contrary to scientific consensus) induce abortions. The government has already agreed that these employers are not required to provide such coverage. ... This should not be a difficult case. In a secular society, religious freedom demands respect and accommodation, not a veto over government action that benefits others who believe differently. (11/6)

My own intuition is that the Obama administration chose this fight, and should have avoided it by quietly making an exception for religious nonprofits with doctrinal objections. For one thing, contraception is an inexpensive routine purchase that is exactly the sort of thing that insurance shouldn’t cover (for the same reason your car insurance doesn’t cover routine service: you’d just end up pre-paying the service in the form of higher insurance premiums). For another, the number of people employed by these groups is small. Picking this fight was not worth amping up the culture wars. America doesn’t need more things to have bitter partisan battles over. We’ve already got a years-long backlog to get through. (Megan McArdle, 11/6)

The Affordable Care Act has generated an enormous amount of partisan rancor, but with more access to data, it is worth taking stock of how it has actually been working. We can safely say that the policy is costing less than anticipated, perhaps 20 percent less, according to a Congressional Budget Office estimate, and that it has reduced the number of Americans without insurance. But the numbers also suggest that by some measures, the Affordable Care Act has had only a limited impact on economic inequality. (Tyler Cowen, 11/6)

Conservative lawmakers in our home states of Utah and Florida recently defeated a combined three proposals to expand Medicaid under ObamaCare. They were absolutely right to do so, as the fiscal messes in states that did expand Medicaid demonstrate. ... Florida and Utah taxpayers will thank their legislators in the years to come. Consider the experience of the states that did expand Medicaid. “At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017,” the Associated Press reported in July. ... This has blown holes in state budgets. (Evelyn Everton and Chris Hudson, 11/6)

Last week's election results in Kentucky and Virginia dashed any hope that attacks on Obamacare might finally be losing their political currency. Healthcare providers and payers should brace themselves for a full year of well-funded assaults on the law. (Merrill Goozner, 11/7)

At his first press conference since his election, [Kentucky Gov.-elect Matt] Bevin said he wants to design a plan that would require participants to pay premiums or co-pays and that his plan would not re-enroll people up to 138 percent of the poverty rate. He added that his goal “isn’t an attempt to cut people off. It is an attempt to have people take responsibility.” If his goal isn’t to cut people off, the key will be to find price points that people can afford. It’s tough for a family of four to live on $33,000 without having to pay for insurance or medical care, and even the slightest increase could mean they are priced out of the market. (Joseph Gerth, 11/7)

One year from this week, Colorado voters will make a fundamental choice about health care in our state. We can stick with the status quo — the Affordable Care Act, which leaves hundreds of thousands with no health insurance — or we can switch to a new health plan, designed in Colorado, that will cover everybody and cut costs sharply for almost every family and business in the state. This new plan has been named ColoradoCare, precisely because it is not Obamacare. It's a system of universal coverage proposed by state Sen. Irene Aguilar, a Denver physician, along with health policy experts around the state. When Aguilar's plan came up in the legislature, the private insurance companies crushed it. They fear (and they're right) that competition from ColoradoCare will force them to cut their soaring premiums. (T.R. Reid, 11/6)

Asking whether the Obamacare Cadillac tax will increase worker wages might seem nonsensical on its face. But wait until you hear the answer: yes AND no. Don’t worry: Schrodinger’s cat hasn’t wandered into the thicket of health policy (nor am I channeling my inner two-handed economist). It’s a trick question: the answer depends on whether employers respond to the Cadillac tax by trimming health benefits to avoid the tax, or instead simply keep their health benefits as is and pass the tax onto their employees. For employers who trim health benefits I have a high degree of confidence that on average, worker wages will rise. For employers who absorb the Cadillac tax increase, average worker wages will fall. (Chris Conover, 11/6)

Within last week’s strong jobs report was yet another good month for the health-care sector, which added 45,000 jobs. The growth of jobs in this sector is a long-term trend, driven in no small part by our aging demographics. Even when we were hemorrhaging jobs in the depths of the last recession, health care was an outlier, never experiencing even one negative month of job growth during the downturn. (Jared Bernstein and Ben Spielberg, 11/9)

Did you catch that line from Mike Huckabee during the last Republican presidential debate in which he calls for a declaration of war on four major diseases? "I really believe that the next president ought to declare a war on cancer, heart disease, diabetes and Alzheimer’s," he said, "because those are the four things that are causing the greatest level of cost.” ... A "cures caucus" is building within Republican ranks. ... It seems some Republicans are betraying conservative dogma -- perhaps most emphatically pushed by Cruz -- that says government agencies are inept and federal spending inane. But the cures caucus makes eminent sense. (Paula Dwyer, 11/8)

You may not know it, but you could be on the hook to pay at least $124 this year for a drug you probably don’t take. The drug is a new class of cholesterol-lowering agents called PCSK9 inhibitors. ... According to a recent article in The New England Journal of Medicine by Kevin A. Schulman and his colleagues at Duke, even if the price came down to about $11,000 per patient per year, and only 1.1 million of the roughly 23 million middle-age Americans with high cholesterol actually took these drugs, the bill would be so high that for a typical insurance plan, “annual insurance premiums would increase by $124 for every person” in the insurance plan. (Ezekiel J. Emanuel, 11/7)

Starting around the turn of the millennium, the United States experienced the most alarming change in mortality rates since the AIDS epidemic. This shift was caused, not by some dreadful new disease, but by drugs and alcohol and suicide — and it was concentrated among less-educated, late-middle-aged whites. We had hints that something like this was happening. We knew suicide was increasing among the middle-aged, that white women without a high school degree were struggling with health issues, that opiate addiction was a plague in working-class communities. But we didn’t know it was all bad enough to send white death rates modestly upward in the richest nation in the world. (Ross Douthat, 11/7)

Driving this opioid epidemic, in large part, is a disturbing change in the attitude within the medical profession about the use of these drugs to treat pain. Traditionally, opioid analgesics were largely used to treat pain stemming from terminal diseases like cancer, or for short-term uses, such as recovering from surgery. But starting in the 1990s, there has been a vast expansion in the long-term use of opioid painkillers to treat chronic nonmalignant medical conditions, like low-back pain, sciatica and various musculoskeletal problems. To no small degree, this change in clinical practice was encouraged through aggressive marketing by drug companies. (Richard A. Friedman, 11/7)

When Arnold Fisher mustered out of the U.S. Army in 1954 after a stint in Korea, he left as a corporal. But he didn’t leave the service. ... Now he is in his ninth decade, and this Veterans Day will find the Fisher Brothers’ senior partner aiming much higher than skyscrapers. Today his obsession is the human brain—specifically, how Americans can help our warriors who return from the battlefield with injuries few understand. (William McGurn, 11/6)

In recent years, America’s corporations have created a private system for handling disputes that benefits them greatly while denying consumers their day in court. ... Even more disturbing, the shift away from the civil justice system has gone beyond disputes about money. Nursing homes, obstetrics practices and private schools increasingly use forced-arbitration clauses to shield themselves from being taken to court over alleged discrimination, elder abuse, fraud, hate crimes, medical malpractice and wrongful death. For the most part, Congress has looked the other way. (11/7)

The 104th US Congress marked an important period in the legislative legacy of then-Rep Jay Woodson Dickey, Jr, (R, Ariz). Only 2 years into his 8-year congressional tenure, Rep Dickey spearheaded the 1996 enactment of 2 far-reaching amendments. In so doing, Rep Dickey assured the prohibition of public funding of gun violence research and human embryo research by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), respectively. The lasting impact of the 2 amendments can hardly be overstated. Both remain in effect. Now, in an interview 20 years later with the Huffington Post, the retired 75-year-old congressman expressed his regrets over the curbing of gun violence research. Similar sentiments have been expressed earlier in a 2012 op-ed with the Washington Post. No such qualms have been publicly articulated relevant to the generation-long funding freeze of human embryo research. (Eli Y. Adashi and I. Glenn Cohen,, 11/6)