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Hillary Clinton and Donald Trump sparred over ObamaCare at the presidential debate Sunday night, with Trump calling to repeal it entirely and Clinton acknowledging flaws but calling for improvements. Trump, the GOP nominee, and other Republicans have put a focus on premium hikes, and Trump pointed to them as evidence of the need to repeal the law. Clinton, the Democratic nominee, agreed that premiums and healthcare costs in general are a problem but called for going forward, not starting over. (Sullivan, 10/9)

The presidential candidates Sunday night discussed the Affordable Care Act at the second of three debates between them by sticking with their usual statements. The first audience question at the town hall style debate was about rising health insurance premiums, deductibles and copays as well as increasing prescription drug prices. The questioner asked what the candidates would do to make healthcare more affordable. (Muchmore, 10/9)

Donald Trump has repeatedly claimed that the Affordable Care Act is a disaster, and did so again Sunday, noting that Americans’ monthly insurance premiums are rising by “astronomical” amounts. “Your health insurance, you’re health care, going up by numbers that are astronomical — 68%, 59%, 71%,” he said. This is a major exaggeration. (Levey and Mascaro, 10/9)

Trump vastly exaggerates the cost of President Barack Obama's Affordable Care Act. The cost of the coverage expansion in Obama's health care law is nowhere near what the government spends on Medicare and Medicaid, for example. (10/9)

It's Vermont Sen. Bernie Sanders — not Clinton — who supports a Canada-style government-run health care system. While Clinton's health care proposals would expand the government's role in the health care system, she's not talking about dismantling the current system, which is a hybrid of employer-sponsored coverage, government programs like Medicare and Medicaid, and individually purchased insurance. (10/9)

Congressional Republicans have promised their replacement plan for Obama's health care law would provide coverage for the uninsured, but they have not provided enough detail to allow a rigorous comparison. A complete repeal of the health care law would wipe the slate clean, and lawmakers would have to start over. (10/9)

Donald Trump has repeatedly claimed over the past week that Bill Clinton “torched” the Affordable Care Act when the former president brought up the health law during a campaign rally for Hillary Clinton in Michigan on Monday. Trump was asked about his comments again again during Sunday’s debate. His claims are, at best, misleading. The former president did note that some people are still struggling to afford healthcare, despite the 2010 law, often called Obamacare. (Levey, 10/10)

The federal government will choose health plans for hundreds of thousands of consumers whose insurers have left the Affordable Care Act marketplace unless those people opt out of the law’s exchanges or select plans on their own, under a new policy to make sure consumers maintain coverage in 2017. “Urgent: Your health coverage is at risk,” declares a sample “discontinuation notice,” drafted by the government for use by insurers. It tells consumers that “if you don’t enroll in a plan on your own, you may be automatically enrolled in the plan picked for you.” (Pear, 10/8)

A House Republican is circulating a letter among his colleagues urging Speaker Paul Ryan (R-Wis.) to sue the Obama administration to prevent millions of dollars in legal settlements with ObamaCare insurers. The letter from Rep. Chris Stewart (R-Utah) says a lawsuit should be initiated to prevent a potential payout from an obscure legal fund at the Treasury Department. (Sullivan, 10/7)

Tennessee’s largest insurer, BlueCross BlueShield of Tennessee, announced in late September that it would significantly limit its participation in the Affordable Care Act exchanges. BlueCross will no longer offer individual plans in the Nashville, Memphis and Knoxville regions. The departure encompasses 30 counties with 100,000 consumers expected to be affected. The move is not a total surprise. BlueCross shared in August that it was reevaluating its strategy for selling to individuals and families. Though the company was allowed to raise its 2017 premiums by 62 percent — one of the largest increases in the country — BlueCross couched the approval in uncertainty. (Tolbert, 10/9)

Covered California’s big 2017 rate hikes are starting to hit home for consumers. The state health insurance exchange began mailing notices to its 1.3 million customers on Wednesday, alerting them that they can determine exactly how much the premiums for their current plans will rise in 2017, and begin shopping around for cheaper options. (Bazar, 10/7)

As Texas' largest insurer eliminated hundreds of thousands of coverage plans for some of the state's sickest patients and asked for double-digit rate increases last year, its Chicago-based nonprofit parent company rewarded 10 top executives with a combined $48 million in bonuses. Patricia Hemingway Hall, the now-retired CEO at Health Care Service Corp., the largest customer-owned insurer in the nation with Blue Cross and Blue Shield divisions in five states including Texas, earned the most. Her $16.57 million pay included a $14.9 million bonus, according to 2015 compensation records obtained from the Illinois Department of Insurance. (Deam, 10/8)

About 10 million Americans buy individual insurance coverage without cost-reducing federal subsidies on the marketplaces on the open market, according to the Congressional Budget Office... While consumers have faced sticker shock, the insurers have faced what might be called "sicker shock." They are raising premiums after finding that many of the customers buying plans on the individual market were sicker and more costly to insure than expected when the health law was implemented. (Anderson, 10/7)

After decades of taking a back seat to other social issues, fixing the nation's broken system of care for millions of Americans suffering from mental illness and drug addiction has risen to the top of Congress' agenda. Lawmakers are poised to pass a sweeping package of mental healthcare reforms during the lame-duck session next month, following enactment in July of legislation to address the epidemic of opioid addiction. They and advocacy groups are optimistic the Senate will follow the House in approving bipartisan legislation to revamp the government's mental healthcare efforts and increase funding for prevention and treatment. (Meyer, 10/8)

Just 55% of psychiatrists accepted private insurance as payment in 2010 (compared with 89% of doctors in other medical specialties) and the percentage had declined 17% since 2005, according to a 2014 study published in JAMA Psychiatry. Medicare and Medicaid acceptance rates among psychiatrists were also lower compared with the rates of other physicians. The same study found 55% of psychiatrists accepted Medicare reimbursement, compared with 86% of physicians in other specialties, while 43% accepted Medicaid, compared with 73% of other doctors. (Johnson, 10/8)

The state will adopt new policies it hopes will better protect patients at its mental hospitals against sexual assaults as part of a proposed settlement with a former patient who was abused on two separate occasions, including by another patient with HIV. After 20 months of negotiations with the victim's attorneys, the Department of Health and Mental Hygiene, which oversees the state's mental health facilities, agreed to develop a safety and protection plan, as well as conduct psychiatric evaluations for all patients. (McDaniels, 10/7)

Harris County Judge Rory Olsen is now accepting involuntary psychiatric commitment requests signed by doctors of osteopathic medicine, a reversal of his position that health care leaders complained aggravated the area's already limited access to mental health care. Olsen on Friday changed his policy to only grant the requests from medical doctors following Texas Attorney General Ken Paxton's decision to review whether osteopathic doctors have the legal authority to certify an individual is mentally ill, dangerous and in need of commitment. (Ackerman, 10/7)

Before the United States permitted a terrifying way of interrogating prisoners, government lawyers and intelligence officials assured themselves of one crucial outcome. They knew that the methods inflicted on terrorism suspects would be painful, shocking and far beyond what the country had ever accepted. But none of it, they concluded, would cause long lasting psychological harm. Fifteen years later, it is clear they were wrong. (Apuzzo, Fink and Risen, 10/09)

The internal watchdog of the U.S. Department of Health and Human Services says the often-substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources and difficulty attracting and keeping skilled staff. (10/7)

This fall, employees in Chicago and across the country might notice their employers touting so-called telemedicine — in which health care is delivered remotely via phone, video or other technologies — as they gear up for insurance open enrollment. Telemedicine often is offered in addition to or as part of traditional insurance benefits, and some telemedicine companies bypass employers entirely, offering it directly to consumers. So far, employees haven't warmed to the idea, either because they don't understand it, don't know it's available or because they're skeptical of getting a doctor's opinion via telephone. (Schencker, 10/7)

The underlying technology behind the digital currency Bitcoin is piquing interest in corners of Nashville's health care sector, thanks to its potential to upend the way data is shared. Blockchain, a distributed database that records transactions, can be tough for people to grasp, but with understanding often comes a sense of excitement about the possibilities, experts said. It's a way to securely transfer things of value — such as data or currency — without a middleman, said Corey Todaro, director of research and analytics at Martin Ventures. (Fletcher, 10/7)

The nation’s drug-addiction epidemic is driving a dramatic increase in the number of children entering foster care, forcing many states to take urgent steps to care for neglected children. Several states, such as New Hampshire and Vermont, have either changed laws to make it possible to pull children out of homes where parents are addicted, or have made room in the budget to hire more social workers to deal with the emerging crisis. Other states, such as Alaska, Kansas and Ohio, have issued emergency pleas for more people to become foster parents and take neglected children, many of them infants, into their homes. (Wiltz, 10/7)

The emergence of fake opiates that have been mixed with or sold as heroin, fueling a raging drugepidemic, has led to a proposed legislation in Kentucky to fight such synthetic drugs. Attorney General Andy Beshear, Kentucky House legislators and law enforcement officials Friday announced that the bill would add fentanyl analogues not approved for human use to the list of illegal drugs. It would, in addition, increase penalties for trafficking in such drugs. (DiMio, 10/7)

Nearly 100 national health and medical groups — including the American Heart Association, the American Diabetes Association and the Centers for Disease Control and Prevention — enjoy sponsorships by Coca-Cola Co. or PepsiCo, according to a new study by two Boston University researchers. The report lands as the sugar industry’s supersized role in shaping — and spinning — health policy has come under increasing scrutiny. It also comes as the negative health effects of sugar and sugary drinks, including a link to rising obesity rates, are better understood. (Lauerman, 10/10)

Diet and nutrition are now the biggest risk factors for people's health across the globe, even in poorer countries. That's according to a recent report published by the Global Panel on Agriculture and Food Systems Nutrition, an independent group of experts on nutrition and health. (Chatterjee, 10/8)

A large share of American men between the ages of 25 and 54 who aren’t in the labor force may suffer from serious health conditions that are “a barrier to work” and suffer physical pain, sadness, and stress in their daily lives, according to research being presented next week by Princeton University labor economist Alan Krueger...Polls show that Republican presidential candidate Donald Trump has strong support among lower-income men without a college education, who are among the most likely to be out of the labor force because of a job-related disability. (Coy, 10/7)

In what some are calling the “biorights” movement, patients are refusing to provide specimens unless they are compensated; are promised that useful medical information will be returned to them; or are granted some control over how their biological samples will be studied... Human DNA derived from biological samples is in especially high demand as drug companies, the government, and academic centers race to turn their genetic secrets into valuable medical treatments. One research firm predicts that biological samples like those DNAsimple collect will generate $23 billion in revenue by 2018. (Daley ahnd Cranley, 10/10)

Every year, more than 400 Americans die from unintentional carbon monoxide poisoning that's not linked to fire, according to the Centers for Disease Control and Prevention. More than 20,000 go to the emergency room and some 4,000 are hospitalized because of it. In 2014, 22 Floridians died due to unintentional carbon monoxide poisoning that was linked to generators, boats and cars, according to the latest data available from the state. More than 250 went to the emergency room and nearly 60 were hospitalized that year.Carbon monoxide is a byproduct of anything that burns gas. (Miller, 10/7)

When the birth control pill debuted more than 50 years ago, women wanted to know: Is it safe? There wasn't much evidence to answer that question, but women embraced the Pill as a revolutionary improvement in contraception. Today, millions of women around the world use hormonal contraceptives that have expanded beyond the Pill to patches, implants, injections and uterine devices. Decades of research support their safety, and serious but very rare side effects such as blood clots are finally much better understood. But other areas of research lag, and we still don't know as much as we'd like about how these medications affect women's mental health. (Haelle, 10/9)

Lined up against the likes of legalizing pot and abolishing the death penalty, Proposition 52 is probably the last measure that even the most earnest voters will get around to discussing at their neighborhood ballot parties. But supporters, ranging from Republicans to Democrats, hospitals and health care consumer groups, say the proposition that asks voters to lock in billions of dollars in hospital fees in order to take advantage of billions in federal matching funds is vital to California’s ability to pay for the health care of the state’s poorest residents. (Seipel, 10/8)

Gov. Terry Branstad has highlighted extra benefits under Iowa's new Medicaid program to show the privatized system functions better than the former state-run setup, but the agency overseeing Medicaid acknowledges it knows little about how the so-called value-added services are actually working for patients. That lack of detail hasn't stopped Branstad from using the perks — such as waived gym membership fees, prenatal services and free cellphones — to help sell in public remarks and press releases the pros of Medicaid under private management. (Rodriguez, 10/9)

The state Department of Health Services overreached in seeking to recoup Medicaid payments from dozens of independent private duty nurses who care for severely disabled patients in their homes, a Waukesha County judge has ruled. The health department exceeded its authority when it asked the nurses to return Medicaid payments because the nurses didn’t fully comply with various rules in documenting the care they provided, Circuit Court Judge Kathryn Foster decided Sept. 27. The cases don’t involve alleged fraud. (Wahlberg, 10/9)

When Gov. Doug Ducey sought to overhaul the state’s Medicaid program, he asked the federal government for a big stick. But federal health regulators last week stripped Arizona’s proposed Medicaid overhaul of some of its most muscular enforcement proposals. And the changes that the federal government will allow to stand require a degree of cooperation from low-income individuals who qualify for Medicaid coverage. (Alltucker, 10/7)

Gov. Mark Dayton has invited Allina hospital officials and Minnesota nurses to continue contract negotiations at his house Monday morning. Dayton and Lt. Gov. Tina Smith invited negotiators for Allina Health and the Minnesota Nurses Association to come by at 11 a.m. Monday, according to a news release. Nearly 5,000 nurses at five Allina hospitals in the Twin Cities have been on strike since Labor Day, hoping to persuade the company to maintain their health benefits and address safety concerns. (Belcamino, 10/9)

The most frequent health issues in Cincinnati among minorities are heart disease, diabetes, obesity, hypertension and HIV/AIDS. These groups often times do not seek proper health care for a number of reasons, including: Preventive care is a low priority; they are uninsured or underinsured; they have limited access to multicultural or quality medical professionals; they distrust the medical establishment; or they simply are unaware of the importance of a healthy lifestyle. By providing access to initial health screenings and long-term care, the First Ladies for Health initiative is working to prevent members of our community from falling victim to these disparities. (Dena Cranley and Barbara Lynch, 10/7)

The Center for Reproductive Rights late Friday filed its request for that amount in attorney’s fees and other expenses incurred in the lawsuit challenging House Bill 2, which required all Texas facilities performing abortions to meet hospital-like standards and forced doctors at those clinics to have admitting privileges at a hospital less than 30 miles away. In a lawsuit brought by the New York-based organization on behalf of Texas abortion providers, the Supreme Court overturned those provisions on a 5-3 vote. Because the abortion providers were the prevailing party in the federal lawsuit, the court has allowed the Center for Reproductive Rights and other attorneys who worked on the case to ask to recover costs for the lawsuit. (Ura, 10/8)

It was a sweltering day in Pomona in August 2015 when Katie Dix collapsed during a rave at the Los Angeles County Fairgrounds. She went into cardiac arrest and died at a nearby hospital. Dix’s family expected that an autopsy and lab tests would take a few weeks, but as months went by they grew frustrated and angry. Her relatives would call repeatedly, only to be told: “Next month.” “It was excruciating for her parents,” said Lee Sherman, the family’s attorney. “It is horrible enough to deal with your child’s death — the reports, the speculation. They just wanted answers.” (Winton and Sewell, 10/9)

A spike in the number of cases of a mysterious polio-like illness has led to a new alert from the Centers for Disease Control and Prevention. As of August, at least 50 people in 24 states were confirmed to have acute flaccid myelitis, a viral infection that attacks the body’s nervous system and has led to paralysis and death. The federal agency posted an update earlier this week. In July, the Texas Department of State Health Services issued a warning to health providers after seven incidents were reported by the end of June. (Rice, 10/8)

Planned Parenthood Mohawk Hudson, a separate Schenectady-based affiliate, has seen the demand in its Saratoga Springs Health Center since providing services for the transgender community over the last year and a half, said spokeswoman Emma Corbett. Transgender patients, including Stoffer, have been willing to travel many miles to the clinic due to a lack of trust in services elsewhere. The health center has provided services to 50 transgender individuals this year. (Hughes, 10/9)

There are very few pediatric immunotherapy clinical trials – a search of ClinicalTrials.Gov turns up 10 active clinical trials, including the one in Augusta. Part of it is the numbers game – there will be an estimated 10,380 cases of cancer this year in children 14 and younger vs. nearly 1.7 million in adults, according to the American Cancer Society. (Corwin, 10/9)

The year's first case of West Nile virus in Columbus was reported this morning in a 71-year-old man who has been hospitalized. No additional information about him was available. The Columbus case is the second in Franklin County. The county case was reported on Sept. 9 and was in a 54-year-old man, who has since recovered. (Rinehart, 10/7)

Cincinnati’s situation, while unusual, is not unique. Investigations by the VA's inspector general and the Government Accountability Office (GAO) have revealed difficulties in the VA's relationship with medical schools and teaching hospitals, which often have different goals than the VA. The problems between the VA and the medical schools are turning up in numerous ways. (Saker, 10/7)

A financial collapse is threatening the survival of the Parkinson's Association in San Diego, which has spent the past 27 years helping thousands of people cope with the life-altering disease. Its cash reserves depleted, the organization laid off its final four employees last week, culminating a downsizing effort that started last year. Today its executive director is working as a volunteer, and the nonprofit is struggling to pay its $5,000 monthly rent for an office devoid of workers. (Sisson, 10/6)

Hispanic women 40 and older in the United States had the lowest rate of getting a mammogram over the past two years, according to the American Cancer Society. In 2013, the most recent data available, the mammography rate was 62 percent for Hispanic women versus 67 percent for Asians, 66 percent for non-Hispanic blacks and whites and 63 percent for American Indians and Alaska Natives. Healthcare experts tackled this disparity at a University of Miami symposium, “Women´s Cancers in the Americas: Strategies for Synergy,” on Wednesday. (Hsieh, 10/7)

With all the controversy that seems to surround healthcare in the news these days, it's reassuring to know Medicare Part D is performing well both administratively and in patient service. Since its inception ten years ago, the program consistently runs under its projected budget, costing 45 percent less than Congressional Budget Office estimates. In addition, nine out of ten beneficiaries say they're satisfied with their coverage. (Sherry Williams, 10/9)

During a week when 179 lawmakers including one Democrat called on the CMS to “stop experimenting with Americans' health” with mandatory payment reforms, the CMS announced without fanfare or opposition that it will allow some of the nation's leading insurers selling Medicare Advantage plans to use value-based insurance design in as many as 10 states starting in 2018. OK, it's only a pilot. But VBID remains one of the most promising reforms to health insurance to come along in decades. Medicare beneficiaries in VBID-style plans will be paying lower co-pays and deductibles for high-value healthcare services. (Merrill Goozner, 10/8)

Permit us to interrupt the presidential candidates’ Twitter blasts with a serious request: Please devote some time ... to health, science, technology and related matters. Debates should explore new topics, not just rehash the attacks and talking points heard in every interview and stump speech. ... Medicine deserves some frank appraisals from both candidates. How will they provide leadership to handle disease outbreaks like Zika and help those suffering from mental illness or opiate addiction? Diseases kill far more people than terrorists do. Research into scientific areas deserves more federal funding. Who will make sure NASA, the Centers for Disease Control and Prevention and other agencies have adequate resources to keep America at the forefront of innovation? (10/8)

Given its name, you’d expect the federal 340B Drug Discount Program to save money for the American health system. When it comes to cancer, though, it’s actually a major driver increasing costs, according to a report from the Community Oncology Alliance. The program was created in 1992 to financially support so-called safety net hospitals that provide charity care to poor and underserved patients. ... But “creative uses” of 340B have contributed to increasing the cost of cancer care, boosted revenues for hospitals (which charge more for cancer care than community oncology practices), and expanded the use of hospital outpatient cancer services. (Debra Patt, 10/7)

The Affordable Care Act is a revolutionary piece of legislation that addressed a major need: expanding Americans’ ability to access the health care system. This imperfect and embattled law now covers 90 percent of citizens and brought about a reasonable change in the way medical providers do business so they would squarely focus on better health outcomes. In addition, ACA ended the practice of denying a patient insurance coverage because of a pre-existing condition and elevated the role of preventive care. ... However, uncertainty persists about the law due to repeated efforts to repeal it.The solution requires bipartisan cooperation to fix what is wrong with the law and grow its promise of making Americans healthier and reducing health care costs. (David Plazas, 10/9)

You probably have no idea what your surgery will cost — and good luck trying to find out. But once it exceeds the out-of-pocket limit on your insurance, you don’t care. You won’t walk over to Chevy for a cheaper price. The result is a fun-house mirror reflection of free market economics. People don’t understand what they’re buying, and insurance is paying most of the bill. So medical providers don’t really have to compete on quality or price.The things they do compete on — convenience, whiz-bang technology, heart-tugging TV ads — push prices up, not down. (Jim Gallagher, 10/9)

California’s ballot initiative process traditionally has been a laboratory for new methods of campaign deceit. Novel examples of hypocrisy, misrepresentation, deliberate errors of commission and omission all have been paraded past the voters, often lubricated by millions of dollars in corporate funding. That’s not the case with Proposition 56, a November ballot measure that would more than triple the state tax on cigarettes and levy excise taxes on e-cigarettes for the first time. (Michael Hiltzik, 10/7)

The state Commerce Department recently announced that consumers who buy health insurance on their own will face average rate increases of 50 to 67 percent for 2017. While just 5 percent of Minnesotans buy health insurance on their own instead of getting it through their jobs or public programs such as Medicare, some people simply won’t be able to afford health insurance. Financial aid to instantly discount monthly premiums is available through MNsure, but not everyone qualifies. The Star Tribune Editorial Board has called for a special session to provide immediate relief to people potentially priced out of this market. (10/7)

In August, a medical student at the Icahn School of Medicine at Mount Sinai in New York jumped out of an eighth-story window to her death. Stories like this are too common among budding doctors across the United States. In May, a medical student at the University of Southern California took his own life. At the University of California at San Diego, a third-year medical student killed himself last year. Two years ago, when I was a medical student at Harvard, a fellow student died of suicide. (Nathaniel Morris, 10/9)

In 44 states a jail or prison holds more mentally ill individuals than the largest state psychiatric hospital, reports the Treatment Advocacy Center. The total includes Nebraska. For example, in the Douglas County Jail about 20 percent of inmates, or about 290, would have a serious mental illness, based on national statistics, TAC said. (10/10)

You may have read or heard about the study debunking the five-second rule. It said that no matter how fast you pick up food that falls on the floor, you will pick up bacteria with it. Our continued focus on this threat has long baffled me. Why are we so worried about the floor? So many other things are more dangerous than that. (Aaron E. Carroll, 10/10)

A truly dedicated anti-garden fanatic could, of course, just call in the bulldozers. But this will make it more difficult, expensive and noticeable to do so. By itself, this is a mildly amusing instance of a political figure trying to reach into the future and prop up her own legacy. But it’s actually an example of a much bigger political phenomenon, one that matters a great deal for both our political system and our economy. (Megan McArdle, 10/7)