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Health insurance prices for next year under the Affordable Care Act are now available in about a dozen states, giving Americans their first look at the sharp increases many will pay for coverage if Congress does not extend subsidies that have made some plans more affordable. The annual enrollment period for Obamacare is expected to begin Nov. 1, but the costs for some Americans are becoming publicly available piecemeal through some state marketplaces. The federal website healthcare.gov, which includes 28 other state marketplaces, is slated to post prices before the end of October. (Abelson and Sanger-Katz, 10/17)

“Actually being able to write something that can be put in effect between now and Nov. 1? I don’t know how it gets done,” said Sen. Mike Rounds (R., S.D.). “There are fundamental differences between what Republicans want and what Democrats want on this issue.” (Wise, Mathews and Ferek, 10/19)

Republicans have attacked Democratic health care demands in shutdown debate as funding medical care for undocumented immigrants. The reality is more complicated. Immigrants living in the United States illegally are ineligible for federal health plans, including Medicaid and Medicare, as well as insurance sold through Affordable Care Act marketplaces. But federal money can indirectly help those immigrants by reimbursing hospitals that are required to provide emergency care to all patients and by supporting state Medicaid programs that use their own money to offer coverage to patients without legal status. (Ovalle, 10/20)

In related news —

A plan to give undocumented immigrants access to Maryland’s state health insurance marketplace next year has been put off until 2028 by state officials, citing recent federal policies affecting immigrants as well as overall uncertainty in health care markets. (Brown, 10/18)

More on the federal shutdown —

The White House feels as confident about the shutdown on day 19 as it was on day one– in part because congressional Republicans have, for the most part, remained largely in line. “There’s no discussions at all at the rank-and-file level, and what is there even for Republicans to be skittish about?” said a Senate GOP aide granted anonymity to discuss the dynamics between the White House and Congress. (Gangitano, 10/19)

Rep. Ro Khanna surprised Fox News host Shannon Bream on Sunday when he said he agrees with Republican Rep. Marjorie Taylor Greene (Ga.) on health care. The California Democrat’s remarks came as the ongoing government shutdown appears to be without end as Democrats and Republicans blame each other. In their discussion on the shutdown during “Fox News Sunday,” Bream pointed out that Democrats are demanding an extension of Covid-era subsidies through the Affordable Care Act. When asked why Democrats are holding the line over a policy that was “always supposed to sunset,” Khanna replied: “I agree with Marjorie Taylor Greene. The health care system is broken.” (Daniels, 10/19)

Unlike some mandatory spending programs like Social Security, which continues to pay beneficiaries during a shutdown, the WIC program is run using discretionary federal funds appropriated by Congress and allocated to state and tribal agencies by the USDA. WIC cost the federal government about $7.3 billion in fiscal year 2024, and Congress approved another $7.6 billion for fiscal year 2025, which ended Sept. 30. Without more federal financing, state governments, if they have money to spare, would have to decide whether to use state resources to finance the program in their areas and then request federal reimbursement when the government reopens. (Gore, 10/17)

A group representing the nation's osteopathic medical schools urged Congress to end the federal government shutdown before its deeper effects take hold. Outlining current and anticipated impacts from the first 2 weeks of the shutdown, officials with the American Association of Colleges of Osteopathic Medicine (AACOM) voiced support for two bills that address key challenges faced by its member institutions. ... The budget-driven shutdown leaves the nation's 44 osteopathic schools disproportionately exposed because of their mission focus and funding structure. More than half of schools are located in health professional shortage areas, and they depend heavily on federal programs for medical education, clinical training, and research funding. (McCreary, 10/17)

Linda Klonsky usually orders her prescription eye drops from a Canadian pharmacy that charges $250 for a three-month supply. But that came to an abrupt halt late this summer when it came time for her to reorder, as the Trump administration’s latest trade edict prompted dozens of international postal services to suspend shipments to the United States. With little choice, the 75-year-old turned to a CVS near her home in Silver Spring, Maryland, and bought 30 days’ worth of similar drops for $740 — nearly nine times what she usually pays. (Najmabadi, 10/18)

Janet McCaskill was on vacation in Arizona with her husband and best friend when she heard that President Donald Trump had suggested he might be able to bring the cost of popular weight-loss drugs down to $150 a month. “The thought of it going to $150 a month is dramatic,” said McCaskill, a grandmother from North Carolina who’s lost 100 pounds with the help of GLP-1 medicines, a class best known for the diabetes drug Ozempic. “That is most fantastic – if it comes to pass.” (Tirrell, 10/17)

President Donald Trump and his top officials have repeatedly promised to tap the billions of dollars collected from their historic tariff hikes for key priorities like troop pay, nutrition assistance and farmer bailouts. That’s not how it works. The administration has brought in about $200 billion in tariff revenue so far this year, cash the president and members of his Cabinet have boasted is a sign their tariff hikes are succeeding — and have suggested they can now use at their discretion. ... The reality, however, is that the White House has extremely limited power to direct those funds without congressional direction, since revenue generated by the federal government flows into the Treasury and Congress decides how that money gets doled out. (Desrochers and Scholtes, 10/19)

In his keynote address at the HLTH 2025 event in Las Vegas on Sunday evening, Cost Plus Drugs co-founder and entrepreneur Mark Cuban complimented TrumpRx, President Trump’s website for drug discounts. Cuban said he is a fan of the concept, which will help Americans purchase certain prescription drugs directly from participating manufacturers. (Perna and Kacik, 10/19)

How philanthropists are coping with the tariffs —

Health systems are embracing cryptocurrency, real estate and and stock gifts as donors who once wrote checks navigate economic volatility. Tariffs, inflation and the government shutdown have squeezed some philanthropists’ cash reserves, prompting nonprofit health systems’ foundations to get more creative in their funding requests. Many of those requests are seeking support for mental healthcare efforts, patient financial assistance funds, community health initiatives, workforce training, new technology, cancer care and cardiovascular programs, foundation directors said. (Kacik, 10/17)

In other news about the Trump administration —

The Trump administration is making Luigi Mangione “a pawn to further its political agenda” and uttering or posting statements about him that are prejudicing the accused killer’s prospects at a fair trial, his attorneys argued Friday in a new court filing that asked a federal judge to either dismiss the indictment or take the death penalty off the table. Federal prosecutors said President Donald Trump’s social media posts calling Mangione “a pure assassin,” and subsequent reposts by Justice Department officials, did not prejudice Mangione “because the statements were made by persons not associated with this matter.” The defense said the government can't make that claim because of Trump’s unprecedented intervention in Justice Department matters. (Katersky and Hemingway, 10/17)

The Trump administration’s decision to lay off most employees within the U.S. Department of Education’s special education office was described by the president this week as part of cuts to “Democrat programs that we were opposed to.” This was news to many conservative parents of disabled children, as well as disability policy experts. ... “Education for people with disabilities goes hand in hand with conservative ideals,” wrote disabled journalist Eric Garcia in a recent MSNBC column. “While that may seem counterintuitive, having people with disabilities integrated into larger society is a way to reduce the chance that they have to depend on the government.”. (Luterman, 10/17)

The study found that advanced cancer patients who received a Covid vaccine within 100 days before taking an immunotherapy drug during the pandemic lived longer than patients who did not, in a retrospective analysis. Researchers from MD Anderson Cancer Center presented the study at the European Society for Medical Oncology conference in Berlin on Sunday. The results are intriguing cancer immunologists and oncologists, who reacted with both excitement and caution.  (Chen, 10/19)

Over the last year, venture capitalist Noubar Afeyan has watched his signature creation, Moderna Therapeutics, go from perhaps the world’s most celebrated company, hailed for helping ease a once-in-a-century pandemic, to a target of government officials promoting falsehoods about mRNA technology. Those attacks, Afeyan warned Thursday, would not end with Moderna or mRNA vaccines. They are a canary in the coal mine for a larger assault on science and expertise, he said. (Mast, 10/20)

The Big Cities Health Coalition is the latest group to take a strong public stand in support of vaccination as a direct response to concerns that the federal government is limiting access and raising doubts. “We are united behind a simple message: get vaccinated,” the group wrote in a statement that was published Monday. It was signed by two dozen public health leaders from some of the nation’s largest cities, in both Democrat- and Republican-led states. (McPhillips, 10/19)

The Washington Post spoke to two infectious-disease experts about how they make their own decisions and how they talk about these issues with friends and family. Caitlin Rivers, an infectious-disease epidemiologist and senior scholar at the Johns Hopkins Center for Health Security, is a 35-year-old mother of an 11-year-old and 6-year-old twins. She also writes a weekly newsletter that tracks covid, influenza, RSV and food recalls. Andrew Pavia is a 69-year-old pediatrics infectious-disease physician at the University of Utah. (Sun, 10/19)

In a precursor to what we might expect in the coming flu season in the United States and across the Northern Hemisphere, a new study shows flu vaccine effectiveness to be around 50% for both clinic visits and hospital stays for influenza during the 2025 Southern Hemisphere flu season. (Wappes, 10/17)

During Courtney Gardner’s first visit to a travel clinic, she learned about all the diseases she could catch on an upcoming trip to India: typhoid, Japanese encephalitis, hepatitis A, chikungunya, cholera, malaria. The litany of health risks wasn’t the biggest surprise; it was the $2,751 bill for the consultation and immunizations. “It was sticker shock,” said Gardner, 56, who lives in Maryland. “I’m grateful for the service, and I get that there’s a cost, but it had never occurred to me that it would be so much.” (Sachs, 10/15)

Facing with an uncertain financial landscape for rural hospitals, the hospital board voted to hear competing presentations from Tampa General Hospital, AdventHealth and NorthStar. (Newhouse, 10/17)

A new report found that mobile health clinics can provide rural communities with access to healthcare in areas where healthcare facilities and healthcare workers may be scarce. (Carey, 10/18)

More health industry updates —

A five-day strike that affected hundreds of Kaiser Permanente clinics and hospitals in California and Hawaii came to an end after the union representing workers said it had “new momentum” to head back to the bargaining table, but no apparent agreement has been reached. (Hernandez, 10/19)

FutureCare, a company that operates rehabilitation and wellness centers across the region, has opened in Annapolis, the company’s 16th facility. (Rothstein, 10/17)

Mission Hospital administrators were aware, before the sale, that HCA Healthcare intended to cut hundreds of staff positions once it acquired Asheville’s flagship hospital, including deep reductions to the nursing staff that caused Mission’s then-president to have “significant concerns,” according to depositions filed recently in a long-running antitrust lawsuit against HCA. Jill Hoggard Green, a registered nurse who was Mission’s president and chief operating officer from 2011 until the sale of nonprofit Mission to HCA in February 2019, testified in a deposition earlier this year that she was “very, very concerned” when she learned that HCA was “working on building models related to reducing nursing.” (Lewis, 10/17)

Mission Hospital should again be put in immediate jeopardy, the worst sanction a hospital can face, the North Carolina Department of Health and Human Services has recommended. The finding, made by NCDHHS and reported to the U.S. Centers for Medicare & Medicaid Services (CMS), is a devastating blow to the largest healthcare provider in western North Carolina: For the second time in two years, and the third since for-profit HCA Healthcare bought the nonprofit Mission Health system in 2019, the hospital risks losing Medicare and Medicaid funding because of deficiencies in care so severe that state inspectors believe they pose imminent risk of serious injuries or death to patients. (Evans and Jones, 10/17)

A patient found dying on the floor of her room at Mission Hospital led to a previously unreported citation of “immediate jeopardy” in 2021, two years after Asheville’s flagship hospital was acquired by HCA Healthcare, court documents show. The 2021 sanction, for violating federal hospital safety regulations so severely that patients are in imminent danger of serious injury or death, was not disclosed by HCA. It was followed in 2024 by a second, widely publicized immediate jeopardy citation against HCA and Mission, for violations that contributed to the deaths of four patients.  (Lewis, 10/17)

On Medicare and Medicaid —

Mayo Clinic will be out of network next year for most UnitedHealthcare and Humana Medicare Advantage plans. Starting Jan. 1, Mayo facilities in Minnesota, Wisconsin and Iowa will not be in network for UnitedHealthcare members enrolled in Medicare Advantage individual plans and Dual Eligible Special Needs Plans. In-network coverage will continue for group Medicare Advantage plans, which offer employers flat monthly fees. (Kacik, 10/17)

Some health plans are finding new business opportunities customizing coverage for the sickest Americans. (Goldman, 10/20)

�鶹Ů�� Health News: Private Medicare, Medicaid Plans Exaggerate In-Network Mental Health Options, Watchdogs Say 
Companies running private Medicare and Medicaid insurance plans inaccurately list many mental health professionals as being available to treat the plans’ members, a new federal watchdog report says. The investigators allege that some insurers effectively set up “ghost networks” of psychologists, psychiatrists, and other mental health professionals who purportedly have agreed to treat patients covered by the publicly financed Medicare and Medicaid plans. In fact, many of those professionals do not have contracts with the plans, do not work at the locations listed, or are retired, the investigators said. (Leys, 10/20)

A type of mpox that causes severe illness has been identified in three California residents who had not traveled abroad, the first time the more virulent form has spread within the United States, health officials said on Friday. ... California health officials say the three patients — one in Long Beach and two in Los Angeles — were hospitalized and are now recovering at home in isolation. They have not found a link among the three cases. (Jacobs, 10/17)

A Pennsylvania high school student died from bacterial meningitis, according to the local school district. Ryan Duffy, 18, a senior at Neshaminy High School in Langhorne, contracted Streptococcus Pneumoniae Meningitis last week and was treated in the ICU before dying Tuesday, according to a letter sent to parents by the Neshaminy School District and obtained by ABC News. (Leath, 10/17)

On reproductive health —

A year after lawmakers spent the summer discussing possible solutions to Wyoming’s crippling shortage of maternity care services and came up dry, the interim Joint Labor and Health Committee is moving two proposals forward that they say will help. (Kudelska, 10/17)

Some states have rates comparable to El Salvador, Belize and Azerbaijan. (Fitzpatrick, 10/20)

On mental health care —

The Will County Board on Thursday approved a $10 million levy for the Community Mental Health Board, which grants funding for organizations that provide services for mental health treatment, substance use issues and for individuals with intellectual and developmental disabilities. (Mullins, 10/18)

Juliana Peralta, 13, kept slipping further from reality —from her parents, her friends, and anything she could actually touch —and into a virtual world where an artificial intelligence chatbot enveloped her with what she mistook for empathy. “You’re the only one I can truly talk to,” the Colorado girl messaged the chatbot in an app called Character.AI, according to a federal lawsuit filed in September by her family. (Barker, 10/17)

If you need help —

On substance use and addiction —

The last battle to legalize marijuana in the nation’s third-largest state triggered lawsuits, fingerpointing and a possible criminal investigation. Get ready for Round two. Trulieve, the state’s largest medical marijuana company, has already put up nearly $26 million to bankroll a recreational pot initiative for the 2026 ballot. But the new campaign is opposed again by Gov. Ron DeSantis, and now there are fresh allegations that his administration is improperly using its power to block the measure from going to voters. (Fineout, 10/19)

Lavender Timmons popped the trunk of her weather-beaten 2007 Ford Focus parked near the city’s homeless shelter. Regulars gathered around, including one drug user who in the past bought sterile syringes from the illicit market. Timmons, executive director of Evansville Recovery Alliance, wanted to offer them new needles to keep them from contracting HIV, hepatitis C or other infections. But a police car idled a couple blocks away. “The cops are watching us,” Timmons said. (Ovalle and Wallace, 10/19)

The president of a leading addiction medicine group issued stark warnings on hardline Trump administration policies on substance use, low rates of addiction treatment uptake, and a rise in problem gambling. (Facher, 10/20)

Food allergies in children dropped sharply in the years after new guidelines encouraged parents to introduce infants to peanuts, a study has found. For decades, as food allergy rates climbed, experts recommended that parents avoid exposing their infants to common allergens. But a landmark trial in 2015 found that feeding peanuts to babies could cut their chances of developing an allergy by over 80 percent. In 2017, the National Institute of Allergy and Infectious Diseases formally recommended the early-introduction approach and issued national guidelines. (Bajaj, 10/20)

On breast and prostate cancer —

AstraZeneca, Daiichi Sankyo and Gilead have made big advances in treating the hardest-to-tackle type of breast cancer, boosting prospects for tens of thousands of patients a year. The drugmakers are unveiling trial results for existing drugs in “triple negative” breast cancer — so-called because it is not one of the three main types. These include the first ever study showing a medicine can extend the life of patients who cannot be treated with immunotherapy drugs, the majority of triple negative cases. (Kuchler and Temple-West, 10/19)

Combining the two procedures allows for the removal of breast tissue and rebuilding the breast immediately, instead of doing two separate operations. (Mowdawalla, 10/13)

Men whose prostate cancer returns after surgery or radiation therapy may now benefit from a new drug combination shown in clinical trials to cut the risk of death by more than 40%. (Harley, 10/19)

More health and wellness news —

M.C.I. Foods Inc. has recalled over 90,000 pounds of its ready-to-eat breakfast burritos and wraps because of a potential listeria contamination in the products’ eggs. The Food Safety and Inspection Service (FSIS) announced the recall on Saturday after M.C.I. Foods notified the FSIS of a positive listeria contamination after conducting a routine test from its external suppliers. (Reilly, 10/19)

Entrepreneurs aim to remove microplastics from the body, but the cost can be steep and the clinical benefit remains uncertain. (Osaka and Gilbert, 10/18)

Endometriosis is a painful condition where tissue similar to the uterine lining grows outside the uterus in the pelvic region, most often on the ovaries, fallopian tubes or pelvic tissue. Despite its wide prevalence and potential to cause debilitating pelvic pain and infertility, researchers say the disease remains underdiagnosed and poorly understood. Now, emerging research is exploring a possible link between endometriosis and microplastic exposure, raising questions about how environmental contaminants might contribute to development of the condition. (Atwater, 10/20)

For much of the 20th century, the academic medicine ideal was clear: a physician-researcher supported by NIH grants, publishing in high-impact journals, climbing a predictable ladder of assistant to associate to full professor. Research was formal, structured, and often slow. Productivity was measured in citations, and prestige came from peer-reviewed work and institutional affiliation. But that model no longer holds uncontested sway. (Jonathan Avery, 10/17)

TikTok and YouTube have made stars of influencers who tout — often with the help of celebrities — the virtues of various lifestyles from veganism to juicing to subsisting on nothing but meat. Advocates of some of these trends even claim their diets have cured them of serious diseases. (F.D. Flam, 10/18)

Earlier this year, I was invited to discuss gestational surrogacy with dozens of the heads of women’s rights organizations looking to shape global policy. I was startled to discover I was the only participant on the Zoom call who had anything positive to say about surrogacy. (Arthur L. Caplan, 10/20)

The deadliest cancers in Illinois are those of the lung, colon/rectum and prostate. These three cancers account for over half of all cancer deaths across our Prairie State. The good news is that these cancers also all have preventative screening tests available that can find cancer before any symptoms arise and treat pre-cancers and cancers early, before they have a chance to spread. (Wenora Johnson, 10/20)

In 2021 and again in 2023, more than 200 scientific journals issued a rare joint call for health professionals to treat climate change and biodiversity loss as one indivisible global health emergency. This framing reflects a growing recognition that human wellbeing is inextricably linked to the wellbeing of other animals and the planet. (Neil Vora and Chris Walzer, 10/20)