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It's sign-up season for the Affordable Care Act, but the Trump administration isn't making it easy — cutting the enrollment period in half, slashing advertising and dialing back on counselors who help consumers get through the process. Many people already faced fewer choices and higher premiums. But President Donald Trump's decision to cancel a subsidy to insurers that lowers consumer costs compounded the turmoil, pushing premiums even higher. (Alonso-Zaldivar, 10/30)

Obamacare is about to have its worst open-enrollment season ever — and that’s no accident. President Donald Trump and Republicans in Congress still aim to dismantle the 2010 law. Making it look bad helps their cause, even as they’ve failed repeatedly to repeal or replace Obamacare. The new theory for Republicans: If fewer people enroll in Obamacare, there will be less of a constituency to save it. (Demko, Pradhan and Cancryn, 10/29)

ObamaCare made it through nearly 10 months of repeal attempts with Republicans in full control of Washington. It now faces another crucial period starting Wednesday. It’s the first test of how the Trump administration will handle enrollment under the law it claims is “imploding.” With the president making no secret of his desire to kill the law completely, Democrats accuse the administration of "sabotage" and say the number of new enrollees is likely to drop as a result. (Sullivan, 10/29)

Starting next week, Americans will again be able to shop for health plans on the Affordable Care Act marketplaces. Open enrollment in most states runs from Nov. 1 through Dec. 15. But a lot of people don't know that because the Trump administration slashed the marketing budget for Affordable Care Act, also known as Obamacare. So states, municipalities, community groups, insurers and others are strengthening their outreach efforts. In Texas, some cities and local governments are doing their best to get the word out, but it will be hard to reach the more rural communities. (Lopez and Dembosky, 10/28)

Kaiser Health News: Money For Health Law Navigators Slashed — Except Where It’s Not
Despite all the efforts in Congress to repeal the health law this summer and fall, the Affordable Care Act is still the law of the land. People can start signing up for health insurance for 2018 starting Nov. 1. But the landscape for that law has changed a lot. Take navigators. Those are specially trained people who help consumers sign up for coverage. The federal government cut navigator funding by 41 percent. But that’s not an across-the-board cut. Some groups and states are dealing with far deeper cuts, while others will have dollars close to what they had last year. (Olgin, 10/30)

In open enrollment news from the states —

Open enrollment begins Nov. 1, the annual period when individual health insurance buyers can switch plans. Many will want to consider their options carefully -- and swiftly -- experts say. Instead of having until Jan. 31 to decide, consumers this year have six weeks ending Dec. 15, and actually less time than that. The online federal insurance exchange, where most Oregonians buy plans and receive financial help, will be shut down for 12 hours on five of those six Sundays. (Hunsberger, 10/29)

Yet the most consequential change could be the higher sticker price for health insurance policies: The average price in Michigan of an individual plan will jump a record 26.9% for 2018. That compares to an average 16.7% increase from 2016 to 2017, and 6.5% from 2015 to 2016. Roughly 300,000 Michiganders are expected to get enrolled in a plan during open enrollment, down from previous years and about 3% of the total population. (Reindl, 10/27)

When the Affordable Care Act open enrollment period for health insurance begins on Wednesday, many individuals who buy their own policies will suffer sticker shock because of a sharp increase in premiums. But the state’s large and small businesses are girding for higher premiums to cover their workers in 2018 too. (Radelat, 10/30)

On Nov. 1, the ACA’s annual open enrollment period will begin, just like every other year. But this time the Trump administration has made several changes to the program that make things a little different. The administration cut the advertising budget for the program, as well as the budget for “navigators” — people who help guide insurance shoppers through the enrollment process. (Shemkus, 10/27)

Consumers are struggling to separate fact from fiction as the open enrollment period approaches for health insurance plans sold on the Affordable Care Act's federal exchange, advocates and insurance companies say. The controversial health care law lives on, even as the Trump administration and Republicans in Congress look for ways to kill it. (Griffin, 10/30)

With the fifth year of open enrollment for Affordable Care Act coverage due to begin Nov. 1, Florida insurers and consumer advocates have six weeks to reach Scherr and others like her who may be more discouraged and confused than ever about the health law commonly known as Obamacare. There are challenges including rising premiums, a shorter window to sign up, and confusion over the status of Obamacare. (Chang, 10/27)

Kaiser Health News: Rural Areas — Already Short On Health Resources — Face Enrollment Hitches
Ms. Stella’s, a home-cooking restaurant in Milledgeville, Ga., serves roast beef, grilled pork chops, chicken wings and oxtails with 24 sides from which to choose. Last spring, owners Jeri and Lucious Trawick opened a second restaurant in Eatonton, about 20 miles away, and Jeri decided to leave her full-time job to help shepherd the expansion. But she needed to update the couple’s health insurance and went shopping on the Affordable Care Act’s online marketplace. Trawick, 43, who considers herself nearly as skilled with a computer as she is with a skillet, found the Obamacare website daunting. (Anderson, 10/27)

Kaiser Health News: Big Gains In Latino Coverage Poised To Slip During Chaotic Enrollment Season
Latinos, who just a year ago were highly sought customers for the Affordable Care Act’s marketplace plans may not get the same hard sell this year. The Trump administration’s laissez-faire approach toward the upcoming enrollment period for the health law’s insurance marketplaces could reverse advances made in the number of Latinos with coverage, fear navigators and community activists. (Andalo, 10/30)

Obamacare math is getting more complicated, but a way to save substantial money in 2018 is now apparent, especially for Ohioans who earn too much money to qualify for subsidies. Buy through an insurance broker or agent, or call the insurer directly. (Koff, 10/27)

The Trump administration on Friday proposed new health insurance regulations that could affect basic benefits required by the Affordable Care Act, but not for a couple of years. Loosening "Obamacare" benefit requirements was a major sticking point for congressional Republicans in thus-far fruitless efforts to repeal the law. The complex new plan from the administration would give states a potential path to easing some requirements. (Alonso-Zaldivar, 10/27)

The CMS proposed a rule late Friday aimed at giving states more flexibility in stabilizing the Affordable Care Act exchanges and in interpreting the law's essential health benefits as a way to lower the cost of individual and small group health plans. ... The CMS said the rule would give states greater flexibility in defining the ACA's minimum essential benefits to increase affordability of coverage. States would play a larger role in the certification of qualified health plans offered on the federal insurance exchange. And they would have more leeway in setting medical loss ratios for individual-market plans. (Meyer, Livington and Dickson, 10/27)

Five months after President Donald Trump nominated Stephen Parente to be an assistant secretary for Health and Human Services, the nation's largest health insurer quietly gave a $1.2 million gift to a tiny academic research center that Parente helped found and served as director over the past decade. Parente, who is still awaiting confirmation as HHS’ assistant secretary of planning and evaluation, for which he was nominated in April, would head an office that often assesses policies that affect the insurance industry. It is currently researching the impact of Obamacare on the insurance market. (Diamond, 10/30)

In other news from the administration —

He joined a Republican administration last month that's often accused of downplaying or disregarding science, but the new surgeon general says he's "nonpartisan" and will let science and data drive his approach to the opioid epidemic. "It's more important than ever to have that objective voice," physician Jerome Adams said in his first sit-down interview since taking office. "Everyone's got their own opinion (but) make no mistake, the science does matter."  (O'Donnell, 10/28)

Planned Parenthood sharply criticized President Trump on Saturday over his rumored nominee to be the next ambassador-at-large for global women’s issues at the State Department, saying her appointment would be like "putting an arsonist in charge of the fire department." Politico reported Friday night that Penny Young Nance was being considered for the post. Nance currently serves as the president and CEO of Concerned Women for America, a conservative women's group. (Bowden, 10/28)

The Trump administration announced Friday it is relaxing a federal privacy rule that prevents health providers from notifying family members about a drug overdose, one of the administration’s most significant policy shifts to combat the nation’s opioid crisis. The new rule will explicitly permit health-care providers to share information with family members, friends and legal representatives about a patient’s medical condition if the patient is in crisis or incapacitated, such as during an opioid overdose. (Hackman, 10/27)

Opioid addictions are hitting America’s workforce hard. President Donald Trump’s move to declare the crisis a national public health emergency offers some hope for relief: It means Labor Department dislocated-worker grants could be used to help provide jobs for people sidelined by the epidemic. But there’s an irony here. The president has proposed cutting that very grant program by nearly half in fiscal year 2018 -- shrinking the program to $117 million from $220.8 million. The spending bill reported out of the House Appropriations Committee would also reduce program funding, by slightly less. Congress has yet to agree on a 2018 spending package, so it remains to be seen whether a cut comes to fruition. (Smialek, 10/27)

President Donald Trump's formal declaration last week that the opioid epidemic is a public health emergency was light on details for the path forward. Nonetheless, the healthcare industry anticipates Trump's special commission will shed more light with its final set of policy recommendations, including ideas for improved coordination between federal agencies.The Commission on Combating Drug Addiction and the Opioid Crisis is slated to release its final report Nov. 1, roughly seven months after the panel was formed to identify effective solutions to the opioid abuse epidemic. (Johnson, 10/28)

New Jersey Gov. Chris Christie (R) said in a Sunday interview that he expects President Trump to first ask for “billions” of dollars to fight the opioid epidemic. “I think it’s going to be the subject of negotiation with Congress,” Christie told ABC’s “This Week.” The comment from Christie, who heads Trump’s opioid commission, comes after the president on Thursday declared the opioid crisis a public health emergency. (Shelbourne, 10/29)

Parents of children who overdosed on opioids have waited patiently for President Trump to declare the epidemic a "national emergency," as he twice promised he would. On Thursday, some were disappointed. To some survivors, the declaration instead of a public health emergency is too little, too late. (O'Donnell and DeMio, 10/26)

Advocates and doctors in opioid-ravaged Kentucky urged President Donald Trump's acting chief health official to spend more money on fighting the drug epidemic one day after he signed an order declaring the crisis a national public health emergency. Acting Health and Human Services Secretary Eric Hargan toured a clinic in Lexington, Kentucky, on Friday that specializes in treating pregnant women and their babies addicted to opioid-based drugs like heroin and prescription painkillers. (10/27)

Rachel Martin talks to Louisiana State Health Secretary Dr. Rebekah Gee, who was one of the people who met with the president before he declared a public health emergency. (Martin, 10/27)

While declaring the opioid crisis a national public health emergency Thursday, President Donald Trump said: "Nobody has seen anything like what's going on now." He was right, and he was wrong. Yes, this is the most widespread and deadly drug crisis in the nation's history. But there has been a long string of other such epidemics, each sharing chilling similarities with today's unfolding tragedy. (10/28)

As other college students head out to party on a Saturday night, Julie Linneman, a sophomore at Villanova University, rides the subway to a small rowhouse in West Philadelphia to meet with “her people,” a posse of students who understand what it’s like to be taken down by opioids. Ms. Linneman is a bespectacled 22-year-old who favors shredded jeans. She is a fan of cooking shows, fantasy fiction and Paul McCartney. She spent her first attempt at sophomore year — the one at Northern Kentucky University — in her dorm room, high on heroin. (Spencer, 10/30)

The billionaire founder and top executive of a drug company that manufactures a prescription opioid has been arrested and charged with bribing doctors to overprescribe the drug, CNN reports. John Kapoor, 74, of Insys Therapeutics, was arrested Thursday in Arizona. Authorities say his company had been giving illegal kickbacks to doctors to encourage prescriptions of the powerful painkiller Subsys, which is typically only used for end-stage cancer patients. (Delk, 10/27)

It’s a video that might elicit a lingering sense of dread and, perhaps, déjà vu. A sheriff’s deputy approaches a dark blue Nissan with its door ajar in a darkened convenience store parking lot. A man and a woman are passed out in the front seats, their bodies gaunt and motionless. In the back, a baby girl, 8 months old, is asleep, strapped in a car seat. (Ugwu, 10/26)

Erika Hurt had become the face of drug addiction. The young mother was captured in a photograph by police, passed out in the driver's seat of her car outside a Dollar General store in Hope, Ind. — an empty syringe still resting between the 25-year-old addict's fingers. The snapshot captured yet another horrifying moment in the worsening U.S. opioid epidemic. What was not seen that Saturday afternoon last October was her 10-month-old son, buckled into his car seat in the back. (Bever, 10/27)

As deaths from opioid overdoses rise around the country, the city of Baltimore feels the weight of the epidemic. "I see the impact every single day," says Leana Wen, the city health commissioner. "We have two people in our city dying from overdose every day." As part of Baltimore's strategy to tackle the problem, Wen issued a blanket prescription for the opioid overdose drug naloxone, which often comes in a nasal spray, to all city residents in 2015. (Aubrey, 10/27)

Like most puppies, Zoey is energetic and insatiably curious. When she’s outside, the 3-month-old yellow Labrador keeps her nose pointed to the ground, sniffing things, tackling flowers and chewing on random objects without hesitation. Such was the case on a recent morning, when owner Peter Thibault took Zoey out for a walk on their wooded neighborhood street in Andover, Mass. At some point, he noticed Zoey had lunged toward an empty cigarette box that had been discarded near a tree — and then put it in her mouth. He bent down to try to take the package away from her. (Wang, 10/28)

More than 3,200 suspected opioid overdoses have been reported to state officials since June 15, with more than 400 of those deaths, the Arizona Department of Health Services said. The updated data, released in an Oct. 17 blog post by ADHS Director Cara Christ, highlights a growing problem in Arizona and nationally. (McCrory, 10/27)

The number of overdose deaths involving opioids has quadrupled since 1999, federal health data show. Last year in Minnesota, the number of drug overdose deaths was nearly six times higher than it was in 2000. As a result, many children have been orphaned, sent to live in foster homes or with relatives. (Shah, 10/29)

Addiction doctors say that the Cincinnati region does not have enough treatment facilities for everyone who needs the help. Many who want treatment do not know how to get what is available, and many who are addicted do not have the means, including transportation or a phone, to find treatment. (DeMio, 10/29)

Cuyahoga County officials on Friday filed a lawsuit accusing several major prescription drug companies of intentionally misleading the public about the dangers of opioids to sell more painkillers as they raked in "blockbuster profits." The 269-page complaint, filed in Cuyahoga County Common Pleas Court, claims drug manufacturers, distributors and four influential doctors unjustly enriched themselves as they acted as a criminal enterprise and conspired to break numerous state laws meant to protect consumers. (Shaffer, 10/27)

Earlier this month, the toy-giant Mattel announced it had pulled the plug on plans to sell an interactive gadget for children. The device, called Aristotle, looked similar to a baby monitor with a camera. Critics called it creepy. Powered by artificial intelligence, Aristotle could get to know your child — at least that was how the device was being pitched. (Doucleff and Aubrey, 10/30)

Underweight women are at increased risk for early menopause, a new study has found. This study, in Human Reproduction, followed 78,759 premenopausal women ages 25 to 42 beginning in 1989. Over the following 22 years, 2,804 of them reported natural menopause before age 45. (Bakalar, 10/26)

Barbara Campbell has twice had shingles. Each time, one side of her body was covered in “thousands of these horrid blisters.” She could only wear the lightest silk blouse. Anything else touching her skin hurt too much. “I’m in terror of having it happen again,” said Campbell, 79, of Fort Lauderdale, Fla., describing the painful rash that will affect almost 1 out of 3 people in their lifetime. Because of allergies, she couldn't get the Zostavax vaccine, which is made with live, albeit weakened virus. (Sun, 10/28)

Nonalcoholic fatty liver disease and its more aggressive form, nonalcoholic steatohepatitis, have become the fastest-growing reasons for liver transplants in young Americans, according to a recent study. Typically, older adults experience the slow progression of fatty liver disease that is not related to alcohol but can lead ultimately to liver cirrhosis. As a result of increasing childhood obesity, hypertension and diabetes, however, more young adults are reaching end-stage liver disease early in life, researchers say. (Crist, 10/29)

A new survey conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health asked members of different ethnic and racial groups about their experiences with discrimination. Ninety-two percent of African-American respondents said they felt discrimination against African-Americans exists in the United States today, and at least half said they have experienced it themselves at work or when interacting with police. (Martin, 10/28)

Like Fuller, physicians across the country are viewing firearms violence as a public-health threat and asking patients about guns as they would any other safety issue, said Dr. Michael Munger, president of the American Academy of Family Physicians. These conversations aren’t new, but Munger said the topic is being brought to the forefront by mass shootings. (Viviano, 10/29)

Certain birth defects of the face and heart can occur when babies’ mothers have a fever during the first trimester of pregnancy, a crucial time in an embryo’s development. Now scientists have figured out the molecular players that make it so. In an experiment with chicken embryos, a temporary rise in incubation temperature — meant to mimic feverlike conditions — was enough to produce defects to the face and heart. Such an elevation in temperature, called hyperthermia, affects the activity of heat-sensitive channels in cells necessary for an embryo’s development, researchers report online in the journal Science Signaling. (Cunningham, 10/28)

Jessica Allen was already the mother of two boys when she decided to become a surrogate. The pay she would receive to carry another woman’s child to term — $30,000 — would allow Allen to become a stay-at-home mom, as well as save for a new house. It would also be her “chance to give a family the blessing of a child,” her partner, Wardell Jasper, told her, according to the New York Post, which first reported the story. (Wang, 10/28)

It has been nearly seven years since Sarah Hughes had pre­eclampsia, but she still remembers the anguish of missing her newborn’s first three days of life when this pregnancy complication sent her back to the hospital with dangerously high blood pressure. Hughes said she could tolerate the gasping for breath and intense headache as well as the painful, intravenous magnesium sulfate she received to reduce the chances of a seizure, but she could not stand being away from her new child, who was at home being cared for by relatives. (Neumann, 10/28)

There are two medications that prevent preterm birth, the most common cause of perinatal death in the United States. One costs 16 cents a week, one $285 a week. Poor black women aren’t getting either. Why? In 2015, for the first time in eight years, the rate of preterm birth in the United States rose, despite increased understanding of preventive measures. Preterm births cost Americans an estimated $26 billion per year. (Abbott, 10/29)

In other news —

The woman stumbled into a public hospital late one night, her stomach turning as she approached the lobby. She was bleeding. Dr. Damian Levy ushered her into a room. Like many of his patients at Hospital Alvarez in Buenos Aires, she was young and poor. At first, she refused to tell him why she was there.Then she burst into a tearful confession. She had tried to perform her own abortion at home and used 40 tablets of the drug misoprostol — nearly three times the suggested dosage for inducing a miscarriage. She was worried that the hospital would report her to police. (Parvini, 10/29)

In the days and weeks before Providence Hospital closed its maternity ward, Caitlin Givens, a midwife, explained to pregnant patients what they needed to do to continue their prenatal care. She talked to them about scheduling appointments with a different provider, how many visits they would need before their delivery. She reminded them they needed their blood pressure checked regularly. (Itkowitz, 10/28)

Florida Gov. Rick Scott's push to force nursing homes to add generators in the aftermath of Hurricane Irma could be blocked after a judge ruled there was no pressing danger that justifies the order. Scott called for the rules after residents at the Rehabilitation Center at Hollywood Hills died in the days after Irma wiped out power to much of South Florida. (Fineout, 10/27)

The new rules were issued in September, days after the death of eight patients from a Broward County nursing home that lost central air conditioning when Hurricane Irma hammered the state. Under direction from Gov. Rick Scott, two state agencies demanded nursing homes and assisted-living facilities quickly add generators and fuel to maintain safe temperatures for at least four days during a power outage. The industry balked, with three groups representing elder-care facilities mounting legal challenges focused in part on what they argued was an impossible schedule. (Kamp, 10/27)

Meanwhile, outlets report on nursing home news out of Texas and D.C. —

Murky water started seeping into a Port Arthur, Texas, nursing home four days after administrators decided to shelter in place. Volunteers — one even brandishing a gun — demanded relocation of the elderly residents, at least two of whom died in the days after police ultimately ordered the evacuation. The deaths of elderly residents at Lake Arthur Place and other Texas and Florida facilities after hurricanes made landfall in August and September have heightened scrutiny of the evacuation procedures at nursing homes and assisted living facilities. (Lauer and Spencer, 10/29)

The cries began shortly before 5 a.m., echoing down the almost empty corridors of United Medical Center’s nursing home. From his bed in Room 704, Warren Webb’s moans cohered into words: “Help! I can’t breathe!” A registered nurse appeared and adjusted the height of his bed. But the nurse quickly began arguing with Webb’s wheelchair-bound roommate, who was pleading for her to do more to help. Webb rolled out of bed and landed on the floor, his diaper coming loose. (Jamison, 10/29)

When Caitlin Comfort decided to go to medical school, the Yale grad had her heart set on staying on the East Coast. But her wallet had different ideas. Facing $90,000 per year price tags for tuition, she said no thanks, and started applying to schools back home in Texas. That’s exactly what state legislators and educators want. In Texas, a decades-old law caps tuition at public medical colleges in a bid to bridge a doctor shortage by a) getting students like Comfort to come back, or, b) getting students like her partner, Justin Cardenas, to stay in Texas to get their degree. Right now, tuition is about $6,550 per year for in-state students. (Satyanarayana, 10/30)

Jack Greene’s lawyers say he’s severely mentally ill. The Arkansas death row inmate says they’re lying. As Greene approaches a Nov. 9 execution date, his lawyers are raising questions about who should determine his mental competency. Arkansas gives considerable weight to its prison director’s opinion in deciding whether a condemned inmate has the mental capacity to understand his execution; Greene’s lawyers want doctors to have a greater say. (Kissel, 10/29)

Amid a heat wave that could make West Nile virus more likely to spread, the number of people infected with the disease in Los Angeles County continued to climb this week. At least 230 people in L.A. County have fallen sick with West Nile this year, and 17 of them have died, health officials said Friday. The number of people infected is already the third-highest ever in the county, according to health officials — and the season has yet to end. (Karlamangla, 10/27)

A Dallas woman on Thursday was the last of seven people sentenced in a large-scale health care fraud scheme. Cynthia Stiger, 52, was sentenced to 10 years in federal prison and ordered to pay $23.6 million in restitution to Medicare and Medicaid. Stiger was convicted in April 2016 of one count of conspiracy to commit health care fraud. She was one of several people involved in the record $373 million home health care fraud scheme orchestrated by Dr. Jacques Roy, a former Rockwall physician. (Martin, 10/28)

For immigrants in the country illegally, the fear of running into U.S. Immigration and Customs Enforcement (ICE) agents has made some public places appear threatening. In the current environment, that can include a visit to the emergency room. (Dooling, 10/30)

Tenet Healthcare will cut about 1,300 jobs as part of an initiative to save $150 million on annual operating expenses. The Dallas-based hospital operator also expects to report a net loss from continuing operations of approximately $366 million in third quarter. Tenet announced its preliminary financial results for the three months ending Sept. 30 early Friday. The current executive chairman and CEO, Ronald Rittenmeyer, said the changes will help to “drive organic growth, expand margins, and better support our hospitals and other facilities in delivering higher levels of quality and patient satisfaction." (Rice, 10/28)

More than 900 Texas Children's Health Plan members' personal and medical information may have been compromised in a security breach late last year. Affected members of the insurance plan, which consists of Medicaid and Children's Health Insurance Program patients, were notified by mail on Friday. Last month, a review of the insurance plan revealed that a former employee had emailed batches of member information from her office to a personal email account in November and December against company policy. (Deam, 10/27)

The state is starting to see gains from the requirement beginning last year that all children be tested for lead poisoning at the ages of one and two. The Maryland Department of the Environment reported last week that the number of 1- and 2-year-olds tested for lead in 2016 was 12.2 percent higher than the average for the previous six years. The largest increases were in Howard, Frederick and Carroll counties, where testing rates increased by more than half. (McDaniels, 10/27)

Pre-nursing students enrolled at Arapahoe Community College who live in rural towns like Elizabeth and Franktown no longer have to commute to Littleton to knock out their prerequisite science classes. The community college’s Parker campus at 15653 Brookstone Drive recently added two science laboratories for microbiology and physiology — two course areas required in a medical track progression. The additions were part of a more than $1 million renovation of the extension campus that wrapped up this year. (Mitchell, 10/27)

The Chicago group UMedics trains people how to handle medical emergencies, including gunshot wounds. One trainee is a gunshot victim who credits the program with saving his life. (Hefferman, 10/27)

A Chicago-area chiropractor was found guilty on 18 counts of health care fraud in connection with about $10 million in false insurance claims made over nearly a decade, according to an indictment released by the FBI. Enrique “Henry” Posada, 55, owner of Associated Back Care and Rehabilitation at 4354 W. 63rd St. in West Lawn, and who was a licensed chiropractor from 1996 until July of this year, was found guilty at the conclusion of a jury trial Friday. The charges, initially announced in March by Joel R. Levin, acting U.S. Attorney for the Northern District of Illinois, were that Posada presented false inventories to insurance companies — including, but not limited to Medicare — for services that never were provided, the indictment states. (Rosenberg-Douglas, 10/28)

Given the scale of the opioid epidemic, the nation should be mobilizing. More people are dying than at the peak of the HIV/AIDS scourge. In some places, overdose deaths are exceeding homicides, suicides and traffic deaths combined. President Trump offered useful actions and ideas at a White House ceremony Thursday, such as measures to prevent addiction with “really great advertising,” create nonaddictive painkillers and bolster law enforcement against illegal imports of the synthetic opioid fentanyl. But Mr. Trump’s announcements, including the designation of a public-health emergency, are not enough. (10/28)

President Trump’s long-anticipated announcement addressing the epidemic of opioid addiction was — ah, how to put this diplomatically — more talk than walk. It was good to hear Trump frame the problem as a public health emergency, not a criminal justice one — a departure from the bad old “war on drugs” days. But there just wasn’t much to his announcement other than vague commitments, troubling insinuations and missed opportunities. (10/28)

You’d think it would be impossible to kill 100 people a day, every day, without inducing widespread shock and deafening demands for action. But that’s what opioids have been doing for the past decade, and Americans have given it only passing attention. This year, the toll is expected to rise to 175 a day — 64,000 in all. (Steve Chapman, 10/27)

President Donald Trump promised to come out swinging with Thursday’s emergency declaration on opioid abuse. Swing, he did, but he failed to make contact. By labeling the crisis a public health emergency, Trump skirted a legal definition that would have prompted emergency federal funding and placed the drug epidemic on a scale similar to major disaster response. He should have pledged a dollar amount equal to the challenge of combating an addiction epidemic that, by his own assessment, contributed to at least 64,000 U.S. overdose deaths last year. (10/28)

President Donald Trump on Thursday declared the opioid crisis a nationwide public health emergency. Like many Trump proposals, the details are unclear. Administration officials have noted that the declaration, which lasts for 90 days and can be renewed, comes with no dedicated dollars. But they said it will allow them to use existing money to better fight the crisis. Officials also said they would urge Congress, during end-of-the year budget negotiations, to add new cash to a public health emergency fund that Congress hasn’t replenished for years. (Joel Kurtinitis, 10/27)

Last October, fentanyl killed my brother Mike at age 47. As the CDC reported this summer, Mike was one of 20,100 Americans to die from the drug last year. We now recognize addiction as a disease — and a major national health crisis. (Joseph Walsh, 10/27)

Last month, as Republican leaders were preoccupied with another unsuccessful attempt to replace Obamacare, a senior Trump administration official issued a warning about a different major medical program, Medicare. The official, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, wrote in The Wall Street Journal that Medicare was facing a fiscal crisis. She announced that she was asking the agency’s innovation center for ideas to address it, and that part of the answer was to give consumers “incentives to be cost-conscious.” This has some Democrats worried that she’s trying to move Medicare toward something called premium support, which would be a huge change for consumers. (Austin Frakt, 10/30)

One of the major problems facing our country is the high cost of Medicare and Medicaid — and healthcare in general. The hope of everyone is to live a long healthy life, but why should it cost two to three times as much in our country than in any other wealthy nation? (Sheldon B. Lubar and Timothy L. Smunt, 10/27)

Former Gov. Terry Branstad was an avid Donald Trump supporter leading up to the 2016 presidential election. Gov. Kim Reynolds was glued to his side with an approving smile. Voters in this state ultimately helped send Trump to the White House. What did this political support earn Iowans? Nothing, when it came to helping Iowa shore up its individual health insurance market. Perhaps worse than nothing. (10/27)

On Thursday President Donald Trump declared war on the opiate crisis. That same day congressional Republicans effectively raised the white flag in that war by advancing Trump’s budget. To quote the Wizard of Oz, “Pay no attention to that man behind the curtain.” The budget would decimate funding for Medicaid. According to nonpartisan analysis, cuts are more than $1 trillion for Medicaid over a decade’s time and $473 billion for Medicare. They’re almost certainly worse, as additional “savings” from safety net programs is undefined. (Brendan Williams, 10/30)

There's no doubt that both sides on the Issue 2 drug-pricing ballot issue in Ohio hope voter doubts created by their conflicting claims and accusations will bring them victory. But let's cut through the clutter: As much as Issue 2 might feel good, it's unworkable. (10/28)

Before Ohioans vote on Issue 2, the ballot initiative that would create price controls in Ohio for prescription drugs, a quick backward glance through history is instructive. Richard Nixon imposed a price and wage freeze in August 1971. A political win in the short run, Nixon's scheme was ultimately a colossal failure, ushering in some of the worst inflation in 20th-century American history. (Grover Norquist, 10/29)

Few in Ohio are unaware of Issue 2, thanks to the avalanche of ads. From listening, you could be either scared of rising drug prices or fighting mad at the greedy drug companies. But most are just confused and totally uncertain as to how to vote! And the real underlying questions are not addressed at all. (J.B. Silvers, 10/29)

This month, 41 Democrats introduced a bill with a simple mission: It would undo the Trump administration’s recent change to the Affordable Care Act that paves the way for virtually any employer to deny its employees access to contraception without a co-payment. Before President Trump’s new guidance, the law required nearly all employers to offer workers health insurance plans that include contraception without cost. But the new rules, effective immediately after the announcement, allow any employer to request that the government let it opt out based on religious or moral objections. (Bryce Covert, 10/29)

Junk-bond buyers appear to have a blind spot when it comes to for-profit health care companies. They've snapped up bonds of Tenet Healthcare Corp. and Community Health Systems Inc. despite the drastically souring outlook for both hospital operators. Some of this may be idiosyncratic or the result of specific investors' strategies (or unwillingness to sell). Franklin Resources Inc., for example, now owns nearly 20 percent of Community Health's total debt and more than half of its $1.9 billion of bonds maturing in 2019, according to recent filings compiled by Bloomberg. (Lisa Abramowicz and Max Nisen, 10/27)

During recent years, the reported quality scores for [University of Louisville] Hospital and the James Graham Brown Cancer Center have not been where we want them. Now we own our results and we are changing. One of the most visible actions we have taken is the hiring of over 100 registered nurses in our first 60 days of operations. This brings more caregivers directly to the bedside to ensure our patients receive the best care possible. Additionally, we have made significant strides on other indicators such as a decrease in our mortality index and a reduction in the average length of stay. (Ken Marshall, 10/29)

Cook County’s short-lived penny-an-ounce sweetened beverage tax was a very bad idea. Just ask County Board President Toni Preckwinkle. Here’s an even worse idea: The Illinois General Assembly’s flirtation with a bill that would prohibit counties throughout the state from enacting such a tax. (10/27)