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The next president could be dealing with an ObamaCare insurer meltdown in their very first month. The incoming administration will take office just as the latest ObamaCare enrollment tally comes in, delivering a potentially crucial verdict about the still-shaky healthcare marketplaces. (Ferris, 8/11)

At the start of 2015, Marilyn Tavenner held one of the most important jobs in health care: Implementing Obamacare, as the head of CMS. Six months later, she'd swapped it for a completely different major role: Lobbying to change Obamacare, as the head of America's Health Insurance Plans. It's an unusual career shift, and it's given Tavenner — a long-time government official turned top lobbyist — a rare perspective on the changes unfolding in the industry. (Diamond, 8/10)

The rallying cry to repeal Obamacare, a staple of Republican campaigns, is falling behind national security and the economy as the most prominent themes on the stump this year. Donald Trump typically makes a passing mention to repealing the Affordable Care Act, but he hasn’t dived into the details. He recently promised to replace the health law with “something.” (Haberkorn, 8/10)

Donald Trump has spawned a new industry, what might be called Trumpology — the study of his mental state and personality. Numerous pundits have suggested that the Republican presidential nominee has some kind of mental illness or medical condition that explains his boastfulness, intemperate outbursts and thin-skinned response to criticism. A recurring theme among these commentators is that Trump displays textbook signs of what psychiatrists call "narcissistic personality disorder." Not that Hillary Clinton has been spared the long-distance psychiatric evaluations. ... But psychiatric kibitzing is a slippery business. Largely lost in the conversation about Trump is the fact that a personality disorder is not a mental illness, strictly speaking. (Achenbach and Nutt, 8/10)

One of the lowest points of Donald Trump's campaign for the presidency has involved accusations that he mocked a reporter with a disability. “Now, the poor guy — you've got to see this guy," Trump said while jerking his arms in front of his body at a rally in South Carolina in November. ... [It] drew worldwide attention to a rare congenital joint condition known as arthrogryposis. Arthrogryposis typically affects development of the arms and legs and results in the joints being fixed in a bent or straightened position. ... A new study published in the BMJ on Tuesday suggests another intriguing possibility — that arthrogryposis may be yet another condition linked to Zika. (Cha, 8/10)

A federal judge said Wednesday that he would begin trial proceedings on Dec. 5 in the Justice Department’s antitrust challenge to the proposed merger of Aetna Inc. and Humana Inc. The start date is a compromise between the proposals of the two sides, but it also amounted to a setback for the insurance companies. When he opened a scheduling hearing Wednesday, U.S. District Judge John Bates said he was leaning toward an early November trial, which would have allowed him to decide the case before the end of the year. (Kendall, 8/10)

A federal judge is set to hear the looming antitrust challenge against Aetna and Humana's proposed $37 billion merger in December, with a decision coming in mid-January. According to media reports, U.S. District Judge John Bates scheduled the highly anticipated trial for a Dec. 5 start date during a status conference in the U.S. District Court for the District of Columbia on Wednesday. (Teichert, 8/10)

Health insurers Aetna Inc. and Humana Inc. will go to trial against the U.S. on Dec. 5 in defense of their planned $37 billion merger, pushing a judge’s decision on the tie-up beyond their deadline for completing the deal by year-end. The decision on the trial’s timing came Wednesday after the Justice Department tried to persuade U.S. District Judge John D. Bates in Washington to delay the start until January, after the companies’ self-imposed Dec. 31 merger deadline. (Harris and McLaughlin, 8/10)

The cost of getting your health insurance through work will go up an average of 5 percent next year, according to a new survey of large employers by the National Business Group on Health. The cost for employers will go up 6 percent. This is the third consecutive year that employers’ health costs have risen by 6 percent. While that’s still more six times the current rate of inflation, it’s likely a smaller increase than will be experienced by consumers who purchase insurance through the public exchanges. (Braverman, 8/10)

Men with testicular cancer, who are without insurance or on Medicaid (government insurance for low-income patients), tend to have more advanced disease upon diagnosis, larger tumors and a greater risk of dying, compared with those who have private insurance, according to researchers at the Dana-Farber Cancer Institute. While testicular cancer is curable for most patients, even when it has spread, delaying treatment can lead to more advanced, and potentially fatal, disease, researchers write. That's why removing barriers — to both medical care and financing treatment — should be "an important part of the war on cancer," says Christopher Sweeney, a medical oncologist at the Dana-Farber Cancer Institute in Boston and lead author of the study, published online this week in the journal Cancer. (Zimmerman, 8/9)

Piedmont on Tuesday announced the contract agreement with Blue Cross and Blue Shield of Georgia, the state’s largest insurer. It comes just weeks after Piedmont and UnitedHealthcare failed to reach a new contract. Piedmont hospitals and physicians have been “out of network” for tens of thousands of United members in Georgia since July 1. (Miller, 8/10)

A New Port Richey pharmacy is at the center of a federal indictment that accuses eight people of obtaining millions of dollars in fraudulent reimbursements from private insurance companies, Medicare and the Tricare military health care program...According to the indictment, unsealed Tuesday, the co-conspirators used A to Z Pharmacy Inc. in New Port Richey and several Miami-area pharmacies to submit false claims for prescription compounded medications. (8/10)

The Obama administration is planning to remove a major roadblock to marijuana research, officials said Wednesday, potentially spurring broad scientific study of a drug that is being used to treat dozens of diseases in states across the nation despite little rigorous evidence of its effectiveness. The new policy is expected to sharply increase the supply of marijuana available to researchers. (Saint Louis and Apuzzo, 8/10)

The government on Thursday will refuse again to allow the use of marijuana for medical purposes, reaffirming its conclusion that the drug's therapeutic value has not been proved scientifically, according to government officials, and defying a growing clamor to legalize it for the treatment of a variety of conditions. In an announcement scheduled to be in the Federal Register, the Drug Enforcement Administration will turn down requests to remove marijuana from "Schedule I," which classifies it as a drug with "no currently accepted medical use" in the United States and precludes doctors from prescribing it. (Bernstein, 8/10)

Hospitals across the United States are throwing away less-than-perfect organs and denying the sickest people lifesaving transplants out of fear that poor surgical outcomes will result in a federal crackdown. As a result, thousands of patients are losing the chance at lifesaving transplants, and the altruism of organ donation is being wasted. “It’s gut-wrenching and mind-boggling,” said Dr. Adel Bozorgzadeh, a transplant surgeon at UMass Memorial Medical Center in Worcester, Mass. (Ross, 8/11)

Puerto Rico is in the midst of one of the worst Zika outbreaks of any region in the northern hemisphere. The island has been reporting roughly 1,500 new cases of Zika each week. Hundreds of pregnant women are already infected, and public health officials say the outbreak in Puerto Rico probably won't start to subside until September or October. Yet health officials also say efforts to stop the spread of the virus are being hampered by mistrust, indifference and fatigue among residents, over what some view as just the latest tropical disease to hit the island. (Beaubien, 8/10)

Preparing for the possibility of local transmission, Public Health in Georgia has contracted with a private mosquito control company. The agency is also planning to release a 50-page response plan for health officials in districts around the state. And it’s prepared to set up a call center in case of an emergency.The most important message, Drenzek said, is to protect pregnant women, who should be “well aware where Zika transmission is ongoing.” (Miller, 8/10)

Northern Kentucky Public Health officials said Wednesday that privacy concerns prevented them from notifying the city of Alexandria about insecticide spraying around the home of a resident who picked up the Zika virus while traveling. “The spraying is done in such a concentrated area, a matter of blocks, around the affected person, that to identify the neighborhood would likely be a violation” of the federal patient privacy law, said Emily Gresham Wherle, spokeswoman for the public health department. (Mayhew and Saker, 8/10)

It’s been a little over a week since it was confirmed that the Zika virus has spread locally in Miami’s Wynwood neighborhood. In the heart of that neighborhood is The Wynwood Yard—an all-outdoor food and culture venue. Within hours of the Zika announcement, Della Heiman—founder of the Wynwood Yard and owner of Della Test Kitchen—temporarily closed the space. She decided not to charge rent to the six other businesses at the Yard for the week they’ve been closed. (Mack, 8/10)

A few months ago, when Dr. Thomas Lee logged in to his patients' electronic medical records to renew a prescription, something unexpected popped up. It was a notice that one of them had died. Lee, a primary care doctor at Brigham and Women's Hospital in Boston, was scheduled to see the patient in three days."I was horrified," he says. ... He wanted to know what had happened, but he couldn't find anything in the medical records or in a Web search. "I just felt really guilty that I had not pushed harder to get him in sooner," says Lee. When he couldn't find out anything, he decided to phone the man's house to offer condolences — maybe even to apologize. "So I called, and to my shock he answered," says Lee. (Bichell, 8/10)

The CMS has added five new measures that are being gradually factored into its nursing home star ratings intended to help consumers research and compare the quality of facilities...The calculations that determine nursing homes' quality ratings, which are posted on the CMS' website, Nursing Home Compare, will now include successful discharges, outpatient emergency department visits, nursing home admissions and improvement in function for short-term residents, or those who stay in nursing homes for up to 100 days. (Whitman, 8/10)

Kaiser Health News staff writer Anna Gorman reports: "Low-income Californians who are elderly and disabled were less likely to go to the emergency room or be hospitalized after their in-home caregivers participated in an intensive training program, according to a report. Under a pilot program, nearly 6,000 aides in Los Angeles, San Bernardino and Contra Costa counties were trained in CPR and first aid, as well infection control, medications, chronic diseases and other areas. All were workers of the In-Home Supportive Services program, who are paid by the state to care for low-income seniors and people with disabilities, many of them relatives." (Gorman, 8/11)

If keeping moms alive while pregnant and in the weeks just after birth is a good barometer of health care in a country, the U.S. looks pretty bad. A study published this month (Aug. 5, 2016) in Obstetrics and Gynecology says the maternal mortality rate rose 27 percent (26.6 percent) between 2000 and 2014 in the U.S. while 157 countries reported a decrease during the same period. Maternal mortality is still rare, but the increase is "a national embarrassment," said study author Eugene Declercq, a professor of community health sciences at the Boston University School of Public Health. "Our rates are comparable to Iran, the Ukraine and Russia, not countries we generally want to compare out health outcomes to." (Bebinger, 8/11)

When planning for a disaster on the scale of the Pulse Night Club shooting, researchers say it’s important to study what actually happens – and not what you think is going to happen. Conventional wisdom often doesn’t play out during a mass shooting.That these two survivors [Patience Carter and Akyra Murray] did the initial search for victims defies the conventional wisdom that police and paramedics do the search and rescue. (Aboraya, 8/10)

Matt Resnik has helped changed the face of autism in his hometown. When he was diagnosed as a child, his parents poured their hearts into getting him therapy, even launching an organization, in hopes he would outgrow his challenges and find his place as an independent adult in the world. Instead, they’ve helped shape the world around him. (Donvan, 8/10)

Tennessee lags most of the country in policies designed to fight and prevent cancer diagnoses and treatment, according to a new progress report. The state received red or yellow classifications — falling short or making progress, respectively — in 10 legislative categories from the American Cancer Society Cancer Action Network's "How Do You Measure Up" report. An estimated 37,650 people in Tennessee will be diagnosed with cancer in 2016, according to the organization. (Fletcher, 8/10)

The Florida Department of Health has confirmed a case of brain-eating amoeba. The potentially deadly infection was contracted by a swimmer who bathed in unsanitary water at a private residence in Broward County, ABC News 10 reports.The amoeba, whose scientific name is Naegleria fowlerii, can cause a rare and devastating infection of the brain, according to the Centers for Disease Control (CDC). (Gallagher, 8/11)

A revamped women's health program in Texas that ousted Planned Parenthood is giving a $1.6 million state contract to the nonprofit of an anti-abortion activist, who state officials said Wednesday submitted a "robust" proposal for helping low-income women in rural areas. The Heidi Group's Carol Everett has been a visible abortion opponent at the Texas Legislature. She supported two major anti-abortion restrictions the U.S. Supreme Court struck down in June, and last year, Republican lawmakers incensed by undercover video taken of Planned Parenthood operations and staffers invited her to discuss abortion clinics. (8/10)

A group led by an anti-abortion advocate appears to be one of the largest recipients of state funding from the “Healthy Texas Women” program, which lawmakers recently created to help women find health care services paid for by the state. The Heidi Group, a Round Rock-based center that has promoted alternatives to abortion to low-income women, is set to receive $1.6 million from the women’s health program, according to the comptroller’s office. That makes it the second-highest grant recipient on the current list, behind the Harris County public health department, which will receive $1.7 million. (Walters, 8/10)

After the Missouri Legislature passed a law in 2014 requiring women to wait 72 hours before terminating a pregnancy, a team of filmmakers started collecting their stories. They interviewed dozens of women over several months, many of whom had crossed the Mississippi River to go to a clinic in Illinois, where the rules governing abortions are more relaxed. (Bouscaren, 8/11)

The Texas economy, long driven by manufacturing and oil, is now being fueled by something much more stable — the booming health care industry, a Texas Workforce Commission official said Wednesday in Live Oak. (Hendricks, 8/10)

A needle exchange program currently confined to the city of Wilmington is going statewide. Legislation being signed into law Thursday by Gov. Jack Markell authorizes the statewide expansion of the needle exchange program, which is aimed at reducing the spread of HIV, hepatitis and other diseases. Lawmakers approved the bill earlier this summer on the final night of this year’s legislative session. (8/11)

Cuyahoga County would lose about $20 million a year under a federally mandated change to the way Medicaid managed care companies are taxed, county executive Armond Budish said. Ohio, though, is looking for a way around the sales tax losses, which would hit counties and transit authorities across the state -- and elsewhere across the country. The state has until the end of its next regular legislative session – June 30, 2017 – to alter its taxing structure for those managed care companies, said John Charlton, director of communications for the Ohio Office of Budget and Management. (Farkas, 8/10)

Hundreds of Minnesotans with mental health problems are languishing in hospital psychiatric units for weeks, even months, because they have nowhere to go for less intensive care, according to a comprehensive study to be released this week. As a result, private hospitals are absorbing millions of dollars in unreimbursed costs, while patients who are well enough to be released are being deprived more appropriate care at a fraction of the cost. (Serres, 8/10)

The six-decade-old Russell Home for Atypical Children, facing closure by the state two months ago, has worked out a deal that should allow all current residents to stay — thanks to an outpouring of support from local residents and political representatives...The complicated deal — hammered out after an anonymous complaint was filed last October — requires the nonprofit to split its property into two addresses, modify its already-in-progress $1.8 million construction project and buy a portable classroom for its day program. (Santich, 8/10)

Seven months after Pennsylvania officials settled an ACLU lawsuit over treatment delays for mentally ill people awaiting trial, the Philadelphia courts have moved a first handful of defendants from prison to medical care. Seven people in the custody of the Philadelphia prisons were ordered transferred Wednesday to one of three new mental health facilities in the city, according to Gregg Blender, a lawyer in the mental health unit of the Defender Association of Philadelphia. (Slobodzian, 8/11)

As part of National Health Center Week, Franklin Mayor Ken Moore invited health care workers and community leaders from across the region to Williamson County on Wednesday to brainstorm on how to make the state a healthier place to live. Although Moore, a retired surgeon, and other health care professionals addressed the group, the mayor said the primary focus of the meeting would be the round table discussions that would follow. (Buie, 8/10)

School district officials have created an advisory committee to address concerns about its health insurance plan and are now recruiting members from other town boards and unions to participate. The move follows repeated requests by the town’s teachers’ union, the New Fairfield Education Association, to switch to the state’s health insurance plan. The union says the state plan would save its members and the district money. (Rigg, 8/10)

Five dead birds and one sentinel chicken in separate communities tested positive for West Nile virus, the Contra Costa County Mosquito and Vector Control District reported Wednesday. The birds were found in Concord, Alamo, Orinda, Brentwood and Antioch. The chicken is from Holland Tract, near Knightsen. County officials currently do not plan to fog for mosquitoes. If they bite humans, infected mosquitoes can pass along the virus, which in some cases can be fatal. (Cameron, 8/10)

The Cleveland area leads the state in the number of deaths and serious health problems caused by air pollution, and ranks ninth worst in the country, according to a new report released today. The Health of the Air report, compiled by the American Thoracic Society and New York University's Marron Institute of Urban Management, found that air pollution causes as many as 9,320 deaths each year in metropolitan areas in the U.S. The number of air pollution-related deaths are comparable to the 9,967 alcohol-related traffic deaths that occurred in the U.S. in 2014. (McCarty, 8/10)

A proposal to lift the seven-year ban on diet sodas in Colorado’s high schools would feed a variety of health problems among the state’s school kids, including obesity and tooth decay, health advocates say. Several groups, including the Colorado PTA, have lined up against the idea, saying it would open school doors to bad health habits and soda companies offering corporate sponsorships to cash-starved school districts. (Whaley, 8/10)

Cindy Martinez, a former Marine, and husband David, a Gwinnett County police officer, say Northeast Georgia Physicians Group — Urgent Care and Dr. Minkailu Sesay missed signs of a serious infection and sepsis last summer. In the months that followed, the story captured widespread attention as the wife had numerous surgeries from the unexplained ailment and the community rallied around the family to lend support and funds. The Martinez family was unrelentingly positive throughout the ordeal, calling the wife’s survival a “miracle” due of praise to God. (Sharpe, 8/9)

Americans should be more worried than ever about Medicaid, which provides health insurance for America’s most vulnerable. The cost of the $500 billion program is expected to rise to $890 billion by 2024, according to the Centers for Medicare and Medicaid Services. Yet more spending doesn’t necessarily mean better care for beneficiaries, 57% of whom are low-income minorities. The expansion of Medicaid is one of the most misguided parts of ObamaCare—shamefully expanding second-class health care for the poor. (Scott W. Atlas, 8/10)

Near the end of my tenure as editor-in-chief of AJN, the American Journal of Nursing in 2009, I asked one of the coordinators of our pain column to write an article on opioid dependence and addiction. The diversion and misuse of drugs such as oxycodone, with a resultant spike in overdose deaths, had been widely reported in the news media. Her surprising response continues to resonate for me as we face the urgent public health problem of opioid abuse. (Diana Mason, 8/9)

The “prescribing” of marijuana, however, remains illegal under federal law, where it is classified as a Schedule I substance under the Controlled Substances Act of 1970, meaning that the federal government considers marijuana a substance with a high potential for dependency or addiction, with no accepted medical use in treatment. Therefore, under federal law, marijuana cannot be knowingly or intentionally distributed, dispensed, or possessed, and an individual who aids and abets another in violating federal law or engages in a conspiracy to purchase, cultivate, or possess marijuana may be punished to the same extent as the individual who commits the crime. (Jumayun J. Chaudhry, Arthur S. Hengerer, and Gregory B. Snyder, 8/9)

More than 100 state and national medical societies are trying to water down the Physician Payments Sunshine Act, a law that protects doctors and their patients from undue influence by pharmaceutical and medical device companies. They’re welcome to do that. But they can’t rewrite history in the process. ... As the person who wrote the first draft of the Sunshine Act, and then worked for years to get it passed, I’d like to notify American doctors: “Your professional societies are misleading you.” In fact, our concern about corporate bias and poor quality in medical education and scientific publishing was one thing that led us to promote the bill in the first place. (Paul D. Thacker, 8/10)

Both critics and advocates of Obamacare have assumed that a fallback position exists for a collapse in the government-run markets. A failure of the Affordable Care Act would prompt demands to transition from controlled markets to outright socialized medicine. However, Colorado’s experiment has become yet another cautionary tale about the dangers of single-payer systems. (Edward Morrissey, 8/11)

Nearly everything you have been told about the food you eat and the exercise you do and their effects on your health should be met with a raised eyebrow. Dozens of studies are publicized every week. But those studies hardly slake people’s thirst for answers to questions about how to eat or how much to exercise. Does exercise help you maintain your memory? What kind? Walking? Intense exercise? Does eating carbohydrates make you fat? Can you prevent breast cancer by exercising when you are young? Do vegetables protect you from heart disease? (Gina Kolata, 8/11)

This was not unexpected. After months of warnings from public health officials and scientists, the first locally transmitted cases of the Zika virus were reported in South Florida. Any illusion that this mysterious menace would not take hold in local mosquito populations and threaten multitudes more Floridians is gone. Any notion that the threat was overblown is dispelled. President Barack Obama, more than 40 Senate Democrats and Republican Sen. Marco Rubio want Congress to return to Washington to deal with the issue, which is exactly what should happen. (8/11)

Going back to the nation's founding, cigarette smoking has wreaked havoc on U.S. public health and contributed to an astronomical death toll. According to the Centers for Disease Control and Prevention, cigarette smoking causes about one of every five deaths in the United States each year. Despite decades of anti-tobacco education and abstinence-promotion messaging, the problem persists, with an estimated 40 million adults currently who smoke cigarettes and thousands more teens who try their first cigarette each day. (Caroline Kitchens, 8/10)

When the election dust is finally settled in November and the new Kansas legislators are sworn in, they will find they have a lot of work to do to help the state’s most vulnerable residents. Those Kansans have lost a lot of ground since Gov. Sam Brownback and the Republican-dominated Legislature pushed through tax cuts in 2012 for the wealthiest residents and limited liability companies in hopes of generating a cornucopia of jobs. The experiment has failed miserably, and the burden of balancing Kansas’ cash-starved budget has fallen heavily on kids with cuts to education and programs affecting low-income families and senior citizens. (8/10)

As more and more physicians move to specialty practices, quality primary and outpatient care are falling by the wayside, and veterans are among those paying the price. That’s why the proposal by the Veterans Health Administration to expand the role and authority of nurses is laudable. The proposal would amend the Department of Veterans Affairs’ medical regulations policy to allow their patients to receive care from qualified advanced practice registered nurses, or APRNs. The proposal would effectively increase access to quality health care for our veterans. (Sharon Horner, 8/10)

I am tired of hearing the tragic personal stories, frustrated by reading the news coverage and perplexed by the official responses to the litany of post-9/11 Wisconsin veterans who either die in Veterans Affairs care or are struggling to secure help. There is a pattern and it must stop. Whether it takes place at Tomah VA Medical Center, the Clement J. Zablocki VA Medical Center in Milwaukee or at the Iowa City VA Medical Center where a young Wisconsin veteran was seeking treatment, veterans who survived battle overseas are becoming casualties in our own country even as they seek treatment inside the walls of VA hospitals. (Daniel Seehafer, 8/10)

In the last four decades, I’ve been to more psychologists and psychiatrists than I can count, from New York to California, from the East Side to the West Side. ... For whatever reason, I’m now in a place where I feel I can offer advice to others searching for their equilibrium. (Jane Gross, 8/10)

Few pocketbook issues are as widespread or as hard to fathom as the soaring cost of prescription drugs. Enter Senate Bill 1010, up Thursday in the Assembly Appropriations Committee. A sunshine bill, it doesn’t set prices or raise taxes; it just demands a few fundamental, and extremely relevant, facts. SB 1010 would require drugmakers to give some justification and notice before they raise the price of big-ticket drugs in the market. (8/10)

In an election season the news headlines may lead us to believe that politicians can’t agree on anything. Not so fast. There is an issue on which both Republicans and Democrats can and do agree — the importance of community health centers in the U.S. health care system. Community health centers have been around for over five decades, effectively rooting out sickness and poverty in some of the most challenged communities. (Craig Glover, 8/10)