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More than 4 million people picked Obamacare plans in the 39 states that use the federal HealthCare.gov marketplace in the first six weeks of the 2017 sign-up period, the U.S. said Wednesday. The figure includes 1.1 million new customers and 2.9 million renewals through Dec. 10, the Centers for Medicare and Medicaid Services said in a statement. Sign-ups typically accelerate as the Dec. 15 deadline for Jan. 1 coverage approaches, and the government said more than 700,000 signed up on Dec. 12 and 13, without providing details. (Tracer, 12/14)

The number of Americans signing up for 2017 health plans through HealthCare.gov is running slightly ahead of a year ago, even as President-elect Donald Trump and a Republican Congress prepare to dismantle the law that provides the coverage. Customers new to the Affordable Care Act marketplaces account for just 25 percent of the enrollment so far, however, compared with almost 40 percent at about the same time last year, according to figures released Wednesday by federal health officials. (Goldstein, 12/14)

Signups for Affordable Care Act plans gained steam earlier this month with more than 4 million people choosing 2017 plans on the federal exchange through Dec. 10, according to data out Wednesday. The pace continued this week despite vows by Republican officials that the law will be repealed soon after Congress returns in January and in time for the Trump administration. Health and Human Services Secretary Sylvia Burwell tweeted that more than 325,000 people signed up on the federal exchange HealthCare.gov on Monday and about that many chose plans on Tuesday. (O'Donnell, 12/15)

More than 4 million people signed up for insurance coverage on Obamacare as of Dec. 10, the Centers for Medicare and Medicaid Services said Wednesday. Of the 4 million sign-ups that have taken place since Nov. 1, 1.1 million have been from new customers, 2.9 million have been people renewing coverage. The sign-up period has been open for six weeks. (McIntire, 12/14)

Four million individuals have signed up for insurance coverage under President Barack Obama’s signature health care law so far during the current open enrollment period, including 1.1 million new customers, according to data provided Wednesday by the Centers for Medicare and Medicaid Services. The snapshot comes as Republicans in Congress ramp up their efforts to repeal significant aspects of the 2010 health care overhaul (PL 111-148, PL 111-152). The new information, which captures enrollment data from Nov. 1 to Dec. 10, does not include the more than 700,000 individuals who signed up on Monday and Tuesday of this week. Those days were “two of the biggest days of any Open Enrollment,” CMS said in a statement. Of the 4 million total people who purchased health plans, 2.9 million were individuals who renewed coverage. (Williams, 12/14)

Californians are signing up in higher numbers than they did last year for health plans sold on the state’s health insurance exchange, despite great uncertainty over the future of Obamacare. More than 25,000 new consumers chose new Covered California plans in just two days earlier this week, exchange officials said Wednesday. Because of the last-minute rush, Covered California officials have extended the enrollment deadline for coverage that begins January 1. Consumers now have until midnight on Dec. 17 to choose plans. Coverage purchased after this Saturday’s deadline will start either on February 1st or March 1st. (Bartolone, 12/15)

The extension to midnight Saturday — from midnight Thursday — comes after exchange officials on Wednesday cited a “strong increase in demand,” noting that 25,000 new enrollees had signed up for a plan on Monday and Tuesday — almost double the figure for the same two-day period in 2015. (Seipel, 12/14)

With the deadline approaching, about 144,181 Illinois residents — including 108,238 in the Chicago area — had signed up for health insurance through the Obamacare exchange as of Sunday. Americans have until the end of Thursday to sign up for coverage that begins Jan. 1. Those who miss that cutoff can still sign up through Jan. 31, though their coverage won't begin with the new year. The numbers released by the federal government Wednesday show that Illinois residents are still interested in buying coverage through the exchange despite uncertainty about the future of the Affordable Care Act, also known as Obamacare. (Schencker, 12/14)

The number of Tennesseans enrolling in Obamacare for 2017 has nearly doubled in the past two weeks, as people rush to meet the Dec.15 deadline. Tennessee's enrollment numbers through Nov. 26 lagged national rates and those from 2015. More than 55,000 Tennesseans had then signed up for a plan on HealthCare.gov, a number that has since climbed to more than 104,666 as of Dec. 10. (McGee, 12/14)

Minnesotans have just one day left to buy health insurance on MNsure if they want it to take effect Jan. 1. But the Thursday midnight deadline comes as major questions remain unresolved about MNsure’s future — and about how much some MNsure customers will have to pay for their insurance. MNsure is the state-run marketplace for people buying individual health insurance. More than 44,000 people have signed up for plans on MNsure since open enrollment started Jan. 1, double the rate seen last year. Premiums for plans on MNsure have risen significantly this year as insurers try to stanch losses stemming from an insured population that’s older and sicker than expected. (Montgomery, 12/14)

Senate Democrats will never vote to repeal Obamacare. But once the deed is done, a surprising number of them say they’re open to helping Republicans replace it. “If it makes sense, I think there’ll be a lot of Democrats who would be for it,” said Sen. Claire McCaskill (D-Mo.). As Republicans aim to make good on their years-long vow to quash Obamacare and replace it with their own health care vision, they’ll have to do something Democrats were never able to: Bring members of the opposing party on board. (Everett and Haberkorn, 12/15)

The nation’s top health official is giving her starkest post-election outlook yet about the fate of ObamaCare, warning that the GOP’s plan will immediately unravel the insurance marketplace. “The idea of ‘repeal and replace’ is really, ‘repeal and collapse,’” Health and Human Services Secretary Sylvia Mathews Burwell said in an interview with "PBS Newshour" this week. Burwell, who has largely stayed out of the spotlight since the election, is now emerging as a vocal critic of the GOP’s push to sign a repeal bill within Donald Trump’s first 100 days as president. (Ferris, 12/14)

Taxpayers will fork over nearly $10 billion more next year to cover double-digit premium hikes for subsidized health insurance under President Barack Obama's law, according to a study being released Thursday. The analysis from the Center for Health and Economy comes as the Republican-led Congress is preparing to repeal "Obamacare" and replace it with a GOP alternative whose details have yet to be worked out. (12/15)

The Republicans are committed to repealing the Affordable Care Act. On Monday, Senate Majority Leader Mitch McConnell said that the Senate will vote in early January to repeal the law, and then it will figure out what to replace it with. (Hobson, 12/14)

A contingent of state senators and other officials, led by Senate President Stanley Rosenberg, arrives in Minneapolis Thursday (forecast: partly cloudy with a high of 6 degrees) for two days of meetings with public officials, academic researchers, and health care executives. It’s part of a broader investigation of whether Massachusetts needs new legislation to curb rising medical spending. (Dayal McCluskey, 12/14)

Congressional Republicans' plans to repeal the Affordable Care Act could threaten New Orleans' unique system of primary care clinics, which Mayor Mitch Landrieu believes should be a national model for delivering urban health care. Long funded under a stopgap stream of federal funding that was never intended to be permanent, Medicaid expansion has provided the clinics with a stable source of money that was thought to be a long-term solution. But now that Congressional Republicans and President-elect Donald Trump have begun discussing the possibility of rolling back Medicaid and Medicare funding, and repealing the law that provides for lower-cost health insurance through Healthcare.gov, the mayor and clinic leaders see the long-term strategy as fraught with uncertainty. (Litten, 12/14)

As congressional Republicans begin to face the consequences of repealing the Affordable Care Act early next year, GOP members of the powerful Senate Finance Committee signaled on Tuesday, they were open to proposals for preserving expanded Medicaid coverage for millions of adults and children, even while cutting other vital elements of Obamacare. (Pianin, 12/14)

They are outnumbered in the Georgia House of Representatives by almost two-to-one, but Democrats plan to dig in on several issues when the Legislature returns next month. That's the message from House Minority Leader Stacey Abrams, D-Atlanta.  Although Republicans in Washington have promised to repeal and replace the Affordable Care Act (also called Obamacare), Abrams promises Democrats will continue to push Georgia officials to expand the state's Medicaid rolls, to cover more uninsured people.  (O'Hayer, 12/14)

Mindful of the clock ticking down to a Trump presidency, the Obama administration issued a final rule on Wednesday to bar states from withholding federal family-planning funds from Planned Parenthood affiliates and other health clinics that provide abortions. The measure takes effect two days before the Jan. 20 inauguration of Donald J. Trump. The rule was proposed three months ago, when many Democrats assumed the next president would be Hillary Clinton; she presumably would have promoted the rule’s completion if it were still pending. (Calmes, 12/14)

The rule stipulates that states may not prohibit an organization from participating in Title X — the state-federal program that gives out tens of millions of dollars for family planning — for any reason other than the organization’s ability to provide services. It is designed to undercut efforts in some states to withhold taxpayer money from Planned Parenthood, which offers a variety of health-care services, primarily to low-income women. While the money cannot be used for abortions, some conservative lawmakers have targeted the group because it also offers the procedure at some of its clinics. Abortion rights groups lauded the rule but cautioned that it could be reversed by the next administration. (Somashekhar, 12/14)

"President Obama has cemented his legacy as a champion for women's health," said Planned Parenthood President Cecile Richards in a written release. "This rule protects birth control, cancer screenings, [sexually transmitted infection] testing and treatment and other health care for millions of people." (Kodjak, 12/14)

The Obama administration on Wednesday released a long-awaited regulation that bars states from defunding Planned Parenthood for political reasons. The rule comes after more than a dozen GOP governors and state legislatures have attempted to block Medicaid funding from going toward Planned Parenthood clinics in their state. Nearly all the defunding actions have been challenged in court, and many have already been struck down, including in Ohio, Mississippi and Arkansas. (Ferris, 12/14)

The Obama administration on Wednesday moved to make it harder for states to restrict federal funding for health care providers such as Planned Parenthood that have family planning or women’s health services. While the move was cheered by Democrats and public health advocates, the praise from some groups was coupled with an acknowledgment that next year, Republicans in Congress and the new administration could simply undo the policy. Over the past five years,13 states have attempted to shut down providers who offer abortion by changing how they distribute the federal money for family planning, which is known as Title X funding. Some states have done this by redistributing the funds toward hospitals or general community health centers, and away from clinics that specialize in family planning, including those that don’t provide abortions. (Siddons, 12/14)

It’s an idea that has long been used as an argument against abortion — that terminating a pregnancy causes women to experience emotional and psychological trauma. Some states require women seeking abortions to be counseled that they might develop mental health problems. Now a new study, considered to be the most rigorous to look at the question in the United States, undermines that claim. (Belluck, 12/14)

A new study offers a window into the mental state of women after they seek an abortion. Women who were denied an abortion experienced more initial anxiety and lower self-esteem and life satisfaction than women who received one, according to a study published today in the JAMA Psychiatry journal. Researchers followed nearly 1,000 women in 21 states over five years after they tried to obtain an abortion. They followed a group who received the procedure, and another who were denied. (Bowen, 12/14)

Leaders of the Ohio House are consulting with Republican members about whether to reconvene in Columbus in an attempt to override Gov. John Kasich's veto of the Heartbeat Bill. While Speaker Cliff Rosenberger believes Kasich "made an important step forward" by approving a 20-week abortion ban, "some members believe the veto of the Heartbeat Bill took a step backward on this important issue," said House GOP spokesman Brad Miller. (Ludlow, 12/14)

Not all hospitals are created equal, and the differences in quality can be a matter of life or death. In the first comprehensive study comparing how well individual hospitals treated a variety of medical conditions, researchers found that patients at the worst American hospitals were three times more likely to die and 13 times more likely to have medical complications than if they visited one of the best hospitals. (Abelson, 12/14)

The Food and Drug Administration on Wednesday partially rejected an application by Swedish Match North America Inc. to market its tobacco pouches as being less harmful than cigarettes. Eight products in the company’s General brand of tobacco pouches, called snus, represent the first test case in a program in which the agency is considering whether to allow companies to advertise some tobacco products as safer than cigarettes. (Maloney, 12/14)

U.S. health officials have rejected an attempt by a Swedish company to remove several health warnings from its smokeless tobacco pouches, though regulators left open the possibility for other labeling changes it seeks. The Food and Drug Administration announced Wednesday that it denied the request by Swedish Match to remove warnings about gum disease and tooth loss from its chewable pouches, called snus. It's the first decision of its kind handed down by the agency since it gained authority to review the relative risks of tobacco products in 2009. (12/14)

The Food and Drug Administration (FDA) Wednesday denied a request from a Swedish tobacco company to remove health warnings from its smokeless tobacco product. Swedish Match North America Inc. submitted a modified risk tobacco product (MRTP) application for snus, a moist powder tobacco pouch that users put behind their upper lip.  FDA said it denied the company’s first request to remove warnings of risk for gum disease and tooth loss from labels based on scientific evidence and other data. (Wheeler, 12/14)

The Obama administration is pledging to finalize revisions to the federal rules governing medical research — despite criticism from scientists and the looming specter of the Trump presidency. Officials at the Department of Health and Human Services have been working on changes to those regulations, collectively known as the Common Rule, for years now. Parts of the proposal have been vigorously opposed by many researchers, and Republicans in Congress have warned the administration not to finalize any new regulations during the transition to a Donald Trump presidency. But federal officials told STAT this week that the agency still intends to finish the revisions before Obama leaves office. (Scott, 12/14)

The National Institutes of Health is expected to release soon a breakdown of the funding available in fiscal year 2017 for President Barack Obama’s cancer moonshot initiative, agency Director Francis Collins told CQ Roll Call. The 21st Century Cures bill (HR 34) signed by Obama on Tuesday will provide $300 million in funding next year for the program. Collins, in an interview Wednesday, said the agency would release the money allocations intended to help meet the focus areas outlined earlier this year in a federal task force report in the “not too distant future.” (Williams, 12/14)

A former peer reviewer for the Annals of Internal Medicine has admitted to taking a paper rejected from that journal, changing the author names and title, and publishing it as his own in another journal. Today, the true author of the study, Michael Dansinger, MD, from Tufts Medical Center in Boston, Massachusetts, published an open letter to the plagiarist in the Annals of Internal Medicine. (Frellick, 12/12)

It’s a researcher’s worst nightmare: Pour five years, and at least 4,000 hours, of sweat and tears into a study, only to have the work stolen from you — by someone who was entrusted to confidentially review the manuscript. But unlike many sordid tales of academia, this one is being made public. Dr. Michael Dansinger, of Tufts Medical Center, has taken to print to excoriate a group of researchers in Italy who stole his data and published it as their own. (Marcus and Oransky, 12/12)

Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there’s little proof they reduce rates of overdoses or deaths. More than prescriptions are at stake. Critics worry the drugmakers’ nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000. (Perrone, Mulvihill and Whyte, 12/15)

Critics say the answer pharmaceutical companies are pushing to address the ongoing opioid crisis boosts their profits while forcing taxpayers to shoulder the costs. Some drugmakers aim to replace ubiquitous painkillers such as Vicodin and Percocet with harder-to-abuse formulations that are patent-protected and command higher prices — a plan that could cost government-funded health programs hundreds of millions of dollars in higher medication expenses. (Whyte and Perrone, 12/15)

The Associated Press and the Center for Public Integrity investigated how pharmaceutical companies are using their political clout to push a new form of opioids as their answer to the epidemic of prescription painkiller abuse. The pills are marketed as abuse-deterrents because they usually are difficult to crush and dissolve, but they also are lucrative for the industry. (12/15)

Then there’s the close-knit nature of the tribe. That can be a huge help to doctors — the medical staff knows exactly which neighbors or relatives to call to track down a patient who hasn’t shown up for his Suboxone strips. But the strong connections binding the community can also drag down individuals trying to overcome addiction. It’s hard to break habits when you’re surrounded by so many friends with the same cravings for opioids. The rate of drug-related deaths among American Indian and Alaska Native people has almost quadrupled since 1999, according to the Indian Health Service. It’s now double the rate in the US as a whole. Oklahoma — home to the 120,000 citizens of Cherokee Nation — leads the country in prescription painkiller abuse. (Thielking, 12/15)

Two years after it was approved by California voters, Prop 47 has scaled back mass incarceration of drug addicts, but successful reform is woefully incomplete. Proponents celebrate how the law freed at least 13,500 inmates from harsh sentences in crowded prisons and jails, but Prop 47 has done little to help these people restart their lives. Instead, the unprecedented release of inmates has exposed the limits of California’s neglected social service programs: Thousands of addicts and mentally ill people have traded a life behind bars for a churning cycle of homelessness, substance abuse and petty crime. Prop 47 earmarked millions saved in prison costs for inmate rehabilitation, but not a penny has been spent. Meanwhile, the state’s shortage of treatment programs is more glaring than ever. (Castellano, Kelman, Hwang, Carlson, Wu and Espino, 12/14)

“Help is on the way,” U.S. Sen. Jeanne Shaheen, D-NH, said after visiting the Farnum Center in Manchester to discuss federal efforts to combat the opioid epidemic. The New Hampshire delegation applauded President Barack Obama signing the 21st Century Cures Act into law this week to commit $1 billion nationwide to the public health crisis. Shaheen called the funding a good downpayment. The money will be targeted to states with higher rates of addiction. Sadly, New Hampshire is in the top tier of states based on the severity of the drug problem. (Tuohy, 12/15)

As the Alcohol, Drug and Mental Health Board of Franklin County took new steps this week to fight the still-raging opiate crisis, the Columbus Foundation added support by announcing a first-of-its kind community fundraising effort to aid in the battle. (Price, 12/15)

Ohioans believe drug use is a health problem. In fact, they say it's the most urgent health problem in the state. Results of an Ohio Health Issues Poll released today show that 21 percent of those surveyed believe drug use was it. The next biggest response was concern about health insurance, at 18 percent. (The concerns include the cost of health care, coverage gaps for those who are insured, accessibility to insurance and general worries about the Affordable Care Act, or Obamacare.) (DeMio, 12/15)

Gov. Terry McAuliffe said Wednesday that he will propose $31.7 million in new funds to improve the state’s mental health system and curb the increasingly dire opioid crisis. The funding includes $5.3 million in general fund dollars to boost access to opioid addiction treatment and to help prevent fatal overdoses. (Demeria, 12/14)

No sooner was the ink dry on President Obama’s signature on the 21st Century Cures Act than states, including Connecticut, started competing for new law’s $1 billion in grants to fight opioid addiction. The massive bill – which also funds Obama’s “cancer moonshot,” reforms the mental health system and expedites federal approval of certain drugs – provides $500 million this year and $500 million next year to states hardest hit by the opioid epidemic. There’s a lot of competition for that. (Radelat, 12/14)

The state Board of Medicine has revoked the license of a physician assistant, who previously was reprimanded for over-prescribing opiates. Christopher Clough, who was once one of the largest prescribers of oxycodone in the state, in August 2014 agreed to abide by certain restrictions while his case was being investigated by the board. Those restrictions included the need for him to get pre-approval of a supervisory physician before performing pain procedures. It also required a “telephonic or face-to-face consultation” between him and the physician, along with other documentation. (Grossmith, 12/15)

In the blood of a patient infected with Zika, researchers have found key proteins that could help them create medicines and vaccines to fight the rapidly spreading virus. A study published Wednesday in the journal Science Translational Medicine describes two antibodies that were able to “eliminate” samples of the Zika virus when tested in laboratory dishes. When the researchers gave either of the antibodies to mice that had been deliberately infected with Zika, the animals “were completely protected against ZIKV infection,” according to the study. (Healy, 12/14)

Among women who had symptoms or were exposed in the first trimester, 11 percent had fetuses or infants with birth defects. There were no reports of birth defects in fetuses of infants with exposure only in the second or third trimester. The study used laboratory tests to tell if the mother, fetus or baby had at some point been infected with Zika or similar viruses. But the tests couldn't necessarily tell which virus, or when. Four percent of the babies or fetuses had microcephaly, a devastating abnormality that causes very small heads and brain damage. (Stein, 12/14)

The chances of delivering a baby with a birth defect are about one in 16 for mothers infected with Zika while pregnant, according to a new report published in the Journal of the American Medical Association using preliminary data from the U.S. Zika Pregnancy Registry. (Chang and Pugh, 12/14)

A series of studies released Wednesday shed a preliminary light on the Zika virus’ consequences for children infected in the womb. But, experts said, the findings also highlight additional challenges: identifying affected babies and making sure they receive needed follow-up care as they grow. That task could prove complicated, especially as new data emphasizes the virus may cause more damage than previously thought. (Luthra, 12/14)

Federal health officials warned pregnant women on Wednesday to avoid visiting Brownsville, Tex., because of the threat of infection with the Zika virus. At least five cases of Zika transmitted by local mosquitoes have been reported in the last few weeks, and temperatures are still high enough for mosquitoes to thrive, the Centers for Disease Control and Prevention said. (McNeil, 12/14)

Federal health officials on Wednesday urged pregnant women to consider postponing travel to Brownsville, Tex., because of five local cases of Zika virus infection that have been reported. The Centers for Disease Control and Prevention sent an advisory to clinicians in its health alert network saying that the CDC is designating Brownsville, on the border with Mexico, a Zika cautionary area for testing and travel guidance. (Sun, 12/14)

Pregnant women should avoid the Brownsville area if they can and guard against mosquito bites if they can't, the Centers for Disease Control and Prevention said Wednesday, citing an increased risk of contracting the Zika virus there. (Evans, 12/14)

It's a cold, damp fall day in London. But in a windowless basement laboratory, it feels like the tropics. It's hot and humid. That's to keep the mosquitoes happy. "In this cage, we have the adult mosquitoes," says Andrew Hammond, a genetic engineer at Imperial College London, as he picks up a container made out of white mosquito netting. ... Scientists have altered mosquitoes' genes before. But these insects aren't just any genetically engineered mosquitoes. (Stein, 12/14)

School shootings have increased every year since the 2012 Sandy Hook massacre - primarily in rural states that have less gun control and less spending on mental health and education, a new study has found. Other findings of the study, which documented 154 school shootings from 2013 to 2015, are that: 99 percent of the shooters were boys. 66 percent of the shootings were intentional. Connecticut and 10 other states with stricter gun laws and more spending on mental health and education had no school shootings during those three years. (Ryser, 12/14)

Political debates over guns have a long history. But [Vivek] Murthy has said his position on guns is not about politics. He looks at the deaths and injuries caused by gunshots as a medical problem, from the perspective of data. Gun incidents kill more than 30,000 people every year in America, and cause 60,000 injuries. (Kanne, 12/14)

Regulators in the US will require new warnings be added to the labels of certain anesthetic and sedation drugs, the Food and Drug Administration announced Wednesday, indicating that use of the drugs could possibly harm young children’s brains. The warnings will apply to children under 3 and to pregnant women during their third trimester, and pertain to procedures that last longer than three hours or to repeated exposure to the drugs. A single short exposure to general anesthesia has not been found to have negative brain effects for children. (Joseph, 12/14)

The Food and Drug Administration warned Wednesday that repeated or lengthy use of general anesthesia or sedation drugs for children younger than 3 or pregnant women in their third trimester may affect youngsters' developing brains. The agency, which said its warning is based on a comprehensive analysis of the latest research, issued a “drug-safety communication” to inform health-care providers, parents and pregnant women about the risks of using the drugs repeatedly or for more than three hours at a time. It also ordered manufacturers to add warnings to their products' labels. (McGinley, 12/14)

Hawaii is the healthiest state in the country for the fifth consecutive year, according to an annual state-by-state health ranking report. The 2016 America's Health Rankings highlight some long-term improvements in overall health across the country and some disturbing new trends. (Bowerman, 12/15)

Illinois boasts more primary care physicians and fewer smokers than most states — but it also has higher levels of air pollution, chlamydia and excessive drinking, according to a new report ranking states on a number of health measures. Overall, Illinois ranked smack in the middle of the country — 26th in the nation — for total health, according to the United Health Foundation's America's Heath Rankings annual report, released Thursday. That's up two spots from the year before. Illinois and other states were ranked on dozens of measures. (Schencker, 12/15)

Florida fell three notches to 36 among all 50 states in the annual “America’s Health Ranking” for 2016 released Thursday by the United Health Foundation, a nonprofit arm of insurer United Health Group. For the fifth straight year, Hawaii was ranked the nation’s healthiest state. Massachusetts finished second followed by Connecticut, Minnesota and Vermont. (Pugh, 12/15)

As of 12:01 Thursday morning, adults over the age of 21 can possess up to an ounce of marijuana on their person, and have another 9 ounces for personal use kept locked at home. Adults can also now grow up to six marijuana plants, a maximum of 12 per household. While it's still illegal to buy marijuana, and retail shops are at least a year away from opening, legalization will likely have an impact on the the way of life here in Massachusetts. (Brown, 12/15)

Beginning at midnight, marijuana will officially become legal in Massachusetts. But, since retail sales of the drug won’t be allowed until at least January 2018, the commonwealth has found itself in a legal grey zone. So, what happens if you’re stopped by police and you’ve got marijuana? It depends how old you are—and how much you’ve got. (Prignano, 12/14)

As Florida prepares for the arrival of medical marijuana, the Miami-Dade School Board is urging lawmakers to keep cannabis away from school children — unless they have a prescription. At a meeting on Wednesday, the board voted unanimously to call on the Florida Legislature to ban medical marijuana dispensaries within 2,500 feet of schools if they sell anything other than the drug, such as pipes and other paraphernalia, and to prohibit medical marijuana products made to look like candy. The board also called for a ban on medical marijuana on school property without supervision, adding the three proposed restrictions to its 2017 State Legislative Platform. (Gurney, 12/14)

When emergency medical technicians were called to a mass casualty event in Brooklyn last summer, dispatchers used a word more associated with apocalyptic Hollywood movies than medical emergencies: zombies. Emergency workers reported multiple people at the scene, near a subway station on Myrtle Avenue and Broadway, on the border of Bushwick and Bedford-Stuyvesant, “all of whom had a degree of altered mental status that was described by bystanders as ‘zombielike,’” according to a study published Wednesday in the New England Journal of Medicine. (Santora, 12/14)

Gov. Jay Inslee has proposed adding hundreds of millions of dollars to the troubled mental-health system and eventually downsizing the state’s two psychiatric hospitals by moving patients into community-based facilities. The governor’s plan to reshape Washington’s mental-health system was the centerpiece of a 2017-19 state operating-budget proposal he unveiled Wednesday that would total $46.7 billion over the two-year budget cycle. The Democrat’s plan represents a more than 20 percent spending hike over the $38.2 billion two-year budget approved in 2015 — something sure to draw the ire of Republican lawmakers. (O'Sullivan, 12/14)

By 2030, more than 60 million older adults could be driving on the nation’s roadways. But don’t expect many more states to put added restrictions on their ability to get behind the wheel. Legislatures have become increasingly reluctant to restrict driver’s licenses for seniors or impose extra requirements — such as vision or road tests — for getting them renewed based solely on their advancing age. That’s partly because older people are generally considered safe drivers, more programs exist to improve their driving skills, and recent studies have shown that many of the restrictions aren’t as effective as once thought in preventing traffic fatalities. (Bergal, 12/15)

PrairieCare, a fast-growing Twin Cities mental health provider, is seeking state permission to double-bunk pediatric patients at its psychiatric hospital in Brooklyn Park, due to the number of children and teens who can’t find open beds when they suffer mental and behavioral crises. The for-profit provider wants to add second beds to 21 of the 50 inpatient rooms at its year-old hospital, and filed a plan this fall with the Minnesota Department of Health, which must now decide whether to recommend the project to the Legislature. (Olson, 12/14)

The constitutional rights of intellectually disabled people at a state-run center in Pueblo were violated when officials strip searched them to determine whether they had been abused, a lawsuit filed Wednesday on behalf of 18 residents alleges...In March 2015, the Colorado Department of Human Services strip searched 62 residents at the Pueblo Regional Center for the severely intellectually disabled. The state’s public health department later determined the searches “resulted in disregard of individual rights including privacy, dignity and respect” and “resulted in individuals being scared and confused and some remained agitated days after the inspections took place.” (Osher, 12/14)

The private medical staff that cares for inmates inside the Arapahoe County Detention Facility allowed a 37-year-old man to die on the floor of his cell in a pool of blood and vomit after ignoring his rapidly declining health, according to a federal lawsuit filed this week. Jeffrey Lillis died on Dec. 14, 2014, from sepsis caused by bacterial pneumonia after complaining for days that he didn’t feel well, recording an escalating fever and coughing up blood. His death involved a rare “cadaveric spasm,” in which the entire muscular system stiffens at death and is “usually associated with violent deaths happening under extremely physical circumstances with intense emotion,” according to the lawsuit filed in U.S. District Court in Colorado. (Phillips, 12/14)

Sen. Vicki Schmidt will chair the Senate Public Health and Welfare Committee next year, regaining a position she last held in 2012.“ I’m certainly excited to chair public health and welfare again and excited for the opportunities to explore issues that are very important to Kansans,” Schmidt said in a phone interview Wednesday. Schmidt, a Republican pharmacist from Topeka, last chaired the committee during the 2012 legislative session, when the chamber was led by moderate Republicans. (Marso, 12/14)

A committee of legislators formed to study the consolidation of licensing boards for a dozen public health professions ultimately decided Wednesday to recommend few changes. Consolidation of the boards was one of the recommendations from a government efficiency study lawmakers commissioned last year to help them identify cuts to close persistent budget deficits. But most of the licensing boards involved strongly opposed consolidation, and Rep. Dan Hawkins noted that consolidation would not help with the state general fund deficits because the boards are almost entirely funded through fees on their members. (Marso, 12/14)

The governor’s task force investigating cancer clusters on the Seacoast issued a set of recommendations Wednesday. The task force was charged with investigating potential causes for unusually high rates of two cancers among children living in a region of the Seacoast. Today the task force issued a set of recommendations, including one to extend municipal water to homes near the Coakley Landfill – a superfund site that was investigated as a potential cause of the high cancer rates. (Moon, 12/14)

The Medical College of Wisconsin and Froedtert Health are starting a family-medicine residency program at Froedtert Community Memorial Hospital, an initiative that could help relieve the shortage of physicians in the specialty. Family-medicine has been the most in-demand medical specialty for 10 consecutive years, according to Merritt Hawkins, which recruits physicians. (Boulton, 12/14)

For the first time in California, mixed martial artists – along with professional boxers – will undergo testing before and possibly after bouts to help determine if they have suffered neurological damage or deficiencies. All fighters scheduled for Saturday’s UFC Fight Night on Fox at Golden 1 Center have been given baseline testing on cognitive awareness and balance using an iPad with proprietary software designed for the C3 protocol. It stands for Comprehensive Concussion Care and is modeled after tests administered by the Cleveland Clinic’s Professional Fighter Brain Health Study. (Billingsley, 12/14)

Firefighters responded to a two-alarm fire at NYU Langone Medical Center early Wednesday afternoon. Smoke billowed over the East River from 560 First Ave., part of a construction site within the medical complex. There were 106 firefighters who responded to the blaze and got it under control shortly before 1 p.m., FDNY officials said. One person was treated for minor injuries. The fire broke out on the seventh floor of the site, according to NYU Langone. NYU Langone is in the middle of construction on the Helen L. and Martin S. Kimmel Pavilion, an 830,000-square-foot building alongside its flagship Tisch Hospital. The project's cost is $1.4 billion, according to the organization's most recent financial statements, and the pavilion is scheduled to open in 2018. (LaMantia, 12/14)

[Dierda] Lee is part of what researchers call a disturbing trend. Americans aged 25 to 44 are seeing their rates of stroke go up 43 percent. Researchers aren’t sure why. It could be an increase in obesity, diabetes and bad cholesterol in the younger age group. It could be that advances in imaging are diagnosing more strokes that might previously have been missed. (Aboraya, 12/14)

In the past eight years, Texas lawmakers have tried nearly a dozen times to pass a law requiring drug screenings or testing for applicants for state welfare benefits. Ahead of next year's legislative session, supporters are hopeful momentum is finally on their side. (Evans, 12/15)

Most people think the ACA was successful in California because the state loved the law while it was under attack in most of the rest of the country. But there were many other more important factors, the first of which was the sheer size of California. (Micah Weinberg, 12/14)

In Kansas, there is an issue central to the success of local businesses and the growth of our state’s economy. It helps address the state’s budget crisis, brings much-needed jobs to our state, and allows us to sit in the driver’s seat – coming up with our own solutions, encouraging personal responsibility, and making sure our tax dollars are wisely spent. The issue might surprise you. It is expanding the state’s Medicaid program, KanCare. (Joe Reardon and Gary Plummer, 12/15)

This is about more than polls and election results – it’s about making a real difference in the lives of some of the most vulnerable populations in our state. Not only unborn children, but also minorities and the impoverished. Abortion impacts these communities on a devastating level. According to the latest U.S. Census and Ohio Department of Health statistics, African-Americans make up a little more than 12 percent of Ohio’s population, but of the nearly 21,000 children that lost their lives to abortion last year, more than 40 percent were African-American. And according to the Guttmacher Institute, an organization that advocates for abortion, children conceived in impoverished families are three times as likely to be aborted. (Aaron Baer, 12/14)

A new administration is coming to Washington, promising yet another health care reform. Although the debate over health policy will surely be more unpredictable with President-elect Trump than it has been with most other politicians, that does not mean it will be entirely novel. Indeed, the past half-century of health debate likely provides a good road map for what is coming. (David Cutler, 12/14)

Voters opposed to Obamacare have waited six years for the opportunity to repeal it. Since the election, Republicans have suggested that it might take as many as three more years to unwind the gears of the Affordable Care Act, especially when it comes to Medicare. The “repeal and delay” strategy to push off the heavy lifting until yet another election had passed, stirred grumblings of discontent among Republicans who had already expressed considerable disgust at the party’s inability to keep its promises on the ACA. (Edward Morrissey, 12/15)

The Zika crisis, which seems to have faded from memory since it became a big news item this summer, has roared back with a vengeance, thanks to a just-published study indicating that the virus’ effect on infants of women infected during pregnancy is much worse than previously known. The study, published in the New England Journal of Medicine, found that 42% of infants infected in the womb had serious birth defects. Previously, attention focused on an outbreak of microcephaly among infected babies, but that turns out to be merely the tip of the iceberg, appearing in 3% of the newborns. (Michael Hiltzik, 12/14)

Human illness caused by Zika virus infection has been described for several decades, but this pathogen was in a sense better classified as an infectious diseases “trivia question” before reports of larger outbreaks appeared within the last 10 years. Nonspecific symptoms of viral infection, including fever, rash, arthralgia, and conjunctivitis, have been described for Zika infection, and asymptomatic infection is fairly common. However, now that strong and accumulating evidence has implicated Zika infection during pregnancy in severe central nervous system sequelae after infection of the fetus, there has been increased urgency in acquiring a greater understanding of the pathophysiology of Zika disease, and efforts to control the spread of this virus have escalated. (William J. Muller and Emily S. Miller, 12/15)

Surgical residency is notoriously arduous and the longer hours compared with other specialties can take a toll on some residents. That’s why it’s important for mentors to keep a watchful eye on resident mentees. Those who are thinking about leaving may be too overwhelmed to see how their talents have great value. As educators and clinicians, we have a responsibility to cultivate—not waste—this valuable potential. (Julie A. Freischlag and Michelle M. Silva, 12/14)

As Jane’s 7-year-old daughter, Kelsey, lay in the intensive care unit, shaking from seizures, Jane needed people to listen to her and trust her. Jane — not a textbook — knew which of the five different seizure medicines worked best for Kelsey, and which had little effect. But the doctors weren’t paying much attention to “just a mom.” With help from her patient navigator, Jane convinced the doctors to stop treating Kelsey like a seizure disorder and start treating her like Kelsey. Navigators guide patients and their families as they move through the health care system. While interactions with navigators have traditionally happened outside of hospitals, particularly for cancer patients, their services are also needed for people in the hospital and their families. (Kelly Michelson, 12/14)

The risks of participating in a clinical trial cannot be predicted with certainty at the time of trial design, especially when evaluating novel therapies. Accordingly, once the trial is initiated, periodic and ongoing review of accumulating study data is necessary to ensure the continued appropriateness of enrolling and treating patients in the trial. This oversight activity is often conducted by a data monitoring committee (DMC), also known as a data and safety monitoring board, generally composed of scientific, medical, statistical, and other experts. Ideally, this oversight process ensures that a clinical trial is stopped if the benefit-risk balance for participants or the expected value to society no longer justifies continuing. (Roger J. Lewis, Karim A. Calis and David L. DeMets, 12/13)

Columbus’ decision to curtail its “Cadillac” emergency-medical-response system, by sending only one highly trained paramedic on basic runs along with an emergency medical technician, is a pragmatic one. It is the result of economic reality, a fast-growing city and a review of data. But this change is also a stop-gap solution for a fire division whose staffing is stretched too thin: City leaders seem to have a spare $5 million to help the Cleveland Browns build a practice camp in what could be the city’s fanciest recreation center, but they can’t seem to scrape together the dollars to add firefighters to meet a surging demand for service. (12/15)