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One of the first things Tracy Trovato did — once she overcame the shock of learning her 42-year-old, marathon-training husband had leukemia — was look through their health insurance documents.She dug up one paper that said the plan would pay no more than $1 million for medical services in a lifetime. The Chicago woman and her husband, Carlo, called their insurance company in a panic. (Schencker, 12/19)

When he campaigned for president, Donald Trump made repealing and replacing the Affordable Care Act a signature issue. Polling suggests that such a move would have the biggest impacts on communities that gave Mr. Trump some of his highest levels of support, potentially complicating the politics of a repeal effort. More than 20 million Americans now depend on the ACA, also known as Obamacare, for health insurance. Data from Gallup indicate that a lot of those people live in counties that favored Mr. Trump. (Chinni, 12/19)

People who want to sign up for a policy on healthcare.gov after the annual open enrollment period ends Jan. 31 may have to produce a paper trail proving that they qualify for a “special enrollment period” before their coverage can begin, according to details of a pilot program described last week by federal officials. But the verification measures, long sought by insurance companies, may deter the very consumers the marketplace needs to attract: healthy people who may not bother signing up if doing so is a hassle. (Andrews, 12/20)

Three in 10 Missouri adults could have difficulty purchasing their own health insurance if the Affordable Care Act the next Congress fully repeals the Affordable Care Act. That’s because one of the act’s main provisions requires insurance companies to cover individuals with pre-existing conditions — a definition that once included pregnant women, cancer patients in remission and people with such common medical issues as obesity.  (Bouscaren, 12/19)

Warning that nearly 1 million Ohioans could lose health coverage, advocates for the poor and disabled urged Gov. John Kasich to oppose a plan by congressional Republicans and President-elect Donald Trump to repeal Obamacare unless they have a replacement. (Candisky, 12/20)

Peter Lee, who runs what is arguably the most successful Obamacare state exchange, has spent a lot of time thinking about what would happen to California’s insurance market if the health care law is repealed. With Republican lawmakers on the verge of making that happen, Covered California’s executive director says he’s encouraged by their discussions about replacing coverage for the millions who’d lose insurance without Obamacare. Lee says there are lessons that even the incoming Trump administration can learn from California’s Obamacare experience, and he hopes to provide at least some input to Republicans shaping an Obamacare replacement package. (Colliver, 12/19)

What if your doctor's gender could influence your chance of surviving a visit to the hospital? A big study of older patients hospitalized for common illnesses raises that provocative possibility — and also lots of questions. Patients who got most of their care from women doctors were more likely to leave the hospital alive than those treated by men. (Tanner, 12/19)

When a patient goes to the best hospital, he or she usually hopes for a doctor who is knowledgeable and experienced. Something else to wish for? A woman physician. That’s because female doctors may on average be better than their male counterparts at treating patients in the hospital and keeping them healthy long-term, according to findings published Monday in JAMA Internal Medicine. (Luthra, 12/19)

The findings not only launch a grenade at the gender pay gap in medicine, they also suggest the methods of female physicians — if replicated broadly — could significantly improve the quality of medical care in the United States. (Ross, 12/19)

An estimated 32,000 fewer patients would die every year “if male physicians could achieve the same outcomes as female physicians,” the authors, a group of Harvard researchers, wrote in the study. Patients treated by women had mortality rates of 11.07%, compared with 11.49% for those seen by men. Readmission rates were 15.02% among those seen by women, compared with 15.57% for male physicians. (Whitman, 12/19)

The researchers estimated that if male physicians could achieve the same results as their female colleagues, they would save an extra 32,000 lives among Medicare patients alone each year --  a feat that would rival wiping out motor vehicle accident deaths nationwide. Previous studies have found that female physicians are more likely to follow practice guidelines based on scientific evidence. They also spend more time with patients, talk with them in more reassuring and positive ways and ask more questions about their emotional and social well-being. (Painter, 12/19)

"The association was consistent across a variety of conditions and across patients’ severity of illness,” report authors wrote. “Taken together with previous evidence suggesting that male and female physicians may practice differently, our findings indicate that potential differences in practice patterns between male and female physicians may have important clinical implications for patient outcomes.” (Braverman, 12/19)

Vineet Arora, an associate professor of medicine at the University of Chicago, praised the research but was cautious to read too much into the main result, pointing out that it was important to remember the effect might stem from multiple factors. “It could be something the doctor is doing. It could be something about how the patient is reacting to the doctor,” Arora said. “It’s really hard to say. It's probably multi-factorial.” What the study drove home for Arora, who works as a hospitalist, is that women are certainly not worse doctors than men — and they should be compensated equitably. (Johnson, 12/19)

The study, published Monday by JAMA Internal Medicine, explored possible reasons for the gap, including the chance that male doctors cared for more severely ill patients, and where doctors worked. Research suggests doctors practice differently across regions of the U.S. and studies show that hospital quality varies. But nothing explained the difference, raising questions about what might be the cause. An answer is important, because it may identify ways that some doctors get better results—ways that can be copied by other doctors to improve care overall, health-care quality researchers said. (Evans, 12/19)

Sen. Tim Kaine, the former Democratic nominee for vice president, will serve on the Health, Education, Labor and Pensions Committee next Congress. The Virginia Democrat made the announcement Monday in Richmond, while speaking at a roundtable with health care providers and advocacy groups. He noted the post will give him an opportunity to work on health and education issues, which he said were “two longtime passions.” (McIntire, 12/19)

Enthusiasm for cancer immunotherapy is soaring, and so is Arie Belldegrun’s fortune. Dr. Belldegrun, a physician, co-founded Kite Pharma, a company that could be the first to market next year with a highly anticipated new immunotherapy treatment. But even without a product, Dr. Belldegrun has struck gold. (Richtel and Pollack, 12/19)

Thanks to the openness of Caitlyn Jenner and others, public awareness of transgenderism — and demand for trans-specific medical care like counseling, hormone treatments, and genital surgery — is exploding, even for the youngest of patients. At the 30-plus clinics for transgender youth across the US, doctors like [Johanna] Olson-Kennedy can barely keep up with the demand. Chicago’s Lurie Children’s Hospital, for example, opened its trans clinic just four years ago but already has 500 patients — and a four-month waiting list. Seattle Children’s Hospital opened its clinic in October and immediately got scores of calls. Olson-Kennedy’s clinic, the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, is the country’s largest, treating 725 trans youth from across the western US. Five hundred of those patients are Olson-Kennedy’s. (McFarling, 12/20)

How many spoonfuls of sugar can you have in a day? The World Health Organization advises no more than about 6 teaspoons of added sugar -- less than a can of soda. The same recommendation was made for children in a study published in the journal Circulation in August.The US government put a limit on sugar for the first time in its 2015 dietary guidelines, recommending that added sugar should make up no more than 10% of your daily calories. For a 2,000-calorie-a-day diet, that would be 12 teaspoons. Now, a review paper published in the journal Annals of Internal Medicine on Monday suggests that such guidelines might be wrong, saying they are based on low-quality evidence. (Howard, 12/19)

The term “freshman 15” describing the dozen or so pounds that college students typically put on during their first year of school may be a bit of a misnomer, according to a recent study in the Journal of Nutrition Education and Behavior. The study, led by researchers from the University of Vermont, found that students gain an average of just 3 pounds during their freshman year but about 10 pounds by the time they graduate. (Caiola, 12/19)

Thousands of neighborhoods across the country have higher lead poising rates than Flint, Mich., according to a Reuters investigation published today. The Centers for Disease Control defines high lead content as 5 micrograms or more per deciliter, and 2.5 percent of children under six have elevated rates nationwide. Reuters found nearly 3,000 neighborhoods with double the rates of poisoning found in Flint. Roughly 1,000 neighborhoods had rates that were at least four times higher. (Wagner, 12/19)

An EPA report about fracking is reigniting fears over the extraction of oil and gas from rock below the earth. The agency says it’s unable to fully characterize the severity of fracking’s impact on drinking water. But it does point to circumstances that could make ground water vulnerable. The majority of U.S. fracking happens in seven zones – three of them at least partially in Texas, and some residents are concerned, reports CBS News correspondent Manuel Bojorquez. (12/20)

As the death toll from the opioid crisis mounts, families are increasingly weaving desperate warnings into the obituaries of loved ones about the horror that can result when people abuse painkillers, heroin, and synthetic drugs such as fentanyl. Many words of remembrance have been transformed into pleas for help — directed at lawmakers, families suffering similar experiences, and the general public. Families are using these public notices to push for better and more treatment options while spreading the message that addiction is a disease and not something to be endured in shameful silence. (Armstrong, 12/20)

Follow the pills and you'll find the overdose deaths. The trail of painkillers leads to West Virginia's southern coalfields, to places like Kermit, population 392. There, out-of-state drug companies shipped nearly 9 million highly addictive — and potentially lethal — hydrocodone pills over two years to a single pharmacy in the Mingo County town. Rural and poor, Mingo County has the fourth-highest prescription opioid death rate of any county in the United States. (Eyre, 12/17)

As the opioid crisis takes hold, Howard County's only outpatient clinic for those with substance abuse disorders who are Medicaid recipients or uninsured will close on Dec. 31. Roughly 750 of the clinic's clients will move to community care providers as the state phases out grant funding for clinics run by local health departments and transitions to a fee-for-service model that pays health care providers for each service provided. The shift, pushed by 2014 legislation as the state embraces an integrated system of care, reimagines health departments' roles from service providers to local authorities that oversee and manage treatment. (Waseem, 12/20)

The Pentagon has quietly sidelined a program that placed blast gauges on thousands of combat troops in Afghanistan. NPR has learned the monitoring was discontinued because the gauges failed to reliably show whether service members had been close enough to an explosion to have sustained a concussion, or mild traumatic brain injury. (Hamilton, 12/20)

Could improving sleep boost a soldier’s recovery from post-traumatic stress disorder? New York drug maker Tonix Pharma seems to think so; it’s testing a long-approved muscle relaxant, cyclopenzaprine, as a way to help calm the brain before sleep to subdue PTSD symptoms. The company just got breakthrough designation from the Food and Drug Administration, and will be entering Phase 3 trials in patients with military-related PTSD in the first quarter of 2017. (Keshavan, 12/20)

For the first time, scientists have found evidence of specific and long-lasting changes in the brains of pregnant women. The changes were measured in brain areas that are responsible for social cognition and the ability to understand the thoughts and intentions of others, suggesting that they may intensify maternal bonding with a newborn. (Nutt, 12/19)

U.S. women are increasingly using marijuana during pregnancy, sometimes to treat morning sickness, new reports suggest. Though the actual numbers are small, the trend raises concerns because of evidence linking the drug with low birth weights and other problems. In 2014, almost 4 percent of pregnant women said they’d recently used marijuana, up from 2.4 percent in 2002, according to an analysis of annual drug use surveys. (Tanner, 12/19)

California’s hospitals are getting better at preventing patient infections, but the threat is still significant and nearly 20,000 infections were reported in 2015, according to new state data released Friday by the California Department of Public Health. From 2014 to 2015, 56 California hospitals demonstrated “significant improvement” in preventing certain infections, including ones in the blood and those resulting from surgery, according to the department’s report. (Ibarra, 12/19)

State officials will give potential contractors two extra weeks to submit bids to operate Osawatomie State Hospital but cautioned they might not receive any proposals they like. Tim Keck, interim secretary of the Kansas Department for Aging and Disability Services, on Monday told the Legislature’s Special Committee on Larned and Osawatomie State Hospitals that the department will extend the deadline to submit bids from Dec. 29 to Jan. 10, to give private contractors time to ask more questions. (Wingerter, 12/19)

nyone living in Tennessee can visit a Saint Thomas Health walk-in clinic without leaving their home. Saint Thomas Health On Demand, as of Friday, is an around-the-clock virtual clinic that people can use by smartphone, tablet or computer to get a diagnosis and treatment for many common issues, such as urinary tract infections, pink eye, sinus problems or colds. (Fletcher, 12/19)

CalPERS on Monday rejected its staff’s recommendation to again invest in tobacco stocks and instead widened the ban on tobacco investments for the nation’s largest public pension fund. The staff of the California Public Employees’ Retirement System had recommended that the system’s board approve ending restrictions on tobacco investments managed by its own staff. The ban began 16 years ago. (Peltz, 12/19)

The delay in the state’s licensing of nurses was among the major complaints found by a survey released in September by the New Hampshire Health Care Association. That complaint was repeated by many in attendance at last week’s annual meeting of the Home Health Care Association of New Hampshire. These two groups represent the bulk of New Hampshire’s elder health care providers, including nursing homes, assisted living facilities, at-home care and adult day cares — and they are feeling the brunt of a nursing shortage. (Grosky, 12/20)

Nearly $2 million in grant funding will help researchers in the University of South Florida College of Nursing study a potential method of preventing delirium in the intensive care unit... The intervention is called Family Automated Voice Reorientation (FAVoR). Recordings play for patients every hour during the day, helping orient them using a familiar voice. (McNeill, 12/19)

Medical-technology company Lensar Inc., which makes lasers used in cataract surgery, filed for chapter 11 protection Friday with a deal to hand control of the company to its senior lender while preserving more than $125 million in tax credits. The Orlando, Fla., company’s immediate aim is to maintain a “business-as-usual atmosphere” during its chapter 11 case, Chief Executive Nicholas Curtis said in a declaration filed with the U.S. Bankruptcy Court in Wilmington, Del. Friday. (Chaney, 12/19)

How fit are the students of the Los Angeles Unified School District? According to a statewide test, not nearly as fit as they should be.L.A. Unified students at two of three tested grade levels performed a tad less well on the California Physical Fitness test last year than they did the year before. And overall, fewer than one-third of the tested students passed each fitness area assessed. (Resmovits, 12/19)

We all know exercise is good for us. But how does it really work inside our bodies? That’s the question behind a $2.3 million grant recently awarded to two UC Davis researchers who will study how intense bouts of exercise change the minute, molecular structures inside tissue, muscle and organs. It’s part of a nationwide, six-year study by researchers at more than 20 universities and health research centers, funded by the National Institutes of Health. (Buck, 12/19)

California’s birth rate has fallen to the lowest levels in modern state history, according to new Department of Finance estimates, which peg the state population at 39.4 million after growing by 295,000 from July 1, 2015 to July 1, 2016. (Miller, 12/19)

The National Highway Traffic Safety Administration found Florida's roads are among the deadliest for motorcyclists. Florida Highway Patrol's data also points to 2016 to being a deadlier year on the roads in Lee, Charlotte, Hendry, Manatee, and Sarasota counties for all motorists. (Smith, 12/19)

California last year enacted legislation to regulate for-profit medical marijuana businesses. And voters in November legalized pot for recreational use by passing Proposition 64, a measure that also allows people convicted of certain state (though not federal) marijuana offenses to petition to expunge criminal records or reduce charges. To date, 26 states and Washington, D.C., have legalized marijuana in some form, with licensed pot shops flourishing in many locations.(Hecht, 12/19)

A gene that can make many bacteria highly resistant to crucial antibiotics has been found for the first time on a livestock farm in the United States, and researchers say they will begin looking more closely at other farms to determine whether the problem is widespread. (Viviano, 12/19)

Having waited years for the chance to repeal Obamacare, Republicans will finally have the opportunity in 2017. With the GOP controlling the White House, the Senate and the House of Representatives, the party can drive a stake through the Patient Protection and Affordable Care Act without a single Democratic vote — much as Democrats passed it in 2010 without a single Republican in support. But repealing the ACA is one thing, improving the U.S. healthcare system quite another. The current GOP strategy will almost certainly make millions of Americans worse off than they are today, and even worse off than they were before the ACA (better known as “Obamacare”) was passed. (12/20)

Over the past few weeks, a stream of data has revealed the desperation of an almost catatonic America, taking place outside of the dominant media corridors and conversations. For example, according to the Centers for Disease Control (CDC), deaths in 2015 from heroin abuse surpassed deaths from gun homicides, an unprecedented phenomenon for a country seen as more addicted to its firearms. Total opioid deaths, including overdoses of prescription drugs like OxyContin and synthetic opiates like fentanyl, hit 33,092 last year. One-third of users of these drugs for more than two months report a physical dependency, which suggests that the mortality rate will rise. (David Dayen, 12/20)

As deaths from opioid overdoses continue to rise, the 21st Century Cures Act has provided a billion dollars over the next two years to states for opioid prevention and treatment programs. The new funding is sorely needed. To really be effective, the solutions to this epidemic, as with any drug epidemic, need to deal both with the suppliers and the users. (Drew Altman, 12/19)

In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge. ... So why is there a gender-based difference in physicians' care? The authors admit that they are "unable to identify exactly why female physicians have better outcomes than male physicians." We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research. (John Henning Schumann and Sarah-Anne Henning Schumann, 12/19)

You probably know where to pump the cheapest gas and how to get price comparisons online in seconds for headphones and cars. But how would you find the best deal on an M.R.I. or a knee replacement? No idea, right? This lack of price transparency in health care has been cited as one of the reasons we spend too much on it. It’s easy to overpay. Health care prices vary tremendously. And there is no established relationship with quality. (Austin Frakt, 12/19)

The burden of health care costs has been a national challenge for the last 50 years. Costs have consistently grown faster than the rest of the economy and, as a consequence, have crowded out other discretionary spending by government and employers while creating progressive hardship for individuals, particularly the low-income employed. These facts are unquestioned, but as we prepare to act on local remedies it is important to consider where our state stands on the national spectrum. (David Torchiana, 12/19)

The U.S. Health and Human Services Department’s Office of the Inspector General released a report Wednesday that showed the number of questionable short-term hospital stays decreased and outpatient treatment has become more common since the government’s 2013 rule change. But it also suggests that Medicare paid almost $2.9 billion that year for inpatient stays that lasted less than two nights -- charges that might be inappropriate under the revised policy. ... The findings reflect the complex nature of the program. (Lilo H. Stainton, 12/20)

After years spent fighting to defend and protect the Affordable Care Act, the Obama administration took action that violates the central tenets of its signature health care law. The about-face came in a regulation handed down last week by the Centers for Medicare and Medicaid Services that tacitly allows insurers to discriminate against dialysis patients based solely on their health condition. (Hrant Jamgochian, 12/19)

A recent study in the Journal of the American Medical Association concludes that 27 percent of medical students around the world exhibit symptoms of depression and 11 percent have thought of taking their own lives. ... It raises important questions about both medical education and the way medicine is practiced today, particularly the many non-patient-care-related demands on a physician’s attention. There are at least two ways to explain the high rates of depression among medical students. One focuses on the people who are attracted to careers in medicine. Perhaps medical students are more perfectionistic than others and more liable to become discouraged when they make mistakes. It is also possible that medical students are especially compassionate and more liable to become depressed by frequent contact with suffering. (Richard Gunderman, 12/19)

For years, I’ve taught in nursing programs and conducted research studies on to make better use of nurses in our health care system, particularly nurse practitioners in primary care. But it wasn’t until I found myself in a Boston ambulance several years ago that I really got a true look at America’s grim health care reality. (Lusine Poghosyan, 12/20)

It seems that the narrative that's taken hold in this country regarding abortion is that it is a selfish, heartless, and irresponsible act conducted by women who do not want the inconvenience of raising a child. Maybe that's because women often don't talk about their own abortions, or why they had them. (Jeanne Bauer, 12/19)

Earlier this month, Ohio legislators passed two extreme abortion restrictions. One would have banned abortion after a fetal heartbeat could be detected, as early as six weeks into a pregnancy. That bill passed by Ohio legislators would have prevented Ohio's abortion clinics from providing abortion care to about 97 percent of the women they serve, thereby banning nearly all abortions in the state. Ohio Gov. John Kasich vetoed it last week. (Ushma Upadhyay, 12/19)

In 1964, the U.S. surgeon general announced a definitive link between tobacco use and cancer. Despite this and mountains of additional evidence, the use of tobacco products remains the No. 1 cause of preventable death in the United States, killing more than 480,000 annually. Additionally, tobacco use is estimated to cost more than $300 billion per year in direct health care costs and lost productivity in the United States. So why is it, more than 50 years after this causal link was proven, there are still some who question the wisdom of public policies designed to protect all Americans from this public health hazard? (Brian Donohue, 12/19)

If published research and data were freely accessible and reusable by researchers of diverse interests, urgently needed solutions could be greatly accelerated. Scientists could quickly cross-check important studies, catching potentially consequential mistakes. Medical providers could access the latest technical guidance, improving patient care. And students around the world could build on each other’s work. With openness, good ideas could truly come from anyone, anywhere. (Richard Wilder and Melissa Levine, 12/19)

Ever since researchers with the legendary Framingham Heart Study created the first calculator to gauge the chances of having a heart attack, such tools have become a routine part of medicine. But the results aren’t as straightforward to interpret as the answers you used to get from your old high-school graphing calculator. The problem has to do with the challenge of interpreting the concept of risk. (Michael Pencina, 12/19)