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Donald J. Trump, desperate for a winning political issue in the final two weeks of the presidential race, fiercely attacked Hillary Clinton on Tuesday over sharp premium increases that will hit some Americans covered under the Affordable Care Act. “The rates are going through the sky,” Mr. Trump said at a rally in Sanford, Fla., referring to double-digit increases in battleground states like North Carolina and Iowa. (Healy and Goodnough, 10/25)

Suddenly armed with fresh political ammunition, Donald Trump and anxious Republicans across the nation seized on spiking health care costs Tuesday in a final-days effort to spark election momentum. The Republican presidential nominee, trekking across must-win Florida, insisted "Obamacare is just blowing up" after the government projected sharp cost increases for President Barack Obama's signature health care law. Democrat Hillary Clinton, fighting to block Trump in the same battleground state, has vowed to preserve insurance for the millions of Americans covered under the law, but her team described the cost surge as a "big concern." (10/25)

At three events across Florida, Trump claimed that the Affordable Care Act was “blowing up” and vowed he would introduce legislation on his first day in office to replace it. “Repealing Obamacare and stopping Hillary’s health-care takeover is one of the single most important reasons that we must win on Nov. 8,” Trump declared at a rally here. He decried the “politicians who rammed this monster down our throats and said: “Hillary Clinton wants to keep it. She wants to spend a fortune on it. ... She wants to double-down on Obamacare and make it even more expensive and worse.” (Sullivan, Gold and Wagner, 10/25)

"All of my employees are having a tremendous problem with Obamacare," Trump told reporters during an appearance at the National Doral Golf Club in Miami. "What they're going through with their health care is horrible because of Obamacare." (Horsley, 10/25)

Donald Trump on Tuesday sought to take advantage of the Obama administration’s confirmation of Obamacare premium rates growing 25 percent on average next year, tying the increases to his experience as a businessman. “My employees are having a tremendous problem with Obamacare,” Trump told reporters at an event with at the Trump National Doral Miami, a hotel he owns in Florida. “What they’re going through with health care is horrible because of Obamacare,” he added, per Bloomberg News. Questions immediately arose about Trump’s comments, as The Trump Organization provides benefits to its full-time employees, like most large U.S. employers. Trump later told Fox News his employees don’t want Obamacare and are happy with the coverage they are provided through The Trump Organization. (McIntire, 10/25)

David Feder, Trump Doral’s general manager, said after Mr. Trump’s event that the resort provides health insurance coverage to nearly all of the resort’s 1,200 employees. “There really isn’t a need for the vast majority of our employees to purchase Obamacare,” Mr. Feder said. Mr. Feder said he was not certain what Mr. Trump meant when he said the Affordable Care Act was causing problems for Trump employees. “I wouldn’t say he’s incorrect,” Mr. Feder said. “I would tell you that the only employees I know who may purchase Obamacare are typically part-timers. Again, they’re not full-time employees, so they wouldn’t be eligible for the benefits, and typically in corporate America that’s the way it is.” (Epstein, 10/25)

In February, Trump told Fox News' Sean Hannity that his employees “don't have to worry about Obamacare.” Why? “I treat them really good with health care,” he said. “It's a very important thing.” This makes more sense than saying that all of his employees are having “tremendous problems.” Obamacare is not an insurance program; it is a federal policy that encourages universal health-care coverage by providing a system (the federal or state exchanges) for individuals to get insurance if they are unemployed or their employers don't provide coverage — and by taxing individuals who forgo coverage. To ensure affordability, the government subsidizes those who enroll under one of the exchanges, assuming they're at a certain income level. If Trump's employees were having these tremendous problems with Obamacare, it would mean that they were not receiving coverage through Trump, which he'd said they do. (Bump, 10/25)

Donald Trump on Tuesday claimed that the Obama administration is lying about the size of ObamaCare premium hikes, saying it put out a "phony" number.  The administration on Monday announced that the average premium increase for a benchmark ObamaCare plan will be 25 percent for 2017, a number Republicans quickly seized on to criticize the healthcare program.  But Trump took the line of attack a step further.  “And the number of 25 percent is nothing,” the GOP presidential nominee told Fox News. “That’s a phony number, too, that’s a lie, just like everything else.”  The 25 percent figure is from a 40-page report released by the Department of Health and Human Services on Monday. (Sullivan, 10/25)

Donald Trump took dead aim at Obamacare Tuesday, hoping to use news about skyrocketing premiums as a sword to cut into Hillary Clinton’s sizable lead in the presidential race and put his Democratic rival on the defensive. “This election is going to be about Obamacare. It’s going to be about jobs,” Trump said at a Tuesday morning event in Miami. “Obamacare is just blowing up.” By evening, the embattled Republican nominee had sharpened his attacks on the healthcare program. “It’s killing our businesses. It’s killing our small businesses. And it’s killing individuals,” he said in Tallahassee, his fifth event of the day in the crucial swing state. (Jacobs, 10/25)

Sharp premium increases for coverage under the Affordable Care Act are giving Republican candidates from the top of the ticket down a shared cudgel in the home stretch of the campaign. In recent weeks, many state regulators have been publishing steep increases from market leaders for insurance sold through HealthCare.gov, which offers plans for people in three dozen states who don’t have coverage through an employer or government program such as Medicare. (Radnofsky and Epstein, 10/25)

It was ostensibly the news that Senate and House Republicans had been waiting for: Two weeks before Election Day, we get word that the average premium for Obamacare health plans sold through HealthCare.gov — the one Republicans have been railing against for six years now — is going to spike by roughly 25 percent, as much as triple 2016 rates. And congressional Republicans were ready. The day the premiums for the Affordable Care Act were announced, Sen. John McCain (R-Ariz.) was out with an ad lambasting his opponent for supporting the law. (Phillips, 10/25)

One of the most endangered Senate Republicans released a new ad Tuesday hitting her opponent for supporting the “health care law” hurting families in New Hampshire. The ad, from Sen. Kelly Ayotte, was released Tuesday after the Obama administration confirmed double-digit insurance premium hikes in some states for next year. Republicans are jumping on the news as fodder for their argument that Obamacare isn’t working, but the Ayotte ad doesn’t reference Obamacare or the Affordable Care Act. (McIntire, 10/25)

Republicans trying to defend their House and Senate majorities – and not talk about Donald Trump’s controversies – pounced on Monday’s news of a big rate hike for Americans who purchase health care plans on government-run exchanges. As they see it, a blow to Obamacare should be a blow to all Democrats – a message that Republican campaigns pushed on Tuesday in newly released campaign ads and statements. The issue could impact with the electorate, Republican strategists say. But the impact is less than it could be because the party’s nominee is not helping to drive the message. (Yokley, 10/25)

Spiking premiums aren’t exactly an October surprise, and their impact this election cycle is hardly a foregone conclusion. News about larger premium increases for 2017 has been dribbling out for months, ahead of the start of the law’s fourth enrollment season, which begins Nov. 1. And most Americans will be unaffected by the big rate increases: Less than 10 percent of Americans purchase coverage through the individual market, and millions of people receive Obamacare subsidies to lower their monthly premiums. (Demko and Pradhan, 10/25)

Hillary Clinton on Tuesday conceded that many Americans are seeing their premiums go up under Obamacare. But the Democratic nominee cautioned against scrapping the Affordable Care Act, and said health care costs would "skyrocket" under a President Trump. (Griffiths, 10/25)

Hillary Clinton responded to news of ObamaCare premium hikes on Tuesday by saying she is going to “tackle” the problem of high costs, while defending the health law overall. “We’re going to really tackle that, we’re going to get co-pays and premiums and deductibles down, we’re going to tackle prescription drug costs,” Clinton told the radio station Hot 105. Republicans have jumped on the Obama administration’s announcement on Monday that premiums for the benchmark ObamaCare plan will increase by an average of 25 percent for 2017. (Sullivan, 10/25)

Among the issues sharply dividing Hillary Clinton and Donald Trump in this year’s presidential election is the Affordable Care Act, considered by many to be President Barack Obama’s signature achievement. ... Without question, more than six years after becoming law, the Affordable Care Act remains troubled. On the plus side, some 20 million more Americans have health insurance today because of the law, and the nation’s uninsured rate is at a historic low. (Boulton, 10/25)

The fourth open enrollment kicks off Nov. 1 and will run for three months. The latest HHS report released this week shows the average benchmark plan premium in 2017 will be $302, compared with $242 in 2016. HHS uses the second-lowest cost silver premium for a 27-year-old before tax credits as its benchmark. It's the most popular plan on the exchanges and the one used to calculate premium subsidies. Premium hikes varied widely across the 39 states using the federal HealthCare.gov exchange. Arizona will experience the largest average increase for the benchmark plan at 116%, HHS said. Benchmark plan premiums will rise 69% on average in Oklahoma and 63% in Tennessee. At the same time, benchmark premiums in some states, including Arkansas, Indiana and Ohio, will increase only slightly or even decrease in 2017. (Livingston, 10/25)

Democrats came to the defense of ObamaCare on Tuesday, amid Republican attacks over premium increases. White House Press Secretary Josh Earnest and former President Bill Clinton both stood up for the healthcare law, while also noting there are areas that need to be fixed. Democratic presidential nominee Hillary Clinton, however, did not mention ObamaCare at her only scheduled campaign rally of the day, choosing not to address the issue as she stumped in Coconut Creek, Fla.  (Sullivan, 10/25)

Republicans in Congress are wary of a potentially steep increase in the cost of ObamaCare, and they want a fresh tally of how much the government will be spending on subsidies after insurance premium prices rise by double digits. The GOP leaders of the House Energy and Commerce Committee are asking the Obama administration for new numbers on the healthcare law’s subsidies after it confirmed Monday that premiums would increase by an average of 25 percent across the country next year. That’s more than three times last year’s increase. (Ferris, 10/25)

Healthier people will avoid buying Affordable Care Act health insurance plans as premiums climb, threatening the stability of the market, Aetna Inc. Chief Executive Officer Mark Bertolini said.“ As the rates rise, the healthier people pull out because the out-of-pocket costs aren’t worth it,” Bertolini said at Bloomberg’s The Year Ahead Summit in New York. “Young people can do the math. Gas for the car, beer on Fridays and Saturdays, health insurance. ”Premiums for health plans sold to individuals under the ACA, known as Obamacare, are going up by about 25 percent on average for next year. Bertolini said that as costs rise, more individuals will decide not to buy health plans. (Tracer and Dogerty, 10/25)

President Barack Obama is leaving the White House in a few months, but the troubles of his signature health care law continue to make headlines. With premiums rising by double digits and many consumers scrambling to replace coverage because their insurer bailed out, the 2017 sign-up season that starts Nov. 1 looks challenging. Obama says it's just "growing pains" but critics see the threat of market collapse, a death spiral. Here are some questions and answers for consumers ahead of the law's fourth open enrollment season. (10/26)

While the passage of Obamacare has increased overall insurance coverage dramatically, the exchanges have still struggled to attract younger and higher-income enrollees at the rates that designers had hoped. One problem, according to a new analysis from Avalare Health, may be that the penalties for failing to enroll are not high enough. The reports finds that a 27-year-old earning $24,000 a year would pay $1,523 in premiums for a silver plan, but just $695 in penalties for not signing up. (Braverman, 10/25)

The big news in healthcare today is about Obamacare. The federal government says premiums for 2017 for some of the more popular plans in the program will go up an average of 25 percent. The healthcare exchange is having a rough time of it — insurance companies keep pulling out, and healthy young people the system needs aren't opting in quickly enough. Here's a look at how we got here, and what it might take to move forward. (Adams, 10/25)

Big rate increases next year in the state’s individual market mean that Minnesotans who buy health insurance on their own will pay above-average premiums — a startling reversal from 2014 when individual market rates in much of the state were among the lowest in the nation. A federal report this week looked at rates for “benchmark” plans across 44 states and found a family of four in Minnesota will pay $1,396 per month for the coverage. That’s about 28 percent higher than the average across most of those states at $1,090 per month. The silver lining is that higher premiums mean bigger federal subsidies for those who qualify, with state officials suggesting there are about 100,000 people in Minnesota who haven’t been tapping tax credits even though they could get them. (Snowbeck, 10/26)

Ohioans who get their health-care coverage through the Affordable Care Act’s federal marketplace can relax a bit; those premium spikes averaging 25 percent in the news since Monday won’t apply in many cases here. In fact, in Cleveland, according to an analysis by the Kaiser Family Foundation, the premium for one popular plan used as a benchmark actually will go down by $5 for a hypothetical consumer who is 40, doesn’t smoke and earns $30,000 per year. In Columbus, according to a health-care advocacy group, the monthly premium for the same plan for the same hypothetical person will rise by about 4.5 percent. (Edwards, 10/26)

Gov. Mark Dayton on Tuesday sent a letter to legislative leaders asking them to come up with a plan to help those facing double-digit health insurance price increases. The DFLer’s letter underscored the request he announced last week: He would like them to draft an agreeable solution by Nov. 1, just as those who get their health insurance through the individual market will have to start deciding their 2017 coverage plans. Dayton said he would await for their response before taking further action. In Minnesota, Republicans and Democrats have expressed alarm at health insurance company’s approved plans to increase the premiums they charge to those buying coverage on the individual market. (Stassen-Berger, 10/25)

Rate increases for Obamacare on the New Hampshire marketplace are lower than the national average of 22 percent announced on Monday by the federal government, on the eve of another open enrollment season for the Affordable Care Act. The Granite State has the second-lowest increase in the country for the “benchmark” silver plan used to compare all states — a policy for a 27-year-old male. That premium increased 2 percent between 2016 and 2017. But if you compare all of the individual plans offered by New Hampshire’s two largest insurers, the average increase is 11 to nearly 14 percent. (Solomon, 10/25)

The Obama administration announced this week that premiums for certain mid-level plans on the federal health insurance exchange, healthcare.gov, will rise by an average of 25 percent next year, dwarfing this year’s increases and echoing similar announcements by many state-based exchanges. (10/26)

The eastern St. Louis metro area has been particularly hard hit by health insurance companies exiting the Affordable Care Act exchange. This week, the federal government released prices for 2017, which include substantial hikes in western Illinois.Insurance brokers in Belleville say three metro east counties — St. Clair, Madison and Monroe — will have just one insurer to choose from this year: Blue Cross Blue Shield. (Bouscaren, 10/26)

Kansans who get their health insurance through the federal Affordable Care Act website can’t buy yet — but they can look. The U.S. Department of Health and Human Services has opened what agency officials call a “window shopping” option on healthcare.gov, ahead of the official Nov. 1 open enrollment start date. A green button on the site’s homepage allows users to “Preview 2017 Plans and Prices” by entering their ZIP code and some personal information. For example, the preview showed 11 plans available for a 35-year-old male living in Shawnee County who does not use tobacco products. (Marso, 10/25)

Families in Massachusetts and across the country are spending more of their paychecks on health care as rising premiums and deductibles continue to outpace incomes, according to a study. In an analysis to be released Wednesday, the Commonwealth Fund, a New York-based research foundation, said Massachusetts families spent 7.3 percent of their incomes on health insurance last year. That was up from 5.7 percent in 2010 and 5.2 percent a decade ago. The rise in health insurance premiums moderated from 2010 to 2015, compared with the previous five years, the study said, but families and individuals didn’t feel that slowdown because their incomes couldn’t keep pace. (Dayal McCluskey, 10/26)

The growth in employees’ share of health-care premiums and deductibles has slowed over the past decade, but their incomes have lagged behind, according to a new study. The slower increase in premiums reflects a nationwide trend in health expenses. But the shift hasn’t felt like a reprieve to many people because the growth of deductibles hasn’t abated as much and their incomes haven’t kept up. (Johnson, 10/26)

The warning signs of what would become a deadly opioid epidemic emerged in early 2001. That’s when officials of the state employee health plan in West Virginia noticed a surge in deaths attributed to oxycodone, the active ingredient in the painkiller OxyContin. They quickly decided to do something about it: OxyContin prescriptions would require prior authorization. It was a way to ensure that only people who genuinely needed the painkiller could get it and that people abusing opioids could not. But an investigation by STAT has found that Purdue Pharma, the manufacturer of OxyContin, thwarted the state’s plan by paying a middleman, known as a pharmacy benefits manager, to prevent insurers from limiting prescriptions of the drug. (Armstrong, 10/26)

The New Jersey state medical board has suspended the license of a doctor accused of “indiscriminately prescribing” a nasal-spray version of the powerful painkiller fentanyl, including to a patient who later overdosed and died. Dr. Vivienne Matalon, a Cherry Hill, N.J., family physician, agreed to the suspension pending an investigation by the board and a final resolution of professional misconduct allegations filed against her by the state. The voluntary suspension was agreed to on Friday, according to a press release issued Tuesday by state Attorney General Christopher S. Porrino. (Armstrong, 10/25)

Former House Speaker Newt Gingrich will be joining former Obama adviser Anthony Kapel “Van” Jones on stage on Monday in Washington to discuss a topic that they've not spoken much about in the past: the nation's opioid addiction crisis. The two men — along with former U.S. representative Patrick Kennedy, who has written a memoir about his struggles with cocaine, painkillers and alcohol — are “founding advisers” of a nonprofit that popped up in the summer called Advocates for Opioid Recovery. Its mission is “advancing a science-based, evidence-based treatment system that can reduce death and suffering from opioid addiction. (Cha, 10/24)

Dustin French, 29, had four drug overdoses in the span of a year. “I was dead on arrival to the hospital,” he said of his last heroin overdose, which happened in April. “I woke up … and I didn’t feel like myself. I could tell this time I was really dead.” Now, he says, he’s 100 days clean. He lives with his girlfriend. And he has three sons: an 8-year-old, a 2-year-old and a 1-year-old. He credits his turnaround to a relationship he launched in the emergency department with a “peer recovery specialist” — someone who had herself struggled with addiction. (Luthra, 10/26)

Oral cancer is on the rise in American men, with health insurance claims for the condition jumping 61 percent from 2011 to 2015, according to a new analysis. The most dramatic increases were in throat cancer and tongue cancer, and the data show that claims were nearly three times as common in men as in women during that same period with a split of 74 percent to 26 percent. The startling numbers — published in a report on Tuesday by FAIR Health an independent nonprofit — are based on a database of more than 21 billion privately billed medical and dental claims. They illustrate both the cascading effect of human papillomavirus (HPV) in the United States and our changing sexual practices. (Cha, 10/25)

National health officials sounded the alarm last week about a troubling rise in chlamydia, gonorrhea and syphilis rates, with cases reaching an all-time high in 2015. Now health officials say the picture is even worse in California, where sexually transmitted disease rates are higher than the national average and climbing even faster. “Cases of syphilis, gonorrhea and chlamydia are going up in California at a concerning rate,” Dr. Karen Smith, director of the California Department of Public Health, said Tuesday. “This is the second year in a row that we have seen increases in all three diseases.” (Karlamangla, 10/25)

In research published Tuesday in Cell Reports, scientists announced that they had used CRISPR/Cas9 to test gene after gene after gene in human immune system cells — 45 genes in all, sometimes simultaneously and sometimes individually — to identify those that have anything to do with infection by the HIV virus, which causes AIDS when it infiltrates those T cells. For years, scientists have known that mutations in some genes can keep HIV from getting inside T cells (editing genes to create that protective mutation is being tested in a clinical trial). But it never hurts to find more ways to block HIV infection, scientists at the University of California, San Francisco, and the Gladstone Institutes figured. (Begley, 10/25)

An ultrasound device meant to speed healing of bone fractures is ineffective, according to a new clinical trial — though it has been on the market for 22 years and has rung up hundreds of millions of dollars in sales. The trial at sites in Canada and the United States involved 501 patients who had surgical repair of fractures of the tibia — the larger of two leg bones between the knee and ankle. It found that patients treated with “low-intensity pulsed ultrasound” healed at the same rate as those given a sham treatment. (Their healing was assessed by X-rays and by how quickly they could bear full weight and return to normal activities.) It was by far the largest randomized, controlled clinical study of the technology. (Piller, 10/25)

Too many mothers stop breastfeeding their babies too soon, and a panel of experts says doctors, nurses and other health professionals should do more to change that. In light of the “convincing evidence that breastfeeding provides substantial health benefits for children,” primary care providers should discuss breastfeeding with women when they are pregnant, when they are in the hospital to give birth, and after they have gone home with their newborns, according to new guidelines from the U.S. Preventive Services Task Force. (Kaplan, 10/25)

Routine heading of a soccer ball can cause damage to brain structure and function, according to a new study from the United Kingdom that is the first to detect direct neurological changes by impacts too minor to cause a concussion. The research, published this week in EBioMedicine, studied brain changes among amateur players, ages 19 to 25, who headed machine-projected soccer balls at speeds modeling a typical practice. Though the results seen were temporary, they trigger questions about possible cumulative damage done over time. (Nutt, 10/25)

You may have wondered this in past years as you nauseously contemplated the wreckage of mini-candy-bar wrappers surrounding you: Just how much Halloween candy would it take to make a human not just sugar-sick and riven by remorse but actually dead? Well, the science-is-fun-minded folks at the nonprofit American Chemical Society have done some back-of-the-envelope calculations on a likely lethal dose of trick-or-treat loot. (Goldberg, 10/25)

Breast cancer is not just a woman’s disease. While 99 percent of breast cancer cases stem from women, about 2,500 men in the United States contract breast cancer every year. And because awareness is scant, men often don’t go to a doctor promptly after discovering something suspicious — such as a lump in the chest area. Indeed, by the time men often seek medical attention, their cases are usually farther along. (Villa, 10/25)

Researchers have launched an innovative medical experiment that's designed to provide quick answers while meeting the needs of patients, rather than drug companies. Traditional studies can cost hundreds of millions of dollars, and can take many years. But patients with amyotrophic lateral sclerosis, or Lou Gehrig's disease don't have the time to wait. This progressive muscle-wasting disease is usually fatal within a few years. (Harris, 10/25)

In 1988, when the world committed to eradicating polio, there were an estimated 350,000 children disabled, said CDC Director Dr. Tom Frieden at the event. So far this year, there have been only 27 diagnosed cases of polio, he said. Some of the current cases are in hard-to-reach areas of Pakistan and Afghanistan, said Reza Hossaini, director of polio eradication with UNICEF. He told the audience, “Polio is almost defeated.” (Kanne, 10/25)

A Kansas City, Kansas, home health care agency and its owner will pay $1.8 million to settle allegations that it paid kickbacks in return for referrals of Medicaid patients to the agency. Best Choice Home Health Care Agency Inc. and its owner, Reginald B. King, will pay the federal government just more than $1 million and the state of Kansas $788,220 to resolve the case, according to court documents unsealed Monday. The case was filed under the False Claims Act by the recipient of the kickbacks, Christopher Thomas of Parkville, Missouri. The act allows citizens to sue on behalf of the government and collect a portion of any recovery if the government decides to intervene, which it did in this case. (Margolies, 10/25)

This year marks the 50th anniversary of Medi-Cal. Today, state leaders will honor the state-federal health insurance system for the poor, recognition that coincidentally coincides with Californians casting mail ballots on three Nov. 8 propositions that have major financial implications for the program. Medi-Cal is the largest insurer in the state and serves 13 million Californians – a number officials say ballooned in the wake of federal health care overhaul. (Luna, 10/25)

County jails have become the default mental health provider in many communities since the 1990s, when Kansas and many other states closed state hospital beds with the idea that people with mental illnesses could be better treated in their communities. The new system worked well for many Kansans with mental illness, although others struggled to get the help they needed and instead found themselves ensnared by the criminal justice system. Some Kansas counties are responding to the problem. Douglas County has a standing contract with the Bert Nash Community Mental Health Center in Lawrence to provide mental health care to those in the county jail who need it. (Wingerter, 10/26)

Kansas prisons weren’t intended to function like psychiatric hospitals, but they have had to adapt as more inmates showed signs of serious mental illnesses in recent years. In January 2013, then-Kansas Department of Corrections Secretary Ray Roberts told lawmakers the number of adult inmates with mental illnesses had increased 126 percent since 2006. He estimated 38 percent of inmates were mentally ill, and 14 percent had a severe and persistent mental illness. The number of inmates needing mental health care hasn’t fallen in the three years since then. (Wingerter, 10/26)

A new report shows that Florida hospitals have increased their number of residency slots 19 percent since 2013. The state faces a severe shortage of about 7,000 medical specialists through 2025. Since Florida policymakers began focusing on graduate medical education in 2013, hospitals have filled 736 more residency slots. A total of 310 newly filled residency slots were in physician specialties facing the most severe shortages. The report, “Training Tomorrow’s Doctors: Graduate Medical Education in Florida 2016 Annual Report” was produced by the Safety Net Hospital Alliance of Florida (SNHAF) and the Teaching Hospital Council of Florida to document and evaluate progress toward increasing residency slots. (Miller, 10/25)

A new report from the New Jersey Hospital Association found that patients with behavioral health diagnoses, especially those with substance abuse problems, were responsible for a disproportionate share of the increase in emergency department visits in the state over the last five years. The state report comes on the heels of a survey and several studies released recently by the American College of Emergency Physicians (ACEP) that found that emergency departments are often clogged with psychiatric patients who are waiting for inpatient care.  Nationally, about half of emergency physicians said mental health care in their communities was worse this year than last.  That percentage was 49 percent in Pennsylvania and 38 percent in New Jersey. (Burling, 10/25)

The closing days of the push to make Colorado the nation's first state with universal health care are showing why supporters face such steep odds. Most voters have already received ballots in the mail and endured a long campaign to explain the measure, but huge questions remained at a meeting this week in suburban Denver to examine the proposal: How much is this really going to cost? Who would decide what my health care would look like? And what if it all ends in failure? (10/25)

Youth who are battling depression in Virginia are among the least likely in the nation to receive treatment for their mental illness, according to a study released recently by a national nonprofit group. Only one out of four Virginia youth suffering from major depression is treated — a rate that falls below all but two other states, according to Mental Health America’s annual rankings of mental health systems across the country. Virginia’s untreated youth was one of the biggest factors that led to a precipitous drop for the state in this year’s overall ranking, which was released at a time when lawmakers are meeting to discuss ways to improve the system. (Kleiner, 10/25)

Colorado Springs is in the midst of a teen suicide cluster. That should be more than enough to scare adults into action to improve adolescent mental health care in Colorado — and there is much room for improvement. First The Gazette and then Newsweek identified the trend of teens taking their own lives in a horrifying contagion of death that has left 29 kids dead in two years, many from the same few schools. No one is certain what exactly drives rashes of suicides like this, but one thing is certain — data shows that children and adults are much less likely to attempt suicide if they have access to mental health care. (Schrader, 10/25)

Two years after it dumped a homeless woman on skid row with no identification and wearing only paper pajamas, a Hawaiian Gardens hospital has agreed to pay $450,000 to settle a lawsuit filed by Los Angeles, the city attorney’s office announced. City Atty. Mike Feuer sued Gardens Regional Hospital & Medical Center last year after the woman, identified in the suit as Jane Roe to protect her privacy, was dropped off by a hospital van in 2014. She was found wandering the streets and eventually ended up in front of Union Rescue Mission. (Serna, 10/25)

Gov. Nathan Deal and Atlanta Mayor Kasim Reed are scheduled to announce a corporate expansion Wednesday, and people with knowledge of situation said the company involved is health care giant Anthem, parent of Blue Cross Blue Shield of Georgia. The company is expected to announce it is adding new corporate and technology jobs in the city.The number of jobs wasn’t immediately known, but was said to be in the hundreds. (Trubey and Bluestein, 10/25)

The city is owed nearly $700,000 from those who have used EMS transport services and is looking to get as much of that money back as possible. City Council's Safety Committee met Monday night to discuss legislation that would have the city contract with the Ohio attorney general for the collection of the unpaid fees, which date to August, 2008. While it would be difficult to collect all the money, as some people have died within the past eight years, council members believe the state's authority will help it get back a lot of what is owed, including from those who have moved elsewhere. (Piorkowski, 10/25)

Consulting firm EY is partnering with Johns Hopkins Medicine to try to make hospitals and other health care organizations safer. The firm plans to help its health care clients devise safety plans and initiatives using clinical research and expertise from the Johns Hopkins Armstrong Institute for Patient Safety and Quality. EY also plans to develop new products for its clients under the long-term contractual partnership. Financial details were not disclosed, and EY does not share client information. (McDaniels, 10/25)

Former MetroHealth System executive Edward Hills and three dentists were arrested Tuesday morning following a grand jury's indictment in a racketeering and corruption case involving the hospital's Department of Oral Health and Dentistry. Prosecutors accuse the quartet of giving and taking hundreds of thousands of dollars in bribes, as well as airplane tickets, an LED TV and a Louis Vuitton briefcase. Their schemes touched upon the hospital system's residency program, as well as remedial training required for dentists by the Ohio State Dental Board, according to court filings. (Heisig, 10/25)

State health officials are asking residents to take precautions after three cases of the mumps were found to have links to the University of New Hampshire campus in Durham. The New Hampshire Department of Health and Human Services, Division of Public Health Services, issued a release this week urging residents to take precautions against the transmission of mumps, which officials warn can spread easily — particularly among college-age students. (Feely, 10/25)

A bold initiative by the University of Washington to improve the health of all the world’s people is getting a big boost from the Bill & Melinda Gates Foundation, which is writing a $210 million check to build a home for the project — the largest single donation the UW has ever received. The new building will house many of the players in the UW’s Population Health Initiative, announced in May by UW President Ana Mari Cauce and envisioned as a major focus of the UW’s faculty, researchers and students for the next 25 years. Virtually every college and department at the university is expected to play some kind of role. (Long, 10/25)

A groundbreaking program that has helped people with dementia by having them interact with horses will launch at the UC Davis School of Veterinary Medicine at the end of this month after a test run at Stanford University. The veterinary school, the UC Davis School of Medicine’s Alzheimer’s Disease Center and the nonprofit group Connected Horse will collaborate on a clinical trial, which will pair people undergoing early stage dementia and mild cognitive impairment and their caregivers with horses in the hopes of improving the patients’ demeanor and communication skills. (Caiola, 10/25)

For seven years, Elizabeth Tracey Mae Wettlaufer worked as a nurse in southwestern Ontario, moving between long-term care facilities to tend to the elderly and vulnerable. ... It’s a job that sees death often, one that ushers ailing minds and failing bodies through their final months. Which could explain why nobody noticed when at least eight residents in Wettlaufer’s care died during that seven year period. They were all in their later years, between ages 75 and 96. (Mettler, 10/26)

Technically, medical marijuana has been legal in Ohio since a new law, House Bill 523, took effect Sept. 8. But as of yet — and probably not until 2018 — patients in Ohio cannot legally buy marijuana for medical purposes. Before that happens, the complicated, time-consuming job of drafting rules, policies, certifications, licenses and many other things must be completed. Rules don’t have to be in place, by law, until next year. Only after rules go through two state oversight agencies can cultivators begin growing marijuana crops, with processing, lab testing and sales through licensed dispensaries to follow. (Johnson, 10/26)

Drugmakers are becoming increasingly vocal in fighting a California ballot proposition on drug prices, concerned that the more $100 million in funding raised by lobbies opposing the initiative won’t be enough to stop it. ... Known as Proposition 61, the initiative intends to bring down the cost of prescription drugs by prohibiting California state agencies, such as Medi-Cal and state prisons, from paying more than the price paid by the U.S. Department of Veteran Affairs. While Medi-Cal, the state health program for the poor, already can negotiate with drug companies, the national VA typically gets the best deal. VA rates may be about 20 percent lower than Medicaid’s, according to Piper Jaffray analyst Joshua Schimmer. (Chen, 10/25)

PhRMA's decision to hike membership dues 50 percent will increase the trade group's considerable coffers to more than $300 million per year — a financial advantage it hasn’t enjoyed since 2009, when drug makers came out largely unscathed in Obamacare negotiations. PhRMA is bolstering its war chest as it gears up to spend hundreds of millions on ads pushing back against politicians from both parties who have attacked its members over pricing. (Karlin-Smith and Palmer, 10/25)

Public anger at perceived price-gouging by drugmakers has fueled calls for lawmakers to take action. State legislators in California tried, pushing two bills aimed at shedding more light on prescription drug pricing. Both of those efforts died before the end of the session. In California and many other states, however, legislators aren't the only ones with the power to make law. (Castellucci, 10/22)

The opponents of Proposition 61 have put more than $100 million behind its defeat. The measure would bar state government entities from spending more for medications than the lowest price paid by the Department of Veterans Affairs, which generally gets big discounts. Federal law mandates a 24 percent discount for the VA, but the discount is sometimes more, and some veterans’ groups worry that the VA would no longer be able to negotiate deeper discounts should Proposition 61 become law. They also warn that drug companies could simply compensate by raising prices. (Cadelago, 10/25)

Despite widespread public furor over the soaring  of prescription drugs and accusations of price-gouging against pharmaceutical firms, the federal government has to date failed to find a solution. Some states aren’t waiting around for it to deliver. California residents will vote on a ballot initiative, Proposition 61, on Nov. 8 that would ensure state agencies pay the same or less for prescription drugs as the U.S. Department of Veteran Affairs. The federal agency gets a 24 percent discount off the list price, and often negotiates even steeper discounts on a drug-by-drug basis. (Gibson, 10/21)

A group of 300 institutional investors, including many with ties to religious organizations, is waging a new campaign to press drugmakers to justify their price increases. The investors, members of the New York-based Interfaith Center on Corporate Responsibility, are asking 17 drug companies—including Johnson & Johnson, Pfizer Inc. and Merck & Co.—to be more transparent about when and why they raise prices. (Loftus, 10/24)

In the latest bid to put a lid on rising drug costs, a coalition of 300 institutional investors has filed shareholder resolutions with 11 big US drug makers to explain and justify all price increases and the risks these may pose to stockholders. At the same time, the Interfaith Center on Corporate Responsibility also wrote six large European companies to schedule talks about transparency around their pricing. The resolutions ask the companies to issue reports by November that list the rates of price increases for all of their top-selling brand-name medicines between 2010 and 2016, along with the rationale and criteria used to raise prices. (Silverman, 10/24)

Upcoming changes to the Food and Drug Administration’s reviews for generic drugs could have an impact on drug prices if they help introduce more competition to the market. In separate public meetings on Thursday and Friday, FDA officials discussed their plans for renewing the programs that charge generic drugmakers a fee to go through the application process. The FDA has been scrutinized for aspects of its generic approval programs that critics contend prevent cheaper generic therapies from coming to market. (Siddons, 10/24)

Specialty drugs get a lot of attention when it comes to higher costs, although price increases are occurring across the board. Specialty drug prices are projected to increase 18.7 percent next year (after growing 18.9 percent in 2016). Although they comprise less than 1 percent of prescriptions, specialty drugs account for 35 percent of the prescription drug price trend, according to HR Consultancy Segal. Meanwhile, the overall cost of all drugs prescribed for employees under age 65 is expected to grow 11.6 percent next year, on top of an 11.3 percent hike this year. (Braverman, 10/24)

Any company that plans to mimic the approach taken by Sarepta Therapeutics to win regulatory approval of a drug should think twice. That was the blunt message delivered on Tuesday by a high-ranking US Food and Drug Administration official in the wake of simmering controversy over a recent decision to approve a Sarepta drug for Duchenne muscular dystrophy, a rare and fatal disease. (Silverman, 10/20)

For the third time this month, a US senator is harshly criticizing a deal that Mylan Pharmaceuticals reached with the US Department of Justice for shortchanging Medicaid over rebates for its EpiPen device, which sparked national outrage after a series of price hikes. In an Oct. 21 letter, Elizabeth Warren (D-Mass.) complained to US Attorney General Loretta Lynch that the $465 million settlement “fails to hold Mylan accountable” and is “shockingly soft on this corporate wrongdoer,” because Mylan did not admit any wrongdoing, none of its executives were penalized, and the company can deduct the payment from its corporate taxes. (Silverman, 10/24)

Massachusetts Senator Elizabeth Warren is the latest critic of the $465 million settlement that drugmaker Mylan NV said it reached with the federal government over Medicaid rebates for its EpiPen allergy shot. In a letter Friday to Attorney General Loretta Lynch, the Democratic senator wrote that her staff calculated Mylan underpaid Medicaid rebates by an estimated $530 million -- $65 million more than the settlement -- mostly because Mylan didn’t pay the required inflation rebate. Warren wrote the settlement with the Department of Justice is “shamefully weak” because it lacks criminal penalties or any incentive to “prevent drug companies from engaging in abusive schemes to defraud Medicaid and rip off taxpayers.” (Hopkins, 10/21)

If you leave the American Tobacco Trail and drive east, past Dame’s Almost Famous Chicken & Waffles, Bullock’s Bar-B-Que, and the Truly Blessed Hair Salon, you will eventually come to the world’s largest research park. This 16-square-mile stretch of Piedmont pine forest is home to about 200 companies that develop drugs and devices, run clinical trials, and otherwise push the boundaries of bioscience. GlaxoSmithKline, Merck & Co., and Biogen all have offices here, as do other industry leaders and startups. This is Burr country. (Kaplan, 10/25)

EpiPen may be a budget buster for some households, but new data indicates prescriptions for the allergy emergency device are outpacing last year’s figures. At the same time, though, more prescriptions were written recently for lower-cost alternatives and, as a result, last month marked the first time in three years that EpiPen’s share of prescriptions for such devices fell. The number of prescriptions written for the auto-injector in August rose 19 percent from the same month a year ago. Overall, the number of prescriptions are up 14 percent through September, compared with the same period in 2015. In fact, there were 40 percent more prescriptions written in the first nine months of this year compared with 2013, even as the price for EpiPen was rising, according to Athenahealth, which provides technology services to physicians. (Silverman, 10/25)

The huge increase in the price of a lifesaving lead poisoning treatment has prompted a Michigan lawmaker to call for a congressional investigation into Valeant Pharmaceuticals. Two years ago, the drug maker boosted the list price for Calcium EDTA by roughly 2,700 percent. After Valeant bought the drug in 2013 as part of a deal in which it took over another company, the list price for a package of vials started rising quickly. After being stable at $950, Valeant raised the price several times before closing out 2014 at more than $26,900. (Silverman, 10/21)

An analysis jointly published this week by the Center for Responsive Politics and FairWarning, a non-profit news organization, highlights the political clout exerted by the Pharmaceutical Research and Manufacturers of America (PhRMA), a major industry group, and some of the largest U.S. drug companies. Since early 2003, the drug manufacturing industry spent more than $1.9 billion on lobbying members of Congress on Medicare Part D and other issues important to the industry. In just 2015 and the first half of this year, the industry’s lobbying bill was equivalent to spending $468,108 on every member of Congress, according to the Center for Responsive Politics. (Pianin, 10/20)

Three of the area's largest pharmaceutical companies are in the thick of an intense California-based battle over rising drug costs, a fight that could spread to Illinois and other states. AbbVie, Takeda and Astellas, along with other major drug companies, have contributed nearly $86 million toward an effort to defeat Proposition 61. That's an Election Day ballot referendum where voters decide yes or no about regulating prices of drugs purchased by some California agencies on behalf of 4.4 million people whose health care is covered by the state. (Reed, 10/21)

The United Nations Children’s Fund has made a deal with six vaccine manufacturers that will cut in half the price of a shot that protects children against five diseases, the fund announced last week. The deal will mean three years’ worth of vaccine at an average price of 84 cents a dose; buyers currently pay about $1.84, according to Unicef. (McNeil, 10/24)

The industry created to keep drug prices in check is capitalizing on a lack of government oversight to rake in huge profits — often at the expense of patients, health plans and pharmacies, critics say. Drugmakers such as Mylan have been the target of much consumer wrath after the cost of its EpiPen, used to treat potentially deadly reactions to food allergies and bee stings, rose by more than 500 percent in just a few years. But a lesser-known group of companies called pharmacy benefit managers, or PBMs, also play a critical role in driving up drug prices, said former state Rep. Tim Brown, a Bowling Green Republican. And not enough people know about it. (Pyle, 10/23)

Typically, the discovery that a product is less useful than initially thought does not cause that product's price to rise by more than 70 percent. But that's basically what has happened to Ariad Pharmaceuticals's blood-cancer medicine Iclusig, partly due to the sometimes-warped logic of pharmaceutical pricing. Vermont Senator Bernie Sanders has questioned Ariad's logic in this case, first in an October 14 tweet calling Ariad greedy, which hit the company's stock price by 14 percent. He followed up on Thursday with a letter demanding information about Iclusig price hikes, causing Ariad's stock to fall even further. (Max Nisen, 10/21)

The pharmaceutical industry has been put on the defensive about rising cost of prescription drugs, with some executives called to testify in Congress about price gouging. In a recent interview, Andrew Witty, the chief executive of GlaxoSmithKline, who is retiring in March, talked about prices, epidemics and other health issues. The interview has been condensed and edited. (Vikas Bajaj, 10/21)

Addressing high drug prices has become a key priority for American health policy. Both presidential candidates have discussed it, and congressional hearings on the subject have become fairly normal. The question, then, isn’t whether we’ll do something on drug pricing, but what that something will be. On this front, the Center for American Progress (CAP) deserves some credit. Their recent drug price reform proposal takes a big step beyond the usual talking points about drug prices. The authors of the proposal envision a system of “binding arbitration” to mediate high drug prices. The basic idea is to find an alternative to national drug formularies (how most countries control drug prices) while still pushing down drug prices. (Yevgeniy Feyman, 10/19)

Sometimes disappointing shareholders is the friendliest thing a company can do. Novartis has been sitting on a massive $12.8 billion stake in Roche since 2003. The company earlier this year said it was considering selling the stake -- at a premium or not. But Swiss newspaper Sonntagszeitung reported Monday such a sale is on hold, with Novartis reluctant to sell until it can use the cash on a big acquisition. Otherwise, shareholders might just demand Novartis give the cash to them, in buybacks or a special dividend. (Max Nisen, 10/25)

When the Republican-controlled Congress approved a landmark program in 2003 to help seniors buy prescription drugs, it slapped on an unusual restriction: The federal government was barred from negotiating cheaper prices for those medicines. Instead, the job of holding down costs was outsourced to the insurance companies delivering the subsidized new coverage, known as Medicare Part D. (Stuart Silverstein, 10/21)

A new virtual-reality attraction planned for Knott’s Berry Farm in Buena Park, Calif., was announced last month in advance of the peak haunted-house season. The name, “Fear VR 5150,” was significant. The number 5150 is the California psychiatric involuntary commitment code, used for a mentally ill person who is deemed a danger to himself or others. (Andrew Solomon, 10/26)

Many Americans do not realize the consequences of the lack of treatment options. In reality, Americans will lose money if they do not support the Mental Health Reform Act. According to the National Alliance on Mental Illness, “serious mental illness costs America $193.2 billion in lost earnings every year.” Mood disorders, including major depression, dysthymic disorder and bipolar disorder, are the third most common cause of hospitalization in the U.S. for both youth and adults 18 to 44. (Monica Rae Garcia, 10/25)

Advances in medicine and efforts to prevent chronic diseases are lengthening the healthy life span of Americans. They are also helping create a new and highly productive segment of the workforce: seniors. Consider these facts: workers over 55 represent the only age group in which participation in the labor force is growing, in contrast to the steady decline among younger workers. Even more striking, there has been a tripling in the ranks of workers 65 and over, from 2 percent of the workforce in 2000 to 6 percent today. (Rosalind C. Barnett and Caryl Rivers, 10/25)

Are you a Medicare recipient? Do you use a chiropractor? If the answer is yes to both questions, it’s highly likely the federal government should not have paid for your services. But don’t worry: You won’t have to pay Uncle Sam back. (Joe Davidson, 10/26)

“Value” is the most important concept in healthcare today. But it’s problematic. Futurists say our system is transitioning from volume to value. Device and drug manufacturers tout the value of their products. It even found its way into Wednesday night’s Presidential debate when frontrunner Hillary Clinton answered Chris Wallace’s query Medicare’s long-term viability with the following reply: “We’ve got to get costs down, increase value, emphasize wellness. I have a plan for doing that.” (Paul Keckley, 10/24)

The demand for health care in the United States is growing as the average age of our population increases. Because of this change in demographics, the Department of Health and Human Services expects our shortage of primary care physicians to reach 20,000 by 2020. Mid-level health care professionals are starting to fill the void, but state-level regulation is stifling their considerable potential. (Edward Timmons and Conor Norris, 10/26)

Today, many of my internal medicine trainees barely know where the radiology department is. Just as your record player and LPs are now long gone, in your local hospital today, the films, the analog X-ray machines, and even those charming film conveyor belts have left the building.Why? In 2000, only 8 percent of U.S. hospitals had some version of a game-changing computer technology called the Picture Archiving and Communications System, or PACS. By 2008, more than three out of four did.Because radiology was the first medical specialty to computerize, what has happened to it — at once shocking and, in retrospect, entirely predictable — is our canary in the digital coal mine, its experience offering important lessons for patients, clinicians and health care systems. (Bob Wachter, 10/25)

The Affodable Care Act is “blowing up,” Donald Trump claimed at a Tuesday rally, jumping on the government’s announcement that premiums for a popular group of ACA plans will increase by 25 percent next year. “All of my employees are having a tremendous problem with Obamacare,” he claimed. Well, no. ACA rates are going up by double digits, but that does not mean that most people’s premiums are. Most people — including, we presume, quite a few Trump employees — get their health insurance through their employers, not the ACA marketplaces for individual insurance-buyers. For that matter, most of those individual buyers also will not face a huge premium spike. The 25 percent is an average, masking regional variation, and most people buying on the ACA marketplaces get significant government help that softens any top-line premium increase. So — surprise! — Mr. Trump is wrong. (10/25)

ObamaCare has suddenly been injected back into the 2016 election debate, on the news of the law’s 25%-plus average premium increase for 2017. Even Donald Trump is talking about it. With only two weeks to go, this is a moment for voters to hold accountable the Democrats who imposed this debacle on the country over voter objections. (10/25)

The Obama administration released the prices for many Obamacare health plans on Monday, and they showed big increases in many parts of the country. Obamacare customers will begin shopping for new plans next week, just a few days before the presidential election. The news fanned political interest in the health law — both presidential campaigns were talking about the topic on Tuesday — and whether its structure of private insurance markets is sustainable. The health law will almost certainly stay on the minds of politicians in the next administration: Both Hillary Clinton and Donald J. Trump have proposed substantial changes to it. (Reed Abelson and Margot Sanger-Katz, 10/25)

The price hikes have renewed calls by Republicans to repeal the law, better known as Obamacare. And there’s no denying that the increases are going to be painful for many working-class Americans who don’t get coverage through their employers. One key driver of the premium hikes is the disproportionately high cost of covering the people who’ve signed up for Obamacare. Although the law requires virtually all adult Americans to obtain insurance, too many younger, healthier people have either flouted the mandate or chosen to buy the less comprehensive policies that the Obama administration unwisely allowed to remain on the market. (10/26)

The Affordable Care Act has improved and expanded health insurance to cover millions more Americans. But it is far from perfect, and the sharp increase in premiums for plans sold under the program shows some of the problems that the next president and Congress need to fix. Premiums will increase by 25 percent on average for midlevel plans next year, according to the Department of Health and Human Services, but most Americans will be largely insulated from price increases by federal subsidies. About 85 percent of the 10.5 million people who bought insurance through the online health exchanges this year received subsidies; that proportion is likely to increase in 2017 as premiums rise. (10/25)

You can almost set your watch by it: Every year, when new premium rates for the Affordable Care Act exchange plans are published by the government, critics proclaim that the law has failed Americans by failing to rein in prices. This year, the cries are sure to be even louder, because premium increases nationwide are averaging about 25%. (Michael Hiltzik, 10/25)

“All of my employees are having a tremendous problem with Obamacare,” Donald Trump said today, which is odd because under the law, Trump should be providing health coverage to his employees, at least the full-time ones. That means that the actual problems with the Affordable Care Act don’t affect them. But it’s fair to say that the Republican presidential nominee is not the only one laboring under misconceptions about what the ACA is, how it works, what its genuine problems are, and how they might be fixed. (Paul Waldman, 10/25)

Donald Trump opened up a new attack line today, blasting Obamacare over the news that premiums are set to increase sharply for some people buying insurance on the exchanges. The New York Times reports that his campaign is convinced that this is a game changer for him that will put Hillary Clinton badly on the defensive in the race’s final days, since she wants to preserve and build upon the law. But Trump botched his attack, and everyone is having a good laugh over it. (Greg Sargent, 10/25)

Thomas Wolfe once wrote that you can’t go home again, but Evan Bayh—a former two-term Democratic governor and U.S. senator from Indiana—is trying. After casting the deciding 60th vote for ObamaCare, Mr. Bayh retired in 2011 and cashed in as a fixer on Washington’s K Street. Now he’s running against Republican Rep. Todd Young—and his own liberal voting record—to reclaim the seat. (Allysia Finley, 10/25)

Twenty million more people today have health insurance than before the Affordable Care Act launched in 2010. That’s a million more than the combined populations of Missouri and Illinois. Yes, the Obama administration announced Monday that premiums on most government health exchanges will increase next year by an average of 25 percent. That’s bad news, and there’s no way to sugarcoat it. Private insurers underpriced their plans, and this is a course correction. The signature achievement of President Barack Obama’s administration will need some fixes. But 20 million people refute Republican presidential candidate Donald Trump’s assertions that “Obamacare is a disaster.” (10/25)

The ACA's individual mandate is not working for either insurers or consumers. Three out of the big five insurers — Aetna, United Healthcare, and Humana — have effectively pulled out of the exchanges after losing hundreds of millions of dollars. Seventeen of the ACA's 23 non-profit health-insurance co-ops, which received $2.4 billion in taxpayer funds, have failed and five others are on the brink of collapse. (Andy Puzder, 10/24)