Marketplace: California Consumers Are Buying Gold Health Insurance Plans In Record Numbers
Obamacare’s open enrollment period closes for most states Friday. Thanks to a complicated federal formula, a spike in premiums this year has given consumers who are eligible for subsidies more money to buy insurance. (Gorenstein, 12/13)

The New York Times: Strong Demand For Health Insurance As Deadline Looms
More than one million people signed up last week for health insurance under the Affordable Care Act, pushing the total in the federal marketplace to nearly 4.7 million, the Trump administration said Wednesday, days before the annual enrollment period is scheduled to end. The number of sign-ups on HealthCare.gov from Nov. 1 through Saturday was about 17 percent higher than the same time last year. But the final tally is likely to fall short of the 9.2 million who were in plans at the end of the last open enrollment period, which was twice as long as the current one. (Pear, 12/13)

Meanwhile, a new report touts the benefits of the Affordable Care Act —

Los Angeles Times: Obamacare Is Helping Patients Get To The Doctor And Pay Their Medical Bills, New Report Finds 
Fewer Americans are putting off doctor visits or struggling with medical bills, according to a new report examining the effect of the Affordable Care Act. The report – based on a state-by-state survey of data collected by the federal government – provides powerful new evidence that insurance gains made through the 2010 healthcare law are helping millions of patients get needed medical care. (Levey, 12/13)

Sacramento Bee: Advice For California On Single-Payer Health Care 
State lawmakers are exploring how – and when – to expand coverage to all Californians, while also reining in soaring health care costs that make the U.S. the most expensive in the world for medical care. The best option for California is to create the nation’s first universal, taxpayer-financed health care system that gets rid of the need for private insurance companies, some Democrats said this week after hearing from a blue state governor who tried to create such a system, known as single-payer health care. (Hart, 12/14)

Stat: Hospital And Pharma Lobbyists Spar Over Drug-Discount Program Before Time Runs Out
Hospital and pharmaceutical industry lobbyists are facing off as lawmakers scramble to finalize a year-end spending deal that could include changes to the controversial 340B program. Hospitals want Congress to use the package to reverse a $1.6 billion cut to the program that the Trump administration finalized this fall, and which is set to take effect Jan. 1. Drugmakers don’t. And if the package does end or delay the cut, they want hospitals to disclose far more information about the discounts they get under the program, according to a half dozen lobbyists from both industries and several congressional staffers. (Mershon, 12/14)

Modern Healthcare: California, North Carolina And New York Hit Hardest By 340B Cuts
The CMS' planned $1.6 billion in Medicare cuts to 340B hospitals across the nation will disproportionately impact providers in California, North Carolina and New York, according to a new study. Slashing the 340B drug discount program, which is intended to lower operating costs for hospitals to give its low-income patients access to drugs, would result in large funding cuts across California, North Carolina and New York hospitals, ranging from $62 million to $126 million, researchers for consultancy Avalere found. Overall, six states will see drug payment cuts of more than $50 million next year. (Kacik, 12/13)

San Diego Union-Tribune: San Diego VA's Haywire Alert System Led To Bad Flu Vaccine, 'Accountability' Actions Underway
After a San Diego VA refrigerator failed and left 1,500 people with useless flu shots in October, the La Jolla VA hospital director says temperature alerts went to the wrong people and nobody took action — for 10 days. "I take this very seriously," Dr. Robert Smith said in an interview. “Individual accountability is going to be — or in my opinion, should be — part of our response.” As of this week, the “accountability actions” are underway, U.S. Department of Veterans Affairs officials in San Diego said. (Steele, 12/13)

Capital Public Radio: Keep Your Cell Phone Away From Your Body, New State Guidelines Warn
The California Department of Public Health released a new set of guidelines on cell phone use and radiation risk — revisiting a years-long debate about whether the pocket-sized gadgets we can’t live without are slowly giving us cancer. (Caiola, 12/13)

In other public health news —

Sacramento Bee: Being Stubborn, Optimistic And Loving Family, Country Could Keep You Alive Longer, Study Finds
Stubborn people might have another reason to be headstrong — it could keep them alive longer. That’s according to a new study published Tuesday in the journal International Psychogeriatrics, which found that traits like stubbornness, optimism, a love for family and country and a willingness to work hard are common among some Italians aged 90 to 101. (Magness, 12/13)

San Jose Mercury News: Cafe Helps People Recover From Addiction, Trauma, Homelessness
Recovery Café San Jose [is] a center to help individuals recover from whatever trauma, addiction or living situation they’re suffering from, be it drug or alcohol addiction, homelessness or mental health issues. ...The Café offers classes in their School for Recovery — eight-week courses that teach members life skills such as cooking, which will culminate in a food handler’s certificate for employment. And all the while, students get counseling and meals. (Brassil, 12/13)

Los Angeles Times: Smoking, Drinking And Drug Abuse Decline Among U.S. Teens, Who Prefer Pot And Vaping, Study Finds
About 1 in 3 middle and high school students surveyed in 2017 said they had used some kind of illicit drug sometime in their life. Two decades ago, that figure was 43%. Likewise, 17% of students surveyed in 2017 said they smoked cigarettes at least once, and 26% said they had been drunk. In the 1990s, those figures reached highs of 58% and 46%, respectively. “The rates of drug use among teenagers in our country are the lowest they’ve ever been for some drugs,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. (Kaplan, 12/13)

The Washington Post: Fracking Sites May Raise The Risk Of Underweight Babies, New Study Says
Living within half a mile of a hydraulic fracturing site carries a serious risk for pregnant women, a new study has found. The drilling technique, also known as fracking, injects high-pressure water laced with chemicals into underground rock to release natural gas. Women who lived within that distance to fracking operations in Pennsylvania were 25 percent more likely to give birth to low-weight infants than were mothers who lived more than two miles beyond the sites. (Fears, 12/13)

The Wall Street Journal: Study Links Lower Birth Weights To Living Near Fracking Sites
That research underscores a problem that has bedeviled the industry and regulators: While the benefits of hydraulic fracturing are widespread, the costs are very localized. The drilling and completion technologies commonly known as fracking have turned the U.S. into an energy superpower while lowering both energy prices and carbon dioxide emissions. To accommodate the industry’s rapid growth over the past decade, several regions of the country—including parts of Pennsylvania, Colorado, Texas and North Dakota—have been turned into industrialized zones, sometimes overlapping with communities. (Gold, 12/13)

Los Angeles Times: Babies Born To Moms Who Lived Near Fracking Wells Faced Host Of Health Risks, Study Suggests
Many of the toxic chemicals used in the hydraulic fracturing process are known carcinogens. Toxic gases, including benzene, are released from the rock by fracking. And the high-pressure pumping of a slurry of chemicals into the ground is widely thought to release toxins and irritants into nearby air and water. The noise and pollution emitted by trucks and heavy machinery also may affect the health of people living nearby. (Healy, 12/13)

San Jose Mercury News: Uber Reduces Ambulance Usage Across The Country, Study Says
In what is believed to be the first study to measure the impact of Uber and other ride-booking services on the U.S. ambulance business, two researchers have concluded that ambulance usage is dropping across the country. A research paper released Wednesday examined ambulance usage rates in 766 U.S. cities in 43 states as Uber entered their markets from 2013 to 2015. (Seipel, 12/13)

In other news from across the state —

Santa Rosa Press Democrat: Major Services At Sutter North Bay Health Plaza Resume Following Tubbs Fire Damage
It is considered the “mother ship” for hundreds of Sutter Health-affiliated doctors, nurses, medical assistants and other staff in Sonoma County, a key outpatient facility used by more than 190,000 patients a year and providing a dizzying array of medical services from birth to death. That was before the Tubbs fire torched oak and redwood trees that surround the three-story building, lapped at its brick walls and blew out or damaged 262 windows, forcing its closure until just recently. On Tuesday, patients and their providers walked in and out of the medical office building at 3883 Airway Drive where, for the most part, few signs of the disastrous fire remained. (Espinoza, 12/13)

Modesto Bee: Modesto Leaders Ban Pot Dispensaries Downtown. Marijuana Emporium Proposed For Former Longs Drug Site
The Modesto City Council voted late Tuesday night to allow as many as 10 marijuana dispensaries in the city. None of the retail cannabis stores will emerge in the downtown area. (Carlson, 12/13)

The New York Times: Republican Tax Bill In Final Sprint Across Finish Line
The day after suffering a political blow in the Alabama special Senate election, congressional Republicans sped forward with the most sweeping tax rewrite in decades, announcing an agreement on a final bill that would cut taxes for businesses and individuals and signal the party’s first major legislative achievement since assuming political control this year. ... In a break from the House bill, the agreement would allow taxpayers to continue to deduct high out-of-pocket medical expenses, and it would retain a provision allowing graduate students who receive tuition stipends to avoid paying taxes on that benefit. Also included in the consensus bill is the Senate’s repeal of the Affordable Care Act requirement that most Americans have health insurance or pay a penalty and a provision that opens the Arctic National Wildlife Refuge in Alaska to energy exploration. (Tankersley, Kaplan and Rappeport, 12/13)

Bloomberg: GOP Tax Compromise Would Repeal Obamacare’s Individual Mandate
Republican lawmakers will overturn a key piece of the Affordable Care Act in their tax overhaul, a victory in a long GOP campaign against the health law. Senate Majority Leader Mitch McConnell said the compromise tax bill from House and Senate negotiators will end the health law’s requirement that all individuals buy insurance or pay a fine. Doing so could jeopardize Obamacare’s already-shaky marketplaces, by reducing the number of healthier people who sign up for insurance. (Tracer and Rausch, 12/13)

Sacramento Bee: What Will GOP Tax Plan Mean For Jerry Brown's 2018 Budget?
California receives more than $2 billion annually from CHIP to enroll about 1 million children in Medi-Cal. Palmer estimates that money will run out in January. Without federal support, which compromises at least two-thirds of the program’s funding, the state will have to find another way to pay for it. (Koseff, 12/13)

In other national health care news —

The Hill: Collins Confident Health Subsidies Will Be In Spending Bill
Funding for key ObamaCare insurer subsidies is likely to be included in the upcoming government funding bill, Sen. Susan Collins (R-Maine) said Wednesday. Collins said she had received reassurances Tuesday from Vice President Pence that the subsidies, opposed by House conservatives, would be in the funding bill. (Weixel, 12/13)

The Washington Post: Facing Senate Rejection, Controversial Pick To Head EPA Chemical Office Bows Out
Michael Dourson, whose nomination to become the Environmental Protection Agency’s top chemical safety official drew widespread criticism, withdrew from consideration Wednesday after it became clear the Senate probably would not confirm him. Dourson’s decision, which was confirmed by two senior administration officials who spoke on the condition of anonymity to discuss personnel matters, prevents him from likely becoming the first Trump nominee rejected by the Senate. (Dennis and Eilperin, 12/13)

Stat: ‘Big Black Box Called PBMs’ Draws Attention From Lawmakers Trying To Solve Drug Prices
As lawmakers are puzzling over the question of why so many patients are paying so much money for prescription drugs — and what to do about it — Republicans are focusing increasing scrutiny on the middlemen: pharmacy benefit managers. “What I’m seeing, and what the public sees, is that we’ve got this big black box called PBMs,” said Rep. Morgan Griffith, a Virginia Republican, at a Wednesday House subcommittee hearing. (Swetlitz, 12/13)

Stat: Precision Medicine Is Rapidly Advancing. Precision Public Health Could Be Next
Rapid advances in personalized medicine have sparked interest in another new idea: precision public health. Essentially, it’s the thought that if doctors could pinpoint populations with genetic vulnerabilities — like those prone to obesity, depression, or cancer — they might be able to treat those diseases sooner, slow their progression, or even prevent them altogether. It could be a more effective preventive medicine tactic than the blanket approaches used right now (Thielking, 12/13)