San Diego Union-Tribune: Covered CA Looking Healthy Despite Trump Attack
All the talk about killing the Affordable Care Act this year apparently has not sent Californians running from Covered California, the state’s health insurance exchange. According to an update released Wednesday, more than 102,000 Californians signed up for Covered California policies in November, a 28 percent increase over last year. While some analysts have said they expect exchanges  operated by the federal government in other states to see enrollment decrease by about 20 percent, California seems to be bucking that trend. (Sisson, 12/6)

The New York Times: UnitedHealth Buys Large Doctors Group As Lines Blur In Health Care
In another example of the blurring boundaries in the health care industry, UnitedHealth Group, one of the nation’s largest insurers, said on Wednesday that it is buying a large physician group to add to its existing roster of 30,000 doctors. UnitedHealth’s Optum unit will acquire the physician group from DaVita, a large for-profit chain of dialysis centers, for about $4.9 billion in cash, subject to regulatory approval. DaVita operates nearly 300 clinics across a half-dozen states, including California and Florida. (Abelson, 12/6)

Modern Healthcare: UnitedHealth's Optum To Buy DaVita Medical Group For $4.9 Billion
DaVita Medical Group's physician network provides care to approximately 1.7 million patients every year via its 300 clinics in California, Colorado, Florida, Nevada, New Mexico and Washington state. The group also runs 35 urgent-care centers and six outpatient surgery centers. "Combining DaVita Medical Group and Optum advances our shared goal of supporting physicians in delivering exceptional patient care in innovative and efficient ways while working with more than 300 healthcare payers across Optum in ways that better meet the needs of their members," Optum CEO Larry C. Renfro said in a statement. (Teichert, 12/6)

Bloomberg: UnitedHealth Buys DaVita's Doctor Groups For $4.9 Billion
“Combining DaVita Medical Group and Optum advances our shared goal of supporting physicians in delivering exceptional patient care in innovative and efficient ways,” Larry Renfro, chief executive officer of Optum, said in a statement Wednesday.(Tracer, 12/6)

San Diego Union-Tribune: An Epic Quest To Detect Cancer
Finding needles in a haystack is the life-and-death job of San Diego’s Epic Sciences. The needles are extremely rare cancer cells that hide among the millions of normal cells in the blood of cancer patients. The privately held company uses a combination of imaging technology to detect abnormal cells in a blood sample, along with DNA sequencing of those abnormal cells for cancer. A spinoff of The Scripps Research Institute, Epic Sciences raised $40 million in venture funding in May to further develop its technology. (Fikes, 12/6)

Orange County Register: Asian American Women Have Tough Time Seeking Help For Eating Disorders, Says Study
Young Asian American women tend to have cultural and family influences that discourage them from seeking help for eating disorders, according to new research led by Yuying Tsong, Cal State Fullerton associate professor in human services. Compared with a general population with eating disorders, young Asian American women displayed some common themes, the study found. (Fawthrop, 12/6)

In other public health news —

Modesto Bee: Still A Threat: Encephalitis Case Revealed In Stanislaus County
It turns out that a Stanislaus County man who became sick in September was stricken by St. Louis encephalitis, a virus that has reappeared in the Northern San Joaquin Valley this year. The county Health Services Agency made the case public Wednesday but did not identify the individual, who is in his 70s. Like the West Nile virus, the St. Louis disease is transmitted by mosquitoes. Both of the viruses may cause encephalitis, or inflammation of the brain, in people who are infected. (Carlson, 12/6)

KQED: Before You Try The Ketogenic Diet, Read This
Louison Labeaume believes a ketogenic diet has done him a lot of good. Not only has he lost 25 pounds on the popular low carb/high fat regimen, he even wonders if it helped push his prostate cancer into remission. While some research has been conducted into the diet’s ability to starve cancer cells, there has been little evidence to date that this could be the case. (Smith, 12/6)

The Mercury News: Does Your Dog Lick Your Face? Could Be Deadly As Well As Icky
Beware of dog! Generations of dog owners have cherished the licks of their canine companion as if they were kisses, but now medical experts warn that letting a dog lick your face may well be a bacteria bomb. Think about it. How do doggies greet each other? It’s not with a handshake, is it? They spend a whole lot of time sniffing posteriors, among other rather germ-ridden locations. Some of the bacteria lurking in that adorable doggy mouth may even be lethal. (D'Souza, 12/6)

San Diego Union-Tribune: Flu Report Shows Elevated Activity Continuing In San Diego County
The region’s latest weekly flu report, released Wednesday by the county Health and Human Services Agency, adds 182 confirmed influenza cases to the season total, nearly 80 more than were tallied last week and more than four times as many as were detected from Nov. 26 through Dec. 2 last year. No new flu-related deaths were reported this week, and about 2 percent of emergency department visits to local emergency departments had flu-like symptoms, a rate that is one percentage point less than last week. There have been four flu-related deaths so far this season and six people across San Diego County have been admitted to intensive care units. (Sisson, 12/6)

In other news from across the state —

East Bay Times: Alternatives Submitted For Sheltering Berkeley Homeless
Attorneys representing a group of homeless people have submitted a plan for sheltering the city’s homeless population that calls for short-term suspension of regulations they say criminalize homelessness, including limitations on lying on commercial sidewalks and spreading belongings, and on sleeping in vehicles. Other short-term remedies proposed by Dan Siegel of Oakland-based Siegel, Yee & Brunner in a Nov. 27 filing in U.S. District Court for the Northern District of California include suspending enforcement of city rules prohibiting camping in city parks, at the Berkeley Marina, other open space, and city-owned lots. (Lochner, 12/6)

Ventura County Star: Air Quality Plummets Because Of Fire, Especially In Ojai Valley
The smoke can contribute to long-term problems for people with asthma, emphysema or heart disease. Dr. Raj Bhatia, an Oxnard pulmonologist, tells patients with pre-existing conditions to wear a surgical mask inside at home and to wear N95 masks if they go into fire-exposed areas. Short exposure can cause irritation but likely won ’t cause lasting issues, Bhatia said. The worst air in the region on Wednesday was in the Ojai Valley because of the fire activity that brought mandatory or voluntary evacuations for the entire valley, said Ventura County Air Pollution Control Officer Mike Villegas. Air quality can be graded as good, moderate, unhealthy for at-risk people, unhealthy for everyone, very unhealthy and hazardous. (Kisken, 12/6)

Reuters: Sign-Ups Pick Up In Week Five Of 2018 Obamacare Open Enrollment: U.S.
The number of people signing up for 2018 Obamacare plans picked up significantly during the fifth week of open enrollment, a U.S. government agency reported on Wednesday, but the number of participants appears to be falling short of last year's numbers with just over a week of enrollment left. For the week ended Dec. 2, the U.S. Department of Health and Human Services said 823,180 people signed up for 2018 Obamacare individual insurance in the 39 states that use the federal government website Healthcare.gov. (Abutaleb, 12/6)

The Associated Press: Health Law Sign-Ups Seen As Falling Short Though More Enroll
Americans are signing up in growing numbers for the Affordable Care Act's subsidized health insurance, the government said Wednesday. But with enrollment season cut in half and just over a week to go, experts say the final tally will likely fall short. About 3.6 million people signed up through Dec. 2 in states served by the federal HealthCare.gov website, according to the Centers for Medicare and Medicaid Services. That's about 20 percent higher than the comparable period last year. (12/6)

The Washington Post: Enrollment In ACA Marketplaces Brisk Yet Lags Last Year’s Total As Deadline Nears
The 3.6 million figure is half of the total at the comparable point in the sign-up period for 2017 coverage, according to an analysis by the Washington-based consulting firm Avalere Health. To reach the 9.2 million enrollees that states relying on the federal marketplace had by the final deadline, a huge surge of people would need to take action by the time the season concludes on Dec. 15 or be automatically re-enrolled just afterward. (Goldstein, 12/6)

Politico: Politico Survey: Insurers On Pace To Record Obamacare Profits For First Time
Insurers have finally figured out how to make money in the Obamacare markets: Charge more. After taking a beating for three years, health plans jacked up their rates for 2017, with the average premium on the most popular products rising more than 20 percent. That created sticker shock for many Obamacare customers while putting many insurers on pace to record profits this year for the first time, according to a POLITICO analysis of 31 regional Blue Cross Blue Shield plans, many of which dominate Obamacare markets in their states. (Demko, 12/7)

The New York Times: Tax Bill Is Likely To Undo Health Insurance Mandate, Republicans Say
House and Senate negotiators thrashing out differences over a major tax bill are likely to eliminate the insurance coverage mandate at the heart of the Affordable Care Act, lawmakers say. But a deal struck by Senate Republican leaders and Senator Susan Collins of Maine to mitigate the effect of the repeal has been all but rejected by House Republicans, potentially jeopardizing Ms. Collins’s final yes vote. (Pear and Kaplan, 12/6)

The Hill: Study: ObamaCare Bills Backed By Collins Would Lower Premiums
Two bipartisan ObamaCare fixes being pushed by GOP Sen. Susan Collins (Maine) would reduce premiums by 18 percent in 2019, according to a new study. The study from Avalere, a consulting firm, finds that the two bills would more than cancel out the projected premium increase from repealing ObamaCare’s mandate that most individuals purchase health insurance. (Sullivan, 12/6)

In other news —

The Washington Post: Ryan Says Republicans To Target Welfare, Medicare, Medicaid Spending In 2018
House Speaker Paul D. Ryan (R-Wis.) said Wednesday that congressional Republicans will aim next year to reduce spending on both federal health care and anti-poverty programs, citing the need to reduce America's deficit. “We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit,” Ryan said during an appearance on Ross Kaminsky's talk radio show. "... Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking.” (Stein, 12/6)

The Hill: Ryan Pledges 'Entitlement Reform' In 2018
Health-care entitlements such as Medicare and Medicaid “are the big drivers of debt,” Ryan said, “so we spend more time on the health-care entitlements, because that's really where the problem lies, fiscally speaking." Ryan said he’s been speaking privately with President Trump, who is beginning to warm to the idea of slowing the spending growth in entitlements. (Weixel, 12/6)